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Biomedical subjects

M Brown

Publications and source records attributed to M Brown.

At least 685 records · Page 38Linked to original sources
PubMed1983

A pharmaceutical profile of diabetic patients.

Although there have been innumerable studies documenting various aspects of the morbidity caused by diabetes mellitus in the population, very little attention has been paid to patterns of therapeutic management of diabetic patients. The United States Public Health Service Ambulatory Care Data System (USPHS ACDS), a computerized patient information entry and recording system with a complete pharmaceutical record for each patient, was used to compare patterns of pharmaceutical consumption among diabetic patients as opposed to non-diabetic patients in a population of approximately 90,000 individuals. Drug use by diabetics was significantly higher than by non-diabetics. Cardiovascular drug use, in particular, was considerably higher. Substantially higher consumption of anti-lipemic agents, anti-gout drugs, anti-hypertensives, sedatives and tranquilizers was also found in the diabetic population. The higher use of all drugs by diabetics could be partially explained by a demonstrably higher frequency of out-patient visits by diabetics. However this factor alone could not account for very much higher use of certain selective drug groups by the diabetics. In most cases, these selective increases among the diabetics paralleled expected patterns of disease for which those drug groups are prescribed. The investigation of pharmacotherapeutic profiles of the diabetic population adds a new dimension to the epidemiological study of this disease.

Adult↗
PubMed1983

Upper limb reconstruction in quadriplegia: functional assessment and proposed treatment modifications.

The functional results following reconstruction of key grip (40 limbs in 30 patients) and active elbow extension (14 limbs in 9 patients) in higher spinal level quadriplegic patients were reviewed and results were classified as follows: Good result (55% of operated limbs)--Patients were very pleased with the greater ease and capabilities in performing functional activities. Fair result (30%)--Patients were moderately satisfied; thumb instability and poor finger position during pinch were the two greatest sources of dissatisfaction. Poor result (15%)--Patients were disappointed, usually because of progressive contracture, spasticity, or pain. On preoperative assessment, these were the weakest patients or those who had the longest interval between injury and surgery. In 10 of 14 limbs functionally active elbow extension was obtained, although the long convalescent time was a deterrent. Based on these results, the modifications in the following areas of treatment protocol were made: (1) Patient selection--Of those patients with only minimum levels of functional resources, only the most highly motivated should have elective reconstructive surgery. (2) Surgical technique--Procedures to better stabilize the thumb metacarpophalangeal joint and to assist in positioning the other digits during pinch include a stronger tenodesis of the thumb extensor tendons to the metacarpal and tenodesis of the superficialis tendons of the index and long fingers to the proximal phalanx. Other procedures include modification of the methods of attachment of tendon transfers to shorten convalescence following reconstruction of active elbow extension. (3) Postoperative care--postoperative problems develop insidiously. Frequent reassessment is mandatory.

Elbow Joint↗
PubMed1983

Transformation of retinal glia cells into lens phenotype: expression of MP26, a lens plasma membrane antigen.

We describe experiments in which dissociated cells from differentiated, post-mitotic neural retina of late chicken embryos (13 and 16 days) rapidly and consistently transform (transdifferentiate) in vitro into lens-like phenotype and form spherical lentoids. Using immunohistochemical and other tests, we have established that the lentoids arise from the progeny of definitive retinal glia cells (Müller cells). An early event in their transformation is the appearance in the cell surface of MP26, a plasma membrane protein characteristic of lens but not found in the retina. The results support the hypothesis that the phenotype of definitive glia cells in the retina is stabilized by contact-mediated interactions with neurons; disruption of cell contacts and cell separation alter surface properties of the glia cells, decontrol their phenotype, and predispose them to phenotype transformation.

Animals↗
PubMed1983

Comparative examination of female urethral pressure profiles measured by CO2 and H2O infusion techniques.

The urethral closure pressure profile (UCPP) was recorded in 100 consecutive patients using both the water infusion and the carbon dioxide infusion methods. Ninety-one per cent of the patients complained of discomfort during CO2 infusion. Thirty-two of the CO2 profiles were distorted due to patient discomfort or shortcomings in the design of the measuring system, and in these no quantitative comparisons could be made. In 68 cases the profile measurements were compared: average maximum closure pressures and functional urethral lengths were slightly less with the CO2 but some individual variations were substantial. We concluded that unreliability and patient reaction make CO2 infusion less suitable than H2O for measuring UCPP.

Adult↗
PubMed1983

Structure-activity relationships of somatostatin analogs in the rabbit ileum and the rat colon.

UNLABELLED: Somatostatin increases absorption of electrolytes and inhibits diarrhea in patients with endocrine tumors and short bowel syndrome. In an attempt to develop a gut-specific somatostatin analog, each amino acid in the somatostatin molecule was replaced with L-alanine, deleted, or substituted with its D-isomer. The potency of each analog to stimulate ion transport in the rabbit ileum was then determined using the modified Ussing chamber technique. The results were compared to the ability of each analog to inhibit the stimulated release of growth hormone from cultured rat anterior pituitary cells and to inhibit the arginine-stimulated release of insulin and glucagon in the rat in vivo. Analogs that showed gut selectivity were then tested for their ion transport properties in the rat colon. RESULTS: (a) Substitution with L-alanine or deletion of the amino acid at position 6, 7, 8, or 9 and deletion of Threonine(10)-produced analogs with significantly reduced ion transport properties to <4% of somatostatin's action. The substitution also markedly reduced the ability of the compounds to inhibit the release of growth hormone, insulin, and glucagon. (b) Selectivity of intestinal ion transport was achieved by any one of the following alterations: L-alanine substitution at Phenylalanine(11), deletion of Phenylalanine(11), substitution with D-lysine at Lysine(4), or substitution with L-alanine at Lysine(4). These compounds had intestinal ion transport properties of 52, 34, 139, and 94%, respectively, while demonstrating little or no inhibition of growth hormone, insulin or glucagon release. CONCLUSIONS: (a) Phenylalanine(6), Phenylalanine(7), Tryptophan(8), and Lysine(9) are required for the ion transport and other biologic actions of somatostatin, whereas Threonine(10) serves as an essential spacer. (b) Alteration at Phenylalanine(11) or Lysine(4) yields analogs that are selective for ion transport in the rabbit ileum and rat colon. These findings should be taken into consideration when developing a gut-specific somatostatin analog that can be useful in the treatment of diarrhea.

Alanine↗
PubMed1983

The fluid bridge test for urethral incompetence. A comparison of results in women with incontinence and women with normal urinary control.

A new urodynamic test which detects the entry of fluid into the proximal urethra has been used in the investigation of women with urinary incontinence. The test is positive if a "fluid bridge" is established between the bladder and a test point in the urethra. The test results from 30 incontinent patients were compared with those from 30 women with normal urinary control who had been matched for age and parity. Twenty-four of the incontinent women had a positive fluid bridge test (FBT) at 0.5 cm from the bladder neck compared with 6 of the women in the control group. The difference between the test results in the two groups was highly significant (X2 = 19.27, p less than 0.001). In the incontinent patients a diagnosis was made after full clinical examination (which included an attempt to demonstrate stress leakage), cystometry and urethral closure pressure profile measurement. In a number of cases (23%) the only evidence of urethral incompetence was a positive FBT. We conclude that the FBT is a more sensitive index of sphincter weakness than are other non-radiological urodynamic tests.

Adult↗