Biomedical subjects

J Greenberg

Publications and source records attributed to J Greenberg.

At least 109 records · Page 6Linked to original sources

PubMed1992

Terror management and tolerance: does mortality salience always intensify negative reactions to others who threaten one's worldview?

Terror management research has shown that reminding Ss of their mortality leads to intolerance. The present research assessed whether mortality salience would lead to increased intolerance when the value of tolerance is highly accessible. In Study 1, given that liberals value tolerance more than conservatives, it was hypothesized that with mortality salience, dislike of dissimilar others would increase among conservatives but decrease among liberals. Liberal and conservative Ss were induced to think about their own mortality or a neutral topic and then were asked to evaluate 2 target persons, 1 liberal, the other conservative. Ss' evaluations of the targets supported these hypotheses. In Study 2, the value of tolerance was primed for half the Ss and, under mortality-salient or control conditions, Ss evaluated a target person who criticized the United States. Mortality salience did not lead to negative reactions to the critic when the value of tolerance was highly accessible.

Attitude to Death↗

PubMed1992

Why do people need self-esteem? Converging evidence that self-esteem serves an anxiety-buffering function.

Three studies were conducted to assess the proposition that self-esteem serves an anxiety-buffering function. In Study 1, it was hypothesized that raising self-esteem would reduce anxiety in response to vivid images of death. In support of this hypothesis, Ss who received positive personality feedback reported less anxiety in response to a video about death than did neutral feedback Ss. In Studies 2 and 3, it was hypothesized that increasing self-esteem would reduce anxiety among individuals anticipating painful shock. Consistent with this hypothesis, both success and positive personality feedback reduced Ss' physiological arousal in response to subsequent threat of shock. Thus, converging evidence of an anxiety-buffering function of self-esteem was obtained.

Adaptation, Psychological↗

PubMed1992

Retinitis pigmentosa, AD type I: exclusion of linkage to D3S47 (C17) in a large South African family of British origin.

Linkage analysis has been performed on a large South African family of British origin in which 39 persons in 6 generations had early onset Type I autosomal dominant retinitis pigmentosa (ADRP). Tight linkage was excluded between the disease and the D3S47 locus on chromosome 3. This finding is further evidence for genetic heterogeneity in ADRP.

Chromosomes, Human, Pair 3↗

PubMed1992

Dose-ranging study of depot disulfiram in alcohol abusers.

The object of this early Phase 2 study was to determine the dosage of depot disulfiram (DSF) required to induce sustained sensitivity to alcohol. Sixteen abstinent alcohol abusers were studied in an unblinded ascending-dose trial of DSF suspended in either (1) 5% methylcellulose or (2) 0.1% polysorbate 80. Five pairs of subjects received a single subcutaneous dose of Formulation A (1.0, 2.0, 2.5, 3.0, or 3.5 g). Three pairs were treated with Formulation B (60, 75, or 90 mg/kg) plus an oral loading dose of DSF (15 mg/kg). Subjects were challenged with oral alcohol (0.15 g/kg) before treatment, and on days 7, 14, 21, and 28. Subjective and objective responses to alcohol challenges (skin temperature, breath acetaldehyde, pulse rate, and blood pressure) were measured, and mobilization of DSF was assessed by carbon disulfide levels in breath. Treatment with Formulation B (75 or 90 mg/kg) plus an oral-loading dose (15 mg/kg) was consistently followed by sustained sensitivity to alcohol. Some subjects experienced the subjective and objective features of the DSF-ethanol reaction for 28 days, but these reactions achieved statistical significance only on day 7 for objective changes and on days 7 and 14 for subjective discomfort. Breath carbon disulfide was detectable until day 28 in all subjects receiving more than 1.0 g DSF, demonstrating sustained release of the drug. Treatment with depot DSF merits further study for its potential benefits in chronic alcohol abuse.

Adult↗

PubMed1992

Phase II study of cisplatin, ifosfamide with mesna, and etoposide (PIE) chemotherapy for advanced non-small cell lung cancer.

Ifosfamide has shown promising single-agent activity in non-small cell lung cancer (NSCLC). We combined ifosfamide (1,800 mg/m2 plus mesna 1,100 mg/m2 by intravenous [IV] continuous infusion daily for 3 days) with cisplatin (20 mg/m2 IV for 3 days) and etoposide (80 mg/m2 IV for 3 days) and treated 41 chemotherapy-naive patients with recurrent or metastatic NSCLC. Fifteen (40.5%) of the 37 evaluable patients had objective responses (1 complete and 14 partial). Patients with good performance status (Zubrod scale 0 or 1) had a higher response rate than the patients with poor performance status (Zubrod scale 2) (11 of 21 patients [52.4%] versus four of 16 [25.0%]), but the difference was not statistically significant (P = .09). Median survival has not been reached, with 17 patients still alive after a median follow-up of 39 weeks (range, 21 to 56). Significant myelosuppression occurred, with granulocytopenia being the dose-limiting toxicity. Overall, treatment was well tolerated. Considering the pooled response rate of 32% with cisplatin/etoposide regimens and the previous experience from our institution, the results with this three-drug regimen are very encouraging, and its further investigation is warranted.

Adenocarcinoma↗

PubMed1992

Phase II study of cisplatin, ifosfamide, and etoposide combination for advanced non-small cell lung cancer: final report.

Ifosfamide has shown promising single-agent activity in non-small cell lung cancer. We combined ifosfamide (1,800 mg/m2, plus 1,100 mg/m2 of mesna by intravenous continuous infusion daily for 3 days) with cisplatin (20 mg/m2 intravenously for 3 days) and etoposide (80 mg/m2 intravenously for 3 days) and treated 41 patients with recurrent or metastatic non-small cell lung cancer who had received no prior systemic chemotherapy. Fifteen (40.5%) of the 37 evaluable patients had objective responses (one complete and 14 partial). Patients with a good Zubrod performance status (ie, 0 or 1) had a higher response rate than those with poor performance status (ie, 2) (11 of 21 [52.4%] v 4 of 16 [25.0%]), but the difference was not statistically significant (P = .09). Median survival was 28 weeks for all patients and 59+ weeks for responders, with 11 patients still alive after a median follow-up of 59 weeks (range, 51 to 77 weeks). Overall, treatment was well tolerated, with granulocytopenia being the most frequent toxicity. Considering the pooled response rate of 32% with a cisplatin/etoposide regimen and the previous experience from our institution, the results with this three-drug regimen are encouraging, and its further investigation is warranted, particularly for patients who have good performance status and in a neoadjuvant setting.

Adult↗

PubMed1992

Mutations of the KIT (mast/stem cell growth factor receptor) proto-oncogene account for a continuous range of phenotypes in human piebaldism.

Piebaldism is a rare autosomal dominant disorder of pigmentation, characterized by congenital patches of white skin and hair from which melanocytes are absent. We have previously shown that piebaldism can result from missense and frameshift mutations of the KIT proto-oncogene, which encodes the cellular receptor tyrosine kinase for the mast/stem cell growth factor. Here, we report two novel KIT mutations associated with human piebaldism. A proximal frameshift is associated with a mild piebald phenotype, and a splice-junction mutation is associated with a highly variable piebald phenotype. We discuss the apparent relationship between the predicted impact of specific KIT mutations on total KIT-dependent signal transduction and the severity of the resultant piebald phenotypes.

Amino Acid Sequence↗

PubMed1992

Gender differences in infirmary use at a residential summer camp.

Studies of health behavior in adults show that women report more morbidity and greater health service utilization than do men, despite lower mortality rates. Explanations involve social and biological gender differences in adult life. Infirmary utilization at a residential summer camp where parental influence is minimized was studied to determine whether these gender differences occur in the pediatric age group. Three hundred ninety-eight campers, 8 to 18 years old were studied. Girls were observed to make greater use of the infirmary than boys (p less than .01) and were especially likely to present with minor trauma, both musculoskeletal (p less than .05) and skin (p less than .01). No correlation was found between age and frequency of visits. Obvious morbidity was similar for boys and girls, in that no gender difference was observed in those visiting for definite medical indications alone or in those admitted. However, a difference was evident in those visiting for minor and trivial problems, particularly in those making three or more visits for minor and trivial problems (p less than .01). Although obvious morbidity was no different in campers, girls used the infirmary more than boys in a manner similar to that reported for adult health behavior. This suggests that gender differences occur earlier than suspected and are not simply related to adult social roles.

Adolescent↗

PubMed1992

Ion-trap detection of volatile organic compounds in alveolar breath.

We describe a method for the collection and microanalysis of the volatile organic compounds in human breath. A transportable apparatus supplies subjects with purified air and samples their alveolar breath; the volatile organic compounds are captured in an adsorptive trap containing activated carbon and molecular sieve. The sample is thermally desorbed from the trap in an automated microprocessor-controlled device, concentrated by two-stage cryofocusing, and assayed by gas chromatography with ion-trap detection. Compounds are identified by reference to a computer-based library of mass spectra with subtraction of the background components present in the inspired air. We used this device to study 10 normal subjects and determined the relative abundance of the volatile organic compounds in their alveolar breath. The breath-collecting apparatus was convenient to operate and was well tolerated by human volunteers.

Air Pollutants↗

PubMed1991

Method for the collection and analysis of volatile compounds in the breath.

A new method is described for the collection and assay of volatile compounds in the breath. Subjects expired into a pump-assisted collecting apparatus in which the breath was drawn through a water trap and then through an adsorptive trap where the volatile compounds were captured on graphitized carbon and molecular sieve. The sample was subsequently eluted from the trap by thermal desorption, concentrated by two-stage cryofocusing, then assayed by gas chromatography with flame ionization and flame photometric detection. Several compounds were regularly observed in the breath of normal human volunteers, including peaks eluting with the same retention times as isoprene, ethanol, acetone, acetaldehyde and carbon disulfide. As a quantitative assay for endogenous isoprene in the breath, the method was sensitive, linear, accurate and reproducible. This method provided a number of advantages: the collection technique was acceptable to volunteers and could be used at sites remote from the laboratory. The automated assay allowed isoprene and several other volatile compounds in the breath to be observed consistently and with improved sensitivity.

Acetaldehyde↗

PubMed1991

The use of anterior Caspar plate fixation in acute cervical spine injury.

Optimal management of cervical cord injury in the presence of documented instability and/or compression of neural elements remains a controversial topic. Surgery and internal stabilization of cervical spine fracture/dislocations are effective and well accepted, but controversy exists on the relative merits of the anterior versus the posterior approach as well as the optimal timing of surgical intervention. We report our experience with the Caspar technique and instrumentation for anterior stabilization in 54 patients for acute cervical spine injury. Our series consists of 38 male and 16 female patients whose ages ranged from 16 to 68 years, with a mean age of 29.2 years. Thirty-two of these patients had complete neurological sensory/motor deficits at the time of presentation, eight were neurologically intact, and 14 had preservation of some motor and sensory function. All 54 patients had radiographic evidence of posterior instability as well as anterior disruption of either a vertebral body or intervertebral disk. We found that "early" intervention (less than 24 hours after injury) was performed frequently in the neurologically compromised patients. Twelve of the 22 patients undergoing surgery less than 24 hours after admission regained significant neurological function, with 13 of 22 developing postoperative complications. In the "delayed" group (surgery more than 24 hours after injury, mean 14.3 days), 14 patients experienced postoperative complications, with 15 of 24 demonstrating neurological improvement. The eight patients who were intact did uniformly well. There was no mortality during the follow-up. All 54 patients showed a solid fusion (clinically and radiologically) within 6 months of surgery. In two cases the plates had to be removed, without risking the fusion. Our experience suggests that although anterior cervical fusion and Caspar plating remain appropriate for patients with documented anterior compromise of the canal, it should not substitute for more traditional posterior stabilization procedures. Because this route has the potential for more serious complications, it should be reserved for the cases in which anterior decompression is deemed necessary or posterior fusion was unsuccessful. With appropriate selection of patients, no adverse effect of early surgery was demonstrated. In fact, neurologically compromised patients had the benefits of increased ease of patient care and early transfer to rehabilitation.

Adolescent↗

PubMed1991

Acute and long-term effects on limb function of combined modality limb sparing therapy for extremity soft tissue sarcoma.

A retrospective review is presented on 145 patients who underwent limb-sparing surgery and radiation therapy (with or without adjuvant chemotherapy) for their primary soft tissue sarcomas of the extremities on protocol between 1975 and 1986. The focus on our analysis was the acute and long term toxicity of treatment on limb function. The most common acute complication was skin reaction, occurring in 52 patients (36%). Long term (occurring after more than 1 year following all treatment) treatment complications in the extremity were as follows: bone fracture = 6%; contracture = 20%; pain requiring narcotics = 7%; edema greater than 2+ = 19%; moderate to severe decrease in range of motion = 32%; moderate to severe decrease in manual muscle strength = 20%; orthotic device required = 9%; cane or crutch required = 7%; chronic infection = 9%; and tissue induration = 57%. Three amputations for treatment complications were required. Inclusion of more than 50% of the joint in the radiation portal was associated with a higher frequency of contracture. High nominal standard dose (greater than 1760 rets, greater than 63 Gy at 1.8 Gy per fraction) resulted in more painful limbs as well as limbs with increased edema, decreased manual muscle strength, decreased range of motion, and skin telangiectasias. Edema was more often noted in patients with a longer radiation portal (greater than 35 cm), as was tissue induration. Chronic ulcer or infection was more frequently seen in patients with lower extremity tumors and when more than 75% of the extremity diameter was irradiated. Although chemotherapy given concurrent with radiation therapy was associated with a higher number of acute skin reactions, this did not appear to translate into increased long term morbidity. The percentage of patients ambulating without assistive devices and with mild or no pain was 84%. Careful attention to the techniques of radiation therapy may have a significant impact on minimizing acute and long term complications of limb sparing treatment for extremity soft tissue sarcoma.

Combined Modality Therapy↗

PubMed1991

Examining the world of the depressed: do depressed people prefer others who are depressed?

Two studies were conducted to examine the interpersonal world of the depressed person. In Study 1, depression levels and perceptions of depressed and nondepressed people and their best friend were assessed to test the hypothesis that depressed Ss have best friends who are themselves more depressed than the best friends of nondepressed Ss. The hypothesis was confirmed, suggesting that depressed persons may prefer others who also tend toward depression. To examine this possibility, in Study 2 depressed and nondepressed college students spoke with one another in either depressed-depressed, nondepressed-depressed, or nondepressed-nondepressed pairs. It was found that depressed Ss felt worse than nondepressed Ss after speaking with nondepressed targets, but not after speaking with depressed targets. There were no differences in liking or in perceived similarity between the groups. Implications for the social world of the depressed person are discussed.

Attitude↗

PubMed1991

Evidence of codependency in women with an alcoholic parent: helping out Mr. Wrong.

A conceptualization of codependency and its development, which is based largely on the writings of Karen Horney, is presented. It is proposed that having learned to obtain approval and self-esteem by conforming to the demands of an exploitive person, women with alcoholic parents will continue to seek opportunities to help such people. On the basis of this analysis, it was hypothesized that women with alcoholic parents would be more helpful to an experimenter portrayed as exploitive than to one portrayed as nurturant; women with nonalcoholic parents were expected to exhibit the opposite pattern. The results strongly supported the existence of codependent behavior in the women with alcoholic parents. The implication of these findings and directions for future research were briefly discussed.

Adolescent↗

PubMed1991

On the relationship between self-focused attention and psychological disorder: a critical reappraisal.

A recent review of the literature on the role of self-focused attention in psychological dysfunction (Ingram, 1990) is critically examined. This article (a) reexamines the evidence relevant to Ingram's proposal that self-awareness is a nonspecific factor involved in virtually all forms of psychopathology and argues that this conclusion is not warranted by the existing evidence; (b) takes issue with his premise that the fact that self-awareness is associated with a variety of psychological dysfunctions poses a conceptual dilemma; (c) corrects several important inaccuracies and mischaracterizations in his presentation of Carver and Scheier's (1981) cybernetic control theory and Pyszczynski and Greenberg's (1987) self-regulatory perseveration theory; and (d) critiques the "self-absorption" model that he proposed as an alternative to extant theories and concludes that this conceptualization does not add to the understanding of either self-awareness processes or psychopathology.

Attention↗

PubMed1991

Hearing impairment and pigmentary disturbance.

Hearing impairment is a variable manifestation of several heritable conditions in which pigmentation of the skin or eyes is abnormal. Some of these disorders are well recognized although uncommon, while others are virtually private syndromes. Practical issues concerning the major conditions of this type are reviewed in this article on a basis of a survey of 4452 profoundly deaf children attending special schools in Southern Africa, together with investigations in affected families. The Waardenburg syndrome (WS), which is the most common deafness-depigmentation disorder, was present in 121 (2.7%) of the 4452 deaf scholars. Further studies in 7 multigeneration affected families confirmed phenotypic variability and indicated a need for internationally agreed diagnostic criteria. In 4 Cape Town families of mixed ancestry the WS-I gene was linked to the 2q37 locus, but in another large kindred no linkage could be demonstrated. Nonallelic heterogeneity is possible. There is uncertainty concerning possible interrelationship between WS and piebaldism. The phenotypic consistency of a South African family in which 7 persons in 3 generations had gross piebaldism in the absence of disturbance of hearing or involvement of the eyes and periorbital structures is suggestive that this disorder and WS are separate entities. Molecular investigations indicate that the gene for piebaldism in this kindred is not situated at the WS-I locus 2q37. Deafness and hyperpigmentation are present in neurofibromatosis type II (acoustic neuromata) and the multiple lentigines syndrome, while retinal pigmentation is a feature of the Usher syndrome. This latter entity is apparently much less common in Southern Africa than in other parts of the world.

Albinism↗

PubMed1991

Targeting long-term care for the frail elderly: models from the Social/HMO demonstration.

This study examined the effect of differing eligibility rules for receipt of long-term care services in the four sites of the Social/HMO National Demonstration Program. Data from the first year of Social/HMO enrollment were used to model the probability of receiving a comprehensive assessment of need for long-term care benefits. Sites using state criteria for Medicaid reimbursement of a nursing home stay were more likely to give assessments to elders with functional impairment problems, whereas those using broader eligibility criteria gave assessments to enrollees with a wider range of characteristics. The results indicate that decisions about eligibility for care have important access and cost implications for consumers, payers, and providers.

Activities of Daily Living↗

PubMed1990

Autoregulation remains intact during stable xenon inhalation in the baboon.

To test the possible effect of 32% end-tidal Xe concentration upon autoregulation, 5 baboons, Papio anubis/cynocephalus, were anesthetized/paralyzed with propranolol 0.02, diazepam 0.1, morphine sulfate 0.1, and pancuronium 0.2 (mg/(h.kg)). The animals were subjected to a servocontrolled blood infusion-withdrawal program to control central aortic blood pressure (CAP). PaCO2 was held to 30 to 35 torr, with individual variation less than 3 torr by control of ventilation and by including CO2 in the Xe/O2 mixture. Three to six CBF measurements were made in each subject over the above range. In four animals the CAP was varied between 18 and 150 torr, with corresponding CBF measurements. The CAP range was extended to 196 torr in the 5th animal by IV administration of phenylephrine. Significant lowering of global blood flow did not occur above 40 torr mean CAP. While regulated flow persists to about 150 torr at the high end, there is a breakaway between 150 and 190 torr where flow increased 90%. A 4th order polynomial fit of the data has the characteristic appearance of the familiar autoregulation curve. We conclude that autoregulation is preserved even in the presence of FIXe of 32% in the breathing mixture.

Animals↗