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Biomedical subjects

G Mason

Publications and source records attributed to G Mason.

At least 19 recordsLinked to original sources

Effectiveness of one-year participation in school-based volunteer-facilitated peer support groups.

This study evaluated the effectiveness of one-year participation in a program of volunteer-facilitated peer support groups conducted in a southeast Texas high school. One hundred eighteen students who experienced emotional distress or behavioral problems voluntarily participated in weekly groups facilitated by adult volunteers who were not mental health professionals. Seventy-six participants anonymously assessed the program using an instrument developed to evaluate the group experience. Results indicated that the program was highly accepted by the students even though two-thirds had initially felt uncomfortable in the groups. There was significant improvement in the interpersonal, internal, and school domains. Two-thirds of the alcohol and substance users reported reducing their intake or abstaining. The beneficial effects reported by a majority of the participants indicate that schools opting to implement this early intervention program can look forward to encouraging results within one year.

Adolescent

A high incidence of melanoma found in patients with multiple dysplastic naevi by photographic surveillance.

OBJECTIVES: (1) To assess the incidence of melanoma in a cohort of patients with dysplastic melanocytic naevi (DMN) and the relationships between incident melanomas and preexisting naevi and between melanoma risk and numbers of DMN. (2) To examine the role of the patient versus the physician in detecting melanoma and the relative value of surveillance versus prophylactic excision. DESIGN: Prospective cohort study. PATIENTS AND SETTING: Two hundred and seventy-eight adults, each with five or more DMN, were followed up for a mean period of 42 months in a private dermatology practice. DMN were clinically diagnosed. RESULTS: Twenty new melanomas were detected in 16 patients, corresponding to an age-adjusted incidence of 1835/100000 person-years, 46 times the incidence in the general population. Eleven were detected because of changes evident in comparison with baseline photographs and nine were detected by patients or their partners. Thirteen of the 20 melanomas arose as new lesions and only three from DMN. Melanoma risk rose with increasing numbers of DMN. CONCLUSIONS: Increasing numbers of DMN are associated with increasing melanoma risk. Surveillance (baseline photography and follow-up) enabled early diagnosis of melanoma and was very much more cost-effective in preventing life-threatening melanoma than prophylactic excision of DMN.

Adolescent

Counselling implications of chromosomal abnormalities other than trisomy 21 detected through a maternal serum screening programme.

OBJECTIVE: To identify counselling requirements, we reviewed the frequency and type of non-trisomy 21 chromosome abnormalities found at amniocentesis after maternal serum screening for Down's syndrome. DESIGN: The study involved a review of the cytogenetic results of amniocenteses performed because of a raised maternal serum screening risk. SETTING: The maternal serum screening and amniocenteses were performed at hospitals in the Yorkshire region. SAMPLE: 1715 amniocenteses were performed as a result of a raised maternal serum screening risk for the period 1990 to 1993. METHODS: The cytogenetic results were classified into the main categories of numerical and structural chromosomal abnormalities. MAIN OUTCOME MEASURES: The nature and frequency of abnormal cytogenetic results were identified in which parental samples were required in order to determine if the abnormal finding was de novo or familial and/or for which specialist genetic counselling was required. RESULTS: Sixty-nine pregnancies of 1715 amniocenteses were identified with a chromosomal abnormality (4.0%): 35 (2.0%) with trisomy 21 and 34 (2.0%) with another chromosomal abnormality. For 20 of these 34 abnormalities, parental karyotypes were required and in 29 of the 34 specialist genetic counselling was required. CONCLUSIONS: Women undergoing maternal serum screening and, in particular, those proceeding to amniocentesis, should be informed that there is an equal chance that a chromosomal abnormality other than trisomy 21 will be found at amniocentesis, the nature of which usually requires parental samples and specialist counselling.

Amniocentesis

Altered thrombomodulin staining in blistering dermatoses.

The immunocytochemical distribution of thrombomodulin (TM) was examined in sections of skin from patients with blistering dermatoses occurring in the presence and absence of acantholysis. Skin sections were stained using polyclonal and monoclonal anti-human TM antibodies and were correlated with the staining pattern that resulted when using the monoclonal antibody 32-2B, which recognises the chief desmosomal adhesion molecule desmoglein I (DG I). Our study demonstrates a loss of TM staining in acantholytic dermatoses, occurring only in the region of actual disruption of the intercellular bridging between keratinocytes in the stratum spinosum. The thrombomodulin antigen expression paralleled the DG I expression. The strong correlation between the DG I and TM immunostaining pattern in both normal skin and acantholytic dermatoses supports the concept that TM has a role in mediating adhesion processes between keratinocytes.

Acantholysis

Differentiation of growth retarded from normally grown fetuses and prediction of intrauterine growth retardation using Doppler ultrasound.

OBJECTIVE: To assess the hypothesis that infants exhibiting catch-up growth as an indicator of intrauterine growth retardation (IUGR) have a higher incidence of predelivery abnormal Doppler results. SETTING. Obstetric unit, St James's University Hospital, Leeds. PARTICIPANTS: One hundred and ninety-six women with singleton pregnancies at high risk of IUGR, delivered between October 1992 and August 1993. MAIN OUTCOME MEASURES: Postnatal catch-up growth during the first seven months. RESULTS: Forty-six of the 196 infants demonstrated catch-up growth and were therefore classified as growth retarded; 85% of this group had had abnormal Doppler results prior to delivery, compared with 14% of the normally grown group. However, there is considerable overlap in birthweight ratio distribution between the two groups. CONCLUSION: This study confirms the existence of a population of IUGR infants of average birthweight ratio. Doppler appears to distinguish IUGR (as defined by catch-up growth) from normal growth more successfully in infants with an average birthweight ratio than in infants with a low birthweight ratio and is a better predictor of IUGR than SGA.

Adult

Imaging inflammatory diseases with neutrophil-specific technetium-99m-labeled monoclonal antibody anti-SSEA-1.

UNLABELLED: Imaging inflammatory diseases with a 99mTc-labeled neutrophil-specific agent that can be injected directly intravenously continues to be a challenge. METHODS: The antibody, anti-SSEA-1, chosen from studies of 10 neutrophil-specific MAbs, recognizes CD-15 antigens (5.1 x 10(5)/human PMN) with a high association constant (kd = 10(-11) M). One hundred micrograms of MAb labeled with 10-20 mCi 99mTc either by a direct or DTPA conjugation method were injected intravenously into 12 patients (9 men, 3 women, aged 19-48 yr) with clinical evidence of ongoing inflammatory processes. Vital signs of all patients were recorded before and up to 3 hr following administration of the MAb. HAMA was determined in two patients. Anterior and posterior spot views and whole-body images were obtained. All patients except one underwent biopsy, US or CT examinations and/or surgical procedures. Blood samples collected from five patients were analyzed. In nine patients, quantitative organ distribution was determined and radiation dosimetry was calculated. RESULTS: Labeling yields were 94.8% +/- 1.4% and 95.8% +/- 3.5%, respectively. All patients had unequivocally positive images within 3 hr of the MAb injection. Eleven of these were confirmed by other modalities. One patient recovered on antibiotics and was sent home without surgery or other procedures. The lack of radioactivity in the thyroid or gastrointestinal tract indicated that the in vivo stability of the agent was excellent. At 3 hr postinjection, bladder activity in six patients was 1.3% +/- 0.4% of the administered dose. At this time, splenic uptake (7.7% +/- 1.0% ad. dose) and red marrow uptake (14 +/- 1.8%) were lower than those of 111In-WBC. At 49.0% +/- 3.2% administrated dose, liver uptake was at the upper limit with 111In-WBC uptake. Renal uptake was only 2.4% +/- 0.03% administered dose. At 2 hr postinjection, 14% to 51% of the radioactivity was associated with PMN. Radioactivity with lymphocytes was 0.7% to 10.9%, 1.2% to 4.3% with platelets and 1.1% to 2.4% with RBC. No HAMA were detectable in either patient, and no adverse reaction was detectable in any patient. CONCLUSION: Results are highly encouaging and have prompted us to prepare a kit for instant preparation and to initiate clinical trials.

Abscess

In search of effective programs to address students' emotional distress and behavioral problems part III: student assessment of school-based support groups.

Emotional distress and behavioral problems are common in high schools. This report describes the efficacy of an in-school program based on participation in volunteer-facilitated peer support groups in addressing these problems. Two hundred and fifty students who experienced such problems participated in weekly 50-minute peer support groups led by adult nonmental health professional volunteers. The students anonymously evaluated their progress and program acceptability using an instrument developed specifically to evaluate the group experience. Analysis of the evaluation of the 131 respondents documented the reliability of a proposed Self-Assessment Questionnaire which showed that participation led to improvement in school, interpersonal, and internal domains. The program was highly accepted and showed other signs of success: half of the alcohol and substance users reduced their intake, and 60% of those who considered dropping out of school continued their education. The results provide preliminary evidence that peer support groups show promise as an economical and well-accepted method for early recognition and management of emotional and behavioral problems in high schools. For some adolescents, these groups may be the only acceptable or available therapeutic modality.

Adolescent

Clinical significance of fetal choroid plexus cysts.

Choroid plexus (CP) cysts are commonly detected on routine mid-trimester ultrasound scan. When associated anomalies are detected, the risk is sufficient to justify an invasive diagnostic test such as amniocentesis. However, the risk when no associated anomalies are detected is much less well defined. This information is required to determine the appropriate management in cases of apparently isolated CP cysts. We thought the only way to resolve the difficulties in counselling prospective parents was to conduct a prospective study in a large unselected population. A registry of fetal CP cysts detected over 3 years in the Yorkshire Region was compiled and we identified 524 CP cysts. These cases were then amalgamated and analysed with 1361 cases from prospective studies reported in the world English literature and a further 71 unpublished cases identified from a 2 year prospective series from Ninewells Hospital, Dundee. The risk of chromosomal abnormalities was 1 in 150 (95% CI 1 in 85, 1 in 261) when no fetal anatomic abnormalities, apart from the CP cysts themselves, were detected antenatally. The risk increased to approximately 1 in 3 if any other associated ultrasound abnormalities were detected antenatally. The risk did not appear to be related to whether or not cyst size diminished as gestation progresses, whether they were unilateral or bilateral, and whether they were small or large in size (60-80% < 10 mm). 76% of aneuploidic cases were trisomy 18 and 17% were trisomy 21. The risk of Down's syndrome in fetuses with CP cysts but no other anomalies detected antenatally is 1 in 880. The probability of a chromosomal abnormality is high when CP cysts are associated with any other antenatally detected anomaly, indicating a clear need to offering amniocentesis. The predictive value is much lower when no other anomalies are detected. In such cases, it is probably advisable to regard CP cysts as an indication for detailed ultrasound assessment, rather than invasive testing.

Brain Diseases

Proton nuclear magnetic resonance spectroscopic imaging of human temporal lobe epilepsy at 4.1 T.

We performed proton magnetic resonance spectroscopic imaging (MRSI) at high magnetic field (4.1 T) to study N-acetylaspartate, creatine, and choline levels in the brains of normal control subjects and patients with intractable temporal lobe epilepsy. We compared the results of MRSI to those of other presurgical techniques to determine the sensitivity of this method in the lateralization of the epileptic focus. The normal hippocampal creatine-N-acetylaspartate ratio was 0.71 +/- 0.14 with no differences between left and right. Using the mean control hippocampal creatine-N-acetylaspartate ratio plus 2 standard deviations to identify statistically significant changes, we found lateralizing metabolic abnormalities corresponding to the operated temporal lobe in all patients. Four patients (40%) had contralateral abnormalities, and 2 of them had bilateral independent seizure onset confirmed by intracranial electroencephalographic studies. Statistically significant increases in the choline-N-acetylaspartate ratio in comparison to healthy volunteers were observed in 8 of the 10 patients. With the creatine-N-acetylaspartate ratio, MRSI demonstrated a 100% sensitivity compared to magnetic resonance imaging, which identified pathology in 70% of the patients. These findings suggest that proton MRSI yields a distinctive metabolic profile in patients with temporal lobe epilepsy and is sensitive in detecting bilateral metabolic abnormalities in some patients. These preliminary findings suggest that MRSI is more sensitive than magnetic resonance imaging in the lateralization of epileptic foci in temporal lobe epilepsy.

Adult

Fungal eosinophilic pustular folliculitis.

A young woman presented with a persistent unilateral erosive and pustular plaque of the forearm. Repeated biopsy was required to make the diagnosis of a fungal cause for her eosinophilic pustular folliculitis.

Adult