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Biomedical subjects

J D Webster

Publications and source records attributed to J D Webster.

At least 19 recordsLinked to original sources
PubMed2005

Impact of tumour depth, tumour location and multiple synchronous masses on the prognosis of canine cutaneous mast cell tumours.

The goal of this study was to determine the significance of tumour depth, tumour location and multiple synchronous tumour masses for the prognostic evaluation of canine cutaneous mast cell tumours (MCTs). The study population consisted of 100 formalin-fixed, paraffin-embedded cutaneous MCTs that had been surgically removed from 100 dogs and submitted to the Diagnostic Center of Population and Animal Health at Michigan State University between 1998 and 2001. None of the dogs had received chemotherapy or radiation therapy. For each case the following data were obtained from the referring veterinarians: sex, breed, weight, age at diagnosis, diagnostics performed, adjunct medications given at the time of surgery, tumour location, number of tumour masses, tumour recurrence (development of MCTs at the surgical site), development of additional MCTs at distant sites (outside the surgical margins), tumour duration before removal, survival time and cause of death, if applicable. Tumour depth was determined through microscopic evaluation of 5 microm sections stained with haematoxylin and eosin. Based on univariable and multivariable survival analysis, dogs with multiple synchronous cutaneous MCTs at the time of diagnosis have a worse prognosis compared with dogs with single tumours. Additional treatment beyond surgical excision alone should be considered for these animals. Older dogs and Boxers with cutaneous MCTs were at higher risk to develop additional MCTs at distant sites (outside the surgical margins), and older and male dogs with cutaneous MCTs had significantly shorter survival times. Univariable analysis also determined that dogs with cutaneous MCTs located on the head and neck had an increased risk of additional MCT development at distant sites and that sterilized dogs with cutaneous MCTs had shorter survival times. However, these findings were not confirmed by multivariable analysis. Tumour depth was of no prognostic significance for dogs with cutaneous MCTs.

Animals↗
PubMed2004

The use of KIT and tryptase expression patterns as prognostic tools for canine cutaneous mast cell tumors.

Cutaneous mast cell tumors (MCTs) are one of the most common tumors in dogs. Currently, prognostic and therapeutic determinations for MCTs are primarily based on the histologic grade of the tumor, but a vast majority of MCTs are of an intermediate grade, and the prognostic relevance is highly questioned. A more detailed prognostic evaluation, especially of grade 2 canine MCTs, is greatly needed. To evaluate the prognostic significance of KIT and tryptase expression patterns in canine cutaneous MCTs, we studied 100 cutaneous MCTs from 100 dogs that had been treated with surgery only. The total survival and disease-free survival time and the time to local or distant recurrence of MCTs were recorded for all dogs. Using immunohistochemistry, 98 of these MCTs were stained with anti-KIT and antitryptase antibodies. Three KIT- and three tryptase-staining patterns were identified. The KIT-staining patterns were identified as 1) membrane-associated staining, 2) focal to stippled cytoplasmic staining with decreased membrane-associated staining, and 3) diffuse cytoplasmic staining. The tryptase-staining patterns were identified as 1) diffuse cytoplasmic staining, 2) stippled cytoplasmic staining, and 3) little to no cytoplasmic staining. Based on univariate and multivariate survival analysis, increased cytoplasmic KIT staining was significantly associated with an increased rate of local recurrence and a decreased survival rate. The tryptase-staining patterns were not significantly associated with any survival parameter. On the basis of these results, we propose a new prognostic classification of canine cutaneous MCTs, according to their KIT-staining pattern, that can be used for the routine prognostic evaluation of canine cutaneous MCTs.

Animals↗
PubMed1998

Immunization coalitions that work: training for public health professionals.

Coalition development is a major strategy to increase immunization rates. However, if local and state coalitions are to succeed, their staffs need training and technical assistance in coalition development, community planning, and program implementation. The National Coalition Training Institute trains key health agency staff in 87 state, territorial, and urban sites to perform needs assessments, use data to guide planning, plan comprehensive strategies, and evaluate their coalitions. The curriculum is based on training needs that are identified by a national survey of immunization coalitions, effective approaches, and participant evaluation. According to evaluations conducted during its first year, the National Coalition Training Institute is meeting the needs of participants.

Curriculum↗
PubMed1998

CINCH: an urban coalition for empowerment and action. Consortium for the Immunization of Norfolk's Children.

CINCH (Consortium for the Immunization of Norfolk's Children) is an urban coalition that was developed in 1993 to improve childhood immunization rates in Norfolk, Virginia. CINCH involves diverse citizens and institutions in effective community-based assessment, planning, and action. A needs assessment from 1993 found that only 49% of Norfolk 2-year-olds were adequately immunized. Using this data, CINCH developed a plan focused on education and communication, support for at-risk families, increased access to immunizations, and improved immunization delivery. After federal funding ended in 1995, members voted to expand the scope of the coalition to address additional child health needs and to broaden the membership. CINCH is a model for a sustainable city-citizen learning environment that intervenes to "help families help themselves to better health." The coalition is presented as an organization that focuses on community empowerment and development. The stages of coalition development and implications for coalition implementation in other sites are discussed.

Child↗
PubMed1997

A nitrogen-free hypocaloric diet and recombinant human growth hormone stimulate postoperative protein synthesis: fasted and fed leucine kinetics in the surgical patient.

Twelve otherwise healthy patients undergoing elective surgery for resection of rectosigmoid adenocarcinoma were randomly allocated to two groups: one group receiving intravenous dextrose 5% 600 to 800 kcal.d-1 (DX, n = 6) and the other group receiving the same amount of dextrose intravenously plus recombinant human growth hormone (DX + rGH, n = 6). Supplementation with rGH started on the day of surgery and continued postoperatively for 5 days. No nitrogen was provided in the diet. This regimen was started 3 days before surgery and continued for 5 days after surgery. Protein kinetics were studied over a period of 8 hours in all patients. Following an overnight fast, a primed constant infusion of L-[1-13C]leucine was maintained for 4 hours (fasted state) and continued for a further 4 hours (fed state) during which 5% beet dextrose (low 13C content) with or without rGH was administered. The isotope studies were performed on the day before surgery and 6 days after surgery. Other measurements included urinary nitrogen excretion, gaseous exchange, and plasma concentrations of insulin, GH, and insulin-like growth factor-I (IGF-I). Addition of rGH to the dextrose diet had a significant positive effect on protein synthesis (P = .02). Surgery was responsible for a significant increase in postoperative whole-body protein breakdown and synthesis and leucine oxidation (P < .01), although lesser changes were observed in the DX group. An interaction between rGH and surgery was associated with a significant increase in protein synthesis (P = .009), but not with changes in either protein breakdown or leucine oxidation. Carbohydrate provision in the form of beet dextrose during the fed state of the isotopic study did not attenuate the significant decrease in protein synthesis (P = .01) or breakdown (P = .003) either before or after surgery, probably reflecting the absence of nitrogen in the diet. No significant interaction was found between rGH and feeding. These results of leucine kinetics indicate that addition of rGH to a low-dextrose intake in the absence of dietary nitrogen can actually promote protein synthesis. The low levels of leucine oxidation could be explained by the fact that amino acids resulting from protein degradation were directed preferentially toward resynthesis of new proteins rather than to oxidative pathways. There was a significant increase in plasma insulin and GH in the group receiving rGH (P < .05). The postoperative plasma concentration of IGF-I did not change in the latter group compared with the DX group, in which IGF-I concentration decreased significantly (P < .05) as part of the response to combined surgery and dietary restriction. Although both IGF-I and insulin are independently capable of stimulating protein synthesis, elevated levels of either hormone or GH itself may primarily modulate protein synthesis, even with a low intake of carbohydrates.

Adenocarcinoma↗
PubMed1997

Growth hormone modulates amino acid oxidation in the surgical patient: leucine kinetics during the fasted and fed state using moderate nitrogenous and caloric diet and recombinant human growth hormone.

Twelve patients (aged 70 +/- 9 years) who were scheduled for resection of rectosigmoid colon adenocarcinoma but were otherwise healthy were randomly allocated after surgery to receive either peripheral parenteral nutrition alone ([PPN] n = 6) or in combination with recombinant human growth hormone (rGH) at a daily dose of 0.15 U x kg(-1) x d(-1)(PPN + rGH, n = 6). The daily nutritional regimen was 0.1 g nitrogen x kg(-1) x d(-1) and 20 kcal x kg(-1) x d(-1) (nonprotein energy was supplied as 60% lipid and 40% carbohydrate), and it was maintained for 6 days before and 6 days after surgery. Protein kinetics were studied in all 12 patients during the fasted and fed states before and 6 days after surgery using an 8-hour 13C-leucine tracer infusion. Daily urinary nitrogen, gaseous exchange, and plasma insulin, growth hormone, and insulin-like growth factor-I (IGF-I) were determined before and after surgery. Surgery was responsible for significant increases in postabsorptive whole-body protein flux and synthesis and leucine oxidation (P < .01). Supplementation of PPN with rGH contributed to a significant attenuation of the postoperative increase in leucine oxidation (P = .02), with a significant increase in whole-body protein synthesis (P = .02) and no effect on protein breakdown (P = .40). During the fed state, leucine oxidation increased significantly (P = .005), with the greatest change occurring in the PPN group. Feeding was associated with a significant decrease in whole-body protein breakdown before and after surgery in both groups (P = .001). Postoperative urinary nitrogen excretion was lower but was not statistically significant in the PPN + rGH group compared with the PPN group. There was a significant increase in oxygen consumption (VO2) and carbon dioxide production (VCO2) as a result of feeding and surgery (P < .01). Supplementation with rGH caused a decrease in the respiratory quotient (RQ) (P = .04), particularly after surgery, indicating a direct effect of rGH on fatty acid oxidation. Circulating plasma insulin increased significantly in both groups with feeding and rGH supplementation (P < .05). This was enhanced after surgery, particularly in the rGH group (P < .05). Plasma growth hormone decreased after surgery in the PPN group (P < .05), but did not change as a result of feeding. The circulating levels increased in the PPN + rGH group following subcutaneous administration before or after surgery. Plasma IGF-I decreased after surgery in the PPN group (P < .05), and no changes occurred in the PPN + rGH group with feeding. The present findings suggest a distinct positive effect of rGH on protein synthesis in catabolic patients receiving a moderate intake of nitrogen and calories. This is achieved by modulation of amino acid oxidation. The acute effect of intravenous (IV) nutrients on protein metabolism during the catabolic phase of surgical stress caused a direct decrease in protein breakdown with no effect on protein synthesis.

Adenocarcinoma↗
PubMed1997

The Reminiscence Functions Scale: a replication.

This article reports the findings of a replication and validation study of the factor structure of the recently developed Reminiscence Functions Scale (RFS) [1]. Three hundred and ninety-nine adult subjects ranging in age from seventeen to forty-five years (M age = 22.7, SD = 5.7) completed the RFS. A principal components analysis indicated the viability of an eight-factor scale which strongly parallels the earlier scale construction. Factors were labeled: Boredom Reduction, Death Preparation, Identity, Problem-Solving, Conversation, Intimacy Maintenance, Bitterness Revival, and Teach/Inform. Internal consistency scores ranged from .74 to .86 and closely duplicated original scores. Age differences on Death Preparation and Teach/Inform were replicated. Potential uses of the RFS are documented.

Adolescent↗
PubMed1995

Post-surgery epidural blockade with local anaesthetics attenuates the catecholamine and thermogenic response to perioperative hypothermia.

Core (aural canal) and mean skin (15 sites) temperatures, plasma adrenaline, noradrenaline and metabolites, and gaseous exchange were measured before, during and for 4 h after surgery in sixteen patients scheduled for elective colorectal surgery. All patients received general anaesthesia and no measures were taken to prevent the perioperative loss of body heat. At time of abdominal wall closure, when the core temperature was below 35.0 degrees C, the patients were randomly allocated to receive either 20-30 mg of papaveretum i.v. (papaveretum group, n = 8) or 15 ml of bupivacaine 0.75% via thoracic (T9) epidural route to obtain a T4-S5 sensory blockade (epidural group, n = 8). Continuous infusion of either i.v. papaveretum or epidural 0.25% bupivacaine was continued after surgery. During the recovery period of four hours the rate of increase in core and mean skin temperatures was significantly slower in the epidural group compared with the papaveretum group (P < 0.01). Plasma catecholamine concentrations remained elevated after surgery in the papaveretum group, whilst they decreased significantly once epidural blockade was established (P < 0.001). There was a lower trend, however not significant, in the rise of postoperative oxygen consumption and plasma glucose concentration in the epidural group compared with the papaveretum group.

Aged↗
PubMed1993

Construction and validation of the Reminiscence Functions Scale.

This research introduces the Reminiscence Functions Scale (RFS), a 43-item questionnaire that can be used to assess reminiscence functions over the lifecourse. Adults (710) ranging in age from 17 to 91 (mean age = 45.76 years) completed a 54-item Reminiscence Functions Scale-prototype measure, the results of which were submitted to a principal components analysis. Results indicated the viability of a 43-item, 7-factor solution with good reliability. Factors were labeled: Boredom Reduction, Death Preparation, Identity/Problem-Solving, Conversation, Intimacy Maintenance, Bitterness Revival, and Teach/Inform. A separate validity study demonstrated the predictive validity of the RFS. Directions for future research are discussed.

Adolescent↗
PubMed1989

Effects on weight and metabolic rate of obese women of a 3.4 MJ (800 kcal) diet.

103 obese women (mean [SD] Quetelet's index [weight/height2] 38 [8] kg/m2) were admitted to a metabolic ward and were kept strictly to a diet providing 3.4 MJ (800 kcal) daily for 3 weeks. Body weight was measured daily and fasting resting metabolic rate (RMR) on days 1, 7, and 21. Both weight and RMR fell more rapidly in the first week than later. The thermic effect of feeding fell immediately on the lower energy intake, and there was an adaptive reduction of about 6% in RMR in week 1. After 3 weeks, the average weight loss was 4.9 (1.2) kg (about 5% of initial weight) and the average fall in RMR 8.8%. If after substantial weight loss a woman eats just enough to maintain energy balance the adaptive reduction in metabolic rate is restored to normal, and the thermic effect of feeding is restored in proportion to the new energy intake, but total energy requirements remain less than in the obese state to the extent that fat-free mass has been reduced. Thus, an obese woman who reduces weight by 30% over a year will thereafter have requirements for weight maintenance which are reduced by about 15%.

Adult↗
PubMed1989

Weight loss in 108 obese women on a diet supplying 800 kcal/d for 21 d.

A series of 108 obese women were studied for 21 d in a metabolic ward on a diet supplying 800 kcal/d (3.4 MJ/d), with 4.5 g protein nitrogen, 40% energy from fat, and 46% from carbohydrate. The average total weight loss was 5.0 kg. During the second and third week on the diet the rate of weight loss was 211 +/- 77 g/d (mean +/- SD) and individual values were well predicted by admission resting metabolic rate (RMR) (r = 0.66, p less than 0.0001). The calculated energy density of the weight lost in this phase was 7000 kcal/kg (29.3 MJ/kg). However, the weight loss in the first week had a labile component of 815 +/- 1202 g, which was not well predicted by RMR (r = 0.20, p less than 0.05). The effect of this labile component was to obscure the overall rate of weight loss so some of the patients did not show net weight loss until day 13 of the diet, although they were in negative energy balance.

Adult↗
PubMed1989

Inpatient-outpatient randomized comparison of Cambridge diet versus milk diet in 17 obese women over 24 weeks.

Twenty-two obese women were recruited for a prospective cross-over trial of the effects of either the Cambridge Diet (CD) or 1200 ml milk with iron and vitamin supplements (milk) during a three-week inpatient study, then 20 weeks as outpatients, then a final week as inpatients. Five dropped out, leaving eight who took initially milk and then CD and nine who took CD and then milk. Within each diet group five women had their jaws wired together during the outpatient phase. The four groups (CD/milk, with/without jaw wiring) were initially well matched for age, height, weight and resting metabolic rate (RMR). There was no significant difference (by unpaired t test) between the groups during the initial inpatient phase in rate of weight loss, or N loss/kg weight loss, but patients on CD during days 13-22 had a greater daily N loss than those on milk (2.08 vs 0.28 g N/day, P = 0.02). When the change in weight loss, N loss and N/kg weight loss on changing diet within a patient group was compared by paired t test the patients changing from milk to CD showed no significant change, but patients changing from CD to milk showed a reduced rate of weight loss (0.36-0.23 kg/day; P = 0.012), a reduced N loss (2.02-0.28 g N/day; P = 0.0013) and reduced loss of N/kg (6.26 to 1.02 g N/kg; P = 0.025). During the outpatient phase weight loss was not significantly related to the diet, but patients with jaws wired lost more weight than those without jaw wiring (0.151 vs 0.077 kg/day; P = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Process variables of the life review: counseling implications.

The concept of the life review as a developmental process is examined with three main objectives. First, the life review is placed within a developmental framework as a dynamic rather than static occurrence in which the individual is an active agent. Secondly, in order to clarify the possible process variables of the life review, three interactive stages are identified and elaborated. Finally, possible counseling interventions are suggested for practitioners working with elderly persons.

Aged↗
PubMed1987

Metabolic effects and secretory properties of a radiation-induced transplantable rat insulinoma.

The metabolic effects and secretory properties of a radiation-induced transplantable insulinoma were examined in 16-17 week old NEDH rats. Subcutaneous subscapular implantation of tumour fragments resulted in hyperphagia, increased body weight gain, marked hyperinsulinaemia and severe hypoglycaemia, with the resulting death of the recipient by 27 days. Ultimate tumour size was 2.1 +/- 0.4 g (mean +/- SEM). At 3 days after transplantation, plasma glucose and insulin responses to intraperitoneal glucose, insulin, arginine and adrenaline were similar to control rats. At 20 days, plasma glucose concentrations of insulinoma-bearing rats remained low throughout glucose tolerance tests, and insulin responsiveness to glucose stimulation was absent. 2-Deoxy-D-glucose produced only a small rise of glucose concentrations in tumour-bearing rats. Insulin sensitivity was not appreciably impaired at 20 days despite severe hyperinsulinaemia and hypoglycaemia. The ability of adrenaline and propranolol to suppress plasma insulin and raise plasma glucose concentrations was also retained. At 20 days, glucagon evoked a marked plasma insulin response with no change in plasma glucose concentrations. In contrast, arginine and glibenclamide failed to stimulate insulin above high basal concentrations.

Adenoma, Islet Cell↗
PubMed1987

A cross-sectional cost/benefit audit in a hospital obesity clinic.

A cross-sectional survey was made of the 25 men and 127 women attending a hospital obesity clinic over a period of 6 weeks. Among the men the mean (+/- s.d.) age was 37 (+/- 14) years, weight 115.2 (+/- 25.4) kg, height 1.70 (+/- 0.09) m, and Quetelet's index 39.6 (+/- 6.4) kg/m2. Among the women the corresponding values were 41 (+/- 15) years, 102.2 (+/- 22.3) kg, 1.60 (+/- 0.07) m, and 40.3 (+/- 9.2) kg/m2. The most common reasons for wishing to lose weight among both men and women was to improve appearance, shortness of breath and pain in weight-bearing joints. About one-third of the patients tested had raised fasting plasma triglyceride levels. Only one had tests indicating hypothyroidism, and two were hyperthyroid. None of these characteristics predicted how long the patient would continue to attend the clinic. Weight loss was calculated according to the duration of attendance at the clinic, and the method of treatment. Two men and 15 women were treated by jaw-wiring, and the remainder by dietary advice alone. No anorectic or thermogenic drugs were used. Among men treated by diet alone the mean weight loss after 1-3 months, 4-6 months, 7-12 months and greater than or equal to 13 months attendance was 5.0 +/- 6.2 kg, 12.4 +/- 11.0 kg, 12.4 +/- 10.2 kg and 13.0 +/- 5.2 kg respectively. Two men treated by jaw-wiring had lost 23.9 and 57.9 kg.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Description of a human direct calorimeter, with a note on the energy cost of clerical work.

1. A heat-sink calorimeter, suitable for the measurement of energy expenditure in human subjects over periods up to 26 h, is described. 2. The performance of the calorimeter is illustrated by a study of four normal subjects at rest or performing clerical work for a period of 7.5 h. Each condition was measured in duplicate in each subject. On the resting days the subjects were recumbent, and on the working days they were seated throughout the measurement period. Heart rate was monitored by infra-red telemetry and physical activity by an ultrasound movement detector. Urinary cortisol excretion was also measured as an indicator of stress. 3. In each subject the mean heat loss on working days was higher than that on resting days: the increase ranged from 5.1% to 16.7%, with a mean value of 10.0% (P = 0.015). There was no significant difference between resting and working days in heart rate, physical activity or urinary cortisol excretion. 4. The present study confirms that tiring clerical work has very little effect on 24 h energy expenditure.

Adult↗