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Biomedical subjects

A Laidlaw

Publications and source records attributed to A Laidlaw.

16 recordsLinked to original sources

Older people in China and the United Kingdom differ in the relationships among parathyroid hormone, vitamin D, and bone mineral status.

To explore whether there are ethnic differences in relationships among parathyroid hormone (PTH), vitamin D, and bone mineral status, 352 healthy volunteers, 60-83 years old, were studied in Shenyang, Peoples' Republic of China (108 men, 110 women), and in Cambridge, UK (67 men, 67 women), in late winter. Early morning fasting blood and 2-h fasting urine were analyzed for 25-hydroxyvitamin D (25OH-D), PTH, and free deoxypyridinoline (DPD). Hip bone mineral status was measured using dual-energy X-ray absorptiometry (Lunar). There were significant differences (P < 0.001) in plasma 25OH-D and PTH concentrations between Shenyang and Cambridge [25OH-D nmol/L: Shenyang = 29.0 (SD 12.7), Cambridge = 35.7 (12.9)]; PTH ng/L: Shenyang = 34.3 (13.4), Cambridge = 25.2 (11.0)]. PTH was negatively related to 25OH-D in both populations. The relationship was exponential, best described by an inverse log-log equation with no break point (P < 0.001), indicating that the exponential curve did not tend toward a low plateau. PTH was higher for a given 25OH-D and decreased less with increasing 25OH-D in Shenyang than in Cambridge (country-ln25OH-D interaction, P = 0.0005). After adjusting for bone area, weight, height, age, and sex, hip bone mineral content (BMC) was significantly related to PTH concentration in Cambridge but not in Shenyang [femoral neck coefficient: Cambridge = -0.064 (SE 0.027), P = 0.02; Shenyang = -0.027 (0.028), P = 0.3; trochanter: Cambridge = -0.116 (0.034), P = 0.001; Shenyang = -0.019 (0.027), P = 0.5]. There was a significant country-lnPTH interaction at the trochanter (P = 0.02), but not at the femoral neck (P = 0.7). A weak positive association between BMC at the femoral neck and 25OH-D concentration was found in Cambridge [coefficient: 0.054 (0.028), P = 0.05] but not in Shenyang (coefficient: -0.013, P = 0.5; country-ln25OH-D interaction, P = 0.07). Urinary DPD concentration was also positively related to plasma PTH concentration in Cambridge subjects only [coefficient: 0.2 (0.08), P = 0.02]. These data suggest that although PTH increases when 25OH-D decreases, and Chinese people have a higher PTH for a given 25OH-D, older Chinese adults may be more resistant than Britons to the effects of PTH on bone.

Aged↗

Age- and gender-related differences in bone mineral status and biochemical markers of bone metabolism in Northern Chinese men and women.

The aim of this study was to provide insight into the bone mineral status and biochemical markers of bone metabolism in a Chinese population from Shenyang, in the north of China, where hip fracture incidence is low. A total of 194 healthy men and women, aged 25-35 years and 65-75 years, were studied. Bone mineral density (BMD) at the lumbar spine (LS) and femoral neck (FN) was measured using dual-energy X-ray absorptiometry. Fasting blood and 24 h urine samples were collected for bone alkaline phosphatase (bAP), osteocalcin, calcium, phosphate, and free deoxypyridinoline (Dpd). Both older women and men had lower BMD compared with younger women and men by 27.2 +/- 3.0% (mean +/- SE) and 9.8 +/- 3.0% at the LS and 22.0 +/- 3.4% and 12.8 +/- 3.4% at the FN, respectively, after adjusting for bone and body size (p < 0.01). BMD at the two sites was lower in older women than in older men by 10.7 +/- 4.1% and 10.2 +/- 4.2%, respectively, after size correction (p < 0.05). Plasma bAP, osteocalcin, calcium, and phosphate concentrations were higher in older women than younger women by 69.3 +/- 9.7%, 77.2 +/- 11.1%, 7.5 +/- 2.3%, and 8.0 +/- 3.8%, respectively, and older men by 67.6 +/- 11.1%, 72.1 +/- 11.0%, 7.7 +/- 2.3%, and 23.8 +/- 3.8%, respectively (p < 0.01). However, plasma osteocalcin, calcium, and phosphate concentrations were lower in older men compared with their younger counterparts by 35.6 +/- 11.0%, 8.7 +/- 2.3%, and 14.1 +/- 3.8%, respectively (p < 0.05). Urinary calcium and phosphate output were lower in older men compared with younger men by 48.0 plus minus 10.3% and 27.6 +/- 6.9%, respectively (p < 0.01), whereas there were no differences between older and younger women. No differences in Dpd between older and younger groups were found. This study demonstrates that bone mineral status is lower in older people in Shenyang, as has been shown in populations elsewhere. The pronounced low bone mineral status in older women may be associated with increased bone turnover, which was not observed in older men.

Adult↗

Inbred lines of mice derived from long-term growth selected lines: unique resources for mapping growth genes.

Lines of mice selected for many generations for high or low growth in several laboratories around the world have been collected, and from these, inbred lines are being developed by recurrent full-sib mating in Edinburgh. There are seven high selected lines and four low lines (each low line is from the same base population as one of the high lines), and the histories of each are summarized. Mean body weight of males at 70 days of age in the Edinburgh laboratory in the heaviest inbred line (77 g) is 4.8-fold higher than in the lightest line (16 g), and 1.9-fold higher than in the least extreme high line (41 g). Litter size, food intake, and fat content also differ substantially. These inbred extreme selected lines are a uniquely valuable resource for QTL or gene mapping, candidate gene identification, and elucidation of epistatic effects.

Animals↗

Macular hole surgery using silicone oil tamponade.

BACKGROUND/AIMS: Most surgeons performing macular hole surgery using long acting gas recommend strict postoperative face down posturing for 10-15 days. Patients with chronic systemic illness such as arthritis may be unable to carry out this postoperative regime. Thus there is a need for alternative techniques that would eliminate such a regime. The authors review a series of patients who underwent macular hole surgery using silicone oil without any postoperative posturing. METHODS: A retrospective case note review was performed of patients who had undergone macular hole surgery with silicone oil tamponade. The patients were unable to posture due to chronic illness and had stage 2, 3, or 4 full thickness macular holes. Removal of silicone oil performed with or without cataract surgery was arranged 3 months or more after surgery. RESULTS: 10 eyes of 10 patients underwent surgery. Duration of oil tamponade ranged from 3-9 months. Following oil removal the hole was closed in eight eyes (80%), of which only three showed any improvement in visual acuity (38%) even after cataract extraction. All eyes developed cataract to varying degrees and one eye developed raised intraocular pressure which settled after oil removal. A serious complication, endophthalmitis, occurred in one eye following removal of sutures after cataract extraction. CONCLUSION: The anatomical results (80%) in this series are in keeping with those reported in other studies using gas tamponade. The visual results are disappointing and less rewarding than those obtained after successful surgery using gas tamponade.

Aged↗

Choroidal effusions and hypotony caused by severe anterior lens capsule contraction after cataract surgery.

PURPOSE: To report the clinical features and management of two patients with pseudophakic anterior capsule contraction with secondary tractional ciliary body detachments and hypotonous choroidal effusions. METHODS: Case reports. RESULTS: In two eyes of two patients with pseudophakia, severe anterior lens capsule contraction and tractional ciliary body detachments, anterior capsulotomy (one Nd:YAG laser, one surgical), was followed by resolution of the ocular hypotony and resolution/nonrecurrence of the choroidal effusions. In both cases, continuous curvilinear capsulorhexis was used during cataract surgery. CONCLUSION: Anterior capsule contraction following pseudophakia may result in tractional ciliary detachment and secondary ocular hypotony. Radial anterior capsulotomy appeared to be effective in both cases.

Aged↗

Pruritus: more scratch than itch.

Itch is one of the major symptoms of skin disease although it remains poorly studied. Little is known about its mediators or the neurological processes involved in either the detection of an itch stimulus or the induction of the main response to itch, scratch. This lack of knowledge may be due to the subjective nature of the sensation itself and the related difficulties in quantifying it, and is compounded by the absence of a convincing animal model. Defining itch as that sensation which provokes the desire to scratch provides two approaches to measurement, that of itch itself, and the behavioural response, scratch. The measurement of itch itself traditionally involves the use of questionnaires or visual analogue scale, both of which rely on the dubious assumption that the subject is able to relate their experiences accurately. By contrast experimental induction of itch and measurement of areas of allokinesis around application sites may provide a more reliable and repeatable method of itch quantification. Recent advances in two areas that may prove relevant are discussed: new technological improvements in movement meters and compatible software; and some recently described animal models.

Humans↗

Effect of growth hormone on height, weight, and body composition in Prader-Willi syndrome.

AIMS: To evaluate the effect of the administration of growth hormone on stature, body weight, and body composition in children aged between 4 and 10 years with Prader-Willi syndrome. METHODS: Height, weight, and skinfold thickness were recorded in 25 children using standard anthropometric techniques at recruitment, and six months later, shortly before the start of daily subcutaneous injections of growth hormone. Body composition was assessed via a measurement of total body water using stable isotopes. Measurements were repeated at the end of the six months of growth hormone administration. Measurements of height, weight, and skinfold thickness were expressed as standard deviation scores (SDSs). RESULTS: There was a significant reduction in the percentage of body fat after growth hormone treatment; height velocity doubled during treatment; body weight did not change significantly when expressed as an SDS. Skinfold thickness at both the triceps and subscapular site decreased in absolute terms and when expressed as an SDS. CONCLUSIONS: These results indicate sufficient potential benefit to justify a more prolonged trial of growth hormone treatment and an exploration of different dosage regimens in children with Prader-Willi syndrome.

Body Composition↗

Total energy expenditure in 9 month and 12 month infants.

OBJECTIVES: To measure the total energy expenditure of 9 and 12 month old infants and compare with current recommendations for energy intake. DESIGN: Cross-sectional study. Total energy expenditure assessed using the doubly labelled water technique over a 10 d period. Classical anthropometric measurements taken. SETTING: Community based study in and around Cambridge, UK. SUBJECTS: Twenty infants aged 9 months of age and 20 infants aged 12 months of age recruited via local hospital birth records. MAIN OUTCOME MEASURES: Total energy expenditure calculated via the doubly labelled water technique. RESULTS: Measurements of total energy expenditure was successful in 34 cases. Mean total energy expenditure was 73.5 kcal/kg, 73.2 kcal/kg, 77.1 kcal/kg and 77.6 kcal/kg in the nine month old boys, nine month old girls, twelve month old boys and twelve month old girls respectively. These measurements are approximately 17% below current recommendations (FAO/WHO/UNU, 1985) at nine months of age and 22% below at one year of age. CONCLUSION: The data are consistent with findings in younger infants and older children in that the measurements of total energy expenditure are about 20-25% below current recommendations. It is unlikely that contemporary infants are being underfed and thus more likely that changes in feeding practices and modification of infant formula composition has led to the reduction in energy intake and energy expenditure in such infants.

Anthropometry↗

Good Samaritan surgeon wrongly accused of contributing to President Lincoln's death: an experimental study of the President's fatal wound.

BACKGROUND: When President Abraham Lincoln was shot in the back of the head at Ford's Theater in Washington, D.C., on April 14, 1865, he was immediately rendered unconscious and apneic. Doctor Charles A. Leale, an Army surgeon, who had special training in the care of brain injuries, rushed to Lincoln's assistance. When Doctor Leale probed the wound in Lincoln's thickened scalp, feeling for the bullet, he dislodged a blood clot, and Lincoln began to breathe again. However, Lincoln progressively deteriorated and died at 7:22 AM on April 15, 1865. During the postmortem examination of Lincoln's body, numerous secondary missiles of bone and metal were found in the track of pultaceous brain tissue, extending completely through the brain to the front of the skull. In February 1995, an article in a popular magazine alleged that Doctor Leale had caused further (fatal) damage to Lincoln's brain by thrusting his finger into the brain through the bullet hole. The article alleged (wrongly) that most bullet wounds of the brain incurred in Civil War times were not fatal. STUDY DESIGN: The following study demonstrates that it is impossible to introduce even the tip of the little finger through a hole in the skull resulting from a .41-caliber bullet fired from a derringer. In our study, a .41-caliber derringer was used to fire bullets into numerous fresh skulls; the bullet holes all had razor-sharp edges and were much too small to accommodate a fingertip. RESULTS: Thus, the allegation that President Lincoln's brain was damaged further because Doctor Leale thrust his finger through the bullet hole into the brain parenchyma is not valid. In this study, experimental data are presented to demonstrate the foregoing point. CONCLUSIONS: The wound made by John Wilkes Booth's derringer ball in Lincoln's brain was devastating; it was clearly the cause of his death. Good Samaritan surgeon Leale has been falsely accused of contributing to Lincoln's death.

Brain Injuries↗

Experimental duplication of the important physical evidence of the lapel bulge of the jacket worn by Governor Connally when bullet 399 went through him.

By duplicating the wound to the neck of President Kennedy, which caused bullet 399 to turn sideways, and having it then hit a Connally-type rib cage with shirt and jacket, we reproduced the right-sided bulge of the jacket worn by Connally, with lapel eversion, which is so significant in frame 224. The extensive damage to his shirtfront was from the hail of rib fragments and soft tissue, exactly as described with his own shirt. Our tumbling bullet then went on to fracture a radius and be recovered intact except that it was somewhat flattened and bent and had lead extruded from the rear, as did bullet 399. Fragments of this lead were scraped off on the ragged bone-ends of some of our fractured radiuses, just as with Governor Connally's radius. It is believed that this duplication of the jacket and lapel bulge of Governor Connally, which occurred dependably, when we reproduced the circumstances at Dallas, confirmed this very important detail in this technical demonstration of the findings in the shooting of President Kennedy and Governor Connally. The bulge and the lapel eversion of the jacket worn by Governor Connally, starting in Zapruder frame 224, does indeed establish, beyond any shadow of a doubt, the exact moment when bullet 399 went through him. The right arms of both men were seen to react simultaneously, immediately thereafter. It also permits us to establish that there was plenty of time (three and one-half seconds) between the first two shots (frames 160 to 224) and even more time (five seconds) between the last two shots (frames 224 to 313), for Oswald to reload, reacquire his target (the head of President Kennedy) plus two full seconds to lock onto it. If the bullet does not traverse the neck of President Kennedy, it does not cause Governor Connally's jacket and lapel to bulge. The lapel bulge is a very important bit of actual physical evidence in establishing the fact that one bullet hit both men and that Oswald had plenty of time to hit the President, first in the neck and then in the head. These experiments confirm the mechanism of the lapel bulge and the behavior of the bullet.

Famous Persons↗

Can second eye cataract extraction be justified?

A prospective study was carried out to test the null hypothesis that there is no additional benefit to be gained from second eye cataract extraction. Twenty-nine patients with unilateral cataract but contralateral pseudophakia completed a questionnaire enquiring into their visual disability and underwent testing of monocular and binocular visual acuity, contrast sensitivity, glare disability, fusion and stereopsis. These tests were repeated 4 months after second eye cataract extraction and lens implantation. Patients universally considered their vision to have been improved by second eye surgery and the prevalence of all symptoms were significantly reduced by this procedure. Normal binocular summation and stereopsis were restored following second eye cataract extraction. Symptomatic patients may benefit from second eye cataract extraction with lens implantation.

Aged↗

Outpatient management of small traumatic hyphaemas: is it safe?

In this prospective study patients with small traumatic hyphaemas were managed as ambulatory outpatients. No routine systemic or topical treatment was given. The patients were reviewed daily in the Casualty Department until the blood had cleared, after which they were examined fully. The incidence of rebleeding and the number of days for the blood to clear were comparable to figures for hospitalised bed-bound patients. Nine patients (21%) defaulted from follow-up. Outpatient management of small traumatic hyphaemas is safe in compliant patients and may save valuable resources.

Adolescent↗

Appearances of choroidal osteomas with diagnostic imaging.

The diagnostic imaging appearances of three choroidal osteomas (osseous choristomas) are presented. This rare, benign choroidal tumour is being recognized with increasing frequency, and is important to remember in the differential diagnosis of any unusual mass in the ocular fundus lest it be mistaken for a more sinister lesion. All three osteomas were demonstrated by ocular ultrasound (US), fluorescein angiography (FA) and computed tomography (CT) but none by plain radiography. None of the lesions was visible on magnetic resonance imaging (MRI); the reason for this is probably the bony nature of the tumours. The appearances of choroidal osteomas on US, FA, plain radiography and CT are discussed. To our knowledge this is the first report of a series of choroidal osteomas investigated by MR.

Adult↗

Soap gets in your eyes.

We present a previously unreported series of five cases of acute angle closure glaucoma associated with watching the Australia soap opera "Neighbours". Two cases were bilateral and associated with watching two episodes of "Neighbours" on the same day. The pathogenesis, and possible role of watching soap operas in the causation of primary angle closure glaucoma is discussed.

Aged↗