Acute hepatitis following enflurane anaesthesia.
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Biomedical subjects
Publications and source records attributed to M Reeves.
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Programmed cell death during development resulting from the lack of appropriate survival factors has been demonstrated in both neurons and oligodendrocytes and occurs mostly in the form of apoptosis. We now demonstrate that Schwann cells in the rat sciatic nerve undergo apoptosis during early postnatal development and that the amount of apoptosis is markedly increased by axotomy. The apoptotic Schwann cells express the low-affinity nerve growth factor receptor but not myelin-related proteins, indicating that they are in the premyelinating state. Apoptosis resulting from normal development or from axotomy can be inhibited markedly by exogenous neuregulin. Consistent with this, the neuregulin receptor components erbB2 and erbB3 are expressed and phosphorylated in developing sciatic nerve. These data suggest that Schwann cell number in developing peripheral nerve is regulated by apoptosis through competition for axonally derived neuregulin.
The employment of simulations and games has been widely recommended for use in nurse education but there are few reports of their introduction or evaluation. This paper describes the use and evaluation of a simulation game which prepares students for a management module in an English National Board pilot scheme course. Evaluation took place by using a questionnaire completed by 528 students and by participant observation by the facilitators. The evaluation indicates that a simulation game is an appropriate way of preparing students for practice and that it provides a realistic and safe environment for enjoyable and meaningful learning to take place.
From 1987 to 1991, 26 patients with CML and a median age of 31 years received allogeneic BMT from a partially mismatched related donor (PMRD) who shared at least one haplotype with the recipient. Nine patients were in accelerated phase (AP), and 11 patients were in blast crisis (BC) at the time of BMT. Patients were mismatched either in graft-versus-host or host-versus-graft directions for one antigen in 3 patients, two antigens in 14 patients, and three antigens in 9 patients. All patients were prepared with a regimen consisting of total body irradiation, etoposide, cytosine arabinoside, cyclophosphamide and methylprednisolone. All marrows were treated ex vivo with T10B91.A-31, a monoclonal antibody directed toward the alpha beta heterodimer of the CD3 receptor, and rabbit complement. Additional GVHD prophylaxis included either the anti-CD5 immunoconjugate XomaZyme-H65, cyclosporine, or both in combination with methylprednisolone. Eight patients did not have sustained engraftment. The 100-day survival was 42%. The incidence of > or = grade II acute GVHD was 29%. The incidence of chronic GVHD was 50% and was limited in all cases. The median survival at 4 years for all 26 patients was 27%. Seven patients (CP 1, AP 3, BC 3) remain in hematologic remission 1297-2241+ days after transplantation. AlloBMT from a PMRD may be considered for patients with advanced CML who lack a matched sibling or unrelated donor.
A study was undertaken to determined if a suitable biosorbent could be found for removal of nickel at low concentrations (< 20 parts per million [ppm]) from a chemically complex wastewater effluent generated by electroplating operations. Algae and cyanobacteria were chosen as candidate biosorbent materials because they are easy to grow and they have the ability to withstand processing into biosorbent materials. Several species were screened for nickel-biosorption capacity initially, and three species of cyanobacteria were selected for further study based on their performance in the scoping tests. When compared to live controls, autoclaving improved the binding capacities of all three species, but usually biosorption data from experiments with live cells were more consistent. None of the three species was able to bind nickel efficiently in actual effluent samples. Further experimentation indicated that sodium ions, which were present in high concentrations in the effluent, were interfering with the ability of the cells to bind nickel. Adsorption isotherm plots for biosorption of nickel by two species of Anabaena in NiCl2-deionized water solutions were prepared.
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Total of 627 AI in 332 Holstein cows in nine herds were used to examine the relationship between serum urea N and conception rate. Cows were assigned randomly to one of three isocaloric diets varying in protein degradability and content. The AI occurred from 50 to 150 DIM. Mean serum urea N for each cow from 50 to 150 DIM was used to examine conception rate and serum urea N. The clinical interpretation of serum urea N on conception rate is evaluated using Bayes theorem from two approaches (dichotomization vs. continuous). Test information resulting from dichotomization of serum urea N into high and low categories (maximizing the average of test sensitivity and specificity) is compared with likelihood ratio approaches allowing a continuous measure. Likelihood ratio test indicates that conception rate decreases with serum urea N of > 14.9 mg/dl, but dichotomized test suggests that the decrease does not occur until serum urea N is > 20 mg/dl.
OBJECTIVE: To evaluate the role of foods in sporadic listeriosis. DESIGN: Microbiologic survey of foods collected from refrigerators of patients with listeriosis identified through active laboratory-based surveillance. Patient and food Listeria monocytogenes isolates were subtyped to identify foods contaminated with the same strain of L monocytogenes that caused illness in the patient; samples of these foods were obtained from the retail source. SETTING: Multistate population-based study conducted between 1988 and 1990. RESULTS: Listeria monocytogenes grew from at least one food specimen in the refrigerators of 79 (64%) of 123 listeriosis patients; 11% of more than 2000 food specimens collected in the study contained L monocytogenes. Twenty-six (33%) of 79 refrigerators with foods that grew L monocytogenes contained at least one food isolate of the same strain as that in the corresponding patient, a frequency much higher than would be expected by chance (P less than .001). Multivariate analysis showed that of the food specimens that grew L monocytogenes, foods that were ready-to-eat, foods that grew L monocytogenes by a direct-plating method (a measure of the level of contamination), and foods that contained serotype 4b isolates were independently associated with an increased likelihood of containing the patient-matching strain. CONCLUSION: We identified specific food and L monocytogenes isolate characteristics--ready-to-eat foods, foods containing higher concentrations of L monocytogenes, and foods containing serotype 4b--which were associated with disease-causing strains. These results can provide guidance to industry and regulatory agencies in developing strategies to prevent listeriosis.
An epidemic of meningococcal disease occurred in Nairobi, Kenya, during 1989, outside the "meningitis belt" of sub-Saharan Africa. About 3800 cases occurred between April and November (250/100,000 population). The case-fatality rate was 9.4% among hospitalized patients. Areas that included Nairobi's largest slums had particularly high attack rates. The epidemic displayed an unusual age distribution, with high attack rates among those 20-29 years old. A vaccination campaign was conducted. By early January, the weekly case count had fallen to 25 from a high of 272 (in September). A case-control study estimated the vaccine efficacy to be 87% (95% confidence interval, 67%-95%). A model estimated that the vaccination campaign reduced the number of cases by at least 20%. Multilocus enzyme electrophoretic typing demonstrated that the strain responsible for this large epidemic is closely related to strains that caused other recent epidemics, documenting further spread of what may be a particularly virulent clonal complex of group A Neisseria meningitidis.
Streptococcus pneumoniae isolates resistant to penicillin, chloramphenicol, tetracycline and sulfamethoxazole-trimethroprim are being recovered with increasing frequency in the United States. We analyzed the penicillin-binding proteins (PBPs), multilocus enzyme electrophoresis (MLEE) genotypes, and ribotypes of 22 multiresistant serotype 23F isolates of S. pneumoniae from the United States and 1 isolate each from Spain and South Africa. Also included were seven multiresistant isolates of other serotypes, three penicillin-resistant but chloramphenicol-susceptible serotype 23F isolates, and two penicillin-susceptible isolates (one penicillin-susceptible isolate was serotype 23F). Fifteen of the 22 multiresistant isolates from the United States and the isolates from Spain and South Africa had identical PBP patterns, MLEE profiles, and ribotypes. Six of the remaining seven multiresistant isolates were related by PBP pattern, but demonstrated slightly different MLEE and/or ribotype profiles, possibly because of acquisition of additional resistance markers (four of the six isolates were also resistant to erythromycin). The remaining multiresistant serotype 23F isolate had a unique PBP pattern and ribotype and was only distantly related to the other pneumococcal isolates by MLEE analysis. The PBP patterns, MLEE profiles, and ribotypes of the multiresistant serotype 23F isolates were easily distinguished from those of six multiresistant isolates of other serotypes; three other penicillin-resistant, chloramphenicol-susceptible, serotype 23F isolates; and two penicillin-susceptible isolates. One exception was a multiresistant serotype 19A isolate that was highly related to the clonal group by PBP pattern and MLEE analysis and that had a ribotype similar to those of the other erythromycin-resistant serotype 23F isolates. MLEE analysis and ribotyping were more discriminating than were the PBP patterns in discerning strain differences. These data strongly suggest that a multiresistant clone of S. pneumoniae serotype 23F that is related to multiresistant isolates from Spain and South Africa has become disseminated in the United States. Clinicians should be alerted to the spread of these multiresistant strains in the United States.
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A method is described for non-invasively measuring the increase in lower limb blood flow during transfemoral lumbar aortography. Flow measurements were made using a continuous wave Doppler-shift ultrasound transducer placed over the contralateral femoral artery. The effect of the non-ionic contrast medium B15000 (Iopamidol), conventional contrast medium (Urografin 370) and Urografin 370 plus Lignocaine were compared in a double-blind trial. All three produced an increase in flow which reached a peak between 12 and 45 s after injection. The peak flow following Iopamidol was significantly lower than that from both Urografin 370 alone and with addition of Lignocaine. There was a difference of lesser degree between Urografin 370 plus Lignocaine and Urografin 370 alone; however, this was not statistically significant. The subjective assessments of pain and patient 'discomfort' paralleled these objective flow measurements.
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By a computer simulation the relative proportion of specified geometrical shapes produced by the sectioning of a mass of randomly-oriented red cells is determined. It is shown that the proportions obtained on the assumption that the cells are all of identical shape are the same as if they had come from a population of cells possessing the normally accepted spread of shapes. It is suggested that a sectioning technique based on the principles presented in this paper could form the basis of a relatively simple procedure for determining on a quantitative basis deviations of red cells from their normal shape.
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