Biomedical subjects
Publications and source records attributed to S L Hammond.
This describes the clinical picture of neurogenic TOS, supraclavicular surgical technique, and results of surgery as well as surgical complications.
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PURPOSE: This study was conducted to investigate and illustrate the use of Indium In-111 pentetreotide scintigraphy as it applies to carotid body tumors (CBT). Localization has relied primarily on ultrasonography, computed tomography, and magnetic resonance imaging with angiographic confirmation. These methods only assess the cervical bifurcation without providing an evaluation of metastasis in patients without symptoms or recurrence in patients after surgery. METHODS: Indium In-111 pentetreotide scintigraphy was used in five patients with a diagnosis of CBT. Four patients were evaluated after surgical excision for evidence of tumor recurrence. One patient was evaluated before excision for diagnostic confirmation. RESULTS: No evidence of tumor recurrence was demonstrated in the four patients who had undergone previous CBT excision. One of these patients had increased activity in the pituitary, later confirmed as an enlarged pituitary without evidence of an adenoma with computed tomography. The diagnosis of CBT was confirmed in the patient evaluated before surgery. This patient also had increased activity in the occipital region, confirmed as the site of previous ischemia on computed tomography. CONCLUSION: Indium In-111 pentetreotide scintigraphy is a new innovative method for viewing neuroendocrine tumors. Its potential lies not only in tumor localization but also in identification of recurrent tumor at the operative site and metastatic disease.
The clinical observation that a laparoscopic cholecystectomy is a minimally invasive operation has not been demonstrated on a biochemical basis. Interleukin-6, a known endogenous pyrogen and hepatocyte-stimulating protein, correlates with the significance of surgical trauma. Utilizing the IL-6 immunoassay, we studied this biochemical parameter of trauma to compare its response in laparoscopic vs open cholecystectomy. Sixteen patients who underwent only laparoscopic cholecystectomy showed peak IL-6 concentrations of 51 pg/ml (22-86) vs a peak IL-6 concentration of 124 pg/ml (56-225) for open cholecystectomy. Six additional patients who underwent an ERCP followed by laparoscopic cholecystectomy showed a dramatic rise in peak IL-6 concentration to 315 pg/ml (15-634). These results biochemically confirm the true minimal invasiveness of laparoscopic cholecystectomy. The findings in the ERCP-followed-by-laparoscopic-cholecystectomy group support the theory that two invasive procedures in close proximity may prime the cytokine system in its response to surgical trauma.
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The National Cancer Institute (NCI) estimates on the basis of current knowledge alone that, at a minimum, 30,000 lives could be saved in the year 2000 if Americans would modify their dietary habits. A recent innovative way of responding to this challenge was the Kellogg Company/NCI All-Bran advertising campaign. This paper will describe the campaign, and its impact on consumers, cereal industry sales, food industry advertising practices, health regulatory policy, and the organizational credibility of both NCI and Kellogg. For the past three years, Kellogg has included NCI's cancer prevention messages in their advertisements for All-Bran cereal and on their bran cereal boxes. This collaborative effort has stimulated considerable controversy over whether the health claims made on the cereal label are in violation of federal food labeling regulations. Meanwhile, research has demonstrated the positive impact of the campaign on consumer's knowledge and behavior regarding fiber as well as on Kellogg's profits. Other manufacturers are anxious to jump on the "branwagon"; however, many unanswered questions remain about this new approach to health advertising.
This article presents the gatekeeping funnel as a model of the process that a public service announcement (PSA) goes through from distribution until it reaches its target audience. Process measures such as bounceback postcards, the Broadcast Advertisers Report (BAR), and analysis of audience response are suggested as ways of monitoring this funneling process. The model is then applied to the National Cancer Institute's PSA campaign designed to promote cancer prevention awareness. Three waves of PSAs were distributed between March 1984 and May 1985. Two of these waves of PSAs were targeted to the general public and the third wave was targeted to black audiences. Bounceback postcards, BAR data, and the Cancer Information Service (CIS) call data exemplify the gatekeeping funnel model described in the article. When the messages were distributed, they had the potential of reaching 170 million adults with televisions. BAR data show that the gatekeeping function narrowed the number of people potentially exposed to the messages to 24 million, or 14% of the total. Yet only 144,000 people, or less than one-tenth of 1% responded to the messages by calling the CIS number and asking about cancer prevention. This analysis may help PSA campaign planners to develop more realistic expectations for message effects.
A serum-free medium with bovine pituitary extract as the only undefined supplement has been developed for long-term culture of human mammary epithelial cells. This medium supports serial subculture of normal cells for 10-20 passages (1:10 splits) without conditioning or special substrates, and it supports rapid clonal growth with plating efficiencies up to 35%. It consists of an optimized basal nutrient medium, MCDB 170, supplemented with insulin, hydrocortisone, epidermal growth factor, ethanolamine, phosphoethanolamine, and bovine pituitary extract. Replacement of pituitary extract with prostaglandin E1 and ovine prolactin yields a defined medium that supports rapid clonal growth and serial subculture for three or four passages. Cultures initiated in these media from normal reduction mammoplasty tissue remain diploid and maintain normal epithelial morphology, distribution of cell-associated fibronectin, expression of keratin fibrils, and a low level of expression of milk fat globule antigen. Large cell populations can now be generated and stored frozen, permitting multiple experiments over a period of time with cells from a single donor. These media greatly extend the range of experiments that can be performed both conveniently and reproducibly with cultured normal and tumor-derived human mammary epithelial cells.
A new medium (MCDB 104) has been developed which will support clonal growth of WI-38 cells at concentrations of serum protein as low as 25 micrograms per ml (equivalent to 0.05% serum). The principal factors responsible for reduction of the protein requirement are: (a) adjustment of all nutrient concentrations in medium F12 to experimentally determined optimum values for WI-38 cells; (b) supplementation with trace elements; (c) replacement of hypoxanthine and folic acid with adenine and folinic acid; and (d) coating of the culture surface with polylysine. Individually, many of these modifications exert only a small effect on cellular growth at reduced protein concentrations, but collectively their effect has been very substantial. Other strains of fibroblast-like human diploid cells from amniotic fluid, fetal lung and newborn foreskin also will grow at reduced concentrations of serum protein in the new medium.
Clonal growth of WI-38 cells with a plating efficiency of 45% has been achieved in a synthetic nutrient mixture (MCDB 102) supplemented with either whole or dialyzed fetal bovine serum precisely. Deviation by a factor of three in either direction from the optimum concentration (9.0 x 10(-5) M) eliminates essentially all clonal growth. A high concentration of glutamine (2.5 x 10(-3) M) is also needed for optimum clonal growth.
PURPOSE: The authors report on the use of Palmaz balloon-expandable intraluminal metallic stents to supplement conventional balloon angioplasty and to primarily treat a variety of supra-aortic arterial atherosclerotic lesions manifested by claudication or embolic phenomena. PATIENTS AND METHODS: Results from a series of seven patients are reported. Five patients received stents following percutaneous balloon angioplasty (PTA): four patients received five stents for suboptimal initial result of PTA and one patient received one stent for early restenosis following successful PTA. Two patients received three stents primarily: one patient had one stent placed for a highly eccentric innominate lesion and the other patient had two stents placed for an ulcerated nonocclusive subclavian lesion causing blue digits. RESULTS: Treatment produced immediate angiographic or hemodynamic improvement in all seven patients. Clinical follow-up was obtained on all patients (mean, 10 months; range, 3-18 months). One patient had an episode of vertigo after PTA of a right subclavian lesion that resolved after thrombolytic therapy and stent placement. CONCLUSION: The placement of metallic stents in supra-aortic arteries represented an effective adjunct to PTA of atherosclerotic stenoses in these vessels. Primary stent placement may be an effective treatment for selected lesions.
In 1996, the Centers for Disease Control and Prevention launched a 50-day exercise campaign called the "Director's Physical Activity Challenge" to stimulate its employees to exercise. Of the 5822 eligible employees, 3740 (64%) joined, but pre- and post-data was available on only 1192 (20.5%) people. Of this group, 86% of those in contemplation and 64% of those in preparation, and 34% of those in action advanced to a higher stage.