Abnormal development of peripheral lymphoid organs in mice deficient in lymphotoxin.

Mice rendered deficient in lymphotoxin (LT) by gene targeting in embryonic stem cells have no morphologically detectable lymph nodes or Peyer's patches, although development of the thymus appears normal. Within the white pulp of the spleen, there is failure of normal segregation of B and T cells. Spleen and peripheral blood contain CD4+CD8- and CD4-CD8+ T cells in a normal ratio, and both T cells subsets have an apparently normal lytic function. Lymphocytes positive for immunoglobulin M are present in increased numbers in both the spleen and peripheral blood. These data suggest an essential role for LT in the normal development of peripheral lymphoid organs.

Application of the CO2 laser to infertility surgery.

In addition to use of the CO2 laser in gynecologic surgery for the treatment of pelvic, vaginal and vulvar neoplasms, it has been more recently applied to the treatment of infertility. The advantages afforded by the laser over conventional techniques are discussed. The authors' clinical experience in the surgical treatment of infertility, with emphasis on endometriosis and microtubal surgery, are described, and use of the new electro-pulsed laser in infertility surgery is evaluated.

Chronic community violence: what is happening to our children?

Chronic violence is a growing problem in our society today as evidenced, among other factors, by the ever-increasing murder rate in many of our large urban centers in the United States. Emphasis has begun to be placed on chronic violence, causes that may contribute to it, and the impact of this violence on cities and the country at large. While concern has been expressed, we still have not addressed adequately, nor do we fully understand, the effects on the children who must grow up in environments where they are repeatedly being exposed to significant levels of violence.

Women's health. Part II: Individual, environmental and economic factors affecting adherence to recommended screening practices for breast cancer.

In order for cancer mortality rates to be sufficiently reduced to meet the goals set by the National Cancer Institute, it is imperative that we broaden our understanding of the factors which affect participation in preventive health practices. Early detection and diagnosis of breast cancer are associated with participation in mammography, breast self-examination, and seeking medical care. A stratified random sample of women residing in Orleans Parish (40 to 65 years of age; annual family incomes < $40,000) were surveyed by telephone. Results of the survey were examined to determine the impact of individual, environmental, and economic factors on adherence to recommended screening practices for breast cancer. Results indicate a significant proportion of women are not adhering to recommended practices. Preventive health practices were positively related to physician recommendation of a mammogram and how the physician communicated with the patient; patient's income; belief in Powerful Others Locus of Control; and beliefs about the efficacy of early diagnosis and treatment. Fear of breast cancer was negatively related to preventive health practices. Findings highlight the utility of an ecological perspective in the development of secondary prevention strategies for breast cancer.

Women's health: early detection and screening practices for breast and cervical cancer.

A telephone survey of Orleans Parish residents (25 to 65 years old; annual family incomes < $40,000) was conducted to explore cancer-related knowledge, beliefs, and practices. This paper presents descriptive information about knowledge and practices pertinent to early detection of cancer (breast self-examination, Pap smear, and mammogram) among women (N = 315). Income-related differences were observed. Women in the lower income group were less likely to routinely practice breast self-examination, and also less likely to have had a recent Pap smear or mammogram. Gaps in knowledge regarding the purpose of Pap smears and mammograms were noted. This sample of women reported their physicians are not routinely recommending Pap smears or mammograms. Findings highlight the need for community education programs to enhance awareness of the purpose and importance of cancer screening practices, particularly among the poor. In addition, all medical professionals who have contact with women need to reiterate the importance of regular participation in cancer-screening practices.

Cancer awareness and attitudes toward preventive health behavior.

Elevated rates of morbidity and mortality among ethnic minorities have been linked to alterable patterns of behavior, including preventive health practices. African Americans in Louisiana are not only at increased risk for cancer, they also have poorer prognosis. This investigation describes beliefs, knowledge, and attitudes relevant to general and cancer-specific preventive health practices in a sample of African Americans (n = 48). Findings suggest a number of important differences exist between males and females in their attitude toward health issues. Females valued and expressed greater concern over their health status. Females also expressed greater confidence in their doctor's ability to diagnose cancer before it is too serious, while males appear to hold a more pessimistic view of the effectiveness of early detection. Although the use of a convenience sample limits the generalizations that can be made, present findings identify issues germane to the development of effective intervention strategies for this population.

Assessment of attitudes toward school-based health promotion programs.

Teachers from Orleans Parish public junior and senior high schools completed a survey designed to assess their health-related behaviors and their attitudes toward school-based health promotion programs. Findings suggest that teachers' behaviors and attitudes, as well as school policies toward smoking, are not optimal to creating a pro-health promotion environment. While teachers recognize the value of preventive programs for adolescents and many feel well qualified to implement such programs, few actually do. Resolution of these discrepancies are necessary early steps in increasing primary efforts needed for cancer control in Louisiana.

Tobacco, alcohol, and marijuana use among black adolescents: a comparison across gender, grade, and school environment.

Self-report measures of tobacco, alcohol, and marijuana use were administered to 2,748 black adolescents, grades 7 through 12. The proportion of students who had tried any of the substances increased by grade. Males and females were not significantly different in their use of cigarettes and alcohol. Males were more likely to have tried smokeless tobacco, smoked marijuana, and used combinations of substances. Females who reported using more than one substance preferred the combination of cigarettes and alcohol. Significant effects of school environment were noted. Increasing age-related experimentation is exacerbated by school setting (junior high versus senior high). Given that blacks have disproportionately high cancer prevalence and mortality rates, intervention programs may also need to consider school environment, substance specific initiation points, and combined use preferences in order to maximize the desired effect within this population.

Meeting the needs of special populations: a formative evaluation of a school-based smoking prevention program.

The National Cancer Institute has recommended three minimum components for school-based smoking prevention programs: short-term physiological effects, social consequences, and refusal skills. This investigation compares these minimum components with participant evaluations of the usefulness of content areas of a prevention program. Three hundred 9th grade students participated in the study. Results indicate that Health Hazards, Nonsmokers' Rights, Decision-Making Skills, and Peer Influences were most often rated as "Very Helpful" in resisting pressures to smoke. Assessment of initial knowledge of the health hazards and consequences associated with tobacco use indicate that 77% of the students received a "D" or lower. Results suggest that this group of adolescents, who are at risk for becoming adult smokers, may not be adequately served by public information sources and may therefore benefit from the inclusion of an additional minimum component: information about the long term health consequences associated with smoking.

Perceptions of cancer and its causes among "Industrial Corridor" residents: the LMRICS Planning Project. Lower Mississippi River Interagency Cancer Study.

The Industrial Corridor is composed of 11 parishes heavily concentrated with petrochemical facilities along the Mississippi River from Baton Rouge to the mouth of the river. There exists a generalized belief that the proximity of these waste-emitting industries to residential areas has adversely impacted the health of the residents including increasing the rates of cancer. At the same time, Louisiana Tumor Registry data do not support the widely held belief of excess cancer rates in the corridor. A community in the corridor was chosen to explore the issues of health beliefs, health-seeking behavior, and perceived quality of life. An extensive questionnaire was developed and administered to a sample of community residents. The results of the questionnaire suggest there may be multiple factors that influence the perceived well-being and preventive health practices of corridor residents.

Surgical management of endometriosis with the carbon dioxide laser.

This study was designed to evaluate the efficacy of reconstructive microsurgery with the carbon dioxide laser for the treatment of infertile women suffering from endometriosis. One hundred and eight women evaluated for infertility and endometriosis underwent reconstructive microsurgery with the carbon dioxide laser. All cases were classified in accordance with the American Fertility Society's classification. Postoperatively, conception rates for the mild-to-moderate and the severe-to-extensive groups were estimated by life table methods for analysis. Estimates of the cumulative pregnancy rate were 55% for the mild-to-moderate group and 88% for the severe-to-extensive group. The abortion rate was 17% and the ectopic pregnancy rate was 3%.

Analysis of electronically pulsed versus quasi-continuous wave carbon dioxide lasers in an animal model.

In this study we sought to compare laser tissue interaction in both the quasi-continuous waveform and electronically pulsed waveform of the carbon dioxide laser. An intramode analysis of the electronically pulsed form (at 350 and 650 pulses per second) was also undertaken. Intraperitoneal laser incisions were made on New Zealand white female virginal rabbits and tested at days 0, 5, 15, and 20. Testing involved proximal and midsection analysis of the laser sites to evaluate total area of vaporization, total area of tissue thermal damage, maximum diameter of injury at epithelial surface, maximum depth of laser penetration, angle of vaporization crater edges, and angle of tissue thermal injury of the three modes. Analysis of proximal versus midsection preparation revealed different zones of vaporization and injury within the same laser site. The zone of injury with respect to time was nonuniform, suggesting that the laser output in the electronically pulsed mode was not constant. An in vivo tissue lens phenomenon was also detected, resulting in a compound thermal vaporization and injury pattern.