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Biomedical subjects

C Rosa

Publications and source records attributed to C Rosa.

At least 55 records · Page 3Linked to original sources
PubMed1993

Resident training in a multidisciplinary breast clinic.

A multidisciplinary breast clinic was initiated at William Beaumont Army Medical Center involving resident and staff physicians from the Departments of Obstetrics and Gynecology, General Surgery, Radiology and Pathology. During the period August 1988 to May 1989, 2,186 mammograms (MOGs) were screened. For this report, 197 patients were evaluated. Of them, 187 patients had been referred to the breast clinic based on MOG findings. Pathologic specimen correlation with the mammograms was performed on a periodic basis. Thirty-four patients were biopsied based on either physical examination or MOG findings. Biopsy diagnoses included: normal tissue (1), fibrocystic disease (18), sclerosing adenosis (1), fibroadenoma (8), mastitis (1) and intraductal carcinoma (5). The Multidisciplinary Breast Clinic provided improved care through expedited patient management. Resident training was accomplished through refinement of examination and diagnostic skills, management of abnormal MOGs, needle aspiration of breast masses and improved communication between the different medical disciplines.

Breast Diseases↗
PubMed1992

[The structural aspects of the pharmacological activity of calcium antagonists. A general profile and the results of a pilot study of nicardipine].

The authors examine the most recent findings on arterial hypertension with particular emphasis to morphological changes of the arterial wall and to the results of nicardipine treatment in spontaneous hypertensive rats (SHR). According to these assumptions the authors evaluate the effects of nicardipine on the microvascular network by means of a funduscopic examination in 8 hypertensive patients. The preliminary data suggest that nicardipine has a positive structural and morphological effect on the vessel network.

Delayed-Action Preparations↗
PubMed1991

Comparison of Novak and Pipelle endometrial biopsy instruments.

A randomized study compared the Novak and Pipelle endometrial biopsy instruments with respect to quality of the biopsy obtained and pain related to the procedure. Fifty-five subjects were randomized to one of two groups. Twenty-six women had a biopsy using the Pipelle, followed immediately by one using the Novak instrument; 29 had the procedures performed in the reverse sequence. After the procedures, each woman completed a pain questionnaire. Individual histology slides were reviewed in a blinded fashion. The two biopsies from each subject were paired, and a reviewer indicated the preferred type of biopsy. The scores were analyzed by nonparametric tests. The instruments yielded biopsies of similar quality (z = -0.18, P = .856). Pain scores were lower for the Pipelle (z = -3.40, P = .001). The pathologist showed no preference when choosing Novak or Pipelle slides (chi 2 = 2.08, P = .149). In our patient population, the Pipelle instrument was comparable to the Novak instrument in obtaining adequate tissue and was significantly less painful.

Adult↗
PubMed1990

Effect of ketanserin on pain perception in arterial hypertension.

An association between increased tolerance to pain and arterial hypertension has been reported in experimental animals and confirmed in humans. The underlying mechanisms remain elusive. We have recently reported that diuretics and beta-blocking treatment do not influence pain sensitivity, despite significant reductions in arterial blood pressure. In the present study, ketanserin was evaluated. As in previous work, pain perception was assessed with a tooth pulp tester. Ten hypertensive subjects were studied basally, after 15 days and after 3 months of ketanserin treatment (20 mg twice daily). Significant reductions in arterial blood pressure and of pain thresholds were observed, but no correlation between these changes occurred. These preliminary data indicate that, contrary to other hypotensive drugs, ketanserin tends to decrease or reverse the abnormality in pain modulation observed in hypertensive patients. The lack of a correlation between effects on blood pressure and pain sensitivity seems, however, to favor the hypothesis of two independent underlying mechanisms.

Adult↗
PubMed1990

Education on breast disease in an obstetrics and gynecology training program: a multidisciplinary approach.

Breast cancer affects one in ten women during their lifetime. Recognizing the importance of early detection in the prognosis of this condition, the American Board of Obstetrics and Gynecology has stated guidelines encouraging breast disease education in obstetrics and gynecology training programs. To fulfill this academic responsibility, we have organized a multidisciplinary Breast Disease Detection and Treatment Clinic where patients with abnormal mammograms or any breast-related complaints are evaluated and managed. In cooperation with the radiology department and general surgery service, a mammogram review conference has been instituted. Abnormal mammograms are reviewed with a radiologist. Our activities have been coordinated such that a general surgery staff member and resident are present during the breast clinic hours to review mammograms and to examine the patients with the gynecologist, providing immediate consultation. Needle aspiration of breast cysts, repeat imaging studies, and general surgery referrals for breast biopsies are performed as indicated. The patient receives integrated care of her breast problem in one visit, and our residents gain the experience of diagnosing and managing breast problems which, before establishment of this clinic, were referred to the general surgery department. This multidisciplinary approach developed in our institution helps us provide the most efficient care to our patients, while providing our residents with integrated teaching and training concerning the diagnosis and management of breast disease.

Ambulatory Care Facilities↗
PubMed1990

Routine screening for hepatitis B in an obstetric population.

A prospective study was performed to determine whether the Centers for Disease Control (CDC) risk factors for hepatitis B are reliable predictors of the hepatitis B surface antigen carrier state in an obstetric population. At their initial obstetric visit, 1466 consecutive patients had their serum screened for hepatitis B surface antigen by radioimmunoassay. During the initial interview, the physician obtained information regarding the presence of any of the CDC risk factors for hepatitis B (ethnicity or history of venereal disease, blood transfusion, hepatitis exposure, hepatitis, drug abuse, or occupational exposure). Twelve women were found to have positive hepatitis B surface antigen, for a prevalence of 0.82%. Six of these 12 had risk factors. Five had high-risk ethnic background, two of whom also had a history of hepatitis. One health care worker, a nurse, was also positive for hepatitis B surface antigen. The other six patients had no recognized risk factors. If hepatitis B surface antigen had been evaluated according to the CDC risk-factor guidelines, half of hepatitis B surface antigen-positive patients would not have been identified.

Female↗
PubMed1989

Prolactin and thyrotropin responses to nursing during the early puerperium.

This study investigated the possible role of thyrotropin-releasing hormone (TRH) as a physiologic prolactin-releasing factor by measuring prolactin (PRL) and thyrotropin (TSH) responses to nursing. Eight women had serum samples drawn at 15-minute intervals for 1 hour while nursing during three separate periods in the hour while nursing during three separate periods in the first month postpartum. The samples were frozen and assayed in a single batch for PRL and TSH. Mean PRL levels during suckling increased greater than 50% over baseline values in all three sampling sessions. In contrast, suckling had no effect on circulating TSH. Our data fail to support the previously reported observation of a release of TSH in response to nursing and provide further indirect evidence that TRH is not responsible for the brisk release of PRL with suckling.

Adolescent↗
PubMed1989

Biosynthesis of the protein encoded by the c-met proto-oncogene.

The proto-oncogene c-met encodes a transmembrane protein with structural features of a growth factor receptor. We have previously shown that the c-met protein (c-Met) is a heterodimer of two disulphide linked chains of 50 kd (alpha) and 145 kd (beta). In this work we have studied the biosynthesis of the c-met product in a gastric carcinoma cell line (GTL-16) where the c-met gene is amplified and overexpressed. Following metabolic labelling of the cells in the presence of tunicamycin, anti-met antibodies immunoprecipitate a protein of 150 kd. In pulse-chase experiments carried out in the absence of tunicamycin, a 170 kd product appears first. Within the next few minutes, this precursor modifies its SDS migration, probably as a consequence of modification(s) of its intra-chain disulphide bonds. After 45 min of chase, this single polypeptide precursor is cleaved to form a 50 kd alpha subunit and a 145 kd beta subunit that are joined by disulphide bonds in an alpha beta complex with an apparent molecular weight of 190 kd. The presence of N-linked oligosaccharides in both the precursor and the mature protein was shown by enzymatic de-glycosylation of the immunoprecipitated proteins. The half-life of the mature protein was calculated to be approximately 5h. The c-met protein has similar structure and biosynthesis in other human cell lines.

Cell Line↗
PubMed1988

Arterial hypertension is associated with hypalgesia in humans.

An association between increased blood pressure and hypalgesia has been reported in several studies in animals and in a few reports in humans. We investigated the relationship between hypertension and pain perception by comparing the response to graded electrical stimulation of the tooth pulp, which is thought to represent an exclusively nociceptive system. The test was performed with a commercial tooth pulp tester in a large series of subjects with borderline or established hypertension and in three groups of normotensive controls: volunteers, nonhypertensive patients, and medical students with a well-established or no family history of hypertension. Subjects had to report when they started to feel pulp stimulation (sensory threshold) and when this became painful (pain threshold). Sensory and pain thresholds were obtained as means of the measurements on four healthy, unfilled teeth. Sensory thresholds were significantly higher in subjects with borderline or established hypertension than in two of the three normotensive groups (volunteers and normotensive patients), whereas no significant difference was observed between the two hypertensive groups. The results for the pain threshold were qualitatively similar but less clear and less amenable to statistical analysis because this parameter could not be determined with accuracy in a number of subjects in whom the subjective pain threshold was above the upper range of stimulation of the instrument. The association between blood pressure levels and pain perception was further confirmed by the highly significant correlation found for the overall data between mean arterial blood pressure and both thresholds.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Relationship between pain sensitivity, cardiovascular reactivity to cold pressor test and indexes of activity of the adrenergic and opioid system.

An association between increased blood pressure levels and hypoalgesia has been reported in the experimental animal and in man. The relation between pain perception and cardiovascular function is however still obscure. In order to gain some insight into this aspect, normotensive subjects with low and high tolerance to pain, as assessed by tooth pulp stimulation, were compared for blood pressure and heart rate during cold pressor test, 24 hr urinary catecholamines, supine and upright PRA and plasma beta-endorphin levels. No significant difference was observed between the two groups for casual blood pressure, heart rate and PRA. Compared to subjects with low tolerance to pain, those with high tolerance to pain were significantly older and had: 1) significantly higher levels of diastolic blood pressure and of beta endorphin levels during cold pressor test; 2) significantly higher beta-endorphin levels after cold pressor test; 3) a significantly higher excretion of noradrenaline (but not of adrenaline and dopamine).

Adult↗
PubMed1987

Changes in renal function during physical and mental effort.

Aim of the study was to evaluate the renal responses to physical and mental effort in essential hypertension by means of a non-invasive radioisotopic method. Renal uptake rate of Tc99m-DMSA was evaluated in 10 subjects. Starting from 5 to 15 minutes after dose injection counts over the kidney region were acquired by means of a gamma-camera time-activity curves were obtained for each kidney. In non-stimulated patients DMSA uptake rate increased regularly; in the remaining cases both isometric exercise and mental effort induced an abrupt reduction of the uptake rate which increased again after the end of the test. Although the relation of DMSA uptake rate to renal function is not yet fully understood, we tentatively interpret these results as indicating blood flow reductions during these stressful conditions.

Humans↗
PubMed1986

Comparison of pain perception in normotensives and borderline hypertensives by means of a tooth pulp-stimulation test.

Recent studies indicate a reduced sensitivity to pain in genetically and experimentally hypertensive rats. A similar finding is also reported for human established hypertension. However, to our knowledge, no data have been reported in borderline hypertension. The aim of this study was to assess in subjects with borderline hypertension the sensory and pain thresholds by a noninvasive pulp-stimulation test performed with a commercial pulp tester that delivered stepwise increased electrical stimuli to four healthy teeth. The data reported are the means of measurements. In order to assess the possible importance of differences in the selection of the controls, two distinct groups of normotensives were chosen, one of volunteers and the other of outpatients. Significantly higher values for the pain and sensory thresholds were observed in borderline hypertensives compared with pooled normotensives. No significant effect on pain perception could be observed for sex, whereas a significant tendency toward higher threshold levels was found for younger subjects. In two normotensive groups, the sensory and pain thresholds were significantly higher in volunteers than in patients. These results suggest that changes in pain perception are present not only in established hypertension but also in borderline hypertension and, moreover, that differences in the selection of normotensive controls can have important influences on the results.

Adult↗
PubMed1985

Carboxyterminal peptide fragments of the beta subunit are urinary products of the metabolism of desialylated human choriogonadotropin.

Previous investigations of patients with gestational trophoblastic neoplasia have shown that their urines often contain carboxyterminal peptide (CTP) fragments of the choriogonadotropin (hCG) beta-subunit as well as forms of hCG deficient in sialic acid. In order to determine whether beta-CTP fragments are among the urinary products of the peripheral degradation of desialylated hCG (as-hCG), using a continuous infusion technique, we gave highly purified as-hCG to humans. Six healthy subjects were given a loading dose of 0.8 mg of as-hCG followed by an infusion of the same preparation. An overall mean infusion rate of 62.9 micrograms/min was maintained for 6 h, and the mean serum concentration of as-hCG achieved during the infusion was 72.1 ng/ml. In all six subjects, beta-CTP fragments were the predominant immunoreactive forms of as-hCG in urine obtained during the infusion. In contrast, the urine of subjects infused with hCG has been shown to contain hCG itself, but nil beta-CTP fragments or as-hCG. After the as-hCG infusion was stopped, the excretion of the beta-CTP fragments in urine declined rapidly. There were no beta-CTP fragments detectable in sera obtained during the infusion or in sera incubated with as-hCG at 37 degrees C. After incubation with as-hCG for 4 h, the urine of normal subjects contained small amounts of beta-CTP fragments; however, the apparent proteolytic activity was too low to account for either the quantity of beta-CTP fragments produced during the infusion or the extremely low levels of as-hCG in the urine. These data demonstrate the existence in humans of a peripheral metabolic pathway that cleaves beta-CTP fragments from as-hCG and allows their excretion in urine. Thus, the frequent presence of beta-CTP fragments in the urines of patients with gestational trophoblastic neoplasia can be accounted for in part by the metabolism of the forms of hCG that bear an altered carbohydrate structure, which are prevalent in this disease.

Adult↗
PubMed1985

Comparison of sensory and pain threshold in tooth pulp stimulation in normotensive man and essential hypertension.

Recent studies indicate a diminished responsiveness to noxious stimuli in arterial hypertension in the experimental animal. A similar finding is also reported in the only study published to our knowledge on this subject in man. The aim of the study was to assess in humans the sensory and pain threshold by a non-invasive tooth pulp stimulation test (stepwise increased electrical stimuli delivered by a commercial pulp tester). Subjects had to report when they started to feel pulp stimulation and when this became painful. The data reported are the means of the measurements on four healthy teeth in each subject. Significantly higher values (expressed as relative units [RU]) were found in 28 non-treated essential hypertensives compared with 33 normotensive controls for sensory threshold (40.64 +/- 8.07 versus 29.96 +/- 6.82 RU, P < 0.0001) and for pain threshold (55.67 +/- 12.74 versus 42.08 +/- 12.58 RU, P < 0.001). Multivariate analysis of variance showed that this difference was apparently not related to age and sex. These data lend further support to the view that pain modulation may be altered in the hypertensive state in man.

Adolescent↗
PubMed1985

Acute effect of captopril on single kidney glomerular filtration rate in arterial hypertension.

Recent studies have reported that captopril can acutely induce a marked decrease of glomerular filtration rate in kidneys affected by renal artery stenosis, an effect detectable by scintigraphic techniques. Experience which confirms and extends this observation, obtained in five patients with renovascular hypertension, is reported here. For comparison, eight essential hypertensives and six patients with non-vascular unilateral renal diseases were studied. In each patient the ratio of glomerular filtration rate between the two kidneys was estimated during two consecutive scintigraphic studies with the glomerular tracer 99mTc-DTPA: in all renovascular patients captopril induced a marked decrease of glomerular filtration rate on the affected side, whereas negligible changes were observed in all other subjects. These results confirm that captopril may almost completely suppress glomerular filtration in kidneys affected by unilateral renal artery stenosis, an effect which may not be apparent clinically because of compensation by the other kidney, but which is scintigraphically detectable. Renal scintigraphy after captopril is easy to perform and non-invasive. It therefore seems to be a promising tool for the screening of renovascular hypertension.

Captopril↗
PubMed1984

Effect of desialylation of human chorionic gonadotropin on its metabolic clearance rate in humans.

We determined the MCR and other kinetic parameters of desialylated hCG (as-hCG) in eight subjects (four men and four women), aged 20-47, using a single injection of 1 mg of a highly purified preparation. The plasma disappearance curve was fitted to a single exponential equation, with a half-time of disappearance of 3.56 +/- 0.62 min (mean +/- SD) and an initial volume of distribution of 1790 +/- 582 ml/m2. The mean MCR of as-hCG was 349 +/- 96 ml/min X m2. The mean transit time of as-hCG was 373 times shorter than that of hCG. The rapid plasma disappearance of as-hCG could not be accounted for by renal clearance into urine, since less than 0.05% of the as-hCG injected was excreted in the urine, nor could it be explained by degradation by plasma proteases, since as-hCG was not appreciably degraded during incubation in human serum at 37 C for 3 h. These data show that desialylation markedly accelerates the MCR of hCG in the human in spite of reduced renal excretion and, therefore, indicate the presence of a highly active pathway for uptake of desialylated glycoproteins.

Adult↗
PubMed1984

Metabolism, distribution and excretion of purified human chorionic gonadotropin and its subunits in man.

We have characterized the distribution, metabolism and excretion of hCG and its subunits in normal human subjects. The initial apparent volume of distribution was the same for hCG, hCG beta, and hCG alpha. Their disappearance curves fit a two-component exponential model, and calculations indicated that both the rapid and slow phase half-times of hCG are approximately 10-fold greater than those of hCG beta and 30-fold greater than those of hCG alpha. Despite the more rapid metabolic clearance rates of the subunits, their renal clearance is 2- to 3-fold less than that of hCG. Thus, renal clearance accounts for less than 1% of the metabolic disposal of the subunits, whereas it represents a major fraction (20-25%) of the metabolic disposal of hCG. After injection of the isolated beta subunit of hCG, two forms were excreted in the urine. One was intact hCG beta and the other was a discrete fragment of the hCG beta which appears to lack the hCG beta carboxyterminal peptide immunologic determinant; we have termed this later material an hCG beta core fragment.

Chorionic Gonadotropin↗