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Biomedical subjects

N Smith

Publications and source records attributed to N Smith.

At least 145 records · Page 8Linked to original sources
PubMed1993

Pooled human IGG (PHIG) inhibits the binding of anti-myeloperoxidase antibodies to myeloperoxidase.

This study demonstrates that pooled human immunoglobulin (PHIG) contains anti-idiotypes to anti-myeloperoxidase (MPO) antibodies and can inhibit the binding of anti-MPO to MPO. The variability seen in the inhibitory effect of different PHIG preparations in the same and also in different patient sera suggests heterogeneity in the idiotypic repertoire of anti-MPO antibodies.

Antibodies, Anti-Idiotypic↗
PubMed1993

Evaluation of the inflammatory infiltrate in pouchitis with 111In-labeled granulocytes.

BACKGROUND: The aim of this study was to elucidate the inflammatory infiltrate in pouchitis and define the changes following metronidazole therapy. METHODS: Twenty-seven patients underwent functional grading, sigmoidoscopic and histological scoring, 111In-labeled granulocyte scanning, and 4-day fecal collections for 111In-labeled granulocyte excretion. Six of the patients with pouchitis underwent repeat studies after 1-month treatment with metronidazole, 400 mg three times daily. RESULTS: The grade of macroscopic inflammation in the pouch mucosa (sigmoidoscopic score) correlated well with the acute histological score (P < 0.0001), chronic histological score (P < 0.001), 4-hour 111In scan (P < 0.001), 24-hour 111In scan (P < 0.001), and with 4-day fecal 111In excretion (P < 0.001). After metronidazole therapy there was decreased inflammatory grade sigmoidoscopically and histologically on the 4- and 24-hour scans and decreased 4-day fecal 111In granulocyte excretion. CONCLUSIONS: This study confirms that the inflammatory infiltrate in pouchitis is acute or chronic, is characterized by neutrophils, is usually localized to pouch mucosa, and is always decreased after metronidazole therapy.

Acute Disease↗
PubMed1993

Preimplantation diagnosis or chorionic villus biopsy? Women's attitudes and preferences.

The objective of this work was to assess women's attitudes and preferences to two methods of prenatal diagnosis for genetic disease: embryo and chorionic villus biopsy (CVS). The design involved a structured postal questionnaire sent to women in the Grampian region with different reproductive experiences. The population sample included 46 women who had had genetic counselling because of a family history of a single gene disorder, 18 women who had had CVS for a single gene disorder, 158 women who had had CVS for other reasons, 200 women who had recently delivered a normal baby and 50 women who had experience of in-vitro fertilization (IVF). The main outcome measures were attitudes to family limitation, prenatal diagnosis, termination for fetal abnormality, embryo biopsy and CVS. Of the women surveyed, 38% preferred embryo diagnosis, whereas 42% favoured CVS and termination. Women with previous experience of CVS preferred this option whereas those with experience of IVF as infertility treatment were more likely to favour embryo diagnosis, as were women who had had genetic counselling for a single gene disorder. It was concluded that a substantial number of women find embryo diagnosis more acceptable than CVS when the pregnancy is at high risk. This is especially true amongst those with experience of IVF or who are at risk themselves. A demand for embryo diagnosis has been demonstrated.

Adolescent↗
PubMed1993

p53 immunoreactivity in cutaneous PUVA tumors is similar to that in other non-melanoma skin neoplasms.

Expression of the p53 tumor suppressor gene product was determined in keratoses and skin cancers associated with psoralen photochemotherapy (PUVA). An immunocytochemical study was employed using CM-1 (polyclonal) and Do-1 (monoclonal) antibodies to human wild-type p53. Thirty-two cutaneous lesions and 20 perilesional PUVA-irradiated skin biopsies were examined from 7 patients, all of whom had received more than 200 PUVA treatments and/or a cumulative UVA dose of greater than 1000J/cm2 as treatment for widespread plaque psoriasis. p53 immunoreactivity was seen in 7 of 15 squamous cell carcinomas (46.7%), 5 of 8 dysplastic keratoses (62.5%) and in no basal cell carcinomas or benign keratoses. The overall prevalence of p53 immunoreactivity in 46.2% of malignant or dysplastic PUVA-associated skin tumors is similar to that previously found by our group in comparable skin tumors from the general population. Most patients with lesions showing positive p53 immunoreactivity had, however, been exposed to additional risk factors before receiving PUVA therapy. p53 gene sequencing of PUVA-associated non-melanoma skin cancer (NMSC) may clarify whether p53 mutation contributes to the development of these tumors and whether this relates to PUVA therapy or prior carcinogen exposure.

Adult↗
PubMed1993

Managing family problems in advanced disease--a flow diagram.

The interaction between patient, family and professional team can sometimes make difficult situations worse rather than better. This flow diagram attempts to clarify the process by which a professional assesses situations and suggests ways in which people can gain understanding about their difficulties. Once everyone has a greater understanding of what is or is not happening, the diagram points to ways in which professionals can use questions to help patient and family create a solution that is workable both for them and for the professionals.

Adaptation, Psychological↗
PubMed1993

Treatment for glaucoma: adherence by the elderly.

OBJECTIVES: The purpose of this study was to determine the extent of nonadherence to treatment for glaucoma among elderly patients. METHODS: This was a retrospective cohort study of 2440 patients older than age 65 who were enrolled in the New Jersey Medicaid Program and who were newly initiated on a topical agent for the treatment of glaucoma. Two patient-specific measures of nonadherence were employed: (1) no filled prescription for any glaucoma medication over a 12-month period after the initiation of therapy and (2) number of days without therapy for glaucoma during this 12-month period. RESULTS: By the first measure, 569 patients (23%) were found to be nonadherent. The mean number of days without therapy during the study year was 112. Factors associated with nonadherence included the use of glaucoma medication requiring more than 2 administrations per day and the presence of multiple other medications in the patient's drug regimen. Patients started on multiple glaucoma medication were more adherent than those started on a single agent. Age and sex were not found to be predictors of nonadherence. CONCLUSIONS: Substantial nonadherence was found to be common in this population. More attention to the issue of nonadherence could result in important benefits in the preservation of sight.

Aged↗
PubMed1992

The isolation and partial characterization of trypsinogen, pancreatic secretory trypsin inhibitor and multiple forms of chymotrypsinogen and trypsin from the pancreas of the ostrich (Struthio camelus).

1. PSTI, two chymotrypsinogens and two trypsins were purified to homogeneity by acid extraction, salt fractionation, SP-Sephadex C-50 chromatography and RP-HPLC. 2. A third chymotrypsinogen, a trypsinogen and another trypsin were purified using an alkaline extraction procedure, followed by Trasylol- and Benzamidine-Sepharose affinity chromatography and hydroxylapatite chromatography. 3. The enzymes differed in amino acid composition as well as in specific activities towards synthetic amidase and esterase substrates. 4. N-terminal amino acid sequences were determined for one chymotrypsinogen and one trypsin.

Amino Acid Sequence↗
PubMed1991

Disposition kinetics of orally administered enoximone in patients with moderate to severe heart failure.

Enoximone is a phosphodiesterase inhibitor, which has been studied extensively for use in the management of patients with moderate-to-severe heart failure. The authors have studied the absorption and disposition kinetics of enoximone and its primary metabolite, enoximone sulfoxide, after both single oral doses of enoximone and at steady-state after short-term chronic oral therapy. A total of ten patients (two female, eight male) with moderate-to-severe heart failure (NYHA class II-IV) were enrolled into the study after giving written informed consent. The plasma levels of enoximone sulfoxide were greater than those of enoximone at all sampling times. The peak enoximone sulfoxide plasma concentrations ranged from 3.5 to 17.3 times the peak enoximone plasma levels for individual patients. The average steady-state plasma concentrations for enoximone were 115 +/- 40 ng/mL and 190 +/- 78 ng/mL for 50 mg every 8 hours and 100 mg every 8 hours dosage regimens, respectively. The absorption and disposition kinetics of enoximone were found to be significantly variable between patients. The authors also evaluated the relationship between dose administered and steady-state plasma levels as well as the relationship between the observed and predicted steady-state plasma levels. The authors found a linear relationship between the dose that was administered and the accrued plasma levels, as well as a good correlation between the predicted and observed steady-state levels. Although these data confirm previous reports that the sulfide metabolite of enoximone accumulates extensively in the plasma during oral therapy, reaching levels much higher than those of enoximone, these data do not support previous suggestions that the disposition of enoximone is nonlinear.

Administration, Oral↗
PubMed1991

Prenatal diagnosis for dystrophia myotonica using the polymerase chain reaction.

The polymerase chain reaction has been used to detect an abundant class of short repeat DNA families of the form (dC-dA)n.(dG-dT)n, known as microsatellites. These units are found throughout the human genome and have been characterized for several loci including APOC2 on chromosome 19q12-q13.2. The locus APOC2 is linked to the gene for dystrophia myotonica and a microsatellite within this locus was used to derive polymorphisms in a family to predict the inheritance of the disease. Chorionic villus sampling (CVS) was performed at 15 1/2 weeks' gestation. Following DNA extraction from the CVS material and parental blood samples, microsatellite analysis was carried out by the polymerase chain reaction.

Adult↗
PubMed1991

Treatment of fetal supraventricular tachycardia with flecainide acetate after digoxin failure.

Transplacentally administered digoxin is the drug of choice for the treatment of fetal supraventricular tachycardia. We describe a case of fetal supraventricular tachycardia associated with fetal hydrops that did not respond to digoxin treatment because of a lack of transplacental passage. In contrast, flecainide acetate crossed the placenta and cured the fetus. The clinical implications of this new treatment are discussed.

Adult↗
PubMed1991

Treating Type A behaviours and mild hypertension in middle-aged men.

Unmedicated mildly hypertensive Type A men were randomly allocated to one of three conditions: stress management intervention training (N = 15), Type A management (N = 15), and delayed Type A management intervention. Significantly greater reductions in blood pressure at rest and during the Type A structured interview were found following the active interventions than during the minimal treatment control period of the delayed intervention. Type A management was more successful in changing a number of Type A behaviours, including anger, hostility and global Type A behaviour. Changes on measures of anger-in, -out, hostility, and SI ratings of Type A behaviour were associated with changes in systolic and diastolic blood pressure reactivity during interview.

Adult↗
PubMed1991

Using research-based interventions to decrease patient falls.

The purpose of this study was to decrease patient falls by applying relevant interventions found in the nursing research literature. Clinical nurse specialists assisted staff with the application of selected research-based patient fall program interventions on two adult medical-surgical specialty units in a tertiary care facility. The fall rate on these two units decreased during the study year, while the all-hospital patient fall rate increased. To encourage comparison of fall data among institutions, a standard method for calculating fall rate is presented.

Accidental Falls↗
PubMed1991

Analysis of beta, gamma, and delta T-cell receptor genes in lymphomatoid papulosis: cellular basis of two distinct histologic subsets.

To investigate the histogenesis of lymphomatoid papulosis (LYP), we have analyzed the configuration of the beta, gamma, and delta T-cell receptor (TCR) and Ig genes in DNA from 31 biopsies of 18 patients with this condition and also from peripheral blood mononuclear cells of eight of these patients. Immunoglobulin genes were in a germ-line configuration in all patients, and TCR genes were in a germ-line configuration in six patients. In nine patients, one or two rearranged bands (RB) were detected with both beta and gamma TCR probes and in one patient with beta, gamma, and delta TCR probes. Two patients, in whom beta and delta TCR genes were in a germline configuration, had evidence of multiple discrete rearrangements of gamma TCR genes, consistent with a polyclonal T-cell population. Analysis of multiple biopsies revealed that RB, when present, were identical in different lesions from individual patients. All but one of the peripheral blood samples showed a germ-line configuration. The exception had evidence of a rearrangement of gamma and delta in peripheral blood and a beta and gamma rearrangement within tissue. This study has established that only a proportion of patients with LYP have a monoclonal T-cell proliferation. Correlation with the clinicopathologic and immunophenotypic data revealed that a T-cell clone was limited to patients with Willemze type B LYP or "mixed type" LYP, whereas patients with type A LYP consistently showed a germline configuration of TCR genes. This study indicates that in LYP the atypical hyperchromatic cerebriform mononuclear cells of type B invariably constitute a monoclonal T-cell population whereas the atypical CD30 positive type A cells represent a proliferation of cells of non-B, non-T-cell lineage.

Adult↗