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Biomedical subjects

J Nash

Publications and source records attributed to J Nash.

At least 55 records · Page 3Linked to original sources
PubMed1994

Reduction of spasticity in cerebral palsy using feedback of the tonic stretch reflex: a controlled study.

Subjects with cerebral palsy aged six to 19 years undertook a training programme to reduce spasticity and contracture of the triceps surae muscle using feedback of the gain of the tonic stretch reflex. Stretch reflex gain was significantly reduced (by 50 per cent on average) in all eight test subjects, whereas there was no significant change in control subjects, matched for age and level of spasticity, who had no reflex training. Contracture of the triceps surae muscle was not altered. Since the reduction in spasticity can be expected to slow the recurrence of muscle shortening, it is suggested that for correction of muscle contracture, muscle-lengthening procedures to promote muscle growth should be combined with reflex training to maintain the growth achieved.

Adolescent↗
PubMed1994

'Conversion' from ulcerative colitis to Crohn's disease associated with corticosteroid treatment.

A man who was a non-smoker presented with clinical, histological, and radiological features typical of distal ulcerative colitis. Prolonged treatment with corticosteroids was associated with the development of numerous granulomata, stricturing, and perianal disease. It is speculated that the immunosuppression associated with the corticosteroid treatment may have induced a change from ulcerative colitis to Crohn's disease of the colon. This case report lends support to the hypothesis that these conditions may just represent different forms of a continuum of inflammatory bowel disease.

Adult↗
PubMed1994

Histamine H2-receptor antagonists in peptic ulcer disease. Evidence for a prophylactic use.

The H2-receptor antagonists have undoubtably been successful in healing primary gastric and duodenal ulcers so there is a tendency to assume that they will be equally successful when used as prophylactic agents. When used to prevent gastroduodenal ulceration induced by nonsteroidal anti-inflammatory agents, they are unsuccessful in protecting against gastric damage, but reduce the incidence of duodenal ulceration. However, their effect on the incidence of serious complications remains unknown. In the prevention of stress ulceration and bleeding in intensive care units there is evidence of a beneficial effect of H2-receptor antagonists, but other agents are also equally effective. In patients who present with haematemesis and melaena, there is little evidence to show that H2-receptor antagonists reduce rates of transfusion or surgical intervention, or decrease mortality.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1994

A comparison of the three most common Papanicolaou smear collection techniques.

OBJECTIVE: To evaluate three common instruments for sampling the endocervical canal: the Q-tip applicator, the Cytobrush, and the Cervex brush. METHODS: Clinical, cytologic, and histologic data were collected from patients enrolled in the colposcopy clinic at the National Naval Medical Center. Subjects were assigned to one of three techniques: a combination of spatula and swab, a combination of spatula and Cytobrush, and the Cervex brush alone. RESULTS: There was no significant difference in the ease of use or the amount of patient discomfort among the three methods, although the Cytobrush caused an increase in mild cervical bleeding. The Cytobrush yielded the greatest number of endocervical cells. The swab produced the lowest number of endocervical cells and the greatest cellular distortion. The ability to identify patients with biopsy-proven dysplasia was comparable for each of the three methods. CONCLUSION: The Cytobrush was the best device for sampling the endocervical canal, but it was no more sensitive in detecting cervical dysplasia.

Adult↗
PubMed1993

Risk of aseptic meningitis after measles, mumps, and rubella vaccine in UK children.

Cases of aseptic meningitis associated with measles/mumps/rubella vaccine were sought in thirteen UK health districts following a reported cluster in Nottingham which suggested a risk of 1 in 4000 doses, substantially higher than previous estimates based on cases reported by paediatricians (4 per million). Cases were ascertained by obtaining vaccination records of children with aseptic meningitis diagnosed from cerebrospinal fluid samples submitted to Public Health Laboratories or discharged from hospital with a diagnosis of viral meningitis. Both methods identified vaccination 15-35 days before onset as a significant risk factor and therefore indicative of a causal association. With both, half the aseptic meningitis cases identified in children aged 12-24 months were vaccine-associated with onset 15-35 days after vaccine. The study confirmed that the true risk was substantially higher than suggested by case reports from paediatricians, probably about 1 in 11,000 doses. However, the possibility that the aseptic meningitis induced by vaccination was largely asymptomatic and a chance laboratory finding in children investigated for other clinical conditions, particularly febrile convulsions, could not be excluded. Comparison of national reports of virus-positive mumps meningitis cases before and after the introduction of this vaccine indicated that the risk from wild mumps was about 4-fold higher than from vaccine. Altogether, 28 vaccine-associated cases were identified, all in recipients of vaccines containing the Urabe mumps strain. The absence of cases in recipients of vaccine containing the Jeryl Lynn strain, despite its 14% market share, suggested a higher risk from Urabe vaccine. A prospective adverse event surveillance system using the study methods is currently being established to assess the risk, if any, from the Jeryl Lynn strain which is now the only mumps vaccine used in the UK.

Child, Preschool↗
PubMed1993

Intermediate nerve conduction velocities define X-linked Charcot-Marie-Tooth neuropathy families.

Three genetic loci for the Charcot-Marie-Tooth (CMT) syndromes with slow motor nerve conduction velocities (hereditary motor and sensory neuropathy: HMSN type I) have been mapped to chromosomes 1 (CMT1B), 17 (CMT1A), and the X chromosome (CMTX). The clinical features of these three CMT subgroups are similar. To determine whether any clinical features distinguish CMTX families, the range of clinical findings and motor nerve conduction velocities were examined in two large CMTX families, the range of clinical findings and motor nerve conduction velocities were examined in two large CMTX families with CMTX proven by linkage to X-chromosome markers. CMTX males had more wasting and weakness than CMTX females or individuals with CMT1A. Patellar reflexes were more often retained in CMTX. Motor nerve conduction velocities were faster than in CMT1A. Intermediate-range median nerve conduction velocities were present in CMTX females (45 +/- 9 m/sec; range, 26 to 61 m/sec). These velocities were significantly faster than those for CMT1A females (22 +/- 8 m/sec, p < 0.0001). Median nerve conduction velocities in CMTX males (31 +/- 6 m/sec) were significantly slower than in CMTX females and faster than in CMT1A males (20 +/- 6 m/sec, p < 0.0001). The combination of slow conduction velocities in affected males (< 40 m/sec) and intermediate-range median motor conduction velocity results (> 40 m/sec) in affected or obligate carrier females is a useful distinguishing feature to separate CMTX from CMT1A, as intermediate conduction velocities are not present in autosomal-dominant dominant CMT1A families. This feature defines possible CMTX families for linkage studies. Families with no male-to-male inheritance of the syndrome, slow motor nerve conductions in affected males, and normal or intermediate-range conduction velocities in carrier females should be considered to be X-linked CMT families.

Adolescent↗
PubMed1993

Birth of the "chiropractic angel": a Caduceus counterpoint.

Use of the winged angel with raised hands as a chiropractic emblem began circa 1928. Although often attributed to the National Chiropractic Association (NCA), the emblem was created prior to the NCA's formation, and was initially "copyrighted ... for the exclusive use of members of the American Society of Chiropractors." The emblem appeared as part of the ASC's advertising in popular national magazines, including American Legion Monthly, Cosmopolitan, Liberty, and Physical Culture. First use of the chiropractic angel to represent the NCA and its ally, the Internatonal Chiropractic Congress (ICC), took place at the NCA and ICC joint national convention in Denver in 1933. The emblem was formally adopted by the NCA at its 1934 convention in Pittsburgh. This paper reviews some of the early history of the emblem and its use by the ASC and the NCA.

Chiropractic↗
PubMed1992

Epithelial proliferation in Barrett's esophagus by proliferating cell nuclear antigen immunolocalization.

Proliferating cell nuclear antigen (PCNA) is an auxiliary protein to DNA polymerase delta and is an absolute requirement for cellular proliferation. Specialized-type Barrett's columnar-lined esophagus (CLE) is associated with adenocarcinomatous change. In the present study, the cellular proliferation of three histological types of CLE was assessed by semiquantitative evaluation of PCNA immunolocalization in 93 biopsy specimens from 45 patients using the murine monoclonal PC10. Statistical comparison was performed by the Mann-Whitney U test. Luminal surface cell labeling was uncommon in all histological types other than specialized CLE where 25 of the 43 biopsy specimens had at least occasional luminal surface cell labeling. Mean crypt labeling score of 4.06 for specialized type exceeded that for junctional (mean, 3.12; P < 0.001) and fundic types (mean, 1.6; P < 0.001). Gland cell PCNA staining scores for specialized-type CLE (mean, 3.18) exceeded that of junctional (mean, 1.97; P < 0.001) and fundic (mean, 1.04; P < 0.001). Summated PCNA scores for specialized-type, mean of 8.29, exceeded junctional mean score of 5.45 (P < 0.001) and fundic mean score of 2.76 (P < 0.001). PCNA immunolocalization reveals a high proportion of cells in cycle in the specialized-type CLE and expansion of the proliferative compartment, which may explain the association of specialized-type CLE with malignancy.

Antibodies, Monoclonal↗
PubMed1992

Bronze-2 Gene Expression and Intron Splicing Patterns in Cells and Tissues of Zea mays L.

A large fraction of the transcripts of the Bronze-2 (Bz2) gene of maize (Zea mays L.) are unspliced in purple husk tissues. The accumulation of unspliced messages could have destructive potential if the intron-bearing mRNAs are translated into aberrant proteins. Our initial studies suggested that both genetic and physiological factors may influence the degree of splicing failure. Nuclear background rather than cis-sequence effects is shown to contribute to the genetic component. The accumulation of unspliced message does not appear to be directly influenced by diurnal effects on transcript abundance, by the expression level of the Bz2 gene, or by thermal stress. We also show that maize cell cultures (Black Mexican Sweet, BMS) can be used to examine the molecular details involved in splicing failure. Much like whole maize plants, the BMS cells excise the Bz2 intron with varying degrees of efficiency. In contrast with heterologous constructs containing plant introns, splicing of the native Bz2 intron can appproach 100% in BMS cells. Splicing of transcripts from a marked, introduced gene can be compared to the endogeneous Bz2 gene facilitating analysis of the impact of sequence changes.

Journal Article↗
PubMed1991

Intestinal surgery performed on gynecologic cancer patients.

A retrospective review covering a 9-year period revealed 113 patients who underwent 157 major bowel procedures during 130 operations performed solely by gynecologic oncology surgeons. Forty-eight percent of the operations were done for tumor cytoreduction, and 33% were performed for a bowel obstruction. Other indications included colostomy closure, fistula repair, resection for multiple enterotomies, temporary diversions, repair of perforated bowel, treatment for severe proctosigmoiditis, management of ureteral stricture, treatment for vulvar necrosis, and resection of an incidental small bowel tumor. Of the 157 procedures, 44% were colostomies, 32% were bowel resections with reanastomosis, 9% were urinary conduits, 6% were intestinal bypass procedures, 5% were colostomy closures, and 4% were ileostomies. Postoperative complications occurred in 32% of the 130 operations. These included wound infection, death, sepsis, fistula formation, urinary tract infection, unexplained febrile morbidity, anastomotic leakage, stomal infarction, adult respiratory distress syndrome, bowel obstruction, deep venous thrombosis, and wound hematoma. Four of the eight deaths were due to tumor progression, three were from sepsis, and one was from adult respiratory distress syndrome. Of the 130 operations, 89 (68%) were associated with no complications. These data support the concept that gynecologic oncology surgeons are able to perform intestinal operations as therapy for gynecologic malignancies with acceptable complication rates. Since a thorough understanding of the natural history of the cancer, familiarity with alternative therapeutic options, and knowledge of the prognosis are important in making operative decisions, and since gynecologic oncologists are technically capable of performing operations on the small bowel and colon, referral of patients with a primary or recurrent gynecologic malignancy or with a subsequent intestinal complication after initial therapy should be directed to the gynecologic oncologist whenever possible.

Adult↗
PubMed1991

Is essential tremor benign?

We analyzed the results of the Sickness Impact Profile, a self-reporting measure of sickness-related dysfunction in 753 essential tremor (ET) patients, 87 controls from the general population, and 145 patients with Parkinson's disease (PD). Compared with the general population, ET patients had significantly greater dysfunction in all but one category. Communication, Work, Emotional Behavior, Home Management, and Recreation and Pastimes were particularly impaired in ET. The PD patients had significantly higher dysfunction in all categories as compared with ET patients. We conclude that significant disability can occur in ET and, compared with PD, ET tends to be less severe but causes relatively greater psychosocial dysfunction.

Aged↗
PubMed1991

Radical vulvectomy with partial rectal resection and temporary colostomy as primary therapy for selected patients with vulvar carcinoma.

The patient with carcinoma of the vulva may present with tumor involvement of the perirectal area. Traditional treatment has often involved ultraradical therapy including a radical vulvectomy with posterior or total pelvic exenteration in an effort to obtain adequate surgical margins. Five-year survival rates for these patients range from 20-50%, and major operative morbidity as well as psychological problems are associated with this extensive surgery. Five patients treated for a locally advanced vulvar carcinoma involving the perirectal area were thought to be candidates for a rectum-sparing procedure. They underwent a radical vulvectomy, bilateral inguinal lymphadenectomy, partial rectal resection, and a diverting colostomy. Four of the five patients agreed to a colostomy closure 6 months after their primary therapy; these four patients have resumed normal bowel function. All patients remain clinically free of tumor.

Adenocarcinoma↗
PubMed1990

Osseous metaplasia in ovarian papillary serous cystadenocarcinoma.

The finding of osseous metaplasia within an ovarian papillary serous cystadenocarcinoma is very rare. A review of the medical literature reveals only two previously published cases where mature bone was found in an ovarian serous cystadenocarcinoma. This report presents an additional case of this unusual phenomenon whose clinical significance remains uncertain.

Cystadenocarcinoma↗