PubMed Health⌕ Search

Biomedical subjects

G R Milner

Publications and source records attributed to G R Milner.

At least 19 recordsLinked to original sources

Neurocognitive symptoms and impairment in an HIV community clinic.

BACKGROUND: Neurocognitive impairment is a frequent complication of HIV infection and heralds a poor survival prognosis. With the availability of highly active antiretroviral therapy (HAART), survival times for HIV-infected patients have markedly increased although the effects of HAART on the prevalence of neurocognitive impairment remain uncertain. OBJECTIVE: To determine the relationship between self-reported neurocognitive symptoms and neuropsychological (NP) performance together with the impact of HAART among HIV-infected patients. METHODS: A cross-sectional study was performed in which patients without previously documented neurocognitive impairment attending an HIV community clinic were questioned about neurocognitive symptoms and a NP test battery was administered. RESULTS: Of the eighty-three patients examined, neurocognitive symptoms were reported by 34% of patients and were associated with a shorter duration of HAART and higher viral loads. Patients reporting neurocognitive symptoms were also more likely to exhibit impaired NP performance (p<0.005) with NP impairment being detected in 46% of all patients examined (12% with HIV-associated dementia). Neuropsychological impairment was directly correlated with age (p<0.001), plasma viral load (p<0.005) and inversely correlated with the number of prescribed antiretroviral drugs (p<0.01). CONCLUSIONS: These results suggest that neurocognitive symptoms are predictive of impaired NP performance and that NP impairment remains a frequent finding among older patients with higher viral loads. An increased number of antiretroviral drugs may be neuroprotective.

Adult↗

Sex determination of ancient human skeletons using DNA.

A method for determining the sex of human skeletons was developed using molecular genetic techniques. The amelogenin gene, found on the X and Y chromosomes, was examined using the polymerase chain reaction (PCR) and a nonradioactive dot blot procedure. DNA was analyzed from 20 modern individuals of known sex and 20 skeletons from an archaeological site in central Illinois dating to A.D. 1300. An independent assessment of the sex of each skeleton was made according to standard osteological methods. The sex of 19 ancient and 20 modern individuals was accurately determined using this molecular genetic technique. Molecular sex determination will be especially useful for juvenile and fragmentary remains when it is difficult, or impossible, to establish an individual's sex from morphological features.

Amelogenin↗

Colour flow mapping in the diagnosis of the calf deep vein thrombosis.

This prospective trial was organized to evaluate further the role of colour flow Doppler ultrasound techniques in the diagnosis of deep vein thrombosis (DVT) with particular reference to the isolated calf lesion. In 100 patients ultrasound was compared against the recognized gold standard of ascending venography. Fifty venograms were positive for DVT compared with 49 on ultrasound, a sensitivity of 98%. The specificity of ultrasound for DVT in the 50 patients without DVT on venography was 100%. Forty-five venograms demonstrated calf thrombus with varying proximal extent. Sixteen proved to be isolated calf lesions and these were all identified by ultrasound (100% sensitivity and specificity respectively for isolated calf DVT). In five of these isolated calf thrombus cases, results suggested that ultrasound better diagnosed the presence of thrombus. Ultrasound diagnosed significant pathology in 13 of the normal venogram patients giving an overall diagnostic yield of 62% as compared to 50% at venography.

Adolescent↗

Carnivore alteration of human bone from a late prehistoric site in Illinois.

The nature and pattern of destruction of human bone by scavenging animals, probably canids, is described for 30 Oneota skeletons from a west-central Illinois cemetery dated at ca. A.D. 1300. The most frequently damaged parts of the skeleton include bones covered by relatively little soft tissue, such as the major joints of the limbs, and those in the facial, abdominal, and gluteal regions.

Adolescent↗

Pattern matching of age-at-death distributions in paleodemographic analysis.

Model age-at-death distributions are generated from fertility and mortality rates derived from two present-day, traditional human societies with widely differing cultural systems: the !Kung hunters-and-gatherers and Yanomamo horticulturalists. Visual examination of these models demonstrates that fertility has more of an effect than mortality on the overall configuration of the age-at-death distributions of stable populations. Comparisons with a late prehistoric Oneota skeletal sample from the American Midwest illustrate how reference age-at-death schedules can be used 1) to identify whether a given skeletal sample approximates an age-at-death distribution expected of an extant human population and 2) to provide a basis for developing further testable hypotheses about the demographic and cultural characteristics of past populations.

Africa, Central↗

Assessment of bone age: a comparison of the Greulich and Pyle, and the Tanner and Whitehouse methods.

A comparison of two methods of bone-age estimation has been made using the hand and wrist radiographs of 66 boys and 58 girls. An estimate made using the specialist auxological technique of Tanner and Whitehouse was compared with three separate estimates obtained by the atlas matching method of Greulich and Pyle (1971). Two of the latter estimates were carried out by two dedicated radiologists whose results showed close agreement. The third estimate made using the Greulich and Pyle method was derived from the routine reports of a number of radiologists at initial presentation. Only in one narrow age-range for girls was there a significant inter-observer difference, and the reasons for this are discussed. Estimates made using the method of Greulich and Pyle were younger than those made using that of Tanner and Whitehouse. There was a linear relationship between the two methods for the boys but not for the girls. It is suggested that atlas matching methods still have a valuable place in non-specialist hospitals concerned with initial diagnosis rather than with the long-term care of growth problems.

Adolescent↗

Effects of glucose and amino acids on insulin, glucagon and zymogen granule size of foetal rat pancreas grown in organ culture.

Foetal rat pancreatic rudiments explanted on day 14 of gestation were grown for 6 days in organ culture in medium containing glucose (5.5(1G) or 16.5(3G)mmol/l) and amino acids at the 'physiological' (1AA) or seven times the 'physiological' (7AA) concentration. Cultures were also performed in medium to which zinc sulphate had been added at 10(-7) to 10(-5) mol/l concentration. At the end of the period of culture the diameters of insulin, glucagon and zymogen granule profiles in the rudiments were compared with those in normal 20-day foetal pancreas by quantitative morphology. The beta cell volume, the number of granules per beta cell, the insulin granular volume fraction and the area of insulin granule core and halo were also measured under selected experimental conditions. Zymogen granule profiles were largest in vivo, intermediate in diameter when grown in 1G x 7AA medium and smallest in 1G x 1AA medium. The mean diameter of glucagon granule profiles remained constant for growth in vivo, in 1G x 7AA medium. Insulin granule profiles were largest in 1G x 1AA medium or in 1G x 7AA medium, smallest in 3G x 1AA mdeium and of intermediate diameter in vivo. Amino-acid enrichment increased the diameter of insulin granules and glucose enrichment decreased it. The addition of zinc to the culture medium had no effect on insulin granule diameter. In 1G x 7AA cultures the beta cells were of similar size to those in vivo, but there were 29% fewer insulin granules per cell. The increased size of the insulin granules in 1G x 7AA cultures resulted in the insulin granule volume fraction in 1G x 7AA being 17.6 compared with 10.8% in vivo. Insulin granule cores were made larger by amino-acid enrichment of the culture medium but they were unaffected by glucose. The haloes were larger in 7AA medium and smaller in 3G medium. Glucose and amino-acid enrichment had a significant interaction on halo area, the mean area in 3G x 7AA medium being less than would have been expected from the summation of the effects of the two conditions.

Amino Acids↗

Bone marrow culture studies in refractory cytopenia and 'smouldering leukaemia'.

As an adjunct to conventional haematological and cytogenetic data, 22 cases of refractory cytopenia, and five with chronic myelomonocytic leukaemia, (CMML) were studied by bone marrow culture. Cultures from II such patients without an excess of marrow myeloblasts usually showed low, or undetectable, numbers of cells capable of giving rise to colonies of granulocytes and/or macrophages (CFUc) but near-normal numbers of cluster-forming cells and cells capable of forming erythroid colonies (CFUE). Those with similar blood pictures, but in whom the marrow contained a slight excess of myeloblasts (II cases), showed a more profound defect in growth patterns: low or undetectable numbers of CFUC, clusters and CFUE, results similar to those found in acute myeloblastic leukaemia, into which three of this group evolved. The patients with CMML gave comparatively normal CFUC, cluster and CFUE growth patterns.

Blood Platelets↗

Neonatal islet cell transplantation in the diabetic rat: effect on hepatic enzyme activity and glucose homeostasis.

Intraperitoneal transplantation of collagenase-digested, isogeneic, neonatal rat pancreatic tissue successfully reversed streptozotocin-induced diabetes in 77% of recipients. The low serum immunoreactive insulin, hyperglycaemia, glycosuria and weight loss, characteristic of the diabetic animal, were corrected and the reduced activities of hepatic glucokinase and pyruvate kinase, and the low glycogen concentration of the liver of diabetic rats were restored to normal. Forty-three per cent of the successfully transplanted rats became normoglycaemic within 1 month of transplantation whereas 57% took from 1 to 6 months to achieve normoglycaemia and displayed a mild glucose intolerance when subjected to a glucose load. The rats which had not become normoglycaemic 6 months after transplantation showed some amelioration of the diabetic state, as shown by increased serum immunoreactive insulin and hepatic glycogen concentration and a slow weight gain compared with diabetic controls.

Animals↗

Granulocyte function in myeloblastic leukaemia.

A study of granulocyte function in myeloblastic leukaemia is reported. Function was assessed by the ability of peripheral blood granulocytes to ingest and kill Candida albicans in bitro. Depressed cidal activity was observed in 11 patients with smouldering leukaemia and in 19 patients with acute myeloid leukaemia. Cidal activity was lowest in the untreated acute disease; this improved during cytoreduction therapy and was maintained when remission occurred. Leukaemic plasma depressed the function of control granulocytes; the possible role of a plasma "factor" is discussed.

BCG Vaccine↗

Chronic myelomonocytic leukaemia.

The natural history and haematological features of 18 patients with a chronic form of myelomonocytic leukaemia are described. The majority were elderly and, in this series, females predominated. Haematological prodomata, such as unexplained monocytosis, leucopenia, or thrombocytopenia were common, and the clinical onset was insidious. Splenomegaly was variable but tended to increase as the disease progressed. Anaemia was usually less than in the acute disease, unless compounded by iron deficiency. The blood film typically showed a mixed monocytosis and granulocytosis, cells in both lines showing abnormalities. 'Paramyeloid' cells, appearing in Romanowsky stained films intermediate between myelocytes and monocytes, were characteristic, although cytochemical and electron microscopical analysis suggests that these cells may be allotted to one or other cell line. The marrow aspirate was characteristically hypercellular, showed granulocytic hyperplasia, and, in contrast to the well-differentiated blood picture, the proportion of poorly differentiated cells, including blasts, was high. Serum lysozyme levels were usually raised. Five of the 18 cases survived more than 5 years, while 10 lived 2 years or longer. The morphological and clinical features form part of a spectrum including acute myelomonocytic leukaemia, into which several of the patients transformed. Recognition of the syndrome is important because the patients are probably best managed without intensive chemotherapy.

Aged↗