PubMed Health⌕ Search

Biomedical subjects

A J Franks

Publications and source records attributed to A J Franks.

At least 19 recordsLinked to original sources
PubMed1995

Major trauma workload within an English Health Region.

The incidence, distribution and clinical patterns of life-threatening and multiple injuries were evaluated within an English Regional Health Authority area. Cases of major injury were identified retrospectively for the 12 month period October 1988 to September 1989 using data from the 16 Accident and Emergency (A&E) units within the Yorkshire Health Region, and coroners' records. There were 968 cases of fatal and serious injury, meeting the criterion of an injury severity score greater than 15, 67 per cent (645) being due to road traffic incidents. Thirty-five per cent (337) died at the scene or before reaching hospital, whilst 65 per cent (631) survived to reach an A&E unit (0.082 per cent of the Region's annual A&E case load), 75 per cent arriving outside of normal office hours. Eleven per cent (72) died prior to ward admission and 34 per cent (213) were immediately transferred to a secondary medical referral centre. Three hundred and sixty-seven patients (38 per cent) survived to be discharged from acute hospital care whilst 188 (19 per cent) died as in-patients. Major injuries were found to be distributed throughout the Authority area in rough proportion to district population density with a regional incidence of 27 cases per 100,000. This study has quantified a group of patients with very specific and specialized needs, but further research and debate is required to decide how these needs are best met.

Accidents, Traffic↗
PubMed1994

Health and health care of rural populations in the UK: is it better or worse?

OBJECTIVE--To review available evidence on the problems facing rural health care in the UK. In particular, to determine whether the health of rural populations is worse than that of town dwellers and how the quality of health care is influenced by rurality. CRITERIA FOR INCLUSION AND EXCLUSION OF ARTICLES--A wide variety of publications and data sources were used. A number of computerised databases with different specialisations (for example medical, health care management) were used to identify relevant published articles. In addition, reports, reviews, and surveys produced by agencies for local circulation were identified by approaching academic, service, and voluntary bodies thought likely to have an interest in rural health. Although this "grey" literature is not subject to peer review, the relative lack of relevant UK publications made it a useful data source for illustrative purposes. Similarly, published articles based on rural health in other developed countries were used when UK data were lacking. CONCLUSIONS--Although the evidence concerning the health and health care of the UK rural populations is suggestive, it is very general and further research is needed. Levels of urban health seem to be generally worse than in rural areas, but contradictions do exist. The evidence on quality of care suggests that service accessibility is a central problem, and rural populations have poorer access than others. Within rural populations, such disadvantage is not uniformly experienced--it affects some groups more than others. In addition, the NHS does not seem to have a consistent policy about whether rurality should influence resource allocation, and how it should be incorporated.

Health Care Rationing↗
PubMed1993

Extracorporeal photochemotherapy in progressive systemic sclerosis.

BACKGROUND: Extracorporeal photochemotherapy, an immune-modulating form of therapy, has been shown to be effective in the treatment of autoimmune diseases. We evaluated the effects of extracorporeal photochemotherapy in the treatment of patients with progressive systemic sclerosis (PSS). METHODS: Nine patients with active progressive systemic sclerosis were treated with extracorporeal photochemotherapy on 2 successive days monthly. The duration of therapy ranged from 6 to 21 months. RESULTS: A significant improvement was noted in the skin, musculoskeletal system, functional index, and symptoms including Raynaud's phenomenon, dyspnea, fatigue, dysphagia, and arthralgias, as well as improvement of cutaneous ulcers. Stabilization of the pulmonary function studies was also noted in the majority of patients over the course of therapy. No serious side effects were noted throughout the course of therapy in the 9 patients. CONCLUSIONS: The results suggest that photopheresis may be beneficial in selected early cases of progressive systemic sclerosis.

Activities of Daily Living↗
PubMed1992

Audit and research.

Explore the source record for details and available documents.

Management Audit↗
PubMed1990

Mast cells, nerves and fibrosis in the appendix: a morphological assessment.

Mast cells are closely associated with nerves in the mucosa of the appendix vermiformis, and obliteration of the appendiceal lumen by fibrous tissue is accompanied by neurogenous hyperplasia. However, changes in the density of mast cells in this process have not been reported. Accordingly, fibrosis was graded in haematoxylin and eosin sections from 46 samples of human appendix. This was compared with mast cell number in toluidine blue-stained slides and nerve density in PGP9.5-immunoreactive sections. In the mucosa, the mast cell number in the samples with minimal fibrosis was three times greater than in those classified as normal (P less than 0.0001), and this declined in the more fibrotic samples. The mucosal nerve scores paralleled the mucosal mast cell changes, and stereological analysis revealed a correlation of mast cell number and nerve density within the lamina propria of the same specimens (r = 0.49-0.90). In the submucosa, mast cell numbers and nerve scores were not significantly different in the different histological grades and obliterated samples resembled normal submucosa, except that a dense axial block of nerve staining was often present. The progressive fibrotic changes in appendices provide a human model for studying the relationships of nerves, mast cells, and fibrosis in the gastrointestinal tract.

Appendix↗
PubMed1989

Development of the cerebellum with particular reference to cellular differentiation in the external granular layer.

Immunocytochemical evidence of differentiation in developing human cerebellum is presented in this study. Antibodies to neuron specific enolase, neurofilament protein, glial fibrillary acidic protein, vimentin, cytokeratin, epithelial membrane antigen and lymphoid markers, DLC and Leu 7 were used. The external granular layer showed positivity with neuronal markers between 27 weeks gestation and 4 months postnatal, but was negative for all other markers including glial fibrillary acidic protein. Characteristic staining reactions were noted in the other cerebellar layers. Monoclonal antibodies, UJ13A (pan-neuroectodermal marker) and G10 (localising microtubule-associated protein MAP1x) were also used in a limited number of cryostat sections and were positive and negative, respectively, in the external granular layer. The results of this study are discussed in relation to the theory that the external granular layer may be one source of medulloblastomas.

Biomarkers↗
PubMed1989

Immunohistochemical localisation of tissue plasminogen activator in human brain tumours.

The distribution of tissue plasminogen activator (t-PA) has been studied in a series of 38 human brain tumours and two specimens of cerebral cortex, using the monoclonal antibody ESP6. t-PA was localised in vascular endothelium in the majority of tumours and both the cortical specimens, confirmed by double staining with Ulex europaeus lectin (Uel) and Factor 8-related antigen. Nineteen out of 22 high grade astrocytomas showed strong endothelial staining whereas staining was weak or absent in the four low grade astrocytomas studied. No consistent relationship was found between the pattern of staining and tumour grade in the other tumours, although strong staining of the three metastatic lesions with Uel was observed. Among the astroglial tumours only one glioblastoma showed any tumour cell staining for t-PA, which raises questions concerning the origin of t-PA producing cells derived from human gliomas in vitro. Studies of t-PA in brain tumours should take account of this vascular localisation before concluding that the activity is derived from neoplastic cells.

Brain Neoplasms↗
PubMed1988

Status epilepticus complicating migraine.

We describe 2 patients who developed status epilepticus in association with migraine attacks. One patient died and at the autopsy had ischaemic changes confined to the occipital lobes. The second patient made an uneventful recovery.

Adult↗
PubMed1987

S-100 protein in Schwann cells of the developing human peripheral nerve. An immunohistochemical study.

From approximately 7 weeks gestational age in developing human peripheral nerve, as in adult nerve, S-100 protein was found to be expressed solely and uniformly by Schwann cells associated with axons. In embryos younger than 7 weeks S-100 was much less constant and many cells did not show clear staining. The trigger for the initial appearance of the protein at around this age remains unclear although a relationship of S-100 expression in Schwann cells to close axonal contact is suggested. The value of S-100 protein in distinguishing Schwann cells from perineurial cells in normal nerves and nerve sheath tumours remains unclear.

Embryo, Mammalian↗
PubMed1987

Paraplegia due to massive asbestos-related pleural and mediastinal fibrosis.

A case of massive pleural and mediastinal fibrosis related to occupational exposure to asbestos is presented. The terminal illness was marked by the acute onset of paraplegia. Autopsy revealed occlusive lesions of upper intercostal arteries within sheets of dense fibrous tissue and an ischaemic myelopathy. The presence of vascular lesions suggests a relationship with idiopathic mediastinal fibrosis.

Arterial Occlusive Diseases↗
PubMed1985

Nutrition and health in the first year of life on a Pacific atoll. Observations on Abemama Atoll, Central Pacific.

The growth of 50 children on a coral atoll has been studied during their first year of life. Initially the population median weight rose above the international norm, but later declined, resulting in a median weight at 12 months below this norm. Data on age of introduction of foods, diarrhoeal illness and general morbidity indicated an association between growth faltering and episodes of fever between four and 12 months but no association with diarrhoea. No statistically significant relationships were found between the age of introducing solid food and the age of first diarrhoea, or between the ages of introduction of protein or energy foods and growth faltering. The effects of fever on growth are probably mediated by temporary appetite suppression in the context of marginal nutrition accentuated by the difficulties of weaning. Records of village or home treated illnesses highlight the discrepancies between village and health service based records.

Body Height↗
PubMed1985

Epithelioid neurilemmoma of the trigeminal nerve: an immunohistochemical and ultrastructural study.

A 50-year-old male presented with facial pain due to an extrinsic intracranial tumour involving pontine nerve roots. Biopsy and subsequent partial surgical excision indicated origin from the trigeminal nerve. Histologically the tumour had features of a neurilemmoma but in addition contained a population of epithelioid cells. Immunohistochemical studies demonstrated S100 protein in the non-epithelioid component but no reaction in the epithelioid cells, whilst vimentin was present in both cell types. Ultrastructurally the epithelioid cells showed features consistent with a Schwann cell nature and may represent a less well differentiated cell population derived from a Schwann cell precursor. The significance of these findings in relation to the cell of origin of neurilemmomas is discussed.

Cranial Nerve Neoplasms↗