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Biomedical subjects

J Daly

Publications and source records attributed to J Daly.

At least 19 recordsLinked to original sources
PubMed1995

Factors associated with a positive reexcision after excisional biopsy for invasive breast cancer.

BACKGROUND: Breast-conserving therapy followed by adjuvant radiotherapy represents an alternative to mastectomy as a treatment for invasive breast cancer. When excisional biopsy has been performed outside the parent institution, reexcision is often performed, with tumor being identified in 32% to 62% of the subsequent specimens. We analyzed not only the factors associated with a positive reexcision but also those factors associated with final surgical margins that are positive for tumor. METHODS: Between 1978 and 1991, 956 female patients with American Joint Committee on Cancer clinical stage I or II breast cancer were treated with breast-conserving therapy where a total of 420 patients underwent reexcision after an initial excisional biopsy. Several factors were analyzed to determine their association with a positive reexcision, the status of the final surgical margin, and the nature of the disease present within the reexcision specimen. RESULTS: Factors that correlated with a positive reexcision in both univariate and multivariate analysis were clinical tumor size, method of detection, the pathologic status of the axillary lymph nodes, and the histologic appearance. Those factors associated with finding invasive disease at the time of reexcision were clinical tumor size, clinical presentation, and nodal status. The single factor associated with finding residual in situ disease at the time of reexcision was histologic appearance of the primary tumor. A final positive margin was associated with method of tumor detection, age of the patient, and the presence of axillary lymph node metastases. CONCLUSIONS: The most significant factors associated with a positive reexcision are clinical tumor size, method of tumor detection, pathologic nodal status, and histologic appearance. Patients with larger tumors or those that are detected by physical examination, as well as invasive lobular carcinomas, may require a more generous initial resection to achieve negative surgical margins and avoid the likelihood of reexcision.

Adult↗
PubMed1994

A method for distinguishing human and mouse cells in solid tumors using in situ hybridization.

A common technique used in the study of human malignancies involves the inoculation of nude mice with human neoplastic cells. It is usually assumed that the tumor arising is composed predominantly of human cells with mouse tissue present only to provide minimal stromal support. Several reports, however, have shown evidence of host cell neoplastic transformation. Therefore, in order to effectively study and characterize such xenografts, it is important to establish the relative involvement of human and mouse cells. In the present study, a method for easily distinguishing human and mouse cells is described. The method involves in situ hybridization of formalin-fixed tissues using DIG-labeled oligomer probes which correspond to species-specific portions of Alu sequences. This method can be applied to archival material either as a means of confirming that the tissue taken from nude mice xenografts is predominantly human or as a vehicle for studying the mechanisms of host cell neoplastic transformation and their relevance to human malignant spread. The proposed technique may also serve as a basis for other in situ applications, particularly those involving formalin-fixed tissues and oligomer probes.

Animals↗
PubMed1991

Radioimmunoguided surgery using iodine 125 B72.3 in patients with colorectal cancer.

Preliminary data using B72.3 murine monoclonal antibody labeled with iodine 125 suggested that both clinically apparent as well as occult sites of colorectal cancer could be identified intraoperatively using a hand-held gamma detecting probe. We report the preliminary data of a multicenter trial of this approach in patients with primary or recurrent colorectal cancer. One hundred four patients with primary, suspected, or known recurrent colorectal cancer received an intravenous infusion of 1 mg of B72.3 monoclonal antibody radiolabeled with 7.4 x 10 Bq of iodine 125. Twenty-six patients with primary colorectal cancer and 72 patients with recurrent colorectal cancer were examined. Using the gamma detecting probe, 78% of the patients had localization of the antibody in their tumor; this included 75% of primary tumor sites and 63% of all recurrent tumor sites; 9.2% of all tumor sites identified represented occult sites detected only with the gamma detecting probe. The overall sensitivity was 77% and a predictive value of a positive detection was 78%. A total of 30 occult sites in 26 patients were identified. In patients with recurrent cancer, the antibody study provided unique data that precluded resection in 10 patients, and in another eight patients it extended the potentially curative procedure.

Antibodies, Monoclonal↗
PubMed1991

Characteristics of treatment drop-outs among two samples of chronic headache patients.

To examine the psychological characteristics of those who terminate treatment for headaches prematurely, this investigation employed 179 posttraumatic headache patients and 67 nontrauma headache patients who underwent electromyographic (EMG) biofeedback therapy. Dependent variables included the patient's age, socioeconomic status, duration of headache, forehead EMG levels, and MMPI. Multivariate analyses of variance revealed no significant differences between the drop-outs and non-drop-outs among the trauma headache patients, but three MMPI scales (Psychopathic-Deviate, Paranoia, and Mania) were significantly higher among the nontrauma headache patients who dropped out of treatment. These data imply that different characteristics underlie the drop-out behavior for different pain conditions and that efforts to uncover a single drop-out pattern may not be realistic.

Age Factors↗
PubMed1991

Temporal variation in morphological and genetic characteristics within a hybrid population of Culex pipiens (Diptera: Culicidae).

Samples of mosquitoes in the Culex pipiens L. complex from Memphis, Tenn., were collected from June to November 1985 and examined in regard to allozyme frequencies and ratios of the two arms of the phallosome of the male genitalia (DV/D). The dominant allozymes of hexokinase (HkA) and 6-phosphogluconate dehydrogenase (PgdF) significantly increased in frequency during this period as did the mean DV/D ratio. An analysis of gene frequencies by species group designated by DV/D ratios revealed no significant differences among Cx. pipiens, Cx. quinquefasciatus Say, and intermediates. The lack of association of gene frequencies with the taxa determined by the DV/D ratio indicated that although allozyme frequencies were correlated temporally with the DV/D ratio in the population, they were not associated with subspecies. These results are consistent with previous work that has shown latitudinal association and thermal stability differences in the major allozymes of these enzymes in the Cx. pipiens complex.

Animals↗
PubMed1991

Gastrointestinal adaptation to diets of differing fat composition in human volunteers.

The effect of a low fat diet (9 MJ) v a high fat diet (19.26 MJ), each consumed separately for four and 14 days, on gastric emptying and mouth to caecum transit time of a high fat test meal and body weight and satiety were examined in groups of 10 and six normal male volunteers. The half time for gastric emptying (t1/2) and the mouth to caecum transit time of a high fat test meal was significantly faster after the high fat diet than the low fat diet when consumed for 14 days (t1/2=98 (80-116) v 147 (88-206) minutes (median (range)), p less than 0.05; mouth to caecum transit time 240 (130-350) v 360 (200-520) minutes, p less than 0.05), but not when consumed for only four days. The mean (SEM) body weight of all subjects significantly increased during the 14 day high fat diet (74.7 (1.3) v 72.7 (1.6) kg, p less than 0.05) but was not influenced during the consumption of the low fat diet. When subjects were given an appetising meal to consume on the day that they had consumed the transit test meal, they ate similar amounts irrespective of their recent dietary history, though the eating rate was significantly slower after the high fat diet (mean (SEM)) 46.7 (1.9) v 71.3 (14.8)/min, p less than 0.05). Maintaining normal subjects on a high or low fat diet for two weeks resulted in a desensitisation or sensitisation respectively of the mechanisms by which nutrients regulate gastrointestinal transit. These findings emphasise the importance of the recent dietary history in the interpretation of gastric emptying and small bowel transit time data.

Adaptation, Physiological↗
PubMed1991

Rectal carcinoma: staging at MR imaging with endorectal surface coil. Work in progress.

To increase the accuracy of local staging of rectal carcinomas at magnetic resonance (MR) imaging, the authors placed on endorectal coil mounted on a balloon in a position adjacent to the lesion. Use of such a local coil resulted in increased signal-to-noise ratio compared with use of a body coil; higher-resolution images were obtained because the field of view was decreased. The depth of wall invasion by rectal carcinoma was correctly staged with endorectal MR imaging in 11 of 12 patients. In the detection of perirectal adenopathy, use of MR enabled correct identification of positive perirectal nodes in four of seven patients (57%). There were no false-positive diagnoses of perirectal adenopathy at MR. Endorectal MR imaging is an evolving and promising technique for the local staging of rectal carcinomas, but further studies are needed to demonstrate its efficacy.

Female↗
PubMed1991

A comparison of selected demographic characteristics and academic performance of on-campus and satellite-center RNs: implications for the curriculum.

This study compared two groups of RN students and noted that there is a difference between the profile of the on-campus student and the student in satellite areas. The demographic profile differences revealed that the RN students in satellite centers were slightly older, were employed, and worked more hours each week. They tended to work full-time, traveled farther to attend classes, had more children, and projected a longer time necessary to complete the SCN than their campus counterparts. The academic profile differences revealed that the satellite center RN students had higher ACT-PEP mean scores and transfer GPAs than their on-campus peers. On-campus RN students had higher University of Iowa GPAs and higher grades in the Pathology course and Foundations of Nursing Practice course than satellite center RN students.

Career Choice↗
PubMed1991

Effects of flexibility training on enhancing spinal mobility in older women.

The purpose of this study was to examine the extent to which spinal flexion and extension, or spinal mobility, could be improved in a population of older adults participating in a 10 week flexibility training program. Twenty female volunteers, mean age 71.8, were randomly assigned to either the experimental group (flexibility training) or the control group (no training). Prior to the initiation of training, all subjects were tested for total spinal mobility, the combined sum of spinal flexion and extension. Subjects in the experimental group were exposed to a series of flexibility exercises, three times per week, for 20-30 minutes in duration, for a total of 10 weeks. The control group participated in an alternative exercise program with the experimental group, including walking, swimming, dance, and other locomotor activities, however, they did not receive the additional flexibility training. At the conclusion of the 10 week period, all subjects were retested for spinal mobility, using back flexion and extension measures. Results indicated a significant improvement in spinal mobility in the experimental group, and virtually no measurable change in the control group. This study suggests that specialized training in back flexibility for older adults is warranted, and that significant gains in spinal mobility can be obtained, regardless of age.

Aged↗
PubMed1990

Components of energy expenditure in tumor-bearing animals.

Single snapshot measurements of resting energy expenditure (REE) suggest that hypermetabolism contributes to cancer cachexia, but tumor impact on total 24-hr energy expenditure (TEE) is unknown. Automated multicage indirect calorimetry was employed to measure daily energy expenditure in adult Buffalo rats (n = 16) randomized to tumor inoculation or controls. Measurements included baseline REE, activity EE (AEE), thermic response to food (TEF), and TEE. Rats (n = 16) were randomized. Metabolic measurements, tumor size, and body weight were recorded weekly. Animals were sacrificed at Week 5 for analysis of host and tumor composition. Significant depletion of total lean body mass occurred in TB rats (greater than 15% wt loss, ANOVA P less than 0.001) which inversely correlated with tumor growth (r = -0.81, P less than 0.001). REE, TEF, AEE, and TEE did not change in controls (ANOVA P = n.s.). In TB rats, a 19.5% increase in REE occurred (119.4 +/- 3.3 to 138.7 +/- 1.8 kcal/kg LBM/day, P less than 0.01). TEE remained unchanged (157.3 +/- 5.6 vs 152.9 +/- 3.6 kcal/kg LBM/day, P = n.s.) due to a 66% decrease in AEE (32.9 +/- 3.1 to 10.5 +/- 1.7 kcal/kg LBM/day, P = 0.01). TEF did not change (4.7 +/- 0.8 vs 5.0 +/- 0.3 kcal/kg LBM/day, P = n.s.). Both TB and controls demonstrated a decreased REE in response to a 24-hr fast (7.9% vs 4.8%, P = n.s.). Respiratory quotient decreased in both groups when comparing fed to fasted values: TB (0.86 to 0.76) and controls (0.86 to 0.71), but the decline was greater in controls (P = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Sex differences in small-magnitude heart-rate responses to sexual and infant-related stimuli: a psychophysiological approach.

Small-magnitude (2-3 beats per minute) heart-rate responses can show sex differences if assessed with a psychophysiological approach in which temporally fine-grained methods are used to determine topographical differences. Such differences emerged when 15 males and 37 females were shown videosegments depicting emotional scenes. Specifically, males accelerated to erotic segments (couples making love), while females accelerated to segments showing babies crying. In addition, the peak development of baby-cry-elicited accelerations occurred about 1 second before that of erotic segment-elicited accelerations. The results are consistent with a preparatory-response interpretation, but more research is needed both to investigate the generality of these sex differences in heart-rate responses, and to determine the role of experiential and psychosocial factors.

Adult↗
PubMed1989

Technological innovation and the labour process in health care.

The process of technological innovation in health care is explored in this paper using labour process theory. Taking the specific case study of diagnostic imaging technology it argues for the utility of labour process theory for analysing the professional labour process as a means of delineating the social contexts in which technological innovation provides a means of empowering workers.

Health Policy↗
PubMed1989

Abrupt changes in mixed venous blood gas composition after the onset of exercise.

It has been assumed that increases in both O2 uptake and ventilation occurring within the first few seconds after the onset of exercise cannot be the result of changes in blood gas composition reaching the central circulation because of the circulatory delay from the exercising limbs (A. Krogh and J. Lindhard, J. Physiol. Lond. 42: 112-136, 1913). We sought to validate this assumption by measuring the time course of pulmonary arterial blood gases during the transition from rest to exercise. Six healthy men underwent pulmonary arterial catheterization and then performed transitions from rest to moderate cycle ergometer exercise. An anaerobic sampling manifold withdrew 19 samples of blood during the rest-to-exercise transition; sampling interval was usually 4 s. Blood gas analysis showed that, on average, from rest-to-steady-state exercise, O2 saturation (Svo2) fell from 71 to 41% and mixed venous PCO2 (PvCO2) rose from 42 to 59 Torr. Contrary to our expectations, Svo2 decreased and PvCO2 increased with no discernible latency after exercise onset (by 10% and 2 Torr, respectively, within 6 s). The half time for the Svo2 decrease was 32 s, whereas for the PvCO2 increase it was 80 s. The time course of superior vena cava blood gas composition was determined in several experiments; no rapid changes after exercise onset were found. We conclude that at exercise onset there is a rapid fall in Svo2 and rise in PvCO2 well in advance of arrival of blood produced by exercising legs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

The bolus tie-over "pressure" dressing in the management of full thickness skin grafts. Is it necessary?

It has been taught that the bolus tie-over "pressure" dressing is essential for the successful "take" of full thickness skin grafts. This was tested in a prospective randomised trial in which 40 full thickness grafts were either managed with the conventional bolus dressing, or alternatively with quilting sutures and no dressing. Whether under local or general anaesthesia there was only one total graft failure from haematoma (tie-over bolus group) and one partial graft failure from haematoma (quilted group). Sixty-five per cent. of all grafts were performed by junior surgical trainees. The bolus tie-over "pressure" dressing does not appear essential for full thickness skin graft survival in the areas of the head and neck studied.

Aged↗