Biomedical subjects
D Cooper
Publications and source records attributed to D Cooper.
Evidence that immune deficiency after marrow transplantation is not caused by AIDS-associated retrovirus.
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Bathrooms designed for the disabled.
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Treatment selection for stage IIIA Hodgkin's disease patients.
Two treatment policies for the therapy of patients with Stage IIIA Hodgkin's disease are compared. From 1969-1976, 49 newly diagnosed and pathologically staged IIIA patients received total nodal irradiation (TNI) alone (no liver irradiation). Although actuarial survival was 80% at 5 years and 68% at 10 years, actuarial freedom from relapse was only 38% at 5 years. Accordingly, a new treatment policy was instituted in 1976. Patients with either CS IIIA disease, multiple splenic nodules, IIIA with a large mediastinal mass or III2, received combined modality therapy (combination chemotherapy and irradiation). All others received TNI. Thirty-six patients have been treated under the new program. The actuarial survival is 90% at 5 years and the relapse-free survival is 87%, suggesting the superiority of this approach.
Monoclonal antibody studies of mammalian epithelial keratins: a review.
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Intestinal microbial flora after feeding phytohemagglutinin lectins (Phaseolus vulgaris) to rats.
Incorporation of purified phytohemagglutinin (PHA) lectins derived from red kidney beans (Phaseolus vulgaris) in the diet of weanling rats will cause growth failure, malabsorption of nutrients, and bacterial overgrowth in the small intestine. These effects are not caused by feeding a similar quantity of PHA to germfree rats. To define the morphological and bacterial changes on the mucosal surfaces of the jejunum, ileum, and cecum in greater detail, we pair fed two groups of weanling rats isocaloric, isonitrogenous diets with or without 0.5% PHA protein. On the jejunal surfaces of control rats, the mucous layer was a confluent covering with sparsely scattered bacteria and protozoa. In PHA-treated rats, the mucous layer was thin and discontinuous, and the microvillous surface of the tissue was extensively populated by bacterial cells of two distinct morphotypes--a gram-negative rod and a gram-positive coccobacillus. In all PHA-treated animals, these bacteria formed adherent monospecific or mixed adherent microcolonies on the tissue surface. Tissue damage was observed in PHA-exposed jejunal tissue as evidenced by vesiculation of the microvillous plasma membrane and by damage to the brush border membrane. On the ileal surfaces of control rats, there was a thick mucous layer within which small numbers of bacteria and protozoa were seen. Segmented filamentous bacteria were anchored in the tissue surface. In PHA-treated rats, the ileal surface was only incompletely covered by a mucous layer, and the overlying mucosal surface was extensively covered by large numbers of protozoan cells (predominantly Hexamita muris). Most of the ileal surfaces not covered by the mucous layer were occupied and virtually occluded by an overgrowth of these protozoan cells with occasional cells of Giardia muris and the tissue-associated segmented bacillus. In the ceca of control rats, the mucosa was incompletely covered by a discontinuous mucous layer and colonized by an unnamed Spirillum sp., other bacteria, and occasional protozoa. The cecal surfaces of PHA-treated rats retained most of their incomplete overlying mucous layer, which was heavily colonized by the same type of Spirillum sp. seen in untreated animals; intestinal crypts were colonized. These descriptive morphological studies demonstrate that exposure to purified PHA in the diet caused characteristic changes in the microbial ecology of the small intestine. The changes in microbial flora contributed to the malabsorption of nutrients in the small intestines of PHA-fed animals.
Classification of human epithelia and their neoplasms using monoclonal antibodies to keratins: strategies, applications, and limitations.
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The significance of left ventricular volume measurement after heart transplantation using radionuclide techniques.
Multigated equilibrium blood pool scanning using Technetium 99m labeled red blood cells was used to measure left ventricular volumes in three heterotopic and one orthotopic heart transplant recipient(s). Simultaneously, an endomyocardial biopsy was performed and the degree of acute rejection was assessed by a histological scoring system. The scores were correlated to changes in ejection fraction and heart rate. Technetium 99m scanning data were pooled according to the endomyocardial biopsy score: no rejection; mild rejection; moderate rejection, and severe rejection. In each group, the median of the left ventricular volume parameters was calculated and correlated with the endomyocardial biopsy score, using a non-parametric one-way analysis of variance. A decrease in stroke volume correlated best with the endomyocardial biopsy score during acute rejection. A decrease in end-diastolic left ventricular volumes did not correlate as well. Changes in the end-systolic left ventricular volumes were not statistically significant, but using a simple correlation between end-systolic left ventricular volumes and endomyocardial biopsy the correlation reached significance. Changes in left ventricular volumes measured by Technetium 99m scanning may be useful to confirm the presence or absence of acute rejection in patients with heart grafts.
Subcutaneous hormone implants for the control of climacteric symptoms. A prospective study.
55 postmenopausal women on established hormone replacement therapy were treated with either oestradiol and testosterone implants or placebo at the time of return of climacteric symptoms. Their response to therapy was assessed prospectively. The statistically highly significant levels of symptom relief that followed an oestradiol and testosterone implant were contrasted sharply with the lack of any significant relief with placebo. Despite the success of oestradiol and testosterone implants in relieving symptoms of the climacteric, symptoms returned once the treatment was stopped. Evidence is presented that it is the fall in hormone levels rather than the level itself that provokes the return of climacteric symptoms.
The use of aIF, AE1, and AE3 monoclonal antibodies for the identification and classification of mammalian epithelial keratins.
Recent data have indicated that specific keratin molecules can provide useful markers for studying different types and stages of epithelial differentiation. To utilize these protein markers, however, it is important to establish the keratin nature of the molecules and identify unambiguously the individual keratin species. In this paper, we show that this can be done relatively easily by one- and two-dimensional gel electrophoresis combined with immunoblotting using three monoclonal antibodies (aIF, AE1, and AE3). The aIF antibody has previously been shown to crossreact with all classes of intermediate-filament proteins. Using one- and two-dimensional immunoblotting, we establish that this antibody recognizes all known epithelial keratins of human and rabbit, although the reaction is relatively strong for the larger, basic keratins and is relatively weak for some of the smaller, acidic keratins. In contrast, AE1 and AE3 monoclonal antibodies have previously been shown to be highly specific for the acidic and basic subfamilies of the keratins, respectively. The combined use of the broadly reacting aIF antibody and the subfamily-specific AE1 and AE3 monoclonal antikeratin antibodies should facilitate the immunological definition, identification, and classification of mammalian epithelial keratins.
Profile of dangerous and non-dangerous offenders referred for pre-trial psychiatric assessment.
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Sex hormones and skin collagen content in postmenopausal women.
Skin biopsy specimens were taken from 29 postmenopausal women who had not been given hormone replacement therapy and from 26 women who had been treated with oestrogen and testosterone implants for two to 10 years. The mean hydroxyproline content and therefore the mean collagen content in the skin was found to be 48% greater in the treated than the untreated women, who were matched for age. This difference was significant (p less than 0.01). The implication of this finding is that oestrogen or testosterone, or both, prevents the decrease in skin collagen content that occurs with aging and protects skin in the same way as it protects bone in postmenopausal women.
Lack of correlation between ocular hypertensive response to topical corticosteroids and progression of retinopathy in insulin-dependent diabetes mellitus.
We studied the relationship of intraocular pressure responsiveness to topical corticosteroids and the development of retinopathy in 86 patients with insulin-dependent juvenile-onset diabetes available for long-term follow-up and examination during 1982. Eleven patients had background retinopathy at the initial examinations. High (GG) and intermediate (NG) corticosteroid responsiveness was more common in these 86 patients (13 high responders and 39 intermediate responders) than in previously reported volunteer series. Background diabetic retinopathy was present at the end of the study in 75 of the 86 patients and proliferative retinopathy was present in 29. The proportions of patients developing either type of retinopathy were similar among the low (NN), intermediate, and high response groups. The rate of diabetic retinopathy development was related to the duration of the disease and not to the intraocular pressure response to topical corticosteroids.
Intensive bedside teaching of physical examination to medical undergraduates: evaluation including the effect of group size.
The effectiveness of intensive bedside teaching of techniques of physical examination of the alimentary system to students commencing their clinical training was assessed. All students viewed a videotape demonstrating these techniques and then participated in a morning practice examination session but only half of the class received afternoon bedside teaching of physical examination in addition. Teaching in history taking was used as a 'placebo' for the control group, and half the students in each of the study and control groups were taught in units of four, the other half in units of eight. Thus the effect of group size could also be estimated. After 1 week, the students' performance of a physical examination was assessed using a standardized scoring chart which demonstrated good reliability. The study group performed significantly better than the control and within the study group there was a trend for the students taught in smaller units to perform better.
Mental health in a remote community.
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Medical library support in rural areas.
Physicians in rural areas often feel professionally isolated due to lack of access to medical center services, particularly library services. To test the need for and use of medical library services, an experimental program was established for physicians in southeastern Kentucky. Physicians were given a toll-free number to call for assistance or to make requests, and persons in two rural locations were trained in the use of basic library reference sources. A communication procedure to a university medical center was established to help patrons obtain information. Evaluation of the service showed that users were much more satisfied with the availability of medical library resources.
Videotape demonstration of physical examination: evaluation of its use in medical undergraduate teaching.
A videotape demonstration of the physical examination of the alimentary system was used, in place of a traditional lecture, in the first week of a teaching programme for half of a group of commencing, clinical students. At the end of the week, these students obtained higher scores than the matched controls in a clinical assessment which utilized an objective scoring-chart especially for this study.
The design and use of an instrumented mG2 capsule filling machine simulator.
The problems of instrumenting a continuous motion dosator nozzle capsule filling machine (mG2 type) are discussed and the construction of an mG2 simulator is described. A standard filling turret is employed with mechanical modification so that the dosator does not rotate. This allows instrumentation in the form of the strain dosator piston, to measure compression and ejection stresses during filling, as well as distance transducers, to measure the corresponding piston and dosator movements. An experimental method is described for using this machine to study the filling of lactose powders.