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H Young

Publications and source records attributed to H Young.

At least 91 records · Page 5Linked to original sources
PubMed1996

Attitudes toward use of nursing homes and home care in older Japanese-Americans.

OBJECTIVE: A cohort of 1142 older Japanese Americans was identified to study preferences and attitudes regarding use of long-term care (nursing home or home care). DESIGN: Prospective cohort study. PARTICIPANTS AND SETTING: Older Japanese Americans in King County, Washington. RESULTS: Subjects were asked to consider hypothetical situations in which they were temporarily disabled by hip fracture or permanently disabled by dementing illness. If they fractured a hip, only 12% intended to use a nursing home; 29% intended to recover at home with the help of family or friends; another 54% intended to use paid home health care. If they became demented, the majority (53%) intended to use a nursing home; only 11% intended to rely on family or friends for care, and another 29% intended to use paid home health care. Similar responses were observed when subjects were asked what most members of their family or friends would wish them to do; however, they tended to value the perceived wishes of religious figures or the Japanese American community-at-large less than those of family or friends. Significant correlates with intention to enter nursing homes were lack of social support (unmarried, few or no close relatives or housemates), female gender, and high levels of acculturation into American society (never lived in Japan, English-speaking only). Other factors that were not significantly correlated were health perceptions, satisfaction and life control scales, and health care utilization (hospitalizations and MD visits). In multivariate logistic regression, marital status and level of acculturation were the most powerful independent predictors of intention to enter nursing homes. Age and female gender were predictors of intention to use home care. In the base population of subjects, the prevalence of nursing homes use (5%) was similar to that of the general US older population. CONCLUSIONS: We conclude that older Japanese Americans in the Pacific Northwest often intend to enter nursing homes if they became disabled by dementing illness. Actual use is similar to other older populations. This may be attributable largely to the existence of an ethically appropriate nursing home which is strongly supported by, and familiar to, this close-knit community. Intention to use long-term care services appears to be dependent primarily on the level of social supports and acculturation into American society.

Aged↗
PubMed1996

Noninvasive monitoring of tumor metabolism using fluorodeoxyglucose and positron emission tomography in colorectal cancer liver metastases: correlation with tumor response to fluorouracil.

PURPOSE: To investigate and measure the metabolism of colorectal cancer liver metastases using 18F-fluorodeoxyglucose positron emission tomography (FDG PET), before and during the first month of chemotherapy. The findings were compared with tumor outcome conventionally assessed using changes in tumor size. PATIENTS AND METHODS: Patients with colorectal cancer liver metastases were treated with fluorouracil (5FU) as a protracted venous infusion (300 mg/m2/d), with or without interferon-alpha 2b for two 10-week blocks separated by a 2-week break. Before and at 1 to 2 and 4 to 5 weeks on treatment, FDG PET scans were performed. Patients fasted, were injected intravenously with FDG (50 to 100 MBq), and scanned using a large-area positron camera; the image data was processed such that regions of interest could be identified. The results were expressed as a ratio of FDG uptake in the tumor and normal liver (T:L) or as a semiquantitative standardized uptake value (SUV). These measures were compared with the tumor dimensions measured on a computed tomographic (CT) scan performed at 12 weeks from commencement of chemotherapy. RESULTS: Twenty patients were studied; however, two did not have assessable liver metastases. Objective partial responses were observed in 11 of 18 patients. A total of 27 metastatic lesions were assessable. Pretreatment T:L ratios and SUVs did not correlate with tumor response, although response was associated with lower 1- to 2-week (1.84 v 2.17; t=2.667; P < .02) and 4- to 5-week (1.36 v 2.28; t=5.02; P < .001) T:L ratios, and 4- to 5-week (3.57 v 4.95; t=2.492; P < .05) SUVs. Expressed as a percent of the baseline values of the T:L ratio, responding lesions had a greater reduction in metabolism (67% v 99%; t=7.53; P < .001). The 4- to 5-week T:L ratio was able to discriminate response from nonresponse both in a lesion-by-lesion and overall patient response assessment (sensitivity 100%; specificity 90% and 75%, respectively). CONCLUSION: Positron emission tomography used to evaluate the uptake of FDG in tumors yields data that correlate with the antitumor effect of chemotherapy in patients with liver metastases from colorectal cancer.

Antimetabolites, Antineoplastic↗
PubMed1995

Pharmacokinetics and biodistribution of radiolabelled idoxifene: prospects for the use of PET in the evaluation of a novel antioestrogen for cancer therapy.

With a view to evaluating the role of PET imaging in the development of new anticancer drugs, we are investigating the novel antioestrogen pyrrolidino-4-iodotamoxifen (idoxifene). [125I]idoxifene and [131I]idoxifene have been produced in no-carrier-added form using a tributyl stannylated precursor, and the bio-distribution and dynamic behaviour of the compound investigated using syngeneic transplantable mammary tumours in the rat. Our findings support the use of PET imaging with 124I to study the clinical pharmacology of idoxifene. Factors other than hormone receptor levels appear to influence tumour uptake and therefore, possibly the biological effects of this compound.

Animals↗
PubMed1995

Nutritional assessments, food security and famine.

The widely held view that malnutrition is a late indicator of famine is challenged on the basis of evidence that people often deliberately reduce their food intake as an early response to inadequate food security. This broadens the possible interventions in response to high malnutrition rates to include measures to support livelihoods under threat of collapse. In the late stages of famine, social disruption and distress migration often result in a degraded health environment which may raise the threshold of nutritional status associated with an increased mortality risk. It is important to assess the underlying causes of malnutrition and the associated health risks. At present, the main objective of nutrition surveys is usually to obtain a reliable estimate of the prevalence of malnutrition among children under five years of age, with little analysis of the underlying causes of malnutrition. Experience from the 1984-85 famine in Darfur led to the development of an alternative approach to nutritional assessment which could be applicable elsewhere in Africa. The combination of quantitative and qualitative methods was particularly valuable as a means of gaining a wider and deeper understanding of the nature of the nutritional situation.

Cause of Death↗
PubMed1995

Malnutrition and poverty in the early stages of famine: North Darfur, 1988-90.

In this article we report findings on the relationship between malnutrition and poverty during a period of acute food insecurity in Darfur, Sudan. Children of rich and poor families were equally likely to be malnourished, which is explained in terms of people's responses to the threat of famine. This finding has important implications for targeting interventions in the early stages of famine. Appropriate interventions at the early stages of famine are livelihood and income support to the most vulnerable. The entitlement theory of famine causation assumes that the poor are most vulnerable, and become malnourished and die during famines. In this article we show that this assumption does not hold. Even though poverty is the root cause of malnutrition, it does not follow that anthropometric status can be used to target individual poor families, or even that targeting the poor is appropriate in famine situations.

Chi-Square Distribution↗
PubMed1995

Nutrition, disease and death in times of famine.

In this article we review the relationship between malnutrition and mortality, and the interaction of morbidity, with the aim of clarifying the health risks of malnutrition in situations of famine and food insecurity. Apart from reviewing what is known about this relationship, we highlight areas where further research is needed. Among refugee and famine affected populations living in camps, there appears to be a close association between high rates of malnutrition and excess mortality. Results from community-based prospective studies of malnutrition and mortality among individuals conclude that as nutritional status declines the risk of death increases, although the discriminating power of different nutritional indices and the strength of the association varies considerably in different locations and at different times. These differences are attributed mainly to the different prevailing patterns of morbidity and growth failure, which are influenced by both environmental and social factors. In situations of famine and population displacement, the deterioration in the health environment increases exposure to infection and is likely to raise the threshold of nutritional status which corresponds to an increased risk of mortality. This has important implications for nutritional assessments and interventions.

Africa↗
PubMed1995

Serovar specific immunity to Neisseria gonorrhoeae: does it exist?

OBJECTIVE: To determine whether the host immune response to gonorrhoea provides limited serovar specific protection from reinfection. SUBJECTS: 508 episodes of gonorrhoea diagnosed at a city centre genitourinary medicine clinic including 22 patients with multiple infections over a 4 year period. METHODS: Patients with recurrent gonococcal infection were analysed with respect to the initial and subsequent serovars isolated. RESULTS: No significant difference was seen in the prevalence of serovars isolated following a repeat infection compared with those without repeat infections. The site of the initial infection did not appear to influence the subsequent serovar isolated. CONCLUSION: We found no evidence of serovar specific immunity in our population. It remains possible that populations with a higher prevalence of gonorrhoea and more frequent infections may have a quantitatively greater immune response.

Adolescent↗
PubMed1995

Serotonin immunoreactivity in the ventral nerve cord of the primitive crustacean Anaspides tasmaniae closely resembles that of crayfish

Syncarid crustaceans, of which only a few living species remain, have articulated segments with well-developed appendages along the length of the body, an arrangement thought to resemble that of the earliest malacostracan crustaceans. Decapod malacostracans have fused thoracic segments and reduced abdominal appendages. Modern representatives of the two groups are separated by at least 300 million years of evolutionary history. The serotonin immunoreactivity of ganglia and connectives from the ventral nerve cord of the syncarid Anaspides tasmaniae was compared with that of serially homologous ganglia of the crayfish Cherax destructor. Both species show the serotonin-immunoreactive longitudinal fibre bundles described from other decapods and thought to be part of a neuromodulatory network. They also have in common a number of the cell bodies associated with this system. Each species has some serotonergic cells in the region examined that are not present, or that do not stain, in the other species.

Journal Article↗
PubMed1995

Storage and repeated recovery of Neisseria gonorrhoeae using cryovials.

One hundred gonococcal isolates, representing eight protein IA serovars and 14 protein IB serovars, were stored at -70 degrees C using the Pro-Lab Microbank cryovial storage system. At monthly intervals a bead from each cryovial was removed and cultured on modified New York City medium. The overall recovery rate was 98.6% (2365/2400), the 35 failures representing 13 separate isolates. There was a small but significant decrease in recovery in the last 12 months of the trial (97.8%) compared with the first 12 months (99.8%), which may have been due to a sampling problem rather than a temporal phenomenon. Failures were significantly associated with minor serovars, suggesting that the transmissibility/viability of minor serovars may be lower than that of common serovars and could be a significant factor in the epidemiology of gonococcal infection. We conclude that Pro-Lab Microbank cryovials provide a highly effective and convenient system for storage of Neisseria gonorrhoeae, particularly when multiple retrieval is required, and the system offers many advantages over conventional lyophilisation.

Cryopreservation↗
PubMed1995

Gonococcal serovar patterns in Glasgow: 1990-1992.

Using monoclonal antibodies directed against protein 1 (major outer membrane protein) in the cell wall of Neisseria gonorrhoeae it is possible to serotype the gonococcus into different sub-groups. This study was designed to analyse the distribution of such serovars in Glasgow, Scotland, and report associations between serovars and clinical features of infection. N. gonorrhoeae isolated from all patients with a diagnosis of gonorrhoea attending genitourinary medicine clinics in Glasgow were serotyped between January 1990 and December 1992. The results were then correlated with sexual orientation of patients, penicillin sensitivity, site of infection, location of acquisition of infection and presence of symptoms. Six hundred and four episodes of gonococcal infection were analysed and an association between certain serovars with sexual orientation, penicillin sensitivity and asymptomatic infection was found. No association between serovar type and locality of acquisition of infection was apparent. Although there was a decreasing trend in the incidence of gonorrhoea overall, infections in homosexual men increased over the three-year study period. The associations between serovars and other features of gonococcal infection are discussed. The observed increase in homosexually-acquired infection has implications with regard to the spread of human immunodeficiency virus infection in this area, and suggests that attempts to promote safer sex in this group are failing.

Adolescent↗
PubMed1994

Enzyme-linked fluorescent detection for automated multiplex DNA sequencing.

Initiatives to sequence DNA on a large scale have created a need for increased throughput and decreased costs. One scheme for increasing throughput, multiplex sequencing, involves the processing of a mixture of sequencing templates followed by sequential hybridization to reveal the individual sequence ladders on a membrane. Because multiplex sequencing has not been fully automated, and has not seemed automatable, few sequencing efforts have attempted to exploit it. We describe here a scheme for the automation of multiplex sequencing. Probe hybridized to target DNA is detected via spatially localized enzyme-linked fluorescence. Light output is high enough that imaging is possible with simple instrumentation. Direct imaging within an automated hybridization apparatus is made feasible so that the entire process will be automatic once a multiplex membrane is produced. The technique has the potential to increase severalfold the throughput of automated sequencing instruments required for sequencing the human genome.

Base Sequence↗
PubMed1994

Evaluation of copper(II)-pyruvaldehyde bis (N-4-methylthiosemicarbazone) for tissue blood flow measurement using a trapped tracer model.

Copper(II)-pyruvaldehyde bis (N-4-methylthiosemicarbazone) (Cu-PTSM) labelled with 62,64Cu is a promising radiotracer for the study of blood flow using positron emission tomography (PET). We have investigated the application of a simple trapped tracer model to measurements of tissue 64Cu-PTSM uptake combined with continuous arterial sampling. A dual-tracer method was used to compare blood flow estimated by 64Cu-PTSM with values derived from measurements using cobalt-57 microspheres in the rat. Prolonged retention of 64Cu-PTSM following intravenous administration was initially confirmed in both normal tissues and tumours. After intraventricular 64Cu-PTSM infusion, cumulative arterial 64Cu activity increased progressively, and after extraction in n-octanol was found to plateau to levels corresponding with those reached following administration of 57Co microspheres. Rapid and species-dependent rates of 64Cu-PTSM decomposition to non-extractable 64Cu complexes were found in rat and human blood in vitro (70% +/- 6% and 43 +/- 5% respectively at 16 min), demonstrating the need for immediate processing of arterial samples. Close agreement was found between blood flow estimated by 64Cu-PTSM and 57Co microsphere methods in tissues of low to moderate flow: muscle (0.01, 0.08, 0.07 ml/min per gram; mean difference, mean 64Cu, mean 57Co), brain (0.09, 0.52, 0.43 ml/min per gram) and kidney (-0.16, 2.29, 2.45 ml/min per gram). Estimates of cardiac output also compared favourably between the two methods (5.7, 59.8, 54.1 ml/min). We conclude that a simple tissue trapping model may be suitable for the derivation of blood flow estimates using 62,64Cu-PTSM, PET imaging and continuous arterial blood sampling.

Animals↗
PubMed1994

A socioeconomic, clinical and serological study in an African city of prostitutes and women still married to their first husband.

The aim of this paper was to compare women involved in prostitution with a group of women still married to their first husband and reporting having had only one sexual partner, in order to ascertain what factors if any contributed to women going into prostitution or staying still married to their first husband, their only sexual partner, and thereafter to compare clinical and serological aspects of the gynaecological conditions of the women in these two groups. The role of prostitutes in transmission of sexually transmitted diseases (STD) is widely recognised. Socioeconomic factors determining whether a woman will drift into prostitution or have a stable first marriage are largely unknown as are prevalence rates of STD, pelvic inflammatory disease (PID) and cervical cancer in these women. A socioeconomic, clinical and serologic study is reported for 2111 Ethiopian women attending teaching hospitals and maternal and child health clinics in Addis Ababa, analysing basic demographic data of three groups of women: (i) 278 engaged in prostitution, (ii) 730 still married to their one and only sexual partner, and (iii) 1103 single, widowed, divorced or married to their second or subsequent partner. Thereafter groups (i) and (ii) were compared and contrasted with regard to further socioeconomic, clinical and serological associations. The most significant socioeconomic associations for women in prostitution were low income (95% had < 50 Ethiopian birr [< U.S. $25] per month), ethnic group, and the timing of first coitus in relation to the menarche (81% were first married by age 15), in that order. Women still married to their first sexual partner had higher income, higher age at first marriage and longer duration of marriage. Sero-prevalence rates of STD in prostitutes were high: gonorrhoea 88%, genital chlamydiae 78%, syphilis (TPHA) 62%, HSV2 and HBV 46%, and chancroid 19%: 67% had PID and 2.9% cervical cancer. In comparison, rates for women married to their first and only sexual partner were: gonorrhoea 40%, genital chlamydiae 54%, syphilis (TPHA) 19%, HSV2 33%, HBV 35%, chancroid 13%, PID 47% and cervical cancer 1%. While the very high prevalence of STD in women involved in prostitution is not so unexpected, the high rate of STD in women still married to their first and only sexual partner is indicative of male promiscuity. Control of prostitution and diseases spread by it, together with education of both men and women is a national priority.

Adolescent↗
PubMed1994

Penicillin susceptibility testing of penicillinase producing Neisseria gonorrhoeae by the E test: a need for caution.

The penicillin MICs of 52 clinical isolates of penicillinase producing Neisseria gonorrhoeae (PPNG) and five reference strains were tested by agar dilution and the E test. All 52 PPNG were scored resistant (> or = 2 mg/L) by agar dilution whereas only 78.8% (41/52) and 82.7% (43/52) were classified as resistant by normal (0.016-256 mg/L) and low range (0.002-32 mg/L) E test MICs respectively. Isolates with an E test penicillin MIC > or = 0.19 mg/L should be checked by a specific test for beta-lactamase production.

Gonorrhea↗