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Biomedical subjects

J L Rosenberg

Publications and source records attributed to J L Rosenberg.

At least 19 recordsLinked to original sources
PubMed1986

Reduction of blood loss using tourniquets and 'compression' dressings in excising limb burns.

Excessive blood loss can limit the area of burn excised per sitting, lead to selection of en bloc rather than tangential excision, and increase the number of surgical procedures required per patient. Twenty-four burned extremities were studied to measure blood loss, complications, and effectiveness of a technique for tangentially excising burns of extremities using tourniquet hemostasis followed by application of steel-wool-pad 'compression' dressings before tourniquet release. An average of 7.3 days postburn (PB), a mean of 7% body surface area (BSA) burn was excised per extremity with a mean blood loss of 29 ml/% BSA burn excised (less than one fifth of recently published values). Graft take averaged 91%. There was no evidence of neurocirculatory injury or other complications. When applied as described and carefully monitored, hemostatic tourniquets followed by 'compression' dressings can safely reduce blood loss associated with the exclision of limb burns and allow larger areas to be excised at each operation.

Bandages↗
PubMed1983

Diagnosis and management of intraluminal duodenal diverticulum.

The descending part of duodenum is the principal site for an intraluminally projecting mucosal pouch or diverticulum, but this unusual lesion may also occur elsewhere in the upper gastrointestinal tract. We report three patients in whom a large intraluminal duodenal diverticulum (IDD) was diagnosed radiographically at the ages of 15, 27, and 68 years, respectively. Fiberoptic duodenoscopy was performed in the two symptomatic cases for the removal of impacted food from IDD or dilatation of its outflow aperture. Guidelines for the diagnosis and treatment of IDD are provided based on our experience and review of the pertinent literature.

Adolescent↗
PubMed1980

An evaluation of total parenteral nutrition in the management of inflammatory bowel disease.

Total parenteral nutrition (TPN) is commonly used in the management of inflammatory bowel disease (IBD). Claims of its effectiveness are conflicting, and most reports have been limited to short-term assessments. We undertook a nonrandomized prospective study of the effects of TPN on the course of IBD in 30 patients whose disease was refractory to medical therapy, 20 with Crohn's disease and 10 with ulcerative colitis. Parameters of nutritional improvement, subjective and objective clinical response during TPN, and long-term outcome were assessed. All but one of the patients gained weight. Seven of the 20 Crohn's patients, including 3 of 4 with fistulas, had no response to TPN. The other 13 had reduction of diarrhea, relief of abdominal pain, and an improved sense of well-being during TPN. On long-term follow-up, five of these patients relapsed and required surgery; five remain improved with active disease controlled by medication 2--24 months later, and three are symptom-free and off all medication 20--48 months later. Clinical improvement during TPN was observed in only four of the 10 ulcerative colitis patients; six required colectomy after 9--24 days of TPN. Of the four responders, one relapsed and had colectomy one month later, two continue to have active disease controlled by medication five and 43 months later, and one has been symptom-free and off all medication for over three years. We conclude that TPN is useful adjunctive therapy for IBD patients requiring bowel rest and nutritional repletion. Dramatic clinical improvement occurs in some patients but is unpredictable.

Adolescent↗
PubMed1978

Localized giant pseudopolyposis of the colon in ulcerative and granulomatous colitis.

The occurrence of localized large clusters of colonic pseudopolyps in 4 patients is described. The underlying disease was chronic ulcerative colitis in 2 cases and granulomatous colitis in 2 others. Each lesion presented as a bulky polypoid mass causing partial or total occlusion of the transverse segment or splenic flexure of the colon. The radiographic and pathologic features of this rare entity are illustrated, and the previously reported 10 cases are briefly reviewed.

Adult↗
PubMed1978

Liver disease and vasculitis in a patient taking cromolyn.

Hypersensitivity reactions to cromolyn sodium occur rarely. On several occasions they have been associated with peripheral eosinophilia and granulomatous inflammation. Liver disease has not been reported previously as a complication of inhaled cromolyn. We describe here a woman in whom marked peripheral eosinophilia, liver disease, and systemic vasculitis developed while taking cromolyn and resolved or improved on discontinuation of the drug and treatment with corticosteroids. The liver disease was similar to primary biliary cirrhosis except that marked eosinophilic infiltration and granulomas were present initially. Studies of the patient's serum for binding of carbon 14-labeled cromolyn, the skin for deposits of the drug, and the circulating lymphocytes for stimulation by cromolyn failed to demonstrate any abnormalities. However, the elevated IgG and IgM levels, the positive rheumatoid factor and antimitochondrial antibody, and the reduced serum complement, which returned to normal on discontinuation of the drug therapy, suggests that immunologic mechanisms may have played a role in the pathogenesis of this patient's illness.

Blood Proteins↗
PubMed1976

Inflammatory bowel disease in all three members of one family.

The occurrence of inflammatory bowel disease in all three members of one family is described. Studies of white blood cell chromosomes, histocompatibility antigens, and cellular and humoral immunity failed to explain this unusual phenomenon. However, the appearance of inflammatory bowel disease in an entire family reemphasizes the potential role of genetic and environmental influences in the pathogenesis of some cases of ulcerative colitis and Crohn's disease.

Adult↗
PubMed1975

A controlled trial of azathioprine in Crohn's disease.

To determine the efficacy of azathioprine in the treatment of Crohn's disease, a 26-week double-blind trial was performed. 20 patients with Crohn's disease, requiring at least 10 mg of prednisone/day over the 3 months prior to entering the study were randomized into placebo (10 patients) and major criterion of success in the trial. There were 7 relapses in the placebo group (5 patients) and 2 relapses in the azathioprine group (2 patients). Complications including fistulae were not affected by the medications. The mean reduction in steriod dosage in the azathioprine group at the end of the trial (-15.5 mg) was greater than in the placebo group (-6.1 mg). These results suggest that azathioprine may permit reduction or discontinuation of steroids without the worsening of symptoms in some patients who appear to require steroids for control of their symptoms. The clinical features of this "AZA-responsive subgroup" remain to be defined.

Adolescent↗
PubMed1975

A controlled trial of azathioprine in the management of chronic ulcerative colitis.

To determine the efficacy of azathioprine in the treatment of ulcerative colitis, a 6-month double blind trial was carried out. Thirty patients with chronic ulcerative colitis who required the equivalent of at least 10 mg of prednisone per day over the 3 months prior to entering the study were randomized into placebo and azathioprine (1.5 mg per kg) treatment groups. Reduction of steriods was a major objective of the trial. Age and sex distribution, number of bowel movements, sense of well being, steroid dosage, and findings on proctoscopy, rectal biopsy, and colon X-ray initially were similar in the two groups. No side effects were associated with azathioprine. Although steroid dose was lower (p less than 0.05) in the azathioprine group at the termination of the study, no difference between the two groups could be detected in the number of bowel movements, sense of well being, and findings on proctoscopy during the first 3 weeks compared with the last 3 and during the first 3 months compared with the last 3. Although azathioprine does not confer dramatic benefit upon patients with chronic ulcerative colitis who require steroids, it does permit reduction of steroid dosage without apparent worsening of the disease. Its major value in ulcerative colitis may be in facilitating significant decreases or complete discontinuance of steroids.

Adolescent↗
PubMed1972

Quantum accumulation in photosynthetic oxygen evolution.

Three independent methods have been used to determine the size of the quantum accumulation unit in green plant photosynthesis. This unit is defined as that group of pigment molecules within which quantal absorption acts must take place leading to the evolution of a single O(2) molecule. All three methods take advantage of the nonlinearity of oxygen yield with light dose at very low dosages. The experimental values of this unit size, based on an assumed model for the charge cooperation in O(2) evolution, ranging from 800 to 1600, suggest that there is either limited energy transfer between energy-trapping units or chemical cooperation among oxygen precursors formed in several neighboring energy-trapping units. Widely diffusible essential precursors to molecular oxygen are ruled out by these results. Inhibition studies show that O(2) evolution is blocked when 3-(3,4-dichlorophenyl)-1,1-dimethylurea (DCMU) is added to chloroplasts after two preliminary flashes and before a third flash which would have yielded O(2) in the absence of DCMU. This experiment is interpreted as evidence that the site of DCMU inhibition is on the oxidizing side of system II. Pretreatment of chloroplasts with large concentrations of Tris, previously believed to destroy O(2) evolution by blocking an essential reaction in the electron chain between water and system II, may be alternately interpreted as promoting the dark reversal of the system II light-induced electron transfer.

Chloroplasts↗