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Biomedical subjects

E Stein

Publications and source records attributed to E Stein.

At least 19 recordsLinked to original sources
PubMed1992

Using patient reports to assess hospital treatment of persons with AIDS: a pilot study.

Providing efficacious, compassionate, and efficient medical care to persons with HIV infection is one of the greatest challenges that will face US hospitals this decade. Unfortunately, there have been almost no studies of how organizational arrangements are related to the quality of care. We developed an interview protocol and conducted a pilot study to evaluate the instrument's ability to detect differences in selected interpersonal aspects of care provided to persons with AIDS. We evaluated the care received in two different treatment models in a major teaching hospital: a designated AIDS unit and general medical beds. We assessed several areas of patient care that are clinically important and that patients can evaluate: communication between patients and providers, patient education, respect for patient preferences, emotional support, involvement of family and friends, trust and confidence, physical care, pain management, AIDS knowledge, perceived segregation, confidentiality, and financial information. Patients generally were very satisfied with their hospital care, but many reported problems with certain aspects of their care. The instrument used detected differences between the care reported by patients treated in general hospital beds and in a designated AIDS unit in several specific aspects of care.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Prostate visualization studies in males homozygous and heterozygous for 5 alpha-reductase deficiency.

Male pseudohermaphrodites with 5 alpha-reductase deficiency have ambiguous genitalia and nonpalpable prostates on rectal examination, suggesting the dihydrotestosterone dependency of these structures. To clearly delineate the status of the prostate, male pseudohermaphrodites with 5 alpha-reductase deficiency had transrectal sonography of the prostate performed, and the results were compared to that of age-matched male controls. In six male pseudohermaphrodites, magnetic resonance imaging studies of the prostate were also performed. Heterozygote fathers also had transrectal sonography of the prostate performed and the results compared to age-matched controls. The prostates of the male pseudohermaphrodites appeared as platelike soft tissue structures posterior to the urethra on both prostatic ultrasound and magnetic resonance imaging. Prostatic volume, as determined on prostatic ultrasound by two different methods, was significantly smaller (approximately one-tenth) than the volume of age-matched controls. Transurethral ultrasound guided biopsy of the prostate in two affected subjects revealed stromal tissue. These results correlate with undetectable prostate-specific antigen in affected subjects, suggesting atrophic epithelium or lack of epithelial differentiation. This study demonstrates the dihydrotestosterone dependence of the prostate for normal differentiation and growth. The presence of some prostatic tissue in the male pseudohermaphrodites may be due to the fact that there is a decrease and not an absence of 5 alpha-reductase activity, and/or that the increased level of testosterone in subjects with this condition partially compensates for the decreased level of dihydrotestosterone. There was no difference, however, in prostate size between heterozygous fathers and age-matched control males. The heterozygote fathers had dihydrotestosterone production sufficient for normal prostate growth and development.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed1992

Complex pharmacological properties of recombinant alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionate receptor subtypes.

The pharmacological properties of two glutamate receptor subtypes, GluR-A/B and GluR-B/D, were examined in RNA-injected Xenopus oocytes using two-electrode voltage clamp. Concentration-response relations revealed that the potencies of L-glutamate, kainate, and alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionate (AMPA) varied slightly between the two receptor subtypes, but the rank order of agonist potency did not. The EC50 values for GluR-A/B receptors were 3.31 microM for AMPA, 6.16 microM for glutamate, and 57.5 microM for kainate, whereas the EC50 values for GluR-B/D receptors were 5.01 microM, 32.3 microM, and 64.6 microM for AMPA, L-glutamate, and kainate, respectively. The potencies of 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX) and 2,3-dihydroxy-6-nitro-7-sulfamoyl-benzo(f)quinoxaline (NBQX) were quantified by Schild analysis. The potency of NBQX at blocking currents mediated by GluR-A/B receptors changed depending on the agonist used to activate the receptors (pA2 values were as follows: for block of kainate, 7.23 +/- 0.01; L-glutamate, 6.78 +/- 0.02; AMPA, 6.95 +/- 0.02). Differences between agonists were less marked in cells expressing GluR-B/D receptors (pA2 values: kainate, 7.28 +/- 0.01; L-glutamate, 7.30 +/- 0.02; AMPA, 7.35 +/- 0.01). In each case, the slope of the Schild regression was not different from unity, consistent with competitive antagonism of these receptors by NBQX. CNQX also blocked GluR-A/B and GluR-B/D receptors competitively but was less potent than NBQX and did not differentiate between agonists or subunit combination. These data suggest that L-glutamate, kainate, and AMPA bind to different receptor substructures on recombinant AMPA receptors and that NBQX but not CNQX binds to these sites with different affinities. Moreover, because the properties of these binding sites vary between GluR-A/B and GluR-B/D receptors, our findings provide a basis for mutational analysis aimed at identifying receptor domains involved in agonist and antagonist binding.

6-Cyano-7-nitroquinoxaline-2,3-dione↗
PubMed1991

Group therapy in a forensic setting.

Mentally ill offenders are especially difficult patients to rehabilitate. Although group therapy is a universal method of treating these patients, their ability to benefit from group therapy has not been proven. The authors studied a group of patients held on Warrants of the Lieutenant Governor to assess their personality characteristics and their ability to develop group dynamics which are beneficial in other patient populations. The findings were that forensic patients have personality characteristics which preclude the development of these therapeutic dynamics.

Activities of Daily Living↗
PubMed1991

Clinical support groups that work.

A support group for nurses who care for patients with AIDS has been meeting at a major teaching hospital in New York City for the past year. The authors believe its success has been determined by three components: the group's ability to first, express feelings; second, do a needs assessment and plan programs to meet those needs; and third, participate in the organizational development system of the hospital. Management recognizes the importance of the group, endorses it, and supports it verbally and behaviorally.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Primary structure and functional expression of the alpha-, beta-, gamma-, delta- and epsilon-subunits of the acetylcholine receptor from rat muscle.

The isolation and characterization of five clones carrying sequences of the alpha-, beta-, gamma-, delta- and epsilon-subunit precursors of the rat muscle acetylcholine receptor (AChR) are described. The deduced amino acid sequences indicate that these polypeptides contain 457-519 amino acids and reveal the structural characteristics common to subunits of ligand-gated ion channels. The pattern of subunit-specific mRNA levels in rat muscle shows characteristic changes during development and following denervation, suggesting that innervation of muscle reduces the expression of the alpha-, beta- and delta-subunit mRNAs, suppresses the expression of the gamma-subunit mRNA, and induces expression of epsilon-subunit mRNA. Subunit-specific cRNAs generated in vitro were injected into Xenopus laevis oocytes, resulting in the assembly of two functionally different AChR channel subtypes. The AChR gamma, composed of the alpha-, beta-, gamma- and delta-subunits, has functional properties similar to those of the native AChRs in fetal muscle. The AChR epsilon, composed of alpha-, beta-, delta- and epsilon-subunits, corresponds to the end-plate channel of the adult muscle. Thus in rat skeletal muscle the motor nerve regulates the expression of two functionally different AChR subtypes with different molecular composition by the differential expression of subunit-specific mRNAs.

Amino Acid Sequence↗
PubMed1990

Acute and chronic effects of bone ablation with a pulsed holmium laser.

A pulsed holmium laser transmitted through a quartz fiber was used to create osteotomies in the facial bones and sinuses of rabbits. The ablation process was quantified and residual thermal injury was assessed by light microscopy. Adjacent thermal damage was determined to vary between 130 and 220 microns and was independent of radiant exposure and pulse repetition rate. In other studies, large osteotomies were made to examine the biological response and to assess the technical feasibility of using fiber-delivered laser pulses in an operative setting. The animals tolerated the procedure without obvious problems and postoperative follow-up revealed a vigorous healing response. Because it can ablate both bone and soft tissue and can be transmitted through readily available, flexible quartz fibers, the holmium laser may prove to be a useful adjunct to endoscopic sinus surgical procedures.

Animals↗
PubMed1990

Suppression of MLR and DTH responses in miniature swine by pretreatment with ultraviolet (UV)-irradiated peripheral blood lymphocytes.

Ultraviolet (UV)-irradiation of peripheral blood lymphocytes (PBL) of miniature swine prevented them from initiating proliferative responses in allogeneic mixed lymphocyte reactions (MLR). When pigs were given 4 weekly intravenous transfusions of UV-irradiated allogeneic donor PBL differing in major histocompatibility (MHC), PBL of recipient pigs progressively responded less vigorously to donor PBL in MLRs over the treatment period. These pigs did not produce anti-donor PBL antibody. Pigs treated with UV-irradiated PBL also had negligible delayed type hypersensitivity (DTH) responses to donor PBL at the end of the treatment period. In contrast, pigs receiving injections of untreated allogeneic PBL gave strong DTH responses to donor PBL, high proliferation in MLRs with donor PBL and all produced anti-donor PBL antibody.

Animals↗
PubMed1990

Thromboxane A2 augments adrenergic neurotransmission.

Platelet microsomes were utilized to generate thromboxane A2 in rabbit isolated superior mesenteric arteries to assess the effects of thromboxanes on neurotransmission. The microsomes were added to rabbit isolated mesenteric arteries to determine effects of thromboxanes on the following: 1) contractile force; 2) neurogenic contractions; 3) norepinephrine-induced contractions; and 4) electrically stimulated norepinephrine release. Immunoreactive thromboxane B2 concentrations were measured and all responses of the microsomes were correlated with thromboxane production. The microsomes generated thromboxane B2, increasing bath concentrations form 529 +/- 63 pg/ml to 4249 +/- 385 pg/ml at the highest dose. Basal force was increased 0.53 +/- 0.16 g by the highest microsome dose. Neurogenic force generation was enhanced to 303 +/- 57% of control while norepinephrine release was increased to 270 +/- 98% of control. Norepinephrine-induced contractions also were enhanced by the microsomes. Exogenous thromboxane B2 augmented adrenergic neurotransmission and norepinephrine-induced contractions only at concentrations exceeding 1 microM. These results are consistent with a potentiative neuromodulatory role of thromboxane A2 which is both of a pre- and postjunctional nature.

Animals↗
PubMed1990

Fetal pancreas transplantation in miniature swine. IV. Suppression of DTH and MLR responses by treatment with ultraviolet light-irradiated peripheral blood lymphocytes.

Irradiation of peripheral blood lymphocytes of miniature swine with ultraviolet light prevented them from initiating proliferative responses in allogeneic mixed lymphocyte reactions and also reduced IL-2 production in these MLRs. When pigs were injected in a series of 4-5 weekly transfusions with UV-irradiated allogeneic PBL differing at the MHC, PBL of recipient pigs progressively responded less strongly to donor PBL in MLRs over the treatment period. These pigs also gave negligible delayed-type hypersensitivity responses to donor PBL at the end of the treatment period. Of the seven UV-irradiated PBL-treated pigs, four produced no antidonor PBL antibody and three produced antibody. Serum from the three antibody-producing pigs also suppressed MLRs of unrelated PBL. By contrast, pigs that received a series of injections of untreated allogeneic PBL gave strong DTH responses to donor PBL and heightened proliferation in MLRs with donor PBL, and all produced antidonor PBL antibody.

Animals↗
PubMed1990

[The morphology of the palatine arch of pongids].

With the help of frontal cuts through casts of skulls of Pongids we demonstrated the postnatal development of the form of the hard palate. The form of the hard palate is similar to a semicircle in the frontal cut. In the Chimpanzee the palatal form in the frontal cut ist not as semicircular as in the other great apes and is similar to the palatal form of humans in the molar region. The differences between Pongo pygmaeus and the african apes consists in the fact, that the palate of the Pongo pygmaeus has a stronger vault in the canine region than the palate of the Gorilla and Chimpanzee.

Animals↗