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K Morris

Publications and source records attributed to K Morris.

At least 37 records · Page 2Linked to original sources
PubMed2001

Multimodality image-guided epilepsy surgery.

Co-registration of imaging modalities in the diagnosis of epilepsy is now commonly used in major epilepsy centres. However, the incorporation of these registrations into an image-guided system has only recently been developed. Using techniques of segmentation, surface matching and/or voxel-based matching, we have been able to co-register FLAIR MRI, SPECT, PET, and subdural grids into the 3-D space of the volumetric MRI and use these images on the StealthStation Image-Guided System to resect these foci. This greatly aids the surgeon in performing a more precise tailoring of the cortical resection so as to maximize the excision of the epileptogenic zone while minimizing the impact on eloquent cortex and epileptogenic foci.

Adult↗
PubMed2001

Integrative noetic therapies as adjuncts to percutaneous intervention during unstable coronary syndromes: Monitoring and Actualization of Noetic Training (MANTRA) feasibility pilot.

BACKGROUND: Patients undergoing percutaneous coronary intervention (PCI) for unstable coronary syndromes have substantial emotional and spiritual distress that may promote procedural complications. Noetic (nonpharmacologic) therapies may reduce anxiety, pain and distress, enhance the efficacy of pharmacologic agents, or affect short- and long-term procedural outcomes. METHODS: The Monitoring and Actualization of Noetic Training (MANTRA) pilot study examined the feasibility of applying 4 noetic therapies-stress relaxation, imagery, touch therapy, and prayer-to patients in the setting of acute coronary interventions. Eligible patients had acute coronary syndromes and invasive angiography or PCI. Patients were randomized across 5 treatment groups: the 4 noetic and standard therapies. Questionnaires completed before PCI reflected patients' religious beliefs and anxiety. Index hospitalization end points included post-PCI ischemia, death, myocardial infarction, heart failure, and urgent revascularization. Mortality was followed up for 6 months after hospitalization. RESULTS: Of eligible patients, 88% gave informed consent. Of 150 patients enrolled, 120 were assigned to noetic therapy; 118 (98%) completed their therapeutic assignments. All clinical end points were available for 100% of patients. Results were not statistically significant for any outcomes comparisons. There was a 25% to 30% absolute reduction in adverse periprocedural outcomes in patients treated with any noetic therapy compared with standard therapy. The lowest absolute complication rates were observed in patients assigned to off-site prayer. All mortality by 6-month follow-up was in the noetic therapies group. In patients with questionnaire scores indicating a high level of spiritual belief, a high level of personal spiritual activity, a low level of community-based religious involvement, or a high level of anxiety, noetic therapies appeared to show greater reduction in absolute in-hospital complication rates compared with standard therapy. CONCLUSIONS: Acceptance of noetic adjuncts to invasive therapy for acute coronary syndromes was excellent, and logistics were feasible. No outcomes differences were significant; however, index hospitalization data consistently suggested a therapeutic benefit with noetic therapy. Of all noetic therapies, off-site intercessory prayer had the lowest short- and long-term absolute complication rates. Definitive demonstration of treatment effects of this magnitude would be feasible in a patient population about 4 times that of this pilot study. Absolute mortality differences make safety considerations a mandatory feature of future clinical trials in this area.

Angioplasty, Balloon, Coronary↗
PubMed2001

Modeling of powder blending using on-line near-infrared measurements.

A model to quantify the degree of mixing in pharmaceutical powder mixing operations was developed. The additive volume mixing model is based on the determination of the characteristic volume of agitation for a given blender, which is dependent on process parameters such as the formulation ingredients, the geometry of the mixer, and the batch load. The calculation of this characteristic volume of agitation is based on the determination of the fitted fraction of formulation mixed after the first blender rotation. A variation of this model, denominated the iterative mixing model, was also developed. On-line near-infrared (NIR) measurements were taken throughout the runs to obtain the mixing profile and the dynamics of the powder bed as a function of blender rotations. Studies were conducted at two scales using two different formulations to study and compare the calculated characteristic volume of agitation for each blender-formulation system. This approach elucidates the existing relationship between the characteristic mixing parameters and critical rotations (required rotations to achieve content uniformity) for a given system and represents a step toward scale-up of solids mixing operations.

Algorithms↗
PubMed2001

Three-year survey of bacteremia and fungemia in a pediatric intensive care unit.

BACKGROUND: Knowledge of the pattern of blood stream infection (BSI) in patients in intensive care units (ICUs) can help determine antibiotic prescribing policy and infection control procedures. However, there have been few pediatric-based studies. METHODS: Surveillance of BSI in a pediatric ICU for 3 years, amounting to 131 episodes of significant bacteremia and fungemia. RESULTS: The incidence of BSI was 39.0 per 1,000 admissions (10.6 per 1,000 bed days). Eighty-four (64.1%) episodes were ICU-acquired, and 27 (20.6%) were community-acquired. Gram-positive, Gram-negative and anaerobic bacteria accounted for 62.2, 30.8 and 1.4%, respectively, of the 143 microorganisms isolated, 5.6% were yeasts. Neisseria meningitidis was the most common species in community-acquired infections, and staphylococci predominated in hospital-acquired episodes. Eighty-seven percent of patients had significant underlying disease, including 60.3% with congenitally acquired conditions. Intravascular devices were the most common source of infection, accounting for 41.2% of all episodes. The crude mortality in children with BSI was 26.5%, compared with 8.1% in those without BSI. CONCLUSIONS: The pattern of BSI in ICUs is partly determined by the type of patient treated. However, some observations are generally applicable, notably the increasing importance of antibiotic-resistant bacteria that are often of low virulence and device-associated. Our experience suggests that universal use of broad spectrum empiric antibiotics to cover these pathogens (which risks further promoting antibiotic resistance) may not improve patient outcome. Our study provides a basis for other pediatric ICUs to evaluate their rates and outcomes of BSI.

Adolescent↗
PubMed2001

Ultraviolet-B exposure leads to up-regulation of senescence-associated genes in Arabidopsis thaliana.

Exposure to UV-B radiation resulted in a loss of chlorophyll and an increase in lipid damage in a similar manner to that induced during natural senescence. In addition, exposure to UV-B led to the induction of a number of genes associated with senescence (SAG12, 13, 14, and 17). These results show, for the first time, that exposure to UV-B can lead to cellular decline through active and regulated processes involving many genes also associated with natural senescence.

Arabidopsis↗
PubMed2000

High direct estimate of the mutation rate in the mitochondrial genome of Caenorhabditis elegans.

Mutations in the mitochondrial genome have been implicated in numerous human genetic disorders and offer important data for phylogenetic, forensic, and population genetic studies. Using a long-term series of Caenorhabditis elegans mutation accumulation lines, we performed a wide-scale screen for mutations in the mitochondrial genome that revealed a mutation rate that is two orders of magnitude higher than previous indirect estimates, a highly biased mutational spectrum, multiple mutations affecting coding function, as well as mutational hotspots at homopolymeric nucleotide stretches.

Amino Acid Substitution↗
PubMed2000

Ciprofibrate therapy improves endothelial function and reduces postprandial lipemia and oxidative stress in type 2 diabetes mellitus.

BACKGROUND: Exaggerated postprandial lipemia (PPL) is a factor in atherogenesis, involving endothelial dysfunction and enhanced oxidative stress. We examined the effect of ciprofibrate therapy on these parameters in type 2 diabetes mellitus. METHODS AND RESULTS: Twenty patients entered a 3-month, double-blind, placebo-controlled study. Each subject was studied fasting and after a fatty meal, at baseline, and after 3 months of treatment. Glucose and lipid profiles were measured over an 8-hour postprandial period. Endothelial function (flow-mediated endothelium-dependent vasodilatation [FMD]) and oxidative stress (electron paramagnetic resonance spectroscopy) were measured after fasting and 4 hours postprandially. At baseline, both groups exhibited similar PPL and deterioration in endothelial function. After ciprofibrate, fasting and postprandial FMD values were significantly higher (from 3.8+/-1. 8% and 1.8+/-1.3% to 4.8+/-1.1% and 3.4+/-1.1%; P<0.05). This was mirrored by a fall in fasting and postprandial triglycerides (3. 1+/-2.1 and 6.6+/-4.1 mmol/L to 1.5+/-0.8 and 2.8+/-1.3 mmol/L, P<0. 05). Fasting and postprandial HDL cholesterol was also elevated (0. 9+/-0.1 and 0.8+/-0.1 mmol/L and 1.2+/-0.2 and 1.2+/-0.1 mmol/L, P<0. 05). There were no changes in total or LDL cholesterol. Fasting and postprandial triglyceride enrichment of all lipoproteins was attenuated, with cholesterol depletion of VLDL and enrichment of HDL. There were similar postprandial increases in oxidative stress in both groups at baseline, which was significantly attenuated by ciprofibrate (0.3+/-0.6 versus 1.5+/-1.1 U, P<0.05). CONCLUSIONS: This study demonstrates that fibrate therapy improves fasting and postprandial endothelial function in type 2 diabetes. Attenuation of PPL and the associated oxidative stress, with increased HDL cholesterol levels, may be important.

Adult↗
PubMed2000

Support for linkage of autism and specific language impairment to 7q3 from two chromosome rearrangements involving band 7q31.

Childhood autism is characterised by impairments in communication and reciprocal social interaction together with restricted/stereotyped interests, which are evident before 3 years of age. Specific developmental disorders of speech and language (SDDSL) are characterised by impairment in the development of expressive and/or receptive language skills which is not associated with intellectual, sensory, physical, or neurological impairment. Family and twin studies indicate a substantial genetic component in the aetiology of both disorders. They also reveal increased rates of SDDSL in relatives of autistic individuals, suggesting that this phenotype can represent one manifestation of the genetic liability for autism. Modelling of the recurrence risk for autism and milder phenotypes, such as SDDSL, suggest that three or four epistatic loci may be aetiologically involved. A recently published linkage study of an exceptional family with an apparently dominantly inherited SDDSL implicated chromosome band 7q31 as the site of the putative susceptibility locus (SPCH1). This region of chromosome 7 also shows strong linkage in multiplex families with autism. We present two individuals (one has autism, the other SDDSL) with different, apparently balanced chromosome rearrangements involving a breakpoint at 7q31.3. Fluorescence in situ hybridisation was used to localise the breakpoints to an approximately 1 cM interval between CFTR and D7S643. Our findings may be of interest and relevance to the genetic aetiology of autism, and helpful in the search for susceptibility loci for SDDSL and autism. Am. J. Med. Genet. (Neuropsychiatr. Genet. ) 96:228-234, 2000.

Autistic Disorder↗
PubMed2000

Comparison and reproducibility of fast and conventional spoiled gradient-echo magnetic resonance sequences in the determination of knee cartilage volume.

Quantitation of articular cartilage by magnetic resonance imaging and three-dimensional reconstruction has been validated and is likely to be a useful outcome measure in clinical trials of arthritis. The cost of magnetic resonance imaging is largely dependent on scanning time. The aim of this study was to compare a fast spoiled gradient-echo sequence magnetic resonance imaging scanning protocol, which takes 5 minutes and 44 seconds, with the standard, previously validated spoiled gradient-echo sequence protocol, which takes 11 minutes and 56 seconds, in the measurement of knee cartilage volume. Cartilage volumes calculated from the standard and fast magnetic resonance imaging sequences were similar. The median absolute percentage overestimation or underestimation of the cartilage volume with the fast sequence for 10 normal subjects was 2.5, 4.1, and 3.2% for patellar, femoral, and tibial cartilage, respectively. For eight subjects with osteoarthritis, the percentages were 4.3 and 3.9% for femoral and tibial cartilage, respectively. The fast spoiled gradient-echo sequence protocol had very high intra-rater and inter-rater reproducibility in normal subjects and in those with osteoarthritis. Because the cost of magnetic resonance imaging scanning is largely determined by scan time, the faster scanning protocol means that the cost of estimates of knee cartilage volume can be significantly reduced, thus increasing the feasibility of this methodology.

Adult↗