Biomedical subjects

S Walter

Publications and source records attributed to S Walter.

At least 163 records · Page 9Linked to original sources

PubMed1994

B and T lymphocyte subsets enter peripheral lymph nodes and Peyer's patches without preference in vivo: no correlation occurs between their localization in different types of high endothelial venules and the expression of CD44, VLA-4, LFA-1, ICAM-1, CD2 or L-selectin.

Many lymphocytes enter tissues such as peripheral lymph nodes, and Peyer's patches through high endothelial venules (HEV). It is known that HEV differ in the expression of adhesion molecules as lymphocyte subsets do. Through the interaction of these molecules B and T lymphocyte subsets are thought to be preferentially directed into lymphoid organs. However, it is unclear which role these mechanisms play in vivo, since there are no studies demonstrating that blood lymphocyte subsets preferentially interact with different types of HEV in vivo. Therefore, in the present study the frequency of B, T, CD4+ and CD8+ lymphocytes in the wall of the HEV of rat peripheral lymph nodes and Peyer's patches was analyzed by immunohistology. In addition, the expression of CD44, VLA-4, LFA-1, ICAM-1, CD2 and L-selectin on B and T lymphocyte subsets of the blood was determined by flow cytometry. Although B and T lymphocytes showed significantly different levels of expression for each adhesion molecule investigated, the relation of B and T lymphocytes within the HEV of peripheral lymph nodes and Peyer's patches was strikingly comparable (38.0 +/- 5.2% vs. 40.6 +/- 5.7% and 62.0 +/- 5.2% vs. 59.4 +/- 5.7%, respectively). The same was true for CD4+ and CD8+ cells. Thus, although HEV and the blood lymphocyte subsets differ markedly in their expression pattern of adhesion molecules, the existing levels are sufficient to mediate comparable entrance of B and T lymphocyte subsets into both types of HEV.

Animals↗

PubMed1994

[Metastatic eye neoplasms. Review of the literature apropos of 4 cases].

Malignant disease metastatic to the eye is a common entity afflicting hundred patients each year. Breast carcinoma is the most common carcinoma responsible for ocular metastases with an estimated range probably closer to 30% and prevalence of 11.000 women by year in United-States. Breast carcinoma is followed by lung cancer and adenocarcinoma of an unknown primary. The diagnosis should be suspected in patient with history of carcinoma and a decreased visual acuity or any other visual symptom. The most useful diagnostic techniques include direct ophthalmoscopy, ultrasonography, computed tomography and magnetic resonance imaging. The cornerstone of treatment of ocular metastases remains radiation therapy. The overall response rates of earlier diagnosis, according to measurement of visual acuity, may be ranged from 72 to 94%. Early diagnosis and treatment of those lesions are a primary concern to maximize the quality of life until death of patients with metastatic disease. We report four cases of women with breast cancer metastatic to the eye.

Breast Neoplasms↗

PubMed1994

Prevention of urethral stricture recurrence using clean intermittent self-catheterization.

OBJECTIVE: To investigate the effect of clean intermittent catheterization (CIC) on prevention of urethral stricture recurrence after internal urethrotomy. PATIENTS AND METHODS: Of 55 men who were randomly selected, 43 completed the investigation. Of these, 21 patients performed CIC weekly for 1 year following Sachse's operation for urethral stricture and 22 patients formed the control group after the same operation. All had an objective examination for urethral stricture every 2 months after surgery. RESULTS: Significantly fewer (P < 0.01) patients developed recurrence of urethral stricture within the first postoperative year in the CIC group (n = 4) compared with the control group (n = 15). No CIC complications were seen, and patients who completed the CIC programme considered the method fully acceptable. CONCLUSION: Weekly CIC is a simple method of reducing the frequency of urethral stricture recurrence after internal urethrotomy.

Adolescent↗

PubMed1994

Prolonged survival after high-dose rate endobronchial radiation for malignant airway obstruction.

STUDY OBJECTIVE: To show that prolonged survival can be observed after high-dose rate (HDR) endobronchial brachytherapy as the sole treatment for some selected patients presenting with an endobronchial malignant obstruction. PATIENTS: Twenty-nine patients (group 1) who presented with an endoluminal localized tumor without metastatic extension were treated by HDR endobronchial brachytherapy and are compared with 22 subjects who presented with extraluminal dissemination and were palliatively treated (group 2). TREATMENT PROTOCOL: Treatment consisted of sessions of two exposures, delivering 7 Grays at a 10-mm radius from the center of the applicator each, and repeated every 15 days, to a maximum of six exposures. Endoscopic response and survival are the main criteria of assessment. RESULTS: Follow-up bronchoscopies, performed 2 months after the end of the procedure, showed tumor regressions: macroscopic complete responses (CR) were observed in 21 of 25 patients evaluable in group 1, and 6 of 22 in group 2, with histologic CR in 18 and 2 patients, respectively. Median overall survival was not reached in group 1 after 23 months of follow-up; it was 5 months for group 2. CONCLUSIONS: These results confirm that HDR brachytherapy can be used as a monotherapy for carefully selected patients who have small tumors to all appearances limited to the bronchial lumen and bronchial wall without adjacent parenchymal extension or metastatic disease.

Airway Obstruction↗

PubMed1994

Alfuzosin in the treatment of benign prostatic hyperplasia: effects on symptom scores, urinary flow rates and residual volume. A multicentre, double-blind, placebo-controlled trial. ALFECH Study Group.

In order to assess the efficacy and safety of alfuzosin, a selective alpha-1 receptor antagonist, 205 patients with Benign Prostatic Hyperplasia (BPH) were randomly assigned in a double-blind, placebo-controlled manner, to receive either alfuzosin 2.5 mg TID or placebo TID during 12 weeks. After 12 weeks symptom scores-assessed according to the Madsen-Iversen scale were significantly reduced in the alfuzosin group and peak flow rate significantly increased compared to the placebo group. There were no significant differences concerning adverse events or withdrawals. Alfuzosin proved to have a beneficial effect in patients with symptomatic BPH with few and minor adverse events.

Adrenergic alpha-Antagonists↗

PubMed1994

An evaluation of the assess peak flow meter on human volunteers.

The Assess peak flow meter was tested by comparing PEF values obtained on it for 49 normal subjects, with the values obtained for the same subjects on the Wright and mini-Wright meters. Its reproducibility was tested by comparing its coefficient of variation with that of the other 2 instruments. PEF values on the Assess were 5% lower in lower ranges and 9% higher in higher ranges tested as compared with those on the Wright. Values from the mini-Wright and Wright paralleled each other with the former values 3-5% higher. Variabilities on the Assess were 20-50% higher than those of the other 2 meters. Further, PEF values > 670 L/min could not be read by the Assess. Although the Assess fulfils necessary criteria for accuracy and reproducibility, it appears to be less reliable than the other 2 instruments, and its range limits and utility.

Adolescent↗

PubMed1994

Epidemiology of infrequent voiding and associated symptoms.

In an attempt to study the epidemiology of infrequent voiding and its associated symptoms, 1613 women aged 20-25, 30-35 or 40-45 years randomly selected among the ordinary female population in Northern Jutland in Denmark were sent a questionnaire. It was to be answered anonymously. The women were asked about voiding frequency, frequency of nocturnal voidings, urinary infections, problems in initiating voiding and urinary leaking symptoms. The response rate was 65.0%. Overall, 7.7% of the women in the 3 groups had a voiding frequency of 3 or less per day. We found that women aged 20-25 had a higher rate of this low voiding frequency than women in the two older groups, (p < 0.001). Women aged 40-45 had a higher rate of urinary leaking symptoms than the two younger groups, (p < 0.02). In all 3 groups, women who voided 3 times or less per day had significantly more urinary infections than those with 4 or more voidings per day, (p < 0.01). The investigation has given some impression of the frequency of the infrequent voiding and the frequency of its associated symptoms.

Adult↗

PubMed1994

Clean intermittent self-catheterization.

The pathogenesis and the symptomatology of the infrequent voiding syndrome is discussed. The acceptability of clean intermittent self-catheterization as a treatment modality for women with the infrequent voiding syndrome is documented through questionnaires and retrospective study of patient records in fifty-four women. This study is part of a study already published.

Adult↗

PubMed1994

Effects of short-term isotonic & isometric training on cardiovascular & pulmonary function.

A randomised control trial of short-term exercises on specific cardiovascular and respiratory parameters was undertaken in normal male college students. The effects of isotonic training (5BX programme) and isometric training (a programme of isometric exercises working all major groups of muscles) were compared with a control group with no specific workout. Both isotonic and isometric training resulted in significant cardiovascular improvement but seemed inadequate to improve vital capacity and flow rates. Isotonic training in addition, improved ventilatory efficiency. It is concluded that such isotonic or isometric training of thrice a week for ten weeks, requiring no equipment, less time and space can be promoted to improve physical fitness.

Adolescent↗

PubMed1993

[Is it possible to live with clean intermittent catheterization?].

In the period 1983 to 1992, 208 patients with bladder dysfunction were introduced to clean intermittent self-catheterization. Through questionnaires and retrospective study of patient records we found that 57% of the patients were very satisfied with this treatment modality. Seventy percent found it easy to learn to catheterize themselves and 39% experienced improval of everyday life. Thirty-five percent never had bacteriuria. No serious complications were seen. Conclusively we found that clean intermittent self-catheterization is a good treatment modality for patients with bladder dysfunction. It is easy to learn, easy to perform and is very well accepted by the patients.

Adolescent↗

PubMed1993

Characteristics of an exochitinase from Streptomyces olivaceoviridis, its corresponding gene, putative protein domains and relationship to other chitinases.

Streptomyces olivaceoviridis efficiently degrades chitin. Shotgun cloning of partially Sau3A-cleaved DNA using the multicopy vector pIJ702 and Streptomyces lividans 66 as host resulted in the identification of the plasmid pCHI O1 which harbours an insert of 4.6 kb. In the presence of chitin as sole carbon source, transformants of S. lividans 66 carrying pCHI O1 or its derivatives with smaller inserts overproduced an exochitinase which was purified to homogeneity. The chitin-inducible enzyme with an isoelectric point of 4.0 shows optimal activity at pH 7.3 and 55 degrees C, has an apparent molecular mass of 47 kDa and is competitively inhibited by the pseudosugar allosamidin. The enzyme was identified as an exochitinase since it generates exclusively chitobiose from chitotetraose, chitohexaose, and colloidal high-molecular mass chitin. Sequence analysis of a reading frame of 1794 base pairs and comparison of the deduced amino-acid sequence allowed the identification of the putative catalytic domain, one region with significant similarity to the type-III module of fibronectin and one domain of unknown function. Multiple sequence alignment and hydrophobic-cluster analysis of 25 chitinolytic enzymes from bacteria, fungi and plants allowed the identification of their characteristic domains. The exochitinase from S. olivaceoviridis shares highest similarity with the chitinase D from Bacillus circulans.

Acetylglucosamine↗

PubMed1993

DNA ploidy, proliferation index, grade, and stage as prognostic factors for vulvar squamous cell carcinomas.

DNA analysis by flow cytometry has been reported to be a useful prognostic technique for a variety of malignant tumors. The goal of this study was to examine DNA ploidy status and proliferation index as potential predictors of recurrence and survival for patients with squamous cell vulvar carcinomas. The DNA ploidy, percentage of cells in the S-phase of the cell cycle, stage, and histologic grade were analyzed in 42 patients. Flow cytometry was performed on archival paraffin-embedded tissue. The histologic specimens were reviewed by a single pathologist. Thirty-four tumors (81%) were diploid and eight (19%) demonstrated an aneuploid peak. The percentage of cells in the S-phase (proliferation index) was calculated for all patients. The 5-year survival rate was 68% for diploid tumors and was 75% for aneuploid tumors. The difference between these rates was not statistically significant (P < or = 0.65). S-phase fraction was also not a useful predictor for recurrence or overall survival. FIGO stage and histologic grade were accurate predictors for both recurrence and 5-year survival. Multiple predictor analysis using stage, grade, ploidy status, and proliferation index did not identify any subgroup which would predict recurrence better than FIGO stage and grade. DNA ploidy and S-phase fraction analysis do not appear to be clinically useful prognostic factors for vulvar squamous cell carcinomas.

Adult↗

PubMed1993

Effect of time elapsed since previous voiding on the detection of Chlamydia trachomatis antigens in urine.

To determine if the time elapsed since previous voiding affects the sensitivity of an enzyme immunoassay (EIA) to detect Chlamydia trachomatis in urine, 882 women and 428 men were tested for chlamydial infection in urethral specimens by isolation in cell culture (women and men) and EIA with blocking confirmation (women only). Of the 36 women (4.1%) and 38 men (8.9%) who were positive for Chlamydia trachomatis in the urethra, 55.5% (20/36) and 81.6% (31/38) respectively were positive in the first void urine (FVU) sediment by confirmed EIA. In women the sensitivity of the EIA performed on FVU was 67.8% (19/28) if the urine had been in the bladder < 3 hours and decreased to 12.5% (1/8) if longer times had elapsed (odds ratio 13.7; 95% confidence interval 1.4 to 700.0) with no obvious confounding. In men a weaker association was present (odds ratio 2.7; 95% confidence interval 0.4 to 22.3). These findings should enable investigators to optimize the analysis of urine to diagnose chlamydial infections.

Antigens, Bacterial↗

PubMed1993

Modelling psychosocial effects of exposure to solid waste facilities.

A parallel case study design was used to investigate psychosocial effects in populations exposed to solid waste facilities. Psychosocial effects were defined as a complex of distress, dysfunction and disability, manifested in a range of psychological, social and behavioural outcomes, as a consequence of actual or perceived environmental contamination. This paper presents the results of logistic regression analyses designed to identify determinants of psychosocial effects of exposure. The data come from an epidemiologic survey of residents (N = 696) living within a prescribed radius from each of three solid waste facilities in southern Ontario. The analytical model has three main components: external variables (e.g. individual and exposure-related variables); mediating variables (e.g. social network membership and involvement, general health status measures); and outcome variables (e.g. concern, effects and actions). Results for a series of site specific analyses show that outcome measures can be successfully explained by a combination of external and mediating factors. In general, variables from each of the three main components enter the concern-related models while the action models are clearly dominated by social network variables. Analyses using data from all three sites indicate the explanatory power of site-related characteristics. However, given the number and diversity of variables in the models, there is no support for a simple cause and effect relationship. The implication is that strategies aimed to address and alleviate psychosocial effects need to be specific to the characteristics of the populations in particular settings.

Adaptation, Psychological↗

PubMed1993

Oestriol in the treatment of postmenopausal urgency: a multicentre study.

UNLABELLED: Oestrogen deficiency in postmenopausal women is thought to be important in the genesis of lower urinary tract symptoms, in particular the 'urge syndrome'. Evidence to support the use of oestrogen therapy in symptomatic postmenopausal women is, however, limited. Oestriol is a weak, naturally occurring oestrogen that may be beneficial to the urogenital tissues without stimulating the endometrium. We have investigated the use of oestriol in the treatment of postmenopausal sensory and motor urge incontinence. MATERIALS AND METHODS: A double-blind, placebo-controlled, randomised, multicentre study of 3 mg oral oestriol/day for 3 months in the treatment of women with urge incontinence was undertaken. RESULTS AND CONCLUSIONS: Sixty-four women were recruited into the study. Although oestriol produced both subjective and objective improvement in lower urinary tract function, it was not significantly better than placebo. Some of the difficulties of running a multicentre study were encountered.

Double-Blind Method↗

PubMed1993

The urethral plug II: an alternative treatment in women with genuine urinary stress incontinence.

An improved design of the recently developed urethral plug was evaluated for the treatment of women with genuine urinary stress incontinence. The plug consists of an oval meatal plate, a soft stalk and 1 or 2 spheres along the stalk with fixed distances between the meatal plate and the spheres. Inside the stalk is a removable semi-rigid guide pin to ease insertion. Forty women were randomly allocated to treatment with either the 2-sphere or the 1-sphere plug during period 1 (2 weeks). In period 2 (2 weeks) the patients used the other plug. They then continued with what they judged to be the better plug in period 3 (2 months). Eighteen patients (45%) completed period 3 with the "preference" plug and 17 were subjectively and objectively continent or improved. Fourteen of these women preferred the 2-sphere device. The plugs were equally effective in patients with mild or severe incontinence. To accommodate variations in urethral length and to avoid the loss of plugs, the devices are available in different lengths. Six women developed urinary tract infections and 2 of these had a plug in the bladder. The urethral plug is an effective treatment in a group of women with stress incontinence. Removal by hand is advisable in order to avoid retention of plugs in the bladder.

Adult↗

PubMed1993

A new patient weighted symptom score system (DAN-PSS-1). Clinical assessment of indications and outcomes of transurethral prostatectomy for uncomplicated benign prostatic hyperplasia.

A patient weighted symptom score system, the Danish Prostatic Symptom Score (DAN-PSS-1), including a disease specific self administered quality of life questionnaire, is presented. The model was evaluated pre- and postoperatively in 29 patients apparently suffering from uncomplicated benign prostatic hyperplasia. The score system is based on the severity of 12 symptoms related to bladder storage and voiding function, and three questions related to sexual function (symptom score). For each of these parameters the patient must also evaluate its influence on his daily life (bother score). In the 29 patients with uncomplicated benign prostatic hyperplasia (BPH) bother scores exceeded symptom scores for the irritative symptoms but not for the obstructive symptoms, and surprisingly the symptom score was less improved than the bother score 6 months after transurethral resection of the prostate (TUR-P). Furthermore the postvoiding dribble was worsened after the operation. We find that this model, DAN-PSS-1, assists in creating a solid base for the indication for and the evaluation of treatment of uncomplicated BPH.

Aged↗

PubMed1993

[High dose endobronchial curietherapy and its role in the relief of bronchial obstruction due to tumors].

The prognosis of tumours invading the lumen of the tracheobronchial tree is very poor. The majority of patients can only be offered symptomatic treatment. Different techniques to relieve bronchial obstruction have recently been developed. Amongst these is endobronchial radiation treatment at high dosage, with the advantage of enabling ambulatory treatment to be given with a satisfactory tolerance level. The treatment combines treatment both of the luminal invasion, but also of the component of the tumour which is extrinsic to the bronchi. Following a review of the literature, we have reviewed the technique, the indications and the results of this new method of treatment.

Airway Obstruction↗