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Biomedical subjects

N Evans

Publications and source records attributed to N Evans.

At least 55 records · Page 3Linked to original sources
PubMed2000

Acid dissociation constants of bilirubin and related carboxylic acid compounds in bile salt solutions.

Bilirubin, the yellow-orange tetrapyrrole pigment of jaundice, is essentially insoluble in pure water, but is much more soluble in solutions of bile salts such as sodium taurocholate. The biophysical chemistry of bilirubin in bile salt solutions is affected by changes in the pH of the solution in the range 5-9, suggesting that interactions with bile salt molecules and micelles may alter the acidity of the pigment. We have examined this possibility by determining the apparent pKa values for a series of carboxyl 13C-enriched model compounds, including the bilirubin analog mesobilirubin XIIIalpha, in solutions of sodium taurocholate and sodium taurodeoxycholate. Apparent pKa values were determined by 13C NMR titrations in dimethyl sulfoxide-water mixtures. The results show that the acidity of all compounds is decreased, or pKa increased, in micellar bile salt solution relative to pure water and that the effect is greatest for the larger, less water-soluble compounds. We have proposed a model to explain these results and discussed the implications of these findings for the biophysical chemistry of bilirubin in bile.

Bile Acids and Salts↗
PubMed2000

Limits on a composite Higgs boson.

Precision electroweak data are generally believed to constrain the Higgs boson mass to lie below approximately 190 GeV at 95% confidence level. The standard Higgs model is, however, trivial and can only be an effective field theory valid below some high energy scale characteristic of the underlying nontrivial physics. Corrections to the custodial isospin violating parameter T arising from interactions at this higher energy scale dramatically enlarge the allowed range of Higgs mass. We perform a fit to precision electroweak data and determine the region in the (m(H),delta T) plane that is consistent with experimental results. Overlaying the estimated size of corrections to T arising from the underlying dynamics, we find that a Higgs mass up to 500 GeV is allowed.

Journal Article↗
PubMed2000

Identification of an EDG7 variant, HOFNH30, a G-protein-coupled receptor for lysophosphatidic acid.

We have identified a cDNA, designated HOFNH30, which encodes a 354 amino acid G-protein-coupled receptor (GPCR). This receptor has 96% amino acid identity to the Jurkat-T cell-derived EDG7 and could be a splice variant. RT-PCR analysis demonstrated that HOFNH30 mRNA is expressed in placenta whereas EDG7 mRNA shows highest expression in prostate. The HOFNH30 gene is localized to human chromosome 1p22. 3-1p31.1. When HOFNH30 was expressed in RBL-2H3 cells, LPA and phosphatidic acid (PA) induced a calcium mobilization response with EC(50) values of 13 nM and 3 microM, respectively. LPA also induced phosphorylation of mitogen-activated protein kinase (p42(MAPK) and p44(MAPK)) in HOFNH30-transfected but not vector-transfected RBL-2H3 cells. In the present study, we have identified a novel variant from the EDG receptor family, a GPCR for which LPA is a high-affinity endogenous ligand.

Amino Acid Sequence↗
PubMed2000

MR imaging of lumbar facet joint synovial cysts.

The increasing application of magnetic resonance (MR) imaging of the spine has raised the awareness of lumbar facet synovial cysts (LFSC). This well recognised, yet uncommon condition, presents with low back pain and radiculopathy due to the presence of an extradural mass. The commonest affected level is L4/5 with a mild degenerative spondylolisthesis a frequent associated finding. MR imaging is the technique of choice to detect and diagnose a LFSC. This pictorial essay, drawing on experience of 43 cases seen in 40 patients, illustrates the spectrum of appearances that can be encountered and suggest differing causes for the variable signal characteristics exhibited. Computed tomography (CT) can be of value in some cases to aid interpretation of the MR images. In addition, CT facet arthrography by injection of air or iodinated non-ionic contrast medium may be used to confirm the diagnosis in doubtful cases as well as noting whether the patients presenting symptoms can be provoked. A comprehensive review of the existing literature is presented.

Humans↗
PubMed2000

Snakebites and ethnobotany in the northwest region of Colombia: Part I: traditional use of plants.

In Antioquia and Chocó, traditional healers attend 60% of snakebites. With the aim to produce an inventory of the plants used by the healers to treat snakebites and to document the methods of preparation, administration, the dosage, number of patients treated throughout their years of practice with treatment results, 20 healers with experience in Bothrops, Porthidium and Bothriechis envenomations were interviewed between August, 1996 and November, 1998. They belong to nine black and three indigenous rural communities located near the towns of Bojayá, Vigía del Fuerte, Unguía (Atrato river valley), Nuquí and Bahía Solano (Pacific coast). Based on field interviews, 101 species of plants were identified as used to treat snakebites. The part used of each plant varies according to the species. Sixty plants are used in the form of drinks prepared by infusion, decoction or maceration; 78 as external baths on the affected extremity; 11 for steam application and 39 for poultices; the latter is used mainly when the bite is complicated by local necrosis. In mild and moderate envenomations, they generally use a mixture of three plants, while in severe cases they mix from five to 12, a handful of each one. Treatment is generally performed for 1-3 days, when the patient reacts positively. They reported to have treated 454 patients during their years of experience, 20 of them (4.4%) died. With the guidance of the healers, 77 species of plants were collected and photographed. These plants belong to 41 families, of which Piperaceae (13 species), Araceae (six species), Asteraceae (five species) and Gesneriaceae (three species) have the highest number of species.

Animals↗
PubMed2000

Echocardiography on neonatal intensive care units in Australia and New Zealand.

OBJECTIVE: To establish the number of neonatal intensive care units (NICU) in Australia and New Zealand where echocardiography is performed by neonatologists, and to establish attitudes to the training of neonatologists in echocardiography. METHODOLOGY: A survey was conducted of the directors of all 29 level 3 NICU in the Australian and New Zealand Neonatal Network. Replies were received from all NICU. RESULTS: In 41% of NICU, a neonatologist provides the primary echocardiography service, with half these units having more than one neonatologist with skills. Sixty-eight per cent of the other units would like a neonatologist to develop these skills in the future. Units without a neonatologist with echocardiographic skills were generally less satisfied with their service, benefits and problems for both types of unit are described. Eleven per cent of units felt neonatologists should not be doing echocardiography and 96% of units felt training guidelines should be established. CONCLUSIONS: Ultrasound in neonatology and other specialties is moving beyond its traditional boundaries and becoming part of the acute care doctors' diagnostic repertoire. This trend needs to be recognized in the specialty training and the ultrasound accreditation processes.

Australia↗
PubMed2000

A randomized trial of enteral feeding volumes in infants born before 30 weeks' gestation.

OBJECTIVE: To compare the effect of two volumes of enteral feeds on postnatal growth in infants born before 30 weeks gestation. METHODOLOGY: Fifty-four infants, less than 30 weeks gestational age, who reached full enteral feeds were randomized to remain on 150 mL/kg per day (150 group) or increase to 200 mL/kg per day (200 group). The primary outcome measure was growth at 35 weeks corrected gestational age (CGA). RESULTS: There were no statistically significant differences in demographic or clinical parameters between the study groups at commencement of the study, although there was a trend for infants in the 150 group to be lighter (895 g vs 1020 g, P = 0.27). Milk intakes were increased in 43% of the infants in the 150 group, whereas 54% of the infants in the 200 group required reduced intakes. Infants in the 200 group had greater daily weight gains (16.7 g/kg per day vs 15.2 g/kg per day, P = 0.047) and at 35 weeks CGA were heavier (2020 g vs 1885 g, P = 0.014) and had a greater arm fat area (282 mm2 vs 218 mm2, P = 0.009). There was no difference in length or head circumference at 35 weeks CGA, and no difference in any growth parameter at 1 year of age. Morbidity was not different between the groups. CONCLUSIONS: The individual milk volume requirements for adequate weight gain without significant adverse effects vary between 150 and 200 mL/kg per day in extremely premature infants. For many infants in both groups, the assigned target volume was not appropriate. Increased milk intakes (and therefore higher caloric and mineral intakes) are associated with increased daily weight gains and a greater weight at 35 weeks CGA. The weight gain may be due to an increase in fat deposition.

Anthropometry↗
PubMed2000

The use of ultrasound in the diagnosis of invasive lobular carcinoma of the breast less than 10 mm in size.

AIM: To assess the ability of ultrasound to detect small (<10 mm) invasive lobular carcinoma (ILC) of the breast. Previous reporters have suggested very low sensitivity rates for identifying these tumours on ultrasound. We reviewed our own experience to see how our figures compared. MATERIALS AND METHODS: We retrospectively analysed all cases of pure small ILC diagnosed at Breast Test Wales over the first 9-year period of the National Health Breast Screening Programme. All mammograms and ultrasound examinations were reviewed and findings assessed. We also obtained similar information on small invasive ductal carcinoma (IDC) for comparison. RESULTS: Sixteen cases of pure small ILC were diagnosed during the study period. Fourteen of the 15 patients (93%) who underwent an ultrasound examination had abnormal findings. A definitive pre-operative diagnosis using ultrasound guided sampling was obtained in all 14 patients. A larger number of small IDCs (152) were diagnosed during the same study period and the sensitivity of ultrasound in this group was recorded as 80%. CONCLUSION: Our findings suggest a much higher sensitivity for ultrasound in the detection of small ILC than has been previously described. Its use should be encouraged particularly as it facilitates biopsy and pre-operative diagnosis.

Aged↗
PubMed2000

Ductal shunting, high pulmonary blood flow, and pulmonary hemorrhage.

OBJECTIVE: To describe the relationship among ductal shunting, estimated pulmonary blood flow, and pulmonary hemorrhage in very preterm infants. STUDY DESIGN: A total of 126 babies born before 30 weeks' gestation (median gestation 27 weeks, range 23 to 29 weeks) underwent echocardiography at 5, 12, 24, and 48 hours of age; measurements included right and left ventricular output, superior vena cava flow, and color Doppler diameter of any ductal shunt. Pulmonary blood flow was derived from the sum of right ventricular output and estimated ductal shunt flow. RESULTS: Twelve (9.5%) babies had a pulmonary hemorrhage at a mean age of 38 hours. Compared with the rest of the cohort, these 12 babies were less likely to have had antenatal steroids (59% vs 90%) and were less mature (26 weeks vs 27 weeks). At the echocardiogram closest to the pulmonary hemorrhage, 11 (92%) of the 12 babies had a significant patent ductus arteriosus >1.6 mm in diameter (median 2 mm, range 0.7 to 2.4 mm), and the median pulmonary blood flow was 326 mL/kg/min (range 210 to 598 mL/kg/min). These measurements were significantly higher than those found in the rest of the cohort in the same period (median duct diameter 0.5 mm [range 0 to 2.9 mm], median pulmonary blood flow 237 mL/kg/min [range 107 to 569 mL/kg/min]). At 5-hour echocardiography the babies with pulmonary hemorrhage had significantly larger diameter ducts but similar pulmonary blood flow. CONCLUSIONS: Pulmonary hemorrhage in preterm babies is associated with significant ductal shunting and high estimated pulmonary blood flow.

Coronary Circulation↗
PubMed2000

Superior vena cava flow in newborn infants: a novel marker of systemic blood flow.

BACKGROUND: Ventricular outputs cannot be used to assess systemic blood flow in preterm infants because they are confounded by shunts through the ductus arteriosus and atrial septum. However, flow measurements in the superior vena cava (SVC) can assess blood returning from the upper body and brain. OBJECTIVES: To describe a Doppler echocardiographic technique that measures blood flow in the SVC, to test its reproducibility, and to establish normal ranges. DESIGN: SVC flow was assessed together with right ventricular output and atrial or ductal shunting. Normal range was established in 14 infants born after 36 weeks' gestation (2 measurements taken in the first 48 hours) and 25 uncomplicated infants born before 30 weeks (4 measurements taken in the first 48 hours). Intra-observer and interobserver variability were tested in 20 preterm infants. RESULTS: In 14 infants born after 36 weeks, median SVC flow rose from 76 ml/kg/min on day 1 to 93 ml/kg/min on day 2; in 25 uncomplicated very preterm infants, it rose from 62 ml/kg/min at 5 hours to 86 ml/kg/min at 48 hours. The lowest SVC flow for the preterm babies rose from 30 ml/kg/min at 5 hours to 46 ml/kg/min by 48 hours. Median intra-observer and interobserver variability were 8. 1% and 14%, respectively. In preterm babies with a closed duct, SVC flow was a mean of 37% of left ventricular output and the two measures correlated significantly. CONCLUSIONS: This technique can assess blood flow from the upper body, including the brain, in the crucial early postnatal period, and might allow more accurate assessment of the status of systemic blood flow and response to treatment.

Blood Flow Velocity↗
PubMed2000

Low superior vena cava flow and intraventricular haemorrhage in preterm infants.

OBJECTIVES: To document the incidence, timing, degree, and associations of systemic hypoperfusion in the preterm infant and to explore the temporal relation between low systemic blood flow and the development of intraventricular haemorrhage (IVH). STUDY DESIGN: 126 babies born before 30 weeks' gestation (mean 27 weeks, mean body weight 991 g) were studied with Doppler echocardiography and cerebral ultrasound at 5, 12, 24, and 48 hours of age. Superior vena cava (SVC) flow was assessed by Doppler echocardiography as the primary measure of systemic blood flow returning from the upper body and brain. Other measures included colour Doppler diameters of ductal and atrial shunts, as well as Doppler assessment of shunt direction and velocity, and right and left ventricular outputs. Upper body vascular resistance was calculated from mean blood pressure and SVC flow. RESULTS: SVC flow below the range recorded in well preterm babies was common in the first 24 hours (48 (38%) babies), becoming significantly less common by 48 hours (6 (5%) babies). These low flows were significantly associated with lower gestation, higher upper body vascular resistance, larger diameter ductal shunts, and higher mean airway pressure. Babies whose mothers had received antihypertensives had significantly higher SVC flow during the first 24 hours. Early IVH was already present in 9 babies at 5 hours of age. Normal SVC flows were seen in these babies except in 3 with IVH, which later extended, who all had SVC flow below the normal range at 5 and/or 12 hours. Eight of these 9 babies were delivered vaginally. Late IVH developed in 18 babies. 13 of 14 babies with grade 2 to 4 IVH had SVC flow below the normal range before development of an IVH. Two of 4 babies with grade 1 IVH also had SVC flow below the normal range before developing IVH, and the other 2 had SVC flow in the low normal range. In all, IVH was first seen after the SVC flow had improved, and the grade of IVH related significantly to the severity and duration of low SVC flow. The 9 babies who had SVC flow below the normal range and did not develop IVH or periventricular leucomalacia were considerably more mature (median gestation 28 v 25 weeks). CONCLUSIONS: Low SVC flow may result from an immature myocardium struggling to adapt to increased extrauterine vascular resistances. Critically low flow occurs when this is compounded by high mean airway pressure and large ductal shunts out of the systemic circulation. Late IVH is strongly associated with these low flow states and occurs as perfusion improves.

Antihypertensive Agents↗
PubMed2000

Cardiovascular effects of an intravenous bolus of morphine in the ventilated preterm infant.

AIM: To examine the cardiovascular effects of an intravenous bolus of morphine, 100 microg/kg, in 17 ventilated preterm infants. METHODS: Heart rate and blood pressure were monitored. Right ventricular output, superior vena caval flow, and the width of the ductus arteriosus were measured by Doppler echocardiography 10 and 60 minutes after the morphine injection, and the values compared with baseline values by the paired t test. RESULTS: There was a small but significant fall in heart rate (2.1% at 10 minutes, 4.3% at 60 minutes) consistent with a sedative effect. There was no effect on systolic, diastolic, or mean blood pressure. There was no significant effect on systemic blood flow as measured by either right ventricular output or superior vena caval flow. Ductal width was significantly reduced by a mean of 16% at 60 minutes, suggesting that normal duct closure was not inhibited. CONCLUSION: No cardiovascular effects of an intravenous bolus of morphine could be detected.

Analgesics, Opioid↗
PubMed2000

Airway inflammation and etiology of acute exacerbations of chronic bronchitis.

STUDY OBJECTIVES: The etiologic role of bacterial pathogens isolated from sputum culture in 40 to 50% of acute exacerbations of chronic bronchitis (AECB) is controversial. If bacterial pathogens cause these AECB, they should be associated with greater neutrophilic airway inflammation than pathogen-negative exacerbations. DESIGN: This hypothesis was tested by comparing levels of interleukin (IL)-8, tumor necrosis factor (TNF)-alpha, and neutrophil elastase (NE) in 81 sputum samples obtained from 45 patients with AECB. Four groups were compared. In the first three groups, nontypable Haemophilus influenzae (n = 20), Haemophilus parainfluenzae (n = 27), and Moraxella catarrhalis (n = 14) were isolated as sole pathogens, respectively. In the fourth group, only normal flora was isolated (n = 20). Paired samples, obtained from individual patients at different times, that differed in their culture results were also compared. SETTING: An outpatient research clinic at a Veterans Affairs Medical Center. PATIENTS: These patients were participating in a prospective, longitudinal study of the dynamics of bacterial infection in chronic bronchitis, for which they were seen in the study clinic on a monthly basis as well as when they were experiencing symptoms suggestive of AECB. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: H influenzae exacerbations were associated with significantly higher sputum IL-8, TNF-alpha, and NE. M catarrhalis exacerbations demonstrated significantly higher sputum TNF-alpha and NE when compared to pathogen-negative exacerbations. H parainfluenzae-associated exacerbations had an inflammatory profile similar to pathogen-negative exacerbations. Sputum elastase level distinguished bacterial from nonbacterial AECB and correlated with clinical severity of the AECB. CONCLUSIONS: Increased airway inflammation associated with isolation of H influenzae and M catarrhalis supports an etiologic role of these pathogens in AECB.

Acute Disease↗
PubMed1999

The ordered visual transduction complex of the squid photoreceptor membrane.

The study of visual transduction has given invaluable insight into the mechanisms of signal transduction by heptahelical receptors that act via guanine nucleotide binding proteins (G-proteins). However, the cyclic-GMP second messenger system seen in vertebrate photoreceptor cells is not widely used in other cell types. In contrast, the retina of higher invertebrates, such as squid, offers an equally accessible transduction system, which uses the widespread second messenger chemistry of an increase in cytosolic calcium caused by the production of inositol-(1,4,5)-trisphosphate (InsP3) by the enzyme phospholipase C, and which may be a model for store-operated calcium influx. In this article, we highlight some key aspects of invertebrate visual transduction as elucidated from the combination of biochemical techniques applied to cephalopods, genetic techniques applied to flies, and electrophysiology applied to the horseshoe crab. We discuss the importance and applicability of ideas drawn from these model systems to the understanding of some general processes in signal transduction, such as the integration of the cytoskeleton into the signal transduction process and the possible modes of regulation of store-operated calcium influx.

Amino Acid Sequence↗
PubMed1999

SAPHO syndrome: 20-year follow-up.

Considerable attention has been paid in the past 10 years to the radiological spectrum of disease entities belonging to the SAPHO syndrome. We report an unusual case presenting with an extra-axial (femoral) lesion, prior to description of this syndrome, which was radiologically and histologically mistaken for a parosteal osteosarcoma. Nineteen years later, a further lesion developed in the scapula together with the typical sternoclavicular manifestations, at which stage the correct diagnosis of SAPHO syndrome was established.

Acquired Hyperostosis Syndrome↗