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Biomedical subjects

R E Taylor

Publications and source records attributed to R E Taylor.

At least 37 records · Page 2Linked to original sources
PubMed2000

Education and training of senior house officers in clinical oncology departments.

A survey of clinical oncology departments has been undertaken to ascertain the educational training of senior house officers (SHOs). Questionnaires were sent to the clinical directors of all UK clinical oncology departments, who were asked to forward questionnaires to individual SHOs. Replies were received from 26 of 54 departments, identifying 88 SHO posts and, from these, 48 SHOs have returned questionnaires. The clinical directors considered that the main function of the SHOs was to supervise the care of ward patients, but that gaining experience in oncology was also important. Forty-four of the 88 posts (50%) were part of a fixed medical rotation. Twenty-three of 26 (88%) departments had a designated consultant to supervise SHO training. In 22 of the 26 (85%) departments there was protected teaching time for SHOs, the majority organized and carried out by consultant clinical oncologists. SHOs in clinical oncology departments are pluripotential; many pursue careers other than clinical oncology and have differing career objectives. Thirty-one of 48 (65%) SHOs considered that the post had met their expectations. Recommendations are made for the maintenance and improvement of the educational opportunities for SHOs in clinical oncology departments.

Adult↗
PubMed2000

Atypical Charles Bonnet hallucinations: an elf in the woodshed, a spirit of evil, and the cowboy malefactors.

In this article, the authors review the literature on the Charles Bonnet syndrome (CBS), a condition involving visual hallucinations in normal persons with severe sight loss. Attempts to assess the characteristics of this "phantom vision" have resulted in descriptions of a "typical" CBS hallucination. However, the many exceptions to a modal CBS experience cause the authors to postulate two other general categories of CBS hallucinations: a) the atypical sensory/perceptual (ASP), and b) the atypical psychodynamic (APD) hallucinations. Case studies illustrating these two types are provided. Extending the categories of Charles Bonnet hallucinations allows for more specific diagnosis, treatment, and may result in the possibility of greater precision in future research.

Aged↗
PubMed2000

The need for the moving junction in craniospinal irradiation.

The moving junction is used in craniospinal irradiation (CSI) to smooth out any dose inhomogeneity across the head/spine junction. The aim of this study was to demonstrate the extent of the head/spine junction inhomogeneity in treatment plans of actual patients and to compare stationary and moving junction data. The radiotherapy plans, prescriptions and case notes of 18 patients (12 medulloblastomas, 3 supratentorial primitive neuroectodermal tumours, 2 pineoblastomas and 1 pineal germinoma) treated with CSI (35 Gy in 21 fractions over 29 days) were examined. At 16 months median follow-up (range 1.5-35.5 months), no junctional recurrences or myelopathy were observed. Using the moving junction technique the mean maximum anterior cord dose, from 5 cm caudal to 3 cm cephalad of the Day 1 junction, was 36.3 Gy, and the mean minimum anterior cord dose was 32.9 Gy, with a mean within-patient variation of 3.4 Gy (9.7% of 35 Gy). In four patients, comparison of dose variation across the field junction was made between the original plans and a re-plan using a stationary junction. The effect of a matched junction, a 2 mm overlap and a 2 mm gap were studied both for moving junction and stationary junction techniques. Dose variations were similar in all cases for exactly-matched fields, but for a 2 mm overlap or gap the dose variation was smaller in all but one case for the moving junction technique. These data suggest that the moving junction is important to minimize the risk of overdose or underdose across the spine/head junction in CSI.

Adolescent↗
PubMed1999

Anandamide inhibition of recombinant AMPA receptor subunits in Xenopus oocytes is increased by forskolin and 8-bromo-cyclic AMP.

Anandamide is an endogenous cannabinoid receptor agonist with similar pharmacological effects as D9-tetrahydrocannabinol, the major psychoactive compound in marijuana. Because anandamide does inhibit long-term potentiation, and cannabinoid abuse is known to affect learning and memory, the effects of anandamide on recombinant AMPA glutamate receptor (GluR) subunit currents were studied in Xenopus oocytes. All subunit currents were not affected by SR-1 41716A (a selective CB1 cannabinoid receptor antagonist), but were blocked by the selective AMPA antagonist CNQX and were sensitive to anandamide. Anandamide directly inhibited kainate (KA) activated homomeric GluR1; GluR3 and heteromeric GluR1/3; GluR2/3 receptor currents with IC50 values of 161+/-19, 143+/-12, 148+/-10 and 241+/-107 microM, respectively. The sensitivity of all the subunits to anandamide was not significantly different. Anandamide inhibition was voltage-independent, specific, and could not be duplicated by arachidonic acid or WIN 55,212-2 mesylate. Furthermore, anandamide effects were potentiated by forskolin (an adenylyl cyclase stimulator) and 8-bromo-cAMP (a cAMP analog), whereas MDL-HCl (an adenylyl cyclase inhibitor) caused a reversal of anandamide inhibition of GluR receptor current. Anandamide inhibition appears to be mediated by cAMP synthesis, and may underlie the involvement of this brain cannabinoid agonist in the modulation of fast synaptic transmission in the CNS.

8-Bromo Cyclic Adenosine Monophosphate↗
PubMed1999

Analgesic responses to intrathecal morphine in relation to CSF concentrations of morphine-3,beta-glucuronide and morphine-6,beta-glucuronide.

This study was performed to determine whether variations in analgesic responses to intrathecal morphine could be explained by cerebrospinal fluid (CSF) concentrations of morphine metabolites. Twenty-four CSF samples were collected at the beginning, middle and end of treatment periods in seven cancer patients with pain of malignant origin. CSF concentrations of morphine-3,beta-glucuronide (M3G) and morphine-6,beta-glucuronide (M6G) metabolites were measured by gas chromatography/mass spectrometry. Analgesic responses to morphine were estimated concurrent with CSF collection using a visual analog scale representing percentages of pain relief. Effective analgesia was defined as > or = 75% pain relief. CSF concentration of M3G and M6G in the 24 samples were 722 +/- 116 ng/ml and 699 +/- 158 ng/ml, respectively. CSF samples were categorized into two groups: (1) those collected during effective analgesia (N=14), and (2) those collected during ineffective analgesia (N=10). M6G levels detected in group 1 samples (effective analgesia) were significantly greater than those found in group 2 samples (ineffective analgesia) (978 +/- 243 ng/ml vs 309 +/- 68 ng/ml, P<0.05). Intergroup differences in CSF M3G concentrations and M3G/M6G ratios were not significant. It is concluded that CSF M6G may be indicative of effectiveness of analgesia in cancer patients subjected to intrathecal morphine.

Adult↗
PubMed1999

Long-term survival following non-Hodgkin's lymphoma arising in Wiskott-Aldrich syndrome.

Wiskott-Aldrich syndrome (WAS) is a rare X-linked recessive trait, characterized by thrombocytopenia, eczema, immunodeficiency and a high risk of malignancy, usually leukaemia or lymphoma. Until recently, most patients died before the age of 10 years. A patient with WAS who developed extranodal non-Hodgkin's lymphoma at the age of 16 years is reported. Despite thrombocytopenia at presentation, chemotherapy was well tolerated. There was disease progression after first line chemotherapy and radiotherapy, but the patient responded to second line chemotherapy with cisplatin, vincristine and etoposide. He remains disease free 9 years after completing treatment.

Adolescent↗
PubMed1998

Quantitation of estrogen receptor mRNA copy numbers in breast cancer cell lines and tumors.

Several clinical studies have suggested that the content of estrogen receptor (ER) in breast tumors influences the survival, tumor recurrence, and response to antiestrogen therapies. Therefore, the ability to precisely quantitate the ER content in tumor tissues will be of significant benefit to women with breast cancer. Although immunohistochemical and polymerase chain reaction (PCR) methods have been described for the detection and semiquantitation of ER, none of them precisely quantitate ER copy numbers in tumor samples. In the present report we describe a molecular approach to accurately quantitate ER mRNA copy numbers using a reverse-transcription PCR (RT-PCR) template competition method. A competitor template was devised by inserting unrelated nucleic acid sequences into an ER cDNA clone. A template competitive RT-PCR analysis was then performed to determine the number of copies of ER mRNA. As a standard of reference for the ER mRNA copy numbers from various samples, the mRNA copy numbers of a constitutively expressed gene, glyceraldehyde-3-phosphate dehydrogenase (GAPDH), were also quantitated. The ER quantitations were performed in three positive cell lines, MCF-7, T47D, and ZR-75, and two positive tumor tissues by this approach. Our results described here show that among the cell lines studied, T47D expresses the highest copy numbers of ER. We also present here that ER as low as 10(3) copies per 10(5) copies of GAPDH can be detected and quantitated in tumor samples by the template competition method. In addition, the molecular approach can simultaneously detect, distinguish, and quantitate exon deletion variant copy numbers of ER. The results described in this report indicate that the ratios of exon 7 deletion variant to wild type in the tumor tissues are significantly higher than in the cell lines studied.

Breast Neoplasms↗
PubMed1998

Structure and upstream region characterization of the human gene encoding rod photoreceptor cGMP phosphodiesterase alpha-subunit.

Rod photoreceptor cGMP phosphodiesterase (PDE6) is a three-subunit (a, b, g2) enzyme that functions to reduce intracellular cytoplasmic cGMP levels, an integral feature of the phototransduction cascade of vision. To allow assessment of the potential for defects in the gene encoding the alpha-subunit (PDE6A) to cause visual dysfunction, and to begin to dissect the basis for photoreceptor-specific expression of this gene, we have characterized the structural gene and upstream region. The human PDE6A gene consists of 22 exons spanning about 60 kb with the intron/exon junctions highly conserved in comparison to the mouse and human PDE6B genes. Using ribonuclease protection and primer extension assays, a predominant transcription start point (tsp) was identified 120 bp upstream of the initiator ATG. To begin functional analysis of the PDE6A promoter, approx 4 kb of sequence were determined upstream of the tsp. Comparison of this upstream sequence with an approximately 500 bp sequence upstream of the mouse Pde6a gene revealed five distinct segments of identity all within 100 bp upstream of the human PDE6A tsp. A TATA box adjacent to a photoreceptor-specific RET1-like binding site, an SP1 site, and two novel putative cis-element sequences were found. A consensus initiator element sequence is present at the tsp. Additionally, within a 2.5-kb segment beginning 900 bp upstream of the tsp two Alu, a MIR, an L1, and two MER repetitive elements were found. Electrophoretic mobility shift assays generate a retina-specific bandshift using a 322-bp fragment containing the putative promoter region or a multimer of the RET1-like site. DNA footprinting assays revealed footprints over the primary transcription startpoint and the RET1-like and TATA box regions. These results indicate that a 220-bp segment of the PDE6A gene upstream region is important for tissue-specific expression.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMed1998

Links between social network and quality of life: an epidemiologically representative study of psychotic patients in south London.

Quality of life has been found to be associated with social networks in patients with psychiatric disorders. We aimed to determine whether quality of life was related to social network size in group of severely mentally ill subjects living in the community. In a population-based, prospective controlled study of two sector mental health teams in South London, a random sample of representative 1-year prevalent cases of non-organic psychosis was identified. Patients were interviewed at baseline, and associations between quality of life and social network size were analyzed cross-sectionally. For average quality of life there was increase up to a certain level of social network size (about 20 social contacts). For the quality of life subscore on social relations there appeared to be an optimal middle level of network size (10-12), with lower subscores for smaller and larger networks. Multivariate analysis confirmed the associations between quality of life and social network size. In analyses of network subgroups the importance of confiding contacts was underlined.

Adolescent↗
PubMed1998

Imaging of laser-polarized solid xenon.

The enhanced spin polarization produced by optical pumping of gaseous rubidium/xenon samples has made possible a number of recent experiments in nuclear magnetic resonance (NMR) spectroscopy and magnetic resonance imaging (MRI). Here we report MRI of laser-polarized xenon in the solid phase at low temperature. Due to the high xenon density in the solid phase and the enhanced spin polarization, it is possible to achieve high intensity and spatial resolution of the image. Signals were observed from xenon films solidified onto the glass container walls and not from an enclosed chili pepper.

Lasers↗
PubMed1998

Toxicity and dosimetry of fractionated total body irradiation prior to allogeneic bone marrow transplantation using a straightforward radiotherapy technique.

Since 1989, we have used a relatively straightforward technique for giving total body irradiation (TBI), using anterior and posterior parallel opposed fields with the arms and fists acting as compensators. The dosimetry, toxicity and outcome of 48 patients (26 adults, 22 children) treated with TBI using this technique have been audited. A dose of 14.4 Gy in eight fractions over 4 days was prescribed to all patients with an unrelated donor and 12 Gy in six fractions over 3 days to those with a sibling donor. From May 1994, all children received 14.4 Gy because of a recommendation from the United Kingdom Children's Cancer Study Group. The range of lung dosimetry was -6% to +7% when the dose was specified to the lung maximum. The trunk doses were all within +/-10% of the prescribed dose. Doses to other regions of the body were less homogeneous but clinically acceptable in that the minimum doses were never less than -10% of the prescribed dose. Mucositis was the most common side effect; its treatment with opioids was more frequent after 14.4 Gy than after 12 Gy (P=0.0004) and in adults than in children (P=0.01). No cataracts have yet been seen in these patients. The radiation was not found to be a proven cause of clinical pneumonitis, although there was one death due to interstitial pneumonitis, which was likely to have been caused by cytomegalovirus infection in which radiation pneumonitis could not be excluded. There were no other suspected TBI-related deaths. In conclusion, this straightforward technique achieved acceptable dosimetry and was well tolerated.

Abdomen↗
PubMed1998

Quality of life outcomes for intensive versus standard community mental health services. PRiSM Psychosis Study. 9.

BACKGROUND: We report the impact on the quality of life (QOL) of people with psychosis of an intensive compared with a standard model of community care. METHOD: People with psychosis, in two sectors in south London, were interviewed with a variety of measures at baseline, and at two-year follow-up (n = 138). After baseline, services within one sector were reorganised, and a more intensive model of community care was introduced. QOL was measured using the Lancashire Quality of Life Profile. RESULTS: The two overall QOL measures, global QOL and the average of the domain-specific scores, were remarkably stable over time. There was weak evidence for an improvement in living situation domain in the intensive sector; this may be accounted for by a large drop in in-patient admissions. In both sectors objective QOL was poor, and there was little change in any of the objective indicators except in-patient admissions, and a suggestion of increased social activity in the intensive sector. CONCLUSIONS: We failed to find an effect of intensive community care on QOL in people with psychosis. This may indicate an insensitivity to change in QOL measures, or that the intervention failed to produce the kind of changes in mental health and functioning which would be reflected in improved QOL.

Adult↗
PubMed1997

In vivo NMR and MRI using injection delivery of laser-polarized xenon.

Because xenon NMR is highly sensitive to the local environment, laser-polarized xenon could be a unique probe of living tissues. Realization of clinical and medical science applications beyond lung airspace imaging requires methods of efficient delivery of laser-polarized xenon to tissues, because of the short spin-lattice relaxation times and relatively low concentrations of xenon attainable in the body. Preliminary results from the application of a polarized xenon injection technique for in vivo 129Xe NMR/MRI are extrapolated along with a simple model of xenon transit to show that the peak local concentration of polarized xenon delivered to tissues by injection may exceed that delivered by respiration by severalfold.

Humans↗