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Biomedical subjects

R L Anderson

Publications and source records attributed to R L Anderson.

At least 91 records · Page 5Linked to original sources
PubMed1995

Reports of the childhood home environment in early-onset dysthymia and episodic major depression.

This study addressed 2 questions: (a) is early-onset dysthymia associated with reports of a disturbed childhood home environment; and (b) can adverse early experiences account, at least in part, for the differing clinical presentations of dysthymia and major depression? Participants included 97 outpatients with early-onset dysthymia, 45 outpatients with episodic major depression, and 45 normal controls. The early home environment was assessed blind to diagnosis using both interview and self-report measures. Early-onset dysthymia patients reported significantly more physical and sexual abuse and poorer relationships with both parents than normal controls. In addition, patients with dysthymia reported having received significantly poorer parenting than those with episodic major depression. The results could not be accounted for by mood state effects, comorbidity with borderline and antisocial personality disorder, or comorbid major depression.

Adolescent↗
PubMed1995

Compositional changes in trypsin inhibitors, phytic acid, saponins and isoflavones related to soybean processing.

Soybeans are high in protein but also contain a number of minor constituents traditionally considered to be antinutritional factors. These include trypsin inhibitors, phytic acid, saponins and isoflavones. These compounds are now thought to have beneficial biological effects in the diet, such as lowering blood cholesterol or preventing cancer. Soybean processing changes the content of these minor constituents in various ways. This review discusses the changes in content of trypsin inhibitors, phytic acid, saponins and isoflavones as soybeans are processed into the conventional protein ingredients, flours, concentrates and isolates, as well as some of the traditional Oriental soybean foods.

Food Handling↗
PubMed1995

Blepharospasm and related facial movement disorders.

The variable clinical features and the relatively good response of blepharospasm to botulinum-toxin type A are now well established. The etiology and pathophysiology of blepharospasm and related facial movement disorders are still poorly understood. Genetic and histopathologic studies over the last year have contributed to our understanding of this disease. The most significant progress has been made in the electromyographic studies of the the levator palpebrae and orbicularis oculi muscles. Subclassification based on the electromyographic abnormalities of these two muscles have begun to improve our understanding of the variable responses to botulinum-toxin type A. Further electromyographic studies may help identify the best sites of injection for optimal response and differentiate patients requiring limited or complete myectomy. The development of the limited myectomy has provided excellent functional and cosmetic results with quick recovery times in selected patients.

Blepharospasm↗
PubMed1995

In vivo growth of a murine lymphoma cell line alters regulation of expression of HSP72.

We have identified a murine B-cell lymphoma cell line, CH1, that has a much-diminished capacity to express increased levels of heat shock proteins in response to heat stress in vitro. In particular, these cells cannot synthesize the inducible 72-kDa heat shock protein (HSP72) which is normally expressed at high levels in stressed cells. We show here that CH1 fails to transcribe HSP72 mRNA after heat shock, even though the heat shock transcription factor, HSF, is activated correctly. After heat shock, HSF from CH1 is found in the nucleus and is phosphorylated, trimerized, and capable of binding the heat shock element. We propose that additional signals which CH1 cells are unable to transduce are normally required to activate hsp72 transcription in vitro. Surprisingly, we have found that when the CH1 cells are heated in situ in a mouse, they show normal expression of HSP72 mRNA and protein. Therefore, CH1 cells have a functional hsp72 gene which can be transcribed and translated when the cells are in an appropriate environment. A diffusible factor present in ascites fluid is capable of restoring normal HSP72 induction in CH1 cells. We conclude that as-yet-undefined factors are required for regulation of the hsp72 gene or, alternatively, that heat shock in vivo causes activation of hsp70 through a novel pathway which the defect in CH1 has exposed and which is distinct from that operating in vitro. This unique system offers an opportunity to study a physiologically relevant pathway of heat shock induction and to biochemically define effectors involved in the mammalian stress response.

Animals↗
PubMed1995

Periventricular venous collagenosis: association with leukoaraiosis.

PURPOSE: To investigate the association between an age-related degenerative disease of subependymal veins and leukoaraiosis. MATERIALS AND METHODS: Brains obtained at autopsy from 22 patients (average age, 73.2 years; range, 25-95 years) were examined with magnetic resonance (MR) imaging and neuropathologic methods with alkaline phosphatase microvascular staining. The degrees of leukoaraiosis shown on MR images and of deep venous occlusion were scored independently and results compared with logistic regression analysis. RESULTS: Noninflammatory collagenous thickening of venous walls resulting in severe periventricular venous stenosis was found in 13 (65%) of 20 patients over 60 years old. Advanced leukoaraiosis was found in 10 (77%) of these 13 patients. Greater venous disease was associated with more severe leukoaraiosis. CONCLUSION: Periventricular venous collagenosis, a commonly observed and previously ignored degenerative disease of elderly humans, is strongly associated with leukoaraiosis. Stenosis or occlusion of deep cerebral veins may promote development of leukoaraiosis.

Adult↗
PubMed1995

DSM-III-R axis II comorbidity in dysthymia and major depression.

OBJECTIVE: Dysthymia is generally believed to be associated with a high rate of DSM-III-R axis II comorbidity. However, it is unclear whether this rate is higher than that for other axis I disorders, how many dysthymic patients have personality disorders, and what the most common co-occurring axis II conditions are. METHOD: Ninety-seven outpatients with early-on-set dysthymia and 45 with episodic major depression were administered structured diagnostic interviews for axis I and II disorders. In addition, knowledgeable informants were independently interviewed about axis II conditions in the patients. RESULTS: A significantly greater proportion of dysthymic patients (60%) than patients with episodic major depression (18%) met criteria for a personality disorder. The most common axis II conditions among dysthymic patients were borderline, histrionic, and avoidant personality disorder. Informants' reports yielded similar results. CONCLUSIONS: These data indicate that early-onset dysthymia is associated with significantly greater axis II comorbidity than episodic major depression. Further work is necessary to elucidate the processes underlying this association.

Adult↗
PubMed1995

Bcl-2 and thermotolerance cooperate in cell survival.

Apoptosis is a normal physiological process of cell death that can also be experimentally induced by a variety of cytotoxic stimuli. The protein product of the oncogene bcl-2 is an effective inhibitor of apoptosis in mammalian cells, including that caused by exposure to heat. Transient heat resistance can be induced by prior exposure of cells to mild heat treatment. This thermotolerant state is believed to be mediated by an increase in the steady-state concentration of one or several heat shock proteins. Using both morphological and long-term end points, i.e., the appearance of apoptotic cells as assessed by nuclear morphology and clonogenic cell survival, we show that bcl-2 expression confers on thermotolerant cells an even greater resistance to heat-induced cell death. bcl-2 expression does not alter either the steady-state or heat-induced expression of heat shock proteins in cells, nor is bcl-2 itself a stress-inducible protein. The results suggest bcl-2 and the thermotolerant state act via independent mechanisms to inhibit apoptosis and provide evidence that two separate pathways can collaborate to promote cell survival.

Animals↗
PubMed1995

Short-term efficacy of oral dimercaptosuccinic acid in children with low to moderate lead intoxication.

OBJECTIVE: To determine the short-term efficacy of meso-2,3-dimercaptosuccinic acid (DMSA) in mild to moderately lead poisoned children. METHODS: Medical records of all pediatric patients receiving 19 days of DMSA between June 1991 and May 1993 were reviewed retrospectively. Patients were included if their pretreatment blood lead concentration (BPb) was 1.21 to 2.36 mumol/L (25 to 49 micrograms/dL) and excluded if they: received DMSA through participation in a pharmaceutical company-sponsored drug study; underwent chelation therapy in the previous 28 days; or received another chelating agent concomitantly with DMSA; or if noncompliance was documented. Homes were inspected and abated of major hazards before chelation therapy. BPb and blood zinc protoporphyrin concentration (ZnP) were obtained at baseline. DMSA was administered in a dose approximating 10 mg/kg per dose every 8 hours for 5 days, followed by 10 mg/kg per dose every 12 hours for 14 days. Baseline laboratory studies were repeated weekly while the patients were receiving therapy and for 2 weeks after therapy, then monthly unless chelated again. RESULTS: Of the 46 children who were treated with DMSA, 18 were excluded from the analysis. In the remaining 28 children, the mean +/- SD pretreatment BPb and ZnP were 1.79 +/- 0.33 mumol/L (37 +/- 6.9 micrograms/dL) and 1.26 +/- 0.64 mumol/L (71 +/- 36.1 micrograms/dL), respectively. The percent reduction (mean +/- SD) in BPb compared with baseline was -43% +/- 20.8%, -26% +/- 16.9%, and -31% +/- 20.2% on mean days 18, 30, and 80, respectively, whereas the changes in ZnP were -12% +/- 21.7%, -20% +/- 18.1%, and -31% +/- 21.9%, respectively. Eighty percent of patients had 20% or more reduction in their pretreatment BPb and/or ZnP after completion of DMSA therapy (95% confidence interval, 61, 92%). No significant adverse effects were observed except for neutropenia (absolute neutrophil count of 0.752 x 10(9)/L) in one patient. CONCLUSION: Our findings support the short-term efficacy of DMSA in children with BPb of 2.36 mumol/L (49 micrograms/dL) or less.

Administration, Oral↗
PubMed1995

Family study of early-onset dysthymia. Mood and personality disorders in relatives of outpatients with dysthymia and episodic major depression and normal controls.

BACKGROUND: The nosological status of dysthymia has generated considerable controversy. The major issues include whether dysthymia should be classified as a form of mood or personality disorder and, if dysthymia is classified as a mood disorder, whether it is sufficiently distinct from major depression to warrant a separate category. METHODS: We conducted a family study of 97 outpatients with early-onset dysthymia, 45 outpatients with episodic major depression, and 45 normal controls, and their 882 first-degree relatives. Axis I and II disorders were assessed in relatives using direct and informant interviews and all available medical records. RESULTS: The rate of major depression in the relatives of early-onset dysthymic probands was significantly greater than in the relatives of normal controls and non-significantly greater than in the relatives of episodic major depressive probands. The rate of dysthymia was significantly greater in the relatives of dysthymic probands than in relatives of both major depressive probands and normal controls. Rates of most personality disorders were increased in the relatives of the dysthymic and major depressive probands compared with relatives of normal controls. In addition, the relatives of dysthymic probands had significantly higher rates of any personality disorder and any cluster B disorder than those of episodic major depressive probands, although these differences disappeared after controlling for Axis II comorbidity in the probands. Finally, dysthymic probands with and without a lifetime history of major depression did not differ on rates of psychiatric disorders in relatives. CONCLUSIONS: There is a strong familial relationship between dysthymia and major depression. However, dysthymia is also somewhat distinct in that it aggregates specifically in the families of patients with dysthymia. Finally, dysthymia and episodic major depression both appear to have a familial association with the personality disorders, although the link appears to be somewhat stronger for dysthymia.

Adolescent↗
PubMed1994

A critical review of the new oral cephalosporins. Considerations and place in therapy.

Oral cephalosporins are key antimicrobials in the family physician's therapeutic armamentarium. The list of available agents within this class has been recently expanded to include cefixime, cefprozil, cefpodoxime proxetil, and loracarbef. Each of these antibiotics has differing antimicrobial coverage patterns and approved therapeutic uses. Compared with older, more established antimicrobials such as penicillin, amoxicillin, cefaclor, a combination of amoxicillin and clavulanate potassium, and erythromycin, the newer cephalosporins offer little, if any, therapeutic advantage. Clinical efficacy has been shown to be equal in virtually all studies comparing the newer cephalosporins with traditional agents for various community-acquired infections. While the four newer agents may be given less often, they are relatively expensive. In light of the available clinical data, the newer oral cephalosporins should be reserved as second- or third-line choices.

Administration, Oral↗
PubMed1994

Epidemic gram-negative bacteremia in a neonatal intensive care unit in Guatemala.

BACKGROUND: Nosocomial bloodstream infection is an important cause of morbidity and mortality among neonates. From September 1 through December 5, 1990 (epidemic period), gram-negative bacteremia developed in 26 neonates after their admission to the neonatal intensive care unit (NICU) of Hospital General, a 1000-bed public teaching hospital in Guatemala with a 16-bed NICU. Twenty-three of the 26 patients (88%) died. METHODS: To determine risk factors for and modes of transmission of gram-negative bacteremia in the NICU, we conducted a cohort study of NICU patients who had at least one blood culture drawn at least 24 hours after admission to the NICU and performed a microbiologic investigation in the NICU. RESULTS: The rate of gram-negative bacteremia was significantly higher among patients born at Hospital General, delivered by cesarian section, and exposed to selected intravenous medications and invasive procedures in the NICU during the 3 days before the referent blood culture was obtained. During the epidemic period, the hospital's chlorinated well-water system malfunctioned; chlorine levels were undetectable and tap water samples contained elevated microbial levels, including total and fecal coliform bacteria. Serratia marcescens was identified in 81% of case-patient blood cultures (13/16) available for testing and from 57% of NICU personnel handwashings (4/7). Most S. marcescens blood isolates were serotype O3:H12 (46%) or O14:H12 (31%) and were resistant to ampicillin (100%) and gentamicin (77%), the antimicrobials used routinely in the NICU. CONCLUSIONS: We hypothesize that gram-negative bacteremia occurred after invasive procedures were performed on neonates whose skin became colonized through bathing or from hands of NICU personnel.

Bacteremia↗
PubMed1994

Expectant management of preterm premature rupture of the membranes.

OBJECTIVES: Our purpose was to (1) evaluate expectant management of preterm premature rupture of the membranes between 20 and < 36 weeks' gestation and (2) compare outcomes in service and private populations. STUDY DESIGN: The study included only singleton pregnancies prospectively managed between 20 and < 36 weeks' gestation with proved preterm premature rupture of the membranes. None of the patients received prophylactic antibiotics, tocolytics, or steroids, and none of the neonates received surfactant or had lethal anomalies. Patients (n = 511) were divided into private (n = 194) and staff (n = 317) categories, but all were managed identically. RESULTS: Approximately 50% of patients were delivered within 48 hours. Infection is more likely with preterm premature rupture of membranes before 28 weeks' gestation (p = 0.001), as is fetal death associated with infection (p < 0.001). Other findings in this study were (1) no significant differences in evaluated outcomes between private and staff patients, except that significantly more vaginal deliveries occurred in staff patients, (2) a prolongation of pregnancy > or = 7 days in 12.9% of patients, (3) a significant increase in the rate of maternal infection if preterm rupture of membranes occurred before 28 weeks' gestation, (4) a significant increase in fetal and neonatal deaths if preterm premature rupture of membranes occurred before 28 weeks, and (5) an increased probability of survival whose rate of increase is dependent on the gestational age at which preterm premature rupture of membranes occurred. For babies weighing < 1500 gm at birth compared with controls, babies delivered of mothers not having preterm premature rupture of membranes, 1-year follow-up revealed (1) a significantly lower incidence of pulmonary interstitial emphysema and cerebral palsy in the study group delivered before 28 weeks' gestation, (2) a significantly lower incidence in bronchopulmonary dysplasia in the study group delivered after 28 weeks' gestation, and (3) no significant differences in the incidence of intraventricular hemorrhage, pneumothorax, or Bayley Mental Developmental Index < 68 between those delivered before or after 28 weeks' gestation. CONCLUSION: Over 47.8% of the patients continued their pregnancy beyond 48 hours, and in 12.9% of cases expectant management of preterm premature rupture of membranes prolonged the pregnancy by > or = 7 days. The maternal infection rate is greater before 28 weeks' gestation and is associated with higher fetal-neonatal mortality. Status has little impact on outcome. Expectant management is not detrimental to quality of survival. Survival probability increases at a more rapid rate with preterm premature rupture of membranes after 22 weeks of gestation.

Adult↗
PubMed1994

Aquatic safety of Lagenidium giganteum: effects on freshwater fish and invertebrates.

Eleven freshwater species were exposed to a zoosporeproducing fungus, Lagenidium giganteum, with the goal of determining species sensitivity with standard and new test procedures. The tests included standard, 4-day acute exposures of cladocerans (Ceriodaphnia dubia, Daphnia pulex, and D. magna) and the fathead minnow (Pimephales promelas). Standard 7-day chronic exposures of C. dubia and a 7-day embryo-larval exposure of P. promelas were also conducted. New, 4-day acute, methods were developed for mosquitos (Aedes aegypti), chironomids (Chironomus sp.), oligochaetes (Lumbriculus sp.), cyclopoid copepods, snails (Physa sp.), hydrozoans (Hydra sp.), and ostracods. To assess L. giganteum zoospore (z) infectivity, each test included daily bioassays with the mosquito (A. aegypti), a target organism. Four-day A. aegypti LC50s ranged from 81 to 516 z/ml. Ceriodaphnia dubia acute test LC50s were as low as 6700 z/ml and the 96-hr LC50 from the chronic test was near 6250 z/ml with reproductive impairment at 12,500 z/ml. Daphnia sp. were also susceptible, with LC50s near 7700 z/ml for D. pulex and 9400 z/ml for D. magna. Chironomus tentans was infected at concentrations of > or = 5000 z/ml, but mortality was low and an LC50 could not be calculated even after exposures to 50,000 z/ml. The 7-day, early life stage test with P. promelas produced reduced larva growth in most treatments. Several species (Hydra sp., L. variegatus, ostracoda, copepoda, Physa sp., and P. promelas) were not affected in acute tests at exposures of 50,000 z/ml. The data show, contrary to many reports, that L. giganteum may affect some nontarget aquatic species. The key to successful laboratory tests is monitoring and maintaining the zoospores infection capacity.

Aedes↗
PubMed1994

Irradiated homologous aorta in eyelid reconstruction. Part 1: Technique and animal research.

Reconstruction of full thickness eyelid defects requires the correction of posterior lamella (tarsus, conjunctiva) and anterior lamella (skin, muscle). Various tarsal substitutes--conchal and nasal cartilage, banked sclera, hard palate, irradiated homologous tarsal plates, periosteum, temporalis fascia, and composite grafts from the opposite eyelid--have been used for posterior lamellar replacement over the years. Eyelid-sharing procedures and full thickness flaps have also been described. At times, because of extensive tissue loss, the eyelid reconstruction can be particularly challenging because of the shortage of tissue. We describe a new posterior lamellar technique using irradiated homologous aorta. The experimental surgical procedure in rabbits, the clinical response, and the histological fate of the donor aorta are described in Part 1 followed by our experience with four patients in Part 2.

Animals↗
PubMed1994

Primary adenoid cystic carcinoma of the lacrimal sac: report of a case.

A 41-year-old white woman presented with a 1-month history of epiphora and a painless medial canthal mass on the left that was unresponsive to antibiotic treatment. Computerized tomography (CT) and magnetic resonance imaging (MRI) scans delineated a soft tissue mass with bony destruction originating in the area of the left lacrimal sac with extension into the maxillary and ethmoid sinuses and inferomedial orbit. Open biopsy of the mass revealed adenoid cystic carcinoma (ACC). On surgical exploration, the tumor was found to originate from the lacrimal sac wall. Radical surgery with wide excision of surrounding bone and periorbital tissue was performed in light of the histological diagnosis and tumor extension. Orbital exenteration was not performed in order to preserve the patient's left eye. A 6-week course of adjunctive radiotherapy was applied without complication. The patient was clinically and radiologically free of tumor at 1-year follow-up. This case represents only the third time that primary ACC arising from the lacrimal sac has been reported.

Adult↗
PubMed1994

Irradiated homologous aorta in eyelid reconstruction. Part II. Human data.

Reconstruction of posterior lamellar eyelid defects requires a tissue substitute that is either identical to the tissue lost (i.e., surrounding or nearby tarsus) or donor tissue that serves the same supportive role. With extensive lid defects, at times an alternative tissue to tarsus may be required. Irradiated homologous aorta is available as a posterior lamellar substitute. It provides a structural framework for the surrounding lid tissues to grow on and is incorporated into the normal eyelid anatomy. It is available to the reconstructive ophthalmic surgeons as an alternative donor tissue in the presence of extensive lid defects.

Adenocarcinoma↗