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Biomedical subjects

S Wolff

Publications and source records attributed to S Wolff.

At least 55 records · Page 3Linked to original sources
PubMed1998

[Reducing concomitant illnesses of morbid obesity after gastric banding].

Kuzmak's adjustable gastric banding procedure is well established and has proven to be efficacious in obese patients. After gastric banding we observed a good weight loss and an improvement in metabolic syndrome diseases. Therefore we were able to reduce the dosage of preoperative medication in patients with diabetes or hypertension.

Adult↗
PubMed1997

Allogeneic bone marrow transplantation in patients who relapse after autologous transplantation.

Increasing numbers of patients have received autologous stem cell transplants (ASCT) for hematologic malignancies. Since only a fraction of these patients are cured, physicians are more frequently faced with the dilemma of how to manage relapse post-transplant. Potential advantages of allogeneic transplantation (alloBMT) over ASCT include lack of graft tumor contamination and presence of a graft-versus-tumor effect. For this reason, patients who relapse after ASCT are often considered candidates for allogeneic bone marrow transplantation. However, there is limited knowledge on the outcome of alloBMT in patients who relapse after ASCT. We retrospectively analyzed the outcome of 20 patients with malignant lymphoma (n = 14) and AML (n = 6) who underwent alloBMT after failing an ASCT. The median age was 30 (17-41) years and the interval from ASCT to alloBMT was 10.5 (2-25) months. Seventeen patients died between 0.3 to 11 months (median 2.0) after alloBMT, all due to BMT-related toxicities. Three patients remain alive and free of disease at 1.1, 1.2 and 2.5 years after alloBMT. Sixteen of the 18 evaluable patients (89%) developed grade II-IV acute GVHD. Patients undergoing alloBMT after ASCT have a very high treatment-related mortality and incidence of grade II-IV acute GVHD. Alternative treatments with salvage chemotherapy, radiation or investigational approaches should be considered in patients who relapse after ASCT.

Adolescent↗
PubMed1997

High-dose chemotherapy with autologous hematopoietic stem-cell support for breast cancer in North America.

PURPOSE: To identify trends in high-dose therapy with autologous hematopoietic stem-cell support (autotransplants) for breast cancer (1989 to 1995). PATIENTS AND METHODS: Analysis of patients who received autotransplants and were reported to the Autologous Blood and Marrow Transplant Registry. Between January 1, 1989 and June 30, 1995, 19,291 autotransplants were reviewed; 5,886 were for breast cancer. Main outcomes were progression-free survival (PFS) and survival. RESULTS: Between 1989 and 1995, autotransplants for breast cancer increased sixfold. After 1992, breast cancer was the most common indication for autotransplant. Significant trends included increasing use for locally advanced rather than metastatic disease (P < .00001) and use of blood-derived rather than marrow-derived stem cells (P < .00001). One-hundred-day mortality decreased from 22% to 5% (P < .0001). Three-year PFS probabilities were 65% (95% confidence intervals [Cls], 59 to 71) for stage 2 disease, and 60% (95% Cl, 53 to 67) for stage 3 disease. In metastatic breast cancer, 3-year probabilities of PFS were 7% (95% Cl, 4 to 10) for women with no response to conventional dose chemotherapy; 13% (95% Cl, 9 to 17) for those with partial response; and 32% (95% Cl, 27 to 37) for those with complete response. Eleven percent of women with stage 2/3 disease and less than 1% of those with stage 4 disease participated in national cooperative group randomized trials. CONCLUSION: Autotransplants increasingly are used to treat breast cancer. One-hundred-day mortality has decreased substantially. Three-year survival is better in women with earlier stage disease and in those who respond to pretransplant chemotherapy.

Adult↗
PubMed1996

Aspects of the adaptive response to very low doses of radiation and other agents.

When human lymphocytes and other cells are pre-exposed to very low doses of ionizing radiation and subsequently exposed to a high dose, less genetic damage, i.e., fewer chromosome aberrations, is found than is observed in cells that had not been pre-exposed. This has been termed the adaptive response and has been attributed to the induction of a repair mechanism by the low dose exposure. Several experiments have now been carried out on this adaptive response to better characterize the phenomenon. (A) Experiments with differential display of mRNAs indicate that human lymphocytes exposed to 2 cGy of X-rays have somewhat different mRNAs expressed than do unexposed cells. This is providing access to DNA that might be involved in adaptation. (B) Other experiments with embryonic cells from transgenic mice that are deficient in superoxide dismutase (SOD) have shown that the adaptive response is unrelated to the amount of SOD in the cells, and thus is independent of superoxide radicals. (C) Experiments in which very low doses of various restriction enzymes were electroporated into human lymphocytes have shown that low levels of double-strand DNA breaks alone are able to induce the adaptive response. (D) Experiments in which human male lymphocytes (XY chromosome constitution) and human female lymphocytes (XX chromosome constitution) were cocultivated have shown that adaptation is not caused by a change in the rate of cell progression to mitosis after a challenge dose, and is a further indication that cell stage sensitivity is not a factor in the adaptive response.

Adaptation, Physiological↗
PubMed1996

Segregation of DNA polynucleotide strands into sister chromatids and the use of endoreduplicated cells to track sister chromatid exchanges induced by crosslinks, alkylations, or x-ray damage.

The method of Matsumoto and Ohta [Matsumoto, K. & Ohta, T. (1992) Chromosoma 102, 60-65; Matsumoto, K. & Ohta, T. (1995) Mutat. Res. 326, 93-98] to induce large numbers of endoreduplicated Chinese hamster ovary cells has now been coupled with the fluorescence-plus-Giemsa method of Perry and Wolff [Perry, P. & Wolff, S. (1974) Nature (London) 251, 156-158] to produce harlequin endoreduplicated chromosomes that after the third round of DNA replication are composed of a chromosome with a light chromatid and a dark chromatid in close apposition to its sister chromosome containing two light chromatids. Unless the pattern is disrupted by sister chromatid exchange (SCE), the dark chromatid is always in the center, so that the order of the chromatids is light-dark light-light. The advent of this method, which permits the observation of SCEs in endoreduplicated cells, makes it possible to determine with great ease in which cell cycle an SCE occurred. This now allows us to approach several vexing questions about the induction of SCEs (genetic damage and its repair) after exposure to various types of mutagenic carcinogens. The present experiments have allowed us to observe how many cell cycles various types of lesions that are induced in DNA by a crosslinking agent, an alkylating agent, or ionizing radiation, and that are responsible for the induction of SCEs, persist before being repaired and thus lose their ability to inflict genetic damage. Other experiments with various types of mutagenic carcinogens and various types of cell lines that have defects in different DNA repair processes, such as mismatch repair, excision repair, crosslink repair, and DNA-strand-break repair, can now be carried out to determine the role of these types of repair in removing specific types of lesions.

Alkylating Agents↗
PubMed1996

Echocardiographic predictors of survival after surgery for mitral regurgitation in the age of valve repair.

The objective of this study was to identify echocardiographic and clinical predictors of survival after mitral valve surgery when mitral repair is an option. In 132 patients undergoing mitral valve repair or replacement for the diagnosis of mitral regurgitation, preoperative echocardiograms were analyzed quantitatively and reviewed by two independent observers for structural abnormalities of the mitral valve. In Cox regression analysis, clinical factors such as age (mortality rate ratio [MRR] 1.7/decade, 95% confidence intervals [CI] 1.1, 2.4), and New York Heart Association class IV (MRR 3.1, 95% CI 1.4, 6.7) and echocardiographic factors including morphologic evidence of endocarditis or myxomatous disease (MRR 0.3, 95% CI 0.1, 0.7) were significant predictors of overall survival, although valve repair itself was not. End-systolic dimensions and volumes were not, likely related to the small number of patients with markedly increased end-systolic dimensions or volumes (5 patients [4%] with end-systolic dimension > 5.5 cm, 12 patients [9%] with end-systolic volume index > 60 ml/m2). New York Heart Association class IV (MRR 2.9, 95% CI 1.3, 6.4), age (MRR 1.7/decade, 95% CI 1.2, 2.6), and the presence of calcification (MRR 4.6, 95% CI 1.3, 16.2) were independent predictors of survival in multivariate analysis. In this contemporary cohort of patients undergoing repair or replacement for mitral regurgitation, factors such as echocardiographically determined cause of disease and presence of calcification predicted survival; traditional measurements such as end-systolic dimensions and volumes were less predictive, most likely because patients underwent surgery before their ventricles became markedly enlarged. Clinical factors such as age and functional status remained the most potent predictors of survival after surgery for mitral regurgitation.

Age Factors↗
PubMed1996

Activation of aldose reductase in rat lens and metal-ion chelation by aldose reductase inhibitors and lipoic acid.

Sorbitol formation in rat lenses incubated with high levels of glucose was related to activation of aldose reductase (AR). The hyperglycaemia-activated aldose reductase was inhibited by alpha-lipoic (thioctic) acid, O-phenanthroline and aldose reductase inhibitors (ARIs) including Zeopolastat (ZPLS), Sorbinil (SBN) and AL-1576. This study also examined ARIs for the ability to chelate metal ions. We found that ARIs suppress copper-dependent ascorbate oxidation, lipid peroxidation and hydrogen peroxide production in erythrocytes. ARIs also increased partition of copper ions into noctanol, which indicates formation of lipophilic complexes. Our data support the hypothesis that transition metals may be involved in activation of the polyol (aldose reductase) pathway. Also, ARIs function as metal-chelating antioxidants that may contribute to their therapeutic role for diabetic complications.

1-Octanol↗
PubMed1995

Changes in coagulation and fibrinolysis in patients with sickle cell disease compared with healthy black controls.

Seventeen parameters of coagulation and fibrinolysis were measured in 33 patients with sickle cell disease; 30 were tested in steady state (SS) and 19 in crisis (Cr). There were 16 patients in both groups. The same parameters were measured in 16 controls of similar ethnic origin (Black controls; BC) and 20 Caucasian controls (CC), all with HbA only. Highly significant differences (P < 0.001) between Black and Caucasian control groups were noted for: fibrinogen, fibrinopeptide-A (FPA), beta-thromboglobulin (beta TG) and D-dimer. Significant differences (P < 0.03) in plasminogen activator inhibitor (PAI) and functional antithrombin III levels were also noted. Results of the sickle cell patients were therefore compared with those of the Black controls. Sickle cell patients in SS had raised v Wf compared with BC, which increased further during Cr (P = 0.001), but showed no significant increase in fibrinogen. Functional protein C was reduced in SS (P = 0.004) but with no further fall in Cr, while free protein S was normal in SS but reduced in Cr (P = 0.02). Total protein S and ATIII were normal in SS and Cr. FPA and beta TG were not significantly raised in SS or Cr compared with BC. There were, however, highly significant increases in D-dimer and thrombin-antithrombin complexes (TAT) in both SS and Cr compared with BC (P < 0.001 for SS and Cr vs BC). Thus significant activation of coagulation with consequent increase in fibrinolysis occurs during both the sickle cell crisis and in the steady state.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Schizoid personality in girls: a follow-up study--what are the links with Asperger's syndrome?

Child psychiatric records of 33 girls given a diagnosis of "schizoid" personality in childhood, were compared with records of a control group of other referred girls and with those of 32 pairs of "schizoid" and control boys. Seventeen "schizoid" girls were seen again in adult life and compared with 32 "schizoid" boys previously followed up at the same age. The features of "schizoid" girls in childhood and adult life were very similar to those of the boys. A striking finding, possible due to referral bias, was the high rate of antisocial conduct in "schizoid" girls, both in childhood and later life. The dilemmas of diagnostic classification of this group of patients are discussed.

Adolescent↗
PubMed1995

The concept of resilience.

OBJECTIVE: The concept of resilience highlights the complexity of psychopathology, helps to clarify possibilities for prevention and keeps hope alive in clinical practice. This paper reviews definitions of resilience, the nature of risk factors and of moderating processes. METHOD: The place of single case studies is described, the components of resilience are outlined and consideration is given to how resilience can be fostered in the face of adversities and stresses: socio-economic deprivation, family discord and divorce, and maternal depression. CONCLUSION: A plea is made for increased efforts to make knowledge more widely available: public and politicians need to know how decisions about housing, employment, welfare, education and criminal justice impinge on the development of children, and what changes in the macro-environment will preserve and enhance childhood resilience.

Achievement↗
PubMed1994

"Schizoid" personality in childhood: auditory P300 and eye tracking responses at follow-up in adult life.

The auditory P300 response and smooth pursuit eye tracking were recorded from a group of 23 male adult subjects who had been diagnosed in childhood as having schizoid personality. No differences were found in these physiological measures between the study group, their matched controls of other child psychiatric patients, and a group of population controls. The essentially negative findings are discussed in the light of abnormalities of these psychophysiological responses previously found in schizophrenic patients, in some of their biological relatives, and in other groups of psychiatric patients, including autistic children and adults with a diagnosis of borderline and schizotypal personality disorder. Results suggest that "schizoid" children, despite their high scores on a measure of schizotypy, do not have schizophrenia spectrum disorder or that schizotypy is a heterogeneous condition.

Acoustic Stimulation↗
PubMed1994

Adaptation to ionizing radiation induced by prior exposure to very low doses.

In human and animal cells, an adaptive response has been found to make cells somewhat refractory to the induction of chromosomal damage by high doses applied subsequently. These responses can also be induced in vivo by irradiating animals with low, or chronic doses. In regard to cytogenetic damage, and presumably those mutations that are cytogenetic in origin, the induced response leads to the repair, or rejoining, of broken chromosome ends, which means that chromosome aberrations, deletional (or null) mutations, DNA double-strand breaks, and even cellular survival that is dependent upon the genetic (cytogenetic) integrity of the cell can be endpoints that will show an adaptive response to ionizing radiations.

Adaptation, Physiological↗
PubMed1993

Phase I trial with recombinant human interleukin-3 in patients with lymphoma undergoing autologous bone marrow transplantation.

Recombinant human interleukin-3 (rhIL-3) was administered to 30 patients undergoing autologous bone marrow transplant (ABMT) for treatment of lymphoma. In this phase I dose escalation study, rhIL-3 was administered from day 0 to 20 after ABMT by 2-hour intravenous infusion at dose levels of 1, 2, 5, and 10 micrograms/kg/d. Seventeen patients did not complete therapy with rhIL-3. Eleven requested early discontinuation for malaise, confusion, transplant complications, or rapid engraftment and were removed from the study, whereas six patients developed grade III toxicity, including fever (three patients), or headache (three patients) possibly attributable to rhIL3. Other common toxicities included diarrhea, rigors, mucositis, and rash. The maximum tolerated dose of rhIL-3 was 2 micrograms/kg/d. No evidence of earlier hematopoietic cell recovery was observed compared with similar historical patients treated with recombinant human granulocyte-macrophage colony-stimulating factor. Future trials will be needed to determine alternate schedules of administration of rhIL-3 or the use of rhIL-3 in combination or in sequence with other growth factors.

Adult↗