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Biomedical subjects

A Unger

Publications and source records attributed to A Unger.

At least 37 records · Page 2Linked to original sources
PubMed1991

E-cadherin expression in squamous cell carcinomas of head and neck: inverse correlation with tumor dedifferentiation and lymph node metastasis.

Tissue sections of 32 squamous cell carcinomas (SCCs) of the head and neck were investigated for the expression of the epithelium-specific cell adhesion molecule E-cadherin. We found that E-cadherin expression is inversely correlated both with the loss of differentiation of the tumor and with lymph node metastasis. The well-differentiated SCCs expressed E-cadherin, often as strongly as the normal stratified epithelium (12 cases were tested); the moderately differentiated SCCs expressed intermediate amounts of E-cadherin or were heterogeneous (15 cases were analyzed); whereas the poorly differentiated SCCs were all E-cadherin-negative (five cases were investigated). Furthermore, seven of eight infiltrated lymph nodes of SCCs were E-cadherin-negative. These data indicate that the loss of the cell adhesion molecule E-cadherin in fact plays an important role in the progression of human squamous cell carcinomas, i.e., that down-regulation of expression is associated with dedifferentiation and metastasis of the tumor cells in vivo.

Adult↗
PubMed1991

Early and late results following coronary bypass surgery beyond the age of 75 years.

The indication for coronary bypass surgery in the elderly has been dramatically expanded in recent years. The results, however, are often contradictory. 1,538 consecutive patients undergoing cardiac surgery were divided into two groups by their age at the time of operation: younger than 75 years (n = 1,480) and 75 years and older (n = 58). These groups were compared with regard to influencing factors of early and late mortality, morbidity, and quality of life. Preoperatively, the clinical condition of the group greater than or equal to 75 years was significantly worse than the condition of the group less than 75 years (NYHA IV: greater than or equal to 75 years: 63.8%; less than 75 years: 31.9%). Cerebrovascular diseases occurred more often in the patients greater than or equal to 75 years (stroke or transient ischemic attack: greater than or equal to 75 years: 8.6%; less than 75 years: 2.3%). The necessity of carotid reconstruction prior to coronary surgery was significantly higher in the patients greater than or equal to 75 years: (greater than or equal to 75 years: 5.2%; less than 75 years: 1.5%). Diabetes mellitus could be observed in 19.0% of the patients greater than or equal to 75 years and in 10.1% of the patients less than 75 years. The preoperative ejection fraction was similar in both groups. Cardiopulmonary bypass time and crossclamping time of the aorta did not differ significantly. Both groups received approximately the same number of distal coronary anastomoses. Rethoracotomy due to hemorrhage had been observed more often in the older group (greater than or equal to 75 years: 8.6%; less than 75 years: 4.5%).(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1990

Neuromyelitis optica (Devic's syndrome) and pulmonary tuberculosis.

Neuromyelitis optica and acute necrotic myelopathy occur in association with pulmonary tuberculosis. We studied 8 patients with either neuromyelitis optica (6), acute myelopathy (1), or acute optic neuropathy (1) in close temporal association with pulmonary tuberculosis, but with no evidence for CNS tuberculosis. Neurologic symptoms preceded the use of antituberculosis medication in 5 patients. Different patients showed similar clinical features, suggesting a consistent disease pattern. Autopsy examination (1 patient) revealed extensive spinal cord and optic nerve demyelination. We identified only 5 additional patients seen over the same period with idiopathic neuromyelitis optica, thus suggesting that the close temporal relationship to pulmonary tuberculosis is not coincidental. The syndrome is most likely due to an immune reaction to tuberculosis rather than the use of antituberculosis medication.

Adolescent↗
PubMed1988

[Prolactin stimulation using the metoclopramide test in females taking oral contraceptives].

In 31 patients taking oral contraceptives (o.c.) for a period between 1 year to more than 3 years, basal serum prolactin levels and metoclopramide induced prolactin values were determined 30 and 60 minutes following an i.v. injection of 10 mg of metoclopramide. The basal prolactin levels were elevated in 7 women to more than 1,000 mU l. The 3 groups of patients taking o.c. with different estrogen doses showed higher drug induced increase of their prolactin levels than the controls. These differences were statistically significant between groups I and III and the control group. No differences could be found between the challenged values of the users groups. The prolactin increase challenged with 200 micrograms TRH in 5 women under o.c. was considerably smaller than that observed in the metoclopramide groups, but exceeded the TRH induced levels found in the controls. The significance of these findings is discussed with special reference to the promotion of prolactinomas.

Adult↗
PubMed1987

The production of pregnancy associated alpha glycoprotein (PAG) from human peripheral blood mononuclear cells.

A sensitive enzyme-linked immuno-assay has been developed which can measure the amounts of pregnancy-associated alpha 2 glycoprotein (PAG) produced by human peripheral blood mononuclear cells (MNC) in culture. Ethinyl oestradiol, indomethacin and pokeweed mitogen (PWM) stimulated PAG production directly while indomethacin produced an additional increase in PAG production by PWM-stimulated MNC probably by inhibiting the production of prostaglandins with down-regulatory effects on the MNC. Oestrogen stimulation of MNC produced significant increases in PAG levels only by the MNC of women on oral contraceptives but not from the cells of males or of females of reproductive age not on oral contraceptives. Since PAG has immunosuppressive properties these observations may be of relevance in understanding the mechanisms involved in the significant decrease in the incidence of rheumatoid arthritis in women taking oral contraceptives.

Azides↗
PubMed1986

Nutritional practices and outcome of extremely premature infants.

We analyzed the records of 182 newborns with birth weights under 1000 g, who survived longer than seven days, to determine risk factors for subacute mortality and morbidity. Statistical analysis using logarithm-linear modeling was used to identify complex interactions and to minimize confounding. Nosocomial infection, necrotizing enterocolitis, male gender, and chronic lung disease (CLD) were identified as independent risk factors for subacute mortality. Male gender and CLD were associated with increased mortality only among patients who received parenteral nutrition (PN). Moreover, PN, rather than enteral nutrition (EN), was a risk factor for delayed growth, nosocomial infection, and CLD. Delayed initiation of EN was associated with decreased necrotizing enterocolitis risk only among male infants with birth weights under 775 g. Our results do not support elective withholding of EN in other groups of extremely low-birth-weight infants. We conclude that indications for PN and for withholding initiation of EN in very-very-low-birth-weight infants need to be established by prospective studies.

Body Weight↗
PubMed1984

Delayed cutaneous hypersensitivity in rheumatoid arthritis: the influence of nutrition and drug therapy.

Significant depression of delayed cutaneous hypersensitivity (DCH) to seven common recall antigens was found in 50 patients with rheumatoid arthritis (RA) compared with 50 matched controls. Complete skin anergy was seen in 12 (24%) of the RA patients but in none of the control subjects. In addition, a nutritional assessment of all subjects tested showed significantly lower serum albumin and body mass indices in the RA compared with the control group. Analysis of these 100 subjects showed a significant correlation (r = 0.53, p less than 0.001) between the number of positive skin reactions and the concentration of serum albumin suggesting an association between nutritional status and DCH. No single factor could be identified to distinguish the reactive and anergic RA patients with the possible exception of drug treatment in that a higher proportion of patients on sodium aurothiomalate or immunosuppressive therapy than D-penicillamine was found in the anergic group. It is likely that the cause of impaired DCH in RA is multifactorial and our findings suggest that drug treatment and nutritional status may be an important contributor to it.

Adult↗
PubMed1984

A single step radial immunodiffusion (RID) method for the quantitation of monomeric IgM.

Monomeric IgM (7S IgM) is present in the serum of patients with certain inflammatory and neoplastic conditions. In the past it has been necessary to separate 7S IgM from 19S IgM by chromatography or ultra-centrifugation prior to its quantification, however, 7% agarose gels allow migration of 7S molecules while retarding the migration of larger (19S) molecules. We describe the development of a RID method on 7% agarose and detail the optimum conditions for the preparation of gels and standards in order to quantify 7S IgM present in serum in a single step without prior separation from 19S IgM. The major difficulties encountered were in the preparation of the agarose gels and the conditions necessary to overcome the difficulties are described. A linear relationship was found between the ring diameter squared and the 7S IgM concentration. The assay could detect as little as 15 micrograms/ml of 7S IgM. Within assay variability was 15.4%. In the sera of 45 normal individuals monomeric IgM was not detected whereas 15 (43%) of an unselected group of patients with rheumatoid arthritis had measurable levels of 7S IgM. This method for quantifying 7S IgM is both simple and inexpensive, and because of the ease with which large numbers of sera can be processed in a single assay it is less time consuming than other methods used to quantify 7S IgM.

Humans↗
PubMed1983

Disease activity and pregnancy associated alpha 2-glycoprotein in rheumatoid arthritis during pregnancy.

Fourteen patients with rheumatoid arthritis were studied during pregnancy and clinical disease activity and serum concentrations of pregnancy associated alpha 2-glycoprotein (PAG) measured at monthly intervals until parturition. Disease activity diminished during pregnancy in 10 patients (group 1) and increased or remained unchanged in four (group 2). The mean PAG concentration produced by group 1 was 1250 +/- 737 mg/1, which was significantly higher than the mean of 470 +/- 304 mg/1 produced by group 2. Furthermore, there was a highly significant negative correlation coefficient (r = -0.41; p less than 0.001) between disease activity and PAG concentrations during gestation. Since there was no significant difference between the two groups of patients in any of the other serum factors measured, and since PAG has immunosuppressive properties in vitro, the results suggest that this protein may play an important part in inducing the remissions of rheumatoid arthritis which frequently occur during pregnancy.

Arthritis, Rheumatoid↗
PubMed1983

The effects of intravenous pulse methylprednisolone on immunological and inflammatory processes in ankylosing spondylitis.

Acute phase reactants, serum immunoglobulins and immune complexes and T cell function were measured in eight patients with active ankylosing spondylitis (AS) before and up to 3 months after three pulses of 1 g methylprednisolone. There was a two stage effect. The first stage was an early anti-inflammatory event with a fall in clinical disease activity mirrored by changes in acute phase reactants particularly prealbumin. The second stage occurred later and was an immunological event with a fall in serum IgA and IgG and a rise in mitogenic response, mixed lymphocyte response and delayed cutaneous hypersensitivity. Most of these changes returned towards pre-treatment levels by 3 months. This study has shown that pulse methylprednisolone has an immediate anti-inflammatory and a prolonged immunological effect in AS.

C-Reactive Protein↗
PubMed1983

Prostaglandin-mediated immunoregulation: reduced sensitivity of in vitro immunoglobulin production to indomethacin in rheumatoid arthritis.

Spontaneous and pokeweed mitogen (PWM) stimulated in vitro immunoglobulin production from peripheral blood mononuclear cells (PBMC) of control subjects and rheumatoid arthritis (RA) patients both receiving non-steroidal anti-inflammatory drugs (RA + NSAID) was measured by an enzyme linked immunosorbent assay (ELISA). Spontaneous IgG and IgM-RF production from the RA + NSAID was significantly higher than in control subjects. IgM production was also elevated but not significantly. Indomethacin (10(-6) - 10(-8)M) added to in vitro cultures failed to influence spontaneous production from either group. PWM stimulated IgG production was not significantly different between the two groups whilst IgM synthesis was significantly reduced in the RA individuals. IgM-RF production was observed only in the RA + NSAID group. Indomethacin inhibited PWM stimulated IgG and IgM production in control individuals but was significantly less potent on IgG, IgM and IgM-RF production from the RA + NSAID group. This reduction in the inhibitory effect of indomethacin correlated significantly with the high spontaneous immunoglobulin production and a low PWM stimulation index observed in the RA + NSAID group. Indomethacin had no significant effect on PWM stimulated PBMC proliferation in the rheumatoid individuals. These results suggest that B lymphocytes from some RA + NSAID are 'pre-committed' to produce immunoglobulins spontaneously in culture, possibly as a consequence of activation in vivo, and are therefore relatively insensitive to PWM stimulation. These B lymphocytes may have progressed beyond the immunoregulatory steps involving prostaglandins.

Arthritis, Rheumatoid↗
PubMed1983

Spontaneous and pokeweed mitogen induced in vitro immunoglobulin and IgM rheumatoid factor production by peripheral blood and synovial fluid mononuclear cells in rheumatoid arthritis.

Enzyme-linked immunosorbent assays (ELISA) were used to measure IgG, IgM and IgM rheumatoid factor (IgM RF) production in supernatants of pokeweed mitogen (PWM) stimulated peripheral blood mononuclear cells (PBMNC) of patients with rheumatoid arthritis (RA) and controls. Spontaneous and stimulated IgG and IgM production by RA and controls was comparable, but spontaneous production of IgM RF was only observed in RA and was related to their drug therapy. A significant difference was found between PWM induced IgM RF production in RA and controls and also between patients on "second-line" and on nonsteroidal anti-inflammatory drugs (NSAID). In addition, spontaneous IgM RF production by synovial fluid cells was significantly higher than the paired PBMNC.

Adult↗
PubMed1982

Circadian variation in disease activity in rheumatoid arthritis.

Disease activity in rheumatoid arthritis as measured by repeated estimation of joint pain, stiffness, articular index, and grip strength was shown to have a circadian rythm, maximal activity being seen between 0200 and 0400 and minimal activity in the early afternoon. This variation in disease activity may be related to circadian alterations in immune and inflammatory responses (such as immune complexes and neutrophil function) dependent on alterations in circulating concentrations of steroids. The circadian variation in disease activity has important implications in assessment of patients, prescription of drugs, and performance of drug trials.

Adult↗