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Biomedical subjects

K Morton

Publications and source records attributed to K Morton.

At least 19 recordsLinked to original sources

Human hydration level monitoring using embedded piezoresistive microcantilever sensors.

Embedded piezoresistive microcantilever (EPM) sensors were used to measure osmolality changes in both saliva mimic solutions and true human saliva. Osmolality changes in human saliva or urine may prove to be reliable, simple, and easy to measure markers for tracking human hydration levels. EPM sensors used in these experiments show good response to osmolality changes in both NaCl-based saliva mimic solutions and to human saliva. The addition of zero-point offset correction to EPM sensors allows for tracking of saliva osmolality changes with high accuracy. Also, the same EPM sensors exhibit a large enough range of osmolality response to make them potentially suitable for urine or blood serum osmolality monitoring.

Biosensing Techniques↗

Thirty-four patients with carcinoma of the cervical esophagus treated with chemoradiation therapy.

OBJECTIVE: To review the experience of 2 institutions in the management of localized carcinoma of the cervical esophagus with chemoradiation therapy. DESIGN: A series of 34 patients received chemoradiation therapy for a 5-year period. All patients were treated with curative intent. Three different regimens were used, all involving concomitant chemotherapy and high-dose radiation therapy. Data relating to toxic effects, local control of disease, and disease-free and overall survival were prospectively collected. SETTING: Two combined clinics at separate major hospitals where multidisciplinary care is the standard practice for this disease. PATIENTS: Patients with biopsy-proved carcinoma of the cervical esophagus. INTERVENTIONS: Patients received 3 different chemotherapy regimens. Two of the regimens used a combination of cisplatin and fluorouracil. The high-dose cisplatin regimen was a large dose of cisplatin (80 mg/m2) given on days 1 and 22 followed by a 96-hour infusion of fluorouracil (800 mg/m2) from days 2 to 5 and from days 23 to 26. The low-dose cisplatin regimen was cisplatin, 20 mg/m2, from days 1 to 5 and from days 22 to 26 and the same 96-hour infusion of fluorouracil. The third regimen used fluorouracil alone. The mean radiation dose administered was 61.2 Gy in 29.6 fractions during 41.8 days using 4- or 6-mV photons and a shrinking field technique. RESULTS: The results of treatment have shown a high rate of local control, although some patients developed metastases. The local complete response rate following treatment was 91%, and the rate of local control of disease was 88%. The projected actuarial 5-year survival rate was 55%. Death from other causes was common. The acute toxic effects of the treatment were acceptable, with only 5 patients requiring nasogastric feeding or gavage. Two patients died of complications related to strictures. CONCLUSION: Concomitant chemoradiation therapy, should be the treatment of choice for carcinoma of the cervical esophagus.

Adenocarcinoma↗

Chemoradiation for inoperable non small cell lung cancer: a phase II study using a regimen with acceptable toxicity.

Over the past few years there have been numerous schedules of combined modality therapy proposed as being useful in the management of inoperable non-small cell lung cancer (NSCLC). These have generally involved the use of high dose radiation therapy to doses of the order of 60 Gy combined with chemotherapy given prior to or concurrently with the radiation. Concurrent chemotherapy has been given with the intention of being both active in NSCLC and with the role of being a possible radiosensitiser. The most commonly employed drugs have been cisplatin, etoposide, 5-fluorouracil, vindesine and mitomycin. Although response rates of the primary tumour to the combined therapy have been optimistic, there has not been a great survival benefit with the median survival in most series remaining at just over 12 months. In this study we have prospectively treated a group of patients with non-metastatic inoperable NSCLC with a regimen of known acceptable toxicity. These patients were inoperable because they were unfit for surgery or had locally advanced disease. The local radiological response rate was 86% and the median survival for the whole group was 13 months. Adenocarcinomas appeared to do significantly worse than squamous cell carcinomas. Toxicity was acceptable and lower than reported in other similar series. There was one treatment related death. We feel that this combination of radiation therapy and chemotherapy is a reasonable compromise for a disease which still has a very poor outlook.

Adult↗

Multicenter trial validation of a camera-based method to measure Tc-99m mercaptoacetyltriglycine, or Tc-99m MAG3, clearance.

PURPOSE: To evaluate an improved camera-based method for calculating the clearance of technetium-99m mercaptoacetyltriglycine (MAG3) in a multicenter trial. MATERIALS AND METHODS: Tc-99m MAG3 scintigraphy was performed in 49 patients at three sites in the United States and Canada. The percentage of the injected dose of Tc-99m MAG3 in the kidney at 1-2, 1.0-2.5, and 2-3 minutes after injection was correlated with the plasma-based Tc-99m MAG3 clearances. The data were combined with the results obtained in 20 additional patients in a previously published pilot study. RESULTS: Regression models correlating the plasma-based Tc-99m MAG3 clearance with the percentage uptake in the kidney for each time interval were developed; there was no statistically significant difference among sites in the regression equations. Correction for body surface area statistically significantly (P < .005) improved the correlation coefficient for each time interval. For the 1.0-2.5-minute interval, the body surface area-corrected correlation coefficient for the four combined sites was .87, and it improved to .93 when one outlier was omitted from the analysis. Similar results were obtained with the other time intervals. Independent processing by two observers showed no clinically important differences in the percentage dose in the kidney or in relative function. CONCLUSION: An improved camera-based method to calculate the clearance of Tc-99m MAG3 was validated in a multicenter trial.

Adolescent↗

Use of PCR for prenatal and postnatal diagnosis of congenital rubella.

A reverse transcription-nested PCR assay (RT-PCR) was evaluated for diagnosis of congenitally acquired rubella in utero and during infancy. RT-PCR was compared with virus isolation for retrospective detection of rubella virus in placental and fetal tissues obtained after termination of pregnancy following primary rubella or rubella virus reinfection. Concordant results were obtained for 85% of samples; rubella virus RNA was detected by RT-PCR alone in four samples, and rubella virus was detected by isolation alone in two samples. Samples were also obtained for prenatal diagnosis of congenital infection; rubella virus RNA was detected in three of seven chorionic villus samples and one of three amniotic fluid samples by RT-PCR, while rubella virus was isolated in only one chorionic villus sample. To demonstrate that the RNA extracted from chorionic villus samples contained amplifiable RNA, a nested RT-PCR was used to detect keratin mRNA. Rubella virus was detected in placenta in two cases in which the fetus was uninfected, and there was no evidence of rubella virus in the placenta from one case in which the fetus was infected. Thus, detection of rubella virus in chorionic villus samples by RT-PCR may not always correctly predict fetal rubella virus infection. RT-PCR was successfully used for the diagnosis of congenitally acquired rubella in infancy. Rubella virus RNA was detected in cyropreserved or formalin-fixed lens aspirates obtained from infants in India with serologically confirmed congenital rubella but not in samples from controls with inherited cataract.

Amniotic Fluid↗

Reasons for rubella susceptibility among pregnant women in west Lambeth.

One hundred and thirty-three pregnant women who delivered at St Thomas' Hospital, in 1990 were noted to require rubella vaccination post partum. Fifty-three (39%) had completed a telephone questionnaire in order to determine reasons for susceptibility to rubella. Laboratory reports confirmed that 92 women were rubella seronegative and 27 had low levels of antibody. Of the 53 women interviewed, 25 gave a history of one or more rubella immunizations, 20 had no history of immunization and vaccination history was unknown for eight. Eleven of the 20 unvaccinated women had not been at school in the UK between 11 and 14 years of age. Eighty-seven per cent of the patients' general practitioners had no knowledge of their patients' rubella antibody status. Ninety-four per cent of the 133 women received rubella vaccine post partum. The Department of Health guidelines should be more vigorously implemented in order to identify and immunize remaining rubella susceptible women of child-bearing age. Susceptibility among women with a history of rubella immunization suggests that the seroconversion rate following rubella immunization in clinical practice may be lower than in vaccine trials.

Africa↗

Psychological functioning of children with craniofacial anomalies and their mothers: follow-up from late infancy to school entry.

Twenty-three mothers and their 5- to 7-year-old children with craniofacial anomalies (CFA) who were assessed during the child's infancy were followed. Three types of CFA were included: cleft lip and palate (CLP), isolated cleft palate (CP), and sagittal synostosis. Measures of child status focused on behavior-problem frequency and self-concept. Mothers completed self-report measures of emotional well-being, marital satisfaction, and social support. Results indicated that (1) a sizable minority (18%) of the children with CFA had clinically significant behavior-problem scores shown in concordant reports by parent and teacher of behavior problems; (2) individual differences in child functioning within the CFA group were predicted by observational measures of earlier mother-infant interaction during play and teaching situations; (3) mothers of children with CLP reported less favorable social support than mothers of children with CP or sagittal synostosis.

Analysis of Variance↗

The changing phenotypic appearance of a malignant vulval neoplasm containing both carcinomatous and sarcomatous elements.

We describe the changing phenotypic appearance over a 7-year period of a malignant neoplasm of the vulva. This lesion was studied by light and electronmicroscopy and immunohistochemical techniques. The tumour contained both carcinomatous and sarcomatous elements including osteosarcomatous differentiation. To our knowledge osteosarcomatous differentiation has not been reported previously at this site. We submit that the best term for this type of neoplasm, based on tumour differentiation rather than reputed histogenesis, is carcinosarcoma. Tumours such as these occurring in the female genital tract should be distinguished from metastatic mixed Müllerian tumours.

Biomarkers↗

A further look at infection at the time of therapeutic abortion.

Microbiological investigations and clinical follow-up were performed on 516 patients undergoing first-trimester termination of pregnancy, over a 2-year period. Chlamydia trachomatis was isolated by pre-operative microbiological screening in 6.7% of patients, gonococcus in 0.4% and Trichomonas vaginalis in 2%. Candida spp and Gardnerella vaginalis were isolated from 16% and 28% of the women, respectively. Patients who had positive cervical chlamydial isolation were significantly younger (less than 22 years) than those who did not. Doctor's clinical diagnosis of genital tract infection was found to be associated with a positive screening result but not with the likelihood of postabortal pelvic infection. Among the 175 patients followed up in the outpatient clinic, 4 of the 15 patients with a positive result for N. gonorrhoeae, C. trachomatis and/or T. vaginalis developed postoperative pelvic infection, which is significantly more than the group who did not harbour any of these three organisms (9/114).

Abortion, Therapeutic↗

Expression of CD15 antigen in urinary bladder transitional cell carcinoma.

The biopsy specimens of 91 patients between the ages of 38 and 94 with transitional cell carcinoma of the bladder were retrospectively reviewed to determine if the expression of CD15 antigen detected by a monoclonal antibody MC2 was correlated with prognosis. Expression was variable, ranging from strong expression of the antigen by only the superficial cells in well differentiated papillary lesions to weak expression by most cells in solid or invasive tumours. In the invasive component there was a correlation between MC2 expression and tumour type, suggesting that the cell surface carbohydrate detected by MC2 may have a role in cell adhesion. There was no correlation between staining and survival. It is concluded that tumour type, grade, and stage remain the best prognostic indicators of urothelial tumours.

Adult↗

Corneal stromal wound healing in rabbits after 193-nm excimer laser surface ablation.

An argon fluoride excimer laser (193 nm) with a moving slit delivery system was used to perform anterior myopic keratomileusis in both eyes of 24 New Zealand white rabbits. Rabbits were killed immediately after ablation and at intervals up to 100 days. By slit-lamp microscopy, four rabbits at day 100 exhibited four clear corneas and four corneas had central, spotty, subepithelial haze. Light and electron microscopy documented corneal healing. In the early stages a transient acellular zone in the anterior stroma appeared over a period of three weeks, followed by an increased number of fibrocytes. In the corneas with opacification, focal areas of 20-microns-thick subepithelial scarring were present. An unexpected finding was transient damage to posterior stromal keratocytes and endothelial cells. The endothelium produced a layer of granular material that migrated anteriorly across Descemet's membrane. Immunochemistry at day 6 showed a marked staining for collagen IV, proteoglycans, fibronectin, and laminin.

Animals↗

Colocalization of fibroblast growth factor binding sites with extracellular matrix components in normal and keratoconus corneas.

Basic and acidic fibroblast growth factor (bFGF, aFGF) binding sites were determined in frozen sections of normal and keratoconus corneas. After incubation with I-125 radiolabelled growth factors, corneal binding sites were revealed by autoradiography. The growth factors were localized mainly to Descemet's membrane and to the epithelial basement membrane. FGF binding sites were generally similar in normal and keratoconus corneas. The binding specificity was demonstrated by competitive inhibition experiments with an excess of unlabelled growth factors. The binding sites were sensitive to pretreatment of the corneal sections with heparitinase. We have attributed FGF's basement membrane affinity to one of its constituents, proteoheparan sulfate. Proteoheparan sulfate, laminin, collagen type IV, and fibronectin were all revealed by immunofluorescent techniques. While keratoconus cornea stroma had less laminin but more fibronectin than normal corneas the main difference lied in type IV collagen which was overexpressed in keratoconus epithelium.

Adult↗

In vivo binding of topically applied human bFGF on rabbit corneal epithelial wound.

We present the results of the first evaluation of human placenta extracted basic fibroblast growth factor (bFGF) in a rabbit corneal epithelium wound-healing model. Healing dose-response experiments after selective epithelial wounding with iodine vapors demonstrated that bFGF accelerated the repair process in a saturable manner. Corneal binding of topically applied 125I-labeled bFGF was investigated using radioassay and autoradiographic techniques. Basic FGF was shown to bind specifically to denuded epithelial basement membrane in a very stable fashion and not to the intact epithelium. No transfer of the topical bFGF to the aqueous humor or any intraocular structure could be observed. The stability of this interaction was further demonstrated by reextracting and characterizing the labeled factor from treated corneas. The specificity of the fixation was documented by in vivo topical competition with unlabeled bFGF or heparin. We propose that bFGF-basement membrane interactions play a role in corneal wound healing.

Administration, Topical↗

Angiolymphoid hyperplasia with eosinophilia: report of a case arising from the radial artery.

A case of angiolymphoid hyperplasia with eosinophilia arising from the radial artery is presented. Histologically, there was proliferation of atypical endothelial cells forming vascular spaces and solid cords, with a background infiltrate of inflammatory cells and prominent tissue eosinophilia. Immunohistochemical studies demonstrated vimentin and factor VIII related antigen in the endothelial cells. The lymphoid infiltrate was polyclonal. These lesions, which typically occur in the dermis and subcutaneous tissue of the head and neck, are known by a variety of different names reflecting disagreement regarding their pathogenesis. The probable nature of the process is discussed.

Aged↗