Biomedical subjects
Publications and source records attributed to M F Brown.
Thirty-eight intra-articular ganglia were found in knees that were painful or had the symptoms of a mechanical derangement. During the period of study, 6,500 knees were examined arthroscopically by one surgeon. Thirty-five of the ganglia arose at the insertions of the cruciate ligaments. Excision of the ganglion yielded excellent results in 22 knees, good in 14, and fair in one.
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Pigeons were trained to match color and line orientation element or compound samples in a symbolic matching-to-sample task. In subsequent test sessions with element and compound samples, there was an initial superiority of element matching for the element-trained group and of compound matching for the compound-trained group. This difference persisted over the course of 100 test sessions for the element-trained group, whereas element- and compound-matching accuracy converged for the compound-trained group. In a second experiment, in which sample duration was manipulated, element-matching accuracy was superior to compound-matching accuracy for both groups. Thus, element-matching accuracy was superior to compound-matching accuracy under conditions that rule out generalization decrement and training history as explanations. The data are interpreted as supporting the view that the dimensions of visual compound stimuli compete for a limited cognitive resource.
Resting energy expenditure (REE) is reported to increase by 24% in adults following elective operations; however, similar data are not available for children. We studied REE in 12 children (14 operative procedures) to test the hypothesis that children experience a similar rise in REE as adults following operation. The operations included endorectal pull-through, gastric resection, ileostomy closure, and other major abdominal procedures. REE was measured daily by indirect calorimetry using a computerized bedside metabolic cart. All subjects (7 males, 5 females; age range, 8 to 19 years; mean age, 14.7 years) were measured supine, in bed, and after an overnight fast. REE was expressed as kilocalories per unit body surface area (BSA) per day. In addition, respiratory quotient (RQ) was calculated for each patient. Contrary to adults, these children did not demonstrate a significant increase in REE following major operative procedures. Furthermore, there was no change in RQ postoperatively. These data demonstrate that children might have a different response to surgical stress than adults. We theorize that children are able to convert energy expended on growth to energy spent on wound repair and healing, thus avoiding the overall increase in energy expenditure seen in the adult population.
We report six pediatric patients who had a partial splenectomy for splenic cysts and a seventh patient who had a total splenectomy. There were six epidermoid cysts and one traumatic cyst. All patients had benign postoperative courses. All patients who underwent partial splenectomy had a significant postoperative rise in platelet count that subsequently returned toward baseline. This rise implies a loss of splenic function, although the exact meaning of this is unclear. All patients had late postoperative liver-spleen scans that showed mean spleen size and function to be normal. We have described several methods of partial splenectomy used at Children's Hospital of Philadelphia. Recommendations for patients undergoing partial splenectomy include preoperative pneumococcus and Hemophilus influenzae vaccinations and prophylactic antibiotics postoperatively. The antibiotics are terminated if a liver-spleen scan and platelet count at the end of 3 months' time are normal.
We have investigated the molecular features of recombinant membranes that are necessary for the photochemical function of rhodopsin. The magnitude of the metarhodopsin I to metarhodopsin II phototransient following a 25% +/- 3% bleaching flash was used as a criterion of photochemical activity at 28 degrees C and pH 7.0. Nativelike activity of rhodopsin can be reconstituted with an extract of total lipids from rod outer segment membranes, demonstrating that the protein is minimally perturbed by the reconstitution protocol. Rhodopsin photochemical activity is enhanced by phosphatidylethanolamine head groups and docosahexaenoyl (22:6 omega 3) acyl chains. An equimolar mixture of phosphatidylethanolamine and phosphatidylcholine containing 50 mol% docosahexaenoyl chains results in optimal photochemical function. These results suggest the importance of both the head-group and acyl chain composition of the rod outer segment lipids in the visual process. The extracted rod lipids and those lipid mixtures favoring the conformational change from metarhodopsin I to II can undergo lamellar (L alpha) to inverted hexagonal (HII) phase transitions near physiological temperature. Interaction of rhodopsin with membrane lipids close to a L alpha to HII (or cubic) phase boundary may thus lead to properties which influence the energetics of conformational states of the protein linked to visual function.
The pectoralis major myocutaneous flap has been used to cover many different defects. This article will describe the use of the lateral portion of the pectoralis major muscle to cover exposed axillary structures when the latissimus dorsi muscle is not available for coverage.
Coronary artery disease due to atherosclerosis takes the lives of approximately 550,000 Americans each year--an enormous toll. Put in economic terms, the cost to the United States alone has been estimated to exceed 60 billion dollars annually. We have found that well-resolved proton (1H) NMR spectra can be obtained from human atheroma (fatty plaque), despite its macroscopic solid appearance. The fraction of the total spectral intensity corresponding to the sharp 1H NMR signals is temperature dependent and approaches unity at body temperature (37 degrees C). Studies of the total lipids extracted from atheroma and cholesteryl esters were conducted to identify the chemical and physical origin of the spectral signature. The samples were characterized through assignment of their chemical shifts and by measurement of their T1 and T2 relaxation times as a function of magnetic field strength. The results suggest that the relatively sharp 1H NMR signals from human atheroma (excluding water) are due to a mixture of cholesteryl esters, whose liquid-crystalline to isotropic fluid phase transition is near body temperature. Preliminary applications to NMR imaging of human atheroma are reported, which demonstrate early fatty plaque formation within the wall of the aorta. These findings offer a basis for noninvasive imaging by NMR to monitor early and potentially reversible stages of human atherogenesis.
Cardiovascular disease due to atherosclerosis is a leading cause of death in the United States as well as other developed countries. This paper describes the development of image processing, pattern recognition, and graphical display techniques to non-invasively quantify the atherosclerotic disease process using magnetic resonance imaging (MRI). We have demonstrated the ability to identify the soft tissue classes of (1) normal, smooth muscle wall, (2) fatty plaque, (3) complex, fibrous plaque, and (4) calcified plaque. The objective of this work has been to combine functional information, such as plaque tissue type, with structural information, represented by 3-D display of vessel structure, into a single composite display. The results of this work provide a "high information content" display which will aid in the diagnosis and analysis of the atherosclerotic disease process, and permit detailed and quantitative studies to assess the effectiveness of therapies (e.g. changes in diet, exercise and drug administration).
Well-resolved proton (1H) NMR spectra of solid human arterial plaque can be acquired. Studies have been carried out of human fatty plaque obtained postmortem (ex vivo), the total lipids extracted from human atheroma, and a model mixture of cholesteryl esters whose lipid composition resembles that of human atheroma. In each case, well-resolved 1H NMR spectra were obtained at body temperature (37 degrees C), with little or no underlying broad signal. Such sharp 1H NMR spectra are typical of isotropic fluids, whereas solid and liquid-crystalline materials give rise to much broader spectral lines. The results suggest the sharp 1H NMR spectra of human atheromatous lesions at body temperature are due largely to the presence of intracellular and extracellular droplets of cholesteryl esters in the isotropic liquid phase. These findings provide a necessary basis for use of 1H NMR techniques to image quantitatively the lipid constituents of human atheroma in vivo, and to study their chemical and physical properties.
Human synovial tissues have been assayed for the production of cartilage degrading activity (CDA). This activity is thought to be homologous with catabolin/interleukin 1 (IL1) produced by porcine synovium and leucocytes and by human leucocytes. The CDA of 26 rheumatoid (RA) and 41 non-rheumatoid synovia was measured on a dry weight basis. The rheumatoid synovia showed a threefold increase in activity over the non-rheumatoid, but there was no significant overall difference on a deoxyribonucleic acid (DNA) basis. The rheumatoid synovia appeared to consist of two populations; in over half the samples CDA was not related to cellularity, but eight patients had a high CDA and a high cellularity.
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31P NMR studies of rod outer segment (ROS) and sarcoplasmic reticulum (SR) membranes have been performed under conditions where broad and narrow spectral components can be clearly resolved. Control studies of an anhydrous, solid powder of 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC), as well as aqueous binary mixtures of 1,2-distearoyl-sn-glycero-3-phosphocholine (DSPC) and 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC), demonstrate clearly that broad spectral components can be detected. For the codispersions of DSPC and DOPC in the mixed-phase region at 22 degrees C, the 31P NMR spectra consist of a superposition of a broad component and a narrow, axially symmetric component, due to coexisting solid and liquid-crystalline domains, which are in slow exchange on the 31P NMR time scale. The 31P NMR spectra of the native ROS and SR membranes, however, consist of only a narrow component, to within experimental error, indicating that most or all of the phospholipids are in the liquid-crystalline (L alpha) phase at 22 degrees C. The above conclusions are in agreement with many, but not all, previous studies [see, e.g., Yeagle, P.L. (1982) Biophys. J. 37, 227-239]. It is estimated that at most 10% of the phospholipids in the ROS and SR membranes could give rise to broad 31P NMR spectral components, similar to those seen for anhydrous or solid-phase lipids, corresponding to approximately 7 phospholipids/rhodopsin molecule and approximately 11 phospholipids/Ca2+-ATPase molecule, respectively.
Concern regarding the proportion of brown eggs being laid with abnormal egg shells led to an investigation of the relationship between disturbance or stress and egg shell appearance and quality. The abnormalities fell into two main classes: misshapen or bulging eggs and eggs coated with a superficial layer of amorphous calcium, variously termed dusted, white banded, chalky or pink eggs. Translocation of hens from pens to cages resulted in a decrease in egg production and an increase in the proportion of abnormal eggs over the succeeding 18 d. Disturbance to flocks on deep litter resulted in an increase in the proportion of eggs laid with abnormal shells on the following day, not only in the flocks directly affected but also in an adjacent flock. Exclusion from their nests of birds accustomed to laying in nest boxes resulted in disturbed prelaying behaviour, retention of eggs in the shell gland and an increased proportion of coated eggs. Administration of 0.1, 0.25 or 1.0 mg of adrenaline subcutaneously resulted in the retention of eggs currently in the hens' shell glands and in an increased proportion of eggs with abnormal egg shells being laid during the following 10 d. A dose response effect was apparent. There was evidence that the nature of the particular abnormality produced was dependent on the stage of egg formation at which the disturbance was imposed and, if retention followed, upon the length of time the egg was retained. Disturbances when eggs were only lightly calcified tended to result in misshapen eggs, while those occurring when oviposition was imminent tended to result in coated eggs. Dusted or pink eggs followed moderate retention whereas white banded eggs were seen after prolonged retention. These observations may provide a basis for a non-invasive method of assessing stress in laying hens as well as helping to account for hitherto inexplicable occurrences of declining egg shell quality.
High sensitivity, differential scanning calorimetry studies of bovine retinal rod outer segment (ROS) disk membranes and aqueous dispersions of the extracted ROS phospholipids have been performed. ROS disk membranes were found to exhibit a broad peak of excess heat capacity with a maximum at less than about 3 degrees C, ascribable to a gel-to-liquid crystalline phase transition of a fraction of the phospholipids. A similar thermotropic transition was observed for aqueous dispersions of the total extracted and purified ROS phospholipids. Comparison of the results obtained for the dispersion of total ROS phospholipids to those of the purified head group fractions suggests that the thermotropic behavior reflects a gel-to-liquid crystalline transition, leading to lateral phase separation, involving those phosphatidylcholine (PC) molecules containing saturated fatty acyl chains, possibly together with the highest melting ROS phosphatidylethanolamine (PE) and phosphatidylserine (PS) components. The interpretation of the thermal behavior of the ROS disk membranes depends on whether the transition is assumed to derive from the ROS PC and/or PE/PS fractions, and whether the transbilayer arrangement of the ROS phospholipids is assumed to be symmetric or asymmetric. The calorimetric data can be simply explained in terms of an asymmetric distribution of the major ROS disk membrane phospholipids (G.P. Miljanich et al., J. Membrane Biol. 60:249-255, 1981). In this case, the transition would arise from the PE/PS fractions in the outer ROS disk membrane monolayer, and the anticipated transition from the PC in the inner monolayer would be broadened due to interaction with cholesterol. For the ROS membranes at higher temperatures, two additional, irreversible transitions are observed at 57 and 72 degrees C, corresponding to the thermal denaturation of opsin and rhodopsin, respectively.
Recent NMR relaxation studies of lipid bilayers and biomembranes are explained and briefly discussed. The results of both 2H and 13C NMR investigations suggest that, in addition to rapid local fluctuations of the hydrocarbon chains, slower, more collective motions of the bilayer exist. When the influence of the latter is recognized and properly accounted for, the contribution from local motions can be used to estimate a value for the microviscosity of the bilayer which corresponds to that of a simple n-paraffinic liquid. In general, the dynamic behavior of lipid bilayers as studied by NMR appears quite similar to that of simpler liquid crystals.