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Biomedical subjects

D Wood

Publications and source records attributed to D Wood.

At least 19 recordsLinked to original sources
PubMed2000

Sitting balance following brain injury: does it predict outcome?

Balance dysfunction is commonly observed following traumatic brain injury. There are many proposed predictors of functional outcome in the traumatic brain injury population. It was hypothesized that the degree of balance dysfunction on admission to rehabilitation would be a significant predictor of the need for assistance at discharge, as measured by the Functional Independence Measure (FIM). This study involved 237 cases of traumatic brain injury patients admitted to a rehabilitation unit between November 1989 and September 1996. Using a multiple regression model, controlling for age, initial Glasgow Coma Score (GCS), rehabilitation admission strength, sitting balance and standing balance, it was found that the degree of impairment in sitting balance at admission to rehabilitation was a significant predictor of Discharge FIM-Total (FIM-T) score (p < 0.0001) and also of selected elements from the Discharge FIM-Motor (FIM-M) score (p < 0.0005). The combination of age, initial admission GCS, rehabilitation admission strength, standing balance and sitting balance accounted for 29% of the variance in the Discharge Total FIM score. Among these, sitting balance was the second most powerful predictor of both selected elements of the Discharge FIM motor score and discharge FIM-T. Sitting balance predictive capacity was exceeded in power only by age. Impairments in sitting balance appear to have a significant impact on functional outcome. Emphasis on unique rehabilitation techniques to treat balance dysfunction in the adult TBI population is warranted.

Activities of Daily Living↗
PubMed2000

Interaction of yellow fever virus French neurotropic vaccine strain with monkey brain: characterization of monkey brain membrane receptor escape variants.

Binding of yellow fever virus wild-type strains Asibi and French viscerotropic virus and vaccine strains 17D and FNV to monkey brain and monkey liver cell membrane receptor preparations (MRPs) was investigated. Only FNV bound to monkey brain MRPs, while French viscerotropic virus, Asibi, and FNV all bound to monkey liver MRPs. Four monkey brain and two mouse brain MRP escape (MRP(R)) variants of FNV were selected at pH 7.6 and 6.0. Three monkey brain MRP(R) variants selected at pH 7.6 each had only one amino acid substitution in the envelope (E) protein in domain II (E-237, E-260, or E274) and were significantly attenuated in mice following intracerebral inoculation. Two of the variants were tested in monkeys and retained parental neurotropism following intracerebral inoculation at the dose tested. We speculate that this region of domain II is involved in binding of FNV E protein to monkey brain and is, in part, responsible for the enhanced neurotropism of FNV for monkeys. A monkey brain MRP(R) variant selected at pH 6.0 and two mouse brain MRP(R) variants selected at pH 7.6 were less attenuated in mice, and each had an amino acid substitution in the transmembrane region of the E protein (E-457 or E-458).

Animals↗
PubMed2000

[The role of phytohormones in tumor formation in radish].

Tumor formation was studied in inbred radish lines that produce tumors on plant roots during flowering. In all radish lines under consideration, the sequences homologous to oncogenes tmr/tml of Agrobacterium tumefaciens were revealed by Southern hybridization. No sequences homologous to the tms locus of A. tumefaciens and the oncogenes of A. rhizogenes were determined. It was found that auxin sensitivity and the tumor-producing capacity were coinherited. We suggest that tumor phenotype arise as a result of a combination between agrobacterial "cytokinin" oncogenes and certain alleles of "auxin" radish genes.

Blotting, Southern↗
PubMed1999

Protein transmission during Dean vortex microfiltration of yeast suspensions.

Substantially higher rates of protein and fluid volume transport for microfiltration of yeast suspensions were possible with improved hydrodynamics using centrifugal fluid instabilities called Dean vortices. Under constant permeate flux operation with suspended yeast cells, a helical module exhibited 19 times the filtration capacity of a linear module. For feed containing both BSA and beer yeast under constant transmembrane pressure with diafiltration, about twice as much protein (BSA and other proteins from cell lysis) was transported out of the feed by the helical module as compared with the linear module. The volumetric permeation flux improvements for the helical over the linear module ranged from 18 to 43% for yeast concentrations up to 4.5 dry wt %.

Animals↗
PubMed1999

The cytotoxic effect of titanium particles phagocytosed by osteoblasts.

The cytotoxic effect of different concentrations of titanium particles on osteoblasts was studied in vitro. It was found that the viability of the osteoblasts was inversely proportional to the particle concentration. Phagocytosis of particles by the osteoblasts was evident and was demonstrated to be responsible for cell necrosis. Moreover, during and after phagocytosis, the osteoblasts released products that were cytotoxic for other osteoblasts, as established with a conditioned medium assay. The titanium particles thus had both a direct and an indirect effect on osteoblast viability. It also was observed that the titanium particles induced a process of programmed cell death (apoptosis) when co-cultured with osteoblasts. The results of this study suggest that not only is the amount of wear debris generated important, but the local accumulation of the debris also may have a significant impact on bone cell function.

Analysis of Variance↗
PubMed1999

Rapid release and unusual stability of immunodominant peptide 45-89 from citrullinated myelin basic protein.

Myelin basic protein (MBP) exists in a population of isoforms and isomers. The 18.5 kDa MBP-C1, the main human adult isoform, has 170 residues and is relatively unmodified, whereas the same isoform can be citrullinated on six arginine residues to create the MBP-C8 (MBP Cit6) isomer. MBP Cit6 dominates in MS brain, accounting for 45% rather than 25% of the population of MBP isomers. In the fulminant form of MS, known as Marburg's Disease, 18 of the 19 arginines in MBP are citrullinated (MBP Cit18). Citrullination of MBP could lead to instability of myelin or limited remyelination. In this investigation, the susceptibilities to degradation by cathepsin D of MBP Cit6 and MBP-C1, both from normal and MS brain tissue, and Marburg MBP Cit18 were compared. The pattern of digestion was similar, and no differences of corresponding isomers in normal and MS brain were noted. However, normal MBP Cit6 was degraded 10-fold more rapidly than MBP-C1, and MBP Cit18 was degraded even more rapidly. MBP peptide 45-89 was preserved regardless of isomer type or source. Its generation was directly related to the citrulline content of the MBP substrate being 4 times faster in normal MBP Cit6 and 35 times faster in Marburg MBP Cit18 than in normal MBP-C1. Peptide 45-89 from a citrullinated MBP exhibited more deamidation, and, regardless of source, showed an alpha-helix structure in a lipid mimetic environment. We postulate that the generation of MBP peptides, including those that are dominant and encephalitogenic, is directly related to deimination of arginine to citrulline in MBP.

Brain↗
PubMed1999

Guidelines--a missed opportunity.

Progress is slow in the integration of coronary heart disease prevention into daily clinical practice by cardiologists and other physicians working in cardiology, internal medicine and primary healthcare. This is not due to a lack of professional recommendations on coronary prevention. As new knowledge has become available, new generations of recommendations have been published. In surveys of secondary prevention practice, risk factor recording and management falls short of these recommendations and there is considerable potential to further reduce the risk of another major ischemic event in patients with established coronary disease. The most recent recommendations from the Joint Task Force of the European Society of Cardiology, European Atherosclerosis Society and European Society of Hypertension reinforce the importance of secondary prevention and how they can be extended to primary prevention by targeting high-risk individuals in the general population. It is hoped that development of guidelines at a national level will ensure a common approach to coronary heart disease prevention throughout Europe.

Cardiology↗
PubMed1999

Dental materials: 1997 literature review.

This review of the published literature on dental materials for the year 1997 has been compiled by the Dental Materials Panel of UK. It continues a series of annual reviews started in 1973. Emphasis has been placed upon publications, which report upon the materials science or clinical performance of the materials. The review has been divided by accepted materials classifications (fissure sealants, glass polyalkenoate cements, dentine bonding, dental amalgam, endodontic materials, casting alloys, ceramometallic restorations and resin-bonded bridges, ceramics, denture base resins and soft lining materials, impression materials, dental implant materials, orthodontic materials, biomechanics and image processing, resin composites, and casting investment materials and waxes). Three hundred and thirty three articles have been reviewed.

Dental Materials↗
PubMed1999

Reliability of drop size from multi-dose eye drop bottles: is it cause for concern?

PURPOSE: Responses to topically applied ocular drugs vary between patients. The volume of drug instilled is of particular importance as one of many sources of response variation, but the reliability of drop volume from eye drop bottles is unknown. Hence, the repeatability of drop volume and factors affecting this for a variety of drug manufacturers were considered in this study. METHODS: Nineteen bottles, one from each primary manufacturer in the UK, were examined. The mass of all drops expelled from each bottle was measured with respect to the bottle type, handling angle, drop number, drug and concentration. The accuracy (repeatability and trueness) of drops from each bottle was also evaluated. RESULTS: Drop volume varied significantly between drug manufacturers, ranging from 33.8 microliters to 63.4 microliters. The handling angle of the bottle also influenced drop volume, with angles less than 60 degrees giving smaller drops. Drop number exhibited no significant effect upon drop volume. However, the drug type and its concentration did significantly affect the volume of the drop expelled from the bottle, with higher concentrations giving rise to larger drops. Repeatability coefficients across the range of bottles varied between +/- 2.24 microliters and +/- 10.76 microliters (mean +/- 5.07 microliters). CONCLUSIONS: It is well reported that drug volume instilled has a significant effect on the degree of response. However, there are currently no official regulations concerning eye drop volume in either the UK or the USA. Since drop volume has been shown to vary significantly depending upon a variety of factors, it may be appropriate that the regulatory bodies consider the consequences of variable drop size.

Administration, Topical↗
PubMed1999

'Hello, my name is Gabriel, I am the house officer, may I examine you?' or the Objective Santa Christmas Examination (OSCE).

OBJECTIVE: To design a clinical examination of high content validity suitable for use as a formative assessment tool with pre-registration house officers (PRHO'S) towards the end of their first house officer post. DESIGN: A multicentre collaboration between four UK medical schools who offer undergraduate curricula which are problem-based, systems-based, patient-orientated, student-centred, jargon-laden and utterly staff-bewildering. MAIN OUTCOME: An objective structured clinical examination (OSCE) which is suitable for use with graduates of UK medical schools. It assesses the knowledge, skills and attitudes essential for future careers in a hierarchical system where protecting the senior staff from all forms of irritation is paramount. RESULTS: PRHO'S who excel in this examination get better references. CONCLUSION: The OSCE format can be used to provide 'real-life' scenarios appropriate to the season.

Career Choice↗
PubMed1999

Clinical audit of 5 years provision of the Odstock dropped foot stimulator.

The Odstock dropped foot stimulator (ODFS) is a foot switch controlled single channel neuromuscular stimulator for correction of dropped foot. Following a randomized controlled trial, the ODFS was recommended for use in the United Kingdom's National Health Service and a clinical service established. The patient performance was assessed by measurement of walking speed over 10 m, physiological cost index (PCI), and by questionnaire. After 4.5 months stroke patients (n = 111) showed a mean increase in walking speed of 27% and reduction in PCI of 31% with stimulation and changes of 14% and 19%, respectively, unassisted. Multiple sclerosis patients (n = 21) gained similar orthotic benefit but no carry over. The principal reason cited for using the equipment was that it reduced the effort of walking. The principal reasons identified for discontinuing were an improvement in mobility, electrode positioning difficulties, and deteriorating mobility. A comprehensive clinical follow-up service is essential to achieve the maximum continuing benefit from FES based orthosis.

Cerebrovascular Disorders↗
PubMed1999

Registration and management of smoking behaviour in patients with coronary heart disease. The EUROASPIRE survey.

AIMS: To establish to what extent smoking status and its management is recorded in coronary patients' medical records, and to investigate their motivation to change smoking behaviour. METHODS: In EUROASPIRE, a survey on secondary prevention in 21 hospitals in the Czech Republic, Finland, France, Germany, Hungary, Italy, the Netherlands, Slovenia and Spain, data were collected from records of 4863 consecutive patients =<70 years of age, with previous (>6 months) admission for coronary bypass operation, angioplasty, myocardial infarction or ischaemia. Of these, 3569 patients were interviewed 1.6 years following their index hospitalization. RESULTS: Of the 82% of patients whose pre-hospitalization smoking behaviour was known, 34% were smokers. Documentation was significantly better in younger patients, in males and patients requiring angioplasty or bypass operation. In only 35% of 1364 smokers was the smoking habit recorded again after discharge from hospital At the time of the interview, 554 of the interviewed patients were still smoking. In over 90% of the smokers, advice to quit smoking was reported at interview. A positive relationship was found between receiving advice and seeking help to stop smoking, between receiving advice to stop smoking and attempting to stop, as well as between seeking help and attempting to stop. CONCLUSION: In almost 20% of coronary patients, smoking habits are not documented in medical records, and in only 35% of the smoking patients is smoking status documented at the follow-up. After a cardiac event requiring hospitalization as many as 50% of patients continue their smoking habit and so there is further potential to reduce the risk of recurrent coronary disease. Advice to stop smoking motivates patients to seek help and to attempt to stop smoking. Physicians repeated advice to stop smoking is important and smoking status should always be documented at follow-up.

Adult↗
PubMed1999

Ocular effects of antimuscarinic compounds: is clinical effect determined by binding affinity for muscarinic receptors or melanin pigment?

Although antimuscarinic drugs are being used with increasing frequency in clinical practice for the purposes of mydriasis and cycloplegia, the extent of their actions varies considerably between different compounds. Investigation of the binding characteristics of these agents revealed that as their reported clinical potency increased, so did their specific binding affinity for muscarinic receptors in the iris sphincter and ciliary muscle and their nonspecific binding affinity for melanin pigment. However, the affinity of each drug for melanin pigment was much lower than for the muscarinic receptors. Therefore, although binding to melanin can significantly influence the overall response, differences in the clinical effect of various compounds appear to be primarily due to their differences in specific affinity for muscarinic binding sites.

Animals↗