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Biomedical subjects

J F Shaw

Publications and source records attributed to J F Shaw.

At least 19 recordsLinked to original sources
PubMed1992

Ultrasound assessment of the problem kidney transplant: a surgical prospective.

Ultrasound investigation contributes to the assessment of transplanted kidneys. Ureteric obstruction and peri-transplant fluid collections are shown satisfactorily, but the differentiation of graft rejection from cyclosporin A nephrotoxicity and continuing acute tubular necrosis is less straightforward. Doppler ultrasound is used to detect changes in graft blood circulation, but the results of such assessment vary between centers, and further improvements are required to improve the accuracy of diagnosis of causes of graft impairment by noninvasive methods.

Cyclosporine↗
PubMed1992

Prevalence of serum antibodies against lymphocytic choriomeningitis virus in selected populations from two U.S. cities.

An ELISA was developed for measuring serum antibodies against the arenavirus lymphocytic choriomeningitis virus (LCMV) and a closely related isolate termed callitrichid hepatitis virus (CHV). The ELISA was used to test sera from healthy adults and from hepatitis patients. In Birmingham, Alabama, the seropositivity rate for healthy black women was 5.1% (7/138), and the rate for patients with all types of hepatitis or cirrhosis was 4.3% (2/46). In San Antonio, Texas, the seropositivity rate among a clinical series of patients with non-A, non-B hepatitis was 0 (0/20), and the rate among persons rejected from blood donation because of high serum alanine aminotransferase levels was 2.4% (2/82). These results indicate that infection with LCMV or CHV is common in Birmingham but that infection is not associated with hepatitis.

Adult↗
PubMed1991

Immobilized enzyme system for determination of sialic acid in serum or urine.

An immobilized enzyme system has been developed and employed to determine the concentration of sialic acid (N-acetylneuraminic acid) in human serum and urine. Two enzyme pairs, neuramindiase-Neu-5-Ac lyase and pyruvate oxidase-peroxidase, have been respectively co-immobilized onto 1,12-aminododecane-agarose with glutaraldehyde. The relative specific activity of the co-immobilized neuraminidase and Neu-5-Ac lyase were 60% and 78%, and those of pyruvate oxidase and peroxidase were 50% and 95% of the corresponding soluble enzymes, respectively. The optimal reaction pH at 37 degrees C for each of the co-immobilized enzymes was about one pH unit higher than that of the corresponding soluble enzyme. The optimal reaction temperature of each enzyme was increased as a result of immobilization. The thermal stability at 45 degrees C of the immobilized neuraminidase, Neu-5-Ac lyase, pyruvate oxidase, and peroxidase were increased 80-, 83-, 115-, and 147-fold, respectively. Km and Vm of each immobilized and co-immobilized enzyme have also been determined. The system provided a convenient and rapid method to determine the concentration of total sialic acid without pretreatment of the sample. The results correlated satisfactorily with those obtained by using a soluble enzyme system. The co-immobilized enzymes were stable for at least 1 year of 500 tests when used repeatedly. The system is thus a reproducible and reliable novel assay method for sialic acid in the serum or urine sample.

Enzymes, Immobilized↗
PubMed1990

Single dose cefotaxime plus metronidazole versus three dose cefuroxime plus metronidazole as prophylaxis against wound infection in colorectal surgery: multicentre prospective randomised study.

OBJECTIVE: To establish whether a single preoperative dose of cefotaxime plus metronidazole was as effective as a standard three dose regimen of cefuroxime plus metronidazole in preventing wound infection after colorectal surgery. DESIGN: Prospective randomised allocation to one of two prophylactic antibiotic regimens in a parallel group trial. Group sequential analyses of each 250 patients were performed. SETTING: 14 District general and teaching hospitals. PATIENTS: 1018 Adults having colorectal operations were randomised, of whom 943 were evaluated. Demographic features, conditions requiring surgery, and operative procedures were similar in the two groups. Most patients had surgery for carcinoma of the colon or rectum. INTERVENTIONS: Group 1 received cefotaxime 1 g intravenously plus metronidazole 500 mg intravenously preoperatively. Group 2 received cefuroxime 1.5 g intravenously plus metronidazole 500 mg intravenously preoperatively, followed by cefuroxime 750 mg intravenously plus metronidazole 500 mg intravenously eight hours and 16 hours postoperatively. MAIN OUTCOME MEASURES: Development of surgical wound infection (as evidenced by the presence of pus), death, or discharge from hospital. RESULTS: Wound condition was scored on a five point scale on alternate days until discharge or for up to 20 days postoperatively. Wound infection rates were: group 1, 32/453 (7.1%; 95% confidence interval 4.7% to 9.4%); group 2, 33/454 (7.3%; 95% confidence interval 4.9% to 9.6%). Death rates (group 1: 26/470 (5.5%); group 2: 31/471 (6.6%], the incidence of postoperative complications, the median duration of hospital stay (12 days), and antibiotic tolerance were all similar in the two groups. Pooled data from groups 1 and 2 showed that wound infections were more frequent when minor faecal contamination had occurred at operation and when the duration of operation exceeded 90 minutes (greater than 90 min 11.2% of cases; less than 90 min 4.8%) and were associated with an extended hospital stay. CONCLUSIONS: A single preoperative dose of cefotaxime plus metronidazole is an efficacious as a three dose regimen of cefuroxime plus metronidazole in preventing wound infection after colorectal surgery and has practical advantages in eliminating the need for postoperative antibiotics.

Adolescent↗
PubMed1990

Survey of the use of thrombolysis for acute limb ischaemia in the UK and Ireland.

A total of 156 vascular surgeons from the UK and Ireland responded to a postal questionnaire on the use of thrombolysis in acute limb ischaemia. Almost half had used thrombolysis in the previous 12 months. Low dose intra-arterial streptokinase (89 per cent) was the regimen most frequently used, but 33 per cent had used intravenous streptokinase. Detailed results for 103 patients (limb salvage rate 60 per cent, amputation rate 35 per cent, mortality rate 5 per cent) were similar to those of previously published reports. Complications in most series were infrequent, but in the entire survey there were six bleeding-related deaths and one death from anaphylaxis. A total of 67 per cent of surgeons with working experience indicated that selected patients with acute arterial thromboses were most suitable for thrombolysis, particularly if there was no neurological deficit and no run-off for surgical bypass. Distal or late emboli and graft occlusions were regarded as appropriate by some surgeons. This study demonstrated that many vascular surgeons currently use thrombolysis, although sparingly and in selected cases. Patients with acute limb ischaemia should be managed by experienced vascular surgeons who are aware of the new therapeutic alternatives, an ideal supported by almost three-quarters of respondents to this survey.

Acute Disease↗
PubMed1989

Pleomorphic xanthoastrocytoma. Report of four cases.

Four cases of pleomorphic xanthoastrocytoma (PXA), a low-grade leptomeningeal glioma with a reported favorable prognosis affecting young patients, are reported together with a discussion and review of management and prognosis. A literature review has confirmed a favorable prognosis in at least 50% of patients with this disorder. Seventeen of 35 reported patients are still alive and often seizure-free for a mean period of 7.4 years (range 2 to 18 years) after diagnosis. Five patients have died within 2 years and four between 9 and 25 years after diagnosis of PXA. In some cases in which death followed shortly after diagnosis, there may have been histological confusion between PXA and a malignant glioma with heavily lipidized tumor cells. Nonetheless, transformation of PXA into a malignant astrocytoma or glioblastoma with eventual death may occur many years after initial diagnosis. From the currently reported cases it does not appear possible on clinicopathological grounds to predict which patients will have a favorable prognosis. Optimal management of PXA seems to be primary surgical resection with later surgery for residual or recurrent tumor. The role of radiotherapy in the management of PXA is at this time uncertain.

Adolescent↗
PubMed1979

Multiple intestinal perforation due to Celestin tube.

Two cases of multiple intestinal perforation caused by the nylon from the core of disintegrating oesophageal Celestin tubes migrating down the alimentary tract are described. It is suggested that Celestin tubes should not be used in patients likely to survive for more than a few months.

Aged↗
PubMed1978

The incidence of HLA antigens in black primary open-angle glaucoma patients.

We compared the HLA antigen frequencies in black primary open-angle glaucoma patients to those in black non-glaucomatous patients; normal, nondiseased black persons; and nondiseased North American blacks. We found no statistically significant alteration in HLA antigen frequencies in black open-angle glaucoma patients as compared to a control population.

Adult↗
PubMed1976

Conformations of lysine-sensitive aspartokinase.

1. The technique of differential thermal and proteolytic inactivation has been employed as a conformational probe for the lysine-sensitive aspartokinase (EC 2.7.2.4) of Escherichia coli B. 2. L-Amino acid inhibitors of this enzyme each induce a characteristic enzyme conformation. This is evidenced by rates of thermal and proteolytic inactivation and Arrhenius activation energies for thermal inactivation which are characteristic of the amino acid present. 3. Phenylalanine and leucine binding are mutually exclusive as evidenced by competitive behavior in thermal inactivation experiments, suggesting a hydrophobic amino acid binding site with broad specificity. 4. The phenylalanine-dependent conformation and the leucine-dependent conformation differ considerably. In comparison with the native enzyme, the former is more labile to proteolysis by trypsin whereas the latter is more stable. First-order rate constants for thermal inactivation of the phenylalanine- and leucine-dependent conformations are, respectively, about one-half and one-tenth that of the native enzyme. 5. Items 3 and 4 taken together suggest that the conformations are ligand induced and do not arise via ligand stabilization of spontaneously arising conformers.

Aspartate Kinase↗
PubMed1976

Retrospective analysis of 100 consecutive patients undergoing related living donor renal transplantation.

One hundred consecutive patients receiving related donor kidneys were analyzed in regards to graft and patient survival, morbidity, mortality, histocompatibility and rehabilitation. The average followup was 3 years and 2 months with a minimum post transplant evaluation of one year. Donor morbidity was minimal and the mortality nil. Recipient mortality was 17%, all of which occurred after the first two post transplant months. The most serious life threatening complications after transplantation were due to infection. The greatest morbidity was secondary to aseptic necrosis. The overall graft survival at one year was 94%, 2 years--87%, 3 years--81% and 4 and 5 years--72%. Separation of patients according to tissue typing revealed 95% of recipients with A and B matched kidneys to be alive 5 years later compared to 55% of patients receiving C and D matched kidneys. Rehabilitation was good to excellent in 76% of the living patients and poor in only 4%. These results suggest related donor renal transplantation to be the treatment of choice for patients with chronic renal failure excluding only those individuals who are exceptionally high risks in terms of morbidity and mortality.

Acute Kidney Injury↗
PubMed1976

HLA typing.

I present an overview of HLA typing, a method of evaluating donor-recipient compatibility. The major histocompatibility system in man, the HLA region, considered to control the immunologic response to transplantation and perhaps to certain diseases, is discussed in relation to chromosomal location, chromosomal mapping, association with other markers, nomenclature of the gene products (the HLA antigens), inheritance of the HLA antigens, and methods of determining these antigens. Use of HLA typing is currently most applicable in the correlation of certain diseases with HLA antigen frequency, in evaluating donor-recipient pairs for renal and bone marrow transplantation and for transfusion of platelets and granulocytes and in paternity testing.

Animals↗