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Biomedical subjects

R C Young

Publications and source records attributed to R C Young.

At least 19 recordsLinked to original sources
PubMed2006

Proceedings of a GOG workshop on intraperitoneal therapy for ovarian cancer.

Ovarian cancer is the leading cause of gynecologic cancer deaths in the U.S. The concept of intraperitoneal drug delivery for therapy of intraperitoneal cancers, such as ovarian cancer, arose in the 1960s. The field of intraperitoneal cisplatin therapy for ovarian cancer was initiated in the late 1970s and early 1980s. The markedly improved survival data resulting from a phase III trial of intraperitoneal cisplatin for ovarian cancer in early 2006 led to an NCI Clinical Announcement and a Gynecologic Oncology Group-sponsored workshop on intraperitoneal therapy in January, 2006, in San Diego, California. The proceedings of this workshop summarize both research trial results and practical implementation issues associated with intraperitoneal therapy discussed at this workshop.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2006

Cognitive impairment in bipolar disorder in old age: literature review and findings in manic patients.

BACKGROUND: Descriptions of aged patients with bipolar (BP) disorder have commented on cognitive impairments. However, the literature regarding cognitive test performance in this population has apparently been scant. METHOD: 1. We reviewed studies reporting cognitive performance in aged BP patients. 2. We compared the performance of elderly BP manic patients and aged community comparison subjects on the Mini-Mental State Examination (MMSE) and the Mattis Dementia Rating Scale (DRS). RESULTS: 1. Seven published studies of cognitive measures in aged BP patients were identified. They utilized different assessment methods and addressed different illness states, but they indicate impairments in these patients. 2. In our sample, the manic patients (n=70) had lower MMSE scores and DRS scores than did the comparison subjects (n=37). In these patients, cognitive scores were not significantly associated with Mania Rating Scale scores. LIMITATIONS: The patients in our study were assessed cross-sectionally, and they were treated naturalistically. CONCLUSIONS: Manic or depressed BP elders have impaired cognitive function; in some patients these impairments may persist. Research characterizing these impairments and their clinical implications is warranted.

Adult↗
PubMed2004

Paediatric upper limb contracture release following burn injury.

PURPOSE: The aim of this study was to assess the functional outcome in children who had undergone release of upper limb burn contractures at the axilla, elbow and wrist. METHODS: We studied a series of 10 patients reconstructed with local flaps (n = 5), Integra artificial skin (n = 10) and micro-vascular free tissue transfer (n = 5) to release contracted axillae (n = 8), elbows (n = 5) and wrists (n = 7). Follow-up ranged from 6 months to 6 years and outcome was assessed by functional improvement. RESULTS: Full functional release was achieved in all cases at the time of the surgery. Local flaps resulted in good or excellent outcomes in all five cases. Six patients reconstructed with Integra were assessed as having an excellent outcome whereas four had a poor outcome. Free tissue transfer with excellent result was achieved in five children. CONCLUSIONS: This series assessed the three treatment options that we have used for the release of upper limb post-burn contractures. We have shown that local flaps fashioned from burnt skin survive, Integra requires extended post-operative care to prevent recontraction and free tissue transfer is safe in young children. Each method when used appropriately has produced excellent results which have been maintained over the follow-up period.

Adolescent↗
PubMed2003

Antidepressant-associated mania in late life.

BACKGROUND: Elderly patients can present with mania for the first time late in life, and some elders treated with antidepressants can present with mania. Clinical characteristics of antidepressant-associated mania (AAM) in late life have not been examined. OBJECTIVES: The aims of the study were to identify elders with AAM and to compare selected clinical characteristics to those of manic elders who had not been treated with an antidepressant. We hypothesized that AAM patients would have later age at presentation of bipolar disorder. METHODS: We retrospectively reviewed inpatients with manic disorder who were aged >or=60 years. The sample was selected from admissions prior to 1990. RESULTS: AAM patients (n = 11) were more often experiencing first manic episode, and they had later age at onset of first manic episode, compared to non-AAM patients (n = 46). Most of the AAM patients had been treated with tricyclic agents. CONCLUSIONS: These preliminary findings invite further investigation. Related studies may contribute to risk-benefit analyses for the use of particular antidepressants in the elderly. Also, first episode mania in late life may prove to be a useful model of vulnerability to AAM.

Adolescent↗
PubMed2003

A composite poly-hydroxybutyrate-glial growth factor conduit for long nerve gap repairs.

There is considerable evidence that peripheral nerves have the potential to regenerate in an appropriate microenvironment. We have developed a novel artificial nerve guide composed of poly 3-hydroxybutyrate (PHB) filled with glial growth factor (GGF) suspended in alginate hydrogel. Gaps of 2-4 cm in rabbit common peroneal nerve were bridged using a PHB conduit containing either GGF in alginate hydrogel (GGF) or alginate alone (Alginate), or with an empty PHB conduit (Empty). Tissues were harvested 21, 42 and 63 days post-operatively. Schwann cell and axonal regeneration were assessed using quantitative immunohistochemistry. At 21 days, addition of GGF increased significantly the distance of axonal and Schwann cells regeneration in comparison with that observed in Alginate and Empty conduits for both gap lengths. The axons bridged the 2-cm GGF conduits gap by 63 days, with a comparable rate of regeneration seen in 4-cm conduits. Schwann cells and axonal regeneration quantity was similar for both gap lengths in each group. However, at all time points the quantity of axonal and Schwann cells regeneration in GGF grafts was significantly greater than in both Alginate and Empty conduits, the latter showing better regeneration than Alginate conduits. The results indicate an inhibitory effect of alginate on regeneration, which is partially reversed by the addition of GGF to the conduits. In conclusion, GGF stimulates a progressive and sustainable regeneration increase in long nerve gap conduits.

Alginates↗
PubMed2002

Chemical assaults in Hong Kong: a 10-year review.

The aim of this study was to assess the patients admitted to Prince of Wales Hospital Burns Unit, Hong Kong between September 1991 and August 2001 following chemical assault. A total of 2319 burns were admitted during the study period of which 19 had been subjected to chemical assault. All victims sustained a burn injury to the head and neck area and 47% of victims' eyes were burnt. A total of 84% required surgical intervention. Where a reason for the attack was admitted most were due to relationship difficulties. This study has defined the victims of chemical assault in Hong Kong. At a time when the overall number of assaults in Hong Kong is at its lowest level for 5 years it is of concern that there appears to have been a recent increase in the number of chemical assaults in Hong Kong.

Adolescent↗
PubMed2002

Poly-3-hydroxybutyrate (PHB): a resorbable conduit for long-gap repair in peripheral nerves.

The repair of peripheral nerve injuries with an autologous nerve graft is still the treatment of choice, although it is widely recognised that the method is associated with donor-site morbidity and a suboptimal functional outcome. An alternative approach is to use a nerve conduit to provide a guidance channel for the regenerating nerve. This study investigates the potential of poly-3-hydroxybutyrate (PHB) nerve conduits to bridge long nerve gaps (up to 4 cm) in a rabbit common-peroneal-nerve injury model. Regeneration was assessed up to 63 days postoperatively, and compared with that achieved using nerve autografts. By 42 days, regenerating axons had bridged nerve gaps of all lengths in groups with nerve autografts and in those with PHB conduits. The regeneration distance increased with time but did not vary with gap length (P </= 0.009, 14 versus 21 days, PHB tube 2 cm, 3 cm and 4 cm, Mann-Whitney U -test). At 42 days, the area of immunostained regenerating fibres in the PHB group was greater than that in the nerve autograft group (P < 0.001, PHB versus autograft, 21 and 42 days, three-way analysis of variance (ANOVA)). These results suggest that PHB conduits support peripheral nerve regeneration up to 63 days, and that they are suitable for long-gap nerve injury repair.

Analysis of Variance↗
PubMed2001

Human papilloma virus (HPV)-E6/E7 and epidermal growth factor receptor (EGF-R) protein levels in cervical cancer and cervical intraepithelial neoplasia (CIN).

BACKGROUND: About 90% of cervical cancers and advanced cervical intraepithelial neoplasia (CIN II/III) are squamous epithelial cells with mRNA for human papillomavirus (HPV)16 and 18 and up-regulated epidermal growth factor receptor (EGF-R). Since presence of proteins rather than mRNA may be truly indicative of active infection or disease progression, establishing reliable methods for quantifying these proteins in cervical biopsies is important. METHOD: We have established an objective semi-quantitative immunofluorescent antibody assay to reliably assess the levels of HPV-E6/E7 and EGF-R proteins in the cervical biopsies from 12 normal women, five women with CIN I, 15 with CIN II/III and ten with cervical cancer. RESULTS: HPV-E6/E7 and EGF-R, when present, were specific to para-basal, basal and squamous epithelial cells (negative in stromal cells). Nine of ten women with cervical cancer and 15 (14 CIN II/III; 1 CIN I) of 20 women with CIN were positive for HPV-E6/E7. All 12 controls were HPV-negative. The controls and six women with CIN (four with CIN I) negative for HPV had low levels of EGF-R. The only exception was one woman with cervical cancer negative for HPV, with high levels of EGF-R. Levels of HPV-E6/E7 and EGF-R were significantly higher (P < 0.001 vs. controls) in women with advanced CIN II and III (P< 0.05 vs. controls in CIN I) and cervical cancer. The HPV-E6/E7 and EGF-R levels correlated significantly (r = 18.98; P < 0.001, by linear regression analysis). CONCLUSION: We have established a highly specific and sensitive semi-quantitative immunofluorescent antibody assay for measuring levels of HPV-E6/E7 proteins and EGF-R in archival cervical biopsies. Our data suggest an association between HPV-E6/E7 and EGF-R.

Carcinoma, Squamous Cell↗
PubMed2001

Just teasing: a conceptual analysis and empirical review.

Drawing on E. Goffman's concepts of face and strategic interaction, the authors define a tease as a playful provocation in which one person comments on something relevant to the target. This approach encompasses the diverse behaviors labeled teasing, clarifies previous ambiguities, differentiates teasing from related practices, and suggests how teasing can lead to hostile or affiliative outcomes. The authors then integrate studies of the content of teasing. Studies indicate that norm violations and conflict prompt teasing. With development, children tease in playful ways, particularly around the ages of 11 and 12 years, and understand and enjoy teasing more. Finally, consistent with hypotheses concerning contextual variation in face concerns, teasing is more frequent and hostile when initiated by high-status and familiar others and men, although gender differences are smaller than assumed. The authors conclude by discussing how teasing varies according to individual differences and culture.

Cultural Characteristics↗
PubMed2001

Intracellular calcium gradients in cultured human uterine smooth muscle: a functionally important subplasmalemmal space.

The plasma membrane contains the key elements for the control of coupling excitation to contraction in smooth muscle. The superficial calcium buffer barrier, initially proposed by van Breemen for vascular smooth muscle, may participate in the regulation of calcium entry in other smooth muscle types. To investigate the relationship between the sarcoplasmic reticulum (SR) and the plasma membrane in myometrial smooth muscle cells, we performed experiments using videofluorescence imaging and cell-attached electrophysiology. The cell-attached patch was used as a reporter for the free calcium in the subplasmalemmal space by monitoring openings of the Maxi-K channel. Calcium green-1 was used to simultaneously monitor changes of the deep cytosolic calcium concentrations. The cell with the patch attached was stimulated via an intercellular calcium wave from an adjacent cell. In this fashion, release of SR calcium was accomplished with minimal disturbance of the plasma membrane and the subplasmalemmal space of the cell studied. With physiological bathing solution, six of seven calcium waves activated Maxi-K channels. Surprisingly, the Maxi-K channels began opening 6.3 +/- 4.7s (range 2.6-15.0s) after the wave passed the pipette location. When plasma membrane calcium fluxes were inhibited with 100 microM lanthanum, no Maxi-K channel openings were observed in six of seven experiments. These results are best explained by a subplasmalemmal space in which the calcium concentration is largely controlled by store-operated channels. These results suggest the superficial buffer barrier as merely one aspect of subplasmalemmal regulation of calcium dynamics, and emphasize the importance of store-operated calcium channels during dynamic calcium changes.

Calcium↗
PubMed2001

The mechanism of propagation of intracellular calcium waves in cultured human uterine myocytes.

OBJECTIVE: The primary goal of this work was to determine the relative importance of sarcoplasmic reticulum inositol 1,4,5-triphosphate receptors and ryanodine receptors in the mechanism of intracellular calcium wave propagation in human uterine myocytes. A secondary goal was to identify the rate-determining step of calcium wave propagation. STUDY DESIGN: Pregnant human myometrium was obtained at the time of cesarean delivery, enzymatically dispersed, and cultured through several passages. Intracellular calcium wave velocities were measured with video fluorescence microscopy and the calcium-dependent fluorescent dye calcium green 1. Experimental conditions were modified by exposure of the cells to ruthenium red (blocked ryanodine receptor), ryanodine (locked open ryanodine receptor), oxytocin (increased inositol-1,4,5-triphosphate), sodium butyrate (intracellular acidification), ammonium chloride (intracellular alkalinization), and elevation of temperature (from 19 degrees C to 30 degrees C). RESULTS: Wave velocities were found to be the same for spontaneously occurring (9.6 +/- 2.6 microm/s) and oxytocin-stimulated (10.3 +/- 3.4 microm/s) waves. Advance treatment of the cells with ryanodine or ruthenium red failed to change oxytocin-stimulated wave velocities from control values. The temperature dependence of calcium wave velocities was studied across the range 19 degrees C to 30 degrees C. Plots of wave velocities versus the inverse of the temperature yielded apparent activation energies that were the same for spontaneous (13.2 +/- 0.3 kcal/mol) and oxytocin-induced (14.3 +/- 1.6 kcal/mol) waves. After intracellular acidification by treatment with butyrate (20 mmol/L) wave velocities increased by 44%. Wave velocities decreased by 35% after treatment with ammonium chloride (20 mmol/L). CONCLUSION: Propagation of intracellular calcium waves in cultured human uterine myocytes exhibited mechanisms of sarcoplasmic reticulum calcium release that could use either inositol 1,4,5-triphosphate receptors alone or ryanodine receptors alone, or both together. The rate-determining step for calcium wave propagation was diffusion of calcium though a highly buffered cytoplasm.

Ammonium Chloride↗
PubMed2001

Differing mechanisms of inhibition of calcium increases in human uterine myocytes by indomethacin and nimesulide.

OBJECTIVE: Indomethacin, an inhibitor of cyclooxygenase types 1 and 2, and nimesulide, a cyclooxygenase 2 selective inhibitor, are both well-known inhibitors of prostaglandin production. It has been assumed that the tocolytic mechanism of nimesulide and indomethacin is only through decreased prostaglandin production. The purpose of this study was to test the hypothesis that either nimesulide or indomethacin, or both, has a mechanism of action on human myocytes other than inhibition of prostaglandin production. STUDY DESIGN: Human uterine myometrium was obtained from consenting patients during cesarean deliveries. Myocytes were cultured, plated, and loaded with a calcium-dependent fluorescent dye, calcium green 1. The relative concentrations of intracellular free calcium were determined by measurement of time-dependent fluorescence changes by means of a video fluorimeter. In all experiments, cells were stimulated with prostaglandin F2alpha, 30 micromol/L. Experiments were performed without pretreatment (control) or with pretreatment consisting of indomethacin, 10 micromol/L, or nimesulide, 30 micromol/L. The percentages of cells demonstrating calcium increases were counted and compared by means of the Fisher exact test. A P value =.05 was considered significant. RESULTS: After prostaglandin F2alpha exposure, 33% of cells showed an increase in intracellular free calcium under control conditions. When pretreated with nimesulide, 39% of cells responded to prostaglandin F2alpha (P =.59). When pretreated with indomethacin, only 16% of cells responded to prostaglandin F2alpha (P =.019). CONCLUSIONS: Pretreatment with nimesulide failed to reduce the fraction of cells that responded to prostaglandin F2alpha. In contrast, pretreatment with indomethacin significantly reduced the fraction of responding cells. These data suggest that, in vitro, indomethacin exhibits a mechanism of tocolysis other than inhibition of prostaglandin synthesis.

Calcium↗
PubMed2001

Standards for assessment of lung function and respiratory health in minority populations: some challenges linger into the new millennium.

Results of pulmonary function tests (as an indicator of respiratory health) are from 11 to 13 percent lower in African Americans and other racial ethnic populations than in Caucasians when controlled for gender, age, and height. Environmental factors influencing these indices are circadian variation, altitude, air pollutants, technology, state of nutrition, smoking history, and other indicators of lifestyle. A combination of subtle, genetically determined anthropometric variants may also be operative, the extent of which is controversial. Population-based, population-specific standards are required to avoid erroneous diagnosis of cardiorespiratory disease, erroneous assessment of operative risk, unfair hiring practices when lung function tests are used for preemployment evaluation in dusty occupations, and unfair labeling when workers apply for disability compensation. Tailoring of statistical prediction standards from simple linear to more complex polynomial regression models will increase the accuracy of population prediction standards for pulmonary function variables into the 21st century.

Adult↗