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Biomedical subjects

G Fletcher

Publications and source records attributed to G Fletcher.

At least 19 recordsLinked to original sources
PubMed1991

Energetic and metabolic studies of intragastric infusion of calories before and after exercise training.

The technique of intragastric infusion of calories was used to examine the energetics and metabolic response to fasting, feeding and overfeeding states in adult, sedentary subjects. All subjects were studied before and after participating in a 12-week aerobic exercise training program that increased maximum aerobic capacity by an average of 15.6 percent. Body weight did not change during the exercise program, but there was a slight and statistically significant increase in fat-free mass and a significant decrease in fat mass. The exercise program did not affect food intake (as determined from food records). When subjects were studied before exercise training, there was no increase in energy expenditure above fasting levels during continuous infusion of calories at a rate near the subject's maintenance energy requirements. When infusion rate was increased to twice maintenance, energy expenditure increased significantly and produced a measurable thermic effect of food. The changes in glucose, insulin and free fatty acids did not parallel the changes in energy expenditure, but changes in lactate levels did. Moreover, there were some gender differences in the pattern of substrate and hormone changes with changes in feeding state. Exercise training did not alter either energy expenditure or the pattern of changes in substrates and hormones with changes in feeding state. In summary, the exercise program led to changes in body composition without measurable changes in either food intake (assessed from diet records) or energy expenditure (assessed during fasting and continuous infusion of calories). The change in body composition must have been due to either (1) the energy cost of the exercise itself, or (2) changes in the substrates used for oxidation, either during or following exercise bouts. We conclude that exercise, unlike food restriction, can lead to changes in body composition without altering body weight or metabolic rate, and can contribute to the acquisition and maintenance of a desirable body weight and composition.

Adipose Tissue↗
PubMed1990

Information needs of patients and visitors in a district general hospital.

A survey of the information needs of patients and visitors to a large District General Hospital was conducted during a one-month period in 1988 to identify sources of information used by patients and their visitors, whether these sources were perceived as adequate and what improvements were suggested. The findings indicate that of 406 respondents, 37% had wanted to know more about a particular condition within the preceding 12 months. The most frequently used sources of information were general practitioners, hospital doctors and nurses, and written material. The most frequent inquires were about disease aetiology and prevention, and the treatment and prognosis of a wide range of medical conditions. Thirty-six per cent of the inquirers had received little or none of the information that they sought. Visitors were more likely than patients to be dissatisfied with presently available sources of information, and patients over 60 years old were more likely to be satisfied than younger groups. Dissatisified persons were most often seeking improved access to doctors and nurses, more explanations from these staff, and more readily available booklets and leaflets. The results are discussed in relation to previous findings with hospital in-patients. They support a stated need in the recent Government White Paper, Working For Patients, for patient information leaflets and for clear and sensitive explanations about what is happening to them in hospital.

Adolescent↗
PubMed1990

Age-related changes in the cervical facet joints: studies with cryomicrotomy, MR, and CT.

The cervical facet joints of 20 cadavers were studied systematically with MR, CT, cryomicrotomy, and histologic sections to determine the anatomic changes that occur with age. Uniform layers of cartilage and subarticular cortical bone characterize the cervical facet joints in cadavers under 20 years of age. Most adult cervical facet joints have only a discolored or microscopically thin layer of cartilage and have irregularly thickened subarticular cortical bone. The appearance of the cervical facet joints changes significantly with aging.

Adult↗
PubMed1984

Management of stage T3 and T4 glottic carcinomas.

Between 1959 and 1979, 242 patients with T3 and T4 lesions of the vocal cords were treated at our institution. Treatment consisted of total laryngectomy in all patients. Different modalities of regional node dissections were performed on 187 patients. In addition, 50 patients received irradiation with cobalt-60 postoperatively for specific features of the disease. In the group of 192 patients whose treatment consisted of surgery alone, 28 (14 percent) had recurrence in the neck and 10 (5 percent) had stomal recurrence. Of the patients treated with combined therapy, three (6 percent) had ipsilateral neck recurrences and one (2 percent) had stomal recurrence. For lesions staged N0, failure rates above the clavicles were 16 percent and 31 percent for patients with T3 and T4 lesions, respectively, in the group treated by surgery alone, 9 percent and 6 percent for patients with T3 and T4 lesions, respectively, in the combined therapy group. The rate of failure above the clavicles for lesions staged N+ was 32 percent in the group treated with surgery alone and 8 percent in the combined therapy group. In this study, a correlation was made between the failure rates above the clavicles and different clinical and histologic characteristics of the tumor, surgical findings, and the different modalities of cervical node dissection used. From analysis of the data, recommendations have been made for the selective treatment of patients with advanced glottic carcinomas.

Adult↗
PubMed1983

Preoperative or postoperative irradiation as adjunctive treatment with radical mastectomy in breast cancer.

Results from the standpoint of survival rates and locoregional failures are compared in three series of patients having had a radical mastectomy for breast cancer: (1) radical mastectomy alone for the patients who had essentially outer quadrant lesions and a negative axilla; (2) postoperative irradiation when the axillary nodes were positive and/or the tumor was centrally located or in the inner quadrants; and (3) preoperative irradiation for patients with an outside biopsy presenting with a very disturbed breast with edema and ecchymosis, and in a small group of patients with a lesion of clinically borderline operability. The ten-year survival rates are identical in the three groups. In the radical mastectomy alone group, 14% of the patients had positive axillary nodes, in the preoperative irradiation group 30% (probably one half of the true incidence without preoperative irradiation), and in the postoperative group, 71%. This data is indicative that irradiation, either pre- or postoperatively, has survival benefits since there is direct relationship between the percentage of patients with positive axillary nodes and the survival rates. However, there is no evidence that preoperative irradiation is superior to postoperative irradiation.

Breast Neoplasms↗
PubMed1980

Alterations in the cell envelope of Escherichia coli late in bacteriophage T4 infection.

The cell envelope of Escherichia coli was examined for changes during late stages of bacteriophage T4 infection. Late events in T4 infection are shown to result in (i) a reduction in the effectiveness of membrane separation procedures employing either isopycnic sucrose gradient centrifugation or selective solubilization of inner membrane by detergent (Sarkosyl or Triton X-100), (ii) the appearance of a 54 000 dalton host protein in membrane preparations, (iii) the adventitious presence of detergent-resistant phage morphogenetic structures in membrane preparation, and (iv) a decrease in the activity of NADH oxidase and an apparent alteration in its association with inner membrane. These modifications occur regardless of the state of the e and t genes of T4.

Bacterial Proteins↗
PubMed1978

Identification of the Escherichia coli cell division gene sep and organization of the cell division-cell envelope genes in the sep-mur-ftsA-envA cluster as determined with specialized transducing lambda bacteriophages.

From a lysogen with lambda integrated in the leu operon, specialized transducing phages that carry the cell division, murein biosynthesis, and envelope permeability genes located about 0.5 min to the right of leu were isolated. These phages were used to identify the previously undiscovered cell division gene sep. A genetic map proves that sep is located in the sequence leuA sep murE murF murC ddl ftsA envA. A physical map of this region was prepared by heteroduplex analysis of the phage DNAs. Overlapping segments of host DNA extended rightward for as much as 26.4 kilobase pairs from the prophage insertion point (thought to be in leuA) to include all the genes through envA.

Cell Division↗
PubMed1975

Treatment of clear cell adenocarcinoma in young females.

Eight cases of clear cell adenocarcinoma treated at The M. D. Anderson Hospital are reviewed. Six such lesions were primarily vaginal carcinomas and 2 involved the cervix. Five patients with early carcinomas were treated entirely with a transvaginal cone or interstitial irradiation and 4 are living and well, 2 to 8 years after completion of therapy. We believe that this experience justifies further treatment of early clear cell carcinomas with conservative radiation. This form of therapy is particularly important since the DEX-exposed patients represent an identifiable high-risk group which should augment the chances for early diagnosis.

Adenocarcinoma↗