Search PubMed⌕ Search

Biomedical subjects

J Parker

Publications and source records attributed to J Parker.

At least 55 records · Page 3Linked to original sources

sucker encodes a zebrafish Endothelin-1 required for ventral pharyngeal arch development.

Mutation of sucker (suc) disrupts development of the lower jaw and other ventral cartilages in pharyngeal segments of the zebrafish head. Our sequencing, cosegregation and rescue results indicate that suc encodes an Endothelin-1 (Et-1). Like mouse and chick Et-1, suc/et-1 is expressed in a central core of arch paraxial mesoderm and in arch epithelia, both surface ectoderm and pharyngeal endoderm, but not in skeletogenic neural crest. Long before chondrogenesis, suc/et-1 mutant embryos have severe defects in ventral arch neural crest expression of dHAND, dlx2, msxE, gsc, dlx3 and EphA3 in the anterior arches. Dorsal expression patterns are unaffected. Later in development, suc/et-1 mutant embryos display defects in mesodermal and endodermal tissues of the pharynx. Ventral premyogenic condensations fail to express myoD, which correlates with a ventral muscle defect. Further, expression of shh in endoderm of the first pharyngeal pouch fails to extend as far laterally as in wild types. We use mosaic analyses to show that suc/et-1 functions nonautonomously in neural crest cells, and is thus required in the environment of postmigratory neural crest cells to specify ventral arch fates. Our mosaic analyses further show that suc/et-1 nonautonomously functions in mesendoderm for ventral arch muscle formation. Collectively our results support a model for dorsoventral patterning of the gnathostome pharyngeal arches in which Et-1 in the environment of the postmigratory cranial neural crest specifies the lower jaw and other ventral arch fates.

Amino Acid Sequence↗

An evaluation of ICNP intervention axes as terminology model components.

In this paper we evaluate selected axes of the International Classification of Nursing Practice (ICNP) as terminology model components for nursing actions by dissecting and categorizing two data sets of term phrases (Patient Care Data Set and Home Health Care Classification). Second, we critically analyze the relationships between the ICNP axes and terminology model components used to formally define procedures (including nursing actions) in SNOMED RT. Our findings demonstrate that the semantic categories represented by the ICNP intervention axes are relevant sources for terminology model components for nursing actions. In addition, our findings suggest that only minimal additions or extensions to the current semantic links of SNOMED RT are needed to support the formal definition of nursing actions such as those contained in PCDS and HHCC.

Models, Theoretical↗

Tobacco and the risk of acute leukaemia in adults.

Self-reported smoking histories were collected during face-to-face interviews with 807 patients with acute leukaemia and 1593 age- and sex-matched controls. Individuals who had smoked regularly at some time during their lives were more likely to develop acute leukaemia than those who had never smoked (odds ratio (OR) = 1.2, 95% confidence interval (CI) 1.0-1.4). The association was strongest for current smokers, defined here as smoking 2 years before diagnosis (OR = 1.4, 95% CI 1.1-1.7). With respect to the numbers of years smoked, risk estimates were raised in all groups except those who had smoked for fewer than 10 years. Similarly, the odds ratio decreased as the number of years 'stopped smoking' increased, falling to one amongst those who had given up smoking for more than 10 years. No significant linear trends were found, however, with either the numbers of years smoked or the numbers of years stopped smoking, and no significant differences were found between AML and ALL.

Acute Disease↗

Staff confidence in dealing with aggressive patients: a benchmarking exercise.

Interacting with potentially aggressive patients is a common occurrence for nurses working in psychiatric intensive care units. Although the literature highlights the need to educate staff in the prevention and management of aggression, often little, or no, training is provided by employers. This article describes a benchmarking exercise conducted in psychiatric intensive care units at two Western Australian hospitals to assess staff confidence in coping with patient aggression. Results demonstrated that staff in the hospital where regular training was undertaken were significantly more confident in dealing with aggression. Following the completion of a safe physical restraint module at the other hospital staff reported a significant increase in their level of confidence that either matched or bettered the results of their benchmark colleagues.

Adaptation, Psychological↗

Transvaginal ultrasound diagnosis of a live twin tubal ectopic pregnancy.

A case of live twin tubal ectopic pregnancy diagnosed by transvaginal ultrasound is presented. This is a rare occurrence and we have calculated the incidence to be approximately 1:125,000 pregnancies. There have been more than 100 case reports of twin tubal ectopic pregnancy but only four previous reports where two foetal heart motions have been visualized. The introduction of high-resolution transvaginal ultrasound has resulted in earlier diagnosis of ectopic pregnancy and contributed to the decrease in morbidity that has occurred over recent years.

Adult↗

[The Nucleus Double Array Cochlear Implant: a new concept in obliterated cochlea].

AIM: In order to increase the number of intracochlear electrodes to be inserted into a totally obliterated cochlea a special implant has been developed in collaboration with Cochlear Ltd. The implant features two separate electrode carriers containing 11 and 10 active electrodes, respectively, and a reference electrode on the receiver stimulator package. The potential stimulation modes include monopolar and bipolar stimulation as well as stimulation between both arrays. SURGICAL TECHNIQUE: A cochleostomy at the round window provides access to the scala tympani. Newly formed bone is removed as far as the anterior portion of the basal turn. Care is taken to identify and preserve the osseous border of the cochlea. A second cochleostomy is performed immediately caudal to the cochleariform process after removal of the incus. New tissue can be removed here in the same way. The two electrode carriers are then placed into the first and the second turn respectively. The remaining procedure corresponds to the procedure for cochlear implantation in cases in which the cochlea is not obliterated. PATIENTS: For the purpose of a clinical study n = 10 patients aged between 32-66 years with an obliterated cochlea were fitted with a double array cochlear implant. All patients showed signs of total obliteration of the basal turn either in preoperative imaging or during surgery. Intraoperative inspection revealed that the second turn was not obliterated in 4 of 10 patients. POSTOPERATIVE RESULTS: Postoperatively, a standard test battery was used to determine auditory performance over a period of time. All patients achieved significantly better speech understanding due to the additional apical electrode array. No complications occurred. CONCLUSION: In cases involving an obliterated cochlea, the number of intracochlear electrodes can be increased with the double array implant. As a result, the patients achieve significantly better auditory results.

Adult↗

Are very low birthweight births among American Indians and Alaska Natives underregistered?

BACKGROUND: International infant mortality rates vary widely. This variation has been attributed to many factors, including differential reporting. In the US, American Indians and Alaska Natives (AI/AN), who generally have low socioeconomic status, have a low neonatal mortality rate. One possible explanation is underregistration of very low birthweight (VLBW, < 1,500 g) births. We hypothesized that underregistration may occur disproportionately among AI/AN residing on or near reservations (areas controlled by an American Indian group). We estimated infant mortality in these areas. METHODS: Linked birth-infant death files for 1989-1991 were used to compare VLBW and neonatal mortality among AI/AN infants in counties with reservations with those in non-reservation counties. The VLBW rates for non-reservation counties were applied to the reservation risk distribution to calculate directly adjusted VLBW and neonatal mortality rates for reservation counties. This method assumes that greater registration in non-reservation counties yields a more accurate estimate of the relationship between risk factors and outcomes. RESULTS: Despite a higher prevalence in reservation counties of risk factors, the reported VLBW rate was 0.84% in reservation and 1.17% in non-reservation counties. The neonatal mortality rate was 5.4 per 1,000 in reservation counties and 6.0 in non-reservation counties. Direct adjustment yielded a VLBW rate of 1.28% (95% CI: 1.14-1.39) and a neonatal mortality rate of 6.7-9.8 per 1,000 in reservation counties. CONCLUSIONS: Reported neonatal mortality among AI/AN may understate the true rate due to underregistration of VLBW births. Direct adjustment may be useful in estimating infant mortality rates for populations with incomplete vital registration.

Age Distribution↗

Dose-dependent protein adduct formation in kidney, liver, and blood of rats and in human blood after perchloroethene inhalation.

Perchloroethene (PER) was a widely used solvent and is an environmental contaminant. In bioassays for carcinogenicity, PER was found to increase the incidence of liver tumors in mice and of renal tumors in male rats. Toxic effects of PER after repeated administration are likely caused by bioactivation. PER bioactivation occurs by two pathways. Oxidation by cytochrome P450 results in trichloroacetyl chloride, which binds to lipids and proteins. Glutathione S-conjugate formation from PER and further processing of the formed S-(trichlorovinyl)glutathione to S-(trichlorovinyl)-L-cysteine, followed by cysteine conjugate beta-lyase catalyzed cleavage, resulted in the reactive dichlorothioketene, which binds to proteins under formation of N epsilon-(dichloroacetyl)-L-lysine in proteins. The objective of this study was to comparatively quantify the dose-dependent formation of protein adducts from PER in rats and humans using antibodies with high specificity for either N epsilon-(trichloroacetyl)-L-lysine or N epsilon-(dichloroacetyl)-L-lysine in proteins. Male and female rats (n = 2, per concentration and time point) were exposed to 400, 40, and 10 ppm PER for 6 h and killed at various time points. Formation of N epsilon-(dichloroacetyl)-L-lysine and N epsilon-(trichloroacetyl)-L-lysine in proteins was comparatively quantified in subcellular fractions from liver and kidney and in blood. In addition, three male and three female human volunteers were exposed to 10 and 40 ppm PER, and formation of protein adducts in blood was analyzed using the antibodies and GC/MS after immunoaffinity enrichment of modified proteins. In liver and kidney subcellular fractions and blood of PER-exposed rats, dose-dependent formation of N epsilon-(dichloroacetyl)-L-lysine and N epsilon-(trichloroacetyl)-L-lysine in proteins was observed. Highest concentrations of N epsilon-(dichloroacetyl)-L-lysine in proteins were formed in kidney mitochondria, followed by kidney cytosol. Only low concentrations of N epsilon-(dichloroacetyl)-L-lysine in proteins were present in liver proteins; blood concentrations of N epsilon-(dichloroacetyl)-L-lysine in proteins were 5 to 10 fold lower than in kidney mitochondria. Highest concentrations of N epsilon-(trichloroacetyl)-L-lysine were found in microsomal and cytosolic proteins from the liver of rats exposed to PER. A higher protein adduct formation was seen in PER-exposed-male than -female rats for N epsilon-(dichloroacetyl)-L-lysine in renal mitochondrial proteins, after exposure to 400 ppm PER. In human blood samples taken 0 and 24 h after the 6 h exposures to PER, N epsilon-(trichloroacetyl)-L-lysine-containing proteins were present in low concentrations. N epsilon-(Dichloroacetyl)-L-lysine-containing proteins were not detected either by Western blotting or GC/MS after immunoaffinity chromatography. The obtained results indicate a dose-dependent covalent binding of PER metabolites to proteins in rat liver, kidney, and blood and suggest that the concentration of covalent protein adducts is much lower in blood of humans as compared to the blood of rats exposed under identical conditions.

Adult↗

Microlaparoscopic left upper quadrant entry in patients at high risk of periumbilical adhesions.

We performed a prospective study of microlaparoscopic direct entry in the left upper quadrant (LUQ) to determine the efficacy of this technique and the incidence and site of anterior abdominal wall adhesions in high-risk patients. Direct insertion of the MiniPort introducer was successful with 1 attempt in 16 patients and in 2 attempts with 1 patient. Overall, 12 patients (71%) had either bowel or omentum adherent to the anterior abdominal wall. Eight of the 12 patients (75%) with a previous midline abdominal wall incision were found to have subumbilical adhesions. Two patients were noted to have LUQ omental adhesions. Direct insertion of a 2 mm microlaparoscopic primary port in the LUQ appears to be simple, safe and quick to perform. It provides an excellent view of the peritoneal surface of the anterior abdominal wall and umbilical area. This procedure is likely to be the preferred method of peritoneal entry in high-risk patients in the future.

Abdominal Muscles↗