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Biomedical subjects

E Harrison

Publications and source records attributed to E Harrison.

At least 37 records · Page 2Linked to original sources

Long-term increases in synaptic density in chick CNS after passive avoidance training are blocked by an inhibitor of protein synthesis.

Long-term increases in synaptic density (first recorded 24 h after training of chicks on a one-trial passive avoidance task, and still present 48 h post training), are found bilaterally in a part of the striatum, the lobus parolfactorius (LPO) [23,36], and are believed to reflect a trace of long-term memory formation. Such increases in synaptic density are most likely to occur by either de novo synthesis of new synaptic material, or via post-translational modification of pre-existing components. Several previous studies have shown that inhibitors of protein synthesis such as anisomycin injected just before, or after training, can prevent long-term memory formation in the chick. The present study therefore examined whether the long-term increases in synaptic density in the LPO that occur after passive avoidance training can be blocked by anisomycin. Our data show clearly that chicks injected with anisomycin 30 min pre-training were amnesic on testing 24 h later, and the bilateral increases in synaptic density (of spine and shaft synapses) seen in saline injected trained controls, were significantly reduced, demonstrating that protein synthesis de novo is involved in the post-training increase in synaptic density in the LPO.

Animals↗

Population trends in the fine spatial re-organization of synaptic elements in forebrain regions of chicks 0.5 and 24 hours after passive avoidance training.

Two regions in the forebrain of domestic chicks (Gallus domesticus), the intermediate and medial hyperstriatum ventrale and the lobus parolfactorius, have previously been shown to be important centres of biochemical, pharmacological and physiological change following one-trial passive avoidance training. The purpose of the present study was to examine, at the electron microscopic level, the fine spatial re-arrangement of synaptic structures in the intermediate and medial hyperstriatum ventrale (at 30 min), and in the lobus parolfactorius (at 24 h), post-training using comprehensive biometrical designs, image analysis and stochastic approaches. In intermediate and medial hyperstriatum ventrale, no significant differences in the numerical density of synapses either between control and trained chicks, or between hemispheres, were revealed using the disector method. However, after training, a nested-ANOVA demonstrated an increase in the thickness of pre- and post-synaptic electron densities (estimated via image analysis) only in the left intermediate and medial hyperstriatum ventrale, whereas synaptic apposition zone profiles increased in length bilaterally. In presynaptic terminals from the intermediate and medial hyperstriatum ventrale, stochastic analysis revealed that training resulted in the re-distribution of synaptic vesicles between two spatial pools relative to synaptic apposition zones, in both hemispheres producing a large number of synaptic vesicles closer to synaptic apposition zones; a nearest neighbour analysis of synaptic apposition zone profiles indicated that the lateral shape of the synaptic apposition zone after training is more complex in both hemispheres. In the lobus parolfactorius at 24 h post-training the main changes in synaptic fine structure involved a shift of synaptic vesicles away from synaptic apposition zones in the right hemisphere with the distance between synaptic apposition zones decreasing; in the left lobus parolfactorius, synaptic apposition zones became more regular/round in shape with a greater distance between them after training. These data suggest that the initial acquisition of memory involves population changes in the fine spatial organization of synaptic vesicles and synaptic apposition zones in synapses in the intermediate and medial hyperstriatum ventrale, which indicate a possible tendency towards greater synaptic efficacies. These changes are as dynamics as the molecular changes which have hitherto been considered the preserve of short-term correlates of memory formation.

Animals↗

Nurse caring and the new health care paradigm.

The current health care environment has ignited a renewed interest in the value of nurse caring and its potential effect on quality of care and patient satisfaction. This study compared perceptions of nurse caring behaviors of inpatient hospice nurses and the families of inpatient hospice clients. The Professional Caring Behaviors Instrument was administered to staff nurses and family representatives in the hospice of a midwestern hospital. Perceptions of nurse caring behaviors were similar for both groups. Only one item. "The caring nurse respects the patient's spiritual beliefs," was significantly more important to the nurses than the family members. Several differences in perceptions were noted in relationship to age.

Adult↗

Analysis of outcome measures used in the study of patellofemoral pain syndrome.

Validation of evaluation methods is necessary in order to appropriately monitor Patellofemoral Pain Syndrome (PFPS) patients and to determine the effectiveness of treatment and prevention programs. The goal of this study was to investigate the psychometric properties of five evaluation methods: a functional index questionnaire (FIQ), visual analogue scales (VAS) for pain, a patellofemoral function scale (PFS), a step test and a subjective report of functional limitations. Measurements for each of the six components were taken on 56 PFPS patients participating in a randomized clinical trial, prior to and at one month following treatment. Modest test-retest reliability for the FIQ, VAS and step test were found. High internal consistency for the FIQ and modest internal consistency for the PFS were demonstrated. The VAS and FIQ were found to be good discriminators for measuring clinical change, while the step test was found to be reliable but poor at detecting clinical change. The PFS, which combines a number of evaluation areas into an index, demonstrated potential to detect clinical change, however, conclusions are limited as reliability testing was not performed.

Activities of Daily Living↗

Collaborative research.

Our experience of collaborative research "the process of working with others in pursuit of scientific discovery" has been a most rewarding experience. The nurses and physicians have developed mutual respect and appreciation of the value of each other's practice, and true collaboration has emerged. The relationships between the nurses and physicians have developed over time and have been supported by our visionary Associate Director for Nursing, Kathryn McKeon. Throughout this process of collaboration, we've grown to appreciate each others strengths and recognize what each discipline has to offer. We have also learned that when we work together, it is the patient who ultimately benefits most. The neurologists' holistic approach to patient care and their respect for nursing practice have greatly contributed to the establishment of truly collaborative research.

Clinical Trials as Topic↗

Tissue-specific androgen-inhibited gene expression of a submaxillary gland protein, a rodent homolog of the human prolactin-inducible protein/GCDFP-15 gene.

The human PRL-inducible protein (PIP)/gross cystic disease fluid protein-15 is expressed in pathological conditions of the mammary gland and in several exocrine tissues, such as the lacrimal, salivary, and sweat glands. In human breast cancer cells, the expression of PIP/gross cystic disease fluid protein-15 is stimulated by androgen and PRL, and inhibited by estrogen. However, it is not known whether the expression of PIP in other tissues is under similar hormonal regulation. In the present study we employed reverse transcriptase-polymerase chain reaction followed by rapid amplification of complementary DNA (cDNA) ends to amplify the PIP cDNA homolog, the submaxillary gland protein (SMGP) in the mouse. The mouse PIP/SMGP cDNA encodes a putative secreted peptide of 144 amino acids with a 51% identity with human PIP. Using the mouse PIP/SMGP cDNA as a probe, we examined the tissue- and cell-specific expression of PIP/SMGP messenger RNA by in situ hybridization and Northern blot analysis of mouse and rat tissues. Hormonal regulation was also studied in the rat. PIP/SMGP messenger RNA expression was only detected in the lacrimal and submaxillary glands of the rodents. In the rat submaxillary gland, PIP/SMGP gene expression was confined to the acinar cells. In the male rat lacrimal gland, castration resulted in an increase in expression, and in both male and female rats, androgen replacement abolished PIP/SMGP gene expression. This pattern of regulation was not observed in the submaxillary gland and was actually reversed in human breast cancer cells. PRL had no effect on the regulation of PIP/SMGP in either salivary or lacrimal glands. Our study indicates that tissue-specific factors are important in determining the hormone responsiveness of the PIP/SMGP gene. Regulation of the PIP/SMGP gene in vivo may provide a useful model system to study the mechanism of down-regulation of expression by androgen in a tissue-specific manner.

Amino Acid Sequence↗

Spatial re-arrangement of the vesicle apparatus in forebrain synapses of chicks 30 min after passive avoidance training.

A quantitative ultrastructural study of synapses was carried out in the forebrain IMHV (intermediate and medial hyperstriatum ventrale) of 1-day-old chicks 30 min after training to avoid pecking at a bead coated with methyl anthranilate. In 10 birds (5 control and 5 trained), the length, curvature and the number of the synaptic active zone profiles were measured, and the active zone profile length was observed to increase in trained chicks. The spatial arrangement of synaptic vesicles with respect to the active zone was examined using a statistical stereological approach. This showed that vesicles are not located uniformly but accumulate in two spatial pools which appear to rearrange following training, with a greater number of vesicles near the active zone. These data may reflect subtle changes in the functional efficacy of synapses in the IMHV in the initial phases of memory formation.

Animals↗

Ventricular arrhythmias during treatment with alteplase (recombinant tissue plasminogen activator) in suspected acute myocardial infarction.

Continuous electrocardiography during the first 24 hours of a stay in a coronary care unit was used to record ventricular arrhythmias during treatment with alteplase (recombinant tissue plasminogen activator) or placebo. Recordings were made on 378 of the 436 patients admitted to a double blind trial of alteplase or placebo in one participating centre of the Anglo-Scandinavian study of early thrombosis (ASSET), patients being selected according to the availability of recorders. Of these, 309 (158 given alteplase and 151 placebo) had greater than 5 hours of analysable data. Most of the arrhythmias were recorded in patients with an in hospital diagnosis of myocardial infarction. Ventricular couplets and ventricular tachycardia were significantly more common in the patients treated with alteplase. Further, in patients with myocardial infarction who had ventricular extrasystoles, couplets, or ventricular tachycardia type a, the number of hours in which each arrhythmia was recorded was significantly higher in the alteplase group. The various ventricular arrhythmias in the alteplase group tended to cluster in the first 4-12 hours of the recordings. During the first 24 hours admission there were four episodes of ventricular fibrillation in the alteplase group and five in the placebo group of taped patients. By one month there had been 18 deaths in these 309 patients (alteplase four, placebo 14). These bore no relation to any recorded arrhythmia. Clinical records for the patients with no or minimal tape data yielded six further episodes of ventricular fibrillation during the first 24 hours (three in the alteplase group and three in the placebo group). Of the total 436 patients, 10 of the 218 patients in the alteplase group had died by one month compared with 22 of the 218 patients treated with placebo. The use of alteplase increases the incident of non-life threatening ventricular arrhythmias. These results, however suggest that arrhythmia after thrombolysis in the pre-hospital phase may be less of a problem than it is perceived to be.

Adolescent↗

Post-prandial worsening of angina: all due to changes in cardiac output?

BACKGROUND: The precise mechanism leading to the post-prandial worsening of angina has yet to be adequately defined. It has been attributed to an increase in double product but is perhaps more likely to be related to an increase in cardiac output after food. This study was designed to evaluate the effects of food on patients' exercise tolerance and compare these with changes in haemodynamic variables. METHODS: 23 patients with chronic stable angina who had post-prandial worsening of their angina were studied. The patients were evaluated on two occasions and at each visit they underwent two symptom limited treadmill exercise tests. They remained fasting on the first visit and were given a 1400 kcal meal 60 minutes before the second exercise test on the second visit. Time to onset of 1 mm ST segment depression, heart rate, systemic arterial blood pressure, and cardiac output were measured at rest and during exercise. RESULTS: There were no differences in any of the variables during the two exercise tests on the day the patients remained fasting. After the meal exercise tolerance fell significantly by 136 seconds and the stage at which 1 mm ST segment depression was first seen was also significantly reduced. Resting cardiac output increased significantly by 0.86 1/min with the patients sitting and by 0.89 1/min standing. The exercise times after food were significantly related to cardiac output even when fasting times were taken into account. Resting heart rate increased significantly by 8.3 beats per minute sitting and 10.4 beats per minute standing. There was little change in blood pressure and no evidence that the double product predicted the post-prandial exercise time. CONCLUSIONS: Worsening of angina was related to the increase in cardiac output after a meal and successful treatment will depend upon the prevention of this increase.

Aged↗

Does prolonged breastfeeding adversely affect a child's nutritional status?

In 202 children who visited a children's hospital in the city of Accra, Ghana, breastfeeding beyond the age of 19 months was found to be associated with malnutrition. The effect of weaning on food intake was then studied in 15 breastfed malnourished children in a rural community. Before weaning (complete cessation of breast-feeding) protein and energy intakes of all the malnourished children were about half those of 5 normal children. 10 of the malnourished children were weaned, and their intakes rose to the levels of the normal children; the 5 who continued breastfeeding maintained their low intakes. These results indicate that prolonged breastfeeding can reduce total food intake and thus predispose to malnutrition. They also suggest that in Ghana and other developing countries the proper weaning age may be about 18 months.

Age Factors↗

Efficacy and safety of medium- and high-dose diltiazem alone and in combination with digoxin for control of heart rate at rest and during exercise in patients with chronic atrial fibrillation.

We evaluated the efficacy and the safety of medium-(240 mn/day) and high-dose (360 mg/day) diltiazem alone and in combination with digoxin when used for control of heart rate in 12 patients with chronic atrial fibrillation. Medium-dose diltiazem was comparable to therapeutic dose of digoxin at rest (88 +/- 19 vs 86 +/- 12 beats/min) but superior during peak exercise (154 +/- 23 vs 170 +/- 20 beats/min; p less than .05). High-dose diltiazem resulted in better control of heart rate than digoxin both at rest (79 +/- 17 beats/min; p less than .05) and exercise (136 +/- 25 beats/min; p less than .05) but was associated with side effects in 75% of the patients. Combined therapy of digoxin and diltiazem enhanced the effect of digoxin alone and resulted in significantly better control of heart rate at rest (67 +/- beats/min with medium-dose and 65 +/- beats/min with high-dose diltiazem) and during peak exercise (132 +/- 32 and 121 +/- 24 beats/min, respectively). However, the difference in heart rate between these two doses was not significant. Reduction of heart rate combined with concomitant effect on blood pressure resulted in a significant fall in pressure-rate product at rest from 10,077 +/- 1708 mm Hg/min on digoxin alone to 7877 +/- 1818 mm Hg/min after the addition of medium-dose diltiazem (p less than .05) and during exercise form 25,670 +/- 3606 to 18,439 +/- 4115 mm Hg/min (p less than .05). Continued therapy with digoxin combined with diltiazem 240 mg/day for 21 +/- 8 days in nine patients showed persistent effect on heart rate and blood pressure without any toxic manifestations or change in serum digoxin (1.5 +/- 0.4 vs 1.3 +/- 0.4 ng/ml) or plasma diltiazem concentrations (204 +/- 72 vs 232 +/- 129 ng/ml). In conclusion, medium-dose diltiazem when combined with digoxin is an effective and safe regimen for the treatment of patients with chronic atrial fibrillation and enhances digoxin-mediated control of heart rate both at rest and during exercise.

Adult↗

Constant velocity dynamometer: an appraisal using mechanical loading.

Measurement characteristics of two constant velocity dynamometers (Cybex II, Lumex, Inc., NY) were evaluated at 11 selected speeds (0 to 5 rad X s-1) under various conditions of inert gravitational loading. A linear accelerometer was affixed to the lever arm. Speed settings were standardized percentages of each machine's maximum tachometer feedback voltage (0 to 100% Vfb max). Regression of Cybex transducer-observed voltages (V0) on true, i.e., expected, torques (Me) revealed that, for any static loading condition or angle, the measurement system was essentially linear and valid, although greater variance was evident for smaller torques. However, different calibrations, i.e., regression lines, were required for different speed settings. The error in predicting Me from V0 increased substantially with increased % Vfb max. Methodologies which assume constant velocity dynamic loading induce questionable, often invalid, results and inferences. Dynamic V0 represents both gravitational and inertial components. Considerable fluctuations in lever arm instantaneous velocity were ascribed to the combined influence of load and % Vfb max upon the servomotor. After computing inertia-corrected Me, calibration variability and prediction error were markedly reduced. Unexplained variability may be due to poor proximity of the Cybex transducer to the force application point. We concluded that: Cybex II should be calibrated only statically; use of an optimal filter will avoid false estimates of joint torque; inertial corrections must be applied in order to minimize potentially serious errors due to system angular acceleration; and reported muscle function relationships might be usefully re-assessed in view of these findings.

Biomechanical Phenomena↗

Simple devices for the physically disabled.

A report is given on a number of devices for the disabled that have been developed in the Biomedical Engineering Department at the Mississippi Methodist Rehabilitation Center. The primary criteria used in selection of devices to be included use simplicity, ease of fabrication and low cost.

Automobile Driving↗

Distancing for intimacy in lesbian relationships.

The authors present a collaborative treatment model designed to help the closely merged, troubled lesbian relationship. Therapeutic techniques focus on change in territorial, temporal, monetary, cognitive, emotional, and environmental space. A case example illustrates the interventions, which include individual and conjoint work, collaboration between therapists, education, bibliotherapy, referral to gay community resources, and specific suggestions for behavior change. The therapeutic goal is to restore intimacy to the relationship by offering each partner increased distance, personal space, and individual autonomy.

Adaptation, Psychological↗

Mitral valve aneurysm: clinical features, echocardiographic-pathologic correlations.

Aneurysm of the mitral valve occurs most commonly in association with infective endocarditis of the aortic valve. The probable mechanism of its formation is destruction of the aortic valve which results in a regurgitant jet that strikes the anterior leaflet of the mitral valve, creating a secondary site of infection leading to the development of an aneurysm. Perforation of these aneurysms may occur, resulting in mitral regurgitation and pulmonary edema from a ventricle already volume overloaded from aortic regurgitation. This report describes the clinical and echocardiographic-pathologic findings in five patients with pathologically proven aneurysm of the mitral valve. There are no clinical features that appear specific for this abnormality. The two-dimensional echocardiographic feature that is helpful in the diagnosis is a bulge of the mitral valve leaflet toward the left atrium that persists throughout the cardiac cycle. Preoperative diagnosis is important because a mitral valve aneurysm may produce serious complications and is frequently overlooked during surgery. Repair of the aneurysm may be feasible; otherwise, valve replacement becomes necessary. Careful two-dimensional echocardiographic examination should be done in patients with left-sided infective endocarditis to detect an aneurysm of the mitral valve.

Adult↗