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Biomedical subjects

S J Erickson

Publications and source records attributed to S J Erickson.

At least 19 recordsLinked to original sources
PubMed2002

Hypocarbia in the ventilated preterm infant and its effect on intraventricular haemorrhage and bronchopulmonary dysplasia.

OBJECTIVE: To examine the relationship between PaCO2 levels in ventilated very preterm infants and (i) the incidence of severe intraventricular haemorrhage (IVH) and periventricular leukomalacia (PVL); and (ii) bronchopulmonary dysplasia (BPD). METHODS: A retrospective cohort analysis of preterm infants comparing PaCO2 levels with the incidence of severe IVH/PVL and BPD was carried out on patients born at less than 29 weeks gestation from 1992 to 1994 and admitted to the tertiary neonatal intensive care unit at the King Edward Memorial Hospital (314 infants). During the first 96 h, PaCO2 levels were examined including lowest and highest PaCO2 levels, mean PaCO2 levels and duration of hypocarbia both pre- and post-surfactant administration. RESULTS: Of the 314 infants, there were 40 early neonatal deaths (less than 48 h) who were not included in the analysis. Of the 274 surviving infants, 72 (26%) infants had severe IVH. Infants whose PaCO2 fell below 30 mmHg at any stage in the first 48 h of life had an increased risk of severe IVH or PVL (odds ratio 2.38; 95% CI 1.27-4.49; P = 0.007). Of the 265 survivors to 36 weeks corrected gestational age, 134 (51%) had BPD. Infants with at least three PaCO2 values less than 30 mmHg in the first 24 h of life had an increased risk of BPD (odds ratio 2.21; 95% CI 1.05-4.57; P = 0.036). CONCLUSIONS: The risk of severe IVH/PVL was significantly increased by hypocarbia. There was also an association between hypocarbia and BPD, particularly when hypocarbia was prolonged. These findings suggest that avoidance of hypocarbia may reduce the incidence of severe IVH/PVL and BPD in preterm infants.

Bronchopulmonary Dysplasia↗
PubMed2001

Are perceived neighborhood hazards a barrier to physical activity in children?

BACKGROUND: We hypothesized that children's perceptions of more neighborhood hazards would be associated with less physical activity, less aerobic fitness, and a higher body mass index. OBJECTIVE: To examine the association between a hazardous neighborhood context and physical activity in children. METHODS: Fourth-grade students (n = 796) of diverse ethnic and economic backgrounds completed measures of neighborhood hazards, self-reported physical activity, physical fitness, height, and weight. Parents (n = 518) completed telephone interviews and provided data on their education level and occupation. RESULTS: As expected, children from families of lower socioeconomic status perceived significantly more neighborhood hazards. Contrary to our hypothesis, the perception of more hazards was significantly associated with more reported physical activity. This finding was not explained by school heterogeneity, alteration of the hazards measure, or differences in socioeconomic status. CONCLUSION: To further examine the relationship between neighborhood hazards and physical activity, we suggest that future studies include assessments of sedentary behavior, parental fear of violence, parental regulation of children's leisure activities, and cost and quality of available play areas and organized sports.

Acculturation↗
PubMed2001

Trauma and personality correlates in long-term pediatric cancer survivors.

To explore the relationship between PTSD and trauma-spectrum symptoms, including personality and functional correlates, in long term pediatric cancer survivors (N = 40), we assessed these constructs with a structured interview for PTSD, a clinical interview, and self-report questionnaires. Thirty-five out of 40 participants (88%) currently met at least one trauma symptom at a functionally significant level. These survivors demonstrate high levels of restraint and low levels of distress, representative of a repressive adaptive style. After more than 5 years since treatment completion, the relatively high levels of current trauma-spectrum symptoms may reflect the long-term deleterious impact of childhood cancer.

Adaptation, Psychological↗
PubMed2001

Median "pseudoneurapraxia" at the wrist: reassessment of palmar stimulation of the recurrent median nerve.

OBJECTIVE: To determine the occurrence and effect of incidental deep ulnar nerve (DUN) costimulation during palmar stimulation of the recurrent median nerve (RMN). DESIGN: Observational. SETTING: Electromyography laboratory. PARTICIPANTS: Seventeen asymptomatic adult volunteers (34 hands) and 4 fresh cadaver hands. MAIN OUTCOME MEASURES: Median nerve stimulation at the wrist and careful incremental surface and subcutaneous (needle) palmar stimulation were performed while recording thenar and first dorsal interosseous manus compound muscle action potentials. Thenar palm-to-wrist amplitude difference (P -- W Delta) and palm-to-wrist amplitude ratio (P/W) were compared with published values. Correlation of DUN costimulation with falsely elevated P -- W Delta and P/W values was assessed. Multiplanar magnetic resonance imaging (MRI) and subsequent dissection of 4 fresh cadaver hands was done to measure the distance between the RMN and DUN at the palmar stimulation site. RESULTS: Two groups emerged: Group I (63%), with DUN stimulation, and II (37%), with no DUN stimulation. When DUN costimulation occurred (Group I), there was a statistically significant increase in P -- W Delta (p =.002 percutaneous, p =.02 subcutaneous) and P/W (p =.004 percutaneous, p =.007 subcutaneous) when compared with previously published data. Combining all trials on all hands, 53% and 25% had P -- W Delta values and P/W values that exceeded previously published normative data, respectively. The mean distance between the DUN and RMN at the palmar stimulation site was determined by dissection (1.2cm) and MRI (1.5cm). CONCLUSIONS: Close proximity of the DUN to the RMN causes frequent and often unavoidable DUN activation during palmar stimulation of the RMN. This inadvertent stimulation may cause a false diagnosis of median neurapraxia at the wrist.

Adult↗
PubMed2001

In vivo proton (H1) magnetic resonance spectroscopy for cervical carcinoma.

Proton magnetic resonance spectroscopy (MRS) may be a useful tool in both the initial diagnosis of cervical carcinoma and the subsequent surveillance after radiation therapy, particularly when other standard diagnostic methods are inconclusive. Single voxel magnetic resonance (MR) spectral data were acquired from 8 normal volunteers, 16 patients with cervical cancer before radiation therapy, and 18 patients with cervical cancer after radiation therapy using an external pelvic coil at a 1.5-T on a Signa system. The presence or absence of various resonances within each spectrum was evaluated for similarities within each patient group and for spectral differences between groups. Resonances corresponding to lipid and creatine dominated the spectrum for the eight normal volunteers without detection of a choline resonance. Spectra from 16 pretreatment patients with biopsy-proven cervical cancer revealed strong resonances at a chemical shift of 3.25 ppm corresponding to choline. Data acquired from the 18 posttreatment setting studies was variable, but often correlated well with the clinical findings. Biopsy confirmation was obtained in seven patients. H1 MRS of the cervix using a noninvasive pelvic coil consistently demonstrates reproducible spectral differences between normal and neoplastic cervical tissue in vivo. However, signal is still poor for minimal disease recurrence. Further study is needed at intervals before, during, and after definitive irradiation with biopsy confirmation to validate the accuracy of MRS in distinguishing persistence or recurrence of disease from necrosis and fibrosis.

Adult↗
PubMed2000

Are overweight children unhappy?: Body mass index, depressive symptoms, and overweight concerns in elementary school children.

BACKGROUND: It is commonly believed that overweight children are unhappy with their weight. However, population-based data addressing this association are lacking. OBJECTIVES: To evaluate the association between obesity and depressive symptoms in a diverse, school-based sample of preadolescent children, and to examine whether overweight concerns play a role in this association. DESIGN, SETTING, AND PARTICIPANTS: Third-grade students (N = 868, mean age, 8.4 years) attending 13 public elementary schools in Northern California were measured for weight and height, and were asked to complete self-report assessments of depressive symptoms and overweight concerns. RESULTS: A modest association between depressive symptoms and body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) was found for girls (r = 0.14, P<.01), but not for boys (r = 0.01, P<.78). Among girls, depressive symptoms were strongly associated with overweight concerns (r = 0.32, P<.001). After controlling for level of overweight concerns, BMI was no longer significantly associated with depressive symptoms among girls. In contrast, after controlling for BMI, overweight concerns remained significantly associated with depressive symptoms. CONCLUSIONS: This study provides cross-sectional evidence for a relationship between depressive symptoms and BMI in preadolescent girls, but not in preadolescent boys. This relationship seems to be explained by an excess of overweight concerns. Assessing overweight concerns may be a useful method to identify those overweight girls who are at highest risk for associated depressive symptoms.

Attitude to Health↗
PubMed2000

Sonography of the foot and ankle.

Sonography of the foot and ankle is a quick, relatively inexpensive imaging modality that can be used to diagnose a variety of pathologic conditions. Sonography is particularly well suited for the assessment of tendons, soft-tissue masses, and suspected foreign bodies. Visualization of internal structural detail typically equals or exceeds that of MR imaging. Diagnostic accuracy, however, requires meticulous attention to technical parameters and proficiency with the transducer.

Ankle↗
PubMed1998

Clonidine poisoning--an emerging problem: epidemiology, clinical features, management and preventative strategies.

OBJECTIVE: To ascertain whether the incidence of clonidine poisoning in children has increased given the probable increase in clonidine use for treatment of childhood behavioural disorders. METHODS: Cases of clonidine poisoning requiring hospital admission between 1985-95 inclusive were reviewed and demographic data pertinent to each admission were recorded. A literature review was also performed, with particular emphasis on incidence, clinical presentation and management of clonidine poisoning. RESULTS: There were 14 cases of clonidine poisoning during the specified period eight cases presenting in the last 2 years. These eight children or their siblings had been prescribed clonidine for behavioural disorders. The most common signs at presentation were alteration of conscious state (71%) and bradycardia (50%). Nine children were given activated charcoal while seven cases underwent gastric lavage or induced emesis. Although six children were admitted to intensive care, length of hospital stay was less than 24 h in all cases and all had a favourable outcome. CONCLUSION: We concluded that the incidence of clonidine poisoning had increased over the specified period and that, based on our results, this was likely to be due to an increase in clonidine use in childhood behavioural disorders. Based on our data and that from literature review it was evident that there are inconsistencies in the management of clonidine poisoning and that safety measures, namely packaging and education, are inadequate given the increasing profile of clonidine use.

Attention Deficit Disorder with Hyperactivity↗
PubMed1998

Detection of osteomyelitis in the neuropathic foot: nuclear medicine, MRI and conventional radiography.

The diagnostic efficacy of (1) combined three-phase bone scintigraphy and In-111 labeled WBC scintigraphy (Bone/WBC), (2) MRI, and (3) conventional radiography in detecting osteomyelitis of the neuropathic foot was compared. Conventional radiography was comparable to MRI for detection of osteomyelitis. MRI best depicted the presence of osteomyelitis in the forefoot. Particularly in the setting of Charcot joints, Bone/WBC was more specific than conventional radiography or MRI.

Adult↗
PubMed1998

Cloning, characterization, and gene organization of K-Cl cotransporter from pig and human kidney and C. elegans.

We isolated and characterized the cDNAs for the human, pig, and Caenorhabditis elegans K-Cl cotransporters. The pig and human homologs are 94% identical and contain 1,085 and 1,086 amino acids, respectively. The deduced protein of the C. elegans K-Cl cotransporter clone (CE-KCC1) contains 1,003 amino acids. The mammalian K-Cl cotransporters share approximately 45% similarity with CE-KCC1. Hydropathy analyses of the three clones indicate typical KCC topology patterns with 12 transmembrane segments, large extracellular loops between transmembrane domains 5 and 6 (unique to KCC), and large COOH-terminal domains. Human KCC1 is widely expressed among various tissues. This KCC1 gene spans 23 kb and is organized in 24 exons, whereas the CE-KCC1 gene spans 3.5 kb and contains 10 exons. Transiently and stably transfected human embryonic kidney cells (HEK-293) expressing the human, pig, and C. elegans K-Cl cotransporter fulfilled two (pig) or five (human and C. elegans) criteria for increased expression of the K-Cl cotransporter. The criteria employed were basal K-Cl cotransport; stimulation of cotransport by swelling, N-ethylmaleimide, staurosporine, and reduced cell Mg concentration; and secondary stimulation of Na-K-Cl cotransport.

Amino Acid Sequence↗
PubMed1997

Follow-up evaluation of prostate cancer patients infused with autologous dendritic cells pulsed with PSMA peptides.

BACKGROUND: We recently conducted a phase I clinical trial administering autologous dendritic cells pulsed with prostate-specific membrane antigen (PSMA) peptides to advanced prostate cancer patients. Participants were divided into 5 groups receiving 4 or 5 infusions of peptides alone (PSM-P1 or -P2; groups 1 and 2, respectively), autologous DC (group 3), or DC pulsed with PSM-P1 or -P2 (groups 4 and 5, respectively). Seven partial responders were observed. Follow-up evaluation of these responders is presented in this report. METHODS: Clinical monitoring for hematological studies and prostate markers was conducted up to 370 days from the start of the phase I study. Data collected include: lymphocyte, hematocrit, alkaline phosphatase, prostate-specific antigen (PSA), free PSA, and PSMA levels. RESULTS: Groups 4 and 5 (patients infused with DC pulsed with PSM-P1 or -P2) represented 5/7 responders. The length of response was between 100 days (1 patient) to 200 days or above (6 patients). Four patients still remained responsive at the end of the period of observation. CONCLUSIONS: The responses observed in this phase I clinical trial are significant and of long duration. Most of the responders were in treatment groups infused with DC pulsed with PSM-P1 or -P2, suggesting the requirement of both components for effective immunotherapy.

Alkaline Phosphatase↗
PubMed1997

Fast gradient echo magnetic resonance imaging of the normal diaphragm.

To determine the ability of fast gradient-recalled echo (GRE), breath-hold magnetic resonance imaging (MRI) to depict all regions of the diaphragm, 13 volunteers were scanned in coronal and sagittal planes. The central to anterior left hemidiaphragm and the posterior lumbar portions were each demonstrated in 12 subjects (92%). The crura were visible crossing anterior to the aorta in the sagittal plane in eight subjects (62%) and in the coronal plane in six subjects (46%). In the sagittal plane, the right crus was evident in eight subjects (62%). Muscular portions of the diaphragm in contact with the liver or body wall were less frequently discernible, and the central tendon could not be confidently resolved. Several artifacts occurred that interfered with visualization of the diaphragm. These observations indicate that many regions of the diaphragm can be seen with fast GRE, breath-hold MRI, but there are some limitations in depicting the diaphragm in its entirety.

Adult↗
PubMed1997

MR imaging diagnosis of triangular fibrocartilage pathology with arthroscopic correlation.

OBJECTIVE: The goal of this study was to compare MR imaging with arthroscopy in evaluating triangular fibrocartilage (TFC) pathology. MATERIALS AND METHODS: The results of 178 MR imaging examinations of the wrist were independently reviewed by two musculoskeletal radiologists who were unaware of the the clinical history, including any subsequent surgery. One hundred forty-nine of these studies were obtained from symptomatic patients. Of these patients, 56 underwent arthroscopic evaluation of the TFC. The remaining 29 studies were obtained from control volunteers and duplicate cases to reduce bias. The data were divided into categories based on Palmer's classification of TFC injury. Diagnostic sensitivity, specificity, and accuracy were calculated for each category. RESULTS: Of the 56 patients who underwent arthroscopic evaluation of the TFC, 27 had TFCs that were intact at surgery. Also, 27 complete perforations and two partial defects were found at surgery. Sensitivity for detecting central degenerative perforations was 91% for both observers I and II. Sensitivity for detecting radial slitlike tears was 100% and 86% for observers I and II, respectively. Sensitivity for detecting ulnar-sided avulsions was 25% and 50% for observers I and II, respectively. CONCLUSION: MR imaging is accurate in revealing TFC perforations.

Adult↗
PubMed1997

Appropriateness of imaging procedure requests: do radiologists agree?

OBJECTIVE: We explored the agreement among radiologists in their evaluation of the appropriateness of individual requests for imaging procedures. MATERIALS AND METHODS: We reviewed 318 noninterventional CT, sonographic, MR imaging, and nuclear medicine procedures ordered at a general internal medicine clinic during 8 months in 1995. Five subspecialty radiologists used data from the radiology request from and clinic notes to independently rate the appropriateness of each requested imaging procedure on a four-point scale. The radiologists were unaware of the results achieved by each procedure. Each case was reviewed by at least three radiologists, of whom at least one had relevant subspecialty expertise. Agreement among radiologists was analyzed using Cohen's kappa statistic and weighted kappa statistics and Cronbach's alpha statistic. RESULTS: Nonchance agreement (kappa) was .19 +/- .05; weighted kappa was .24 +/- .05. Interrater agreement was significantly greater than that expected from chance alone (p < .01). The composite score, defined as the average of the radiologists' scores for each case, showed moderate reliability, as evidenced by a value for Cronbach's alpha of 70. CONCLUSION: In the absence of explicit criteria, we found modest but statistically significant agreement among radiologists about the appropriateness of individual requests for imaging procedures. The disagreement among radiologists highlights the importance of developing well-reasoned, explicit criteria by which to judge the appropriateness of diagnostic radiology procedures. Further study is needed to elucidate the relationship between appropriateness and actual patient outcomes.

Adult↗
PubMed1997

MR imaging of the ankle and foot.

Optimal MR imaging of the ankle and foot demands attention to coil selection, patient positioning, and prescription of the imaging parameters. Though useful in the evaluation of many osseous conditions, MR imaging is perhaps most frequently used in the evaluation of osteochondral lesions and suspected osteomyelitis. Soft-tissue masses with a predilection for the foot and ankle include plantar fibromatosis, ganglion cysts, and interdigital neuromas.

Ankle Joint↗
PubMed1997

Normal MR imaging anatomy of the elbow.

This article discusses the normal, clinically relevant MR imaging anatomy of the elbow. A compartmental approach is utilized to help simplify this anatomically complex region. Imaging techniques, common anatomic variants, and imaging pitfalls are also briefly discussed.

Elbow Joint↗
PubMed1996

Evaluation and comparison of two new prostate carcinoma markers. Free-prostate specific antigen and prostate specific membrane antigen.

BACKGROUND: Two new prostate cancer markers, free-prostate specific antigen (f-PSA) and prostate specific membrane antigen (PSMA) were recently introduced. This report summarizes a prospective two-year multicenter test of their diagnostic or prognostic capabilities. Total PSA was also measured. METHODS: There were four clinical groups studied: (1) 226 individuals from a screening project undergoing ultrasound and biopsy evaluation had markers obtained: (2) 68 patients suspected of having prostate cancer and undergoing 2 or more biopsies had the markers obtained on multiple occasions: (3) 100 patients undergoing radical prostatectomy had markers obtained pre- and post-operatively: and (4) 31 patients with metastatic prostate cancer each had multiple samples for marker assay obtained over a 2-year period. In all, 465 patients had one or more samples obtained and studied. RESULTS: Free-PSA affords little additional diagnostic advantage compared with total PSA in the screening population. The receiver operating characteristic curves for diagnostic accuracy were ranked: (1) PSA density; (2) total PSA; (3) f-PSA; and (4) PSMA, PSMA showed the best correlation with stage of the primary tumor in the screened group. In the multiple negative biopsy group, f-PSA varied from 12 to 21%. PSMA values were evaluated in all histologic categories. PSA density was > or = 0.15 in all categories. In the prostatectomy cases PSA values postoperatively were quite low in Stage II; f-PSA was of no value. Later, f-PSA was increased in association with elevated total PSA values. Mean PSMA values were above normal in all postoperative time periods except in Stage III patients at 6 months to 1 year postoperatively. PSA densities were all > or = 0.15. In patients with metastatic carcinoma, elevated PSMA values correlated best with a poor prognosis (clinical progression), as has been described. CONCLUSIONS: These data suggest that f-PSA values do not provide additional diagnostic benefit compared with total PSA in screening populations, in the presence of suspected cancer, postprostatectomy, or in metastatic disease. PSMA is of prognostic significance, especially in the presence of metastatic disease, and correlates well with the stage of disease in cancers detected in a screened population.

Antigens, Neoplasm↗