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Biomedical subjects

P Clark

Publications and source records attributed to P Clark.

At least 181 records · Page 10Linked to original sources
PubMed1991

Ultrastructural changes in the nucleolus of facial motor neurons following axotomy during an early critical period in development.

In this study, the effects of axotomy on the ultrastructure of the nucleolus and associated organelles were examined in fetal, newborn, and early postnatal facial motoneurons of the hamster. Golden hamsters used for this study were the 14-day fetus, newborn (0 days; less than 6 hr) and 2, 4, 7, and 9 days postnatal ages, with 3 animals per group. For prenatal surgeries, pregnant hamsters were anesthetized and the facial nerves severed in the fetuses via electrocautery through the uterine wall and amniotic membrane. For postnatal surgeries, the animals were anesthetized and the right facial nerve exposed and severed at its exit from the stylomastoid foramen. At the appropriate postoperative times, the animals were reanesthetized and perfused-fixed. The facial nuclear groups were dissected and processed for routine electron microscopy. Microbody and coiled body frequencies were determined from the number of neurons containing these structures per number of neurons sampled per animal in each experimental or control group and subjected to statistical analysis. Nucleolar reactive changes that occurred during this developmental sequence fell into two major categories. The first category displayed by most injured cells consisted of an initial compacting of fibrillar material and reduction in vacuolar space. The second category appeared to represent a progression from this first stage of nucleolar reactivity into degenerative changes involving a striking segregation of nucleolar components into five distinct regions. The incidence of microbodies increased as a result of axotomy, whereas the presence of coiled bodies decreased at the later postoperative stages in the older animals. With increasing age and nucleolar maturation, the nucleolar reactive pattern became less pronounced and severe, and neuronal survival predominated. It appears, therefore, that the two categories of nucleolar changes following axotomy during early development correlate with changes observed in nucleoli under conditions of rRNA downregulation. It is hypothesized from these results that a key step in the ability of neurons to survive axotomy and successfully regenerate at these early developmental stages occurs at some point in ribosomal RNA transcription and/or processing. Complementary information at the molecular level concerning changes in nucleolar synthetic activity and ribosome production will be necessary to test this hypothesis.

Animals↗
PubMed1991

Phase I immunotoxin trial in patients with B-cell lymphoma.

Fifteen patients with refractory B-cell lymphoma were treated in a Phase I dose escalation clinical trial with a highly potent immunotoxin consisting of the Fab' fragment of a monoclonal anti-CD22 antibody (RFB4) coupled to chemically deglycosylated ricin A chain. All patients had low, intermediate, or high grade non-Hodgkin's lymphoma. The immunotoxin was administered i.v. in two to six doses at 48-h intervals. The peak serum concentration and the t1/2 were not dose dependent among patients and averaged 1.3 micrograms/ml and 86 min, respectively. Three patients made antibody against A chain, and a fourth made antibody against both A chain and mouse immunoglobulin. Antibody responses were low (less than or equal to 85 micrograms/ml) in three patients and were not detected until 1 mo after treatment. The maximum tolerated dose of the immunotoxin was 75 mg/m2. Dose-related toxicities included vascular leak syndrome, fever, anorexia, and myalgia. Dose-limiting toxicities included pulmonary edema and/or effusion, expressive aphasia, and rhabdomyolysis (resulting in reversible kidney failure). There was no evidence of liver dysfunction. Partial responses were achieved in 38% of evaluable patients, and in those patients who had greater than 50% CD22+ tumor cells, 50% of the patients achieved a partial response. Clinical responses were not related to tumor grade and were generally transient, lasting between 1 and 4 mo.

Adult↗
PubMed1991

Myeloablative therapy with autologous bone marrow transplantation as consolidation of remission in patients with follicular lymphoma.

A study has been in progress since June 1985 to evaluate the use of myeloablative therapy (cyclophosphamide [60 mg/kg x 2] and total body irradiation [200 cGy x 6]) followed by reinfusion of autologous bone marrow in patients in second or subsequent remission of B-cell non-Hodgkin's lymphoma. The marrow mononuclear cell fraction is being treated in vitro with three cycles of the monoclonal antibody anti-CD20 (anti-B1, Coulter Immunology) and baby rabbit complement (Pel-Freez). Thirty-eight patients with follicular lymphoma (age range 29-61 years, median 43) have been treated to date. At the time of treatment, 28 patients were in second remission, 7 were in third, and 3 were in more than third remission. Twenty-three patients were in complete remission, 15 had residual disease (7 had lymph nodes less than 2 cm diameter, 4 had less than 10% bone marrow infiltration, 1 had involvement of lymph nodes and bone marrow, and 3 had involvement at other sites). Of the 38 study patients, 32 are alive; 6 have died, 4 in remission. Two of the deaths were treatment related: 1 resulted from cerebral haemorrhage at 29 days; 1 resulted from systemic fungal infection at three months). One patient died from secondary acute myelogenous leukaemia at four years, and another from an unrelated cause. Two patients died following relapse. The median time to engraftment was 28 days (range 15-45 days) for neutrophils greater than 0.5 x 10(9)/L and 28 days (range 15-46 days) for platelets greater than 20 x 10(9)/L.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Location of abnormalities in panoramic radiographs of edentulous patients.

A series of 308 panoramic radiographs of edentulous patients was examined for the presence of pathoses to determine whether any predictive basis could be found for occurrence of abnormalities by sex, age, or location. Radiolucencies, radiopacities, and retained roots and teeth were recorded by size and by anterior or posterior location in edentulous jaws. Radiopacities were the most frequently found abnormality (18% of subjects), followed by retained roots (8%), radiolucencies (3%), and retained teeth (3%). No significant correlation was found by chi-square test between type or location of abnormality and sex of the patient. There was, however, a significant relationship between location and type of abnormality. Radiopaque and radiolucent lesions were more frequently found in the mandible, and unerupted teeth and retained roots were more frequently seen in the posterior maxilla. Selective radiographs to detect retained roots and unerupted teeth in the posterior maxilla may be most productive in terms of prosthodontic treatment outcome. Otherwise, this study finds no basis for selection of intraoral sites for specific intraoral radiographs of asymptomatic edentulous patients.

Aged↗
PubMed1991

Phosphatase production by a Citrobacter sp. growing in batch cultures retarded by anaerobic or osmotic stress, and the effect of the osmoprotectant glycine betaine.

The effect of 500 mM NaCl on the growth, and phosphatase production of a Citrobacter sp. was investigated. Although growth was retarded, phosphatase production was enhanced by 50%. Relief from osmotic stress using the osmoprotectant glycine betaine gave normal growth, but phosphatase activity was reduced. The Citrobacter sp. ceased to grow following a shift to anaerobic conditions, but anaerobically-incubated cells continued to produce phosphatase after a transient lag.

Anaerobiosis↗
PubMed1991

Different training patterns and bone mineral density of the femoral shaft in elite, female athletes.

The effects of sporting activity and of menstrual status on the bone mineral content of the femoral mid-shaft were investigated. The cohort consisted of 67 elite, female athletes comprising 21 runners, 36 rowers, and 10 dancers. Twenty five of these athletes were amenorrhoeic, 27 eumenorrhoeic, and 15 were taking the oral contraceptive. The bone mineral content was also measured in 13 eumenorrhoeic, sedentary women. The mean (95% confidence interval) bone mineral content in the runners was 1.51 (1.47 to 1.55) g/cm2, which was significantly higher than in the rowers, dancers, and sedentary controls whose values were 1.43 (1.40 to 1.47), 1.39 (1.33 to 1.45), and 1.40 (1.34 to 1.45) g/cm2 respectively. There was no significant difference in the bone mineral content between the amenorrhoeic, eumenorrhoeic, and oral contraceptive taking athletes. These results may have implications for devising exercise strategies to reduce the possibility of fractures in later life.

Adult↗
PubMed1991

Effects of calcitonin gene-related peptide on normal and atheromatous vessels and on resistance vessels in the coronary circulation in humans.

BACKGROUND: Calcitonin gene-related peptide (CGRP) is a potent dilator of normal epicardial coronary vessels in humans, but its effects on myocardial blood flow and atheromatous coronary vessel diameter are unknown. METHODS AND RESULTS: Seven patients were entered for study of the effects of CGRP on coronary blood flow and 13 for the comparison of its effects on normal and atheromatous coronary arteries. In the first seven patients, left anterior descending artery (LAD) diameter at an angiographically normal site, coronary sinus oxygen saturation (CSO2S), systemic blood pressure, and heart rate were measured during intracoronary infusion of increasing concentrations of CGRP (up to 200 ng/ml at 2 ml/min) followed by intracoronary adenosine (0.267 micrograms/ml at 2 ml/min) and finally intracoronary glyceryl trinitrate (GTN) (5 micrograms/ml at 2 ml/min). CGRP dilated the normal segment of the LAD by 22.6 +/- 8% (mean +/- 95% confidence interval), p less than 0.001, with only a small increase in CSO2S from 40.1 +/- 2.7% to 47.3 +/- 2.7%, p less than 0.001. Adenosine, a potent dilator of myocardial resistance vessels, caused no further increase in LAD diameter but caused a rise in CSO2S from 47.3 +/- 2.7% to 76.0 +/- 2.7%, p less than 0.001. GTN caused no further increase in LAD diameter. As heart rate-blood pressure product remained unchanged throughout the study, the increase of CSO2S indicated only a small increase in myocardial blood flow after CGRP infusion. In 13 patients with atheromatous coronary artery disease, the effects of intracoronary CGRP at angiographically normal sites, stenoses, angiographically normal sites immediately adjacent to stenoses, and sites of coronary artery wall irregularity were compared after intracoronary infusion of a single dose of CGRP (200 ng/ml at 2 ml/min) followed by intracoronary GTN (5 micrograms/ml at 2 ml/min). At these four sites, CGRP resulted in dilatation by 17.0 +/- 5.6%, 15.3 +/- 12.1% (NS), 7.6 +/- 5.4% (NS), and 15.9 +/- 7.8%, respectively. There was no significant further dilatation after GTN at any of the four sites. CONCLUSIONS: These data indicate that CGRP has little effect in humans at rest on coronary resistance vessels in nonischemic myocardium but causes marked dilatation of normal arteries and variable dilatation of atheromatous epicardial arteries.

Calcitonin Gene-Related Peptide↗
PubMed1991

Cell guidance by ultrafine topography in vitro.

Laser holography and microelectronic fabrication techniques have been employed to make grating surfaces in fused quartz with ultrafine period (260 nm) in an attempt to mimic the topography of aligned fibrillar extracellular matrix (ECM), which, in the past, has been shown to affect the behaviour of cells in vitro and in vivo. The alignment of BHK cells, MDCK cells and chick embryo cerebral neurones on 260 nm period grating surfaces (130 nm grooves separated by 130 nm) of various depths (100, 210 and 400 nm) was examined. While all gratings aligned BHK cell populations, the degree of alignment was dependent on depth. The response of single MDCK cells to the grating patterns was both to align precisely to the direction of the gratings, and to elongate; only their elongation was depth-dependent. MDCK cells that were part of epithelial cell islands, and the outgrowth of neurites from chick embryo neurones, were mainly unaffected by the grating surfaces. It is clear that topography on this scale can control cell behaviour, but guidance of this type is strongly dependent on cell type and cell-cell interactions.

Animals↗
PubMed1991

Metatarsal head excision for rheumatoid arthritis. 4-year follow-up of 68 feet with and without hallux fusion.

Thirty-four painful deformed rheumatoid feet treated by excision of all five metatarsal heads were compared with 34 similar feet in which the lesser metatarsal heads were excised and the first metatarsophalangeal joint was arthrodesed. In the latter group, one third had failure of fusion of the hallux, and this produced the worst results. Metatarsalgia and plantar callosities were more common after excision arthroplasty, but shoe fitting and correction of deformity were better in this group. However, the results were more variable in the fusion group, and the complication and reoperation rates were higher. For this reason, excision arthroplasty, rather than fusion of the hallux, is recommended when the lesser metatarsal heads are removed.

Adult↗
PubMed1990

Ultrastructural and morphometric analysis of nucleolar and nuclear changes during the early growth period in hamster facial neurons.

In this study, progressive developmental changes in the nucleus and associated organelles, including the nucleolus, coiled bodies, nuclear envelope, and nucleoplasm, of hamster facial motor neurons were characterized by two parallel analyses: ultrastructural and morphometric. Golden hamsters (Mesocricetus auratus) used for this series were the 14-day fetus, newborn (less than 6 hr), and 1, 2, 3, 4, 5, 7, 9, 11 and 13 days postnatal ages, with 3 animals per group. Following anesthesia and perfusion fixation, facial nuclear groups were dissected and processed for electron microscopy. Electron micrographs and camera lucida tracings of nuclear profiles were collected and analyzed. The ultrastructural analysis revealed progressive changes in the nucleolus from a compact, segregated type to a reticulated form characteristic of actively protein-secreting cells. Nucleolar microbodies and fibrillar centers were seen at all ages; the latter structures appeared to decrease in size and increase with age in the series. The nucleolus-associated chromatin became less condensed, suggesting an increase in the incorporation of rDNA into the nucleolus proper. Coiled bodies, both free and attached to nucleoli, were found in varying frequencies. The nucleoplasm of neurons at the earliest stages contained large numbers of heterochromatin clumps, which decreased concomitantly with an increase in interchromatin granules and fibrils during the later stages. Nuclear envelope invaginations, polarized along one side of the nucleus, increased throughout the developmental period examined. These changes occurred in concert with a 61% increase in nuclear size and a 47% increase in the length of nuclear envelope. The sequence of nuclear changes observed during this early period of normal facial neuronal growth completes the study of a series of distinctly defined cytomorphic events in this cell type, the lability of which can be experimentally tested for their functional roles in neuronal development.

Animals↗
PubMed1990

Menstrual state and exercise as determinants of spinal trabecular bone density in female athletes.

OBJECTIVE: To study the effects of amenorrhoea and intensive back exercise on the bone mineral density of the lumbar spine in female athletes. DESIGN: Cross sectional study comparing amenorrhoeic with eumenorrhoeic athletes and rowers with non-rowers. SETTING: The British Olympic Medical Centre, Northwick Park Hospital. PATIENTS: 46 Elite female athletes comprising 19 rowers, 18 runners, and nine dancers, of whom 25 were amenorrhoeic and 21 eumenorrhoeic. MAIN OUTCOME MEASURE: Trabecular bone mineral density of the lumbar spine measured by computed tomography. RESULTS: Mean trabecular bone mineral density was 42 mg/cm3 (95% confidence interval 22 to 62 mg/cm3) lower in the amenorrhoeic than the eumenorrhoeic athletes; this difference was highly significant (p = 0.0002). Mean trabecular bone mineral density was 21 mg/cm3 (1 to 41 mg/cm3) lower in the non-rowers than the rowers; this was also significant (p = 0.05). There was no interaction between these two effects (p = 0.28). CONCLUSION: The effect of intensive exercise on the lumbar spine partially compensates for the adverse effect of amenorrhoea on spinal trabecular bone density.

Adult↗
PubMed1990

The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee.

To develop criteria for the classification of fibromyalgia, we studied 558 consecutive patients: 293 patients with fibromyalgia and 265 control patients. Interviews and examinations were performed by trained, blinded assessors. Control patients for the group with primary fibromyalgia were matched for age and sex, and limited to patients with disorders that could be confused with primary fibromyalgia. Control patients for the group with secondary-concomitant fibromyalgia were matched for age, sex, and concomitant rheumatic disorders. Widespread pain (axial plus upper and lower segment plus left- and right-sided pain) was found in 97.6% of all patients with fibromyalgia and in 69.1% of all control patients. The combination of widespread pain and mild or greater tenderness in greater than or equal to 11 of 18 tender point sites yielded a sensitivity of 88.4% and a specificity of 81.1%. Primary fibromyalgia patients and secondary-concomitant fibromyalgia patients did not differ statistically in any major study variable, and the criteria performed equally well in patients with and those without concomitant rheumatic conditions. The newly proposed criteria for the classification of fibromyalgia are 1) widespread pain in combination with 2) tenderness at 11 or more of the 18 specific tender point sites. No exclusions are made for the presence of concomitant radiographic or laboratory abnormalities. At the diagnostic or classification level, the distinction between primary fibromyalgia and secondary-concomitant fibromyalgia (as defined in the text) is abandoned.

Adult↗
PubMed1990

The first phase insulin response to intravenous glucose is highly reproducible.

To determine the reproducibility of the first phase insulin response to intravenous glucose, ten normal subjects underwent two intravenous glucose tolerance tests separated by at least two weeks. Intravenous dextrose (0.3 g/kg) was administered over 2 min by continuous infusion and arterialised-venous samples were taken from a retrogradely cannulated hand vein in the opposite arm. Within subjects, median coefficient of variation for the 3 min insulin was 4.0% (range 1.2-24.3%) and median coefficient of variation for the 0-10 min area was 6.7% (range 1.7-18.8%). These coefficients of variation are close to those of the assay itself (less than 10%). Despite this, between subject responses varied by greater than sixfold. In conclusion, contrary to previous reports the intravenous glucose tolerance test is highly reproducible. This makes it a very valuable tool for further studies of the pathogenesis of diabetes.

Adult↗
PubMed1990

Quality of everyday life in long stay institutions for the elderly. An observational study of long stay hospital and nursing home care.

The observational study reported here was part of a wider evaluation of long stay care for elderly people. The observational study showed that it was essential not to rely on interview material alone. Qualitative techniques provided insights into behaviours, moods and interactions which would have been difficult to measure using traditional survey techniques. The data collected was analysed in relation to the theory of the total institution and disengagement theory. Although the survey data presented evidence of block treatment of individuals in both long stay hospital wards and smaller nursing homes for the elderly, the observational study showed that only the ward setting conformed closely to Goffman's concept of the total institution. In addition, the study indicated that involvement in activities and interaction with others promotes positive feelings among elderly people, and questions the validity of disengagement theory.

Affect↗
PubMed1990

An extracellular microelectrode array for monitoring electrogenic cells in culture.

This paper describes a planar array of microelectrodes developed for monitoring the electrical activity of cells in culture. The device allows the incorporation of surface topographical features in an insulating layer above the electrodes. Semiconductor technology is employed for the fabrication of the gold electrodes and for the deposition and patterning of an insulating layer of silicon nitride. The electrodes have been tested using a cardiac cell culture of chick embryo myocytes, and the physical beating of the cultured cells correlated with the simultaneous extracellular voltage measurements obtained. It was found that extracellular stimulation of the cells was possible via the same electrodes used for recording.

Action Potentials↗