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Biomedical subjects

K Carson

Publications and source records attributed to K Carson.

At least 19 recordsLinked to original sources
PubMed2002

Survival of patients with newly diagnosed glioblastoma multiforme treated with RSR13 and radiotherapy: results of a phase II new approaches to brain tumor therapy CNS consortium safety and efficacy study.

PURPOSE: The objectives of this phase II study were to determine survival, safety, pharmacokinetics (PK), and pharmacodynamics (PD) of 2,4-[[(3,5-dimethylanilino)carbonyl]methyl]phenoxy]-2-methylpropionic acid (RSR13, efaproxiral) 100 mg/kg per day administered with standard cranial radiotherapy (RT) for the treatment of glioblastoma multiforme (GBM). RSR13, a synthetic allosteric modifier of hemoglobin, is a radiation-enhancing agent that noncovalently binds to hemoglobin, reduces oxygen-binding affinity, and increases oxygen unloading to hypoxic tissue. PATIENTS AND METHODS: Fifty patients with newly diagnosed GBM (Karnofsky performance status >or= 60) were enrolled onto this multicenter phase II study. Patients received daily RSR13 100 mg/kg intravenously infused for 30 minutes immediately before cranial RT (60 Gy in 30 fractions). Supplemental oxygen was given during RSR13 infusion and continued until after the RT treatment was completed. RT was given within 30 minutes of the end of RSR13 infusion. PK and PD determinations were performed. RESULTS: The median survival for the RSR13-treated patients was 12.3 months with 1-year and 18-month survival rates of 54% and 24%, respectively. Twenty-four percent of patients had greater than grade 2 toxicity, which was generally transient and self-limited. A significant PD effect on hemoglobin-oxygen binding affinity was demonstrated for most patients. CONCLUSION: RSR13 (100 mg/kg) administered immediately before cranial RT is well tolerated and is pharmacodynamically active. Median survival in excess of 1 year is favorable.

Adult↗
PubMed2001

The fate of the fibrous capsule after saline implant removal.

After removal of a silicone breast implant, if a capsulectomy is not performed, the residual capsule may persist, become calcified, and appear on routine mammograms. The fate of the capsule around saline implants is less clear. The purpose of this study was to determine the fate of the capsule around saline-filled implants in an animal model. Rats were implanted with 6-ml tissue expanders, which were left in place for 4 months. The implants were then removed and the capsules around the injection port (smooth surface) and tissue expander (textured surface) were examined sequentially. The capsules contracted and dissipated gradually over a year in association with a pericapsular vascular proliferation. It may not be necessary to perform a capsulectomy at the time of saline implant removal.

Animals↗
PubMed1999

Pulmonary vascular morphological changes in cirrhotic patients undergoing liver transplantation.

Cirrhosis and portal hypertension may be associated with pulmonary hypertension and pulmonary dysfunction. However, morphological pulmonary vascular lesions in patients with cirrhosis have not been well characterized morphometrically. We morphometrically evaluated pulmonary vessels in liver transplant recipients with pretransplantation cirrhosis and correlated our findings with pretransplantation cardiopulmonary function, postoperative course, and postmortem cardiopulmonary findings. Autopsy lung slides from 23 transplant recipients with pretransplantation cirrhosis were examined. External vessel diameter, intimal thickness, and arterial medial thickness were measured with a micrometer after pentachrome staining. The percent of total diameter comprised by intima or media was calculated for each vessel. Medical records were reviewed for smoking history, pretransplantation cardiopulmonary function testing, and postoperative course. Autopsy cases without liver or significant cardiopulmonary diseases, matched for age, sex, and smoking history, served as controls. Transplant recipients had significantly more pulmonary venous intimal thickening than matched controls (P <.0001). Sixty-five percent (15 of 23) of these patients had some degree of pretransplantation pulmonary dysfunction, defined by abnormalities in pulmonary function tests, oxygen saturation, and/or increased pulmonary artery pressures. However, the severity of venous intimal thickening did not correlate with the severity of pretransplantation pulmonary dysfunction. Arterial intimal and medial thickness were not statistically significantly different from controls. Pulmonary venous intimal thickening and resultant luminal impingement are morphological findings not previously described in this population. The arterial lesion, when present, is similar to that seen in pulmonary hypertension from other causes. These pulmonary vascular lesions may be implicated in pulmonary dysfunction in patients with cirrhosis and may be associated with increased posttransplantation cardiopulmonary morbidity and mortality.

Adult↗
PubMed1999

The Relationship between Children's Emotional and Behavioral Problems and the Social Responses of Elementary School Teachers.

This study examined the relationship between children's emotional and behavioral problems and teachers' social responding. Elementary school students completed the Children's Depression Inventory and a parent completed the Child Behavior Checklist. Teachers rated children on measures of interpersonal attractiveness and personal rejection. Teachers' ratings of student interpersonal attractiveness were significantly correlated with the level of student depression, internalizing problems, externalizing problems, and overall psychopathology. However, teachers' ratings of personal rejection toward students only correlated with externalizing behavior problems. Family income was also related to child adjustment and teacher ratings. Externalizing behavior problems best predicted both lower interpersonal attractiveness and increased personal rejection, even after controlling for family income. Copyright 1999 Academic Press.

Journal Article↗
PubMed1998

Relaxation therapy in Tourette syndrome: a pilot study.

To evaluate the feasibility and efficacy of behavioral relaxation therapy as treatment for Tourette syndrome, 23 patients were recruited from a university-based pediatric Tourette syndrome referral clinic. Individuals were randomized and stratified according to initial tic severity and the presence of attention-deficit hyperactivity disorder into either relaxation therapy or a minimal therapy (control) group. Sixteen patients, mean age 11.8 years (S.D. 2.8 years), completed the 3-month study, which included weekly, hour-long, individual training sessions for 6 weeks. Individuals (n = 7) in the relaxation therapy group demonstrated a significantly increased ability to relax, compared with the minimal therapy (awareness and quiet time training) group. At 6 weeks, tic findings, based on five established tic severity scales, revealed greater improvement in the relaxation treatment group, but values failed to reach statistical significance. No difference between therapy groups was apparent at the 3-month evaluation. The acquired ability to relax did not significantly affect behavioral measures on the Child Behavioral Checklist. On the basis of this pilot study, relaxation therapy appears to have a limited role in the treatment of tics in Tourette syndrome.

Adolescent↗
PubMed1998

A randomized trial of once vs twice daily administration of intravenous granisetron with dexamethosone in patients receiving high-dose cyclophosphamide, thiotepa and carboplatin.

The purpose of this study was to determine the optimal schedule of i.v. granisetron and dexamethosone for control of nausea and emesis in patients receiving high-dose chemotherapy (HDC). Seventy patients with breast cancer received high-dose cyclophosphamide, thiotepa and carboplatin (CTCb) for 3 consecutive days. All 70 received dexamethasone 12 mg i.v. and granisetron 1 mg i.v. prior to infusion of CTCb and were randomized to receive placebo (n = 37) or an additional identical dose of granisetron (n = 33) 12 h later. Beginning on day 2 of chemotherapy administration, 55 patients evaluable later self-administered a cocktail of diphenhydramine (benadryl), lorazepam (ativan) and dexamethasone (BAD). Fourteen of 37 patients (38%) receiving granisetron once a day and 15/33 (44%) receiving it twice a day had a complete response during the first 24 h following the first doses of chemotherapy (P = 0.52). In the 55 evaluable patients receiving BAD, 18 of 29 (62%) in the once daily group and 14/26 (54%) in the twice daily group required additional medications (P = 0.54). The median time to first emetic episode was 20 h (range 6.6-79.5) for patients receiving once a day and 21.4 hours (range 5.8-105.3) for patients receiving twice a day granisetron (P = 0.48). Five patients in the once daily and seven patients in the twice daily group had complete control of nausea and emesis throughout the study period (P = 0.37). It was concluded that there were no statistically significant differences in nausea and emetic control between dexamethasone with once daily or twice daily i.v. granisetron administration in patients receiving high-dose CTCb.

Adult↗
PubMed1997

Recurrence of nonalcoholic steatohepatitis in a liver transplant recipient.

A 42-year-old white man with morbid obesity and hypertriglyceridemia was noted to have nonalcoholic steatohepatitis (NASH) at the time of a laparoscopic cholecystectomy for presumed gallstone pancreatitis. His postoperative course was complicated by a 50-kg weight loss and continued right upper quadrant pain. Repeat liver biopsy revealed NASH with accompanying micronodular cirrhosis. Due to progressive fatigue, he underwent an orthotopic liver transplantation complicated by a 36-kg weight gain. Sixteen months posttransplantation, a liver biopsy revealed the recurrence of NASH. Screening for defects in fatty acid oxidation proved negative.

Adult↗
PubMed1996

Putting things in perspective: building on our experience.

The science and policy underlying food labeling and food fortification have evolved over the past 30 years to a point where dietary guidance and nutrition labeling now provide consumers with highly sophisticated, very specific information about links between diet and health. The focus was once on prevention of nutrient deficiency diseases, but today it is on reducing the risk of chronic diseases and health-related conditions. The Nutrition Labeling and Education Act of 1990, with its provisions for authorization of health claims on food labels, has provided a gateway through which a broader realm of nutrition and health information can be made available to consumers. However, the interpretation and implementation of the health claim provisions must evolve, based on a strong foundation of supporting science, so that industry may more readily make health information available to consumers in a form that is easily understood and effectively used in making their dietary choices. We must develop a database to support claims of beneficial effects of food components. We must be assured that the beneficial effects are not outweighed by safety concerns. And we must develop an environment that is conducive to conducting the research to develop these data. This can only be accomplished through the collaborative efforts of industry, academia, consumers and public health agencies.

Food Labeling↗
PubMed1995

The precision of practice analysis results in the professions.

A practice analysis, in which an appropriate sample of professionals is asked to describe what they do in their practices, is considered an essential part of the content-related validity evidence for licensure and certification tests. This article examines the precision of estimates of the mean frequencies for categories of activities in an activity inventory administered on two occasions about 6 weeks apart. In particular, it explores the variability in estimates of the mean frequencies for categories due to the sampling of respondents, activity statements, and occasions. The results suggest that samples of 200 respondents, about 10 to 20 activity statements per category, and one occasion are adequate for estimating the mean frequency for each category.

Analysis of Variance↗
PubMed1994

The regulatory environment past and future--incentive or impediment to developments in food science and technology: a perspective from FDA.

The best system for protecting public health is one that involves two layers of control before food reaches the consumer. The first layer of control is the industry's clear responsibility to prepare food that is safe. The second layer of control is the monitoring that is provided by government to ensure that the industry is doing its job and is in fact producing safe food. While some may view this "second layer" as an impediment in the development and marketing of new technologies, there is another way to look at the "regulatory environment". The regulatory environment itself, is not an impediment to the development of food science and technology. The regulatory environment, with all its components--scientists, consumers, industry, and Congress--defines "safety" within the context of today's technology, scientific capability, and tolerance level of the lay public. The entire regulatory environment serves to guide the development of food science and technology by providing signposts, in the form of scientifically sound regulatory decisions. The scientific basis of these decisions becomes building blocks on which to rest further refinement of the technology, product, ingredient, or packaging material or on which research in related technologies or research in innovative directions can build. This scientific groundwork becomes very important as more and more companies move away from having self-contained research laboratories toward using commercial laboratories and academic institutions, as well as participating in cooperative research endeavors to meet food safety and product development research needs.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Scintigraphic evaluation of sialadenitis.

Salivary gland scintigraphy using 99Tcm sodium pertechnetate and a 20-min dynamic data acquisition with a sialogogue at 10 min was employed as the primary imaging modality in sialadenitis in 32 patients. Paired asymptomatic glands within the study group were used to establish control values for a number of computer-derived functional parameters. The shape of the activity-time curve was described as: H = hyperactive, N = normal, M = median, S = sloped, F = flat, O = obstructed. Of seven patients who had ductal stones on plain films, two passed stones prior to sialography and had normal curves, whole the remaining five patients had Type O curves. Parametric evidence of gland dysfunction was identified in an additional seven symptomatic glands, six being hyperactive; histology identified an acute inflammatory infiltrate in the only excised gland in this group. Glandular hypofunction was identified in one case, in which histology revealed extensive fibrosis and glandular atrophy. Type M and S curves were found in 28 glands, 75% of which were asymptomatic. Only one gland was indicated as hypoactive by calculated parameters, and this showed a Type S curve. Scintigraphy and plain films represent the least invasive and, we feel, the most suitable primary method of investigating sialadenitis. Conventional contrast sialography may be reserved for cases with no identifiable stone but an obstructed curve. The use of functional parameters and curve morphology to determine gland dysfunction other than obstruction is non-specific, probably insensitive and is unlikely to alter clinical management. We propose an algorithm for the investigation of sialadenitis.

Adolescent↗
PubMed1992

Cholinesterases in the amyloid angiopathy of Alzheimer's disease.

Vessels affected by amyloid angiopathy in patients with Alzheimer's disease also displayed intense acetylcholinesterase and butyrylcholinesterase activity when examined by light and electron microscopy. The enzymatic properties of the vessel-bound cholinesterases were identical to those of the cholinesterases associated with senile plaques and neurofibrillary tangles. This cholinesterase activity is of unknown origin but represents one of the very few features common to all the major pathological markers of Alzheimer's disease.

Aged↗
PubMed1990

The basis for choice reaction time slowing in Alzheimer's disease.

Slowed reaction time has been suggested as an early feature of Alzheimer's disease (AD), but the basis for this slowing has not been established. Patients with mild AD were compared with controls on a choice reaction time task, both cued (CCRT) and uncued (CRT). Initial and 1-year followup data were analyzed both as mean reaction times and as parameters of a fitted two-component quantitative model (the ex-Gaussian model). Slowing of CRT proved to be a sensitive test for AD. Slowing was due to changes in both the sensory/motor and the decisional components of the CRT model. However, these changes were found in both AD and slower, older controls. The modeling of CRT in AD is discussed.

Aged↗
PubMed1989

Depression and Alzheimer's disease.

In his classic case, Alzheimer described cognitive symptoms such as amnesia, aphasia, and apraxia and noncognitive symptoms such as delusions and agitation. Recent studies have suggested that depression also occurs in Alzheimer's disease. In this study, 144 patients who met criteria for Alzheimer's disease were examined for depression on a modified version of the Present State Examination. The prevalence rate of major depression was 17%. The depressed Alzheimer's disease patients were more cognitively impaired and more disabled than the nondepressed patients. Studies are needed to clarify the etiology and treatment of depression in Alzheimer's disease.

Aged↗
PubMed1988

Language dysfunction in early- and late-onset possible Alzheimer's disease.

Disproportionate involvement of language has been claimed to be a distinguishing feature of Alzheimer's disease (AD) with onset before age 65. We tested this hypothesis in a group of 133 patients with possible AD by NINCDS criteria. Sixty-one had onset of symptoms prior to age 65; the remaining 72, at 65 or later. The two groups were well matched on overall dementia severity as measured by the Mini-Mental State Exam. Using standardized tests, we did not find any significant differences in the severity of language dysfunction between the two groups, particularly after controlling for greater attention/concentration deficits in the early-onset group. Previous reports of differences in language dysfunction between early- and late-onset AD may have been due to small sample sizes and nonstandardized testing.

Age Factors↗