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Biomedical subjects

J Hogg

Publications and source records attributed to J Hogg.

At least 19 recordsLinked to original sources
PubMed2000

Continuity and change in the use of residential services by adults with intellectual disability: the Aberdeen cohort at mid-life.

The present paper reports a follow-up study of a representative cohort of people with intellectual disability, now in middle age, who entered adult services on leaving school in the late 1960s, and whose adult years have coincided with a period of radical policy change and considerable service expansion. The present authors focus on the changes which have taken place in their use of residential services over this period. Firstly, the situation in early adulthood when they were last studied is examined. At this time, 60% of the cohort were still living at home, almost all with both parents. The remaining 40% were in institutions, mainly long-stay mental handicap hospitals. Out-of-home placement is associated with gender (maleness), challenging behaviour, and the absence of one or both parents. The present authors compare this with the situation 20 years later. The most significant change in this time is the expansion of the community sector, accounting for about half of the surviving cohort, with numbers still at home or in hospital correspondingly reduced. Almost half of the cohort had experienced little or no change in residential situation. On average, they were less intellectually and socially able than those who had moved into community provision.

Activities of Daily Living↗
PubMed1999

Behavior states: now you see them, now you don't.

Guess, Roberts, Behrens, and Rues (1998) presented reliability data from recordings of behavior state using a 13-category coding system. Interobserver agreement was reported at 63% to 91% across categories. In an attempt at replication, we found lower levels of reliability (0% to 80%). To determine the reasons for different results, we obtained measurements of behavior states from video-recordings by five of Guess et al.'s observers. Again, replication was unsuccessful. Obtained mean percentage agreement on occurrence for individual behavior states and participants ranged across observer pairs from 0% to 58% (kappa range was 0 to .64). Some possible reasons for failures to replicate are discussed.

Humans↗
PubMed1999

Cellular distribution and ontogeny of insulin-like growth factors (IGFs) and IGF binding protein messenger RNAs and peptides in developing rat pancreas.

To determine the role of insulin-like growth factors (IGFs) and their binding proteins (IGFBPs) in the development of the pancreas, and specifically of the islets of Langerhans, we have examined the cellular distribution and developmental changes in the expression of IGFs and IGFBPs in the pancreas of the fetal and neonatal rat between 19.5 days of gestation and postnatal day 28. This represents a period of substantial growth and restructuring of the beta cell component in islets of this species. IGF-I, IGF-II, and IGFBPs-1 to -6 mRNAs were localized by in situ hybridization, and peptides by immunohistochemistry, in histological sections. IGF-II mRNA was highly expressed in islet cells and some ductal epithelial cells in late fetal and early neonatal life, but was barely detectable by postnatal day 28. IGF-II peptide showed a similar distribution. IGF-I mRNA was barely detected in the fetus or neonate and was localized predominantly in the ductal and acinar tissues after postnatal day 7. IGF-I immunoreactivity was associated with some islet cells in the fetus and neonate, suggesting an endocrine rather than a paracrine source. We performed co-localization studies to assess whether the distribution of IGFs within the pancreas might be due to a sequestration by locally produced IGFBPs. The presence of mRNAs for both IGFBPs-1 and -2 was minimal in the pancreas prior to postnatal day 7, although subsequently IGFBP-1 mRNA was seen in islet cells, while IGFBP-2 mRNA was localized in both islets and acinar tissues. In contrast, both IGFBPs-1 and -2 immunoreactivities were identified in islets from late fetal life, suggesting a circulatory source for these IGFBPs during early pancreatic development. IGFBPs-3 to -5 mRNAs and immunoreactivities were identified within islet cells throughout fetal and neonatal life, with IGFBPs-3 and -5 being mainly associated with the alpha cell-rich islet mantle. The results show a compartmentalization of IGFs within pancreatic tissue, reflecting both paracrine and endocrine sources. The localization and action of IGFs in pancreas likely involves sequestration and distribution by endogenous as well as circulating IGFBPs.

Animals↗
PubMed1997

Intellectual disability and ageing: ecological perspectives from recent research.

Ageing in people with intellectual disabilities has become a central concern of service providers and research workers during the past 20 years. Their emergence as an identifiable population of older people with intellectual disabilities reflects, in part, improvements in medical and social service provision. However, interest in this group is primarily a reflection of the fact that, despite services developed in the light of principles of normalization, they remain readily identifiable as people in receipt of specialist intellectual disability services, in consequence typically clearly differentiated from the mainstream of older people generally. Analysis of this situation and other factors impacting on older people with intellectual disabilities can be undertaken through the use of ecological models conceptualized in terms of interacting, nested ecologies. The emergence of research on the impact of cultural influences on family carers and service provision is addressed within the framework of the ecological model, and methodological cautions are offered. The enduring the role of family carers and their motivation to continue caring is described.

Adult↗
PubMed1997

Interobserver agreement and disagreement in continuous recording exemplified by measurement of behavior state.

Continuous observational recording was used to measure behavior state of 3 adults with profound and multiple disabilities. Observations were made over 56.7 hours, including 21.9 hours with two observers recording independently. Overall percentage agreement was satisfactory (i.e., exceeded 80%). Agreement on occurrence was, however, generally unsatisfactory at a mean of 63.5%, with 5 of 16 Subject x State Agreement Indices over 80%. Percentage disagreement on occurrence, a previously unreported measure, was computed to quantify sources of disagreement. The agreement data were superimposed on participants' behavior state profiles to demonstrate how conclusions can be drawn from the data, despite their generally inadequate reliability. This approach to interobserver agreement and presentation of data is suggested for researchers investigating entities that are not directly amenable to observation.

Adult↗
PubMed1996

Colour duplex ultrasonography versus angiography in the diagnosis of lower-extremity arterial disease.

Colour duplex scanning is reported to be an accurate non-invasive tool for the diagnosis of lower-extremity arterial disease. The authors at the South Coast Vascular Laboratory have conducted a prospective audit to determine the efficacy of colour duplex scanning in a vascular surgical practice. The aims of this prospective trial were to compare the accuracy of colour duplex scanning with intra-arterial digital subtraction angiography (DSA) in the localization and classification of aortoiliac and femoropopliteal artery disease. Ninety-one lower limbs in 50 patients were evaluated independently by colour duplex scanning and DSA. The lower-limb vasculature was divided into eight segments: infrarenal aorta, common iliac artery, external iliac artery, common femoral artery, proximal, middle and lower thirds of the combined length of the superficial femoral and above-knee popliteal artery, and lastly the below-knee popliteal artery. A total of 558 arterial segments were examined. The Kappa value of duplex scanning compared with 'gold standard' DSA was 0.57. For detecting haemodynamically significant arterial lesions of > 50% reduction in diameter, duplex scanning had a sensitivity of 75%, specificity of 90%, positive predictive value of 77% and negative predictive value of 89% compared with DSA. The level of accuracy obtained does not support the use of duplex as a sole method of investigation for lower-extremity arterial disease in the authors' case. However, the high negative predictive value of colour duplex may be useful in excluding haemodynamically significant disease. This study emphasizes the importance of prospective auditing to determine individual accuracy with duplex examination for arterial disease, and enables clinical decision making to be based on tests with a known accuracy.

Angiography, Digital Subtraction↗
PubMed1996

Practice guidelines for the clinical assessment and care management of Alzheimer's disease and other dementias among adults with intellectual disability. AAMR-IASSID Workgroup on Practice Guidelines for Care Management of Alzheimer's Disease among Adults with Intellectual Disability.

The AAMR/IASSID practice guidelines, developed by an international workgroup, provide guidance for stage-related care management of Alzheimer's disease, and suggestions for the training and education of carers, peers, clinicians and programme staff. The guidelines suggest a three-step intervention activity process, that includes: (1) recognizing changes; (2) conducting assessments and evaluations; and (3) instituting medical and care management. They also provide guidance for public policies that reflect a commitment for aggressive care of people with Alzheimers's disease and intellectual disability, and avoidance of institutionalization solely because of a diagnosis of dementia.

Activities of Daily Living↗
PubMed1995

Gene for the catalytic subunit of mouse DNA-dependent protein kinase maps to the scid locus.

The gene encoding the catalytic subunit of DNA-dependent protein kinase (DNA-PKcs) has been proposed recently as a candidate gene for the mouse severe combined immune deficiency (scid) locus. We have used a partial cDNA clone for human DNA-PKcs to map the mouse homologue using a large interspecific backcross panel. We found that the mouse gene for DNA-PKcs does not recombine with scid, consistent with the hypothesis that scid is a mutation in the mouse gene for DNA-PKcs.

Animals↗
PubMed1995

Basic fibroblast growth factor increases dopaminergic graft survival and function in a rat model of Parkinson's disease.

The clinical use of fetal neural grafts as an intracerebral source of dopamine for patients with Parkinson's disease has met with limited success. Since basic fibroblast growth factor (bFGF) enhances the survival and growth of dopaminergic neurons in vitro, we explored whether cells genetically modified to produce bFGF would improve the functional efficacy of dopaminergic neurons implanted into rats with experimental Parkinson's disease. Results show that bFGF-producing cells grafted together with fetal dopamine neurons have potent growth-promoting effects on the implanted neurons in vivo. Moreover, rats implanted with such co-grafts display the most pronounced behavioural improvements post-grafting. These findings not only provide insight into the function of bFGF in situ, but also suggest an approach for enhancing the survival and function of dopamine neurons grafted into the damaged brain.

Animals↗
PubMed1995

Expression of biologically active basic fibroblast growth factor by genetically modified rat primary skin fibroblasts.

Basic fibroblast growth factor (FGF-2) is normally expressed as a cell-associated protein, and accordingly it is not clear how it exerts its action on target cells in vivo. It has been proposed that cells release, by death or other mechanisms, small amounts of FGF-2 that then acts in an autocrine manner. To address the question of whether it is necessary that FGF-2 remain cell associated or needs to be secreted from cells to have biological activity, we expressed the 18-kDa form of FGF-2 in primary fibroblasts as a cell-associated (FGF-2-B) or as a secreted (FGF-2-S) protein. FGF-2 protein is detected in cell lysates and membrane fractions of both cell types, whereas it is present in significant amounts only in the conditioned medium of FGF-2-S cells. No FGF-2 is detected in control (untransfected) cells. FGF-2-S cells also grow faster than the control of FGF-2-B cells. Yet, when evaluated for their ability to promote the survival of embryonic hippocampal neurons in vitro, both the cell types are active, establishing the activity of the transgene product. We conclude that FGF-2 is active when engineered to be expressed as a cell-associated form or secreted from cells.

Animals↗
PubMed1995

The applicability of the Kaufman Assessment Battery for Children (K-ABC) with older adults (50+ years) with moderate, severe and profound intellectual impairment.

To define the intellectual characteristics of a population of older people (50+ years) with severe intellectual impairment who were the focus of a wider demographic study, participants were assessed on the Kaufman Assessment Battery for Children (K-ABC). Test material was modified to make it age-appropriate and culturally suitable. Of the 122 people in the population [chronological age (CA) = 63.5 years; range 50-90 years], 61 were successfully tested on the K-ABC (CA = 60.9 years; range 51-81 years). Factor analysis closely replicated the factorial structure demonstrated for younger children. Separate Sequential and Simultaneous Mental Processing factors were identified, with subtests from the Achievement Scale loading on these factors and not constituting a separate factor. Application of hierarchical cluster analysis confirmed the factor structures. Inferences in relation to cognitive development from a Piagetian perspective are drawn, and the utility of information on mental processing for educational intervention with older persons with severe intellectual impairment is noted.

Achievement↗
PubMed1995

Colour-coded duplex ultrasonography in selection of patients for transluminal angioplasty.

Transluminal angioplasty can be used to relieve symptomatic lower extremity arterial disease with minimal morbidity. This prospective study compares the accuracy of colour-coded duplex ultrasonography with intra-arterial digital subtraction angiography in selection of femoro-popliteal lesions for angioplasty. Isolated, short (< 6 cm) and haemodynamically significant stenosis (> 50% reduction in diameter) were considered for angioplasty. Colour-duplex selection and exclusion was in agreement with angiography in 68 out of 86 lower limbs (79%). The sensitivity, specificity, positive and negative predictive value of colour duplex compared with angiography yielded values of 60.9, 87.5, 60.9 and 85.7%, respectively. The discrepancy between colour duplex and digital subtraction angiography can be partly explained by the tendency of duplex to underestimate the severity and length of disease. It is concluded that colour-coded duplex can be used as a screening tool for lower extremity arterial disease to select appropriate lesions for endovascular procedures. The accuracy of duplex in the present study was not perfect and the decision for further intervention should be based on clinical grounds.

Angiography, Digital Subtraction↗
PubMed1995

Analysis of breakthrough pain in 50 patients treated with intrathecal morphine infusion therapy. Development of tolerance or infusion system malfunction.

Fifty patients with intractable benign pain were treated with intrathecal morphine (IT-MS) infusion therapy. Median follow-up was 39 months (range 5-70). Breakthrough pain was reported in 45 (90%) patients in 75 outpatient clinic events. A diagnostic algorithm was developed to evaluate and efficiently treat these patients. A programmed bolus (50% of daily dose) identified that 50 (67%) breakthrough events where due to partial tolerance to the IT-MS. Radiographic survey of the catheters identified malfunctions in 11 patients. Attempts to withdraw CSF from the side-port demonstrated obstruction in 7 due to kinking not seen on X-rays. Side-port myelography demonstrated scarring that obstructed the flow of morphine to the spinal cord in 2 patients. Benefits were regained after all surgical catheter corrections. In total, partial tolerance was seen in 23 patients (46%) during 50 (67%) breakthrough events, 15 patients (30%) required 22 catheter revisions during 27% of breakthrough events and 2 patients had progressive disease. True tolerance was encountered in only 5 patients (10%) during 5 (7%) breakthrough pain events.

Adult↗
PubMed1995

Distribution of integrins alpha v beta 6 and alpha 9 beta 1 and their known ligands, fibronectin and tenascin, in human airways.

We have previously identified two integrins, alpha 9 beta 1 and alpha v beta 6, from guinea pig airway epithelium. The extracellular matrix protein tenascin is a ligand for both of these receptors, and fibronectin is also a ligand for alpha v beta 6. In the present study, we used immunohistochemistry to examine the expression and spatial distribution of the alpha 9 subunit, alpha v beta 6, tenascin, and fibronectin in the proximal airways of 10 normal nonsmoking subjects and eight patients undergoing lung resection for cancer. We also performed the same analyses on sections of peripheral lung obtained from an additional seven subjects undergoing lung resection. alpha 9 was highly expressed throughout the airway epithelium (but not on alveolar epithelium) irrespective of clinical status. In contrast, alpha v beta 6 was expressed on proximal airway epithelial cells in four of eight smokers undergoing lung resection, but in none of the normal subjects and none of the distal airways examined. On bronchial epithelial cells cultured from resected airways, alpha v beta 6 was highly expressed on cells grown from patients who did not appear to express the receptor in vivo, as well as from subjects who did, suggesting that some component of the in vitro environment can induce expression. Although both tenascin and fibronectin were present below the proximal airway epithelium of both normal nonsmoking subjects and smokers, the spatial patterns of integrin and ligand expression were not congruent, because the integrins were present diffusely on the cell surface and on some cells that were not in contact with the basement membrane, whereas the ligands were present principally in the subepithelial layer. These findings are compatible with the existence of as-yet unidentified ligands for each of these integrins--for example, ligands involved in homotypic cell-cell interactions within the epithelium.

Biopsy↗
PubMed1995

Malignant melanoma of the lacrimal sac.

Although malignancies of the lacrimal sac are rare, malignant melanoma of the lacrimal sac is an exceedingly rare occurrence. Patients with abnormalities of the nasolacrimal system may come to otolaryngologists for evaluation. Treatment of lacrimal sac malignancies will necessitate consultation of a head and neck surgeon. The triad of symptoms commonly found in these patients includes epiphora, bloody reflux from the lacrimal punctum, and a medial canthal mass. Early local recurrence occurs frequently. Radical surgical treatment, including wide-field en bloc resection of the entire nasolacrimal system, affords the best protection against local recurrence and provides the best opportunity for enhanced patient survival. Adjunctive therapy in this disorder remains controversial.

Humans↗
PubMed1994

Effects of ischaemia on neurotransmitter release from the isolated retina.

The effects of "ischaemia" (glucose-free Krebs-bicarbonate medium gassed with N2/CO2) on the release of glutamate and other major neurotransmitters in the retina were examined using the isolated rat and rabbit retina. Amino acid transmitters, acetylcholine, and dopamine were measured by HPLC. The release of glutamate, aspartate, GABA, and glycine from ischaemic retinas was more than doubled after 30 min, and after 90 min of ischaemia the release of amino acids was approximately 15-20-fold that of control values. Ischaemia also produced large increases in the release of dopamine from both the rat and especially the rabbit retina. In contrast, the release of acetylcholine from the rat retina was significantly decreased by ischaemia, although the release of choline was increased. Because the ischaemia-induced release of glutamate, aspartate, and GABA from the rat retina was completely Ca independent, and exposure of the retina to high K (50 mM) did not stimulate amino acid release, it is concluded that the mechanisms underlying the ischaemia-induced release do not involve an initial release of K or an influx of calcium.

Acetylcholine↗