Biomedical subjects

N Murphy

Publications and source records attributed to N Murphy.

At least 37 records · Page 2Linked to original sources

PubMed2000

What makes a good dentist and do recent trainees make the grade? The views of vocational trainers.

OBJECTIVE: The aim of this paper is to examine the factors that vocational trainers regard as important in a 'good' dentist and to assess whether they think recent graduates were achieving these factors. DESIGN: The study was based on a statistical analysis of returns from a postal questionnaire. SETTING: Postal questionnaires were sent to all vocational advisors in England who then sent them on to a number of their vocational trainers. MATERIALS AND METHODS: The questionnaire was analysed using various statistical techniques including factor analysis. Analysis was undertaken to determine whether student or trainer characteristics influenced the trainer's responses. RESULTS: The vocational trainers judged that the group of skills that contribute to technical ability are the most important component in making a 'good' dentist. However, the most important single skill is communication with patients, closely followed by diagnostic skills and communication with the dental team. The areas where trainees are most likely to fall short in terms of actual as compared to desired performance are in areas of technical ability. CONCLUSION: Overall, recent trainees scored rather well when compared with an idealised good dentist. However, it is clear that more evaluation of vocational training is needed. Recent studies, including this one have looked at several different aspects of vocational training. However, the time seems ripe for a full-scale prospective evaluation.

Attitude of Health Personnel↗

PubMed2000

Phenotyping apolipoprotein E*3-leiden transgenic mice by two-dimensional polyacrylamide gel electrophoresis and mass spectrometric identification.

Apolipoprotein E (ApoE) plays an important role in cholesterol and triglyceride metabolism, being one of the major structural components of chylomicrons and very low density lipoprotein (VLDL) remnants. ApoE functions as a ligand in the receptor-mediated uptake of these remnants from the blood by the liver. A variant form of ApoE, apolipoprotein E*3-Leiden, shows reduced affinity for the low density lipoprotein (LDL) receptor, and results in the dominant expression of type III hyperlipoproteinemia. Two-dimensional electrophoresis (2-DE) has been used to characterise protein expression in serum samples from control and transgenic mice expressing the human ApoE*3-Leiden mutation, fed a cholesterol-rich diet, and transgenic mice fed a normal diet. For the identification of proteins, single silver-stained spots were excised from the 2-DE gels and subjected to in-gel enzymatic digestion. Extracted peptides were analysed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS). This proteomic approach has enabled the ApoE*3-Leiden variant to be positioned in a 2-DE separation of serum proteins, and has identified changes in the expression of haptoglobin, indicating that this protein may provide a marker for the potential onset of atherosclerosis.

Amino Acid Sequence↗

PubMed2000

Concentrations of antimony in infants dying from SIDS and infants dying from other causes.

OBJECTIVES: Raised concentrations of antimony have been found in infants dying of sudden infant death syndrome (SIDS). The presumed source of this antimony is toxic gases generated from fire retardants that are present in cot mattresses. The aim of this study was to determine the role of antimony in SIDS. DESIGN: Samples of liver, brain, serum, and urine were collected from all patients dying from SIDS and a group of aged matched control infants who had died of other causes. SETTING: Nationwide study in Ireland. SUBJECTS: 52 infants dying from SIDS and 19 control infants aged > 7 days and < 1 year. RESULTS: The median concentration of antimony in the liver and brain of infants dying of SIDS was < 1 ng/g, with no difference detected between the infants dying from SIDS and the control infants. The range of antimony in the serum of infants dying of SIDS was 0.09-0.71 microg/litre (median, 0.26). Although no difference was found between infants dying from SIDS and control infants, SIDS infants were found to have higher concentrations when compared with healthy infants in the 1st year of life, probably as a result of release of antimony into serum after death. Urine antimony concentrations in infants dying from SIDS were < 3.91 ng/mg (corrected for creatinine) and similar to values found both in control infants and healthy infants. CONCLUSION: There is no evidence to support a causal role for antimony in SIDS.

Antimony↗

PubMed2000

Effect of prone sleeping on circulatory control in infants.

BACKGROUND: The mechanism of death in sudden infant death syndrome (SIDS) remains unclear. Progressive bradycardia is the pre-eminent terminal event, suggesting that circulatory failure might be a crucial factor. Vasomotor tone regulates the circulatory system by controlling blood volume distribution while maintaining venous return and blood pressure. AIM: To examine whether prone sleeping, the most consistently identified risk factor for SIDS, has a measurable influence on vasomotor/circulatory control. METHODS: 44 full term infants (mean age, 7.9 weeks) were studied during an overnight sleep. Recordings were made while the infants were horizontal and asleep in the supine and prone positions, and repeated after a head up tilt to 60 degrees, maintained for 30 minutes, while in both sleep positions. Blood pressure, heart rate, anterior shin, and anterior abdominal wall skin temperatures were measured. RESULTS: Systolic blood pressure was lower, but peripheral skin temperature and heart rate were higher during sleep, while horizontal, in the prone rather than the supine position. After tilting, there was a greater reduction in blood pressure and a greater increase in peripheral skin temperature and heart rate when in the prone position. Anterior abdominal wall skin temperature did not vary in either sleeping positions while horizontal or tilted. CONCLUSION: Prone sleeping has a measurable effect on circulatory control, with a reduction in vasomotor tone resulting in peripheral vasodilatation, a higher peripheral skin temperature, a lower blood pressure, and a higher resting heart rate. Because vasomotor tone is crucially important in circulatory control this could be a factor in increasing the risk of SIDS.

Autonomic Nervous System↗

PubMed2000

Replacement of an obturator section of an existing two-piece implant-retained edentulous obturator.

There is an increasing number of people in the community who have postablative surgery for tumors of the maxilla. Postsurgical defects these individuals have are usually restored by means of a complete or partial denture obturator with various materials, including resilient silicone extensions. These patients require long-term maintenance of their obturator prostheses, which must be considered in the context of their general health and ongoing medical care. When a resilient silicone bulb is used to obturate the defect, the silicone sometimes deteriorates, whereas the denture base remains functional. This article describes a simple procedure to construct a replacement, resilient silicone bulb obturator while retaining the original complete or partial denture base.

Adult↗

PubMed1999

Infection-associated decline of cape buffalo blood catalase augments serum trypanocidal activity.

Clearance of trypanosomes from the blood of infected Cape buffalo was associated with the development of two responses: (i) complement-dependent and clone-specific lytic activity and (ii) complement-independent trypanocidal activity that was not restricted by trypanosome clone or species. This latter activity was mediated by H2O2 and required the presence of xanthine oxidase in serum but not the addition of purine substrates. Expression of the xanthine oxidase-dependent trypanocidal activity in Cape buffalo serum was coincident with, and required, a decline in its H2O2 catabolic activity. The H2O2 catabolic activity of Cape buffalo serum was due solely to catalase and declined by eightfold around the time that trypanosomes were cleared from the blood, accompanied by a fivefold drop in erythrocyte-associated catalase activity. The Cape buffalo did not develop subsequent parasitemic waves. Clearance of parasitemia in similarly infected cattle was also associated with development of trypanosome clone-specific lytic activity, but not with the acquisition of H2O2-dependent trypanocidal activity in serum, and the cattle supported recurring parasitemia. The lack of trypanocidal activity in pre- and postinfection cattle sera was due to their low content of xanthine oxidase and sustained catalase activity. These data strongly suggest that an infection-induced serum oxidative response, the efficacy of which is amplified by a decline in blood catalase, contributes to suppression of recurring parasitemia in Cape buffalo.

Animals↗

PubMed1999

Circulating interleukin 6 and interleukin 10 in community acquired pneumonia.

BACKGROUND: Inflammatory cytokine concentrations correlate with severity of sepsis. We hypothesised that patients with community acquired pneumonia (CAP) associated with systemic inflammatory response syndrome (SIRS) would have greater interleukin 6 (IL-6) production due to activation of the inflammatory cytokine cascade, matched by a significant anti-inflammatory cytokine response. Interleukin 10 (IL-10) was evaluated as a potential surrogate marker of severity of sepsis in CAP and age related impairment of the cytokine response was studied in elderly patients with CAP. METHODS: Circulating immunoreactive IL-6 and IL-10 levels were measured in 38 patients with CAP subdivided into a group fulfilling the criteria for SIRS (n = 28) and a non-SIRS group (n = 10) in a variety of age groups and correlated with APACHE II scores. RESULTS: 80% had circulating IL-6 levels (median 46.7 pg/ml, range 4.6-27,000) and 60% had circulating IL-10 levels (median 15.5 pg/ml, range 2.5-765). Concentrations of both were significantly increased in patients with SIRS compared with non-SIRS patients. Those with activation of the inflammatory cytokine cascade (IL-6 positive) produced more IL-10 than IL-6 negative patients. Older patients had a similar cytokine response. Both cytokines correlated positively with APACHE II scores. CONCLUSIONS: This is the first demonstration of circulating IL-10 in CAP. A greater counter-inflammatory response in patients with SIRS and in IL-6 positive patients suggests a potential immunomodulatory role for IL-10 in controlling the inflammatory cytokine response in CAP. IL-10 concentrations correlate with severity of illness in CAP and may be of prognostic importance. There is no age related impairment in the cytokine response.

APACHE↗

PubMed1998

Quality of life in multiple sclerosis in France, Germany, and the United Kingdom. Cost of Multiple Sclerosis Study Group.

OBJECTIVE: To assess the quality of life (QoL) of patients with multiple sclerosis in France, Germany, and the United Kingdom with a cross sectional study. METHODS: Patients were classified into three severity groups according to the expanded disability severity scale (EDSS); stage I, II, and III, corresponding to mild (EDSS 1.0-3.5), moderate (EDSS 4.0-6.0), or severe (EDSS 6.5-8.0) multiple sclerosis respectively. Ninety patients with multiple sclerosis and 30 control patients without multiple sclerosis were recruited in each country. Control patients were matched to the patients with multiple sclerosis according to age and sex. Quality of life was assessed using the functional status questionnaire (FSQ). RESULTS: The aspects of QoL that were mostly affected in the three countries under study were physical function and general wellbeing. Social role function decreased with increased severity of disease in France and in particular in Germany. Multiple sclerosis did not seem to have an impact on psychological function. The QoL of control patients was systematically higher than that of patients with multiple sclerosis. CONCLUSIONS: Use of such a generic scale showed that progression of multiple sclerosis is accompanied by a decrease in QoL and suggested that this could be a relevant measurement in assessing the effect of treatment and progression of disease. Variation between countries, however, may be important.

Adult↗

PubMed1998

Economic evaluation of multiple sclerosis in the UK, Germany and France.

A cross-sectional cost-of-care study was performed to assess the economic burden of multiple sclerosis (MS) in France, Germany and the UK. Patients were stratified into 3 groups according to the Expanded Disability Severity Scale (EDSS): stages I, II and III, corresponding to mild (EDSS 1.0 to 3.5), moderate (EDSS 4.0 to 6.0) and severe (EDSS 6.5 to 8.0) MS, respectively. 90 patients with MS and 30 non-MS control patients were recruited in each country. Control patients were matched to the patients with MS on the basis of age and gender. Demographic, clinical and economic data during the 3-month period prior to entry were collected in patient interviews. Total costs included actual expenditures, such as direct medical and non-medical costs, as well as indirect costs. From the societal perspective, the total cost of MS for 3 months was estimated at 1,928 US dollars, 3,941 US dollars and 5,678 US dollars in France, 2,772 US dollars, 2,056 dollars and 5701dollars in Germany, and 5,125 US dollars, 6,751 US dollars and 14, 622 US dollars in the UK, for stage I, II and III patients, respectively. The major medical cost driver in the UK was outpatient consultations, whereas hospitalisations were the major component in Germany and France. The major cost in the UK arose from the dependence of patients with MS on caregivers, which caused high non-medical, societal costs compared with France and Germany. From both the societal and health insurance perspectives in each country, costs for control patients were lower than those for stage I MS patients. MS represents a major financial burden on the individual, the family, health services and society, and these costs increase with MS progression.

Adult↗

PubMed1997

Economic evaluation of Nootropil in the treatment of acute stroke in France.

The primary objective of this study was to investigate the economic impact of treatment of acute ischaemic stroke with piracetam vs placebo according to the societal perspective in France. Socio-demographic, clinical and resource utilisation data for piracetam and placebo patients during the acute phase following stroke was obtained from the Piracetam Acute Stroke Study (PASS) clinical trial database. The economic analysis was based on the population defined as being treated within 6 h 59 min following stroke and presenting an initial Orgogozo score of less than 55. Resource utilisation data concerning the rehabilitation phase, outpatient follow-up and institutionalisation was obtained from decision tree analysis. There was a higher percentage of autonomous patients in the piracetam group (27.8%) compared to placebo (22.9%). The mean duration of hospitalisation (autonomous 21.8 days; non-autonomous 30.3 days) and the cost of an autonomous patient was lower than a non-autonomous patient. The total cost per stroke patient receiving piracetam was estimated at 103 KF during the 6-month period, compared to 106 KF per placebo patient. The major cost driver was hospitalisation during the acute phase, representing approximately 50% of the total cost per patient. In patients with moderate to severe stroke treated within 6.59 h, piracetam was cost-effective compared to placebo over the 6-month study period.

Aged↗

PubMed1997

Effect of skin movement on the analysis of skeletal knee joint motion during running.

It is not known how well skin markers represent the skeletal knee joint motion during running. Hence the purpose of this investigation was to compare the skin marker derived tibiofemoral motion with the skeletal tibiofemoral motion during running. In addition to skin markers attached to the shank and thigh, triads of reflective markers were attached to bone pins inserted into the tibia and femur. Three-dimensional kinematics of the stance phase of five running trials were recorded for three subjects using high-speed cine cameras (200 Hz). The knee motion was expressed in terms of Cardan angles calculated from both the external and skeletal markers. Good agreement was present between the skin and bone marker based knee flexion/extension. For abduction/adduction and internal/external knee rotation, the difference between skeletal and external motion was large compared to the amplitude of these motions. Average errors relative to the range of motion during running stance were 21% for flexion/extension, 63% for internal/external rotation, and 70% for abduction/adduction. The errors were highly subject dependent preventing the realization of a successful correction algorithm. It was concluded that knee rotations other than flexion/extension may be affected with substantial errors when using skin markers.

Adult↗

PubMed1997

Tibiocalcaneal motion during running, measured with external and bone markers.

OBJECTIVE: The purpose of this study was to compare tibiocalcaneal motion during running based on skeletal markers with tibiocalcaneal motion based on external markers. DESIGN. IN VIVO: measurements of external and skeletal tibiocalcaneal kinematics. BACKGROUND: External (shoe, skin) markers are typically used to determine rearfoot kinematics. However, it is not known if such markers are able to provide a good representation of the skeletal (tibiocalcaneal) kinematics. METHODS: Bone pins were inserted into the tibia and calcaneus of five subjects. The 3-D motion of markers attached to bone pins as well as of external markers attached to the shank and shoe were determined during the stance phase of five running trials. Intersegmental motion was expressed in terms of Cardan angles (plantarflexion/dorsiflexion, abduction/adduction, inversion/eversion). RESULTS: It was found that the skeletal inversion/eversion, abduction/adduction, and plantarflexion/dorsiflexion motions were similar across the subjects. The shape of the tibiocalcaneal rotation curves based on external markers were similar to those based on bone markers. However, the rotations were generally overestimated when using external markers, e.g. the average maximal eversion motion calculated from external markers was 16.0 degrees whereas the skeletal maximal eversion motion was only 8.6 degrees. These discrepancies were mainly due to the relative movement between shoe markers and underlying calcaneus. CONCLUSIONS: External markers are only gross indicators of the skeletal tibiocalcaneal motion. The rotations derived from external shoe and shank markers typically overestimate the skeletal tibiocalcaneal kinematics. RELEVANCE: Quantitative results determined from external markers have to be used with caution. For tibiocalcaneal rotations, external markers may be used to show trends, but absolute values cannot be trusted.

Journal Article↗

PubMed1997

An experimental in vivo method for analysis of local deformation on tibia, with simultaneous measures of ground reaction forces, lower extremity muscle activity and joint motion.

This paper presents the pilot procedures of a new in vivo experimental method for measures of local bone deformation on tibia. The tibia transducer consists of a strain gauge mounted on a surgical staple, and was designed to measure local bone deformation. Pilot measurements were undertaken during two standardized conditions of forefoot and heel landing in seven healthy volunteers. Implantation of two tibia force transducers on tibia were performed under local anaesthesia. The local peak tibia deformation occurred at 20-42 ms (median) after ground contact, and was up to eight times higher during stance phase loading compared with standing still on one leg. Ground reaction forces, muscle activation patterns and kinematics were registered simultaneously, and were used to validate that the observed local deformation on tibia occurred under controlled and clinically relevant conditions. The new method may be used for investigating local deformation within various bone structures of the lower extremity. There are further methodological issues to address before major clinical interpretations may be concluded. In order to verify that the strain gauge transducer system was valid, a controlled displacement of the staple shanks was performed with a micrometer, and showed a linear relationship between applied deformation and strain gauge response (r = 0.97-0.99). In addition, a linear relationship was found between externally applied static forces and strain gauge response in a four-point bending cadaver system (r = 0.96-0.98).

Adult↗

PubMed1996

Effects of absorption by Io on composition of energetic heavy ions.

The Galileo heavy ion counter is sensitive to ions with atomic numbers Z >/= 6 and energies greater than approximately 6 MeV per nucleon. During Galileo's passage through Jupiter's inner magnetosphere, the observed composition of these heavy ions was consistent with the presence of singly ionized iogenic O, Na, and S and highly ionized solar C, O, and Ne. The solar component is absorbed more strongly by Io because its gyroradius is smaller than Io's diameter.

Carbon↗

PubMed1996

Argatroban: a synthetic thrombin inhibitor of low relative molecular mass.

Argatroban is an arginine derivative that is a highly specific thrombin inhibitor. Experimentally, it is more effective than heparin but it is not known whether this is the case in humans. The trials reported with argatroban to date have been too small to define either the efficacy or the safety of the drug. Large-scale clinical trials are under way in a variety of settings, including unstable angina, coronary angioplasty and acute myocardial infarction.

Animals↗

PubMed1995

Trypanosoma congolense: developmental regulation of protein kinases and tyrosine phosphorylation during the life cycle.

In higher eukaryotes, key steps in the control of growth and proliferation are regulated by protein phosphorylation. However, little is known about the role of protein phosphorylation in the developmental cycles of pathogenic protozoa. In Trypanosoma brucei, only the bloodform and procyclic form stages can be obtained in sufficient numbers for biochemical analyses. However, the entire life cycle of Trypanosoma congolense can be generated in vitro, providing sufficient material for analyses of the different developmental stages. The studies reported here provide a series of snapshots documenting the activity of a number of protein serine/threonine kinases and the pattern of tyrosine-phosphorylated proteins throughout the T. congolense developmental cycle. Metacyclic forms and mammalian bloodforms showed similar profiles of protein kinase activity, as did procyclic forms and epimastigotes. Most tyrosine-phosphorylated proteins were shared between all developmental stages, with the exception of a 100-kDa metacyclic-specific species. The developmental changes in molecules involved in protein phosphorylation in the different developmental stages support the concept that changes in protein phosphorylation networks are important correlates of the developmental process in African trypanosomes.

Animals↗

PubMed1995

Synergistic effects of acetylcholine and glutamate on the release of arachidonic acid from cultured striatal neurons.

The activation of muscarinic and NMDA receptors by carbachol and NMDA, respectively, stimulated the release of [3H]arachidonic acid ([3H]AA) from cultured striatal neurons. Striking synergistic effects were observed when both agonists were coapplied. This synergistic response was suppressed by atropine or (5R, 10S)-(+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-im ine hydrogen maleate and inhibited by magnesium. It was markedly reduced in the absence of external calcium and suppressed by mepacrine. NMDA strongly elevated the intracellular calcium concentration ([Ca2+]i), but carbachol was ineffective. Ionomycin, alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate, or potassium depolarization, which increased [Ca2+]i but was ineffective on [3H]AA release, also potentiated the carbachol response. Sphingosine and Ro 31-8220 suppressed the responses evoked by carbachol, NMDA, or both agonists. However, no synergistic responses could be observed when phorbol 12-myristate 13-acetate was associated with either carbachol or NMDA. Together, these results suggest that both the massive influx of calcium induced by NMDA and the coupling of muscarinic receptors with a putative phospholipase A2 are required for the strong synergistic effects of carbachol and NMDA on [3H]AA release. Synergistic effects were also observed with acetylcholine and glutamate in the presence of magnesium, further revealing the physiological relevance of this process.

Acetylcholine↗

PubMed1995

Glucose regulates glutamate-evoked arachidonic acid release from cultured striatal neurons.

L-Glutamate stimulates the liberation of arachidonic acid from mouse striatal neurons via the activation of N-methyl-D-aspartic acid (NMDA) receptors and by the joint stimulation of alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate (AMPA) and metabotropic receptors. In this study, we investigated whether starving cultured mouse striatal neurons of glucose would modify glutamatergic receptor-mediated arachidonic acid release. Glucose deprivation for 30 min led to enhancement of the NMDA-evoked release of arachidonic acid, compared with that observed in the presence of glucose. This enhanced response depended on both the concentration of glucose and the length of time of glucose deprivation. The enhanced NMDA response appeared to result from both a release of glutamate and the subsequent additional release of arachidonic acid due to the activation of AMPA and metabotropic receptors. Indeed, the increased NMDA response was completely reversed when extracellular glutamate was enzymatically removed. Moreover, glucose deprivation potentiated the combined AMPA/metabotropic receptor-evoked release of arachidonic acid, even in the absence of extracellular glutamate. However, removing glucose did not improve the calcium rise induced by AMPA or NMDA. The ATP-evoked release of arachidonic acid from striatal astrocytes was not altered by glucose starvation. In summary, glucose deprivation affected two properties of striatal neurons: (a) it induced an NMDA-evoked release of glutamate from striatal neurons and (b) it selectively potentiated the AMPA/(1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid-evoked release of [3H]arachidonic acid without altering the authentic NMDA-mediated response.

Adenosine Triphosphate↗