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Biomedical subjects

B M Jones

Publications and source records attributed to B M Jones.

At least 19 recordsLinked to original sources
PubMed1992

Pulmonary angiography in a non-teaching hospital over a 12-year period.

OBJECTIVE: To report the safety of pulmonary angiography in a non-teaching hospital and discuss the place of this investigation in the diagnosis of pulmonary embolism. DESIGN AND SETTING: A retrospective review of all patients undergoing pulmonary angiography over a 12-year period, November 1979 to October 1991, at Dandenong Hospital, Melbourne. A protocol was established whereby each procedure was performed with the assistance of staff and equipment from the intensive care unit to provide haemodynamic monitoring and measurement of pulmonary artery pressures. PATIENTS: During the review period 114 patients underwent pulmonary angiography, most (108) for suspected pulmonary embolism. RESULTS: One hundred and fifteen pulmonary angiograms were performed, and no deaths related to the procedure occurred. Complications included perforation of the right atrium in three patients, with no sequelae. Cardiac arrhythmias were common but self-limiting. CONCLUSION: In our series, pulmonary angiography was a safe procedure if undertaken with the appropriate monitoring measures. A protocol which includes the participation of the intensive care unit has proved helpful. In addition, it was found that clinical symptoms and signs were unreliable and in 24 patients who also had ventilation-perfusion (V/Q) scans, only seven scans were accurate. A review of the literature indicates that V/Q scans lack specificity and that pulmonary angiography may be performed safely. The latter investigation should be more frequently performed.

Angiography↗
PubMed1992

Longitudinal study of quality of life and psychological adjustment after cardiac transplantation.

OBJECTIVE: To assess the psychological adjustment and quality of life of a sample of cardiac transplant recipients over time. DESIGN: The patients were consecutive recipients of new hearts which were transplanted between November 1984 and December 1986. Thirty-eight patients were entered into the study, but at final follow-up only 27 were assessed; six patients had died and five could not be contacted. Patients were seen before transplantation, at discharge, then at 4, 8 and 12 months after transplantation and finally at a mean of 4.2 years after transplantation. They were assessed by means of standardised questionnaires. The results were compared across time and correlated with demographic data and medical data collected at the initial assessment. Only patients who were alive and responded at each point of follow-up were included in the study. SETTING: All patients were seen at St Vincent's Public Hospital and were tertiary care patients. MAIN OUTCOME MEASURES: The main outcome measures were anxiety, depression and well-being. These measures were assessed by means of the Spielberger State Trait Anxiety Scale, the Beck Depression Inventory and the Campbell Well-Being Scale. At the four year follow-up the Nottingham Health Profile was also used. RESULTS: Scores for anxiety, depression and well-being improved significantly after transplantation and did not deteriorate over time. No significant correlations were found between psychological measures and medical or demographic data. CONCLUSIONS: The results showed no evidence of mood disorder and a high level of well-being in this sample of cardiac transplant recipients up to four years after transplantation.

Adaptation, Psychological↗
PubMed1992

Defective B-cell and regulatory T-cell function in Wiskott-Aldrich syndrome.

We report two Chinese boys with Wiskott-Aldrich syndrome presenting with gastro-intestinal bleeding, eczema and recurrent infection. They had thrombocytopenia and the mean platelet volume was small. Serum IgG and IgA were elevated and lymphocyte proliferation in response to phytohaemagglutinin, concanavalin A and pokeweed mitogen was defective. Despite documented herpes simplex virus type 1 and cytomegalovirus infection in one patient, he did not mount any humoral response. The generation of antibody-secreting cells in response to pokeweed mitogen was markedly defective in a plaque-forming cell assay. Both patients' regulatory T-cell and B-cell functions were defective in this assay. The genetic defect in Wiskott-Aldrich syndrome therefore affects T-cells, B-cells and platelets.

Antibody Formation↗
PubMed1992

Relationship between intracranial pressure and intracranial volume in craniosynostosis.

Premature fusion of cranial sutures in craniosynostosis has been thought to lead to craniostenosis, which in turn may lead to increased intracranial pressures. In 41 consecutive patients with craniosynostosis, intracranial pressure and intracranial volume were measured. Of the 41 patients, 38 (92.6%) had raised intracranial pressure but only 4 (9.7%) had a decreased skull volume. In the present study, there is no correlation between intracranial volume and intracranial pressure. This study confirms that the measurement of intracranial volume, a non invasive procedure, cannot be used to assess intracranial pressure and to avoid an invasive procedure.

Aging↗
PubMed1992

Complications in paediatric craniofacial surgery: an initial four year experience.

107 children undergoing transcranial craniofacial surgery in a paediatric hospital have been reviewed to assess the incidence and type of complications which arose. This represents the first 4 years' experience of the craniofacial team. There were no deaths or permanent adverse sequelae of surgery. A total of 53 complications were seen in 42 patients. In 9.3% of patients they were potentially life-threatening, serious in 12.1% and of a minor nature in 28%. The more serious complications were related either to haemorrhage and/or vasovagal shock at operation or to infection post-operatively. Infants undergoing monoblock frontofacial advancements and those with tracheostomies were at particular risk.

Adolescent↗
PubMed1992

Cell-cycle progression rates and sister chromatid exchange frequencies in the bone marrow of patients with myelodysplastic syndrome and acute myeloid leukemia.

The proliferation characteristics of leukemic cells may be a determining factor in disease course and response to therapy. The present study compares the rate of cell-cycle progression in the bone marrow of 16 hematologically normal subjects, 19 patients with acute myeloid leukemia (AML), and 23 patients with myelodysplastic syndrome (MDS). The frequency of sister chromatid exchanges (SCE) in bone marrow cells is also compared. MDS and AML patients showed a reduction in the rate of cell-cycle progression compared with normal subjects. Patients with 'high risk' MDS (RAEB/RAEB-t) did not differ significantly from patients with AML but had a significantly slower rate of cell-cycle progression than patients with 'low-risk' MDS (PASA/RA). There was no correlation between the rate of cell-cycle progression and clonal karyotype status or the percentage of blast cells in either MDS or AML. There were no significant differences in SCE frequency between normal subjects and MDS or AML patients.

Acute Disease↗
PubMed1992

Chromosome aberrations following cytotoxic therapy in patients in complete remission from lymphoma.

The frequency of chromosome aberrations in the peripheral blood of patients successfully treated for Hodgkin's disease (HD) and non-Hodgkin's lymphoma is compared with that seen in age-matched haematologically normal subjects. Findings are considered in relation to risk factors associated with the development of secondary myelodysplastic syndrome (MDS) or acute myeloid leukaemia (AML). Overall aberration frequencies were not significantly increased in patients compared with normal subjects. However, there were differences in aberration type. The frequency of exchanges was significantly higher among patients (P less than 0.01) and the frequency of gaps lower (P less than 0.0005). The mean frequency of exchanges was also greater in patients receiving multiple compared to single courses of therapy (P less than 0.0005) and in patients receiving radiotherapy or combined modality therapy compared to chemotherapy alone (P less than 0.005 and P less than 0.0005). Four patients had aberration frequencies greater than 2 SD above the patient mean. One of these was also found to have a mutation of the ras oncogene. None of the patients has yet developed secondary MDS/AML.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

The effect of palate repair on otitis media with effusion.

Cleft palate in children is very frequently associated with otitis media with effusion. In this prospective study of 150 cleft palate children aged between 2 and 18 months, the prevalence of otitis media with effusion at myringotomy before palate repair was 92 percent. Otoscopic and tympanometric follow-up assessments for 140 children indicate that there is minimal improvement in middle ear status after palate repair. The condition is persistent in 70 percent of children up to 4 years of age. Furthermore, there is no evidence that age at repair or type of cleft is influential. These findings have implications for otologic management of cleft palate children. Early routine unilateral ventilation to ensure adequate hearing but minimize the morbidity of ventilation tubes is advocated.

Cleft Palate↗
PubMed1992

Intracranial pressure and intracranial volume in children with craniosynostosis.

Intracranial volume and intracranial pressure have been measured in 66 children with craniosynostosis, 48 boys and 18 girls. The premature fusion of skull sutures is assumed to restrict skull growth and predispose to elevated intracranial pressure. Thirteen children (20 percent) had raised intracranial pressure and demonstrated a significant restriction of skull growth. In this series, volume measurement alone, however, did not serve as a reliable predictor that the intracranial pressure was raised.

Adolescent↗
PubMed1992

Biphasic rise of serum immunoglobulins G and A and sex influence on serum immunoglobulin M in normal Chinese children.

A study was conducted on 751 healthy children from child health clinics, kindergartens and schools, and 80 normal adults to establish reference ranges for serum immunoglobulins (Ig) G, A and M concentrations in normal Chinese. Serum IgG, IgA and IgM concentrations were determined by nephelometry. Serum IgG and IgA were shown to have a significant rise during the preschool age as well as at puberty with a plateau phase in between. This biphasic maturation profile has not been reported in Caucasians and the reasons for the observed difference have yet to be elucidated. Serum IgM concentrations were shown to be higher in females than in males, reaching significance in most age groups beyond 4 years of age. The difference between the two sexes in Chinese was of similar magnitude as that reported for Blacks and Caucasians, that is, 30%. Our findings support the hypothesis that the human X chromosome may carry quantitative genes for IgM.

Adolescent↗
PubMed1991

Parotid haemangioma in infants: MR imaging at 1.5T.

Parotid gland neoplasms are uncommon and account for less than 2% of human tumours. Haemangiomas account for about 50% of parotid tumours in infants and children compared to only 2% in adults. As the clinical course of infantile haemangiomas may be self limiting and the initial treatment is expectant, early and accurate diagnosis is essential. We report 3 cases of paediatric parotid haemangioma and discuss the Magnetic Resonance (MR) characteristics of these tumours. In two cases the diagnosis was proven histologically and in one case Computed Tomography (CT) was also performed.

Female↗
PubMed1991

Defective neutrophil and lymphocyte function in leucocyte adhesion deficiency.

We report a Chinese girl with the moderate phenotype of leucocyte adhesion deficiency (LAD), presenting with persistent omphalitis and recurrent soft tissue infections. She had subnormal adhesion-dependent neutrophil functions, such as chemotaxis and chemiluminescence response to a particulate stimulant (opsonised zymosan). Despite her adequate humoral response to documented herpes simplex virus type 1, parainfluenza type 2 and adenovirus infection in vivo, there was marked impairment in the generation of plaque-forming cells (PFC) driven by pokeweed mitogen (PWM) in vitro. IgM PFC were less severely affected than IgG and IgA PFC, probably because IgM production is less dependent on T cell help than IgA and IgG production. The patient's B cells and accessory cells had reduced function compared with the control subsets, while helper function of her CD4+ cells was virtually absent in the PWM-driven PFC assay. She also had marked defect in natural killer cell activity. The proliferation of her lymphocytes was normal to several plant lectins, including phytohaemagglutinin, concanavalin A and PWM, but markedly defective to OKT3.

Antigens, CD↗
PubMed1991

Aberrant T-regulation in rheumatoid arthritis and IgA nephropathy affects CD5+ and CD5- B lymphocytes equally.

T-suppressor function and T-helper function in healthy adults, elderly patients with non-immune diseases, and patients with rheumatoid arthritis (RA) and IgA nephropathy (IgAN) were titrated by adding graded concentrations of CD8+ cells to autologous CD8-depleted peripheral blood mononuclear cells (PBMC), or CD4+ cells to CD8- 4- PBMC, respectively. Following culture with pokeweed mitogen (PWM), numbers of CD5+ and CD5- immunoglobulin-secreting cells were determined using a combination of rosetting with anti-CD5-coated Dynabeads and reverse haemolytic plaque formation (Jones, 1990). Of 11 RA patients studied, eight had slightly reduced suppressor activity for CD5+ and CD5- IgM-secreting cells, and three with active disease and high serum levels of C-reactive protein, could not suppress IgG, IgA or IgM secretion by either B subset. Helper activity for both CD5+ and CD5- B cells was slightly but significantly increased in RA patients. One of eight patients with IgAN could not suppress IgG, IgA or IgM production by CD5+ or CD5- B cells, and all IgAN patients required strikingly fewer CD4+ cells for PWM-induced activation of CD5+ and CD5- B cells than controls. It was concluded that in two immunologically mediated diseases in which some patients have raised numbers of circulating CD5+ B cells, aberrant T-regulation affects CD5+ and conventional CD5- B cells equally.

Antibody Formation↗
PubMed1991

CD5+ B-lymphocytes are as dependent on T-helper cells and as responsive to T-suppressor cells in pokeweed mitogen-stimulated activation as conventional CD5- B-lymphocytes.

Pokeweed mitogen (PWM)-stimulated cultures were established with varying numbers of CD4+ or CD8+ cells and CD5+ immunoglobulin-secreting cells were subsequently identified using a combination of haemolytic plaque formation and rosetting with immunobeads coated with anti-Leu-1. It was found that CD5+ and CD5- B-cells required similar numbers of CD4+ cells for half-maximum plaque-forming cell (PFC) induction and that 50% suppression of both CD5+ and CD5- PFC occurred with similar numbers of CD8+ cells. Suppression of both CD5+ and CD5- PFC could occur when T-helper signals were supplied by a PWM-stimulated culture supernatant, indicating that both subsets could be directly suppressed by CD8+ cells rather than by indirect suppression of T-helper cells. It is concluded that CD5+ B-cells are as responsive to T-regulatory influences as conventional CD5- B-cells.

Adult↗