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Biomedical subjects

D Sullivan

Publications and source records attributed to D Sullivan.

At least 127 records · Page 7Linked to original sources
PubMed1985

The vulnerable child syndrome: fact and theory.

Studies which have evaluated parent-child relationships following a life-threatening event indicate that parents and children have subsequent interactional difficulties. This study sampled a group of 17 mothers who gave birth to a low birth weight infant (mean weight 1260 grams) and compared them to 17 mothers of normal infants matched for age, education and marital status. The mothers were studied at the infant's adjusted chronological age of 12 to 18 months. At that time all infants were developing normally as determined by the Denver Prescreening Questionnaire. The results indicated that mothers of low birth weight infants did not demonstrate any greater degree of depression or over-protection than their matched controls. The findings of this preliminary study suggest the need for reassessing the relationship between prematurity and other life-threatening events and the psychological sequelae associated with the vulnerable child syndrome. Previous studies are reviewed, and their methodologies are discussed.

Adolescent↗
PubMed1984

Evolution of obesity in young people in Busselton, Western Australia.

The height and weight measurement of 928 young people of Busselton were collected over a period of up to 11 years. The prevalence of obesity was low in early childhood and increased progressively through adolescence and adulthood, so that 9% of male subjects and 16% of female subjects aged 21 years or over, were obese. The prevalence and degree of obesity were both greater in female subjects than in male subjects. Although most obese young adults were not obese in childhood, 50% of those who were obese between the ages of 9 and 14 years were still obese when examined in young adult life, and were at greater risk of becoming obese adults than were their non-obese peers. Most subjects who subsequently became obese young adults were significantly heavier than their non-obese peers at all ages from the age of 6 years.

Adolescent↗
PubMed1984

Medial restraints to anterior-posterior motion of the knee.

We investigated the motion of cadaver knees before and after section of the medial structures and anterior cruciate ligament. The knees were tested using a 5-degrees-of-freedom in vitro knee-testing apparatus that measured anterior-posterior, medial-hateral, and axial displacement as well as internal-external and valgus-varus rotation. The fiexion angle could be varied but was fixed for each individual test. A 125-newton anterior-posterior force was applied perpendicular to the tibial shaft and the resulting motion of the knee was measured. In five knees the anterior cruciate ligament was cut first, followed by progressive cuts of the structures on the medial side (superficial medial collateral ligament, deep medial ligament, oblique fibers of the superficial medial ligament, and the posteromedial part of the capsule). Conversely, in five knees the medial structures were progressively cut first, followed by section of the anterior cruciate ligament. Tests were performed after each cut. With an intact anterior cruciate ligament, progressive cutting of the medial side had no effect on anterior and posterior displacements. When section of the medial structures followed cutting of the anterior cruciate ligament, anterior displacement exceeded that seen after isolated section of the anterior cruciate ligament. The anterior and posterior load-tests were repeated with the tibia fixed in 5 degrees of internal and 5 degrees of external rotation. Fixed external notation had no effect on anterior and posterior displacements. Fixed internal rotation significantly decreased anterior displacement only when both the anterior cruciate ligament and the medial structures were cut. The amounts of tibial rotation and tibial torque resulting from the applied anterior and posterior forces were low compared with our previous results, and we attributed this to decreased constraints on motion of the knee in the current testing apparatus. CLINICAL RELEVANCE: Athletic injuries of the knee frequently involve both the anterior cruciate ligament and the medial side of the knee. Clinical studies have demonstrated that combined injuries of the anterior cruciate and medial collateral ligaments often cannot be successfully managed conservatively. Our in vitro findings support the clinical data and suggest that injuries to the medial structures further compromise anterior stability when they accompany anterior cruciate injuries.

Adult↗
PubMed1983

Lymphoscintigraphy for malignant melanoma. Surgical considerations.

Lymphoscintigraphy using technetium-99m atimony sulfur colloid was performed in 22 patients with melanoma referred to Duke University Comprehensive Cancer Center in an attempt to identify patterns of regional lymphatic drainage. Scans from six patients revealed lower extremity lesions with three located below the knee, one in the popliteal space, and two others proximal to the knee joint. Despite the location of the primary, all scans but one showed initial drainage to the inguinal nodes bypassing the popliteal lymph node group. Of the three patients who had primary melanoma of the posterior scalp, the lymphatic drainage was directed to the posterior cervical nodes. No drainage to the parotid nodes or anterior neck nodes was visualized. The knowledge gained from lymphoscintigraphy resulted in posterior neck dissections instead of the standard anterior neck dissection and superficial parotidectomy. In areas of ambiguous lymphatic drainage from the trunk, radiocolloid scanning can identify areas at risk for developing metastatic disease. Six lesions within 5 cm of the midline demonstrated bilateral axillary or groin drainage in 83 per cent of the patients. For two lesions near Sappey's line colloidal uptake to the ipsilateral axilla and groin was the rule. After a 3-year follow-up, during which time 70 to 90 per cent of lymph node metastases are predicted to occur, no nodal metastases were ever documented in areas that did not show colloidal uptake. No correlation was found between amount of radiolabel in positive compared to negative nodes, although those nodes that were completely replaced by tumor contained no 99mTc activity and were negative on scanning.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

Hospital payroll costs, productivity, and employment under prospective reimbursement.

This paper reports preliminary findings from the National Hospital Rate-Setting Study regarding the effects of State prospective reimbursement (PR) programs on measures of payroll costs and employment in hospitals. PR effects were estimated through reduced-form equations, using American Hospital Association Annual Survey data on over 2,700 hospitals from 1969 through 1978. These tests suggest that hospitals responded to PR by lowering payroll expenditures. PR also seems to have been associated with reductions in full-time equivalent staff per adjusted inpatient day. However, tests did not confirm the hypothesis that hospitals reduce payroll per full-time equivalent staff as a result of PR.

Cost Control↗
PubMed1981

An analysis of the effects of prospective reimbursement programs on hospital expenditures.

Prospective reimbursement (PR) programs attempt to restrain increases in hospital expenditures by establishing, in advance of a hospital's fiscal year, limits on the reimbursement the hospital will receive for the services it provides to patients. We used data complied from a sample of approximately 2700 community hospitals in the U.S. for each year from 1969 to 1978 to estimate the effects of prospective reimbursement programs on hospital expenditures per patient day, per admission, and, to a lesser extent, per capita. The statistical evidence indicates that some PR programs have been successful in reducing hospital expenditures per patient day, per admission, and per capita. Eight programs--in Arizona, Connecticut, Maryland, Massachusetts, Minnesota, New Jersey, New York, and Rhode Island--have reduced the rate of increase in expenses by 2 percentage points or more per year and, in some cases, by as much as 4 to 6 percentage points. There are indications, although less strong, that PR programs also reduced expenses in Indiana, Kentucky, Washington, western Pennsylvania, and Wisconsin. There are no indications of cost reductions for programs in Colorado and Nebraska. An analysis of the relative effectiveness of the various programs suggests that mandatory programs have a significantly higher probability of influencing hospital behavior than do voluntary programs. Some voluntary programs, however, are shown to be effective.

Analysis of Variance↗
PubMed1980

Accuracy of radionuclide imaging in distinguishing renal masses from normal variants.

To determine the accuracy of scintigraphy in distinguishing true renal masses from normal variants, 40 patients with excretory urographic findings indicating a possible, but not definite, mass lesion were studied. Scintigraphy correctly identified 17 true masses and 17 normal variants. Four false positive and two false negative results were obtained.

Abscess↗
PubMed1979

The organization of a nuclear DNA sequence from a higher plant: molecular cloning and characterization of soybean ribosomal DNA.

The recombinant DNA vector, lambda Charon 4A, was used to construct a library of DNA sequences from the genomic DNA of soybean (Glycine max). To define the organization of ribosomal DNA (rDNA) in the soybean genome, clones containing sequences complementary to both 17S and 25S rRNA have been isolated from this library and used in conjunction with Southern blot hybridization. The rRNA genes are tandemly reiterated with a relatively small unit repeat length of 7.8 kb. There is no heterogeneity in the length of the rDNA repeat units although they display limited differences in either base sequence or pattern of methylation. The cloned rDNA sequences are shown to comprise the entire repeat unit and have been used to obtain a detailed restriction map as well as an approximate transcription map of soybean rRNA genes. The cloning of rDNA from soybean suggests that recombinant DNA techniques can be successfully applied to the genomic DNA of higher plants despite the high degree of methylation exhibited by plant DNA.

Bacteriophage lambda↗
PubMed1979

An evaluation of the 24-hour RAIU test performed with an Anger camera and a pinhole collimator.

RAIU measurements obtained with a conventional thyroid uptake probe have been compared with those obtained with an Anger camera and a pinhole collimator. Although the field distribution for the pinhole collimator deviates markedly from the IAEA recommendations, the group data from the comparative measurements in this series were identical, with a confidence level of 99%. However, in several cases the data from differing measurement regimes for individuals varied markedly.

Humans↗
PubMed1977

The treatment of perceptual disturbances in schizophrenia with naloxone hydrochloride.

The authors treated 12 schizophrenic patients who had overt hallucinatory symptoms with intravenously administered naloxone hydrochloride, a narcotic antagonist purported to have antihallucinatory properties. They found no evidence of the effectiveness of naloxone in preventing hallucinations over that of placebo when administered in a randomized, double-blind fashion.

Adult↗
PubMed1977

Gray scale ultrasound and isotope scanning: complementary techniques for imaging the liver.

Technical advances in gray scale ultrasound have led to better signal-to-noise ratios and improved resolution. A display of the texture of the liver is now possible, making ultrasound an important complementary technique to radioisotope scanning. In the positive radioisotope scan, ultrasound permits differentiation of isotopically cold areas into neoplasms, benign cysts, and abscesses. In addition, when the radioisotope scan is equivocal, ultrasound is invaluable in differentiating normal variants from disease states. Dilated intrahepatic ducts can also be identified. Examples of the use of ultrasound in defining radioisotope abnormalities are presented.

Adult↗