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Biomedical subjects

B Berman

Publications and source records attributed to B Berman.

At least 127 records · Page 7Linked to original sources
PubMed1987

Cerebral palsy spasticity. Selective posterior rhizotomy.

We have performed selective posterior rhizotomies on 60 children with cerebral palsy. The procedure involves lumbar laminectomy with stimulation of the rootlets (fascicles) of the second lumbar to the first sacral posterior roots bilaterally; those rootlets associated with an abnormal motor response, as evidenced by sustained or diffused muscular contraction, are divided leaving intact rootlets associated with a brief localized contraction. The patients were between 20 months and 19 years of age representing all degrees of physical handicap and ranging from profoundly retarded to normal intelligence. Follow-up has been from 1 to 5 years. Each child was assessed pre- and postoperatively and graded in the following categories: muscle tone, power, sitting, standing, walking, upper limb function, and speech. The patients whose function improved most dramatically following rhizotomy were purely spastic and intelligent, were significantly more affected by spasticity in the lower than the upper limbs, had some degree of forward locomotion, and could side-sit independently. Patients with severe athetosis or marked contractures improved least.

Adolescent↗
PubMed1987

Persistence of a reduced-collagen-producing phenotype in cultured scleroderma fibroblasts after short-term exposure to interferons.

Transient exposure to inflammation-associated, fibroblast-stimulatory factors appears to initiate fibrosis by inducing the persistently activated phenotypes displayed by fibroblast cultures derived from scleroderma skin and other fibrotic tissues. To determine whether one class of fibroblast-inhibitory factors, the interferons (IFNs), plays a role in terminating fibrosis by acting as persistent fibroblast deactivators, we inhibited (40-60%) the growth and collagen production of normal dermal fibroblasts and hypercollagen-producing scleroderma fibroblasts by short-term exposure to IFN-alpha, beta, or gamma. During subsequent subculture in the absence of IFNs, the growth and collagen production of normal fibroblasts and the growth of scleroderma fibroblasts increased to untreated control levels after two to three passages. In contrast, collagen production by scleroderma fibroblasts remained inhibited for at least five passages (18 cell doublings) and was not further suppressed by subsequent IFN exposure. These data suggest that IFNs may help terminate fibrosis by suppressing persistently activated fibroblast functions.

Cell Division↗
PubMed1986

Establishment of a clinical teaching associates breast examination program for medical students.

A program was designed to instruct medical students on how to obtain a history pertinent to breast abnormalities and to perform a breast examination. The use of clinical teaching associates provides direct student instruction and critiques during the examination. In addition, students are taught how to instruct patients in the breast self-examination and to properly document breast abnormalities. Such a program should be considered for incorporation in all physical diagnosis courses as well as in residency training programs and seminars for practicing physicians.

Breast↗
PubMed1986

Intralesional recombinant alpha-2 interferon for the treatment of patients with condyloma acuminatum or verruca plantaris.

We conducted a multicenter double-blind study comparing human recombinant intralesional alpha-2 interferon (IFN) and placebo in 237 patients with the clinical diagnosis of condyloma acuminatum or verruca plantaris. A single wart on each patient was injected with 0.1 mL containing 10(6) IU of IFN, 10(5) IU of IFN, or placebo three times weekly for three weeks, and the response to treatment was followed up for 12 weeks. Among 91 of the 114 patients with condyloma acuminatum who completed the study, complete clearing of the treated wart occurred in 16 (53%) of 30 patients receiving 10(6) IU of IFN compared with six (19%) of 32 receiving 10(5) IU of IFN and four (14%) of 29 receiving placebo. In the group of 100 patients with plantar warts, there was no apparent benefit associated with interferon administration. Seven patients (3%) had treatment discontinued due to adverse reactions. Intralesional alpha-2 IFN is of benefit in the treatment of a single condyloma; its role in the treatment of multiple lesions remains to be clarified. Its role in the treatment of verruca plantaris, where no response was seen, also remains to be clarified.

Adult↗
PubMed1985

Gamma interferon is the lymphokine and beta interferon the monokine responsible for inhibition of fibroblast collagen production and late but not early fibroblast proliferation.

Human peripheral blood mononuclear cells activated with concanavalin A (Con A) or lipopolysaccharide (LPS) produce, respectively, lymphokines (LK) of 50,000 Mr or monokines (MK) of 20,000 Mr that inhibit the growth and collagen production of cultured human dermal fibroblasts. Because antigenic typing of the antiviral activity of these LK and MK preparations revealed that LK contained mainly gamma interferon (IFN-gamma), and MK, primarily IFN-beta, we investigated if any of the fibroblast-inhibiting activities could be attributed to human IFN. Unlike LK and MK, which act within 24 h to inhibit the growth of subconfluent foreskin and adult dermal fibroblasts, samples of purified, natural derived IFN-alpha, -beta, and -gamma and recombinant DNA-derived IFN-alpha 2 and -gamma were ineffective inhibitors at 24 h and required 48-72 h to significantly inhibit growth. However, all IFN did mimic LK/MK action in causing concentration-dependent inhibition of collagen production by confluent fibroblast microcultures. Furthermore, the collagen production-inhibiting activity of Con A-induced LK supernatant and its 50,000 Mr fraction was completely suppressed by 10(3) neutralizing U/ml of either polyclonal or monoclonal antibody to IFN-gamma, while polyclonal antibodies to IFN-alpha and -beta had no effect. Similarly, the collagen production-inhibiting activity of LPS-induced MK supernatant and its 20,000 Mr fraction was suppressed by polyclonal anti-IFN-beta but not by anti-IFN-alpha or -gamma. Anti-IFN failed to reverse early-acting LK or MK growth-inhibiting activities. These data suggest collagen production-inhibiting LK and MK are IFN-gamma and IFN-beta, respectively, and that early acting, growth-inhibiting LK and MK are not IFN.

Cell Division↗
PubMed1985

Addition of short-contact anthralin therapy to an ultraviolet B phototherapy regimen: assessment of efficacy.

The purpose of this study was to determine whether the addition of short-contact anthralin therapy to an ultraviolet B phototherapy regimen would result in more rapid resolution of psoriatic plaques. A bilateral paired comparison between an ultraviolet B phototherapy regimen with and without short-contact anthralin was completed in eleven patients. Only two of the patients responded faster on the anthralin-treated side. Our results do not support the routine addition of short-contact anthralin therapy to ultraviolet B phototherapy regimens, but this combination may be more effective in a minority of patients.

Anthracenes↗
PubMed1985

Interferon enhancement of HLA-DR antigen expression on epidermal Langerhans cells.

Langerhans cells (LCs) are dendritic epidermal cells whose ability to function as accessory/stimulatory cells in initiating the immune response is, like that of macrophages, dependent on the expression of class II major histocompatibility antigens. In normal human skin approximately 50% of LCs identified by cell surface T6 antigenicity also express HLA-DR histocompability determinants. We report here that recombinant DNA-derived human interferon (IFN)-gamma, but not IFN-alpha 2, induces the expression of HLA-DR antigens by the population of human epidermal LCs on which such antigens normally are not detected. IFN-gamma effectively induced HLA-DR on both neonatal and adult epidermal LCs and such induction was blocked by neutralization with a murine monoclonal antibody to IFN-gamma. IFN-gamma induction of LC HLA-DR expression is inhibited by prostaglandin E2 (PGE2) and is mimicked by the presence of fatty acid cyclooxygenase inhibitors, known to reduce PGE2 production. These results suggest that IFN-gamma may play a role in regulating skin-associated immune responses through enhanced expression of HLA-DR antigens on LCs and that such enhancement may be mediated by alterations in arachidonic acid metabolism.

Cyclooxygenase Inhibitors↗
PubMed1985

Reduced epidermal Langerhans cell densities in patients with pulmonary malignancies do not correlate with anergy or nutritional status.

Epidermal Langerhans cell (ELC) densities are markedly reduced in a number of clinical situations including anergic sarcoidosis patients. To help determine whether this reduction is related to the anergic or nutritional status of the patient, we examined the non-sun-exposed epidermis of 23 hospitalized patients with various malignancies (MP), 10 hospitalized control (HC) patients without malignancy, and 24 biopsies from historical control (HIC) patients. There was no significant difference in the density of HLA-DR+ ELC among HC, HIC, or patients with nonpulmonary malignancy (primary or metastatic). Six patients with pulmonary malignancy had significantly fewer HLA-DR+ and OKT6+ epidermal cells. The reason ELC densities are reduced specifically in pulmonary malignancies remains under study.

Adult↗
PubMed1985

The resolution of health problems in school children.

The resolution rates of health problems identified in school children by primary care, physical examination, or screenings were examined during a two-year period. The evaluation component of the National School Health Program involved a range of school health services provided in four states to more than 13,000 children. A school nurse practitioner-health aide team worked in collaboration with a community physician consultant to manage the resolution of identified problems. More than 95% of the problems were resolved or in process of resolution at the end of each school year. Resolution patterns were relatively consistent across problem severity levels. Factors contributing to the timely resolutions of health problems by nurse practitioners included their ability to manage and resolve more than 90% of the problems within the school-based practice with physician backup and their access to a medical support network for external referrals.

Child↗
PubMed1985

The aging skin.

The anatomic, biochemical, and physical changes occurring in the skin with aging are reviewed and discussed. An attempt is made to distinguish between changes resulting from accumulated injury from environmental factors and the changes of aging per se.

Adolescent↗
PubMed1984

An integrative approach to intracranial hydraulic physiology. I. Basic concepts, pressure-volume relationships, and infusion studies.

A computer simulation of the anatomy of the intradural fluid compartment is used to explore intracranial hydraulic physiology. It examines the mutual interactions of fluid flow rates, volumes, and pressures that control the physiology of the intracranial fluid. The mechanisms of change in intracranial pressure despite the fixed volume constraint are elucidated. The physical origins of the pressure-volume curve and data on the infusion of cerebrospinal fluid are examined. The dynamic behavior of this passive system closely simulates the observed physiologic response to bolus infusion, constant rate infusion, hypercapnia- hypocapnea , and hydrocephalus.

Brain↗
PubMed1983

T6-antigen-bearing cells in eosinophilic granuloma of bone.

T6-antigen-bearing Langerhans' cells were detected in a touch imprint of eosinophilic granuloma involving a thoracic vertebra of an 11-year-old boy. It is interesting to note that in this localized form of histiocytosis X, no T6-antigen-bearing Langerhans' cells were found in the peripheral blood. Immunofluorescence detection of T6 antigenicity has not been described in this disease and may serve as a rapid diagnostic test.

Antigens↗
PubMed1983

Achieving optimal immunization levels in school-age children.

In a school-based immunization program in four states, 70% of the students were fully immunized by the end of the first year and 85% by the end of the second year. Because of student turnover, 20% of the immunization levels achieved by the end of a school year were not sustained into the subsequent year. Levels reported by the state immunization officers were higher than those recorded by school personnel. Completed immunization series for students requiring immunizations were 33% to 40% higher for students enrolled at the start of the year than for students who entered during the school year. Students who were unimmunized at the beginning of the year had a better change (P less than 0.001) of being immunized by the end of the year than those whose immunization status was unknown. To maintain high levels, a program must be sustained and continuing, provide immunizations, and have careful administrative monitoring of child-specific population-based data. Schools are uniquely able to provide all of these elements, which can augment the efforts of private practitioners.

Child↗
PubMed1983

Comparative values of school physical examinations and mass screening tests.

In this study mass screenings identified more problems than did physical examinations, but more problems per 100 contacts were identified by physical examinations (51.6) than by screenings (4.7). When time necessary to accomplish the evaluation is considered, screenings are a more efficient way of identifying problems in the general diagnostic categories for which screenings can be provided, but most (85.8%) of the problems identified by physical examination were in categories for which screenings are not provided. Overall, 99.1% of the problems were identified without overlap between physical examinations and screenings. Eighty-three percent of the problems identified by physical examinations were previously unknown. By the end of the school year, 86.3% of the problems identified by physical examinations and 94.5% of those identified by screenings had been or were in the process of being resolved. The integration of physical examinations and screenings in a school setting, staffed by nurse practitioners supported by physicians, can maximize the identification and resolution of health problems.

Child↗