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Biomedical subjects

Thomas Smith

Publications and source records attributed to Thomas Smith.

31 records · Page 2Linked to original sources

A case-control study of parental occupation, leukemia, and brain tumors in an industrial city in Taiwan.

We conducted a case-control study in an industrial city in Taiwan to determine whether parents of newly diagnosed patients who were younger than 30 years old with leukemia or brain tumors or the patients themselves were more likely to have been employed in certain occupations or industries. Job histories were collected for parents (and for subjects if they worked) on 103 newly diagnosed cases of leukemia, 74 newly diagnosed cases of brain tumors, and 417 controls matched for age and sex. All jobs since the age of 16 that the subjects held for more than 6 months, a total of approximately 4,000 jobs, were coded for occupation and industry according the standard four-digit system used in Taiwan. Matched-pair analyses were performed comparing cases and controls among all jobs held by subjects and both parents using four-digit occupation and industry codes. Separate analyses also were performed for parental jobs held during the preconception, perinatal, and postnatal periods. Odds ratios (ORs) were adjusted for subject smoking, parental smoking, and exposure to medical radiation. Certain industry and occupation four-digit codes were significantly associated with increased odds ratios of childhood tumors. Including work during any or all periods, leukemias were more common in children of fathers who had worked (1) as wood treaters (adjusted OR 16.03, 95% confidence interval CI = 1.77-145.5), and (2) as building finishers and related trades workers (adjusted OR 4.08, 95% CI = 1.12-14.8), whereas brain tumors were more common in children of mothers who had worked (1) in electronic parts and components manufacturing (adjusted OR 13.78, 95% CI = 1.47-129.0) and 2) as textile and garment workers (adjusted OR 7.25, 95% CI = 1.42-37.0), as well as in subjects who had worked with certain electronic parts and components (adjusted OR 28.67, 95% CI = 2.88-285.6). Leukemias were more common in children of fathers who had worked in the preconception period (1) as wood treaters (adjusted OR 12.17, 95% CI = 1.36-109.2), (2) as building finishers and related trades workers (adjusted OR 4.08, 95% CI = 1.12-14.8), (3) as electronic equipment assemblers (adjusted OR 4.56, 95% CI = I 1.05-19.9), and (4) as certain other assemblers (adjusted OR 10.24, 95% CI = 1.02-102.6). In addition, leukemias were more common in children of fathers who had worked in the perinatal period (1) as wood treaters (adjusted OR 13.08, 95% CI = 1.36-125.5) and (2) as building finishers and related trades workers (adjusted OR 4.51, 95% CI = 1.04-19.6). Brain tumors were more common in children of mothers who had worked in the preconception period (1) in electronic parts and components manufacturing (adjusted OR 11.81, 95% CI = 1.20-116.3), and (2) as textile and garment workers (adjusted OR 7.25, 95% CI = 1.18-31.0).

Adolescent↗

Using soluble polymers in latent biphasic systems.

A new strategy for carrying out reactions with a soluble polymer-bound reagent or catalyst is described. In this latent biphasic process, a solvent mixture at the cusp of immiscibility is prepared and used to carry out a reaction under homogeneous conditions. Then, after the reaction is complete, this mixture is perturbed by the addition of solvent or some other perturbing agent to produce a biphasic mixture. The product-containing phase is then separated under liquid/liquid conditions from the polymer-containing phase. The generality of this process is demonstrated using both dye-labeled polymers as surrogates for polymer-bound catalysts and with various polymer-bound organic and transition metal catalysts or reagents. In cases where a polymeric catalyst is used, the addition of fresh solvent and substrate reforms the original mixture allowing facile reuse of the catalyst.

Journal Article↗

Multiplexed liquid arrays for simultaneous detection of simulants of biological warfare agents.

Liquid array-based multiplexed immunoassays designed for rapid, sensitive, specific, and simultaneous detection of multiple simulants of biological warfare agents have been developed. In both blind and standard laboratory trials, we demonstrate the simultaneous detection of four simulant agents from a single sample. The challenge agents comprise broad classes of pathogens (virus, protein toxins, bacterial spores, vegetative cells). Assay performance of each analyte was optimized, and dose-response curves and the limits of detection (LODs) for individual analytes are presented. Assay performance, including dynamic range, sensitivity, and LODs for liquid arrays and enzyme-linked immunosorbant assay were compared and are shown to be similar. Maximum assay sensitivity is obtained in approximately 1 h, and good sensitivity is achieved in as little as 30 min. Although the sample matrixes are very complex, even for highly multiplexed assays the samples do not exhibit evidence of nonspecific binding, demonstrating that the assays also have high specificity.

Bacteria↗

Sensitivity of chest fluoroscopy compared with chest CT and chest radiography for diagnosing hydropneumothorax in association with percutaneous nephrostolithotomy.

OBJECTIVES: Hydropneumothorax (HPTX) is recognized as a potential complication of percutaneous nephrostolithotomy (PCNL), particularly with supracostal access. Postoperative chest radiography (CXR) is routinely used to evaluate the chest after PCNL. We prospectively compared the sensitivity of intraoperative chest fluoroscopy with immediate postoperative portable CXR and postoperative day 1 chest computed tomography (CT) for the detection of pleural fluid. METHODS: A total of 89 consecutive patients (mean age 47.9 +/- 13.3 years; 100 renal units) undergoing PCNL were prospectively evaluated with intraoperative fluoroscopy at the conclusion of the procedure and then with anteroposterior CXR in the postanesthesia care unit and postoperative day 1 noncontrast, thin-cut CT of the kidneys and lung bases. CT imaging of the lung bases comprised the reference standard for detecting pleural fluid. RESULTS: A total of 104 percutaneous renal accesses in 100 renal units, 60 above and 44 below the 12th rib, were used. In 16 cases (16%), a second-stage procedure was performed to clear residual stone fragments detected on post-PCNL CT. HPTX was detected in 1, 8, and 38 cases by initial fluoroscopy, immediate postoperative CXR, and CT scan, respectively. Intervention was necessary in 7 patients. In 2 patients with fluoroscopic evidence of pleural fluid (1 at the initial PCNL and 1 during second-look flexible nephroscopy), intraoperative pleural drainage was performed percutaneously. In the other 5 patients, intervention was determined by the size of the HPTX on chest CT scan (n = 1) or the presence of symptoms (n = 4). In no case was intervention performed on the basis of the immediate postoperative CXR findings when intraoperative chest fluoroscopy was negative. CONCLUSIONS: Intraoperative chest fluoroscopy during PCNL is sufficient to detect clinically significant HPTXs, and, therefore, routine postoperative CXRs are not necessary. However, a high index of suspicion based on clinical symptoms postoperatively should prompt chest imaging.

Adult↗

Combined-modality treatment for resectable metastatic colorectal carcinoma to the liver: surgical resection of hepatic metastases in combination with continuous infusion of chemotherapy--an intergroup study.

PURPOSE: Despite technical improvements that have minimized the morbidity and mortality of hepatic surgery, the long-term outcome of resection of hepatic metastases of colorectal cancer remains poor, with the majority of patients experiencing treatment failure in the liver. Because arterial chemotherapy regimens targeted to the liver have demonstrated high response rates, an intergroup trial of adjuvant therapy for patients undergoing hepatic resection of liver metastases from colorectal cancer was initiated. PATIENTS AND METHODS: Patients with one to three potentially resectable metastases were randomized preoperatively to receive no further therapy (control arm, 56 patients) or postoperative hepatic arterial floxuridine combined with intravenous continuous-infusion fluorouracil (chemotherapy arm, 53 patients). After exclusion of patients identified as ineligible for the planned treatment at the time of surgery, there were 45 control patients and 30 on the chemotherapy arm. The study was powered to evaluate improvement in time to recurrence and hepatic disease-free survival, not overall survival. RESULTS: The 4-year recurrence-free rate was 25% for the control arm and 46% for the chemotherapy group (P =.04). The 4-year liver recurrence-free rate was 43% in the control group and 67% in the chemotherapy group (P =.03). The median survival of the 75 assessable patients was 49 months for the control arm and 63.7 months for the chemotherapy arm (P =.60). The median survival of all 109 patients was 47 months for the control arm compared with 34 months for the chemotherapy arm (P =.19) CONCLUSION: These data demonstrate that adjuvant intra-arterial and intravenous chemotherapy was beneficial in prolonging time to recurrence and pre-venting hepatic recurrence after hepatic resection of colorectal cancer.

Antimetabolites, Antineoplastic↗

Involvement of the MEN1 gene locus in familial isolated hyperparathyroidism.

BACKGROUND: Familial isolated hyperparathyroidism (FIHP) is a hereditary disorder characterised by uni- or multiglandular parathyroid disease. A subset of families are likely to be genetic variants of other familial tumour syndromes in which PHPT is the main feature, for example multiple endocrine neoplasia type 1 (MEN 1) and the hyperparathyroidism-jaw tumour syndrome (HPT-JT). OBJECTIVE: To investigate seven families diagnosed with FIHP, each with two to eight affected family members, to clarify the underlying genetic mechanism. METHODS: The entire MEN1 gene was sequenced for germline mutations and, in addition, tumour specimens were analysed in comparative genomic hybridisation and loss of heterozygosity studies. RESULTS: Two families exhibited MEN1 mutations, L112V and 1658delG, which were associated with loss of the wild-type 11q13 alleles in all tumours analysed. In the remaining five families, no MEN1 mutation was identified. CONCLUSION: These results support the involvement of the MEN1 tumour suppressor gene in the pathogenesis of some of the FIHP kindreds. However, loss on chromosome 11 was seen in all tumours exhibiting somatic deletions, although in two families the tumour deletions involved 11q distal to MEN1. We conclude that the altered MEN1 gene function is of importance in the development of FIHP.

Adult↗

A one-year neonatal mouse carcinogenesis study of quinacrine dihydrochloride.

Quinacrine is an acridine derivative under investigation for its use in nonsurgical female sterilization. Safety issues regarding the carcinogenic potential of quinacrine have been raised because it is mutagenic and clastogenic in vitro. The objective of the study was to evaluate the carcinogenic potential of quinacrine dihydrochloride (quinacrine) in neonatal mice treated with single intraperitoneal doses on postpartum days 8 and 15 and observed for 52 weeks. Neonatal Crl: CD-1 mice of each sex were randomly allocated into four treatment groups (0, 10, 50, and 150 mg/kg), dosed twice with quinacrine suspended in carboxymethylcellulose, observed for 52 weeks post dose, and then euthanized, necropsied, and subjected to a full histopathological examination. In male mice, tumor incidence was not significantly increased at any site at any dose level. In female mice, the incidence of benign uterine endometrial stromal polyps was slightly greater at the mid and high dose (> or = 50 mg/kg), as was the incidence of endometrial hyperplasia. The incidence of polyps in these groups was not significantly greater than in controls by pair-wise comparison but was significantly greater (p = .042) by the linear trend test. The authors conclude that quinacrine administered twice to neonatal mice may have enhanced or accelerated the development of endometrial hyperplasia and uterine stromal polyps at higher doses. Because uterine stromal polyps are a commonly observed benign tumor in older mice, the significance of this finding is unclear and will require a weight of evidence evaluation for a conclusion on the carcinogenic potential of quinacrine.

Animals↗

Nursing care quality initiative for care of hospitalized elders and their families.

This report describes a Nursing Care Quality Initiative (NCQI) through which a new model of care for hospitalized older adults and their families, the Family-Centered Geriatric Resource Nurse (FCGRN) model, was introduced. Eighteen units in 10 hospitals participated in the NCQI Project. Educational, clinical, and evaluation components of the NCQI Project are described.

Aged↗

Hospitalized elders: changes in functional and mental status.

This article describes outcomes of a new model of care for hospitalized elders and their families. Patient functional and cognitive status on admission and discharge were evaluated for changes as a result of an educational program for preparing family-centered geriatric resource nurses. Patients in the intervention group (n = 173) demonstrated significant improvements in outcome measures (functional and cognitive status) from admission to discharge. A subset (n = 50) was selected from the 173 subjects who comprised the intervention group; this subset was compared with control subjects (n = 44); no statistically significant differences were noted between the 2 groups. Suggestions for future research are presented.

Activities of Daily Living↗

Effect of terminal sterilization by irradiation on amber Type I and Type III glass containers containing veterinary oxytetracycline suspension.

The purpose of this study is to determine the effect of terminal sterilization by gamma irradiation on 500-mL amber Type I and Type III glass containers (bottles) containing oxytetracycline (OTC) (25% W/V) suspension formulated using 20% (W/V) phospholipids syrup. The formulation was developed for veterinary parenteral administration. The results of terminal sterilization were used to assess the acceptability for this suspension product. OTC is light-sensitive and needs to be stored in amber glass containers. Amber Type I and Type III glass containers were considered for this formulation during development. Type I is a highly resistant, borosilicate glass (oxidized glass). Type III, which is soda-lime glass (reduced glass, see Materials and Methods), may also be used for parenteral products. The amber Type I and Type III glass containers, containing the suspension, were irradiated at 20-40 kGy for 150 min. In order to determine the sterility of the suspension, ampoules of the biological indicator, Bacillus pumilus, were placed in a number of bottles of the suspension. The bottles with the biological indicators were then positioned among the rest of the production bottles as per a radiation dose-mapping study conducted at the sterilization facility. Potency determination and stability evaluations for OTC were performed using high pressure liquid chromatography (HPLC). The results indicate that the gamma irradiation dose of 20-40 kGy for 150 min was able to inactivate 10(6) Bacillus pumilus spores in ampoules. After gamma sterilization, OTC concentration, pH, particle size, endotoxins, and sterility were evaluated. The assay results were comparable for the suspension in amber Type I and Type III glass containers. Sterility and pyrogenicity were measured by the USP Membrane Filtration Method and USP Bacterial Endotoxins Test, respectively. The suspension in the amber Type III glass container was also chemically (HPLC) and physically (suspension mean particle size, viscosity, density, and syringeability) stable for at least 12 months at room temperature. However, amber Type I glass darkened following irradiation, leading to a substantial reduction in glass transparency. The appearance of amber Type III glass was acceptable. Thus, the "reduced" glass, such as soda-lime, was found to be much less susceptible to darkening than the highly oxidized borosilicate amber. Due to the potential aesthetic concerns with Type I glass, the amber Type III glass container was selected for this suspension formulation.

Chromatography, High Pressure Liquid↗