Do breast cancer survivors increase their physical activity and enhance their health-related quality of life after attending community-based wellness workshops?

Many breast cancer survivors may be at increased risk for physical and psychological complications from cancer treatments. Research has shown that regular exercise can help ameliorate some of the lingering side effects of breast cancer treatments and improve health-related quality of life (HRQOL). Additionally, certain stress management techniques have helped increase HRQOL in breast cancer survivors. Few educational programs exist which address both the promotion of physical activity and use of mindfulness-based strategies to improve the health of breast cancer survivors. Community-based wellness workshops were designed to promote regular exercise and use of mindfulness-based techniques. There was an increase in physical activity and improvements on several HRQOL domains 1 month following the exercise workshops; although the results were not significant, they are encouraging.

Adenovirus chromatin structure at different stages of infection.

We investigated the structure of adenovirus deoxyribonucleic acid (DNA)-protein complexes in nuclei of infected cells by using micrococcal nuclease. Parental (infecting) DNA was digested into multimers which had a unit fragment size that was indistinguishable from the size of the nucleosomal repeat of cellular chromatin. This pattern was maintained in parenteral DNA throughout infection. Similar repeating units were detected in hamster cells that were nonpermissive for human adenovirus and in cells pretreated with n-butyrate. Late in infection, the pattern of digestion of viral DNA was determined by two different experimental approaches. Nuclear DNA was electrophoresed, blotted, and hybridized with labeled viral sequences; in this procedure all virus-specific DNA was detected. This technique revealed a diffuse protected band of viral DNA that was smaller than 160 base pairs, but no discrete multimers. All regions of the genome were represented in the protected DNA. To examine the nuclease protection of newly replicated viral DNA, infected cells were labeled with [3H]thymidine after blocking of cellular DNA synthesis but not viral DNA synthesis. With this procedure we identified a repeating unit which was distinctly different from the cellular nucleosomal repeat. We found broad bands with midpoints at 200, 400, and 600 base pairs, as well as the limit digest material revealed by blotting. High-resolution acrylamide gel electrophoresis revealed that the viral species comprised a series of closely spaced bands ranging in size from less than 30 to 250 base pairs.

Transmission of murine leukemia virus (Scripps) from parent to progeny mice: a comparison of assay systems.

Transmission of murine leukemia virus (MuLV) from parent to progeny C3H/St and C57BL/St mice was examined by four assay systems: 1) recovery of infectious NB-tropic MuLV from spleen cultures, 2) the radioimmunoassay for p30 antigenemia, 3) morphologic examination for lymphoma development, and 4) the indirect fluorescent antibody technique for antinuclear antibodies (ANA). Transmission of MuLV (Scripps) occurred in 90-100% of C3H/St and C57BL/St progeny nursed by mothers with p30 antigenemia. All assays except ANA were equally sensitive for the determination of MuLV transmission in C3H/St mice, but the incidence of transmission in C57BL/St mice was determined only by assays of their cultured spleens for MuLV. Incidences of ANA were increased in all generations of C57BL/St mice compared with controls; the route of transmission of MuLV (Scripps) was not a factor. Only C3H/St mice infected by virus transmitted from parent to progeny developed ANA. Infectious MuLV was invariably recovered from spleens cultured from mice with p30 antigenemia, which was present in all mice that developed lymphoma. NB-tropic MuLV was also recovered after prolonged cultivation from spleens of 75% of C57BL/St progeny mice that did not develop p30 antigenemia. These suggested that MuLV (Scripps) could exist either as a productive persistent or nonproductive latent infection in C57BL/St mice.

Transmission of murine leukemia virus (Scripps) from parent to progeny mice as determined by p30 antigenemia.

All mice of C57BL/St, C3H/St, BALB/cSt, NZB/Scr, and NZW/Lac strains developed high levels of p30 antigenemia after inoculation at birth with murine leukemia virus (Scripps). Transmission of virus from neonatally infected parents to their progeny for three successive generations, as evidenced by development of p30 antigenemia, varied among the five strains. Through the three generations, 100% transmission occurred in C3H/St and BALB/cSt mice, 50 to 61% transmission occurred in C57BL/St and NZW/Lac mice, and 11% transmission to the first generation, with no subsequent transmission, occurred in the NZB/Scr mice. Transmission appeared to occur readily via the milk in all strains. Intrauterine events also played a role with evidence of some viral transfer prior to birth in the C3H/St strain or, conversely, the development of resistance to infection prior to birth in C57BL/St mice. The occurrence of litters from infected parents containing both normal offspring and offspring with elevated p30 appeared to be the result of variable resistance in the intact offspring, perhaps as a result of intrauterine events, and not related to cellular resistance observable in tissue culture or to dominant genetic factors.

Congenital funnel-shaped tracheal stenosis: an asymptomatic lethal anomaly of early infancy.

Two infants with an unusual variant of congenital tracheal stenosis (funnel-shaped distal trachea) are described. Six other reports have appeared in the literature. This anomaly is asymptomatic from 1 to 3 months after birth, despite nearly complete tracheal obstruction. Staged surgical repair and/or definitive correction have been hampered by the size of the tracheal lumen, length of the deformity, and nondistensibility of the complete cartilaginous rings in the distal trachea.

Thoracoscopic evaluation of intrathoracic lesions in children.

In the last 3 years, we have used transthorascopic biopsy for the diagnosis of intrathoracic pulmonary lesions in 17 children ranging in age from 5 months to 17 years. The procedure is performed under a variety of anesthetic conditions ranging from local infiltrative to general endotracheal anesthesia. A fiberoptic rod lens system with cautery is utilized for direct observation and biopsy of intrathoracic pulmonary lesions. Biopsy specimens have been adequate for diagnosis in each child. Death and morbidity have not occurred. This technique is a safe, direct means under minimal anesthesia for the diagnosis of diffuse or localized intrathoracic disease in children.

Detection of human papillomavirus (HPV) using dot blot and Southern blot, hybridizing with a mixture of seven probes.

A previously presented method for the detection and typing of human papillomavirus (HPV) DNA has been modified for the simultaneous analysis of HPV types 6, 11, 16, 18, 31, 33 and 35. The method has two steps, where a dot blot test is used to exclude cases that do not hybridize with HPV-DNA. The remaining cases are then analysed by a Southern blot procedure, using a mixture of subgenomic probes for the simple and accurate analysis of HPV types. When the procedure was used for the analysis of clinical samples, patient groups at varying risk were found to differ with regard to the prevalence of HPV infections. Thus, the virus was detected in only 8.8% of otherwise healthy young women - i.e. women without clinical signs of HPV-related disease - as compared to 48% of women who also had cervical intraepithelial neoplasia (CIN). A similarly high prevalence was found in patients in whom CIN persisted (42%) as compared to those in whom the morphological lesion regressed to normal (8%).

Inguinal hernias in premature infants operated on before discharge from the neonatal intensive care unit.

Sixteen premature infants were operated on during the two-year period from 1981 through 1982 for inguinal hernia prior to discharge from the hospital. There were no complications from the hernias before surgery and during administration of anesthesia and postoperative recovery, and no recurrences, would infections, or testicular atrophy was noted in long-term follow-up. In contrast to a controlled group of 11 full-term patients of this same age who were operated on as outpatients, the operating room time, operation time, and time in the recovery room were significantly increased for the premature infants. This resulted in a 22% increase in cost for the correction of the premature inguinal hernias. Analysis of the factors in repair of these hernias indicates that this increased cost will have to be accepted as part of the care of premature infants in neonatal intensive care units.

Prevention of postoperative peritoneal adhesions: efficacy of povidone.

The appearance and severity of peritoneal adhesions after simple laparotomy and after adhesiolysis were studied in a rabbit model. Adhesions were induced by direct abrasion with latex glove and dry gauze; control rabbits had abrasion only. Study groups had abrasion and treatment with 10% or 25% povidone. Results showed a significant reduction in the number of adhesions and in the severity of adhesions after treatment with povidone. This study supports the further investigation of the efficacy of povidone in preventing postoperative peritoneal adhesions.

Arterial injuries in children.

Twenty-nine children sustained major arterial injuries secondary to gunshot wounds (nine), blunt injuries (11), penetrating injuries by sharp objects (five), and arteriographic injury (four). The femoral artery was most commonly injured, followed by the brachial, the carotid, subclavian, popliteal, aorta, innominate, and vertebral arteries. We repaired the majority of the arterial injuries by resecting the damaged vessel, with primary anastomosis or interposition grafting when necessary to avoid tension. Postoperative complications included clotted grafts in two patients, which were rendered patent by reoperation. Two children died postoperatively, although both had successful vascular repairs. All vascular repairs were patent at one year, and limb length disparity has occurred in one patient following a nerve injury. Our data indicate that early exploration and repair of all suspected vascular injuries can be accomplished with excellent results, even in young children.

Gruentzig balloon catheter dilation for acquired bronchial stenosis in an infant.

A long stricture of the left main bronchus, which was resistant to the traditional methods of treatment, developed in a 992-gm twin who was ventilated for 114 days. The patient had two bronchial dilations with the Gruentzig balloon catheter placed under fluoroscopic control and inflated to 6 atm of pressure. The treatment was well tolerated by the patient, and one year after the Gruentzig balloon dilation she had a normal chest roentgenogram. Gruentzig balloon catheter dilation is a new technique for repairing bronchial stenosis in infancy without major intrathoracic surgical intervention.

Gastrointestinal perforation in infants.

We found that the mortality rate was no greater in patients with necrotizing enterocolitis complicated by perforation compared with the rate in those with other causes of perforation in similar weight classes. Iatrogenic injuries had a 50 percent mortality rate in all gestational age and birth weight categories and, therefore, great caution and surveillance are of utmost importance when using invasive monitoring and therapeutic modalities to prevent this cause of perforation. Term infants had a preponderance of mechanical causes of perforation which mainly occurred in the foregut and proximal midgut, whereas premature infants have a preponderance of asphyxial or ischemic events underlying perforations which mainly occurred in the ileocolic region and were often associated with necrotizing enterocolitis. Although neonatal intestinal perforation is a catastrophic event, the very premature infant weighing less than 1,000 g at birth is at significantly greatest risk. The discouraging 20 percent survival rate in the less than 1,000 g premature infants presents a challenge to the surgeon, since the overall survival rate was 59 percent and the term infants had a 78 percent survival rate. A substantial share of the mortality in the infants weighing less than 1,000 g at birth relates to the occurrence of intracerebral hemorrhage and bronchopulmonary dysplasia. Vigorous medical and surgical approaches can be used to salvage premature infants in all weight classes with gastrointestinal perforation.

Rectal prolapse in infants and children.

Rectal prolapse that is intractable to the usual medical therapy was successfully managed without significant complications in 10 patients by simple subcutaneous encirclement of the anus with a heavy nonabsorbable suture, which was in place until the suture was removed or broke after 4 to 6 months. Four patients required two sutures and one needed a third insertion. Since this procedure is simple, has no serious complications, and controls rectal prolapse, it is recommended as the preferred initial surgical treatment of this condition.

Tracheostomy in children without heart disease.

A series of 27 patients less than 15 years of age who had tracheostomies from 1968--1975 showed that only two of these patients had cardiac disease as the primary lesion. Only three pneumothoraces could be definitely attributed to the tracheostomy, while sepsis in two patients and pneumonia in one patient might possibly have been related to the tracheostomy itself. One death was due to the performance of the tracheostomy. In patients who have tracheostomy for noncardiac conditions, performance of the tracheostomy in the operating room with an endotracheal tube in place, the use of plastic or silastic body contour conforming tubes, and proper intensive care nursing immediately after tracheostomy have reduced complications to a minimum and made the performance of tracheostomy in this age group a safe and effective procedure when oro- or nasotracheal intubation is inadequate.

Early repair of diaphragmatic hernia to correct associated anomalies.

The case of a seven-month-old infant is reported who had an eventration of the left hemidiaphragm associated with two bronchopulmonary foregut anomalies, duplication of the esophagus, and intralobar sequestration of the left upper lobe. The literature indicates that eventration of the diaphragm is associated with pulmonary sequestration in up to 50% of patients. Since the eventration itself obscures roentgenographic evidence of other foregut anomalies, the concomitant diagnosis and treatment of possible foregut anomalies is another justification for surgical repair of eventration of the diaphragm.

Total anomalous pulmonary venous return: report of a case diagnosed on ECMO.

After repeated echocardiographic assessment and cardiology consultation, a 2,750-g, 36 weeks' gestation neonate with esophageal atresia, tracheo-esophageal fistula, and pneumonia thought to be complicated by persistent pulmonary hypertension was placed on extracorporeal membrane oxygenation (ECMO). While on ECMO, pre-oxygenator and umbilical artery blood gas patterns suggested the diagnosis of total anomalous pulmonary venous return which was subsequently confirmed by cardiac catheterization.

Diagnosis of a Morgagni hernia complicated by a previous normal chest x-ray.

A normal chest x-ray in a child does not mean that a Morgagni hernia cannot develop in that patient. The case of a patient whose treatment was complicated by confusion of the herniation of fatty omentum with a primary mediastinal mass is presented here. The difficulty in diagnosing this case is illustrated by this patient report.

Suprapubic dermoid sinus.

Two newborns with suprapubic sinuses ending in relationship to the urachus at the umbilicus are reported. Other recent reports indicate that these sinuses are not so uncommon and are due to abnormalities of urachal development in conjunction with a suprapubic dermoid sinus.

Transtracheal drainage of lung abscesses in children.

Experience with three patients with primary lung abscesses indicates that transtracheal catheter drainage of lung abscesses is a safe and beneficial procedure in childhood. The ability to drain abscesses not easily reached percutaneously will promote emptying and collapse of the abscess and provide bacteriological information which will enable the physician to select the correct antibiotics.

The concomitant presence of gastroschisis and prune belly syndrome in a twin.

This is a report of a case of gastroschisis and prune belly syndrome in a black male infant, the second born of dizygotic twins. This infant died of sepsis secondary to peritonitis that developed from a leaking gastrostomy site.