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Biomedical subjects

M Thomas

Publications and source records attributed to M Thomas.

At least 145 records · Page 8Linked to original sources
PubMed2002

Airway resistance estimation by best fit analysis in very premature infants.

Plethysmographic measurement of airway resistance (R(aw)) has been determined by single-point analysis, usually at 50% of maximum inspiratory flow (MIF). Computer-assisted (best fit) analysis, however, allows R(aw) to be calculated by applying a regression line to any portion of the plethysmograph pressure-flow loop. We determined whether the results of best fit analysis using a computer program, sampling at 200 Hz, were influenced by the portion of the inspiratory loop analysed and if best fit or single-point analysis gave more reproducible results. Twenty infants of median gestational age 26 (range 24-28) weeks, were studied at a median age of 12 (12-14) months corrected for prematurity. R(aw) was calculated by best fit analysis between 0 and 33% MIF, 0 and 50% MIF and 0 and 67% MIF and single-point analysis at 50% of MIF. Similar mean R(aw) values were obtained by best fit analysis between 0 and 33% MIF (2.79 kPa/(l/s)) and 0 and 50% MIF (3.01 kPa/(l/s)) and single-point analysis at 50% MIF (2.86 kPa/(l/s)), but best fit analysis between 0 and 67% gave higher results (3.60 kPa/(l/s)), p < 0.0001. Within the linear portion of the inspiratory loop, the mean intrasubject coefficient of variation was lowest for best fit analysis between 0 and 50% MIF. Best fit computerized analysis between 0 and 50% MIF is recommended as the analysis of choice.

Airway Resistance↗
PubMed2002

A new era of dental education at the University of Sydney, Australia.

Dental education is currently under scrutiny in order to most appropriately address community needs for the new millennium. Educational outcomes need to include a commitment to life-long learning, and an emphasis on professional ethics and moral responsibility. These needs are supported by new forms of information delivery with a focus on the electronic media, by student centred and self-directed coursework, and by clinical stimulation. Additionally, at the University of Sydney, selection will follow a first degree. This will allow candidates time for an informed decision to be made for their future professional career and for a period of experience in the tertiary education system.

Australia↗
PubMed2002

Lipoprotein (a) does not participate in the early acute phase response to training or extreme physical activity and is unlikely to enhance any associated immediate cardiovascular risk.

AIMS: To investigate the proposal that lipoprotein (a) (Lp(a)) contributes to the acute phase response and thus possibly to the acute cardiac risks associated with major physical effort. METHODS/RESULTS: Fit, healthy, British army recruits were reviewed at the beginning and the end of a 10 week programme of basic training concluding with an intense 48 hour military exercise. Final recruit assessment was staggered over the last week of training, giving rise to six recruit groups, with determination of Lp(a), C reactive protein (CRP), fibrinogen, albumin, and total creatine kinase values from 12 hours to five days after the final exercise. A clear acute phase response was seen following the final exercise, marked by a significant increase in circulating concentrations of fibrinogen and a reduction of albumin, and a trend with non-significant increases in CRP. CONCLUSION: Lp(a) did not behave as an early marker of the acute response. Previous reports may have been confounded by concurrent disease in older subjects and by late sampling. Lp(a) determination for cardiovascular risk profiling is not confounded by associated physical effort. It is also unlikely that the acute risks of major physical effort are enhanced by any process involving Lp(a).

Acute-Phase Reaction↗
PubMed2002

Myelopathy from intracranial dural arteriovenous fistula.

Dural arteriovenous fistulas arising intracranially are an uncommon cause of progressive myelopathy. This report is of a patient in whom the diagnosis of the condition was confounded by coexisting small vessel cerebrovascular disease.

Aged↗
PubMed2002

Early tandem high-dose ifosfamide, carboplatin, etoposide therapy with stem cell rescue for small-cell lung cancer: brief report on the results of a phase-I/II trial.

OBJECTIVE: High-dose therapy (HDT) for small-cell lung cancer is experimental. Late intensification HDT for chemosensitive disease can increase the number and quality of remissions and prolong relapse-free survival, but has not yet shown impact on overall survival. This is possibly due to resistant residual disease. To overcome the development of resistance, we have tested early intensification tandem HDT. METHODS: We performed a phase-I/II trial using 1 conventional cycle of ifosfamide, carboplatin, etoposide (ICE) plus granulocyte colony-stimulating factor for stem cell recruitment followed by 2 cycles of high-dose ICE with rescue by CD34+ cell-enriched peripheral blood mononuclear cells. Dose escalation was performed for the 2 high-dose ICE cycles. Radiotherapy for limited disease was according to standard protocols. RESULTS: 17 patients were entered: 2 female patients; 15 male patients; median age 53 (range 36-65) years; 2 patients with limited disease, and 15 patients with extensive disease. We treated 4 patients at dose level 1, 11 patients at level 2, and 2 patients at level 3. The maximum tolerable dose was at level 2 with neuropathy being dose-limiting. Overall, toxicity was < or = grade 2 for all patients up to dose level 2 with hematotoxicity being grade 4 for all patients. There were 15 partial remissions (88%), 1 no change (6%), and 1 progressive disease (6%). Median time to progression was 7.9 months. Overall survival was 12.9 months (median). CONCLUSIONS: Early intensification with this protocol is feasible. Although a comparatively good response rate and median time to progression have been observed in this group dominated by patients with extensive disease, overall survival is short and no substantial long-term survival was found.

Adult↗
PubMed2002

Novel homozygous splice acceptor site GnRH receptor (GnRHR) mutation: human GnRHR "knockout".

Mutations in the GnRH receptor (GnRHR) have been shown to be responsible for a significant number of autosomic recessive and, less commonly, sporadic cases of idiopathic hypogonadotropic hypogonadism. We describe a woman with complete GnRH resistance secondary to a novel homozygous GnRHR gene mutation, transmitted as an autosomal recessive trait. The propositus presented with primary amenorrhea and absent thelarche and pubarche. Dynamic tests demonstrated absent spontaneous gonadotropin pulsatility, and no response to either exogenous pulsatile (10 microg/pulse at 90-min intervals over 6 h) or acute (100 microg) GnRH administration. However, she responded to exogenous gonadotropin administration, with a resulting normal pregnancy. Genomic DNA extracted from peripheral blood was PCR amplified using amplimers spanning intron-exon boundaries for the three exons of GnRHR and revealed a homozygous splice junction mutation (G to A transversion) at the intron 1-exon 2 boundary. Her unaffected sister, with a totally normal phenotype, was heterozygous for this mutation. After lymphocyte Epstein-Barr virus transformation, RNA was extracted and subjected to RT-PCR, using primers located in the first and third exons. Results showed a transcript lacking all of exon 2 (exon 2 skipping), with splicing of exon 1 to exon 3. This created a frame shift, generating a coding sequence for three new amino acids, followed by a stop codon. Although it is not clear whether the mutant receptor is actually expressed, the resultant mRNA sequence was presumed to produce a truncated receptor with no binding or signaling capacity.

Adolescent↗
PubMed2002

Biochemical measures in a population-based study: effect of fasting duration and time of day.

BACKGROUND: Epidemiological studies generally aim to make simple but unbiased measurements of individuals. For this reason measurements of metabolic variables (including blood lipids, glucose and insulin) are usually carried out after a period of fasting. Few studies have examined the extent to which the use of a defined protocol for fasting in epidemiological studies abolishes the influence of fasting duration and time of day on biochemical measurements. METHODS: Cross-sectional survey of British Regional Heart Study participants (4,252 men aged 60-79 years), in which men without diabetes were asked to provide a blood sample after fasting for at least 6 h. Serum total, HDL and LDL cholesterol, triglyceride and insulin, and plasma glucose concentrations were measured between 08:00 h and 18:00 h. RESULTS: Non-fasting men had lower mean LDL cholesterol and higher glucose, insulin and triglyceride levels than fasting men; these differences were more marked among diabetics. Among fasting men without diabetes, insulin and glucose levels were strongly related to time of day, falling gradually throughout the morning and remaining stable in the afternoon. Because of these relationships and the dependence of fasting duration on time of day, insulin and glucose displayed a periodic relation with fasting duration above 6 h. These associations were largely abolished by adjustment for time of day; associations with time of day were unaffected by adjustment for fasting duration. Triglyceride concentrations fell with increasing fasting duration. This relationship was also mediated through a gradual increase in triglyceride levels throughout the day. Adjustments to compensate for these variations are described. DISCUSSION: Even after fasting, biochemical measurements may still differ in relation to fasting duration and time of day. In epidemiological studies, it is important to standardize both the period of fasting and the time of day as much as possible, and make adjustments where necessary.

Aged↗
PubMed2002

Influences of parity and level of feed intake on reproductive response to insulin administration after weaning in sows.

In three experiments, the influence of insulin administered after weaning was examined in primiparous sows given extra feed or in primiparous compared to multiparous sows. In Exp. 1, 171 primiparous and 231 multiparous crossbred sows on a commercial farm were injected with 0.4 IU/kg BW insulin (Eli Lilly Lente Iletin II) or saline for 4 d beginning the day after weaning (d 0) and were fed 2.3 kg/d until mating. In Exp. 2, 153 primiparous sows from the same farm as those in Exp. 1 were injected with insulin or saline as in Exp. 1 and were fed 2.7 or 3.6 kg/d until mating. In Exp. 3, 63 primiparous crossbred sows were injected with insulin or saline as described above and fed either 2.3 or 4.5 kg/d for 5 d after weaning and were remated. On the commercial farm (Exp. 1 and 2), insulin administration increased percentage in estrus for primiparous sows compared to multiparous sows (treatment x parity interaction, P < 0.02) but tended to lower litter size in primiparous sows (treatment x parity interaction, P < 0.06). In Exp. 2, insulin combined with extra feed increased (P < 0.05) litter size by two pigs but tended (P < 0.07) to decrease farrowing rate in that group (treatment x feed interaction). Weaning-to-estrus interval, pregnancy rate, ovulation rate, and embryo survival were not influenced by treatment or feeding level (Exp. 3); however, postweaning intake and embryo survival were negatively related for saline-treated sows only (r = -0.55; P < 0.01), and backfat depth at weaning and embryo survival were positively related for insulin-treated sows only (r = 0.44; P < 0.05). Overall, insulin administration differentially influenced reproduction in primiparous sows and may have interacted with metabolic or nutritional state of the animal.

Adipose Tissue↗
PubMed2002

[Peritoneal tuberculosis: 27 cases in the suburbs of northeastern Paris].

SETTING: Peritoneal tuberculosis did not disappear from France during the 1990s. OBJECTIVE: To determine the characteristics of peritoneal tuberculosis in the north-eastern suburbs of Paris. METHOD: A retrospective study of cases diagnosed with peritoneal tuberculosis between 1990 and 1998 in five suburban hospitals in the north-east region of Paris. RESULTS: Twenty-seven cases of adult peritoneal tuberculosis were diagnosed. There were nine women and 18 men, with a mean age of 37.5 years, 88.9% of whom were foreign born. General and digestive symptoms--abdominal pain and/or ascites--were present in 96.3% of the cases. The mean delay in treatment was 30 days. Peritoneal involvement was isolated in 25.9% of cases, and associated with pulmonary tuberculosis in 40.7% or hepatic tuberculosis in 25.9%. Co-infection with HIV (human immunodeficiency virus) was present 14.8% of cases. Culture of ascites fluid, laparoscopy and/or laparotomy (n = 17), with directed biopsy, aided in the formal diagnosis of peritoneal tuberculosis in 59.2%. One relapse and one case of multiresistance were observed. The mean duration of treatment was 9 months (range 6-12 months). Three patients received treatment with corticosteroids, and 91.2% of the patients achieved cure without sequelae. CONCLUSION: Peritoneal tuberculosis is not rare in the Paris region. The diagnosis should be suspected in case with ascites and fever, and can be confirmed by laparoscopy with sampling for bacteriology and histology. The methods of treatment need to be standardised.

Abdominal Pain↗
PubMed2002

Hematopoietic growth factors in drug-induced agranulocytosis.

Drug-induced agranulocytosis (DIA) is a potentially fatal disorder. Hematopoietic growth factors have been used in the treatment of DIA. We report nine cases of DIA treated with granulocyte macrophage - colony stimulating factor (GM-CSF) in a dose of 300 microg/day. All the patients had evidence of systemic infection. Mean time to reach an absolute neutrophil count of 0.5 x 10(9)/L was three days. One patient succumbed to the disease. The cause of death was multiorgan failure. No adverse events were observed with GM-CSF. We conclude that hematopoietic growth factors are useful in shortening the period of neutropenia and reducing morbidity and mortality in these patients.

Adolescent↗
PubMed2002

Ankylosing spondylitis associated with non-Hodgkin's lymphoma.

Malignancies have rarely been reported in patients with ankylosing spondylitis either as a complication of therapy or de novo. Here we report a 37 years male with ankylosing spondylitis who developed non-Hodgkin's lymphoma during the course of his illness.

Adult↗
PubMed2002

Nitrogen removal in a SBR using the OGAR process control system.

OGAR is an industrial process control system that utilises on-line redox measurements to control the aeration sequence in an activated sludge process. Compared to conventional process control systems that use dissolved oxygen, OGAR makes use of redox as a control parameter during both aerobic and anoxic conditions. This paper reports on its first application in a sequencing batch reactor. The principal aim of this project is to demonstrate the capability of OGAR to achieve concentrations of total nitrogen in the treated effluent of less than 10 mg/L, which are typically stipulated by Queensland's Environmental Protection Agency (EPA). In this study the use of the control system resulted in the following SBR performance: consistent effluent total nitrogen less than 5.0 mg/L; ammonia concentration reduced from 31.6 mg/L to 0.32 mg/L, effluent nitrate 2.8 mg/L; DO setpoint 1.5 mg/L had 10% higher effluent total nitrogen compared to DO setpoint 4.0 mg/L and redox end-points for nitrification 400 mV, denitrification 150 mV.

Ammonia↗
PubMed2002

Effect of thoracic epidural anaesthesia on colonic blood flow.

BACKGROUND: The effect of thoracic epidural block on splanchnic blood flow is unclear. It remains to be resolved if sympathetic block, increases or decreases regional splanchnic blood flow and whether regional splanchnic flow becomes dependent on cardiac output or perfusion pressure. A clear understanding of the regional haemodynamic consequences of an epidural block may modify practice with respect to epidural anaesthesia. METHODS: Fifteen patients, who underwent anterior resection for rectal cancer, had invasive intraoperative monitoring of arterial pressure, central venous pressure, cardiac output, inferior mesenteric artery flow (Doppler flow probe), and colonic serosal red cell flux (laser Doppler probe), while an epidural block was established with local anaesthetic. In three consecutive time periods, arterial pressure was first allowed to fall (to a mean arterial pressure of 60 mm Hg), then treated with colloid fluid resuscitation and finally by vasopressors until the pre-epidural arterial pressure had been restored. RESULTS: On induction of epidural block, there was a reduction in mean colonic serosal red cell flux to 65% and inferior mesenteric artery flow to 80% (mean) of pre-epidural levels. There was a strong association between mean arterial pressure and both measured inferior mesenteric artery blood flow (P < 0.004) and colonic serosal red cell flux (P < 0.0001). Changes in cardiac output were poorly associated with either inferior mesenteric artery blood flow (P = 0.638) or colonic serosal red cell flux (P = 0.265). Inferior mesenteric artery blood flow and colonic serosal red cell flux were restored to pre-epidural levels after arterial pressure had been improved with a vasopressor. CONCLUSION: Once intraoperative epidural block has been established, colonic serosal red cell flux and inferior mesenteric artery flow are more closely associated with changes in mean arterial pressure than changes in cardiac output. The measured reduction in colonic flow does not respond to an increase in cardiac output with fluid resuscitation, but requires the use of a vasopressor to increase arterial pressure, before colonic blood flow is improved.

Aged↗
PubMed2001

HPV E6 and MAGUK protein interactions: determination of the molecular basis for specific protein recognition and degradation.

It has recently been shown that the high-risk human papillomavirus (HPV) E6 proteins can target the PDZ-domain containing proteins, Dlg, MUPP-1, MAGI-1 and hScrib for proteasome-mediated degradation. However, the E6 proteins from HPV-16 and HPV-18 (the two most common high-risk virus types) differ in their ability to target these proteins in a manner that correlates with their malignant potential. To investigate the underlying mechanisms for this, we have mutated HPV-16 and HPV-18 E6s to give each protein the other's PDZ-binding motif. Analysis of these mutants shows that the greater ability of HPV-18 E6 to bind to these proteins and to target them for degradation is indeed due to a single amino acid difference. Using a number of assays, we show that the E6 proteins interact specifically with only one of the five PDZ domains of MAGI-1, and this is the first interaction described for this particular PDZ domain. We also show that the guanylate kinase homology domain and the regions of MAGI-1 downstream of amino acid 733 are not required for the degradation of MAGI-1. Finally, in a series of comparative analyses, we show that the degradation of MAGI-1 occurs through a different mechanism from that used by the E6 protein to induce the degradation of Dlg and p53.

Amino Acid Motifs↗