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Biomedical subjects

J C Wagner

Publications and source records attributed to J C Wagner.

At least 19 recordsLinked to original sources

Anabolic steroid use among adolescents in Nebraska schools.

The extent of anabolic steroid use among adolescent sports participants and nonparticipants in Nebraska schools was studied. The Nebraska Secondary School Survey administered in 1991 contained 19 new items designed to determine rates of use of anabolic steroids and to measure participation in school sports. Schools participating in the survey are part of the Toward a Drug Free Nebraska training project; when the 1991 survey was conducted, training did not address ergogenic drug use. The survey was administered on a voluntary and confidential basis to Nebraska students in grades 7 through 12. A total of 4722 students in 62 secondary schools were surveyed; 3183 (67.4%) identified themselves as participants in school-sponsored sports. Of all the respondents, 117 (2.5%) reported having used anabolic steroids in the preceding 30 days. Some 4.5% of all the male respondents were steroid users, versus 0.8% of all the females. Of the students who reported using anabolic steroids, 72.6% were sports participants. Steroid users, whether they participated in sports or not, were more likely to use alcohol, tobacco, and other drugs than were nonusers of steroids. Among sports participants and nonparticipants, anabolic steroid users were more likely than nonusers to report acting violently. Nebraska students (grades 7 through 12) who participated in school-sponsored sports were more likely than non-participants to use anabolic steroids. Steroid-using athletes were more likely to use alcohol, tobacco, and other drugs than athletes who did not use steroids.

Adolescent

Intrapleural administration of vitreous high duty ceramic fibres and heated devitrified ceramic fibres does not give rise to pleural mesothelioma in rats.

In order to determine whether they are potentially carcinogenic to the pleural mesothelium, three samples of ceramic fibre have been administered to rats by the intrapleural route. These samples were a high-duty grade refractory ceramic fibre (manufactured by Thermal Ceramics Ltd) in the as-manufactured vitreous state and two devitrified samples produced by heating the same fibre for 2 weeks at 1200 degrees C and for two weeks at 1400 degrees C. The mean lifespans of the groups of rats treated with vitrified and devitrified ceramic fibres were not significantly different from that of the control rats. In these studies none of the treated or control rats developed pleural mesothelioma, making it unlikely that ceramic fibres of this type, whether vitreous or devitrified, are potentially carcinogenic to the pleural mesothelium.

Animals

Analysis of medical texts based on a sound medical model.

Automatic understanding of natural language is a complex task due to the presence of ambiguities. In particular, semantic ambiguities which are often immediately and unconsciously solved by human beings, are raised when analyzing natural language sentences by computer. The latter has to know the implicit and contextual information in order to resolve these difficulties. Nowadays in medicine, a considerable effort is deployed to model semantic contents of the medical domain. Such a task is usually performed separately from linguistic considerations. The goal of this paper is to highlight the key issues of basing a medical language processing system on a sound semantic model. To illustrate the requirements and advantages of such a conceptual approach to the analysis process, the experiment conducted to adjust the RECIT analyzer to the GALEN model is shown.

Models, Theoretical

Multilingual natural language generation as part of a medical terminology server.

Re-usable and sharable, and therefore language-independent concept models are of increasing importance in the medical domain. The GALEN project (Generalized Architecture for Languages Encyclopedias and Nomenclatures in Medicine) aims at developing language-independent concept representation systems as the foundations for the next generation of multilingual coding systems. For use within clinical applications, the content of the model has to be mapped to natural language. A so-called Multilingual Information Module (MM) establishes the link between the language-independent concept model and different natural languages. This text generation software must be versatile enough to cope at the same time with different languages and with different parts of a compositional model. It has to meet, on the one hand, the properties of the language as used in the medical domain and, on the other hand, the specific characteristics of the underlying model and its representation formalism. We propose a semantic-oriented approach to natural language generation that is based on linguistic annotations to a concept model. This approach is realized as an integral part of a Terminology Server, built around the concept model and offering different terminological services for clinical applications.

Language

Fiber levels and disease in workers from a factory predominantly using amosite.

The Cape Boards Plant at Uxbridge produced insulation board containing amosite asbestos between 1947 and 1973 with only small amounts of chrysotile. After 1973 only amosite was used. In this study we examined lung samples from 48 workers who had been employed at the plant and who had come to autopsy. The study investigated the fiber levels against the lung pathology including amount of interstitial fibrosis and numbers of ferruginous bodies. The degree of interstitial fibrosis and number of asbestos bodies were graded and the tissues were analyzed by transmission electron microscopy and energy dispersive X-ray analysis and the fibers counted and typed. The 48 cases included 5 mesotheliomas and 14 lung cancers. The mineral analysis results were dominated by the amosite fiber levels. The amounts of chrysotile were relatively small. There were higher levels in lung cancer cases than mesotheliomas and higher levels in mesothelioma cases than those who had died from nonasbestos related diseases. Analysis of the lung tissues showed a consistent pattern of high amosite levels, which confirms the impression that amosite was the predominant form of asbestos used and also indicates that the factory had been a very dusty one.

Asbestos, Amosite

A study of Spanish sepiolite workers.

BACKGROUND: Sepiolite is an absorbent clay that is used as pet litter. It forms thin crystals, which are a transition between chain and layered silicates. Inhalation studies in animals have shown no evidence of pulmonary damage. This paper reports a cross sectional study of the total work force of the largest sepiolite production plant in the world. METHODS: Two hundred and eighteen workers (210 men and eight women) were studied. Height, age, and smoking history were recorded. Chest radiographs were read according to the International Labour Office (ILO) classification by two readers. Readings were used to construct a numerical score, which was then used in statistical analyses. Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were divided by the square of the height. Casella size selective personal samplers were used in randomly selected operatives to collect dust eight years before the rest of the study was carried out. These samples were evaluated gravimetrically. Total dust samples were examined by optical and electron microscopes. Results were analysed by bivariate linear regression, chi 2 tests, and analysis of variance. RESULTS: When allowance was made for smoking habit workers exposed to dry dust showed a significantly greater decline in FEV1 with age than workers with little exposure to dry dust. A similar pattern applied to FVC. Radiographic score showed deterioration with age but no clear differences from other variables. High concentrations of dust were found in the bagging department and also in the classifier shed. CONCLUSIONS: The major finding was that lung function deteriorated more rapidly in those who had had more exposure to dust, but there was no evidence of any accompanying radiographic change.

Adult

[Double trans-suture technique in colorectal surgical anastomosis. Apropos of 45 cases].

The double trans-suture technique in colorectal anastomoses is an entirely mechanical one which consist of the transformation of two linear sutures in a circular one. During, 2 years, between March 1990 and March 1992, this technique was performed on 45 patients, of whom about two-third had a carcinoma of rectosigmoid. No postoperative mortality occurred. One patient developed an anastomatic stenosis, and another one a clinical leakage. The double trans-suture technique has not only the advantages of the double stapling technique but also avoids the incidents of performing a proximal purse.

Aged

Purification and characterization of proteinase yscJ, a new yeast peptidase.

A newly recognized peptidase, designated proteinase yscJ, was purified from the yeast Saccharomyces cerevisiae. The enzyme is of non-vacuolar origin and cleaves the Tyr-Lys bond of the synthetic peptide substrate Cbz-Tyr-Lys-Arg-NH-Ph (Cbz, benzyloxycarbonyl; NH-Ph, 4-nitroanilide) and the Glu-Lys bond of the substrate Boc-Glu-Lys-Lys-NH-Mec (Boc, butoxycarbonyl; Mec, 4-methylcoumarinyl) with high efficiency. Optimum pH for cleavage of Cbz-Tyr-Lys-Arg-NH-Ph is in the range 7.0-7.5. The purified enzyme has a molecular mass of approximately 58 kDa, as judged by gel filtration on a Superose 12 FPLC column. Mercury compounds and EDTA were found to be potent inhibitors of proteinase yscJ activity.

Amino Acid Sequence

Metabolic regulation of the trehalose content of vegetative yeast.

We have investigated the mechanism by which heat shock conditions lead to a reversible accumulation of trehalose in growing yeast. When cells of S. cerevisiae M1 growing exponentially at 30 degrees C were shifted to 45 degrees C for 20 min, or to 39 degrees C for 40 min, the concentration of trehalose increased by about 25-fold; an effect reversed upon lowering the temperature to 30 degrees C. This was compared to the more than 50-fold rise in trehalose levels obtained upon transition from the exponential to the stationary growth phase. Whereas the latter was paralleled by a 12-fold increase in the activity of trehalose-6-phosphate synthase, no significant change in the activities of trehalose-synthesizing and -degrading enzymes was measured under heat shock conditions. Accordingly, cycloheximide did not prevent the heat-induced accumulation of trehalose. However, the concentrations of the substrates for trehalose-6-phosphate synthase, i.e. glucose-6-phosphate and UDP-glucose, were found to rise during heat shock by about 5-10-fold. Since the elevated levels of both sugars are still well below the Km-values determined for trehalose-6-phosphate synthase in vitro, they are likely to contribute to the increase in trehalose under heat shock conditions. A similar increase in the steady-state levels was obtained for other intermediates of the glycolytic pathway between glucose and triosephosphate, including ATP. This suggests that temperature-dependent changes in the kinetic parameters of glycolytic enzymes vary in steady-state levels of intermediates of sugar metabolism, including an increase of those that are required for trehalose synthesis. Trehalose, glucose-6-phosphate, UDP-glucose, and ATP, were all found to increase during the 40 min heat treatment at 39 degrees C. Since this also occurs in a mutant lacking the heat shock-induced protein HSP104 (delta hsp104), this protein cannot be involved in the accumulation of trehalose under these heat shock conditions. However, mutant delta hsp104, in contrast to the parental wild-type, was sensitive towards a 20 min incubation at 50 degrees C. Since this mutant also accumulated normal levels of trehalose, we conclude that HSP104 function, and not towards a 20 min incubation at 50 degrees C. Since this mutant also accumulated normal levels of trehalose, we conclude that HSP104 function, and not the accumulation of trehalose, protects S. cerevisiae from the damage caused by a 50 degrees C treatment.

Glucose-6-Phosphate

Background incidence of mesothelioma: animal and human evidence.

Evidence is presented showing that mesotheliomas can have causes other than exposure to asbestos dust, in both experimental animals and humans. In experimental animals, for example, results from two major experimental laboratories suggest that at least 10% may be taken for background incidence, whereas a third laboratory suggests that the experimental group must have a rate exceeding 30% "Background" also includes mesotheliomas found in association with nonfibrous and fibrous nonasbestiform agents. Mesotheliomas in humans can be broadly classified in a manner similar to those of experimental animals: (1) spontaneously occurring, (2) those with a latent period less than 10 years, (3) childhood mesotheliomas, (4) familial cases, (5) cases before the 20th century, (6) mineralogically negative mesotheliomas, and (7) mesotheliomas caused by nonasbestiform agents. The importance of the acceptance of these "background" cases lies in the fact that a basis is provided for the study of the incidence of disease associated with various types of asbestos.

Animals

Carcinogenicity of the insulation wools: reassessment of the IARC evaluation.

In assessing the health evidence concerning man-made mineral fibers, the chemical composition, surface activity, durability, and size of fibers have to be taken into account. Special-purpose fine glass fibers need to be separated from the insulation wools (glass, rock, and slag wool). The epidemiological evidence is sufficient to conclude that there has been no mesothelioma risk to workers producing or using glass wool, rock wool, or slag wool. The epidemiological studies have been large and powerful, and they show no evidence of a cause-effect relationship between lung cancer and exposure to glass wool, rock wool, or slag wool fibers. There is some evidence of a small cancer hazard attached to the manufacturing process in slag wool plants 20 to 50 years ago, when asbestos was used in some products and other carcinogenic substances were present. However, this hazard is not associated with any index of exposure to slag wool itself. Animal inhalation studies of ordinary insulation wools also show that there is no evidence of hazard associated with exposure to these relatively coarse, soluble fibers. The evidence of carcinogenicity is limited to experiments with special-purpose fine durable glass fibers or experimental fibers, and only when these fibers are injected directly into the pleural or peritoneal cavity. Multiple chronic inhalation studies of these same special-purpose fine glass fibers have not produced evidence of carcinogenicity. It is suggested that the present IARC evaluation of the carcinogenic risk of insulation wools should be revised to Category 3: not classifiable as to carcinogenicity to humans.

Animals

The discovery of the association between blue asbestos and mesotheliomas and the aftermath.

As this is the 30th anniversary of the publication of our paper "Diffuse pleural mesotheliomas and asbestos exposure in the north west Cape Province," and 1 December 1990 is the first anniversary of John Gilson's death, I think it is appropriate to subunit this paper. It covers the background of the discovery of the series of mesotheliomas in the north western region of the Cape Province, and the subsequent publication, which has become the most cited paper in industrial medicine. It was John Gilson who directed the next phase, which substantiated this discovery. He clarified the situation in his summary of the report to the director of the International Agency for Research in Cancer in 1972. This I have quoted in full and have had the temerity to update to 1990. I am sure that many will want to elaborate these views, and I hope that they will submit their opinions to this journal.

Asbestos

Enhancement of athletic performance with drugs. An overview.

Drug use among athletes has become a recognised problem in sports. Athletes may use drugs for therapeutic indications, for recreational or social reasons, as ergogenic aids or to mask the presence of other drugs during drug testing. Stimulants were some of the first drugs used and studied as ergogenic aids. Amphetamines may increase time to exhaustion by masking the physiological response to fatigue. Caffeine may improve utilisation of fatty acids as a fuel source thereby sparing muscle glycogen. Cocaine and other sympathomimetic drugs have little or no effect on athletic performance. Anabolic steroids appear to have the potential to increase lean muscle mass and strength under certain conditions. Human growth hormone may also be used for an anabolic effect, but data on this effect are lacking. Erythropoietin may represent a pharmacological alternative to blood doping by increasing red blood cell mass. The use of narcotic analgesics is not necessarily ergogenic but can be harmful if used to allow participation of an athlete with a severe injury. According to the American College of Sports Medicine alcohol does not possess an ergogenic effect. However, it may be used to reduce anxiety or tremor prior to competition. Marijuana does not increase strength. Tobacco products may produce psychomotor effects or control appetite which may be beneficial to some athletes. Other drugs used by athletes include beta-blocking agents, diuretics, and a variety of nutritional supplements. In addition, diuretics and probenecid may be taken to mask drug contents in the urine. Whether the ergogenic effects are real or perceived, the potential for adverse effects exists for all of these drugs. Potential health complications represent a serious risk to an otherwise healthy population. Further research on the long term health risks in athletes taking ergogenic drugs is needed.

Adrenergic beta-Antagonists

Antibiotic sensitivity and the prescribing information sheet: assisting the prescribing physician.

The concept conceived 5 years ago is now a reality. Physicians have information readily available for empiric prescribing from the home, office, or hospital. The other two hospitals in the city have implemented the systems. The reaction of physicians has been extremely favorable. In fact, two new publications for the outpatient/community and for the pediatric populations are now under way at the suggestion of physicians. Plans are in place to assess physician satisfaction and use of the information sheet within the coming year. Presently, too little time has passed to evaluate whether changes in prescribing have actually occurred. In fact, it may never be possible to identify how many instances of inadvisable prescribing are prevented with good initial information. However, for the relatively low cost involved, this has been an exciting new opportunity for education, as well as a method to promote cost-effective and appropriate antibiotic therapy.

Anti-Bacterial Agents

Anabolic steroids--a review of the clinical toxicology and diagnostic screening.

Anabolic steroids have been used by athletes since the 1950s to increase size and strength in order to improve their performance. The abuse of these substances has since expanded to include junior high and high school male and female athletes and non-athletes. The anabolic and androgenic effects of these agents, when taken in the doses needed to produce increases in size and strength, result in significant serious adverse effects involving the skin, liver, cardiovascular, musculoskeletal, endocrine and reproductive systems. Some of these effects are irreversible. It is essential that clinical toxicologists, emergency room physicians and psychiatrists are familiar with the physical and psychological effects, as well as the changes in laboratory parameters, that typically occur from chronic use of anabolic steroids. The toxicities and representative clinical profiles of steroid users are presented, and the methods available for diagnostic screening using psychological testing and urine analysis are also reviewed.

Anabolic Agents

Characterization of excessive collagen production during development of pulmonary fibrosis induced by chronic silica inhalation in rats.

The activation of collagen synthesis during development of silicotic fibrosis was studied in rats exposed, in dusting chambers, to respirable SiO2 for periods of 2, 4, 6 or 12 months. Control animals were exposed similarly to clean air or TiO2. Development of fibrosis was followed by histological examination, measurement of lung weight and determination of lung collagen content (as hydroxyproline). A steady increase in lung weight and collagen content together with changes in cellularity and metabolic activity of the lungs, as ascertained by chemical determination of DNA and RNA, were measured in the lungs of the SiO2-exposed animals. Hybridization of total lung RNA, extracted at each time point, with cDNA probes specific for type I and type III procollagen mRNA levels showed that the development of fibrosis was associated with increased levels, as compared to age matched controls, of pulmonary procollagen mRNAs. Interestingly, the highest levels of procollagen mRNAs were observed in young (pretreatment control) animals, suggesting that during pulmonary development collagen metabolism in lungs is even greater than during development of fibrosis. In rats exposed to SiO2 the increase in type III procollagen mRNA occurred earlier than the increase in type I procollagen mRNAs. These observations demonstrate both age-dependent and silicosis-related changes in pulmonary procollagen mRNA levels. The results suggest that development of silicosis is associated with an altered capacity of the lungs to regulate collagen accumulation.

Administration, Inhalation

Pharmaceutical services at the Tenth Pan American Games.

The pharmaceutical services provided by volunteers, including more than 100 pharmacists, at the 1987 Pan American Games in Indianapolis, Indiana, are described. Pharmacists at a local hospital were given responsibility for doping control and operation of the medical clinic pharmacy at the games. Barracks at a U.S. Army facility within the games' boundaries were converted into the clinic; an area on the second floor was equipped as the pharmacy. The pharmacy secured the necessary licensure and obtained drug products and supplies. Volunteer pharmacists were recruited and instructed about responsibilities, procedures, and security. The formulary was based on the 1983 Pan American Games formulary, the 1988 Olympic Games formulary, and requests from the Pan American Sports Organization. In the 26 days that the pharmacy was open, 968 prescriptions were filled. The drugs most commonly prescribed were ibuprofen, terfenadine, acetaminophen, penicillin V potassium, clotrimazole cream, and naproxen. A doping control center located at each competition venue was staffed by a physician, pharmacists, nurses, medical technologists, and nonmedical personnel. After an event, selected athletes were escorted to a doping control center, where a medical history and urine sample were obtained. The urine was tested for pH and specific gravity, and the coded specimen bottles were sealed for transport to the laboratory. Each step was documented on special forms. A total of 981 athletes were tested; six athletes had positive test results. The 1987 Pan American Games provided a unique opportunity for pharmacists to assist in providing medical services at a large athletic event and to become involved in doping control.

Americas