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Biomedical subjects

D Moran

Publications and source records attributed to D Moran.

At least 55 records · Page 3Linked to original sources
PubMed1993

Is renal biopsy justified for the diagnosis and management of the nephrotic syndrome in the elderly?

During the past decade, controversy has raged about the necessity of renal biopsy for the management of the idiopathic nephrotic syndrome. The debate has centered on whether a precise diagnosis is imperative for steroid treatment or whether such therapy can be given blindly. The above question has not been addressed in the elderly. In this retrospective study 30 patients aged > 60 years, all of whom underwent a renal biopsy for an unexplained nephrotic syndrome, were categorized according to histological findings and clinical evolution of their disease. The spectrum of histology was diverse, the most common renal lesion diagnosed being membranous glomerulopathy (MGN) (23%). At variance with other works is the relatively high incidence of membranoproliferative glomerulonephritis (MPGN) (20%) found by us. Minimal change disease (MCD) and amyloidosis were encountered in 5 (17%) and 4 patients (13%), respectively. Specific therapy (steroids) was administered in 11 patients. No benefit of steroid treatment was shown in patients with either MGN or MPGN. The only lesion which responded to steroids was MCD (3 complete remissions, 1 partial). Only one biopsy was complicated by a clinically significant perirenal hematoma requiring blood transfusion. No surgical intervention was necessary. Our findings tend to favor a positive approach to the performance of a renal biopsy in the management of the nephrotic syndrome in the elderly.

Aged↗
PubMed1993

Variants of alpha 1-antitrypsin in Puerto Rican children with asthma.

A survey of 393 Puerto Rican and 354 non-Hispanic pediatric patients at Beth Israel Hospital, New York, revealed a significantly larger percentage of asthmatic subjects among Puerto Ricans, confirming findings of a study of Puerto Rican adults in New York. Assays of alpha 1-antitrypsin (AAT) concentration and phenotypes in 61 Puerto Rican asthmatic children revealed a significantly larger number with an S or Z variant in AAT phenotype. The AAT concentration was not a significant variable in this relationship, since four of five subjects with intermediate deficient AAT concentrations and a PiM phenotype were among control nonasthmatic Puerto Rican subjects. A family history of asthma was more common among asthmatic than control subjects and was most common for variant AAT phenotypes in either asthmatic or control subjects. We speculate that the S or Z variant of AAT affects the inflammatory response in such a way as to predispose to asthma.

Adolescent↗
PubMed1992

[Glucose polymer solutions and prolonged exertion in the heat].

The effect of glucose polymer solutions on physical performance has been extensively investigated, mainly under controlled laboratory conditions. The influence of such beverages on fluid balance and on glycemic state in the field, during prolonged exercise of moderate intensity (a 134 km march) in the heat (32-41 degrees C, 60-14% relative humidity) was therefore studied. 48 endurance-trained men were randomly assigned to drink either a 7.2% glucose polymer (GP) electrolyte beverage or tap water (TW); there were 24 in each group. Each group was then divided into subgroups that either consumed fluid ad libitum, or were instructed to consume 1000 ml/hr. Mean fluid consumption of all subgroups was similar. There was a greater change in plasma volume for the TW than for the GP group (+7.9% vs. +4.8%, respectively; p less than 0.05). However, in neither the GP nor the TP group did dehydration exceed 2% of body weight. Blood glucose concentration increased significantly in subjects ingesting GP (p less than 0.01) while it decreased on each day of march in those drinking TW. It is concluded that the fluid intake recommended at present by the IDF is adequate to maintain hydration within the normal range during physical effort in the heat. The differences between the GP and the TW groups in this study do not justify the substitution of glucose-polymer solutions for water during prolonged, moderate exercise.

Adult↗
PubMed1992

Relationships between deposition of Chernobyl originating caesium and ruthenium radionuclides and rainfall in Ireland.

Deposition data for caesium and ruthenium radionuclides in Ireland as a result of the Chernobyl accident were obtained by high-resolution gamma-ray spectrometry of soil samples taken at 111 locations throughout the country. Investigation of the relationships between deposition and recorded rainfall in relevant periods enabled an assessment to be made of the activity concentration within the plume during the wash-out phase. Detailed surveys in two regions of the country enabled a comparison to be made of the relative deposition of ruthenium and caesium isotopes. No evidence was found to suggest any difference in wash-out ratios for the two ruthenium isotopes.

Accidents↗
PubMed1992

Transfer characteristics of radiocaesium from soils to permanent pasture.

Depth profile measurements of 137Cs and 134Cs were carried out in 11 permanent pastures that had been exposed to fallout from the Chernobyl accident. In addition to gamma-ray spectrometric analysis, the selected pastures were characterized by several soil parameters, the influence of which on transfer was investigated. Sampling of soil and pasture grass was undertaken during a period extending from the Spring of 1987 to the Autumn of 1988. The results show that there has been limited downward migration of Chernobyl-derived caesium. In October 1988 more than 88% of the 137Cs attributable to Chernobyl was mainly confined to the top 10 cm of undisturbed soil, with 79% on average in the top 5 cm. The distribution of pre-Chernobyl caesium at the 11 sites was also evaluated. In an investigation of the influence of soil parameters on transfer to grass, a negative correlation with pH was observed in 1987. In April 1987 concentration ratios for 137Cs in grass ranged from 0.03 to 0.49. In general, comparison of the concentration ratio values showed a decreasing trend over the 18 months.

Accidents↗
PubMed1992

The role of federal waivers in the health policy process.

Federal waiver programs enable states to bypass the requirements of federal programs such as Medicare and Medicaid to experiment with different ways of financing, organizing, and delivering health care. In tracking waiver activity from 1980 to 1990, the authors found that federal involvement with waivers lost momentum during the latter part of the 1980s, while state involvement increased. Three key issues dominate the discussion of waivers: administrative control, the role of the states, and the ability to evaluate demonstration waivers. Examination of the chronology of waiver activity suggests the emergence of a new era, wherein federal control reemerges as a way to counter the increased fragmentation of health policies among states. If this is the case, four areas need to be addressed: (1) balance of political and research objectives; (2) administrative flexibility for states; (3) careful scrutiny of rules; and (4) increased accountability. These recommendations can guide the federal government, with the states as partners, in its attempt to regain momentum in the use of waivers to expand the knowledge base.

Health Policy↗
PubMed1992

Effects of heat-exercise stress, NBC clothing, and pyridostigmine treatment on psychomotor and subjective measures of performance.

This study investigated the effects of pyridostigmine pretreatment, NBC protective gear, and heat-exercise exposure on psychomotor performance and subjective sensations in eight healthy male volunteers. Exercise in heat enhanced performance of vertical addition (+7.3%, p less than 0.001) but prolonged the reaction time (+4.4%, p less than 0.01). The effects of pyridostigmine, protective gear, and the interactions between the various stressors were not significant. Cognitive performance was not dependent on body core temperature. Multiple complaints of subjective discomfort arose from wearing the protective garment. The results suggest the existence of a significant subjective discomfort but an absence of major cognitive decrements in a multiple-stresses state of chemical warfare alertness.

Exercise↗
PubMed1991

Voltage-dependent -L-type Ca2+ channels participate in regulating neural crest migration and differentiation.

General models of cell activation implicate Ca2+ conductance as pivotal in conveying transmembrane signals. During embryonic development, both cell migration and differentiation are influenced by changes in Ca2+; and, as a consequence, the modulation of Ca2+ is important in the control of many morphogenetic processes. Because Ca2+ conductance may be regulated at voltage-dependent Ca2+ channels (VD-CCs), we investigated whether neural crest cells develop VDCCs and, if so, whether they function in regulating migration and establishing cytomorphology. Autoradiography indicates that neural crest cells in vitro develop -L-type Ca2+ channels during migration and differentiation. Blockage of these channels by verapamil, both in vivo and in vitro, leads to a dramatic and reversible inhibition of neural crest migration. Alterations are manifest in vitro in cell-to-cell and cell-to-substratum contact and in the organization of the actin cytoskeleton. In whole embryos, verapamil or nifedipine inhibits pigment pattern formation. Moreover, blockage of the -L-type Ca2+ channels in whole embryos or cultures, after cells have already migrated and differentiated, results in a significant change in individual cell shape and in the overall pigment cell pattern, suggesting further that maintenance of the differentiated state also requires regulation at the -L-type Ca2+ channel. Since certain aspects of neural crest adhesion and cytoskeletal function are dependent on Ca2+, it is suggested that interactions that regulate the availability of Ca2+ through the VDCC may provide coordinate control of motile and adhesive interactions at the cell-substratum interface.

Actins↗
PubMed1990

Effect of pyridostigmine on the exercise-heat response of man.

The effect of pyridostigmine on thermoregulatory responses was evaluated during exercise and heat stress. Eight heat acclimated, young adult male subjects received four doses of pyridostigmine (30 mg) or identical placebo tablets every 8 h, in a double blind, randomized, cross-over trial. A 30.3%, SD 4.6% inhibition of the circulating cholinesterase (ChE) activity was induced in the pyridostigmine-treated group. The subjects were exposed to 170-min exercise and heat-stress (dry bulb temperature, 33 degrees C; relative humidity 60%) consisting of 60 min in a sitting position and two bouts of 50-min walking (1.39 m.s-1, 5% gradient) which were separated by 10-min rest periods. No differences were found between treatments in the physiological responses and heat balance parameters at the end of exposure: heart rate (fc) was 141 beats.min-1, SD 16 and 150 beats.min-1, SD 12, rectal temperature (Tre) was 38.5 degrees C, SD 0.4 degrees and 38.6 degrees C, SD 0.3 degrees, heat storage was 60 W.m-2, SD 16 and 59 W.m-2, SD 15 and sweat rate was 678 g.h-1, SD 184 and 661 g.h-1, SD 133, in the pyridostigmine and placebo treatments, respectively. The changes in Tre and fc over the heat-exercise period were parallel in both study and control groups. Pyridostigmine caused a slight slowing of fc (5 beats.min-1) which was consistent throughout the entire exposure (P less than 0.001) but was of no clinical significance. The overall change in fc was similar for both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Heat-exercise performance of pyridostigmine-treated subjects wearing chemical protective clothing.

Pyridostigmine bromide is currently the pretreatment of choice for operation in a chemical warfare (CW) environment. Under CW conditions, subjects are exposed to thermal stress caused by CW protective clothing. This investigation was conducted to determine if pyridostigmine affects various physiological and biophysical parameters of human temperature regulation in subjects wearing CW protective clothing. Pyridostigmine was administered orally in a randomized double-blind cross-over study in four doses of 30 mg every 8 h. An average of 33% whole blood cholinesterase inhibition was induced in the pyridostigmine treated group 4 h after ingestion of last tablet. The subjects were exposed to 170 min exercise-heat stress (Tdb = 33 degrees C; rh = 60%) consisting of 60 min in a sitting position and two 50-min walks (1.39 m.s-1, 5% grade) separated by 10 min of rest. Non-evaporative heat exchange was significantly higher, -14.0 and -10.6 W.m-2 (p less than 0.03), for the pyridostigmine-treated subjects. No additional differences were found between treatments in the physiological responses and heat balance parameters at the end of exposure: heart rate (HR) was (mean +/- S.D.) 154 +/- 16 and 151 +/- 24 bpm, rectal temperature (Tre) was 39.0 +/- 0.4 and 38.9 +/- 0.2 degrees C, heat storage over the 2 h of exercise was 62 +/- 15 and 70 +/- 15 W.m-2, and sweat rate was 832 +/- 185 and 748 +/- 52 g.h-1, in the pyridostigmine and placebo treatments, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Structural studies of a hornet venom allergen antigen 5, Dol m V and its sequence similarity with other proteins.

The primary structures and the disulfide-bond pairings of two chromatographic forms A and B of a venom protein from white-faced hornet (Dolichovespula maculata) were determined. This protein, designated as antigen 5 (Dol m V), has 204-205 amino acid residues and it contains 4 disulfide bonds. This protein is an allergen in man but its biologic function in hornet is not yet known. Dol m V is found to have partial sequence similarity with pathogenesis-related proteins from tobacco and tomato leaves and with a sperm-coating protein from rat epididymis.

Amino Acid Sequence↗
PubMed1989

Measurements on retention and transfer characteristics of radiocaesium from poor quality upland soils to heather and from heather to sheep.

This paper presents results from initial measurements of Cs-134, Cs-137 and K-40 activities made on poor quality upland soils and associated Calluna vulgaris vegetation. Soil-plant radiocaesium and potassium relationships were investigated. Chernobyl caesium shows a higher concentration ratio from soil to heather compared to the older weapons-test caesium. Significant radiocaesium levels have been measured (both in vivo and in vitro) in sheep grazing four sites. There was a significant correlation found between radiocaesium concentrations in sheep and activity deposited in the soil.

Accidents↗
PubMed1985

A review of Leiske style semi-flexible intraocular lenses 1981-1984.

A consecutive series of 205 patients had 237 intracapsular cataract extractions performed with the insertion of a semi-flexible intraocular lens in the period 1981-1983. The average follow-up period was 17.8 months; 87.0% of cases obtained a visual acuity of 6/12 or better after operation, compared with 80.6% of cases whose preoperative visual acuity was 6/36 or worse. Twenty-six eyes (11%) had clinical cystoid macular oedema at some stage after operation, and seven eyes (3%) had persistent cystoid macular oedema at final follow-up. Only one eye had a postoperative retinal detachment. Thirty eyes (14.1%) required treatment for elevated intraocular pressure at some time after operation.

Aged↗