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Biomedical subjects

A Paz

Publications and source records attributed to A Paz.

At least 55 records · Page 3Linked to original sources
PubMed1997

Effect of meal composition on alertness and performance of hospital night-shift workers. Do mood and performance have different determinants?

We have studied the effect of diet composition on performance during, and after night-shift work. On three occasions 21 night workers at the Hadassah University Hospital, Jerusalem ate one of three meal plans--a diet enriched with protein (PROT 52%), carbohydrate (CHO 70%) or their regular (REG) diet (PROT 18%, CHO 55%); fat composition was held constant (ca. 27%). Outcome measures were subjective alertness, psychometric performance, and plasma concentrations of glucose, insulin and amino acids. Insulin and glucose levels were similar after the different diets. There were no clear relationships between tyrosine and tryptophan ratios and performance. However, within PROT diet, differences in psychometric performance correlated with glucose (p = 0.05) and insulin concentrations (p = 0.04), and the tyrosine:large neutral amino acid ratio correlated with alertness (p = 0.05). After the CHO diet, glucose concentrations related to sleepiness (p = 0.035). In this population, self-selected for night-shift work, there were no clear-cut differences in subjective feelings or objective performance between the different diets. The preferred regular diet gave the best performance and had a metabolic profile similar to the CHO diet. This suggests that a CHO:PROT ratio of around 3.0 might give the optimal balance between mood and performance during night-shift work.

Adult↗
PubMed1997

A genetic sequence change in the 3'-noncoding region of the androgen receptor gene in prostate carcinoma.

OBJECTIVE: We intended to identify structural changes in the hormone-binding domain and C-terminal region of the androgen receptor (AR) gene in carcinoma of prostate specimens. METHODS: Twelve prostate cancer specimens from prostate resections were analyzed for the presence of mutations in the E-H exons and part of the 3'-untranslated region of the AR cDNA, using RT-PCR and direct sequencing. RESULTS: A polymorphic sequence spanning 17 nucleotides was identified in the 3'-untranslated region of the AR cDNA from one prostate carcinoma tissue, suggesting the presence of a somatic mutation. No mutations were identified in the coding sequence of the hormone-binding domain of the AR cDNA. CONCLUSION: These results suggest that AR mutations are probably uncommon molecular events in the early stages of prostate cancer.

Adenocarcinoma↗
PubMed1997

Transvesical prostatectomy in elderly patients.

PURPOSE: We assessed the results of transvesical prostatectomy in patients older than 80 years. MATERIALS AND METHODS: We studied 98 patients 80 to 90 years old who underwent transvesical prostatectomy between 1986 and 1993, including those with a large prostate (preoperative estimated weight more than 80 gm.), numerous or large cystolithiasis and large bladder diverticulum, which are indications for open prostatectomy. Clinical data were obtained by chart review. RESULTS: The indications for surgery were urinary retention in 53 patients (54%), severe obstructive urinary symptoms in 18 (18.4%), cystolithiasis in 17 (17.3%), prostatic bleeding in 10 (10.2%) and bladder diverticulum in 2 (2%). Accompanying diseases were present in 69 patients (70.6%), including ischemic heart disease in 41 (42%), diabetes mellitus in 17 (17.3%) and arterial hypertension in 14 (14.3%). A total of 59 patients (60.2%) underwent surgery while under general anesthesia and 39 (39.8%) received regional anesthesia. Average operative time was 62 minutes. Of the patients 40 (40.8%) received 1, 14 (14.3%) received 2 and 2 (2%) received 4 units of blood. No postoperative deaths or life threatening complications were noted. The immediate postoperative complications included urinary tract infection in 20 patients (20.5%), wound infection in 3 (3.0%) and orchiepididymitis in 3 (3.0%). Postoperative mild to moderate incontinence was noted in 2 patients (2.0%). Bladder neck constriction and urethral strictures occurred in 4 (4.1%) and 3 (3.0%) patients, respectively. CONCLUSIONS: Transvesical prostatectomy can be performed safely in elderly patients with a low morbidity rate.

Age Factors↗
PubMed1997

Postejaculation serum prostate-specific antigen level.

OBJECTIVE: This study was carried out to determine whether ejaculation may modify the serum prostate-specific antigen (PSA) level and to investigate whether postejaculation serum PSA may play a role in male hypofertility work-up. METHODS: Serum PSA concentration was determined before and 1 h after ejaculation in 18 healthy men (group A) and in 16 men with male-factor infertility (group B). PSA change (delta) was recorded and analyzed. RESULTS: Postejaculation serum PSA differed significantly from basal levels (p = 0.0037 by the Wilcoxon signed rank test). Following ejaculation, a rise was noticed in 74% of subjects. The median relative change in PSA concentration was 54%. No difference in respect to mean, median and relative change was observed between study groups. In two cases (6%), PSA rose from normal level to more than 4 ng/ml. CONCLUSION: A significant postejaculation serum PSA elevation does occur, it is thus recommended that men abstain from ejaculation for 24 h prior to PSA sampling. Postejaculation PSA was not found to significantly correlate with hypofertility.

Adult↗
PubMed1996

[Late solitary metastases of breast origin presenting as primary colonic carcinoma].

The case of a 72-year-old woman with 2 solitary metastases to the colon of breast origin with mimicked primary colonic cancer is presented. The primary breast lesion was an infiltrating duct carcinoma and the metastases to the colon were discovered 6 years later. Some of the regional lymph nodes draining the colon were infiltrated by tumor, probably originating from the 2 colonic metastases. This is an unusual condition that has not as yet yet been reported.

Aged↗
PubMed1996

The pattern of radionuclide scrotal scan in torsion of testicular appendages.

The aim of this study was to define the radionuclide scrotal imaging (RSI) pattern in cases of torsion of testicular appendages and to correlate it with the duration of symptoms. Two hundred and seventeen patients with acute scrotal pain were evaluated prospectively during the past 13 years. Two groups of patients were defined according to the interval between the onset of symptoms and the performance of RSI: group A comprised patients in whom RSI was performed within 5 h after the onset of symptoms, while group B comprised patients in whom RSI was performed between 5 and 24 h after the onset of symptoms. An SPX-4 Elscint or an Apex 405 gamma camera with a parallel hole or converging collimator was used. Between 5 and 15 mCi of technetium-99m pertechnetate was injected as a bolus intravenously. The radionuclide angiogram consisted of six to eight consecutive 5-s frames. The scrotal static scan was obtained immediately following the radionuclide angiogram. The "hot dot" sign, which is a small spot of increased tracer perfusion and uptake on RSI, was not present during the first hours after the onset of symptoms. Therefore, RSI is inaccurate and is not indicated for the diagnosis of torsion of testicular appendages of less than 4-5 h duration. The hot dot sign was, however, demonstrated on the RSI in 45% of the patients with scrotal pain lasting between 5 and 24 h. The overall sensitivity and accuracy of RSI in diagnosing torsion of testicular appendages in this group of patients were 68% and 79%, respectively. In all the patients with a positive hot dot sign, torsion of testicular appendages was found at exploration (specificity 100%). Therefore, the hot dot sign was found to be pathognomonic of torsion of testicular appendages.

Adolescent↗
PubMed1996

A computer-assisted molecular epidemiologic approach to confronting the reemergence of tuberculosis.

Molecular epidemiologic approaches have provided important insights into the pathogenesis and epidemiology of tuberculosis. However, continued progress in this field will be reliant on the development of computerized information management systems capable of analyzing large numbers of bacterial DNA fingerprints and incorporating this with data collected as part of conventional disease surveillance. The specific attributes of these computer systems must be tailored to the nature and scope of the research question. In this article, the authors describe a system being used for the surveillance of Mycobacterium tuberculosis strains in San Francisco. The current performance characteristics are described, and potential future developmental directions are outlined. This system demonstrates several general principles of computerized molecular epidemiology that are likely to be of increasing applicability to a variety of pathogens.

Computer Simulation↗
PubMed1996

Late solitary pancreatic metastasis from renal cell carcinoma.

A 76-year-old woman was admitted for a pancreatic mass. Twenty-one years previously she had undergone a left nephrectomy for renal cell carcinoma. A computerized tomography-guided needle biopsy of the pancreatic mass raised the suspicion of metastatic renal cell carcinoma. Final pathologic examination of the resected mass after distal subtotal pancreatectomy confirmed the preoperative diagnosis of metastatic renal cell carcinoma.

Aged↗
PubMed1996

[Complete cytogenetic remission of chronic myeloid leukemia with low-dose interferon alfa-2b and monthly high-dose busulfan].

Two patients with chronic myelogenous leukaemia were treated according to an original regimen consisting of the association of alpha-2b interferon, three days a week, plus hydroxyurea during ten months, followed by interferon (same doses) and intermittent high doses of busulphan (50 mg, one dose per month, up to 6 doses). Both patients achieved minor cytogenetic remission in the first stage (50% and 80% of Ph'-positive metaphases, respectively). Upon concluding the second phase, one patient attained complete cytogenetic remission and the other showed major cytogenetic remission (3% Ph'-positive metaphases); complete remission was achieved in the second patient after 4 more doses of busulphan. Both patients remain in complete cytogenetic remission after 4 and 2 years, respectively, with three weekly doses of interferon as maintenance therapy. This protocol is quite different to others applied so far and might represent a good choice for patients unsuitable for bone marrow transplantation.

Adult↗
PubMed1995

[Testicular metastasis from transitional cell carcinoma of the bladder].

We present a 54-year-old man with a testicular metastasis originating from a transitional cell carcinoma of the urinary bladder. Initially, radical cystectomy and ileal-conduit urinary diversion were performed, followed 9 months later by urethrectomy for local recurrence. A year later he presented with a tumorous right testis proved to harbor transitional cell carcinoma.

Carcinoma, Transitional Cell↗
PubMed1995

The value of radionuclide scrotal imaging in the diagnosis of acute testicular torsion.

OBJECTIVE: To assess the accuracy of radionuclide scrotal imaging (RSI) in the diagnosis of testicular torsion and torsion of testicular appendages. PATIENTS AND METHODS: Eighty-seven patients (mean age 30.1 years, range 8-65) who presented with acute scrotal pain were evaluated by RSI and the results correlated with the clinical and surgical findings. RESULTS: Of the 87 patients, 44 underwent scrotal exploration and 42 patients were treated conservatively. One patient with a 'missed torsion' pattern on RSI refused operation and was lost to follow-up. Of the 44 patients who underwent surgery, testicular torsion was found in 30 and torsion of testicular appendages in 14 patients. The specificity of the RSI in diagnosing testicular torsion was 100% and the sensitivity was 98%. An area of increased tracer activity in the presence of a normal radionuclide angiogram was suggestive of torsion of testicular appendages with a specificity of 93%. Of the 42 patients who were treated conservatively, 19 had epididymitis, according to clinical and RSI findings, 10 had torsion of testicular appendages, two had orchiepididymitis, two had hydrocele, two had haematocele and seven patients had normal testes. At a follow-up examination, normal testicles were found in all 42 patients. CONCLUSION: The RSI may assist in the evaluation of nontraumatic acute scrotum, and can clearly distinguish among testicular torsion, torsion of testicular appendages and epididymitis.

Adolescent↗
PubMed1995

[Hereditary hemorrhagic telangiectasia presenting with hematuria and severe anemia].

A patient with hereditary hemorrhagic telangiectasia was admitted with hematuria and severe anemia after mild recurrent episodes of epistaxis. Telangiectasias were found in the skin and buccal and nasal mucosa. No defect in the coagulation mechanism was found; thrombocyte count and function were normal. On cystoscopy, tortuous engorged vessels, some actively bleeding, were seen in the trigonal mucosa. Biopsy showed enlarged vessels in the lamina propria. Electrocoagulation of the bleeding vessels stopped hematuria, but 6 months later it recurred. This time Nd-YAG laser was used to stop the bleeding after electrocoagulation was ineffective.

Adult↗
PubMed1994

The epidemiology of tuberculosis in San Francisco. A population-based study using conventional and molecular methods.

BACKGROUND: The epidemiology of tuberculosis in urban populations is changing. Combining conventional epidemiologic techniques with DNA fingerprinting of Mycobacterium tuberculosis can improve the understanding of how tuberculosis is transmitted. METHODS: We used restriction-fragment-length polymorphism (RFLP) analysis to study M. tuberculosis isolates from all patients reported to the tuberculosis registry in San Francisco during 1991 and 1992. These results were interpreted along with clinical, demographic, and epidemiologic data. Patients infected with the same strains were identified according to their RFLP patterns, and patients with identical patterns were grouped in clusters. Risk factors for being in a cluster were analyzed. RESULTS: Of 473 patients studied, 191 appeared to have active tuberculosis as a result of recent infection. Tracing of patients' contacts with the use of conventional methods identified links among only 10 percent of these patients. DNA fingerprinting, however, identified 44 clusters, 20 of which consisted of only 2 persons and the largest of which consisted of 30 persons. In patients under 60 years of age, Hispanic ethnicity (odds ratio, 3.3; P = 0.02), black race (odds ratio, 2.3; P = 0.02), birth in the United States (odds ratio, 5.8; P < 0.001), and a diagnosis of the acquired immunodeficiency syndrome (odds ratio, 1.8; P = 0.04) were independently associated with being in a cluster. Further study of patients in clusters confirmed that poorly compliant patients with infectious tuberculosis have a substantial adverse effect on the control of this disease. CONCLUSIONS: Despite an efficient tuberculosis-control program, nearly a third of new cases of tuberculosis in San Francisco are the result of recent infection. Few of these instances of transmission are identified by conventional contact tracing.

AIDS-Related Opportunistic Infections↗
PubMed1993

Prenylated protein methyltransferase of rat cerebellum is developmentally co-expressed with its substrates.

High levels of prenylated protein methyltransferase are expressed in the developing rat cerebellum and are responsible for methylation of endogenous G-proteins and 50-52 kDa synaptosomal proteins. Enzyme activity in cerebellar synaptosomes of 3 week postnatal rats is 2-fold higher than that found in adult rat cerebellum. A 10-fold rise in activity occurs at the end of the second and during the third postnatal weeks, followed by a subsequent decline. Expression of the enzymes' substrates follows the same pattern. The high methyltransferase activity in 3-week-old cerebellum coincides with the period of granule cell migration and synaptogenesis, suggesting a regulatory role for the enzyme and its substrates in cerebellar ontogenesis.

Aging↗
PubMed1993

The uniquely distributed isoprenylated protein methyltransferase activity in the rat brain is highly expressed in the cerebellum.

Isoprenylated protein methyltransferase, the enzyme which catalyzes the reversible methylation of signal transducing G-proteins was studied in nine brain regions of the rat brain using S-farnesyl cysteine analogs as substrates. Enzyme activity, as determined with N-acetyl-S-farnesyl-L-cysteine (AFC) was found in the nuclear, synaptosomal and microsomal fractions of all brain regions but not in the cytosol. The enzyme is a unique methyltransferase with respect to its brain distribution. The rank order of activity of the enzyme is cerebellum >> midbrain > medulla > forebrain regions, where activities in cerebellar synaptosomal and nuclear fractions (28-32 pmol AFC [methyl-3H]ester formed/min/mg prot) are 20 to 30 times higher than those of the corresponding fraction of the forebrain regions. This distribution is reminiscent of that of neurotransmitter receptors and signal transduction molecules and suggests a regulatory role for the enzyme, particularly in the cerebellum.

Animals↗
PubMed1986

Phage and host genetic determinants of the specific anticodon loop cleavages in bacteriophage T4-infected Escherichia coli CTr5X.

Anticodon loop cleavages of two host tRNA species occur in bacteriophage T4-infected Escherichia coli CTr5X, a host strain restricting phage mutants deficient in polynucleotide kinase (pnk) or RNA ligase (rli). The cleavage products accumulate with the mutants but are further processed in wt infection through polynucleotide kinase and RNA ligase reactions. Inactivating mutations in stp suppress pnk- or rli- mutations in E. coli CTr5X and, as shown here, also abolish the anticodon nuclease, implicating the stp product with this activity. We show also that there exist other suppressing mutations of a pnk- (pseT2) mutation that appear not to affect the anticodon nuclease and are not in stp. It has been shown that a single locus in E. coli CTr5X, termed prr, determines the restriction of pnk- or rli- mutants. A transductant carrying prr featured upon infection the anticodon nuclease reaction products, suggesting that prr determines the specific manifestation of this activity. However, prr does not encode the tRNA species that are vulnerable to the anticodon nuclease.

Anticodon↗
PubMed1984

[Vegetative dystrophic epidermolysis bullosa. Urogenital manifestations and treatment with hydantoin].

Dystrophic epidermolysis bullosa has a rare recessive polydysplastic vegetant variant, which was described by Nicolas et al. Two siblings are reported. The male was affected by urethral lesions, an exceptional finding in this disease. Many members in family died of renal insufficiency . A variety of therapeutics was indicated along ten years. Only hydantoins caused a marked involution of the lesions. An interesting feature was that high drug levels in the blood produced not only common side effects, such as macrulia , but also exacerbation of the dermatosis and growth of new lesions, which took on a botriomicoid aspect.

Adolescent↗