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Biomedical subjects

S Braun

Publications and source records attributed to S Braun.

At least 109 records · Page 6Linked to original sources
PubMed1999

Impact of respiratory syncytial virus immune globulin in 1996-1997: a local controlled comparison.

BACKGROUND: Immune globulin containing high titers of neutralizing antibodies specific for respiratory syncytial virus (RSV) is clinically used to prevent hospitalizations for RSV-related respiratory infections among high-risk infants. However, recommendations regarding which patient populations should receive RSV immune globulin are inconsistent. OBJECTIVE: To compare hospitalization rates for prematurely born infants with and without chronic lung disease who received RSV immune globulin with similar infants whose parents refused such treatment during the 1996-1997 winter season. DESIGN: Inception cohort study. PARTICIPANTS: Infants born at less than 35 weeks' gestation and less than 6 months old without lung disease and children who had been born prematurely, had chronic respiratory disease, and were less than 2 years old at the onset of the RSV season. MAIN OUTCOME MEASURE: Hospitalization for an RSV-related respiratory illness. RESULTS: Seventy-six infants (66 [87%] with chronic lung disease and 10 [13%] born prematurely without lung disease) received RSV immune globulin; 65 infants (18 [28%] with chronic lung disease and 47 [72%] born prematurely without lung disease) did not. Three (4%) of the treated group and 2 (3%) of the untreated group were hospitalized for RSV infections. Of those with chronic lung disease, 5% (3/66) of those treated with RSV immune globulin were hospitalized, compared with 11% (2/18) of those untreated. Of those born prematurely without lung disease, no infant in the treated (0/10) or untreated (0/47) group was hospitalized. CONCLUSIONS: The risk of hospitalization of infants born prematurely who are younger than 6 months without lung disease is low. Current recommendations for preventing RSV illness in this group by using RSV immune globulin may require inclusion of more specific clinical characteristics rather than gestational age alone.

Chronic Disease↗
PubMed1999

Successful treatment of malignant placental site trophoblastic tumor with combined cytostatic-surgical approach: case report and review of literature.

OBJECTIVE: Although rare among gestational trophoblastic diseases, the clinical relevance of malignant placental site trophoblastic tumor (PSTT) derives from its potential malignancy associated with early systemic tumor cell dissemination and manifestation of fatal metastases. Because of the low number of cases reported so far worldwide, several treatment strategies have been under consideration, which will be debated following this case report. METHOD: We present the case of a 33-year-old female with PSTT and metastases to the vagina and lung. A 9-month delay in accurate diagnosis was caused by a misinterpretation of her symptoms as signs of a spontaneous abortion. Specialized pathological examination finally led to the diagnosis of PSTT. Primary surgical treatment consisting of abdominal hysterectomy and unilateral salpingo-oophorectomy was followed by multiple resections of recurrent vaginal disease. After the completion of six cycles of EMA/CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine) chemotherapy, hCG titers stayed within the normal range. The patient is without evidence of disease 39 months after primary diagnosis. RESULT: This is the third case of documented long-term remission (>1 year) in metastatic PSTT after combined cryostatic-surgical treatment. CONCLUSION: Since the few previously reported cases with prolonged remission have been treated with the described combined cytostatic-surgical approach consisting of cytoreductive surgery and adjuvant chemotherapy, this approach may be recommended for metastatic PSTT.

Adult↗
PubMed1999

Micrometastatic bone marrow involvement: detection and prognostic significance.

The present review focuses on the methodology and clinical significance of new diagnostic approaches to identify individual cancer cells present in bone marrow, both as a frequent site of metastasis formation and an indicator organ for hematogenous tumor cell dissemination. The steadily increasing number of studies on this issue is characterized by considerable methodological variations of important variables, such as the size of the study population, and the reliability of monoclonal antibodies used for tumor cell detection. Emerging data indicate that this disturbing heterogeneity might be overcome by the use of reliable and specific anti-cytokeratin antibodies (for example, A45-B/B3) as, for the time, standard markers for the detection of micrometastatic tumor cells in bone marrow. Prospective clinical studies have shown that immunoassays based on anti-CK antibodies identify patients' subgroups with a poor clinical prognosis with regard to early metastasis manifestation and reduced overall survival in various epithelial tumor entities, including breast, colon, rectum, stomach, esophagus, prostate, renal, bladder, and non-small cell lung cancer. The immunocytochemical assays may be therefore used to improve tumor staging with potential consequences for adjuvant therapy, because disseminated cells appeared to be dormant, non-cycling (for example Ki-67 antigen-negative) cells, suggesting a resistance to cell-cycle dependent therapy, such as chemotherapy. Therefore, cell-cycle independent antibody-based immunotherapy might be an interesting option to complement chemotherapy. Another promising clinical application is monitoring the response of micrometastatic cells to adjuvant therapies, which, at present, can only be assessed retrospectively after an extended period of clinical follow-up. The outlined current strategies for detection and characterization of cancer micrometastasis might help to design and control new therapeutic strategies for secondary prevention of metastatic relapse in patients with operable primary carcinomas.

Biomarkers, Tumor↗
PubMed1999

Polyploidization and losses of chromosomes 1, 2, 6, 10, 13, and 17 in three cases of chromophobe renal cell carcinomas.

Clonal chromosome aberrations identified after short-term culture are presented for three cases of chromophobe renal cell carcinomas (RCC). All tumors revealed abnormal karyotypes with a varying proportion of polyploid tumor cells. Common numerical abnormalities were combined losses of chromosomes 1, 2, 6, 10, 13, and 17. Clonal karyotypic evolution was demonstrated in one case in which several related clones could be identified. An additional balanced translocation t(3;14)(p24;q22) observed in this case proved to be of constitutional nature by cytogenetic analysis of normal kidney cells and peripheral blood lymphocytes. These cytogenetic findings provide further evidence that chromophobe renal cell carcinomas are characterized by a highly specific combination of chromosomal losses most commonly including chromosomes 1, 2, 6, 10, 13, and 17.

Adenocarcinoma↗
PubMed1999

Biomechanical considerations in distraction of the osteotomized dentomaxillary complex.

The completely osteotomized dentomaxillary complex is essentially a free body constrained only by its soft tissue attachments. Therefore the line of action and point of application of any protractive force(s) used during distraction osteogenesis must be considered relative to its center of mass. This is in contrast to the nonsurgically separated dentomaxillary complex, which is a constrained body, and therefore the application of protractive force(s) must be considered relative to its center of resistance. These two centers are not coincident. With knowledge of the location of the center of mass, predictable protraction of the dentomaxillary complex can be achieved. In this study, the center of mass of an adult maxillary specimen osteotomized to emulate a Le Fort I osteotomy was determined. Protractive force(s) through the center of mass will produce linear advancement along its line of action. Protractive movement of the dentomaxillary complex can be adjusted downward and forward or upward and forward by locating the protractive force(s) line of action superior or inferior to the center of mass. A cleft patient is described wherein the surgically separated dentomaxillary complex is protracted downward and forward with a force vector superior to its approximate center of mass. This results in a predictable increase in overbite and overjet with negligible mandibular rotation.

Adult↗
PubMed1999

A new accurate approach to the anterior ratio with clinical applications. Part 1: a computer program.

The arcs of the six anterior maxillary and mandibular teeth have recently been described mathematically by the hyperbolic cosine function with a maxillary correlation coefficient (r ) of 0.885 and a mandibular correlation coefficient (r ) of 0.951. Because the geometric relationships of the anterior dental arcs are known when the occlusion is Class I, a computer program has been developed for use in clinical practice. Rapid forecasting of the interrelationships between the maxillary and mandibular arc depths (related to overjet) with variations in the mesiodistal sums of the six maxillary and mandibular anterior teeth for various intercanine widths is now possible with ease and accuracy (+/- 0.1 mm). Clinical applications are illustrated.

Adult↗
PubMed1999

A new accurate approach to the anterior ratio with clinical applications. Part II: a nomographic solution.

Evaluating the anterior ratio is useful to forecast potential tooth mass discrepancies and related overjet or underjet. Because the arcs of the six anterior teeth have recently been described by the mathematical hyperbolic cosine function, it has permitted the design of a nomograph for ready use in clinical practice. A nomograph is a simple chart on which one can draw a straight line that will intersect three scales representing variables that satisfy an equation. A clinician may now evaluate and forecast the effects on overjet with purposeful alterations in the sums of the six maxillary and mandibular anterior tooth masses for various cross-arch canine widths with an accuracy of +/-0.5 mm.

Adult↗
PubMed1999

Friction in perspective.

In the past, most frictional resistance studies have been conducted in a steady state condition that does not simulate the dynamics of the oral environment. Various oral functions as chewing, swallowing, speaking, etc, as well as the oral tissues contacting any orthodontic appliances, result in periodic, repetitive, minute relative motion at the bracket/arch wire interfaces several thousand times each day. This in turn affects the normal forces at the interfaces, and because frictional resistance is directly proportional to the normal force, a pilot study was undertaken to emulate the dynamic environment of the oral cavity and its effect on frictional resistance. Tests of a limited sample of stainless steel arch wires and brackets typically used in sliding mechanics revealed that frictional resistance was effectively reduced to zero each time minute relative movements occurred at the bracket/arch wire interfaces. Factors such as the degree of dental tipping, relative arch wire/slot clearances, and method of tying, did not have a measurable effect on frictional resistance in the simulated dynamics of the oral environment.

Dental Stress Analysis↗
PubMed1999

An evaluation of the shape of some popular nickel titanium alloy preformed arch wires.

The mathematical Beta function is shown to be an accurate planar representation of the natural human arch form defined by the spatial coordinates of the labial and buccal dental/bracket interfacing surfaces in the maxillary and mandibular arches. Graphic planar representations of the corresponding bracket base spatial coordinates of 33 popular preformed nickel titanium arch wires and bracket assemblies were superimposed on each of the relevant maxillary and mandibular natural forms. The arch forms of the preformed nickel titanium arch wires and bracket assemblies did not emulate the natural human arch form. The average mandibular natural human arch form first molar/canine width ratio is 2.38/1; the same preformed arch wire/bracket ratio is 1.87/1. These ratios for the maxillary arch are 1.92/1 and 1.54/1, respectively. The average canine width exceeded the natural canine width by 5.95 mm in the mandibular arch and 8.23 mm in the maxillary arch. The corresponding mandibular first molar and maxillary first molar widths exceeded the natural human first molar arch width by 0.84 mm and 2.68 mm, respectively. These findings have implications with respect to posttreatment stability and facial esthetics. "Round tripping" teeth resulting from subsequent change to stainless steel arch wires to restore a more natural human arch form and size may result in deleterious tissue effects.

Cephalometry↗
PubMed1999

Prevalence of the angiotensin I converting enzyme insertion/deletion polymorphism, plasma angiotensin converting enzyme activity, and left ventricular mass in a normotensive Chilean population.

The aim of this study was to estimate the prevalence of the different alleles of the angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and associated plasma ACE activity, as well as cardiac echocardiographic structure, in a healthy Chilean population. We selected 117 healthy normotensive subjects (aged 45 to 60 years, middle socioeconomic status, nonobese, and nondiabetic) from a population-based study concerning the prevalence of risk factors for chronic diseases (Conjunto de Acciones Para la Reducción Multifactorial de las Enfermedades no Transmisibles [CARMEN]). The frequencies of the I and D alleles were 0.57 and 0.43, respectively. Mean plasma ACE activity was 15.3 +/- 3.9 U/mL. Compared with subjects with the II genotype, plasma ACE activity was significantly higher in subjects with the ID and DD genotypes with no difference between them. No correlation was observed between blood pressure and plasma ACE activity. Among the three different genotypes there was no difference in left ventricular (LV) dimensions or in LV mass. No correlation between plasma ACE activity and LV mass was observed for either gender or different genotypes. Multivariate linear regression analysis using LV mass and LV mass index as dependent variables showed independent effects (P < .05) for gender (higher LV mass in men) and diastolic blood pressure, but not for the DD genotype. In conclusion, in this population, the presence of the D allele on the ACE gene determined higher circulating ACE activity. However, in this normotensive healthy population, male gender and diastolic blood pressure, but not the presence of the D allele, were associated with increased LV mass.

Alleles↗
PubMed1999

Measuring developmental and functional status in children with disabilities.

This study compared performance on the Functional Independence Measure for Children (WeeFIM), the Battelle Developmental Inventory Screening Test (BDIST), and the Vineland Adaptive Behavior Scales (VABS) in children with developmental disabilities. The three instruments were administered to 205 children with identified disabilities. All 205 children were tested using the WeeFIM instrument. The BDIST was administered to 101 children and the VABS to the remaining 104 children. Administration was counterbalanced and randomized across all three instruments. A proportional sampling plan was used to select the 205 children, who ranged in age from 11 to 87 months. A variety of medical diagnoses and levels of severity of motor, cognitive, and communication impairments were systematically included in the sample. Correlations (r) among subscales for all three instruments ranged from 0.42 to 0.92. Correlations for total scores ranged from 0.72 to 0.94. Analyses of potential moderator variables found no significant relation between age and severity of disability (r=0.05) or between socioeconomic status (SES) and severity of disability (r=0.21). Correlations with age were strongest for those subscale scores involving gross and fine motor skills. Correlations with SES and subscale scores ranged from 0.03 to 0.18. The three instruments provide important information regarding childhood performance in motor, self-care, communicative, cognitive, and social skills. The WeeFIM instrument requires less administration time and provides information directly relevant to evaluating functional outcomes for children with disabilities and their families.

Child↗
PubMed1999

Biological characteristics of micrometastatic cancer cells in bone marrow.

There is emerging evidence that epithelial tumor cells are able to disseminate to secondary organs at an early stage of primary tumor development. One of the most prominent secondary organs screened for this type of dissemination is bone marrow. Even in cancer entities where overt skeletal metastases are rare (e.g., colorectal and ovarian cancer), bone marrow is a prognostically relevant indicator organ for the presence of hematogenous micrometastases. The currently available data suggest that bone marrow micrometastases represent a selected population of dormant cancer cells which still express a considerable degree of heterogeneity. The analysis of micrometastatic cells will open a new avenue to assess the molecular determinants of early tumor cell dissemination and subsequent outgrowth into overt metastases. Moreover, monitoring the elimination of bone marrow micrometastases and identification of treatment-resistant tumor cell clones may help to increase the efficacy of adjuvant therapy. This review summarizes the current knowledge on the biological characteristics of micrometastatic cancer cells in bone marrow of patients with solid epithelial malignancies.

Animals↗
PubMed1999

Aortobifemoral prosthetic infection treated by cryopreserved arterial homografts of the European Homograft Bank.

The excision of an infected aortobifemoral Dacron graft 9 years after implantation and bilateral axillofemoral Dacron bypass reconstruction led to reinfection of the extra-anatomic bypass grafts. A new aortobifemoral reconstruction was performed using cryopreserved homografts delivered by the European Homograft Bank in Brussels and both axillo-femoral prostheses were removed. No signs of infection and no alterations of the homografts can be detected 3 years later.

Aorta, Abdominal↗
PubMed1999

A reexamination of various extraoral appliances in light of recent research findings.

The location of the center of resistance of the dentomaxillary complex has recently been identified more accurately than before. Based on this new finding, various modifications of the common facebow are presented for use in protraction therapy. Clinical applications for specific treatment objectives are also reviewed. Orthopedic and biomechanical implications of various standard retraction type extraoral appliances are also analyzed.

Biomechanical Phenomena↗
PubMed1999

C-axis: a growth vector for the maxilla.

Based on M-point, defined as the center of the largest circle that is tangent to the superior, anterior, and palatal outlines of the maxilla in the sagittal view, a growth axis and its direction are described for each gender from age 7.4 to 18.75 years. Growth increments along the C-axis, defined by sella-M-point, are described by regression formulas with correlation coefficients of 0.618 for females and 0.669 for males. The vector (direction) of the growth axis, defined by the angle S-M-C-axis, increases in females from 42.21 degrees at 7.4 years to 44.47 degrees at 18.75 years, with a standard deviation of 3.55 degrees. In males, it increases from a mean of 41.69 degrees at 7.6 years to 45.55 degrees at 18.6 years, with a standard deviation of 2.74 degrees. This is based on 172 serial lateral cephalograms of 20 females and 174 serial lateral cephalograms of 19 males. The C-axis incremental growth change and its vector offer a means of quantifying complex maxillary growth in the sagittal plane via cephalometric measurements relative to and coordinated with other craniofacial structures.

Adolescent↗
PubMed1999

Papillary renal cell carcinoma with clear cell cytomorphology and chromosomal loss of 3p.

AIMS: Cytogenetic studies on renal cell carcinomas (RCCs) have disclosed a correlation between chromosome aberrations and histomorphological features. Nevertheless, it is still controversial whether the cytomorphology of the tumour cells (clear cell, chromophilic, chromophobe) or their growth pattern (nonpapillary, papillary) is more discriminative for the combined histomorphological-cytogenetic classification of RCCs. METHODS AND RESULTS: Three RCCs with papillary growth pattern and clear cell cytomorphology were analysed by classical cytogenetics using standard G-banding techniques. Each tumour displayed clonal aberrations leading to loss of terminal 3p chromosomal segments. Monosomy 14 was also consistently found. Trisomy 17 was not observed in any of the tumours. CONCLUSIONS: This series of three RCCs consisting of clear cells with papillary architecture revealed chromosomal aberrations characteristic for the conventional (clear cell) RCC. Irrespective of the predominant papillary growth pattern, none of the cases were characterized by trisomy of chromosomes 3q, 7, 8, 12, 16, 17 and 20 and loss of Y chromosome which are widely regarded as the most consistent genetic alterations for papillary RCC. Therefore, our cytogenetic findings provide evidence that papillary clear cell RCCs should be classified according to their cytomorphology rather than their growth pattern even when papillary architecture is prominent.

Adult↗