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Biomedical subjects

G Bond

Publications and source records attributed to G Bond.

18 recordsLinked to original sources

Irradiation-induced atherosclerosis: a factor in therapeutic planning.

Early primary head and neck cancers (stages I and II) and occult metastatic neck disease have caused debate regarding the choice between surgery and irradiation. The arguments for each are reviewed with a new consideration: the acceleration and/or induction of carotid atherosclerosis in irradiated patients. We present clinical case reports (n = 9), a retrospective clinical evaluation for the occurrence of carotid atherosclerosis in irradiated head and neck cancer patients (n = 57) and a comparison study of the extent and distribution of atherosclerosis in irradiated (n = 29) and nonirradiated head and neck cancer patients controlled for age, blood pressure, and tobacco use. The results show that carotid atherosclerosis is found in a wider anatomic distribution and to a greater extent in irradiated than in nonirradiated patients. We conclude that carotid atherosclerosis is induced and/or accelerated by neck irradiation. The implications as they relate to choice of treatment, to pretreatment evaluations, and to long-term follow-up are discussed.

Aged

The Psychosocial Levels System. A new rating scale to identify and assess emotional difficulties during bone marrow transplantation.

The "Psychosocial Levels System" assesses patients on three gradations of intensity: Level 1 (mild/minimal); Level 2 (moderate); and Level 3 (severe), taking into account past psychiatric history, quality of family and social support, prior coping history, coping with disease and treatment, quality of affect, proneness to anticipatory problems, and mental status. Based on initial psychiatric interviews, 42 BMT patients were rated by the authors. Results showed strong and significant concordance amongst raters. Retrospective global "level" ratings assigned by each patient's liaison therapist were highly concordant with the record-review generated ratings by the authors, emphasizing the significant convergent validity of the system.

Adaptation, Psychological

Asymmetrical nature of the muscular anatomy of the infantile pylorus: a possible consideration in pyloromyotomy.

Post-mortem studies of the normal infantile pylorus have demonstrated an asymmetrical structure with the mucosa protruding under the circular muscle at the lesser curve but not on the anterior surface. In addition the circular muscle was often discontinuous at the pyloroduodenal junction with only longitudinal fibres or even fibrous tissue separating the mucosa from the serosa. In a further specimen in which a pyloromyotomy had been performed 10 weeks previously, this asymmetry was more pronounced. This anatomy suggests that in pyloric stenosis it may be safer to site the caudal part of the pyloromyotomy incision on the anterior surface, rather than on the anterosuperior surface as most authors recommend. Perforation of the mucosa is predicted to be less likely.

Humans

A comparison of antihypertensive drug effects on the progression of extracranial carotid atherosclerosis. The Multicenter Isradipine Diuretic Atherosclerosis Study (MIDAS).

Hypertension is a major risk factor for coronary heart disease (CHD) and is the primary risk factor for stroke. Drug trials lowering blood pressure by pharmacological means have demonstrated impressive reduction in both fatal and nonfatal stroke (33 to 50%) that are virtually identical to the predicted stroke reduction, considering the observed diastolic blood pressure change (5 to 6mm Hg). On the other hand, reduction of CHD risk has been less impressive in these same trials. Although statistically significant, the reduction in CHD risk is roughly one-half (14%) of that predicted (25%) when results from these drug trials are analysed in aggregate. Most trials have used moderate to high dosages of thiazide diuretics or beta-blockers as therapies. Several factors may account for the disappointing results in CHD risk reduction. These drugs may induce metabolic disturbances in lipids, increased glucose tolerance, insulin resistance, or cause inadequate regression of left ventricular hypertrophy, thus attenuating the predicted reduction in CHD risk associated with pharmacological blood pressure lowering. Isradipine is a new dihydropyridine calcium antagonist that is highly effective in lowering blood pressure. Isradipine also has antiatherogenic properties in animal models of atherosclerosis. The effect of isradipine on atherosclerosis in humans is unknown. The Multicenter Isradipine Diuretic Atherosclerosis Study (MIDAS) is a 3-year double-blind, randomised trial in over 800 men and women with hypertension, aged 40 years or older. The primary aim of MIDAS is to compare the efficacy of isradipine 2.5 to 5.0mg twice daily vs hydrochlorothiazide 12.5 to 25mg twice daily in retarding the progression of extracranial carotid atherosclerosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Copper metabolism in growing sheep given kale (Brassica oleracea) and ryegrass (Lolium perenne)-clover (Trifolium repens) fresh forage diets.

Kale (Brassica oleracea) and ryegrass (Lolium perenne)-clover (Trifolium repens) pasture grown under similar soil conditions were grazed in the vegetative state by growing lambs of 23.6 kg initial live weight for 24 weeks. Forty-eight lambs grazed each forage. The kale and pasture contained respectively 4 and 14 mg copper/kg dry matter (DM), 7.2 and 3.1 g total sulphur/kg DM and 0.4 and 1.1 mg molybdenum/kg DM. Subcutaneous injections of Cu (12 mg) were given to half the animals grazing each forage during weeks 1, 6, 12 and 18. All ninety-six animals were slaughtered at the end of the experiment and an additional group of twelve animals was slaughtered when the experiment commenced. Liver Cu was determined on all slaughtered animals and heart muscle cytochrome oxidase (EC 1.9.3.1) activity on those slaughtered at week 24. Blood samples removed at 6-week intervals were assayed for activity of superoxide dismutase (EC 1.15.1.1; SOD) and serum Cu concentration determined. Wool growth, live-weight gain and cytochrome oxidase activity of biopsied hind-limb muscle were also measured at 6-week intervals. Control animals grazing pasture showed an accumulation of total liver Cu during the experiment. Animals grazing this diet and given Cu injections showed an additional accumulation of liver Cu equivalent to the supplementary Cu administered, but Cu supplementation did not affect the activity of any of the Cu-containing enzymes measured and did not affect live-weight gain or wool growth. Control animals grazing kale showed a depletion of total liver Cu and reductions in serum Cu concentrations during weeks 18 and 24.(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Feed

Influence of arsenic exposure and smoking on lung cancer among smelter workers: a pilot study.

A pilot study of 300 smelter workers from the cohort reported by Lee and Fraumeni [1969] has been studied: 150 men from their heavy exposure group and 150 men from the rest of the cohort randomly selected. Usable smoking habits were obtained from 86% of the sample. Estimates of the total lifetime work exposure were made from available measurements. A very high risk of lung cancer (SMR 1429) was observed among the most heavily exposed workers. Excess risks, though still present, were much less in those with lower exposures. There was a lower proportion of nonsmokers among the heavily exposed arsenic workers than among the other workers. This suggests that there may be some interaction between smoking and arsenic exposure. Moreover, comparison of smoking habits reported by smelter workers suggested that, as a group, they smoked more heavily than average for the United States population. A small study of proxy smoking histories suggested that these were valid and unbiased. The work continues on an enlarged sample.

Arsenic

A correlation between a spectrophotometric quantitation of rabbit spermatozoan motility and velocity.

Rabbit sperm motility was measured spectrophotometrically and a sperm motility index (SMI) was obtained. A comparative analysis between the SMI values and the velocity of motile sperm (obtained by time lapse photography of sperm tracks) was performed. The SMI specifically was compared to the mean velocity of the first 300 sperm cells observed and to the mean velocity of just the first 300 progressively motile sperm cells. In both comparisons, the SMI was highly correlated to the sperm track length (sperm velocity). In addition, a modification of the spectrophotometric procedure is described which allows measurements of the SMI to be made on semen extended into egg-yolk glycerine cryopreservation agents.

Animals

Alcoholics in interactional group therapy: an outcome study.

Three interactional therapy groups of alcoholic patients (N = 20) were formed, and treatment outcome after eight months and again after 12 months of therapy was compared with the outcome of 17 neurotic patients in comparable therapy. Outcome assessment was obtained from three sources: patient, therapist, and independent judge, using both nomothetic and ideographic measures. The results indicated that although more alcoholic than neurotic patients terminated therapy within the first six sessions, a higher percentage of alcoholic patients remained in therapy for 12 months. At the end of 12 months, both samples had improved along a wide variety of variables, and there were no significant differences between the alcoholic and neurotic population in degree of improvement.

Adult

The impact of a weekend group experience on individual therapy.

Thirty-three patients in long-term individual therapy were referred to one of three weekend groups: two experimental (affect-arousing, gestalt therapy) groups and one control (meditation-Tai Chi) group. The impact of the weekend group experience (WGE) on individual therapy was examined six and 12 weeks later. At six weeks the patients in the experimental groups showed, on some measures, a significantly greater improvement in their individual therapy than did controls. By 12 weeks, there were no demonstrable differences. The WGE was not without risk: even though the group leaders were highly trained, responsible clinicians, two patients suffered considerable psychological damage. The control (meditation-Tai Chi) group offered a relatively innocuous experience; there was no risk, but few members found the specific procedures useful in their lives. Intense affect arousal in the WGE was not related to positive change in subsequent individual therapy. Those expressing the greatest affect in either experimental group were no more likely to have had a measurable positive impact on their subsequent individual therapy than patients expressing little or no measurable affect.

Adjustment Disorders

Outcome in psychotherapy evaluated by independent judges.

To overcome common limitations in assessing the outcome of psychotherapy, the following method was used: independent assessment by teams of experienced psychotherapists; individualized measures of outcome; and videotaped clinical interviews to allow the judges to rate, at one sitting, a patient's clinical state before and after eight months of therapy. Agreement between the judges' ratings was low both for the severity of the clinical state and for its outcome. Possible reasons for this low agreement are discussed.

Adult

Patients' expectations of therapeutic improvement and their outcomes.

The authors studied the relationship between patients' expectations of therapeutic improvement and their actual outcomes after 8 and 12 months of group psychotherapy. Using patients' self-evaluations and assessments by therapists and independent judges, they found a positive relationship between expectations and outcomes only when assessments were derived from patients. The authors discuss the possibility of a continuing expectational set in patients toward psychotherapy.

Adult

The future.

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Diving