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S T Young

Publications and source records attributed to S T Young.

At least 19 recordsLinked to original sources
PubMed1999

A probability-based multivariate statistical algorithm for autofluorescence spectroscopic identification of oral carcinogenesis.

A probability-based multivariate statistical algorithm combining partial least-squares (PLS) and logistic regression was developed to identify the development stages of oral cancer through analysis of autofluorescence spectra of oral tissues. Tissues were taken from a 7,12-dimethylbenz[a]anthracene-induced hamster buccal pouch carcinogenesis model. Analyses were conducted at various excitation wavelengths, ranging from 280 nm to 400 nm in 20 nm increments, to assess classification performance at different excitations. For each excitation the PLS analysis and logistic regression were combined, on the basis of cross validation, to calculate the posterior probabilities of samples belonging to four stages of cancer development: normal tissues, hyperplasia, dysplasia and early cancers and frankly invasive cancers. Results showed that the 320 nm excitation wavelength optimally classified the cancer development stages: the accuracy rates for identifying samples at that excitation were 91.7%, 83.3%, 66.7% and 83.3% for the four respective stages. The average accuracy rate was 81.3%. These results suggest that the algorithm described in this study might be useful for the detection of human oral cancers.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1997

Safety and efficacy of carvedilol in severe heart failure. The U.S. Carvedilol Heart Failure Study Group.

BACKGROUND: Many patients remain markedly symptomatic despite optimal current therapy for heart failure. Beta-blockers have often been viewed as contraindicated in this group because of their potential adverse short-term effects on cardiac function. METHODS AND RESULTS: One hundred thirty-one patients with severe congestive heart failure were enrolled into a double-blind, placebo-controlled study of the vasodilating beta-blocker carvedilol. All patients had symptomatic, advanced heart failure while on standard triple therapy, as evidenced by a mean ejection fraction of 0.22, marked reduction in distance traveled in a 6-minute corridor walk test, and severe impairment in quality of life measured by the Minnesota Living With Heart Failure Questionnaire. After a 2-week, open-label test of 6.25 mg twice daily carvedilol, 105 patients were randomized (2:1) to receive either carvedilol (up to 25 mg twice daily, n = 70) or matching placebo (n = 35) for 6 months while background therapy with digoxin, diuretics, and an angiotensin-converting enzyme inhibitor remained constant. Ten patients (8%) did not complete the open-label period because of adverse events and 11.4% in both the carvedilol and placebo groups dropped out in the double-blind phase. The study was terminated early by the Data Safety and Monitoring Board and follow-up evaluation was therefore aborted before the projected number of patients and follow-up time was achieved. Quality of life, which was the primary endpoint, improved similarly in the carvedilol and placebo groups, whereas the global assessment by the physicians and the patient exhibited a better response to carvedilol (P < .05). Hospitalization and mortality rate were too low to evaluate a difference, and exercise time and New York Heart Association classification did not change significantly in response to the drug. Left ventricular ejection fraction rose significantly (+0.09) in the carvedilol group compared with the placebo group (+0.02, P = .004). CONCLUSION: The beta-blocker carvedilol can be safely employed in patients with severe heart failure. Improved left ventricular function with a trend for some improvement in symptoms combined with the experience with the drug in the larger population of less severe patients in this multicenter trial suggests that carvedilol may have a favorable long-term effect in heart failure of diverse severity.

Adrenergic beta-Antagonists↗
PubMed1996

Double-blind, placebo-controlled study of the effects of carvedilol in patients with moderate to severe heart failure. The PRECISE Trial. Prospective Randomized Evaluation of Carvedilol on Symptoms and Exercise.

BACKGROUND: Carvedilol has improved the symptomatic status of patients with moderate to severe heart failure in single-center studies, but its clinical effects have not been evaluated in large, multicenter trials. METHODS AND RESULTS: We enrolled 278 patients with moderate to severe heart failure (6-minute walk distance, 150 to 450 m) and a left ventricular ejection fraction < or = 0.35 at 31 centers. After an open-label, run-in period, each patient was randomly assigned (double-blind) to either placebo (n = 145) or carvedilol (n = 133; target dose, 25 to 50 mg BID) for 6 months, while background therapy with digoxin, diuretics, and an ACE inhibitor remained constant. Compared with placebo, patients in the carvedilol group had a greater frequency of symptomatic improvement and lower risk of clinical deterioration, as evaluated by changes in the NYHA functional class (P = .014) or by a global assessment of progress judged either by the patient (P = .002) or by the physician (P < .001). In addition, treatment with carvedilol was associated with a significant increase in ejection fraction (P < .001) and a significant decrease in the combined risk of morbidity and mortality (P = .029). In contrast, carvedilol therapy had little effect on indirect measures of patient benefit, including changes in exercise tolerance or quality-of-life scores. The effects of the drug were similar in patients with ischemic heart disease or idiopathic dilated cardiomyopathy as the cause of heart failure. CONCLUSIONS: These findings indicate that, in addition to its favorable effects on survival, carvedilol produces important clinical benefits in patients with moderate to severe heart failure treated with digoxin, diuretics, and an ACE inhibitor.

Adrenergic beta-Antagonists↗
PubMed1996

Carvedilol inhibits clinical progression in patients with mild symptoms of heart failure. US Carvedilol Heart Failure Study Group.

BACKGROUND: We tested the hypothesis that carvedilol inhibits clinical progression in patients with mildly symptomatic heart failure due to left ventricular (LV) systolic dysfunction. METHODS AND RESULTS: Patients (n = 366) who had mildly symptomatic heart failure with an LV ejection fraction (LVEF) < or = 0.35, had minimal functional impairment (defined as the ability to walk 450 to 550 m on a 6-minute walk test), and were receiving optimal standard therapy, including ACE inhibitors, were randomized double-blind to carvedilol (n = 232) or placebo (n = 134) and followed up for 12 months. The primary end point was clinical progression, defined as death due to heart failure, hospitalization for heart failure, or a sustained increase in heart failure medications. Clinical progression of heart failure occurred in 21% of placebo patients and 11% of carvedilol patients, reflecting a 48% (P = .008) reduction in the primary end point of heart failure progression (relative risk, 0.52; CI, 0.32 to 0.85). This effect of carvedilol was not influenced by sex, age, race, cause of heart failure, or baseline LVEF. Carvedilol also significantly improved several secondary end points, including LVEF, heart failure score, NYHA functional class, and the physician and patient global assessments. Carvedilol reduced all-cause mortality but had no effects on the Minnesota Living With Heart Failure scale, the distance walked in 9 minutes on a self-powered treadmill, or cardiothoracic index. The drug was well tolerated. CONCLUSIONS: Carvedilol, when added to standard therapy, including an ACE inhibitor, reduces clinical progression in patients who are only mildly symptomatic with well-compensated heart failure.

Adolescent↗
PubMed1995

A flexible pressure pump for cardiovascular studies.

Pressure pumps are useful in cardiovascular studies and in the evaluation of many circulatory devices. Currently available pumps are, however, far from perfect in their methods of syncrhonization, flexibility, and frequency response. To overcome these disadvantages, this study reports the design of a new pressure pump based on a linear motor. The pump can accurately synchronize with an animal's heart beats by using a phase-lock loop (PLL) technique. It has great flexibility and the ability to generate both arbitrary pressure waves and pure sinusoidal waves. The pressure pump has a frequency response of up to 50 Hz which is suitable for cardiovascular studies on rats, rabbits, cats and dogs.

Animals↗
PubMed1994

A possible relation between pressure loading and thickened leaflets of the aortic valve: a model simulation.

A much smaller percentage of thickened leaflets of the aortic valve have been found in the right or left coronary leaflet than in the noncoronary leaflet. This study investigated the pressure loading transferring to the leaflets of the aortic valve and their effects on the valvular thickening. A simple ascending aorta model was established, and a simulation was made. The pressure loading in the coronary and noncoronary leaflets then were estimated. The simulation results showed that 5.8% to 17.% percentage of pressure loading to the coronary leaflet may be decreased by the coronary perfusion in diastole. The coronary arteries play an important role on pressures in the sinuses of Valsalva. The smaller pressure loading transferring to the coronary leaflet than that to the noncoronary leaflet is one reasonable explanation related to the thickened leaflets of the aortic valve.

Aorta↗
PubMed1994

CT of the liver in patients with metastatic breast carcinoma treated by chemotherapy: findings simulating cirrhosis.

OBJECTIVE: Although the hepatotoxic effects of systemic chemotherapy are well known, CT findings in the liver after systemic chemotherapy have received little attention in the literature. In some patients with breast carcinoma metastatic to the liver who have received chemotherapy, a morphologic pattern develops similar to that associated with cirrhosis. This pattern is characterized by a lobular hepatic contour, segmental volume loss, and enlargement of the caudate lobe. The purpose of this study was to describe the CT appearance of this pseudocirrhosis and to correlate it with pathologic findings. MATERIALS AND METHODS: We reviewed 65 CT examinations of 22 patients with stage IV breast carcinoma with hepatic metastases, who were receiving systemic chemotherapy and for whom abdominal CT scans showed pseudocirrhosis. Nineteen of 22 patients had follow-up CT scans at intervals ranging from 1 to 15 months. Criteria for the diagnosis of pseudocirrhosis included a lobular hepatic contour, segmental volume loss, and enlargement of the caudate lobe. CT findings were correlated with pathologic findings in seven patients. RESULTS: In all patients, CT scans showed retraction of the capsular surface of the liver (15 diffuse, seven focal) with a lobular margin, a finding also seen in advanced cirrhosis. The retraction occurred at the site of subjacent metastases. Findings evolved over 1-3 months. Six of seven patients had pathologic findings suggestive of nodular regenerative hyperplasia. No patients had pathologic evidence of cirrhosis. CONCLUSION: In patients undergoing systemic chemotherapy for breast cancer metastatic to the liver, a pattern may develop that mimics the CT appearance of hepatic cirrhosis. Pathologic findings suggest nodular regenerative hyperplasia as a possible cause.

Adult↗
PubMed1993

Appearance of oxidized cellulose (Surgicel) on postoperative CT scans: similarity to postoperative abscess.

OBJECTIVE: Oxidized regenerated cellulose (Surgicel), a sterile knitted fabric that causes thrombus formation because of its physical properties, is frequently used for intraoperative hemostasis. Unlike traditional surgical sponges, it is bioabsorbable and can be left in the surgical bed. On CT scans, the appearance of the retained oxidized cellulose can mimic that of an abscess. The purpose of this study was to describe the appearance of oxidized regenerated cellulose on postoperative CT scans so that an erroneous diagnosis of an abscess can be avoided. MATERIALS AND METHODS: We reviewed the CT examinations of five postoperative patients in whom oxidized regenerated cellulose had been used for surgical hemostasis. Operative reports and surgeons confirmed the use of oxidized cellulose. Four CT scans were abdominal examinations, and one was a head examination. RESULTS: In four cases, CT scans showed focal, linear collections of gas within masses with mixed attenuation in or near the operative site. No air-fluid levels were present. In three patients, cultures of specimens obtained by aspiration were negative for pyogenic organisms. CONCLUSION: Retained oxidized cellulose can mimic an abscess on CT scans. Focal collections of air centrally located within a mass should alert the radiologist that oxidized cellulose may have been placed in the operative site, and an appropriate history should be sought.

Abscess↗
PubMed1992

Multiple productivity measurement approaches for management.

Managers may desire an approach to combining multiple productivity measurements into one score. This article demonstrates two approaches to aggregating multiple measurements, data envelope analysis (DEA) and the Multicriteria Performance/Productivity Measurement Technique (MCP/PMT). These methods are applied to actual hospital materials management data and do not result in significantly different results. The productivity analysis must then be tempered according to managerial judgement.

Efficiency↗
PubMed1992

The filter properties of the arterial beds of organs in rats.

The frequency properties of arterial beds in organs were studied by temporarily ligating the renal, the gastric, the splenic or the superior mesenteric arteries of rats. Blood-pressure waves of the tail arteries were recorded before and during the ligations, and were analysed by Fourier's transformation. Their frequency spectra have been found to change profiles following specific patterns with the ligations of different arteries. The results were significant with regard to the frequency selectivities of the organic arterial beds. Such frequency properties can be clearly explained when the circulation system is viewed as an electrical circuit network in which the organic arterial beds work as filters.

Animals↗
PubMed1992

Laparoscopic nephrectomy in a porcine model.

Laparoscopic nephrectomy was performed in 15 male pigs, the procedure was successful in 14. Extraction of the intact kidney through a 5-cm lower abdomen incision was done in 7 animals; complete destruction and evacuation of the kidney was accomplished by a round-knife suction device through a 1-cm port in another 7 pigs. Grossly, the specimen consisted of sausage-like tubular renal tissue and a small amount of tissue debris. Pathology revealed that the glomerular and tubular structures were well preserved, no interstitial hematoma could be found. Four ports were usually used, one 1-cm umbilical camera port, one 0.5-cm port for ureter traction, and two 1-cm working ports along the midclavicular line. All the pigs recovered uneventfully. The average operation time was 3 h 20 min. The application of endo-GIA (United States Surgical Corporation) for renal hilum reduced the operative time to 2 h 20 min. Complications included renal vein tear during endoclip application and cutting in the first case, mild subcutaneous emphysema in 2 cases. This first pig received exploratory laparotomy for the repair and ligation of the renal vein. No more major complications occurred with increasing experience. From this porcine experiment, we conclude that the combination of laparoscopy, a tissue destroyer and an endobag for the entrapment of kidney seem to be a promising technique for clinical nephrectomy.

Animals↗
PubMed1991

Cocaine induces striatal c-fos-immunoreactive proteins via dopaminergic D1 receptors.

The protooncogene c-fos produces a phosphoprotein, Fos, which regulates gene transcription processes. In neuronal systems, Fos has been proposed to couple synaptic transmission to changes in gene expression by acting in the cell nucleus in concert with other proteins to form complexes in the promoter regions of target genes. We report here that the acute administration of a single dose of the indirect-acting dopaminergic agonist cocaine increases multiple Fos proteins in rat caudate nucleus. The increase is dose-dependent and is apparent immunocytochemically at 1 hr, maximal at 2 hr, and absent 48 hr after treatment. The increase seen immunocytochemically is composed of several molecular weight species as assessed by Western blotting of proteins from isolated striatal cell nuclei. Administration of the specific dopaminergic receptor antagonists sulpiride and SCH-23390 prior to cocaine support a significant role for D1 but not for D2 receptors in mediating this effect. These data indicate that D1 dopamine receptors are linked to a cellular immediate-early gene system(s) and suggest an action of cocaine at one or more levels of gene expression via modulation of transcriptional processes in activated cells.

Amino Acid Sequence↗
PubMed1991

[The tracing of brain tissue and 3-D imaging display CT image application: 3-D recursive tracing].

The size and the shape of brain tissue offer lots of information for clinical diagnosis and treatment. The commercial imaging systems, such as x-ray computer tomography (CT) and magnetic resonant image (MRI), always display only two dimensional (2-D) image, which makes quantitative diagnosis of the variation of brain tissue very difficult. Furthermore, some tissue may be connected through little vessels, which is also difficult to identify using discrete 2-D image. In this study, we processed CT image data using an general purpose IBM personal computer. A new three dimensional (3-D) recursive tracing algorithm was proposed. This new algorithm can automatically extract the image of brain tissue in each 2-D image. The information obtained was therefore used to reconstruct 3-D image. This system allows user to observe 3-D size and shape of brain tissue from arbitrary view. Such 3-D image can also be used to calculate the volume of tissue. Using overlay projecting method, it can display skin, bone, brain tissue and gray material at the same time. Such display method accurately shows the relative position of each tissue and offer physicians important information for diagnosis and treatment.

Algorithms↗
PubMed1989

Specific frequency properties of renal and superior mesenteric arterial beds in rats.

In order to investigate the effects of arterial beds on pressure waveforms in arteries, the pressure waves observed in the rat tail artery were resolved into their Fourier moduli before and during ligation of the left renal artery and the superior mesenteric artery. Consistently different patterns of waveform changes in the tail artery were seen on occlusion of these vessels. Ligation of the renal artery reduced, and of the superior mesenteric artery increased, the pressure harmonics over most of the spectra. These results imply that to study the changes in the pressure contours as the observation point is moved downstream, one may have to account separately for the contributions of individual arterial beds. This is relevant in considering the degree to which it is appropriate for data to be amalgamated in models of the systemic arterial bed.

Animals↗
PubMed1989

Materials management in investor-owned, nonprofit government, and other general hospitals.

This article compares investor-owned, nonprofit government, and other general hospitals in Georgia in the areas of materials management practices, systems, and performance. Findings reveal investor-owned hospitals paid less for supplies but did not demonstrate performance in other areas that was superior to that of other types of hospitals.

Analysis of Variance↗
PubMed1988

Transurethral prostatectomy with computer-monitored resectoscope.

Based on the difference in electrical conductivity between hyperplastic prostatic tissue and tissue of the surgical capsule, we have developed a monitoring computer that distinguishes the former from the latter. The computer sounds an alarm when the cutting loop of the resectoscope touches the capsule, followed by an automatic cut-off of the power source 0.4 s later; thus inadvertent perforation of the surgical capsule can be avoided in most cases. The function of the computer has been tested in 73 patients with benign prostatic hyperplasia. The results show that, with Nesbit's technique of transurethral resection, tiny perforations of the surgical capsule, usually 1 to 2 mm in diameter, occurred in all 30 patients operated on without computer monitoring, but only 3 of 73 computer-monitored patients had such an occurrence. There was a slight increase in the weight of resected prostatic tissue among the computer-monitored patients, but the difference between the time spent on the procedure between the two groups of patients was not significant. Apart from its monitoring function, the computer may reduce eye strain and mental stress in the surgeon, especially when resecting a large hyperplastic prostate.

Aged↗