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Biomedical subjects

K Kelly

Publications and source records attributed to K Kelly.

At least 181 records · Page 10Linked to original sources
PubMed1991

Growth factors in lung cancer: possible etiologic role and clinical target.

Growth factors play an important role in the pathogenesis and progression of all histologic types of lung cancer. Ideas for the exploitation of growth factors in lung cancer management are growing. The inhibition of the interaction between growth factors and their receptors, utilization of negative growth factors, interruption of the signal transduction pathways, or effecting decreased growth factor and/or receptor expression, could result in cell death, and all seem logical possibilities for new and specific treatment approaches. There can be no question that observations of the abnormal expression of growth factors have made a startling impact in every aspect of cancer research. The elucidation of their role in cell proliferation, coupled with our growing knowledge of the functions of oncogenes, has given birth to a unifying concept for the etiology of malignant transformation, which hopefully will translate into new, less toxic, more effective, and desperately needed lung cancer treatment.

Amino Acid Sequence↗
PubMed1991

Coronary angioplasty of diffuse coronary artery disease.

From January 1983 through December 1987, 98 patients underwent angioplasty of at least one diffusely diseased coronary artery. Diffuse coronary disease was described as: group I, narrowing greater than or equal to 50% that involved the entire vessel (40 patients), group II, long lesions greater than or equal to 2 cm in length (39 patients), group III, three or more lesions in the same vessel (19 patients). There were 65 men and 33 women, with a mean age of 60 years; 64 patients (65%) had unstable angina, 23 patients (23%) were diabetic, 31 (32%) had prior myocardial infarctions, and 12 had prior bypass surgery. Multivessel disease was present in 89% of patients. Angioplasty of only the diffusely diseased vessel was performed in 41 patients, and additional vessels were dilated in 57 patients. Overall, of 396 lesions (four per patient) and 197 vessels (two per patient) attempted, success was achieved in 382 lesions (96%) and 187 vessels (95%); angiographic success was achieved in 112 of 120 diffusely diseased vessels (93%). Clinical success was achieved in 91 patients (93%). The overall complication rate (death, myocardial infarction, urgent bypass surgery) was 8% (8 of 98): six patients (6%) had myocardial infarction (one Q wave, five non-Q wave), one patient (1%) had urgent bypass surgery, and two patients (2%) died (one during bypass surgery). The majority of complications (7 of 8 or 87%), including the two deaths, occurred in group I patients, with a 17.5% rate, versus 2.5% in group II and 0% in group III, p less than 0.002.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Placental teratoma.

The rare teratoma of the placenta has been compared to the fetus amorphus, two distinguishing characteristics being the teratoma's lack of structural organization and lack of large vessels entering the tumor. A case of placental teratoma and theories of origin are discussed.

Adult↗
PubMed1991

Contrasts between symptoms of summer depression and winter depression.

Epidemiological studies and studies of clinical populations suggest that there are primarily two opposite patterns of seasonally recurring depressions: summer depression and winter depression. In addition, there is preliminary evidence that the two seasonal types of depression may have opposite types of vegetative symptoms. In the present study, we prospectively monitored symptoms of depression in 30 patients with recurrent summer depression and 30 sex-matched patients with recurrent winter depression and compared the symptom profiles of the two groups. Consistent with predictions based on the earlier reports, we found that winter depressives were more likely to have atypical vegetative symptoms, with increased appetite, carbohydrate craving, weight gain and hypersomnia, and that summer depressives were more likely to have endogenous vegetative symptoms, with decreased appetite and insomnia. A cluster analysis performed on the patients' symptom profiles without reference to season of occurrence of their episodes separated 78% of the summer depressives and winter depressives from each other on the basis of their symptoms (chi 2 = 19.29, P less than 0.001).

Adult↗
PubMed1991

Retrospective analysis of 318 cases of uterine sarcoma.

A study of data from 318 cases of uterine sarcoma presenting during a 10-year period (1967-1976) is reported. All but 6 of the patients had at least a 5-year follow-up (98% 5-year follow-up). Overall 5-year survival was 31%, with the major prognostic indicator being tumour stage. Despite the tendency for mixed mesodermal tumours to present in older women with more advanced disease, survival was not statistically different to those patients with leiomyosarcomas. Thus, the propensity for tumour dissemination in leiomyosarcomas should not be underestimated. Leiomyosarcomas are less likely to present with abnormal symptoms than are other sarcomas, and their occurrence as an incidental finding on histological examination underlines the need for an adequate inspection of the intra-abdominal contents at hysterectomy. The tendency to treat all sarcomas as if they were endometrial tumours may be fallacious, and an alternative classification (such as the TNM system) may be required. Recurrence of tumour tended to be at distant sites (distant:pelvic recurrence rate 3:1). Adjuvant radiotherapy is unlikely to alter distant disease foci, and thus the development of combination chemotherapeutic regimens using agents which have shown to result in tumour response seem warranted. Such trials will need to be organised on a multicentre basis to attain statistically evaluable numbers of patients.

Adult↗
PubMed1991

Interstitial IR-192 implants of the oral cavity: the planning and construction of volume implants.

The success of radioactive implant therapy for head and neck carcinomas depends critically on careful planning and execution of the implant procedure. In this paper we discuss our experience with oral tongue and floor of mouth implants, and some innovations introduced to facilitate these procedures. Implants were carried out using standard angiocatheters modified with magnetic caps at the open end and terminated with Teflon spacers and lead shot at the closed end. The importance of accurate source placement and careful determination of the target dose rate is discussed with numerical examples. Differential hot-loading of sources is clearly indicated in cases of extension of the lesion to the dorsal or lateral tongue surface. For dorsal surface extension the use of Teflon spacers at the closed ends of the catheters helps to ensure adequate coverage of the target volume with the higher dose region enclosing the demonstrable tumor. All 10 patients implanted with this technique are controlled without recurrence at a median follow-up of 38 months. The two complications observed appeared to be associated with excessive hot-loading of edge plane sources.

Brachytherapy↗
PubMed1991

Chronic intracochlear electrical stimulation in the neonatally deafened cat. II. Temporal properties of neurons in the inferior colliculus.

The major focus of this study was to define the effects of chronic intracochlear electrical stimulation (ICES) on single unit responses in the inferior colliculus from three experimental groups: 1) normal adults 2) neonatally-deafened/unstimulated adults; and 3) neonatally-deafened/chronically stimulated adults. The major findings include: 1) IC neurons in normal adults showed a diversity of perstimulus responses to ICES which were qualitatively similar to those evoked by acoustic stimuli. They responded with: an onset burst, a sustained discharge, a decrease in their spontaneous activity, or a strong post-stimulus response. The excitatory responses showed either a monotonic or a nonmonotonic increase in activity with increasing stimulus intensity. Response latencies ranged from 5 to over 40 ms. 2) Responses to ICES in normal and deafened/unstimulated animals were virtually indistinguishable from one another. 3) In contrast, responses to ICES in neonatally deafened stimulated animals were different from normal and from deafened, unstimulated animals. Their perstimulus response latencies were significantly shorter, their late response latencies were significantly longer, and the frequency of occurrence of inhibitory and late responses were significantly higher. From these results we conclude that the responses to intracochlear electrical stimulation are directly comparable to those observed following normal acoustic stimulation; that development of cochleotopic organization of the inferior colliculus is not affected by the almost complete lack of normal acoustic input experienced by neonatally deafened animals; and that the basic response properties of IC units are likewise unaffected by neonatal deafening. Moreover, the results suggest that, although the limited regime of electrical stimulation employed in these studies produced no major qualitative distortions in the perstimulus response patterns of IC neurons, it did result in some quantitative changes in those responses.

Animals↗
PubMed1991

Nursing administration model for administrative practice.

The winds of change have swept in a new era for nursing. Complex decisions can be aided by a conceptual model for nursing administration practice. The authors discuss how the Iowa Model of Nursing Administration can be used by nurse administrators to solve administrative problems. Two practical examples are described.

Decision Making, Organizational↗
PubMed1990

Cloning of a mitogen-inducible gene encoding a kappa B DNA-binding protein with homology to the rel oncogene and to cell-cycle motifs.

We have cloned and characterized a mitogen-inducible gene isolated from human T cells that predicts a protein of 968 amino acids. The amino-terminal domain has regions homologous to the oncogene rel and to the developmentally important gene dorsal of Drosophila. The carboxy-terminal domain contains repeat structures found in a variety of proteins that are involved in cell-cycle control of yeast and in tissue differentiation in Drosophila and Ceanorhabditis elegans, as well as in the putative human oncogene bcl-3 and in the ankyrin protein. A truncated form of the product of this gene translated in vitro is a DNA-binding protein which interacts specifically with the kappa B binding site found in many inducible genes, including the enhancer in human immunodeficiency virus. This gene is yet another in a growing list of important regulatory molecules whose expression is transcriptionally induced upon cellular activation.

Amino Acid Sequence↗
PubMed1990

Two inflammatory mediator cytokine genes are closely linked and variably amplified on chromosome 17q.

Mitogenic stimulation of resting T cells results in the de novo transcription of a large number of genes including those encoding regulatory molecules such as lymphokines. The genomic organization of two newly described induced lymphokine genes, 464.1 and 744.1, has been determined. 464.1 and 744.1 appear to be the human homologues of the recently cloned murine macrophage inflammatory proteins, MIP-1 alpha and MIP-1 beta, respectively. The 464.1 and 744.1 genes share 55% amino acid homology and demonstrate parallel regulation of induced expression in T cells. It was therefore of interest to observe that these genes are closely linked in the human genome, separated by 14 kb, and are organized in a head to head fashion. Each of the genes is present in an additional nonallelic copy (referred to as 464.2 and 744.2) as part of an apparent amplification unit in the genome of many individuals. The 464.2 gene is expressed and potentially encodes a protein highly related to 464.1, varying in 5 of 92 amino acids. As expected, 464.2 and 744.2 are also closely linked to each other as determined by population linkage disequilibrium studies. Individuals bearing a chromosome with a third amplification event, involving a 464-related gene but not a 744-related gene, are also infrequently observed. These genes are all located on chromosome 17 in bands q11-q21, the region implicated in von Recklinghausen neurofibromatosis (NF1) and in acute promyelocytic leukemia (AML-M3).

Amino Acid Sequence↗
PubMed1990

Expression of a zinc finger gene in HTLV-I- and HTLV-II-transformed cells.

Gene products encoded by the human T cell leukemia virus (HTLV) types I and II mediate transformation by the transactivation of cellular genes necessary for proliferation, probably including transcriptional regulatory factors. By searching for factors that may control proliferation, a zinc finger gene (225) was identified that was constitutively expressed in all HTLV-I- or HTLV-II-transformed cell lines examined, whereas in normal T cells it was only transiently expressed after mitogenic stimulation. The 225 gene was also constitutively expressed in two HTLV-I-transformed helper T cell clones, but not in the parental cell lines. Thus this putative cellular transcriptional factor, which was abnormally expressed in retrovirus-infected cells, may have a role in transformation.

Amino Acid Sequence↗
PubMed1990

Enlargement of cerebral third ventricle in psychotic patients with delayed response to neuroleptics.

Enlargement of the cerebral third ventricle appears to be a replicable finding in groups of patients with psychotic illnesses, and there is evidence for an association of third ventricle enlargement with poorer response to treatment. Third ventricle area and width were measured from computed tomography (CT) scans in 24 mood-incongruent psychotic patients and 14 controls age and gender matched to schizophrenic patients. Patients were treated with a fixed dose of haloperidol and classified as rapid responders (55% symptom reduction on New Haven Schizophrenic Index (NHSI) within 4.5 +/- 1.3 days) or delayed responders (55% symptom reduction on NHSI within 18.6 +/- 10.5 days). The significant enlargement of third ventricle area was isolated among the 12 delayed neuroleptic responders (19.3 +/- 9.0 mm2) compared with the 14 controls (11.7 +/- 4.8 mm2, p = 0.01), and 12 other mood-incongruent psychotics. Third ventricle width also showed a trend towards larger width in the delayed responders. There was a clear positive correlation between ventricular size and patient's age exclusively in the delayed responders (r = 0.78); a comparable relationship between ventricular size and age was not present in controls, or in the other psychotics. This finding is consistent with an age-related progressive degenerative process in the central nervous system (CNS) isolated to the neuroleptic-delayed responsive psychotics.

Adult↗
PubMed1990

The potential for adjuvant therapy in early-stage cervical cancer.

Adjuvant therapy may potentially improve prognosis in women with early-stage cervical cancer who are at high risk of relapse after primary therapy. Patients with lymph node involvement at surgery are at high risk of recurrence and may benefit from adjuvant therapy, but many patients are treated with radical radiotherapy. At present there is no method of accurately identifying patients at high risk of recurrence in the latter group. A retrospective analysis of 141 surgically managed cases with stage I/II a cervical cancer is presented. The study aims were to characterize patients at high risk of relapse, identify independent prognostic variables predicting for relapse and, using these variables, develop a model, that would accurately predict high-risk patients. Univariate analysis identified depth of invasion, substage, lymph node involvement, lymphatic and blood vessel invasion and tumour differentiation as significant prognostic variables. After stratification for depth of invasion, which did not conform to the proportional hazards assumption implicit in the Cox model, Cox regression analysis showed substage, lymphatic and vascular invasion and histological tumour type to be independent prognostic variables. Using these variables, classification models were constructed that would be applicable to patients treated with either surgery or radiotherapy. Applying the models to 110 cases with greater than 18 months follow-up, 11/18 (61%) and 11/19 cases (58%) predicted as being at high risk of relapse have developed recurrence. Highly active chemotherapy is now available for this disease. We have demonstrated that combined bleomycin, ifosfamide and cisplatin (BIP) is one of the most active regimens in this disease. BIP produces cytoreduction in around 70% of patients with recurrent and primary advanced disease. Responses are achieved rapidly and acute radiotherapy toxicity is not enhanced by giving chemotherapy prior to radical local radiotherapy. A multicentre, prospective randomized trial testing the role of BIP as adjuvant therapy in patients with positive nodes at radical hysterectomy is now in progress. A complementary study testing the role of adjuvant chemotherapy in high-risk patients treated with radical radiotherapy is in preparation.

Adenocarcinoma↗
PubMed1990

Effects of different wavelengths in seasonal affective disorder.

The aim of this study was to compare the relative therapeutic efficacies of three different light sources for treating winter depression. A balanced incomplete block crossover design was employed, whereby all patients (n = 18) were randomly assigned to two out of the three treatment conditions: white, red and blue light. The degree of depression was assessed by the 21-item Hamilton Depression Rating Scale. The data suggest that at a photon density of 2.3 X 10(15) photons/s/cm2, white light has greater therapeutic benefit than red or blue light. It is clear that a larger sample population should be tested to confirm this result. This preliminary finding indicates that light sources currently in use for phototherapy could not be improved by narrowing the wavelengths provided and shifting them towards either end of the visible spectrum.

Adult↗
PubMed1990

Early serum CA125 response and outcome in epithelial ovarian cancer.

The prognostic value of serum CA125 levels before and after two courses of chemotherapy was assessed in 50 patients with advanced epithelial ovarian cancer. Patients with serum CA125 values below 35 U/ml after two courses were significantly more likely to achieve complete remission and had a significantly longer median survival. In multivariate analysis, serum CA125 levels after two courses were the most important independent prognostic factor: it was possible to predict survival status at 12 months with an overall accuracy of 93%. Serum CA125 can be used to evaluate quantitatively chemotherapeutic response and at an early stage classify patients into good and poor risk groups. Such an approach would facilitate the selection of appropriate therapy and could reduce toxicity.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1990

Chronic intracochlear electrical stimulation in the neonatally deafened cat. I: Expansion of central representation.

Intracochlear electrical stimulation via cochlear prostheses has been employed as a means of providing some hearing to deaf children. Since chronically restricted stimuli are known to have profound effects on central nervous system development, it is important to examine the effects of chronic intracochlear electrical stimulation in a neonatally deafened animal model. In this study neonatally deafened cats were implanted with a scala tympani electrode consisting of two pairs of electrodes. Chronic electrical stimulation was delivered using one electrode pair and consisted of charge-balanced biphasic pulses (200 microseconds/phase, 30 pps) at 2 dB above the electrically evoked auditory brain stem response (EABR) threshold for 4 h/day or at 6 dB 1 h/day, 5 days/week, for up to 3 months. The second electrode pair was unstimulated and served as an internal control. Following chronic stimulation, acute mapping experiments were performed in the central nucleus of the inferior colliculus (ICC) using single unit and multi-unit recording techniques and activating each electrode pair separately. In addition to these chronically stimulated animals, 2 other groups of experimental animals were studied: A normal group consisting of prior normal adult cats that were acutely implanted; and an unstimulated control group consisting of neonatally deafened adult cats that were either acutely implanted or implanted at 8-10 weeks of age but not chronically stimulated. Among the major findings of this study are: Electrical stimulation of the intracochlear bipolar electrode consistently produces activation of a reproducibly limited sector of the ICC. The location of this activated sector was found to be consistent with the known cochleotopic organization of the ICC and the intracochlear location of the stimulating electrodes. No major differences in the spatial representation of activated electrodes were found between prior normal cats and neonatally deafened unstimulated cats. The locations, shapes and widths of these spatial representations were virtually indistinguishable indicating that ICC cochleotopic organizations were equivalent in these two experimental groups. In contrast, the ICC representation of chronically stimulated electrode pairs were found to be significantly different. The average area activated by chronically stimulated electrode pairs at 6 dB above minimum threshold was approximately twice that of unstimulated deafened animals and prior normal animals; and it was larger, but not significantly so, than the average of the unstimulated electrode pair in the same experimental group.(ABSTRACT TRUNCATED AT 400 WORDS)

Acoustic Stimulation↗
PubMed1990

A randomized trial comparing whole abdominal radiotherapy with chemotherapy following cisplatinum cytoreduction in epithelial ovarian cancer. West Midlands Ovarian Cancer Group Trial II.

The potential role of consolidation therapy has been tested in a randomized trial in ovarian cancer. Patients were randomized to receive either whole abdominal radiotherapy using the moving strip technique (n = 56) or one year of chlorambucil (n = 53) following primary surgery, five courses of cisplatinum 100 mg/m2, and second look laparotomy. Overall survival at two years was 35%. There was no significant difference in survival between the two groups, and in spite of the observation that approximately 50% of the patients were optimally debulked prior to consolidation, no subgroups in either arm could be identified who might benefit from consolidation therapy. Toxicity was considerable in both arms, and almost 50% of patients were unable to complete the planned treatment in both arms. These results suggest that after primary surgery and cisplatinum chemotherapy, there is no indication for consolidation therapy with either radiotherapy or alkylating agents.

Abdomen↗