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Biomedical subjects

R H Jones

Publications and source records attributed to R H Jones.

At least 163 records · Page 9Linked to original sources

Initiating ethanol drinking in a simian social group in a naturalistic setting.

We examined in nine group-living, male Japanese Snow monkeys the initiation of alcohol-drinking behavior in an enriched environment where both social and nonsocial stimuli could influence drinking. The monkeys usually could move freely between an indoor shelter and a large outdoor corral, which contained three drinkometers. During daily 2-hr sessions in pre- and post-training periods (with food and water available ad libitum), the drinkometers held (on different days) Koolaid-saccharin, water, water with 5% ethanol, Koolaid-saccharin with 5% ethanol, or Koolaid-sucrose with acetic acid (matched in calories and palatability to Koolaid-saccharin with 5% ethanol). Between pre- and post-training periods was a long training period, in which Koolaid-saccharin with various ethanol concentrations was presented with the daily food ration in 2-hr drinking sessions. On other selected training days, water with 5% ethanol was presented. During training sessions some monkeys drank high doses; others did not. During the period of peak drinking, the daily mean ethanol consumption ranged among animals from 0.54-1.99 ml/kg. Blood ethanol concentrations then sometimes exceeded 100 mg/dl. During the post-training period, with return to ad libitum food and water, consumption declined from these peaks, but remained significantly higher than pretraining consumption; the ethanol solution was established as a reinforcer. Monkeys differed significantly in the extent of this pre/post increase. In both pre- and post-training periods, consumption was significantly greater when all three drinkometers operated, compared with only one. On pretraining days when only one drinkometer operated, more dominant animals drank significantly more than less dominant animals; this difference disappeared by the post-training period, as less dominant animals learned to use the drinkometers at times when the dominant animals eschewed the machines. Pretraining consumption did not predict (among animals) post-training consumption. Before, during, and after training, these animals drank less of both alcohol and control solutions than did members of another species, which we had studied in smaller indoor pens. We discuss possible explanations and implications.

Alcohol Drinking↗

Dyspepsia in England and Scotland.

A validated postal questionnaire has been used to establish the prevalence of dyspeptic symptoms in five geographical locations from the south coast of England to the north of Scotland. The six month period prevalence of dyspepsia in the 7428 respondents to the questionnaire is 41% and equal between the sexes, with similar prevalence rates in the centres studied. There is considerable overlap between upper abdominal symptoms and symptoms of heartburn; 56% of patients with dyspepsia experience both groups of symptoms. Symptom frequency falls progressively with age in men and women, but the proportion of people seeking medical advice for dyspepsia rises with age. One quarter of the dyspeptic patients studied have consulted a general practitioner about their symptoms. This study suggests that the prevalence of dyspepsia in the community has changed little over the last 30 years, despite evidence that the frequency of peptic ulcer disease is falling. Symptom prevalence is unrelated to social class, but this factor is associated with consultation behaviour, the consultation rate rising from 17% in social class 1 to 29% in social class 4. The use of investigations--barium meal and endoscopy--is similarly related to social class; the lowest rate for ulcer diagnosis (4.7%) is found in social class 1 and the highest (17.1%) in social class 5.

Adult↗

Prognostic value of radionuclide angiography in medically treated patients with coronary artery disease. A comparison with clinical and catheterization variables.

To evaluate the usefulness of multiple measures from rest and exercise radionuclide angiography (RNA) in predicting cardiovascular death and cardiovascular events (death or nonfatal myocardial infarction) and to assess the prognostic usefulness of the RNA relative to clinical and catheterization data, we studied 571 stable patients with symptomatic coronary artery disease who had upright rest/exercise first-pass RNA within 3 months of catheterization and were medically treated. With a median follow-up of 5.4 years, 90 patients have died from cardiovascular causes, and 147 patients have either died or suffered a nonfatal myocardial infarction. Using the Cox regression model and a preselected group of RNA variables, the most important RNA predictor of mortality was exercise ejection fraction (chi 2 = 81, p less than 0.00001). Neither rest ejection fraction nor the change in ejection fraction from rest to exercise contributed additional predictive information. Two other RNA study variables, the change in heart rate from rest to exercise and rest end-diastolic volume index, did contribute additional prognostic information to the exercise ejection fraction (chi 2 = 23, p less than 0.0001). Compared with noninvasive clinical data (history, physical examination, electrocardiogram, and chest radiograph), RNA variables were considerably more predictive of mortality (chi 2 = 71 [clinical variables] versus chi 2 = 104 [RNA]). Remarkably, the strength of the relation of RNA variables with mortality was equivalent to that of the set of catheterization variables previously demonstrated in our large angiographic population to be prognostically important (chi 2 = 104 [RNA] versus chi 2 = 102 [catheterization variables]). The RNA contained 84% of the information provided by clinical and catheterization descriptors combined. Furthermore, the RNA contributed significant additional prognostic information to the clinical and catheterization data (chi 2 = 13.6, p = 0.0035). For cardiovascular events, the relative prognostic usefulness of the RNA was similar, although relations with this outcome were generally weaker. Descriptors from the rest/exercise RNA exhibit a powerful relation with long-term outcomes and can be useful in defining risk, even when clinical and catheterization data are available.

Cardiac Catheterization↗

Study of efficacy of urea compound versus emollient cream in avulsive therapy of dystrophic nails.

The efficacy of commercially available urea compound was evaluated in twenty dystrophic nails in ten matched pairs of patients and compared to an emollient cream used under an occlusive dressing for seven days. The results of the study indicate no significant differences between the two treatment modalities. Both procedures provided excellent avulsion of dystrophic nails.

Diabetes Complications↗

Serial assessment of ventricular performance after valve replacement for aortic stenosis.

The purpose of this investigation was to examine changes in cardiac function after aortic valve replacement in patients with chronic aortic stenosis. Eleven consecutive patients with severe aortic stenosis were studied by radionuclide angiocardiography before; after 1, 2, 4, 6, 8, and 18 to 24 hours; and late after operation. Measurements of cardiac output, mean systemic blood pressure, heart rate, and left ventricular ejection fraction were similar before and immediately after operation. Significant early changes were observed in pulmonary capillary wedge pressure (27 to 13 mm Hg; p less than 0.001), left ventricular end-diastolic volume (214 to 166 ml; p less than 0.01), pulmonary blood volume (700 to 462 ml/m2; p less than 0.01), and right ventricular ejection fraction (0.54 to 0.68; p less than 0.001). A radionuclide angiocardiogram acquired a mean of 3.5 months after operation revealed increased resting left ventricular ejection fraction (0.49 to 0.58; p = 0.05), decreased end-systolic volume (91 to 59 ml; p less than 0.05), and decreased end-diastolic volume (166 to 135 ml; p less than 0.02) compared with measurements before operation. Improved exercise tolerance occurred in nine patients. The significant change in function during the early period after valve replacement was a maintenance of baseline cardiac output at a reduced level of left ventricular filling. Several months after operation, left ventricular volumes decreased further, resting ventricular performance was improved, and improved maximal exercise function was demonstrated. These changes probably reflected morphologic normalization after aortic valve replacement.

Aortic Valve↗

Perfusion and function at rest and treadmill exercise using technetium-99m-sestamibi: comparison of one- and two-day protocols in normal volunteers.

The purpose of this study was to explore the feasibility of performing rest and exercise technetium-99m-sestamibi (99mTc-sestamibi) studies on the same day. We prospectively studied 34 asymptomatic volunteers using two different protocols (17 patients studied using one-day protocol and 17 patients studied using two-day protocol). For the one-day protocol, the rest study was performed first. For the two-day protocol, the exercise study was performed first followed by a second-day rest study. Left and right ventricular ejection fractions, myocardium/lung, myocardium/liver, myocardium/spleen, and myocardium/gallbladder count ratios were similar for the one- and two-day groups. No significant difference was observed in any variable measured. These data suggest that 99mTc-sestamibi can be used for rest and treadmill exercise studies performed on the same day to provide assessment of ventricular function and perfusion similar to studies performed on separate days.

Abdomen↗

The evolution of medical and surgical therapy for coronary artery disease. A 15-year perspective.

To elucidate the factors associated with improved survival following coronary artery bypass surgery, we studied 5809 patients receiving medical or surgical therapy for coronary artery disease. Three factors were associated with a significant surgical survival benefit: more severe coronary disease, a worse prognosis with medical therapy, and a more recent operative date. Patients with more extensive coronary obstruction had the greatest improvement in survival. Patients with a poor prognosis because of factors such as older age, severe angina, or left ventricular dysfunction had a reduction in risk that was proportionate to their overall risk on medical therapy. Survival with surgery progressively improved over the study period and by 1984 surgery was significantly better than medical therapy for most patient subgroups. Thus, contemporary coronary revascularization is associated with improved longevity in many patients with ischemic heart disease, especially in those with adverse prognostic indicators.

Age Factors↗

Validation of pressure-volume data obtained in patients by initial transit radionuclide angiocardiography.

In order to validate the measurement of pressure-volume loops and stroke work in humans, simultaneous digital subtraction ventriculography (DSA) and first-pass radionuclide angiocardiography (RNA) coupled with high-fidelity micromanometer left ventricular pressure measurements were undertaken in 34 patients, mean age 75 +/- 9 years, with aortic stenosis. Twenty-nine patients had a repeat study after balloon valvuloplasty, for a total of 63 DSA and RNA pressure-volume loops. All data were analyzed in a systemic fashion in order to minimize intra- and interobserver error. Linear regression analysis was used to calculate the degree of agreement between the two technologies. Left ventricular ejection fraction (RNA: 0.47 +/- 0.17, DSA: 0.49 +/- 0.18) had a correlation coefficient of 0.96; left ventricular end-diastolic volume (RNA: 171 +/- 42 ml, DAS: 168 +/- 52 ml) and end-systolic volume (RNA: 95 +/- 50 ml, DSA: 89 +/- 50 ml) had correlation coefficients of 0.89 and 0.95, respectively. Left ventricular stroke volume (RNA: 75 +/- 26 ml, DSA: 75 +/- 27 ml) had a correlation coefficient of 0.92, while integrated pressure-volume loop or stroke work (RNA: 15.6 +/- 6.6 ergs 10(6), DSA: 15.9 +/- 6.3 ergs 10(6] had a correlation coefficient of 0.89. These data demonstrate that RNA measurements of left ventricular chamber dynamics concur with that obtained with DSA. With semiautomated data analysis, the portable first-pass RNA pressure-volume data are also less labor-intensive. Moreover, multiple measurements of ventricular performance during hemodynamic manipulations in the catheterization laboratory or operating room would allow for a more precise estimation of left ventricular performance.

Aged↗

Analysis of the early rise in aortic transvalvular gradient after aortic valvuloplasty.

The relationship between dynamic changes in aortic valve gradient and left ventricular ejection performance in the early period after successful percutaneous aortic valvuloplasty has not been described in detail. Accordingly 20 adult patients with severe symptomatic calcific aortic stenosis underwent first-pass radionuclide angiography and Doppler echocardiography before, immediately after, and 2 to 4 days after the valvuloplasty procedure. A significant (p less than 0.001) reduction in peak-to-peak (72 +/- 24 mm Hg to 36 +/- 11 mmHg) and mean (60 +/- 20 mm Hg to 34 +/- 9 mm Hg) transaortic gradient and an increase in aortic valve area (0.5 +/- 0.2 cm2 to 0.8 +/- 0.2 cm2) were measured by high-fidelity micromanometer catheters immediately after aortic valvuloplasty. Results of Doppler echocardiography showed a significant (p less than 0.001) immediate decrease in peak instantaneous (81 +/- 22 mm Hg to 53 +/- 15 mm Hg) and mean (48 +/- 14 mm Hg to 31 +/- 9 mm Hg) aortic gradients. However, 2 to 4 days later a significant (p less than 0.001) return of peak (56 +/- 15 mm Hg to 65 +/- 20 mm Hg) and mean (31 +/- 9 mm Hg to 39 +/- 12 mm Hg) transvalvular gradient occurred. Aortic valve area as determined by the continuity equation also increased from 0.4 +/- 0.2 cm2 to 0.6 +/- 0.2 cm2 immediately after the procedure (p less than 0.001), then partially returned to baseline (0.5 +/- 0.2 cm2; p less than 0.005) at 2 to 4 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Mammalian cAMP-responsive element can activate transcription in yeast and binds a yeast factor(s) that resembles the mammalian transcription factor ANF.

The human ATF and AP1 transcription factors bind to highly related DNA sequences. Their consensus binding sites differ by a single nucleotide, but this single change is crucial in determining factor binding specificity. We have previously identified an AP1 (yAP1) binding activity in yeast. In this report we identify a yeast ATF (yATF) binding activity whose specificity can be distinguished from that of yAP1 by the same crucial nucleotide that distinguishes binding of human ATF and AP1. The ATF binding site can act as an efficient upstream activating sequence in vivo, suggesting that yATF is a transcriptional activator. The yATF DNA-binding complex is phosphorylated and the binding activity of partially purified yATF can be enhanced in vitro by the addition of protein kinase A, indicating that the phosphorylation state of yATF may be important in determining its ability to bind DNA.

Activating Transcription Factors↗

Right and left ventricular performance during and after abdominal aortic aneurysm repair.

To evaluate the effect of aortic occlusion and limb reperfusion on global and regional function of the right and left ventricle during infrarenal abdominal aortic aneurysm repair, 23 patients underwent five intraoperative first-pass radionuclide angiocardiograms: 1) before the skin incision, 2) at aortic cross-clamp, 3) 20 minutes after aortic occlusion, 4) at unclamping, and 5) after skin closure. A subset of twelve patients had simultaneous transesophageal echocardiography to evaluate left ventricular wall stress. Parameters measured included the electrocardiogram (ECG), heart rate, blood pressure, pulmonary artery pressure, the cardiac output, the left and right ventricular ejection fractions, left ventricular volumes, and left ventricular wall stress. Significant changes (p less than 0.01) were observed at aortic clamping in the left ventricular ejection fraction (from 0.56 to 0.48), end-diastolic volume (from 171 to 225 ml), end-systolic volume (from 85 to 127 ml), mean blood pressure (from 82 to 91 mmHg), and meridional end-systolic wall stress (from 53 to 67 10(3) dyne/cm2). Once the clamp was removed, significant variations were seen in the left ventricular ejection fraction (from 0.51 to 0.58), end-diastolic volume (from 205 to 187 ml), end-systolic volume (from 105 to 94 ml), mean blood pressure (from 84 to 69 mmHg), and meridional end-systolic wall stress (from 67 to 46 10(3) dyne/cm2). No differences were observed between the two aortic occlusion studies, and the baseline level of function was recovered in all parameters during the last study. These data quantify the changes in heart function that occur during abdominal aortic aneurysm operation and demonstrate that the majority of the adaptations that occurred were due to a variation in afterload.

Aged↗

Fasting and postabsorptive hepatic glucose and insulin metabolism in hyperthyroidism.

The effect of thyroid hormone excess on hepatic glucose balances and fractional hepatic extraction of insulin and glucagon was examined in six conscious dogs with catheters in the portal vein, hepatic vein, and femoral artery and Doppler flow probes on the portal vein and hepatic artery. An oral glucose tolerance test was performed before and after the animals were made hyperthyroid by intramuscular thyroxine administration (100 micrograms.kg-1.day-1) for 10 days. In the basal state and after oral glucose, insulin and glucagon levels in the three vessels and the basal fractional hepatic extraction of insulin and glucagon were not significantly modified by thyroid hormone. These results suggest that in short-term thyrotoxicosis insulin secretion is not impaired, and the rise in fasting plasma glucose and increased hepatic glucose production could reflect hepatic insulin resistance, increased availability of precursors for gluconeogenesis, or increased glycogenolysis. Hyperthyroidism significantly increased basal flows in the portal vein (14.7 +/- 0.6 vs. 12.9 +/- 0.5 ml.kg-1.min-1), the hepatic artery (4.8 +/- 0.3 vs. 3.9 +/- 0.2 ml.kg-1.min-1) and vein (19.6 +/- 0.7 vs. 16.9 +/- 0.4 ml.kg-1.min-1), the fasting plasma glucose concentration (104 +/- 3 vs. 92 +/- 2 mg/dl), and basal hepatic glucose output (2.1 +/- 0.2 vs. 1.5 +/- 0.2 mg.kg-1.min-1). It did not alter the nonhepatic splanchnic uptake of glucose, the percent of orally administered glucose that appeared in the portal vein (47 +/- 2 vs. 45 +/- 11%), the percent of hepatic uptake of glucose (59 +/- 11 vs. 74 +/- 22%), or the shape of the glucose tolerance test.

Animals↗

The effect of nitroglycerin on response to tracheal intubation. Assessment by radionuclide angiography.

The effect of intravenous (IV) nitroglycerin (NTG) on perioperative myocardial ischemia as detected by single pass radionuclide angiocardiography was studied in 20 patients scheduled for elective coronary artery bypass grafting (CABG). Ten patients, selected at random, received IV NTG 1 microgram.kg-1.min-1 (NTG group) and 10 others, IV saline (control group). Anesthetic induction consisted of midazolam 0.2 mg.kg-1, vecuronium 0.1 mg.kg-1, and 50% N2O in O2. ECG leads I, II, and V5 were monitored for ST segment changes. Single pass radionuclide angiocardiography (RNA) was performed at 5 times: prior to induction, prior to tracheal intubation, and at 1, 3.5, and 6 min following intubation. The presence of new regional wall motion abnormalities (RWMA) was determined from each RNA study as compared with the preinduction measurement. Apart from one patient in the control group who developed a new "v" wave after intubation, there was no evidence of ischemia by pulmonary capillary wedge pressure. No ECG evidence of ischemia was detected in any patient. Despite this, new regional wall motion abnormalities were observed in 3 patients in the control group and 1 patient in the NTG group. Blood pressure and heart rate responses of patients with new RWMA were not significantly different from other patients. The low incidence of ischemia in this population precludes a definitive statement regarding the efficacy of IV NTG, but the lower incidence of RWMA in the NTG group suggests a protective effect.

Coronary Circulation↗

Assessment of left ventricular functional preservation during isolated cardiac valve operations.

To evaluate intraoperative changes in myocardial performance during valvular operations, ventricular functional measurements were obtained in 16 patients before and after elective cardiac valvular replacement. Six patients had mitral regurgitation, four had mitral stenosis, and six had calcific aortic stenosis; all patients underwent isolated mitral or aortic valve replacement. Cold potassium crystalloid cardioplegia, topical hypothermia, and low-flow systemic hypothermia were employed uniformly. Just before and 10 minutes after cardiopulmonary bypass was discontinued, left ventricular pressure and volume data were recorded at four to five different steady-state levels of filling produced by blood infusion or withdrawal from the aortic cannula (mean end-diastolic pressure range, 10-22 mm Hg; mean end-diastolic volume range, 120-168 ml). Portable first-pass radionuclide ventriculography and simultaneous micromanometry were used for construction of left ventricular pressure-volume loops from which stroke work and end-diastolic volume were calculated. Two-dimensional transesophageal echocardiograms also were recorded, and epicardial pacing maintained heart rate as constant as possible. As compared with prebypass measurements, echocardiographic left ventricular wall volume changed insignificantly after the valvular procedures (178-181 ml/m2, p greater than 0.5). The stroke work-end-diastolic volume relationship before and after operation was highly linear in all studies (mean = 0.97). The slope and x intercept of this relationship did not change significantly after operation, indicating a stable level of left ventricular function (from 12.7 x 10(4) to 10.0 x 10(4) ergs/ml and from 67 to 57 ml, respectively; p greater than 0.3).(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiopulmonary Bypass↗

Expression of the SV40 promoter in fission yeast: identification and characterization of an AP-1-like factor.

The SV40 promoter is expressed well in the fission yeast S. pombe, and it initiates transcription at the same site as in mammalian cells. The majority of the enhancer sequences, however, do not contribute to this activity. DNAase I footprint analysis of the promoter revealed the presence of an AP-1-like factor in S. pombe cells that protects a region of the promoter almost identical to that protected by human AP-1. The specificity of binding of the yeast and mammalian AP-1 proteins was found to be similar. We have found two AP-1-like binding activities in budding yeast cells, one of which appears quite distinct from the binding activity of the product of the budding yeast GCN4 gene. We also demonstrate that in fission yeast the AP-1 binding site can act as an upstream activating sequence. The DNA-protein complexes containing the mammalian AP-1 and fission yeast AP-1-like factors are sensitive to phosphatase treatment, indicating that they may be phosphorylated.

Deoxyribonuclease I↗

Analytical electron microscopy study of high Tc superconductor YBa2Cu3O7.

The high Tc superconducting material YBa2Cu3O7 shows a complex relationship between microstructure and oxygen content, which are controlled by length of heat treatment, atmosphere, and quench rate. An AEM investigation studying changes in the oxygen near edge features was undertaken. Electron energy loss spectroscopy (EELS) measurements have the important advantage that they can be made on single crystal grains, allowing orientation-dependent studies. Both ion-milled and crushed samples with varying O2 content were analyzed. The structure of YBaCu3O7 was determined by neutron diffraction to be orthorhombic with distinct Cu-O chains along the b-axis as well as Cu-O planes in the a-b plane. Therefore, by looking for a crystallographic dependence of the oxygen K-edge one might be able to distinguish inequivalent oxygen atoms by their core level binding energy and correlate site occupancy with varying O2 content. The EELS results on the oxygen K-edge are strongly dependent on oxygen content, most noticeably when the c-axis is parallel to the electron beam.

Barium↗