On planning and design: the hospital's market.
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Biomedical subjects
Publications and source records attributed to J Thomas.
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24 recordings of night-time sleep in three patients suffering from progressive supranuclear paralysis were carried out. There was observed: a tendency to insomnia, disappearance of spindles, an invasion of slow sleep immediately it appeared by the muscular and ocular criteria of paradoxical sleep, a considerable reduction in paradoxical sleep in the strict sense of the term, the latency of which in making its appearance was, however, maintained; progressive invasion of the paradoxical phases by slow waves. These abnormalities differ from those found in Parkinson's disease.
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In this study parameters of humoral antibody (HA) and cell-mediated immunity (CMI) were measured before and after transplant in 44 renal transplant patients. The results indicated that, before transplant, CMI parameters but not HA measurements correlated with early graft rejection crises. In antithymocyte globulin (ATG)-treated patients, a striking loss of early rejection activity occurred which correlated with ablation of T cells in the peripheral blood. ATG-treated patients also had a marked loss of T cell reactivity, as measured by phytohemagglutinin (PHA) blastogenesis and these parameters also correlated with allograft reactivity. Concanavalin A (Con-A) reactivity, however, did not correlate well with early rejection activity. Triple drug therapy with ATG, but not prednisone-Imuran therapy, caused a marked fall of T cell levels and reactivity within hours of the first dose of ATG. None of the ATG-treated patients had irreversible or progressive rejection in the first month after transplant and only 32 percent of patients had rejections, of which more than 70 percent were Type I. A "permissive" level of T cells of about 20 percent of normal was associated with over 95 percent of acute rejection crises, whereas no correlation of a variety of humoral antibody parameters and rejection has been seen in our unit. These studies suggest a primary role of the T cell in early allograft reactivity and indicate that future immunosuppressive techniques for human transplantation should be directed toward effective monitoring and modulation of T cell levels and reactivity in the early post-transplant period.
Three general surveys of a village population of 7000 in a highly endemic area in Purulia District, West Bengal, have included clinical examination and earlobe skin snip examinations. Multiple between-survey follow-up examinations have also been conducted of both bacillary positives and cases. In the general population 5.8% of the individuals showed bacteriological positivity with a concentration technique for AFB without showing clinical signs of infection. During two years of observation clinical leprosy was diagnosed in 13.6% of bacillary positives, in 4.8% of nuclear family contacts of clinical cases and 2.3% of the rest of the general population of the villages.
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The pharmacokinetics of chlormethiazole have been studied in six healthy volunteers following an intravenous infusion of the drug. The log. plasma concentration-time curve of chlormethiazole after cessation of the infusion was found to be curvilinear and was fitted therefore, by a bi-exponential equation computed by non-linear least squares regression analysis. Half-lives for the initial alpha-phase (0.54+/-0.05 h) and the terminal beta-phase (4.05+/-0.60 h) were calculated together with other pharmacokinetic parameters of the two compartment open model. An explanation for the discrepancy between the presently reported plasma half-lives and those appearing in the literature has been presented. The pharmacokinetic treatment of the plasma concentration-time data obtained following intravenous infusion also enabled the prediction that the maximal systemic availability of an orally administered dose of chlormethiazole would be of the order of 15%.
Differences from the normal were found in the serum proteins of coal workers suffering from pneumoconiosis which were similar to those in subjects suffereing from bronchitis, cancer and rheumatoid arthritis. The differences consisted of decreased albumin and increased globulin contents, and decreased sulphydryl contents, and decreased sulphydryl contents in both albumin and globulin proteins. These differences caused a reduction in the number of protein sulphydryl groups in serum. In pnemoconiotic coal workers the amount of idsulphide-linked cysteine in albumin increased above the normal, the increase tending to depend on the severity of the pneumoconiosis. Apart from this correlation the above differences could not be used to diagnose the class of pneumoconiosis.
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The pharmacokinetics of the new anti-inflammatory agent tolmetin have been studied after its oral administration to normal subjects and to patients with rheumatoid arthritis. Plasma concentration-time data were fitted to a one-compartment open model. Following single oral doses, no basic differences in rates of drug absorption and elimination were found between normal subjects and arthritic patients. For the 12 subjects studied, the overall mean elimination rate constant was 0.839 hr-1, corresponding to a plasma half-life of 0.83 hr. The drug was rapidly absorbed and had a mean apparent volume of distribution of 0.098 l/kg. Plasma levels and pharmacokinetic parameters of tolmetin in arthritic patients after multiple dosing were smaller to those after a single dose.
Eighty-four 4-quinolinehydrazones were synthesized and tested for antiviral activity. Thirty nine derivatives were active against influenza A2 and/or Coxsackie B1 in mice at a dose of 25 mg/kg sc. Structure-activity relationships of 44 derivatives (21 inactive) were analyzed qualitatively using a modified Free-Wilson approach.