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Biomedical subjects

B Fletcher

Publications and source records attributed to B Fletcher.

At least 37 records · Page 2Linked to original sources
PubMed1991

Metastatic small cell tumor of bone with 'true' rosettes and glial fibrillary acidic protein positivity.

A 15-year-old black girl was admitted to St. Jude Children's Research Hospital with a lytic lesion involving the right fourth metacarpal bone with a solitary metastasis to the ipsilateral axillary lymph node. Histologic examination of both the primary lesion and metastasis revealed a primitive small round cell lesion. Abundant rosettes with central lumina were present in the metastasis. Immunohistochemical stains performed on sections of the metastasis were strongly positive for glial fibrillary acidic protein (GFAP) and negative for neuron-specific enolase (NSE), S-100 protein, and Leu-7. Electron microscopic examination of the metastasis revealed lumen formation with apical microvilli and juxtaluminal junctional complexes. This tumor exhibits features that are suggestive, but not definitive, of primitive ependymal differentiation and further expands the morphologic and immunophenotypic range of small round cell tumors of bone.

Adolescent↗
PubMed1991

The TIS11 primary response gene is a member of a gene family that encodes proteins with a highly conserved sequence containing an unusual Cys-His repeat.

The TIS11 primary response gene is rapidly and transiently induced by both 12-O-tetradecanoylphorbol-13-acetate and growth factors. The predicted TIS11 protein contains a 6-amino-acid repeat, YKTELC. We cloned two additional cDNAs, TIS11b and TIS11d, that contain the YKTELC sequence. TIS11, TIS11b, and TIS11d proteins share a 67-amino-acid region of sequence similarity that includes the YKTELC repeat and two cysteine-histidine containing repeats. TIS11 gene family members are not coordinately expressed: (i) unlike TIS11, the TIS11b and TIS11d mRNAs are detectable in quiescent Swiss 3T3 cells and are not dramatically induced by 12-O-tetradecanoylphorbol-13-acetate; (ii) cycloheximide superinduction does not occur for TIS11b and TIS11d; and (iii) unlike TIS11, TIS11b expression is extinguished in PC12 pheochromocytoma cells.

Amino Acid Sequence↗
PubMed1991

Failure of supplementation with vitamin E to prevent bronchopulmonary dysplasia in infants less than 1,500 g birth weight.

In a randomized trial to determine whether oral vitamin E reduced stages III and IV bronchopulmonary dysplasia (BPD) by 50%, 268 infants were randomly allocated, after stratification by birth weight and severity of disease, to receive vitamin E 25 units or an indistinguishable placebo. The experimental (E) group and the control (C) group were similar in weight, gestational ages, Apgar scores, severity of illness, and initial oxygen and ventilator exposure. Serum vitamin E levels were significantly different within 48 h of administration and remained well above normal adult levels from the first week of life in the experimental group. There was no difference in the rates of early death, BPD at 28 days, or mortality from BPD. Severity was similar and no difference was seen in the incidence of necrotizing enterocolitis or sepsis. There was no evidence that vitamin E supplementation offered protection against chronic lung disease in infants less than 1,500 g birth weight.

Bronchopulmonary Dysplasia↗
PubMed1989

Maximizing the functional status of geriatric patients in an acute community hospital setting.

Patients (n = 103) admitted to an inpatient geriatric care unit focusing on restoration of functional status were compared to similar patients (n = 75) admitted to a control-unit. Study unit patients showed significantly greater improvement in basic functional capabilities from admission to discharge than did control-unit patients. A mixed picture evolved when length of stay and total charges of study and control-unit patient were compared by diagnostic-related groups.

Activities of Daily Living↗
PubMed1988

Occupation, marriage and disease-specific mortality concordance.

Mortality statistics for more than 500 different occupations were examined for all causes of death, neoplasms, circulatory diseases, respiratory diseases, and deaths from external causes. The paper shows that a married woman's life expectancy, and her cause of death, is reliably associated with the occupational mortality risk of her husband. It demonstrates that this is so when social class is controlled, when statistically contaminating 'outliers' are excluded, and when the correlation of any particular cause of death with other causes of death is partialled out. The findings suggest that specific occupational risks are transmitted between marital partners, perhaps through psychological mechanisms.

Adult↗
PubMed1985

The relative efficacy of avoidant and nonavoidant coping strategies: a meta-analysis.

A casual review of the research literature on coping strategies suggests that strategies involving avoidant tactics are effective in reducing pain, stress, and anxiety in some cases, whereas nonavoidant strategies (called here attention), appear to be more effective in others. This article reports the results of a series of meta-analyses to ascertain whether there are systematic patterns in the empirical literature that describe when attention strategies are more or less effective than avoidant strategies. In particular, we consider the role of different kinds of attentional sets and also the role of time--whether some kinds of strategies work best in the early phases of the stress experience, and others are more efficacious in later phases of the stress experience. Results of an overall analysis of studies providing tests of attention versus avoidance indicated little evidence for one strategy's superiority. However, supplementary analyses, motivated by theoretical reasons, suggest there are boundary conditions that define the relative efficacy of a specific strategy. Overall, avoidance was associated with more positive adaptation in the short-run. However, attention was superior to avoidance if the former involved a focus on sensory schemata rather than emotional processing. If attention involved an emotional interpretational set or no explicit set, then it was associated with more negative outcomes than avoidance. In terms of long-term outcomes, avoidance indicates better outcomes initially, but with time, attention was associated with more positive outcomes. A final set of analyses found that both attention and avoidance facilitate adaptation as compared with no instruction controls. The meta-analyses suggest the important role of interpretational set and whether one looks at the immediate or at the long-term effects of coping. Limitations of the analyses and directions for future research are discussed.

Adaptation, Psychological↗
PubMed1985

Multifocal osteonecrosis in adolescents with Crohn's disease: a complication of therapy?

Three adolescents with severe Crohn's ileocolitis developed osteonecrosis after receiving intravenous corticosteroids and parenteral nutrition, including 10% lipid infusion. Each had achieved clinical remission with therapy. However, several months following completion of therapy, each developed arthralgias and arthritis of weight-bearing and non-weight-bearing joints. Roentgenographic evaluation revealed osteonecrosis involving multiple joints. Osteonecrosis may result from the interference with blood flow to bone and has been produced in animals by infusion of lipid solutions and administration of corticosteroids. We report these cases of osteonecrosis as a probable complication of corticosteroid and lipid infusion in adolescents treated for severe Crohn's disease.

Adolescent↗
PubMed1982

A perinatal approach to the diagnosis and management of gastrointestinal malformations.

Ultrasonography now offers the opportunity to evaluate selected high-risk pregnancies for the presence of fetal malformations that are amenable to corrective measures as well as of those that remain incompatible with life. The authors observed major fetal malformations in 1% of 6050 cases that underwent antenatal ultrasonographic evaluation. A series of 9 prenatally diagnosed gastrointestinal tract anomalies, including the first documented instances of esophageal atresia diagnosed in utero, is presented in detail. Abdominal wall defects were those most commonly encountered in this series and were diagnosed as early as 16 weeks' gestation. The gastrointestinal system is not only one of the most common sites of birth defects, but it is also the one wherein lies the greatest hope for a successful neonatal outcome. The value of prenatal diagnosis in a comprehensive perinatal approach to congenital gastrointestinal lesions is emphasized. Forewarning the obstetrician and altering the pediatric-surgical team for resuscitation, immediate postnatal evaluation, and timely intervention decrease neonatal mortality and increase the chance of long-term infant survival.

Abnormalities, Multiple↗