The degradation of the academic dogma.
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Biomedical subjects
Publications and source records attributed to S Porter.
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The goals of this study were to quantitate biochemical markers of bone metabolism on days 1-15 after bilateral tibial marrow ablation surgery in young adult rats and to determine the effect of a single dose of methylprednisolone (2 mg/kg) or deflazacort (2.5 mg/kg) given at the time of ablation. Unexpectedly, serum calcium levels rose to a maximum of 15.9 mg/dl on day 7 after marrow ablation and remained above normal through day 15. This increase was blocked by a single intramedullary injection of methylprednisolone or deflazacort immediately following ablation; however, the fact that both drugs produced a characteristic rapid 3- to 10-fold increase in the serum alpha 2-macroglobulin level demonstrates that the drugs rapidly reached the circulation. Both methylprednisolone and deflazacort also inhibited intramedullary deposition of collagen by 40-60% on day 7, a time near which operated control animals achieved maximal accumulation of new bone in this model. Histological comparisons among the three experimental groups were largely consistent with biochemical results. The urinary hydroxyproline/creatine ratio for the operated control group doubled on day 3 and then returned to presurgical levels on day 7 and later. The timing and size of the hydroxyproline/creatinine peak, as well as the fact that the intratibial osteoclastic response peaks on days 8-10 after ablation, suggests it results from extratibial bone resorption induced by marrow ablation. Consistent with this rationale, urinary calcium excretion in operated controls rose 9-fold from day 0 to day 3 and appeared to plateau over the period from day 3 to day 9, before returning to a near presurgical level on day 15. Elevated excretion of calcium noted on days 9-15 in deflazacort-treated animals, which occurs in the absence of a detectable increase in resorption marker hydroxyproline, may however be due to the known action of glucocorticoids in increasing kidney filtration of calcium. In summary, this is the first report to show that bilateral tibial marrow ablation in rats causes a rapid hypercalcemia and calciuria which is accompanied initially by a peak of bone resorption marker urinary hydroxyproline. We speculate that the source of calcium and hydroxyproline is extratibial osteoclastic bone resorption induced by circulating cytokines whose release from ablated tibias or osteoclastogenic action is inhibitable by methylprednisolone and deflazacort.
The Gfi-1 protooncogene encodes a nuclear zinc-finger protein that carries a novel repressor domain, SNAG, and functions as a position- and orientation-independent active transcriptional repressor. The Gfi-1 repressor allows interleukin 2 (IL-2)-dependent T cells to escape G1 arrest induced by IL-2 withdrawal in culture and collaborates with c-myc and pim-1 for the induction of retrovirus-induced lymphomas in animals. Here we show that overexpression of Gfi-1 also inhibits cell death induced by cultivation of IL-2-dependent T-cell lines in IL-2-deficient media. Similarly, induction of Gfi-1 in primary thymocytes from mice carrying a metal-inducible Gfi-1 transgene inhibits cell death induced by cultivation in vitro. The protein and mRNA levels of the proapoptotic regulator Bax are down-regulated by Gfi-1 in both immortalized T-cell lines and primary transgenic thymocytes. The repression is direct and depends on several Gfi-1-binding sites in the p53-inducible Bax promoter. In addition to Bax, Gfi-1 also represses Bak, another apoptosis-promoting member of the Bcl-2 gene family. Therefore, Gfi-1 may inhibit apoptosis by means of its repression of multiple proapoptotic regulators. The antiapoptotic properties of Gfi-1 provide a potential explanation for its strong collaboration with c-myc during oncogenesis.
Cocaine abuse is a major public health problem worldwide and is increasingly common in Europe. Oral use of cocaine in two patients resulted in unusual white lesions on their anterior maxillary gingivae/vestibule. GDPs should be alert to this newly described lesion.
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We have demonstrated previously a loss of constitutional heterozygosity on the short arm of chromosome 3 in approximately 50% of oral squamous cell carcinomas. In the present study, we have investigated 30 oral dysplastic lesions (DLs), presenting clinically as either erythroplakias or leukoplakias with histopathological features of either severe epithelial dysplasia or carcinoma in situ, for LOH on chromosome 3p using 15 microsatellite markers. Thirteen of the 30 LDs (approximately 43%) showed allelic imbalance at one or more loci. The pattern of loss in these lesions defined three noncontiguous regions of interstitial deletions that overlap with those defined for oral squamous cell carcinomas. These data indicate that the alteration of tumor suppressor genes on chromosome 3p is probably an early event in oral carcinogenesis. Additionally, 7 of the 30 DLs showed microsatellite instability. However, the frequency of loci showing microsatellite instability per lesion was low.
A case of acute myelogenous leukemia (AML) French-American-British (FAB)-type M5b is described, secondary to myelodysplastic syndrome (MDS), in which a primary clone containing a dup(1)(p22p36) and a subclone containing dup(1)(p22p36), were identified. This is believed to be a novel mutation in AML.
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This paper seeks to engage in the debate about the role of sociology in nurse education that has been conducted in the pages of Nurse Education Today by Hannah Cooke (1993) and Keith Sharp (1995). Cooke's paper is addressed first. It is argued that in her application to nursing of Foucauldian notions of power, Cooke inflates the salience of power to the development of holistic care. In doing do, she diverts her argument away from the central problematic of her paper, namely her identification of critical structural approaches as being essential to nursing sociology. Cooke's conclusions on this issue are defended against the attack made upon them by Sharp. First, it is contended that Sharp's argument that the multiparadigmatic nature of sociology means that it cannot act as a guide for nurses is self-contradictory. Second, it is argued that his characterization of nursing work as essentially instrumental is misguided, in that the prosecution of holistic care entails a more reflexive form of action. Finally, it is posited that his interpretation of Cooke's perspective as narrow political vision is unsustainable.
Multiple hamartoma syndrome (Cowden's syndrome), a rare genodermatosis with predominant mucocutaneous features, particularly hamartomas, and Cowden/Lhermitte-Duclos disease, the combination of multiple hamartomas with cerebellar hypertrophy, typically present with cutaneous and oral papillomatosis as major features of both uncommon disorders. This article details the clinical features of three patients with multiple hamartoma syndrome and one with both disorders.
Data were examined to determine trends in survival from cancers of the oral cavity and pharynx in Scotland between 1968 and 1987, and to analyse survival rates and the previously noted increases in the incidence of such cancers according to the level of social deprivation. Incidence data on oral cavity and pharyngeal cancer and survival rates following diagnosis were obtained from the Information and Statistics Division of the Common Services Agency for the National Health Service in Scotland, covering the period 1968-92. It was found that survival rates for cancers of the tongue, mouth and pharynx diagnosed among persons less than 65 years of age decreased between 1968-72 and 1983-87. Five year relative survival rates fell from 47% to 39% over this period, while the equivalent rates among persons older than 65 years have shown a modest improvement from 34% to 38%. When considered by level of social deprivation, survival is lower among persons from the most deprived areas, and it is among such persons that the recent increases in occurrence of cancers of the oral cavity and pharynx have primarily occurred. The poorer survival among those from more socially deprived areas, and the evidence that the largest increase in incidence has occurred in such areas may to some extent explain the non-favourable trends in mortality. More importantly it emphasises the potential benefits of targeting such a population for oral health information. An educational campaign should include both information on the risk factors for developing oral cancer, and also the importance of seeking an early professional consultation in the case of symptoms.
This paper is a response to the challenges laid down by Hannah Cooke in a paper in the Journal of Advanced Nursing entitled "Boundary work in the nursing curriculum: the case of sociology' (Cooke 1993a). In her paper, Cooke noted that the outlook of nursing and sociology are inimicable because nursing's concentration on individuals is at variance with sociology's concern with wider social issues. We argue that it is possible for nursing research to give due attention to social structures without losing its focus on individuals. One methodology that could facilitate this broadening of nursing's epistemological boundaries is critical realist ethnography, which works under the assumption that the relationship between social structures and individual actors involves a two-way process, in that while the enablements and constraints imposed by structures influence individual actions, those actions in turn either maintain or transform social structures. To demonstrate how such a methodology could be applied in nursing research, we work through a case study concerning the theory-practice gap, arguing that the gap is neither the result of clinicians' ignorance of nor antipathy to theory, but is largely generated by the lack of resources enjoyed by nurses, which in turn is a reflection of the social structure of capitalism within which nurses operate.
Obeso et al reported that simple motor tics in Tourette's syndrome were not associated with premotor potentials, which were present when patients mimicked their tics voluntarily, suggesting that spontaneous tics were not generated in the same manner as voluntary movements. Five patients with simple motor tics were studied using a similar paradigm. Premotor potentials were examined during spontaneous tics and during voluntary imitation of the tics. All patients had premotor negativity with the voluntary movements. As in the study of Obeso et al, spontaneous tics were not preceded by premotor potentials in three patients. However, premotor negativity was present with spontaneous tics in two patients and resembled the NS' segment of the premotor potential seen with self paced, voluntary movements. A similar premotor potential pattern has been reported with voluntary movements performed in response to external triggering stimuli. In patients with Tourette's syndrome, the eliciting signals could be internal sensations.
In 1990 an outbreak of ataxia occurred in over 700 pigs in the north of England. Epidemiological studies demonstrated that the disorder was associated with the consumption of feed from a particular supplier and that one component (wheat screenings) was common to the batch of feed with which the ataxia was associated. An analysis of the feed demonstrated the presence of an organophosphorus pesticide, later identified as isofenphos, a pesticide not approved for use in the United Kingdom. The wheat screenings had been imported from France and the warehouse in which they had been stored was contaminated with isofenphos, which is approved for restricted use in France. Isofenphos is known to cause delayed neuropathy. The dose to which the pigs were theoretically exposed would be expected to have resulted in neuropathy (manifested as ataxia).
Children with hearing impairments have been found to suffer a high rate of physical and sexual victimization relative to children in general. The purpose of this investigation was to compare the amount and accuracy of the information contained in the eyewitness accounts of deaf and hearing children. Fifteen deaf and 11 hearing children, aged 8 to 10 years, individually witnessed a series of slides depicting a wallet theft. Their recall was then tested by using the Step-Wise Interview (Yuille, Hunter, Joffe, & Zaparniuk, 1993) consisting of a free recall component followed by increasingly directive questions. Separate 2 x 2 (deaf/hearing x question type) between-within factorial ANOVAs were conducted on the amount and accuracy of the information in the accounts (A = .025). Results indicated no main or interaction effects for amount recalled. However, a main effect for question type and an interaction effect were evidenced in the analysis on accuracy. Although the accuracy scores of the two groups did not differ in free recall, the deaf children provided much less accurate responses to directive questions whereas the accuracy of the hearing children declined only slightly. Implications for criminal investigations are discussed.
This paper is a response to Keith Sharp's (1994) argument in the Journal of Advanced Nursing that sociology cannot in principle provide a knowledge base for nursing work. The aim here is to reassert the appropriateness of including sociology in the nursing curriculum. Three arguments put forward by Sharp are engaged with. First, he questions nursing's need for any theoretical basis at all. This hypothesis is rejected on the grounds that any occupation that is involved in complex decision-making requires some sort of theoretical guidance. Second, Sharp argues that the multi-paradigmatic nature of sociology makes it inappropriate for nurses who require more certain knowledge as a basis for their actions. Two responses to this argument are made: first, that the fissures within sociology are not as great as Sharp portrays them and, second, that nurses possess adequate criteria to be able to judge between different sociological propositions. Sharp's final argument is that the reflexive approach of sociology is an inappropriate way of thinking for nurses, whose approach is instrumental. In reply, it is noted that Sharp's instrumental model of nursing action does not adequately reflect the manner in which nurses interact with patients, and that 'new nursing' practices require reflexivity on the part of the nurse.
To study the relative sensitivity of rat tracheal epithelial and mesothelial cell DNA to oxidant damage, we used the comet assay, a gel microelectrophoresis method that allows visual determination of DNA strand breaks on a cell-by-cell basis, to evaluate damage after hydrogen peroxide exposure. By both a qualitative and a quantitative assay, tracheal epithelial mesothelial cells demonstrated a similar dose-response increase in the number of cells showing strand breaks and the number of breaks per cell after exposure to increasing concentrations of hydrogen peroxide; but even at the highest concentration, some cells failed to show damage. By contrast, 100% of cultured V79 lung fibroblasts showed evidence of damage. Catalase and deferoxamine largely prevented the formation of strand breaks, while superoxide dismutase was not protective. To evaluate DNA repair, cells were exposed to 10 microM hydrogen peroxide for 10 min, washed, and maintained in culture medium; by 2 h the proportion of mesothelial and epithelial cells showing comets had returned to control levels for both cell types. Both cell types also showed a similar pattern of increasing damage after continuous exposure to 10 microM hydrogen peroxide for periods up to 2 h. We conclude that, in this system, 1) mesothelial and tracheobronchial epithelial cells show a similar pattern of DNA injury and repair after hydrogen peroxide exposure; 2) hydrogen peroxide damages DNA of both cell types via a mechanism probably related to the iron-catalyzed formation of hydroxyl radical; and 3) both types of cells appear to be heterogeneous in their sensitivity to oxidant damage, with some cells showing extreme resistance to such damage.