Search PubMed⌕ Search

Biomedical subjects

M Benson

Publications and source records attributed to M Benson.

At least 73 records · Page 4Linked to original sources
PubMed1999

[Experiences fo three year's routine operation of an anesthesia information management system (AIMS) at a university clinic in Giessin].

PURPOSE: In 1994, the Department of Anaesthesiology and Intensive Care Medicine of the Justus Liebig University at Giessen decided to install an Anaesthesia Information Management System (AIMS). Individual aspects and results from routine operation are presented, demonstrating the quality of the documentation and the value of information at the anaesthesiological workstation. The paper discusses which adaptations are necessary according to the experience gathered. METHODS: For the installation of the system Apple Macintosh Clients (Apple Computer, Inc., Cupertino, California) and a File Server were integrated into the partially existing hospital network. The hospital network had to be enlarged during the project according to the Anaesthesiological requirements. The software of the Hospital Information System (HIS) and an HTML browser were installed at individual workstation computers in addition to the Anaesthesia documentation software NarkoData (ProLogic GmbH, Erkrath). The remote control software Timbuktu (Farallon, Alameda, USA) has been added to facilitate remote administration. The file administration programme FileWave (Wave Research, Berkeley, USA) is used for file distribution. Since 1995, all anaesthesia procedures have been documented with the system, either by online or postoperative recording. Since 1997, the recorded information has been stored in a relational Oracle 7 data bank (Oracle Corporation). RESULTS: From 1995 to 1997, 60,405 anaesthesiological procedures have been recorded with the help of this AIMS at 111 decentralised workstations. In 1997, 87.8% of the 21,130 performed anaesthesia procedures have been recorded online with the system and 12.2% postoperatively. From 1995 to 1997, the number of recorded procedures increased by 6.4% from 19,854 to 21,130. Because of lacking interfaces at some patient monitoring stations, the automatic recording of patient data could only be implemented at 69 workstations (62%). With the corresponding access rights, important patient information from the HIS (diagnoses, laboratory results, etc.), records of previous Anaesthesia procedures, numerous statistics, and the whole information from the hospital's intranet (including e-mail) are available at the anaesthesiological workstation at any time. CONCLUSION: The implementation of the AIMS and an effective user support have been able to increase significantly the quality of documentation, the flow of information at the anaesthesia workplace and the number of recorded Anaesthesia procedures. All recorded data can be analysed immediately The expansion of the automatic data transfer from the patient monitoring, interfaces to other computer subsystems of the hospital and a practicable evaluation programme are necessary for further enhancing the efficiency of the AIMS.

Anesthesiology↗
PubMed1999

Optimum dose of ursodeoxycholic acid in primary biliary cirrhosis.

BACKGROUND: Ursodeoxycholic acid (UDCA) improves liver function tests and prolongs survival in primary biliary cirrhosis (PBC). The dose of 10- 15 mg/kg/day used in the large trials has largely been based on that used for gallstone dissolution. The only dose-response study of UDCA in PBC suggested that a dose of 8 mg/kg/day was the most efficacious. However, disease stage of the patients was not known, higher doses of UDCA were not tried and there was no 'washout period' between the different doses. The aim of this study was to determine the optimum dose of UDCA in early-stage PBC (stage 1 and 2). METHODS: Twenty-four biopsy-proven early-stage PBC patients (one male, 23 female) received five doses of UDCA (0, 300, 600, 900, 1200 mg/day) each for 8 weeks with 4-week washout periods between doses. Symptoms (pruritus, fatigue, diarrhoea) were assessed on a four-point scale (none, mild, moderate, severe). Liver function tests (LFTs) were performed using conventional methods, and serum bile acids were measured using gas liquid chromatography. RESULTS: The dose of 900 mg/day produced the greatest enrichment of UDCA in serum bile acids; although there was no difference in the enrichment of UDCA between the different doses. There was a trend towards normalization of the abnormal LFTs in a dose-dependent manner (for y-glutamyl transferase (yGT), alkaline phosphatase (ALP), alanine transaminase (ALT) and IgM). Multi-factorial analysis showed that UDCA treatment, irrespective of dose, was significantly better than placebo for all the variables. The 900 and 1200 mg doses were better than both 300 and 600 mg using yGT and total bilirubin as variables, better than 300 mg using ALP and IgM as variables, and better than 600 mg using albumin as a variable. No variables showed a significant difference between 900 and 1200 mg. CONCLUSION: The optimum dose of UDCA is 900 mg/day (equivalent to 13.5 mg/kg/day).

Adult↗
PubMed1999

A young man with a heavy heart.

A 34 year old man presented with acute chest pain. His ECG was very abnormal but stable and he was treated with opiate analgesia. When his condition did not improve, chest radiography and cardiac ultrasound were performed. Both revealed metal dense deposits in the heart. On questioning, the patient revealed that he had self injected with mercury 15 years before. Self injection of elemental mercury is rare but well described and normally used by those who are suicidally depressed or who seek to improve sexual or athletic performance. Intravenous mercury may be deposited in the right heart and can result in ECG abnormalities, which may later be mistaken for changes due to coronary or other cardiac disease and result in inappropriate medication and hospitalisation.

Adult↗
PubMed1999

Phase I trial of docetaxel with estramustine in androgen-independent prostate cancer.

PURPOSE: To evaluate the toxicity, efficacy, and pharmacokinetics of docetaxel when combined with oral estramustine and dexamethasone in a phase I study in patients with progressive metastatic androgen-independent prostate cancer. PATIENTS AND METHODS: Thirty-four men were stratified into minimally pretreated (MPT) and extensively pretreated (EPT) groups. Estramustine 280 mg PO tid was administered 1 hour before or 2 hours after meals on days 1 through 5, with escalated doses of docetaxel from 40 to 80 mg/m2 on day 2. Treatment was repeated every 21 days. RESULTS: Thirty-four patients were assessable for toxicity and 33 for response. In the MPT patients, dose-limiting myelosuppression was reached at 80 mg/m2, with six patients experiencing grade 3/4 granulocytopenia. In EPT patients, escalation above 70 mg/m2 was not attempted. Fourteen MPT (70%) and six EPT (50%) patients had a > or = 50% decline in serum PSA on two consecutive measurements taken at least 2 weeks apart. The overall 50% PSA response rate was 63% (95% confidence interval [CI], 28% to 81%). Of the 18 patients with bidimensionally measurable disease, five (28%; 95% CI, 11% to 54%) achieved a partial response. At the time of entry onto the study, 15 patients required narcotic analgesics for bone pain; after treatment, eight (53%) discontinued their pain medications. The area under the curve for docetaxel increased linearly from 40 to 70 mg/m2. At 80 mg/m2, the measured area under the curve was 8.37 (standard deviation, 0.724), which was significantly higher than the previously reported values. CONCLUSION: The recommended phase II dose of docetaxel combined with estramustine is 70 mg/m2 in MPT patients and 60 mg/m2 in EPT patients. This combination is active in men with androgen-independent prostate cancer.

Aged↗
PubMed1999

Phase I/II studies of docetaxel (Taxotere) combined with estramustine in men with hormone-refractory prostate cancer.

Evaluation of the combined regimen of estramustine and docetaxel (Taxotere; Rhône-Poulenc Rorer, Collegeville, PA) in men with hormone-refractory prostate cancer is in its early stages. While this combination is promising in terms of efficacy, adverse events associated with estramustine are a concern. Estramustine has been associated with side effects such as nausea, vomiting, edema, and serious vascular events. Reported here are the results of phase I and phase II trials in which 280 mg estramustine was given three times daily on days I to 5 in 21-day treatment cycles with docetaxel at varying doses. Data from patients evaluable thus far support the efficacy of this combination, both in chemotherapeutically naive patients and in those who have had prior therapy. A survival benefit from this combination appears achievable from these early studies. As significant antitumor activity can be achieved with docetaxel alone, future studies need to define the minimal dose of estramustine for this combination.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

Association of distinct yeast Not2 functional domains with components of Gcn5 histone acetylase and Ccr4 transcriptional regulatory complexes.

The NOT genes were originally identified in a yeast genetic screen that selected mutations resulting in increased utilization of a non-consensus TC TATA element of the HIS3 promoter. Here, we present evidence that the N-terminus of Not2 interacts with components of the Ada/Gcn5 histone acetyltransferase complex. Loss of this interaction either through abrogation of Not2 N-terminal function or deletion of ada2 or gcn5 results in derepression of the HIS3 TC element. This suggests that association of Not2 with the Ada/Gcn5 histone acetyltransferase complex is involved in regulation of the HIS3 promoter. Association between the Not and CCR4 transcriptional regulatory complexes has also been observed recently. Our phenotypic analyses suggest that these CCR4-related Not2 functions are mediated by a functionally independent domain of Not2 that includes the highly conserved C-terminus. Chimeric proteins containing the yeast Not2 N-terminus fused to the human C-terminus function in yeast, suggesting that the Not2 C-terminus represents a distinct modular domain whose function is conserved between higher and lower eukaryotes.

Acetyltransferases↗
PubMed1998

Antibodies against human putamen in children with Tourette syndrome.

BACKGROUND: Similar to the model for Sydenham's chorea, antineuronal antibodies, which develop in response to a preceding streptococcal infection, have been speculated to have a role in the development of Tourette syndrome (TS). METHODS: Serum antibodies against human caudate, putamen, and globus pallidus (interna and externa) were assayed by enzyme-linked immunosorbent assay (ELISA) and Western blot techniques and results were correlated with clinical characteristics and markers of streptococcal infection. SUBJECTS: A total of 41 children with TS (mean age, 11.3 years) and 39 controls (mean age, 12.1 years) were included. RESULTS: Compared with controls, TS subjects had a significant increase in the mean (p=0.006) and median (p=0.002) ELISA optical density (OD) levels of serum antibodies against putamen, but not caudate or globus pallidus. Western blots on 20 control and 20 TS serum samples showed that specific antibodies to caudate/putamen occurred more frequently in TS subjects at 83, 67, and 60 kDa; antigens were present in a synaptosomal fraction. TS subjects with a positive family history of tics had higher OD values (p < or = 0.04), but no association was shown with age of tic onset, tic severity, sudden onset of tics, or presence of attention-deficit hyperactivity disorder or obsessive-compulsive disorder. Risk ratio calculations in TS and control groups and in study subjects dichotomized for high and low putamen OD values were similar for titers of antistreptolysin O > or = 166 or antideoxyribonuclease B > or = 170. A subgroup analysis limited to subjects with elevated streptococcal titers, however, showed a significantly (p < or = 0.004) larger number of TS subjects with elevated OD levels. CONCLUSION: Children and adolescents with TS had significantly higher serum levels of antineuronal antibodies against putamen than did controls, but their relation to clinical characteristics and markers for streptococcal infection remains equivocal.

Adolescent↗
PubMed1998

Nonulcer dyspepsia and Helicobacter pylori, with comment on posteradication symptoms.

In two London hospitals during five months in 1997, among patients referred for esophago-gastroduodenoscopy, 250 complained of dyspepsia for more than two days per week. Of these, 190 gave informed consent to enter a study of H. pylori infection in nonulcer dyspepsia, but only 42 (22%) were found to have H. pylori infection without a peptic ulcer. At the time of this interim report, of these patients, 26 had been treated with omeprazole, amoxicillin, and clarithromycin, four weeks had elapsed since treatment, and H. pylori had been eradicated. Of these 26 patients, 15 (58%) had lost nearly all their symptoms. This is the first report of loss of symptoms in patients with nonulcer dyspepsia after treatment with omeprazole, amoxicillin and clarithromycin with early follow-up after four weeks. However, this was not a placebo-controlled study and the number of patients was small, so it is not possible to conclude whether H. pylori could be one cause of nonulcer dyspepsia. The increasing incidence of posteradication esophagitis is discussed as is the possible need for more sophisticated management of nonulcer dyspepsia.

Adult↗
PubMed1997

Cytokines in nasal fluids from school children with seasonal allergic rhinitis.

Allergic rhinitis is a particularly good model for studies of cytokine production in vivo. In this study the occurrence of the cytokines IL-4, IL-5, IL-10 and IFN-gamma as well as the soluble receptor for IL-4 in nasal lavage fluids were assayed in 38 school children, with seasonal allergic rhinitis, and 19 healthy age-matched, non-atopic controls, using highly sensitive enzyme immunoassays. IL-4 levels in patients with seasonal allergic rhinitis were markedly increased in comparison with those in non-atopic controls or in atopic patients before the start of the pollen season. In controls, but not in the atopic patients, levels of IFN-gamma and IL-5 were significantly higher in specimens obtained during the pollen season than in those obtained outside the season. The IL-4/IFN-gamma ratios were significantly higher in atopic than in non-atopic subjects and further increased in atopic patients during the season. In addition to IL-4, elevated levels of IL-10 were observed in association with seasonal rhinitis. Following treatment with a topical steroid (budesonide) there was a statistically significant increase of the levels of soluble IL-4 receptor. These findings indicate that nonatopic and atopic individuals react to pollen exposure with distinct cytokine patterns in agreement with the Th1/Th2 concept. Topical steroids may possibly decrease inflammation by increasing the formation of soluble IL-4 receptor.

Adolescent↗
PubMed1997

Can paediatricians benefit from the Internet?

It is likely that many paediatricians will find the Internet useful. The main benefits are probably the ease and speed of communication and immediate access to a few databases such as MEDLINE. It is also practical to integrate the import, processing, storage, and export of data into one's own computer. It is also possible that the Internet in all its forms will become an integrated part of our daily paediatric practice as a result of the increased usage of the Internet by patients, parents, and paediatricians.

Computer Communication Networks↗
PubMed1996

Embolic stroke in a pregnant patient with a mechanical heart valve on optimal heparin therapy.

A 28-year-old woman with a mechanical aortic heart valve experienced an embolic stroke in early pregnancy after her anticoagulation therapy was changed from warfarin to heparin. This occurred despite use of a subcutaneous heparin infusion pump and optimal anticoagulation. Thromboembolism can occur in pregnant patients with mechanical heart valves despite optimal heparin therapy.

Adult↗
PubMed1996

Interleukin (IL)-6 and IL-8 in children with febrile urinary tract infection and asymptomatic bacteriuria.

Urine and serum interleukin (IL)-6 and IL-8 responses were higher in children with febrile urinary tract infection (n = 61) than in those with asymptomatic bacteriuria (n = 39). By univariate analysis, cytokine levels were related to age, sex, reflux, renal scarring, urine leukocytes, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and bacterial properties (P fimbriae but not hemolysin). Multivariate modeling showed that urine IL-6 responses were higher in girls than boys, increased with age, and were positively associated with CRP, ESR, serum IL-6, and urine leukocyte counts. The urine IL-8 response was not influenced by age, but it was influenced by P fimbriae and was associated with ESR, CRP, urine leukocytes, and female sex. The results show that cytokine responses to urinary tract infection vary with the severity of infection and that cytokine activation is influenced by a variety of host and bacterial variables.

Bacteriuria↗
PubMed1996

Additive effects of extra cellular matrix proteins and platelet derived mitogens on human retinal pigment epithelial cell proliferation and contraction.

PURPOSE: In proliferative vitreoretinopathy (PVR) retinal pigment epithelial cells (RPE) cells are thought to synthesize and interact with extracellular matrix (ECM) proteins to form fibrocellular membranes attached to the retina, which the cells then progressively contract detaching the retina. Haemorrhage into the eye is an exacerbating factor in the pathology. To investigate some of the possible interactions between ECM proteins, platelet mitogens and RPE cells in this study, we examined the combined effect of platelet derived mitogens and ECM proteins on RPE cell proliferation and contraction. METHODS: Cells were cultured on a range of individual ECM proteins as well as on the ECM deposited by normal vitreous fluid and exposed to platelet mitogens. Effects on cell proliferation and cell detachment from these substrates and tissue culture plastic were examined. RESULTS: We report additive/synergistic effects of platelet mitogens (PDGF and TGFb1) as well as bFGF, with ECM proteins (laminin, fibronectin, collagen 1 and vitreous-deposited ECM) on RPE proliferation. Further we report stimulation of RPE cell contraction on vitreous proteins when exposed to serum prepared from platelet-rich plasma. In this context it was noticeable that it was cells grown on vitreous matrix plus pigment rather than cells grown on clear vitreous that exhibited this behaviour. CONCLUSIONS: This study supports a combined action of platelet mitogens and matrix proteins in inducing RPE cell proliferation and contractility and provides a simple in vitro model of some of the late stages of PVR.

Blood Platelets↗
PubMed1994

Cervical ripening with the cytokines interleukin 8, interleukin 1 beta and tumour necrosis factor alpha in guinea-pigs.

It has been suggested that the collagenolytic enzymes released from white blood cells which infiltrate the pregnant human uterine cervix at term are responsible for connective tissue changes which take place during the ripening process. Similarly, an infiltration of inflammatory cells occurs in pregnant guinea-pigs either spontaneously at term or at preterm after treatment with the antiprogestin onapristone. The objective of this study was to evaluate the effects of the inflammatory cytokines interleukin 8 (IL-8), interleukin 1 beta (IL-1 beta), tumour necrosis factor alpha (TNF-alpha) and a combination of IL-1 beta and TNF-alpha on cervical ripening in guinea-pigs during advanced pregnancy. The cytokines were applied locally (intracervically) in a gel for 2 days and the effects were assessed on the third day by both extensibility measurements and morphological evaluation. IL-8 treatment on days 42 and 43 post coitum (p.c) and on days 48 and 49 p.c. (term: day 67 +/- 3 p.c.) significantly (P < 0.05) increased cervical extensibility at both stages of pregnancy. Although IL-1 beta treatment (days 42 and 43 p.c.) led to a slight increase in cervical extensibility, this effect was not statistically significant. An electron microscope study performed on days 48 and 49 p.c. revealed a pronounced cervical ripening accompanied by the dissolution of collagen fibres, stromal oedema and the infiltration of polymorphonuclear leukocytes in all cytokine-treated groups. The morphological effects of IL-8 and IL-1 beta were indistinguishable from those observed during normal cervical ripening at term.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗