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Biomedical subjects

P Wozniak

Publications and source records attributed to P Wozniak.

At least 19 recordsLinked to original sources

An association between the matrix metalloproteinase 1 promoter gene polymorphism and lymphnode metastasis in breast cancer.

A single guanine insertion (1G/2G polymorphism) in the promoter of the matrix metalloproteinase (MMP-1) gene creates a binding site for the transcription factor and may affect the level of transcription of MMP-1. An elevated level of MMP-1 in cancer cells may facilitate their invasion and contribute to metastasis. To evaluate the contribution of 1G/2G polymorphism in the development and/or progression of breast cancer we genotyped 135 subjects with breast cancer. The 1G/2G polymorphism was determined by the method based on restriction endonuclease digestion. We found that the frequency of the 2G allele was higher in lymphnode-metastasis patients than in the group without metastasis (p < 0.001). We did not find differences between distribution of the genotypes and frequencies of alleles in cancer patients and in healthy subjects served as control. Our results suggest that allele 2G may be associated with lymphnode metastasis in patients with breast cancer and therefore it can be considered as a prognostic marker in this disease.

Alleles↗

Treatment of high-risk superficial bladder cancer with maintenance bacille Calmette-Guérin therapy: preliminary results.

OBJECTIVE: To evaluate, in a prospective study, the effects and results of maintenance therapy with bacille Calmette-Guérin (BCG) in treating patients with high-risk superficial bladder cancer. PATIENTS AND METHODS: In all, 155 patients were enrolled in a randomized study of transurethral resection alone (53) or combined with intravesical BCG (102) as a treatment for superficial bladder cancer. BCG was administered for six consecutive weeks followed by three weekly instillations in months 3, 6, 12, 18, 24, 30 and 36 after resection. Recurrence, progression, prognostic factors and side-effects were assessed and analysed. RESULTS: After a median (range) follow-up of 23 (6-42) months, 83 of the 102 patients treated with BCG (81%) were disease-free, compared with 24 of the 53 treated with resection alone (45%). There was also a significant difference in tumour progression and time to progression between the trial arms. The disease progressed in eight patients (8%) treated with BCG and in 12 (23%) of those treated by resection alone. Independent risk factors for progression were DNA ploidy status and stage. Only the completion of treatment was predictive of outcome (risk of recurrence) for patients treated with BCG. CONCLUSION: Maintenance BCG therapy was better than resection alone in reducing the incidence of recurrence and progression in patients with high-risk superficial bladder cancer.

Adjuvants, Immunologic↗

Lateral spine densitometry in obese women.

The lateral (LAT) spine scan has been suggested as a more sensitive measure than posterior-anterior (PA) scanning for assessing age-related bone loss in normal-weight postmenopausal women. The measurement error of PA and LAT bone mineral density (BMD) using dual energy X-ray absorptiometry (DXA) has also been shown to rise with incremental increases in fat and from large variance in fat thickness, respectively. The purpose of this cross-sectional study was to determine specific affects of obesity on paired PA and LAT lumbar (L2-L4) BMD and Z score (BMD of patient versus age-matched reference data-base) correlation in 30 obese postmenopausal women (mean BMI +/- SD = 33.3 +/- 4.06). The mean PA and LAT BMD +/- SD were 0.946 +/- 0.123 and 0.749 +/- 0.134, respectively. The mean PA and LAT Z scores were -0.17 +/- 1.15 and 0.80 +/- 1.7. The correlation between PA and LAT BMD was significantly lower (r = 0.55; P < 0.05) than previously reported, and PA and LAT Z score correlation was (r = 0.57; P = 0.0016). After adjusting for body mass index (BMI), percent body fat, fat mass, and truncal fat by DXA, waist:hip ratio (WHR) and visceral and subcutaneous abdominal fat by computerized axial tomography (CT), PA and LAT Z score correlation increased to r = 0.62; P = 0.0065. In our subjects, the mean LAT Z score was 4.6 times higher than the mean AP Z, contrary to previous observations in normal-weight postmenopausal women. Our findings may be due to increased soft tissue composition and fat inhomogeneity in the LAT scanning field resulting in increased X-ray attenuation in obesity.

Absorptiometry, Photon↗

Long-term efficacy and safety comparison of sertindole and haloperidol in the treatment of schizophrenia. The Sertindole Study Group.

Sertindole is an atypical antipsychotic that is efficacious in schizophrenia and is associated infrequently with extrapyramidal symptoms (EPS). This study assessed time to treatment failure with 24 mg/day sertindole or 10 mg/day haloperidol in 282 clinically stable neuroleptic-responsive outpatients with schizophrenia. During a 5-week transition period, patients were randomized to treatment with sertindole or haloperidol; other treatments were gradually discontinued. Patients then received treatment through Day 365. Time to treatment failure was numerically superior in sertindole-treated patients compared with haloperidol-treated patients, although this difference was not statistically significant. Sertindole-treated patients, however, remained free of hospitalization for exacerbation of schizophrenia and remained medically compliant significantly longer than did haloperidol-treated patients. In addition, there were significantly fewer reports of EPS in sertindole-treated patients and sertindole therapy was generally well tolerated. Patients transitioned well from other antipsychotic agents to sertindole. Sertindole appears to be an effective long-term treatment for schizophrenia.

Adolescent↗

Power lines and ionizing radiation.

The magnetic field and ionizing radiation dose rate were measured near ground level in the vicinity of a utility power line. The dose rate was monitored using thermoluminescence detectors. Measurements were made at distances up to about 100 m from the main transmission line from the Kewaunee Nuclear Power Plant while the plant was in operation and while the plant was shut down for refueling. No evidence was found that the dose rate is significantly different in the presence of the magnetic field from the power line than in its absence.

Climate↗

Validity and reliability of reported dietary intake data.

OBJECTIVE: To compare two training techniques for validity and reliability of dietary instruments and the measurement of total energy expenditure (TEE) to determine whether technique could influence the accuracy of food portion estimates. DESIGN: Adult women were randomized into a control group and an experimental group for comparison of training technique. SETTING: University and research center. SUBJECTS: Five hundred women were screened using the Three-Factor Eating Questionnaire to identify restrained eaters or disinhibitors. Other criteria for selection included good health; absence of thyroid, respiratory, or other diseases; normal menstrual cycles; between the ages of 18 and 50 years. Forty-nine were recruited, with an attrition rate of 10% for a total sample of 44 subjects. INTERVENTION: The control group (n = 26) was trained with food models and the experimental group (n = 18) was trained with a combination of food models and life-sized food photographs. All subjects completed two 24-hour recalls and 14 consecutive days of food records. TEE was measured by the doubly-labeled water method. MAIN OUTCOME MEASURES: Training would improve the accuracy of food portion estimates. STATISTICAL ANALYSES PERFORMED: Analysis of variance, the paired t test, Pearson's correlation coefficient, and Wilcoxon's ranking test. RESULTS: The mean reported intake between instruments was found to be reliable; however, the comparison with TEE was underreported by 21.4% and was thus nonvalid. Training technique made no difference in validity or reliability. Both training techniques improved the accuracy of food portion estimates; however, improvement was enhanced with food photographs. APPLICATIONS/CONCLUSION: The findings indicate that training can improve food portion estimates, and dietary instruments may provide reliable but nonvalid results.

Adult↗

T lymphocyte subpopulations and lymphocyte proliferative activity in normal and pre-eclamptic pregnancy.

The purpose of this study was to assess whether any changes occur in the cellular immunity in normal and pre-eclamptic pregnancy. T lymphocyte subpopulations and the lymphocyte proliferative responses to mitogens (PHA, Con A, PWM) in the fetal calf serum were examined in normal pregnant and pre-eclamptic primiparas in the third trimester of pregnancy. In normal pregnancy the absolute and percentage numbers of CD3+ and CD4+ T cells were significantly lower and the CD4+/CD8+ ratio almost halved, in comparison with non-pregnant subjects. In the pre-eclamptic women a decreased absolute and percentage content of CD8+ T cells and increased percentage of CD3+ and CD4+ lymphocytes were found--in comparison with the normal pregnant women--which led to an almost 2.5-fold increase of the CD4+/CD8+ ratio. No disorders were found in the lymphocyte proliferative responses to mitogens in either normal or pre-eclamptic pregnancy. We conclude that despite the shifts among T lymphocyte subsets, mitogen-induced lymphocyte proliferation presents its functional stability and unchanged reactivity in normal and pre-eclamptic pregnancy.

CD3 Complex↗

Maternal and paternal disciplinary styles: relations with preschoolers' playground behavioral orientations and peer status.

To explore relations among parents' self-reported disciplinary styles, preschoolers' playground behavioral orientations, and peer status, 106 mothers and fathers of preschool-age children (age range = 40-71 months) participated in home disciplinary style interviews. Observations of their children's playground behavior in preschool settings and measures of sociometric status were also obtained. Results indicated that children of more inductive mothers and fathers (i.e., less power assertive) exhibited fewer disruptive playground behaviors. In addition, daughters and older preschoolers of inductive mothers exhibited more prosocial behavior. Children of inductive mothers were also more preferred by peers. Few significant relations were found between paternal discipline and child behavior/peer status. Age-related patterns of behavior also indicated that older preschoolers who engaged in more prosocial and less antisocial and disruptive playground behavior were more preferred by peers. In addition, child behaviors were found to mediate maternal discipline and peer status.

Child, Preschool↗

Usefulness of the automatic implantable cardioverter defibrillator in improving survival of patients with severely depressed left ventricular function associated with coronary artery disease.

Clinical outcome was analyzed among a group of 39 consecutive patients with coronary artery disease, left ventricular (LV) ejection fractions less than 30% and arrhythmias that required an automatic implantable cardioverter defibrillator (AICD) in an attempt to better define the role of the device in patients with severely depressed LV function. Twenty-nine (74%) were survivors of out-of-hospital cardiac arrest and 10 (26%) had ventricular tachycardia that was refractory to electrophysiologically guided antiarrhythmic therapy. The study group had the following demographic characteristics: 90% were men, mean age was 64 years (range 41 to 79) and mean LV ejection fraction was 21 +/- 4%. Concomitant pharmacotherapy included antiarrhythmic drugs 31 (79%), vasodilators in 22 (56%) and digoxin in 20 (51%). There was no statistical difference in baseline characteristics between survivors and nonsurvivors. Patients were followed for a mean of 24 months (range 2 to 72) from implantation. The difference between actuarial survival--77% at 1 year and 72% at 2 years--and projected survival without the AICD (patients who survive without appropriate device discharge)--30% at 1 year and 21% at 2 years--was significant (p less than 0.01 and less than 0.05 at 1 and 2 years, respectively). This study suggests that the AICD improves survival in patients with coronary artery disease despite severely depressed LV function.

Adult↗

Effect of boron on vitamin D deficient rats.

The effects of different levels of dietary boron were determined in vitamin D deficient rats. Vitamin D deficient diets containing either 0.158 ppm or 2.72 ppm of boron were fed to rats for 11 w, and calcium, magnesium, and phosphorus apparent absorption and balance were measured in the twelfth week. Higher apparent absorption and balance values for calcium and phosphorus were observed in the rats with higher dietary boron, but very few differences were seen in body wt, organ wt, and bone parameters. Balance measurements represented the present status of the rats after 12 w on the diets, but other measurements represented an accumulation over the lifetime of the rat, including a suckling period with ample vitamin D and boron. The data demonstrated that when rats are vitamin D deficient, as indicated by hypocalcemia, the level of boron in the diet affects mineral balance.

Animals↗

Randomized, placebo-controlled trial of human surfactant given at birth versus rescue administration in very low birth weight infants with lung immaturity.

A randomized, placebo-controlled trial of human surfactant given intratracheally at birth (prophylactic) versus rescue administration after the onset of severe respiratory distress syndrome (RDS) was conducted among preterm infants born at 24 to 29 weeks of gestation. Singleton fetuses were randomly assigned to receive (1) placebo (air), (2) prophylactic surfactant treatment, or (3) rescue surfactant treatment; infants of multiple births received either (1) prophylactic or (2) rescue treatment. Of 282 potentially eligible fetuses, 246 infants received treatments at birth and 200 infants had RDS. Outcomes are presented both as an intention-to-treat analysis (including infants who met exclusion criteria at or after birth) and as a full treatment protocol analysis for those infants with RDS and likely to benefit from surfactant. Preterm infants (mean 1.0 kg birth weight, 27 to 28 weeks of gestational age) randomly assigned to receive prophylactic treatment received surfactant soon after birth; those assigned to receive rescue surfactant had instillation at a mean age of 220 minutes if the lecithin-sphingomyelin ratio was less than or equal to 2.0 and no phosphatidylglycerol was detected in either amniotic fluid or initial airway aspirate, oxygen requirements were a fraction of inspired oxygen of greater than 0.5, and mean airway pressure was greater than or equal to 7 cm H2O from 2 to 12 hours after birth. Up to four treatment doses (or air) were permitted within 48 hours; approximately 60% of surfactant-treated infants required two or more doses. Surfactant-treated infants had significantly less pulmonary interstitial emphysema than placebo-treated infants (p = 0.02), but there were no other significant differences in mortality rates or morbidity. Indexes of oxygenation and ventilation were improved in surfactant recipients during the first 24 hours. An intention-to-treat analysis found no significant differences between infants given placebo and surfactant-treated infants or between prophylactic- and rescue-treated infants; an improved total mortality rate (p = 0.002) was found among surfactant-treated infants in Helsinki but not in San Diego. Among infants with RDS, the total mortality rate was significantly improved (p = 0.004) with surfactant treatment but not the proportion alive and without bronchopulmonary dysplasia at 28 days (p = 0.052), or the proportion alive and without bronchopulmonary dysplasia at 38 weeks of postconceptional age (p = 0.18) to adjust for differences in prematurity. Deaths caused by RDS or bronchopulmonary dysplasia were significantly reduced among surfactant recipients (p = 0.0001). Neither among singletons nor among multiple-birth infants was there a selective advantage to prophylactic versus rescue treatment.(ABSTRACT TRUNCATED AT 400 WORDS)

Bronchopulmonary Dysplasia↗

Recovery of rats from vitamin D-deficient mothers.

Two separate studies were conducted using weanling rats from either an unsupplemented, low vitamin D colony or a supplemented, adequate vitamin D colony. Severe hypocalcemia, slower increases in body weight gain, and lower apparent calcium, magnesium, and phosphorus balance values occurred in the rats from the low vitamin D colony fed a purified AIN-76A, vitamin D-devoid diet compared to rats from the vitamin D-adequate colony fed the same diet. Apparent calcium, magnesium, and phosphorus balance values, as well as most other measurements, in rats from the low vitamin D colony fed a purified AIN-76a, vitamin D-adequate diet were greater than or equal to those of rats never subjected to low vitamin D. This was suggestive of overcompensation in recovery from low maternal vitamin D. However, rats from the low vitamin D colony fed an unrefined (chow), vitamin D-adequate diet had lower apparent balance and bone values compared with rats from the vitamin D-supplemented colony fed the same diet. Presumably high levels of calcium, magnesium, and phosphorous in the unrefined diet prevented any overcompensation during recovery, as occurred with purified diets, from the earlier vitamin D deficiency. Overall, results indicated weanling rats from a low vitamin D colony had low vitamin D stores and were marginally vitamin D-deficient. In addition, recovery from the marginal deficiency had occurred to a large extent after feeding a purified, vitamin D-adequate diet. The results suggest the use of low vitamin D colony rats as a model for human, marginal vitamin D deficiency.

Animals↗

Relationships between steps taken in selecting a nursing home and consumers' satisfaction.

Analysis of data related to selection of a nursing home by 411 families of nursing home residents led to the conclusion that steps selected and taken by consumers in the selection of a home were associated with their subsequent satisfaction with the home. Satisfaction was greater (a) for families in agreement about the home selected and (b) for families who investigated all homes in an area before selecting one. Less satisfied were families (a) who were forced to make an immediate decision about placement following illness of a patient, (b) who felt they lacked sufficient time to investigate homes, and (c) who chose the first home with space available.

Consumer Behavior↗

Atrialization of right ventricular pressure during acute cardiac allograft rejection.

We describe a patient who, during an episode of acute cardiac rejection, developed such severe systolic dysfunction that there was transient near-adynamic function of the right ventricle. This right ventricular dysfunction was reflected hemodynamically by the unusual finding of atrialization of right ventricular pressures. The patient's cardiac function returned to normal after treatment with extensive immunotherapy.

Acute Disease↗

Iatrogenic internal mammary artery to coronary vein fistula.

Iatrogenic aortocoronary vein fistula following coronary artery bypass surgery is a rare complication. We describe the first reported case of inadvertent anastomosis of the left internal mammary artery to cardiac vein. The clinical characteristics and consequences as well as the angiographic characteristics of this fistula are described. Precautions that may be taken to prevent this complication are also addressed.

Aged↗