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Biomedical subjects

M C Benson

Publications and source records attributed to M C Benson.

90 records · Page 5Linked to original sources
PubMed1987

Prostate cancer in men less than 45 years old: influence of stage, grade and therapy.

We analyzed patients with histologically proved adenocarcinoma of the prostate to determine the natural history of prostatic cancer in men less than 45 years old. The mean age of the patients was 41 years (range 36 to 44 years). At presentation 5 patients were asymptomatic, 5 had voiding symptoms, 3 had bone pain, 3 had hematuria and 1 had testicular pain. Followup in these patients ranged from 19 to 270 months, with a mean of 111 months. Six patients with clinical stage B disease at diagnosis underwent radical retropubic prostatectomy. These patients enjoy projected 10 and 15-year survival rates of 100 and 82 per cent, respectively. Four patients with stage C disease died of prostatic cancer, although 1 survived for 204 months. Of 4 patients with stage D disease 3 died within 13 months, while 1 still is alive at 48 months. No patient with a Gleason tumor score of 8 to 10 survived more than 13 months. Patient age at presentation appears to be less important than clinical stage, histological grade or treatment modality in the prediction of the course of prostatic cancer. Young men with localized disease at presentation should be treated aggressively and they should have survival rates comparable to actuarial expectancy.

Adenocarcinoma↗
PubMed1987

The role of surgery in the treatment of hormone resistant prostatic cancer.

The role of surgery in the treatment of hormone refractory prostatic cancer is extremely limited. Rarely, patients with locally advanced, uncontrollable, non-metastatic prostatic cancer enjoy prolonged survival. However, these patients represent an extremely small percentage of patients with prostatic cancer. Radical surgery should be applied to palliate selected patients with uncontrollable local symptoms. However, prostate cancer rarely behaves in a manner necessitating this type of intervention and thus only rarely do patients require radical surgery for local palliation.

Humans↗
PubMed1987

Management of primary stage D prostatic cancer.

Androgen withdrawal rarely if ever results in a cure of prostatic carcinoma. Thus, if the object of therapy is to cure rather than palliate, it is necessary for us to alter our strategem so as to trick the prostatic cancer cells into dying while sparing the host. Data has been presented that suggest that tumor cell heterogeneity and the preexistence of populations of cells resistant to androgen withdrawal are responsible for the failure of hormonal therapy. Additionally, the use of androgen withdrawal as a single mode of therapy may actually induce a more rapid emergence of cells resistant to chemotherapeutic intervention by increasing the genetic instability of the tumor population. Assuming that a tumor is composed of a heterogeneous population of cells and the institution of unimodal therapy will exert a destabilizing influence on the tumor, the logical therapy for disseminated disease would be multimodal therapy. Animal models suggest that the most effective therapy for disseminated disease would be a combination of androgen withdrawal and cytotoxic chemotherapy instituted as early as possible when the number of cells capable of division, stem cells, is at minimum. Whether or not early, sequential withdrawal, repletion, withdrawal of hormones to synchronize the tumor cell cycle and increase the growth fraction of the tumor will have any beneficial effects remains to be determined. This form of androgen priming should be safer than in patients with hormonally refractive disease since LHRH initially stimulates testosterone production without any significant irreversible sequelae. Although the above therapeutic logarithms may prove to have no therapeutic advantage over androgen withdrawal alone, it certainly seems a good starting point for a change in our therapeutic concepts. Only by adopting new approaches based upon what we know about tumor biology can we hope to impact on the current dismal prognosis.

Combined Modality Therapy↗
PubMed1986

The application of flow cytometry to the assessment of tumor cell heterogeneity and the grading of human prostatic cancer: preliminary results.

A new method has been developed to assess quantitatively tumor cell morphology and tumor cell heterogeneity. Preliminary results suggest that this method may be capable of predicting the metastatic potential of a tumor based upon analysis of a biopsy sample. A flow cytometric grading index was established based upon the mean and variance in perpendicular and forward light scatter. The mean was included to assess the tumor as a whole. The variance was included to assess the range of morphological heterogeneity within the tumor. This flow cytometric grading index has allowed for the accurate prediction of the ultimate pathological stage in a small series of human prostatic cancers obtained at the time of radical retropubic prostatectomy and lymph node dissection. Patients with high flow cytometric index values had seminal vesicle invasion and capsular penetration by prostatic cancer. Those with intermediate index values had capsular penetration only. The patient with a low index value had a small cancer confined totally to the surgical specimen.

Aged↗
PubMed1986

Planning and integrating a behavioural sciences curriculum.

This paper describes methods of planning and integrating an introductory course in human behaviour for first-year medical students, from a primary care perspective. The conceptual model is based on a synthesis of the literature on stress, stress responses and human development. An experiential component integrates didactic material and clinical experience. The teaching methods are based on formats, such as grand-rounds, used by postgraduate doctors. Specific techniques are described to integrate the diverse components of the curriculum: timing of learning experiences; training of academic staff; preparation of patient volunteers; and use of student representatives.

Attitude of Health Personnel↗
PubMed1985

A model for teaching the brief psychosocial interview.

A technique to teach first-year medical students to conduct brief interviews that focus on how medical illness affects the daily life of patients is described. The technique includes a conceptual model of the interview and an explicit teaching method for instructors and students. With the conceptual model, the structure, goals, and techniques of interviewing are identified, and an operational definition of empathic interviewing is provided. The teaching methods include a manual and a seminar for faculty members, a syllabus for students, workshops for students using live patient volunteers, and evaluations of the students' interviews based on the conceptual model.

Education, Medical↗
PubMed1985

Career orientations of medical and pediatric residents.

Educators have expressed concern about the declining percentage of graduating residents who choose an academic career. This study identifies characteristics of postgraduate physicians that are associated with intentions to pursue an academic career or a full-time private practice. Data were obtained from 299 residents in pediatrics and internal medicine at five academic medical centers in Southern California, using self-report questionnaires. Preference for an academic career was strongest among residents who were most satisfied with their work, were frequently sponsored by faculty, had published, or who either lived alone or were married to another professional. The likelihood of full-time private practice was strongest among residents who were less frequently sponsored by faculty, had not published, lived with others, were from certain medical schools, or were females. Training programs may wish to consider some of these factors in the selection of residents and in program development.

Academic Medical Centers↗
PubMed1984

The application of perpendicular and forward light scatter to assess nuclear and cellular morphology.

Perpendicular and forward light scatter have been employed in a multiparametric approach to distinguish the various lines of the transplantable Dunning R3327 rat prostatic adenocarcinoma. Perpendicular light scatter has been shown to correlate with nuclear size and shape. The average intensity of forward light scatter and perpendicular light scatter signals was demonstrated to increase as cells became less well-differentiated. The combination of perpendicular and forward light scatter allows for the discrimination of histologically indistinguishable tumors and may therefore be useful to establish a system of grading cancer.

Adenocarcinoma↗
PubMed1984

The use of multiparameter flow cytometry to assess tumor cell heterogeneity and grade prostate cancer.

Multiparametric flow cytometry has permitted the quantitative assessment of tumor cell heterogeneity within a single tumor. This technique was applied to four tumor lines with biological activity similar to the variety observed in human prostate cancer. These tumors were derived from the Dunning R3327 transplantable rat prostatic adenocarcinoma and have permitted the development of an index to assess, quantitate, and discriminate variation in the aggressive nature of these tumors. The index is based upon measurements of the mean and the variance for perpendicular light scatter and forward light scatter. Perpendicular light scatter has been shown to correlate with nuclear shape, volume, and roundness as measured by digitized image analysis. Forward light scatter increases in quantity and range as the tumors become more undifferentiated. This technique is rapid, reproducible, and applicable to the quantitative measurement of cytometric parameters on large numbers of individual tumor cells.

Adenocarcinoma↗
PubMed1972

Role of DNA and specific cytoplasmic receptors in glucocorticoid action.

Glucocorticoids induce tyrosine aminotransferase (EC 2.6.1.5) synthesis in cultured rat hepatoma cells. These steroids penetrate the cell membrane and bind to specific cytoplasmic receptor proteins. The resulting complex binds to the nucleus. This nuclear binding has now been studied in a cell-free preparation. The reaction appears to require a temperature-dependent modification of the steroid-receptor complex. There is a fixed number of nuclear sites that are half saturated at a complex concentration of 6 to 24 x 10(-11) M. Treatment with deoxyribonuclease destroys nuclear-binding capacity. The complex also binds to purified HTC cell DNA with characteristics similar to the binding to isolated nuclei, and, as in intact cells, receptors complexed with an anti-inducer steroid bind very poorly to DNA. These data suggest that the nuclear sites for binding steroid-receptor complexes are on the DNA. Since the extent of complex binding to purified DNA exceeds that observed with isolated nuclei, chromosomal proteins may act to restrict binding to certain regions of the DNA. These studies suggest that steroid hormones stimulate the synthesis of specific proteins by affecting the transcription of structural or regulatory genes.

Binding Sites↗
PubMedDate not supplied

A home-visit program for first-year medical students as perceived by participating families.

A program to train first-year medical students to identify the impact of chronic disease on family functioning consists of a lecture/demonstration, reading materials, and a family home visit for small groups of eight students and an instructor. The authors used a self-report questionnaire to evaluate 30 families (88% response rate) participating in the home visits. Although 28% of families reported they were uncomfortable sharing a family problem, 90% of families reported no tensions or problems as a consequence of the visit. Two-thirds of the families learned new information about their family and two families decided to visit a health professional as a result of the visit. Almost all families were willing to participate again, demonstrating that family home visits are feasible and have few adverse consequences in a well-supervised training program.

Curriculum↗