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Biomedical subjects

L Gottesman

Publications and source records attributed to L Gottesman.

32 records · Page 2Linked to original sources
PubMed1984

The use of water-soluble contrast enemas in the diagnosis of acute lower left quadrant peritonitis.

The traditional work-up of patients with lower left quadrant peritonitis often includes the eventual use of barium-enema radiography. Diagnosis is usually delayed until adequate patient stabilization allows diagnostic contrast enemas. Delay of accurate diagnosis may, at times, have serious clinical sequelae. The use of barium enema in acute lower left quadrant peritonitis has both theoretic and actual disadvantages. These include extravasation of barium, with resultant barium cellulitis and peritonitis, precipitation of acute obstruction, and delay in evaluation by endoscopy, sonography, computerized tomography, and angiography. Forty recent cases of lower left quadrant peritonitis were evaluated on admission by water-soluble contrast enema. Water-soluble contrast enemas appear to be safe and accurate and avoid the aforementioned disadvantages of barium.

Acute Disease↗
PubMed1984

Diagnosis of isolated perforation of the gallbladder following blunt trauma using sonography and CT scan.

Perforation of the gallbladder from blunt abdominal trauma is relatively rare, and is usually diagnosed at laparotomy for associated visceral injury. Isolated injury of the gallbladder may be unrecognized leading to delayed diagnosis and its associated increased morbidity. Computerized tomography, sonography, and HIDA Tc99m may be used in the early diagnosis of the acutely perforated gallbladder.

Abdominal Injuries↗
PubMed1983

Perineal abscess eight years after total proctocolectomy for ulcerative colitis.

Total proctocolectomy following surgery for ulcerative colitis and carcinoma may be associated with difficulty in healing of the perineal wound. The presentation of delayed abscesses may be insidious in nature and present a diagnostic dilemma. We present a patient with delayed abscess eight years following total proctocolectomy for ulcerative colitis. Early use of computerized tomography is helpful in evaluating the late occurrence of pain in these patients.

Abscess↗
PubMed1983

Predictive value of intracutaneous xenon clearance for healing of amputation and cutaneous ulcer sites.

A previously reported technique for the assessment of skin blood flow in the lower extremities of patients with ischemic lesions was evaluated using intracutaneous xenon clearance. The radioisotope was injected above and below both the ankle and the knee and flow was measured using a gamma camera with a low-energy collimator, 88-keV photopeak, and a 20% window. Healing was more frequent when skin blood flow was equal to or greater than 2.4 ml/min/100 g (38/39 patients) than when flow was less than 2.4 ml/min/100 g (4/7 patients). The authors conclude that this technique can be used to help determine the appropriate site for amputation in lower limb ischemic lesions.

Amputation, Surgical↗
PubMed1980

Superior vena cava syndrome: report of a new operative technique.

A case of superior vena cava syndrome secondary to longstanding benign obstructing disease is presented. A new method of surgical technique is detailed. Clinical manifestations, etiology, anatomy, diagnosis, and treatment of superior vena cava syndrome are reviewed and principles of successful surgical treatment of the venous system are elucidated. The multiplicity of clinical and experimental techniques utilized in the past is succinctly tabulated.

Humans↗
PubMed1976

Synchronization of the electrocorticogram by visceral and somatic bradykinin stimulation in anesthetized cats.

The cortical response to visceral and somatic bradykinin stimulation was studied in cats under light to moderate pentobarbital anesthesia. Following the injection of bradykinin into arteries supplying visceral organs and somatic structures, a marked cortical synchronization was recorded. The bilateral, rhythmic discharge in the theta to alpha range was best seen on SI; occasionally the contralateral SI response was more prominent. The cortical synchronization and its distribution were the same for visceral and somatic stimulation. There was only minimal response desensitization to multiple injections of bradykinin in rapid succession. Following transection of the thoracolumbar spinal cord, synchronization failed to develop after hindlimb injections but continued to be seen after forelimb stimulation; similarly, partial denervation of a limb blocked the bradykinin response. No synchronization or desynchronization could be produced by epinephrine and nitroglycerine which caused phasic changes in systemic blood pressure equal to or greater than those seen with bradykinin. The results are discussed in terms of possible pathways and receptors. It is suggested that bradykinin acts primarily on free nerve endings common to visceral and deep somatic tissue with convergence of impulses occurring at spinal and higher levels. The preferential response of SI may reflect afferent activity generated by natural, painful stimulation of deep somatic and visceral organs. Normally, this component would be masked by the concomitant non-specific arousal response of the medial reticulo-thalamic system which was depressed by the anesthetic.

Afferent Pathways↗
PubMedDate not supplied

Unit responses in the ventrobasal thalamus (VPL) of the cat of bradykinin injected into somatic and visceral arteries.

Under light to moderate sodium pentobarbital anesthesia one half of the thalamic neurons displaying place and modality specific responses to low intensity mechanical stimulation of contralateral receptive fields also responded, by excitation or by inhibition, to bradykinin injections into somatic and visceral arteries. Partial or complete somatovisceral convergence was commonly seen in neurons with otherwise typical lemniscal properties. The response intensities varied considerably for different neurons; the responses to somatic bradykinin were always stronger than to visceral injections. The time course of the response was comparable to that seen in peripheral nerves, other central sites, and the behavioral reaction to bradykinin. Control experiments indicated the independence of the bradykinin responses from variations in blood pressure or general arousal effects. It is suggested that modulation of ventrobasal thalamic activity may be an important factor in central nociceptive processing.

Animals↗