The consent form revisited.
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Biomedical subjects
Publications and source records attributed to J Sloan.
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EMLA (eutectic mixture of local anesthetics) cream is a topical formulation of a mixture of lidocaine and prilocaine. It has been used to achieve local analgesia after application under an occlusive dressing. We carried out a double-blind randomized controlled clinical trial to assess the effect of 5% EMLA (25 mg/mL of lidocaine and of prilocaine) in reducing the pain caused by infiltration of local anesthetic in eyelid surgery. Pain was assessed by means of a modified visual analogue scale ranging from 0 (no pain) to 10 (excruciating pain) in 25 consecutive patients (average age 65 years) undergoing bilateral eyelid surgery. Clinical significance was defined as a difference in pain scores of 3 or more between EMLA and placebo. The mean pain scores for EMLA and placebo were 3.1 and 4.0 respectively, a nonsignificant difference. The EMLA preparation was found not to be clinically effective in reducing pain caused by infiltration of local anesthetic in eyelid surgery.
A new Clostridium perfringens-Escherichia coli shuttle plasmid has been constructed and its complete DNA sequence compiled. The vector, pJIR418, contains the replication regions from the C. perfringens replicon pIP404 and the E. coli vector pUC18. The multiple cloning site and lacZ' gene from pUC18 are also present, which means that X-gal screening can be used to select recombinants in E. coli. Both chloramphenicol and erythromycin resistance can be selected in C. perfringens and E. coli since pJIR418 carries the C. perfringens catP and ermBP genes. Insertional inactivation of either the catP or ermBP genes can also be used to directly screen recombinants in both organisms. The versatility of pJIR418 and its applicability for the cloning of toxin genes from C. perfringens have been demonstrated by the manipulation of a cloned gene encoding the production of phospholipase C.
Four patients with Carney's complex, one sporadic and three familial, are described. The sporadic case was a young male with centrofacial lentigines, who developed cyclical Cushing's syndrome secondary to bilateral pigmented nodular adrenocortical disease, two separate left atrial myxomas, and buccal mucosal myxomas. The three familial cases, who all had varying degrees of centrofacial/mucosal lentigines and cutaneous myxoid tumours, were a woman with myxoid mammary fibroadenomatosis and a left atrial myxoma, her daughter who developed a prolactin-secreting pituitary adenoma, and her son who had bilateral large-cell calcified Sertoli cell testicular tumours, and an axillary psammomatous melanotic schwannoma.
This study described and compared the childbirth expectations of high-risk and low-risk pregnant women and then examined the influence of anxiety, risk status, and childbirth preparation on these expectations. This descriptive correlational study employed a convenience sample of 75 high-risk nulliparas and 77 low-risk nulliparas. Results indicated that high-risk pregnant women had significantly less positive expectations for their childbirth experience than did low-risk pregnant women. In particular, high-risk pregnant women expected more medical intervention and more difficulty coping with pain during their labor and birth. For both groups of women, anxiety was negatively correlated with childbirth expectations, whereas childbirth preparation was positively correlated with childbirth expectations.
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Fifty members of a family with a unique autosomal dominant bone disease were investigated. Nineteen of the family members were either known to have, or were strongly suspected of having the disease. All but one of these had a hearing loss which was conductive in the younger age group and mixed in the older members. The common finding in those who had middle ear surgery was replacement of the long process of incus by a fibrous band. The histological features were similar to those found in Paget's disease. The age of onset, distribution of lesions and radiographic findings, however, were not typical of this disorder.
Qa-2 molecules are weak transplantation antigens encoded by class I genes of the major histocompatibility complex. When expressed in transgenic CBA mice, Qa-2 molecules provoke rapid rejection of skin grafts and strong, Qa-2 specific, cytotoxic T-cell responses. Efficient rejection of skin grafts from Qa-2 transgenic mice takes place when Qa-2 molecules are attached to the cell membrane with a glycophosphatidyl anchor or by a transmembrane protein domain, except that rejection times are slightly longer in the former case. These results demonstrate that Qa-2 molecules can behave as major transplantation antigens, as do closely related H-2 molecules. Failure of Qa-2 molecules to provoke strong T-cell responses in non-transgenic mice is probably due to the very low level of expression of Qa-2 molecules in skin keratinocytes from such mice since these cells express increased levels of Qa-2 molecules in all Qa-2 transgenic mice.
Achalasia of the oesophagus is an uncommon neuromuscular disorder characterized by symptoms of dysphagia and regurgitation of undigested food. The results of treatment of 43 patients with achalasia over 10 years are presented. Clinical data on presenting complaints and duration, and all subsequent treatments, were recorded. Patients were contacted to assess their current symptomatic status.
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Familial cases of non-polyposis colorectal cancer have recently attracted much interest. Little is known about the characteristic histology or natural history of disease in such cases. Our aim was to determine, through a population-based study, whether mucin-secreting tumours were associated with a positive family history and whether 'familiality' was an independent prognostic variable. All patients under 55 years of age with histologically verified colorectal cancer in Northern Ireland during 1976-78 were studied. The family history was validated in 95% of all non-polyposis cases (n = 205), and the proband's histologic specimen reviewed in over 99%. Mucin-secreting tumours were significantly associated with a positive family history, but familiality was not found predictive of survival in a multivariate analysis controlling for age, sex, stage, site, symptom duration, differentiation, and histologic type.
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McCroskey (1982) has hypothesized that there are various forms of apprehension about communication some of which are situation specific and some of which are best thought of as traits. Other research has established a relationship between personality variables and a trait conception of apprehension about communication. If McCroskey's distinction between trait and situation-based state is appropriate, personality variables ordinarily associated with trait apprehension about communication should not correlate as highly with forms defined as more situation specific, such as anxiety about public speaking. Multiple regressions were performed using trait measures of apprehension about communication (the Personal Report of Communication Apprehension) and situation-based anxiety (the public speaking factor of the Personal Report of Communication Apprehension) as dependent variables. As hypothesized, contributions of personality were less for trait than situation-specific apprehension about communication. The inclusion of self-monitoring as a moderator variable added additional information about the contributions of personality to situation-specific apprehension about communication, with personality being more predictive of apprehension about public speaking for low self-monitors.
All rats subjected to total or paradoxical sleep deprivation by the disk apparatus developed severe ulcerative and hyperkeratotic skin lesions localized to the plantar surfaces of their paws and to their tails. Yoked control rats only occasionally developed similar appearing lesions, which were always much less severe than in deprived rats. The deprived rat lesions could not be explained by pressure, disk rotation, water immersion, infection, necrotizing vasculitis, tyrosinemia, protein deficiency, or reduced rates of mitosis. Thus, although paw and tail lesions constitute a very reliable and severe symptom of total or selective sleep deprivation in the rat that potentially could yield insights into the pathogenic mechanisms induced by sleep loss, the mediation of the lesions remains unknown.
Glycerol:NADP+ 2-oxidoreductase (EC 1.1.1.156) was isolated from Schizosaccharomyces pombe, purified and characterized. It had an Mr of 57,000, and SDS-PAGE revealed two polypeptides, of Mr 25,000 and 30,000. Its coenzyme requirement was satisfied exclusively by NADP. The pH optimum for glycerol oxidation was 9.5, for dihydroxyacetone reduction 6.0. Rates of oxidation with some structurally related diols were three- to six-fold lower than for glycerol, while glyceraldehyde and other carbonyl compounds showed negligible rates of reduction. Neither monovalent nor divalent cations activated the enzyme. Apparent Km and Vmax values were determined. The enzyme is similar to glycerol dehydrogenases isolated from Mucor javanicus and from Dunaliella parva but differs considerably from the glycerol:NAD+ 2-oxidoreductase of S. pombe.
We report 40 cases in one family of an autosomal dominant bone dysplasia, which, though similar in some aspects to Paget's disease, seems unique in some features and in its natural history. The disease shows both general and focal skeletal changes, the latter being mainly in the limbs with an onset from the second decade. Progressive osteoclastic resorption is accompanied by medullary expansion which leads to pain, severe deformity and a tendency to pathological fracture. The serum alkaline phosphatase and urinary hydroxyproline are variably elevated, while other biochemical indices are normal. Most patients had an associated deafness of early onset and loss of dentition. No previous description of this disease has been found in the literature.
The subjects were 90 children between 6 and 15 years of age, 30 with autistic, 30 with mentally retarded, and 30 with nonhandicapped brothers or sisters. The children were questioned about their sibling relationships in an open-ended interview, and, in the case of children with handicapped siblings, they also responded to questions about particular problems they faced in regard to their brothers or sisters. In addition, mothers filled out a behavior rating scale in which they described the positive and negative aspects of their children's behavior toward the sibling. In general, children and mothers rated the sibling relationships positively. Group comparisons indicated that children with autistic and mentally retarded siblings did not differ on any self-report measures. Children with nonhandicapped siblings reported that their family relations were slightly more cohesive but otherwise did not differ in terms of their self-reports from children with handicapped siblings. Mothers of nonhandicapped children, however, rated the sibling relationships more negatively than did mothers of handicapped children. Further analyses revealed that status variables (age, gender, family size) were not as highly correlated with the quality of sibling relationships with handicapped children as were specific problem areas (e.g., perceptions of parental favoritism, coping ability, concerns about the handicapped child's future).
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