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Biomedical subjects

D Moran

Publications and source records attributed to D Moran.

At least 19 recordsLinked to original sources

Ontogenetic development of the gastrointestinal microbiota in the marine herbivorous fish Kyphosus sydneyanus.

Molecular techniques were used to investigate the composition and ontogenetic development of the intestinal bacterial community in the marine herbivorous fish Kyphosus sydneyanus from the north eastern coast of New Zealand. Previous work showed that K. sydneyanus maintains an exclusively algivorous diet throughout post-settlement life and passes through an ontogenetic diet shift from a juvenile diet which is readily digestible to an adult diet high in refractory algal metabolites. Terminal restriction fragment length polymorphism (T-RFLP) analysis was used to investigate the relationship between bacterial community structure and fish size. Bacterial diversity was higher in posterior gut sections than anterior gut sections, and in larger fish than in smaller fish. Partial sequencing of bacterial 16S rDNA genes PCR amplified and cloned from intestine content samples was used to identify the phylogenetic affiliation of dominant gastrointestinal bacteria. Phylogenetic analysis of clones showed that most formed a clade within the genus Clostridium, with one clone associated with the parasitic mycoplasmas. No bacteria were specific to a particular intestinal section or size class of host, though some appeared more dominant than others and were established in smaller fishes. Clones closely related to C. lituseburense were particularly dominant in most intestine content samples. All bacteria identified in the intestinal samples were phylogenetically related to those possessing fermentative type metabolism. Short-chain fatty acids in intestinal fluid samples increased from 15.6 +/- 2.1 mM in fish <100 mm to 51.6 +/- 5.5 mM in fish >300 mm. The findings of this study support the hypothesis that the ontogenetic diet shift of K. sydneyanus is accompanied by an increase in the diversity of intestinal microbial symbionts capable of degrading refractory algal metabolites into short-chain fatty acids, which can then be assimilated by the host.

Age Factors↗

Theoretical study of icosahedral closo-borane, -alane, and -gallane dianions (A(12)H(12)(2-); A = B, Al, Ga) with endohedral noble gas atoms (Ng = He, Ne, Ar, and Kr) and their lithium salts (Li[Ng@A(12)H(12)](-) and Li(2)[Ng@A(12)H(12)]).

Geometries, energies, vibrational frequencies, and magnetic properties have been computed at the B3LYP level with the 6-31G and 6-311+G basis sets for a family of endohedral closo-boranes, -alanes, and -gallanes Ng@A(12)H(12)(2-) with noble gas atoms (Ng) located in the centers of icosahedral [B(12)], [Al(12)], and [Ga(12)] clusters. The endohedral structures of most of the systems are minima lying above separated Ng + A(12)H(12)(2-) by 166 (He@B(12)H(12)(2-)) and 403 (Ne@B(12)H(12)(2-)) kcal/mol for boranes; 29 (He@Al(12)H(12)(2-)), 63 (Ne@Al(12)H(12)(2-)), 154 (Ar@Al(12)H(12)(2-)), and 189 (Kr@Al(12)H(12)(2-)) kcal/mol for alanes; and 39 (He@Ga(12)H(12)(2-)), 71 (Ne@Ga(12)H(12)(2-)), and 213 (Ar@Ga(12)H(12)(2-)) kcal/mol for gallanes. Three types of transition states are found for the exit of Ng from a cage: via an edge (TS-1), through a face (TS-2), and via a more extensive deformation through a pentagonal cage "neck" (TS-3). The most favorable exit path depends on the rigidity of the cage, the exothermicity of the dissociation, and the relationship between the size of the internal cavity of the cage and the Ng atomic radius. Ng exit via TS-3 is preferred for He@Al(12)H(12)(2-), Ne@Al(12)H(12)(2-), He@Ga(12)H(12)(2-), Ne@Ga(12)H(12)(2-), Ar@Al(12)H(12)(2), and Kr@Al(12)H(12)(2-). Helium exits via a cage edge (TS-1) for He@B(12)H(12)(2-), while for Ne@B(12)H(12)(2-) the neon exits via a triangular face (TS-2). Exit barriers (H(exit)(double dagger)) are high enough (30-60 kcal/mol) for all helium clusters and for Ne@Al(12)H(12)(2-) and Ne@Ga(12)H(12)(2-) to ensure the kinetic stability of these systems. The barriers for Ar@Al(12)H(12)(2-) and Kr@Al(12)H(12)(2-) decrease to 10-15 kcal/mol, while Ne@B(12)H(12)(2-) has a very low exit barrier and is not expected to be stable kinetically. There is a linear dependence of Ng@A(12)H(12)(2-) cage size on the Ng atomic radii; that is, the heavier Ng atoms "bulge" the cages. Nucleus independent chemical shifts (NICS) indicate that all three A(12)H(12)(2-) anions are aromatic but the alanes are the least so. A face- or edge-coordinated external Li(+) cation has a moderate effect on the structure and vibrational and magnetic properties of the helium-containing clusters, i.e., Li[He@A(12)H(12)](-). In contrast, for systems with very large exothermicities of Ng exit, Li(+) complexation promotes their dissociation. Thus, the internal atom Ne exits from the cage of Li[Ne@B(12)H(12)](-) and the salt dissociates into Ne + LiB(12)H(12)(-) without barrier. Systems with two Li(+) ions located initially above opposite cage faces (Li(2)[Ng@A(12)H(12)]) undergo complex intramolecular rearrangements leading to destruction of the icosahedral closo structures.

Journal Article↗

The almost bottleable triplet carbene: 2,6-dibromo-4-tert-butyl-2',6'-bis(trifluoromethyl)-4'-isopropyldiphenylcarbene.

Computations on 2,6-dibromo-4-tert-butyl-2',6'-bis(trifluoromethyl)-4'-isopropyldiphenylcarbene (1) using ab initio and density functional theory methods underscore the unusual stability of the triplet over the singlet state. At the B3LYP/6-311G(d,p) level, the triplet state had a slightly bent central C-C-C bond angle of 167 degrees, whereas this angle in the singlet was 134 degrees. The B3LYP singlet-triplet splitting (12.2 kcal/mol) was larger than that of the parent molecule (5.8 kcal/mol), diphenylcarbene (2), which also has a triplet ground state. The energy of a suitable isodesmic reaction showed the triplet and singlet states of (1) to be destabilized, by 6.3 and 12.5 kcal/mol, respectively, due to the combined effects of the CF3, Br, and alkyl substituents. The linear-coplanar form of (3)(1), which might facilitate dimerization or electrophilic attack at the more exposed diradical center, was prohibitively (35.9 kcal/mol) higher in energy. Our results confirm Tomioka's conclusion that the triplet diarylcarbene, ortho-substituted with bulky CF3 and Br substituents, is persistent due to steric protection of the diradical center. Dimerization and other possible reaction pathways are inhibited, not only by the bulky ortho substituents but also by the para alkyl groups. The increase in stability of the triplet ((3)(1)) state relative to the singlet ((1)(1)) state does not influence the reactivity directly.

Journal Article↗

Changes in heart rate variability following acclimation to heat.

We studied the sympatho-vagal balance during acclimation to heat in eight healthy individuals. The subjects, dressed in shorts and tennis shoes, underwent a 10 d procedure of acclimation. Daily exposure lasted 115 min--5 min rest followed by 2 bouts of 50 min exercise (walking on a treadmill at a work load of approximately 350 watt) separated by 10 min rest-at 40 degrees C and 40% relative humidity. We analyzed the time and frequency domains of 256 R-R intervals, toward the end of the second bout of exercise, on the first and tenth days of acclimation. Typical changes for heat acclimation (a reduction in rectal temperature and heart rate, an increase in sweat rate) were observed. Concomitant to a decrease in the final heart rate on the tenth day, sympathetic tone increased. We suggest that, except for the chronotropic response, changes in the sympatho-vagal balance may reflect several adaptive mechanisms of the cardiovascular system. Peripheral factors rather than intrinsic cardiac factors are of relatively greater importance in the direct control of cardiac function.

Acclimatization↗

[Prediction of physiological response from mathematical models].

The ability to predict the physiological responses of workers exposed to extreme environmental conditions, has been a challenge to environmental physiologists for more than 3 decades. Therefore, mathematical models have been developed to predict metabolic rate under various levels of work intensity and dynamic changes in body temperature and heart rate. Based on the effect of exercise on the cardiovascular system, a model was developed to predict mean arterial blood pressure as a function of heart rate. Physiological strain could also be estimated on the basis of thermoregulatory and cardiovascular strains. This paper summarizes knowledge accumulated during 25 years of studies in the field of mathematical modeling of physiological parameters. Besides analyzing the logic underlying each model, it explains the scientific approach in developing a model from its early concept to the model's application in the field.

Blood Pressure↗

Linking substance abuse and serious mental illness service delivery systems: initiating a statewide collaborative.

In the past, persons with serious mental illness and substance abuse often found themselves in parallel systems of care that inadequately addressed their needs. Recent advances have seen the development of an integrated approach to care for these disorders in both the public and private sectors. While some state departments of mental health have developed integrated systems of care for public sector patients, no department appears to have developed such a system for both public and private clients, and there appears to be no published journal report of a model to induce cooperation by all stakeholders. This article outlines a two-step approach by the Massachusetts Department of Mental Health to foster stakeholder cooperation in designing an integrated system of care for both public and private clients with co-occurring disorders.

Delivery of Health Care, Integrated↗

An innovation in developing world cataract surgery: sutureless extracapsular cataract extraction with intraocular lens implantation.

PURPOSE: The benefits of sutureless cataract surgery have not been available to the majority of developing world patients. This report describes a surgical technique developed to gain the benefits of self-sealing sutureless techniques, without the need for costly, complex instrumentation, expensive consumables, or difficult nucleus fragmentation manoeuvres in the anterior chamber. METHOD: A detailed description of a sutureless technique that uses only standard manual extracapsular cataract extraction instrumentation is presented. The clinical records of 362 consecutive completed sutureless surgeries were reviewed, and preliminary indicative data of visual outcome for those having follow up between postoperative weeks 3 and 8 are also presented. RESULTS: Hospital and eye camp experience confirms this operation offers speed, routinely 5 min or less with mature cataracts, reduced cost because no suture, viscoelastic or anterior chamber maintainer is needed, wound security and stability, and rapid effective visual rehabilitation. Uncorrected distance visual acuity during the third to eighth postoperative week was available for 266 of the 362 patients (73%): 10, 145, 101, and 10 had acuities of better than 6/9, 6/9-6/18, 6/24-6/60, and worse than 6/60, respectively. Ninety-seven, 165, 12, and two of the 276 (76%) patients with recorded corrected distance acuity were in the same groups. Comparing postoperative with preoperative corneal astigmatism for each patient with postoperative information available (208), without regard to axis, the amplitude of astigmatism worsened by a mean of 0.94 dioptres (+/- 0.17, 95% confidence; +/- 1.23 standard deviation; 7.5D maximum worsening; 2.5D maximum improvement). No attempt has been made to analyse complication type or frequency in this preliminary report. CONCLUSION: The authors believe this sutureless cataract extraction technique to be an innovation with widespread application in the developing world. Further and more exhaustive critical appraisal is warranted.

Cataract Extraction↗

Arthritis care: comparison of physicians' and patients' views.

OBJECTIVES: To understand the expressed needs of physicians and their patients with respect to arthritis care, identify areas of agreement and disagreement in doctor and patient views of arthritis care, and to determine the types of educational programs needed. METHODS: Focus group interviews were conducted with 14 physicians of varied specialties and 12 patients with arthritis from Oxford Health Plans. Interviews were audiotaped and transcribed. Analyses were performed by using text processing programs from the Unix computer operating system. Common themes were identified and summarized. RESULTS: Physicians and patients agreed that pain and loss of functioning were the most important problems patients with arthritis faced and that arthritis was incurable. Both agreed that doctors need more time to discuss individual concerns with their patients. More information about diet and exercise and strategies for reducing social isolation were needed. Doctors and patients disagreed about the value of nutritional supplements, joint replacement, and referrals to specialists. Disagreement also existed regarding the belief that pain was an inevitable part of the aging process, and with respect to the use of drug and surgical therapy. CONCLUSIONS: Areas of agreement and disagreement were discussed. Collaboration and negotiation were identified as constructive responses to conflicts between physicians and patients. Patients need to be taught self-care strategies to minimize the impact of arthritis on their daily lives. The specific continuing education needs of physicians involved training in exercise, nutrition, occupational and physical therapy, prescriptions, and alternative medicine.

Aged↗

Chemoprevention of tobacco-smoke lung carcinogenesis in mice after cessation of smoke exposure.

Male strain A/J mice were exposed for 6 h per day, 5 days per week to a mixture of 89% cigarette sidestream smoke and 11% mainstream smoke. Total suspended particulate concentrations were 137 mg/m(3). In experiment 1, animals were exposed for 5 months to tobacco smoke and given a 4 month recovery period in air. Lung tumor multiplicity was 2.4 and incidence 89%. Animals exposed to filtered air had 1.0 tumor per lung (65% incidence). In animals kept for 5 months in smoke, removed into air and then fed a diet containing a mixture of myoinositol and dexamethasone, tumor multiplicity was 1.0 and incidence was 62%. These values were significantly (P < 0.01) lower than in animals exposed to smoke and identical to values seen in controls. In animals fed a diet containing 250 mg/kg each of phenethyl isothiocyanate and benzyl isothiocyanate during the entire 9 months, lung tumor multiplicity was 2.1 and incidence 96%, not significantly different from animals exposed to smoke and fed control diet. In experiment 2, animals were exposed for 5 months to smoke, followed by a 4 month recovery period in air and were fed during the entire period a diet containing either D-limonene or 1, 4-phenylenebis(methylene)selenoisocyanate (p-XSC). In animals exposed to tobacco smoke and fed control diet, lung tumor multiplicity was 2.8, whereas in the animals fed D-limonene it was 2. 6 and in the animals fed p-XSC it was 2.4. The differences to the controls were statistically not significant. It was concluded that myoinositol-dexamethasone successfully prevents the development of tobacco smoke-induced lung tumors even if administered when the animals have 'quit' smoking. On the other hand, agents otherwise shown to prevent lung tumor formation following administration of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone or benzo[a]pyrene were ineffective against tobacco smoke.

Animals↗

Safety and efficacy of digital rectal examination in patients with acute myocardial infarction.

OBJECTIVE: Digital rectal examination (DRE) is often ignored or deferred in acute myocardial infarction (AMI). The aim of this study was to determine the safety and efficacy of DRE in patients with AMI. METHODS: This was a prospective, comparative, stratified study in an inner-city teaching hospital. A total of 480 patients from intensive care and telemetry units were stratified into three groups. Group I included 160 patients with AMI in whom a DRE was performed and electrocardiographic (EKG) recordings were obtained. Group II included 155 patients with AMI in whom DRE was not done, but EKG recordings were made. Group III consisted of 165 patients without AMI in whom DRE was performed and EKG recordings were obtained. Sustained arrhythmias and vital signs were measured. RESULTS: None of the patients developed sustained arrhythmias and there was no change in vital signs. DRE resulted in the detection of several clinically significant findings. CONCLUSION: DRE was found to be safe in our stable patients with AMI.

Adult↗

Dantrolene and recovery from heat stroke.

Several authors have shown that dantrolene may be effective in the treatment of heat stroke patients. However, the scant data available are still controversial. The aim of this investigation was to establish an animal experimental model for studying the efficacy of this drug both as a prophylactic agent and as a means of hastening the cooling process after heat stroke. Male albino rats were divided into five groups: Sedentary controls (SC), Sedentary+dantrolene (S+D), Exercise controls (EC), and Exercise+dantrolene (E+D, E+D1). The drug (140 mg x kg(-1) body weight) was administered i.v. either prior to subjection to heat stress (40 degrees C) (S+D, E+D) or upon development of heat stroke syndrome (E+D1). In the S+D group, dantrolene administered prior to heat stress (HS) delayed the development of heat stroke by 70%, although colonic temperature (Tc) at the onset of heat stroke was similar to that in group SC (43.0 +/- 0.1 degrees C and 43.2 +/- 0.4 degrees C for S+D and SC, respectively). In E+D animals, dantrolene shortened exercise endurance in the heat by 17.5%, but concomitantly hindered severe Tc rise (40.9 +/- 0.2 degrees C and 40.0 +/- 0.2 degrees C for EC and E+D, respectively). Administration of dantrolene on the development of heat stroke appeared to improve cooling in the exercise group (0.25 degrees C x min(-1) and 0.18 degrees C x min(-1), for the first 1 5 min of cooling, for E+D1 and EC, respectively). The results suggest that dantrolene is effective as a prophylactic agent in sedentary animals only. It also might have application on development of heat stroke. It is hypothesized that the observed rapid cooling is associated with dantrolene's effect on muscle contraction, thus leading to attenuated heat production and peripheral vascular relaxation.

Analysis of Variance↗

Modern surgery for global cataract blindness: preliminary considerations.

Unoperated cataract in the developing world remains ophthalmology's major unsolved problem. Recent developments have brought into question the assumptions of those who have thought that extracapsular surgery with implantation of a posterior chamber intraocular lens is an unrealistic approach to the treatment of global cataract blindness. High-quality 1-piece posterior chamber intraocular lenses are being manufactured locally for approximately $10 each. Most ophthalmologists can be trained to perform extracapsular surgery in a 1-month course. This process is particularly effective if outstanding local surgeons receive intensive training to become instructors. While the incidence and treatment of posterior capsule opacification requires further study, the development of a low-cost YAG laser may be a solution. Imaginative ways to recover costs will need to be developed if the staggering prevalence of cataract blindness is to be effectively addressed. The improved result of modern surgery may make patients more willing to pay for their operation.

Blindness↗

Acclimatization strategies--preparing for exercise in the heat.

More than 200 years ago, in 1768, Lind in his monograph: "An assay on diseases incidental to Europeans in hot climate" pointed out that habituation to hot climates reduced the danger to health. Two centuries later, Lind and Bass in a classical study which was carried out under hot/dry climatic conditions (49 degrees C and 20% rh) demonstrated that the adaptation to heat may be described as the series of physiological adjustments that occur when a person who is accustomed of living in a cool environment is transferred to a hot climate. This adaptation is a process which is fully achieved after 10 to 14 days of exposure to heat, but two thirds or even 75% of the adaptation is obtained already within 5 days (1). According to this study improved tolerance to heat is related to typical physiological changes: heightened sweating response, lowered heart rate, and lowered rectal temperature during exercise in the heat.

Acclimatization↗

How significant is magnesium in thermoregulation?

Nine apparently healthy male subjects, mean age 22.8 yr, SD 4.1, free from disease, medication or addiction who gave informed consent, underwent acclimation process in a heat chamber; exposed during 2 h daily for 10 consecutive days to a temperature of 40 degrees C and 40% relative humidity while walking on a treadmill elevated by 3 degrees at a speed of 5 km/h (VO2 1.2 1.min-1). Serum, mononuclear and erythrocyte magnesium (S-Mg, M-Mg and E-Mg, respectively) were monitored on day 1, 5 and 10 before and after the heat exposure. S-Mg decreased while M-Mg increased after the heat exposures, suggesting a shift of S-Mg to mononuclear cells. The decrease of S-Mg was sustained at the end of the acclimation process. E-Mg increased up to day 5 and decreased gradually approximating the baseline by day 10. Mg appears to play a significant role in heat acclimation.

Adult↗