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Biomedical subjects

L R Young

Publications and source records attributed to L R Young.

At least 19 recordsLinked to original sources
PubMed2000

Quality of pharmacotherapy consultations provided by drug information centers in the United States.

We evaluated the performance of 116 U.S. drug information centers in responding to specific questions about drugs. The primary measures were correctness of responses and extent of probing for patient data. Questions addressed the effect of ranitidine on blood alcohol concentrations, the potential interaction between didanosine and dapsone, prevention of nonsteroidal antiinflammatory drug (NSAID)-induced peptic ulcers, and use of erythromycin for diabetic gastroparesis. The percentages of centers providing correct overall responses were 70% for the ranitidine question, 90% for the didanosine-dapsone question, 8% for the NSAID question, and 20% for the erythromycin question. For the three patient-specific questions, the percentages of centers eliciting vital patient data were 27% for the didanosine-dapsone question, 86% for the NSAID question, and 5% for the erythromycin question. In providing pharmacotherapy consultations, drug information centers generally failed to obtain pertinent patient data, thereby risking incorrect responses and inappropriate recommendations.

Drug Information Services↗
PubMed2000

Vestibular reactions to spaceflight: human factors issues.

Vestibular function, along with other sensory systems influencing spatial orientation, can have a profound influence on the ability of astronauts to function effectively. Beyond the well-known problems of space motion sickness, vestibular effects can influence astronaut well-being and performance during all phases of a space mission. This paper discusses some of the major vestibular reactions affecting human factors encountered in all space missions, and covers them chronologically in the following sequence: launch, early on-orbit, late on-orbit, EVA, artificial gravity, re-entry, and post-landing.

Aerospace Medicine↗
PubMed2000

Parkinson's disease: focus on management alternatives.

AUDIENCE: This activity is designed for physicians, pharmacists, nurses, health planners, directors of managed care organizations, and payers of health services. GOAL: To understand the impact that Parkinson's disease has on patients and to identify areas of drug therapy that can be optimized to improve a patient's quality of life. OBJECTIVES: 1. Discuss the epidemiology and pathophysiology of idiopathic Parkinson's disease (IPD). 2. Identify causes of secondary parkinsonism and medications associated with drug-induced parkinsonism. 3. Discuss the cardinal and secondary manifestations of IPD. 4. Outline the 6 stages of IPD. 5. Identify therapeutic alternatives for various levodopa treatment failures. 6. Identify the 3 newer antiparkinson agents and state their mechanisms of action, common adverse effects, drug interactions, and appropriate use. 7. Identify the appropriate use, common adverse effects, and drug interactions of dopamine agonists, anticholinergic agents, monoamine oxidase inhibitors, and catechol-O-methyltransferase inhibitors in Parkinson's disease therapy.

Activities of Daily Living↗
PubMed2000

Effectiveness of an expert system for astronaut assistance on a sleep experiment.

BACKGROUND: Principal Investigator-in-a-Box ([PI]) is an expert system designed to train and assist astronauts with the performance of an experiment outside their field of expertise, particularly when contact with the Principal Investigators on the ground is limited or impossible. In the current case, [PI] was designed to assist with the calibration and troubleshooting procedures of the Neurolab Sleep and Respiration Experiment. [PI] displays physiological signals in real time during the pre-sleep instrumentation period, alerts the astronauts when a poor signal quality is detected, and displays steps to improve quality. METHODS: Two studies are presented in this paper. In the first study 12 subjects monitored a set of prerecorded physiological signals and attempted to identify any signal artifacts appearing on the computer screen. Every subject performed the experiment twice, once with the assistance of [PI] and once without. The second part of this study focuses on the postflight analysis of the data gathered from the Neurolab Mission. After replaying the physiological signals on the ground, the frequency of correct [PI] alerts and false alarms (i.e., incorrect diagnoses by the expert system) was determined in order to assess the robustness and accuracy of the rules. CONCLUSIONS: Results of the ground study indicated a beneficial effect of [PI] and training in reducing anomaly detection time and the number of undetected anomalies. For the in-flight performance, excluding the saturated signals, the expert system had an 84% detection accuracy, and the questionnaires filled out by the astronauts showed positive crew reactions to the expert system.

Adult↗
PubMed1999

Artificial gravity considerations for a mars exploration mission.

Artificial gravity (AG), as a means of preventing physiological deconditioning of astronauts during long-duration space flights, presents certain special challenges to the otolith organs and the adaptive capabilities of the CNS. The key issues regarding the choice of AG acceleration, radius, and rotation rate are reviewed from the viewpoints of physiological requirements and human factors disturbances. Head movements and resultant Coriolis forces on the rotating platform may limit the usefulness of economical short centrifuges for other than brief periods of intermittent stimulation.

Aerospace Medicine↗
PubMed1999

The use of a postoperative morbidity survey to evaluate patients with prolonged hospitalization after routine, moderate-risk, elective surgery.

UNLABELLED: Vital healthcare resources are devoted to caring for patients with prolonged hospitalization after routine, moderate-risk surgery. Despite the significant cost, little is known about the overall incidence and pattern of complications in these patients. Four hundred thirty-eight patients undergoing a diverse group of routine, moderate-risk, elective surgical procedures were enrolled into a prospective, blinded, cohort study. Complications were assessed using a postoperative morbidity survey. The main outcome was postoperative complication, defined as either in-hospital death or prolonged postoperative hospitalization (> 7 days). The mortality rate was 1.6%. Postoperative complications occurred in 118 patients (27% [95% CI 23-31]). Complications frequently observed in these patients included: gastrointestinal 51% (42-60), pulmonary 25% (17-33), renal 21% (14-28), and infectious 13% (7-19). Most complications were not directly related to the type/site of surgery. Indices of tissue trauma (blood loss [P < 0.001], surgical duration [P = 0.001]) and tissue perfusion (arterial base deficit [P = 0.008], gastric pHi [P = 0.02]) were the strongest intraoperative predictors of complications. Despite a low mortality rate, we found that complications after routine, moderate-risk, elective surgery are common and involve multiple organ systems. Our 9-point survey can be used by healthcare providers and payers to characterize post-operative morbidity in their respective settings. IMPLICATIONS: Little is known about the overall incidence and pattern of complications in patients with prolonged hospitalization after routine, elective surgery. We prospectively assessed these complications using a novel postoperative morbidity survey. The postoperative morbidity survey can be used in future clinical outcome trials, as well as in routine hospital-based quality assurance.

Data Collection↗
PubMed1999

Neutrophil elastase increases MUC5AC mRNA and protein expression in respiratory epithelial cells.

Chronic neutrophil-predominant inflammation and hypersecretion of mucus are common pathophysiological features of cystic fibrosis, chronic bronchitis, and viral- or pollution-triggered asthma. Neutrophils release elastase, a serine protease, that causes increased mucin production and secretion. The molecular mechanisms of elastase-induced mucin production are unknown. We hypothesized that as part of this mechanism, elastase upregulates expression of a major respiratory mucin gene, MUC5AC. A549, a human lung carcinoma cell line that expresses MUC5AC mRNA and protein, and normal human bronchial epithelial cells in an air-liquid interface culture were stimulated with neutrophil elastase. Neutrophil elastase increased MUC5AC mRNA levels in a time-dependent manner in both cell culture systems. Neutrophil elastase treatment also increased MUC5AC protein levels in A549 cells. The mechanism of MUC5AC gene regulation by elastase was determined in A549 cells. The induction of MUC5AC gene expression required serine protease activity; other classes of proteases had no effect on MUC5AC gene expression. Neutrophil elastase increased MUC5AC mRNA levels by enhancing mRNA stability. This is the first report of mucin gene regulation by this mechanism.

Adenocarcinoma↗
PubMed1998

Spaceflight influences on ocular counterrolling and other neurovestibular reactions.

Exposure to extended periods of weightlessness in orbital flight has profound effects on the neurovestibular system and influences head and eye movements, postural control, and spatial orientation. The associated space motion sickness is among the earliest of the signs of adaptation to this new environment. This report both reviews the prominent neurovestibular phenomena associated with going into space and returning to earth and relates the issues to vestibular compensation and rehabilitation. New results from the Spacelab SLS-2 mission are included, showing significant reductions in postflight ocular counterrolling and changes in ocular counterrolling left/right asymmetries after 2 weeks in space.

Humans↗
PubMed1996

The dynamic contributions of the otolith organs to human ocular torsion.

We measured human ocular torsion (OT) monocularly (using video) and binocularly (using search coils) while sinusoidally accelerating (0.7 g) five human subjects along an earth-horizontal axis at five frequencies (0.35, 0.4, 0.5, 0.75, and 1.0 Hz). The compensatory nature of OT was investigated by changing the relative orientation of the dynamic (linear acceleration) and static (gravitational) cues. Four subject orientations were investigated: (1) Y-upright-acceleration along the interaural (y) axis while upright; (2) Y-supine-acceleration along the y-axis while supine; (3) Z-RED-acceleration along the dorsoventral (z) axis with right ear down; (4) Z-supine-acceleration along the z-axis while supine. Linear acceleration in the Y-upright, Y-supine and Z-RED orientations elicited conjugate OT. The smaller response in the Z-supine orientation appeared disconjugate. The amplitude of the response decreased and the phase lag increased with increasing frequency for each orientation. This frequency dependence does not match the frequency response of the regular or irregular afferent otolith neurons; therefore the response dynamics cannot be explained by simple peripheral mechanisms. The Y-upright responses were larger than the Y-supine responses (P < 0.05). This difference indicates that OT must be more complicated than a simple low-pass filtered response to interaural shear force, since the dynamic shear force along the interaural axis was identical in these two orientations. The Y-supine responses were, in turn, larger than the Z-RED responses (P < 0.01). Interestingly, the vector sum of the Y-supine responses plus Z-RED responses was not significantly different (P = 0.99) from the Y-upright responses. This suggests that, in this frequency range, the conjugate OT response during Y-upright stimulation might be composed of two components: (1) a response to shear force along the y-axis (as in Y-supine stimulation), and (2) a response to roll tilt of gravitoinertial force (as in Z-RED stimulation).

Acceleration↗
PubMed1996

Tactile influences on astronaut visual spatial orientation: human neurovestibular studies on SLS-2.

Human spatial orientation in spaceflight is initially disturbed by the absence of usable graviceptor information from the otolithic organs. Experiments measuring astronaut visually induced motion (vection) strength on various flight days during the first 10 days of the Spacelab Life Sciences-2 mission demonstrated two new phenomena in addition to confirming the initial increased weighting of visual and localized tactile cues. The reliance on tactile and visual noninertial cues apparently declined after a week in space, as the crew became able to utilize their internal reference frame. Subjects also showed that even nondirectional tactile cues served as a direction anchor and inhibited visually induced roll sensation relative to a new loosely tethered test condition. Individual perceptual styles were again revealed among the four astronauts tested. The readaptation to 1 G similarly shows a period of reinterpretation of inertial and visual cues to spatial orientation. The results are discussed in terms of an internal-model representation of body orientation, with time-varying weights applied to extrinsic and intrinsic signals.

Adult↗
PubMed1995

The vestibulo-ocular reflex of the squirrel monkey during eccentric rotation and roll tilt.

The vestibulo-ocular reflexes (VOR) are determined not only by angular acceleration, but also by the presence of gravity and linear acceleration. This phenomenon was studied by measuring three-dimensional nystagmic eye movements, with implanted search coils, in six male squirrel monkeys during eccentric rotation. Monkeys were rotated in the dark at a constant velocity of 200 degrees/s (centrally or 79 cm off axis) with the axis of rotation always aligned with gravity and the spinal axis of the upright monkeys. The monkey's orientation (facing-motion or back-to-motion) had a dramatic influence on the VOR. These experiments show that: (a) the axis of eye rotation always shifted toward alignment with gravito-inertial force; (b) the peak value of horizontal slow phase eye velocity was greater with the monkey facing-motion than with back-to-motion; and (c) the time constant of horizontal eye movement decay was smaller with the monkey facing-motion than with back-to-motion. All of these findings were statistically significant and consistent across monkeys. In another set of tests, the same monkeys were rapidly tilted about their naso-occipital (roll) axis. Tilted orientations of 45 degrees and 90 degrees were maintained for 1 min. Other than a compensatory angular VOR during the angular rotation, no consistent eye velocity response was observed during or following the tilt for any of the six monkeys. The absence of any eye movement response following tilt weighs against the possibility that translational linear VOR responses are due to simple high-pass filtering of the otolith signals. The VOR response during eccentric rotation was divided into the more familiar angular VOR and linear VOR components. The angular component is known to depend upon semicircular canal dynamics and central influences. The linear component of the response decays rapidly with a mean duration of only 6.6 s, while the axis of eye rotation rapidly aligns (< 10 s) with gravito-inertial force. These results are consistent with the hypothesis that the measurement of gravito-inertial force by the otolith organs is resolved into central estimates of linear acceleration and gravity, such that the central estimate of gravitational force minus the central estimate of linear acceleration approximately equals the otolith measurement of gravito-inertial force.

Acceleration↗
PubMed1995

Portion sizes in dietary assessment: issues and policy implications.

Accurate estimates of energy and nutrient intake of individuals and populations are contingent on the reliability of information obtained about food intake, food composition, and portion size. This article reviews issues related to the definition, determination, and use of portion sizes in dietary assessment and public education.

Eating↗
PubMed1994

Perceptual and eye movement responses elicited by linear acceleration following spaceflight.

Responses of four crewmembers were measured before and after a 9-d Spacelab Mission during inter-aural (y-axis) and longitudinal (z-axis) linear acceleration. During one test, eye movements were recorded with simultaneous sinusoidal acceleration and constant-velocity optokinetic stimulation. Postflight responses indicated changes in the horizontal sinusoidal response during the y-axis trials. In another test, subjects indicated direction of acceleration during a series of low acceleration steps. More incorrect direction indications were observed postflight, and the y-axis sensitivity increased while the z-axis sensitivity decreased for three subjects. In a third test, subjects used a joystick to null pseudo-random linear motion. Not one subject showed a significantly enhanced ability to null linear motion in the y-axis, while two subjects showed an enhanced ability during z-axis testing postflight. Oculomotor and perceptual responses to linear acceleration are modified by exposure to microgravity and become more variable postflight. The observed changes may be due to an altered interpretation of inertial cues in space that is inappropriate postflight.

Acceleration↗
PubMed1994

The interaction of otolith organ stimulation and smooth pursuit tracking.

The interaction of otolith organ stimulation and horizontal pursuit eye tracking in humans was studied in two different paradigms. In the first we measured the effects of lateral linear acceleration on ocular tracking of a retinal after-image, as compared to eye movements produced by acceleration alone (the linear VOR). The second paradigm determined the improvement in smooth oculomotor tracking presumably due to otolith input, by comparing tracking of an earth-fixed target during subject motion to tracking of target motion with the subject stationary. Subject and target motions in each case were sinusoidal. After-image tracking enhanced the gain of the linear VOR by a factor of 2 to 10. This is interpreted to mean that oculomotor efferent copy information is used to reconstruct an internal representation of target velocity, which is then tracked by the oculomotor system in the after-image condition. In the second paradigm, linear motion information transduced by the otolith organs combined with visual target information to yield improved oculomotor tracking over either system alone.

Adult↗