PubMed Health⌕ Search

Biomedical subjects

R Liebman

Publications and source records attributed to R Liebman.

18 recordsLinked to original sources
PubMed2000

Immunohistochemical expression of uPA, uPAR, and PAI-1 in breast carcinoma. Fibroblastic expression has strong associations with tumor pathology.

The urokinase-type plasminogen activator (uPA) system has been implicated in tumor spread. We have used immunohistochemistry to examine three components of this system, ie, uPA, uPA receptor (uPAR), and plasminogen activator inhibitor-1 (PAI-1), in a pilot study on 142 cases of breast carcinoma. We wished to determine whether there were any relationships between expression of the proteins in either tumor cells or fibroblasts and clinical and pathological features. Strong uPA expression in each cell type was significantly related to high tumor grade (P = 0.013 and 0.008, respectively), and was more common in invasive than in in situ carcinomas (P < 0.0001). Fibroblastic expression of uPAR was only related to the presence of invasion (P < 0.0001). Strong PAI-1 expression in both cell types was seen in high-grade tumors (tumor cells, P = 0.012; fibroblasts, P < 0.001), but only fibroblastic expression was related to the presence of invasion (P = 0.042). Fibroblastic expression of both uPA and uPAR were positively correlated with tumor size. Although patients with strong fibroblastic expression of uPA showed a tendency toward a shorter time to relapse, none of the plasminogen activator proteins were significantly associated with relapse-free survival. These results suggest that strong expression of uPA, uPAR, and PAI-1 in fibroblasts rather than in tumor cells have the most impact on the clinical behavior of breast cancer. Larger prospective studies are needed to confirm these findings.

Adult↗
PubMed1984

Outpatient treatment of anorexia nervosa.

The authors discuss outpatient treatment of the anorectic in terms of a process catalyzed in therapy sessions that takes place throughout the patient's daily life. The goal to reverse the physical and psychological symptoms of the disorder within the natural context of family, school or work, and community while enhancing development and adaptation is clearly defined. Treatment is described as holistic; the patient's mind and body are treated in concert.

Adolescent↗
PubMed1983

Interdisciplinary model for the inpatient treatment of adolescents with anorexia nervosa.

This paper describes the inpatient phase of an anorexia nervosa treatment program in an adolescent unit of a children's hospital. This program focuses on four goals: improving eating behavior, improving socialization, achieving initial weight gain, and engaging the patient and her family with an outpatient psychotherapist. The patients were divided into three groups according to severity. All five Group I patients (less than 25% body weight loss) had a composite 100% achievement of the four goals. Twenty out of 21 Group II patients (greater than 25% body weight loss) had 100% achievement of the four goals. Three out of six Group III patients (greater than 25% body weight loss and requiring hyperalimentation) had 100% achievement of the four goals. The success of this inpatient program is felt to be due to the pediatric-psychiatric collaboration, the involvement of the family during the inpatient phase, the therapeutic use of an interdisciplinary team and of the social system of the inpatient unit including other patients and recreation therapist.

Adolescent↗
PubMed1979

Predicting performance in a child psychiatry program for pediatric residents.

As part of an evaluation of a program to train pediatric residents in child psychiatry, measures were made of the following variables predictive of the residents' performance in the program: personality traits, attitude toward psychiatry, willingness to treat psychological problems, preprogram interview performance, length of commitment to pediatrics, and frequency of interaction with teachers in the program. Outcome variables were pediatric residents' course evaluation, frequency of interaction with teachers in the program, and postprogram interview performance. In multiple regression equations the variables predictive of the residents' performance explained up to 72 percent of the variance of the residents' participation in the program, 88 percent of the variance of the postprogram interview, and 61 percent of the variance of the residents' course evaluations.

Attitude of Health Personnel↗
PubMed1977

Recurrent abdominal pain: gaining control of the symptom.

The treatment of recurrent abdominal pain without organic cause requires that the families involved change their focus from organic to emotional issues. This is done during a family conference with the pediatrician, in which a positive approach to the problem is outlined. Following such a plan avoids the pitfalls of continuing an inappropriate and organically oriented response to the family's needs and also avoids threatening the family with emotionally charged personal needs too soon. When the transition period is successfully negotiated, the child's symptoms often are alleviated without further psychological intervention. In cases where further psychiatric intervention is indicated, a foundation has been laid for successful treatment. Nineteen patients have been successfully treated either by the pediatrician alone or have successfully begun psychotherapy, thus preventing unnecessary medical tests and further "doctor shopping", which characteristically accompanies such cases.

Abdomen↗
PubMed1976

Pediatric-psychiatric liaison as a model for teaching pediatric residents.

The pediatrician's function as a comprehensive family health practitioner has frequently been ignored. A major problem is that pediatric residents are not trained or are inadequately trained to assess emotional, behavioral, and family problems that may be an integral part of the patient's symptoms. At the Children's Hospital of Philadelphia, a pediatric-psychiatric liaison program has evolved in which pediatric residents learn the principles and skills necessary to manage these problems. Ultimately, the liaison program will enable the staff pediatricians who use these principles to assume appropriate responsibility for educating the pediatric trainees.

Child Psychiatry↗
PubMed1976

An integrated treatment program for psychogenic pain.

The family characteristics associated with the presence of recurrent abdominal pain are identified. The involvement on the pediatrician and the effects of this involvement on the patient, family, and perpetuation of the symptoms are described. A successful therapeutic program combining behavior modification and family therapy is elaborated. Changes in the structure and functioning of the family are vital to the outcome of therapy and the prevention of recurrence of symptoms.

Abdomen↗
PubMed1975

A conceptual model of psychosomatic illness in children. Family organization and family therapy.

Linear and open systems (multiple feedback) models of psychosomatic illness in children are contrasted in terms of their implications for cause and treatment. An open systems family model is presented that describes three necessary (but not independently sufficient) conditions for the development and maintenance of severe psychosomatic problems in children: (1) a certain type of family organization that encourages somatization; (2) involvement of the child in parental conflict; and (3) physiological vulnerability. Predisposition for psychosomatic illness, symptom choice, and maintenance are discussed within this conceptual framework. We report on family therapy strategies based on this model and the results of family treatment with 48 cases of "brittle" diabetes, psychosomatic asthma, and anorexia nervosa.

Adolescent↗
PubMed1975

Family lunch session: an introduction to family therapy in anorexia nervosa.

Family lunch sessions have proved a useful diagnostic and therapeutic technique in the treatment of anorexia nervosa. This paper describes the goals of these sessions and the strategies employed in the restructuring of family relationships. Data are presented illustrating changes in eating behavior of eight identified patients.

Anorexia Nervosa↗