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Biomedical subjects

J P Goldfarb

Publications and source records attributed to J P Goldfarb.

14 recordsLinked to original sources
PubMed1986

The effects of two new inotropic agents on microsomal liver function in patients with congestive heart failure.

The aminopyrine breath test (APBT) was used to study patients with chronic congestive heart failure before and after treatment with two chemically similar inotropic agents, amrinone (AR) and milrinone (MR), to determine their effects on hepatic microsomal function. Liver chemistries and cardiac indices were measured and correlated with the 2-hour APBT score in 11 patients with chronic congestive heart failure (5 treated with AR, 6 with MR) and five healthy control subjects. Despite normal or near-normal liver chemistries, patients with chronic congestive heart failure demonstrated overall depressed hepatic microsomal oxidative function. Patients with severe congestive heart failure had a lower mean pretreatment APBT score (AR = 3.05 +/- 1.02, MR = 5.38 +/- 3.09) when compared with healthy controls (10.02 +/- 1.02). However, the APBT score for each individual could not be predicted from the cardiac index. Although the mean cardiac index increased significantly in both the AR and the MR treated patients by 26.14% +/- 15.28 (p less than 0.01) and 40.0% +/- 42.27 (p less than 0.025), respectively, compared with pretreatment values, the mean APBT score fell by 62.02% +/- 22.5 (p less than 0.005) in the former and increased by 38.35% +/- 25.69 (p less than 0.01) in the patients receiving MR. This discordance between the effects of AR and MR suggests possible differences in the effects of the two drugs on hepatic microsomal function.

Adult↗
PubMed1985

A comparison of cimetidine and sucralfate in the treatment of bleeding peptic ulcers.

To assess the efficacy of cimetidine versus sucralfate in terminating or preventing further bleeding of peptic ulcers, patients presenting with bleeding from duodenal or gastric ulcers were openly randomized to receive cimetidine 1800 mg/day or sucralfate 8 g/day for a 1-wk period. All patients were endoscoped within 8 h of their presentation with bleeding. Patients were included only if they had evidence of severe or active bleeding. After randomization, patients were assessed for transfusion requirements, continued bleeding and rebleeding, the need for emergency surgery, and medication side effects. Ten patients were randomized to each group. Mean transfusion requirements were the same in both groups. In the cimetidine group, two patients rebled and two had serious side effects. In the sucralfate group, two patients had rebleeding requiring surgery, and there were no side effects of therapy. Sucralfate may be an alternative to cimetidine in treating bleeding peptic ulcers.

Aluminum↗
PubMed1985

Bile duct carcinoma in an adolescent.

Bile duct carcinoma is a relatively uncommon lesion that usually presents in the 6th to 7th decade. The only prior reported cases under the age of 20 were two patients with diseases known to predispose to the development of this tumor. We report a case of a 17-year-old girl with a bile duct tumor without any known predisposing factors.

Adenocarcinoma↗
PubMed1983

An unusual pedunculated polyp of the colon: association with schistosomiasis.

A patient with long-standing, nonspecific abdominal symptoms had a barium enema showing a single pedunculated polyp. This was removed by colonoscopic polypectomy and found to be an inflammatory polyp associated with Schistosoma mansoni infection. We review the relationship and significance of schistosomiasis to colonic polyps.

Barium Sulfate↗
PubMed1983

Gastric carcinoid: two unusual presentations.

We report two cases of gastric carcinoid that presented as benign-appearing polyps. One presented with multiple, benign-appearing polyps--a particularly unusual presentation for an uncommon tumor. The second patient had a single polypoid gastric carcinoid and atropic gastritis with pernicious anemia. These atypical presentations and uncommon association of gastric carcinoid are discussed.

Adult↗
PubMed1982

Characterization of rat colonic cell surface glycoconjugates by fluoresceinated lectins. I. Importance of fixation techniques.

Cryostat and paraffin embedded sections from cecum, proximal and distal colonic segments of male Sherman rats were examined by fluorescence microscopy after labeling with six fluorescein-conjugated lectins. These FITC-conjugated lectins were used as specific probes to define the labeling pattern of carbohydrate containing components of the lumenal and basolateral surfaces of epithelial cells, goblet cell mucin and lumenal mucin at all three sites. Marked regional differences in labeling were detected, indicating that the various carbohydrate components of these cells differ significantly along the length of the colon. Furthermore, the patterns of labeling components with each lectin appeared to vary depending on the fixation technique employed. Cryostat preparations generally resulted in a broader distribution of label and more intense staining with these lectins than fixed paraffin sections. While the reason(s) for these variations remain unclear at this time and will require further studies, the present data emphasize the importance of the fixation method when interpreting results obtained utilizing FITC-conjugated lectins.

Animals↗
PubMed1982

Enflurane hepatitis.

Enflurane (ethrane; 2-chloro-1,2,2-trifluoroethyl difluoromethyl ether) has been widely used as an alternative general anesthetic agent to halothane over the past decade because halothane has been directly linked to hepatocellular damage. Several case reports have subsequently described a hepatitis after exposure to enflurane. We describe another case of enflurane hepatitis which supports earlier reports of this entity, discuss possible mechanisms of such hepatocellular damage, and review the pertinent literature.

Anesthesia, General↗
PubMed1982

Shigella enterocolitis and acute renal failure.

Although acute renal failure secondary to infections is relatively common in adult patients, uremia requiring dialysis has not previously been reported in an adult patient with shigella enterocolitis. Our patient, infected with S flexneri, had severe renal failure without any evidence of sepsis, rhabdomyolysis, or the hemolytic-uremic syndrome. Antibiotic therapy with trimethoprim-sulfamethoxazole appeared to play a role in his eventual recovery.

Acute Kidney Injury↗
PubMed1982

Chronic erosive gastritis: clinical, diagnostic, and pathological features in nine patients.

We have recognized nine patients with gastric mucosal lesions which were characterized by an erosion with surrounding mucosal elevation. This lesions has previously been called chronic erosive or varioliform gastritis. Patients were investigated because of upper gastrointestinal symptoms (n = 7), weight loss (n = 2), and/or bleeding (n = 3). Radiologically the appearance was of typical target lesions. Pathological features included pseudopyloric metaplasia, pyloric gland hyperplasia, acute and chronic inflammation, edema, and fibrosis. Atypia was present in biopsies from four patients and in one was incorrectly interpreted as representing intramucosal carcinoma. The remaining patients were treated with antacids and/or cimetidine with resolution of symptoms and in five patients repeat endoscopy demonstrated resolution of the lesions. Chronic erosive gastritis may cause upper gastrointestinal symptoms indistinguishable from peptic ulceration. Greater numbers of patients will have to be treated in a controlled fashion to determine the natural history of the disease and the most efficacious treatment.

Chronic Disease↗
PubMed1981

Early gastric cancer.

We found 28 cases (13%) of early gastric cancer from among 213 cases of gastric cancer resected over a 10-yr period. The incidence was higher in the second 5 yr than the first. The lesions were classified into type I (polypoid, 29%), type II (superficial, 21%). Type III (ulcerated, 32%), and mixed (18%) according to the Japanese classification. Twenty-nine percent had lymph node metastases. In only 50% of the early cases had endoscopy or radiology suggested that the lesions were malignant. Biopsy diagnosis of carcinoma was made in 20 cases preoperatively and was negative for carcinoma in 4 others. Adequate numbers of endoscopic biopsy specimens must be taken to ensure a diagnosis in early gastric cancer. Follow-ups were obtained in all early, and 70% of the advanced cancer patients. Life table survival curves revealed 5-yr survival rates for 68% for the early gastric cancer and 27% for the advanced cancer cases (p less than 0.01). None of the patients in the first group died of gastric cancer. The early gastric cancer patients had a 32% incidence of other, nongastric malignancies compared to 7.7% in the advanced cancer group. Gastric cancer is being diagnosed at an early stage and the survival rates for these patients are significantly greater than those with advanced gastric cancer.

Actuarial Analysis↗