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Biomedical subjects

D Ireland

Publications and source records attributed to D Ireland.

At least 37 records · Page 2Linked to original sources
PubMed1998

Borderline malignant change in recurrent müllerian papilloma of the vagina.

Malignant change occurred in a benign, recurrent vaginal müllerian polyp. The patient, a 49 year old woman with cerebral palsy, presented with a polypoid mass in the vagina. At four years of age she had presented with a haemorrhagic polyp, and over the following years she had recurrent irregular bleeding and regrowth of the polypoidal mass, requiring a total of 10 operations to excise the polyp. Histological examination of the specimen showed typical müllerian features with tubal, endometrioid, and endocervical cell types. There were significantly abnormal nuclei, indicating low grade or borderline malignancy. Review of previous biopsies showed similar müllerian features but no atypia. This is the first reported case of borderline malignant change in a previously benign recurrent müllerian papilloma of the vagina. Definitive radical surgery or radiotherapy is contraindicated in this patient and she remains under follow up.

Disease Progression↗
PubMed1997

Legal issues in ambulatory surgery.

Professional liability is an issue of increasing concern to all health care practitioners. The components that constitute professional liability are discussed. Issues that safeguard and define nursing practice are explored from the ambulatory setting perspective.

Ambulatory Surgical Procedures↗
PubMed1997

Evaluation and treatment of uncompensated unilateral vestibular disease.

This article reviews the general literature regarding the clinical evaluation and treatment of a unilateral vestibular deficit. The clinical approach by the authors is highlighted with a focus on bedside examinations and cyclodeviation measurements. Vestibular rehabilitation is currently considered the best approach to rehabilitation at present, and its physiologic basis is reviewed. When applied early in the course of recovery, vestibular rehabilitation can hasten compensation and also reduce symptoms resulting from permanent deficits caused by vestibular injury.

Humans↗
PubMed1996

Single image random dot stereogram: principles and clinical implications.

BACKGROUND: The single image random dot stereogram is different from traditional stereograms in that it does not require a stereoscope or stereo glasses for viewing. There is an artistic variation of these stereograms in which the random dots have been replaced with colorful geometric patterns. An observer needs to view them according to specific instructions. While most observers can see the hidden stereo images after a few trials, some are not able to perceive the effect even after numerous attempts. METHODS: This paper explains the underlying principles by which these stereograms are constructed and describes the reasons why some individuals are not able to appreciate this stereo effect. A unique requirement for the successful viewing of these stereograms is divergence of the eyes from the plane of the stereogram. This unusual divergence may be the reason for unsuccessful viewing. By converting a single image random dot stereogram to a Brewster stereogram, an observer can view the same stereogram with a stereoscope, thus eliminating the divergence requirement. RESULTS: Using this modified viewing method, some previously unsuccessful observers were able to see the stereo effect. CONCLUSIONS: The main reason for unsuccessful viewing by a person with normal stereo vision is an inability to initiate or maintain the proper amount of divergence.

Depth Perception↗
PubMed1994

Panic disorder in patients attending a clinic for vestibular disorders.

In a study of the prevalence of panic and other anxiety disorders in persons with complaints of dizziness, 87 patients referred to a clinic for vestibular disorders completed self-rating measures of anxiety and depression; 32 also underwent a structured diagnostic interview. Thirteen (14.9%) of the patients met the DSM-III-R criteria for panic disorder, agoraphobia, or both. They rated themselves as much more disabled by their dizziness than the patients with no psychiatric disorder. Panic disorder was equally prevalent among patients with and without vestibular disease. In some cases panic disorder may provide an explanation for the dizziness, whereas in others it may be a comorbid condition compounding the disability attributable to the vestibular disorder.

Adult↗
PubMed1991

Multisensory integration in the human vestibular velocity storage mechanism?

To test the hypothesis that auditory inputs can interact with the optokinetically or vestibularly-charged human VSM, we examined the effects of sound on rotational nystagmus and HOKAN. Subjects were rotated at 60 degrees/s, in either clockwise (CW) or counterclockwise (CCV) direction, for a total of 3 min. After 1 min of constant rotation, the optokinetic surround (7 ft dia., 2 degrees stripes at 18 degrees intervals) was illuminated for 60 s and the ensuing HOKAN was recorded for 60 s (standard DCEOG). The chair was stopped 60 s later and the post-rotatory nystagmus (PRN) was recorded. The acoustic stimulus (4/s, 10 ms pulses) was presented to the subject by a loudspeaker in 4 randomized test conditions: (1) fixed to the surround-on during OKN, off during OKAN (2) fixed to the surround-off during OKN, on during OKAN (3) rotating with the subject-on during OKN, off during OKAN (4) rotating with the subject-off during OKN, on during OKAN. In all conditions, the sound was on during per- and post-rotatory nystagmus. Each test was performed on a different day and consisted of 4 randomized control and test trials (CW and CCW). Under none of the above conditions was the rotatory or optokinetic decay affected by the presence of stationary or rotating sound. This absence of alteration of PRN by sound cues contradicts that reported by Kollar et al. (1988). Our evidence that neither HOKAN nor post rotatory nystagmus decay is affected by sound cues supports the conclusion that, under our conditions, multisensory interaction does not occur in the human VSM.

Acoustic Stimulation↗
PubMed1990

Role of centralization of surgery in Stage IB carcinoma of the cervix: a review of 498 cases.

A review was undertaken of 498 patients with stage IB carcinoma of the cervix managed over a 15-year period in the Regional Gynaecological Oncology Centre, Gateshead. All but 4 were treated by radical hysterectomy, with adjuvant radiotherapy and/or chemotherapy for those with involved pelvic nodes. The overall 5-year survival in those with negative nodes was 91.4% compared with 50.5% in those with positive nodes (P less than 0.05). Of those dying from the disease, 7 patients only (1.4%) developed central recurrence, the remainder experiencing pelvic side-wall or distant recurrence. There was no difference in survival related to patient age. There were three deaths related to surgery and a fistula rate of only 1.2%. Bladder hypotonia and lymphocyst affected a minority of patients in the long term. The data support the case for radical surgery in stage IB carcinoma of the cervix, managed on a centralized referral basis.

Adult↗
PubMed1990

Is routine colposcopic assessment necessary following laser ablation of cervical intraepithelial neoplasia?

The colposcopic and cytological findings at follow-up of 1000 women treated by laser ablation for cervical intraepithelial neoplasia or human papillomavirus infection at the Regional Department of Gynaecological Oncology, Gateshead, were reviewed. Colposcopy detected six of 27 patients with residual disease compared with cytology which was abnormal in 26 of the 27 and detected 21 as abnormal on the first visit after laser treatment. In our unit invasive disease after laser treatment was never detected solely on initial colposcopic review.

Adolescent↗
PubMed1989

Enhanced chemiluminescence ELISA for the detection of antibody to hepatitis B virus surface antigen.

A chemiluminescent enzyme linked immunosorbent assay (ELISA) for the detection of antibody to hepatitis B virus surface antigen (anti-HBs) in human serum has been developed. Polystyrene microtitre plates were coated with recombinant, yeast-derived hepatitis B surface antigen (rec-HBsAg). Patient serum samples and appropriate controls were added to the rec-HBsAg-coated wells and incubated to bind anti-HBs. The wells were then washed and a fluorescein isothiocyanate (FITC) conjugate of a human plasma-derived hepatitis B surface antigen (HBsAg) was added. Following incubation and further washing, the bound FITC-labelled HBsAg was detected after addition of a horseradish peroxidase (HRP) conjugate of a monoclonal anti-FITC antibody and assaying for the enzyme. The activity of the HRP was measured using luminol and hydrogen peroxide as substrates and iodophenol as a chemiluminescence enhancer. The luminescence was recorded using a camera luminometer. Preliminary tests have shown the assay to be suitable for the detection of antibody in sera from both vaccinees and also from individuals with a past hepatitis B virus infection. The use of the FITC-anti-FITC system together with the measurement of a chemiluminescence signal makes possible the completion of this assay in a few hours. The assay has been shown to be both specific and sensitive and provides a permanent photographic record.

Colorimetry↗
PubMed1989

Invasive cancer of the cervix after laser treatment.

Over a period of 8 years and 6 months, 1979-1988, 4222 women were treated with laser ablation for cervical intraepithelial neoplasia (CIN) with or without papillomavirus infection of the cervix. Of 3738 patients followed up, nine were diagnosed as having invasive cancers of the cervix, four of which were microinvasive. It is stressed that each woman treated with laser must have frequent, long-term cytological follow-up.

Cervix Uteri↗
PubMed1989

Is it time for a reconsideration of the criteria for cone biopsy?

Between August 1985 and November 1988, 475 laser cone biopsies were performed at the Regional Gynaecological Oncology Unit in Gateshead. Of these, 332 were performed for abnormal cervical cytology and unsatisfactory colposcopy. The negative cone rate in this group was 34%. In those with cytological abnormalities up to and including mild dyskaryosis the figure was 64% and there were no cases of invasive disease. In this group the authors have reconsidered the criteria for cone biopsy and suggested biopsy of the visible ectocervical lesion combined with endocervical curettage or brushing. Those with negative histology or cytological abnormalities less than moderate dyskaryosis should be managed conservatively.

Adult↗
PubMed1988

Co-expression of the hepatitis B surface and core antigens using baculovirus multiple expression vectors.

The hepatitis B (HB) virus DNA sequences coding for the pre-core (preC) or C antigens (HBpcAg, HBcAg) have been inserted into the baculovirus plasmid transfer vector, pAcYM1, such that the HB viral sequences are under the control of the polyhedrin promoter of Autographa californica nuclear polyhedrosis virus (AcNPV). Spodoptera frugiperda cells infected with either of the derived recombinant plasmids in the presence of infectious AcNPV DNA yielded recombinant, polyhedrin-negative viruses that expressed high levels of the respective HBpcAg or HBcAg (representing approx. 5 to 10% and approx. 40% of the stained cellular proteins, respectively). The particulate 27 nm HBcAgs have been purified to homogeneity from infected cell extracts by density gradient centrifugation. Dual expression transfer vectors containing the HBcAg gene sequences and the coding sequences of the HB viral S antigen (HBsAg), each gene under the control of its own copy of the polyhedrin promoter, have also been constructed and used to derive recombinant viruses. The recombinant with the HB C and S genes expressed high levels of the HBcAg (approx. 40% of the cellular proteins) and low levels of the HBsAg (approx. 2% of the stained cellular proteins). Dual expression, occluded, recombinant baculoviruses that make HBsAg, as well as the AcNPV polyhedrin protein, have been prepared that are highly infectious for Trichoplusia ni caterpillars, allowing reproducible preparation of the antigen in larvae. Using radioimmunoassays (RIAs) and ELISAs, the recombinant HBcAg (RIA) and HBsAg (ELISA) have been used to identify human antibodies to HB virus with results that compare favourably with the data obtained with non-recombinant antigens.

Amino Acid Sequence↗
PubMed1988

The management of the patient with abnormal vaginal cytology following hysterectomy.

Thirty-two patients presenting with abnormal vaginal cytology following hysterectomy were studied. Seven (21.8%) had had hysterectomy for benign conditions whilst 25 (78.1%) had cervical intraepithelial neoplasia (CIN) or invasive cervical carcinoma. Twenty-five patients had partial or total vaginectomy (15 as the primary procedure), and one required laser treatment following vaginectomy. Of 11 (34.3%) patients treated primarily by laser, five subsequently required vaginectomy because of persistent or recurrent cytological abnormality. All four patients treated with topical 5-fluorouracil or dinitrochlorobenzene subsequently required surgery. Nine of the 32 patients (28.1%) proved to have invasive carcinoma of the vagina on histological examination of the vaginectomy specimen. At the time of writing all patients in the study are well with no evidence of disease.

Adult↗
PubMed1987

Mucin production in cervical intraepithelial neoplasia and in stage 1b carcinoma of cervix with pelvic lymph node metastases.

Sections from cervical intraepithelial neoplasia (CIN 3) and stage 1b carcinoma of the cervix were stained with periodic acid-Schiff (PAS) and alcian blue to identify the presence of intracellular mucin. One out of seven specimens of CIN 3 demonstrated intracellular mucin. In a series of 33 patients with stage 1b carcinoma of the cervix with pelvic lymph node metastases, PAS demonstrated intracellular mucin staining patterns that were similar in both tumour and lymph node in most patients. In the subgroup of 23 patients classified as having squamous carcinoma, 8 (35%) demonstrated intracellular mucin to some degree and only 2 (25%) of those 8 were alive after 3 years compared with 13 of the other 15 (87%) who did not show any mucin staining (P less than 0.01).

Adenocarcinoma↗
PubMed1985

Metaphase-arrest technique applied to human cervical epithelium. II. Cell production rates in normal and pathological cervical epithelium.

An application of the metaphase-arrest technique to human cervical epithelium, in vivo, was utilized to obtain cell birth rate data for seventy-six patients with normal and pathological cervical epithelium. Mean cell production rates for basal and parabasal layers of normal epithelium were 0.91 and 0.92 cells/1000 cells/hr respectively. Histologically normal epithelium adjacent to CIN (cervical intra-epithelial neoplasia) had a significantly higher rate for the parabasal layer compared to the 'normal' group (P less than 0.05). Values for the lower two-thirds of CIN III were 8-10 times higher than for normal epithelium, with microinvasive carcinoma having the highest rates of all. Values for wart-affected cervical epithelium (NCWVI) were intermediate between normal and CIN, but there was activity in the superficial layer, possibly reflecting activity of the papilloma virus. Large variation in birth rates between individuals in the same histological category was noted for each group, this being particularly the case in six patients with early invasive carcinoma. The data is used to attempt to elucidate some of the uncertainties surrounding the aetiology and biological behaviour of cancer of the cervix and its precursors. Sources of inaccuracy are emphasized and practical difficulties discussed.

Adult↗
PubMed1985

A critical evaluation of three methods of studying cell proliferation in human cervical epithelium.

Three experiments describing applications of cell kinetic techniques to the human cervix are presented. The mitotic index is shown not to be associated with histologic differentiation, node metastasis, or survival rates in cervical squamous carcinoma, although inherent sources of inaccuracy may be a contributory factor. The second experiment, a new application of the metaphase arrest technique to cervical epithelium, allows an estimation of cell production rates in normal, dysplastic, wart-affected cervical epithelium, and in invasive carcinoma. Confidence limits are wide, rendering individual values imprecise in isolation. The third project describes a modification of in vitro labeling of cervical biopsy specimens using tritiated thymidine followed by autoradiography. Labeling indexes are produced for normal and pathological cervical epithelium. Although successful labeling was not achieved in every case, the labeling index for cervical intraepithelial neoplasia (CIN stage III) is significantly greater than for normal epithelium. The metaphase arrest technique appears to be the most applicable of the three to the study of the human cervix, yielding a useful parameter of cell proliferative activity. The labeling index gives an indication of activity that is useful for comparative studies, but that does not provide data regarding actual proliferative rates. More sophisticated experiments using radioactive materials are ethically inadmissable.

Adult↗