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Biomedical subjects

D Morris

Publications and source records attributed to D Morris.

At least 109 records · Page 6Linked to original sources
PubMed1995

The etiology of hyperandrogenism in women.

This review considers recent evidence which has implicated steroidogenic alterations as elements on the etiology of the androgen excess associated with polycystic ovary syndrome. The importance of circulating dehydroepiandrosterone sulphate as a precursor for ovarian follicular testosterone is discussed and evaluated in the face of indications that the activity of P450-c17-alpha-hydroxylase is altered at both adrenal and ovarian level in polycystic ovary syndrome. The impact of weight and insulin resistance on circulating dehydroepiandrosterone concentrations is discussed, and related to the endocrine changes in polycystic ovary syndrome. Androgen excess in women arises from multiple endocrine disturbances, which evidently commonly include the steroidogenic pathways.

Androgens↗
PubMed1995

Customer complaints in the National Health Service.

This paper addresses the role of consumer complaints in the flourishing quality assurance industry within the National Health Service (NHS), and considers the traditional ethos of complaints within the service. The advent of the internal market is considered as one of a range of factors which may change attitudes of NHS staff to complaints. In evaluating how complaints services might develop relevant literature is reviewed and recent national data on complaints procedures are cited.

Attitude of Health Personnel↗
PubMed1995

Digital image databasing.

A previous two-part article by Simon Brown described the acquisition, editing, compression and initial storage of digital images taken in the clinical studio. Due to the higher-than-expected demand for this clinical service, additional factors had to be considered when dealing with large numbers of images. These included storage on writable compact disc (CD) drives and a system for retrieving images from these devices which was flexible enough to handle the requirements of different specialities and be usable by all medical illustration staff.

CD-ROM↗
PubMed1995

Using oligonucleotide probe arrays to access genetic diversity.

As the Human Genome Project and related efforts identify and determine the DNA sequences of human genes, it is important that highly reliable and efficient mechanisms are found to access individual genetic variation. It is only through a greater understanding of genetic diversity that the true benefit of the Human Genome Project will be realized. One approach, hybridization to high-density arrays of oligonucleotides, is a fast and effective means of accessing this genetic variation. Light-directed chemical synthesis has been used to generate miniaturized, high-density arrays of oligonucleotide probes. Application-specific oligonucleotide probe array designs have been developed for the rapid screening of characterized genes. Dedicated instrumentation and software have been developed for array hybridization, fluorescence detection and data acquisition and analysis. In a specific and challenging application, oligonucleotide probe arrays have been used to screen the reverse transcriptase and protease genes of the highly polymorphic HIV-1 genome to explore genetic diversity and detect mutations conferring resistance to antiviral drugs. Results from this application strongly suggest that oligonucleotide probe arrays will be a powerful tool for rapid investigations in sequence checking, pathogen detection, expression monitoring and DNA molecular recognition.

Base Sequence↗
PubMed1994

Causes of higher in-hospital mortality in women than in men after acute myocardial infarction.

Clinical, laboratory and cardiac catheterization parameters were reviewed in 355 men and 155 women hospitalized at a tertiary care referral center between February 1987 and December 1991 to analyze why women have a higher in-hospital mortality rate than do men after acute myocardial infarction. Hospital mortality was 21.4% in women and 12.1% in men (p = 0.007). In comparison with men, women were older (63.3 +/- 11.9 vs 60.5 +/- 12.6 years; p = 0.023), had more systemic hypertension (46.5 vs 34.4%; p = 0.001) and higher serum total cholesterol levels (211 +/- 51 vs 197 +/- 49 mg/dl; p = 0.0015), sought medical care later (8.9 vs 5.3 hours; p = 0.026), were referred later (47.7 vs 43.7 hours; p = 0.063) and had more shock (34.8 vs 24.2%; p = 0.013). Logistic regression analysis revealed 5 variables predictive of hospital mortality; age > 65 years, diabetes, shock, non-Q-wave infarction, and not undergoing cardiac catheterization. Gender was of borderline significance in predicting hospital mortality. Cardiac catheterization, performed in 88% of women and 87% of men, showed similar rates of 1-, 2- and 3-vessel disease, and similar characteristics of the infarction-related artery. The differences in hospital mortality between men and women are due to a combination of pre- and in-hospitalization factors in women. The excess mortality is not due to differences in disease severity as evaluated by cardiac catheterization information.

Age Factors↗
PubMed1994

ED length-of-stay and illness severity in dizzy and chest-pain patients.

Emergency department (ED) length of stay, illness severity, and patterns of ED-based testing can be used to compare different ED patient populations. To assess the relative significance of ED patients with dizziness and chest pain in emergency medicine practice, the investigators formed a retrospective chart review of 3,864 adults (age > or = 16 years) seen at the University of North Carolina Hospitals' ED during May and June of 1991. Patients were eligible if they had any complaint of dizziness (n = 259), nontraumatic chest pain (n = 168), or both (n = 18). ED length of stay and illness severity, as measured by Acute Physiology and Chronic Health Evaluation (APACHE) II score, were not significantly different between the two groups. Dizzy and chest-pain patients were both high users of ED-based testing, but management patterns were different. Chest-pain patients were more likely to undergo electrocardiogram and x-ray testing, whereas dizzy patients more often received testing such as brain computed tomography scanning (10.8% v 3.6%, P = .01). ED patients with dizziness and chest pain were similar with regard to ED length of stay. Given their overall similarities to the chest-pain group, dizzy patients appear to represent a significant population of ED patients and may warrant more clinical study.

Adult↗
PubMed1994

A prospective study of proneness to acute respiratory illness in the first two years of life.

BACKGROUND: This study sought explanations for the proneness to respiratory events in young Australian children. METHODS: Prospective respiratory symptom diaries on 836 children collected data on respiratory symptoms and episodes. Questionnaires to mothers and birth and pregnancy records provided 56 known and possible predictors which were tested against two summary respiratory outcomes in each of the first and second years of life. RESULTS: The two summary respiratory variables recorded for first and second year of life give four outcome variables. In fitting multivariate regression models to predict outcomes, use of child care in early childhood and mothers' experience of respiratory illness in the 12 months before birth were significant predictors for all four outcomes. Number of siblings was a predictor for three of the four outcomes. Sleep difficulty during pregnancy in the mother, and respiratory hospitalization of the infant in the first year, were significant predictors for both first-year outcomes. Unexpected and unexplained findings emerged for alcohol intake during pregnancy, passive smoking and breastfeeding in relation to the second year respiratory outcomes. Less than 9% of variance in outcome scores was explained in any of the four multiple regression models but this rose to between 24% and 31% when a corresponding score from the other year was added to the model. CONCLUSIONS: Proneness to respiratory illness is an important entity; its determinants are largely unknown and events in pregnancy or the perinatal period explain only a small proportion of the between-infant variability.

Acute Disease↗
PubMed1993

Expression of biologically active recombinant keratinocyte growth factor. Structure/function analysis of amino-terminal truncation mutants.

Keratinocyte growth factor (KGF) is a newly identified member of the fibroblast growth factor (FGF) family (FGF-7). KGF is expressed by stromal fibroblasts and acts on epithelial cells in a paracrine mode. To facilitate structure/function studies, we utilized the T7 prokaryotic expression system to synthesize this growth factor. Recombinant KGF (rKGF) was mitogenic with a specific activity around 10-fold higher than native KGF. By in vitro mutagenesis, we generated a series of KGF mutants with sequential deletions of the amino-terminal domain, the most divergent region among different FGF members. Mutant proteins, produced in bacteria, were tested for their ability to bind heparin, bind and activate the KGF receptor, and induce DNA synthesis. Heparin binding properties were preserved with deletion of up to 28 amino-terminal residues of the mature KGF but lost by the deletion of an additional 10 residues. Biological activity of mutants with deletions of up to 10 residues was comparable to that of rKGF. However, deletion of 29 residues resulted in significantly reduced ability to stimulate KGF receptor tyrosine-kinase activity and DNA synthesis, although this mutant bound the receptor at high affinity. These characteristics of a partial agonist may be useful in the development of competitive antagonists of KGF action.

Amino Acid Sequence↗
PubMed1993

Increased viral titer through concentration of viral harvests from retroviral packaging lines.

Dependent on the viral vector and the specific assay used, viral titers produced from commonly used retroviral packaging cell lines have an upper limit in the range of 10(5) to 10(7) infectious units/ml. We have developed a generally applicable method, using hollow-fiber filtration technology, which allows for the concentration of infectious virus derived from packaging lines. This method resulted in a reproducible 10- to 30-fold increase in viral titer and can readily be scaled to accommodate larger input volumes. Over 80% of the input virus is recovered in an infectious form in the concentrate. Concentrated virus containing media was seen to produce higher infection frequencies in Jurkat T cells as compared to unconcentrated virus containing media; however, this was not proportional to the differences in viral titer observed by limiting dilution analysis on NIH-3T3 cells. These results are discussed in relation to the importance of factors other than viral titer in determining transduction frequencies.

3T3 Cells↗
PubMed1993

Effects of synthetic growth hormone-releasing factor in women treated with gonadotrophin.

To evaluate the effects of synthetic growth hormone-releasing factor (GRF) in women with idiopathic infertility who were treated with human menopausal gonadotrophin (HMG), 13 women with this condition were randomly assigned to undergo treatment with HMG-GRF (500 micrograms twice daily) or HMG-placebo. Conception occurred in four of six women (14 cycles) who received HMG-GRF and in one of seven women (22 cycles) who received HMG-placebo. No difference was found in the amount of HMG and the duration of HMG required to induce ovulation between the two groups of patients. The overall serum growth hormone and insulin-like growth factor I concentrations were higher in the GRF than in the placebo group. No difference was found in serum oestradiol or inhibin concentrations between the two groups. Our results suggest that in women with idiopathic infertility, administration of GRF does not decrease the duration or the amount of HMG required to induce ovulation. However, it appears that in this small group concomitant treatment with GRF increases the pregnancy rates in women who are treated with HMG (4/14 cycles compared with 1/22 cycles).

Adult↗
PubMed1993

MacFee incision: a safe approach to the neck.

We reviewed 37 neck dissections done via the MacFee or double horizontal cervical incision to excise neoplasms located in the oral cavity and oropharynx, with draining cervical lymph nodes. One half of the patients had immediate reconstruction with myocutaneous flaps. Approximately 70% of the patients had advanced tumors and many were malnourished at presentation. Three wound complications involving the MacFee incision occurred in patients who were malnourished and required reconstruction. These wound complications were corrected with conservative therapy. Preoperative radiotherapy was a morbid cofactor. None of the patients had carotid artery involvement, wound dehiscence, or deep cervical infections. The MacFee incision can be used in major head and neck resections, with operative morbidity comparable to that of other techniques.

Female↗
PubMed1993

The MMSE to assess the cognitive state of elders. Mini-Mental State Examination.

In both nursing practice and research settings, valid and accurate information on the cognitive function of elderly persons is necessary. However, methods and criteria for evaluating an elder's mental status are inconsistent. A formal screening tool such as the Mini Mental State Examination (MMSE) would enable nurse clinicians and researchers to use a common method for identifying cognitive impairment. In addition, the MMSE score can readily describe levels of impairment across settings. Although certain limitations exist when using this instrument, the MMSE has been successfully employed by some nurses in selected clinical and research settings as a brief but accurate screen of cognition in older persons.

Aged↗