Ultrasonography in the management of penetrating ocular trauma.
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Anterior Eye Segment↗
Biomedical subjects
L Hart
Publications and source records attributed to L Hart.
Correlation of prostate-specific antigen and prostate-specific antigen density with outcome of prostate biopsy.
OBJECTIVE: We attempt to correlate prebiopsy serum prostate-specific antigen (PSA) concentration and prostate-specific antigen density (PSAD) with histologic results of prostate biopsy. METHOD: Sixty-two consecutive patients underwent prostate biopsy because of elevated PSA greater than 4 ng/mL and/or abnormal findings on digital rectal examination (DRE). PSAD was calculated from dividing the serum PSA concentration by the prostate volume as determined by transrectal ultrasound (TRUS). PSA and PSAD were compared to biopsy outcome. RESULTS: The mean PSAD values of the cancer versus noncancer (benign prostatic tissue, benign prostatic hyperplasia, and prostatitis) groups were significantly different (p < 0.019). However, there was great overlap in individual values. The mean PSA levels of the cancer versus noncancer groups also were significantly different (p < 0.0079). In patients with PSA levels between 4 and 10 ng/mL, 11 of 32 (34%) had positive biopsy findings for cancer. Eleven of 29 patients (38%) with normal DRE findings and elevated PSA levels (> 4 ng/mL) had positive biopsy findings for cancer. Seven of 19 patients (37%) with normal DRE findings and elevated PSA levels between 4 and 10 ng/mL had positive biopsy specimens for cancer. CONCLUSIONS: PSAD, though suggestive, is not definitive for cancer or noncancer. Patients with inflammation (prostatitis) present in their biopsy specimens have serum PSA levels and PSAD values intermediate between those with benign tissue (without inflammation) and cancer. We think that prostate biopsy is important in patients with PSA levels between 4 and 10 ng/mL even if their DRE result is normal, as our data indicate that over one third of these patients harbor detectable prostate cancer.
Aged↗
Characterization of tumor-infiltrating lymphocyte subsets from human renal cell carcinoma: specific reactivity defined by cytotoxicity, interferon-gamma secretion, and proliferation.
The detection of T cells with specificity for human renal cell carcinoma (RCC) has been difficult to document. In an attempt to improve our identification of RCC-reactive T cells, tumor-infiltrating lymphocytes (TIL) were expanded in interleukin-2/interleukin-4 (IL-2/IL-4) and then separated into CD4+ and CD8+ subsets using antibody-coated biomagnetic beads. TIL grown in IL-2/IL-4 expanded to greater numbers than TIL grown in IL-2 alone. From 16 patients in whom subset separation was performed, three CD4+ and three CD8+ TIL consistently had specificity for RCC that was detected by cytotoxicity, proliferation, or interferon-gamma (IFN-gamma) production. Four of the six lines were derived from the IL-2/IL-4 cultures. Two CD8+ TIL lines displayed specific lytic activity, lysing the autologous tumor but not allogeneic RCC or nonrenal tumors. Moreover, the lytic activity of these lines was blocked by anti-CD3 antibody, suggesting that tumor recognition was through the TCR/CD3 complex. Two additional TIL lines showed preferential lysis of RCC because they were cytotoxic for autologous tumor and one or more allogeneic RCC but not other tumor types. Two nonlytic CD4+ lines as well as the two CD8+ lines that were specifically lytic also produced IFN-gamma in response to the autologous tumor but not allogeneic RCC. Although these TIL lines produce IFN-gamma when stimulated with tumor alone, the addition of 5 U/ml of IL-2 significantly enhanced IFN-gamma secretion. The four TIL lines that showed specificity for RCC in terms of IFN-gamma production also had enhanced proliferation to the autologous RCC plus IL-2 but not to multiple allogeneic RCC plus IL-2. These studies demonstrate that TIL from RCC patients contain both CD4+ and CD8+ T cells that have specificity for RCC. In addition to cytotoxicity, specificity to RCC can be defined by IFN-gamma production and proliferation.
CD4-Positive T-Lymphocytes↗
Helicobacter pylori eradication in patients with peptic ulcer disease: clinical consequences and financial implications.
We assessed clinical consequences and financial implications of Helicobacter pylori eradication in 175 patients with peptic ulceration, of whom 106 had been free from H. pylori infection for a mean of 3.2 years, while 69 remained infected. We used quarterly questionnaires to examine consumption of ulcer-healing medication and antacids. In the 106 successfully treated patients, gastrointestinal haemorrhage as a complication of peptic ulcer complications during the 344 patient years after eradication (0.003 per patient year) was 18-fold lower than during the 912 patient years before eradication (0.056 per patient year). Of the H. pylori-negative patients, 12-18% used ulcer-healing medication during any one of the three-month periods of the survey, compared with 34-51% of the patients with residual H. pylori infection. The average cost of the ulcer-healing drugs consumed by the H. pylori-negative patients was 30.59 pounds during the 12 months of the survey, compared with 99.05 pounds for H. pylori-positive patients. Consumption of antacids was also lower in the H. pylori-negative group. Successful eradication of H. pylori significantly reduced the annual cost of ulcer-healing drugs consumed by the patients with ulcer disease. Maintenance of ulcer remission following successful eradication of H. pylori also significantly reduced ulcer complications.
Antacids↗
Transient and stable expression of gusA fusions with rice genes in rice, barley and perennial ryegrass.
Transcriptional and translational fusions were made between the reading frame coding for beta-D-glucuronidase and sequences of either a constitutively expressed rice gene (GOS2) involved in initiation of translation or a light-inducible rice gene (GOS5). The transient expression of the fusions was studied via particle bombardment of seedling tissues of rice, perennial ryegrass and barley. Furthermore, the results of transient and stable expression were compared for cell suspensions of four rice varieties, one barley variety and one perennial ryegrass variety. The GOS2-gusA fusions were active in all three monocots studied. Best results were obtained for a construct having both a transcriptional and a translational fusion as well as intron and exon sequences (PORCEHyg). The level of GUS activity was in the range of activities as obtained by the 35S CaMV promoter transcriptionally fused to gusA. The gusA fusion with the light-inducible gene (GOS5) was active in green seedling tissues of all monocots studied. Also a weak expression compared to the GOS2 constructs was found in stably transformed rice callus. The gusA fusions with the mannopine synthase promoters 1' and 2' of the TR-DNA were transiently expressed at lower levels in cell suspensions than PORCEHyg. For stably transformed rice callus the expression of the GOS2-gusA fusion often decreased during prolonged subculture. This decrease in GUS activity and the various GUS-staining phenotypes of transgenic calli are explained by the presence of different cell types in the suspensions used and in the calli. It is presumed that the nature of the cells and their relative contribution in the calli change drastically upon further subculture.
Amino Acid Sequence↗
Transient and stable expression of gusA fusions with rice genes in rice, barley and perennial ryegrass.
Transcriptional and translational fusions were made between the reading frame coding for beta-D-glucuronidase and sequences of either a constitutively expressed rice gene (GOS2) involved in initiation of translation or a light-inducible rice gene (GOS5). The transient expression of the fusions was studied via particle bombardment of seedling tissues of rice, perennial ryegrass and barley. Furthermore, the results of transient and stable expression were compared for cell suspensions of four rice varieties, one barley variety and one perennial ryegrass variety. The GOS2-gusA fusions were active in all three monocots studied. Best results were obtained for a construct having both a transcriptional and a translational fusion as well as intron and exon sequences (PORCEHyg). The level of GUS activity was in the range of activities as obtained by the 35S CaMV promoter transcriptionally fused to gusA. The gusA fusion with the light-inducible gene (GOS5) was active in green seedling tissues of all monocots studied. Also a weak expression compared to the GOS2 constructs was found in stably transformed rice callus. The gusA fusions with the mannopine synthase promoters 1' and 2' of the TR-DNA were transiently expressed at lower levels in cell suspensions than PORCEHyg. For stably transformed rice callus the expression of the GOS2-gusA fusion often decreased during prolonged subculture. This decrease in GUS activity and the various GUS-staining phenotypes of transgenic calli are explained by the presence of different cell types in the suspensions used and in the calli. It is presumed that the nature of the cells and their relative contribution in the calli change drastically upon further subculture.
Amino Acid Sequence↗
Current quality-of-life research challenges in arthritis relevant to the issue of clinical significance.
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Activities of Daily Living↗
The influence on blood pressure during daily activities of a single session of aerobic exercise.
Previous research has examined the effectiveness of a single session of aerobic exercise in lowering blood pressure responsivity to the subsequent presentation of a nonexercise stressor in the laboratory. This case study was designed to explore the possibility that a single session of aerobic exercise might lower blood pressure for up to 4 hours postexercise as the subject engaged in his usual activities at home and at work. The subject was an untrained, unmedicated, borderline hypertensive who underwent ambulatory blood pressure monitoring as he maintained a normal schedule of activities over a 5-day period. On 2 of the 5 days, the subject exercised at 8:30 AM for 30 minutes at 70% VO2max. Blood pressure readings on days when the subject read for 30 minutes were compared with readings on days when he exercised. He showed an average reduction in systolic blood pressure of 26.4 mm Hg at 2 hours after exercise, 24.2 mm Hg at 4 hours afterward, and 12.2 mm Hg at 9 hours after the exercise. Changes in diastolic blood pressure and heart rate were smaller and less consistent. The authors concluded that the modifying influence of a single session of aerobic exercise on blood pressure responsivity to subsequent laboratory-based stressors may also extend to the natural environment. The discussion addresses theoretical, methodological, and clinical considerations in the use of aerobic exercise to modify excessive blood pressure reactivity.
Adult↗
Individual differences in children's response to pain: role of temperament and parental characteristics.
Sixty-five families were enlisted in a study exploring factors associated with distress behavior in 5-year-old children receiving diphtheria-tetanus-pertussis immunizations. At a home visit 1 month before the immunization, the following measures were obtained: (1) the Behavioral Style Questionnaire, a measure of temperament: (2) parental self-reports of medically related attributes (eg. "good patient"); (3) parental attitudes toward pain in children and responsiveness to their child's pain; and (4) parental prediction of distress at upcoming immunization. The child's distress behavior during the immunization was evaluated using a modification of the Procedure Rating Scale-Revised and, after the procedure, the child's assessment of his or her pain was elicited using the Oucher. Children's mean Procedure Rating Scale-Revised score was 2.57 of a possible 11. Thirty-one (48%) had low (less than or equal to 1) and 7 (11%) had high distress scores (greater than or equal to 2 SD above the mean). Factors positively correlated with distressed behavior included more "difficult child" cluster characteristics, the individual temperamental dimension of adaptability, but few parental attitudes and attributes. Parent's predictions of distress were the strongest correlates. These findings document the variation that children demonstrate in response to pain and offer some insight into associated innate and environmental factors. These results imply that treatment strategies derived from parental knowledge and tailored to individual characteristics of the child may be most effective in alleviating pain-related distress in medical settings.
Attitude↗
The Duke AFM Program. Intensive induction chemotherapy for metastatic breast cancer.
Forty-five patients have completed treatment with AFM, an intensive induction chemotherapy regimen composed of Adriamycin (doxorubicin, Adria Laboratories, Columbus, Ohio), 5-fluorouracil, and methotrexate with folinic acid rescue. This regimen was designed to produce rapid and extensive tumor shrinkage prior to high-dose alkylating agent chemotherapy with autologous marrow support. The overall response rate was 91%, and 38% of patients achieved complete clinical responses after a mean of 70 days on treatment. Hematologic and mucosal toxicity were extensive, but no toxic deaths were noted. AFM is a potent remission induction regimen for metastatic breast cancer, but its considerable toxicity suggests caution in its use for routine breast cancer treatment.
Adult↗
Detection of human immunodeficiency virus in infected CEM cells using fluorescent DNA probes and a laser-based computerized image cytofluorometry system.
Quantitative nonradioactive methods to measure the human immunodeficiency virus (HIV) in individually infected cells are needed for the direct assessment of HIV infection, for the evaluation of antiviral chemotherapy and for testing the efficacy of vaccines. As a first step in accomplishing this goal, we built an argon ion laser-based computerized image cytofluorometry (ALCIC) system and determined this instrument's ability to quantitatively measure HIV nucleotides in infected lymphocytes. ALCIC consisted of a 43-mW argon ion laser connected to a Zeiss Universal microscope via a fiberoptic cable, a charged coupled-device video camera, a video frame grabber and array processor and a Micro Vax II computer using computer programs written in FORTRAN. HIV RNA and DNA were detected in infected CEM lymphocytes in culture by in situ hybridization using acetylaminofluorene (AAF)-labeled HIV-DNA probes, a rabbit anti-AAF antibody and a fluorescein-labeled goat anti-rabbit antibody. ALCIC measurements showed that 61% of the CEM cells were infected and that quantitative differences were distinguishable within this group. The levels of fluorescein isothiocyanate (FITC) fluorescence were sixfold or more greater than that observed with the same system using a 100-W mercury lamp for illumination; the improved intensity of the laser-based system is due to greater excitation intensity of the laser and the matching of the excitation spectrum to the peak wavelength of FITC. ALCIC has potential clinical value for determining the effect of antiviral agents on HIV infection and for assessing the susceptibility of different cell types to infection.
DNA Probes↗
Maximal aerobic exercise following prolonged sleep deprivation.
The effect of 60 h without sleep upon maximal oxygen intake was examined in 12 young women, using a cycle ergometer protocol. The arousal of the subjects was maintained by requiring the performance of a sequence of cognitive tasks throughout the experimental period. Well-defined oxygen intake plateaus were obtained both before and after sleep deprivation, and no change of maximal oxygen intake was observed immediately following sleep deprivation. The endurance time for exhausting exercise also remained unchanged, as did such markers of aerobic performance as peak exercise ventilation, peak heart rate, peak respiratory gas exchange ratio, and peak blood lactate. However, as in an earlier study of sleep deprivation with male subjects (in which a decrease of treadmill maximal oxygen intake was observed), the formula of Dill and Costill (4) indicated the development of a substantial (11.6%) increase of estimated plasma volume percentage with corresponding decreases in hematocrit and red cell count. Possible factors sustaining maximal oxygen intake under the conditions of the present experiment include (1) maintained arousal of the subjects with no decrease in peak exercise ventilation or the related respiratory work and (2) use of a cycle ergometer rather than a treadmill test with possible concurrent differences in the impact of hematocrit levels and plasma volume expansion upon peak cardiac output and thus oxygen delivery to the working muscles.
Adult↗
The visual evoked potentials to the light emitting diode compared to the flash and pattern reversal stimulus.
Light-emitting diode (LED), flash (FL) and pattern reversal (PR) stimuli were used to elicit visual evoked potentials (VEPs) in 16 normal subjects (32 eyes) and 39 patients (78 eyes) with signs of visual system abnormality. Latencies and amplitudes (plus standard deviations) of 5 components of each response, correlation coefficients of the normal and abnormal responses and false negatives and positives are presented for the 3 kinds of stimuli. The data show that responses to LED stimuli are very similar to those of FL stimuli and should be useful in the operating room to monitor the visual pathways, if various endogenous factors known to affect late responses can be stabilized.
Adolescent↗
Not just a cleaner.
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Attitude of Health Personnel↗
Comparison of continuous arteriovenous haemofiltration and haemodialysis in acute renal failure.
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Acute Kidney Injury↗
Radiosensitivity of peripheral blood lymphocytes in autoimmune disease.
The proliferation of peripheral blood lymphocytes, cultured with Con A, can be inhibited by ionizing radiation. Lymphocytes from patients with conditions associated with autoimmunity, such as rheumatoid arthritis, systemic lupus erythematosus and polymyositis, are more radiosensitive than those from healthy volunteers or patients with conditions not associated with autoimmunity. The nuclear material isolated from the lymphocytes of patients with autoimmune diseases is, on average, lighter in density than the nuclear material from most healthy controls. This difference in density is not related to increased sensitivity to ionizing radiation but the degree of post-irradiation change in density (lightening) is proportional to the initial density, i.e. more dense nuclear material always shows a greater upward shift after radiation. The recovery of preirradiation density of nuclear material, 1 h after radiation exposure, taken as an indication of DNA repair, correlates with the radiosensitivity of lymphocyte proliferation (Con A response); failure to return to pre-irradiation density being associated with increased sensitivity of proliferative response. These results require extension but, taken with previously reported studies of the effects of DNA methylating agents, support the idea that DNA damage and its defective repair could be important in the aetio-pathogenesis of autoimmune disease.
Adult↗
Interpretation of Doppler segmental pressures in peripheral vascular occlusive disease.
Measurement of Doppler segmental arterial pressures in the lower extremity using narrow pneumatic cuffs has become a standard noninvasive diagnostic technique. Correlation between arteriographic and noninvasive studies was available for 345 aortoiliac segments and 326 femoropopliteal segments. If stenoses of 50% or greater and occlusions were considered hemodynamically significant, the sensitivity to aortoiliac disease was 97%, but only 67% to femoropopliteal disease. The specificity for hemodynamically insignificant disease was 50% and 68%, respectively. Accuracy was influenced by the presence of associated aortoiliac or femoropopliteal disease. The sensitivity to hemodynamically significant femoropopliteal disease was 55% if there was associated aortoiliac disease, and 89% in its absence. In the presence of significant femoropopliteal disease, specificity for the absence of aortoiliac disease decreased from 70% to 41%.
Angiography↗
Controlled trial of clinical utility of serum salicylate monitoring in rheumatoid arthritis.
A crossover double-blind controlled trial was performed on 36 patients with rheumatoid arthritis to assess the necessity for serum salicylate monitoring in determining optimal dosage. There was no clinically or statistically significant increase in the clinical improvement of patients associated with serum monitoring but potentially toxic serum levels occurred without tinnitus when serum monitoring was not used.
Arthritis, Rheumatoid↗