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Biomedical subjects

B Feldman

Publications and source records attributed to B Feldman.

At least 37 records · Page 2Linked to original sources
PubMed1998

Intraperitoneal pressures and clinical parameters of total paracentesis for palliation of symptomatic ascites in ovarian cancer.

OBJECTIVE: The present study was designed to prospectively evaluate the intraperitoneal pressure, as well as clinical and hemodynamic effects of total paracentesis, as palliation of symptomatic ascites in ovarian cancer patients. METHODS: Prospective study of 35 sequential total paracenteses was performed using a Veres cannula on patients with advanced recurrent ovarian cancer with symptomatic tense ascites. Relevant clinical symptoms and patient well-being were evaluated. Vital signs, abdominal parameters, and hydrostatic intraperitoneal pressure were recorded before, during, and after the procedure. RESULTS: Intraperitoneal pressure dropped from 30 +/- 7 cmH2O before paracentesis to 13 +/- 6 cmH2O after the procedure (P < 0.0001). Marked symptomatic improvement was observed in all patients (89% complete relief, 11% partial relief), while all the patients tolerated the procedure well without any complications. The mean volume of ascitic fluid removed was 4800 ml. Mean respiratory rate and mean heart rate were both significantly decreased following the procedure (29.3 to 21.4 respirations per min and 101.5 to 93.6 beats per min, respectively). Mean systolic blood pressure mildly decreased (6.6 mmHg), while the mean diastolic blood pressure did not significantly change. None of the patients presented signs or symptoms of hypovolemia during or after the total paracentesis. CONCLUSIONS: Measurement of intraperitoneal pressures during total paracentesis for tense ascites in ovarian cancer patients indicated that the severity of symptoms correlated with the intraperitoneal pressure prior to paracentesis, but not with the volume of ascites. Intraperitoneal pressures measured following total paracentesis in patients with ovarian cancer were similar to the baseline intraperitoneal pressure measured in patients undergoing peritoneal dialysis.

Ascites↗
PubMed1998

Postpartum myocardial infarction induced by methergine.

A 28-year-old woman presented to the emergency department for evaluation of acute chest pain. She lacked risk factors for coronary artery disease and her initial electrocardiogram (ECG) was nondiagnostic. Within 45 minutes of presentation she developed nausea, vomiting, restrosternal chest pain, and ECG changes compatible with an acute inferoposterior myocardial infarction. Emergent cardiac catheterization revealed three-vessel coronary artery ectasia and two-vessel occlusion. She underwent emergency coronary artery bypass grafting. Her myocardial ischemia was believed to have been induced by methergine, which she had been taking over the preceding 3 days. The etiology and pathophysiology of coronary artery ectasia, as well as the cardiovascular effects of methergine and a related drug, ergotamine, are discussed.

Adult↗
PubMed1997

Murine FGF-12 and FGF-13: expression in embryonic nervous system, connective tissue and heart.

The molecular cloning of cDNAs encoding murine fibroblast growth factor-13 (FGF-13/FHF-2) and three isoforms of murine FGF-12 (FHF-1) is described. Like their highly conserved human counterparts, murine FGF-12 and FGF-13 are part of a distinct subfamily of FGF-like proteins characterized by a greater degree of amino acid sequence cross-homology and by conserved N-terminal domains which do not include secretion signal sequences. In addition to their expression in several adult tissues, both of these FGF genes are prominently and regionally expressed in midgestation mouse embryos, as revealed by in situ hybridization. Fgf12 and fgf13. RNAs were detected in developing central nervous system in cells outside the proliferating ependymal layer, and fgf13 RNA was also found throughout the peripheral nervous system. Fgf12 is expressed in developing soft connective tissue of the limb skeleton and in presumptive connective tissue linking vertebrae and ribs. Both FGF genes are also expressed in the myocardium of the heart, with fgf12 RNA found only in the atrial chamber and fgf13 RNA detected in both atrium and ventricle. On the basis of their novel structure and patterns of expression, FGF-12 and FGF-13 are anticipated to perform embryonic functions distinct from other known FGF molecules.

Adult↗
PubMed1997

Seat belt placement resulting in uterine rupture.

A 20-year-old woman with a 27-week intrauterine pregnancy was admitted to a Level II trauma center after a motor vehicle crash. She had a seat belt abrasion over her lower abdomen. Fetal death was established, and subsequent computed tomographic scanning detected uterine rupture with intra-abdominal displacement of the fetus. This finding dispelled any thought of placental abruption and led directly to laparotomy with repair of the uterus and removal of the dead fetus. Recently, and 7 years after the trauma, the patient presented for prenatal care of a new pregnancy. Proper seat belt placement is reviewed and the value of abdominal computed tomographic examination is underscored. An updating comment about airbags is included.

Adult↗
PubMed1996

Stretching of the cervix and stripping of the membranes at term: a randomised controlled study.

OBJECTIVE: To determine whether routine antepartum stretching of the cervix and stripping of the membranes at term would shorten the length of pregnancies, and whether this correlated with cervical status and fetal and maternal parameters. DESIGN: A prospective, randomised, controlled study of 293 term gravidas, free of medical complications, divided into two groups: stretching/stripping, and non-stretching/stripping. Digital separation of the fetal membranes from the lower uterine segment, and cervical stretching, were performed during routine vaginal examination of the first group. In the second group, only routine vaginal examination was performed. RESULTS: Of 293 patients, 152 underwent a trial of stretching and stripping; 141 served as a control group. The mean interval (hours to delivery after the procedure) was 136 h (S.D. 10), compared to 161 h (S.D. 11) in the control group (P = 0.095; not significant), but with only a trend towards the shorter interval in the first group. When patients were matched according to weeks of gestation and fetal and maternal parameters, only those at 41 weeks' gestation or more had a significant reduction in the interval from the procedure to delivery (mean 91 h (S.D. 8) compared to mean 125 h (S.D. 10) in the control group; P < 0.007). This observation was independent of cervical status and other maternal or fetal parameters. CONCLUSIONS: Only patients > or = 41 weeks' gestation benefitted from stretching of the cervix and stripping of the fetal membranes. The effect was not dependent on the cervical status or other maternal and fetal parameters.

Adult↗
PubMed1996

Identity, sexuality and the self in late adolescence.

This paper explores the concepts of identity, sexuality and the self within the context of adolescent development. The development of the identity concept in adolescence is traced in Jung's theoretical, clinical and autobiographical writings. Jung's adolescent development is viewed as the matrix out of which the identity concept emerged within analytical psychology. This was later elaborated theoretically by Jung in Symbols of Transformation (1912/1956). One of Jung's clinical cases of a late adolescent is discussed in which themes related to the development of identity and sexuality emerged. An adolescent case from the author's analytic practice is presented where similar themes of identity, homosexuality and self emerged. The developmental and symbolic themes which emerged in the analysis are viewed within the context of the transference/countertransference relationship.

Adolescent↗
PubMed1996

Comparison of hematologic reference intervals between culture system and type of hybrid striped bass.

OBJECTIVE: To determine and compare hematologic reference intervals for hybrid striped bass from different culture systems and for 2 types of hybrid. DESIGN: Observational comparison study. ANIMALS: Clinically normal sunshine bass (reciprocal hybrid striped bass, female Morone chrysops X male M saxatilis) raised in high-density recirculating systems, sunshine bass raised in tanks with biofilters, and palmetto bass (original hybrid striped bass, female M saxatilis X male M chrysops) raised in tanks with biofilters. PROCEDURES: Hematologic reference intervals were determined for fish from the different production systems, following the National Committee for Clinical Laboratory Standards guidelines. Reference intervals from the 3 groups were compared. RESULTS: Reference intervals were significantly different between sunshine bass in the 2 culture systems and between sunshine and palmetto bass. Many of the differences were slight, but notable differences were observed. Sunshine bass in recirculating systems had higher total leukocyte, lymphocyte, neutrophil, and monocyte counts than did either hybrid in tanks. Palmetto bass had a greater number of neutrophils than monocytes, whereas sunshine bass had more monocytes than neutrophils. Additionally, palmetto bass had a lower PCV and hemoglobin value than did either group of sunshine bass. CONCLUSIONS: Separate reference intervals should be developed for hybrid striped bass in different culture systems and for different types of hybrids. CLINICAL RELEVANCE: Determining reference intervals for hybrid striped bass provides a tool to assess the health status of these fish.

Animals↗
PubMed1996

Blood biochemical reference intervals for sunshine bass (Morone chrysops x Morone saxatilis) in three culture systems.

OBJECTIVE: To determine and compare biochemical reference intervals for sunshine bass (hybrid striped bass) from 3 culture systems. DESIGN: Observational comparison study. ANIMALS: Clinically normal sunshine bass (reciprocal hybrid striped bass, female Morone chrysops x male M saxatilis raised in high-density recirculating systems (80 g/L), low-density tanks (5 g/L) with biofilters, and cages (70 g/L) in a fresh water pond. PROCEDURE: Biochemical reference intervals were determined for fish from the different production systems following the National Committee for Clinical Laboratory Standards guidelines. Reference intervals from the 3 groups were compared. RESULTS: Reference intervals were significantly different between sunshine bass in the various culture systems. Though most of the differences in reference intervals were minor, fish in the high-density recirculating system had higher concentrations of total protein, albumin, globulin, creatinine, and phosphorus, and lower chloride values. There were no significant differences in glucose concentrations among the 3 groups of fish, and no differences in cortisol concentrations between fish in tanks and cages. CONCLUSIONS: Separate reference intervals should be developed for hybrid striped bass in different culture systems. CLINICAL RELEVANCE: Determining biochemical reference intervals for hybrid striped bass provides a tool to assess the health status of these fish.

Alkaline Phosphatase↗
PubMed1995

Requirement of FGF-4 for postimplantation mouse development.

Fibroblast growth factors (FGFs) are thought to influence many processes in vertebrate development because of their diverse sites of expression and wide range of biological activities in in vitro culture systems. As a means of elucidating embryonic functions of FGF-4, gene targeting was used to generate mice harboring a disrupted Fgf4 gene. Embryos homozygous for the null allele underwent uterine implantation and induced uterine decidualization but did not develop substantially thereafter. As was consistent with their behavior in vivo, Fgf4 null embryos cultured in vitro displayed severely impaired proliferation of the inner cell mass, whereas growth and differentiation of the inner cell mass were rescued when null embryos were cultured in the presence of FGF-4 protein.

Animals↗
PubMed1995

Glyburide crosses the placenta in vivo in pregnant rats.

Non-insulin-dependent diabetes mellitus (NIDDM) is normally treated by oral hypoglycaemic agents, but their use is excluded during pregnancy because of their potential teratogenic and hypoglycaemic effects on the fetus. This caveat was recently questioned as glyburide was shown to cross an isolated cotyledon in vitro in insignificant amounts. In the present study, placental transport of glyburide in vivo was examined as an indispensable step towards clinical trials. Tritiated glyburide, C14 albumin or C14-labelled diazepam were injected into 13, 9 and 11 pregnant rats, respectively and the radioactivity was measured thereafter in maternal blood and in whole fetal extracts. The ratios between radioactivity in fetal tissue to that in maternal blood for glyburide (0.535 +/- 0.068) were similar to those of diazepam (0.641 +/- 0.057) which readily crosses the placenta. However, they differed significantly from those for albumin (0.048 +/- 0.0004) which does not cross. Moreover, glyburide in fetal tissue consistently reflected its concentration in maternal blood when measured at consecutive intervals after intravenous injection in the mother. In contrast, albumin in fetal tissue was low at all time points regardless of its levels in maternal blood when measured at different times after injection. These data suggest that glyburide crosses the placenta of pregnant rats and should therefore be considered with caution as a hypoglycaemic agent in the treatment of gestational diabetes.

Animals↗
PubMed1995

Lycopene is a more potent inhibitor of human cancer cell proliferation than either alpha-carotene or beta-carotene.

The antiproliferative properties of lycopene, the major tomato carotenoid, were compared with those of alpha- and beta-carotene. Lycopene, delivered in cell culture medium from stock solutions in tetrahydrofuran, strongly inhibited proliferation of endometrial (Ishikawa), mammary (MCF-7), and lung (NCI-H226) human cancer cells with half-maximal inhibitory concentration of 1-2 microM; alpha- and beta-carotene were far less effective inhibitors. For example, in Ishikawa cells, a 4-fold higher concentration of alpha-carotene or a 10-fold higher concentration of beta-carotene was needed for the same order of growth suppression. The inhibitory effect of lycopene was detected after 24 hours of incubation, and it was maintained for at least three days. In contrast to cancer cells, human fibroblasts were less sensitive to lycopene, and the cells gradually escaped growth inhibition over time. In addition to its inhibitory effect on basal endometrial cancer cell proliferation, lycopene also suppressed insulin-like growth factor-I-stimulated growth. Insulin-like growth factors are major autocrine/paracrine regulators of mammary and endometrial cancer cell growth. Therefore, lycopene interference in this major autocrine/paracrine system may open new avenues for research on the role of lycopene in the regulation of endometrial cancer and other tumors.

Anticarcinogenic Agents↗
PubMed1994

Serum levels of soluble interleukin-2 receptor. A marker of disease activity in localized scleroderma.

OBJECTIVE: To determine whether circulating serum levels of soluble interleukin-2 receptor (sIL-2R) are elevated in patients with localized scleroderma, and if levels of sIL-2R can differentiate between active and inactive disease. METHODS: Seventeen patients with localized scleroderma were categorized by overall physician assessment into active, inactive, and indeterminate groups, according to disease activity. Serum sIL-2R levels were analyzed and correlated with disease activity. RESULTS: The mean sIL-2R level was significantly higher (P = 0.005) in those with active disease (1,675 +/- 823 units/ml) than in those with inactive disease (722 +/- 218 units/ml). CONCLUSION: Serum sIL-2R levels are elevated in patients with localized scleroderma. When present, elevated sIL-2R levels appear to be able to differentiate active from inactive disease. This fact also suggests cell-mediated immune activation in this condition. Further serial studies are required to assess the value and sensitivity of sIL-2R levels in measuring changes in disease activity.

Adolescent↗
PubMed1994

Is hypersomnolence a feature of seasonal affective disorder?

We examined hypersomnolence as experienced among individuals meeting standardized diagnostic criteria for Seasonal Affective Disorder (SAD). Data were available from 115 individuals attending a mood disorders clinic specializing in treatment of this disorder. Three modes of assessment were employed: retrospective self-reports (Seasonal Patterns Assessment Questionnaire), cross-sectional interviews (Standardized Interview Guide for the Hamilton Depression Scale, SAD Version), and prospective sleep diaries. Results indicated that self-reported total hours of sleep varied significantly across the seasons, with longest sleep occurring in winter and shortest sleep in summer. Seasonal sleep changes, as indicated by the SPAQ did not correlate significantly, however, with severity of depressive symptoms as indicated by the Hamilton scale. Multiple regression analyses indicated that only social activity levels (one of seven SPAQ items) was significantly and uniquely related to the severity of depression. When data obtained by the three instruments were compared, self-reported hours of sleep (whether measured by SPAQ or Hamilton interview) were significantly higher than indicated by prospective sleep diaries. We conclude that hypersomnolence may not be a central feature of SAD and that the validity of the SPAQ as an index of this disorder requires further investigation.

Adult↗
PubMed1994

A panel of monoclonal antibodies to rat plectin: distinction by epitope mapping and immunoreactivity with different tissues and cell lines.

A panel of twelve monoclonal antibodies (mAbs) to plectin was analyzed to localize molecular epitopes and assess their utility for various immunotechniques. Based on staining patterns obtained by immunoblotting of proteolytic plectin fragments five groups of mAbs with spatially closely linked epitopes were distinguished. In combination with previous results obtained with recombinant mutant proteins, the epitopes of all mAbs could be shown to reside within three separated domains of plectin's rod domain. Immunoblot analyses of several different rat tissues and a number of cultured cell lines derived from various species, including rat, hamster, cow, mouse and man, revealed considerable variations in immunoreactivity of antibodies. Differences in mAb immunoreactivities were also revealed by immunofluorescence microscopy of different tissues and cultured cell lines. One third of the mAbs examined produced staining patterns that were indistinguishable from those generated by conventional rabbit antisera, confirming the widespread and highly divers cellular localization of plectin previously reported. Microinjection of several monoclonal antibodies into Rat 1 cells had no detectable effects on the structure and organization of plectin arrays or of other cytoskeletal filaments. This new collection of mAbs provides a more reliable tool for histological studies than previously available antisera and should be useful for studies of tissue and cell type specific functions of plectin domains in vivo and in vitro.

Animals↗
PubMed1994

Post-acute rehabilitation outcome: relationship to case-management techniques and strategy.

Successful outcome for the traumatically brain-injured (TBI) patient is dependent on both a productive clinical therapy program and an effective case-management strategy by the carrier. This retrospective study focuses on identifying those case-management techniques which contributed to improvement in the disability, living, and occupational status of patients in a post-acute rehabilitation program. Statistical analysis indicated a positive relationship between two case-management factors and improved patient outcome. Additional analysis demonstrated predictive qualities of specific admission data for patient program cost. A review of these case-management techniques and their impact on discharge disability, living, and occupational status will be discussed.

Adult↗