Preventing neural tube defects. Government needs to take action.
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Government↗
Biomedical subjects
B Brown
Publications and source records attributed to B Brown.
Prospective trial of preoperative concomitant boost radiotherapy with continuous infusion 5-fluorouracil for locally advanced rectal cancer.
RATIONALE: To evaluate the response to a concomitant boost given during standard chemoradiation for locally advanced rectal cancer. METHODS AND MATERIALS: Concomitant boost radiotherapy was administered preoperatively to 45 patients with locally advanced rectal cancer in a prospective trial. Treatment consisted of 45 Gy to the pelvis with 18 mV photons at 1.8 Gy/fraction using a 3-field belly board technique with continuous infusion 5FU chemotherapy (300mg/m(2)) 5 days per week. The boost was given during the last week of therapy with a 6-hour inter-fraction interval to the tumor plus a 2-3 cm margin. The boost dose equaled 7.5 Gy/5 fractions (1.5 Gy/fraction); a total dose of 52.5 Gy/5 weeks was given to the primary tumor. Pretreatment tumor stage, determined by endorectal ultrasound and CT scan, included 29 with T3N0 [64%], 11 T3N1, 1 T3Nx, 2 T4N0, 1 T4N3, and 1 with TxN1 disease. Mean distance from the anal verge was 5 cm (range 0-13 cm). Median age was 55 years (range 33-77 years). The population consisted of 34 males and 11 females. Median time of follow-up is 8 months (range 1-24 months). RESULTS: Sphincter preservation (SP) has been accomplished in 33 of 42 (79%) patients resected to date. Three patients did not undergo resection because of the development of metastatic disease in the interim between the completion of chemoradiation (CTX/XRT) and preoperative evaluation. The surgical procedures included proctectomy and coloanal anastomosis (n = 16), low anterior resection (n = 13), transanal resection (n = 4). Tumor down-staging was pathologically confirmed in 36 of the 42 (86%) resected patients, and 13 (31%) achieved a pathologic CR. Among the 28 tumors (67%) located <6 cm from the anal verge, SP was accomplished in 21 cases (75%). Although perioperative morbidity was higher, toxicity rates during CTX/XRT were comparable to that seen with conventional fractionation. Compared to our contemporary experience with conventional CTX/XRT (45Gy; 1.8 Gy per fraction), improvements were seen in SP (79% vs. 59%; p = 0.02), SP for tumors <6 cm from the anal verge (75% vs. 42%; p = 0.003), and down-staging (86% vs. 62%; p = 0.003). CONCLUSION: The SP rate with concomitant boost radiation has been highly favorable with rates of response which are higher than those previously reported for chemoradiation without administration of a boost. Further evaluation of this radiotherapeutic strategy appears warranted.
Adult↗
A novel, one-pot ring expansion of cyclobutanones. Syntheses of carbovir and aristeromycin.
A novel, one-pot ring-expansion procedure was developed using Me3S(O)I, NaH, and Sc(OTf)3. The scope and limitations were briefly examined, and a tentative mechanism was proposed. Application of the methodology to known cyclobutanone 1 provided the corresponding cyclopentanone, which was successfully advanced to (+)-carbovir and (+)-aristeromycin.
Adenosine↗
Prostacyclin for secondary pulmonary hypertension.
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Anemia, Sickle Cell↗
Variation in vernier acuity with age.
Many visual functions deteriorate with increasing age, vernier acuity apparently being an exception. We used an improved experimental protocol to investigate vernier thresholds in subjects in four age groups. Vernier threshold was found to increase with increasing age, and the difference in this, compared with previous findings is probably due to the smaller inter-pixel angle used. Vernier acuities in young subjects in other studies seem to have been underestimated. As vernier acuity did not vary with retinal illuminance and the sensitivity loss does not seem to be a learning effect, neural rather than optical changes are likely to account for the deterioration. Measurement of vernier acuity may have clinical application in the determination of visual function behind cataract, and it will be necessary to consider the effect of age on vernier acuity.
Adult↗
Effectiveness and biomechanics of spinal orthoses in the treatment of adolescent idiopathic scoliosis (AIS).
In this prospective study, the effectiveness and biomechanical factors of spinal orthoses in the treatment of moderate adolescent idiopathic scoliosis (AIS) patients were investigated. In the first 20 months of orthotic treatment, the values of standing AP Cobb's angle, apical vertebral rotation, lumbar lordosis as well as thoracic kyphosis showed significant reduction (P<0.05), however, the angle of trunk inclination and trunk listing did not. The values of those reducible parameters reached their lowest values within the first 12 months of orthotic treatment and then the values gradually increased but they were still below the pre-brace values. The mean pressure of The pressure pads was found to be 7.09 +/- 1.77 kPa (53.2 +/- 13.3 mmHg) while the mean tension of the straps was 26.8 +/- 5.2N. The standing AP Cobb's angle strongly correlated with the pad pressure (correlation coefficient=0.931, p<(.05) and strap tension (correlation coefficient=0.914, p<0.05). The strap tension and pad pressure strongly correlated and the correlation coefficient was 0.873 (p<0.05). This suggests that in the consideration of biomechanical function of spinal orthoses, the focus may be upon how tightly the orthosis was fastened and if the location and direction of the pressure pads are the correct. Therefore, for enhancing independent standard tension should be set in each strap, and regular and close monitoring is needed.
Adolescent↗
Abdominal insufflation does not cause hematogenous spread of colon cancer.
BACKGROUND AND PURPOSE: Previous investigators have suggested that port-site recurrences are possibly a result of abdominal insufflation, forcing viable cancer cells into the circulation to metastasize and thrive in areas of trauma. Using a syngeneic animal cancer model, we tested the hypothesis that pneumoperitoneum increases the incidence of wound metastasis by a blood-borne mechanism. METHODS: Male BD IX rats (N = 150) were injected intraperitoneally with 2 x 10(5) viable syngeneic 1,2-dimethylhydralazine-induced colon cancer cells (DHD-K12). Animals were divided into three groups: A (abdominal insufflation with 3-cm incision on the back into muscle remote from the peritoneum); B (3-cm back incision alone); and C (control group with 3-cm midline abdominal incision). Three weeks after surgery, the animals were euthanized and autopsied. RESULTS: In the two groups with back wounds, the incidence of cancer growth at the incision was zero, as demonstrated grossly and by histologic sample (A: 0/47, B: 0/43). In contrast, the autopsied control group had a 42% incidence of metastasis to the wound (25/59). There seemed to be no difference in the distribution of intra-abdominal disease between those rats that underwent insufflation and those that did not. CONCLUSION: It is unlikely that pneumoperitoneum promotes hematogenous wound implantation of free intraperitoneal cancer cells.
Animals↗
Repeatability and intercorrelations of standard vision tests as a function of age.
PURPOSE: We assessed repeatability and intercorrelations of five standard vision tests in subjects with normal vision. METHODS: Seventy-eight subjects (aged 21 to 68 years) completed five measurements each of high- and low-contrast visual acuity, near visual acuity and contrast sensitivity (Pelli-Robson chart). RESULTS: Except for correlations between high- and low-contrast visual acuity (r = 0.78), intercorrelations between tests were low to moderate (r < 0.5). For each measure, variability for the group was about one line on the chart (one triplet for the Pelli-Robson chart) and the minimum variability for an individual subject was about one third of this. On average, 1 to 2 lines can be expected to be lost over the normal lifespan on each test. Variability in responses did not increase significantly with age for any test. CONCLUSIONS: The criterion for judging change on commonly used clinical vision tests is about one line for subjects over a wide age range.
Adult↗
Effective vaccine for lassa fever.
Lassa fever has been estimated to cause 5,000 deaths annually in West Africa. Recently, war in the zone where Lassa fever is hyperendemic has severely impeded control and treatment. Vaccination is the most viable control measure. There is no correlation between antibody levels and outcome in human patients, and inactivated vaccines produce high titers of antibodies to all viral proteins but do not prevent virus replication and death in nonhuman primates. Accordingly, we vaccinated 44 macaques with vaccinia virus-expressed Lassa virus structural proteins separately and in combination, with the object of inducing a predominantly TH1-type immune response. Following Lassa virus challenge, all unvaccinated animals died (0% survival). Nine of 10 animals vaccinated with all proteins survived (90% survival). Although no animals that received full-length glycoprotein alone had a high titer of antibody, 17 of 19 survived challenge (88%). In contrast, all animals vaccinated with nucleoprotein developed high titers of antibody but 12 of 15 died (20% survival). All animals vaccinated with single glycoproteins, G1 or G2, died, but all those that received both single glycoproteins (G1 plus G2) at separate sites survived, showing that both glycoproteins are independently important in protection. Neither group had demonstrable antibody levels prior to challenge. We demonstrate that in primates, immune responses to epitopes on both glycoproteins are required to protect against lethal challenge with Lassa virus without having untoward side effects and that this protection is likely to be primarily cell mediated. We show that an effective, safe vaccine against Lassa virus can and should be made and that its evaluation for human populations is a matter of humanitarian priority.
Animals↗
Pilot study of the multifocal electroretinogram in ocular hypertension.
AIMS: To investigate the variation of retinal function in ocular hypertension (OHT) using the multifocal electroretinogram (MERG), that can objectively assess regional retinal responses using kernel analysis. METHODS: Patients with OHT were recruited for 61 flash MERG recording. The first and second order kernel responses were analysed and compared with responses from a normal group. All the patients with OHT had full eye examinations and visual field analysis to ensure they had no ocular pathology, apart from high IOP (>/= 22 mm Hg). RESULTS: In OHT, both the first and the second order kernel responses showed a reduction in magnitude compared with control values. The second order kernel responses showed larger relative reduction of amplitude than the first order responses. In addition, the macula showed a greater reduction in response than the periphery. CONCLUSIONS: First order and second order kernel analyses are useful for detecting changes of retinal response in OHT. The second order kernel analysis is important in measuring the inner retinal activity and is an important factor in detecting the early glaucoma case. Diminished macular response may be a useful sign in early glaucomatous changes.
Adult↗
Primary culture of avian pancreatic acinar cells for heterologous gene expression.
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Animals↗
Automated enzymatic mitochondrial antibody assay for the diagnosis of primary biliary cirrhosis.
Primary biliary cirrhosis is a progressive autoimmune disease that affects middle aged women, resulting in liver cirrhosis. We describe here an automated enzymatic mitochondrial antibody assay adapted for performance on laboratory analysers for the serological diagnosis of primary biliary cirrhosis. This assay detects the characteristic autoantibody directed against the 74kDa E2 subunit of the pyruvate dehydrogenase complex. Analysis of receiver operator characteristic curve data indicated that the automated enzymatic mitochondrial assay procedure discriminated clinically identified patients with primary biliary cirrhosis from normal subjects with a sensitivity of 83% and a specificity of 100%. This method compared favourably against a commercial ELISA method which had a sensitivity of 73% and a specificity of 100%. The automated enzymatic mitochondrial antibody assay is a high throughput assay of use for the routine diagnosis of patients with primary biliary cirrhosis with autoantibodies to the E2 subunit of the pyruvate dehydrogenase complex. The method is of potential value for economical and rapid screening to detect asymptomatic primary biliary cirrhosis in the at-risk segment of the population, namely middle aged women.
Autoantibodies↗
Ultrasonographic imaging of the testis and epididymis of the bottlenose dolphin, Tursiops truncatus aduncas.
Eight male bottlenose dolphins, Tursiops truncatus aduncas, underwent examination of the reproductive organs to investigate the use of real-time B-mode ultrasonography in assessment of reproductive status and to establish normal ultrasonographic appearances. Ultrasonography allowed repeatable examinations which were well tolerated by all animals. Ultrasonography was used to examine the testes, epididymides, vasa deferentia, penis, bulbourethral and bulbocavernosal muscles; the prostate was not convincingly distinguished from surrounding muscles. Testicular echopatterns and size differed among individuals. Three distinct testicular echopatterns were discerned and could be used to differentiate males of different reproductive status. Ultrasonographic appearance of the testes provides useful data in assessing the reproductive status of male dolphins.
Animals↗
Role of corticotropin-releasing factor (CRF) receptors in the anorexic syndrome induced by CRF.
Genetic manipulations of corticotropin-releasing factor (CRF)(1) and CRF(2) receptors have resulted in data suggesting that the CRF(2) receptor could mediate the effects of CRF on appetite or satiety. We have attempted to obtain pharmacological evidence for this hypothesis by comparing the ability of a high-affinity peptide, mixed CRF antagonist [cyclo 30-33,f12,L18,21E30, A32,K33]sucker fish urotensin (12-41)NH(2) [cUTSN (12-41)] with a small-molecule CRF(1)-selective antagonist, NBI-27914, and a CRF(2)-selective peptide antagonist, antisauvagine-30, to attenuate the anorexic effects of CRF. We also monitored other behaviors that accompanied CRF-induced anorexia. CRF-induced anorexia was significantly correlated with a reduction in locomotor activity and an increase in freezing behavior and piloerection. cUTSN (12-41) and antisauvagine-30 significantly attenuated the effects of CRF (0.04 nmol) on food intake along with the behavioral syndrome that accompanied anorexia. In contrast, NBI-27914 did not attenuate either of the above-mentioned CRF-induced phenomena when given centrally at doses ranging from 0.13 to 10 nmol/2.5 microl or when given orally at 20 to 40 mg/kg. Although these data support the hypothesis that the CRF(2) receptor mediates the appetite suppression induced by CRF, they also suggest that the CRF(2) receptor could mediate the stress-like behaviors that accompany CRF-induced appetite suppression.
Animals↗
Chronic relapsing pancreatitis in a child. Use of the Puestow procedure to achieve ductal drainage.
A case of chronic relapsing pancreatitis presenting in an 8-year-old African Jamaican girl is outlined. Aggressive supportive management failed to control pain and vomiting. The Puestow Procedure effectively procedure aborted these symptoms. The use of the Puestow procedure should not be inordinately delayed in chronic relapsing pancreatitis if symptoms persist, since it may not only control pain but also halt declining pancreatic function.
Child↗
Soft contact lens wear in Hong Kong-Chinese: predicting success.
The tear stability and tear volume of 55 asymptomatic Hong Kong-Chinese were assessed before soft contact lens (Hydron Zero 6) were and repeated on three visits over 28 weeks of lens wear. Soft lens wear caused a significant initial transient decrease in the non-invasive tear break-up time (NITBUT), but no change in tear volume as assessed by the self-prepared cotton thread test (SP-CTT) and phenol red thread (PRT) test. After 28 weeks, the subjects were classified according to the length of time they could wear their lenses without dry eye related signs and symptoms. The NITBUT and PRT tests were unable to predict the success of soft contact lens wear. However, the SP-CTT gave a sensitivity and specificity of 88.5 and 52.4%, respectively, in the prediction of subjects most likely to be successful wearers. The positive and negative predictive values at the chosen cut-off point were 69.7 and 78.6%, respectively. Wetting values, that is, combinations of NITBUT and SP-CTT values or NITBUT and PRT values, did not predict success in soft contact lens wear.
Adult↗
Men in nursing: ambivalence in care, gender and masculinity.
This paper briefly reviews some aspects of the history of men in nursing and suggests that for centuries men have been at the forefront of caring work, and that it was in the mid-nineteenth century when shifts in the nature of masculinity and femininity occurred, spearheaded by Florence Nightingale, which resulted in nursing becoming feminised. Drawing on techniques of oral history, this paper presents the experiences of two men who pioneered the return of men into nursing, and how their work changed in the course of their working lives. Both men saw a shift away from institutional hierarchies towards a more patient centred model, which accompanied comparable developments in their own thinking in different fields of nursing. There were differences in the work they did and how they constructed their pasts, yet there were also similarities in the way they developed their philosophy of caring for patients.
Historiography↗
What matters most in nursing's future?
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Awards and Prizes↗