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Biomedical subjects

S S Goldstein

Publications and source records attributed to S S Goldstein.

5 recordsLinked to original sources
PubMed1985

Predictive value of a low serum trypsinogen.

Previous studies, in selected populations, have determined that a low serum trypsinogen can be seen in chronic exocrine pancreatic disorders (CP) and primary diabetes mellitus (DM). In this study, we investigated the predictive value of a low serum trypsinogen. The study population consisted of 488 consecutive emergency room patients admitted to our hospital on whom a serum amylase was drawn by the emergency room staff. Of the sera drawn, 418 were saved and tested for immunoassayable trypsinogen. Ten of 418 (2.4%), had a low level of this marker (less than 10 ng/ml). Of these 10, four had obvious historical or clinical evidence of CP during their initial hospitalization. Six patients, however, had no initial evidence of CP. Follow-up was obtained in three of the six, and all three had evidence of CP despite absence of symptoms. Of the 418 patients, 37 had DM. A low trypsinogen was found in three of these 37, and all three had concomitant CP. We conclude that this new assay has excellent predictive value in diagnosing chronic exocrine pancreatic disorders.

Adult↗
PubMed1985

Diagnostic assays in acute pancreatitis. A study of sensitivity and specificity.

The sensitivity and specificity of five assays used to diagnose acute pancreatitis were studied: two amylase assays; one lipase; one trypsinogen; and one pancreatic isoamylase. Thirty-nine patients with acute pancreatitis were compared to 127 controls with abdominal pain. Using the upper limit of normal both amylase assays appeared sensitive but somewhat nonspecific (specificities of 88.9% and 86%, respectively). The trypsinogen and pancreatic isoamylase assays were also relatively nonspecific (specificity of 82.8% and 85.1%). Most nonspecific elevations occurred between a one- and twofold elevation of each assay. Lipase, however, maintained excellent specificity (99%) at its upper limit of normal. If the level of best cutoff is used instead (the level that best enhances sensitivity and specificity), the specificities of both amylase assays, as well as the trypsinogen and pancreatic isoamylase assays, exceed 95%. At the best cutoff level, trypsinogen maintains a qualitative advantage in sensitivity over lipase or pancreatic isoamylase (97.4% as compared to 86.5% and 84.6%).

Acute Disease↗
PubMed1984

Intestinal obstruction due to bezoars.

A patient with acute intestinal obstruction due to unrecognized gastric phytobezoars is presented. There was no history of prior gastric or other abdominal surgery. At laparotomy several fragments of rubbery material were discovered obstructing the ileocecal valve. Exploration of the upper gastrointestinal tract revealed two partially fragmented bezoars in the stomach which were removed through a gastrotomy. After surgery the patient recounted the ingestion of persimmons a few weeks before the onset of her symptoms. A review of the literature reveals bezoars to be an infrequent, although not an altogether rare, cause of small bowel obstruction in patients without antecedent gastric surgery. A careful dietary history should accompany all patients presenting with acute intestinal obstruction.

Bezoars↗
PubMed1974

Changes of action potential shape and velocity for changing core conductor geometry.

The theoretical changes in shape and velocity of an action potential were computed in regions of changing core conductor geometry. Step decrease and step increase of diameter, branch points, and gradual taper or flare of diameter were studied. Results showed increase of both velocity and peak height as the action potential approaches a point of step decrease. A step increase causes decrease of both velocity and peak height with approach; propagation may either fail, succeed with brief delay, or, with longer delay, succeed in both forward and reverse directions. With branching, both the shape and the dimensionless velocity, tautheta/lambda, remain unchanged when the d(3/2) values are matched. Without such matching, the changes of shape and dimensionless velocity of an action potential correspond to those found for step decrease or step increase of diameter. For regions of flare or taper, it was found (for a specific previously defined class) that velocity changed in proportion with the changing length constant. A simple formula was found to predict how this proportionality constant depends upon the amount of flare or taper.

Action Potentials↗