Coronary angioplasty following acute perioperative myocardial infarction.
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Angioplasty, Balloon↗
Biomedical subjects
S Roth
Publications and source records attributed to S Roth.
Action methods in systemic therapy: dramatizing ideal futures and reformed pasts with couples.
This article presents a method for conducting a couple session that illustrates a theoretically valid role for action techniques (as opposed to verbal methods) in post-Milan systemic interviewing. Useful in an opening meeting or in consultation, it pointedly activates client resources while deemphasizing current problems. The interview format begins with contracting for ground-rules and listing clients' strengths. Each partner then creates and enacts: a scene illustrating that partner's ideal future for the relationship; a related past painful scene (usually from childhood); and a "reform" of that scene "as it should have occurred." Both partners play multiple roles in all scenes. Last and least, each partner succinctly describes his or her view of the current problem. In the enactments, rapid shifts in time dimension and multiple novel roles played by both partners efficiently promote in the couple the release from constraining beliefs and interactional patterns that is ordinarily sought by purely verbal methods in Milan-derived systemic interviews.
Acting Out↗
A model system that demonstrates interactions among extracellular matrix macromolecules.
Binding interactions among fibronectin (FN), glycosaminoglycan chains (GAG) and hyaluronate binding proteins (HABP) have been examined using a bead aggregation assay. 3H-FN binds to Dowex beads coated with chondroitin sulfate GAG chains (CS) but not to beads coated with hyaluronic acid (HA). Assays of bead agglutination indicate that FN has multiple binding sites for CS. Binding of 3H-FN to HA-beads is slightly promoted by exogenous divalent cations but this interaction does not aggregate Dowex-HA. The interaction between FN and CS reduces the previously reported ability of Dowex-CS to associate with HA-beads (Turley, E.A. and Roth, S. 1980, Nature Vol. 283, 268-271). HABP bind to HA and to a lesser extent CS. These proteins both stabilize the interaction between HA- and CS-beads in a manner reminiscent of the stabilization of HA-proteoglycan interactions by link protein and permit aggregation of Dowex-CS-FN with Dowex-HA. This simple bead aggregation assay allows rapid characterization of properties that may help to clarify how macromolecular constituents spontaneously assemble into an interstitial matrix.
Agglutination Tests↗
Misoprostol heals gastroduodenal injury in patients with rheumatoid arthritis receiving aspirin.
High-dose aspirin therapy for rheumatoid arthritis is frequently associated with severe gastrointestinal injury. To explore the possibility of reversing such damage, we conducted a double-blind, multicenter study with misoprostol, a prostaglandin E1 analog, which has demonstrated mucosal protective, gastric antisecretory, and ulcer healing properties. We also studied possible interference of misoprostol with continuing aspirin treatment in the management of patients with rheumatoid arthritis. Patients with confirmed rheumatoid arthritis and endoscopically documented gastroduodenal lesions were randomly assigned to receive 200 micrograms of misoprostol four times a day (123 patients) or placebo (116 patients). Each concurrently received 650 to 1300 mg of aspirin four times a day. After eight weeks of treatment, misoprostol was statistically superior to placebo in healing gastric mucosal injury (70% vs 25%) and duodenal mucosal injury (86% vs 53%). Patients with gastric or duodenal ulcers on admission had superior ulcer healing rates with misoprostol (67% vs 26%). There was no evidence of interference with the antirheumatic properties of aspirin. Mild to moderate adverse experiences were equally noted in misoprostol and placebo groups. Misoprostol, coadministered with aspirin, is well tolerated and highly effective in healing aspirin-associated gastroduodenal lesions in patients with rheumatoid arthritis without altering the therapeutic benefits of aspirin.
Adult↗
Adverse responses following intraoperative administration of orthoclone OKT3.
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Adult↗
[Questionable hyperparathyroidism: diagnostic value of thallium-technetium subtraction scintigraphy].
The diagnostic exclusion of hyperparathyroidism belongs to the standard repertoire of a practicing urologist involved in stone prophylaxis. Primary indicators of hyperparathyroidism are increases in serum calcium and in parathyroid hormone. Additional diagnostic methods are needed, since the methods most often used so far are inadequate, especially insofar as adenomas and ectopic tumors or recurrences can remain unrecognized. Exploratory surgical intervention means a difficult and traumatizing operation. Therefore, a sensitive technique for localization of adenomas is an urgent necessity. Thallium-pertechnetate subtraction scintigraphy was first introduced for localization of an adenoma of the parathyroid by Ferlin's group. This technique yielded better results than any previously known methods, with a success rate of 92%. The object of the present paper is not only to present a method that is not yet sufficiently well accepted among urologists, but also to offer a critical evaluation of the examination results known so far. The method cannot yet make exploratory surgery unnecessary, even when clinical and biochemical examinations give rise to a strong suspicion. However, since ectopic adenomas and possible relapse can be recognized with 90-100% accuracy, which is important in deciding on the surgical strategy, the method should be included in the preoperative diagnostic armamentarium.
Adenoma↗
[Ileocystoplasty and enteropathies].
The formation of a neobladder by the transformation of sections of the terminal ileum has become an important alternative to supravesical urinary diversion. The discussion about the optimal urosurgical technique however has, so far ignored the problems of consecutive enteric defunctionalization and deficiency symptoms resulting from the anatomical shortening of the ileum. The analysis of experimental investigations and functionally comparable syndromes, such as Crohn's disease, permits an insight into the pathophysiological consequences. These relate to disorders in the bile acid and vitamin B12 metabolism and to the potential induction of a secondary hyperoxaluria, with a subsequent oxalate calculus diathesis. Further more, the reduction of the absorption area in the ileum can lead to calcium and vitamin D malabsorption with the development of intestinal osteopathy. These pathophysiological relationships must be taken into account in the long-term medical care of patients with ileal neobladder. The preventive and therapeutic measures are described.
Calcium↗
Cytological surveillance of carcinoma in situ during and after intravesical chemotherapy.
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Administration, Intravesical↗
[Aneurysm of the abdominal aorta as a retroperitoneal urologic emergency].
Ten percent of the patients with a symptomatic abdominal aortic aneurysm have initial complaints of genitourinary disorders. From April 1985 to May 1988 12 aortic aneurysms have been seen primarily in the division of urology Düren. In 9 of these 12 cases it was ultrasonography, which led to the diagnosis. The treatment must be individualized, and in case of obstructive uropathy the question of an adjuvant or monotherapeutic urological proceeding depends upon the age and symptoms of the patient. Urinary diversion by ureteral splint or nephrostomy contains risks, so that control strategy (watchful waiting) or treatment with steroids have to be considered.
Aorta, Abdominal↗
Motivational factors in nonincarcerated sexually aggressive men.
Research on convicted rapists has demonstrated the importance of several key motivational factors in male sexual aggression. In particular, anger at women and the need to dominate or control them have been repeatedly implicated. Although anger and power have also been shown to be important in understanding college men who report sexually aggressive behavior, there has been little research on what underlies these motives. This research combined questions assessing these underlying motivational factors, as well as questions dealing with underlying sexual motivation and disinhibition, with a slightly modified version of the Sexual Experiences Survey (Koss & Oros, 1982). In Study 1, subjects were 184 male undergraduates. Factor analysis of the questions composing the four scales yielded four slightly modified scales. Scales measuring underlying anger, underlying power, and disinhibition significantly differentiated sexually aggressive from nonaggressive men but did not distinguish between men who were coercive, manipulative, or nonaggressive. In a replication on a smaller sample (n = 70), underlying anger, underlying power, and disinhibition again differentiated sexually aggressive from nonaggressive men.
Adult↗
[The urologic spirale: a therapeutic possibility in the treatment of prostatic carcinoma].
The urological spirale used exclusively as an intraprostatic catheter without communicating with the extracorporeal space offers patients with obstructive invasive prostatic carcinoma, who are unsuitable for surgical intervention, an additional treatment. Without interfering with the function of the urethra the danger of an ascending infection caused by a foreign body and the discomfort of a foreign body can be avoided. Occasionally normal micturition can be established. This was successful in 4 out of 8 patients for 3-12 months approximately, although in 2 of the 4 patients the spirale had to be removed on account of persistent irritation and infection. In the other 2 the spirale was successful until death after approximately 12 months. Even if we do not agree with the high rate of acceptability claimed in men suffering from cancer of the prostata, the attempt to use the spirale seems justified in special circumstances.
Carcinoma↗
A woman's homosexual transference with a male analyst.
A woman in analysis with a male analyst developed a significant homosexual transference during the middle phase of treatment. The expression and working through of this material (in displacement) is seen as reflecting one example of the influence of gender on the psychoanalytic process. For the male analyst to utilize this transference, he must make a clear distinction between the negative oedipal phase and the preoedipal (pregenital) phase in female development.
Adult↗
[Vesico-enteral fistulas: solutions to a diagnostic dilemma].
The diagnostic proof of vesico--enteral fistulas is necessary before proceeding to surgical treatment. The detection, however, can often be difficult because of nonspecific symptoms and unreliable uro-radiologic and endoscopic investigations. Additional and more sensitive diagnostic procedures are evaluated like computer tomography, the simple Bourne-test and a radioisotopic test.
Adult↗
Biochemical characterization of polypeptide components involved in neurite fasciculation and elongation.
Polypeptide components and carbohydrate linkage types of F11 antigen and G4 antigen, two chick cell-surface glycoproteins implicated in neurite fasciculation and elongation [Rathjen, F.G., Wolff, J.M., Bonhoeffer, F. and Rutishauser, U. (1987) J. Cell Biol. 104, 343-353], have been studied in comparison to mouse L1 antigen. Tryptic fingerprint analysis does not reveal any relation of the 130-kDa components of G4 or F11 antigens to each other or to neural cell-adhesion molecules. The 180/190-kDa component of G4 antigen comprises parts of the 130-kDa and 80/65-kDa components and shares a sequence corresponding to the amino terminus of the G4 130-kDa component as shown serologically with anti-peptide sera. This closely parallels the relationship found for mouse L1 antigen components. In contrast, the F11 170-kDa component is different from the F11 130-kDa component, as shown serologically and by fingerprint analysis. A combination of chemical and enzymatic deglycosylation methods reveals that while O-glycosylation cannot be detected F11 130-kDa, G4 130-kDa and L1 140-kDa components contain N-linked carbohydrates. Endoglycosidase H treatment shows that the oligosaccharides present in the G4 130-kDa component and mouse L1 are mostly of the complex type, while the F11 130-kDa component consists of two populations, one containing mainly complex-type carbohydrates and a second containing high-mannose/hybrid-type carbohydrates.
Amino Acid Sequence↗
[The retained bladder catheter. Technics for its removal].
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Catheters, Indwelling↗
Initial adhesion of murine fibroblasts to collagen and fibronectin occurs by two mechanisms.
The adhesion of Balb/c 3T12 cells to fibronectin (FN) and to denatured (DC) or native (NC) collagen is differentially sensitive to divalent cations and to sodium azide. Short-time adhesion (10 min) to FN requires either Mg2+ or Mn2+, whereas only Mn2+ stimulates attachment to DC and NC. Azide treatment only slightly affects adhesion of cells to FN, but strongly inhibits cell attachment to DC and NC. Attachment to any of these substrata is unaffected by monensin and by treatment of the cells with an intracellular fraction, making unlikely the possibility that molecules released by secretion or cell lysis participate in the adhesive process. Soluble collagen inhibits the adhesion of cells to DC and NC, but does not affect adhesion to FN. Finally, rabbit antiserum against collagen binding proteins inhibits cell attachment to NC and DC; the cells, however, attach normally to FN in presence of this antiserum. Taken together, our results support the view that 3T12 cells attach directly to native or denatured collagens and that FN is not required for this process.
Animals↗
Safe use of induced hypotension in a patient with cirrhotic liver disease.
Induced hypotension was used in a patient with chronic active hepatitis and cirrhosis presenting for clipping of an intracranial aneurysm. A mean arterial pressure of 50 mmHg was produced with a combination of sodium nitroprusside and labetalol. The patient sustained no postoperative changes in hepatic function. Previous studies have examined the effects of induced hypotension on the function of the normal liver, but there is relatively little information available on its effects in the presence of liver disease. The lack of an adverse outcome in this patient does not prove the safety of this technique in patients with liver disease; further studies of this patient group are required.
Adult↗
Regulation of T-cell functions by L-lactate.
Lactate is a product of glycolytically active macrophages. After stimulation with concanavalin A accessory cell-depleted splenic T-cell populations were found to produce only minute amounts of T-cell growth factor (TCGF); but substantial amounts of TCGF were produced if the cultures were supplemented either with splenic adherent cells or with lactate but not with interleukin-1 (IL-1). IL-1 was capable, however, of supporting TCGF production by the thymoma subline EL4-6.1. TCGF production in cultures of accessory cell-depleted splenic T-cell populations was demonstrable with 10(-3) M L-lactate, and optimal responses (plateau level) were obtained with 4-6 X 10(-2) M L-lactate. Cultures of macrophages were found to accumulate up to 5 X 10(-2) M lactate. Our experiments indicate, therefore, that lactate serves as a regulatory signal by which macrophage-like accessory cells enhance helper-T-cell functions. Lactate is apparently not the only mediator of accessory cell function since plateau levels of TCGF production were markedly lower with lactate than with splenic accessory cells; but L-lactate was found also to determine the magnitude of T-cell-mediated immune responses in vivo and in cultures of unfractionated lymphocyte populations. The production of interferon in accessory cell-depleted and concanavalin A-treated T-cell cultures, however, was not significantly affected by lactate. Concanavalin A-stimulated splenic T-cell populations were found to consume glucose rapidly and to release lactate into the supernatant. This indicates that the cells contain more lactate and pyruvate than they can utilize by their respiratory metabolism. The administration of external lactate or pyruvate was found to inhibit the utilization of glucose by the mitogenically stimulated T cells.
Animals↗