Is the health craze Christian?
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Christianity↗
Biomedical subjects
A Miller
Publications and source records attributed to A Miller.
Radiation resistance of microorganisms on unsterilized infusion sets.
Three different methods were used for detecting and isolating microorganisms with high radiation resistance from the microbial contamination on infusion sets prior to sterilization. By all three methods, microorganisms with a radiation resistance high enough to be a critical factor in a sterilization process (D-6 value greater than or equal to 30 kGy) were found with a frequency of approximately two colony forming units (cfu) per 100 product items, even though the product items in two of the series of analyses were irradiated with doses of 3-6 kGy. The frequency of occurrence of isolates with D-6 values greater than or equal to 30 kGy was 0.45 per 1000 cfu of the total aerobic count. Eight different isolates of microorganisms had D-6 values greater than or equal to 40 kGy when irradiated in dried laboratory preparation. All but one of these were classified according to morphologic criteria as Deinococcus, and all but one had nonlinear dose-response relationships in semilogarithmic presentation.
Bacteria↗
Desquamative interstitial pneumonia associated with chrysotile asbestos fibres.
The drywall construction trade has in the past been associated with exposure to airborne asbestos fibres. This paper reports a drywall construction worker with 32 years of dust exposure who developed dyspnoea and diminished diffusing capacity, and showed diffuse irregular opacities on chest radiography. He did not respond to treatment with corticosteroids. Open lung biopsy examination showed desquamative interstitial pneumonia. Only a single ferruginous body was seen on frozen section, but tissue examination by electron microscopy showed an extraordinary pulmonary burden of mineral dust with especially high concentrations of chrysotile asbestos fibres. This report emphasises the need to consider asbestos fibre as an agent in the aetiology of desquamative interstitial pneumonia. The coexistent slight interstitial fibrosis present in this case is also considered to have resulted from exposure to mineral dust, particularly ultramicroscopic asbestos fibres.
Asbestos↗
Respiratory findings among ironworkers: results from a clinical survey in the New York metropolitan area and identification of health hazards from asbestos in place at work.
Diseases associated with asbestos are prevalent in the construction trades primarily as the result of the previously widespread use of insulation materials containing asbestos in the building industry. Workers in metal related trades, who are employed at construction sites, but who do not routinely use such materials in their work, may also be at risk for asbestos hazards. To assess such risk, a clinical survey was conducted on 869 ironworkers from the New York metropolitan area. A high prevalence of abnormalities on chest radiographs was found. Three hundred and twenty nine (38%) of the examined workers had pleural abnormalities on their chest radiographs consistent with asbestos induced effects. The prevalence of radiographic abnormalities indicating interstitial lung disease was low (7%) as was the prevalence of restrictive pulmonary function impairment (7%). Association was found between forced vital capacity (FVC) and pleural abnormalities on chest radiographs. Although ex-smokers appeared to have the highest prevalence of abnormalities, regression analyses showed that duration of employment in the ironworkers' trade was the most important factor associated with them.
Asbestos↗
Combined modality therapy of Hodgkin's disease: 10-year results of National Cancer Institute of Canada Clinical Trials Group multicenter clinical trial.
The purpose of this study was to compare four methods of treatment for stage III-IV Hodgkin's disease. Between January 1972 and September 1976, 266 patients with stage IIIB, IVA, and IVB Hodgkin's disease from 21 cancer treatment centers across Canada were registered as eligible; 40 were found to be ineligible. Of the 226 remaining patients, only seven were followed for less than 10 years. All patients received three courses of mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) chemotherapy, which induced a complete response (CR) in 36%; an additional 42% obtained adequate disease control. Patients were randomly assigned to (1) treatment with radiation to the abdomen and mantle (group AX3, 62 patients) or (2) continue their treatment with an additional three courses of MOPP (group A, 105 patients). For the A group, a second randomization took place 3 months later (regardless of status at that time) to (1) no further treatment (AC6, 23 patients), (2) radiotherapy to the abdomen and mantle (AX6, 48 patients), or (3) maintenance chemotherapy at 3-month intervals for 1 year (AC10, 26 patients). The survival of AX3 patients was somewhat better than for the A group, but the difference was not significant (P = .0565). However, there was a significant interaction (P = .0029) between age and treatment, so that among patients less than 30 years of age, the survival of the A group was better, whereas for older patients, treatment with AX3 resulted in improved survival. Age itself remained a significant prognostic factor for survival after controlling for the amount of radiotherapy delivered to the abdomen and the dose intensity of vincristine for the first three courses of chemotherapy. The addition of radiation therapy to MOPP significantly reduced the frequency of nodal relapses. These results suggest that combined modality therapy may be beneficial for some patients with Hodgkin's disease and that age must be carefully considered in interpreting the results of clinical trials in Hodgkin's disease.
Adolescent↗
A placebo-controlled, double-blind, randomized, two-center, pilot trial of Cop 1 in chronic progressive multiple sclerosis.
We found Cop 1 to be effective and relatively safe in a previous (exacerbating-remitting) clinical trial. This current trial involves 106 chronic-progressive patients. The major end point, confirmed progression of 1.0 or 1.5 units (depending on baseline disability) on the Kurtzke Expanded Disability Status Scale, was observed in nine (17.6%) treated and 14 (25.5%) control patients. The differences between the overall survival curves were not significant. Progression rates at 12 and 24 months were higher for the placebo group (p = 0.088) with 2-year probabilities of progressing of 20.4% for Cop 1 and 29.5% for placebo. We found a significant difference at 24 months between placebo and Cop 1 at one but not the other center. Two-year progression rates for two secondary end points, unconfirmed progression, and progression of 0.5 EDSS units, (p = 0.03) are significant.
Chronic Disease↗
Monocular elevation weakness and ptosis: an oculomotor fascicular syndrome?
The topographic arrangement of the fascicular portion of the oculomotor nerve in the midbrain is not known. A patient with infarction involving the lateral portion of the fascicle had isolated monocular elevation paresis and ptosis, suggesting that the fibers destined to the elevators of the eye and eyelid course laterally in the fascicle.
Aged↗
Antecedents and outcomes of decision speed in different environmental contexts.
This study refined and extended some findings of previous research on decision-making speed. Decision speed was associated with simultaneous consideration of many alternatives, regardless of context. In contrast, the relationship between board experience and decision speed was context-specific. Similarly, decision speed was associated with higher performance only in high-velocity environments.
Biotechnology↗
Amalgam and mercury toxicity: an update.
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Dental Amalgam↗
Continued experience with intraoperative angioscopy for monitoring infrainguinal bypass grafting.
Intraoperative angioscopy provides direct, in vivo, three-dimensional visualization of the interior of the blood vessels and grafts. We have shown previously that with the application of the basic principles of irrigation and with a dedicated irrigation pump that routine intraoperative angioscopy can be performed with consistent high quality results during lower extremity revascularization. In our total experience with angioscopy as a monitoring procedure during infrainguinal bypass grafting, 259 intraoperative angioscopies, during 63 femoropopliteal and 196 distal bypass grafts, were performed from May 1, 1987, to October 31, 1989. Mean total irrigation fluid used in the study was 448 ml (range, 0 to 1400 ml) with good visual quality in more than 80% of the studies. The overall failure rate was 1.5%. No complications were directly attributable to the insertion of the angioscope or the use of the pump. Based on the angioscopic findings, 124 clinical or surgical decisions were made in 259 of the angioscopies. The incidence of graft failure in this study was 8.1% (less than 30 days) and 4.8% (greater than 30 days) with a mean follow-up of 272 days. Direct inspection of the interior of the graft and native vessels at the time of surgery has resulted in the recognition of previously unsuspected vein-graft pathology. Angioscopy as the sole monitoring procedure for infrainguinal bypass grafting is safe, effective, and reliable and may not only improve the durability of these grafts but may improve our understanding of the pathogenesis of graft failure and of the progression of the underlying atherosclerotic disease.
Adult↗
American Association of Dental Schools presentation to the FDA Dental Products Panel.
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Animals↗
Angioscopically directed valvulotomy: a new valvulotome and technique.
Despite a large experience with "blind" retrograde valvulotomy in in situ vein bypass grafting, the incidence of residual competent valves remains high, and valvulotome-induced injury is common. In this study we describe a new valvulotome and technique of angioscopically directed valvulotomy and review the video tape recordings of 85 completion angioscopies of in situ femorodistal bypasses. Fifty-three vein grafts were prepared with the blind retrograde valvulotomy technique and 32 vein grafts with the new valvulotome and angioscopy. The use of the new valvulotome and technique is compared with that of the standard blind retrograde valvulotomy technique, and the normal endoluminal anatomy and incidence of primary disease in saphenous vein grafts was noted. The incidence of valvulotome-induced injury was 5/32 (15.6%) and 45/53 (85%) in vein grafts prepared with angioscopically directed valvulotomy and blind retrograde valvulotomy, respectively. Residual competent valves were found in 10/53 (18.9%) in blind retrograde valvulotomy and 0/25 of angioscopically directed valvulotomy vein grafts (p = 0.0114). In 22/53 vein grafts unsuspected primary disease was detected. Angioscopically directed valvulotomy with the new valvulotome and technique is feasible, reliable, and safe. It avoids residual competent valves, minimizes valvulotome-induced injury, and allows the detection and correction of unappreciated primary vein graft abnormalities. The new valvulotome and technique is a first step in the complete endoluminal preparation of the in situ vein graft.
Aged↗
Lung function in former intravenous drug abusers: the effect of ubiquitous cigarette smoking.
PURPOSE: To determine whether former intravenous drug abusers (IVDAs) demonstrate reductions in pulmonary function, especially in the diffusing capacity (DLCO), after adjustment for the effects of their ubiquitous smoking habit. Knowledge of baseline DLCO in this high-risk group is important in evaluating the effects of human immunodeficiency virus (HIV) and ensuing opportunistic infections. PATIENTS AND METHODS: Measurements of single-breath DLCO, forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1) were compared with predictive values that adjust for the effects of smoking. Patients were 98 ambulatory former IVDAs regularly attending a methadone maintenance program (62 men and 36 women; 94 current smokers, two ex-smokers, and two nonsmokers). RESULTS: When adjusted for smoking, FEV1 and DLCO were no different in the study sample than in cross sections of the general population: mean FEV1 105% predicted (men) and 97% predicted (women), mean DLCO 95% predicted (men) and 99% predicted (women). Eleven percent of the IVDAs had abnormal values for DLCO; only one subject had a value less than 50% of predicted. CONCLUSIONS: Most former IVDAs who regularly attend an ambulatory methadone program have normal DLCO values when the effects of smoking are taken into account. A decrease in DLCO in such subjects is presumptive evidence of superimposed disease, most likely related to opportunistic infections or HIV-associated malignancy or alveolitis.
Adult↗
Cognitive-developmental systems theory in pervasive developmental disorders.
The concept of reality systems is introduced in context of cognitive-developmental systems theory. Examination of the parallels between the reality systems of normal infants and those of children with pervasive developmental disorders supports the view that the latter are stalled at an early stage of development. Evaluation of pervasively disordered children with closed-system and system-forming disorders indicates the aberrant manner in which such children orient toward and engage objects and events, a manner that precludes flexible adaptation to people or surroundings. Attention is given the role of interruption as it triggers a compensatory reaction to maintain systems and the contribution of such reactions in developing the intentional behavior so lacking in children with pervasive developmental disorders. Finally, the author discusses theory-driven strategies to correct deficits in the body schema, coping with surroundings, social development, and communication and representation.
Child↗
The measurement of the rotational diffusion coefficient of bovine plasma fibronectin by electric birefringence technique.
Although the conformation of fibronectin has been widely investigated by various techniques, there has not yet been any determination of its rotational diffusion coefficient. We report here this determination by the transient electric birefringence study of solutions of bovine plasma fibronectin at physiological ionic strength. The solutions showed a positive birefringence. A linear relationship was observed between the intensity of the birefringence at equilibrium and the square of the electric field within the range of fields applied (up to 12.5 kV.cm-1). The field-independent decay of the induced birefringence was described by a single exponential with a relaxation time of 0.76 (+/- 0.08) microsecond at 23 degrees C. This establishes fibronectin in solution as a globally rigid structure with a rotational diffusion coefficient, at 20 degrees C, of 202,000 s-1. This result allows the first rigorous determination of the low-resolution structure of fibronectin. It is important to notice that the analysis combines only results obtained in physiological conditions on native molecules and follows a strict hydrodynamic interpretation. The conclusion of this work is that a hollow sphere of about 20 nm external diameter can be proposed as a model for the three-dimensional structure of the fibronectin molecule in solution. This new model suggests the fibronectin could have the structure of a carrier protein.
Animals↗
Cross-linkage sites in type I collagen fibrils studied by neutron diffraction.
Cross-links in tendon collagen are essential for the biomechanical strength of healthy tissue. The nature and position of these cross-links has long been a subject for conjecture. We have approached this problem in a non-destructive manner, by studying neutron diffraction from collagen fibrils that have been specifically deuterated by reduction at keto-amine and Schiff base groups with sodium borodeuteride (NaB2H4). The intensities of the first 23 meridional reflections were recorded for both native and reduced tendons. These data were used to calculate the neutron-scattering density profile of the 67 nm (D) repeat of type I collagen fibrils in rat tail tendon. This approach not only succeeds in determining the location of the cross-linkage sites with respect to the fibril structure, as projected onto the fibre axis, but also presents a novel form of the isomorphous derivative solution to the phase problem.
Animals↗
Adjuvant therapy in stage I and stage II epithelial ovarian cancer. Results of two prospective randomized trials.
About a third of patients with ovarian cancer present with localized disease; despite surgical resection, up to half the tumors recur. Since it has not been established whether adjuvant treatment can benefit such patients, we conducted two prospective, randomized national cooperative trials of adjuvant therapy in patients with localized ovarian carcinoma (International Federation of Gynecology and Obstetrics Stages Ia to IIc). All patients underwent surgical resection plus comprehensive staging and, 18 months later, surgical re-exploration. In the first trial, 81 patients with well-differentiated or moderately well differentiated cancers confined to the ovaries (Stages Iai and Ibi) were assigned to receive either no chemotherapy or melphalan (0.2 mg per kilogram of body weight per day for five days, repeated every four to six weeks for up to 12 cycles). After a median follow-up of more than six years, there were no significant differences between the patients given no chemotherapy and those treated with melphalan with respect to either five-year disease-free survival (91 vs. 98 percent; P = 0.41) or overall survival (94 vs. 98 percent; P = 0.43). In the second trial, 141 patients with poorly differentiated Stage I tumors or with cancer outside the ovaries but limited to the pelvis (Stage II) were randomly assigned to treatment with either melphalan (in the same regimen as above) or a single intraperitoneal dose of 32P (15 mCi) at the time of surgery. In this trial (median follow-up, greater than 6 years) the outcomes for the two treatment groups were similar with respect to five-year disease-free survival (80 percent in both groups) and overall survival (81 percent with melphalan vs. 78 percent with 32P; P = 0.48). We conclude that in patients with localized ovarian cancer, comprehensive staging at the time of surgical resection can serve to identify those patients (as defined by the first trial) who can be followed without adjuvant chemotherapy. The remaining patients with localized ovarian cancer should receive adjuvant therapy, and with adjuvant melphalan or intraperitoneal 32P should have a five-year disease-free survival of about 80 percent.
Adult↗
New angioscopic findings in graft failure after infrainguinal bypass.
We have previously shown that intraoperative angioscopy is a safe, useful, and effective method for monitoring infrainguinal bypass grafts. The videotaped recordings of the intraoperative angioscopy studies of 25 failed infrainguinal bypass grafts inserted between May 1987 and July 1989 and 3 failing grafts that were angioscoped during the subsequent graft salvage procedure were reviewed in a systematic fashion according to a fixed protocol, to identify any endovascular findings either initially missed or in which the relevance to graft failure had been unappreciated at the time of bypass grafting. We were able to identify new venous pathologic characteristics and highlight endoluminal features, of both a technical and nontechnical nature, which have a probable causal relationship to graft failure. However, the significance of some of the endovascular findings that were seen during infrainguinal bypass grafting has yet to be fully defined.
Adult↗