Relative strength predicts function even in the obese.
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Activities of Daily Living↗
Biomedical subjects
John J Lee
Publications and source records attributed to John J Lee.
Breast conserving surgery and accelerated partial breast irradiation using the MammoSite system: initial clinical experience.
HYPOTHESIS: Balloon catheter-based accelerated partial breast irradiation (APBI) may result in desirable short-term outcomes in patients undergoing breast conserving surgery. DESIGN: Prospective consecutive case series. SETTING: Tertiary multidisciplinary referral center. PATIENTS: Forty selected patients with invasive breast carcinoma undergoing breast conserving surgery and MammoSite device placement. INTERVENTIONS: Breast conserving surgery, sentinel and/or axillary node dissection, placement of the new balloon catheter applicator (MammoSite device), and APBI. MAIN OUTCOME MEASURES: Infection, early and late seroma, device explantation, time to initiating APBI, acute toxic effects on the skin, and cosmesis using the Harvard Scale. RESULTS: Thirty-nine patients underwent MammoSite device placement at the time of lumpectomy; 1 patient underwent percutaneous device placement after lumpectomy. Nineteen patients (49%) had drainage catheters placed in the breast cavity at the time of lumpectomy. Wound infection developed in 3 patients (8%). Five devices (12%) were explanted because of unfavorable final pathological findings or infection. The mean time to the start of APBI in patients who did not undergo simultaneous drain placement was 7.2 days (range, 5-12 days), compared with 5.1 days (range, 3-8 days) in patients who did (P = .008). With a mean follow-up of 13.3 months (range, 2-28 months), patients completing APBI had limited toxic effects on the skin, with excellent or good cosmetic results in 39 patients (97%). CONCLUSIONS: Use of the MammoSite system in APBI has favorable short-term outcomes. Infection and radiation treatment delay are common and may warrant use of perioperative antibiotics and drain placement, respectively. A small number of patients who have device placement at the time of lumpectomy will require explantation because of unfavorable final pathological findings. Short-term outcomes of MammoSite brachytherapy support further studies comparing APBI with standard whole breast irradiation in patients undergoing breast conserving surgery.
Adult↗
Sensitivity of multiple damage parameters to compressive overload in cortical bone.
Damage accumulation plays a key role in weakening bones prior to complete fracture and in stimulating bone remodeling. The goal of this study was to characterize the degradation in the mechanical properties of cortical bone following a compressive overload. Longitudinally oriented, low-aspect ratio specimens (n=24) of bovine cortical bone were mechanically tested using an overload-hold-reload protocol. No modulus reductions greater than 5% were observed following overload magnitudes less than 0.73% strain. For each specimen, changes in strength and Poisson's ratio were greater (p=0.02) than that in modulus by 10.8- and 26.6-fold, respectively, indicating that, for the specimen configuration used in this study, longitudinal elastic modulus is one of the least sensitive properties to a compressive overload. Residual strains were also proportionately greater by 6.4-fold (p=0.01) in the transverse than axial direction. These results suggest that efforts to relate microcrack density and morphology to changes in compressive mechanical properties of cortical bone may benefit from considering alternative parameters to modulus reductions.
Adaptation, Physiological↗
Pupil dilation with intracameral 1% lidocaine during glaucoma filtering surgery.
PURPOSE: To evaluate pupil dilation from intracameral injection of nonpreserved 1% lidocaine. DESIGN: Observational case series of 25 consecutive phakic trabeculectomies. METHOD: Patients were evaluated in the operating room setting and given one drop of topical tetracaine preoperatively. Nonpreserved 1% lidocaine (0.1 cc) was injected intracameraly into the anterior chamber through a paracentesis site at the corneal limbus. Pupil diameter was measured after instillation of topical tetracaine, before injection of intracameral lidocaine. Postinjection measurements were made at 1, 3, and 5 minutes. RESULTS: The mean male pupil diameter was significantly greater than female dilation at every time point. The mean blue iris diameter was greater than brown at 1 and 3 minutes, but there was no difference at 5 minutes or more. There was no racial difference in the pupil dilation response to intracameral lidocaine. CONCLUSIONS: Nonpreserved intracameral 1% lidocaine produces immediate pupil dilation in previously undilated phakic patients during trabeculectomy surgery.
Anesthesia, Local↗
A marine dinoflagellate, Amphidinium eilatiensis n. sp., from the benthos of a mariculture sedimentation pond in Eilat, Israel.
A species of Amphidinium bloomed in a mariculture sedimentation pond that was used to grow bivalves near the Gulf of Eilat, Israel. Its overall length averaged 13 microm, the hypocone was 11 microm, and its width was 8 microm. It has a ventral ridge. The sulcus begins at the longitudinal flagellar pore and does not project forward in the apex toward the transverse flagellar pore and left margin of the cingulum. The sulcus is a very shallow groove that projects variably about a third of the body length toward the antapex. The cingulum is a deep groove as it circles the cell from the left ventral side to the dorsal side and then becomes very shallow on the right ventral side as it arches posterior toward the longitudinal flagellar pore. Using a modified method for studying dinoflagellate chromosomes in the SEM, we observed 31 chromosomes. The plastid is dorsal and peripheral with 6 ventrally projecting peripheral digital lobes that wrap around the sides of the ventral and posterior nucleus. Amphidinium eilatiensis n. sp. is morphologically closest to Amphidinium carterae and Amphidinium rhynchocephalum, but it does not have the obvious thecal plates or polygonal units described for the former species. Instead, it has a series of spicules, bumps, and ridges on its surface. It differs from A. rhynchocephalum by two morphological characters: surface morphology and gross plastid architecture. The amplified fragments of the rDNA from A. eilatiensis n. sp. isolated from 2 separate sedimentation ponds in Eilat include the 3'- end of the SSU rDNA (about 100 nt), the whole ITS region (ITS1 + 5.8S + ITS2) and the 5'-end of the LSU rDNA (about 900 nts). The total length of the sequences ranged from 1,460 nt. (A. eilatiensis isolate #1) to 1,461 nts. (A. eilatiensis isolate #2). The latter sequences are identical, the difference in length being due to three insertions. Amphidinium eilatiensis is genetically more closely related to A. carterae than to A. klebsii, with respectively 2.36% and 6.93% of sequence divergence.
Animals↗