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Biomedical subjects

M A Turner

Publications and source records attributed to M A Turner.

At least 91 records · Page 5Linked to original sources
PubMed1991

Holidays and atopic eczema.

Information was collected by telephone about 300 holidays taken over a three year period by 126 children with severe atopic eczema. During the holidays, improvement in eczema occurred more frequently (112/300, 37%) than deterioration (63/300, 21%). There was a significant correlation between improvement and a more southerly holiday location: improvement was common in holidays taken in the Mediterranean or further south (63/92, 69%), but holidays in northern Britain were more likely to be associated with deterioration (27/100, 27%) than improvement (13/100, 13%). Changes in eczema were correlated with changes in asthma in 231 holidays taken by children with both conditions, but improvement was not significantly associated with pet ownership. All patients returned to their preholiday state, usually within two weeks of return home. The causes of changes in eczema while on holiday have not been identified.

Adolescent↗
PubMed1990

Lunate silicone replacement arthroplasty in Kienböck's disease: a long-term follow-up.

We report a long-term follow-up (average, 5 years) of 10 patients who had lunate silicone replacement arthroplasty for treatment of Kienböck's disease. Clinical results were assessed on relief of pain, return to normal occupation, and range of motion. At 18- to 20-months follow-up, eight patients had satisfactory results, whereas at final follow-up only five of the patients had satisfactory results. Three of five patients with radiographs averaging 57 months after operation had evidence of particulate synovitis. Contrary to our previous publications on silicone replacement arthroplasty, it was concluded that the success rate for silicone replacement arthroplasty and the incidence of particulate synovitis do not warrant the continued use of silicone replacement arthroplasty as a primary treatment modality for Kienböck's disease.

Adolescent↗
PubMed1990

Three separate classes of bacterial ice nucleation structures.

Studies of the properties of the ice nucleation structure exposed on the surfaces of various bacteria such as Pseudomonas syringae, Erwinia herbicola, or various strains of Ice+ recombinant Escherichia coli have shown that there are clearly three major related but chemically distinct types of structures on these cells. First, the ability of Ice+ cells to nucleate super-cooled D2O has been examined, and it has been found that this ability (relative to the ability of the same cells to nucleate super-cooled H2O) exhibited three characteristic nucleating patterns. The rarest structure, called class A, is found on only a small fraction of cells in a culture, nucleates H2O at temperatures above -4.4 degrees C, and is an effective nucleator of super-cooled D2O. A second class of structure, called class B, is found on a larger portion of the cells, nucleates H2O between -4.8 and -5.7 degrees C, and is a relatively poor nucleator of super-cooled D2O. The class C structure is found on almost all cells and nucleates at -7.6 degrees C or colder. These three classes of structures were also differentiated by their sensitivities to low concentrations of water-miscible organic solvents such as dioxane or dimethyl sulfoxide. Depending on the specific bacterial strain, the addition of these solvents to bacterial suspensions lowered the nucleation activity of the class A structure by 1,000-fold or more. The nucleation activities of class B structures in the same culture were highly resistant to these compounds and were lowered only by 20 to 40%. The class C structures were more sensitive than Class B structures were, and the nucleation activities decreased 70 to 90%. Finally, the pH sensitivity of these three classes of structures was examined. The class A structure was destroyed in buffers at pH 4.5 lower but was stable in buffers at higher pHs. The class B structure was less sensitive to acidic buffers but was destroyed at pH 5.5 or lower and was stable at higher pHs. However, the class C structure was unaffected by incubation in buffers with pHs of 3.5 to 9.0. Suggestions for the actual nucleation structures of the three classes are proposed.

Deuterium↗
PubMed1990

Mediastinal pseudocyst associated with chronic pleural effusions.

We present a patient who had chronic, bilateral pleural effusions without evidence of parenchymal, retrocardiac or mediastinal masses. A CAT scan of the abdomen and chest revealed the extension of a large abdominal pseudocyst through the diaphragm into the posterior mediastinum. The pseudocyst resolved with conservative management.

Chronic Disease↗
PubMed1990

Parental uncertainty in critical care hospitalization of children.

The purpose of this qualitative study was to explore the dimensions of uncertainty, including the source, family effect, and parental response, of parents whose child was hospitalized in a pediatric intensive care unit (PICU). A convenience sample of 13 parents of 8 critically ill children served as subjects for this study. Data were collected using a modified grounded theory method with 1 to 1-1/2 hour interviews of parents within 2-4 days after admission of their child to the PICU. A model of PICU uncertainty was derived which identified four areas in which ambiguity, conflicting information, or perceived inefficiency gave rise to uncertainty. These areas included: environmental uncertainty, illness uncertainty, caregiver uncertainty, and family systems uncertainty. Findings are related to Mishel's Theory of Uncertainty (1987) and implications for pediatric nursing research are discussed.

Adult↗
PubMed1989

Treatment of biliary obstruction caused by metastatic cancer.

Over an 8-year period, among 41 patients with obstructive jaundice caused by metastases to the liver or lymph nodes adjacent to the porta hepatis, palliative biliary decompression was established surgically in 11, by percutaneous transhepatic biliary drainage (PTBD) in 25, and by both methods in 2. Three patients had no drainage procedure performed. Early mortality after drainage occurred in 6 of 38 patients, and the median survivals (actuarial) for the remaining 32 patients were 4.5 months for the surgical group (range 2 to 21 months) and 4 months for the PTBD group (range 2 to 14 months). Although there were trends toward more frequent hospital readmissions and episodes of cholangitis in the PTBD group, the only statistically significant difference was in the number of catheter manipulations required. We concluded that when patients develop obstructive jaundice as a manifestation of metastatic cancer, useful palliation can be achieved by either surgical or percutaneous decompression.

Adult↗
PubMed1989

Excision of residual masses after platinum based chemotherapy for non-seminomatous germ cell tumours.

Between January 1980 and June 1987, 42 patients receiving platinum based combination chemotherapy for advanced non-seminomatous germ cell tumours had residual masses, detected by computed tomography, after four or six treatment courses without tumour marker evidence of active disease. Resection of retroperitoneal (n = 32), pulmonary (n = 4) or thoracoabdominal (n = 2) disease revealed residual malignancy in nine patients (21%), differentiated teratoma in 14 (33%) and fibrosis or necrosis in 15 (36%). Laparotomy showed no evidence of a mass in four instances. Of the 42 patients, 14 had malignant teratoma undifferentiated in the primary tumour only one of whom (7%) had evidence of malignancy in the specimen resected post-chemotherapy. Conversely, six of 15 patients (40%) whose primary tumour was malignant teratoma intermediate had residual malignant tissue after treatment. With a median follow up of 36 months from post-chemotherapy surgery, 36 patients (86%) are continuously disease-free. Relapses occurred in one of nine patients with residual malignancy (11%), three of 14 with differentiated teratoma (21%), one of 15 with necrosis or fibrosis (7%) and in one patient who had a normal laparotomy. Four patients have died from their tumours, but two are currently disease-free following further surgery and chemotherapy for relapse. Neither primary nor post-chemotherapy histology was predictive of relapse, and although relapse was numerically more common in patients whose residual mass was incompletely excised (three of 12), this was not statistically significant.

Adolescent↗
PubMed1989

Management of biliary obstruction in patients with unresectable carcinoma of the pancreas.

Clinical and pathologic data from 73 patients with unresectable carcinoma of the pancreas treated from 1980 to 1987 were reviewed to evaluate the efficacy of biliary enteric bypass and percutaneous transhepatic biliary drainage (PTBD) in the treatment of malignant biliary obstruction. Fifty-two patients underwent biliary enteric bypass with no operative deaths and with a 15% operative morbidity. These patients had a median postoperative hospitalization of 12 days. Four patients (8%) eventually developed recurrent jaundice, and three of these were successfully treated with PTBD. The median survival for these 52 patients was 7 months. Twenty-one patients underwent PTBD with an 81% technical-success rate. These patients had a 33% early complication rate and a 33% in-hospital mortality. The median hospitalization was 13 days postdrainage. Of the 14 patients surviving the initial hospitalization, 86% developed late complications requiring 16 hospital admissions and ten emergency room visits for a total of 155 days of hospitalization. The median survival for those patients undergoing PTBD was 4 months from the time of diagnosis and 2 months from the time of catheter drainage. Surgical bypass offers excellent palliation for malignant biliary obstruction with extremely low morbidity and mortality in properly selected patients; PTBD is useful in the treatment of those patients with extensive disease, who are poor surgical candidates, or who have failed previous surgical drainage. There is a role for both of these palliative procedures in the management of patients with biliary obstruction from pancreatic cancer.

Adenocarcinoma↗
PubMed1989

Surgical discectomy in an active-duty military population: a report of 66 consecutive cases.

Sixty-six consecutive active duty military personnel with herniated lumbar intervertebral discs were treated by open surgical discectomy. Of these patients, 54 (82%) had relief of their radiating leg pain and were able to return to full duty status. The other 12 patients (18%) were unable to return to full duty because of either persistent postoperative radiating leg pain or low back pain. Open surgical discectomy is an effective treatment modality for lumbar disc herniations in a military population with a vigorous life-style mandated by their active duty status.

Humans↗
PubMed1989

Enterolithiasis as a cause of intestinal obstruction.

Enteroliths are an uncommon cause of intestinal obstruction. We report two patients in whom this occurred. Conditions causing stasis predispose formation of enteroliths, which may be either radiopaque or radiolucent. They have a characteristic appearance on plain radiographs and on contrast examinations. Early recognition is helpful in preventing complications.

Aged↗
PubMed1988

[N,N-bis(2-hydroxyethyl)dithiocarbamato-S,S']dichlorogold( II).

[Au(C5H10NO2S2)Cl2], Mr = 448.1, space group P212121 (No. 19), a = 7.446 (2), b = 11.434 (4), c = 13.110 (3) A, V = 1116.2 (5) A3, Z = 4, Dm = 2.74 (5), Dx = 2.67 g cm 3, graphite-monochromatized Mo Ka radiation, lambda = 0.71069 A, mu = 144.0 cm-1, F(000) = 832.2, T = 298 K, R = 0.0432, wR = 0.0397 for 1974 unique reflections and 118 parameters. The gold atom is in a roughly squareplanar environment, distorted as a result of the small bite distance of the chelating dithiocarbamate ligand. Molecules pack in the crystal lattice such that there are linear...S...Au...S... chains parallel to the a axis.

Hydrogen Bonding↗
PubMed1988

Secretion and export of IGF-1 in Escherichia coli strain JM101.

The processing of LamB-IGF-1 fusion protein and the export of processed IGF-1 (insulin-like growth-factor-1) into the growth medium was examined in the Escherichia coli host strain, JM101. Several strain or plasmid modifications were tried to increase export of periplasmic (processed) IGF-1 into the growth medium of JM101. These included: (1) use of a lon null mutant strain to increase accumulation levels of unprocessed LamB-IGF-1 fusion protein; (2) use of an alternative drug resistance marker on the expression plasmid rather than beta-lactamase, thereby reducing any competition for processing of LamB-IGF-1 by signal peptidase; (3) examination of whether phage M13 gene III protein expression caused more periplasmic IGF-1 to be exported into the growth medium due to increased outer membrane permeability; and (4) examination of the effect of E. coli or yeast optimized IGF-1 codons. None of these strain or plasmid modifications caused any significant increase in export of IGF-1 into the growth medium of JM101. Solubility studies of LamB-IGF-1 and processed IGF-1 showed that virtually all of the LamB-IGF-1 and IGF-1 remaining within the cell after a 2 h induction period was insoluble. This implied that only soluble LamB-IGF-1 was processed to IGF-1 and that only soluble IGF-1 was exported into the growth medium. Taken together, the results indicated that LamB-IGF-1 and IGF-1 solubility were the limiting factors in secretion of IGF-1 into the periplasm and export of IGF-1 into the growth medium.

Amino Acid Sequence↗
PubMed1988

Mechanical versus biological heart valves: a ten-year comparison in a single centre.

Between January 1977 and December 1986, 1606 Bjørk-Shiley tilting disc prostheses (BS) and 1346 Carpentier Edwards porcine prostheses (CE) were implanted in 1300 and 1156 patients, respectively, at the same institution. During the time of implantation, both valves have developed: the BS through standard disc and convexo-concave to monostrut, and the CE valves from standard to supra-annular. Newer valve types were used where applicable as they became available. Preoperative status in respect of age and cardiac rhythm were similar. There were significantly more females (64% BS: 54% CE, P less than 0.001); worse NYHA grade (74% Grade 111 and IV-BS: 56% 111 and IV-CE, P less than 0.001) more closed heart surgery (26% BS: 18% CE, P less than 0.001) and more previous open heart surgery (11.6% BS: 8.9% CE, P less than 0.001) in the BS group. All BS patients were anticoagulated and 49% of mitral CE patients and 7% of aortic CE patients were anticoagulated. There was no significant difference between the two groups in hospital mortality (BS 7.2%: CE 6.3%), late mortality (BS 2.5%/patient year: CE 3.2%/patient year) overall incidence of systemic embolism (BS 1.3%/patient year: CE 1.4/patient year), prosthetic valve endocarditis (BS 0.7%/patient year: CE 0.9%/patient year), valve failure (BS 0.5%/patient year: CE 0.9%/patient year) or peri-prosthetic leak (BS 1.2%/patient year: CE 1.3%/patient year). The incidence of systemic embolism in the aortic position was lower with the BS prosthesis (BS 0.2%/patient year: CE 1.2%/patient year, P less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Does low-dose propranolol reduce the incidence of supraventricular tachyarrhythmias following myocardial revascularisation? A clinical study.

During 1986, 343 consecutive patients who underwent isolated coronary bypass grafting were given 10 mg of propranolol three times daily for six postoperative weeks to help prevent supraventricular tachyarrhythmias. The incidence of these arrhythmias in this group was compared to that in a similar group of 337 consecutive patients who underwent coronary surgery in 1984 at the same institution and did not receive propranolol. There was no significant difference in the overall incidence of such arrhythmias between the propranolol group (10.8%) and the control group (10.4%). In preoperatively beta-blocked patients, the arrhythmia incidence in the propranolol group (9.9%) was lower than that in the control group (13.8%) but the difference did not achieve statistical significance. The two groups were also similar with respect to the ventricular response rates at the onset of the arrhythmia and the effectiveness of therapeutic intervention. These results suggest that propranolol in the above dosage does not significantly reduce the incidence of supraventricular tachyarrhythmias after myocardial revascularisation.

Adrenergic beta-Antagonists↗
PubMed1987

Undigested vegetable matter identified on barium-enema examination.

Undigested vegetable matter may reach the colon intact and be discovered on barium-enema examination. The authors demonstrate several examples of filling defects in the colon caused by vegetable matter. The characteristic shape and corresponding dietary history should allow for an appropriate diagnosis.

Barium Sulfate↗
PubMed1987

Pitfalls in cholangiographic interpretation.

Cholangiography is a well established method of evaluating the biliary tract, and the typical appearances of the more commonly encountered biliary tract disorders have been well described. There are many pitfalls, however, in the interpretation of cholangiograms that become apparent as large numbers of patients are examined. These pitfalls may be secondary to: congenital anatomic alteration, failure to appreciate normal biliary ductal anatomy, technical errors, and interpretative confusion. Awareness of these pitfalls is emphasized to avoid serious cholangiographic misdiagnosis.

Bile Duct Diseases↗