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Biomedical subjects

N Reed

Publications and source records attributed to N Reed.

7 recordsLinked to original sources

Benefits and weaknesses of a cardiac rehabilitation programme.

The British Heart Foundation and the Chest, Heart and Stroke Association have allocated funds to develop cardiac rehabilitation programmes. We have recently completed and now evaluate an exercise-based rehabilitation course reinforced with advice about return to normal activity for 110 patients who had suffered acute myocardial infarction. Patients admitted to the Plymouth cardiac care unit were randomised into groups: a control group to receive standard hospital care, and a rehabilitation group who, in addition, received an exercise programme reinforced with advice. Patients were assessed at entry to the study and at intervals thereafter. Assessment was by questionnaire and objective tests consisting of a 12-minute walking test and weekly outpatient pedometry. In the rehabilitation group patients were able to walk further and faster, return to work earlier, undertake more housework, and resume normal sexual activity; they were less short of breath and did not experience more angina. However, the rehabilitation course brought little benefit to the patients' perception of well-being and their anxiety about health or their outlook on life. Exercise and advice are important components of a rehabilitation programme, but more attention needs to be given to the psychological aspects of recovery from a heart attack.

Adult

Carboplatin-based combination chemotherapy for advanced carcinoma of the cervix.

A combination of carboplatin, vincristine, methotrexate and bleomycin (COMB) was given to 29 patients with locally advanced, metastatic or recurrent cervical carcinoma. A total of 85 cycles of chemotherapy were given, with half of the patients receiving greater than 3 cycles. Both the response rate (32.1%) and the median duration of response (30 weeks) were relatively disappointing. Renal toxicity was minimal, but one-third of our patients experienced severe (WHO grades 3 and 4) nausea and vomiting. This combination showed little advantage over carboplatin used as a single agent.

Adult

Demonstration of YAC target cell lysis by murine granulated metrial gland cells.

Granulated metrial gland (GMG) cells are a consistently observed but poorly understood feature of the murine uterus during successful pregnancy. From morphological studies and antibody phenotyping it has been suggested that GMG cells may be members of the natural killer (NK) cell lineage. However, lysis of murine NK cell targets by GMG cells has not been observed although lysis of freshly dissociated trophoblast cells by GMG cells has been recorded using timelapse video. We failed to demonstrate significant interactions between migrating GMG cells, collected from explant cultures under previously reported cultures conditions, and YAC target cells. However, YAC cell lysis did occur if hrIL-2 was present throughout the periods of explant culture and lysis assay. Furthermore, lysis was enhanced if the pregnant females were treated with the interferon inducer poly I.C. 24 hr before metrial gland collection. GMG cells expressed perforin and serine protease mRNA. Consistent with the lysis experiments, expression of these genes was enhanced when the cells were incubated with hrIL-2. Our data provide further support for a relationship between GMG cells and NK cells, but do not establish a relationship of identity since hrIL-2, a growth factor sufficient for the culture of NK cells, cannot support growth or prolong survival of GMG cells.

Animals

Characterization of cytokine production by the metrial gland and granulated metrial gland cells.

The metrial gland and its population of bone marrow-derived, large, granulated, lymphocyte-like cells, termed granulated metrial gland (GMG) cells, are consistent but poorly understood, decidua-associated features of pregnancy in the mouse and other species. Decidua, a complex maternal tissue, is thought to be a source of cytokines important for placental development. Thus, it is important to determine if lymphokine or cytokine production is among the activities of the metrial gland and GMG cells. Media conditioned by culture of either metrial gland explants or migrating GMG cells were evaluated for various cytokine activities. At least four activities were present: CSF-1, IL-1, a factor promoting proliferation of DA-1 cells that was not GM-CSF, IL-3 or erythropoietin and an activity cytotoxic to the CSF-1-dependent macrophage cell line 5/10.14. CSF-1 and IL-1 appeared to be products of the GMG cells. Cytokines not present at detectable levels included IL-2, IL-4, TNF-alpha and TGF-beta. Qualitatively, the cytokine profiles remained constant throughout days 8-16 of gestation. mRNA from migratory GMG cells was isolated and assayed for eleven cytokine mRNAs by polymerase chain reaction-based amplification of cDNA synthesized from mRNA. GMG cell RNA contained transcripts for LIF and CSF-1 but did not contain transcripts for GM-CSF, G-CSF, IL-2, IL-3, IL-4, IL-6, IL-7, IFN-gamma or TNF-alpha. TGF-beta transcripts were detected in occasional samples at very low levels. Since GMG cells are highly mobile cells that migrate throughout the placenta and into trophoblast-lined maternal blood spaces, their function in pregnancy may involve the delivery of very localized differentiation or growth regulatory signals to the developing fetal trophoblast and placenta.

Animals