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Biomedical subjects

C Hill

Publications and source records attributed to C Hill.

At least 145 records · Page 8Linked to original sources
PubMed1998

Prognostic value of histological and biological markers in pharyngeal squamous cell carcinoma: a case-control study.

Between 1980 and 1985, 914 patients with head and neck squamous cell carcinoma underwent lymph node dissection in our institution. The prognostic value of clinical factors has already been reported (Mamelle et al, 1994, Am J Surg 168: 494-498). We present here a comparison of biological characteristics of pharyngeal tumours in patients who developed distant metastasis and in patients without metastasis, matched on tumour site, node site and size, and year of diagnosis. Tumour differentiation, keratinization, vascular emboli, immunohistochemical expression of p53, c-erb-B2, Rb and bcl2 were first assessed in 31 pairs of patients. Factors of potential interest were then determined in 32 additional pairs of patients. Statistical analysis showed that the risk of distant metastasis was halved in patients with tumours expressing c-erb-B2 compared with patients with c-erb-B2-negative tumours (P = 0.05). The significance of c-erb-B2 expression and its potential value as a prognostic factor is discussed.

Biomarkers, Tumor↗
PubMed1998

Critical study of prognostic factors in childhood acute lymphoblastic leukaemia: differences in outcome are poorly explained by the most significant prognostic variables. Fralle group. French Acute Lymphoblastic Leukaemia study group.

We determined the proportion of survival variability explained by the usual prognostic factors in childhood acute lymphoblastic leukaemia (ALL) during a prognostic study of 1552 patients enrolled in three consecutive Fralle group protocols (Fralle 83, Fralle 87 and Fralle 89). The event-free survival rates at 5 years were 54.8% (SD 1.9), 43.1%) (SD 2.7) and 55.6% (SD 2.2), respectively. In the univariate analysis the following variables were predictive of poor outcome: male gender, elevated leucocytosis (> 50 x 10(9)/l), circulating blastosis. haemoglobin >12 g/dl, platelet count <100 x 10(9)/l, age under 1 year or over 9 years, enlarged mediastinum, nodes, spleen and liver, T phenotype, absence of CD10+ cells; testicular and meningeal involvement, poor response to induction therapy (CCSG M3), and LDH >400 U/l. Among the cytogenetic features, hyperdiploidy had a protective effect, whereas hypodiploidy, translocation and other structural abnormalities had a negative influence, particularly in cases of t(9;22) or t(4;11). Multivariate analysis summarized the prognostic information in terms of four variables: age, gender, leucocytosis and cytogenetic features. Missing data had little influence on the results. However, despite their significance in the multivariate analysis, these four variables each had very low predictive power (1.1% for gender, 2.0% for age, 3.5% for leucocytosis, and 1.6% for cytogenetic features). Thus, the most significant prognostic factors in childhood ALL each explain no more than 4% of the variability in prognosis. This may explain the disappointing practical value of these factors and underlines the need for prognostic tools in childhood ALL.

Age Factors↗
PubMed1998

Sequence and analysis of the 60 kb conjugative, bacteriocin-producing plasmid pMRC01 from Lactococcus lactis DPC3147.

The complete sequence of pMRC01, a large conjugative plasmid from Lactococcus lactis ssp. lactis DPC3147, has been determined. Using a shotgun sequencing approach, the 60,232 bp plasmid sequence was obtained by the assembly of 1056 underlying sequences (sevenfold average redundancy). Sixty-four open reading frames (ORFs) were identified. Analysis of the gene organization of pMRC01 suggests that the plasmid can be divided into three functional domains, with each approximately 20 kb region separated by insertion sequence (IS) elements. The three regions are (i) the conjugative transfer region, including a 16-gene Tra (transfer) operon; (ii) the bacteriocin production region, including an operon responsible for the synthesis of the novel bacteriocin lacticin 3147; and (iii) the phage resistance and plasmid replication region of the plasmid. The complete sequence of pMRC01 provides important information about these industrially relevant phenotypes and gives insight into the structure, function and evolution of large gram-positive conjugative plasmids in general. The completely sequenced pMRC01 plasmid should also provide a useful framework for the design of novel plasmids to be incorporated into starter strain improvement programmes for the dairy industry.

Bacteriocins↗
PubMed1998

A new twist to the myocutaneous turnover flap for closure of a spinal defect.

We have described the deepithelialized myocutaneous turnover of a gluteus maximus island flap based on the superior gluteal vessels used for closure of an acquired midline defect of the lower back complicated by cerebrospinal fluid fistula. Cerebrospinal fluid fistula, although a rare complication of an acquired midline back defect, further adds to the reconstructive challenge of such a wound. As this case illustrates, cerebrospinal fluid fistula can have serious and potentially life-threatening implications and so demands rapid surgical intervention. Dural patching with fascia lata graft having already failed, reconstruction was achieved using a well vascularized deepithelialized cutaneous patch on a gluteus maximus island turnover flap. The technique of deepithelializing a skin island for dural repair could be applied to any myocutaneous flap used in reconstruction of a midline back defect complicated by cerebrospinal fluid leak. This provides a method of dural repair and reconstruction of the defect in one step and obviates the need for cerebrospinal fluid diversion.

Aged↗
PubMed1998

Design of a phage-insensitive lactococcal dairy starter via sequential transfer of naturally occurring conjugative plasmids

The plasmid-free Lactococcus lactis subsp. cremoris MG1614 is highly phage sensitive and lacks lactose fermenting ability (Lac) and primary casein degrading ability (Prt). Food grade gene transfer systems were used to sequentially superimpose different phage defense systems on this background, resulting in a gradual increase in resistance to bacteriophage in the derivatives. pLP712, encoding Lac and Prt, was then transferred to one of these hosts, into which plasmids encoding adsorption inhibition, restriction modification, and abortive infection had already been introduced. This resulted in a phage-resistant strain which was successfully used as a single-strain starter for cheddar cheese manufacture under industrial conditions.

Journal Article↗
PubMed1998

Lacticin 3147, a broad-spectrum bacteriocin which selectively dissipates the membrane potential.

Lacticin 3147 is a broad-spectrum bacteriocin produced by Lactococcus lactis subsp. lactis DPC3147 (M. P. Ryan, M. C. Rea, C. Hill, and R. P. Ross, Appl. Environ. Microbiol. 62:612-619, 1996). Partial purification of the bacteriocin by hydrophobic interaction chromatography and reverse-phase fast protein liquid chromatography revealed that two components are required for full activity. Lacticin 3147 is bactericidal against L. lactis, Listeria monocytogenes, and Bacillus subtilis; at low concentrations of the bacteriocin, bactericidal activity is enhanced when target cells are energized. This finding suggests that the presence of a proton motive force promotes the interaction of the bacteriocin with the cytoplasmic membrane, leading to the formation of pores at these low lacticin 3147 concentrations. These pores were shown to be selective for K+ ions and inorganic phosphate. The loss of these ions resulted in immediate dissipation of the membrane potential and hydrolysis of internal ATP, leading to an eventual collapse of the pH gradient at the membrane and ultimately to cell death. Our results suggest that lacticin 3147 is a pore-forming bacteriocin which acts on a broad range of gram-positive bacteria.

Adenosine Triphosphate↗
PubMed1998

Evaluation of lacticin 3147 and a teat seal containing this bacteriocin for inhibition of mastitis pathogens.

Lacticin 3147 is a broad-spectrum bacteriocin produced by Lactococcus lactis subsp. lactis DPC3147 which is bactericidal against a range of mastitis-causing streptococci and staphylococci. In this study, both lacticin 3147 and the lantibiotic nisin were separately incorporated into an intramammary teat seal product. The seal containing lacticin 3147 exhibited excellent antimicrobial activity and might form the basis of an improved treatment for the prevention of mastitis in dry cows.

Animals↗
PubMed1998

Is in-hospital stroke mortality an accurate measure of quality of care?

We examined the validity of using in-hospital stroke mortality as predicted by the Cleveland Hospital Outcomes Indicators of Care Evaluations (CHOICE) model as a measure of quality of care. A total of 223 patients admitted to the hospital for stroke were evaluated by the CHOICE model, which predicted that 19 stroke deaths would occur. We reviewed the 19 patients with the highest predicted mortality, according to CHOICE, and three additional patients who died following stroke. We found that The CHOICE model accurately predicts in-hospital stroke mortality for large populations but not for individual patients. CHOICE and other stroke outcome models rely heavily on early Do Not Resuscitate orders and coma but exclude important variables found in the literature on stroke. No correlation between in-hospital stroke mortality and quality of care was demonstrated. Mortality prediction models used to guide consumers on where to receive stroke care are potentially misleading, as they do not assess functional neurologic recovery or the process of care that are essential elements of quality.

Cerebrovascular Disorders↗
PubMed1998

[Evaluation of the quality of life in clinical research in cancerology].

This article clarifies the methodological aspects of quality of life evaluation and its use in cancer research. The quality of life of an individual is a complex, multidimensional, subjective concept, the perception of which is expressed optimally by individual his/herself. The tools most often used to measure the quality of life in clinical research are based on psychometry. They take at least three dimensions into account: physical, psychological and social. They must be valid, reliable and sensitive. These qualities must be verified again when translated into another language. A review of the main tools is provided. The place to be assigned to quality of life evaluation in clinical research is discussed. Routine evaluation is to be excluded because the quality of life is a subjective phenomenon that is tricky to measure and this evaluation increases the temporal and financial costs of the study, without forgetting the intrusive aspect of this action. On the other hand, as long as it contributes substantially to decision-making regarding the choice of curative or palliative treatments, or interventions necessary for the rehabilitation of the patient, it is an assessment criterion that must be included in the study.

Humans↗
PubMed1998

How many cancers are cured?

One can often read in the lay press that 50% of cancers can be cured. Knowing the frequency and the relative 5-year survival rate for each cancer site, one can estimate the probability of cure. This estimation is presented for cancers diagnosed in 1975, using 5-year survival rates for cancers diagnosed in the period 1978-1985. The 5-year survival probability after a diagnosis of cancer is 37%. The statement that 50% of cancers are cured is too optimistic, and is not based on reliable data. One can nevertheless hope to achieve a 50% cure rate in the beginning of the xxi-st century.

Journal Article↗
PubMed1998

[What rate of cure for cancer?].

One can often read in the lay press that 50% of cancers can be cured. Knowing the frequency and the relative 5-year survival rate for each cancer site, one can estimate the probability of cure. This estimation is presented for cancers diagnosed in 1975, using 5-year survival rates for cancers diagnosed in the period 1978-1985. The 5-year survival probability after a diagnosis of cancer is 37%. The statement that 50% of cancers are cured is too optimistic, and is not based on reliable data. One can nevertheless hope to achieve a 50% cure rate in the beginning of the XXI-st century.

France↗
PubMed1998

Degenerative conditions of the lumbar spine treated with intervertebral titanium cages and posterior instrumentation for circumferential fusion.

Thirty-five consecutive patients were evaluated at an average follow-up time of 20 months after circumferential lumbar spinal fusion. All patients had degenerative conditions of the lumbar spine and same-day anterior spinal fusion by using titanium cages packed with autograft bone and posterior instrumentation combined with a posterolateral autogenous bone graft. The purpose of this study was to determine whether anterior titanium cage placement and posterior instrumentation with autologous bone graft was a safe and efficacious procedure in patients with degenerative disease of the lumbar spine. Fusion rates, complications, pain relief, medication use, and work status were specifically analyzed. Although previous reports documented the use of this technique for trauma and tumor cases, few studies assessed clinical and radiographic results in patients with degenerative conditions of the lumbar spine. Plain radiographs were used to determine spinal fusion at each spinal level. All patients were administered preoperative and postoperative questionnaires regarding three specific clinical-outcome parameters. These consisted of pain level, medication use, and work status. Intraoperative and postoperative complications were also documented. Radiographic results showed that 61 (97%) of 63 lumbar levels undergoing an arthrodesis procedure fused either anteriorly, posteriorly, or both. Of the 35 patients in this series, 33 (94%) fused at all levels, and two did not. Substantial pain relief was reported in 46% of all patients. Thirteen (37%) patients had one or more surgical complications. Circumferential spinal fusion in patients with degenerative etiologies yields excellent radiographic fusion rates and good pain relief. The procedure is technically demanding and is associated with a high rate of complications.

Adult↗
PubMed1997

The binding of both [3H]nemonapride and [3H]raclopride is increased in schizophrenia.

We performed a postmortem autoradiographic study to compare the density of dopamine D4-like sites in caudate putamen section from age-matched schizophrenia (n = 15) and control (n = 15) populations. The densities of the D4-like sites were estimated by subtracting the density of [3H]raclopride (binding D2 and D3 receptors) from the density of [3H]nemonapride (binding D2, D3, and D4 receptors). The findings revealed that in the schizophrenia population there was a significant increase in the binding of both [3H]nemonapride (2.3-fold) and [3H]raclopride (1.9-fold). In addition, in the schizophrenia population the density of D4-like sites was increased 2.6-fold.

Adult↗
PubMed1997

Results of a European randomized trial of Etanidazole combined with radiotherapy in head and neck carcinomas.

PURPOSE: The aim of the study was to evaluate the efficacy and toxicity of Etanidazole, a hypoxic cell sensitizer, combined with radiotherapy in the treatment of head and neck squamous cell carcinoma. METHODS AND MATERIALS: A total of 374 patients from 27 European centers were included in this trial between 1987 and 1990. Treatment was either conventional radiotherapy alone (between 66 Gy in 33 fractions and 74 Gy in 37 fractions, 5 fractions per week), or the same radiotherapy dose plus Etanidazole 2 g/m2, three times weekly for 17 doses. A minimization procedure, balancing for center, site, and T stage (T1-T3 vs. T4) was used for randomization. RESULTS: Among the 187 patients in the Etanidazole group, 82% received at least 14 doses of the drug. Compliance to the radiotherapy protocol was 92% in the Etanidazole group and 88% in the control group; the main cause of deviation was acute toxicity, which was observed at an equal rate in the two treatment groups. Fifty-two cases of Grade 1 to 3 peripheral neuropathy were observed in the Etanidazole group vs. 5 cases, all of Grade 1, in the control group (p < 0.001). The 2-year actuarial loco-regional control rates were 53% in the Etanidazole group and 53% in the control group (p = 0.93), and the overall 2-year survival rates were 54% in each group (p = 0.99). CONCLUSION: Adding Etanidazole to conventional radiotherapy did not afford any benefit for patients with head and neck carcinoma. This study failed to confirm the hypothesis of a benefit for patients with N0-N1 disease, which had been suggested by the results of a previous study (10).

Adult↗
PubMed1997

The pattern and structure of one-person households in England and Wales and France.

"This paper examines the increase of one-person households during the 1980s in England and Wales and France set within the broader context of household change in Europe as a whole....One-person households vary geographically by age, with younger one-person households found especially in larger urban areas; older one-person households have a more varied distribution, although rural and traditional retirement areas have particular concentrations. Increases in numbers are a result of both compositional changes in the population (increasing numbers of divorced and never-marrieds as well as increasing numbers of elderly) and also an increasing propensity to live alone, especially among younger age groups."

Age Factors↗