The teaching of death certification.
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Cause of Death↗
Biomedical subjects
S A Kelly
Publications and source records attributed to S A Kelly.
Mucosa-associated gastric lymphoma occurring in an HIV-antibody-positive patient.
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Gastric Mucosa↗
Enhancement of metastatic potential by gamma-interferon.
Preincubation of murine colon 26 colon adenocarcinoma cells with gamma-interferon (IFN-gamma), but not alpha-interferon, produced a significant increase in experimental pulmonary metastases in syngeneic BALB/c and T-cell-deficient BALB/c nude mice. The enhancement was seen after as little as 1 h of exposure to 1 unit/ml of IFN-gamma and persisted for at least 72 h following removal of the cytokine. IFN-gamma exerted its effects by increasing the pulmonary retention of cells during the first 6 h following tumor cell injection. During this period all cells visualized in the lung were trapped in pulmonary capillaries. The enhancement was not due to modulations in class I major histocompatibility complex surface antigen expression; nor was it due to alterations in cell size, adhesion to components of the extracellular matrix in vitro, heterotypic or homotypic adhesion, sensitivity to lysis by activated peritoneal macrophages, osmotic fragility, enhancement of surface class II major histocompatibility complex antigen expression, or enhancement of intercellular adhesion molecule-1 (ICAM-1). Colon 26 was completely resistant to natural killer cell-mediated lysis in vitro, and IFN-gamma did not modulate the ability of colon 26 to form conjugates with isolated splenocytes. In vivo elimination of anti-asialo GM1 + cells increased pulmonary metastasis, and in such mice, there was no longer a difference in metastatic potential between control and IFN-gamma-treated cells. We conclude that low doses of IFN-gamma generated at the site of the tumor by host-infiltrating cells or during cytokine therapy could enhance the survival of tumor cells in the circulation and enhance their metastatic potential.
Adenocarcinoma↗
c-Ki-ras gene mutations in dysplasia and carcinomas complicating ulcerative colitis.
One hundred and nine samples comprising carcinomas, adenomas, dysplastic, inflamed and normal mucosa from patients with sporadic colon cancer and ulcerative colitis (UC) were analysed for c-Ki-ras mutations. DNA was extracted from archival paraffin-embedded material, amplified using the polymerase chain reaction (PCR) and the PCR products analysed using restriction enzyme digestion. Forty-two per cent (14/33) of the sporadic carcinoma controls contained Ki-ras codon 12 mutations in contrast to 24% (8/33) of ulcerative colitis carcinomas. A significantly higher c-Ki-ras mutation rate was observed in rectal carcinomas (72%) in comparison to colonic carcinomas (28%) in control patients (P less than 0.04), while the opposite was observed in UC patients. The difference between the incidence of c-Ki-ras mutations in rectal carcinomas in UC (9%) and in sporadic rectal carcinomas (72%) was also significant (P less than 0.01). This lower prevalence rate and different site distribution of c-Ki-ras mutations in UC carcinomas compared to sporadic carcinomas suggests that specific genetic differences may underlie the causation of carcinomas arising in these situations.
Codon↗
Unilateral enlargement of the parotid gland in a patient with sialosis and contralateral parotid aplasia.
A case of unilateral aplasia of the parotid gland with sialosis of the contralateral parotid is described, together with a review of the literature. Aplasia and sialosis are both rare conditions of the major salivary glands and do not appear to have been reported previously as occurring together.
Adult↗
Normative contrast sensitivity data for young children.
Contrast sensitivity (CS) was measured in children ages 3 to 7 years using the Vistech Contrast Sensitivity distance chart (VCTS 6500). The purpose of the study was to determine how effectively the technique could be used with young children and to establish normative data for this age group. Of 286 children participating in a vision screening, the contrast sensitivity function (CSF) was measurable on 241 (84%) under binocular conditions and 229 (80%) under both binocular and monocular conditions. The 219 binocular CSF's and 208 monocular CSF's obtained from visually normal children were used to establish normative data and then compared to similar data from 50 visually normal young adults. The results indicated that there is an effect of age between 3 and 7 years, children are significantly less sensitive than adults, and adult-like levels of CS are not yet reached at 7 years of age. In addition, although the children's mean contrast thresholds fell within the norms provided with the VCTS 6500, the variability in the children's CSF's precludes using the Vistech data for diagnostic purposes in the young. The normative data are presented to assist the clinician in evaluating CS in young children when using the VCTS 6500.
Adult↗
Computer assisted selection and assessment of antibodies in the diagnosis of lymphomas.
With increasing numbers of reagents the problem of selecting appropriate antibodies to solve problems in the diagnosis of lymphoma is becoming more complex. One approach is to use a computer program to optimise the selection process. Such a program was devised, incorporating data from an extensive literature search. When presented with a differential diagnosis it selects the most appropriate antibody panel and when given the results evaluates the relative likelihood of each possible diagnosis. In a retrospective study 81% of the tests used had been non-discriminatory, but using the results of the remaining 19% of the tests, the computer was able to select the "correct" diagnosis with a high degree of certainty. The development and use of this system illustrated several problems in the application of computer assisted diagnostic techniques in histopathology. These problems include incomplete data and lack of understanding of the process of histopathological diagnosis.
Algorithms↗
Effect of yellow-tinted lenses on brightness.
Magnitude estimates of brightness were obtained for small (5-deg diameter) and large (15 deg X 20 deg) targets viewed through yellow-tinted lenses (ytl's) and luminance-matched neutral lenses. The results indicate that brightness perception with ytl's is up to 40% greater than that with neutral lenses when the spatial extent of the stimulus exceeds the fovea. The onset of the enhancement effect is coincident with the chromatic threshold, and its end point is coincident with psychophysical estimates of rod saturation. In a second experiment, brightness estimates were obtained for the ytl's and neutral lenses during the cone plateau of the dark adaptation curve when rods, but not cones, were desensitized by bleach. The brightness-enhancement effect was negligible. These results confirm the subjective impression that brightness perception is enhanced by ytl's and indicate that this effect is mediated, in large part, by the contribution of rod signals to the chromatic pathway.
Adult↗
Establishing smoking cessation programs in dental offices.
Cigarette smoking is the leading cause of preventable death and disease in the United States. Because dental personnel treat millions of patients who are cigarette smokers, they have a unique opportunity to help persons quit the smoking habit. Effectively designed, office-based programs should involve all or most dental team members and contain the following components: a procedure that identifies smokers and records changes in their smoking status, a personal evaluation of each smoker's motivation to quit, an assessment of the degree of nicotine dependence experienced by potential quitters, the prescription of nicotine polacrilex therapy for appropriate candidates, personalized counseling commensurate with each patient's level of quitting readiness and, an effective system that ensures consistent patient follow-up and support.
Behavior Therapy↗
The use of simultaneous radiotherapy and 5-flurouracil in patients with inoperable squamous cell lung cancer.
Over a 2-year period, 17 patients with histologically proven squamous cell carcinoma of the bronchus, assessed as inoperable or incurable on surgical or medical grounds, were treated with palliative radiotherapy and a concurrent 120-h infusion of 5-flurouracil, at a dosage of 1 g/day. The treatment was found to be well tolerated with no major toxicity. The degree of palliation and survival obtained was found to be no different to that of a historical matched control group, treated with radiotherapy alone, with median survival in the two groups of 35 weeks and 42 weeks respectively (log rank test P greater than 0.69). We conclude that although a non-toxic treatment regime, no benefit was obtained by the addition of 5-flurouracil to palliative radiotherapy.
Aged↗
The relevance of animal tumour models to the preclinical screening of cytokines.
This article assesses the value of animal models in determining the mechanism of action and spectrum of activity of cytokines. It examines the merits of animal models of transplantable and metastatic tumours and the value of human xenografts grown in immunodeficient mice and discusses how well they compare with the human situation. Results from the use of five cytokines in animal models of cancer are presented.
Animals↗
Calcium alginate as a temporary recipient bed dressing prior to the delayed application of split skin grafts.
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Alginates↗
Retrieving information on the neurophysiology of speech.
A search for literature on the relationship between the autonomic nervous system and speech was performed via the DIALOG Information Service on four databases: BIOSIS Previews, EMBASE, MEDLINE, and PsycINFO. A doctoral candidate in the Department of Audiology and Speech Sciences at Purdue University reviewed the citations retrieved for relevancy. Then, the coverage of the relevant literature by the four databases was analyzed. MEDLINE yielded the greatest number of relevant citations followed by EMBASE, BIOSIS, and PsycINFO. The four databases showed little overlap in coverage of citations or journal titles. This study indicates that it would be advantageous to search all four databases for the speech scientist.
Evaluation Studies as Topic↗
Effect of repeated testing on contrast sensitivity.
The effect of repeated testing on contrast sensitivity was examined across days and between eyes with the Nicolet CS-2000 Vision Tester. Monocular contrast sensitivity functions (CSF's) were measured with the standard technique for training days 1 to 5 on a group of 20 subjects. The group was then divided into four groups of five subjects each. A single post-training CSF was obtained for each group 1, 3, 5, or 7 days after the cessation of training. Results show that there is no measurable effect of practice on contrast sensitivity over a 5-day training period, nor is there any decrease in performance in the absence of training. CSF's were also obtained on both eyes of a separate group of subjects. We found no transfer of learning either between eyes within a single session or across multiple training sessions. We conclude that although the absence of a significant practice effect has important clinical advantages, the variability of the technique is high, allowing only robust experimental effects to be detected.
Adult↗
Background size and saturation of the rod system.
To determine the effect of background size on saturation of the human rod system, we measured threshold-vs-intensity (tvi) functions for a 24'-diameter, middle-wavelength test stimulus against long-wavelength background fields that were either 2 degrees or 8 degrees in diameter. When thresholds were measured against a series of background intensities presented during a single experimental session (a standard tvi procedure), rod increment thresholds were higher against the smaller background and eventually disappeared above cone increment thresholds at moderate background intensities. This result suggests that background diameter does influence rod system saturation. However, when adaptation to the smaller background was limited to a 5 min exposure to a single background intensity per experimental session, then thresholds against that background were rod- rather than cone-mediated and were comparable to rod thresholds against an 8 degrees background. Therefore, under these stimulus conditions, background size apparently does not influence rod system saturation unless adaptation to the smaller background is prolonged. Based on previous studies, we suggest that the rod-desensitizing effect of small backgrounds under conditions of prolonged adaptation is due to a post-retinal mechanism.
Adaptation, Ocular↗
Radiation pneumonitis in patients treated for breast cancer.
An analysis of 201 breast cancer patients having post-operative radiotherapy to the chest wall between January 1981 and May 1983 has identified those patients with chest symptoms following radiotherapy and these have been critically assessed with regard to the possibility of radiation pneumonitis being their cause. The inner contour of the anterior chest wall has been reconstructed on the radiation plan and the area of lung irradiated to a significant level in the mid-plane of the tangential fields determined. The incidence and severity of pneumonitis has been shown to rise exponentially with increase in the irradiated volume. A method of measuring the thickness of the chest wall using the simulator has been devised so that this information may be incorporated into the planning process in order to reduce the area of lung at risk.
Breast Neoplasms↗
The identification of antigenic determinants by a coupled inhibition-agar diffusion method.
The determination of the chemical nature of immunodeterminant groups of carbohydrate antigens has been achieved by a micro method coupling inhibition and double diffusion in agar. This method has been tested with antigens which react with anti-lactose, anti-galactose, anti-N-acetyl-glucosamine and antirhamnose antibodies. The analysis can be performed with as little as 10 micrograms of inhibitor, 0.2 microgram of antigen and 10 micrograms of antibody. The procedure has also been used for the identification of the determinant groups of 2 antigens with a phosphoglycan structure. The determinants of these antigens have been found to be N-acetyl-beta-glucosamine 1-phosphate and beta-glucose 1-phosphate. The glycosyl 1-phosphate units are novel types of antigenic determinants and antigens with such determinants should be useful for investigating the interactions of antigens with homologous antibodies. The specificity of monoclonal antibodies directed at an O-antigen has been determined by use of the coupled method.
Agar↗
The influence of cones on rod saturation with flashed backgrounds.
The increment threshold for a middle-wavelength test flash was measured at the onset of a concentric long-wavelength background flash under conditions that have previously been shown to result in rod system saturation. The influence of the cone system on rod saturation under these conditions was assessed using the Stiles-Crawford effect in normal subjects and by measuring rod thresholds in protanopes, who are deficient in long-wavelength cones. When the background flash is made less effective for cones through the Stiles-Crawford effect, the onset of rod saturation occurs at a higher luminance of background flash than normal. Similarly, protanopes do not show the characteristics of rod saturation until a much higher-than-normal luminance of background flash. The results suggest that rod system saturation with flashed backgrounds is strongly influenced by cones.
Adaptation, Ocular↗