Significance of contaminated islet preparations in clinical islet transplantation.
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Biomedical subjects
Publications and source records attributed to J Field.
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Percutaneous endoscopic gastrostomy (PEG) is the preferred method for administration of long-term enteral tube feeding. However, most published studies describe only short-term follow-up in any detail. We report the long-term outcome and complication rate after PEG insertion in 49 patients (mean [SE] age 64 [2] years) whose mean length of PEG feeding was 175 days (range 30-560). Data were collected prospectively. PEG insertion was technically successful in all cases, with a procedure-related mortality of 2%. Early (< 30 days) mortality and morbidity were 8% and 22%, respectively. Of 45 patients surviving for more than 30 days, 76% were able to return home and 6 patients were eventually able to revert to oral feeding. There were 27 late complications: 2 site infections, 17 mechanical problems, and 8 episodes of gastrointestinal dysfunction. 51% of patients had no problems at all and 22% had 2 or more complications. 47% of complications required a hospital visit for resolution. Long-term enteral feeding by PEG was safe, effective, and had a low complication rate. Our patients were managed by a specialist nutrition team, a policy that may reduce the complication rate and hospital visits for patients being fed at home, and allow early discharge of dysphagic patients, thereby reducing costs.
17 patients with established algodystrophy following trauma were treated with serial intravenous regional guanethidine blockade. Subjective improvement occurred in all cases. This improvement could be confirmed quantitatively using objective assessment criteria. The subjective and objective improvements demonstrated in each of the features of algodystrophy correlate closely (p < 0.001). There appears to be no difference in the effectiveness of one block compared to another in the same patient.
100 consecutive patients with Colles' fracture were assessed functionally three months after the injury, and the result correlated with initial shortening of the radius. Three methods were used to measure radial shortening; only the one that measured the distance from distal radial to distal ulnar surfaces correlated with functional outcome. It is concluded that this is the most valid method of measurement and the deficiencies of the other methods are discussed.
OBJECTIVES: To determine the effect of intravenous regional guanethidine on post-traumatic algodystrophy. METHODS: Ten of 20 consecutive patients with algodystrophy after Colles' fracture were treated with serial intravenous regional guanethidine blockades and the other 10 were treated with physiotherapy alone. Patients were assessed before and after each block and then monthly over a six month period. RESULTS: The treated patients had subjective and objective improvements in the assessed features of algodystrophy; treatment resulted in a significant reduction in finger tenderness at five and six months. CONCLUSIONS: Guanethidine blockade induces short term benefits in the symptoms of algodystrophy but improves finger tenderness only in the long term.
Darrach's procedure was performed for post-traumatic symptoms in the inferior radio-ulnar joint in 36 patients, who were reviewed after a mean follow-up of 6 years. Only 18 of the patients had a satisfactory clinical result. Poor outcome was associated with osteoarthritis of the wrist, the occurrence of algodystrophy and a short ulnar remnant.
"The preparation and fieldwork for the National Survey of Sexual Attitudes and Lifestyles was carried out between 1987-1991. The survey was a combination of a face-to-face interview and self-completion questionnaire and comprised 18,876 individuals aged 16-59 years in Great Britain. The response rate was similar to other sample surveys on less sensitive topics. Women were overrepresented but the distributions of other demographic characteristics were similar to other data sets. The external validity and internal consistency of the data were found to be adequate. The likely sources and effects of bias are discussed."
There are no data in the literature concerning the outcome of Colles' fracture beyond six years. One hundred consecutive patients with displaced Colles' fractures were reviewed ten years after the injury. Function, radiographic anatomy, osteoarthrosis, and reflex sympathetic dystrophy (algodystrophy) were all objectively assessed. By the time of this review, 35 patients had died. Eighty-five percent of those surviving had a satisfactory outcome. Forty-two percent had improved functionally in ten years and 20% had deteriorated. Initial and ten-year radial shortening and early finger stiffness significantly correlated with final outcome. Dorsal angulation influenced early but not ten-year function. Sixty-two percent of those with an unsatisfactory result had objective features of reflex sympathetic dystrophy, compared with only 6% of those with a satisfactory result. Osteoarthrosis was found in 37%, but in only 4% was it associated with an unsatisfactory outcome.
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Britain's first large, national survey of sexual attitudes and lifestyles will allow improved estimates of the magnitude of the HIV epidemic in Britain and should lead to better strategies for prevention.
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In all, 85 per cent of Colles' fractures are clinically satisfactory after 10 years. Clinical results improve little after 3 months. Displaced intraarticular fracture, wrist deformity and algodystrophy are associated with an unsatisfactory outcome.
The long-term outcome of algodystrophy is unknown. Ten years after Colles' fracture, 26% of 55 cases showed features of the syndrome. The finding of poor finger function three months following the fracture correlated significantly with the presence of components of algodystrophy after ten years.
Prophylactic intravenous cefamandole nafate was administered by the systemic, systemic with probenecid (causing renal tubular blockade of antibiotic excretion), and intravenous regional routes. Bone antibiotic levels were assayed 15 minutes and 12 hours after administration, and hematoma concentrations after 8 hours. Bone concentrations after intravenous regional administration were significantly greater than systemic after 15 minutes, but were not detectable after 12 hours. Probenecid produced inhibitory concentrations in bone after 12 hours and also increased hematoma antibiotic concentrations to three times those achieved by systemic administration. Adequate prophylaxis may be possible with two rather than three doses of cefamandole if probenecid is used.
We have identified, cloned, and studied a gene, cap, encoding a protein that is associated with adenylyl cyclase in the fission yeast Schizosaccharomyces pombe. This protein shares significant sequence homology with the adenylyl cyclase-associated CAP protein in the yeast Saccharomyces cerevisiae. CAP is a bifunctional protein; the N-terminal domain appears to be involved in cellular responsiveness to RAS, whereas loss of the C-terminal portion is associated with morphological and nutritional defects. S. pombe cap can suppress phenotypes associated with deletion of the C-terminal CAP domain in S. cerevisiae but does not suppress phenotypes associated with deletion of the N-terminal domain. Analysis of cap disruptants also mapped the function of cap to two domains. The functional loss of the C-terminal region of S. pombe cap results in abnormal cellular morphology, slow growth, and failure to grow at 37 degrees C. Increases in mating and sporulation were observed when the entire gene was disrupted. Overproduction of both cap and adenylyl cyclase results in highly elongated large cells that are sterile and have measurably higher levels of adenylyl cyclase activity. Our results indicate that cap is required for the proper function of S. pombe adenylyl cyclase but that the C-terminal domain of cap has other functions that are shared with the C-terminal domain of S. cerevisiae CAP.