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Kazis LE, Sager A, Bailey HM, Vasudevan A, Garrity B, Tompkins R. Physical Rehabilitation and Mental Health Care after Burn Injury: A Multi-Nation Study. J Burn Care Res 2021; 43:868-879. [PMID: 34788851 DOI: 10.1093/jbcr/irab214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
While remarkable improvements have been made to acute hospital burn care in recent decades, it is not matched by improvements in post-acute care, including physical rehabilitation and mental health. Progress in acute hospital treatment of burn survivors now highlights the next important step-addressing care once a patient leaves intensive treatment and is discharged to the community. Long-term physical rehabilitation and mental health services are vital to improving quality of life for burn survivors. Using qualitative methods, we apply the adapted Reeve framework to assess and compare post-acute physical rehabilitation and mental health care across thirteen countries on six continents. Twenty semi-structured interviews were conducted with burn surgeons and rehabilitation specialists. One major theme that emerged was the importance of training and resources to the quality of post-acute care. This exploratory study suggests the value of investing scarce resources in a range of low-cost interventions to improve follow-up burn care. One intervention identified here is short-term training in post-acute rehabilitation and mental health to upgrade and standardize best clinical practices to address as-yet unmet post-discharge needs of burn survivors.
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Affiliation(s)
- Lewis E Kazis
- Boston University School of Public Health, Department of Health Law, Policy & Management
| | - Alan Sager
- Boston University School of Public Health, Department of Health Law, Policy & Management
| | - Hannah M Bailey
- Boston University School of Public Health, Department of Health Law, Policy & Management
| | | | - Brigid Garrity
- Boston University School of Public Health, Department of Health Law, Policy & Management
| | - Ron Tompkins
- Massachusetts General Hospital, Center for Engineering in Medicine & Surgery
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Wideman ES, Dunnigan A, Jonson-Reid M, Kohl P, Constantino J, Tandon M, Recktenwald A, Tompkins R. Nurse home visitation with vulnerable families in rural areas: A qualitative case file review. Public Health Nurs 2019; 37:234-242. [PMID: 31860152 DOI: 10.1111/phn.12699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 12/03/2019] [Accepted: 12/04/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Nurse home visiting may address challenges and resource disparities that threaten maternal and infant well-being in rural areas, but little is known about United States' program implementation. This qualitative study explored how family and community characteristics affected rural nurse home visiting. SAMPLE The sample for content analysis included families beginning services in 2010-2011 living in the rural counties with the highest caseloads (433 families). DESIGN Electronic nurse home visiting case files from three rural counties were analyzed using a content analysis approach. The partner agency provided input on key constructs of interest but independent coding was also done to capture additional themes. Quantitative county level data and comments from member checking informed interpretation. Member checking included individual nurses serving the selected counties (n = 3) and input from an agency level supervisory meeting for validation. RESULTS Concerns of families served (e.g., mental health) may not be unique to rural areas, but challenges to accessing resources and constellation of needs were. Nurses adapted engagement and service strategies to meet these needs. CONCLUSION Agencies serving rural areas should allocate resources and adapt training to support nurses based on unique community profiles. More research on rural nurse home visiting practice and outcomes is needed.
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Affiliation(s)
- Ellie S Wideman
- Psychology, Maryville University of Saint Louis, Saint Louis, MO, USA
| | | | | | - Patricia Kohl
- Brown School of Social Work, Washington University, Saint Louis, MO, USA
| | - John Constantino
- Division of Child and Adolescent Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Mini Tandon
- Division of Child and Adolescent Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
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3
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Ben-David V, Jonson-Reid M, Tompkins R. Addressing the Missing Part of Evidence-based Practice: The Importance of Respecting Clinical Judgment in the Process of Adopting a New Screening Tool for Postpartum Depression. Issues Ment Health Nurs 2017; 38:989-995. [PMID: 28771385 PMCID: PMC7017911 DOI: 10.1080/01612840.2017.1347221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of the present study was to examine the role of nurse's clinical judgment in the uptake of an evidence-based tool assessing postpartum depression, the Edinburgh Postpartum Depression Scale. Nurses in a home visitation program were being asked to regularly screen for postpartum depression. The screener was introduced as a new standard of practice for nurses. A qualitative investigation of the nurses' reactions in addition to an evidence-based screener was conducted. Prior to and during the implementation, several meetings were held with the nurses and the research team to discuss the nurses' experience with the tool. Nurses participated in semi-structured interviews and notes were reviewed to identify themes that may be useful in further understanding evidence-based practice in nurses' home visitation. It was found that the process of uptake included three phases: dissatisfaction with the utility of the tool; problem solving and integration of clinical judgment into a complementary instrument, and eventual reliance on the standardized tool. Respecting the nurses' field experience and clinical judgment was the key to the process of adoption of an evidence-based tool. The process uncovered here requires a larger scale study to see if this can be used across various settings and with differing screening mechanisms to increase comfort with the use of recommended non-health screening tools.
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Affiliation(s)
- Vered Ben-David
- a Brown School of Social Work , Washington University in St. Louis , St. Louis , Missouri , USA
| | - Melissa Jonson-Reid
- a Brown School of Social Work , Washington University in St. Louis , St. Louis , Missouri , USA
| | - Ron Tompkins
- b Nurses for Newborns , St. Louis , Missouri , USA
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Nicks SE, Weaver NL, Recktenwald A, Jupka KA, Elkana M, Tompkins R. Translating an Evidence-Based Injury Prevention Program for Implementation in a Home Visitation Setting. Health Promot Pract 2016; 17:578-85. [PMID: 26826110 DOI: 10.1177/1524839915622196] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Safe N' Sound (SNS), a computer-based childhood injury prevention program, provides individually tailored information to parents about their child's injury risks with specific behavioral recommendations. We translated SNS for implementation in a home visitation organization in order to increase its capacity to effectively address injury prevention and decrease the burden of injury experienced by high-need families. The aim of this study was to identify behavioral and organizational barriers and facilitators to translating and implementing SNS in a home visitation setting. Nurse home visitors (NHVs) participated in semistructured interviews that examined perceptions of program implementation, intervention characteristics, individual characteristics of NHVs, and recommendations for improving implementation. The utility of the program for promoting injury prevention systematically and its alignment with the organization's mission were facilitators of successful implementation. Barriers included NHVs' concerns about overburdening clients and missed educational opportunities related to injury risks not addressed by the program and delayed delivery of educational reports. Findings illustrate the dynamic interactions of intervention characteristics with organizational and individual factors and suggest that customizing implementation to organizational capacity and specific needs may better support successful program implementation in home visitation settings.
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Affiliation(s)
- Shannon E Nicks
- Saint Louis University College for Public Health & Social Justice, St. Louis, MO, USA
| | - Nancy L Weaver
- Saint Louis University College for Public Health & Social Justice, St. Louis, MO, USA
| | | | - Keri A Jupka
- Saint Louis University College for Public Health & Social Justice, St. Louis, MO, USA
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Grelewicz Z, Suzuki K, Kohlbrenner R, Obajuluwa A, Ng E, Tompkins R, Epstein M, Hori M, Baron R. SU-FF-I-03: Computer-Aided Diagnostic Scheme for Detection of Hepatocellular Carcinoma in Contrast-Enhanced Hepatic CT: Preliminary Results. Med Phys 2009. [DOI: 10.1118/1.3181122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Sakaguchi DS, Murphey RK, Hunt RK, Tompkins R. The development of retinal ganglion cells in a tetraploid strain of Xenopus laevis: a morphological study utilizing intracellular dye injection. J Comp Neurol 2009; 224:231-51. [PMID: 19180813 DOI: 10.1002/cne.902240205] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The morphological development of retinal ganglion cells was examined in a tetraploid strain of Xenopus frogs. The enlarged cells of the tetraploid strain facilitate the application of intracellular techniques. Using an in vitro retinal preparation and Nomarski optics, intracellular recording and dye injection were carried out under visual control on ganglion cells in central retina from 2 days of development (stage 24) to metamorphosis (stage 64). We identified three phases in the morphological differentiation of ganglion cells. During the first phase (stages 24-30), all cells were neuroepitheliallike in form and possessed robust resting potentials in the range of -35 to -60 mV, and dye-coupling was occasionally observed between neighboring cells. During the second phase of ganglion cell development (stages 31-45) the neurons had begun to elaborate axons and dendrites. These cells possessing neurites had resting potentials between -15 and -30 mV, and no dye-coupling was observed between neighbors. During the third and final phase of maturation, from stage 46 onward, three distinct morphological types of ganglion cells could be identified. Type I cells had the smallest somata and the smallest-diameter dendritic arborizations. The profusely branched dendrites of these cells ramify extensively throughout the inner plexiform layer. Type II cells had large somata, intermediate-diameter dendritic fields, and a highly elaborate dendritic branching pattern. These cells were seen to arborize within two sublamina in the inner plexiform layer. Type III cells had large somata, the largest-diameter dendritic fields, and a dendritic arbor with long primary branches but little higher-order branching. These large dendritic fields were confined to a single sublamina of the inner plexiform layer, abutting the inner nuclear layer. While most phase 3 cells showed radial axon trajectories from the soma to the optic disc, a minority of cells (1-5%) with erratic and nonradial axon trajectories were also observed. Our data provide a morphological description of ganglion cell maturation in the central retina of Xenopus. We show that very early in development (as early as stage 46) three distinct morphological types of retinal ganglion cells are present, which correspond to the three classes of ganglion cells previously described in adult Xenopus (Chung et al., '75).
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Affiliation(s)
- D S Sakaguchi
- Neurobiology Research Center, Department of Biological Sciences, State University of New York at Albany, Albany, New York 12222, USA
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Schröder S, Küssner D, Tompkins R. 2.202 Use of dopamine agonists and levodopa in Germany: Do German neurologists adhere to national Parkinson guidelines? Parkinsonism Relat Disord 2007. [DOI: 10.1016/s1353-8020(08)70613-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Feezor RJ, Baker HV, Mindrinos M, Tannahill CL, Brownstein B, Fay A, MacMillan S, Laramie J, Hayden D, Schoenfeld D, Xiao W, Moldawer LL, Cobb JP, Davis R, Tompkins R. RNA ISOLATION METHODS AFFECT THE MEASURE-MENT OF HUMAN LEUKOCYTE GENE EXPRESSION RESULTING FROM SEB STIMULATION. Shock 2003. [DOI: 10.1097/00024382-200306001-00195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Cao H, Krishnan G, Goumnerov B, Tsongalis J, Tompkins R, Rahme LG. A quorum sensing-associated virulence gene of Pseudomonas aeruginosa encodes a LysR-like transcription regulator with a unique self-regulatory mechanism. Proc Natl Acad Sci U S A 2001; 98:14613-8. [PMID: 11724939 PMCID: PMC64730 DOI: 10.1073/pnas.251465298] [Citation(s) in RCA: 259] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2001] [Accepted: 09/04/2001] [Indexed: 01/31/2023] Open
Abstract
The human opportunistic pathogen Pseudomonas aeruginosa strain PA14 infects both plants and animals. Previously, using plants to screen directly for P. aeruginosa virulence-attenuated mutants, we identified a locus, pho34B12, relevant in mammalian pathogenesis. Here, nonsense point mutations in the two opposing ORFs identified in the pho34B12 locus revealed that one of them, mvfR (multiple virulence factor Regulator), is able to control all of the phenotypes that mutant phoA34B12 displays. Both genetic and biochemical evidence demonstrate that the mvfR gene encodes a LysR-like transcriptional factor that positively regulates the production of elastase, phospholipase, and of the autoinducers, 3oxo-dodecanoyl homoserine lactone (PAI I) and 2-heptyl-3-hydroxy-4-quinolone (PQS), as well as the expression of the phnAB operon, involved in phenazine biosynthesis. We demonstrate that the MvfR protein is membrane-associated and acts as a transcriptional activator until cells reach stationary phase, when a unique negative feedback mechanism is activated to signal the down-regulation of the MvfR protein. This work reveals an unprecedented virulence mechanism of P. aeruginosa and identifies a unique indispensable player in the P. aeruginosa quorum-sensing cascade.
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Affiliation(s)
- H Cao
- Department of Surgery, Harvard Medical School, Massachusetts General Hospital and Boston Shriners Institute, 50 Blossom Street, Boston, MA 02114, USA
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10
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Daltroy LH, Liang MH, Phillips CB, Daugherty MB, Hinson M, Jenkins M, McCauley R, Meyer W, Munster A, Pidcock F, Reilly D, Tunell W, Warden G, Wood D, Tompkins R, Cullen M, Calvert C, Hunt J, Purdue G, Saffle J, Yurt R. American Burn Association/Shriners Hospitals for Children burn outcomes questionnaire: construction and psychometric properties. J Burn Care Rehabil 2000; 21:29-39. [PMID: 10661536 DOI: 10.1097/00004630-200021010-00007] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To develop a standardized, practical, self-administered questionnaire to monitor pediatric patients with burns and to evaluate the effectiveness of comprehensive pediatric burn management treatments, a group of experts generated a set of items to measure relevant burn outcomes. Children between the ages of 5 and 18 years were assessed in a cross-sectional study. Both parent and adolescent responses were obtained from children 11 to 18 years old. The internal reliability of final scales ranged from 0.82 to 0.93 among parents and from 0.75 to 0.92 among adolescents. Mean differences between parent and adolescent were small; the greatest difference occurred in the appearance subscale. Parental scales showed evidence of validity and potential for sensitivity to change. In an effort to support the construct validity of the new scales, they were compared with the Child Health Questionnaire and related to each other in clinically sensible ways. These burn outcomes scales reliably and validly assess function in patients with burns, and the scales have been developed in such a way that they are likely to be sensitive to change over time.
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Affiliation(s)
- L H Daltroy
- R.B.B. Multipurpose Arthtritis and Musculoskeletal Diseases Center, Brigham and Women's Hospital, and Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Sheridan R, Weber J, Prelack K, Petras L, Lydon M, Tompkins R. Early burn center transfer shortens the length of hospitalization and reduces complications in children with serious burn injuries. J Burn Care Rehabil 1999; 20:347-50. [PMID: 10501318 DOI: 10.1097/00004630-199909000-00002] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Prompt transfer of the child with acute burns can be difficult from distant or inaccessible locations, and it is believed that the outcomes of children with serious burns whose transfer to a specialized burn care facility is delayed may be compromised. A 4-year experience with 16 consecutive children with serious burns (> or =20% of the body surface area) whose transfer to a burn care facility was delayed for 5 or more days was reviewed to document the difficulties that can follow such delays. These 16 children had an average age of 8.6+/-1.6 years and an average wound size of 57.6%+/-5.8% of the body surface area, and they arrived a mean of 16.3+/-3.4 days after the injury (range, 5 to 44 days). These children had undergone an average of 1 operation, excluding escharotomies, at referring facilities. Only 4 (25%) of the children had no infectious focus at transfer, and at admission resistant bacteria were recovered from 9 (56%) of the children and fungal organisms were found in 10 (63%). Compared with a concurrently managed matched control group of patients admitted to the burn center within 24 hours of injury, the delayed-transfer group had statistically significantly more bacteremia, renal dysfunction, wound sepsis, and central venous catheter days. It was also more expensive to manage these children; the delayed-transfer group required statistically significantly longer to achieve 95% wound closure, and they had greater total lengths of hospital stay and more rehabilitation days. The early transfer of children with serious burns to a specialized burn center may truncate hospitalization and thereby reduce costs.
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Affiliation(s)
- R Sheridan
- Shriners Burns Institute, Massachusetts General Hospital, Department of Surgery, Harvard Medical School, Boston 20114, USA
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12
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Abstract
BACKGROUND Prolonged enteral feedings are required occasionally in seriously burned individuals. We have employed percutaneous endoscopic gastrostomy (PEG) in selected patients who require particularly prolonged access, thus prompting this review. METHODS The PEG procedure was performed under general anesthesia in combination with another surgical procedure using a variety of commercially available needle and guidewire kits in 14 patients. RESULTS These 14 patients had an average age of 55.2 +/- 6.6 years and a burn involving 38 +/- 8% of the body surface. Eleven of these patients had suffered an inhalation injury. The tubes were placed an average of 57 +/- 10.5 days after injury through unburned and unharvested skin in four patients (28%), healed donor sites in five patients (35%), healed burn in one patient (1%), and grafted burn in four patients (28%). One patient, whose catheter was placed through a grafted fascial excision, developed moderate local wound erosion. Tubes were known to have been left in place as long as 155 days. However, most were removed in rehabilitation hospitals, and we were unable to determine how long most were left in place. We are unaware of any problems with the tubes occurring after discharge from the acute care setting. CONCLUSIONS In selected patients, PEG can provide more comfortable access for prolonged enteral feedings than nasogastric tubes and can be placed with minimal morbidity.
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Affiliation(s)
- R Sheridan
- Department of Surgery, Division of Burns and Trauma, Bigelow 1302, Massachusetts General Hospital, Shriners Burns Hospital, Harvard Medical School, Boston, MA 02114, USA
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Abstract
By cooling the blood just before returning it to the body, marked reduction in the temperature of the heart, brain, liver, and kidney can be produced easily and with great economy in heat transfer, since the great bulk of the animal or patient, consisting of skin, muscle, and bone, is cooled much more slowly. This results in a marked oxygen saving, due to the direct antimetabolic effect of the cooling. Metabolic acidosis can be avoided and so far no irreversible effects of the cooling have been discoverable. Warming is so greatly facilitated by the heat stored in the nonvital areas that it is not necessary to warm the blood returning from the extracorporeal circuit. The use of safe, low, extracorporeal flows offers a number of possible advantages including great simplicity of cannulation and of the pump oxygenator design and operation.
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Affiliation(s)
- E C Peirce
- East Tennessee Tuberculosis Hospital, Knoxville, USA
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Sheridan R, Choucair R, Donelan M, Lydon M, Petras L, Tompkins R. Acellular allodermis in burns surgery: 1-year results of a pilot trial. J Burn Care Rehabil 1998; 19:528-30. [PMID: 9848044 DOI: 10.1097/00004630-199811000-00012] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We grafted 10 sites on 6 children with limited (< 25%) areas of body surface available for donor harvest with an acellular allogenic dermis and a thin autograft. Matched control sites were grafted with autograft alone. Study site autografts (0.0074 +/- 0.0007 in, median 0.006 in, range 0.006 to 0.012 in) were thinner than control site autografts (0.0102 +/- 0.0008 in, median 0.012 in, range 0.006 to 0.013 in), with a P value of .015. Endopoints were initial engraftment (in percent) as judged by a blinded experienced observer and Vancouver scar scores. The 6 children (3 girls and 3 boys) had an average age of 5.2 +/- 0.9 years (range 2.8 to 10 years) and an average burn size of 68.7% +/- 6.7% total body surface area (range 47% to 85% total body surface area). The 10 study and control sites were treated with 10 separate procedures; 9 of the procedures were reconstructive and 1 was performed for the excision of an acute burn. Successful initial epithelialization was noted at 7 days postburn for 83% +/- 3.4% (range 60% to 95%) at the cryopreserved acellular human dermis sites and 83.3% +/- 4.3% (range 60% to 98%) at the control sites (not significant, P = .96). At a mean follow-up interval of 43.7 +/- 3.6 weeks (median 52, range 26 to 52 weeks), the differences between the study and control sites in the total mean (pigmentation, vascularity, pliability, and height) of the patients' Vancouver scar scores were not different.
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Affiliation(s)
- R Sheridan
- Shriners Burns Hospital, Boston, MA 02114, USA
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Ryan CM, Thorpe W, Mullin P, Roberts W, Tompkins D, Kelleher P, Sheridan R, Tompkins R. A persistent fire hazard for older adults: cooking-related clothing ignition. J Am Geriatr Soc 1997; 45:1283-5. [PMID: 9329499 DOI: 10.1111/j.1532-5415.1997.tb03792.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Sheridan RL, Hinson M, Nackel A, Blaquiere M, Daley W, Querzoli B, Spezzafaro J, Lybarger P, Martyn J, Szyfelbein S, Tompkins R. Development of a pediatric burn pain and anxiety management program. J Burn Care Rehabil 1997; 18:455-9; discussion 453-4. [PMID: 9313130 DOI: 10.1097/00004630-199709000-00018] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
To facilitate effective management of pain and anxiety, and to permit more objective assessment of changes in this management, a pain and anxiety guideline was developed and has been followed uniformly for 3 years. The guideline describes four patient care categories: (1) ventilated acute, (2) nonventilated acute, (3) chronic acute, and (4) reconstructive. A small and consistent formulary was emphasized. A specific guideline for background, procedural, and transition pain and anxiety management was developed for each patient care category. All pain and anxiety medications given to all acutely burned children admitted to the Institute for 12 consecutive months were recorded, and daily pain and anxiety discomfort scores were noted using a 5-level action-based bedside scoring system. Doses of individual pain and anxiety medications were calculated as mg per kg per patient-day in each category, and all doses were found to be within guideline specifications. The efficacy of the guideline was judged by four discomfort scores: (1) background pain, (2) procedural pain, (3) background anxiety, and (4) procedural anxiety, and were adequate in all patient categories. There were no complications related to overmedication experienced during the interval. Our objective was to develop a guideline for pain and anxiety management that: (1) was safe and effective over a broad range of ages and injury acuities seen in the unit, (2) was explicit in its recommendations, (3) had a limited formulary to optimize staff familiarity with agents used, and (4) took advantage of the presence of a bedside nurse to continuously evaluate efficacy and intervene when needed through dose-ranging. Although many drugs are appropriate, our choices were based on institutional familiarity and simplicity. This process of developing a clear and consistent guideline can be duplicated in any unit.
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Sheridan RL, MacMillan K, Donelan M, Choucair R, Grevelink J, Petras L, Lydon M, Tompkins R. Tunable dye laser neovessel ablation as an adjunct to the management of hypertrophic scarring in burned children: pilot trial to establish safety. J Burn Care Rehabil 1997; 18:317-20. [PMID: 9261697 DOI: 10.1097/00004630-199707000-00007] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Hypertrophic scarring is a major source of morbidity in patients with burns. The physiologic characteristics are poorly understood, but increased neovascularity is typically seen in those wounds destined to become hypertrophic. We theorize that ablation of the developing neovasculature may favorably influence the development of the hypertrophic scar. The goal of this pilot trial was to establish the practicality and safety of tunable dye laser neovessel ablation at 585 nm. Ten sites of evolving hypertrophic scar in nine children were treated with a series of 450 msec 6.75 J/cm2 pulses at 585 nm. Although all children had the expected transient posttreatment purpura, no pain, ulceration, pruritus, or worsening of the lesions was seen. The technique appears safe and is worthy of continuing investigation. Investigations with higher fluences and multiple treatments are in progress.
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Abstract
The use of stable isotopes to analyze intracellular metabolism is a powerful technique because of the wealth of information contained in the distribution of isotopes in key metabolites. We present a new numerical method of using measurements of isotope isomer (isotopomer) distributions to calculate the fluxes through a biochemical reaction network. Nuclear magnetic resonance (NMR) and/or mass spectroscopy can quantify the isotopomers which result from the metabolism of an isotopically enriched substrate. These data can be analyzed via a numerical model of the metabolic network which uses atom-mapping matrices to simplify model construction. The atom-mapping matrices describe the transfer of atoms from reactant to product and the resulting isoopomer balance equations are compact and intuitive. These equations are solved iteratively to determine the unknown intracellular fluxes. Results from the numerical method agreed with an analytical solution developed for the analysis of the tricarboxylic acid cycle in perfused hearts.
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Affiliation(s)
- C Zupke
- Surgical Services, Massachusetts General Hospital, Boston, USA
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Earley EM, Reinschmidt DC, Tompkins R, Gebhardt BM. Tissue culture of a mixed cell thymic tumor from Xenopus laevis. In Vitro Cell Dev Biol Anim 1995; 31:255-7. [PMID: 7795842 DOI: 10.1007/bf02633995] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Weber J, Sheridan R, Hopkins C, Tompkins R. Weekly central venous catheter change in pediatric burn patients. Am J Infect Control 1993. [DOI: 10.1016/0196-6553(93)90268-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Saunders K, Longmire W, Tompkins R, Chavez M, Cates J, Roslyn J. Diffuse bile duct tumors: guidelines for management. Am Surg 1991; 57:816-20. [PMID: 1746801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The majority of patients with bile duct cancer have small focal adenocarcinomas localized to the upper, middle, or lower third of the bile duct. In contrast, a small subgroup of patients have been identified with bile duct tumors that are diffuse, involving multiple segments of the extrahepatic biliary tract. Among 186 patients with documented bile duct cancer treated at the UCLA Medical Center between 1954 and 1988, 13 patients (7%) had diffuse lesions. Patients with diffuse tumors had markedly poorer survival rates than did those with focal lesions. As diffuse tumors are not amenable to resection, surgical management consists primarily of establishing suitable biliary drainage. All patients with bile duct cancer should undergo careful intraoperative evaluation to exclude a diffuse lesion before tumor resection.
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Affiliation(s)
- K Saunders
- Department of Surgery, UCLA School of Medicine 90024
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Abstract
Recent studies have advocated the nonoperative treatment of elderly patients with bile duct cancer using biliary endoprostheses. In addition to a 30-day mortality rate of 9%, disadvantages with this approach include lack of a definitive diagnosis and the inability to assess resectability. For comparison, we reviewed 42 consecutive cases of bile duct cancer managed surgically at UCLA (from 1954 to 1988) among patients age 70 years or older. Histologic confirmation of bile duct cancer was obtained for 40 surgical patients (95%) in the series. The 30-day mortality rate was 10%. There was a trend to more aggressive surgical management during the study, with a concomitant doubling in survival rates (from 21% among patients treated between 1954 and 1978 to 53% among patients treated between 1979 and 1988 at 1 year after surgery.) We conclude that elderly patients should not be denied surgical evaluation of malignant neoplasms of the bile duct simply on the basis of age.
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Affiliation(s)
- K Saunders
- Department of Surgery, UCLA School of Medicine 90024
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Domingues RC, Mikulis D, Swearingen B, Tompkins R, Rosen BR. Subcutaneous sacrococcygeal myxopapillary ependymoma: CT and MR findings. AJNR Am J Neuroradiol 1991; 12:171-2. [PMID: 1899505 PMCID: PMC8367572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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24
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Affiliation(s)
- R Tompkins
- Department of Cell and Molecular Biology, Tulane University, New Orleans, Louisiana 70118
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Lipscomb MF, Alvarellos T, Toews GB, Tompkins R, Evans Z, Koo G, Kumar V. Role of natural killer cells in resistance to Cryptococcus neoformans infections in mice. Am J Pathol 1987; 128:354-61. [PMID: 3618730 PMCID: PMC1899629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Previous studies have suggested a possible role for natural killer (NK) cells in resistance to some fungal infections, including Cryptococcus neoformans infections. The role of NK cells in early clearance of C neoformans from tissues and in long-term survival was studied in mice following intravenous inoculations of the organism. Mice treated with anti-asialo GM1 antiserum to temporarily reduce NK activity demonstrated an increase in colony-forming units (CFU) of C neoformans in the lung 24 hours after an intravenous inoculation of the organism. CFU in liver, spleen, kidney, and brain were not different in anti-asialo GM1 antiserum-treated versus control mice. An NK-specific reagent, anti-NK 1.1 monoclonal antibody, was used to deplete mice of NK cells in vivo for at least 14 days without affecting other natural defenses. The number of C neoformans retained in the lungs 24 hours after inoculation of the organism was significantly greater in NK cell-depleted mice than in controls, although CFU in other organs were unaffected. Following the intravenous inoculation of C neoformans, the survival of anti-NK 1.1-treated mice was not different from control mice. The effect of NK cell activity on resistance to C neoformans was also determined after an intratracheal inoculation of the organism. Mice pretreated with anti-NK 1.1 demonstrated no increases in CFU in the lungs, spleen, or brain as compared with controls. These data indicate that NK cells can play a role in vivo in early resistance against C neoformans if the organism is delivered via the intravenous route. However, NK cells do not play a role in either determining survival after an intravenous inoculation nor in resistance during an infection acquired via the respiratory tract.
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Abstract
Morphological aspects of four different groups of Golgi impregnated brain cells from a tetraploid strain of Xenopus laevis frogs were compared to analogous cells in comparably sized diploid frogs. The cells examined included neurons from the telencephalon, caudal hypothalamus, and optic tectum, and radial glial cells from the optic tectum. The brains of tetraploid frogs appeared grossly normal and were the same size and contained similar cell types as diploid brains. As observed in previous studies on polyploid amphibia, somal diameters increased significantly in tetraploid cells for each of the four groups of cells examined. Also, the total length of the dendritic arbors in tetraploid brain cells increased significantly by factors ranging from 1.4 to 2.4 times the total length of the analogous processes in diploid cells. Tetraploid neurons in the telencephalon and hypothalamus increased their arbor lengths predominantly by increasing the number of dendritic branches, while maintaining the average distance between branch points in the dendritic segments. In contrast, the tetraploid large pear-shaped neurons in the optic tectum had significantly longer terminal dendritic segments than the analogous diploid neurons, although these tetraploid neurons maintained their average number of dendritic segments per cell. Tetraploid tectal radial glial cells appeared to increase both their number of branches and the lengths of their terminal segments. Thus, the mode by which tetraploid brain cells achieved longer dendritic arbors varied from cell type to cell type. These results suggest a hypothetical basis for possible effects of genomic size on vertebrate brain structure and evolution at the cellular level.
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27
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Dudek FE, Ide CF, Tompkins R. Unresponsive, a behavioral mutant in Xenopus laevis: electrophysiological studies of the neuromuscular system. J Neurobiol 1987; 18:237-43. [PMID: 3572392 DOI: 10.1002/neu.480180208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Normal Xenopus laevis embryos begin movements at 1 day after fertilization. Embryos homozygous for the unresponsive mutation fail to move until 4 days after fertilization (just prior to feeding), after which they recover slowly. Electrophysiological studies were undertaken to determine the focus of this mutation. Formamide treatment of normal embryos was used to produce a phenocopy of the unresponsive condition, permitting direct comparisons between mutant and normal embryos. Intracellular recordings from muscle cells were obtained in formamide-treated and untreated preparations with both normal and unresponsive animals. Local electrical stimulation evoked either isolated endplate potentials and action potentials or after-discharges of these events in all preparations. A decrease in illumination also caused a burst of endplate potentials and action potentials. Therefore, the electrophysiology of the neuromuscular junction in unresponsive appears qualitatively normal; the effect of the mutation on the motor system is probably distal to the neuromuscular junction, either at or subsequent to excitation-contraction coupling.
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Reinschmidt D, Friedman J, Hauth J, Ratner E, Cohen M, Miller M, Krotoski D, Tompkins R. Gene-centromere mapping in Xenopus laevis. J Hered 1985; 76:345-7. [PMID: 4056365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Gynogenesis was used to map eight loci to their centromeres in Xenopus laevis. Several loci remote from their centromeres were identified. This information may be useful in distinguishing gynogenetic diploid progeny produced by suppression of second polar bodies from gynogenetic diploid progeny homozygous at all loci produced by suppression of first cleavage of gynogenetic haploids.
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Abstract
To follow the subsequent history of grafted tissue in experiments designed to study regulation and commitment in the amphibian neural plate, previous workers have relied on graft scars, vital dyes applied externally to cells, or xenoplastic grafts. Each of these methods has been criticized on the grounds that they do not indicate unambiguously the origins of individual cells within the operated host. To overcome these difficulties, homoplastic, genetically marked embryonic grafts were taken from the prospective spinal neuroectoderm of triploid and tetraploid Xenopus laevis frogs and transplanted to presumptive eye and prosencephalic regions of the neural plate of diploid X. laevis embryos. Orthotopic presumptive eye grafts also were done. Marked cells were scored in section either by nucleolar number or computerized nuclear size analysis. Of 28 heterotopically grafted embryos that survived to stage 41, when the retina has differentiated, prospective spinal cord neuroectoderm in eight animals gave rise to cell types unique to the eye. The remaining 20 survivors appeared to be mosaic. These results substantiate claims of regulation in the neural plate and extend these observations to the level of individual cell types, a level of resolution not previously obtained in other studies.
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Krotoski DM, Reinschmidt DC, Tompkins R. Developmental mutants isolated from wild-caught Xenopus laevis by gynogenesis and inbreeding. J Exp Zool 1985; 233:443-9. [PMID: 3973558 DOI: 10.1002/jez.1402330313] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Xenopus laevis obtained from indigenous African populations are a rich source of mutants affecting development. Gynogenesis and inbreeding were used to isolate mutants affecting development from wild-caught Xenopus laevis females. Fourteen mutants were recovered from eight females tested. One mutant was recovered from each of two females. This load of 1.875 developmental mutants per female is similar to that found in the axolotl (Ambystoma mexicanum), a urodele amphibian, and is only slightly less than the load of mutants with major developmental effects found in Drosophila and man. These results suggest that the anuran amphibian Xenopus laevis, an ancestrally tetraploid species, has undergone extensive diploidization of developmentally important loci and that gynogenesis and inbreeding of wild-caught animals can provide adequate mutants at diploid loci for developmental genetic studies.
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Ide CF, Reynolds P, Tompkins R. Two healing patterns correlate with different adult neural connectivity patterns in regenerating embryonic Xenopus retina. J Exp Zool 1984; 230:71-80. [PMID: 6726148 DOI: 10.1002/jez.1402300110] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Nasal and temporal one-third-sized eye fragments, formed by ablation at stage 32-33 of Xenopus laevis embryos, heal and, in about 50% of the cases, survive to make eyes in the postmetamorphic animal which have mappable visuotectal projections. The majority of nasal one-third eyes have duplicate projections whereas the majority of temporal one-third eyes have unduplicated projections. Most nasal one-third eye fragments and a minority of temporal eye fragments heal by the extrusion of cells from the center of the cut edge into the region of the ablation, forming a tongue of cells between the distal cut edges. This healing pattern is correlated with duplicated visuotectal projections. Most temporal one-third fragments and a minority of nasal one-third fragments heal by rounding up; that is, the distal cut edges collapse to meet in the region of the ablation. This healing pattern is correlated with the formation of unduplicated visuotectal projections. During tongue formation, neurons and undifferentiated cells are transferred from the original fragment into the tongue in a disorderly array, but quickly re-form normal retinal order. We propose that the tongue cells retain their original determination to connect to the same tectal positions as the fragment from which they originated, despite their new positions, and that this mosaicism, coupled with cell movement into the tongue, established duplicate visuotectal projections.
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Tompkins R, Szaro B, Reinschmidt D, Kaye C, Ide C. Effects of alterations of cell size and number on the structure and function of the Xenopus laevis nervous system. Adv Exp Med Biol 1984; 181:135-46. [PMID: 6532155 DOI: 10.1007/978-1-4684-4868-9_11] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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33
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Dobrinska MR, Furst DE, Spiegel T, Vincek WC, Tompkins R, Duggan DE, Davies RO, Paulus HE. Biliary secretion of sulindac and metabolites in man. Biopharm Drug Dispos 1983; 4:347-58. [PMID: 6661513 DOI: 10.1002/bdd.2510040407] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The biliary secretion of sulindac and metabolites after a single 400 mg oral dose of the drug was studied in 3 elective gallbladder surgical patients following placement of an occludable T-tube in the common bile duct. Bile and systemic plasma were sampled at frequent intervals for up to 36 h postdose. The apparent biliary clearance (Vcl,bile) of the prodrug sulindac is about 25 times greater than that of the pharmacologically active sulfide metabolite. The total biliary flux of drug in normal man with an uninterrupted enterohepatic cycle, calculated from Vcl,bile and historic mean plasma drug AUCinfinity0 values, averages 144 and 12.2 per cent of the dose as sulindac and the sulfide metabolite, respectively. Thus, enterohepatic recycling of the drug in man is principally in the form of the prodrug which not only limits exposure of the intestine to the active moiety but also sustains systemic concentrations of active drug upon reabsorption of the prodrug.
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34
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Kaye C, Schermer JA, Tompkins R. Tolerance maintenance depends on persistence of the tolerizing antigen: evidence from transplantation studies on Xenopus laevis. Dev Comp Immunol 1983; 7:497-506. [PMID: 6357880 DOI: 10.1016/0145-305x(83)90034-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
In order to assess the role of antigen persistence in the tolerant state, tolerance was induced in Xenopus laevis by the embryonic transplantation of whole eyes or tail tissue. Both types of transplants were seen to heal in and persist, with no signs of immunological incompatibility. At metamorphosis, tail resorption occurred and grafted tail tissue was lost. Eye transplants were maintained through metamorphosis in most eye grafted animals. Eye graft recipients which had maintained the transplant were observed to accept challenge skin allografts from donors of the same genotype as the eye donor in all but one case, while recipients which had lost the eye transplant at metamorphosis or had the eye transplant experimentally removed sometimes did not accept the challenge skin graft. Animals tail grafted as embryos did not accept post metamorphic skin grafts from donors of the same genotype as the tail tissue donor, but rejection was not accelerated. It is proposed that tolerance induction is dependent on the presence of appropriately presented antigen at a time when precursor thymocyte cells are migrating to the thymus, prior to their processing into alloreactive cells, and that tolerance maintenance is dependent upon the persistence of the tolerizing antigen.
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Abstract
Xenopus laevis thymectomized at stages 41 through 49 accept first set allografts, while animals thymectomized at stage 51 or older reject allografts in times similar to intact animals. However, thymectomy at progressively earlier stages results in a greater proportion of animals unable to reject second set grafts. In some animals, the allograft response remains deficient even after multiple challenges. The results indicate that alloreactive cells are thymus dependent, and suggest that the thymus processes precursor thymocytes starting upon its formation at around stage 41. The processed cells, competent to respond to alloantigens, are released to the periphery almost immediately. While an increasing pool of processed T cells accumulates during stages 41-49, the persistent defective allograft response displayed by animals thymectomized during these stages suggests that early thymectomy may leave a population of alloreactive cells qualitatively defective in some subpopulation necessary for normal allograft responses, or that any residual cells processed prior to thymectomy are capable of only limited clonal expansion.
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36
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Ide C, Reynolds P, Tompkins R. Duplication of positional information in regeneration of eye-bud fragments results from a specific healing pattern. Int J Dev Neurosci 1983. [DOI: 10.1016/0736-5748(83)90336-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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37
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Gibbs DA, Spellacy E, Tompkins R, Watts RW, Mowbray JF. A clinical trial of fibroblast transplantation for the treatment of mucopolysaccharidoses. J Inherit Metab Dis 1983; 6:62-81. [PMID: 6410119 DOI: 10.1007/bf02338973] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This paper reports the clinical and biochemical results in six patients with Hurler disease (Mucopolysaccharidosis IH; McKusick 25280), two patients with Hunter disease (Mucopolysaccharidosis II; McKusick 25285) and one patient with Sanfilippo B disease (Mucopolysaccharidosis IIIB; McKusick 25292) who were treated by fibroblast transplantation. Except for one patient who died for a coincidental reason, the patients have been studied for between 2.5 and 4.5 years. The clinical course of the disease was not materially altered. There was no evidence that the patients had developed immune responses against the transplanted fibroblasts. Transplantation did not produce measurable levels of either alpha-L-iduronidase (EC 3.2.1.76) in the leukocytes from patients with Hurler disease or of N-acetyl-alpha-D-glucosaminidase (EC 3.2.1.50) in the plasma of the patients with Sanfilippo B disease. Under the conditions used for the assay, leukocytes from the patients with Hunter disease had detectable levels of residual alpha-L-idurono-2-sulphate sulphatase activity which were increased after the transplants, although these changes were of inconstant size and their time course was not consistently related to the transplantations. Cytogenetic studies in cases where the donor was of the opposite sex detected only cells of the recipient's sex among the fibroblasts grown from biopsies of the transplantation sites. The technique used would have detected a donor to recipient cell ratio of 1:100. We found no consistent long-term trends in the excretion patterns of glycosaminoglycans and oligosaccharides from either a quantitative or qualitative point of view which could be specifically related to the transplantation. The combined administration of immunosuppressive doses of prednisolone and azathioprine was associated with an increased excretion of the lower molecular weight glycosaminoglycans. We conclude that fibroblast transplantation is not therapeutically useful in the diseases studied.
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38
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Taylor JR, Tompkins R, Demers R, Anderson D. Electroconvulsive therapy and memory dysfunction: is there evidence for prolonged defects? Biol Psychiatry 1982; 17:1169-93. [PMID: 7171661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The authors reviewed 39 papers which concern the long-term effects of electroconvulsive therapy (ECT) on human memory. Although the authors caution that methodological considerations preclude a decisive assessment, the majority of the studies suggest that ECT does not normally produce prolonged memory defects. Some recent studies do document subtle but persistent defects several months after ECT, especially in personal autobiographical material. These defects appear to be more annoying than seriously incapacitating. Variables considered important in an ideal design of studies on ECT and memory are discussed.
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40
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Abstract
The thesis that lymphocytes originate in situ by the direct transformation of epithelial cells within the thymic primordium in anurous frogs is untenable. On the contrary, in both the leopard frog and the African clawed toad, the lymphocytes that first appear in the embryonic thymus are derived from extrathymic lymphopoietic cells that invaded the developing organ. The exact source of origin of the invading lymphopoietic cells remains problematic.
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41
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Ide CF, Tompkins R, Miszkowski N. Neuroanatomy of Spastic, a behavior mutant of the mexican axoloti: Purkinje cell distribution in the adult cerebellum. J Comp Neurol 1977; 176:373-86. [PMID: 915044 DOI: 10.1002/cne.901760306] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The spastic mutant, found in the Mexican axolotl, shows swimming coordination and equilibrium deficiencies. Histological analyses of wild-type and spastic mutant cerebella previously characterized in physiological studies revealed changes in Purkinje cell location in the mutant auricle or vestibulo-cerebellum. Purkinje cells are "translocated" ventrally correlated with a similar translocation of vestibular single units described previuosly (Ide, '77). Where wild-type Purkinje cells are distributed from the surface to a depth of 250 micrometers, mutant Purkinje cells are "crowded" between 250 and 350 micrometers. Although mutant granule cells are present, boundaries between granule cell and Purkinje cell zones are less precise in mutants. Cerebellar nucleus cells are translocated medially, failing to organize into the discrete cell group appearing in wild-type. Cerebellar white matter tracts and fibers show changes, both in orientation with respect to the underlying tegmentum, and in fascicular organization. Obvious changes in the gross anatomy of the cerebellum are confirmed in reconstructions which define cell and fiber translocation. Thus, the spastic gene is compatible with differentiation of all cerebellar elements, but appears to alter interactions between cells, or between cells and the external milieu. Although all cell types are present in the mutant cerebellum, they fail to attain their proper positions along all three body axes.
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Abstract
Skin rotation grafts were performed in Rana pipiens tadpoles producing misdirected reflexes in adult frogs. The pattern of innervation fields of dorsal and ventral rami of segmental nerves 3, 4, 5 and 6 were investigated by recording from the severed rami with suction electrodes. Innervation patterns of regenerated fields were influenced by graft borders and adjacent fields. Misdirected reflexes were found for ventral skin on the dorsal side only when innervated by ventral rami in a manner never seen in normal or sham operated animals. This suggested that selective reinnervation has occurred.
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Abstract
The homozygous recessive spastic mutant found in the Mexican axolotl shows violent coiling and thrashing behavior when subjected to strong tactile or electrical stimulation. In order to establish the time of onset of the first behavioral manifestation of the spastic gene, an etiological analysis of the ontogeny of swimming behavior in mutants and wild type siblings was undertaken. The locomotor patterns shown by embryos in response to an electrical stimulus were analyzed quantitatively from the embryonic early flexure stage through the larval early feeding stage. Spastic larvae failed to show dorsal-up swimming frequencies equal to those of sibling controls from day 12 (Harrison stage 40) of development indicating a lack of equilibrium. Both spastics and their siblings showed "sinusoid swimming" and "coiling" behavior in response to an aversive stimulus through day 18 (Harrison state 46, early feeding stage) of development. From day 18, wild type siblings abruptly decreased "coiling" behavior and showed strong "escape swimming" in response to an intense stimulus. Spastics never developed "escape swimming" patterns but retained a mixture of "sinusoid swimming" and "coiling" patterns characteristic of pre-feeding stage larvae.
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45
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Diamond H, Alexander S, Kuzell W, Lussier A, Odone D, Tompkins R. Naproxen and aspirin in rheumatoid arthritis: a multicenter double-blind crossover comparison study. J Clin Pharmacol 1975; 15:335-9. [PMID: 1092727 DOI: 10.1002/j.1552-4604.1975.tb01461.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
One hundred nineteen adults with active definite or classical rheumatoid arthritis were studied in a multicenter double-blind crossover study of naproxen (500 mg/day) and aspirin (3.6 Gm/day). Each drug was given in sequence for a six-week study period. Patients already receiving corticosteriod and/or gold therapy were maintained at constant dose throughout the study, but analgesics and other nonsteroidal antiinflammatory agents were discontinued at baseline. Objective and subjective evaluations by both investigator and patient were carried out at two-week intervals. No significant difference in global evaluation of efficacy or individual measures of efficacy was observed between aspirin and naproxen therapy, although physicians' global evaluation tended to favor naproxen. Sedimentation rate was lower on aspirin (naproxen 43.1 mm/hr; aspirin 38.7 mm/hr; P=0.02). Naproxen, 250 mg twice daily, was significantly better tolerated than aspirin, 900 mg four times daily. Mild, moderate, and severe side effects were less frequent with naproxen. The incidence of heartburn was significantly lower on naproxen, and significantly fewer patients terminated their six-week study period on naproxen than on aspirin. There were no significant deviations from baseline values in hematocrit, white cell or differential counts, or in tests of renal and hepatic function during the course of the study.
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46
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Abstract
Oocytes of five stages of development were isolated from ovaries of Xenopus laevis and allowed to take up radioactive amino acids. After six hours of labeling the amount of label incorporated into perchloric acid precipitable material from the soluble oocyte fraction and the specific activity of the label free pool was determined. From these figures an estimate of the rate of protein synthesis was calculated. Labeled soluble protein from each oocyte stage was analyzed by electrophoresis on SDS polyacrylamide gels. The gel was dried and autoradiographed to determine the qualitative pattern of soluble protein synthesis during various stages of oogenesis. Our results indicate that no significant differences exist in the rate of protein synthesis among any of the stages of oogenesis investigated. The qualitative pattern of soluble protein synthesized during the labeling period is similar among the oocyte stages. Moreover, this qualitative pattern of soluble protein synthesis is the same as the pattern of soluble protein accumulated up to that time during oogenesis. These results suggest a stable synthesis and accumulation of maternal protein products during Xenopus oogenesis, in marked contrast to the results that have been reported for RNA synthesis during oogenesis in Xenopus. Our results are discussed in terms of the present understanding of the process of maternal information accumulation.
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Diamond H, Alexander S, Kuzell W, Lussier A, Odone D, Tompkins R. A multi-center double-blind crossover comparison study of naproxen and aspirin in patients with rheumatoid arthritis. Scand J Rheumatol 1973; 2:171-5. [PMID: 4590045 DOI: 10.3109/03009747309097120] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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48
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Caskey C, Scolnick E, Tompkins R, Milman G, Goldstein J. [38] Release factors: in vitro assay and purification. Methods Enzymol 1971. [DOI: 10.1016/s0076-6879(71)20040-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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49
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50
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Caskey T, Scolnick E, Tompkins R, Goldstein J, Milman G. Peptide chain termination, codon, protein factor, and ribosomal requirements. Cold Spring Harb Symp Quant Biol 1969; 34:479-88. [PMID: 4909515 DOI: 10.1101/sqb.1969.034.01.054] [Citation(s) in RCA: 71] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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