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Biomedical subjects

P Gorman

Publications and source records attributed to P Gorman.

At least 37 records · Page 2Linked to original sources
PubMed1999

Incidence of operative procedures on cleft lip and palate patients.

The incidence of operative procedures in a group of 374 cleft lip and palate patients was determined by a chart review. These patients were part of a long term study funded by the National Institute of Dental Research at the Lancaster Cleft Palate Clinic. The chart review provided a breakdown of the primary and secondary procedures performed on the patients. Although the secondary procedures carried out were underestimated in this study, it is clear that these operations comprise a major component of the successful treatment of these patients. The results of the study and the implications in today's managed care environment are discussed.

Child↗
PubMed1999

The usefulness of handheld computers in a surgical group practice.

We designed a system using hand-held computers allowing physicians in the hospital setting to access their surgical schedules, to track patients in multiple hospitals, and to quickly enter billing information. The physicians would then update their schedules and pass billing information electronically when they returned to the office. The system was successfully implemented, it was well accepted by clinicians and staff users, and it showed an increased capture of charges. Whether an economically important effect on the number of days to post hospital charges will be evident after follow-up data has been collected.

Appointments and Schedules↗
PubMed1998

Primary stenting of atherosclerotic renal artery ostial stenosis.

Percutaneous transluminal angioplasty for atherosclerotic ostial lesions of the renal arteries has resulted in high restenosis rates. Recent reports of angioplasty with intravascular stenting show improved results over angioplasty alone. The purpose of this study is to review the results of primary stenting of ostial renal artery stenosis at our institution. Twenty one patients (11 men, 10 women, age 63 +/- 11 years), with atherosclerotic renal artery ostial stenosis in association with hypertension or renal insufficiency underwent renal angioplasty with primary stenting during a 2-year period. Medical records were reviewed for indications, technical success, complications, restenosis, response of hypertension and response of renal insufficiency. A technical success was defined as a normal postprocedure arteriogram with no residual stenosis and no residual gradient. Restenosis was defined as > or =60% diameter reduction identified by arteriography, or duplex scan demonstrating a renal artery to aortic ratio of > or =3.5. Thirty-three stents were placed in 25 arteries with four patients having bilateral procedures. All patients were hypertensive. Nine patients (43%) had chronic renal insufficiency (creatinine > or =1.5 mg/dl). One patient was on hemodialysis. The immediate technical success rate was 95%. Six complications occurred in four patients (two pseudoaneurysms, two dissections requiring additional stents, renal failure, and atheroembolization). Mean arterial blood pressure improved from 117 +/- 13.4 to 103 +/- 12.8 mmHg (p = 0.002) after stenting. Serum creatinine levels decreased from 1.48 +/- 0.57 to 1.31 +/- 0.41 (p = 0.07). Eight patients developed restenosis. The mean follow up was 13 +/- 7 months. Life table analysis showed a cumulative restenosis rate of 65 +/- 18% at 24 months. We advise caution in the application of renal stenting for the treatment of ostial lesions, particularly in patients for whom standard surgical revascularization options are available.

Aged↗
PubMed1997

Characterization of cryptic rearrangements and variant translocations in acute promyelocytic leukemia.

Acute promyelocytic leukemia (APL) is typified by the reciprocal translocation, t(15; 17)(q22; q21), leading to the formation of PML-RARalpha and RARalpha-PML fusion genes. We have characterized 7 cases of morphologic APL found to lack the t(15; 17) on conventional cytogenetic assessment. In 6 of 7 cases, cryptic PML-RARalpha rearrangements were identified by reverse transcriptase-polymerase chain reaction and fluorescent in situ hybridization (FISH); whereas, in the remaining patient, APL was associated with the variant translocation, t(11; 17)(q23; q12-21), leading to the formation of PLZF-RARalpha and RARalpha-PLZF fusion genes. In each of the cases with cryptic PML-RARalpha rearrangements, PML-RARalpha transcripts were detected in the absence of RARalpha-PML, consistent with the concept that PML-RARalpha is the critical oncogenic fusion protein. In 4 of these cases with evaluable metaphase spreads, the occurrence of a nonreciprocal translocation was confirmed by FISH with sole formation of the PML-RARalpha fusion gene; in 3 cases with morphologically normal chromosomes 15 and 17, RARalpha was inserted into PML on 15q, whereas in the remaining patient the PML-RARalpha fusion arose due to insertion of 15q-derived material including PML into RARalpha on 17q. Immunofluorescence studies were performed using antibodies raised against PML and PIC 1, a ubiquitin-homology domain protein previously identified as an interaction partner of PML. In acute myeloid leukemia (AML) of subtypes other than M3, PIC 1 was localized to the nuclear membrane and colocalized with PML within discrete nuclear bodies. In APL cases with cryptic PML-RARalpha rearrangements, the characteristic microparticulate pattern of PML staining was detected with partial colocalization with PIC 1, indicative of disruption of the nuclear bodies; whereas in t(11; 17)-associated APL, PML and PIC 1 remained colocalized within discrete nuclear bodies, as observed in non-APL cases. Although deregulation of the putative growth suppressor PML and delocalization of other nuclear body constituents have been advocated to play a key role in the development of t(15; 17)-associated APL, the present study shows that disruption of PML nuclear bodies per se is not a prerequisite for the pathogenesis of APL.

Chromosomes, Human, Pair 15↗
PubMed1997

Chromosomal localization, gene structure and transcription pattern of the ORFX gene, a homologue of the MHC-linked RING3 gene.

We have mapped the human ORFX gene to chromosome 9q34 and determined its complete gene structure. Comparison with RING3, the human MHC-linked homologue on 6p21.3, shows the two gene structures to be highly conserved but with an approximate threefold expansion in the ORFX introns. RING3 and ORFX are found to be ubiquitously expressed in human adult and foetal tissues. Evidence suggests that the two genes may have arisen from an ancient duplication in a common ancestral chromosome.

Adult↗
PubMed1997

Treadmill aerobic exercise training reduces the energy expenditure and cardiovascular demands of hemiparetic gait in chronic stroke patients. A preliminary report.

BACKGROUND AND PURPOSE: Elevated energy costs of hemiparetic gait contribute to functional disability after stroke, particularly in physically deconditioned older patients. We investigated the effects of 6 months of treadmill aerobic exercise training on the energy expenditure and cardiovascular demands of submaximal effort ambulation in stroke patients with chronic hemiparetic gait. METHODS: Nine older stroke patients with chronic hemiparetic gait were enrolled in a 6-month program of low-intensity aerobic exercise using a graded treadmill. Repeated measures of energy expenditure based on steady state oxygen consumption during a standardized 1-mph submaximal effort treadmill walking task were performed before and after training. RESULTS: Six months of exercise training produced significant reductions in energy expenditure (n = 9; 3.40 +/- 0.27 versus 2.72 +/- 0.25 kcal/min [mean +/- SEM]; P < .005) during a given submaximal effort treadmill walking task. Repeated measures analysis in the subset of patients (n = 8) tested at baseline and after 3 and 6 months revealed that reductions in energy expenditure were progressive (F = 11.1; P < .02) and that exercise-mediated declines in both oxygen consumption (F = 9.7; P < .02) and respiratory exchange ratio (F = 13.4; P < .01) occurred in a strong linear pattern. These stroke patients could perform the same standardized submaximal exercise task at progressively lower heart rates after 3 months (96 +/- 4 versus 87 +/- 4 beats per minute) and 6 months of training (82 +/- 4 beats per minute; F = 35.4; P < .002). CONCLUSIONS: Six months of low-intensity treadmill endurance training produces substantial and progressive reductions in the energy expenditure and cardiovascular demands of walking in older patients with chronic hemiparetic stroke. This suggests that task-oriented aerobic exercise may improve functional mobility and the cardiovascular fitness profile in this population.

Aged↗
PubMed1997

Word frequency analysis of dictated clinical data: a user-centered approach to the design of a structured data entry interface.

The design of a functional interface for direct entry of physical exam data by physicians remains a formidable challenge for developers of clinical information systems. Many developers use a theoretical approach, basing the interface on a model of the structure of the information and of the user-system interaction that is developed with one or more clinical domain expert(s). We explored the use of empirical analysis as a basis for the design of a structured data entry (SDE) interface. A collection of physical examination data from actual trauma patients, dictated by trauma surgeons, was used for the analysis. Using simple parsers written in Visual BASIC, we used word frequency analysis (WFA) and manual editing to identify the frequencies of unique terms used by physicians in recording 688 HEENT and 712 LUNG physical exams. A second-pass WFA was used to determine associated descriptive terms. A simple SDE interface was created based on the results of these analyses. The interface was then evaluated by assessing the extent to which the HEENT and LUNG segments of similar physical exams could be fully recorded using the empirically-based SDE interface. Using this interface, 68% of 200 trial HEENT exams, and 85% of 200 trial LUNG exams could be fully recorded. The interface was also considered helpful in recording substantial portions of the remainder of the exams. We believe that WFA can be a useful tool for finding empirical basis for SDE design.

Humans↗
PubMed1995

MELAS syndrome.

Explore the source record for details and available documents.

Adult↗
PubMed1994

Mapping of the genes encoding human inducible and endothelial nitric oxide synthase (NOS2 and NOS3) to the pericentric region of chromosome 17 and to chromosome 7, respectively.

Nitric oxide (NO) is an important molecular messenger regulating the functions of a wide variety of cells and tissues. NO is synthesized from L-arginine by a variety of isoforms of the enzyme nitric oxide synthase (NOS). We have used Southern blotting analysis on DNAs obtained from a panel of human-rodent hybrid cell lines to map the gene encoding the inducible NOS (NOS2) to chromosome 17cen-17q11 and the gene encoding the endothelial form of NOS (NOS3) to chromosome 7. Fluorescence in situ hybridization using a NOS2 probe gave several signals in the 17p11-q11 pericentromeric region.

Amino Acid Oxidoreductases↗
PubMed1993

Does the medical literature contain the evidence to answer the questions of primary care physicians? Preliminary findings of a study.

OBJECTIVE: To assess the quality of information retrieved in MEDLINE searches performed to answer clinical questions of primary care physicians. SETTING: Ambulatory rural and nonrural practices. PARTICIPANTS: Active, non-academic primary care physicians; professional medical librarians, a general internist. DESIGN: Descriptive study in 3 stages: 1) Office Interviews, to record questions that arise in primary care practice; 2) Online Searches, to locate information that might answer these questions; and 3) Critical Appraisal to determine the quality of the information contained in the articles retrieved. MAIN RESULTS: Of 74 articles judged by clinicians to be relevant to their questions, 2 were critical reviews, 14 reported results of randomized controlled trials, and 4 reported results of cohort studies. The remainder contained weaker evidence: 1 reported results of a case-control study, 6 were longitudinal case series, 13 were cross-sectional descriptions of disease, 12 were cross-sectional descriptions of diagnostic testing, and 22 were review articles which did not meet criteria for a critical review. CONCLUSION: Searching the medical literature to answer the questions of primary care physicians was successful in retrieving recent, relevant information, and often provided "a clear answer" to the question, but the cost of using bibliographic retrieval was high, and fewer than a third of the articles retrieved contained high quality evidence.

Decision Making, Computer-Assisted↗
PubMed1992

Cloning and chromosome mapping of the human interleukin-1 receptor antagonist gene.

By screening a human genomic library with an interleukin-1 receptor antagonist (IL-1ra) cDNA probe, we have isolated a 15 kb clone which contains the entire coding region of the gene as expressed in monocytes, and includes 6 kb of 5'-upstream sequence. The gene contains four exons which code for the secreted form of the IL-1ra, however, our clone does not contain the alternative first exon used to generate an intracellular form of the protein as the protein as found in epithelial cells. Analysis of the sequence reveals a consensus TATA box, and three Alu repeats, two of which are in the upstream region and one in intron 3. The sequence also reveals an 86 bp motif tandomly repeated four times within intron 2, and may reflect the polymorphism known to exist in this region of the gene. By in-situ fluorescence hybridization we have shown that the IL-1ra gene is found on the long arm of chromosome 2 and maps to 2q13-14.1. Previous studies have revealed that IL-1 alpha, and IL-1 beta and both type I and type II forms of the IL-1 receptor all map close to this region of chromosome 2.

Amino Acid Sequence↗
PubMed1991

Therapy for women hospitalized with acute pyelonephritis: a randomized trial of ampicillin versus trimethoprim-sulfamethoxazole for 14 days.

The efficacy of the traditionally recommended ampicillin (Amp) plus gentamicin (GM) regimen was compared with that of a trimethoprim-sulfamethoxazole (TMP/SMZ)-plus-GM regimen and the adequacy of 14 days total therapy for acute uncomplicated pyelonephritis (AUPN). Eighty-five women hospitalized for AUPN were randomly assigned to receive either Amp, 1 g intravenously (iv) every 6 h for 3 days, then 500 mg orally four times daily, or TMP/SMZ, 160/800 mg iv every 12 h for 3 days, then 160/800 mg orally twice daily. Initially, all patients also received GM every 8 h iv (mean, 606 doses). Antimicrobial resistance necessitated modifying therapy of 14 (32%) of the Amp recipients but of none of the TMP/SMZ recipients (P less than .001). Both regimens produced a satisfactory bacteriologic and clinical response in all cases. Reinfection occurred in 11% of Amp and in 8% of TMP/SMZ recipients. No patient experienced relapsing infection. The TMP/SMZ regimen was less costly and less likely to require modification due to antimicrobial resistance.

Acute Disease↗
PubMed1991

Comparison of xylazine with tiletamine-zolazepam (Telazol) and xylazine-ketamine anesthesia in rabbits.

Although widely used to provide short term anesthesia, ketamine-xylazine does not always produce satisfactory anesthesia. We compared the efficacy of ketamine-xylazine to tiletamine-zolazepam-xylazine for producing surgical anesthesia in rabbits. Four of six rabbits receiving ketamine-xylazine and all of the 12 animals given tiletamine-zolazepam-xylazine were anesthetized successfully. The mean surgical anesthesia time in the ketamine-xylazine group was 35 +/- 6 minutes as compared to the tiletamine-zolazepam-xylazine group, 72 +/- 8 minutes (p less than 0.05). There was no significant difference in the interval between the injection of the different anesthetic mixtures and the loss of either the righting reflex, the jaw reflex or the toe web pinch reflex. Respiratory rates and arterial oxygen partial pressure were higher in the ketamine-xylazine group (p less than 0.05). However, in both groups arterial blood pressure and arterial PO2 were lowered, while arterial PCO2 was elevated. No nephrotoxicity occurred. Tiletamine-zolazepam-xylazine provides effective surgical anesthesia in rabbits and in many cases may be preferable to conventional ketamine-xylazine regimen.

Anesthesia↗
PubMed1989

The human alpha 2(XI) collagen gene (COL11A2) maps to the centromeric border of the major histocompatibility complex on chromosome 6.

Type XI collagen, a minor structural component of cartilage fibrils, is composed of three chains, alpha 1(XI), alpha 2(XI), and alpha 3(XI). Using a cloned fragment of the human alpha 2(XI) collagen gene (COL11A2) as a molecular probe for in situ hybridization and somatic cell hybrid mapping, we have localized the gene to the short arm of chromosome 6, region 21.3. By exploiting the rich source of probes provided by the major histocompatibility complex (MHC) genes, which also map to this chromosomal band, we have constructed macrorestriction maps of the region by pulsed-field gel electrophoresis and have localized the alpha 2(XI) collagen gene to the centromeric extreme of the MHC. Finally, we have demonstrated, by the isolation of overlapping cosmid clones, that the gene is 45 kb centromeric to the HLA-DPB2 locus and oriented with the 3' end toward the MHC. The COL11A2 locus thus demarcates the proximal boundary of the MHC. This finding may have implications for the understanding of certain MHC-linked diseases.

Centromere↗
PubMed1989

Assignment of the gene encoding the beta-subunit of the human fibronectin receptor (beta-FNR) to chromosome 10p11.2.

A cDNA corresponding to the beta-subunit of the human fibronectin receptor (beta-FNR) was used as a probe in Southern blot analysis of mouse/human somatic cell hybrid DNAs and in in situ hybridization to metaphase chromosomes. The beta-FNR cDNA detects sequences present on human chromosome 10 as well as recognizing homologous sequences in the genome of the mouse parent of the somatic cell hybrids. In situ hybridization refined the localization of human sequences reacting with the beta-FNR cDNA to 10p11.2. The A-1A5 monoclonal antibody which recognizes the beta-subunit of the fibronectin receptor on the cell surface was used to confirm that the sequences present on chromosome 10 correspond to those required for expression of beta-FNR.

Animals↗
PubMed1988

Vasodilator response to dopamine in the ferret pulmonary circulation.

1. The isolated perfused lung of the ferret was used to study the effects of dopamine receptor agonists and antagonists. Under constant flow, a fall in pulmonary artery pressure reflects a vasodilator response. Since tone is normally low, agonists were given during hypoxic pulmonary vasoconstriction to enable detection of dilator responses. 2. Vasodilator responses were produced by bolus doses of dopamine over the range 0.1 to 5.0 micrograms kg-1, and by the selective DA1 agonist SK&F 38393 (1-phenyl-7,8-dihydroxy-2,3,4,5-tetrahydro-1H-3-benzazepine hydrochloride). 3. The dopamine response was blocked by low doses of the selective DA1-antagonist SCH23390 (R-(+)-8-chloro-2,3,4,5-tetrahydro-3-methyl-5-phenyl-1H-3-benzazepine-7- ol maleate), and by sulpiride. 4. The vasodilator response to the relatively selective DA2-agonist N,N-di-n-propyl dopamine occurred only at high dose and was incompletely blocked by the selective DA2 antagonist domperidone at a cumulative dose of 10 mg kg-1. 5. Thus dopamine receptors of the DA1 type may mediate vasodilatation in the ferret pulmonary circulation, but no evidence was obtained for the existence of DA2-receptors.

Animals↗
PubMed1987

The human homologue of the mouse t-complex gene, TCP1, is located on chromosome 6 but is not near the HLA region.

Southern blot analysis indicates that there are four sequences in the human genome related to the mouse t-complex gene Tcp-1. All four genes were cloned and partial sequencing showed that one of them was a functional gene, and the other three were pseudogenes. The human sequences were all approximately 90% related to each other and 82-89% related to the mouse Tcp-1a sequence. Human TCP1 cDNA clones from both fibrosarcoma and B cell lines confirmed that there was a single expressed gene. mRNA transcripts of different sizes were accounted for by two different polyadenylation signals. The human TCP1 gene shared some amino acid substitutions with the mouse t-complex allele (Tcp-1a) which were not found in Tcp-1b. The functional human TCP1 gene was mapped, using a panel of somatic cell hybrids, as well as in situ analysis, to the long arm of chromosome 6 at 6q23-qter and thus is not closely linked to the HLA complex on the short arm. For this reason and others it is unlikely that there is a human equivalent of the mouse t-complex.

Amino Acid Sequence↗