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Biomedical subjects

M Steiner

Publications and source records attributed to M Steiner.

At least 91 records · Page 5Linked to original sources
PubMed1998

Association of salivary mutans streptococci with discoloured pits and fissures.

Experimental studies have demonstrated that mutans streptococci play a major role in caries etiology. Several previous epidemiologic studies found a positive association of salivary mutans streptococci with caries prevalence. The present epidemiologic study aimed at detecting a possible association of salivary mutans streptococci with brown discoloured pits and fissures, supposing that discolouration indicates caries. In the Canton of Zurich 1035 schoolchildren, aged 6.5-12.5, were examined with regard to caries prevalence and presence of discolourations in pits and fissures. A commercially available, semi-quantitative test was used to estimate the salivary level of mutans streptococci in each child. The salivary level (low/high) of mutans streptococci was significantly associated with the presence of slightly brown discoloured (C1), clearly brown discoloured (C2) and cavitated (C3) pits and fissures. The odds ratios were 1.5 (P<0.01) for C1, 2.5 (P<0.001) for C2 and 5.0 (P<0.001) for C3 pits and fissures. The findings are consistent with the hypothesis that brown discolouration indicates caries. Furthermore, the findings suggest that this type of discolouration at elementary school age indicates increased caries activity.

Age Factors↗
PubMed1998

alpha-1-Microglobulin: epidemiological indicator for tubular dysfunction induced by cadmium?

OBJECTIVES: To evaluate the suitability of alpha-1-microglobulin as a marker for cadmium induced renal dysfunction. METHODS: alpha-1-Microglobulin was studied in a cross sectional survey in relation to the body burden of cadmium. Concentrations of alpha-1-microglobulin in 24 h urine of 831 people aged 2-87 years were analysed in association with urinary cadmium excretion, cadmium blood concentration, age, sex, occupational and smoking history, and estimated creatinine clearance. Participants came from a population residentially exposed to cadmium and from two control populations matched for socioeconomic status. RESULTS: The excretion of alpha-1-microglobulin/24 h ranged from 0.1 mg to 176.3 mg and 44.4% of samples showed concentrations near the detection limit. Ordinal logistic regression analysis of people of all ages identified a high risk only for males compared with females (odds ratio (OR) 2.14; 95% confidence interval (95% CI) 1.56 to 2.94), age group, and duration of living on contaminated soil (OR 1.03/year; 95% CI 1.02 to 1.04), but not urinary cadmium excretion (OR 1.30; 95% CI 0.96 to 1.77) as significant predictors. For people < or = 50 years of age a weaker effect of sex (OR 1.76; 95% CI 1.13 to 2.73) and age group and an effect of similar magnitude for the duration of soil exposure (OR 1.03; 95% CI 1.01 to 1.04) were found. Also, the urinary cadmium excretion (OR 2.26; 95% CI 1.38 to 3.70) and occupational exposure (OR 1.71; 95% CI 1.03 to 2.83) were found to be significant in this younger age group. The estimated creatinine clearance had no significant impact on the alpha-1-microglobulin excretion. CONCLUSION: alpha-1-Microglobulin is a suitable marker for early tubular changes only for people < or = 50 years. It may not be sufficiently specific for cadmium, and therefore not a suitable surrogate for cadmium exposure in epidemiological studies.

Adolescent↗
PubMed1998

Double-blind, fixed-dose, placebo-controlled study of paroxetine in the treatment of panic disorder.

OBJECTIVE: This study was designed to determine the minimum paroxetine dose effective for treating panic disorder. METHOD: Of 425 patients with DSM-III-R panic disorder with or without agoraphobia who underwent a 2-week drug-free screening period, 278 patients were randomly assigned to double-blind treatment with a 10-week course of placebo or paroxetine at a dose of 10, 20, or 40 mg/day. RESULTS: At 40 mg/day, paroxetine was superior to placebo across the majority of outcome measures. Despite a mean of 9.5 to 11.6 full panic attacks during the screening period, 86.0% of the patients taking 40 mg of paroxetine, 65.2% of those taking 20 mg, 67.4% of those taking 10 mg, and 50.0% of the placebo-treated patients were free of full panic attacks during the 2 weeks ending at week 10. The 40-mg paroxetine group experienced significantly greater global improvement than the placebo group and significantly greater improvement in frequency of full and limited-symptom panic attacks, intensity of full panic attacks, phobic fear, anxiety, and depressive symptoms, usually evident by week 4. All doses of paroxetine were well tolerated, and adverse effects were consistent with those associated with selective serotonin reuptake inhibitors. CONCLUSIONS: Paroxetine is an effective and well-tolerated short-term treatment of panic disorder. The minimum dose demonstrated to be significantly superior to placebo was 40 mg/day, although some patients did respond at lower doses.

Adult↗
PubMed1998

Effects of electroconvulsive therapy and desipramine on neuroendocrine responses to the clonidine challenge test.

OBJECTIVE: To investigate responses to the clonidine challenge test in depression, and after electroconvulsive therapy (ECT) or desipramine treatment for depression, in order to determine the usefulness of noradrenergic responses to clonidine as a state or trait marker in depression. PATIENTS: Twenty-six patients with depression and 15 control subjects. SETTING: The psychiatric ward of St. Joseph's Hospital in Hamilton. INTERVENTIONS: In the patients with depression: clonidine challenge pre- and post-treatment with ECT or desipramine. In the controls: 2 clonidine challenge tests 4 to 8 weeks apart. OUTCOME MEASURES: The primary measure was the growth hormone response to the clonidine challenge. Plasma norepinephrine, 3-methoxy-4-hydroxyphenylglycol (MHPG), cortisol, blood pressure, pulse and sedation levels were examined in subgroups of participants as secondary measures. RESULTS: The pre-treatment growth hormone response to clonidine was significantly more blunted in patients than in controls (p = 0.02). This response improved in both treatment groups after therapy and, although it remained decreased, there was no longer a significant difference in response between the patients and the controls. In the patients, a decreased growth hormone response to clonidine at baseline was correlated with response to treatment. Of the secondary measures, patient baseline norepinephrine levels were significantly elevated pre- and post-treatment, although there were no significant group-by-time challenge effects. MHPG levels were not significantly different pre- and post-treatment between patients and controls. Baseline blood pressure and pulse were elevated in the patients pre- and post-treatment. These differences were not statistically significant and did not change after treatment. Sedation levels were not significantly different among the groups at baseline. Clonidine-induced sedation occurred significantly earlier in the patients pretreatment and improved to the range of the controls after treatment. Pretreatment cortisol response was significantly more blunted in the patients who received ECT than in the controls; however, the group-by-time effect post-treatment was no longer significant. DISCUSSION: Treatment with either desipramine or ECT modified noradrenergic functioning in patients with depression, as assessed by growth hormone response to the clonidine challenge. In the patients, a decreased growth hormone response at baseline was correlated with clinical response. Changes between pre- and post-treatment measures suggest that this challenge test may not be sensitive enough to serve as a trait marker but may correlate with the state of depression in a subpopulation of these patients.

Adrenergic alpha-Agonists↗
PubMed1998

Efficacy studies of paroxetine in panic disorder.

The optimal assessment of treatment outcome for studies assessing the efficacy of treatments for panic disorder has been a controversial topic. A recent National Institute of Mental Health (NIMH)-sponsored consensus conference addressed this important topic, and a summary paper regarding assessment of essential elements of the disorder resulted. Among other conclusions, it was agreed that several different domains should be considered as essential. This article reviews three pivotal studies assessing the efficacy of paroxetine for the treatment of panic disorder, and evaluates these studies for inclusion of those variables considered essential. Additionally, some data were reanalyzed to determine the percentage of individuals in these studies who are unequivocal responders (i.e., were both panic-free and rated on global assessment as responders). A longer-term treatment and relapse study is also mentioned briefly.

Antidepressive Agents, Second-Generation↗
PubMed1998

Circulating ICAM-1 and VCAM-1 in peripheral artery disease and hypercholesterolaemia: relationship to the location of atherosclerotic disease, smoking, and in the prediction of adverse events.

We examined the relationship of soluble intercellular adhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule-1 (sVCAM-1) with smoking and hypercholesterolaemia in peripheral artery disease (PAD). Serum samples were obtained from 119 patients with objectively-proven PAD, 39 patients with hypercholesterolaemia but asymptomatic for PAD, and 132 age and sex matched asymptomatic controls. Using ELISAs, we found increased sICAM-1 and sVCAM-1 (both p <0.01) in the patients with PAD relative to the controls, but no significant change in patients with hypercholesterolaemia. However, the effect for sVCAM-1 was lost when smoking was entered as a covariate. Only sICAM-1 was higher in patients with PAD in the femoral/iliac arteries compared to the carotid arteries (p <0.05). In a 39-month follow-up of 112 patients with PAD, increased ICAM-1 weakly (univariate p <0.05) predicted those 57 whose disease progressed (i.e. to end points such as myocardial infarction and arterial surgery). However, high fibrinogen was a much better (univariate p = 0.001, multivariate p <0.05) predictor of disease progression. We suggest (i) that increased levels of sVCAM-1 in atherosclerosis are due to smoking, (ii) that increased sICAM-1 is independent of this risk factor, (iii) that both these changes are independent of hypercholesterolaemia, and (iv) that increased sICAM-1 is a weak predictor of disease progression in peripheral atherosclerosis.

Aged↗
PubMed1998

Perinatal mood disorders: position paper.

Psychiatric disorders associated with childbearing are traditionally divided into three categories that reflect severity: postpartum blues, postpartum depression, and postpartum psychosis. It is estimated that while more than 80 percent of women may experience some fluctuations in mood in either the antepartum period or postpartum, only 10 to 20 percent may meet DSM-IV criteria for major depression and 0.1 to 0.2 percent will show signs of psychosis. Pregnancy and childbirth have an enormous combined psychological and physiological effect on a woman's body; a causal link between hormonal changes and changes in mood has been suggested. The evidence (or lack of) for a biological component of postpartum mood disorders is briefly reviewed. Assessment and treatment of antepartum and postpartum mood fluctuations is further discussed with emphasis on more education, recognition, and if possible, prevention of these disorders.

Depression, Postpartum↗
PubMed1997

MHC class I and II expression in prostate carcinoma and modulation by interferon-alpha and -gamma.

BACKGROUND: Expression of Major Histocompatibility Complex (MHC) class I and II antigens are critical for the cellular immune response. Loss of MHC expression represents one mechanism by which cancer cells escape immune recognition. PURPOSE: To define MHC class I and II expression by prostate cancer (PCa) in vivo and in vitro and the ability to modulate MHC expression in vitro with IFN-alpha and -gamma. METHODS: Frozen tissue sections of 25 benign prostatic hyperplasia (BPH) and 18 PCa specimens were studied by immunohistochemistry. PCa cell lines LNCaP, PC-3, and DU-145 were studied by FACS, ELISA, and cytospin. Class I was detected by monoclonal antibody (mAb) W6/32, and class II by mAb 13.17. The effects of IFN-alpha and -gamma were assessed by testing the three cell lines in the presence or absence of varying concentrations of the cytokine for varying incubation times. RESULTS: Class I was strongly expressed by 24/25 BPH specimens; 4/18 (22%) PCa were homogeneously class I-positive, while 5/18 (28%) were heterogeneously positive and 9/18 (50%) were class I-negative. PC-3 and DU-145 expressed normal levels of class I, while LNCaP expressed only low levels. All line except LNCaP demonstrated significant up-regulation of class I with either IFN-alpha or -gamma. Class II expression was not seen in BPH epithelium nor in 17/18 PCa. Class II could be only weakly induced in the three PCa lines. CONCLUSIONS: These findings confirm prior studies demonstrating that class I expression is commonly lost or diminished in PCa. In addition, class II up-regulation by IFN-gamma appears very limited in relation to other normal or neoplastic epithelium. IMPLICATIONS: The present findings, taken together with previous studies, are most consistent with the expression of neoantigens by PCa, which are recognized and appropriately eliminated by the cellular immune system. This selective pressure favors outgrowth of cells which down-regulate or lose class I and/or class II expression. Understanding PCa immunobiology will help in the development of effective immunotherapy for this disease.

Enzyme-Linked Immunosorbent Assay↗
PubMed1997

dl-alpha-tocopherol, a potent inhibitor of phorbol ester induced shape change of erythro- and megakaryoblastic leukemia cells.

Synthetic vitamin E, dl-alpha-tocopherol, added to a human erythroleukemia HEL and a megakaryoblastic leukemia, Meg-01, cell culture produced potent dose-dependent inhibition of phorbol ester-induced adhesion and of the morphologic changes accompanying it. The inhibition was reversible by withdrawal of supplemental vitamin E from the medium. dl-alpha-Tocopherol also inhibited protein kinase C activity both at baseline and after phorbol ester stimulation. Arachidonic acid stimulated protein kinase C activity of erythroleukemia cells and promoted their adhesion, an effect that was also inhibited by dl-alpha-tocopherol. Introduction of a protein kinase C-neutralizing antibody or a protein kinase C-inhibitor substrate into permeabilized HEL cells inhibited phorbol ester-induced adhesion and shape change. dl-alpha-Tocopherol also affected the cellular distribution of protein kinase C, shifting the major portion of the enzyme to the cytosol fraction and reducing phorbol ester-induced membrane association of the enzyme. Thus, protein kinase C appears to mediate shape change and adhesion, both of which are strongly inhibited by dl-alpha-tocopherol.

Arachidonic Acid↗
PubMed1997

Cortisol, hedonics, and maternal responsiveness in human mothers.

New mothers are more attracted to the body odor of newborn infants than are nonmothers. In this study we investigated the relation of postpartum hormones and of prior experience with infants to this enhanced maternal attraction to infant odors. New mothers were asked to complete a hedonics task, using a pleasantness scale to provide an attraction score to different odorants presented on a cotton substrate in a 1-pt Baskin-Robbins container. Mothers were "blind" to the contents of the container. Participants also completed an extensive set of 100-item likert scales concerning their attitudes toward infants, care taking, own maternal adequacy, and other interpersonal relations. Mothers were videotaped interacting with their infants and provided salivary samples prior to the interaction. Salivary samples were assayed by radioimmunoassay (RIA) for salivary concentrations of cortisol, progesterone, and testosterone. Results show that first-time mothers with higher cortisol concentrations were more attracted to their own infant's body odor. Mothers with higher cortisol levels were also better able to recognize their own infants' odors. While cortisol was not related to attitudinal measures of maternal responsiveness, mothers with more prior experience interacting with infants exhibited both more attraction to infant odors and more positive maternal attitudes. Together, prior maternal experience and postpartum cortisol explain a significant proportion of the variance in mothers' attraction to newborn infant odors. These relations are discussed in terms of the variety of "meanings" cortisol could have during the postpartum period.

Adult↗
PubMed1997

Necrotizing skin lesions induced by low-molecular-weight heparin after total knee arthroplasty.

We report the unusual complication of focal necrotizing skin lesions accompanied by moderate thrombocytopenia in a female patient undergoing thromboprophylaxis with low-molecular-weight heparin after total knee arthroplasty. Heparin-induced thrombocytopenia was suspected and confirmed using the heparin-induced platelet activation assay. The skin lesions improved gradually after the discontinuation of heparin application. In addition to the description of this exceptionally rare adverse effect of low-molecular-weight heparin, a brief discussion of previously reported cases is provided.

Aged↗
PubMed1997

[Ultrasound biomicroscopy for localization of artificial lens haptics after trans-scleral suture fixation].

Correct positioning of transscleral haptics for sulcus fixation of IOL haptics may be difficult due to lack of visual control by the surgeon. We determined the haptic sites in eyes which underwent secondary IOL implantation with transscleral suturing using ultrasound biomicroscopy (UBM) (Humphrey Instruments, Inc., San Leandro, CA, USA). Eighteen eyes of 17 patients were included in the study. The follow-up time ranged from 1 to 36 months (mean: 7 months). The positions of 36 IOL-haptics were documented by UBM examination. Twelve haptics (33%) were found in the sulcus, whereas 18 haptics (50%) were located posteriorly to the sulcus. Six haptics (17%) were identified anteriorly to the sulcus. There were no complications resulting from dislocation. In one of the eyes, suture infection occurred requiring surgical revision and antibiotic therapy.

Follow-Up Studies↗
PubMed1997

Effect of fluoxetine on menstrual cycle length in women with premenstrual dysphoria.

OBJECTIVE: To examine whether changes in menstrual cycle length occurred in women who received 20 mg of fluoxetine per day and women who received 60 mg of fluoxetine per day as compared with women who received placebo. METHODS: A two-cycle, single-blind placebo phase was followed by a six-cycle double-blind phase. Only placebo nonresponders were randomized to one of three treatment arms: placebo, fluoxetine 20 mg/day, or fluoxetine 60 mg/day. Cycle length was established using a prospective daily calendar. Cycle-length data from women who completed at least three treatment cycles were used in this analysis. Cycle-length change was defined a priori as cycle lengthening or shortening of 4 days or more (1 or more standard deviations from the mean change between baseline cycles). RESULTS: Eleven of the 62 women receiving 60 mg of fluoxetine per day and seven of the 70 women receiving 20 mg of fluoxetine per day but only one of the 61 women in the placebo group demonstrated cycle-length change at the end of the first treatment cycle (P = .011). In total, 15% of the women in the fluoxetine 60 mg/day group demonstrated a cycle-length change during two of the three observed cycles compared with 6% of the women in the fluoxetine 20 mg/day group and 3% of the women in the placebo group (P = .048). Women with cycle-length changes demonstrated either shortening or lengthening only. There were no differences between the number of women with changes in either direction. CONCLUSION: Cycle-length change occurred more frequently in the fluoxetine 60 mg/day group than in the fluoxetine 20 mg/day or placebo groups. The effects of selective serotonin reuptake inhibitors on menstrual cycle length are mostly unknown and warrant careful monitoring in women of reproductive age, who are the prime consumers of these medications.

Adult↗
PubMed1997

Myositis ossificans traumatica of the masseter muscle: review of the literature and report of two additional cases.

Myositis ossificans traumatica of the masseter muscle is uncommon. The condition is benign and results in reactive heterotopic bone formation, usually producing limitation of opening of the jaws. Radiographic and microscopic examination can confirm the diagnosis. Treatment of myositis ossificans traumatica of the masseter muscle is surgical, with other modalities used when occurring in other muscles of the body.

Adolescent↗