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Biomedical subjects

M Taylor

Publications and source records attributed to M Taylor.

At least 433 records · Page 24Linked to original sources

Skeletal stability and relapse patterns after Le Fort I osteotomy using miniplate fixation in patients with isolated cleft palate.

We present a series of 14 consecutive isolated cleft palate patients aged 17 to 25 years (mean 19 years) who underwent Le Fort I maxillary advancement fixed with miniplates by the senior author (Posnick) over the period 1987-1991. Ten of the patients underwent autogenous bone grafting; all were stabilized intraoperatively with four miniplates, a prefabricated acrylic splint, and intermaxillary fixation. The patients were analyzed to determine amount and timing of horizontal and anterior and posterior vertical relapse, correlation between advancement and relapse, effect of a pharyngoplasty in place at time of osteotomy, effect of performing multiple jaw procedures, and maintenance of overjet and overbite. Tracings of preoperative and serial postoperative lateral cephalograms (immediate, 6 to 8 weeks, and 1 year) were analyzed to calculate horizontal and vertical maxillary changes and the amount of overjet and overbite maintained. Clinical follow-up ranged from 1.5 to 5.5 years (mean 2.5 years). No significant difference was seen in vertical or horizontal change or relapse between patients who had maxillary surgery alone (n = 10) and those who had operations in both jaws (n = 4), nor did outcome vary significantly for those who had a pharyngoplasty in place (n = 8) at the time of their Le Fort I osteotomy. The mean "effective" maxillary advancement for the group was 6.4 mm, with 5.4 mm maintained 1 year later (mean relapse 1.0 mm).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Extracellular matrix derived from hair and skin fibroblasts stimulates human skin melanocyte tyrosinase activity.

There is indirect evidence that both skin and hair melanocytes are regulated by the activity of adjacent cells. In hair, the specialized fibroblasts (dermal papilla cells) appear to play a role in the regulation of hair growth. Hair pigmentation may relate to hair growth. In skin, melanocytes are located adjacent to the basement membrane zone. As far as we are aware, direct interactions of fibroblasts with melanocytes have not previously been investigated. Accordingly, the objective of this study was to develop co-culture conditions in which to investigate whether dermal fibroblasts from skin or hair could influence melanocyte differentiation. The influence of fibroblast-conditioned media, co-culture with fibroblasts, and fibroblast-derived extracellular matrix (ECM) on normal human skin melanocyte tyrosinase activity was examined. Fibroblasts from both skin and hair were capable of altering melanocyte morphology and significantly increasing tyrosinase activity when melanocytes were cultured in the absence, but not the presence, of the major proliferative drives. Although stimulation of tyrosinase activity was detectable with conditioned medium and co-culture with fibroblasts, the most striking result was obtained with the fibroblast-produced ECM which, on average, produced a four-fold increase in tyrosinase activity within 6 days. Thus, the study describes co-culture conditions in which the stimulatory effect of the fibroblast on melanocyte differentiation can be examined.

Cell Differentiation↗

Children's understanding of knowledge acquisition: the tendency for children to report that they have always known what they have just learned.

Children's attention to knowledge-acquisition events was examined in 4 experiments in which children were taught novel facts and subsequently asked how long they had known the new information. In Experiment 1, 4- and 5-year-olds tended to claim they had known novel animal facts for a long time and also reported that other children would know the novel facts. This finding was replicated in Experiment 2, using facts associated with chemistry demonstrations. In Experiments 3 and 4, children were taught new color words. 5-year-olds, but not 4-year-olds, distinguished between novel and familiar color words, reporting they had not known the novel words before the test session, but they had always known the familiar words. 4-year-olds in Experiment 4 were better able to distinguish novel and familiar color words when the teaching of the novel words was an explicit and salient part of the procedure.

Child Development↗

Treatment of subjects with refractory periodontal disease.

The aim of the present study was to evaluate the effect of non-surgical periodontal therapy with the adjunct of a selected antibiotic in subjects diagnosed with refractory periodontal disease. 21 subjects were selected for the study; all had a history of periodontal surgery, tetracycline therapy, and regular maintenance by a periodontist. When disease activity was detected, a bacterial sample was taken and a whole plaque susceptibility test was performed. Before the outcome of the susceptibility test the subjects were assigned to either antibiotic or placebo therapy. All subjects received scaling and rootplaning prior to antibiotic or placebo therapy. Based on the susceptibility test, subjects in the antibiotic group were treated either with Augmentin or clindamycin. The results demonstrated that in subjects with refractory periodontal disease there was no significant difference (N.S.) in the proportion of sites losing attachment before and after treatment (11.3% and 12.4%, respectively) over a 2-year post therapy observation period. However, the proportion of sites showing gain of attachment increased from 0.9% before therapy to 5.1% (p = 0.029) following selective antibiotic therapy when combined with scaling and rootplaning. The remainder of sites showed no change between pre- and post-therapy monitoring periods. The progression of attachment loss in the active sites could not be completely stopped over the entire 2-year period. After 12-15 months following therapy, there was a tendency towards new loss of attachment and an increase of pocket depth. However, all 4 subjects treated with placebo drug demonstrated continuous deterioration and had to be retreated. Although the proportion of sites losing attachment decreased from 5.1% to 2.3% (N.S.), the proportion of sites gaining attachment also decreased from 2.0% to 1.0% (N.S.). The results suggest that scaling and rootplaning together with selected antibiotic therapy repeated every 12-15 months may be beneficial for these subjects although it may not completely stop progressive attachment loss.

Adult↗

Madness and Maastricht: a review of reactive psychoses from a European perspective.

Brief reactive psychosis has had a chequered career as a valid diagnostic entity, and lack of an international consensus has undermined the concept, but clinical observation attests to its durability. As the European community derestricts its labour boundaries, resulting in psychiatrists increasingly practising outside their country of training, I would suggest that this examination of 'brief reactive psychosis' becomes particularly pertinent with respect to differing diagnostic trends across Europe and elsewhere.

Europe↗

Genetic haplotyping of ataxia-telangiectasia families localizes the major gene to an approximately 850 kb region on chromosome 11q23.1.

The genotyping data given localize the major A-T gene to an approximately 850 kb region. They also localize the group A A-T gene (ATA) to a region that contains the approximately 850 kb region. They are compatible with linking A-TFresno to 11q22-23. NBS-V2 does not link to this region. Four non-linking families contain only single affecteds, suggesting that these may be spontaneous mutations rather than evidence for an A-T gene outside the 11q22-23 region. Finally, two other non-linking families contain recombinant haplotypes that are compatible with a second A-T gene at 11q22-23, slightly distal to the approximately 850 kb region. However, convincing evidence for a second gene is still lacking.

Adult↗

MRSA in the operating department.

In recent years, infection control in the operating department has focused on the concept of universal precautions. This allows protection for both patients and staff in relation to blood borne pathogens. Recent research, however, suggests that the introduction of universal precautions could lead to an increase in the transmission of other pathogens, for example, Methicillin Resistant Staphylococcus Aureus (MRSA). This article aims to provide a brief overview of the universal precautions, followed by an in-depth consideration of MRSA, its history, incidence, transmission, effect and implications for both patients and staff in the operating department.

Cross Infection↗

The A-1 antigen: a novel marker in experimental peripheral nerve injury.

Expression of the Schwann cell phenotype is regulated by signals from the adjoining axon. After axotomy, the Schwann cell ceases the production and maintenance of the myelin sheath and assumes phagocytic properties necessary to digest its own myelin. The molecular mechanisms responsible for this behavior remain unclear. A monoclonal antibody termed BIKS was produced after the immunization of mice with guinea pig lymphoid tissue. This antibody recognizes a cytoplasmic vesicle-associated molecule (A-1 antigen) which is abundant in all tissue macrophages but is also expressed in small amounts in normal Schwann cells. Following axotomy, the A-1 antigen appears to be translocated from a perinuclear site to accumulate in large quantities around myelin ovoids in Schwann cells, as well at the nodes of Ranvier-sites where Wallerian degeneration is known to commence. The level of the antigen remains high when axons are prevented from regeneration. During repair of crush injury, however, the level of antigen drops concomitant with the ingrowth of regenerating axons, suggesting axonal control of A-1 antigen expression.

Animals↗

Clinical immunoscintigraphy of recurrent ovarian cancer with indium 111-labeled B72.3 monoclonal antibody.

OBJECTIVE: To prospectively evaluate the ability for immunoscintigraphy with monoclonal antibody CYT-103 labeled with indium 111 to detect tumor presence in 15 patients with ovarian cancer undergoing second-look surgery. DESIGN: Prospective, open-label, nonrandomized trial. SETTING: Hospital-based nuclear medicine facility and operating room. STUDY PARTICIPANTS: Patients with previous ovarian cancer scheduled for second-look surgery. MAIN OUTCOME MEASURE: Correctness of prediction of immunoscintigraphy for presence or absence of ovarian cancer compared with serum CA 125 titer and computed tomography. RESULTS: Immunoscintigraphy, computed tomography, and serum CA 125 titer had respective sensitivities of 92%, 42%, and 42%; specificities of 67%, 100%, and 100%; accuracies of 87%, 53%, and 53%; and diagnostic values of 59%, 42%, and 42%. The full regional extent of recurrent tumor was correctly detected in 45% of patients by immunoscintigraphy and in none of the patients by computed tomography. Immunoscintigraphy detected miliary tumor in two of four patients and computed tomography, as expected, was unable to detect miliary disease. CONCLUSIONS: Recurrent ovarian cancer often presents as multiple small lesions throughout the abdominal cavity. In this subset of patients, immunoscintigraphy may be particularly well suited for detection of the presence of recurrent tumor.

Antibodies, Monoclonal↗

Comparison of cytosolic calcium shifts, superoxide generation, and lactoferrin secretion in the neutrophils of atopics and nonatopics.

We previously found that platelet-activating factor (PAF) stimulated greater lactoferrin secretion by neutrophils of atopics than nonatopics. To help understand underlying mechanisms, we compared agonist-stimulated lactoferrin secretion with another response, superoxide generation, to determine whether there is a global alteration in the reactivity of atopic neutrophils to these stimuli. We also determined Ca2+ mobilization in such neutrophils because such mobilization is a signaling pathway for both superoxide generation and granule content exocytosis. Although PAF again stimulated greater lactoferrin secretion in atopic than in nonatopic neutrophils, the peak superoxide secretion and cytosolic Ca2+ mobilization were not significantly different in atopics and nonatopics. Leukotriene B4-induced superoxide secretion and cytosolic Ca2+ shifts were also similar in atopics and nonatopics. These findings suggest that (1) the enhanced PAF-induced lactoferrin secretion in atopic neutrophils is not a reflection of greater PAF binding or broad-based cell hyperreactivity and (2) a selective signaling pathway in atopic neutrophils may be responsible for the enhanced lactoferrin secretion. These findings may be relevant to in vivo events because we have found increased PAF and lactoferrin release in skin chambers overlying immunoglobulin E-mediated human skin reactions.

Calcium↗

Bone single-photon emission tomography in recent meniscal tears: an assessment of diagnostic criteria.

Bone single-photon emission tomography (SPET) was performed in 40 patients within 6 months of acute knee injury where internal derangement of the knee was suspected, and the results related to the arthroscopy findings. Scan features with high sensitivity, specificity, and predictive accuracy for a meniscal tear could not be obtained on planar imaging. However, a half-crescent or more of increased tibial plateau activity on transaxial SPET gave a sensitivity of 89%, a specificity of 76%, a positive predictive accuracy of 77% and a negative predictive value of 89%. For longitudinal (bucket handle) tears alone the optimum scan pattern was a full crescent of increased tibial plateau activity with adjacent femoral activity and increased blood pool activity which gave corresponding values of 78%, 94%, 78% and 93%. It is concluded that the inclusion of tibial plateau activity of less than a full crescent and the presence of femoral condyle and blood pool activity in the diagnostic criteria improves the ability of bone SPET to detect meniscal tears. The value of bone SPET in the diagnosis of meniscal tears suggests that it could have a significant role to play in the management of knee injuries.

Adolescent↗

A placebo controlled trial of fluticasone propionate in asthmatic children.

Fluticasone propionate is a synthetic steroid for use by the inhaled route. It's high topical potency and low systemic bioavailability make it suitable for use in asthmatic children. A total of 258 children were randomised in a double-blind study to receive fluticasone propionate (50 micrograms bd) as the dry powder formulation inhaled via a Diskhaler inhaler, or matched placebo (with current therapy) for 4 weeks throughout which time diary cards were completed. During clinic visits lung function and adrenal function were measured. Fluticasone propionate produced a significantly greater increase in morning peak expiratory flow rate (PEFR) (adjusted mean difference over days 1-28, 17 l/min (95% CI; 10, 24); P < 0.001) and evening PEFR (adjusted mean difference over days 1-28, 16 l/min (95% CI; 9, 23); P < 0.001). In addition, diary card symptom scores, beta 2-agonist rescue and clinic lung function improved significantly on fluticasone propionate. There were few adverse events and basal plasma cortisol remained within the normal range. In conclusion fluticasone propionate at 50 micrograms bd is superior to placebo (current therapy) in the treatment of childhood asthma with no evidence of adverse effects.

Administration, Inhalation↗

Sustained hemodynamic response to flosequinan in patients with heart failure receiving angiotensin-converting enzyme inhibitors.

OBJECTIVES: We evaluated the short- and long-term effects of flosequinan in 47 patients with severe heart failure despite ongoing captopril treatment. BACKGROUND: There have been no previous evaluations of the long-term hemodynamic effects of any direct-acting vasodilator in patients with heart failure receiving an angiotensin-converting enzyme inhibitor. Flosequinan is an arterial and venous vasodilator with actions similar to those of the hydralazine-isosorbide dinitrate combination. METHODS: After baseline hemodynamic measurements using balloon-tipped pulmonary artery and radial arterial catheters, patients were randomized to receive 50, 100 or 150 mg of flosequinan daily. Hemodynamic variables were measured immediately before and after short-term flosequinan administration and after 8 weeks of therapy. RESULTS: With short-term flosequinan administration, mean arterial, right atrial and left ventricular filling pressures decreased by 6.4 +/- 1.1, 3.8 +/- 0.5 and 7.3 +/- 0.7 mm Hg, respectively (all p < 0.001). Cardiac index increased by 0.5 +/- 0.1 liters/min per m2, systemic vascular resistance decreased by 616 +/- 105 dynes.s.cm-5 and heart rate increased by 4 +/- 1 beats/min (all p < 0.001). After 8 weeks of long-term flosequinan administration, the vasodilator effect of a dose of flosequinan persisted. Compared with pretreatment baseline values, mean arterial, right atrial and left ventricular filling pressures at the peak effect of flosequinan were decreased by 3.5 +/- 1.3, 2.8 +/- 0.7 and 5.1 +/- 1.3 mm Hg, respectively (all p < 0.01). Systemic vascular resistance had decreased by 585 +/- 95 dynes.s.cm-5, cardiac index had increased by 0.5 +/- 0.1 liters/min per m2 and heart rate had increased by 10 +/- 2 beats/min (all p < 0.001). CONCLUSIONS: The arterial and venous vasodilator flosequinan exerts both short- and long-term sustained hemodynamic effects in patients with heart failure receiving angiotensin-converting enzyme inhibitors.

Adult↗