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Biomedical subjects

L Rosoff

Publications and source records attributed to L Rosoff.

At least 19 recordsLinked to original sources
PubMed1979

Renal hemodynamics and the renin--angiotensin system in cirrhosis: relationship to sodium retention.

Renal hemodynamics and the renin-angiotensin-aldosterone system were investigated in 15 cirrhotic patients without renal failure on controlled sodium intake of 140-160 mEq/day and related to the degree of sodium retention as measured by urinary sodium excretion. Fourteen patients were free of clinical ascites when studied. The distribution of renal blood flow was measured by the noninvasive technique of computerized radioisotope renography. In 11 patients, outer cortical renal plasma flow, expressed as a percentage of total effective renal plasma flow, was directly proportional to sodium excretion (P less than or equal to 0.01). Three patients with severe sodium retention (UNa.V less than or equal to 10 mEq) had estimated outer cortical renal plasma flows of less than or equal to 274 ml/min/1.73 M2 as compared to eight cirrhotics with better (UNa.V greater than or equal to 50 mEq) sodium tolerance (mean = 438 ml/min/1.73 M2). A significant inverse correlation (P less than or equal to 0.01) existed between outer renal cortical blood flow and plasma renin activity. No significant relationship was observed between glomerular filtration rate, total effective renal plasma flow, plasma aldosterone concentration and sodium excretion. These results provide further evidence that a renal vascular abnormality exists in cirrhosis, and that diminished outer cortical renal perfusion is related to the elevated renin levels and sodium intolerance observed in cirrhotic patients.

Angiotensin II↗
PubMed1978

Management of the appendiceal mass.

The records of forty-three patients with clinically diagnosed appendiceal abscess were reviewed to compare operative vs nonoperative therapy. Thirteen patients were operated on shortly after admission. Eleven of these had appendectomy or drainage of an abscess; two patients had right hemicolectomy. There were no serious complications, and median hospitalization was 7.2 days. Thirty patients were initially treated nonoperatively. Twenty-six of these did well and were discharged a median of 11 days after admission. Four patients required operations for failure to respond. One patient died of a pulmonary embolism. Four patients returned with recurrent appendicitis and underwent appendectomy. Three patients were later found to have other disease processes. Good results can be obtained with either form of therapy. Patients not operated on should be examined to exclude lesions masquerading as appendiceal abscesses.

Abscess↗
PubMed1978

Triiodothyronine-secreting (toxic) adenoma of the thyroid gland: light and electron microscopic characteristics.

A patient with thyrotoxicosis due to a triiodothyronine (T3)-secreting autonomous adenoma is described. The histmorphology of the neoplasms was similar to other neoplasms previously reported. Ultrastructural features of the adenoma are compatible with a very actively secreting follicular cell and are best compared with the ultrastructure of a diffuse toxic goiter. Distinctive features that separate toxic adenomas from various thyroid carcinomas and normal thyroid parenchyma are discussed.

Adenoma↗
PubMed1978

Chronic hepatitis.

Explore the source record for details and available documents.

Azathioprine↗
PubMed1977

Urinary cyclic AMP analyzed as a function of the serum calcium and parathyroid hormone in the idfferential diagnosis of hypercalcemia.

Urinary cyclic AMP (UcAMP) appropriate for the serum calcium concentration was determined in normal subjects during the base-line state and during alteration in their serum calcium concentrations by saline and calcium infusions. This was compared to the UcAMP in 76 patients with hypercalcemia and 5 patients with hypocalcemia. In 54 of 56 patients with primary hyperparathyroidism, the UcAMP was inappropriately high for their serum calcium concentration, the 2 exceptions having renal failure. In four patients with vitamin D intoxication, sarcoidosis, milkalkali syndrome, and thiazide-induced hypercalcemia and in five patients with hypocalcemia due to hypoparathyroidism, the UcAMP was appropriately low for their serum calcium concentration. In 16 patients with nonparathyroid neoplasms, 10 had UcAMP levels that were inappropriately high suggesting ectopic parathyroid hormone (PTH)-mediated hypercalcemia and 6 had UcAMP levels that were appropriately low suggesting that their hypercalcemia was due to osteolytic factors other than PTH. Correlations between UcAMP, serum calcium concentration, and carboxyl-terminal immunoreactive PTH suggest that random UcAMP is a sensitive accurate reflection of circulating biologically active PTH. If there is adequate renal function (serum creatinine concentration less than 2.0 mg/dl), a random UcAMP expressed as mumol/g creatinine and analyzed as a function of the serum calcium concentration completely separates patients with PTH and non-PTH-mediated hypercalcemia.

Adult↗
PubMed1976

Pancreatic abscess following acute pancreatitis.

Pancreatic abscess is probably the most serious complication of acute pancreatitis. During the ten-year period from 1966 to 1975, twenty-eight patients with pancreatic abscess following acute pancreatitis were treated by surgical drainage. A review of these cases revealed that there was a lull in the clinical course of the antecedent pancreatitis prior to the time of surgical drainage in 70% of the cases. Despite an aggressive surgical approach, there were major postoperative problems in 26 patients. Sepsis persisted in 14 patients. Major gastrointestinal hemorrhage occurred in seven, intra-abdominal bleeding in nine, and fistulization in 13. Fourteen patients died (a mortality of 50%). The operative treatment of pancreatic abscess must be aggressive and persistent. In addition to extensive drainage with soft sump drains, vigilance must be exercised to avoid pressure against bowel or major vessels. Reoperation should be considered if postoperative improvement is not sustained.

Abscess↗
PubMed1975

Studies of renin and aldosterone in cirrhotic patients with ascites.

Plasma renin activity and aldosterone metabolism were investigated in patients with cirrhosis and refractory ascites. All patients initially showed marked elevations of plasma and renin activity and plasma aldosterone. Although metabolic clearance of aldosterone was reduced, increased secretion rate was the major factor leading to elevated plasma levels. The elevated plasma renin activity and plasma aldosterone were only minimally affected by posture, dietary sodium restriction, and diuretic administration, suggesting a near-maximal degree of secondary aldosteronism. In most patients plasma renin activity and plasma aldosterone returned to normal when spontaneous natriuresis appeared. However, in 2 patients during spontaneous diuresis and in all 3 given aminoglutethimide, sodium excretion was poorly correlated with plasma renin activity and plasma aldosterone, suggesting that other tubular and/or vascular factors are important in the intense sodium reabsorption found with cirrhosis and ascites.

Aldosterone↗