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Abstract
SummaryParasympathomimetic activity is exerted by fractions of alcoholic extract of defatted peanuts previously reported effective in hemostasis. The acetylcholine-like effects on isolated tissues may be enhanced by eserine and blocked by atropine. The activity is destroyed by fresh plasma. From studies on active crystalline products obtained by treating the peanut extracts with ammonium reineckate and with potassium triiodide, we conclude that we are working with a mixture of two substances - choline and an ester of choline. We suggest that clinical improvement afforded hemophiliacs by consumptions of defatted peanuts (or extracts thereof) may be attributable to choline.
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2
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Wang E, Konikoff M, Owen W, Maples K. P252 Association of P21R and H159Y polymorphism with common variable immunodeficiency and protein losing enteropathy. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.08.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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3
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Lee RW, Ortiz-Zapater E, Weitsman G, Fruhwirth G, Owen W, Ng T, Santis G. T6 MET targeted therapy in Lung adenocarcinoma: Does ‘Resistant’ EGFR make a MET-responsive dimer? Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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4
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Howlett P, Lungu N, Owen W, Breen R, Baker L. P191 With A Low Incidence Of Drug-induced Hepatitis, Should We Be Offering Latent Tb Treatment To More Patients Over The Age Of 35? Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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5
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Ortiz-Zapater E, Lee R, Fruhwirth G, Weitsman G, Owen W, Ng T, Santis G. 357: Targeted therapy makes EGFR promiscuous: EGFR and c-Met interaction in lung cancer. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50318-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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6
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Affiliation(s)
- W Owen
- Guy's and St Thomas's Hospital Trust, London
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7
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Abstract
BACKGROUND We sought to determine whether late versus early referral to a nephrologist in patients with chronic kidney disease influences the initial choice of hemodialysis (HD) versus peritoneal dialysis (PD) or the likelihood of switching treatment modalities in the first six months of therapy. METHODS Using New Jersey Medicare/Medicaid claims, all patients who started RRT between January 1991 and June 1996 and were diagnosed with renal disease more than one year prior to RRT were identified. In the resulting cohort of 3014 patients, 35% had their first nephrologist consultation < or =90 days prior to initiation of dialysis. RESULTS After controlling for demographic characteristics, socioeconomic status and underlying renal disease, age, black race [Odds ratio (OR) = 0.56], race other than black or white (OR = 0.56), and socioeconomic status (OR = 0.68) influenced the choice of initial treatment modality, but timing of the referral did not. However, patients starting on PD who were referred late were 50% more likely to switch to HD than were patients who saw a nephrologist earlier [Hazard's ratio (HR) = 1.47]. In patients originally on HD, diabetic nephropathy (HR = 1.49) and black race (HR = 0.69) influenced the likelihood of switching to PD, but the timing of referral did not. CONCLUSIONS These results refute earlier findings that late referral may limit access to PD. We found that modality choice depends on factors such as age, race, or socioeconomic status, rather than on than timing of nephrologist referral. Late referral does not influence the likelihood to switch modality in patients starting on HD, but does so in patients starting on PD.
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Affiliation(s)
- W C Winkelmayer
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
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8
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Eknoyan G, Levin N, Nissenson A, Owen W, Levey AS, Bolton K. NKF and RPA collaborating on clinical practice guidelines for chronic kidney disease. Nephrol News Issues 2001; 15:13, 54. [PMID: 12099224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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9
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Lacson E, Teng M, Lazarus JM, Lew N, Lowrie E, Owen W. Limitations of the facility-specific standardized mortality ratio for profiling health care quality in dialysis. Am J Kidney Dis 2001; 37:267-75. [PMID: 11157366 DOI: 10.1053/ajkd.2001.21288] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Health care quality is assessed by profiling measures of care and/or health outcomes. However, such tools to measure outcome as standardized mortality ratio (SMR) are often used without thorough validation of their strengths and limitations. Our study compared the dialysis facility-specific SMR and SMR-based rating using different statistical methods and followed them over time. All Fresenius Medical Care, North America dialysis facilities (n = 377) that contributed patient data from 1993 to 1995 (>103,500 patient-years) were included. Four distinct statistical methods (US Renal Data System [USRDS], Poisson, logistic, and Cox regression) were used to compute facility-specific SMRs and rank and classify facilities. The analysis compared the SMR and SMR-based rating of dialysis facilities between SMR method and over time. Different methods produced statistically significant differences in SMR distribution (P < 0.05). The USRDS method produced SMR values that decreased over time (P < 0.001). Based on 90% confidence intervals to determine outliers, the SMR-dependent ranking of dialysis facilities varied by method (P < 0.001). SMR-based ranking was stable over time except for the USRDS method (P < 0.001). Contingency table analysis showed up to a 33% total misclassification rate between SMR methods when ranking facilities. The facility-specific SMR and SMR-based ranking are both sensitive to statistical technique. Because the SMR yields different results in a year and over time and because there is no demonstrable gold standard, conclusions based on any one technique are unstable and unreliable. Regulatory monitoring, actions, and/or performance awards should be avoided based on this measure. However, a facility-specific SMR estimated in any valid way may be useful as an epidemiological research tool.
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Affiliation(s)
- E Lacson
- Home Dialysis Therapies and Health Care Information Services, Dialysis Services, Fresenius Medical Care, North America, Lexington, MA, USA.
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10
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Abstract
Inherited cancer syndromes may predispose to more than one type of cancer, and these characteristically develop at an earlier age than their sporadic counterparts. The occurrence in a single individual of multiple, early onset primary cancers may indicate an inherited cancer susceptibility. Familial adenomatous polyposis (FAP), an autosomal, dominantly inherited susceptibility to colorectal adenomas and cancer also predisposes to childhood medulloblastomas and to a specific rare histologic type (cribriform variant) of papillary thyroid cancer. We describe a patient who developed a childhood medulloblastoma of the cerebellum, and subsequently a cribriform papillary thyroid cancer. These cancers predated the diagnosis of FAP in this patient, who was later found to have several relatives with FAP. The adenomatous polyposis coli (APC) mutation delineated in this family was in the region associated with those causing an increased risk of thyroid cancer. We submit that the diagnosis of the cribriform variant of papillary thyroid cancer in a young individual, especially after a previous cancer diagnosis, should alert the physician to the possibility of a diagnosis of FAP.
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Affiliation(s)
- P A Fenton
- Guy's, King's and St. Thomas' School of Medicine, London, United Kingdom
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11
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Seradge H, Tian W, Kashef GH, Seradge A, Owen W. The Oklahoma repair technique: a biomechanical study of a new suture repair technique. J Okla State Med Assoc 2000; 93:551-6. [PMID: 11197950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
We designed and evaluated the biomechanical advantages of a new (Oklahoma) suture technique for repairing flexor tendons in fresh, frozen cadaver specimens. Forty flexor digitorum profundi tendons from the middle three fingers were sharply cut and repaired with a number 3-0 braided polyester using the new technique and the Modified Kessler technique with and without an epitenon repair. The repaired tendons were then stressed to failure. The Modified Kessler with epitendon repair initiated gap formation on an average of 15.3 +/- 2.7 newtons and failed at 40.9 +/- 4.3 newtons. The Oklahoma suture technique with a running epitenon repair initiated gap formation on average of 48.6 (SD +/- 4.0) newtons and required an average load of 57.9 (SD +/- 3.0) newtons to fail. Thus, it was significantly stronger than the modified Kessler technique with epitendon repair (P < 0.01). The tendons repaired with the Oklahoma and epitenon repair suture technique did not form a 2 mm gap prior to failure. The epitendon repair increased the resistance to gap formation by 80% to 100% and the repair failure by 17.5% to 25% for both types of repairs. We concluded that the addition of the epitendon repair increases the tensile strength of the repair regardless of the core suture technique, and it should be used. In comparison with the Modified Kessler repair technique, the Oklahoma repair technique has superior tolerance to gap initiation, 2 mm gap formation, and physical failure of the repaired tendon.
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Affiliation(s)
- H Seradge
- Orthopaedic & Reconstructive Center, 1044 SW 44th, 6th Floor, Oklahoma City, OK 73109, USA
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12
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Affiliation(s)
- E B Wu
- Cardiothoracic Centre and. Oesophageal Investigation Unit, Guy's and St Thomas' Hospital, London, UK
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13
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Lau T, Owen W, Yu YM, Noviski N, Lyons J, Zurakowski D, Tsay R, Ajami A, Young VR, Castillo L. Arginine, citrulline, and nitric oxide metabolism in end-stage renal disease patients. J Clin Invest 2000; 105:1217-25. [PMID: 10791996 PMCID: PMC315437 DOI: 10.1172/jci7199] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The kidneys are thought to be a major site of net de novo arginine synthesis, but the quantitative status of arginine metabolism and its substrate precursor relationship to nitric oxide (NO) synthesis in end stage renal disease (ESRD) patients have not been characterized. We have investigated kinetic aspects of whole body arginine metabolism in six patients with ESRD. They received two pre- and two post-hemodialysis intravenous tracer infusion studies with L-[guanidino-(15)N(2)]arginine and L-[(13)C]leucine during the first study, and L-[5-(13)C]arginine and L-[5-(13)C-ureido,5,5, (2)H(2)]citrulline during the second study. Arginine homeostasis in ESRD patients was found to be associated with a lower rate of arginine oxidation, and despite the decrease in renal function, the rate of de novo arginine synthesis appeared to be preserved. Plasma citrulline concentrations and flux were also elevated in these subjects compared with healthy adults. The rate of whole body NO synthesis was increased in the ESRD patients, but apparently not different pre- and post-hemodialysis therapy. The anatomic site(s) responsible for the maintenance of net de novo arginine synthesis and for the elevated NO synthesis and its pathophysiological importance in ESRD remain to be established.
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Affiliation(s)
- T Lau
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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14
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Bergström J, Lindholm B, Lacson E, Owen W, Lowrie EG, Glassock RJ, Ikizler TA, Wessels FJ, Moldawer LL, Wanner C, Zimmermann J. What are the causes and consequences of the chronic inflammatory state in chronic dialysis patients? Semin Dial 2000; 13:163-75. [PMID: 10833777 DOI: 10.1046/j.1525-139x.2000.00044.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- J Bergström
- Department of Clinical Science, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
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15
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Abstract
AIMS To evaluate capsaicin's effects on heartburn, dyspepsia, gastric acidity and emptying, and gastro-oesophageal reflux, and to test the hypothesis that capsaicin induces heartburn and exacerbates symptoms by sensitizing the oesophagus. METHODS Eleven heartburn sufferers underwent two separate pH monitoring sessions and assessments of gastric emptying (13C-octanoic acid breath test), heartburn and dyspepsia (100 mm VAS) after a non-irritant meal. The meal consisted of a sausage biscuit with egg, cheese and 30 g raw onion, 8 oz chocolate milk and a peppermint patty. Thirty minutes prior to meal consumption, subjects were administered a placebo capsule. On visit 1, subjects consumed the meal containing 100 microl 13C-octanoic acid cooked in the egg, over 15 min. On visit 2, subjects consumed the meal plus 5 mg capsaicin in gelatin capsules. RESULTS Oesophageal and gastric pH profiles and gastric emptying were not different between meals. Capsaicin did not alter mean heartburn and dyspepsia scores (P > 0.05), but significantly decreased time to peak heartburn (120 min vs. 247 min; P < 0.003). Time to peak dyspepsia was not altered by capsaicin (P > 0.05). CONCLUSION Capsaicin enhances noxious postprandial heartburn, presumably by direct effects on sensory neurons.
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Affiliation(s)
- S Rodriguez-Stanley
- The Oklahoma Foundation for Digestive Research, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
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16
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Abstract
There is extensive literature supporting an important role for acidosis in inducing net protein breakdown, both in experimental animals and humans. However, the clinical importance of the moderate intermittent metabolic acidosis frequently observed in hemodialysis patients has not been determined. We performed a cross-sectional analysis of the baseline laboratory data in the first 1,000 patients recruited to the Hemodialysis Study, looking for correlations between predialysis serum total carbon dioxide levels and parameters related to dietary intake and nutritional status. We found the mean predialysis serum total carbon dioxide level was moderately low (21.6 +/- 3.4 mmol/L; mean +/- SD) despite the use of bicarbonate dialysate and an average single-pool Kt/V of 1.54. Predialysis serum total carbon dioxide level correlated negatively with normalized protein catabolic rate (P < 0.001), suggesting patients with lower serum total carbon dioxide levels have a greater protein intake. The degree of acidosis observed in our patients does not seem to have a deleterious effect on the nutritional status of these patients because correlation of serum total carbon dioxide level with nutritional parameters, such as serum creatinine and serum albumin levels, was either negative or not statistically significant. Further investigation of the effect of modifying serum bicarbonate concentration on nutritional markers is needed to test these hypotheses.
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Affiliation(s)
- J Uribarri
- Beth Israel Medical Center, New York, NY, USA.
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17
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Abstract
Gastroesophageal reflux is frequently found in patients with chest pain despite normal coronary anatomy, but little data on the effect of specific medication exist. After performing 24 h ambulatory pH monitoring and the Bernstein test on 23 patients with normal coronary anatomy, we gave omeprazole, 40 mg nocte, for six weeks to these and to a control group of ten patients with coronary disease. Pain episodes per fortnight fell from 16.2 to 12.0 (P=0.02) in the patients with normal anatomy and from 19.6 to 17.1 (nonsignificant) in the patients with coronary disease. Improvement occurred in seven (30%) of the patients with normal coronary anatomy compared with one (10%) of those with coronary disease, while complete resolution occurred in four (17%) and none, respectively. Improvement or complete resolution were not predicted by the results of 24 h pH monitoring, although there was a trend towards the prediction of efficacy by the Bernstein test. Omeprazole shows promise as a treatment for patients with chest pain despite normal coronary anatomy and larger placebo-controlled trials should now be undertaken.
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Affiliation(s)
- J Chambers
- Department of Cardiology, Guy's Hospital, London, UK
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18
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Abstract
From 347 cases of documented cubital tunnel syndrome, 160 required cubital tunnel release and medial epicondylectomy over a 10-year period and were considered for this retrospective study. These patients were monitored for 3 years after surgery. According to the modified scale of McGowan, 86% of patients were considered stage II. Eighty-one percent of the patients were symptom free, and 96% of the patients improved by 1 Wilson and Krout grade following surgery. We considered return of symptoms 3 months or longer after surgery as recurrence; there were 21 recurrences. There was no correlation between recurrence and limb dominance, patient age at the time of surgery, or length of preoperative conservative treatment. Of the patients with recurrences, 44% were in their fourth decade of life. The rate of recurrence in females (18%) was almost twice that in males (10%). The rate of recurrence was increased twofold when the patient did not return to work within 3 months. When concomitant ipsilateral carpal tunnel was present (44%), the recurrence rate was 17% compared with 9% in those without carpal tunnel syndrome. The recurrence rate was 20% when ipsilateral thoracic outlet syndrome was present compared with 9% in patients without other ipsilateral maladies. Therefore, higher recurrence rates should be anticipated in female patients, in patients with concomitant ipsilateral thoracic outlet syndrome and/or carpal tunnel syndrome, in patients in their third or fourth decade of life, or in patients not returning to work within 3 months after surgery.
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Affiliation(s)
- H Seradge
- Department of Orthopaedics, The Hand Institute of Oklahoma, Orthopaedic & Reconstructive Center, Oklahoma City 73109, USA
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Adde M, Shad A, Venzon D, Arndt C, Gootenberg J, Neely J, Nieder M, Owen W, Seibel N, Wilson W, Horak ID, Magrath I. Additional chemotherapy agents improve treatment outcome for children and adults with advanced B-cell lymphomas. Semin Oncol 1998; 25:33-9; discussion 45-8. [PMID: 9578060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We report the updated results of an intensive treatment protocol for children (< 18 years) and adults (> or = 18 years) with advanced B-cell lymphomas. The protocol consists of two chemotherapy regimens: A, consisting of cyclophosphamide, doxorubicin, vincristine and high-dose methotrexate (CODOX-M), and B, consisting of ifosfamide, etoposide, and high-dose cytarabine (IVAC). Both cycles included intrathecal chemotherapy (cytarabine or methotrexate). Patients received a total of four cycles in the following sequence: A, B, A, B. Sixty-six previously untreated patients, enrolled before October 1996, were included in the present analysis. Of these, 55 had Burkitt's or Burkitt's-like lymphoma and 11 had diffuse large B-cell lymphoma. There were 53 males ad 13 females; 40 were children and 26 were adults (age range, 3 to 57 years). To date, 61 patients have achieved a complete response to therapy. Two patients subsequently relapsed, but one of these is a long-term survivor after further therapy and a bone marrow transplant. The event-free survival rate is 85% at I year and beyond. The median potential follow-up period is 48 months (range, 12 to 96 months) for patients remaining in complete remission. Neutropenia occurred in 98% of cycles and infection in 46% of A cycles and 50% of B cycles, but the duration was shortened in B cycles by the administration of granulocyte colony-stimulating factor. Positive blood cultures were observed in 21% of A cycles and 28% of B cycles, and there have been three toxic deaths. These results are better than those achieved with an earlier version of CODOX-M, suggesting that the addition of the IVAC regimen is responsible for the improved results. The similarity of the outcome in children and adults, however, confirms our previous observation that, at least in adults younger than 60 years with Burkitt's or Burkitt's-like lymphomas, treatment with regimens similar to those used in children is warranted.
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Affiliation(s)
- M Adde
- Division of Clinical Sciences, National Cancer Institute, Bethesda, MD 20892, USA
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20
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Abstract
OBJECTIVE The management of recurrent benign esophageal strictures is a difficult clinical problem, especially in patients who are not surgical candidates. We evaluated the role of uncovered metallic endoprostheses in four patients who had strictures that were resistant to repeated balloon dilatation. CONCLUSION Our preliminary experience indicates that uncovered metallic endoprostheses can be effective in treating a select group of patients who have benign esophageal strictures and for whom multiple dilatations have failed. It is also important to note that epithelial hyperplasia can result in stenoses and recurrent dysphagia.
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Affiliation(s)
- B S Tan
- Department of Radiology, United Medical School, Guy's Hospital, London, United Kingdom
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Cooke RA, Anggiansah A, Wang J, Chambers JB, Owen W. Hyperventilation and esophageal dysmotility in patients with noncardiac chest pain. Am J Gastroenterol 1996; 91:480-4. [PMID: 8633495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Hyperventilation is known to cause esophageal spasm, but the importance of this interaction in clinical practice is unknown. In the present study, we report the effects of hyperventilation provocation on esophageal motility in a consecutive series of patients with noncardiac chest pain. METHODS In a prospective observational study design, 46 consecutive patients with normal coronary angiograms were studied. Esophageal motility was recorded at rest and after voluntary over-breathing at 40 breaths/min for 3 min. RESULTS Hyperventilation was associated with a significant fall in mean distal peristaltic amplitude [66 (SD 28) to 55 (SD 24) mm Hg, p <0.001] and mean duration [2.9 (SD 0.7) to 2.6 (SD 0.9) s,p = 0.02]. It induced diffuse spasm in two (4%) patients, and nonspecific motility disorders in 10 (22%). Chest pain was reproduced in seven (15%) patients, but in none did this coincide with an important change in peristaltic amplitude, duration, or frequency. CONCLUSION Hyperventilation has important effects on esophageal motility, and manometrists should be aware of these before recommending that anxious patients overbreathe to help relaxation during clinical studies. Although overbreathing is a common source of dysmotility, it rarely produces chest pain via its effects on the esophagus.
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Affiliation(s)
- R A Cooke
- Department of Cardiology, Guy's and St. Thomas NHS Hospital Trust, London, United Kingdom
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22
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Hann N, Asghar A, Owen W, Asal N. Smoking: high hazards in high school. J Okla State Med Assoc 1995; 88:247-251. [PMID: 7629607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
BACKGROUND Young people in school are at an impressionable age, peer pressures are intense, and the probability that they will pick up a high-risk behavior, such as smoking, is high. The key to reduction of smoking among adults is to target our prevention efforts at young adults and teens. OBJECTIVE To study the prevalence and trend of smoking among young adults and teens and to formulate guidelines on smoking reduction to guide those who counsel young people. STUDY DESIGN The study design is cross sectional. METHODS This study is based on the data from the Oklahoma Behavioral Risk Factor Surveillance System and the National Youth Risk Behavioral Surveillance System - the two systems that monitor the prevalence of behaviors that most influence health. RESULTS The prevalence of smoking among young adults (age 18-24) in Oklahoma is high at more than 21%. The disturbing feature is that it is higher among young females than among young males. The prevalence of smoking among young adults is the highest among high school dropouts and is more than 38%. It is lower among high school graduates (about 28%) and lowest among college graduates (about 18%). The percentage of smoking among students who classify themselves as current smokers rises from 23% to 30% as the students progress from grade 9 to 12 and the percentage of frequent smokers increases from 8% to 16%. CONCLUSIONS Guidelines suggested for counselors are: 1. Along with smoking, look for comorbid behaviors such as alcohol use, drug abuse, and high-risk sexual behavior. 2. Ask whether the student has easy access to free cigarette samples. 3. Check whether the teen is trying to lose weight; suggest appropriate methods for losing weight if smoking is being used for losing weight. 4. Target health education efforts early in a student's school career starting in elementary school, but concentrate especially at the 8th or 9th grade level to have maximum preventive impact.
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Affiliation(s)
- N Hann
- Tobacco Use Prevention Office, Oklahoma State Department of Health, Oklahoma City 73117-1299, USA
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Highley MS, Hill ME, Ziras N, Samandas N, Mason RC, Owen W, Dussek J, Barker S, Harper PG. High-dose folinic acid with 5-fluorouracil bolus and continuous infusion in the treatment of advanced gastric and oesophageal adenocarcinoma. Br J Cancer 1993; 67:407-8. [PMID: 8431376 PMCID: PMC1968156 DOI: 10.1038/bjc.1993.75] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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Jacobson MA, Owen W, Campbell J, Brosgart C, Abrams DI. Tolerability of combined ganciclovir and didanosine for the treatment of cytomegalovirus disease associated with AIDS. Clin Infect Dis 1993; 16 Suppl 1:S69-73. [PMID: 8381032 DOI: 10.1093/clinids/16.supplement_1.s69] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Ganciclovir is one of only two drugs licensed by the U.S. Food and Drug Administration for the treatment of opportunistic cytomegalovirus (CMV) disease. The combination of ganciclovir and zidovudine has been reported to be poorly tolerated because of dose-limiting hematologic toxicity; thus we retrospectively examined the tolerability of combination therapy with ganciclovir and didanosine in 32 patients with AIDS. These patients were receiving ganciclovir for CMV disease in addition to didanosine in the Videx U.S. Expanded Access Program. During the period of combined therapy, dose-limiting hematologic toxicity (absolute neutrophil count, < 500 cells/microL) developed in only 9.4% of patients and severe anemia (hemoglobin level, < 8.0 g/dL) in only 12.5%. Rates of dose-limiting intolerance to didanosine were similar to those previously reported in the Expanded Access Program. Overall, 15 of 32 patients in the current study tolerated therapeutic doses of didanosine in combination with ganciclovir; in contrast, only 5 of 29 patients tolerated zidovudine (600 mg/d) in combination with ganciclovir in the largest trial of therapy with this combination whose results have been published to date (P = .02, Fisher's exact test). Since recent data suggest that the administration of some form of antiretroviral therapy prolongs survival in patients with CMV retinitis, coadministration of didanosine with ganciclovir should be considered for such patients who do not tolerate other regimens with activity against both retroviruses and CMV.
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Affiliation(s)
- M A Jacobson
- Department of Medicine, University of California, San Francisco
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25
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Owen W. After Hillsborough. Nurs Times 1990; 86:16-7. [PMID: 2359709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Smith BA, Soderblom LA, Banfield D, Barnet C, Basilevsky AT, Beebe RF, Bollinger K, Boyce JM, Brahic A, Briggs GA, Brown RH, Chyba C, Collins SA, Colvin T, Cook AF, Crisp D, Croft SK, Cruikshank D, Cuzzi JN, Danielson GE, Davies ME, De Jong E, Dones L, Godfrey D, Goguen J, Grenier I, Haemmerle VR, Hammel H, Hansen CJ, Helfenstein CP, Howell C, Hunt GE, Ingersoll AP, Johnson TV, Kargel J, Kirk R, Kuehn DI, Limaye S, Masursky H, McEwen A, Morrison D, Owen T, Owen W, Pollack JB, Porco CC, Rages K, Rogers P, Rudy D, Sagan C, Schwartz J, Shoemaker EM, Showalter M, Sicardy B, Simonelli D, Spencer J, Sromovsky LA, Stoker C, Strom RG, Suomi VE, Synott SP, Terrile RJ, Thomas P, Thompson WR, Verbiscer A, Veverka J. Voyager 2 at Neptune: Imaging Science Results. Science 1989; 246:1422-49. [PMID: 17755997 DOI: 10.1126/science.246.4936.1422] [Citation(s) in RCA: 106] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Voyager 2 images of Neptune reveal a windy planet characterized by bright clouds of methane ice suspended in an exceptionally clear atmosphere above a lower deck of hydrogen sulfide or ammonia ices. Neptune's atmosphere is dominated by a large anticyclonic storm system that has been named the Great Dark Spot (GDS). About the same size as Earth in extent, the GDS bears both many similarities and some differences to the Great Red Spot of Jupiter. Neptune's zonal wind profile is remarkably similar to that of Uranus. Neptune has three major rings at radii of 42,000, 53,000, and 63,000 kilometers. The outer ring contains three higher density arc-like segments that were apparently responsible for most of the ground-based occultation events observed during the current decade. Like the rings of Uranus, the Neptune rings are composed of very dark material; unlike that of Uranus, the Neptune system is very dusty. Six new regular satellites were found, with dark surfaces and radii ranging from 200 to 25 kilometers. All lie inside the orbit of Triton and the inner four are located within the ring system. Triton is seen to be a differentiated body, with a radius of 1350 kilometers and a density of 2.1 grams per cubic centimeter; it exhibits clear evidence of early episodes of surface melting. A now rigid crust of what is probably water ice is overlain with a brilliant coating of nitrogen frost, slightly darkened and reddened with organic polymer material. Streaks of organic polymer suggest seasonal winds strong enough to move particles of micrometer size or larger, once they become airborne. At least two active plumes were seen, carrying dark material 8 kilometers above the surface before being transported downstream by high level winds. The plumes may be driven by solar heating and the subsequent violent vaporization of subsurface nitrogen.
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Abstract
Breast cancer has 20 different histologic descriptions grouped into four categories, A, B, C, and D, based on prognosis. An analysis of 3,902 patients has revealed significant differences in outcome. Class A disease--for the most part in situ--was relatively benign, with a frequency distribution of 5%. Positive nodes were found in 1.6%, and five-year survival curves exceeded 91%. Class B (mucinous, medullary, etc) occurred in 4.1% of patients. Fewer advanced stages indicated less aggressive tumors, and survival at five years was 75%. The most common class, C (85%), had a five-year survival of 66%, closely related to stage. Class D tumors, 4.3% with ill defined, wildly infiltrative borders, and undifferentiation, were ominous with 33% demonstrating distant spread at first diagnosis. The five-year survival was only 46%. Epidemiologic findings revealed a high incidence of bilaterality and high family risk in some categories, but not in others. Mammography should be done in all class A lesions. A complete pretreatment metastatic survey is recommended for class D patients, as well as those with advanced stage II and III lesions. Indications for various surgical and adjuvant therapies are described.
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Henriksen R, Owen W, Nesheim M, Mann K. Investigation of the Catalytic Properties of the Dysthrombin, Thrombin Quick. Thromb Haemost 1979. [DOI: 10.1055/s-0038-1665671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Thrombin Quick (TQ) may be isolated following treatment of Prothrombin Quick [Owen, et al, Mayo Clinic Proceedings, 53: 29-33, (1978)] with Taipan venom, phospholipid and ca2+. The clotting activity of TQ with fibrinogen is 1/200 that of nornar thrombin (T). The activation of Factors V and VIII, and the aggregation of platelets by TQ occurs with an effectiveness of about 1/50 that of thrombin. when incubated with antithrombin III, both T ad TQ fom inhibitor complexes as determined by dodecylsulfate gel electropheresis. Titration of T and TQ with the fluorescent inhibitor dansylarginine-4-ethylpiperidine amide indicates an equivalent number of active sites based on protein absorption at 280 nm. However, the two enzymes may be distinquished by the decreased fluorescence enhancement observed with TQ relative to T, indicating an increased polarity in the inhibitor binding site of TQ. With the substrate benzoylarginine ethylester, TQ has a Km = 4.5 × 10-5M and kcat= 6.93 compared to Km = 4.0 × 10-5M and kcat= 17.7 for T. This indicates that the defect in TQ esterase activity is in the catalytic mechanism itself and not in substrate binding. The rate of inhibition of TQ by diisopropylphosphofluoridate is decreased. Decreased acylation and deacylation rates for TQ relative to T are observed for hydrolysis of the active site titrant 4-methykl-umbelliferyl-p-guanidinobenzoate
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Affiliation(s)
- R Henriksen
- Dept. of Path., Univ. of Iowa, Iowa City, IA, U.S.A
| | - W Owen
- Dept. of Path., Univ. of Iowa, Iowa City, IA, U.S.A
| | - M Nesheim
- Dept. of Med., Mayo clinic, Rochester, MN, U.S.A
| | - K Mann
- Dept. of Med., Mayo clinic, Rochester, MN, U.S.A
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Abstract
Variability in coronary arteriogram readings was studied by having cine films from ten patients read by eleven readers. Three of the eleven subsequently met as an expert panel to provide a joint evaluation which could serve as a standard. Considerable variability was found between individual readers and between readers and the panel. The average standard deviation for estimation of any segmental stenosis by any single reader was 18%. Disagreement about the number of major vessels with a 70% stenosis occurred 31% of the time. Discrepancies were most likely to occur in analyzing distal arterial segments, in reading nonopacified segments, and during analysis of films showing more severe disease or having poorer technical quality. Recent experience in reading arteriograms seemed to be the most important characteristic in determining the accuracy of a reader. A protocol for the use of three readers is suggested.
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Hoge AF, McGregor FH, Barney JA, Elkins RC, Asal N, Owen W, Anderson P. A workable approach towards breast cancer control. J Okla State Med Assoc 1976; 69:463-9. [PMID: 993879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Jackson B, Owen W, Boudreaux HB. Pharmacological and chemical characteristics of peanut extracts effective in hemostasis. Thromb Diath Haemorrh 1966; 16:257-264. [PMID: 5989045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Owen W. Pubna Charitable Dispensary. Cases from Hospital Practice. Ind Med Gaz 1886; 21:175-177. [PMID: 28999630 PMCID: PMC5001061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Owen W. Case from Hospital Practice. Ind Med Gaz 1882; 17:131. [PMID: 28998850 PMCID: PMC5151890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- W. Owen
- 2nd Medical Officer, Port Blair
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