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PubMed1986

The decline in occupational sex segregation during the 1970s: census and CPS comparisons.

An assessment of changes in occupational sex segregation during the 1970s, as measured by the Census and Current Population Survey, is complicated by the recent reclassification of occupations. Once this is taken into account, it is apparent from both the Census and the CPS that there was a decline in occupational sex segregation in the 1970s and that the decline was probably more substantial than in the 1960s.

Demography↗

PubMed1985

[Malignant change of duodenal adenoma--a case report and review of the literature].

A 69-year-old woman with a large crater-forming carcinoma of the duodenal bulbus which was associated with a prominent tumor of tubulovillous adenoma in immediate proximity is reported. Histologically, an adenoma-carcinoma sequence was strongly suggested. A review of the literature from both Japan and other countries, after reclassification of histologic patterns, suggested that tubulovillous adenoma in the duodenum may be predominant as compared with that of the colon.

Adenoma↗

PubMed1985

[Prediction of pulmonary hypertension from simple, noninvasive parameters using discriminant analysis].

Based on a large number of males with chronic obstructive bronchitis, the usefulness of discriminant analysis for prediction of pulmonary hypertension has been investigated. Two groups were formed: 227 men with overt pulmonary hypertension; 145 patients without pulmonary hypertension Applying the discriminant analysis, 9 variables were selected step by step; 6 out of them were measurably contributing to the discrimination of both groups. As relevant turned out diameter of the right descending pulmonary artery, FVC% predicted, FEV1% FVC, pa2, systolic blood pressure, and RV% TLC. In a procedure of reclassification, based upon the calculated discriminant functions, 82,6% of the cases were correctly classified (sensitivity 80,6%, specificity 86,2%). A pocket calculator programme following the method by Läuter gave identical results. The application of the discriminant function to a new group of 147 unselected men with chronic obstructive bronchitis corroborated the foregoing results. 79,1% of all patients with overt or latent pulmonary hyper-tension were detected. For overt hypertension the sensitivity was 88,4%, for latent hypertension 62,5%. Using this method, decision-making regarding heart catheterism can be improved. It must be stressed, however, that this discriminant function is not valid for women and for other diagnosis groups in males.

Bronchitis↗

PubMed1985

[Therapy of testicular tumors in childhood].

Between 1954 and 1984 41 primary testicular tumours were treated in 40 children at the age of 0 to 9 years as well as 9 secondary testicular tumours in malignant systemic diseases or metastases. The histological reclassification of the number of cases revealed 15 yolk-sac-tumours, 10 differentiated teratomas of immature subtype, 1 intermediary malignant teratoma, 3 undifferentiated malignant teratomas, 2 Sertoli-cell-tumours (1 double-sided) and 5 rhabdomyosarcomas. 2 children each with undifferentiated malignant teratomas and rhabdomyosarcomas died, all before 1970. 5 children with yolk-sac-tumours and 2 with rhabdomyosarcomas who since 1974 have been treated with Ablatio testis and combination chemotherapy live without tumour. Histological classification and division into stages are proved and form the basis of a therapy conception which in all testicular tumours apart from the Ablatio testis contains the chemotherapy of different intensity (HTK-84), taking into consideration form of tumour, stage and age of the children. The retroperitoneal lymphadenectomy is recommended only in the proof of metastases.

Adolescent↗

PubMed1967

Heritable disorders of mucopolysaccharide metabolism.

The heritable diseases of mucopolysaccharide metabolism have undergone reclassification during the past several years as a result of advances in knowledge. Recognition of clinical, genetic and biochemical differences has made it possible to delineate six types of mucopolysaccharidosis. All types are characterized by excessive excretion of one or more acid mucopolysaccharides in the urine. The underlying defect is not known at present, but recent investigations have suggested possible defects in protein binding and increased biosynthesis and storage of the various mucopolysaccharides. Treatment of these disorders has been unrewarding, although administration of corticosteroids may be of some benefit.Several diagnostic tests are now available for the determination of excessive urinary acid mucopolysaccharide excretion.

Carbohydrate Metabolism, Inborn Errors↗

PubMedDate not supplied

Corneal arcus and hyperlipoproteinaemia.

A corneal arcus is a lipid deposition mainly consisting of cholesterol and phospholipid. Its prevalence varies in different populations and races, increases with age and is greater in the male. Earlier studies related the presence and severity of a corneal arcus to plasma lipid levels and linked it with certain familial hyperlipidaemias. The recent reclassification of such disorders in terms of hyperlipoproteinaemia now links the premature occurrence of an arcus with familial Type II and III hyperlipoproteinaemia. Other rare plasma lipid disorders in which corneal opacities occur are Tangier Disease and lecithin:cholesterol acyl transferase deficiency.

Adult↗

PubMed1979

Using financial ratio analysis to compare hospitals' performance.

Financial ratio analysis allows a hospital to evaluate its own performance over time and to compare itself with other hospitals. Through reclassification procedures, potential distortions are reduced, and administrative decisions can be based on more reliable rations. Step 1 reclassifies financial statements for analysis, step 2 computes and explains ratios, and step 3 combines ratios into patterns for interpretations. Step 4 describes the 209-hospital sample, step 5 compares three individual hospitals' ratios to industry ratios, and step 6 discusses behavior of two hospitals' ratios and industry ratios over time.

Accounting↗

PubMed1984

Opioid drugs and their receptors. A summary of the present state of knowledge.

New developments in the field of opioid pharmacology have necessitated the reclassification of drugs formerly lumped together as 'narcotic analgesics'. Various developments pertaining to the characterization of opioid receptors, endogenous 'opioid ligands' and the subclassification of opioid receptors are reviewed. At the moment no entirely satisfactory classification of opioid analgesics appears to be possible; however, these drugs can be divided into 'agonist' and 'agonist-antagonist' analgesics on the basis of their interactions with mu-, kappa- and sigma-receptors. Individual agonist and agonist-antagonist analgesics vary in their analgesic potencies. However, by selecting the correct dosage analgesic effects approximately equivalent to those of 10 mg morphine can be achieved with most of these drugs. The agonist analgesics produce morphine-like 'drug-seeking behaviour' and have a high potential for abuse; the agonist-antagonist analgesics generally have a lower potential for abuse. The agonist-antagonist analgesics are not a homogeneous group; some of these compounds produce psychotomimetic and adverse haemodynamic effects, this probably being due to interaction with sigma-receptors. Nalbuphine, an agonist-antagonist analgesic devoid of 'sigma effects', appears to be an interesting new drug in the development of opioid analgesics with more selective actions.

Analgesics, Opioid↗

PubMed1980

[Beta-2-microglobulin and rheumatoid factor levels in the synovial fluid (author's transl)].

The object of this study was to determine whether levels of beta-2-microglobulin and of rheumatoid factor measured by an enzyme-immunoassay allowed good discrimination between inflammatory and degenerative arthropathies. A multiparametric study of synovial fluid was performed on 85 specimens from patients with rheumatoid arthritis, chondrocalcinosis, mechanical arthritis and traumatic arthopathies. A beta-2-microglobulin level of less than 4 mg/l is a result very mich in favor of a non-inflammatory arthropathy (48/49 cases). The quantification of intra-articular rheumatoid factor allows for reclassification in the context of sero-negative rheumatoid arthritis.

Arthritis, Rheumatoid↗

PubMed1983

[Necessity for and construction of cytological data banks].

Analytical and quantitative cytology is based upon photometric and morphometric measurements of single cells in stained cytological specimens. It analyzes the features of single cells and cell populations with respect to their cytodiagnostic relevance. One way to do this is the establishment of learning sets of visually selected cells, and the intercomparison of unknown cells with these data sets. Difficulties arise with the visual classification of single cells from PAP-stained gynecological smears and the pooling into classes due to the considerable photometric variation from specimen to specimen. It is demonstrated, that neither for a cancer prescreening apparatus nor an interactive diagnostic machine, highly differentiated learning sets can be dispensed with. The build-up of the TUDAB learning sets and results of single cell classification, visual reclassification, as well as population analysis and specimen classification are shown.

Cell Physiological Phenomena↗

PubMed1983

[Clinical use of a minicomputer in the evaluation of chemico-clinical parameters in the diagnosis of hepato-biliary-pancreatic diseases of surgical significance. 3 methods compared].

Bayes theorem; multivariance analysis, and the discriminating function of Mahalanobis applied to sixteen laboratory examinations employed in the diagnosis of diseases of the extrahepatic bile ducts and pancreas gave the following results: 1) the weight of each test was first measured in general terms, and then with regard to different levels of differentiation, with a classification in decreasing order in each case; 2) little redundancy was noted, and few examinations were of relatively negligible importance; furthermore, combinations of several tests did not lead to positive results; 3) reclassification according to the formula of Bayes and by means of the discriminating function proved sound supports for clinical decision, since they provided 70% and 80% of exact classification respectively; 4) the importance of the minicomputer in the construction of experimental diagnostic models was substantiated.

Biliary Tract Diseases↗

PubMed1983

Biotypes of Staphylococcus epidermidis and Micrococcus organisms, isolated from intramammary infections, reclassified into species of the genus Staphylococcus (epidermidis, hyicus, xylosus, and sciuri).

In a previous report (5), strains of Staphylococcus epidermidis and Micrococcus isolated from bovine intramammary infections were classified by the Baird-Parker (B-P) system and by serologic typing of the proteolytic enzymes. Since then, newer methods for distinguishing the genera Staphylococcus and Micrococcus and for defining new species have been reported. By utilizing these methods, the organisms from the original study were reclassified as follows: S. epidermidis B-P subgroup II, proteinase group F strains as S. epidermidis; S. epidermidis B-P subgroup III, proteinase group B strains as Staphylococcus hyicus subsp. chromogenes (pigmented) or subsp. hyicus (nonpigmented) and proteinase groups H and BH strains that were coagulase positive and nonpigmented as subsp. hyicus; B-P Micrococcus subgroup 6, proteinase group NR strains as Staphylococcus xylosus and subgroup 6, proteinase group G strains as Staphylococcus sciuri and S. xylosus. The reclassification of the strains increased the percentage of intramammary infections attributed to staphylococci from 62%, as first reported, to at least 86%.

Animals↗

PubMed1983

Anti-hepatitis B core immunoglobulin M in the serologic evaluation of hepatitis B virus infection and simultaneous infection with type B, delta agent, and non-A, non-B viruses.

The clinical value of an enzyme-linked immunosorbent assay for the detection of immunoglobulin M (IgM) antibody to hepatitis B core antigen (anti-HBc IgM) was evaluated by testing serum samples from the following groups of patients: (a) 27 individuals who had been diagnosed as having acute hepatitis B virus (HBV) infection, (b) 29 hepatitis B surface antigen (HBsAg) carriers, (c) 6 subjects with acute non-B hepatitis, and (d) 10 HBsAg-negative but anti-HBc-positive subjects who were suspected of being index cases for the intimate transmission of HBV. Whereas 24 of the 27 individuals with presumed acute HBV infection exhibited anti-HBc IgM, only 2 of 29 HBsAg carriers were found to be positive. Hepatitis B surface antigen persisted during an 8-mo observation period in 3 anti-HBc IgM-negative subjects with acute HBsAg-positive hepatitis. Before anti-HBc IgM testing, it was considered that these cases had evolved to the HBsAg carrier state. However, the regular demonstration of anti-HBc IgM in acute type B hepatitis, as well as the failure to detect this antibody in the majority of HBsAg carriers, led to reclassification of these cases as probable instances of acute non-A, non-B or delta-agent hepatitis superimposed on the HBsAg carrier state. Through additional testing, the diagnosis of non-A, non-B (NANB) infection was confirmed in 2 of these cases, and delta-agent infection was identified in the third. None of the non-B hepatitis cases exhibited anti-HBc IgM. However, 5 of the 10 suspected type B index cases were anti-HBc IgM-positive, indicating that they were very recently infected and most likely had infected their cohabiting sexual partners. The results from this study indicate that testing for anti-HBc IgM may improve serodiagnostic accuracy when acute NANB and delta-agent hepatitis occur in previously unrecognized HBsAg carriers. Moreover, it may be a useful test in defining potential high risk sources of exposure to HBV.

Antibodies, Viral↗

PubMed1984

Anesthesia-induced myocardial depression: quantitation of effects on systolic and diastolic function.

The effect of general anesthesia induced with halothane and nitrous oxide on left ventricular (LV) contractility and diastolic mechanics was directly assessed in the chronically instrumented canine model. Seven dogs were instrumented with ultrasonic dimension transducers to measure LV diameter and micromanometers to measure LV transmural pressure. Contractility was assessed by the slope (EES) of the end-systolic pressure-diameter relationship PES = EES (LES - LD). Diastolic compliance was assessed by fitting end-diastolic pressure-dimension data to the exponential P = alpha (e beta epsilon L-1), where alpha and beta are nonlinear elastic coefficients. A new index (ID20) that identifies the dose of anesthetic necessary to depress the inotropic state by 20% was calculated to be 0.63% for halothane. Contractility was progressively decreased by halothane, with EES falling from 10.1 +/- 0.6 at control to 6.7 +/- 0.4 at 1% halothane and to 4.2 +/- 0.5 at 2% halothane (p less than 0.05 at each halothane level). However, similar levels of halothane did not significantly alter alpha and beta, nor did they significantly shift the exponential diastolic compliance curve from control. Seven patients who underwent coronary artery bypass grafting conducted under narcotic anesthesia showed a similar halothane-induced depression of contractility; 0.5% halothane decreased EES from 11.5 +/- 2.0 to 8.0 +/- 2.4 (p less than 0.01). Use of ID20 allows reclassification of anesthetic agents in accord with their myocardial depressant effects, which with halothane appears to be caused by decreased inotropism without alterations in diastolic chamber mechanics.

Animals↗

PubMed1984

Medical management of disorders of swallowing.

Disorders of swallowing in a given patient can result from abnormalities of dentition, the oral cavity (mouth and pharynx), the cricopharyngeal muscle, esophageal skeletal (proximal) or smooth (distal) muscle, the lower esophageal sphincter, and the stomach. Recent advances include refinements in esophageal manometric techniques with reclassification of motility disorders; newer drugs to treat gastroesophageal reflux; recognition of more frequent infections of the esophagus in immunosuppressed patients; and adaptation of the use of medications such as nitrates and calcium-channel blockers, which were previously primarily cardiotonic, for investigative treatment of esophageal motility abnormalities.

Combined Modality Therapy↗

PubMed1984

[Cluster analysis of alcoholic patients based on personality variables, social insecurity and control orientation].

200 alcoholics from 6 clinics with different therapeutic orientations were tested with the Freiburg Personality Inventory (Fahrenberg et al. 1978), an assertiveness-inventory (Ullrich u. Ullrich 1977), and a translated version of the Levenson (1973)-Locus of Control. On the base of a hierarchical-agglomerative cluster analysis four types of patients were suggested: 1) An aggressive-depressive, 2) a depressive-social anxious external controlled, 3) an assertive, 4) and a high stable alcoholic with well-balanced mood and internal control. The highest changes of generalized variance in a stepwise discriminant analysis were found on depression, misfortune-anxiety, impulsivity and control by powerful others. The reclassification rate was 85.5%. Out of 24 biographical data no one differed between the groups. The hypotheses of a population variation over different clinics was not supported. Differential therapeutic indications for the groups were discussed.

Alcoholism↗

PubMed1983

Typical and atypical carcinoids within the pulmonary APUD tumor spectrum.

The behavior of pulmonary APUD tumors is not constant; management is controversial, and morphology has reached its limit as a tool for prognostic assessment and therapeutic planning. We have studied 24 patients with carcinoids; 17 patients with typical carcinoids presented with Stage I disease, but one patient later died most probably of small cell undifferentiated lung cancer (SCLC). Seven patients with atypical carcinoids included three with Stage III cancers, one patient with simultaneous bilateral carcinoids, and one patient with simultaneous adenocarcinoma. Of 17 patients with typical carcinoids, 16 or 92% are disease free or died of unrelated causes. Of seven patients with atypical carcinoids, five or 71% are disease free. Tumor doubling time of atypical carcinoids, was 79.6 months (45 to 120) or six times shorter than that of typical carcinoids (p less than 0.05). Two of the three deaths from cancer were probably from SCLC and one from a synchronous adenocarcinoma. Review of diagnostic material from 12 patients with SCLC who survived a mean of 41 months (24 to 134) showed that diagnosis had rested on cytology alone in four patients and that, in seven patients, the quality or extent of the original diagnostic material was adequate to make the diagnosis of a malignant tumor but inadequate to permit reclassification. Tumor cells from 11 patients with carcinoids (seven typical and four atypical) and 28 patients with SCLC had DNA measurement by image analysis. The mean DNA content of typical and atypical carcinoids and SCLC is 1.17, 1.25, and 1.94 respectively (p less than 0.001). These findings strongly suggest a relationship between DNA content and atypia or malignancy in APUD lung tumors. We conclude that there are at least two levels of virulence among carcinoids represented by typical and atypical carcinoids. The prognosis for treated Stage I typical and atypical carcinoids is excellent. When deaths occur, they are from systemic cancer. Current evidence indicates that DNA measurements by image analysis may help to discriminate levels of malignancy among APUD pulmonary cancers and thereby help to clarify therapeutic controversies.

Adenocarcinoma↗

PubMed1983

[Malignant salivary gland tumors. Effect of histology and site on prognosis].

From 1965-1975 we treated 207 patients with malignant tumors of the salivary glands. While the localization of these tumors (minor salivary glands, submandibular gland, parotid gland) had no distinct influence on their prognosis, the influence of the histological tumor type is substantial. After histological reclassification of all tumors with grading of differentiation of adenoid cystic carcinomas (tubular, solid, cribriform), mucoepidermoid and acinic cell carcinomas (both well-, respectively poorly differentiated) we could establish 4 different prognostic groups by observing the respective determinate survival rates. The most favorable prognosis is found for tubular adenoid cystic carcinomas, well-differentiated acinic cell and mucoepidermoid carcinomas (5 year survival rate 100%), followed by the solid and cribriform adenoid cystic carcinomas, the poorly differentiated acinic cell carcinomas and the salivary duct carcinomas (5 year survival rate about 65%). With 5 year survival rates of 40%, the adenocarcinomas, poorly differentiated mucoepidermoid carcinomas and squamous cell carcinomas have a poor prognosis, and the prognosis of the carcinomas in pleomorphic adenoma and of undifferentiated carcinomas is even poorer with a 5 year survival rate of 25%.

Humans↗