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Biomedical subjects

J Milton

Publications and source records attributed to J Milton.

At least 37 records · Page 2Linked to original sources
PubMed1998

Fine needle aspiration cytology in the investigation on non-Hodgkin's lymphoma.

AIMS: To assess the value of flow cytometry (FCM) in the diagnosis and classification of reactive lymphoid hyperplasia and malignant lymphoma by fine needle aspiration (FNA) cytology. METHODS: Forty six fine needle aspirates of lymphoproliferative disorders were examined by FCM as well as routine cytological assessment. An immunoglobulin light chain ratio (LCR) was calculated for clonality analysis. Additional immunophenotyping was performed in 15 cases. RESULTS: All 25 cases of reactive lymphoid hyperplasia were polyclonal by FCM (LCR < 2/1); 17 of 20 cases of B cell non-Hodgkin's lymphoma were monoclonal (LCR > 3/1). Analysis of cells based on size facilitated detection of small populations of clonal neoplastic cells. Analysis of CD5, CD10, and CD23 expression by FCM facilitated subclassification of mantle cell lymphoma, small lymphocytic lymphoma, and some lymphomas of follicle centre cell origin. One case of T cell non-Hodgkin's lymphoma was correctly classified by FCM. CONCLUSIONS: FNA cytology is a reliable method for investigation of lymphoproliferative disorders. Although excision biopsy and histopathological examination remain the gold standard for primary diagnosis and classification of non-Hodgkin's lymphoma, FNA cytology with clonality analysis and immunophenotyping by FCM is useful for distinguishing reactive from neoplastic lymphoid populations, and can facilitate lymphoma classification.

Adult↗
PubMed1998

Learning with technology: use of case-based physical and computer simulations in professional education.

This presentation will clarify contemporary ideas on the role of technology in education and how it can be employed to improve student learning experiences and outcomes. The paper will emphasise RMIT's role in providing quality education that is relevant to today's world and professional practice. It will examine a specific collaborative (RMIT & ACU), interdisciplinary project 'Pregnancy Simulator: Developing and Enhancing Student Learning of Assessment Skills'. This project consist of a physical pregnancy model connected to a multi-media computer-assisted learning package for the purpose of enhancing student learning of abdominal assessment skills. Our paper outlines an innovative technology-based teaching project and includes current educational issues or problems encountered in professional education, steps already taken to address these difficulties and how this project intends to facilitate learning. It identifies expected learning outcomes for midwives, nurses and medical students, and examines pedagogical principles applied to technological applications designed to provide guided discovery for allowing students to build confidence and competence in professional education. The case-based physical and computer simulations contextualise learning to assist transfer of learning to real world situations. This paper will also discuss how technology-based projects can be evaluated and integrated into university curricula to enhance student learning.

Computer Simulation↗
PubMed1998

Learning with technology: use of case-based physical and computer simulations in professional education.

This paper describes a multimedia technology project in midwifery education and how it is being developed to improve student learning experiences and outcomes. The role of the university providing quality education relevant to today's world and professional practice is emphasised. A collaborative (Royal Melbourne Institute of Technology and Australian Catholic University) interdisciplinary project 'Pregnancy Simulator: Developing and Enhancing Student Learning of Pregnancy Assessment Skills' was developed with university and direct Commonwealth support. This project consists of a physical simulation of a pregnant woman at term and case-based multimedia computer simulations designed to develop and enhance student learning of abdominal assessment skills. A key feature of the development has been to design a learning experience explicitly on an authoritative theory-based view of teaching, in this case Diana Laurillard's 'Conversational Framework'.

Computer Simulation↗
PubMed1997

Modeling accident frequencies as zero-altered probability processes: an empirical inquiry.

This paper presents an empirical inquiry into the applicability of zero-altered counting processes to roadway section accident frequencies. The intent of such a counting process is to distinguish sections of roadway that are truly safe (near zero-accident likelihood) from those that are unsafe but happen to have zero accidents observed during the period of observation (e.g. one year). Traditional applications of Poisson and negative binomial accident frequency models do not account for this distinction and thus can produce biased coefficient estimates because of the preponderance of zero-accident observations. Zero-altered probability processes such as the zero-inflated Poisson (ZIP) and zero-inflated negative binomial (ZINB) distributions are examined and proposed for accident frequencies by roadway functional class and geographic location. The findings show that the ZIP structure models are promising and have great flexibility in uncovering processes affecting accident frequencies on roadway sections observed with zero accidents and those with observed accident occurrences. This flexibility allows highway engineers to better isolate design factors that contribute to accident occurrence and also provides additional insight into variables that determine the relative accident likelihoods of safe versus unsafe roadways. The generic nature of the models and the relatively good power of the Vuong specification test used in the non-nested hypotheses of model specifications offers roadway designers the potential to develop a global family of models for accident frequency prediction that can be embedded in a larger safety management system.

Accidents, Traffic↗
PubMed1995

Encephalopathy is the dose-limiting toxicity of intravenous hepsulfam: results of a phase I trial in patients with advanced hematological malignancies.

Hepsulfam is a bisulfamic ester which is similar in structure to busulfan and is believed to act as a bifunctional alkylator inducing both DNA-DNA and DNA-protein crosslinks. Prior studies in patients with refractory solid tumors have identified the dose-limiting toxicity of hepsulfam to be cumulative myelosuppression resulting in prolonged leukopenia and thrombocytopenia. This phase I trial was designed to determine the maximally tolerated dose of hepsulfam administered intravenously in patients with refractory leukemias and other advanced hematologic malignancies. Hepsulfam was administered as a 30-min or 2-h intravenous infusion to 21 patients with advanced leukemia or multiple myeloma. All patients had been extensively treated and had progressive disease. Cycles were repeated every 5 weeks. Cohorts of patients were treated at 360, 480, 640, and 800 mg/m2. The dose-limiting toxicity of intravenous hepsulfam was severe encephalopathy. The single patient treated at 800 mg/m2 became comatose within 48 h and required 3 weeks for his mental status to return to baseline. There were, however, no irreversible neurological sequelae. Several patients treated at 640 mg/m2 had clinical evidence of toxic deliriums and slowing of alpha rhythm waves on electroencephalograms indicative of a gray-matter encephalopathy. When hepsulfam was infused over 30 min, patients complained of uncomfortable parasthesias, but when the drug was administered over 2 h, these acute symptoms were less common. Myelosuppression was observed in most patients. Among those patients who had some suppression of their leukemia, peripheral blood counts recovered to pretreatment levels after 3-5 weeks. Apart from CNS toxicity, non-hematologic toxicity was minimal. Pharmacokinetic studies demonstrated rapid clearance of hepsulfam so that the drug was not reliably detected in the plasma after 24 h. The recommended phase II dose of hepsulfam as a single 2-h intravenous infusion is 480 mg/m2, but this dose provided relatively little clinical benefit for patients with refractory leukemia. The dose-limiting toxicity is CNS toxicity with increasingly severe encephalopathy at doses > or = 640 mg/m2. It would be reasonable to investigate further dose escalation of hepsulfam in a divided dose schedule to minimize the peak concentrations which may be related to the encephalopathy. EEG monitoring is recommended for early detection of slowing of alpha rhythm waves. Hematopoietic stem cell support will probably be required at total doses exceeding 800 mg/m2.

Adult↗
PubMed1995

Displaying electrocorticographic findings on gyral anatomy.

Human electrocorticographic findings recorded from subdural arrays of electrodes were topographically mapped directly onto magnetic resonance images of gyral anatomy. With this technique gyri involved in generating somatosensory evoked potentials and epileptic phenomena are easily identified. Regions of the cortex which exhibit local spectral changes associated with cognitive tasks can also be visualized. These composite images of structure and function can provide insight regarding the functional organization of human cortex in relation to gyral anatomy and localized pathologic rhythms.

Brain Mapping↗
PubMed1995

The effects of multiple UV exposures on HIV-LTR expression.

Previous studies have shown that cellular stress agents such as UV radiation induce transcription from the long terminal repeat (LTR) of the human immunodeficiency virus (HIV). Using HeLa cells stably transfected with the HIV-LTR sequence, which transcriptionally drives the chloramphenicol acetyl transferase (CAT) reporter gene, we examined the effects of multiple exposures to UVC (254 nm) on HIV-LTR-CAT expression. Low doses (< or = 5 J m-2) had no effect on CAT expression, but up to 29-fold induction was observed with 10 J m-2 when cells were harvested 48 h after completion of the exposure. Little difference was noted in induction levels when cells were exposed to one 25 J m-2 dose, viable cells were harvested at 24 h, 48 h or 72 h, and cell lysates were assayed for CAT expression. Two sequential 12.5 J m-2 exposures, given 24 h apart, resulted in an additive effect on CAT expression; these two exposures produced CAT activity equivalent to that induced following a single 25 J m-2 dose. This additive effect was not evident at the lower doses (< or = 5 J m-2) or at the higher doses. Maximal induction was observed using doses from 25 to 37.5 J m-2. Multiple exposures with either the low (< or = 5 J m-2) or high doses (> 25 J m-2) did not result in an additive effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Chloramphenicol O-Acetyltransferase↗
PubMed1990

Pressure measurements during automatic breast compression in mammography.

Breast compression during X-ray mammography results in improved image quality at a lower radiation dose to the patient, and, as a consequence, the Department of Health recommends that automatic breast compression devices are fitted to mammographic X-ray units. However, the degree of breast compression is not standardized and can vary depending on the size of the patient, the particular mammography X-ray unit and the conditions of its use. A pressure measuring system was used to determine accurately the pressure on the breast. This system takes the form of a fluid-filled neonatal cuff connected to a pressure transducer by a fluid line. The pressure measuring system was calibrated and tested, first without and then with the patients, to assess its practical feasibility. The elements of the pressure measuring system, the techniques involved in its calibration and its use on patients in the clinical environment are described here. The system has proved to be a quick and simple method of relating the pressure on the breast to the pressure reading of the mammography X-ray unit.

Automation↗
PubMed1987

Frequency analysis of the sleep EEG in depression.

Eight patients with major depressive disorder (seven bipolar and one unipolar) and matched controls had sleep studies, on which frequency analysis of the electroencephalogram (EEG) was performed. Total sleep and sleep efficiency were decreased in the patients, but there was no significant difference in rapid eye movement (REM) latency between the two groups. Frequency analysis revealed no group differences in power in the delta band (0.23-2.5 Hz) or the whole EEG spectrum (0.23-25 Hz). These findings suggest that mean REM latencies are not always shorter in major depression. The results are discussed in light of a previous report of decreased delta energy in the sleep EEG of unipolar patients.

Adult↗
PubMed1987

Effect of monocular occlusion on rotary pursuit performance.

An experiment was conducted comparing a monocularly occluded to a control group (n = 8 per group) on a rotary pursuit task over a 24-hr. period. The results show that, notwithstanding a practice effect, the monocular group exhibited a significant depression-enhancement effect previously reported only for measures of temporal visual acuity. Evidently this effect generalizes to more complex tasks.

Adult↗
PubMed1986

Feasibility and usefulness of family record cards in general practice.

In order to determine the feasibility of family record cards in general practice a research secretary created cards for 1825 households from a practice of 10 600 patients. The capital cost was pound108 and the time taken by the secretary was 1638 hours, which is equivalent to a wage of pound1330 for a maximum grade secretary, assuming a 70% rebate paid by the family practitioner committee. Approximately six and a half hours of receptionist/secretarial time are needed each week to maintain the system. The doctors spent a mean of three minutes checking and completing the initial update of each card.Before the cards were introduced, most information about families was held in the doctors' heads, and little was written in the records even though the doctors considered family information relevant in 33% of consultations. After the introduction of family record cards the doctors had access to reasonably complete information about the family at 98% of consultations and the cards were used at 95% of consultations. The doctors believed the information was useful for establishing rapport, identifying patients' concerns, obtaining relevant history, forming diagnostic hypotheses and managing the present complaint. Trainees and locums found the cards more useful than principals.

England↗
PubMed1977

Countersymbiotic suicide.

In the course of studying the outcome of treatment for severely disturbed schizophrenics on a special ward, the authors encountered three instances of suicide with many features in common. All three cases involved young Hispanic male patients who demonstrated pathologically symbiotic relationships with their mothers. None had a history of overt suicide attempts prior to their actual death by jumping. These incidents occurred while the patients were en route to, or at, the maternal home on an unauthorized leave from the hospital. We present the case histories and offer a dynamic interpretation. In each case, it is likely that the underlying desire was to kill the mother. This either was not permissible or, alternatively, the patients' ego boundaries were not sufficiently clear to permit differentiation of self and mother. The patients saw any attempt, short of suicide, to loosen the symbiotic bond as being futile, hence, our terminology of the event as "countersymbiotic suicide."

Adolescent↗