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Biomedical subjects

S M Hirsch

Publications and source records attributed to S M Hirsch.

12 recordsLinked to original sources

Nucleolar organizer regions in squamous cell carcinoma of the head and neck.

Nucleolar organizer regions are collections of nucleolar proteins associated with ribosomal genes that can be visualized in histologic sections using a silver colloid stain, thus the term silver-staining nucleolar organizer region (AgNOR). In some tissues, the number of AgNORs per nucleus correlates with cellular proliferation and, independently, with malignant change. AgNORs were studied in 66 paraffin-embedded head and neck squamous cell carcinomas and in 12 samples of normal tonsillar squamous epithelium. Carcinomas had a significantly higher mean AgNOR count than the benign epithelium (P less than .0001). Among carcinomas, mean AgNOR count increased with stage of the disease (P less than .001), but there was no significant correlation with histologic grade or DNA ploidy as determined by flow cytometry. These data suggest that AgNOR count should be evaluated as a possible aid in differentiating benign from malignant squamous epithelial proliferations in the head and neck, and also possibly as a prognostic marker in these carcinomas.

Aneuploidy

Concomitant chemotherapy and split-course radiation for cure and preservation of speech and swallowing in head and neck cancer.

To assess the ability of simultaneous cisplatin, 5-Fluorouracil, and radiation to substitute for surgery and radiation in advanced head and neck cancer, we have retrospectively selected from our phase II study a subgroup of 29 patients having primary disease requiring either more than a hemiglossectomy or a laryngectomy for control. Patients included 22 with stage IV and 7 with stage III disease, 12 tongue, 10 hypopharynx, and 7 larynx primaries. The treatment consisted of concurrent cisplatin, 5-Fluorouracil, and split-course radiation every other week for a total of 7 cycles within 13 weeks. With a median follow-up of 5 years, 86% of patients had preservation of speech and/or swallowing function. Median survival was 45 months, with 14 (48%) patients currently alive and disease free, 11 (38%) dead from their cancer, and 4 (14%) dead of other causes. The overall failure rate was 38%. Advanced-stage presence of N3 nodal disease and fewer than 7 cycles of chemotherapy received were significantly associated with increasing failure rates. This program of concomitant cisplatin, 5-Fluorouracil, and radiation produced control rates quite competitive with surgery and radiation and is appropriate for definitive testing in a randomized trial.

Adult

Survey research and the silent majority.

A survey conducted at the New York University Dental Center demonstrated that significant differences exist between patients who are ready participants in research efforts and those who require the more persistent attention of the researcher. In addition, patients who were questioned while in treatment emphasized different reasons for selecting a dental school for treatment than did those patients who were interviewed prior to beginning treatment. The importance of collecting data from a truly random sample of patients is stressed and elaborated with reference to the marketing implications of the results. Strategies for patient recruitment and retention require knowledge that is complete and does not suffer from systematic absences in the data base. Careful data collection methods are described and advocated.

Academic Medical Centers

Ontogeny of defensive reactions in Norway rats.

Young rats of several ages were presented with stimuli (a caged domestic cat, a footshock, and a suddenly moving object) known to be aversive to adults and disruptive of behavior in mature animals. Twenty-day-old rats were relatively unaffected by these events, while rats aged 30 days and older tended to reduce their locomotion and freeze upon the presentation of these cues. These data are consistent with Bolles' hypothesis that shock-elicited responses are innate defensive reactions. We also suggest that the inefficient passive avoidance learning in juvenile rats may result from their deficit in shock-induced freezing.

Age Factors

The effect of infertility on marriage and self-concept.

Two groups of subjects (couples seeking medical treatment for infertility and couples not yet attempting to conceive) completed questionnaires assessing the impact of infertility on their marriages and self-concept. Infertile individuals experienced greater dissatisfaction with themselves and their marriages. Females experienced greater discontent over time and had greater emotional investment than males. Infertile couples, labeled noncommunicators, were found to be affected even more by infertility. Nurses can play vital roles in counseling infertile couples.

Adult