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Biomedical subjects

R Thompson

Publications and source records attributed to R Thompson.

At least 73 records · Page 4Linked to original sources
PubMed1993

The pull-through procedure: technical factors in influencing outcome, with emphasis on pouchitis.

BACKGROUND: The purpose of the study was to review those features that we believed to be critical to the successful performance of the ileal pouch-anal anastomosis, or pull-through, procedure, and specifically the complication of pouchitis. METHODS: The charts of 205 patients who successfully underwent ileal pouch-anal anastomosis procedure were reviewed. No follow-up was available in five patients; therefore, the basis of this report and its analysis was based on 200 consecutive procedures in which at least two of the three surgeons participated. Particular emphasis was placed on continence, particularly nighttime continence. The incidence of pouchitis, either a single episode or intermittent episodes, was surveyed. Particular attention was paid to the level of rectal mucosectomy and anastomosis at the top of the columns of Morgagni, thus retaining the transitional zone. RESULTS: Only 5% of patients were incontinent in the absence of pouchitis. Twenty-five patients (13%) wore a pad at night, but only nine (5%) wore a pad during the day. Of those patients with pouchitis, 6% (12) have had a single episode and 12% (23) were intermittently on medication. Therapy of pouchitis was usually carried out with ciprofloxacin 500 mg by mouth everyday or twice a day. CONCLUSIONS: Ileal pouch-anal anastomosis is an excellent procedure, provided technical details are adhered to. Satisfactory outcome with respect to nighttime continence can be achieved with rectal mucosectomy with minimal manipulation and retaining the transitional epithelium, performing the pouch anastomosis at the top of the columns of Morgagni. The incidence of pouchitis is disappointing but need not be inhibiting of either patients or carrying out this life-saving procedure in patients with ulcerative colitis and familial polyposis.

Adolescent↗
PubMed1993

Glutamate rich Plasmodium falciparum antigen (GLURP).

We have characterized a glutamate rich Plasmodium falciparum antigen, GLURP, which by immunoassays appears to be present in both the pre-erythrocytic and erythrocytic stages of the vertebrate life cycle. The gene, which is located on chromosome 10, encodes a polypeptide of 1271 residues with a predicted molecular mass of 145 kDa. Rabbit antiserum against a fusion protein expressing the C-terminal end of the molecule detects a protein with a molecular mass of 220 kDa. The sequence includes two hydrophobic regions: one consisting of 23 residues and located by the N-terminus which may act as signal peptide, and the second located at the C-terminus consisting of 33 predominantly hydrophobic residues. Except for these hydrophobic regions the protein is hydrophilic and highly charged. The sequence has two tandem repeats designated as R1 and R2. These regions were found to be conserved in isolates from different geographical areas. High levels of anti-GLURP antibodies have been shown to correlate with low parasite density. The indication of GLURP being present in all stages of the parasite in the human host raises significantly the prospects of the potential of this molecule.

Adult↗
PubMed1992

Embolus in transit.

Since the advent of echocardiography, embolus in transit, historically found during surgical exploration or on postmortem examination, has been found with increasing frequency on antemortem examination. There is an inherent high mortality rate with this condition and awareness of the association between deep venous thrombosis and embolus in transit is paramount. On echocardiography the embolus is typically seen as a pleomorphic mass moving in a tumbling fashion. The most frequent symptoms are dyspnea and near syncopal episodes. The most common signs are diastolic "tumor plop" and a systolic ejection murmur heard on auscultation. Despite the success of some medical interventions, surgery should be strongly considered in patients with embolus in transit.

Aged↗
PubMed1992

Estimation of changes in genetic parameters in selected lines of mice using REML with an animal model. 1. Lean mass.

Analysis was undertaken using Restricted Maximum Likelihood (REML) with an animal model of the results of selection for 20 generations for predicted lean mass in 10-week-old male mice. There were three replicates, each comprising high, low and unselected control lines. The overall estimates of heritability (h2) and common environmental correlations (c2) from results of the first seven generations were 0.51 +/- 0.03 and 0.21 +/- 0.01, respectively. Analyses of data from different lines and different numbers of generations were undertaken but with all pedigrees and data included, which enabled inferences to be drawn on changes in variance that were not due simply to inbreeding or short-term effects of selection. Estimates of h2 were lower in selected lines than the control, increasingly so in later generations, indicating departure from the infinitesimal model assumption of unlinked additive genes each of very small effect. In addition, values of c2 became higher in high than in control or low selected lines.

Analysis of Variance↗
PubMed1992

Estimation of changes in genetic parameters in selected lines of mice using REML with an animal model. 2. Body weight, body composition and litter size.

Restricted Maximum Likelihood (REML) with an animal model was used to estimate genetic parameters of body weight, body consumption and litter size of lines of mice selected for 20 generations on an index of lean mass at 10 weeks in males, highly correlated with body weight, and for a further 18 generations on body weight at 10 weeks in males and females. Univariate and multivariate estimates of heritability were about 0.5 and those of common environment correlations were about 0.25 for both body weight and composition. Body weight and fat pad weight had genetic and phenotypic correlations of about 0.5. The heritability estimate of litter size was about 0.15 from univariate analysis, rather lower from multivariate, and the estimate of its genetic correlation with body weight was about 0.25. There were reductions in heritability of both body weight and litter size in later generations, even though full pedigrees were fitted and inferences made to the base population, but a plateau in response to selection for increased body weight could not be explained by a complete attenuation of genetic variance.

Animals↗
PubMed1992

Methods of segregation analysis for animal breeding data: a comparison of power.

Maximum likelihood segregation analysis provides potentially the most powerful method for the detection of segregating major genes. Segregation analysis requires the comparison of the likelihood of the data under the combined model (allowing both polygenic and major gene genetic variation) with the likelihood of the data under the polygenic model (allowing only polygenic genetic variation). In this study three approximations to the combined model likelihood were compared using simulated data, both with and without a segregating major gene, containing observations on paternal half-sibs. The use of Hermite integration to replace the integration in the combined model likelihood provided the most powerful test for a major gene. Two approximations, based on extensions of linear-mixed-model theory and estimating transmitting abilities for sires, were also considered. These approximations were less powerful than the use of Hermite integration, although the approximation estimating a transmitting ability for each major genotype for the sires was an improvement over the approximation estimating a single transmitting ability. For each approximation the frequency of detection of a major gene depended on the proportion of the genetic variance explained by the simulated major gene and whether the major gene caused the distribution to be skewed.

Alleles↗
PubMed1992

Methods of segregation analysis for animal breeding data: parameter estimates.

Three approximations to the combined model likelihood (including variation due to both polygenes and a major gene) used in segregation analysis were compared in their ability to estimate the parameters describing the model. Paternal half-sib data simulated under four different combined models were used. In general, when a combined model provides the best explanation of the data the parameter estimates from all three approximations investigated are, on average, in good agreement with the values simulated. The use of Hermite integration to replace the integration in the combined model likelihood provided the parameter estimates closest to those stimulated. The other two approximations, based on extensions of linear mixed-model theory, gave estimates further from the expected values, however, these latter two methods can estimate transmitting abilities for the sires directly from the analyses. The three approximations are similar in their ability to genotype sires at the major locus. On average, with the models studied here, about 65 per cent of sires can be successfully genotyped.

Alleles↗
PubMed1992

A sequence-specific DNA-binding protein recognising a GA-rich element cooperates with Oct-1 at the herpes simplex virus type 1 IE3 promoter.

Herpes simplex virus immediate early (IE) gene transcription is regulated via the upstream TAATGARAT motif and involves the recruitment of the ubiquitous octamer-binding protein Oct-1 and a component of the virion Vmw65 into a multiprotein complex termed the immediate early complex (IEC). An upstream GA-rich element (GA-RE) has been postulated to mediate a response to Vmw65 independent of TAATGARAT. We have studied IEC formation in gel shift assays using DNA fragments containing these sequence elements from the HSV-1 IE gene 3 promoter in different combinations. The results show that a factor which footprints to the GA-RE cooperates with Oct-1 to increase IEC levels on a TAATGARAT motif located 5 bp 5' to the GA-RE. The factor alone is unable to promote IEC formation. We were unable to demonstrate any effect of this factor on a TAATGARAT motif located 16 bp from the GA-RE, suggesting that this effect is not universal for all TAATGARAT motifs.

Base Composition↗
PubMed1992

Craniofacial form in class III cases.

Lateral skull cephalograms from 50 patients who subsequently had surgical correction of their Class III malocclusion were analysed using a complete linkage cluster analysis based on skull shape. Five subgroups were identified and are described. All subjects had a degree of mandibular prognathism while only 14 per cent had maxillary retrognathism. An increased lower face height was found in 58 per cent.

Adult↗
PubMed1992

Variance decomposition in the estimation of genetic variance with selected data.

Estimation of genetic variance in populations under selection involves assumptions on base animals. Base animals are often considered unselected and it also has been proposed to treat selected base animals as fixed. The consequences of assumptions on base animals in the estimation of genetic variance in selected populations are not fully understood. Variance decompositions are introduced for simple designs to quantify the differences between models that treat base animals in different ways. Independent contrasts were constructed and REML estimates of variance components were compared for different designs and selection rules. The method shows how selection is accounted for in a complete model and why estimation of variance components can become biased when base animals are treated as fixed.

Animals↗
PubMed1992

Secretory leucocyte proteinase inhibitor: inhibition of fibronectin degradation by neutrophil elastase.

Degradation of surface-bound fibronectin of the upper respiratory tract by human leucocyte elastase (HLE) was shown to favour colonization of these mucosal surfaces by Gram-negative bacteria. We investigated the degradation of fibronectin by purified HLE and by enzymes released from stimulated human polymorphonuclear leucocytes (PMNs), in the presence of recombinant secretory leucocyte proteinase inhibitor (rSLPI) and alpha 1-proteinase inhibitor (alpha 1-PI), the two main inhibitors of HLE within the airways. Our results show that HLE degraded fibronectin at concentrations as low as 0.2 nM. To inhibit the degradation of fibronectin by pure HLE in an experimental system in which the enzyme was premixed with inhibitor, a twofold molar excess of rSLPI and an equimolar concentration of alpha 1-PI were required. On the other hand, a fivefold molar excess of rSLPI was necessary to inhibit degradation of fibronectin by enzymes released from stimulated neutrophils. In order to estimate the role of oxidants generated by stimulated PMNs in the activation of the inhibitory capacity of rSLPI by stimulated PMNs, we preincubated PMNs with antioxidants such as superoxide dismutase, methionine, catalase or Na-azide prior to stimulation of the cells. Under these conditions, a threefold molar excess of rSLPI over released HLE was required to inhibit the degradation of fibronectin, raising the possibility that either exogenous or endogenous antioxidants in the lung could be important in improving the efficacy of this therapeutic antiprotease. We conclude that a molar excess of rSLPI to HLE is always necessary to inhibit fibronectin degradation by HLE, and that addition of antioxidants partly prevents the inactivation of rSLPI by oxidants released from stimulated PMNs.

Antioxidants↗
PubMed1992

Managing resources in the operating department.

A number of articles on the problems of resource management have been published in these pages over the past few years. Although these articles highlighted some of the difficulties and problems faced by theatre nurses, none actually gave a means of resolving them.

Cost-Benefit Analysis↗
PubMed1992

Hemicorporectomy for acute aortic occlusion: a case study.

Hemicorporectomy has been done for potentially curable pelvic malignancy and for intractable pelvic sepsis with bone involvement. In this report, the authors describe the first use of hemicorporectomy to treat ischemic gangrene of the limbs and pelvic soft tissues secondary to acute aortic occlusion.

Acute Disease↗
PubMed1991

First steps in audit.

The results of two audit projects carried out in a District Orthodontic Unit are described. Although prospective data collection was the goal, it was found that this method yielded little information as the data collection forms were poorly filled in. The main problem was a lack of definition of terms and inadequate discussion between clinical and clerical staff. A retrospective audit using five clearly defined fields was more successful. It is very important that there is provision to verify the data collected. The time commitment for clinical staff should not be underestimated.

Data Collection↗
PubMed1991

Lung asbestos fiber content and mesothelioma cell type, site, and survival.

All ascertainable cases of malignant mesothelioma in Australia were notified to a national surveillance program in the period January 1, 1980 to December 31, 1985. There were 854 cases obtained and 823 confirmed on clinical (77) or histologic (746) ground. Tumor site was known in 759 cases (685 pleural and 74 peritoneal). Lung fiber content analyses by light microscopy and analytic transmission electron microscopy with energy-dispersive x-ray analysis were done on 226 cases in which postmortem material was available, using the method of Rogers. Cell type was determined by a five-member expert panel of pathologists appointed by the Royal College of Pathologists of Australasia. There was a statistically significant trend between lung fiber content (fibers/g dry lung) and cell type from epithelial (low fiber content) through mixed to sarcomatous (high fiber content). This trend was most apparent for total uncoated fibers (chi-square = 6.8, df = 1, P less than 0.01) and crocidolite (chi-square = 6.7, df = 1, P less than 0.01). Lung fiber content also was associated with tumor site; higher lung fiber content being associated with peritoneal tumors. This relationship was significant for all fiber content measures except chrysotile and was independent of the fiber content-cell type relationship (log-linear analysis). Survival from time of provisional diagnosis was significantly longer for epithelial (mean, 13 months; standard deviation [SD], 12.8) and mixed (mean, 10.2 months; SD, 8.7) types than sarcomatous cell types (mean, 5.8 months; SD, 6.5; P less than 0.0001, by analysis of variance on log10 survival time). Survival time was significantly greater for pleural tumors (mean, 11.4 months; SD, 13.4) than peritoneal tumors (mean, 8.6 months; SD, 12.5) (P less than 0.005, by Student's t test on log10 survival time).

Asbestos↗
PubMed1991

The incidence of malignant mesothelioma in Australia 1982-1988.

From 1980 to 1985, the Australian Mesothelioma Surveillance Program, and since 1986, the Australian Mesothelioma Register, have been collecting data on all cases of malignant mesothelioma that could be ascertained in Australia. Incidence rates were calculated on 854 Program and 696 Register cases (total 1271) diagnosed in Australia between January 1, 1982 and December 31, 1988. Australia has one of the highest national rates of mesothelioma in the world (15.8 cases per million of population aged 20 years and older), and the rate is rising. The rate is far higher in males (28.3) than females (3.3). The Western Australian rate (28.9) is the highest among the states, as may be expected because of the crocidolite mine at Wittenoom; however, the largest numbers of cases occur in the more populous and industrial New South Wales. The high incidence rate, its expected continuing increase, and absence of a history of exposure to asbestos in approximately 28% of cases, demand consideration of potential environmental factors other than asbestos in the causation of this tumor, as well as continued surveillance.

Adult↗