Lactate sensitivity in sleeping panic disorder patients and healthy controls.
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Adult↗
Biomedical subjects
J Fine
Publications and source records attributed to J Fine.
Histologic evaluation of pigmented lesions in Connecticut and its influence on the reporting of melanoma.
BACKGROUND: Underreporting of melanoma to state tumor registries has been identified as a problem in gathering accurate statistics on melanoma incidence. OBJECTIVE: Our purpose was to examine two factors that could influence the reporting of melanoma to the Connecticut Tumor Registry: histologic diagnosis of melanoma in the private offices of dermatologists and histologic diagnosis of melanoma in out-of-state laboratories. METHODS: From December 1990 to April 1991, questionnaires were sent to all known practicing dermatologists in the state of Connecticut (N = 149). Of the 127 dermatologists who were eligible, 124 (97.6%) completed the survey. RESULTS: The estimated number of melanomas diagnosed in private offices during 1990 was 9 to 18; this was based on the number of dermatologists who officially read their own slides (n = 19), the estimated number of melanomas diagnosed by these 19 dermatologists (n = 91), and the percentage of melanomas and uncertain pigmented lesion cases sent for consultation (80% to 90%). According to the estimates of Connecticut dermatologists, out-of-state laboratories diagnosed 84 of 523 melanomas (16%) in Connecticut residents. CONCLUSION: The diagnosis of melanoma in private offices did not appear to be a significant factor in underreporting whereas the diagnosis of melanoma in out-of-state laboratories did appear to be more significant. However, the possibility exists that some of these latter melanomas would eventually be reported at the time of reexcision.
Biopsy↗
An analysis of interobserver recognition of the histopathologic features of dysplastic nevi from a mixed group of nevomelanocytic lesions.
BACKGROUND: The diagnostic criteria for the histopathologic recognition of the dysplastic nevus are defined, but difficult to apply in practice. However, the use of skin biopsy is on the increase to search for this nevus because of a possible role in melanomagenesis. OBJECTIVE: The aim was to determine the degree of observer reproducibility in the detection of histologic nevomelanocytic dysplasia as measured across multiple observers and to test whether each observer was precise over a wide sample population. A second aim was to gain some measure of the threshold a person has for such lesions. METHODS: Histologic specimens from 50 coded nevomelanocytic tumors, which included a group of dysplastic nevi, were independently read by five observers in a blinded fashion. At study completion, the same 50 cases were read again by a melanoma reference pathologist and results analyzed by Cohen's kappa to assess agreement and interobserver variation. RESULTS: Corrected rates of agreement for dysplastic nevi ranged from 0.32 to 0.71. CONCLUSION: Continued study and experience are required for precision and reproducibility in the histologic recognition of dysplastic nevi.
Dysplastic Nevus Syndrome↗
Safe sex behavior in drug-addicted males as a function of object relations.
An inventory of sexual behavior was administered in a hospital detoxification program to 127 drug-addicted males, who also completed a modified form of the Defense Mechanisms Inventory (DMI) which yields a measure of object relations. Condom use was shown to be related to an object relations mode that typifies the individual who can structure reality and needs without requiring an integral aspect of "the other" in his approach. Standardization and factor analytic data are also presented for the DMI and the object relations measure for this population. The resulting pattern and the small effect size are discussed within the reality constraints of the addicted patient, as well as within the psychometric parameters inherent in psychoanalytic research.
Adult↗
Chasing the dragon: a wider perspective.
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Administration, Inhalation↗
The use of intonation to communicate in pervasive developmental disorders.
The objective of this paper was to employ a functional linguistic approach to explore pragmatic failure in the spontaneous speech of subjects with pervasive developmental disorders (PDD). Patterns of intonation use were compared among subjects with Asperger's syndrome (AS), high-functioning autism (HFA), and psychiatric out-patient controls (OPC) with a variety of non-specific social problems. Written transcripts and audio-recordings were used to measure rates of various intonation types relative to the amount of speech produced. The major finding of the study was that the HFA subjects less often tend to employ useful patterns of intonation for communication than the AS or OPC groups. This suggests that HFA either send random intonation signals to hearers or else demonstrate systematic misuse of the linguistic system. AS subjects differed little from the controls. The implications of these results for understanding the communicative failure of PDD subjects is discussed.
Adolescent↗
Airway oedema and obstruction in guinea pigs exposed to inhaled endotoxin.
Protein extravasation and airway conductance (SGaw) were examined in awake guinea pigs exposed to inhaled endotoxin or saline for three hours. A significant increase in protein extravasation (as estimated by the leakage of protein bound Evans blue dye) was seen in the conducting airways of endotoxin exposed animals compared with saline exposed animals. Mean dye extravasation was significantly increased by one to threefold in the mainstem and hilar bronchi of endotoxin exposed animals. These changes in extravasation were accompanied by decrements in pulmonary function and by an influx of polymorphonuclear leucocytes into the airway wall. The SGaw decreased significantly by 60-90 minutes into exposure to endotoxin and had decreased by 22% and 34% at the end of exposure in the low and high dose endotoxin groups, respectively. Similar findings were obtained in animals exposed to cotton dust. Contrary to studies suggesting that platelet activating factor (PAF) is involved in the systemic and peripheral lung effects of endotoxin, pretreatment with the PAF antagonist WEB2086 did not prevent the conducting airway injury produced by inhaled endotoxin.
Aerosols↗
The relationship of prostaglandins to cAMP, IgG, IgM and alpha-2-macroglobulin in gingival crevicular fluid in chronic adult periodontitis.
Gingival crevicular fluid, collected from 8 patients with chronic adult periodontitis before and 21 days after root planing and scaling, was analysed for prostaglandin E2, 6KPGF1 alpha, cAMP, IgG, IgM and alpha-2-macroglobulin, and their inter-relationship evaluated. There was a significant decrease in the levels of prostaglandin E2, IgG, IgM and alpha-2-macroglobulin after treatment, whereas the levels of 6KPGF1 alpha and cAMP remained essentially unchanged. The level of prostaglandin E2 decreased by 35%, IgG by 32%, IgM by 90%, and alpha-2-macroglobulin by 79%. There was a significant degree of correlation between prostaglandin E2 and 6KPGF1 alpha and cAMP before treatment but not after, but no correlation between prostaglandin E2 and IgG, IgM and alpha-2-macroglobulin either before or after. This correlation pattern indicates the involvement of E2, prostaglandin 6KPGF1 alpha and cAMP in inflammation in the periodontium. The changes in IgG, IgM and alpha-2-macroglobulin reflect yet another mechanism of host response which appears to be independent of prostaglandins.
6-Ketoprostaglandin F1 alpha↗
Chasing the dragon: the smoking of heroin and cocaine.
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Cocaine↗
AIDS-related risk behaviors among substance abusers.
Ninety-two substance abusers were surveyed about AIDS-related risk behaviors. The questionnaire administered elicited information on demographics, sexual practices, substance abuse, and risk behaviors involving the use of needles. Results indicated an appropriate base of prevention knowledge and patients' efforts to modify vulnerability to HIV exposure. Nevertheless, patients continue to engage in behaviors resulting in HIV exposure and transmission.
Acquired Immunodeficiency Syndrome↗
Extracellular nucleotides stimulate receptor-mediated calcium mobilization and inositol phosphate production in human fibroblasts.
In human skin fibroblasts, low concentrations of extracellular ATP stimulated 45Ca2+ efflux from a slow-turnover intracellular pool, accompanied by inositol phosphate generation. These effects of ATP were not due to a generalized increase in plasma-membrane permeability. The EC50 (concn. giving 50% stimulation) for ATP was dependent on Ca2+ and Mg2+ concentrations in a manner which indicates that a form of ATP uncomplexed with bivalent cations is the active species. The rank order of potency of nucleotides was: ATP = UTP greater than adenosine 5'-[gamma-thio]triphosphate greater than ITP greater than ADP greater than UDP greater than other nucleoside triphosphates. Adenosine 5'-[alpha beta-methylene]triphosphate, adenosine 5'-[beta gamma-methylene]triphosphate and 2-methylthio-ATP were inactive. Thus the nucleotide specificity of this receptor is different from that of previously characterized P2 purinoceptors. Nucleotide-stimulated 45Ca2+ mobilization and inositol phosphate production were markedly inhibited by phorbol ester, and partially inhibited by pertussis-toxin pretreatment. These findings suggest that the coupling of nucleotide receptor to phospholipase C is mediated both by a pertussis-toxin-sensitive G-protein and by a pertussis-toxin-insensitive mechanism.
Adenosine Triphosphate↗
Tear gas--harassing agent or toxic chemical weapon?
Tear gas has gained widespread acceptance as a means of controlling civilian crowds and subduing barricaded criminals. The most widely used forms of tear gas have been o-chlorobenzylidenemalononitrile and omega-chloroacetophenone. Proponents of their use claim that, if used correctly, the noxious effects of exposure are transient and of no long-term consequences. The use of tear gas in recent situations of civil unrest, however, demonstrates that exposure to the weapon is difficult to control and indiscriminate, and the weapon is often not used correctly. Severe traumatic injury from exploding tear gas bombs as well as lethal toxic injury have been documented. Moreover, available toxicological data are deficient as to the potential of tear gas agents to cause long-term pulmonary, carcinogenic, and reproductive effects. Published and recent unpublished in vitro tests have shown o-chlorobenzylidenemalononitrile to be both clastogenic and mutagenic. Sadly, the nature of its use renders analytic epidemiologic investigation of exposed persons difficult. In 1969, eighty countries voted to include tear gas agents among chemical weapons banned under the Geneva Protocol. There is an ongoing need for investigation into the full toxicological potential of tear gas chemicals and renewed debate on whether their use can be condoned under any circumstances.
Adult↗
Extracellular adenosine triphosphate activates phospholipase C and mobilizes intracellular calcium in primary cultures of sheep anterior pituitary cells.
In primary cultures of sheep anterior pituitary cells extracellular ATP (ED50 0.4-0.8 microM) stimulated efflux of 45Ca2+ from a slow-turnover intracellular pool. ADP was also effective whereas AMP and adenosine were not. The ATP effect was not due to cell permeabilization as 100 microM ATP did not elicit efflux of 2-deoxy[3H]glucose metabolites. This 45Ca2+ mobilization may be mediated by inositol trisphosphate, since ATP (ED50 1 microM) stimulated inositol phosphate generation. These results demonstrate P2-purinoceptors in sheep anterior pituitary cells which are coupled to phospholipase C activation and intracellular Ca2+ mobilization, and raise the possibility of a regulatory role for extracellular ATP in the anterior pituitary.
Adenosine Triphosphate↗
A behavioral measure of AIDS information seeking by drug and alcohol inpatients.
A nonreactive, observational research method was used to measure AIDS information-seeking behavior of patients on four drug and alcohol inpatient units at a large public hospital in New York City. Results showed only 23 inquiries from 271 male and female patients over a six-week interval. Possible explanations and implications of these results are discussed.
Acquired Immunodeficiency Syndrome↗
Interactive computer-video modules for health sciences education.
Advances in electronic image recording and computer technology have resulted in a remarkable increase in the power and flexibility of interactive computer-video teaching systems. The University of Washington Health Science Videodisc Development Group first demonstrated a laser videodisc controlled by a remote central computer in 1980. Even this rudimentary unit highlighted basic medical informatics principles including: rapid accessibility; a "generic" or multi-purposed format; ease of computer control; and large collections of valid, rigorously reviewed images. Advances in medical informatics have led to the development of the following previously undescribed series of teaching units: 1. The hypertext programs Hypercard, Linkway, and Guide have been used with videodiscs to develop easy-to-use instructional and reference materials. These materials demonstrate the ease with which a computer-naive instructor may develop new programs and the advantages that the intuitive nature of these programs brings to student users. 2. Patient simulations using single and double screens plus pre-defined knowledge structures; 3. Interactive single topic tutorials using preset knowledge structures; 4. A key-word-based disc searching system; 5. Electronic video microscopy; 6. A series of programs developed independently by health science faculty who have purchased multi-purpose videodiscs that demonstrate the flexibility of the multi-purpose or "generic": collection concept.
Computer Simulation↗
Usefulness of frequent skin examination for the early detection of second primary cutaneous melanoma.
This report describes the efficacy of skin examination for the early detection of second primary cutaneous melanomas among patients with nonfamilial melanoma. A series of 121 patients with newly diagnosed first primary cutaneous melanomas participated in a study of melanoma and dysplastic nevi. Of the 121 study participants, six patients were subsequently diagnosed with a second primary melanoma. For five of these patients, frequent skin examinations resulted in the detection of second primaries that were shallower in depth than was the first primary melanoma. In four cases, the second primaries were identified in low-risk growth phases (less than 0.76 mm); three of these low-risk tumors were melanoma in situ.
Humans↗
Abuse of the child and anxiety in the adult.
We report on the early development and family background of 20 patients admitted to an anxiety disorders clinic serving a disadvantaged population. Sixteen of these 20 patients had been abused or neglected. Nineteen had a diagnosis of at least one personality disorder. We discuss the relationship between the patients' backgrounds and their current disorders. It is our thesis that the traumatic background of our patients is the major factor that allows anxiety to be passed across the generations.
Adult↗
Prevention of sore throat after nasotracheal intubation.
The influence of tube size, cuff inflation, and pharyngeal packing on development of sore throat after nasotracheal intubation was studied. Pharyngeal packing was found to be the most significant factor, followed by tube size and inflation of the cuff.
Adolescent↗