Search PubMed⌕ Search

Biomedical subjects

J M Hall

Publications and source records attributed to J M Hall.

At least 19 recordsLinked to original sources

An investigation into the reduction in flow rate of intravenous fluid by antireflux valves.

We have investigated the extent to which antireflux (non-return) valves impede the maximum flow rate of crystalloid in intravenous infusion systems when administered either under gravity or with 300 mmHg added pressure. When used with a 16G cannula, a reduction in flow rate of 19-38% was consistently seen. With a 20G cannula, no significant reduction in flow was found. The valve tested that produced the least reduction in flow was the Westcott Sae-flo valve.

Catheterization, Peripheral↗

Prospects for efficient detectors for fast neutron imaging.

A physical model describing in detail the process of fast neutron imaging in luminescent screens is presented. The detection quantum efficiency, luminosity and inherent spatial resolution of the screen were calculated using this model. Properties of transparent and disperse screens were compared. Two imaging systems were suggested to improve the detection efficiency and spatial resolution. A stack consisting of alternating neutron converters and image plates can help in obtaining both high spatial resolution and efficiency. A system containing a screen of special form and a diaphragm can be of use especially in the case of the fan beam.

Journal Article↗

Characterization of adenosine receptors mediating the vasodilator effects of adenosine receptor agonists in the microvasculature of the hamster cheek pouch in vivo.

1 The aim of this study was to characterize the adenosine receptor mediating vasodilation in the microvasculature of the hamster cheek pouch in vivo. A range of adenosine agonists was used including N6-cyclopentyladenosine (CPA) (A1 agonist), 5'-N-ethylcarboxamidoadenosine (NECA) (non-selective), 2-chloroadenosine (2CADO) (non-selective), 2-p-(2-carboxyethyl)-phenethylamino-5'-N-ethylcarboxamidoadenosine (CGS 21680) (A2A agonist), N6-(3-iodobenzyl)-adenosine-5'-N-methyluronamide (IBMECA) (A3 agonist) and adenosine, as well as the adenosine antagonists 8-sulphophenyltheophylline (8-SPT) (A1/A2 antagonist), 1,3-dipropyl-8-cyclopentylxanthine (DPCPX) (A1 antagonist) and 4-(2-[7-amino-2-(2-furyl)[1,2,4]-triazolo[2,3-a][1,3,5]triazin-5-ylamino]ethyl)phenol (ZM 241385) (A2A antagonist). 2 All the adenosine analogues used induced vasodilation at concentrations between 10 nm and 1 microm, and the potency order was NECA > CGS 21680 > 2CADO > CPA=IBMECA >> adenosine, indicating an action at A2A receptors. 8-SPT (50 microm) antagonized vasodilator responses to NECA with an apparent pKB of 5.4, consistent with an action at A1 or A2 receptors and confirming that A3 receptors are not involved in this response. 3 DPCPX (10 nm) had no effect on vasodilation evoked by NECA, suggesting that this response was not mediated via A1 receptors, while ZM 241385 (10 nm) antagonized dilator responses to NECA with an apparent pKB of 8.9 consistent with an action via A2A receptors. 4 Overall these results suggest that adenosine A2A receptors mediate vasodilation in the hamster cheek pouch in vivo.

Animals↗

Effects of age and alcoholism on sleep: a controlled study.

OBJECTIVE: Sleep problems are common, costly and potentially fatal in older adults. Sleep problems are also commonly associated with alcoholism. Yet few studies have examined the combined effects of alcoholism and aging on sleep. The purpose of this study was to investigate the main and interactive effects on sleep of diagnostic group and age group. METHOD: Alcohol dependent patients (n = 139; 118 men) and nonalcoholic controls (n = 87; 57 men) completed full-montage polysomnography, structured psychiatric diagnostic interviews, validated rating scales and alcohol histories at the University of Michigan between 1989 and 1996. The sample was divided for analytic purposes into older (aged 55+ years) and younger (aged <55 years) subgroups. RESULTS: After controlling for gender, race, body mass index and psychiatric-related sleep symptoms, alcoholics and older adults had significantly decreased total sleep time, and increased Stage 1 sleep percentage, respiratory distress and periodic limb movements. Older adults also had decreased delta sleep percentage and shorter rapid eye movement sleep latencies. Significant interactions were found between alcoholism and age group for Stage 1 sleep percentage, sleep-disordered breathing and periodic limb movements, with older alcoholics having the most disturbances. Older alcoholics had the highest mean values for sleep latency and the lowest mean values for sleep efficiency and delta sleep percentage when compared with the other three groups. CONCLUSIONS: Older alcoholics have increased sleep disturbances when compared with younger alcoholics and with nonalcoholics of both age groups. Care providers should screen for sleep problems among older adults with alcohol problems.

Adult↗

Conceptualizing resilience in women older than 85: overcoming adversity from illness or loss.

Resilience in women older than 85 is defined as the ability to achieve, retain, or regain a level of physical or emotional health after devastating illness or loss. This concept analysis of resilience in women older than 85 is based on the strategy suggested by Meleis. Resilience in women older than 85 is symbolized by a coiled wire, enclosed within a box similar to a jack-in-the-box. Environmental factors within the jack-in-the-box include frailty, determination, previous experience with hardship in learning how to cope, access to care, culturally based health beliefs, family support, self-care activities, caring for others, and functioning like efficiently working machines. External factors that influence the ability of the wire to recoil include the structure of the box itself and stress. More study is needed regarding diverse older women's experiences of resilience to develop a workable, clinically focused theory.

Acute Disease↗

Sleep disordered breathing in patients with cluster headache.

OBJECTIVE: To study subjects with active or inactive cluster headache (CH) for occult sleep disordered breathing (SDB). BACKGROUND: CH frequently occurs during sleep. The authors previously found that symptoms of SDB predicted reported occurrence of CH in the first half of the night, which suggested that CH could be triggered in some cases by unrecognized SDB. METHODS: The authors performed polysomnography in 25 adults (22 men) with CH. Subjects were not selected for any sleep-related complaint. In addition to standard measures, studies included monitoring of end-tidal carbon dioxide (n = 22), and esophageal pressure (n = 20). RESULTS: The rate of apneas and hypopneas per hour of sleep was >5 in 20 subjects (80%; 95% CI, 64% to 96%), minimum oxygen saturation was <90% in 10 subjects, maximum negative esophageal pressure ranged from -13 to -65 cm H2O, and maximum end-tidal carbon dioxide was > or =50 mm Hg in eight subjects. The eight subjects with active (versus inactive) CH at the time of study had higher maximum end-tidal carbon dioxide levels (50 +/- 3 versus 44 +/- 5 mm Hg; p = 0.0007). More severe oxygen desaturation was associated with reports that CH typically occurred in the first half of the nocturnal sleep period (p = 0.008). CONCLUSIONS: SDB occurred in the majority of patients with CH. Evaluation of a patient with CH should include consideration that SDB may be present.

Adult↗

Clinical trials in the genomic era: effects of protective genotypes on sample size and duration of trial.

It is well known that individuals can vary widely in their disease susceptibilities. One potential source of this variation is the genetic makeup of individuals, which can confer either protection or susceptibility to disease. Here we examine the effects of protective genotypes on the sample sizes and time required to detect differences between clinical trial arms. We show that including individuals with protective genotypes in a clinical trial can increase required sample sizes and trial duration. One can deal with this issue by pregenotyping subjects and selectively enrolling them based on their genotype. Thus we also calculate the number of individuals that must be recruited and pregenotyped to fulfill sample size requirements. The benefits of genotypically screening study subjects will depend on numerous factors, including ease of patient recruitment, cost of genotyping, long-term costs of study (or long-term cost per subject), and the strength of the protective effect. We present several examples that show the potential value of incorporating information about protective genotypes into a clinical trial.

Clinical Trials as Topic↗

First-trimester prenatal diagnosis of a thoracic cystic lesion associated with fetal skin edema.

An unusual case of chest cyst diagnosed at the end of the first trimester in a dizygotic twin pregnancy and managed conservatively is reported. Between 11 and 14 weeks of gestation, ultrasound revealed a relatively large echopoor lung cyst occupying the left side of the chest, displacing the mediastinum and the heart. This was associated with increased nuchal translucency thickness and generalized skin edema. Subsequent sonograms showed complete resolution of the cyst together with the skin edema. The fetuses were delivered at term and had an uncomplicated postnatal outcome. This case emphasizes the role of reduced venous return as a cause of early fetal hydrops. Diagnosis and follow-up of a congenital lung cyst from the end of the first trimester should enable early intervention to be made.

Adult↗

Anaesthesia with remifentanil and rocuronium for caesarean section in a patient with long-QT syndrome and an automatic implantable cardioverter-defibrillator.

A 24-year-old woman with congenital long-QT syndrome (LQTS) required caesarean section at 32 weeks' gestation. Her risk of premature death from malignant ventricular tachyarrhythmias had necessitated implantation of an automatic cardioverter-defibrillator (AICD) with pacemaker capability. The patient expressed a preference for general anaesthesia. To minimise the risk of increased serum catecholamine concentrations and consequent ventricular arrhythmias, an analgesia-based regimen was chosen. With cardioversion, defibrillation, and antitachycardia pacing functions of the AICD selectively deactivated, anaesthesia was induced with bolus doses of thiopentone and remifentanil. Rocuronium was used for neuromuscular block. Anaesthesia was maintained with nitrous oxide and isoflurane, supplemented by a remifentanil infusion. We outline the pathophysiology and treatment of LQTS, and discuss the anaesthetic management of an obstetric patient with the congenital syndrome. This is the first reported case of caesarean section in a patient with an AICD, and the first description of the use of either remifentanil or rocuronium in LQTS.

Journal Article↗

CYP3A activity in African American and European American men: population differences and functional effect of the CYP3A4*1B5'-promoter region polymorphism.

OBJECTIVE: Cytochrome P4503A (CYP3A) activity exhibits considerable interindividual variability. Possible differences in CYP3A activity were investigated in European American and African American men with the use of midazolam as an in vivo probe. METHODS: Midazolam was simultaneously administered intravenously (1 mg, [15N3]-labeled) and orally (2 mg, unlabeled in capsule form) to 15 young healthy European American men and a similar group of men of African American descent. Plasma concentration-time curves were measured. The subjects were subsequently genotyped with respect to the CYP3A4*B1 polymorphism (A-290G) in the 5'-promoter (nifedipine-specific element) region. RESULTS: The oral bioavailability of midazolam was about equally determined by intestinal and hepatic extraction with CYP3A activity at the former site exhibiting greater variability. Oral bioavailability was related to intestinal metabolism (r = 0.98), whereas hepatic CYP3A activity contributed little to the interindividual variability (r = 0.03). A lower systemic clearance (265+/-54 versus 310+/-56 mL/min; P = .04), but not oral clearance, was observed in African Americans. With one exception, the African Americans possessed a variant CYP3A4*1B allele (4 heterozygotes A/G and 10 homozygote G/G), whereas all of the European Americans were wild-type homozygotes (A/A). Hepatic CYP3A activity and the systemic clearance of midazolam were about 30% lower in G/G homozygotes than in A/A homozygotes (252+/-53 versus 310+/-54 mL/min; P = .02), and a gene-dose effect was present (P = .01). There was no genotype/phenotype relationship with respect to the oral clearance of midazolam. CONCLUSION: Comparison of CYP3A activity between populations is complicated by frequency distribution differences in the regulatory CYP3A4*1B polymorphism and lower hepatic CYP3A activity associated with the variant allele. However, this reduction is modest; therefore no major and clinically important difference in CYP3A activity is present between Americans of African or European descent.

Administration, Oral↗

Linkage disequilibrium and allele-frequency distributions for 114 single-nucleotide polymorphisms in five populations.

Single-nucleotide polymorphisms (SNPs) may be extremely important for deciphering the impact of genetic variation on complex human diseases. The ultimate value of SNPs for linkage and association mapping studies depends in part on the distribution of SNP allele frequencies and intermarker linkage disequilibrium (LD) across populations. Limited information is available about these distributions on a genomewide scale, particularly for LD. Using 114 SNPs from 33 genes, we compared these distributions in five American populations (727 individuals) of African, European, Chinese, Hispanic, and Japanese descent. The allele frequencies were highly correlated across populations but differed by >20% for at least one pair of populations in 35% of SNPs. The correlation in LD was high for some pairs of populations but not for others (e.g., Chinese American or Japanese American vs. any other population). Regardless of population, average minor-allele frequencies were significantly higher for SNPs in noncoding regions (20%-25%) than for SNPs in coding regions (12%-16%). Interestingly, we found that intermarker LD may be strongest with pairs of SNPs in which both markers are nonconservative substitutions, compared to pairs of SNPs where at least one marker is a conservative substitution. These results suggest that population differences and marker location within the gene may be important factors in the selection of SNPs for use in the study of complex disease with linkage or association mapping methods.

Alleles↗

Core issues for female child abuse survivors in recovery from substance misuse.

Female survivors of childhood abuse have increased risk for substance misuse. Childhood abuse survivors describe current mental health and substance misuse services as not addressing central problems, the "heart of the matter." Negative core issues related to abuse events, contexts, substance use, and current problems were explored in open-ended interviews with 20 female abuse survivors. Most were marginalized because of cocaine use, poverty, and ethnic status. Narrative analysis involved within- and between-account comparisons through adequate paraphrasing of in vivo descriptions. Results include in-depth description of basic core beliefs, developmental core influences, and current core experiences. Implications for practice and policy include appreciation of the influence of negative core experiences on mental health, substance misuse recovery, and preparedness for adulthood demands.

Adolescent↗

Development of peptide antagonists that target estrogen receptor beta-coactivator interactions.

The biological actions of estrogen are manifest through two genetically distinct estrogen receptors (ER alpha and ER beta) that display nonidentical expression patterns in target tissues. The phenotypic alterations in response to estrogens in mice disrupted for either or both of these receptors are not identical, suggesting that each subtype plays a unique role in ER-action. However, the lack of subtype-specific agonists and antagonists has made it difficult to define the processes that are regulated by ER alpha and/or ER beta. Previously, we have reported the identification and characterization of a series of LXXLL-containing peptide antagonists that block estrogen signaling by preventing the association of ER alpha with required coactivators. As expected, given the similarity of the coactivator binding pockets among nuclear receptors, most of the peptide antagonists identified inhibited the activity of multiple receptors. However, by altering sequences flanking the core LXXLL motif, some receptor selectivity was afforded. Building on this observation, we have screened combinatorial phage libraries, expressing peptides in the format X7LXXLLX7, for peptides that interact in a specific manner with ER beta. Using this approach, a series of highly specific, potent peptide antagonists have been identified that efficiently inhibit ER beta-mediated estrogen signaling when introduced into target cells. Interestingly, in cells where both ER subtypes were expressed, these ER beta antagonists were capable of attenuating ER action, suggesting that ER alpha and ER beta do indeed form functional heterodimeric complexes. We believe that suitably formulated versions of these peptides can be used to study ER beta action in vitro and in vivo. In addition, the unanticipated specificity of the peptides identified should serve as an impetus to investigate the use of this approach to develop peptide antagonists of other nuclear receptors and unrelated transcription factors.

Amino Acid Motifs↗

Japan's progressive sex: male homosexuality, national competition, and the cinema.

This essay serves as a broad investigation of the origins of what came to be called the "gay boom" in 1990's Japanese cinema: a culmination of print media, television, and especially films which made the gay male not merely a visible (political) subject but also the site of displaced contestations of gendered (female) desire. The most visible transnational signifier of the "gay boom" was the 1992 film Okoge, a film which, in keeping with a Japanese trend which relocates the gay male as a safe displacement of female desire, posits the heterosexual female as the audience's point of identification in a film about the lives of gay Japanese men. Using this as a starting point, this essay seeks to explore how male homosexuality and gender construction operate within both Japanese nationalism and the transnational discourse of Japanese cinema's dissemination.

Art↗