PubMed Health⌕ Search

Biomedical subjects

A G Cole

Publications and source records attributed to A G Cole.

10 recordsLinked to original sources

The central nervous system, its cellular organisation and development, in the tadpole larva of the ascidian Ciona intestinalis.

From its numerical composition, the central nervous system (CNS) of the ascidian larva is one of the simplest known nervous systems having a chordate plan. Fewer than 350 cells together constitute a caudal nerve cord, an interposed visceral ganglion containing motor circuits for swimming and, rostrally, an expanded sensory vesicle containing major sensory and interneuron regions of the CNS. Some cells are ependymal, with ciliated surfaces lining the neural canal, while others are clearly either sensory receptors or motoneurons, but most are distinguishable only on cytological grounds. Although reassignments between categories are still being made, there is evidence for determinancy of total cell number. We have made three-dimensional cell maps either from serial semithin sections, or from confocal image stacks of whole-mounted embryos and larvae stained with nuclear markers. Comparisons between the maps of neural tubes in embryos of successive ages, that is, between cells in one map and their progeny in older maps, enable us to follow the line of mitotic descent through successive maps, at least for the caudal neural tube. Details are clear for the lateral cell rows in the neural tube, at least until the latter contains approximately 320 cells, and somewhat for the dorsal cell row, but the ventral row is more complex. In the hatched larva, serial-EM reconstructions of the visceral ganglion reveal two ventrolateral fibre bundles at the caudalmost end, each of 10-12 axons. These tracts include at least five pairs of presumed motor axons running into the caudal nerve cord. Two pairs of axons decussate. Complementing this vertebrate feature in the CNS of the larval form of Ciona, we confirm that synapses form upon the somata and dendrites of its neurons, and that its motor tracts are ventral.

Animals↗

Group cognitive-behavioral therapy and group interpersonal psychotherapy for the nonpurging bulimic individual: a controlled comparison.

This study evaluated the effectiveness of group cognitive-behavioral treatment (CBT) and group interpersonal psychotherapy (IPT) for binge eating. Fifty-six women with nonpurging bulimia were randomly assigned to 1 of 3 groups: CBT, IPT, or a wait-list control (WL). Treatment was administered in small groups that met for 16 weekly sessions. At posttreatment, both group CBT and group IPT treatment conditions showed significant improvement in reducing binge eating, whereas the WL condition did not. Binge eating remained significantly below baseline levels for both treatment conditions at 6-month and 1-year follow-ups. These data support the central role of both eating behavior and interpersonal factors in the understanding and treatment of bulimia.

Adult↗

Inverse ratio ventilation compared with PEEP in adult respiratory failure.

We have compared the cardiorespiratory effects of an inspiratory: expiratory (I:E) ratio of 4:1 with a ratio of 1:2 in 10 adult patients requiring intermittent positive pressure ventilation (IPPV) for acute respiratory insufficiency. Further comparisons were made with IPPV with positive end-expiratory pressure (PEEP) which was adjusted to achieve an equal external end-expiratory volume (EEEV) to that produced by the 4:1 ratio, as determined by respiratory inductive plethysmography, and with an I:E ratio that only changed the EEEV minimally (IRV-min). Percentage pulmonary shunt (Qs/Qt) was reduced equally with PEEP and with the 4:1 I:E ratio but both patterns reduced cardiac output and oxygen delivery. IRV-min also reduced Qs/Qt significantly but had no effect on cardiac output so that oxygen delivery was increased. The dead space to tidal volume ratio (VD/VT) during IPPV-4:1 and IRV-min was reduced significantly when compared with that during IPPV-1:2. The clinical implications of the findings suggest that for some ITU patients, a modest increase in I:E ratio to between 1.1:1 and 1.7:1 may produce better gas exchange without significantly effecting the cardiac output.

Adult↗

Paratracheal abscess after tracheostomy.

Mediastinal abscess formation in the paratracheal region is a complication of tracheostomy that has previously been only sparsely reported. We present a case which highlights this complication and illustrates some of the diagnostic difficulties with which it may be associated. In this case septicaemia-developed as a secondary complication and diagnosis of the abscess was dangerously delayed because the radiographic appearance masqueraded as a left upper lobe consolidation and because its rarity led to a low index of suspicion.

Abscess↗

Small oxygen analysers.

Analysers using a polarographic electrode had a tendency to react to nitrous oxide, which was considered dangerous with one analyser. However, they had cheaper running costs and a faster response time than the galvanic-cell analysers. These latter analysers were slightly cheaper initially but their sensors were expensive and had a reduced life in the presence of nitrous oxide. Details of accuracy tests have been presented and opinions expressed with regard to the most satisfactory analysers for clinical use.

Costs and Cost Analysis↗

Amiloride in primary hyperaldosteronism.

Amiloride is a potassium-sparing diuretic used in spontaneous and diuretic-induced hypokalemia. The effect of amiloride was studied prospectively in 12 patients with primary hyperaldosteronism. Four patients had unilateral adrenal adenomas and eight had bilateral adrenal hyperplasia. All patients were hypertensive and their mean plasma potassium levels were low. Amiloride, 10 to 40 mg daily, was given for 6 mo. Mean plasma potassium levels rose (0.96 mEq/l, P less than 0.001) and remained normal throughout the study without potassium supplementation. Mean blood pressure was lowered by amiloride (22/10 mm Hg, P less than 0.001) but normotension required concomitant antihypertensive therapy in most patients. No significant adverse clinical or laboratory experiences could be directly attributed to amiloride therapy. There was no correlation between the response to therapy and the plasma aldosterone levels, aldosterone secretion rate, or presence of a unilateral adrenal adenoma. Our study demonstrates the efficacy of amiloride in the correction of hypokalemia and amelioration of hypertension in primary hyperaldosteronism.

Adult↗

Importance of potassium in patients with acute myocardial infarction.

The records of 151 patients entering a coronary care unit and subsequently diagnosed as having an acute myocardial infarction were reviewed. The prevalence of hypokalemia, its relationship to diuretic treatment and the development of either ventricular tachycardia or ventricular fibrillation were studied. At admission, 14% of patients were hypokalemic. The presence of hypokalemia was related to previous diuretic therapy. Twenty-three percent of patients receiving diuretics as compared to 7% of patients not taking diuretics had a serum potassium of 3.5 mEq/L or less. Thirty-seven patients experienced either ventricular tachycardia or ventricular fibrillation. The presence of hypokalemia was associated with an increased frequency of both of these arrhythmias. Sixty-seven percent of patients with a serum potassium of less than 3.1 mEq/L had these serious ventricular arrhythmias compared to 40% of patients with a serum potassium between 3.1 and 3.5 mEq/L and 20% of normokalemic patients. The prevalence of premature ventricular beats was not correlated with the presence of hypokalemia. We conclude that hypokalemia is not only a common problem in patients with acute myocardial infarction but a clinically significant factor in the development of life threatening arrhythmias. Primary prevention of hypokalemia and its prompt treatment are indicated in these patients.

Arrhythmias, Cardiac↗