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Biomedical subjects

B King

Publications and source records attributed to B King.

At least 91 records · Page 5Linked to original sources
PubMed1994

Techniques for understanding the customer.

Who are the customers and what do they want? Every health care employee sometimes serves as a supplier providing input to an activity and sometimes as the recipient of the activity. This article explains the Kano model, which distinguishes between expected quality, one-dimensional, quality, and exciting quality. It also introduces Quality Function Deployment and the Customer Window, two tools for understanding and prioritizing customer demands.

Consumer Behavior↗
PubMed1994

Immunocytochemical localization of nonluteal ovarian relaxin.

Relaxin has been demonstrated to be produced by the corpus luteum of the menstrual cycle and pregnancy and is also produced by the endometrium and decidua, although these nonluteal sources may not contribute to circulating relaxin concentrations. The reports of luteal production of relaxin have failed to consider nonluteal ovarian sources. To look for sources of nonluteal ovarian relaxin, human ovaries were collected from patients who underwent removal of the ovary for a variety of reasons. Tissues were fixed in formalin and embedded in paraffin. Two monoclonal antibodies were used for immunocytochemical staining, one directed against human relaxin and the other against the C peptide of prorelaxin. In addition to the expected staining of corpora lutea, the luteinized theca interna but not granulosa of developing follicles from ovaries with an active corpus luteum of the cycle also stained positive for both relaxin and prorelaxin. Ovaries from term pregnant women with luteinized theca also demonstrated staining for relaxin and prorelaxin. In addition to luteal and thecal cell staining, small clusters of pseudodecidual cells in the periphery of the ovary stained positive for relaxin and prorelaxin. These data indicate that the ovary contains theca interna-derived structural elements in addition to the corpus luteum that produce relaxin when a corpus luteum is active, while granulosa-derived elements do not. This suggests that luteal production of relaxin is from theca-derived elements and may explain instances of independent relaxin and progesterone secretion.

Adult↗
PubMed1993

Candidemia from a urinary tract source: microbiological aspects and clinical significance.

Twenty-six cases of candidemia associated with a well-defined urinary tract source were retrospectively identified and reviewed. Urinary tract abnormalities were present in 23 of 26 patients (88%), 19 (73%) of whom had urinary tract obstruction. Nineteen patients had undergone urinary tract procedures before the onset of candidemia. Episodes of candidemia were brief and low-grade in intensity (median duration, 1 day; median colony count, 1.5 cfu/10 mL of blood). Only eight patients (31%) received > or = 500 mg of amphotericin B. There were five in-hospital deaths (19%); two of these deaths were attributed to candidiasis. No late complications of candidemia were documented for the surviving patients. Patients with urologic pathology and candiduria who undergo surgery or manipulation of the urinary tract are at significant risk for candidemia, and further studies should examine the issue of administration of prophylaxis to this group.

Adolescent↗
PubMed1993

Survivor focus groups: a quality assurance technique.

The use of a total quality management frame work by the palliative care team (PCT) at the Chedoke-McMaster hospitals has led to a standardized method of obtaining feedback from some of the hospitals' customers. Every three months, a focus group is convened of randomly chosen significant others who were most involved in a nonprofessional caregiving role for the deceased patients. The participants are invited to discuss their perceptions of the quality of care provided by the PCT and how it could be improved. This paper describes the procedures used and feedback received in the first year of this audit procedure. The lessons learned during implementation of this audit procedure and how this feedback has affected the PCT's functioning are discussed. This process can provide information for continuous improvement of the care provided by the PCT.

Caregivers↗
PubMed1992

Detection of occult lymph node metastases in malignant melanoma.

An accurate prediction of the prognosis of melanoma is dependent on the ability to determine the presence or absence of malignant cells in lymph nodes. Our laboratory has developed a method for screening lymph node sections for the presence of micrometastatic disease. The nodes obtained from regional lymphadenectomies are dissected free from surrounding tissue and divided into halves. One-half is subjected to routine histopathological evaluation and the other one-half is disrupted into a single cell suspension and placed into cell culture. Lymph nodes from 19 patients with malignant melanoma were evaluated by tissue culture. Tumor cells were isolated in 125 of the 173 nodes examined. In contrast, only 14 of these nodes were initially found positive for melanoma by routine pathological evaluation. All lymph nodes positive for melanoma by pathological evaluation were also culture positive. Examination by cell culture has led to an upgrade in the stage of disease in 58% of the histologically node-negative patients. In addition, 43% of the patients who were histologically node negative but culture positive have recurred, suggesting some clinical correlation. These results indicate that the tissue culture method for detecting micrometastatic lymph node disease may prove more reliable and sensitive than current techniques for determining the presence of occult melanoma.

Antigens, Neoplasm↗
PubMed1991

Detection of submicroscopic lymph node metastases in patients with melanoma.

A cell culture technique was developed to investigate submicroscopic lymph node metastases in patients with stage 1 or 2 malignant melanoma. Lymph nodes were isolated from standard dissections and bivalved. Half of the node was evaluated by routine histopathologic examination, while the other half was processed and placed into tissue culture. Three hundred twenty-three lymph nodes were collected from 41 patients. The cell culture technique identified 155 of 323 lymph nodes containing micrometastases, while only 20 of 323 lymph nodes tested positive with routine histochemical processing. Nine patients were upgraded from stage 1 or 2 to stage 3 disease after micrometastases were identified in lymph node cultures. Identification of melanoma was confirmed by cytologic examination, immunohistologic staining, and the presence of GD3 ganglioside and 250-kd glycoprotein melanoma-associated antigens. This study provides evidence that the culture of lymph nodes is a sensitive method for the detection of micrometastases. In addition, this procedure may change prognosis and identify candidates for adjuvant therapies.

Antibodies, Neoplasm↗
PubMed1991

5-Hydroxytryptamine (5-HT)-induced shape change in human platelets determined by computerized data acquisition: correlation with [125I]-iodoLSD binding at 5-HT2 receptors.

The 5-HT-induced shape change and subsequent aggregation of platelets provides a functional assay for 5-HT2 receptors. In the present study we describe a method to increase aggregometer sensitivity by digital conversion of the voltage produced by changes in light transmittance through a platelet suspension, thereby allowing accurate analyses of the primary shape-change response. The pharmacology of 5-HT-induced shape change was then compared with that of [125I]-iodoLSD binding in human platelets. 5-HT caused a dose-dependent change in platelet shape (maximum response 5 x 10(-6) M, EC50 10(-6) M). Furthermore, there was a significant correlation across a selection of drugs between IC50 values for inhibition of 5-HT-induced shape change and for inhibition of platelet binding of the 5-HT2 receptor ligand [125I]-iodoLSD. These results support the hypothesis that 5-HT-induced shape change and [125I]-iodoLSD binding in human platelets are mediated through the same receptor, and validate the methods of data acquisition described.

Blood Platelets↗
PubMed1991

In vivo studies of cartilage regeneration after damage induced by catabolin/interleukin-1.

The response of the rabbit knee joint to a brief episode of cytokine induced damage is described. After three intra-articular injections of catabolin/interleukin-1 all joint cartilages showed an immediate extensive loss of proteoglycan (glycosaminoglycan), which was gradually replaced over three to four weeks. Glycosaminoglycan biosynthesis (measured by 35SO4 uptake) was initially depressed, but at one week had almost doubled its rate as compared with the normal side. This increased synthetic activity was further maintained throughout the duration of the experiment (28 days), though the rate gradually fell. Histological cartilage metachromasia to toluidine blue mirrored the glycosaminoglycan changes. No disturbance of the articular cartilage collagen network was found. It is considered, therefore, that during treatment for arthritis the indigenous chondrocyte must continue to be capable of carrying out regenerative matrix repair and that antiarthritic agents should first be screened for interference with that process.

Animals↗
PubMed1990

Selective conservative management of abdominal gunshot wounds: a prospective study.

A prospective study of 111 patients with low velocity gunshot wounds of the abdomen was conducted to determine whether a policy of selective conservative management based on repeated physical examination is a safe form of treatment. Laparotomy was undertaken in 89 patients (80 per cent), seven of which were negative. Of the patients 22 (20 per cent), eight of whom were considered to have peritoneal penetration, underwent conservative management. None required delayed laparotomy. Eight patients (7 per cent) died, all deaths occurring in the positive laparotomy group. The incidence of significant intra-abdominal injury if the peritoneal cavity had been penetrated was 89 per cent. Selective conservative management may be applied safely to a limited group of patients with gunshot wounds of the abdomen.

Abdominal Injuries↗