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Biomedical subjects

N Hershfield

Publications and source records attributed to N Hershfield.

6 recordsLinked to original sources
PubMed1999

Pancreatic polypeptide hyperplasia causing watery diarrhea syndrome: a case report.

Neuroendocrine tumours of the pancreas can secrete numerous peptides, leading to various recognizable clinical syndromes. The secretion of pancreatic polypeptide has been used as a marker for neuroendocrine tumours but is considered to be a biologically inert peptide. A 37-year-old woman had watery diarrhea syndrome from pancreatic polypeptide hyperplasia. Only 2 other reported cases in the literature have described pancreatic polypeptide hyperplasia; however, this is the first reported case in which the patient was successfully treated by surgical resection, with a 2-year follow-up. This report and review of the literature illustrate that pancreatic polypeptide hypersecretion may present as a clinical endocrinopathy.

Adult↗
PubMed1993

Expression pattern of metalloproteinases and their inhibitors changes with the progression of human sporadic colorectal neoplasia.

Several studies have implicated the extracellular matrix-degrading metalloproteinases (MMPs) as essential agents in tumor cell invasion and metastasis. In the present study, we have investigated the patterns of expression of a number of MMPs and their specific tissue inhibitors (TIMP-1 and TIMP-2) in human colonic tissue samples that represent various stages of progression from adenomas showing different degrees of dysplasia to adenocarcinomas. We assessed levels of mRNA by Northern blot analysis and the results were measured semiquantitatively by densitometry. In total, we analyzed nine adenomas of varying size and with varying degrees of dysplasia, three adenomas with adenocarcinoma (malignant polyps), and five adenocarcinomas. Although expression of MMP and TIMP mRNA was highly intercorrelated, transcripts for stromelysin 3 and TIMP-2 (high) showed the strongest relation to the neoplastic process. Detection of stromelysin 3 mRNA accompanied a diagnosis of severe dysplasia or malignancy, whereas levels of TIMP-2 (high) mRNA transcripts permitted finer distinctions on the neoplastic continuum. These data indicate changes within extracellular matrix acquired during the process of malignant transformation of human sporadic colorectal neoplasia.

Adolescent↗
PubMed1989

Midazolam in upper gastrointestinal endoscopy: a single-blind dose-finding study.

Midazolam is a water soluble benzodiazepine with potent sedative and amnestic properties. Sixty unpremedicated patients who were to undergo upper endoscopy for diagnostic purposes were enrolled in an open, non-randomized study to assess the efficacy of 4 increasing dosages of midazolam (0.05, 0.10, 0.15 and 0.20 mg/kg). Efficacy measures included Trieger test (psychomotor drawing), presence of anterograde amnesia, patient rating (PR) of the sedation, evidence of inflammation at the site of the injection and physician's global assessment (PGA). The 4 patient groups were similar in age, sex and ASA class. Eight of the 15 patients who received the 0.05 mg/kg and 1 patient each in the 0.10 mg/kg and 0.15 mg/kg group were considered to be treatment failures and required supplemental diazepam. PR (excellent-good) was constant for all doses throughout. Nearly all patients had anterograde amnesia. Deterioration in the Trieger test results was associated with increasing dose (ANOVA, p less than 0.05). There were no significant changes in vital signs. Signs of phlebitis were noted in two patients who received both diazepam and midazolam. PGA rating rose from 26.7% (0.05 mg/kg) to 80.0% (0.20 mg/kg) (p less than 0.01). Few adverse effects (unrelated to dosage) were noted. Midazolam is a well tolerated benzodiazepine which provides satisfactory sedation for endoscopy. If no premedication is given, there are no benefits to be gained from using a dose greater than 0.10 mg/kg.

Adult↗
PubMed1987

Chronic pancreatitis associated with ulcerative colitis.

A twelve-year-old girl without apparent predisposing factors developed chronic pancreatitis, and 10 months later had fulminant onset of ulcerative colitis requiring a colectomy. This report strengthens the evidence for a relationship between pancreatitis and inflammatory bowel disease.

Child↗