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Biomedical subjects

M Beer

Publications and source records attributed to M Beer.

208 records · Page 12Linked to original sources
PubMedDate not supplied

Treatment of inoperable tracheobronchial obstructive lesions with the Palmaz stent.

PURPOSE: The treatment of inoperable tracheobronchial stenoses with Palmaz stents is analyzed in terms of the clinical effect, typical complications, and long-term follow-up. METHODS: Twenty-seven Palmaz stents were placed in 22 patients with the help of a rigid bronchoscope. RESULTS: Stents were implanted in the distal trachea, the main bronchi, and the lower lobe bronchi. Twenty-one of 22 patients reported an immediate subjective improvement in their respiratory situation. The mean survival time was 12 months; in two patients the stents were well tolerated for up to 40 months. A redilation of three stents was successful up to 33 months. In three cases a dislocation of the stent was observed; after bronchoscopic retraction a new stent was successfully implanted in each case. CONCLUSIONoff Treatment of inoperable tracheobronchial stenoses with the Palmaz stent is a safe procedure that provides an immediate improvement of the patient's pulmonary situation. The Palmaz stent shows a minimal complication rate in the long-term follow-up.

Adult↗
PubMedDate not supplied

Gene-specific labeling of chromatin for electron microscopy.

In restriction enzyme digested Xenopus laevis erythrocyte chromatin, the 5S oocyte genes were specifically labeled with colloidal gold so they could be identified in an electron microscopic study. Nuclei were digested first with HindIII restriction endonuclease followed by T7 exonuclease to leave single-stranded 3' tails on the fragments. A biotinylated 15-mer oligonucleotide complementary to the tail on the 3' end of the 5S gene was annealed to the chromatin, and streptavidin complexed colloidal gold was bound to it. In a spread for electron microscopy the labeled fragments were readily recognized.

Animals↗
PubMedDate not supplied

Exacerbation of Whipple's disease associated with infliximab treatment.

A 34-year-old man with chronic inflammatory joint disease and recurrent fever over 6 years was diagnosed as having Still's disease. Treatment with corticosteroids and azathioprine was ineffective. Therefore, infliximab/ methotrexate was started. The patient subsequently developed a wasting disease with rapid weight loss, erythema nodosum, diarrhoea, progressive lymph node enlargement, and a sigmoido-vesical fistula. Histological analysis of several enlarged lymph nodes, the margins of the fistula, and the small bowel established the diagnosis of Whipple's disease (WD). The presence of Tropheryma whipplei (Tw) DNA in the tissues was confirmed by polymerase chain reaction (PCR). Careful re-evaluation of biopsies taken from the ileum and the liver 2 years earlier, which at that time was not judged to be diagnostic for WD, retrospectively showed subtle histological signs of WD and were positive for Tw DNA. In summary, infliximab treatment seems to increase the risk of exacerbation of WD. WD should be carefully ruled out prior to application of tumour necrosis factor-alpha (TNF-alpha) blockade.

Adult↗
PubMedDate not supplied

Fluconazole versus amphotericin B in the treatment of esophageal candidiasis in cancer patients.

Thirty-one patients with malignancy and endoscopy-confirmed symptomatic esophageal candidiasis were randomly assigned to receive oral fluconazole, 200 mg once daily, or intravenous amphotericin B, 0.3 mg/kg, over 1-4 weeks. Clinical efficacy was determined weekly and follow-up esophageal endoscopy with biopsy and culture performed whenever possible. Both agents produced rapid resolution of symptoms, especially dysphagia and odynophagia. All 13 evaluable patients in the fluconazole group and 10/12 treated with amphotericin had clinical improvement. Endoscopy showed eradication of the fungus in all 11 patients undergoing repeat endoscopy, with cure or improvement of esophagitis. The incidence of adverse effects attributable to treatment was higher in the amphotericin group. The efficacy of oral fluconazole in esophageal candidiasis appears to be equivalent to that of amphotericin, with fewer adverse reactions.

Adolescent↗
PubMedDate not supplied

Why change programs don't produce change.

Faced with changing markets and tougher competition, more and more companies realize that to compete effectively they must transform how they function. But while senior managers understand the necessity of change, they often misunderstand what it takes to bring it about. They assume that corporate renewal is the product of company-wide change programs and that in order to transform employee behavior, they must alter a company's formal structure and systems. Both these assumptions are wrong, say these authors. Using examples drawn from their four-year study of organizational change at six large corporations, they argue that change programs are, in fact, the greatest obstacle to successful revitalization and that formal structures and systems are the last thing a company should change, not the first. The most successful change efforts begin at the periphery of a corporation, in a single plant or division. Such efforts are led by general managers, not the CEO or corporate staff people. And these general managers concentrate not on changing formal structures and systems but on creating ad hoc organizational arrangements to solve concrete business problems. This focuses energy for change on the work itself, not on abstractions such as "participation" or "culture." Once general managers understand the importance of this grass-roots approach to change, they don't have to wait for senior management to start a process of corporate renewal. The authors describe a six-step change process they call the "critical path."

Administrative Personnel↗
PubMedDate not supplied

The case of the unpopular pay plan.

Three years after launching the team-based Quality For All program, Top Chemical Company CEO Sam Verde was searching for a team-based compensation system that would reflect his company's new philosophy. With a committee gathered to discuss the issue, Verde confronts the fact that changing pay plans is an issue few people can agree on. "Very simply," explains vice president for compensation Gilbert Porterfield, "the plan is designed to give employees working on teams real incentives for constant improvement and overall excellence. The variable aspect of the system pays employees for the performance of their group." This doesn't sit well with the others. "It's going to punish teams like mine for the failings of others instead of rewarding us for the work we do and have already done," says packaging team representative Ruth Gibson. Another committee member feels that team-based anything is a "motivational happy land that doesn't square with how people really work." While Verde likes the proposed pay plan, he has doubts over whether his employees will accept the risk. Upper management has no problem basing 60% of its pay on TopChem's performance. But getting line employees to risk part of their salaries--even as little as 4%--on the ups and downs of the chemical industry may be more trouble than it's worth. Four experts on compensation reveal where Top Chemical went wrong in its plan and how Sam Verde might bring about change successfully.

Commerce↗
PubMedDate not supplied

Cracking the code of change.

Today's fast-paced economy demands that businesses change or die. But few companies manage corporate transformations as well as they would like. The brutal fact is that about 70% of all change initiatives fail. In this article, authors Michael Beer and Nitin Nohria describe two archetypes--or theories--of corporate transformation that may help executives crack the code of change. Theory E is change based on economic value: shareholder value is the only legitimate measure of success, and change often involves heavy use of economic incentives, layoffs, downsizing, and restructuring. Theory O is change based on organizational capability: the goal is to build and strengthen corporate culture. Most companies focus purely on one theory or the other, or haphazardly use a mix of both, the authors say. Combining E and O is directionally correct, they contend, but it requires a careful, conscious integration plan. Beer and Nohria present the examples of two companies, Scott Paper and Champion International, that used a purely E or purely O strategy to create change--and met with limited levels of success. They contrast those corporate transformations with that of UK-based retailer ASDA, which has successfully embraced the paradox between the opposing theories of change and integrated E and O. The lesson from ASDA? To thrive and adapt in the new economy, companies must make sure the E and O theories of business change are in sync at their own organizations.

Commerce↗
PubMedDate not supplied

Cardiotoxicity evaluation in patients treated with a mitoxantrone combination as adjuvant chemotherapy for breast cancer.

Indices of cardiac function were measured in 49 women who received adjuvant treatment for stage II breast cancer. The combination chemotherapy consisted of six monthly courses of cyclophosphamide, 500 mg/m2, mitoxantrone, 10 mg/m2 and fluorouracil, 500 mg/m2 (CNF). Left ventricular function was assessed by echocardiography, systolic time intervals and nuclear angiography. The values of the echocardiographic left ventricular end diastolic diameter (Dd) and end systolic diameter (Ds), and those of the index of preejection period (PEPI) and the ratio of the preejection period to left ventricular ejection time (PEP/LVET), determined in 41 patients before chemotherapy, at midcourse and after chemotherapy by echocardiography and systolic time intervals (STI), showed a slight but significant increase. All these values remained within normal limits. Resting nuclear angiography, performed before and after treatment, showed a decrease in LVEF by 10% or more in four patients; the postchemotherapy values remained within the normal range in all cases. In conclusion, adjuvant treatment of breast cancer patients with 6 cycles of the CNF combination, as judged by its effect on the measured indices, does not appear to be cardiotoxic.

Adult↗
PubMedDate not supplied

Induction of matrix protein synthesis in human glomerular mesangial cells by the terminal complement complex.

Exposure of human glomerular mesangial cells (GMC) in culture to sublytic doses of the terminal complement proteins C5b-8 and C5b-9 caused a transient increase in abundance of mRNA specific for collagen type IV and fibronectin; mRNA of laminin was not affected. Since C5b-9 is found deposited in inflamed or sclerotic areas we propose that stimulation of matrix protein synthesis by C5b-9 might contribute to the development of glomerular sclerosis.

1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗