Biomedical subjects
J Campbell
Publications and source records attributed to J Campbell.
Pyrimethamine-sulfadoxine still effective against Plasmodium falciparum in Jayapura, Irian Jaya: RI-type resistance in 2 of 18 patients.
The sensitivity of Plasmodium falciparum infections to pyrimethamine-sulfadoxine was studied in 18 Indonesian patients in Jayapura, Irian Jaya. In 16 of the 18 patients parasitaemia was cleared by day 6 and the patients remained without parasitaemia through day 28. Two of the 18 patients had late recrudescences consistent with RI-type resistance; one each on days 14 and 21. Pyrimethamine-sulfadoxine is still an effective antimalarial for most patients with falciparum malaria in Jayapura.
Effects of antioxidants on aflatoxin-induced hepatic tumors in rats.
Female Wistar rats pretreated with Aflatoxin B1 (AFB) were administered reduced glutathione, butylated hydroxytoluene, methionine or ascorbic acid on a daily basis, p.o., for 8 months. None of the treatments produced a decrease in incidence or size of hepatic nodules. While there was some evidence that ascorbic acid reduced the incidence of cystic cholangioma, the ascorbic acid and methionine treatment groups also contained significantly fewer animals surviving to the 26-month sacrifice. The lack of effect of glutathione is not consistent with previous work showing a marked glutathione dependent regression of AFB-induced hepatocellular carcinoma.
Congenital prepubic sinus: possible variant of dorsal urethral duplication (Stephens type 2).
We report on 3 patients with a midline sinus extending from the skin overlying the pubis to the anterior wall of the bladder. Two sinuses were lined by transitional epithelium. The sinuses were surrounded by bundles of smooth muscle and lacked any inflammatory reaction, which suggests a developmental origin. Possible etiological causes for this unusual congenital anomaly are discussed. We conclude that these sinuses may represent a variant of epispadiac duplication of the urethra.
Energy cost of three-point crutch ambulation in fracture patients.
The energy consumption associated with unilateral nonweight-bearing (three-point) crutch ambulation was evaluated in a group of 25 newly injured fracture patients immobilized in a long or short leg cast. After 5 min of crutch ambulation, the rate of oxygen uptake was 32% greater than the value for normal walking (averaging 15.7 ml/kg-min); the heart rate was 53% greater than normal (averaging 153 beats/min); and the respiratory quotient was markedly elevated (averaging 1.03). In those subjects able to ambulate for 10 min, these values averaged 17.6 ml/kg-min and 173 beats/min, approaching the peak values for maximal upper extremity exercise. The prescription of three-point crutch ambulation is a severe exercise challenge requiring strenuous arm and shoulder exertion under anaerobic conditions. These findings account for the common clinical experience that the newly injured fracture patient, unable to weight bear on an injured limb and requiring crutches, is a severely restricted ambulator.
Use of plasma segments for estimating factor VIII activity in pools of fresh frozen plasma.
This study describes a procedure for estimating the factor VIII activity of pools of fresh frozen plasma destined for fractionation into factor VIII concentrates. This information is useful for estimating overall yields. We compared the factor VIII activity of plasma packs and the attached segments shortly after the production of fresh frozen plasmas, during storage at -30 degrees C for up to 4 weeks, after shipping at -20 degrees C to the fractionation site, after storage at -30 degrees C at the fractionation site, and after cryoprecipitation. The factor VIII activity of the segments and the plasma packs were indistinguishable at all stages except after cryoprecipitation. Our results suggest that, prior to the cryoprecipitation stage, a pool of a representative number of plasma segments can be used to determine the factor VIII activity of the plasma pool to be fractionated.
Race, socioeconomic status, and the subjective well-being of older Americans.
Causal examination of factors influencing life satisfaction among older Americans can provide knowledge important to social policy development. Using rotated factor analysis, this study isolates two dimensions of life satisfaction, labeled happiness and morale, using data from the 1981 Harris survey on aging. Race, SES characteristics, and the two intervening variables of self-assessed health status and problems experienced are tested through path analysis on the two attributes of life satisfaction. Most of the effects of race and SES are mediated by self-assessed health status and problems experienced, and these two intervening variables are the strongest direct predictors of happiness and morale. Of particular significance are results which demonstrate that racial background has a strong influence on problems experienced, and that education is more influential than income on the life satisfaction factors tested in this study.
Ultrasound screening for spina bifida: cranial and cerebellar signs in a high-risk population.
Cranial and cerebellar ultrasound markers of open spina bifida were evaluated in a prospective screening study of 436 pregnancies at high risk for this fetal abnormality. Twenty-six fetuses with open spina bifida were diagnosed. Values below the fifth percentile for gestation were found for biparietal diameter (BPD) in 17 fetuses (62%) and for head circumference in nine (35%). The anterior horn of the lateral cerebral ventricle/hemisphere ratio was above the 95th percentile in 11 (42%), and there was ventriculomegaly of the posterior horn of the lateral ventricle in 14 (54%). Scalloping of the frontal bones, referred to as the "lemon sign," was present in all 26 cases and also in five (1%) of the structurally normal fetuses. A cerebellar abnormality was found in 25 cases (96%). In nine fetuses (35%), the cerebellum was absent, and in 16 cases (62%), the cerebellar hemispheres curved anteriorly, producing the "banana sign." The predictive ability of each ultrasound marker to detect open spina bifida was evaluated by measuring the sensitivity, specificity, and predictive value of a positive and negative test. These findings demonstrated that certain cranial and cerebellar markers, in particular the lemon sign and the banana sign or absent cerebellum, are consistent features of open spina bifida and are likely to improve the diagnostic accuracy of ultrasonography in the evaluation of pregnancies at high risk for this fetal abnormality.
Effect of fenoprofen on thyroid function tests.
We observed that a few patients taking the anti-inflammatory drug fenoprofen showed increases in total and free T3 serum levels without convincing evidence of an associated thyrotoxicosis. To confirm these findings, two volunteers were given fenoprofen for two weeks. Within this time total T3 levels almost doubled and free T3 levels increased threefold. Administration of fenoprofen did not have any measurable effect on T4 or TSH estimations. Cross-reactivities of fenoprofen and 4'-hydroxyfenoprofen were studied with antisera from various total and free T3 assays. Results show that the metabolite cross-reacts with the antisera from Amerlex total and free T3 assay kits. A lesser degree of interference was observed with the Corning total and free T3 assays. 4'-hydroxyfenoprofen had no effect on an 'in house' total T3 assay. Laboratories should therefore be aware of the possibility that their assay may be subject to interference by fenoprofen or its metabolites while clinicians should be aware of this interference in order that they may avoid unnecessary and harmful treatment.
Clinical diagnosis of umbilical swellings and discharges in children.
Umbilical swellings and discharges are frequently seen in paediatric practice. Whereas the diagnosis of umbilical hernia and the much rarer conditions of exomphalos and gastroschisis should not be problematic, urachal and vitello-intestinal tract remnants that require surgery may resemble the common umbilical granuloma, which may be treated with silver nitrate. A comparison is made of the features of cases that required admission to the Royal Children's Hospital, Melbourne, for umbilical problems from 1973 to 1985, inclusive. A diagnostic protocol to assist the attending primary care physician is suggested.
Birth centre confinement at the Queen Victoria Medical Centre: four years' experience.
A review of the first four years of the functioning of the birth centre at the Queen Victoria Medical Centre is presented. In that time, 1040 pregnant women were accepted for confinement there. Of these, 52 withdrew for non-obstetric reasons, while 470 were transferred to alternative obstetrical care--274 because of antepartum complications and 196 because of intrapartum problems. Therefore, 518 women were delivered in the birth centre. The care of the women is entrusted almost entirely to a team of midwives and this review demonstrates an enviable safety record.
A comparison of radiolabelled agents for thrombus imaging using a rabbit model.
The quantitative uptakes of five potential thrombus-localizing radiopharmaceuticals in experimental thrombi of the rabbit jugular vein have been compared to assist with the selection of a thrombus imaging agent for clinical use. Three hours after injection, 111In-platelets were clearly the agent of choice but at 18 h 99mTc-fibrinogen had more favourable characteristics. Both agents were superior to 99mTc-plasmin or its acyl derivatives, including 99mTc-streptokinase-activated anisoylplasminogen. The ease of preparation coupled with favourable biological properties suggest that 99mTc-fibrinogen should be of value in the clinical situation.
A survivor group for battered women.
Nursing care of battered women and other survivors of violence can be effectively provided through group intervention. Using Lifton's survivor group prototype, a group of battered women met on a weekly basis for one and a half years. The model, its implementation, literature supporting the effectiveness of this kind of group, and a content analysis of the major themes of the group's discussions are presented.
Assessment of cancer pain by the McGill Pain Questionnaire: results of two scoring methods in a sample of British patients and comparison with previous studies.
Pain experienced by 29 British cancer patients was evaluated by the McGill Pain Questionnaire. The questionnaires were analysed according to the traditional and a newly proposed scoring method. The results were compared with previously published studies. Scores relating to the sensory and affective components of pain were found to be similar for all groups of cancer pain patients. On the contrary, differences between groups were found for evaluative scores of the overall experience of pain. A previously observed pattern of pain intensity-complexity correlation in cancer pain patients was reproduced. Interpretations of the similarities and discrepancies among groups of patients are discussed.
Approaches to overcome in vivo anti-cancer drug resistance.
Therapeutic efficacy of anticancer drugs against malignant diseases is limited because of the selection and regrowth of drug resistant cells. This problem is compounded by the development of cross-resistance to other useful chemotherapeutic agents which severely limits treatment alternatives. Development of approaches to overcome and/or circumvent drug resistance will depend on the precise understanding of the mechanism(s) of resistance not only at the target tumor cell level (in vitro) but also in vivo. The data on L1210 sensitive to araC transplanted s.c. demonstrated that although target cells are highly sensitive to araC, the lack of in vivo response of solid L1210 cells (s.c.) is primarily due to limited drug delivery to the target. Approaches that would modify these processes should improve on the therapeutic selectivity of this agent. In contrast, in cells where the mechanism of resistance is deletion of a key anabolic enzyme (e.g. CdR kinase), these cells are collaterally sensitive in vitro and in vivo to DAUR. This type of resistance, however, could not be overcome by liposome encapsulation of araC or araCTP. With respect to AM resistance, the concentration of VRP for in vitro reversal of resistance of P-388/AM was difficult to achieve in vivo without significant host toxicity. Continuous infusion of VRP, however, demonstrated that at the maximally tolerated doses of VRP it was not possible to achieve any significant therapeutic effects against P-388/AM. The use of liposomes or modulation by VRP does not appear to be a fruitful approach in overcoming AM resistance, especially in cells which possess a high degree of resistance. Metabolic modulation of FU by dLCF appears to be a promising area of investigation and deserves further investigation concerning quantitation of the intracellular pools of folate and ways to modulate them.
Diabetes: adequate competent clinical review.
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Immunohistochemical demonstration of S-100 protein in salivary gland neoplasms.
A peroxidase-antiperoxidase technique for S-100 protein has been applied to 68 salivary glands. These included 17 pleomorphic adenomas, seven adenoid cystic carcinomas, 23 adenolymphomas and a number of other neoplasms. In addition, five specimens of myoepithelial sialadenitis ('benign lymphoepithelial lesion') and five normal parotid glands were included. Consistent results were obtained, myoepithelial cells and cells in myxoid and chondroid areas in pleomorphic adenomas staining intensely. In adenoid cystic carcinoma, on the other hand, there was no staining. The adenolymphomas possessed intensely S-100 protein-positive cells in the interfollicular lymphoid areas; these were probably interdigitating reticulum cells. In addition, branching structures, probably corresponding to Langerhans' cells, were observed in the epithelium of adenolymphomas.
Studies of 99mTc-acylplasmins as agents for thrombus detection.
It has been proposed that acylation at the active site of plasmin is able to prevent its reaction with alpha 2-antiplasmin without affecting the fibrin affinity of the enzyme. To investigate the possibility that 99mTc-labelled acylplasmins are improved thrombus-detecting agents, six acylating agents were synthesised and their reaction with plasmin and the labelling of the products with 99mTc studies. Uptake of 99mTc-acylplasmins in an in vitro thrombus model was complicated by precipitation processes, which may in part account for the rapid blood clearance in rabbits and high liver uptake in mice injected with the compounds. Quantitative measurements using an in vivo rabbit thrombus model demonstrated that guanidinobenzoyl-plasmin exhibited nearly a threefold increase in thrombus uptake compared with non-acylated 99mTc-plasmin. The observed uptake is less than that obtained with 125I-fibrinogen at clinically useful time intervals post-injection but represents a significant advantage over the use of 99mTc-plasmin.