Search PubMed⌕ Search

Biomedical subjects

G Gillespie

Publications and source records attributed to G Gillespie.

At least 73 records · Page 4Linked to original sources
PubMed1999

The changing role of health information managers.

Torn between paper and computers, health information managers are searching for their niche in a health care industry that's using more data in more ways. And information technology is forcing them to redefine their role.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1999

Image is everything.

Digital imaging is transforming the practice of radiology. But provider organizations face many technical and financial challenges on the road to becoming filmless. Their own reluctance to let go of the film habit is making the transition to digital images difficult. And the complexity of the myriad technologies, as well as the high prices delivery systems and hospitals still must pay to acquire them, are slowing the march toward filmless radiology departments.

Capital Expenditures↗
PubMed1997

Clonal populations of T-cells in patients with B-cell malignancies.

Patients with B-cell malignancies are often immunosuppressed and have defective T-cell function in vitro. In addition they frequently have unusual T-cell populations in the peripheral blood including an increase in the number of activated T-cells and an inverted CD4:CD8 ratio. More recently several reports have documented the presence of large, monoclonal populations of T-cells in patients with paraproteinaemia, B-CLL and hairy cell leukemia. Such cells can reach very high levels in the peripheral blood, occasionally representing over 50% of all CD8+ T-cells. These clonally expanded cells have a characteristic morphology and phenotype in that they are often large, granular cells with natural killer cells markers. Their properties have not been studied in detail but they appear to suppress immunoglobulin production and kill cell targets in an MHC-unrestricted manner. The relationship of clonal T-cells to the B-cell tumour is unclear. They may be directly interacting with the malignant clone or alternatively be nonspecifically activated secondary to a disruption of the immune homeostasis by tumour cells. If they indeed represent an attempt by the immune response to control the malignant cells it is possible that they may be utilised in future attempts at immunotherapy.

CD4-Positive T-Lymphocytes↗
PubMed1996

Clonal populations of CD4+ and CD8+ T cells in patients with multiple myeloma and paraproteinemia.

Patients with paraproteinemia have abnormalities in their T-cell subsets including inversion of the CD4:CD8 ratio and increased expression of activation markers. Recently, distortions in T-cell receptor (TCR) TCRAV and TCRBV gene segment expression have been reported, although the significance of these observations is unclear given the finding of clonal populations of CD8+ T cells in healthy elderly individuals. We have used an extensive range of TCR V-region-specific monoclonal antibodies to assess TCRAV and TCRBV expression in patients with myeloma and paraproteinemia. TCR sequence analysis was used to assess the clonality of expansions and 3-color fluorescence-activated cell sorting analysis determined the phenotype of the expanded populations. The patients show novel oligoclonal expansions within the CD4+ subset and show an increased frequency of CD8+ expansions. Oligoclonal CD4+ T cells belong to the rare CD4+CD28- T-cell subset, a phenotype associated with granular morphology. CD45RA and CD11b are expressed on many of the CD8 T-cell expansions. Comparison of T-cell receptor sequences from two T-cell clones in one patient suggests a possible role for a common peptide antigen in the generation of the expansions. Further work is needed to identify the relevance of such T cells to the B-cell proliferation.

Aged↗
PubMed1995

K12 is located on the Kell blood group protein in proximity to K/k and Jsa/Jsb.

K12 is a high-prevalence antigen, with no known antithetical partner, that is associated with the Kell blood group system. We report studies on the 5th propositus (MS) with the K:-12 phenotype and the second case to show that the K12 is inherited. The anti-K12 in his serum did not destroy antigen-positive incompatible red cells transfused on at least 3 occasions over 6 years. Red cell membranes from MS possessed the Kell protein that was indistinguishable from control membranes. K12 antigen was shown by immunoprecipitation to be on a protein with an apparent molecular mass of 93,000 and by monoclonal antibody immobilization of erythrocyte antigens (MAIEA) assay to be on the Kell protein in proximity to K/k and Jsa/Jsb antigens. These data remove the K:-12 phenotype from its current Kell-related (or para Kell) status and elevates the K12 antigen to a bona fide member of the Kell blood group system.

Antibodies, Monoclonal↗
PubMed1992

Retroperitoneal necrotizing fasciitis.

Necrotizing fasciitis is a mixed infection of the skin and subcutaneous tissues with a characteristic clinical and pathological appearance. Early radical surgical excision of all affected tissue is the treatment of choice. In a series of 19 patients with necrotizing fasciitis, bacteriological assessment in 15 confirmed the mixed nature of the infection, with Bacteroides sp. isolated from ten patients. All 12 patients who underwent radical surgical excision survived. A subgroup of patients was identified in whom the appearance of necrotizing fasciitis in the abdomen or perineum was indicative of more extensive disease in the retroperitoneal tissues. Surgical resection of all affected tissue was not feasible in these cases and the outcome was uniformly fatal, giving an overall mortality rate for the series of 37 per cent.

Aged↗
PubMed1991

Early endoscopic sphincterotomy for retained bile duct stones after gallbladder surgery.

Endoscopic sphincterotomy (ES) was performed in 36 patients (age range 33-88 years; median 63 years) with retained bile duct stones after cholecystectomy (32 patients) or cholecystostomy (4 patients). The median time interval between surgery and ES was 28 days (range 10-216 days). At the time of ES, 23 patients had a T-tube in situ. Clearance of the bile duct was achieved by T-tube irrigation in 15 patients, and by basket or balloon extraction in seven patients. Spontaneous clearance of the duct after ES occurred in 12 patients, while two patients required widening of the sphincterotomy to allow successful basket extraction. Complications occurred in four patients (11%). Two patients sustained significant haemorrhage from the ES site and subsequently died. One patient developed mild acute pancreatitis while another had persisting cholangitis before and after ES. Both of these patients recovered with conservative management. While ES performed soon after gallbladder surgery allows for early bile duct clearance, the small but significant risk of potentially lethal haemorrhage suggests that its use should be reserved for patients in whom other non-operative methods have failed or are inappropriate.

Adult↗
PubMed1990

Use of subjective information in scientific psychology: III. The internal image during visual perception: an introspectionist analysis.

On the basis of personal observation, the writer describes certain characteristics of hypnopompic visual imagery that lead to an understanding of how the internal visual image is experienced. This understanding helps us to see how an internal two-dimensional visual perceptual image could be experienced as an external environment positioned around the observer. The writer suggests how the three-dimensionalized perceptual image is constructed, how it gives the effect of directional looking within the context of seeing widely, and how certain features of visual perception can best be accounted for by the mediation of perception by an internal image.

Attention↗
PubMed1989

Endoscopic sphincterotomy for bile duct stones in patients with intact gallbladders.

Endoscopic sphincterotomy was performed in 121 patients (age ranged 34-92 years; median 80 years) with intact gallbladders and bile duct stones. Clearance of the duct by basket or balloon extraction was attempted in 97 patients (80 per cent) and achieved in 93 of these patients (96 per cent). In 24 patients the duct was left to empty spontaneously and this occurred in 22 patients. Immediate complications due to endoscopic sphincterotomy occurred in five patients (two haemorrhage, two perforation, one haemorrhage and perforation). Of the 101 patients reviewed 12-72 months (median 24 months) after endoscopic sphincterotomy, 76 (75 per cent) have remained asymptomatic throughout the follow-up period. Eighteen patients (18 per cent) required cholecystectomy for recurrent gallbladder symptoms 1-24 months after endoscopic sphincterotomy. One of the asymptomatic patients underwent cholecystectomy on the advice of his consultant. A further seven had recurrent biliary colic or cholangitis necessitating enlargement of the sphincterotomy and further stone retrieval in three of these patients. Endoscopic sphincterotomy is an effective treatment for bile duct stones in high risk patients, but subsequent cholecystectomy is required in a significant number of patients owing to continuing gallbladder symptoms.

Adult↗