Search PubMed⌕ Search

Biomedical subjects

D P Morris

Publications and source records attributed to D P Morris.

26 records · Page 2Linked to original sources
PubMed1995

Practical aspects of acoustic rhinometry: problems and solutions.

Acoustic rhinometry now has an established place in the rhinology laboratory as a measure of nasal geometry. We aimed to investigate several aspects of technique in order to offer some guidance on preferred procedures. We studied the effects of nosepiece seal quality, nosepiece aperture diameter, angle of inclination of the wave tube (in two planes), palate position and inter-observer variation on the nasal area-distance function. One hundred nasal cavities in adults and children were examined: 50 normal and 50 pathological. Each factor was examined intensively in 20 cavities, and reproducibility data obtained on all 100 cavities. The baseline mean coefficient of variation for nasal cavity volume (V1) was 6% and for minimum cross-sectional area (MCA) was 8%. Altering the angle of incidence of the wave tube in the axial and coronal planes caused considerable change in the traces from the anterior nasal cavity, including the I- and C-notches, and affected the MCA significantly (p < 0.01, Wilcoxon signed rank test). Using a small nosepiece aperture accentuated the I-notch, and the nosepiece in some cases became the site of the minimal area. Addition of a silicone-based sealant to the standard nosepiece caused a mean reduction of 14.3% in nasal volume, if the seal quality was suspected to be suboptimal. Nasopharyngeal volume decreased by a mean of 28.6% when the palate is raised by the modified Valsalva manoeuvre, and no difference was found between quiet oral respiration and cessation of nasal respiration. Acoustic rhinometry is sensitive to minor changes in the details of technique. We recommend using an intermediate range of angles in both planes, the addition of a sealant where the nosepiece seal is suspect, use of newer improved nosepieces and synchronizing readings with either cessation of nasal respiration or with quiet oral respiration. There is a pressing need for international agreement on such details if collaboration and clinical application of acoustic rhinometry is to flourish.

Acoustics↗
PubMed1994

Experimental studies of the resolution of acoustic rhinometry in vivo.

The ability of acoustic rhinometry to detect objects of defined size in nasal cavities has hitherto been investigated only in cadavers and models. We aimed to determine the resolution of the technique in the nose of living subjects. Silicone spheres of 3.0, 5.0, and 7.0 mm diameter were placed at two sites in the decongested and locally anaesthetised nasal cavities of 3 healthy adults. Acoustic rhinometry area-distance functions were obtained before and after insertion of the spheres, with further control data obtained after removal of the sphere from the nasal cavity. Six nasal cavities were studied in each test state on two separate occasions. The 3.0 mm sphere caused a statistically significant change in cavity volumes in only 17% of cases when placed in the middle meatus and in 8% at the nasal value (Mann-Whitney U-test; p < 0.05). The detection rates for the 5.0 mm sphere were 50% in the middle meatus and 50% at the nasal valve. When the control and test curves were compared by superimposition and the cross-sectional areas at the site of perturbations compared statistically (Mann-Whitney U-test) the detection rates in the middle meatus were: 33%-3.0 mm and 67%-5.0 mm sphere. The detection rate at the nasal valve region was 25%-3.0 mm sphere and 58%-5.0 mm. The 7.0 mm sphere was detected in 100% cases by volume changes, and 80% by area changes. Acoustic rhinometry can reliably detect changes of volume and area in the living nose resulting from the introduction of a 7 mm sphere into the nasal valve or middle meatal region in most cases. Smaller spheres are detected in only a fraction of cases. The resolution of the technique is therefore close to 7.0 mm (1.44 cm3). These findings are important when interpreting acoustic rhinometry data in monitoring patients with nasal pathology.

Acoustics↗
PubMed1994

Reduction in junior doctors' hours in an otolaryngology unit: effects on the 'out of hours' working patterns of all grades.

This study aimed to assess the effects of recent controls on juniors' duty hours (the 'New Deal') on the work performed by all grades of ENT medical staff 'out of hours'. For 100 days in 1993 the out of hours duties of all grades of doctor in the Otolaryngology Unit were monitored using daily logs. Three patterns of cover were run in parallel and subjected to comparison: Light: Senior House Officer (SHO)--Consultant (CON); Traditional: SHO-Intermediate (Registrar or Senior Registrar)--Consultant; Cross-cover--Pre-Registration House Officer (PRHO)--Intermediate-Consultant. The SHO 'out of hours' daily workload did not differ significantly between the traditional and light systems (median hours: 5.6 versus 5.0). There was an increase in working hours for the intermediate (registrar or senior registrar) grade of 84 per cent when the cross-cover system was in operation compared with the traditional system (median hours: 5.0 versus 2.8; p < 0.0001--Mann-Whitney U test). Consultant working hours increased by an average of 132 per cent as a result of removal of the intermediate tier (median hours: 1.7 versus 0.80; p < 0.0001). Reduction in on-call hours of junior staff resulted in a need for cross-cover and also in the frequent removal of an intermediate tier of staff. This has been shown to have a considerable effect on working patterns for intermediate and senior grades in an ENT unit of average size. Further reductions would be expected to have major effects on the working patterns of the consultant grade and considerably dilute the emergency experience of trainees.

Consultants↗
PubMed1993

Characterization of the purified vitamin K-dependent gamma-glutamyl carboxylase.

Vitamin K-dependent carboxylase, purified from bovine liver, has properties similar to those reported for the carboxylase activity present in crude, solubilized microsomes. The purified carboxylase was found to possess the vitamin K epoxidase activity, believed to be essential for vitamin K-dependent carboxylation, but did not contain vitamin K epoxide reductase activity. Kinetic studies of the carboxylase done under defined conditions were complicated by the non-Michaelis-Menten kinetic behavior observed for reactions with two of the enzymes substrates, FLEEL and vitamin K1 hydroquinone. Initial rate experiments with the substrate FLEEL demonstrated behavior consistent with substrate inhibition and gave half-maximal activity at 1 mM FLEEL. Experiments with the substrate vitamin K1 hydroquinone also displayed non-Michaelis-Menten kinetics, as maximal activity was reached prematurely in relation to behavior at lower concentrations. Half-maximal activity was observed at 35 microM vitamin K1 hydroquinone. Initial rate experiments with varying NaH14CO3 concentration displayed Michaelis-Menten kinetics and gave a Km(app) of 0.29 mM. At cosubstrate concentrations chosen to obtain near-maximal activity, initial rate studies with varying NaH14CO3 concentration indicated a kcat near 1.0 s-1. Removal of the fourth substrate, oxygen, resulted in the loss of more than 99% of carboxylase activity. The sulfhydryl reagent N-ethylmaleimide inhibited carboxylase irreversibly, as did the anticoagulant warfarin.

Amino Acid Sequence↗
PubMed1991

Identification and purification to near homogeneity of the vitamin K-dependent carboxylase.

Vitamin K-dependent carboxylase catalyzes the modification of specific glutamic acids to gamma-carboxyglutamic acid in several blood-coagulation proteins. This modification is required for the blood-clotting activity of these proteins and has thus been the subject of intense investigation. We have now identified the bovine vitamin K-dependent carboxylase and purified it to near homogeneity by an affinity procedure that uses the 59-amino acid peptide FIXQ/S (residues -18 to 41 of factor IX with mutations Arg----Gln at residue -4 and Arg----Ser at residue -1). The carboxylase as purified has a molecular weight of 94,000. It is also the major protein that can be cross-linked to iodinated FIXQ/S and is the only protein whose cross-linking is prevented by a synthetic factor IX propeptide. The degree of purification is about 7000-fold with reference to ammonium sulfate-fractionated microsomal protein from liver.

Amino Acid Sequence↗
PubMed1987

[3H]forskolin. Direct photoaffinity labeling of the erythrocyte D-glucose transporter.

Irradiation of erythrocyte ghosts in the presence of [3H]forskolin resulted in a concentration-dependent, covalent incorporation of radiolabel into several of the major membrane protein bands. Most of the incorporation occurred in four regions of the gel. Peak 1 (216 kDa) was a sharp peak near the top of the gel in the region corresponding to spectrin. Peak 2 appeared to be associated with band 3 (89 kDa), while a third peak occurred around the position of band 4.2 (76 kDa). The fourth region of labeling was a broad area between 43-75 kDa which corresponds to the region of the glucose transporter. Forskolin labeling of this region was inhibited by cytochalasin B and D-glucose, but not L-glucose. Extraction of extrinsic membrane proteins resulted in a loss of radiolabeled protein from the 216- and 76-kDa regions. Treatment of membranes labeled with either cytochalasin B or forskolin with endo-beta-galactosidase resulted in identical shifts of the 43 to 75-kDa peaks to 42 kDa. Similarly, trypsinization of membranes photolabeled with either cytochalasin B or forskolin resulted in the generation of a 17-kDa radiolabeled fragment in both cases. Photoincorporation of [3H]cytochalasin B into the glucose transporter was blocked in a concentration-dependent manner by unlabeled forskolin.

Affinity Labels↗