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Biomedical subjects

R Britton

Publications and source records attributed to R Britton.

13 recordsLinked to original sources
PubMed1996

Utilization of intravenous immunoglobulin to ameliorate alloantibodies in a highly sensitized patient with a cardiac assist device awaiting heart transplantation. Fluorescence-activated cell sorter analysis.

Surgery surrounding the use of mechanical assistance in cardiac transplant candidates often leads to multiple blood/platelet transfusions and subsequent development of alloantibodies. This is a case report of a 50-year-old male patient who had received blood transfusions during coronary bypass grafting 9 years earlier. He presented in acute and chronic heart failure and, despite therapy, became moribund with multisystem organ failure. His ejection fraction was 10%. A Novacor ventricular assist device was implanted on May 19, 1995 (day 0). The patient received 44 U of blood and 20 U of platelets. Although his percent reactive antibodies (PRA) were negative before surgery by fluorescence-activated cell sorter analysis, the PRA 3 days after implantation of the ventricular assist device was 80%; it increased to 100% by day 7. In an attempt to decrease the PRA, intravenous immunoglobulin was given at 3-week intervals. The PRA became negative and the patient received a donor heart that was negative by fluorescence-activated cell sorter cross-match on day 64. On days 69-72, a dramatic increase in alloantibody activity was promptly reversed with additional intravenous immunoglobulin. Currently at posttransplant month 12, the patient shows no humoral, cellular, or vascular evidence of rejection.

Blood Transfusion↗
PubMed1994

Interpretation: selected fact or overvalued idea?

The authors describe Bion's use of the notion of the 'selected fact' in the evolution of analytic interpretations. They draw attention to the similarity between the emergence of a 'configuration' from a selected fact and the crystallisation of delusional certainty from an 'overvalued idea'. The risks to the patient of the imposition of an overvalued idea is described. They emphasise the importance of monitoring the subsequent development in sessions following interpretations for evidence of conscious and unconscious reactions to it and offer clinical examples of the use of a selected fact in arriving at an interpretation and the unconscious use of an overvalued idea to form an interpretation and the subsequent analysis of its effects.

Adult↗
PubMed1994

Publication anxiety: conflict between communication and affiliation.

The author suggests that publication anxiety is ubiquitous and natural; it can produce inhibition, symptomatic disorders of the text, or simply overt anxiety. Anxiety-free publication occurs where anxiety is denied as part of a manic defence which produces complacent orthodoxy, triumphant iconoclasm, or an illusion of originality. A discriminating journal usually detects this and publication fails. If the anxiety is excessive, there may be an inhibition of publication such as afflicted Darwin. Lesser degrees of anxiety may result in distraction or distortion due to a compromise between the urge to communicate an idea and the desire to consolidate affiliation with a significant group through shared language, common belief systems, totemic figures or ritual utterances. The author sees this conflict as internal to the individual. It is shaped by Oedipal anxieties which are given different emphasis and intensity by the scientific contexts current at the time. If the 'paradigm', under the influence of which the analyst is writing is in the ascendant, publication is relatively free of anxiety for most writers who are content to add to its application. Some, however, suffer 'anxiety of influence', fearing that their existence as originators of ideas is threatened. When the stability of the paradigm is threatened, due to the accumulation of anomalies, publication anxiety, with both persecutory and depressive elements is intensified. This increases the conflict between the need for affiliation and the desire for communication and may result in defensive writing or distorted texts.

Anxiety↗
PubMed1993

Conservation and evolution of the rpsU-dnaG-rpoD macromolecular synthesis operon in bacteria.

The macromolecular synthesis (MMS) operon contains three essential genes (rpsU, dnaG, rpoD) whose products (S21, primase, sigma-70) are necessary for the initiation of protein, DNA, and RNA synthesis respectively. PCR amplifications with primers complementary to conserved regions within these three genes, and subsequent DNA sequencing of rpsU-dnaG PCR products, demonstrate that the three genes appear to be contiguous in 11 different Gram-negative species. Within the Gram-negative enteric bacterial lineage, the S21 amino acid sequence is absolutely conserved in 10 species examined. The putative nuteq antiterminator sequence in rpsU consists of two motifs, boxA and boxB, conserved in primary sequence and secondary structure. The terminator sequence, T1, located between rpsU and dnaG is conserved at 31 positions in nine enterobacterial species, suggesting the importance of primary sequence in addition to secondary structure for transcription termination. The intergenic region between rpsU and dnaG varies in size owing to the presence or absence of the Enterobacterial Repetitive Intergenic Consensus (ERIC) DNA element. The rpoD gene contains rearrangements involving a divergent sequence, although two carboxy-terminal regions which encode functional domains are conserved in primary sequence and spacing. Our data suggest that primary sequence divergence and DNA rearrangements in both coding and non-coding sequences account for the interspecies variation in operon structure. However, MMS operon gene organization and cis-acting regulatory sequences appear to be conserved in diverse bacteria.

Bacteria↗
PubMed1993

Nutrient metabolism by gut tissues.

The gut uses a disproportionate amount of energy (about 25% of total oxygen consumption) for the size of the tissue (about 6% of body weight). Therefore, knowledge of metabolites used in gut tissues is important to assess nutrient needs. The VFA produced intraruminally are used to varying degrees by rumen epithelial tissue. A review of net portal absorption data essentially confirms earlier studies that show acetate, propionate, and butyrate metabolism by stomach tissue to be 30, 50, and 90%, respectively, of ruminant production. Glucose also is used by rumen epithelial tissue; however, glutamine appears to be a poor substrate for energy production. Tissue of the small intestine uses glutamine, glucose, and ketones but does not use VFA very well for energy. Cecal and colonic tissues can use glucose and glutamine for energy, but butyrate is the preferred substrate in both tissues.

Animal Nutritional Physiological Phenomena↗
PubMed1987

A comparison of Goldmann and Humphrey automated perimetry in patients with glaucoma.

Humphrey automated threshold perimetry (Program 30-2) was performed on 42 eyes of 25 patients with glaucoma to determine both the sensitivity and specificity of automated perimetry in detecting glaucomatous visual field defects. Automated perimetry sensitivity was 90.38%, while automated perimetry specificity was 91%. Fifty-two patients and a technician took part in a survey to determine their preference for either test. Patients generally preferred having Goldmann perimetry. The technician favoured Humphrey automated perimetry. Program 30-2 on the automated perimeter took 25% longer to perform than Goldmann perimetry.

Attitude of Health Personnel↗
PubMed1985

Influence of protein degradability in range supplements on abomasal nitrogen flow, nitrogen balance and nutrient digestibility.

Two metabolism trials were conducted with yearling steers fed mature native forage to measure the effect of supplemental protein degradability on selected metabolic variables. Supplements contained 40% crude protein equivalence. In Trial 1, four abomasal-cannulated steers weighing 290 to 379 kg were fed supplements containing the following N sources: (1) 15% corn, 85% urea (U); (2) 100% soybean meal (SBM); (3) 10% corn, 40% soybean meal, 50% urea (SBM-U) and (4) 14% corn, 36% blood meal, 50% urea (BM-U). Equal portions of the daily diet (2.2% of body weight) were fed every 2 h. Treatment differences were not significant for organic matter digestibility, abomasal organic matter flow, nonammonia N flow, feed N flow, bacterial N flow and efficiency of microbial protein synthesis. There was a positive (P less than .05) relationship between quantity of slowly degraded protein fed and nonammonia N flow (r = .97) or feed N flow (r = .98). Escape N was determined to be 21.5, 16.5 and 54.2% in SBM, SBM-U and BM-U supplements, respectively. In the second trial, no supplement, SBM, SBM-U and BM-U were fed in a N balance trial. Dry matter, crude protein and neutral detergent fiber digestibilities were higher (P less than .05) for steers fed supplemented diets. Acid detergent fiber digestibility was higher (P less than .05) for steers supplemented with SBM than steers fed the unsupplemented diets. Nitrogen retention was greater (P less than .05) for cattle fed SBM and BM-U than for cattle fed SBM-U or no supplement.(ABSTRACT TRUNCATED AT 250 WORDS)

Abomasum↗
PubMed1984

Experimental radial keratectomy in rabbits for the correction of aphakia.

The effect on central corneal curvature of radial keratectomy was examined. Ten rabbits had six equally spaced radial wedges removed from the cornea of one eye. Preoperative and serial postoperative keratometry readings were performed to follow the change in refractive power. The follow-up period was 3 months. Radial keratectomy produced an initial steepening of the central cornea, but this effect had disappeared by the end of the follow-up period. It is suggested that this could well have been because the 10/0 prolene sutures pulled through the rabbit cornea, which does not possess a Bowman's membrane.

Animals↗