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Biomedical subjects

J Morris

Publications and source records attributed to J Morris.

At least 379 records · Page 21Linked to original sources
PubMed1990

The postoperative spine. Magnetic resonance imaging.

MRI is rapidly becoming the imaging modality of choice in the diagnostic assessment of patients with persistent or recurrent symptoms following spinal surgery. It displays the normal postoperative findings as well as most causes of FBSS. MRI can differentiate persistent or recurrent disk herniation from postoperative scar formation with a greater degree of confidence than other imaging modalities. MRI can determine clinically important functional instability when CT and conventional radiography are inconclusive. This can be particularly helpful in evaluating the patient with multiple lumbar surgeries. MRI can also determine the presence of other causes of the FBSS such as lateral spinal stenosis, arachnoiditis, fat graft compression on the thecal sac, and presence of postoperative hematoma or postoperative infection.

Adipose Tissue↗
PubMed1990

Automated percutaneous discectomy: a prospective multi-institutional study.

A prospective multi-institutional study was carried out to evaluate automated percutaneous discectomy in the treatment of lumbar disc herniations. Of the 327 patients who prospectively met the study criteria and were followed for longer than 1 year, 75.2% were successfully treated. When patients (n = 168) who prospectively did not meet the study criteria were treated, the success rate was 49.4%. One case of discitis was reported; otherwise, no other serious complications were noted, and specifically no vascular or nerve damage was encountered. This study indicates that automated percutaneous discectomy can be used successfully to treat lumbar disc herniations with minimal morbidity and emphasizes the need for proper patient selection.

Humans↗
PubMed1989

Dietary calcium, physical activity, and risk of hip fracture: a prospective study.

OBJECTIVE: To determine whether low dietary calcium intake and physical inactivity are risk factors for hip fracture among subjects aged 65 and over. DESIGN: Fifteen year follow up study of a large cohort of randomly selected elderly people living in the community, who had taken part in the 1973-4 survey of the Department of Health and Social Security, and for whom dietary and other data were recorded at initial interview and medical assessment. SETTING: Eight areas in Britain (England (five), Wales (one), and Scotland (two]. SUBJECTS: 1688 Subjects living in the community, of whom 1419 subjects (720 men and 699 women) agreed to participate. 1356 Subjects completed a seven day dietary record and 983 (542 men and 441 women) agreed to be assessed by a geriatrician. RESULTS: Incidence of hip fracture increased with age and was higher in women than men. Comparison with matched controls showed no evidence that the risk of hip fracture was related to calcium intake: the odds ratio for the lowest third of dietary calcium compared with the highest was 0.7 (95% confidence interval 0.1 to 3.9) after adjustment for smoking and body mass index. The adjusted odds ratio for the lowest third of outdoor activity compared with the highest was 4.3 (0.7 to 26.8), and that for grip strength was 3.9 (0.7 to 23.0). CONCLUSIONS: Reduced intake of dietary calcium does not seem to be a risk factor for hip fracture. Further evidence is provided that physical activity in the elderly protects against hip fracture.

Age Factors↗
PubMed1989

Iodine deficiency impairs intellectual and neuromotor development in apparently-normal persons. A study of rural inhabitants of north-central China.

Intelligence was measured by means of the Hiskey-Nebraska Test of Learning Aptitude or the Griffiths Mental Development Scales in a sample of 369 patients from iodine-deficient rural villages (Baihuyao), iodine-sufficient rural villages (Huanglo) and urban populations to test for the damaging effects of iodine deficiency on the development of the nervous system in the presumed healthy section of a community. In urban school-children who were aged seven to 14 years (n = 78), a normal range of measured intelligence was found (mean +/- SD intelligence-quotient score, 107.0 +/- 18.3). By comparison, intelligence-quotient scores were lower in all rural cohorts (a rural suppression effect) but the distribution of intelligence-quotient scores showed a further shift to the left in the iodine-deficient township. In Baihuyaon villagers who were aged 30-35 years (n = 50), who were born during the period of severe iodine deficiency, 72% of villagers had an intelligence-quotient score of less than 70 compared with 41% (P less than 0.05) of villagers who were aged 28-35 years from Huanglo, a rural iodine-sufficient control group (n = 49). Although measured intelligence was higher in Baihuyaon children whose mothers had received iodized salt - 44% of seven- to 14-year-old children had intelligence-quotient scores of less than 70 (n = 141)--it remained significantly depressed compared with rural (n = 51) and urban (n = 78) control subjects (18% and 4%, respectively). These findings were consistent with other parameters (that is, the persistently-high rate of goitre), which indicated that the salt-iodization programme was inadequate. In the iodine-deficient village, lower intelligence-quotient scores showed a relationship with the detection by audiometry of nerve deafness and with the presence of abnormal neurological signs. The latter included spasticity and pyramidal signs which were of a similar pattern to the neurological deficits that have been demonstrated in overt neurological cretins. We conclude that iodine deficiency imposes a further suppressive effect on the intellectual performance of rural inhabitants, and results in a shift of the entire population distribution of cognitive skills to a lower level.

Adolescent↗
PubMed1989

Ovarian follicular fluid eicosanoid concentrations during the pre-ovulatory period in humans.

Prostaglandins are involved in ovulation and in every mammal studied so far, ovulation has been inhibited by prostaglandin inhibition. Information regarding the role of leukotrienes and thromboxanes in ovulation is more limited. In order to study the production of eicosanoids in human pre-ovulatory follicular fluid, follicular aspiration was timed by means of serial ultrasound scans and human chorionic gonadotrophin (hCG) to be immediately pre-ovulatory. 11 women were studied and the eicosanoids measured by radioimmunoassay (RIA). The follicular fluid was found to contain leukotrienes (LT) B4, LTC4 (D4, E4), prostaglandin (PG) E2, PGF2 alpha 6 keto PGF1 alpha k and thromboxane (TX) B2. This is the first published report of leukotrienes in human follicular fluid in spontaneous cycles, and is one of the few reports showing prostaglandins and thromboxanes. The significance of demonstrating leukotrienes in human follicular fluid is discussed as is the correlation between individual eicosanoids in the human ovary.

Dinoprostone↗
PubMed1989

Chronic actinic dermatitis: an immunohistologic and photobiologic study.

Photobiologic, histologic, and immunohistochemical findings in 14 patients with chronic actinic dermatitis were compared. Grading of routine histologic features of involved skin demonstrated a spectrum of abnormalities ranging from changes resembling chronic dermatitis to those of cutaneous T cell lymphoma. Immunohistochemical staining showed dermal infiltrates to consist predominantly of T lymphocytes, with a significant trend toward lower CD4+/CD8+ ratios in cases with more florid histologic findings. Circulating CD4+/CD8+ cell ratios were normal in five patients and reduced in one patient. Photosensitivity extending to wavelengths longer than 340 nm was detected in eight patients, but the spectrum of photobiologic abnormality did not appear to correlate with either grading of histologic severity or variation in T cell subsets in lesional skin.

Aged↗
PubMed1989

The contribution of childbearing to the sex difference in first admission rates for affective psychosis.

This epidemiological study examines the contribution of childbearing to the sex difference in first admission rates for affective psychosis. The effects of sex, age, marital status and parity on first admission rates are examined in 114 patients admitted from a defined catchment area. The rate of first admission in females is almost twice that in males. Using logistic regression analysis one significant factor accounting for this sex difference emerges: female parity. The effect of parity is evident up to the age of 54, and it entirely accounts for the sex difference in relative risk. Nonparous females have a lower relative risk of admission than males. An apparent effect of marital status is only significant in females, and is accounted for by parity and age.

Adolescent↗
PubMed1989

A controlled study of neuropsychological deficits in acute spinal cord injury patients.

According to a number of studies, between 40% and 60% of acute traumatic spinal cord injury (SCI) patients demonstrate cognitive dysfunction resulting from various forms of cerebral damage, including concurrent or premorbid closed head injury, chronic alcohol or substance abuse, and other causes. However, applicability of findings from these reports has been limited due to the use of inadequate neuropsychological testing techniques and the lack of control data. In a collaborative investigation, 81 acute SCI patients and 61 non-injured control subjects between 18 and 55 years of age completed a comprehensive motor-free neuropsychological test battery, including: Halstead Category Test (HCT), Vocabulary Subtest (VOCAB) of the Wechsler Adult Intelligence Scale - Revised; Mental Control (MC) Subtest, and Initial and Recall trials of Logical Memory (LM) and Paired Associates (PA) Subtests of the Wechsler Memory Scale; and the 8 trials of the Rey Auditory Verbal Learning Test (RAVLT). Percentages of retained information on the LM and PA were also calculated. Impairment levels for each test were defined as values which exceeded two standard deviations (one-tailed) from the control mean. Based on this definition, the prevalence of neuropsychological abnormality on each test ranged between 10% and 40%. Mean performance levels of patients were significantly more impaired than those of control subjects for all tests except for the Interference trial of the RAVLT and for the percentages of retained information on the LM and PA subtests. Comparison of test results of SCI patients with those of control subjects demonstrates that poor attention span and limited initial learning ability are frequent problems among SCI patients. Other common neuropsychological deficits among these patients include poor concentration ability, impaired memory function, and altered problem solving ability. These deficits may interfere with rehabilitation following SCI.

Adolescent↗
PubMed1989

"Pseudoascites" secondary to an amylase-producing serous ovarian cystadenoma. A case study.

Large intraabdominal cystic tumors may mimic ascites. In particular, large ovarian cystadenomas may be mistaken for ascites, and when tapped, may contain an elevated cyst fluid amylase. The amylase from ovarian neoplasms, however, is distinguishable from pancreatic or salivary amylase in that it is more acidic in its isoelectric focusing. Additionally, epithelial cells from the tumor do not contain zymogen granules when examined with electron microscopy. We describe what we think is the third reported case of a patient with "pseudoascites" secondary to an amylase-producing serous cystadenoma.

Adult↗
PubMed1989

UVA sunbeds: tanning, photoprotection, acute adverse effects and immunological changes.

The effects on 31 normal subjects following exposure to sunbeds containing UVA lamps with minimal UVB emission have been compared in a double-blind study with the effects on nine control subjects of a similar exposure course three times weekly for 4 weeks to sunbeds emitting visible light. On previously untanned areas, all those subjects on active treatment developed a mild tan; in tanned areas they all developed a moderate tan, while all control subjects developed a minimal to mild tan. The mean protection factor against later UVB-induced erythema was 3.2 +/- 0.3 after the active course and 1.6 +/- 0.2 among the controls. Significantly more frequent adverse cutaneous effects for active subjects were pruritus, erythema, freckling, burning sensation, dryness and polymorphic light eruption. Cutaneous Langerhans cell numbers, and blood CD3+ (pan T-cell) and CD4+ (helper T-cell) lymphocyte subsets were reduced in both active and control groups. CD8+ (cytotoxic/suppressor T-cell) counts were similarly but not significantly reduced in both groups. Pityrosporum yeast counts were significantly reduced in both groups. The changes found in both groups seem attributable to small amounts of UVB emission from both active and control lamps.

Adolescent↗
PubMed1989

Polymorphic light eruption: an immunopathological study of evolving lesions.

Polymorphic light eruption (PLE) papules were successfully induced on previously affected sites in 11 out of 14 patients with PLE 4-20 h after single exposures to suberythemogenic doses of solar simulated radiation. Histological examination of biopsies performed 1 h, 5 h, 24 h, 72 h and 144 h post-irradiation revealed onset within 5 h of perivascular cellular infiltration. The infiltrate was dominated by lymphocytes in both early and established lesions, without evident epidermal pathology. Immunohistochemistry demonstrated a predominance of CD4+ cells in lesions up to 72 h post-induction, but later biopsies were dominated by a CD8+ infiltrate. Significantly increased numbers of dermal macrophages and CD1b+ cells were detected 1 h and 5 h post-irradiation, respectively. These findings are consistent with a delayed type hypersensitivity response underlying the pathogenesis of polymorphic light eruption.

Adult↗
PubMed1989

A randomized controlled trial of the provision of a social support service during pregnancy: the South Manchester Family Worker Project.

A pilot scheme was introduced in Manchester to provide additional social support to pregnant women at above average risk of giving birth to a low-birthweight baby. The help of lay workers, known as family workers, was made available to eligible women. The effect on infant birthweight of offering the help of a family worker was assessed by a randomized controlled trial. No significant differences were observed between the experimental and control group, but on a number of grounds the interpretation of this finding is not straightforward, and further research is recommended.

Allied Health Personnel↗
PubMed1989

Origin and behaviour of emphysematous bullae.

Giant emphysematous bullae are believed to produce symptoms of pulmonary compression and collapse by containing gas under pressure that has been generated through valvular feeding airways. To examine this hypothesis, we have measured oxygen and carbon dioxide tensions (PO2, PCO2) in four patients and pressure within the bullae in three patients immediately before surgery. During spontaneous tidal respiration PO2 in the bulla was higher than arterial PO2 but did not rise as fast during the breathing of oxygen. The intra-bulla pressure during inspiration was negative (-5.5 to -19 cm H2O) and similar to pleural pressure in phase and degree. During intermittent positive pressure ventilation in two patients airway pressures were transmitted to the bulla with the development of a positive end expiratory pressure within the bulla. Histological examination of the walls of the bullae in the four patients and adjacent lung tissue in an additional patient failed to identify any valvular mechanism. The available information suggests that bullae develop after retraction and collapse of surrounding lung away from a region of weakness.

Adult↗
PubMed1989

Retrorenal colon: implications for percutaneous diskectomy.

It has been recommended that computed tomography (CT) with the patient prone be performed in every patient undergoing percutaneous diskectomy; this would enable detection of a retrorenal location of the colon, which could interfere with the percutaneous procedure. In this evaluation of 346 prone CT studies, only one patient (0.29%) was found to have retrorenal or retropsoas bowel that would have been perforated at diskectomy. Because of this extremely low prevalence, the performance of prone CT in every patient undergoing percutaneous lumbar diskectomy is not believed to be necessary.

Adolescent↗
PubMed1989

Four-times-a-day dosing frequency is better than a twice-a-day regimen in subjects requiring a high-dose inhaled steroid, budesonide, to control moderate to severe asthma.

Fifty-three adult asthmatic subjects requiring 800 micrograms or more of inhaled beclomethasone dipropionate were enrolled in a double-blind parallel group study of 6-month duration to compare the efficacy and side effects of inhaled budesonide in doses of 800, 1,200, and 1,600 micrograms given two or four times a day (BID or QID). After a two-week observation period to establish baseline, subjects were given the same dose of budesonide as they would be for beclomethasone dipropionate; however, the frequency regimen (BID or QID) was randomly allocated. Subjects were asked to fill in diary cards describing their asthmatic symptoms, need for medication, and throat symptoms. They were assessed by a physician every 4 wk, at which time spirometry was performed. Throat swabs were done at every other monthly visit. Cortisol and response to cortisol after synthetic ACTH injection were assessed at the beginning and end of the trial. Thirty-six subjects, half in each group, completed the study. Those on the BID regimen had almost twice as many days with nocturnal asthma and cough and almost three times as many days with disability due to asthma. There were also twice as many relapses in the BID regimen as judged by the clinician. These relapses mainly occurred toward the end of the study. The maximal daily swings in peak expiratory flow rates were slightly greater in the BID group, although this difference was not physiologically significant. Spirometry, cortisol secretion, and the response after synthetic ACTH injection were not significantly different in either group from the beginning to the end of the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗