Biomedical subjects

A Murray

Publications and source records attributed to A Murray.

At least 199 records · Page 11Linked to original sources

PubMed1997

Transport in vitro fertilisation: three years experience at a district general hospital.

Transport in vitro fertilisation (IVF) is an important development in assisted conception. We report our experience of transport IVF treatment from May 1993 to April 1996 at Arrowe Park Fertility Centre. A total of 74 patients were treated during this period. The main indications of treatment were tubal damage, unexplained infertility of more than 3 years duration, polycystic ovarian disease and endometriosis. Total number of simulated ovarian cycles were 101. Thirteen cycles were abandoned. Eighty-eight transport IVF cycles led to 29 pregnancies, giving a live birth rate and on-going pregnancy rate per patient of 31% and per cycle rate of 23%. There was one case of severe ovarian hyperstimulation syndrome. Of the 74 patients, 70 (95%) patients preferred to have treatment at the local hospital. Transport IVF is an effective, efficient and economic way of providing assisted conception at district general hospital. The success rate and safety of transport IVF are comparable with conventional IVF treatment.

Journal Article↗

PubMed1997

Measurement of angioplasty lumen volume and wall compliance: a laboratory study.

We have developed a device and technique for measuring the pressure-volume characteristics of an arterial segment from a standard angioplasty balloon, enabling us in this laboratory study to investigate the ability of the technique to measure changes in lumen volume and wall compliance. Percutaneous transluminal coronary angioplasty (PTCA) is a valuable clinical procedure for alleviating arterial stenosis, but the long-term success of the technique is less than ideal. The ability to monitor the effect of the balloon on the artery during inflations could lead to improvements in the technique. In this study, 10 different lumen diameters (1.6 to 3.4 mm) were produced in a Perspex block, and six different wall compliances produced with silicone tubes of constant inner diameter (2.0 mm) but different outer diameters (3.5 to 6.0 mm) A standard PTCA balloon was inflated under automatic control at a constant rate of 0.05 ml s-1 to 800 kPa (8 bar). Pressure and volume data were recorded to computer continuously throughout the procedure. Differences in lumen volume of +/-0.01 ml and wall compliance of +/-5% could be differentiated with greater than 95% confidence. We conclude that our technique allows small changes in lumen volume and wall compliance to be differentiated using a standard angioplasty catheter and balloon.

Angioplasty, Balloon, Coronary↗

PubMed1997

Mitochondrial transmission during mating in Saccharomyces cerevisiae is determined by mitochondrial fusion and fission and the intramitochondrial segregation of mitochondrial DNA.

To gain insight into the process of mitochondrial transmission in yeast, we directly labeled mitochondrial proteins and mitochondrial DNA (mtDNA) and observed their fate after the fusion of two cells. To this end, mitochondrial proteins in haploid cells of opposite mating type were labeled with different fluorescent dyes and observed by fluorescence microscopy after mating of the cells. Parental mitochondrial protein markers rapidly redistributed and colocalized throughout zygotes, indicating that during mating, parental mitochondria fuse and their protein contents intermix, consistent with results previously obtained with a single parentally derived protein marker. Analysis of the three-dimensional structure and dynamics of mitochondria in living cells with wide-field fluorescence microscopy indicated that mitochondria form a single dynamic network, whose continuity is maintained by a balanced frequency of fission and fusion events. Thus, the complete mixing of mitochondrial proteins can be explained by the formation of one continuous mitochondrial compartment after mating. In marked contrast to the mixing of parental mitochondrial proteins after fusion, mtDNA (labeled with the thymidine analogue 5-bromodeoxyuridine) remained distinctly localized to one half of the zygotic cell. This observation provides a direct explanation for the genetically observed nonrandom patterns of mtDNA transmission. We propose that anchoring of mtDNA within the organelle is linked to an active segregation mechanism that ensures accurate inheritance of mtDNA along with the organelle.

Cell Division↗

PubMed1997

Baroreflex function in sedentary and endurance-trained elderly people.

OBJECTIVE: to determine the differences associated with age and endurance exercise training on the baroreflex function of healthy subjects. DESIGN: cross-sectional study. SETTING: university research department. PARTICIPANTS: 26 (10 female) sedentary, healthy, normotensive elderly subjects (mean age 67 years, range 62-81), eight (two female) elderly endurance-trained athletes (66 years, 62-69) and eight (two female) young (30 years, 25-34) subjects. MEASUREMENTS: baroreflex sensitivity was quantified by the alpha-index, at high frequency (HF, 0.15-0.35 Hz) and mid frequency (MF, 0.05-0.15 Hz), derived from spectral and cross-spectral analysis of spontaneous fluctuations in heart rate and blood pressure. RESULTS: resting heart rate was significantly lower in endurance-trained athletes than sedentary elderly people (58 +/- 12 versus 68 +/- 11 min(-1), P < 0.05) but not different to that in healthy young subjects (63 +/- 9 min[-1]). alpha(HF) in sedentary elderly subjects (8.1 +/- 4.2 ms.mm Hg[-1]) was lower than both endurance-trained elderly athletes (14.8 +/- 4.8 ms.mm Hg(-1), P < 0.05) and healthy young subjects (28.3 +/- 21.8 ms.mm Hg(-1), P < 0.05) and was not significantly different between endurance-trained elderly athletes and healthy young subjects (P = 0.10). alpha(MF) in healthy young subjects (15.4 +/- 8.8 ms.mm Hg[-1]) was greater than in sedentary elderly subjects (6.5 +/- 3.2 ms.mm Hg(-1), P < 0.01) and endurance-trained elderly athletes (6.9 +/- 2.0 ms.mmHg(-1), P < 0.01), while there was no significant difference between the two elderly groups (P = 0.66). CONCLUSIONS: both components of the baroreflex measured by the alpha-index show a decrease with age. Elderly endurance-trained athletes have less reduction in the high, but not mid, frequency component of the alpha-index compared with sedentary elderly subjects. Some of the age-related changes in baroreflex sensitivity may be related to physical fitness and activity levels.

Adult↗

PubMed1997

Caudal tramadol for postoperative analgesia in pediatric hypospadias surgery.

Ninety boys, aged 13-53 months, undergoing repair of hypospadias, were allocated randomly to receive 0.8 ml kg-1 of one of three solutions into the caudal extradural space: group B received bupivacaine 2 mg kg-1, group T received tramadol 2 mg kg-1 in 0.9% saline and group BT a mixture of both. Postoperative pain was assessed hourly for 12 h after injection using a modified TPPPS pain score and additional analgesia was administered to those children whose pain scores were > 3/10. Nine patients (30%) in group T required additional analgesia within 1 h of surgery compared with only two (6.7%) and three (10%) patients in groups B and BT, respectively (P = 0.04). Mean duration before additional analgesia was required in the remaining patients was 9.3 (SD 3.0) h in group B, 10.7 (2.2) h in group T and 10.5 (2.0) h in group BT (P > 0.20). There were no significant differences between the groups in mean ventilatory frequency, sedation scores, incidence of emesis, facial flushing or pruritus. We conclude that caudal tramadol had a slow onset of action and that the addition of tramadol to bupivacaine, when both drugs were administered caudally, did not significantly prolong the duration of action of bupivacaine.

Analgesia, Epidural↗

PubMed1997

The role of size, sequence and haplotype in the stability of FRAXA and FRAXE alleles during transmission.

Factors involved in the stability of trinucleotide repeats during transmission were studied in 139 families in which a full mutation, premutation or intermediate allele at either FRAXA or FRAXE was segregating. The transmission of alleles at FRAXA, FRAXE and four microsatellite loci were recorded for all individuals. Instability within the minimal and common ranges (0-40 repeats for FRAXA, 0-30 repeats for FRAXE) was extremely rare; only one example was observed, an increased in size at FRAXA from 29 to 39 repeats. Four FRAXA and three FRAXE alleles in the intermediate range (41-60) repeats for FRAXA, 31-60 for FRAXE) were unstably transmitted. Instability was more frequent for FRAXA intermediate alleles that had a tract of pure CGG greater than 37 although instability only occurred in two of 13 such transmissions: the changes observed were limited to only one or two repeats. Premutation FRAXA alleles over 100 repeats expanded to a full mutation during female transmission in 100% of cases, in agreement with other published series. There was no clear correlation between haplotype and probability of expansion of FRAXA premutations. Instability at FRAXA or FRAXE was more often observed in conjunction with a second instability at an independent locus suggesting genomic instability as a possible mechanism by which at least some FRAXA and FRAXE mutations arise.

Alleles↗

PubMed1997

Sympathetic reinnervation and heart rate variability after cardiac transplantation.

BACKGROUND: Heart rate variability is thought to measure autonomic modulation, but the relation has never been demonstrated directly in humans. AIM: To test the hypothesis that increased low frequency heart rate variability reflects sympathetic reinnervation after cardiac transplantation. PATIENTS: 24 cardiac transplant recipients at the time of routine surveillance coronary angiography two or more years after cardiac transplantation, and 10 controls with normal coronary arteries undergoing angiography for investigation of chest pain. SETTING: Regional cardiothoracic centre. METHODS: Sympathetic effector function at the sinus node was assessed by measuring the fall in cycle length for two minutes after injection of tyramine to the artery supplying the sinus node. Heart rate variability was measured from three-minute RR interval sequences at rest, during metronomic respiration, and before and after atropine. RESULTS: The logarithm of the low frequency component of heart rate variability during metronomic respiration was linearly related to the logarithm of the change in cycle length after injection of tyramine (R2 = 0.28, P = 0.007). Absolute units more accurately reflected sympathetic effector function than did normalised units or the ratio of low frequency to high frequency. Atropine did not affect high frequency heart rate variability in transplant recipients. CONCLUSIONS: The low frequency component of heart rate variability is directly related to sympathetic reinnervation to the sinus node.

Coronary Angiography↗

PubMed1997

Measuring QT dispersion: man versus machine.

OBJECTIVE: To compare manual and computer automated techniques for measuring QT dispersion. DESIGN: Assessment of the ability of manual and automatic measurements of QT dispersion to discriminate between a normal group and two cardiac groups. SUBJECTS: 12 simultaneous electrocardiogram leads were recorded from 25 healthy volunteers, 25 subjects after myocardial infarction, and 25 with cardiac arrhythmias. MAIN OUTCOME MEASURES: For each subject, QT dispersion was measured as the difference between the maximum and minimum QT from all 12 leads and separately for only those leads with T amplitudes of > 100 microV and for those > 250 microV. RESULTS: Manual QT dispersion (T > 100 microV) was greater (P < 0.02) in the arrhythmia patients (mean (SD), 45 (21) ms), but not the infarction patients (54 (36) ms), than in the normal subjects (39 (13) ms). There were no significant differences when all T waves were included. QT dispersion was significantly reduced by an average of 30% when T waves < 100 microV were excluded, and by 51% when those < 250 microV were excluded. Automatic techniques gave different measurements for dispersion in comparison with manual measurements. Three of the four automatic techniques detected significant differences between normal and both patient groups when no leads were excluded (P < 0.01) as well as when T waves < 100 microV were excluded (with increased significance, P < 0.002). CONCLUSIONS: Measurements of QT dispersion from small T waves increases measurement variability and reduces the potential for detecting clinical differences. Automatic measurement of QT dispersion gives different results from manual measurement, but can satisfactorily discriminate between normal and abnormal groups with good quality electrocardiograms.

Arrhythmias, Cardiac↗

PubMed1997

Identification of non-organic instability by sway magnetometry.

This paper describes the application of sway magnetometry, which objectively measures stability, to assist in the identification of non-organic instability. Three subject groups were studied; 14 normal subjects, 14 subjects with organic dizziness, and 19 subjects assessed as having possible non-organic dizziness before further clinical investigation. Eight of these 19 were subsequently classed as having non-organic dizziness on grounds of their history, clinical examination and standard audio-vestibular investigations. Movement in the horizontal plane at the hips was measured by sway magnetometry in each subject. The absolute and percentage change in path length and area were determined for 15 s before and 15 s after the subject was informed that the test was starting. For absolute path length and area, five out of the eight subjects with non-organic dizziness showed an increase in sway above the upper limit of normal, while only one out of the other 11 subjects in the group showed such an increase (P < 0.02). None of the subjects in the normal or organic group exceeded the upper limit of normal when results were expressed as absolute change in path length or area. Sway magnetometry can provide valuable data to assist the clinician in identification of non-organic dizziness.

Adolescent↗

PubMed1997