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Biomedical subjects

R Gal

Publications and source records attributed to R Gal.

At least 73 records · Page 4Linked to original sources
PubMed1996

Coping with stress in families of servicemen: searching for "win-win" solutions to a conflict between the family and the military organization.

The objective of this research was to explore the coping patterns of servicemen's families with the competing demands of two institutions: the military organization and the family. The sample comprised one hundred career soldiers along with their families. The research instruments included individual interviews, a battery of questionnaires, and a role-playing task. Examination of the couple's joint coping modes yielded two major categories of families-families that were successful in their efforts to resolve the military vs. family conflict, and families that did not manage to reconcile the competing demands of these two domains. Within each of these two categories there were a variety of distinct profiles. To compare the dynamics of successful coping with less successful coping regarding the military vs. family conflict, a conceptual model was suggested. This model subsumes the antecedent variables (job issues, support network, and couple relationships); mediating variables (cognitive appraisal of conflict severity and coping potential, as well as actual coping strategies); and outcome variables reflecting the degree of adjustment to the military vs. family conflict.

Adaptation, Psychological↗
PubMed1996

Correlation between tumour and serum beta 2m expression in patients with breast cancer.

HLA class I antigens are composed of a major histocompatibility complex (MHC) encoded heavy chain that is associated non-covalently with a light chain beta-2 microglobulin (beta-2m). When the HLA complex is metabolized, beta-2m is shed into the serum. A large variety of human and experimental tumours have altered MHC class I expression. In a previous study we observed elevated mean beta-2m serum levels in breast cancer patients, as compared to controls. To study the relationship between tumour expression and serum levels, we examined 54 patients with breast cancer. Tumour beta-2m was determined by immunohistochemistry and serum levels by the ELISA technique. Of the 54 patients, 38 had low and 16 had high beta-2m expression on the tumour. There was a significant correlation between tumour beta-2m and serum beta-2m levels (P = 0.02), with patients whose tumours expressed high beta-2m having high serum beta-2m levels. There was an inverse correlation between tumour grade and tumour beta-2m expression which approached statistical significance (P = 0.06). These findings suggest that in a substantial number of patients the high serum levels derive from shedding of beta-2m from tumour cells. These levels may have implications for tumour growth and metastases due to influences on immunological responses.

Adult↗
PubMed1996

Sodium hyaluronate as a tool in strabismus surgery in rabbits.

BACKGROUND AND OBJECTIVE: The authors tested whether coating tissue with sodium hyaluronate (Na-HA) reduced postoperative adhesions and accelerated the healing process in strabismus surgery. MATERIALS AND METHODS: The surgical technique was tested during recession and resection operations performed on 30 rabbits and was compared with the use of NaCl 0.9%. Clinical, biomicroscopic examinations were performed on postoperative days 1, 2, 7, and 30 and histopathologic examinations were performed on postoperative days 2, 7, and 30. RESULTS: Clinically, there were no statistically significant differences between the study group and the control group. Also, there were no statistically significant differences between the two groups for most of the histopathologic criteria; however, new vessel formation was smaller with Na-HA than without it. Statistical significance was defined as P < .05. CONCLUSION: The authors found no significant positive effect of Na-HA on postoperative healing in rabbits.

Animals↗
PubMed1996

Beneficial effect of granulocyte-colony stimulating factor in scleromyxoedema associated with severe idiopathic neutropenia.

The treatment of scleromyxoedema is notoriously difficult. We present a patient with long-standing diffuse scleromyxoedema associated with functional impairment who developed chronic idiopathic neutropenia complicated by recurrent life-threatening infections. Treatment with recombinant granulocyte--colony stimulating factor led to normalization of the neutrophil count, prevented further systemic infections, and unexpectedly was associated with a striking clinical improvement of her skin disorder and decrease in mucin deposition in the dermis.

Chronic Disease↗
PubMed1996

Phenotypic modulation of fibroblasts in massive ovarian edema: an immunohistochemical study of three cases.

An immunohistochemical study of three cases of massive ovarian edema revealed coexpression of vimentin, total actins, alpha-smooth muscle actin, desmin and low molecular weight cytokeratins in the stromal spindle cells composing the edematous ovarian tissue. In addition these stromal cells expressed smooth muscle myosin which is a marker for terminal smooth muscle differentiation. This remarkable fibroblastic cell plasticity in massive ovarian edema may represent yet another example of fibroblastic modulations occurring under the influence of microenvironmental stress factors.

Actins↗
PubMed1996

Late solitary pancreatic metastasis from renal cell carcinoma.

A 76-year-old woman was admitted for a pancreatic mass. Twenty-one years previously she had undergone a left nephrectomy for renal cell carcinoma. A computerized tomography-guided needle biopsy of the pancreatic mass raised the suspicion of metastatic renal cell carcinoma. Final pathologic examination of the resected mass after distal subtotal pancreatectomy confirmed the preoperative diagnosis of metastatic renal cell carcinoma.

Aged↗
PubMed1995

Transesophageal echocardiographically guided atrial transseptal catheterization in patients with normal-sized atria: incidence of complications.

The incidence of cardiac complications from atrial transseptal catheterization has never been quantified in patients with normal-sized atria. Series defining the complication rate are derived from diseased hearts with structural changes that may alter the complication rate of the procedure. The generation of a standardized incidence of perforation in a population of structurally normal atria has important implications. A total of 46 atrial transseptal catheterizations guided by transesophageal echocardiography (TEE) for radiofrequency ablation of left-sided accessory pathways was performed in 42 patients during a 3-year period (1990-1993). Clinical and echocardiographic data were analyzed, with special attention given to TEE reports pre- and post-transseptal catheterization. Only one complication occurred in the 46 procedures (2.2%): a perforation of the left atrium that led to pericardial effusion and cardiac tamponade. In a small series of patients with normal sized atria, we have demonstrated that TEE-guided transseptal catheterization in a procedure with a low complication rate.

Adult↗
PubMed1995

Acid mucin and high molecular weight cytokeratin in prostatic lesions: evaluation of a combined histochemical and immunohistochemical stain.

OBJECTIVE: To evaluate the presence of acid mucins and high molecular weight cytokeratin (KER) in prostatic lesions using a combined histochemical and immunohistochemical stain consisting of Alcian blue at pH 2.5(AB) with a strept-avidin-biotin complex (SAB) staining for KER (SAB-KER). MATERIALS AND METHODS: Sections were obtained from archival paraffin blocks which included 20 cases of prostatic carcinoma, 30 cases of benign hyperplasia, and five cases of basal cell hyperplasia. Sections were stained for mucosubstances using the AB stain, for KER using SAB-KER and by both AB and SAB-KER, the combined stain (CS). RESULTS: With the CS stain KER, which is present in the prostatic basal cells, was not detected in malignant glands and in 60% of these cases intraluminal blue-stained acidic mucin was seen. On the other hand, all benign hyperplastic prostatic glands were devoid of intraluminal acidic mucin and showed staining for KER of their basal cells. Areas of basal cell hyperplasia were strongly positive for KER and intraluminal acidic mucin was seen in one case. Each of the stains separately gave similar results to the CS method but the contrast between the areas of carcinoma and hyperplasia was accentuated by the CS, and small foci of carcinoma were easily detected. CONCLUSION: The combined AB+SAB-KER stain is quicker to perform and allows the simultaneous appraisal of acid mucin and KER.

Avidin↗
PubMed1995

Is it possible to improve the autopsy rate?

To improve the autopsy rate in a department of internal medicine, the method reported by Clayton and Sivak in 1992 was simplified and applied for a 12 month period, from January through December 1993. The basic principle of this method is involvement of the senior resident staff and supervision of the project by the head and deputy head of the department, on a daily basis. A simple form was designed for this purpose and was completed for each case. Results were compared with those between the same months in 1992. An increase in the autopsy rate from 1.8% in 1992 to 26.7% during the trial period in 1993 was noted.

Autopsy↗
PubMed1994

Ablation of left free-wall accessory pathways using radiofrequency energy at the atrial insertion site: transseptal versus transaortic approach.

INTRODUCTION: Transcatheter ablation of the left free-wall atrioventricular accessory pathways (AP) by delivery of radiofrequency current at the ventricular insertion site has been shown to be effective. The efficacy of such a technique targeting the atrial insertion site of the AP was evaluated. METHODS AND RESULTS: One hundred consecutive patients with left free-wall APs and symptomatic supraventricular tachyarrhythmias were included. APs were manifest in 55 patients and concealed in 45. There were 55 men and 45 women with a mean age of 35 years. A total of 107 left free-wall APs were identified in these patients. In these 100 patients, successful ablation was accomplished in all by using a transseptal (45 patients) or transaortic (54 patients) technique. In one patient, ablation was accomplished from within the coronary sinus. Seven patients required a repeat ablative procedure, which was performed successfully. During 107 ablative procedures, six were associated with nonfatal complications including pericardial effusion (hemopericardium) in two patients, mild mitral regurgitation in two patients, swelling of the left arm in one patient, and staphylococcal bacteremia in one patient. Eighty-two (82%) patients underwent a repeat electrophysiologic study 6 to 8 weeks after successful ablation and were found to have no functioning AP or inducible supraventricular tachycardia. During a mean follow-up of 20 +/- 8 months, none of the 100 patients had a recurrence of tachyarrhythmias. CONCLUSION: These data indicate that the atrial insertion site of the AP can be successfully ablated in the majority of patients with left free-wall APs by using either a transseptal or transaortic approach. Furthermore, both techniques are associated with minimal morbidity and no mortality.

Adult↗
PubMed1994

Chronic myelomonocytic leukemia associated with primary amyloidosis.

A case of chronic myelomonocytic leukemia (CMML) associated with primary amyloidosis (AL) is presented. Hepatosplenomegaly, macroglossia, and xanthelasma were the major physical findings. Laboratory tests showed macrocytic anemia, thrombocytopenia, monocytosis and a bi-clonal gammopathy. Early monocytes and monoblasts were noted in the bone marrow aspiration biopsy. Cytogenetic evaluation showed a clonal deletion of chromosome 21 long arm (21q-). Amyloid was present in the liver, tongue and xanthelasma. In addition, the patient was noted to have osteosclerosis of the lower extremities. Treatment with prednisone and colchicine resulted in a subjective response. The unusual association of CMML, and primary amyloidosis is discussed.

Adult↗
PubMed1994

The expression of HLA class I antigen in prostate cancer in relation to tumor differentiation and patient survival.

The expression of HLA class I antigens was studied using the immunoperoxidase technique on 30 patients with prostate cancer and 29 patients with benign prostatic hypertrophy (BPH). Forty-three percent of the tumors stained positive, in contrast to 21% of the BPH. An inverse relationship was noted between class I expression and degree of tumor differentiation: 88% of the well-differentiated tumors (8/9) expressed class I antigen, compared with 33% (3/9) of the moderately differentiated and 16% (2/12) of the poorly differentiated tumors. No significant survival difference was found between those with class I-positive and -negative tumors. However, when both class I expression and degree of differentiation were considered, those with positive tumors at each level of differentiation had better survival than those with negative tumors. These data suggest that HLA class I expression may serve as a finite prognostic factor and may have relevance in future immunotherapy.

Adenocarcinoma↗
PubMed1994

Systemic distribution of beta 2-microglobulin-derived amyloidosis in patients who undergo long-term hemodialysis. Report of seven cases and review of the literature.

A search for visceral amyloid deposits was performed on autopsy material from 20 patients who had been receiving long-term hemodialysis treatment for 4 to 21 years. Visceral amyloid was found in seven patients who had undergone hemodialysis for more than 10 years. Histochemically, the amyloid was permanganate sensitive, and immunohistochemically, it stained positively for beta 2-microglobulin. The amyloid was found mainly in the wall of blood vessels, in the form of subendothelial nodules, bulging into the vessel's lumen. The amount of amyloid increased with increasing years of hemodialysis treatment. The organs most frequently involved were the heart, gastrointestinal tract, and lungs. Smaller deposits were seen in medium blood vessels of all other visceral organs. Only the spleen was "resistant" to amyloid deposition; the reason for this splenic resistance is unknown. A similar organ distribution was found in the 19 previously reported autopsy cases. Clinically, one patient experienced a perforation of the small intestine, probably related to the narrowing of the intestinal blood vessels by amyloid deposits, and this patient died of peritonitis.

Adult↗
PubMed1992

Transesophageal echocardiography with a single-plane probe. Long-axis views of the heart from the apical (transgastric) approach.

The literature suggests that during transesophageal echocardiography (TEE), a short-axis view can be obtained in the gastric position using a single-plane probe. Recently, we have found that a long-axis apical display of the heart can be achieved by placing the tip of the probe in the fundus of the stomach. In a 3-month period, we attempted to obtain this view in 54 consecutive patients. Twelve of the patients had TEE done under general anesthesia, while the other 42 patients had the procedure performed under sedation with midazolam at hospital bedside or as an outpatient. The long-axis transgastric view was obtained in 51 of the 54 patients (94%). The image quality was graded subjectively as good in 39 (72%) and fair in the other 12 patients (22%). This view helped to establish the diagnosis in eight patients (15%) and to increase the level of confidence about the accuracy of the diagnosis in 23 (43%) other patients. Four patients' findings are described. We conclude that the new long-axis transgastric view is easy to obtain, does not add much time to the usual TEE study, does not add to the low complication rate of TEE, and may help to interrogate the distal structures of the heart.

Adolescent↗