Biomedical subjects
J F O'Dea
Publications and source records attributed to J F O'Dea.
Unilateral or bilateral electroconvulsive therapy for depression? A survey of practice and attitudes in Australia and New Zealand.
OBJECTIVE: We report the findings of the first survey of the practice of electroconvulsive therapy (ECT) for the treatment of depression in Australia and New Zealand. The major aim was to examine the frequency of use of unilateral and bilateral electrode placement, as bilateral ECT has been recently recommended as the treatment of choice by the Royal College of Psychiatrists (UK). DESIGN: A questionnaire about details of ECT given in the second half of 1989 was forwarded to the medical superintendents of 130 psychiatric hospitals and units in Australia and New Zealand. RESULTS: Reports were received from 96 psychiatric institutions representing a response rate of 74%. In these units, 915 patients were treated with ECT during the study period. In contrast to depressed patients in the United Kingdom or the United States, a majority of Australian and New Zealand patients given ECT were found to receive unilateral ECT (63%). There were marked regional differences in practice, with patients in New South Wales being more likely to receive unilateral ECT, and those in Queensland and New Zealand bilateral ECT. In the majority of units, bilateral ECT was not considered to be indicated in preference to unilateral ECT for either severe, suicidal or psychotic depression. CONCLUSION: The discrepancies between regional practices probably reflect the current uncertainty regarding the balance between the relative efficacy and morbidity of these two forms of treatment. Until these central issues of relative efficacy and morbidity are clarified, it would be inappropriate for local professional bodies to recommend a preferred mode of ECT administration.
Fibroblast stimulation in schistosomiasis. V. Egg granuloma macrophages spontaneously secrete a fibroblast-stimulating factor.
Isolated intact egg granulomas from the liver of Schistosoma mansoni-infected mice have been previously shown to elaborate factors in vitro that can stimulate fibroblasts for biological functions that are of potential importance in the pathogenesis of hepatic fibrosis in schistosomiasis. We report here that cell cultures obtained from monodispersed granuloma cell suspensions, and specifically enriched for macrophages (95% to 100%) spontaneously elaborated fibroblast proliferation-stimulating activity in vitro. These cells possessed functional and phenotyptic characteristics of activated macrophages. In contrast, control peritoneal macrophages from uninfected mice lacked such phenotypic characteristics, and did not spontaneously elaborate fibrogenic activity in vitro. The granuloma macrophage activity was present, pre-formed within the isolated cells, and was continuously elaborated during 72 hr of incubation. By gel infiltration chromatography (Sephacryl S-200 sf), fibroblast-stimulating activity was identified in two pooled fractions, one with estimated molecular radius (Mr) of 46 kd to 57 kd and the other with Mr of 10 kd to 16 kd. Preparative isoelectric focusing in granular gel of crude macrophage culture supernatants identified peak activity in fractions with pI approximately 5. Two different serine esterase inhibitors had no effect on the ability of crude granuloma macrophage supernatants to stimulate fibroblast proliferation. Whereas crude and chromatographed fractions of granuloma macrophage supernatant were active for fibroblasts, they had minimal or no interleukin 1 (IL 1) activity when tested in a thymocyte proliferation assay. In contrast, resident peritoneal macrophages from the same infected mice spontaneously secreted substantial IL 1 and fibroblast-stimulating activity in vitro. We conclude that egg granuloma macrophages are activated in vivo to secrete fibrogenic molecules functionally distinct from IL 1, which might contribute to the pathogenesis of hepatic fibrosis in schistosomiasis.