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Biomedical subjects

M Stein

Publications and source records attributed to M Stein.

At least 235 records · Page 13Linked to original sources
PubMed1992

The value of postoperative irradiation in renal cell cancer.

This is a retrospective analysis of 147 evaluable patients, with histologically proven renal cell carcinoma, who were referred to our center between 1977 through 1988. All patients with disease limited to the kidney underwent nephrectomy. Post-operative megavoltage irradiation, with a median dose of 46 Gy, was given to 56 patients, using parallel opposing portals, or multiple field technique. Five and 10 year actuarial survivals in irradiated patients (Rt+) were 50 and 44%, respectively, and in non-irradiated patients (Rt-) 40 and 32%, respectively. The disease recurred locally in a total of 19 patients; 16 had tumor bed recurrence and three had scar recurrence. Local recurrence by stage was as follows: T2 N0M0: RT+ 0/17, RT- 2/28; T3 N0M0: RT+ 4/37 (10%), RT- 11/30 (37%) (p less than 0.05); T4 N0M0: RT+ 1/2, RT- 1/5. Two of the local recurrences in irradiated patients developed in a surgical scar which was not included in the treatment volume. Significant toxicity developed in three patients (5%). It is concluded that post-operative irradiation can reduce local recurrence rate in T3 N0M0 renal cell carcinoma. It is recommended that the surgical scar should always be included in the treatment volume and irradiated to a full dose.

Actuarial Analysis↗
PubMed1992

Viscosity and social cohesion in temporal lobe epilepsy.

Clinical case reports suggest that viscosity, the behavioural tendency to talk repetitively and circumstantially about a restricted range of topics, is common in patients with temporal lobe epilepsy (TLE). Such patients are also reported to exhibit heightened levels of social cohesion, the tendency to become interpersonally "clingy". This "sticky" interpersonal style may be particularly common in TLE patients with a left sided temporal lobe seizure focus. To test this hypothesis, self-report and observer rating scales were developed to assess both viscosity and social cohesion. Subjects consisted of patients with right, left, or bilateral temporal lobe seizure foci, absence or primary generalised tonic-clonic seizures, psychiatric controls (panic disorder patients), and normal controls. Elevations on the viscosity scale were observed primarily in TLE patients with left or bilateral seizure foci. Viscosity scores also correlated with seizure duration and left handedness. No group differences were observed on the social cohesion scale. These findings are consistent with the hypothesis that viscosity results from subtle interictal language disturbances, although other pathogenetic mechanisms are discussed.

Anomia↗
PubMed1992

Pneumatic reduction of intussusception: 5-year experience.

Pneumatic reduction of 246 intussusceptions was attempted in 219 patients over a 5-year period. The mean age of the patients was 15.4 months. Successful reduction was achieved in 199 cases (80.9%). Bowel perforation occurred in seven cases (2.8%), requiring needle decompression of tension pneumoperitoneum in one case. Recurrence of intussusception occurred in 27 cases (11%). The mean fluoroscopy time was 3.5 minutes +/- 0.2 in successful reductions and 9.3 minutes +/- 0.9 in failed reductions (P less than .001). Logistic regression analysis helped identify four independent predictors of failure, as follows: (a) ileoileocolic intussusception (P less than .001), (b) long duration of symptoms (P less than .001), (c) rectal bleeding (P less than .01), and (d) failed reduction with barium at another institution (P less than .05). Predictors of bowel perforation were a younger age (P less than .05) and long duration of symptoms (P less than .05). Surgery was performed in 48 cases (19.5%), 16 of which required bowel resection. Transmural necrosis of bowel wall was found in nine specimens. The most important predictor of outcome in this series was a long duration of symptoms. Pneumatic reduction is a useful substitute for barium in the management of pediatric intussusception.

Air↗
PubMed1992

Impairment of polymorphonuclear leukocyte function and metabolic control of diabetes.

OBJECTIVE: In this study, ingestion of Staphylococcus aureus and "bacteria killing" (BK) were measured to evaluate polymorphonuclear leukocyte (PMN) phagocytic functions and chemiluminescence response (CL) to phorbol-myristic acetate (PMA) as respiratory burst activity with regard to metabolic control parameters in diabetic patients. RESEARCH DESIGN AND METHODS: PMN phagocytic functions were assessed in 40 diabetic patients, all receiving insulin and in poor metabolic control, with 3H-thymidine-labeled Staphylococcus aureus in a modified radiometric assay. Bacteria killing was determined by pure-plate counting of surviving bacteria (colony-forming units [cfu]) and luminol-enhanced CL in response to PMA as a measure of respiratory burst. PMN function data were correlated to HbA1 as parameter of recent metabolic control. RESULTS: PMN of diabetic patients showed a significant reduction in Staphylococcus aureus (50.7 +/- 4.1%) and BK (29.4 +/- 4.2%) compared with healthy nondiabetic control subjects (76.6 +/- 4.6% and 16.3 +/- 3.1%, respectively, P less than 0.001), and PMN CL response was markedly reduced in diabetic patients also. Linear regression analysis showed a highly significant negative correlation of HbA1 versus Staphylococcus aureus (r = -0.67, P = 0.001) and a positive correlation for BK (r = 0.73, P less than 0.001). This was also true for CL, although this did not reach statistical significance (P = 0.06). CONCLUSIONS: The data obtained demonstrate impaired PMN phagocytic functions and CL response in diabetic patients. These findings suggest inhibitory effects of elevated glucose concentrations on PMNs, a possible role of protein glycosylation for impairing PMN function, thus contributing in part to altered host defense.

Adult↗
PubMed1992

A comparative study of the schizontocidal efficacy and safety of artemether versus chloroquine in uncomplicated malaria.

Forty-seven patients with uncomplicated falciparum malaria were randomly assigned to receive either artemether (n = 24), 9.6 mg/kg body weight intramuscularly over five days or chloroquine (n = 23), 25 mg/kg body weight orally. Patients were kept in hospital for seven days followed by review on days 14, 21 and 28. Five patients on chloroquine were withdrawn before day seven due to treatment failure. Of the remaining patients, parasite clearance time was 33.0 +/- 13.6 hours for the artemether group and 63.3 +/- 14.7 hours for patients on chloroquine (p < 0.001). No significant difference was recorded in fever clearance time between the two groups of patients. Recrudescence rate for patients on artemether was 14.3 pc compared to 57.1 pc for the chloroquine group (p < 0.05). No major adverse events were recorded for either treatment group although five patients on artemether had a transient spike of temperature after clearance of parasitaemia. In conclusion, our study has shown that no major adverse events were experienced by patients on artemether and the rate of parasite clearance for the artemether group was superior to that of patients on chloroquine.

Adolescent↗
PubMed1992

[Impaired induction of chemiluminescence and function of polymorphonuclear neutrophilic granulocytes in diabetes mellitus].

The aim of this study was to investigate PMN-chemiluminescence response as a measure of respiratory burst activity and the phagocytic PMN function "ingestion" with regard to metabolic control parameters in diabetes mellitus (d.m.) in comparison to healthy controls. Our findings demonstrated a significant reduction of chemiluminescence response and ingestion in diabetic patients compared to controls (p less than 0.01 resp.); further an inverse relation of metabolic control parameters in d.m. and PMN impairment, suggesting inhibitory effects on PMN function, thus leading or contributing at least in part to altered host defense.

Diabetes Mellitus↗
PubMed1992

[Reduced phagocytic capacity of circulating granulocytes in diabetes mellitus].

Impaired PMN function is regarded as a major cause for infectious complications in diabetes mellitus (d.m.). The aim of this study was to investigate the phagocytic PMN functions "ingestion" (IN) and "bacterial killing" (BK) with regard to metabolic control parameters and influences of variable glucose concentrations on these PMN functions in vitro. Our findings demonstrated a significant reduction of IN and BK in diabetic subjects compared to controls (p less than 0.001 resp.). The differences between type I and type II d.m. did not reach statistical significance. Linear regression analysis showed significantly negative correlations for fasting blood-glucose concentrations as well as glycosylated hemoglobin (HbA1) and IN (r = -0.34, p 0.03; r = -0.67, p = 0.001) and a highly positive for BK (r = 0.73, p = 0.0001). In vitro there was a significant decrease in IN and BK both in diabetic subjects and controls for glucose concentrations greater than 27.7 mmol/l (p = 0.01 resp.). These data clearly demonstrated impaired PMN ingestion and bacterial killing in diabetic patients, and the degree of PMN dysfunction is inversely related to the degree of metabolic control of diabetes. These findings suggest inhibitory effects of hyperglycemia on PMN functions, thus contributing at least partly to altered host defense in diabetes mellitus.

Blood Bactericidal Activity↗
PubMed1992

Hereditary ovarian cancer: a dilemma in prognosis.

Five women in three generations developed ovarian cancer. We closely monitored 36 descendent women in this family who were at high risk for developing this disease. Prophylactic oophorectomy is considered the optimal way to prevent the development of ovarian cancer. In the light of the young age of the women at risk and their strong objection to oophorectomy, we closely monitored the examinees for early signs of cancer for more than 5 years. None of them developed cancer. The dilemma in treatment of women at risk is discussed.

Adenocarcinoma↗
PubMed1991

[Spermatocytic seminoma of the testis].

During 1968-1988, 6 patients with Stage I spermatocytic seminoma were registered at this oncology center. They represent 7% of a total of 83 patients referred for testicular seminoma (mean age 41 years, range 30-75). All 6 underwent high inguinal orchiectomy and 5 received postoperative radiotherapy. 1 refused any postoperative treatment. In a mean follow-up of 64 months (range 25-204), 4 patients were alive with no evidence of disease, 1 had died of ischemic heart disease without evidence of recurrence of the seminoma, and 1 was lost to follow-up after no evidence of disease was found 90 months after radiotherapy. In the light of our experience and reports in the literature, spermatocytic seminoma has a very good prognosis, although metastatic potential cannot be ruled out. Decision as to treatment should be based mainly on the stage of the disease.

Adult↗
PubMed1991

The effect of high hydrostatic pressure on the modulation of regulatory enzymes from spinach chloroplasts.

High hydrostatic pressure enhanced the specific activity of regulatory enzymes of the Benson-Calvin cycle (fructose-1,6-bisphosphatase, glyceraldehyde-3-P dehydrogenase, phosphoribulokinase) which are modulated by the ferredoxin-thioredoxin system. High activity of chloroplast fructose-1,6-bisphosphatase required dithiothreitol, fructose 1,6-bisphosphate, and Ca2+. At 100 bar the A0.5 for fructose 1,6-bisphosphate (0.3 mM) was lower than that at 1 bar (1.5 mM), whereas similar variations of pressure did not alter the A0.5 for Ca2+ (55 microM). The response of chloroplast glyceraldehyde-3-P dehydrogenase exposed to 500 bar was a 4-fold increase in the NADP-linked activity; conversely, the NAD-dependent activity remained unchanged. The concerted action of high pressure and Pi (or ATP), both activators of chloroplast glyceraldehyde-3-P dehydrogenase, led to inactivation. On the other hand, the activity of phosphoribulokinase increased 10-fold when the enzyme was incubated at 1500 bar; the activation process was strictly dependent on the presence of dithiothreitol. At variance with these enzymes, bovine liver fructose-1,6-bisphosphatase, yeast glyceraldehyde-3-P dehydrogenase, and chloroplast ribulose 1,5-bisphosphate carboxylase, whose activities are not modulated by reduced thioredoxin, were inactivated by high pressure. The comparison of oligomeric enzymes revealed that the stimulation of specific activity by high pressure correlated with thioredoxin-mediated activation, and it did not depend on a particular subunit composition. Present results show that high pressure resembled thioredoxin, cosolvents, and chaotropic anions in its action on regulatory enzymes of the Benson-Calvin cycle. The comparison of physiological and non-physiological modulators suggested that thioredoxin-mediated modifications of noncovalent interactions is an important event in light-dependent regulation of chloroplast enzymes.

Animals↗
PubMed1991

Corticosterone regulation of type I and type II adrenal steroid receptors in brain, pituitary, and immune tissue.

Type I and Type II adrenal steroid receptor levels were compared in the brain, pituitary and immune system of adrenalectomized rats in the presence or absence of several replacement doses of corticosterone. Six days of adrenalectomy produced an up-regulation of Type II adrenal steroid receptors in the brain and spleen. The lowest replacement dose of corticosterone (equivalent to resting levels of this hormone) blocked this Type II receptor up-regulation, while higher replacement doses of corticosterone were associated with widespread Type I and Type II adrenal steroid receptor down-regulation. However, the dose of corticosterone required for receptor down-regulation varied between tissues. Specifically, hippocampal receptors were most sensitive to corticosterone, whereas pituitary receptors were the least sensitive. All tissues examined, except the pituitary, exhibited a down-regulation of Type II receptors with a high corticosterone replacement dose which approximated acute stress levels of this hormone. In summary, physiologically relevant concentrations of corticosterone were capable of down-regulating Type I and Type II adrenal steroid receptors in multiple brain areas and peripheral immune tissues, including peripheral blood mononuclear cells. In contrast, adrenal steroid receptor levels in the pituitary were relatively insensitive to regulation by corticosterone.

Adrenalectomy↗