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Biomedical subjects

L Macfarlane

Publications and source records attributed to L Macfarlane.

14 recordsLinked to original sources
PubMed2003

Pathological features of breast cancer response following neoadjuvant treatment with either letrozole or tamoxifen.

Morphological characteristics, grading features, proliferation marker MIB1, apoptosis (by Tdt-mediated duTP-biotin nick-end labelling (TUNEL)), Bcl-2 expression, oestrogen receptor (ER) and progesterone receptor (PgR) status were compared in ER-positive breast cancers before and after 3 months of neoadjuvant therapy with either letrozole or tamoxifen. Daily treatment was with letrozole 2.5 mg (12 patients) or 10 mg (12 patients), or with tamoxifen 20 mg(24 patients). Letrozole treatment was associated with a pathological response in 17 of 24 (71%) patients. The predominant change in grading features was a decrease in mitosis, and the expression of MIB1 was reduced in all of the 22 evaluable cases. Whilst only marginal changes were observed in ER expression following letrozole therapy, PgR reactivity was reduced in 20 of 21 evaluable cases which were initially PgR-positive, becoming undetectable in 16 patients. Tamoxifen treatment was associated with pathological response in 15 of 24 (63%) tumours. In contrast to letrozole, the dominant change in grading feature was an increase in tubule formation, ER score was markedly reduced in most cases, and the most common effect on PgR was an increased expression. Following treatment with either tamoxifen or letrozole, variable effects were observed on the apoptotic index and expression of Bcl-2. These results indicate that both letrozole and tamoxifen have marked influences on the pathological features of breast cancer during neoadjuvant therapy. However, the effects of the two agents varied such that the phenotypes of letrozole- and tamoxifen-treated tumours differ markedly. Effects on clinical, pathological and biological endpoints were frequently disconcordant--future studies will therefore require the evaluation of multiple parameters in order to fully assess tumour response.

Antineoplastic Agents↗
PubMed2003

Detection of Dientamoeba fragilis by culture.

Symptoms associated with Dientamoeba fragilis include diarrhoea, abdominal pain, nausea, vomiting, epigastric pain and weight loss. A possible link between D. fragilis and irritable bowel syndrome (IBS)-like symptoms has been reported, and therefore the presence of this parasite should be excluded before making a diagnosis of IBS. Over a six-month period, 976 faecal samples were submitted to NPHS Microbiology Aberystwyth for routine microbiological analysis. All samples were also cultured for parasites using Robinson's xenic medium. Trichrome staining was undertaken whenever practicable, but many stools had insufficient material. D. fragilis was isolated from 25 (2.6%) patients, whereas Cryptosporidium spp. was detected in 16 (1.6%) patients. D. fragilis was only detected in nine (1.3%) out of 685 specimens stained with trichrome, although four of the 25 culture-positive stools had insufficient sample for staining. Parasite culture proved to be less laborious than trichrome staining and dramatically increased D. fragilis detection rate.

Adolescent↗
PubMed2002

Incidence of Blastocystis hominis in faecal samples submitted for routine microbiological analysis.

Over a one-year period, 1390 faecal samples were submitted to Aberystwyth Public Health Laboratory for routine microbiological examination. All were stained using a commercial trichrome method. Blastocystis hominis was detected in 96 (6.9%), making it the most common parasite found in the study. Of the B. hominis-positive specimens, 73% were missed on direct microscopy. Molecular typing of B. hominis has revealed extensive genetic diversity in morphologically identical strains and thus detection by microscopy alone may not be sufficient to confirm the role of this organism in human disease.

Animals↗
PubMed2000

Maximizing thoracic organ transplant opportunities: the importance of efficient coordination.

BACKGROUND: In Australia, despite large distances and one of the world's lowest multiorgan donor rates (11.4/million population/year), the thoracic organ transplant (TOTx) rate of 9.6/million population/year is one of the world's highest. METHODS: As an example of the Australian approach, a system of transplant coordination and organ allocation has evolved at the Alfred Hospital. Donor organs are assigned locally, or between the 4 major TOTx units on rotation. The recipient team then selects appropriate recipients, matching by blood group, size, cytomegalovirus (CMV) status, prospective cross matching and clinical status. An experienced recipient coordinator takes responsibility for organization of the retrieval and transplant process, including all operating room staff, all medical personnel, and transport for the donor team and the potential TOTx recipients. RESULTS: Between February 1989 and February 1999, 307 hearts, 48 heart/ lung, 124 single and 116 bilateral lung transplants were performed from 452 donor offers (52% beyond 500 miles). This represents 1.74 organs transplanted/thoracic donor and compares favourably to American United Network for Organ Sharing (1.43) and European (1.3) figures. CONCLUSIONS: The Australia TOTx model has enabled high transplant rates by efficiently using the available donor organs. This has been achieved through an enlarged, experience TOTx team, the optimizing of donor acceptance criteria and improving coordination logistics to allow multiple thoracic procedures simultaneously.

Australia↗
PubMed1999

Improved recognition of MRSA case clusters by the application of molecular subtyping using pulsed-field gel electrophoresis.

Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly common in hospital and community populations, making the recognition of true nosocomial outbreaks more difficult. We have used pulsed-field gel electrophoresis (PFGE) with Sma I digestion to analyse retrospectively two perceived outbreaks of epidemic methicillin-resistant Staphylococcus aureus 15 (EMRSA 15) colonization. The first cluster of cases in patients and staff on a general ward (ward D) revealed three different antibiograms based on differences in ciprofloxacin and rifampicin sensitivities. All isolates typed using PFGE, which was more discriminatory than phage-typing. One PFGE banding profile labelled type 5 was predominant, but 12 isolates proved to be subtypes of type 5 and two were PFGE type 11. Four staff members carried a strain not found in patients, three carried strains found in patients and transient carriage was highlighted as a problem when screening staff. PFGE enhanced the epidemiological data and proved that the cases on this ward did not comprise one large outbreak but numerous sporadic cases and smaller clusters. In contrast, isolates from a second cluster of cases which occurred on ward F were indistinguishable using antibiograms, phage-typing and PFGE, confirming this was more likely to be a true outbreak of colonization. We conclude that PFGE usefully augments epidemiological information and allows more logical infection control decisions to be made, with better utilization of scarce resources.

Bacterial Typing Techniques↗
PubMed1997

Hospital activity. Barred facts.

Barcode technology is applicable to a number of crucial management issues in the NHS, including internal efficiency, contract pricing and the effectiveness of care. Its enormous potential lies in the ability to record in detail over a number of dimensions such as time, staff group, patient type, and cost. But the effort involved is considerable. Projects have to be actively managed, users have to be willing participants and data has to be analysed. Where short cuts have been sought, projects have failed to deliver their full potential. The data is merely a means to an end, but a very powerful one. It brings together people who may normally work independently, and the process of collecting barcode data is a perfect mechanism for bringing together the patient, the professional and the purse strings.

Electronic Data Processing↗
PubMed1997

Antagonist inhibition curves and the measurement of dissociation constants.

1. Experiments carried out on guinea-pig isolated ileum with carbachol as agonist and diphenyl-acetoxyethyl-dimethyl-ethyl-ammonium (DADMEA) bromide as antagonist gave results which fit the theoretical relation between fractional inhibition (Q) of the effects of an agonist ([A]) and the concentration of a competitive antagonist ([B]): this also involves the Hill coefficient (logistic slope factor, P) for the agonist concentration-response curve and the degree of agonist stimulation, [A]/[A]50, where [A]50 produces a half-maximum response. 2. Values of IC50 and an exponent, P', can be obtained by fitting Q to [B] using a logistic approximation to the relation. Both P' and IC50 should be greater with higher agonist stimulation but the increase in P' may be masked by errors in extreme values of Q. Estimates of IC50, however, invariably increased with higher agonist stimulation but with a steep concentration-response curve (P > 1) and low agonist stimulation ([A]/[A]50 < 1, IC50 can be less than KD. 3. KD was calculated from the results in three ways; (i) by a least-squares fit of Q to [B] using the values of P and [A]/[A]50 calculated from the control concentration-response curve; (ii) from the value of IC50 for each line and the values of P and [A]/[A]50 and (iii) by using the agonist concentration-response curve to calculate the dose-ratio and estimate of KD for each in the presence of the antagonist. The methods gave similar results (nM: 11 experiments), 12.4 +/- 1.1 (i), 11.7 +/- 0.9 (ii), 14.8 +/- 1.6 (iii) but there are advantages in using methods (i) or (ii) rather than (iii). 4. The method by which KD is calculated is less important than the experimental design: the plan used in this work, with alternative small and large responses from the tissue, is very suitable for estimating KD with low concentrations of antagonists and small dose-ratios. Although it is not a sensitive test for competitive behaviour because only a small range of concentrations of antagonist is tested, the estimate of affinity should be free from complications involved in the use of higher concentrations of antagonist (and agonist) and the nature of the antagonism can always be checked by doing further experiments in the presence of a known competitive antagonist.

Animals↗