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Biomedical subjects

A Spigelman

Publications and source records attributed to A Spigelman.

At least 19 recordsLinked to original sources
PubMed2001

Prevention of orthopaedic wound infections: a quality improvement project.

Using clinical practice improvement methodology, a project was undertaken to reduce the incidence of surgical wound infections following elective hip and knee replacement surgery. A team was established, key measures for improvement were identified, strategies for change were developed and an action plan was implemented. Outcomes for this project included a reduction in the rate of clean surgical wound infection for joint replacement surgery from 28% to zero. Average length of stay for total hip replacement surgery was reduced from 13.9 to 9.3 days and from 14.6 to 10.4 days for total knee replacement surgery. Guidelines for patient selection were developed along with a protocol for the management of preparation to prevent urinary tract infections. Post-discharge surveillance and a preoperative rehabilitation and exercise programme have been implemented. There is potential for wider uptake and implementation of the quality principles described herein.

Arthroplasty, Replacement, Hip↗
PubMed1998

Peutz-Jeghers disease: most, but not all, families are compatible with linkage to 19p13.3.

A locus for Peutz-Jeghers syndrome (PJS) was recently mapped to chromosome 19p13.3. Each of 12 families studied was compatible with linkage to the marker D19S886. We have analysed 20 further families and found that the majority of these are consistent with a PJS gene on 19p13.3. Three families were, however, unlinked to 19p13.3 and none of the available PJS polyps from these families showed allele loss at D19S886. There were no obvious clinicopathological or ethnic differences between the 19p13.3 linked and unlinked families. There appears, therefore, to be a major PJS locus on chromosome 19p13.3 and the possibility exists of a minor locus (or loci) elsewhere.

Chromosomes, Human, Pair 19↗
PubMed1997

Nuclear DNA content of fine needle aspirates of invasive ductal carcinomas of the breast.

Patients with aggressive breast cancers benefit from chemotherapy prior to surgery. If the biology of the breast cancers were better characterised pre-operatively, more patients at risk could be offered chemotherapy. We have assessed nuclear DNA content of fine needle aspirates (FNA) of 103 invasive ductal breast cancers and compared this to tumour size, node status and histological grade. Median follow-up was 18 months so no prognostic studies were made. Diploid and non-diploid tumours were distributed equally in node negative and positive patients. However non-diploidy status increased in line with known prognostic markers of tumour size and histological grade. This suggests that ploidy might contribute to the pre-operative assessment of prognosis. We conclude that nuclear DNA of breast cancer FNAs may be of value in the pre-operative biological assessment of breast cancer patients.

Adult↗
PubMed1996

DNA ploidy on cytologic and tissue sections of breast lumps. A comparison using image analysis.

OBJECTIVE: Ploidy correlation between cytologic and histologic breast specimens would permit preoperative measurement of ploidy and may assist in patient management. STUDY DESIGN: DNA indices were measured on fine needle aspirates (FNAs) of 50 breast lumps and the results compared with ploidy of histologic specimens from the same lump. RESULTS: Thirty-six of 50 were histologically malignant, and 14/50 were benign. The mean DNA index of malignant tissue sections was 1.23 (range, 0.61-2.62) and on corresponding cytology was 1.49 (range, 0.79-3.18). Fourteen benign tissue sections had a mean DNA index of 0.94 (range, 0.51-1.37) and a mean DNA index of 1.06 (range, 0.74-2.13) on cytology. DNA indices of FNAs and corresponding tissue sections revealed a correlation between the two (Pearson's correlation coefficient = .386, P value = .006). CONCLUSION: Our results show that the DNA indices are comparable using image analysis on FNAs and tissue sections on the same surgical breast specimens. This demonstrates that ploidy can be achieved on cytologic breast material and may have a role in the preoperative assessment of breast cancers.

Breast Neoplasms↗
PubMed1991

Parental divorce as a factor in children's perception of human relationships: an analysis of human movement responses in the Rorschach test.

The subjects were 108 Swedish children between 10 and 12 years old, who constituted a divorce and a non-divorce group of 27 girls and 27 boys each. Rorschach Tests were administered individually and human movement responses were analysed. Non-divorce children perceived more cooperative and fewer hostile interactions than the divorce children. Responses containing figures engaged in hostile interaction were most common among divorce girls, whereas the divorce boys had difficulties in perceiving any interaction whatsoever. The different effect of parental divorce on the ability of girls and boys to develop satisfactory social relationships is discussed.

Child↗
PubMed1991

Hostility, aggression, and anxiety levels of divorce and nondivorce children as manifested in their responses to projective tests.

The effects of parental divorce on the levels of aggression, hostility, and anxiety in children, as measured by the Rorschach test, together with the type and direction of aggression, as measured by the Rosenzweig Picture-Frustration (P-F) Study, were studied. The Rorschach and the Rosenzweig P-F study were administered to a nonclinical sample of 108 Swedish children ranging in age from 10 to 12 years old. The subjects constituted a divorce and a nondivorce group of 27 girls and 27 boys each. Children of divorced parents (hereafter referred to as divorce children, divorce boys, or divorce girls) showed significantly higher levels of hostility, aggression, and anxiety than children of married parents (hereafter referred to as nondivorce children, nondivorce boys, nondivorce girls). There were significant differences found in the type and direction of aggression between divorce girls and boys. Divorce boys showed more extraggression and ego defensive reactions, whereas divorce girls tended to evade aggression. The differences between divorce and nondivorce groups and the diversity of reactions between divorce boys and girls are discussed.

Aggression↗
PubMed1991

Indications of depression and distress in divorce and nondivorce children reflected by the Rorschach test.

The appearance of depressive features, as reflected by responses to the Rorschach test, were explored in two groups of children from divorced and nondivorced families (referred to here as divorce and nondivorce children). The relationships between the depression scores and the children's hostility, aggression, and anxiety levels were also studied. The Rorschach Inkblot Test was individually administered to a nonclinical sample of 108 Swedish school children between 10 and 12 years old. The subjects constituted two groups, a divorce group (27 girls, 27 boys) and a nondivorce group (27 girls, 27 boys). Divorce children scored significantly higher on Exner's (1986) Depression Index than their nondivorce peers. Furthermore, divorce children with depressive features in their Rorschach responses were found to have a high level of hostility and aggression (as manifested in their Rorschach protocols), whereas no such associations were found among nondivorce children.

Aggression↗
PubMed1984

Isolated congenital pulmonary incompetence: case report and literature review.

Although the literature fails to clearly define the prognosis of isolated congenital pulmonary incompetence (ICPI), there are suggestions that the lesion is not necessarily benign. A case report is presented of pulmonary valve replacement for ICPI which reversed not only symptoms but also electrocardiographic manifestations of right ventricular overload. A literature review is included with the case report.

Electrocardiography↗
PubMed1983

Quantitative assessment of postsurgical breakdown of the blood-aqueous barrier.

Breakdown and reestablishment of the blood-aqueous barrier (BAB) following experimental surgical trauma was evaluated by anterior segment slitlamp fluorophotometry. Substantially more fluorescein leakage was caused by 6-mm limbal incisions for at least the first four postoperative days than was produced by 3-mm incisions. Following 3-mm corneal incisions, leakage of fluorescein closely paralleled that of fluorescein-labeled dextran 70 (molecular weight, 70,000) for the first three postoperative days. On the fourth postoperative day, the BAB appeared reestablished to fluorescein-labeled dextran 70 but was still abnormally permeable to fluorescein. Thus, it appears that although fluorescein is the most sensitive technique of demonstrating breakdown of BAB, it may not always be an indicator of large-molecule permeability.

Animals↗
PubMed1975

Problems with bovine heterografts for hemodialysis. Recognition, correction, and prevention.

1. Careful examination of the peripheral blood vessels is essential in choosing the site for an arteriovenous heterograft. 2. Ischemia of the hand or fingers was avoided by placing upper extremity grafts in the forearm. 3. In the lower extremity, if peripheral pulses are normal, a straight thigh graft is preferred. 4. The recipient vien in the antecubital fossa should be no less than 4 mm in diameter; in the lower extremity the venous anastomosis should be made to the common femoral vein. 5. "Graft hypertension" is a sign of inadequate venous runoff and should be corrected before false aneurysms develop or occlusion of the graft occurs. 6. Most thrombosed grafts can be reopened and should be explored promptly through an incision near the venous end.

Animals↗