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Biomedical subjects

L Green

Publications and source records attributed to L Green.

338 records · Page 19Linked to original sources
PubMedDate not supplied

Thrombin is present in the lungs of patients with primary extremity osteosarcoma and pulmonary metastases.

Osteosarcoma is a rare cancer, which metastasizes to the lung in up to 80% of cases. Thrombin is involved in metastasis and is present in the lungs of patients with pulmonary metastases (PM). To identify its role in PM and osteosarcoma, we measured thrombin levels in the bronchoalveolar lavage fluid (BALF) of 15 patients. BALF was collected at different stages of the disease and correlated with the diagnosis of PM. We also assessed fibrinogen overexpression in the tumors. We found that 11/15 (73%) patients with high thrombin levels in the lungs developed PM within the first 12 months from primary surgery. The median thrombin concentration in the BALF of these patients increased up to 8x10(-9) M (range, 3x10(-9)M-15x10(-9)M), which represents a more than 100-fold increase compared to patients without PM (p<0.0001). Eight of 15 (53%) primary and 11/15 (73%) metastatic samples showed fibrinogen overexpression. A significant difference between high thrombin levels, fibrinogen overexpression and PM was found compared to patients without PM (p=0.00073 and p=0.025). These results show that thrombin levels are increased in the lungs of patients with primary osteosarcoma and a high risk of developing PM. They suggest that thrombin may be involved in the development of PM.

Bone Neoplasms↗
PubMedDate not supplied

A community-based cohort of 201 consecutive patients with primary Sjögren's syndrome in Israel: Ashkenazi patients compared with those of Sephardic descent.

OBJECTIVE: To determine the spectrum and prevalence of the varied manifestations, associated conditions and laboratory abnormalities of patients with primary Sjögren's syndrome in Israel and compare them between individuals of Sephardic and Ashkenazi descent and with data from the literature. METHODS: A retrospective study of a cohort of 201 consecutive patients diagnosed and followed at a single academic medical center. All cases were diagnosed using stringent criteria according to the American European Concensus Group including a labial minor salivary gland biopsy in all cases. RESULTS: Patients' mean age was 57 years and 84% were women. Overall, more than 98% of patients had sicca symptoms of dry eyes and mouth. About 35% of the cohort had hematological manifestations--primarily immune cytopenias, protein immunoelectrophoresis abnormalities and lymphoma. About 20% had associated neurological conditions (not only peripheral but often central nervous system) and 15% had pulmonary involvement. In addition, thyroid disease, liver disease, vascular or cutaneous manifestations, synovitis, ocular and renal disease could be found. In fact, the presenting manifestation was extraglandular or an abnormal test result in 39% of the patients. CONCLUSION: No significant differences were found in glandular or extraglandular manifestations or laboratory test results between Ashkenazi and Sephardic patients, despite their genetic differences. A negative history of sicca symptoms effectively rules out primary Sjögren's syndrome in this cohort. These symptoms may not be volunteered by patients and the large variety of extraglandular involvement patterns and associated conditions observed may dominate the patient's presentation, and mandate physicians' awareness and a high index of suspicion for a timely diagnosis.

Academic Medical Centers↗
PubMedDate not supplied

Report of the New England Task Force on Reducing Heart Disease and Stroke Risk.

Five years ago, a task force on reducing risk for heart disease and stroke was established by the six New England States. The task force included representatives from State public health departments, academia, the corporate sector, and voluntary organizations. This article is the final report of the task force. Heart disease and cerebrovascular disease are major causes of mortality in the New England region. Heart disease causes nearly 40 percent of all deaths in each of the six States and cerebrovascular disease, 7 percent of the deaths. Major risk factors for ischemic heart disease that have been identified--elevated serum cholesterol, high blood pressure, and cigarette smoking--are caused largely by lifestyle behaviors. Similarly, cerebrovascular disease results largely from uncontrolled high blood pressure, much of which is attributable to unhealthy lifestyle behaviors. In a series of studies evidence has accumulated that the reduction or elimination of these risk factors results in a decline in mortality rates. Many intervention programs have been mounted in the region, but there has been no population-wide effort to attack these risk factors. The task force proposed a broad range of activities for New Englanders at sites in the community and in health facilities. These activities would promote not smoking, exercising regularly, and maintaining desirable levels of serum cholesterol and blood pressure.

Adolescent↗
PubMedDate not supplied

Variations in the organization and expression of human histone genes in normal diploid and tumor cell lines.

The organization and expression of human histone genes were examined in W138 normal human diploid fibroblasts, SV40 transformed W138 cells, A549 epithelial lung carcinoma cells, two adeno-carcinoma cell lines (LOVO and HT29) and three leukemia cell lines (HL60, KG1 and K562). Analysis of the restriction enzyme digests of total genomic DNAs by hybridization with a series of cloned human histone sequences indicated polymorphic organization of at least a subset of the moderately reiterated human histone genes in these cells. Quantitative and qualitative differences were also observed in the representation of histone mRNAs by Northern blot analysis using cloned human histone genes as hybridization probes. However, there was no apparent correlation between variations in the representation of transcripts from various copies of the histone genes, variations in histone gene organization, and the extent of tumor progression.

Base Sequence↗
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Reevaluation of things past. A test of the "retrospection hypothesis" using a CER procedure with rats.

The ability of rats to reevaluate previously presented information in light of subsequently provided information was evaluated using a CER (conditioned emotional response) procedure. In Experiment 1, rats suppressed responding to a compound light + tone stimulus that was repeatedly paired with shock. Groups of rats were then presented with only one element of the compound (the tone), either presented alone or paired with shock, for 15 days. During this 15-day period, two control groups received trials with the shock alone or neither stimulus nor shock. All of the rats were then tested with the other element of the compound (the light). Rats that had received the tone paired with shock during the intervening training continued to suppress to the light, whereas rats that had received the tone alone showed rapid extinction of the CER to light. The control groups showed that this effect was not due to the number of shock presentations received. A subsequent experiment also demonstrated that these results were not due to nonspecific stimulus effects. Apparently, a subsequent change in the associative strength of one element results in a similar change to the other element of a previously established compound stimulus.

Animals↗
PubMedDate not supplied

Fine needle aspiration of the pancreas. In quest of accuracy.

Percutaneous fine needle aspiration (FNA) is the diagnostic method of choice for patients with a pancreatic mass. A positive cytologic diagnosis allows administration of neoadjuvant therapy in patients with resectable disease and avoids laparotomy in patients with locally advanced or metastatic disease. Ninety patients underwent computed tomographically guided FNA of the pancreas, and the results were compared to the final histologic diagnosis. The initial sensitivity for diagnosis of pancreatic adenocarcinoma was 70%. To improve our diagnostic accuracy, 19 independent cytologic criteria were evaluated for each case. Multivariate logistic-regression analysis identified three major criteria (nuclear crowding and overlapping, nuclear contour irregularity, irregular chromatin distribution) and four minor criteria (nuclear enlargement, single epithelial cells, necrosis, mitoses) as the most important predictors of malignancy. In the presence of two or more major or one major and three minor criteria, the sensitivity and specificity for the diagnosis of pancreatic adenocarcinoma were 100%. Objective application of these criteria improved our diagnostic sensitivity to 90%.

Adenocarcinoma↗
PubMedDate not supplied

Acute otitis media in adults: a report from the International Primary Care Network.

BACKGROUND: Of 22 million visits annually to United States physicians for acute otitis media, almost 4 million are by patients 15 years old or older. Yet the clinical spectrum and variables related to recovery have not been reported for adults. METHOD: Data originated from 3224 primary care patients with acute otitis media, of whom 500 were 15 years old or older, who were enrolled in a prospective study in eight countries. At the initial visit, history, symptoms, physical findings, and treatment were recorded. At a 2-month follow-up visit, changes in treatment and recovery were recorded. RESULTS: Compared with children, adults sought care more quickly after symptom onset; were more likely to have had a tonsillectomy or adenoidectomy; and were more likely to complain of ear pain, decreased hearing, sore throat, and ear discharge. Children were more likely to have a history of recent upper respiratory tract infection, serous otitis media, and ear tubes; symptoms of fever, diarrhea, and vomiting; and tympanic membrane findings of redness, bulging, and ear tubes in place. History of reduced hearing, allergy, prophylactic antibiotics, and tympanic membrane findings characterized as opaque or dull, fluid, draining pus, perforation, and not visualized were equally frequent in both age groups. For adults, neither type nor duration of antibiotic affected outcome. Patients receiving antibiotics had lower rates of recovery than those who did not. The likelihood of a poor outcome increased with an increasing number of past episodes of acute otitis media and with increasing age. CONCLUSION: Although history and symptoms differ in adults and children, the similarity of tympanic membrane findings is consistent with previous reports of a similar bacterial spectrum in both groups. Recovery is related more to individual patient characteristics and history than to antibiotic therapy. Adults have an increased rate of poor outcome at 2 months compared with children.

Acute Disease↗
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Conference report: community-based health promotion--state of the art and recommendations for the future.

The evaluators of the Henry J. Kaiser Family Foundation Community Health Promotion Grants Program in the West and the Foundation brought together 21 researchers, funders, and community organizers with a variety of perspectives on community-based health promotion to share what has been learned to date and how that knowledge should be applied in the future. The two-day conference was divided into three sessions, covering conceptual, implementation, and evaluation issues. Specific topics were selected by the organizers with input from participants. Two papers were presented in each session, followed by comments from discussants and a general discussion involving the entire group. The dominant theme of the conference was the relationship between communities and outside institutions, focusing on problems with the current state of relations and how they might be improved in the future. All viewed building partnerships between communities and institutions as a desirable goal; however, the challenges involved in building effective partnerships are considerable and require a substantial investment to make them work. Recommendations that emerged from the discussions included explicitly acknowledging the diverse interests of the parties in community-based programs at the earliest stages of program planning; making a concerted effort to bridge the cultural gaps that exist among the parties; structuring funding to allow enough lead time for partnerships to develop or using social reconnaissance to identify strong existing partnerships; and integrating the evaluation more closely into the process of program development.

Community Participation↗