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Biomedical subjects

J Morton

Publications and source records attributed to J Morton.

At least 91 records · Page 5Linked to original sources
PubMed1996

The remediation of clumsiness. I: An evaluation of Laszlo's kinaesthetic approach.

The effectiveness of a kinaesthetic training programme proposed by Laszlo for children with movement difficulties was evaluated by comparing two groups of 10 'clumsy' children matched pairwise on age, IQ and sex as well as degree of kinaesthetic and motor impairment. Tests of kinaesthetic ability, using the Parameter Estimation by Sequential Testing (PEST) procedure, and motor competence administered before and after treatment revealed an improvement in both groups on all measures but no differential effect of the training programme. Immediately after training, the changes we obtained in motor performance were confined to balance skills but, at follow up, 3 months later, changes in manual and ball skills were also evident. This unusual pattern of change requires replication. Our findings forced us to consider the possibility that any effect of Laszlo's recommended training programme had been obscured by our use of the PEST procedure, which had in itself facilitated motor learning.

Case-Control Studies↗
PubMed1996

The remediation of clumsiness. II. Is kinaesthesis the answer?

The paper reports the second of two studies designed to evaluate the effectiveness of the Kinaesthetic Training Programme (Laszlo and Bairstow, 1985) for children with movement difficulties. Three groups of 12 children were matched on age, IQ and sex as well as degree of kinaesthetic and motor impairment. One group received the Laszlo training, another received a training programme designed to avoid explicit reference to kinaesthesis and the third group received no training. Children receiving no intervention failed to show a change in performance. By contrast, the motor competence of both groups of treated children improved significantly. There was no advantage for the Laszlo trained group. It seems that in designing a remediation programme for clumsy children, the way that training is presented is as important as its actual content.

Activities of Daily Living↗
PubMed1995

Loss of heterozygosity on chromosome 11 q in breast cancer.

AIMS: Chromosome 11q23 seems to be a site of frequent mutation in cancer. It also contains loci such as ataxia telangiectasia with possible importance in the pathogenesis of breast tumours. The short arm of chromosome 11 has been studied extensively in breast cancer, but the long arm, in particular the distal part, has been studied less frequently. Cytogenetic analysis has shown possible involvement of chromosome 11q in breast tumours. Chromosome transfer experiments have also implicated chromosome 11q in breast cancer. A high frequency of mutations might therefore be expected to occur on chromosome 11q in breast cancers. METHODS: Using restriction fragment analysis, the primary tumours of 41 patients with breast cancer were screened for mutations at five loci on chromosome 11q (D11Z1, INT2, (FGF3), DRD2, NCAM, and D11S29). RESULTS: Allelic loss occurred at a high frequency (59%) at D11S29. At NCAM, novel alleles were frequently seen on autoradiographs. Relatively low frequencies of mutation were detected at the other loci. Allelic loss at D11S29 was associated with the presence of lymph node metastases, but this may be a chance association. CONCLUSIONS: The frequency of allelic loss at the DS11S29 locus is high. The significance of novel alleles at NCAM and their relation to allelic loss at D11S29 are unclear. The results presented here do not permit fine mapping of a region of allelic loss, but suggest that the region of greatest loss lies distal to DRD2. The results provide further evidence for the importance of gene(s) near 11q23 in the pathogenesis of breast cancer, and of tumours in general.

Breast Neoplasms↗
PubMed1995

Plaque abrasion and intra-aortic balloon leak.

STUDY OBJECTIVE: To determine and correct cause of high incidence of intra-aortic balloon leaks (ruptures). DESIGN: Epidemiologic investigation of factors associated with intra-aortic balloon leak, and sequential application of corrective measures evaluated by continued concurrent data collection. SETTING: Thirty-four-bed ICU in 598-bed tertiary care medical center. INTERVENTIONS: Procedure changed to place smaller balloons (34 mL instead of 40 mL) in patients less than 163 cm in height. MEASUREMENTS AND RESULTS: Demographic and clinical data on all patients showed no change after initial interventions, followed by significant drop (8 to 2%) in incidence of balloon leak when smaller, shorter balloons were placed in shorter patients. CONCLUSIONS: Placement of larger, longer balloons in patients increases risk of perforation of balloon by calcific plaque in the distal thoracic and abdominal aorta.

Aged↗
PubMed1995

Improving customer satisfaction: emerging lessons about strategy and implementation.

A six-phase strategy has been developed and tested to strategically improve customer satisfaction across an entire managed care system. This article summarizes the theoretical underpinnings of the approach and highlights the first two phases of the overall strategy. Emerging lessons about strategy and implementation are described. A follow-up article will include a description of the last four phases of the strategy and a summary of initial results associated with the implementation of this approach.

Consumer Behavior↗
PubMed1995

Improving customer satisfaction: emerging lessons about strategy and implementation, Part 2.

This article describes a six-phase strategy designed to systematically improve customer satisfaction across an entire managed care system. Part 1 (Spring 1995) of this two-part series summarized the theoretical underpinnings of the approach and highlighted the first two phases of the improvement strategy. Those phases involve systematically listening to the organization's customers and using customer information to strategically target key areas for improvement. This article describes the specifics of the last four phases of the strategy; these phases involve achieving and sustaining unprecedented levels of improvement in targeted areas. Initial results and emerging lessons associated with the implementation of this strategy are summarized.

Leadership↗
PubMed1995

The inflammatory response to particulate wear debris in total hip arthroplasty.

OBJECTIVE: To identify the cell types and patterns of cell distribution associated with particulate wear debris in the membranes of patients who undergo revision of hip arthroplasty. DESIGN: Case series. SETTING: Three university-affiliated hospitals. PATIENTS: Twenty-nine patients who underwent revision of a hip arthroplasty for reasons other than infection. Eight patients were excluded because loosening of the prosthesis was found to be associated with infection, leaving 21 patients, 18 with aseptic loosening and 3 with recurrent dislocation. INTERVENTION: Retrieval of inflammatory membranes from loosened total hip prostheses. MAIN OUTCOME MEASURES: Results of aerobic and anaerobic tissue cultures, number of macrophages, T cells and B cells, and presence and histologic pattern of particulate debris in the membranes. RESULTS: None of the tissue cultures grew any organisms. All membranes contained T cells and macrophages, but B cells were present in only three patients at a low level. Particulate debris, surrounded by macrophages and foreign-body giant cells, was present in all membranes. Three histologic patterns were noted: type I--mostly fibrous tissue with cells and macrophages widely scattered through membrane (3 membranes); type II--fibrous membrane with a significant number of T cells, macrophages and foreign-body giant cells and well-defined foreign-body granulomas (7 membranes); type III--diffusely scattered T cells, ill-defined granulomas, "foamy" macrophages and fewer foreign-body giant cells than in type II (11 membranes). CONCLUSIONS: These findings document the key cellular elements involved in cell-mediated immunity in association with particulate wear debris in aseptically loosened total hip arthroplasty membranes. T-cell amplification of the innate macrophage inflammatory reaction to particulate debris may play a role in the mechanism of particle clearance.

Adult↗
PubMed1995

Oncocytic metaplasia of bile duct epithelium in hepatic GVHD.

A 15-year-old female underwent matched unrelated BMT for chemotherapy resistant ALL. She died 3 months later from septicaemia complicating grade IV GVHD. Light and electron microscopic examination of the post-mortem liver confirmed GVHD and showed oncocytic metaplasia of interlobular bile duct epithelium. We report that oncocytic metaplasia of bile duct epithelium is part of the pathological spectrum of hepatic GVHD.

Adolescent↗
PubMed1995

Generic total hip arthroplasty.

To decrease implant costs for total hip arthroplasty, a number of different options are available, including the use of remaindered implants, older designs, discounted stock, or specifically designed implants manufactured and sold at low cost. To determine the prevalence of these practices, 80 questionnaires were mailed to members of the Hip Society; 55 (79%) were completed and returned. In addition, 32 questionnaires were mailed to a representative group of orthopaedic surgeons in Canada; 29 (90%) were completed and returned. Analysis of these returns revealed that 73% of the respondents used a low-cost prosthesis for certain indications in total hip arthroplasty. No uniform policy with regard to cost containment or to the definition of low cost was apparent. In a parallel study, the results of a clinical trial with a generic hip implant in 150 patients observed for 2 years or longer revealed the general improvement in hip scores and the rate of complication to be compatible with those of other, more-expensive hip prostheses. Control of prosthetic costs as a means of influencing the cost of arthroplasty appears to be a wide-spread practice.

Aged↗
PubMed1995

Allogeneic BMT from a donor with fragile X syndrome: cytogenetic and molecular evaluation.

We report the first case of engraftment of bone marrow collected from a donor with Fragile X syndrome with subsequent cytogenetic and molecular evaluation. Engraftment was prompt and stable. Whilst the Fragile X abnormality could be detected initially by molecular techniques in the peripheral blood, it could not be detected cytogenetically while the patient was receiving CsA.

Adult↗
PubMed1994

Language and its biological context.

All reasonably functioning newborn humans learn any native language effortlessly. No other species can learn human language even with effort. Such facts indicate that young humans are similar in ways which match them to properties shared by the set of natural languages. We would expect some similarities to be found in the baby's brain and others in the surrounding environment.

Adult↗
PubMed1994

Neuromyopathic complications in a patient with anorexia nervosa and vitamin C deficiency.

A 19-year-old female patient with anorexia nervosa developed profound weight loss over 1 year associated with vegetarianism and excessive exercise. There was severe wasting and proximal muscle weakness in the legs and bilateral weakness of eye closure. A purpuric rash developed due to vitamin C deficiency. This case demonstrates a new neurological sign in anorexia nervosa indicating a weakness of the orbicularis oculi muscles as part of a more general myopathy. The myopathic and scorbutic features may have a common pathogenesis.

Adult↗