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Biomedical subjects

L S Gottlieb

Publications and source records attributed to L S Gottlieb.

At least 37 records · Page 2Linked to original sources

Lung cancer among Navajo uranium miners.

Lung cancer has been a rare disease among the Indians of the southwestern United States. However, the advent of uranium mining in the area has been associated with an increased incidence of lung cancer among Navajo uranium miners. This study centers on Navajo men with lung cancer who were admitted to the hospital from February 1965 to May 1979. Of a total of 17 patients with lung cancer, 16 were uranium miners, and one was a nonminer. The mean value of cumulative radon exposure for this group was 1139.5 working level months (WLMs). The predominant cancer type was the small cell undifferentiated category (62.5 percent). The low frequency of cigarette smoking in this group supports the view that radiation is the primary cause of lung cancer among uranium miners and that cigarette smoking acts as a promoting agent.

Adult↗

Immunocytochemical localization of carcinoembryonic antigen in benign and malignant colorectal tissues. Assessment of diagnostic value.

Immunoperoxidase and immunofluorescence staining for carcinoembryonic antigen (CEA) was performed on paraffin and frozen sections, respectively, of colonic carcinomas (70), liver and lymph node metastases (20), mesenteric nodes (150), mucosa adjacent to carcinoma (40), colonic resection margins (20), normal colon (ten), and colorectal polyps (64) in order to assess its potential diagnostic value. On the basis of this study of the immunocytochemical localization of CEA in colorectal tissues, conclusions were as follows. (1) Localization of CEA to glycocalyx of surface epithelial cells is a normal finding in the colon and is similar in normal colon and mucosa distant and adjacent to infiltrating carcinoma. (2) Although strongly positive cell surface and intraluminal staining frequently correlates with the presence of carcinoma in neoplastic polyps, it is not by itself a reliable diagnostic criterion. (3) Failure to demonstrate CEA in a gland-forming carcinoma makes a diagnosis of colorectal carcinoma unlikely. (4) Poorly differentiated colorectal carcinoma usually contains much less demonstrable surface CEA, but may occasionally stain cytoplasm strongly. (5) Although lymph node micrometastases from colorectal carcinoma are readily demonstrated by immunoperoxidase staining for CEA, screening of hematoxylin and eosin-stained sections by a competent pathologist appears to be adequate for their detection.

Carcinoembryonic Antigen↗

Myxoma of bone in a nonhuman primate.

A myxoma of the mandibles in an adult female Macaca mulatta is described. The left mandible was markedly enlarged by the tumor, which extended from the symphysis to the temporomandibular joint. The tumor had extended a short distance across the symphysis into the right mandible. It was composed of a glistening mucinous material. Radiographs of the tumor showed a large expansile radiolucent lesion of the left mandible without soft tissue involvement. Light microscopy demonstrated capillaries, stellate shaped cells with processes up to 15 mu long, very few other cell types, and an amorphous ground substance. Electron microscopic examination revealed similarity to the myxoma of bone of man. The oxytalan fibers discovered in this myxoma have not been found in myxomas before and suggest the tumor is odontogenic in origin. The incidence of spontaneous neoplasia in general and that of spontaneous oral tumors in particular in nonhuman primates are reviewed.

Animals↗

Cholestasis and hepatic metastases: a factor contributing to extreme elevations of carcinoembryonic antigen.

Records of 19 autopsied patients with metastatic carcinoma were studied to elucidate the contribution to the elevation of antemortem plasma carcinoembryonic antigen (CEA) levels (range, 5.9--136,000 ng/ml) of 1) liver pathology and dysfunction, 2) tumor morphology and CEA content, and 3) tumor spread and location. Liver function tests and plasma CEA recorded within 8 weeks of death, autopsy records of tumor spread, liver weight (as an index of liver tumor mass), and histologic sections were reviewed. Tissue CEA was demonstrated in 15 patients by an immunoperoxidase method. Cholestasis was seen in histologic sections of tissue from 8 of 10 patients, and elevated bilirubin was seen in 7 of 10 patients with hepatic metastases and CEA levels greater than 1,000 ng/ml In contrast, histologically observed cholestasis and elevated bilirubin were seen in only 1 of 8 patients with CEA less than 500 ng/ml. A significant correlation was found between the plasma CEA level and histologically observed cholestasis (P less than 0.01). Serum bilirubin also correlated significantly (P less than 0.01), but alkaline phosphatase did not. Liver weight (tumor mass) showed a positive correlation with cholestasis (P less than 0.01) but not with circulating CEA. Markedly elevated plasma CEA levels (greater than 1,000 ng/ml) seen preterminally may partially reflect impaired excretion of CEA by the hepatobiliary system rather than, or in addition to, preterminal increase in CEA-producing tumor.

Bilirubin↗

Ornithopulmonary disease.

Severe pulmonary infections in man may be caused by exposure to infected birds or their droppings. Ornithosis, histoplasmosis and cryptococcosis develop as a result of inhalation of an infective agent. Pigeon-breeder's lung is an allergic alveolitis caused by a hypersensitivity reaction to avian droppings or feathers. This condition is recurrent and is best treated by avoidance of further exposure. Corticosteroids are useful in acute cases.

Animals↗

Tissue localization of zinc glycinate marker and carcinoembryonic antigen by immunofluorescence. II. Immunofluorescence microscopy.

Preliminary indirect immunofluorescence studies on the zinc glycinate marker (ZGM) were compared with carcinoembryonic antigen (CEA) immunofluorescence, ZGM, detected in 26 of 29 human colon adenocarcinomas, was associated with the epithelial component of the malignant glands. Fluorescence was generally less strong and more granular for ZGM than for CEA and was found in intraglandular spaces, luminal border areas, and cytoplasm. ZGM concentration and tissue localization appeared to be related to tumor differentiation. ZGM was also detected in benign colon mucosae (adjacent to and distant from the carcinomas) from patients with colon carcinoma, but differed from CEA in that it was present in the deep crypt portion only. Gastric, pancreatic, esophageal, and anal adenocarcinomas, as well as benign gastric pyloric and small bowel mucosae had detectable ZGM. CEA, but not ZGM, was observed in 20 nongastrointestinal carcinomas to date. Studies are under way to determine whether ZGM is a marker associated with colon and gastrointestinal adenocarcinoma specifically or undifferentiated crypt cells of the colon and digestive tract in general.

Adenocarcinoma↗

Respiratory tract burns after aspiration of hot coffee.

We present the fingings in a patient with acute thermal burn to the upper and lower airway who developed mucosal edema followed by patchy areas of granuloma-like lesions in the trachea and bronchi. A four-month follow-up showed resolution of the gross lesions, but functional alterations remained. This patient illustrates the necessity for repeated direct observation and functional evaluation of the lower airway folllowing thermal injury, which can be a life-threatening disorder.

Adult↗

Pulmonary and rhinocerebral mucormycosis. Successful outcome with amphotericin B and griseofulvin therapy.

An ominous prognosis is associated with combined pulmonary and rhinocerebral mucormycosis (phycomycosis). We report the case of a diabetic patient with ketoacidosis who had extensive pulmonary and rhinocerebral mucormycosis that responded satisfactorily to amphotericin B and griseofulvin therapy. The affected lung is completely atelectatic and has remained so for 12 months without evidence of necrosis or abscess formation.

Adult↗

Swyer-James (Macleod's) syndrome. Variations in pulmonary-bronchial arterial blood flow.

The Swyer-James (Macleod's) syndrome (or unilateral hyperlucency of the lung) frequently presents a diagnostic problem. Two cases of this entity are reported that demonstrate its similarity to and differentiation from pulmonary embolism and other intrapulmonic disorders. Detailed roentgenologic and physiologic studies were performed to define the diagnostic criteria of this syndrome. The reciprocal relationship of the bronchial arterial circulation in the hyperlucent lung was described.

Adult↗

Comparison of tracheobronchial suction catheters in humans. Visualization by fiberoptic bronchoscopy.

Tracheobronchial suctioning was performed in 20 patients undergoing diagnostic or therapeutic bronchoscopic examination. The effect of a single suctioning procedure on the airway mucosa was observed and recorded by still and cine photography through a fiberoptic bronchoscope. A variety of catheters of various designs were evaluated. All produced a negligible amount of trauma, and none was superior in efficiently evacuating mucus from the airways. Mucosal trauma with tracheobronchial suctioning procedures is more likely due to repetition, vigor, and amount of suction applied, regardless of which type of catheter is used.

Bronchi↗

Flexible fiberoptic bronchoscopy and endobronchial tamponade in the management of massive hemoptysis.

Flexible fiberoptic bronchoscopic examination with systematic bronchial lavage was performed in ten patients with massive hemoptysis. Localization of the bleeding to the distal segments of the bronchial tree and endobronchial balloon tamponade were achieved in all cases. The technique is rapid, simple, and effective in controlling life-threatening hemoptysis in patients who are unsuitable for resection due to inadequate pulmonary reserve or other causes.

Adult↗

Augmentation of ethanol absorption by mono- and disaccharides.

Assessment of the influence of nutritional substrates on the disposition of ingested ethanol from the blood requires, first, an understanding of the influence that these may exert upon ethanol absorption from the gastrointestinal tract. In this report, the effects of various carbohydrates on the intestinal absorption of ethanol were studied. When carbohydrates (50 mM) were perfused simultaneously with ethanol (50 mM) in vivo in the rat small bowel, ethanol absorption increased up to 34% (P less than 0.005) above controls receiving ethanol alone. Of the monosaccharides, fructose, 3-O-methylglucose, glucose, or galactose added to an ethanol perfusate, only glucose or galactose increased ethanol absorption over control animals receiving ethanol alone. Of the disaccharides tested, sucrose and maltose, but not lactose, enhanced ethanol absorption. Addition of varying concentrations of maltose to an ethanol perfusate augmented ethanol absorption in a direct proportion to the quantity of glucose absorbed, rather than to the quantity of maltose hydrolyzed. Augmentation of ethanol absorption by carbohydrates appears to be dependent upon sugar-active transport. Ethanol, dissolved in intraluminal water, may cross the mucosa in water absorbed during sugar-active transport. This quantity of ethanol is absorbed in addition to that which normally crosses the mucosa by diffusion down its concentration gradient.

Animals↗

Adenoid cystic carcinoma (cylindroma) of the trachea masquerading as asthma.

A 40-year-old woman was admitted with upper airway obstruction; chest roentgenogram with tomograms, laryngoscopy, and bronchoscopy verified the presence of a subglottic tumor. Spirometry disclosed a maximum inspiratory flow rate more reduced than in the maximum expiratory flow rate, suggestive of upper airway obstruction. The pathologic conditions were consistent with cystic adenoid carcinoma (cylindroma) of the trachea. The patient underwent tracheostomy and total laryngectomy with an uneventful recovery. No evidence of local extension or distant metastases were evident at time of surgery.

Adult↗