Biomedical subjects
Publications and source records attributed to S Moore.
Innovative surgical approaches to current adult lumbar scoliosis result in faster recovery time and greater satisfaction regarding patient abilities after surgery. Combined ASF/PSF requires expert surgical team coordination throughout the perioperative period to achieve positive patient results.
The therapeutic options for the treatment of acute Graves orbitopathy include high-dose oral corticosteroids, surgical decompression, and radiotherapy. The former two treatments are associated with significant morbidity. Although there have been a number of reports of the efficacy of radiotherapy, its role in the management of this disease is still questioned. The authors reviewed 84 cases of acute Graves orbitopathy treated with either high-dose systemic corticosteroids or radiotherapy (2000 rad to each involved orbit). Radiotherapy resulted in significant improvement in subjective and objective signs of orbital congestion and was more effective than high-dose corticosteroids in relieving compressive optic neuropathy. Of the patients with compressive optic neuropathy, only 1 of 29 treated with radiotherapy required surgical decompression, whereas, 6 of 16 treated with corticosteroids required surgery. This study suggests that radiotherapy has greater efficacy and fewer complications than high-dose systemic corticosteroids in the treatment of acute Graves orbitopathy.
Type I diabetes is associated with the DQ loci of the MHC and to a lesser extent with the T cell antigen receptor (TcR) beta chain genes. The non-obese diabetic (NOD) mouse is an animal model of human diabetes, in which up to 90% of female mice develop overt insulin-dependent diabetes. Genetic studies in the NOD mouse suggest that there are at least three diabetogenic genes; one that maps to the MHC, another that may map to the mouse Thy-I locus, and a third that has still to be identified. We have investigated loci in the vicinity of the human Thy-I locus on chromosome 11q23 and report here the results of restriction fragment length polymorphism (RFLP) analysis of the CD3 epsilon locus of 168 Caucasoid patients with type I diabetes. While no association was found between this locus and type I diabetes, a significant difference in the frequency of the CD3 epsilon 8-kb allele was found between male and female patients (0.268 versus 0.430; P less than 0.0025, Pc = 0.02) and between female patients and healthy female controls (0.430 versus 0.267; P less than 0.015). These results suggest that a gene residing on chromosome 11q23 may confer susceptibility to type I diabetes in women.
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The interactions between serum lipoproteins isolated from rabbits fed a cholesterol-supplemented diet for six weeks, and soluble extracts of arterial neointima enriched in proteoglycans extracted from normocholesterolaemic rabbit aortas, were studied in an in vitro system. Neointimal tissues of rabbit aorta, which developed during three months following a selective endothelial injury, were excised and the areas covered or uncovered by regenerated endothelium were separated. To isolate the proteoglycan enriched fraction, both normal and injured tissue was homogenized in a sucrose solution containing protease inhibitors, centrifuged, and further fractionated by gel exclusion chromatography. The composition of the soluble extracts and each of their corresponding proteoglycan enriched fractions were analyzed in terms of protein and glycosaminoglycan content. Lipoproteins of donor animals fed an atherogenic diet were prepared by sequential ultracentrifugal flotation after density adjustment with KBr. Aliquots of electrophoretically pure lipoprotein fractions were incubated with proteoglycan enriched fraction from uninjured, denuded, or endothelium-covered neointima in the presence of Ca++ and Mg++ at 4 degrees C. The complexes formed during incubation were separated by centrifugation. The cholesterol content of the complexes was considered as an index of binding capacity. Results were expressed as micrograms of cholesterol bound per mg of glycosaminoglycan. The data reveal the higher affinity of hypercholesterolaemic lipoprotein fractions for aortic proteoglycans, as compared to normocholesterolaemic lipoproteins. In addition, when evaluating the relevance of the proteoglycan enriched fraction source, the affinity of fractions extracted from aortic neointima was found to be much higher for hypercholesterolaemic lipoproteins. These results suggest the role that proteoglycan-lipoprotein interactions could play in the event of the combined actions of endothelial injury and hypercholesterolaemia in the pathogenesis of atherosclerosis.
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The purpose of this study was to determine the presence of postural adjustments before a reaching task by seated subjects. Nine seated subjects performed a rapid reaching task to a target placed at shoulder height, 45 degrees to the right of midline. Reach time, timing and magnitude of forces produced by the movement, and onset of deltoid muscle activity were analyzed under supported versus unsupported, and near versus far reach conditions. Reach time was proportional to reach distance. For all reach conditions, initial movement of the center of body mass occurred in a direction toward the target, ie, opposite in direction to reactive forces produced by the accelerating arm. Regardless of support, reactive forces were recorded approximately 30 to 50 msec before arm movement, and represented a greater percentage of body weight, for the far reach conditions. Peak acceleration to the right occurred at proportionately the same time into reach regardless of support or reach distance. Peak acceleration occurred earlier in the supported conditions. This paper provides kinetic evidence of postural adjustments before a rapid reaching task performed by seated subjects.
Post-translational processing of the precursor for rat gastrin yields products that include peptides phosphorylated at Ser96, amidated at Phe92, and sulfated at Tyr87 or Tyr103. The phosphorylation site is immediately adjacent to the processing point that gives rise to the biologically active amidated gastrins. We have examined changes in post-translational processing which occur in gastrin cells from rats that are physiologically stimulated (by feeding) or unstimulated (by fasting). Peptides were identified using site-directed radioimmunoassays and chromatographic systems that resolve phosphorylated, amidated, and sulfated progastrin products, including intermediates generated prior to amidation (i.e. C-terminal glycine-extended variants). Assays for Phe92-amidated peptides and for the C-terminal tryptic fragment of progastrin indicated decreases in the total tissue concentrations of immunoreactive peptide with fasting; in contrast, the tissue concentrations of glycine-extended biosynthetic intermediates were similar in fasted and fed rats. Taken together the data suggest a relative failure in amidation mechanisms in unstimulated cells. The endopeptidase cleavage of progastrin was not influenced significantly by fasting. However, the phosphorylation of peptide products containing Ser96 was depressed significantly in fasted rats. The proportions of amidated peptides sulfated at Tyr87 were generally lower than their corresponding glycine-extended biosynthetic precursors, but in both cases the proportion of peptide in the sulfated form was lower than for peptides sulfated at Tyr103. Feeding did not change the sulfation of amidated heptadecapeptide gastrin or its glycine-extended variant. The results suggest that the mechanisms determining phosphorylation and amidation of progastrin-related peptides depend on the patterns of stimulation of gastrin cells. The observation that decreased phosphorylation is associated with a failure to produce active amidated products is consistent with a regulatory function for phosphorylation in gastrin production.
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The management of 10 cases of penile gunshot wounds treated at Henry Ford Hospital from 1982 to 1986 is reviewed. All patients were assaulted by low velocity weapons (handguns). Eight patients had associated injuries, predominantly to the genital region (thigh, pubis, and scrotum). There were 5 urethral injuries; 4 were treated with primary repair, the remaining patient underwent delayed repair, complicated by severe urethral strictures requiring reoperation. Blood at the urethral meatus was suggestive of urethral injury but microscopic hematuria was not. Five penile injuries did not involve the urethra and were treated by debridement and primary wound closure with no immediate or delayed complications. In dealing with these injuries we recommend a high index of suspicion for urethral and regional organ injury and primary urethral closure if at all possible.
Indirect immunofluorescence (IIF) can be a powerful tool for determining the site on spermatozoa to which antibodies bind. Human sera that contain anti-sperm antibodies are often of low titre, and may contain antibodies directed against both intracellular and surface antigens. We have developed an IIF protocol that helps to distinguish intracellular from surface labelling. The two types of labelling were differentiated by exposing the spermatozoa to Hoechst 33258, a nuclear stain of low membrane permeability, to tag the spermatozoa that had disrupted membranes. Surface labelling detected in this fashion was patchy. It was much more uniform if the spermatozoa were fixed in paraformaldehyde, or if a univalent, Fab fragment was used as the second antibody. Thus, it is likely that most of the patchy appearance is due to the bivalent second antibody cross-linking mobile antigen-antibody complexes. For some sera, patching was so pronounced that it appeared to remove the label from portions of the sperm surface, giving a misleading picture of the regions to which the antibodies were directed. Fourteen sera were used in IIF and none of them labelled spermatozoa solely on the head or on the tail.
A discipline is 'characterized by a unique perspective, a distinct way of viewing all phenomena, which ultimately defines the limits and nature of its inquiry' (Donaldson & Crowley 1978). Further, Chinn & Jacobs (1987) define discipline as a 'branch of instruction; a body of knowledge and of systematizing that knowledge within an area of concern or domain of inquiry'. The position taken in this paper is that nursing, as it approaches the year 2000, is an evolving discipline that is 'dedicated to the advancement of knowledge which contributes to the pursuit of excellence of care' (AARN 1985). The writer agrees with Jennings' (1987) position that theory gives definition to nursing's body of knowledge, and direction to research and practice. This paper addresses some of the issues and concerns related to the development of nursing knowledge which serves as a cornerstone for the discipline. It goes on to consider briefly a few tasks that face nursing as it approaches the year 2000.
The authors contend that the methods used to prepare current practitioners for competent and confident participation in the resolution of complex ethical dilemmas are inadequate. They identify some of the forces affecting nursing ethics, and discuss a need for renewed evaluation of how nurses can be helped to fulfill their mandate of ethical practitioner. They also suggest strategies for nurses to contribute effectively to ethical decisions that affect their patients as well as the healthcare system within society.
"This paper describes the publications produced by the Demographic and Health Surveys (DHS) program and discusses the availability of DHS datasets through the DHS Data Archive."
The response to air-dry injury to the carotid artery of the normolipemic rabbit was compared with the response to de-endothelialization with a balloon catheter. Air drying induced an inflammatory response that resembled arteritis rather than atherosclerosis. There was medial damage, neutrophil but not macrophage infiltration, and fibrin formation, limited smooth muscle proliferation, which regressed after 3 months, and no lipid deposition. Within 1 week the smooth muscle cells were mainly of the secretory phenotype, and a neointima had formed. At 4 weeks the neointimal proliferation continued, but most cells showed a contractile phenotype. By 3 months, the lesion consisted of fibromuscular thickening with few small smooth muscle cells. Balloon injury induced minimal medial damage and continuing intimal proliferation with no evidence of regression by 3 months. It is concluded that air drying the carotid artery induces smooth muscle damage as well as endothelial cell loss, and this stimulates a wound-healing mechanism that is different from the response to selective intimal injury.
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