Misplaced and inappropriate.
Explore the source record for details and available documents.
Antibiotic Prophylaxis↗
Biomedical subjects
E McKay
Publications and source records attributed to E McKay.
Validation of a semi-automated scintigraphic technique for detecting episodic, real-time colonic flow.
The relationships between the movement of colonic content and regional pressures have only been partially defined. During the analysis of a combined colonic scintigraphic and manometric study, a quantitative technique for determining discrete, episodic, real-time colonic flow was developed. Our aim was to validate this technique through the construction of a computer-generated phantom model of known antegrade and retrograde motility. The anthropoid phantom was rasterized into a 6-mm voxel model to create a 3D voxel phantom of the colon with four distinct colonic segments. Associating a time/activity curve with each segment simulated dynamic behaviour. Activity in the model was based on data obtained from human colonic scintigraphic recordings using 30 MBq of (99m)Tc sulphur colloid. The flow was simulated by modifying the input time/activity functions to represent episodes of net flow of 2%, 5% or 10% of segmental content. Our quantitative technique was applied to the phantom model to measure the accuracy with which simulated flows were detected. Our quantitative technique proved to be a sensitive and specific means of detecting the presence and the magnitude of discrete episodes of colonic flow and therefore, should improve our ability to correlate colonic flow and motor patterns.
Adult↗
Oropharyngeal scintigraphy: a reliable technique for the quantitative evaluation of oral-pharyngeal swallowing.
A valid and reliable technique to quantify the efficiency of the oral-pharyngeal phase of swallowing is needed to measure objectively the severity of dysphagia and longitudinal changes in swallowing in response to intervention. The objective of this study was to develop and validate a scintigraphic technique to quantify the efficiency of bolus clearance during the oral-pharyngeal swallow and assess its diagnostic accuracy. To accomplish this, postswallow oral and pharyngeal counts of residual for technetium-labeled 5- and 10-ml water boluses and regional transit times were measured in 3 separate healthy control groups and in a group of patients with proven oral-pharyngeal dysphagia. Repeat measures were obtained in one group of aged (> 55yr) controls to establish test-retest reliability. Scintigraphic transit measures were validated by comparison with radiographic temporal measures. Scintigraphic measures in those with proven dysphagia were compared with radiographic classification of oral vs. pharyngeal dysfunction to establish their diagnostic accuracy. We found that oral ( p = 0.04), but not pharyngeal, isotope clearance is swallowed bolus-dependently. Scintigraphic transit times do not differ from times derived radiographically. All scintigraphic measures have extremely good test-retest reliability. The mean difference between test and retest for oral residual was -1% (95% CI -3%-1%) and for pharyngeal residual it was -2% (95% CI -5%-1%). Scintigraphic transit times have very poor diagnostic accuracy for regional dysfunction. Abnormal oral and pharyngeal residuals have positive predictive values of 100% and 92%, respectively, for regional dysfunction. We conclude that oral-pharyngeal scintigraphic clearance is highly reliable, bolus volume-dependent, and has a high predictive value for regional dysfunction. It may prove useful in assessment of dysphagia severity and longitudinal change.
Adolescent↗
Treating vulvar vestibulitis with electromyographic biofeedback of pelvic floor musculature.
OBJECTIVE: To evaluate the effectiveness of electromyographic biofeedback of pelvic floor musculature in the management of patients with moderate to severe vulvar vestibulitis syndrome. STUDY DESIGN: Twenty-nine patients with moderate to severe vulvar vestibulitis syndrome were included in this study. Each patient was given a computerized electromyographic assessment of pelvic floor muscles. She was then provided with a portable electromyographic home trainer biofeedback device, and specific instructions were given to perform biofeedback-assisted pelvic floor muscle rehabilitation exercises. The patients received monthly evaluations of the pelvic floor muscles to ensure and motivate compliance and to monitor improvement and symptom changes. Patients were evaluated on a monthly basis for vestibulodynia and dyspareunia. RESULTS: Fifteen of the 29 treated patients (51.7%) demonstrated markedly decreased introital tenderness, and 14 of them (93.3%) were able to resume sexual activity without discomfort. Nine patients (31.0%) demonstrated a significant decrease in introital tenderness and pain, and six of the nine (66.7%) resumed sexual activity. Thus, 20 of the 29 women (69%) became sexually active. Following completion of treatment, 24 (88.9%) reported negligible or mild pain. Five of the 29 did not show any significant improvement, and none of them were able to resume sexual activity. Within six months of the start of therapy, 90% ultimately resuming sexual activity had done so. CONCLUSION: Electromyographic biofeedback of pelvic floor musculature is an effective approach to vulvar vestibulitis.
Adult↗
Weight loss in Huntington's disease.
Explore the source record for details and available documents.
Humans↗
Measurement of cognitive performance in computer programming concept acquisition: interactive effects of visual metaphors and the cognitive style construct.
An innovative research program was devised to investigate the interactive effect of instructional strategies enhanced with text-plus-textual metaphors or text-plus-graphical metaphors, and cognitive style on the acquisition of programming concepts. The Cognitive Styles Analysis (CSA) program (Riding,1991) was used to establish the participants' cognitive style. The QUEST Interactive Test Analysis System (Adams and Khoo,1996) provided the cognitive performance measuring tool, which ensured an absence of error measurement in the programming knowledge testing instruments. Therefore, reliability of the instrumentation was assured through the calibration techniques utilized by the QUEST estimate; providing predictability of the research design. A means analysis of the QUEST data, using the Cohen (1977) approach to size effect and statistical power further quantified the significance of the findings. The experimental methodology adopted for this research links the disciplines of instructional science, cognitive psychology, and objective measurement to provide reliable mechanisms for beneficial use in the evaluation of cognitive performance by the education, training and development sectors. Furthermore, the research outcomes will be of interest to educators, cognitive psychologists, communications engineers, and computer scientists specializing in computer-human interactions.
Aptitude Tests↗
An assessment of the sensitivity of the Cedars-Sinai quantitative gated SPECT software to changes in the reconstruction of the short-axis slices.
OBJECTIVE: This study assessed whether variations in count density, reconstruction filtering parameters and the short-axis orientation selected for reconstructions of myocardial short-axis slices significantly influenced the left ventricular ejection fraction (LVEF) calculated from a gated myocardial perfusion SPECT study. METHODS: The Cedars-Sinai quantitative gated SPECT software package was used to estimate the LVEF from gated 99mTc-sestamibi and 201TI gated SPECT studies in 20 patients. Oblique slices were reconstructed 12 times for each study, independently varying the filter cutoff and the orientation of the short axis each time. RESULTS: There were no clinically significant changes in the LVEF over the range of cutoff frequencies or orientation for either the 201TI or 99mTc-sestamibi studies. There was excellent agreement between the LVEF calculated from the 201TI and 99mTc-sestamibi studies on the same patients using the default filter (mean difference = 0.25% points). CONCLUSIONS: The Cedars-Sinai quantitative gated SPECT software package for parallel-hole collimators can be used with confidence to obtain an LVEF, and is not sensitive to variations in count density, filtering parameters or short-axis orientation.
Algorithms↗
Effects of publicity and a warning letter on illegal cigarette sales to minors.
The study aimed to assess rates of illegal cigarette sales to children and the impact on these rates of publicity and a warning letter threatening prosecution. Children aged 12 and 13 made two repeat purchasing attempts, three months apart, at 255 randomly selected tobacco retail outlets in Sydney. A randomly selected 50 per cent of retail outlets which sold cigarettes illegally at the first attempt were sent warning letters threatening prosecution. Publicity about the undercover buying operation was organised between the attempts. At the first attempts, 39 per cent of shops sold cigarettes to the children and 32 per cent sold them at the second attempt. Shops which sold on the first occasion and received warning letters reduced selling by 69 per cent compared to the 40 per cent reduction in shops which sold cigarettes on the first attempt and were not sent warning letters, a net reduction of 29 per cent seemingly attributable to the warning letters (95 per cent confidence interval 8 per cent to 50 per cent). It is extremely easy for children as young as 12 to buy cigarettes. The combined effects of publicity about undercover buying operations and warning letters threatening prosecution seem capable of reducing selling by about 29 per cent. Because of inconsistencies in selling or refusals, future attempts to measure selling rates to children should use repeat purchasing attempts and classify outlets as 'selling', 'not selling' or 'sometimes selling'.
Adolescent↗
Influence of aging on oral-pharyngeal bolus transit and clearance during swallowing: scintigraphic study.
The aim of the study was to determine the influence of normal aging on regional transit and the efficiency of bolus clearance during the oral and pharyngeal phases of swallowing. We compared scintigraphically derived oral-pharyngeal transit times and isotope clearance during swallowing in 21 healthy aged volunteers (mean age 68 +/- 8 yr) and 9 young controls (mean age 28 +/- 7.5 yr). Subjects swallowed 5- and 10-ml water boluses mixed with 30 MBq 99mtechnetium tin colloid. Oral and pharyngeal transit times, pharyngeal clearance time, and postswallow residual counts in each region were derived from time-activity curves. Pharyngeal residual counts were significantly greater in the aged than in controls (P = 0.0008), but age did not influence oral residual. Aging significantly prolonged oral transit time (P = 0.02), pharyngeal transit time (P = 0.0004), and pharyngeal clearance time (P = 0.0001). We conclude that normal impairs the efficiency of pharyngeal clearance during swallowing, prolongs scintigraphic measures of oral-pharyngeal transit, and increases the exposure time of the glottis to the swallowed bolus.
Adult↗
Evaluation of white cell scintigraphy using indium-111 and technetium-99m labelled leucocytes.
Indium-111 oxine labelled leucocyte (111In oxine leucocyte) scintigraphy is the test of choice in detecting occult infection and localising focal inflammation. 111In oxine labelling is technically difficult and expensive and leucocyte labelling with technetium-99m stannous colloid (99mTc Sn colloid) has been considered to be an alternative. Leucocytes from 40 cases referred for investigation of occult infection or localisation of inflammation were simultaneously labelled with 111In oxine and 99mTc Sn colloid with dual isotope acquisition performed at 1, 3 and 24 h. Twenty-four hour 99mTc Sn colloid scans were corrected for 111In downscatter. Each case was independently interpreted by two experienced observers. Twenty-one patients demonstrated positive 111In oxine leucocyte scans. Using 111In oxine leucocyte scans as the gold standard, 99mTc Sn colloid leucocyte scanning had an overall sensitivity of 86% and a specificity of 95%. Clinical follow-up verified that three patients had false negative 99mTc Sn colloid leucocyte scans and one patient had a false positive. Further clinical evaluation of 99mTc Sn colloid labelled leucocytes is required before they can become a reliable replacement for 111In oxine leucocytes.
Colloids↗
The RL neurovirulence locus in herpes simplex virus type 2 strain HG52 plays no role in latency.
We have demonstrated that the variant JH2604 of the herpes simplex virus type 2 (HSV-2) strain HG52 is completely avirulent in BALB/c mice following intracranial inoculation, with an LD50 of greater than 10(7) p.f.u./mouse compared to the wild-type LD50 of less than 10(2) p.f.u./mouse. In JH2604, a 1.5 kbp deletion extends from the DR1/Ub junction of the 'a' sequence to 511 bp upstream of the 5' end of IE1 in both long repeats. We have since constructed a second variant (2701) in which only 850 bp are removed from the RL. This deletion lies entirely within the sequences deleted in JH2604 and leaves intact most of a short 189 bp open reading frame (ORF) highly conserved between HSV-1 and HSV-2. Like JH2604, 2701 shows wild-type growth characteristics and is neither host range- nor temperature-restricted. This was most noteworthy in the case of mouse 3T6 cells. 2701 has an LD50 of 5 x 10(5) p.f.u./mouse on intracranial inoculation, a value intermediate between those of HG52 and JH2604. In assays for intracranial replication, JH2604 exhibits no detectable growth with a rapid decline in virus titre, 2701 shows limited growth over the first 24 to 36 h post-inoculation before the titre again declines and HG52 grows rapidly, reaching a high titre until the mice die. Taken together these results suggest that a region of the genome upstream of IE1 encodes a gene product essential for HSV replication in neurons of the central nervous system. It is highly likely that the conserved ORF is in an important region of a polypeptide essential for neurovirulence, although the upstream sequences present in 2701 but absent from JH2604 must also play a role. Although JH2604 and 2701 are avirulent, they both establish latent infection in the dorsal root ganglia of BALB/c mice and reactivate in vitro in a manner indistinguishable from HG52. This suggests a distinct separation of the factors involved in neurovirulence and the establishment of/reactivation from latency.
Animals↗
Immunogenicity and pathogenicity of temperature-sensitive modified respiratory syncytial virus in adult volunteers.
Single temperature-sensitive (ts) mutants of a subgroup A strain of respiratory syncytial (RS) virus whose multiplication is restricted at 39 degrees C in MRC-6 cells and double ts mutants that are restricted at 38 degrees C, were obtained following mutagenesis using 5-fluorouracil and acridine-like compounds. Isolation and propagation of the parental RSS-2 strain of RS virus and its derived ts mutants were carried out entirely in MRC-5 human diploid cells. The immunogenicity and disease-producing ability of four of these mutants and the parental unmodified strain have been assessed by intranasal administration into groups of about 20 adult volunteers. The results of these trials indicate that the capacity of the parental RSS-2 strain to produce upper respiratory tract infection in adults was not diminished by limited propagation in MRC-5 cells. The mutants on the other hand were impaired in this respect to varying extents. The double mutant tslB in particular has characteristics that suggest that it may be suitable for further development as a live RS virus vaccine. It retained near normal immunogenicity and replicative ability in the upper respiratory tract, while exhibiting greatly reduced disease-producing potential.
Adult↗
Variant forms of ataxia telangiectasia.
Two ataxia telangiectasia patients with unusual clinical and cellular features are described. Cultured fibroblasts and PHA stimulated lymphocytes from these two patients showed a smaller increase of radiosensitivity than cells from other A-T patients, as measured by colony forming ability or induced chromosome damage respectively, after exposure to ionising radiation. The response of DNA synthesis to irradiation of these cells was, however, the same as for other A-T patients. Cells from a third patient with some clinical features of A-T but with a very protracted course also showed low levels of radiation induced chromosome damage, but colony forming ability and the response of DNA synthesis after irradiation were no different from cells of normal subjects. There was, however, an increased level of translocations and unstable chromosomal rearrangements in this patient's lymphocytes.
Adolescent↗
Incontinentia pigmenti in a boy with Klinefelter's syndrome.
A boy with the cutaneous lesions of incontinentia pigmenti is described. Chromosomal analysis revealed the 47,XXY karyotype of Klinefelter's syndrome. Since incontinentia pigmenti trait is usually lethal in males, the possibility of the second X chromosome protecting against fetal death is discussed.
Genes, Dominant↗
X linked muscular dystrophy with contractures.
Another family with X linked muscular dystrophy affecting particularly the humeral and tibial muscles is described. Cardiomyopathy in the eldest male necessitated the insertion of a pacemaker.
Adolescent↗
A familial insertion involving an active nucleolar organiser within chromosome 12.
As far as the authors are aware this is the first report of the insertion of an active NOR into a non-acrocentric chromosome, although a simple translocation involving an active NOR has been previously recorded. More specifically, this case involves the non-reciprocal translocation of the centromere and stalk of an acrocentric into 12p, generating an apparently stable dicentric chromosome. The insertion is seen in three generations and may be relatively genetically benign. The abnormality is fully described by G and sequential C banding, DA/DAPI fluorescence, kinetochore staining, and Ag-NOR staining, and the findings are discussed in the light of the limited published reports of insertion in man.
Chromosomes, Human, 6-12 and X↗
Menkes kinky hair disease: a search for closely linked restriction fragment length polymorphism.
In a large kindred with X-linked Menkes disease, linkage studies were performed with a restriction fragment length polymorphism (RFLP) that had been found with a cloned hybridisation probe from the proximal short arm of the X chromosome. This RFLP was considered as a potential genetic marker since the Menkes gene seems to be located near the centromere. Moreover, there is circumstantial evidence that in the (para) centric region of the X chromosome cross-overs are relatively rare. Unexpectedly, however, at least two cross-overs were detected in this family which suggests that the DNA sequence employed is of limited use for early diagnosis and carrier detection in this fatal hereditary disorder.
Alleles↗
Serum antibody to poliovirus in patients in a mental deficiency hospital, with particular reference to Down's syndrome.
Neutralization tests for poliovirus antibodies were carried out on 74 patients in an adult mental deficiency hospital: 37 patients with Down's syndrome and 37 non-Down's mental defectives. The distribution of antibody titres to poliovirus types 1, 2 and 3 did not differ significantly between the two groups. Most patients had antibody to at least one poliovirus type but less than a third had antibodies at a titre of 1/8 or greater to all three types. The low level of poliovirus immunity in this population may be of epidemiological importance.
Adolescent↗