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Biomedical subjects

J Johnson

Publications and source records attributed to J Johnson.

At least 325 records · Page 18Linked to original sources
PubMed1993

Speech and swallow function after tonsil/base of tongue resection with primary closure.

Speech and swallowing function was examined in 11 patients who underwent surgical resection of greater than 1 cm of tongue base, tonsil, and faucial arch with mandible resected on the side of the tumor and reconstruction by primary closure. Preoperatively and 1 and 3 months post-healing, high fidelity audio recordings were made of a 6- to 7-minute conversational speech sample, the sentence version of The Fisher Logemann Test of Articulation Competence was administered, and videofluoroscopic assessment of oropharyngeal swallow was conducted. All subjects exhibited changes in speech and swallowing function postoperatively, with little improvement during the study. Patients exhibited greatest difficulty on stop and fricative consonants and bolus propulsion. Comparison with patients who received anterior tongue and floor of mouth resections and distal flap reconstruction revealed consistently better speech performance by the tonsil/base of tongue patients, although the same phonemes were affected. Swallow function was equally affected in the two groups. Results are discussed in terms of locus of surgical resection, nature of reconstruction, and need for swallowing therapy.

Analysis of Variance↗
PubMed1993

Menhaden, coconut, and corn oils and mammary tumor incidence in BALB/c virgin female mice treated with DMBA.

Omega-3 fatty (n-3) acids are believed to inhibit the rate of occurrence and the growth of mammary tumors in rats treated with 7,12-dimethylbenz[a]anthracene (DMBA). Linoleic acid, on the other hand, has been shown to promote mammary tumorigenesis. This study was undertaken to see whether replacing 18% of the corn oil (high in linoleic acid) in a 20% fat diet with menhaden oil (high in n-3 fatty acids, low in linoleic acid) or coconut oil (low in n-3 fatty acids, low in linoleic acid), while keeping constant the cholesterol, antioxidant, and total fat content, would affect tumor incidence in virgin female BALB/c mice dosed with DMBA. Dietary treatment had no effect on body weight, feed intake, or survival to 44 weeks of age (36 wks after the first of 6 DMBA doses). Mammary tumor incidence was the same in the menhaden oil and coconut oil diet groups but was significantly higher in the 20% corn oil diet group. The protective effect of menhaden oil and coconut oil may be due, at least in part, to the decreased linoleic acid content of these diets relative to the corn oil diet. We conclude that n-3 fatty acids per se do not seem to inhibit tumor formation.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1993

Epidemic meningococcemia and purpura fulminans with induced protein C deficiency.

Patients with epidemic infections caused by Neisseria meningitidis serogroup C were studied to assess the relationship of abnormal coagulation parameters to prognosis. Patients were categorized into stages within the first hour of observation according to severity of illness. During the epidemic years 1986 through 1991, 113 patients with bacteriologically proven N. meningitidis infection were observed, 15 of whom died. Purpura fulminans was seen in 28 patients, of whom 14 (50%) died. Among the 14 surviving patients who had purpura fulminans, 10 suffered gangrene with deforming autoamputation secondary to the dermal microvascular thrombosis and hemorrhagic necrosis. Evaluation of the induced diffuse intravascular coagulation in 59 patients included studies of the naturally occurring anticoagulants, focusing on protein C and protein S. The magnitude of the declining levels of protein C, the degree of thrombocytopenia, and the presence of fibrin split products are directly related to the clinical severity of the illness (P = .0053). Thus, in individuals with severe disease expression, the risk of purpura fulminans with death or deformity was significantly increased when the platelet count was < 50,000 cells/mm3 (P = .0001) and protein C levels were low (P = .0158). The immaturity of the protein C system in children who are < 4 years of age may contribute to the rapid and more frequent pathogenesis of purpura fulminans. Therapy directed at replacement of the naturally occurring anticoagulants, such as protein C, may ultimately improve the prognosis for individuals with purpura fulminans.

Adolescent↗
PubMed1993

Immunoglobulin-A detection and the investigation of clinical toxoplasmosis.

Current serological methods for the investigation of Toxoplasma gondii infection are unreliable for the diagnosis of congenital disease, reactivated infection associated with the acquired immune deficiency syndrome (AIDS), or the determination of the date of onset of infection. An enzyme-linked immunosorbent assay (ELISA) and an immunosorbent agglutination assay (ISAGA) were developed for the detection of toxoplasma-specific immunoglobulin-A (IgA) and used to investigate patients in these three categories. The IgA ISAGA and IgA ELISA were found to be reproducible and specific tests. The IgA ISAGA demonstrated enhanced sensitivity. Measurement of IgA in patients with toxoplasma-associated lymphadenopathy of known duration and AIDS patients with toxoplasma infection was of limited value. Detection of specific IgA by ISAGA was more sensitive than conventional methods for the diagnosis of congenital toxoplasmosis. We recommend the investigation of infant sera with IgA ISAGA. IgA estimation is not indicated in other clinical situations.

Acquired Immunodeficiency Syndrome↗
PubMed1993

An epidemiological study of disorders in late childhood and adolescence--I. Age- and gender-specific prevalence.

Developmental aspects of psychiatric disorders may be inferred from patterns of age differences in prevalence. Age-specific prevalences are provided for nine disorders in a general population sample of ages 10-20. Age and gender patterns for several disorders suggest developmental stage-associated risks. These include oppositional disorder in both genders and conduct disorder and major depression in girls. Major depression shows a pattern suggestive of a role for the onset of puberty. The prevalence of one or more disorders did not differ by age or gender. However, the pattern of specific diagnoses varied greatly by both age and gender.

Adolescent↗
PubMed1993

Agoraphobia without panic: clinical reappraisal of an epidemiologic finding.

OBJECTIVE: In the United States, the consensus among clinicians and researchers, reflected in DSM-III-R, is that agoraphobia is a conditioned response to panic attacks and almost never occurs without panic attacks. The predominant view in the United Kingdom is that agoraphobia frequently occurs in the absence of panic. While clinicians report that they rarely see patients with agoraphobia who have no history of panic disorder, community studies report that agoraphobia without panic disorder is common. For example, the Epidemiologic Catchment Area (ECA) study found that 68% of 961 persons with agoraphobia had no history of panic attacks or disorder. METHOD: To understand this discrepancy, 22 subjects who had been diagnosed as having agoraphobia without panic disorder or panic attacks in the ECA study were blindly reinterviewed 7-8 years later with the Schedule for Affective Disorders and Schizophrenia--Lifetime Version Modified for the Study of Anxiety Disorders; data from these interviews were blindly reviewed by a research psychiatrist who was not involved in the original data collection or the reinterview process. RESULTS: On reappraisal, 19 of the 22 subjects had simple phobias or fears but not agoraphobia. One subject had probable agoraphobia without panic attacks, one had definite panic disorder with agoraphobia, and one had probable agoraphobia with limited symptom attacks. CONCLUSIONS: Epidemiologic studies that used the Diagnostic Interview Schedule and lay interviewers, such as the ECA study, may have over-estimated the prevalence of agoraphobia without panic. Agoraphobia without panic attacks occurs but is uncommon, and the diagnostic boundary between agoraphobia and simple phobia is unclear.

Aged↗
PubMed1993

Epidemiology of panic disorder in African-Americans.

OBJECTIVE: The authors investigated the prevalence and clinical characteristics of panic disorder among African-Americans and whites in a community study. METHOD: A total of 4,287 African-American and 12,142 white subjects were interviewed at five sites as part of the Epidemiologic Catchment Area study. Panic disorder and other diagnoses were made using the National Institute of Mental Health Diagnostic Interview Schedule and DSM-III criteria. RESULTS: The lifetime prevalence of panic disorder was 1.2% among African-Americans and 1.4% among whites, a nonsignificant difference. Comparisons between African-Americans and whites on age at onset, years with panic disorder, and suicide attempts revealed no significant differences. Rates of individual panic symptoms in African-American and white subjects with panic disorder were similar, although African-Americans reported a higher mean number of symptoms during their worst episode. Among subjects with comorbid panic disorder, African-Americans and whites had similar rates of major depression, alcohol abuse, drug abuse, obsessive-compulsive disorder, agoraphobia, somatization disorder, and schizophrenia. Patterns of treatment seeking among African-American and white panic subjects were similar, with the exception that African-Americans were significantly less likely to seek help from a mental health professional in private practice. CONCLUSIONS: On the basis of these findings, the authors conclude that panic disorder in the community is similar among African-Americans and whites with respect to lifetime prevalence, age at onset, years of disorder, symptom distribution, suicide attempts, and comorbidity with other psychiatric disorders. Differences in the diagnosis and treatment of panic disorder by race are not due to differences in the prevalence or nature of the disorder.

Adult↗
PubMed1993

Characterization of Actinomyces with genomic DNA fingerprints and rRNA gene probes.

Cellular DNA from 25 Actinomyces naeslundii and Actinomyces viscosus strains belonging to the 7 taxonomic clusters of Fillery et al. (1978) and several unclustered strains was obtained by enzymatic and N-lauroylsarcosine/guanidine isothiocyanate treatment of whole cells, followed by extraction of the nucleic acid. The DNA samples were digested with restriction endonucleases BamHI or PvuII, and agarose gel electrophoresis was used to obtain DNA fingerprints. The DNA fragments were subjected to Southern blot hybridization with a digoxigenin-labeled cDNA probe transcribed from Escherichia coli 16S and 23S rRNA. The patterns of bands from genomic (DNA fingerprints) and rDNA fingerprints (ribotypes) were used for comparison between the taxonomic cluster strains and strains within clusters. Representative strains from each taxonomic cluster provided different BamHI DNA fingerprints and ribotype patterns with 3 to 9 distinct bands. Some strains within a cluster showed identical ribotype patterns with both endonucleases (A. naeslundii B120 and A. naeslundii B102 from cluster 3), while others showed the same pattern with BamHI but a different pattern with PvuII (A. naeslundii ATCC 12104 and 398A from cluster 5). A viscosus ATCC 15987 (cluster 7) and its parent strain T6 yielded identical fingerprint and ribotype patterns. The genomic diversity revealed by DNA fingerprinting and ribotyping demonstrates that these techniques, which do not require phenotypic expression, are suited for study of the oral ecology of the Actinomyces, and for epidemiological tracking of specific Actinomyces strains associated with caries lesions and sites of periodontal destruction.

Actinomyces↗
PubMed1993

Catatonia: the tension insanity.

A historical review of Kahlbaum's Catatonia is presented. He attributed the condition to organic cerebral disease. It is now best considered as a neuropsychiatric syndrome due to a wide variety of organic disease processes, manifest in catelepsy in a setting of an abnormal mental state, most commonly an affective disorder. Chronic catatonic states were common sequelae of encephalitis lethargica; this disease has now disappeared in epidemic form with a resulting fall in the incidence of catatonia in psychiatric hospitals. Acute catatonia, due to medical and particularly pharmacogenic causes, continues to occur in current psychiatric practice.

Brain↗
PubMed1993

Differential autoantibody responses to thyroid peroxidase in patients with Graves' disease and Hashimoto's thyroiditis.

In order to examine the specificity of the autoantibody response to thyroid peroxidase (TPO, previously identified as thyroid microsomal antigen) in autoimmune thyroid disease, we examined reactivity of sera from 45 Hashimoto's and 48 Graves' patients to native thyroid microsomes, denatured and reduced human TPO and several recombinant fragments of human TPO corresponding to amino acids 457-933 of the native protein. Both Graves' and Hashimoto's sera bound native, denatured and reduced TPO at significantly greater rate than normal controls, and no differences were noted between the two disorders in binding to these forms of the autoantigen. Binding was also noted to two recombinant fragments of TPO, corresponding to amino acids 513-633 and 633-933 in TPO. The frequency of autoantibodies to the TPO AA(633-933) region was not significantly different in Hashimoto's vs. Graves' disease patients (58% vs. 65% respectively), and appeared to relate to evidence of glandular inflammation in the Graves' patients (presence of anti-thyroglobulin antibodies and elevated anti-microsomal antibody levels). In contrast, antibodies to the TPO AA(513-633) fragment were significantly more common and of higher titer in Hashimoto's vs. Graves' disease patients, and did not correlate with any measure of glandular inflammation. These results identify two specific regions of TPO autoantibody binding and indicate that there are differences in the autoantibody response to TPO in Hashimoto's and Graves' diseases.

Adolescent↗
PubMed1993

Once-a-day therapy for sinusitis: a comparison study of cefixime and amoxicillin.

The efficacy and safety of a once-a-day antibiotic in the treatment of sinusitis was studied. Two randomly assigned groups were treated with either once-a-day cefixime, a third generation cephalosporin, or amoxicillin three times a day. One hundred and fourteen patients were evaluated with antral punctures, microbiologic evaluation, and radiographic studies. Cultures revealed 40% gram-negative organisms, 48% gram-positive, and 12% anaerobes. The most common bacteria were Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus aureus and viridans group streptococci. Ninety-four percent of the cefixime group were cured compared with 96% of the amoxicillin group. Staphylococcus resistance was a problem in both groups, necessitating an occasional change to amoxicillin-clavulanate potassium in the amoxicillin group. Once-a-day antibiotics offer the potential for improved compliance in the treatment of sinusitis. Cefixime offers an additional benefit of covering beta-lactamase producing strains of bacteria which are increasing in incidence and resistant to many penicillins.

Administration, Oral↗
PubMed1993

A preliminary ethnographic decision tree model of injection drug users' (IDUs) needle sharing.

This article presents a preliminary ethnographic decision tree model of the needle sharing and HIV risk decision-making processes common to injection drug users (IDUs) in Houston, Texas. Ethnographic tree decision modeling is a rigorous qualitative method used to understand and predict how and why people in certain groups do things the way they do. The model was developed from data collected from focus group and individual interviews and naturalistic observations. The research participants were White, African-American and Latino male and female IDUs. The model presents IDUs' needle-sharing routines or scripts based on several prioritized criteria. The model supports other researchers' findings that social roles play an important part in shaping IDUs' needle sharing. Yet, the model attempts to specify the different kinds of roles and relationships. The model suggests that social roles IDUs play and the status hierarchy between roles are the translation mechanisms that organize IDUs' social relationships into drug and HIV risky activities.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Gynecologic tumors in tamoxifen-treated women with breast cancer.

OBJECTIVES: To present six additional cases of gynecologic tumors in tamoxifen-treated breast cancer patients, review the literature, and recommend measures for surveillance. METHODS: The hospital and office records of patients treated with tamoxifen at the University of Kansas Medical Center and Research Medical Center were analyzed. A comprehensive review of tamoxifen in the English and European literature was performed using MEDLINE and the bibliographies of various articles. RESULTS: From 1985-1992 at our institutions, six tamoxifen-treated breast cancer patients developed gynecologic tumors: three endometrial adenocarcinomas, a mixed müllerian sarcoma, a fallopian tube carcinoma with adenofibroma of the endometrium, and recurrent hyperplastic endometrial polyps. The literature contained 61 cases of adenocarcinoma of the endometrium and possibly four cases of uterine sarcomas in tamoxifen-treated breast cancer patients. The number of gynecologic malignancies reported is now 70. In 35 of the patients, the mean age (+/- standard deviation) was 63.9 +/- 12.0 years, and 61 of 66 patients (92.4%) were postmenopausal. Of the endometrial adenocarcinomas, 25 of 27 (92.6%) were stage I, and 11 of 27 (40.7%) were grade 1. The dose of tamoxifen was 20 mg/day in 15 (23.4%), 30 mg/day in 11 (17.2%), and 40 mg or higher in 38 (59.4%); 57% were treated with tamoxifen for less than 2 years. CONCLUSIONS: Tamoxifen is a safe and reliable treatment of breast cancer, but data suggest an association with endometrial cancer. We propose close monitoring of patients taking tamoxifen and prompt evaluation of any uterine bleeding or pelvic complaint.

Adenocarcinoma↗