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Biomedical subjects

S Kinsey

Publications and source records attributed to S Kinsey.

22 records · Page 2Linked to original sources

Mini-BEAM followed by BEAM and ABMT for very poor risk Hodgkin's disease.

High dose chemotherapy and autologous bone marrow transplantation (ABMT) is an effective form of salvage therapy in patients with relapsed or resistant Hodgkin's disease. Patients with large tumour masses at the time of ABMT have a poorer prognosis and we have therefore administered intermediate dose BCNU, etoposide, cytarabine and melphalan (mini-BEAM) prior to high dose therapy with the same agents (BEAM) and ABMT in such patients. In addition we have used the same strategy in patients with bone marrow infiltration at the time of relapse in an attempt to clear the bone marrow for transplant. A total of 23 patients received mini-BEAM and 21 proceeded to BEAM and ABMT. Platelet engraftment was delayed compared to BEAM recipients who had not received mini-BEAM (P = 0.008) but there was only one procedure related death. Responses to BEAM and ABMT were not predicted by the response to mini-BEAM indicating a dose response effect at the upper end of the dose intensity spectrum. At 2 years, the overall survival and progression free survival are 61% and 46% respectively for this group of Hodgkin's patients with extremely poor prognosis.

Adult↗

Plasma D-dimer levels and their relationship to serum fibrinogen/fibrin degradation products in hypercoagulable states.

Plasma D-dimer was measured and compared with serum fibrinogen/fibrin degradation product levels (FDPs) in patients with disseminated intravascular coagulation (DIC) and other conditions associated with a hypercoagulable state. D-dimer (N less than 200 ng/ml) was elevated in all 43 patients with DIC, in 48 of 59 patients with liver disease, in 22 of 27 patients with acute leukaemia at presentation, in 17 of 23 patients with malignant disease, in 29 of 39 women in the third trimester of a complicated pregnancy, in 17 of 18 patients with deep venous thrombosis and in only four of 27 patients with acute myocardial infarction. There was a significant correlation between plasma D-dimer and serum FDP levels (P less than 0.01) as follows; DIC: r = 0.58, liver disease: r = 0.57, acute leukaemia: r = 0.84, malignancy: r = 0.87. The frequent elevation of D-dimer observed in liver disease, acute leukaemia, malignancy and complicated pregnancy indicates that a hypercoagulable state is a common occurrence in these conditions although in liver disease elevated levels resulting from a failure of normal clearance mechanisms cannot be excluded. The close relationship between D-dimer and FDP levels suggests that serum FDPs predominantly arise from the interaction of plasmin with crosslinked fibrin rather than with fibrinogen in the conditions in which these were compared.

Blood Coagulation Disorders↗

Surface oximetry. A new method to evaluate intestinal perfusion.

Accepted methods to evaluate intestinal vascularity intraoperatively include standard clinical criteria (SCC), doppler ultrasound (DUS), and intravenous fluorescein (FLF). A combination of methods is often used to overcome disadvantages of individual techniques. Assessment of intestinal vascularity by FLF was compared to SCC, DUS, and pulse oximetry (POX) in segments of intestine demonstrating arterial, venous and arteriovenous occlusion, to determine if POX might supplement the assessment of intestinal vascularity. POX uses a commercially available instrument to assess tissue oxygenation and arterial flow, and is rapid, reproducible, and noninvasive. POX appears to be a superior technique when compared to SCC and DUS.

Animals↗

Detection of optical asymmetry in amino acids by gas chromatography for extraterrestrial space exploration: results of a new soil processing scheme with breadboard instrumentation.

The life-detection experiments of the Viking spacecraft are of an active biology type that will attempt to elicit metabolic responses from soil samples. Because bioresponses may be difficult to stimulate, it is desirable also to devise a purely chemical life-detection experiment. The unique chemical property of living systems on which such an experiment could be based is the optical activity of the amino acids that compose its protein. We have devised a new soil processing scheme which has been laboratory tested and for which we have built semi-automated breadboard instrumentation. The system involves the operations of heating, filtering, evaporation, conversion of the isolated amino acids to volatile diastereomers, injection onto a gas chromatographic column, and detection using a flame ionization detector. The breadboard form of the soil processing scheme and instrumentation has been successfully end-to-end tested.

Amino Acids↗