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Biomedical subjects

M Reynolds

Publications and source records attributed to M Reynolds.

At least 37 records · Page 2Linked to original sources
PubMed2000

Randomized comparison of cisplatin/vincristine/fluorouracil and cisplatin/continuous infusion doxorubicin for treatment of pediatric hepatoblastoma: A report from the Children's Cancer Group and the Pediatric Oncology Group.

PURPOSE: Previous studies demonstrated that chemotherapy with either cisplatin, vincristine, and fluorouracil (regimen A) or cisplatin and continuous infusion doxorubicin (regimen B) improved survival in children with hepatoblastoma. The current trial is a randomized comparison of these two regimens. PATIENTS AND METHODS: Patients (N = 182) were enrolled onto study between August 1989 and December 1992. After initial surgery, patients with stage I-unfavorable histology (UH; n = 43), stage II (n = 7), stage III (n = 83), and stage IV (n = 40) hepatoblastoma were randomized to receive regimen A (n = 92) or regimen B (n = 81). Patients with stage I-favorable histology (FH; n = 9) were treated with four cycles of doxorubicin alone. RESULTS: There were no events among patients with stage I-FH disease. Five-year event-free survival (EFS) estimates were 57% (SD = 5%) and 69% (SD = 5%) for patients on regimens A and B, respectively (P =.09) with a relative risk of 1.54 (95% confidence interval, 0.93 to 2.5) for regimen A versus B. Toxicities were more frequent on regimen B. Patients with stage I-UH, stage II, stage III, or stage IV disease had 5-year EFS estimates of 91% (SD = 4%), 100%, 64% (SD = 5%), and 25% (SD = 7%), respectively. Outcome was similar for either regimen within disease stages. At postinduction surgery I, patients with stage III or IV disease who were found to be tumor-free had no events; those who had complete resections achieved a 5-year EFS of 83% (SD = 6%); other patients with stage III or IV disease had worse outcome. CONCLUSION: Treatment outcome was not significantly different between regimen A and regimen B. Excellent outcome was achieved for patients with stage I-UH and stage II hepatoblastoma and for subsets of patients with stage III disease. New treatment strategies are needed for the majority of patients with advanced-stage hepatoblastoma.

Antibiotics, Antineoplastic↗
PubMed2000

Emotional disclosure in school children.

Recent research with adults by Pennebaker and his colleagues has found that emotional disclosure through writing about stressful events appears to have significant benefits in terms of psychological and physical health outcomes. This report describes a controlled trial of emotional disclosure, adapted for school children, with the major hypothesis that the repeated description of negative events will have beneficial effects on measures of mental health, attendance, and school performance. The sample consisted of children aged 8-13 years from four schools, a primary and a secondary school both from a suburban and an inner-city area. Children were randomly assigned to one of three conditions: writing about negative events, writing about nonemotional events, and a non-writing control group. Children in all groups were seen four times during a single week and were then followed up after 2 months with measures of health and school performance. The intervention was well received by both schools and children, and the scripts written by the emotional and nonemotional writing groups differed in content in the predicted ways. Contrary to expectation, there was little evidence of a specific effect of emotional disclosure, and several possible reasons for this are discussed. Nevertheless, there was a general reduction in symptom measures, indicating that children may have benefited from their involvement in the study. Although there are several possible explanations for our findings, they indicate that it is both feasible and potentially valuable to give children opportunities to engage in discussion about sources of stress and their reactions to them.

Affect↗
PubMed2000

HCFA's new restrictions on the operation of hospital outpatient facilities.

The Health Care Financing Administration has promulgated new regulations that substantially alter the manner in which it treats Outpatient Facilities. This Article (1) provides an overview of these new restrictions on the operation of Outpatient Facilities; (2) discusses potential unintended consequences associated with these restrictions; and (3) raises issues that providers must consider as they assess how to comply with these new restrictions.

Aged↗
PubMed2000

Vital signs monitoring from home with open systems.

This study investigates the applicability of a novel codification scheme based on two healthcare informatics standards (namely the VITAL (ENV 13734) and DICOM Sup. 30 Waveform Interchange) in addressing the robust interchange of waveform and medical data in remote healthcare applications. To further address system validation and clinical acceptance issues, pilots were set-up between home-monitoring stations and a hospital-based telemedicine consultation center. The pilots focused in assessing applicability, technical feasibility and performance of the proposed codification scheme based on the two standards. This paper presents the system and services requirements as studied for a home-care application, the design goals for the preservation of security stature, the practical issues of validation and the results of integrating these codification schemes into a commercial patient connected device.

Computer Systems↗
PubMed1999

Cell surface colligin/Hsp47 associates with tetraspanin protein CD9 in epidermoid carcinoma cell lines.

Hsps expressed on the cell surface have been associated with tumor invasiveness and used as targets for molecular surveillance. The present study utilized four human oral squamous cell carcinoma cells lines, SCC-4, SCC-9, SCC-15, SCC-25, the murine epidermoid carcinoma cell line LL/2, and primary cultures of human gingival fibroblasts to assess the cell surface expression of colligin/Hsp47, a proposed marker for malignancy. Immunoprecipitation studies following protein crosslinking revealed that Hsp47 was associated with a number of membrane proteins including the tetraspanin CD9. Cytometric analyses were performed to determine the distribution of cell surface colligin/Hsp47 during the phases of the cell cycle. These studies showed that colligin/Hsp47 was not limited to any phase of the cell cycle in epidermoid carcinoma cells. Boyden chamber tumor invasion assays and colloidal gold migration assays utilizing a reconstituted basement membrane (Matrigel), collagen type I, and laminin-5 substrates revealed that cell lines expressing constitutive high levels of colligin/Hsp47 manifested the lowest invasion and migration indices. The incorporation of antibodies against Hsps into the migration and invasion assays, likewise, increased the invasion indices and the phagokinetic migration indices. These data indicate that colligin/Hsp47 is anchored to the cell membrane in a complex with CD9 where it moderates tumor cell invasion and motility possibly by acting as a serpin protein inhibitor or as a receptor for collagen.

Animals↗
PubMed1999

Pediatric liver tumors.

An infant or child who presents with a large intrahepatic mass will most likely have a malignant tumor. In children, benign tumors constitute only 30% of liver tumors and most are vascular in origin. Treatment of benign vascular tumors is conservative and seldom surgical. Hepatoblastoma is the most common malignant tumor followed by hepatocellular carcinoma. Treatment of malignant tumors is based on a combination of surgery and chemotherapy. Children with hepatic malignancies that can be resected have an excellent prognosis. Other rare benign and malignant tumors of the liver do occur and surgery plays a critical role in management.

Algorithms↗
PubMed1999

In vitro evidence for the presence of hematopoietic stem cells in the adult human liver.

Previous studies have identified novel lymphoid phenotypes in the adult human liver and provided evidence to suggest that lymphoid differentiation can occur locally in this organ. The aim of this study was to examine the adult human liver for the presence of hematopoietic stem cells that may provide the necessary precursor population for local hematopoietic and lymphoid differentiation. Hepatic mononuclear cells (HMNC) were extracted from normal adult liver biopsy specimens using a combination of mechanical disruption and enzymatic digestion. The stem cell marker CD34 was found on 0.81% to 2.35% of isolated HMNCs by flow cytometry. CD34(+) HMNCs were positively selected using magnetically labeled beads, and the enriched population was further examined for surface markers characteristically expressed by immature hematopoietic cells and early progenitors. CD45 was expressed by 49% (+/-23%) of CD34(+) HMNCs, indicating their hematopoietic origin. CD38, one of the first markers to be expressed by developing progenitor cells was found on 50% (+/-22%) of CD34(+) HMNCs indicating the presence of both pluripotent stem cells and committed precursors. The majority (90%) of CD34(+) HMNCs coexpressed the activation marker human leukocyte antigen DR, consistent with actively cycling cells. Functional maturation of these hepatic progenitors was shown by the detection of multilineage hematopoietic colony formation after tissue culture. Erythroid (BFU-E), granulocyte-monocyte (CFU-GM), and mixed colonies (CFU-GEMM) were detected after culture of unseparated HMNCs and the enriched CD34(+) HMNC population; 14.3 +/- 13.2 (mean +/- SD) BFU-E, 3.1 +/- 3.1 CFU-GM, and 0.4 +/- 0.9 CFU-GEMM per 1 x 10(5) unseparated HMNCs and 16.0 +/- 9.5 BFU-E and 1.7 +/- 0.9 CFU-GM were identified per 2.4 x 10(3) CD34(+) HMNCs plated. The detection of surface markers characteristic of immature hematopoietic cells and colony formation in tissue culture provides evidence for the presence of hematopoietic stem cells and early progenitor cells in the adult human liver. This would suggest that the adult human liver continues to contribute to hematopoiesis and may be an important site for the differentiation of lymphohematopoietic cells involved in disease states, such as autoimmune hepatitis and graft rejection after liver transplantation.

Antigens, CD↗
PubMed1999

Intrusive memories in depression and posttraumatic stress disorder.

This study compared the stressors and consequent intrusive memories reported by matched samples of patients with posttraumatic stress disorder (PTSD) and major depression. Although intrusive memories were slightly more common among PTSD patients, both quantitative and qualitative measures revealed few differences between the groups. PTSD patients were more likely to have experienced personal illness or assault, and depressed patients family deaths and illness, and interpersonal events. Factor analysis of the associated emotions and memory characteristics suggested the existence of specific links between fear and reliving, and helplessness and out-of-body experiences. Possible inhibitory relationships between fear and sadness, and between guilt and anger, were also noted.

Adult↗
PubMed1999

The Thought Control Questionnaire--psychometric properties in a clinical sample, and relationships with PTSD and depression.

BACKGROUND: Recent developments in research suggest that particular attempts to control thoughts may contribute to the problem of intrusion. An instrument capable of identifying strategies for dealing with unwanted intrusions in clinical populations may be used for differentiating between thought control strategies that may or may not be helpful. METHODS: The Thought Control Questionnaire (TCQ) (Wells & Davies, 1994) developed and validated on a normal sample, was administered to a clinical sample in order to investigate the consistency of the original factor structure and its psychometric properties. The sensitivity of the scale to change associated with recovery was also examined. Relationships between individual differences in thought control strategies and psychiatric symptoms in patients with DSM-IV major depression, and PTSD with or without major depression were investigated. RESULTS: The Scree Test suggested a six-factor solution which was rotated. This solution split the original distraction subscale into separate behavioural and cognitive distraction, otherwise the subscales were almost identical to those obtained in non-clinical subjects. As this split has been shown to be unreliable, further analyses in this study were based on the five-factor version of the TCQ obtained by Wells & Davies (1994). Predictors of recovery and of symptoms in PTSD and depression were explored. CONCLUSIONS: Correlations between the TCQ subscales and other measures suggest that particular thought control strategies may be associated with the symptoms of PTSD and depression. The TCQ scales appear to be sensitive to changes associated with recovery. Significant differences emerged in thought control strategies between depressed and PTSD patients. Hierarchical regression analysis showed distraction, punishment and reappraisal control strategies predicted depression scores in depressed patients while use of distraction predicted intrusions in PTSD.

Adult↗
PubMed1999

Autobiographical memory processes and the course of depression.

The authors report a 6-month follow-up study of clinically depressed patients. At baseline, 2 indexes of autobiographical memory functioning were assessed: the presence of spontaneous intrusive memories of stressful life events and performance on the Autobiographical Memory Test (J. M. G. Williams & K. Broadbent, 1986), which measures overgeneral memory. The index of overgeneral memory was associated with greater levels of spontaneous intrusion of stressful memories. Overgeneral memory did not predict outcome, but depression at follow-up was predicted by the amount of intrusion and avoidance of stressful memories, even after controlling for initial severity of psychiatric symptoms.

Aged↗
PubMed1999

A randomized trial of cognitive therapy and imaginal exposure in the treatment of chronic posttraumatic stress disorder.

A randomized trial was performed in which imaginal exposure (IE) and cognitive therapy (CT) were compared in the treatment of chronic posttraumatic stress disorder (PTSD). Patients who continued to meet PTSD caseness at the end of a 4-week symptom-monitoring baseline period (n = 72) were randomly allocated to either IE or CT. There was a significant improvement in all measures over treatment and at follow-up, although there were no significant differences between the 2 treatments at any assessment. A significantly greater number of patients who showed worsening over treatment received IE, although this effect was not found at follow-up. Patients who worsened showed a greater tendency to miss treatment sessions, rated therapy as less credible, and were rated as less motivated by the therapist. It was concluded that either exposure or a challenge to cognition can result in symptom reduction, although neither resulted in complete improvement.

Adult↗
PubMed1998

Intrusive cognitions, coping strategies and emotional responses in depression, post-traumatic stress disorder and a non-clinical population.

Patients with major depression but not PTSD, patients with PTSD with or without comorbid depression, and a sample of non-clinical controls, were interviewed about their most prominent intrusive cognition, coping strategies and emotional responses. Evaluative thoughts were more likely to be reported by the depressed sample and the control sample. They were also common in the PTSD group, but other types of intrusions were also common, particularly personal memory. All three groups reported a wide variety of different types of intrusive cognition, both singly and in combination. These included elaborative cognitions, future-oriented thoughts or images that represented an elaboration of a specific personal memory. Cognitions were more frequent, unacceptable, and intrusive in the PTSD group in the month preceding interview, but the two clinical groups did not differ in the use of or effectiveness of coping strategies, or in emotional responses.

Adaptation, Psychological↗
PubMed1998

Dermatofibrosarcoma protuberans and the Bednar tumor: treatment in the pediatric population.

Dermatofibrosarcoma protuberans (DFSP) is a low-intermediate-grade cutaneous sarcoma that has a marked propensity for local recurrence after excision. The Bednar variant of this tumor is even less common and is distinguished histologically by the dispersal of melanin containing cells in an otherwise typical DFSP. Both are considered to be tumors of the third and forth decades of life, but both DFSP and the Bednar variant have been described in children. Until this report of a congenital Bednar tumor, only the DFSP has also been described in the neonate. The histopathology and surgical management of DFSP and Bednar tumors are outlined with emphasis on reported experience in the pediatric population. The surgical management of these lesions in children is based on numerous series in adults and the limited pediatric experience. The recommended treatment is wide excision with 3-cm margins of visibly uninvolved tissue and inclusion of superficial fascia.

Dermatofibrosarcoma↗
PubMed1998

Neonatal disorders of the external genitalia and vagina.

Abnormalities of the external genitalia and vagina range from simple lesions to very complex anomalies of the genitourinary and gastrointestinal systems. The author describes the most common disorders of the external genitalia and vagina in the neonate, and current management strategies.

Cloaca↗
PubMed1998

Hsp47 binds to the KDEL receptor and cell surface expression is modulated by cytoplasmic and endosomal pH.

Hsp47 is a novel glycoprotein that binds specifically to procollagen and is retained in the ER by its COOH-terminus RDEL peptide sequence (Satoh, M. et al. Jol. Cell Biol. 1996; 133: 469-83). In this paper, we report that erd2P, the KDEL receptor, is distributed, coprecipitates with, and binds to Hsp47. Also, under stress conditions and lowering of pHi, the cytoplasmic epitope of erd2P is not recognized by erd2P antibodies unless the cells are pretreated with NEM. Coincident with the masking of the cytoplasmic epitope of erd2P, following lowering of pHi, Hsp47 is not retained but eludes its retention receptor to be expressed on the cell surface. Alkalization of the endosomal compartments by treatment with NH4Cl or chloroquine also results in the loss of Hsp47 to the cell surface, presumably by inhibiting the retrieval of trans-Golgi network proteins from the cell surface. The expression of Hsp47 on the cell surface under conditions of stress and alteration of pHi and pHe posture Hsp47 as a serpin family protein that may modulate cell migration during development and invasion and metastasis in cancer.

Amino Acid Sequence↗