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Biomedical subjects

L A Stein

Publications and source records attributed to L A Stein.

At least 19 recordsLinked to original sources
PubMed2001

Pseudoaneurysm of the superior mesenteric artery after pancreas transplantation treated by endovascular stenting.

Pseudoaneurysm after pancreas transplantation can have serious consequences, including rupture, hemorrhage, and graft loss. We describe a 38-year-old patient who presented with a pseudoaneurysm of the donor superior mesenteric artery 1 month after pancreas transplantation. Selective arteriography was performed and the lesion was repaired with endovascular placement of a 28-mm covered stent. Laparotomy was avoided. The pancreatic graft was continuing to function well 9 months later. As far as we know, this minimally invasive approach was not previously reported. According to published series, pseudoaneurysms often occur secondary to infection and require operative intervention necessitating graft pancreatectomy. Patients can present with serious symptoms including hypotension and shock. Therefore, it is important to detect pseudoaneurysm in a timely manner. Computed tomography and Doppler ultrasound are important diagnostic tools in this regard. We demonstrated the utility of endovascular stenting in the treatment of pseudoaneurysm after pancreas transplantation. When used in a timely manner in well selected patients, endovascular stenting can abrogate the need for operative intervention and its attendant morbidity.

Adult↗
PubMed2001

Use of the MMPI-A to detect substance abuse in a juvenile correctional setting.

In this study, we examined the ability of the MMPI-A (Butcher et al., 1992) to detect substance abuse problems in a juvenile correctional setting. Specifically, we evaluated the Alcohol/Drug Problem Acknowledgment scale (ACK; Weed, Butcher, & Williams, 1994), the Alcohol/Drug Problem Proneness scale (PRO; Weed et al., 1994), and the MacAndrew Alcoholism Scale-Revised (MAC-R; Butcher et al., 1992) in the prediction of substance abuse. In addition, the incremental validity of ACK in comparison to PRO was evaluated, as was the incremental validity of PRO in comparison to ACK. The sample consisted of 123 boys and girls from ajuvenile correctional facility in Northeastern Ohio. Results indicate that ACK and PRO, but not MAC-R, were related to interviewer ratings of substance abuse. Results point to the superiority of ACK over PRO in substance abuse identification.

Adolescent↗
PubMed2000

Development of an Infrequency-Psychopathology scale for the MMPI-A: the Fp-A Scale.

This article describes the development and initial validation of the Infrequency-Psychopathology scale, Fp-A, for the MMPI-A (Butcher et al., 1992). The scale parallels the Infrequency-Psychopathology scale, F(p), that has been developed for the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). Results demonstrated that the 40-item Fp-A scale is superior to the F scale at discriminating between faking-bad and accurate reports of psychopathology, although the improvement over F was modest, particularly when compared to the improvement found for the F(p) scale. The difference seemed to reflect the superiority of the MMPI-A F scale to the MMPI-2 F scale. Even so, the findings suggest that the identification of overreporting on the MMPI-A could potentially be enhanced by using Fp-A as an adjunct to the F scale.

Adolescent↗
PubMed1998

Kinetic tuning of myosin via a flexible loop adjacent to the nucleotide binding pocket.

A surface loop (25/50-kDa loop) near the nucleotide pocket of myosin has been proposed to be an important element in determining the rate of ADP release from myosin, and as a consequence, the rate of actin-myosin filament sliding (Spudich, J. A. (1991) Nature 372, 515-518). To test this hypothesis, loops derived from different myosin II isoforms that display a range of actin filament sliding velocities were inserted into a smooth muscle myosin backbone. Chimeric myosins were produced by baculovirus/Sf9 cell expression. Although the nature of this loop affected the rate of ADP release (up to 9-fold), in vitro motility (2.7-fold), and the Vmax of actin-activated ATPase activity (up to 2-fold), the properties of each chimera did not correlate with the relative speed of the myosin from which the loop was derived. Rather, the rate of ADP release was a function of loop size/flexibility with the larger loops giving faster rates of ADP release. The rate of actin filament translocation was altered by the rate of ADP release, but was not solely determined by it. Through a combination of solute quenching and transient fluorescence measurements, it is concluded that, as the loop gets smaller, access to the nucleotide pocket is more restricted, ATP binding becomes less favored, and ADP binding becomes more favored. In addition, the rate of ATP hydrolysis is slowed.

Actins↗
PubMed1998

Masked bilateral superior oblique muscle paresis. A simple overcorrection phenomenon?

OBJECTIVE: This study aimed to determine a mechanism by which the masked bilateral superior oblique muscle paresis phenomenon may be explained. DESIGN: A retrospective study of the authors' patients with the preoperative diagnosis of a unilateral superior oblique muscle paresis was performed. Patients in whom an apparent contralateral superior oblique muscle paresis developed after surgery (masked bilateral superior oblique muscle paresis) were compared with those patients in whom this condition did not develop. PARTICIPANTS: One hundred eight patients participated. RESULTS: Of the 108 patients studied, 30 (27.7%) patients had signs of an apparent superior oblique muscle paresis develop in the contralateral eye after surgery. In comparing those patients in whom an apparent contralateral superior oblique muscle paresis did develop after surgery with those patients in whom this finding did not develop, no significant differences were found in the age at surgery; etiology (traumatic vs. nontraumatic); average hyperdeviations in primary gaze, ipsilateral and contralateral gazes, and ipsilateral and contralateral head tilts; average V pattern; inferior and superior oblique muscle function; extorsion on double Maddox rod testing; and objective fundus extorsion. CONCLUSION: Analysis of the authors' data showed that a surgical overcorrection of a unilateral superior oblique muscle paresis can masquerade as an apparent contralateral superior oblique muscle paresis. This is caused by a persistence of the head tilt and side gaze misalignment pattern from the original superior oblique muscle paresis.

Adult↗
PubMed1998

Long-term stability of MMPI-A scales.

Adolescents (24 boys, 37 girls) from public school settings were given the MMPI-A on 2 occasions with approximately 1 year between testing sessions. Long-term stability of validity, clinical, content, supplementary, and the new Psychopathology Five scales are examined and correlation coefficients are presented. The reliabilities of the MMPI-A scales are consistent with previously reported data. In addition, improvements made during development of the MMPI-A may have led generally to modest increases in stability of the clinical scales for adolescents. Given the importance of both short-term and long-term test-retest data in the evaluation of the validity of an assessment instrument, this study represents an important step in evaluating the validity of the MMPI-A for assessment of personality.

Adolescent↗
PubMed1997

Apparent contralateral inferior oblique muscle overaction after unilateral inferior oblique muscle weakening procedures.

BACKGROUND: Unilateral inferior oblique muscle weakening surgical procedures often lead to the appearance of inferior oblique muscle overaction in the contralateral eye. The purpose of this study was to determine how different types of unilateral inferior oblique muscle procedures affect the apparent function of the inferior oblique muscle in the contralateral eye. METHODS: A computer search was performed to locate all patients on the pediatric ophthalmology service at the Wilmer Ophthalmological Institute who underwent a unilateral inferior oblique muscle weakening procedure from 1980 to 1994. Only patients with a diagnosis of primary inferior oblique muscle overaction were included in the study. RESULTS: Fourteen patients met the inclusion criteria. One patient had undergone an anterior transposition of the inferior oblique muscle, seven patients had undergone a 10 mm recession of the inferior oblique muscle, and six patients had undergone a myectomy of the inferior oblique muscle. Before the operation,there was no difference in the inferior oblique muscle function of the contralateral eye among the three groups. However, after the operation apparent inferior oblique muscle overaction developed more frequently and to a greater degree in the contralateral eye among patients in the anterior transposition and 10 mm recession groups than among patients in the myectomy group. CONCLUSION: Either anterior transposition or 10 mm recession of the inferior oblique muscle may limit elevation in abduction in the eye on which inferior oblique muscle surgery was performed. The limitation of elevation in abduction may create apparent inferior oblique muscle overaction in the contralateral eye.

Adult↗