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Biomedical subjects

J Healey

Publications and source records attributed to J Healey.

At least 19 recordsLinked to original sources
PubMed2002

[FGD PET in a patient with pseudofractures from osteomalacia].

We present the case of a 42 year old man, with a history of multiple fractures and generalized pain for two years. A three phase bone scan, demonstrated multiple fractures involving the ribs, both ankles and feet. After going through a battery of tests which included an FDG PET scan (to exclude an occult malignancy), the patient was diagnosed with osteomalacia and hyperparathyroidism. The FDG PET scan, demonstrated multiple foci of increased FDG uptake throughout the axial skeleton, in a pattern highly suggestive of pseudofractures, rather than osseous metastases.

Adult↗
PubMed2001

Anabolic effects of rhIGF-I/IGFBP-3 in vivo are influenced by thyroid status.

BACKGROUND: There are close interrelationships between hormones that regulate bone formation and protein biosynthesis. For example, growth hormone and thyroid hormones can influence plasma levels of insulin-like growth factor-I (IGF-I). A patient's status regarding hormones other than IGF-I may thus indirectly modify the efficacy of IGF-I treatment. The aim of the current study was to determine if a statistical method could be used to identify key endocrine variables controlling an individual's response to IGF-I treatment. DESIGN: Biochemical profiles from the somatotropic, thyroid and adrenal axes were determined on two separate occasions in two different study cohorts. Each cohort was divided into four groups: placebo, low, medium and high dose of recombinant human IGF-I/IGF binding protein-3 (rhIGF-I/IGFBP-3). The relative changes in collagen C-terminal peptide (CICP) levels were explained as a function of the basal endocrine profile of each treated individual. This relationship was further examined in an experimental rat model, where undernourished rats were rendered hypothyroid by propylthiouracil and subsequently treated with rhIGF-I/IGFBP-3. RESULTS: The results of our statistical analysis in both cohorts indicated that each subject's response to rhIGF-I/IGFBP-3 administration was controlled in part by the individual's thyroid status prior to drug administration (r = 0.78 for both cohorts). The results from the animal study revealed that IGF-I treatment stimulated muscle protein synthesis by 35 +/- 9% (P = 0.05) in euthyroid rats but not in hypothyroid rats. CONCLUSION: The relationship between endocrine axes is not simple. An improved understanding of the interactions between neuroendocrine systems may facilitate the design of efficient drug regimens in the treatment of diseases such as osteoporosis and muscle wasting.

Adult↗
PubMed2000

Characterization of the inhibition of DNA synthesis in proliferating mink lung epithelial cells by insulin-like growth factor binding protein-3.

Insulin-like growth factor binding protein-3 (IGFBP-3) can inhibit cell growth by directly interacting with cells, as well as by forming complexes with IGF-I and IGF-II that prevent their growth-promoting activity. The present study examines the mechanism of inhibition of DNA synthesis by IGFBP-3 in CCL64 mink lung epithelial cells. DNA synthesis was measured by the incorporation of 5-bromo-2'-deoxyuridine, using an immunocolorimetric assay. Recombinant human IGFBP-3 (rh[N109D,N172D]IGFBP-3) inhibited DNA synthesis in proliferating and quiescent CCL64 cells. Inhibition was abolished by co-incubation of IGFBP-3 with a 20% molar excess of Leu(60)-IGF-I, a biologically inactive IGF-I analogue that binds to IGFBP-3 but not to IGF-I receptors. DNA synthesis was not inhibited by incubation with a preformed 1:1 molar complex of Leu(60)-IGF-I and IGFBP-3, indicating that only free IGFBP-3 inhibits CCL64 DNA synthesis. Inhibition by IGFBP-3 is not due to the formation of biologically inactive complexes with free IGF, since endogenous IGFs could not be detected in CCL64 conditioned media; any IGFs that might have been present could only have existed in inactive complexes, since endogenous IGFBPs were present in excess; and biologically active IGFs were not displaced from endogenous IGFBP complexes by Leu(60)-IGF-I. After incubation with CCL64 cells, (125)I-IGFBP-3 was covalently cross-linked to a major thick similar400-kDa complex. This complex co-migrated with a complex formed after incubation with (125)I-labeled transforming growth factor-beta (TGF-beta) that has been designated the type V TGF-beta receptor. (125)I-IGFBP-3 binding to the thick similar400-kDa receptor was inhibited by co-incubation with unlabeled IGF-I or Leu(60)-IGF-I. The ability of Leu(60)-IGF-I to decrease both the inhibition of DNA synthesis by IGFBP-3 and IGFBP-3 binding to the thick similar400-kDa receptor is consistent with the hypothesis that the thick similar400-kDa IGFBP-3 receptor mediates the inhibition of CCL64 DNA synthesis by IGFBP-3.

Animals↗
PubMed2000

Interfacing computerized biomechanical analysis in monitoring the motor development of children.

This research investigated the effectiveness of using kinematic analysis to monitor the motor development of children on three fundamental movement patterns. 12 children with specific motor delays were filmed before and after participation in the 2-hr. per week, 7-wk. program. The film was analyzed (60 frames per second) using a 2-dimensional analysis system. There were no significant differences when a Wilcoxon matched pairs signed-ranks test was applied to the galloping and skipping center of gravity and linear velocities of the ball data. Timing of the peak linear velocities of the upper body showed subjects increasingly exhibited the more advanced, sequential pattern and no longer exhibited the less advanced simultaneous pattern after the program. It was concluded the changes in timing were evidence of improvements in coordination.

Biomechanical Phenomena↗
PubMed1999

Colon polyp registries and colorectal cancer control.

This cohort of 252 subjects in the Roger Williams Hospital Polyp Registry who had adenomatous polyps removed in 1990, was followed for 6 years. Thirty subjects died during that period. Follow-up rate for the 222 living patients (88.1% of total) was 85%. New adenomatous polyps were found in 59% of the endoscoped subjects. Risk factors for new polyps included family history of colorectal carcinoma (p = 0.00079), right-sided location (p = 0.0108), and (probably) prior adenomatous polyps (p = 0.0595). In addition, three colorectal carcinomas, two of which were Dukes stage A, were found 1, 1, and 6 years after index polypectomy. If, as is common practice, the two first-year cancers are excluded, the observed incidence of metachronous colorectal cancer was 0.8/1000 patient years, which is substantially less than the expected incidence of such carcinomas in reference populations. Compared to the 1984 and 1987 cohorts in the polyp registry, colonoscopy was used more frequently and sigmoidoscopy less so for surveillance. Within the sigmoidoscopy group, the flexible instrument continued to rise in popularity as compared with rigid sigmoidoscopy. In addition to helping reduce the incidence of metachronous colorectal carcinomas, the polyp registry also serves the educational function of sensitizing physicians and their patients to the need to detect and treat these premalignant lesions. Enrollees in the registry also provide a source for studies designed to evaluate possible inhibitory effects of dietary, chemopreventive, and other agents on colorectal neoplasias.

Adenomatous Polyposis Coli↗
PubMed1999

Quantifying driver stress: developing a system for collecting and processing bio-metric signals in natural situations.

A system for quantifying the physiological features of emotional stress is being developed for use during a driving task. Two prototypes, using sensors that measure the driver's skin conductance, respiration, muscle activity, and heart activity are presented. The first system allows sampling rates of 200 Hz on two fast channels and 20 Hz on six additional channels. It uses a wearable computer to do real-time processing on the signals and has an attached digital camera which was used to capture images of the driver's facial expression once every minute. The second system uses a car-based computer that allows a sampling rate of 1984 samples per second on eight channels. This system uses multiple video cameras to continuously capture the driver's facial expression and road conditions. The data is then synchronized with the physiological signals using a video quad-splitter. The methods for extracting physiological features in the driving environment are discussed, including measurement of the skin conductance orienting response, muscle activity, pulse, and respiration patterns. Preliminary studies show how using multiple modalities of sensors can help discriminate reactions to driving events and how individual's response to similar driving conditions can vary from day to day.

Automobile Driving↗
PubMed1997

p53 and MDM2 alterations in osteosarcomas: correlation with clinicopathologic features and proliferative rate.

BACKGROUND: Alterations of the p53 gene and of MDM2, a gene coding for a p53 binding protein, have been implicated in the pathogenesis of osteosarcoma (OS). METHODS: To determine the frequency of alterations of the p53/MDM2 pathway in OS and their possible correlation with clinicopathologic features, MDM2 copy number and p53 protein levels were determined in a series of 83 samples of OS by quantitative Southern blot analysis and immunohistochemistry, respectively. RESULTS: Positivity for p53 was found in 26.5% and MDM2 amplification in 6.6% of the samples analyzed in a mutually exclusive fashion with one exception. Overall, alterations of the p53/MDM2 pathway occurred in 34% of cases; p53 accumulation was not associated with a higher proliferative rate. The mean age of patients with p53 positive OS (40 years) was older than that of the p53 negative group (28 years) (P < 0.04). Furthermore, three of the four cases of OS arising in Paget's disease showed p53 accumulation. CONCLUSIONS: Alterations of the p53/MDM2 pathway are frequent in OS and usually represent mutually exclusive tumorigenic events. p53 does not appear to be a major determinant of proliferative rate in OS.

Adult↗
PubMed1995

Correlation of the findings of thallium-201 chloride scans with those of other imaging modalities and histology following therapy in patients with bone and soft tissue sarcomas.

We performed a retrospective [corrected] study to evaluate the imaging potential of thallium-201 as compared with other imaging modalities in differentiating residual/recurrent tumors from post-therapy changes in patients with musculoskeletal sarcomas. 201Tl scans, magnetic resonance imaging (17), X-ray computed tomography (6) or contrast angiography (6) studies in 29 patients previously treated for musculoskeletal sarcomas were correlated with either histopathologic findings (26 patients) or 2-year clinical follow-up (three patients). All imaging studies were acquired within 2 weeks. Ratios of 201Tl tumor uptake to the contralateral (28 patients) or adjacent region of interest were calculated. When qualitative interpretation was in doubt, only those cases with a ratio of 1.5 or more were considered suggestive of recurrent of residual viable tumor tissue. Residual or recurrent tumor tissue was verified in 21 patients by biopsy. All had true-positive 201Tl scans while the other imaging modalities were true-positive in 20 and equivocal in one. In eight patients, there was no evidence of viable tumor tissue as proven by biopsy in five and long-term clinical follow-up in three. 201Tl scan was false-positive (ratio 1.5) in one patient and true-negative in seven while the other imaging modalities had four false-positives. The average 201Tl ratios were 2.8+/-1.1 in the true-positive cases and 1.3+/-0.3 in the true-negative cases. The percentage sensitivities, specificities, and accuracy for 201Tl were 100%, 87.5%, and 96.5% versus 95%, 50%, and 82.7% respectively for other imaging modalities. These results indicate that 201Tl scintigraphy is more accurate than other imaging modalities in differentiating residual/recurrent musculoskeletal sarcomas from post-therapy changes.

Adolescent↗
PubMed1995

Changing consumer perceptions in healthcare marketing.

This paper serves as a survey of how hospitals are looking for new and innovative ways to market their hospital (E.R.) to the consumer. Traditionally, the Emergency Department in a hospital was the area that consistently lost money. Today more than ever, MBA's and other business professionals are being hired by hospitals in order to reverse this spiraling trend. This paper deals with hospitals across the U.S. who have employed many new and exciting ways of marketing a service to the consumer in a way that has never been done before.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Intraosseous hemangioma of the talus: a case report.

A 35-year-old female patient presented to us with a lesion in the talus that on AP-roentgenographic view simulated an osteoid osteoma. Final pathology revealed it to be an intraosseous hemangioma. An intraosseous hemangioma at this site is extremely uncommon and has not been previously reported.

Adult↗
PubMed1994

Treatment of a second bone osteosarcoma. 3 cases and an unusual MRI finding.

We report 3 patients with a second bone involved with osteosarcoma. They were found among approximately 200 cases of limb-sparing surgery with chemotherapy. 1 patient had the unusual finding of a positive MRI scan with all other routine tests negative. The first and then the second bone tumor were successfully removed with limb-sparing surgery. All 3 patients are doing well, with no evidence of disease.

Adolescent↗
PubMed1992

The relationship between thallium uptake, blood flow, and blood pool activity in bone and soft tissue tumors.

Twenty patients with known primary untreated and recurrent bone and soft tissue tumors underwent thallium imaging and three-phase bone imaging in the same session. The ratio of thallium uptake in the tumor tissue to the contralateral normal tissue areas was compared with the same ratio for phase 1 (blood flow or arterial phase), phase 2 (blood pool), and phase 3 (delayed medroxy-diphosphonate, MDP, uptake). There was poor correlation between Tl uptake and phases 1 and 3 of the bone scan ratios; r = 0.37 and 0.46; P = 0.097 and 0.047, respectively. The thallium uptake ratios correlated well with blood pool ratios (phase 2) (r = 0.84 and P less than 0.01). In contrast to uptake into normal muscle, Tl-201 uptake into tumor is not highly dependent on blood flow alone and other factors predominate in determining its magnitude.

Bone Neoplasms↗
PubMed1992

Chemotherapy for nonmetastatic osteogenic sarcoma: the Memorial Sloan-Kettering experience.

PURPOSE: Adjuvant chemotherapy improves disease-free survival (DFS) for patients with osteogenic sarcoma (OS). We reviewed our experience with OS to determine prognostic factors, the role of preoperative chemotherapy and subsequent histologic response, and the role of salvage chemotherapy after poor initial response. METHODS: From 1975 to 1984, we saw 279 patients with previously untreated OS without metastasis. All patients received intensive chemotherapy and underwent surgical resection of primary tumor. Chemotherapy included high-dose methotrexate; Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH); and bleomycin, cyclophosphamide, and dactinomycin (BCD). Selected patients also received cisplatin. RESULTS: DFS was not affected by use of preoperative chemotherapy versus immediate surgery, by use of limb-sparing surgery versus amputation, age, sex, or dose intensity of chemotherapy. DFS did correlate with serum lactate dehydrogenase (LDH), alkaline phosphatase, primary tumor site, race, and histologic response to preoperative chemotherapy. There was no difference in DFS for patients with a poor histologic response who did or did not receive cisplatin, although patients who did receive cisplatin had a longer time to relapse. The 5-year DFS was 76% for patients aged less than or equal to 21 years who had extremity primary tumor and were treated with the T10 protocol. CONCLUSIONS: Intensive chemotherapy can achieve DFS for a high proportion of patients with OS. Although it is a powerful predictor of DFS, histologic response to preoperative chemotherapy cannot be assessed at diagnosis. We have not shown an ability to salvage patients with an unfavorable response. We need to increase the proportion of patients with a favorable response, identify the patients who will have an unfavorable response, and develop novel treatments to salvage poor responders.

Adolescent↗
PubMed1991

Osteoid osteoma. Diagnosis, localization, and treatment.

The preoperative insertion of a needle under computed tomographic scan, performed under local anesthesia, is a convenient and important new way to localize the nidus in osteoid osteoma. It necessitates less bone removal, which should reduce the postoperative fracture rate. It should also help to locate the lesion during surgery. Some clinical points and previously unstressed pathologic findings are also discussed.

Aspirin↗