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Biomedical subjects

K R Harris

Publications and source records attributed to K R Harris.

At least 19 recordsLinked to original sources
PubMed1996

Serum C-reactive protein. A useful and economical marker of immune activation in renal transplantation.

This study investigated whether serial daily measurements of serum C-reactive protein (sCRP) in 187 renal allograft recipients could help discriminate episodes of renal dysfunction due to rejection or cyclosporine (CsA) nephrotoxicity and help adjust immunosuppression in the early posttransplant period. Excellent primary graft function was associated with an initial peak of sCRP on day 2 after transplant (median, 29 microg/ml; range, 4 to >200 microg/ml) with a return to <20 microg/ml in all patients by day 5 (median, 7 microg/ml; range, 2-19 microg/ml). Stable graft function (mean creatinine, 155 microg/ml) was accompanied by a median sCRP of 4 microg/ml (range, 1-19 microg/ml). In 30 episodes of rejection responsive to methylprednisolone, sCRP was initially significantly raised to a median of 49 microg/ml (P<0.001) but fell rapidly in response to treatment to a median of 11 microg/ml and continued to fall. In 19 episodes of rejection unresponsive to methylprednisolone, median initial sCRP levels were significantly higher (P<0.001) at 119 microg/ml and were still at a median of 77 microg/ml at the end of the treatment. Twenty-four patients in whom renal dysfunction was associated with CsA nephrotoxicity showed no increase in sCRP concentrations; median sCRP concentrations remained at <5 microg/ml throughout the episodes. A similar pattern was seen in patients with acute tubular necrosis. Serial sCRP measurements provide economical and reproducible evidence of immune activation, help discriminate renal dysfunction due to CsA nephrotoxicity or rejection, and allow appropriate modification of immunosuppressive therapy.

Adolescent↗
PubMed1996

Endothelium-derived relaxing factor (nitric oxide) has a tonic vasodilating action on coronary collateral vessels.

OBJECTIVES: We sought to determine whether endothelium-derived relaxing factor (nitric oxide) exerts a tonic vasodilating effect on coronary collateral channels developed in response to myocardial ischemia. BACKGROUND: Although the coronary collateral circulation is known to react to several vasoactive agents, the role of endogenously produced nitric oxide is unclear. METHODS: Coronary collateral channels were induced in the left circumflex artery bed of 12 chronically instrumented dogs by either ameroid implantation or repeated occlusion of the left circumflex coronary artery. With the native circumflex artery occluded, aortic and circumflex pressures and microsphere flows were measured before and after systemic administration of NG-nitro-L-arginine methyl ester, an arginine analogue known to block the synthesis of nitric oxide. RESULTS: NG-nitro-L-arginine methyl ester increased mean aortic pressure from a mean +/- SEM of 92 +/- 4 to 114 +/- 4 mm Hg, whereas pressure in the occluded circumflex artery decreased from 61 +/- 4 to 55 +/- 4 mm Hg. The increase in aortic-circumflex pressure gradient (from 31 +/- 4 to 59 +/- 5 mm Hg) was accompanied by a decrease in flow in the circumflex bed (from 1.31 to +/- 0.14 to 1.09 +/- 0.15 ml/min per g), resulting in an increase in coronary collateral resistance averaging 173 +/- 37% (from 26 +/- 4 to 64 +/- 9 mm Hg/ml per min per g, p < 0.01). The increase in collateral resistance could be partially reversed by administration of L-arginine. CONCLUSIONS: We conclude that nitric oxide normally exerts a substantial tonic dilating effect in coronary collateral vessels. Disease-induced alterations in endothelial function may limit collateral perfusion importantly.

Animals↗
PubMed1996

A comparison between Mohs micrographic surgery and wide surgical excision for the treatment of dermatofibrosarcoma protuberans.

BACKGROUND: There is growing evidence that Mohs micrographic surgery (MMS) is the treatment of choice for dermatofibrosarcoma protuberans (DFSP). OBJECTIVE: This study retrospectively compared the recurrence rates of DFSP after MMS with those after wide surgical excision; results at the Mayo Clinic and in the world literature were evaluated. In addition, preoperative tumor sizes and postoperative defect sizes after MMS were compared to determine whether MMS conserved more normal tissue than wide surgical excision. METHODS: The medical records of 84 patients with DFSP who had been treated at the Mayo Clinic were reviewed. They were categorized into two treatment groups: MMS and surgical excision. RESULTS: Fifteen patients with DFSP who underwent MMS had follow-up data available; one of these patients had local recurrence (recurrence rate, 6.6%; average duration of follow-up, 40 months). Thirty-nine patients had wide excision; four of these patients had local recurrences and one had pulmonary metastases (recurrence rate, 10%; average duration of follow-up, 36 months). A review of the world literature revealed neither local recurrences nor metastases in the 11 studies in which DFSP was treated with MMS. Overall, including our results, the average recurrence rate of DFSP after MMS was 0.6% (range, 0% to 6.6%) and the total recurrence rate was 1.6% (1 of 64). Including our series, DFSP was treated with wide excision in 15 studies; the average recurrence rate was 18% (range, 0% to 60%) and the total recurrence rate was 20% (100 of 489). In eight published studies, DFSP was surgically resected with undefined or conservative excisional margins; the average recurrence rate was 43% (range, 26% to 60%) and the total recurrence rate was 44% (140 of 317). A surgical margin of 2.5 cm to deep fascia was required for complete clearance of all tumors treated with MMS. Twenty-two percent of tumors were removed with a 0.5 cm margin, 50% with a 1.0 cm margin, 67% with a 1.5 cm margin, and 89% with a 2.0 cm margin. CONCLUSION: On the basis of our results and data compiled from the literature, MMS may be the treatment of choice for DFSP because of its high cure rate and maximal conservation of tissue.

Adolescent↗
PubMed1994

The spelling for writing list.

Four different vocabulary lists based on the study of children's writing were used to generate a basic spelling list for students with learning disabilities and other poor spellers. For each vocabulary list, the smallest number of different words that accounted for 80% of the words children used in their writing were identified. Words that were common to only one or two of the lists or not normally used by children until fourth grade or later were eliminated. Each word was assigned a grade placement based on difficulty, pattern of occurrence in children's writing, and placement on current vocabulary lists and spelling materials. The resulting spelling list of 335 words is provided.

Child↗
PubMed1990

Paradigms.

Explore the source record for details and available documents.

Child↗
PubMed1989

Improving learning disabled students' skills at composing essays: self-instructional strategy training.

This study was conducted to determine if self-instructional strategy training would improve learning disabled students' writing. Students were taught a strategy designed to facilitate the generation, framing, and planning of argumentative essays. Training effects were investigated using a multiple-baseline across-subjects design, with multiple probes in baseline. Strategy instruction had a positive effect on students' writing performance and self-efficacy. Effects were maintained over time and transferred to a new setting and teacher. Evidence for generalization to a second genre, story writing, was also obtained. The students and their special education teacher recommended the use of the strategy with other students.

Child↗
PubMed1986

The effects of cognitive-behavior modification on private speech and task performance during problem solving among learning-disabled and normally achieving children.

Recent research has supported the hypothesis that poor performance among learning-disabled (LD) children is frequently the result of deficits in self-regulation of strategic behaviors, rather than structural or ability deficits. As a result, cognitive-behavior modification (CBM) techniques that emphasize development of self-regulation through self-verbalizations (private speech) have been strongly recommended. The present study examined the natural occurrence of regulatory private speech among LD and normally achieving children during problem solving, as well as the effects of CBM training on private speech and task performance. Results indicated significant deficiencies in private speech and task performance among LD children; CBM training resulted in significant improvements. These results provide further verification of deficits in self-regulation of cognitive activity among LD children and import implications for intervention.

Behavior Therapy↗
PubMed1986

Self-monitoring of attentional behavior versus self-monitoring of productivity: effects on on-task behavior and academic response rate among learning disabled children.

I investigated the differential effects of self-monitoring of attentional behavior and self-monitoring of productivity on on-task behavior and academic response rate. Subjects were four learning disabled children with significant attentional problems. Results indicated relatively equivalent increases in on-task behavior over baseline during all treatment phases. Academic response rate also improved under both interventions, with self-monitoring of productivity showing a superior effect for one subject, an equivalent effect for one subject, and less clear results for two subjects.

Attention↗
PubMed1985

Azathioprine and cyclosporin: different tissue matching criteria needed?

Of 275 renal transplants performed over seven years in a single unit, azathioprine was the main immunosuppressive agent in 128 and cyclosporin in 147. With azathioprine graft survival was, as expected, negatively related to the number of HLA mismatches; with cyclosporin the reverse held true.

Actuarial Analysis↗
PubMed1985

Conceptual, methodological, and clinical issues in cognitive-behavioral assessment.

This article reviews cognitive-behavioral assessment principles and procedures. The functions of such assessments are noted, and issues and advances in cognitive assessment are discussed. The need for integrated cognitive, behavioral, and affective assessments is then explored. Finally, conceptual methodological, and clinical issues in the integration of assessments and study of reciprocal determinants are presented.

Behavior Therapy↗