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Biomedical subjects

H Walker

Publications and source records attributed to H Walker.

At least 73 records · Page 4Linked to original sources
PubMed1988

Implementing an integrated clinical information system.

The authors examine the vital role nursing professionals have played in the successful implementation of a sophisticated computer system at a regional medical center in the midwest. From preselection analysis through training and implementation, nurses have assumed primary responsibility for managing the multifaceted adaptation and installation of a comprehensive array of patient care functions. This experience can serve as an invaluable example of the relationship between information management, patient management, cost management, and quality enhancement in the hospital setting.

Computer Systems↗
PubMed1986

The significance of host haemopoietic cells detected by cytogenetic analysis of bone marrow from recipients of bone marrow transplants.

Bone marrow from 39 patients who received a bone marrow transplant (BMT) from a matched donor of different sex were studied by chromosome analysis for evidence of mixed haemopoietic chimaerism (MC). Recipient metaphases were detected in the bone marrow of 10 patients after BMT. Patients in whom MC was detected within 6 weeks of BMT did not all have a poor outcome. Two of seven are disease-free survivors at greater than 470 and greater than 632 d. All three patients in whom MC was diagnosed more than 6 weeks after BMT subsequently relapsed. Four factors appear to be important in determining the probability of relapse when MC is detected in a patient after BMT: the timing of detection of residual recipient cells; the proportion of these cells in the bone marrow; persistence of these cells in increasing proportions; and the karyotype of the recipient metaphases detected. Cytogenetic assessment may provide the earliest indication of relapse in these patients. In addition, this study provides further evidence that cyclophosphamide and total body irradiation, as used in these patients, may be inadequate conditioning therapy for BMT.

Adolescent↗
PubMed1983

Radiosensitisation of cells in vitro with misonidazole: dependence on endogenous sulphydryl.

The radiosensitisation conferred upon hypoxic mammalian cells by misonidazole can be reduced by the addition of exogenous sulphydryl compounds and enhanced by the diminution of endogenous non-protein sulphydryl compounds (NPSH). A similar enhancement of the effect of misonidazole has been demonstrated in bacteria which are genetically low in NPSH. In the experiments reported here, the radiosensitising ability of various concentrations of misonidazole on anoxic populations of a single strain of mammalian cells, containing different amounts of NPSH, has been measured. At misonidazole concentrations of 3mM and less, about twice as much misonidazole was required to confer the same degree of radiosensitisation on the cells which contained a high concentration of NPSH as was needed for cells which contained half the amount of NPSH. At these concentrations, misonidazole did not deplete endogenous NPSH. 5mM misonidazole conferred the same enhancement of sensitivity in both high- and low-NPSH-containing cells. The oxygen enhancement ratio, and extrapolation number of the survival curves, for cells irradiated without misonidazole were not affected by the variation in NPSH.

Animals↗
PubMed1982

A chronic myeloproliferative disorder associated with monosomy 7 in the bone marrow cells; normal karyotype in acute transformation.

A chronic myeloproliferative disorder associated with monosomy 7 of the bone marrow cells is described in a male infant. After nearly 4 years, during which time no drug therapy was given, the disease transformed to a 'blast crisis' and at this stage the karyotypes of the marrow and unstimulated blood cells were shown to be normal. It is proposed that the development of the myeloproliferative disorder associated with monosomy 7 is a multistage process and the acquisition of the chromosomal abnormality is a secondary event.

Bone Marrow↗
PubMed1982

How important are prostaglandins in the urology of man?

Although the discovery of prostaglandins (PGs) is to be attributed to investigations into the semen plasma and the accessory sex glands, it has been the female genital function and its relationship to the PGs rather than male genital function which has been the subject of intensive research in the past. This survey is intended to provide some idea of which known PGs play a part in the function of the male genital tract and of the urinary bladder. PGs, above all PGE, occur in testicle tissue, have a modulating effect on the LH-dependent steroid synthesis and possibly influence sperm density and sperm function. The PGs certainly play a part in the motility of the vas deferens and participate decisively in blood flow regulation in male genitals. The basal tone and contractility of the testicle capsule are partly controlled by PGs. Connections between reduced PGE levels in semen plasma and infertility are discussed. PGs are partly responsible for the basal tone and the emptying mechanism in the urinary bladder, and are transmitters acting between the nervous system and the muscular stimulus response. The significance to be attributed to PGs and the effect of urinary bladder carcinomas on their synthesis is still largely unclear. Animal studies and in vitro investigations reveal interesting aspects. The seminal vesicle synthesizes very large amounts of PGs, which probably display their action in the semen plasma and with this also in the female genital tract; there is a close relationship between the steroid and prolactin effects and PGs in the prostate gland. Together with prolactin, PGs are modulators of the stimulatory effects of steroids on this organ. On the other hand, the PGs formed in the prostate gland also exert a certain "remote action' in semen an in the urinary bladder. The importance of PGs in inflammatory changes in the prostate gland and the therapeutic possibilities for these clinical symptoms which may result from influencing PGs can be seen from some studies, but it is not yet possible to draw a final conclusion a this point in time.

Animals↗
PubMed1981

Heterogeneous blast cell crises in Philadelphia negative chronic granulocytic leukaemia.

A case of Philadelphia negative chronic granulocytic leukaemia (Ph1-CGL) is described showing features only previously demonstrated in Ph1+ disease. These features include: (1) lymphoid blast crisis, determined by morphology and immunological marker analysis; (2) dual blast cell populations that can be distinguished both morphologically and by immunological markers; (3) clonal evolution, as shown by the emergence of chromosome markers and in one of the cell lines a change in membrane phenotype. These changes were apparently associated with the emergence of a relatively drug resistant subclone of leukaemic cells. This study demonstrates that the lymphoid blast crisis of CGL, and its sequelae, can occur in Ph1- cases. It is similar in respect to morphology, enzyme, and membrane markers and responsiveness to vincristine and prednisolone therapy to the lymphoid blast crisis seen in Ph1+ CGL. This suggests that the Philadelphia chromosome is a clonal marker only, and its presence is not directly related to the subsequent clinical course of the disease.

Bone Marrow↗
PubMed1981

Peripheral responses to thyroid hormone before and after L-thyroxine therapy in patients with subclinical hypothyroidism.

Twenty patients with serum levels of T4 and T3 within the normal range but with elevated serum concentrations of TSH were evaluated before and after treatment with L-T4. This therapy increased serum T4 (5.5 +/- 1.1 to 8.8 +/- 1.8 microgram/dl) and T3 (116 +/- 20 to 137 +/- 28 ng/dl) levels. Cardiac systolic time intervals (STI) were significantly (P less than 0.01) reduced by this therapy. The preejection period (123 +/- 18 to 114 +/- 14 msec; n = 12), the change in preejection period (+17 +/- 17 to +6 +/- 15 msec; n = 12), the ratio of preejection period to left ventricular ejection time (0.412 +/- 0.068 to 0.357 +/- 0.063 msec; n = 12), and the interval from the Q wave of the electrocardiogram to the pulse wave arrival time at the brachial artery (224 +/- 10 to 200 +/- 13 msec; n = 10) were consistently reduced. Cardiac STI were significantly correlated with serum TSH and T4 levels, but not with serum T3 levels. Normalization of serum TSH levels was associated with changes in QKd measurements even in those patients with minimal elevations in serum TSH. These studies demonstrate that patients having the combination of elevated TSH but T4 and T3 levels in the normal range have alterations in STI which can be changed significantly by L-T4 in doses which normalize TSH secretion. These data suggest that such patients have a mild form of primary hypothyroidism.

Adult↗