Thoracolumbar burst fractures. Surgical intervention from a nursing perspective.
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Biomedical subjects
Publications and source records attributed to S Moore.
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Immunocytochemical techniques used in conjunction with confocal scanning laser microscopy (CSLM) and electron microscopy have been used to demonstrate, for the first time, the distribution of the parasitic platyhelminth neuropeptide, neuropeptide F (NPF) in the cestode, Moniezia expansa. Antisera were raised to intact NPF(1-39) and to the C-terminal decapeptide of NPF(30-39). These antisera were characterized and validated for use in both immunocytochemistry and radioimmunoassay (RIA). NPF immunoreactivity (IR) was detected using both antisera throughout all of the major components of the central and peripheral nervous systems of the worm. The pattern of NPF-IR was found to mirror the IR obtained using a C-terminally directed pancreatic polypeptide (PP) antiserum and FMRFamide antisera; blocking studies using these antisera revealed that FMRFamide and PP antisera cross-react with NPF(M. expansa). RIA of acid-alcohol extracts of the worm measured 114 ng/g using the C-terminal NPF antiserum and 56 ng/g using the whole-molecule-directed antiserum. While the C-terminally-directed NPF antiserum cross-reacts with NPF-related peptides from other invertebrates, the whole-molecule-directed NPF antiserum is specific for NPF(M. expansa). The C-terminal NPF antiserum has potential for use in the identification and purification of NPF analogues from other platyhelminth parasites.
During myocardial ischaemia, functional compensation occurs by non-ischaemic regions of the left ventricle (LV). Anaesthetics may affect compensation by altering contractility, metabolism and perfusion. This was studied in dogs anaesthetized with fentanyl (150 micrograms kg-1 loading dose and 100 micrograms kg-1 h-1) or 0.75% and 1.5% halothane and subjected to left anterior descending artery (LAD) occlusion. After 15 min of anterior wall ischaemia, cardiac output, mean arterial pressure and LV maximum dP/dt were diminished in the 1.5% halothane but not in the 0.75% halothane or fentanyl groups. In all groups, stroke volume decreased, LV end-diastolic pressure increased and anterior wall function deteriorated (measured as systolic shortening, peak systolic intramyocardial pressure (IMP), regional wall stroke work (RSW) and slope of preload recruitable stroke work curve (Mw)) with ischaemia. Functional changes in the lateral (non-ischaemic) wall were different between groups. Regional function during occlusion in this area improved with fentanyl (mean (SEM) IMP, RSW and Mw increased by 23 (2)%, 37 (3)% and 69 (7)%, respectively), was relatively well maintained with 0.75% halothane and diminished with 1.5% halothane.
The paradigm for study of anticipatory postural adjustments permits investigation of the coordination of postural and voluntary components of functional movement. The purpose of this study was to investigate whether there were anticipatory postural adjustments for voluntary movement in seated subjects under clinically relevant conditions. Eight neurologically normal subjects performed a reaching task to a target placed at shoulder height, 45 degrees to the right of midline. Onsets and magnitudes of lateral and fore-aft reactive forces associated with the movement and of electromyographic (EMG) activity of the ipsilateral deltoid and external abdominal oblique and contralateral paraspinal muscles were monitored. Conditions of trunk support, reach speed, and distance reached were manipulated. Onsets of deltoid muscle EMG activity preceded onsets of postural muscle (external oblique and paraspinal) EMG activity in 70% of all trials for seated subjects in contrast to reports of EMG activity onset in the postural muscles in advance of the prime mover in standing subjects who performed a similar task. The role of the trunk musculature and the significance of reactive forces in advance of hand movement were equivocal. This study has implications for evaluation of postural instability in persons unable to stand for testing.
We used a monoclonal antibody recognizing chondroitin sulfate (CS) to investigate by immunocytochemistry the characteristics displayed in situ by aortic proteoglycans (PG) containing CS side chains. The antibody specifically precipitated metabolically labeled PG from aortic extracts. Anti-CS specificity was also tested directly on tissue sections and was confirmed by the virtual abolition of immunolabeling on those previously digested with CS-specific enzymes. The overall CS-PG distribution assessed by light microscopy after embedding in Lowicryl KM4 by silver-enhanced immunogold recapitulated that obtained on frozen sections with immunoperoxidase. Extracellular concentrations of CS-PG were very high in the innermost regions of aorta and decreased in the media. The reaction was weak and diffuse in the adventitia. By electron microscopy, the detailed labeling of CS-PG discriminated patterns of organization at both the regional and the molecular level and enabled morphometric estimations. In relation to other components of the extracellular matrix, we found that CS-PG and elastin mutually excluded each other, while two types of CS-PG were differently associated with collagen within media or adventitia. The use of high-resolution immunodetection for the in situ characterization of aortic CS-PG could add specific information relevant to many biological processes in which these molecules have been implicated.
In the planning of MRI protocols to monitor disease activity in multiple sclerosis (MS), the clinical subtype needs to be considered. In this serial gadolinium-enhanced MRI study, we demonstrated differences between patients with early relapsing/remitting MS and benign MS in both the production of new lesions and the occurrence of enhancement.
Laryngeal chondrosarcomas are uncommon, and those that contain a distinct, nonchondroid, high-grade spindle cell sarcoma (the so-called "dedifferentiated" chondrosarcoma or chondrosarcoma with additional malignant mesenchymal component [CAMMC]) are extremely rare. Laryngeal CAMMC merit special attention, as CAMMC in other sites portends a poor prognosis. Eleven patients with laryngeal chondrosarcomas are reported on; 2 of these patients had CAMMC. On follow-up, 3 of the 11 patients had recurrences. The first had recurrence 4 and 11 years after tumor enucleation; that patient died disease free 2 years after salvage total laryngectomy. The second had recurrence 2 years after partial laryngectomy and was lost to follow-up after salvage total laryngectomy. The last patient recurred 13 years after partial laryngectomy and underwent salvage total laryngectomy; that patient was one of the two who developed CAMMC, and he also developed stomal recurrence of the "dedifferentiated" component 3 years after total laryngectomy. The other 8 patients are disease free after partial laryngectomy (6) or total laryngectomy (2) 10 months to 12 years later (mean: 51 months). This includes the 1 other patient with CAMMC, who is disease free 60 months after total laryngectomy. Laryngeal CAMMC has been shown, in at least one of the two patients, to be associated with a poor outcome. Patients with recurrent laryngeal chondrosarcomas do not have a poorer outcome after salvage total laryngectomy. The authors advocate partial laryngectomy if technically feasible.
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Acute myeloid leukaemia (AML) blast cells express haemopoietic growth factor receptors. However, their presence does not predict response to the cognate ligand in vitro. This suggests that haemopoietic growth factor receptor structure or function may be abnormal in some cases of acute myeloid leukaemia. The granulocyte-macrophage colony-stimulating factor receptor alpha-chain gene (GM-CSF-R) has recently been localised to the pseudoautosomal region of the sex chromosomes. A sex chromosome is lost in 25% of cases of AML FAB subtype M2. The loss of one allele of this gene may have some aetiological significance in AML if the other allele is altered leading to abnormal receptor structure, function or number. In this initial study, we have examined DNA from leukaemic cells of 29 patients with AML, including three with FAB subtype M2 with deletion of an X or Y chromosome for evidence of gross rearrangement of this gene. We report that although the gene is highly polymorphic for a number of restriction enzymes, we have found no evidence of gross rearrangement in AML.
The cytogenetic response of 10 patients with chronic myeloid leukaemia (CML) to human recombinant interferon-alpha 2a (rhIFN alpha 2a) was compared to the Philadelphia chromosome (Ph) status of the pre-treatment peripheral blood cells after in vitro culture under long-term bone marrow culture (LTBMC) conditions. Pre-treatment light density peripheral blood cells were cultured in LTBMC on sex-mismatched irradiated allogeneic stromal layers with weekly cytogenic examination of metaphases in the non-adherent cell fraction. This was correlated with the patients' response to rhIFN alpha. Two groups of patients, five showing a cytogenetic response (responsive) and five who failed to achieve a cytogenetic response (nonresponsive) were studied. At the initiation of the LTBMCs the Ph' was found to be present in 100% of the cells analysed for nine patients and 97% for one patient. Pretreatment peripheral blood from four responsive patients demonstrated a decline in the proportion of Ph'-positive cells (Ph+) after 1 to 2 weeks in LTBMC. In contrast, peripheral blood from all the non-responsive subjects showed persistence of the Ph+ clone in 100% of the cells analysed out to a maximum of 3 to 5 weeks in LTBMC. A significant difference was observed (Fisher exact test, p = 0.023) between the two patient groups in respect to the appearance of normal clones in the nonadherent population. The presence of Ph- metaphases in LTBMC of peripheral blood cells of CML patients may predict their cytogenetic response to rhIFN alpha 2a.
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The distribution of endogenous apolipoprotein B (apo B) was studied in both normal and balloon catheter-injured aortas of standard fed rabbits. Using light and electron microscopy, the distribution within entire aortic walls and individual tissue compartments was investigated by immunocytochemistry using an antibody raised against rabbit apo B. The concentration of apo B across the vessel wall dropped sharply from the luminal front towards the media of the normal aortas. The strong superficial reaction was mainly due to a heavy, yet specific, labelling of endothelial cells. Significant concentrations of apo B were also detected within the innermost regions of the extracellular space. The characteristics associated with the labelling of the intimal layer suggested an intense uptake and transcellular transport of apo B by endothelial cells. In contradistinction, normal smooth muscle cells did not appear to be labelled. In the previously injured aortas, the same features of strong superficial apo B labelling were present in the areas covered by regenerated endothelial cells, but not in those persistently deendothelialized. The smooth muscle cells of these regions appeared to show a low uptake of apo B. The increased concentrations of apo B in deeper interstitial areas of injured aortas, indicated the contribution of the extracellular matrix to apo B accumulation. This was especially prominent in the advanced lesions, selectively developed within neointima covered by regenerated endothelium. A rather uniform labelling pattern accompanying small lipid particle deposits, suggested a direct extracellular accumulation of circulating lipoproteins. Intensely labelled foam cells and irregularly distributed apo B within areas of cellular necrosis were detected as well. Injury-mediated responses of the cellular and extracellular aortic components can trigger the development of lipoprotein accumulations characteristic of atherosclerosis within aortas of normocholesterolemic animals.
In a retrospective study of 77 patients with acute facial palsy, the results of the nerve excitability test (NET) and electroneurography (ENoG) were analyzed in order to establish a mathematic correlation and to relate the prognostic NET values to quantitative ENoG results. The two tests are related by exponential functions. Coefficients of correlation were higher for the results between NET and the optimized lead placement (OLP) ENoG compared to NET and standardized lead placement (SLP) ENoG. The highest correlation coefficients were demonstrated when NET was performed over the marginal and zygomatic branches of the facial nerve and OLP ENoG recorded in the nasolabial region. Good prognostic NET threshold differences in patients with a small percentage of intact motor axons, calculated by ENoG, may represent segmental demyelination or the deblocking phase of neuropraxia. The tests are complimentary in establishing the integrity of the facial nerve in acute paralysis.
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Chromogranin A is produced in many endocrine cell types, and is widely used as a marker in endocrine-cell pathology and secretory-cell biology. There is some evidence that it may be proteolytically processed to yield the putative pancreatic regulatory peptide, pancreastatin, and, in order to characterize the relevant pathways in gastrointestinal and pancreatic endocrine cells, we have used, in radioimmunoassay, site-directed antibodies to pancreastatin itself (L331) and to a sequence of chromogranin A immediately C-terminal to pancreastatin (L300). The latter antibody revealed three major forms of immunoreactivity of 8 kDa and five peptides of approx. 3 kDa in bovine pancreas and gut extracts. The 8 kDa peptides were characterized as chromogranin A-(248-313)-peptides, i.e. C-terminally extended forms of pancreastatin; two of the 8 kDa variants differed in two positions, confirming a polymorphism predicted from cDNA sequencing. One of the 3 kDa peptides was characterized as chromogranin A-(297-313)-peptide, i.e. the C-terminal heptadecapeptide of the 8 kDa peptide that would be liberated after cleavage to yield pancreastatin. On the basis of chromatographic studies, immunohistochemistry and the stoichiometry of different immunoreactive peptides, three different pathways of chromogranin A processing were identified: in adrenal chromaffin cells chromogranin A existed mainly as the unmodified intact protein, in pancreatic islet and gastric antral endocrine cells pancreastatin and the 3 kDa peptides were major products, but in small intestine and gastric corpus endocrine cells there was little nor no pancreastatin and the 8 kDa cleavage product predominated. There are therefore important differences in the distribution of chromogranin A-derived peptides between quite closely related populations of endocrine cells that are attributable not only to variable post-translational cleavage but also to the expression of different primary sequences. It seems possible that in different cell types chromogranin A-derived peptides might subserve a variety of different functions.
Hyperimmunized rabbit anti-rat apolipoprotein antibodies showed reactivity to proteins in Saccharomyces cerevisiae. Antiapolipoproteins A1, B and E reacted with proteins in both a crude extract and a lipid enriched fraction. Protein reactivity was dependent on antisera dilution. Furthermore, the different antiapolipoproteins tested reacted with individually distinct yeast proteins, possibly suggesting the presence of a variety of yeast apolipoproteins with distinct cellular functions as is the case with mammalian apolipoproteins. The specificity of the antibody was directed toward the yeast protein and not a lipid moiety.
This small experimental study describes the effects on the NMR relaxation times in normal cat brain of a 5-day course of high dose methylprednisolone and, separately, a 1-month course of standard dose daily chlorpromazine. Methylprednisolone had no influence on T1 or T2 in these tissues, but chlorpromazine produced a transient fall of T1 of thalamus, and rise in T2 of white matter: both normalize after 4 weeks. The mechanism of these changes is unknown. It is concluded that these drugs should not interfere with the quantitative MRI monitoring of brain abnormalities in patients receiving them, although the unlikely occurrence of longer term effects of chlorpromazine has not been excluded.