Abbreviations cm, Centimeter; CT, Computer tomography; ERCP, Endoscopic reterograde cholangiopanc... more Abbreviations cm, Centimeter; CT, Computer tomography; ERCP, Endoscopic reterograde cholangiopancreatography; EUS, Endoscopic ultrasound; h, Hour; min, Minute; n, Number. ... Correspondence Ms Sarah Thomasset, Department of Hepatobiliary and Pancreatic ...
Campylobacter jejuni enteritis can lead to musculoskeletal, neuropathic or other health sequelae.... more Campylobacter jejuni enteritis can lead to musculoskeletal, neuropathic or other health sequelae. We investigated the coexistence, seasonal occurrence, strain-type associations and impact on work capacity of different health problems following C. jejuni enteritis in a Lancashire population during 1999 and 2001. A semistructured questionnaire was used to characterize health problems that occurred in the community after laboratory-confirmed episodes of C. jejuni enteritis. The questionnaire was posted to all adults in the Preston and Chorley area who developed C. jejuni enteritis in 1999 or 2001. All Campylobacter isolates from this population were serotyped. Several types of sequelae occurred consistently in both years, including the coexistence of musculoskeletal and neuropathic problems. There was no evidence of C. jejuni strain-type associations or seasonal preponderance for any type of sequela. The overall health impact of C. jejuni enteritis, as measured by workdays lost, was hi...
American Journal of Respiratory and Critical Care Medicine, Sep 1, 2001
The booster effect varies between populations, but has not been studied in the UK. The aim of thi... more The booster effect varies between populations, but has not been studied in the UK. The aim of this study was to investigate the effect of repeat tuberculin tests at 1 wk in BCG-vaccinated healthy subjects (all hospital employees) in the UK; we have assessed whether a booster effect is present 48 and 72 h after injection. Twenty-six subjects received two tuberculin tests (both 10 units) administered by the Mantoux technique-Tests 1 and 2. At Test 2 there was a significant increase in induration at 48 h (mean, 7.8 mm; p < 0.001), no difference at 72 h (mean, 0.2 mm; p = 0.93), and a reduction at 96 h (mean, -4.2 mm; p = 0.02). There were more positive results (> 15 mm induration) at Test 2 compared with Test 1 at 48 h (19 vs. 9, respectively; p = 0.002), but similar numbers at 72 h (11 vs. 10, respectively). These results show that repeat tuberculin testing in this BCG-vaccinated population caused a booster effect that varied with the time of measurement and was maximal at 48 h.
CONTEXT: Patients with resectable pancreatic cancer comprise a small subgroup of the overall popu... more CONTEXT: Patients with resectable pancreatic cancer comprise a small subgroup of the overall population with the disease from around 15 to 20%, with nearly all patients dying from their disease within 7 years of surgery. In the light of such bleak statistics, data regarding what factors may influence outcome, following attempted curative resection is essential in order to optimise the treatment options for patients.METHODS: This review analysed all English-language publications using PubMed and Web of Science databases for studies detailing outcomes following resection for pancreatic ductal adenocarcinoma from 1980 to the present day.MAIN OUTCOME MEASURES: The data examined from papers were post-operative mortality rates, median survival, yearly survival rates and other factors which may have influenced long-term survival; such as patient demographics, operative details and tumour characteristics (such as example tumour size, lymph node metastases and tumour differentiation).RESULTS: There has been significant improvement in post-operative mortality over the last decades with a modest improvement in long-term survival. With the exception of post-operative blood transfusion, tumour characteristics remain the only significant features influencing survival after pancreatic cancer surgery. Favourable prognostic factors include tumour size less than 2 cm, negative resection margin, lymph node negative tumours, well-differentiated tumours and absence of perineural or blood vessel invasion.CONCLUSION: In light of these data, it could be reasoned that tumour size, on cross-sectional imaging, might be employed as means of selecting the most appropriate candidates for surgery, in cases where the risks of resection are high.
International journal of fertility and women's medicine
To test the hypothesis that treating dysfunctional uterine bleeding by automated application of e... more To test the hypothesis that treating dysfunctional uterine bleeding by automated application of electrothermal energy to the uterine cavity, with precise regional control, might yield results equivalent to those reported for hysteroscopically directed laser and electrosurgical endometrial ablations. Patients with life style compromising menorrhagia, referred to six gynecologic surgical centers for hysterectomy or endometrial ablation, were admitted to the study if they had normal cervical cytology, a benign endometrial biopsy, no defined cause for their bleeding, and consented to participate in the evaluation of a newly developed Vesta DUB Treatment System. The device consists of a silicone-inflatable electrode carrier to be inserted into the uterine cavity and a controller to monitor and distribute current from a matched electrosurgical generator. Treatment involved a 3-minute or shorter warm-up period and a 4-minute treatment phase. Three- to 24-month follow-up data were available for 187 patients, with a mean follow-up of 14.8 months. The amenorrhea rate was 38%. Bleeding was reduced in 95% of patients. Actuarially, 88 +/- 3% of patients should expect to be free of menorrhagia, dissatisfaction, or need for a second procedure out to 24 months. The unique regional feed-back control offered by this system causes thorough, evenly distributed, thermal destruction 4-5 mm into the myometrium that reduces bleeding with durability equivalent to published reports of hysteroscopic endometrial ablation.
JSLS: Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
The purpose of this study was to assess the long-term efficacy of laparoscopic laser surgery in t... more The purpose of this study was to assess the long-term efficacy of laparoscopic laser surgery in the treatment of painful pelvic endometriosis. We conducted a long-term follow-up of 56 patients who had participated in a randomized, double-blind controlled study at a tertiary referral center for the laparoscopic treatment of endometriosis. The patients had pelvic pain, minimal-to-moderate endometriosis, and underwent laser laparoscopy. We asked patients whether they had now achieved satisfactory symptom relief or whether they had received any further medical intervention for their endometriosis. The main outcome measure was continued symptom relief after treatment and subsequent medical history. Of the original 56 patients, we were able to contact 38 (67.9%). The mean (range) time since operation was 73 months. Painful symptoms had recurred in 28/38 (73.7%) patients at some point since their operation. The median (range) time for recurrence was 19.7 (5-60) months. At the time of follow-up, satisfactory symptom relief was reported in 21/38 (55.3%) patients. The remaining 17/38 (44.7%) patients continued to experience painful symptoms, and eight eventually had a hysterectomy. This study suggests that operative laparoscopy can have long-term benefits for the majority of women with pelvic pain due to endometriosis, but because of the small numbers, this study lacks the power to demonstrate this conclusively.
Page 349. 28 Outcome Measures and Adhesion Formation: Pain and Postsurgical Adhesion David MB Ros... more Page 349. 28 Outcome Measures and Adhesion Formation: Pain and Postsurgical Adhesion David MB Rosen and Christopher JG Sutton CONTENTS Mechanism of Formation of Postsurgical Adhesions 321 Adhesion Formation: Laparotomy or Laparoscopy? ...
The clinical outcome of each technique in terms of cyst recurrence, pregnancy rates, pain relief ... more The clinical outcome of each technique in terms of cyst recurrence, pregnancy rates, pain relief and patient satisfaction are broadly similar, but this may reflect study design and in particular, the variable follow up periods, and methods used to document outcome ...
Subjects and setting All patients undergoing a gynaecological laparoscopy at The Royal Surrey Cou... more Subjects and setting All patients undergoing a gynaecological laparoscopy at The Royal Surrey County Hospital between 1 February 2000 and 31 January 2001. Surgeons completed a standard form at the time of the procedure, and these were cross-checked with patient discharge ...
The expression of the complete human gastric lipase (HGL) gene in Saceharomyces cerevisiae grown ... more The expression of the complete human gastric lipase (HGL) gene in Saceharomyces cerevisiae grown in defined medium resulted in the secretion of active recombinant HGL (rec.HGL) to levels of up to approximately 11 mg/liter. Of the total measurable HGL activity, 90% was detected by assaying intact cells, suggesting that the majority of rec.HGL produced was secreted but stayed attached to the cell wall. The remaining 10% was present in the growth medium and from this source active rec.HGL was purified 300-fold by a combination of hydrophobic interaction and ion-exchange chromatography. Rec.HGL migrated on reduced SDS-PAGE as three bands with estimated molecular masses of 47,45, and 43 kDa. All three forms cross-reacted with an antibody raised to natural HGL and their treatment with Endo H showed them to be N-linked glycosylation variants of a single polypeptide. The 47-kDa species was isolated using lentil lectin Sepharose 4B and shown to possess a specific activity comparable to that ...
Abbreviations cm, Centimeter; CT, Computer tomography; ERCP, Endoscopic reterograde cholangiopanc... more Abbreviations cm, Centimeter; CT, Computer tomography; ERCP, Endoscopic reterograde cholangiopancreatography; EUS, Endoscopic ultrasound; h, Hour; min, Minute; n, Number. ... Correspondence Ms Sarah Thomasset, Department of Hepatobiliary and Pancreatic ...
Campylobacter jejuni enteritis can lead to musculoskeletal, neuropathic or other health sequelae.... more Campylobacter jejuni enteritis can lead to musculoskeletal, neuropathic or other health sequelae. We investigated the coexistence, seasonal occurrence, strain-type associations and impact on work capacity of different health problems following C. jejuni enteritis in a Lancashire population during 1999 and 2001. A semistructured questionnaire was used to characterize health problems that occurred in the community after laboratory-confirmed episodes of C. jejuni enteritis. The questionnaire was posted to all adults in the Preston and Chorley area who developed C. jejuni enteritis in 1999 or 2001. All Campylobacter isolates from this population were serotyped. Several types of sequelae occurred consistently in both years, including the coexistence of musculoskeletal and neuropathic problems. There was no evidence of C. jejuni strain-type associations or seasonal preponderance for any type of sequela. The overall health impact of C. jejuni enteritis, as measured by workdays lost, was hi...
American Journal of Respiratory and Critical Care Medicine, Sep 1, 2001
The booster effect varies between populations, but has not been studied in the UK. The aim of thi... more The booster effect varies between populations, but has not been studied in the UK. The aim of this study was to investigate the effect of repeat tuberculin tests at 1 wk in BCG-vaccinated healthy subjects (all hospital employees) in the UK; we have assessed whether a booster effect is present 48 and 72 h after injection. Twenty-six subjects received two tuberculin tests (both 10 units) administered by the Mantoux technique-Tests 1 and 2. At Test 2 there was a significant increase in induration at 48 h (mean, 7.8 mm; p < 0.001), no difference at 72 h (mean, 0.2 mm; p = 0.93), and a reduction at 96 h (mean, -4.2 mm; p = 0.02). There were more positive results (> 15 mm induration) at Test 2 compared with Test 1 at 48 h (19 vs. 9, respectively; p = 0.002), but similar numbers at 72 h (11 vs. 10, respectively). These results show that repeat tuberculin testing in this BCG-vaccinated population caused a booster effect that varied with the time of measurement and was maximal at 48 h.
CONTEXT: Patients with resectable pancreatic cancer comprise a small subgroup of the overall popu... more CONTEXT: Patients with resectable pancreatic cancer comprise a small subgroup of the overall population with the disease from around 15 to 20%, with nearly all patients dying from their disease within 7 years of surgery. In the light of such bleak statistics, data regarding what factors may influence outcome, following attempted curative resection is essential in order to optimise the treatment options for patients.METHODS: This review analysed all English-language publications using PubMed and Web of Science databases for studies detailing outcomes following resection for pancreatic ductal adenocarcinoma from 1980 to the present day.MAIN OUTCOME MEASURES: The data examined from papers were post-operative mortality rates, median survival, yearly survival rates and other factors which may have influenced long-term survival; such as patient demographics, operative details and tumour characteristics (such as example tumour size, lymph node metastases and tumour differentiation).RESULTS: There has been significant improvement in post-operative mortality over the last decades with a modest improvement in long-term survival. With the exception of post-operative blood transfusion, tumour characteristics remain the only significant features influencing survival after pancreatic cancer surgery. Favourable prognostic factors include tumour size less than 2 cm, negative resection margin, lymph node negative tumours, well-differentiated tumours and absence of perineural or blood vessel invasion.CONCLUSION: In light of these data, it could be reasoned that tumour size, on cross-sectional imaging, might be employed as means of selecting the most appropriate candidates for surgery, in cases where the risks of resection are high.
International journal of fertility and women's medicine
To test the hypothesis that treating dysfunctional uterine bleeding by automated application of e... more To test the hypothesis that treating dysfunctional uterine bleeding by automated application of electrothermal energy to the uterine cavity, with precise regional control, might yield results equivalent to those reported for hysteroscopically directed laser and electrosurgical endometrial ablations. Patients with life style compromising menorrhagia, referred to six gynecologic surgical centers for hysterectomy or endometrial ablation, were admitted to the study if they had normal cervical cytology, a benign endometrial biopsy, no defined cause for their bleeding, and consented to participate in the evaluation of a newly developed Vesta DUB Treatment System. The device consists of a silicone-inflatable electrode carrier to be inserted into the uterine cavity and a controller to monitor and distribute current from a matched electrosurgical generator. Treatment involved a 3-minute or shorter warm-up period and a 4-minute treatment phase. Three- to 24-month follow-up data were available for 187 patients, with a mean follow-up of 14.8 months. The amenorrhea rate was 38%. Bleeding was reduced in 95% of patients. Actuarially, 88 +/- 3% of patients should expect to be free of menorrhagia, dissatisfaction, or need for a second procedure out to 24 months. The unique regional feed-back control offered by this system causes thorough, evenly distributed, thermal destruction 4-5 mm into the myometrium that reduces bleeding with durability equivalent to published reports of hysteroscopic endometrial ablation.
JSLS: Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
The purpose of this study was to assess the long-term efficacy of laparoscopic laser surgery in t... more The purpose of this study was to assess the long-term efficacy of laparoscopic laser surgery in the treatment of painful pelvic endometriosis. We conducted a long-term follow-up of 56 patients who had participated in a randomized, double-blind controlled study at a tertiary referral center for the laparoscopic treatment of endometriosis. The patients had pelvic pain, minimal-to-moderate endometriosis, and underwent laser laparoscopy. We asked patients whether they had now achieved satisfactory symptom relief or whether they had received any further medical intervention for their endometriosis. The main outcome measure was continued symptom relief after treatment and subsequent medical history. Of the original 56 patients, we were able to contact 38 (67.9%). The mean (range) time since operation was 73 months. Painful symptoms had recurred in 28/38 (73.7%) patients at some point since their operation. The median (range) time for recurrence was 19.7 (5-60) months. At the time of follow-up, satisfactory symptom relief was reported in 21/38 (55.3%) patients. The remaining 17/38 (44.7%) patients continued to experience painful symptoms, and eight eventually had a hysterectomy. This study suggests that operative laparoscopy can have long-term benefits for the majority of women with pelvic pain due to endometriosis, but because of the small numbers, this study lacks the power to demonstrate this conclusively.
Page 349. 28 Outcome Measures and Adhesion Formation: Pain and Postsurgical Adhesion David MB Ros... more Page 349. 28 Outcome Measures and Adhesion Formation: Pain and Postsurgical Adhesion David MB Rosen and Christopher JG Sutton CONTENTS Mechanism of Formation of Postsurgical Adhesions 321 Adhesion Formation: Laparotomy or Laparoscopy? ...
The clinical outcome of each technique in terms of cyst recurrence, pregnancy rates, pain relief ... more The clinical outcome of each technique in terms of cyst recurrence, pregnancy rates, pain relief and patient satisfaction are broadly similar, but this may reflect study design and in particular, the variable follow up periods, and methods used to document outcome ...
Subjects and setting All patients undergoing a gynaecological laparoscopy at The Royal Surrey Cou... more Subjects and setting All patients undergoing a gynaecological laparoscopy at The Royal Surrey County Hospital between 1 February 2000 and 31 January 2001. Surgeons completed a standard form at the time of the procedure, and these were cross-checked with patient discharge ...
The expression of the complete human gastric lipase (HGL) gene in Saceharomyces cerevisiae grown ... more The expression of the complete human gastric lipase (HGL) gene in Saceharomyces cerevisiae grown in defined medium resulted in the secretion of active recombinant HGL (rec.HGL) to levels of up to approximately 11 mg/liter. Of the total measurable HGL activity, 90% was detected by assaying intact cells, suggesting that the majority of rec.HGL produced was secreted but stayed attached to the cell wall. The remaining 10% was present in the growth medium and from this source active rec.HGL was purified 300-fold by a combination of hydrophobic interaction and ion-exchange chromatography. Rec.HGL migrated on reduced SDS-PAGE as three bands with estimated molecular masses of 47,45, and 43 kDa. All three forms cross-reacted with an antibody raised to natural HGL and their treatment with Endo H showed them to be N-linked glycosylation variants of a single polypeptide. The 47-kDa species was isolated using lentil lectin Sepharose 4B and shown to possess a specific activity comparable to that ...
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