Controlled-drinking advocates challenge use of abstinence model in treatment of addiction.
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Biomedical subjects
Publications and source records attributed to L Cohen.
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The cytoplasmic tyrosine kinase, Bruton's tyrosine kinase (Btk, formerly bpk or atk), is crucial for B cell development. Loss of kinase activity results in the human immunodeficiency, X-linked agammaglobulinemia, characterized by a failure to produce B cells. In the murine X-linked immunodeficiency (XID), B cells are present but respond abnormally to activating signals. The Btk gene, btk, was mapped to the xid region of the mouse X chromosome by interspecific backcross analysis. A single conserved residue within the amino terminal unique region of Btk was mutated in XID mice. This change in xid probably interferes with normal B cell signaling mediated by Btk protein interactions.
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The transvaginal ultrasound echo patterns of 39 surgically proven cystic teratomas were retrospectively reviewed. Six different ultrasound echo patterns could be differentiated, ranging from purely cystic to densely echogenic. Importantly, in 82% of the tumors, areas of dense echogenicity were noted. Although the transvaginal appearance of cystic teratomas may allow correct preoperative prediction, the variable nature of the echo patterns makes differentiation from malignant tumors difficult.
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A patient presenting the association of anomalous cerebral dominance for language, as revealed by crossed aphasia, and partial visceral situs inversus is described. Although it cannot be excluded that the two abnormalities coincided by chance, it is suggested that they both resulted from a single aberration of development.
Serial serum prostate-specific antigen (PSA) levels were analyzed retrospectively for prognostic implications in 70 patients with locoregional (Stages B2, C, and D1) prostate cancer who were managed with high energy neutron beam therapy. Three groups of patients were identified. Group I included 30 patients whose serum PSA level decreased to the reference range (0-4 ng/mL) following neutron therapy and remained so subsequently: 28 (93%) remained disease-free and 2 (7%) have failed distantly. All 30 patients (100%) had no evidence of locally progressive disease. This group was categorized as having a good prognosis. The mean time for serum PSA value to decline to reference range was six months; calculated mean time to achieve a stable base-line PSA was 53 +/- 37 days. Follow-up period ranged from twelve to fifty-six months (median: 21 months). Group II consisted of 13 patients in whom there was an initial decrease in serum PSA to reference range followed by a subsequent increase: 6 of 13 (46%) have no overt clinical progression of disease; 7 (54%) have either persistent locoregional or distant metastatic disease. Follow-up period was from twelve to seventy-two months (median: 39 months). Calculated mean time to achieve stable baseline PSA for serum PSA in this group was 61 +/- 21 days. Group III patients had a persistently elevated or rising serum PSA concentration. Of 27 patients in this group, only 9 (33%) have no evidence of disease progression, while 18 patients (67%) have failed already, either locoregionally or distantly. Follow-up period ranged from twelve to sixty-nine months (median: 21 months). Mean time to achieve stable baseline of serum PSA in this cohort of patients with a poor prognosis was 108 +/- 76 days. We conclude that PSA has a predictable prognostic value in patients with locally advanced prostate cancer managed with high energy neutron beam therapy. Rapid normalization of PSA after therapy indicates a good prognosis. Persistent elevation signifies either presence of persistent locoregional disease or development of distant metastases. Subsequent elevation of the serum PSA concentration after definitive therapy signals progression of prostate cancer.
It has been suggested that impulsivity and aggression are associated with neuropsychiatric impairment. Neurological soft signs may be a useful marker of nonspecific brain damage, and may therefore be increased in impulsive and aggressive patients compared with normal control subjects. A structured examination was used to evaluate neurological soft signs in 28 patients with personality disorders characterized by impulsivity and 28 healthy control subjects. All of the patients met DSM-III-R criteria for borderline personality disorder, and 10 also met criteria for antisocial personality disorder. All patients were questioned about past history of physical aggression, and a subset of 18 patients underwent neuropsychological testing with a select battery. Left-sided neurological soft signs were significantly increased in patients compared with normal control subjects. Patients with a history of aggression, however, had significantly more right-sided neurological soft signs than those without a history of aggression. Increased neurological soft signs were associated with impairment on the Wisconsin Card Sort, a test of frontal lobe executive function. Specific neuropsychiatric abnormalities, such as lateralized neurological soft signs and associated impairment on select neuropsychological tests, may be present in patients with personality disorders characterized by impulsivity.
This study relates antioxidant status and blood pressure (BP) in 168 healthy residents of Augusta, GA, following usual diets. BP ranges were systolic (S) 84-152, mean 112 +/- 1 mm Hg, and diastolic (D) 52-96, mean 72 +/- 1 mm Hg. Plasma concentrations of ascorbic acid (AA) were significantly inversely related to SBP (r = -0.18, P < 0.05) and DBP (r = -0.20, P < 0.01); with regression equations SBP vs AA = -0.083C + 116 and DBP = -0.077C + 76. Highest and lowest quintiles of AA differed significantly in mean SBP (108 +/- 2, 113 +/- 2 mm Hg) and DBP (69 +/- 1, 74 +/- 2), P < 0.05. Plasma AA concentrations were significantly lower in the smokers. By deleting smokers, the inverse relations of SBP and DBP with plasma AA and the slopes of the equation were enhanced. Plasma selenium, alpha-tocopherol, alpha-tocopherol:cholesterol ratio, retinol and taurine were not related to BP; whereas male gender, body mass index, body fat distribution, plasma cholesterol, low density lipoprotein cholesterol, and triglycerides correlated.
The Centers for Disease Control (CDC) have recently lowered the acceptable blood lead concentration in young children from < or = 25 to < or = 10 micrograms/dl (< or = 1.21 to < or = 0.48 mumol/L). The incidence of lead toxicity with respect to geographical areas and socioeconomic status has not yet been defined. We evaluated the incidence of increased lead concentration in inner-city, suburban, and rural children aged 9 months to 3 years. Seven hundred eighty of the 4,196 studied inner-city samples (18.6%) had lead concentrations > or = 10 micrograms/dl (0.48 mumol/L), of which only 71 (1.6%) had lead values > or = 25 micrograms/dl (1.21 mumol/L). Only 5 of the 212 studied children (2.4%) from suburbia and 7 of the 120 children (5.8%) from rural communities had blood lead concentrations > or = 10 micrograms/dl (0.48 mumol/L). None of these children, however, had a lead concentration > or = 15 micrograms/dl (0.73 mumol/L). In contrast, 276 inner-city subjects (6.6%) had lead values > or = 15 micrograms/dl (0.73 mumol/L). Our data indicate that a correlation exists between geographical location and blood lead concentration in young children. Government health agencies at all levels should prioritize their limited resources for those areas that are most at risk for lead poisoning.
This study was conducted to determine the efficacy of the T cell flow cytometry crossmatch (T-FCXM) test in 841 first cadaver donor transplants. Results showed one-year graft survival rates were 82% for T-FCXM-negative patients, compared with 75% for T-FCXM-positive patients (P = 0.01). Early one-month graft failure was 13 percentage points higher in those with a positive T-FCXM than those with a negative T-FCXM. The positive crossmatch patients also had more frequent immunological failures. A positive T-FCXM was found in 39% of the sensitized patients (PRA > 10%) and 8% of those who had not been sensitized. Patients with a positive T-FCXM in either category had a 74% graft survival rate. Thus, most of the T-FCXM-positive results occurred in patients with complement-fixing antibodies. It is suggested that flow cytometry crossmatching (FCXM) be used prospectively, despite the fact that many patients with a positive crossmatch did have successful transplants (TXs). In the current climate of a cadaver kidney scarcity and large recipient waiting pools, utilization of kidneys for patients with the highest probability of success seems a most prudent policy.
Aphemia, also called anarthria or severe apraxia of speech, is a rare disorder of speech production usually resulting from vascular lesions affecting the inferior premotor cortex of the left hemisphere. A patient presenting with aphemia as the sole manifestation of primary progressive aphasia (PPA) is reported.
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This pilot study evaluated neuropsychological dysfunction in obsessive-compulsive disorder (OCD) and Parkinson's disease (PD). Both OCD and PD patients had impairment on visuoconstructional tasks but not on tasks of immediate memory and focused attention, suggesting common selective deficits in these two disorders with basal ganglia involvement.