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Biomedical subjects

J Lessing

Publications and source records attributed to J Lessing.

10 recordsLinked to original sources
PubMed2001

Retrospective stratification of a consecutive cohort of prostate cancer patients treated with a combined regimen of external-beam radiotherapy and brachytherapy.

PURPOSE: The evaluation of clinical variables that influence biochemical relapse-free survival in a cohort of patients treated by combined radiotherapy over a fixed interval. METHODS AND MATERIALS: Three hundred forty-eight patients diagnosed with clinical Stage T1--T3a prostate cancer were treated with a course of (103)Pd or (125)I brachytherapy followed by a limited course of external beam radiation formed the basis for study. All censored patients had a minimum 2-year follow-up. Biochemical relapse-free survival (BRFS) was estimated using a modified American Society for Therapeutic Radiology and Oncology consensus definition. Discrete "risk groups" were developed based on BRFS as influenced by pretreatment parameters. RESULTS: Significant risk factors contributing to biochemical failure were serum prostate-specific antigen (PSA) greater than 20 ng/mL, Gleason sum of 7 or greater, or clinical stage T2c or greater. Five-year biochemical control for those exhibiting no risk factor was 88%; one risk factor, 75%; two or more risk factors, 51%. The differences in BRFS among all three risk groups were statistically significant. Outcomes for patients presenting with PSA 10 to 20 ng/mL, but otherwise low-risk disease, fared no differently from those low risk patients presenting with PSA less than 10 ng/mL. CONCLUSIONS: Combined radiotherapy with (103)Pd or (125)I followed by external beam radiotherapy achieves a high rate of biochemical and clinical control in patients with low- to intermediate-risk clinically organ confined disease.

Analysis of Variance↗
PubMed1999

[PVT--tension-free vaginal tape--a new minimally invasive surgical technique for female stress incontinence: preliminary results].

We evaluated the safety and efficacy of the tension-free vaginal tape procedure (TVT) in 20 consecutive women with urodynamically proven genuine stress incontinence. Mean operating time under spinal analgesia was 37.2 +/- 13 minutes and 80% were discharged within 24 hours. There were 5 uncomplicated, intraoperative bladder perforations, but no defects in healing nor tape rejection. The objective cure rate was 95%, while the subjective rate was 100%. Although follow-up was short (9-16 months), the TVT method seems to be safe and effective for stress urinary incontinence.

Female↗
PubMed1998

The role of routine pelvic lymph node sampling in patients with stage I endometrial carcinoma: second thoughts.

BACKGROUND AND METHODS: The cases of 245 patients diagnosed during 1980-1989 with stage I endometrial carcinoma were retrospectively reviewed in order to assess the contribution of lymph node sampling (LNS) to both course of treatment and outcome. The 183 women treated by gyneco-oncologic surgeons had undergone the standard surgical procedure of total abdominal hysterectomy (TAH), bilateral salpingo-oophorectomy (BSO) and pelvic lymph node sampling (LNS). Sixty-two other women, treated by gynecologists, received only TAH and BSO. Of women who had received TAH+BSO+LNS, 105 (57.4%) were referred for adjuvant radiotherapy on the basis of one or any combination of high grade histology (G2 or G3), myometrial invasion to a depth of 50% or more and LNS positivity. Of the group who had not had LNS, 37 (59.7%) likewise received adjuvant radiotherapy but on the bases of histology and/or depth of invasion. RESULTS AND CONCLUSIONS: Recurrence and survival over a mean follow-up period of 7.5 years (range 5-15 years) showed no significant differences between the patients who underwent LNS and those who did not. Of 43 recurrences, six were among 'low risk' women (those with both minimal invasion and low grade histology), suggesting a special need among this group for the additional staging information which LNS may provide.

Carcinoma↗
PubMed1995

Adrenal pseudocyst: report of two cases.

Adrenal cysts are uncommon lesions. The authors discuss two cases of adrenal pseudocyst, and its classification and possible pathogenesis and complications. The role of radiologic findings in preoperative evaluation of renal/suprarenal masses also is detailed.

Adrenal Gland Diseases↗
PubMed1994

The hemizona assay is of good prognostic value for the ability of sperm to fertilize oocytes in vitro.

OBJECTIVES: To assess the prognostic value of hemizona assay (HZA) in predicting the success of IVF. DESIGN: Samples from 133 patients, who were referred for semen evaluation, were tested by HZA. Thirty samples were tested twice to assess interassay variation. Seventy couples were also referred for IVF. Results of HZA were compared with standard parameters of sperm quality, fertilization rates, and pregnancies. RESULTS: The intra-assay and interassay coefficient of variation were 8% and 14%, respectively. Hemizona assay results had the highest correlation with sperm morphology (r = 0.60). Of all parameters evaluated, fertilization rates were best predicted by hemizona index (HZI) (r = 0.75). The assay was found to have high sensitivity and specificity rates, at a threshold HZI of 23%. CONCLUSIONS: The HZA is a valuable prognostic test for IVF. With a threshold HZI of 23%, it has a good predictive value for fertilization rates in IVF, and may thus be used for patient preselection before IVF.

Female↗
PubMed1987

Free alpha-subunit response to gonadotropin-releasing hormone in women with polycystic ovaries.

The response of glycoprotein hormone free alpha-subunit to gonadotropin-releasing hormone (GnRH) was evaluated in 12 women with polycystic ovaries (PCOs). Six of these women were premedicated for 3 days with micronized 17 beta-estradiol before receiving a 100-micrograms bolus of GnRH. In nonmedicated PCO patients, GnRH did not significantly alter basal free alpha-subunit levels. In four of the six PCO patients receiving estrogen premedication, a significant increase in free alpha-subunit was observed; these four patients had low progesterone levels at the time of the GnRH test. Among the six premedicated patients, two had elevated (greater than 4 ng/ml) progesterone levels, and the GnRH tests showed no significant effect on the levels of free alpha-subunit. The study revealed a dissociation between the free alpha-subunit responses to GnRH and the responses of luteinizing hormone; a closer relationship was observed between free alpha-subunit and follicle-stimulating hormone responses. It was concluded that the lack of a free alpha-subunit response to GnRH in PCO patients is not due to a primary inability of the pituitary gonadotroph to produce free alpha-subunit but is a consequence of an altered estrogenic milieu, and a free alpha-subunit response to GnRH may reflect the replenishment of both follicle-stimulating hormone and luteinizing hormone in the gonadotrope.

Adult↗
PubMed1985

Relaxin in the pregnant baboon: evidence for local production in reproductive tissues.

We examined the nonluteal production of relaxin in the pregnant baboon. In experimental animals (n = 5), the corpus luteum-bearing ovary was removed in early pregnancy (days 25-30), and intact pregnant baboons served as controls. In both groups of baboons, peripheral, uterine, and ovarian venous blood samples and amniotic fluid were collected immediately before hysterotomy, which was performed late in pregnancy (days 139-142). After hysterotomy, samples of reproductive and control tissues were obtained (placenta, decidua, myometrium, fetal membranes, and omentum). Relaxin concentrations were determined in all samples using an antiporcine relaxin RIA. In unilaterally oophorectomized pregnant baboons, peripheral plasma levels of relaxin were below the limits of detection (less than 157 pg/ml) for 100 days following corpus luteum removal, while levels in control pregnant baboons were greater than 1000 pg/ml. Relaxin levels in uterine venous plasma were comparable to peripheral plasma levels in each group. Relaxin concentrations in amniotic fluid of both groups were below the limits of detection (less than 157 pg/ml). Relaxin was found in decidua, placenta, and myometrium in those pregnant baboons in which the corpus luteum-bearing ovary had been removed over 100 days earlier. This finding together with the absence of a relaxin gradient in uterine venous plasma and undetectable relaxin levels in amniotic fluid is a strong indication of local relaxin production in reproductive tissues without contribution to peripheral plasma levels.

Amniotic Fluid↗
PubMed1977

Otoadmittance in normal subjects.

Otoadmittance audiometry was performed on a group of young subjects (18-30 years old) with normal hearing. Mean values and standard deviations for static admittance, conductance and susceptance were computed on the basis of the point of maximum compliance, as well as the point of zero cross (drum-free position). In addition, the values of curve width for conductance and susceptance, middle ear pressure and the threshold of the acoustic reflex for pure tones and interrupted tones were evaluated. Subjects presenting an abnormality of the tympanic membrane were studied as a separate group. The results obtained in this study were compared with those reported in the literature.

Adolescent↗