Showing papers by "Saint Francis University published in 1997"

The national cancer data base report on race, age, and region variations in prostate cancer treatment

Abstract: BACKGROUND Patterns of care for prostate cancer patients in the United States have changed as early detection has improved. The National Cancer Data Base of the American College of Surgeons Commission on Cancer provides information about the treatment of patients in all age, race, and regional groups from institutions that represent cancer care at the community level as well as in medical centers. METHODS Data on 251,416 prostate cancer patients diagnosed between 1992 and 1994 were studied. Patient and disease characteristics, including age, race, the geographic region from which a case was reported, American Joint Committee on Cancer stage, and tumor grade were related to the primary pattern of treatment. Stage-standardized comparisons were made among different age groups, race groups, and regional groups. RESULTS Stage and tumor grade varied little across age, race, and regional classifications. African American patients were more likely than white patients to have Stage IV prostate cancer at the time of diagnosis. Men older than 75 years had greater proportions than younger men of both the earliest and the most advanced stages of cancer. Overall, 24.6% of patients received no cancer-directed therapy, 11.6% were treated with hormones or endocrine surgery, 28.6% received radiation therapy, 28.3% underwent radical prostatectomy, and 6.9% were treated by other modalities or combinations of modalities. Treatment patterns varied markedly by age. The selection of radical prostatectomy relative to no treatment and radiation therapy varied by race and region. CONCLUSIONS The results of this study showed that prostate cancer treatment varies by patient age, race, and geographic region. The reasons for some of these variations are not well understood and deserve further investigation. Cancer 1997; 80:1261-6. © 1997 American Cancer Society.

Maternal expectations about normal child development in 4 cultural groups.

Abstract: Objective: To determine whether expectations about normal infant and child development are different among mothers from 4 ethnocultural groups. Participants: Two hundred fifty-five mothers (90 Puerto Rican, 59 African American, 69 European American, 37 West Indian–Caribbean) whose children received health care at hospital-based pediatric clinics and private pediatricians' and family practitioners' offices. Design: Verbally administered questionnaire that included 25 questions in which mothers were asked to give their opinions about the age at which a normal child should begin to accomplish standard developmental milestones. Analysis: Responses (mean ages at which mothers expected children to attain the milestones) from each group were compared after controlling for age of mother, number of children, level of education, and socioeconomic status. Results: Significant differences among ethnic groups' responses were seen for 9 of 25 developmental milestones. Differences were mainly seen among personal and social milestones, and Puerto Rican mothers tended to expect children to attain these milestones at a later age than did other mothers. No differences in responses were seen between Spanish- and English-speaking Puerto Rican mothers. European-American mothers expected children to take first steps and become toilet trained at a later age. Conclusions: Developmental expectations differ among mothers from different ethnocultural groups. Many of these differences can be explained by underlying cultural beliefs and values and specific child-rearing practices. Clinicians should ask about maternal expectations during child health visits to interpret mothers' concerns and opinions about their children's development. Arch Pediatr Adolesc Med. 1997;151:1144-1150

Transforming growth factor β1 inhibits collagenase 3 expression by transcriptional and post‐transcriptional mechanisms in osteoblast cultures

Abstract: Transforming growth factor (TGF) β1 is an autocrine regulator of bone cell function. We demonstrated that TGF β1 enhances bone collagen synthesis, but its effects on collagen degradation are not well characterized. We tested the effects of TGF β1 on rat collagenase 3 expression in cultures of osteoblast-enriched cells from fetal rat calvariae (Ob cells). Treatment with TGF β1 at 0.4 nM decreased steady state collagenase mRNA levels after 2 to 24 h. This dose-dependent effect was observed at TGF β1 concentrations of 4 pM to 1.2 nM, and was accompanied by decreased levels of immunoreactive procollagenase. The protein synthesis inhibitor cycloheximide increased collagenase transcripts, but did not prevent the effect of TGF β1 on collagenase mRNA levels. TGF β1 accelerated the decay of collagenase mRNA in transcriptionally arrested Ob cells. In addition, TGF β1 decreased the levels of collagenase heterogeneous nuclear RNA and the rate of collagenase gene transcription in Ob cells. TGF β1 enhanced the expression of tissue inhibitors of metalloproteinases (TIMP) 1 and 3 and caused a modest decrease of TIMP 2 mRNA levels. In conclusion, TGF β1 decreases interstitial collagenase transcripts and protease levels in Ob cells by transcriptional and post-transcriptional mechanisms, and this effect may contribute to its actions on bone matrix. J. Cell. Physiol. 170:145–152, 1997. © 1997 Wiley-Liss, Inc.

Regulation of Collagenase-3 by Bone Morphogenetic Protein-2 in Bone Cell Cultures

Abstract: Bone morphogenetic protein-2 (BMP-2), a member of the transforming growth factor superfamily of peptides, induces ectopic bone formation in vivo. The actions of BMP-2 on osteoblastic cells include stimulation of collagen synthesis, but the role of BMP-2 on collagen degradation is not known. We examined whether BMP-2 affects the expression of collagenase-3, an enzyme that degrades type I collagen at neutral pH, and that of tissue inhibitors of matrix metalloproteinases (TIMPs) in primary osteoblast-enriched cells from 22-day-old fetal rat calvariae. BMP-2 suppressed collagenase messenger RNA (mRNA) and immunoreactive protein levels. BMP-2 did not affect collagenase mRNA stability, but it reduced collagenase heterogeneous nuclear RNA levels and decreased the rate of transcription of the collagenase gene. BMP-2 also stimulated TIMP 1 and TIMP 3 mRNA levels, but failed to alter TIMP 2 expression. In conclusion, our studies indicate that BMP-2 suppresses collagenase-3 gene transcription and stimulates TIMP 1 a...

Interleukin 6 is autoregulated by transcriptional mechanisms in cultures of rat osteoblastic cells.

Abstract: Interleukin 6 (IL-6), a cytokine produced by skeletal cells, stimulates osteoclast recruitment. The IL-6 soluble receptor (sIL-6R) increases IL-6 activity, and IL-6 and sIL-6R levels are increased in conditions of increased bone resorption. We examined the production of IL-6 by primary rat osteoblasts (Ob cells) cultured in the presence of IL-6 and sIL-6R. IL-6 alone did not induce IL-6 transcripts, but IL-6 was stimulatory in the presence of sIL-6R. Furthermore, sIL-6R by itself increased IL-6 transcripts. Cycloheximide superinduced IL-6 transcripts and did not prevent the effect of IL-6 and sIL-6R. IL-6 in the presence of sIL-6R stimulated IL-6 rates of transcription and the activity of IL-6 promoter fragments in transiently transfected Ob cells. 5' deletions of the IL-6 promoter and targeted mutations of the multiple response element (MRE)/cAMP responsive element (CRE), the nuclear factor for IL-6 (NF-IL-6), and the nuclear factor-kappaB (NF-kappaB) binding sites indicated that NF-IL-6 and NF-kappaB, in combination with MRE/CRE, binding sites are required for the induction of the IL-6 promoter by IL-6. In conclusion, IL-6 induces its own synthesis in osteoblasts by transcriptional mechanisms. This positive feedback may be important in conditions of increased bone resorption.

Interleukin-6 with its soluble receptor enhances the expression of insulin-like growth factor-I in osteoblasts.

Abstract: Interleukin (IL)-6, a cytokine produced by skeletal cells and known to increase bone resorption, has mitogenic effects for bone cells, possibly by regulating the synthesis of other local factors. We tested the effects of IL-6 and its soluble receptor (IL-6sR) on the expression of insulin-like growth factor (IGF)-I and IGF-II in cultured osteoblast-enriched cells from fetal rat calvariae (Ob cells). IL-6 did not modify IGF-I messenger RNA (mRNA) levels, but when tested in the presence of IL-6sR, IL-6 at 1 to 100 ng/ml increased IGF-I transcripts by up to 3.2-fold after 24 h. IL-6sR caused a small increase in IGF-I mRNA levels when tested alone. IL-6 and IL-6sR increased immunoreactive IGF-I levels by 2.4-fold after 24 h and 6.4-fold after 48 h. Cycloheximide prevented, and indomethacin markedly decreased, the effect of IL-6 and IL-6sR on IGF-I mRNA levels, but hydroxyurea did not. IL-6 and IL-6sR did not alter the decay of IGF-I mRNA in transcriptionally arrested Ob cells, and the half-life of the predomin...

Binding of immunoglobulin G from patients with autoimmune thyroid disease to rat sodium-iodide symporter peptides: evidence for the iodide transporter as an autoantigen.

Abstract: The recent cloning of the rat sodium-iodide symporter (rNIS) from FRTL-5 cells makes possible studies of the role of this thyroid-specific protein as an antigen in autoimmune diseases of the thyroi...

Interleukin-6 and its soluble receptor regulate the expression of insulin-like growth factor binding protein-5 in osteoblast cultures.

Abstract: Interleukin-6 (IL-6), a cytokine produced by bone cells, is known to influence bone resorption by stimulating the development of osteoclasts from precursor cells and to have mitogenic actions on osteoblastic cells. Insulin-like growth factors (IGFs) are important local regulators of bone formation, and IGF binding protein (IGFBP)-5 stimulates bone cell growth and enhances the effects of IGF-I. We tested the effects of IL-6 in the presence and absence of its soluble receptor (sIL-6R) on IGFBP-5 expression in cultures of osteoblast-enriched cells from 22-day-old fetal rat calvariae (Ob cells). When tested individually, IL-6 and sIL-6R had a modest stimulatory effect on IGFBP-5 messenger RNA (mRNA) levels. In contrast, when IL-6 and sIL-6R were tested in combination, they caused a considerable increase in IGFBP-5 mRNA levels, and IL-6 at 100 ng/ml and sIL-6R at 125 ng/ml increased IGFBP-5 transcripts by 5- to 7-fold after 24 h. The effect of IL-6 and sIL-6R on IGFBP-5 transcripts was not blocked by indometha...

Insulin-like growth factor I inhibits the transcription of collagenase 3 in osteoblast cultures.

Abstract: Insulin-like growth factor (IGF) I is an autocrine regulator of bone remodeling which inhibits bone collagen degradation and interstitial collagenase 3 mRNA levels. The mechanism of this inhibitory effect on collagenase 3 expression is not known. We tested the effects of IGF I on collagenase 3 gene expression in cultures of osteoblast-enriched cells from 22 day fetal rat calvariae (Ob cells) to determine whether transcriptional or posttranscriptional mechanisms were involved in the regulation of the collagenase 3 gene. IGF I at 10-100 nM caused a dose-dependent decrease in collagenase mRNA and protein levels. IGF I did not modify the half-life of collagenase 3 mRNA in transcriptionally arrested Ob cells, whereas it decreased the levels of interstitial collagenase 3 heterogeneous nuclear RNA. In addition, IGF I decreased the rates of transcription of the collagenase gene and the activity of a 2.1 kilobase collagenase 3 promoter construct transiently transfected into Ob cells. In conclusion, IGF I decreases the expression of collagenase 3 mRNA by transcriptional mechanisms.

Growth factor regulation of insulin-like growth factor binding protein-6 expression in osteoblasts.

Abstract: Previously we have shown that transforming growth factor β (TGF β) 1, basic fibroblast growth factor (FGF), and platelet-derived growth factor (PDGF) BB inhibit the synthesis of insulin-like growth factor (IGF) II, but their effects on IGF binding protein (IGFBP)-6 in osteoblast cultures are not known. IGFBP-6 binds IGF II with high affinity and prevents IGF II–mediated effects, so that a possible mode of regulating the IGF II available to bone cells would be by changing the levels of IGFBP-6. To enhance our understanding of the actions of growth factors on the IGF II axis in bone, we tested the effects of TGF β1, basic FGF, PDGF BB, IGF I, and IGF II on the expression of IGFBP-6 in cultures of osteoblast-enriched cells from 22 day fetal rat calvariae (Ob cells). Treatment of Ob cells with TGF β1 caused a time- and dose-dependent decrease in IGFBP-6 mRNA levels, as determined by Northern blot analysis. The effect was maximal after 48 h and observed with TGF β1 concentrations of 0.04 nM and higher. TGF β1 also decreased IGFBP-6 polypeptide levels in the medium, as determined by Western immunoblot analysis. Cycloheximide at 3.6 μM decreased IGFBP-6 transcripts and prevented the effect of TGF β1. The decay of IGFBP-6 mRNA in transcriptionally arrested Ob cells was not modified by TGF β1. In addition, TGF β1 decreased the rates of IGFBP-6 transcription as determined by a nuclear run-on assay. In contrast, basic FGF, PDGF BB, IGF I, and IGF II did not change IGFBP-6 mRNA levels in Ob cells. In conclusion, TGF β1 inhibits IGFBP-6 expression in Ob cells by transcriptional mechanisms. Since IGFBP-6 binds IGF II and prevents its effects on bone cells, decreased synthesis of IGFBP-6 induced by TGF β1 could be a local feedback mechanism to increase the amount of IGF II available in the bone microenvironment. J. Cell. Biochem. 66:77–86, 1997. © 1997 Wiley-Liss, Inc.

Retinoic acid regulates the expression of insulin-like growth factors I and II in osteoblasts.

Abstract: Insulin-like growth factors (IGF) I and II are the most abundant growth factors secreted by skeletal cells, and retinoic acid has many important actions on cell differentiation and osteoblastic function. Some of these actions may be mediated by changes in the expression of IGF I and II since IGFs are known to enhance the differentiated function of the osteoblast. We examined the effects of all-trans-retinoic acid on IGF I and IGF II expression in cultures of osteoblast-enriched cells from 22 day fetal rat calvariae (Ob cells). Retinoic acid caused a transient increase in IGF I and IGF II mRNA levels after 6 h, but after 24 and 48 h of treatment a dose-dependent decrease was observed. Cycloheximide prevented the inhibitory effect of retinoic acid. Retinoic acid treatment for 48 h decreased IGF I polypeptide levels in the culture medium. In contrast, 48 h exposure to retinoic acid increased IGF II polypeptide levels, possibly due to increased levels of IGF binding protein-6. The decay of IGF I and II mRNA in transcriptionally arrested Ob cells was similar in control and retinoic acid-treated cells. After 2 h, retinoic acid increased the rates of IGF I and II transcription, as determined by a nuclear run-on assay and heterogeneous nuclear RNA levels, but after 24 h retinoic acid was inhibitory. Retinoic acid had opposite effects to IGFs in osteoblasts and inhibited DNA and collagen synthesis. In conclusion, following a small transient increase, retinoic acid causes a pronounced decrease in IGF I and IGF II mRNA expression in Ob cells. However, treatment with retinoic acid causes a decrease in IGF I and an increase in IGF II polypeptide levels. These changes in the IGF/IGFBP axis may be relevant to the mechanism of action of retinoic acid in bone. J. Cell. Physiol. 172:253–264, 1997. © 1997 Wiley-Liss, Inc.

Impact of HIV on mortality from acute lower respiratory tract infection in rural Zambia

Abstract: AIMS—To establish the prevalence and clinical correlates of HIV among children with acute lower respiratory tract infection. METHODS—Children admitted to a rural Zambian hospital were studied over an eight month period. The diagnosis of acute lower respiratory tract infection was made clinically, according to World Health Organisation (WHO) criteria. Clinicians, who were unaware of the children's HIV status, prescribed antibiotic and supportive treatment according to WHO guidelines. HIV status was established using the polymerase chain reaction (Amplicor HIV1, Roche) applied to dried blood spots. RESULTS—Acute lower respiratory tract infection was diagnosed in 132 children (median age 8 months, range 1 month to 4 years). The WHO criteria for severe or very severe pneumonia were met by 96/132 patients (73%) and 21 patients (16%) died. HIV dried blood spot PCR was positive in 14 cases (11%), of whom four fulfilled the WHO clinical case definition for paediatric AIDS and five died. The group as a whole were malnourished, but the HIV positive children were more severely malnourished (mean z score for weight = −3.01) than the HIV negative children (mean z score = −1.73, p < 0.001). The relative risk of death was 2.6 in the HIV positive group but this was not significant (p = 0.079). CONCLUSIONS—An important minority of children with acute lower respiratory tract infection in rural Zambia will be infected with HIV. However, most HIV positive children presenting with respiratory infection will survive given simple antibiotic and supportive treatment.

ECT in the elderly.

Abstract: Depression is a common clinical problem in the elderly. Risk factors in this population include genetic vulnerability, psychosocial losses, medical comorbidity, cerebrovascular disease, and neurodegenerative disorders. Depression in the elderly may have severe consequences, including high rates of suicide, malnutrition or dehydration, high utilization of medical services, impaired recovery from medical illnesses, and inappropriate placement in residential care facilities. A significant number of older depressed patients may not respond to anti-depressant medications, suffer intolerable medication side effects, or have illnesses with symptoms or consequences so severe that it is not feasible to wait the time required for one or more antidepressant trials to work. For many of these patients ECT can be a dramatically effective treatment. With appropriate evaluation and monitoring, ECT can be performed with relative safety even for patients with serious concurrent medical illnesses. Serious adverse effects are rare, and cognitive consequences of ECT are generally circumscribed and of limited duration; there is no evidence of "brain damage" or permanent change in cognitive ability from ECT. After a recovery period memory function is often better than it was during the episode of depression. For patients who have been refractory to or intolerant of medication, maintenance ECT can be an effective strategy for preventing early relapse. Further research is needed, however, to clarify the optimum use of MECT schedules and pharmacotherapy combinations to most effectively and safely prevent relapse of depression in different elderly populations and to help predict who will best respond to which treatment modalities.

Growth factors and bone

Abstract: Skeletal cells secrete a variety of growth factors that either enhance the replication of the bone cells or modify their differentiated function. The synthesis and activity of skeletal growth factors can be modified by systemic hormones, local factors, and binding proteins.

Gestational psittacosis : case report and literature review

Abstract: In Europe, Chlamydia psittaci is a relatively common cause of abortion in sheep and other mammals. Psittacosis in humans is typically described as a mild-to-moderate flu-like illness. If psittacosis is acquired during pregnancy, it can present as a severe, progressive, febrile illness, with headache, disseminated intravascular coagulation, abnormal liver enzyme studies, and impaired renal function. Only cases with significant fetomaternal morbidity and mortality have been reported. Recovery from this disease follows termination of pregnancy and appropriate antibiotic therapy. Direct exposure of gravid humans to infected products of conception is the most commonly reported mode of transmission. Diagnosis is suggested by the placental histopathologic findings, which consist of an intense, acute intervillositis, perivillous fibrin deposition with villous necrosis, and large irregular basophilic intracytoplasmic inclusions within the syncytiotrophoblast. Commercially available genus-specific monoclonal antichlamydial antibody is available for the rapid confirmation of the diagnosis. In the United States, only two cases of gestational psittacosis have been previously reported. In contrast to the experience in Europe, both cases were associated with psittacine birds. This is the first reported instance of ovine-related gestational psittacosis documented in the United States. Gravid patients should be warned to avoid contact with sheep and their products, particularly during the spring lambing period.

Ultrasound diagnosis of subdural abscess complicating meningitis.

Abstract: mesenteric border may lead to necrosis and removal may be technically difficult. Tension on the mesenteric border may cause perforations or open up any sealed perforations with consequent peritoneal contamination. Multiple enterotomies with piecemeal removal of the bezoar may be required. Careful search for any I l l r lJ S,irg 1991:53:,4c7 inadvertent perforations is mandatory. In our patient, 3 De Bakey M, Ochsner A, Bezoars and concentrations: A be effected en comprehensive revicw of the literature with an analysis of through a single gastrotom)’, albeit with Some 303 collected cases and a presentation of 8 additional cases. difficulty. Siirger:,* 1938;4:93463 REFERENCES