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P Strang

Publications and source records attributed to P Strang.

At least 73 records · Page 4Linked to original sources

Cadmium-substituted skeletal troponin C. Cadmium-113 NMR spectroscopy and metal binding investigations.

The binding of cadmium to skeletal troponin C (STnC) has been measured by equilibrium binding and by 113Cd NMR spectroscopy. The equilibrium binding experiments have shown that there are two cadmium binding sites on STnC with a high affinity for Cd2+ (KCd congruent to 10(7) M-1) and two with a lower affinity for Cd2+ (KCd congruent to 10(3) M-1). The former binding constant is comparable to Ca2+ binding to the Ca2+-Mg2+ (structural) sites of STnC and the latter is about a factor of one hundred less than Ca2+ binding to the Ca2+-specific (regulatory) sites of STnC. In the presence of Mg2+ the affinity of Cd2+ for the higher affinity sites was lowered, yielding a KMg of approximately 10(3) M-1. These data clearly suggest that the two sites with high affinity for Cd2+ are the same as the Ca2+-Mg2+ sites (Zot, H., and Potter, J. D. (1982) J. Biol. Chem. 257, 7678-7683). The 113Cd NMR is shown to be temperature-dependent. The room temperature spectrum consists of two resonances at -107.8 and -112.7 ppm with respect to a 0.1 M solution of Cd(ClO4)2. Lowering the temperature to 4 degrees C alters the cadmium exchange dynamics, and results in a four line 113Cd spectrum. The two new resonances at -103.1 and -109.8 ppm probably arise from cadmium binding to the Ca2+-specific (regulatory) sites on STnC; whereas, the resonances at -107.8 and -112.7 ppm correspond to cadmium binding at the Ca2+-Mg2+ (structural) sites, respectively. When the 113Cd2+-substituted protein was titrated with Ca2+, the two resonances corresponding to the high affinity sites were reduced in intensity, followed by a reduction in intensity of the lower affinity Cd2+ sites. Based on the assignments made here and the known binding constants of STnC for Ca2+ (Potter, J. D., and Gergely, J. (1975) J. Biol. Chem. 250, 4628-4633) and the Cd2+ affinities reported here, one would not predict these results. Ca2+ should have first bound to the sites with the lower affinity Cd2+. Since the direct binding experiments clearly demonstrate that the high affinity Cd2+ sites are the Ca2+-Mg2+ sites, we can only conclude that Cd2+ binding to the protein (probably to the lower affinity Ca2+-specific sites) dramatically alters the affinity of the Ca2+-Mg2+ sites for Ca2+. It is suggested that an allosteric coupling network exists between all classes of binding sites.

Animals↗

GP anaesthetists.

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Anesthesia Department, Hospital↗

Compulsory blood alcohol testing of road crash casualties in Victoria: the first three years.

The history, rationale and implementation of legislation for compulsory blood alcohol tests on adult road crash casualties presenting at Victorian hospitals are reviewed. Drinking drivers admitted to casualty departments can now be identified and prosecuted; doctors can obtain blood alcohol test results on road crash casualties without threat of litigation; drinking drivers with alcohol problems may be directed to appropriate re-education or rehabilitation programmes; the opportunity also exists for treatment of non-driver casualties with alcohol problems. In the first three years of testing, 27.1% of 21,863 male driver casualties had blood alcohol concentrations in excess of the legal limit of 0.05 g/100 mL (11 mmol/L), and 13.7% had blood alcohol levels in excess of 0.15 g/100 mL (33 mmol/L); the blood alcohol levels in 8.7% of 9187 female driver casualties exceeded 0.05 g/100 mL, and in 3.7% exceeded 0.15 g/100 mL. Non-drivers had a slightly lower incidence of elevated alcohol concentrations. The implementation of further drink-driving countermeasures, expansion of services for the management of alcohol problems, and development of a national policy directed at prevention of alcohol abuse are recommended.

Accidents, Traffic↗

Prognostic significance of flow cytometry studies in B-cell non-Hodgkin lymphoma.

The prognostic relevance of flow cytometric DNA measurements of lymph node biopsies in relation to histopathology according to the Kiel classification, stage, age and presence or absence of B-symptoms was investigated in 106 patients with non-Hodgkin lymphomas (NHL) of proven B-cell type. Biopsies were taken at diagnosis before treatment. The mean proportion of cells in S-phase was significantly lower in the 76 patients with a 'low grade' NHL (4.4 per cent) than in the 30 patients with a 'high grade' NHL (13.0 per cent) (p less than 0.0001). High S-phase rates were associated with a poor prognosis within the whole material (p less than 0.01) and within the group of 'high grade' NHL (p less than 0.05). In the subgroup CB-CC lymphomas of 'low grade' NHL, the prognostic value of the S-phase rate was stronger than any other investigated parameter (p less than 0.05). In multivariate analyses, the S-phase rate gave, in several subgroups, independent prognostic information, besides clinico-pathological variables.

B-Lymphocytes↗

Comparison between flow cytometry and single cell cytophotometry for DNA content analysis of the uterine cervix.

The DNA content of tumor cells in imprints and biopsies from 33 patients with invasive squamous cell carcinoma and 5 patients with adenocarcinoma of the uterine cervix were analyzed by flow cytometric and single cell cytophotometric methods. A correlation of r = 0.83 was found between the modal DNA values obtained by the two methods. Both methods discriminated between diploid and aneuploid tumors and gave comparable but not identical results. Single cell cytophotometric measurements were in this study more reliable than flow cytometric measurements in diploid tumors. Multiple stemlines, small aneuploid peaks and the so called S-phase rate could only be determined by the flow cytometric technique. Flow cytometry seems to be the method of choice in determination of the DNA content in cervical carcinoma cells and cytophotometric single cell measurements are of complementary value.

Adenocarcinoma↗

Flow cytometric DNA patterns in cervical carcinoma.

Flow cytometric measurements of the DNA content were performed in a prospective study of 167 women with invasive squamous cell carcinoma of the uterine cervix. Ploidy level and the proportion of S-phase cells were correlated to age, menopausal age, staging according to FIGO and histopathology. With increasing age a successive shift from a dominance of peri-diploid and peri-tetraploid values to marked aneuploidy was found. Peri-diploid and peri-tetraploid tumors were more often found in premenopausal than in post-menopausal women (p less than 0.001). The mean S-phase rate was significantly higher in women aged 60-89 years than in women aged 20-59 years (p less than 0.01). More aneuploid tumors were found in stages III and IV than in stages IB and II (p less than 0.01). The mean S-phase rate was higher in stages III and IV (20.8%) than in stages IB and II (17.2%) (p less than 0.01). No statistically significant correlation was shown between ploidy level and histopathology or between S-phase rate and histopathology. In 37 patients polyclonal tumors were found. The reproducibility of the method was good (r = 0.99).

Adult↗

Fentanyl patches for the treatment of pain in dying cancer patients.

It has been claimed that fentanyl patches are less suitable for elderly patients and for patients who are terminally ill and dying. In a retrospective survey of 205 cancer patients who died within the hospital-based home care in Norrköping, Sweden between January 1997 and June 1998 we identified 34 patients who had used fentanyl patches. 30 patients were possible to evaluate for the analgesic efficacy of transdermal fentanyl. 18 out of 30 patients were treated with fentanyl until time of death. The estimated efficacy was good or moderate in 93% and 88%, respectively, of patients younger or older than 65 years of age.

Administration, Cutaneous↗

Treatment modality affects long-term quality of life in gynaecological cancer.

UNLABELLED: In order to survey the side effects after cancer treatment, quality of life data were collected from females in clinical remission. MATERIALS AND METHODS: The study was cross-sectional; every patient that visited the outpatient clinic during a period of three months was asked to anonymously complete the EORTC QLQ-C30 questionnaire and five additional specific questions related to gynaecological cancer. RESULTS: In total, 235 patients (90%) returned the questionnaire. In general, both the levels of functioning and symptomatology were time-dependent. Patients with short treatment-free intervals reported more problems than the others. When using treatment modality as an independent variable in the statistical calculations, a treatment-related effect on functioning and symptomatology was demonstrated (p < 0.05 to p < 0.001). Patients previously treated with chemotherapy had poorer role- and cognitive functioning and more problems with fatigue, nausea, vomiting, dyspnoea, constipation and financial problems, compared with those not treated with chemotherapy (p < 0.05 to p < 0.01). Those patients who had been treated with external radiotherapy and/or brachytherapy had significantly more problems with flatulence and diarrhoea (p < 0.05 to p < 0.001). In conclusion, patients who underwent treatment for gynaecological cancer reported long-term side effects also many years after finishing treatment. The problems where related to treatment modality which should be considered, especially when planning adjuvant treatment.

Adult↗

89Strontium in the management of painful sceletal metastases.

PURPOSE: To make a review of the literature of 89strontium-chloride and a retrospective study of time to palliative intended external irradiation, number of portals and overall-survival after 89strontium-chloride therapy. RESULTS: In total 93 patients were treated 116 times with 89strontium. The patients with prostatic carcinoma received 91% of all 89strontium therapies. Median over-all survival was 10 months after injection. In those cases when 89strontium was given before palliative radiotherapy, the average of total number of local fields was significantly lower (1.1 versus 4.1) compared to those cases where local fields preceded 89strontium therapy. However, time to 89new external irradiation after 89strontium injection was equal between these groups (3.8 versus 2.9 months). CONCLUSION: A review of literature conclude that 89strontium is effective for the reduction of pain originating from osteoblastic metastases. It also reduce the need for external radiotherapy and therefore is cost-effective. However, 89strontium is more effective in an early phase of the metastatic disease and preferably as an adjuvance to external radiotherapy.

Bone Neoplasms↗

Correlations between serum progesterone and smoking, and the growth fraction of cervical squamous cell carcinoma.

BACKGROUND: Possible correlations between growth fraction of squamous cervical carcinomas and serum progesterone (se-P) concentrations, smoking habits and DNA ploidy were studied. MATERIALS AND METHODS: The DNA S-phase fraction (SPF), measured by flow cytometry was used as a marker of tumour growth in 103 cases of squamous cervical cancer stage IB-IV. DNA-ploidy (peridiploidy vs. aneuploidy), Se-P, se-Estradiol, smoking habits, parity, menopausal status, clinical stage and histopathological grading were compared to SPF < 14% vs. SPF > or = 14%. RESULTS: Aneuploidy, (odds ratio (OR) 10.0), se-P > or = 2.6 nmol/l (OR 7.5) and smoking (OR 3.0) were significantly associated with SPF > or = 14%, after adjustments for all factors included in the study. The association with se-P and smoking was attributed to an increased risk for the premenopausal women in the study. DISCUSSION: In this study an increased tumour growth was associated with increased leves of se-P, smoking and aneuploidy in women with invasive squamous cervical carcinoma. This study seems to experimentally confirm epidemiological studies, where smoking and long-term use of oral contraceptives have been linked to cervical neoplasms.

Adult↗

Symptom assessment in advanced palliative home care for cancer patients using the ESAS: clinical aspects.

UNLABELLED: Four hundred and thirty-one cancer patients were assessed with the ESAS and a VAS-QoL at admission to Hospital-based home care (HBHC) and subsequently. RESULTS: Pain and nausea were well-controlled (mean 2.5 and 1.8) whereas patients were less satisfied with appetite, activity and sense of well-being. Dyspnoea and anxiety (lung cancer, p<0.001 and p<0.01) and pain (prostate cancer, p<0.01), were related to diagnosis while activity, drowsiness, appetite and well-being to survival (p<0.05 to p<0.001). The correlations between individual symptoms and well-being were low (0.2-0.5), whereas the correlation between well-being and the Symptom Distress Score (SDS) was 0.76. "Well-being" was a better word to use than QoL. DISCUSSION: ESAS is useful in HBHC and data show that symptoms other than merely pain and nausea are of importance. As the global measurement (one VAS) of well-being has a high correlation with SDS, this single measurement may be clinically adequate for quality assurance of symptom control in dying cancer patients.

Adult↗

Prognostic significance of flow cytometric and clinical variables in endometrial adenocarcinoma stages I and II.

In a prospective study comprising 447 women with endometrial carcinoma stages I-II, the prognostic significance of clinical and flow cytometric variables was evaluated in univariate and multivariate analyses. The parameters studied included age, uterine cavity depth, clinical stage, histopathologic grade, myometrial invasion, weight, body mass index (BMI), parity, diabetes, oestrogen treatment, DNA - content and S-phase fraction. Patient selection for surgery influenced prognosis with a better survival in operated patients. In the univariate analysis the following parameters correlated with survival: age, grade, myometrial invasion, DNA - content and S- phase fraction. In the multivariate analyses which included clinical variables only, age, grade and myometrial invasion remained significant, but when flow cytometric variables were added, only S-phase fraction and myometrial invasion contained prognostic information. S-phase fraction also generally correlated with time of recurrence.

Adenocarcinoma↗

Diagnostic methods in planning palliation of spinal metastases.

In a prospective study of 30 patients with newly diagnosed spinal metastases the benefit of different imaging techniques in planning palliation was studied. Magnetic resonance imaging (MRI) was compared to scintigraphy, conventional radiography and computerized tomography (CT), prior to radiotherapy or surgery. In the first comparison, a total of 159 pathologic lesions could be evaluated. MRI was superior in the detection of suspect metastases compared to conventional radiography and scintigraphy (P less than 0.0001 and p less than 0.01, respectively). MRI also gave useful information about adjacent soft tissue components, vessels, nerves and spinal cord compression, i.e. useful information when planning stabilizing surgery. Both MRI and CT were sensitive and specific methods but when comparing 120 pathologic lesions the detection rate of MRI was significantly higher than that of CT (p less than 0.01). In conclusion, scintigraphy and conventional radiography are adequate enough if palliative radiotherapy is planned. When considering surgery MRI is advocated preoperatively for defining operability.

Female↗

Prognostic indices in endometrial adenocarcinoma stages I and II. A study based on clinical, histopathological and flow cytometric variables.

In a prospective study including 447 patients with endometrial adenocarcinoma stages I and II, clinical and flow cytometric variables were studied in univariate and multivariate analyses. During the follow-up period of 3 to 65 months, 41 patients died of their disease and 26 patients died of intercurrent disease. Based on the results of multivariate analyses, five different prognostic indices were constructed. Using these indices, individual index values were calculated for each patient. The index values were correlated with survival and were used to identify a small high-risk group (10% of the patients) and a large low-risk group (90% of the patients). Indices 1 and 2 were constructed for pre-treatment situations. Index 1 included age and histopathologic grade and identified a small high-risk group and a large low-risk group with a 3-year survival of 62% and 91% respectively. Index 2 also comprised S-phase fraction and distinguished a high-risk group with a 3-year survival of 54% from a low-risk group with a 3-year survival of 93%. Indices 3 and 4 were constructed for patients after surgery, when the degree of residual myometrial tumor invasion was known. Index 3 included age, histopathologic grade and residual myometrial invasion rendering a 3-year survival of 44% and 93% for the high- and low-risk groups respectively. Index 4 also comprised S-phase fraction and identified a high-risk group and a low-risk group with 3-year survival figures of 59% and 96%, respectively. Index 5 included age and histopathologic grade and was constructed for post-treatment situations in unoperated patients. The index separated a high-risk group from a low-risk group with a 3-year survival of 56% and 88%, respectively. In summary, the results from our study show that the prognostic indices made it possible to identify high and low-risk groups in different clinical situations which may prove useful in selecting candidates for future trials with adjuvant or reduced treatment.

Adenocarcinoma↗

Flow cytometry and interactive image cytometry in endometrial carcinoma. A comparative and prognostic study.

Comparative DNA measurements were performed in 139 women with endometrial carcinoma using flow cytometry (FCM) and interactive image cytometry (ICM). Ploidy level and the percentage of S-phase cells were determined by FCM and ploidy level and the percentage of cells with a DNA content exceeding 2.5c, 3c, 4c and 5c, respectively, were calculated by ICM. The aim was to compare ploidy level obtained by the two methods and to evaluate the prognostic value of all the above-mentioned parameters. Recurrence or residual disease after completing treatment were used as end-points. Follow-up time was 18-48 months. An agreement was obtained in 85% of the cases as regards ploidy level, but in 15% the tumors were regarded as near-diploid by one method and as grossly aneuploid by the other. Both ploidy level (both methods) and S-phase rate (FCM) were correlated with histopathologic grade (p less than 0.001 and p less than 0.05, respectively). In univariate analysis, ploidy level (obtained either by FCM or ICM) correlated with recurrence rate, with a more favourable prognosis for near-diploid cases. When using multivariate models (Cox analysis) including clinical variables, ploidy level by FCM (but not ICM) was still significant as regards prognosis. In the multivariate analysis, S-phase fraction (as measured by FCM) also yielded independent prognostic information. In a separate analysis the proportion of cells with a DNA content greater than 5c gave independent prognostic information besides that of the S-phase fraction and ploidy level. We conclude that measurements of the percentage of cells exceeding 5c give prognostic information beyond the information obtained from flow cytometric determination of ploidy level and S-phase fraction.

Aged↗

Cancer-related pain and its influence on quality of life.

In a prospective study 84 consecutive patients with cancer-related pain were interviewed and they also completed a comprehensive self-questionnaire concerning their pain and its influence on physical, emotional, cognitive and social qualities of life. Visual Analogue Scales, VAS, (10 cm lines) were used. The mean intensity of pain was 3.9 (range 1-9). Sixty-one (73%) patients experienced two or more different types of pain. Anxiety and depressive feelings correlated with the intensity of pain (p = 0.003 and p = 0.0004). The parameters were significantly higher in patients who had no pain-free or almost pain-free periods (p = 0.02 and p = 0.002). Pain had a negative influence on ADL functions and on concentration in 76% and 56% of the patients, respectively. Social activities such as visits and conversations decreased significantly with increasing pain (p = 0.0001). It is concluded that unrelieved pain not only causes physical suffering, but also influences different aspects of quality of life. As effective pain control is achievable in most cases with already existing analgesics and complementary methods, more efforts should be focused on pain relief.

Activities of Daily Living↗

Influence of oestrogen on growth of endometrial carcinoma.

The influence of endogenously produced oestrogen on the growth of endometrial carcinoma was studied in postmenopausal 128 patients with endometrial adenocarcinoma. Plasma concentration of oestrone (E1) and oestradiol (E2) showed wide variations. Hormone levels were analysed in relation to growth rate, expressed as S-phase rate measured by flow cytometry, and to ploidy level. When the whole unclassified group was studied, no statistical relationship between E1 and E2 levels and S-phase rates were found. However, when peridiploid tumors (1.8-2.2 c) were divided according to histopathological grades, well differentiated tumors with low oestradiol concentrations (less than 60 pmol/I) had significantly lower S-phase rates than those with higher oestradiol levels (p less than 0.01). Aneuploid tumors showed high S-phase rates regardless of plasma oestradiol concentrations.

Aged↗

The reproducibility of flow cytometric analyses in human tumors. Methodological aspects.

Various methodological aspects of flow cytometry were studied in material from endometrial carcinoma, ovarian tumors and bladder carcinoma. Measurements of identical samples on two different occasions gave an excellent correlation of the obtained DNA values, r = 0.997 and a good reproducibility of the S-phase rate, r = 0.87. In large tumors different DNA values were found in 5/36 cases when central and surface biopsies were compared (indicating tumor heterogeneity) which stresses the importance of multiple biopsies. The S-phase rate of the surface biopsies was generally higher. Comparing staining with ethidium bromide and DAPI, a good correspondence of ploidy determinations in human bladder tumors was found, provided that diploid cells from the normal tissue component were used as internal reference. When ethidium bromide staining was used, there was a good agreement between the values of tumor ploidy obtained by external standardization using lymphocytes and internal standardization using diploid tumor cells, respectively. In DAPI staining with lymphocytes as an external standard the tumor ploidy was systematically overestimated by about 10% due to suboptimal staining of lymphocytes after 3 hours. This difference decreased after 18 hours of staining. Determination of S-phase fraction showed a good correlation between DAPI and ethidium bromide stained bladder tumor samples (r = 0.86). Human lymphocytes as an external standard showed good reproducibility. In conclusion, flow cytometric measurements of the ploidy level and S-phase rate are highly reproducible provided that tumor heterogeneity is taken into account and proper preparation and standardization methods are used.

DNA, Neoplasm↗