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Biomedical subjects

L Welch

Publications and source records attributed to L Welch.

At least 19 recordsLinked to original sources
PubMed2006

A systematic review on the efficacy of cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for diffuse malignancy peritoneal mesothelioma.

BACKGROUND: In the past, diffuse malignant peritoneal mesothelioma (DMPM) was regarded as a preterminal condition. The length of survival was dependent upon the aggressive versus indolent biologic behavior of the neoplasm. The overall median survival was approximately 1 year after systemic chemotherapy. Cytoreductive surgery (CRS) combined with perioperative intraperitoneal chemotherapy (PIC) has been used as a treatment alternative, but the efficacy of this combined treatment remains to be established. PATIENTS AND METHODS: Searches for relevant studies published in peer-reviewed medical journals on CRS and PIC for DMPM before May 2006 were carried out on six databases. The reference lists of all retrieved articles were reviewed for further identification of potentially relevant studies. Expert academic surgeons in Washington, DC, USA were asked whether they knew about any important unpublished data. Two investigators independently evaluated each study according to predefined criteria. The quality of each study was assessed. Clinical effectiveness was synthesized through a narrative review with full tabulation of results of all included studies. RESULTS: Seven prospective observational studies from six tertiary institutions were available, allowing 240 DMPM patients for assessment. The median survival ranged from 34-92 months. The 1-, 3- and 5-year survival varied from 60% to 88%, 43% to 65% and 29% to 59%, respectively. The perioperative morbidity varied from 25% to 40% and mortality ranged from 0% to 8%. CONCLUSIONS: This systematic review evaluated the current evidence for CRS and PIC for DMPM. Seven observational studies were available for assessment, which demonstrated an improved overall survival, as compared to historical controls, using systemic chemotherapy and palliative surgery.

Antibiotics, Antineoplastic↗
PubMed2001

The absence of depth constancy in contour stereograms.

Stereoscopic surfaces constructed from Kanizsa-type illusory contours or explicit luminance contours were tested for three-dimensional (3-D) shape constancy. The curvature of the contours and the apparent viewing distance between the surface and the observer were manipulated. Observers judged which of two surfaces appeared more curved. Experiment 1 allowed eye movements and revealed a bias in 3-D shape judgment with changes in apparent viewing distance, such that surfaces presented far from the observer appeared less curved than surfaces presented close to the observer. The lack of depth constancy was approximately the same for illusory-contour surfaces and for explicit-contour surfaces. Experiment 2 showed that depth constancy for explicit-contour surfaces improved slightly when fixation was required and eye movements were restricted. These experiments suggest that curvature in depth is misperceived, and that illusory-contour surfaces are particularly sensitive to this distortion.

Adult↗
PubMed2001

Motion capture depends on signal strength.

When flickering dots are superimposed onto a drifting grating, the dots appear to move coherently with the grating. In this study we examine: (i) how the perceived direction of a compound stimulus composed of superimposed grating and dots, moving in opposite directions with equal speeds, is influenced by the relative strength of the motion signals; (ii) how the perceived speed of a compound stimulus composed of superimposed grating and dots, moving in the same direction but at different speeds, is influenced by the relative strength of the motion signals; and (iii) whether this stimulus is discriminable from its metameric speed match. Dot signal strength was manipulated by using different proportions of signal dots in noise and different dot lifetimes. Both the perceived direction and speed of these compound stimuli depended upon the relative motion-signal strengths of the grating and the dots. Those compound stimuli that appeared coherent were not discriminable from the speed-matched metameric compound stimuli. When the signals were completely integrated into a coherent compound stimulus, the local motion signals were no longer perceptually available, though both contributed to the global percept. These data strongly support a weighted-combination model where the relative weights depend on signal strength, instead of a winner-takes-all model.

Humans↗
PubMed2000

Newly designed retraction devices for intestine control during laparoscopic aortic surgery: a comparative study in an animal model.

BACKGROUND: Recent clinical studies have demonstrated the feasibility of laparoscopic surgery for aortic occlusive and aneurysmal disease. However, transperitoneal aortic access is compromised by poor exposure in the operative field from uncontrolled bowel. The retractors that are currently available are inadequate for this task. The development of new retractors would help to facilitate laparoscopic aortic surgery. METHODS: Six female piglets (28-30 kg) in each group underwent laparoscopy with pneumoperitoneum (12 mmHg). Exposure of the infrarenal aorta and cross-clamping were undertaken through a transperitoneal approach. Two paddles inserted in a polyester bilayer (mobile device, group A) or a mesh net fixed to the abdominal wall (fixed device, group B) were used to retain the bowel. Aortotomy and suturing were performed to mimic a vascular procedure. After bleeding was controlled, the intraabdominal pressure (IAP) was lowered to 6 mmHg, and retraction was assessed for 30 min. The main outcome measures were time to deploy the retractors, time to perform the vascular procedure, time to withdraw the devices, and total procedural time. Blood loss and frequency of retraction failure were also recorded. RESULTS: Mean time to deploy the device was 22 +/- 12 min in group A and 36 +/- 34 min in group B (n.s.). Vascular surgery time averaged 60 +/- 24 min in group A and 68 +/- 16 min in group B (n.s.). The times to withdraw the nets were 3.6 +/- 1.2 min and 13.5 +/- 8.2 min, respectively (p < 0.05). Total surgery time was 155 +/- 41 min vs 174 +/- 49 min (n.s.). There were six retraction failures, five in group A and one in group B. When lower IAP was used, there was only one failure in each study group. Mean blood loss was <150 ml in both groups. There were no major complications. CONCLUSIONS: Both methods provided adequate exposure of the infrarenal aorta. Vascular surgery time and blood loss were similar for both groups. The movable device proved more usable and, at lower IAP, more effective. The results of this study demonstrate effective bowel retraction for laparoscopic aortic surgery.

Animals↗
PubMed1998

The design of arm pressure covers to alleviate pain in high G maneuvers.

HYPOTHESIS: Arm pain has been noted especially when increased coverage anti-G suits are worn in combination with PBG (pressure breathing during G) in high G centrifuge test runs. Arm pain has forced the termination of test runs and has the potential to cause a serious decrement in a pilot's ability to function effectively during high-G flight. Based on the theory that arm pain is caused by fluid pooling in the arm, four new pressure cover systems for the arm were designed and tested. METHODS: Seven test subjects wore each design in a series of runs in a dynamic flight simulator (DFS). Subjects experienced both gradual and rapid onset rate runs with G levels ranging from +3.0 G to +9.0 G. Data were collected on the maximum G's achieved, pain location, and pain intensity. Subjective responses on the comfort and function of each design and overall arm cover design preferences were also obtained via a questionnaire. RESULTS: Analysis of the DFS data, using a two-factor ANOVA (subjects, designs), revealed that each of the new designs provided significantly better protection from arm pain than the control condition (no protection) and that each of the designs significantly improved the maximum G level attained during rapid onset acceleration in the range of +1 G. CONCLUSION: No positive correlation was found between subject ranking of the four new design concepts at the conclusion of the study in terms of the pain reduction they provided and the pain levels reported during DFS testing.

Adult↗
PubMed1997

Motion interference: perturbing perceived direction.

The minimum stimulus necessary to define motion is a change in position from one location to another in time, but past studies have provided evidence that the human motion system integrates motion over more than two positions. In this study we demonstrate strong sequential interactions affecting perceived direction in apparent-motion sequences; a perturbing dot can bias the perceived direction of motion between two test dots to which it is relatively close in space (up to 100 min arc) and time (up to 300 msec). These sequential interactions suggest a motion mechanism sensitive to the spatial characteristics of motion trajectories; the interactions are greatest for evenly spaced targets positioned along a single axis. The implications for motion-detection models and models based on attention as a mechanism to create apparent motion are discussed.

Humans↗
PubMed1997

Recruitment mechanisms in speed and fine-direction discrimination tasks.

The minimum information necessary to specify motion requires a change in position across time. Previous studies have shown that human motion measurements improve with more than two frames of motion. This study clarifies how motion information is integrated to produce the best speed and direction discrimination. Using random-dot kinematograms, fine-direction discrimination thresholds and speed discrimination thresholds are assessed as a function of dot lifetime. Specifically, we ask if performance on both tasks depends on dot lifetime in the same manner. If both speed and direction discrimination performance improve the same way with increasing dot lifetime, this would indicate that both tasks have the same integration limit and both tasks may depend on the same underlying mechanisms. Experiment 1 shows that for both tasks a four-frame dot lifetime is necessary for observers to reach asymptotic threshold levels. The absolute level of performance improves with increasing stimulus duration or signal-to-noise ratio, but the integration limit itself does not vary. Experiment 2 examines whether this integration limit is constrained by the number of frames or by the temporal duration of the dot lifetime. The data in Experiment 2 suggest that both a minimum number of samples and a minimal temporal integration period determine the integration limit for recruitment mechanisms. The results suggest that speed and fine-direction discrimination depend upon the same underlying motion mechanisms. These results are discussed in relation to possible underlying physiological substrates and computational models of motion measurement.

Discrimination, Psychological↗
PubMed1997

The effect of inducer polarity and contrast on the perception of illusory figures.

A study designed to determine how inducer-surround contrast and inducer polarity affect the contour clarity and the lightness of illusory figures is reported. Using magnitude estimation procedures, ten naive subjects rated both the contour clarity and the lightness of Kanizsa squares. The magnitude of the inducer-surround contrast and the inducer polarity (all-black, all-white, or black-and-white) were varied randomly on each trial. The data indicate that contour clarity increases with contrast at the same rate across polarity conditions but that contour clarity at any given contrast level depends significantly on polarity. Contour clarity judgments were significantly lower when the inducers were all-white than when the inducers were all-black or black-and-white, and significantly greater in the 'mixed' polarity case (black-and-white inducers) than in the 'same' polarity case (the average of the all-black and all-white inducer conditions). Inducer contrast and polarity significantly affected the lightness of the illusory figure in a manner consistent with simultaneous spatial contrast. Also, for a given increment in contrast, contour clarity altered significantly more than surface lightness, regardless of inducer polarity. The findings suggest that the mechanism which mediates boundary formation is sensitive to the direction of contrast, and that the boundary formation mechanism is more sensitive than the surface lightness mechanism to changes in contrast magnitude. The results are considered within the context of neural network models of form perception.

Adolescent↗
PubMed1997

Velocity-dependent improvements in single-dot direction discrimination.

Thirty-six Brown University students participated in three experiments designed to address perceptual learning. In each experiment, visual discrimination thresholds were tracked over 4,200 trials. Results from Experiment 1 suggest that the pattern of threshold reduction on a single-dot motion-direction discrimination task was stimulus direction specific and matched (in a velocity-dependent manner) the threshold reduction pattern previously reported for a line-orientation discrimination task. In Experiment 2, it was determined that the stationary-line-orientation-specific practice effects originally reported by Vogels and Orban (1985) could be replicated but were contingent on line length. Similarly, the results from Experiment 3 suggest that practice effects originally reported by Ball and Sekuler (1987) could be replicated but were contingent on stimulus velocity. Implications for the mechanisms underlying direction and orientation discrimination are considered.

Adolescent↗
PubMed1996

Midsagittal corpus callosum area, intelligence, and language dominance in epilepsy.

Alterations in midsagittal corpus callosum (CC) area and morphology have been suggested in several disease processes of the nervous system. In addition, some studies found a relation of CC area to handedness, language dominance, and gender. The relation of CC area to measures of intelligence and memory and the effect of epilepsy on CC area have received less attention. In this study CC area was measured on midsagittal magnetic resonance images in 48 patients undergoing presurgical evaluation of epilepsy and in 20 control subjects. All patients had the Wada test and formal neuropsychological testing. The mean CC area of the epilepsy group was significantly smaller than that of control subjects (p < 0.00001). CC area showed a positive correlation with presurgical performance IQ (p = 0.008) and full-scale IQ (p = 0.048), but not with memory scores or language dominance. There was no relation of CC area to location of epileptic focus, seizure types, age at onset, epilepsy duration, or etiology. The presence of an atrophic lesion was associated with a smaller CC area. The correlation of total CC area with performance and full-scale IQs may reflect axonal loss in patients with a low IQ resulting from the etiology of epilepsy or the epilepsy itself.

Adolescent↗
PubMed1994

Carbon monoxide controversies: neuropsychologic testing, mechanism of toxicity, and hyperbaric oxygen.

Recent animal and clinical data require a reevaluation of the traditional approach to the patient exposed to carbon monoxide. Unfortunately, these new data are inconclusive and generate controversies regarding the indications and value of neuropsychologic testing, cause of carbon monoxide toxicity, and indications (if any) for hyperbaric oxygen therapy. These controversies and their implications for the emergency physician are discussed.

Animals↗
PubMed1994

MRI asymmetries and language dominance.

OBJECTIVE: To examine the relationship between language dominance, as measured by Wada testing, and hemispheric asymmetries on MR brain images. BACKGROUND: A previous report that did not include verification of language dominance compared the length of the planum temporale with hemispheric asymmetries seen on CT and inferred that occipital lobe asymmetry is related to language dominance. METHODS: Language dominance was identified by the Wada test in 57 patients evaluated for surgical treatment of epilepsy. Fifty-five had an MRI scan that allowed accurate measurement. In a blinded fashion, two examiners independently measured bilateral frontal, parietal, and occipital lobe lengths on MR scan for each patient. Measurements of asymmetries were compared with language dominance established by the Wada test. RESULTS: Reliability of measurement between the examiners was 97%. Asymmetry of the occipital lobe length on MR scan 10 mm above the tentorium was the only measurement significantly related to language dominance (p < 0.01). Occipital lobe length was longer on the left in 19 (40%) and on the right in 10 (21%) patients with left dominance. The right lobe was longer in six of seven (86%) patients with bilateral dominance. One patient with right hemisphere dominance had a longer left lobe. None of the measurements significantly related to handedness. CONCLUSION: Asymmetries of occipital lobe length relate to language dominance, but such dominance cannot be reliably identified by MR in an individual patient.

Adolescent↗
PubMed1993

Improving education and resources for health care providers.

Workers and citizens are turning increasingly to the health care system for information about occupational and environmental reproductive hazards, yet most primary care providers and specialists know little about the effects of occupational/environmental toxicants on the reproductive system or how to evaluate and manage patients at potential risk. Although it is unrealistic to expect all clinicians to become experts in this area, practitioners should know how to take a basic screening history, identify patients at potential risk, and make appropriate referrals. At present, occupational and environmental health issues are not well integrated into health professional education in the United States, and clinical information and referral resources pertaining to reproductive hazards are inadequate. In addressing these problems, the conference "Working Group on Health Provider Education and Resources" made several recommendations that are detailed in this report. Short-term goals include enhancement of existing expertise and resources at a regional level and better integration of information on occupational/environmental reproductive hazards into curricula, meetings, and publications of medical and nursing organizations. Longer term goals include development of a comprehensive, single-access information and referral system for clinicians and integration of occupational and environmental medicine into formal health professional education curricula at all levels.

Curriculum↗
PubMed1992

Three-dimensional illusory contours and surfaces.

Under general viewing conditions, objects are often partially camouflaged, obscured or occluded, thereby limiting information about their three-dimensional position, orientation and shape to incomplete and variable image cues. When presented with such partial cues, observers report perceiving 'illusory' contours and surfaces (forms) in regions having no physical image contrast. Here we report that three-dimensional illusory forms share three fundamental properties with 'real' forms: (1) the same forms are perceived using either stereo or motion parallax cues (cue invariance); (2) they retain their shape over changes in position and orientation relative to an observer (view stability); and (3) they can take the shape of general contours and surfaces in three dimensions (morphic generality). We hypothesize that illusory contours and surfaces are manifestations of a previously unnoticed visual process which constructs a representation of three-dimensional position, orientation and shape of objects from available image cues.

Form Perception↗
PubMed1992

Neural computing in cancer drug development: predicting mechanism of action.

Described here are neural networks capable of predicting a drug's mechanism of action from its pattern of activity against a panel of 60 malignant cell lines in the National Cancer Institute's drug screening program. Given six possible classes of mechanism, the network misses the correct category for only 12 out of 141 agents (8.5 percent), whereas linear discriminant analysis, a standard statistical technique, misses 20 out of 141 (14.2 percent). The success of the neural net indicates several things. (i) The cell line response patterns are rich in information about mechanism. (ii) Appropriately designed neural networks can make effective use of that information. (iii) Trained networks can be used to classify prospectively the more than 10,000 agents per year tested by the screening program. Related networks, in combination with classical statistical tools, will help in a variety of ways to move new anticancer agents through the pipeline from in vitro studies to clinical application.

Alkylating Agents↗
PubMed1992

Hard metal interstitial pulmonary disease associated with a form of welding in a metal parts coating plant.

We describe two cases of hard metal pulmonary disease (one fatal) in workers employed in the same area of a metal coating plant using the detonation gun process for applying a durable metal surface to metal parts. In this form of welding, a mixture of powdered metals, including tungsten carbide and cobalt, is heated by ignition of a flammable gas and propelled from the end of the "gun" at high temperature and velocity to form a welded metal coating. This process is done in an enclosed chamber and with each application, large volumes of fine aerosols are created. Inhalation exposure to hard metal may occur during the mounting and removal of the metal parts between applications, in spite of engineering controls and industrial hygiene surveillance. One of the cases presented with minimal chest x-ray abnormalities and an obstructive pattern on pulmonary function testing, although subsequent open lung biopsy showed diffuse interstitial pulmonary fibrosis. The fact that two cases of hard metal pulmonary interstitial disease occurred where thorough exposure control procedures and a surveillance program for cobalt were in place may indicate the need for revisions of the current technology used when hard metal is applied in the detonation gun process.

Adult↗
PubMed1992

The precision of size constancy.

The precision of objective size judgments, made when target disparity changed at random from trial-to-trial, was compared to the precision of angular size judgments made under the same condition. Subjects judged incremental changes in the vertical distance separating a pair of horizontal lines. For the objective judgments (in cm), the angle subtended by the target separation decreased with increasing depth consistent with the natural geometry of physical objects. For the angular judgments (in arc min), the angular separation did not change with disparity. For separations subtending an angle < 10 arc min, objective thresholds were considerably higher than angular thresholds, indicating that size constancy does not function well at small scales. At larger scales (> 20 arc min), the Weber fractions for angular and objective thresholds were nearly equal (approximately 6%) for two of the three subjects. These same two subjects also learned to judge "objective size" when angular subtense systematically increased with increasing depth in an exact inversion of the natural relationship. Although their "anti-constancy" judgments were less precise (approximately 9%) than their constancy judgments, the fact that subjects could learn this task with little practice suggests that constancy itself may be a learned response. Angular thresholds for targets presented only in the fixation plane were significantly lower than the angular thresholds measured with random changes in disparity, showing that observers with normal stereopsis do not have direct access to information about the angle subtended at the retina.

Depth Perception↗