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Biomedical subjects

C Smart

Publications and source records attributed to C Smart.

At least 19 recordsLinked to original sources
PubMed2005

Method for the generation and cultivation of functional three-dimensional mammary constructs without exogenous extracellular matrix.

During puberty, pregnancy, lactation and post-lactation, breast tissue undergoes extensive remodelling and the disruption of these events can lead to cancer. In vitro studies of mammary tissue and its malignant transformation regularly employ mammary epithelial cells cultivated on matrigel or floating collagen rafts. In these cultures, mammary epithelial cells assemble into three-dimensional structures resembling in vivo acini. We present a novel technique for generating functional mammary constructs without the use of matrix substitutes.

Animals↗
PubMed2003

[Iodine-125 transperineal prostate brachytherapy with preplanning technique: pre and post-implant dosimetry results analysis].

PURPOSE: Post-implant CT-based dosimetry is the only method of assessing the quality of permanent prostate brachytherapy. As a consequence of our permanent feedback with the preplanned technique, geometric and dosimetric criteria for optimal seed implantation are proposed and pre and post-implantation dosimetric results are presented. PATIENTS AND METHODS: In 2000 and 2001, one hundred and twenty patients with early stage prostate cancer were treated with transperineal I-125 preplanned brachytherapy (RAPID Strand, Amersham Health). The prescription dose was 145 Gy to the planning target volume. For the pre-planning and post-implant dosimetry the Variseed 6.7 version software was used (Varian Medical Systems). The D90, V100 and V150 values, the position of the dose peak [Dose] peak) and the full width at half maximum (FWHM) on differential dose volume histogram from both planned and post-implant dosimetry were compared for all patients. RESULTS: For preplanned dosimetry, the mean values for D90, V100, V150, [Dose] peak, FWMH were respectively of 199Gy, 100%, 70%, 220Gy, 113Gy. For post-implantation, these values became respectively of 157Gy, 90%, 62%, 220Gy, 194Gy. CONCLUSION: In our practice, differences are noted between preplanned and post-implant dosimetry parameters that should be anticipated to assure optimal definitive result. A working methodology both for performing the preplanned dosimetry and for evaluating the post-implantation dosimetric results is proposed.

Brachytherapy↗
PubMed2003

Radiographic measurement of joint space height in non-osteoarthritic tibiofemoral joints. A comparison of weight-bearing extension and 30 degrees flexion views.

There have been many reports which suggest that in patients with tibiofemoral osteoarthritis, a reduction in joint space is demonstrated better on weight-bearing radiographs taken with the knee in semiflexion than in full extension. The reduction has been attributed to the loss of articular cartilage in the contact area in a semiflexed arthritic knee. None of these studies have, however, included normal knees. We have therefore undertaken a prospective, double-blind, randomised study in order to evaluate the difference in the joint-space of arthroscopically-proven normal tibiofemoral joints as seen on weight-bearing full-extension and 30 degrees flexion posteroanterior radiographs. Twenty-two knees were evaluated and the results showed that there may be a difference of up to 2 mm in the two views. This difference could be attributed to the inherent differential thickness of the articular cartilage in different areas of the femoral and tibial condyles and a change in the areas of contact between them.

Adolescent↗
PubMed2001

Local expression of expansin induces the entire process of leaf development and modifies leaf shape.

Expansins are a family of extracellular proteins proposed to play a key role in wall stress relaxation and, thus, in cell and tissue growth. To test the possible function of expansins in morphogenesis, we have developed a technique that allows transient local microinduction of gene expression in transgenic plants. We have used this system to manipulate expansin gene expression in various tissues. Our results indicate that local expansin expression within the meristem induces a developmental program that recapitulates the entire process of leaf formation. Moreover, local transient induction of expansin expression on the flank of developing primordia leads to the induction of ectopic lamina tissue and thus modulation of leaf shape. These data describe an approach for the local manipulation of gene expression and indicate a role for expansin in the control of both leaf initiation and shape. These results are consistent with the action of cell division-independent mechanisms in plant morphogenesis.

Gene Expression Regulation, Plant↗
PubMed2001

Genetic diversity of Pierce's disease strains and other pathotypes of Xylella fastidiosa.

Strains of Xylella fastidiosa isolated from grape, almond, maple, and oleander were characterized by enterobacterial repetitive intergenic consensus sequence-, repetitive extragenic palindromic element (REP)-, and random amplified polymorphic DNA (RAPD)-PCR; contour-clamped homogeneous electric field (CHEF) gel electrophoresis; plasmid content; and sequencing of the 16S-23S rRNA spacer region. Combining methods gave greater resolution of strain groupings than any single method. Strains isolated from grape with Pierce's disease (PD) from California, Florida, and Georgia showed greater than previously reported genetic variability, including plasmid contents, but formed a cluster based on analysis of RAPD-PCR products, NotI and SpeI genomic DNA fingerprints, and 16S-23S rRNA spacer region sequence. Two groupings of almond leaf scorch (ALS) strains were distinguished by RAPD-PCR and CHEF gel electrophoresis, but some ALS isolates were clustered within the PD group. RAPD-PCR, CHEF gel electrophoresis, and 16S-23S rRNA sequence analysis produced the same groupings of strains, with RAPD-PCR resolving the greatest genetic differences. Oleander strains, phony peach disease (PP), and oak leaf scorch (OLS) strains were distinct from other strains. DNA profiles constructed by REP-PCR analysis were the same or very similar among all grape strains and most almond strains but different among some almond strains and all other strains tested. Eight of 12 ALS strains and 4 of 14 PD strains of X. fastidiosa isolated in California contained plasmids. All oleander strains carried the same-sized plasmid; all OLS strains carried the same-sized plasmid. A plum leaf scald strain contained three plasmids, two of which were the same sizes as those found in PP strains. These findings support a division of X. fastidiosa at the subspecies or pathovar level.

Bacterial Typing Techniques↗
PubMed2000

A review of the nutritional needs of Meals on Wheels consumers and factors associated with the provision of an effective meals on wheels service-an Australian perspective.

OBJECTIVE: A review of the literature was undertaken to identify the nutritional needs of elderly MOW consumers and factors affecting the ability of existing programs to meet those needs. The focus was on the Australian experience but drawing on the world literature. DESIGN: Keyword search of English language based computer databases of the medical and health literature. RESULTS: Several studies suggest the nutritional intake of MOW consumers is below recommended levels, although the risk of nutritional deficiency has not always been identified. The literature indicates the effectiveness of Meals on Wheels programs are affected by a range of issues including the appropriateness of nutritional standards, menu selection, portion control, level of consumption and customer satisfaction. The literature recommends control of time and temperatures associated with food handling procedures, along with education of providers and customers, to assist in the provision of a safe food supply. CONCLUSIONS: Meals on Wheels is an important service, providing meals to housebound consumers. While the effectiveness of such programs is dependent on a range of variables, the nutritional impact of the service and the standard of food hygiene are fundamental assessment criteria. SPONSORSHIP: This work was supported by a grant from the NSW Meals on Wheels Association, Australia. European Journal of Clinical Nutrition (2000) 54, 275-280

Aged↗
PubMed1999

Brachytherapy and vaginal hysterectomy for low-stage uterine cervix carcinoma.

OBJECTIVE: The aim of this study was to assess safety and efficiency of a limited vaginal hysterectomy after brachytherapy in patients with early uterine cervix carcinoma without unfavorable prognostic factors. All tumors were less than 1.5 cm in diameter. MATERIAL AND METHODS: Between October 1992 and December 1995, 22 patients with low-stage uterine cervix carcinoma (stage Ia2 with vascular invasion, 3 cases; stage Ib1, 19 cases) were included in this study. Patients underwent the following procedures: single utero-vaginal brachytherapy after a previous negative laparoscopic lymphadenectomy (median number of lymph nodes: 12) followed 6 weeks later by a limited vaginal hysterectomy. RESULTS: Two mild intraoperative complications were noted. Venous hemorrhage (100 cc) occurred in one patient during lymphadenectomy and another patient experienced bladder injury during hysterectomy. These two complications were successfuly controlled with no need for laparotomy. Only one late complication was observed and was evaluated as a bladder grade G2(b) according to the Franco-Italian glossary. With a 30 (22-50) month follow-up, no recurrence was reported. CONCLUSION: These results appear promising in patients with very early cervix carcinoma but remain to be confirmed on a larger scale.

Adult↗
PubMed1998

Acromioclavicular dislocation. Conservative or surgical therapy.

A literature review was performed to clarify available information which influences decisions whether to advise a young adult patient to undergo surgery for a severely displaced acromioclavicular dislocation. Twenty-four papers were retrieved yielding 1172 patients of whom the mean followup for the 833 surgically treated patients was 43.7 months and not surgically treated was 60.4 months. Of the 24 papers, only five reported surgical and conservative outcomes; two of these papers used prospective randomized methodology and three used nonrandomized methodology. Fourteen papers reported surgical outcome only and five papers reported conservative outcome only. Overall, 88% of surgically treated patients and 87% of nonsurgically treated patients had a satisfactory outcome. Complications most commonly listed were (surgically treated versus nonsurgically treated): need for further surgery (59% versus 6%), infection (6% versus 1%), and deformity (3% versus 37%). Return to activity was no quicker with surgery. Pain was not any more common without surgery. Range of movement was more frequently normal or near normal without surgery (95% versus 86% if surgically treated) and so was strength (92% versus 87%). Meta-analysis of the four studies including data from surgical and conservative therapy showed on significant benefit from surgery. Power studies suggest that to show a statistically significant benefit from surgery, large studies would be required, which, given the relative incidence of these injuries, would probably be multicenter and therefore vulnerable to methodologic difficulties. There does not seem to be any reason to recommend an operative procedure to a patient with a Rockwood et al Type III injury based on the evidence currently available.

Acromioclavicular Joint↗
PubMed1997

Upper limb traumatic amputees. Review of prosthetic use.

The prosthetic status of the traumatic upper limb amputees was reviewed. Fifty-five upper limb amputees were reviewed using a detailed questionnaire, telephone or clinic review and by case note study. Twenty-three patients were traumatic amputees and 32 were congenital amputees. The amputees' function, prosthetic use and satisfaction were evaluated and this formed the basis of a scoring system. The traumatic group were less satisfied with their prosthesis and their functional ability was poorer, especially in the use of the myoelectric prosthesis. Traumatic amputees were their prosthesis for an average of 6.5 hours per day compared to 9.3 hours in the atraumatic group. None of the traumatic amputees fitted after 12 weeks returned to gainful employment. Early prosthetic fitting, rehabilitation and post-traumatic counselling are advocated in upper limb traumatic amputees in order to achieve an optimum prosthetic benefit for the patient.

Adolescent↗
PubMed1994

Prognostic factors and survival of patients aged less than 45 years with colorectal cancer.

Colorectal cancers in 92 patients aged 45 years and under presenting over a 20-year period (1970-1990) were studied. A delay of more than 4 months in presentation was seen in 27 per cent of patients. All underwent surgery, 14 per cent emergency and 86 per cent elective, and follow-up was available for 91 patients. Overall, 14 per cent of patients had Dukes A tumours, 32 per cent Dukes B, 36 per cent Dukes C and 18 per cent Dukes 'D'. Local recurrence occurred in eight (9 per cent) of the 92 patients and overall 5- and 10-year survival rates were 61 and 59 per cent. Multivariate analysis identified independent risk factors for local recurrence to be mucinous carcinoma (relative effect 4.9) and the presence of intramural vascular invasion by tumour (relative effect 9.4). For overall survival, independent risk factors were involvement of the regional lymph nodes by tumour (relative effect 2.0), extramural invasion by tumour cells (relative effect 3.0), tumour size (relative effect 1.8) and the presence of metastatic disease at initial diagnosis (relative effect 3.7).

Adolescent↗
PubMed1993

A National Cancer Institute sponsored screening trial for prostatic, lung, colorectal, and ovarian cancers.

BACKGROUND. Ovarian cancer is the fifth most common cause of cancer-related death in American women. The median age at diagnosis is about 62 years; incidence rises rapidly after age 60. Pelvic examination has been the primary method for detection of ovarian carcinoma. It is insensitive for the detection of early disease, however: most women present with disease beyond the pelvis (Stages III and IV) and are not curable with existing techniques. Two new technologies may be useful as screening tools for earlier detection of ovarian cancer. CA 125 is an antigenic determinant expressed on an ovarian cancer cell line. Transvaginal ultrasound (TVUS) images the ovaries from within the vagina and can be performed by a technician in about 10 minutes. In small preoperative studies of women with ovarian masses, serum CA 125 levels have been elevated (typically above 35 U/ml) in over two-thirds of cases and in up to 50% of Stage I cases. The test is not absolutely specific: elevations have been reported with pregnancy, endometriosis, menstruation, benign ovarian tumors, and with cancers of the breast, colon, pancreas, lung, stomach, and liver. Nevertheless, the specificity of CA 125 in postmenopausal women has been reported at about 95% or more. TVUS provides higher resolving power for ovarian abnormalities than transabdominal ultrasound or physical examination; however, experience with it is limited. CA 125 and TVUS may be complementary. CONCLUSIONS. For these reasons, the National Cancer Institute is planning a randomized trial of all three tests versus routine medical care in women of ages 60-74 years. This is part of a larger trial to determine the efficacy of screening for lung, colorectal, and ovarian cancers in women, and for lung, colorectal, and prostatic cancers in men. Seventy-four thousand women will be randomized in the study.

Aged↗
PubMed1993

Thiopurine methyltransferase activity in a sample population of black subjects in Florida.

Thiopurine methyltransferase (TPMT), is an enzyme detected in the human red blood cell that catalyzes the S-methylation of thiopurine drugs and is known to exist as a genetic polymorphism in white subjects. Investigations in this laboratory of red blood cell TPMT showed interethnic differences also existed in North American black subjects. A sample group of black subjects in Florida had a mean activity of 8.64 +/- 3.47 U/ml red blood cells and an antimode of 6.5 units, which represented values significantly lower than those obtained for both the mean activity and the antimode in other populations. The findings of this study suggest the possibility that TPMT activity may be under genetic control in North American black subjects and that this ethnic group may be at greater risk of experiencing thiopurine-induced toxicity caused by the lower overall mean activity of the enzyme.

Adolescent↗
PubMed1986

Two cellular pathways regulate the response to TNP-Ficoll in Xenopus laevis.

The initiation of the anti-TNP response to TNP-Ficoll in the amphibian Xenopus laevis has been studied. Although the response to this antigen is thymus independent in mammals, it is thymus dependent for the first three days following immunization in Xenopus. This thymus regulation is not MHC restricted, since it can be substituted for by thymus xenografts, and by prior or co-injection of heterologous red blood cells or Concanavalin A. The pathway which is activated by the Con A to substitute for the thymus is NMU sensitive, unlike the thymic pathway. The peripheralised alternative pathway is activated by particulate but not soluble TNP-Ficoll. The thymus-dependent and alternative pathways are discussed in terms of their possible nature, regulation and evolutionary significance.

Animals↗
PubMed1986

In vitro IgE production by peripheral blood lymphocytes and rectal mucosal biopsies and antigen-induced basophil degranulation in patients with inflammatory bowel disease.

IgE production by peripheral blood lymphocytes (PBL) and rectal mucosal biopsies in vitro has been examined in patients with ulcerative colitis (UC) and Crohn's disease (CD). The degranulation of peripheral blood basophils to food antigens has also been investigated in these patients. Mitogen-induced IgE production was reduced in patients with UC, but enhanced in PBL cultures from patients with CD. Increased numbers of basophils degranulated in the presence of cows' milk in UC patients, but normal responses occurred in patients with CD. This evidence supports the suggested role of IgE-mediated mechanisms involving mast cell/basophil interactions in the pathogenesis of inflammatory bowel disease.

Antigens↗
PubMed1985

Drug dependence units in England and Wales. The results of a national survey.

Drug dependence units (DDUs) form the cornerstone of government policy response to problem drug taking. Yet we know surprisingly little about the facilities that they can provide and what treatment policies they adopt. This paper constitutes a modest attempt to fill some of the gaps in our knowledge and points to the need to base future policy recommendations on detailed empirical research.

England↗
PubMed1985

Social policy and drug dependence: an historical case study.

A detailed examination is presented of the background to the reports and policy developments concerning drug dependence which emerged in Britain during the 1960s. Analysis of documents and interviews with policy makers, officials and doctors involved in the events of the period, reveal that explanatory models in terms of 'moral panic' or 'power struggle' tend to oversimplify the complex processes involved. The role in policy formation of the media, government departments and groups within the medical profession is considered. The patterns of conflict and convergence are seen to overlap simple lines of 'interest'--we find conflict within the medical profession, convergence between the Home Office (legal) and elements of the medical professions (medical). The resulting legal and institutional framework involved only loose guidelines from the centre about treatment, and the shape of policy was determined by individual doctors in the new hospital treatment centres. The apparent re-run of the 1960s being staged in the 1980s will require detailed research in the future in order to avoid superficial comparisons.

History, 20th Century↗