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Biomedical subjects

J White

Publications and source records attributed to J White.

At least 289 records · Page 16Linked to original sources
PubMed1995

Outcome and prognostic factors for local recurrence in mammographically detected ductal carcinoma in situ of the breast treated with conservative surgery and radiation therapy.

PURPOSE: We have retrospectively reviewed our institution's experience treating a predominantly mammographically detected population of ductal carcinoma in situ (DCIS) patients with conservative surgery and radiation therapy (CSRT) to determine outcome and prognostic factors for local recurrence. METHODS AND MATERIALS: Between January 1, 1982 and December 31, 1988, 52 consecutive cases of DCIS of the breast were treated with CSRT at William Beaumont Hospital. Forty-six (88%) were mammographically detected nonpalpable lesions. All patients underwent at least an excisional biopsy and 28 (54%) were reexcised. The axilla was surgically staged in 41 (79%) and all were N0. The entire breast was irradiated to 45-50 Gy over 5-6 weeks. The tumor bed was boosted in 49 (94%) so that the minimum dose was 60 Gy. The three patients not boosted received a minimum dose of 50 Gy to the entire breast. Pathologic materials were reviewed by one of the authors. RESULTS: The predominant DCIS pattern was comedo in 40%, cribriform in 28%, solid in 17%, and micropapillary in 15%. The predominant nuclear grade was Grade I in 51%, Grade II in 49%, and Grade III in 0%. The median follow-up is 68 months. There have been three recurrences in the treated breast at a median time to failure of 30 months. The 5- and 8-year actuarial local recurrence rate is 6%. One patient recurred with invasive ductal cancer at 28 months, and the other two recurrences were DCIS at 30 and 50 months. All three patients were treated with salvage mastectomy. The patient who recurred locally with an invasive cancer developed metastasis and died at 64 months. The 5- and 8-year actuarial cause-specific survival rates are 100% and 97%, respectively. The following pathologic factors were analyzed for an association with local recurrence: predominant DCIS histology, predominant nuclear grade, and highest nuclear grade. Of these, the predominant nuclear grade was the best predictor of local recurrence (p = 0.070). No clinical or treatment related factor analyzed was associated with local recurrence. CONCLUSION: Our results indicate that excellent local control (94%) at 8 years is obtainable after CSRT in a mammographically detected population of patients with DCIS. The predominant nuclear grade was the only factor found that may be associated with local recurrence.

Adult↗
PubMed1995

Nervus terminalis ganglion of the bonnethead shark (Sphyrna tiburo): evidence for cholinergic and catecholaminergic influence on two cell types distinguished by peptide immunocytochemistry.

The nervus terminalis is a ganglionated vertebrate cranial nerve of unknown function that connects the brain and the peripheral nasal structures. To investigate its function, we have studied nervus terminalis ganglion morphology and physiology in the bonnethead shark (Sphyrna tiburo), where the nerve is particularly prominent. Immunocytochemistry for gonadotropin-releasing hormone (GnRH) and Leu-Pro-Leu-Arg-Phe-NH2 (LPLRFamide) revealed two distinct populations of cells. Both were acetylcholinesterase positive, but LPLR-Famide-immunoreactive cells consistently stained more darkly for acetylcholinesterase activity. Tyrosine hydroxylase immunocytochemistry revealed fibers and terminal-like puncta in the ganglion, primarily in areas containing GnRH-immunoreactive cells. Consistent with the anatomy, in vitro electrophysiological recordings provided evidence for cholinergic and catecholaminergic actions. In extracellular recordings, acetylcholine had a variable effect on baseline ganglion cell activity, whereas norepinephrine consistently reduced activity. Electrical stimulation of the nerve trunks suppressed ganglion activity, as did impulses from the brain in vivo. During electrical suppression, acetylcholine consistently increased activity, and norepinephrine decreased activity. Muscarinic and, to a lesser extent, alpha-adrenergic antagonists both increased activity during the electrical suppression, suggesting involvement of both systems. Intracellular recordings revealed two types of ganglion cells that were distinguishable pharmacologically and physiologically. Some cells were hyperpolarized by cholinergic agonists and unaffected by norepinephrine; these cells did not depolarize with peripheral nerve trunk stimulation. Another group of cells did depolarize with peripheral trunk stimulation; a representative of this group was depolarized by carbachol and hyperpolarized by norepinephrine. These and other data suggest that the bonnethead nervus terminalis ganglion contains at least two cell populations that respond differently to acetylcholine and norepinephrine. The bonnethead nervus terminalis ganglion appears to differ fundamentally from sensory and autonomic ganglia but does share some features with the neural circuits of forebrain GnRH systems.

Acetylcholinesterase↗
PubMed1995

Adaptive Silicon Monochromators for High-Power Insertion Devices. Tests at CHESS, ESRF and HASYLAB.

X-ray wigglers which produce tens of kilowatts of photon power within the white beam will soon become available at third-generation sources of synchrotron radiation. Insertion devices that produce several kilowatts already exist and we have used those at CHESS, ESRF and HASYLAB to test adaptive 111 silicon water-jet-cooled monochromators at up to 2 kW total incident beam power. This development from earlier work at the Brookhaven National Synchrotron Light Source (NSLS) uses the pressure in the water coolant to provide active compensation of the strain field in the thermal footprint, nulling its effect to within residual variations in Bragg angle of only a few arc s. The design is robust, vacuum compatible and uses no moving mechanical parts.

Journal Article↗
PubMed1995

A follow-up study of cognitive bias in generalized anxiety disorder.

Patients with generalized anxiety disorder (GAD) without concurrent depression (n = 11) and normal controls (n = 17) were tested twice, about 2 months apart, on a modified Stroop colour-naming task, which presented anxiety-related, depression-related and neutral words in masked and unmasked exposure conditions. GAD patients received cognitive behaviour therapy in the test-retest interval, and were also retested at follow-up, about 20 months after initial testing. GAD patients showed interference in colour-naming negative words across both masked and unmasked conditions before treatment, but not post-treatment, compared with controls. Reduced interference effects of masked threat words over time correlated with reduced ratings of anxious thoughts at post-treatment, and at follow-up, in GAD patients. Thus, the preconscious bias for threat information in GAD appears to vary over time in association with changes in anxious thoughts and worries.

Adolescent↗
PubMed1995

Nucleocapsid- and virus-like particles assemble in cells infected with recombinant baculoviruses or vaccinia viruses expressing the M and the S segments of Hantaan virus.

The formation of Hantaan (HTN) virus nucleocapsid-like structures (NLS) or virus-like particles (VLP) from expressed gene products was investigated in two eukaryotic systems. Baculovirus expression of the HTN virus small segment (S), which encodes the viral nucleocapsid protein, resulted in assembly of NLS inside infected insect cells. The NLS and authentic ribonucleocapsids, prepared by detergent disruption of HTN virions, had similar sedimentation characteristics and morphologies, and were recognized by HTN virus N-specific antibodies. Co-expression of S and the medium segment (M), which encodes the two viral envelope glycoproteins (G1 and G2), did not efficiently generate VLP in the baculovirus-insect cell system, but VLP were observed in lysates and supernatants of cells infected with a recombinant vaccinia virus co-expressing HTN virus M and S. The VLP sedimented in sucrose to densities consistent with HTN virions, and some of them bore a striking resemblance to Hantaan virions when examined by immunoelectron microscopy.

Animals↗
PubMed1995

Multiple binding sites for bacterial superantigens on soluble class II MHC molecules.

We used surface plasmon resonance to study the binding of a set of soluble mouse I-E class II major histocompatibility molecules, each occupied by a different single peptide, to the staphylococcal enterotoxin superantigens, SEA and SEB. The rates of association and dissociation to SEA varied greatly depending on the I-E-bound peptide. By contrast, binding to SEB yielded fast association and dissociation rates, which were relatively peptide independent. The results also indicated nonoverlapping binding sites for SEB and SEA on class II and raised the possibility of enhanced SAg presentation to T cells by cross-linking of cell surface class II.

Amino Acid Sequence↗
PubMed1995

Selective processing of negative information: effects of clinical anxiety, concurrent depression, and awareness.

Anxious patients (n = 20) and normal controls (n = 20) carried out a modified Stroop color-naming task with anxiety- and depression-related words in supraliminal and subliminal exposure conditions. Within the anxious group, patients with generalized anxiety disorder (GAD) without concurrent depression (n = 11) showed more color-naming interference for anxiety words than neutral words in comparison with patients with a combined diagnosis of GAD and depression (n = 9). Compared with controls, the GAD subgroup without concurrent depression showed slower color naming for negative than neutral words, in both supraliminal and subliminal conditions, replicating K. Mogg, B. P. Bradley, R. Williams, and A. Mathews's (1993) results. These findings provide further evidence of an anxiety-related bias for negative information in preconscious processes and highlight the importance of assessing concurrent depression.

Adolescent↗
PubMed1995

Problems with registration of cutaneous malignant melanoma in England.

The aim of the study was to assess the completeness and accuracy of cancer registration for cutaneous malignant melanoma. The study was conducted in seven health districts in England and one health board in Scotland from 1987 to 1989 with a total resident population of 3.6 million. Records from pigmented lesion clinics and pathology laboratories collected during the Cancer Research Campaign's health education programme to promote the early detection of melanoma were matched with cancer registrations from a total of five regional cancer registries. In England 74% out of a total of 642 cases of invasive malignant melanomas (ICD 172) and 44% out of a total of 155 in situ melanomas (ICD 232) had been registered compared with 96% and 100% respectively in Scotland. A significantly higher proportion of late-stage cases was found among registered than among non-registered cases in England (P < 0.001). In all registries the majority of superficial spreading in situ melanomas were miscoded as invasive cases. The annual incidence of invasive malignant melanoma in the English study areas was found to be seven per 100,000 in men and 11 per 100,000 in women, similar to that reported in Scotland. The registries are best at recording thick or late-stage melanomas. As the skin cancer target for Health of the Nation depends on monitoring trends in the incidence of malignant melanoma, future improved ascertainment of cases and changes in the type of cases being registered must be taken into account.

England↗
PubMed1995

Patterns of knowing: review, critique, and update.

Carper's patterns of knowing in nursing have been consistently cited in the nursing literature since they appeared in 1978. The degree to which they represent nursing knowledge in the mid-1990s is explored, and a major modification is suggested--the addition of a fifth pattern, sociopolitical knowing. The article also suggests modifications to the model for nursing knowledge put forward by Jacobs-Kramer and Chinn to enable this model to be used more effectively as a framework for exploring processes of inquiry into nursing knowledge and practice.

Cognition↗
PubMed1995

Cancer Research Campaign health education programme to promote the early detection of cutaneous malignant melanoma. I. Work-load and referral patterns.

From 1987 to 1989 a campaign to promote the early detection of cutaneous malignant melanoma was conducted in the areas of seven health authorities in England and Scotland (total population 3.6 million). Data were collected on 17,155 patients attending pigmented lesion clinics (PLCs) in each study area during the campaign. After a dramatic rise in PLC referral rates in the first month of the campaign the average monthly referral rate among the target population in the study period settled to an average of 13 per 10(5), a twofold increase compared with the pre-campaign period. Over 85% of patients at all PLCs were seen within 4 weeks of referral from their general practitioners. The melanoma to non-melanoma detection ratio was (1:33). The organization of future early detection initiatives needs careful review and planning, in order to improve their effectiveness in all sections of the population, and to enable health services to cope with the increased work-load.

Adult↗
PubMed1995

Cancer Research Campaign health education programme to promote the early detection of cutaneous malignant melanoma. II. Characteristics and incidence of melanoma.

The effect on the detection and characteristics of melanoma, resulting from the Cancer Research Campaign's health education programme to promote the early detection of melanoma in the general population, was studied from 1987 to 1989. The seven study areas in England and Scotland yield a target population of 3.6 million. Data were collected from local clinic-based registers, pathology laboratories, and the cancer registries. The average annual incidence rates of melanoma were seven and 12 per 10(5) in males and females, respectively, age-standardized to England and Wales, 1988. These rates are similar to the national figures for Scotland, where there is a national melanoma register, but higher than those reported by the English and Welsh cancer registries. The incidence was significantly higher in females than males (P < 0.001), and increased with age. Fifty-three per cent and 65% of cases in males and females, respectively, were thin (Breslow thickness < or = 1.5 mm), similar to the national figures from Scotland. No significant decrease in the incidence of late-stage tumours was found in either sex as a result of the campaign. Because of difficulties with ascertainment of cases in England, the main evaluation will focus on future trends in mortality rates for melanoma.

Adult↗
PubMed1995

The Kropp-onlay procedure (Pippi Salle procedure): a simplification of the technique of urethral lengthening. Preliminary results in eight patients.

OBJECTIVE: To lengthen the urethra to increase bladder outlet resistance in adolescent girls with a neurogenic bladder. PATIENTS AND METHODS: During a 2-year period (1992-94), eight girls (mean age 13.5 years, range 9-19) underwent a Kropp-onlay urethral lengthening associated, for six of them, with a bladder augmentation. Seven of the eight patients patients were spina bifida and confined to a wheelchair. One patient had had a previous transverse myelitis. A Benchekroun hydraulic value (in three cases) and a Malone procedure (in two cases) were performed at the same stage. The technique of Kropp-onlay urethral lengthening, which creates a flap value mechanism which leaks when the bladder is too full, is described and illustrated. RESULTS: Seven of eight patients were dry during the day and four were occasionally damp during the second part of the night. One could not be dry for more than 2 h during the day but had a very hyperactive detrusor. She developed two bladder stones which required an open vesicotomy. One developed a urethral fistula requiring a second Kropp-onlay procedure and became dry afterwards. Two patients, who did not undergo a bladder augmentation, needed oxybutinin therapy to obtain a satisfactory result. Post-operative urodynamic measurements are discussed. CONCLUSION: The Knopp-onlay urethral lengthening is easier to perform than the original Kropp procedure. The preliminary results are similar to those of alternative techniques (e.g. urethral suspension) but long-term reliability of this technique remains unknown.

Adolescent↗
PubMed1995

Associations of scores on the White-Campbell Psychological Birth Order Inventory and the Kern Lifestyle Scale.

This study investigated the relations among psychological birth order, actual birth order, and lifestyle. The study also further examined the convergent validity of the White-Campbell Psychological Birth Order Inventory. This inventory and Kern's Lifestyle Scale were administered to 126 individuals in a southeastern urban university. The several analyses of variance and canonical correlation analysis (1) supported a stronger relationship between psychological birth order and lifestyle than between actual birth order and lifestyle, (2) identified differential relationships between particular birth-order positions and lifestyle scales that were predicted and in accord with Adlerian theory, and (3) further supported the validity of the inventory. The results reaffirmed the lifestyle pattern and birth-order characterizations of Adlerian theory.

Adult↗