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Biomedical subjects

S Weitzman

Publications and source records attributed to S Weitzman.

At least 55 records · Page 3Linked to original sources
PubMed1996

Metastatic osteosarcoma of the kidney presenting as renal hemorrhage.

PURPOSE: Renal osteosarcoma may arise as a metastasis from a primary bone osteosarcoma or as a primary renal tumor. Metastatic renal osteosarcoma has been found at autopsy in approximately 10% of patients who die of this disease. PATIENT AND METHODS: A case report of a young Chinese patient presenting with acute onset of renal infarction and hemorrhage from a renal metastasis of osteosarcoma is presented, as well as a review of the literature. RESULTS: Some patients with solitary renal metastatic osteosarcoma may have long-term disease-free survival after nephrectomy. Early diagnosis and thus increased awareness of this condition is important.

Adult↗
PubMed1996

Biological monitoring of workers' exposure to bromine.

The use of serum bromine concentration (SeBr) as a measure of exposure was examined in an occupational cohort. Associations with work site, department type, chemical handling, and occupation, as proxy measures of exposure, were studied. SeBr was associated with all of these measures. SeBr was also associated with various demographic characteristics (age, country of origin, and education) in men. In women, there was no association between SeBr and age, country of origin, or education. The use of SeBr as a measure of exposure is discussed. The conclusion is that the exposure to bromine can be assessed by regular monitoring of SeBr.

Adult↗
PubMed1996

Stimulation and inhibition of human mammary epithelial cell duct morphogenesis in vitro.

We previously determined that normal human mammary epithelial cells (HMECs) placed on the basement membrane-like substance Matrigel form structures, whereas malignant breast cells do not (1). In the present study, we determined that the structures formed by normal cells on Matrigel resembled breast ducts in vivo by electron microscopy, and the process of their formation recapitulated what is known of duct formation in vivo. We therefore used this model to study less well-understood aspects of breast morphogenesis. Two priming signals appeared necessary for initiation of morphogenesis: one provided by the Matrigel and one by the cells in an autocrine fashion. Evidence for this included diminished duct formation by cells plated low-concentration Matrigel or at low cell densities, and the reversal of the latter by conditioned medium from high-density cells on Matrigel. Antibodies to bFGF inhibited morphogenesis, suggesting a stimulatory autocrine role for this factor, and antibodies to TGF-beta 1 stimulated duct formation, suggesting an inhibitory autocrine role. Added TGF-beta 1 abolished morphogenesis and stimulated normal cells to wander through Matrigel as do malignant cells. Conditioned medium from normal cells did not stimulate malignant cells to form ducts, but conditioned medium from tumor cells diminished normal morphogenesis, suggesting that malignant cells secrete an inhibitor of morphogenesis.

Biocompatible Materials↗
PubMed1995

[Retinopathy and serum uric acid in diabetics].

Low serum uric acid (UA) levels have been reported in diabetics. In a group followed for 15 years it was reported that low UA levels preceded the onset of diabetic retinopathy. We studied 95 consecutive diabetic clinic patients between July and September 1992. There was no significant difference in UA levels between those with or without retinopathy: 5.0 +/- 1.2 (SD) mg--vs. 5.3 +/- 1.3, respectively. Multiple regression analysis showed that higher UA levels were related independently to high body mass index (overweight, obesity), and male gender, but not to age, duration of diabetes, glycosylated hemoglobin, diabetic treatment or retinopathy.

Body Mass Index↗
PubMed1995

Co-amplification of MYCN and a DEAD box gene (DDX1) in primary neuroblastoma.

DEAD box proteins are putative RNA helicases that have been implicated in cellular processes involving alteration of RNA secondary structure, such as translation initiation and splicing. These proteins share eight conserved amino acid motifs, including Asp(D)-Glu-(E)-Ala(A)-Asp(D) which is part of a more extended motif. Recently, we have shown that the novel DDX1 gene containing a DEAD box motif maps to the same chromosome band as MYCN at 2p24 and is co-amplified with MYCN in retinoblastoma cell lines. Here, we show that the DDX1 gene is co-amplified with the MYCN gene in 2 of three neuroblastoma cell lines and that DDX1 RNA levels correlate with DDX1 gene copy number. Since amplification of MYCN is an indicator of poor prognosis in neuroblastoma, it was of interest to determine whether co-amplification with DDX1 occurred in clinical samples of neuroblastoma and whether such a finding carried any additional prognostic significance. We determined the gene copy number of DDX1 in 32 neuroblastoma patient samples (representative of all stages): 13 were MYCN amplified and 19 had normal copy numbers of the MYCN gene. Of the 13 neuroblastomas that were MYCN amplified, seven were also DDX1 amplified. Of the 19 that were not MYCN amplified, none were DDX1 amplified. This is the first example of a gene that is co-amplified with MYCN at a high frequency in neuroblastoma. While there was a trend towards a worse clinical outcome with co-amplification, the numbers were too small to reach significance.

Child↗
PubMed1995

[Cost of insulin-dependent diabetes vs cost of its prevention].

Accumulating evidence suggests that insulin-dependent diabetes mellitus (IDDM) is an autoimmune disease which can be predicted from immunologic markers. Encouraging results of recent IDDM prevention trials with insulin raises the question of cost benefit of such procedures, in addition to the obvious medical benefit. We estimated the expected cost benefit of national screening and preventive efforts in Israel (population 5 million in 1993). Due to the expense of immunological testing, we considered only relatives of IDDM patients who have a 3-5% risk of developing overt disease. Our screening showed that 225 (3.4%) of 7500 in this group (aged 1-54 years) carried islet autoantibodies, and about 50% progressed to diabetes within 3 years. The cost of testing for serological and metabolic markers was $6000 per subject; an additional $3,000 per subject is estimated to be the cost of preventive treatment. On comparing these numbers to only the minimal, life-long, direct cost of an IDDM patient ($30,000, based on 3 different analyses), we conclude that there is a cost benefit of programs for screening for IDDM and preventive treatment.

Adolescent↗
PubMed1995

A hospice/palliative medicine rotation for fellows training in hematology-oncology.

A clinical hospice/palliative medicine rotation for physicians enrolled in a three-year hematology/oncology fellowship was established in academic year 1993-1994 as a way to accomplish important training goals in pain management and the palliative care of patients with terminal illness. This study was conducted to obtain initial information about its effectiveness. Ten fellows, one at a time, evaluated new hospice/palliative medicine consultations, supervised the care of patients on an inpatient hospice/palliative care unit, and visited patients at home. For the first 13 months, seven fellows were assigned to this rotation for one month each, and three fellows were assigned to spend two separate months each. A self-report evaluation of the experience was administered at the end of each service month. In five of these 13 evaluations, the fellows reported their skills in managing pain and symptoms to be much improved, and in eight they indicated their skills were improved; none stated that there had been no change. Comfort and skill with discussing death, dying, and advanced directives with patients and families were reported by the fellows to be much improved in nine evaluations, improved in three, and unchanged in one. In nine evaluations, the fellows reported their understanding of hospice/palliative care as a program and approach to patient care was much improved; in two, improved; and in two, unchanged. All of the fellows would recommend this rotation to other fellows. A clinical rotation in palliative medicine and hospice care is a useful addition to the curriculum of fellows training in hematology-oncology.

Clinical Competence↗
PubMed1995

Housestaff training in cancer pain education.

A program for improving housestaff education in cancer pain control was piloted on an inpatient oncology unit during academic year 1992-93. Housestaff (four or five first-year residents and two more senior residents per month) received a three-day lecture series each month. A total of 32 housestaff participated. A questionnaire (Test A) about cancer pain was administered before the series. The subjects scored 58% correct (range 49-69). When Test A was repeated at the end of each rotation, the subjects scored 83% correct (range 82-86, p < 0.0001). A quiz on analgesic dosing (Test B) was also administered. The subjects scored 38% (range 20-56) before the lectures, 81% (range 72-93) immediately after the lectures, and 57% (range 44-67) at the end of the rotation. The authors conclude that this pilot project improves knowledge about cancer pain, but sustained reinforcement is needed if analgesic dosing skills are to be maintained.

Education, Medical, Graduate↗
PubMed1995

Preoperative strategies in the management of Wilms tumor.

Prenephrectomy therapy is well tolerated and results in easier operations, with significantly fewer tumor ruptures during surgery, and a favorable stage distribution as determined by the surgical specimen. As in other solid tumors of childhood, acceptable disease-free and actual survival figures with a minimum of early, intermediate, and late complications remain the aim of this strategy.

Canada↗
PubMed1994

Concurrent RhGM-CSF does not offset myelosuppression from intensive chemotherapy: randomized placebo-controlled study in childhood acute lymphoblastic leukemia.

To determine whether recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) can offset the myelosuppressive effects of intensive chemotherapy, we carried out a double-blind placebo-controlled trial in which 40 patients with acute lymphoblastic leukemia (ALL) were randomized into two groups of 20 each. One group received rhGM-CSF (5.5 micrograms/kg SC) coadministered with chemotherapy and the other, placebo coadministered with chemotherapy from day 5 to day 11 and from day 19 to day 25 of the 28-day intensification phase of our institutional high-risk protocol for childhood ALL. The results indicate that, at the dose and schedule used, rhGM-CSF did not prevent neutropenia or shorten the number of days required to complete this phase of therapy. In addition, the treated and placebo groups showed no significant difference in absolute neutrophil counts, number of days with neutropenia, number of days with fever, number of days spent in hospital, or number of days on antibiotics during the 28-day study period. There was also no difference between the two groups in the number, type, or severity of infectious episodes. Two of 20 patients in the treatment group have relapsed, whereas none of the patients in the placebo group has yet relapsed (follow-up: 3-37 months), but these events were not statistically significant. We conclude that treatment with rhGM-CSF at the dose and schedule employed is not clinically beneficial.

Adolescent↗
PubMed1994

Acute tumour lysis syndrome complicating treatment of stage IVS neuroblastoma in infants under six months old.

Acute tumour lysis syndrome (ATLS) is a common complication of the treatment of haematopoietic malignancies. It is also well recognized in many nonhaematopoeitic malignancies of adults. There are very few reports of the syndrome occurring during therapy for the nonhaematopoeitic malignancies of childhood, and none has previously been reported in the treatment of neuroblastoma. We report the cases of four patients presenting to The Hospital for Sick Children (HSC) between 1985 and 1992 who developed ATLS during treatment for stage IVS neuroblastoma. ATLS is a significant risk in patients undergoing therapy for stage IVS neuroblastoma, particularly where this has been delayed.

Acute Disease↗
PubMed1994

Gestational diabetes among Bedouins in southern Israel: comparison of prevalence and neonatal outcomes with the Jewish population.

Differences in the prevalence of gestational diabetes mellitus (GDM) have recently been reported between various ethnic populations. In the Negev region of Israel, a universal free screening programme for GDM was implemented in 1985. Between 1 March 1987 and 31 July 1988 11,003 deliveries occurred at the Soroka Medical Center, which provides free delivery and postnatal care to the whole Jewish and Bedouin population of the region. GDM was found in 5.7% of Jewish and in 2.4% of Bedouin women (odds ratio, 2.3, 95% confidence interval (CI) 1.8-2.9; P < 0.0001). Ethnicity was unrelated to maternal outcome, perinatal mortality or to any of the examined morbidity conditions of the newborn. The incidence of major congenital malformations was significantly higher in Jewish than in Bedouin infants of GDM women (Fisher's Exact Test, P < 0.03). Conversely, Jewish infants had fewer minor congenital anomalies (odds ratio 0.26, 95% CI 0.09-0.73). In a multivariate logistic regression model, gestational age, mode of delivery and insulin requirement during pregnancy were the only factors independently associated with neonatal morbidity. The results of this study suggest that in our health care system, among women with GDM ethnicity is not associated with an excess of unfavourable maternal or infant outcomes.

Adult↗