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Biomedical subjects

M Morrell

Publications and source records attributed to M Morrell.

12 recordsLinked to original sources
PubMed2003

A new device for the treatment of female stress urinary incontinence.

Treatment for stress urinary incontinence (SUI) comprises a broad range of possible interventions. Non-surgical options include absorbent pads, vaginal weights and cones, biofeedback and minimally invasive techniques such as urethral bulking agents (UBAs). Surgical interventions range in complexity from sling surgery and suspension techniques to more major surgeries such as burch colposuspension. Each option has its challenges and limitations. This paper will focus on UBAs, which are implantable materials whose purpose is to augment urethral tissue function and restore continence. The characteristics required of such materials, and the challenges to be overcome when incorporating them in a successful product design, will be described and discussed. Particular attention will be given to the latest developments in the administration of polydimethylsiloxane elastomer UBA.

Biocompatible Materials↗
PubMed2001

Structural brain abnormalities in patients with schizophrenia, epilepsy, and epilepsy with chronic interictal psychosis.

Chronic interictal psychotic syndromes, often resembling schizophrenia, develop in some patients with epilepsy. Although widespread brain abnormalities are recognized as characteristic of schizophrenia, prevailing but controversial hypotheses on the co-occurrence of epilepsy and psychosis implicate left temporal lobe pathology. In this study, quantitative MRI methods were used to address the regional specificity of structural brain abnormalities in patients with epilepsy plus chronic interictal psychosis (E+PSY, n=9) relative to three comparison groups: unilateral temporal lobe epilepsy without chronic psychosis (TLE, n=18), schizophrenia (SCZ, n=46), and healthy control subjects (HC, n=57). Brain measures, derived from a coronal spin-echo MRI sequence, were adjusted for age and cerebral volume. Relative to HC, all patient groups had ventricular enlargement and smaller temporal lobe, frontoparietal, and superior temporal gyrus gray matter volumes, with the extent of these abnormalities greatest in E+PSY. Only TLE had temporal lobe white matter deficits, as well as smaller hippocampi, which were ipsilateral to the seizure focus. Structural brain abnormalities in E+PSY are not restricted to the left temporal lobe. The confluence of cortical gray matter deficits in E+PSY and SCZ suggests salience to chronic psychosis.

Adult↗
PubMed2001

Automatic extraction of acronym-meaning pairs from MEDLINE databases.

Acronyms are widely used in biomedical and other technical texts. Understanding their meaning constitutes an important problem in the automatic extraction and mining of information from text. Here we present a system called ACROMED that is part of a set of Information Extraction tools designed for processing and extracting information from abstracts in the Medline database. In this paper, we present the results of two strategies for finding the long forms for acronyms in biomedical texts. These strategies differ from previous automated acronym extraction methods by being tuned to the complex phrase structures of the biomedical lexicon and by incorporating shallow parsing of the text into the acronym recognition algorithm. The performance of our system was tested with several data sets obtaining a performance of 72 % recall with 97 % precision. These results are found to be better for biomedical texts than the performance of other acronym extraction systems designed for unrestricted text.

Abbreviations as Topic↗
PubMed1999

MRI abnormalities associated with partial status epilepticus.

OBJECTIVE: To report neuroimaging findings in patients with complex partial status epilepticus. BACKGROUND: During status epilepticus, neuroimaging may be used to exclude other neurologic conditions. Therefore, it is important to identify the neuroimaging features that are associated with status epilepticus. In addition, MRI characteristics may provide insight into the pathophysiologic changes during status epilepticus. METHODS: The history and neuroimaging examination results of three patients with complex partial status epilepticus were reviewed. Studies obtained during status epilepticus included diffusion-weighted MRI (DWI), MR angiography (MRA), postcontrast T1-weighted MRI, T2-weighted MRI, and CT. Follow-up MRI was obtained in two patients, and autopsy results were available for the third. RESULTS: Some of the MRI and CT findings during partial status epilepticus mimicked those of acute ischemic stroke: DWI and T2-weighted MRI showed cortical hyperintensity with a corresponding low apparent diffusion coefficient, and CT showed an area of decreased attenuation with effacement of sulci and loss of gray-white differentiation. However, the lesions did not respect vascular territories, there was increased signal of the ipsilateral middle cerebral artery on MRA, and leptomeningeal enhancement appeared on postcontrast MRI. On follow-up imaging, the abnormalities had resolved, but some cerebral atrophy was present. CONCLUSIONS: The radiologic characteristics of status epilepticus resemble those of ischemic stroke but can be differentiated based on lesion location and findings on MRA and postcontrast MRI. The MRI abnormalities indicated the presence of cytotoxic and vasogenic edema, hyperperfusion of the epileptic region, and alteration of the leptomeningeal blood-brain barrier. These changes reversed, but they resulted in some regional brain atrophy.

Adult↗
PubMed1999

Pharmacokinetics, safety, and efficacy of combination treatment with methotrexate and leflunomide in patients with active rheumatoid arthritis.

OBJECTIVE: To examine the safety and pharmacokinetics of and clinical response to leflunomide, a de novo pyrimidine synthesis inhibitor, when administered to patients with active rheumatoid arthritis (RA) who have been receiving long-term methotrexate therapy. METHODS: This was an open-label, 52-week study in which 30 patients with RA that remained active despite therapy with methotrexate at 17+/-4 mg/week (mean +/- SD) for > or =6 months were given leflunomide, 10-20 mg/day. Patients were assessed for adverse effects, pharmacokinetic measurements of leflunomide and methotrexate, and clinical response by American College of Rheumatology (ACR) 20% response criteria. RESULTS: Twenty-three patients completed 1 year of treatment. No significant pharmacokinetic interactions between leflunomide and methotrexate were noted. This combination therapy was generally well tolerated clinically, with the exception of elevations of liver enzyme levels. Seven patients withdrew from the treatment regimen: 2 withdrawals were voluntary, 3 were due to persistent elevation of plasma transaminase levels, and 2 were due to lack of efficacy. Of the patients, 16 (53%) met ACR 20% response criteria. Two met ACR criteria for remission after 1 year. CONCLUSION: The combination of methotrexate and leflunomide has therapeutic potential in RA.

Adult↗
PubMed1994

A prospective, randomized, double-blind comparison of epidural and intravenous sufentanil infusions.

BACKGROUND: The site of action (spinal vs. central) of epidurally administered lipid-soluble opioids has been the subject of controversy. We compared the efficacy, plasma concentration and side effects of epidural and intravenously administered sufentanil for postoperative pain relief. METHODS: Using a double-blind, prospective design, 50 patients scheduled for intraabdominal operations during combined epidural-general anesthesia were randomized into one of two groups. Patients in group 1 (n = 24) received a 1-microgram/ml sufentanil infusion epidurally at 0.2 microgram.kg-1.h-1 and a saline infusion intravenously at the same rate. Patients in group 2 (n = 26) received a 1-microgram/ml sufentanil infusion intravenously at 0.2 microgram.kg-1.h-1 and a saline infusion epidurally at the same rate. Intravenous morphine sulfate was available in 2-mg increments to all patients in the postanesthesia care unit until visual analogue scale (0-100 mm) pain score was < or = 30. Then, a patient-controlled intravenous pump providing morphine on demand (1 mg with a 10-min lockout) was begun. Blood samples were drawn for sufentanil plasma levels and patients were assessed for pain, sedation and nausea for the 48 h after commencement of the infusions. RESULTS: Similar visual analogue pain, sedation, and nausea scores were found between the patients in the two groups. No differences were found in supplemental morphine requirements and plasma sufentanil concentrations between the patients in the two groups. A higher incidence of excessive sedation requiring infusion decrease was infusion decrease was found in the intravenous group (six vs. one, P < 0.05). CONCLUSIONS: Many clinical similarities were found when epidural and intravenous sufentanil infusions were compared. The higher incidence of excessive sedation in the patients receiving intravenous sufentanil could not be explained on the basis of plasma sufentanil concentrations alone. This study indicates that little clinical difference exists between epidural and intravenous administration of sufentanil.

Aged↗
PubMed1984

Two kinds of timing in circadian incubation rhythm of ring doves.

Ring dove males share incubation with females by sitting on the nest for a block of time in the middle of the day. The timing of nest exchanges was studied by experimentally delaying the onset, in the morning, of the male's sitting bout. Such delays induced a concomitant but smaller delay in the offset of the male's sitting bout in the afternoon. The female, however, approached the nest to start her bout of sitting at the usual time in the afternoon even though her previous sitting bout had ended later than usual. These findings, together with data on interactions between the pair at the afternoon exchange, suggest that the behavior of the sitting male reflects an interval timing mechanism initiated with the onset of his sitting bout. In contrast the attempts to regain the nest by the nonsitting female probably reflect a circadian oscillation.

Animals↗