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Biomedical subjects

W Taylor

Publications and source records attributed to W Taylor.

At least 127 records · Page 7Linked to original sources
PubMed1988

Biological effects of the hand-arm vibration syndrome: historical perspective and current research.

The objective of this paper is to highlight gaps of information regarding mechanisms of vascular, neurological, and musculo-skeletal damage caused by vibration. Also addressed is evidence that high noise level may act synergistically to the development of vibration syndrome of the hand and arm. Areas of research currently active in psychophysical and neurophysiological investigations to increase our understanding of tactile and spatial discrimination are discussed. Although the importance of sensory loss or "fine touch" is understood, there is neither a proven objective scientific test with which the syndrome can be diagnosed nor is there a scale of damage assessment. Determining the exact role of the central nervous system in assessing damage from vibration is difficult in view of nonspecific symptoms reported from eastern Europe and from Japan. To complicate matters still further, there is the possibility that repeated, rapid mechanical movements of the hand and arm associated with handling heavy tools produce carpal tunnel syndrome but that the injury is not directly attributed to vibration. Therefore, it follows that there could exist an element of carpal tunnel syndrome in many vibration syndrome cases.

Arm Injuries↗
PubMed1988

Reduction of incorrect antibiotic dosing through a structured educational order form.

Antibiotics are often used inappropriately in hospitals. We created a structured antibiotic order form designed to guide physicians toward correct therapeutic decisions without restricting their clinical options. Educational messages and graphic reminders were incorporated into a new form required to order parenteral antibiotics at a teaching hospital. Pharmacokinetic considerations were emphasized. The forms were supplemented with brief literature reviews and appropriate references. Before introduction of the form, pharmacokinetically incorrect orders for clindamycin, cefazolin sodium, and metronidazole hydrochloride accounted for 90%, 60%, and 75% of patient-days of therapy for these drugs, respectively. Immediately after implementation of the form, nonrecommended dosing schedules dropped to under 6% of patient-days for all three antibiotics. Savings from these drugs alone accounted for over $76,000 annually. We conclude that in a period of increasing constraints on hospital budgets and proliferating restrictions on physicians' clinical choices, educational intervention at the time orders are written can provide a cost-effective and noncoercive means of improving some forms of acute-care clinical decision making.

Anti-Bacterial Agents↗
PubMed1987

Fructosamine in a diabetic clinic.

Serum fructosamine concentrations were measured in 660 adults attending the diabetic clinic at Auckland Hospital over a 12 month period. Only 44 (6.6%) patients had results within the physiological range whereas 237 (35.9%) patients had values greater than 3.7 mmol/l consistent with poor blood glucose control. Moreover, patients with elevated frustosamine values had a much higher frequency of retinopathy than the normal fructosamine group. When frustosamine values were compared with physician's assessment of control and with random glucose results, we found weak correlations suggesting that poor control in many patients was not previously recognised. We conclude that fructosamine measurement in a diabetic clinic provides important clinical information complementing traditional assessments of metabolic control.

Adolescent↗
PubMed1987

Calcium binding domains and calcium-induced conformational transition of SPARC/BM-40/osteonectin, an extracellular glycoprotein expressed in mineralized and nonmineralized tissues.

SPARC, BM-40, and osteonectin are identical or very closely related extracellular proteins of apparent Mr 43,000 (Mr 33,000 predicted from sequence). They were originally isolated from parietal endoderm cells, basement membrane producing tumors, and bone, respectively, but are rather widely distributed in various tissues. In view of the calcium binding activity reported for osteonectin, we analyzed the SPARC sequence and found two putative calcium binding domains. One is an N-terminal acidic region with clusters of glutamic acid residues. This region, although neither gamma-carboxylated nor homologous, resembles the gamma-carboxyglutamic acid (Gla) domain of vitamin K dependent proteins of the blood clotting system in charge density, size of negatively charged clusters, and linkage to the rest of the molecule by a cysteine-rich domain. The other region is an EF-hand calcium binding domain located near the C-terminus. A disulfide bond between the E and F helix is predicted from modeling the EF-hand structure with the known coordinates of intestinal calcium binding protein. The disulfide bridge apparently serves to stabilize the isolated calcium loop in the extracellular protein. As observed for cytoplasmic EF-hand-containing proteins and for Gla domain containing proteins, a major conformational transition is induced in BM-40 upon binding of several Ca2+ ions. This is accompanied by a 35% increase in alpha-helicity. A pronounced sigmoidicity of the dependence of the circular dichroism signal at 220 nm on calcium concentration indicates that the process is cooperative. In view of its properties, abundance, and wide distribution, it is proposed that SPARC/BM-40/osteonectin has a rather general regulatory function in calcium-dependent processes of the extracellular matrix.

Amino Acid Sequence↗
PubMed1987

Are chronic digestive complaints the result of abnormal dietary patterns? Diet and digestive complaints in children at 22 and 40 months of age.

We studied 149 healthy children at 22 months of age and 74 at 40 months of age, employing a 24-hour dietary record based on premailed food measurement guide and telephone questionnaire. Parents cooperated in 94% of contacts. Chronic digestive complaints decreased from 27% to 5% of the sample over the study period: constipation from 16% to 3%, chronic diarrhea from 8% to 1%, and abdominal pain from 5% to 1%. Excessive fluid intake (1470 +/- 600 vs 840 +/- 300 mL/d) correlated most strongly for seven children at 22 months experiencing alternating symptoms of chronic diarrhea and constipation or abdominal pain. Many other children tolerated dietary extremes without complaint. All macronutrient categories except dietary fiber intake increased over the study period. Thus, excessive fluid intake may provoke symptoms suggesting the irritable bowel syndrome in a susceptible group of younger children. Failure to increase fiber intake from 22 to 40 months of age leaves children on an immature diet whose effects require further study.

Child, Preschool↗
PubMed1987

Annexins--new family of Ca2+-regulated-phospholipid binding protein.

Calcium and phospholipid binding proteins have been identified and localized by immunocytochemistry in a wide range of cells and tissues. Two of these proteins (calpactins) also bind F-actin and are substrates for tyrosine kinases. The similar membrane-binding properties of these molecules arise from conserved amino acid sequences and a model is proposed for the tertiary structure of a common calcium and phospholipid binding domain.

Animals↗
PubMed1987

Pulmonary vascular structural and functional changes in papain-induced emphysema in dogs.

We evaluated the pulmonary circulatory effects of emphysema produced by papain in 6 dogs that received 4 weekly treatments of papain administered by aerosolization. A control group of 6 dogs received saline treatments. Hemodynamic measurements were performed during normoxic and hypoxic (10% oxygen) ventilation approximately 3 and 6 months after treatment. Baseline hemodynamic parameters were comparable in both groups and were unchanged at 6 months in the control group. In the papain-treated group at 6 months, there were significant reductions in PaO2 (95 +/- 4 to 79 +/- 3 mm Hg, p less than 0.005) and increases in mean pulmonary artery pressure (12 +/- 1 to 18 +/- 3 mm Hg, p less than 0.05) and pulmonary vascular resistance (2.0 +/- 0.3 to 6.2 +/- 2.1 units, p less than 0.01). Morphometric evaluation demonstrated increased medial thickness in muscular pulmonary arteries less than 50 mu in size. Morphologic evaluation confirmed the presence of panlobular emphysema with papain administration. We conclude that chronic emphysema produced in dogs by aerosol administration of papain results in elevated pulmonary artery pressure, which is characterized pathologically by medial hypertrophy of small pulmonary arteries. This model appears suitable for further study of the pathogenesis of pulmonary vascular disease associated with chronic lung disease.

Animals↗
PubMed1987

The Stockholm Workshop scale for the classification of cold-induced Raynaud's phenomenon in the hand-arm vibration syndrome (revision of the Taylor-Pelmear scale).

On the basis of experience accumulated over the past few years, a revision has been made in the currently used Taylor-Pelmear scale for the staging of Raynaud's phenomenon in persons exposed to vibration from hand-held tools, while retaining as much as possible of the well-established advantages of the scale for research and its proved usefulness for clinical and medicolegal purposes. The 0T and 0N stages of symptoms have been omitted, together with the parallel disability scale. A separate staging for neurological disorders connected with the syndrome was proposed and accepted at the workshop "Symptomatology and Diagnostic Methods in the Hand-Arm Vibration Syndrome," held in Stockholm in 1986. The criteria descriptions have been changed so as to minimize their reliance on seasonal factors. The new staging system--a stage 0 and four stages (1-4) with attacks of cold-induced Raynaud's phenomenon--clearly defines the differences in the descriptions of the stage criteria in order to improve their clinical usefulness. A numerical scoring based on the extent and distribution of finger blanching was not, however, introduced, whereas a score based on the number of affected fingers on each hand was proposed, considered, and accepted.

Arm↗
PubMed1987

Sensorineural stages of the hand-arm vibration syndrome.

Recent work has shown that the vascular signs and neurological symptoms commonly associated with exposure of the hand to vibration may develop independently. A classification for the neurological component of the hand-arm vibration syndrome has been developed for those symptoms dominated by sensory afferent involvement, based on the results of objective tests on 634 hands. The first symptomatic stage (1SN) consists essentially of episodic finger numbness with or without tingling, the second involves, in addition, reduced sensory perception (2SN), while the most severe stage (3SN) focuses on reduced tactile discrimination and/or manipulative dexterity. Consistent implementation of this classification by means of objective tests requires one, or more, precise, quantitative measure of peripheral somatosensory dysfunction, in addition to the traditional neurological tests (fine touch, pain, and temperature). Measurements of tactile function by means of esthesiometry or vibrotactile perception appear suited to this purpose. A procedure for staging individual hands may then be based on combining numerical scores assigned to the results of the traditional neurological tests and, additionally, esthesiometer and/or vibrotactile perception thresholds.

Hand↗
PubMed1987

Multiple enteroliths in a chronically obstructed duodenal loop after Roux-en-Y biliary diversion.

A case of chronic mechanical obstruction of the duodenal loop due to stricturing of the enteroenterostomy after diversion following a Polya gastrectomy for bile reflux gastritis is reported. The dilated loop contained several hundred enteroliths. The clinical and chemical evidence strongly supports the view that the enteroliths were formed in the intestinal loop. This complication of Roux-en-Y reconstruction has not previously been recognized.

Anastomosis, Roux-en-Y↗
PubMed1986

The developmental expression of the gene for TFIIIA in Xenopus laevis.

The sequence of the trans-acting positive transcription factor TFIIIA has been deduced by sequencing cDNA and genomic DNA clones. Using DNA from a homozygous diploid animal we show that there is one gene for TFIIIA per haploid genome of X. laevis. Protein sequencing of proteolytic fragments of TFIIIA orients the protein in its interaction with the internal control region (ICR) of the 5S RNA gene. The protein lies along the DNA with its carboxyl terminus at the 5' end of the ICR and its amino terminus at the 3' end. The developmental pattern of TFIIIA and its mRNA during oogenesis and embryogenesis are consistent with the idea that the abundance of TFIIIA plays an essential role in the developmental change in 5S RNA gene expression. The change to almost exclusive somatic 5S RNA gene expression by gastrulation occurs using either the TFIIIA that was synthesized by oocyte and/or TFIIIA synthesized from maternal mRNA.

Amino Acid Sequence↗
PubMed1986

Liver lesions in BALB/C mice induced by an anabolic androgen (Decadurabolin), with and without pretreatment with diethylnitrosamine.

Male BALB/C mice were treated with the anabolic androgen Decadurabolin (17 beta-hydroxy-19-nor-androst-4-ene-17 beta-n-decanoate) (DecaD) with and without pretreatment with diethylnitrosamine (DEN). Treatment with DEN alone caused development of severe hepatocytic dysplasia in all animals; 11/11 had cystadenomas and 3/11 haemangiomas, both of which were benign. Mice treated with DecaD alone developed only moderate to severe hepatocytic dysplasia. Treatment with DecaD after DEN induced neoplasms in the livers; 15/15 had severe dysplasia; 14/15 had cystadenomas, 2/15 had haemangiomas, and 4/15 developed nodular proliferation. Single hepatomas were seen in 4/15 livers, two of which also had multiple hepatomas. Control animals had normal liver histology. We conclude that DecaD enhances the hepatocarcinogenicity of DEN, especially with respect to neoplastic lesions in hepatocytes.

Anabolic Agents↗
PubMed1986

The effect of a progestin-only oral contraceptive on biliary lipid composition in the cat.

Following a control period of 5 weeks, 3 female cats with chronic gastric and duodenal fistulae were given 37.5 micrograms of the progestin D-norgestrel for 15 weeks. The study was continued for 8 weeks after withdrawal of treatment. Bile was collected via the duodenal fistula at 7-10 day intervals. During treatment the combined molar percentage of biliary cholesterol of all cats (4.2 +/- 0.4, n = 34) was significantly lower than during the control period (8.2 +/- 1.3, n = 11) [P = 0.001], and remained depressed after treatment withdrawal (5.5 +/- 1.0, n = 11) [P = 0.02]. The molar percentage of phospholipids remained unchanged in all animals, and that of total bile acids increased during treatment in one animal. As assessed by triangular coordinate plotting, the bile of each animal became less saturated with cholesterol during norgestrel administration. These results support the concept that the oestrogen component may be a major factor in the development of increased biliary cholesterol saturation in users of mixed-type oral contraceptives.

Animals↗