PubMed Health⌕ Search

Biomedical subjects

D Riley

Publications and source records attributed to D Riley.

At least 163 records · Page 9Linked to original sources
PubMed1989

Blood use in head and neck tumor surgery. Potential for autologous blood.

Recent increased concern regarding the risks of homologous blood transfusion led us to examine the use of blood products for head and neck tumor surgery. Major head and neck surgical procedures at three University of Washington (Seattle)-affiliated hospitals during 1987 were reviewed. Seventy-seven patients were identified. Parameters studied included the following: tumor site and stage, prior treatment, surgical procedure, preoperative and postoperative hematocrit values, estimated blood loss, operative and postoperative blood product use, and operative time. Data were grouped by procedure. Maxillectomy/midface procedures showed the highest average estimated blood loss (1037 mL) and the highest average blood use (1.5 units), followed by composite resections (883 mL and 0.8 units) and laryngectomies (724 mL and 0.9 units). When the data were subgrouped, larynogopharyngectomy (1450 mL and 4.0 units) and composite resection with mandibular swing (1300 mL and 1.0 units) showed the highest blood loss and blood product use. In the assessable groups, previous administration of radiation did not make a significant difference in blood loss or procedure time. However, blood loss correlated well with procedure time in all groups. The great majority of patients met all requirements to function as blood donors (84%). Sixty-five percent of patients met all criteria and used less than 2 units of blood, making autologous blood a reasonable option for the majority of patients with head and neck tumors.

Blood Transfusion, Autologous↗
PubMed1989

Displaced subcapital fractures of the femur: a prospective randomized comparison of internal fixation, hemiarthroplasty and total hip replacement.

In a prospective trial of 278 patients aged over 65 years, treatment of displaced subcapital fractures was randomly allocated to closed reduction and internal fixation with a sliding compression screwplate, Moore hemiarthroplasty, or total hip treatment with a Howse semicaptive prosthesis. One year after operation there was little difference between the three groups in mortality (25 per cent) or general complications. The revision rate within the first year was highest for internal fixation (25 per cent), but many of the replacements also required a further anaesthetic for reduction of a dislocation (Moore, 11 per cent; Howse 12.5 per cent). Total hip replacement resulted in the least pain and most mobility at 1 year, while hemiarthroplasty was worst in these respects. We conclude that internal fixation and particularly primary total hip replacement should be given serious consideration in the management of the elderly patient with a displaced subcapital fracture.

Aged↗
PubMed1989

Frozen shoulder and other shoulder disturbances in Parkinson's disease.

The frequency of shoulder disturbances, particularly frozen shoulder, has not been assessed previously in Parkinson's disease. In a survey of 150 patients compared with 60 matched control subjects a significantly higher incidence of both a history of shoulder complaints (43% vs. 23%) and frozen shoulder (12.7% vs. 1.7%) was found in the Parkinson's disease population. Those developing a frozen shoulder had initial disease symptoms indicative of akinesia twice as frequently as tremor while the ratio was reversed in those without frozen shoulder. In at least 8% of the patients frozen shoulder was the first symptom of disease, occurring 0-2 years prior to the onset of more commonly recognised features. Parkinson's disease should be added to the list of causes of frozen shoulder, and clinicians must be aware that the latter is often the presenting symptom of Parkinson's disease.

Activities of Daily Living↗
PubMed1989

The Cancer Research Campaign trials of adjuvant therapy for early breast cancer.

It is now assumed that for many women there has already been dissemination of tumour at the time of diagnosis of their early breast cancer. Systemic treatment is required if a cure is sought. The use of perioperative cyclophosphamide and long-term tamoxifen, either as single agents or in combination, has been investigated in the Cancer Research Campaign Breast Adjuvant Trial. A total of 2,230 women were recruited to the study. A benefit has been seen for both agents. The implications of these results for the current treatment of women with early breast cancer and for the design of future trials are discussed.

Aged↗
PubMed1988

Use and abuse of performance indicators.

An audit was performed by this department after allegations by the regional health authority of low productivity. It was found that the health authority had underestimated the number of operations performed in 1983 by only 5%, but an inexact classification and grading of operations had led to errors in the performance indicators of 19.8% for the "weighted number of operations" and 34.5% for the "number of major operations per consultant." When the throughput of orthopaedic departments in districts was compared by the regional health authority it was found that such errors in performance indicators had been further compounded by the inconsistent use of population data and incorrect data on medical staffing. Medical practitioners and the health authorities are alerted to this amplification of inaccurate data. Other methods for assessing trauma and orthopaedic surgery are proposed, such as a simplification of the Office of Population Censuses and Surveys classification of surgical operations, grading operations based on time spent in the operating theatre, and provision of computer programs to code for diagnosis and operation when writing discharge summaries.

Catchment Area, Health↗
PubMed1988

Hemiballism in multiple sclerosis.

Hemiballism has rarely been reported in the setting of multiple sclerosis. Review of clinical descriptions cast some doubt on the accuracy of the diagnosis of the movement disorder in several previous cases. We report a patient with definite multiple sclerosis, with videotape documentation of hemiballism, and demonstration of a plaque in the contralateral subthalamic nucleus on a magnetic resonance image.

Adult↗
PubMed1988

A plasma steroid hormone binding protein in the viviparous water snake, Nerodia.

A plasma steroid binding protein (SHBP) with medium-high affinity and limited capacity was characterized in the viviparous water snake, Nerodia. This SHBP shows similarity to SHBPs previously described in some other nonmammalian species. A single binding component was detected by Scatchard analyses with a medium-high affinity for testosterone (T), estradiol (E), progesterone (P), and corticosterone (B). Equilibrium dissociation constants (Kd) for these steroids are as follows: T, 3.6 x 10(-8) M; E, 3.7 x 10(-8) M; P, 5.9 x 10(-8) M; B, 12.1 x 10(-8) M. In competition studies (at saturation) the relative binding affinities (RBA) for E (1.0) and T (1.0) were higher than those for P (0.8) and B (0.59). Further analysis of binding specificity for [3H]estradiol at 100-fold excess competitor concentrations revealed that dihydrotestosterone also competes; however, estrone and estriol were relatively poor competitors. Displacement of 3H-E by antiestrogen clomiphene derivatives and synthetic estrogen varied; enclomiphene citrate (67.8%), clomiphene citrate (42.2%), diethylstilbestrol (37.3%), and zuclomiphene citrate (15.2%). The SHBP has a relatively high binding capacity (Bmax = 0.09-0.7 M), which may be correlated with the relatively high circulating plasma steriod levels in this species. Scatchard analysis, disc gel electrophoresis, sucrose gradient centrifugation, and competition studies indicate the presence of a single moiety binding estradiol, testosterone, progesterone, and corticosterone. The estradiol-SHBP complex is unstable, exhibiting very short times of association (t less than 1.5 min) and dissociation (Kd = 0.0165 sec-1, t 1/2 = 18.3 sec). Measurement of SHBP levels throughout the seasonal reproductive cycle revealed high levels of binding in previtellogenic, vitellogenic, early pregnant, and postpartum animals. A significantly lower level of SHBP was detected in mid-late pregnancy.

Animals↗
PubMed1988

Immunology of giardiasis.

Symptoms of giardiasis vary widely - partly owing to host characteristics and partly, perhaps, to different 'strains' of the parasite. In parallel, the immune response to Giardia also varies - involving humoral and cellular components both in the serum and the intestinal mucosa. In this article, Neal denHollander, Doone Riley and Dean Befus take a critical look at accumulating information about Giardia immunology, and discuss how the miscellany of factors may contribute to the immunopathology of the disease.

Journal Article↗
PubMed1988

Hepatic progesterone receptors: characterization in the turtle Chrysemys picta.

High and low affinity progesterone (P)-binding proteins similar to those described in the chick oviduct were characterized for the first time in liver cytosol in an oviparous turtle, Chrysemys picta. Two forms of high affinity P receptor were separated by diethyl aminoethyl (DEAE)-Sepharose anion exchange chromatography; the A form eluted in low salt buffer, and the B form at a KCl concentration of 0.20 M in a linear gradient. After photoaffinity labeling of crude cytosol with [3H] R5020, two overlapping peaks of radioactivity were detected with sodium dodecyl sulfate-polyacrylamide gel electrophoresis. After separation with DEAE-Sepharose and photoaffinity labeling, the A form migrated as a single peak with a mol wt of 90,000, and the B form as a single peak with a mol wt of 123,000. The affinity (Kd, 2.9 X 10(-9) M), capacity (1 pmol/mg protein), and binding specificity were characteristic of a P receptor. P competed most effectively for [3H]P binding. R5020 and deoxycorticosterone were good competitors; 5 alpha-pregnenolone, 17 alpha-hydroxyprogesterone, and testosterone were quite effective; cortisol, corticosterone, aldosterone, and 5 alpha-dihydrotestosterone were poor competitors. A lower affinity P-binding component (Kd, 1 X 10(-7) M; maximum binding, 15 pmol/mg protein) co-eluted from DEAE-Sepharose columns with the A and B receptor forms. This is the first description of a hepatic P receptor in any vertebrate.

Affinity Labels↗
PubMed1988

An estrogen receptor in the liver of the viviparous watersnake, Nerodia; characterization and seasonal changes in binding capacity.

Understanding of steroid receptors is derived largely from the mammalian uterus and avian oviduct, and we have sought to characterize steroid receptors in relationship to natural cycles in subavian species. Here we report a putative estrogen receptor associated with the vitellogenic cycle in the female viviparous watersnake, Nerodia. Estrogen binding in cytosolic and nuclear hepatic cell extracts exhibits the following characteristics: high affinity (Kd, 1.3 X 10(-9) M cytosol; 5.7 X 10(-10) M nuclear extract), steroid specificity for natural estrogens, association time of 1 h at 22 C and 4 h at 0 C, and dissociation rate of 0.0268 min-1 at 0 C (half-time, 11.2 min) and 0.322 min-1 at 22 C (half-time, 0.906 min). Both cytosolic and nuclear estrogen binding are target organ specific; binding is low to undetectable in lung, skeletal muscle, and intestine and present in liver, oviduct, and kidney. A sedimentation coefficient of 6S was demonstrated in cytosol under low or high salt conditions, and a sedimentation coefficient of 3.5S was found in nuclear extract. Nuclear location of the receptor is indicated by extraction of increasing amounts of receptor by increasing KCl concentrations up to 0.5 M; 50% of the binding is extracted by 0.16 M KCl. Nuclear estrogen binding is increased significantly after estrogen injection. This estrogen-binding moiety is unusual, since it does not bind to the synthetic estrogen diethylstilbestrol, to antiestrogen clomiphene derivatives, or to calf thymus DNA-cellulose and diethylaminoethyl-Sepharose. Significant changes in cytosolic and nuclear hepatic estrogen receptor levels correlate with vitellogenic stage.

Animals↗
PubMed1988

Practical application of a low-protein diet for Parkinson's disease.

Thirty-eight patients with Parkinson's disease were treated with a protein-restricted diet in addition to their usual drug regime. Patients who had failed to obtain a significant response to levodopa previously did not benefit. Sixty percent of those with fluctuations in response to levodopa improved, primarily obtaining an increase in the ratio of "on" to "off" hours. Benefit was always noted within a week of diet initiation. The diet was well tolerated with a low incidence of side effects, which could usually be reversed by a reduction in levodopa dosage. A low-protein diet is a simple adjunct to levodopa therapy that can be readily instituted on an outpatient basis. It may improve even those patients with fluctuations who have failed to obtain optimal benefit from all forms of manipulation of the dosage schedule of levodopa or the addition of newer ancillary medications.

Body Weight↗
PubMed1988

Eimeria maxima (Apicomplexa): a comparison of sporozoite transport in naive and immune chickens.

This study compared the early stages of infection in naive and immune chickens infected with Eimeria maxima. An immunoperoxidase stain was developed and used to detect sporozoites and early schizonts in tissue sections of intestinal epithelium. A significantly higher proportion of sporozoites was present in the crypts of naive chickens, 48 hr postinoculation of oocysts, compared to immune chickens. Sporozoites in immune birds tended to remain in the lamina propria rather than migrate to the crypts. Sporozoites were found within intraepithelial lymphocytes (IEL's) in the epithelium, the lamina propria, and the crypts of both naive and immune chickens. Parasites in IEL's of immune birds at the ultrastructural level and there were no apparent morphological abnormalities. Livers and spleens, of both immune and naive chickens that had been inoculated with Eimeria maxima, produced patent infections when fed to susceptible chickens. Infections could be transferred up to 72 hr post-inoculation of the donor birds. Peak oocyst production in the recipient birds occurred 7-8 days after the transfers. This time period approximates the prepatent period in a natural infection and thus implies that the extraintestinal stage was a sporozoite.

Analysis of Variance↗