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Biomedical subjects

W Rubin

Publications and source records attributed to W Rubin.

At least 19 recordsLinked to original sources
PubMed1991

Medical treatment of peptic ulcer disease.

Our understanding of PUD and its treatment has improved dramatically during the past 15 years. During this time, many new effective drugs have been approved by the FDA, and possibly even more potent and effective therapies are now being evaluated. The H2-blockers, sucralfate, and antacids heal over 90% of duodenal ulcers in 6 to 8 weeks, and H2-blockers heal about 80% of gastric ulcers by 8 weeks and over 90% by 12 weeks. The new, more potent pump blockers (omeprazole) promise to be even more effective drugs, even for the healing of patients who are taking NSAIDS. However, the potential hazards of marked, long-term acid suppression must still be evaluated. Maintenance therapy with H2-blockers or sucralfate, ideally used for patients who would otherwise have frequent symptomatic recurrences of duodenal ulcer disease or who have had complications, reduces the relapses, especially symptomatic relapses. Maintenance therapy with H2-blockers also seems to reduce the recurrences of GUD, but this use has not yet received FDA approval. Elimination of H. pylori infection with antibiotics may prove to reduce recurrent ulcer disease and negate the need for maintenance therapy. Colloidal bismuth subcitrate alone, which suppresses but does not eradicate H. pylori infection, seems to be an effective ulcer drug and may even reduce the rate of early recurrences. Effective ulcer therapy, especially if it prevents recurrent disease, may reduce the complications of PUD, but this expectation has yet to be established. The use of prophylactic cytoprotective prostaglandins (misoprostol) reduces the incidence of NSAID-induced GUD.

Antacids↗
PubMed1991

Practical method of reporting test results in neurotologic disorders.

A more practical method of reporting the neurotologic test results became desirable in the course of preparing case reports. This need grew out of the necessity to organize neurotologic tests results in a simple, easily understandable, nonredundant manner. Tests organized in this manner were vestibular and auditory tests. Vestibular tests included electronystagmography, rotational testing, and posturography. Auditory tests included pure-tone testing, speech testing, impedance testing, and auditory brainstem responses.

Hearing Tests↗
PubMed1990

The dizzy patient: etiologic treatment.

The basis for the vestibular complaint in dizzy patients should be viewed as having an etiology rather than a description of its clinical presentation. Effective treatment of vestibular disorders is based on the stabilization of the vestibular abnormality, to allow for central vestibular compensation. While not all of the etiologies for dizziness have been described, there are effective etiologic treatments available. These fit into categories of neurotransmitters, blood sugar and blood fat control, hormones, minerals, and treatments for autoimmune dizziness.

Autoimmune Diseases↗
PubMed1990

Etiologic diagnosis in neurotologic disease.

The inner ear is a converter (transducer) of mechanical to electrical energy for both hearing and balance functions. This task is accomplished as a result of the presence of the chemicals within the perilymph and endolymph. Maintaining normal hearing and balance function is dependent upon the availability of the proper chemicals to perform this transduction task. The inner ear functions as an internal body organ and its efficiency in regard to performing its tasks related to hearing and balance function are chemically dependent upon many body systems.

Ear, Inner↗
PubMed1990

How do we use state of the art vestibular testing to diagnose and treat the dizzy patient? An overview of vestibular testing and balance system integration.

The physician must be the captain of the vestibular diagnostic team based on his interest, knowledge, and capability. It is not the battery of vestibular or etiologic function tests used that provides diagnostic answers. It is the intelligent application and use of the indicated vestibular tests that are practically correlated and clinically evaluated that will give the knowledgeable physician significant information. This can best be accomplished when testing is done in physical proximity to the responsible physician and when the tests used are knowledgeably ordered and evaluated. Under such circumstances, vestibular function testing is always cost-effective and therapeutically useful.

Audiology↗
PubMed1989

Efficacy of alternative tests for delayed-cyclic food hypersensitivity.

With the oral challenge food test (OCFT) used as the standard for delayed-cyclic food hypersensitivity diagnosis, blinded comparison studies were accomplished with 175 in vitro food specific IgE and 180 IgG radioallergosorbent tests, 180 food enzyme-linked immune complex assays, and 155 in vivo Multi-Test prick tests. The study was multi-centered, eight physicians and 37 patients participating. All of the compared tests were shown to be approximately 50% efficient when compared with the OCFT results, and, thus, nonefficacious.

Double-Blind Method↗
PubMed1986

Allergy and the immunologic aspects of otitis media with effusion.

We reviewed the literature since 1980, and discovered that there is a distinct small subset of patients with otitis media with effusion (OME) in whom the middle ear acts as a shock organ for an IgE-mediated, type I allergic reaction. In the majority of patients, however, no direct relationship between the type I reaction and OME can be drawn. Both the type III and type IV reactions are strongly incriminated in the pathogenesis of OME. Much work remains to be done to clarify the exact role of the immune system in OME.

Humans↗
PubMed1985

Site of lesion vestibular function testing.

The results of conventional electronystagmography (ENG) sometimes are confusing. The Hallpike alternate binaural bithermal (ABB) caloric test is helpful diagnostically except for the group of "sick patients that have a normal test." Conventional ENG tests also fall short in the area of objective confirmation of patient progress. What does each test tell us regarding site of lesion? 1. Alternate binaural bithermal stimulation gives us information about the semicircular canals -- particularly the horizontal semicircular canal -- pickup head. 2. Simultaneous binaural bithermal stimulation gives information brain stem connections -- switching and relay. 3. Rotation testing gives information about the processing by the brain -- central control.

Adult↗
PubMed1984

Identification of the APUD endocrine cells of rat fundic mucosa by means of combined amine fluorescence and electron microscopy.

Rat fundic mucosa contains numerous APUD endocrine cells that can take up 5-hydroxytryptophan (5-HTP) and decarboxylate it to 5-hydroxytryptamine (serotonin), detectable by its formaldehyde-induced yellow fluorescence. To identify these cells by electron microscopy, pieces of rat gastric mucosa were incubated with DL-5-HTP. Some specimens were fixed in 4% formaldehyde-0.5% glutaraldehyde, while others were frozen, freeze-dried, and exposed to paraformaldehyde vapors. Thick sections of the Epon-embedded specimens were examined and photographed by fluorescence microscopy, and fluorescing and nonfluorescing cells were identified by electron microscopy in serial thin sections. Control specimens, not incubated with 5-HTP, revealed fluorescence of only the mast cells and EC cells, which were abundant in the pylorus, but rare in fundic mucosa. Specimens incubated with 5-HTP also exhibited numerous yellow fluorescent endocrine cells in fundic mucosa, which cells were found to be the ECL cells; the A-like cells did not fluoresce. In pyloric mucosa, many G and D (D1) cells also exhibited weak or moderate fluorescence after 5-HTP incubation. Thus, this study supports the contention of previous radioautographic studies that the ECL, but not the A-like, cells are the APUD endocrine cells of rat fundic mucosa, that G and D cells also possess some APUD activity, and that EC cells represent the enterochromaffin cells, which normally synthesize and store demonstrable quantities of serotonin.

5-Hydroxytryptophan↗
PubMed1984

Harmonic acceleration as a measure of vestibular compensation.

The results of conventional electronystagmography (ENG) sometimes are confusing. The Hallpike alternate binaural bithermal (ABB) caloric test is helpful diagnostically except for the group of "sick patients that have a normal test". Conventional ENG tests also fall short in the area of objective confirmation of patient progress. What does each test tell us regarding site of lesion? Alternate binaural bithermal stimulation gives us information about the semicircular canals--particularly the horizontal semicircular canal--pickup head. Simultaneous binaural bithermal stimulation gives information about brain stem connections--switching and relay. Rotation testing gives information about the processing by the brain--central control.

Humans↗
PubMed1983

Vestibular function testing: where are we in 1983?

Conceptual, technological, electronic and computer revolutions have transformed the methodology for evaluating the patient with dysequilibrium. What has been said and written for the past 25 years is not currently applicable. Present day, cost effective, clinical evaluation format is presented, including changes and deletions in the conventional ENG test battery. It also includes the addition of computer technology in the rotation and ocular tracking tests. These deletions and additions in technique provide the clinician with more useful practical data for diagnosis. There is also capability for patient follow-up and monitoring. These concepts are presented from the clinical vantage point and are supported with patient evaluation examples.

Caloric Tests↗
PubMed1981

An electron microscopic radioautographic identification of the APUD endocrine cells in the rat gastric pyloric glands.

The rat stomach was shown some years ago to contain numerous endocrine cells with APUD ability--cells that could take up the amino acids L-5-hydroxytryptophan (5-HTP) or L-dihydroxyphenylalanine (L-DOPA) and could decarboxylate them to their respective amines, 5-hydroxytryptamine (5-HT, serotonin) and dopamine, by means of the enzyme DOPA-decarboxylase. In a recent study, most of the APUD endocrine cells in the rat oxyntic mucosa were shown by electron microscopic radioautography to be the enterochromaffinlike cells, while the A-like cells were shown to lack APUD ability. To identify the APUD cells in the pyloric mucosa, pieces of rat pylorus were incubated in organ culture with 3H-5-HTP and were processed for light microscopic and electron microscopic radioautography. Additional specimens were incubated with 3H-5-HTP and carbidopa, an inhibitor of DOPA-decarboxylase, used to block the decarboxylation of 3H-5-HTP to 3H-5-HT, or with 3H-5-HT, used to determine where exogenous 3H-5-HT localizes in the pyloric mucosa. The 3H-5-HTP labeled all three types of endocrine cells identified within the pyloric glands--the G, enterochromaffin, and D cells. As this labeling was inhibited by carbidopa, and as exogenous 3H-5-HT labeled these cells only lightly, the labeling must have resulted from the uptake and intracellular conversion of the 3H-5-HTP of 3H-5-HT. Thus despite their morphologic differences, all rat pyloric endocrine cells possess APUD ability, a property shared by many, but not all, of the peptide- and amine-producing endocrine cells located throughout the body.

5-Hydroxytryptophan↗