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R Steele

Publications and source records attributed to R Steele.

At least 55 records · Page 3Linked to original sources
PubMed1997

Bereavement.

Explore the source record for details and available documents.

Adaptation, Psychological↗
PubMed1996

Complications of urological laparoscopy: a standardized 1 institution experience.

PURPOSE: Urological laparoscopy has a significant and steep learning curve plus its own unique set of complications. Our retrospective study documents the success at 1 institution of maintaining a low number of complications during urological laparoscopy using a standardized approach plus clinicians with significant laparoscopic experience. MATERIALS AND METHODS: We evaluated 282 consecutive adults who underwent urological laparoscopic procedures at our institution. Of the procedures 241 (85%) were performed for pelvic lymph node dissection, and 41 (15%) for renal and other miscellaneous conditions. The common factor in all of these laparoscopic procedures was a single team approach, thus standardization for the entire series of procedures. RESULTS: Of 12 complications (4.2%) 5 were noted intraoperatively and 7 were discovered in the postoperative period. Five patients (1.8%) required open surgical intervention, including 3 intraoperative repairs of vascular (1), ureteral (1) and bladder (1) injuries. Procedures were aborted because of technical difficulties in 7 patients (2.8%) and because of hemorrhage during adrenalectomy in 1. Delayed complications included ureteral injury in 1 patient, seroma at the trocar site in 2, exacerbation of bowel diverticulitis requiring surgical intervention in 1, prolonged endotracheal intubation for hypercapnia in 1 and transient brachial nerve palsy in 2. CONCLUSIONS: Along with appropriate patient selection and adequate instrumentation, the benefit of significant laparoscopic experience and standardization cannot be overemphasized. The success of this combined approach is reflected in the low rate of major (2%) and minor (2.5%) complications experienced at 1 institution.

Adult↗
PubMed1995

Human breast carcinoma cells transfected with the gene encoding a c-myc promoter-binding protein (MBP-1) inhibits tumors in nude mice.

We have identified previously a gene from a human cervical carcinoma cell (HeLa) cDNA expression library that encodes a M(r) approximately 37,000 c-myc promoter-binding protein (MBP-1), which binds to the TATA box sequences of c-myc P2 promoter and exerts a negative regulatory function by down-regulating c-myc expression. In normal human tissues, this cloned gene showed variable expression. In this study, we have demonstrated that introduction of the MBP-1 gene into human breast carcinoma cells reduced their ability to invade through a basement membrane matrix in vitro but did not alter their growth rate. Human breast carcinoma transfected with MBP-1 cells showed a loss of anchorage-independent growth and also suppressed tumor formation in athymic nude mice. These results suggest the possible involvement of MBP-1 as a tumor suppressor gene in human breast carcinoma cells.

Animals↗
PubMed1995

Transcriptional regulation of cellular and viral promoters by the hepatitis C virus core protein.

The genomic region encoding the hepatitis C virus (HCV) core protein was cloned into a mammalian expression vector to study its role on the transcriptional regulation of cellular proto-oncogene and viral promoters. Using a transient transfection assay in human hepatocellular carcinoma (HepG2) cells, we demonstrate that the HCV core protein activates the human c-myc, Rous sarcoma virus long terminal repeat (LTR), and simian virus 40 (SV40) early promoters; and suppresses the c-fos promoter and human immunodeficiency virus type 1 (HIV-1) LTR activity. The transcriptional regulation of cellular proto-oncogenes by the HCV core protein suggests possible involvement of the core protein in the deregulation of normal hepatocyte growth and hepatocarcinogenesis.

3T3 Cells↗
PubMed1995

Use of warfarin in non-rheumatic atrial fibrillation: a commentary from general practice.

Seven randomized trials published in the last six years have shown that warfarin reduces the risk of ischaemic strokes and death in patients with atrial fibrillation. The annual rates of major bleeding episodes in all these trials were low and, as a result, doctors in primary and secondary care are being encouraged to consider using warfarin for patients with atrial fibrillation unless there are obvious contraindications. However, the populations used in these studies were highly selected and rigorously monitored throughout the trial period to minimize the risk of bleeding in a way which probably could not be expected in routine primary care. Although the rates of major bleeding episodes were uniformly low, the rates of minor bleeding episodes were much higher and these could impact substantially on patients' views of the treatment and on the workload of the primary care team. Evidence is now at hand which allows the stratification of risk in patients with atrial fibrillation which should enable those who are at greatest risk to be considered for this form of treatment. Patients may develop risk factors over time which could render them unsuitable for continuation of warfarin therapy. The general practitioner is centrally placed to make the decision about initiating or continuing treatment or indeed stopping it. Several models for decision making in warfarin treatment from primary and secondary care are proposed.

Atrial Fibrillation↗
PubMed1994

One-stage laparoscopic pelvic lymphadenectomy and radical perineal prostatectomy.

Laparoscopic pelvic lymph node dissection is currently an accepted procedure for staging adenocarcinoma of the prostate. To assess the feasibility and efficacy of performing laparoscopic pelvic lymph node dissection and radical perineal prostatectomy during the same anesthesia, we retrospectively analyzed 98 patients with clinically localized adenocarcinoma of the prostate who were candidates for radical prostatectomy. Of the patients 12 (12%) underwent laparoscopic pelvic lymph node dissection only since they had metastatic disease to the pelvic lymph nodes on frozen section evaluation (the Gleason pathological grade was 2 to 4 in 2 patients, 5 to 7 in 8 and 8 in 2). Of the remaining 86 patients who underwent radical perineal prostatectomy for definitive management 76 (88%) underwent 1-stage radical perineal prostatectomy immediately after laparoscopic pelvic lymph node dissection, while 10 (12%) in the initial stages of our series underwent delayed perineal prostatectomy following laparoscopic pelvic lymph node dissection (2-stage). The average postoperative hospital stay in the 1-stage group was 3.11 days, yet 19 (25%) patients were discharged from the hospital within 48 hours and another 39 (51%) within 72 hours. Thus, 76% of the patients were discharged from the hospital within 72 hours of laparoscopic pelvic lymph node dissection and radical perineal prostatectomy. The advent of laparoscopic pelvic lymph node dissection and radical perineal prostatectomy has found a resurgence at our institutions, with its lower morbidity rate and more rapid return to normal activity for these patients. Based on our results, we recommend laparoscopic pelvic lymph node dissection followed by radical perineal prostatectomy as a 1-stage treatment option for localized adenocarcinoma of the prostate.

Adenocarcinoma↗