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Biomedical subjects

J M Berman

Publications and source records attributed to J M Berman.

42 records · Page 3Linked to original sources

CT patterns of nodular hepatic and splenic sarcoidosis: a review of the literature.

PURPOSE: The purpose of our study was to investigate the less commonly demonstrated CT patterns nodular hepatosplenic sarcoidosis. METHOD: We studied five women patients, utilizing contrast enhanced incremental or spiral CT. We also performed a literature search of hepatosplenic sarcoid for the years 1966-1995. RESULTS: We found five nodular hepatic and/or splenic patterns of sarcoidosis. CONCLUSION: We conclude that increased awareness and recognition of these patterns of nodular hepatic/splenic sarcoidosis on CT will greatly improve detection and diagnosis of abdominal sarcoidosis.

Adult↗

Effect of a glutamine-supplemented enteral diet on methotrexate-induced enterocolitis.

Administration of an elemental diet to rats given methotrexate (MTX), 20 mg/kg intraperitoneally (ip), results in 100% mortality from severe enterocolitis. Previous studies indicate that glutamine (GLN), which is not present in elemental diets, is the preferred oxidative substrate for the gut and may facilitate intestinal recovery after injury. This study investigated the effects of a glutamine-supplemented elemental diet (GLN-ED) on nutritional status, intestinal morphometry, bacterial translocation and survival in this lethal model of intestinal injury. Three experiments were performed. In the first experiment, rats received an intragastric elemental diet supplemented with either 2% GLN or an equivalent amount of glycine (Control). After 4 days animals received either MTX, 20 mg/kg ip, or saline ip and were killed 3 days later. The GLN-ED resulted in significantly decreased weight loss, improved nitrogen retention, and increased mucosal weight, protein, and DNA content of the jejunum and colon. In the second experiment rats were assigned to diet as in the first experiment, but all animals received MTX. Control diet animals died within 120 hrs of MTX administration. The GLN-ED group had significantly longer survival time and decreased mortality. In the third experiment animals were assigned to diet and MTX as in the first experiment. Ninety-six hrs later aortic blood cultures revealed enteric bacteremia in animals administered MTX. GLN-ED resulted in a significant reduction in the incidence of bacteremia. These experiments showed that a GLN-ED significantly improved nutritional status, decreased intestinal injury, decreased bacterial translocation, and resulted in improved survival in a lethal model of enterocolitis.

Animals↗

Stimulation of intestinal mucosal growth with intracolonic infusion of short-chain fatty acids.

Dietary fiber, which stimulates intestinal mucosal growth, is fermented by anaerobic bacteria in the rat hindgut to the short-chain fatty acids (SCFA) acetate, propionate, and butyrate. Butyrate is the preferred oxidative fuel of the colonocyte in vitro, and the provision of preferred intestinal fuels has been shown to stimulate mucosal proliferation in vivo. This study determined whether chronic colonic infusion of butyrate or a combination of SCFA would stimulate intestinal mucosal growth in an animal deprived of its normal source of SCFA, fiber fermentation in the cecum. Adult male Sprague-Dawley rats were fed a fat- and fiber-free elemental liquid diet and underwent cecectomy, ileocolic anastomosis, and insertion of a proximal colonic infusion catheter. Rats were then assigned to receive either a continuous infusion of butyrate (20 mM, 40 mM, or 150 mM), SCFA (70 mM acetate + 35 mM propionate + 20 mM butyrate), or saline, or to receive no infusion. A seventh group underwent proximal colonic transection and reanastomosis. After 7 days, jejunal, ileal, and proximal colonic segments were analyzed for mucosal weight, protein, RNA, and DNA. In the colon, the 40-mM butyrate infusion resulted in significant elevations in all mucosal parameters relative to all three control groups, saline infusion, no infusion, and transection. Both the 20-mM butyrate and the SCFA groups showed increased colonic mucosal DNA compared to controls. In the jejunum and ileum, mucosal DNA content was significantly greater in the SCFA group than in the control groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetates↗

Ampicillin-resistant H influenzae cellulitis and shock in an adult.

Over a three-day period, pharyngitis, neck swelling, deep voice, dysphagia, fever, and cellulitis of the anterior neck and upper chest developed in a 63-year-old woman. Sixteen hours following the institution of intravenous ampicillin, septic shock developed and the patient became comatose. Ampicillin-resistant Hemophilus influenzae type B was found in a culture taken from her blood and pharynx. In patients who have an upper respiratory tract infection and severe cellulitis of the neck, initial therapy should include chloramphenicol because of the possibility of ampicillin-resistant Hemophilus influenzae infection.

Ampicillin↗

Anesthetic management of a massively morbidly obese patient.

BACKGROUND AND OBJECTIVES: A 408-kg patient presented for surgical resection of a lower extremity mass. METHODS: A specially designed bed and well-planned transport were used to deliver the patient to the operating room suite. The anesthetic technique included a continuous subarachnoid catheter with tetracaine and epinephrine. Intraoperative monitoring consisted of electrocardiography, pulse oximetry, intraarterial blood pressure, and mental status examinations. Massive intraoperative hemorrhage was treated with rapid volume infusions and vasopressors. RESULTS: Resection of a lower extremity mass was accomplished and the patient was eventually discharged from the hospital. CONCLUSIONS: The case report emphasizes that prior planning of all aspects of patient care is important in massively morbidly obese patients and that regional anesthesia is a valuable option in these patients.

Anesthesia, Conduction↗