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Biomedical subjects

M Weinstein

Publications and source records attributed to M Weinstein.

At least 19 recordsLinked to original sources

Elevated cholesterol metabolism and bile acid synthesis in mice lacking membrane tyrosine kinase receptor FGFR4.

Heparan sulfate-regulated transmembrane tyrosine kinase receptor FGFR4 is the major FGFR isotype in mature hepatocytes. Fibroblast growth factor has been implicated in the definition of liver from foregut endoderm where FGFR4 is expressed and stimulation of hepatocyte DNA synthesis in vitro. Here we show that livers of mice lacking FGFR4 exhibited normal morphology and regenerated normally in response to partial hepatectomy. However, the FGFR4 (-/-) mice exhibited depleted gallbladders, an elevated bile acid pool and elevated excretion of bile acids. Cholesterol- and bile acid-controlled liver cholesterol 7alpha-hydroxylase, the limiting enzyme for bile acid synthesis, was elevated, unresponsive to dietary cholesterol, but repressed normally by dietary cholate. Expression pattern and cholate-dependent, cholesterol-induced hepatomegaly in the FGFR4 (-/-) mice suggested that activation of receptor interacting protein 140, a co-repressor of feed-forward activator liver X receptor alpha, may mediate the negative regulation of cholesterol- and bile acid-controlled liver cholesterol 7alpha-hydroxylase transcription by FGFR4 and cholate. The results demonstrate that transmembrane sensors interface with metabolite-controlled transcription networks and suggest that pericellular matrix-controlled liver FGFR4 in particular may ensure adequate cholesterol for cell structures and signal transduction.

Animals↗

Haploid loss of the tumor suppressor Smad4/Dpc4 initiates gastric polyposis and cancer in mice.

The tumor suppressor SMAD4, also known as DPC4, deleted in pancreatic cancer, is a central mediator of TGF-beta signaling. It was previously shown that mice homozygous for a null mutation of Smad4 (Smad4-/-) died prior to gastrulation displaying impaired extraembryonic membrane formation and endoderm differentiation. Here we show that Smad4+/- mice began to develop polyposis in the fundus and antrum when they were over 6 - 12 months old, and in the duodenum and cecum in older animals at a lower frequency. With increasing age, polyps in the antrum show sequential changes from hyperplasia, to dysplasia, in-situ carcinoma, and finally invasion. These alterations are initiated by a dramatic expansion of the gastric epithelium where Smad4 is expressed. However, loss of the remaining Smad4 wild-type allele was detected only in later stages of tumor progression, suggesting that haploinsufficiency of Smad4 is sufficient for tumor initiation. Our data also showed that overexpression of TGF-beta1 and Cyclin D1 was associated with increased proliferation of gastric polyps and tumors. These studies demonstrate that Smad4 functions as a tumor suppressor in the gastrointestinal tract and also provide a valuable model for screening factors that promote or prevent gastric tumorigenesis.

Age Factors↗

Do health interview surveys yield reliable data on chronic illness among older respondents?

Previous research evaluating quality of health interview survey data has generally relied upon comparisons of household interview data with medical records or other external sources of information. However, "gold standards" are not always satisfactory or available. This paper illustrates an alternative approach to the evaluation of data quality-examination of the reliability of reports of chronic conditions in longitudinal surveys. The data come from national samples of older Americans (First National Health and Nutrition Examination Survey Epidemiologic Followup Study, 1971-1975, 1982-1984, 1986) and older Taiwanese (Survey of Health and Living Status of the Elderly, 1989, 1993, 1996). The results show that, among respondents who reported a chronic condition at a given interview, the likelihood that the condition was acknowledged at the subsequent interview was higher for hypertension and diabetes than for arthritis and stroke. Low levels of consistency for stroke appear to result partly from the poor wording of questions. In Taiwan, younger, more educated persons and those experiencing severe conditions were somewhat more likely to acknowledge the condition at follow-up compared with their respective counterparts. Women and persons of high cognitive status in the United States and respondents in both countries who used a proxy to report the occurrence of a stroke were also more likely to acknowledge conditions at follow-up.

Adult↗

Radiation and intra-arterial cisplatin: effects on arteries and free tissue transfer.

OBJECTIVES: To determine the histopathologic effect of combined intra-arterial cisplatin administration and hyperfractionated external beam radiation treatment (HYPERRADPLAT) on potential recipient arteries in the neck and to analyze the efficacy of free tissue transfer (FTT) in patients undergoing HYPERRADPLAT. DESIGN: Cisplatin-perfused and nonperfused artery segments were harvested during planned interval neck dissection performed 6 to 10 weeks after HYPERRADPLAT. These segments were evaluated by light microscopy and transmission electron microscopy. All patients undergoing FTT after HYPERRADPLAT were reviewed retrospectively. SETTING: Academic medical center. PATIENTS AND INTERVENTION: Eight patients undergoing HYPERRADPLAT for head and neck squamous cell carcinoma and planned interval neck dissection were prospectively studied. All patients had a perfused artery sampled, and 3 also had a nonperfused (control) artery sampled. Five patients undergoing FTT after HYPERRADPLAT were retrospectively analyzed for outcome of FTT. RESULTS: No consistent histological or ultrastructural differences were detected between injected and noninjected arteries. Both demonstrated intimal thickening, collagen and elastin deposition in the intimal layer, and, occasionally, intimal smooth muscle proliferation. A smaller fraction of the injected and noninjected arteries demonstrated smooth muscle cell vacuolation, elastic fiber degeneration, and calcific deposits. Four of 5 FTTs in patients undergoing HYPERRADPLAT were successful. CONCLUSIONS: The changes seen in the injected and noninjected arteries were characteristic of ionizing radiation. Arteries treated with HYPERRADPLAT had no observable difference from vessels treated with radiation alone. These vessels can be used with caution as recipient vessels for FTT. Further clinical experience is needed to establish the expected results of FTT using these arteries.

Antineoplastic Agents↗

Optical coherence tomography as a method for identifying benign and malignant microscopic structures in the prostate gland.

OBJECTIVES: Optical coherence tomography (OCT) is a new optical imaging technique capable of providing cross-sectional imaging of tissue microstructure in vivo and in real time. OCT was used in the setting of the human prostate ex vivo, and the images acquired were compared with those obtained using standard histopathologic methods. METHODS: Multiple samples (3 to 6) were obtained from the radical prostatectomy specimens of 7 men with clinically localized (T1c-2, N0, M0) adenocarcinoma of the prostate. These specimens were 1 cm in length and 1 mm x 1 mm in rectangular cross section. Specimens were first imaged using OCT and then embedded and stained in preparation for histopathologic evaluation. Co-registration of the images obtained using OCT and standard histopathologic evaluation provided the basis for comparison. RESULTS: Structural architecture on the order of 50 to 150 microm within benign glandular epithelium, fibroadipose tissue, and malignant glandular epithelium could be resolved to a depth of approximately 0.5 mm using OCT. CONCLUSIONS: Microscopic resolution is possible in human prostatic tissue using OCT. Further studies using this technique to improve the detection and staging of adenocarcinoma of the prostate are ongoing.

Adenocarcinoma↗

Fibroblast growth factor receptors (FGFRs) and their roles in limb development.

Fibroblast growth factor (FGF) receptors constitute a family of four membrane-spanning tyrosine kinases (FGFR1-4) which serve as high-affinity receptors for 17 growth factors (FGF1-17). To study functions of FGF/ FGFR signals in development, mice that carry mutations in each receptor have been created by gene targeting. Analysis of these mutant mice revealed essential functions of FGF receptors in multiple biological processes, including mesoderm induction and patterning, cell growth and migration, organ formation and bone growth. In this review we discuss recent work with FGF receptors to illustrate mechanisms, through which the FGF/FGFR signals specify vertebrate limb initiation, outgrowth and patterning.

Animals↗

Decalcification and bond failure: A comparison of a glass ionomer and a composite resin bonding system in vivo.

Decalcification during orthodontic treatment is a serious problem. A glass ionomer agent is now available to bond orthodontic brackets as an alternative to composite resins. This prospective study was a clinical trial to determine if a glass ionomer bonding system (Fuji Ortho LC) decreases the incidence of decalcification without increasing the amount of bonding failures. A prospective clinical trial with 16 patients encompassing a total of 298 teeth was conducted. The 149 control teeth were bonded with a light-cured composite resin (Reliance Light Bond) whereas the 149 experimental teeth were bonded with the light-cured glass ionomer agent. Patients were followed for a period of 12 to 14 months. All teeth were evaluated for breakage (bonding failure rate), and all maxillary anterior teeth (96) were evaluated for decalcification on a graded scale. The glass ionomer failure rate was 24.8%, and was higher than the composite resin failure rate of 7.4% (P <.001). There were more glass ionomer bond failures in 12 of 16 patients (P <.001). Enamel decalcification was similar in the 2 bonding systems.

Acid Etching, Dental↗

Effectiveness of a fluoride-releasing sealant in reducing decalcification during orthodontic treatment.

Decalcification and caries during orthodontic treatment still remains a problem. A method to protect the susceptible area beneath and adjacent to bonded attachments, independent of patient compliance, would be extremely beneficial. A clinical trial was performed using a dual-cured lightly filled BIS-GMA fluoride-releasing sealant. The barrier effect of this material on white spot formation, gingival irritation, and plaque accumulation during fixed orthodontic therapy was examined. Twenty patients with a total of 225 metal brackets placed on anterior teeth participated in this study. Brackets were placed in both arches in a conventional manner with a chemically cured, unfilled bonding resin; 112 teeth (every other tooth) received the barrier material after bracket placement, while the remaining 113 teeth served as controls. Intraoral photographic slides were taken before and after treatment and were evaluated blindly by 7 observers for white spot formation. Gingival and plaque indexes were recorded initially and consecutively every 6 months. Observation time ranged from 5 to 18 months. The results of this prospective clinical study indicated that there was no significant difference (P >.05) between the decalcification rates of the treatment or control groups. Likewise there was no added benefit with respect to plaque accumulation or gingival irritation.

Adolescent↗

Mice lacking Smad3 show accelerated wound healing and an impaired local inflammatory response.

The generation of animals lacking SMAD proteins, which transduce signals from transforming growth factor-beta (TGF-beta), has made it possible to explore the contribution of the SMAD proteins to TGF-beta activity in vivo. Here we report that, in contrast to predictions made on the basis of the ability of exogenous TGF-beta to improve wound healing, Smad3-null (Smad3ex8/ex8) mice paradoxically show accelerated cutaneous wound healing compared with wild-type mice, characterized by an increased rate of re-epithelialization and significantly reduced local infiltration of monocytes. Smad3ex8/ex8 keratinocytes show altered patterns of growth and migration, and Smad3ex8/ex8 monocytes exhibit a selectively blunted chemotactic response to TGF-beta. These data are, to our knowledge, the first to implicate Smad3 in specific pathways of tissue repair and in the modulation of keratinocyte and monocyte function in vivo.

Animals↗

Intensity and continuity of services and functional outcomes in the rehabilitation of persons with schizophrenia.

OBJECTIVE: The intensity and continuity of services delivered to individual clients in a community-based psychosocial rehabilitation program were examined in relationship to functional changes in the clients that occurred during the first 12 months of the program. METHODS: Subjects were 41 clients with schizophrenia or schizoaffective disorder who were admitted to an intensive psychosocial rehabilitation program. Measures of clinical and psychosocial functioning were derived from client interviews administered at baseline and six and 12 months later. Measures of service intensity and continuity came from data gathered daily by staff over 12 months. RESULTS: The results supported the hypotheses that greater intensity and longitudinal continuity of services are related to more client improvement as indicated by reduced rates of hospitalization and improved psychosocial functioning after both six and 12 months. Although clients' symptom levels increased over time, a significant relationship was noted between service intensity and continuity and better symptom outcomes after 12 months. Multiple regression analyses indicated that an average of 22 percent, and as much as 28 percent, of the change in clinical and functional outcomes after 12 months of rehabilitation was explained by the intensity and longitudinal continuity of services. CONCLUSIONS: Clients who received more contact hours with staff and who had fewer gaps in service delivery achieved greater rehabilitative improvement in social, work, and independent-living domains and had fewer days of hospitalization. Based on these findings, clinicians, administrators, and researchers can assume that the intensity and longitudinal continuity of services are important to achieving rehabilitative outcomes in some community-based psychosocial rehabilitation models.

Adult↗

Angiogenesis defects and mesenchymal apoptosis in mice lacking SMAD5.

The transforming growth factor-beta (TGF-beta) signals are mediated by a family of at least nine SMAD proteins, of which SMAD5 is thought to relay signals of the bone morphogenetic protein (BMP) pathway. To investigate the role of SMAD5 during vertebrate development and tumorigenesis, we disrupted the Smad5 gene by homologous recombination. We showed that Smad5 was expressed predominantly in mesenchyme and somites during embryogenesis, and in many tissues of the adult. Mice homozygous for the mutation died between days 10.5 and 11.5 of gestation due to defects in angiogenesis. The mutant yolk sacs lacked normal vasculature and had irregularly distributed blood cells, although they contained hematopoietic precursors capable of erythroid differentiation. Smad5 mutant embryos had enlarged blood vessels surrounded by decreased numbers of vascular smooth muscle cells, suffered massive apoptosis of mesenchymal cells, and were unable to direct angiogenesis in vitro. These data suggest that SMAD5 may regulate endothelium-mesenchyme interactions during angiogenesis and that it is essential for mesenchymal survival.

Animals↗

Sustained attention and related perceptuomotor functions.

The present study examined the relationship between two measures of sustained attention on the Continuous Performance Test (reaction time and omission errors) and several performance measures on neuropsychological tests. Analysis suggests that sustained attention as measured by processing speed predicts performance on neuropsychological measures of relatively greater complexity and that the Stroop test, which requires maintaining steady focus on a changing stimulus field, may be more sensitive to lapses in attention than other neuropsychological tests.

Adult↗

Sustained attention on a continuous performance test.

The present study compared means of 54 nonpatients on two Continuous Performance Test measures in five administration conditions. Both response measures differentiated performance among the conditions, certain of which may have an alerting function that facilitates deployment of attention. Appreciable attentional demand or effort, however, may limit this facilitative effect.

Adolescent↗

Teaching group treatment in doctoral programs for counseling psychology.

We surveyed the 71 doctoral programs in counseling psychology approved by the American Psychological Association to examine whether and how group counseling or therapy was taught. Responses from 31 programs listed at least one graduate course in group counseling; over half offered more than one. In most cases the introductory course was required. Analysis also indicated that introductory courses often included an in-class or an out-of-class experiential component, focused either primarily or exclusively on outpatient therapy and used Yalom's interpersonal approach. Discussion focused on the importance of courses in group interventions in doctoral programs in counseling psychology and the differences and similarities in academic training of group interventions in programs in counseling and clinical psychology.

Counseling↗