Biomedical subjects
B Jones
Publications and source records attributed to B Jones.
The effect of antacids or cimetidine on the oropharyngeal flora of outpatients in a gastroenterology clinic.
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"Bubbly" duodenal bulb in celiac disease: radiologic-pathologic correlation.
Small (1-4 mm) hexagonal filling defects were found on air-contrast studies of the duodenal bulb in three patients with unresponsive (atypical) celiac disease. Multiple biopsies confirmed both celiac disease and peptic duodenitis. Stimulated acid outputs determined in two patients were in the peptic ulcer range. Cimetidine therapy led to improved absorption in all three patients. Repeat upper gastrointestinal series and endoscopy in one patient showed no evidence of nodularity or peptic duodenitis, indicating that these changes may be reversible. Peptic disease may contribute to nodularity in the duodenal bulb and relative lack of response to a gluten-free diet of some patients with celiac disease. The finding of tiny nodules in the duodenal bulb in a patient with malabsorption should lead to consideration of celiac disease as a primary diagnosis with peptic duodenitis as an aggravating factor.
Lymphadenopathy in celiac disease: computed tomographic observations.
Lymphadenopathy in patients with celiac disease is generally viewed with alarm due to the association between celiac disease and intestinal lymphoma. Four patients with celiac disease are described in whom significant mesenteric and paraaortic adenopathy was demonstrated by computed tomography (CT). The subsequent clinical course of these patients revealed no evidence of lymphoma. In two patients with longstanding celiac disease and recent relapse, exploratory laparotomy revealed reactive hyperplasia in the enlarged glands; in one patient this was associated with intestinal ulceration, and in the other no underlying pathology was found. Follow-up CT scans in both these patients demonstrated regression of the findings with clinical improvement. In the other two patients, CT was performed as part of the initial evaluation. Follow-up CT in one of these patients revealed almost complete regression of the adenopathy after institution of a gluten-free diet. The other, with a 2 year duration of CT-documented abdominal adenopathy prior to diagnosis, became asymptomatic with weight gain for over 1 year after institution of a gluten-free diet.
Desmoid tumors in Gardner syndrome: use of computed tomography.
Desmoid tumors are known to be associated with Gardner syndrome and, when located in the mesentery, can contribute to morbidity and mortality. Computed tomography (CT) was used to evaluate six patients with Gardner syndrome who, after colectomy, complained either of abdominal pain or of palpable masses. In five patients, desmoids of the mesentery, abdominal wall, and paraspinous muscles were diagnosed; four of these were later proven surgically. The sixth case, with both CT and subsequent surgery negative for desmoid lesions, is included to illustrate the ability of CT to replace exploratory surgery in certain instances. CT provides a relatively noninvasive means of assessing and following patients with Gardner syndrome after colectomy and delaying or preventing further surgery or, if necessary, providing a surgical "road map" to optimize unavoidable procedures.
Functional measurement scales of painful electric shocks.
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Bullet wounds of the left lower chest and arterial bullet embolism.
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Pneumatosis intestinalis: role of computed tomography in diagnosis and management.
Four patients with pneumatosis intestinalis (PI) demonstrated by computed tomography are presented. Computed tomography delineated the location and extent of PI more accurately than plain abdominal radiographs and demonstrated any coexisting abdominal pathology. Lung window settings were important in the detection of intramural air and obviated the need for intraluminal contrast to outline the circumferential pattern of PI. In one patient PI would have been overlooked entirely using only conventional abdominal window settings. This technical observation could have potential clinical significance in the investigation of patients with suspected intestinal ischemia or gangrene where the appearance of intramural air is an ominous prognostic sign.
Results of computerized tomography, psychometric testing and dietary studies in social drinkers, with emphasis on reversibility after abstinence.
The frequency of abnormal results of cranial computerized tomography (CT), psychometric testing and dietary studies was established in a prospective study of 39 light-to-moderate drinkers (below 120 g/day) of both sexes. Thirty-one subjects showed some degree of cerebral atrophy on CT scan and, of these, 25 also showed abnormalities on psychometric testing. Psychometric deficits were found in three subjects with a normal CT scan. Cerebral atrophy was reversed in 10 of 11 subjects who abstained from alcohol for between three and 12 months. On re-examination after six months, five of the 11 subjects showed improved performance in most psychometric tests. Sixteen subjects were deficient in some dietary factor and all but one of these had abnormal results of CT scan or psychometric testing. The deficiencies found were in kilojoules (six subjects), iron (five subjects), protein (four subjects), calcium (seven subjects), thiamin (six subjects), and ascorbic acid (one subject). Eight subjects had multiple dietary deficiencies; all but one were women. Four had a low red blood cell level of thiamin, but normal serum levels. This was thought to reflect an impairment in the metabolism of this vitamin due to the effect of alcohol. All four subjects with a low red blood cell thiamin level were found to have cerebral atrophy on CT scan and two had psychometric deficits.
Both a monoclonal antibody and antisera specific for determinants unique to individual cloned helper T cell lines can substitute for antigen and antigen-presenting cells in the activation of T cells.
Two antisera and a monoclonal antibody raised in BALB.K mice against cloned, major histocompatibility complex (MHC)-restricted, antigen-specific helper T cell lines are described. These antibodies are specific for individual cloned T cell lines and are potent inducers of T cell proliferation. The induction of T cell proliferation by these antibodies requires the presence of an adherent accessory cell. There is no H-2 restriction between this accessory cell and the cloned T cell, nor is this antibody-induced proliferation blocked by a monoclonal anti-Fc receptor antibody. The requirement for an accessory cell, however, is eliminated in the presence of an IL-1- or IL-2-rich supernatant. Thus this system allows the analysis of helper T cell activation with only a single cell type present. Anti-T cell sera also induce T cell-dependent B cell proliferation and immunoglobulin secretion. The induction of T cell-dependent B cell activation by these sera does not require H-2-matched T cells and B cells. The specificity of these antibodies and their ability to stimulate cloned helper T cells in the absence of antigen and antigen-presenting cells strongly suggest that these antibodies are directed against antigen and/or Ia recognition sites on the T cell.
Subpopulations of B cells distinguished by cell surface expression of Ia antigens. Correlation of Ia and idiotype during activation by cloned Ia-restricted T cells.
We have investigated in vitro the induction of antibody responses to phosphorylcholine (PC) by cloned T helper (Th) cell lines. The cloned Th cells are antigen specific, in this case ovalbumin (OVA), self-Ia recognizing, and induce antibody secretion only if the hapten, PC, is physically linked to the carrier (OVA) molecule. The plaque-forming cell (PFC) response generated in the presence of cloned Th cells is idiotypically diverse with 5-40% of the secreting B cells bearing the TEPC-15 (T15) idiotype. The interaction of the cloned Th cells and unprimed B cells requires recognition of B cell surface Ia glycoproteins for all B cells activated to secrete anti-PC antibody, whether they be T15-bearing or not. More importantly, however, effective interaction between a cloned Th cell and a B cell is determined by the quantity of B cell surface Ia glycoproteins. Our results indicate that quantitative differences in B cell surface Ia antigens are directly related to B cell activation by the cloned Th cell. The high Ia density B cells are most easily activated by cloned Th cells, and these appear to be mainly non-T15-bearing. These data suggest that the failure of cloned Th cells to effectively activate T15-bearing B cells in vitro may be due to the lower relative Ia density of these B cells and therefore to their inability to interact effectively with cloned Ia-recognizing Th cells. These results imply that monoclonal T cells may distinguish between T15-bearing and non-T15-bearing B cells based on their Ia density.
Comparison of intermediate-dose methotrexate with cranial irradiation for the post-induction treatment of acute lymphocytic leukemia in children.
We compared two regimens with respect to their ability to prolong disease-free survival in 506 children and adolescents with acute lymphocytic leukemia. All responders to induction therapy were randomized to treatment with 2400 rad of cranial irradiation plus intrathecal methotrexate or to treatment with intermediate-dose methotrexate plus intrathecal methotrexate, as prophylaxis for involvement of the central nervous system and other "sanctuary" areas. Patients were then treated with a standard maintenance regimen. Complete responders were stratified into either standard-risk or increased-risk groups on the basis of age and white-cell count at presentation. Among patients with standard risk, hematologic relapses occurred in 9 of 117 given methotrexate and 24 of 120 given irradiation (P less than 0.01). The rate of central-nervous-system relapse was higher in the methotrexate group (23 of 117) than in the irradiation group (8 of 120) (P = 0.01). Among patients with increased risk, radiation offered greater protection to the central nervous system than methotrexate (P = 0.03); there was no difference in the rate of hematologic relapse. In both risk strata the frequency of testicular relapse was significantly lower in the methotrexate group (1 patient) than the radiation group (10 patients) (P = 0.01). Methotrexate offered better protection against systemic relapse in standard-risk patients and better protection against testicular relapse overall, but it offered less protection against relapses in the central nervous system than cranial irradiation.
Evidence that the Thy-1 molecule is the target for T cell mitogenic antibody against brain-associated antigens.
Rabbit anti-mouse brain (RaMBr) antiserum can induce Lyt-1+, Lyt-2-, T cells to proliferate and stimulates the same T cell subset to induce B cell proliferation. The aim of this report is to demonstrate that the mitogenic determinant recognized on the T cell surface by RaMBr antiserum is located on the Thy-1 molecule expressing the products of the Thy-1a and Thy-1b alleles. Evidence is drawn from serological and genetic experiments. The brain T cell cross-reactive, mitogenic determinant is not expressed on Thy-1- mutants of the BW5147 T cell lymphoma that fail to express the Thy-1 molecule but do express other T cell surface proteins such as T-200 and gp 69, 71. Monoclonal anti-Thy-1.1 and anti-Thy-1.2 antibodies block the binding to the appropriate T cells of the majority of the serum antibody from RaMBr antiserum. The absorption of mitogenic antibody was blocked in a similar fashion, thus demonstrating the close association of the determinant and the Thy-1 antigen defined by monoclonal alloantibodies. The mitogenic and Thy-1.1 determinants are probably located on the same molecule because of the data obtained with the BW5147 Thy-1- mutants and the observation that Thy-1a T cells, which express a lower level of surface Thy-1 than Thy-1b T cells, also express lower levels of the determinant recognized by RaMBr antiserum. Furthermore, in (AKR x DBA/2)F1 mice (Thy-1a/b) which express less Thy-1.1 antigen than Thy-1.2 at the surface, the mitogenic determinant was found to be preferentially associated with Thy-1.2. The coordinated genetic control of the surface levels of the Thy-1 determinant and the mitogenic determinant suggests that both determinants are situated on the same molecule in the T cell membrane.
Some problems with Bryden and Sprott's "statistical determination of degree of lateralization".
Bryden and Sprott (Neuropsychologia 19, 571-581, 1982) have proposed an index, lambda, of lateralization that has the same range of possible values no matter what the overall level of accuracy obtained in the experiment. It is shown by way of example that changes in lambda over the levels of the independent variable may be predictable from increases in the level of accuracy for the right and left sides. Specifically, if accuracy increases at a constant rate for the two sides, then lambda, except for some highly artificial situations, is constrained to increase or decrease. It is argued that difficulties associated with the difference between correct responses for the two sides as an index of the degree of lateralization may have been exaggerated. It is shown for hypothetical data that the difference measure may have many of the properties of lambda.
Unnecessary intravenous urography in young women with recurrent urinary tract infections.
Intravenous urography was evaluated in 201 young women with recurrent urinary tract infections. In 118 of 121 patients with uncomplicated recurrent infections the intravenous urogram (IVU) was normal. Insignificant abnormalities were found in only three cases. It is concluded that, in order to avoid unnecessary investigation, an additional risk indication should be present to warrant an IVU. The additional risk indications have been identified.
Magnitude estimates of cold pressor pain: effects of suggestions, cognitive strategy, and tolerance.
Pain magnitude when subjects immersed an arm in ice water was assessed by means of a magnitude estimation procedure during baseline and posttest sessions. Before the posttest session, subjects either received or did not receive an analgesic suggestion. Best-fit functions were linear, though power fits were also good. Analgesic suggestions had no effect on the rate of change in pain intensity. When subjects were classified as copers or catastrophizers on the basis of written testimony, pain intensity increased more rapidly for catastrophizers than for copers during the posttest session but not during the baseline session. Subjects who kept their arm immersed for more than 240 s were classified as high in tolerance. High-tolerance subjects experienced a slower rate of growth in pain intensity than low-tolerance subjects. Theoretical implications of the results are discussed.