Biomedical subjects

A Kiss

Publications and source records attributed to A Kiss.

At least 163 records · Page 9Linked to original sources

PubMed1994

[Cystectomy in the management of bladder cancer].

In the course of 20 years 83 patients with tumor of the bladder were treated by cystectomy. The infiltrations of the tumors were 14 pT1, 12 pT2, 44 pT3 and 13 pT4. There were metastatic regional lymph nodes in 11 cases (13%). The urinary diversions were 64 ureterosigmoidostomies, 18 ileal conduits and one cutaneous ureterostomy. The perioperative complication rate was 48% and mortality rate was 12%. The 3-year and 5-year survivals were 50% and 44.4%, respectively. Twenty three patients (28%) died as a result of cancer recurrence. Parallel with the increase in the depth of neoplastic bladder wall infiltrations increases were observed in the rates of lymph node metastates and tumorous mortality while a decrease of survival was noted. Owing to the observed significant differences in survival (3-year survivals 12/23 vs 0/4.5-year survivals 9/20 vs 0/2) and tumorous mortality (9/38 vs 4/6) of the T3a and T3b stage patients the authors think it has to be justified to separate the two patient groups as regarding therapy and prognosis. In T3a cases cystectomy is employed as monotherapy, while for T3b cases also adjuvant chemotherapy is recommended. The prognosis of tumors extending over the bladder wall is extremely poor. An exception to this in the bladder cancer infiltrating the prostate following whose extirpation authors have observed more than ten-year survivals in two cases.

Adolescent↗

PubMed1994

Distribution of glial fibrillary acidic protein-immunopositive structures in the brain of the red-eared freshwater turtle (Pseudemys scripta elegans).

The distribution of glial fibrillary acidic protein (GFAP)-immunoreactivity is described in serial Vibratome sections of the turtle brain. The results are discussed in relation to our previous studies of rat and chicken brains. In the turtle brain, the distribution of GFAP-positive elements is rather evenly abundant as compared to that observed in the chicken and rat. The GFAP-positive structures are fibers of different length and orientation, but the stellate cells are not GFAP-positive. The basic systems is the radial ependymoglia, directed from the ventricles toward the outer surface of the brain. This system also contains some transverse and randomly oriented fibers. The cell bodies are not usually GFAP-positive. The large brain tracts could be recognized by their weak immunostaining, but gray matter nuclei could not be identified on the basis of immunostaining against GFAP. The layers of the optic tectum could be distinguished, as well as the gray and white matter of brain stem and spinal cord and the molecular and granular layers of the cerebellum. In the cerebellum, a fiber system resembling the Bergmann-fibers, a strong midline raphe and coarse transverse fibers could be observed. These latter fibers have no equivalent in other cerebella. Their perikarya proved also to be GFAP-positive, and seemed to be dividing in the adult turtle brain. We conclude that the appearance of GFAP-positive stellate cells had a great importance in the evolution of avian and mammalian brains strengthening the thicker brain walls and assisting in the formation of local differences of GFAP-immunoreactivity in different brain areas.

Animals↗

PubMed1994

Support of the transplant team.

Both patients and staff in a bone marrow transplantation (BMT) unit have to cope with the effects of an aggressive treatment that helps many patients but also kills some. This has led to the regular involvement of support services in most American BMT units. This article describes the experience in 4 years of continuous psychosomatic liaison activity at the BMT unit at the University Hospital in Basel. The specific stressors a transplant team is subject to are described, such as high morbidity and mortality of patients and the close relationship between patients and staff members. Support for the transplant team consists in the following activities: a psychosocial interview with each patient at the beginning of his or her hospital stay; weekly psychosocial round-ups with the whole team; regular participation in ward rounds; organization of workshops to prevent burnout. Although an empirical evaluation of this approach is lacking, the clinical evidence suggests that constant and reliable team support helps to stabilize the team, adding to its inner security. This ultimately improves patient care.

Attitude of Health Personnel↗

PubMed1994

Splenic injury: a rare complication of percutaneous nephrolithotomy.

Splenic injury in the course of percutaneous nephrolithotomy is extremely rare. We report on a splenic perforation and subcapsular haematoma of a female patient who was treated for staghorn stone in the left kidney by percutaneous nephrolithotomy. The splenic injury without external bleeding was diagnosed by ultrasonography and computed tomography. The patient was subjected to splenectomy.

Aged↗

PubMed1994

Evaluation of 88 cystectomies for bladder cancer.

Cystectomies performed in 88 patients with bladder cancer in the course of 20 years had perioperative complications in 47%, mortality in 11%, with a decreasing tendency in the last 10 years. The extent of infiltration of the removed tumours was pT1 in 14 cases, pT2 in 14 cases, pT3 in 47 cases, and pT4 in 13 cases. Regional lymph node metastases were present in 11 cases (12.5%). Three-year survival was 50%, while five-year survival was 44.4%. Twenty-three patients (26%) died because of tumour recurrences. With increasing infiltration of the bladder wall lymph node metastases and tumour-related mortality also increased, while survival decreased. On the basis of the significant differences encountered in the survival and tumour-related mortality of patients with T3a and with T3b tumours, the distinction between the two groups with respect to therapy and prognosis is justified. In T3a tumours cystectomy is applied as monotherapy, while in T3b tumours adjuvant chemotherapy is also indicated. The prognosis of tumours extending beyond the bladder muscles is extremely unfavourable, with the exception of bladder cancers infiltrating the prostate, the removal of which may result in lasting survival in a part of the cases.

Actuarial Analysis↗

PubMed1994

The integration of alternative treatment modalities in HIV infection--the patient's perspective.

The relationship between professionals representing conventional treatment (CT) and professionals representing non-conventional therapies (alternative therapy (AT) and/or psychotherapy (PT)) is usually characterized by mutual scepticism and mistrust, the overriding fear being that either side will evoke unjustified hopes or will provide false treatment. We investigated whether patients with HIV infection had unrealistic hopes in non-conventional treatment (non-CT), to what extent they use non-CT, and whether perceived benefit and harm differ between the two modes of treatment. We examined a sample of 100 patients with documented HIV-infection in the out-patient department using a self-developed questionnaire, the Hospital Anxiety and Depression Scale (HAD) and data concerning the HIV status. Fifty-six patients used AT and/or PT. Severity of HIV disease did not differ between users and non-users of non-CT. The most important reasons for the use of AT were 'strengthening the body and resistance; supplementing conventional therapy'. Users of non-CT rated the competence of CT lower than non-users in solving medical problems (VAS-scores 0-100: 65.5 +/- 17.6 vs 76.3 +/- 17.7; p = 0.003) and in solving emotional problems (VAS scores 0-100: 35.8 +/- 21.2 vs 48.2 +/- 28.9; p = 0.02). Users of non-CT were significantly more anxious 8.4 +/- 4.8 vs 5.5 +/- 4.6; p = 0.004) and more depressive (5.7 +/- 4.5 vs 3.7 +/- 4.5; p = 0.03) than non-users. Expectations and hopes did not differ between users of AT and non-users: main hopes were a delay of disease progression (76% vs 71%) and an alleviation of symptoms (78% vs 66%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

The cuticular localization of integument peptides from particular routing categories.

The distribution of integument peptides in relation to chitin and structural features has been studied in the surface epidermis of the caterpillar of Calpodes ethlius by immunoblotting and immunogold labelling using antibodies prepared to peptides isolated from lamellate endocuticle or from hemolymph. The intermoult cuticle consists of an epicuticle, an endocuticle of many chitin containing lamellae, and a chitin containing assembly zone directly above the apical epidermal microvilli and the perimicrovillar space. During the intermoult, the epidermis secretes peptides constitutively, that is, secretory vesicles containing peptides exocytose without accumulating, traverse the perimicrovillar space and form lamellae in the assembly zone. At moulting, the epidermis deposits ecdysial droplets in addition. These interrupt the last few lamellae which later go on to become the perforated ecdysial membrane. The integument is involved with four routing classes of peptide. Secretion is apical into the cuticle (C), basal into the hemolymph (H), bidirectional (BD), or transported to the cuticle across the epidermis from the hemolymph (T). Some peptides change their routing at moulting. There are several patterns of localization. (1) C and BD cuticular peptides occur mainly in chitin containing lamellate cuticle. (2) Some are also present in epicuticle, and are therefore not obligatorily linked to chitin or matrix between chitin fibers. Cuticular peptides that also occur in the hemolymph are glycosylated, whereas most that are only secreted apically into the cuticle are not. All BD but few C peptides carry alpha-D-glucose/alpha-D-mannose. Some C and BD peptides carry N-acetyl glucosamine. (3) C36 extracted from cuticle has most N-acetyl glucosamine and colocalizes with chitin rather than the protein matrix. It is therefore probably the main link between chitin fibers and the matrix. (4) H235 is barely detectable at the apical cell surface during the intermoult but is abundant at moulting around and below the ecdysial droplets. (5) T66 occurs in intermoult lamellate cuticle. At moulting, alone among the peptides examined, it is in ecdysial droplets. Intermoult C and BD peptides are not in ecdysial droplets but continue to be present in the ecdysial membrane, suggesting that constitutive secretion is independent from the exocytosis of transported moult peptides. T66 differs from most hemolymph peptides in that it does not carry N-acetyl glucosamine or alpha-D-glucose/alpha-D-mannose. (6) Weakly reacting BD peptides (and some H peptides barely detectable in cuticle) localize near the apical surface. Their distribution therefore favours apical secretion and retrieval as a mechanism for basal secretion.

Animal Structures↗

PubMed1994

Co-expression of c-abl and c-myb oncogenes in Philadelphia chromosome-negative, bcr-negative chronic myeloid leukaemia.

Three cases of Philadelphia (Ph) chromosome-negative, bcr-negative chronic myeloid leukaemia (CML) have been investigated for oncogene expression by Northern blot and cytoplasmic RNA dot blot hybridization. Considerably high levels of expression of c-abl and c-myb were observed in all cases. In the Ph-negative cells the normal 6.0 and 7.0 kb c-abl and 3.8 kb c-myb transcripts were found. No amplification of c-abl or c-myb oncogenes was detected in the DNAs of Ph-negative CML cells. Data suggest that co-operation between the overexpressed c-abl and c-myb oncogenes is causally related to Ph-negative bcr-negative CML.

Adolescent↗

PubMed1994

Solid state investigation of mefloquine hydrochloride.

Mefloquine hydrochloride was crystallized under different conditions and the products were studied by thermal analysis, IR spectroscopy and X-ray diffraction. It was demonstrated that different conditions of crystallization resulted in different crystal structures. The alpha- and delta-modifications were hydrates, the beta- and gamma-forms were polymorphs, the epsilon-form was an acetone solvate and theta-mefloquine was tetrahydrofuran solvate. During long storage at room temperature, the alpha-, delta- and theta-forms of mefloquine hydrochloride were transformed. By heat treatment of the delta-, epsilon and theta-modifications, a new crystal structure was obtained.

Calorimetry, Differential Scanning↗

PubMed1994

Clathrin polymerization is not required for bulk-phase endocytosis in rat fetal fibroblasts.

To assess the role of clathrin in the bulk endocytic flow of rat foetal fibroblasts, the rate of internalization of fluid-phase and membrane-lipid tracers were compared, under control conditions and after inhibition of endocytic clathrin-coated pit formation. After intracellular potassium depletion or upon cell transfer into 0.35 M NaCl, the rate of internalization of receptor-bound transferrin and the residual membrane area of plasmalemmal clathrin-coated pits and vesicles were similarly decreased by approximately 90%. In contrast, the initial rate (< 5 min) of intracellular accumulation of the fluid-phase tracer HRP was not affected. Both in control and treated cells, the rate of HRP accumulation declined after approximately 5 min, and was twofold lower in treated cells, due to enhanced regurgitation. After correction for regurgitation, the endocytic rate constant was similar to measurements at shorter intervals and identical in control and treated cells. Similarly, the rate of internalization and the steady-state level of intracellular accumulation of two fluorescent lipid derivatives, 6-[N-(7-nitro-2,1,3-benzoxadiazol-4-yl)amino]hexanoylglucosylsp hingosine (C6-NBD-GlcCer) and 1-[4-(trimethylamino)phenyl]-6-phenylhexa-1,3,5-triene (TMA-DPH), were not affected by potassium depletion, indicating that the endocytic membrane traffic was equally preserved. Finally, the size distribution of primary endocytic particles that were accessible to HRP within 15 s before glutaraldehyde fixation was also indistinguishable in control and potassium-depleted cells. The simplest explanation is that clathrin polymerization is necessary to concentrate receptor-bound ligands in primary endocytic vesicles, but superfluous to the basic endocytic machinery in rat foetal fibroblasts.

Animals↗

PubMed1994

Stress-specific regulation of corticotropin releasing hormone receptor expression in the paraventricular and supraoptic nuclei of the hypothalamus in the rat.

Corticotropin releasing hormone (CRH), a major regulator of pituitary ACTH secretion, also acts as a neurotransmitter in the brain. To determine whether CRH is involved in the regulation of hypothalamic function during stress, CRH receptor binding and CRH receptor mRNA levels were studied in the hypothalamus of rats subjected to different stress paradigms: immobilization, a physical-psychological model; water deprivation and 2% saline intake, osmotic models; and i.p. hypertonic saline injection, a combined physical-psychological and osmotic model. In agreement with the distribution of CRH receptor binding in the brain, in situ hybridization studies using 35S-labeled cRNA probes revealed low levels of CRH receptor mRNA in the anterior hypothalamic area, which were unaffected after acute or chronic exposure to any of the stress paradigms used. Under basal conditions, there was no CRH binding or CRH receptor mRNA in the supraoptic (SON) or paraventricular (PVN) nuclei. However, 2 h after the initiation of acute immobilization, CRH receptor mRNA hybridization became evident in the parvicellular division of the PVN, with levels substantially increasing from 2 to 4 h, decreasing at 8 h and disappearing by 24 h. Identical hybridization patterns of CRH receptor mRNA were found in the parvicellular PVN after repeated immobilization; levels were similar to those after 2 h single stress following immobilization at 8-hourly intervals for 24 h (3 times), and very low, but clearly detectable 24 h after 8 or 14 days daily immobilization for 2 h. On the other hand, water deprivation for 24 or 60 h and intake of 2% NaCl for 12 days induced expression of CRH receptor mRNA in the SON and magnocellular PVN, but not in the parvicellular pars of the PVN.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1994

Convergence of topographic projections to the inferior colliculus from the auditory subcollicular nuclei.

Light and electron microscope studies on experimental material were undertaken in order to identify the composition of sets of specific subcollicular afferents converging to distinct groups of neurons in the inferior colliculus and the morphological characteristics of their parent cells. Microinjections of the retrograde tracer HRP placed in gride-like distribution into the CNIC revealed topographical order and quantitative differences in the convergence of axon projections from specific regions of the VCN, DCN, MSO, LSO, VNLL and DNLL. Pilot studies indicated very low number of labelled neurons and without discernible topographic arrangement in the auditory brain-stem nuclei, when the microinjections were in or largely in the cortical or external nuclei of the inferior colliculus. Neurons occupying the ventromedial quadrant of CNIC receive converging contralateral input projections from the dorsal part of the DCN, dorsomedial half of the LSO, and DNLL as well as ipsilateral connections from the ventral part of the VNLL, DNLL and the dorsal half of the MSO. The set of converging afferents to neurons in the ventrolateral quadrant of CNIC arises from the contralateral part of the VCN, the DNLL and from the ipsilateral ventral part of the VNLL, dorsal part of the MSO and the dorsolateral half of the LSO. Projections to cells of the dorsomedial and dorsolateral quadrants are mirror images of those to the ventral ones across the transverse axis of the CNIC.

Animals↗

PubMed1994

[Vesico-vaginal fistula after abdominal hysterectomy. Use of the Legueu technique].

Vesicovaginal fistulas are commonly seen as a complication of abdominal (or vaginal) Hysterectomy. The signs and symptoms of a vesicovaginal fistula depend upon its size and location. Identification of a vesicovaginal fistula includes an intravenous urogram; cystoscopy may be performed in order to evaluate the possibility of immediate or delayed repair. Case report. Principles of surgical repair. The principles of surgical closure are similar: 1) total separation of the tissues comprising the wall of the vagina and the wall of the bladder; 2) sharp excision of the fistulous tract between to two structures; 3) closure of the defects with non-overlapping suture lines; 4) where possible, interposition of alternative tissue between the two suture lines. The intervention proposed by Legueu allows an abdominal transperitoneal approach to the fistula and is comprehensive of these principles. With such a procedure we have treated successfully two cases which required surgical closure. CONCLUSIONS. In patients who develop vesicovaginal fistulas as a complication of abdominal hysterectomy, we have applied the intervention proposed be Legueu, which allows closure of the fistula via a transperitoneal route. Preliminar diagnostic evaluation and following of the foundamental principles of correct surgical closure are indispensable to accomplish a successful intervention.

Adult↗

PubMed1994

Prognostic significance of bone marrow reticulin fibres in idiopathic myelofibrosis: evaluation of clinicopathological parameters in a scoring system.

A clinicopathological scoring system was performed for obtaining a better estimate of prognosis in 50 patients with idiopathic myelofibrosis (IMF). Laboratory parameters including Hb-level, leukocyte and platelet counts, percentage of blast cells in peripheral blood, spleen and liver size, and a semiquantitative histological grading of reticulin fibre content of bone marrow biopsies taken at the time of initial diagnosis were analysed. Based upon these haematological and histological parameters three prognostic groups could be categorized with a significantly different survival (low-risk group with 21 patients = 75 months; medium-risk group with 18 patients = 51 months, and 11 patients in a high-risk group = 18 months). In an univariate (log rank test) and in a multivariate regression analysis the Hb-concentration, mild splenomegaly (less than 5 cm) and a higher grade of bone marrow reticulin content proved to be important prognostic parameters, whilst leukopenia, thrombocytopenia and the presence of peripheral blast cells were only of prognostic significance within the first 6 months from initial diagnosis. It was concluded that the increase of reticulin fibre deposition in bone marrow together with anaemia and mild splenomegaly could be responsible for a progressively worse life-expectancy of high-risk patients with idiopathic myelofibrosis.

Adult↗

PubMed1994

[Retroperitoneal abscesses: clinical and therapeutical aspects].

The authors explain the clinical and anatomical features of retroperitoneal abscesses, which occur less commonly than peritoneal infections. Retroperitoneal abscesses arise chiefly from injuries in adjacent structures, but they may be primary when caused by hematogenous bacterial spread. The pyogenic bacteria have replaced Mycobacterium tuberculosis as the major causative organism. Retroperitoneal abscesses may be symptomless, but fever and abdominal pain are prominent features. The differential diagnosis includes retroperitoneal tumors and hematomas. These lesions are best delimited by CT scanning which localizes them accurately. The treatment consists in a prompt and adequate drainage and systemic antibiotics therapy. Drainage by catheter, however, has a lower success rate than the surgical approach. The surgical mortality rate is about 25%.

Abscess↗

PubMed1994

[Postoperative pulmonary thromboembolism].

The authors report their finding concerning the frequency of postoperative pulmonary thromboembolism in an autopsy series of subjects who had died with 15 days of surgery. In all cases the relationship was evaluated between death and age, sex, the underlying pathology and the type of surgery.

Adolescent↗

PubMed1994

[Use of ultrasonic surgery in laparoscopic cholecystectomy].

INTRODUCTION: Laparoscopic cholecystectomy now represents a valid alternative to traditional surgery in the treatment of gallstone diseases. For the past twenty years laparotomic cholecystectomy has represented the golden standard of gallstone treatment given its extremely low mortality rate (0.5%) and equally acceptable morbidity rate. Laparoscopic cholecystectomy now appears to have taken over the position of elective treatment. Sophisticated techniques, such as ultrasound scalpels make this form of surgery particularly safe. MATERIALS AND METHODS: The authors report a series of 50 patients who underwent laparoscopic cholecystectomy in which ultrasound surgery was used in 40 cases using the CUSA system. The gallbladder hilus is prepared using ultrasound manipulation following the secure identification, respect and clipping of the cystic artery and duct. DISCUSSION AND CONCLUSIONS: Laparoscopic cholecystectomy appears to be the ideal treatment for gallstone diseases. In the series reported here the use of the ultrasound scalpel allowed the gallbladder hilus to be reach skeletization, preserving the main structures and keeping the operating field clean and blood-free, without increasing operating times. The possibility of severe accidents, such as vascular lesions to the hepatic artery or vena portae, or damage to the common bile duct or other abdominal organs are reduced using this technique.

Adult↗

PubMed1994

Hypnosis and the allergic response.

In recent years our knowledge of the immune system and the pathogenesis of immune disorders has increased. There has been much research on the complex connections between the psyche, the central nervous system and the immune system and the effect of mood on disease processes. This paper reviews the evidence on the effects of hypnosis on the allergic skin test reaction, on allergies, particularly respiratory allergies and hayfever, and on bronchial hyperreactivity and asthma. Hypnosis, which is generally regarded as an altered state of consciousness associated with concentration, relaxation and imagination, and amongst other characteristics an enhanced responsiveness to suggestion, has long been thought to be effective in the amelioration of various bodily disorders. It has seemed that the state of hypnosis is capable of a bridging or mediating function in the supposed dualism between mind and body. There has been great variation in the experimental and clinical procedures such as type of hypnotic intervention employed, the training of subjects and the timing of the intervention. Also, variability in the type of allergen used and its mode of application is evident. But despite these limitations, many of the studies have shown a link between the use of hypnosis and a changed response to an allergic stimulus or to a lessened bronchial hyperreactivity. There is as yet no clear explanation for the effectiveness of hypnosis, but there is some evidence for an influence on the neurovascular component of the allergic response.

Asthma↗