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Biomedical subjects

M Poole

Publications and source records attributed to M Poole.

At least 19 recordsLinked to original sources
PubMed2006

Spinodal decomposition in solid isotopic helium mixtures.

We report the first observations of spinodal decomposition in solid helium isotopic mixtures, using NMR measurements. The experiments were performed at a 3He concentration of 50% where the transition proceeds through the critical point. We used an initial pressure such that the system remained solid. Our observations indicate that the transition occurs by the mechanism of spinodal decomposition and we are able to study its evolution in real time.

Journal Article↗
PubMed2006

Development and usefulness of an instrument for the standard description and comparison of services for disabilities (DESDE).

OBJECTIVE: Mental health research has made significant progress in international comparison and instrument development. This study reports the adaptation of the European Service Mapping Schedule (ESMS) to the assessment of services for persons with disabilities. METHOD: Qualitative groups were used to develop the Description and Evaluation of Services for Disabilities in Europe (DESDE). The psychometric analysis of DESDE covered: feasibility, inter-rater reliability, descriptive validity and internal validity. A demonstration study was also carried out. RESULTS: Compared to the original ESMS, a new main branch and several sub-branches were added. We identified 826 services for persons with disabilities, which provided 1284 main types of care. The feasibility and reliability was good for the majority of codes. Only 6% of services were not properly classified. The Boolean factor analysis supported the internal validity of DESDE. CONCLUSION: DESDE is a useful and reliable instrument for the assessment of services for persons with disabilities.

Disability Evaluation↗
PubMed2002

Vascular endothelial growth factor gene therapy in ischaemic rat skin flaps.

Gene therapy with the complementary DNA (cDNA) of the angiogenic cytokine vascular endothelial growth factor (VEGF) has emerged as a promising strategy in the treatment of myocardial and lower-limb ischaemia. The objective of this study was to determine whether these principles could be applied to a recognised model of skin-flap ischaemia. Plasmid vectors including the cDNA of green fluorescent protein (GFP) and one of three VEGF isoforms (A165, B167 or B186) were constructed, and their base sequences confirmed. GFP expression was used as a marker of successful in vitro transfection of human endothelial cells with each plasmid. The plasmids were then administered subcutaneously to rat abdominal skin flaps surgically rendered ischaemic, and the percentage of viable tissue was assessed at 1 week. Angiograms of the flaps and histological preparations of flap tissue were assessed for evidence of angiogenesis. The survival of flaps treated with VEGF A165 or B167 cDNA was significantly greater than that of controls (P < 0.05). The survival of flaps treated with VEGF B186 cDNA was greater than that of controls, but statistical significance was not reached. Angiograms and microvessel density counts failed to produce evidence of angiogenesis. With improved delivery strategies, VEGF may have a role in the management of surgical ischaemia.

Analysis of Variance↗
PubMed2001

Altered expression of the carboxylesterases ES-4 and ES-10 by peroxisome proliferator chemicals.

The nonspecific carboxylesterases (EC.3.1.1.1) are a large group of enzymes that play important roles in the metabolism of foreign xenobiotics and endogenous lipids, including activators of the peroxisome proliferator-activated receptor alpha, a nuclear receptor that is the central mediator of peroxisome proliferator (PP) effects in the rodent liver. A number of reports have demonstrated that PP exposure leads to alterations in levels of carboxylesterases in the liver. In this study, we determined by Western blot analysis whether exposure to diverse PP results in alteration of expression of two highly expressed microsomal carboxylesterases. Chronic exposure to the PP WY-14,643 (WY) and gemfibrozil (GEM), but not di-n-butyl phthalate (DBP), led to decreases in ES-4 in male rat livers. ES-4 was increased in female rat livers treated with GEM. WY exposure led to decreases in ES-10 in male and female rat livers. ES-10 was increased in female rats treated with DBP. Compared with other end points that are altered within days after PP exposure, the downregulation of ES-4 and ES-10 by WY was considerably slower, occurring between 1 and 5 weeks of exposure. Decreased expression of ES-4 was observed at doses of WY or GEM as low as 10 or 8000 ppm, respectively, whereas decreased expression of ES-10 was more resistant to changes by any PP occurring only with WY at doses as low as 50 ppm. After chronic exposure to WY or diethylhexyl phthalate in wild-type mice, kidney, but not liver, expression of ES-4 and ES-10 was downregulated. These decreases in kidney ES expression were not observed in PPARalpha-null mice lacking a functional PPARalpha gene, demonstrating the importance of this transcription factor in these changes. These studies demonstrate that ES protein expression is under complex control by PP that is sex- and compound-dependent. These results lend support to the hypothesis that PP exposure leads to a reprogramming of expression of enzymes important in the metabolism of PPARalpha activators.

Animals↗
PubMed2001

A review of therapeutic angiogenesis and consideration of its potential applications to plastic and reconstructive surgery.

The use of exogenous agents to stimulate the growth of new blood vessels into ischaemic tissue is a potentially revolutionary therapy in a wide variety of clinical specialties. Therapeutic angiogenesis research has been mostly confined to ischaemia of the heart and the lower limb. There has been relatively little research into the potential applications of the technique to plastic, reconstructive and burns surgery. In this paper, relevant published work is reviewed and potential applications of therapeutic angiogenesis to our specialty are considered.

Angiogenesis Inducing Agents↗
PubMed2001

Hypertension outcomes in an urban nurse-managed center.

PURPOSE: To assess the quality of hypertension (HTN) care in an urban nurse-managed center (NMC) by chart audits of insured and uninsured (N = 52) African Americans who were managed by nurse practitioners. DATA SOURCES: A chart audit form was developed by the authors that merged Health Plan Employer Data and Information Set (HEDIS) criteria with the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) criteria. CONCLUSIONS: There was near comparable hypertension control among the two groups. No difference was found in systolic blood pressure (BP) control; however, the uninsured group had a slightly greater average diastolic BP compared with the insured group. There was no significant difference in the number of HTN medications or the number of risk factors. A significant difference was found in the number of NP visits per year between the two groups; the uninsured group averaged 3.2 more visits per year. IMPLICATIONS FOR PRACTICE: Nurse practitioners in this NMC were able to manage HTN in a high-risk population despite a lack of insurance coverage for anti-hypertensive prescriptions. The finding that the uninsured group had more clinic visits per year than the insured group is significant in that it increases the cost of providing care for these patients and the health care system. The patient cost in time, transportation and burden needs further assessment.

Antihypertensive Agents↗
PubMed1999

Orbital and globe rotation: the role of the periorbita.

We hypothesize that excyclorotation of the globe and extraocular muscle cone associated with external orbital rotation around each orbital axis in craniofacial conditions could be at least partially corrected by leaving the anterior periorbita (periosteum lining the orbit) attached to the surgically rotated portion of the orbit. This hypothesis was tested by comparing the degree of rotation of the globe in response to internal rotation of the anterior orbit, leaving the periorbita attached to the rotated portion of the orbit on one (study) side, and stripping the periorbita on the opposite (control) side, in nine fresh cadavers. There was a highly significant difference (P < 0.0001) between the study and control sides. The possible extrapolations of this finding to the clinical situation are discussed.

Analysis of Variance↗
PubMed1999

Health status in 52 long-term survivors of pediatric brain tumors.

The percentage of children who survive childhood brain tumors is increasing. A number have neurological and other sequelae which impact on the quality of their survival. We reviewed long-term survivors using a standardized health status instrument. The mothers of 52 survivors of brain tumors were surveyed. Eight different aspects (attributes) of health status were scored. The first 6 of these attributes were scored in a health status index (HSI) developed at McMaster University. Subgroup analysis was performed. Limitation in the quality of life was found in one of the 8 attributes in all but 2 of the subjects. The health status index (HSI) score using the first 6 attributes of this survey had a median of 0.73 (range 0.16-1.00). This score is lower than that found in previously surveyed survivors of leukemia or other childhood cancers. Examination of age at diagnosis, extent of surgery, sex and therapeutic modalities used showed no correlation with HSI score. Those with supratentorial astrocytomas had a lower HSI score (0.65) than those with infratentorial astrocytomas (0.85) (p = 0.05). Children with craniopharyngiomas had a poor score (0.64). This survey shows that the survivors of brain tumors have an appreciable burden of morbidity. Most have deficits in health status that affect many areas of their lives. Apart from site of the primary tumor, there was little correlation between subgroups studied and health status. The health status of children who survive brain tumors is lower than that of survivors of other childhood malignancies.

Adolescent↗
PubMed1998

Design of a 2 T multipole wiggler insertion device for the SRS.

Two new identical insertion devices have been designed for the Daresbury SRS. They are 2 T permanent-magnet multipole wigglers that will provide high flux in the X-ray region. This paper describes the magnetic and mechanical design of the arrays of steel pole pieces and permanent-magnet blocks. Also given is the engineering design of the support structure that will cope with the very large forces present while maintaining high levels of precision in gap setting and parallelism. The engineering design has been fully assessed using finite-element techniques to predict the deflections of critical parts of the structure. These two devices are due to be installed into the SRS by the end of 1998.

Journal Article↗
PubMed1997

Unusual pathogen in a man with HIV infection.

A 41-year-old man who had tested positive for HIV infection presented with cough, yellow sputum, fever, and chills of 10 days' duration. He was short of breath at rest and had a poor appetite. He did not have chest pain, bloody sputum, or weight loss.

Adult↗
PubMed1997

Intra-operative radiation therapy in pediatric neuroblastoma.

External beam irradiation (EBRT) has been shown to improve response rates and event-free survival in children with neuroblastoma and regional lymph node metastases. Irradiation during surgical exposure (intra-operative radiotherapy, IORT) with displacement of adjacent radiosensitive organs out of the treatment field allows for more precise delineation of the target volume and significantly reduces the amount of normal tissue exposed to irradiation. We have incorporated IORT into the treatment regimen of 24 children with neuroblastoma between the years of 1983-1991. IORT was directed to any residual tumor or the tumor bed; the median dose of radiation was 1,000 cGY, equivalent to 3,000 cGY of conventional EBRT. There were 11 males and 13 females. Two patients had stage II, 12 patients had stage III, and 10 patients had stage IV disease. Ten children received IORT for suspected recurrent or persistent neuroblastoma. Twelve patients were disease-free survivors following IORT with a median follow-up of 54 months. For those patients with stage III disease, seven children were disease-free survivors, while only three of 10 patients with stage IV disease survived (median follow-up 30 months). Disease-free Survival (DFS) correlated with the achievement of local tumor control in children with both stage III and IV neuroblastoma. There was limited morbidity and no episodes of obstructive uropathy were encountered. We conclude that IORT appears to be well tolerated and may have therapeutic benefit for a select group of patients with neuroblastoma. IORT merits future exploration by prospective study.

Child↗
PubMed1997

Protocol for accurate assessment of ABPI in patients with leg ulcers.

Ankle brachial pressure index (ABPI) calculations are performed by nurses in the assessment of patients with leg ulceration. The measurement of pressure in one arm alone can result in inaccuracy which may be clinically significant. Two vascular nurse technologists performed ABPI measurements on 250 patients with 487 lower limbs. Community nurses replicated the study on 71 patients, assessing 123 lower limbs. The study shows that 22% of patients in the vascular laboratory and 20% in the community had a difference in brachial pressures of > or = 15 mmHg, indicating the presence of arch vessel or upper limb arterial disease. Furthermore, 6% of patients in the laboratory and 2% in the community demonstrated that the difference in brachial pressures affected the ABPI calculation around the value of 0.8, thus potentially influencing their clinical management. ABPI measurements should be performed, taking both brachial pressures for optimum results.

Adult↗
PubMed1995

Chemoradiotherapy for organ preservation in oral and pharyngeal carcinoma.

OBJECTIVES: To use concurrent chemoradiotherapy as primary treatment for resectable head and neck squamous cell carcinoma to (1) demonstrate the feasibility of an organ preservation approach for nonlaryngeal sites; (2) evaluate the toxic reactions and response to a new combination of two platinum compounds; and (3) monitor the effect of therapy on oral and pharyngeal function. DESIGN: Case series, a prospective single-armed trial. SETTING: Tertiary referral center. PATIENTS: Twenty-two patients with head and neck squamous cell carcinoma of the oral cavity, oropharynx, and hypopharynx for whom surgery would significantly compromise function were entered in this trial. INTERVENTION: Standard fractionation external-beam radiation therapy (2 Gy/Fx; total, 70 Gy) was given during a 9-week period, including a 2-week break after 40 Gy, concurrently with eight weekly doses of carboplatin and three doses of cisplatin (100 mg/m2) at 3-week intervals. A biopsy was performed 12 weeks after the completion of chemoradiotherapy to assess clinical response. All patients presenting with nodes greater than 3 cm had planned neck dissection. MAIN OUTCOME MEASURES: Tumor response, toxic reactions, survival, and oral and pharyngeal function. RESULTS: Overall complete response was 86%. Estimated overall 2-year survival was 64%, and disease-specific survival was 71% (median follow-up time, 25 months). Five patients have died of disease and two of unrelated causes. Treatment was completed by all, with toxic reactions including myelosuppression, mucositis, and dysphagia. Half of the patients required gastrostomy. CONCLUSIONS: Concurrent chemoradiotherapy using two platinum analogues was tolerated with good local control and survival. Notable dysphagia was common. This study provides pilot data for randomized clinical trials to confirm the usefulness of chemoradiotherapy for nonlaryngeal organ preservation.

Adult↗
PubMed1994

Responding to sexual discrimination: the effects of societal versus self-blame.

Although self-blame has been considered to be a useful coping tool for victims, its benefits within the context of group discrimination are equivocal. The present research hypothesized that women encouraged to engage in self-blame for sex discrimination would be more likely to endorse accepting the situation or to endorse the use of individual, normative actions. In contrast, women encouraged to engage in societal blame for sex discrimination would be more likely to participate in nonnormative actions aimed at enhancing the status of women as a group. Female students in Canada were subjected to a situation of discrimination and were encouraged to blame either themselves or society. They were then given the opportunity to respond to the discrimination by endorsing various actions. A profile analysis of the endorsed actions indicated that the women encouraged to blame themselves were most likely to endorse accepting the situation, whereas the women encouraged to blame society endorsed nonnormative individual confrontation.

Adaptation, Psychological↗
PubMed1992

The effects of soft tissue coverage on bone graft resorption in the craniofacial region.

Experiments were performed to study the amount of resorption of endochondral bone grafts in pockets covered by muscle tissue compared to pockets covered by subcutaneous tissue in immature rabbits at 16 weeks post-grafting. In the first group the grafts were used as onlays on the buccal surfaces of the mandible with cover by masseter on one side of the face and subcutaneous tissues on the other. The second experiment was similar but the grafts were fixed semi-rigidly with wiring. In the third the grafts were used as onlays on the cranium with muscle or subcutaneous tissue coverage. The fourth group of bone grafts were implanted into muscle and subcutaneous tissue pockets in the abdominal wall. Bone graft resorption was significantly greater when covered by muscle than by subcutaneous tissue. This effect is probably mediated by movement imparted to the graft by adjacent active muscle, and over-rides any benefits of increased vascularising potential muscle may have. Semi-rigid fixation offered no protection against this effect.

Animals↗
PubMed1990

Leech therapy and bleeding wound techniques to relieve venous congestion.

Temporary restoration of capillary skin blood flow can be established by using leeches or by the creation of a dermal wound and the promotion of continued bleeding from the wound site in a flap with venous occlusion. An increasing restoration of capillary flow occurred with initial application of the leech and tended to exceed other techniques of restoring flow. However, all techniques of exsanguination, including leech therapy, restored very low perfusion over a two-hour course of therapy for a volume of tissue simulating a distal finger replant. The temporary increase in flap perfusion with a single leech application was greatest during the feeding activity of the leech and tapered off after the leech was satiated, to approximate flows achieved with local heparin injection and a punch wound.

Animals↗