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Biomedical subjects

A Wright

Publications and source records attributed to A Wright.

At least 217 records · Page 12Linked to original sources
PubMed1993

Nursing implications of low-dose heparin to infusate to improve infusion site survival in children.

Initiation of intravenous (i.v.) infusions in hospital wards is a common surgical procedure. Unfortunately many of these infusions will fail due to phlebitis and/or extravasation. Such failure may cause considerable patient discomfort, interfere with i.v. therapy and increase the nurse's workload. I.v. problems with adults have been evaluated extensively, however little attention has been given to children. Heparin is effective in reducing thrombus formation and studies have demonstrated other properties as well, such as anti-inflammatory, anti-irritant, maintenance of endothelial integrity and homeostasis, and tissue healing. The purpose of this study was to determine if the addition of low-dose heparin to infusate would prolong infusion site survival in children. An experimental design was used whereby patients were randomly allocated into control and treatment groups. The treatment group received pre-mixed fluids containing 1 unit/ml of heparin whilst the control group received standard fluids. Data were collected using a standard form and information such as type and size of cannula, sex, age, date and time of cannulation, site, signs of phlebitis/extravasation, reasons for cannula removal and type of fluids and drugs infused, were recorded. Failure incidence was analysed by Cox's multivariate hazards model, life-table method and log rank tests. The results showed a highly significant difference (Chi 2 20.42, p < 0.0001) in decreasing infusion failure with the addition of low-dose heparin to infusate. Nursing implications could include a decrease in the incidence of extravasation and phlebitis, an increase in effective vein usage, fewer problems with i.v. flow rates, a reduction in medical/nursing hours associated with re-cannulations, less likelihood of systemic sepsis, and less patient worry and discomfort due to local venous reactions and re-cannulations.

Child↗
PubMed1993

Epidemic typhus fever and hearing loss: a histological study (Hallpike collection of temporal bone sections).

Hearing loss as a frequent complication of louse-borne epidemic typhus fever has been well documented in the reports of ENT specialists serving in both the Allied and the German armies in the last war. The present paper describes the characteristic histopathological features as noted in sections of the temporal bones from five British soldiers who died in 1944 of typhus fever during the last war in Eastern Asia. The VIIIth nerve showed multiple 'typhus nodules' and there was extensive interstitial neuritis of the VIIIth nerve and demyelination of the nerve fibres. There were also widely scattered aggregations of mononuclear cells in the inner ear. This unique study was based on the Hallpike collection of temporal bone sections.

Adult↗
PubMed1993

Opposing behavioural alterations in male and female transgenic TGF alpha mice: association with tumour susceptibility.

Psychosocial factors are thought to influence risk and survival from cancer. We have previously studied specific behaviours in transgenic male CD-1 MT42 mice, which overexpress the gene encoding human transforming growth factor alpha (TGF alpha) in multiple tissues, and which develop a high incidence of spontaneous hepatocellular carcinoma. The male TGF alpha mice spent a lengthened time immobile in the swim test, were highly aggressive, had increased plasma levels of 17 beta-estradiol (E2), and reduced natural killer (NK) cell activity. The female transgenic MT42 TGF alpha mice do not develop an increased rate of tumours at any site. We hypothesised that if the alterations in male TGF alpha mice are associated with their development of hepatocellular carcinomas, female TGF alpha should not show these alterations. The data in the present study indicate that female TGF alpha mice display shortened immobility in the swim test, suggesting an improved ability to cope with stress, and appear less aggressive in the resident-intruder test than non-transgenic female CD-1 mice. The female TGF alpha mice also exhibit a 3-fold increase in the plasma levels of E2, and a 3-fold increase in NK cell activity. These findings suggest that the elevated expression of TGF alpha in the transgenic mice is associated with gender-specific behavioural alterations, and the development of spontaneous hepatocellular tumours in the males. Furthermore, TGF alpha alters hormonal and immune parameters similarly in both sexes. It remains to be determined whether the development of hepatocarcinoma in the male TGF alpha animals is associated with an impaired ability to cope with stress and elevated aggressive tendencies and/or whether manipulations leading to an impaired ability to cope with stress will promote tumourigenesis in female TGF alpha mice.

Aggression↗
PubMed1993

Cellular versus vascular rejection in transplant kidneys. Correlation of radionuclide and Doppler studies with histology.

The presence of two distinct subtypes of renal allograft rejection are well documented by histological studies. The differentiation between vascular rejection (VR) and cellular rejection (CR) is essential for proper management by avoiding the need for unnecessary and potentially harmful immunosuppressive treatment of VR. A histological pattern with features that are similar and confusable with some cases of rejection may be seen in cyclosporin A toxicity (CyT). To evaluate the efficiency of Guy's perfusion index (GPI) and the Doppler pulsatility index (DPI) in differentiating these two histological subtypes, a prospective study was designed in which a total of 140 radionuclide tests and 133 ultrasounds scans performed on the same day on 58 patients during the first 3 months post-transplant were analysed, and the results correlated with the histological findings of 84 renal biopsies. Results show that the GPI had a sensitivity of 86.5% and a specificity of 94% in differentiating VR and CyT from CR, while the DPI had values of 83% and 69%, respectively. Chi-squared analysis showed a higher significant association between the GPI and histology (P < 0.0001) compared to that of the DPI and histology (P < 0.005), while Youden's index (J) showed a significant difference (P < 0.05) between GPI and DPI. It is concluded that GPI is more sensitive and specific than DPI in differentiating transplants that are well perfused from those with poor perfusion (VR and CyT).

Adult↗
PubMed1993

Errors in the assessment of tympanic membrane perforations.

It is commonly stated that operative closure of large perforations of the tympanic membrane is less successful than closure of small perforations. Few authors mention the exact size of the perforations studied, and fewer still give their method of measuring perforations. We describe a photographic method of assessing the size of perforations relative to the total drumhead, measuring them with a computerized digitizing pad. Thirteen temporal bones were selected at random. Perforations of different sizes, shapes and at different sites were fashioned in the tympanic membranes. These were assessed by clinicians of all grades, who were asked to draw the perforations and give estimates of the perforation size as a percentage of the total drumhead. Visual estimates and drawings were compared with a photographic objective method. Gross errors (some in excess of 100%) were apparent in both estimates and drawings. There was a highly significant statistical difference between the objective method and visual estimates and drawings (P < 0.001). Greater clinical experience was not correlated with better performance in estimating the size of perforations.

Diagnostic Errors↗
PubMed1993

Evaluation of several common standards for the X-ray microanalysis of thin biological specimens.

The question of the best type of standard to use for X-ray microanalysis of thin biological specimens remains unanswered. Standards embedded in an organic matrix have the advantage that they resemble biological specimens, but their composition is generally not known exactly. We compared several standards and, surprisingly, inorganic binary salts sprayed onto a supporting film were the most suitable: they corresponded closely with several other methods using organic matrices; they were easily produced; and their composition is known. Glutaraldehyde-urea aminoplastic resin thin sections and thin films containing dissolved salts were problematic. The composition of the polymer appears to be variable, and the thin films did not correspond with any other standard tested. Chelex100 bio-standard beads and flakes loaded with accurately determined concentrations of ions, embedded in epoxy resin and thin sectioned, tended to correspond to the results obtained with the binary salts. However, the results from some bio-standards were inexplicably aberrant. An epoxy resin standard was used for bromine, and was found to agree closely with the binary standards.

Electron Probe Microanalysis↗
PubMed1993

Hybrid antibodies.

One of the major advantages of genetic engineering is the ability to produce novel, hybrid antibodies. Hybrid antibodies can be assembled using fragments from different antibodies with the objective of assembling novel combinations of antibody-related effector functions. To efficiently achieve this goal it is necessary to have a precise understanding of the structure-function relationships within the antibody molecule. Secondly, it is possible to produce hybrids of antibodies with non-immunoglobulin proteins thereby achieving unique combination of functional properties. In this case it is necessary to consider both the desired functional properties and the means of assembling the protein components so as to maintain these properties. In all cases it is necessary to have the cloned gene segments, appropriate vectors and expression systems.

Animals↗
PubMed1993

Spinal fusion in the athlete.

Although there are a few anecdotal descriptions of the athlete who has gone on to win fame and fortune following a successful spinal fusion, there has been little, if any, scientific data available to aid the surgeon in his treatment of these highly motivated patients. At present, there is no guide to patient selection or to the operative procedure of choice. There is no standard postoperative rehabilitation program, and to date, an outcome study is sadly lacking. Therefore, it is worthwhile to look into this subject in greater detail.

Attitude of Health Personnel↗
PubMed1992

Modulation of the dimerization of a transcriptional antiterminator protein by phosphorylation.

The transcriptional antiterminator protein BglG inhibits transcription termination of the bgl operon in Escherichia coli when it is in the nonphosphorylated state. The BglG protein is now shown to exist in two configurations, an active, dimeric nonphosphorylated form and an inactive, monomeric phosphorylated form. The migration of BglG on native polyacrylamide gels was consistent with it existing as a dimer when nonphosphorylated and as a monomer when phosphorylated. Only the nonphosphorylated dimer was found to bind to the target RNA. When the dimerization domain of the lambda repressor was replaced with BglG, the resulting chimera behaved like an intact lambda repressor in its ability to repress lambda gene expression, which suggests that BglG dimerizes in vivo. Repression by the lambda-BglG hybrid was significantly reduced by BglF, the BglG kinase, an effect that was relieved by conditions that stimulate dephosphorylation of BglG by BglF. These results suggest that the phosphorylation and the dephosphorylation of BglG regulate its activity by controlling its dimeric state.

Bacterial Proteins↗
PubMed1992

Clinicians and research: recurring obstacles and some possible solutions.

We surveyed clinicians in residential treatment centers (RTCs) to explore their perceptions of barriers to and resources for accomplishing research and scholarly pursuits. A nationwide sampling of RTCs generated a sample of 273 respondents, which consisted of 95 psychologists, 27 psychiatrists, and 151 social workers. Our sample of clinicians expressed very favorable attitudes toward research and the scientist-practitioner model. However, the great majority are not combining the roles of clinician and researcher/scholar. The most frequently cited barriers to scholarly activity were insufficient time, research not part of the job description, and lack of funding. Recommendations are offered.

Attitude of Health Personnel↗
PubMed1992

Successful percutaneous balloon catheter treatment of renal artery occlusion and anuria.

Progressive renal failure may be due to renal artery stenosis and occlusion. Gradual occlusion of the renal arteries may allow the development of collateral arterial supply sufficient to avoid dialysis. Even when dialysis is required, significant viable renal parenchyma may still be present to allow escape from dialysis following revascularization of one or both kidneys. The chance of success in such cases is thought to be better if the patient still produces a significant amount of urine. We report here a patient who was completely anuric for five days and in whom excellent renal function returned after balloon angioplasty of one of two occluded renal arteries.

Acute Kidney Injury↗
PubMed1992

The significance of cone biopsy resection margins.

This 12-year retrospective study examines the significance of margin involvement with dysplasia at cone biopsy in relation to follow-up. Of 300 cone biopsies, 123 (41%) had margin involvement. These cases of margin involvement were associated with more severe dysplasia (P less than 0.0001) and a higher chance of subsequent abnormal cytological follow-up (P less than 0.0001) and residual dysplasia at subsequent surgery (P less than 0.0001). Involvement of the endocervical margin at the initial cone biopsy was a sensitive predictor of future abnormality, with an incidence of subsequent abnormal cytology of 29% and residual disease of 82% in those undergoing further surgery. In those cases where the margins had been clear, the incidence of abnormal cytological follow-up was 8%, with 12% residual disease in those undergoing subsequent surgery. Margin involvement was a better predictor of residual disease at repeat surgery than abnormal follow-up cytology (positive predictive value, 79% vs 60%, respectively).

Adolescent↗
PubMed1992

DNA-binding by the glucocorticoid receptor: a structural and functional analysis.

The glucocorticoid receptor belongs to a family of ligand activated nuclear receptors. This family includes, in addition to the receptors for steroid hormones, receptors for thyroid hormone, retinoic acid and 1,25-dihydroxy vitamin D3 as well as some receptors with as yet unknown ligands. The glucocorticoid receptor DNA-binding domain has been expressed in E. coli. The purified protein binds to the same DNA sequences as the native receptor and is therefore suitable for biochemical and structural studies of the DNA-binding function of the receptor protein. This protein has been shown to bind as a dimer to its DNA-binding site. Protein-protein interactions facilitate DNA-binding and a segment responsible for these interactions has been identified close to the C-terminal zinc-binding site. The family of nuclear receptors, with their related DNA-binding sites, provides an opportunity to study determinants for DNA sequence recognition. A segment close to the N-terminal zinc ion has been shown to be responsible for the target specificity of glucocorticoid and estrogen receptors. DNA-binding domains of nuclear receptors include nine conserved cysteine residues which have been shown to coordinate two zinc ions and zinc has been shown to be required for the structural integrity and DNA-binding ability of the glucocorticoid receptor DNA-binding domain. A motif for DNA recognition, based around zinc ions, was first described for transcription factor IIIA and nuclear receptors were believed to recognize DNA via a similar motif. However, the three-dimensional structure determination of the glucocorticoid receptor DNA-binding domain shows that its structure is clearly different from that of the TFIIIA type zinc-binding domains.

Amino Acid Sequence↗
PubMed1992

Growth of Haemophilus influenzae in human milk: synthesis, distribution, and activity of IgA protease as determined by study of iga+ and mutant iga- cells.

The nonencapsulated, IgA protease-positive Haemophilus influenzae strain Rd and serogroup b clinical isolates were found to proliferate in human milk. Growth did not require supplemental X and V factors. In milk, strain Rd synthesized IgA protease, but it was completely inhibited by antibody, so secretory IgA in milk cultures remained intact. Inhibition was largely attributable to IgA1 antibodies. Rd cells also aggregated during growth in milk and showed colony size variation, whereas a protease-negative mutant of Rd (Rd225DK) aggregated less and had uniform colony size. Like differences in protease inhibition, these differences in growth pattern were mediated by secretory IgA1. Thus, milk antibody not only inhibited the extracellular protease but also interacted directly with the enzyme precursor or related antigens on growing bacterial cells. This self-protective property of milk secretory IgA may be an important immunologic attribute for the upper respiratory mucosa of the infant.

Culture Media↗
PubMed1992

Preliminary observations concerning treatment of visual discomfort and associated perceptual distortion.

A system for therapeutic precision tinting is described. Some individuals who are subject to perceptual distortion of text no longer perceive the distortion when the text has a particular colour. A simple colorimeter enables an observer to illuminate text with light of a particular chromaticity, varying first CIE 1976 hue angle (huv), then saturation (suv), and then luminance, to obtain a setting that maximizes visual comfort and reduces any perceptual distortion. The colorimeter setting is then matched by a combination of tinted trial lenses. The combination uses only two dyes at a time from a selection of seven, unless a dark lens is required, when a third neutral (grey) dye is added. The subject observes both text and a normal scene when wearing tinted trial lenses. A variety of trial lenses are compared including those that match the colorimeter setting and others with similar hue angle. Spectacle lenses are then tinted so as to have a spectral transmission identical to that of the chosen combination of trial lenses. Certain patients with reading disorders, eye-strain, headaches or photosensitivity epilepsy report benefit when wearing spectacles tinted according to the above techniques. The physiological basis for the therapeutic effects is uncertain, but may involve a selective impairment of luminance or colour-difference channels.

Adolescent↗
PubMed1992

Use of colistin-polymyxin B-cellobiose agar for isolation of Vibrio vulnificus from the environment.

Colistin-polymyxin B-cellobiose agar was employed for the isolation of Vibrio vulnificus from shellfish. Isolates were examined phenotypically and with a gene probe and monoclonal antibody specific for V. vulnificus. Results indicated that colistin-polymyxin B-cellobiose agar is superior to both sodium dodecyl sulfate-polymyxin B-sucrose agar and thiosulfate-citrate-bile salts-sucrose agar in its ability to select and differentiate this species from background vibrios.

Agar↗