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Biomedical subjects

J Chamberlain

Publications and source records attributed to J Chamberlain.

At least 109 records · Page 6Linked to original sources
PubMed1989

Role of dietary restriction in Haemoccult screening for colorectal cancer.

The aim of this study was to investigate the effect of dietary restrictions on the positivity rate and yield of neoplasia during a study based on Haemoccult screening for colorectal neoplasia. Of 18,925 participants who completed Haemoccult tests on a normal diet, 647 (3.4 per cent) were positive. All repeated the test with dietary restrictions: 251 remained positive and underwent further investigations which revealed 35 carcinomas and 169 adenomas in 129 subjects. The remaining 396 were sent a further Haemoccult test at 3 months. Of these, 317 (80.1 per cent) completed the test: 31 (9.8 per cent) were positive. Further investigation of the 31 positive subjects revealed four carcinomas and 20 adenomas. Retesting with dietary restriction will reduce the false positive rate of Haemoccult when used for colonic cancer screening. However, if the retest is negative a further test should be performed. To minimize the adverse effect this may have on compliance, we have allowed an interval of 3 months to elapse before this retest is requested.

Adenoma↗
PubMed1989

Characterization of patients with glycerol kinase deficiency utilizing cDNA probes for the Duchenne muscular dystrophy locus.

Genomic DNA from five previously unreported patients with glycerol kinase deficiency (GKD), dystrophic myopathy, and adrenal insufficiency were studied with genomic probes and cDNA probes for the Duchenne muscular dystrophy (DMD) locus. These individuals, together with those reported by ourselves and others, show that patients with a contiguous gene syndrome involving the DMD, GK, and adrenal hypoplasia congenita (AHC) loci have a broader distribution of microdeletion breakpoints than those observed among patients with classical DMD. This study demonstrates the use of the DMD cDNA probes to delineate the centromeric deletion breakpoints for patients with Xp21 microdeletions extending beyond the DMD locus. It also shows the practical diagnostic application of the DMD cDNA probes when the diagnosis of GKD is entertained in a patient with known DMD and only DNA is available for study.

Adolescent↗
PubMed1989

Screening and the costs of treating colorectal cancer: some preliminary results.

This paper describes a hospital costing analysis of 85 colorectal cancer patients treated in the context of a randomised control trial at the Queen's Medical Centre, Nottingham. Estimates are presented for investigation, surgical and inpatients costs. Comparisons between study and control group patients reveal only a small difference in overall costs of treatment.

Aged↗
PubMed1989

Psychiatric morbidity associated with screening for breast cancer.

The 28-item GHQ was used to assess psychiatric morbidity in 302 women attending for routine breast cancer screening, 300 women attending for further investigation of a positive screening result and 150 women referred for investigation of breast symptoms. The GHQ-28 was administered on arrival at the relevant clinic and three months later. Medical records were used to determine the outcome of the clinic attendance. Women were classified into routinely screened women, women with false positive screening results, symptomatic women with a benign diagnosis, newly diagnosed cancer patients and previously treated cancer patients. When tested on arrival at the clinic, 25% of routinely screened, 30% of women with false positive results and 35% of symptomatic women with benign conditions were probable cases of psychiatric morbidity. The only statistically significant difference was between the routinely screened and symptomatic benign groups. Levels of anxiety were significantly higher in those with false positive results and in the symptomatic benign group than in the routinely screened. Three months later the prevalence of probable psychiatric morbidity had fallen to 19% in both the routinely screened and those with false positive results but remained significantly higher in the symptomatic benign group (31%). Probable cases of psychiatric morbidity among newly detected cancer patients rose from 34 to 46% over the 3-month period. Among women who had had breast cancer diagnosed in the past prevalence remained at 21%. The prevalence of probable psychiatric morbidity in screened women is similar to that in the general population. Among women referred for further investigation because of a false positive screening result prevalence was only slightly increased and there was no evidence of a sustained increase in anxiety. Provided that delays are kept to a minimum and that women are kept informed, a breast cancer screening programme does not increase psychiatric morbidity. Further research is required in cancer patients to determine whether those diagnosed in asymptomatic women have a higher and more sustained degree of psychiatric morbidity than those diagnosed in women who are aware of symptoms.

Aged↗
PubMed1989

Gamma irradiation of isolated rat islets pretransplantation produces indefinite allograft survival in cyclosporine-treated recipients.

In this study we have examined the use of low-dose gamma-irradiation for the reduction of islet immunogenicity in the strong allogeneic combination of WAG rat islets transplanted into diabetic AUG recipients. First, we determined that gamma-irradiation reduced immunogenicity in vitro by use of a modified MLR with WAG islets as stimulators and AUG splenocytes as responders. We then determined the maximum dose of gamma-irradiation that could be used (250 rads) before islet function was affected. As 250 rads islet pretreatment alone was ineffective in prolonging allograft survival, we combined the pretreatment with a short course (days 0, 1, 2; 30 mg/kg) of cyclosporine. We found that CsA was only effective in significantly prolonging allograft survival when given subcutaneously in olive oil. The CsA treatment alone gave a significantly prolonged survival time for the islet allografts (median, 37 days vs. 6 days for controls), but when combined with the 250 rads islet pretreatment a synergistic effect was seen with 100% becoming long-term survivors (greater than 100 days). The long-term surviving AUG rats from both the CsA alone group and the CsA plus 250 rads pretreated islets group were challenged with WAG dendritic cells (DC). The islets from the 250 rads pretreated group were subsequently rejected (day 6) while the CsA alone group were not affected. The role of low dose gamma-irradiation when combined with CsA treatment of islet graft recipients in inducing specific unresponsiveness will be discussed.

Animals↗
PubMed1989

Complementary DNA probes for the Duchenne muscular dystrophy locus demonstrate a previously undetectable deletion in a patient with dystrophic myopathy, glycerol kinase deficiency, and congenital adrenal hypoplasia.

Genomic DNA from a patient with dystrophic myopathy, glycerol kinase deficiency, and congenital adrenal hypoplasia was investigated using cDNA probes for the Duchenne muscular dystrophy (DMD) locus. Genomic probes had not detected a deletion in this patient. Southern analysis of Hind III-digested genomic DNA from this patient identified a deletion when the three distal Hinc II DMD cDNA fragments were used as probes. The deletion began in the genomic region corresponding to the 1.05-kb Hinc II cDNA fragment and extended through the 3' end of the DMD gene. This represents a centromeric breakpoint that corresponds to a position approximately 10.2-10.6 kb from the 5' end of the 14-kb DMD cDNA. These investigations demonstrate the value of the DMD cDNA probes for improved diagnoses in patients with molecular lesions involving the DMD locus. Furthermore, this novel deletion involving the coding portion of the 3' end of the DMD gene assists in the ordering of exons in this region and will provide insight into the functional role of the carboxy terminus of the DMD gene product, dystrophin.

Adrenal Insufficiency↗
PubMed1989

Large-scale purification of human islets utilizing discontinuous albumin gradient on IBM 2991 cell separator.

A new method is described for the large-scale purification of human pancreatic islets with a discontinuous gradient of bovine serum albumin formed on an IBM 2991 cell separator. Fifteen human pancreases were processed, and after density-gradient centrifugation, a mean of 2643 islets/ml pancreatic digest were recovered with a mean purity of 63% and contained in 430 microliter mean vol. Viability of gradient-isolated islets was compared with that of non-density-gradient islets (handpicked) and showed no difference in function. This technique allows isolation of intact, viable human islets of Langerhans of sufficient purity for potential human transplantation.

Adult↗
PubMed1989

Successful reversal of diabetes in nude rats by transplantation of isolated adult human islets of Langerhans.

A method is described in which the viability of isolated adult human islets of Langerhans can be assessed in vivo. The Rowett nude rat, made diabetic with streptozocin (STZ), has been used as the islet recipient in these studies. Although these animals are athymic and are able to accept xenogeneic grafts for prolonged periods, they are very susceptible to dehydration and infection once made diabetic. Therefore, a considerably shortened diabetes induction period was used. The basis of the study was to prepare pure adult human pancreatic islets that were cultured for 48 h. Nude rats were given 80 mg/kg i.v. STZ during islet isolation and were transplanted with 800-1000 islets under the renal capsule at 48 h. To monitor islet function, animals were bled regularly for random blood glucose measurements and were given a glucose tolerance test at day 20. The kidney containing the graft was removed on day 21 to allow histological assessment of the graft and to confirm that glucose control was due to the transplanted islets and was not secondary to reversion of the animal's own islets. Seven rats were transplanted, and five were deemed to have received viable human islets. Two rats that received islets from the same donor did not reverse their diabetes and were found by histology to have vacuolated islet structures with scant insulin-staining tissue under the kidney capsule. This method allows a definitive judgment of the ability of isolated adult human islets to reverse diabetes.

Adult↗
PubMed1989

Cervical screening in the workplace.

In an attempt to improve cervical cytology screening uptake in women aged over 40, a mobile screening unit was used to make screening easily available to women at work. This service was organized jointly between the District Health Authority, the Women's National Cancer Control Campaign and the South West Thames Regional Cancer Organization, and was offered to all companies employing at least 25 women. Thirty-nine out of 82 companies accepted the offer. Among those companies which were able to supply a register of their employees aged over 40, 91 per cent of eligible women attended the mobile clinic. The clinic doctors followed District guidelines in not taking smears from women who had been screened and found negative within the previous three years, or who had had a hysterectomy for an unrelated reason. Of the 1038 women who attended the clinic, cervical smears were taken from 568 (55 per cent). Fifteen women were found to have cervical neoplasia, of whom nine had either never been screened before or had last been screened more than five years previously; a further two women (one of whom was found to have early invasive cancer) had previously had an abnormal smear for which the recommended follow-up had not been done. It was not possible to quantify the benefits of other tests (clinical breast examination, blood pressure, urinalysis and gynaecological examination) included in the screening clinic, but they were popular with the women attending. Provided that the health authority is involved in the planning and organization of workplace screening, it can be a valuable adjunct to improving screening coverage, particularly for women aged over 40.

Adolescent↗
PubMed1989

Metabolism and pharmacokinetics of 14C-pentoxifylline in healthy volunteers.

The metabolism and pharmacokinetics of 14C-pentoxifylline (Trental) have been studied in three healthy male volunteers after oral administration of 200 mg (50 microCi). The radiolabelled drug was rapidly absorbed and by 6 h 89.1 +/- 2.4% of the 14C material was excreted in the urine. The dosed 14C material (96.9 +/- 2.2%) was recovered in excreta by 24 h with 93.3 +/- 2.3% in the urine 3.0 +/- 0.2% in the faeces. Peak plasma levels of radioactivity (4.1-6.2 micrograms eq ml-1) occurred 0.25-0.75 h after administration. This radioactivity decayed in a biexponential fashion with an initial half-life of 1.01 +/- 0.13 h and a terminal half-life of 36.06 +/- 16.94 h. The peak plasma levels (0.48-2.25 micrograms ml-1) of parent drug, as measured using a specific gas chromatographic assay also occurred at 0.25-0.75 h and subsequently decayed extremely rapidly with an initial half-life of 0.18 +/- 0.15 h and terminal half-life of 0.76 +/- 0.44 h. Urinary 14C-labelled metabolites were separated by semi-preparative high performance liquid chromatography and characterised by mass spectrometry and by comparison with authentic synthetic compounds. Of the dosed 14C-pentoxifylline, greater than 90% could be identified as characterised metabolites in urine.

Biotransformation↗
PubMed1988

Registering cancer.

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Catchment Area, Health↗
PubMed1988

Preparing nurses to work with the chronically mentally ill.

Nursing has been a major contributor to the ongoing care of the long term patient for hundreds of years. In recent times, however, its' focus has been changing to reflect a broader range of activities and roles for nurses. Masters level and recently doctoral level programs have sprung up in centers throughout the country. This workforce consists of a true career ladder for professional nurses beginning with the B.S.N. generalist, an advanced Masters' level clinician, and a scientist scholar at the Ph.D. or D.N.Sc. level. This paper describes training and practicum at each level as it relates to the chronic patient.

Chronic Disease↗
PubMed1988

In vivo assessment of isolated pancreatic islet viability using the streptozotocin-induced diabetic nude rat.

In order to establish a model for the in vivo assessment of islet function we have used the Rowett nude rat with transplantation of allogeneic and xenogeneic (mouse) islets into the renal subcapsular space following a minimal period of diabetic induction. Thirty-one nude rats were given streptozotocin and 30 became diabetic with blood glucose levels of greater than 20 mmol/l at 48 h. Rat and mouse islets were prepared by intraductal collagenase and bovine serum albumin density gradient isolation. Eight rats received transplants of freshly prepared allogeneic islets and 8 rats received transplants of 48 h cultured allogeneic islets. Seven rats received transplants of 48 h cultured mouse islets. Diabetes was reversed in all animals and all remained normoglycaemic for 21 days. Graft removal by nephrectomy resulted in hyperglycaemia in 22 out of 23 animals. Histological examination of the grafts showed a band of endocrine tissue beneath the renal capsule which stained strongly positive for insulin and there was no evidence of lymphocytic infiltration/rejection. One rat remained normoglycaemic after graft removal, which may represent recovery of the animal's own islets from the streptozotocin-induced diabetes. Control rats remained diabetic until death. In conclusion, the athymic nude rat can be used for the assessment of allogeneic and xenogeneic islet function when a short (48 h) period of streptozotocin-induced diabetes is used. This model offers a potential method for assessing in vivo function of isolated human islets.

Animals↗