Biomedical subjects
D Hanson
Publications and source records attributed to D Hanson.
Incidence and prediction of pressure ulcers in five patient care settings.
Pressure ulcers (PU), one example of an alteration in skin integrity, remain a prominent healthcare concern in all patient care settings. Incidence refers to the number of "new cases occurring over a given time period" (NPUAP, 1989, p. 26). Adult patients (n = 190) in five patient care settings who were assessed to be free of PUs on admission were followed over a specified period of time to assess the incidence of pressure ulcer development for each setting. Subjects each had a skin assessment, along with a risk assessment utilizing the Braden Scale. A demographic data form was also completed on each subject. Pressure ulcers developed post-admission in 18 (9%) patients, 11 of whom were acute care patients and eight of whom were patients in skilled care. No patients developed pressure ulcers in the rehabilitation, home care, or hospice settings. Incidence for acute care was 15% and 28% in skilled care. Braden predictor scores were also recommended for each setting and factors associated with pressure ulcer development were discussed.
A computer program for analyzing bivariate flow karyotypes.
This article describes a computer program for analyzing bivariate flow karyotypes of human chromosomes stained with Hoechst 33258 (HO) and chromomycin A3 (CA). The karyotype first is divided into regions that contain chromosome peaks. The chromosomes that are associated with those areas are identified. The distributions in these areas then are fitted with mathematical functions of increasing complexity. The process starts by fitting a specified number of univariate Gauss functions to projections of the HO and CA distributions of each area. The final fit can include multiple bivariate Gauss functions, including a background function for debris subtraction. The results of one stage in the fitting process serve as seed values for the next, more complex step. Since the program autonomously estimates the starting values for the iterative fitting procedures, the fit results are insensitive to operator bias and the program will consistently converge to the same solutions. The resulting table of parameter values can be used to compare flow karyotypes to a reference data set.
Salivary gland tumors of the oral cavity.
Between 1961 and 1985, 62 patients with malignant salivary gland tumors of the oral cavity underwent surgery with curative intent at the University of California, Los Angeles (UCLA) Medical center. All patients had a minimum follow-up of 2 years. Fifty of 62 (81%) patients presented with T1-2 primary tumors. The tumors arose from the palate in 41/62 (66%) patients. The most common histologic type was adenoid cystic carcinoma comprising 34 of 62 (55%) cases. Radical resection was performed in 46 cases and wide local excision in 16 patients. Postoperative radiation therapy was used in 24 cases due to advanced stage and/or positive surgical margins. Results of treatment were analyzed by stage of disease, modes of treatment, histology, and surgical extent. Local control of small lesions reached 100% at 10 years with either radical resection alone or local excision. With residual tumor at the surgical margins, the incidence of local recurrence was 4/14 (29%) for those who received adjuvant radiation therapy and 5/10 (50%) for those who did not. The vast majority of mucoepidermoid carcinomas were early stage and low grade. These lesions had an excellent prognosis with a control rate of 100%. In contrast, there was a 29% (10/34) failure rate for adenoid cystic carcinoma. The 5-, 10-, and 15-year actuarial survivals for the whole group were 94%, 84%, and 73%, respectively. Our results indicate that for early stage disease, wide local excision may offer patients the chance to avoid the cosmetically and functionally debilitating effects of radical surgery without compromising treatment outcome. Adjuvant radiation therapy appears to reduce the local recurrence for those with residual tumor at the surgical margins.
Long-wave ultraviolet light induces phospholipase activation in cultured human epidermal keratinocytes.
Long wave ultraviolet radiation (UVA) has been shown to play an important role in the overall response of skin to solar radiation, including sunburn, tanning, premature aging, and non-melanoma skin cancer. UVA induction of inflammation in human skin is thought to be mediated by membrane lipid derived products. In order to investigate the mechanism of this response we examined the effect of UVA on phospholipid metabolism of human epidermal keratinocytes in culture. Keratinocytes were grown in serum free low calcium medium. The cells were prelabeled with [3H] arachidonic acid or [3H] choline and irradiated with UVA (Honle 2002-Hg vapor lamp). Identification and quantitation of specific membrane phospholipid-derived components was achieved using high-performance liquid chromatography, paper chromatography, and radioimmunoassay. UVA resulted in a linear dose dependent release of [3H] arachidonic acid into medium between 1 and 20 joule/cm2. This response was inhibited in an oxygen-reduced environment. The radiolabel released was predominantly free arachidonate and cyclooxygenase metabolites. Cyclooxygenase metabolites prostaglandin E2 and prostacyclin derivative, 6-keto-prostaglandin F1a, were stimulated following UVA irradiation, but the lipoxygenase metabolite, leukotriene B was not detected. Maximal release was measured immediately after irradiation and changed little over 24 h post-irradiation. UVA stimulated an increase of [3H] choline metabolites glycerophosphorylcholine and phosphorylcholine in media extracts suggesting UVA activation of phospholipase C and phospholipase A2 or diacylglyceride lipase.
Self-injury in psychiatric in-patients.
Suicide and self-injury in-patients were identified on the basis of a retrospective content analysis of special incidence reports completed the preceding year at an urban state psychiatric hospital. Select clinical and biodemographic variables were then examined, and in order to determine the importance of these variables in the prediction of incident severity, a multiple regression analysis was performed. Schizophrenic patients were found to be significantly over-represented among both the self-injury and suicide patients.
Apnea-onset definition significantly affects pneumogram results.
Pneumogram (PG) scoring methods have not been standardized. To determine the extent to which varying definitions for apnea-onset and apnea-termination will result in clinically significant differences in calculated apnea density (A6/D%) and periodic breathing, we analyzed 40 randomly selected PGs. All PGs were initially scored using end-expiration (EE) to mark the beginning of each apnea. As the second definition, peak inspiration (PI) was used to identify the onset of each apnea. All apneas greater than or equal to 6 s in duration and all episodes of periodic breathing were identified. The differences between results obtained by each definition were compared by paired t-test. The differences between the EE and PI definitions were statistically significant (p less than 0.01) for A6/D%, periodic breathing, longest apnea, and number of apneas greater than 11 s, with the PI definition consistently resulting in higher values. In summary, calculated PG results are significantly different, both clinically and statistically, depending on the scoring definition utilized for apnea-onset. Although each definition will yield results that are internally consistent, it is crucial that the normative standards used for comparison be derived utilizing the same scoring definition.
Ultraviolet radiation alters choline phospholipid metabolism in human keratinocytes.
Ultraviolet radiation B (UVB-290-320 nm) induces inflammation and hyperproliferation in human epidermis. This response is associated with the recovery from irradiated skin of inflammatory mediators derived from membrane phospholipids. We have previously reported that UVB stimulates the production of such mediators by human keratinocytes (HK) in culture. In these studies we examined the effect of UVB on the metabolism of choline containing phospholipids in HK prelabeled with [3H] choline. UVB (400-1600J/m2) stimulated a dose dependent release of [3H] choline from HK within minutes of irradiation. Examination of media extracts by paper chromatography revealed that the released [3H] choline was predominately in the form of glycerophosphorylcholine. Examination of label remaining in membranes of cells after irradiation by acid precipitation and HPLC revealed that the origin of the released [3H] choline was the membrane phosphatidylcholine/lysophosphatidylcholine. These data support a concept of UVB stimulation of both a phospholipase A (1 or 2) and a lysophospholipase. These UVB induced alterations of HK membrane phospholipid metabolism likely have profound effects on UVB-induced inflammation and control of cell growth in human skin.
Social gaze, social avoidance, and repetitive behavior in fragile X males: a controlled study.
Preference for social gaze as well as the percentage occurrence of social gaze, nonverbal social avoidance, and nonverbal repetitive behaviors were examined in autistic and nonautistic prepubertal males with the fragile X syndrome (fra[X]) during social interaction with a parent or stranger. Comparison groups were nonhandicapped, Down syndrome, atypical pervasive developmental disorder, and autistic males. The subjects with fra(X) and the nonhandicapped and Down syndrome control subjects discriminated parent from stranger as evidenced by their avoidance behavior. The overall percentage of avoidance was higher, however, for both parent and stranger, among the males with fra(X). Autistic and atypical groups without fra(X) failed to discriminate parent from stranger in their avoidance behavior. Possible explanations for these group differences in terms of language level or degree of language demand were ruled out. Implications for research concerning the relations among fra(X), autism, and mental retardation were discussed.
Parents' views about having a child after a SIDS death.
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Salivary gland tumors of the palate: the UCLA experience.
A retrospective review of 38 patients with salivary gland tumors of the palate treated between 1961 and 1984 is presented. The majority of tumors were identified at an early stage. Most (23 of 38 cases) originated over the hard palate. The most common histological type was adenoid cystic carcinoma (22 cases). Twenty-five patients were treated with surgery alone, of whom, three had wide local excision. Thirteen patients received postoperative radiation therapy in addition to surgery. The local control was comparable for surgery alone and combined therapy (88% and 85%, respectively) although the combined therapy group was biased by more advanced disease, inadequate margins, and/or poorly differentiated histologies. Mucoepidermoid lesions had an excellent prognosis with local control of 100%. In contrast, there was a 23% recurrence rate for adenoid cystic carcinoma. Regional neck node metastasis was noted in 2% of the patients. This experience indicates that radical resection of palate salivary gland malignancy with adequate margins results in excellent local control. Adjuvant radiation therapy is recommended in cases where there is a question of adequate margins and in advanced lesions of high grade tumors.
Speech-language and the fragile X syndrome: initial findings.
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Benoxaprofen photosensitization of phospholipase activation in mammalian cells in culture.
Benoxaprofen (BPF) induces a clinical photosensitivity which resembles idiopathic solar urticaria. This response is mediated by degranulation of mast cells. Since mast-cell degranulation is known to be modulated by phospholipid alteration, we examined the effect of BPF and ultraviolet radiation (UV) on phospholipid metabolism of C3H 10 T1/2 cells in culture. BPF + UVB (280-320 nm) induced release of [3H]arachidonic acid (AA) but did not alter the release of [3H]choline from prelabelled cells. This suggests that BPF photosensitizes phospholipase A2 activation. Such activation probably represents an integral step in the mechanism of BPF photosensitization of mast-cell degranulation.
The effect of 12-O-tetradecanoylphorbol-13-acetate (TPA) on phospholipid metabolism of human epidermal keratinocytes in culture.
The tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) stimulated the release of [3H]choline from prelabelled membrane phospholipids of cultured keratinocytes obtained from normal human skin. In contrast, TPA in the concentration range of 10(-12) to 10(-6) g/ml failed to induce deacylation of [3H]arachidonic acid or stimulate [3H]prostaglandin production in prelabelled keratinocytes. In addition, TPA did not induce [3H]choline incorporation into the membrane phospholipids of these cells. The previously reported inability of TPA to stimulate a proliferative response in these cell cultures may be related to the resistance of these cells to TPA-induced alterations of arachidonate metabolism.
Major salivary gland tumors: treatment results and prognostic factors.
A retrospective review of 133 patients with major salivary gland carcinomas treated between 1955 and 1981 is presented. The majority of cases (104) originated in the parotid gland. The most common histological type was mucoepidermoid carcinoma (39 cases). Tumor-free interval was longest for patients with acinic cell and mucoepidermoid carcinomas. In contrast, adenoid cystic carcinoma was poorly controlled, regardless of the form of treatment. Initial control of primary major salivary gland tumors was inversely related to the presence of disease at the surgical margins. In cases with microscopic or gross disease at the surgical margins, postoperative radiation therapy controlled the tumor locally in 18 of 26 patients (69%). Postoperative radiation therapy was generally used only in cases with high-grade histologies, advanced stages, or positive surgical margins. Of the patients treated with surgery alone, 53% achieved local control, as compared to 75% of the group which received postoperative radiation therapy. Although the difference was not statistically significant, we would have expected the combined therapy group to have a lower control rate due to more advanced disease. There was a low salvage rate (22%) and a high incidence of distant metastasis (60%) in recurrent cases. The data indicates that complete surgical resection results in the best local control, with or without adjuvant radiation. When the surgical margin is inadequate and re-excision not possible, adjuvant radiation therapy appears to have a role to optimize local control and survival.
Home pneumograms in normal infants.
To obtain age-specific normative data, we performed home cardiorespiratory recordings (pneumograms) in 56 normal infants at 1 month of age. A repeat pneumogram was performed at 3 months in 39 infants. Total sleep time was determined and all sleep intervals were summed and analyzed for five respiratory pattern variables: frequency of all apneic episodes greater than or equal to 6 seconds in duration (A6/D%), periodic breathing, longest apneic episode, and number of episodes greater than 11 and greater than 15 seconds. The normal infants at 1 and at 3 months were compared with 66 patients with apnea of infancy. Median A6/D% was 0.1 in the normal infants at 1 and 3 months, compared with 0.64 in those with apnea of infancy (P less than 0.001). Median periodic breathing was 0.4 and 0.2 episodes per 100 minutes in the normal infants at 1 and 3 months, respectively, compared with 1.25 in infants with apnea of infancy (P less than 0.001). Median longest apneic episode was 8.0 seconds in the normal infants at 1 and 3 months, compared with 11 seconds in those with apnea of infancy (P less than 0.001). No normal infant had an apneic episode greater than 15 seconds in duration, whereas the group with apnea of infancy had 0.4 +/- 1.0 episodes of apnea of greater than 15 seconds (P less than 0.01). Despite these significant group differences, use of these respiratory patterns either alone or in combination permitted only about 80% correct classification of normal infants and those with apnea of infancy.
Respiratory patterns during sleep and temperament ratings in normal infants.
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Ultraviolet radiation stimulates the release of arachidonic acid from mammalian cells in culture.
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