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Biomedical subjects

S Meyers

Publications and source records attributed to S Meyers.

At least 91 records · Page 5Linked to original sources
PubMed1986

Random prospective study of vindesine versus vindesine plus high-dose cisplatin versus vindesine plus cisplatin plus mitomycin C in advanced non-small-cell lung cancer.

In this phase III randomized study, 124 evaluable patients with unresectable non-small-cell lung cancer (NSCLC) were randomized to vindesine v cisplatin (120 mg/m2) plus vindesine v cisplatin (60 mg/m2) plus vindesine plus mitomycin C. The objective response rate for cisplatin and vindesine was 27% v 20% for cisplatin, vindesine, and mitomycin C, and 14% for vindesine alone (P = .25 for cisplatin and vindesine v vindesine). The percentage of patients having stable disease (no progression for a minimum of 3 months) was 20% (cisplatin and vindesine), 27% (cisplatin, vindesine, and mitomycin C), and 26% (vindesine alone), respectively. The median survival time for vindesine was 18 weeks, compared with 26 weeks for cisplatin and vindesine and 17 weeks for cisplatin, vindesine, and mitomycin C. Overall survival was not statistically different for cisplatin plus vindesine v vindesine (P = .65). There was no evidence for improved duration of remission or survival of responders with the cisplatin (120 mg/m2) and vindesine arm. This study failed to demonstrate sufficient therapeutic benefit for cisplatin and vindesine (+/- mitomycin C) compared with single-agent vindesine to justify the increased cost and toxicity of these combination regimens.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Fecal alpha 1-antitrypsin measurement: an indicator of Crohn's disease activity.

Random fecal alpha 1-antitrypsin levels were determined in 34 patients, 24 with Crohn's disease, and 10 "controls" having diarrheal illnesses not associated with intestinal protein loss, in an effort to evaluate its usefulness as a measure of Crohn's disease intestinal activity. In the control group, all alpha 1-antitrypsin levels were less than 2 mg/g dry wt of stool. The mean fecal level among those with Crohn's disease was 52.9 mg/g (range less than 2 to greater than or equal to 200). There was a strong correlation between disease activity, as measured by a clinical score, and the alpha 1-antitrypsin levels (Spearman r = 0.65, p = 0.001). This correlation was similarly strong among those with colitis or ileitis. A fecal value greater than 20 mg/g may provide a rough guideline to separate patients with clinically active disease from those with inactive Crohn's disease, despite a considerable range of fecal levels among patients with a particular clinical score. Fecal alpha 1-antitrypsin levels correlated with several other laboratory measures that have been proposed as indicators of Crohn's disease activity. The serum orosomucoid, C-reactive protein, and albumin correlated with the clinical activity score among some of our patient groups. Both clinical scores and laboratory parameters, however, may have limited usefulness in a variety of circumstances. Random fecal alpha 1-antitrypsin determinations seem to provide a reliable, although not directly quantitative, measure of the intestinal activity among patients with Crohn's disease, especially when other methods may be inconclusive.

Adolescent↗
PubMed1985

Left-handedness and inflammatory bowel disease.

Handedness has been reported to be associated with several disorders, including "immune disease." We examined the specific association between left-handedness and inflammatory bowel disease in 213 persons. We personally questioned 43 patients with Crohn's disease, 40 with ulcerative colitis, 70 control patients with various gastrointestinal disorders, and 60 hospital employees with no known immune or gastrointestinal disorder. The clinical diagnosis of each patient was rigorously established. Handedness was determined by The Oldfield Inventory. Study groups were well matched for age, sex, socioeconomic, and cultural backgrounds. The incidence of left-handedness among these groups was 9.3% for those with Crohn's disease, 15.0% among those with ulcerative colitis, 11.4% and 13.3% among the control groups, respectively. There was no excess of left-handedness, within any subgroup, when those with inflammatory bowel disease were analyzed according to sex; or disease location, duration, or overall severity. Our data do not confirm the previously suggested association of left-handedness and inflammatory bowel disease.

Adolescent↗
PubMed1984

Knowledge-based simulation of genetic regulation in bacteriophage lambda.

We have developed a general-purpose computer program for the functional simulation of regulatory genetics. This simulator is knowledge-based and was developed using the Unit System, a software tool for the acquisition, representation, and manipulation of hierarchically organized knowledge. The advantages of a knowledge-based design are presented, and the simulator's architecture is described. Its performance on the decision between lytic and lysogenic growth in Bacteriophage Lambda is reported.

Bacteriophage lambda↗
PubMed1984

Long-term antigen specific and non-specific T-cell lines and clones in uveitis.

T-cell lines, initially expanded with either mitogens or the uveitogenic S-antigen obtained from the eyes of three uveitis patients, were maintained in vitro for 4-8 weeks. S-antigen specific T-cell clones were derived from the peripheral blood of a fourth patient. The surface marker characteristics clearly demonstrate these cells to be T-cells. Both OKT4+ and OKT8+ clones and cell lines were found using immunofluorescence microscopy, an ELISA technique, or the laser cytofluorograph, but some could be only definitely identified as T-cells with the antibody to the IL-2 receptor, and not the OKT series of monoclonal anti-sera. These studies underscore how dynamic the expression of T-cell membrane markers can be, and that commercially available monoclonal anti-sera to T-cell membrane markers may not identify all T-cells in long term culture. This is the first report of the isolation of an antigen specific T-cell clone relevant to the eye, and the technique described will allow clonal expansion of ocular cells in order to study their functional characteristics.

Adolescent↗
PubMed1984

Mycobacterium avium-intracellulare-associated colitis in a patient with the acquired immunodeficiency syndrome.

A 40-year-old bisexual man with the acquired immunodeficiency syndrome developed abdominal pain and bloody diarrhea. At sigmoidoscopy, the mucosa of the rectum and sigmoid colon was edematous, erythematous, and friable, with multiple linear and oval erosions. Histologic examination of rectal biopsies demonstrated innumerable acid-fast bacilli free and within macrophages of the lamina propria. Mycobacterium avium-intracellulare was cultured from the rectal biopsy specimens. Pulmonary tissue and bone marrow cultures also demonstrated this organism. Therapy with several antimycobacterial agents resulted in improvement of symptoms. Among immunocompromised patients the spectrum of enteric pathogens causing colitis should be expanded to include Mycobacterium avium-intracellulare, a potentially treatable organism.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Periileostomy fistulae in Crohn's disease.

Fifteen of 214 patients with an ileostomy constructed during the course of Crohn's disease developed periileostomy fistulae. In each case this was the consequence of recurrent ileal disease. The incidence was higher in female patients as well as those with a prior history of either intraabdominal abscess or any type of fistula. Periileostomy fistulae are frequently multiple. In addition to the clinical features of recurrent disease, periileostomy fistulae cause additional symptoms that are particularly distressing. These result from the proximity of the fistula to the stoma and the difficulty of maintaining the seal of an appliance. All periileostomy fistulae require resection and reconstruction of the stoma. Superficial fistulae with relatively smooth skin around the stoma may be reconstructed using the original stoma site; but deep fistulae with severe peristomal excoriation, induration and inflammation require transposition to a different quadrant. This may, in suitable cases, be carried out by direct stoma-to-stoma transposition, without formal laparotomy. The quality of life following successful reconstruction of the stoma is excellent, even though some patients will develop additional recurrent disease. To date none of these patients have developed another periileostomy fistula.

Adolescent↗
PubMed1983

Does intestinal resection heal the pyoderma gangrenosum of inflammatory bowel disease?

A retrospective study of nine patients with active pyoderma gangrenosum at the time of operation for inflammatory bowel disease showed two patterns of postoperative skin healing: 1) prompt healing within 2 months, occurred in five patients with moderate to severe inflammatory bowel disease. 2) skin disease persisted in four others, healing only after a year. Three of these patients had mild ulcerative colitis, and in them, the operation was carried out in the hope of curing crippling pyoderma gangrenosum. The fourth patient had only an intestinal bypass for ileitis. Our observations suggest that prompt skin healing may occur after surgery in patients with severe inflammatory bowel disease, but not necessarily in those with milder bowel disease or in those in whom some bowel disease persists.

Adolescent↗
PubMed1983

Corticotropin versus hydrocortisone in the intravenous treatment of ulcerative colitis. A prospective, randomized, double-blind clinical trial.

Sixty-six patients hospitalized for ulcerative colitis were treated in a prospective, double-blind, clinical trial. They received either 120 U/day of intravenous corticotropin or 300 mg/day of intravenous hydrocortisone. Patients were randomized within strata defined by whether they had received oral corticosteroids continuously for at least 30 days before the study (group A, 35 patients), or whether they had received no such prior treatment (group B, 31 patients). Twenty-eight of the 66 patients (42%) achieved remission. In group B, the proportion of patients entering remission was greater with corticotropin than with hydrocortisone (63% vs. 27%, 0.025 less than p less than 0.05). The opposite trend was observed within group A, for whom hydrocortisone appeared more effective (53% vs. 25%, 0.05 less than p less than 0.10). Impaired adrenal responsiveness, as measured by serum cortisol and dehydroepiandosterone-sulfate levels, did not explain the different responses to therapy within the two study groups. Twenty of 28 patients whose acute therapy was successful were still in remission 1 yr after study. These data suggest that, at the doses used, intravenous corticotropin therapy of severe ulcerative colitis is the more effective choice for those patients not previously treated with corticosteroids, while intravenous hydrocortisone seems preferable for patients already receiving steroid treatment.

Adrenocorticotropic Hormone↗
PubMed1982

Q fever in maritime Canada.

Only nine cases of Q fever were recorded in Canada in the 20 years prior to 1978. In the 18 months from August 1979 to January 1981 the disease was diagnosed serologically in six patients from the Maritime provinces. All were epidemiologically unrelated and none had been exposed to animals. Five had pneumonia and one had chronic Q fever with probable prosthetic valve endocarditis. Three of the five pneumonia patients presented with signs and symptoms of an acute lower respiratory tract infection and were indistinguishable clinically from other patients with atypical pneumonias. The other two with pneumonia presented with nonresolving pulmonary infiltrates and complained of decreased energy. Four of the five pneumonia patients responded well to treatment with erythromycin; the fifth required two courses of tetracycline. The patient with chronic Q fever had a large amount of cryoglobulins in his serum and evidence of immune complex disease. These cases indicate that Q fever should be considered as a possible cause of atypical pneumonia in Canada.

Adult↗
PubMed1982

Prediction of child abuse in an ambulatory setting.

A prospective random study was performed on 476 patients, up to 2 years of age, by full-time registered nurses in the emergency room. The parent (caretaker) and child were assessed in an effort to predict child abuse. The incidence of abuse rose from 2.5% to 15.2% if one or more abnormal features were present in parent or child (p less than .0003). Abuse developed in 19% of unkempt children and 28% of children with abnormal bruises, burns, or bites. The incidence of abuse increased to 42% (P less than .002) when these factors were present together. An unkempt child with an abnormal parenting pattern and a 30% chance of being abused (P = .007).

Ambulatory Care↗
PubMed1981

Surgery and its sequelae in Crohn's colitis and ileocolitis.

Indications for surgery, operative procedures, and the early and late sequelae of surgery for Crohn's ileocolitis have been studied in a series of 250 patients admitted to Mount Sinai Hospital, New York, between 1960 and 1975. The most common indications for surgery were small-bowel obstruction in ileocolitis, and medical intractability in Crohn's colitis. Early postoperative complications (within 30 days of surgery) followed 79 operative procedures (15%), and were most commonly wound infections (7%), intra-abdominal abscess (2.6%), and postoperative intestinal obstruction (2.4%). Late sequelae (30 days to 15 years following surgery) included intestinal obstruction in 36 patients, external fistulae in 41 patients, and ileostomy problems in 19 patients, and were most frequently caused by recurrent disease in the terminal portion of the ileum. Mortality following surgery for Crohn's disease may be subdivided into two groups, early and late. All eight early postoperative deaths were secondary to sepsis, present in every instance prior to operation. The eight late deaths were caused by metastatic cancer in six and recurrent disease in two. Resection of excluded segments of bowel, as in four of the patients in this series, will reduce the late cancer risk.

Crohn Disease↗
PubMed1981

Cutaneous vasculitis complicating coeliac disease.

A 38 year old female, with chronic uncontrolled coeliac disease, presented with the rare complication of cutaneous leucocytoclastic vasculitis. Detailed study failed to identify any cause for the vasculitis, other than the underlying coeliac disease. Haematuria and proteinuria with mesangial nephritis were also demonstrated on renal biopsy with electron microscopic study. It is speculated that exogenous or endogenous antigens permeated the abnormal small bowel mucosa leading to formation of circulating immune complexes. Subsequent tissue deposition of these complexes then resulted in vasculitis and nephritis. The skin lesions cleared completely after treatment with a strict gluten free diet.

Adult↗