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Biomedical subjects

W Taylor

Publications and source records attributed to W Taylor.

At least 109 records · Page 6Linked to original sources
PubMed1991

Hand-arm vibration syndrome: clinical evaluation and prevention.

Increasing recognition by workers that blanching of their fingers may be due to hand-arm vibration exposure from the tools they use at work and their consequent claims for compensation emphasize a need for better clinical evaluation and prevention. We describe the symptoms and signs, and enumerate the diagnostic procedures (both screening and laboratory) necessary to establish the diagnosis and severity grading of subjects with hand-arm vibration syndrome. Although effective treatment of the condition other than avoidance of further vibration exposure is still being researched, prevention is all important. The necessary steps are identified.

Hand↗
PubMed1991

Sleep and nocturnal acid reflux in normal subjects and patients with reflux oesophagitis.

Nocturnal gastro-oesophageal reflux may be important in the pathogenesis of reflux oesophagitis. This study aimed to determine whether: (1) gastro-oesophageal reflux occurs during sleep in patients with reflux oesophagitis and, if so, to explore the mechanism, and (2) the sleep pattern of patients with oesophagitis is different from that of control subjects. After a standard evening meal, simultaneous manometric, oesophageal pH, and polysomnographic recordings were obtained in 11 patients with endoscopic oesophagitis and 11 control subjects. Patients with gastrooesophageal reflux disease had significantly more total reflux episodes throughout the nocturnal monitoring period than control subjects (105 v 6). Ninety two of 105 episodes of gastro-oesophageal reflux in patients occurred during the awake state and 10 during sleep stage II. A number of reflux episodes occurred during brief periods of arousal from the various sleep stages. Of the 105 reflux events recorded in patients, 42 were induced by transient lower oesophageal sphincter relaxation, 20 by stress reflux, 22 by free reflux mechanisms, and in 21 the mechanism was unclear. The sleep pattern and the time spent in each sleep stage was not different between the two groups. It is concluded that the awake state is crucial for the occurrence of nocturnal reflux episodes in normal subjects as well as in patients with reflux oesophagitis and that the difference between the frequency of gastro-oesophageal reflux between normal subjects and patients cannot be explained by different sleep patterns.

Adult↗
PubMed1991

Medullary carcinoma of the thyroid presenting as multifocal bronchial carcinoid tumour.

A 21 year old man presented with diarrhoea and flushing after meals and later developed miliary shadowing on his chest radiograph. Multifocal bronchial carcinoid tumour was diagnosed initially, but at necropsy metastatic medullary carcinoma of the thyroid was found. Multifocal bronchial carcinoid tumour should not be accepted as a primary diagnosis without first excluding medullary carcinoma of the thyroid because of the need to screen relatives of affected patients.

Adult↗
PubMed1991

Pneumothorax and malignant mesothelioma in patients over the age of 40.

Five patients over the age of 40 with malignant mesothelioma of the pleura presented with a spontaneous pneumothorax in the course of five years. The diagnosis of malignant mesothelioma was not suspected at surgery but was made by histological examination of the pleurectomy specimens. During this time 91 pleurectomies for recurrent pneumothorax were performed, 45 in patients over the age of 40; malignant mesothelioma therefore accounted for 11% of spontaneous pneumothorax requiring pleurectomy in this age group. The association of spontaneous pneumothorax and malignant mesothelioma is not emphasised in current publications. These five cases highlight the need for all pleurectomy specimens in cases of spontaneous pneumothorax to be sent for histological examination and for a full occupational history to be taken, especially in older patients.

Adult↗
PubMed1991

Long-term outcome following anterior cerebral artery ligation for ruptured anterior communicating artery aneurysms.

The long-term prognosis (15 years) was determined for 17 patients who had undergone anterior cerebral artery (ACA) ligation as the sole treatment for an anterior communicating artery aneurysm. The number of early and late rebleeds was lower than expected from previously ruptured aneurysms. Late ischemia was not a major complication while late postoperative epilepsy occurred in 19% of survivors. In a review of previously published series, ACA ligation appears to have significantly reduced the rates of both early and late rebleeding. This study helps to define the late results of "conservative" operations for ruptured aneurysms.

Cerebral Angiography↗
PubMed1990

A comparison of a controlled release (CR/ZOK) formulation of metoprolol, once daily, with conventional metoprolol tablets, twice daily, in mild to moderate hypertension.

In a randomized double-blind multicenter study in 100 hypertensive patients, the effect of once daily (od) dosing with a new controlled release (CR/ZOK) formulation of metoprolol was compared with that of twice daily (bid) dosing with metoprolol conventional tablets. Eligible patients had a resting seated diastolic blood pressure (DBP) greater than or equal to 95 mm Hg and less than 110 mm Hg at the end of a 6-week open placebo run-in. The active treatment phase lasted 8 weeks. The starting dose was 100 mg od in the CR/ZOK group (N = 53) and 50 mg bid in the tablet group (N = 47). The dose was increased to 200 mg od and 100 mg bid, respectively, in nonresponders (DBP greater than 95 mm Hg) at the end of the first 4-week period. Approximately 40% of both groups received concomitant diuretic therapy throughout the study. The SBP, DBP and HR were reduced compared to baseline in both treatment groups after 4 and 8 weeks. After 4 weeks, 85% of the CR/ZOK group and 74% of the tablet group had DBP less than 95 mm Hg. After another 4 weeks, the corresponding figures were 93% and 93%. There was no statistically significant difference between the treatment groups in the decrease in either SBP, DBP or HR, nor was there any difference in the percentage of responders. Both treatments were equally well tolerated. In conclusion, the antihypertensive effect of once daily dosing (100-200 mg) with the new CR/ZOK formulation of metoprolol is as effective as that of twice daily dosing (50-100 mg) with conventional metoprolol tablets.

Adult↗
PubMed1990

Sequencing and characterization of the 185 kDa cell surface antigen of Streptococcus mutans.

The gene spa P (formerly designated as spa P1) encoding the Mr 185,000 surface antigen I/II of Streptococcus mutans, serotype c (strain NG5) has been sequenced. The deduced amino acid sequence of antigen I/II (1561 residues) includes a putative signal peptide (residues 1-38), as well as a transmembrane region (residues 1537-1556). The N-terminal part of the protein (residues 39-550) is particularly rich in alanine and includes three tandem repeats of a sequence of 82 residues. This region is predicted to be alpha-helical, adopting a coiled-coil formation, and may account for the cell surface hydrophobicity associated with expression of antigen I/II. In contrast the C-terminal region (residues 800-1549) is proline-rich, favouring an extended conformation. Comparison with the sequence determined from Strep. mutans strain MT8148 showed that antigen I/II is highly conserved with the exception of a short central region (residues 750-805). N-terminal sequencing of purified antigens I and II components indicated that antigen I extends from the amino-terminus of the intact Mr 185,000 surface antigen while antigen II extends from residue 996.

Amino Acid Sequence↗
PubMed1990

Prevalence survey of cytomegalovirus infection in children in Chengdu.

Cytomegalovirus (CMV) is a common worldwide perinatal infection. Although usually asymptomatic, it may cause deafness in up to 15% of these infants. A cross-sectional study was performed to determine the age-specific prevalence of CMV seropositivity in Chinese children and to determine if any risk factors for infection could be identified. In a two-stage sampling procedure, nine districts were randomly selected from 70 citizenship districts in Chengdu, Sichuan Province, People's Republic of China. Then, 1,950 households were randomly selected from 11,886 households and interviewed. Blood was obtained from all children aged less than seven years and assayed using an enzyme-linked immunosorbent assay method. A subgroup of sera was retested at the research laboratory and also sent to the National Reference Laboratory in Beijing. Kappa values for the test agreement with the reference laboratory and retesting within the study laboratory were 0.94 and 0.86, respectively. Seropositivity averaged 52% in those aged less than one year and 60% in those between four and seven years. A higher rate of seropositivity was observed in urban versus rural children (odds ratio (OR) = 2.55), breast feeding in urban areas only (OR = 1.87), and day care versus home care setting (OR = 1.59). High CMV seroprevalence, even in the first year of life, was observed in this population of well children in Chengdu, China. An association was observed between seroprevalence and residence, method of feeding, and day care attendance.

Bottle Feeding↗
PubMed1990

Metastatic cutaneous malignant melanoma of the vitreous and retina.

A case of cutaneous malignant melanoma metastasising to the retina in a 71-year-old patient who presented with vitreous opacities is discussed. In view of the increasing incidence of cutaneous malignant melanoma in our community the possibility of ocular metastases merits consideration.

Aged↗
PubMed1990

Appropriate and inappropriate neuroendocrine products in pulmonary tumourlets.

Pulmonary tumourlets are focal aggregates of neuroendocrine cells that occur in the periphery of the lung and may be associated with chronic inflammation and scarring. Six such lesions were seen in five lungs from a series of 35 pairs of lungs studied at necropsy. All were immunoreactive for neurone-specific enolase, protein gene product 9.5, and a range of neuroendocrine products. Of the peptides found in neuroendocrine cells in normal human lungs, gastrin releasing peptide was present in all tumourlets and calcitonin in all but one; none contained leucineenkephalin. Of a series of peptide and protein hormones not present in the neuroendocrine cells of healthy human lungs, growth hormone was present in all six tumourlets and adrenocorticotrophin in two. Identical patterns of peptide expression were displayed by neuroendocrine cells in the airway associated with the tumourlets in two cases. Such cells were increased in number and abnormally clustered. Aberrant expression of peptides might accompany the morphological changes in the pulmonary neuroendocrine cells seen in diseased lungs, their florid focal proliferation occasionally resulting in the formation of a tumourlet.

Aged↗
PubMed1990

Thecal cell reaction associated with an ovarian leiomyoma and presenting with virilization.

A 56-year-old woman presented with marked hirsutism and virilization of gradual onset. Menstruation had ceased at 43 years. The serum testosterone was grossly elevated (49 nmol/l) with levels of estradiol well above the postmenopausal range (200 pmol/l). Both serum testosterone and estradiol levels showed a marked but transient increase during the administration of the GnRH analog, buserelin. This indicated that the release of these steroids was under gonadotropin control. Bilateral oophorectomy revealed a greatly enlarged left ovary, and histology demonstrated a leiomyoma of the ovary with marked thecal reaction, which was probably responsible for the elevated serum testosterone and virilization. Testosterone levels returned to normal after bilateral oophorectomy. Excessive thecal androgen production associated with non-epithelial ovarian tumors is extremely uncommon and the response to buserelin has not previously been reported.

Buserelin↗
PubMed1990

Anatomy of an instrument tray from central sterile supply to the operating room.

One can understand the importance of quality control measures to ensure that instrument trays meet specific standards on a consistent basis. The essence of the role of the quality control supervisor of CSS is to support the surgical services provided in the OR. Since technology is constantly changing, it is paramount that the quality control supervisor keep abreast of new knowledge and improve services to meet the needs of the OR.

Central Supply, Hospital↗
PubMed1989

Measurement of vibration of hand-held tools: weighted or unweighted?

The standards for hand-arm vibration have evolved from research studies in the late 1960s and were based on discomfort and tolerance levels. The lower frequencies were more intolerant and were weighted accordingly. The vascular and neurologic components of the hand-arm vibration syndrome may develop independently, and recent epidemiologic studies have shown both underestimation and overestimation in the incidence of Raynaud's phenomenon from the International Standard Organization dose-response criteria with respect to different tools. The validity of the current International Standard Organization, British Standards Institute, American National Standards Institute, and The American Conference of Governmental Industrial Hygienists Threshold Limit Values is therefore questionable. The weighted and unweighted frequency spectra of various hand-held tools are presented in this paper. It is concluded that, until such time as more dose-effect data become available, unweighted measurements should be determined. Furthermore, the frequencies measured should be extended to 5 kHz.

Arm↗