Biomedical subjects

C J Alexander

Publications and source records attributed to C J Alexander.

At least 37 records · Page 2Linked to original sources

PubMed1995

Lewis X antigen immunostaining in the diagnosis of transitional cell carcinoma.

Immunodetection of the Lewis X antigen has been suggested as a useful adjunct in the diagnosis of transitional cell carcinoma. To determine the specificity of Lewis X antigen immunostaining in this setting, we studied routinely processed, formalin-fixed tissue from 38 transitional cell carcinomas and 42 nonneoplastic urothelial lesions using the P12 monoclonal antibody to Lewis X antigen and an avidin-biotin immunohistochemical technique. Because Lewis X immunostaining of occasional umbrella cells has previously been noted in normal urothelium, staining of umbrella cells was not considered sufficient for a positive reaction in our study. Immunoreactivity for Lewis X antigen was seen in 34 of 38 (89%) cases of transitional cell carcinoma, in three of three cases of urothelial dysplasia, and in 20 of 39 (51%) of the reactive urothelial lesions. We conclude that immunostaining for the Lewis X antigen is not specific in the diagnosis of transitional cell carcinoma.

Antibodies, Monoclonal↗

PubMed1994

Relation between the finger positions used in the precision and partial power grips and the regional prevalence of osteoarthritis.

The correlation between digital flexion angles used in the precision and partial power grips and the reported regional prevalence of osteoarthritis was studied by goniometric measurement of six female subjects using the grips in 40 preselected activities. Normal interphalangeal ranges were determined by goniometric measurement in 20 normal female subjects. Both grips show a highly significant inverse correlation between mean flexion at each joint and the local prevalence of osteoarthritis. The conflict between these data implicating underuse and those supporting the theory of overload can be reconciled by postulating that primary and secondary osteoarthritis arise from different mechanisms. The former may be bifactorial, with incomplete use initiating the process and cartilage loading determining the rate of progress.

Adult↗

PubMed1994

Utilisation of joint movement range in arboreal primates compared with human subjects: an evolutionary frame for primary osteoarthritis.

OBJECTIVE: To determine whether an arboreal lifestyle required full use of movement ranges underutilised in nine joint groups in humans, because under-utilisation of available movement range may be associated with susceptibility to primary osteoarthritis. METHODS: Utilisation of the nine joint groups was studied in two species of primate exercising in a simulated arboreal environment, using 'focal animal' observation techniques supplemented by telephoto photography and by review of archival material from other sources. Fifteen apes were observed over a total observation period of 20.2 man-hours and 152 films were analysed for utilisation of movement range. RESULTS: With one exception, all the movement ranges reported to be under-utilised in humans were fully utilised by the apes in climbing activities. The exception, metacarpophalangeal extension, was an essential component of the chimpanzee ground progression mode of knuckle walking. CONCLUSIONS: The underused movement range in several human joints is explicable as residual capacity from a semiarboreal lifestyle. If the correlation with primary osteoarthritis is confirmed, it suggests that the disease may reflect a disparity between inherited capacity and current need. The significance of the result lies in its implication that primary osteoarthritis may be preventable.

Animals↗

PubMed1993

Osteoarthritis of the metacarpophalangeal joints: the relation between ray prevalence, trauma, and utilisation.

The gradient in prevalence of idiopathic osteoarthritis of the metacarpophalangeal (MCP) joints from the index to the little finger was used to test three theories. Trauma was correlated by analysis of fracture incidence in the four rays in 142 patients. Correlation with utilisation of arc was assessed by goniometric measurement of mean MCP flexion in five hand positions in a sample of 200 activities, and recording utilisation of these positions by behavioural observation techniques in the course of 2831 actions, 2746 domestic and 85 nondomestic. Both correlations were negative. The hypotheses of excessive loading and incomplete use were compared and tested against external evidence. It is suggested that the gradient in MCP prevalence of osteoarthritis is consistent with a bifactorial aetiology, with site and incidence determined by incomplete use, and with the rate of progress by cartilage loading.

Female↗

PubMed1993

Sexual activities, desire, and satisfaction in males pre- and post-spinal cord injury.

Thirty-eight spinal cord injured (SCI) males (median age = 26) completed an 80-item multiple choice questionnaire (median 37 months postinjury) which assessed sexual functioning pre- and post-spinal cord injury in four areas: (i) sexual activities and preferences, (ii) sexual abilities, (iii) sexual desire, arousal, and satisfaction, and, (iv) sexual adjustment. Frequency of sexual activity decreased following SCI with a reduction in intercourse and increased interest in alternative sexual activities. Of complete quadriplegic subjects 38% reported the ability to have an orgasm accompanied by ejaculation underscoring the need for physiological studies. Partner's desire for sex as perceived by the SCI individual was correlated with frequency of sex and numbers of sexual partners postinjury. Subject's perceptions of their own and partner's sexual desire decreased following SCI. Sexual satisfaction decreased postinjury and was positively correlated with both the patients' and their partners' interest in penile-vaginal intercourse. Of the subjects, 27% reported sexual adjustment difficulties and 74% relationship difficulties but only 22% received counseling. Results indicate the importance of the availability and desire of a sexual partner in the sexual activities and satisfaction of the SCI individual. SCI patient and staff sexual education and counseling continue to be strong needs.

Adolescent↗

PubMed1993

Sexual activities, response and satisfaction in women pre- and post-spinal cord injury.

Twenty-five spinal cord injured (SCI) women (median age = 34) completed an 80-item multiple choice questionnaire (median 50 months postinjury) that assessed sexual functioning pre-spinal cord injury and post-spinal cord injury in four areas: (1) sexual adjustment; (2) sexual activities and preferences; (3) sexual desire, arousal and satisfaction; and (4) sexual abilities. Frequency of sexual activity decreased following SCI. Intercourse was the favorite activity preinjury; whereas, kissing, hugging and touching were favored postinjury. Sexual desire and satisfaction decreased postinjury. Ability to achieve lubrication and orgasm with various types of spinal injuries is reported. Although most women did not receive sexual information or counseling, 76% of the sample believed they had been adjusting well sexually. Results are discussed accounting for the limitations of self-report methodology in sexuality research. The need for laboratory based, physiologic studies is underscored.

Adolescent↗

PubMed1993

Long-term use of computerized bicycle ergometry for spinal cord injured subjects.

Twenty-eight spinal cord injured subjects who participated in an electrical stimulation bicycle ergometry home program were surveyed to determine perceived benefits, home exercise adherence, and predictors of continued home exercise with electrical stimulation. Subjects were classified as users or nonusers depending upon if they used the electrical stimulation ergometry on a regular basis in the home during the past four months. Nineteen subjects qualified as users and nine were nonusers. Ninety-five percent of the users cycled at least twice per week whereas the majority of the nonusers stopped regular home exercise within one month postclinic discharge. All subjects generally perceived increases in muscle bulk and endurance. Users and nonusers perceived inconsistent results related to spasticity. Minimal effects were noted with neurogenic pain and swelling. Adherence to the home exercise program was significantly related to sex of subject and pre-injury exercise habits. Results are discussed in relation to the costs and benefits of electrical stimulation bicycle ergometry in the home.

Adolescent↗

PubMed1992

The threshold effect: consequence of change in the frequency of food intake in the presence of a functional threshold.

Studies on diseases thought to be diet-induced have so far assumed that the effect of a food depends solely on the amount ingested. When the metabolism of a food derivative is dependent on a threshold-dependent mechanism this single variable assumption is invalid, as the net effect of the derivative will also depend on intake frequency. In this paper the consequences of varying intake frequency in the presence of a notional threshold are analysed mathematically. It is shown that at the low frequency end of the scale relevant to human diet, if a metabolic threshold exists then the net effect of a food will be critically dependent on intake frequency, and that the effect of changing frequency may exceed that produced by even substantial changes in quantum. It is concluded that epidemiological studies which have not included data on frequency of intake involve a potential error and could be misleading.

Diet↗

PubMed1991

Psychological assessment and treatment of sexual dysfunctions following spinal cord injury.

Sexual dysfunction following SCI has received increased attention in recent years. Despite this attention, many physicians and allied health care workers respond to patients' sexual concerns with dismissal or reassurance. Moreover, physiological and medical aspects of sexual dysfunction tend to be emphasized at the exclusion of the emotional aspects of sexuality. A multidimensional, integrative approach to the assessment and treatment of sexual dysfunctions across the entire sexual response cycle following SCI is emphasized. The rationale and procedure of brief sexual counseling is discussed.

Humans↗

PubMed1990

Osteoarthritis: a review of old myths and current concepts.

Radiology is dependent on an accurate understanding of the pathological process. This review of primary osteoarthritis identifies eight areas in which widely held concepts are either demonstrably false or fall short of proof. In some, the concepts have been disproved by the gradual accumulation of evidence. In others, the error is due to radiological misinterpretation while in a third group, the evidence is not in dispute, but the logical framework used in its assessment is flawed. Awareness of these deficiencies simplifies radiological interpretation and clarifies research objectives.

Aging↗

PubMed1989

Relationship between the utilisation profile of individual joints and their susceptibility to primary osteoarthritis.

Two subjects were studied for 1 to 3 weeks during the course of their normal domestic activities. Utilisation profiles were derived for ten joints, using a systematic time-series sampling technique adapted from behavioural biology. At each joint the proportion of the available range utilised was noted. The results were compared with the known regional prevalence of primary osteoarthritis. There was a correlation between the degree to which a joint was incompletely utilised, and its susceptibility to osteoarthritis. The hypothesis is advanced that primary osteoarthritis may be due to incomplete joint utilisation.

Activities of Daily Living↗

PubMed1988

Prevention of steroid-induced osteoporosis with (3-amino-1-hydroxypropylidene)-1,1-bisphosphonate (APD).

In a prospective, randomised, placebo-controlled trial comparing the effect of (3-amino-1-hydroxypropylidene)-1,1-bisphosphonate (APD) (150 mg/day) plus calcium (1 g/day) with that of calcium alone on the bone mass of patients receiving long-term glucocorticoid therapy, the mean metacarpal cortical area in patients receiving APD increased by 1.2% between 0 and 6 months (p less than 0.06) and then remained stable between 6 and 12 months. In contrast, this index progressively declined in the placebo group (p less than 0.05 at 12 months). The two groups differed significantly in the changes at both 6 and 12 months (p less than 0.01). Mean vertebral mineral density, as measured by quantitative computed tomography, increased by 19.6% over 12 months in the APD group (p less than 0.02) but showed a non-significant decline of 8.8% in controls. The differences between the changes were again significant (p less than 0.005). Biochemical indices and bone histomorphometry indicated a reduction in bone resorption and bone formation but there was no evidence of osteomalacia. APD may thus prevent bone loss in glucocorticoid-treated patients over a year.

Calcium↗

PubMed1988

The threshold effect: consequences of change in the frequency of food intake in the presence of a functional threshold.

Eating↗

PubMed1982

Hepatic and splenic haemorrhage as a complication of toxaemia of pregnancy in a patient with circulating lupus anticoagulant.

A 29 year old pregnant woman presented at 28 weeks with severe upper abdominal pain. Features of pre-eclamptic toxaemia became apparent and intrauterine death occurred abruptly. The development of shock, a reduction in haemoglobin from 124 to 88 g/l without evidence of external blood loss and tender hepatosplenomegaly suggested major intrahepatic and intrasplenic haemorrhage. This suggestion was supported by ultrasound and CT scans. The patient made a complete recovery over a period of weeks. She was shown to have a circulating LE-inhibitor and had major thrombotic episodes involving her leg veins.

Adult↗

PubMed1979