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Biomedical subjects

A Cooper

Publications and source records attributed to A Cooper.

At least 307 records · Page 17Linked to original sources
PubMed1984

Morbidity and mortality of short-bowel syndrome acquired in infancy: an update.

The advent of total parenteral nutrition (TPN) has made survival beyond infancy possible for large numbers of patients who have sustained massive small intestinal loss due to a variety of intraabdominal catastrophes. However, the quantity and quality of life have been limited by the development of late sequelae due both to the protracted use of TPN and the long-term complications of foreshortening of the gut. To determine to what extent the morbidity and mortality of short-bowel syndrome (SBS) may have improved over the last 10 years, we reviewed our experience since 1973 with patients losing more than 50% of total small intestinal mass in infancy. The etiologies of SBS in the 16 study patients were necrotizing enterocolitis (6), midgut volvulus (5), multiple atresias (3), gastroschisis (1), and congenital SBS (1). Overall survival was 81%; total small intestinal length (SIL) at the time of diagnosis was 44.2 +/- 7.9 cm in survivors and 30.3 +/- 7.8 cm in nonsurvivors, probability values not significant. Although no patient survived without an ileocecal valve whose total SIL was greater than 20 cm, the three deaths in this series were not related directly to the SIL, but to end-stage liver disease resulting from TPN-associated cholestasis. Among the survivors, adaptation to enteral feedings required 13.8 +/- 2.5 mo, during which time weaning from TPN occurred; weight at adaptation was 6.87 +/- 1.32 kg.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1984

The dissection sign of nonreducible ileocolic intussusception.

A retrospective study of 90 cases of ileocolic intussusception seen over a 5-year period was undertaken to identify features of failed hydrostatic reductions. A new, reliable sign of nonreducible intussusception was found: the dissection sign. Of the 90 cases, 23 demonstrated barium dissecting between the intussusceptum and intussuscipiens ; of those, nine had necrotic bowel found at surgery. All of the 23 cases with dissection failed hydrostatic reduction. Of the 23 patients, 22 were below age 2 years. None of those reduced by barium enema had dissection. The dissection sign on barium enema for ileocolic intussusception is an indication to discontinue hydrostatic reduction and to institute surgical treatment, especially in patients under age 2 years.

Barium Sulfate↗
PubMed1984

Seeking help for marital problems: the role of the general practitioner.

Marital disharmony is a widespread phenomenon but it is largely hidden. Research, however, suggests that of the people with marital problems more approach the general practitioner than any other professional. This preliminary study reports on the help-seeking patterns of a sample of 60 patients in primary care identified as having marital problems, and a comparison is made with patients with housing problems. Men, it appeared, are less likely than women to confide in friends or relatives concerning marital problems and are less likely to find it helpful when they do; similarly, men are less likely to discuss their marital difficulties with their family doctor. Women were more satisfied with their doctor's help, which was mainly emotional support rather than more intensive counselling or referral. The implications of these preliminary findings are discussed.

Family Practice↗
PubMed1983

The errors of thymidine labelling in breast cancer.

The site to site error and reproducibility of counting error have been assessed in the routine thymidine labelling of breast cancer. Despite modifications of technique designed to minimize these errors both were found to be inaccurate to within 0.5 labelling index %. Since the majority of tumours had labelling indices below 2% this measurement is not a critical determinant of tumour behaviour.

Breast Neoplasms↗
PubMed1981

Nutritional assessment: an integral part of the preoperative pediatric surgical evaluation.

Comprehensive nutritional assessment in adults has revealed that 50% of hospitalized patients suffer from acute protein calorie malnutrition (PCM), a state which correlates with increased surgical morbidity and mortality. We report our results examining the same question in children, and on the basis of these data suggest that nutritional assessment be a routine part of the preoperative evaluation of all pediatric surgical patients. We studied 198 children and found that the overall prevalence of acute PCM was 54%; but if premature and term infants less than three months of age are selected, the prevalence of acute PCM was a striking 63%. If only surgical patients are considered, the prevalence of acute PCM among patients hospitalized for trauma or burns was 31% for elective operation 39%, and for acute but complex operative procedures 64%. These data demonstrate that a remarkably high prevalence of acute PCM exists among hospitalized pediatric and pediatric surgical patients. Whether aggressive perioperative nutritional support can reverse such acute PCM and favorably influence morbidity and mortality is currently speculation, but that acute protein calorie malnutrition is far more prevalent among hospitalized pediatric patients that is generally realized, and that comprehensive nutritional assessment is essential to identify the "at risk" nutritionally deprived pediatric surgical patient, have now been proven.

Adolescent↗
PubMed1981

The liver and immunoregulation of neuroblastoma growth.

C1300 neuroblastoma, like human neuroblastoma, elicits an immune response in its host and as a result provides an animal model in which to study the enigmatic behavior of this common childhood tumor. Since the liver is a favored site for neuroblastoma metastasis, especially the favorably regressing IV-S stage, and since the liver is a known producer of immunoregulatory factors, this study report a systematic assessment of liver cell tumor cell interaction, the effect on tumor immunogenicity, and the potential for tumor growth control. Immunization-excision-challenge assays in 120 A/J mice with C1300 demonstrate the tumor to be antigenic; but in a second experimental sequence with 120 mice, normal whole liver cells were admixed with C1300 tumor cells in vitro and incubated for one hour prior to animal innoculation. The immunogenicity is dramatically minimized in the admixture group when compared with controls (antigenic ratio = 1.67 versus 3.07, p less than .02). However, if prior to such liver cell-tumor cell admixture the liver cells are sonicated and the lysate ultracentrifuged, a contrasting result is obtained. In 4 additional experiments utilizing 120 mice, the tumor cell is rendered a more potent immunogen following soluble fraction admixture (antigenic ratio = 1.99 versus 1.56, p less than .05). These data suggest that such whole cell and subcellular soluble factor immunoregulatory interactions are operative in determining immunogenicity of a tumor innoculation. We speculate that the progression or regression of clinical neuroblastoma within the liver may be similarly influenced since a host-tumor interaction depends on eliciting an antitumor response to an antigenic stimulus.

Animals↗
PubMed1981

Spurious conformational transitions in proteins?

Temperature-dependent dynamic processes in biological macromolecules can produce sharp and reversible transitions in spectroscopic properties that might be misinterpreted as evidence for thermally induced conformational changes. This provides a rational explanation for the paradoxical case of D-amino acid oxidase [D-amino-acid:oxygen oxidoreductase (deaminating), EC 1.4.3.3], for which a sharp fluorescence transition at 14 degrees C, not observed by sensitive calorimetry [Sturtevant, J. M. & Mateo, P. L. (1978) Proc. Natl. Acad. Sci. USA 75, 2584-2587], could be due to a dynamic quenching process of large activation energy, rather than a change in conformational state of the protein. Similar interpretations may be valid in other systems studied by experimental techniques that depend, directly or indirectly, on molecular relaxation processes.

D-Amino-Acid Oxidase↗
PubMed1981

Family therapy training in clinical psychology programs.

In a national questionnaire survey of graduate programs offering the Ph.D. or Psy.D. in clinical psychology, the status of family therapy training was examined. With a 79 per cent response rate (102 programs), the study found that 10 per cent of the nationwide faculty identified themselves as primarily family therapy oriented, 32 per cent of the programs had no family-oriented faculty members, 18 per cent of all psychotherapy courses were family therapy courses, and 21 per cent of the schools had no family therapy course. The ratings of the importance of providing students with family therapy training were found to be unrelated to the number of family therapy courses available but positively correlated with the percentage of family therapy courses within the total curriculum.

Data Collection↗
PubMed1981

Childhood pemphigus initially seen as eosinophilic spongiosis.

The condition of a 3-year-old boy with an intermittent, generalized, bullous eruption was initially diagnosed as (and treated as) bullous impetigo. After a relapse, two skin biopsies were performed. Each biopsy specimen showed the changes of eosinophilic spongiosis. A third biopsy specimen was also examined by direct immunofluorescence microscopy. The specimen showed deposition of IgG in the intercellular region of the epidermis. The patient's serum contained intercellular antibodies in a dilution of 1:160, confirming the diagnosis of pemphigus. A biopsy should be performed in the case of a child with a persistent or recurring bullous eruption; immunofluorescence microscopy of the biopsy is essential.

Child, Preschool↗