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Biomedical subjects

J Thomas

Publications and source records attributed to J Thomas.

At least 379 records · Page 21Linked to original sources

Detection of amplified sequences at 5q11-->q13 in a homogenously staining region found by fluorescent in situ hybridization in a case of B-cell non-Hodgkin's lymphoma.

Gene amplification is one of the molecular mechanisms possibly involved in the initiation of tumorigenesis. Homogenously staining regions and double minutes have been shown to contain amplified DNA sequences. We report here a case of B-cell non-Hodgkin's lymphoma (NHL) carrying an abnormal chromosome 5 with an hsr-like region at 5q11-->q13. Chromosome "painting" with a chromosome 5-specific library (pBS5) showed that the amplified material was indeed derived from chromosome 5. Further identification of the amplified DNA sequences was performed with a set of YAC probes localized to 5q12-->q14. The amplified region contained genetic loci defined by D5S6, D5S125, D5S112, and D5S39. A three-fold level of DNA amplification was visualized by Southern blotting using a DNA probe from the amplified region. The present results suggest that unknown gene(s) at 5q11-->q13 might be involved in the process of lymphomagenesis when amplification occurs.

Chromosome Banding↗

Psychological sequelae following the Gulf War. Factors associated with subsequent morbidity and the effectiveness of psychological debriefing.

BACKGROUND: The aim was to study the effect of brief counselling and psychological debriefing following a trauma on subsequent morbidity. METHOD: We investigated psychological morbidity in 62 British soldiers whose duties included the handling and identification of dead bodies of allied and enemy soldiers during the Gulf War. Of these soldiers, 69% received a psychological debriefing on completion of their duties. The subjects completed by post a demographic questionnaire, the General Health Questionnaire (GHQ-28) and the Impact of Events Scale. RESULTS: After nine months 50% had evidence of some psychological disturbance suggestive of posttraumatic stress disorder (PTSD); 18% had sought professional help; 26% reported relationship difficulties. Neither prior training nor the psychological intervention appeared to make any difference to subsequent psychiatric morbidity. Morbidity at nine months was more likely in those with a history of psychological problems and those who believed their lives had been in danger in the Gulf. CONCLUSIONS: These findings show that a psychological debriefing following a series of traumatic events or experiences does not appear to reduce subsequent psychiatric morbidity and highlights the need for further research in military and civilian settings.

Adult↗

A randomized study in stage IIIB and IV Hodgkin's disease comparing eight courses of MOPP versus an alteration of MOPP with ABVD: a European Organization for Research and Treatment of Cancer Lymphoma Cooperative Group and Groupe Pierre-et-Marie-Curie controlled clinical trial.

PURPOSE: We report a prospective randomized study comparing the relative efficacy of alternating chemotherapy mechlorethamine, vincristine, procarbazine, and prednisone/doxorubicin, bleomycin, vinblastine, and dacarbazine (MOPP/ABVD) with the standard MOPP chemotherapy in patients with stage IIIB and IV Hodgkin's disease (HD). The purpose is to study the influence of time of remission on clinical outcome. PATIENTS AND METHODS: After two courses of MOPP, patients were randomized to receive six further courses of MOPP, or two courses of ABVD followed by two courses of MOPP and two courses of ABVD. Radiotherapy was given to areas presenting with masses > or = 5 cm and to residual masses after course no. 4. Evaluation of response (complete remission [CR]) took place after two courses (CR2), after four courses (CR4), at the end of chemotherapy (CR8), and after additional radiotherapy (CR(CT + RT)). Logistic regression analysis was used to study prognostic factors for response at the end of chemotherapy. Cox analysis was used to study prognostic factors for survival. Two hundred seven patients were registered, 192 (93%) of whom were randomized. RESULTS: The CR rate at the end of chemotherapy (CR8) was similar in both arms (57% v 59%). However, there were more progressions in the MOPP arm compared with the MOPP/ABVD arm (23% v 8%, P = .014). A significantly higher failure-free survival (FFS) rate was found in the MOPP/ABVD arm (60% v 43% at 6 years, P = .025). There was no difference in the relapse-free survival (RFS) or survival rate. Of patients not in CR4, only 28% still reached a CR8. RFS at 6 years of patients with CR4 (69%) was not different from that of patients with CR8 (68%); patients with a CR(CT + RT)) had a lower RFS rate (48%). CR4 (P < .001) predicted strongly for final remission at the end of chemotherapy. Cox analysis showed that age more than 50 years, six or more involved lymph node areas, no CR by the fourth cycle, chemotherapy with MOPP alone, and no radiotherapy were unfavorable factors for survival. CONCLUSION: MOPP/ABVD chemotherapy significantly improved response and FFS rates, but had no influence on RFS and survival rates. Early CR (CR4) is an important factor for final remission and might be used to select a group of patients with a good prognosis.

Adolescent↗

Application of physiotherapy outcome measures to the managed care model.

Managed Care (MC) is a multidisciplinary model for health care delivery that organizes and sequences the caregiving process. Its objectives include: 1) to reduce length of stay and resource consumption, and 2) to measure, maintain or improve patient outcomes related to care received. Our tertiary care facility is the first Canadian hospital to implement MC. Patient care is directed through the use of a Care Map. Each map is specific to a pathological state and its treatment, i.e. Total Knee Replacement (TKR), and consists of a Patient Problem List, with related patient-centred outcomes, and a Critical Path. The Critical Path outlines the temporal sequence of the provision of care. Most key events on a Care Map are determined anecdotally. The purpose of this project was to collect outcome information in patients assigned to the Total Knee Replacement Care Map in an attempt to validate the existing Care Map or make recommendations for revisions. Inter-rater and intra-rater reliability of knee range of motion-was calculated using the Intra Class Correlation Coefficient (ICC). ICC values ranged from .64-.97. Seventeen patients were assessed. All patients were measured on Day 6 and 8 of the Care Map. This process has resulted in validation of certain range estimates and recommendations for revision of others.

Aged↗

Health visitors' role in services for children with disabilities.

Health visitors play a vital role within the specialist child development team providing support for children with disabilities and their families, write Margaret Yerbury and Jim Thomas. They report the findings of a study which revealed the significant contribution of health visitors and nurses in such teams in contributing to the ability of families to develop skills to meet their child's special needs and maximise the child's potential. The study also revealed concern among parents and professionals where no specialist health visiting support was available. This vital service may be at risk from cuts in health visiting services, they warn.

Child↗

Video-assisted endoscopic thoracic sympathectomy in the management of intractable palmar hyperhydrosis.

Minimally invasive endoscopic surgical techniques have revolutionised patient management. We present our findings in our first 10 cases of bilateral video-assisted endoscopic thoracic sympathectomy in the management of intractable palmar hyperhydrosis including the first such procedure in Singapore. We have found the procedure to have minimal morbidity, good patient acceptance and all patients have remained with dry palms.

Adult↗

Cardiovascular systemic invasion by hepatocellular carcinoma: incidence and pattern in a west African population.

To determine the frequency of cardiovascular systemic invasion by hepatocellular carcinoma (HCC). Eighty-one Nigerian patients who had autopsy examinations were studied. Of these, 36 (44%) had tumour thrombi within the cardiovascular system (CVS) or metastases to the heart itself. Compared with the patients without CVS invasion, no clinicopathologic findings distinguished these two groups from each other. Furthermore, CVS invasion did not worsen the generally bad prognosis of these patients with liver cancer. It is concluded that CVS invasion is frequent and difficult to diagnose by clinical examination. Patients who are selected to undergo hepatic resection must be assessed by imaging techniques to exclude CVS invasion. However, it is unlikely that frequent and routine imaging procedures will affect the generally bad prognosis of the majority of the patients.

Adolescent↗

[Uro-oxalic renal lithiasis. Special aspects].

In a paper published in 1974, it was reported that uro-oxalic stones are found more often in subjects with group O than with group A blood types although the proportions of these two blood types are approximately equivalent in the French population. The present work confirms these data, the ratio of group O to group A renal lithiasis being approximately 3 to 1. In a paper published in 1987, uro-oxalic stones were found to occur preferentially on the left side: 84 on the left and 39 on the right. The present work confirms this notion since in 57 cases, stones were bilateral in 2 cases, on the left in 39 and on the right in 16. Extra corporeal shock wave lithotripsy was performed in 40 of the 57 cases and showed that uro-oxalic stones are more resistant to shock-waves than the other types of stones. They are about as hard as calcium oxalate monohydrate stones or harder in certain cases: A mean of 3,865 shock-waves were required in the 40 cases of the uro-oxalic lithiasis treated with the HM3 Dornier device, while the mean number of shock-waves required for all types of stones in general varies from 2,000 to 2,500. In 4 cases, 5,000 or 6,000 high power shock-waves (7,000 in one session and 9,500 in two sessions) had to be used to obtain a satisfactory result. The calcium oxalate part of these stones is almost always composed of calcium oxalate monohydrate.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Group Antigens↗

Migraine treatment by oral magnesium intake and correction of the irritation of buccofacial and cervical muscles as a side effect of mandibular imbalance.

A previous paper showed a significant decrease in average erythrocyte magnesium level in 79 migraine patients as compared to 55 controls. This paper completes the results of the initial evaluation, with 152 migraine cases and 85 controls. Serum and erythrocyte magnesium determinations show the following results. Mean serum magnesium was 0.82 mmol/litre in migraine patients and 0.85 mmol/litre in controls, P < 0.005. Mean erythrocyte magnesium was 2.04 mmol/litre in migraine patients and 2.32 mmol/litre in controls, P < 0.0005. These results confirm those of the first paper, but show a more significant difference between the means of the two groups for serum magnesium, which was not significant for the lower number of people involved in the previous study. In all migraine cases without exception clinical evaluation showed an abnormal sensitivity of the buccofacial and cervical muscles which was unilateral and homolateral when migraine was unilateral; it was bilateral when migraine was bilateral. The muscles which were the most sensitive to palpation were the sternocleidomastoid, external pterygoid and scalene. These findings show that migraine patients have a magnesium deficit, which, while not constant, is a frequent occurrence. This raises the problem of the relationship between migraine and other disorders characterized by magnesium deficit, such as latent tetany, mitral valve prolapse, and certain allergies. This magnesium deficit probably promotes muscle irritability, especially when a local imbalance factor results in a permanent pathological stimulation. In addition to irritation and hypersensitivity, migraine attacks occur, particularly after stress, digestive, endocrine and neurological problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

A novel internal antigen which distinguishes germinal centre cells from other B-cell types.

A new monoclonal antibody, 4KB51, is described which labels the majority of B cells in blood and in mantle and marginal zones but not germinal centre lymphocytes or plasma cells. Antibody 4KB51 also stains monocytes, neutrophils and the majority of T cells. It recognizes an intracellular antigen of 160,000 MW (unreduced) and 68,000 MW (reduced). Antibody 4KB51 labels the tumour cells in all cases of hairy cell leukaemia and in four of the 16 cases of centrocytic B-cell lymphoma studied. No labelling of the other lymphomas (114 cases) or lymphoid leukaemias (13 cases) tested was seen. Antibody 4KB51 may be of value in defining B-cell subsets and in the differential diagnosis of hairy cell leukaemia and centrocytic lymphomas. The pattern of reactivity of 4KB51 suggests that its target antigen may play a functional role, possibly involved in lymphocyte homing.

Antibodies, Monoclonal↗

Phenylarsine oxide and hydrogen peroxide stimulate glucose transport via different pathways in isolated cardiac myocytes.

The aim of this study was to investigate the stimulating effects of sulfhydryl reagents on glucose transport in isolated rat heart muscle cells and to compare them with the action of insulin. Low concentrations of the sulfhydryl oxidants hydrogen peroxide (H2O2) and diamide (5-100 microM), but also of phenylarsine oxide (PAO) (0.5-3 microM), that is known to specifically react with vicinal SH-groups, stimulated the rate of 2-deoxy-D-glucose uptake by a factor of 4 to 8 in these cells, while higher concentrations were inhibitory. The stimulating effects of H2O2 or diamide, and, to a significantly lesser extent, those of PAO or insulin, were depressed in cells pretreated with the sulfhydryl-alkylating agent N-ethylmaleimide (56-100 microM). H2O2 raised the Vmax and lowered the Km of 3-O-methyl-D-glucose uptake, while PAO or insulin solely increased Vmax. The increase in glucose transport caused by H2O2 was antagonized by the beta-adrenergic agonist isoprenaline (1 microM) or by a membrane-permeant cyclic AMP analog, whereas the effects of PAO or insulin were not altered. The action of H2O2 was additive with the stimulation induced by the protein phosphatase inhibitors okadaic acid (1 microM) or vanadate (6 mM), whereas the responses to PAO or insulin were reduced in the presence of these agents. Finally, H2O2 and PAO, but not insulin, acted additively with the protein kinase C ligand phorbol myristate acetate (0.8 microM) and with phospholipase C (0.03 units/ml). We conclude that, in cardiac myocytes, H2O2, on the one hand, and PAO (and possibly insulin), on the other hand, stimulate glucose transport via at least two distinct, SH-dependent pathways. These pathways, in turn, differ from a protein kinase C- and from a phospholipase C-mediated mechanism.

3-O-Methylglucose↗