Comprehensive dentistry. Removing the financial barriers.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to D Hill.
Explore the source record for details and available documents.
Nonimmune hydrops fetalis may become the commonest form of hydrops seen in Western countries during the perinatal period, and it has at least a 50% mortality. This report describes five infants with nonimmune hydrops associated with maternal hydramnios and with congenital fetal lesions or disorders, ie, mediastinal teratoma, pulmonary leiomyosarcoma, Beckwith-Weidemann syndrome with omphalocele, fetal tachycardia, and Down's syndrome. Three of the infants survived the neonatal period and two of these underwent surgery for resection of their tumors early in the neonatal period. The third had an omphalocele repaired at 6 hours of age. The literature is reviewed with respect to the pathophysiology of nonimmune hydrops. Its diagnosis and treatment are discussed, with special emphasis on the role of ultrasound in its early diagnosis and optimal prenatal and postnatal management, and on the morbidity seen in survivors.
Explore the source record for details and available documents.
The automatic external defibrillator is a simple device that can be used by nonprofessional rescuers to treat cardiac arrest. In 1287 consecutive patients with out-of-hospital cardiac arrest, we assessed the results of initial treatment with this device by firefighters who arrived first at the scene, as compared with the results of standard defibrillation administered by paramedics who arrived slightly after the firefighters. Of 276 patients who were initially treated by firefighters using the automatic defibrillator, 84 (30 percent) survived to hospital discharge (expected rate according to a logistic model, 17 percent; P less than 0.001), as compared with 44 (19 percent) of 228 patients when fire-fighters delivered only basic cardiopulmonary resuscitation and the first defibrillation was performed after the arrival of the paramedic team. Few patients with conditions other than ventricular fibrillation survived. In a multivariate analysis of characteristics that influenced survival after ventricular fibrillation, a better survival rate was related to a witnessed collapse (odds ratio, 3.9; 95 percent confidence interval, 2.0 to 7.6), younger age (odds ratio, 1.2; 95 percent confidence interval, 1.0 to 1.4), the presence of "coarse" (higher-amplitude) fibrillation (odds ratio, 4.2; 95 percent confidence interval, 1.6 to 11.0), a shorter response time for paramedics (odds ratio, 1.4; 95 percent confidence interval, 1.0 to 2.1), and initial treatment by firefighters using an automatic external defibrillator (odds ratio, 1.8; 95 percent confidence interval, 1.1 to 2.9). These findings support the widespread use of the automatic external defibrillator as an important part of the treatment of out-of-hospital cardiac arrest, although the overall impact of the use of this device on community survival rates is still uncertain.
The question whether the aggregated published research suggests that breast self examination is beneficial was explored in a meta-analysis of 12 studies including a total of 8118 patients with breast cancer that related the practice of breast self examination to regional lymph node state or tumour diameter. Based on the six studies for which data were available, 39% of patients (1115/2852) who reported having done breast self examination at least once before their illness had evidence of cancer in the lymph nodes compared with 50% of women (1348/2713) who had not done the examination. Logistic regression analysis showed this difference to be significant (odds ratio 0.66, confidence interval 0.59 to 0.74). Combining six studies which reported the circumstances of detection disclosed that 42% of women (272/652) who found their tumour while doing breast self examination had evidence of cancer in the nodes compared with 46% of women (871/1901) who found the tumour accidentally; this difference was not significant. Analysis of eight studies which used the diameter of the tumour to indicate the extent of disease tended to confirm the findings on lymph node state, in particular the benefit of premorbid breast self examination. Significantly fewer women who had practised the examination before the illness (56%; 1205/2137) had tumours of 2 cm or more diameter compared with women who had not practised the examination (66%; 1500/2260). The combined odds ratio for that analysis was 0.56, confidence interval 0.38 to 0.81. These findings appear to be good evidence of the benefit of encouraging women to practise self examination of the breasts regularly.
Explore the source record for details and available documents.
Vaporization of atheromas in 10 human aorta segments immersed under flowing blood in vitro were done using the EFF probe. No increase in packed cells of the flowing blood following atheroma vaporization were noted suggesting absence of post vaporization debris. No damage to the aorta underlying the vaporized atheroma was noted on light microscopy suggesting well localized vaporization process. This study suggests that EFF probe might be a safe tool for intravascular endarterectomy.
Since 1976, 23 patients with cyclophosphamide-induced cystitis were treated. These patients presented with a variety of urinary problems, including incontinence, hematuria and vesicoureteral reflux. Vesicoureteral reflux was found in 9 patients, hydronephrosis in 4 and a contracted fibrotic bladder in 3. Of the 23 patients 18 had undergone a combination of radiation and cyclophosphamide therapy. Based on this experience a general outline is developed for evaluation and treatment of patients with cyclophosphamide-induced cystitis and its potentially severe complications.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The Streptococcus cremoris Wg2 proteinase gene, cloned in S. lactis, specified a proteinase which exhibited the same specificity toward casein as did the proteinase isolated from the original host. Although the cloned gene lacked the last 130 codons, the proteinase still specifically degraded beta-casein. Deletion of the C-terminal 343 amino acids from the proteinase did not influence this specificity. Cell-free transcription-translation studies of plasmids carrying deletion derivatives of the proteinase gene showed that the 100-kilodalton C-terminally truncated proteinase still exhibited proteolytic activity. Crossed immunoelectrophoresis revealed that proteins A and B identified in the proteolytic system of S. cremoris Wg2 are both encoded by the proteinase gene. A working model based on integration of available genetic, immunological, and biochemical data is presented to explain this result.
The electromagnetic field focusing (EFF) probe, which is based on the principle of eddy current convergence, produces intense pinpoint heat at its point of contact with tissue. This allows cutting and vaporization of tissue and coagulation of vessels. The present experiments were conducted to study heat distribution to the surrounding tissue in brain and phantom and the effect on the brain of vaporization of intracerebral tumors in 19 rabbits. The follow-up period was as long as 47 days. The heating pattern showed a rise of temperature up to 250 degrees C at the probe tip, with minimal or no temperature increase at 2 mm and beyond. Minimal or no change was noted in the surrounding brain after tumor vaporization, indicating that this system would be safe in the vaporization of brain tumors in clinical neurosurgery.
Explore the source record for details and available documents.
A national survey of 23,359 Australian schoolchildren who were predominantly in the age range of 12-17 years was undertaken in 1984 to determine their levels of use of tobacco and alcohol. The prevalence of current smoking behaviour (that is, at least one cigarette in the past week) rose with age to 34% among girls and 29% among boys at 15 years of age. The prevalence of current drinking behaviour (that is, at least one drink in the past week) rose with age to 49% among girls and 56% among boys at 17 years of age. Very few pupils reported daily drinking but from 15 years of age between 12% and 14% of the sampled students reported smoking every day. Boys who currently smoked and drank reported higher consumptions of tobacco and alcohol than did girls who currently smoked and drank. Most smoking and drinking took place at weekends. Normal responses for intention to smoke in the future, and for drinkers and smokers "self-referent labels" are also reported, and it is suggested that health education programmes for schoolchildren usefully could be focused on these psychological factors.
We have isolated a cDNA molecule from a human adult muscle cDNA library which is deleted in several Duchenne muscular dystrophy patients. Patient deletions have been used to map the exons across the Xp21 region of the short arm of the X chromosome. We demonstrate that a very mildly affected 61 year old patient is deleted for at least nine exons of the adult cDNA. We find no evidence for differential exon usage between adult and fetal muscle in this region of the gene. There must therefore be less essential domains of the protein structure which can be removed without complete loss of function. The sequence of 2.0 kb of the adult cDNA shows no homology to any previously described protein listed in the data banks although sequence comparison at the amino acid level suggests that the protein has a structure not dissimilar to rod structures of cytoskeletal proteins such as lamin and myosin. There are single nucleotide differences in the DNA sequence between the adult and fetal cDNAs which result in amino acid changes but none that would be predicted to change the structure of the protein dramatically.
The electromagnetic field focusing (EFF) probe is capable of producing well circumscribed, intense heat at the point of contact with the tissue. Experimental studies were carried out to assess this probe as a neurosurgical tool using 38 rats and 4 mice with mammary carcinoma. The study on the rats included study of the cutting, coagulating and vaporizing effect on brain tissue including study of blood brain barrier disruption and heat dissipation. The study on the mice included the study of vaporizing property of the probe on solid tumours. The probe proved to be an excellent tool for cutting, coagulating and vaporizing purposes with very minimal disruption of blood brain barrier and demonstrated well circumscribed heating pattern. The study indicates that this tool combines the beneficial effect of both the YAG and CO2 laser.
Autologous adrenal cortex was completely dissected off the medulla using microdissection. The adrenal medulla tissue was transplanted to the lateral ventricle in twenty-one adult rats. Group A consisting of ten animals received 200 units of HCG per 100 gram body weight daily for one week and then on every alternate day for seven weeks. The remaining rats (group B) served as control. After eight weeks the brains were removed and a volumetric study was done using histological sections. High pressure liquid chromatography (HPLC) with electrochemical detection for catecholamine assay of the graft was also undertaken. The graft survival in group A was significantly higher (p less than 0.005) than group B. The level of norepinephrine was significantly higher in group A while dopamine was higher in group B. The higher volume of graft tissue in group A suggests that HCG may help in increased survival and growth of the transplanted tissue. Higher levels of norepinephrine in group A would suggest a tendency for such grafts to be active to a greater extent with the treatment of HCG.