Just how short can hospital stays be?
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Biomedical subjects
Publications and source records attributed to L M Walker.
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Apical cells of 5-day-old dark-grown protonemata of the moss Ceratodon purpureus (Hedw.) Brid. are negatively gravitropic and appear to utilize amyloplasts as statoliths. These cells exhibit a characteristic plastid zonation (five zones) with one zone (No. 3) specialized for the lateral sedimentation of amyloplasts. Basipetal centrifugation displaces all amyloplasts in the apical cell to the end wall. In basipetally centrifuged protonemata observed using infrared videomicroscopy, tip extension occurred with or without amyloplasts present in the apical dome. The initial return of upward curvature was always correlated with the return and sedimentation of amyloplasts in zone 3. Subsequent vigorous upward curvature was correlated with distinct amyloplast zonation and further sedimentation in zone 3. Initial downward ("wrong way") curvature, which often preceded upward curvature, correlated with the presence of amyloplasts in the apical dome (zone 1). These data support the hypotheses that nonsedimenting amyloplasts in zone 1 are necessary for initial downward curvature and that amyloplast sedimentation in zone 3 is necessary for upward curvature.
The kinetics of gravitropism and of amyloplast sedimentation were studied in dark-grown protonemata of the moss Ceratodon purpureus (Hedw.) Brid. The protonemata grew straight up at a rate of 20-25 micromoles h-1 in nutrient-supplemented agar. After they were oriented to the horizontal, upward curvature was first detected after 1-1.5 h and reached 84 degrees by 24 h. The tip cells exhibited an amyloplast zonation, with a tip cluster of non-sedimenting amyloplasts, an amyloplast-free zone, and a zone with pronounced amyloplast sedimentation. This latter zone appears specialized more for lateral than for axial sedimentation since amyloplasts sediment to the lower wall in horizontal protonemata but do not fall to the basal wall in vertical protonemata. Amyloplast sedimentation started within 15 min of gravistimulation; this is within the 12-17-min presentation time. The data support the hypothesis that some amyloplasts function as statoliths in these cells.
The mortality of 3783 non-malignant hypertensive patients attending the Glasgow Blood Pressure Clinic between 1968 and 1983 and followed for an average of 6.5 years was compared with that in three control groups: the general population of Strathclyde a group of 15 422 subjects aged 45-64 years and screened in Renfrew and Paisley between 1972 and 1976, and a group of hypertensives seen in a blood pressure clinic based on general practice in Renfrew. Average blood pressure for men at entry to the Glasgow Clinic was 181/111 mmHg falling to 158/96 mmHg during treatment. Corresponding values for women were 185/109 mmHg and 161/96 mmHg. Seven hundred and fifty clinic patients (451 males) died during follow-up, the commonest causes of death in both sexes being myocardial infarction and stroke. All-cause age-adjusted mortality (deaths per 1000 patient-years) was 41.4 for men and 22.1 for women. At all ages in both sexes and for all levels of initial blood pressure mortality was less in patients whose blood pressure was reduced most. Without a randomized control group it is not certain that lower mortality in those with well controlled blood pressure was due to treatment, although this is the most likely explanation. Cigarette smoking, a history of myocardial infarction, angina or stroke, retinal arterio-venous nipping, raised blood urea, an abnormal electrocardiogram (ECG) and secondary hypertension were associated with increased risk, but heavy alcohol intake, obesity, haematocrit greater than 45%, hypokalaemia and social class were not. Life table analysis showed that, despite some reduction of mortality by treatment, the relative risk to men and women in the clinic remained two- to five-times that of the general population. The benefits of treatment were not such as to restore normal expectation of life even when blood pressure was well controlled. Excess mortality in the clinic could not be explained by difference of smoking habit or social class. This suggests that there is in the hypertensive patients of the Glasgow Clinic an element of irreducible risk, that treatment may be beneficial in some respects but harmful in others, or that patients at particularly high risk are selectively referred to the clinic.
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A case report of serial chromosome studies on a child presumed to have acute lymphoblastic leukemia (ALL) is presented. Hematologic remission was achieved after 3 weeks and maintained until death 63 weeks later. The classic Philadelphia chromosome translocation was found, both at diagnosis and throughout the course of the disease, in a proportion of cells from PHA-stimulated blood cultures. The finding is related to other reports of Philadelphia-positive clones in ALL, as well as those in chronic myeloid leukemia and its acute transformation, and other myeloproliferative disorders. The origin of the Philadelphia chromosome in this case is considered in the light of current stem cell theory, and its relevance to lymphocytic neoplasia is discussed. We believe that the finding of a Ph1-positive clone in a cell line morphologically indistinguishable from normal lymphocytes in a case of acute leukemia is unique.
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