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Biomedical subjects

P Schafer

Publications and source records attributed to P Schafer.

12 recordsLinked to original sources

Metastatic and nonmetastatic models of retinoblastoma.

To generate animal models of retinoblastoma that closely resemble metastatic and nonmetastatic human disease for the purposes of examining tumor biology and developing alternate treatments, human retinoblastoma cell lines were injected into the vitreal cavities of immunodeficient mice. Two reproducible animal models with contrasting biological behaviors analogous to human retinoblastoma have been developed. The Y79 retinoblastoma model demonstrated specific tumor evolution similar to that seen in human invasive and metastatic disease. Y79 retinoblastoma cells formed intraocular tumors that were initially confined to the vitreal cavity. Tumors progressively invaded the retina, subretinal space, choroid, optic nerve head, and anterior chamber of the eye. Tumors progressed into the subarachnoid space and focally invaded the brain. Metastases were detected in the contralateral optic nerve. Large tumors developed extraocular extensions. The histology of the tumors showed a poorly differentiated pattern with high mitotic rate, foci of necrosis, and calcification. The WERI-Rb model more closely resembled nonmetastatic human retinoblastoma. WERI- Rb tumors were localized in the eye with only anterior choroidal invasion at late stages. To examine potential biological differences in vitro, the retinoblastoma cell lines were cocultured with adherent choroid cells or adherent glioma cells which represent the targets of invasive retinoblastoma in vivo. Consistent with the in vivo observations, Y79 cells but not WERI-Rb cells adhere specifically to both the choroidal and the glioma cell lines.

Animals↗

Infusional ECarboF in patients with advanced breast cancer: a very active and well-tolerated out-patient regimen.

We performed a trial using the combination of epirubicin 50 mg/m2/day 1, carboplatinum AUC 5/day 1 and continuous 5-fluorouracil (5-FU) 200 mg/m2/day (every 4 weeks for 6 months) to confirm the efficacy and low toxicity profile of this regimen in breast cancer. In 51 patients with metastatic (n = 33) or locally advanced (n = 18) breast cancer the overall response rate was 86% (95% confidence interval (95% CI): 73%-94%): 94% in locally advanced and 81% metastatic disease. Grade 3-4 toxicity was low: 4% of patients presented with febrile neutropenia, 16% with severe palmar-plantar syndrome, 10% with Port-a-cath thrombosis. This study confirms the high efficacy of infusional 5-FU-based regimens and justifies further research into novel promising oral 5-FU derivatives.

Adult↗

Working with Dave. Application of Peplau's interpersonal nursing theory in the correctional environment.

Achieving therapeutic relationships with forensic patients is dependent upon nurses' awareness of personal needs, reactions to the patient, recognition of their participation in the pattern, the effects of this participation on others, and the changes they needed to make. Nurses have more extensive contact with the forensic patients than other health care professionals. Consequently, the potential exists for nurses--through interpersonal relationship--to have the greatest therapeutic impact or to engage in patterns that replicate pathology-producing situations (Peplau, 1978). The goal is not that nurses be perfect, but that they be aware of imperfections and capable of exploring them.

Adult↗

Adenoid cystic carcinoma of the breast: utility of immunocytochemical study with collagen IV on fine-needle aspiration.

A case of adenoid cystic carcinoma (ACC) of the breast in a 71-year-old woman is reported. This neoplasm accounts for about 0.1% of all breast cancers. The mammography showed a well-delineated mass without calcifications. Cytologic examination of percutaneous fine-needle aspiration (FNA) material gave the diagnostic of ACC, which was confirmed by histologic examination. This report emphasizes the utility of immunocytochemical study with collagen IV antibody on FNA material of this uncommon tumor.

Aged↗

When a client develops an attraction: successful resolution versus boundary violation.

Psychiatric mental health nursing in correctional institutes is an exciting field, presenting the correctional nurse with a number of challenges. A challenge of particular significance is that encountered when a client develops an attraction to a nurse. Nursing education traditionally has not equipped nurses with the theoretical knowledge or experience to address this phenomenon in clinical practice. Consequently, attractions may not be successfully resolved, resulting in boundary violations that leave the correctional nurse feeling battered. Although attraction in the therapeutic relationship is a well-documented phenomenon in the psychosocial literature, nursing has not addressed this issue sufficiently. Only when the precipitating factors are defined clearly from a sociocultural context, which includes the profession and the correctional environment, can interventions for implementation be identified. The socialization of nurses, how nursing conceptualizes professionalism, gender issues, the atmosphere of the correctional environment and the potential for dual relationships that stem from the multiple roles of the nurse, are factors that the author contends contribute to a lack of boundary setting and maintenance in the nurse-client therapeutic relationship. Consequently, this results in difficulties in assisting a client to resolve attraction successfully.

Empathy↗

The intracellular assembly of antigenic-peptide-class II complexes.

The immune system employs remarkable strategies to ensure that foreign antigens, from the most complex pathogens to the simplest proteins, are displayed on the surfaces of cells which are targets of T lymphocyte recognition. At the heart of these strategies is the molecular transformation of a soluble protein antigen to a complex of a small peptide containing the antigenic determinant bound to a cell surface Major Histocompatibility Complex class I or class II protein. This process is termed antigen presentation. Progress in a variety of laboratories over the last several years has yielded a wealth of information about the molecular mechanisms underlying antigen presentation, providing potential new approaches to vaccine design. Here we describe recent studies in our laboratory aimed at elucidating the intracellular site in B lymphocytes in which antigenic peptide-class II complexes are assembled for recognition by helper T cells and the regulation of this assembly process. Our results suggest that processed antigen-class II complexes are assembled in a unique compartment in the endocytic route which contains all the necessary cellular and molecular machinery for assembly and that B cells regulate the assembly process in response to external and internal signals.

Antigen-Presenting Cells↗

Ultrasonographical investigation of periportal fibrosis in children with Schistosoma mansoni infection: reversibility of morbidity seven months after treatment with praziquantel.

Five hundred thirty six Sudanese schoolchildren with Schistosoma mansoni infection were treated at random with either 20 mg or 40 mg/kg praziquantel. Seven months later 420 children could be reinvestigated by ultrasonography. Reduction of egg excretion and reversibility of sonographically-proven periportal fibrosis (PF) was not significantly different in the two groups. Schistosoma mansoni-induced PF grade II decreased from 22.9% to 6.7% and grade III from 5.2% to 1.6%. An increased prevalence of PF grade I, from 10% to 29.8% of the investigated patients, was observed. This increase was caused partly by a downshifting of patients who had PF II (n = 45) and PF III (n = 8) before therapy, but also by patients who developed PF I in the seven months after therapy (n = 56). The overall percentage of patients with PF before and after treatment was 38.1%. Of 420 children, 17.4% increased in their PF grade, 55% remained at the same level and 27.6% improved. Children younger than 11 years of age had a higher rate of complete reversibility than older ones. The percentage of patients with hepatomegaly decreased significantly (11.6% to 6.9%; p = 0.001). The rate of splenomegaly remained unchanged. It was concluded that within seven months therapy with praziquantel resulted in a considerable qualitative improvement of PF in Sudanese schoolchildren with S. mansoni infection.

Child↗

Metabolism of acyclic and cyclic N-nitrosamines in cultured human bronchi.

The metabolism of carcinogenic N-nitrosamines was studied in normal-appearing bronchial specimens obtained from 4 patients. Explants of bronchi were cultured in a chemically defined medium for 7 days. N-Nitrosamines [N-nitrosodimethylamine (DMN), N-nitrosodiethylamine (DEN), N,N'-dinitrosopiperazine (DNP), N-nitrosopyrrolidine (NPy), and N-nitrosopiperidine (NPd)] labeled with 14C were each then added at 100 mumoles for 24 hours. Measurable CO2 was formed by bronchial explants from: 1) DMN, DEN, and NPy in all 4 patients; 2) DNP in 3 of 4 patients; and 3) NPd in only 1 of 4 patients. In all bronchial specimens, these N-nitrosamines and/or their metabolites bound to bronchial mucosal DNA and protein. Binding levels were higher to protein than to DNA. Binding levels of DNP were as high as those with the two acyclic N-nitrosamines DMN and DEN, but binding levels of NPy and NPd were lower. Human bronchus was shown to metabolize and bind acyclic and cyclic N-nitrosamines found in the environment and in tobacco smoke.

Bronchi↗

Metabolism of dimethylnitrosamine and 1,2-dimethylhydrazine in cultured human bronchi.

The metabolic activation of several chemical classes of procarcinogens is being studied in cultured human bronchi. Previous studies have shown that carcinogenic polynuclear aromatic hydrocarbons are metabolically activated by the bronchial epithelium. In the study reported here, dimethylnitrosamine and 1,2-dimethylhydrazine were also found to bind to both cellular DNA and protein. Bronchial DNA was methylated in both the O-6 and N-7 positions of guanine. In addition to polynuclear aromatic hydrocarbons, an aliphatic nitrosamine and a methylhydrazine can now be added to the list of xenobiotic chemical carcinogens metabolized by human bronchus.

Biotransformation↗

Selective intracavitary and coronary hypothermic cardioplegia for myocardial preservation.Clinical, physiologic, and ultrastructural evaluation.

Intraoperative myocardial protection was evaluated in two groups of patients undergoing coronary surgery in whom different techniques for cardiac arrest were utilized. In group A, profound selective myocardial hypothermic (15 to 18 C) arrest was achieved by perfusing a coolant (7 to 10 C) into the left ventricular cavity and the coronary circulation. The average anoxic arrest time was 82.5 +/- 27 minutes. In group B, ventricular fibrillation and moderate hypothermia were used. Group A patients showed rapid physiologic recovery, low average myocardial creatinine phosphokinase (MB-CK) isoenzyme levels (7.8 IU) , and a well-preserved myocardial ultrastructure. In group B, three patients showed abnormal physiologic recovery; six patients needed postoperative inotropic support; and in seven patients, electron-microscopy revealed irreversible focal changes. The average MB-CK isoenzyme level was 85.6 IU. Analysis of our data demonstrates that when myocardial protection during coronary bypass grafting is achieved by selective profound intracavitary and coronary cooling, there is physiological, ultrastructural, and biochemical evidence of less intraoperative myocardial damage than when ventricular fibrillation is applied.

Adult↗

Examining Peplau's pattern integrations in long-term care.

Contrary to the societal view that only the frail elderly reside in long-term care facilities, many young adults who require residential care to maintain optimal health, or who are in a rehabilitation program, also live in these facilities. The relationships between residents and caregivers in long-term care facilities may develop into relationships that are more typically familial than professional. With these emerging family-like relationships, the interpersonal pattern interactions may be healthy or unhealthy and may create opportunities for growth or pathology-producing patterns. This article illustrates how applying Peplau's concept of need-pattern integrations in the long-term care setting has the potential to enhance understanding, and subsequently guide interactions, between younger residents and caregivers. The potential is greatest when interactions are guided.

Adult↗