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Biomedical subjects

D Doherty

Publications and source records attributed to D Doherty.

At least 19 recordsLinked to original sources
PubMed2006

A comparison of the effects on bispectral index of mild vs. moderate hypothermia during cardiopulmonary bypass.

BACKGROUND AND OBJECTIVE: Bispectral Index correlates with depth of hypnosis in adult patients. Bispectral index monitoring has been separately examined and validated during both mild and moderate hypothermic cardiopulmonary bypass. However, the effect on bispectral index of these two differing cardiopulmonary bypass temperature regimes has not previously been compared, particularly with the use of volatile anaesthetic agents. METHODS: Following Institutional Ethics Committee approval and informed consent, 30 patients undergoing coronary artery bypass grafting had additional bispectral index monitoring. Sixteen patients had mild hypothermic bypass (32-34 degrees C), and 14 had moderate hypothermic bypass (28-30 degrees C). Anaesthesia was standardized, and was maintained with enflurane throughout surgery. Scores were recorded at 14 specific event-related time points during surgery. RESULTS: This study has demonstrated that in this adult population, a relationship exists between bispectral index score and temperature throughout the duration of cardiac surgery, which included mild or moderate hypothermic cardiopulmonary bypass. It also demonstrated that patients which were categorized as having received moderately hypothermic cardiopulmonary bypass had lower bispectral index scores than those patients who received mild hypothermic cardiopulmonary bypass, at time points corresponding approximately with median steady-state bypass temperature, pre-re-warming and early re-warming periods. CONCLUSIONS: Moderate hypothermic cardiopulmonary bypass has lower bispectral index scores when compared to mild hypothermic cardiopulmonary bypass, at a steady state of inspired enflurane. This may reflect an actual increase in the depth of hypnosis. However, as this study did not address the physico-chemical changes of the volatile agent or the accuracy of the bispectral index algorithm at lower temperatures, we would not advocate a change in practice based solely on this report.

Aged↗
PubMed2006

Health-related issues in individuals with agenesis of the corpus callosum.

OBJECTIVES: To explore and compare the prevalence and expression of specific health-related variables in a large survey sample of persons with agenesis of the corpus callosum (ACC) and their siblings. METHODS: Caregiver surveys of individuals with ACC (n=189) and their siblings (n=189) provided data regarding diagnoses, physical features, neurological and sensory information, feeding, elimination and sleep concerns, and some behavioural features. RESULTS: Compared with their siblings, individuals with ACC had more concurrent conditions and were more likely to have altered pain perception and sensitivity to touch. In addition, individuals with ACC had more sensory deficits and abnormalities as well as altered patterns of feeding/eating, elimination and sleep. CONCLUSIONS: These data raise important questions for future research and suggest the need for increased vigilance by caregivers and health-care professionals of individuals with callosal disorders. Early detection and intervention may help prevent or ameliorate health problems in this population.

Adolescent↗
PubMed2005

Analysis of feeding behavior with direct linear transformation.

AIM: The sucking pattern of term infants is composed of a rhythmic alteration of expression and suction movements. The aim is to evaluate if direct linear transformation (DLT) method could be used for the assessment of infant feeding. SUBJECT AND METHODS: A total of 10 gnormalh infants and two infants with neurological disorders were studied using DLT procedures and expression/suction pressure recordings. Feeding pattern of seven gnormalh infants were evaluated simultaneously recording DLT and pressures. The other infants were tested non-simultaneously. We placed markers on the lateral angle of the eye, tip of the jaw, and throat. The faces of infants while sucking were recorded in profile. The jaw and throat movements were calculated using the DLT procedure. Regression analysis was implemented to investigate the relationship between suction and expression pressures and eye-jaw and eye-throat movement. All regression analyses investigated univariate relationships and adjusted for other covariates. RESULTS: Ten gnormalh infants demonstrated higher suction pressure than expression pressure, and their throat movements were larger than jaw movements. Two infants with neurological problems did not generate suction pressure and demonstrated larger movements in their jaw than throat. The simultaneous measurement (n=7) showed a significant correlation, not only between eye-jaw distance and the expression pressure, but also between eye-throat distance and suction pressure. The change in the eye-jaw distance was smaller than the changes in the eye-throat distance in gnormalh infants (p<0.001). CONCLUSIONS: The DLT method can be used to evaluate feeding performance without any special device.

Humans↗
PubMed2005

AHI1 mutations cause both retinal dystrophy and renal cystic disease in Joubert syndrome.

BACKGROUND: Joubert syndrome (JS) is an autosomal recessive disorder characterised by hypotonia, ataxia, mental retardation, altered respiratory pattern, abnormal eye movements, and a brain malformation known as the molar tooth sign (MTS) on cranial MRI. Four genetic loci have been mapped, with two genes identified (AHI1 and NPHP1). METHODS: We screened a cohort of 117 JS subjects for AHI1 mutations by a combination of haplotype analysis and sequencing of the gene, and for the homozygous NPHP1 deletion by sequencing and marker analysis. RESULTS: We identified a total of 15 novel AHI1 mutations in 13 families, including nonsense, missense, splice site, and insertion mutations, with some clustering in the WD40 domains. Eight families were consanguineous, but no single founder mutation was apparent. In addition to the MTS, retinal dystrophy was present in 11 of 12 informative families; however, no subjects exhibited variable features of JS such as polydactyly, encephalocele, colobomas, or liver fibrosis. In contrast to previous reports, we identified two families with affected siblings who developed renal disease consistent with nephronophthisis (NPH) in their 20s. In addition, two individuals with classic NPH were found to have homozygous NPHP1 deletions. CONCLUSIONS: Overall, 11% of subjects had AHI1 mutations, while approximately 2% had the NPHP1 deletion, representing a total of less than 15% in a large JS cohort. Some preliminary genotype-phenotype correlations are possible, notably the association of renal impairment, specifically NPH, in those with NPHP1 deletions. Subjects with AHI1 mutations may be at risk of developing both retinal dystrophy and progressive kidney disease.

Abnormalities, Multiple↗
PubMed2005

Menopausal hormone therapy and irregular endometrial bleeding: a potential role for uterine natural killer cells?

CONTEXT: Irregular bleeding affects many users of combined menopausal hormone therapy (HT) and commonly leads to invasive and expensive investigations to exclude underlying malignancy. In most cases no abnormality is found. OBJECTIVE: The main objective of this study was to explore the role of uterine natural killer (uNK) cells and their regulatory cytokine IL-15 in irregular bleeding in HT users. DESIGN: This was a prospective observational study conducted between 2002 and 2004. SETTING: The study was conducted in a tertiary referral menopause clinic at King Edward Memorial Hospital, Western Australia. PATIENTS: Patients included 117 postmenopausal women taking combined HT. INTERVENTIONS: Outpatient endometrial biopsies were taken during and outside bleeding episodes. MAIN OUTCOME MEASURES: The relationship between endometrial uNK cells (CD56+) and bleeding patterns was measured. We also addressed the impact of HT exposure on uNK cell populations, the relationship between endometrial IL-15 expression and uNK cell populations, and killer Ig like receptor genotype in subjects with irregular bleeding. RESULTS: Endometrial CD56+ uNK cells were significantly increased in biopsies obtained during bleeding episodes (P < 0.001), compared with HT users with no bleeding. The highest level of IL-15 expression was also seen in biopsies taken during bleeding. No clear relationship between killer Ig like receptor genotype and bleeding on HT was observed. CONCLUSIONS: Little is known about the mechanisms underlying irregular bleeding in HT users. This is the first report of uNK cells and their association with regulating cytokines in postmenopausal endometrium and demonstrates a possible mechanism by which HT may induce irregular bleeding.

CD56 Antigen↗
PubMed2005

Erythromycin as a prokinetic agent in preterm neonates: a systematic review.

BACKGROUND: It often takes several days or even weeks to establish full enteral feeds (FEFs) in preterm, especially extremely low birthweight neonates because of feed intolerance related to gastrointestinal hypomotility. Clinical trials of erythromycin as a prokinetic agent in preterm neonates have reported conflicting results. AIM: To systematically review the efficacy and safety of erythromycin as a prokinetic agent in preterm neonates. METHODS: Only randomised controlled trials in preterm neonates (gestation < or = 37 weeks) were considered eligible for inclusion. The primary outcome was the time to reach FEFs of 150 ml/kg/day. The secondary outcomes included the incidence of erythromycin related adverse effects such as diarrhoea, cardiac arrhythmias, and hypertrophic pyloric stenosis. No restrictions were applied on the dose (low: 3-12 mg/kg/day; antimicrobial: > or = 12 mg/kg/6-8 hours) and route (oral or intravenous) and mode (prophylactic or rescue) of administration. The standard methodology for systematic reviews was followed. A subgroup analysis was pre-planned based on the dose and mode of drug administration. RESULTS: Seven trials (three prophylaxis, four rescue) with various doses, routes and modes of administration, and durations of erythromycin treatment and different results were found to be eligible for inclusion in the analysis. Meta-analysis could not be performed, as specific data were either inadequate or not available. CONCLUSION: The conflicting trial results may be explained by differences in dose and route and mode of administration of erythromycin and in gastrointestinal motor responses in the presence of different feeding conditions-for example, fasting v fed state, intermittent v continuous feeds. Gestational and postnatal ages during erythromycin treatment are also important.

Erythromycin↗
PubMed2005

Predictors of body mass index and associations with cardiovascular risk factors in Australian children: a prospective cohort study.

OBJECTIVE: To examine predictors of body mass index (BMI) at the age of 8 y in a prospective study of Australian children. DESIGN: Longitudinal survey of a cohort of Australian children followed from the 16th week of gestation to 8 y. SUBJECTS: In total, 741 boys and 689 girls who attended the survey as 8 y olds. MEASUREMENTS: Weight and height, blood pressure measured by automated oscillometry, fasting blood lipids and glucose. Questionnaire assessment of activity and diet. RESULTS: Proportions of overweight including obesity in boys and girls were, respectively, 22 and 25% at 1 y, 14 and 14% at 3 y, 13 and 18% at 5 y and 15 and 20% at 8 y. At the age of 1, 3, 6 and 8 y, children with overweight including obesity showed significantly more adverse cardiovascular risk factors. Blood pressure (BP) was significantly higher by 2/3 mmHg (systolic/diastolic) at 1 y, 3/2 mmHg at 3 y, 4/2 mmHg at 5 y and 6/2 mmHg at 8 y; HDL was significantly lower (P=0.002) by 8% and triglycerides were significantly higher by 27% (P<0.001). In multivariate regression, BMI at the age of 8 y was significantly predicted positively by birth weight, mother's BMI and hours spent in watching television at the time of the survey of 6 y olds. Mothers being ex-smokers or non smokers and children being 'slightly active' and 'active' negatively predicted BMI in 8 y olds. In a subset of 298 children with information about fathers, paternal BMI was an additional independent predictor. Maternal or paternal overweight including obesity each independently increased risk of overweight including obesity at the age of 8 y three-fold. A food factor with consumption of cereals and breads as the major components derived from a Food Frequency Questionnaire in a subset of 340 children was also an independent negative predictor of BMI in multivariate models. CONCLUSION: The increasing rate of overweight including obesity, particularly in girls, is associated with an increase in cardiovascular risk factors very early in life. Improvement of health-related behaviours within the family and a focus on promotion of activity in children should be priorities in achieving weight control.

Birth Weight↗
PubMed2003

Changes in endometrial blood vessels in the endometrium of women with hormone replacement therapy-related irregular bleeding.

BACKGROUND: Irregular bleeding affects up to 60% of hormone replacement therapy (HRT) users. The mechanism of this bleeding is not understood. Reduced endometrial microvascular integrity appears to underlie breakthrough bleeding in pre-menopausal women and the aim of this study was to establish whether similar changes are seen in HRT users and hence to elucidate a possible mechanism of irregular bleeding. METHODS: Endometrium from 34 HRT users with amenorrhoea, irregular bleeding or regular bleeding was assessed for endometrial endothelial cell density (anti-CD34), number of blood vessels per mm(2), vascular basal lamina components (laminin, collagen IV and heparan sulphate proteoglycan) and in 32 subjects and 23 controls for perivascular smooth muscle alpha (SMA). Findings were compared with a control population of 29 post-menopausal women not using HRT, other sex steroids or tamoxifen and with no vaginal bleeding. Staining intensity was assessed in a blinded fashion in all immunohistochemical studies. RESULTS: Four significant differences in endometrial blood vessels were observed between HRT users and controls: (i) a significantly lower density of endometrial endothelial cells (EC staining for CD34) per mm(2) was present in HRT users compared with controls (P < 0.001); (ii) endothelial cells (EC) were predominantly organized within blood vessels (83%) in controls but in HRT users EC were dispersed in the tissues with only 29% in organized vessels (P <0.001); (iii) supportive perivascular cell SMA was significantly reduced in 23 post-menopausal HRT users compared with 23 post-menopausal controls (n = 29, P = 0.013) and (iv) an atrophic or inactive histological pattern of endometrium was more frequently seen in the controls (P < 0.001). CONCLUSIONS: These findings support the hypothesis that exposure to HRT profoundly alters endometrial blood vessels, reducing structural integrity thereby predisposing to irregular bleeding in HRT users.

Actins↗
PubMed2002

Induction of cyclo-oxygenase-2 in non-small cell lung cancer cells by infection with DeltaE1, DeltaE3 recombinant adenovirus vectors.

Infection of epithelial-derived cells by adenovirus vectors has myriad effects on cellular behavior and function. Some are relevant to the desired effect of the encoded transgene and therapeutic goals of gene therapy approach. The current experiments describe the induction of COX-2 protein and PGE-2 production by non-small cell lung cancer (NSCLC) cells following infection with a first generation (DeltaE1, DeltaE3) Ad vector. COX-2 overexpression by malignant cells has been shown to enhance cellular invasion, induce angiogenesis, regulate anti-apoptotic cellular defenses and augment immunologic resistance through production of PGE-2. Data show DeltaE1, DeltaE3, Ad5 vector infection induces dose-dependent increases in PGE-2 production by NSCLC cell lines. Data with UV/psoralen inactivated vectors and control vectors show this effect is dependent on Ad vector gene expression, but independent of the transgene expressed. Selective blockade of ERK with PD98029 abrogated induction of PGE-2 by Ad vectors. Consistent with these data, detectable increases in COX-2 protein were seen at 48 h after infection by Western blot that were paralleled by increases in the phosphorylation of ERK-1/2. UV/psoralen-inactivated vector did not induce COX-2 protein or ERK phosphorylation at 48 h. Further, an inhibitor of NF-kappa B (NFkappaB) translocation to the nucleus, SN50, had no effect on PGE-2 levels. In contrast, Ad vector infection did induce NFkappaB activity measured by NFkappaB-luciferase reporter plasmid, transfected into a NSCLC cell line. Collectively the data indicate DeltaE1, DeltaE3, Ad5 vector infection leads to ERK phosphorylation with parallel increases in COX-2 protein and PGE-2 production. These effects appear unrelated to NFkappaB and are dependent on gene expression by the vector. This information may need to be considered when defining targets for cancer gene therapy and/or the choice of viral vector.

Adenoviridae↗
PubMed2001

Leukemic mantle cell lymphoma: clinical and pathologic spectrum of twenty-three cases.

Twenty-three patients with marked leukemic involvement by mantle cell lymphoma (MCL) are described. Each patient had an absolute lymphocyte count more than 10 x 10(9)/L. The diagnosis of MCL was supported by compatible immunophenotypic findings and the t(11;14)(q13;q32) in all cases. Morphologically, these cases exhibited a spectrum of findings that we divided into two groups using a cutoff of 20% large or blastoid cells (log rank test, P =.004). Patients with small-cell (<20%) morphologic features survived longer than patients with large/blastoid (> or =20%) morphologic features, (P =.003, log rank test). The most common additional karyotypic abnormality identified in this study involved chromosome 17, in 13 of 23 (56.5%) cases, which correlated with p53 overexpression but not with cytologic features. We conclude that cytologic features of MCL predict the prognosis of patients with marked leukemic involvement. Chromosome 17 abnormalities are common in leukemic MCL, may be involved in pathogenesis, and are associated with p53 expression.

Adult↗
PubMed2001

Basis of the superiority of cefoperazone amphotericin teicoplanin for isolating Campylobacter upsaliensis from stools.

The optimum method for isolating Campylobacter upsaliensis from stools has not been clearly defined. In a preliminary study, cefoperazone amphotericin teicoplanin (CAT) selective medium isolated six C. upsaliensis strains which were not detected using modified cefoperazone charcoal deoxycholate (mCCDA). In order to identify the factors that underlie the superiority of CAT over mCCDA for isolating C. upsaliensis, we examined the effect of incubation time and antibiotic content of culture media on the growth of C. upsaliensis isolates using semiquantitative methods. The recovery of a subgroup of C. upsaliensis isolates from seeded stool specimens was also evaluated. Differences in growth of C. upsaliensis on CAT and mCCDA were modest and were not explained by the antibiotic profiles of the two media. Recovery of C. upsaliensis from spiked human feces on CAT was superior to that on mCCDA at lower concentrations of organisms (10(3) CFU/ml). We conclude that although CAT is more suitable than mCCDA for the isolation of C. upsaliensis from stools, the superiority of CAT for detecting this organism is not accounted for by the antibiotic composition of the medium.

Amphotericin B↗
PubMed2001

Functional recovery after rehabilitation for cerebellar stroke.

BACKGROUND AND PURPOSE: Relatively few data exist concerning functional recovery after ischemic and hemorrhagic cerebellar stroke. We studied patients admitted to a rehabilitation hospital after cerebellar stroke to quantify recovery after rehabilitation therapy and to identify variables that predicted functional outcome. METHODS: This study was a retrospective review of consecutive cases admitted in a 4-year period with new cerebellar infarct or hemorrhage. Clinical features of stroke were recorded and comorbidities scored with the Charlson Index. Follow-up information was obtained by telephone interview. The Functional Independence Measure (FIM) was scored at admission (AFIM), discharge (DFIM), and follow-up (FFIM). Outcome measures were DFIM and FFIM. Univariate and multivariate analyses were performed. RESULTS: Fifty-eight cases were identified (mean age 69.2 years; 49 infarcts, 9 hemorrhages). Mean AFIM was 65.5, and mean DFIM was 89.8. Mean AFIM was significantly higher in the infarct than in the hemorrhage subgroup (70 versus 43, P:=0.006). Mean DFIM was also higher in the infarct subgroup but did not reach statistical significance (93 versus 74, P:=0.1). Follow-up information was obtained for 45 cases (78%) (mean interval 19.5 months). Median FFIM was 123.5. Outcome was significantly positively correlated with AFIM and initial presenting syndrome of vertigo/vomiting/ataxia/headache. Outcome correlated negatively with preexisting comorbidity score, altered level of consciousness at initial presentation, and superior cerebellar artery infarction. On multivariate analysis, AFIM and comorbidity score were independent predictors of outcome. CONCLUSIONS: Substantial improvement of mean FIM score frequently occurs after rehabilitation after cerebellar infarction. Functional outcome is best predicted by preexisting comorbidities and functional status at the time of discharge from acute hospitalization.

Aged↗
PubMed2000

Coding of deflection velocity and amplitude by whisker primary afferent neurons: implications for higher level processing.

Within the rat whisker-to-barrel pathway, local circuits in cortical layer IV are more sensitive to the initial timing of deflection-evoked thalamic responses than to the total number of spikes comprising them. Because thalamic response timing better reflects whisker deflection velocity than amplitude, cortical neurons are more responsive to the former than the latter. The aim of this study is to determine how deflection velocity and amplitude may be encoded by the primary afferent neurons innervating the vibrissae. Responses of 81 extracellularly recorded trigeminal ganglion neurons (60 slowly and 21 rapidly adapting) were studied using controlled whisker stimuli identical to those used previously to investigate the velocity and amplitude sensitivities of thalamic and cortical neurons. For either slowly (SA) or rapidly adapting (RA) neurons, velocity is reflected by both response magnitude, measured as the total number of evoked spikes/stimulus, and initial firing rate, measured as the number of spikes discharged during the first 2 ms of the response. Deflection amplitude, on the other hand, is represented only by the SA population in their response magnitudes. Thus, in both populations initial firing rates unambiguously reflect deflection velocity. Together with previous findings, results demonstrate that information about deflection velocity is preserved throughout the whisker-to-barrel pathway by central circuits sensitive to initial response timing.

Afferent Pathways↗
PubMed1999

Developing leaders for the health service of the future: the experience in Ireland.

How can we identify and then develop the people who will provide the leadership in our health services in the next ten to fifteen years? That was the question the Office of Health Management addressed in 1997. The paper outlines the leadership competencies used to select the participants and indicate how they were developed. It will also describe the programmes content and design, the issues that arose in the course of the programme and the evaluation framework. It concludes with an assessement of the obstacles the potential young leaders are likely to encounter and gives an indication of how it is proposed to continue to support these young people in the future.

Evaluation Studies as Topic↗
PubMed1998

Reduced nitric oxide reactivity of a new recombinant human hemoglobin attenuates gastric dysmotility.

The objective of this investigation was to compare the gastric motility effects of two recombinant hemoglobin variants, rHb1.1, and rHb3011, the latter having decreased nitric oxide reactivity via mutagenic alteration. Variants were administered to rats at 750 and 1500 mg/kg, i.v., prior to feeding a meal. The percentage of meal emptied was determined 45 min after feeding. rHb1.1 reduced gastric emptying significantly (48% and 71%), whereas rHb3011 was significant (42%) only at the higher dose (p < 0.05). The results suggest that rHb1.1 inhibits gastric emptying by scavenging NO, and this effect is significantly reduced by rHb3011, which has decreased NO reactivity.

Animals↗
PubMed1998

Defining the outcome of immunosuppression withdrawal after liver transplantation.

Successful immunosuppression withdrawal should benefit the natural history of organ transplantation patients. To identify the clinical hazards of removing drug treatment and possible characteristics that predict a favorable outcome in long-term liver recipients, immunosuppression was withdrawn completely and the clinicopathological outcome documented in 18 liver recipients. Indication for transplantation, HLA matching, early rejection history, and presence of microchimerism were examined as predictors of outcome. Chimerism was determined by polymerase chain reaction-based examination for donor-specific HLA-DRB1 alleles and Y-gene-specific nucleotide sequences. At 3 years, 5 patients (28%) remained completely off immunosuppression; 12 patients (67%) experienced histological graft changes: acute rejection in 4, portal tract inflammation/hepatitis in 7, and necrosis in 1. Hepatitis B or C viral infections did not account for the nonrejection patterns. Unmasking of systemic disorders occurred. Chimerism, demonstrated in 7 patients (39%), with skin the optimal tissue, was not associated with tolerance. Parameters associated with successful drug withdrawal were transplantation for non-immune-mediated liver disorders, fewer donor-recipient HLA A, B, and DR mismatches, and a low incidence of early rejection. Immunosuppression withdrawal is a feasible option in a proportion of selected liver recipients, but identification of tolerant patients remains imprecise.

Adult↗
PubMed1998

A Drosophila RNA helicase gene, pitchoune, is required for cell growth and proliferation and is a potential target of d-Myc.

This article describes the characterization of a new Drosophila gene that we have called pitchoune (pit) (meaning small in Provence) because mutations in this gene produce larvae that cannot grow beyond the first instar larval stage although they can live as long as 7-10 days. All the tissues are equally affected and the perfectly shaped larvae are indistinguishable from first instar wild-type animals. Analysis of mutant somatic clones suggests a function in cell growth and proliferation, which is supported by the fact that cell proliferation is promoted by pit overexpression. Tagged-Pit, when transfected in S2 cells, localizes mainly to the nucleolus, pointing towards a possible role in ribosome biogenesis and, consequently, in protein biosynthesis. pit encodes a DEAD-box RNA helicase, a family of proteins involved in the control of RNA structure in many cellular processes and its closest homologue is a human DEAD-box RNA helicase, MrDb, whose corresponding gene transcription is directly activated by Myc-Max heterodimers (Grandori, C., Mac, J., Siëbelt, F., Ayer, D. E. and Eisenman, R. N. (1996) EMBO J. 15, 4344-4357). The patterns of expression of d-myc and pit are superimposable. Ectopic expression of myc in the nervous system drives an ectopic expression of pit in this tissue indicating that in Drosophila as well, pit is a potential target of d-Myc. These results suggest that myc might promote cell proliferation by activating genes that are required in protein biosynthesis, thus linking cell growth and cell proliferation.

Amino Acid Sequence↗