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Biomedical subjects

M Kelly

Publications and source records attributed to M Kelly.

At least 217 records · Page 12Linked to original sources
PubMed1994

Baseline silent cerebral infarction in the Asymptomatic Carotid Atherosclerosis Study.

BACKGROUND AND PURPOSE: In a group of patients with high-grade asymptomatic carotid artery stenosis, we prospectively determined the prevalence and radiological characteristics of clinically asymptomatic brain infarction evident on computed tomography. Risk factors and extent of carotid disease were also determined. METHODS: Patients randomized into the Asymptomatic Carotid Atherosclerosis Study (ACAS) underwent a neurological history, a detailed stroke/transient ischemic attack questionnaire, and a detailed neurological examination. Computed tomography scans were examined by standardized criteria developed as part of a quality-control program supervised by a neuroradiologist. The presence, location, and size of all cerebral infarctions evident by computed tomography were determined. RESULTS: Among 1132 patients, 848 had no history of stroke or transient ischemic attack. One hundred twenty-six patients (15%) had a silent infarct; 95 (11%) had one, 24 (3%) had two, and 7 (1%) had three or more infarcts. The infarct size was small and deep for 117 patients (72%), less than one-half lobe for 45 (28%), and one-half to less than one lobe for 1 (0.5%). The silent infarcts were evenly distributed ipsilaterally and contralaterally to the study artery but were significantly more frequent in the right hemisphere (P < .05). Factors associated with silent infarction were abnormal gait (P < .001), abnormal deep tendon reflexes or plantar responses (P = .038), but not degree of carotid stenosis. Silent infarction was less frequent among this totally asymptomatic cohort (15%) compared with those with transient ischemic attacks (34/139, 25%; P < .001). CONCLUSIONS: Silent infarction in the setting of asymptomatic carotid stenosis is not uncommon, but silent infarctions are rarely sizable. The clinical significance of silent cerebral infarction in patients with asymptomatic carotid artery stenosis has yet to be established.

Adult↗
PubMed1994

Congener-specific levels of dioxins and dibenzofurans in U.S. food and estimated daily dioxin toxic equivalent intake.

Food, especially meat, milk, and fish, is the immediate source of almost all polychlorinated dibenzo-p-dioxins (PCDDs), dibenzofurans (PCDFs), and dioxinlike compounds in the general population. To estimate intake of these highly toxic compounds, we performed congener-specific dioxin analyses for the first time on U.S. food for 18 dairy meat, and fish samples from a supermarket in upstate New York. 2,3,7,8 Tetrachlorodibenzo-p-dioxin (TCDD, "dioxin") toxic equivalents (TEqs) on a wet weight basis for the dairy products ranged for 0.04 to 0.7 ppt, meat TEqs ranged from 0.03 to 1.5 ppt, and fish TEqs ranged from 0.02 to 0.13 ppt. Previous human breast milk and infant formula analyses were used with the current preliminary food data to estimate a range of dioxin intake for Americans. Average daily food intake of TEqs for an adult weighing 65 kg was estimated to be between 0.3 and 3.0 pg/kg body weight, for a total of 18-192 pg TEq, using 1986 American consumption rates. Due to the relatively high level of PCDDs and PCDFs commonly found in human breast milk from American women and from women in other industrial countries, a nursing infant may consume an average of 35-53 pg TEq/kg body weight/day in its first year of life. This may be compared with the current U.S. EPA virtually safe dose of 0.006 pg TCDD/kg body weight per day over a 70-year lifetime based on an upper limit cancer risk of 10(-6), or the 10 pg/kg/day used by some European government agencies.

Adult↗
PubMed1994

Assistance in living assures aging in place.

Life care and other large retirement centers transfer failing residents to assisted living units or nursing beds at various points. North Hill, a life care center, keeps many of its residents in their apartments years longer, with every department contributing to a creative, cost-effective Assistance-in-Living home care program. This program could inspire home care agencies to contract their services to other such communities.

Activities of Daily Living↗
PubMed1994

Preoperative serum CA-125 and CA-72 in predicting endometriosis in infertility patients.

CA-125, a high-molecular-weight glycoprotein antigen, has been identified as a possible marker for endometriosis, with discrepant results. CA-72, another glycoprotein antigen, is expressed by a variety of adenocarcinomas, including endometrial carcinoma. This controlled, prospective study evaluated serum CA-125 and CA-72 levels in 35 consecutive patients with endometriosis of varying stages and in patients without endometriosis. Serum CA-125 and CA-72 were measured with immunoradiologic methods prior to diagnostic laparoscopy for infertility evaluation. Endometriosis, scored by American Fertility Society guidelines, was identified in 19 patients, and 16 patients had normal pelvic findings. CA-125 and CA-72 levels were not different between patients with no pelvic disease (controls) and women with stage I-IV endometriosis. The positive predictive value of CA-125 was 0%; the negative predictive value was 47%. The positive predictive value of CA-72 was 5%; the negative predictive value was 53%. CA-72 and CA-125 are not helpful in the routine workup of the infertile woman to determine the likelihood that she has pelvic endometriosis.

Antigens, Neoplasm↗
PubMed1994

Extraperitoneal 'laparoscopic' adrenalectomy.

The technique of extraperitoneal 'laparoscopic' adrenalectomy is described in two cases, a left sided 1 cm Conn's tumour and a right sided 3.5 cm incidental non-functioning tumour. The extraperitoneal approach has the advantage of direct access to the adrenal gland without the need to mobilize abdominal organs, while maintaining all the advantages of minimal access surgery.

Adrenal Gland Neoplasms↗
PubMed1993

Home treatment with intravenous enzyme replacement therapy for Gaucher disease: an international collaborative study of 33 patients.

Intravenous enzyme replacement therapy (Alglucerase; Ceredase; Genzyme Corp, Boston, MA) is an effective and safe treatment for patients with type 1 Gaucher disease. In an attempt to reduce its high cost, a "low-dose high-frequency" protocol (30 U/kg/mo, 3 times a week) was introduced and found to be as effective as the original high-dose protocol (60 U/kg every 2 weeks). Because receiving frequent infusions creates a burden for many patients, we have implemented a program of home treatment for our patients. We now report the safety and feasibility of low-dose/high-frequency home intravenous enzyme-replacement therapy in 33 patients with Gaucher disease. The chronic nature of the treatment, its safety, lack of adverse effects, the stable condition of most patients, and the need to reduce the high cost make enzyme replacement for Gaucher disease a good candidate for intravenous home therapy.

Adolescent↗
PubMed1993

Two cysteines, two histidines, and one methionine are ligands of a binuclear purple copper center.

Cytochrome c oxidase contains a copper center, CuA, which is involved in electron transfer from cytochrome c to the oxygen-reducing active site. This center is distinct from types 1, 2, and 3 copper sites and related only to a purple copper center in nitrous oxide reductase. At present it is not clear whether this site is mononuclear or is comprised of two copper atoms in a mixed valence (Cu(I)-Cu(II)) configuration. Here we use a model of CuA, engineered into a structurally related but initially copperless protein, to study the structure of this copper center. The results from biochemical analysis, site-directed mutagenesis, and electrospray mass spectrometry support the binuclear model. Two cysteines, two histidines, and one methionine are the major ligands of two coppers. Substitution of these residues results in either a complete loss of color or dramatic changes in the absorbance spectrum. In contrast, substitution of the invariant glutamate residue, which is located between the copper-binding cysteines, leads to a minor perturbation of the optical spectrum.

Amino Acid Sequence↗
PubMed1993

Accessibility and distribution of intraerythrocytic antigens of Plasmodium-infected erythrocytes following mild glutaraldehyde fixation and detergent extraction.

Malarial antigens on the surface of infected erythrocytes have been described by many investigators. However, few of these antigens have been unambiguously demonstrated to be exposed on the surface of erythrocytes. This study demonstrates that mild glutaraldehyde fixation results in the cytoplasmic face of the host membrane becoming accessible to antibody under conditions that normally do not expose the cytoplasmic face of uninfected erythrocytes. These results indicate that caution should be used in interpreting data on the membrane disposition of malarial antigens. Detergent extraction of the glutaraldehyde-fixed erythrocytes results in an increased permeabilization such that malarial antigens on the parasite surface and within the cytoplasm of the infected erythrocyte are accessible to antibody. The accessibility of these antigens was demonstrated by both immunofluorescence and two-color flow cytometry. The antigens within the host cytoplasm were not diffuse but associated with patchy aggregates. Analysis of the antigens associated with the cytoplasmic aggregates by immunoelectron microscopy indicated that they were not associated with membrane-bound compartments. The fixation and permeabilization protocol described herein will have useful applications for the characterization and analysis of malarial antigens.

Animals↗
PubMed1993

Medical/dental management of a chronic hepatitis C patient. A case report.

Hepatitis C accounts for 20% to 40% of all acute viral hepatitis, with between 150,000 and 170,000 new cases reported in the United States each year. Approximately 50% of these patients will progress to chronicity with potential hepatic disorders. In an average dental practice that treats 20 patients each day, it is estimated that one hepatitis C patient will be encountered every 2 weeks. Because numerous dental procedures stress the immune, coagulation, and metabolic systems, a thorough understanding of the potential complications imposed by hepatitis C to these systems is essential. This case study encompasses comprehensive medical and dental management of the chronic hepatitis C patient. It includes assessment, intervention, and evaluation, as well as projected planning for future treatment.

Blood Coagulation Tests↗
PubMed1993

Effects of beta-funaltrexamine treatment and sexual isolation in the perinatal period on the development of mu-opioid receptors and nociception.

Male and female rats were segregated from birth (sexually isolated animals). Additional litters containing both male and female pups were kept as controls (mixed-housed animals). beta-FNA (5 mg/kg) or water was administered SC at day 0 or day 7 to isolated and mixed-housed animals. The development of mu-opioid receptors and nociceptive responses in the two groups was assessed at day 7 or 14, respectively. Mu-receptor binding was measured in whole brain using (3H) DAGO as a binding ligand and nociception assessed using the tail immersion test. beta-FNA treatment depressed mu-receptors when measured 1 but no 7 days later. However, male and female rats treated at day 0 with beta-FNA had lower brain protein content. Sexual isolation had little effect on mu-receptor number and did not augment the beta-FNA effect. However, isolation increased pain sensitivity in 7-day-old animals and in 14-day-old females. beta-FNA treatment had little effect on nociceptive threshold but reversed the effects of sexual isolation.

Animals↗
PubMed1993

Control of infection in an international airline.

The paper examines the possible sources of infection on an international aircraft, including the provision of food, the supply of drinking water, and the removal of waste. It considers aspects of control, and explains some of the steps which have to be taken by a major international carrier to ensure that the high quality expected by the customer is provided in all areas of the world, even those where natural resources and expertise may be limited. The emphasis is on providing a safe product, and removing any possible risk of infection of the passengers.

Aircraft↗
PubMed1993

Occupational stress in head teachers: a national UK study.

This study assessed occupational stress amongst 2,638 head teachers of primary and secondary schools, together with principals/directors of further and higher education establishments, throughout the United Kingdom. Data were collected on personal/job demographics, sources of job stress, mental health, job satisfaction and coping strategies. These data were analysed by SPSS-X, producing univariate, bivariate and multivariate techniques. It was found that as we moved from the further/higher education level to secondary to primary sectors, the levels of job dissatisfaction and mental ill health rose. In addition, it was found that, with the exception of primary schools, female head teachers in secondary and FHE seem to be suffering significantly greater job dissatisfaction than their male counterparts, although this does not translate itself into mental ill health. Male head teachers, on the other hand, seem to suffer more mental ill health than their female counterparts. And finally, the two main sources of occupational stress that appear in many of the multivariate analyses as predictors of job dissatisfaction and mental ill health are 'work overload' and 'handling relationships with staff'. The implications of all these findings are discussed in detail.

Adult↗
PubMed1993

Automation, bar coding bring patient account management down to size.

By combining bar code scanning technology with computer-assisted record retrieval technology, St. Vincent Hospital and Healthcare Center in Indianapolis, Ind., has automated its patient financial records management operation. In the process, the hospital has not only streamlined its account management process, but has also reduced labor and storage costs and improved access to patient information.

Efficiency↗
PubMed1993

(-)-2-(N-propyl-N-2-thienylethylamino)-5-hydroxytetralin (N-0923), a selective D2 dopamine receptor agonist demonstrates the presence of D2 dopamine receptors in the mouse vas deferens but not in the rat vas deferens.

Experiments were carried out using the D2 dopamine receptor-selective agonist (-)-2-(N-propyl-N-2-thienylethylamino)-5-hydroxytetralin (N-0923) in the rat and the mouse isolated vas deferens to determine whether these tissues contained inhibitory D2 receptors in addition to their inhibitory alpha-2 adrenoceptors. In the mouse vas deferens N-0923 and the alpha-2 adrenoceptor agonist clonidine inhibited the electrically evoked twitch responses. The actions of clonidine, but not of N-0923, were antagonized by the alpha-2 antagonist idazoxan (pKb = 7.9), and responses to N-0923 were antagonized by the D2 antagonist sulpiride (pKb = 8.1). In the rat vas deferens, clonidine, but not N-0923, inhibited the twitch responses and these inhibitions were antagonized by idazoxan (pKb = 7.9) but not by sulpiride. Other D2 receptor agonists were tested in the mouse and in the rat vas deferens for their ability to activate D2 and alpha-2 receptors, respectively. At the D2 receptors in the mouse vas deferens (alpha-2 blocked) the potency order was (+)-propyl-9-hydroxy-naphtoxazine > pergolide > N-0923 = apomorphine > bromocriptine > quinpirole > dopamine. At the alpha-2 receptors in the rat vas deferens the potency order was pergolide > bromocriptine > (+)-propyl-9-hydroxynapthoxazine > apomorphine > quinpirole > or = dopamine. N-0923 was inactive but antagonized the responses to clonidine. N-0923 was therefore the most D2 receptor selective agonist tested.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic alpha-2 Receptor Antagonists↗