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Biomedical subjects

D Garvin

Publications and source records attributed to D Garvin.

6 recordsLinked to original sources
PubMed2000

Impact of baseline symptom severity on future risk of benign prostatic hyperplasia-related outcomes and long-term response to finasteride. The Pless Study Group.

OBJECTIVES: To evaluate the long-term effects of finasteride on symptoms, acute urinary retention (AUR), and the need for benign prostatic hyperplasia (BPH)-related surgery in relationship to baseline symptom severity. METHODS: A total of 3040 men with BPH were treated for 4 years with finasteride or placebo. The changes from baseline in symptoms and the incidence of BPH-related surgery and AUR were determined in men with mild (less than 8), low-moderate (8 to 12), high-moderate (13 to 19), and severe (greater than 19) baseline quasi-American Urological Association symptoms for all patients and for the subgroup with a baseline prostate-specific antigen (PSA) level of 1.4 ng/mL or greater. RESULTS: In patients who completed the 4-year study, the change in symptom score, stratified by baseline symptom severity, was +1.4 +/- 0.5 (mild), -0.8 +/- 0.3 (low-moderate), -3.6 +/- 0.3 (high-moderate), and -7.7 +/- 0.5 (severe) in finasteride-treated patients and, respectively, +3.4 +/- 0.5, +0.7 +/- 0.3, -1.4 +/- 0.3, and -5.3 +/- 0.6 in placebo-treated patients (between-group P <0.01). The between-group differences were greater in the subgroup of patients with a baseline PSA of 1.4 ng/mL or greater. The risk of BPH-related surgery increased among placebo patients with increasing baseline symptom severity to a greater extent than the risk of AUR. Finasteride reduced the risk of AUR or the need for BPH-related surgery in all subgroups (P <0.001), especially in men with a baseline PSA of 1.4 ng/mL or greater. CONCLUSIONS: Compared with placebo, finasteride had a beneficial effect on symptoms, AUR, and BPH-related surgery in all symptom categories. BPH-related surgery, but not AUR, occurred more commonly in placebo-treated men with more severe baseline symptoms. The greatest absolute benefit of finasteride on symptoms and the reduction in risk of AUR and surgery was in men with higher baseline symptom scores and a baseline PSA level of 1.4 ng/mL or greater.

Aged↗
PubMed2000

Accurate repair of the prolapsed vagina by use of measured lateral flaps.

OBJECTIVE: We report our experience with a technique for planning the final vaginal caliber and location of the vaginal apex in patients with severe vaginal prolapse. STUDY DESIGN: During the 2-year period ending April 1998, the technique was used in all 27 patients who were undergoing vaginal repair of prolapse performed by Mitchel S. Hoffman, MD, and who desired to retain the vagina but required at least partial excision. The major steps included determination of sites for lateral apical support, definition of the desired introital caliber, marking of the measured lateral vaginal flaps, excision of the intervening epithelium (and uterus if present, n = 14), high peritoneal closure, closure of the anterior vaginal wall, placement of apical supporting sutures, and completion of closure with tying of supporting sutures. Small flaps were designed for the 8 patients who did not anticipate further sexual intercourse. RESULTS: The only intraoperative complication was hemorrhage >1000 mL in 3 patients. Immediate anatomic results were considered excellent for 26 patients. The only early postoperative complication was hemorrhage in a patient being treated with an anticoagulant; she responded to conservative management. Follow-up was available for 24 patients (21-42 months of follow-up; mean, 29 months). All patients had complete relief of prolapse symptoms. Anatomic results remained excellent for 21 of the 24 patients; in the remaining 3 patients asymptomatic grade 2 cystoceles developed at 6 to 12 months. Three patients had new urinary symptoms that persisted. Nine patients resumed sexual intercourse, with no difficulties noted. CONCLUSION: Defining the vaginal apex and designing lateral vaginal flaps facilitate the precise creation of an anatomically and functionally appropriate vagina, with reasonable morbidity, good symptomatic relief, and mild alteration of surrounding organ function.

Aged↗
PubMed1998

Intrathyroidal parathyroid cancer presenting as a left neck mass.

Parathyroid carcinoma is a rare clinical entity with a reported incidence of between 0.5% and 4% of all patients with primary hyperparathyroidism. Equally as unusual is the presence of an intrathyroidal parathyroid gland, which is usually found at the time of exploration by exclusion after extensive dissection has been performed in the usual anatomic locations for the parathyroid glands. This is the description of a case of intrathyroidal parathyroid cancer that presented as primary hyperparathyroidism with a left neck mass. On exploration, an enlarged left lobe of the thyroid was present and no left superior pole parathyroid gland was found with exploration. A left thyroid lobectomy was performed that confirmed a parathyroid cancer that was entirely intrathyroidal. This is the first known reported case in the literature of a carcinoma arising within the thyroid gland.

Carcinoma↗
PubMed1994

A novel anther-expressed adh-homologous gene in Lycopersicon esculentum.

Two novel tandemly-oriented open reading frames (ORFs) with homology to alcohol dehydrogenase (ADH) were isolated from tomato. The predicted amino acid composition for each of the two tandem adh genes indicates the presence of 22 and 21, respectively, of 22 amino acids conserved in ADH proteins from plants and animals. However, comparison to known plant adh genes reveals a significantly lower similarity indicating that they belong to a novel class of ADHs. According to mapping data, the adh-homologous ORFs do not represent either of the previously studied adh1 or adh2 genes of tomato. The tandem genes, termed adh3a and adh3b, mapped to a distal region of the long arm of chromosome 4, unlike adh1, which maps closer to the centromere. Adh3a and adh3b have over 90% similarity to each other at the nucleotide and putative peptide levels. The adh3a gene has ten exons and nine introns with the transcription initiation site 57 bp upstream of the translation start. A putative TATA box and polyadenylation site have been identified. Adh3a is transcribed and, according to cDNA sequence analysis, fully processed in the late stages of anther development. According to transformation analysis, tissue-specific regulatory elements reside within the -448 to +724 region. The termination codon of adh3a is separated from the putative adh3b translation start site by 789 bp of intervening sequence. The 5' untranscribed sequences of each gene contain a stretch of 68 bp with 78% similarity. Within this stretch are sequences which are homologous to sequences found in anaerobically-induced or pollen-expressed genes from various plant species.

Alcohol Dehydrogenase↗
PubMed1992

Chloroplast DNA inversions and the origin of the grass family (Poaceae).

The phylogenetic affinities of the grass family (Poaceae) have long been debated. The chloroplast genomes of at least some grasses have been known to possess three inversions relative to the typical gene arrangement found in most flowering plants. We have surveyed for the presence of these inversions in grasses and other monocots by polymerase chain reaction amplification with primers constructed from sequences flanking the inversion end points. Amplification phenotypes diagnostic for the largest inversion (28 kilobase pairs) were found in genera representing all grass subfamilies, and in the nongrass families Restionaceae, Ecdeiocoleaceae, and Joinvilleaceae, but not in any other monocots--notably, Flagellariaceae, Anarthriaceae, Cyperaceae, or Juncaceae. This finding is consistent with one of the two principal views of grass phylogeny in suggesting that Poaceae and Cyperaceae (sedges) are not closest relatives. A second (approximately 6 kilobases) inversion appears to occur in a subset of the families possessing the 28-kilobase inversion and links Joinvilleaceae and Poaceae, while the smallest inversion appears unique to grasses. These inversions thus provide a nested set of phylogenetic characters, indicating a hierarchy of relationships in the grasses and allies, with Joinvilleaceae identified as the likely sister group to the Poaceae.

Base Sequence↗