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Biomedical subjects

J H Fuller

Publications and source records attributed to J H Fuller.

At least 109 records · Page 6Linked to original sources
PubMed1989

Blood pressure, proteinuria and their relationship with circulatory mortality: the WHO Multinational Study of Vascular Disease in Diabetics.

A study has been made of hypertension and its associated vascular risk in 2319 male and 2412 female participants in the WHO Multinational Study of Vascular Disease in Diabetics. Rates of hypertension were higher in non insulin-dependent diabetics (NIDDs) compared with insulin-dependent diabetics (IDDs). On average, diastolic blood pressures were lower in IDDs than NIDDs. The frequency of isolated systolic hypertension varied between 2.5% and 5.6%. In a 6 to 7 year mortality follow-up, hypertension was significantly associated with an increased risk of circulatory death, even allowing for its association with proteinuria.

Adult↗
PubMed1988

The relationship of high density lipoprotein subfractions to alcohol consumption, other lifestyle factors, and coronary heart disease.

Serum high density lipoprotein (HDL) levels are inversely related to the risk of coronary heart disease. Controversy exists regarding the relative importance of HDL subfractions, and few studies have related subfraction levels to lifestyle factors associated with coronary risk. We examined the relationship of the major subfractions, HDL2 and HDL3, to alcohol consumption, cigarette smoking, physical exercise, body mass index, and socioeconomic status in 88 men and 49 women aged 35-64 years. Body mass index was inversely related to HDL2-cholesterol (C), particularly in men, but had no significant relationship with HDL3-C. Cigarette smoking and degree of physical exercise were not significantly related to either HDL subfraction. Alcohol consumption had a strong positive correlation with HDL3-C in both sexes; this association was statistically significant after controlling for cigarette smoking, body mass index, and serum triglyceride. Minnesota-coded ECG abnormalities and positive responses to the WHO chest pain questionnaire were associated with lower levels of HDL-C and HDL2-C in both sexes, and significantly lowered levels of HDL3-C in men but not women. These findings suggest that HDL3-C, as well as HDL2-C, may be related to coronary risk, and indicate that the protective effects of alcohol consumption may be mediated via this subfraction.

Adult↗
PubMed1988

Depression and diabetes.

The incidence and prevalence of depression in diabetic patients in the United Kingdom is unknown. Since depression may influence blood glucose control which in turn may be related to the development of diabetic complications, it is important to estimate its prevalence in diabetic patients. The prevalence of depression was investigated in a group of Caucasian and West Indian, insulin-(IDDM) and non-insulin-dependent (NIDDM) adult diabetics and a non-diabetic comparison group. Prevalence of depression was 8.5% for both groups and a further 19.2% and 14.6%, respectively, had borderline depression. Presence of depression was unrelated to sex, ethnic group, duration or type (IDDM or NIDDM) of diabetes and social class but significantly related to type of accommodation, marital status, and amount of social contact. A higher percentage of diabetics with psychiatric symptoms had one or more current complications compared to 'normal' diabetics. Diabetics suffer from a similar amount of depression to non-diabetics, but psychiatric symptoms may be related to the frequency of diabetic complications.

Adult↗
PubMed1987

Head movements during optokinetic stimulation in the alert rabbit.

Pigmented rabbits with their heads free to move about the vertical axis were seated inside a rotating optokinetic drum in order to evoke the optocollic reflex (OCR). At drum velocities below 5 degrees/s, head movements were inconsequential, and eye velocity generally matched drum velocity. At velocities between 5-15 degrees/s head movements were irregular and slight; head velocity was less than 20% of drum velocity, and gaze was undercompensatory by 1-3 degrees/s (retinal image motion of 1-3 degrees/s). At drum velocities above 15 degrees/s, and especially above 30 degrees/s, head movements were substantial (more than 20% of the drum velocity), but gaze was undercompensatory by 60-70% of the stimulus velocity. In the same rabbits in the same test periods and conditions, the vestibulo-collic reflex (VCR) was evoked with vision with minimal gaze undercompensation relative to a stationary surround; however, when deprived of vision the VCR gain dropped. The present results support the notion that with vision, the OCR does not contribute significantly to the improvement of the VCR response, since massive undercompensation of the gaze relative to the rotating drum was required in OCR testing to evoke head movements similar to those seen in VCR tests. Due to many differences in operating characteristics of the vestibular and optokinetic systems, and due to the nature of OCR testing, there were several unexpected results: in some cases head movements did not result in summation of vestibular and optokinetic reflexes, and with sinusoidal drum rotations of about 2 degrees/s2 peak acceleration there was overcompensation (gaze moves faster than the drum) for intervals up to 20 s. Thus, optokinetically generated active head movements could produce behavior strongly contrasting with passively induced head movements in visual-vestibular tests. It is tentatively concluded that in mammals there is a vestigial and specific optokinetic control of gaze and that the optokinetic control of the head is weak (relative to the eyes). However, other non-reflex mechanisms controlling head movements-such as stimulus entrainment and temporal asymmetries in the vestibular and optokinetic reflexes-must also be considered to explain all facets of the data.

Animals↗
PubMed1987

The force-velocity relation of the rabbit digastric muscle.

In 30 animals, the digastric was made to pull actively against a slide loaded by a servo-controlled linear motor. Force and velocity were recorded at the end of active shortening to the in-situ (jaw-closed) muscle length. Passive and active force-length relations were also determined in 17 of the rabbits. The empirical force-velocity data were fitted to a hyperbolic equation. The average speed of muscle shortening at zero load was 14.67 cm/s. Mean maximum isometric force at in-situ length (P0) was 1267 g, and the mean ratio a/P0 was 0.18. The average time-to-peak twitch tension was 31.8 ms under isometric conditions. In-situ muscle-belly length was about 3 per cent less than optimum length for isometric force. Maximum muscle force was positively correlated with animal size, but maximum velocity showed no relation to force or length. The estimated maximum speed of sarcomere shortening was 26 micron/s, which is slightly slower than in fast limb muscles of the cat, and may indicate the presence of both histochemical type I and II fibres. The isometric force after shortening had ceased was less than P0, and was correlated with the velocity during shortening. This depression of isometric force may result from an alteration of the excitation-coupling system during activation. These observations suggest a role for the digastric in the rapid acceleration and deceleration of the mandible near the jaw-closed position during opening and closing.

Animals↗
PubMed1985

Role of life events and difficulties in the onset of diabetes mellitus.

The role of stressful life and difficulties in the onset of insulin-dependent (Type 1) diabetes mellitus was examined in a group of 13 newly diagnosed diabetics and sibling and neighbourhood controls. Subjects aged between 17-34 years, were interviewed and information was collected over the 3 year period preceding clinical diagnosis of diabetes. Diabetics had a higher frequency of one or more severe life events prior to diagnosis i.e. 77% compared with their siblings and age/sex matched controls i.e. 39% and 15% respectively. Diabetics also had a higher percentage of 2 or more severe life events prior to diagnosis i.e. 54% compared with 8% for siblings and 8% for neighbourhood controls. The frequency of severe difficulties was also higher for diabetics--46% compared with 13% and 23% for siblings and neighbourhood controls respectively. Stressful events and difficulties may be triggering factors involved in the aetiology of insulin-dependent diabetes.

Adolescent↗
PubMed1985

Eye and head movements in the pigmented rat.

Vestibular, optokinetic, and spontaneous eye and head movements have been examined in the hooded rat. Eye movement range was 18-20 degrees, and frequency of ocular saccades was 5-20/min; there was a weak linkage of eye and head movements and a weak vestibulocollic reflex. Response to optokinetic stimulation with unity gain (eye velocity matches drum velocity) was seen only at velocities below 1 deg/sec; maximal eye velocity evoked by drum velocities of over 20 deg/sec never exceeded 4-6 deg/sec. These motor responses were not altered by head movements: thus, gaze velocity is not improved by optocollic (head movement) responses, and such optocollic activity occurs only when substantial retinal image motion is present.

Animals↗
PubMed1985

Cervicocollic reflex: its dynamic properties and interaction with vestibular reflexes.

Electromyographic activity of dorsal neck muscles elicited by sinusoidal rotations of the body and head was studied in decerebrate cats over a wide range of rotational frequencies and amplitudes. Rotation of the body with the head held fixed in space elicited a cervicocollic reflex (CCR) in the biventer cervicis, complexus, obliquus capitis inferior, rectus capitis major, and splenius muscles. As stimulus amplitude increased, CCR amplitude increased first rapidly and then more slowly, displaying two linear incremental sensitivity ranges. In contrast, the vestibulocollic reflex (VCR) elicited by whole body rotation had a minimum stimulus threshold below which no response was observed, whereas the vestibuloocular reflex (VOR) saturated at intermediate stimulus intensities. When stimulus frequency was varied, the CCR exhibited second-order dynamic behavior. At frequencies below 0.5 Hz, muscle EMG activation was in phase with peak platform angular deviation in the direction that stretched the muscle, and the gain measured as the percent modulation of EMG activity per degree of rotation remained constant. As frequency increased to 3-4 Hz, response phase advanced by 120 deg or more and gain increased with a slope approaching 40 dB/decade. The data were well-fitted by second-order transfer functions containing two zeros. Both the dynamic behavior of the CCR and its high sensitivity to small stimuli resemble the properties of muscle spindle primary afferents, suggesting that the latter may provide the major input responsible for the CCR. Dynamic properties and gains of the CCR and VCR were quite similar at frequencies between 0.2 and 3-4 Hz. Transfer functions of both reflexes contained two zeros whose time constants were correlated in a population of 11 cats, suggesting that reflex dynamics may be matched to the mechanical properties of each animal's head-neck system. Interaction of the CCR and VCR was studied under two conditions. When the head was driven by a servomotor while the body remained stationary, EMG activation by the two reflexes added linearly to produce a large response. When the body was rotated with the head allowed to counterrotate about the C1-C2 joint, the two reflexes combined linearly in an antagonistic fashion: the CCR acted to oppose head rotations produced by the VCR, thus preventing the ratio of head counterrotation to body rotation from exceeding 0.5. The data indicate that the CCR and VCR behave approximately linearly, both individually and in combination. Acting together, the two reflexes assist each other in preventing oscillation of the head on a stationary body.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1985

Causes of death in diabetes mellitus.

The main sources of information on diabetes mortality are national mortality statistics, insurance studies and follow-up studies of defined cohorts of diabetics. The problems of the diagnostic accuracy of death certification in relation to diabetes mellitus are examined. The major causes of death in diabetics are discussed, as are recent time trends in diabetes mortality.

Actuarial Analysis↗
PubMed1984

Social class and risk factors for vascular disease in diabetes.

Mortality statistics for England and Wales and for the U.S.A. indicate that death rates from diabetes mellitus are higher in the lower socioeconomic classes. In an attempt to explain this mortality difference, social-class differences in possible risk factors for the large- and small-vessel disease complications of diabetes have been examined in 95 insulin dependent diabetics (IDDs) and 79 non-insulin dependent diabetics (NIDDs) and comparative data obtained from 155 non-diabetic controls. Control males in the lower social class group were significantly shorter, more obese, smoked more and had lower Type A behaviour scores. Lower class female controls had significantly higher serum cholesterol levels. For the diabetic groups there were no social class differences in either fasting blood glucose levels or the prevalence of diabetic complications. Lower class NIDDs were significantly shorter and had lower Type A scores. This group also had higher mean cholesterol levels and smoked more, but these differences did not achieve statistical significance. Male IDDs showed no significant social class differences in possible risk factors but lower class females IDDs smoked more and had higher mean triglyceride levels. This concentration of risk factors for vascular disease in the diabetics of lower social class, particularly the NIDDs, may partly explain the increased mortality found in this group.

Adult↗
PubMed1983

Mortality from coronary heart disease and stroke in relation to degree of glycaemia: the Whitehall study.

In the Whitehall study of 18 403 male civil servants aged 40-64 years the 10 year mortality rates from coronary heart disease and stroke showed a non-linear relation to two hour blood glucose values, with a significantly increased risk for glucose intolerant subjects with concentrations above the 95th centile point (5.4-11.0 mmol/l; 96-199 mg/100 ml) and for diabetics (blood glucose greater than or equal to 11.1 mmol/l; greater than or equal to 200 mg/100 ml). Multiple logistic analysis showed that between one half and three quarters of the relative risks for deaths from coronary heart disease and stroke were "unexplained" by between group differences in risk factors such as age, blood pressure, obesity, smoking, cholesterol concentration, and electrocardiographic abnormalities. Within the glucose intolerant and diabetic groups the risk factors most strongly related to subsequent death from coronary heart disease were age and blood pressure, with less consistent relations for smoking, cholesterol concentration, and obesity. This study confirms the importance of hypertension as a cardiovascular risk factor in groups with glucose intolerance and diabetes, and this may have important preventive implications.

Adult↗
PubMed1983

Vestibular-oculomotor interaction in cat eye-head movements.

When cats make slow scanning head movements, intersaccadic counterrotary eye movements are driven by the vestibulo-ocular reflex, but reset or forward saccades are not directly affected by vestibular afference. When the movements are rapid (approximately 200 deg./sec), large (greater than 40 degrees), and executed in single step shifts gaze (whether in the dark or during visual fixation shifts between known targets), there is no longer any clear vestibular effect on any eye movements during the gaze shift. The vestibulo-ocular reflex is active only at the beginning of head rotation and again at its termination as the gaze reaches its goal, even in the absence of vision. It is postulated that head-in-space and eye-in-orbit movements are perfectly monitored to adjust the amplitude of gaze shifts, despite the lack of overt vestibular effects on eye movements.

Animals↗
PubMed1983

Diabetes mortality: new light on an underestimated public health problem.

Mortality from diabetes is underestimated four- to fivefold by methods of analysis of death certification data which use only underlying cause of death. This problem is partially overcome by coding all conditions mentioned on death certificates. For a sample of deaths in England and Wales over the years 1972-1977, the observed proportion of certificates with specific underlying causes of death for certificates mentioning diabetes was compared with the expected proportion for all certificates. These observed/expected ratios were significantly increased in each sex for circulatory diseases and were significantly reduced for neoplasms. For 'nephritis' they were also increased, especially below 45 years of age. These results were confirmed by an analysis of underlying cause of death in a cohort of nearly 6,000 members of the British Diabetic Association. Of the 2,134 deaths in this cohort, diabetes was not mentioned on 33% of the death certificates. For the period 1972-1977, death rates for circulatory diseases associated with diabetes increased by 6% for males but remained constant for females.

Adolescent↗
PubMed1982

Interrelationships of microangiopathy, plasma glucose and other risk factors in 3583 diabetic patients: a multinational study.

In a multinational study, fasting plasma glucose values in 3583 diabetic patients, aged 34-56 years, were related to the characteristics of these subjects and to the presence and severity of microangiopathy as ascertained by standardised methods. The patients were from nine different populations and ranged in number from 193 to 686 per population (London, Warsaw, Berlin (FRG), New Delhi, Tokyo, Havana, Oklahoma Indians, Arizona Pima Indians, and a national sample in Switzerland). In the total group, mean fasting plasma glucose was 8.1 mmol/l for those on diet alone, 9.7 mmol/l for those on oral agents, and 12.7 mmol/l for insulin-treated patients, of whom 25% had values exceeding 16.5 mmol/l. Since many variables were measured in each patient, it was possible to take into account many confounding factors in evaluating the relationship of plasma glucose levels to retinopathy and nephropathy.

Adult↗
PubMed1982

High density lipoprotein subfractions in insulin-dependent diabetic and normal subjects.

Serum lipoproteins have been separated by preparative ultracentrifugation in randomly selected groups of insulin-dependent diabetics and in age- and sex-matched non-diabetic controls. The major high density lipoprotein (HDL) subclass; HDL2 (density (d) 1.063-1.125 kg X m-3) and HDL3 (d greater than 1.125) and the further fractions of HDL2:HDL2b (d 1.063-1.100) and HDL2a (d 1.100-1.125) were also separated and their cholesterol (C) concentrations determined. These diabetic men and women were relatively normolipaemic and the major difference from controls was a significantly raised total HDL-C in men which was confirmed by a separate chemical precipitation method. This increase was associated with a significant rise in HDL2a-C and in total HDL2-C concentration. The non-significant increase in diabetic women compared to men was associated with poorer metabolic control. Among factors influencing serum HDL2-C concentration, the most important was the negative association with the level of very low density lipoprotein-triglycerides. Although insulin-dependent diabetics have an increased risk of atherosclerotic coronary heart disease (CHD), this is not reflected in their HDL subfraction-C distribution which, if present in non-diabetics, would be expected to confer protection from CHD.

Adult↗