Immunohistochemical detection of protein kinase C-beta (PKC-beta) in tumour specimens of patients with non-small cell lung cancer.
Explore the source record for details and available documents.
Aged↗
Biomedical subjects
D Thornton
Publications and source records attributed to D Thornton.
Risk adjustment of Florida mental health outcomes data: concepts, methods, and results.
This article discusses outcome evaluation systems for mental health programs. It reviews and critically evaluates design and analysis methods for strengthening the validity of such uncontrolled comparisons. The article examines methods for statistically adjusting preexisting groups, now referred to as risk adjustment or case-mix adjustment, and offers guidelines for determining when this procedure is appropriate. Then, analyses on two dependent variables--a global rating of functioning and a consumer satisfaction measure--available from an outcomes evaluation system currently underway in Florida are used to demonstrate the proposed method of risk adjustment. Results for 24 providers of mental health services showed that while risk adjustment only made a small difference in the overall provider rankings, the ranking of some specific providers changed considerably. The article concludes with a discussion of the implications of this research.
Adult↗
Australian high-dose-rate brachytherapy protocols for gynaecological malignancy.
There is no consensus over the optimal dose fractionation schedules for high-dose-rate (HDR) brachytherapy used for gynaecological malignancy. In Australian public hospital departments of radiation oncology, HDR brachytherapy for gynaecological cancer is being more commonly used. A survey of public departments that are using this technology, or that plan to introduce this technology, was performed. Their current protocols are presented. In general, protocols are similar biologically; however, the practical aspects such as the number of fractions given do vary and may reflect resource restrictions or, alternatively, differences in interpretations of the literature and of the best protocols by clinicians.
Australia↗
Treatment of sexual offenders who are in categorical denial: a pilot project.
This paper describes an approach to treatment for sexual offenders who are in categorical denial. Other efforts to have them, at least partially, admit responsibility had failed and they were to be released from prison without any treatment. Evidence that suggests denial is not predictive of risk and that treatment may reduce the risk of these offenders is reviewed. Essentially, this paper offers a possible approach to dealing with these intractable deniers which, it is suggested, is better than not trying to modify their risk, and that may prove to be effective.
Adaptation, Psychological↗
Dosimetric improvements following 3D planning of tangential breast irradiation.
PURPOSE: To evaluate the dosimetric difference between a simple radiation therapy plan utilizing a single contour and a more complex three-dimensional (3D) plan utilizing multiple contours, lung inhomogeneity correction, and dose-based compensators. METHODS AND MATERIALS: This is a study of the radiation therapy (RT) plans of 85 patients with early breast cancer. All patients were considered for breast-conserving management and treated by conventional tangential fields technique. Two plans were generated for each patient. The first RT plan was based on a single contour taken at the central axis and utilized two wedges. The second RT plan was generated by using the 3D planning system to design dose-based compensators after lung inhomogeneity correction had been made. The endpoints of the study were the comparison between the volumes receiving greater than 105% and greater than 110% of the reference dose, as well as the magnitude of the treated volume maximum dose. Dosimetric improvement was defined to be of significant value if the volume receiving > 105% of one plan was reduced by at least 50% with the absolute difference between the volumes being 5% or greater. The dosimetric improvements in 49 3D plans (58%) were considered of significant value. Patients' field separation and breast size did not predict the magnitude of improvement in dosimetry. CONCLUSION: Dose-based compensator plans significantly reduced the volumes receiving > 105%, >110%, and volume maximum dose.
Breast Neoplasms↗
The biochemical characterization of aggrecan from normal and tibial-dyschondroplastic chicken growth-plate cartilage.
Tibial dyschondroplasia (TD) is a disorder of endochondral ossification characterized by the presence of an avascular, non-mineralized cartilage lesion extending from the growth plate into the metaphysis. Cells within the TD growth plate fail to differentiate to full hypertrophy, and instead appear to maintain a 'pre-hypertrophic' or 'transitional' status. Studies of the expression and distribution of cartilage matrix macromolecules in the TD growth plate have shown a marked decrease in the levels of aggrecan in the TD matrix. In the present study we compared the biochemical characteristics of the aggrecan molecules extracted from normal epiphyseal and TD cartilage. We have shown three major differences between normal and TD cartilage aggrecan. These are: (1) increase in molecular mass; (2) increase in the number of keratan sulphate chains; and (3) difference in the pattern of sulphation in TD aggrecan. Such changes in biochemical characteristics of the aggrecan monomers in TD cartilage may be associated with the lack of mineralization of the diseased cartilage. The present study provides a basis for further investigations into the importance of proteoglycans in normal and pathological bone development.
Aggrecans↗
Psychopathy and the predictive validity of the PCL-R: an international perspective.
Its controversial past notwithstanding, psychopathy has emerged as one of the most important clinical constructs in the criminal justice and mental health systems. One reason for the surge in theoretical and applied interest in the disorder is the development and widespread adoption of reliable and valid methods for its measurement. The Hare PCL-R provides researchers and clinicians with a common metric for the assessment of psychopathy, and has led to a surge in replicable and meaningful findings relevant to the issue of risk for recidivism and violence, among other things. Most of the research thus far has been based on North American samples of offenders and forensic psychiatric patients. We summarize this research and compare it with findings from several other countries, including England and Sweden. We conclude that the ability of the PCL-R to predict recidivism, violence, and treatment outcome has considerable cross-cultural generalizability, and that the PCL-R and its derivatives play a major role in the understanding and prediction of crime and violence.
Antisocial Personality Disorder↗
Improving risk assessments for sex offenders: a comparison of three actuarial scales.
The study compared the predictive accuracy of three sex offender risk-assessment measures: the RRASOR (Hanson, 1997), Thornton's SACJ-Min (Grubin, 1998), and a new scale, Static-99, created by combining the items from the RRASOR and SACJ-Min. Predictive accuracy was tested using four diverse datasets drawn from Canada and the United Kingdom (total n = 1301). The RRASOR and the SACJ-Min showed roughly equivalent predictive accuracy, and the combination of the two scales was more accurate than either original scale. Static-99 showed moderate predictive accuracy for both sexual recidivism (r = 0.33, ROC area = 0.71) and violent (including sexual) recidivism (r = 0.32, ROC area = 0.69). The variation in the predictive accuracy of Static-99 across the four samples was no more than would be expected by chance.
Actuarial Analysis↗
Phase II study of the multitargeted antifolate LY231514 (ALIMTA, MTA, pemetrexed disodium) in patients with advanced pancreatic cancer.
PURPOSE: To determine the safety and activity of LY231514 (ALIMTA, MTA, pemetrexed disodium, Eli Lilly and Co., Indianapolis, IN) in chemotherapy-naïve patients with advanced pancreatic cancer. PATIENTS AND METHODS: Patients with unresectable or metastatic pancreatic cancer received LY231514 600 mg/m2 as a 10-minute infusion every three weeks. RESULTS: Forty-two patients were enrolled in this phase II trial. The median age was 60.3 (range 37-77) years; 79% had metastatic disease. Neutropenia was common (40% of patients > or = grade 3) but infectious complications were rare. Significant anemia or thrombocytopenia occurred in < 20% of patients. Non-hematologic toxicities included grade 2 or 3 skin reaction which was ameliorated by dexamethasone. Elevations of bilirubin or transaminases were infrequent (< 25% of patients) and did not require dose reductions or treatment delays. Thirty-five patients received two cycles of therapy and were evaluable for response. One complete (duration 16.2 months) and one partial (duration 6.9 months) were observed resulting in an objective response rate of 5.7% for evaluable patients. In addition, 17 patients (40%) had stable disease that lasted > or = 6 months in 5 patients. The median survival was 6.5 months, with 28% of patients alive at one year. CONCLUSIONS: LY231514 is a well-tolerated agent with minimal objective antitumor activity in pancreatic cancer. The median and one year survival times, which may be important indicators in phase II trials of new agents, are of interest. Combination trials of LY231514 in pancreatic cancer are planned.
Adenocarcinoma↗
Mantle planning: report of the Australasian Radiation Oncology Lymphoma Group film survey and consensus guidelines.
The purpose of the present paper was to measure the variation in mantle planning in Australia and New Zealand. A chest X-ray (CXR) of a patient in the supine position with a neck node marked by wire was sent to every radiation oncologist in Australia and New Zealand. They were to mark on the CXR the lung blocks that they would use to treat this patient, assuming that the patient had stage IA Hodgkin's disease. These marks were compared with a small sample of radiologists who were asked to define the mediastinum on the same CXR. Radiation oncologists were also asked to complete a short questionnaire about other modifications to their treatment fields and their experience with this technique. One hundred and six films were sent out and 44 radiation oncologists replied. There was a maximum variation in the placement of their lung blocks of 6 cm. Half of the lung blocks were within a 2-cm range. One respondent said they would not use a mantle field to treat this patient. Mediastinal coverage was inadequate in at least 50% of cases. There was a very large variation in mantle field planning practices within Australia and New Zealand. For this reason Australasian Radiation Oncology Lymphoma Group has produced consensus guidelines for mantle block design. These are appended to the present paper.
Australia↗
Does the disbursement of income increase psychiatric emergencies involving drugs and alcohol?
OBJECTIVE: To determine if the incidence of psychiatric emergencies involving drugs or alcohol supports the argument that mentally ill persons contribute to elevated mortality during the days following disbursement of private earnings and public income transfers. STUDY DESIGN: Interrupted time-series using Box-Jenkins methods. DATA COLLECTION/EXTRACTION METHODS: Daily counts of adults admitted to psychiatric emergency services in San Francisco after using drugs or alcohol were derived from medical records for the period January 1 through June 30, 1997. PRINCIPAL FINDINGS: Psychiatric emergencies among males who had used drugs or alcohol were elevated in the early days of the month. Such emergencies among females were not similarly elevated. Emergencies among females who had not used drugs or alcohol were elevated in the early days of the month. CONCLUSION: Elevated mortality in the first week of the month may be attributable, in part, to the "check effect" or use of drugs and alcohol by mentally ill males in the days after they receive income. The contribution of women is more complex and may be induced by drug or alcohol abuse among persons in their social networks. The check effect suggests that persons with a history of substance abuse and mental illness should be offered the opportunity to have their income managed by someone who can monitor and influence how the money is being spent. The fact that drug- or alcohol-related admissions among males exhibit temporal patterns suggests that the provision of preventive as well as treatment services may be strategically scheduled.
Adult↗
Following the electronic trail.
How can you protect patient information while maintaining immediate access for qualified employees? HIM professionals across the country are taking leadership roles in developing and managing audit trails for computerized health information. Here are a few of their success stories.
Computer Security↗
Osteolymphoma (primary bone lymphoma): an Australian review of 70 cases. Australasian Radiation Oncology Lymphoma Group (AROLG).
BACKGROUND: To examine prognostic factors, treatment outcomes and design future studies for Osteolymphoma (OL)--also known as primary bone lymphoma. METHODS: Between 1979 and 1993, 70 patients with OL were treated in nine Australian centres. The effect of patient-, tumour-, and treatment-related factors on local control, distant disease-free survival and overall survival were assessed by multivariate analysis. RESULTS: Most patients (94%) received radiotherapy (RT) (median dose 40 Gy) and 56% received chemotherapy. Multifocal disease was present in 20% of patients. The five year rates of overall survival and local control were 59% and 82%. Although there was a trend towards better results with the addition of chemotherapy, on multivariate analysis, there were no factors identified which appeared to impact upon overall and disease-free survival. Among the distant recurrences, there was a high proportion in bone (33%). Six patients suffered pathological fractures after treatment. CONCLUSION: High rates of local control were achieved by RT, but the overall survival remains relatively poor, worse than nodal lymphoma. The natural history of the disease suggests that OL may be a distinct entity, different to nodal lymphomas, so the results of clinical trials in nodal lymphoma may not be relevant to OL. Prospective studies could define the outcome of combined modality therapy and set a benchmark for testing further proposals, as well as improving our knowledge of the clinical features of OL.
Adult↗
Particle nucleation in the tropical boundary layer and its coupling to marine sulfur sources
New particle formation in a tropical marine boundary layer setting was characterized during NASA's Pacific Exploratory Mission-Tropics A program. It represents the clearest demonstration to date of aerosol nucleation and growth being linked to the natural marine sulfur cycle. This conclusion was based on real-time observations of dimethylsulfide, sulfur dioxide, sulfuric acid (gas), hydroxide, ozone, temperature, relative humidity, aerosol size and number distribution, and total aerosol surface area. Classic binary nucleation theory predicts no nucleation under the observed marine boundary layer conditions.
Journal Article↗
Tangential irradiation of the intact breast: the ABC of the technique.
This paper describes in detail the setup of breast irradiation using an isocentric tangential technique. This setup method does not require any special devices or calculations beyond simple arithmetic. We will discuss some of the practical problems and pitfalls that result from the oblique incidence of the radiation beams and the slope of the chest wall and provide possible solutions.
Breast Neoplasms↗
Adequate irradiation of the internal jugular lymph node chain: technical considerations.
PURPOSE: This research aimed to study the anatomic relationship between the internal jugular vein with the surrounding internal jugular lymph node chain and the underlying bony anatomical structures which are commonly used as landmarks for radiation therapy planning. METHODS AND MATERIALS: Twelve patients with carcinoma of the head and neck region were studied prospectively. Using our three-dimensional planning system, a beam's-eye view of the internal jugular vein was projected onto a lateral and anterior simulation film. Quantitative measurements were made in every case of the anatomic relationship between the internal jugular vein and the posterior border of the cervical vertebrae and sagittal midline. RESULTS: The distance between the posterior border of the internal jugular vein and the posterior border of the cervical vertebrae ranged between 0 and 2.5 cm. The distances between the sagittal midline and the medial border of the internal jugular veins ranged between 2 and 4 cm. CONCLUSION: To ensure adequate irradiation of the internal jugular lymph nodes, the posterior border of the lateral radiation therapy upper-neck fields should be placed at least 1 cm posterior to the posterior aspect of the cervical vertebrae. The midline block used in the lower neck anterior field should not exceed 2 cm in width.
Cervical Vertebrae↗
Clear the floor! Five steps to better-looking (and safer) corridors.
Explore the source record for details and available documents.
Floors and Floorcoverings↗
Regulation of murine osteoblast macrophage colony-stimulating factor production by 1,25(OH)2D3.
Macrophage colony stimulating factor (MCSF) is important for formation of osteoclasts. We investigated the ability of 1,25(OH)2D3 to regulate osteoblast production of MCSF. Mouse calvarial osteoblasts were cultured for 2 days +/- 1,25(OH)2D3. Since 1, 25(OH)2D3 decreased osteoblast proliferation by 17.6 +/- 1% at 10 nM and 11 +/- 4% at 1 nM, the effect of growth rate on MCSF secretion was examined. Limiting cell proliferation by serum did not affect MCSF production. 1,25(OH)2D3 (1 nM) increased MCSF production (U/10(5) cells) maximally by 68 +/- 33% (n = 3) with an ED50 for 1, 25(OH)2D3 of 5 x 10(-11) M. To investigate effects of 1,25(OH)2D3 on MCSF gene regulation, RT-PCR primers were designed to identify the mRNA coding for the membrane-bound isoform of MCSF. Simultaneous RT-PCR of glyceraldehyde-phosphate dehydrogenase (GAP) allowed semiquantitative assessment of MCSF mRNA between treatment groups expressed as the MCSF/GAP RT-PCR product ratio; both MCSF and GAP (+) primers were labeled with 32P-ATP for phosphorimage quantitation. The membrane-bound MCSF/GAP PCR product ratio was not affected by proliferative rate when growth was limited by [serum]. The MCSF/GAP RT-PCR product ratio was dose dependently increased by 1,25(OH)2D3, maximally at 1 nM at 2.2 +/- 0.2 = fold (n = 10). 1,25 (OH)2D3 also increased the expression of an RT-PCR MCSF/GAP product ratio which represented the secreted isoform of MCSF. The ability of 1,25(OH)2D3 to pretranslationally regulate expression of membrane-bound osteoblast MCSF may be important in osteoblast:osteoclast interactions.
Animals↗