Effect of hormone replacement therapy on cancer detection by mammography.
Explore the source record for details and available documents.
Breast Neoplasms↗
Biomedical subjects
M E Cohen
Publications and source records attributed to M E Cohen.
Use of shoulder flexors to achieve isometric elbow extension in C6 tetraplegic patients during weight shift.
The anterior deltoid muscle has been found to be active during elbow extension in normal volunteers and in C6 tetraplegic patients lacking a functional triceps. Using surface electromyography (EMG) on normal volunteers and on patients with spinal cord injury (SCI) at the C6 motor level, we evaluated whether the anterior deltoid and biceps brachii muscles are active during closed chain elbow extension in a simulated weight shift position. Thirteen normal volunteers performed isometric contractions at 5 submaximal levels of force ranging from 4-25 kg. Six SCI patients performed isometric contractions at force levels of 20%, 40%, 60%, 80% and 100% maximum voluntary contraction (MVC). Surface EMG over the right biceps, triceps, and anterior deltoid muscles was recorded for each participant and the root mean square (rms) electromyographic activity level for each muscle was determined at each level of force. Statistical analyses using repeated ANOVA with Tukey HSD post-hoc tests were performed for each level of force. The results indicated increasing rms activity of the triceps and anterior deltoid muscles with increasing force in normal volunteers to a significant degree (P < 0.05). SCI patients showed significant increasing activity of the anterior deltoid with increasing force, but showed minimal triceps rms activity. In both groups, the biceps showed minimal rms activity. SCI patients exhibited significantly greater rms activity of the anterior deltoid at low force compared with normal volunteers. The results suggest that the anterior deltoid aids in isometric elbow extension during a simulated weight shift maneuver.
Activities of Daily Living↗
On the interpretation of microbial clusters in periodontal disease.
Cluster analysis is sometimes used in periodontal research to describe patterns of microbial identifications observed among cases (subjects or sites). These patterns are assumed to define subsets of cases that are meaningful, in the sense of defining periodontal subgroups that have reliable differences in some aspect of their disease. However, cluster analysis is an exploratory, first-stage technique that does not incorporate the machinery that allows one to evaluate the statistical significance and reliability of the patterns observed. Problems inherent in drawing inferences from cluster analysis are discussed and, as one methodological example of how the statistical significance of clustering might be determined, a randomization-based test for binary scaled microbial identifications is described. The introduction of cluster analysis to the study of periodontal microbiology was important and innovative, but future work needs to incorporate validation by either statistical means or independent replication. The present rarity of such confirmatory methods in the literature suggests caution in accepting specific cluster-based hypotheses about patient-microbial patterns.
Analysis of Variance↗
Group dynamics in forensic pretrial decision-making.
This study examines how forensic evaluators' opinions that pertain to diagnosis, competency to stand trial, and criminal responsibility (Maryland's version of the not guilty by reason of insanity plea) are rendered at a state forensic hospital for defendants pleading not criminally responsible. Pretrial evaluations completed independently by a psychiatrist, a psychologist, and a social worker were presented at a forensic staff conference where psychiatrist and psychologists openly "voted" on diagnosis, competency to stand trial, and criminal responsibility. These results were then sent to the court. The purpose of this study was to assess the clinicians' level of agreement and the role that conformity played in the decision-making process. A sample of twenty court-ordered pretrial evaluations of defendants examined at the hospital between March and June 1991, with evaluators' opinions generated by a secret ballot, were compared with a matched control group from an earlier time, when opinions were generated by open ballot. The study was designed to compare the opinions of forensic evaluators in the issues of diagnosis, competency to stand trial, and criminal responsibility between the two samples. The defendants in the experimental group and the control group were matched on the basis of age, race, sex, and offense. It was hypothesized that with secret ballot voting there would be a greater disparity of agreement regarding diagnosis, competency to stand trial, and criminal responsibility opinions compared with the open method of voting. However, the results of this study did not support that hypothesis. There was little disparity on forensic opinions rated either by secret or open voting.
Adolescent↗
Brush border phosphatidylinositol 3-kinase mediates epidermal growth factor stimulation of intestinal NaCl absorption and Na+/H+ exchange.
In terminally differentiated ileal villus Na+-absorptive cells, epidermal growth factor (EGF) stimulates NaCl absorption and its component brush border Na+/H+ exchanger, acting via basolateral membrane receptors, and as we confirm here, a brush border tyrosine kinase. In the present study we show that brush border phosphatidylinositol 3-kinase (PI 3-kinase) is involved in EGF stimulation of NaCl absorption and brush border Na+/H+ exchange. In rabbit ileum studied with the Ussing chamber-voltage clamp technique, EGF stimulation of active NaCl absorption is inhibited by the selective PI 3-kinase inhibitor wortmannin. PI 3-kinase, a largely cytosolic enzyme, translocates specifically to the brush border of ileal absorptive cells following EGF treatment. This translocation occurs as early as 1 min after EGF treatment and remains increased at the brush border for at least 15 min. EGF also causes a rapid (1 min) and large (4-5-fold) increase in brush border PI 3-kinase activity. Involvement of PI 3-kinase activity in intestinal Na+ absorption is established further by studies done in the human colon cancer cell line, Caco-2, stably transfected with the intestinal brush border isoform of the Na+/H+ exchanger, NHE3 (Caco-2/NHE3 cells). Brush border Na+/H+ exchange activity was measured using the pH-sensitive fluorescent dye 2'7'-bis(carboxyethyl)5-(6)-carboxyfluorescein. EGF added to the basolateral surface but not apical surface of Caco-2/NHE3 cells increased brush border Na+/H+ exchange activity. The EGF-induced increase in brush border Na+/H+ exchange activity was completely abolished in cells pretreated with wortmannin. EGF treatment caused increased tyrosine phosphorylation of PI 3-kinase in both ileal brush border membranes and Caco-2/NHE3 cells, suggesting that a tyrosine kinase upstream of the PI 3-kinase is involved in the EGF effects on Na+ absorption. In conclusion, the present study provides evidence in two separate intestinal models, the ileum and a human colon cancer cell line, that PI 3-kinase is an intermediate in EGF stimulation of intestinal Na+ absorption.
Androstadienes↗
Perfusion liquid chromatography of whey proteins.
A perfusion reversed-phase (RP) HPLC method was developed for the rapid separation of the main bovine whey proteins: alpha-lactalbumin (alpha-LA), serum albumin (BSA) and the genetic variants of beta-lactoglobulin (A and B) (beta-LG A and beta-LG B). For the method development, the influence of factors favouring structural changes of proteins (temperature and organic acid concentration in the mobile phase), gradient and other chromatographic conditions and the mass of protein injected was examined. The optimized method allowed the separation of proteins in about 1.5 min (cycle time 3.5 min) with resolution around 1.0 for the beta-lactoglobulins. The method was applied to the determination of proteins in a whey from raw bovine milk. The precision of the determinations was < or = 3.75 mg per 100 ml (S.D.). With respect to the accuracy, errors < or = 7.0% in the determination of alpha-LA, beta-LG A and beta-LG B were obtained, compared with an RP-HPLC reference method. However, higher errors in the quantification of BSA were found owing to the lack of purity of the peak assigned. In addition, the proposed method has proved to be very useful in the detection of homologous whey proteins from different species (cow, sheep and goat) in milk mixtures.
Animals↗
Long term survivors of childhood brain stem gliomas treated with hyperfractionated radiotherapy. Clinical characteristics and treatment related toxicities. The Pediatric Oncology Group.
BACKGROUND: Over the past decade, the principal focus of research in pediatric brain stem gliomas has been on the use of hyperfractionated radiotherapy (HRT). The purpose of this study was to evaluate the clinical characteristics and treatment related toxicities of long term survivors of HRT treatment. METHODS: Of the 130 children with brain stem tumors treated with escalating doses of HRT on Pediatric Oncology Group (POG) #8495, there are only 9 long term survivors. Prospectively collected data, including flow sheets and all pretreatment and follow-up radiologic studies, were reviewed for these patients. Additional information was requested from the treating institutions with regard to sequelae of treatment. RESULTS: Clinical characteristics (including age, sex, duration of symptoms, and presenting signs) for the nine surviving patients were not different from the total population of patients treated on POG #8495. Pretreatment imaging, however, revealed that only four of the nine patients had typical diffuse intrinsic pontine lesions and, conversely, that at least three of the nine patients had lesions that would now be considered relatively favorable. Complete information regarding treatment related toxicity was available for eight patients, only one of whom is without sequelae. Seven have schooling difficulties, two have a seizure disorder, five have hearing loss, and two have required growth hormone replacement. Follow-up imaging findings were striking in four of the eight patients because of white matter changes consistent with leukoencephalopathy (two patients), diffuse microhemorrhages (one patient), and dystrophic calcification (one patient) in the radiation field. CONCLUSIONS: The high frequency of treatment related sequelae in long term survivors of HRT suggests a need for caution in the use of HRT, particularly in patients who have brain stem tumors with a more favorable prognosis.
Adolescent↗
Asymmetric signal transduction in polarized ileal Na(+)-absorbing cells: carbachol activates brush-border but not basolateral-membrane PIP2-PLC and translocates PLC-gamma 1 only to the brush border.
In ileal Na+ absorptive cells, carbachol inhibits NaCl absorption and its component brush-border Na+/H+ exchanger, acting via basolateral membrane (BLM) receptors. This carbachol effect involves brush-border but not BLM protein kinase C. In the present work we describe another asymmetric aspect of signal transduction in these epithelial cells, this time involving phosphatidylinositol 4,5-bisphosphate (PIP2)-specific phospholipase C (PLC). Thirty seconds and 1 min after carbachol treatment, brush-border PIP2-specific PLC activity increased, returning to control levels by 2.5 min. Involvement of brush-border tyrosine kinase(s) in this effect was suggested by inhibition of the carbachol effect on NaCl absorption by the tyrosine kinase inhibitor genistein, added to the mucosal but not the serosal surface. Luminal genistein pretreatment also prevented the carbachol-induced increase in brush-border PLC activity. In contrast, carbachol exposure did not change the BLM PIP2-specific PLC activity. Western analysis and immunoprecipitation demonstrated that PLC-gamma 1 is present in the brush border and that carbachol increases the PLC-gamma 1 amount in the brush border. Both the brush border and BLM contain PLC-beta 3 and a small amount of PLC-delta 1 but no PLC-beta 1, whereas BLM lacks detectable PLC-gamma 1. No change in PLC-beta 3 or PLC-delta 1 amount in the brush border occurred with carbachol exposure. No change in tyrosine phosphorylation of brush-border PLC-gamma 1 occurred with carbachol treatment. The Ca2+ ionophore A23187 did not alter PIP2-specific PLC activity in either the brush border or the BLM. These studies demonstrate that carbachol but not Ca2+ ionophore effects on brush-border NaCl absorption are associated with increases in brush-border but not BLM PIP2-specific PLC activity and in the amount of brush-border PLC-gamma 1, and involve tyrosine phosphorylation. This asymmetric aspect of epithelial signal transduction, together with the previous demonstration of localization of high-sensitivity IP3 stores to the apical membrane area in intestinal epithelial cells, shows that different aspects of signal transduction occur at the apical and basolateral membranes in epithelial and requires studies in both domains to define mechanisms of intracellular signalling.
Animals↗
Propofol: an alternative general anesthetic for outpatient oral surgery.
PURPOSE: This study compared propofol with methohexital for use in outpatient general anesthesia for oral surgery procedures. PATIENTS AND METHODS: Fifty American Society of Anesthesia (ASA) class I or II patients undergoing elective minor oral surgery procedures were selected for inclusion in the study. Participants were randomly divided into two groups-propofol-treated and methohexital-treated. All anesthetic agents were titrated in bolus using dosages standardized by weight. After premedication with intravenous midazolam and fentanyl, general anesthesia was induced either by propofol or methohexital. The quality of the anesthesia was subjectively evaluated by the anesthetist, surgeon, and the patient. Also, a standardized battery of tests was developed to quantitatively evaluate recovery from anesthesia. RESULTS: Propofol showed significantly less percentage increase in diastolic blood pressure and heart rate than methohexital. However, at the same time, propofol showed significantly greater percentage lowering of diastolic blood pressure. The mean low heart rate percentage of preoperative baseline were different, but both were greater than 100%. The anesthetist and patient evaluations showed no statistically significant difference in the acceptance of either agent. No patient in either group had any recollection of pain with induction or any recollection of the operation itself. There were no statistically significant effects of group in recovery test performance, although patients tended to recover more quickly in the symbol digit test and object recall test with propofol. No patient complained of any postoperative complications secondary to the anesthetic. CONCLUSIONS: Propofol is a suitable agent for induction and maintenance of general anesthesia for outpatient oral surgery procedures. It provides a smooth induction of anesthesia with few excitatory effects.
Adjuvants, Anesthesia↗
Strength post-spinal cord injury: myometer vs manual muscle test.
This study was designed to compare changes in strength after spinal cord injury (SCI) with the use of a hand held myometer to the manual muscle test (MMT). Eighty-eight C4-C8 Frankel A-D tetraplegic subjects were tested at various times up to 2 years post-SCI. Elbow flexor strength on successive examinations were grouped according to their early and later MMT scores (3.5 with no change in MMT. 3.5 to 4.0, and 3.5 to 4.5; 4.0 with no change in MMT, 4.0 to 4.5, and 4.0 to 5.0; 4.5 with no change in MMT, and 4.5 to 5.0). For each group, later myometric measurements (MYO) were expressed as percents of their earlier MYO and were analyzed using paired Student t-tests. Later MYO were 116, 205, 232% (P > 0.05, P < 0.002, P < 0.05) of their earlier MYO for groups 3.5 with no change in the MMT, 3.5 to 4.0, and 3.5 to 4.5 respectively. Later MYO were 140, 139, 191% (P < 0.05, P < 0.02, P < 0.0001) of their earlier MYO for groups 4.0 with no change in MMT, 4.0 to 4.5, and 4.0 to 5.0 respectively. Later MYO were 127 and 126% (P < 0.01, P < 0.02) of their earlier MYO for groups 4.5 with no change in MMT and 4.5 to 5.0 respectively. In conclusion the hand held myometer detected changes in muscle strength not detected by the MMT.
Adolescent↗
Effect of model fitting artifacts on the stepwise approach to identifying patterns of attachment loss.
The stepwise approach to the determination of periodontal attachment loss involves fitting linear, logarithmic, and exponential models to individual site data and concluding that the form of loss is consistent with the model that has the greatest r-value, provided that the model predicts loss in excess of a site-specific threshold. Logarithmic and exponential fits are considered to define early and late bursts, respectively, while linear fit describes loss at a constant rate. In a recently published study, the stepwise approach was applied to 6,935 sites in patients with established periodontitis and, of 581 loss detections, 195 (33.6%) were linear, 224 (38.6%) logarithmic, and 162 (27.9%) exponential. However, curvilinear patterns may occur by chance and regression algorithms that can fit such curvature may have an advantage unrelated to the true mechanism(s) [correction of mchanism(s)] of periodontal destruction. To investigate the implications of this possibility, proportions of linear, logarithmic, and exponential fit were estimated by simulation under four different conditions. These conditions incorporated random or random plus linear change, but no nonlinear effects. The relative proportions of model fits described in the published study were approximated in all of these conditions. It would appear that the observed proportions are ubiquitous to the modelling approach itself, and do not constitute evidence of a causal non-linear biological mechanism. The stepwise approach may be useful for detecting change but relevance to causal processes seems problematic.
Algorithms↗
NHE2 and NHE3 are human and rabbit intestinal brush-border proteins.
Rabbit NHE2 and NHE3 are two epithelial isoform Na+/H+ exchangers (NHE), the messages for which are found predominantly and entirely, respectively, in renal, intestinal, and gastric mucosa. The current studies used Western analysis and immunohistochemistry to identify and characterize the apical vs. basolateral membrane distribution of NHE2 and NHE3 in intestinal epithelial cells. Based on Western analysis, NHE2 and NHE3 both are present in brush-border but not basolateral membranes of small intestine. Both NHE2 and NHE3 are 85-kDa proteins. Consistent with Western analysis, NHE2 and NHE3 are immunolocalired to the brush-border but not basolateral membranes of villus epithelial cells, but not goblet cells, in human jejunum and ileum and in surface epithelial cells in the ascending and descending colon and rectum. In addition, NHE2 and NHE3 are present in small amounts in the crypt cell brush border of human jejunum, ileum, ascending and descending colon, and rectum. In rabbit jejunum, ileum, and ascending colon, NHE2 and NHE3 are present in the brush border of epithelial and not goblet cells, again much more in the villus (small intestine)/ surface cells (colon) than the crypt. NHE2 but not NHE3 is present in the brush border of rabbit descending colon surface cells and in small amounts in crypt cells. NHE2 and NHE3 are both human and rabbit small intestinal and colonic epithelial cell brush-border Na+/H+ exchanger isoforms that colocalize in all intestinal segments except rabbit descending colon, which lacks NHE3.
Animals↗
Interleukin-1 beta, prostaglandin E2, and immunoglobulin G subclasses in gingival crevicular fluid in patients undergoing periodontal therapy.
Determination of the presence of inflammatory products found in gingival crevicular fluid (GCF) may be of value in evaluating both periodontal disease status and the outcome of therapy. Immunoglobulin G subclasses 1 through 4 (IgGs), interleukin 1-beta (IL-1 beta), and prostaglandin E2 (PGE2) have all been shown to be present in GCF. This study monitored IgGs, IL-1 beta, and PGE2 in GCF of 18 adult patients as they progressed through periodontal treatment toward maintenance therapy. Sites were selected from the most severely affected sextant as determined by probeable crevice depth (PD) at initial examination (IE). GCF was collected on four occasions: initial examination; 4 weeks after completion of initial therapy (oral hygiene counseling, and scaling and root planing); 3 months after completion of surgery; and 7 to 9 months later at a maintenance visit. All variables were reduced to binary form (positive or negative), and break points chosen to separate the approximately symmetrical bell-shaped areas (negatives) from the skewed tails (positives). Repeated measures analyses of variance were performed to detect significant changes in all variables across time. Significant improvements were observed for all the clinical variables measured: PD, attachment level, and bleeding on probing. However, significant reductions for the GCF components only occurred in the concentrations of IL-1 beta and PGE2, but were not evident until the maintenance sampling. Surprisingly, GCF:serum ratios of IgG subclasses did not change significantly over the course of the investigation. The robustness of the levels of these components may be due to inflammation associated with the healing process, or to a further plaque induced response.
Adult↗
Tobacco use habits of naval personnel during Desert Storm.
This study examined availability and usage of tobacco products, and their potential impact on the oral health of naval personnel deployed to Desert Storm. Of 4,200 surveys mailed to a randomly selected sample, 45.6% were returned (N = 1,915). The respondents included 55.9% who reported a present or former smoking habit, 34.1% who identified themselves as current smokers (SM), and 23.8% who were smokeless tobacco (ST) users. Tobacco products were easily and inexpensively accessible through ship stores, exchange, or military support organizations (USO). While in the Persian Gulf, 7.0% started SM and 9.3% started ST, resulting in an overall 4.7 and 6.1% increase in SM and ST, respectively. Of those who were already tobacco users, 29.2% reported more SM use and 19.0% used ST more often. Stress (35.1%) and boredom (21.4%) were the most frequently cited reasons to start or increase use. Although 30.5% of respondents reported military personnel have encouraged them to quit, 77.2% reported that anti-smoking efforts have been unsuccessful in influencing them to quit. Since the tobacco usage rate is higher in the military than in the civilian sector, greater emphasis on preventive efforts in warranted to promote health and wellness.
Adult↗
Lack of efficacy of postoperative chemotherapy and delayed radiation in very young children with pineoblastoma. Pediatric Oncology Group.
Eleven infants with pineoblastomas were treated with prolonged postoperative chemotherapy in an attempt to delay radiation and reduce neurotoxicity. These infants were part of the Pediatric Oncology Group infant brain tumor study but the outcome of infants with pineoblastomas was not previously reported. Ages ranged from 1 month to 35 months, with eight of 11 < or = 12 months at diagnosis. Four had + cytology and three had + myelograms at diagnosis. The majority had partial surgical resection (25-75% reduction in tumor) and 10 had shunts. Chemotherapy consisted of two 28-day cycles of cyclophosphamide plus vincristine, followed by one 28-day cycle of cisplatin plus etoposide. Craniospinal radiation was planned following completion of either 2 years of chemotherapy (children less than 24 months at diagnosis) or following one year (children 24-36 months at diagnosis). Neuroimaging results following two cycles of cyclophosphamide and vincristine were one partial response, five stable disease, and five progressive disease. There were no responders in the leptomeninges. All children ultimately failed chemotherapy (2 months-11 months). Nine failed in the primary site. Of those eight children in whom a metastatic workup was performed at time of progression, all had evidence of leptomeningeal disease. Six received radiation following failure on chemotherapy. All failed either in the primary site, leptomeninges or extraneurally (peritoneal cavity). All children died. Survival following diagnosis ranged from 4 months to 13 months. This chemotherapy regimen was neither effective in controlling tumor in the primary site nor in treating or preventing leptomeningeal spread.
Antineoplastic Combined Chemotherapy Protocols↗
Treatment of blue nevi with the Q-switched ruby laser.
The common blue nevus is a benign, localized collection of dermal melanocytes. To date, removal required excisional surgery to eliminate pigment that usually extends into the reticular dermis. We report the successful long-term elimination of common blue nevi on the nasal skin of two patients whose lesions were treated with the laser emission of 694 nm energy from the Q-switched ruby laser.
Adult↗
Elbow extension using anterior deltoids and upper pectorals in spinal cord-injured subjects.
OBJECTIVE: Surface electromyography was used to identify muscles active in isometric elbow extension in spinal cord-injured (SCI) patients. DESIGN: Tetraplegic subjects participated in this cohort study aimed at identifying some of the muscles that are active during isometric elbow extension. SETTING: Regional Spinal Cord Injury (SCI) Center. PATIENTS: The patients had to have a C6 motor level on the right side (wrist extensor > or = 3/5) with 0/5 or 1/5 elbow extensor muscle power. Of 32 patients who could be contacted by telephone, 6 eventually were able to make it to the SCI center for testing. MEASUREMENTS: The patients performed a series of isometric elbow extension contractions of 25%, 50%, and 75% of maximum voluntary contraction (MVC) as measured by a force transducer. Surface electromyography (EMG) of the right elbow extensor, anterior deltoid, and upper pectoral muscles was measured using the root mean square (rms) of the amplitude of the motor unit activity as the parameter of muscle activity. Statistical analyses were performed using a repeated analysis of variance (ANOVA) with Tukey post-hoc HSD for each percentage of MVC. RESULTS: For each muscle tested, there was significantly (p < 0.05) greater rms activity for each percentage of MVC except between 50% and 75% MVC of the elbow extensor muscle. However, the elbow extensor muscle had minimal EMG activity when compared with the amplitude of the rms activity of the anterior deltoid and upper pectoral muscles for each percentage of MVC. CONCLUSION: The results of the study suggest that the anterior deltoid and the upper pectoral muscles exert an isometric elbow extension force for C6 quadriplegic patients.
Adult↗
Effects of gender-related factors on the incidence of localized alveolar osteitis.
Numerous literature references have suggested increased risk for localized alveolar osteitis associated with female gender, use of oral contraceptives, and point in menstrual/contraceptive cycle. However, the available information has not been systematically considered with the intent to accurately estimate the magnitude of these effects. The present review suggests that under certain conditions, some of which may be avoidable, females may have at least a two to threefold increase in osteitis risk compared with males. It appears that this greater risk may be reduced by considering hormonal cycles when scheduling elective exodontia.
Contraceptives, Oral, Hormonal↗