The effects of lifestyle and type a behavior on the life-stress process

To evaluate the effects of personal factors such as lifestyle and Thpe A behavior on the life-stress process, we analyzed data randomly collected from 428 metropolitan Tokyo residents. Path analysis techniques were implemented to examine the direct and indirect effects of lifestyle and the Type A behavior pattern between life events, subjective stress and depressive symptoms. The following results were obtained: 1. Persons with a healthy lifestyle perceived a lower subjective stress level. 2. Although females with a healthy lifestyle had fewer direct depressive symptoms, males with a healthy lifestyle had fewer indirect depressive symptoms due to alleviation of subjective stress. 3. Type A males perceived a lower subjective stress level and Type A females experienced more life events. It is suggested that mental health is modified not only by lifestyle but also by Type A behavior in the life-stress process. In particular, the preservation and promotion of a healthy lifestyle appear to reduce subjective stress and may be an important factor for the improvement of mental ill health.     

Flow cytometric analysis of the DNA content of thymomas

In this study, the prognostic value of determining the nuclear DNA content of thymomas by flow cytometry was evaluated. Of a total 31 resected thymomas, 10 (32%) showed DNA aneuploidy, the presence of which was significantly correlated with an advanced clinical stage of disease. The patients with an aneuploid tumor had a poorer prognosis than those with a diploid tumor, demonstrating a survival rate of 50% at 7 postoperative years, which was considerably less favorable than that of the patients with a diploid tumor, being 100% in the same period (p<0.05). Moreover, patients with a high DNA index (DI), i.e., a DI1.5, tended to have a poorer prognosis than those with a low DI. These findings indicated that the DNA content can be an important prognostic index in patients with thymomas.     

A STUDY OF POSTDIAGNOSIS BREAST CANCER CONCERNS FOR WOMEN LIVING IN RURAL AND REMOTE QUEENSLAND. PART I: PERSONAL CONCERNS

The findings presented in this paper are part of a research project designed to provide a preliminary indication of the support needs of postdiagnosis women with breast cancer in remote and isolated areas in Queensland. This discussion will present data that focuses on the women's expressed personal concerns. For participants in this research a diagnosis of breast cancer involves a confrontation with their own mortality and the possibility of a reduced life span. This is a definite life crisis, creating shock and needing considerable adjustment. Along with these generic issues the participants also articulated significant issues in relation to their experience as women in a rural setting. These concerns centred around worries about how their partner and families cope during their absences for treatment, the additional burden on the family of having to cope with running the property or farm during the participant's absence or illness, added financial strain brought about by the cost of travel for treatment, maintenance of properties during absences, and problems created by time off from properties or self-employment. These findings accord with other reports of health and welfare services for rural Australian and the generic literature on psycho-oncology studies of breast cancer.     

Coping in thebarrio: Case studies of Mexican-American families

This paper reports preliminary findings of a study of coping abilities of Mexican-American families. The purpose of the study was to identify variables related to styles of behavior that can be characterized as adaptive. A complex of factors differentiated families who were judged to be dealing effectively with their environment (copers) from those who were not (noncopers). The factors included the health status of the children, various child-rearing attitudes and practices, and patterns of decision making as they related to a more general ability of parents to conceptualize and organize time.The authors wish to thank Bernard R. Cavazos and Maria Rosario de los Santos for their help in data collection and interpretation.     

A method for increasing confidence in respiratory gas exchange measurements in mechanically ventilated patients.

Measurement of O2 uptake (VO2) and CO2 output (VCO2) with automated instruments can be used to optimize nutritional management of critically ill patients. However, these measurements may be made infrequently because of calibration problems or suspected inaccuracies, especially when the patient is given supplemental oxygen. A simple method is described for periodic testing of automated gas exchange measurements. While a test lung is mechanically ventilated an accurately known mixture of CO2 and nitrogen is introduced into the inspired gas, simulating VO2 by dilution and VCO2 by addition of CO2. The ratio of VCO2:VO2 (respiratory gas exchange ratio, R) in the "expired gas" should be [FGCO2/(1-FGCO2)] x [(1-FIO2)/FIO2], where FGCO2 is the fraction of CO2 in the diluting gas and FIO2 is the fraction of O2 in the inspired gas. R is independent of the flow rate of the diluting gas or the rate of ventilation of the test lung. Using a mixing chamber-mass spectrometer, we found that R calculated from measurement of CO2 and O2 concentrations in the simulated mixed expired gas closely matched the predicted R for FIO2 = 0.21-0.50. On the other hand, when an automated gas exchange measurement device was tested, R was sometimes excessively high, especially for FIO2 greater than 0.35. This method, using a single diluting gas and without precision flowmeters, may be useful for periodic testing of respiratory gas exchange instruments in the intensive care unit. If a discrepancy is found between measured and predicted R, measurements should not be relied upon until further calibration or repairs can be effected.     

The cholinergic deficit coincides with Abeta deposition at the earliest histopathologic stages of Alzheimer disease

Effective therapeutic intervention in Alzheimer disease (AD) will be most effective if it is directed at early events in the pathogenic sequence. The cholinergic deficit may be such an early event. In the present study, the brains of 26 subjects who had no history of cognitive loss and who were in early histopathologic stages of AD (average Braak stage less than II) were examined at autopsy to determine whether a cortical cholinergic decrement was associated with Abeta concentration or deposition. In the superior frontal and inferior temporal gyri, the choline acetyltransferase (ChAT) activity of plaque-containing cases was significantly decreased (p < 0.05, unpaired, two-tailed t-tests), measuring 70.9% and 79.5%, respectively, relative to plaque-free cases. In the inferior temporal gyrus, Spearman's rank correlation analysis showed that ChAT activity had a significant inverse correlation with Abeta concentration (p = 0.075; r = -0.3552). The results indicate that the cholinergic deficit is established at an early histopathologic stage of AD, before the onset of clinical symptoms.     

Angiographic Embolization for Intraperitoneal and Retroperitoneal Injuries

Angiographic embolization (AE) has been used extensively for bleeding control after injuries to the face and neck. Its role in abdominal trauma requires further exploration. We reviewed the medical records of 137 consecutive patients who underwent angiography with the intent to embolize bleeding sites within the abdomen. Of them, 97 (71%) had blunt and 40 (29%) had penetrating trauma. AE was performed for hemorrhage associated with pelvic fractures (97 patients), liver lacerations (n= 26), renal lacerations (n= 12), splenic lacerations (n= 5), other injuries (n= 9), and multiple injuries (n= 12). On angiography, 102 patients were found to have bleeding sites and underwent AE, with angiographic and clinical bleeding control in 93 (91%). The rate of successful hemostasis by AE was identical in blunt and penetrating trauma patients. There was no major morbidity after AE. No factors predicted patients with a high likelihood to have a positive angiogram. Patients who had AE before or after a period of attempted hemodynamic stabilization in the intensive care unit were no different with respect to hemodynamic parameters immediately before AE or effectiveness of AE for bleeding control. AE is a safe and effective method for controlling bleeding after blunt and penetrating intra- and retroperitoneal injuries. Early AE may be used in selected patients as a front-line therapeutic intervention that offers expeditious hemostasis and prevents delays in definitive bleeding control.