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Biomedical subjects

R Smith

Publications and source records attributed to R Smith.

At least 1,351 records · Page 75Linked to original sources

Lack of correlation between the clinical assessment of cardiovascular status and exercise electrocardiography.

One hundred and seventy-one patients who had had a myocardial infarction were evaluated at the Institute for Aviation Medicine, Pretoria. Patients were graded according to the New York City Heart Association classification of cardiac functional capacity and then subjected to exercise electrocardiography. Only 20% of the 74 patients whose exercise electrocardiograms revealed ischaemic heart disease felt that their cardiovascular function was limiting their daily activity. This lack of correlation between the two forms of assessment was highly significant (P less than 0,0001). It is therefore concluded that clinical evaluation of an individual with known ischaemic heart disease may be misleading.

Adult↗

Post-operative pain: effect of extent of injury and attention.

The relationship to pain level of extent of injury (as measured by number of teeth extracted) and attention paid to the injury (as measured by frequency of pain ratings) was studied in patients with dental postoperative pain. Patients had either 2 or 4 impacted wisdom teeth removed and rated their pain either 2 or 5 times during the experiment. A positive correlation was found between extent of injury and reported pain level as well as between frequency of pain rating and pain level. The correlation between frequency of pain rating and pain level was found only in patients with 4 teeth extracted. To our knowledge, this is the first study which quantitatively evaluates the relationship between amount of injury and level of pain. This study also suggests that the degree to which manipulations of psychological variables alter an individual's pain perception may depend on the extent of injury.

Adolescent↗

Hemodynamics of intravenous nitroglycerin during aortic clamping.

Anesthetic management and dosage schedules of vasodilators have not been standardized in many studies of aortic cross clamping (CCL). For this reason, 25 consecutive patients with arteriosclerotic disease of the aorta were studied, all having received the same anesthetic management. Six patients who received nitroglycerin during the cross clamp period, at a dosage of 0.25 micrograms/kg/min, were compared with 19 who underwent CCL without the drug. Contractility was maintained in the nitroglycerin group, but not in the other group. Despite a low cardiac index in both groups, peripheral blood flow was adequate only in the nitroglycerin group. Intrapulmonary shunt was higher in the nitroglycerin group, but it did not significantly decrease the Pao2. Nitroglycerin infusion seems to be helpful in maintaining pre-CCL contractility and adequacy of peripheral blood flow.

Aorta, Abdominal↗

An electronmicroscopic study of the distribution of myelin basic protein in multilayer dispersions of diacylphosphatidylserine.

Although dispersions containing lipid and protein are widely used as model systems to explore the properties of biomembranes, the extent of mixing of the two components has generally not been determined. Here, the distribution of bovine myelin basic protein in dispersions with bovine brain L-alpha-diacylphosphatidylserine (PS) has been examined electronmicroscopically. Dispersions of PS were prepared by hydrating a known amount of dried lipid with buffer or with buffer containing an equal weight of myelin basic protein or lysozyme. The lipid-protein complexes were separated from unbound protein by centrifugation in 0-60% sucrose density gradients. In both systems only a few percent of the protein was unbound and the resultant recombinants, which gave single bands on the gradients, contained about 50% protein by weight. After removal of the sucrose by dialysis the dispersions were fixed in 2.5% glutaraldehyde and 1% osmium tetroxide, dehydrated and embedded in epoxy resin. Thin sections cut from these blocks were incubated, after removal of osmium tetroxide, with antiserum raised in rabbits against human myelin basic protein. Excess antiserum was removed and the antigen-antibody complexes on the thin sections were labelled with 13 nm diameter colloidal gold particles stabilized with protein A. The distributions of these gold particles were examined under an electronmicroscope. Comparison of the labelling patterns for PS, PS-lysozyme and PS-basic protein demonstrated specific labelling in the last, and showed the gold particles to be uniformly dispersed. It was concluded that in these dispersions the protein and lipid were intimately mixed at the molecular level.

Animals↗

1H-nuclear magnetic resonance study of the association of the basic protein of central nervous system myelin with lysophosphatidylcholine.

High-resolution 270 MHZ 1H-nuclear magnetic resonance spectroscopy has been used to follow the interaction of myristoyllysophosphatidylcholine with bovine myelin basic protein. At lipid/protein ratios up to 30:1 it proved possible to follow changes in the spectra of both the protein and the lipid. Lysophosphatidylcholine induced several changes in the protein spectrum. Foremost amongst these changes were downfield shifts of histidine C2 protons, and upfield shifts and broadening of the phenylalanine aromatic proteins. Several other resonances assigned to nonpolar amino acid side chains also broadened. But even at a lipid/protein molar ratio of 30:1 the majority of the protein appeared to remain in a loosely coiled conformation. In the presence of the protein the lipid acyl chain peaks were moved upfield and broadened, whereas the resonances associated with the head-group protons were unaffected. These changes were consistent with partial immobilization of the acyl chain of lysophosphatidylcholine on binding to the basic protein, with hydrophobic interactions providing the predominant attraction between this lipid and the basic protein.

Amino Acids↗

Skeletal effects of orthovoltage and megavoltage therapy following treatment of nephroblastoma.

A review of 19 patients treated for nephroblastoma between 1945 and 1978 by nephrectomy and radiotherapy with chemotherapy showed a marked improvement in cure rate in recent years. In the decade from 1950 to 1960 there are four survivors. From 1960 to 1970, there are nine survivors from 25 cases and since 1970 there are 19 survivors from 27 cases. Skeletal effects of radiation therapy have been reviewed in 22 patients--seven of whom had orthovoltage and 15 megavoltage therapy. Similar skeletal changes followed both orthovoltage and megavoltage therapy, being more severe after the adolescent growth spurt and when the follow-up was longer. The radiation dose was normally 3000 cGy and skeletal changes followed the lowest dose of 2200 cGY. Scoliosis of the lumbar spine, concave to the side of the tumour, with angulation ranging from less than 5 degrees to 54 degrees developed in 12 patients; all but one showed asymmetry of the body LV2. Kyphosis was present in three patients; anterior beaking of the vertebral body in 10; and 16 patients showed asymmetry of more than one vertebral body. Iliac hypoplasia was present in 19 patients, being unilateral when only the renal bed was irradiated. Analysis of the radiological changes expressed as a total score against the age at follow-up shows that severe changes follow orthovoltage therapy. It is too early to assess the full extent of megavoltage therapy simply because patients have not been followed up for a comparable length of time.

Adolescent↗

Review of the social situation of paraplegic and tetraplegic patients rehabilitated in the Hexham Regional Spinal Injury Unit in the north of England over the past four years.

The various aspects of the social circumstances of patients rehabilitated in the North of England Regional Spinal Injury Unit between 1975 and 1979 have been investigated. The study was carried out by making use of computerised analysis of a specially developed questionnaire. A Research Medical Social Worker was appointed to visit each patient at their home in order to record all relevant information into the questionnaire. A summary of the resulting information is presented. The study has been of particular value in two respects. Firstly, it has revealed the comprehensive social circumstances of these patients. Secondly, it has enabled us to evaluate the quality of service provided by the Hexham Regional Spinal Injury Unit, and it has enabled us to recommend an expansion of some of the aspects of the service provided by a Spinal Injury Unit.

Adolescent↗

Measuring behavioural disturbance of elderly demented patients in the community and its effects on relatives: a factor analytic study.

In recent years increasing interest has centered on the elderly psychogeriatric patient living in the community and the part played by relatives in supporting these patients. There is a need, however, for ways of assessing the behavioural disturbance shown by such patients at home and the effect this behaviour has on relatives. Ratings by relatives of the behaviour at home of elderly dementing patients attending a geriatric psychiatry day hospital, together with the relatives' own ratings of the degree of stress and upset being experienced were obtained. Using the technique of factor analysis was shown that the patient's behaviour and the relative's reaction could be analysed into a number of separate categories and that these were differentially related to each other. Thus, for example, personal distress in the relative was related mainly to the amount of apathetic and withdrawn behaviour shown by the patient, whereas negative feelings held by the relative towards the patient were related only to the degree of disturbance of the patient's mood. The construction of scales measuring these different aspects of patient's behaviour and relative's reaction is described.

Aged↗

A two-year reject/retake profile analysis in pediatric radiology.

With increasing interest in the use of reject/retake analysis as an integral part of a routine quality assurance program in diagnostic radiology comes the need for a better understanding of the information obtained. The present study investigated the reject/retake profiles in a pediatric radiology department on a long-term basis. Retake profiles have been continually analyzed for a period of 24 months. Emphasis of the analysis were placed upon understanding the characteristics of the profiles observed and the effectiveness of the corrective actions implemented. The analysis indicated that after the implementation of a comprehensive quality assurance program, the overall rejection profile is predominantly determined by the rate of positioning errors.

Pediatrics↗