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Biomedical subjects

P Martin

Publications and source records attributed to P Martin.

At least 559 records · Page 31Linked to original sources
PubMed1993

Autologous marrow transplantation for patients with acute myeloid leukemia in untreated first relapse or in second complete remission.

PURPOSE: This study compares outcomes of autologous bone marrow transplantation (ABMT) in patients with acute myeloid leukemia (AML) in untreated first relapse (REL1) or in second complete remission (REM2). PATIENTS AND METHODS: Forty-seven patients with AML in REL1 (n = 21) or in REM2 (n = 26) were treated with busulfan (BU) and cyclophosphamide (CY) with or without total-body irradiation (TBI) followed by ABMT. All REL1 patients and four REM2 patients had marrow stored during first remission (REM1). Twenty-seven had marrow stored with and 20 without treatment in vitro with 4-hydroperoxycyclophosphamide (4-HC). Eighteen patients received BU and CY and 29 received BU, CY, and TBI. REL1 patients relapsed within a median of 9 months (range, 2 to 26) after marrow harvest and were transplanted a median of 30 days (range, 9 to 87) from detection of relapse. RESULTS: With a median follow-up of 2.1 years (range, 0.4 to 5.3), 19 patients survive in remission (10 of 21 in REL1; nine of 26 in REM2). The actuarial probabilities of relapse-free survival at 2 years for patients transplanted in REL1 and REM2 were 45% +/- 22% and 32% +/- 18%, respectively (P = .33). The corresponding probabilities of relapse were 30% +/- 26% and 44% +/- 23%, respectively (P = .45). No conclusions could be drawn about the benefits of adding TBI to BU plus CY. There were no significant differences in neutrophil or platelet recovery or in posttransplant probabilities of relapse and nonrelapse mortality between patients who received marrow treated or not treated with 4-HC. CONCLUSION: These results suggest that ABMT may produce long-term leukemia-free survival in approximately one third of patients with AML in REL1 or in REM2. There is no apparent clinical advantage in attempting to obtain second remissions in relapsed patients before ABMT if marrow has been cryopreserved during REM1. Although a strategy of transplantation in REL1 has advantages for the patient, such an approach involves the storage of marrow, which may not be used, and is impractical without the coordinated support of the treating physician, the patient, and the marrow transplant center.

Acute Disease↗
PubMed1993

[Palliative endoscopic treatment of malignant occlusive jaundice with a balloon expandable metal stent].

Balloon-expandable Strecker-stents were endoscopically inserted in 13 patients (8 females, 5 men; mean age 75.2 [55-99] years) suffering from malignant obstructive jaundice. The stent implantation was difficult in one patient because of trouble to retract the balloon carrying the stent. A prompt regression of the cholestasis resulted in 11 patients. Two patients with long-distance stenoses of the common hepatic duct showed a persistent icterus due to an incomplete drainage of the stenoses. Therefore a second stent was implanted by means of transhepatic procedure in one case. Additional early complications such as cholangitis did not occur within four weeks after insertion. During the follow-up of four up to 41 weeks (mean follow-up 15.2 weeks) we observed late complications in five patients: stent migration in one patient after 10 weeks; relapsed jaundice in four patients 11 up to 41 weeks after stent implantation (the reason of jaundice was unknown for these patients were not again sent to our hospital because of their bad conditions). Six patients were alive without evidence of icterus on the date of examination. Considering data from the literature Strecker-stent implantations have been rarely performed in biliary duct stenosis till now. But the results demonstrate that an effective drainage of bile duct stenoses can be achieved in a high percentage by means of balloon-expandable metal stents. The insertion of the stent can be rather easily performed in stenoses situated in Vater's papilla and common bile duct provided that the guide wire has passed the stenosis.

Aged↗
PubMed1993

Structure and DNA-binding properties of Pax-QNR, a paired box- and homeobox-containing gene.

After differential screening of a complementary DNA library constructed from quail neuroretina cells (QNR) infected with the v-myc-containing avian retrovirus MC29, we have isolated a complementary DNA clone which identifies a mRNA essentially expressed in the neuronal layer of the retina. This complementary DNA encodes a protein containing paired box and homeobox domains. This gene, called Pax-QNR, is homologous to the murine Pax-6 and human AN genes, which are mutated in the autosomal dominant mutation small eye (Sey) of the mouse and aniridia in humans. Here, we report the genomic exon-intron organization, as well as the existence of alternative splicing events taking place at both the 5' end and the middle part of the gene. A Pax-QNR clone translated in reticulocyte lysate directed the synthesis of a 46 kilodalton protein able to bind specifically to the e5 sequence present upstream of the Drosophila even-skipped gene and target of the Drosophila paired protein. The Pax-QNR paired and homeobox domains individually expressed in bacteria are both able to recognize the e5 sequence.

Alternative Splicing↗
PubMed1993

Exacerbation of psoriasis due to interferon-alpha treatment of chronic active hepatitis.

Interferon-alpha is an immune modulating drug which is indicated for the treatment of chronic viral hepatitis B and C. Several previous reports have suggested an association between treatment of patients with interferon-alpha and the development or exacerbation of autoimmune diseases. We report two patients with chronic viral hepatitis in whom treatment with interferon-alpha was associated with dramatic worsening of previously diagnosed psoriasis, necessitating discontinuation of the drug.

Adult↗
PubMed1993

The problem of gastrointestinal bleeding.

Gastrointestinal bleeding accounts for more than 300,000 hospital admissions per year in the United States. Despite the introduction of an array of novel diagnostic and therapeutic approaches, the mortality rate associated with gastrointestinal bleeding has remained stable at 5% to 12%, primarily because of the rising percentage of elderly patients with gastrointestinal bleeding and the high mortality of bleeding that occurs during the course of a hospitalization for an unrelated medical problem. With defined high-risk subgroups of patients and competing diagnostic and therapeutic techniques, the study of gastrointestinal bleeding lends itself almost ideally to the application of outcomes and effectiveness research.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1993

Rapid development of lymphoma following liver transplantation in a recipient with hepatitis B and primary hemochromatosis.

We report a case of a posttransplant lymphoproliferative disorder (PTLD) which presented in a liver allograft shortly after transplantation. The patient, who had been transplanted because of cirrhosis due to primary hemochromatosis and chronic hepatitis B infection (HBV), developed early recurrent HBV in the graft, and 2 months after transplantation, liver biopsies showed a malignant large-cell lymphoma. The neoplastic cells demonstrated Epstein-Barr virus DNA by in situ hybridization. The patient died 3.5 months posttransplant due to liver failure. At autopsy, the liver showed nodules of malignant lymphoma, massive hepatic necrosis, and iron overload, but no evidence of rejection. This report suggests that the grafted liver can be the site of PTLD in recurrent HBV and hemochromatosis.

Adult↗
PubMed1993

Consequences of cryopreserving first remission autologous marrow for use after relapse in patients with acute myeloid leukemia.

Ninety-eight patients with AML had marrow harvested and cryopreserved at a median of 6 months (range 1-36 months) after achieving first CR with the intent of performing an ABMT at the first sign of relapse. Thirty-three of the 98 patients have not relapsed and 32 survive at a median of 64 months (range 10-105 months) after marrow storage. Sixty-five of the 98 patients relapsed at a median of 7 months (range 1-53 months) after marrow storage. The survival at 2 and 4 years for the 65 patients who relapsed was 22% and 8% respectively. Sixteen of 24 patients treated initially with chemotherapy were ultimately transplanted and two are surviving 21 and 41 months following ABMT and allogeneic marrow transplant respectively. There were no survivors among the eight patients treated with chemotherapy who were not transplanted. Thirty-eight of the 65 patients who relapsed proceeded directly to ABMT without attempts at remission induction, and eight survive disease-free 15-114 months following ABMT. One of the first 17 patients treated with cyclophosphamide and total body irradiation survives without relapse. The probabilities of relapse-free survival, non-relapse mortality, and relapse for the 17 most recent patients prepared with busulfan-containing regimens were 41%, 39% and 32% respectively. Surviving patients had longer first remissions (p = 0.08) and lower peripheral blood blast counts at the time of transplant (p = 0.02) when compared with patients who died. These data suggest that ABMT in untreated first relapse is a reasonable approach for the treatment of patients with AML who relapse.

Adolescent↗
PubMed1993

Survivors of the century.

Stereotypical views of the elderly hold that very old persons are less adaptable to change and less comfortable handling crisis situations. Over the last five years, we have had the privilege of meeting 96 people aged 100 years or older as part of the National Institute of Mental Health (NIMH) funded, Georgia Centenarian Study (R01 MH 43435-05). We have encountered optimistic, wise individuals very engaged in living. Our research team continues to be amazed at the quality of life and the individual differences amongst centenarians.

Adaptation, Psychological↗
PubMed1993

[Chlamydia trachomatis conjunctivitis in adults. Study of diagnostic techniques].

The place of Chlamydia trachomatis in acute or chronic conjunctivitis is certainly underestimated due to the difficulties involved in the diagnosis. Three diagnostic techniques for Chlamydia trachomatis conjunctivitis were compared: conjunctival sac swab for ELISA technique, scraping of the tarsal conjunctiva for direct immunofluorescence and for culture. Two groups of patients were studied: 73 patients with acute or chronic conjunctivitis and 44 asymptomatic patients. 19.2% of the patients in the first group had a positive result with the two techniques and 6.8% of the patients in the second group also had positive results with the same criteria. Our results show that indirect immunofluorescence is the technique most frequently positive, followed by ELISA, while culture remains the most specific but the least sensitive technique. The existence of healthy carriers Chlamydia trachomatis is demonstrated.

Adolescent↗
PubMed1992

Actin cables and epidermal movement in embryonic wound healing.

Skin wounds in embryos heal rapidly and perfectly. Even though the epidermis appears to be stretched taut over the surface of a structure such as a growing limb bud, its response to wounding is to close over the lesion, rather than to gape more widely. In adult wounds, the epidermis seems to migrate by means of lamellipodia, crawling over the exposed connective tissue. But in embryonic wounds we do not see lamellipodia. The epidermis at the edge of the wound looks smooth, as though under a circumferential tension. Here we show that a cable of filamentous actin appears to run continuously around most of the wound margin. It is confined to the single row of basal cells at the free edge of the epidermis. We suggest that the actin cable acts as a contractile 'purse string' to close up the embryonic wound.

Actins↗
PubMed1992

Antidepressant profile in rodents of SR 58611A, a new selective agonist for atypical beta-adrenoceptors.

beta 2-Adrenoceptor agonists possess antidepressant-like activity in animals and man, but their peripheral side-effects prevent their therapeutic use. Atypical beta-adrenoceptors have not been demonstrated in the central nervous system, but are known to exist in peripheral tissues such as the rat colon. We have now studied the antidepressant-like effects in rodents of a new selective atypical beta-adrenoceptor agonist, SR 58611A. SR 58611A was active with minimal effective doses of 0.1-0.3 mg kg-1 i.p. in several models (antagonism of the hypothermia induced by apomorphine and reserpine; potentiation of the toxicity produced by yohimbine; reversal of learned helplessness), but was inactive in the tests of reserpine-induced ptosis and behavioural despair. The antidepressant-like effect of SR 58611A was not antagonised by selective beta 1- or beta 2-adrenoceptor antagonists, but was blocked by high doses of the non-selective beta-adrenoceptor antagonists, propranolol and alprenolol. Unlike beta 2-adrenoceptor agonists, SR 58611A did not reduce locomotor activity or increase water intake at doses up to 10 mg kg-1. Therefore, SR 58611A may represent the prototype of a new class of antidepressant compounds.

Adrenergic beta-Agonists↗
PubMed1992

Differing effects of alpha-difluoromethylornithine and CGP 40116 on polyamine levels and infarct volume in a rat model of focal cerebral ischaemia.

Focal cerebral ischaemia was induced in rats by occlusion of the left middle cerebral artery. Two days later, infarct volume was determined by magnetic resonance imaging and the concentrations of the polyamines putrescine (PU), spermine and spermidine by HPLC. In control (occluded) animals, PU levels were elevated in infarcted and non-infarcted areas of the left hemisphere. Treatment with the ornithine decarboxylase (ODC) inhibitor alpha-difluoromethylornithine, prevented the ischaemia-induced increase in tissue PU without affecting infarct volume. Conversely, administration of the N-methyl-D-aspartate (NMDA) receptor antagonist CGP 40116 decreased cortical infarction without changing the tissue content of PU. We conclude that there is no direct link between NMDA receptor activation and brain PU, or PU and post-ischaemic tissue damage, and that inhibitors of ODC are not cerebroprotective in this animal model of stroke.

2-Amino-5-phosphonovalerate↗