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Biomedical subjects

A J Moore

Publications and source records attributed to A J Moore.

At least 37 records · Page 2Linked to original sources
PubMed2000

A study to investigate the ability of subjects with chronic lung diseases to provide evidential breath samples using the Lion Intoxilyzer 6000 UK breath alcohol testing device.

The Lion Intoximeter 3000 has been used for evidential breath testing in the U.K. for some years. Some individuals with lung diseases have difficulty in providing evidential breath samples using the device. This study describes an investigation that we have carried out on a newer instrument--the Lion Intoxilyzer 6000UK--which is now in use in the U.K. The study was designed to investigate the ability of subjects with a variety of lung diseases to provide evidential breath samples using this device. The 40 adult subjects investigated comprized 10 normal controls, 10 with asthma, 10 with chronic obstructive pulmonary disease (COPD) and 10 with restrictive lung disease. After baseline spirometry, subjects were given alcohol to drink, the quantity based upon body weight. After a gap of at least 20 min, subjects were asked to provide evidential breath samples in accordance with.the test procedure built into the Lion Intoxilyzer 6000UK. The results showed that two asthmatic subjects, four with COPD and three with restrictive lung disease failed to provide evidential breath samples even after four attempts. Despite the device requiring a minimum sample volume of 1.2 l, eight of the nine subjects who failed had a forced vital capacity (FVC) of more than 1.5 l. Seven of these nine subjects had a forced expiratory volume in 1 sec (FEV1) of less than 1.0 l. In conclusion, this study has shown that some subjects with lung diseases may have difficulty in providing evidential breath samples using the Lion Intoxilyzer 6000 UK.

Adult↗
PubMed2000

Results of posterior cervical foraminotomy for treatment of cervical spondylitic radiculopathy.

We evaluated the results of posterior cervical foraminotomy for spondylitic radiculopathy using a questionnaire sent to all 77 patients who had undergone surgery between 1990 and 1995 at our institution. Sixty-two patients (40 male) returned their questionnaires, one of whom had undergone two procedures (dealt with as separate events). Sixty patients complained of pre-operative arm pain; of these 42 (70%) had complete or > 75% resolution of their pain, 14 (23%) had < 75% improvement in their pain and four (7%) had the same or worsened pain at the time of the questionnaire. Sixteen patients (27%) reported initial improvement in symptoms with subsequent deterioration. The mean patient satisfaction score using a linear analogue scale from 0 to 10 was 7.5. Main postoperative complaints were neck pain (22%), persisting motor deficit (6%) and persisting sensory deficit (9%). One patient suffered nerve root damage at surgery. For unilateral and, in some cases, multi-level degenerative disease causing cervical radiculopathy, posterior cervical foraminotomy is a useful technique with the advantage of avoiding fusion, immobilization and the long-term risk of instability.

Adult↗
PubMed2000

Deprivation, urbanisation and Perthes' disease in Northern Ireland.

It has been suggested that Perthes' disease is more prevalent in urban areas, and that the risk increases with deprivation. We present the findings of a preliminary analysis of Perthes' disease in Northern Ireland, which is shown to have one of the highest national annual rates of incidence in the world (11.6 per 100000). Of the 313 children diagnosed over a seven-year period, 311 were allocated to the enumeration districts of the 1991 census, thus allowing the incidence to be calculated using both spatial and non-spatial aggregation. The cases were grouped according to the size of the settlement from highly urbanised to open countryside and by level of area deprivation. While the incidence of Perthes' disease was found to be associated with indicators of the level of deprivation for areas, there was no evidence to suggest that there was an increased risk in urban areas; the highest rate was found in the most deprived rural category.

Adolescent↗
PubMed1999

A study to investigate the ability of subjects with chronic lung diseases to activate the roadside Lion Alcolmeter SL-400.

The Lion Alcolmeter SL-2 is widely used for road-side breath-testing by police in the UK. However, some individuals with lung diseases have difficulty in activating the device. This study describes an investigation that we have carried out on a new device called the Lion Alcolmeter SL-400 which has recently been introduced into use by police forces in the UK. The manufacturers state that the machine requires a minimum continuous expiratory flow rate of 25 litres per minute and a minimum expired volume of 1.5 litres, after which a breath sample is automatically taken and analysed. Our study was designed to investigate the ability of subjects with a variety of lung diseases to activate this device. The 40 adult subjects investigated consisted of 10 normal controls, 10 with asthma, 10 with chronic obstructive pulmonary disease and 10 with restrictive lung disease. After baseline lung function tests were performed, the subjects were then given alcohol to drink, the amount of which was based upon their body weight. After a gap of at least 20 minutes, the subjects were then asked to attempt up to three blows into the Alcolmeter. Our results showed that three asthmatic subjects, four with chronic obstructive pulmonary disease and two with restrictive lung disease, failed to successfully activate the device even after three attempts. All of the subjects who failed to activate the device had an expired breath volume of more than 1.5 litres, but seven out of these nine subjects had a Forced Expiratory Volume (FEV1) of less than 1.1 litres. In conclusion, this study has shown that some subjects with lung diseases may have difficulty in activating the SL-400 roadside alcolmeter device.

Adult↗
PubMed1998

Posterior fossa meningiomas: surgical experience in 52 cases.

BACKGROUND: Early reports of the surgical management of posterior cranial fossa meningiomas (PCFM) yielded poor results with high rates of mortality and morbidity. With the advent of modern neuroimaging and microsurgical techniques the results of surgery have improved markedly, but despite these advances removal of these lesions remains a challenge. METHODS: The results of the surgical treatment of PCF meningiomas were examined with the aim to identify particular features associated with increased mortality and morbidity. RESULTS: Of 713 patients with meningioma, 52 patients were identified with PCFM. Total macroscopic excision was achieved in 44 patients (84%). Postoperative complications occurred in 28 patients (54%) with permanent sequelae in 18 (35%). There were no mortalities in the immediate postoperative period. Follow-up ranged from 14 to 174 months (mean 42), tumour has recurred in 11 patients (21%) with a long-term mortality of 11%. At their latest follow-up 41 (79%) of patients achieved Glasgow outcome scores of 4 or 5. CONCLUSIONS: Total excision of tumour should remain the goal of treatment in patients with PCFM. Despite the recent advances in preoperative planning and surgical techniques, the morbidity associated with surgery remains significant. Notwithstanding, the majority of patients achieve a good outcome with surgical treatment.

Adolescent↗
PubMed1998

The value of screening for Down's syndrome in a socioeconomically deprived area with a high ethnic population.

OBJECTIVE: To assess the utility of biochemical antenatal screening for Down's syndrome in a socioeconomically deprived area with a high proportion of Asian women from the Indian Subcontinent. DESIGN: Audit of Down's syndrome biochemical screening service over a four-year period. SETTING: Teaching hospital and community antenatal clinic in inner city Birmingham. POPULATION: Women booked between October 1992 and December 1996. METHODS: Blood for screening was collected between 14 and 21 weeks gestation, alpha-fetoprotein and intact human chorionic gonadotrophin were measured in serum and the risk of Down's syndrome was calculated. MAIN OUTCOME MEASURES: Uptakes of screening and amniocentesis, screen positive rate, odds of being affected given a positive result, miscarriages associated with amniocentesis offered following a high risk result, detection rate, number of Down's cases prevented and a cost analysis. Outcome measures were compared between Asians and Caucasians. RESULTS: Overall 11,974 women (71%) accepted serum screening. The screen positive rate was 8.3% in Asians and 5.0% in Caucasians. The uptake of amniocentesis in women following a high risk result was 54% overall (35% Asian, 67% Caucasian). Nineteen cases of Down's syndrome were identified, of which 13 occurred in women who opted for biochemical screening. The detection rate of the biochemical screening programme was 85% (11/13). Of these 11 cases, six (none of whom were Asian) elected to have an amniocentesis, of whom four thereafter had a termination. CONCLUSION: In this study the public health benefits of screening for Down's syndrome in a socioeconomically deprived area with a high Asian population, were small.

Amniocentesis↗
PubMed1998

Skull base techniques for aneurysm occlusion.

Aneurysms of the vertebrobasilar system carry relatively high operative mortality and morbidity due to their anatomical location. A variety of skull base techniques is described to improve access to these lesions and to reduce or abolish the need for retration on neurovascular structures. Surgical results are generally favorable and should encourage a more widespread application of these techniques in appropriate circumstances.

Arteries↗
PubMed1997

Quantitative analysis of trabecular morphogenesis in the human costochondral junction during the postnatal period in normal subjects.

BACKGROUND: Quantitative histomorphometric features of the bone growth plate in the human rib have been investigated in infants, ranging in age from 3-36 weeks (mean 18.6 weeks) to provide data currently not available. METHODS: Measurements were taken in each histological zone of the growth plate. Data from 20 cases were pooled and parameters describing the characteristic features of trabecular bone calculated using morphometric formulae. The measurements were made from the resting zone of the cartilage to the secondary spongiosa, 3.78 mm from the starting point. RESULTS: Cartilage volume fraction decreased from 78% in the resting zone to a bone volume fraction of between 20% and 30% in the secondary cancellous bone. Cartilage matrix surface increased rapidly in the cartilage and bone mineral surface declined in correspondence with the development of primary bone. The distance between chondrocyte lacunae was observed to decrease throughout the cartilage to a transverse septa thickness of 18 microns in the hypertrophic zone. A rapid increase in trabecular thickness to 128 microns was observed in the primary spongiosa, the secondary spongiosa ranging between 137 microns and 168 microns. Spacing, chondrocyte profile transverse diameter, increased to 30 microns in the hypertrophic zone, following which an increase in trabecular separation to 347 microns was observed in the primary spongiosa. The number of transverse intervals between individual chondrocyte lacunae was observed to increase in the cartilage to a maximum of 21.3 cartilaginous or mineralised septa per mm of growth plate length in the hypertrophic zone. Trabeculae in the metaphysis then decreased in number to approximately 1.5 trabeculae per mm in the secondary spongiosa. CONCLUSIONS: These data thus provide new insight into the development of trabecular structure during growth and normal values for the comparison of tissue from skeletal dysplasias and growth disorders.

Achondroplasia↗
PubMed1997

Ambulatory care growth: implications for academic organizations.

This article discusses the implications of the dramatic growth of outpatient activity in academic health care organizations, and, more broadly, in all forms of joint physician-hospital outpatient care. The authors describe several economic, operational, and regulatory factors that influence the success of ambulatory care expansion in the academic environment. A case study of the Metropolitan New York Medicaid managed care environment illustrates the impact of these factors and highlights the specific challenges confronting teaching hospitals and physicians. The attributes of ambulatory care providers that have successfully addressed these challenges are also discussed. Finally, the benefits of the model ambulatory practice structure, employed at a number of teaching institutions across the country, are explored.

Academic Medical Centers↗
PubMed1996

Enzyme replacement therapy in a feline model of Maroteaux-Lamy syndrome.

We report studies that suggest enzyme replacement therapy will result in a significant reduction in disease progression and tissue pathology in patients with Maroteaux-Lamy syndrome (Mucopolysaccharidosis type VI, MPS VI). A feline model for MPS VI was used to evaluate tissue distribution and clinical efficacy of three forms of recombinant human N-acetylgalactosamine-4-sulfatase (rh4S, EC 3.1.6.1). Intravenously administered rh4S was rapidly cleared from circulation. The majority of rh4S was distributed to liver, but was also detected in most other tissues. Tissue half-life was approximately 2-4 d. Three MPS VI cats given regular intravenous infusions of rh4S for up to 20 mo showed variable reduction of storage vacuoles in Kupffer cells and connective tissues, however cartilage chondrocytes remained vacuolated. Vertebral bone mineral volume was improved in two MPS VI cats in which therapy was initiated before skeletal maturity, and increased bone volume appeared to correlate with earlier age of onset of therapy. One cat showed greater mobility in response to therapy.

Animals↗
PubMed1996

Antimicrobial activity of cecropins.

The lytic peptides, cecropins, were originally isolated from the haemolymph of the giant silk moth, Hyalophora cecropia and possess antibacterial and anticancer activity in vitro. This study investigated the antimicrobial activity of these peptides against human pathogens using standardised assay techniques, and the activity of cecropin B on outer and inner bacterial membranes. From a panel of 15 organisms, Gram-negative bacteria were generally more sensitive to cecropins than Gram-positive organisms, especially the lipopolysaccharide defective mutant, Escherichia coli BUE55. Cecropins B and P1 shared similar MIC values whereas Shiva-1, a cecropin B analogue, was less active. Through combination studies with hydrophobic antibiotics and electron microscopy, cecropin B was shown to disrupt the bacterial outer membrane. Protoplasts of Staphylococcus aureus and Staphylococcus epidermidis were resistant to cecropin B, suggesting that the cytoplasmic membranes of Gram-positive organisms were inherently more resistant to the peptide.

Amino Acid Sequence↗
PubMed1995

Extraction of the synthetic lytic peptide, cecropin B, from biological fluid and analysis using reversed-phase high-performance liquid chromatography.

The lytic peptide cecropin B, originally isolated from the giant silk moth Hyalophora cecropia, has been found to possess antibacterial and cell lysis properties in vitro and some anticancer activity in vivo. An HPLC method was developed to study synthetic cecropin B concentrations in biological fluids. Cecropin B was recovered from culture medium by solid-phase extraction (40.0 +/- 2.4%), whereas in plasma it was highly protein-bound. The peptide was dissociated from proteins by citric acid and recovered by ultrafiltration (64.6 +/- 5.9%) and was unstable in plasma (half-life, 0.57 +/- 0.11 h). These analytical methods will facilitate future in vivo pharmacokinetic studies.

Amino Acid Sequence↗
PubMed1995

Inositol 1,2,3-trisphosphate and inositol 1,2- and/or 2,3-bisphosphate are normal constituents of mammalian cells.

1. An inositol trisphosphate (InsP3) distinct from Ins(1,4,5)P3 and Ins(1,3,4)P3, which we previously observed in myeloid and lymphoid cells [French, Bunce, Stephens, Lord, McConnell, Brown, Creba and Michell (1991) Proc R. Soc. London B 245, 193-201; Bunce, French, Allen, Mountford, Moore, Greaves, Michell and Brown (1993) Biochem. J. 289, 667-673], is present in WRK1 rat mammary tumour cells and pancreatic endocrine beta-cells. 2. It has been identified as Ins(1,2,3)P3 by a combination of oxidation to ribitol, a structurally diagnostic polyol, and ammoniacal hydrolysis to identified inositol monophosphates. 3. Ins(1,2,3)P3 concentration in HL60 cells changed little during stimulation by ATP or fMetLeuPhe or during neutrophilic or monocytic differentiation, and Ins(1,2,3)P3 was unresponsive to vasopressin in WRK1 cells. 4. Ins(1,2,3)P3 was usually more abundant than Ins(1,4,5)P3, often being present at concentrations between approximately 1 microM and approximately 10 microM. 5. HL60, WRK-1 and lymphoid cells also contain Ins(1,2)P2 or Ins(2,3)P2, or a mixture of these two enantiomers, as a major InsP2 species. 6. Ins(1,2,3)P3 and Ins(1,2)P2/Ins(2,3)P2 are readily detected in cells labelled for long periods, but not in acutely labelled cells. This behaviour resembles that of InsP6, the most abundant cellular inositol polyphosphate that includes the 1,2,3-trisphosphate motif, which also achieves isotopic equilibrium with inositol only slowly. 7. Ins(1,2,3)P3 is the major InsP3 that accumulates during metabolism of InsP6 by WRK-1 cell homogenates. 8. Possible metabolic relationships between Ins(1,2,3)P3, Ins(1,2)P2/Ins(2,3)P2 and other inositol polyphosphates in cells, and a possible role for Ins(1,2,3)P3 in cellular iron handling, are considered.

Animals↗
PubMed1995

Genetic aspects of communication during male-male competition in the Madagascar hissing cockroach: honest signalling of size.

Male Madagascar hissing cockroaches, Gromphadorhina portentosa, engage in agonistic contests with other males and produce audible sounds or 'hisses' during these interactions. Hisses are used to maintain, rather than to establish, social relationships among males. The agonistic hisses of males are variable and could be used as signals to communicate size or competitive ability of an individual. In this study we examined how size influences male-male competition, as well as the genetic variation and covariation of male body size and components of the agonistic hiss. We found that male size affected the outcome of agonistic interactions between pairs of males: a male that dominated in a pair was significantly larger than the male that was subordinate. However, we found no differences in the hisses produced by dominant and subordinate males after controlling for male weight. We estimated heritabilities, evolvability and genetic correlations for male size and characteristics of the hiss from a full-sib analysis of brothers. The patterns of heritabilities and evolvabilities were very similar. The heritabilities of both male weight and duration of the hiss were significantly greater than zero. There was a significant positive genetic correlation between duration of the agonistic hiss and male weight, and a significant negative genetic correlation between hiss duration and the beginning dominant frequency. There was also a positive phenotypic correlation and a negative environmental correlation between male weight and hiss duration. Thus, hiss duration can signal the present influence of the environment on male size, whereas information from hiss duration and beginning dominant frequency can signal the male's ability to transmit genetic influence for size.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Outcome after repeat lumbar microdiscectomy.

One of the standard treatments for herniation of lumbosacral disc material has become the microdiscectomy. Although multiple studies have assessed the outcome of microdiscectomy, only a few studies have evaluated the outcome of those patients who have undergone a second microdiscectomy at the same location as the original one. The purpose of this study was to review 55 patients who, over a 4-year period, underwent a second microdiscectomy at the same location as their original operation and to evaluate those factors associated with improved outcomes. The results showed the overall outcome to include 86% with complete or partial relief of all pain symptoms; 88% with complete or partial relief of sciatica; 85% with complete or partial relief of back pain; 100% returning to work in an average of 7 weeks; and 89% were glad they had the second operation. Those factors without predictive value included age, sex, weight, height, level of operation, side of operation, surgeon at the first or second operation (e.g. consultant or junior staff), length of the first operation ( < or = 60 min or > 60 min) and duration of symptoms before the first operation. The key features centred on preoperative job status, the interval between recurrence of symptoms and the second operation, and the duration of the second operation ( < or = 90 min).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Comparison of rates of infection of two methods of emergency ventricular drainage.

The rates of infection of two methods of external ventricular drainage in use at Atkinson Morley's Hospital--namely, (a) percutaneous drainage with Rickham reservoirs and (b) tunnelled ventriculostomies--were compared in this retrospective review. Percutaneous drainage of CSF with Rickham reservoirs was associated with a 27% rate of infection as identified by positive microbiological cultures; tunnelled ventriculostomy catheters had a 10% infection rate. The difference in the infection rate between the two methods was statistically significant (P < 0.015). Other variables examined, including the age and sex of the patients and the reasons for ventricular drainage, were not associated with an increased rate of infection. Most infections from either method were caused by a coagulase negative staphylococcus. The average duration of ventricular drainage before identification of positive cultures was 5.7 days for Rickham reservoirs and 6.0 days for ventriculostomies.

Adolescent↗