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Biomedical subjects

N Morgan

Publications and source records attributed to N Morgan.

At least 37 records · Page 2Linked to original sources
PubMed1995

An outbreak of copycat fire raising.

A dangerous outbreak of fire setting occurred on two wards of a Bristol Psychiatric Hospital, in which six patients set eight fires over a five-week period. One was the Intensive Care Unit, the other an admission ward serving the inner city of Bristol. Five of the six patients had moved between the two wards. The sequence of fires is in part explained by 'copycat' behaviour. The fires were set at a time when the hospital was particularly vulnerable because of major service changes. We emphasize the institutional and situational variables that led to disturbed behaviour in a vulnerable group of individuals, with inadequate controls over tension and anxiety.

Adult↗
PubMed1995

Histidinemia in mice: a metabolic defect treated using a novel approach to hepatocellular transplantation.

Histidinemia in mice and in humans is an autosomal recessive disorder of histidine metabolism that leads to high-histidine levels in both plasma and urine and is caused by a lack of hepatic histidine-alpha-deaminase (histidase). We have used a novel approach to hepatocellular transplantation to effect a complete phenotypic cure of histidinemia in a mouse model. Mice lacking histidase were treated with isolated liver cells (approximately 18 x 10(6) hepatocytes and 9 x 10(6) nonparenchymal cells) from histidase-competent donors transplanted into the peritoneum (active transplant group). Recipient mice showed a dramatic decrease, by more than 75%, in urinary histidine levels from day one throughout the course of the experiment, resulting in levels within the normal range for wild-type mice. In comparison, there was no change in urinary histidine levels in the control group of histidase-deficient mice treated with isolated liver cells from mice lacking histidase (statistical comparison between the two groups, P < .003, two-way ANOVA). Histologically, ectopic liver tissue was seen in the peritoneum in association with abdominal wall, pancreas, and peritoneal connective tissue; immunohistochemical evidence showed expression of histidase in the ectopic liver tissue in the active transplant group. This report is the first to show complete correction of a defective biochemical phenotype achieved by hepatocellular transplantation.

Animals↗
PubMed1994

Hepatocyte growth factor/scatter factor expression in human mammary epithelium.

This study reports expression of mRNA for the growth modulator hepatocyte growth factor/scatter factor (HGF/SF) in both benign and malignant human mammary epithelium by in situ hybridization. In benign breast tissue expression was prominent in areas of adenosis and in peripheral acinic cells in lactating breast; in malignant epithelium expression was seen in 15 of 21 cases of in situ and invasive breast cancer. In some cases of invasive ductal carcinoma stronger labeling appeared to be associated with areas of tubule formation compared with areas of infiltrating growth, although this was not a universal finding. In contrast, two examples each of in situ comedo carcinoma and invasive lobular carcinoma were completely negative. HGF/SF mRNA extracted from a breast tumor demonstrated the expected 6-kb transcript on Northern blot analysis. These findings suggest the possibility of an autocrine loop for action of HGF/SF in proliferating mammary epithelium.

Blotting, Northern↗
PubMed1993

Designing a connectionist network supercomputer.

This paper describes an effort at UC Berkeley and the International Computer Science Institute to develop a supercomputer for artificial neural network applications. Our perspective has been strongly influenced by earlier experiences with the construction and use of a simpler machine. In particular, we have observed Amdahl's Law in action in our designs and those of others. These observations inspire attention to many factors beyond fast multiply-accumulate arithmetic. We describe a number of these factors along with rough expressions for their influence and then give the applications targets, machine goals and the system architecture for the machine we are currently designing.

Algorithms↗
PubMed1992

Box Hill Hospital Intensive Care Unit.

The Unit Profile of the Intensive Care Unit at Box Hill Hospital describes the Unit's history and the progression it has made through the past 26 years. Details are given on the type of patients received and the catchment areas this Unit services. The organisational structure and the educational services available are discussed. The breakdown of staff including the nursing and medical staff and the available ancillary services as stated. The critical care course is described in detail to give an outline of and to promote this tertiary based course. It is also hoped this will encourage other hospitals and tertiary institutions to structure such similar courses to provide a more professional education for nurses.

Diagnosis-Related Groups↗
PubMed1992

Cognitive deficits in delirium: assessment over time.

Delirium is commonly defined as a transient organic brain syndrome characterized by concurrent disorders of attention, perception, thinking, memory, psychomotor behavior, and the sleep-wake cycle. One of the difficulties in studying delirium is that symptoms tend to fluctuate over the course of the day. Pre-existing organic brain disease appears to be a significant risk factor for the development of delirium, and numerous studies have shown a high rate of delirium in patients with cerebrovascular disease, Parkinson's disease, and Alzheimer's disease. The cognitive deficits associated with delirium have not been widely studied in a systematic, quantitative fashion. Following resolution of the frank delirium, documented cognitive deficits can be observed, and may persist in a diluted form for a period of months. Residual cognitive deficits may be due to a minimal and persistent confusion or to an underlying brain disorder.

Cognition Disorders↗
PubMed1992

[Concepts about AIDS among the adult population of Managua].

Nicaragua has the lowest prevalence of AIDS in Central America. In other countries where AIDS is more prevalent, the first epidemic of asymptomatic infections with human immunodeficiency virus (HIV) and the second of clinical cases of AIDS have been followed by a third epidemic of fear and discrimination. In December 1989 a study was conducted to investigate knowledge and attitudes about AIDS in a sample of 287 adults in Managua. Most of the interviewees had heard of the disease from newspapers and television, and more than 90% understood how HIV was principally transmitted. However, between one-third and one-half the interviewees believed that HIV could be transmitted by causal contact such as kissing (53%) or by mosquito bites (49%). In addition, the majority considered that isolation of HIV-infected persons and control of immigration into the country would be effective measures for preventing the spread of the disease. These results are similar to findings from studies carried out in other countries of Latin America where the HIV and AIDS epidemics started much earlier. This would suggest that the so-called "third epidemic" of discrimination and fear is affecting Nicaragua in advance of the other two.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Oral almitrine in treatment of acute respiratory failure and cor pulmonale in patients with an exacerbation of chronic obstructive airways disease.

The effects of oral almitrine bismesylate, a respiratory stimulant that acts on peripheral arterial chemoreceptors, was studied in patients with chronic obstructive airways disease and hypoxaemic cor pulmonale. Twenty three patients admitted to hospital with an acute exacerbation of ventilatory failure were randomised to receive either almitrine 100 mg twice a day reducing to 50 mg twice a day over 48 hours or placebo in addition to conventional treatment. On admission the mean (SE) values for blood gas tensions were PaO2 4.8 (0.3) and PaCO2 7.7 (0.3) kPa in the 12 patients who received almitrine and PaO2 4.9 (0.1) and PaCO2 7.6 (0.3) kPa in the 11 who received placebo. After three hours of oxygen therapy at 1 1/min there was a similar rise in PaO2 in both groups, 6.4 (0.2) kPa in those receiving almitrine and 6.6 (0.4) kPa in those receiving placebo. After 24 hours of oxygen therapy values of PaO2 were again similar at 6.3 (0.8) kPa and 6.7 (2.2) kPa respectively. Arterial blood gas tensions improved during the study in those who survived but no significant differences were apparent between the two groups. There were six deaths, five in the almitrine group and one in the placebo group. There were no differences between the groups in respiratory rate, results of spirometry, oxygen requirement, or degree of dyspnoea (on visual analogue scale). The results did not show any benefit from oral almitrine in patients with acute respiratory failure secondary to chronic obstructive airways disease. Plasma almitrine concentrations, however, were often below the optimum therapeutic range, suggesting impaired drug absorption.

Administration, Oral↗
PubMed1991

Risk management: role of the medical record department.

Good record-keeping practices contribute to the high quality of the medical record. Is the medical staff actually aware of the multiple uses of the medical record today as opposed to only a few years ago? This is all in keeping with multiple requirements for accreditation, state licensing requirements, hospital medical staff rules and regulations, and a more aggressive consumer. Physicians and attorneys alike depend on the documentation in the medical record to support their case. An independent detailed recollection of the case by caregivers without use of the medical record would be extremely difficult. Nothing can take the place of an accurate account of the patient's care in the medical record. Defense in the absence of supporting documentation would be very weak, if not lost. It is clear that inadequate or incomplete medical records expose the physician and the hospital to risk. Hospital rules and regulations should be strictly enforced to enhance patient care and to avoid potential legal action. If documentation problems are identified, utilize the medical staff committees for recommendations and action. Medical records are an integral part of patient care responsibility and should be treated as such. The medical record is a legal document that is the most reliable record of care rendered to the patient. In legal settings, the record will be scrutinized by expert witnesses for the plaintiff and the defense. What the records do not contain may be as important as what they do contain when there is an allegation that the patient's condition warranted intervention or action that was not taken.

Documentation↗
PubMed1988

Multichannel cochlear implantation in a patient with bilateral Mondini deformities.

A 31-year-old man with bilateral Mondini dysplasia was successfully implanted with a Nucleus multichannel 22-electrode cochlear prosthesis. To our knowledge, this is the first report of multichannel cochlear implantation in a patient with Mondini dysplasia. The surgical procedure used to insert the device was uncomplicated. Although objective measurements demonstrated only slight improvement in most categories of the Iowa test battery, he has the ability to discriminate pure-tone frequency differences and environmental sounds. Subjectively, he was a satisfied implant user. The surgical feasibility of multichannel implantation in patients with Mondini dysplasia should open the door for improved speech recognition and tonal discrimination in this subset of patients.

Adult↗