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Biomedical subjects

D Jenkins

Publications and source records attributed to D Jenkins.

At least 235 records · Page 13Linked to original sources

Association of fetal growth with elevated maternal plasma zinc concentration in human pregnancy.

This report consists of two separate studies. Study I was a prospective one in which 23 pregnant women ultrasonically diagnosed as having small fetuses were compared with 22 women with large fetuses. Maternal plasma zinc concentrations pre- and post-35 weeks gestation were significantly higher in mothers of small than in mothers of large infants. Twelve women with normal pregnancies participated in study II. Biochemical data obtained in maternal plasma during the third trimester of pregnancy, including total, albumin-bound and alpha 2-macroglobulin-bound plasma zinc concentrations and plasma copper concentration were compared with infant anthropometric data at birth. The results indicated significant negative correlations between maternal plasma zinc and albumin-bound zinc concentrations and plasma copper concentration in the third trimester of pregnancy and mid-arm circumference and ponderal index. The results of these studies, in the light of other data reported for primates and humans, suggest the need for a more extensive investigation of the relationship between maternal circulating zinc and copper concentrations and fetal growth.

Adult↗

Long-term ambulatory treatment of metastatic colorectal adenocarcinoma by continuous intravenous infusion of 5-fluorouracil.

To delineate the efficacy of continuous intravenous 5-fluorouracil (5-FU) infusion therapy for advanced colorectal adenocarcinoma, a study of 36 patients with measurable metastatic disease was conducted. Patients received a daily intravenous infusion of 300 mg/m2 5-FU over a 24-h period utilizing portable infusion devices and central venous catheters. In a population characterized by substantial pretreatment exposure to radiotherapy, chemotherapy, and other indicators of poor prognosis, 13/36 (36%) patients achieved an objective response. An additional 10/36 (28%) patients manifested stable disease (no change) and experienced survival comparable to that of patients with objective response. Toxicity was minimal; patients were able to continue 5-FU infusions 95% of the total time on protocol. There were no adverse hematologic effects or catheter complications. Because previously untreated patients benefited more frequently (positive response, 50%), continuous intravenous infusion should be evaluated further as a primary modality option when 5-fluorouracil antitumor chemotherapy is contemplated.

Adenocarcinoma↗

Expression of fibronectin, laminin, and factor VIII-related antigen during development of the human cutaneous microvasculature.

The regulation of angiogenesis during human skin development is poorly understood. Since fibronectin is involved in cell movement and organization during embryogenesis and morphogenesis in a variety of species, we investigated the expression of fibronectin and factor VIII-related antigen, a marker for endothelial cells, at various stages in the development of the human cutaneous microvasculature. Skin specimens were obtained from 4 human fetuses during the second trimester (14-18 weeks), from newborn foreskins, and from consenting normal adults. Cryostat sections were stained with both fluorescein-conjugated rabbit antihuman fibronectin and rhodamine-conjugated goat antihuman factor VIII-related antigen. Expression of fibronectin in the microvasculature was striking in fetal skin but became progressively less prominent with maturation. Fibronectin appeared in fetal blood vessels as a bright continuous linear array, in neonatal blood vessels as a bright interrupted linear and speckled array, and in adult blood vessels as a sparse interrupted linear and speckled array. In contrast, expression of factor VIII-related antigen by the endothelium became more prominent with the degree of maturation of the microvasculature. Granular factor VIII-related antigen staining was scant in the newly forming blood vessels of fetal skin, bright but focal in the microvasculature of newborn skin, and intense and almost confluent in the blood vessels of adult skin. Although expression of fibronectin and factor VIII-related antigen changed, expression of laminin was consistent throughout development. Staining of the same skin specimens with fluorescein-conjugated sheep antihuman laminin produced a bright continuous linear pattern in all blood vessels. The reciprocal relationship manifested by intense fibronectin staining during human blood vessel development and prominent factor VIII-related antigen staining in mature blood vessels supports the hypotheses that fibronectin plays a role in human blood vessel modulation and morphogenesis, and that factor VIII-related antigen is a marker for endothelial cell differentiation.

Adult↗

Prevalence of human papillomavirus type 16 DNA sequences in cervical intraepithelial neoplasia and invasive carcinoma of the cervix.

The frequency of human papillomavirus (HPV) type 16 in premalignant and malignant lesions of the cervix was investigated and compared with the detection of HPV type 6. In cervical intraepithelial neoplasia (CIN) grades I-III HPV 6 was detected in 28% and HPV 16 in 62% of patients whereas 90% of malignant lesions contained HPV 16 only. In the CIN lesions there was an increase in HPV 16 detection as the severity of disease increased while the level of detection of HPV 6 decreased. Only three (18%) of the cervices that were colposcopically and histologically normal contained HPV genomes; although two of these three women had either a history of genital warts or a sexual partner with penile warts.

Adolescent↗

Duodenal bulb plasma cells in duodenitis and duodenal ulceration.

Using an immunoperoxidase technique IgA, IgM, IgE and IgG plasma cells were studied in endoscopic duodenal bulb biopsies taken from 14 controls, 25 patients with grade 1 duodenitis (Whitehead classification), 12 patients with grade 2 duodenitis and three with grade 3 duodenitis. The control counts were compared with those in the jejunum and rectum. In addition cell counts were compared in 16 pairs of patients, with and without duodenal ulcer, exactly matched for grade of duodenitis. The control counts were not significantly different from counts in jejunum or rectum except for IgG which were higher in the jejunum (p = 0.03). IgA plasma cell counts were significantly increased in both grade 1 and grade 2 duodenitis compared with controls (p less than 0.05 and p less than 0.01). There was no significant difference for the other plasma cells. All plasma cell counts were decreased in the small group of grade 3 duodenitis compared with the other groups. There was no significant difference between counts in duodenitis whether or not there was associated duodenal ulceration. The isolated IgA plasma cell response of the duodenal bulb mucosa in duodenitis is very different from that of the jejunal mucosa in coeliac disease, and the rectal mucosa in inflammatory bowel disease and bacterial colitis and probably represents the basic response to any mucosal damage.

Cell Count↗

Defining duodenitis: quantitative histological study of mucosal responses and their correlations.

Biopsies from 56 patients with endoscopically normal duodenal bulbs, duodenitis, or duodenal ulceration were studied for counts of plasma cells, polymorphs, and eosinophils and extent of gastric metaplasia, villous atrophy, and mucosal oedema. A correlation matrix showed that the counts of different types of plasma cells were closely correlated with each other and that there was also a close correlation between the presence of intraepithelial polymorphs, villous atrophy, and gastric metaplasia. Cluster and discriminant analysis indicated that the histological changes could be grouped by their statistical association into three simple categories: normal, which includes many cases incorrectly labelled in some classification systems as mild or chronic duodenitis; histologically defined mild duodenitis, characterised by an appreciable plasma cell response and oedema usually with intraepithelial polymorph infiltration and gastric metaplasia; and severe duodenitis, with an appreciable polymorph response and villous atrophy but decreased plasma cells. Decreased plasma cells may be an important indication of peptic ulceration.

Aged↗

The Cronkhite-Canada syndrome: an ultrastructural study of pathogenesis.

Electron microscopical and cytochemical studies of intestinal biopsies from a patient with typical features of the Cronkhite-Canada syndrome show that the primary process affects the crypts. This results in cystic dilatation associated with expansion and focal degeneration of the crypt compartment of the intestinal epithelium. The villous epithelium compartment is reduced but ultrastructurally normal. Inflammation and oedema of the lamina propria follows from leakage of mucin through breaks in the abnormal crypts.

Aged↗

Comparison of prevalence of human papillomavirus antigen in biopsies from women with cervical intraepithelial neoplasia.

Human papillomavirus antigen was found in 39 (16%) of 253 colposcopic biopsies from a group of women at high risk for cervical cancer who had been examined in the early 1970s. Immunohistochemical evidence of papillomavirus infection was found in 20 (30%) of 67 cervical intraepithelial neoplasia lesions infected with wart virus from these patients. When these results were compared with results of a similar study carried out in the early 1980s there was no significant difference in the prevalence of human papillomavirus antigen in cervical intraepithelial neoplasia lesions infected with wart virus from women who had been examined over a decade apart.

Adolescent↗

Social adjustment after closed head injury: a further follow-up seven years after injury.

A group of severely head injured patients were reassessed 7 years after injury. This group was the same as that previously reported 2 years after injury. There was no change in their physical or cognitive status; personality problems were still commonly reported but the less disabled had made further progress in returning to their former level of vocational and social activity.

Adolescent↗

Epidemiological monitoring of environmental lead exposures in California State Hospitals.

Blood lead screening of 8062 state hospital residents in California revealed 143 residents with excessive lead levels (greater than or equal to 30 micrograms/dL). This screening was part of the Childhood Lead Project and was performed in 1978. The purpose of this study was to identify "critical" lead sources in California State Hospitals. Accurate identification is crucial if subsequent abatement programs are to be effective. The strategy involved the following sequence of steps: 1) Selection of cases based on blood lead and erythrocyte protoporphyrin screening. 2) Determination of pica habits and environmental exposures through interviews with ward's staff and/or parents. 3) Measurement of lead levels in environmental samples reflecting exposures. 4) Interpreting these data in order to identify critical lead sources. 5) Reducing exposure to critical lead sources. 6) Following up of cases and controls to validate the effects of this strategy. A group of 36 lead-burdened cases with pica (30-60 micrograms Pb/dL blood) and 36 matched controls (PbB less than 20 micrograms/dL) were selected from among the developmentally disabled residents of two California State Hospitals. These subjects were studied in order to identify the lead sources to which they were exposed and to abate the major ones. Three major lead sources were found in the state hospitals: wall and furniture paints (100-45,400 micrograms Pb/g paint); surface soil (33-570 micrograms Pb/g soil); educational format was presented to all involved staff. The results have indicated a trend towards lower lead intake by the lead-burdened cases. In one of the two hospitals a "lead-free unit" had been established. All the lead-burdened cases were transferred to this unit in August 1981. A few months later the blood lead levels of all the cases dropped below 30 micrograms/dL. Initial epidemiological monitoring indicated where there were preventable hazards, which abatement efforts succeeded in reducing. Further monitoring of such problems is indicated in this and other developmentally-disabled populations.

Adolescent↗

A microcomputer system in the delivery suite.

Microcomputer systems have been installed in the delivery suites of two obstetric units which cater between them for nearly 10 000 deliveries annually. The midwifery and medical staff enter administrative, antenatal, anaesthetic and delivery details during labour and as soon after delivery as possible. The computer prints out the official Birth Notification, the entry for the Midwives Register and the record of labour and delivery for the patient's notes. Subsequently the postnatal doctor and anaesthetist, where relevant, enter details of puerperium and anaesthetic follow-up, before the production by the computer of discharge and anaesthetic summaries for the community and records. In the first 6 months of use at the Bristol Maternity Hospital (July to December 1982) 2229 patients were delivered and have had obstetric details recorded on the computer. A general obstetric audit of these patients is presented.

Adult↗

Small intestinal plasma cells in coeliac disease.

Using a modified immunoperoxidase technique to achieve optimum staining and reproducible counts of plasma cells in paraffin embedded tissue, IgA, IgM, IgE, and IgG plasma cells were studied in small bowel biopsies from 20 controls, 23 untreated coeliac patients, 19 treated coeliac patients, and seven patients with Crohn's disease not involving duodenum or jejunum. In controls the ratio of the mean counts for IgA, IgM, IgE, and IgG plasma cells was 2.5:1:1:1 respectively. In patients with untreated coeliac disease, counts of all types of plasma cell were significantly increased approximately two-fold compared with controls although for IgG cells there was considerable overlap. The ratio of the mean plasma cell counts in the untreated coeliac patients was 3.5:1.5:2:1. Counts fell significantly after treatment with a gluten-free diet. There was no significant difference between counts in the controls and the Crohn's disease patients. The changes found in coeliac disease may simply be a non-specific response to mucosal damage. The increases in IgA and IgM plasma cells, however, suggest that the deposits of extracellular IgA and IgM observed in coeliac mucosa are locally produced, and the increase in IgE plasma cells raises the possibility that reaginic type hypersensitivity may be involved in coeliac disease.

Adolescent↗

Rectal mucosal plasma cells in inflammatory bowel disease.

To achieve optimum staining and reproducible counts of plasma cells in paraffin embedded tissue with the immunoperoxidase technique we have found it essential to obtain a plateau count by titration of antisera for each specimen. This modification was used to study IgA, IgM, IgE, and IgG plasma cells in rectal biopsies from 20 controls, 20 patients with ulcerative proctocolitis, 20 with Crohn's colitis, 20 with non-specific proctitis, 15 with bacterial colitis, and seven with Crohn's disease but no apparent large bowel involvement. Counts were correlated with the characteristic histological features of inflammatory bowel disease. In controls the ratio of the mean counts for IgA, IgM, IgE, and IgG plasma cells was 8:3:3:1. All types of plasma cells were very significantly increased in the patients with ulcerative proctocolitis, Crohn's colitis, and non-specific proctitis and counts correlated with the severity of inflammation. There was no significant difference between the counts in these three groups. All counts tended to be higher in bacterial colitis than in controls, the difference being significant for IgA and IgE. When matched for severity of inflammation there was no significant difference between the counts in bacterial colitis and inflammatory bowel disease. The counts in patients with Crohn's disease but no large bowel involvement were not significantly different from controls. These results suggest that changes in plasma cell counts in inflammatory bowel disease are a non-specific response to mucosal damage, possible by a luminal irritant, and do not differentiate the type of inflammatory bowel disease.

Adult↗