Screening for colorectal cancer.
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Colorectal Neoplasms↗
Biomedical subjects
K O'Connor
Publications and source records attributed to K O'Connor.
Recognizing and treating cat scratch disease with encephalopathy in children.
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Cat-Scratch Disease↗
Evaluation of the small intestine by enteroclysis for Crohn's disease.
We reviewed the records of 100 consecutive patients referred for enteroclysis by gastroenterologists because of suspected Crohn's disease of the small bowel to assess the clinical utility of the information obtained by this method. More than one-third of the patients in the study group had subtle lesions of early Crohn's disease, all patients who required surgery had severe disease by radiologic criteria, and none of the 34 patients clinically suspected of having Crohn's disease of the small bowel in whom the enteroclysis was normal developed Crohn's disease in two or more years of clinical follow-up. Enteroclysis provides gastroenterologists with accurate and detailed structural information relevant to the appropriate management of the disease and in our hands is a reliable test for excluding Crohn's disease of the small bowel.
Adolescent↗
Sequence and analysis of a portion of the genomes of Shope fibroma virus and malignant rabbit fibroma virus that is important for viral replication in lymphocytes.
The 10.7-kb BamHI "C" restriction fragment of malignant rabbit fibroma virus (MV) contains genes that are important for its immunosuppressive activity. When this fragment is transferred to a related avirulent leporipoxvirus, Shope fibroma virus (SFV), recombinant viruses show clinical features characteristic of MV: they replicate in lymphocytes and alter immune function in vitro, induce disseminated tumors in recipient rabbits, and are immunosuppressive in vivo. The 10.7-kb BamHI "C" restriction fragment of MV was sequenced in its entirety. Its DNA sequence and the 14 ORF's derived from analyzing this sequence are discussed. Analysis of known open reading frames to which the ORF's from MV's Bam "C" fragment show homology permits us to identify some MV ORF's showing high degrees of similarity to known and postulated proteins produced by vaccinia virus. Functions for some of these vaccinia proteins are known, while functions for others are hypothetical or unknown. Further analysis of genetic determinants of MV's virulence has indicated that two overlapping restriction subfragments of the BamHI "C" fragment can transfer MV's virulent behavior to SFV. The 0.7-kb region in which these two subfragments overlap includes the C-terminus of MV orf C-7 and the N terminus of MV orf C-8. These correspond to the C- and N-termini, respectively, of SFV orf's D-9 and D-10 and to vaccinia orf's D-6 (early transcription factor) and D-7 (subunit of RNA polymerase). We sequenced the region of SFV's BamHI "D" fragment in this area and illustrate here the comparative sequences of this portion of SFV's genome and orf's. On the basis of comparisons between MV, SFV, and vaccinia in this area we discuss the potential significance of these observations.
Amino Acid Sequence↗
Echoic memory in the rat: effects of inspection time, retention interval, and the spectral composition of masking noise.
Memory for tones (1100 vs. 2330 Hz) was studied in 4 rats (Rattus norvegicus), as affected by the durations of both target tones (30 to 620 ms) and noise-filled retention intervals (0 to 480 ms). With a 0-ms delay, performance was near asymptotic with the 30-ms tone, but the memory of this brief tone suffered a massive decrement at retention intervals as brief as 60 ms; in contrast, memory for the 340-ms tone was stable for at least 240 ms. If the retention interval was filled by band-stop noise (with targets presented in the spectral gap), then the rat's memory for brief tones was superior to that obtained with the standard broad-band noise filler, and band-stop noise was better than a band-pass noise that had the tones embedded in the region of its spectral energy. These findings are consistent with the hypotheses that auditory memory in the rat consists of a transient sensorylike echoic store and a short-term store more resistant to the effects of retroactive interference.
Animals↗
Temporal resolution of gaps in noise by the rat is lost with functional decortication.
In Experiment 1 (n = 8), the rat's ability to detect brief gaps in white noise was measured by gap-produced inhibition of an acoustic startle reflex, elicited 100 ms after the gap. After bilateral application of KCl to the cortex, gaps as long as 15 ms provided no reflex inhibition; in contrast, the inhibitory threshold was between 2 and 4 ms in the saline control condition. In Experiment 2 (n = 13), noise pulses of 40, 50, or 70 dB were presented 20-500 ms before the startle stimulus, and in Experiment 3 (n = 5) noise offsets occurred so that the startle stimulus was presented at the end of a 2-30-ms gap. Noise pulses and offsets both inhibited reflex expression equally in saline- and KCl-treated animals. Differences between the normal (saline) functions of noise offsets and gaps suggest additional sensory processing with the longer lead time. The loss of gap sensitivity after KCl application indicates that gap processing, unlike pulses and offsets, depends on cortical mechanisms.
Animals↗
Electrophrenic ventilation: a different perspective.
Since 1972, radio-frequency electrophrenic nerve pacing (EPP) has been an option for assisting the ventilation of patients with chronic paralytic respiratory insufficiency. Most of the medical literature has been favorable regarding its continued application. We reviewed the literature to determine how "successful" application of EPP was defined. Our studies indicated that long-term follow-up of EPP patients has been generally inadequate with little emphasis placed on incidence and severity of complications. There was no standardization in defining successful experiences with EPP. Upper airway instability during pacing, lack of internal pacemaker alarms, and the risk of sudden pacemaker failure necessitate permanent tracheostomy in the great majority of patients but complications of the presence of a tracheostomy were not considered in evaluating the desirability of EPP. Some EPP patients became independent of any ventilatory support thus benefiting minimally from the time commitment, effort, and extreme expense needed for EPP placement and training. We conclude that EPP is a valid option for the properly screened patient but that expense, failure rate, morbidity and mortality remain excessive and that alternative methods of ventilatory support should be explored.
Diaphragm↗
Factors in the diagnostic delays of small bowel malignancy.
The overall survival from primary malignancies of the small intestine has not changed over more than four decades. This generally is ascribed to delays in establishing the diagnosis and the advanced stage of the disease when treatment is begun. There has been no critical analysis of these delays. To answer these questions, we reviewed the records of all patients diagnosed with small bowel malignancy from 1967 to 1988 at the Methodist Hospital of Indiana. The onset and duration of symptoms, first medical consultation, time of performance of diagnostic procedures and surgery were verified in 77 patients with histologically confirmed small bowel malignancies. The longest delay occurs from the time medical help is sought to the time the diagnosis is made, not from the onset of symptoms to the first medical consultation. The small bowel should always be considered as a source of unexplained, persistent subtle abdominal symptoms.
Adult↗
Predictive value of pretransplant IL-2 levels in kidney transplantation.
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Graft Rejection↗
The role of the physician in the late diagnosis of primary malignant tumors of the small intestine.
Survival from primary malignancies of the small intestine has not improved during the last four decades. One reason for this is the advanced stage of disease at the time of surgery. In order to determine why diagnosis is made late, we reviewed the records of all patients with small bowel malignancy diagnosed between 1967 and 1988. The time from the onset of symptoms to the first medical contact and the time from medical contact until diagnosis were evaluated in 77 patients. The average delay in diagnosis attributable 1) to the patient failing to report symptoms was less than 2 months, 2) to the physician not ordering the appropriate diagnostic test was 8.2 months, and 3) to the radiologist failing to make the diagnosis was 12 months. Thus, the major delay in diagnosis was after medical help was sought and not from the onset of symptoms to first medical consultation. Physicians must increase their sensitivity to the subtle but persistent symptoms that necessitate a small bowel evaluation.
Adenocarcinoma↗
New family of high-resolution ion exchangers for protein and nucleic acid purifications from laboratory to process scales.
A new family of polymer-based ion exchangers was tested for the purification of acidic and basic proteins on both the analytical and preparative scales. Protein-Pak HR series packings are available as strong cation (SP) and weak anion (DEAE) exchangers, allowing the development of a purification method regardless of the isoelectric point of protein. Three particle sizes, 8, 15 and 40 microns, are offered in scalable Advanced Purification (AP) glass columns or as bulk packings. The lower back pressures of the 15- and 40-microns packings compared to that of the 8-microns material allow rapid throughput of large volumes without exceeding the pressure limitations of the resin or the column. The capacity of the AP1 (100 mm x 10 mm) glass columns, containing these ion-exchange packings, is comparable to other ion-exchange columns. The resolution of mouse serum, plasmids, and a standard protein mixture was demonstrated and compared with the results obtained with other resin-based ion exchangers of similar particle size. Proteins were purified without significant loss of biological activity or mass.
Alkanesulfonates↗
Molecular analysis of immunosuppression induced by virus replication in lymphocytes.
The relationship between immunosuppression and oncogenesis can be determined by studying the molecular interactions between tumor-inducing viruses and lymphocytes. We approached this study by using a unique system of two genetically related Leporipoxviruses, malignant fibroma virus (MV), and Shope fibroma virus (SFV). MV induces a syndrome of a highly lethal, disseminated myxosarcoma, severe immune suppression, and replicates in lymphocytes both in vivo and in vitro. In contrast, SFV causes a benign fibromyxosarcoma without immune dysfunction and cannot replicate in lymphocytes. Earlier studies demonstrated that transfer of a 10.8-kb Bam HI piece of MV (fragment "C") to SFV resulted in the ability of SFV to replicate in lymphocytes and suppress immune function. These results suggested that lymphocytotropic replication and immune suppression was located on the left side of fragment C. We extended these studies by generating families of recombinants between MV and SFV by using subfragments of fragment C. The resulting recombinant viruses were analyzed for their ability to replicate in lymphocytes, suppress immune function, and produce tumors. Those recombinants expressing MV-like characteristics were mapped by endonuclease digestion. This study demonstrates that recombinants containing a 3.6-kb Nde I subfragment, as well as those containing an overlapping 1.9-kb Hinc II subfragment, were capable of replicating in lymphocytes, suppressing immune functions, and inducing disseminated tumors in rabbits. Our study has therefore identified a portion of MV DNA sufficient to transfer the unique pathogenicity of MV to SFV, and suggests that control of immune suppression and tumor dissemination may not necessarily be mediated by the same viral genes.
Animals↗
Evaluation of melanoma/skin cancer screening in Massachusetts. Preliminary results.
Although screening for melanoma/skin cancer is theoretically of value, few data are available to evaluate its effectiveness or the value of a visual exam by a dermatologist as a cancer screening tool. From the 2560 persons screened for melanoma/skin cancer in Massachusetts in 1986 and 1987, the authors followed the positive screenees to determine their final diagnosis. The authors obtained information on 85% of these persons, and found nine malignant melanomas, 91 non-melanoma skin cancers, 39 dysplastic nevi, and three congenital nevi. The sensitivity of the visual exam by a dermatologist was 89% to 97% and the predictive value positive was 35% to 75% for skin cancer. The authors conclude that the yield of screening is equivalent to that of other major cancer screening efforts and that the sensitivity and predictive value of the visual examination by the dermatologist is appropriate for a cancer screening tool.
Carcinoma in Situ↗
Towards a process paradigm in psychophysiology.
This article discusses a theory and method for classifying psychophysiological phenomena as processes prior to considering them as experimental responses. The initial aim then is to construe experimental units as continuous subject-centered processes whose beginning and end depends on the individuals' actions. Boundaries of such processes are systematically defined by first identifying the process as a dimension. Activities are then classified relative to this dimension. Process units are specified by considering two classes of activity which form opposite ends of the dimension of process. The two classes are equivalent in all respects save along the one dimension. These two classes are termed 'pro'- and 'null'-equivalence and are the process methods version of familiar H1 and H0 of hypothetico-deductive procedures. Proportional presence or absence of a parameter value during pro- and null-equivalence of a process is the basis for inferring that a particular measure does or does not typify the process. Actual parameter values of a measure can then form credible limits by which to classify other processes as equivalent or not. These limits can indicate for example whether two experimental effects are dealing with the same or a different process. There are some difficulties in applying this process method, but the general conclusion is that classifying psychophysiological responses at the outset in terms of process clarifies technical and inferential issues in experimentation.
Behavior↗
Effects of coping style and relaxation on cancer chemotherapy side effects and emotional responses.
This study was designed to determine (a) the relationship of coping style to cancer chemotherapy side effects and (b) whether coping style moderated the impact of a relaxation intervention on anxiety, depression, and nausea associated with chemotherapy. Forty-eight cancer patients were assigned randomly to receive either progressive muscle relaxation training before chemotherapy (experimental group) or standard care (control group). Spearman correlations indicated that a "blunting" or distraction-oriented coping style was associated with less anticipatory anxiety, less depression, and less nausea during and after chemotherapy. Spearman correlations also indicated that a "monitoring" or information-gathering coping style was associated with more anticipatory anxiety, and more nausea before and during chemotherapy. Although there was a significant effect of the relaxation intervention on posttreatment nausea, there were no other between-group differences. The results did suggest, however, that relaxation was effective in reducing anticipatory anxiety among "blunters," but not "monitors," perhaps because relaxation is a distraction strategy and therefore is consistent with a blunting coping style. The effects of coping and relaxation on pretreatment anxiety may have important implications, because anxiety is a key factor in classic conditioning models of anticipatory nausea and vomiting.
Adaptation, Psychological↗
Dizziness and perceptual style.
This study tested the hypothesis that patients suffering from non-organic ('psychogenic') dizziness would score higher on Witkins' frame dependence test than a group of dizzy patients with peripheral organic damage. A computerized version of the portable rod and frame test was administered to a group of 10 chronic ENT patients with peripheral vestibular disease, 10 ENT patients with no detectable organic problems and 10 non-dizzy controls. Contrary to the hypothesis, the psychogenic group had less frame-dependent error than the peripheral group and less (though not significantly so) than the normal group. Four of the psychogenic group had very low frame dependence scores. The experience of dizziness may not be necessarily related to anxiety proneness and may be a function of an inhibitory autonomous perceptual style as well as one overly dependent on external cues.
Adult↗
Smoking reduction based on a situational model of craving.
Eight smokers participated in a smoking-cessation program involving controlled situational reduction and behavioral substitution. Six completed the treatment, and over-all reduction was significant. Reduction was maintained at 12-month follow-up. Ratings of positive images of smoking also changed posttreatment.
Adult↗