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Biomedical subjects

G L Adams

Publications and source records attributed to G L Adams.

At least 55 records · Page 3Linked to original sources
PubMed1990

The effects of adverse growth conditions on the shedding of carcinoembryonic antigen from cultured LS180 colon cancer cells.

The synthesis and release of the tumor marker carcinoembryonic antigen (CEA) from the colon cancer cell line LS180 has previously been reported to be enhanced during the later stages of in vitro culture after growth has stopped. It has been suggested that CEA expression was inversely related to the growth rate for these cells (Kahan, B.D.; Rutzky, L.P.; Legrue, S.J.; Tom, B.H. Methods Cancer Res. 18:197-275; 1979 and Shi, Z.R.; Tsao, D.; Kim, Y.S. Cancer Res. 43:4045-4049; 1983). Our studies indicate, however, that while certain environmental perturbations that halt growth (e.g., glucose starvation and elevated temperatures) do indeed stimulate CEA expression and release; other growth-arresting conditions, such as oxygen starvation, have no effect. Replacement of spent or conditioned medium with fresh medium during the later culture stages resulted in a 10-fold decrease in CEA release, indicating that either depleted nutrients or accumulating cellular products (such as lactate or ammonium) trigger enhanced CEA production.

Carcinoembryonic Antigen↗
PubMed1989

Treatment of head and neck cancer with combined modalities.

Patients with advanced epidermoid carcinoma of the head and neck are often treated with combinations of radiation therapy and surgery. Patients with more advanced malignancies may also receive adjuvant chemotherapy. Prospective randomized protocols provide the most effective means of determining the value of combined modalities versus a single modality only. Preoperative assessment includes direct visualization, palpation, endoscopy and, in selected incidents, CT or MRI scanning. CT scan may provide objective evidence of tumor response when preoperative adjuvant treatment, either as radiation or chemotherapy, is given.

Combined Modality Therapy↗
PubMed1987

Retention of Hispanics in public sector mental health services.

Hispanic underutilization of mental health facilities extends to lowered retention rates among the chronically mentally ill. A theoretical model of retention was developed with four domains of variables: personal traits, accessibility of social support, treatment characteristics, and facility characteristics. Using data collected from CMHC clinical charts in 1983 and 1984, the model was tested using multiple regression and commonality analysis. The model was tenable (R = .59). However, the commonality analysis suggested that most of the unique variance was contributed by the treatment domain. The social support domain made negligible unique contribution. Implications of the model are discussed.

Affective Disorders, Psychotic↗
PubMed1987

"Emergency" laryngectomy and stomal recurrence.

The data on 281 patients who underwent surgical therapy for laryngeal carcinoma from 1976 through 1984 were reviewed, revealing 16 patients who presented with an impending obstruction of the airway that was treated by an "emergency" laryngectomy. A review of the patients in our series did not reveal any serious complications from the procedure and it has allowed effective management of these advanced neoplasms. In addition, 10 patients who developed peristomal recurrences were reviewed. Preoperative factors such as location of lesion, antecedent surgery, and previous radiation therapy were assessed and compared to the patients who underwent "emergency" laryngectomy in an attempt to further define risk factors involved in peristomal recurrence. A strong association with subglottic extension was noted. Also associated in this review was antecedent full-course radiation therapy.

Aged↗
PubMed1986

Cues of disability and treatment continuation of chronic schizophrenics.

Serious questions have arisen concerning the retention of the chronically ill in outpatient community mental health clinics (CMHC). This study tests a model based upon sociological theories of disability and the sick role to explain differential continuation in treatment among schizophrenics. We hypothesized that economic, social and medical cues facilitate a patient's self-definition of disability and contribute to continuation in treatment. Data were collected from the clinical charts of 879 chronic schizophrenic patients at five CMHC's. Hypotheses were tested using OLS multiple regression and logistic regression. Findings indicated level of functioning may be an important explanatory variable. Analysis strongly indicated the efficacy of the medical model in the area of treatment continuation.

Antipsychotic Agents↗
PubMed1985

Mandibular reconstruction with the A-O plate.

At the University of Minnesota and affiliated hospitals several methods of mandibular reconstruction have been used. From October 1978 through March 1984, 11 patients have undergone reconstruction with the A-O plate technique. These patients had both traumatic and oncologic defects. All patients treated with this technique have achieved a solid mandibular arch. Included is a discussion of the theoretical advantages, preoperative prerequisites, and the operative technique.

Follow-Up Studies↗
PubMed1985

Clostridium difficile colitis following head and neck surgery. Report of cases.

Clostridium difficile, a toxin-producing, gram-positive anaerobe, has been implicated as the causative agent of pseudomembranous colitis, an acute inflammatory bowel disease that generally occurs in association with antimicrobial therapy. This subject has received extensive review in the general surgical, medical, and pediatric literature but has not been specifically addressed in the literature of our specialty. We present the report of four recent cases, including one that progressed to the clinical picture of peritonitis and toxin megacolon. The literature is reviewed regarding presentation, diagnosis, and treatment of C difficile colitis. Familiarity with this disease process may minimize morbidity and prevent disastrous complications following major head and neck surgery.

Aged↗
PubMed1985

The prevalence of tardive dyskinesia in geropsychiatric outpatients.

The prevalence of tardive dyskinesia was studied in a geropsychiatric outpatient clinic. All currently active patients were examined using the Abnormal Involuntary Movement Scale (AIMS) and a standardized procedure. Data were collected on a number of previously reported risk factors. A higher prevalence was noted in both tardive dyskinesia and spontaneous involuntary movement disorders in this patient population. Only sex and duration of exposure to antipsychotic drugs were noted to be significant risk factors.

Aged↗
PubMed1984

Pharmacotherapy of the chronic patient: gender and diagnostic factors.

Clinical data from 1752 patients in five, ambulatory community mental health centers were used to test hypotheses about the diagnosis and psychopharmacotherapy of chronic patients. Analysis focused upon the interrelationships among gender, diagnosis, and the number of medications and dosages prescribed. Men and women differed in their age distributions and in the diagnoses received. Women were more often diagnosed with affective disorders than were men. There were also notable interaction effects with ethnicity. There was little evidence of differential drug prescribing practices, although women were somewhat more likely than men to be prescribed anti-psychotics and anti-depressants in the absence of an appropriate diagnosis.

Adolescent↗
PubMed1984

Diagnosis and pharmacotherapy issues in the care of Hispanics in the public sector.

Clinical data from 1,752 ambulatory patients treated at five public mental health clinics were used to test hypotheses concerning the diagnoses and psychopharmacotherapy of Hispanic patients compared with Anglos and blacks. Hispanics were less likely than the other two groups to be labeled schizophrenic but more likely to be diagnosed as having other mental illnesses. Hispanics were less likely to receive medication than the other two groups. However, when pharmacotherapy was used there were no significant differences among groups in the number of medications prescribed. There were no differences among the groups in the doses prescribed.

Adolescent↗
PubMed1984

Paraprofessionals and psychiatric teams: an updated review.

Paraprofessionals and psychiatric teams are vital, interrelated, and complex components of the mental health care system. However, the literature on them is meager and contradictory. The authors begin the literature update by defining the relevant terms and describing the evolution of paraprofessionals and psychiatric teams. New developments indicate that paraprofessionals are able to perform many basic treatment tasks as members of psychiatric teams and that they are highly adaptable to addressing the service delivery gaps that have occurred during deinstitutionalization and in the treatment of schizophrenia. Advances in the training, structure, and process of psychiatric teams are discussed, and the authors cite new criteria for cost- and treatment-effective teams. With these developments, the authors discuss the problems still faced by paraprofessionals and psychiatric teams.

Allied Health Personnel↗
PubMed1984

Pharyngocutaneous fistula after laryngeal surgery: the role of the barium swallow.

Pharyngocutaneous fistula is one of the major complications following laryngeal surgery. Prior to 1979, patients undergoing laryngectomy at the University of Minnesota were not fed until 9 or 10 days postoperatively if unirradiated and 12 to 14 days if irradiated. Most fistulas were apparent by 14 days postoperatively, but occasionally a patient would develop a fistula as late as a month postoperatively. Starting in 1979, in an attempt to decrease the length of hospitalization as well as prevent fistula formation, routine barium-swallow videoesophagograms were obtained 7 days postoperatively in all laryngectomy patients. If the results were considered normal, the nasogastric tube was removed and oral feedings were started. Of a total of 45 patients undergoing wide-field laryngectomy, there were three clinical fistulas and three radiologic fistulas. Following this protocol, we shortened the average postoperative hospitalization by 2 days without an increase in the rate of fistulization.

Barium Sulfate↗
PubMed1983

Osteomyocutaneous reconstruction of the oral cavity.

Osteomyocutaneous reconstruction of the anterior oral cavity affords rapid rehabilitation that saves the patient hospital time and substantial expense when compared with secondary reconstruction techniques. When successful, it offers more rapid and complete rehabilitation of the oral cavity because of the immediate and permanent maintenance of intraoral relationships without cicatrix. Four patients have successfully undergone reconstruction with this flap. Comparison of hospital records have shown that this operation, when successful, can save 24 to 47 days in the hospital over a period of one to two years in comparison with patients who must have secondary reconstruction substituted for the primary flap. The difference in hospital bills can be as much as $26,000 to $39,000 per patient.

Humans↗
PubMed1983

Boom areas: implications for mental health care systems.

Areas of rapidly shifting population are a perennial phenomenon. Such occurrences offer particular challenges to mental health services. The boom areas which have developed recently in the southwestern rim of the United States have highlighted certain inadequacies in our mental health system. The Houston Consortium, a multi-institutional endeavor, offers one model for addressing these problems. This model emphasizes innovative educational programs geared to local service needs.

Health Occupations↗