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Biomedical subjects

J Buckley

Publications and source records attributed to J Buckley.

At least 19 recordsLinked to original sources

Multiple variants of the human lymphocyte homing receptor CD44 generated by insertions at a single site in the extracellular domain.

The human CD44 cell-surface glycoprotein participates in a wide variety of cell-cell interactions including lymphocyte homing and tumor metastasis. The CD44 antigen is known to display extensive size heterogeneity when compared between different tissue sources although the structural basis for this variation is not yet clear. Recently, two further isotypes in addition to the basic hemopoietic form of the CD44 antigen have been cloned and sequenced and these have been found to contain all or part of a 200-400-base pair insert within the extracellular domain, suggesting that the characteristic heterogeneity in the molecule may be generated by a mechanism of alternative splicing. We have obtained further evidence for alternative splicing, and we report here the cloning and sequencing of six different CD44 sequence variants from a variety of cell lines using a combination of expression cloning and the polymerase chain reaction. Comparison of these variants indicates that each is probably assembled by the insertion of five different exon units in tandem into a discrete site within the membrane proximal region of the extracellular domain. One of the variants contains an exon that shares extensive amino acid sequence homology with a recently described rat CD44 variant that mediates tumor metastasis. Another variant contains a new exon that encodes a tandem repeat of the consensus sequence SG for covalent modification with chondroitin sulfate and is expressed predominantly on mammary tumors. We suggest that a mechanism of alternative exon splicing generates much of the observed structural heterogeneity of CD44 and that the particular set of CD44 variants expressed in a single cell may represent a precise postal code directing the final destination of migrating cells and metastatic tumors.

Amino Acid Sequence

Management of blunt hepatic injuries.

Sixty-three consecutive patients with blunt hepatic trauma were examined. Twenty-four patients underwent immediate operation, and 39 patients were evaluated by computed tomography (CT), of whom 17 underwent operation. Ten patients had no hepatic abnormalities on CT and had operations for associated injuries. Liver injuries were noted in the remaining seven patients, but CT underestimated the injury in four patients. A large hemoperitoneum was present in all seven patients by CT, and the average transfusion was 10 U during initial resuscitation. Twenty-two patients with grade I to III injuries and a small to moderate hemoperitoneum were managed nonoperatively. Six of these patients had transfusions during resuscitation. Only one patient received more than 2 U. There were no deaths and no major complications related to the liver injury. Most patients had repeat CT at 1 week, which demonstrated stable or improving injuries. CT may underestimate the degree of liver injury. Nonoperative management is appropriate in stable patients with grade I to III injuries and a small to moderate hemoperitoneum. These patients should require no more than 2 U of blood, and repeat scans should demonstrate a stable injury.

Accidents, Traffic

Chronic testicular pain following vasectomy.

The incidence of chronic testicular pain following vasectomy has not been previously assessed. We have carried out a survey by postal questionnaire and telephone interview of 172 patients 4 years after vasectomy to assess the incidence of chronic testicular pain. Significant early post-operative complications occurred in 6 patients (3.5%): 2 infection, 3 haematoma and 1 orchitis. Chronic testicular discomfort was present in 56 patients (33%), considered by 26 (15%) to be troublesome but not by the other 30 (17%). Testicular discomfort related to sexual intercourse occurred in 9 cases (5%). Of the 9 patients who had sought further medical help only 2 had had further surgery (1 an epididymectomy and 1 excision of a hydrocele). Only 3 patients regretted having had the vasectomy because of chronic pain. On ultrasound examination, epididymal cysts were a common finding on both asymptomatic and symptomatic patients following vasectomy. Prior to vasectomy, all patients should be counselled with regard to the risk of chronic testicular pain.

Adult

Task versus component consistency in the development of automatic processing: a psychophysiological assessment.

A study was conducted to examine the role of consistency in the development of automatic processing. Subjects performed a memory search task in which consistent and inconsistent attending and responding were factorially combined. The task was performed with memory set sizes of two and four items. Results indicated that automaticity developed with consistent attending regardless of whether responding was consistent or inconsistent. However, measures of reaction time, P300 latency, and P300 amplitude revealed costs for inconsistent responding that were attributed to both stimulus evaluation and response related processes. The results suggest that total task consistency is not necessary for the development of automatic processing. Instead, it appears that automaticity can develop for consistent task components even when stimulus-response consistency is not maintained across the entire task.

Adolescent

Development and transfer of automatic processing.

Two studies were performed to examine the role of consistency in the development and transfer of automatic processing. Ss performed a rule-based memory search task in which they compared multidimensional probes to 1, 2, or 3 memory set rules. Results indicated that learning occurred in the absence of consistency at lower levels of task description (e.g., mapping of individual task components to responses) as long as higher level consistencies existed in the task (e.g., consistent) mapping of task components to a conceptual framework). However, the asymptotic level of this learning was modulated by the consistency with which conjunctions of task components were mapped to decisions. High positive transfer was obtained despite replacement of the exemplars of the memory set rules, suggesting that learning was not specific to the items encountered during training. On the other hand, the magnitude of positive transfer was reduced when the rules were replaced, suggesting that most of the learning took place at the level of specific rules. Some evidence was also obtained for more general process-based learning. Results are discussed in terms of their implications for models of learning and transfer.

Adolescent

Antibodies to Epstein-Barr viral antigens in familial rheumatoid arthritis.

Serum antibodies to Epstein-Barr virus (EBV) were measured in members of twenty-nine families in which two or more first degree relatives had rheumatoid arthritis (RA). These patients were assessed clinically for activity of disease and their treatment recorded. A higher proportion of seropositive individuals was found among patients and affected kindred than among the non-affected groups. Antibody titres to Viral Capsid Antigen (VCA) tended to be higher in patients and affected kindred. In those individuals in whom antibody to Early Antigen (EA) was present there was a lower titre of antibody to Epstein-Barr Nuclear Antigen (ENBA). The results suggest that an immunoregulatory defect may exist in some patients with RA which allows for enhanced expression of EBV.

Antibodies, Viral

Magnetic resonance imaging in hydatid disease.

Magnetic resonance imaging was evaluated in 12 patients with hydatid disease (Echinococcus granulosus). Patients also underwent real time ultrasound and computed tomography imaging. Clear images of hepatic hydatid cysts were produced by magnetic resonance imaging, and intracyst structures were demonstrated. Changes in the appearance of cysts were seen following chemotherapy. Whilst not cost effective at present, if further improvements allow differentiation of simple (epithelial) and hydatid cysts or viable and dead hydatid cysts this technique could be of clinical value.

Echinococcosis

Bone marrow transplantation for acute non-lymphocytic leukemia: a report from the Childrens Cancer Study Group of sixty-seven children transplanted in first remission.

Sixty-seven children with acute non-lymphocytic leukemia (ANLL) in first remission underwent HLA-identical sibling bone marrow transplants as part of a cooperative study by the Childrens Cancer Study Group. Three patients died of sepsis before marrow recovery. Sixty-four patients recovered marrow function and have been followed for a median of greater than 1300 days. Two-year actuarial survival is 59% (95% confidence interval (CI): 47-71%). The risk of relapse by 2 years is 16% (95% CI: 6-26). All relapses occurred among patients with single-dose irradiation (p = 0.07), but these patients also experienced a diminished risk of acute graft-versus-host disease (AGVHD) (p = 0.12) compared to patients conditioned with fractionated irradiation. Radiation technique (single-dose vs fractionated) did not affect survival or the risk of development of interstitial pneumonia. Significant AGVHD (greater than or equal to grade II) occurred in 27 patients (40%). Patients with AGVHD were at increased risk of death due to sepsis or interstitial pneumonia during the first year after transplant, but disease-free survival was unaffected by AGVHD, because all 10 relapses occurred in patients without significant AGVHD. Neither survival nor relapse risk were affected by patient age, sex, white cell count at diagnosis, or FAB classification. This collaborative transplant study has resulted in survival data comparable to those of single institutions and the best reported outcomes of conventional chemotherapy.

Age Factors

Childhood leukemia and parents' occupational and home exposures.

A case-control study of children of ages 10 years and under in Los Angeles County was conducted to investigate the causes of leukemia. The mothers and fathers of acute leukemia cases and their individually matched controls were interviewed regarding specific occupational and home exposures as well as other potential risk factors associated with leukemia. Analysis of the information from the 123 matched pairs showed an increased risk of leukemia for children whose fathers had occupational exposure after the birth of the child to chlorinated solvents [odds ratio (OR) = 3.5, P = .01], spray paint (OR = 2.0, P = .02), dyes or pigments (OR = 4.5, P = .03), methyl ethyl ketone (CAS: 78-93-3; OR = 3.0, P = .05), and cutting oil (OR = 1.7, P = .05) or whose fathers were exposed during the mother's pregnancy with the child to spray paint (OR = 2.2, P = .03). For all of these, the risk associated with frequent use was greater than for infrequent use. There was an increased risk of leukemia for the child if the father worked in industries manufacturing transportation equipment (mostly aircraft) (OR = 2.5, P = .03) or machinery (OR = 3.0, P = .02). An increased risk was found for children whose parents used pesticides in the home (OR = 3.8, P = .004) or garden (OR = 6.5, P = .007) or who burned incense in the home (OR = 2.7, P = .007). The risk was greater for frequent use. Risk of leukemia was related to mothers' employment in personal service industries (OR = 2.7, P = .04) but not to specified occupational exposures. Risk related to fathers' exposure to chlorinated solvents, employment in the transportation equipment-manufacturing industry, and parents' exposure to household or garden pesticides and incense remains statistically significant after adjusting for the other significant findings.

Acute Disease

Effects of norepinephrine on the dog common carotid, coronary and renal arteries: in vitro studies.

The effects of norepinephrine were studied on segments of the common carotid, left circumflex and renal arteries of dogs with the endothelium intact and removed. Norepinephrine induced a dose-dependent increase in tension in segments of the renal and carotid artery but did not produce any effect on the coronary artery. Although the absence of endothelium did not affect the magnitude of the norepinephrine-induced vasoconstriction of the renal artery, it elicited a more pronounced response in the carotid artery in which the endothelium was removed. Our data suggest that the vascular response to norepinephrine is dependent upon the specific arterial bed and, secondly, that the endothelium plays a determinant role in the magnitude of the response of the carotid artery.

Animals

Magnetic resonance imaging and placenta previa.

Twenty-five women with diagnoses of placenta previa on ultrasound examination underwent magnetic resonance imaging examination. An assessment of placental position and the relationship of the lower placental edge to the internal os was made with both techniques and the results were compared. There was complete correlation of placental localization but significant differences were found in the determination of the degree of placenta previa. This occurred more often with posteriorly situated placentas. Magnetic resonance imaging directly affected management with regard to delivery in seven cases. Magnetic resonance imaging provides a technique capable of accurately assessing placental position and its relationship to the cervix, thereby leading to a reduction in hospitalization and inappropriate operations.

Cervix Uteri

Magnetic resonance imaging--its application to cervical carcinoma.

Twenty-five women with primary carcinoma of the cervix were examined with magnetic resonance imaging (MRI). A number of different pulse sequences with T1 and T2 weighting were employed to determine optimum tissue contrast, and the potential for staging cervical cancer was assessed and compared with the clinical findings. MRI is seen to give a unique view of cervical cancer in particular in stage I and II disease where other imaging techniques have known limitations. In addition, stages III and IV were well seen with demonstration of tumour comparable with that of computerized axial tomography (CT).

Adenocarcinoma

Magnetic resonance imaging and hydatidiform mole.

Five women with complete and partial hydatidiform mole were examined by magnetic resonance imaging (MRI). Spin-echo pulse sequences (T2 weighted) were found to provide excellent resolution, while inversion-recovery pulse sequences (T1 weighted) gave better pathological detail. The myometrium was clearly seen on each patient and no invasion by the tumour detected. This corresponded to the histological findings. The potential uses of magnetic resonance in the diagnosis of primary and recurrent trophoblastic disease and its role in management are discussed.

Female

Magnetic resonance imaging and discography in the diagnosis of disc degeneration. A comparative study of 50 discs.

The lumbar spines of 22 patients were examined for disc degeneration by magnetic resonance imaging (MRI) and by discography. The results from 50 intervertebral discs visualised by both techniques were independently assessed and graded on a five-point scale from normality to gross degeneration and then compared. In 44 discs the results agreed. Of the six discs which gave differing results, four discrepancies were due to observer error and two to incorrect placement of the discographic needle. MRI was shown to be more accurate than discography in the diagnosis of disc degeneration. It has several major advantages, which should make it the investigation of choice.

Adult