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D Holley

Publications and source records attributed to D Holley.

9 recordsLinked to original sources
PubMed2005

Opportunity of detecting pre-hypertension: worldwide data on blood pressure overswinging.

Overswinging or CHAT (brief for Circadian Hyper-Amplitude-Tension), that is an excessive circadian variation in blood pressure (BP), has been associated with a large increase in cardiovascular disease risk, present even in the absence of an elevated BP itself. This usually asymptomatic condition is usually overlooked by current practice based on spot-checks, because to be diagnosed, measurements need to be taken around-the-clock, preferably for 7 days at the outset. Once diagnosed, however, a usual circadian BP pattern can be restored by means of certain non-pharmacologic or pharmacologic interventions timed appropriately. Thereby, it is possible to reduce the risk of cardiovascular morbidity and mortality, cerebral ischemic events and nephropathy in particular. For the preparation of guidelines regarding the diagnosis of BP disorders and for the institution of primary as well as secondary preventive measures, it is important to know what the incidence of CHAT is on a global basis. We found 191 cases of CHAT among 1602 mostly 7-day/24-h BP profiles, obtained from several centers in different countries participating in an ongoing project on the BIOsphere and the COSmos (BIOCOS). CHAT incidence is about the same between men and women, but it is diagnosed more often among patients with borderline hypertension or with glucose intolerance. It is also more common among MESOR-hypertensive than among MESOR-normotensive individuals. Priority should be given to the development of an unobtrusive and affordable device to automatically monitor BP and to analyze the data as-one-goes, so that cardiovascular disease risk can be prevented.

Adult↗
PubMed1995

In vitro cytolytic activity of lymphocytes from tumor-draining lymph nodes is associated with increased numbers of CD8+ cells and increased cytokine production.

A murine footpad tumor model was used to determine the cytotoxic activity, tumor specificity, phenotypic profile, and cytokine production of stimulated cells from draining lymph nodes (DLN). Popliteal DLN from 5-day-old P-815 footpad tumors were stimulated with 10(-7) M phorbol 12, 13-dibutyrate +5 x 10(-7) M ionomycin for 16 hr and cultured in IL-2 (20 units/ml) for 7 or 14 days without autologous tumor. Most cells in both groups were CD3+ (93% at Day 7, 99% at Day 14); however, the percentage of CD8+ cells increased as the cell population matured in the presence of low-dose IL-2. On Day 7, the phenotypic profile was 62% CD4+ and 29% CD8+, whereas on Day 14 it was 16% CD4+ and 81% CD8+. Similarly, in vitro cytokine production increased with time in culture. After 7 days, the level of tumor necrosis factor-alpha (TNF-alpha) was 220 pg/mL and the interferon-gamma (IF-gamma) production was 150 pg/ml. At Day 14 the TNF level had increased to 500 pg/ml, and IF production had increased to 350 pg/ml. These increases in the CD8+ population and in cytokine production correlated with the increase in the percentage of target cells killed by the DLN cells. Cytolytic activity against P-815 was only 13% on Day 7 but 39% on Day 14. Neither group of effector cells (Day 7 or Day 14) had any cytolytic activity against the syngeneic tumor cell line L-1210, demonstrating the tumor specificity of the DLN cells. We describe a model for generating tumor-specific cytotoxic T-cells that have significant cytokine production, which may account for previously described in vivo activity.

Animals↗
PubMed1994

Speak with one voice.

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American Medical Association↗
PubMed1993

Routine use of transesophageal echocardiography and color flow imaging in the evaluation and treatment of children with congenital heart disease.

We reviewed our experience with transesophageal echocardiography (TEE) and color flow imaging in 157 consecutive patients with known or suspected heart disease to ascertain the impact of this technology on patient care. TEE was performed for diagnostic purposes (22/157), during interventional cardiac catheterizations (13/157), and during operative procedures (122/157). Diagnostic studies were performed after transthoracic echocardiography (TTE) in 21 of 22 patients. TEE was performed because TTE was inconclusive (15/21) or failed to provide sufficient detail of an abnormality (6/21). TEE detected an abnormality in 6 of 15 inconclusive TTEs. TEE was helpful during interventional cardiac catheterizations, particularly during umbrella closure of septal defects and in patients with complex venous and atrial anatomy undergoing transseptal puncture. TEE studies performed before cardiac operations significantly changed the diagnosis in only 5 of 122 (4%) patients, but the information changed the surgical approach in 4 of 5 of these patients. Postoperative TEE assessment more frequently changed care and resulted in further surgical management in 9 of 122 (7%) or a change in medical management in 6 of 122 (5%) patients. TEE was discontinued because of complications before studies were completed in only 4 of 157 (3%) patients. TEE and color flow imaging is a useful adjunct to care of children with known or suspected congenital heart disease.

Adolescent↗
PubMed1991

Effects of cervical adjustments on lateral-flexion passive end-range asymmetry and on blood pressure, heart rate and plasma catecholamine levels.

The biomechanical and physiological effects of a single, unilateral lower cervical spinal adjustment delivered to the most restricted side of cervical lateral-flexion passive end-range were examined. Only healthy, asymptomatic male subjects who exhibited goniometrically verified lateral-flexion passive range of motion asymmetries of 10 degrees or greater on the morning of the experiment were chosen for the study. Posttreatment goniometric measurements revealed that in sham-adjusted controls, mean lateral-flexion asymmetries had not changed significantly during the 4-hr time period examined. However, in subjects who received lower cervical adjustments, dramatic ameliorations of asymmetry magnitude were observed which persisted throughout the entire 4-hr posttreatment time period. On the other hand, in the face of this rather robust biomechanical effect, heart rate and blood pressure measurements obtained at -60 and -15 min prior to treatments, and at 5, 30, 60, 120 and 240 min following treatments, revealed no significant differences between adjusted and sham-adjusted subjects at any of the time periods examined. Consistent with this, analysis of the plasma concentrations of norepinephrine, epinephrine and dopamine in serial blood samples collected at these same times also failed to reveal significant differences between treatment groups at any of the time periods examined. The results of this investigation indicate that lower cervical adjustments are capable, at least in asymptomatic subjects, of inducing relatively robust biomechanical effects related to passive cervical end-range capability without simultaneously inducing significant alterations in the overall activity of the sympathetic nervous system.

Adult↗
PubMed1985

Relation between apnoea duration and type and neurological status of preterm infants.

The incidence, duration, and type of apnoea were determined in 28 preterm infants born at 27 to 34 weeks' gestation, using polygraphic records of abdominal breathing movements and nasal airflow. Of the 1520 episodes of apnoea of 10 or more seconds duration, 1002 (66%) lasted 10 to 14 seconds, 311 (20%) lasted 15 to 20 seconds, and 207 (14%) lasted more than 20 seconds. Overall, 69% were central in type, 20% were mixed, and 11% were purely obstructive. With increasing duration of apnoea, the proportion of episodes of central apnoea decreased (69 to 29%) while that of mixed apnoea increased (20 to 60%). Eight infants had obstructive apnoea of more than 20 seconds duration. When they were compared with the 10 infants of similar gestational age and birthweight who had central or mixed apnoea, they had a higher incidence of intraventricular haemorrhage, hydrocephalus, positive pressure ventilation via an endotracheal tube, and abnormal neurological development during the first year of life.

Airway Obstruction↗
PubMed1979

A mechanical aid for the treatment of carcinoma of the breast.

A relatively inexpensive mechanical aid is described which, in primary or adjuvant irradiation for breast carcinoma, allows easy and stable reproducibility of the abducted arm position, unobstructed access for lateral tangential portals, and leveling of the anterior chest for regional nodal irradiation. The device may be constructed de novo or from a commonly available treatment-table accessory.

Arm↗