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Biomedical subjects

R Taylor

Publications and source records attributed to R Taylor.

At least 343 records · Page 19Linked to original sources
PubMed1994

Achalasia of the cardia in children: a worldwide survey.

This report summarizes a worldwide survey of achalasia in childhood. The data were obtained by circulating a questionnaire to pediatric surgeons throughout the world. Information was received regarding 175 patients, and the analysis is presented. Childhood achalasia appears to be more common in boys, and familial cases are rare. Regurgitation of food and dysphagia are the most frequent symptoms in affected children. Although 18% of patients had symptom onset during infancy, only 6% of the patients were identified as having achalasia during infancy. The survey suggests only a fair clinical response to transthoracic esophagocardiomyotomy and a good to excellent clinical response to transabdominal esophagocardiomyotomy. A cooperative effort between several institutions will permit the development of prospective treatment protocols for children with achalasia.

Adolescent↗
PubMed1994

Severe impairment of insulin action in adipocytes from amenorrheic subjects with polycystic ovary syndrome.

Adipose tissue was used to characterize the metabolic abnormality of insulin resistance in polycystic ovary syndrome (PCOS). Nine patients with PCOS were studied during a period of amenorrhea and confirmed to be chronically anovulatory by vaginal ultrasound and plasma progesterone measurements. These were compared with six age- and body mass index (BMI)-matched controls (BMI, 27.2 +/- 2.2 in PCOS and 24.7 +/- 2.3 in control subjects). Insulin receptor binding was measured and insulin action was assessed by measuring initial rates of 3-O-methylglucose uptake and by inhibition of lipolysis. The maximum specific insulin receptor binding was 0.62% +/- 0.12% and 1.78% +/- 0.18% per 10-cm2 cell surface (mean +/- SEM) in PCOS and control subjects, respectively (P < .001). Maximum rates of glucose transport were also impaired as compared with controls, with 3-O-methylglucose transport being 0.90 +/- 0.15 versus 1.57 +/- 0.28 pmol/10 cm2/5 s, respectively (P < .05). The concentration of insulin required for half-maximal stimulation of glucose uptake was 165 +/- 36 versus 32 +/- 10 pmol in PCOS and control subjects, respectively (P < .05). The maximum percentage lipolysis inhibition (mean +/- SEM) was 9.5% +/- 1.6% in PCOS and 28.3% +/- 7.2% in control patients, respectively (P < .01). These data demonstrate that there are both insulin binding and postreceptor defects in adipocytes from amenorrheic PCOS subjects. The degree of defect in adipocyte insulin action is greater than would have been anticipated from in vivo data.

Adipocytes↗
PubMed1994

Insulin sensitivity and metabolic clearance rate of insulin in cystic fibrosis.

We have evaluated the metabolic clearance rate (MCR) of insulin and insulin sensitivity in 12 older patients with cystic fibrosis (CF) using the hyperinsulinemic euglycemic clamp method. Compared with a control group matched accurately for age and body mass index (BMI), the MCR of insulin was significantly enhanced in CF CF = 21.85 +/- 1.17 v controls = 16.01 +/- 0.92 mL/kg/min, P < .005), and this difference persisted after correction for lean body mass ([LBM] CF = 26.32 +/- 1.28 v controls = 19.09 +/- 1.09 mL/kg LBM/min, P < .005). Glucose disposal rates (M) were similar in the two groups during the clamp (CF = 7.28 +/- 0.41 v controls = 6.83 +/- 0.60 mg/kg/min, P > .5), but the insulin sensitivity index, M/I x 100 (I = steady-state insulin concentration), was markedly increased in the CF group (CF = 17.62 +/- 1.30 v controls = 11.75 +/- 0.71, P < .005). In conclusion, the MCR of insulin is enhanced in CF, which is in keeping with previous observations on drug metabolism in this disorder. Second, insulin sensitivity is increased in CF, and this points to a compensatory mechanism to counteract the insulinopenia.

Adolescent↗
PubMed1994

A cohort study of unemployment as a cause of psychological disturbance in Australian youth.

Data from the Australian Longitudinal Survey, conducted by the Commonwealth Department of Employment, Education and Training, were analysed to estimate relative risk of psychological disturbance accompanying unemployment in young people aged 15-24 years. Two cohorts were surveyed annually over 4 years during the mid-to-late-1980s; one from the general 15-24 year-old population (N = 8995), and the other selected from Commonwealth Employment Service records (N = 2403). Such large respondent numbers allowed control of confounding by exclusion to isolate employment transition groups suitable for hypothesis testing and quantification of causal relationships. Psychological morbidity was measured using binary outcomes of the 12 item psychological component of the General Health Questionnaire. Excluded from the analysis were those who: suffered from pre-existing physical health problems; were dissatisfied in their job; were self-employed; underwent marriage breakdown during the inter-survey period; had become widowed during the inter-survey period. A Bayesian probabilistic approach was used to calculate probabilities of psychologically normal respondents becoming psychologically morbid, given prior transition from employment to unemployment. Mantel-Haenszel analysis was utilised to estimate relative risks in comparison to a control group of those remaining employed, after controlling for age and gender. An overall relative risk of becoming psychologically disturbed as a consequence of becoming unemployed was estimated to be 1.51 (95% CI: 1.15-1.99). The overall relative risk of recovery from psychological disturbance upon re-employment in those with psychological disturbance was estimated to be 1.63 (95% CI: 1.08-2.48). Residual psychological effects of past unemployment experience and the effects of long-term unemployment were investigated, but found to be non-significant in this study. There was some evidence of psychological adaptation to unemployment, but this was statistically insignificant. Unemployment was a significant cause of psychological disturbance in young people who were initially employed, not suffering physical ill-health, and psychologically normal; conversely, re-employment reversed the effect.

Adaptation, Psychological↗
PubMed1994

Epidemiological characteristics of Kaposi's sarcoma prior to the AIDS epidemic.

Twenty-six cases of Kaposi's sarcoma (KS) were recorded by the New South Wales Central Cancer Registry between 1972 and 1982, prior to the first AIDS diagnoses in Australia. The overall annual incidence was 0.47 per million. Incidence was three times higher in males. The highest incidence was in people born in the Middle East and in males born in southern and eastern Europe.

Acquired Immunodeficiency Syndrome↗
PubMed1994

The effect of noise spectrum on speech recognition performance-intensity functions.

Articulation theory predicts that a subject's absolute or masked threshold configuration will affect the slope of the speech recognition performance-intensity (P-I) function. This study was carried out to test that prediction. Performance-intensity functions for the Technisonic Studios W-22 recordings were obtained from 12 subjects with normal hearing. Four continuous thermal noise maskers, high-pass (HP) noise, white noise, ANSI noise, and talker-spectrum-matched (TSM) noise, were used to shape threshold. P-I function slopes for the averaged data ranged from about 1.6%/dB in HP noise to about 6.7%/dB in TSM noise. At low to moderate speech intensity levels, the positions and slopes of the P-I functions were accurately estimated by an articulation index-type model that included corrections for subject proficiency and for high- and low-frequency spread of masking. At higher intensity levels, performance was overestimated by the model.

Acoustic Stimulation↗
PubMed1994

Affinity-purified Escherichia coli J5 lipopolysaccharide-specific IgG protects neutropenic rats against gram-negative bacterial sepsis.

Antibodies were raised in rabbits by immunization with the heat-killed J5 mutant of Escherichia coli O111 (Rc chemotype). Serum antibodies were separated into purified IgG and IgM by sequential affinity chromatography on protein G-Sepharose and anti-rabbit IgG-Sepharose columns. J5 lipopolysaccharide (LPS)-specific IgG was prepared by affinity chromatography of purified IgG on a J5 LPS-EAH Sepharose 4B affinity column. Purified IgM, IgG, and J5 LPS-specific IgG protected neutropenic rats against lethal challenge with Pseudomonas aeruginosa 12:4:4 (Fisher Devlin immunotype 6). Nine of 16 rats treated with the IgM fraction were protected (P < .001). Thirteen of 20 rats treated with the purified IgG and 6 of 8 treated with J5 LPS-specific IgG were protected compared with none of 25 treated with IgG made from the preimmune serum of the same rabbit (P < .001). These results demonstrate that purified J5 LPS-specific IgG protects against the lethal consequences of gram-negative bacteremia.

Animals↗
PubMed1994

Localization of inhibin and activin binding sites in the testis during development by in situ ligand binding.

Inhibin and activin are related proteins thought to be potential paracrine regulators of testicular development and maintenance of spermatogenesis. Messenger RNA and proteins immunologically related to both factors have been identified in the adult testis. However, the role(s) of these factors in paracrine regulation of testicular function is poorly understood. To identify potential targets for inhibin and activin in immature and adult testis, we used in situ binding of [125I]-labeled ligands to localize and describe the distribution of binding sites for inhibin and activin in testes of 15-, 18-, 21-, 30-, 45-, and 60-day-old rats. Nonspecific binding was defined as that occurring in the presence of a 1000-fold excess of unlabeled recombinant human (rh) inhibin or activin. [125I]-Inhibin was found to bind to interstitial cells throughout development. Inhibin binding was shown to co-localize with cells that showed positive staining for 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD). Competition studies demonstrated that this binding was indeed specific for inhibin. In contrast, [125I]-activin showed two distinct patterns of binding. First, [125I]-activin was shown to bind in a non-stage-dependent manner to cells located in the basal compartment of the seminiferous tubules in testis obtained from animals of all ages studied. Binding of [125I]-activin in the periphery of the tubule could be inhibited entirely by coincubation with excess unlabeled activin and partially with excess unlabeled inhibin. The ability of inhibin to compete with activin for binding appeared to be more pronounced in younger animals. In 45- and 60-day-old animals, a second stage-dependent component of [125I]-activin binding was also apparent. This binding was localized to spermatids found in stage VII-VIII tubules and was inhibited by the presence of excess activin, but not inhibin. These results indicate that inhibin can bind specifically to testicular interstitial cells throughout development and may be an important regulator of Leydig cell testosterone production or interstitial cell function. In contrast, activin appears to bind in a specific and stage-dependent manner to receptors or high-affinity binding proteins on spermatids as well as to sites on the periphery of all seminiferous tubules. These results support the hypothesis that both activin and inhibin may act at several levels to regulate proliferation or differentiation of germ and Sertoli cell function as well as to modulate interstitial cell activity.

3-Hydroxysteroid Dehydrogenases↗
PubMed1994

Insulin regimens for the non-insulin dependent: impact on diurnal metabolic state and quality of life.

A randomized prospective study was conducted to determine whether the insulin regimen for NIDDM subjects poorly controlled on oral therapy should be designed primarily to control basal metabolism or to control mealtime hyperglycaemia. Grossly obese subjects were excluded. After a 2-month run-in phase involving intensive education, subjects were randomized to therapy with twice daily isophane or three times daily soluble insulin. Both Protaphane and Actrapid brought about similar improvement in HbA1 (9.5 +/- 0.5 and 9.7 +/- 0.4%) compared with baseline (11.7 +/- 0.5%; p < 0.001). Diurnal blood glucose profiles showed that despite the good post-prandial control achieved by pre-meal soluble insulin, loss of control occurred overnight, resulting in higher fasting blood glucose levels compared with Protaphane therapy (8.0 +/- 0.8 vs 10.6 +/- 0.8 mmol l-1; p < 0.05). The overall rate of hypoglycaemia was 0.44 patient-1 year-1. Thirty-two mild hypoglycaemic episodes occurred on Protaphane therapy and 79 on Actrapid therapy. Using formal psychometric tests it was shown that insulin therapy was associated with improved treatment satisfaction and that this was greater on Protaphane therapy (p < 0.05). Overall well-being increased similarly in the two groups. All subjects wished to continue with insulin therapy after the conclusion of the study. The insulin regimen for moderately or poorly controlled non-insulin-dependent diabetes should primarily be designed to correct the basal insulin deficiency rather than to mimic normal meal-induced insulin secretion.

Adult↗
PubMed1994

Mark-recapture estimates of injecting drug users in Sydney.

The number of injecting drug users in the Central and Eastern Sydney Area Health Services (CSAHS and ESAHS) in 1989-1990 was estimated by applying the Petersen mark-recapture method to data obtained from the Australian National AIDS and Injecting Drug Use Surveys conducted in 1989 and in 1990. The population estimates for injecting drug users were 8368 (95 per cent confidence interval (CI) 6099 to 11,829) for ESAHS and 1466 (CI 742 to 2841) for CSHS. An estimate was also obtained for the number of injecting opioid users residing within the ESAHS; our figure of 3597 (CI 2731 to 5737) was consistent with previously reported estimates obtained using mark-recapture but based on different data sets.

Adult↗
PubMed1994

Focal necrotising herpes simplex encephalitis: a report of two cases with good clinical and neuropsychological outcomes.

Two patients with atypical focal necrotising herpes simplex encephalitis are described. They presented with relatively mild clinical disease but despite treatment with acyclovir (10 mg/kg/day for three days in case 1 and 10 days in case 2) they developed dramatic, progressive changes (shown on brain CT) that mimicked space occupying lesions of the temporal lobes. Both patients therefore had a diagnostic and therapeutic temporal lesionectomy followed by further 10 day courses of acyclovir. They subsequently went on to make good clinical and neuropsychological recoveries.

Adolescent↗
PubMed1994

Human muscle glycogen resynthesis after exercise: insulin-dependent and -independent phases.

To study the effects of glycogen depletion and insulin concentration on glycogen synthesis, gastrocnemius glycogen was measured with 13C-nuclear magnetic resonance at 4.7 T after exercise. Subjects performed single-leg toe raises to deplete gastrocnemius glycogen to 75, 50, or 25% of resting concentration (protocol I). Insulin dependence of glycogen synthesis was assessed after depletion to 25% with (protocol II) and without (protocol III) infusion of somatostatin to inhibit insulin secretion. After depletion to 75 and 50%, glycogen resynthesis rates were similar (2.4 +/- 0.7 and 2.8 +/- 0.6 mM/h, respectively). When glycogen was depleted to 25% (< 30 mM), the resynthesis rate was significantly higher (P < 0.02) at 33 +/- 7 mM/h, and it declined to 3.5 +/- 0.9 mM/h at > 35 mM glycogen. At < 35 mM glycogen, synthesis was not affected by low insulin (24 +/- 4 mM/h, protocol vs. 19 +/- 3 mM/h, protocol III), whereas at > 35 mM glycogen, synthesis ceased without insulin (-0.07 +/- 0.19 mM/h, protocol II). After depletion to 25% (protocol III), plasma lactate transiently increased (0.81 mM at rest, 1.82 mM 0 h after exercise, and 0.76 mM 2 h after exercise), whereas other plasma constituents did not significantly change. We conclude that after depletion to < 30 mM initial glycogen resynthesis is insulin independent and glycogen dependent, which suggests local control.

Adult↗
PubMed1994

Ca(2+)-dependent Cl- conductance in taste cells from Necturus.

1. Taste responses adapt to a constant chemical stimulus. The present study describes a new ionic conductance in taste cells--a Ca(2+)-dependent anion conductance that may explain taste adaptation. 2. Patch-clamp recordings were made on isolated Necturus taste cells or on taste cells in lingual slices. When Na+ and K+ currents were eliminated with tetrodotoxin (TTX) and tetraethyl-ammonium (TEA) in the bath and replacing K+ with N-methyl-D-glucamine (NMDG+) in the pipette, Ca2+ currents were followed by prolonged outward currents. Outward current was abolished when Ca2+ was substituted with Ba2+ or when Cl- was replaced with large organic anions (methanesulfonate, isethionate, or ascorbate). 3. The outward, Ca-dependent current was reduced by certain agents that block Cl- conductances in other tissues, namely 4-acet-amido-4-isothiocyanostilbene-2,2-disulfonic acid (SITS) and 4,4-diisothiocyanostilbene-2,2-disulfonic acid (DIDS). However, other Cl- channel blockers--9-AC, furosemide and an antibody to Cl channels-had little or no specific effect on the Ca-dependent outward current in Necturus taste cells. 4. We postulate that the biological action of this Ca-dependent anion conductance in situ is to terminate depolarizing receptor potentials, even during maintained chemostimulation, thereby playing an important role in chemosensory adaptation and modulation of impulse discharge patterns in taste buds.

Afferent Pathways↗
PubMed1994

Pseudopregnancy in harp seals (Phoca groenlandica).

Concentrations of circulating progesterone were monitored in a captive breeding group of harp seals. Five females were monitored for 2 years, over which time they either became pregnant (four instances) or displayed an overt pseudopregnancy (five instances). Only one female exhibited consecutive pseudopregnancies. In all pseudopregnancies, serum progesterone values were high and remained high until July, which is close to the time when implantation normally occurs. After this time progesterone concentrations remained high, gradually declining to baseline values over the following four months. In the three females that were pregnant one year and pseudopregnant in the other year, the average progesterone concentration during pseudopregnancy was lower than that exhibited during pregnancy (P < 0.05). All females (except one) increased their mass, girth and condition index over the normal gestation period whether they were pregnant or pseudopregnant. The potential consequences of such a high rate of pseudopregnancy on the use of ovarian scars for estimating reproductive rates and population size are discussed.

Animals↗
PubMed1994

Risk factors for the development of left ventricular hypertrophy in a prospectively followed cohort of dialysis patients.

The objective of this study was to determine the role of hypertension, age, anemia, and hyperparathyroidism in the pathogenesis of left ventricular hypertrophy (LVH) developing after the initiation of dialysis for ESRD. A cohort of dialysis patients who were being treated for ESRD and whose initial echocardiograms after the start of dialysis therapy do not show LVH were studied. Three hundred and thirty-nine patients have been monitored at three centers since 1985. Serial echocardiograms have been performed with M-mode and two-dimensional echocardiography. Data on blood pressure, height, weight, hemoglobin, number and type of antihypertensive medications, and the presence of functioning vascular access have been collected prospectively. Prospective data on serum calcium, serum phosphorus, alkaline phosphatase, and parathyroid hormone levels and skeletal x-rays have also been collected. By the use of set criteria and blinding to echocardiographic outcome, the presence and severity of hyperparathyroidism were graded by consensus. Fifty-one patients met eligibility criteria for inclusion; of these, 14 developed LVH (cases) and 37 did not (controls). Cases had significantly higher systolic blood pressure (P = 0.009) and were older (P = 0.01) than controls. Systolic blood pressure correlated significantly with final posterior left ventricular wall thickness (r = 0.39; P < 0.01). By the use of multivariate analysis, age and systolic blood pressure were significantly and independently associated with increased left ventricular mass index. The frequency of hyperparathyroidism was low and equal in both groups. There was a trend toward more severe anemia in cases that did not reach statistical significance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗