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Biomedical subjects

P Allen

Publications and source records attributed to P Allen.

At least 73 records · Page 4Linked to original sources
PubMed1996

Apnoea and bradycardia during epileptic seizures: relation to sudden death in epilepsy.

OBJECTIVE: To record non-invasively ictal cardiorespiratory variables. METHODS: Techniques employed in polysomnography were used in patients with epilepsy undergoing EEG-video recording at a telemetry unit. RESULTS: Apnoea (> 10, range > 10-63, mean 24 s) was seen in 20 of 47 clinical seizures (three secondary generalised, 16 complex partial, and one tonic) and 10 of 17 patients. Apnoea was central in 10 patients, but obstructive apnoea was also recorded in three of 10. Oxyhaemoglobin saturation (SpO2) dropped to less than 85% in 10 seizures (six patients). An increase in heart rate was common (91% of seizures). Bradycardia/sinus arrest was documented in four patients (mean maximum RR interval 5.36, range 2.8-8.6 s) but always in the context of a change in respiratory pattern. CONCLUSION: Ictal apnoea was often seen. The occurrence of bradycardia in association with apnoea suggests the involvement of cardiorespiratory reflexes. Similar mechanisms may operate in cases of sudden death in epilepsy.

Adolescent↗
PubMed1996

Polyol chewing gums and caries rates in primary dentition: a 24-month cohort study.

The effect of 2-year chewing-gum use on the caries rates of primary teeth was studied in a combined school and home program in a sample of 510 initially 6-year-old subjects with high caries experience, low availability of fluoride, and difficult access to dental care. The gum, formed into either sticks or pellets, comprised either xylitol, sorbitol, or mixtures thereof. The gum was chewed for 5 min under supervision five times a day during the school year, and for variable times during nonschool days. Seven groups were studied. One group received no gum; two xylitol gum groups received either pellet or stick gum as did, two sorbitol gum groups, and two groups received either of two types of xylitol/sorbitol pellet gum. The response variable was the development of a frank carious lesion detectable by physical loss of enamel and probable extension to the dentin for those surfaces of primary teeth that were not cavitated at baseline. Caries rates associated with the use of each of the gum types were compared to the caries rates in the no-gum group. The usage of all polyol gums resulted in a significant decrease of the caries onset rate (p < 0.05). The caries onset risk for a primary surface in the xylitol pellet and the sorbitol pellet groups was 35 and 44% of that in the no-gum group (relative risk, 0.35; 95% confidence interval, 0.21-0.59; relative risk, 0.44; 95% confidence interval, 0.30-0.63, respectively). The caries onset risk in the xylitol stick gum group was 53% of that in the no-gum group (relative risk, 0.53; 95% confidence interval, 0.39-0.72), which was marginally (p = 0.1520) lower than in the sorbitol stick gum group (relative risk, 0.70; 95% confidence interval, 0.52-0.94). The usage of both xylitol/sorbitol mixtures in pellet form was associated with a caries onset rate comparable with the usage of the xylitol stick gum. The largest caries risk reduction was observed in the group receiving xylitol pellet gum.

Belize↗
PubMed1996

Conclusion and review of the Michigan Xylitol Programme (1986-1995) for the prevention of dental caries.

The major results of the Michigan Xylitol Programme (1986-1995) are summarised. The Programme consisted of several clinical trials and laboratory investigations designed to study the usage of xylitol-containing saliva stimulants in the prevention of dental caries. The trials patients included young (initially 6 year olds) and adult or geriatric subjects who were given saliva stimulants (mostly chewing gum) for periods of two weeks to 56 months. A special rationale behind these studies was the need to further test the validity of the 'pentitol-hexitol theory' in the prevention of caries. This theory has maintained that pentitols (sugar alcohols with five hydroxyl groups, such as xylitol) may be cariologically more effective than hexitols (sugar alcohols with six hydroxyl groups, such as sorbitol). The accumulated clinical, sialochemical and microbiologic evidence suggests that xylitol, a natural carbohydrate sweetener of the pentitol type, is more effective in preventing dental caries than sorbitol, and cariologically safer than sorbitol, a natural carbohydrate of the hexitol type. Sorbitol was found to be significantly less cariogenic than sucrose. The Programme's results shed additional light on the cariologic and oral biologic effects of natural, dietary polyols, and suggest that the usage of xylitol chewing gum (and in some cases xylitol dragées) can be considered a valuable additional tool in caries prevention and in stabilisation of caries in all age groups.

Adolescent↗
PubMed1996

Sternal wound dressings--a research study into risk factors.

Papworth Hospital is an internationally renowned centre for cardiothoracic surgery and cardiopulmonary transplantation. Each year approximately 2,000 procedures are carried out. In early 1994 staff had noticed an increase in the number of cardiac patients returning for debridement of sternal wounds following infection. This was obviously an area for concern, and consequently a research project was initiated to examine potential risk factors for sternal wound infection.

Bandages↗
PubMed1995

RNA ligands to human nerve growth factor.

High affinity RNA ligands to human nerve growth factor (NGF) were selected from pools of random RNA using SELEX [Tuerk, C. and Gold, L. (1990) Science, 249, 505-510]. Nerve growth factor, which is a protein required for the development of neurons, is not known to bind nucleic acids as part of its natural function. We describe two of the selected RNA molecules in detail. One of them is highly structured, folding into a pseudoknot with an additional hairpin-loop; this structure provides salt-resistant binding to NGF. The other is unstructured and elevated salt concentrations inhibit its binding. These molecules compete with each other for NGF binding. Our RNAs may furnish useful diagnostic tools for the study of an important neurotrophic protein; additionally, they illustrate another example of the potential for nucleic acids to take part in novel binding interactions.

Base Sequence↗
PubMed1995

Isolation of high-affinity RNA ligands to HIV-1 integrase from a random pool.

We were able to isolate high-affinity RNAs from a random pool that binds to integrase protein from the human immunodeficiency virus-type 1 using the procedure now known as SELEX. Generally, the RNAs fell into three different classes in binding buffer containing 250 mM NaCl: group I class of molecules binds integrase with a dissociation constant (Kd) on the order of 10 nM, group II molecules had a Kd of about 80 nM, and group III about 800 nM. The RNA with the highest affinity from the group I class of molecules, designated P5, was characterized using computer modeling, chemical and enzymatic probing, and deletion analysis. Our secondary structure model for this RNA suggests interactions between looped-out fixed nucleotides and nucleotides from the randomized region; a GNRA tetraloop is also in the structure. We showed that our integrase was able to process a U5 mimic in vitro. P5 competes effectively for binding with the double-stranded DNA mimic of U5 at 180 mM NaCl concentration.

Base Sequence↗
PubMed1995

Hypersensitive response of malignant hyperthermia-susceptible skeletal muscle to inositol 1,4,5-triphosphate induced release of calcium.

Malignant hyperthermia (MH) is associated with abnormal regulation of intracellular calcium in skeletal muscle fibers. Besides a mutation in the ryanodine receptor gene, an increase in inositol, 1,4,5-triphosphate (InsP3) levels could be a possible candidate for the abnormal regulation of intracellular calcium. However, the effect of InsP3 on [Ca2+]i in MH is not known. Microinjection of InsP3 increased intracellular Ca2+ in intact skeletal muscle from malignant hyperthermia susceptible swines (MHS) with a higher potency and efficacy than in muscles from nonsusceptible (MHN) swines. Omission of extracellular Ca2+ or incubation of muscle fibers with Ca2+ channel blockers did not modify the response to InsP3. However, dantrolene (50 microM) a known blocker of intracellular Ca2+ release, decreased resting intracellular Ca2+ concentration and prevented the InsP3-induced increase in intracellular Ca2+. This suggests (i) that MHS skeletal muscles exhibit a higher responsiveness to InsP3-induced release of Ca2+, which could implicate InsP3 in the pathophysiology of MH, and (ii) that the beneficial effect of dantrolene in MHS could be related to its ability to prevent the InsP3-induced release of Ca2+.

Calcium↗
PubMed1995

Chronic accumulation of cadmium in the edible tissues of Oreochromis aureus (Steindachner): modification by mercury and lead.

The influence of mercury and lead on cadmium accumulation was investigated by exposing the fish Oreochromis aureus, or Blue Tilapia, to two heavy metals simultaneously. The chronic accumulation profile of cadmium in the liver, brain, gill filaments, intestine, caudal muscle, spleen, trunk kidney, and gonads was determined for exposure to cadmium alone and with lead or mercury. O. aureus was exposed to cadmium alone at 0.05 and 0.10 mg/L, and mixtures of 0.05 mg/L cadmium with 0.05 mg/L mercury or lead (0.05 and 0.50 mg/L). Little research has previously been carried out on the long-term interaction between these heavy metals and their effects on tissue accumulation of heavy metals. In a food fish such as O. aureus, a knowledge of toxic metal accumulation patterns is of great importance. The highest levels of cadmium were consistently accumulated by the kidney, and the presence of other mercury or lead did not change this trend. The spleen, intestine, and liver also accumulated high levels of cadmium, while the caudal muscle and brain accumulated the lowest levels of cadmium. Separating the viscera from the muscle would therefore reduce the cadmium burden of fishmeal.

Animals↗
PubMed1995

Soft-tissue accumulation of lead in the blue tilapia, Oreochromis aureus (Steindachner), and the modifying effects of cadmium and mercury.

The interaction of mercury and cadmium with lead was investigated by exposing Oreochromis aureus to two heavy metals simultaneously. The chronic accumulation profile of lead was determined by analyzing the liver, brain, gill filaments, intestine, caudal muscle, spleen, trunk kidney, and gonads following exposure to lead alone and in mixtures with mercury and cadmium. Nominal exposure concentrations of lead were 0.05, 0.10, 0.50, and 1.00 mg/L. Mixtures of lead (0.50 or 0.05 mg/L) with cadmium (0.05 mg/L) and lead (0.50 or 0.05 mg/L) with mercury (0.05 mg/L) were also used. Following 140 d of exposure to lead, the highest concentrations of lead consistently accumulated in the trunk kidney. The concentration of lead in the kidney was decreased by coexposure to mercury or cadmium, but increased in the muscle and liver. Under all exposure regimes, the median concentration of lead in the muscle exceeded safety levels recommended for human consumption. In a food fish, such as O. aureus, a knowledge of toxic metal accumulation patterns is of great importance.

Animals↗
PubMed1995

Carpentier-Edwards standard porcine bioprosthesis: clinical performance to seventeen years.

BACKGROUND: The role of porcine bioprostheses in cardiac valve replacement has been under review for several years. The literature deals primarily with age as a determinant of durability, as well as the intermediate-term performance of various prostheses. The performance of the Carpentier-Edwards first-generation standard porcine bioprosthesis is presented over the long-term with further documentation on age determinants. METHODS: The "Guidelines for Reporting Morbidity and Mortality After Cardiac Valvular Operations" were used for definitions of valve-related complications, categorization, and statistical methods. The valve-related complications were evaluated in a time-related manner by actuarial life-table techniques. The Lee-Desu statistic test was used for comparison of performance by valve positions and age groups. Hazard function rates were demonstrated for complications and composites. RESULTS: Of the Carpentier-Edwards porcine bioprostheses implanted in 1,195 patients (1,214 operations, 1,315 valves) commencing in 1975 the early mortality was 7.6% (92). The early mortality without concomitant procedures was 6.1% and with 11.7%. The late mortality was 5.3% per patient-year; 4.6% patient-year without and 7.5% per patient-year with concomitant procedures. The valve-related causes of late mortality (131) were thromboembolism (41), antithromboembolic hemorrhage (14), prosthetic valve endocarditis (20), nonstructural dysfunction (12), and structural valve deterioration (44). The valve-related deaths (early, 7; late, 124) were 21.2% of the total 617 total deaths. Reoperation for valve-related complications was performed in 406 patients (4.1% per patient-year), of which 327 were for structural valve deterioration (3.3% per patient-year). Mortality for reoperation was 0.5% per patient-year (49 patients) or 12.1%. Of the 49 deaths, 33 were caused by structural valve deterioration. The linearized occurrence rate for thromboembolism was 1.6% per patient-year (major, 0.9% per patient-year, and minor, 0.7% per patient-year). The fatal thromboembolic rate was 0.4% per patient-year (41), undifferentiated by valve position. The freedom from thromboembolism was 76% at 17 years (p = not significant by valve position) (major, 87%; fatal, 93%). The freedom from prosthetic valve endocarditis was 92% at 17 years (p = not significant by valve position). The freedom from reoperation, at 15 years, was 38%: aortic (AVR), 55%; mitral (MVR), 20%; and multiple valve replacement (MR), 24% (p < 0.05 AVR > MVR, MR). The freedom from structural valve deterioration, at 15 years, was 41%; AVR, 58%; MVR, 21%; MR, 36% (p < 0.05 AVR > MVR, MR). The freedom from structural valve deterioration was greater for advancing age groups (p < 0.05); AVR > or = 70 years 96% at 12 years, and 65 to 69 years 94% at 12 years and 82% at 15 years; MVR > or = 70 years 85% at 12 years, and 65 to 69 years 54% at 12 years. The freedom from valve-related mortality was 73% at 17 years: AVR, 80%; ; MVR, 61%; and MR, 67% (p < 0.05 AVR > MVR, MR). The freedom valve-related residual morbidity was 94% (p = not significant by valve position). CONCLUSIONS: The Carpentier-Edwards standard porcine bioprosthesis continues to provide satisfactory clinical performance to 17 years. Thromboembolism is a more serious problem than structural failure: 92 major thromboembolic events with 41 fatalities compared with 44 fatalities of which 33 occurred with reoperation. The prosthesis is especially recommended for patients more than 65 years of age for AVR and more than 70 years of age for MVR.

Adult↗
PubMed1995

Effects of signal and masker uncertainty on children's detection.

This paper reports the results of two experiments that examined the effects of signal and masker uncertainty on preschool-age children's and adults' detection of tonal signals in noise maskers. In Experiment 1 (signal uncertainty) the signal was randomly at 501 or 2818 Hz. The majority of the adult listeners showed a slight decrement in performance consistent with an ability to monitor both frequencies simultaneously. The majority of the children, however, showed no decrement in performance, suggesting that the children may not have focused attention at the signal frequency even when it was fixed. In Experiment 2 (masker uncertainty), random-frequency, random-level, tonal distracters were added to each interval of the 2 alternative-forced-choice (2afc) procedure. The effect of masker uncertainty was much larger than that of signal uncertainty. For most of the adult listeners and some of the children, the distracters produced higher thresholds (on average by 10 dB) and shallower psychometric function slopes. For most of the children, thresholds increased by 20 dB or more and psychometric functions were often nearly flat.

Adult↗
PubMed1995

Long-term mercury accumulation in the presence of cadmium and lead in Oreochromis aureus (Steindachner).

The effects of cadmium and lead on chronic mercury accumulation were investigated in O. aureus. After 140 days' exposure the accumulation of mercury in the liver, brain, gill filaments, intestine, caudal muscle, spleen, trunk kidney and eye was analysed. The exposure concentrations were 0.05, 0.10 and 0.20 mg/L for mercury alone. O. aureus was also exposed to mixtures of 0.05 mg/L mercury with lead (0.05 mg/L and 0.50 mg/L or cadmium (0.05 mg/L) and 0.10 mg/L mercury with 0.10 mg/L cadmium. In food fish, a knowledge of toxic metal accumulation patterns is of great importance because of their contribution to the human diet and, as fishmeal, to the diet of agricultural animals. The trunk kidney consistently accumulated higher concentrations of mercury than any of the other tissues investigated.

Animals↗
PubMed1995

Stabilisation of rampant caries: polyol gums and arrest of dentine caries in two long-term cohort studies in young subjects.

The purpose of this paper is to report clinical observations on the stabilisation of dentine caries in two chewing gum studies carried out in young subjects. One study focused on the permanent dentition of 1,277 initially 10-year old subjects, while the other study was carried out on 510 initially 6-year old subjects and focused on the primary dentition. In both trials, several chewing gum formulas containing dietary polyols (xylitol and sorbitol, or their combinations) were used for up to 40 months (10-year olds) or up to 24 months (6-year olds). The daily consumption level of both polyols was up to 10.7 g per subject, used normally in 5-minute chewing episodes 3 to 5 times per day. Supervised chewing in schools lasted 5 min per episode, and for variable times during non-school days. Rehardening of dentine caries lesions was observed clinically by experienced, blinded examiners using sharp dental explorers and fibre optic light. After 40 months (permanent dentition) or after 18 months (primary dentition), rehardening (caries arrest) generally occurred more frequently in subjects who used polyol gums than in subjects who did not receive gum as part of the programmes, or who received sucrose gum. Arrest or non-progression of dentine caries was most frequently observed in subjects who used 100 per cent xylitol gums or mixtures of xylitol and sorbitol, but the differences between gums were not consistently significant. However, the usage of 100 per cent xylitol pellet-shaped gum was more frequently associated with arrest of dentine caries than other treatments. These results and previous studies suggest that high-xylitol chewing gum usage can retard or arrest even rampant dentine caries in conditions where effective restoration and prevention programmes have not been instituted, and can also provide additional protection against further caries development during full implementation of restorative procedures by holding the lesion in a non-progressive condition.

Belize↗
PubMed1995

Fetal methylmercury study in a Peruvian fish-eating population.

Maternal consumption during pregnancy of methylmercury (MeHg)-contaminated fish in Japan and of MeHg-contaminated bread in Iraq caused psychomotor retardation in the offspring. Studies in Iraq suggested adverse fetal effects when maternal hair mercury concentrations were as low as 20 ppm. This prospective study involved 131 infant-mother pairs in Mancora, Peru with peak maternal hair MeHg levels during pregnancy from 1.2 ppm to 30.0 ppm, geometric mean 8.3. The MeHg was believed to be derived from marine fish in the diet. There was no increase in the frequency of neurodevelopmental abnormalities in early childhood. The possible role of selenium or other protective mechanisms in marine fish is discussed. This previously unpublished study was conducted between 1981 and 1984. Our report of August 1985 to the funding agencies has been circulated, and the data were presented at the Twelfth International Neurotoxicology Conference in Hot Spring, Arkansas, October 30 to November 2, 1994. The current account has not been modified or updated since 1985. For reference to interim publications on fetal MeHg studies in Iraq and New Zealand see Marsh et al., 1995.

Adult↗
PubMed1994

Intracellular trafficking in Mycobacterium tuberculosis and Mycobacterium avium-infected macrophages.

Despite the potential role of the macrophage in the eradication of invading microbes, Mycobacterium species have evolved mechanisms to ensure their survival and replication inside the macrophage. Particles phagocytosed by macrophages normally will be delivered into acid lysosomal compartments for degradation. Mycobacterium must, in some way, avoid this fate by modulation of their phagosome. Immunoelectron microscopy of macrophages infected with Mycobacterium avium or Mycobacterium tuberculosis indicates that the vacuolar membrane surrounding the bacilli possesses the late endosomal/lysosomal marker, LAMP-1 (lysosomal-associated membrane protein-1), but lacks the vesicular proton-ATPase. Analysis of the intersection of the bacteria-containing vacuoles with the endocytic network of the macrophage supports previous studies indicating that these bacilli restrict the fusion capability of their intracellular compartments. The occurrence of vesicles containing lipoarabinomannan, discrete from those containing Mycobacterium, indicate that material does traffic out from the mycobacterial vacuole. To compensate for this loss of membrane, the vacuole must remain dynamic and fuse with LAMP-1-containing vesicles to maintain the density of this marker.

Animals↗
PubMed1994

Psychometric functions for children's detection of tones in noise.

This article reports the results of an experiment that used a two-alternative forced-choice task to measure the ability of 3- to 5-year-old children to detect 501 Hz, 1000 Hz, and 2818 Hz sinusoids in noise. Psychometric functions were fit to each individual's data, and thresholds (signal level required for 75% correct) were interpolated from the fitted functions. Results showed that, on average, the children's thresholds were higher and the slopes of their psychometric functions were shallower than those of the adults. However, the between-subjects variability in the children's data was large, and the performance of many individual children was not well described by group mean performance. One-third of the children produced thresholds that were elevated by an average of 10 dB but psychometric function slopes that were adult-like. Another one-third of the children produced thresholds that were elevated relative to those of the adults by an average of 20 dB and psychometric function slopes that were very shallow. The data from a smaller group of children showed large variability in psychometric function slope and threshold, and for a very few children performance was at chance regardless of the signal level. A replication of the study several months later showed that for most listeners the individual patterns of performance persisted over time.

Acoustic Stimulation↗