Showing papers by "Saint Francis University published in 1992"
TL;DR: This study quantifies the benefits of a formalized head injury program, including the concept of trauma rehabilitation, defined as early, aggressive rehabilitation during acute hospitalization, for severely head injured patients.
170 citations
TL;DR: In this model of uncontrolled hemorrhage, immediate IV administration of hypertonic saline/dextran significantly increased hemorrhage volume and mortality and reduction in survival were not as great as that produced by the standard practice of attempting to replace the lost blood with three times that volume of lactated Ringer's.
151 citations
TL;DR: It is concluded that it is advanced stage at presentation that is the most significant prognostic indicator in patients of all ages, and the high incidence of poorly differentiated, right‐sided tumors is responsible for the majority of young patients presenting with advanced disease, resulting in their poorer prognosis.
Abstract: Utilizing Tumor Registry records dating from 1935 to 1988, 50 patients diagnosed with colorectal adenocarcinoma at the age of 40 years or younger were retrospectively studied with respect to sex, race, family history, delay in diagnosis, primary tumor location, tumor differentiation, mucin production, stage at presentation, and the effect of these factors on 5-year survival. This younger group of patients was compared to a computer-generated, randomly selected group of 50 patients 40 years of age or older. There was no difference with respect to sex, racial distribution, family history, symptoms at presentation, or expediency of physician diagnosis between the two groups. Younger patients waited significantly longer to seek medical attention than did their older counterparts. However, those patients who delayed presentation had no higher incidence of advanced disease than those patients who presented earlier. Younger patients had a higher incidence of poorly differentiated, advanced, right-sided tumors. This is in contrast to a predominance of well-differentiated, less advanced, rectosigmoid lesions in the older patients. There was no age-related difference in the incidence of mucin-producing tumors. Overall 5-year survival was 75% in older patients, in contrast to only 51% in younger patients (P = 0.01). We conclude in this study that it is advanced stage at presentation that is the most significant prognostic indicator in patients of all ages. The high incidence of poorly differentiated, right-sided tumors is responsible for the majority of young patients presenting with advanced disease, resulting in their poorer prognosis.
90 citations
TL;DR: Reduced compliance with qid dosing was due in large part to an increase in frequency of six inhalations per day, resulting from tid use, and Compliance with inhaled flunisolide was worse withqid than bid dosing.
74 citations
Journal Article•
TL;DR: The exact role of PDGF in bone remodelling is still uncertain and current information suggests that this factor has a function in the response to inflammation and wound healing.
Abstract: PDGF is a mitogen for cells of the osteoblastic lineage. PDGF is present in the systemic circulation and is locally synthesized by skeletal cells. The systemic form primarily contains PDGF B chains, which are intrinsically more active than PDGF A subunits, the forms secreted by normal bone cells. PDGF AA is regulated by other growth factors and cytokines, which modulate its binding to osteoblastic receptors and its synthesis by skeletal cells. The exact role of PDGF in bone remodelling is still uncertain and current information suggests that this factor has a function in the response to inflammation and wound healing.
71 citations
TL;DR: It is indicated that IL-alpha and TNF-alpha increase PDGF-AA binding and activity for osteoblasts by mechanisms that are at least in part independent of new receptor synthesis, and regulatory events that could control how PDGF binding sites specifically recognize different ligands are suggested.
Abstract: In osteoblast-enriched cultures from fetal rat bone, the A-chain homodimer of platelet-derived growth factor (PDGF-AA) is less potent than the PDGF isoforms containing B chain subunits (PDGF-AB and PDGF-BB), but normal osteoblasts appear to synthesize only PDGF-A subunit mRNA and polypeptide. However, other agents may regulate PDGF-AA activity in skeletal tissue. Pretreatment of osteoblast-enriched cultures with interleukin 1 alpha (IL-1 alpha) or tumor necrosis factor-alpha (TNF-alpha) synergistically enhanced the mitogenic effect of PDGF-AA coincident with increased binding site occupancy, but neither factor augmented PDGF-BB activity or binding. Polyacrylamide gel analysis showed 125I-PDGF-AA binding complexes predominantly at greater than 200 kD and faint labeling at 185 kD. After IL-1 alpha or TNF-alpha pretreatment, PDGF-AA binding increased at both sites, but this effect was more striking at 185 kD, which co-migrated with 125I-PDGF-BB-labeled complexes. PDGF-AA binding sites were rapidly lost by comparison to those for PDGF-BB in cycloheximide-treated cultures, but they remained relatively enhanced by IL-1 alpha and TNF-alpha pretreatment. These studies indicate that IL-alpha and TNF-alpha increase PDGF-AA binding and activity for osteoblasts by mechanisms that are at least in part independent of new receptor synthesis, and suggest regulatory events that could control how PDGF binding sites specifically recognize different ligands.
67 citations
TL;DR: TGF beta 1 has multiple effects on type I collagen in fetal bone-derived cell cultures, including small increases in mRNA, large increases in polypeptide synthesis, and enhanced association of secreted collagen to the cell layer, which may require synthesis of extracellular components unrelated to fibronectin or the beta 1-integrin subunit.
Abstract: Transforming growth factor-beta (TGF beta) stimulates bone formation in vivo and in vitro, related in part to an increase in type I collagen production. In osteoblast-enriched cultures from fetal rat bone, 24- to 48-h TGF beta 1 treatment enhanced collagen synthesis rates by 2.5- to 6-fold, while it increased collagen accumulation by 5- to 10-fold. These effects were not accounted for by similar changes in acid-soluble radioisotope, cell number, or steady state type I procollagen transcripts. Basal collagen synthesis and accumulation were markedly reduced when mRNA transcription was blocked with alpha-amanitin, but the relative stimulatory effects of TGF beta 1 persisted in toxin-treated cultures. Newly synthesized collagen was rapidly secreted into the culture medium. While pulse-chase studies demonstrated that total (medium plus cell-associated) collagen levels were stable throughout the 48-h period, TGF beta 1 increased the fraction of cell-associated collagen between 24-48 h, and this was partially bl...
64 citations
TL;DR: No significant relationship was found between the change in asthma severity and compliance with the beclomethasone regimen, and the concept of severity-modulated compliance with inhaled corticosteroids was not supported.
46 citations
46 citations
TL;DR: A sensitive and reproducible technique for monitoring PDGF-AA levels in cell-conditioned medium is described and it is demonstrated that Ob cells synthesize PD GF-AA.
Abstract: We describe a sensitive technique for the extraction and quantitation of platelet-derived growth factor (PDGF)-AA in serum-free culture medium conditioned by fetal rat osteoblast-enriched (Ob) cells and demonstrate the expression of PDGF-A mRNA in Ob cells. Using C18 Sep-Pak chromatography with a methanol step gradient, we extracted immunoreactive PDGF-AA from the culture medium. A RIA protocol employing a recombinant human PDGF-AA standard enabled us to measure picomolar equivalents of PDGF-AA in Ob cell culture medium. The recovery of recombinant human PDGF-AA was 50 +/- 4%, and the coefficient of variation, including chromatographic extraction, was 15% for intraassay and 8.3% for interassay variability. The polyclonal antibody to recombinant human PDGF-AA displayed approximately 20-30% cross-reactivity with PDGF-AB, but did not bind PDGF-BB or other growth factors and cytokines known to be secreted by bone cells. Medium from Ob cells cultured for 24 h contained 0.9-1.3 pM human PDGF-AA equivalents, and...
45 citations
Journal Article•
TL;DR: A number of studies critical of the DDST examine applications beyond the intended purpose of this instrument, such as identifying developmental delay among biologically vulnerable infants, screening for speech and language problems, and identifying children with moderate to severe delays.
Abstract: The widespread popularity of the Denver Developmental Screening Test (DDST) during the past 25 years has been accompanied by considerable scrutiny. Certain criticisms, such as the lack of updated norms, the limited extent to which norms may apply to groups such as disadvantaged children, and the difficulty in administering some items, appear justified.1 However, a number of studies critical of the DDST examine applications beyond the intended purpose of this instrument, such as identifying developmental delay among biologically vulnerable infants, screening for speech and language problems, and identifying children with moderate to severe delays.2 The inaccurate or inappropriate way in which the test has been administered and interpreted has troubled the test9s developers.3
TL;DR: Patients with shorter duration of diabetes and poor baseline glycemic control were most likely to have clinically significant glycemic responses to this program, leaving unanswered the question of the mechanism of this association.
Abstract: Background: This study prospectively identifies those characteristics of office patients with diabetes that predict subsequent improvement in glycemic control in response to an educational intervention. Methods: Data on demographic factors, disease characteristics, and glycemic control were obtained on a consecutive series of patients referred by their primary physician to a 4-day outpatient diabetes education and care program. Follow-up measurement of g1ycosyIated hemoglobin (HbA1C) was obtained from the same laboratory 2 months later. Analysis using logistic response models identified baseline characteristics associated with improved HbA1C. Results: Among the 169 study subjects, 74 (44 percent) had at least a 20 percent improvement in HbA1C levels 2 months after the program. Among these subjects, mean HbA1C level was 10.6 percent before and 7.4 percent 2 months after the program. Factors associated with improvement in HbA1C values in bivariate and multivariate logistic models included duration of diabetes less than 2 years (risk ratio = 1.90, 95 percent confidence interval (CI) 1.30–2.76) and initial HbA1C level greater than 10 percent (risk ratio = 2.75,95 percent CI 2.08–4.01). Baseline functional status, health locus of control, social support, knowledge of diabetes self-care, age, weight as percentage of ideal body weight, age at diagnosis, race, sex, family history of diabetes, type of diabetes, and mode of treatment were not significant predictors of improved HbA1C. Conclusions: Patients with shorter duration of diabetes and poor baseline glycemic control were most likely to have clinically significant glycemic responses to this program. Severity of disease and regression to the mean were unable to account for this association, leaving unanswered the question of the mechanism of this association. The data also identified a group of patients who do not respond well to this educational approach and for whom novel approaches to behavior change should be considered.
TL;DR: It is indicated that IGF-II synthesis is constitutive in unstimulated primary fetal rat Ob cultures, and that these levels are not directly modulated by short term treatment with a variety of osteotropic hormones.
Abstract: While a number of osteotropic hormones regulate insulin-like growth factor-I (IGF-I) synthesis in osteoblast-enriched (Ob) and intact bone cultures, their direct effects on IGF-II production are still unresolved. For example, cAMP stimulators, such as PTH and prostaglandin E2, increase Ob IGF-I transcript and polypeptide levels within the first 24 h of treatment, but have no effect on IGF-II expression. To examine the possibility that other circulating factors could directly modify IGF-II synthesis by osteoblasts, primary rat Ob cultures were briefly treated with a number of polypeptide and steroid hormones known to regulate bone metabolism. Prepro-IGF-II steady state transcripts were assessed by Northern blot analysis, and immunoreactive polypeptide levels (iIGF-II) were examined by RIA. Predominant prepro-IGF-II transcripts of 3.7 kilobases were readily detected in quiescent Ob cultures, and constitutive iIGF-II levels were approximately 2-7 nM throughout the first 24 h of culture. GH, placental lactoge...
TL;DR: The muscle biopsy results from 14 children with macrocephaly and hypotonia/weakness were correlated with clinical findings compatible with any of the autosomal dominant macroCEphaly syndromes, suggesting that all three of these disorders may represent phenotypic variability at a single genetic locus.
Abstract: The muscle biopsy results from 14 children with macrocephaly and hypotonia/weakness were correlated with clinical findings compatible with any of the autosomal dominant macrocephaly syndromes. Thirteen of the 14 had evidence of lipid storage myopathy, either generalised or focal. All 13 had examinations consistent with either benign familial macrocephaly, Ruvalcaba-Myhre-Smith syndrome, or Bannayan-Zonana syndrome. These results suggest that all three of these disorders may represent phenotypic variability at a single genetic locus.
TL;DR: It is suggested that the degree of female pubertal development can be assessed and classified by careful inspection of the hymen and surrounding tissue and that it is also possible to anticipate the characteristics of these genital tissues following Tanner staging of the breast.
Abstract: The hymen, vestibule, and labia minora should exhibit predictable changes during puberty. Study Objective: To determine if progressive changes of the genital tissues can be related to Tanner staging of the breast. Design Setting and Participants: As part of the medical evaluation of alleged sexual abuse, a series of 168 girls (ages 7–17 years) had colposcopic photography of the hymen, vestibule, and labia minora. The physical appearance of the photographed structures was individually compared to the breast development of each patient. Main Outcome Measures: Genital tissue growth and development may be associated with Tanner staging of the breast. Results: In patients whose breast displayed no or minimal estrogen effect (Tanner I, II) we noted small, pale, thin labia minora; thin, smooth hymenal and vestibular epithelium; abundant fine vasculature; and absent vaginal secretions. In patients with moderate estrogen effect on the breast (Tanner III) we noted hymenal thickening, much less obvious fine vasculature, and slight vaginal secretions. Patients with extensive to full estrogen effect on the breast (Tanner IV, V) had prominently textured vestibular epithelium; abundant vaginal secretions; enlarged, pigmented labia minora; and a thickened hymen with redundant folds. Conclusions: These observations suggest that the degree of female pubertal development can be assessed and classified by careful inspection of the hymen and surrounding tissue. It is also possible to anticipate the characteristics of these genital tissues following Tanner staging of the breast.
TL;DR: Chloroprocaine DPNB approximates the effectiveness of lidocaine, as was evident from decreased change from baseline cry duration, tissue oxygenation, and heart rate during the most stressful events, particularly in the 3-minute wait chloroprocane group.
Abstract: Dorsal penile nerve blocking (DPNB) has been used with success in decreasing neonatal stress during circumcision. This study was designed to confirm the effectiveness of lidocaine in DPNB and to demonstrate that chloroprocaine, a shorter acting anesthetic, is as effective in blocking circumcision stress as lidocaine, but, because of its shorter plasma elimination half-life and time of onset of action, is safer. Five groups of 15 neonates were matched for weight, age, and Apgar scores and randomly assigned to a control group, one lidocaine group and three chloroprocaine groups with 2-, 3- and 5-minute postinjection waiting periods. Each neonate was subjected to six events during circumcision for which heart rate, tissue oxygenation, and cry duration were recorded. We found that, as in previous investigations, DPNB with lidocaine was effective in reducing neonatal stress, as was evident from decreased excursion from baseline heart rate, tissue oxygenation, and cry duration when compared with the control group (nonblocked). Furthermore, chloroprocaine DPNB approximates the effectiveness of lidocaine, as was evident from decreased change from baseline cry duration, tissue oxygenation, and heart rate during the most stressful events, particularly in the 3-minute wait chloroprocaine group. This more rapid onset of regional anesthesia decreases DPNB circumcision time and benefits patients, parents, and physicians.
TL;DR: A supervised group home can be utilized to provide comprehensive care for homeless pregnant young women and it is concluded that this type of residential environment provides a wide range of resources beneficial to the homeless pregnant teen and her baby.
Journal Article•
TL;DR: The literature on two- and three-vessel coronary angioplasty is reviewed with respect to both immediate success and long-term outcome and a therapeutic strategy for performing multivessel coronary artery bypass surgery in the individual patient is outlined.
Abstract: Multivessel coronary angioplasty is currently a revascularization alternative in selected patients with suitable anatomy. The literature on two- and three-vessel coronary angioplasty is reviewed with respect to both immediate success and long-term outcome. A therapeutic strategy for performing multivessel coronary angioplasty in the individual patient is outlined.
TL;DR: It is suggested to the authors' readers that their con-espondence about published papers be submitted as soon as possible after the article appears to help maintain continuity of comment and redress.
Abstract: We will try to publish authors' responses in the same edition with readers' comments. Time constraints may prevent this in some cases. The problem is compounded in the case of a bimonthly jouroal where continuity of comment and redress is dif6cu1t to achieve. When the redress appears 2 months after the comment, 4 months will have passed since the original article was published. Therefore, we would suggest to our readers that their con-espondence about published papers be submitted as soon as possible after the article appears.
TL;DR: An unusual case of a poorly differentiated carcinoma and a primary sarcoma of the lung is reported and the surgical approach to patients with synchronous primary lung tumors should be aggressive.
Abstract: Synchronous primary lung tumors are uncommon, and primary lung sarcomas are especially rare. We report an unusual case of a poorly differentiated carcinoma and a primary sarcoma of the lung. The surgical approach to patients with synchronous primary lung tumors should be aggressive. © 1992 Wiley-Liss, Inc.