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Biomedical subjects

J Green

Publications and source records attributed to J Green.

At least 433 records · Page 24Linked to original sources
PubMed1991

Cardiac growth in fetuses of diabetic mothers with good metabolic control.

To evaluate cardiac growth in fetuses of those diabetic mothers with good metabolic control, we examined M-mode echocardiographic measurements obtained from 24 fetuses of diabetic mothers (FODM) and compared these with measurements from 31 normal fetuses of similar gestational age. Fetuses were grouped into three gestational periods: 20 to 26 weeks, 27 to 33 weeks, and 34 to 40 weeks. The mothers were believed to have good metabolic control on the basis of mean daily glucose profiles and glycosylated hemoglobin A (HbA1C) values of approximately 110 mg/dl (610 mumol/L) and 7.5%, respectively, before fetal scanning, and estimated fetal weight similar to that of normal fetuses during all three gestational periods. Both FODM and normal fetuses had significant increases in M-mode measurements from period 1 to period 3, but in FODM, cardiac hypertrophy developed by late gestation (period 3). This involved the interventricular septum (6.1 +/- 0.7 vs 4.9 +/- 0.3 mm, p less than 0.05), right ventricular free wall (5.7 +/- 0.8 vs 3.2 +/- 0.3 mm, p less than 0.01), and left ventricular free wall (6.4 +/- 0.6 vs 3.3 +/- 0.4 mm p less than 0.01). The interventricular septum/right ventricular free wall ratio was similar, whereas the interventricular septum/left ventricular free wall ratio in FODM was smaller by period 3 (1.0 +/- 0.1 vs 1.6 +/- 0.1, p less than 0.05). The right ventricular diastolic dimension was similar, but the left ventricular diastolic dimension was significantly smaller in FODM during periods 2 and 3 (8.2 +/- 1.2 vs 12.2 +/- 0.7 mm, p less than 0.05). Strict metabolic control did not prevent FODM from having abnormal cardiac growth. We conclude that good metabolic control results in normal estimated fetal weight but that FODM remain at risk for mild global cardiac hypertrophy and altered diastolic dimensions.

Blood Glucose↗
PubMed1991

How do nurses working in hospital accident and emergency departments perceive local general practitioners? A study in six English hospitals.

One hundred and forty-three Accident and Emergency nurses working in six departments in contrasting districts of England completed questionnaires about their perception of local general practice. Much of general practice was perceived as being performed unsatisfactorily. Out-of-hours accessibility, caring for patients with 'difficult' or psychosocial problems, advising on health service usage, and minor surgery and first aid were all thought to be performed particularly badly. In addition, there was considerable inter-district variation with the views expressed in inner London being especially negative. To some extent these views may reflect real short-comings in general practice, but they are likely to be coloured by the disproportionate experience A&E departments inevitably have of patients who are dissatisfied in some way with their GP service. In addition, other factors such as departmental 'culture' and the separation that exists between hospital and community health professionals may have an important influence. The effect such negative perceptions have on the relationship between A&E departments and general practitioners, and the quality of care provided to patients attending A&W with primary care problems are discussed.

Attitude of Health Personnel↗
PubMed1991

Detection of human papillomavirus DNA by PCR in semen from patients with and without penile warts.

OBJECTIVES: To determine the prevalence of urethral HPV infection, as indicated by the presence of HPV DNA in semen, in males with and without penile warts. DESIGN: Prevalence study of HPV types 6/11 and 16 DNA using PCR and Southern blot hybridisation analysis of semen. SETTING: Department of Genitourinary Medicine, Blundell Street Clinic, Leeds General Infirmary and the Assisted Conception Unit (ACU) Kings' College, London. SUBJECTS: Patients attending the Genitourinary Clinic for treatment of sexually transmitted diseases including penile warts and males attending Kings' ACU for investigations of infertility. MAIN OUTCOME MEASURES: HPV DNA detected by polymerase chain reaction (PCR) and/or Southern blot hybridisation in semen. RESULTS: HPV DNA was detected by PCR in 23 of 27 (85%) specimens from patients attending the GUM clinic for treatment of genital warts and in one of two specimens from patients attending the clinic for other conditions. By Southern blot, nine (33%) of the 29 specimens from GUM clinic patients were HPV DNA-positive. HPV DNA was detected by PCR in 43 of 104 (41%) of specimens from males attending the ACU, whilst 70 of these tested by Southern blot hybridisation were all negative for HPV DNA. CONCLUSIONS: The data suggest that urethral HPV infections, as indicated by the presence of HPV DNA in semen, are prevalent in males with and without genital warts.

Blotting, Southern↗
PubMed1991

Accident proneness.

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Accident Proneness↗
PubMed1991

Acute phosphate depletion dissociates hormonal stimulated second messengers in osteoblast-like cells.

The acute effect (24 h) of either phosphate depletion or phosphate surfeit on hormonal stimulated signal transduction systems was studied in the osteoblastic cell line UMR-106. Elevation of intracellular Ca2+ ([Ca2+]in), induced by different calciotropic hormones (PTH, prostaglandin E2, endothelin) was blunted by acute phosphate depletion, whereas at high inorganic phosphate (Pi) concentrations the rise in [Ca2+]in was augmented. Basal [Ca2+]in was not altered by either Pi depletion or Pi excess. The effect of acute phosphate depletion on hormonal mediated [Ca2+]in rise was not observed in the absence of extracellular Ca2+ suggesting that under these conditions, the release of Ca2+ from intracellular stores, is not affected. Also, nonhormonal calcium entry pathways such as depolarization-activated calcium channels or protein kinase C-activated Ca2+ channels were not affected by acute phosphate depletion. cAMP accumulation in the cells, either through receptor or nonreceptor-mediated mechanisms, increased under low Pi conditions and decreased as Pi concentration in the culture media was progressively increased from 0 to 2 mM during 24 h of incubation. Changes in Pi concentration had no effect on basal cAMP generation by the cells. The facilitative effect of acute Pi depletion on agonist-induced cAMP accumulation could be demonstrated in both the presence and absence of the phosphodiesterase inhibitor 3-isobutyl-1-methylxanthine (0.2 mM). PTH receptor binding assessed with [Nle8 Nle18 Tyr34] bovine PTH (1-34) NH2 was not altered by phosphate depletion. We conclude that exposure of osteoblasts to different Pi environments modulates the second messenger responses to hormones in a reciprocal fashion so that acute phosphate depletion down-regulates [Ca2+]in signals while augmenting cAMP generation and vice versa. Inasmuch as bone resorption processes can be modulated by Ca2+ and cAMP the data presented herein suggest that the altered bone resorptive response to calciotropic hormones (e.g. PTH), under surfeit or deficit of phosphate, is mediated by changes in [Ca2+]in and cAMP.

1-Methyl-3-isobutylxanthine↗
PubMed1991

Hormonal and biochemical patterns in subjects from a new endemic goiter area in the Central African Republic.

Hormonal serum patterns of 268 subjects, living in rural villages and in the chief town of the Ouham province (Bocaranga), were studied to accomplish a survey in this endemic goiter area of the Central African Republic (CAR). Circulating TSH, TT3, TT4, FT4, rT3 and TG were determined in an accurately randomized population sample. Urinary excretion of iodine and thiocyanate (SCN) was also measured. The comparison of the mean values of such parameters with control values showed statistically significant differences (P < or = 0.05 divided by 0.001) in all the parameters studied, excepting TT3. The urinary iodine excretion was lower than 35 micrograms/l in the chief town and of 25 micrograms/l in the rural villages. The thiocyanate excretion was constantly greater than 8 mg/l; the I/SCN ratio = 3.7 was clearly lower than in controls. In a sample of 41 subjects, whose hormonal patterns were in the physiological range, significant differences were found between their TT3, TT4, FT4, TSH and TG serum concentrations and the respective control values. The severe iodine deficiency and the high consumption of manioc as a staple food are the prominent etiopathogenic factors of the hyper endemic goiter in this region. The authors believe that extensive iodoprophylactic action is urgently needed.

Adolescent↗
PubMed1990

In vivo and in vitro mutants of FNR the anaerobic transcriptional regulator of E. coli.

FNR regulates the expression of target genes in response to anaerobiosis. It resembles the catabolite gene activator or cAMP-receptor protein (CRP) except for the presence of an N-terminal cysteine cluster, which may form a redox-sensing iron-binding site. Site-directed mutagenesis has shown that 3 of the 4 cysteine residues in the N-terminal cluster (Cys-20, -23 and -29, but not Cys-16) and the only other cysteine residue (Cys-122), are essential for the normal activation and repression of FNR-dependent promoters. Deletion of residues Pro-3-Arg-9 (inclusive) had no effect, but FNR was inactivated by a frameshift extending through the C-terminal DNA-binding domain. Four independent in vivo mutants contained identical Gly-96----Asp substitutions, which may inactivate FNR by distorting a sharp turn between beta-strands in the predicted structure.

Amino Acid Sequence↗
PubMed1990

The 'Medicaidization' of AIDS. Trends in the financing of HIV-related medical care.

Among patients with the acquired immunodeficiency syndrome (AIDS) who were hospitalized in New York City, San Francisco, Calif, and Los Angeles, Calif, from 1983 through 1988, we observed a marked shift in the payer distribution toward Medicaid and away from private insurance. This trend, which we refer to as the "Medicaidization" of AIDS, occurred among whites as well as blacks and Hispanics and increased the burden on public hospitals and emergency rooms. "Medicaidization" jeopardizes access to office-based primary care because of very low reimbursement rates that are paid to physicians by Medicaid relative to private insurance. Policies designed to prevent the loss of employment-based private insurance would slow or reverse the trend to public financing. Increasing Medicaid reimbursement will improve access to care.

Acquired Immunodeficiency Syndrome↗
PubMed1990

The importance of severity of illness in assessing hospital mortality.

Each year, the Health Care Financing Administration (HCFA) releases a report comparing hospital mortality rates with predicted rates. Some argue that the HCFA's prediction model does not adequately account for patient severity. We tested this hypothesis by comparing the HCFA's model (replicated as closely as we could) to a second that added a severity measure (the Stage of Principal Diagnosis at Admission, a subscale of the Severity of Illness Index). In our simulation, the HCFA's model had very limited capacity to predict mortality (average R2, 2.5%). Patients grouped according to admission severity had markedly different mortality rates, which the HCFA's model's predictions could not differentiate. The HCFA model also failed to predict large differences in mortality between hospitals with low- and high-severity admissions. Adding severity to the HCFA's model yielded more than an eightfold increase in the R2, to 21.5%, and reduced instances of higher than expected hospital mortality to chance levels. These findings suggest that the HCFA's mortality release needs to be made much more sensitive to admission severity before it can be used to make valid inferences about the quality or effectiveness of hospital care.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1990

Developmental expression, synthesis, and secretion of insecticyanin by the epidermis of the tobacco hornworm, Manduca sexta.

Insecticyanin was found to be synthesized in several isoelectric forms and stored in the pigment granules in the epidermis. Both major epidermal forms (INS-a, pl 5.5; INS-b, pl 5.7) were found in the cuticle, but only the most basic form, INS-b, was present in the hemolymph. In vitro the epidermis synthesized and secreted both forms into both the cuticle and the medium. Isolation of two cDNA clones for insecticyanin followed by hybridization to epidermal mRNA showed the presence of only one 1.1 kb mRNA, but transcription of the longer cDNA yielded a RNA which produced INS-a but no INS-b. Insecticyanin mRNA was present during the intermolt feeding stages of the 4th and 5th instars and absent during the larval molt and after the onset of metamorphosis. Exposure of either day 2 4th-instar or day 1 5th-instar larval epidermis to 20-hydroxyecdysone (20HE) in vitro caused a dose-dependent decline in this mRNA that was not prevented by simultaneous exposure to JH. When synthesis resumes just before ecdysis, INS-b appears before INS-a; then on the final day of feeding, synthesis of INS-a ceases before that of INS-b. Culture experiments showed that exposure of day 15th epidermis to a small pulse of 20HE followed by an ecdysteroid-free period was best to mimic the in vivo situation, indicating that the small rise of ecdysteroid in the absence of JH on day-2 was responsible for this differential cessation.

Animals↗
PubMed1990

Improved computation of respiratory resistance as measured by transiently increased resistance.

The authors have previously described an automated system for measuring total respiratory resistance. The technique used by this system involves a transient, externally applied increase in resistance to breathing. The utility of this technique is limited by a number of assumptions and to free it from the constraints imposed by one of these assumptions a new method for analysing the data was developed. The paper describes the new method of analysis and presents data comparing the resulting Rrss with those computed using the old method.

Humans↗
PubMed1990

Transvaginal ultrasonographic detection of congenital anomalies in the first trimester.

Transvaginal ultrasonography enables detailed visualization of the first-trimester pregnancy. Thirty-three structural anomalies have been diagnosed in the first trimester of pregnancy during a 2-year study period. An understanding of normal embryonic development is essential before attempting diagnosis in this gestational period.

Congenital Abnormalities↗
PubMed1990

Spinal antinociceptive synergy between clonidine and morphine, U69593, and DPDPE: isobolographic analysis.

The spinal antinociceptive interaction between the opiate receptor subtype agonists morphine (mu), U69593 (kappa) and [D-Pen2,5]-enkephalin (DPDPE; delta) with clonidine (alpha 2 adrenergic) was examined. Male SD rats received fixed ratios of clonidine to morphine (10:1), U69593 (1:3), or DPDPE (10:1) through catheters terminating at the lumbar cord. Graded dose-response curves (DRC) were constructed from tail-flick latencies converted to % maximal possible effect (%MPE), and the ED50 calculated. The DRCs of morphine and U69593 but not of DPDPE were parallel to the DRC of the opiate plus clonidine. Synergy was determined by isobolographic analysis. The ED50 values for the mixtures were significantly less than the theoretical additive ED50 values, indicating synergy between clonidine and morphine, U69593, or DPDPE.

Analgesics↗