Silicon capsule assays with low-bleed silicone gel implants.
Explore the source record for details and available documents.
Breast Implants↗
Biomedical subjects
D Smith
Publications and source records attributed to D Smith.
Biliary sludge: can ultrasound reliably detect the presence of crystals in bile?
OBJECTIVE: To determine the accuracy of routine gallbladder ultrasound in the detection of crystals in bile. METHODS: Preoperative ultrasonography was performed in 40 patients undergoing elective cholecystectomy. Bile was aspirated at operation and examined microscopically for the presence and quantity of crystals. RESULTS: Six patients had echogenic bile, five of whom had large numbers of crystals at microscopy, and one only a few crystals. Thirty-four patients had hypoechoic bile, nine had large numbers of crystals and 25 of these had few or no crystals at microscopy. For those patients with echogenic bile (hyper- or isoechoic) the sensitivity for detection of large numbers of crystals was 5/14 (35.7%) with a specificity of 25/26 (96%). However, if the bile was hypoechoic the sensitivity was 9/14 (65%). CONCLUSION: For those patients with echogenic bile, ultrasound is highly specific for the detection of crystals, although the sensitivity is low. By contrast, those patients with hypoechoic bile at ultrasound would need a further investigation to exclude the presence of crystals.
Adolescent↗
Evidence for neutrino oscillations from muon decay at rest.
Explore the source record for details and available documents.
Journal Article↗
Serum screening for Down's syndrome between 8 and 14 weeks of pregnancy. International Prenatal Screening Research Group.
OBJECTIVE: To determine the value of serum screening for Down's syndrome at 8-14 weeks of pregnancy using seven potential serum markers (alpha-fetoprotein, unconjugated oestriol, total human chorionic gonadotrophin (hCG), free alpha-hCG, free beta-hCG, pregnancy associated plasma protein A (PAPP-A), and dimeric inhibin A). DESIGN: Stored blood samples collected from women at about 10 weeks of pregnancy, prior to having chorionic villus sampling procedure on account of advanced maternal age, were retrieved from pregnancies associated with Down's syndrome and from matched unaffected pregnancies. SETTING: Twenty-one obstetric centres in nine countries. SUBJECTS: Seventy-seven pregnancies associated with Down's syndrome each matched with five controls (except in two cases that were matched with four controls) for maternal age (same five year age groups), duration of storage of the serum sample (same calendar year), and gestational age (usually same week of pregnancy). RESULTS: The levels of two potential markers differed between affected and unaffected pregnancies sufficiently to be of value in screening--free beta-hCG and PAPP-A. The median free beta-hCG level in affected pregnancies was 1.79 times the median level for unaffected pregnancies, and the median PAPP-A level was 0.43 times the normal median. These two markers were combined with maternal age to estimate a woman's risk of having a fetus with Down's syndrome. A screening programme that used a risk cutoff level of 1:300 would detect 63% of affected pregnancies and also classify 5.5% of unaffected pregnancies as screen positive. None of the other five markers added more than 2% detection for the same false-positive rate. CONCLUSION: The performance of screening using maternal age and serum-free beta-hCG and PAPP-A at 10 weeks of pregnancy was better than the double test (alpha-fetoprotein and hCG with maternal age) and similar to the triple test (alpha-fetoprotein, unconjugated oestriol and hCG with maternal age) at 15-22 weeks.
Adult↗
Socioeconomic differentials in cancer incidence and mortality in urban New South Wales, 1987-1991.
Cancer incidence and mortality in urban residents of New South Wales (NSW), 1987 to 1991, were analyzed according to socioeconomic status (SES) for males (m) and females (f). Incidence rates displaying a negative gradient with SES at P < 0.01 included: cancers of the mouth and pharynx (m), oesophagus (m), stomach (m,f), liver (m), pancreas (m), larynx (m), lung (m,f), cervix, kidney (m,f) and all cancers combined (m). Negative mortality gradients at P < 0.01 were observed for mouth and pharynx (m), stomach (m,f), rectum (m), liver (m), larynx (m), lung (m,f) and cervix, and all cancers (m,f). Those sites for which incidence showed a positive gradient with SES included: colon (m,f), melanoma (m,f), breast (f), prostate and testis. For cancer mortality for specific sites no significant (P < 0.01) positive gradients were observed, although for melanoma (m,f) a positive gradient at P < 0.05 was found. Mortality for all cancers considered together in both sexes was significantly higher in the low SES group compared to the high SES group. This is partly because the more-fatal cancers are more common in the lower SES groups. Diet, tobacco use, reproductive factors, occupational and sun exposures are likely to be associated with the patterns observed but are not investigated in this study. Variations in health care between SES groups may also be partly responsible for some of the differences.
Female↗
Herpes simplex virus type 2 inhibition of Fas ligand expression.
Herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) are common human pathogens. In this report we demonstrate the capacity of HSV-2, but not HSV-1, to inhibit the activity and cell surface expression of Fas ligand, an important molecule involved in T-cell apoptosis and cell-mediated cytotoxicity. Cells infected with HSV-2 retained Fas ligand intracellularly instead of expressing it on the cell surface. Addition of anti-Fas antibodies markedly inhibited HSV-2 viral production, suggesting that the capacity of the virus to regulate Fas ligand expression, and thereby programmed cell death, may represent a powerful mechanism for the virus to enhance viral replication.
Animals↗
Differences in calcium kinetics between adolescent girls and young women.
Rapid bone accretion occurs throughout childhood but peaks during adolescence. The achievement of optimal peak bone mass, which can protect against osteoporosis later in life, is greatly dependent on rates of bone accretion. To identify differences in calcium metabolism during rapid vs. slower bone accretion, calcium kinetics were compared in 14 healthy girls aged 11-14 yr and 11 women aged 19-31 yr. Calcium kinetics were measured while subjects were undergoing a calcium balance study in a camp simulating a free-living environment. After 7 days on a diet containing 1,330 mg Ca/day, two stable isotopes were administered (44Ca orally and 42Ca intravenously), and blood samples and all urine and feces were collected for 14 days. Samples were analyzed for total calcium by atomic absorption spectrophotometry and for enrichment of 42Ca and 44Ca by fast atom bombardment mass spectrometry. Data from serum, urine, and feces were analyzed using the Simulation, Analysis and Modeling (SAAM) software. Data were fitted by a three-compartment model; the first pool was the same size in girls and women (1.6 g) but the second and third pools were larger in girls (2.85 vs. 1.66 g and 12 vs. 5 g). Compared with the women, girls absorbed more calcium from the diet (38 vs. 22% or 494 vs. 283 mg/day), excreted less calcium in urine (100 vs. 203 mg/day), deposited more calcium in bone (1,459 vs. 501 mg/day), and resorbed more calcium from the skeleton (1,177 vs. 542 mg/day), whereas endogenous calcium excretion did not differ between girls and women (112 vs. 121 mg/day). Girls retained more calcium than women (282 vs. -41 mg/day) through increased absorption, lower urine excretion, and higher bone turnover.
Absorption↗
Diagnosis and control of contagious caprine pleuropneumonia.
The diagnosis of contagious caprine pleuropneumonia (CCPP) has often been considered difficult. This is because of the confusion that can arise with other mycoplasmoses of small ruminants. Symptoms and lesions can be similar and the isolation of M. capricolum subsp. capripneumoniae (MccF38) requires skilled technicians. Once MccF38 strains are isolated, their identification should not be difficult. New techniques, such as polymerase chain reaction, now offer the possibility of identifying MccF38 directly from dried samples. However, the isolation of MccF38 strains is always required for an official declaration of infection. Until now, the official serological test has been the complement fixation test; the main drawbacks being lack of sensitivity and specificity and also the short persistence of antibodies detected by this technique. The specific competition enzyme-linked immunosorbent assay has now been developed and should enable wide serological enquiries to determine the real prevalence of the disease. Antibiotic treatments are effective but may not prevent persistence in latent carriers. An inactivated vaccine with saponin as an adjuvant has been produced in Kenya, which protects goats for approximately one year.
Animals↗
Transfer of a severely damaged digit to reconstruct an amputated thumb.
We retrospectively reviewed the results of reconstruction of a traumatically amputated thumb with use of an adjacent severely damaged digit in twenty-seven patients (twenty-five male and two female patients). The mean duration of follow-up was nine years (range, two to twenty-one years). The mean age at the time of the reconstruction was thirty-four years (range, thirteen to fifty-six years). Five patients had the reconstruction on the day of the injury and twenty-two, after a mean delay of five months (range, fifteen days to thirteen months). Segments of the index finger were used in twenty-two patients; of the long finger, in four patients; and of the ring finger, in one patient. There were four complications: necrosis of the dorsal skin in one patient, reflex sympathetic dystrophy in one patient, and contracture of the first web space in two patients. Discriminative sensibility was ten millimeters or less, according to the Weber test, in twenty-four thumbs. Cortical integration with reference to the recipient thumb, on stimulation of the pollicized segment, was good in ten patients. Eleven patients could achieve tip-to-tip contact between the thumb and the little finger and twenty-five patients, between the thumb and the most radial finger. The ability to perform activities of daily living was considered good for ten patients, fair for eleven, and poor for six. Only digits with a nail, either present on the transferred segment or as a result of a free vascularized nail transfer, were considered to have a good cosmetic result. Although these results are far from impressive, the reconstruction is a viable alternative for selected patients because it maintains the ability to grasp objects and to oppose the digits.
Activities of Daily Living↗
Primary mediastinal large-B-cell lymphoma: radiologic findings at presentation.
OBJECTIVE: Primary mediastinal large-B-cell lymphoma was recently reclassified as a distinct clinical entity. We wished to review the imaging findings for this disease and to compare the findings with those for other disorders with a similar appearance. MATERIALS AND METHODS: We retrospectively reviewed plain films, gallium scintigrams, MR images, and CT scans for 43 patients with primary mediastinal large-B-cell lymphoma. RESULTS: All but one lesion arose in the anterior mediastinum. Areas of fluid attenuation within the masses were evident on CT scans in 50% of cases. Pleural effusions were seen by chest radiography in 33% of patients. Pericardial effusions were present in 32% of patients who underwent CT scans. Of the 21 patients who underwent gallium scintigraphy, all were reported to have positive findings. Also, MR imaging showed evidence of superior vena cava syndrome in one patient. CONCLUSION: Primary mediastinal large-B-cell lymphoma typically is seen as a bulky anterior mediastinal mass that often contains areas of necrosis.
Adult↗
Characterization of coffea canephora alpha-D-galactosidase blood group B activity.
Enzymatic conversion of type B to O erythrocytes with Coffea (coffee bean) alpha-D-galactosidase was first described by Harpaz and Flowers and subsequently adopted by others (1,2). An enzyme-linked immunosorbent assay (ELISA) and soluble oligosaccharide substrates were used to study deantigenation of B erythrocytes with the Coffea enzyme. For the ELISA, microtiter wells were coated with B membranes and treated with enzyme under a variety of conditions, probed with primary IgM monoclonal anti-B followed by secondary anti-murine mu-chain specific alkaline phosphatase conjugate, then developed with substrate. This technique has allowed the rapid determination of enzymatic activity over a broad range of conditions; the purpose being to determine parameters for efficiently enhancing enzyme activity. Solid phase activity was then compared to activity against soluble oligosaccharide substrates. We have determined that, under the conditions tested, only moderate increases in enzyme activity against the B epitope can be achieved by modifying reaction conditions with the native Coffea enzyme.
ABO Blood-Group System↗
Hypermagnesemia following an acute ingestion of Epsom salt in a patient with normal renal function.
CASE REPORT: Hypermagnesemia is a rare condition that commonly follows excessive therapeutic administration of magnesium sulfate to treat eclampsia of pregnancy. Signs and symptoms of this condition include extreme muscle weakness, loss of deep tendon reflexes, mental status depression, and cardiac dysrhythmias. Clinically significant hypermagnesemia following oral or rectal administration of magnesium containing products in patients with normal renal function is rare. We report a case of hypermagnesemia following massive Epsom salt ingestion that resulted in extreme musculoskeletal weakness and altered mentation.
Central Nervous System Diseases↗
Baseline coagulation assay values for northern elephant seals (Mirounga angustirostris), and disseminated intravascular coagulation in this species.
Coagulation assays, including platelet counts, antithrombin III, fibrinogen, fibrinogen degradation product levels, prothrombin (PT), activated partial thromboplastin (APTT) and activated clotting times (ACT), were performed on 20 healthy juvenile northern elephant seals (Mirounga angustirostris) stranded along the central California coastline from 15 March to 15 April 1994, to establish baseline parameters for this species. Elephant seals appear to have relatively short ACT, PT, and APTT times, while fibrinogen, platelet and antithrombin III levels are similar to domestic species. Based on these mean values in healthy animals, disseminated intravascular coagulation (DIC) was diagnosed in an elephant seal with low plasma fibrinogen and extended ACT, PT and APTT times; this animal had hemorrhages, mixed bacterial suppurative interstitial pneumonia with verminous arteritis, epicarditis, hepatitis and enterocolitis.
Animals↗
Tacrolimus rescue therapy for renal transplant rejection.
Explore the source record for details and available documents.
Adult↗
Comparison of captopril-thiazide and enalapril-thiazide combinations in the management of mild to moderate black hypertensive patients: how important is diuretic dose and duration of action of the ACE-inhibitor?
A double-blind, randomized, parallel-group study was performed to compare the efficacy and tolerability of captopril-thiazide and enalapril-thiazide combinations. After a 3-week placebo run-in period, 47 Black patients with mild to moderate essential hypertension (mean 24-hour diastolic blood pressure (BP) > 90 mmHg and < 115 mmHg) were randomized to receive 1 of 2 combination tablets: captopril 50 mg plus hydrochlorothiazide 25 mg (CAP, n = 24) or enalapril 20 mg plus hydrochlorothiazide 12.5 mg (COR, n = 23) once daily. After 12 weeks of active treatment the mean 24-hour ambulatory BP was reduced from 152 +/- 11/99 +/- 6 to 133 +/- 13/86 +/- 7 mmHg (p < 0.005) in the CAP group and 157 +/- 15/100 +/- 6 to 141 +/- 18/90 +/- 12 in the COR group (p < 0.005). Target BP (24-hour diastolic BP < 90 mmHg) was achieved in 75% (18/24) of patients on CAP and 48% (11/23) on COR (p = n.s.). 24-hour BP load fell significantly with both CAP (from 69% to 34%, p < 0.001) and COR (from 67% to 37%, p < 0.001). Left ventricular mass index decreased by 7% with CAP and 11% with COR. Cardiac index and fractional shortening remained essentially unchanged in both groups. Both treatments were well tolerated and overall incidence of side effects was very low. It is concluded that both CAP and COR are effective, safe first-line antihypertensive choices in Black patients with mild to moderate hypertension with the former showing a trend towards greater efficacy than the latter.
Angiotensin-Converting Enzyme Inhibitors↗
In vitro selection of a novel catalytic RNA: characterization of a sulfur alkylation reaction and interaction with a small peptide.
An in vitro RNA selection for catalytic activity was used to co-select for binding activity to a small peptide. 5'-phosphorothioate-modified RNA (GMPS-RNA) sequences were selected from a randomized pool of oligoribonucleotides for their ability to accelerate a halide substitution reaction with N-bromoacetyl-bradykinin (BrBK). One RNA selected shows a 2,420-fold increase in rate of reaction with BrBK relative to the starting pool. This reaction is specifically inhibited by free bradykinin (Ki 230 microM), indicating that interactions with bradykinin contribute to the rate enhancement. Inhibition of the reaction by the peptide requires both the amino- and carboxy-terminal arginine residues of the peptide for optimal inhibition activity. Reaction with N-bromoacetamide is not enhanced, indicating that the intrinsic reactivity of the 5' phosphorothioate is not increased in the selected RNA. Through 3'-end boundary analysis, much of the catalytic activity of the selected GMPS-RNA is shown to reside in a hairpin structure in the selected region of the molecule. This hairpin structure is also implicated in the recognition of the peptide substrate.
Aldehydes↗
Complete heart block or not.
Explore the source record for details and available documents.
Bradycardia↗
Quantitative measurement of erosion growth and joint space loss in rheumatoid arthritis hand radiographs.
OBJECTIVE: To evaluate the performance of simple, inexpensive quantitative techniques for measuring erosion growth and joint space loss in serial hand radiographs of patients with rheumatoid arthritis (RA). METHODS: Erosions were measured using a plastic overlay template of sample erosion sizes. Joint spaces were measured with a hand held measuring micrometer. In the first phase of testing, a spectrum of individual erosions and joint spaces was measured to determine intra and interobserver correlations and variability. In the 2nd phase, the tools were used to measure serial changes in RA hand radiographs. Observer correlations and the ability to discriminate serial changes were determined and compared to the scoring method of Sharp. RESULTS: Measurements of individual erosion areas and joint spaces were highly reproducible. Intra and interobserver correlations were significant (p < 0.05) for serial erosion growth and joint space loss measurements, as well as changes in Sharp scores. Quantitative measurements correlated highly with the corresponding Sharp score changes. Of all measurements or scores recorded, quantitative joint space loss measurements were statistically superior in discriminating serial change in RA hand radiographs. Quantitatively measured joint space loss correlated well with both erosion growth measurements and serial change in total Sharp scores. CONCLUSION: Quantitative measurement of erosion growth and joint space loss is possible with simple inexpensive techniques. Further study is needed to confirm our data, which suggest that quantitative measurement of joint space narrowing may be the most useful discriminator of serial changes in RA hand radiographs.
Arthritis, Rheumatoid↗