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Craig A, Shapiro G, Ryan D, Eder J, Supko J, Wolanski A, Jones S, Regan E, Bell T, Li C. 218 A phase I and pharmacokinetic trial ARQ 501, an Activated Checkpoint Therapy (TM) agent, in patients with advanced solid tumors. EJC Suppl 2004. [DOI: 10.1016/s1359-6349(04)80226-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Hollamby S, Simmons H, Bell T, Duncan A, Stadler C. Myocardial necrosis in a captive binturong (Arctictis binturong). Vet Rec 2004; 154:596-8. [PMID: 15160846 DOI: 10.1136/vr.154.19.596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
An adult male binturong, Arctictis binturong, which had been anorexic and lethargic for seven days became acutely dyspnoeic and died under anaesthesia. A postmortem examination revealed left ventricular hypertrophy with a thrombus occluding the left ventricular chamber. Histological findings included moderate to severe multifocal, vasculocentric myocardial degeneration and necrosis with fibrosis replacing myocardiocytes. Escherichia coli and Proteus mirabilis were grown on cultures. The animal's serum vitamin E and selenium levels were considered adequate. The aetiology of the chronic myocardial changes could not be determined.
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Anderson MC, Bell T. Forgetting our facts: the role of inhibitory processes in the loss of propositional knowledge. J Exp Psychol Gen 2002. [PMID: 11561927 DOI: 10.1037//0096-3445.130.3.544] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Seven experiments are reported that show that retrieving facts from long-term memory is accomplished, in part, by inhibitory processes that suppress interfering facts. When asked to repeatedly retrieve a recently learned proposition (e.g., recalling The actor is looking at the tulip, given cues such as Actor looking t__), subjects experienced a recall deficit for related facts (e.g., The actor is looking at the violin) on a recall test administered 15 min later. Importantly, this retrieval-induced forgetting was shown to generalize to other facts in which the inhibited concepts took part (e.g., The teacher is lifting the violin), replicating a finding observed by M. C. Anderson and B. A. Spellman (1995) with categorical stimuli. These findings suggest a critical role for suppression in models of propositional retrieval and implicate the mere retrieval of what we know as a source of forgetting of factual knowledge.
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Abstract
OBJECTIVE To define the ability of UK paramedics to recognise ST segment elevation using a prehospital 12 lead electrocardiogram (ECG). METHODS Analysis of the diagnostic ability of seven paramedics 12 months after a two day training course, using interpretation of a 12 lead ECG by two cardiologists as the criterion standard. Comparison of paramedic and A&E SHO diagnosis to determine accuracy, specificity, sensitivity, negative predictive value, and positive predictive value of paramedic interpretation. RESULTS Paramedics showed a median accuracy of 0.95 (95% CI 0.88 to 0.98), a specificity of 0.91 (95% CI 0.53 to 1.0), a sensitivity of 0.97 (95% CI 0.94 to 0.99), a NPV of 0.77 (95% CI 0.62 to 0.92) and a PPV of 0.99 (95% CI 0.92 to 1.0). This was not significantly different from a group of experienced A&E SHOs. CONCLUSIONS UK paramedics can recognise ST elevation using a 12 lead ECG. Radio transmission of an ECG may not be necessary to pre-alert the hospital.
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Anderson MC, Bell T. Forgetting our facts: the role of inhibitory processes in the loss of propositional knowledge. J Exp Psychol Gen 2001; 130:544-70. [PMID: 11561927 DOI: 10.1037/0096-3445.130.3.544] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Seven experiments are reported that show that retrieving facts from long-term memory is accomplished, in part, by inhibitory processes that suppress interfering facts. When asked to repeatedly retrieve a recently learned proposition (e.g., recalling The actor is looking at the tulip, given cues such as Actor looking t__), subjects experienced a recall deficit for related facts (e.g., The actor is looking at the violin) on a recall test administered 15 min later. Importantly, this retrieval-induced forgetting was shown to generalize to other facts in which the inhibited concepts took part (e.g., The teacher is lifting the violin), replicating a finding observed by M. C. Anderson and B. A. Spellman (1995) with categorical stimuli. These findings suggest a critical role for suppression in models of propositional retrieval and implicate the mere retrieval of what we know as a source of forgetting of factual knowledge.
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Meek K, Kienker L, Dallas C, Wang W, Dark MJ, Venta PJ, Huie ML, Hirschhorn R, Bell T. SCID in Jack Russell terriers: a new animal model of DNA-PKcs deficiency. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2001; 167:2142-50. [PMID: 11489998 DOI: 10.4049/jimmunol.167.4.2142] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We recently described the incidence of a SCID disease in a litter of Jack Russell terriers. In this study, we show that the molecular defect in these animals is faulty V(D)J recombination. Furthermore, we document a complete deficit in DNA-dependent protein kinase activity that can be explained by a marked diminution in the expression of the catalytic subunit DNA-dependent protein kinase catalytic subunit (DNA-PKcs). We conclude that as is the case in C.B-17 SCID mice and in Arabian SCID foals, the defective factor in these SCID puppies is DNA-PKcs. In mice, it has been clearly established that DNA-PKcs deficiency produces an incomplete block in V(D)J recombination, resulting in "leaky" coding joint formation and only a modest defect in signal end ligation. In contrast, DNA-PKcs deficiency in horses profoundly blocks both coding and signal end joining. Here, we show that although DNA-PKcs deficiency in canine lymphocytes results in a block in both coding and signal end joining, the deficit in both is intermediate between that seen in SCID mice and SCID foals. These data demonstrate significant species variation in the absolute necessity for DNA-PKcs during V(D)J recombination. Furthermore, the severity of the V(D)J recombination deficits in these three examples of genetic DNA-PKcs deficiency inversely correlates with the relative DNA-PK enzymatic activity expressed in normal fibroblasts derived from these three species.
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MESH Headings
- Alleles
- Animals
- Base Sequence
- Catalytic Domain/genetics
- Cell Line
- DNA-Activated Protein Kinase
- DNA-Binding Proteins
- Disease Models, Animal
- Dog Diseases/enzymology
- Dog Diseases/genetics
- Dog Diseases/immunology
- Dogs
- Fibroblasts/immunology
- Fibroblasts/radiation effects
- Gene Expression Regulation/immunology
- Gene Rearrangement, beta-Chain T-Cell Antigen Receptor
- Humans
- Mice
- Mice, Inbred BALB C
- Mice, SCID
- Molecular Sequence Data
- Nuclear Proteins
- Phenotype
- Polymorphism, Single Nucleotide
- Protein Serine-Threonine Kinases/biosynthesis
- Protein Serine-Threonine Kinases/deficiency
- Protein Serine-Threonine Kinases/genetics
- Purine Nucleotides/genetics
- Purine Nucleotides/metabolism
- Radiation Tolerance
- Receptors, Antigen, T-Cell, alpha-beta/chemistry
- Recombination, Genetic/immunology
- Recombination, Genetic/radiation effects
- Severe Combined Immunodeficiency/enzymology
- Severe Combined Immunodeficiency/genetics
- Severe Combined Immunodeficiency/veterinary
- T-Lymphocyte Subsets/chemistry
- T-Lymphocyte Subsets/enzymology
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Choe JM, Bell T. Genetic material is present in cadaveric dermis and cadaveric fascia lata. J Urol 2001; 166:122-4. [PMID: 11435837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
PURPOSE We determined whether genetic material is present in the commercially processed cadaveric allografts used in sling surgery. MATERIALS AND METHODS We evaluated 16 samples from 2 commercial sources of human allograft, including 8 each of freeze-dried gamma irradiated cadaveric fascia lata and acellular cadaveric dermis. Fresh human rectus fascia and sterile saline served as positive and negative controls, respectively. All samples underwent a standard proteinase K/sodium dodecyl sulfate/phenol extraction technique to isolate DNA. Polymerase chain reaction was done to amplify the retrieved DNA material, spectrophotometry to quantify DNA concentration and agarose gel electrophoresis to determine the size of DNA fragments. RESULTS Of the 16 samples tested from 2 commercial sources of human allograft fascia 14 (87.5%) contained DNA. Mean DNA concentration plus or minus standard error was 258.3 +/- 80.1 and 272.8 +/- 168.8 microg./gm. tissue for cadaveric fascia lata and cadaveric dermis, respectively. Polymerase chain reaction amplified DNA segments of 2,000 bp from 1 of each of the 8 samples of cadaveric fascia lata and cadaveric dermis. CONCLUSIONS Freeze-dried gamma irradiated cadaveric fascia lata and acellular cadaveric dermis contained intact DNA.
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Howell JN, Frederick J, Olinger B, Leftridge D, Bell T, Hess R, Clipp EC. Can nurses govern in a government agency? J Nurs Adm 2001; 31:187-95. [PMID: 11324331 DOI: 10.1097/00005110-200104000-00007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A shared governance model was implemented within the nursing service of the Durham Veterans Affairs Medical Center in 1997. In 1999, members of the Nursing Quality/Staff Education/Research Council examined facility nurses' perceptions of governance to determine the degree to which the model had been implemented. Results of the study indicate that although imperatives at the organizational level were incompatible with three aspects of shared governance, there were three shared governance dimensions pertaining to basic nursing practice that reached or surpassed governance thresholds. This study highlights the potential of nursing management innovation within highly bureaucratic organizations.
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Foss FM, Bacha P, Osann KE, Demierre MF, Bell T, Kuzel T. Biological correlates of acute hypersensitivity events with DAB(389)IL-2 (denileukin diftitox, ONTAK) in cutaneous T-cell lymphoma: decreased frequency and severity with steroid premedication. CLINICAL LYMPHOMA 2001; 1:298-302. [PMID: 11707845 DOI: 10.3816/clm.2001.n.005] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
DAB(389)IL-2 (denileukin diftitox, ONTAK) is a cytokine-targeted fusion protein that delivers the catalytic domain of diphtheria toxin to lymphoma cells expressing the interleukin-2 receptor (IL-2R). In phase I and phase III studies of DAB(389)IL-2 in patients with cutaneous T-cell lymphoma (CTCL), non-Hodgkin's lymphoma, and Hodgkin's disease in which premedications were limited to diphenhydramine and acetaminophen, acute infusion-related hypersensitivity reactions occurred in 70% of patients and vascular leak syndrome (VLS) in 27%, resulting in discontinuation of therapy in 29% of patients. There was no correlation between the dose or half-life of DAB(389)IL-2 and the occurrence of hypersensitivity events or VLS. To explore whether steroid premedication would improve the tolerability of DAB(389)IL-2, we treated 15 patients with CTCL with either dexamethasone or prednisone prior to each dose of DAB(389)IL-2. The incidence of acute infusion events was significantly decreased, with only three patients experiencing acute infusion events (one grade 4) and only two patients developing clinically apparent VLS. Grade 3 skin rash occurred in two patients and moderately severe asthenia in nine patients. A significantly improved response rate of 60% was noted with the use of steroid premedication compared to prior studies in which steroids were prohibited. We conclude that steroid premedication significantly improves the tolerability of DAB(389)IL-2 without compromising the clinical response.
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Bell T, Purcell M, Walker B, Nisbet N. Evaluation of a model of intervention to create a visually enriched environment. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2001; 36 Suppl:92-97. [PMID: 11340851 DOI: 10.3109/13682820109177865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Within a day resource for people with learning disabilities 'stand-alone' signing training proved ineffectual to sustain lasting change in the formalised gestural behaviours of carers. Consideration was given to setting conditions pre- and post-training and a new model of delivery evolved, designed in partnership with day resource staff. Aims of intervention were to promote the adoption and active use of signing as an aid to communication and move towards a partnership framework which values the role of carers as co-facilitators and lessens dependency on the therapist. This paper describes and evaluates a training model which was found to be successful in translating knowledge into changes in practice and discusses the critical factors which should be built into future interventions.
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Ikeyama M, Nakao S, Morikawa H, Yokogawa Y, Wielunski LS, Clissold RA, Bell T. Surface hardness changes induced by O-, Ca- or P-ion implantation into titanium. Colloids Surf B Biointerfaces 2000; 19:263-268. [PMID: 10967500 DOI: 10.1016/s0927-7765(00)00164-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Titanium or titanium alloys are very attractive biomedical materials. Biocompatible elements of oxygen, calcium and phosphorus were implanted into titanium and changes of surface hardness were measured using an ultra micro indenter (UMIS-2000). A multiple load-partial unload procedure that can reveal a hardness versus depth profile was adopted. Depth profiles of concentration of implanted ions were obtained by SIMS measurement. For O and P implantation, it is observed that the hardness increases with the increases in the dose. O implantation produced the largest increase in hardness, up to 2.2 times higher than the unimplanted titanium. On the other hand, Ca implantation produced only a small increase in the hardness that was independent of the ion dose. The surface oxide layer of a Ca implanted titanium sample was much thicker than the unimplanted samples or those implanted with O and P ions. The depth of maximum hardness increases with increasing energy of implanted ions. The depths of the maximum hardness occur at indentation depths of one-third to one-eighth of the mean ranges of implanted ions.
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Manzella J, Benenson R, Pellerin G, Kellogg J, Bell T, Robertson M, Pope D. Choice of antibiotic and risk of colonization with vancomycin-resistant Enterococcus among patients admitted for treatment of community-acquired pneumonia. Infect Control Hosp Epidemiol 2000; 21:789-91. [PMID: 11140916 DOI: 10.1086/501735] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A time-series prospective study of patients admitted to the hospital for treatment of community-acquired pneumonia was undertaken to determine vancomycin-resistant enterococcal perianal colonization rates among patients who received ceftriaxone with or without erythromycin versus those who received levofloxacin. A colonization rate of 16% (8/51) was found in the ceftriaxone-erythromycin group versus 0% (0/52) in the levofloxacin group .
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Paiva MB, Saxton RE, VanderWerf QM, Bell T, Eshraghi AA, Graeber IP, Feyh J, Castro DJ. Cisplatinum and interstitial laser therapy for advanced head and neck cancer: a preclinical study. Lasers Surg Med 2000; 21:423-31. [PMID: 9365952 DOI: 10.1002/(sici)1096-9101(1997)21:5<423::aid-lsm3>3.0.co;2-s] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Direct intratumor injection of cisplatinum (CDDP) and laser therapy were tested for improved treatment of squamous cell carcinoma (SCCA). STUDY DESIGN/MATERIALS AND METHODS Human SCCA tumors were grown as s.c. transplants in nude mice and injected with CDDP (0.4-1.2 mg/gm) in water or in collagen-based gel carrier with epinephrine (epi-gel), followed by interstitial laser therapy (ILT) via 0.6 mm fiberoptics (532 nm/300 J). RESULTS Tumors injected with CDDP epi-gel exhibited a partial response with 2-4-fold tumor growth delay, compared to aqueous drug or untreated SCCA transplants during 10-week follow-up. Combined drug and laser therapy significantly decreased tumor volume with recurrence in only 25% (2/8) of animals tested, compared to 66% tumor regrowth (10/15) after ILT alone. CONCLUSION These initial results suggest laser chemotherapy may become an effective treatment for advanced head and neck cancer.
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64
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T�th A, Bert�ti I, Szil�gyi E, Dong H, Bell T, Juh�sz A, Nagy PM. Surface characterization of ultrahigh molecular weight polyethylene after nitrogen ion implantation. SURF INTERFACE ANAL 2000. [DOI: 10.1002/1096-9918(200008)30:1<434::aid-sia788>3.0.co;2-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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65
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Abstract
Emergency contraception (EC) has been available since 1984 but has been labelled the 'best kept secret' (Winfield, 1995). Because EC was originally termed 'the morning after pill', many people interpreted this literally and missed an opportunity to use the method. More recent publicity has dropped this term and emphasized that the method is effective up to 72 h after unprotected intercourse or contraceptive failure (Burton & Salvage, 1990). Uptake of EC has steadily increased since 1985 but there is still evidence that younger women in particular are least aware of its existence.
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66
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Peterson KL, Graves M, Berke GS, Ye M, Wallace R, Bell T, Sercarz JA. Role of motor unit number estimate electromyography in experimental canine laryngeal reinnervation. Otolaryngol Head Neck Surg 1999; 121:180-4. [PMID: 10471854 DOI: 10.1016/s0194-5998(99)70168-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Laryngeal electromyography has been used clinically to differentiate neuromuscular pathology from other causes of vocal fold immobility such as arytenoid dislocation, tumor invasion, or cricoarytenoid joint fixation. Electromyography has also been used to predict the prognosis for nerve recovery in laryngeal paralysis. Existing electromyographic techniques either record activity with voluntary motion or study nerve conduction. In this study a new technique, motor unit number estimation, a commercially available quantitative method of electromyographic analysis, is used to study the progress of recovery of vocal fold function after recurrent laryngeal nerve injury. Four dogs underwent transection and immediate reanastomosis of selected branches of the adductor and abductor branches of the recurrent laryngeal nerve on 1 side; the opposite side served as a control. Baseline electromyographic and videolaryngoscopic studies were performed. These measures were then repeated in a longitudinal fashion every 6 weeks after denervation. The motor unit number estimation technique indicated a return of motor unit numbers with time, along with estimates of their size. This was consistent with the expected progress of laryngeal reinnervation. These data and their predictive value for nerve recovery will be discussed.
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Abstract
BACKGROUND AND OBJECTIVE Laser resurfacing of eyelids was examined in a series of experiments designed to measure beam parameters, surface temperatures, ablation characteristics, thermal damage, tissue responses and clinical outcomes. These data were collected for the purpose of developing a logical basis for clinical dosimetry. STUDY DESIGN All experiments were conducted with similar short-pulse CO(2) lasers (TruPulse, Albuquerque, NM) where the beam had been carefully characterized and calibrated. The chronological sequence examined begins with the photophysical laser/tissue interactions during the first few microsec of irradiation and ends with an evaluation of the efficacy of wrinkle reduction nine months after treatment. RESULTS Eyelid tissue removed by the first and second passes consisted mostly of epidermis with about 38 microm of thermal damage into the papillary dermis. Erythema resolved within four weeks and most patients experienced 70-100% wrinkle reduction by nine months. CONCLUSION A layer of contracted dermal scar tissue that replaced the thermally challenged zone in the dermis is identified as the substrate for wrinkle reduction. The data support the following dosimetry for periorbital wrinkle reduction: One pass 4-6 J/cm(2) (350-500 mJ into a 3 x 3 mm spot). A second treatment after 9-12 months may be more beneficial than a second pass.
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68
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Wisotzkey JD, Toman J, Bell T, Monk JS, Jones D. MTHFR (C677T) polymorphisms and stage III colon cancer: response to therapy. MOLECULAR DIAGNOSIS : A JOURNAL DEVOTED TO THE UNDERSTANDING OF HUMAN DISEASE THROUGH THE CLINICAL APPLICATION OF MOLECULAR BIOLOGY 1999; 4:95-9. [PMID: 10462625 DOI: 10.1016/s1084-8592(99)80034-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Leucovorin and 5-fluorouracil (5-FU) chemotherapeutics are often used as coinhibitors of the thymidylate synthase pathway to thwart the growth of cancer cells in certain types of neoplasms. The metabolism of leucovorin is mediated through the enzyme methylenetetrahydrofolate reductase (MTHFR). A common polymorphism in the MTHFR gene has been reported to be responsible for as much as a 70% reduction in activity of this enzyme when present in the homozygous form. METHODS AND RESULTS A total of 51 stage III colon cancer patients were identified through our tumor registry. Non-neoplastic, archived tissue was obtained for each patient and subjected to MTHFR C677T PCR-RFLP genotyping. The MTHFR C677T allele was present in 32 patients (28 heterozygotes and 4 homozygotes). The remaining 19 patients carried only the wild-type allele. Overall survival was 42.10% (8/19) for wild types and 43.757% (14/32) for those with at least one C677T allele. Of the four homozygotes identified, three have succumbed to their cancer and one is alive with cancer. CONCLUSIONS We were unable to demonstrate a survival difference between those stage III colon cancer patients receiving leucovorin therapy that carried the MTHFR C677T allele and those that were wild type for this allele. The results of this study suggest that certain subgroups (ie, homozygotes) of patients may benefit from genotypic analysis of the MTHFR gene.
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Abstract
CT has revolutionized the diagnostic work-up of trauma patients with suspected abdominal injuries. A wide range of intraperitoneal and retroperitoneal organ injuries can be quickly and accurately diagnosed with CT. Today, helical CT technology permits even faster examinations, with improved intravenous contrast opacification of parenchymal organs and vascular structures and reduced CT artifacts caused by patient motion, respiration, and arterial pulsation. Severely injured and potentially unstable patients, who might not have been able to tolerate the long CT examinations of the past, may be quickly evaluated today with helical CT. Accurate diagnosis requires high quality CT examinations that are performed with optimum CT protocols. This article reviews the currently recommended helical CT protocols for evaluating patients with suspected abdominal injuries, and the CT findings when injuries are present.
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Wisotzkey JD, Bayliss P, Rutherford E, Bell T. Placental genotyping of the factor V Leiden, prothrombin 20210A and the methylenetetrahydrofolate reductase (MTHFR) C677T alleles in IUGR pregnancies. Thromb Haemost 1999; 81:844-5. [PMID: 10365762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Barone JE, Burns G, Svehlak SA, Tucker JB, Bell T, Korwin S, Atweh N, Donnelly V. Management of blunt splenic trauma in patients older than 55 years. Southern Connecticut Regional Trauma Quality Assurance Committee. THE JOURNAL OF TRAUMA 1999; 46:87-90. [PMID: 9932688 DOI: 10.1097/00005373-199901000-00014] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Many experts have suggested that blunt splenic trauma in patients older than 55 years should not be managed by observation because of supposed increased fragility of the spleen and decreased physiologic reserve in elderly patients. We sought to determine the outcome of nonoperative management of blunt splenic trauma in patients older than 55 years. METHODS For the years 1994 through 1996, data for patients with splenic injury older than 55 years from seven trauma centers in a single state were reviewed. RESULTS Blunt splenic trauma occurred in 41 patients older than 55 years. Eight patients were excluded from further analysis because of death from massive associated injuries within 24 hours of admission. The remaining 33 patients (mean age, 72+/-10 years) were divided into two groups: immediate exploration (10 patients) and observation (23 patients). Observation of blunt splenic injury failed in 4 of 23 patients (17%). No patient deaths were related to the method of management of the splenic injury. CONCLUSIONS Observation of the elderly patient with blunt splenic trauma has an acceptable failure rate of 17%.
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Delcker A, Knappertz VA, Wilson J, Branch C, Bell T, Tegeler C. Transcranial 3D B-mode imaging in a case of cerebral hemorrhage. J Neuroimaging 1998; 8:173-5. [PMID: 9664856 DOI: 10.1111/jon199883173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The case of a patient with temporal lobe hemorrhage is presented. This is the first report of use of a new three-dimensional data acquisition system that entails free-hand scanning with three-dimensional transcranial duplex sonography. Three-dimensional image reconstruction reduced the spatial asymmetry inherent in oblique two-dimensional ultrasonography, making evaluation of the precise location, size, and anatomic relations of intracranial hemorrhage easier.
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Wisotzkey JD, Bell T, Monk JS. Simultaneous polymerase chain reaction restriction fragment length polymorphism identification of the factor V Leiden allele and the prothrombin 20210A mutation. DIAGNOSTIC MOLECULAR PATHOLOGY : THE AMERICAN JOURNAL OF SURGICAL PATHOLOGY, PART B 1998; 7:180-3. [PMID: 9836075 DOI: 10.1097/00019606-199806000-00010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A novel mutation in the 3' untranslated region of the prothrombin gene, prothrombin 20210A, recently has been identified. This mutation is associated with increased serum prothrombin levels and an increased risk for venous thromboembolism. Patients who carry a mutation in the factor V gene (factor V Leiden) have also been demonstrated to be at increased risk for venous thromboembolism, and previous studies have identified a population prevalence of approximately 5% to 10% for the factor V Leiden allele. To simply and reliably identify patients who carry both genetic defects, a novel assay was developed that simultaneously determines the genotype of patients for the factor V Leiden allele and the prothrombin 20210A mutation. Representative samples (samples positive and negative for each mutation and a "double mutant") were then subjected to this single-tube genotyping assay. The results indicate that the simultaneous genotyping of these mutations will readily characterize the allelic status of patients for the two most frequent genetic mutations in the coagulation cascade.
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Baloh RW, Corona S, Jacobson KM, Enrietto JA, Bell T. A prospective study of posturography in normal older people. J Am Geriatr Soc 1998; 46:438-43. [PMID: 9560065 DOI: 10.1111/j.1532-5415.1998.tb02463.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To follow posturographic measurements over time in a group of normal older subjects to see if sway increases with aging and if sway is greater in those with deteriorating balance and falls. SUBJECTS Seventy-two community-dwelling older people (age range 79-91 years), who initially had normal neurological evaluations, were followed with three yearly follow-up examinations. MEASUREMENTS Amplitude and velocity of sway on static and dynamic posturography, Tinetti gait and balance score, reports of falls. RESULTS Velocity of sway on dynamic tests increased significantly during the 3 years of follow-up. The percentage increase in sway was about the same in the anterior-posterior and medial-lateral directions and with eyes open and eyes closed. Subjects with low Tinetti scores had higher sway amplitude and velocity, particularly on dynamic tests, but no measure of sway was significantly different in those who reported falls compared with those who did not report falls. CONCLUSIONS Sway increases in normal subjects over time, and sway is greater in older subjects with deteriorating balance compared with those with normal balance. Sway was not greater in those who fell compared with those who did not fall, probably because falls are highly dependent on individual behavior.
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Greenlees KJ, Machado J, Bell T, Sundlof SF. Food borne microbial pathogens of cultured aquatic species. Vet Clin North Am Food Anim Pract 1998; 14:101-12. [PMID: 9532670 DOI: 10.1016/s0749-0720(15)30282-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
This article provides a broad overview of microbial pathogens associated with marine and fresh water aquatic animals, including Vibrio species, Escherichia coli, Streptococcus iniae, Salmonella species, and Edwardsiella tarda. Historically, cultured fish were not considered important vectors of human pathogens. This situation is changing, partly due to increasing animal densities as a consequence of a rapidly growing industry and partly due to increasing awareness by health care providers of pathogens in aquatic species that may result in human illness. Concerns facing the industry are also discussed along with possible solutions.
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