Biomedical subjects
Publications and source records attributed to K B Thomas.
James Young Simpson first administered chloroform to one of his obstetric patients on 5 November 1847. The speed with which the discovery caught the popular imagination is illustrated by a comic scene in a pantomime which formed part of an entertainment in Edinburgh presented on 27 December in the same year.
The attitude of Joseph Lister (1827-1912) to chloroform is considered with particular reference to contemporary methods of administration and the effect of the agent on cardiac and respiratory function.
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Of 3,848 consultations with patients at 330 general practice surgeries during one year, no diagnosis was made in 1,656, The latter received no effective treatment other than contact with their doctor, and were asked to return if they did not feel better. But 1,191 did not return, Subsequent inquiry showed that 976 (82%) said they had been made better, and a further 131 (11%) said that, though they were no better, they had not sought further treatment.The "successfully untreated" patients were shown not to differ significantly from those patients in whom a definite diagnosis had been made, with regard to neuroticism, extraversion, intelligence, age, sex, marital status, social class, length of stay in the practice, number of consultations, and absence from work. These patients have been called "temporarily dependent" patients and their possible influence on diagnosis is discussed.
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Human collagen type III was immobilized covalently via activated carbohydrate moieties onto hydrazine-treated microtiter plates which could be used to measure von Willebrand factor (vWF) collagen binding activity (vWF:CBA) in an ELISA. Such plates were simple to prepare and remained stable at 4 degrees C and -20 degrees C for at least 2 months. Samples analyzed by this system included (a) normal human vWF fractionated according to the degree of multimerization, (b) normal citrated and EDTA plasma and corresponding serum, and (c) plasma from patients with von Willebrand disease (vWD) types 1 and 2. When related to the concentration of vWF antigen (vWF:Ag), proportionally low levels of vWF:CBA were found for samples lacking the high-molecular-weight multimers, while higher values were obtained for samples containing these multimers. The ratio of vWF:CBA/vWF:Ag sensitively reflected the functional and structural intactness of the vWF molecules for all analyzed samples. Monoclonal antibody directed to the region within the A1 domain of vWF which interacts with the glycoprotein Ib completely inhibited the vWF ristocetin cofactor (vWF:RistCof), while vWF:CBA was not affected. Thus vWF:CBA and vWF:RistCof clearly represent separate, noninterchangeable functional parameters of vWF. In conclusion, our results indicate that the newly described method for the immobilization of collagen onto microtiter plates is suitable for the determination of vWF:CBA. In conjunction with vWF:Ag and the calculated ratio of vWF:CBA/vWF:Ag, this method simplifies the detection and classification of patients with vWD and assists in quality control during the purification of normal vWF.