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Biomedical subjects

P Buckley

Publications and source records attributed to P Buckley.

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

Interferon therapy for agnogenic myeloid metaplasia complicated by immune hemolytic anemia.

A 69-year-old man with agnogenic myeloid metaplasia was treated with interferon-alpha 2 as part of a Phase II clinical trial. The patient responded to this treatment with a definite improvement in bone marrow histology, demonstrating increased numbers of hematopoietic colonies and partial resorption of the myelofibrosis. Chromosomal analysis on 20 cells suggested the re-emergence of normal hematopoietic progenitor cells: whereas previously, all metaphase spreads demonstrated a deletion in chromosome 20, the patient was now chimeric, with two of 20 cells exhibiting a normal karyotype. Nevertheless, the patient's anemia progressed during interferon therapy, with the development of an immunologically mediated hemolytic disorder. This hemolytic process developed after prolonged treatment with interferon, accelerated during therapy, and resolved following splenectomy and withdrawal of the drug. Initially, screening tests failed to detect the presence of the autoantibody. Similar immunologic processes may have been overlooked in other patients treated with interferon, especially if tests for autoantibodies were obtained early in their course of treatment. This case suggests a therapeutic role for interferon-alpha 2 in the management of the myeloproliferative diseases. It is presented, too, to underscore the immunomodulatory potential of the biologic response modifiers and their capacity to induce immunologic disorders.

Aged↗
PubMed1990

Partial splenectomy for symptomatic splenic hamartoma.

Lower pole splenectomy with preservation of residual splenic function was successfully performed in a 3-year-old boy with a symptomatic splenic hamartoma. Following resection, several of the patient's constitutional symptoms resolved. This is the first reported case of a splenic hamartoma treated by partial splenectomy.

Child, Preschool↗
PubMed1990

Psychosis following use of proprietary antidiarrhoeal medicines.

Anticholinergic psychosis was observed to follow ingestion of proprietary antidiarrhoeal preparations by a 63-year-old woman. Possible abuse or accidental overuse of such medicines in the acutely psychotic patient should always be considered.

Belladonna Alkaloids↗
PubMed1989

1-Naphthol--single and repeated dose (30-day) oral toxicity studies in the mouse.

The oral toxicity of 1-naphthol in Charles River CD1 mice was investigated in single (2, 1 and 0.5 g/kg body weight) and 30-day repeat dosing (200, 100 and 50 mg/kg body weight) studies. In the single-dose study, animals dosed by oral gavage at 2 g/kg body weight either died or were killed in extremis between 15 and 90 min after dosing, and although the animals treated at 1 g/kg body weight survived to the end of the study (14 days post-dosing), one male in the 0.5 g/kg body weight dose group was killed in extremis approximately 2 hr after treatment. Acute dosing was associated with histopathological lesions seen in the kidneys and stomachs of mice from all treatment groups. The kidney lesions consisted of degeneration of the distal tubule epithelium, papillary necrosis and tubular dilatation. Gastric changes characterized by splitting of the epithelium of the forestomach and sloughing of the superficial epithelium of the glandular mucosa were generally accompanied by vascular congestion and acute inflammatory cell infiltration. In the 30-day study, mice dosed by oral gavage at 50 and 100 mg/kg body weight tolerated the treatment well, as did the female mice treated at 200 mg/kg body weight. Three male mice in the 200 mg/kg body weight group did, however, show gastric histopathological effects. Two of the mice (one killed in extremis on the fourth day of the study with the other surviving treatment) showed focal mucosal erosion, and a third (killed in extremis on the twentieth day of the study) exhibited peeling of the mucosa of the forestomach. Both of these gastric lesions were considered to be related to treatment at 200 mg/kg body weight. None of the mice in the 30-day study showed any kidney lesions or changes in haematology or clinical chemistry parameters.

Administration, Oral↗
PubMed1989

Fifty years after Freud: Dora, the Rat Man, and the Wolf-Man.

Three of Freud's case histories are reviewed and reexamined from the perspective of modern psychodynamic thinking. The Dora case illuminates advances in our understanding of adolescent psychology and countertransference. The cases of the Rat Man and the Wolf-Man draw attention to our increased awareness since Freud of the importance of the therapeutic relationship and the recognition that a two-person psychology is at work in the psychotherapeutic situation. The heuristic value of such comprehensive case reports is emphasized.

Austria↗
PubMed1989

Elevated soluble interleukin-2 receptor in childhood hemophagocytic histiocytic syndromes.

The serum of children with untreated hemophagocytic syndromes contains elevated levels (23,600 to 75,200 U/mL) of soluble interleukin-2 receptor (SIL2R) that returns toward normal with clinical improvement. These levels are in excess of levels previously reported for benign conditions. They are as high as levels reported for HTLV-1-associated adult T-cell leukemia (HATL) and hairy cell leukemia (HCL) in adults and some children with poor-prognosis non-T, non-B, acute lymphoblastic leukemia (ALL). Serum SIL-2R is a marker of disease activity that has the potential to identify infants at risk for the inherited form of the disease before the disease is clinically expressed.

Adolescent↗
PubMed1988

Gastric ECL-cell hyperplasia and carcinoids in rodents following chronic administration of H2-antagonists SK&F 93479 and oxmetidine and omeprazole.

The histamine H2-receptor antagonist SK&F 93479 induced gastric neuroendocrine (carcinoid) ECL-cell tumor formation in 6/34 male and 8/37 female rats treated for 22-24 months at 1,000 mg/kg/day po. Focal ECL-cell hyperplasia was present in 21/34 males and 15/37 females, with local infiltration through the muscularis mucosae in half these cases. No focal hyperplasias or carcinoids were present after 200 mg/kg/day po treatment. Investigative studies showed evidence for marked and sustained hypergastrinemia increasing on chronic dosing which was capable of restoring gastric acid secretion and pH to near control values. Using morphometric analysis of immunoperoxidase anti-chromogranin A stained sections, a dose-related and time-dependent neuroendocrine ECL-cell hyperplasia was correlated with the sustained elevated hypergastrinemia. A 21-month mouse oncogenicity study showed no focal neuroendocrine cell hyperplasia or carcinoid tumor induction, but a diffuse neuroendocrine cell hyperplasia and an increase in multifocal glandular hyperplasia of the oxyntic mucosa was observed in mice treated with 1,000 mg/kg SK&F 93479 po. The morphological changes observed in both rat and mouse were considered to be secondary to the hypergastrinemia resulting from the pharmacological suppression of gastric acid secretion by SK&F 93479. These changes were also observed to a more marked degree following omeprazole treatment and were only slight following oxmetidine treatment in the rat.

Animals↗
PubMed1988

The measurement of psychodynamic variables.

The paper is concerned with the integration of psychodynamic theory with psychometric theory in order to find meaningful ways to measure psychodynamic variables. Four reasons are suggested for the use of self-report tests in psychotherapy research. These include the need for reliable measuring instruments, cost-efficient methods of data collection, and the progressive refinement of "fuzzy" concepts through the process of test construction. A three-stage approach to outpatient assessment is presented which is called sequential psychodiagnostic evaluation. The first stage refers to the evaluation of crisis issues such as suicidality or psychosis; the second to egodystonic symptom assessment; and the third refers to the assessment of egodystonic states such as personality traits, ego strength and defenses. The construction of a number of these scales is illustrated and their use in a research study of predictors of psychotherapy outcome described.

Defense Mechanisms↗
PubMed1988

The phenotype of human placental macrophages and its variation with gestational age.

The antigenic phenotype of human villous stromal macrophages (M phi s) from first and third trimester placentas was analyzed using a large number of monoclonal antibodies (MAbs) to monocyte (Mo)/M phi-associated cell membrane determinants. The purpose of this study was to investigate M phi phenotypic heterogeneity to create a database for the correlation of M phi phenotype with specific immunologic functions. The results showed that villous stromal mononuclear cells express many cell surface antigens found on Mo and M phi s and that they are morphologically diverse, ranging in appearance from classic Hofbauer cells to spindle-shaped cells with long cytoplasmic processes. Villous stromal M phi s were the numerically dominant cell type in this structure and exhibited some major phenotypic differences from M phi s in other tissues. Comparison of first- and third-trimester placentas revealed variation in antigen expression with increasing gestational age, in particular of class II major histocompatibility complex (MHC) determinants: HLA-DR and HLA-DP antigen density was low on first-trimester villous M phi s and much higher on third-trimester M phi s while HLA-DQ was undetectable in the first trimester but present on cells in third trimester placentas. The CD1 (T6) antigen, found on Langerhans (LH) cells and cortical thymocytes, was detected on villous M phi s by two thirds of the MAbs directed against different epitopes on this determinant. Furthermore, comparison with similar studies of lymphoid tissues showed that villous M phi s and dendritic cells share the expression of a number of other cell surface antigens. Finally, it was shown that M phi s in first- and third-trimester villi exhibit strong reactivity with MAbs (Leu 3a,b) to the CD4 antigen that serves as the receptor for the human immunodeficiency virus (HIV), suggesting that these cells may be a portal of entry or reservoir for this virus in the fetuses of pregnant, HIV+ women.

Antigenic Variation↗
PubMed1985

Determinants of object choice in adulthood: a test case of object-relations theory.

A clinical example of the effects of the absence of the father during the early childhood of a male analysand and its consequences for his later object choice is presented. This patient's biological father left the household when the patient was only a few months old, and his mother did not remarry until he was five years of age. Unconscious fantasies of the lost father, with whom the patient had no contact in reality, and longing for him organized the patient's drives and determined his self-identity as well as his later object choice. The patient developed both a positive and negative identification with the lost father. The identification was with a fantasy object not a real one. The case highlights the need to use a precise term in talking of the object, namely the mental representation of the object which may or may not be built up out of experiences with the real object.

Adult↗
PubMed1985

Screening for cognitive toxicity of anticholinergic drugs.

Impairment of memory by muscarinic anticholinergic drugs has been demonstrated with a variety of agents using both acute administration in normal volunteers and chronic treatment in patients. Cognitive toxicity must be considered in the evaluation of the risks versus the benefits of psychopharmacologic treatment. The relationship between serum levels of anticholinergic drugs measured by radioreceptor assay and performance on the Buschke Selective Reminding Test were investigated to develop strategies for identifying patients with drug-related cognitive impairment. The radioreceptor assay may be of value in screening for patients at high risk for cognitive toxicity. However, there appears to be no alternative to careful longitudinal evaluation of learning and memory in patients after appropriate trial modifications of their medication regimens to identify patients with drug-related impairment.

Adult↗
PubMed1984

Maternal and neonatal blood glucose after crystalloid loading for epidural caesarean section.

Serial blood glucose estimations were made in 30 women undergoing elective Caesarean section under epidural anaesthesia, 2 litres of Hartmann's solution having been rapidly infused as a circulatory preload Neonatal blood glucose estimations were made of cord blood at birth and 1 and 2 hours post delivery. A small rise in maternal blood glucose occurred during the period of preloading and time before delivery, which was not statistically significant (p greater than 0.05). There was no biochemical or clinical evidence of neonatal hypoglycaemia. We conclude that despite rapid infusion of non-dextrose crystalloid solution there is neither danger of a relative maternal hypoglycaemia in fasted mothers nor neonatal hypoglycaemia, and offer an argument that even small amounts of dextrose contained in any preloading mixture are unnecessary.

Acid-Base Equilibrium↗
PubMed1984

Psychodynamic variables as predictors of psychotherapy outcome.

Predicting the outcome of psychotherapy is a central concern in psychiatry. Twenty-one medical students seeking psychotherapy were evaluated on a number of psychodynamic and process variables using self-report scales and scales completed by the therapist before, during, and after psychotherapy. There were significant differences between patients and a comparison group on eight variables before therapy. Ten psychodynamic variables (six representing ego defense mechanisms) and four process variables were found to be highly correlated with outcome measures; the process variables were the best predictors of outcome. The data support the use of psychodynamic and process variables as predictors of outcome in psychoanalytically oriented psychotherapy.

Adult↗
PubMed1983

Is there a characteristic pattern to the treatment history of clinic outpatients with borderline personality?

The prior psychiatric histories, dispositions, and treatment plans for a group of patients with borderline personality, evaluated in an outpatient clinic, were compared to those of evaluated patients diagnosed as having neurotic and/or other personality disorders or schizophrenia. Variables that were found to discriminate patients diagnosed as borderline from the other two groups included a history of past hospitalizations and their duration, frequency of prior outpatient treatment, previous use of psychotropic medications, rates of dropout and referral-out of the clinic, and number of treatment sessions received during a 2-year follow-up period. Patients with borderline personality who had the most previous treatment and the most severe symptoms received the least treatment. The histories of extensive previous treatment are consistent with the frequently brief and unsatisfactory nature of the index clinic contacts.

Adult↗