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Biomedical subjects

M A Goodman

Publications and source records attributed to M A Goodman.

9 recordsLinked to original sources
PubMed1992

Plasma levels of the lipid mediators, leukotriene B4 and lyso platelet-activating factor, in intraoperative salvaged blood.

It has been shown that white cells and platelets release their granules into the plasma of salvaged blood. Whether this release is due to destruction alone or a combination of destruction and activation is not known. Lipid mediators, platelet-activating factor and leukotriene B4, are produced by activated white cells and platelets and have effects on the cardiovascular, respiratory and immune systems and the microcirculation. The aim was to determine if white cells and platelets are activated in salvaged blood by measuring the levels of these lipid mediators. Ten patients undergoing aortic surgery, where intraoperative salvage was used, were studied. Blood samples were taken from the patient's circulation and the salvaged blood before and after washing. The levels of leukotriene (LTB4) and lyso platelet-activating factor (PAF, the stable degradation product of PAF) were measured in the samples by a radioimmunoassay and a bioassay, respectively. The levels of both these substances increased in the unwashed salvaged blood (mean patient levels: LTB4 27 +/- 4.3 ng/ml and L-PAF 73 +/- 8.5 ng/ml; mean unwashed blood levels: LTB4 95 +/- 12.2 ng/ml and L-PAF 172.9 +/- 26.4 ng/ml) and were reduced by washing of the collected blood (mean washed blood levels of LTB4, 23.9 +/- 4.8 ng/ml, and L-PAF 18 +/- 5 ng/ml). The increase of the lipid mediators in the unwashed salvaged blood indicates that white cells and platelets are activated and releasing lipid mediators. Washing of the collected blood is effective in removing the lipid mediators.

Blood Platelets↗
PubMed1978

Metabolic and endocrine alterations in osteosarcoma patients.

Eighteen patients with primary osteosarcoma were studied for abnormal endocrinologic functions. Oral glucose tolerance tests revealed abnormal glucose, insulin, or growth hormone response curves in 78% of the study population. Elevated somatomedin values were noted in 72% of the patients tested. No significant deviations were observed in serum cortisol, estradiol, testosterone, follicle stimulating hormone, and luteinizing hormone levels. Likewise, lipid screening and 24 hour 17-hydroxy and 17-keto steroid excretion levels were normal. Statistically these derangements were unrelated, leading to the hypothesis that some additional factor or factors are present and responsible for the abnormalities noted. These deviations, found in association with primary osteosarcoma, constitute a new "paraneoplastic syndrome."

17-Ketosteroids↗
PubMed1978

Pre-infarction angina secondary to calcific aortic stenosis with Bernheim's effect.

Pre-infarction angina, in the absence of coronary artery disease, was found in a 62 year-old man with severe calcific aortic stenosis. After application of intraaortic balloon pump counter-pulsation, the condition was stabilized, and coronary arteriograms were safely carried out. Interestingly, an elevated right atrial and right ventricular end-diastolic pressure with an associated Bernheim's effect was demonstrated by cardiac catheterization. The hemodynamics of the right heart returned to normal after surgical correction of the aortic stenosis. The clinical indications for intra-aortic balloon pump counterpulsation in this setting are discussed.

Angina Pectoris↗
PubMed1978

Delayed surgical repair of ruptured ligaments: a comparative biomechanical and histological study.

The importance of prompt surgical repair of complete ligament ruptures was quantitated using 38 rabbits with standardized transection injuries ofthe medial collateral ligament of one knee. Tensile testing of the mechanical properties, coupled with histological evaluation allowed assessment of the integrity of suture repairs performed immediately after ligament injury, versus those with 3 and 10 day delay times as well as those with non-operative management. Surgical repair performed within the first 3 days is beneficial in terms of final repair strength. Irreversible ligament strength and stiffness deficits progressively accumulate during the 10 days immediately following injury. Surgical repair after more than 10 days postinjury is contraindicated since the postoperative mechanical properties of the healed ligament do not differ from those for non-operative injury management.

Animals↗
PubMed1978

Experimental fracture healing: evaluation using radionuclide bone imaging: concise communication.

Radionuclide bone imaging was performed in a rabbit model to observe the course of fracture healing and to establish criteria for distinguishing nonunion and delayed healing from normal healing. Sequential gamma-camera images (with pinhole collimator) were collected and subjected to computer analysis. Five groups were established: a) control--immobilization; b) control--immobilization plus periosteal stripping; c) simple fracture--osteotomy; d) delayed union--osteotomy plus periosteal stripping; and e) nonunion--osteotomy, periosteal stripping and polymethyl methacrylate interposed between fracture fragments. Histographic representation of absolute count rates along rabbit tibias followed a predictable pattern in the simple-fracture and delayed-union groups. They differed only in the time of appearance of phases. The nonunion group demonstrated no recognizable sequential pattern. In this experimental model, serial bone scanning with quantitative data analysis has shown potential for indicating the course of healing in fractures and for serving as a guide to treatment.

Animals↗
PubMed1977

Hepatocellular carcinoma in association with androgen therapy.

The case of a young man with hypogonadism, who was treated for five years withmethyltestosterone and who developed hepatocellular carcinoma, is discussed. He received a course of 5-fluorouracil via the hepatic artery. Complete regression has been maintained for four years. It is likely that the androgen therapy is implicated in the development of the liver tumour. Recent reports of untoward effects of steroid hormones are reviewed.

Adult↗
PubMed1976

Primary osteosarcoma of the skull.

In 33 cases of primary osteosarcoma of the skull in a relatively old age group, the sex ratio and poor prognosis is the same as in osteosarcoma of long bones. However, patients in the second decade of life free of neurologic disease have a better prognosis.

Adolescent↗
PubMedDate not supplied

The quality of blood used for transfusion.

The current risk of disease transmission through homologous blood transfusion has lead to a revival in the use of autologous blood. The development of a coagulopathy increases the usage of blood and blood products and therefore the risk of disease transmission. Blood salvaged at operation is subjected to physical and humoral activating factors. The potential systems to be activated are located either in the plasma or non red cell cellular elements. Homologous blood and blood salvaged at operation before and after washing was examined for activation of the plasma and cellular systems by measuring the presence of fibrin degradation products (xDP's), activated complement (C3a) and plasminogen activator and inhibitor activity from the plasma systems; and elastase, serotonin, lysophospholipids, leukotriene B4, lysoplatelet factor and phospholipase A2 from the cellular systems. The plasma systems were activated in the salvaged blood which had elevated levels of xDP's and C3a compared to the patient's blood (p less than 0.05). The products of cellular activation were also elevated in operatively salvaged blood (p less than 0.01 for all the above products). The levels xDP's were normal but the levels of C3a increased in stored blood. The levels of the cellular systems, elastase, serotonin and lysoplatelet activating factor, increased with the duration of storage of bank blood. Unwashed and aged stored blood contains potentially harmful products. Consideration should be given to removal of non red cell elements in blood stored for surgery.

Blood Cells↗