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Biomedical subjects

J Morris

Publications and source records attributed to J Morris.

At least 397 records · Page 22Linked to original sources
PubMed1989

Duration of action of inhaled terbutaline at two different doses and of albuterol in protecting against bronchoconstriction induced by hyperventilation of dry cold air in asthmatic subjects.

Although several studies have examined the duration of the bronchodilator effect of several inhaled beta-2-adrenergic agents, the duration of the blocking effect on bronchial hyperresponsiveness, another key feature of asthma, has seldom been studied. We investigated this problem in eight adult asthmatic subjects who underwent hyperventilation tests with dry cold air on 4 different days. On the first day, five hyperventilation tests with assessment of the level of ventilation causing a 20% fall in FEV1 (PD20) were obtained to evaluate the within-day variability of the test. On the three other visits, after a baseline hyperventilation test, albuterol 200 micrograms, terbutaline 500 micrograms, and terbutaline 1,500 micrograms were administered in a double-blind, randomized way. Hyperventilation tests were carried out 1, 2, 4, and 6 h later. The blocking effect on the treatment days, as assessed by the differences in PD20 for each test compared with baseline PD20 for that day, was corrected for the within-day variability of the control day. There was a significant bronchodilator effect 1 h after administering the drug; it was equivalent for albuterol 200 micrograms (25.6 +/- 14.7%) and terbutaline 1,500 micrograms (21.7 +/- 13.5%) and significantly less for terbutaline 500 micrograms (14.1 +/- 10.0%). Complete or partial blockade on bronchial responsiveness was obtained in the majority (six to seven of eight) of the subjects 1 h after inhaling the bronchodilator, with progressive reduction in the effect later on. Four subjects still showed a blocking effect 6 h after terbutaline 1,500 micrograms was administered, one subject after terbutaline 500 micrograms, and no subjects after albuterol (chi square = 6.6, p = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1989

Effect of the selective leukotriene B4 antagonist U-75302 on antigen-induced bronchopulmonary eosinophilia in sensitized guinea pigs.

The selective leukotriene B4 (LTB4) antagonist, U-75302, 6-(6-(3-hydroxy-1E,5Z-undecadien-1-yl)-2-pyridinyl)-1,5-hexa nediol) was examined for its ability to inhibit the "late-phase" bronchopulmonary eosinophilia that occurs 6 to 24 h after inhalation of specific antigen in sensitized guinea pigs. Groups of 6 male guinea pigs, sensitized with ovalbumin, were pretreated with U-75302, 1.0, 10.0, or 30.0 mg/kg, or vehicle 1 h before and 7 h after antigen inhalation. Twenty-four hours after antigen provocation, the lungs were lavaged for the enumeration of inflammatory cell populations. Doses of U-75302 (1.0, 10.0 and 30.0 mg/kg) administered orally produced 12.2%, (p greater than 0.05), 43.2% (p less than 0.05), and 61.1% (p less than 0.05) inhibition, respectively, of the antigen-induced influx of eosinophils into the bronchial lumen. Neutrophil populations were not significantly affected by treatment with U-75302. In a separate study, we compared the histopathological changes that occurred following antigen challenge in U-75302-treated or vehicle-treated guinea pigs. Vehicle-treated, sensitized animals exhibited marked changes in the airway at 8 min, 6 h, and 24 h after antigen challenge. U-75302 treatment produced a significant reduction in eosinophil adherence to peribronchial/peribronchiolar capillaries followed by a dramatic and specific reduction of peribronchial eosinophil infiltration (81% reduction at 6 h and 79% reduction at 24 h). Neutrophil migration appeared unaffected. These data implicate LTB4 as a mediator of antigen-induced bronchopulmonary eosinophilia in the guinea pig.

Animals↗
PubMed1989

Dementia in Parkinson's disease: the problem of clinicopathological correlation.

Four cases of Parkinson's disease with advanced dementia are described. Postmortem examination revealed cell loss in the substantia nigra, with Lewy bodies present, and loss of cells in the basal nucleus of Meynert. A few tangles were observed in the hippocampus, but no senile plaques or neurofibrillary tangles were found in the neocortex. The authors note that a dramatic dementia syndrome may occur with Parkinson's disease alone, without the associated cytoskeletal markers of Alzheimer's disease. Cases were characterized by disorientation, episodic confusion and hallucinations persisting off medication, disturbed behavior, and the absence of aphasia.

Brain↗
PubMed1989

Changes in the surgical management of early breast cancer in England.

A questionnaire survey of consultant surgeons in England indicates that there has been a considerable change in opinion over the past few years concerning the management of early breast cancer; only 39.1% would now perform mastectomy, whereas 64.4% would perform conservative surgery. The most common forms of management are simple mastectomy and axillary clearance (21.9%); wide excision, axillary clearance plus radiotherapy (20.1%); and wide excision plus radiotherapy alone (16.9%). The majority of the surgeons would offer patients a choice of surgery, but only 52% had access to a breast care nurse.

Attitude of Health Personnel↗
PubMed1989

Ordinal scales and foundations of misinference.

Fundamental deficiencies in the information provided by an ordinal scale constrain the logical inferences that can be drawn; inferences about progress in treatment are particularly vulnerable. Ignoring or denying the limitations of scale information will have serious practical and economic consequences. Currently, there is a high demand for functional assessment scales within the rehabilitation community. It is hoped that such scales will satisfy the very real need for measures of function which reflect the impact of treatment on patient progress. Unfortunately, some commonly used evaluation instruments are not well suited to this task. The underlying rationale for clinical decision-making based on these scales is examined.

Activities of Daily Living↗
PubMed1988

Acute appendicitis, bathrooms, and diet in Britain and Ireland.

Hospital discharge rates after acute appendicitis were analysed in relation to the provision of household amenities and diet in 73 areas of England and Wales, nine health board areas in Scotland, and all eight health board areas of Eire. The rates of acute appendicitis correlated with the percentage of households lacking amenities, in particular fixed baths and hot water systems. Consumption of green vegetables was an additional influence on the geographical distribution of the disease. These findings support a relation between appendicitis and hygiene, which would explain both the rise and fall of the disease during this century.

Acute Disease↗
PubMed1988

Properties of anti-Lyb-2-mediated B-cell activation and the relationship between Lyb-2 molecules and receptors for B-cell stimulatory factor-1 on murine B lymphocytes.

The murine B-cell differentiation antigen Lyb-2 has been shown to be involved in B-lymphocyte activation and has been postulated by some to be related to a receptor for B-cell stimulatory factor I (BSF-1) (H. Yakura et al., J. Immunol. 137, 1475, 1986). Here we have demonstrated that monoclonal antibody (mAB) to Lyb-2 resembles BSF-1 in its ability to activate small resting B cells and enhancement of surface Ia. Anti-Lyb-2 antibodies bound B cells with very high avidity and were able to induce mobilization of cytosolic-free calcium. Anti-Lyb-2 mAB differs from BSF-1 in that BSF-1 but not anti-Lyb-2 is able to synergize with anti-mu in induction of B-cell proliferation. The relation between Lyb-2 molecules and BSF-1 receptors was tested in assays that measure binding of anti-Lyb-2 or BSF-1 in B cells and were found not to compete with each other. It appears that the two B-cell agonists anti-Lyb-2 and BSF-1 may exert their effects on B cells through different cell surface moieties as well as different intracellular pathways.

Animals↗
PubMed1988

Offering patients a choice of surgery for early breast cancer: a reduction in anxiety and depression in patients and their husbands.

Thirty patients with early breast cancer have been studied prospectively to assess whether being offered a choice of surgery (simple mastectomy or wide excision plus radiotherapy) influences levels of anxiety and depression pre- and post-operatively. A significantly higher percentage of the patients not offered a choice of surgery experienced clinical levels of anxiety and depression pre-operatively and up to 2 months post-operatively compared with patients offered a choice; the results were also similar for the husbands of these patients. At 6 months, differences between the 2 groups were not statistically significant, although the trend remained the same with more patients not offered a choice of treatment showing high levels of anxiety and depression. Patients offered a choice of surgery had similar pre-operative levels of anxiety and depression to patients with benign breast disease and patients undergoing surgery for non-cancerous conditions. This study indicates that with proper counselling patients and husbands suffer less stress if they are allowed to take an active part in the treatment of their cancer.

Adult↗
PubMed1988

Choice of surgery for early breast cancer: psychosocial considerations.

A prospective study was conducted with early breast cancer patients who had either been offered, or not been offered, a choice of surgery for treatment. The choice involved mastectomy or wide excision plus radiotherapy. Available evidence suggests that the medical outcome between these two options is similar; this study was designed to investigate selected psychosocial outcomes. It was found that whether or not patients were given a choice was of greater relevance to psychosocial outcomes that was the type of operation performed. Providing a choice led to improved reported adjustments with respect to the ability to undertake work, attitudes towards the future, beliefs about coping, and in physical and psychological functioning.

Adaptation, Psychological↗
PubMed1988

The value of soft tissue signs in wrist trauma.

A retrospective study of the wrist radiographs of 1453 patients presenting with acute wrist trauma was undertaken in order to assess the value of soft tissue signs. A total of 773 radiographs which were judged to be normal were used to evaluate the normal pronator quadratus fat stripe. The distance of the normal pronator fat stripe from the radius was shown to be significantly lower in females than in males and increased with age. The increase with age was greater in males. Although most fractures were associated with some soft tissue abnormality, certain fractures, especially greenstick fractures in children, had normal soft tissue planes. Only 4% of the wrists examined had soft tissue abnormalities with no visible fracture. The presence of soft tissue signs should therefore be considered with suspicion when evaluating wrist radiographs in trauma, but the absence of signs does not necessarily exclude a fracture.

Adipose Tissue↗
PubMed1988

Back impairment and disability determination. Another attempt at objective, reliable rating.

Present disability evaluation schedules for the low back are not scientifically based and produce very great interexaminer differences. The authors have developed a new impairment schedule based on a comprehensive review of the medical literature and the collected opinions of a large number of back specialists. Tests of the new schedule show a marked decrease in interexaminer differences compared to the prior California disability rating schedule. The impairment schedule can be readily adapted to any legal system of disability rating and can be modified easily to reflect new medical knowledge. The result should be a disability rating which is more objective, more scientifically valid, and more consistent, reducing litigation, with fairness to both the low-back impaired worker and the employer.

Disability Evaluation↗
PubMed1988

Safety and efficacy of chymopapain (Discase) in the treatment of sciatica due to a herniated nucleus pulposus. Results of a randomized, double-blind study.

A prospective, multiinstitutional, double-blind trial comparing the effect of chymopapain (Discase) vs. placebo (cysteine-edetate-iothalamate: CEI) for lumbar intervertebral disc rupture with sciatica was carried out on 173 patients, the largest such study reported to date. Patients were matched with respect to age, sex, physical habitus, and level of injection. The procedure was carried out under local anaesthesia. The success rate was superior in the chymopapain group regardless of the method used to assess outcome or the time over the first 6 months at which the two groups were compared: 71% vs. 45% if code breaks were analyzed at 6 months, and 67% vs. 44% if code breaks were defined as lost to follow-up. A single case of anaphylaxis and one case of septic discitis were the only serious complications noted. This study supports the role of chymopapain in the treatment of lumbar disc rupture with sciatica.

Adolescent↗
PubMed1988

Novel molecules that antagonize leukotriene B4 binding to neutrophils.

A series of LTB4 analogues have been synthesized that replace carbons 7-9 of the cis-trans-trans triene unit of LTB4 with a stable ring structure. Meta-substituted pyridine analogues are more potent inhibitors than benzene or furan analogues. C-1 alcohols are often more potent inhibitors than free carboxylic acids, and 5,6-cis double bond compounds are more potent than 5,6-trans compounds. Compounds such as these may prove to be useful in the treatment of inflammatory diseases.

Leukotriene B4↗
PubMed1988

A comparative study of neurological and myxedematous endemic cretinism in western China.

Endemic cretinism occurs in areas of severe iodine deficiency and is manifested by two major clinical patterns, myxedematous and neurological. The relationship between these types and the factors responsible for the clinical variability are not clear. We examined 69 endemic cretins, aged 4-52 yr, categorized clinically at the beginning of the study into the three traditional types of endemic cretins, myxedematous (n = 25), neurological (n = 15), and the mixed form (n = 29), from a previously unreported endemia in Qinghai Province, China. These patients underwent detailed endocrine and neurological examination, including intelligence assessment using the Hiskey-Nebraska Test of Learning Aptitude or the Griffiths Mental Development Scales, audiometry (in a subset of 37 patients); thyroid function testing and thyroid ultrasonography; and radiology of the skull, hand, and hip. We found that categorization of the cretins into the conventional types did not reflect the pathophysiology of the condition, since an identical pattern and intensity of neurological, intellectual, and audiometric deficits were common to and equally present in all three types of endemic cretins regardless of their thyroid function. Gait disorder (in 99%) and pyramidal signs such as patellar hyper-reflexia (in 91%) were the most common neurological abnormalities. There was no difference in mean intelligence test scores among the three groups [overall mean intelligence score (Hiskey or Griffiths tests), 28.8 +/- 12.8 (SD)]. The differing clinical manifestations of cretinism could be explained by the length and severity of thyroid hormone deficiency. Myxedematous cretins were severely thyroid hormone deficient, and as a result sexually immature, dwarfed, and had retarded skeletal maturity. They had clinical and sonographic thyroid atrophy, rather than goiter. Although neurological cretins were euthyroid, linear growth arrest lines (demonstrated radiologically) in the long bones of these cretins suggested previous hypothyroidism. Furthermore, all cretins were growth retarded when compared with peers of similar age and race. Our data therefore suggest that the different clinical types of endemic cretinism are in fact the same disorder phenotypically modified by the length and severity of postnatal hypothyroidism. The neurological manifestations are interpreted as reflecting the effects of maternal and fetal hypothyroxinemia, secondary to severe iodine deficiency, on the developing nervous system.

Adolescent↗
PubMed1988

Sensory form of acute polyneuritis.

A patient presented with severe sensory loss and ataxia with total arreflexia, and elevation of CSF protein with pleocytosis. At autopsy there was extensive lymphocytic infiltration of nerves and posterior roots, sparing the anterior roots. Teased fiber preparation of nerve showed a demyelinating lesion. There were no abnormalities in the CNS. The condition appears to be an acute sensory polyneuritis bearing a close relationship to acute Guillain-Barré syndrome.

Acute Disease↗