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Biomedical subjects

C Reynolds

Publications and source records attributed to C Reynolds.

At least 109 records · Page 6Linked to original sources
PubMed1990

Vocal function following vertical hemilaryngectomy: a preliminary investigation.

Seven consecutive male patients who received a vertical hemilaryngectomy were examined for vocal function employing video-stroboscopic, aerodynamic and acoustic measurement techniques. The results of this preliminary investigation suggest that with the group of patients studied, vocal quality was rated as "rough", "breathy" and "constricted". While large variability was noted between individuals, the general tendencies for the group included: (a) incomplete glottic closure; (b) supraglottic structures (ventricular folds, arytenoids) fulfilled or aided vibratory action of the remaining fold; (c) high average transglottal airflow; (d) reduced maximum phonation time; (e) high and more variable vocal frequency positioned near the top of the frequency range; (f) a lower, more variable, and restricted vocal intensity range, and (g) a reduced vocal fold diadochokinetic (vocal fold opening and closing action) rate. We are currently attempting to determine factors related to individual patient strategies for using either glottic or supraglottic valving during phonation.

Carcinoma, Squamous Cell↗
PubMed1989

The olfactory and cognitive deficits of Parkinson's disease: evidence for independence.

In the present study we sought to determine whether the olfactory deficits of parkinsonism are related to the cognitive and perceptual-motor manifestations of the disease. Pearson correlation coefficients were computed among a number of olfactory, neurological, and neuropsychological measures obtained from 58 Parkinson's disease patients, including the University of Pennsylvania Smell Identification Test, a modified Randt memory test, a reaction time test, a finger-tapping test, ratings of motor and neurological function, and selected verbal and performance subtests of the Wechsler Adult Intelligence Scale--Revised. Data from 38 patients with Parkinson's disease who received odor detection threshold testing were also evaluated. The intercorrelation matrix was subjected to a principal components factor analysis which yielded six clear-cut factors: cognitive/memory, gross motor, oral motor, fine motor, olfactory, and tremor. The olfactory factor received strong and nearly exclusive loadings from the olfactory measures (which did not evidence meaningful loadings on any of the other factors). A ten-trial jackknife procedure revealed the factor structure to be stable. Further support of the independence of the olfactory variables from the other measures was provided by multiple regression and canonical correlation analyses. Overall, these findings lend support to the hypothesis that the olfactory disorder of parkinsonism is independent of the cognitive, perceptual-motor, and memory manifestations of the disease.

Aged↗
PubMed1989

Spatial dispersion of stainable lipid in frozen sections of human aorta.

Frozen sections of human lateral thoracic aorta were stained for lipid with Oil red O. Intensity of staining was judged upon a scale of 0 to 5 brilliance units by matching to a scale of photographs. Microregions, defined by an eyepiece grid, were structured in layers of 100 microns thickness and 1000 microns along the aortic length. The intensity of staining, both total and extracellular, tended significantly to increase with age, intimal thickness and depth into the intima. Aortas having at least one instance of atheronecrosis tended to show generally greater staining intensities than aortas without necrosis, and the tendency was more conspicuous with total than with extracellular staining, implying a greater degree of intracellular staining in the specimens with atheronecrosis. The evidence seems to suggest that the emergence of a necrotic core happens, at least in part, because the affected site has collected an excess of lipid. The evidence further suggests that lipid deposits become excessive with increasing frequency after age 35 years, and that this is associated with intimal thickenings coming to exceed 300 microns. The causes that propel the intimal thickenings remain wholly unknown - those causes seem to have little if anything to do with excess of lipids. Some as yet undetermined qualitative characteristic of the lipids might be of importance in this regard.

Adolescent↗
PubMed1989

A large internal deletion converts yeast LEU3 to a constitutive transcriptional activator.

LEU3 of Saccharomyces cerevisiae encodes an 886-amino-acid polypeptide that activates transcription of at least five genes by binding to an upstream decanucleotide sequence. This activation is dependent on the inducer alpha-isopropylmalate, the synthesis of which is repressed by leucine. We created a 285-amino-acid LEU3 derivative by removing a large block of internal sequences, including a dense cluster of acidic residues. This deletion protein bound to the decanucleotide sequence in vitro and activated gene expression in vivo. In contrast to wild-type LEU3, the truncated LEU3 protein was an effective transcriptional activator when alpha-isopropylmalate synthesis was repressed by leucine.

Chromosome Deletion↗
PubMed1988

Multimodal approach to screening for ovarian cancer.

1010 postmenopausal women were recruited for an ovarian cancer screening programme incorporating serum CA-125 measurement and vaginal examination as initial tests and real-time ultrasonography as a secondary procedure in selected cases. The normal range for serum CA-125 in postmenopausal women was established. The specificity for ovarian cancer of serum CA-125 measurement and vaginal examination were 97.0% and 97.3%, respectively. The combinations of serum CA-125 measurement with ultrasound and vaginal examination with ultrasound achieved specificities of 99.8% and 99.0%, respectively. 100% specificity was achieved by serum CA-125 measurement with vaginal examination and by the combination of all three tests. The findings indicate that no individual screening test has acceptable specificity for ovarian cancer in postmenopausal women. However, the combination of CA-125 measurement with ultrasound did achieve acceptable specificity and offers the most hope of a specific and sensitive method for early detection.

Aged↗
PubMed1988

The availability of physician services: a geographic analysis.

This article describes a new technique for estimating the availability of physician services in small geographic areas. Given counts or estimates of the number of physicians practicing in small geographic areas (e.g., zip codes), the technique allocates a portion of the services of each physician in an area to his home area and to nearby areas in proportion to both the propensity of patients to travel for medical care and the availability of potential patients. The longer the time required for a patient to travel to the physician, the smaller the proportion of the physician's services allocated to the patient's area, with the precise relationship determined by a special analysis. The final estimate of the availability of physician services in each small area is the sum of the service proportions of every physician in all of the small areas. The total supply of physician services is the same as the original total, but the distribution is adjusted to reflect the time that patients are willing to spend traveling to obtain medical care. Although this technique requires considerable data processing, it permits more accurate estimation of the supply of physician services in small geographic areas than is possible with traditional methods. It better represents the probabilistic and interpenetrating nature of physician service areas than alternative techniques and appears to be particularly applicable in estimating the supply of primary care physician services. Actual data for pediatricians and children in northeastern New York using zip codes as the geographic units illustrate the technique. Limitations, applications, and possible extensions are discussed.

Catchment Area, Health↗
PubMed1986

Antigenic heterogeneity among Burkitt's lymphoma cells surviving treatment with monoclonal antibody and complement.

Selective removal of malignant cells from human bone marrow is one requirement for autologous bone marrow transplantation. In earlier studies treatment with multiple monoclonal antibodies and C' was more effective than treatment with individual reagents in eliminating clonogenic Burkitt's lymphoma cells from a twenty-fold excess of human bone marrow. To explore possible mechanisms underlying the additive or synergistic effects observed with multiple reagents, clones of malignant cells that have survived treatment with antibody and C' have now been isolated at limiting dilution. Marked heterogeneity has been observed in binding of different monoclonal antibodies and in resistance to C'-dependent lysis among these different clones. Phenotypic traits were stable for at least two weeks in culture. Clones that survived treatment with the J5 anti-CALLA antibody and C' exhibited a relative decrease in CALLA expression but did not exhibit an increased susceptibility to lysis by anti-CALLA and C'. No selective decrease in gp-26 or B1 was observed in clones treated with J2 or anti-B1. A correlation between CALLA and gp-26 expression was observed in clones treated with J2 and anti-B1, but no clear correlation was observed between antigen expression and susceptibility to C'-dependent lysis. In this model system, escape from C' dependent cytotoxicity does not appear related to the existence of phenotypically stable C' resistant variants within the tumor cell population.

Animals↗
PubMed1985

Management of the diabetic surgical patient. A systematic but flexible plan is the key.

Diabetes control is especially important when the patient is undergoing surgery, as the trauma can result in major metabolic changes. Complications of diabetes must be assessed preoperatively, since they themselves can lead to the need for surgery or can predispose to increased surgical or anesthetic risk. The preoperative blood glucose status of diabetics can be assessed by use of standard laboratory methods, self monitoring devices, urine glucose testing, or measurement of glycohemoglobin level. Blood glucose control can be maximized by designation of one physician on the health care team to be in charge of fluid, electrolyte, and insulin administration on perioperative days. This physician should follow a definite protocol of subcutaneous insulin administration guided by appropriate monitoring of blood glucose response. In special cases, such as surgery in the pregnant diabetic, a more complex scheme of management using low-dose insulin infusion may be required. Coexistence of another endocrine disease with diabetes should be recognized, since it may lead to otherwise unexpected changes in insulin requirements. A systematic and comprehensive yet flexible approach to the treatment of diabetes before, during, and after surgery puts a successful outcome well within the reach of the modern clinician.

Blood Glucose↗
PubMed1984

CA125 antigen levels in obstetric and gynecologic patients.

An immunoradiometric assay using a monoclonal antibody detects an antigenic determinant (CA125) that is present in more than 80% of epithelial ovarian cancers. CA125 levels are elevated in the sera of 16% of women in the first trimester of pregnancy and is found in very high concentration in amniotic fluid. In 988 nonpregnant patients with benign gynecologic disorders, CA125 was greater than 65 U/mL in 1% on a single determination and in 0.5% with two determinations. Given the low rate of positivity in benign gynecologic disease, the CA125 assay may deserve further evaluation for the early detection of ovarian carcinoma.

Adult↗