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Biomedical subjects

M Feder

Publications and source records attributed to M Feder.

At least 19 recordsLinked to original sources

Clinical relevance of chromosome abnormalities in non-small cell lung cancer.

The relationship between clonal chromosome alterations and various clinical parameters was evaluated in 70 patients with non-small cell lung cancer (NSCLC) for whom detailed karyotypic assessment was possible. Included in the analysis are karyotypes of 63 previously published cases and seven new NSCLCs. Clinical features investigated were diagnosis, tumor stage and grade, gender, smoking history measured in pack years, and survival. Certain chromosome abnormalities were significantly associated with histologic subtype, tumor grade, stage, and prognosis. Rearrangements involving chromosome arms 2p and 3q were more common in squamous cell carcinoma (SCC) than in adenocarcinoma (ADC). Loss of 3p was observed more often in SCC. Gain of 7p was more frequent in ADC. Rearrangement of 17p was associated with a lower tumor grade. Rearrangement of Xp and loss of chromosome 12 or 22 were each associated with higher tumor stage. Rearrangement of 3p or 6q was correlated with a better survival outlook. In contrast, loss of chromosomes 4 or 22 portended a poor prognosis. Finally, an increased number of marker chromosomes was observed in patients having a higher number of pack years. These data indicate that chromosome abnormalities can have clinical and pathologic significance in NSCLC.

Adult↗

Functional measures of first-stroke rehabilitation inpatients: usefulness of the Functional Independence Measure total score with a clinical rationale.

OBJECTIVE: The Functional Independence Measure (FIM) was used to measure function in first-stroke patients on admission to and discharge from a rehabilitation center, and to determine gain; all data were analyzed by a clinically oriented approach. DESIGN: All patients admitted after a first supratentorial stroke to a comprehensive rehabilitation facility over a 2-year period were examined prospectively with the FIM. Diagnosis was determined by neuroimaging. Data were collected continuously and stored in the departmental database. For analysis of data, the patients were divided by side of lesion (right or left hemisphere), main clinical syndrome (presence or absence of neglect or aphasic syndromes in those with damage to the right or left hemisphere, respectively), type of lesion (ischemic, hemorrhagic, etc), and site of lesion (cortical or subcortical). SETTING: Neurological rehabilitation ward. PATIENTS: The study population included 151 patients of average age 60.8 years; 60% were men. All were admitted an average of 28.9 days after stroke and rehabilitated for 109.3 days. MAIN OUTCOME MEASURE: The raw FIM total score was determined at 48 to 72 hours after admission and at discharge. FIM gain was calculated by subtracting the FIM discharge score from the FIM admission score for each individual. Length of stay was also recorded. RESULTS: There was no difference in average total FIM scores when patients were divided by side of damage (right or left hemisphere). Significant findings were obtained for the various parameters when the clinical criterion was applied. Patients with neglect or aphasia syndromes showed significantly higher gains despite their lower FIM admission scores, but they had a much longer in-hospital stay. CONCLUSION: The raw FIM total score is a simple, practical, and efficient measure of function in first-stroke patients on admission for rehabilitation, provided an appropriate clinical approach is used during data analysis. Results can be used for comparison with similar measures, determination of admission and discharge policy, and program evaluation. The presence of neglect and aphasic syndromes has a significant effect on the various measures. Length of stay in rehabilitation is also of paramount importance in stroke patients with special clinical syndromes.

Cerebrovascular Disorders↗

Advances in the analysis of chromosome alterations in human lung carcinomas.

A review of chromosomal analyses of human lung carcinomas is presented. Karyotypic studies have revealed multiple cytogenetic changes in most small cell lung carcinomas (SCLCs) and non-small cell lung carcinomas (NSCLCs). In SCLCs, losses from 3p, 5q, 13q, and 17p predominate; double minutes associated with amplification of members of the MYC oncogene family may be common late in disease. In NSCLCs, deletions of 3p, 9p, and 17p, +7, i(5)(p10), and i(8)(q10) often are reported. The recurrent deletions encompass sites of tumor suppressor genes commonly inactivated in lung carcinomas, such as CDKN2 (9p21), RB1 (13q14), and TP53 (17p13). Despite technical advances in cell culture, the rate of successful karyotypic analysis of lung carcinomas has remained low. Alternative molecular cytogenetic methods to assess chromosome changes in lung cancer, particularly comparative genomic hybridization (CGH) analysis, are discussed. Initial CGH studies confirm the existence of many of the karyotypic imbalances identified earlier in lung cancer and have revealed several recurrent abnormalities, such as 10q- in SCLC, that had not been recognized previously. The further application of such molecular cytogenetic approaches should enable investigators to define more precisely the spectrum and clinical implications of chromosome alterations in lung cancer.

Carcinoma, Non-Small-Cell Lung↗

Comparative genomic hybridization detects frequent overrepresentation of chromosomal material from 3q26, 8q24, and 20q13 in human ovarian carcinomas.

We used comparative genomic hybridization (CGH) to identify recurrent chromosomal imbalances in tumor DNA from 25 malignant ovarian carcinomas and two ovarian tumors of low malignant potential (LMP). Many of the carcinoma specimens displayed numerous imbalances. The most common sites of copy number increases, in order of frequency, were 8q24.1, 20q13.2-qter, 3q26.3-qter, 1q32, 20p, 9p21-pter, and 12p. DNA amplification was identified in 12 carcinomas (48%). The most frequent sites of amplification were 8q24.1-24.2, 3q26.3, and 20q13.2-qter. Other recurrent sites of amplification included 7q36, 17q25, and 19q13.1-13.2. The most frequent sites of copy number decreases were 5q21, 9q, 17p, 17q12-21, 4q26-31, 16q, and 22q. Underrepresentation of 17p was observed in six of 16 stage III/IV tumors, but in none of seven stage I/II tumors, suggesting that this change may be a late event associated with the transition of ovarian carcinomas to a more metastatic disease. Overrepresentation of 3q26.3-qter, 5p14-pter, 8q24.1, 9p21-pter, 20p, and 20q13.2-qter and underrepresentation of 4q26-31 and 17q12-21 also tended to be more common in advanced-stage tumors. All ten grade 3 tumors had copy number increases involving 8q24.1, compared to only three of nine grade 2 tumors. Overrepresentation of 3q26.3-qter and 20q13.2-qter was also observed at a higher frequency in high-grade tumors. One of the two LMP tumors displayed chromosomal alterations, which consisted of overrepresentation of 5p and 9p only. Taken collectively, these findings and data from other CGH studies of ovarian cancers define a set of small chromosome segments that are consistently over- or underrepresented and, thus, highlight sites of putative oncogenes and tumor suppressor genes that contribute to the pathogenesis of these highly malignant neoplasms.

Adult↗

Detection of aneuploidy in interphase nuclei from non-small cell lung carcinomas by fluorescence in situ hybridization using chromosome-specific repetitive DNA probes.

Interphase fluorescence in situ hybridization (FISH) is particularly useful for detecting chromosome changes in tumors exhibiting a low mitotic index, as is the case in many human non-small cell lung carcinomas (NSCLCs). A panel of centromeric DNA probes specific for the autosomes 6, 7, 8, 9, 12, 17, and 18 was used to analyze 17 primary NSCLCs. Evidence for aneuploidy was obtained in all specimens. Gain of part or all of chromosome 7 was especially prominent, occurring in a large population of cells in each of 14 tumors (82%). Extra centromeric copies of chromosomes 6, 12, and 17 were also common, being observed in 9 to 11 cases each. Gain of chromosome 9 was infrequent (three tumors). In two cases, most of the nuclei had only a single chromosome 9 fluorescent signal. Karyotypic findings were available for six cases and were generally consistent with the FISH data. Both methods revealed considerable heterogeneity within individual tumors. NSCLC specimens from 26 males were assayed with a Y-specific centromeric sequence; loss of the Y was observed in 13 cases (50%). These investigations demonstrate the feasibility of interphase FISH for the successful analysis of numerical chromosome changes in NSCLCs.

Aneuploidy↗

Recovery in geriatric depression.

BACKGROUND: Clinical characteristics of depression, age at illness onset, medical burden, disability, cognitive impairment, lack of social support, and poor living conditions may influence the course of depression. This study investigates the timetable of recovery and the role of the above factors in predicting recovery in elderly patients with major depression. METHODS: Recovery was studied in 63 elderly (age >63 years) and 23 younger patients with depression who were followed up for an average of 18.2 months (SD, 13.1 months) under naturalistic treatment conditions. Diagnosis was assigned according to Research Diagnostic Criteria after administration of the Schedule for Affective Disorders and Schizophrenia. The Longitudinal Follow-up Interval Examination was used to identify recovery. RESULTS: The recovery rate of depressed elderly patients was similar to that of younger depressed patients. In the elderly patients, age, antidepressant treatment, age at onset, and chronicity of episode were significantly associated with time to recovery since entry. Among these parameters, late age at onset was the strongest predictor of slow recovery. In younger patients, long time to recovery was predicted by weak social support, younger age, cognitive impairment, and low intensity of antidepressant treatment. In the elderly, the intensity of antidepressant treatment began to decline within 16 weeks from entry and approximately 10 weeks prior to recovery. CONCLUSIONS: These findings challenge the view that geriatric depression has a worse outcome than depression in younger adults. However, depressed patients with onset of first episode in late life may be at higher risk for chronicity. Antidepressant treatment prescribed by clinicians may decline prior to recovery despite evidence that high treatment intensity is effective in preventing relapse.

Adult↗

Identification and localization of microsatellite markers covering human chromosome 18.

To generate microsatellite markers from chromosome 18, we have cytogenetically localized a large number of lambda phage using a deletion mapping panel of somatic cell hybrids. Here we describe the identification of 65 new CA-repeat-containing phage and the localization of five markers developed in other laboratories. This approach allows the selection of a subset of markers that are well spaced across the chromosome and can be developed as genetic markers. The use of PCR-based markers should allow for the rapid genomic screening of disease genes on chromosome 18.

Base Sequence↗

Pediatric EMS transport: are we treating children in a system designed for adults only?

Unlike adults, small children and infants do not require stretchers or ambulances for transport from a prehospital scene to the emergency department (ED). This study was designed to determine the importance of this difference in patient transport needs. A Macintosh Classic computer was programmed to compare the time to intubation (TTI) of a child with impending respiratory arrest treated in a standard paramedic/ambulance transport system versus that of a child treated in a system in which a patrolling police car transports the child directly to an ED. The dependent variable TTI was determined, with travel times from the scene to the ED and paramedic intubation success rates as the independent variables. Utilizing this model, police transports demonstrate shorter TTIs for brief scene-to-ED travel times or limited paramedic success rates, while paramedic intubations produced shorter TTIs for long scene-to-ED transports. These results suggest that nonambulance transport of pediatric patients be considered in the development of urban or suburban pediatric Emergency Medical Services.

Acute Disease↗

Testicular dislocation following minor scrotal trauma.

Traumatic dislocation of the testicle is a rare injury generally resulting from severe scrotal trauma and displacement of the testicle into the subcutaneous tissue surrounding the external inguinal ring. The authors report here the extremely unusual case of an abdominal dislocation of the testicle in a young patient with an indirect inguinal hernia. In addition this case is particularly atypical in that the injury resulted from a trivial blow to the scrotum. A new mechanism involving preloading of the cremaster muscle as the source of the dislocation is postulated.

Abdomen↗

Assessment chart for inpatient rehabilitation following stroke.

In order to enable comparison of the post-stroke patient's functional status between different points during the rehabilitation process, an assessment chart was developed; this covered cognitive, basic and integrated functions. The chart was applied by two independent examiners on 36 patients, with a mean age of 60, admitted consecutively for rehabilitation following stroke. The results of the assessment using the chart were compared with those measured with the Kenny Self Evaluation System. There was a positive correlation both between the Kenny System and the developed chart and the two examiners. It is felt that the chart meets the demands of easy applicability, numerical scoring and comprehensiveness. It is sufficiently sensitive to reflect the progress of patients during rehabilitation and enables re-evaluation of initial treatment plans focusing on the needs of the individual patient. The developed chart may serve as a useful tool in the evaluation of stroke inpatients during their rehabilitation.

Activities of Daily Living↗

Urinary continence after stroke: association with cystometric profile and computerised tomography findings.

Repeated cystometry was performed in 17 patients after a cerebrovascular accident. Cranial computerised tomography (CT) was performed in all patients. In this series, urinary continence showed a significant correlation both with cystometric bladder tone and with the CT brain findings. The most favourable prognostic factors for urinary continence were a non-hypertonic bladder and absence of extensive brain lesions.

Adult↗

Preleukemia and leukemia with 12p- and 19q+ chromosome alterations following Alkeran therapy.

Among 20 patients with acute nonlymphocytic leukemia or dysmyelopoietic preleukemia secondary to Alkeran therapy for another tumor, four had a del(12)(p11-p12) and four had a translocation to 19q13 among multiple karyotypic alterations in their neoplastic hematopoetic clones. It is suggested that these two cytogenetic abnormalities may occur nonrandomly in such hemic disorders and may play a limited role in their pathogenesis.

Chromosome Deletion↗

A 2p;11q chromosome translocation in dysmyelopoietic preleukemia.

Three patients with dysmyelopoietic preleukemia had a marrow clone with translocation t(2;11)(p21;q23) as the only chromosome change. In one patient, the cytogenetically altered cells disappeared following treatment with 13-cis-retinoic acid. Although these patients did not constitute a homogeneous clinical subgroup, the 2p;11q translocation should probably be added to the short list of nonrandom karyotypic alterations involving 11q23 that have been described in various hematopoietic disorders.

Aged↗