Biomedical subjects
Publications and source records attributed to J Greenberg.
Four cases of collateral perfusion of a lower extremity by way of an internal mammary artery in the presence of Leriche's syndrome are described. Angiographic documentation preceding coronary artery bypass grafting prevented an acutely ischemic leg in two of the cases.
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Four experiments tested the hypothesis that people distance themselves from others who display characteristics they fear in themselves. In Study 1, participants were given false feedback that they were high or low in repressed anger and were given information about a person who became angry and responded in a violent or nonviolent manner. High anger feedback participants distanced themselves only from the violent person. In Study 2, high anger feedback led to distancing from a violent other but not a dishonest other, whereas dishonesty feedback led to distancing from a dishonest other but not a violent other. The results of Studies 3 and 4 replicated and extended the distancing effect with an anger induction: Participants who were insulted distanced themselves from an angry/violent person, and verbalizing their emotions about being insulted eliminated this effect. Implications for understanding defenses against undesirable self-attributions are discussed.
The present research investigated the role of the physical body as a source of self-esteem and tested the hypothesis derived from terror management theory that reminding people of their mortality increases self-esteem striving in the form of identification with one's body, interest in sex, and appearance monitoring. The results revealed that individuals high in body esteem responded to mortality salience manipulations with increased identification with their physical bodies in Study 1 and with increased interest in sex in Study 2. Study 3 showed that reminders of death led to decreased appearance monitoring among appearance-oriented participants who were low in body esteem. These findings provide insight into why people often go to extreme lengths to meet cultural standards for the body and its appearance.
Reactive oxygen species (ROS) are toxic byproducts of mitochondrial energy production that inflict oxidative stress, a constant barrage of damage to DNA, proteins, lipids, and other biologically important molecules. Oxidative stress has been implicated as a pathologic mechanism in aging and in several diseases. We developed a display of apparent new markers of oxidative stress in human beings, the breath methylated alkane contour (BMAC). The BMAC is a three-dimensional display of C4 to C20 alkanes and monomethylated alkanes in breath, with x-axis = carbon chain length, z-axis = methylation site, and y-axis = alveolar gradient (relative abundance in breath minus relative abundance in room air). In 102 normal human subjects of 9 to 89 years of age, alveolar gradients of components of the BMAC increased significantly with age. The mean alveolar gradient of all components of the BMAC varied from negative in the youngest quartile (ages 9 to 31 years) to positive in the oldest quartile (ages 74 to 89 years)(P < 2.10(-9)). These findings were consistent with an increase in oxidative stress with advancing age, although an age-related decline in clearance by cytochrome p450 may have contributed. The BMAC provides a display of apparent new markers of oxidative stress with potential applications in aging research, clinical diagnosis, pharmacology, and toxicology.
Ethane and pentane in breath are markers of oxidative stress, produced by ROS-mediated lipid peroxidation of n-3 and n-6 polyunsaturated fatty acids (PUFAs), but little is known about other n-alkanes in normal human breath. We investigated the spectrum of alkanes in normal human alveolar breath, and their variation with age. Fifty normal humans were studied (age range 23-75, median 35). Volatile organic compounds (VOCs) in alveolar breath were captured on sorbent traps and assayed by gas chromatography and mass spectroscopy. Alveolar gradients (concentration in breath minus concentration in ambient room air) of alkanes were determined. C4-C20 alkanes were observed in breath and room air. Their mean alveolar gradients were negative from C4 to C12 and positive from C13 to C20. The mean alveolar gradients of four alkanes (C5-C8) were significantly less negative in the older subjects (p < 0.05). There were no significant differences between males and females. Normal human breath contained a spectrum of alkanes which may include new markers of oxidative stress. The mean rate of clearance (via cytochrome p450) exceeded the mean rate of synthesis (by ROS-mediated oxidative stress) for C4-C12 alkanes, while synthesis was greater than clearance for C13-C20 alkanes. The elevated alkane profile in older subjects was consistent with an age-related increase in oxidative stress, though an age-related decline in alkane clearance rate may have contributed.
AIM: To determine the concurrent validity of three self-administered health-related quality of life (HRQOL) questionnaires when administered to patients with amyotrophic lateral sclerosis (ALS). BACKGROUND: ALS is the most common motor neuron disease among adults. As a rapidly progressive and fatal disease, ALS has devastating effects on the patient's relationships, functional capacity and mental health. HRQOL measures include information about patients' physical impairments, functional level, and psychosocial status. This study compares a tool designed for the ALS population, the Sickness Impact Profile ALS-19 (SIP/ALS19), and two tools designed to be used in any population, the Quality of Well-being Scale SA (QWB SA), and the SF-36 Health Survey (SF-36). Correlation of the scores would suggest that each tool is valid as a stand-alone measurement of quality of life for this patient population. METHODS: The SIP/ALS-19, the SF-36, and the QWB SA were self-administered to 19 subjects diagnosed with ALS. The scores for each test were ranked and analyzed for agreement using the Spearman rank correlation coefficient. RESULTS: The SIP/ALS-19 demonstrated moderate to good correlation with the QWB SA and fair correlation with the SF-36. The SF-36 had little to no correlation with the QWB SA. CONCLUSIONS: The study did not demonstrate significant correlation among the three quality of life measures. The SIP/ALS-19, SF-36, and QWB SA each have a different focus in measuring HRQOL. The healthcare practitioner should consider the patient's stage of disease, treatment goals, and type of interventions planned when selecting a HRQOL tool for the ALS patient.
This study evaluates the effectiveness of two strategies--communication and condom skills training--for increasing condom-protected sex in a sample of 510 high-risk women ages 17 to 61. Baseline and 3- and 6-month postintervention interview data were gathered in three cities participating in a randomized trial of a six-session, group skill-building intervention. This analysis was conducted for the entire sample and for six subgroups categorized by age, single or multiple partners, and history of childhood sexual abuse. The dependent variable was the odds ratio of protected sex acts at each follow-up. Structural equation modeling was used to estimate effects for two intervention pathways. The pathway through condom skills increased the odds of protected sex for the intervention group (chi 2 difference = 35, df = 2, p < .05) as well as for all subgroups. The pathways through communication were significant for the intervention group (chi 2 difference = 23, df = 3, p < .05) but fully effective only for participants under 30 and participants who reported childhood sexual abuse. The effectiveness of both pathways diminished at 6 months. WINGS demonstrates that condom skills training can increase protected sex for a heterogeneous group of women. Further research needs to examine how such skill training translates into use of condoms by male partners. To increase the duration of intervention effects, booster sessions may need to be incorporated.
We studied the variation in volatile organic compounds (VOCs) in the breath of 50 normal humans, using gas chromatography and mass spectroscopy. An average breath sample contained 204.2 VOCs (SD=19.8, range 157-241). The alveolar gradient of each VOC (abundance in breath minus abundance in air) varied with rate of synthesis minus rate of clearance. A total of 3481 different VOCs were observed: 1753 with positive alveolar gradients, 1728 with negative alveolar gradients. Twenty-seven VOCs were observed in all fifty subjects. This study confirmed previous reports of wide inter-individual variations. Two new findings were the comparatively small variation in total number of breath VOCs, and the presence of a 'common core' of breath VOCs in all subjects.
BACKGROUND: Many volatile organic compounds (VOCs), principally alkanes and benzene derivatives, have been identified in breath from patients with lung cancer. We investigated whether a combination of VOCs could identify such patients. METHODS: We collected breath samples from 108 patients with an abnormal chest radiograph who were scheduled for bronchoscopy. The samples were collected with a portable apparatus, then assayed by gas chromatography and mass spectroscopy. The alveolar gradient of each breath VOC, the difference between the amount in breath and in air, was calculated. Forward stepwise discriminant analysis was used to identify VOCs that discriminated between patients with and without lung cancer. FINDINGS: Lung cancer was confirmed histologically in 60 patients. A combination of 22 breath VOCs, predominantly alkanes, alkane derivatives, and benzene derivatives, discriminated between patients with and without lung cancer, regardless of stage (all p<0.0003). For stage 1 lung cancer, the 22 VOCs had 100% sensitivity and 81.3% specificity. Cross-validation of the combination correctly predicted the diagnosis in 71.7% patients with lung cancer and 66.7% of those without lung cancer. INTERPRETATION: In patients with an abnormal chest radiograph, a combination of 22 VOCs in breath samples distinguished between patients with and without lung cancer. Prospective studies are needed to confirm the usefulness of breath VOCs for detecting lung cancer in the general population.
Alström syndrome is a rare autosomal recessive disorder characterized by retinal degeneration, sensorineural hearing loss, early-onset obesity, and non-insulin-dependent diabetes mellitus. The gene for Alström syndrome (ALMS1) has been previously localized to human chromosome 2p13 by homozygosity mapping in two distinct isolated populations - French Acadian and North African. Pair-wise analyses resulted in maximum lod (logarithm of the odds ratio) scores of 3.84 and 2.9, respectively. To confirm these findings, a large linkage study was performed in twelve additional families segregating for Alström syndrome. A maximum two-point lod score of 7.13 (theta = 0.00) for marker D2S2110 and a maximum cumulative multipoint lod score of 9.16 for marker D2S2110 were observed, further supporting linkage to chromosome 2p13. No evidence of genetic heterogeneity was observed in these families. Meiotic recombination events have localized the critical region containing ALMS1 to a 6.1-cM interval flanked by markers D2S327 and D2S286. A fine resolution radiation hybrid map of 31 genes and markers has been constructed.
If stereotypes function to protect people against death-related concerns, then mortality salience should increase stereotypic thinking and preferences for stereotype-confirming individuals. Study 1 demonstrated that mortality salience increased stereotyping of Germans. In Study 2, it increased participants' tendency to generate more explanations for stereotype-inconsistent than stereotype-consistent gender role behavior. In Study 3, mortality salience increased participants' liking for a stereotype-consistent African American and decreased their liking for a stereotype-inconsistent African American; control participants exhibited the opposite preference. Study 4 replicated this pattern with evaluations of stereotype-confirming or stereotype-disconfirming men and women. Study 5 showed that, among participants high in need for closure, mortality salience led to decreased liking for a stereotype-inconsistent gay man.
Terror management theory posits that sex is a ubiquitous human problem because the creaturely aspects of sex make apparent our animal nature, which reminds us of our vulnerability and mortality. People minimize this threat by investing in the symbolic meaning offered by the cultural worldview. Because people high in neuroticism have difficulty finding or sustaining meaning, sex is a particular problem for them. In Study 1, mortality salience caused high-neuroticism participants to find the physical aspects of sex less appealing. Study 2 revealed that for such individuals thoughts of physical sex increase the accessibility of death-related thoughts. This finding was replicated in Study 3, which also showed that providing meaning by associating sex with love reduces the accessibility of death-related thoughts in response to thoughts of physical sex. These findings provide insight into why people high in neuroticism have conflicting thoughts about sexuality and why sexuality is so often regulated and romanticized.
Distinct defensive processes are activated by conscious and nonconscious but accessible thoughts of death. Proximal defenses, which entail suppressing death-related thoughts or pushing the problem of death into the distant future by denying one's vulnerability, are rational, threat-focused, and activated when thoughts of death are in current focal attention. Distal terror management defenses, which entail maintaining self-esteem and faith in one's cultural worldview, function to control the potential for anxiety that results from knowing that death is inevitable. These defenses are experiential, are not related to the problem of death in any semantic or logical way, and are increasingly activated as the accessibility of death-related thoughts increases, up to the point at which such thoughts enter consciousness and proximal threat-focused defenses are initiated. Experimental evidence for this analysis is presented.
The RP17 locus for autosomal dominant retinitis pigmentosa has previously been mapped to chromosome 17q by linkage analysis. Two unrelated South African families are linked to this locus and the identification of key recombination events assigned the RP17 locus to a 10 cM interval on 17q22. The work reported here refines the mapping of the locus from a 10 cM to a 1 cM interval between the microsatellite markers D17S1604 and D17S948. A physical map of this interval was constructed using information from the Whitehead/MIT YAC contig WC 17.8. Sequence-tagged site (STS) content mapping of seven overlapping YACs from this contig was employed in order to build the map. A BAC library was screened to cover a gap in the YAC contig and two positive BACs were identified. Intragenic polymorphisms in the retinal fascin gene provided evidence for the exclusion of this candidate as the RP17 disease gene.
Over the past three decades, the influence and importance of social support has been well documented and the findings have suggested a beneficial effect on stress-related situations, mental and physical health, and social functioning. More recently, small group/skills training behavioral interventions have demonstrated success in changing behaviors which affect the transmission of sexually transmitted diseases, including HIV among populations at risk for these diseases. Studies of support groups to date have been conducted exclusively in research settings where women are offered financial incentives for participation. Little is known about the willingness of women to participate in ongoing support groups after successfully completing a skills training intervention. The present study examines the factors that may influence participation among women in a weekly support group after completing a structured, six session HIV/STD intervention. Both quantitative and qualitative data are collected from 265 women in the intervention arm of a multi-site randomized controlled behavioral intervention trial. Results reveal that less than a quarter (22%) of women participated in at least one support group. Participation varied significantly by site, ranging from 34% to 15% (p = .008). Participation was also strongly linked to recent use of domestic violence services. Qualitative data indicated that although monetary incentives play some role in the woman's decision to participate, other factors are also important. These include program outreach, support group size, salience of the group content, consistency of group leadership from the intervention to the support group, and use of peer leaders along with professional facilitators. Implications for design of post-intervention support groups programs are discussed.
OBJECTIVE: Women with histories of interpersonal violence are poorly identified because of barriers in self-disclosure. This study identified differences on maternal health and child behavior between women who report filing a restraining order (RO) and those who do not among a nonreferred sample of women living in high-crime neighborhoods. METHODS: During a maternal interview mothers were asked whether they ever filed a RO, the victim/defendant relationship, the number of times, and the year of the filing. Four types of violence were coded independently based on maternal narratives: verbal harassment, verbal threats or intimidation, physical assault, and destruction of property. We controlled for differences between RO and non-RO groups regarding demographic background, partner characteristics, other types of maternal past victimization, and use of alcohol and illicit drugs. Outcomes for mothers include partner aggression (Conflict Tactics Scale-R), perception of health and bodily pain (SF-36 Health Survey), distress symptoms (SCL90-R), posttraumatic stress (PTS)-related symptoms, and partial posttraumatic stress disorder (PTSD) diagnosis (modified Diagnostic Interview Schedule PTSD-Module). Outcomes for the child include partner aggression (Conflict Tactic Scale-R), behavior problems (CBC 2-3 or Child Behavior Checklist), and PTS-related symptoms (PTS-related symptom checklist). PATIENTS: One hundred sixty patients between 3.0 to 6.1 years who resided within five residential ZIP codes with a high rate of local crime in the City of Boston were drawn from a pediatric care clinic practice. Patients were participants of a larger study about the impact of community violence on mother-child relations. RESULTS: Sixty-four (40%) of 160 mothers reported a history of filing a RO against a current boyfriend or husband (39%), ex-boyfriend or husband (44%), someone known (8%), or other (9%), with a mean of 3.9 years (standard deviation = 3.5 years) since RO filing. After controlling for covariates of marital status, immigrant status, public assistance, and lifetime sexual victimization, we found a significant multivariate analysis of covariance group effect on maternal outcomes. Analysis of covariance analyses indicated that mothers in the RO group experienced higher current partner verbal aggression and physical violence to mother, poorer health, and higher PTS-related symptoms, compared with mothers in the non-RO group. More mothers in the RO group met partial lifetime PTSD diagnosis. Unadjusted for maternal covariates, the multivariate analysis of variance analyses on child outcomes (partner aggression to child, behavior problems, and PTS-related symptoms) indicated a nonsignificant group effect. CONCLUSIONS: Among dyads residing in high-risk crime areas, the incidence of RO histories is substantive considering this was a nonshelter, nonreferred sample. The inquiry about the history of a RO may provide a new and efficient marker to quality of current partner relationship, maternal health, and maternal stress-related symptomatology.