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Biomedical subjects

M B Wallace

Publications and source records attributed to M B Wallace.

47 records · Page 3Linked to original sources
PubMed1998

Is colonoscopy indicated for small adenomas found by screening flexible sigmoidoscopy?

BACKGROUND: There is controversy over whether patients who have a small tubular adenoma on screening flexible sigmoidoscopy should undergo colonoscopic examination of the proximal colon. OBJECTIVE: To prospectively determine the prevalence of advanced polyps in the proximal colon among patients who have small adenomas on screening sigmoidoscopy. DESIGN: Prospective cohort study. SETTING: A health maintenance organization and a Veterans Affairs medical center. PATIENTS: Asymptomatic patients older than 50 years of age who had no risk factors for colon cancer and underwent sigmoidoscopy. INTERVENTION: At the time of sigmoidoscopy, all polyps were biopsied and characterized. All patients with distal adenomas were offered colonoscopy. MEASUREMENTS: The size and histology of polyps identified by sigmoidoscopy and colonoscopy were noted. Polyps were considered advanced if they were larger than 10 mm or were tubulovillous, villous, or malignant. The prevalence of advanced proximal polyps was determined, and patients were stratified by the size and number of distal polyps found by sigmoidoscopy. RESULTS: Among 4490 patients who underwent sigmoidoscopy, a neoplastic lesion was detected in 401 (8.9%) and colonoscopy was done in 301 (75%). Of 90 patients with a single tubular adenoma 1 to 5 mm in diameter in the distal colon, 0% (95% CI, 0.0% to 4.0%) had an advanced proximal polyp compared with 5.4% (CI, 2.4% to 10.4%) of those who had multiple distal polyps 1 to 5 mm or 6 to 10 mm in diameter and 7.9% (CI, 2.6% to 17.6%) of those who had advanced distal polyps (P = 0.013 for trend). The low-risk group with a single tubular adenoma 1 to 5 mm in diameter represented 44% of all patients with distal adenomas or cancers found at flexible sigmoidoscopy. CONCLUSIONS: Among patients undergoing screening sigmoidoscopy, those with single tubular adenomas of 5 mm or less had a low prevalence of advanced proximal polyps. These patients may not benefit from colonoscopy.

Adenoma↗
PubMed1998

Structure-based design, synthesis, and biological evaluation of irreversible human rhinovirus 3C protease inhibitors. 1. Michael acceptor structure-activity studies.

The structure-based design, chemical synthesis, and biological evaluation of peptide-derived human rhinovirus (HRV) 3C protease (3CP) inhibitors are described. These compounds incorporate various Michael acceptor moieties and are shown to irreversibly bind to HRV serotype 14 3CP with inhibition activities (kobs/[I]) ranging from 100 to 600 000 M-1 s-1. These inhibitors are also shown to exhibit antiviral activity when tested against HRV-14-infected H1-HeLa cells with EC50's approaching 0.50 microM. Extensive structure-activity relationships developed by Michael acceptor alteration are reported along with the evaluation of several compounds against HRV serotypes other than 14. A 2.0 A crystal structure of a peptide-derived inhibitor complexed with HRV-2 3CP is also detailed.

3C Viral Proteases↗
PubMed1998

Structure-based design, synthesis, and biological evaluation of irreversible human rhinovirus 3C protease inhibitors. 2. Peptide structure-activity studies.

The structure-based design, chemical synthesis, and biological evaluation of various peptide-derived human rhinovirus (HRV) 3C protease (3CP) inhibitors are described. These compounds are comprised of an ethyl propenoate Michael acceptor moiety and a tripeptidyl binding determinant. The systematic modification of each amino acid residue present in the binding determinant as well as the N-terminal functionality is described. Such modifications are shown to provide irreversible HRV-14 3CP inhibitors with anti-3CP activities (kobs/[I]) ranging from 60 to 280 000 M-1 s-1 and antiviral EC50's which approach 0.15 microM. An optimized inhibitor which incorporates several improvements identified by the structure-activity studies is also described. This molecule displays very rapid irreversible inhibition of HRV-14 3CP (kobs/[I] = 800 000 M-1 s-1) and potent antiviral activity against HRV-14 in cell culture (EC50 = 0.056 microM). A 1.9 A crystal structure of an S-alkylthiocarbamate-containing inhibitor complexed with HRV-2 3CP is also detailed.

3C Viral Proteases↗
PubMed1997

Effects of cross-training on markers of insulin resistance/hyperinsulinemia.

This study examined, through a randomized controlled trial, the effects of cross-training (combined resistance and endurance exercise) on markers of insulin resistance, (e.g., dyslipidemia, intra-abdominal obesity, hyperinsulinemia, and hypertension), body composition, and performance in hyperinsulinemic individuals. Sedentary adult males characterized as hyperinsulinemic (fasting insulin > 2 OuU.mL-1), randomly assigned to two groups (N = 8 each), completed 14 wk of training at 3 d.wk-1. An endurance-only (E) group performed both continuous cycle exercise and walking (30 min each at 60-70% heart rate reserve). A cross-training (C) group performed both endurance and resistance exercise (8 exercises, 4 sets/exercise, 8-12 repetitions/set) in a single session. Both E and C groups demonstrated similar increases in VO2max (25% and 27%) while only C demonstrated an increase in 1 RM bench press (19%) and leg press (25%). The changes induced by C training were significantly greater than those from E training alone in percent fat (6.9 +/- 1.3 vs 1.4 +/- 1.4), insulin concentration (8.5 +/- 2.7 vs 3.0 +/- 1.3 uU.mL-1), glucose levels (11.1 +/- 2.9 vs 5.9 +/- 2.6 mg.dL-1), HDL-C levels (5.1 +/- 1.3 vs 2.9 +/- 1.6 mg.dL-1), triglyceride concentration (43.8 +/- 13.6 mg.dL-1), and systolic blood pressure (14.6 +/- 5.5 vs 8.3 +/- 6.8 mm Hg). Results indicate that the addition of resistance training to an endurance training program will induce significantly greater differences in markers of insulin resistance and body composition in individuals with hyperinsulinemia than endurance training alone.

Adult↗
PubMed1995

Continued benefit of lovastatin in the treatment of hypercholesterolemia in 36 patients.

After one year of treatment, low-dose (20 mg/d) lovastatin achieved continued efficacy without tachyphylaxis in 36 patients with Type IIa or IIb hyperlipoproteinemia. Six week and one year reductions in low density lipoprotein (LDL) cholesterol were significant at 33% and 31% in these patients respectively; reductions in total cholesterol were also significant at 25% and 22% respectively. Increases in high density lipoprotein cholesterol (HDL) were 6% at six weeks and 10% at one year; triglycerides were reduced 16% and 11% respectively. The cholesterol lowering effects were similar for males and females (23% and 21% respectively). Low-dose lovastatin (20 mg/d) is a good choice for reducing cholesterol in patients with primary Type IIa or IIb hyperlipoproteinemia refractory to diet therapy because it is effective in lowering LDL-cholesterol, while raising HDL-cholesterol with few side effects and without tachyphylaxis.

Aged↗
PubMed1994

Cross-correlation analysis of cuneothalamic interactions in the rat somatosensory system: influence of receptive field topography and comparisons with thalamocortical interactions.

1. We simultaneously recorded neuronal responses to cutaneous stimulation from matched somatotopic representations in the nucleus cuneatus and ventrobasal complex of intact, halothane-anesthetized rats. A total of 95 cuneate and 86 thalamic neurons representing hairy skin on the forelimb were activated by hair movements produced by air jets at multiple skin sites. Mean responsiveness was higher among neurons in nucleus cuneatus (34.4 spikes per stimulus) than in thalamus (23.7 spikes per stimulus), a result that was consistent with the greater proportion of "sustained" responses recorded in nucleus cuneatus (80%) than in the thalamus (62%). 2. Cross-correlation analysis of 166 pairs of cuneate and thalamic neurons showed that 56 neuron pairs displayed time-locked correlations in activity that were characterized primarily by excitatory interactions (44 pairs) or a combination of excitatory and inhibitory interactions (10 pairs). Unilateral interactions in the cuneothalamic direction (31 pairs) and reverse direction (11 pairs) were observed, as well as multiphasic interactions in both directions (14 pairs). Most excitatory interactions involved intervals of 1-7 ms between successive cuneate and thalamic discharges, whereas most inhibitory influences involved intervals > 7 ms. Connection strength, defined by the ratio of time-linked interactions to the number of cuneate discharges, varied widely among neuron pairs but was largest for interactions involving interspike intervals of < or = 15 ms. 3. The relationship between connection strength and receptive field topography was analyzed in 103 cuneate-thalamic neuron pairs. The region of skin shared by both neurons varied substantially among neuron pairs and the probability of detecting interactions increased proportionately with larger amounts of receptive field overlap. Neuron pairs with moderate (25-50%) amounts of receptive field overlap had connection strengths 3-4 times greater than neuron pairs with minimal (0-25%) overlap. Connection strength was essentially identical, however, for neuron pairs with moderate or large (> 50%) amounts of overlap. 4. Cuneate-thalamic neuron pairs displaying functional connections were usually tested at multiple peripheral sites, but only 37% (18 of 49) of these neuron pairs displayed interactions at more than one stimulation site. Stimulation at different sites altered the timing of interactions in seven neuron pairs, including three that showed timing shifts across time zero in the cross-correlation histogram. In neuron pairs displaying interactions at multiple sites, connection strengths for 67% of the cases were strongest when stimulation was delivered within the region of receptive field overlap.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1993

Thalamocortical interactions in the somatosensory system: interpretations of latency and cross-correlation analyses.

1. Isolated extracellular neuronal responses to cutaneous stimulation were simultaneously recorded from corresponding peripheral representations in the ventrobasal nucleus and primary somatosensory cortex of intact, halothane-anesthetized rats. Thalamic and cortical neurons representing hairy skin on the forelimb were activated by hair movements produced by a series of 50 or 100 discrete air jets. A corresponding set of neurons representing the glabrous pads of the hind paw were activated by a similar number of punctate mechanical displacements. 2. Cortical electrode penetrations were histologically reconstructed, and 118 neurons in the glabrous skin representation exhibited cutaneous responses that were categorized into supragranular, granular, or infragranular groups according to their laminar position. Minimum latencies of cortical neurons responding to glabrous skin displacement were analyzed, and significant differences were found in the distribution of minimum latencies for the different cortical layers. Mean values for minimum latencies in the infragranular and granular layers were 15.8 and 16.3 ms, respectively, whereas supragranular neurons were characterized by minimum latencies having a mean of 20 ms. The differences between these groups suggests that stimulus-induced afferent activity reaches infragranular and granular layers before contacting supragranular neurons. Average latencies were also calculated on responses occurring during the 1st 20 trials, but the cortical distributions of these values overlapped considerably, and differences between the laminar groups were not statistically significant. 3. In several recording sites, two cortical neurons were recorded simultaneously, and the response latencies of these matched pairs were often substantially different despite the similarity in laminar position. This result indicates that laminar location is not the only determinant of response latency and that serially organized circuits are distributed within, as well as between, cortical layers. 4. From a sample of 302 neurons exhibiting cutaneous responses within histologically identified regions of thalamus or cortex, a set of 143 pairs of neurons recorded simultaneously from both regions was available for cross-correlation analysis. Significant thalamocortical interactions were found in 38 neurons pairs. Analysis of these significant interactions revealed that thalamocortical connection strength, as measured by neuronal efficacy, was two to four times larger for neuron pairs having the cortical cell in granular layer IV than for neuron pairs having an extragranular layer cortical neuron. There was no difference in thalamocortical connection strength between neuron pairs containing supra- or infragranular cortical neurons. 5. Summed peristimulus time histograms revealed stimulus-locked inhibition of spontaneous activity in 4% (8/195) or cortical and 18% (20/107) of thalamic neurons.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1991

Acute effects of resistance exercise on parameters of lipoprotein metabolism.

Ten healthy, trained males (25.4 +/- 3.1 yr) were studied before and after 90 min of resistance exercise to determine the acute effects of high volume (HV) and low volume (LV) sessions on alterations in lipid and lipoprotein concentrations as well as the activity of lecithin: cholesterol acyltransferase (LCAT). The HV session involved the use of 8-12 repetition maximum (RM) loads performed to exhaustion with 60 s rest intervals between sets, while the LV session involved the use of 1-5RM loads with 3 min rest intervals between sets. Fasting blood samples were drawn from an antecubital vein immediately before and after exercise as well as 24, 48, and 72 h post-exercise. Following adjustment for changes in plasma volume, significant changes were only found following the HV session. These included increases in HDL-C (11%) and HDL3-C (12%) 24 h post-exercise. Modifications in HDL-C were significantly different from both the LV and control sessions. In contrast, triglycerides and LCAT were significantly depressed 24 h post-exercise following the HV session when compared with immediate post-exercise values. There were no significant changes in either total cholesterol or HDL2-C at any time. The results of this study suggest that the potential of resistance exercise to affect acute modifications in the lipoprotein profile resides in the volume of exercise performed.

Adult↗