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Biomedical subjects

J Kelleher

Publications and source records attributed to J Kelleher.

At least 55 records · Page 3Linked to original sources
PubMed1989

Bone marrow transplantation.

Bone marrow transplantation for treatment of certain hematologic and nonhematologic diseases is rapidly becoming the treatment of choice for a large number of patients. Over 10,000 marrow transplants have been performed, and over 200 marrow transplant units currently exist. Complex medical and nursing care from marrow transplant teams is required to care for the acute and chronic complications associated with this treatment. This article addresses the history and process of marrow transplantation and nursing assessments and the interventions needed to care for marrow recipients, their donors, and their families.

Bone Marrow Transplantation↗
PubMed1988

Leucocyte zinc in non-Hodgkin's lymphoma and Hodgkin's disease.

Zinc status and the effect of zinc supplementation were assessed in groups of patients with non-Hodgkin's lymphoma and Hodgkin's disease; patients were either untreated or in remission. In the patients in remission, plasma zinc was normal; and whereas 30% of untreated patients had low plasma zinc, the group as a whole did not differ from normal. For mononuclear cell zinc, the range of values in the disease group was far wider than in controls, but there was no significant difference between the means of the groups. Granulocyte zinc was significantly lower in both the groups of patients in remission from non-Hodgkin's lymphoma and Hodgkin's disease compared with the control group. Significant increases were found in the plasma copper, ceruloplasmin, and the copper-to-zinc ratio in several of the patient groups. Plasma zinc increased by 23% with zinc supplementation (50 mg elemental Zn/day), but there was no effect on mononuclear cell or granulocyte zinc. Apart from granulocyte zinc, there is little evidence of zinc deficiency in non-Hodgkin's lymphoma or Hodgkin's disease. However, the presence of depleted granulocyte zinc levels could modify the immune function of this cell population.

Adult↗
PubMed1988

In vivo and in vitro studies of microsphere pancreatic supplements.

Over the past 5 years, the Leeds Regional Cystic Fibrosis (CF) Unit has provided comprehensive annual assessments of CF patients that include dietary assessments and fat absorption studies. Enteric-coated microsphere pancreatic enzyme preparations (microsphere preparations) were compared to conventional enzymes as therapeutic agents for these patients. Presently in the U.K., two microsphere preparations are licensed for use and a further two products are likely to receive licenses in the near future. The success of these preparations is dependent on the ability of the microsphere coating to resist dissolution until the pH exceeds approximately 5.5 and thus prevent inactivation of lipase in the acid environment of the stomach. A study comparing Pancrex V Forte, a conventional enzyme preparation, to three microsphere preparations, Pancrease, Creon, and pancreatin Merck, confirmed the superiority of Pancrease and Creon over Pancrex V Forte and pancreatin Merck with regard to control of symptoms, and nitrogen and fat absorption. Because of differences in the physical characteristics of various microsphere preparations, the dissolution rates of Pancrease, Creon, and pancreatin Merck were compared in vitro. In aqueous buffers, striking differences among the preparations were seen at pH 5.5; whereas only 25% of available lipase was released from Creon, both Pancrease and pancreatin Merck show almost complete dissolution at this pH. Only at pH 6.5 and above do all three preparations show complete dissolution. In duodenal juice, as in aqueous buffers, lipase release from Creon takes place at a lower rate than with the other two preparations until pH 6.0 or higher is attained.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

In vitro mucus glycoprotein production by colonic tissue from patients with ulcerative colitis.

Colonic mucus production was measured in vitro by means of incorporation of tritiated glucosamine using biopsy material from patients with ulcerative colitis and compared with data from patients with Crohn's disease, colonic carcinoma, colonic polyps and patients with apparently normal colonic mucosae. Mucus production was significantly decreased (p less than 0.03) in all patients with ulcerative colitis, and in particular in patients with inactive disease when compared with normal subjects. In patients with active disease mucus production was not significantly different from normal subjects. The radiolabelled material was characterised by gel filtration and ion exchange liquid chromatography as mainly high molecular weight glycoproteins. These results indicate that the quantitative character of colonic mucus is abnormal in inactive ulcerative colitis.

Colitis, Ulcerative↗
PubMed1988

Cytosolic retinoic acid binding protein in the human pancreas.

Cytosolic retinoic acid receptor in carcinoma, chronic pancreatitis, and normal pancreatic tissue were examined using sucrose density gradient centrifugation, isoelectric focussing on agarose gel and saturation analysis. Thirteen patients were studied. Cytosolic retinoic acid binding protein (cRABP) was detected in all the samples with chronic pancreatitis and pancreatic carcinoma, but not in the normal tissue. Using sucrose gradient centrifugation, the highest concentrations of cRABP were found in pancreatic carcinoma tissues, ranging from 5.5-23.9 pmol/mg protein. These concentrations were markedly different than in chronic pancreatitis tissue (0.7-2.7 pmol/mg protein). Saturation analysis of cRABP showed a mean dissociation constant of 21.5 nM and maximum binding sites of 5.2 pmol/mg protein. Cytosolic retinoic acid binding protein was separated at an isoelectric point of 4.5 on agarose gel. The presence of cRABP suggest that retinoic acid may have a role to play in the function of the pancreas.

Adult↗
PubMed1988

Markers for faecal fat estimation in monitoring steatorrhoea in cystic fibrosis.

Polyethylene glycol (PEG) 4000 is one of numerous substances used as non-absorbable markers to correct for variable faecal output when assessing daily faecal losses of nutrients. The introduction of enteric coated micro-encapsulated pancreatic enzyme (EMPE) preparations has greatly improved the control of fat malabsorption in cystic fibrosis and chronic pancreatitis patients. Unfortunately, these enzyme preparations contain significant quantities of PEG 4000 or polyvinyl pyrrolidine (PVP) as components of the enteric coating and thus PEG 4000 cannot be used either as a faecal marker, or in intubation studies, if these enzyme preparations are being used.

Celiac Disease↗
PubMed1988

Ileal pH in cystic fibrosis.

In cystic fibrosis jejunal hyperacidity has an adverse effect on lipid digestion. It is not known whether hyperacidity extends to the ileum. We have studied pH through the whole length of the small bowel in 42 normal and 6 cystic fibrosis subjects by means of pH-sensitive radiotelemetry capsules. In cystic fibrosis subjects the time spent below pH 6.0 was significantly greater during the 1st h in the small bowel than in normal subjects. In the rest of the small bowel the pH remained above 6.0 in both groups. The recordings in the cystic fibrosis group did not show the clear distinction between ileum and colon which is seen in normal subjects. In cystic fibrosis low pH conditions are confined to the proximal small intestine. There is adequate time at optimal pH in the small bowel for dissolution of enzyme supplements and assimilation of nutrients.

Adult↗
PubMed1988

A normal fat diet for cystic fibrosis: is a dietitian still needed?

The dietary intakes of 90 patients receiving various degrees of dietetic support were assessed by a 7-day dietary history. Patients who had contact with a dietitian at least twice a year achieved higher energy and protein intakes than patients with little or no dietetic help. Patients who had one intensive interview with a specialist CF dietitian but had little local dietetic support attained better nutrient intakes than patients with no dietetic support. Dietary misconceptions, which led to restriction of fat and even sugar, were common when patients or parents of CF children received little dietary advice.

Adult↗
PubMed1987

Cytosolic retinoic acid-binding protein in human prostatic dysplasia and neoplasia.

Prostate samples from 41 patients with acute on chronic prostatitis, benign hyperplasia, chronic prostatitis or adenocarcinoma were assayed for cytosolic retinoic acid binding protein (cRABP). Binding protein was detected in all samples. Scatchard analysis revealed dissociation constant values of 15.0-31.8 nM and maximum binding capacity of 5.2 +/- 2.0 (S.E.) pmol/mg protein. Using sucrose density gradient centrifugation, cRABP was quantitated and values varied from 1.2 to 12.5 pmol/mg protein. High levels (greater than 3.5 pmol/mg protein) were found in 28/41 samples. There was no correlation between the cRABP binding/mg protein and the volume (%) of glandular tissue (compared with stroma). While there was no significant difference in the quantities of cRABP in the different disease groups, there was a tendency for a progressive increase from acute on chronic prostatitis to chronic prostatitis, the highest levels being present in carcinoma.

Adenocarcinoma↗
PubMed1987

Super-efficient starch absorption. A risk factor for colonic neoplasia?

We tested the hypothesis that super-efficient starch absorption, by reducing the supply of carbohydrate to the colon, may be associated with and possibly promote colonic neoplasia. By means of breath hydrogen measurements following a potato meal and comparison with the hydrogen response to lactulose, the amount of starch escaping small bowel absorption was measured in 10 patients who had a colonic adenoma removed endoscopically and in 10 controls. The subjects' consumption of starch and fiber was assessed. Percentage unabsorbed starch was approximately half as much in the patients (5.3%) compared with the controls (10.9%, P less than 0.05). Consumption of starch and dietary fiber, and mouth-to-cecum transit times were not significantly different. Unabsorbed starch was calculated to contribute to 6.0 g/day colonic carbohydrate in the patients and 10.9 g/day in the controls (P less than 0.05). This study confirms that unabsorbed starch provides an important quantity of colonic carbohydrate and suggests that super-efficient starch absorption, by reducing this provision, may promote colonic neoplasia.

Breath Tests↗
PubMed1987

Comparison of four pancreatic extracts in cystic fibrosis.

Four different pancreatin products, Pancrease, Creon, Pancrex V Forte, and Pancreatin Merck, were compared in a random crossover trial in children with cystic fibrosis. The results of our study showed that patients who received Creon and Pancrease had fewer gastrointestinal symptoms than patients who received Pancrex V Forte and Pancreatin Merck. Fat absorption was significantly improved with Pancrease when compared with Pancrex V forte and Pancreatin Merck. Also the fat absorption with Creon was superior to that with Pancrex V Forte. There was no significant difference in fat absorption between Pancrease and Creon. Pancrex V Forte and Pancreatin Merck, or Pancreatin Merck and Creon. Faecal nitrogen content was less with both Creon and Pancrease compared with Pancreatin Merck. Creon and Pancrease allow the patient with cystic fibrosis to take a high energy diet without any dietary restrictions.

Adolescent↗
PubMed1987

Composition of pure pancreatic juice in normal human subjects and in pancreatic disease.

Pure pancreatic juice (PPJ) was collected at endoscopic retrograde cholangio-pancreatography from patients with or without pancreatic disease. Two-dimensional polyacrylamide gel electrophoresis of PPJ proteins demonstrated a wide heterogeneity of proteins, differing in molecular weight and isoelectric points. There was one major difference in the protein patterns between normals and those with chronic pancreatitis. A glycoprotein has been identified and shown to be present in 28/30 patients without pancreatic disease, but absent in 11 or greatly reduced in 8 of 19 patients with mild pancreatitis and absent in all 13 patients with moderate or marked pancreatitis and both patients with pancreatic carcinoma.

Adolescent↗
PubMed1987

The clinical effect of correction of vitamin E depletion in cystic fibrosis.

Thirty patients with cystic fibrosis, 24 of whom had longstanding low serum vitamin E, were treated with 50 mg alpha-tocopherol acetate per day for periods of 18-24 months. None of the patients received haematinics during the study period. Throughout the period of study the overall clinical state of the patients did not alter significantly. The serum vitamin E level increased in all patients, but to a variable degree which was not related to the severity of steatorrhoea. A range of nutritional parameters, including anthropometry, vitamin levels, essential elements, haemoglobin and albumin, as well as dietary intake and faecal fat excretion, were assessed at the beginning and end of the study. Haemoglobin was the only parameter to change significantly from 13.14 to 13.47 g/100 ml. Twenty one of the 30 patients showed some increase in haemoglobin values and this increase could not be related to clinical state, fat absorption or dietary intake but was related to the improved vitamin E status.

Adolescent↗