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Biomedical subjects

S Wilson

Publications and source records attributed to S Wilson.

At least 343 records · Page 19Linked to original sources
PubMed1994

Diagnosis of lymphoma in a continuous ambulatory peritoneal dialysis patient by peritoneal fluid cytology.

A 72-year-old woman with diabetic nephropathy receiving continuous ambulatory peritoneal dialysis for 1 year presented with recurrent episodes of sterile cloudy dialysate. Abdominal ultrasound and computed tomography demonstrated retroperitoneal masses. Cytology of the dialysis fluid revealed large atypical lymphocytes with light chain restriction, strongly suggestive of lymphoma. Fine-needle aspiration of the retroperitoneal masses showed cells with identical cytologic and immunocytochemical staining characteristics. This is the first report of de novo lymphoma diagnosed in a continuous ambulatory peritoneal dialysis patient by cytologic analysis of the dialysis effluent.

Aged↗
PubMed1994

The effect of ibuprofen on the level of discomfort in patients undergoing orthodontic treatment.

Studies have shown that patients undergoing orthodontic tooth movement can experience varying degrees of discomfort. The objective of this study was to determine whether nonsteroidal antiinflammatory agents, such as aspirin or ibuprofen, which inhibit prostaglandin synthesis through acetylation and inactivation of the enzyme cyclooxygenase, can suppress orthodontic discomfort by inhibiting the inflammatory response normally observed after orthodontic adjustments. A total of 77 patients were included in a double-blind, randomized, parallel, placebo-controlled, single-dose, analgesic efficacy evaluation of ibuprofen and aspirin. Patients were divided into three groups. Group A received one dose of the drug ibuprofen (400 mg), group B received aspirin (650 mg), and group C received a placebo (beta-lactose). The level of discomfort was assessed using a visual analogue scale at 2, 6, and 24 hours and 2, 3, and 7 days after the insertion of either orthodontic separators or an initial arch wire. A repeated measures analysis of variance and post hoc studentized range statistics showed that the placebo group had significantly more discomfort than either the ibuprofen or the aspirin group at all the time intervals tested. In addition, ibuprofen produced significantly less discomfort than aspirin at the 6 and 24-hour and 2-day time phase after separator placement; and 2 and 6 hours and 2, 3, and 7 days after arch wire placement. These results support a recommendation for ibuprofen as a preferred analgesic in the treatment of discomfort because of postorthodontic adjustments.

Adolescent↗
PubMed1994

The influence of the operating surgeon's specialisation on patient survival in ovarian carcinoma.

A retrospective analysis of ovarian cancer patients registered with the West Midlands Cancer Registry from 1 January 1985 to 31 December 1987 was undertaken to examine the variables associated with survival patterns, with particular reference to the specialty of the surgeon. A total of 1,654 patients were registered, of whom 1,184 had histologically confirmed ovarian cancer, with the operator identified. This consisted of 870 patients operated on by gynaecologists and 314 operated on by general surgeons. A significantly older population and a greater number of patients with stage III/IV disease were operated on by general surgeons. The median survival of patients under the general surgeons' care was 9.87 months, significantly lower (P < 0.0001) than the survival of the gynaecologists' patients (median survival = 29.1 months). Univariate and multivariate analysis correlated poor prognosis with advanced stage disease, older age, the presence of bulky residual tumour and a general surgeon as the operator. Stepwise Cox's proportional hazard analysis confirmed the general surgeon as an independent adverse prognostic factor with a relative hazard ratio of 1.34 (95% confidence interval = 1.05-1.71). Accepting the limitations of retrospective reviews, these findings suggest that every attempt be made to ensure that a gynaecologist is involved in the treatment of patients with ovarian pathology.

Adolescent↗
PubMed1994

Polymerase chain reaction for assessing treatment response in patients with pulmonary tuberculosis.

The use of the polymerase chain reaction (PCR) for assessing treatment response in tuberculosis was investigated. Serial sputum samples were analyzed from 10 Tanzanian patients treated for smear-positive pulmonary tuberculosis, including 4 who relapsed after initially successful treatment. A one-tube nested PCR with a colorimetric detection system was compared with microscopy and culture. Samples were found to be negative by microscopy before they were by PCR or culture, often remaining positive 1-2 months longer by PCR than by culture. For the 76 samples available for both culture and PCR, there was a 76% (58/76) agreement between the methods. Nine samples were negative by culture but positive by PCR; 7 were either negative (5) or equivocal (2) by PCR despite being positive by culture. Two of the 4 relapse cases were detected earlier by PCR than by culture. These results demonstrate that PCR is a promising method for assessing treatment response in pulmonary tuberculosis.

Antitubercular Agents↗
PubMed1994

End-diastolic volume versus pulmonary artery wedge pressure in evaluating cardiac preload in trauma patients.

OBJECTIVE: To evaluate the relative accuracy of right ventricular end-diastolic volume index (RVEDVI) and pulmonary artery wedge pressure (PAWP) for determining cardiac preload. METHODS: A modified pulmonary artery catheter was used to determine RVEDVI, PAWP, and CI 238 times in 32 trauma patients. RESULTS: The initial mean values included cardiac index (CI) = 3.4 +/- 1.3 L/min/m2, PAWP = 14.8 +/- 6.6 mm Hg, and RVEDVI = 99 +/- 40 mL/m2. Cardiac index correlated better with RVEDVI (r = 0.6440; p < 0.001) than with PAWP (r = 0.1068) or CVP (r = 0.1604). In 84 studies in 19 patients, the PAWP was high (19+ mm Hg) in spite of an RVEDVI that was low (< 90 mL/m2) in 22 (26%) or mid-range (90-140 mL/m2) in 49 (58%) of these. In addition, in 12 studies a high RVEDVI (> 140 mL/m2) existed with a relatively low PAWP (< 12 mm Hg). Thus, in 83 (35%) of the studies, PAWP provided information different from the RVEDVI. Of 65 instances in which preload was increased, CI "responded" (> or = 20%) in 26 (40%). The incidence of a response was not affected by the PAWP; however, responses with a RVEDVI of < 90, 90-140, or > 140 mL/m2 were 64%, 27%, and 0 (p < 0.001). CONCLUSION: The RVEDVI more accurately predicted preload recruitable increases in CI than did the PAWP.

Adult↗
PubMed1994

Evidence for an in vivo role of insulin-like growth factor-binding protein-1 and -2 as inhibitors of collagen gene expression in vitamin C-deficient and fasted guinea pigs.

Acutely scorbutic and fasted (vitamin C-supplemented) guinea pigs exhibit decreased collagen gene expression associated with weight loss. We recently demonstrated that circulating insulin-like growth factor-binding protein-1 and -2 (IGFBP-1 and -2) are induced in these deficiencies, and that removal of IGFBP-1 and -2 from serum of such animals by specific antibodies reverses inhibition of cellular IGF-I-dependent functions, including collagen and DNA synthesis. Here we investigated the kinetics of induction of IGFBP-1 and -2 relative to suppression of collagen gene expression. Guinea pigs were fasted for 10-96 h, with 3-24% weight loss, or received an ascorbate-free diet for up to 4 weeks, with 5-28% weight loss during the third and fourth weeks (phase II of scurvy). In both deficiencies, there was noncoordinate regulation of collagen mRNA expression in tissues. Type I collagen mRNA concentrations in skin decreased rapidly after 5-10% weight loss and reached about 10% of normal levels, whereas in bone, there was a later, and not as extensive, decrease. The concentration of cartilage type II collagen mRNA decreased rapidly initially, but then remained at 40-50% of normal. Circulating IGF-I concentrations remained normal during the period when collagen gene expression was initially suppressed, although there was a later decrease. In contrast, mRNAs for IGFBP-1 and -2 and the circulating proteins were induced before or concomitantly with the suppression of collagen gene expression. The ability of fasted or scorbutic guinea pig sera to inhibit IGF-I action in cells increased in parallel with IGFBP activity ([125I]IGF-I binding), which, in turn, mainly reflected the concentration of IGFBP-1 in sera. Serum insulin may be the primary regulator of the IGFBPs. Its levels were decreased to 10-13% of normal when weight loss commenced, whereas cortisol levels, although increased, did not correlate with the induction of IGFBPs. The overall results taken together with our recent findings from cell culture experiments are compatible with circulating IGFBP-1 and -2 acting as inhibitors of collagen gene expression by blocking IGF-I action during fasting and phase II of vitamin C deficiency.

Animals↗
PubMed1994

Scintigraphic assessment of swallow efficiency postlaryngectomy.

There have been reports of a high incidence of hypopharyngeal stenosis in total laryngectomy patients when the surgery requires a partial pharyngectomy for pyriform sinus involvement. In this study, three groups were compared: total laryngectomy patients without partial pharyngectomy, total laryngectomy patients with partial pharyngectomy, and normal controls. All patients had received radiation therapy following surgery. All were maintaining oral nutrition, and none complained of dysphagia. Patients were tested between 1 and 7 months postradiation therapy, with a mean of 3 months. Measures of swallowing efficiency were based on scintigraphic data for a liquid swallow. Patients with partial pharyngectomy had abnormally long oropharyngeal transit times and low efficiency scores. For a subgroup of patients with partial pharyngectomy, swallowing data were available postsurgery and postradiation therapy. Postsurgery this patient group did not differ significantly from normal patients in swallowing efficiency, and swallowing efficiency deteriorated in postradiation therapy. This scintigraphic methodology is shown to be a sensitive method of assessing swallowing function in this patient population.

Adult↗
PubMed1994

Relation of performance on the Kaufman Brief Intelligence Test with the Peabody Picture Vocabulary Test--Revised among preschool children.

58 children enrolled in a university preschool or kindergarten program were administered the Kaufman Brief Intelligence Test (K-BIT) and the Peabody Picture Vocabulary Test--Revised (PPVT--R). The PPVT--R correlated .75 with the K-BIT composite IQ, .69 with the K-BIT Vocabulary standard score, and .57 with the K-BIT Matrices score. The instruments also showed significant agreement (83%) in classifying children into average versus above average categories based upon a 110 standard score on either instrument. Analysis of K-BIT Vocabulary-Matrices differences showed a mean difference of 6 points favoring Vocabulary. Differences ranged from -32 points to 43 points. 64% of the subjects scored higher on the Vocabulary than on the Matrices subtest of the K-BIT. 48% of the sample showed differences between scores on Vocabulary and Matrices of 10 points or more disregarding the direction of the difference. Implications for the concurrent validity of the instrument and interpretation of subscale differences for preschool children were discussed.

Child, Preschool↗
PubMed1994

Subchronic 10 day immunotoxicity of polydimethylsiloxane (silicone) fluid, gel and elastomer and polyurethane disks in female B6C3F1 mice.

Millions of people have been exposed to silicones because of the widespread use in consumer products such as cosmetics and toiletries, food products, household products and paints. Silicones have wide use in medical practice, including lubricants in tubing and syringes, and as implantable devices. The most prevalent silicone in medical use is polydimethylsiloxane. This study was undertaken to determine the subchronic immunotoxicologic potential of the principal constituents of breast implants: silicone fluid, silicone gel and silicone elastomer. An alternative covering for devices containing silicone gels, polyurethane, was also included in the study. Silicone fluid and gel were injected subcutaneously into female B6C3F1 mice (1 ml/mouse) and 6 mm disks of silicone elastomer or polyurethane were implanted subcutaneously. There were no treatment-related deaths or overt signs of toxicity. None of the tested materials had notable effects on body or organ weights, erythrocytes or leukocytes in the blood, blood chemistries such as alanine aminotransferase, urea nitrogen, glucose, albumin or total protein. The cellularity of the bone marrow and responses to CSF-GM and CSF-M were normal. The tested silicones did not alter the distribution of B cells and T cells in the spleen, but polyurethane perturbed the distribution of CD4+CD8+ and CD4-CD8- T cells. The antibody response to sheep erythrocytes was not markedly altered, nor were proliferative responses to concanavalin A, phytohemagglutinin, lipopolysaccharide or allogeneic cells. Reticuloendothelial function was normal, but polyurethane evoked an enhanced phagocytosis of Covaspheres by adherent peritoneal cells. Natural killer cell activity and serum complement were not altered. All silicone materials afforded modest protection to a challenge with Listeria monocytogenes that killed 40 to 58% of control mice. Host resistance to Streptococcus pneumoniae or the B16F10 tumor was not affected by any of the treatments. There is a pattern indicative of some perturbation of T cell differentiation in mice implanted with a polyurethane disk.

Animals↗
PubMed1994

Immunotoxicity of 180 day exposure to polydimethylsiloxane (silicone) fluid, gel and elastomer and polyurethane disks in female B6C3F1 mice.

Millions of people have been exposed to silicones which are present in consumer goods such as cosmetics and toiletries, processed foods and household products. In addition, silicones have been used extensively in medical practice as a lubricant in tubing and syringes, and as implantable devices. A silicone widely used in medical practice is polydimethylsiloxane. This study was undertaken to determine the immunotoxicologic potential of long term exposure to the principal constituents of breast implants: silicone fluid, silicone gel and silicone elastomer. An alternative covering for devices containing silicone gels, polyurethane, was also included in the study. Silicone fluid and gel were injected subcutaneously into female B6C3F1 mice (1 ml/mouse) and 6 mm disks of silicone elastomer or polyurethane were implanted subcutaneously. There were no treatment-related deaths or overt signs of toxicity during the 180 day exposure. None of the tested materials had notable effects on body or organ weights, erythrocytes or leukocytes in the blood, blood chemistries such as alanine aminotransferase, urea nitrogen, glucose, albumin or total protein, or serum CH 50 or C3 levels. The cellularity of the bone marrow and responses to CSF-GM and CSF-M were normal. The tested silicones and polyurethane marginally reduced the level of Ig+ cells in the spleen but did not consistently alter the distribution of T cell surface markers. The antibody response to sheep erythrocytes was not markedly altered, nor were proliferative responses to concanavalin A, phytohemagglutinin, lipopolysaccharide or allogeneic cells. Reticuloendothelial function was normal, as was phagocytosis of chicken erythrocytes and Covaspheres by adherent peritoneal cells. Natural killer cell activity was depressed in all silicone treatment groups and in mice implanted with polyurethane. No silicone or polyurethane treatment group displayed altered susceptibility to a challenge with Listeria monocytogenes, Streptococcus pneumoniae or the B16F10 tumor. The only consistent effect of 180 day exposure to silicone materials or polyurethane was a modest depression of natural killer cell activity.

Animals↗
PubMed1994

Circulating insulin-like growth factor binding proteins (IGFBPs) 1 and 2 induced in vitamin C-deficient or fasted guinea pigs inhibit IGF-I action in cultured cells.

Collagen gene expression and proteoglycan synthesis are decreased in vitamin C-deficient guinea pigs losing weight and in fasted guinea pigs receiving ascorbate. Sera from such guinea pigs contain an insulin-like growth factor (IGF)-I-reversible inhibitor of collagen, proteoglycan and DNA synthesis and elevated levels of 29 and 35-kDa IGF binding proteins (IGFBPs). We now have identified the induced proteins as IGFBPs 1 and 2 and investigated their role as inhibitors. Guinea pig sera were treated with antibodies to IGFBPs 1 and 2 and antibody-IGFBP complexes were removed by passage through a Protein A-Sepharose column. Inhibitor content of fasted and scorbutic sera, and Protein A pass-through fractions derived from them, was assessed by their level of stimulation of DNA and collagen synthesis in 3T3 cells, compared to analogously treated normal guinea pig serum. Removal of IGFBP-1 from scorbutic serum reversed inhibition of collagen and DNA synthesis by more than half but removal of IGFBP-2 was less effective. Removal of both IGFBPs reversed inhibition almost completely. Similar results were obtained with fasted guinea pig serum. Conversely, purified rat IGFBPs 1 and 2 inhibited DNA and collagen synthesis in cells cultured in normal guinea pig serum or IGF-I-stimulated DNA synthesis, with IGFBP-1 being more potent. Thus, IGFBP-1 and, to a lesser extent IGFBP-2, cause inhibition of IGF-I action by sera from fasted and scorbutic guinea pigs and may inhibit collagen gene expression in vivo.

3T3 Cells↗
PubMed1994

The Filipino elder: implications for nursing practice. Knowledge of heritage essential.

1. Ethnic identity is an important variable in health promotion and care. Knowledge of cultural heritage is necessary to assess the unique needs of the individual. 2. Culture affects how one perceives and defines the meaning of illness. In turn, the way in which one defines the meaning of an illness will influence the expectations of both caregivers and clients within the nurse-client relationship. 3. Broadening our understanding of a diverse ethnic population is central to the concept of transcultural nursing. The importance of understanding differences in cultural heritage cannot be ignored by the nurse who cares for a new elderly Filipino immigrant.

Aged↗
PubMed1994

Maternal middle cerebral artery blood flow velocity variation with gestational age.

OBJECTIVE: To assess the variation of the maternal middle cerebral artery blood flow velocity with gestational age in a normotensive pregnant population. METHODS: Middle cerebral artery blood flow velocity was assessed transcranially in 154 normotensive pregnant women using a 2-MHz pulsed probe. We assessed maximum systolic, minimum diastolic, and mean velocity and resistance index. Subjects were classified into seven gestational age categories of 4-week intervals starting from 13 weeks. Analysis of variance was used to indicate a significant difference in cerebral blood flow velocity with gestational age, and Tukey test to assess the significance. RESULTS: Maximum systolic velocity fell significantly in the third trimester (P < .01) to the lowest value (62 cm/second). Minimum diastolic velocity did not change with gestational age (28 cm/second). Mean velocity fell significantly from 25-36 weeks. CONCLUSIONS: Systolic and mean maternal middle cerebral artery blood flow velocity fell significantly with advancing gestational age, even though diastolic velocity did not vary. These changes did not correlate with mean arterial pressure changes with gestational age.

Blood Flow Velocity↗
PubMed1994

Intrinsic and extrinsic predictors of work satisfaction in ambulatory care and hospital settings.

This study assessed the ability of selected intrinsic and extrinsic variables to predict allied health practitioners' work satisfaction in ambulatory care and hospital settings. A total of 413 occupational and physical therapists in Virginia, North Carolina, and South Carolina provided data via a mailed survey. Multiple regression analyses examined the predictive power of selected intrinsic and extrinsic variables upon therapists' work satisfaction in the ambulatory care and hospital setting. The regression model for therapists in ambulatory care settings was a better predictor of work satisfaction than the model for therapists in the hospital setting. Results indicated that respondents' intrinsic orientation toward their work, and their perception of the general working conditions in the organization were two of the strongest predictors of their work satisfaction in the ambulatory care and hospital setting. The findings provide information that can be useful in developing recruitment and retention strategies in both work settings.

Adult↗
PubMed1993

The use of active centre acylation to control the pharmacokinetic profile of a recombinant chimaeric plasminogen activator.

Recombinant hybrid plasminogen activators consisting of the "A" chain of plasminogen linked to the "B" chain of t-PA that are inhibited rapidly by plasma protease inhibitors have recently been described (Robinson et al. Circulation 1992; 86: 548-552). We have now shown that following bolus administration of native hybrid to guinea pigs, fibrinolytic activity was cleared rapidly from the circulation. Active centre acylation appeared to protect the hybrid from inhibition and allowed material to circulate as potentially active species for prolonged periods. Clearance rates of a range of acyl derivatives of the hybrid were 7-35-fold slower than for native hybrid and 20-100-fold slower than for t-PA. Clearance rates were influenced markedly by deacylation rate, such that clearance half-life correlated well with deacylation half-life. We have thus shown that it is feasible to control the pharmacokinetic profile of a recombinant hybrid plasminogen activator over a wide range by selection of an appropriate acyl group for attachment to the active site. Such control is not possible with plasminogen activators that are cleared predominantly by mechanisms other than inhibition.

Acylation↗