Biomedical subjects
Publications and source records attributed to I Jackson.
Following the death of a patient nurses sometimes wonder later how the surviving relatives have coped with the death of their loved one and whether there was any further help that could have been given. This report describes services available to bereaved relatives in Intensive Care Units (ICUs) throughout the UK and how, with limited resources, a formal follow-up service to all bereaved relatives can be achieved.
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An analysis of several G418-resistant ES cell lines produced by electroporation of a promoterless neo gene (NASTI), shows an enrichment for integrations within, or adjacent to, CpG islands. A detailed analysis of two of the cell lines reveals short regions of homology between the genomic target DNA and the construct ends, and that recombination may be mediated by DNA Topoisomerase I. The DNA flanking the insert detects transcription of endogenous genes, and in one cell line divergent transcripts are detected. This use of ES cells should provide an effective and efficient means of creating insertional mutations in mice.
Complications of gynecological laser treatment for perineal disease have been seen with increasing frequency. This may be the result of more women undergoing therapy with this method. Four women presenting with unstable perineal scarring are discussed.
One hundred patients were entered in a randomized, controlled study of adjuvant tamoxifen therapy in gastric carcinoma. Estrogen receptor status was established by an immunohistologic method (ERD5) and 55.8% of the tumors were positive. Tamoxifen had no overall effect on survival, but there was a significant decrease in the survival time of the patients with ERD5-positive tumors. Estrogen receptor status (by the ERD5 method) is an independent prognostic factor in gastric cancer. Tamoxifen therapy does not prolong survival, and new therapeutic strategies require investigation.
A monoclonal antibody (OKT10), which was developed recently, reacts with pro-thymocytes, T cell acute lymphoblastic leukemia (ALL) cells, cells in normal bone marrow (including plasma cells), and activated T cells. Tissues from patients with cutaneous T cell lymphoma were studied for the presence of OKT10-reactive cells with the use of an indirect immunoperoxidase technic. OKT10-reactive cells were identified in three of eight cases of mycosis fungoides, one of two cases of Sézary syndrome, with an equivocal reaction in one of ten cases of large-plaque parapsoriasis and in one of seven positive patch tests (allergic contact dermatitis). The biologic and possible clinical implications are discussed.
A monoclonal antibody OKT 9 which detects a determinant expressed by a variety of proliferating cell types has been recently developed. This antibody was used in conjunction with the immunoperoxidase technique to study the cutaneous lymphoid infiltrates of nine patients with mycosis fungoides, one patient with lymphomatoid papulosis, two patients with Sézary syndrome, and ten patients with large plaque atrophic parapsoriasis (a condition which may terminate in overt mycosis fungoides.) OKT 9 reactive cells were identified in all cases of mycosis fungoides examined, in one case of lymphomatoid papulosis, one of two cases of Sézary syndrome, and one of ten cases of large plaque atrophic parapsoriasis. These results suggest that further studies using OKT 9 should be performed to assess whether OKT 9 reactivity may be used as a prognostic marker in cutaneous lymphomas and prelymphomas.
An immunoperoxidase study was carried out on human tonsil (15 specimens) and human lymph node (5 specimens) using OKT6, a monoclonal antibody which was raised against a determinant on immature thymocytes. OKT6-positive cells were identified in the crypt epithelium of all tonsils examined and in occasional clusters in the interfollicular areas of two lymph nodes. OKT6 has recently been shown to react with epidermal dendritic cells (Langerhans' cells). This study confirms that OKT6-reactive cells may be found outside the thymus. The pattern of staining obtained suggests that OKT6 reactivity belongs to a dendritic subpopulation. The significance of the finding in relation to physiology and pathology is discussed. These physiological findings may also be relevant to the immunotherapy of T-cell lymphomas.
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A false aneurysm in an amputation stump of the second metacarpal produced a pulsatile mass and throbbing pain. Operative findings disclosed a false aneurysm arising from the digital artery on the radial side of the middle finger, with entrapment of the nerve to the ulnar side of the index digit within the aneurysmal sac. Excision of the aneurysm, relocation of the traumatic neuromas, and amputation of the index ray relieved the symptoms.
The diagnosis of empty sella was made correctly by CT scanning in 100% of 19 cases studied.
The authors present a brief review of the problem of diabetes insipidus in neurosurgical patients, with particular emphasis on the differential diagnosis of postoperative and posttraumatic polyuria and the management of diabetes insipidus in these periods. A listing of drugs currently used in its treatment is given.
In two patients who were severely pigmented (Nelson syndrome) following bilateral adrenalectomy for Cushing syndrome, symptoms of hyper-cortisolism developed while they were receiving only physiologic steroid replacement. Cortical assays proved that endogenous cortisol production had not been obliterated. Even after total adrenalectomy, steroid measurement should be performed to guard against adrenocortical excess.
Orbitocraniofacial surgery offers great possibilities to some grossly deformed patients. It is unlike any other aspect of plastic surgery, meriting the creation of a new full-time specialty. The development of a few regional clinical basic science teams located strategically throughout North America is suggested. The primary aim of the teams should be a broad interdisciplinary approach involving basic and clinical research focused on craniofacial anomalies. However, to bring all the necessary multidisciplinary groups into an interdisciplinary team requires central funding to make available the necessary commitment of time to organize a unified thrust of research effort.
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