Search PubMed⌕ Search

Biomedical subjects

M Bishop

Publications and source records attributed to M Bishop.

At least 55 records · Page 3Linked to original sources
PubMed1997

A comparison of two methods for recording the retruded jaw relation in edentulous subjects.

The purpose of this study on 19 edentulous patients was to compare the retruded jaw relations recorded on wax rims at the registration stage with those recorded on finished dentures at insertion. An intra-oral centre-point trace served as the reference point for both sets of measurements. Results showed the two techniques to give mean retruded positions 0.25 mm apart in the occlusal-sagittal plane, but the distributions of the two sets of results differed; those recorded on finished dentures had greater precision, with smaller range and standard deviation. The work confirms the usefulness of a post insertion check record carried out on complete dentures to minimise any occlusal errors introduced at the registration stage.

Aged↗
PubMed1996

Fecal pancreatic elastase 1 is inaccurate in the diagnosis of chronic pancreatitis.

Many tests are available to assess pancreatic function. The ideal test would be simple and have adequate sensitivity in mild to moderate chronic pancreatitis (MCP) and severe CP (SCP). Fecal pancreatic elastase 1 (FPE1) assay (ScheBo Tech) has been proposed as a reliable test to evaluate pancreatic exocrine function, with sensitivities of up to 100% in diagnosing CP. Cutoff values (microgram/g stool) of < 100 have been suggested as SCP, 100-200 as MCP, and > 200 as normal. The test's ability to detect MCP distinguished by the absence of steatorrhea, and its specificity among various etiologies of malabsorption, has not been fully evaluated. The aim of this study was to evaluate this assay in subjects including patients with SCP with steatorrhea, patients with MCP with no steatorrhea, healthy controls, and diseased controls with nonpancreatic malabsorption. Thirty-six subjects [15 healthy controls, 7 malabsorption controls, and 14 subjects with CP (7 MCP, 7 SCP)] had FPE1 assays. One hundred fifty-four assays for FPE1 were run for analysis. The intraassay and interassay intraclass correlation coefficients were 0.93 and 0.90, respectively. All SCP had values of < 100 micrograms/g but more than half of the MCP subjects had FPE1 levels within the normal range. The subjects with nonpancreatic malabsorption had FPE1 values ranging from 55 to > 500 micrograms/g of stool. Although the assay detected SCP with steatorrhea, it did not consistently separate the MCP patients from normals. The majority of those with nonpancreatic malabsorption had false-positive values. These results may differ from previously described data because of the purposeful inclusion of MCP subjects, documented by the lack of steatorrhea, and the inclusion of disease controls with nonpancreatic malabsorption. Although PE1 concentrates in the stool and is not significantly degraded, subtle changes in this enzyme, as in MCP, do not seem to be detectable by this assay. This group continues to be the most difficult group to diagnose clinically.

Adult↗
PubMed1996

Radiation treatment of superior sulcus lung carcinoma.

The survival of patients with superior sulcus lung carcinoma and the effects of treatment were reviewed. From a prospective database of 4123 consecutive new patients with lung carcinoma, 131 (3.2%) cases of superior sulcus lung carcinoma were identified. Seventy-four patients were planned to receive radiation with palliative intent, 53 radical radiotherapy and one was observed only. The remaining three patients, with small-cell carcinoma, were treated with chemotherapy with or without radiotherapy. Of the 53 radically treated patients, nine were treated with pre-operative radiation prior to intended radical resection. Analysis was carried out on the effect on survival of performance status, nodal involvement, weight loss, vertebral body or rib involvement, treatment intent and radical combined modality treatment compared with radical radiation alone. The estimated median survival for the whole group was 7.6 months; for those treated radically it was 18.3 months, while for the palliatively treated patients it was 3.7 months. Radically treated patients with no initial nodal involvement had an estimated median survival of 22 months, while radically treated patients with nodal involvement had an estimated median survival of 8.4 months (P = 0.003). There were no statistically significant differences in survival between radically treated patients grouped according to initial weight loss, performance status, or vertebral body and rib involvement. Patients treated with pre-operative radiation did not survive significantly longer than patients treated with radiation alone, although the numbers are small.

Adult↗
PubMed1996

Allogeneic bone marrow transplantation with T cell-depleted partially matched related donors for advanced acute lymphoblastic leukemia in children and adults: a comparative matched cohort study.

Allogeneic BMT provides the best treatment currently available for long-term disease-free survival in patients with recurrent ALL. Historically, partially matched related donors provided the opportunity for treatment to a greater number of patients than matched related donors at the expense of decreased overall survival. In this study we compare the results in recurrent ALL patients transplanted with either HLA identical sibling bone marrow or partially matched related bone marrow. Thirty-two patients with relapsed ALL received partially matched bone marrows from a relative with one to three HLA, A, B and Dr antigen mismatches. Bone marrow was partially T cell-depleted with murine T10B9.1A-31 moAb. Sixteen patients with relapsed ALL received HLA-matched sibling bone marrows. All partially matched patients received additional GVHD prophylaxis with methylprednisolone in addition to anti-CD5 immunotoxin and/or CYA. All matched patients in addition to methylprednisolone received MTX and/or CYA. We observed no difference in disease-free survival between patients transplanted with partially matched bone marrow (median follow-up 1252 days, range 778-2035 days) vs those transplanted with HLA-matched bone marrow (median follow-up 1472 days, range 1165-2800 days; P = 0.48). Median survival for all patients is 38% (95% CI 24-52%) at 6 years. Patients transplanted in remission had a significant increase in disease-free survival when compared to those in relapse (P = 0.007). Our data suggest that partially matched BMTs from related donors are a comparable alternative to fully matched transplants in patients with ALL.

Adolescent↗
PubMed1995

Gunshot wounds seen at a county hospital before and after a riot and gang truce: Part Two.

An analysis was undertaken of the number of gunshot wound victims seen at a Los Angeles County hospital both before and after the Los Angeles riot. Since the LA riot the gang truce between the "Bloods" and the "Crips" resulted in a significant decrease in the number of gunshot wound victims seen at a level I trauma center in Los Angeles. Unfortunately, this lasted for only three months. The resurgence of shootings, mainly of the drive-by type (82%), to an occurrence rate higher than ever before, has negated any positive effect of the gang truce and indicates the need for additional measures to control gang violence.

Adolescent↗
PubMed1994

Postischemic diazepam is neuroprotective in the gerbil hippocampus.

In this study, we address the hypothesis that enhancement of gamma-aminobutyric acid (GABA) neurotransmission following an ischemic episode is neuroprotective in the hippocampus. Mongolian gerbils were subjected to transient forebrain ischemia for 5 min by occlusion of the carotid arteries and then administered diazepam (10 mg/kg i.p.) 30 min or 30 and 90 min following ischemia. Diazepam produced a significant decrease in both rectal and brain temperature (4-6 degrees C) in the sham and ischemic gerbils. 1 day following the onset of reperfusion, diazepam substantially reduced the hyperactivity normally induced by the ischemic episode. 7 days later, neuronal viability in the hippocampus was assessed. The single dose of diazepam completely protected the CA1 pyramidal cells of the hippocampus in 62% of the gerbils and the double dose of diazepam completely protected CA1 pyramidal neurons in 67% of the gerbils. There was a significant correlation between the degree of pyramidal cell degeneration in the CA1 area of the hippocampus measured 7 days following ischemia and the degree of hyperactivity measured 1 day following ischemia. Diazepam also prevented the loss of [35S]t-butylbicyclophosphorothionate ([35S]TBPS) binding to GABA-gated chloride channels in the dendritic fields of the CA1 area of the hippocampus. Our findings support the hypothesis that enhancement of GABA neurotransmission following an ischemic event may offset neuronal excitability and prevent neuronal death in specific brain regions. We conclude that GABA-enhancing drugs, such as diazepam, are attractive candidates as neuroprotective agents following ischemic insults.

Animals↗
PubMed1994

Clinical outcome of peripheral blood stem cell support.

Two clinical results of peripheral blood stem cell support are commonly considered: (1) the effect on hematopoietic recovery and (2) the effect on the underlying malignancy. The dynamics of hematopoietic recovery after autologous bone marrow transplantation and after autologous peripheral blood stem cell transplantation in a clinical setting are similar if no exogenous cytokines are administered and the peripheral stem cells are collected while their numbers are not deliberately increased (mobilised). If mobilized peripheral stem cells are transplanted, hematopoietic recovery is accelerated. In some circumstances, patients who receive peripheral stem cell transplantation may experience an improved progression-free survival after high-dose therapy when compared with similar patients who receive autologous bone marrow transplantation. Explanations for such a survival advantage might include (1) a lower likelihood of occult tumor cells capable of restoring disease in peripheral stem cell autograft products than in bone marrow harvests, (2) a greater number of cytotoxic effector cells capable of destroying occult tumor cells in the peripheral stem cell collections than in bone marrow harvests, and (3) a different and advantageous pattern of immunologic recovery following autologous peripheral stem cell transplant compared to autologous bone marrow transplant.

Hematopoietic Stem Cell Transplantation↗
PubMed1994

Spent bullets and their injuries: the result of firing weapons into the sky.

People often celebrate holidays by firing guns into the air without realizing that this can cause serious injury or death. The present study identified 118 patients treated since 1985 who were hit with spent bullets. Most (77%) were hit in the head. The mortality rate was 32%, which is significantly higher than for all gunshot wound victims in general seen at the same medical center. Laws have been enacted to help prevent people shooting into the sky, but more education and enforcement are required to prevent these serious and preventable injuries.

Adolescent↗
PubMed1994

Extremity gunshot wounds: Part one--Identification and treatment of patients at high risk of vascular injury.

Cost containment is important in this time of inner-city economic and health-care crisis. This paper examines patients who were treated for gunshot wounds (GSWs) of the extremities. During the study period 1978 through 1992, 16,316 patients (18,349 extremities) were treated for extremity GSWs. Nine patients with asymptomatic injuries in proximity to vascular structures who were treated before the use of duplex Doppler ultrasonography (DDU) were later found to have surgically treatable vascular injuries. These were identified and treated on an outpatient basis with no long-term morbidity or mortality. With the advent of DDU, asymptomatic vascular injuries were no longer missed. A conservative estimate of the cost savings from this study is more than $47,000,000.00. The use of DDU and the enclosed protocols for treating asymptomatic extremity wounds prevented 16,450 needless angiograms, with an additional savings of $32,900,000.00, for a total savings of more than $79,900,000.00. With a more liberal use of DDU and angiography to eliminate the rare missed vascular injuries (0.09%), and the use of protocols to analyze patients with asymptomatic injuries, many extremity GSW victims (79% in this study) can be safely treated as outpatients, eliminating the need for expensive in-hospital observation.

Algorithms↗
PubMed1993

Peripheral stem cell transplantation in non-Hodgkin's lymphoma patients.

Transplantation of circulating progenitor/stem cells collected before and stored during administration of marrow-ablative antitumor therapy has restored sustained hematopoiesis for patients with a variety of malignancies. One of the most common diseases so treated is refractory or relapsed non-Hodgkin's lymphoma (NHL). Autologous peripheral stem cell transplantation (PSCT) often has been used rather than autologous bone marrow transplantation (ABMT) because NHL commonly involves the bone marrow, and because, in some situations, PSCT provides earlier engraftment than ABMT. Between July 1986 and September 1992, 170 adult patients with refractory or relapsed NHL were treated with high-dose therapy and PSCT at the University of Nebraska Medical Center (UNMC). With a median follow-up of 469 days for the evaluable survivors, the actuarial progression-free survival for 167 patients at 6 years after PSCT was 30%. High-dose therapy and PSCT for NHL patients has resulted in long-term progression-free survival and probably cure for some patients. The role of PSCT in this disease continues to evolve.

Actuarial Analysis↗
PubMed1993

Effects of accidental trauma on cytokine and endotoxin production.

OBJECTIVE: To determine the effects of accidental injury of varying severity on interleukin (IL)-1 alpha, IL-6, IL-8, tumor necrosis factor-alpha (TNF-alpha), and endotoxin release. DESIGN: Prospective, multi-unit, longitudinal study. SETTING: Emergency Departments and intensive care units of two university hospitals. PATIENTS: Trauma patients after mild, moderate, and severe injury (Injury Severity Score of < or = 10, 11 to 24, and > or = 25, respectively). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Plasma cytokine and endotoxin concentrations were measured over a 5-day period, starting within 2 hrs of accidental injury. An enzyme-linked immunosorbent assay was used to determine plasma concentrations of IL-1 alpha, IL-6, IL-8, and TNF-alpha. Plasma endotoxin concentrations were measured using a chromogenic limulus amebocyte assay. Preresuscitation samples obtained immediately on arrival in the Emergency Department, and within 2 hrs of injury, demonstrated significant increases of IL-6 and IL-8 concentrations in the severe injury group, in contrast to minimal increases seen after mild or moderate injury. Analysis of serial postresuscitation samples demonstrated rapid increases in IL-6 and IL-8 concentrations within 12 hrs of injury. IL-6 and IL-8 remained increased for 24 hrs after injury, then decreased markedly from their peak values during the next 24 hrs. Increased circulating concentrations of these cytokines continued to be present for > 5 days in the severely injured patients. IL-6 and IL-8 concentrations were only minimally increased in patients 8 and 24 hrs after moderate injury. Endotoxin and IL-1 alpha were not found in any samples, including those samples obtained serially from severely injured patients. No patient at any time point had TNF-alpha concentrations of > 35 pg/mL. CONCLUSIONS: These results demonstrate that severe injury produces rapid, large increases in circulating concentrations of IL-6 and IL-8 that may contribute to the frequent development of the adult respiratory distress syndrome and multiple organ system failure in this clinical setting.

Adult↗