Comprehensive cancer control.
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Biomedical subjects
Publications and source records attributed to S Wasserman.
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A multirelational social network on a set of individuals may be represented as a collection of binary relations. Compound relations constructed from this collection represent various labeled paths linking individuals in the network. Since many models of interest for social networks can be formulated in terms of orderings among these labeled paths, we consider the problem of evaluating an hypothesized set of orderings, termed algebraic constraints. Each constraint takes the form of an hypothesized inclusion relation for a pair of labeled paths. In this paper, we establish conditions under which sets of such constraints may be regarded as partial algebras. We describe the structure of constraint sets and show that each corresponds to a subset of consistent relation bundles between pairs of individuals. We thereby construct measures of fit for a given constraint set. Then, we show how, in combination with the assumption of various conditional uniform multigraph distributions, these measures lead to a flexible approach to the evaluation of fit of an hypothesized constraint set. Several applications are presented and some possible extensions of the approach are briefly discussed. Copyright 2000 Academic Press.
The research described here builds on our previous work by generalizing the univariate models described there to models for multivariate relations. This family, labelled p*, generalizes the Markov random graphs of Frank and Strauss, which were further developed by them and others, building on Besag's ideas on estimation. These models were first used to model random variables embedded in lattices by Ising, and have been quite common in the study of spatial data. Here, they are applied to the statistical analysis of multigraphs, in general, and the analysis of multivariate social networks, in particular. In this paper, we show how to formulate models for multivariate social networks by considering a range of theoretical claims about social structure. We illustrate the models by developing structural models for several multivariate networks.
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In this chapter we review the regulation and execution of the meiotic cell divisions in the context of the developmental program that comprises Drosophila spermatogenesis. Male germ line cells undergoing meiosis are readily identifiable and are of a size and abundance that makes this system well suited for morphological characterizations of cell division. Furthermore, a wide range of molecular genetic techniques are available, facilitating mechanistic investigations. We present an overview of key stages in spermatogenesis and, in particular, meiosis. We consider the pathways controlling entry into the meiotic divisions in the context of established cell cycle regulators as well as newly identified loci required for meiotic entry. We then review the assembly and function of both the meiotic spindle and the contractile ring. We conclude with a consideration of questions and problems that await further investigation.
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Regulation of cell shape is a poorly understood yet central issue in cell biology. Recent experiments indicate that FH proteins link cellular signalling pathways to changes in cell shape. Members of the FH protein family play essential roles in cytokinesis and in driving alterations in cell polarity. This review discusses the structure and function of these proteins and examines the evidence that they interact specifically with Rho GTPases and profilin to organize the actin-based cytoskeleton.
The child welfare system is, for better or worse, an unavoidable associate of the child and adolescent psychiatrist. Although the child psychiatrist rarely plays an integral role in decision making about the children who are involved with the system, the authors point out that a large percentage of children maintained in and involved with the system have psychiatric and developmental disorders. When these children's difficulties are either minimized or unrecognized by child welfare workers, the interventions and treatment that the children receive may be inappropriate. Worse still, when the children's difficulties are improperly addressed, the vicissitudes of the system may further harm them. The authors propose several ways in which the child and adolescent psychiatrist can have an important reparative role and voice in child welfare systems.
PURPOSE: To review post implant morbidity in patients with prior transurethral prostate resection (TURP). METHODS AND MATERIALS: Nineteen patients with stage T1-T2 prostatic carcinoma and prior TURP were treated with I-125 or Pd-103 implantation from 1991 through 1994. Follow-up ranged from 1 to 6 years (median: 3 years). The time from TURP to implantation ranged from 2 months to 15 years (median: 3 years). RESULTS: Only one patient developed mild urinary stress incontinence, 6 months following his I-125 implant. The actuarial freedom from permanent urinary incontinence at 3 years after implantation was 94%. No patient required urethral dilatation for urethral stricture. Eleven patients were sexually potent prior to implantation. At 3 years after treatment, all patients had maintained potency. CONCLUSION: In our experience, there has been remarkably little adverse sequelae following I-125 or Pd-103 implantation in patients with a prior history of TURP.
OBJECTIVE: To determine the prevalence of latex sensitisation among a large group of healthcare workers, study the occupational and non-occupational factors associated with latex allergy, and characterise latex exposure in air and by gloves. METHODS: All 2062 employees of a general hospital in Hamilton, Ontario, Canada who regularly used latex gloves were invited to participate in a cross sectional survey, representing the baseline phase of a prospective cohort morbidity study. Attempts were made to recruit employees who were diagnosed with latex allergy before the survey. Glove extracts were assayed for antigenic protein, and area and personal air samples were obtained on two occasions (summer and winter) to estimate exposure to airborne latex protein. A questionnaire on medical and occupational information was administered by an interviewer. Skin prick tests were performed with latex reagents, three common inhalants, and six foods. RESULTS: The mean (SD) latex protein concentrations were 324 (227) micrograms/g in powdered surgical gloves and 198 (104) micrograms/g in powdered examination gloves. Personal latex aeroallergen concentrations ranged from 5 to 616 ng/m3. There was a total of 1351 (66%) participants. The prevalence of positive latex skin tests was 12.1% (95% confidence interval (95% CI) 10.3% to 13.9%). This prevalence did not vary by sex, age, hospital, or smoking status but subjects who were latex positive were significantly more likely to be atopic (P < 0.01). Participants who were latex positive were also significantly more likely to have positive skin tests to one or more foods (Mantel-Haenszel odds ratio (OR) adjusted for atopy 12.1, 95% CI 7.6 to 19.6, P < 10(-9)). Work related symptoms were more often reported among latex positive people, and included hives (OR 6.3, 95% CI 3.2 to 12.5), eye symptoms (OR 1.9, 95% CI 1.2 to 2.8), and wheezy or whistling chest (OR 4.7, 95% CI 2.8 to 7.9). The prevalence of latex sensitivity was highest among laboratory workers (16.9%), and nurses and physicians (13.3%). When the glove consumption per healthcare worker for each department was grouped into tertiles, the prevalence of latex skin test positivity was greater in the higher tertiles of glove use for sterile (surgical) gloves (P < 0.005) but not for examination gloves. CONCLUSIONS: In this large, cross sectional study of healthcare workers, the prevalence of latex sensitisation was 12.1% (9.5% among all those eligible), and there were significant associations with atopy, positive skin tests to certain foods, work related symptoms, and departmental use of gloves per healthcare worker. This cohort is being followed up prospectively and will be retested to determine the incidence of development of latex sensitivity.
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PURPOSE: To summarize biochemical failure rates and morbidity of external beam irradiation (EBRT) combined with palladium (103Pd) boost for clinically localized high-risk prostate carcinoma. METHODS AND MATERIALS: Seventy-three consecutive patients with stage T2a-T3 prostatic carcinoma were treated from 1991 through 1994. Each patient had at least one of the following risk factors for extracapsular disease extension: Stage T2b or greater (71 patients), Gleason score 7-10 (40 patients), prostate specific antigen (PSA) > 15 (32 patients), or elevated prostatic acid phosphatase (PAP) (17 patients). Patients received 41 Gy EBRT to a limited pelvic field, followed 4 weeks later by a 103Pd boost (prescription dose: 80 Gy). Biochemical failure was defined as a PSA greater than 1.0 ng/ml (normal < 4.0 ng/ml). Patients whose PSA was still decreasing at the last follow-up were censored at that time. Patients whose PSA plateaued at a value greater than 1.0 were scored as failures at the time the PSA first plateaued. RESULTS: The overall, actuarial freedom from biochemical failure at 3 years after treatment was 79%. In Cox proportional hazard multivariate analysis, the strongest predictor of failure was elevated acid phosphatase (p = 0.04), followed by PSA (p = 0.17), Stage (p = 0.23), and Gleason score (p = 0.6). Treatment-related morbidity was usually limited to temporary, RTOG Grade 1-2 urinary symptoms. One patient, who had both a transurethral incision of the prostate (TUIP) and a transurethral resection of the prostate (TURP), developed low-volume urinary incontinence. The actuarial potency rate at 3 years after implantation was 77% for 46 patients who were sexually potent prior to implant. CONCLUSION: Biochemical freedom from failure rates following combined EBRT and 103Pd brachytherapy for clinically localized, high-risk prostate cancer compare favorably with that reported after conventional dose EBRT alone. Morbidity has been acceptable.
BACKGROUND: Monitoring the response to immunotherapy entails understanding exposure to relevant allergens. For the major indoor allergens, this requires sampling of dust from the patient's house. The objectives of this study were to measure indoor allergen levels during a controlled trial of dust mite immunotherapy for asthma and to relate these results to serum antibody levels. METHODS: Eighty-eight asthmatic patients with mite allergy from seven geographic areas in the United States were enrolled in and completed a course of immunotherapy with Dermatophagoides extract or placebo control. Sensitization was evaluated by quantitative measurements of IgG and IgE antibodies. Dust samples were assayed for group I mite (Der p 1 and Der f 1), cat (Fel d 1), and cockroach (Bla g 1) allergens by monoclonal antibody-based ELISA. RESULTS: Over the 4 years of the study, each of the houses had at least one sample that contained more than 2 micrograms of group I mite allergen per gram of dust. Mean mite allergen levels, however, varied over a wide range, from 0.2 microgram/gm or less to more than 50 micrograms/gm. IgE antibodies to mite were present in sera from 78% of the patients, whereas IgE antibodies to cat and cockroach allergens were found in sera from 34% and 11% of patients, respectively. Sixty-four percent of the patients had exposure and sensitization to mite, whereas the comparable figure for each of the other allergens was 5%. CONCLUSIONS: Examination of the results suggested that allergen exposure, relative to a trial of immunotherapy, could be expressed as (1) the maximum level found in the house, (2) the percentage of sites having greater than 2 micrograms/gm, or (3) the mean value at the site with the maximum level. This report provides a background for evaluating the clinical results of immunotherapy in these patients and a model for the way in which sensitization and exposure should be monitored in studies of this kind.
Persons of blood group O are at increased risk of developing cholera gravis. In a randomized, placebo-controlled, double-blind safety-immunogenicity trial of live oral cholera vaccine CVD 103-HgR in 5- to 9-year-old Chilean children, vibriocidal antibody seroconversion (74% overall) did not differ by blood group. However, the reciprocal geometric mean titer (GMT) in blood group O vaccines (GMT = 486) was higher than that in non-O vaccines (GMT = 179) (P < 0.02).
OBJECTIVE: This prospective study evaluated 39 consecutive patients with low back pain (LBP) or neck pain that resulted from a motor vehicle accident who had litigation pending. METHODS: Patients completed a McGill Pain Questionnaire (MPQ) to quantify pain and an Oswestry Low Back Disability Questionnaire (OSW) to quantify function and were interviewed regarding medications and work status at initial and final visits. RESULTS: Thirty-three patients completed an MPQ at initial and final visits. Pain decreased in 29 (88%) and increased in four (12%). Thirty-eight patients completed an OSW at initial and final visits. Function improved in 34 and worsened in four. The authors observed statistically significant improvements in pain, function, and medication use. CONCLUSION: Patients with low back pain or neck pain resulting from a motor vehicle accident showed a statistically significant improvement with treatment despite ongoing litigation.
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Because of its prevalence and severity, Babesia microti infection is an important public health problem. The current treatment of choice is clindamycin plus quinine. However, in some cases other treatments are needed because of drug intolerance or relapse. The activity of azithromycin was investigated for treatment of babesiosis in the hamster model. All animals received vancomycin to prevent antibiotic-associated colitis. Quinine (250 mg/kg/day), azithromycin (150 mg/kg/day), and the combination of azithromycin and quinine were compared. A significant suppression of parasitemia was found in all treatment groups (combination had the greatest effect, followed by azithromycin, then quinine; P < .05). The mean survival was significantly prolonged in the combination group (P < .05). Azithromycin as monotherapy in a higher dose (300 mg/kg/day) also resulted in a significant prolongation of survival (P < .05). Spirogermanium and ciprofloxacin, which have been reported to have antimalarial activity, had no effect on parasitemia or survival in this experimental babesiosis model.
We identified nine new cases of biopsy-confirmed chronic beryllium disease among 505 employees and ex-employees in a company that had manufactured beryllia ceramics from 1958 through 1975. Of tests commonly used in medical surveillance, only a confirmed blood beryllium lymphocyte transformation test had a high positive predictive value for beryllium disease (100%). However, two beryllium disease cases had either a normal or inconsistently abnormal blood test and were identified for diagnostic workup by abnormal chest radiograph. The only risk factor for beryllium disease was beryllium exposure; smoking or allergic history did not affect risk. Degree of beryllium exposure was associated with disease rates, which ranged from 2.9% to 15.8% for beryllia-exposed subgroups. One case of beryllium disease occurred in a "dust-disturber" who did not report past beryllium exposure and who began employment 8 years after commercial beryllia production had stopped. Our data support efforts to prevent beryllium disease by lowering beryllium exposures and to identify subclinical and early disease by broad-based medical surveillance using the blood beryllium lymphocyte test and chest radiograph in beryllium-using industries.