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Biomedical subjects

D O'Connor

Publications and source records attributed to D O'Connor.

17 recordsLinked to original sources
PubMed1992

Clinical surveillance of gynecologic cancer patients.

A survey of gynecologic oncologists was used to determine the optimum follow-up plan for asymptomatic, disease-free patients previously treated for a gynecologic malignancy. Ninety-four (91%) of 103 questionnaires were completed and returned. The majority of respondents recommended a clinic visit for these patients every 3 months for the first year after the completion of therapy, every 3 or 4 months for the second year, every 6 months for the following 3 years, and then annually after this initial 5-year period. Breast, abdominal, lymph node, and pelvic examinations, as well as a pap smear and stool guaiac, were done at each of these clinic visits. A yearly chest X ray was performed by the majority of the survey respondents for the first 3 years following initial treatment. Determinations of serum CA-125 and ovarian germ cell tumor markers were done at each follow-up appointment during the first 5 years after therapy if they were previously elevated. The patients' smoking habits were discussed with them by the majority of respondents. Mammograms were performed periodically before age 50 and then yearly after age 50 by most respondents. Serum cholesterol determinations were accomplished every 5 years or more frequently if indicated. Calcium supplementation was recommended for postmenopausal patients. The majority of respondents did not recommend routine vitamin supplementation or surveillance sigmoidoscopy.

Ambulatory Care↗
PubMed1992

Quantification of implant micromotion, strain shielding, and bone resorption with porous-coated anatomic medullary locking femoral prostheses.

Fourteen femora containing porous-coated anatomic medullary locking (AML) femoral prostheses were retrieved from 12 patients at autopsy. Clinical roentgenograms in 13 femora showed bone remodeling changes, indicating that the implants were fixed by osseointegration. Under simulated physiologic loading, micromotion between the implant and the bone was measured using electrical displacement transducers connected to the implant and to the adjacent cortex. The micromotion between the implants at the areas of porous coating and the adjacent cortex in the one case of failed bone ingrowth measured 150 microns. Maximum relative motion between the cortex and the implant in the areas of porous coating for the 13 cases showing signs of bone ingrowth was 40 microns, and this was completely elastic relative displacement. With all implants, the micromotion between the cortex and the stem was always greatest over the uncoated portion of the stem. Four of the implants were proximally porous coated. With these, the micromotion was greater over the uncoated areas than with more extensively coated stems and was always greatest at the uncoated tip of the prosthesis. The amount of micromotion was directly related to the extent of porous coating on the implant. Maximum tip motion for the proximally coated implants was 210 micra, whereas for the fully porous-coated implants, it was 40 microns. In nine of the autopsies, the contralateral normal femur was obtained in addition to the femur containing the AML (the in vivo remodeled femur). These were used for comparative studies of strain shielding and femoral remodeling. Cortical strains were measured in the in vivo remodeled femora and were compared with measurements made in the contralateral normal femora before and following implantation of a stem identical to that present on the clinically treated side. The data showed major strain reductions in all the postmortem implanted normal femora. Comparison of the strain data from the postmortem implanted normal femora with those from the in vivo remodeled femora clearly indicated that extensive bone remodeling did not result in restoration of cortical strain levels anywhere near normal. Strain shielding continued to exist in all of the remodeled specimens, even up to 7.5 years after surgery. This strain shielding was associated with bone remodeling changes that resulted in regional reductions in bone mineral content that ranged from 7% to 78%. These observations are unique, important, and valuable in defining the in vivo function and clinical behavior of this type of porous-coated femoral component.

Aged↗
PubMed1992

Intestinal invasion by a dysgerminoma in a patient with Swyer syndrome.

An unusual case is presented of advanced dysgerminoma in a patient with Swyer syndrome, 46,XY pure gonadal dysgenesis. Unexpected regional invasion necessitated bowel resection, total abdominal hysterectomy, and bilateral salpingogonadectomy for a complete en bloc excision of the primary tumor mass and the dysgenetic gonads. This report illustrates the possible need for extensive operative resection in patients with Swyer syndrome.

Adnexa Uteri↗
PubMed1990

Metastatic placental site trophoblastic tumor.

A patient with metastatic placental site trophoblastic tumor is presented. Her treatment included several aggressive chemotherapeutic regimens. In this patient, the clinical course and assays of beta-hCG (beta fragment of human chorionic gonadotropin) correlated with her response to these treatments.

Adult↗
PubMed1990

Osseous metaplasia in ovarian papillary serous cystadenocarcinoma.

The finding of osseous metaplasia within an ovarian papillary serous cystadenocarcinoma is very rare. A review of the medical literature reveals only two previously published cases where mature bone was found in an ovarian serous cystadenocarcinoma. This report presents an additional case of this unusual phenomenon whose clinical significance remains uncertain.

Cystadenocarcinoma↗
PubMed1990

Noninvasive cardiac output: simultaneous comparison of two different methods with thermodilution.

The authors attempted to simultaneously measure cardiac output by thermodilution (COtd), thoracic bioimpedance (CObi), and suprasternal Doppler ultrasound (COdopp) in 68 patients. Subgroups separately compared included patients whose lungs were mechanically ventilated, patients undergoing cardiac surgery, aortic surgery, patients with dysrhythmias, and patients with sepsis. The authors also studied the value of the ventricular ejection time (VET) in evaluating the agreement of CObi and COdopp with COtd. Simultaneous CObi and COtd were available in a total of 56 patients (416 data sets) with an overall correlation coefficient r = 0.61, regression slope (m) of 0.52, intercept (y) of 2.46, and mean (CObi-COtd) difference (bias) of -0.67 +/- 1.72 (SD) l/min. Simultaneous COdopp and COtd were available in 59 patients (446 data sets) with an overall r = 0.51, m of 0.53, y of 2.05, and bias of -0.79 +/- 1.95 l/min. CObi agreed most closely with COtd in patients whose lungs were mechanically ventilated, who had not undergone cardiac or aortic surgery, and with VET difference less than 40 ms (16 patients, 99 data sets; r = 0.74; m = 0.97; y = 0.15; bias = -0.02 +/- 1.53 l/min). COdopp agreed most closely with COtd in patients whose lungs were mechanically ventilated, who had not undergone cardiac or aortic surgery, and in sinus rhythm with VET difference less than 40 ms (10 patients, 45 data sets; r = 0.82; m = 0.98; y = -0.07; bias = -0.82 +/-1.03 l/min). VET by radial artery can help evaluate the reliability of CObi and COdopp.

Aorta↗
PubMed1990

Characterization of the traT gene and mutants that increase outer membrane permeability from the Salmonella typhimurium virulence plasmid.

The nucleotide sequence of the traT gene present in the virulence-associated plasmid of Salmonella typhimurium was determined. The predicted TraT protein encoded by this gene was found to consist of 243 amino acids and to resemble the known TraT proteins of the plasmids of the F incompatibility group. Thus it contains a signal sequence of 20 amino acids, an amino-terminal lipid attachment site, and two strongly hydrophobic regions close to each other in the mature protein. A mutation leading to increased permeability of the outer membrane to hydrophobic agents, previously localized to the traT gene, was shown to change a glycine residue to arginine within one of these hydrophobic regions. The same principle was found to apply to TraT of R6-5: the introduction, by site-directed mutagenesis, of either positively or negatively charged amino acids or the helix-disrupting proline in the corresponding hydrophobic region led to increased hydrophobic permeability of the outer membrane.

Amino Acid Sequence↗
PubMed1979

Antibiotic usage in a pediatric medical center.

Antibiotic usage in a large pediatric teaching hospital was evaluated during a three-month period. A total of 1,067 patients received antibiotics and 295 patient records were reviewed. One hundred sixty-nine courses of antibiotics were administered to surgical patients, 77% for surgical prophylaxis. One hundred forty-seven antibiotic courses administered to medical patients were therapeutic in 61.2% and in 35.3% were given because of suspicion of infection. Ampicillin was the most commonly used antibiotic; cephalosporins were used for surgical prophylaxis. Aminoglycosides were used commonly for suspected infection in medical patients. Antibiotic management was inappropriate in 66% of surgical patients and in 21% of medical patients. Not obtaining appropriate studies prior to and during therapy were common infractions on all services. Surgical prophylaxis was freqently inappropriate by reason of no indication, wrong drug or dose, or inappropriate timing.

Adolescent↗
PubMed1979

The assessment of sexual function and marital interaction.

The increasing need expressed by clinicians and researchers alike for valid and reliable psychological measures of sexual behavior and adjustment contrast with the limited available information on the assessment of human sexual functioning. The aim of this article is to present relevant data on the psychometric characteristics of scales designed to measure one or more aspects of human sexual activity and marital interaction. This list is by no means exhaustive but covers most assessments of either individuals or dyads, mainly in a heterosexual context. Under the title of the scales, which have been arranged by alphabetical order according to the first author's name, the information provided may permit a preliminary judgment concerning the potential applicability of the instrument to the reader's need.

Female↗
PubMed1978

Activity patterns of human skeletal muscles: relation to muscle fiber type composition.

The muscle activity of normal ambulatory individuals was recorded continuously for 8-hour (working day) periods. Parameters of activity patterns were defined and numerical outcomes for these parameters were compared across a diverse population of muscles. Several pattern parameters, such as the average percentage of time active, were highly correlated with the percentage of type I fibers of a muscle.

Adult↗
PubMed1978

Long-term trends in human eye blink rate.

Long-term recordings of normal human eye blink behavior (up to 14 h continuously) showed a number of periodic trends in blink rate. Mean rates varied from 2 to 50 blinks/min and periods ranged from 10 min to 2.5 h. Three dominant groupings of mean rates were observed (1) under 6, (2) 8--15 and (3) 20--30 blinks/min; these groups appear to be related to more or less distinct behavioral states of the individual. Blink amplitudes also varied and amplitude and rate showed correlations of possible functional significance. Vision-related behaviors affect both the mean rate of blinking and blink amplitude, and may impose a characteristic strategy on the timing of the individual blinks as well. The latter is referred to as bimodal blinking; this strategy contrasts with the random occurrence of blinks seen normally.

Adult↗
PubMed1976

Selective neuroendocrine effects of low-dose haloperidol in normal adult men.

The neuroendocrine effects of haloperidol, usually reported as side effects of this drug when given in antipsychotic doses, have not been systematically investigated. In the present study five normal adult men were administered saline and two doses of of haloperidol (0.25 mg, 0.5 mg) intramuscularly in a double-blind randomized block design. The anterior pituitary hormones GH, LH, FSH, and PRL were measured in blood samples taken every 20 min for several hours thereafter. The low doses of haloperidol used have been shown by others to alter the human EEG; in our subjects these doses produced no objective or subjective clinical effects. There were no drug related changes in GH, LH, or FSH. PRL, however, showed a prompt, statistically significant, dose-related increase in plasma levels, with a return to baseline with 5 h. Haloperidol has strong dopamine-blocking effects, and the hypothalamic inhibitory mechanism for PRL release is believed to be dopamine-mediated. The results of this study suggest that haloperidol may have utility in low doses primarily for its hypothalamic neuroendocrine effects, and that dose-related PRL release may be a useful paradigm for comparing dopamine-blocking antipsychotic agents in humans.

Adult↗
PubMed1976

Factors involved in immunization program for swine influenza.

The decision to undertake a nationwide program of vaccination against swine influenza requires assessment of the status of immunity of those in various age groups in our population against this agent. Pools of serum were collected from persons born in the years from 1889 to 1943; they were tested for hemaggultinin inhibiting (HI) antibody against the HSW 1N1 influenza virus strains isolated in 1931 and 1976. The titers secured serve as an indication of the average level of immunity of those of different ages. Persons less than 43 years of age are found to be without antibody protection. The need for vaccination of people in different age groups based on mortality statistics of previous epidemics is evaluated. It is realized that no epidemic may occur and that a reduced virulence of the viral agent and use of antibiotics may reduce the death rate if the infection recurs. The extraordinary high mortality in 1918 in people between 15 and 44 years of age deserves recognition together with the fact that those in the same age group are now without protection. The fact that women of childbearing age fall into this group deserves special consideration in view of increased mortality in puerperal women observed in the pandemics of 1918 and 1957. The degree of protection afforded the newborn by transplacental transmission of maternal antibodies is discussed. The need of increasing the level of immunity in those who have varying titers of HI antibodies is considered in relation to the prevalence of cardiopulmonary complications and other chronic diseases in older subjects.

Adolescent↗