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Biomedical subjects

J M Cooper

Publications and source records attributed to J M Cooper.

At least 163 records · Page 9Linked to original sources
PubMed1988

Diagnosing appendicitis in children with acute abdominal pain.

Differentiating acute appendicitis from other causes of acute abdominal pain in children frequently remains unsatisfactory. To determine whether initial historical and physical examination findings might predict final diagnoses, 246 patients with complaints of nontraumatic and nonrecurrent acute abdominal pain were studied. All were between three and 18 years of age and had presented to a hospital-based pediatric emergency department. Each family was telephoned an average of 5.1 days after the visit to determine the patient's subsequent clinical course; operative notes and pathology reports were reviewed for patients receiving surgery. Of these patients with acute abdominal pain, both fever and vomiting were present in 18 of the 24 who eventually had diagnoses of appendicitis, compared with 49 of 222 patients with other final diagnoses (P less than 0.01, with negative predictive value 0.97, sensitivity 0.75, and specificity 0.78, but positive predictive value only 0.27). The duration of the pain at presentation and the frequency of other symptoms (eg, diarrhea, dysuria, anorexia, and lethargy) were unrelated, however, to final diagnosis, as was the duration of the pain and whether abdominal tenderness initially was localized or generalized. Nonruptured appendicitis was generally indistinguishable from ruptured appendicitis preoperatively, by both duration and symptoms. Boys were found more likely to have appendicitis (with or without rupture) than girls (18/118 or 15%, vs. 6/128 or 5%, P less than 0.05). In conclusion, fever and vomiting were noted at presentation more frequently in children with appendicitis than in children with other causes of acute abdominal pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen, Acute↗
PubMed1988

Human mitochondrial respiratory chain deficiencies.

In this paper selected data from 43 patients with histologically defined mitochondrial myopathies who have been investigated biochemically as previously described are presented. The defect was localized to NADH-ubiquinone oxidoreductase (complex I) in 22 cases and to ubiquinol-cytochrome c oxidoreductase (complex III) in a further 10. Two patients had defects of more than one respiratory enzyme complex and another had a deficiency of H+-ATPase. The lesion was not localized in two cases and in vitro mitochondrial studies were normal in five cases.

Electron Transport Complex III↗
PubMed1985

Limiting dilution analysis of induced unresponsiveness to trinitrophenyl: increased suppression of cytotoxic T precursor cells at unchanged frequencies.

In this paper we address the problem of tolerance in the immune system. We are discussing results of experiments that we designed to distinguish between the two major alternative hypotheses that have been invoked for immunological tolerance: clonal deletion/anergy versus suppression. These alternative hypotheses make essentially different predictions with respect to the frequencies of lymphocytes that react with antigens to which the immune system is tolerant: clonal deletion models predict reduced frequencies, whereas in suppression models precursors of effector cells are postulated to occur at frequencies similar to the nontolerant situation. We investigate these questions by limiting dilution analyses of cytotoxic T cell precursors (CTLP), using two different ways to activate them into functional cytotoxic cells (CTL): polyclonally by Concanavalin A (ConA) and specifically by antigen. Tolerance should be apparent in either protocol since neither antigen nor ConA usually activates self-reactive cytotoxic cells. Moreover, in addition to providing information on precursor frequencies, the multihit results usually obtained in limiting dilution experiments of ConA activated T cells allow the determination of quantitative and qualitative parameters of suppression. In addition, clonal anergy situations could be expected to become apparent by a differential sensitivity of precursors to activation with ConA and with antigen. As experimental system we chose the induced unresponsiveness of mice to trinitrophenyl (TNP) achieved by intravenous injection of reactive trinitrobenzenesulfonic acid (TNBS) and measured in a primary cytotoxic response to TNP-coupled syngeneic cells (TNP-SC). An equally specific but perhaps not identical form of unresponsiveness is induced by coupling the responder cell population with TNBS in vitro. Although we do not propose that this model ideally reflects all aspects of self tolerance, we think that in this particular system of induced unresponsiveness the antigen becomes associated with the surfaces of a large proportion of the cells of the body. Therefore, tolerance to widely expressed cell surface determinants might be quite adequately "simulated" by this experimental unresponsiveness. In our limiting dilution experiments we can distinguish between frequent and infrequent cytotoxic precursors which correspond to virgin and memory cells, respectively. For the frequent CTLP the situation is quite clear: they occur at essentially equal frequencies in normal and tolerant mice, as demonstrated by their reactivity to antigen at low cell densities. However, they are under the influence of a suppressive activity which is strongly increased when compared to that of normal mice.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1985

Incidence, significance and remission of tubal spasm during attempted hysteroscopic tubal sterilization.

Four hundred three attempted hysteroscopic tubal sterilizations were performed. Tubal spasm was encountered in 37 cases (9.2%) and prevented bilateral placement of tubal plugs in 16 of those cases. There was some evidence that glucagon was associated with a higher rate of remission and that women using barrier birth control methods experienced a lower incidence of tubal spasm. A number of other factors were found to be unrelated to tubal spasm and its remission.

Diazepam↗
PubMed1983

The role of antibody in the interaction of Salmonella and listeria with peritoneal macrophages.

That in vitro killing by normal and activated macrophages of S. typhimurium and other gram-negative organisms is dependent on the presence of antibody has been confirmed. It has been shown that antibody is required for the binding of S. typhimurium to the surfaces of macrophages. This binding can be inhibited by the Fc portion of immunoglobulin, indicating that the Fc receptors on macrophages are used for binding S. typhimurium. It has also been confirmed that antibody does not appear to be necessary for killing of L. monocytogenes to occur. The organisms bind to the surface of macrophages by different receptors. Binding of L. monocytogenes occurs in the absence of added antibody and Fc fragments of immunoglobulin do not affect the binding. Attachment can be inhibited, however, by removal of divalent cations, a treatment that has no effect on antibody-mediated binding as, under these conditions, the binding of L. monocytogenes to macrophages can be enhanced by antibody. The significance of these findings is discussed.

Animals↗
PubMed1983

Local immunity to klebsiella pneumoniae in the lungs of mice.

The development of local immunity to Klebsiella pneumoniae in the lower respiratory tract is described. Immunity to intranasal infection is produced by systemic immunization resulting in high titers of circulating antibody. Protection also follows intranasal immunization with glutaraldehyde-killed organisms. Low levels of antibodies develop in serum after intranasal immunization. IgA antibody can be detected in the serum of these mice whereas little IgA antibody is detected in the serum of mice immunized systemically. Both IgA and IgG antibodies can be found in the pulmonary secretions of locally immunized mice. IgA and IgG from these secretions may be used to passively transfer protection when used to opsonize the infecting dose of K. pneumoniae. Protection mediated by IgA is not due to any interaction of IgA with cells present in the lower respiratory tract during infection, but exerts its protective effect in the upper respiratory tract, thereby preventing the spread of bacterial infection to the lower respiratory tract.

Administration, Intranasal↗
PubMed1983

Hysteroscopic tubal occlusion with formed-in-place silicone plugs: a clinical review.

The present study is a detailed review of 415 patients undergoing sterilization under local anesthesia with hysteroscopically placed silicone plugs. The authors compiled 3200 woman-months after sterilization without a pregnancy. Up to 90% of women undergoing this procedure in the office have successful completion. The difficulties with the method are outlined, unsuccessful procedures categorized, and radiographs presented, and the outlook for the future is discussed. The method is seen as a viable alternative to laparoscopic sterilization.

Adult↗
PubMed1983

The incidence of intrauterine abnormalities found at hysteroscopy in patients undergoing elective hysteroscopic sterilization.

Hysteroscopic findings in 323 consecutive women requesting transcervical sterilization were analyzed. A remarkably low incidence of intrauterine abnormalities (13%) was found in this group of asymptomatic women as compared to that found in large series of women who experienced abnormal uterine bleeding or infertility. The dramatic difference in the incidence of abnormal hysteroscopic findings between these patient groups supports the concept of routinely performing hysteroscopy when evaluating women with infertility or abnormal uterine bleeding. It also sets a baseline for the prevalence of hysteroscopically demonstrable intrauterine pathology in an asymptomatic population.

Adult↗
PubMed1982

Resistance to Klebsiella pneumoniae and the importance of two bacterial antigens.

The resistance of mice to a lethal infection with Klebsiella pneumoniae, type I, was investigated. Antibody of both IgG and IgM class produced good protection when given with an intra-nasal inoculum of the organism. While antibody directed against capsular antigens was highly protective, so too was antibody directed against a second, non-capsular and heat-labile antigen. This antigen does not appear to be related to either the K or O antigens of Klebsiella and is present in several strains of Klebsiella. It is suggested that this antigen may play a role in determining resistance to this organism by humans.

Absorption↗
PubMed1982

Hysteroscopic tubal occlusion with formed-in-place silicone plugs.

One hundred sixty-one patients underwent hysteroscopic tubal occlusion with formed-in-place silicone rubber plugs over 8 months. In 86% bilateral plug placement was successful with the patient under local anesthesia in an office setting. There have been no pregnancies in 683 woman-months of sterilization to date. The procedure is seen as an effective alternative to current methods of female sterilization. The advantage of the procedure over laparoscopic sterilization is discussed.

Adult↗
PubMed1979

Clearance of bacteria from lungs of mice after opsonising with IgG or IgA.

The clearance of organisms from the lungs of mice was followed after aerosol administration. Preopsonisation of the organisms with immune serum, as a source of specific antibody, enhanced the rate of pulmonary clearance while s.IgA delayed clearance. In the peritoneal cavity, bacteria pre-treated with immune serum were cleared more rapidly than unopsonised bacteria, but s.IgA had little effect. The presence of Fc receptors for IgG and not s.IgA on alveolar macrophages suggests that, in secretions, IgG is the predominant antibody promoting phagocytosis by alveolar macrophages and that any protective effect of s.IgA is not mediated by these cells.

Animals↗
PubMed1978

Changes in the immunoglobulin levels of the mouse gut and serum during conventionalisation and following administration of Salmonella typhimurium.

Increasess in all immunoglobulin classes, except IgM, were observed in the sera of specific pathogen-free (SPF) mice beginning 10 days after their removal from barrier conditions. Concentrations of serum immunoglobulins, comparable with those of conventional mice, were obtained in these animals between 21 and 35 days. Following the removal of germ-free mice from their sterile isolaters, their intestinal IgA levels increased over 35 days to attain levels found in conventional animals. A marked increase in serum immunoglobulin occurred within one day following intravenous administration of live Salmonella typhimurium organisms to SPF animals, and this persisted for longer than 7 weeks (the duration of the study), This rapid elevation in serum immunoglobulin was not elicited by nonbacterial antigens, killed Salmonellae, or viable Vibrio cholerae. Negligible amounts of this immunoglobulin increase could be attributed to specific antibody.

Animals↗
PubMed1976

Gonadoblastoma with tubal pregnancy.

A case of unilateral gonadoblastoma in association with a ruptured ectopic tubal pregnancy is presented. The patient had normal menstrual history prior to a missed period followed by abdominal pain and the passage of clots. The surgical specimens, in addition to the ruptured tubal pregnancy, showed nodular foci of typical gonadoblastoma in the right ovary, the remainder of the ovarian tissue being normal. The left ovary was subsequently removed and examination revealed normal constituents without evidence of tumor. Cytogenetic evaluation of peripheral leukocytes showed cells with a normal female sex chromatin complement, 46-XX, as well as cells with 45 chromosomes in which one of the X chromosomes was missing.

Adult↗
PubMed1975

Iliac artery aneurysm presenting as a complication of hysterectomy.

Aneurysms rarely presenta as a complication of hysterectomy. A case is reported of a left common iliac artery aneurysm causing readmission 2 weeks after total abdominal hysterectomy. The aneurysm remained undiagnosed prior to percutaneous rupture and subsequent laparotomy. The aneurysm was ligated and resected. No graft or arterial repair was attempted because of the infection that was present. Twenty-three days after hysterectomy, the patient underwent above-the-knee amputation. A review of the literatureis undertaken and possible etiolgic mechanisms discussed.

Aneurysm↗
PubMed1975

Oxytocin challenge test in monitoring high-risk pregnancies.

Eighty-nine pregnancies, at risk for placental insufficiency, were monitored with serial oxytocin challenge tests (OCT) and estriol determinations on 24-hour urine collections. Intraamniotic catheters were used to accurately record intrauterine pressure in 63% of the tests; 114 of the 116 tests (98%) were adequate for interpretation. Thirteen positive tests were recorded; however, in only 2 cases did the positive OCT predict a dysmature-postmature infant when estriol determinations were normal. Prompt delivery following a positive OCT can significantly reduce the incidence of fetal wastage.

Apgar Score↗