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Biomedical subjects

D Sullivan

Publications and source records attributed to D Sullivan.

At least 109 records · Page 6Linked to original sources
PubMed1989

Effect of thermal injury in the rat on transfer of IgA protein into bile.

Severe thermal injury is associated with bacterial sepsis; the intestine is considered a likely source of invasive organisms. Because IgA antibody in bile accounts for much of the specific immune defense of the upper intestinal tract in the rat, the effect of thermal injury on the quantity of IgA protein in bile was examined. Sprague-Dawley rats received a 20% to 30% body surface area burn under anesthesia. Eighteen hours later the common bile duct was cannulated and bile was collected for three hours. Total IgA protein in bile decreased 90% after thermal injury. The bile volume, the concentration of bile protein, and free secretory component did not change significantly. Although blood flow to the liver 18 hours after thermal injury was not changed, there was a significant reduction in total IgA concentration in the circulation; both monomeric (m-IgA) and polymeric IgA (p-IgA) were decreased. This finding may explain, in part, the reduced concentration of IgA protein in bile. Although not examined in this study, decreased local hepatic synthesis and/or transport of p-IgA across the hepatocyte may also contribute to the reduced IgA levels in bile.

Animals↗
PubMed1988

Hyperlipidemia as a biochemical basis of magnetic resonance plasma test for cancer.

An increase in the plasma levels of apoprotein B-containing lipoproteins is the basis of the magnetic resonance (MR) test for cancer. The narrow MR line width reported by Fossel and co-workers to be associated with the presence of malignant disease is due to a relative increase of very low density lipoprotein. In contrast, the plasma from healthy controls, which has a much broader spectrum, has a higher proportion of high density lipoprotein. However, plasma from patients with hyperlipidemia unrelated to cancer also show narrow MR line widths and are therefore a confounding variable. We used magnetic resonance spectroscopy (MRS) to assess the plasma from 253 patients with a range of lipid related diseases and cancer, and 28 controls. A significant difference (p less than or equal to 0.0005) of 10 Hz exists between the mean line width of the controls and hyperlipidemics without malignant disease. However, in patients with solid tumours a difference of 7 Hz (p less than or equal to 0.0005) in the mean values is recorded although there is an overlap of 6 Hz compared with the controls. Moreover the MRS method was not found to distinguish patients with lymphomas from the control population. The index was not found to be related to patient age or tumour burden.

Adult↗
PubMed1988

Opportunistic health promotion: do patients like it?

In a five doctor general practice 100 adults attending routine surgeries were given questionnaires to assess the influence of discussing health promotion on their satisfaction with the consultation. Health promotion topics were discussed in 74% of the 86 consultations analysed. Of these consultations, blood pressure was mentioned in the largest number (48%) and breast self-examination in the smallest (6%). Patient satisfaction was not significantly influenced by the inclusion or omission of such topics. The highest mean satisfaction score was for those discussing smoking and the lowest for those discussing alcohol. Most patients (84%) found discussion of health promotion helpful and felt comfortable (62%); only two patients felt uncomfortable doing so.

Adolescent↗
PubMed1988

The Nucleic Acid Blot Analyzer II. ANALYZE, an image analysis software package for molecular biology.

The Nucleic Acid Blot Analyzer, a new instrument providing high-speed imaging of 32P labeled nucleic acids, captures, stores and presents images in digital form, thus lending itself to rapid data handling and analysis as well as replacing conventional X-ray film autoradiography for many applications. A software package called ANALYZE has been specifically designed for the instrument in order to provide automatic or semi-automatic analysis for molecular biological techniques. The software includes image display manipulation, quantitative and positional analysis, as well as file maintenance utilities. The specific application of the software/hardware to various techniques is presented.

Molecular Biology↗
PubMed1988

A continuing education program for nurse practitioners in ambulatory care.

Continuing education should be an integral part of all health care providers' practice. This article discusses the recognition of this need by a group of nurse practitioners in an acute ambulatory care center. The process undertaken in developing the program of continuing education is described. The program outline can serve as a model for other NPs in similar settings.

Ambulatory Care↗
PubMed1987

Gross cystic disease of the breast.

The aetiology of fibrocystic disease of the human breast remains problematical. While oestrogens may cause cystic lesions and epithelial proliferation in the mammary glands of experimental animals and certain progestogens (chlormadinone acetate and medroxyprogesterone acetate) may induce severe myoepithelial hyperplasia in beagles, the classical oral contraceptives (oestrogens and progestogens) reduce the incidence of fibrocystic breast disease in women. The role of prolactin in human breast disease is far from clear despite the fact that in rodents mammary tumors fail to develop following oestrogen administration in the absence of prolactin. Because women with gross cystic disease of the breast are at four times greater risk of developing malignant breast disease, it is felt that the administration of courses of danazol, an impeded androgen derived from the progestin, 17 alpha-ethinyl testosterone, has proved effective in lessening fibrocystic disease of the breast, frequently obviating the need for breast biopsy. The study of the hormonal content of fluid aspirated from gross breast cysts should help elucidate the pathophysiology of breast disease. Breast cyst fluid is rich in androgens, particularly dehydroepiandrosterone sulfate; concentrations of polypeptide hormones like FSH, LH, TSH, PRL, and calcitonin are invariably present sometimes in less and at other times in greater amounts than that found in plasma. Of particular interest is the finding of measurable levels of beta-hCG in cyst fluid but not in the serum. The question arises whether the beta-hCG is biologically active or are the assay values merely the expression of radioimmunoassayable components? Preliminary (as yet unpublished) studies reveal excellent bioactivity as measured by testosterone production in Leydig cell cultures. Time will tell whether elevated levels of bioactive beta-hCG portend neoplastic potential.

Aged↗
PubMed1986

Alpha-2-adrenergic control of prolactin release.

The role of the alpha 2-adrenergic system in regulating prolactin release has been studied in vivo in male rats. Yohimbine administration alone, at doses ranging from 0.2 to 5.0 mg/kg, resulted in a dose-related elevation of plasma prolactin levels from a basal level of 8 +/- 2 to 65 +/- 6 ng/ml at the highest dose. In the same experiment clonidine, 0.2 mg/kg, suppressed basal prolactin levels to 4 +/- 1 ng/ml and returned prolactin levels of all animals receiving 0.2-5.0 mg/kg yohimbine to basal levels. Rats were treated with increasing doses of clonidine (0.05-1.0 mg/kg) in the presence or absence of a constant dose (1.0 mg/kg) of yohimbine. Clonidine alone at doses of 0.05 and 0.2 mg/kg again significantly suppressed prolactin levels, while a dose of 1.0 mg/kg did not (failure of high dose clonidine to suppress prolactin levels suggests an additional effect of clonidine on prolactin secretion unrelated to alpha 2-adrenergic agonist action). All three doses of clonidine completely reversed yohimbine-induced prolactin release. Basal prolactin levels were also significantly reduced by the selective alpha 2-adrenergic agonist UK-14,304 at a dose of 0.2 mg/kg. Yohimbine-induced prolactin release was reversed by UK-14,304 at doses of 0.2 and 1.0 mg/kg, but not at the lowest dose studied, 0.05 mg/kg. The lower potency of UK-14,304 than clonidine in this assay is consistent with the lower potency of UK-14,304 as an alpha 2-adrenergic-agonist antihypertensive agent. Several alpha 2-antagonists in addition to yohimbine were studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

Licensed lay midwifery and the medical model of childbirth.

Previous research has tended to equate lay midwifery with demedicalized care. This paper analyzes how licensed lay midwives in Arizona have been pressured towards a more medical model of childbirth. Licensing has affected midwives' beliefs and practices through increasing their exposure to medical definitions of childbirth and making them legally accountable to the medically dominated State Department of Health Services. The midwives' cumulative experience with handling obstetrical problems has also affected their definitions of childbirth. The midwives have maintained a commitment to holistic care, but have moved towards a more hierarchical style of practice due to changes in their clientele, the need for efficient bureaucratic arrangements, and the desire to earn a living at midwifery.

Arizona↗
PubMed1985

The vulnerable child syndrome: fact and theory.

Studies which have evaluated parent-child relationships following a life-threatening event indicate that parents and children have subsequent interactional difficulties. This study sampled a group of 17 mothers who gave birth to a low birth weight infant (mean weight 1260 grams) and compared them to 17 mothers of normal infants matched for age, education and marital status. The mothers were studied at the infant's adjusted chronological age of 12 to 18 months. At that time all infants were developing normally as determined by the Denver Prescreening Questionnaire. The results indicated that mothers of low birth weight infants did not demonstrate any greater degree of depression or over-protection than their matched controls. The findings of this preliminary study suggest the need for reassessing the relationship between prematurity and other life-threatening events and the psychological sequelae associated with the vulnerable child syndrome. Previous studies are reviewed, and their methodologies are discussed.

Adolescent↗
PubMed1984

Evolution of obesity in young people in Busselton, Western Australia.

The height and weight measurement of 928 young people of Busselton were collected over a period of up to 11 years. The prevalence of obesity was low in early childhood and increased progressively through adolescence and adulthood, so that 9% of male subjects and 16% of female subjects aged 21 years or over, were obese. The prevalence and degree of obesity were both greater in female subjects than in male subjects. Although most obese young adults were not obese in childhood, 50% of those who were obese between the ages of 9 and 14 years were still obese when examined in young adult life, and were at greater risk of becoming obese adults than were their non-obese peers. Most subjects who subsequently became obese young adults were significantly heavier than their non-obese peers at all ages from the age of 6 years.

Adolescent↗
PubMed1984

Medial restraints to anterior-posterior motion of the knee.

We investigated the motion of cadaver knees before and after section of the medial structures and anterior cruciate ligament. The knees were tested using a 5-degrees-of-freedom in vitro knee-testing apparatus that measured anterior-posterior, medial-hateral, and axial displacement as well as internal-external and valgus-varus rotation. The fiexion angle could be varied but was fixed for each individual test. A 125-newton anterior-posterior force was applied perpendicular to the tibial shaft and the resulting motion of the knee was measured. In five knees the anterior cruciate ligament was cut first, followed by progressive cuts of the structures on the medial side (superficial medial collateral ligament, deep medial ligament, oblique fibers of the superficial medial ligament, and the posteromedial part of the capsule). Conversely, in five knees the medial structures were progressively cut first, followed by section of the anterior cruciate ligament. Tests were performed after each cut. With an intact anterior cruciate ligament, progressive cutting of the medial side had no effect on anterior and posterior displacements. When section of the medial structures followed cutting of the anterior cruciate ligament, anterior displacement exceeded that seen after isolated section of the anterior cruciate ligament. The anterior and posterior load-tests were repeated with the tibia fixed in 5 degrees of internal and 5 degrees of external rotation. Fixed external notation had no effect on anterior and posterior displacements. Fixed internal rotation significantly decreased anterior displacement only when both the anterior cruciate ligament and the medial structures were cut. The amounts of tibial rotation and tibial torque resulting from the applied anterior and posterior forces were low compared with our previous results, and we attributed this to decreased constraints on motion of the knee in the current testing apparatus. CLINICAL RELEVANCE: Athletic injuries of the knee frequently involve both the anterior cruciate ligament and the medial side of the knee. Clinical studies have demonstrated that combined injuries of the anterior cruciate and medial collateral ligaments often cannot be successfully managed conservatively. Our in vitro findings support the clinical data and suggest that injuries to the medial structures further compromise anterior stability when they accompany anterior cruciate injuries.

Adult↗
PubMed1983

Lymphoscintigraphy for malignant melanoma. Surgical considerations.

Lymphoscintigraphy using technetium-99m atimony sulfur colloid was performed in 22 patients with melanoma referred to Duke University Comprehensive Cancer Center in an attempt to identify patterns of regional lymphatic drainage. Scans from six patients revealed lower extremity lesions with three located below the knee, one in the popliteal space, and two others proximal to the knee joint. Despite the location of the primary, all scans but one showed initial drainage to the inguinal nodes bypassing the popliteal lymph node group. Of the three patients who had primary melanoma of the posterior scalp, the lymphatic drainage was directed to the posterior cervical nodes. No drainage to the parotid nodes or anterior neck nodes was visualized. The knowledge gained from lymphoscintigraphy resulted in posterior neck dissections instead of the standard anterior neck dissection and superficial parotidectomy. In areas of ambiguous lymphatic drainage from the trunk, radiocolloid scanning can identify areas at risk for developing metastatic disease. Six lesions within 5 cm of the midline demonstrated bilateral axillary or groin drainage in 83 per cent of the patients. For two lesions near Sappey's line colloidal uptake to the ipsilateral axilla and groin was the rule. After a 3-year follow-up, during which time 70 to 90 per cent of lymph node metastases are predicted to occur, no nodal metastases were ever documented in areas that did not show colloidal uptake. No correlation was found between amount of radiolabel in positive compared to negative nodes, although those nodes that were completely replaced by tumor contained no 99mTc activity and were negative on scanning.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

Hospital payroll costs, productivity, and employment under prospective reimbursement.

This paper reports preliminary findings from the National Hospital Rate-Setting Study regarding the effects of State prospective reimbursement (PR) programs on measures of payroll costs and employment in hospitals. PR effects were estimated through reduced-form equations, using American Hospital Association Annual Survey data on over 2,700 hospitals from 1969 through 1978. These tests suggest that hospitals responded to PR by lowering payroll expenditures. PR also seems to have been associated with reductions in full-time equivalent staff per adjusted inpatient day. However, tests did not confirm the hypothesis that hospitals reduce payroll per full-time equivalent staff as a result of PR.

Cost Control↗
PubMed1981

An analysis of the effects of prospective reimbursement programs on hospital expenditures.

Prospective reimbursement (PR) programs attempt to restrain increases in hospital expenditures by establishing, in advance of a hospital's fiscal year, limits on the reimbursement the hospital will receive for the services it provides to patients. We used data complied from a sample of approximately 2700 community hospitals in the U.S. for each year from 1969 to 1978 to estimate the effects of prospective reimbursement programs on hospital expenditures per patient day, per admission, and, to a lesser extent, per capita. The statistical evidence indicates that some PR programs have been successful in reducing hospital expenditures per patient day, per admission, and per capita. Eight programs--in Arizona, Connecticut, Maryland, Massachusetts, Minnesota, New Jersey, New York, and Rhode Island--have reduced the rate of increase in expenses by 2 percentage points or more per year and, in some cases, by as much as 4 to 6 percentage points. There are indications, although less strong, that PR programs also reduced expenses in Indiana, Kentucky, Washington, western Pennsylvania, and Wisconsin. There are no indications of cost reductions for programs in Colorado and Nebraska. An analysis of the relative effectiveness of the various programs suggests that mandatory programs have a significantly higher probability of influencing hospital behavior than do voluntary programs. Some voluntary programs, however, are shown to be effective.

Analysis of Variance↗