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Biomedical subjects

P Swain

Publications and source records attributed to P Swain.

18 recordsLinked to original sources
PubMed1997

Randomised trial of single and repeated fibrin glue compared with injection of polidocanol in treatment of bleeding peptic ulcer.

BACKGROUND: Although injection treatments for ulcer haemostasis seem to be effective, recurrent bleeding remains a serious problem. Large randomised clinical trials are required to show differences between treatment modalities for gastrointestinal bleeding. The aim of this study was to compare the safety and efficacy of repeated endoscopic injection of fibrin glue (FG) with that of single endoscopic injection of polidocanol in the prevention of recurrent bleeding. METHODS: 854 patients with active gastroduodenal bleeding (spurting, oozing), or ulcers with a visible non-bleeding vessel, were randomly assigned one of three endoscopic treatments: single application of polidocanol 1%, single application of FG, or daily repeated application of FG until the visible vessel had disappeared. All patients were pretreated with local injection of epinephrine (1/10,000), and had daily repeat endoscopies until the vessel observed at initial endoscopy was no longer visible. FINDINGS: Recurrent bleeding rates among the 790 patients in whom the rates could be assessed were 58 (22.8%) of 254 in the polidocranol group, 51 (19.2%) of 266 in the FG-single group, and 41 (15.2%) of 270 in the FG-repeated group. The difference between FG-repeated treatment and polidocanol was significant (p = 0.036). Treatment failed, making other treatments (including surgery) necessary, in 34 (13.0%) of 261 in the polidocanol group, 34 (12.4%) of 274 in the FG-single group, and 21 (7.7%) of 274 in the FG-repeated group. The difference between FG-repeated treatment and polidocanol was significant (p = 0.046). The 30-day-mortality rates were low in all three treatment groups (polidocanol 4.7%; FG-single treatment 5.3%, FG-repeated treatment 4.3%). The safety profiles of the three treatment strategies were similar. INTERPRETATION: Repeated injection with FG glue is significantly more effective than injection with polidocanol 1% in the treatment of bleeding from gastroduodenal ulcers.

Adult↗
PubMed1997

Down-regulation of poison ivy/oak-induced contact sensitivity by treatment with a class II MHC binding peptide:hapten conjugate.

Immune regulation of contact sensitivity to the poison ivy/oak catechol was studied at the level of class II MHC-restricted T cell recognition of hapten:peptide conjugates. In this study we have shown that 1) T cells from C3H/HeN (H-2k) mice, immunized with a synthetic I-Ak binding peptide coupled to 3-pentadecyl-catechol (PDC; a representative catechol in urushiol), recognized peptides derived from syngeneic cells linked to the same catechol; 2) T cells from draining lymph nodes of C3H/HeN mice skin-painted with PDC proliferated in response to a peptide carrier:PDC conjugate only when it was linked at the 7th, but not the 4th or the 10th, position on the peptide carrier; and 3) tolerization studies confirmed down-regulation of PDC-induced delayed-type hypersensitivity following treatment with a single I-Ak binding peptide carrying PDC covalently bound to a lysine residue at the middle (7th) TCR contact position. Tolerization with peptide:PDC conjugate resulted in abrogation of hapten-specific T cell proliferative responses that correlated with diminished IL-2 secretion. On the basis of these data we propose that it may be sufficient to couple the hapten at a single, well-chosen position on a carrier peptide to target a relevant population of T cells involved in contact sensitivity.

Administration, Topical↗
PubMed1996

Cutting thread at flexible endoscopy.

BACKGROUND: New thread-cutting techniques were developed for use at flexible endoscopy. A guillotine was designed to follow and cut thread at the endoscope tip. A new method was developed for guiding suture cutters. Efficacy of Nd: YAG laser cutting of threads was studied. Experimental and clinical experience with thread-cutting methods is presented. METHODS: A 2.4 mm diameter flexible thread-cutting guillotine was constructed featuring two lateral holes with sharp edges through which sutures to be cut are passed. Standard suture cutters were guided by backloading thread through the cutters extracorporeally. A snare cutter was constructed to retrieve objects sewn to tissue. Efficacy and speed of Nd: YAG laser in cutting twelve different threads were studied. RESULTS: The guillotine cut thread faster (p < 0.05) than standard suture cutters. Backloading thread shortened time taken to cut thread (p < 0.001) compared with free-hand cutting. Nd: YAG laser was ineffective in cutting uncolored threads and slower than mechanical cutters. Results of thread cutting in clinical studies using sewing machine (n = 77 cutting episodes in 21 patients), in-vivo experiments (n = 156), and postsurgical cases (n = 15 over 15 years) are presented. CONCLUSIONS: New thread-cutting methods are described and their efficacy demonstrated in experimental and clinical studies.

Animals↗
PubMed1993

Helping disabled people--the user's view.

The main needs for most people with physical disabilities are housing and help with daily living. Thus, many of them will find the new emphasis on social aspects of community care particularly relevant. Peter Swain is a disabled man who leads a project in east Devon which ensures that disabled people have a voice in helping to shape the services they need. In this article he explains how the project, Living Options East Devon, works and how the new legislation for community care might affect disabled people.

Community Health Services↗
PubMed1993

Biological characterisation of an Indian isolate of egg drop syndrome-76 virus.

An isolate of egg drop syndrome-76 virus replicated best in primary chicken embryo liver cells and less well in duck embryo liver cells, duck embryo fibroblast cells and chicken embryo kidney cells. The cytopathic effect in chicken embryo liver cells was marked by the presence of round and refractile cells and detachment of cells from the glass surface. The intranuclear eosinophilic inclusion bodies were observed by 24 to 48 hours after infection. No virus multiplication was observed in primary quail embryo fibroblast cells, chicken embryo fibroblast cells or mammalian cells like Vero, BHK-21 and MDBK. Duck embryos supported the maximum growth of the virus, with allantoic fluid having the highest haemagglutinin titre, followed in order by chorioallantoic membrane, skin and internal organs. Chicken and quail embryos did not support the growth of the virus.

Adenoviridae Infections↗
PubMed1991

Gastrointestinal bleeding: endoscopic treatment of peptic ulcer haemorrhage.

The development and study of haemostatic methods that can be used through flexible endoscopes has been one area of gastroenterology in which major advances have been made over the last 15 years. Bioengineering research with lasers and thermal probes as well as the study and application of simple injection techniques has given the endoscopist a range of tools with which to stop bleeding. Randomized controlled trials have provided fairly convincing evidence that these methods can be of value in the treatment of human peptic ulcer bleeding.

Animals↗
PubMed1989

Cystic fibrosis: diagnostic testing and the search for the gene.

Cystic fibrosis (CF) is a lethal genetic disorder inherited as an autosomal recessive at a frequency of about 1/2000 in Caucasian populations. A DNA marker genetically linked to CF was identified through a collaborative effort by random screening with a collection of RFLP markers on a set of CF families. The marker (CRI-L917) was mapped to chromosome 7. Construction of a genetic linkage map spanning the entire chromosome has led to the identification of a subset of 11 markers close to and flanking the CF locus. Using techniques of pulsed-field gel electrophoresis, which allow very large DNA fragments to be separated, we used seven probes to generate a long-range restriction map covering 12 million base pairs surrounding the CF locus. Information from the map is being used to isolate new probes closer to the CF gene. Methods being developed will allow candidate genes to be tested for their ability to correct defects in ion transport in cultured CF cells.

Chromosome Mapping↗
PubMed1983

Laser fragmentation of renal calculi.

Pulsed Nd YAG lasers will fragment all types of urinary calculi rapidly in air. The fragments are much smaller than with any other technique. Large stones can be split into a few discrete fragments which may prove to be an advantage in that the fragments could then be extracted without leaving multiple small fragments behind. Certain pulsed lasers can be transmitted through fine, flexible glass fibres which are small enough to pass through any sized instrument channel. There is therefore an immediate possibility of using this type of laser in the bladder with carbon dioxide instead of an irrigant. Further experiments are planned in order to investigate the possibility of using this mode of laser in the kidney percutaneously.

Endoscopy↗
PubMed1979

Dapsone and severe hypoalbuminaemia. A report of two cases.

Severe hypoalbuminaemia developed in two patients on long-term dapsone treatment for dermatitis herpetiformis. The patients had been treated with dapsone for 3 and 11 years before the syndrome developed and both recovered completely when dapsone was withdrawn. Albumin-turnover studies revealed a great increase in intravascular albumin catabolism and a modest decrease in synthesis.

Adult↗