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At least 721 records · Page 40Linked to original sources
PubMed1996

Radiation therapy for T1,2 glottic carcinoma: impact of overall treatment time on local control.

PURPOSE: Local control probabilities of T1,2 glottic laryngeal cancer were evaluated in relation to dose and fractionation of radiation therapy (RT). MATERIALS AND METHODS: Between 1975 and 1993, 96 T1N0M0 glottic cancers and 32 T2N0M0 glottic cancers were treated with definitive RT. Total RT dose was 60-66 Gy/2 Gy for most of the T1 and T2 tumors, although 10 T2 tumors were treated with hyperfractionation (72-74.4 Gy/1.2 Gy bid). Of the 128 patients, 90 T1 glottic tumors and 30 T2 glottic tumors were followed for > 2 years after treatment. Multivariate analyses using the Cox proportional hazards model and a logistic regression analysis were performed to evaluate the significance of prognostic variables on local control. RESULTS: The 5-year local control probability for T1 tumors was 85%, whereas that for T2 tumors was 71%. Multivariate analyses demonstrated that only overall treatment time (OTT) was a significant variable for local control. Total RT dose, normalized total doses at a fraction size of 2 Gy, and fraction size were not significant. Local control probability of T1 tumors with an OTT of 42-49 days was significantly higher than that of tumors with an OTT of > 49 days (P < 0.02). Only a 1-week interruption of RT, due to holidays, significantly reduced the 5-year local control probability of T1 glottic tumors from 89 to 74% (P < 0.05). CONCLUSIONS: These results indicate that OTT is a significant prognostic factor for local control of T1 glottic tumors.

Adult↗
PubMedDate not supplied

A quantitative method for the assessment of overall effects from a number of similar electrophysiological studies: description and application to event-related potentials in Parkinson's disease.

Eight comparisons of auditory event-related potentials in idiopathic parkinsonism with matched controls were analysed using meta-analytic methods. Overall, there was clear evidence that P2, N2, and P3 peak latencies are delayed in patients. Effect sizes for the difference between patient and control latencies of N2, and to a lesser extent P3, were greater in studies with more cognitively impaired patients. High frequency high pass filter settings were significantly associated with shorter mean P3 latencies in controls, but not patients, so that greater effect sizes tended to be associated with higher high pass cut-off frequencies. These results support the argument for using quantitative methods for the review of clinical psychophysiological studies.

Electroencephalography↗
PubMed1991

Overall survival of breast cancer patients in relation to preclinically determined total serum cholesterol, body mass index, height and cigarette smoking: a population-based study.

Mean overall 5-year survival related to preclinically determined total serum cholesterol, body mass index (BMI), height and cigarette smoking has been analysed among 242 incident cases of breast cancer aged 36-63 years that developed in a population of 24,329 Norwegian women during a mean follow-up of 12 years (range 11-14). The study factors were ascertained at least 1 year prior to diagnosis (mean = 8 years), and the cases have been followed up with respect to death for a mean time of approximately 5 years after diagnosis. Patients whose preclinical total serum cholesterol values were within the highest quartile (greater than or equal to 7.52 mmol/l, mean = 8.58 mmol/l) of the underlying population had a hazard ratio of dying of 2.0 (95% confidence limits, 1.1 and 3.7) compared to cases with cholesterol values in the lowest quartile (mean = 5.28 mmol/l), after adjustment for age at diagnosis, clinical stage, and body mass index. In relation to BMI (Quetelet's index: weight/height2) patients who were obese prior to diagnosis were at higher risk of dying than those who were lean. Compared to patients in the lowest quartile of BMI (mean Quetelet = 21), the hazard ratio was 2.1 (95% confidence limits, 1.2 and 3.8) for patients in the highest quartile (mean Quetelet = 30), after adjustment for age at diagnosis, clinical stage, and total serum cholesterol. For height and for cigarette smoking, no relation with survival was observed. A potential problem of this study might be insufficient information about other well known prognostic factors, but the results suggest that preclinical total serum cholesterol and BMI are positively associated with the risk of dying among women who develop breast cancer.

Adult↗
PubMed1988

Meta-analysis of satisfaction with medical care: description of research domain and analysis of overall satisfaction levels.

Consumer satisfaction with medical care was examined in a meta-analysis of 221 studies. For each study, (1) a coding form was filled out that described sample characteristics, design, and instrument methodology, and (2) the study sample's overall satisfaction level was transformed to a 0.00-1.00 scale. This article summarizes the study attributes as compiled from the coding form, presents grand satisfaction means over all studies, and tests for differences in satisfaction between studies that employed different methods of research.

Community Health Services↗
PubMed1990

Some links between successful implementation of primary health care interventions and the overall utilization of health services.

All societies have need of a sick care system into which the general population has easy access. Such a system is required for the coherent organization of any health care service which is to be effective. Virtually all people want curative care when ill, but generally are less interested in preventive activities. It follows that a sick care service should be as widely available as it is hoped will be a preventive one. An effective sick service provides the basis of sufficiently regular contact with the bulk of the population so as to allow for the successful fulfillment of preventive health care goals. A shift is required from conventional input planning methods--more doctors, more health centers, etc.--to output planning; that is, actual utilization by the population of the services offered. The concern here is with the overall contact rate between the health service and the entire (relevant) population and not just the rate for any one particular health care program. Planning for additional inputs should be based on the expected outputs (contacts) which are expected to flow from those inputs. An average, well distributed annual utilization level of three to four contacts per capita should provide an adequate basis for fulfillment of preventive (and curative) goals in the health sector.

Developing Countries↗
PubMed1975

Induction of UDPglucose dehydrogenase during development, organ culture, and exposure to phenobarbital. Its relation to levels of UDPglucuronic acid and overall glucuronidation in chicken and mouse.

Liver UDPglucose in early chick-enbryo has, by the 19th day of incubation, reached levels existing in young hatched (White Leghorn) chicks. In developing ASH/TO mouse liver, the dehydrogenase is low, but increases sharply at late foetal and weaning stages; adult activity is greater in females than males. The UDPglucuronic acid content of embryo liver from at least 12 days resembles that of adult chicken; in mouse liver it rises over birth and infancy. These differences in relative rates of development of enzyme and nucleotide in the 2 species can explain why overall glucuronidation by liver appears in chick rapidly after hatching, but in mouse only gradually during infancy. UDPglucose dehydrogenase increases in embryo liver, probably by induction, 2-3-fold during culture with phenobarbital and some 5-fold when exposed to the drug in ovo. Phenobarbital treatment also increases the enzyme in late foetal and adult mice, abolishing the sex difference. Differences between induction of UDPglucose dehydrogenase and UDPglucuronyl transferase during development, culture and phenobarbital treatment indicate that control mechanism for these two enzymes are not directly linked.

Alcohol Oxidoreductases↗
PubMed1990

Heat conduction microcalorimetry of overall metabolism in rabbit alveolar macrophages in monolayers and in suspensions.

A technique has been developed for studying the overall metabolism in small numbers of cells in monolayers and in suspensions by measuring the heat exchange rate with a thermopile heat-conduction microcalorimeter. The system was tested with alveolar macrophages from rabbits, and heat flux-time curves could be monitored from numbers of cells as low as 0.05 . 10(6). The metabolic activity was found to be unchanged or to decrease very slowly over a period of 20 h. In a conventional cell medium, without the addition of serum, a mean heat flux value of 19.4 (S.D. 3.2) pW. cell-1 (37 degrees C, pH = 7.4) was obtained for alveolar macrophages in monolayers. The corresponding value for cells in the same medium, with the addition of 20% homologous rabbit serum, was 27.0 (S.D. 2.0). We suggest that this calorimetric method can be used as a short-term cytotoxic test for measuring potentially toxic agents in our environment; this test can involve alveolar macrophages of either animal or human origin. In such an assay, the cells should be used in monolayers, and suspensions should be avoided. We found that when alveolar macrophages were used in suspension, the metabolic activity, measured as heat flux, was dependent on cell concentration, even at values as low as 0.2. 10(6) cells per ml.

Animals↗
PubMed1983

Overall distribution of vasoactive intestinal polypeptide-containing nerves on the wall of cerebral arteries: an immunohistochemical study using whole-mounts.

The overall distribution of vasoactive intestinal polypeptide (VIP)-like immunoreactivity on the wall of the cerebral arteries, including its 3-dimensional profile, was investigated by means of the indirect immunofluorescence method using flat-mounts. VIP-immunoreactive fibers run spirally on the wall of the cerebral arteries. On the wall of the large arteries, such as the vertebral artery, basilar artery, internal carotid artery, within and/or without the circle of Willis, posterior and anterior communicating arteries, proximal parts of anterior, mid and posterior cerebral arteries, these fibers are richly distributed and show a dense grid-like appearance. The highest density was identified on the wall of the anterior cerebral artery, internal carotid artery and anterior communicating artery, while the lowest density was on the posterior communicating artery. On the other hand, on the walls of the branches of these arteries or along distal parts of the anterior, mid and posterior cerebral arteries, the number of VIP-immunoreactive fibers decreased markedly.

Animals↗
PubMed1989

A comparison of the empirical utility of three composite measures of adolescent overall drug involvement.

Researchers have relied on a number of measurement techniques to construct a summated index of drug involvement to reflect both the qualitative and quantitative dimensions of adolescent drug-using behavior. The purpose of this study was to examine the adequacy of three strategies for constructing a composite measure--stage-of-drug-use, unweighted sum of frequencies of use of different substances, and a weighted composite index of substance use. Data for this study were derived from two independent samples of adolescents. The three drug-use measures were assessed both as predictors of consequences of drug use and as outcome measures explained by familial, intrapersonal and interpersonal factors. The weighted composite index of substance use, though conceptually and methodologically superior to the simple (unweighted) sum of frequency, did not perform any better as a predictor or as an outcome variable than the unweighted measure. The weighted composite index of drug involvement is somewhat complicated to calculate and requires substantial resources. The decision whether to use a weighted composite index or a simple sum of frequencies measure of overall drug involvement should be based on both scientific and practical considerations.

Adolescent↗
PubMed1982

Influence of overall treatment time in a fractionated total lymphoid irradiation as an immunosuppressive therapy in allogeneic bone marrow transplantation in mice.

Three groups of C57/BL/Ka mice received total lymphoid irradiation (TLI) in a total dose of 34 Gy in three different fractionation schedules. In the first group daily fractions of 2 Gy were given during 3 1/2 weeks. In the second group 4 to 5 fractions with 3 1/2 hr interval were given each day, thus delivering 17 fractions in 4 days. In the third group three fractions were given daily for two consecutive days and was repeated two times after 8 or 9 days interval, resulting in a total treatment time of 3 1/2 weeks. The tolerance of all different schedules was excellent. No difference in the peripheral white blood cell and lymphocyte counts nor the degree of immunosuppression as measured by phytohaemaglutinin or concanavalin A induced blastogenesis and mixed lymphocyte reaction were observed at the end of the treatment and up to 200 days. When bone marrow transplantation was performed one day after the end of each schedule, chimerism without signs of graft versus host disease was induced in all the groups. However, from the results in a limited number of animals it seems that concentrated schedules were less effective for chimerism induction. It has been demonstrated that it is possible to reduce drastically the overall treatment time for TLI before bone marrow transplantation. Further investigations are necessary in order to determine the optimal time-dose-fractionation factors and the different parameters involved in the transplantation.

Animals↗
PubMed1990

Squamous cell carcinoma of the supraglottic larynx without clinically detectable lymph node metastases: problem of local relapse and influence of overall treatment time.

From January 1965 until December 1979, 203 patients with squamous cell carcinoma of the supraglottic larynx were treated with curative intent. The mean follow-up time was 10 years. The policy was to try to aim for cure by radiation therapy (RT) only, reserving surgery (S) for radiation therapy failures. For 193 patients the treatment consisted of a first series of radiation therapy to a total dose of 40 Gy; if a good response to radiation therapy was obtained, the treatment was continued to a full course of 60-70 Gy (RT-I, n = 132). Patients with tumors considered to have responded poorly to the first series of radiation therapy but who refused surgery or were found medically unfit for operation, were also carried to a full dose of 60-70 Gy (RT-II, n = 33). Surgery was performed in 33 cases; 23 patients had a laryngectomy because of a poor response to radiation therapy and 10 were treated with surgery upfront because of severe respiratory distress. This paper focuses on the local control and survival in the defined treatment groups. In summary, with advancing T-stage a lower survival and higher local relapse rate was found; that is, a 5-year relapse-free survival (RFS) of 53% and corrected survival (CS) of 83% for T2 tumors vs 39% (RFS) and 52% (CS) for T4 tumors. Age more than 60 was associated with a 2.2 times higher risk of dying due to laryngeal cancer. A lower relapse-free survival (T3,4: 43% vs 61%) but a comparable corrected survival (T3,4: 64% vs 69%) for RT-I patients compared to the surgery treated patients was found, due to salvage of the radiation therapy failures. Although the relapse-free survival of RT-I and RT-II was similar (43% vs 38%), the corrected survival for the RT-II patients was worse (44% vs 69%). No influence of dose (Gy) per se on the local relapse rate was observed; however, a positive association between local relapse rate with overall treatment time was found. Death from intercurrent disease was almost twice as high as might have been expected for the normal Dutch population. More than half of the patients who died of intercurrent disease developed a second primary tumor.

Adult↗
PubMed1992

The impact of converting to a biphasic blood-culture system on the overall cost and the incidence of pseudobacteremia.

After converting from a conventional broth (CB) system to a biphasic (BP) agar-slide blood-culture system (Septi-Chek), our laboratory noted an increase in positive blood cultures in general, and in coagulase-negative staphylococci (CNS) in particular. To investigate these findings, we compared all blood cultures collected over a 21-month period using CB and then BP systems, totaling 28,199 blood cultures. The frequency of positive blood cultures increased from 9.2% to 12.7% (p less than 0.0001), whereas CNS isolation increased from 2.6% to 5.2% (p less than 0.0001). There was no significant change in the incidence of true primary or secondary bacteremia due to CNS (p = 0.9). The isolation of other pathogens, including Staphylococcus aureus, Candida albicans, Bacteroides species, and Gram-negative bacilli increased from 6.5% to 7.1% (p less than 0.05). We estimated the cost of processing 28,000 blood cultures by both CB and BP systems, using positivity rates of 9.2% and 12.7%, respectively, and standards provided by the College of American Pathologists (CAP, 1991) for workload hours of technologist time. We calculated a higher overall cost for the BP system. However, the use of this system eliminated the use of needles and syringes for subculture of bottles showing no growth, thus decreasing the risk of technologist exposure to body fluids. Despite the increased cost and more frequent occurrence of pseudobacteremia, the enhanced sensitivity and increased safety of the BP system justified its use in the prompt identification of patients with true bacteremia.

Bacteremia↗
PubMed1992

Functional status as an overall measure of health in adults with cystic fibrosis: further validation of a generic health measure.

We studied the validity of a generic health measure in a population with a chronic, life-shortening illness. Thirty-seven adults with cystic fibrosis (CF) and 46 of their healthy peers completed a questionnaire which included 12 questions on functional status from the RAND Health Insurance Study. For the CF group, the questionnaire and a medical chart review yielded data on 7 additional health variables, including pulmonary function. After data collection, members of the CF group were followed for 5 years, by which time 11 had died. The functional status of the CF group was significantly lower than that of the comparison group. Within the CF group, functional status correlated significantly with 6 of the 7 other health variables. Analysis using the Cox proportional hazards model showed that functional status alone was a significant (p less than 0.001) predictor of a CF subject's survival time; in a multivariate model a non-significant trend suggested that lowered functional status may be associated with an increased risk of early death even after adjustment for pulmonary function and percent ideal body weight. These results extend previous findings and suggest that functional status can be used as an overall measure of health in a wide variety of studies.

Activities of Daily Living↗
PubMed1994

Prognostic value in predicting overall survival of two mucinous markers: CA 15-3 and CA 125 in breast cancer patients at first relapse of disease.

The role of circulating tumour markers in providing prognostic information has been scarcely studied. We evaluated the prognostic significance of two mucinous markers: CA 15-3 and CA 125 in 115 breast cancer patients at first recurrence of disease. At diagnosis of advanced disease bone involvement was found in 64 patients, lung in 57, skin lymph nodes in 21, liver in 20, and brain in 5. Patients were recruited and treated in the same institution with conventional chemo- or endocrine therapy. The follow-up ranged from 3 to 54+ months (median 35). Serum samples were drawn at first recurrence of disease before the start of any endocrine and/or chemotherapy. Patients with CA 15-3 < 30 U/ml survived significantly longer than those with CA 15-3 > 30 U/ml (median 50+ versus 26 months, P < 0.02). Similarly, overall survival of patients with CA 125 < 35 U/ml was significantly higher in comparison with patients with CA 125 > 35 U/ml (median 34.5 versus 18.5 months, P < 0.001). CA 125, but not CA 15-3, maintained its prognostic value in the subgroup of patients with visceral metastases. Both markers were found to be independent prognostic variables in multivariate analysis according to Cox's model. CA 15-3 and CA 125 appeared to be powerful prognostic indicators, in addition to visceral metastases, in patients with advanced breast cancer.

Adult↗
PubMed2006

Prospective epidemiologic evidence of a "protective" effect of smoking on metabolic syndrome and diabetes among Turkish women--without associated overall health benefit.

UNLABELLED: Sex-specific effects of cigarette smoking on the development of metabolic syndrome (MS) and diabetes (DM), concomitant with its clinical impact on CHD, were prospectively evaluated in a cohort of 3385 participants (mean age 48 years), representative of Turks. Heavy smoking denoted smoking 11 or more cigarettes daily. During a mean 5.9-year follow-up, 485 incident cases of MS and 216 of DM were diagnosed. Among women, baseline characteristics as a whole were similar. Smoking status was inversely associated with waist circumference (p=0.004) and predicted in women hyperinsulinemia (p=0.045) after adjustment for age and body mass index. In the prediction of MS, heavy smoking was significantly "protective" (RR 0.50 [95% CI 0.26; 0.94]) in women and in both genders combined, after adjustment for age, baseline family income bracket and physical activity grade. As predictor of new DM, heavy smoking was significantly "protective" (RR 0.54 [95% CI 0.35; 0.83]) in all adults and in women (RR 0.13 [95% CI 0.02; 0.97]), after similar adjustment. Additional adjustment for insulin and CRP levels hardly modified in women the RRs, though attenuated to borderline significance risk for MS and DM due to smaller sample size. Risks of incident CHD and overall mortality were significantly elevated in smoking men, but not in women, when adjusted for age, serum total cholesterol, elevated BP, DM and physical activity grade. CONCLUSIONS: Heavy cigarette smoking is "protective" of future MS and DM in Turkish women, mainly via protection from obesity. A separate modest effect on central obesity appeared independent of plasma insulin concentrations. Evidence of a translated beneficial effect on subsequent CHD or all-cause mortality did not emerge.

Adult↗
PubMed2006

Environmental enrichment increases responding to contextual cues but decreases overall conditioned fear in the rat.

This study aimed at investigating the effects of environmental enrichment on various aspects of contextual processing in adult female rats. In experiment 1, simple conditioning was studied using either a training procedure allowing overshadowing of the contextual cues by signalling footshock with a discrete tone or a training procedure allowing a reduction of this overshadowing by explicitly unpairing the footshock and the tone. In experiment 2, contextual discrimination and contextual occasion-setting were assessed. Rats were daily exposed to two different contexts. In one context, a footshock was delivered 30s after the offset of a tone, whereas in the other context the same tone was presented alone. Experiment 3 examined familiarization to a new context. Experiment 1 showed that environmental enrichment reduced the overshadowing of contextual cues by the tone and also reduced freezing to the more predictive cue according to the training procedure used. Experiment 2 showed that environmental enrichment increased the ability of rats to discriminate two contexts. Experiment 3 showed that enriched rats familiarized faster to a new context than standard rats. Taken together, these results suggest that environmental enrichment in adult rats enhances learning about contextual cues and reduces overall fear associated with aversive events.

Acoustic Stimulation↗
PubMed2004

Influence of interphase layer on the overall elasto-plastic behaviors of HA/PEEK biocomposite.

A three-dimensional finite element unit cell model has been designed and constructed for studying mechanical properties of hydroxyapatite (HA) reinforced polyetheretherketone (PEEK) biocomposite. The model consists of an elastic-brittle HA spherical particle, an elasto-plastic matrix and an interphase layer between the particle and the matrix. The interphase layers with four different kinds of material behaviors have been taken into consideration to examine their effects on the overall properties of the composite. The damage evolution in the matrix and the interphase layer, and the interface failure, were also taken into account. Some other factors, such as mesh sensitivity, loading velocity and mass scale scheme, were also discussed in this investigation. A general-purpose finite element software package, ABAQUS, incorporated with a user-defined material subroutine, was used to perform the analysis. The predicted results were compared with the experimental data obtained from existing literatures. The results predicted by using the cell model with consideration of the matrix degradation and the effects of the damage and failure on the interphase layer are in good agreement with the experimental ones. Hence, the suitability of our proposed cell model incorporated with an appropriate type of the interphase layer for modeling the mechanical properties of the particulate biocomposite could be verified.

Benzophenones↗
PubMed2004

Crystallization kinetics of homopolymers: overall crystallization: a review.

This paper is a brief review of the overall crystallization kinetics of synthetic homopolymers. The basic experimental results are presented and compared with theory that is currently available. It is found, surprisingly, that the more sophisticated theories do no better in explaining experimental results than does the free-growth approximation. This is contrary to what is observed for the crystallization of low molecular weight substances. The reason can be attributed to entanglements and other topological defects that are present in the pure melt and are relegated to the non-crystalline regions as crystallization progresses. This results in a more protracted crystallization than is predicted and is yet to be included in theory.

Crystallization↗