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Biomedical subjects

D C Palmer

Publications and source records attributed to D C Palmer.

At least 19 recordsLinked to original sources

The S-R issue: its status in behavior analysis and in Donahoe and Palmer's learning and complex behavior.

The central focus of this essay is whether the effect of reinforcement is best viewed as the strengthenng of responding or the strengthening of the environmental control of responding. We make the argument that adherence to Skinner's goal of achieving a moment-to-moment analysis of behavior compels acceptance of the latter view. Moreover, a thoroughgoing commitment to a moment-to-moment analysis undermines the fundamental distinction between the conditioning process instantiated by operant and respondent contingencies while buttressing the crucially important differences in their cumulative outcomes. Computer simulations informed by experimental analyses of behavior and neuroscience are used to illustrate these points.

Animals↗

A selectionist approach to reinforcement.

We describe a principle of reinforcement that draws upon experimental analyses of both behavior and the neurosciences. Some of the implications of this principle for the interpretation of behavior are explored using computer simulations of adaptive neural networks. The simulations indicate that a single reinforcement principle, implemented in a biologically plausible neural network, is competent to produce as its cumulative product networks that can mediate a substantial number of the phenomena generated by respondent and operant contingencies. These include acquisition, extinction, reacquisition, conditioned reinforcement, and stimulus-control phenomena such as blocking and stimulus discrimination. The characteristics of the environment-behavior relations selected by the action of reinforcement on the connectivity of the network are consistent with behavior-analytic formulations: Operants are not elicited but, instead, the network permits them to be guided by the environment. Moreover, the guidance of behavior is context dependent, with the pathways activated by a stimulus determined in part by what other stimuli are acting on the network at that moment. In keeping with a selectionist approach to complexity, the cumulative effects of relatively simple reinforcement processes give promise of simulating the complex behavior of living organisms when acting upon adaptive neural networks.

Behavior↗

Small cell undifferentiated carcinoma of the pancreas. Report of a patient with tumor marker studies.

BACKGROUND: Small cell undifferentiated carcinoma of the pancreas is a rare type of pancreatic neoplasm. METHODS: The authors report the clinical and pathologic aspects of a patient with this malignant lesion and an extensive serologic and immunohistochemical survey of potential ectopically produced hormones or tumor markers. RESULTS: Neuron-specific enolase (NSE) emerged as a tumor marker. CONCLUSIONS: NSE could be valuable in the diagnosis and management of other patients with this rare disease.

Biomarkers, Tumor↗

Essentialism and selectionism in cognitive science and behavior analysis.

Contingencies of selection, be they phylogenetic or ontogenetic, merely set boundaries on units; they do not provide blueprints. Thus, variability is fundamental to all products of selection. Skinner, by characterizing the units of analysis in behavior as generic in nature, established his science squarely within the selectionist paradigm, thereby avoiding the tendency, common throughout psychology, to slip into essentialist analyses. The distinction between essentialism and selectionism is refined in this article, and prominent examples of essentialism in linguistics, theories of memory, theories of representation, associationism, and even in behavior analysis are identified. Recent trends in cognitive science--specifically, research on adaptive networks--is amenable to a selectionist interpretation, suggesting the possibility of future fruitful interactions with behavior analysis.

Behaviorism↗

Testicular seminoma in a long-term survivor of the prune belly syndrome.

Patients with the prune belly syndrome have cryptorchidism as a constant feature of the constellation of anomalies. Testes that do not spontaneously descend represent a well-known risk factor for the development of testicular cancer. In this paper, we present the second case of a primary testicular germ cell tumor in a long-term survivor with prune belly syndrome.

Adult↗

Response to exogenous cholecystokinin of six human gastrointestinal cancers xenografted in nude mice.

Gastrointestinal hormones regulate growth of cancers as well as normal tissues. We investigated whether long-term cholecystokinin (CCK) administration might affect growth or metabolism of human tumors xenografted in nude mice. In each experiment, approximately 20 nude mice bearing subcutaneous xenografts of the particular cancer line being studied were used. Half received CCK and half received saline solution intraperitoneally twice daily for 14 days. Tumor volume and body weight were measured every 3 days. If the tumors produced marker substances, these were measured in nude mouse serum and also in the xenografts. Tumor growth was significantly retarded by CCK in two of the six cancers studied. In each case, DNA, RNA, and protein reflected tumor volumes. In one of these tumors (SLU 077), serum carcinoembryonic antigen (CEA) levels paralleled the tumor volumes. In another tumor (SLU 132), serum CEA levels and tumor immunolabeling for CEA and pancreatic oncofetal antigen increased in response to CCK administration, whereas tumor volumes did not. These findings suggest that exogenous highdose CCK altered the growth and metabolism in two of six human cancers studied.

Animals↗

The prognostic importance of steroid receptors in endometrial carcinoma.

Three hundred forty-nine cases of primary endometrial carcinoma (endometrioid, adenosquamous, and clear-cell) were studied to investigate the relative prognostic importance of age, menopausal status, stage, histology, myometrial invasion, and estrogen and progesterone receptor content. Excluding menopausal status, all of these variables had a significant relationship to overall survival in a univariate analysis. Using a Cox multivariate regression analysis, stage, age, and an estrogen receptor value of more than 70 fmol/mg protein, combined with a progesterone receptor value of more than 30 fmol/mg protein, were independently associated with survival. The results demonstrate that for maximum prognostic information, both estrogen and progesterone content of tumors should be measured. Maximum prognostic information is obtained by using cutoff levels that are much higher than those traditionally accepted. This has particular relevance for patient stratification in clinical trials investigating receptor information and response to adjuvant or therapeutic treatment.

Adenocarcinoma↗

Clinical temporary ventricular assist. Pathologic findings and their implications in a multi-institutional study of 41 patients.

Forty-one patients, distributed among four centers, had left (33 patients), right (five), or bilateral (three) temporary ventricular assistance with textured (24) or smooth (17) surfaced diaphragm pumps, during an evaluation supported by the National Institutes of Health. Cardiac failure had occurred in 39 postoperative patients (after aorta-coronary bypass [23], valve replacement [four], both [nine], or other [three]), with total cardiopulmonary bypass time mean 306 minutes (range 69 to 600). Two patients had cardiomyopathy. Death of 35 nonsurvivors was due to myocardial necrosis (14), hemorrhage (nine), cerebrovascular accidents (three), infection (three), and other (six). Mean duration of support in all patients was 62 hours. In 16 patients (40%) whose condition improved, cardiac assist duration was mean 127 hours (range 48 to 264), compared with mean 19 hours (range 1 to 120) in 25 who did not. Of 17 patients in whom duration of support exceeded 72 hours, 15 (88%) improved, 11 were weaned, and six survived long term. Tissue examination (in 33 patients) by biopsy at pump implantation or autopsy revealed coagulation or contraction band myocyte necrosis, with or without hemorrhage, in 26 patients; of these, 10 improved and six were long-term survivors. Pump-related complications (two) included pulmonary embolism, most likely related to a cannulation site thrombus, and an aortic cannulation site infection in one patient each. This study suggests that mechanical cardiac assist may be accomplished with a low complication rate; should not necessarily be denied to patients with existing necrosis, because myocardial necrosis does not preclude improvement or survival; and frequently leads to functional myocardial recovery if patients survive early noncardiac complications, often the result of long duration of cardiopulmonary bypass.

Adolescent↗

Discriminated interresponse times: role of autoshaped responses.

When discriminated interresponse-time (IRT) procedures have been used to assess preference relations among temporally extended operants, deviations from matching have been obtained. Using a yoked-control procedure, the present study found that key pecking in a discriminated IRT procedure has two sources of strength--that arising from the response-reinforcer contingency that is explicitly arranged, and that arising from a stimulus-reinforcer contingency that is a by-product of the explicitly arranged contingency. The key pecking of all lead birds, and that of 3 of the 4 birds exposed to a yoked autoshaping procedure, was controlled by the keylight that signaled the lead birds' criterion IRTs. Because stimulus control of key pecking by the keylight, whether autoshaped or discriminative, fosters deviations from matching, the discriminated IRT procedure does not provide an appropriate basis for conclusions about preference relations among IRTs.

Animals↗

Effect of cholecystokinin on human cholangiocarcinoma xenografted into nude mice.

Gastrointestinal polypeptide hormones regulate growth of various normal gastrointestinal tissues as well as certain visceral cancers. Since cholecystokinin (CCK) promotes growth of normal biliary tract, we sought to determine whether CCK affects the growth and metabolism of human cholangiocarcinoma line SLU 132. Twenty-six nude mice with s.c. xenografts of this cancer received either CCK octapeptide (50 micrograms/kg/dose) or 0.9% NaCl solution (saline) twice a day i.p. for 14 days. Tumor volume was calculated from Vernier caliper measurements. At sacrifice on Day 15, tumors were excised, weighed, and examined histologically. DNA, RNA, and protein were measured in the xenografted carcinomas. Because this cholangiocarcinoma produces carcinoembryonic antigen (CEA), we obtained serum at sacrifice for CEA radioimmunoassay and also tumor tissue for CEA immunolabeling with murine anti-CEA monoclonal antibody. Serum CEA levels were 90% higher in the CCK-treated group. Tumor tissue in the CCK-treated group also contained more CEA than did the controls. Mean tumor volume increased significantly in the saline group during the 14-day treatment period, whereas mean tumor volume did not increase significantly in the CCK group. Exogenous high-dose CCK thus appears to increase production and release of CEA from SLU-132; it also appears to retard growth of this tumor line in the nude mouse.

Adenoma, Bile Duct↗

Heart graft arteriosclerosis. An ominous finding on endomyocardial biopsy.

Heart graft arteriosclerosis remains a severe and irreversible complication of allogeneic heart transplantation despite prophylactic therapy. Immunologically mediated endothelial damage has been proposed as a stimulus for the development of graft arteriosclerosis. The vascular lesions may accumulate large amounts of lipid resembling atheromas, or may be purely proliferative, as illustrated in the case of a 42-year-old heart transplant patient who developed slowly progressive graft dysfunction at eight months posttransplantation. Endomyocardial biopsy ten months posttransplantation revealed proliferative arteriolar occlusion, while changes on the coronary angiogram were minimal. Repeat biopsy at eleven months showed ischemic myocardial necrosis. The patient expired shortly thereafter. On postmortem examination, proliferative graft arteriosclerosis affecting both intramural and epicardial vessels was present, along with massive biventricular infarction. Tissue immunofluorescence studies demonstrated extensive vascular deposition of immunoglobulin and complement. We propose that (1) the presence of proliferative arteriolar occlusion on endomyocardial biopsy is predictive of poor heart graft survival; (2) proliferative graft arteriosclerosis may appear as advanced small vessel disease before extensive large vessel involvement is detected by coronary angiogram; and (3) immunofluorescence results support an immune-mediated mechanism of vascular injury in proliferative heart graft arteriosclerosis.

Adult↗

Carcinoembryonic antigen in experimental rat gastrointestinal carcinoma.

Detection of gastric carcinoma in the experimental rat can be difficult. We investigated whether or not serological testing for carcinoembryonic antigen might aid in the diagnostic process. Twenty-five young adult male Wistar rats were studied; 15 were treated with the carcinogen N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), and 10 received no treatment. A complete autopsy was done on the 22 animals (12 in MNNG group, 10 in control group) that completed the 37-week study. Serum obtained at autopsy was evaluated by radioimmunoassay for the presence of CEA-like immunoreactivity. Grossly normal stomach, as well as gastric and small bowel cancers, were also stained for CEA. Of the 12 autopsied animals in the MNNG group, eight had a total of 12 cancers (seven gastric and five proximal small bowel); in no animal was an elevated serum CEA level detected. Immunoreactive tissue CEA was demonstrable in normal stomach and in gastrointestinal cancers; the tumors usually stained less intensely than adjacent normal stomach and did not exhibit normal intracellular CEA distribution.

Animals↗

High incidence of myocarditis by endomyocardial biopsy in patients with idiopathic congestive cardiomyopathy.

Thirty-five patients with unexplained congestive heart failure were evaluated with endomyocardial biopsy. Utilizing microscopic, ultrastructural and immunofluorescent studies, samples were classified as exhibiting either no inflammation (cardiomyopathy) or active lymphocytic myocarditis, grade I to IV. Twenty-two (63%) of the patients had inflammatory changes. Of these 22 patients, 18 had low grade I or II inflammation, 7 were treated with immunosuppressive agents with improvement in 5 and stabilization in 1. One patient died of progressive congestive heart failure. Three of four patients with high grade III or IV myocarditis died after a fulminant course. The results suggest that inflammatory myocarditis may be more common than previously suspected and add evidence that there may be ongoing inflammation in many cases of congestive cardiomyopathy.

Adolescent↗

Jaundice: a 10 year review of 41,000 live born infants.

A review is presented of jaundiced newborn infants during the 10-year period to 1980. Included are those whose serum bilirubin level was 154 mumol/l or more. Of 41,057 live births, 4,406 (10.7%) infants had hyperbilirubinaemia. The most common (19.9;%) aetiological factor was prematurity, followed by ABO erythroblastosis 7.1%; sepsis 3.4%; Rhesus erythroblastosis 2.7%; bruising 2.2%; multifactorial 1.0% and glucose-6-phosphate dehydrogenase deficiency 0.5%. Treatment was not undertaken in 2,855 (64.7%) infants, but 1,419 (32.2%) received phototherapy alone, 122 (2.7%) infants received both exchange transfusion and phototherapy and 10 (0.2%) infants received exchange transfusion alone. Of the infants requiring exchange transfusion 50.0% had Rhesus erythroblastosis, 28.0% ABO erythroblastosis, 10.6% jaundice of prematurity and the remainder were due to a variety of causes. Sixty-three (1.4%) infants died, with two deaths being related to the hyperbilirubinaemia, as their death was due to necrotizing enterocolitis following exchange transfusion. Phototherapy proved safe with no deaths directly attributable to its use.

ABO Blood-Group System↗