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R Douglas

Publications and source records attributed to R Douglas.

At least 37 records · Page 2Linked to original sources
PubMed1997

Prevalence of IgE-mediated allergy to latex in hospital nursing staff.

BACKGROUND: IgE-mediated hypersensitivity to latex proteins has become a significant clinical problem over the last decade. Nursing and medical staff are at risk because of their occupational exposure to latex. AIMS: To determine the prevalence of type I hypersensitivity to latex allergens in the nursing staff of an Australian hospital. METHODS: A questionnaire which asked about symptoms associated with the use of latex gloves was completed by 140 nurses working in the Alfred Hospital (72 in general medical wards, 68 in intensive care units). Skin prick tests with eluates of five different types of latex glove as well as common aeroallergens (rye pollen and house dust mite) and banana extract were performed. RESULTS: Thirty-one nurses (22%) were skin prick test positive to at least one of the five latex glove eluates. All of these nurses were atopic, having positive skin prick tests to rye pollen or house dust mite. Symptoms of local dryness, itch and erythema associated with glove use were reported by more than half the study group, but not more frequently by those who were skin prick test positive to latex. Urticaria associated with glove use was reported more frequently by those with positive latex skin prick tests (13% vs 4%, p = 0.05). Eighty-seven per cent of the nurses who were latex skin test positive were also positive to banana extract. CONCLUSIONS: IgE-mediated hypersensitivity to latex is common in nurses working in an Australian hospital. Glove associated symptoms were frequently reported, but in most cases the symptoms were more typical of irritant or contact dermatitis rather than type I hypersensitivity reactions. However, the extent of subclinical sensitisation to latex found in this study suggests that symptomatic latex allergy is likely to emerge as an increasing problem for nursing staff in this country.

Adult↗
PubMed1996

Effect of methimazole with or without exogenous L-thyroxine on serum concentrations of thyrotropin (TSH) receptor antibodies in patients with Graves' disease.

Medical treatment of Graves' disease involves use of antithyroid drugs with or without the addition of exogenous L-T4. There have been conflicting reports as to whether the addition of T4 reduces TSH receptor antibodies and improves remission rates more than antithyroid drugs alone. To further examine the effect of drug therapy on serum concentrations of TSH receptor antibodies. 70 patients with Graves' disease were treated with methimazole (Tapazole) alone until they were euthyroid. Then they were randomized to receive either: 1) methimazole alone in a dose sufficient to normalize TSH (0.3-5.4 mIU/L; Group 1); 2) 30 mg methimazole daily plus sufficient T4 (Synthroid) to maintain TSH in the high-normal range (2.0-5.4 mIU/L; Group 2); or 3) 30 mg methimazole daily plus sufficient T4 to suppress TSH to below 0.6 mIU/L (Group 3). The duration of treatment in all groups was 18 months. At baseline and after 6 and 18 months, TSH receptor antibodies were measured both by the ability of patients' sera to stimulate cAMP production by FRTL-5 cells (thyroid-stimulating Ig) and by the ability of patients' sera to inhibit binding of radiolabeled TSH to solubilized porcine thyroid membranes (TSH-binding, inhibiting Ig). Thyroid-stimulating Ig(TSI) and TSH-binding, inhibiting Ig(TBII) concentrations were similar among the three groups at baseline. Mean baseline TSI (expressed as the percent of normal control) for all patients combined was 306 +/- 21%. Mean baseline TBII (expressed as percent inhibition of TSH binding) was 38 +/- 2%. TSI was elevated in 85% and TBII was elevated in 75% of patients at baseline. After 18 months, TSI was elevated in 64% of patients, and TBII was elevated in 28%. Serum TSI decreased by 36 +/- 5% during the study, and there was no significant difference in the degree of reduction among the three groups (P = 0.99). Serum TBII decreased by 59 +/- 3%, and there also was no significant difference among the groups (P = 0.83). At baseline, serum TBII correlated with free T4 (r = 0.33, P < 0.01), total T3 (r = 0.55, P < 0.01), and thyroid size (r = 0.35, P < 0.01). There was no correlation between TSI and any of the baseline parameters or between TSI and TBII at any timepoint. In conclusion, we found that the addition of T4 to methimazole does not result in a greater decrease in TSH receptor antibody concentrations than treatment with methimazole alone. From these results, we would predict no difference in remission rates among these patients, but confirmation of this prediction will need to await long-term follow-up of these subjects.

Adolescent↗
PubMed1995

Modeling direction selectivity of simple cells in striate visual cortex within the framework of the canonical microcircuit.

Nearly all models of direction selectivity (DS) in visual cortex are based on feedforward connection schemes, where geniculate input provides all excitatory synaptic input to both pyramidal and inhibitory neurons. Feedforward inhibition then suppresses feedforward excitation for nonoptimal stimuli. Anatomically, however, the majority of asymmetric, excitatory, synaptic contacts onto cortical cells is provided by other cortical neurons, as embodied in the Canonical Microcircuit of Douglas and Martin (1991). In this view, weak geniculate input is strongly amplified in the preferred direction by the action of intracortical excitatory connections, while in the null direction inhibition reduces geniculate-induced excitation. We investigate analytically and through biologically realistic computer simulations the functioning of a cortical network based on massive excitatory, cortico-cortical feedback. The behavior of this network is compared to physiological data as well as to the behavior of a purely feedforward model of DS based on nonlagged input. Our model explains a number of puzzling features of direction selective simple cells, including the small somatic input conductance changes that have been measured experimentally during stimulation in the null direction, and the persistence of DS while fully blocking inhibition in a single cell. Although the operation at the heart of our network is amplification, the network passes the linearity test of (Jagadeesh et al., 1993). We make specific predictions concerning the effect of selective blockade of cortical inhibition on the velocity-response curve.

Animals↗
PubMed1993

Evidence that TGF-beta can inhibit human T-lymphocyte proliferation through paracrine and autocrine mechanisms.

Transforming growth factor-beta (TGF-beta) has been documented as having an inhibitory effect on the proliferation and growth of human T-lymphocytes. We examined the relative contribution of both exogenous and endogenous TGF-beta to this inhibitory action. Purified human peripheral blood T-cells were cultured with Con A (0.2 microgram/ml), washed with methyl mannopyranoside, and then cultured in rIL-2 (5 U/ml) with or without TGF-beta (80 pM). Proliferation, as measured by uptake of tritiated thymidine at 72 hr, was inhibited by added active TGF-beta. Addition of neutralizing anti-TGF-beta antibodies at the initiation of culture abrogated the antiproliferative effects of TGF-beta. A mink lung cell bioassay was used to measure endogenous TGF-beta production by the T-cells following transient acidification of the supernatants to activate latent TGF-beta. T-lymphocytes cultured with rIL-2 alone produced low levels of TGF-beta, first detectable at 72 hr. The addition of (active) TGF-beta to these cultures resulted in earlier and higher levels of endogenously produced latent TGF-beta protein. This was reflected at the mRNA level as well. The exogenously added active TGF-beta appeared to be depleted during the culture period, presumably by the activated T-cells, which exhibited elevated levels of types I, II, and III TGF-beta receptors. The increase in TGF-beta protein levels was due to endogenous TGF-beta synthesis and secretion as supported by a capture assay using 35S-labeled culture supernatants. These findings indicate that both paracrine and autocrine mechanisms are involved in the inhibitory effects of TGF-beta on the proliferation of normal human T-lymphocytes and suggest that other TGF-beta-producing cells can augment production of TGF-beta by activated T-lymphocytes.

Drug Administration Schedule↗
PubMed1993

The role of alcohol providers in prevention: an evaluation of a server intervention programme.

Server intervention is a relatively new approach in the attempt to reduce the incidence of drinking and driving. Although a number of evaluations have suggested that the approach may be effective, there have been few comprehensive evaluations of such programmes. The present study utilized process evaluation techniques to assess reactions to a programme developed by the Addiction Research Foundation, and a quasi-experimental design to determine the impact of the programme on the serving practices of servers. Actors portrayed behaviours often faced by servers, and observers rated the reactions of the servers, who were unaware of the simulations, to these situations. The programme appears to have been effective in changing behaviour, in that trained servers exhibited less inappropriate responses than did untrained servers. In addition the results suggested that the programme increased servers' knowledge about their obligations and potential strategies for dealing with these situations. The implications of these findings for future implementations of such programmes are discussed.

Accidents, Traffic↗
PubMed1993

Position-specific adaptation in complex cell receptive fields of the cat striate cortex.

1. Responses of complex cells in cat striate cortex were studied with flashed light slit stimuli. The responses to slits flashed in different positions in the receptive field were assessed quantitatively before and after periods of prolonged stimulation of one small region of the receptive field. This type of prolonged stimulation resulted in reduced responsivity over a limited zone within the complex cell receptive field. 2. The adaptation-induced responsivity decrement was generally observed in both the ON and OFF response profiles but could also be restricted to one or the other. In general, the magnitude of the response decrements was greatest in the ON response profiles. The adaptation-induced response decrement did not necessarily spread throughout the receptive field but was restricted to a small region surrounding the adapted receptive field position (RFP). Adaptation spread equally widely across the ON and OFF response profiles despite the smaller adaptation effects in the OFF profile. 3. The adaptation effects from repeated stimulation at a single RFP did not spread symmetrically across the receptive field, and a given cell's preferred direction of motion indicated the direction of the asymmetric spread of the adaptation. RFPs that would be stimulated by a light slit originating at the point of adaptation and moving in the preferred direction (preferred side) showed greater adaptation-induced response decrements than did RFPs that would be stimulated by a light slit moving in the opposite direction from the point of adaptation (nonpreferred side). There was significant enhancement of responses at some RFPs on the non-preferred side of the point of adaptation. This asymmetric spread of adaptation could be caused by adaptation of inhibitory connections that contribute to complex cell direction selectivity. 4. The asymmetry of adaptation was significantly different for the ON and OFF response profiles. The asymmetric spread of adaptation for the ON response profile was similar to that observed previously in simple cells with greater decrements in the preferred direction side of the point of adaptation. However, the OFF response profiles showed less directional asymmetry in the spread of adaptation and showed greater decrements at RFPs in the nonpreferred direction side of the point of adaptation. 5. The similarity between the spread of adaptation in simple and complex cells suggests that the adaptation in these cells is occurring through a common mechanism. The directional asymmetry of the spread of adaptation is likely due to a local postsynaptic mechanism of adaptation rather than presynaptic transmitter depletion.

Adaptation, Physiological↗
PubMed1993

The time course of direction-selective adaptation in simple and complex cells in cat striate cortex.

1. Responses of single cortical neurons in area 17 of anesthetized cats were recorded in response to prolonged stimulation with a patch of drifting square-wave grating. 2. During adaptation in the preferred direction, all neurons showed some reduction in response to motion in the stimulated direction and most showed some reduction in the opposite, nonstimulated direction. 3. For complex cells, the time course of response decrement in both the stimulated and nonstimulated directions was exponential, with an average time constant of 5 s. Response recovery was also exponential but significantly slower, with time constants of 8 and 13 s in the stimulated and nonstimulated directions, respectively. 4. For simple cells the dynamics of the adaptation effect depended on the direction of testing. In the nonstimulated direction the time course of the change in sensitivity was similar to that of complex cells. In the stimulated direction during both the adaptation and recovery periods, simple cells showed an initial rapid exponential change on the order of a few seconds that was followed by a more gradual exponential change. 5. During prolonged stimulation in the nonpreferred direction, there was less overall change in sensitivity. For some neurons the change in sensitivity during adaptation and recovery was exponential, with a short time constant for both simple and complex cells and for stimulated and nonstimulated directions. Other neurons showed no change in sensitivity in either direction and a few neurons showed facilitation during the adaptation period. 6. There appears to be a rapid general or nonspecific process, which may be related to contrast gain control, underlying motion adaptation in striate cortical neurons. An additional slow, direction-selective process is revealed when simple but not complex cells are stimulated in the preferred direction. We suggest that this latter type of adaptation is a key feature underlying the perceptual motion aftereffect.

Animals↗
PubMed1992

Effect of amygdaloid kindling on [3H]dopamine and [14C]acetylcholine release from rat prefrontal cortex and striatal slices.

The involvement of the dopaminergic (DA) systems in the control of limbic kindled seizures is ill defined. The effects of kindling on DA activity may have been overlooked in the past, because of its subtle unilateral occurrence and/or the variance of the endogenous imbalance of DA activity in normal animals. In the present study rats were screened for their endogenous DA imbalance using amphetamine-induced rotational behaviour. Electrical or sham kindling was applied in the hemisphere with the higher endogenous DA activity. Sections of the bilateral prefrontal cortex and dorsal and ventral striatum were dissected either 2 hours or 21 days after the final seizure and the electrically stimulated release of [3H]DA and [14C]acetylcholine (ACh) determined. Release was also measured in the presence of quinpirole or sulpiride to assess the activity of pre- and postsynaptic DA D2-receptors. Long-term effects of kindling consisted of facilitation of ACh release in the ventral striatum contralateral to the kindled amygdala and bilateral depression of DA release in the prefrontal cortex. Kindling therefore produced area specific changes in neurotransmitter systems giving rise to increased pro-convulsive cholinergic activity in the ventral striatum and decreased anti-convulsive dopaminergic activity in the prefrontal cortex.

Acetylcholine↗
PubMed1992

Ambulation using the reciprocating gait orthosis and functional electrical stimulation.

Until recently, rehabilitation engineering offered 2 different methods to improve daily living independence for spinal cord paralyzed subjects. One, the use of various orthotics and the other, the application of functional electrical stimulation. In the present work we chose to combine reciprocating gait orthosis (RGO) with functional electrical stimulation (FES) into one hybrid system. A detailed biomechanical and clinical instruction for the use of this system is given. Results obtained from application of the hybrid system on a complete T4 paraplegic patient demonstrate that the most significant contribution was the reduced invested energy cost required for stand-up and for ambulation.

Adult↗
PubMed1990

Grasping the nettle.

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Administrative Personnel↗
PubMed1990

Visibility of synaptically induced conductance changes: theory and simulations of anatomically characterized cortical pyramidal cells.

A recent report has provided evidence that there are no significant increases in the neuronal input conductance during the response of cortical cells in cat visual cortex to non-preferred visual stimuli (Douglas et al., 1988). A criticism of experiments of this kind is that changes in the membrane conductance occurring in the dendritic tree may not be visible from electrodes that impale the soma. Our paper describes theoretical and numerical results concerning the visibility of synaptically induced conductance changes from intracellular electrodes, in both ideal and anatomically well-characterized cortical neurons. Based on earlier work by Rall (1967), we here derive theoretical expressions for the change in input conductance at any location in a passive dendritic tree resulting from activation of a single synapse and obtain bounds for the effects of multiple synapses. We find that the conductance change measured at the cell body is always less than the sum of the synaptic conductance changes and that this observed conductance change does not depend on the synaptic reversal potential. For the case of an infinite dendritic cylinder, the change in input resistance due to a single synaptic input decays exponentially with distance of the synapse from the recording site. Numerical simulations of synaptic inputs that change approximately as fast as the membrane time-constant produce an increase in input conductance that is only slightly less visible than that of a constant input. We also compute the changes in somatic input conductance of 2 morphologically identified pyramidal cells from cat visual cortex during activity of a single inhibitory basket cell with known synaptic input locations. We find that the increase in conductance due to the activity of the inhibitory basket cells is clearly visible from the cell body of the pyramidal cells and that a 70% reduction in the amplitude of excitation is associated with at least a 30% increase in somatic input conductance, which would be visible in intracellular recordings. Taken together with the negative experimental evidence of Douglas et al. (1988), our results cast doubt on a large class of models of direction selectivity that rely on synaptically mediated inhibitory conductance increases to veto or block excitatory conductances increases.

Animals↗
PubMed1988

Conservative treatment of traumatic closed hepatic haematoma.

A retrospective review was performed of nine patients with closed hepatic haematoma admitted to the Department of Surgery, Auckland Hospital, between 1980 and 1985. All resulted from blunt abdominal trauma due to motor vehicle accidents. Four haematomas were diagnosed at the time of laparotomy and were left undisturbed; four haematomas were diagnosed radiologically were also treated conservatively. One patient underwent partial right hepatic lobectomy, required a significant blood transfusion and developed a subphrenic abscess postoperatively. A further patient died from associated head injuries. The peri-operative mortality for urgent hepatic resection in multiply-traumatized patients is greater than 50%, even in experienced trauma units, and this review suggests that in haemodynamically stable patients with closed hepatic haematomas where the diagnosis can be radiologically ascertained, conservative treatment is a safe and reasonable option.

Adult↗
PubMed1988

Clinical performance of Hickman and Portacath atrial catheters.

A recent advance in semipermanent vascular access has been the development of the totally implanted Portacath atrial catheter. The outcome of 100 sequential insertions of atrial catheters, 61 of which were Hickman catheters and 39 Portacaths, has been retrospectively reviewed in order to determine differences in clinical performance between these two types. The majority (90%) of the patients were from haematology or oncology wards. The incidence of complications was 66% for Hickman catheters and 46% for Portacaths. Local sepsis developed in 34% of the Hickman catheters and line-related septicaemia in 21%. The frequency of local sepsis and septicaemia following Portacath insertion was 31% and 3% respectively. Complications necessitated the removal of 33% of the Hickman catheters and 15% of Portacaths. The mean duration of insertion was 10 weeks for Hickman catheters and 24 weeks for Portacaths. It is concluded that the Portacath is less frequently complicated by sepsis and offers significant advantages for those patients in whom it is used.

Adolescent↗