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Biomedical subjects

I Kaplan

Publications and source records attributed to I Kaplan.

At least 55 records · Page 3Linked to original sources

Heterogeneity of androgen receptor content in advanced prostate cancer.

The principal mode of treatment of advanced (late stage) prostate cancer is androgen ablation. Although the response rate to hormonal ablation is high, relapse ultimately leading to death occurs in the majority of patients in remission from outgrowth of androgen-independent tumor cells. High-grade and high-stage cancers are more likely to progress to androgen independence. This study was undertaken to analyze the expression level of androgen receptor (AR) protein in prostatic carcinomas in relationship to grade and stage of disease. AR protein expression was assessed in 40 archival cases of prostate carcinoma by automated immunohistochemical techniques with standardized development times. Positive nuclei were quantitated by computer-assisted image analysis. Eighty-five percent of the prostatic carcinomas showed high levels of expression, defined as having AR present in more than 50% of the cells by light microscopy. Results of image analysis demonstrated that the variability of AR protein content per unit nuclear area increased with increasing grade (P < .03), regardless of cell size. High-grade prostatic intraepithelial neoplasia (PIN), present in 17 (42.5%) of the 40 cases, showed markedly reduced AR nuclear staining, compared with low-grade PIN or normal prostate. We show that AR content in prostate tumor cells becomes more variable with increasing Gleason score. In high-grade PIN, the in situ precursor of invasive prostate cancer, AR expression is either downregulated and/or restricted to the cytoplasm, but it is not heterogeneous. These data suggest that the heterogeneity in the expression of the receptor increases with progression of invasive prostate cancer and might in part account for a variable response to endocrine therapy.

Adult↗

Select transition zone prostate cancers may be radiocurable despite markedly elevated prostate-specific antigen levels.

In 1993, three men with transition zone prostate cancers were described (Stamey et al., J. Urol. 149: 510-515, 1993) who despite high prostate-specific antigen (PSA) levels remained PSA failure-free at 22 months postoperatively. This report illustrates that prolonged PSA failure free survival may be achieved when external beam radiation therapy is used to treat similar patients.

Actuarial Analysis↗

Self-report disability in an international primary care study of psychological illness.

We assessed the replicability of reliability and validity of a brief self-report disability scale, adapted from the Medical Outcomes Survey (short form), in a 15-center, cross-national, multilingual study of psychological illness among primary care patients (n = 5438). Across all 15 centers in the World Health Organization Collaborative Study of Psychological Problems in General Health Care, the reliability of the disability scale was high and individual items were responsive at similar levels of disability. Self-report disability was consistently correlated with disability in work role (including housework) as rated by interviewers according to the Groningen Social Disability Schedule, a semistructured method taking local norms into account. Disability as measured by the self-report questionnaire was also consistently correlated with depressive symptoms as measured by the General Health Questionnaire. At each center, the disability items formed a moderately to strongly hierarchical (Guttman-like) scale. These findings support the feasibility of using self-report disability scales in cross-national primary care research.

Depression↗

Successful treatment of anal tumors with CO2 laser in elderly, high-risk patients.

The central issue in elderly surgery remains the operative risk, which is usually a direct factor of age, ASA classification, and other pathologies, especially cardiovascular diseases. It is the surgeon's role to define properly the risks involved with a patient and to anticipate the involved operative mortality. Based on this, we performed CO2 laser fulguration of anal canal tumors in 10 patients suffering from either squamous cell or adenocarcinoma localized up to 4 cm from the anus. The rationale was to avoid prohibitive operative and anesthetic risk, achieve local control of disease and improve quality of life by avoiding surgical convalescence and an otherwise certain colostomy. All patients underwent fulguration (25-30 W) every 3-4 months. Complications included minor pain and bleeding. Three patients required operation (Hartman's pouch) within 2 1/2 years due to continuous tumor bleeding and stricture of the anal canal. The remaining 7 patients were treated regularly and satisfactorily by fulguration and the mean survival in this group was 8 years (in all cases the causes of death were unrelated to the procedure or the tumor). We conclude that CO2 laser fulguration of anal canal tumors in elderly, high-risk patients represents an invaluable option of treatment, while avoiding major operative risk, controlling the local spread of disease, maintaining physiological bowel function, and avoiding colostomy. Most importantly, the main dividends of the study are patient satisfaction and maintenance of good quality of life.

Adenocarcinoma↗

The CO2 laser in the treatment of lesions of the eyelids and periorbital region.

The CO2 laser can be used for the treatment of various lesions of the eyelids and peri-orbital region with the advantage over other modalities of precise, controllable, hemostatic, non contact atraumatic ablation with the reduction of post-operative pain and improved cosmetic results. Its application in palpabral and peri-orbital surgery is recommended.

Carbon Dioxide↗

Microleakage of composite resin restorations with a 10 percent maleic acid etchant.

Microleakage of Class V composite resin restorations with margins all in enamel were compared in this in-vitro study using Scotchbond MultiPurpose Adhesive (SMP) (3M Corp.), and Scotchbond II (SB II) (3M Corp). Twenty extracted human molars were randomly separated into two groups: Group One, which used the SMP system and Group Two, which used the SB II system. Circular Class V preparations were cut 1.8 mm deep and 3 mm in diameter using a #556 fissure bur. Cavosurface margins, all in enamel, were beveled. The enamel and dentin were treated following manufacturer's directions for each group, and a microfilled composite resin, Silux Plus (3M Corp), was applied in two hand-placed increments. All teeth were finished with Sof-Lex discs, stored in water for seven days, then thermocycled in a water bath for 100 cycles, alternating from 4 degrees C to 58 degrees C. The teeth were placed in a 5 percent solution of methylene blue, rinsed and then invested in resin. All teeth were sectioned vertically and horizontally and a ratio (percentage) of wall length to amount of leakage along each wall was established. The overall mean leakage of Group One was 15.27 percent and Group Two was 13.84 percent. Looking at individual walls, the mean occlusal wall leakage of Group One was 28.41 percent and Group Two was 12.45 percent. Mean gingival wall leakage of Group One was 15.96 percent and Group Two was 21.80 percent. Comparing the two groups, using a student's t test, there was no significant difference between the overall mean leakage or between the gingival wall leakage (p > 0.05); however, there was a significant difference between the occlusal wall leakage (p < 0.05), with SMP exhibiting more leakage.

Acid Etching, Dental↗

Differential effects of satellite RNA on the accumulation of cucumber mosaic virus RNAs and their encoded proteins in tobacco vs zucchini squash with two strains of CMV helper virus.

The presence of cucumber mosaic virus (CMV) satellite RNA usually reduces the yield of accumulated helper virus, although more so in solanaceous than in cucurbit hosts. The accumulation of viral RNA and viral-encoded proteins of two strains of CMV (Fny- and Sny-) known to differ in their ability to support satellite RNA in zucchini squash was examined in squash and tobacco to determine the effect of satellite RNA on the accumulation of viral-associated components. In the absence of satellite RNA, Fny- and Sny-CMV showed similar levels of accumulation of RNA at 7 days postinoculation (p.i.), but by 14 days p.i. the Fny-CMV RNAs accumulated to lower levels than did both strains at 7 days p.i., in either host. The levels of accumulated Sny-CMV-encoded proteins were higher than those encoded by Fny-CMV in tobacco, but not squash plants, at 7 days p.i. At 14 days p.i., for Fny-CMV vs Sny-CMV, there were differences in the levels of accumulation of most CMV-encoded proteins in both hosts, more exacerbated in tobacco vs squash. The effect of satellite RNA was to intensify these differences; that is, by 7 days p.i., satellite RNA reduced the accumulation of Fny-CMV RNAs 1 and 2 and their encoded proteins in both tobacco and squash but had little or no effect on the accumulation of Sny-CMV RNAs or encoded proteins. By 14 days p.i., the levels of accumulation of all Fny-CMV RNAs and encoded proteins were severely reduced in both hosts, and the levels of accumulation of Sny-CMV RNAs 1 and 2 and their encoded proteins were also reduced in tobacco, but not squash. Sny-CMV did not support satellite RNA accumulation in squash plants or protoplasts. Satellite RNA did not appear to have a direct effect on the movement of either CMV strain. Rather, accumulation studies in tobacco protoplasts indicated that the difference in response of Fny-CMV vs Sny-CMV to satellite RNA in tobacco was due to the extent to which satellite RNA affected the levels of RNA 1, and to a lesser extent RNA 2, and their encoded proteins, 1a and 2a, both components of the CMV replicase.

Cucumber Mosaic Virus Satellite↗

Eight years experience in crush and avulsion type finger amputation.

Between July 1986 and July 1994, we studied 125 total finger amputations due to crush and avulsion type injuries at the Izmir Hand and Microsurgery Hospital. Of the 125 fingers replanted, 88 were successful, for a general survival rate of 70.4%. In the period between 1986 and 1991, we performed end-to-end anastomoses and achieved a survival rate of 48.3% (Group I). Between 1991 and 1994, with the application of a primary interpositional vein graft for the required indications in this type of injury, the general survival rate increased to 77.1% (Group II; P < 0.05). We conclude that the significant increase in the survival rate in Group II is related to both the increased experience of the surgical team and the application of the primary interpositional vein graft.

Adolescent↗

The use of CO2 laser for inguinal hernia repair in elderly, pacemaker wearers.

Interference of electrical current with pacemaker activity is well known and has long been described. Almost every surgical procedure is now performed with the electrical knife, or electrocautery. In patients wearing a pacemaker this poses a problem, because of the danger of electronic interference within the pacemaker with consequent firing-frequency changes and the higher risk of intra- and postoperative bleeding and oozing when using a scalpel instead of cautery. We have performed 25 hernioplasties in elderly patients with permanent pacemakers using the CO2 laser technique. All operations were technically successful, and the immediate and long term (1 year) follow-up proved uneventful. Additionally normal pacemaker function was maintained during surgery and through the follow-up period. CO2 laser surgery is advantageous over electrocautery in patients with pacemakers because it does not interfere with pacemaker activity. Moreover, the laser produces normal hemostasis and does not stimulate muscle and nerve activity during surgery.

Aged↗

A clinical and histopathological study of radicular cysts associated with primary molars.

Radicular cysts originating from primary teeth are considered rare. The study analyzed 49 primary molars with radiolucent lesions ranging from 4-15 mm in diameter. 73.5% of the lesions were diagnosed as radicular cysts, and 26.5% as granulomas. The lesions were more frequent in the mandible. All lesions were associated with severely decayed teeth and only 4 had previous pulp therapy. The present study and the survey of the literature suggest that radicular cysts associated with primary teeth are not rare.

Child↗

Developmental arrest of tooth bud after correction of mandibular fracture.

A case of multiple fractures of the mandible following a car accident in a five-year-old patient is reported. The fracture line passed distal to the first molar tooth bud. The fracture was treated by wire osteosynthesis and skeletal fixation. During the ensuing 18 months, a gradual arrest of the development of the first molar tooth bud was radiologically observed. The eruption process had not been disturbed, and the tooth erupted at the age of 6 1/2 years. Since the distal root had completely failed to develop and the mesial roots showed a diminished size, the tooth was extracted. Histopathological examination revealed disturbed dentin apposition, there was almost complete obliteration of the pulp chamber by globular dentin, and evidence of root resorption.

Child, Preschool↗

Oral health and treatment needs in a non-institutionalized elderly population: experience of a dental school associated geriatric clinic.

The purpose of this study is to report oral and dental findings in a population of independent geriatric patients, who were treated at the Geriatric Dental Clinic, School of Dental Medicine, Tel Aviv University. The study group consisted of 221 patients, 31.2% males and 68.8% females. The mean age was 75.3 years. Of the patients, 75% were edentulous. The most frequent complaint was pain associated with wear of dentures, and the most frequent mucosal lesion was traumatic ulcer (51%). Most dentures were of poor quality (77%). The mean denture age was 9.7 years, increasing as the patient's age increased. Denture hygiene was good in 59%, fair in 11% and poor in 30%. The mean number of visits at the Geriatric Clinic was 5.5 per patient.

Aged↗

[Heterotopic replantation].

In multidigital amputations, it is sometimes better to replant an amputated finger to a different proximal part if a better function can be expected in this position. In our clinical material between October 1991 and March 1994, heterotopic replantation was performed in twelve digits in eleven patients. Three fingers were replanted to the thumb, three to the index, four to the middle, and two to the ring fingers. The functional results were satisfying. The total active range of motion was on an average 24% of a normal finger. Static two-point discrimination was 8.5 mm on an average, and the values for the Semmes-Weinstein test ranged between 3.61 and 6.5. A heterotopic replantation is of special value for primary thumb reconstruction.

Adolescent↗