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Biomedical subjects

G Wood

Publications and source records attributed to G Wood.

At least 55 records · Page 3Linked to original sources
PubMed1995

A self-rating scale for measuring neuroleptic side-effects. Validation in a group of schizophrenic patients.

BACKGROUND: A study was conducted to validate a comprehensive self-rating scale for measuring side-effects of neuroleptic drugs. METHOD: The Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS), which includes 'red herring' items, was twice administered to 50 DSM-III-R schizophrenic patients, who were also interviewed using the UKU side-effect rating scale; 50 unmedicated controls also completed the LUNSERS: RESULTS: The test-retest reliability of the LUNSERS was good (r = 0.811, P < 0.001) as was its concurrent validity against the UKU (r = 0.828, P < 0.001). Scores correlated with chlorpromazine equivalent doses (r = 0.310, P < 0.02). ROC analysis demonstrated that the scale discriminated between patients and non-medicated controls, who scored differently for real side-effects but not for 'red herring' items. CONCLUSIONS: The LUNSERS is an efficient, reliable and valid method of assessing neuroleptic side-effects.

Adult↗
PubMed1995

Weaning from mechanical ventilation: physician-directed vs a respiratory-therapist-directed protocol.

UNLABELLED: To speed weaning and free physicians for other duties, we changed from a physician-directed to a respiratory therapist (RT)-directed protocol for weaning cardiac surgery patients from mechanical ventilation. METHODS: Eligible patients were identified by physicians after which RTs initiated and directed an intermittent mandatory ventilation weaning in accordance with a written weaning protocol. Eligibility criteria for entry into the weaning protocol (Phase 1) were expanded at the end of 4 months to include more complicated and unstable patients to be weaned by the RT-directed protocol (Phase 2). Total ventilation time and the duration of weaning were recorded for all patients during both phases and during the 2-months prior to implementing RT-directed weaning (control period). All patients were physician weaned during the control period. RESULTS: No complications were associated with the introduction of RT-directed weaning. The percentage of all cardiac surgery patients weaned by the RTs increased progressively from 41 to 90% over the 7-month study period. When compared to a similar group of physician-weaned patients in the control period, the RT-weaned patients in Phase 1 and Phase 2 of the study had a significantly shorter median total ventilation time (18.6 vs 16.8 hours [p = 0.02, chi 2.95,1] for Phase 1 and 19.7 vs 17.8 hours [p = 0.04] for Phase 2). CONCLUSIONS: We have demonstrated that respiratory therapists can safely and efficiently wean cardiac surgery patients from mechanical ventilation.

Aged↗
PubMed1994

Substance P inactivating enzymes in human cerebrospinal fluid.

The Km and Vmax values were determined for enzymes in human lumbar cerebrospinal fluid (CSF) that inactivate synthetic substance P (SP = RPKPQQFFGLM-NH2) and produce metabolic products. For the human lumbar CSF samples analyzed in this study, Km = 2.24 +/- 0.93 mM and Vmax = 0.113 +/- 0.035 nmol/ml/min (n = 10; mean +/- SEM) for the rate of decrease of SP. HPLC analysis of the incubated synthetic peptide fragments demonstrated that the primary enzymatically produced fragment is SP(3-11), with minor amounts in decreasing order of SP(1-4), SP(1-7), and SP(1-9). Electrospray ionization mass spectrometry (ESI-MS) confirmed the appropriate molecular weights for the four peptides, SP(3-11), SP(1-4), SP(1-7), and SP(1-9). These data demonstrate that the primary enzyme in human lumbar CSF that acts on synthetic SP is a post-proline cleaving enzyme (PPCE).

Amino Acid Sequence↗
PubMed1993

Assay of preproenkephalin A processing enzymes in human lumbar cerebrospinal fluid.

Vmax and Km measurements have been obtained for endogenous peptidases that are important for methionine enkephalin (ME) homeostasis in humans. Those peptidases in human lumbar cerebrospinal fluid (CSF) act upon several synthetic biologically significant peptides that are also contained within the preproenkephalin Ahuman,1-267 molecule. The amount of endogenous methionine enkephalin-like immunoreactivity (ME-li) in human lumbar CSF is 74.1 +/- 5.7 fmol ME-li/ml CSF (n = 56; mean +/- SE). The kinetic parameters of the various enzymes that inactivate exogenous, synthetic methionine enkephalin (ME, YGGFM) and that also produce ME from two different portions of the preproenkephalin Ahuman,1-267 precursor molecule were determined. The enzyme that inactivates synthetic ME to FM, and that correlates to the rate of decrease of ME, has a Vmax = 560 +/- 43.3 nmol/ml/min and a Km = 4514 +/- 373 microM (n = 56; mean +/- SE). Preproenkephalin Ahuman,186-193 (PA = YGGFMRGL) was added to CSF samples to characterize those processing and converting enzymes that produce the ME pentapeptide. Vmax, as measured by the rate of the decrease of PA to produce YGGFMR, was 0.192 +/- 0.038 nmol/ml/min and a Km of 513 +/- 121 microM (n = 10; mean +/- SE). Similarly, a bovine analog to preproenkephalin Ahuman,128-140 (PPEhuman, GSEILAKRYGGFM; PPEbovine,125-137, GGEVLGKRYGGFM) was used to characterize that enzyme system that produces ME from an N-terminally extended ME peptide. That endopeptidase had a Vmax of 0.120 +/- 0.048 nmol/ml/min with a Km of 734 +/- 296 microM (n = 10). Those endogenous enzymes in human CSF may relate to the proopiomelanocortin convertase enzymes that contain the subtilisin-like catalytic domain.

Amino Acid Sequence↗
PubMed1993

Generalised granuloma annulare successfully treated with pentoxifylline.

Generalised granuloma annulare (GA) is a chronic disease of unknown aetiology and is recalcitrant to many treatment regimes. Some investigators have suggested that an immune medicated vasculitis may be involved in the pathogenesis of GA. We describe a patient with a ten year history of generalised GA, who showed dramatic clearing of the majority of papules after four weeks of treatment with pentoxifylline. This drug has shown promising results in the treatment of many dermatologic disorders including necrobiosis lipoidica diabeticorum, leukocytoclastic vasculitis and Raynaud's phenomenon. Pentoxifylline is thought to reduce blood viscosity via effects on all major blood components, and its clinical effectiveness in generalised GA lends support to a model of immune-medicated vasculitis in the pathogenesis of this disorder. Thus, pentoxifylline offers a well-tolerated and effective alternative to the treatment options available for patients with granuloma annulare.

Blood Viscosity↗
PubMed1992

Decisive action.

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Community Participation↗
PubMed1992

Analysis of proenkephalin A, proopiomelanocortin and protachykinin neuropeptides in human lumbar cerebrospinal fluid by reversed-phase high-performance liquid chromatography, radioimmunoassay and enzymolysis.

A comprehensive high-performance liquid chromatographic, radioimmunoassay, and enzymatic degradation scheme has been developed to analyze several intact neuropeptides and the corresponding peptides created by in vivo enzymolysis of precursors to study neuropeptides in human lumbar cerebrospinal fluid (CSF) and to test the hypothesis that defects in the metabolism (synthesis, degradation) of neuropeptide precursors, neuropeptides, and metabolites play a role in low back pain. CSF samples were obtained from three different patient groups: controls (C), whose low back pain was relieved without lidocaine; pharmacological responders (PR), whose pain was relieved by lidocaine and who were candidates for surgery; and pharmacological non-responders (PNR), whose pain was not relieved by lidocaine and a mid-thoracic anesthetic, and who were not candidates for surgery. The metabolic activity involved during synthesis and degradation of the peptides was assessed by measuring intact, native neuropeptide immunoreactivity in pre-incubated and post-incubated CSF samples, where samples were incubated at 37 degrees C for 1 h. Pre-incubation radioimmunoassay measurements reflected the content of intact peptides present in lumbar CSF at the time of sampling, and post-incubation measurements assayed the amount of peptide that had remained embedded within its precursors [cryptic methionine enkephalin (ME)] and that had been released by the action of CSF peptidases. Significant differences were found in post-incubation samples for the amount of proenkephalin A [ME, leucine enkephalin (LE)] and tachykinin [substance P (SP)] peptides. For example, significant differences were observed for ME-like immunoreactivity (C versus cryptic), SP-like immunoreactivity (PNR versus PR), and LE-like immunoreactivity (PR versus C). No significant differences were observed among the peptides within the pre-incubation samples.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acid Sequence↗
PubMed1991

Survival from pentamidine induced pancreatitis and diabetes mellitus.

Serious and occasionally fatal reactions to pentamidine have been reported and with the increased use of the drug in immunocompromised patients they are likely to become more frequent. We report the development of acute pancreatitis and permanent diabetes mellitus in an AIDS patient treated with intravenous pentamidine for Pneumocystis pneumonia. The literature on pentamidine induced pancreatic damage is reviewed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Spinal sensory radiculopathy due to Angiostrongylus cantonensis infection.

The most common cause of eosinophilic meningitis is the rat lung worm Angiostrongylus cantonensis, a parasite which is endemic in the South East Asian and Pacific regions. While the typical clinical presentation is that of meningitis associated with an eosinophilic pleocytosis, a 45 year old man presented with a radiculomyelopathy, associated with an eosinophilic pleocytosis and cerebrospinal fluid antibodies to A. cantonensis but without signs or symptoms of meningitis. A worm was demonstrated on both computed tomographic myelography and magnetic resonance imaging scan of the spinal cord.

Angiostrongylus↗
PubMed1991

Life threatening infections.

The importance of the rare infections discussed in this article lies in their potential for causing illness and death and the need for prompt and often specific management. Some are associated with characteristic features; others, however, are non specific in presentation. Only a high index of suspicion will ensure correct diagnosis and treatment.

Adolescent↗
PubMed1990

Opioid and tachykinin peptides, and their precursors and precursor-processing enzymes, in human cerebrospinal fluid.

Opioid and tachykinin neuropeptides, which were derived from two biological sources (intact, and released from their corresponding precursors by the action of human cerebrospinal fluid (CSF) neuropeptidases), were characterized in human CSF by using a combination of post-high-performance liquid chromatographic (HPLC) detection techniques. Peptides were separated using gradient and isocratic reversed-phase HPLC. Radioimmunoassay measured immunoreactivity corresponding to several different individual neuropeptides including methionine enkephalin, leucine enkephalin, substance P and beta-endorphin. Commercial enzymes (trypsin, carboxypeptidase B) were used to release methionine- and leucine-enkephalin from precursors. Human CSF also served as a source of endogenous neuropeptidases. Mass spectrometry produced fragment ions that corroborated the amino acid sequence of methionine enkephalin and of substance P derived from both sources (intact, from precursors). These results demonstrated the presence of endogenous intact neuropeptides, several different neuropeptide-containing precursors and appropriate precursor-processing enzymes in human CSF for precursors of methionine enkephalin, leucine enkephalin, beta-endorphin1-31 and substance P.

Amino Acid Sequence↗
PubMed1990

Ventilatory failure due to an improperly placed nasogastric tube.

A case is described of a 35-yr-old patient who was transferred to the operating room for the repair of a right ventricular laceration. Prior to transfer a nasogastric tube was placed unknowingly beyond the tracheal tube cuff into the trachea. During the surgery, the patient's head was turned to insert a central venous line at which time the ventilator low pressure alarm sounded and effective ventilation ceased. The problem was corrected by turning off the nasogastric tube suction. It is postulated that the nasogastric tube became unkinked when the head was turned and this led to the evacuation of gas from the lungs and breathing circuit through the nasogastric tube suction. Identification of the problem was complicated by the lack of a temporal relationship between the insertion and connection to suction of the nasogastric tube, and the episode of ventilatory failure.

Adult↗