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Biomedical subjects

S Cohen

Publications and source records attributed to S Cohen.

At least 271 records · Page 15Linked to original sources
PubMed1996

Speech characteristics associated with the Furlow palatoplasty as compared with other surgical techniques.

Reported here are the results of a retrospective study of the speech outcome for 63 cleft subjects who had Furlow repairs compared with 20 subjects who had other procedures. The two groups of children were similar in cleft type, sex, and race. The same two surgeons repaired the palates in both groups, and the same two speech pathologists with high reliability examined the children at least 5 years postoperatively using the Pittsburgh Weighted Values for Speech Symptoms Associated with VPI (velopharyngeal incompetence). Subjects who had had Furlow repairs were superior on measures of hypernasality, articulation, and total speech scores; and fewer pharyngeal flaps were required by Furlow subjects. These findings suggest the need for randomized, double-blind investigations comparing outcome of the Furlow procedure with the intravelar veloplasty, the V-Y pushback, and other specified procedures.

Cleft Palate↗
PubMed1996

The effects of warming intravenous fluids on intraoperative hypothermia and postoperative shivering during prolonged abdominal surgery.

BACKGROUND: The infusion of several liters of crystalloid solution at room temperature may significantly contribute to intraoperative hypothermia because warming fluid to core temperature requires body heat. The aim of this study was to evaluate the effect of delivering warmed intravenous (IV) fluid to the patient on preventing intraoperative hypothermia. METHODS: Intraoperative core and mean skin temperatures were measured during prolonged abdominal surgery in 18 patients randomly divided into two groups according to intraoperative IV fluid management. In 9 patients (control group) all IV fluids infused were at room temperature. In the other 9 patients (group receiving warmed fluids) all IV fluids were warmed using an active IV fluid tube-warming system. In all 18 patients a warming blanket covered the skin surface available for cutaneous warming. Intraoperative changes in total body heat content (kJ) were calculated from core and mean skin temperatures. RESULTS: At the end of surgery, core temperature was 36.7 +/- 0.2 degrees C in the group receiving warmed fluids and 35.8 +/- 0.2 degrees C in the control group (P < 0.05). The estimated reduction in heat loss provided by warming IV fluid was 217 kJ, a value very close to the theoretical value expected from thermodynamic calculation. During recovery, one patient shivered in the group receiving warmed fluids and seven in the control group (P < 0.05). CONCLUSION: In conclusion, infusion of warmed fluids, combined with skin-surface warming, helps to prevent hypothermia and reduces the incidence of postoperative shivering.

Abdomen↗
PubMed1996

Profile of postdischarge rehospitalizations and acute care visits for seven patient groups.

The study's purpose was to examine postdischarge rehospitalizations and acute care visits in seven high risk, high volume, high-cost patient groups. Subjects were drawn from an urban tertiary teaching hospital. The total sample (N = 764) consisted of seven patient groups (drawn from five randomized clinical trials): very low birthweight (VLBW) infants (n = 79); women post-unplanned cesarean birth (n = 122) and their infants (n = 123); pregnant women with diabetes (n = 55); women post-hysterectomy surgery (n = 109); and elderly with medical cardiac Diagnostic Related Groups (DRGs) (n = 142) and elderly with surgical cardiac DRGs (n = 134). The VLBW infant and pregnant diabetic groups were predominantly African American, the elderly and hysterectomy groups predominantly Caucasian, and the cesarean group almost equally distributed. The lowest rate of rehospitalization (2%) occurred in the cesarean group, the highest (35%) in the pregnant diabetics. In four groups (cesarean and infants, hysterectomy and surgical elderly), 60%-100% of the rehospitalizations occurred within 4 weeks of discharge. Subjects requiring acute care visits ranged from 13% (hysterectomy) to 82% (VLBW infants). Acute care visits demonstrated greater distribution throughout the follow-up periods but also tended to concentrate in the first 4 weeks postdischarge.

Acute Disease↗
PubMed1996

Induction of circles of heterogeneous sizes in carcinogen-treated cells: two-dimensional gel analysis of circular DNA molecules.

Extrachromosomal circular DNA molecules are associated with genomic instability, and circles containing inverted repeats were suggested to be the early amplification products. Here we present for the first time the use of neutral-neutral two-dimensional (2D) gel electrophoresis as a technique for the identification, isolation, and characterization of heterogeneous populations of circular molecules. Using this technique, we demonstrated that in N-methyl-N'-nitro-N-nitrosoguanidine-treated simian virus 40-transformed Chinese hamster cells (CO60 cells), the viral sequences are amplified as circular molecules of various sizes. The supercoiled circular fraction was isolated and was shown to contain molecules with inverted repeats. 2D gel analysis of extrachromosomal DNA from CHO cells revealed circular molecules containing highly repetitive DNA which are similar in size to the simian virus 40-amplified molecules. Moreover, enhancement of the amount of circular DNA was observed upon N-methyl-N'-nitro-N-nitrosoguanidine treatment of CHO cells. The implications of these findings regarding the processes of gene amplification and genomic instability and the possible use of the 2D gel technique to study these phenomena are discussed.

Animals↗
PubMed1996

Health psychology: psychological factors and physical disease from the perspective of human psychoneuroimmunology.

This review addresses the importance of studies of human psychoneuroimmunology in understanding the role of psychological factors in physical illness. First, it provides psychologically and biologically plausible explanations for how psychological factors might influence immunity and immune system-mediated disease. Second, it covers substantial evidence that factors such as stress, negative affect, clinical depression, social support, and repression/denial can influence both cellular and humoral indicators of immune status and function. Third, at least in the case of the less serious infectious diseases (colds, influenza, herpes), it considers consistent and convincing evidence of links between stress and negative affect and disease onset and progression. Although still early in its development, research also suggests a role of psychological factors in autoimmune diseases. Evidence for effects of stress, depression, and repression/denial on onset and progression of AIDs and cancer is less consistent and inconclusive, possibly owing to methodological limitations inherent in studying these complex illnesses, or because psychological influences on immunity are not of the magnitude or type necessary to alter the body's response in these cases. What is missing in this literature, however, is strong evidence that the associations between psychological factors and disease that do exist are attributable to immune changes.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Induction and activation of Stat 5 in the ovaries of pseudopregnant rats.

PRL acts in the ovary to promote the maintenance and function of the corpus luteum. However, the cellular signals that induce these responses have not been clearly defined. In the present report we demonstrate that Stat 5, previously identified as a transcription factor activated by PRL in the mammary gland, is also activated by PRL in the ovaries of pseudopregnant rats. Intraperitoneal injection of PRL into pseudopregnant rats results in the tyrosine phosphorylation and nuclear translocation of Stat 5. This activated Stat 5 possesses DNA-binding activity for a sequence containing the PRL-inducible element. In addition, we report that luteinization of the PMSG-primed ovary by the administration of hCG is accompanied by an induction of Stat 5 protein.

Animals↗
PubMed1996

Antiproliferative effect of pentoxifylline on psoriatic and normal epidermis. In vitro and in vivo studies.

Psoriasis is characterized by abnormal cell proliferation, inflammation and increased biosynthesis of various cytokines. The inhibitory effect of pentoxifylline on some cell functions has been reported widely. This property of pentoxifylline prompted an investigation of its possible role in controlling psoriasis. In the in vitro study normal human keratinocytes proliferation was determined and formation of cornified envelopes was assayed following treatment with pentoxifylline. The in vivo experiment consisted of nude mice grafted with psoriatic or normal skin treated with tetradecanyl phorbol 13 acetate. At the end of the treatment period, the grafts were excised and assessed for acanthosis and labelling index. The in vitro study showed that continuous exposure of normal human keratinocyte cultures to pentoxifylline resulted in a significant dose-dependent inhibition of proliferation, and in induction of cornified envelope formation. The in vivo experiments showed a significant reduction of epidermal thickness and of labeling index in psoriatic and tetradecanyl phorbol 13 acetate-treated normal skin, as compared to the initial values.

Adult↗
PubMed1996

Effect of high doses of 2-CdA on Schwann cells of mouse peripheral nerve.

The present study was undertaken to examine the effect of 2-CdA (Leustatin) on the Schwann cells of myelinated and unmyelinated fibers of peripheral mouse nerve. Two groups of mice were injected intravenously for seven days with 2-CdA: one group received daily doses of 1 mg/kg and the other 0.5 mg/kg. Both doses exceeded those accepted in clinical practice. Mice injected with saline served as controls. The sciatic nerve was then dissected and examined with a transmission electron microscope. The Schwann cells of both the myelinated and unmyelinated nerve fibers of the animals receiving the higher doses of 2-CdA showed nuclear and nucleolus damage, loss of heterochromatin, vacuolization and disorganization of the myelin sheaths. The mesaxons and the axons were also damaged. The Schwann cells of the animals treated with the lower doses appeared undamaged. The results indicate that in contrast to other anticancer drugs known to produce peripheral neuropathy, 2-CdA may cause damage to the Schwann cells only at doses exceeding the therapeutic ones.

Animals↗
PubMed1996

Symptomatic improvement in achalasia after botulinum toxin injection of the lower esophageal sphincter.

OBJECTIVES: The aim of this study was to assess the long term clinical outcome of patients with achalasia after treatment with botulinum toxin. METHODS: Sixty five patients with achalasia (60 idiopathic, five secondary) were treated with injection of botulinum toxin at the gastroesophageal junction. Dysphagia, chest pain, and regurgitation were scored (0 = no symptoms, 1 = mild, 2 = moderate, 3 = severe, 4 = very severe), with the sum representing the total symptom score, at 0, 7, 30, 120, 240, and 365 days posttreatment. Responders were defined as patients with a 50% decrease in total symptom score at 1 month posttreatment. RESULTS: The 60 patients with idiopathic achalasia had significant improvement in symptoms of dysphagia, chest pain, and regurgitation at 1 and 4 wk posttreatment. At 1 month posttreatment, 42 of 60 patients (70%) were classified as responders. Of 33 patients with at least 1 yr follow-up, 36% continued to have a good or excellent response, whereas 39% underwent a subsequent treatment with botulinum toxin, pneumatic dilation, or myotomy. When symptoms recurred after an initial response, patients responded to a second injection of botulinum toxin in six of seven cases. In four of five patients with secondary achalasia, there was no response to botulinum toxin. CONCLUSIONS: Botulinum toxin injection at the gastroesophageal junction significantly improved symptoms in 70% of patients with idiopathic achalasia at 1 month. Recurrent symptoms responded to repeat botulinum toxin treatment in initially responsive patients. In contrast, most patients with secondary achalasia did not improve after botulinum toxin injection.

Anti-Dyskinesia Agents↗
PubMed1996

Sonographic appearance of the endometrium and ovaries during cycles stimulated with human menopausal gonadotropin.

OBJECTIVE: To determine the measurable factors that correlated with a higher conception ratio in one of our subpopulations of infertility patients. STUDY DESIGN: We analyzed 58 menstrual cycles in 24 consecutive infertility patients treated only with human menopausal gonadotropin (hMG) and intrauterine insemination between January 1992 and February 1993 to compare those cycles leading to conception with those that did not with regard to certain factors: endometrial thickness, endometrial layering, number of follicles > or = 15 mm in diameter, peak estradiol level and number of cycles prior to conception. RESULTS: All conceptions occurred in cycles that showed endometrial layering. No patient conceived if the endometrial thickness was < 8 mm. The incidence of conception increased with the number of follicles (one to three) measuring > 15 mm in average diameter. No patient conceived if the serum estradiol was < 192 pg/mL. No conceptions occurred after three successive cycles of treatment. CONCLUSION: Endometrial layering, endometrial thickness of at least 8 mm, a higher number of follicles (up to three) with an average of 15 mm and a serum estradiol level of at least 192 pg/mL correlated with a higher rate of conception.

Adult↗
PubMed1996

Clinical outcomes following penetrating keratoplasty using the Barron-Hessburg and Hanna corneal trephination systems.

Two corneal suction trephination systems currently in use are the Barron-Hessburg and the Hanna trephine. This study assessed the outcome of patients who received penetrating keratoplasty using these two systems. One hundred twenty-four eyes (62 with the Hanna system, 62 with the Barron-Hessburg system) from 98 patients undergoing penetrating keratoplasty were evaluated retrospectively. Best corrected spectacle acuity and corneal astigmatism were assessed 6 and 12 months after surgery. No significant difference was noted between the groups 6 months after surgery. At 12 months, a significant improvement in spectacle acuity was present with 55% of the Hanna group having visual acuity of 20/40 or better compared with 33% of the Barron-Hessburg group (p < 0.005). This difference was greater if eyes having the best visual prognoses were separately evaluated: 74% of the Hanna group had 20/40 vision or better compared with 41% of the Barron-Hessburg group (p < 0.005). In eyes having a good visual prognosis, a significant improvement in visual acuity was present, with 33% of the Hanna group improving nine or more lines compared with 9% of the Barron-Hessburg group (p < 0.05). Postoperative keratometric and refractive astigmatism were not different at 6 or 12 months. We found that visual recovery at 1 year is better using the Hanna system, especially in eyes with good visual prognoses.

Adult↗
PubMed1996

[Study of early postoperative lactitol versus paraffin following anal surgery in 110 adult patients].

The aim of this open and randomised clinical trial was to compare, in terms of efficacy, lactitol with petroleum jelly, regarding the time before recovery of intestinal transit in patients having undergone anal surgery. Efficacy, comfort and tolerability were assessed on day 4 and 7, the convenience of treatments at the end of the period. The main criterion for efficacy was the time taken to obtain the first stool after surgery. Lactitol appears to be more effective than petroleum in terms of recovery of intestinal transit: the first postoperative stool was obtained 13 hours earlier with lactitol. This difference is statistically significant whatever the comparison: survival analysis (p = 0.0018) or t test on means (p = 0.0014). The secondary criteria for efficacy are consistent with this first result: the mean number of stools per day was significantly higher with lactitol (p = 0.046), the daily dose could be-reduced for more patients under lactitol on day 4 (p = 0.004) and, also on day 4, the general efficacy assessment was significantly in favour of lactitol (p = 0.033). The separate analysis of the items included in the comfort score shows that stools are more often "normal or soft" in the petroleum group and that pain on defecation is frequently less severe in the lactitol group. This led to a significantly higher comfort score in the petroleum group from D1 to D4 but not from D1 to D7. Tolerance was rated "good" by 97% of patients on day 7, and no statistically significant difference was observed for any of the tolerability criteria. Lactitol therefore appears to be an interesting choice, with a high benefit/risk ratio, in the treatment of the transitory constipation frequently observed immediately after anal surgery.

Adult↗
PubMed1995

The human urinary epidermal growth factor (EGF) precursor. Isolation of a biologically active 160-kilodalton heparin-binding pro-EGF with a truncated carboxyl terminus.

In this report, we describe the isolation from human urine of a predominant 160-kDa epidermal growth factor (EGF)-immunoreactive glycoprotein that exhibits affinity for heparin. The purification procedure involved concentration and dialysis of 20-30-liter batches of fresh urine on a high capacity ultrafiltration apparatus followed by chromatography on DEAE-Sephacel, heparin-agarose, and Sephacryl S-300. A nearly homogeneous preparation of 160-kDa protein was obtained with a yield of approximately 1 mg of 160-kDa protein from 25 liters of urine. The amino-terminal sequence of the purified 160-kDa protein, H2N-SAPQHXSXPEGTXA-, matched residues 21-34 of the predicted sequence of human prepro-EGF and established that the 160 kDa protein (pro-EGF) is a product of the prepro-EGF gene. Characterization of the carboxyl terminus of the purified protein by digestion with carboxypeptidase B and by immunoblotting with antisera against synthetic carboxyl-terminal and juxtatransmembrane peptides of prepro-EGF indicated that the carboxyl terminus has been truncated at an arginine residue that corresponds, most likely, to the carboxyl-terminal arginine of the EGF moiety. The intact 160-kDa pro-EGF is biologically active as evidenced by its specific binding to the EGF receptor and activation of the EGF receptor tyrosine kinase in A-431 cell membranes. Purified pro-EGF competitively inhibited the binding of 125I-EGF to human fibroblasts, and it stimulated the proliferation of these cells in culture. When immobilized onto culture dishes, the heparin-binding pro-EGF appeared to function both as an adhesion molecule and as a growth factor for serum-free mouse embryo cells.

Amino Acid Sequence↗