Do vouchers hold the key to the funding dilemma?
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Community Participation↗
Biomedical subjects
M Goldsmith
Publications and source records attributed to M Goldsmith.
Spontaneous regression of gastric lymphoma.
Two cases of spontaneous regression of histologically diagnosed large cell lymphoma of the stomach are reported. Regressions occurred after nonspecific therapy including the H-2 antagonist cimetidine and were documented surgically. Spontaneous regression of intermediate and high-grade non-Hodgkin's lymphoma is distinctly uncommon. The possible role of cimetidine in these cases is discussed.
Aged↗
Strengthening the hospital's marketing position through training.
Through the HOSPITAL-ity program, the Department of Human Resources Development at Albert Einstein Medical Center tackled the problem of decreasing hospital occupancy. They did it by using training professionals to help tap the institution's human resources.
Attitude of Health Personnel↗
Regional comparison of technetium-99m DTPA aerosol and radioactive gas ventilation (xenon and krypton) studies in patients with suspected pulmonary embolism.
The regional distribution of [99mTc]DTPA aerosol was compared with that of 133Xe (n = 30) and krypton (n = 24) in a group of patients with suspected pulmonary embolism. All patients had an aerosol study using a recently available commercial generator system, a ventilation study with one of the gases, and perfusion imaging. Regional information was assessed visually on xenon, krypton, and aerosol studies independently by considering each lung as three equal-sized zones. In addition, gas ventilation findings peripheral to regions of aerosol turbulence ("hot spots") were evaluated. Only 64% of the zones were in complete agreement on xenon and aerosol. Most of the discordance between xenon and aerosol was accounted for by minor degrees of 133Xe washout retention in zones that appeared normal in the aerosol study. An agreement rate of 85% was noted between 81mKr and aerosol regionally. The regions of discordance between aerosol and gas studies, however, usually were associated with unimpressive perfusion defects that did not change the scintigraphic probability for pulmonary embolism in any patient. Regarding zones of aerosol hyperdeposition, 76% had associated washout abnormalities on xenon; however, there was no correlation between the presence of these abnormalities or perfusion abnormalities. The results confirm the high sensitivity of 133Xe washout imaging, but suggest that radioaerosol imaging will detect most parenchymal abnormalities associated with perfusion defects of significance.
Adult↗
Kaposi's sarcoma associated with hairy cell leukemia, immune thrombocytopenia, and opportunistic infection.
A 73-year-old man developed Kaposi's sarcoma 6 years after the diagnosis of hairy-cell leukemia, at which time a splenectomy was performed. He received no additional treatment. The Kaposi's sarcoma was complicated by the development of immune thrombocytopenia and Listeria monocytogenes meningitis. Evaluation during the course of his disease revealed lymphopenia, decreased OKT4 + subset, and increased OKT8 + subset. The clinical and immunologic findings in this patient have similarities to the acquired immunodeficiency syndrome.
Aged↗
A new role for HRD in hospitals. How to create a more consumer-oriented work force.
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Attitude of Health Personnel↗
Ultrasound appearance of the brain in very preterm infants and neurodevelopmental outcome at 18 months of age.
The brains of 158 consecutively admitted very preterm infants were repeatedly examined with real time ultrasound. Abnormalities, most commonly periventricular haemorrhage, were detected in 79 (50%). The 109 infants who survived were followed up until they were 16-23 months old. Major or minor neurological or developmental sequelae were found in 5 of 62 infants (8%) with normal ultrasound scans and in an identical proportion, 2 of 25 infants (8%), with uncomplicated periventricular haemorrhage. By contrast, 15 of 21 infants (71%) whose ventricles became enlarged (with or without periventricular haemorrhage) had abnormalities at follow up. The proportion with sequelae depended on the cause and extent of the enlargement. Three of 8 infants (38%) with mild (usually transient) ventricular distension had sequelae, compared with 3 of 4 (75%) with hydrocephalus and 9 of 9 (100%) with cerebral atrophy (2 of whom also had hydrocephalus). Adverse neurodevelopmental sequelae at follow up appeared more often to be attributable to cerebral ischaemia and infarction than to periventricular haemorrhage.
Birth Weight↗
Chronic cadmium exposure: relation to male reproductive toxicity and subsequent fetal outcome.
Acute injections of high doses of Cd induce marked testicular necrosis. However, the effects of low-dose, oral Cd exposure on a chronic basis are not well documented. The present investigation was designed to examine the effects of such exposure as reflected in parameters of spermatotoxicity and histology. Moreover, the impact on fetal outcome was measured by evaluating teratological and postnatal neurobehavior endpoints. Male Long-Evans hooded rats (100 d of age) were exposed to 0, 17.2, 34.4, or 68.8 ppm Cd for 70 d. During this period, the animals were maintained on a semipurified diet to control for the contributions of Zn and other trace elements. Near the end of exposure the males were mated to three female rats. One was sacrificed on d 21 of pregnancy for teratological assessment, including fetal weight, and determination of preimplantation and postimplantation loss. The other two dams were allowed to deliver, and their offspring were tested on tasks of exploratory behavior (d 21) and learning (d 90). Subsequently, the male parent was sacrificed and a variety of measures recorded including weights of testes and caudae epididymides, sperm count and sperm morphology, and Cd content of liver and kidney. One of the testes was also evaluated histologically. No significant effects were observed on any of the parameters of reproductive toxicity or fetal outcome. These findings suggest that, at the doses employed in this study, Cd did not have significant deleterious effects on the male reproductive system. Morever, the traditional view of Cd-related testicular insult, based on acute exposure, injection protocols, needs to be reevaluated in terms of environmental relevance.
Analysis of Variance↗
Drug discrimination learning in lead-exposed rats.
Lead acetate (0.02 or 0.5 percent) was administered to dams throughout the lactation period with half of the litters continuing on lead after weaning. Drug thresholds for d-amphetamine were determined by using the drug-discrimination learning paradigm. All the offspring that had been exposed to lead were less sensitive to the stimulus properties of d-amphetamine irrespective of whether or not they had continued on lead after weaning.
Animals↗
Responsiveness to d-amphetamine in lead-exposed rats as measured by steady state levels of catecholamines and locomotor activity.
Locomotor activity and brain catecholamine concentrations following d-amphetamine challenge were evaluated in lead-exposed rats. Sucklings were exposed to lead via its transfer from maternal drinking solutions (0.02% Pb (Ac)2, 109 ppm Pb) to the maternal milk supply. At 21 days of age half of each exposed litter was weaned to the maternal regimen, the remainder to distilled water. Spontaneous locomotor activity and lead in blood were qualified at 21, 30 and 90 days of age. At 90 days of age rats were also challenged with d-amphetamine sulfate (1.0 mg/kg, SC) and their drug-induced activity recorded for a 2 hours period. One week later the same animals received a similar dose of d-amphetamine and were sacrificed at 0, 0.5, 1, 3, 6, 12, 24 and 48 hours post injection for analysis of whole brain dopamine (DA) and norepinephrine (NE). Catecholamine concentrations did not differ between lead-exposed and control rats in the absence of a d-amphetamine challenge. However, over the 48 hr period following drug challenge, lead-exposed rats had lower whole brain steady state levels of NE than control animals. Similar changes were evident for rats exposed to lead continuously and for those exposed to lead only during the 21 day period from birth to weaning. The spontaneous locomotor activity of lead-exposed and control rats was comparable at all ages tested. However, drug-induced activity was greater in lead-exposed animals than controls. This facilitated drug response was statistically greater than that of controls for continuously lead-exposed rats. Those exposed only during the neonatal period showed similar trends.
Animals↗
Chromatin organization during meiotic prophase of Bombyx mori.
Chromatin organization during the early stages of male meiotic prophase in Bombyx mori was investigated by electron microscopy. The analysis of nuclei prepared by the Miller spreading procedure, suggests that chromatin fibers which are 200-300 A in diameter undergo an orderly folding coincident with the formation of the synaptonemal complex. In very early stages the chromatin is released in linear arrays typical of interphase chromatin material. With time loops containing 5-25 mu of B conformation DNA, initially visualized at the periphery of early meiotic prophase nuclei, aggregate into discrete foci. These foci coalesce to form the longitudinal axis of the chromosome in conjunction with the initial appearance of the axial elements of the synaptonemal complex. At pachytene, the loops are evenly distributed along the length of the chromosome and extend radially so that in well spread preparations the chromosome has a brush-like appearance. Throughout this period nascent RNP-fibers were visualized along some of the loops.
Animals↗
Effect of growth hormone and oxandrolone singly and together on growth rate in girls with X chromosome abnormalities.
The linear growth effects of oxandrolone, human growth hormone, and Ox + hGH were compared in six girls, age 11 to 15 years, with X chromosome abnormalities (three with X,O karyotype, three with Turner syndrome variants). Over six successive three-month periods, the patient received either no treatment, Ox, hGH, or Ox + hGH. The data demonstrate a significant (P less than 0.001) synergistic effect between Ox and hGH in stimulating linear growth in Turner syndrome and its variants.
Adolescent↗
NMR in cancer. X. A malignancy index to discriminate normal and cancerous tissue.
Proton nuclear magnetic resonance relaxation parameters (T1, T2, T1p) were measured on 84 normal and malignant samples of colon, lung and breast tissue at 22.5 MHz. The purpose of this study was to evaluate the ability of NMR measurements to discriminate between normal and malignant tissue. By combining T1 and T2 into a normalized NMR malignancy index, it was possible to discriminate malignant and normal tissue in all 36 colon samples, 22 out of 23 breast samples, and 26 out of 29 lung cases. Furthermore, histologically normal tissue adjacent to malignant colonic tissue was found to have an elevated NMR malignancy index comparable to that of malignant colon.
Breast↗
NMR in cancer. XI. Application of the NMR malignancy index to human gastro-intestinal tumors.
One hundred two specimens of human gastro-intestinal tissue taken from eighty-seven individuals were inspected by proton magnetic resonance techniques (at 22.5 Megahertz). The purpose of the study was to evaluate the diagnostic capabilities of the nuclear magnetic resonance (NMR) technique with regard to the diagnosis of malignancy. The combination of two NMR parameters (spin-lattice ((T1) and spin-spin ((T2)) relaxation times) into a malignancy index yielded complete discrimination between the two populations of tissue. The mean and standard deviations obtained were 2.004 +/- 0.342 for normal tissue, and 3.266 +/- 0.642 for malignant specimens. In addition, the NMR technique indicated that histologically normal tissue taken adjacent to the malignancy was pathologically "involved". Analysis of the electrolyte and water content of such tissues confirms this abnormality.
Digestive System↗
Whole-body nuclear magnetic resonance scanning: n.m.r. studies of tumour cells.
A technique, field-foxusing nuclear magnetic resonance (n.m.r.) spectroscopy (FONAR), is described for doing n.m.r. scans in large samples. The method utilizes a shaped d.c. magnetic field that confines the n.m.r. signal-producing region of the sample to a small volume called the resonance aperture. The aperture contains the required values of the Ho field to fully bracket the band of the r.f. pulse. The magnet system and r.f. pick-up coil that achieved the first human n.m.r. scan are discussed.
Abdominal Neoplasms↗
Field-focusing nuclear nuclear magnetic resonance (fomar).
A technique, field-focusing NMR (FONAR), is described for doing NMR scans in large samples. The method utilizes a shaped D.C. magnetic field that confines the NMR-signal-producing region of the sample to a small volume called the resonance aperture. The aperture contains the required values of the Ho field to fully bracket the band of the r.f. pulse. The magnet system and r.f. pick-up coil that achieved the first human NMR can is discussed.
Humans↗
Nuclear magnetic resonance properties of gynecological tissues.
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Carcinoma, Squamous Cell↗
NMR in cancer, XIII: application of the NMR malignancy index to human mammary tumours.
One hundred and nineteen specimens of human mammary tissue taken from 112 individuals, were inspected by pulsed proton magnetic-resonance techniques (at 22.5 MH2). The purpose of the study was to evaluate the diagnostic capabilities of the nuclear magnetic resonance (NMR) technique with regard to the recognition of malignancy. The combination of two NMR parameters (spin lattice (T1) and spin-spin(T2) relaxation times) into a malignancy index produced better than 95% discrimination between the 2 populations of tissue on a case-by-case basis. The mean and standard deviations obtained were 2.002 +/- 0.351 for normal tissue, and 3.137 +/- 0.667 for malignant specimens. The probability that this difference is not significant is considerably less than 0.01. In addition, specimens of fibrocystic disease and fibrous mastopathy had indices of 2.263 +/- 0.503 and 2.151 +/- 0.505 respectively. Both groups yielded P values less than 0.01 when compared to the malignant specimens.
Adenocarcinoma↗