Judith L. Ladinsky

Multidimensional measurement of cancer pain: Comparisons of US and Vietnamese patients

Abstract This study reports the development of a version of the Brief Pain Inventory (BPI) in Vietnamese and compares responses of Vietnamese cancer patients in pain with patients in the US. Reports that the BPI is able to separately measure the severity of pain and the interference caused by pain are supported. Factor analysis indicates that US an Vietnamese cancer patients give similar responses to pain severity and pain interference items. Because Vietnamese patients receive few analgesics, we predicted they would report greater pain severity. A discriminant function was formed from pain ratings the BPI which separated Vietnamese patients from patients from two Wisconsin hospitals. Vietnamese patients reported higher pain severity but not higher pain interference.

Cellular metabolic activity— A new basis for screening of vaginal cytology?

Abstract The hypothesis that a major difference in metabolic activity exists between cells shed from normal surfaces and these desquamated from epithelial abnormalities such as dysplasia, carcinoma in situ, and frank malignancy has been tested in 93 patients. It has been demonstrated that incorporation of the amino acid C 14 L-leucine is significantly greater in cells obtained from women bearing known epithelial abnormalities in the genital tract, than it is in cells obtained from apparently normal women. The possibility that this difference will permit mass screening of the female population when combined with home cell collection techniques has been discussed.

Changes in the Health Care System of Vietnam in Response to the Emerging Market Economy

This paper discusses the impact on the Vietnamese health care system of the change from a centralized socialist system to a market economy. It discusses recent policies based on expectations in relation to actual outcomes, and the impacts these changes have had on health care delivery and health infrastructure in Vietnam. It has become clear that the private medical sector is draining resources from the State rather than complementing the weakened national health system. Impacts on health education, pharmaceuticals, infrastructure support, geographic distribution of physicians, and equity are all discussed in terms of recent economic changes. It is suggested that adjustments must be made to ensure adequate health care for all Vietnamese including those in rural areas and the urban poor. The State must develop mechanisms to support the national health service before further deterioration occurs.

The kinetics of the generative compartment of the estrogen dependent vaginal epithelium.

The kinetics of the generative compartment of the vaginal epithelium in estrogen treated rats were studied using 3H-thymidine autoradiography. Castrate rats were grouped and treated with varying doses of diethylstilbestrol for a period of two weeks to create a steady state in the vaginal cell population. 3H-thymidine was then made continuously available (hourly injections) and the animals were sacrificed at intervals up to 48 hr. In some renewal systems, the generative compartment contains two populations of cells, one which continuously cycles and another which is in a state of dormancy until a stimulus is applied which activates this population to divide. In an attempt to determine if the basal cell layer of the hormone-dependent vaginal epithelium consists of one population of cells or if it contains two morphologically identical but functionally different cell populations tritiated thymidine was made constantly available for a period of time approximately equivalent to the maximum generative cycle time of the population. If the basal layer is a single cell population consisting exclusively of proliferating cells, continuous exposure to tritiated thymidine for a period of time equivalent to the maximum G2 + M + G1, of the population should result in complete labeling. If, however, it contains a resting reserve population the per cent of labeled cells should reach a plateau at some level less than 100 per cent. It is apparent from the data that complete labeling was attained. It was found in a previous study that labeling index increased with increasing dosage of estrogen. The present study indicates that this increase in labeling index associated with increasing estrogen stimulation was caused by progressive shortening of the generative cycle time rather than by activation of a second population or resting reserve. It seems, therefore, that the hormone-dependent generative compartment of the vaginal epithelium is a homogeneous population of actively proliferating cells.

The volume distribution of human lymphocytes.

Summary Human lymphocytes were separated on glass bead columns and measured electronically for cell volume distribution. Cells from healthy subjects have a modal volume of about 250 μ3, and a mean cell volume around 250 μ3. Skewness of the right limb of the volume distribution curve suggests a second population of large cells. Acute lymphocytic leukemia patients in relapse demonstrate true bimodality, while those in remission do not. Data are presented to suggest that lymphocytes which appear to be large on stained slide preparations may be merely more distensible cells of average volume.

Changes in vaginal cellular activity elicited by varying doses of natural and synthetic estrogens.

Abstract Castrate rats were treated with varying doses of 17 β estradiol and diethyl-stilbestrol for a period of two weeks to allow steady state conditions to pertain in the vaginal epithelial cell population. To estimate the cellular proliferation rate, the number of cells in DNA synthesis in the basal layer was estimated for each dosage level using tritiated thymidine autoradiography. A sigmoidal dose response was noted which was almost identical for the two hormones when the percent labeled basal cells was plotted against log dose. When the dose of estradiol exceeded 0.5 μg/day or the dose of diethylstilbestrol exceeded 1.0 μg/day, toxicity was apparent. Vaginal epithelial thickness, measured in the same animals, correlated almost perfectly with this labeling index at each dosage level, suggesting that epithelial thickness is essentially a pure function of the cellular proliferative response to these hormones.

Effects of irradiation on the generative cycle of the estrogen stimulated vaginal epithelium.

The effects of irradiation (300, 500 and 1500 rads) on mitosis and DNA synthesis in the estrogen primed vaginal epithelium have been studied. Dose‐effect relations and the time sequence of effects on the two processes were investigated. The technique of tritiated thymidine labeling of DNA with autoradiography was used, in conjunction with the mitotic count, to study alterations in the generative cycle. Prior to irradiation, ovariectomized female rats were treated daily with diethylstilbestrol for a period of 2 weeks to create a steady state in the vaginal cell population.

Village-based primary health care in the Central Highlands of Vietnam.

This paper describes the first year of an ongoing village health care and economic development project in the Krong Buk district of Dak Lak province in Vietnams Central Highlands. The project serves 21 villages with a total population of just over 15,000. Most belong to ethnic minority groups. Physicians from the province capital of Boun Me Thuot were trained by a multi-disciplinary team of American health care workers to be trainers and supervisors of 21 village health care workers (VHWs). Two months later, a VHW from each village was trained in primary and preventive health care by the physician-supervisors. Since this initial training, each VHW has been provided with materials, medicines and monthly supervision by the physician-supervisors. The health care component has been complemented by an economic development project based on a system of small loans. Data from the first year of monthly reports and from a baseline survey are presented in this paper.

CELLULAR LOCALIZATION OF RAPID RNA AND PROTEIN SYNTHESIS INDUCED IN PRESENSITIZED LYMPHOCYTES BY A CATIONIC PROTEIN FROM BRAIN.

Abstract Results of previous biochemical experiments indicated that lymph node cells, presensitized to a purified cationic protein from guinea pig brain, were induced to undergo rapid protein synthesis when incubated in the presence of the basic protein. An incubation period of 1 hr was required before the increase in protein synthesis could be observed. In the autoradiographic studies here reported, the nuclei of presensitized cells which appear to be medium lymphocytes, gave evidence of rapid RNA synthesis (possibly messenger RNA) during the initial hour of incubation with the cationic protein. During the second hour of incubation the high rate of protein synthesis was observed in both small and medium lymphocytes. With the aid of fluorescent antigen it was demonstrated that the medium sized lymphocytes contain a material that specifically binds the cationic protein. The role of the medium lymphocyte in the induction of hypersensitive reactions is discussed.

Nutritional status of preschool children in Northern Vietnam

After three decades of war and social turmoil in Vietnam, infant mortality is high and related health and nutritional problems are widespread. Studies which have investigated health or nutrition characteristics of the Vietnamese population are scarce. This paper offers the first multivariate analysis of nutritional status of Vietnamese children in recent history. The relationship between a number of household‐level variables and nutritional outcomes of preschool children surveyed over two years in northern Vietnam is investigated. During four survey rounds, as many as 82% and 80% of children under 72 months fell below a Z‐score of ‐2 for weight/age and height/age, respectively. A maximum of 44% and 57% of children fell below a Z‐score of ‐2 for growth velocity (weight and stature, respectively). Positive predictors of attained growth were hemoglobin level and sex (males having better nutritional status). Household size, weaning practices and household illness were not associated with attained growth.