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Biomedical subjects

J Marcus

Publications and source records attributed to J Marcus.

At least 55 records · Page 3Linked to original sources
PubMed1990

Tissue expansion: past, present, and future.

The history of tissue expansion, technique, indications, and complications are reviewed. A detailed review of delayed tissue expansion's histologic, biochemical, biomechanical, and physiologic changes in the skin is given. There is a net gain in epidermal tissue during delayed expansion. Recent experimental and clinical experience suggests that expansion for 1 to 2 weeks is just as effective as longer delayed expansion for 6 to 8 weeks. A new deviation from standard technique, intraoperative tissue expansion, may have significant implications for dermatologic surgery. Intraoperative tissue expansion is explored in relation to other commonly used techniques of intraoperative load cycling.

Animals↗
PubMed1989

Prosthetic rehabilitation of elderly bilateral amputees.

A retrospective evaluation of vascular amputees, all over 55 years of age, found that 18 underwent bilateral lower limb amputation. The ages of patients ranged from 55 to 83 years, mean age at the time of second amputation was 65.9 years, 13 men and 5 women. Out of the 18 patients, 12 underwent bilateral below knee amputation (BK-BK), 3 below knee and above knee (BK-AK), and 3 bilateral above knee (AK-AK). Six patients (50%) of the 12 with BK-BK were fitted with prostheses. They therefore became users of two prostheses and have achieved a high functional level of rehabilitation despite a high mean age of 67.8 years. Five of these patients had been successful prosthetic users after the first leg amputation. The sixth patient underwent double BK amputation almost at the same time. He was fitted and rehabilitated with two prostheses simultaneously. Patients with BK-AK and AK-AK amputations had not been fitted with two prostheses. Deciding about prosthetic prescription and type of rehabilitation of elderly bilateral amputees is very difficult. Age alone is not a factor in success or failure of prosthetic rehabilitation. The type of rehabilitation for these patients is related mainly to the level of amputation, associated diseases and successful prosthetic use after the first leg amputation. Careful evaluation by a multidisciplinary team is the key for the right treatment decision and successful rehabilitation of this group of patients.

Activities of Daily Living↗
PubMed1988

Age-of-onset heterogeneity in hereditary breast cancer: minimal clues for diagnosis.

Knowledge of the family history of cancer may significantly influence diagnosis and surgical management. Hereditary breast cancer (HBC) is common and accounts for approximately 9% of the total breast cancer burden. The pattern of HBC's natural history, including age of onset, increased incidence of bilaterality, integral tumor combinations in certain kindreds, and vertical transmission consonant with an autosomal dominantly inherited factor, when observed in context with the family history, enables pattern recognition so that the diagnosis might be facilitated. We describe seven families from our Hereditary Cancer Consultation Center (HCCC) and the Creighton Oncology Clinic which are noteworthy for extraordinarily early age of onset. This appears to be an additional example of heterogeneity in HBC and may represent the first account of this remarkable subset. The manner in which age of onset can be incorporated with other aspects of natural history for expediting diagnosis is discussed.

Age Factors↗
PubMed1988

Natural history of colorectal cancer in hereditary nonpolyposis colorectal cancer (Lynch syndromes I and II).

Approximately 5 to 6 percent of the total colorectal cancer burden is accounted for by hereditary nonpolyposis colorectal cancer (HNPCC). Because clinical premonitory signs such as those seen in familial polyposis coli (FPC) are lacking, the clinician must recognize clinical findings and family history typical of HNPCC. The authors have described colorectal cancer expression from a survey of ten HNPCC kindreds. Kindred members with colorectal cancer differed significantly (P less than .05) from patients with sporadic colorectal cancer: 1) mean age of initial colon cancer diagnosis was 44.6 years; 2) 72.3 percent of first colon cancers were located in the right colon, and only 25 percent were in the sigmoid colon and rectum; 3) 18.1 percent had synchronous colon cancers; and 4) 24.2 percent developed metachronous colon cancer, with a risk for metachronous lesions in ten years of 40 percent. Affecteds and their first-degree relatives should undergo early intensive education and surveillance. In families with an early age of onset, colonoscopy should begin at age 25, and biannually thereafter, with fecal occult blood testing of the stool semiannually. Third-party carriers must become more responsive to the costly surveillance measures required for these otherwise healthy patients.

Adult↗
PubMed1988

Differential diagnosis of hereditary nonpolyposis colorectal cancer (Lynch syndrome I and Lynch syndrome II).

Increasing recognition of the statistical burden posed by HNPCC (5 to 6 percent of all colorectal cancer) mandates that physicians have a better understanding of the genetics, natural history, and distinction between the hereditary site-specific variant (Lynch syndrome I) and the Cancer Family Syndrome (Lynch syndrome II). The authors report detailed cancer (all sites) family histories on two prototype families with Lynch syndrome I (Family R) and Lynch syndrome II (Family N), which have been under investigation for more than two decades. Emphasis is placed on shared clinicogenetic features; namely, early age of onset of colonic cancer (approximately age 44), multiple primary colonic cancer (24 percent of cases showed metachronous colonic cancer), predominance of proximal colonic cancer location (approximately 65 percent in the proximal colon), and vertical transmission consonant with an autosomal dominantly inherited factor. An increased predilection for extracolonic cancer, particularly endometrial carcinoma, occurs in Lynch syndrome II and is the primary basis for distinction from Lynch syndrome I. Surveillance and management programs must be wholly responsive to these natural history features.

Adult↗
PubMed1987

Marks and classroom adjustment as early indicators of mental health at age twenty.

The data are derived from a 15-year longitudinal study of 659 urban children who entered kindergarten in 1968, 371 who were interviewed at the age of 20. Analyses related school adjustment and academic performance in the early primary grades, early adolescence, and middle adolescence to mental health outcomes based on responses to a short form of the MMPI at age 20. The results suggest that poor marks, absence of positive coping behaviors, and presence of negative coping behaviors are indicators of later mental health problems, that the absence of positive coping behaviors may be more indicative of later problems than the presence of negative coping behaviors, and that there are sex differences in the time periods at which indicators of school productivity are important.

Achievement↗
PubMed1987

A process model for the development of schizophrenia.

Less than two decades ago scientists interested in the etiology of schizophrenia were still vigorously debating the nature-nurture controversy, with many adhering to the view that the illness grew either out of a constitutional deficit or a pathological family environment. Today, virtually all researchers adopt interactional models that include both constitutional and environmental factors. Interactional models are most often expressed in diathesis-stress terms: Development of schizophrenia requires both a biological vulnerability (diathesis) and stressful life circumstances that facilitate expression of the illness. Modern debate within the field now primarily focuses on understanding the characteristics of the biological diathesis, the stressful environment, and their interaction. Scientists using diathesis-stress theories have employed several research strategies (Rosenthal 1970): (1) consanguinity studies exploring the distribution of illness among the relatives of schizophrenics, (2) twin studies comparing the concordance of schizophrenic illness in monozygotic and dizygotic twin pairs reared together or apart, (3) retrospective studies examining the premorbid behavior and development of schizophrenic parents, and (4) prospective studies of children at high risk for schizophrenia. The population most frequently followed in prospective high-risk studies has been offspring of schizophrenics. Biological offspring of schizophrenics who are reared by their parents are at extremely high risk for becoming schizophrenic themselves, approximately ten times greater risk than the general population. The present paper will make use of the Israeli High-Risk Study to test a diathesis-stress model for the transmission of schizophrenia. The goodness of fit of this model to the data will be explored using a simple decision tree data analytic approach.

Child↗
PubMed1987

Review of the NIMH Israeli Kibbutz-City Study and the Jerusalem Infant Development Study.

The National Institute of Mental Health (NIMH) Israeli Kibbutz-City Study has followed the development of offspring of schizophrenic parents from middle childhood through early adulthood. During childhood, a subgroup of offspring of schizophrenic patients showed clear neurobehavioral deficits often accompanied by poor social competence. Early followup data suggest that this subgroup of high-risk children is at greatest risk for adult schizophrenia spectrum illness. The Jerusalem Infant Development Study has followed a similar population of children at risk for schizophrenia from before birth through middle childhood. A subgroup of dysfunctioning in the high-risk children showed sensorimotor dysfunctioning in the first year of life, which was followed by perceptual, motor, and attentional dysfunctioning in childhood--identical to that found in the NIMH cohort. Results from both studies support the hypothesis that schizophrenic illness involves constitutional factors whose expression can be observed as early as infancy. Results also illustrate the importance of using data-analytic approaches that (1) look for subgroups within high-risk groups rather than only group differences between high- and low-risk groups, and (2) examine profiles of behavior rather than only single variables.

Adolescent↗
PubMed1985

Neurological dysfunctioning in offspring of schizophrenics in Israel and Denmark. A replication analysis.

Neurological functioning was compared in children at risk for schizophrenia from samples recruited in Israel and Denmark. In both samples neurological signs were assessed in school-age children with one schizophrenic parent and a matched group of children with no mentally ill parents. Multidimensional Scalogram Analysis of data identified, in both samples, a radex structure of neurological functioning, radiating from motor to sensory-perceptual signs. In both samples, the gradient of neurological functioning differed between the offspring of schizophrenics and controls. For both the offspring of schizophrenics and controls, the largest number of children showed no or few signs of neurological dysfunctioning. A subgroup of the offspring of schizophrenics, but not the controls, showed multiple signs of neurological dysfunctioning that varied in pattern among individuals.

Adolescent↗
PubMed1985

Individual differences in mood in early childhood: their relation to gender and neonatal sex steroids.

Predominant mood states were assessed for 104 children via 24-hr mother diaries during the first 2 years of life. Consistent sex differences were found across ages and across cohorts: boys were more often reported to be in a happy/excited mood, girls in a quiet/calm mood. The sexes did not differ in the frequency of negative moods (including crying), however. Scores for happy/excited and quiet/calm mood states were quite stable across the ages sampled: 6, 9, 12, 18, and 26 months. These stabilities were generally greater for boys. Negative moods showed only borderline stability. Relationships between the mood scores and five sex-steroid hormones (progesterone, androstenedione, testosterone, estrone, and estradiol), assayed from umbilical cord blood at the time of the children's birth, were assessed. For boys small, but significant, positive relationships were found between happy/excited moods and androstenedione, estrone, and progesterone. Correlations of opposite sign were found between these hormones and boys' scores for quiet/calm mood. For girls, the correlations were low and insignificant, but generally of opposite sign from those found for boys, and a number of hormones showed significant sex-by-hormone interactions in their relation to children's mood scores. The implication of these findings for the understanding of sex differences is discussed. Also discussed are the problems of interpretation posed by the intercorrelations among hormones when hormone scores are used for prediction of aspects of later development.

Affect↗
PubMed1985

Colorectal cancer in a nuclear family. Familial or hereditary?

Because of the high incidence of colorectal cancer, familial aggregations of this disease are common. Differentiation between etiologies contributing to familial clustering (which may have resulted either from common environmental exposure or from mere chance) and primary genetic factors may prove vexing to the physician. This report deals with the myriad problems encountered when attempting to make such etiologic distinctions in order to provide appropriate surveillance and management, based upon tumor spectrum and natural history, for patients at increased cancer risk.

Aged↗