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Biomedical subjects

J Connolly

Publications and source records attributed to J Connolly.

At least 73 records · Page 4Linked to original sources
PubMed1993

The association between a positive T and B cell flow cytometry crossmatch and renal transplant failure.

Between January 1989 and June 1991 329 consecutive cadaveric renal transplants were carried out at this centre and, of those, 36 (10.9%) have failed. In order to assess whether the use of flow cytometry crossmatching (FCXM) would have predicted these failures, we carried out a retrospective T and B cell FCXM study comparing the failure group with a control group of 30 recipients carefully selected from patients transplanted during the same period. The number of first and second transplants in the control and failure groups was 25,5 and 23,8 respectively with six of the controls and three of the failures having panel reactive lymphocytotoxic antibodies > 50%. Stored donor material was available for 31 of the 36 failures. Two colour FCXM was performed using R-phycoerythrin-conjugated antihuman CD3 and antihuman CD19 to identify T and B cells respectively. For each recipient, three pretransplant and one post-transplant sera were tested against lymphocytes from the recipient's kidney donor. A fluorescein isothiocyanate conjugated F(ab')2 rabbit antihuman IgG was used to detect recipient IgG alloantibodies bound to donor T and/or B cells. There were no T or B cell FCXM positive (+) results in the control group whereas 11 of the 31 (35%) failures overall and nine of the 23 (39%) who failed within three months were T and B cell FCXM+ pretransplant (p = 0.0002). Seven of the nine FCXM+ results in the early failure group were with historic sera and two with historic and current sera.(ABSTRACT TRUNCATED AT 250 WORDS)

B-Lymphocytes↗
PubMed1993

Benign retroperitoneal fibrosis and renal cell carcinoma.

We report benign retroperitoneal fibrosis associated with renal cell carcinoma in a 56-year-old woman. Based on the preoperative evaluation and initial surgical exploration, the retroperitoneal mass was assumed to be metastatic renal cell carcinoma and chemotherapy rather than surgical resection was offered to the patient. A second opinion was sought and repeat exploration revealed a resectable cell carcinoma and retroperitoneal tissue that was pathologically benign idiopathic retroperitoneal fibrosis. This report emphasizes that a patient with an otherwise resectable primary tumor must undergo multiple, deep biopsies of retroperitoneal masses before making a presumptive diagnosis of malignant retroperitoneal fibrosis secondary to metastatic cancer.

Biopsy↗
PubMed1993

Personality disorder, tendency to impulsive violence, and suicidal behavior in adolescents.

Inpatient suicide attempters (n = 37) were compared with never-suicidal psychiatric controls (n = 29) with respect to prevalence and severity of personality disorder, history of aggression and assaultive behavior, and other measures of impulsive violence. Attempters, compared with controls, were more likely to show evidence of personality disorder or trait, particularly those of the borderline type. Attempters showed greater number of borderline symptoms than did controls, even after removing the item relating to suicidality. There were no differences between the groups with respect to lifetime history of aggression, history of assaultive behavior, or self-report measures of a tendency to impulsive aggression. Those attempters with personality disorder were much more likely to have made a previous attempt. The apparently high prevalence of personality disorder among adolescent inpatient suicide attempters indicates that the social impairment associated with personality disorder be viewed as an important aspect of treatment.

Adolescent↗
PubMed1993

Cognitive social skills and social self-appraisal in depressed adolescents.

OBJECTIVE: This study was undertaken to determine whether the social cognitive skills and social self-appraisal of depressed adolescents differed from those of other adolescents with nonaffective psychiatric disorders or of adolescents free from disorder. METHOD: Within the age range of 15 to 19, 38 depressed adolescent outpatients (14 boys, 24 girls); 31 nondepressed adolescent outpatients (17 boys, 14 girls); and 34 normal high-school students (18 boys, 16 girls) were assessed using the following dependent measures: Interpersonal Negotiation Interview, Adolescent Social Problem Solving Measure, Adolescent Self Perception Profile, and Interpersonal Dependency Inventory. RESULTS: Depressed adolescents were found to have significantly more negative self-concepts and significantly less social self-confidence than either comparison group. They did not differ from the other adolescents in either social problem-solving ability or interpersonal understanding. CONCLUSIONS: These results indicate that depressed adolescents have unique deficits in social self-evaluation which contribute to ineffective social behavior and the maintenance of dysphoric affect. Treatment of social skill deficits should be based on a careful assessment of the patient's functioning in this area.

Adolescent↗
PubMed1993

Comparison of reagent strip (dipstick) and microscopic haematuria in urological out-patients.

Dipstick (reagent strip) and microscopic urine analysis for haematuria was performed prospectively on 1000 consecutive urine samples taken from urological out-patients. Haematuria was present in 185 samples (18.5%) and absent in 687 (68.7%) using both tests; 98 samples (9.8%) had dipstick haematuria that was not confirmed by microscopy and 30 samples (3%) had microscopic haematuria that was missed on dipstick urine analysis. Dipstick urine analysis had a sensitivity of 86.1% and a specificity of 85%. This study confirms that reagent strip testing for haematuria has both false positive and false negative results and indicates that cytoscopy should be considered in all patients with suspected haematuria.

Adolescent↗
PubMed1993

Adenovirus 12 and dermatitis herpetiformis.

Previous studies have shown that A-gliadin, a major gluten-derived peptide known to activate the gluten-sensitive enteropathy (GSE) of coeliac disease (CD), and the non-structural E1B peptide produced during early lytic gastrointestinal infection with human adenovirus type 12 (AD12) share an identical twelve amino acid sequence. It is suggested that immunological cross reactivity between these two peptides may play an important role in the pathogenesis of CD. As a milder but histologically identical GSE is found in the majority of patients with dermatitis herpetiformis (DH), a condition also thought to be caused by dietary gluten, we postulated that AD12 may also be involved in the pathogenesis of DH. To test this we assayed sera from 40 patients with DH and 18 healthy controls for AD12-neutralizing antibodies as evidence of past viral exposure. Detectable AD12 antibodies (titre of 13 or higher) were found in only 15% (6/40) of DH patients, compared with 27.8% (5/18) controls (not significant). These findings do not support a causative role for AD12 in the pathogenesis of DH.

Adenoviridae Infections↗
PubMed1992

Home based care and standard hospital care for patients with severe mental illness: a randomised controlled trial.

OBJECTIVE: To compare the efficacy of home based care with standard hospital care in treating serious mental illness. DESIGN: Randomised controlled trial. SETTING: South Southwark, London. PATIENTS: 189 patients aged 18-64 living in catchment area. 92 were randomised to home based care (daily living programme) and 97 to standard hospital care. At three months' follow up 68 home care and 60 hospital patients were evaluated. MAIN OUTCOME MEASURES: Use of hospital beds, psychiatric diagnosis, social functioning, patients' and relatives' satisfaction, and activity of daily living programme staff. RESULTS: Home care reduced hospital stay by 80% (median stay six days in home care group, 53 days in hospital group) and did not increase the number of admissions compared with hospital care. On clinical and social outcome there was a non-significant trend in favour of home care, but both groups showed big improvements. On the global adjustment scale home care patients improved by 26.8 points and the hospital group by 21.6 points (difference 5.2; 95% confidence interval -1.5 to 12). Other rating scales showed similar trends. Home care patients required a wide range of support in areas such as housing, finance, and work. Only three patients dropped out from the programme. CONCLUSIONS: Home based care may offer some slight advantages over hospital based care for patients with serious mental illness and their relatives. The care is intensive, but the low drop out rate suggests appreciation. Changes to traditional training for mental health workers are required.

Adult↗
PubMed1992

Colony-forming efficiency response of bone marrow stromal cells to acute blood loss.

Colony-forming efficiency (CFE) was used to monitor the proliferative response of alkaline phosphatase-positive rabbit bone marrow stromal cells to acute blood loss. The CFE of animals subjected to a 1% blood loss was 0.97 compared with 0.06 (p less than 0.01) in nonbled animals. Sera obtained from animals 10 days after an initial blood loss stimulated the CFE of marrow cultures from nonbled donors to the same degree as osteogenin. Erythropoietin and control sera (from nonbled animals) had no effect. Hence, acute blood loss and sera from bled animals stimulate proliferation of alkaline phosphatase-positive marrow stromal cell colonies. The agent(s) responsible is unknown but it is present in serum in response to blood loss. Confirmation of a specific effect on osteoprogenitor cells may warrant the designation "osteopoietin."

Animals↗
PubMed1992

Alpha 4-2 beta 2 and other nicotinic acetylcholine receptor subtypes as targets of psychoactive and addictive drugs.

1. Xenopus oocytes were injected with various muscle and neuronal nicotinic acetylcholine receptor (ACh receptor, cholinoceptor) subunit RNA combinations and their pharmacological properties studied using two-electrode voltage clamp. The functional expression of one of these combinations, rat alpha 4-2 beta 2, has not been previously described. The alpha 4-2 mRNA is a splicing variant transcribed from the alpha 4 gene. In the experiments reported here, the alpha 4-2 beta 2 subtype was functionally indistinguishable from the alpha 4-1 beta 2 subtype. 2. For each subtype, the relative potency of nicotine compared with acetylcholine was obtained by estimating the relative concentration of nicotine which would elicit the same current response as 0.1 microM Ach. The ratios of these concentrations (nicotine: ACh) for the mouse muscle ACh receptor-(alpha 1 beta 1 gamma delta) was 96.1:1. In contrast, the ratios for the rat neuronal subtypes were: alpha 2 beta 2, 1.01:1; alpha 3 beta 2, 2.01:1; alpha 4 beta 2, 0.76:1 and alpha 4-2 beta 2, 0.76:1. The much greater relative nicotine sensitivity of the neuronal subtypes as compared with muscle receptors illustrates their potential to mediate the psychoactive and addictive effects of nicotine. However, it does not appear that the differences in relative nicotinic sensitivity among the neuronal receptors themselves can be used as a simple discriminative tool in neuronal tissue. 3. The slopes of the log dose-log response curves at low ACh concentrations were all greater than 1 but less than 2, suggesting that at least two agonist binding sites mediate the functional response of each hetero-oligomer. 4. The response of all the neuronal subtypes to ACh could be inhibited by the psychoactive drugs mecamylamine, amitriptyline, phencyclidine, trifluoperazine and promethazine. With the exception of the very potent antagonist, mecamylamine, the degree of block of the peak current to ACh produced by 10 microM concentrations of these drugs was remarkably similar (around 50%). 5. The degree of inhibition produced when the antipsychotic drug, trifluoperazine, was co-applied with ACh increased as the duration of application increased. Such an effect was not observed with promethazine, a related phenothiazine derivative which does not have antipsychotic actions.

Acetylcholine↗
PubMed1992

The daily living programme. Preliminary comparison of community versus hospital-based treatment for the seriously mentally ill facing emergency admission.

Patients with a serious mental illness requiring admission were randomised to home care or standard hospital care. Over the initial 18 months, 60 patients entered each group and were studied for a mean of 10 months. Home care reduced hospital use by 80%, with patients being admitted for a mean of 14 days, compared with 72 days for the standard group, but this bed-saving made no difference in direct treatment costs. Home care offers individualised treatment, and many patients require continuing support with the emphasis on areas such as finances and housing.

Activities of Daily Living↗
PubMed1991

Chronic adult renal vein thrombosis: two unusual cases and a review of the literature.

A panorama of signs and symptoms from the primary and associated disease processes complicates the clinical picture of chronic adult renal vein thrombosis (RVT). This has made the diagnosis of RVT very challenging. In addition, this entity is often overlooked in differential diagnosis due to the patient's often multiple other problems. Detecting this condition may lead to restoration of renal function compromised by renal vein obstruction and thus be of critical benefit in patients who often have compromise of renal function. Two unusual presentations of chronic RVT are discussed and provide a basis for review of the salient features of aetiology, diagnosis and disease management, providing what is hoped to be useful suggestions in diagnosis and management of this condition.

Aged↗
PubMed1991

Pharmacological and functional diversity of neuronal nicotinic acetylcholine receptors.

Recent molecular cloning studies have identified several genes encoding alpha and beta subunits of the nicotinic acetylcholine receptor. These genes have distinct, although overlapping, patterns of expression in the brain and peripheral ganglia. Multiple nicotinic receptors with distinct pharmacological and functional properties can be made in oocytes by pairwise combination of different alpha-type subunits with different beta-type subunits. Both alpha and beta subunits contribute to the pharmacological and functional diversity. Evan Deneris and colleagues explain how oocyte expression studies, in concert with immunological and electrophysiological analysis in vivo, are beginning to reveal the subunit compositions of different neuronal nicotinic receptor subtypes.

Animals↗
PubMed1991

The nicotinic receptor genes.

The causative factor(s) of Alzheimer's disease (AD) are presently unknown. However, it has been shown that the number as well as the fraction of high- to low-affinity nicotine binding sites is altered in patients suffering from this disease. This finding, along with the identification of seven genes which code for nicotinic receptors expressed in the mammalian brain, has led to the idea that one nicotinic receptor subtype may be specifically altered in AD. The present article reviews how, through a molecular genetic approach, a family of genes coding for nicotinic acetylcholine receptor subtypes was uncovered. Also discussed is the use of in situ hybridization to determine the distribution of expression of the mRNA encoding for each receptor subtype and the patch clamp technique to characterize their biophysical properties. Determination of the promoters of these genes, as well as the properties of the expressed receptor subtypes, may make it possible to design new specific nicotinic receptor subtype drugs that will treat not only the symptoms of AD but the progression of the disease process as well.

Alzheimer Disease↗