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Biomedical subjects

C J Hutchins

Publications and source records attributed to C J Hutchins.

At least 19 recordsLinked to original sources
PubMed1997

The COBE Spectra cell separator is more effective than the Haemonetics MCS-3P cell separator for peripheral blood progenitor cell harvest after mobilization with cyclophosphamide and filgrastim.

BACKGROUND: Peripheral blood is rapidly replacing bone marrow as a source of hematopoietic progenitor cells for autologous transplantation. The advantages of peripheral blood progenitor cell transplantation are enhanced by the ability to collect sufficient progenitor cells to ensure rapid neutrophil and platelet recovery in a single procedure on some cell separators. STUDY DESIGN AND METHODS: A prospective randomized study was undertaken to compare peripheral blood progenitor cell yields from two cell separators (MCS-3P, Haemonetics and Spectra, COBE). Fifteen consecutive patients were mobilized with cyclophosphamide 2 g per m2 (Day 0) and filgrastim 10 micrograms per kg (Days 1-11). Consecutive collections (Day 10, Day 11) were performed with each machine once: patients were randomly assigned to either machine for the initial collection. RESULTS: Collection time was longer on the MCS-3P (p = 0.001), and the volume processed was greater with the Spectra (p < 0.0001). Despite similar nucleated cell yield (p = 0.62), the yield of CD34+ cells (p = 0.001) and colony-forming units-granulocytic-monocytic (p = 0.0001) was significantly higher with the Spectra. The yield of nucleated cells per unit of blood volume processed was higher for the MCS-3P (p = 0.0007), while the CD34+ cell yield (p = 1) and colony-forming units-granulocytic-monocytic yield (p = 1) per unit of blood volume processed were similar for the two machines. The collection of CD34+ cells at levels > 2 x 10(6) per kg (p = 0.063), 5 x 10(6) per kg (p = 0.031), and colony-forming units-granulocytic-monocytic > 1 x 10(5) per kg (p = 0.25) after a single collection was superior for the Spectra. CONCLUSION: The yield of progenitor cells after collection on the Spectra was superior to that achieved with the MCS-3P, because of the larger volume of blood processed per procedure. This would permit more patients to undergo only one collection.

Blood Volume↗
PubMed1997

Detection of minimal residual disease in an AML patient with trisomy 8 using interphase fish.

Patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) often exhibit clonal chromosomal abnormalities. Using a probe for the centromeric region of chromosome 8, fluorescence in situ hybridization (FISH) on interphase cells was used to detect trisomy 8 in an AML patient whose leukemia was characterised by the karyotype 47, XY, +8, del(9) (q21.1q32). We have demonstrated using FISH the presence of the trisomy at all stages of the patient's disease course (including remission, peripheral blood cell harvest and relapse), whereas conventional karyoptypic analysis was only able to detect the trisomy at diagnosis and clinical relapse. We have also shown using immunophenotyping, cell sorting and FISH, that the trisomic cells in this patient were restricted to the CD34+ subset of blood and bone marrow and could not be found in the CD 34-, T or B cell compartment. Overall we have shown FISH to be a rapid, quantitative method for the detection of cells with numerical chromosome abnormalities. FISH analysis of interphase cells provides valuable information on the status of the whole population, rather than just cycling cells, and can be applied successfully to monitor the level of leukemic cells.

Acute Disease↗
PubMed1988

The effect of pelvic floor exercises in the treatment of genuine urinary stress incontinence in women at two hospitals.

The results of the pelvic floor exercises for the treatment of genuine stress incontinence of urine were compared between two different hospitals geographically 50 miles apart. A perineal pad weighing test was used to assess the quantity of urine lost during exercise before and after treatment. A similar percentage of patients in the two studies responded to treatment and became either completely dry or significantly improved at the end of 3 months interval; 69% at LCH and 65% at LGH. Overall, 67% of patients achieved complete continence or a significant improvement as a result of pelvic floor exercises alone.

Adult↗
PubMed1987

Self-cleavage of RNA in the replication of viroids and virusoids.

Viroids are infectious, circular RNA molecules of 246 to 375 nucleotides found in plants. Virusoids are of similar size and structure but they are dependent on, and encapsidated in, a helper virus. A rolling circle mechanism of replication is considered to account for the presence of greater-than-unit-length plus and minus RNAs of both viroids and virusoids found in infected plants. An essential feature of this mechanism is the specific processing or cleavage of high molecular weight intermediates to produce linear monomers which are then ligated to circular monomers. We have investigated the putative processing cleavage reactions using in vitro-synthesized RNA transcripts of dimeric cDNA clones of the 247-nucleotide avocado sunblotch viroid (ASBV) and of partial cDNA clones of the 324-nucleotide virusoid of lucerne transient streak virus (vLTSV). In both cases, there is a specific, non-enzymic, self-cleavage of plus as well as minus transcripts. The plus and minus sites of cleavage are in neighbouring parts of ASBV and of vLTSV and highly conserved two-dimensional structures can be drawn around the cleavage sites as well as around the putative or demonstrated cleavage sites of precursors of the virusoids of three other viruses and of the linear satellite RNA of tobacco ringspot virus. The results also indicate that the sole function of about one-third of the ASBV and vLTSV molecules is provision of sequences that allow the formation of the self-cleavage structures of both 'plus' and 'minus' RNA precursors during the replication cycle. Similar self-cleavage of 'plus' RNA transcripts of a dimeric cDNA clone of citrus exocortis virus (CEV) was not observed. However, the putative processing site for CEV precursors was located within three nucleotides by site-directed mutagenesis. No two-dimensional structures similar to those found for ASBV and vLTSV were found around the processing site. It is possible that a different type of self-cleavage or enzymic processing event occurs during the replication cycle of CEV and related viroids.

Base Sequence↗
PubMed1986

Self-cleavage of plus and minus RNA transcripts of avocado sunblotch viroid.

Self-cleavage of both plus and minus RNA transcripts of the 247-residue avocado sunblotch viroid (ASBV), prepared from tandem dimeric cDNA clones, occurs specifically at two sites in each transcript to give monomeric plus and minus species. The cleavage reaction occurs both during transcription and on incubation of purified transcripts at pH 8 and 37 degrees C in the presence of magnesium ions to give a 3'-terminal 2',3'-cyclic phosphate and a 5'-terminal hydroxyl group. Although the self-cleavage occurs at different sites in the ASBV molecule for the plus and minus species, very similar secondary structures with high sequence homology can be drawn at each site. The results are considered to provide further evidence that ASBV is replicated in vivo by a rolling circle mechanism involving non-enzymic cleavage of high molecular weight RNA precursors of ASBV.

Genes, Viral↗
PubMed1981

PZ-peptidase activity in the pregnant and non-pregnant human cervix.

PZ-peptidase activity was determined in homogenates of cervical tissue from non-pregnant women, women in late pregnancy and women immediately after delivery. There was a significant increase in activity in late pregnancy and a further increase in post-delivery specimens when compared with non-pregnant tissue. A possible link between rising prostaglandin levels and cervical softening is suggested.

Adult↗
PubMed1980

Spinal analgesia for instrumental delivery. A comparison with pudendal nerve block.

One hundred and eighty-three patients undergoing instrumental delivery were randomly divided into two groups, one of which received low spinal anaesthesia and the other pudendal nerve block for delivery. Both were administered by the operator. No patient who received spinal anaesthesia experienced pain. 62% of patients who had a rotational delivery under pudendal nerve block experienced severe pain; 15% had pain during direct delivery. Hypotension was not observed. The incidence of postnatal complications was similar in each group. Low spinal anaesthesia in the hands of the operator provided superior anaesthesia with no increase in complications.

Anesthesia, Obstetrical↗
PubMed1980

Plasma volume changes in pregnancy in Indian and European primigravidae.

Serial measurements of plasma volume were made in 60 normal healthy primigravidae, 30 of European and 30 of Indian origin, matched for age. Recordings wer made at 16, 22, 28, 34 and 38 weeks gestation using the Evan's blue dye dilution technique with the women lying on their sides. A progressive increase in volume was demonstrated to a plateau between 34 and 38 weeks. The plasma volume of the European group was significantly higher at all stages. There was a significant difference in body size between the groups, and European infants had a higher mean birth weight. When plasma volume was expressed in terms of body weight, both groups gave identical results throughout pregnancy. It is unlikely that there is a constant physiological difference between the two groups that might account for differing obstetric performance.

Asian People↗
PubMed1980

Delivery of the growth-retarded infant.

Birth weight percentiles for gestational age were defined in 10,896 normal single live births of known maturity. Six hundred ninety-six infants with birth weights below the tenth percentile were compared with 574 controls to assess the effects of growth retardation and mode of delivery on fetal condition at birth. An Apgar score of less than 5 at 5 minutes was present in 112 growth-retarded infants and 50 normal infants; clinical fetal distress was present in 190 growth-retarded infants and 78 normal infants. Thirty growth-retarded infants died, 21 of them after 36 weeks' gestation. Apgar scores of less than 5 at 1 and 5 minutes were more often seen in immature infants, but the additional effect of growth retardation was not seen in this group. Forty-nine percent of the growth-retarded infants had low 5-minute Apgar scores after delivery by elective cesarean section, although less mature than the control group. Normal and breech deliveries were also more commonly associated with low scoring in growth-retarded infants, although immaturity was rare. Rotational forceps delivery was well tolerated. Breech and normal vertex deliveries were associated with depression at birth and increased perinatal mortality and morbidity in the growth-retarded infant, irrespective of maturity. Delivery by elective cesarean section was not shown to reverse this trend.

Apgar Score↗
PubMed1978

The diagnosis of incomplete abortion.

A prospective study of 203 patients referred with a diagnosis of incomplete abortion is reported and the final histological diagnosis is discussed. Eighty-six patients (42 percent) were not pregnant, and 14 (7 percent) had other abnormalities of pregnancy. Clinical features of value in confirming the diagnosis were cervical dilation (misleading in 6 percent), uterine enlargement (misleading in 31 percent) and pain (misleading in 34 percent). Amenorrhoea was significantly shorter in patients with dysfunctional bleeding and bleeding prolonged in the other groups, but a wide range was noted. Age did not differ significantly between the two groups. A histological diagnosis was made in all but five patients. No clinical feature was completely reliable and curettage was often necessary to reach a final diagnosis.

Abortion, Incomplete↗
PubMed1978

Scalp infection after fetal monitoring in labour.

Neonatal scalp infection was reviewed over a four year period. The occurrence of such infection was found to be 0.14% of those infants monitored in labour using a spiral scalp electrode and 0.16% of those infants undergoing instrumental delivery. The duration of labour and the membrane-rupture delivery interval did not differ significantly from the total population. Scalp infection after monitoring occurred significantly later (day seven) than after instrumental delivery (day three) and was less often associated with positive bacterial cultures. Scalp damage is probably important in the aetiology of scalp infection, and the course of infection related to the degree of trauma.

Delivery, Obstetric↗
PubMed1978

The functioning of a short-stay emergency gynaecological unit.

Admissions to a small constantly staffed emergency gynaecological unit over a two month period are reported. Of 408 patients seen, 230 were in hospital for less than 36 hours and of these 128 were not admitted to a hospital ward. Of a yearly total of 2000 emergency admissions about 1000 did not need admission to a hospital ward. Full staffing of such a unit for 24 hours each day would thus allow a considerable number of beds to be released for elective work. The referring diagnosis of incomplete abortion proved to be incorrect in 100 of 203 patients. Clinical features and management in these patients are discussed. Pain is an unreliable guide, but opening of the cervix is not often seen unassociated with incomplete abortion.

Abortion, Incomplete↗
PubMed1978

The estriol/creatinine ratio in a random urine sample as a screening test.

The estriol/creatinine ratio was determined in a first morning urine sample in 1808 pregnancies in the 32nd week of gestation. The ratio obtained correlated closely with birthweight and showed a linear increase with percentile birthweight group. There was a 25-fold increase in perinatal mortality in those pregnancies with a ratio below the tenth percentile; all pregnancies ending in stillbirths with birthweight below the tenth percentile gave such a ratio. The single estrogen/creatinine ratio allowed the early detection of a group of pregnancies at high risk of intrauterine growth retardation or major total abnormality without inconvenience for the patient.

Birth Weight↗
PubMed1978

A sensitive hemagglutination assay of human chorionic gonadotropin in the diagnosis of ectopic pregnancy.

Hemagglutination assay of human chorionic gonadotropin (hCG) in the urine of patients suspected of having ectopic pregnancies has proved to be a highly sensitive method of detecting the condition. Moreover, the technique is simple and inexpensive. Hemagglutination assays were used in 167 patients with a diagnosis of ectopic pregnancy and in screening 415 patients in whom there was a possibility of ectopic pregnancy. In the former group, hCG titers in urine of more than 500 IU/liter were detected in 136 patients: among the remaining 31, the pregnancies were clinically old and resolving in 22. Low hCG titers were associated with a significantly shorter period of amenorrhea and a protracted clinical course. In the second group, a false-positive rate of 1.7% occurred when the sensitivity of the assay was limited. Increasing the sensitivity of the assay to avoid false-negative results, though also increasing the false-positive rate, would help to reduce the number of cases in which more complex isotope assays are required.

Chorionic Gonadotropin↗