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Biomedical subjects

C Gordon

Publications and source records attributed to C Gordon.

At least 163 records · Page 9Linked to original sources

Ground reaction forces, center of pressure, and duration of stance with and without an ankle-foot orthosis.

We analyzed the effects of an ankle-foot orthosis (AFO) on the ground reaction forces, the position of the center of pressure, and the timing of stance phase events during walking in 18 healthy volunteers between the ages of 19 and 38 years. The magnitude and direction of the ground reaction forces and the locus of the center of pressure were recorded every one-sixtieth of a second during free-speed ambulation. The horizontal force components of the ground reaction force were plotted vectorially, and the vertical force component was displayed by its magnitude expressed in percentage body weight. All this information was superimposed on the subject's footprint and statistically analyzed, comparing right to left, narrow to wide, and ipsilateral to contralateral use of an AFO. The results showed a significant reduction in the mean duration of the stance phase of 4.83% (p less than 0.05) with the AFO. This reduction was due primarily to the significant reduction during midstance of 7% (p less than 0.025), which was more pronounced with the use of the wide AFO. Using an AFO also resulted in a mean increase of 20% (p less than 0.05) in the vertical force magnitude at the end of push-off. With the use of an AFO, there was a shift of the point of impact at heel strike to a more posterior location and a shift of the trajectory of the center of pressure to a more lateral position throughout the stance phase. These changes should be kept in mind when prescribing an ankle-foot orthosis.

Adult↗

Dysphagia in acute stroke.

A prospective study was undertaken to define the incidence, duration, and consequences of dysphagia in an unselected group of 91 consecutive patients who had suffered acute stroke. The site of the present lesion and of any previous stroke was determined clinically and was confirmed by computed tomography of the brain or necropsy in 40 cases. Of 41 patients who had dysphagia on admission, 37 had had a stroke in one cerebral hemisphere. Only seven patients showed evidence of lesions in both hemispheres. Nineteen of 22 patients who survived a stroke in a hemisphere regained their ability to swallow within 14 days. Dysphagia in patients who had had a stroke in a cerebral hemisphere was associated in this study with a higher incidence of chest infections, dehydration, and death.

Acute Disease↗

Role of immediate versus delayed nephrectomy for failed renal transplants.

The role of timing of transplant nephrectomy after renal transplantation has not been well defined. This report compares the morbidity, mortality, and hospitalization costs of 37 patients undergoing transplant nephrectomy within 14 days after graft failure and return to dialysis, with 31 patients undergoing delayed transplant nephrectomy (less than 14 days after graft failure and return to dialysis). This analysis revealed that there were no significant (P greater than .05) differences in patient morbidity and mortality between these groups. There was, however, a substantial increase (P less than .05) in the cost of hospitalization in the delayed nephrectomy group. For this reason, we recommend early nephrectomy after renal transplant failure in order to minimize the cost of health care for these patients undergoing failed cadaver donor transplant nephrectomy.

Costs and Cost Analysis↗

Evidence for a direct action of exogenous insulin on the pancreatic islets of diabetic mice: II. Prolonged insulin therapy before islet isolation and perifusion.

24 week old diabetic mice of the C57Bl/Ks (db/db) strain were treated with subcutaneous injections of Ultratard M.C. insulin at a dose of 40 mU/animal rising to 100 mU/animal after 12 weeks. The mean plasma insulin value was 146 +/- 20 microU/ml (n = 6). During this time, the mean body weight of the animals rose significantly (p less than 0.05) and the mean blood glucose concentration fell significantly (p less than 0.005) until a value 2-3 times normal was reached, the insulin dose was then adjusted empirically to maintain hyperglycaemia at this level. Pancreatic islets from these animals, untreated diabetic mice and normal (+/+) mice were isolated by collagenase digest and perifused with a modified Krebs-Ringer medium containing either 3 mmol/L or 15 mmol/L glucose. During glucose challenge, normal islets demonstrated the usual biphasic insulin response, but high glucose levels elicited no response from islets of untreated diabetic mice. Previous treatment of diabetic mice with insulin led to a restoration of the first phase of glucose mediated insulin secretion on perifusion and a significant increase (p less than 0.05) in the second phase. Such an improvement in beta-cell function in the face of prevailing hyperglycaemia, even allowing for the possible mediating effect of a 30% fall in blood glucose, was taken as further evidence for a direct action of exogenous insulin on the islets of diabetic mice.

Animals↗

Superior mesenteric artery syndrome after resection of an arteriovenous malformation in the cervical cord.

Any disease process decreasing the angle between the superior mesenteric artery and the abdominal aorta can result in the external compression of the duodenum and subsequent intestinal obstruction. This unusual type of intestinal obstruction known as superior mesenteric artery syndrome is a well-recognized clinical entity. It is diagnosed radiologically by an abrupt, vertical cutoff of barium flow in the third portion of the duodenum. The management is primarily medical but occasionally surgical correction is required. Herein, the diagnosis of superior mesenteric artery syndrome was made in an incomplete quadriplegic woman who had recently undergone surgical resection of an arteriovenous malformation in the cervical cord. This case was managed successfully with gastrointestinal decompression, proper positioning in the side-lying position, and adequate nutrition.

Adult↗

Electrodiagnostic characteristics of acute carpal tunnel syndrome.

Carpal tunnel syndrome (CTS) exemplifies a cumulative trauma disorder which may occur in industrial settings. Occasionally, industrial workers develop CTS acutely over the course of a few days to a few weeks. We recently performed electrodiagnostic studies on 22 workers at a midwestern automobile manufacturing plant who developed symptoms compatible with CTS. All tests were within eight weeks of symptom onset; 70% were within four weeks. The acute syndrome was manifested by a conduction block of sensory, motor, or both fiber types beneath the carpal ligament. All patients received sensory studies; nine had motor studies as well. Sensory nerve latencies were not prolonged in proportion to the symptoms, which were short in comparison to the low amplitude sensory nerve action potential evoked proximal to the carpal ligament. Sensory nerve action potential amplitude at midpalm averaged 200% of the value obtained proximally. Because of short distance and residual latency, comparison of motor latencies proximal and distal to the carpal ligament was less helpful than the difference in amplitude of the evoked potentials. Amplitude of the distal response increased an average of 32%. Prompt identification of acute CTS was followed by a recommendation for job change which, along with conservative therapy, led to resolution of symptoms in 77% of patients. The diagnosis of acute CTS leading to avoidance of inciting activities is beneficial in the industrial setting.

Action Potentials↗

Efficacy of transdermal scopolamine against seasickness: a 3-day study at sea.

Transdermal scopolamine has been reported to provide protection against motion sickness, both while sailing at sea (7-8 h) and under experimental conditions. In this study, we tested the efficacy of transdermal scopolamine and evaluated its side effects during a 72-h cruise at sea. We tested 38 male volunteers, 20-25 years old, who were located on a 3000-ton vessel. The presence of seasickness, defined by Graybiel's diagnostic criteria, was used to calculate percent protection. When sickness was considered as malaise II or more, the drug provided 74, 73, and 39% protection during the three sailing days, respectively. There were no significant differences in the magnitude of the side effects reported by experimental and placebo groups. We conclude that transdermal scopolamine's efficacy against seasickness during a 3-day cruise was not associated with significant side effects and, therefore, we find the drug suitable for long-term use by sailing crews.

Administration, Cutaneous↗

The purification of mouse monoclonal antibodies from ascitic fluid.

A method is described for the purification of monoclonal antibody from mouse ascitic fluid. The fluid is clarified and the lipid removed using silicon dioxide powder, before the immunoglobulin is precipitated using polyethylene glycol. The method provides IgM antibody in high yield and good purity. In the case of IgG antibodies the purity is 30-40% after PEG precipitation and the yield is high. The enriched IgG is adequate for many purposes and is suitable for further purification on an ion exchange column.

Animals↗

Yeast DNA replication.

We have explored various strategies for exploiting the yeast genetic and biochemical system for understanding DNA replication. Because of the long time that has intervened between the isolation of random replication mutants of yeast and the identification of the gene products affected, an alternative approach to elucidating the molecular basis of replication has been needed. One such alternative involves purifying replication proteins, isolating the genes encoding them, and constructing the appropriate mutant from the cloned gene. We have applied this "reverse genetics" strategy to three different replication activities: DNA polymerases, single-stranded DNA binding proteins, and proteins that bind to autonomously replicating sequence (ARS) elements.

DNA Polymerase I↗

The role of the sympathetic nervous system in the regulation of ultradian rhythms in urine excretions.

The effects of alpha and beta adrenoreceptors blockade and surgical kidney denervation on ultradian rhythmicity in urine excretion were investigated in four dogs. Pharmacological treatments and surgical denervation of the kidneys suppressed the ultradian rhythmicity in urine flow but did not completely eliminate the ultradian rhythms in urinary osmolality and in electrolyte concentrations. These findings suggest that the autonomic nervous system plays a major role in the regulation of the ultradian rhythms in water excretion in dogs. The partial persistence of ultradian rhythms in urine osmolality and electrolyte concentrations after autonomic denervation supports the assertion that the ultradian rhythms in solute concentrations are regulated by different mechanisms to those of water excretion, suggesting the possible involvement of a multioscillatory system.

Activity Cycles↗

Transdermal scopolamine: human performance and side effects.

The effect of transdermal scopolamine on performance was tested on 23 naval volunteers. Performance was evaluated by using a battery of professional (naval-related) and cognitive tests. For all tests performed there were no significant differences between the scores obtained in placebo and transdermal scopolamine conditions. These results were in close agreement with subjective estimations of performance. Transdermal scopolamine significantly reduced salivary flow, whereas mood state, visual acuity, and eye accommodation for near vision were not affected. We conclude that transdermal scopolamine administration is not accompanied by decrement in performance abilities and can safely be used by naval crews.

Accommodation, Ocular↗

Effect of transdermal scopolamine on salivation.

The effect of transdermal scopolamine on salivary flow and composition was analyzed in 21 healthy volunteers. The flow rate of whole saliva was significantly lowered by transdermal scopolamine. Significant positive correlations were found between the placebo rate of flow and both the quantity and percentage decreases in response to transdermal scopolamine. The magnesium concentration was significantly increased during transdermal scopolamine administration, whereas the sodium, potassium, and calcium concentrations were not consistently altered. Accordingly, the magnesium secretion rate was unaltered, whereas sodium, potassium, and calcium secretion rates were significantly lowered by transdermal scopolamine administration.

Administration, Topical↗

The modulating effects of flurbiprofen on adriamycin plus vincristine or vindesine in the treatment of advanced breast cancer.

To assess the modulating effects of a non-steroidal anti-inflammatory drug on chemotherapeutic agents, 183 patients with advanced breast cancer have been treated in a randomised study with flurbiprofen or placebo and adriamycin plus a vinca alkaloid. To assess the efficacy of the new vinca alkaloid, vindesine, in breast cancer, patients were further randomised to receive vindesine or vincristine. The overall response rate in evaluable patients was 57%, and the median duration of response in the different treatment groups varied from 6 to 10 months. Response rates and toxicity in vindesine- and vincristine-treated patients were similar, although with vindesine neurotoxicity was slightly lower. Flurbiprofen did not improve the response rate or reduce the toxicity of adriamycin plus vinca alkaloid.

Adult↗

Evidence for a direct action of exogenous insulin on the pancreatic islets of diabetic mice: islet response to insulin pre-incubation.

Pancreatic islets were isolated by collagenase digest from normal (+/+) and severely diabetic (db/db) mice of the C57BL/Ks strain. Batches of islets from the diabetic mice were incubated for 1 h at 37 degrees C in Krebs-Ringer medium containing glucose (3 mmol/l), with or without mouse insulin (50 mU/l), before perifusion. When compared with untreated islets from the same digest, pre-incubation of islets from diabetic mice with insulin elicited a restoration of the biphasic insulin response to a glucose challenge which was indistinguishable from the response of the untreated, control islets from non-diabetic mice. Untreated diabetic islets showed no insulin response to glucose challenge, insulin values being very significantly lower than those of either non-diabetic or treated diabetic mouse islets (p = less than 0.005). The restoration of secretion in treated islets of diabetic mice was shown not to be an artefact. These observations provide evidence for a direct, as yet undefined, action of insulin on the beta cell of the diabetic mouse.

Animals↗

Intraportal autotransplantation of cryopreserved porcine islets of Langerhans.

Mechanically prepared isolated islets of Langerhans were cryopreserved in liquid nitrogen for a period of 4 days. Intraportal autotransplantation studies were performed on two groups of six pigs rendered diabetic by total pancreatectomy (group 2) or by partial pancreatectomy combined with streptozotocin (group 4) and compared with two control groups (groups 1 and 3, respectively). The pigs were assessed for survival, weight gain, glycosuria, polyuria, systemic blood sugar and insulin, and, in selected pigs, intravenous glucose tolerance tests. Results showed that partial pancreatectomy with streptozotocin was the better tolerated experimental diabetes. Variable control of hyperglycemia was obtained over an experimental period of 3 months. Random blood glucose returned to normal in one of six pigs in the totally pancreatectomized group and three of six pigs in the partial pancreatectomy and streptozotocin group. Despite these normal circulating glucose levels, imperfect glucose homeostasis was achieved as shown by the response to glucose tolerance testing. These results report blood glucose control after cryopreserved islet autotransplants in diabetic pigs but further study is still necessary to achieve consistency.

Animals↗