In regard to Joon et al. IJROBP 1999;45:1199-1205.
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Adenocarcinoma↗
Biomedical subjects
P Wolff
Publications and source records attributed to P Wolff.
Iodine deficiency during infancy and early childhood in Belgium: does it pose a risk to brain development?
Iodine deficiency is well documented in Belgium in adults including pregnant women, adolescents, schoolchildren, and neonates, but no data are available in the age group 6 months-3 years. We investigated the status of iodine nutrition in 111 healthy subjects in this age group in an attempt to evaluate the risk of brain damage due to iodine deficiency in Belgium. In 244 causal urine samples collected in these subjects, the median concentration of iodine was 101 micrograms/l vs 180-220 micrograms/l under normal conditions. The daily supplementation of the subjects with a physiological dose of 90 micrograms iodine was followed by a slow and progressive increase of urinary iodine, which reached a normal level only after a delay of about 30 weeks of therapy. This observation suggests that part of the supplement of iodine offered to the children was stored in their thyroid glands until the iodine content of the gland had reverted to normal, reflecting the state of hyperavidity of the thyroid for iodide characteristic of iodine deficiency. In conclusion, infants and young children in Belgium are as iodine deficient as all other age groups of the population and, consequently, are at risk of brain damage. This works further illustrates the need for systematic iodine supplementation of the population in Belgium.
Belgium↗
Randomized trial of choledochocholedochostomy with or without a T tube in orthotopic liver transplantation.
OBJECTIVE: To compare the incidence of biliary complications after liver transplantation in patients undergoing choledochocholedochostomy reconstruction with or without T tube in a multicenter, prospective, randomized trial. SUMMARY BACKGROUND DATA: Several reports have suggested that biliary anastomosis without a T tube is a safe method of biliary reconstruction that could avoid complications related to the use of T tubes. No large prospective randomized trial has so far been published to compare the two techniques. METHODS: One hundred eighty recipients of orthotopic liver transplantation were randomly assigned to choledochocholedochostomy with (n = 90) or without (n = 90) a T tube in six French liver transplantation centers. All types of biliary complications were taken into account. RESULTS: The overall biliary complication rate was increased in the T-tube group, even though these complications did not lead to an increase in surgical or radiologic therapeutic procedures. The major significant complication was cholangitis in the T-tube group; this did not occur in the other group. The incidence of biliary fistula was 10% in the T-tube group and 2.2% in the group without a T tube. Other biliary complications were similar. The complication rate of cholangiography performed with the T tube was greater than with other types of biliary exploration. The graft and patient survival rates were similar in the two groups. CONCLUSION: This study is the first large prospective, randomized trial of biliary complications with or without a T tube. The authors found an increase in the biliary complication rate in the T-tube group, which was linked to minor complications. The T tube did not provide a safer access to the biliary tree compared with the others types of biliary explorations. The authors recommend the performance of choledochocholedochostomy without a T tube in liver transplantation.
Adolescent↗
[Non-surgical treatments of esophageal cancers].
INTRODUCTION: Despite improvements in surgical techniques and perioperative mortality, only slight improvements in the 5-year survival of patients with esophageal cancer have been observed in the last 20 years. Many patients with apparently localized cancer will have recurrences or metastatic disease despite surgery with curative resection. Consequently, multimodal therapies, including chemotherapy and radiotherapy, were introduced. This review outlines and critically analyzes current non-surgical treatments, including palliative care. CURRENT KNOWLEDGE AND KEY POINTS: Esophageal cancers appear to be chemosensitive but the median duration of response is short and toxicity consistent, especially in metastatic disease. Consequently, palliative chemotherapy should be offered preferably within a clinical trial. Chemotherapy as the only adjuvant treatment cannot be recommended outside clinical trials. Radiotherapy alone as a curative treatment has been proven to be inferior to chemoradiotherapy in inoperable tumors. Some data support the use of preoperative chemoradiotherapy, but randomized trials are conflicting. A pathological complete response has been identified as a favorable prognostic factor for survival. Self-expanding esophageal metal stents are a simple and effective palliative treatment of malignant dysphagia and can be considered as the reference treatment in patients with obstruction of the lower esophagus or with fistula. FUTURE PROSPECTS AND PROJECTS: Taxanes should be evaluated in randomized studies using chemotherapy or chemo-radiotherapy. Progress in radiotherapy, such as accelerated fractionation, greater radiation dose, and the addition of brachytherapy, will increase locoregional control and probably survival. The role of secondary surgery in patients responding to chemoradiotherapy still needs to be answered.
Brachytherapy↗
Evidence for role-neutral initial processing of metaphors.
Two models of metaphor processing are contrasted. The structure-mapping model postulates an initially role-neutral alignment process, followed by directional projection of inferences. The attributive categorization model postulates role-specific processing throughout comprehension. To test between these models, the early stages of metaphor comprehension were probed using a technique based on S. Glucksberg, P. Gildea, and H. Bookin's (1982) finding that metaphorical meaning interferes with literal truthfulness judgments. In Experiment 1, interference effects did not differ between normal metaphors and metaphors with reversed terms, suggesting that initial processing is role-neutral. In Experiment 2, we again found no role dependence in interference effects, even for highly conventional metaphors. In Experiment 3, it was verified that (a) full comprehension is role-sensitive and (b) full comprehension reaction times (RTs) are far longer than interference RTs, buttressing the claim that interference is an early-stage effect. Overall, the results support the structure-mapping model of metaphor processing.
Adult↗
Evolution and devolution of folkbiological knowledge.
In this paper we present evidence in support of the hypothesis that the average person's knowledge about trees, and about the natural world in general, has declined during the 20th century. Our investigations are based on examination of a large sample of written material from the 16th through 20th centuries contained in the Oxford English Dictionary. In Analysis 1, we show a precipitous decline in the use of tree terms after, but not before, the 19th century. In Analysis 2, we analyze tree terms at different levels of organization and show that the decline observed in Analysis 1 occurs for all levels of organization. This second analysis also reveals that during the 16th to 19th centuries tree terms became progressively more specific, suggesting that during these periods knowledge about trees increased. In Analysis 3, we show similar rates of decline in other folkbiological categories, indicating that the change in tree terms reflects a general decline in knowledge about living kinds. Also in Analysis 3, we show that several non-biological categories have experienced evolution during the 20th century, indicating that the declines in the 20th century for folkbiological categories are not an inevitable outcome of the corpus. Finally, Analysis 4 also shows declines in the frequency of quotations for which the tree term was not the topic of the sentence, and thus incidental to the purposes of the writer. The results from Analysis 4 reassure us that the results from Analyses 1-3 were not solely due to change in the aims and purposes of writers over the centuries. In sum, the analyses indicate that in the domain of trees, there has been a long and sustained period of conceptual evolution followed by a recent pronounced period of devolution.
Awareness↗
Characterization of myosin V from PC12 cells.
PC12 cell line is a cellular model to study neurite outgrowth and neurotransmitter release mechanisms. Molecular motors may be involved in these responses and myosin V could be a candidate to mediate these effects. Overlay experiments using [(125)I]-calmodulin showed that PC12 cells possess several calmodulin-binding proteins, some of them around 190-210 kDa. Western blots using affinity purified polyclonal antibodies raised against chicken brain myosin V revealed a component of 190 kDa, a molecular mass typical of myosin V. Furthermore, Northern blots using a myosin V probe also detected a transcript of around 12 kbp. Immunofluorescence cytochemistry demonstrated the localization of myosin V throughout the cytoplasm, in the neurites, growth cone tips, and with an intense asymmetrical perinuclear labeling. Western blot analyses of PC12 cellular extracts after FGF-2 and/or dibutyryl cAMP treatment revealed variations between myosin V and myosin II expression during neuronal differentiation. These results demonstrated the presence of myosin V in PC12 cells and also suggest a role for this motor molecule in the neuronal differentiation response in PC12 cells.
Animals↗
Being well in an environmentally challenged world: canary or phoenix?
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Adaptation, Psychological↗
Nerve growth factor-stimulated mitogen-activated protein kinase activity is not necessary for neurite outgrowth of chick dorsal root ganglion sensory and sympathetic neurons.
Nerve growth factor (NGF)-stimulated neurite outgrowth in the rat PC12 tumor cell line recently has been shown to depend on the activation of the mitogen-activated protein (MAP) kinase kinase 1 (MEK1) (Pang et al.: J Biol Chem 270:13585-13588, 1995). In this study we have analyzed whether or not function of the MAP kinase pathway is necessary for NGF-stimulated neurite outgrowth in two subtypes of primary neurons derived from the embryonic chick peripheral nervous system (PNS). Treatment of p21ras-dependent dorsal root ganglion (DRG) sensory neurons (E9) with the MEK1 inhibitor PD98059 at concentrations up to 100 microM did not prevent NGF-stimulated neurite outgrowth. At this concentration NGF-stimulated tyrosine phosphorylation of MAP kinase p42 as well as MAP kinase activity both were decreased by approximately 80%. Essentially the same results were obtained with p21ras-independent sympathetic neurons (E12). We conclude that, in contrast to the PC12 tumor cell line, NGF-stimulated MAP kinase activity is not necessary for neurite outgrowth of DRG sensory and sympathetic neurons derived from the chick PNS.
Animals↗
Purification of fibroblast growth factor-2 from human placenta using tri(n-butyl)phosphate and sodium cholate.
Tri(n-butyl)phosphate (TNBP) and sodium cholate (SC) mixtures have been used to inactivate lipid-enveloped viruses like HIV and hepatitis B. We exploited the use of this combination to purify fibroblast growth factor-2 (FGF-2) from human placenta. Human placentas were extracted in the presence of 0.3% TNBP/0.2% SC and the clarified homogenate was adsorbed to S-Sepharose. The active fractions were further loaded onto a heparin-Sepharose column and purified FGF-2 was eluted with 2.0 M NaCl. FGF-2 purified this way was indistinguishable from FGF-2 purified without TNBP/SC in the extraction step in terms of yield, specific activity and biological response. The lipid-enveloped vaccinia virus was used in a parallel experiment to evaluate the inactivation capacity of our protocol. Under the conditions described here, the combined use of TNBP/SC did not eliminate but reduced significantly the number of vaccinia virus PFUs by log 2-3.
3T3 Cells↗
The effect of a masked stimulus on the response to the masking stimulus.
Four experiments are reported in which the subjects had to respond to a target that masked a preceding prime via metacontrast masking. In one part of Experiment 1, the subjects discriminated the target's shape (square or diamond) by a motor-choice reaction, and in another part they had to respond with a simple reaction. The prime was neutral (circular) with respect to the target's shape. The data showed a facilitation effect. In both tasks the reaction time was reduced by the masked prime. However, the reduction was more pronounced with simple reaction than with choice reaction. In the other experiments, additional primes were used with the same angular shapes as the targets. In Experiments 2 and 3, after discriminating the target's shape by a choice reaction, the subjects had to judge the prime's shape in a signal-detection task. While neither the d' value for discriminating the angular primes from the circular ones (Exp. 2) nor the d' value for distinguishing between the angular primes (Exp. 3) was different from zero, the choice-reaction data showed a congruency effect. With a congruent prime (i.e., a prime that had the same shape as the target), the reaction times were reduced. With an incongruent prime, the reaction times grew. In Experiment 4 the errors were investigated. The facilitation effect was present in the RT, but not in the number of errors, whereas the congruency effect was present in the number, but not in the RT of errors. While the facilitation effect can be attributed either to an unspecific activation by the masked prime or to an influence of the prime on attentional processes, the congruency effect can be explained by the assumption that the masked prime directly activates the specific response, which corresponds to the prime's shape.
Fixation, Ocular↗
[Origin, prevention and treatment of decubitus ulcers].
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Clinical Protocols↗
[Behavioral effect of a subliminal (masked) signal].
Three experiments investigated the influence of a non-consciously perceived visual signal on motor reaction time when subjects were exposed to a stimulus contingency according to the general rules of the Pavlovian conditioning procedure. Conscious perception was prevented by meta-contrast backward masking. A total of 128 adult subjects had to discriminate between two imperative stimuli by means of a choice reaction. Each imperative stimulus was signalled by a different brief figural stimulus (signal). In Experiment 1, the signal was not masked during the training period but was masked during the subsequent test period. The subjects were unable to report the stimulus-contingency to which they were exposed during the training period. Inspite of masking, the signal remained efficient, i.e., reaction time increased when the stimulus-contingency was inverted. In Experiment 2, the signal was masked during the training period but not during the test period. There was no evidence that the masked signal influenced reaction time. In Experiment 3, during the training period, the signal was followed by a distractor instead of the mask. As a result, the distractor prevented the signal from becoming an efficient stimulus similar to the mask in Experiment 2. The data suggest that preattentive (non-conscious) processing is sufficient for a previously learned signal to influence reaction time. On the other hand, focussed attention seems to be a precondition for a stimulus becoming an efficient signal.
Adolescent↗
[Anodontia and hidrotic ectodermal dysplasia, hyporeactive to heat. Effect of acitretin].
We observed an adult female patient presenting an autosomal recessive ectodermal dysplasia difficult to classify among the various reported forms of this disease. She had the major signs of the hidrotic type of the disease (palmo-plantar hyperkeratosis, nail and hair dystrophies, and typical sweat glands) and anodontia as reported in the hypohidrotic form of the syndrome. We evaluated the function of the sweat glands and found them hyporeactive to a heat stimulus. Most of the epithelial alterations have improved under therapy by acitretin.
Acitretin↗
Five years' experience with quadruple sequential immunosuppression.
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Adolescent↗
Intensive care, survival, and expense of treating critically ill cancer patients.
OBJECTIVE: To determine the survival and factors affecting the survival of patients with solid tumors and hematologic cancers who were admitted to the intensive care unit, the time these patients spent at home (meaningful survival) before they died, and the cost per year of life gained and per year of life gained at home. DESIGN: Survival and cost-effectiveness analysis. SETTING: A tertiary-care cancer center at a university medical center. PATIENTS: Every patient admitted to the intensive care unit between July 1, 1988, and June 30, 1990, was entered into the study. This group comprised 83 patients with solid tumors and 64 patients with hematologic cancers. MAIN OUTCOME MEASURES: Factors affecting survival, such as age, sex, malignancy, length of stay in the intensive care unit, and necessity for mechanical ventilator assistance, as well as cost per year of life gained and cost per year of life gained at home. RESULTS: The only factor that significantly affected survival was the requirement for mechanically assisted ventilation for patients with hematologic cancers. More than three fourths of the patients in either group spent less than 3 months at home before dying. The cost per year of life gained for patients with solid tumors was $82,845 and for patients with hematologic cancers was $189,339. The cost per year of life gained at home was $95,142 for patients with solid tumors and $449,544 for patients with hematologic cancers. CONCLUSION: The majority of patients with solid tumors and hematologic cancers admitted to the intensive care unit die before discharge, or, if they survive the hospital admission, they spend a minimal amount of time at home before dying. This limited survival is achieved at considerable cost. Physicians who treat patients with neoplastic disease should discuss potential outcomes and the possibility of withdrawing life-supportive therapy if appropriate with the patient and family, so that a reasonable strategy can be agreed on before the initiation of therapy.
Adult↗
A novel semi-automated paramagnetic microparticle based enzyme immunoassay for hepatitis C virus: its application to serologic testing.
A new rapid serologic enzyme immunoassay for antibodies to hepatitis C virus (HCV) is described. The assay combines synthetic peptide and recombinant antigens representing putative structural and non structural HCV gene products with paramagnetic microparticle assay (MP assay) technology. Assay readout is based upon an enzymatically generated fluorescent product which is quantified with a novel semi-automated washer/reader instrument system. Assay sensitivity and specificity was determined to be greater than the first generation HCV C-100 EIA using a non-A, non-B hepatitis disease panel, an HCV performance panel, an HCV seroconversion panel, dilutions of HCV reactive sera, and random volunteer blood donor specimens.
Evaluation Studies as Topic↗
Evaluation of clinical nurse specialist practice.
Evaluation of the impact of clinical nurse specialist (CNS) practice in today's health care environment is currently one of the most important issues facing these advanced practitioners and nursing administrators. The unique contributions of CNS practice can be demonstrated through use of sophisticated evaluation methods. This paper begins with a discussion of types of evaluation (structure, process, and outcome) that have been utilized in the past and then describes the structure, developmental process, and function of an evaluation instrument recently implemented by a group of CNSs. The evaluation instrument is a step towards the ultimate goal of process-outcome evaluation, the most sophisticated method of evaluating the impact of the CNS. The benefits of utilization of this tool are presented from the perspective of CNSs and nurse administrators.
Employee Performance Appraisal↗