PubMed Health⌕ Search

Biomedical subjects

A J Parker

Publications and source records attributed to A J Parker.

At least 19 recordsLinked to original sources
PubMed2006

Radiological review of specimen radiographs after breast localisation biopsy is not always necessary.

INTRODUCTION: The use of specimen radiographs to confirm the presence of the radiological abnormality in a breast specimen after localisation biopsy is standard practice. This study aims to show that a trained surgeon may assess breast specimen radiographs with similar efficacy as a radiologist. METHODS: This retrospective study assessed all patients who had localisation breast surgery using wire or ultrasound (US) techniques between January 2002 and March 2003. Histopathological records and mammographic details were recorded from the hospital notes. A consultant radiologist and surgeon reviewed the specimen radiographs, identifying mammographic abnormalities and assessing margins. RESULTS: Localisation surgery was performed on 101 patients with US used to localize 68. The median specimen weight was 64g. A malignant diagnosis was made in 86 patients. In 23, the histological resection margins were considered to be close or involved by tumour and re-excision was performed in eight patients. Sixty-one specimen radiographs were reviewed. The radiologist identified every mammographic abnormality, and the surgeon identified the lesion in 58. The positive predictive value of specimen radiographs to identify histologically involved margins was 75 and 74% by the radiologist and the surgeon, respectively. Where good radiograph margins were reported in 40 and 35 patients by the radiologist and surgeon, respectively, 11 and 7 had histologically involved margins. CONCLUSIONS: This study shows that a suitably trained or experienced surgeon can assess specimen radiographs effectively without the need for intraoperative radiological input although complete histological resection is not guaranteed despite specimen radiographs demonstrating clear margins.

Adult↗
PubMed2006

Postthyroplasty implant extrusion.

The case of a 57-year-old gentleman with a left-sided vocal cord palsy following a surgical procedure done elsewhere is being reported. His main problem was dysphonia, and speech therapy did not improve his voice much. A thyroplasty type 1 was done to improve his voice. A Silastic implant was inserted for medialization of vocal cords with a good postoperative result. The patient was followed up in the clinic and presented again 7 months after surgery with extrusion of the Silastic implant. Quite remarkably, his voice did not deteriorate even after the extrusion of the Silastic implant. This could be due to formation of fibrous tissue holding the cords in the medial position. The patient retained an excellent voice, and no further procedure was necessary.

Biocompatible Materials↗
PubMed2005

Fine needle aspiration cytology in the management of a parotid mass: a two centre retrospective study.

OBJECTIVES: There is a diversity of opinion regarding the role of fine needle aspiration cytology (FNAC) in the pre-operative evaluation of the parotid mass. This study further investigates the role of FNAC from the standpoint of the clinician attempting to resolve one or more clinical issues. METHODS: A retrospective study conducted at two UK Hospitals with no overlap of cytopathologists or surgeons. Patients undergoing parotidectomy at each institution were identified from Pathology department databases. The definitive histopathological diagnosis was compared with any pre-operative FNAC diagnosis. Cytology results were classified as suggestive, non-diagnostic, sampling error, or misleading. SETTING: The study was conducted in a District General Hospital and a University Teaching Hospital providing secondary care for each community. RESULTS: For the University Teaching Hospital the sensitivity in distinguishing malignant from benign disease was 79% (95% CI 61-97%) with a specificity 84% (95% CI 73-95%). However, three of eight patients with a primary parotid salivary gland malignancy were reported as having benign disease on FNAC. For the participating District General Hospital the sensitivity in distinguishing malignant from benign disease was 38% (95% CI 13-63%) and specificity 95% (95% CI 73-95%). CONCLUSIONS: Fine needle aspiration cytology does not reliably distinguish a benign from a malignant primary salivary gland neoplasm in the participating institutions. Where clinical teams use FNAC in an attempt to resolve this clinical problem, the results should be interpreted with caution and an ongoing audit of performance is required.

Biopsy, Fine-Needle↗
PubMed2005

Groningen valve change in difficult cases.

A difficult Groningen valve change is one of the problems frequently encountered in the post-laryngectomy patient. A safe and simple technique for this procedure is described.

Device Removal↗
PubMed2005

The effect of transportation on the immune status of Bos indicus steers.

This study investigated the effect of 72 h of road transport on the immune status of Bos indicus steers (n = 10; age = 15 to 18 mo). Total and differential leukocyte numbers and lymphocyte function were determined at 2 d before transport (-48 h), immediately after 72 h of transport (72 h), and 6 d after transport (216 h). Phytohemagglutinin (PHA)-stimulated lymphocyte proliferation, interferon-gamma production, and tetanus-toxoid specific antibody levels were determined. Total leukocyte and eosinophil numbers showed a transient decrease at 72 h (immediately after transport; P < 0.05) and returned to baseline values by 6 d after transport. Lymphocyte numbers and antibody titers were unaffected by transportation. The PHA-stimulated lymphocyte proliferation decreased (P < 0.05) at 72 h and returned to baseline levels 6 d after transport. This study demonstrated that transportation of mature Bos indicus steers caused transient decreases in leukocyte numbers and lymphocyte function, although all measures recovered by 6 d after transport. Therefore, Bos indicus cattle may be vulnerable to infection during this period.

Animals↗
PubMed2004

Comparing perceptual signals of single V5/MT neurons in two binocular depth tasks.

Neurons in the extrastriate visual area V5/MT show perceptually relevant signals in binocular depth tasks, which can be measured as a choice probability (CP) for the neuron. The presence of a CP in a particular paradigm may be an indicator that the neuron is generally part of the substrate for the perception of binocular depth. We compared the responses of those single neurons that show CPs in one stereoscopic depth task with their responses in another stereo task. Each neuron was tested for the presence of 1) CPs during a task in which macaques responded to the sign of binocular depth in a structure-from-motion stimulus, to judge its direction of three-dimensional rotation and 2) a consistent response to the stereo disparity of binocularly anti-correlated stimuli. Previous work, confirmed here, shows that changing the disparity of these binocularly anti-correlated stimuli often fails to yield a coherent change in the depth percept. For each test alone, there are V5/MT neurons that carry signals that are congruent with the perceptual effects. However, on comparing tests, there is no fixed pool of neurons that can account for the binocular depth percept. Excitation of neurons with a measurable CP does not necessarily lead to a change in perception. The cortical circuitry must be able to make dynamic changes in the pools of neurons that underlie perceptual judgments according to the demands of the task.

Action Potentials↗
PubMed2004

Excess cortisol interferes with a principal mechanism of resistance to dehydration in Bos indicus steers.

This study investigated the effects of excess cortisol on physiological mechanisms that resist dehydration in Bos indicus steers (n = 31, 2 yr of age, 193 +/- 21.47 kg mean BW) during a 90-h period. Steers were assigned randomly to one of four groups: 1) no water/no cortisol (n = 8), 2) water/no cortisol (n = 8), 3) no water/cortisol (n = 8), and 4) water/cortisol (n = 7). Animals allocated to cortisol treatment groups were given 0.1 mg x kg BW(-1) x h(-1) of hydrocortisone suspended in isotonic saline for the duration of the study. Total body water, osmolality, hematocrit, urine output, feed and water intake, and plasma concentrations of arginine vasopressin (AVP), angiotensin II (AII), electrolytes, total protein, and albumin were determined at 24-h intervals for 90 h. In the presence of excess plasma cortisol, total body water was maintained in the presence of a water deprivation insult for 90 h, whereas hydration indices, such as total plasma protein and albumin, did not change, supporting the body water data. However, plasma osmolality increased for the water-deprived groups from 24 h (P = 0.008). Hematocrit did not reflect dehydration in any group. Water deprivation induced an increase in endogenous plasma cortisol concentrations after 60 h of the study (P = 0.028). Plasma concentrations of AVP increased with water deprivation (P = 0.006). Excess cortisol decreased the plasma concentration of AVP at 72 h only (P = 0.027) and suppressed plasma concentrations of AII at 24 and 72 h (P < 0.001 and P = 0.036, respectively). Animals treated with excess cortisol maintained urinary output for 48 h before decreasing at 72 h (P = 0.057), although there was no effect on water or feed intake. Water deprivation increased plasma sodium concentrations (P < 0.05) until 72 h, whereas potassium decreased under the influence of excess plasma cortisol (P = 0.001) at 24 h. Water deprivation increased plasma chloride concentration at 72 and 90 h (P = 0.051 and P = 0.026, respectively). Plasma phosphorus decreased at 24 h (P = 0.001) and remained at lesser concentrations for the duration of the study (P = 0.05). These results highlight the complexity of endocrine interactions associated with water balance in Bos indicus steers. We accept our hypothesis that, in the presence of excess cortisol, the renin-angiotensin-aldosterone axis is suppressed; however, homeostasis is achieved through other physiological systems.

Angiotensin II↗
PubMed2003

Dehydration in stressed ruminants may be the result of a cortisol-induced diuresis.

The effect on water and electrolyte balance of stress, simulated by intravenous infusion of cortisol, was studied using 24 18-mo-old Merino wethers (37.0 +/- 0.94 kg mean body weight [BW]) over 72 h. The sheep were allocated to one of four groups: 1) no water/no cortisol (n = 6); 2) water/no cortisol (n = 4); 3) no water/cortisol (n = 6); and 4) water/cortisol (n = 4). Animals allocated to the two cortisol groups were given 0.1 mg x kg BW(-1) x h(-1) of hydrocortisone suspended in isotonic saline to simulate stress for the duration of the experiment. Total body water, plasma cortisol, osmolality and electrolytes, and urine electrolytes were determined at 24-h intervals for 72 h. In the presence of cortisol, total body water was maintained in the face of a water deprivation insult for 72 h. Water deprivation alone did not induce elevated plasma concentrations of cortisol, in spite of a 13% loss of total body water between 48 and 72 h. Infusion of cortisol was found to increase urine output (P = 0.003) and decrease total urinary sodium output (P = 0.032), but had no effect on plasma electrolyte levels or water intake. Water deprivation was found to increase plasma sodium concentrations (P = 0.037). These results indicate that sheep given cortisol to simulate stress suffer from a loss of body water in excess of that associated with a loss of electrolytes, and support the hypothesis that elevated physiological concentrations of cortisol induce a diuresis in ruminants that contributes to dehydration.

Animals↗
PubMed2003

Quantitative analysis of acid-base balance in Bos indicus steers subjected to transportation of long duration.

There is a lack of information pertaining to the effects of transport stress on the acid-base physiology of ruminants. The effect of transportation and/or feed and water deprivation on acid-base balance was studied using 19 2-yr-old Bos indicus steers. The steers were allocated to one of three groups: 1) control, offered ad libitum access to feed and water (n = 8); 2) water and feed deprived, offered no feed or water for 60 h (n = 6); and 3) transported, offered no feed or water for 12 h, and then transported for 48 h (n = 5). Blood gases, electrolytes, lactate, total protein, albumin, anion gap, strong ion difference, and total weak acids were determined at the conclusion of transportation. Arterial blood pH did not differ among the experimental groups. Partial pressure of carbon dioxide (pCO2) was lower for the water and feed deprived (P = 0.023) group than for the control group. Plasma total protein, albumin and total weak acid concentrations were higher for the transported (P = 0.001, P = 0.03, P = 0.01) and water- and feed-deprived (P = 0.000, P = 0.003, P = 0.001) groups, respectively, compared with the control group. Transported animals had a lower plasma concentration of potassium (P = 0.026) compared with the control animals. This study demonstrates that although blood pH remains within normal values in transported and fasted steers, the primary challenge to a transported or feed- and water-deprived animal is a mild metabolic acidosis induced by elevated plasma proteins, which may be the result of a loss of body water. The loss of electrolytes had little effect on the acid-base balance of the animals.

Acid-Base Equilibrium↗
PubMed2003

The Sheffield nose--an occupational disease?

We report a case of silver tattooing of the nasal mucosa in a silver polisher. The concern in such cases is mainly due to the suspicion of melanoma. The diagnosis was confirmed by using the Laser Ablation Inductively Coupled Plasma Mass Spectrometry (LA-ICP-MS) method, which revealed the presence of two types of silver isotopes, at 107 and 109 m/z.

Diagnosis, Differential↗
PubMed2002

A specialization for relative disparity in V2.

Stereoscopic depth perception relies on binocular disparities, or small geometric differences between the retinal images of each eye. The most reliable binocular depth judgments are those that are based on relative disparities between two simultaneously visible features in a scene. Many cortical areas contain neurons that are sensitive to disparity, but it is unclear whether any areas show a specific sensitivity to relative disparity. We recorded from neurons in the early cortical visual area V2 of the awake macaque during presentation of random-dot patterns. The depth of a central region ('center'), and that of an annular surrounding region ('surround'), were manipulated independently in these stimuli. Some cells were fully selective for the resulting relative disparities. Most showed partial selectivity, which nonetheless indicated a sensitivity for the depth relationship between center and surround. Both types of neural response could support psychophysical judgments of relative depth.

Animals↗
PubMed2002

Quantitative analysis of the responses of V1 neurons to horizontal disparity in dynamic random-dot stereograms.

Horizontal disparity tuning for dynamic random-dot stereograms was investigated for a large population of neurons (n = 787) in V1 of the awake macaque. Disparity sensitivity was quantified using a measure of the discriminability of the maximum and minimum points on the disparity tuning curve. This measure and others revealed a continuum of selectivity rather than separate populations of disparity- and nondisparity-sensitive neurons. Although disparity sensitivity was correlated with the degree of direction tuning, it was not correlated with other significant neuronal properties, including preferred orientation and ocular dominance. In accordance with the Gabor energy model, tuning curves for horizontal disparity were adequately described by Gabor functions when the neuron's orientation preference was near vertical. For neurons with orientation preferences near to horizontal, a Gaussian function was more frequently sufficient. The spatial frequency of the Gabor function that described the disparity tuning was weakly correlated with measurements of the spatial frequency and orientation preference of the neuron for drifting sinusoidal gratings. Energy models make several predictions about the relationship between the response rates to monocular and binocular dot patterns. Few of the predictions were fulfilled exactly, although the observations can be reconciled with the energy model by simple modifications. These same modifications also provide an account of the observed continuum in strength of disparity selectivity. A weak correlation between the disparity sensitivity of simultaneously recorded single- and multiunit data were revealed as well as a weak tendency to show similar disparity preferences. This is compatible with a degree of local clustering for disparity sensitivity in V1, although this is much weaker than that reported in area MT.

Animals↗
PubMed2002

Range and mechanism of encoding of horizontal disparity in macaque V1.

The responses of single cortical neurons were measured as a function of the binocular disparity of dynamic random dot stereograms for a large sample of neurons (n = 787) from V1 of the awake macaque. From this sample, we selected 180 neurons whose tuning curves were strongly tuned for disparity, well sampled and well described by one-dimensional Gabor functions. The fitted parameters of the Gabor functions were used to resolve three outstanding issues in binocular stereopsis. First, we considered whether tuning curves can be meaningfully divided into discrete tuning types. Careful examination of the distributions of the Gabor parameters that determine tuning shape revealed no evidence for clustering. We conclude that a continuum of tuning types is present. Second, we investigated the mechanism of disparity encoding for V1 neurons. The shape of the disparity tuning function can be used to distinguish between position-encoding (in which disparity is encoded by an interocular shift in receptive field position) and phase-encoding (in which disparity is encoded by a difference in the receptive field profile in the 2 eyes). Both position and phase encoding were found to be common. This was confirmed by an independent assessment of disparity encoding based on the measurement of disparity sensitivity for sinusoidal luminance gratings of different spatial frequencies. The contributions of phase and position to disparity encoding were compared by estimating a population average of the rate of change in firing rate per degree of disparity. When this was calculated separately for the phase and position contributions, they were found to be closely similar. Third, we investigated the range of disparity tuning in V1 as a function of eccentricity in the parafoveal range. We find few cells which are selective for disparities greater than +/-1 degrees even at the largest eccentricity of approximately 5 degrees. The preferred disparity was correlated with the spatial scale of the tuning curve, and for most units lay within a +/-pi radians phase limit. Such a size-disparity correlation is potentially useful for the solution of the correspondence problem.

Animals↗
PubMed2001

Perceptually bistable three-dimensional figures evoke high choice probabilities in cortical area MT.

The role of the primate middle temporal area (MT) in depth perception was examined by considering the trial-to-trial correlations between neuronal activity and reported depth sensations. A set of moving random dots portrayed a cylinder rotating about its principal axis. In this structure-from-motion stimulus, the direction of rotation is ambiguous and the resulting percept undergoes spontaneous fluctuations. The stimulus can be rendered unambiguous by the addition of binocular disparities. We trained monkeys to report the direction of rotation in a set of these stimuli, one of which had zero disparity. Many disparity-selective neurons in area MT are selective for the direction of rotation defined by disparity. Across repeated presentations of the ambiguous (zero-disparity) stimulus, there was a correlation between neuronal firing and the reported direction of rotation, as found by Bradley et al. (1998). Quantification of this effect using choice probabilities (Britten et al., 1996) allowed us to demonstrate that the correlation cannot be explained by eye movements, behavioral biases, or attention to spatial location. MT neurons therefore appear to be involved in the perceptual decision process. The mean choice probability (0.67) was substantially larger than that reported for MT neurons in a direction discrimination task (Britten et al., 1996). This implies that MT neurons make a different contribution to the two tasks. For the depth task, either the pool of neurons used is smaller or the correlation between neurons in the pool is larger.

Action Potentials↗
PubMed2001

Stereoacuity thresholds in the presence of a reference surface.

With isolated binocular targets, the best depth discrimination is found in the fixation plane (Blakemore, C., Journal of Physiology 211 (1970) 599). More recent studies have suggested that stereoscopic thresholds are not always a simple function of absolute disparity, but depend on the relative disparities in the stimulus. Here, we explored the effects of relative disparity in more detail, taking particular care to control for the possibility that subjects might change their binocular eye position or exploit monocular information provided by additional reference cues. Subjects judged the depth of a vertical target line presented above a comparison line in a blank window within a fronto-parallel reference surface composed of randomly positioned dots. On individual trials, the reference surface was presented at one of three disparities (-10, 0 and +10 arc min). To control for changes in binocular eye position, exposure duration was 150 ms, and experimental conditions with different disparities of the reference surface and comparison line were randomly interleaved. To control for monocular cues, changes in threshold were determined with respect to a disparity noise condition that was in all ways identical to the reference plane condition, except that the disparities of the dots were randomly assigned between 10 and +10 arc min. Stereo-thresholds were lowered by a factor of about 2 when the surface was at the same depth as the comparison line. Thresholds were also lowered when the comparison disparity was close to the same depth as the reference surface, but were often raised when the comparison disparity had the opposite disparity sign. These results provide unequivocal evidence that the fundamental sensitivity of the disparity detecting system can be influenced by relative disparity cues that are not related to the task.

Confidence Intervals↗
PubMed2001

Cortical mechanisms of binocular stereoscopic vision.

The early neurophysiology of binocular vision is largely dominated by measurements of disparity selectivity in cortical neurons in various visual areas. Incisive progress has been made by the intensive study of the mechanism of disparity selectivity of V1 in cortical neurons and the development of a number of tests for the involvement of single neurons in the perception of stereoscopic depth. The picture that now emerges is that cortical area V1 must be a preliminary processing stage for the analysis of stereoscopic depth, whereas some of the extrastriate areas may actually be responsible for the generation of neuronal signals that underlie the perception of binocular depth.

Animals↗
PubMed2001

The neuroendocrinology of chronic fatigue syndrome and fibromyalgia.

BACKGROUND: Disturbance of the HPA axis may be important in the pathophysiology of chronic fatigue syndrome (CFS) and fibromyalgia. Symptoms may be due to: (1) low circulating cortisol; (2) disturbance of central neurotransmitters; or (3) disturbance of the relationship between cortisol and central neurotransmitter function. Accumulating evidence of the complex relationship between cortisol and 5-HT function, make some form of hypothesis (3) most likely. We review the methodology and results of studies of the HPA and other neuroendocrine axes in CFS. METHOD: Medline, Embase and Psychlit were searched using the Cochrane Collaboration strategy. A search was also performed on the King's College CFS database, which includes over 3000 relevant references, and a citation analysis was run on the key paper (Demitrack et al. 1991). RESULTS: One-third of the studies reporting baseline cortisol found it to be significantly low, usually in one-third of patients. Methodological differences may account for some of the varying results. More consistent is the finding of reduced HPA function, and enhanced 5-HT function on neuroendocrine challenge tests. The opioid system, and arginine vasopressin (AVP) may also be abnormal, though the growth hormone (GH) axis appears to be intact, in CFS. CONCLUSIONS: The significance of these changes, remains unclear. We have little understanding of how neuroendocrine changes relate to the experience of symptoms, and it is unclear whether these changes are primary, or secondary to behavioural changes in sleep or exercise. Longitudinal studies of populations at risk for CFS will help to resolve these issues.

Adrenocorticotropic Hormone↗