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Search Results: 1 - 10 of 139739 matches for " K. Myers "
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Persistence of Natural Killer (NK) cell lymphocytosis with hyposplenism without development of leukaemia
Sujoy Khan, K Myers
BMC Clinical Pathology , 2005, DOI: 10.1186/1472-6890-5-8
Abstract: We report a lady with a benign clinical course over 10 years and persistent CD8+/CD3-/CD57+/CD16+ LGL proliferation with presence of Howell-Jolly bodies (functional hyposplenism), an association not previously described.We discuss the possible causes of clonal expansion and conclude that this may be part of the spectrum of immune dysregulation associated with NK-cell lymphocytosis.The lymphoproliferative disease of granular lymphocytes (LDGL) results from the chronic proliferation of large granular lymphocytes (LGL) that may result from antigenic stimulation1,2. Natural Killer (NK) cells constitute approximately 15% of the peripheral blood mononuclear cell fraction. NK cells lack both CD3 and T-cell receptor expression, majority express CD56 and/or CD16 (Fcγ receptor). Granular lymphocytosis greater than 2,000/μL lasting for more than 6 months is regarded as the criteria to define the disease [1,2]. Patients with chronic, indolent NK lymphocytosis may develop cytopenias, splenomegaly, vasculitic skin lesions, and peripheral neuropathy [3]. We discuss a unique case of chronic, indolent NK lymphocytosis who presented with severe hyposplenism and has not developed leukaemia over a decade.A 46-year-old lady was referred to the haematology clinic for evaluation of lymphocytosis in May 1993. She had severe lethargy and intermittent right upper abdominal discomfort without any significant loss in weight. Her past medical history included essential hypertension controlled on atenolol 100 mg once daily and was also on frusemide 40 mg once daily. She had no significant surgical history other than having undergone cholecystectomy in 1972. She had never smoked nor consumed alcohol. Physical examination showed no evidence of lymphadenopathy. Complete blood count showed normal haemoglobin concentration 14.8 g/dl, macrocytosis (MCV 100.1), raised white cell count at 13.4 × 109/L, lymphocytosis (absolute number 6.3 × 109/L), and normal neutrophil count (absolute number 5.6 × 109/L)
Medical Ethics: Context Is the Key Word  [PDF]
John Myers
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.516134
Abstract:

Medical Ethics is no different to Ethics, but relates specifically to the doctor-patient relationship. This relationship is based on mutual trusttrust in the doctor’s expertise and knowledge and trust that the patient is consulting the doctor, for his/her/their own health, wellbeing and welfare, without agenda or bias. In other words, the basis of the doctor-patient relationship is one of mutual trust and confidence. Thus, what is imparted between them is held in the strictest confidence. The doctor must act within the law. No third party influence can be brought to bear on this relationship without the patient’s consent. In the case of minors the relationship is between the child’s guardians as well as the doctor who must act within the law. In the category of “elderly” or adult guardianship or advocacy, those appointed and in positions of trust must take the person’s wishes into account if the patient has capacity to make decisions or has indicated their wish prior to any such appointment. Capacity is defined as consistent belief or wish, awareness of what one does not wish for, satisfaction when wishes are respected and fulfilled and the opposite when they are not. Ethical practice is determined by taking context into account in decision-making and ensuring the sanctity of the patient’s rights and wishes. Abuse is just the opposite, where actions taken or not taken are against a person’s wishes. Personal wish determines best interest. Best interest may also be defined in terms of social functioning and psychological wellbeing. Discussion of ethics in terms of General Systems Theory is also addressed, and affects an action on the environment or others, i.e. ethics in the wider medical context may pertain if the person has a contagious disease and a period of quarantine or “isolation” or barrier” nursing is required, and where precedent is given to society’s best interest over the person’s wishes, as part of an educational process and as required for strategic disease management.

Early identification of retinal subtypes in the developing, pre-laminated chick retina using the transcription factors Prox1, Lim1, Ap2a, Pax6, Isl1, Isl2, Lim3 and Chx10
PHD Edqvist,SM Myers,F Hallb??k
European Journal of Histochemistry , 2006, DOI: 10.4081/987
Abstract: In this study, antibodies toward the transcription factors Prox1, Lim1, Ap2a, Pax6, Isl1, Isl2, Lim3 and Chx10 were used to identify and distinguish between developing cell types in the pre-laminated chick retina. The spatio-temporal expression patterns were analysed from embryonic day 3 (E3) to E9, thus covering a time-span from the onset of retinal cell-fate determination to when retinal laminas can be distinguished. Most transcription factors were found at early stages of development, enabling us to trace various precursor cell populations throughout the lamination process. With time, each transcription factor expression became restricted to distinct laminas or sub-laminas of the maturing retina. These early emerging patterns were compared and found to be consistent with those of the hatched chick retina, where the outer nuclear layer label for Lim3, Isl1 and Isl2. In the inner nuclear layer, horizontal cells labeled for Prox1, Lim1, Isl1, Ap2a and Pax6, bipolar cell labeled for Lim3, Isl1 and Chx10 and amacrine cells labeled for Ap2a, Isl1 and Pax6. The ganglion cell layer labeled for Isl1, Pax6 and Isl2. The immunolabeling patterns of Lim3 and Isl2 have not previously been described in detail.
The QCD sign problem as a total derivative
Jeff Greensite,Joyce C. Myers,K. Splittorff
Physics , 2013, DOI: 10.1103/PhysRevD.88.031502
Abstract: We consider the distribution of the complex phase of the fermion determinant in QCD at nonzero chemical potential and examine the physical conditions under which the distribution takes a Gaussian form. We then calculate the baryon number as a function of the complex phase of the fermion determinant and show 1) that the exponential cancellations produced by the sign problem take the form of total derivatives 2) that the full baryon number is orthogonal to this noise. These insights allow us to define a self-consistency requirement for measurements of the baryon number in lattice simulations.
Investigating corrections to a Gaussian distribution of the complex phase
Jeff Greensite,Joyce C. Myers,K. Splittorff
Physics , 2013,
Abstract: It has been suggested that the density of states approach to performing lattice simulations in QCD with nonzero chemical potential can be modified to improve the signal to noise ratio by performing a cumulant expansion of the complex phase of the fermion determinant, and then simplified by truncating the expansion after the first non-zero cumulant. This truncation corresponds to approximating the distribution of the complex phase of the fermion determinant by a Gaussian form. The crucial question is: how large are the other cumulants? We calculate the distribution of the complex phase from the hadron resonance gas model and from a combined lattice strong coupling and hopping expansion. In the case of the hadron resonance gas model the distribution takes a Gaussian form, but from the strong coupling and hopping expansion there are corrections. We discuss the implications to lattice simulations.
The density in the density of states method
Jeff Greensite,Joyce C. Myers,K. Splittorff
Physics , 2013, DOI: 10.1007/JHEP10(2013)192
Abstract: It has been suggested that for QCD at finite baryon density the distribution of the phase angle, i.e. the angle defined as the imaginary part of the logarithm of the fermion determinant, has a simple Gaussian form. This distribution provides the density in the density of states approach to the sign problem. We calculate this phase angle distribution using i) the hadron resonance gas model; and ii) a combined strong coupling and hopping parameter expansion in lattice gauge theory. While the former model leads only to a Gaussian distribution, in the latter expansion we discover terms which cause the phase angle distribution to deviate, by relative amounts proportional to powers of the inverse lattice volume, from a simple Gaussian form. We show that despite the tiny inverse-volume deviation of the phase angle distribution from a simple Gaussian form, such non-Gaussian terms can have a substantial impact on observables computed in the density of states/reweighting approach to the sign problem.
A Randomized Prospective Assessment of Safety and Effectiveness of Instillation of Tissue Plasminogen Activator in the Management of Intra-Abdominal Abscesses  [PDF]
Suhas A. Kotecha, Murray R. Asch, Andrew J. Myers, Dheeraj K. Rajan
Open Journal of Radiology (OJRad) , 2016, DOI: 10.4236/ojrad.2016.63027
Abstract: Purpose: Catheter drainage of intra-abdominal abscesses has shown to be effective in reducing sepsis and mortality. We sought to determine whether or not tissue plasminogen activator (tPA), a fibrinolytic, is safe and facilitates resolution when used as an adjunct during drainage of intra-abdo-minal abscesses. Methods: A single-blinded, prospective, multi-center, randomized control trial was performed on patients presenting with image confirmed abscesses; the first group (n = 24) received catheter-directed tPA of their abscess and the second group (n = 23) had their abscess drained without tPA instillation. Variables examined included patient age, gender, location of the abscess, pre-drainage volumes and size of catheters inserted. Baseline variables were compared between tPA and non-tPA groups using a chi-square test for discrete variables and a Wilcoxon rank sum test for continuous variables and for the outcome of drainage volume. Results: Technical success of the drainage procedures was 100% for both groups. The tPA group had higher volume of drainage over the first three days (median for total after 3 days: without tPA: 300 mL vs. with tPA: 322 mL, p = 0.42). At days 4 to 7 the tPA group had significant greater drainage volume than did the non-tPA patient group, 150 mL vs. 110 mL (p = 0.046). The number of days to resume diet was also assessed in the 20 patients where this datum was available, 11 tPA and 9 non-tPA with no difference between groups. No adverse events, such as localized or systemic bleeding were encountered. Conclusion: Instillation of tPA into catheter directed intra-abdominal abscesses was safe, easy to perform and was associated with significantly improved drainage of abscesses from days 4 -7.
Optimization of Photocatalytic Degradation of Phenol Using Simple Photocatalytic Reactor  [PDF]
Innocent Udom, Philip D. Myers, Manoj K. Ram, A. F. Hepp, Edikan Archibong, Elias K. Stefanakos, D. Yogi Goswami
American Journal of Analytical Chemistry (AJAC) , 2014, DOI: 10.4236/ajac.2014.511083
Abstract: The phenol photocatalytic degradation was investigated using heterogeneous catalyst Ag-doped ZnO nanowires under UV irradiation. Ag-ZnO nanowires were immobilized on borosilicate glass via a simple hydrothermal technique. Preliminary photodegradation studies were performed with Ag-ZnO nanowires at various concentrations of phenol (10 - 60 mg/L) at undiluted pH. After determination of the optimal initial concentration (30 mg/L), additional parameters including pH and light intensity were investigated to optimize photodegradation of phenol for large-scale application. The experimental results illustrate that the kinetics of degradation of phenol are pseudo-first order. Based on the relationship, experimental model and empirical correlation were generated and compared for validity. The experimental data were found to fit a cubic model (linear in UV irradiation intensity, I, and cubic in pH), over ranges of 10 - 60 W (UV lamp power) and 2.7 - 11.0 (pH) with a coefficient of determination (R2) of 0.9934. This model, of the form K(I, pH) = c00 + c10I + c01pH + c11IpH + c02pH2 + c12IpH2 + c03pH3 was found to yield a better fit than simpler (quadratic) or more complex (quartic) polynomial-based models considered. The model parameters cij and corresponding 95% confidence intervals were obtained.
An audit of informed consent for cesarean section and instrumental delivery in a tertiary referral center in the United Kingdom
Glennon K, Tower C, Gillham J, Myers J
Clinical Audit , 2011, DOI: http://dx.doi.org/10.2147/CA.S13413
Abstract: n audit of informed consent for cesarean section and instrumental delivery in a tertiary referral center in the United Kingdom Original Research (3623) Total Article Views Authors: Glennon K, Tower C, Gillham J, Myers J Published Date April 2011 Volume 2011:3 Pages 1 - 5 DOI: http://dx.doi.org/10.2147/CA.S13413 Kate Glennon1, Clare Tower2, Joanna Gillham3, Jenny Myers2 1St Mary's Hospital, Manchester University, Manchester, UK; 2Maternal and Fetal Health Research Centre, St Mary's Hospital, Manchester, UK; 3St Mary's Hospital, Manchester, UK Purpose: To audit the process of informed consent for cesarean section (CS) and instrumental delivery (ID) in a tertiary referral center in the UK. Design: The Royal College of Obstetricians and Gynaecologists (RCOG) guidelines on consent1 were used as audit standards. A retrospective questionnaire was used to assess patients’ recall and views of the consent process. In total, 116 consent forms were audited (CS = 83, instrumental delivery = 33). Findings: The consent forms complied with the auditable standards on consent for CS, in relation to documentation of the major risks of surgery. The majority of CS consent forms did not meet the standards in terms of documentation of the risk of laceration to baby or the possibility of hysterectomy. However, most women were questioned on consent between contractions, in accordance with the RCOG guidance on consent (50% CS deliveries and 68% instrumental deliveries). The patients who consented for elective CS, were more likely than emergency CS patients to be able to recall the risks explained. Action: The findings of this audit indicate that the introduction of a standardized consent proforma would provide a structured approach to preoperative counselling and documentation.
Transfer of the Arcelin-Phytohaemagglutinin-α Amylase Inhibitor Seed Protein Locus from Tepary bean (Phaseolus acutifolius A. Gray) to Common Bean (P. vulgaris L.)
K.P. Mbogo,J. Davis,J.R. Myers
Biotechnology , 2009,
Abstract: Phaseolus vulgaris cultivars ICA Pijao, Rojo and 5-593 were crossed to the P. acutifolius wild accessions G40199 and an F2 selection from a cross between G40199 and cultivated brown seeded unnamed tepary accession (designated Brown Tepary). G40199 is highly resistant to the two major bruchid pests of common bean: Acanthoscelides obtectus and Zabrotes subfasciatus, but the mechanism for resistance is unknown. Interspecific F1 hybrids with the three common bean parents were generated via., embryo rescue. Recovered hybrids were from ICA-Pijao and 5-593 and were highly sterile and were backcrossed as females to ICA Pijao. Seeds from the BC1F2 plants were screened for protein phenotype and the inheritance of seed storage protein profiles contributed by the tepary bean parents. Most of the F1 hybrids demonstrated introgression of a lectin-like protein of 33 kDa that was found in G40199, but not in the Brown Tepary or common bean lines. This lectin related protein complex was similar to the arcelin (ARL), phytohaemagglutinin (PHA) and α-amylase inhibitor (α-AI) seed storage protein family of P. acutifolius. Genomic DNA sequences from wild accession G40199 and the interspecific hybrids revealed a high sequence similarity to ARL2 and α-AI genes of P. acutifolius. Because lectin-related proteins of P. acutifolius have been associated with strong resistance to bruchids, we hypothesize that these proteins alone or in conjunction with other factors, may contribute to the disputed bruchid resistance mechanism in G40199.
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