Biomedical subjects
Publications and source records attributed to J Little.
Eighteen boys with Duchenne muscular dystrophy were entered into trials to assess the effects of specific ventilatory strength and endurance training programmes. The findings showed an improvement in ventilatory muscle endurance but not in strength as a result of specific respiratory muscle training. The clinical significance of these findings is uncertain, however, and needs further evaluation.
Medical students in Nottingham all complete an honours Bachelor of Medical Sciences course in one department including a research project. The honours programme in community health is described, with results from a survey of the 122 graduates since the medical school started. The 98 (80%) responses showed high levels of satisfaction and gain from the programme, the great majority regarding the course as valuable, enjoyable, and giving both research skills and skills in interpersonal relationships.
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Sleep apnea in association with neurologic disease is uncommon, and its documentation with nocturnal polysomnography (PSG) is rare. Two patients with posterior fossa neurologic disease had obstructive and central sleep apnea on PSG. The first was a 40-year-old woman who experienced a respiratory arrest ten days after neurosurgical decompression of a cervical syrinx associated with syringobulbia. Nocturnal PSG demonstrated obstructive sleep apnea. Tracheostomy was performed and a second nocturnal PSG showed no sleep apnea. The second patient was a 76-year-old woman with daytime hypersomnolence, nocturnal choking spells, progressive spastic paraparesis, and left-sided cerebellar tremor. Neurologic evaluation led to the diagnosis of olivopontocerebellar degeneration. Nocturnal PSG showed multiple episodes of central and obstructive apnea. These cases support the hypothesis that central and obstructive sleep apnea can originate from a central mechanism.
Problems of ascertainment bedevil the investigation of the etiology of congenital anomalies in singletons and in multiple births by epidemiological methods. It is shown that the definition of the population of affected births is ambiguous and that the problem of tracing etiology is complicated by the systematic way in which anomalies may be missed at birth. The available methods of dealing with problems of ascertainment are reviewed. Methods of adjusting for possible bias of ascertainment of affected births, by fitting statistical models to data from several sources, have been employed in some previous studies. In these methods, it is assumed that there are no errors of diagnosis or of recording. However, it is shown that there may be discrepancies in recorded diagnoses between sources, rendering this assumption untenable. In these methods, it is also assumed that the model which is the best fit to the data on the ascertained cases in also the best model for the cases which were not ascertained. This assumption is tested indirectly in a retrospective analysis of data from Aberdeen and Belfast collected concurrently through routine recording systems. It is demonstrated that there was a social process in ascertainment which renders the methods of adjusting for bias of ascertainment at best very complicated and at worst inapplicable.
Nuclei of lymphocytes stimulated in vitro with concanavalin A (Con A) were classified into three morphotypes: I--unstimulated; II--partially stimulated; III--fully stimulated, lymphoblastic nuclei. During the Con A-induced change from morphotype I to III nuclear volume increased up to sixfold, due to a near 10-fold increase in the interchromatinic region. At the same time, condensed chromatin rose in volume by only about 1.5-fold and became disaggregated in to small clumps. Regressive EDTA-uranyl staining demonstrated a large increase in interchromatinic fibrillar material in morphotypes II and III. Nuclear matrices isolated from stimulated murine lymphocytes showed structures comparable to the interchromatinic region of the morphotypes. The Con A-stimulated change in nuclear structure preceded onset of DNA replication and was unaffected by hydroxyurea or cytosine arabinoside. Cycloheximide blocked the structural change, even when given 20 hr after Con A. Autoradiography after [3H]leucine showed incorporation of label in the interchromatinic region of morphotype II and III nuclei, much of which remained stable during a 48-hr chase period. Nuclear structural activation was inhibited by alpha-amanitin but a significant stable nuclear RNA fraction was not detected. We conclude that an important event in lymphocyte activation is extensive synthesis of stable proteinaceous interchromatinic matrix which may be involved in chromatin remodeling and DNA replication and/or transcription.
Data with regard to the proportion of congenital malformations found at birth are presented from a survey of 657 pairs of twins of known zygosity and placentation delivered in Aberdeen and Northeast Scotland between 1968 and 1979. There was an excess of malformed individuals from monozygotic (MZ) pairs, but this did not reach statistical significance. The possible effect of monochorionic placentation in the causation of malformations in MZ twins in general is discussed. It seems that this type of placentation may be of less causative importance than has been previously suggested.
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Improving the nation's health depends on changing lifestyles that are detrimental to health. The school nurse can bring about significant changes in the lifestyles of obese children through the formation of a Health Club. Through participation in the club, children learn to make informed decisions about health. The club aides in health promotion through behavior modification techniques that offer incentives to adopt healthy lifestyles, with the goals of improved health status, quality of life and life expectancy.
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Spasticity, a common symptom of upper motor neuron lesions, may actually aid the patient and should be treated only if it interferes with function, comfort or nursing care. Stretching exercises and elimination of nociceptive stimuli are the first steps in management. If problems persist, medication should be considered. Tenotomies are useful. Motor-point blocks and peripheral nerve blocks are temporary aids, while neurectomies usually provide permanent relief. More drastic neurosurgical procedures are reserved for uncontrolled, incapacitating cases.
A current hypothesis related to non-Hodgkin's lymphoma states that the wide variety of cytologic types in this disorder reflects morphologic alterations during different stages (G1, S, and G2) of the cell cycle involved in the blastogenic transformation of normal lymphocytes. In our investigations of biochemical and structural changes during lymphocyte transformation, we have used correlated stereologic morphometric analysis, assessment of chromatin organization, and autoradiography of human peripheral T-lymphocytes labeled with 3H-thymidine and stimulated with concanavalin A. These studies have confirmed that the characteristic increase in nuclear size and disaggregation of condensed chromatin masses precedes and is independent of DNA synthesis. Since the full range of morphologic alterations observed in lymphocyte transformation can occur in the G1 phase of this process, modifications to the above hypothesis are required. Assessment of the nuclear contour index following mitogen stimulation indicates that at least in this in vivo system, there is no cleaved or convoluted phase during the transformation of human peripheral T lymphocytes.
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Infant mice, reared with both parents were subjected to 1 of 4 different early experience contingencies at 3, 6, 9, and 12 days of age. Observation of parental behaviors following return of the pups to the nest revealed that mothers attended more to pups subjected to intermediate levels of stress, with the differences in maternal behavior persisting across the age span without change. Fathers exhibited marked changes in responsiveness to young across the ages observed, with their attention to young correlating directly with rate of ultrasonic calling by the young.