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Biomedical subjects

A Green

Publications and source records attributed to A Green.

At least 307 records · Page 17Linked to original sources
PubMed1995

Has sexuality anything to do with psychoanalysis?

This paper, prepared as a Sigmund Freud birthday lecture for the Anna Freud Centre, takes the opportunity to clarify and to debate some of the misunderstandings surrounding the meaning and significance of sexuality in psychoanalysis. The author departs from twin observations he has made in the last ten years: direct discussion of sexuality seems to have become marginalised and restricted to specialised papers in psychoanalytic journals. Attempting to question and understand this trend the author recalls that Freud placed sexuality at the centre of psychic development, psychoanalytic theory and clinical work. The contemporary and fashionable focus on object relations, pregenital fixations, borderline pathology and theories and techniques drawn from observations of child development have obscured, the author argues, the meaning and importance of sexuality in psychoanalytic theory and practice. A condensed review of Freud's ideas about sexuality and a re-evaluation of them is aimed at restoring the importance of genital sexuality and the Oedipus complex to their central place. For this author today's sexuality is not Freud's sexuality.

Adult↗
PubMed1994

Heterogeneity of melanoma risk in families of melanoma patients.

While it is recognized that relatives of melanoma patients are at increased risk for this disease, the source and extent of variation in melanoma risk between families of melanoma cases is unknown. Heterogeneity of familial melanoma risk was assessed among the families (comprising 7,666 first-degree relatives) of 1,149 cutaneous melanoma cases diagnosed in Queensland, Australia, between 1982 and 1987. The measure of familial melanoma risk was based on the number of cases of melanoma in the family in excess of those predicted from the age-, sex-, and birth cohort-specific cumulative incidences of melanoma among all relatives in the sample. Probands over-reported melanoma occurrence among their relatives, with a false positive reporting rate of 44.5% (216 false reports out of 485). Only medically verified cases among relatives were included in the analysis. There was statistically significant heterogeneity in family risk, with 53 (4.7%) of the total 1,116 unrelated families containing significantly more melanoma cases than expected considering the size of the family, and the age, sex, and birth cohort distributions of family members. In univariate analyses, members of the high-risk families were significantly more likely to have poor ability to tan, a propensity to sunburn, fair skin color, red hair, and many melanocytic nevi. When all variables were included simultaneously in a multiple logistic regression model, only the associations with tanning ability, skin color, and number of nevi remained significant. There were no significant differences overall between high-risk and other families in the sites and ages at diagnosis of melanoma, although melanomas on variably sun-exposed sites (trunk and legs) were diagnosed earlier in the high-risk families, independent of the stage at diagnosis.

Adult↗
PubMed1994

Comparative studies of UV-induced DNA cleavage by structural isomers of an iodinated DNA ligand.

PURPOSE: To evaluate the importance of the position of the halogen atom in iodinated DNA-binding bibenzimidazoles, with respect to sensitization of UV-A-induced DNA breakage. METHODS AND MATERIALS: Three analogues of iodoHoechst 33258, denoted ortho-, meta- and paraiodoHoechst, according to the site of iodine substitution, were synthesized. Plasmid DNA (pBR322) was used to assay UV-A-induced DNA single-strand breaks (ssbs). The location of the sites of strand breakage was determined by DNA sequencing gel analysis, using a 32P-endlabelled oligoDNA with a single binding site for the ligands. RESULTS: A clear trend in decreasing activity of sensitization of UV-induced DNA ssbs was established: ortho- > meta-, para- > iodoHoechst 33258. The sequencing gel studies showed that orthoiodoHoechst was distinct from the other three compounds, with respect to the sites of DNA strand breakage and the chemistry of the cleavage reaction. CONCLUSION: The position of iodine substitution in iodinated bibenzimidazoles determines the location of the carbon-centered radical on the ligand in the minor groove of DNA. DNA strand cleavage is mediated by abstraction of a nearby deoxyribosyl H-atom. Hence, the position of the radical species determines: which deoxyribosyl group is attacked (i.e., site of cleavage relative to the ligand binding site); which H-atom is abstracted, more specifically which of the five deoxyribosyl carbons is involved (i.e., the chemistry of the cleavage reaction), and the stereochemistry of the transition state for the H-atom abstraction (and hence the efficiency or extent of strand breakage). The ortho-compound represents the best example to date of iodinated DNA ligands designed as potential radiation sensitizers, as an extension of the well-established sensitization by halogenated DNA precursors.

Base Sequence↗
PubMed1994

Phage libraries for generation of clinically useful antibodies.

Insertion of antibody genes into filamentous bacteriophage makes it possible to generate and screen libraries of 10(7) or more antibodies. Each phage expresses an antibody on its surface and contains the corresponding antibody gene. Genes that encode antibodies with desired characteristics are readily selected and their antibodies expressed as soluble proteins in Escherichia coli. We used this system to produce an antibody to carcinoembryonic antigen with higher affinity and better tumour specificity than antibodies currently in use.

Animals↗
PubMed1994

A follow-up dual-task investigation of lateralized effects in right- and left-handed males.

A dual-task follow-up investigation examined the influence of sample size and ideational complexity of cognitive tasks on lateralized effects. With a larger sample (n = 128), results showed a "manual dominance effect" for relaxed and paced nonideational vocalized tasks. A hierarchy of ideational verbal tasks yielded the expected lateralized effects which corresponded with increasingly greater interference in concurrent tapping, but not in strength of laterlized effect. Instead of a trend seen in the earlier work (Steiner, Green, & White, 1992), results revealed a significant difference between handedness groups for one complex spatial task. Finally, outcomes for the other spatial task highlight the importance of assessing tradeoffs in attention.

Adult↗
PubMed1994

A thermal clearance probe for continuous monitoring of cerebral blood flow.

Cortical thermal clearance provides a practical means of continuous assessment of cerebral blood flow. A probe which can be used to monitor cerebral cortical thermal clearance is described. It has proved a reliable method of predicting oligaemia, showing good correlation between measured thermal clearance and the onset of clinical signs of ischaemia. The limitations are its size, invasiveness, small sample volume and difficulty with quantification. It is a useful additional tool in the management of patients suffering from acute neurosurgical disorders.

Blood Flow Velocity↗
PubMed1994

Melanoma and sunburn.

A computer-aided search identified 16 case-control studies which specifically assessed sunburn as a risk factor for cutaneous malignant melanoma. Using unadjusted estimates, a history of sunburn was associated with significantly increased risk of melanoma in all but one study. Four studies were defined as core studies after assessment of study quality; however, only two of these had sufficiently similar definitions of sunburn to allow pooling of results. Using pooled data, the risk of melanoma in those ever sunburned was 2.0 (95 percent confidence interval [CI] = 1.6-2.6), while the highest category of sunburn exposure had a risk of 3.7 (CI = 2.5-5.4). The suggestion that sunburns in childhood carry greater risk of melanoma cannot be supported by pooled analysis. This review demonstrated considerable variation in design and method among the studies, and identified sources of bias which prevented a pooled analysis using all available data. The need for strong epidemiologic evidence relating sunburn to melanoma, particularly in childhood, is of prime importance, since avoidance of sunburn is one of the few potential means of primary prevention of melanoma.

Humans↗
PubMed1994

Recognition of cardiogenic artifact in pediatric capnograms.

The capnograph is in regular use as a respiratory monitor. From measurements of its trace, calculations of breathing rate and end-tidal carbon dioxide can be made. Unfortunately, the reliability of these calculations depends on the quality of the signal. In the case of cardiogenic oscillations, the averaged results may be grossly inaccurate and, therefore, misleading. This paper describes a method for detecting such cardiogenic oscillations and removing their effect from the final results of capnogram analysis. The algorithm used resulted in a sensitivity of 99.6% and a specificity of 99.2%, when compared with manual scoring. The criteria could easily be incorporated into equipment software and are a step in the direction of "intelligent" monitoring.

Algorithms↗
PubMed1994

Hereditary distal myopathy with granulo-filamentous cytoplasmic inclusions containing desmin, dystrophin and vimentin.

A 56-year-old female and her 34-year-old daughter presented with a predominantly distal myopathy affecting the peroneal and calf muscles, neck flexors and hand muscles. Both patients and two other daughters had cardiac arrhythmias, three requiring the insertion of cardiac pacemakers. Skeletal muscle biopsies revealed a complex myopathic process with granular degeneration, rimmed vacuoles and eosinophilic cytoplasmic inclusions. Ultrastructurally, the inclusions were composed of electron dense granular material and filaments forming linear masses beneath the sarcolemma and rounded masses within the cytoplasm of the fibres. Immunohistochemistry revealed labelling of the inclusions for desmin, dystrophin and vimentin, but not for alpha-actinin, spectrin, utrophin or myosin heavy chains. This family shows a hereditary distal myopathy with some features in common with previously-reported cases in which biopsies showed cytoplasmic inclusion bodies containing desmin. This group of diseases is clinically and pathologically heterogeneous. In the present cases, the accumulation of cytoplasmic filaments may reflect a generalised disturbance of filamentous protein metabolism rather than a specific disorder of desmin.

Adult↗
PubMed1994

The Nambour Skin Cancer and Actinic Eye Disease Prevention Trial: design and baseline characteristics of participants.

The Nambour Skin Cancer and Actinic Eye Disease Prevention Trial (the Nambour Trial) is a field trial conducted in an unselected adult population in Australia. Using a randomized 2 x 2 factorial design, the principal aim is to evaluate whether regular use of high-protection sunscreen and/or dietary supplementation with beta-carotene (30 mg daily) can alter the incidence rates of basal cell carcinomas and squamous cell carcinomas of the skin over a minimum follow-up time of 4.5 years. Changes in the incidence of solar keratoses and actinic eye disease and the rate of photoaging after intervention will also be investigated. In 1992, 1626 participants between the ages of 25 and 75 years were enrolled, all of whom had been randomly selected from residents of the southeastern Queensland township of Nambour for an earlier skin cancer prevalence survey. This paper describes the background to the trial and its design, with respect to evaluation of effects on actinic skin disease, and documents the baseline characteristics of participants recruited into the Nambour Trial.

Adult↗
PubMed1994

The treatment-seeking woman at menopause.

Recent studies suggest that health care utilisation by women during menopause transition in general is highly idiosyncratic, despite the widespread advocation of prophylactic hormone therapy and increased health vigilance. The Melbourne Women's Midlife Health Study, a community-based cross-sectional study of 2001 urban Australian-born women aged 45-55 years, evaluated women's physical and emotional experiences, past and present health status, attitudes and beliefs about menopause, health behaviours and current menopausal status in a 30-min telephone interview. This paper reports on those factors related to help-seeking and health care utilisation. Findings show that treatment utilisers, in contrast to non-utilisers, reported a wider range of general symptoms, but reports on vasomotor symptoms did not contribute to the regression analysis. Treatment utilisers were further identified as problem-related or prevention-related utilisers. In three-way analyses, the past and present social and physical health of the problem-related treatment user was reportedly worse than either the prevention-related utiliser or non-utiliser. These findings suggest that medical and societal views about the health of middle-aged women during menopausal transition are likely to be based on the experiences of a particular segment of the population only. It is proposed that biased views of menopause as a time of considerable distress and ill-health are being perpetuated and over-generalised. This perspective appears to have little relevance for the majority of middle-aged women.

Australia↗
PubMed1994

Computer image analysis in the diagnosis of melanoma.

BACKGROUND: It is often difficult to differentiate early melanoma from benign pigmented lesions of similar clinical appearance. OBJECTIVE: Our purpose was to develop a computer image analysis system that has the potential for use as an adjunct to the clinical distinction of melanoma from less serious pigmented lesions. METHODS: The system, consisting of a hand-held device incorporating a color video camera and color frame grabber mounted in a microcomputer, was used in a pigmented lesion clinic. Analysis software extracted features relevant to the size, color, shape, and boundary of each lesion, and these features were correlated with clinical and histologic characteristics on which standard diagnoses of skin tumors are based. For discriminant analysis based on image analysis measurements, equal prior probabilities were assigned to two specified diagnostic groups, namely melanoma and "other pigmented lesions," most of which were melanocytic nevi. RESULTS: In a 20-month period, video images of 164 unselected pigmented lesions for which complete diagnostic data were available were successfully captured using the camera. Sixteen of 18 melanomas, and 89% of pigmented lesions overall, were correctly classified by the image analysis system, compared with 83% based on clinical gradings of lesion characteristics. CONCLUSION: Computer image analysis has the potential to provide a valuable diagnostic aid that could enable clinicians to make highly sensitive and specific diagnoses of early, curable melanoma.

Adolescent↗
PubMed1994

Comparability of naevus counts between and within examiners, and comparison with computer image analysis.

In the course of an investigation of melanocytic naevus development in Queensland, Australia, whole-body naevus counts of 66 adolescents were performed separately by two nurse examiners on two occasions on average 4 weeks apart. There was good agreement between the two examiners for counts of total naevi on the whole body (intra-class correlation coefficient = 0.96) and at selected subsites (face, neck, back, upper arms, lower arms). Agreement was lower when raised naevi only were counted (0.83). Intra-examiner repeatability was high for both nurses, particularly for the more experienced examiner (intra-class correlation coefficients = 0.98 and 0.91 for total naevi on the whole body), and was consistently better when all naevi were counted rather than naevi of a particular size. Independent counts of naevi on the back using a computer imaging technique were reproducible (intra-class correlation coefficient = 0.92), but showed only moderate agreement with counts by the nurse examiners. Overall, these results demonstrate high comparability of naevus counts between and within similarly trained examiners. They do not support the common practice in epidemiological studies of restricting counts to naevi larger than 2 mm, or of counting raised naevi only.

Adolescent↗
PubMed1994

The market and health sector reform.

A new international orthodoxy has developed on health sector reform. The dominant theme of the orthodoxy is the alleged benefits of market style reforms for health development. This is shaping changes formulated, and being implemented, in the British NHS and other European health services (including Central and Eastern Europe), Latin America and a number of developing health systems in Africa and Asia. Sets out a ten-point description of the orthodoxy. Contends that the orthodoxy is showing distinct signs of restricting the analysis and development of health management and planning. This is a matter for considerable concern as the adoption of market-style reforms can generate unforeseen and, in some cases, negative consequences. There is clearly a need for strengthening management research and development as a basis for effective health sector reform.

Consumer Behavior↗
PubMed1994

Naevi in schoolchildren in Scotland and Australia.

To test the hypothesis that children living in subtropical and tropical environments have more naevi than those of similar ethnicity living in temperature countries, a comparative study of melanocytic naevi in 111 schoolchildren from Brisbane, Australia, and 222 from Glasgow, Scotland, was carried out. All children were aged 13-15 years, of European ancestry, and had spent most of their lives at latitudes of less than 30 degrees S (Australia) or greater than 30 degrees N (Scotland). Using an identical protocol, all naevi of 2 mm or more in diameter occurring on the right arm were counted by either a highly experienced research nurse in Brisbane, or a dermatologist in Glasgow. Hair and eye colour, and facial freckling, were assessed by the examiner, and axillary skin colour of children in both cities was measured using the same reflectance spectrophotometer. Children in Brisbane had significantly more naevi than those in Glasgow (P < 0.05), after adjusting for complexion variables. The difference in the geometric mean number of naevi on the arm was much greater among boys (7.7 vs. 4.4, in Brisbane and Glasgow, respectively) than among girls (7.3 vs. 6.7). This has parallels with the sex differences in melanoma at later ages in the two countries. Besides country of residence, freckles and innate skin colour were the most significant predictors of large numbers of naevi, whereas red hair had a significant protective effect. Overall, these data on prevalence of naevi in children from contrasting environments provide some evidence in support of the theory that naevus development is related to the level of sun exposure in childhood and adolescence.

Adolescent↗