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Biomedical subjects

T Roberts

Publications and source records attributed to T Roberts.

At least 73 records · Page 4Linked to original sources

Measurement of rigidity in Parkinson's disease.

Clinical assessment of rigidity in parkinsonian patients is largely qualitative. The reliability and validity of the assessments are sometimes in doubt. Several "engineering" methods of quantifying rigidity have been described, but none has been adopted into general clinical practice. A possible reason is that these methods differ in crucial aspects from the clinical exam. We therefore tackled the problem by monitoring the clinical exam itself, using small sensors to measure the forces and displacements applied. Limb impedance (Z) was computed using parameter identification methods and compared to raters' verbalized ratings of rigidity based on a 5-point scale: the Unified Parkinson's Disease Rating System. The qualitative and quantitative estimates of impedance covaried over a fourfold range, depending on the forces imposed and the subject's motor set. Raters differed by up to 1 full point in their mean qualitative ratings and sometimes disagreed on whether levodopa reduced rigidity. This was not due to any significant differences in the overall range of rigidity they evoked, but rather to the way they scored this range [the ratio of mean rating to mean impedance (R/Z) varied between raters and subjects]. On the other hand, the R/Z ratio was reproducible over separate sets of ratings and may therefore serve to convert measured impedance into a standardized rating. Our results indicate that the current clinical exam may be too abbreviated to detect the sometimes quite small reductions in rigidity after levodopa. We conclude that a device that conveniently quantifies the clinical assessment of rigidity is now available and will lead to more standardized protocols for rating rigidity in the near future.

Antiparkinson Agents↗

Diffusion-weighted MRI of myelination in the rat brain following treatment with gonadal hormones.

Previous studies have demonstrated the ability of high-resolution diffusion-weighted MRI to show maturation of white-matter structures in the developing rat brain. The purpose of this study was to investigate the influence of gonadal steroid hormones on the rate of this development. Starting from their second postnatal day, 16 rat-pups of either sex were repeatedly treated with subcutaneous implants containing 17-beta estradiol or delta-androstene 3,17 dione, respectively. Serial T1-, T2- and diffusion-weighted MRI was performed weekly for 8 weeks using a 4.7 T unit. Maturation of anterior optic pathways and hemisphere commissures was assessed. Diffusion-weighted images were processed to produce "anisotropy index maps", previously shown to be sensitive to white-matter maturation. Compared with untreated rat-pups, estrogen-treated animals showed accelerated, and testosterone-treated animals delayed maturation on anisotropy index maps and histological sections. In all animals, maturational changes appeared earlier on anisotropy index maps than on other MRI sequences or on myelin-sensitive stained sections. Diffusion-weighted imaging, and the construction of spatial maps sensitive to diffusion anisotropy, seem to be the most sensitive approach for the detection of maturational white-matter changes, and thus may hold potential for early diagnosis of temporary delay or permanent disturbances of white-matter development.

Androstenediol↗

Fine structure physical mapping of a 1.9 Mb region of chromosome 13q12.

Through linkage analysis and the identification of structural chromosome rearrangements, a number of disease genes have been mapped to the pericentromeric region of the long arm of chromosome 13. Structural rearrangements, or deletions, of the 13q12 region have been implicated in a range of myeloproliferative neoplasms, and other haematopoietic malignancies. In particular, seven cases of a t(8;13)(p11;q12.1) rearrangement have been noted in patients with an atypical myeloproliferative disorder associated with T-cell leukemia and eosinophilia. We have previously identified a CEPH mega YAC, 943E4, which crosses the translocation breakpoint in archival tumour samples from two patients with this t(8;13) translocation. As an initial step in the characterisation of this translocation breakpoint, we have generated a fine structure physical map of this 1.9 Mb YAC. We have used the method of YAC fragmentation to generate a series of deletion constructs of known size, which provide discreet physical landmarks convenient for mapping genetic markers along the 943E4 YAC. Analysis of these deletion constructs defined the order of ESTs and microsatellite markers in 943E4 as: cen-NIB1257-(ATP1AL1/D13S283)-D13S179E-(D13S5 04E/D13S505E)-D13S824E-D13S182E -D13S221-tel. These markers have also been assigned to physically defined regions relative to the fragmented YAC endpoints and a derived NotI restriction map.

Base Sequence↗

[The helium-3 MRT of pulmonary ventilation: the initial clinical applications].

PURPOSE: of the study is the visualisation of normal pulmonary ventilation in healthy volunteers and the evaluation of abnormalities in patients with different lung diseases using 3He magnetic resonance imaging (3He-MRI). MATERIAL AND METHODS: Hyperpolarized 3He gas (V = 300 ml, p = 3 x 10(5) Pa, polarised to 35-45% by optical pumping, provided in special glass cells) was inhaled by eight healthy volunteers and ten patients with different lung diseases. A 3D FLASH sequence (TR = 11.8 ms; TE = 5 ms; matrix 144 x 256, FOV 350 mm, section thickness 7-10 mm, coronal orientation) was performed in a single breath-hold (22-42 s). Clinical and radiological examinations were available for correlation. RESULTS: The studies were successfully carried out in 8/8 volunteers and in 8/10 patients. The central airways were constantly visualised with intermediate to high signal intensity. The lung parenchyma of volunteers with normal ventilatory function showed rather homogeneous intermediate to high signal, whereas patients with chronic obstructive lung disease and/or pneumonia presented severe signal inhomogeneities. Space-occupying lesions and pleural effusion caused large areas with little or no signal. The represented the lesion and adjacent ventilatory disturbances whose extent had not been presumed from chest x-ray or CT. The spatial resolution was higher than in ventilation scintigraphy. CONCLUSION: 3He MRI is a promising new modality for the assessment of pulmonary ventilation and its anomalies.

Administration, Inhalation↗

Epidemiology of tethered cord with meningomyelocele.

This paper describes the epidemiology of tethered cord syndrome and its etiologies and co-morbidities following initial repair of both meningomyeloceles and lipomeningomyelocele. A review of the pertinent literature and data from 654 cases of meningomyelocele and 118 cases of lipomeningomyelocele has been drawn from a computerized database, Patient Data Management System/fx. Only cases born since 1964 were analyzed for the etiologies, co-morbidities, spinal cord abnormalities detected by contrast studies or MRI and for significant symptoms and signs. Tethered cord symptoms were related to an attachment to a rigid tether for all 31 cases following lipomeningomyelocele repair but 62 (75%) of the 83 post meningomyelocele repair patients developed the symptoms of tethered cord. Causes other than, or in addition to, tethering included an obstructed cerebrospinal fluid shunt, syringohydromyelia, benign tumor and spinal cord hypoplasia. Quantitative differentiation between asymptomatic thin spinal cords and symptomatic spinal cord hypoplasia as well as between central canal enlargement and symptomatic syringohydromyelia could not be demonstrated. Collaborative, multi-center studies of larger numbers of patients are recommended.

Comorbidity↗

The economic burden of Campylobacter-associated Guillain-Barré syndrome.

Guillain-Barré syndrome (GBS) is an autoimmune disease characterized by acute neuromuscular paralysis. Of an estimated annual number of 2628-9575 US cases, 526-3830 are triggered by Campylobacter infection. Research objectives were to identify the lifetime consequences of GBS and, when possible, to quantify their economic burden. The cost-of-illness method was used to calculate annual societal resources spent on medical care and lost productivity due to illness or premature death from Campylobacter-associated GBS. Estimated total costs (in US$) of Campylobacter-associated GBS ($0.2-$1.8 billion) were added to previously estimated costs of campylobacteriosis ($1.3-$6.2 billion) for a total annual cost from Campylobacter of $1.5-$8.0 billion (1995 dollars). It is concluded that up to $8.0 billion in US human illness costs are spent annually because of Campylobacter infection. Economic evaluation of the other costs associated with GBS, such as physical and psychological costs, would increase these estimates.

Campylobacter Infections↗

Dedicated extremity MR imaging. An emerging technology.

Dedicated extremity MR imaging represents a radical departure from conventional whole-body scanning. Extremity MR imaging offers such advantages as reduced cost, more convenient and inexpensive setting, greater patient comfort and safety, and high diagnostic power. This article examines some of the features of extremity MR imaging and how this technology is affecting musculoskeletal imaging in today's environment of cost containment and health care reform.

Arm↗

Economic costs and trade impacts of microbial foodborne illness.

This article presents the economic costs of foodborne diseases for selected countries, the approaches used to calculate these costs, and a discussion on the interaction between microbial food safety issues and international trade in food. The human illness costs due to foodborne pathogens are estimated most completely in the United States of America, where, each year, 7 foodborne pathogens (Campylobacter jejuni, Clostridium perfringens, Escherichia coli O157:H7. Listeria monocytogenes, Salmonella, Staphylococcus aureus, and Toxoplasma gondii) cause an estimated 3.3-12.3 million cases of foodborne illness and up to 3900 deaths. These 7 pathogens are found in animal products and cost the United States an estimated $6.5-$34.9 billion (1995 US$) annually. The presence of foodborne pathogens in a country's food supply not only affects the health of the local population, but also represents a potential for spread to pathogens to visitors to the country and to consumers in countries which import food products. With more complete data on foodborne illnesses, deaths, costs and international trade rejections in each country, indicators could be developed by which changes in food safety can be monitored.

Cost of Illness↗

Regional localization of 192 genic markers on human chromosome 1.

A panel of somatic cell hybrids has been used to localize 192 novel eSTS markers to seven individual subregions of human chromosome 1. The positions of the breakpoints in each of these hybrids have been determined relative to the genetic linkage map of chromosome 1, and so the approximate locations of the genes from which the eSTS markers have been derived can be determined. Although the distribution of the eSTS markers is relatively random, 23% were assigned to the 1p34-p36 region. The hybrid mapping panel does not subdivide the 1q24-q44 region, which contains 36% of the eSTS markers. This analysis, therefore, provides a series of genic markers in which to search for candidates for a variety of human genetic disorders and recessive oncogenes mapped to the same relative position on the chromosome.

Chromosome Mapping↗

Incorporation of 35 novel gene transcripts into the physical and genetic map of human chromosome 13.

A panel of somatic cell hybrids carrying a defined set of rearrangements involving chromosome 13 has been used to assign 35 novel gene transcripts regionally. The positions of the chromosome 13 breakpoints in each somatic cell hybrid have previously been defined relative to the Généthon genetic linkage map. As a result, the position of each gene transcript has been determined relative to both the physical and the genetic linkage maps. Analysis of the distribution of these gene transcripts indicates a slight overrepresentation toward locations on the distal long arm of chromosome 13, with no localizations noted in the 13q22-q31 region. Seven of these novel gene transcripts and the gene encoding small ribonucleoprotein U6 have been mapped to YACs known to contain Généthon microsatellite markers, thereby providing further sublocalization relative to the genetic map. The positioning the these gene transcripts within the genetic and physical maps provide candidate genes for disease loci that are being mapped to the same intervals on the chromosome.

Animals↗

Dopamine secretion by PC12 cells microencapsulated in a hydroxyethyl methacrylate--methyl methacrylate copolymer.

A rat pheochromocytoma cell line (PC12) was encapsulated in a water-insoluble hydroxyethyl methacrylate-methyl methacrylate copolymer by interfacial precipitation from a polyethylene glycol 200 solution into phosphate-buffered saline. The resulting capsules (660 +/- 44 microns in diameter; 84 +/- 27 microns wall thickness) contained viable PC12 cells in a spheroidal arrangement, much like tumour spheroids, the latter grown on surfaces unsuitable for cell attachment. In these spheroids, the viable cells formed a band approximately 100 microns thick, surrounding an inner core of necrotic cells. A similar arrangement was seen 14, 28 and 42 days after encapsulation, with capsules maintained in an in vitro tissue culture environment; the annular ring was roughly constant in size, although the packing density appeared to increase over the 6 week observation period. During the first 4 weeks, when measurements were made the encapsulated cells converted a tetrazolium dye (MTT) into an insoluble formazan product, in a time-after-encapsulation-dependent manner. This indicated that PC12 cells retained viability despite encapsulation and an ability to increase (at least in part) their metabolic capacity, presumably by a combination of proliferation and altered cellular activity. The encapsulated PC12 cells also secreted dopamine when incubated in a high potassium release medium but not in a low potassium, conventional tissue culture medium (RPMI 1640). Consistent with the MTT results, the amount of dopamine released was also dependent on the time after encapsulation, as well as the cell density at the time of encapsulation.

Animals↗

Impact of witnessing death on hospice patients.

In the three decades since the concept of "awareness" was introduced to describe the nature of communication between dying people and their carers, there has been a radical change in hospital policies and medical practice. It is now common for the majority of cancer patients to be given full information about their disease and prognosis. Hospices provide a model of care in which death and dying are dealt with in an open manner. While this approach has been welcomed by the majority of people, a minority might still prefer a more limited awareness. An inevitable part of hospice care is the exposure to, and awareness of, people who are dying. There is little empirical data that considers the impact of death on fellow patients. This pilot investigation compared psychological morbidity, perceptions of comfort and/or distress, and descriptions of a "good death" in hospice cancer patients who reported witnessing a fellow patient's death (n = 34) with patients who did not have this experience (n = 33). Patients were assessed using the Hospital Anxiety and Depression scale, an Events Checklist and a semi-structured interview. The results indicate that patients witnessing a death were significantly less depressed than those who did not. Awareness of dying was found to be both comforting and distressing, although overall patients reported more comforting than distressing events. A "good death" was defined by patients in terms of symptom control, including dying in their sleep, being pain free, quietness and dignity. Narratives were used to describe the meaning of a "good death". Quantitative and qualitative analyses have been undertaken to provide a complex interpretation of these issues.

Adaptation, Psychological↗

Dissociating face processing skills: decision about lip-read speech, expression, and identity.

The separability of different subcomponents of face processing has been regularly affirmed, but not always so clearly demonstrated. In particular, the ability to extract speech from faces (lip-reading) has been shown to dissociate doubly from face identification in neurological but not in other populations. In this series of experiments with undergraduates, the classification of speech sound (lip-reading) from personally familiar and unfamiliar face photographs was explored using speeded manual responses. The independence of lip-reading from identity-based processing was confirmed. Furthermore, the established pattern of independence of expression-matching from, and dependence of identity-matching on, face familiarity was extended to personally familiar faces and "difficult"-emotion decisions. The implications of these findings are discussed.

Adolescent↗

Characterisation of a human chromosome 1 somatic cell hybrid mapping panel and regional assignment of 6 novel STS.

A somatic cell hybrid mapping panel has been constructed which allows subdivision of human chromosome 1 into 8 distinct subregions. All of the hybrids carry copies of chromosome 1 with specific deletions and the position of the breakpoints has been determined relative to the location of microsatellite markers in the genetic linkage map produced by Genethon. The majority of the breakpoints can be positioned between adjacent loci on the map. The usefulness of this hybrid panel for physical mapping has been demonstrated by the regional assignment of 6 novel STS markers made from Alu-PCR clones generated from a hybrid which contains the short arm of chromosome 1.

Chromosome Breakage↗

A novel repressor, par-4, modulates transcription and growth suppression functions of the Wilms' tumor suppressor WT1.

The tumor suppressor WT1 represses and activates transcription. The loss and/or imbalance of the dual transcriptional activity of WT1 may contribute to Wilms' tumor. In this study, we identified par-4 (for prostate apoptosis response) as a WT1-interacting protein that itself functions as a transcriptional repressor. par-4 contains a putative leucine zipper domain and is specifically upregulated during apoptosis of prostate cells (S. F. Sells, D. P. Wood, Jr., S. S. Joshi-Barve, S. Muthukkumar, R. J. Jacob, S. A. Crist, S. Humphreys, and V. M. Rangnekar, Cell Growth Differ. 5:457-466, 1994). The leucine repeat domain of par-4 was shown to interact with the zinc finger DNA binding domain of WT1. Immunoprecipitation-Western blot (immunoblot) analyses demonstrated in vivo WT1-par-4 interactions. par-4 was ubiquitously expressed, and the protein was found in both the nucleus and the cytoplasm. Functionally, par-4 inhibited transcription activated by WT1, but not by the related protein EGR1. Inhibition of WT1-mediated transcription was dependent on the domain of par-4 that mediates its physical association with WT1. In addition, par-4 augmented WT1-mediated repression, possibly by contributing an additional repression domain. Consistent with these results, par-4 functioned as a transcriptional repressor when brought to a promoter via a heterologous DNA binding domain. Significantly, par-4, but not a mutant unable to interact with WT1, rescued growth suppression caused by WT1. Thus, we identified a novel repressor that modulates transcription as well as growth suppression functions of WT1.

Amino Acid Sequence↗

False aneurysm--a complication following an inversion ankle sprain: a case report.

Sprains of the lateral ligamentous structures of the ankle joint as a result of inversion are common and frequently result in pain. In most cases, the pain is related to soft-tissue injury and the associated hemorrhage and swelling. This case report describes the complication of posttraumatic false aneurysm of the peroneal artery following an inversion ankle sprain in a 22-year-old athlete, a complication which should be added to the differential diagnosis as a rare, but important possibility. Emphasis of the case report is placed on the rehabilitation of the patient following medical intervention.

Adult↗