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Biomedical subjects

H Johnson

Publications and source records attributed to H Johnson.

At least 91 records · Page 5Linked to original sources
PubMed1995

Comprehensive tuberculosis control for patients at high risk for noncompliance.

The current tuberculosis epidemic in the United States is marked, in many areas, by high rates of noncompliance with antituberculous regimens. In response to this, a comprehensive program of medical, nursing, social services, and supervised therapy was developed at Bellevue Hospital. Most patients were referred to the on-site directly observed therapy program (DOT) located in the hospital. Patients on DOT received daily or twice weekly therapy, and were given incentives to enhance compliance. Outreach was used to track patients who missed appointments. From November 1992 through July 1993, 113 patients were referred. HIV infection, homelessness, illicit drug use, and alcoholism were common. Follow-up revealed that 11 patients were noncompliant and completely lost to follow-up; of the remaining 102, 99% achieved bacteriologic cure. Of the 102 patients who received therapy, 74 attended the Bellevue DOT clinic, 16 attended other DOT programs in the city or received medication at home, and three died of HIV-related, nontuberculous illness. Nine patients were self-medicated and judged treatment successes. We conclude that a comprehensive hospital-based tuberculosis control program is capable of achieving a high degree of success, even in a population at high risk for noncompliance.

Adult↗
PubMed1995

Preoperative factors of prognostic significance in gastric cancer.

This study was undertaken to investigate the ability of local anatomical and primary histological features of gastric cancers, as well as DNA analysis, to predict prognosis. Using multivariate analysis, results indicate that location of a tumor in the gastric cardia, poor differentiation, involvement of adjacent organs, and aneuploidy are all independent predictors of survival. All of the factors studied can be determined by endoscopic procedures preoperatively on patients with gastric cancers and could be helpful in selecting some patients for perioperative adjunctive therapies.

Adenocarcinoma↗
PubMed1995

Ki-67 reactivity in breast carcinoma analyzed by a computer-assisted image system: preliminary results.

The proliferative index of 63 breast carcinomas was measured on Ki-67 immunostained frozen tissue sections with a computer-assisted image analysis system. The mean proliferative index in estrogen-positive breast carcinomas was lower than in estrogen-negative carcinomas. An inverse relationship between proliferative index and short-term disease-free survival was noted.

Breast Neoplasms↗
PubMed1995

The value of HIDA scans in the initial evaluation of patients for cholecystitis.

One hundred twenty-two consecutive patients who had hepato-iminodiacetic acid (HIDA) scans over a 5-month period were reviewed. These scans were found to have 94% sensitivity, but only 36% specificity for correctly diagnosing pathological variants of cholecystitis. Frequently, HIDA scans were misinterpreted to show common bile duct obstruction (CBDO); only 20% of cases of CBDO suggested on HIDA could be confirmed surgically. Sonography gave 88% to 90% sensitivity and 91% specificity in correctly diagnosing pathological variants of cholecystitis and correctly demonstrated CBDO in 80% of the cases. As first-line studies to evaluate biliary tract disease, HIDA scans are costly and should be eliminated.

Acute Disease↗
PubMed1994

Bladder autoaugmentation by vesicomyotomy in the pediatric neurogenic bladder.

OBJECTIVES: The authors describe the procedure of bladder autoaugmentation by vesicomyotomy in 12 pediatric patients with neurogenic bladders. METHODS: Indications for augmentation included low-capacity, high-pressure bladders with incontinence despite maximal anticholinergic therapy. Clean intermittent catheterization was successfully reinstituted postoperatively and no patient has subsequently required enterocystoplasty. RESULTS: There were no major complications and eight patients underwent concurrent procedures on the bladder. Urodynamic studies revealed a mean increase in capacity of 40% and a mean decrease in leak point pressure of 33% compared with preoperative values. CONCLUSIONS: Early clinical experience would suggest that vesicomyectomy (excision of released detrusor) offers no advantages over vesicomyotomy in pediatric patients. Vesicomyotomy (simple incision into detrusor) proved to be a simple technique that could be safely performed in pediatric patients.

Adolescent↗
PubMed1994

Prevalence of HIV and associated risk behaviour in attendees at a Dublin needle exchange.

The aim of this study was to measure the prevalence of HIV infection and assess the level of equipment-sharing and unsafe sexual activity among attendees at a Dublin needle exchange. Using an anonymous unlinked approach, attendees were asked to complete a brief questionnaire and provide a sample of saliva for HIV testing. Of the 144 attendees eligible for inclusion during the study period, 106 agreed to participate and complete a questionnaire, a response rate of 74%. Of the 81 respondents who submitted a usable saliva sample, 14.8% were HIV positive. Half of the respondents claimed that they had not shared equipment during the preceding 28 days, but a third had shared with multiple partners. Half of the respondents claimed that they had multiple sexual partners during the preceding year, but only a quarter said that they always used condoms. The prevalence of HIV infection is similar to that found in routine linked testing of drug users in Ireland. The high level of unsafe injecting and sexual activity makes clear the need for more effective health promotion among drug users in Dublin.

Acquired Immunodeficiency Syndrome↗
PubMed1993

GAP-43, aFGF, CCK and alpha- and beta-CGRP in rat spinal motoneurons subjected to axotomy and/or dorsal root severance.

The mRNA levels for growth-associated protein 43 (GAP-43), acidic fibroblast growth factor (aFGF), alpha- and beta-calcitonin gene-related peptide (CGRP), cholecystokinin (CCK) and choline acetyltransferase (ChAT) in rat lumbar spinal motoneurons were studied by in situ hybridization 1, 5 and 21 days and 20 weeks following unilateral peripheral nerve sectioning, ventral rhizotomy or dorsal rhizotomy. Furthermore, CGRP- and aFGF-like immunoreactivities in the ventral horn were studied using immunohistochemistry. One to 21 days after axotomy, GAP-43 and alpha-CGRP mRNAs increased in lesioned motoneurons, while the aFGF mRNA levels were marginally higher in motoneurons on the lesion side as compared to the control side. beta-CGRP, CCK and ChAT mRNA levels, on the other hand, decreased during the short-term response (1-21 days) to axotomy. After ventral rhizotomy, but not peripheral axotomy, there was complete disappearance of aFGF-like immunoreactivity in the ventral root proximal to the lesion. In animals subjected to long-term survival (20 weeks) after peripheral axotomy, the expression of all studied substances had returned to normal levels. Unilateral dorsal rhizotomy did not induce any substantial short- or long-term shifts in the cellular expression of the GAP-43, aFGF, CGRP and CCK peptides or their mRNAs in motoneurons of lesioned segments. These results indicate that peptides/proteins in motoneurons are expressed differentially after axotomy. Whereas alpha-CGRP and GAP-43 are up-regulated, CCK and beta-CGRP become down-regulated and aFGF is largely unaffected.

Animals↗
PubMed1993

Neonatal BCG policy and childhood tuberculosis in the Republic of Ireland.

Most, but not all, counties in the Republic of Ireland have neonatal BCG as standard policy. Data on hospital admissions due to tuberculosis were used as an indicator of the impact of local BCG policy on tuberculosis in childhood. Counties which do not have neonatal BCG as standard policy were associated with a significantly higher rate of tuberculosis (relative risk = 3.8) among those less than 15 years of age. Any review of national BCG policy should take this result into consideration.

Adolescent↗
PubMed1993

Sham versus transurethral microwave thermotherapy in patients with symptoms of benign prostatic bladder outflow obstruction.

Transurethral microwave thermotherapy (TUMT) is a single-session, minimally invasive outpatient treatment for patients with symptoms of benign prostatic bladder outflow obstruction. We designed a prospective randomised trial to identify any placebo response. Patients with a Madsen symptom score over 8 for at least 6 months were eligible for study. Two measurements of urinary flow less than 15 mL/s and a residual urine of under 350 mL were also required for entry. Patients with renal dysfunction, upper urinary tract disease, co-existing bladder disease, and malignant prostatic change were excluded. 43 patients were studied: 21 were randomised to receive a sham treatment and 22 to thermotherapy. Sham treatments were done with the urethral applicator in situ. 40 patients were available for evaluation at 3 months. 2 patients had delayed follow-up and 1 patient randomised to TUMT has undergone transurethral resection. The thermotherapy group showed a 70% decrease (from 14.5 to 4.3) in the mean Madsen score, a 53% increase in flow-rate (8.5 to 13.0 mL/s), and 92% decrease in residual urine volume (147 to 12 mL). No significant change was seen in these mean indices in the sham group. There was no difference in the main complication of transient haematuria between the two groups. However, there was a 22% frequency of acute retention in the TUMT group. The results show little significant placebo component to the subjective and objective improvement that occurs in patients who have received TUMT.

Aged↗
PubMed1993

The value of flow cytometric analysis in patients with gastric cancer.

Tumors in the gastric cardia and the body/antrum were studied to determine the effect of ploidy and S-phase fractions on patient survival. Forty-two percent of tumors were located in the cardia and 58% in the body/antrum. Nodal metastases occurred more often with cardia tumors than with body/antrum tumors (86% vs 65%). Aneuploidy occurred more frequently in patients with cardia tumors than in patients with body/antrum tumors (39% vs 20%). Metastasis to lymph nodes was more common in patients with aneuploidy than in patients with diploidy (31% vs 7%). S-phase fractions were not different between aneuploid and diploid tumors. More patients with diploid cancer were alive at 5 years than were patients with aneuploid tumors (90% vs 10%). We conclude that primary cellular differences in gastric tumors of the cardia or body/antrum determine patient survival.

Adenocarcinoma↗
PubMed1993

Kinetics and mechanisms of peptide aggregation. I: Aggregation of a cholecystokinin analogue.

Aggregation kinetics for a tetrapeptide analogue of cholecystokinin (A-71623) have been studied by quasi-elastic light scattering. Aggregation kinetics were quantitated with a kinetic model, described herein, which was modified for quasi-elastic light scattering data. The model predicts that the average molecular weight of peptide aggregates increases in a linear fashion with time. Data generated for A-71623 were consistent with the model presented under conditions of varied ethanol concentration at a fixed peptide concentration, as well as varied A-71623 concentration at fixed ethanol concentration. Although not the primary thrust of this study, experimental design permitted some understanding of the effect of environmental changes on the apparent aggregation kinetics of A-71623. These studies suggest A-71623 aggregation may be partially mediated by hydrophobic bonding.

Chemical Phenomena↗
PubMed1993

The serotoninergic bulbospinal system and brainstem-spinal cord content of serotonin-, TRH-, and substance P-like immunoreactivity in the aged rat with special reference to the spinal cord motor nucleus.

The 5-hydroxytryptamine (5HT) containing bulbospinal pathway was studied with immunohistochemical (IF) and chemical techniques in 2-3 and 30 months old male Sprague-Dawley rats. The coexisting neuropeptides substance P (SP), thyrotropin-releasing hormone (TRH) and galanin were also analysed. Furthermore, the expression of mRNA encoding aromatic L-amino acid decarboxylase (AADC), prepro-TRH, and preprotachykinin (prepro-SP) was analysed with in situ hybridization (ISH) in the midline raphé nuclei inthe lower brainstem. The results showed a decreased number of axonal 5HT fibers with a normal morphology in the ventral horn of the aged rat lumbosacral spinal cord, and several 5HT immunoreactive (IR) fibers with an aberrant morphology, suggestive of axonal degeneration, were intermingled. This was evident in both the dorsal and ventral horn of the spinal cord. The 5HT-IR fibers with an aberrant morphology usually also contained TRH-and/or SP- and/or galanin-like immunoreactivity (LI) in the ventral horn. These signs of degeneration were clearly less evident in the thoracic and cervical spinal cord segments. Moreover, these changes varied between aged litter-mates. This was in agreement with behavioural signs of motor disturbances, present in about 40% of the aged rats and which in all cases were confined to the hindlimbs. Chemical analyses disclosed significantly lower levels of TRH-LI and, in particular, SP-LI in both the ventral and dorsal quandrants of the spinal cord in the aged rat compared to young adults. The differences were largest in the lumbar regions of the spinal cord. Corresponding analysis of 5HT and 5-hydroxyindoleacetic acid (5HIAA) in the same tissue specimens revealed largely unaltered levels of 5HT and a slight increase in 5HIAA, indicating the possibility of an increased 5HT turnover in the aged rat spinal cord. Neurons in nucleus raphé obscurus and nucleus raphé pallidus were immunoreactive to 5HT, and after pretreatment with colchicine to TRH-, SP-, and galanin-LI as well. There was no obvious difference in number of labeled cells, or labeling intensity, between colchicine-treated young adult and aged rats, although, in the corresponding region of medulla oblongata, chemical analysis disclosed significantly lower levels of 5HT, TRH, and, in particular, SP in untreated aged rats. In contrast, in situ hybridization analysis revealed increased mRNA levels encoding prepro-TRH and prepro-SP in old rats, while mRNA content encoding AADC mRNA was similar in young adult and aged rats.(ABSTRACT TRUNCATED AT 400 WORDS)

Aging↗
PubMed1993

The peptidergic motoneurone.

Acetylcholine is the classic transmitter in the spinal cord motoneurone. Recent studies have shown that motoneurones also contain calcitonin-gene related peptide (CGRP) and other peptides. In addition to transmitter-like effects, CGRP may also exert trophic actions, as suggested by changes in CGRP expression in motoneurones during development and following experimental perturbations.

Amino Acid Sequence↗
PubMed1993

Management of major complications encountered with flexible colonoscopy.

Management of 65 consecutive complications associated with flexible colonoscopic procedures is reported. The data show that surgical intervention is rarely necessary to manage hemorrhage following polypectomies, whether this occurs immediately after the procedure or is delayed. Free colonic perforations sustained during endoscopic procedures can be managed safely with primary rather than staged surgical procedures. Microperforations may be treated successfully with or without antibiotics.

Colonic Diseases↗
PubMed1993

Relative risk of aortic and femoral insertion of intraaortic balloon pump after coronary artery bypass grafting procedures.

We compared the preoperative, operative, and postoperative characteristics of patients who required balloon pumps after coronary artery bypass graft procedures to determine the relative risks of femoral and aortic insertion. The balloon pump was inserted into the ascending aorta when femoral insertion was not possible because of occlusive disease or small femoral arteries. Femoral insertion was performed in 81 patients and aortic insertion in 42 patients. Patients with aortic insertion were more likely to be small and female (p < 0.05) and were more likely to have carotid bruits and a history of strokes or transient ischemic attacks (p < 0.05). Death was more common in the patients with aortic insertion (18/42, 42.9%) than in those with femoral insertion (19/81, 23.4%) (p < 0.05), as calculated with single regression analysis. Route of insertion was not a predictor of operative death, according to multiple regression analysis. Leg complications were more common in patients with femoral artery insertion (23/81, 28.4%) than in those with aortic insertion (0/42, 0.0%) (p < 0.05). No sternal complications occurred in either group. New neurologic abnormalities were not significantly different between the patients with aortic and femoral insertion. Aortic insertion is a safe alternative to femoral insertion of intraaortic balloon pumps and is associated with fewer leg complications in small or diseased iliac and femoral arteries. The greater mortality rate with aortic insertion is related to greater comorbidity rate in these patients.

Aged↗