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Biomedical subjects

K Cullen

Publications and source records attributed to K Cullen.

At least 37 records · Page 2Linked to original sources

IGF-I and IGF-II expression in human breast cancer xenografts: relationship to hormone independence.

Although the growth of some estrogen receptor (ER) positive breast cancers can initially be hormonally manipulated, all will eventually escape hormonal control. It is possible that the expression of polypeptide growth factors is initially under the control of steroid hormones, while the hormone unresponsive state is characterized by constitutive expression of growth factors. We studied the relationship between hormone responsiveness and IGF expression in xenograft models. The ER+ T61 xenograft was established from a primary breast cancer and has been continually passaged in athymic mice. ER+ MCF-7 cells and ER-MDA-MB-231 cells were grown in tissue culture and then inoculated into athymic mice. ER+ xenograft growth was regulated by estrogen, but with opposite results--T61 xenografts are inhibited by estrogen, while MCF-7 xenografts require estrogen for tumor formation. All xenografts expressed type I and II IGF receptors. Although T61 xenografts also express an alternatively spliced IGF-I mRNA, its expression was not regulated by estrogen. Both xenografts expressed IGF-II in a hormonally regulated manner--T61 levels were depressed by estrogen, while MCF-7 levels were increased. Thus, in these model systems, xenograft regulation of tumor growth is accompanied by parallel changes in IGF-II expression. In the estrogen independent MDA-MB-231 cells, IGF-II was constitutively expressed. These data show that IGF-II expression correlates with estrogen treatment, suggesting that autocrine expression of IGF-II may mediate estrogen-regulated cell growth.

Animals↗

The very anxious patient.

The successful management of anxiety requires doctors to be supportive of patients and to provide them with some insight into the cause of their anxiety or phobia. Persistent education, reassurance and advice about non drug therapies are necessary.

Anxiety↗

Assessment and treatment of Spanish-speaking sex offenders: special considerations.

While there is an expanding body of literature pertaining to the special considerations related to the treatment of Hispanic patients whose primary language is Spanish, there is virtually no information reported to aid in the assessment and treatment of Hispanic and primarily Spanish-speaking sex offenders. Beyond the obvious problems posed by differences in language, there are a host of transcultural factors that may impact on the evaluation and engagement of this patient population when they are also largely psychologically unsophisticated and from a low socioeconomic level. The experiences in modifying and implementing a special program to accommodate the needs of this patient group is presented. Reticence to discuss sexuality in a group setting, the relationship between therapists and patients as effected by rules of social etiquette, and the reluctance to criticize other members in the group were prominent features attributed to religious and cultural factors. The authors consider it a necessity to be sensitive to these subtle nuances in order to provide adequate treatment.

Adult↗

Decline of lung function and development of chronic airflow limitation: a longitudinal study of non-smokers and smokers in Busselton, Western Australia.

Data collected during seven population health surveys over 18 years in Busselton, Western Australia, were examined to determine the effect of smoking on lung function and to investigate the development of chronic airflow limitation. Lung function was measured and details of respiratory illness and smoking histories were collected from subjects attending surveys at three year intervals from 1966 to 1984. Data from ex-smokers and asthmatic patients (diagnosis based on answer to questionnaire) were excluded. Regression of height adjusted forced expiratory volume in one second (FEV1) on age was calculated individually for 759 non-smokers and 225 regular smokers with four or more observations. Decline in height adjusted FEV1 was similar for men and women. In smokers the rate of decline in FEV1 was greater than in non-smokers and was related to the amount smoked, to the extent that a smoker could expect a 20-30% greater rate of decline than a non-smoker of the same age. Chronic airflow limitation (defined as FEV1/FEV less than 65% or FEV1 less than 65% predicted on at least two occasions) was common, occurring in 24% of men and 18% of women who were regular smokers and in 5% of male and 8% of female non-smokers. These figures are higher than those reported in other populations, especially for women and for non-smokers. Not all chronic airflow limitation was associated with respiratory symptoms, confirming that the condition may be unrecognised until it is advanced.

Adult↗

Female sex offenders: severe victims and victimizers.

Although there is an extensive body of literature concerning male sexual offenders, there is a marked lack of articles describing sexual offenses committed by females. The authors present a review of the existing literature on this topic and describe five cases of female sexual offenders and four cases of female sexual abusers. Implications for the effective assessment and treatment of this unique population are discussed.

Adult↗

Legal and ethical issues in the use of antiandrogens in treating sex offenders.

Antiandrogen treatment of sexual offenders raises serious legal and ethical considerations in both the medical profession and in the courts. Discussion is offered on the use of antiandrogens in both an involuntary and voluntary context. The potential negative impact of this treatment modality on such constitutional issues as privacy interests, right to procreative freedom, freedom of speech and communication, and freedom from cruel and unusual punishment is explored and notable, germane court cases are presented. The need for clear ethical guidelines for the administration of this treatment is stressed.

Androgen Antagonists↗

Effects of xylazine and/or butorphanol or neostigmine on myoelectric activity of the cecum and right ventral colon in female ponies.

Effects of xylazine HCl (0.5 mg/kg of body weight, IV) and/or butorphanol tartrate (0.04 mg/kg, IV) or neostigmine methylsulfate (0.022 mg/kg, IV) on myoelectric activity of the cecum and right ventral colon were studied in 4 conscious female ponies. Eight bipolar Ag/AgCl electrodes were sequentially placed on the seromuscular layer of the cecum (6 electrodes) and right ventral colon (2 electrodes). Recordings began 30 minutes before and continued for 90 minutes after drug administration. Each drug or drug combination was studied on 2 occasions in each pony. Two major patterns of coordinated spike bursts were identified. A series of coordinated spike bursts began at the cecal base and was conducted to the cecal apex (pattern I). A series of coordinated spike bursts began at the cecal apex, traversed the cecum, cecocolic orifice, and right ventral colon and was termed a progressive pattern (pattern II). Xylazine administration caused a significant decrease in patterns I and II for 20 minutes (P less than 0.05). Butorphanol tartrate administration caused a significant decrease in the progressive pattern for 10 minutes (P less than 0.05) without affecting the orally directed pattern. Administration of the combination of xylazine/butorphanol significantly decreased the frequency of pattern I for 40 minutes (P less than 0.05) and pattern II for 30 minutes (P less than 0.05). Neostigmine administration caused a significant increase in the frequency of pattern II for 30 minutes (P less than 0.05) without affecting pattern I (P greater than 0.05). Changes in conduction velocity of pattern I or II or the duration of spiking activity were not significantly different because of any treatment.

Animals↗

The use and abuse of erection measurements: a forensic perspective.

The use of erection measurement studies is proliferating in the assessment and treatment of sexual deviants. Because of the nature of sexual offense, there are many inherent legal complications with the implementation of this technology, specifically its use as evidence. The authors present data from a study of 185 sex offenders in an attempt to illustrate the appropriate utility of erection measurements in treatment and its potential for abuse in the legal context.

Expert Testimony↗

Rate of decline of lung function in subjects with asthma.

Retrospective and prospective questionnaire and lung function data, collected during seven population health surveys over 18 years in Busselton, Western Australia, have been analysed for 92 subjects with asthma and 186 normal subjects. Subjects who had a minimum of four observations over an 18-year period were selected; the age range at first study was 22-69 years. Individual regression analyses of forced expiratory volume in one second (FEV1), adjusted for height, on age were used in analyses. Subjects with asthma had a greater rate of decline in FEV1 (p less than 0.01) and a lower baseline lung function (p less than 0.001). The mean loss of FEV1 in males of 1.7 m height was 50 ml/year in nonsmokers with asthma compared with 35 ml/year in the normal subjects. The effect of asthma was variable and not all subjects with asthma had steep rates of decline. There were insufficient numbers of smokers with asthma to draw conclusions about an effect of cigarette smoking additional to the effect of asthma. No relationship was found between rate of decline of FEV1 and age or atopic status. In subjects with asthma, bronchial hyperresponsiveness, which was measured at the end of the study, accounted for 9% of the variation in rate of decline of FEV1 and airflow limitation, measured by FEV1 FVC, accounted for 10%. Further studies are needed to determine whether the steep rates of decline found in subjects with asthma are preventable.

Adult↗

Patient education program to teach energy conservation behaviors to patients with rheumatoid arthritis: a pilot study.

We report a prospective, randomized pilot study comparing a new workbook-based program, designed to teach patients with rheumatoid arthritis (RA) energy conservation behaviors, with standard occupational therapy (OT). Sixteen patients took part in the new program and nine received the standard therapy. Data on the number of tender or swollen joints, grip strength, walk time, activities of daily living, psychologic adjustment to illness, and daily activity log, were measured before and three months after intervention. Eleven percent of those who received standard therapy and 50% of those who received the workbook increased their amount of physically active time (p = .10). Twenty-two percent of the control group and 50% of those in the workbook group achieved a better balance of rest and physical activity (p = .07). We conclude that the adoption of energy conservation behaviors is different in the two groups. This initial study suggests that interrupting physical activity with rest periods may result in increased physical activity in patients with RA.

Arthritis, Rheumatoid↗

Pedophile types and treatment perspectives.

Pedophiles constitute a heterogeneous group of sex offenders. Direct physiological assessment of sexual arousal has significantly increased our diagnostic skill and capability of monitoring treatment response. Erectile response studies have indicated that the majority of pedophiles and incest offenders show arousal to other paraphilias and frequently to appropriate adult sexual stimuli. Many sexual offenders deny or minimize their problem during initial interviews, but when confronted with laboratory results indicating deviant sexual arousal, they often acknowledge and elaborate on the paraphilia(s). Complete data and diagnoses are crucial in integrating treatment in the cognitive-behavioral paradigm.

Adolescent↗

Pedophilia: an update on theory and practice.

The number of sexual attacks on children is staggering, yet it is extremely difficult to understand what effective treatments are available for the pedophile by reviewing the literature. Therefore, the authors present an update of the changing conceptualizations regarding the offenders and their victims. An overview of the currently used modalities to treat the pedophile is presented with emphasis on the promising cognitive-behavioral approach. A brief description of this approach is given with two case illustrations.

Adult↗

Multiple regression analysis of risk factors for cardiovascular disease and cancer mortality in Busselton, Western Australia--13-year study.

The mortality of 1564 Busselton subjects has been studied from 1966-79 to determine whether risk factors for cardiovascular disease (CVD) and coronary heart disease (CHD) showed any change in emphasis compared with the Framingham Population Study of 20 yr previously. The Busselton analysis used subjects free of probable and suspect coronary heart disease at onset. In men aged 40-59, systolic blood pressure (SBP), forced expiratory volume (FEV), and serum cholesterol levels were significant independent determining variables for CVD mortality and cholesterol for CHD mortality, with SBP being related to CVD in men aged 60-74 yr. In women, there were few indicators of future vascular risk with no significant determining variable for CVD and CHD in 40-59 yr olds, but blood glucose and FEV were significant risk factors for CVD in women aged 60-74 yr. Cholesterol was unrelated to mortality in women but showed negative relationship with cancer in 60-74 yr old men. In total mortality, smoking in men and women, and obesity in women were significant risk factors; 1 hr serum insulin had a negative relationship in men aged 40-59 yr, and a stronger positive relationship in men aged 60-74 yr, but this may have been due to the close negative association of the variable with body size (i.e. height). More studies are required to ascertain whether glucose and insulin have an aetiological role in vascular disease.

Adult↗

Q waves and ventricular extrasystoles in resting electrocardiograms. A 16 year follow up in Busselton study.

Isolated abnormalitites in the resting electrocardiograms of 1546 Busselton people with no history of angina or past myocardial infarction were examined in relation to 16 year mortality. Multivariate discriminate analysis in men showed significant independent relationship for Q waves with coronary heart disease and for ventricular extrasystoles with cardiovascular disease. In women multivariate analysis showed significant relations for ventricular extrasystoles with total mortality and coronary heart disease. There were higher trends in mortality for both men and women with frequent ventricular extrasystoles compared with those with infrequent ventricular extrasystoles.

Adult↗