Biomedical subjects
Publications and source records attributed to N Watson.
Presented a set of MMPI norms for a mixed psychiatric group of adolescents (N = 1022). Normative information is stratified according to five age categories and includes means and standard deviations for the validity, clinical, and 48 content scales. The usefulness of these norms for clinicians is discussed.
Five patients who presented with symptoms of tension and anxiety were subsequently referred to a physiotherapist and treated with Connective Tissue Massage. Psychophysiological recordings of heart rate, frontalis EMG, skin resistance and forearm extensor EMG were taken before and after treatment. All patients showed a significant response to treatment in one or more of the psychophysiological parameters. Results are discussed in relation to the hypothesis that each individual has a unique stress response pattern. Preliminary findings proved interesting and supported clinical findings with regard to the effectiveness of this treatment for some patients suffering from Anxiety States.
A survey of 200 women, admitted with spinal cord injuries over a 20-year-period, revealed that such injuries were much less common in females than males, with a ratio of 1 female to 4.4 males. Women had a higher ratio of cervical injuries, mainly due to elderly ladies falling downstairs at home. Most women (60 per cent) achieved full independence, pressure sores were seldom a problem, and some women were able to return to work in offices and teaching. Women were very rarely at risk of renal failure. Most complete tetraplegics required permanent catheter drainage, with a 30 per cent incidence of leakage and blockage. Regular cystoscopy was advisable and the danger of autonomic dysreflexia had to be prevented. Partial tetraplegics and most paraplegics could manage without permanent catheters. Most became catheter-free, and the practice of self intermittent catheterisation would be the method of choice for the others. The causes of death were unremarkable, except that only 17 per cent of all late deaths were attributable to the injury.
A total of 17 cordectomy specimens and 22 post mortem specimens from long survival spinal injury patients were reviewed. Bone formation within the scar tissue was found in 28.5 per cent of cases. The evidence suggests that this is metaplastic bone formed within dense collagenous scar tissue. The significance of this osseous metaplasia is discussed.
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The diagnosis of hysterical paraplegia, following injury, has only rarely been made, and no report of such cases has been recorded in the recent textbooks by Guttmann, Bedbrook and other authors. In a review of non-traumatic paraplegia, treated at the Sheffield Unit, the diagnosis was not made during a period of 15 years, until the winter of 1977/78 when four such cases were confidently recognised in a short period of time. This surprising development encouraged me to review these cases to ascertain whether there were any common factors to explain such an unusual outbreak. The patients were all young men engaged in heavy physical work and other circumstances common to most of them were service in a uniformed organisation; with psychiatric illness, and marriage breakdown as principal features. Fortunately recovery was rapid and complete in most cases.
A new endoribonuclease activity, RNase F, was partially purified from Escherichia coli cells. This activity can specifically cleave a precursor RNA molecule (of species 1) isolated from T4-infected cells [N. Watson & D. Apirion (1981) Biochem. Biophys. Res. Commun. 103, 543-551]. The cleavage results in products which are very similar to RNA molecules found in the cell, generating a 3'-phosphate and a 5'-hydroxyl groups. The cleavage takes place between a cytosine and an adenine moiety, within a possible loop and stem structure; the cut is in the border between the double-stranded and single-stranded regions of this structure. This specificity of this enzyme could be the introduction of a cleavage near the 3' ends of tRNA molecules and other RNAs like species 1 which could resemble tRNA in their three-dimensional structure.
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We have reported a series of 15 cases of ascending cystic degenerative myelopathy from a total of 1500 spinal injuries over a period of 30 years, an incidence of 1 per cent. although sensory impairment was troublesome in many cases, motor loss was infrequent and minimal and never became severe enough to warrant further investigation or active surgical treatment. A conservative approach is recommended in the management of this complication.
A survey of cases of non-traumatic acquired paraplegia over a 30-year period revealed an admission rate of about 30 per cent of all new admissions to the Unit. Whereas the usual sex ratio of traumatic cases remained constant at 4.5 males to one female the ratio in non-traumatic paraplegia was almost equal between the sexes, five males to four females, thereby influencing the bed allocations between the sexes. Iatrogenic cases formed a very small part of the survey.
Ileus is a common complication of spinal cord injury, resolving within one week of injury in most cases. Two cases are reported in which the ileus developed as a more serious later complication and proved to be very intractable to treatment. Causes and treatment are discussed.
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Gastric air and peristalsis usually are obstacles to ultrasound imaging of the tail of the pancreas. Fifteen normal volunteers were scanned transversely in the supine position before and after intravenous administration of glucagon (1 mg) and oral administration of water. In 13 of 15 subjects glucagon produced a dilated gastric fundus that retained fluid for 30--60 min, thus allowing good imaging of the pancreatic tail in 10 subjects and fair imaging in 2 subjects. This method of creating a gastric sonic window should prove to be valuable in ultrasound imaging of the pancreas.
A study of recent cases of spinal cord damage following aortic surgery confirmed previous reports that damage was confined to the anterior horn cells of the lumbar and sacral segments of the cord, with preservation of posterior column function and satisfactory bladder control.
A prophylactic regime of subcutaneous low-dose heparin for the 1st month, followed by warfarin for the 2nd and 3rd months after spinal cord injury resulted in a dramatic reduction in the incidence of venous thrombosis and pulmonary embolism.
To determine if proteins RNase III and rho, both of which can determine the 3' ends of RNA molecules, can complement each other, double mutants defective in these two factors were constructed. In all cases (four rho mutations tested) the double mutants were viable at lower temperatures, but were unable to grow at higher temperatures at which both of the parental strains grew. Genetic analyses suggested that the combinations of the rnc rho (RNase III-Rho-) mutations was necessary and probably sufficient to confer temperature sensitivity on carrier strains. Physiological studies showed that synthesis and maturation of rRNA, which is greatly affected by RNase III, as well as other RNAs, was indistinguishable in rnc rho strains as compared to rnc rho+ strains, thus suggesting that RNase III and rho do not complement one another in determining the 3' ends of RNA molecules. In rnc rho strains, however, the newly synthesized rRNA failed to accumulate. Thus, decay of rRNA could be the reason for the temperature sensitivity of the double mutant strains. These experiments suggest that RNase III and rho can both protect rRNA from degradation by cellular ribonucleases. They also point to the possibility that the nucleotide sequences involved in the determination of the 3' ends of RNA molecules by these two factors are not identical.
The successful revascularized free transfer of a composite flap of groin skin with attached iliac bone is presented in two patients. The findings in the preliminary dissections and injection studies in cadavers are discussed, and the superficial circumflex iliac system is recommended as a stem for free flaps of groin skin and iliac bone. If iliac bone alone is required for a revascularized graft, then the deep circumflex iliac system would seem suitable for the stem. Further clinical cases are necessary to determine the indications for this procedure, and patients should be carefully selected. The need for preoperative preparation and planning on a sound anatomical background is emphasized, and preoperative angiography seems advisable. The ability to sew small vessels together reliably is one thing: the when and where is another.