A preclinical model to assess the antigenicity of an HLA-A2 melanoma cell vaccine

BACKGROUND: The authors have demonstrated that immunization with melanoma whole-cell vaccine (MCV) augments T-cell responses to melanoma and that cytotoxic T-cells (CTL) recognize allogeneic melanoma-bearing shared HLA-A antigens. A preclinical model was developed to assess CTL activation in vitro using melanoma lines as stimulators. HLA-A2 expression is predominant in melanoma patients and plays a role in HLA class I restricted CTL killing of melanomas. The authors hypothesized that a MCV consisting of allogeneic HLA-A2 melanomas may be as good as autologous melanoma MCV for HLA-A2 patients. METHODS: CTL were generated from peripheral blood lymphocytes of patients with HLA-A2 melanoma by stimulation with autologous melanoma, allogeneic melanoma (HLA-A2 or non-HLA-A2), or allogeneic MCV (mixed HLA-A2 and non-HLA-A2 melanomas). RESULTS: HLA-A2 MCV and autologous melanoma were similar and significantly better stimulators than the others. Specificity also was supported by CTL killing and mixed lymphocyte tumor reaction assays. CONCLUSIONS: These studies provide important information for the studying immunization of patients with HLA-A2 melanoma with an allogeneic HLA-A2 MCV in a Phase I clinical trial.     

The effectiveness of topical diclofenac for lateral epicondylitis

Clinical evidence for a dominant mode of inheritance and anticipation in periodic catatonia, a distinct subtype of schizophrenia, suggests that trinucleotide repeat expansions may be involved in the aetiology of this disorder. Since genes with triplet repeats are putative canditates for causing schizophrenia, we have analysed the polymorphic B33 CTG repeat locus on chromosome 3 in 45 patients with periodic catatonia and 43 control subjects. The B33 CTG repeat locus was highly polymorphic, but all alleles in both the patient and control groups had repeat lengths within the normal range. We conclude that susceptibility to periodic catatonia is not influenced by variation at the B33 CTG repeat locus. Nevertheless, that periodic catatonia displays dominant inheritance and anticipation, characteristic of genetic disorders involving trinucleotide repeats, justifies further screening for triplet repeat expansions in this illness.     

A new model to assess staphylococcal adhesion to intraocular lenses under in vitro flow conditions

Adhesion of staphylococcal cells to intraocular lenses coated with heparin was studied under in vitro flow conditions (280 microl min(-1)) at 37 degrees C. The intraocular lenses were incubated with human cerebrospinal fluid for 1 h or with cerebrospinal fluid including 0.50% plasma for 12 h, prior to bacterial challenge. Two strains of Staphylococcus epidermidis selected for this study, were isolated from biomaterial-associated infections. Bacterial adhesion was quantitated by bioluminescence and visualized by fluorescence microscopy of acridine orange stained bacteria. Surface coating with heparin significantly decreased bacterial adhesion of both strains after incubation with cerebrospinal fluid including 0.50% plasma for 12 h (p = 0.0209). However, no difference in bacterial adhesion was obtained between intraocular lenses with and without heparin, after incubation with cerebrospinal fluid for 1 h (p = 0.327). Microscopy showed that more bacteria were present on intraocular lenses without heparin than on intraocular lenses with heparin. The results show that preincubation with a proteinaceous fluid influences subsequent bacterial adhesion to the polymer surface. The results suggest that IOLs with heparin coating may be less prone to bacterial adhesion under perfusion conditions after surface conditioning in human CSF with 0.50% plasma and a preincubation period of 12 h. Heparin coating might be a valuable tool to decrease implant-associated bacterial endophthalmitis.     

Description of integrated competency examination: tools to assess the chiropractic curriculum effectiveness and students' competency levels

Los Angeles College of Chiropractic (LACC) has developed a variety of methods to monitor the effectiveness of its competency based/problem-centered curriculum. The College introduced two Integrative Competency Examination courses (ICE I and ICE II) to assess the chiropractic program's effectiveness and students' competency levels. The ICE courses are pass/fail examinations that use a multistation, objective structured clinical examination (OSCE) format that involves standardized patients along with cognitive assessment of basic science information as methods of evaluation. ICE I requires students to perform psychomotor skills and interpret clinical data; ICE II requires students to perform at a higher level. They are directed to select, perform and interpret clinical data appropriately and correlate this data with relevant basic science information. Through these two levels of evaluation, the educational program, the individual courses and the competency level of each student are assessed. This paper describes the format, content and evaluation tools used in the ICE courses as well as the potential benefits of the courses.     

Use of a two-compartment model to assess the pharmacokinetics of human ethanol metabolism

The relationship between blood ethanol concentration and hepatic ethanol metabolism commonly is calculated using the Michaelis-Menten equation and a one-compartment model that assumes equality of blood and hepatic ethanol concentrations. However, at low blood concentrations, most of the ethanol arriving at the liver is metabolized, and hepatic ethanol concentrations may fall far below that of the entering blood. We have developed a two-compartment model of ethanol metabolism that accounts for the fall in ethanol concentration that may occur as blood traverses the liver and used this model to make predictions concerning ethanol metabolism at various blood ethanol concentrations. The two-compartment model predicts that near-complete saturation will occur more abruptly and at a lower blood concentration (approximately 3 mM) than is the case with the one-compartment model. Thus, the two-compartment model predicts a near-constant ethanol elimination rate for blood ethanol concentrations above 3 mM (as commonly observed in human subjects), whereas the one-compartment model predicts an increasing elimination rate over the range of concentrations observed in experimental studies. In agreement with observed data, the two-compartment model predicts that first-pass metabolism should be extremely sensitive to the rate of ethanol absorption. Application of this model to previously published data indicated that, when absorption was slowed via concomitant food ingestion, first-pass metabolism accounts for approximately 50% and 10% of ethanol dosages of 0.15 g/kg and 0.3 g/kg, respectively. When ingested without food, there is negligible first-pass metabolism of even very small ethanol dosages (0.15 g/kg). These findings suggest that first-pass metabolism is an unimportant determinant of the blood ethanol response to ingestion of potentially inebriating doses of ethanol.     

A special fluorescent in situ hybridization technique to study peripheral blood and assess the effectiveness of interferon therapy in chronic myeloid leukemia

Using a highly sensitive fluorescence in situ hybridization method with probes for BCR and ABL1 (D-FISH), we studied 37 paired sets of bone marrow and blood specimens, collected within 24 to 96 hours of each other, from 10 patients before and during treatment for chronic myeloid leukemia (CML). The normal range for 500 interphase nuclei was 相似文献   

A training model to facilitate professional effectiveness in power- and sex-salient situations.

Designed a brief, experiential training model to help 36 professional psychology students examine both internal and external constraints to flexible use of power and to increase their effectiveness in power- and sex-salient situations. Ss' evaluations indicate that this model, which was offered as an elective course in a professional training setting, was successful in achieving its goals. The rationale for this model and the steps in its design are described. The model may be considered as a supplement to the socialization process of any professional training program. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A contingency model of conflict and team effectiveness.

The authors develop and test theoretical extensions of the relationships of task conflict, relationship conflict, and 2 dimensions of team effectiveness (performance and team-member satisfaction) among 2 samples of work teams in Taiwan and Indonesia. Findings show that relationship conflict moderates the task conflict–team performance relationship. Specifically, the relationship is curvilinear in the shape of an inverted U when relationship conflict is low, but the relationship is linear and negative when relationship conflict is high. The results for team-member satisfaction are more equivocal, but the findings provide some evidence that relationship conflict exacerbates the negative relationship between task conflict and team-member satisfaction. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A 'black cornea' secondary to topical epinephrine

We report a case of 'black cornea" secondary to topical epinephrine therapy and present the biochemical analysis of the lesion. The formed pigment is a melanin and not the intermediate substance, adrenochrome, as has been previously reported. The pathogenesis of melanin deposition is reviewed and a hypothesis of epinephrine-melanin binding is suggested.     

The effectiveness of topical anesthesia and vibration in alleviating the pain of oral injections

Low cardiac output was corrected by catecholamines in the course of hemofiltration (HF) administered to 37 patients with multiple organ failure after surgery. Catecholamines (adrenaline hydrochloride, noradrenaline hydrotartrate, dopamine hydrochloride, and dobutamine hydrochloride) were used as monotherapy or in various combinations (two, three, or four drugs). Ninety percent of patients with low cardiac output subjected to HF were administered combined catecholamine therapy. Catecholamines provided the hemodynamic stability of HF in patients with low cardiac output. The frequency of noradrenaline administrations and its mean doses were reliably decreased in the course of HF, whereas the mean doses of adrenaline, dopamine, and dobutamine remained virtually the same.     

Use of exercise myocardial perfusion imaging to guide and assess the effectiveness of medical therapy in coronary artery vasospasm

A computed tomography (CT) scan of the head is often routine for patients with new-onset psychosis to rule out somatic causes. Charts of 127 such patients admitted to a major military medical center were examined. Most patients were young and otherwise in good health. Relationships were examined between CT scan findings and demographic variables, seizure history, neurological abnormalities, and discharge diagnosis. None of the 127 patients had an abnormal scan; four had incidental findings. Incidental findings were strongly associated with ethnic minority status but not with neurologic abnormalities, seizure history, or diagnosis. Findings suggest that routine CT scans for all newly psychotic military patients may not be warranted.     

A model to assess the efficacy of moisturizers--the quantification of soap-induced xerosis by image analysis of adhesive-coated discs (D-Squames)

The purposes of this investigation were to examine the effects of unilateral concentric-only leg extension dynamic constant external resistance (DCER) training on: (a) concentric DCER strength in the trained and contralateral (untrained) legs, (b) concentric isokinetic peak torque-velocity curves in the trained and contralateral legs, and (c) retention of concentric DCER strength and concentric isokinetic peak torque in the trained and contralateral legs following detraining. Sixteen adult male (mean age +/- SD = 24.0 +/- 4.0 yr) volunteers comprised training (TR, n = 8) and control (CTL, n = 8) groups. The TR group trained the nondominant limb with concentric-only leg extension DCER exercise (3-5 sets of 6 repetitions at 80% of one-repetition maximum load) for eight weeks followed by eight additional weeks of detraining. The CTL group did not train. All subjects were tested pretraining, posttraining and detraining for unilateral concentric-only leg extension DCER strength as well as concentric isokinetic peak torque at 1.05, 2.09, 3.14, 4.19, and 5.24 rad.s-1 in both legs. Mixed factorial ANOVAs, follow-up, and post-hoc analyses indicated that the training resulted in increased DCER strength in both the trained (42%) and contralateral (15%) legs as well as isokinetic peak torque in the trained leg (7-19%) at velocities ranging from 1.05 to 5.24 rad.s-1. There was no cross-training effect, however, for isokinetic peak torque. Furthermore, the training-induced increases in DCER strength and isokinetic peak torque were retained across eight weeks of detraining.     

A practical guide to topical therapy in children

OBJECTIVE: To determine the duration of time to the recurrence of pain attributable to endometriosis after the discontinuation of treatment with danazol or a GnRH agonist (GnRH-a) in patients who have had a satisfactory response to the treatment. DESIGN: Retrospective study. SETTING: Nine academic medical centers in three countries. PATIENT(S): Three hundred twenty-seven women with diagnosed and staged endometriosis who were treated with at least 6 months of danazol or a GnRH-a and who experienced significant pain relief with therapy. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Duration of pain relief after completion of treatment as determined by a patient-initiated report of pain recurrence or increase in pain severity requiring intervention. RESULT(S): The median time to the recurrence of pain was 6.1 months for patients treated with danazol and 5.2 months for patients treated with a GnRH-a. CONCLUSION(S): Although there was a lack of uniformity in treatment effects across sites, the analyses have taken into account major covariant effects. The time to the recurrence of endometriosis-associated pain after danazol treatment was slightly longer than that after GnRH-a treatment.     

A matrix of kappa-type coefficients to assess the reliability of nominal scales

To investigate the reliability of nominal scales, Kraemer proposed a measurement model from which kappa coefficients could be derived. More recently she suggested a matrix of coefficients as a comprehensive summary of reliability, contrasting this with use of a single summary kappa statistic. The main diagonal of the matrix consists of binary kappa coefficients for each category which measure the reliability of each category relative to all others, while the off-diagonal elements are correlation coefficients for pairs of categories. The off-diagonal elements were suggested as measures of confusion between categories. Schouten also suggested coefficients to assess confusion between pairs of categories, which might be used as alternative off-diagonal elements in a summary matrix. The two types of off-diagonal element will be compared. It will be shown that Schouten's coefficients can be expressed in terms of the parameters of Kraemer's measurement model and that they are more easily interpreted as measures of confusion. First, the maximum value for Schouten's coefficient is one. Secondly, for any pair of categories, Schouten's coefficient equals the proportionate reduction in the probability of classifying a subject in one category of the pair having previously classified them in the other. Thirdly, where the coefficient for a pair of categories is less than the summary kappa statistic, it will be shown that combining these two categories will increase the value of the summary kappa statistic. The methods of analysis are applied to data from a study of the reliability of psychiatric diagnosis and used to identify pairs of classifications between which there is substantial confusion.     

A meta-analytic investigation of Fiedler's contingency model of leadership effectiveness.

Applied meta-analytic techniques to research testing the statistical validity of F. E. Fiedler's (see record 1966-13161-001) contingency model of leadership effectiveness. Past validations of the model, as well as criticisms of those validations, are reviewed and discussed. A meta-analytic solution is presented as a more satisfactory way to assess the validation evidence quantitatively. This approach was used to examine 145 hypothesis tests validating Fiedler's model, as well as the 33 results on which the model is based. The model was extremely robust in predicting group performance, and through the use of meta-analytic techniques it was found that the inclusion of studies not directly examined in earlier reviews served to increase the model's predictive power. (70 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effectiveness of ovarian cancer screening. A decision analysis model

OBJECTIVE: To estimate the effectiveness of ovarian cancer screening with CA 125 and transvaginal sonography. DESIGN: Decision analysis was used to examine the no-screen compared with the screen strategy. SETTING: Estimates of cancer incidence, survival, and life expectancy were derived from population-based data and clinical series. SUBJECTS: A cohort of 40-year-old women of all races and residing in the United States. INTERVENTIONS: A one-time screening intervention. The criterion standard for diagnosis of ovarian cancer was evaluation with exploratory laparotomy. MAIN OUTCOME MEASURE: Average years of life expectancy gained by women in the screened group. RESULTS: Screening for ovarian cancer with a combination of CA 125 and transvaginal sonography increases the average life expectancy in the population by less than 1 day. CONCLUSIONS: Given the limited effect on overall life expectancy, it is unlikely that mass screening for ovarian cancer with CA 125 and transvaginal sonography would be an effective health policy.     

A situational approach to leadership effectiveness.

F. E. Fiedler's contingency model suggests that task-oriented leaders are more effective where the leadership situation is either very favorable or very unfavorable and that relations-oriented leaders are more effective in situations of intermediate favorability. This model was tested among supervisors in both interacting (N = 54) and coacting (N = 48) groups in 2 organizations. Results in the hypothesized direction were attained although they were not generally significant. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multilevel model of minority opinion expression and team decision-making effectiveness.

The consideration of minority opinions when making team decisions is an important factor that contributes to team effectiveness. A multilevel model of minority opinion influence in decision-making teams is developed to address the conditions that relate to adequate consideration of minority opinions. Using a sample of 57 teams working on a simulated airport security-screening task, we demonstrate that team learning goal orientation influences the confidence of minority opinion holders and team discussion. Team discussion, in turn, relates to minority influence, greater decision quality, and team satisfaction. Implications for managing decision-making teams in organizations are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective study to assess the effect of ambulatory teaching on patient satisfaction

PURPOSE: To assess the effect of ambulatory teaching on patients' satisfaction. METHOD: In 1996, 103 adult patients presenting to the Walter Reed General Medicine Walk-in Clinic completed a patient-satisfaction questionnaire immediately following their visits, during which they were initially seen by a trainee (third-year medical student or intern) and then seen by a faculty preceptor. The questionnaire included five items from the validated Medical Outcomes Study (MOS)-9 questionnaire as well as two open-ended questions. Fourteen staff physicians, 13 students (49% of the visits), and 11 interns (51% of the visits) participated in the study. Satisfaction was analyzed by level of training, and the responses from the study patients were compared with the responses from 372 usual-care (i.e., non-teaching) patients from the same clinic, using the chi-squared test. RESULTS: The study patients were typically pleased with their encounters, rating their overall satisfaction as excellent (61%), very good (29%), or good (9%). Nearly two thirds of the patients rated their satisfaction with waiting time to be very good or excellent. Compared with the usual-care patients, the study patients reported equal or greater satisfaction for all five MOS-9 items. Ninety-five percent of the study patients said they would be willing to be seen by a trainee-staff team on future visits. There was no difference in patient satisfaction by trainee level. The study patients cited enhanced interaction (45%), enhanced education (34%), and improved care (26%) as benefits of trainee-involved care, and increased waiting time (18%) and worse care (5%) as drawbacks. CONCLUSION: The results of this study suggest that ambulatory teaching does not adversely affect patient satisfaction, regardless of trainee level, and that patients who have been seen by trainee-staff teams are willing to experience such encounters again.