Biomedical subjects
Publications and source records attributed to J J White.
Cramping abdominal pain with intermittent intestinal obstruction finally prompted investigation in a 4 1/2-year-old boy with severe failure to thrive (FTT). An entero-enteric intussusception was corrected, and celiac disease was identified as the cause of his inanition. Concomitant FTT and cramping abdominal pain should prompt investigation for celiac disease and small-bowel intussusception.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The resolution of the trimethyl headgroup resonance of phosphatidylcholine (PC) and sphingomyelin (SM) in the intact human low-density lipoprotein (LDL) (1)H NMR spectrum at 600 MHz enabled the investigation of LDL surface structure and phospholipid-apoB interactions. We have previously shown that a higher proportion of PC headgroups (25-35% of total PC in LDL) compared to SM were tightly bound to apoB and therefore NMR-invisible [Murphy, H. C., et al. (1997) Biochem. Biophys. Res. Commun. 234 (3), 733-737]. In the present study, we have investigated the mobility of phospholipid (PL) headgroups, using (1)H NMR spin-spin (T(2)) relaxation measurements, in LDL isolated from nine volunteers. We show that both PC and SM exist in two additional and distinct environments indicated by the biexponential behavior of the relaxation decays in each case. The data showed that 36% of PC headgroups had a short T(2) component, mean T(2) of 31 ms, and 64% had a longer T(2) component of 54 ms. Approximately 15% of SM headgroups had a short T(2) component (mean T(2) of 27 ms) and 85% had a longer T(2) component of 78 ms. Therefore the majority of SM headgroups (85%) were more mobile than PC (P < 0.001) and since PC headgroups in organic media were more mobile than SM, we conclude that the characteristic high mobility of LDL SM is not an intrinsic property but arises from a high degree of order in molecular packing of the surface PL of human LDL. We suggest that because PC and SM interact differentially with cholesterol and possibly with neighboring phospholipids, this results in the formation of relatively long-lived microdomains of PL in vivo.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
This study demonstrates that the use of high field 1H NMR spectroscopy permits individual detection of phosphatidylcholine and sphingomyelin molecules at the surface of native low density lipoprotein (LDL) particles. Distinct behaviour was observed for the choline head group -N(CH3)3 resonances of these different phospholipids revealing preferential immobilisation for phosphatidylcholine. This suggests the existence of reversible and irreversible phosphatidylcholine-apolipoprotein B interactions and is consistent with microdomain formation at the surface monolayer of LDL. The novel resonance assignment and results show that 1H NMR can provide efficient and practical means for future studies on the structure and dynamics at the LDL surface.
Explore the source record for details and available documents.
Coma following brain injury may last days or months and is associated with decreased quality of life for survivors and families. One intervention postulated to improve coma recovery is sensory stimulation. This article critically examines current theoretical perspectives and empirical data related to sensory stimulation, discusses the usefulness of sensory stimulation programs (SSP) in critical care settings, and poses strategies for implementation of an SSP. Future directions for nursing practice and research also are addressed.
Community based AIDS prevention programming and research in minority neighborhoods are growing. The AIDS epidemic has demoralized many minority communities and has added to enormously stressing social conditions. Obstacles to effective AIDS prevention programming must be removed before stable, accessible, and culturally relevant services can be provided. A pilot study was conducted to identify the obstacles to AIDS research or intervention in ethnic minority neighborhoods. Twenty-nine administrators and counselors from Community Based Organizations completed questionnaires concerning reasons for entering the field of AIDS prevention, enjoyment of work, hopefulness towards AIDS efforts, priority of AIDS funding, and opinions about most and least helpful prevention efforts in minority communities. Barriers identified as most problematic include insufficient funds, lack of culturally relevant materials, denial of the epidemic in minority communities, distrust of majority culture institutions, and myths/beliefs regarding AIDS contraction, transmission, and origin. Future research ideas are identified to improve culturally relevant AIDS prevention interventions in ethnocultural neighborhoods.
OBJECTIVE: Our objective was to compare neonatal postoperative morbidity for the neonate with prenatally diagnosed gastroschisis delivered vaginally with that for the perinate undergoing elective cesarean at or before the onset of labor. STUDY DESIGN: Retrospective maternal and neonatal data were obtained by chart review on 22 neonates prenatally diagnosed with gastroschisis who underwent operative closure of the ventral wall defect between 1987 and 1991 at Loma Linda University Medical Center. Perioperative data and postoperative courses were compared between 12 infants who underwent labor with vaginal delivery and 10 infants who were delivered by elective cesarean section at or before the onset of labor. RESULTS: Neonatal transports and significant bowel edema were more likely (p < 0.05) in the vaginal delivery group. The elective cesarean section infants had less sepsis (p < 0.05), fewer hospital days (p < 0.01) and parenteral nutrition days (p < 0.01), and shorter time to enteral feedings (p < 0.01). CONCLUSIONS: Elective cesarean section at or before the onset of labor may benefit the fetus with gastroschisis, compared with undergoing labor and vaginal delivery.
In recent years, we have treated two families that had successive siblings with gastroschisis. In the first family, the delivery of their second child, a boy with gastroschisis, was followed 11 months later by the delivery of a girl also with gastroschisis. The mother admitted to use of tobacco, alcohol, and marijuana during both pregnancies; the father was the same for both children. In the other family, the second child was a boy with gastroschisis, and the third, born 6 years later, was also a boy with gastroschisis. The mother denied any use of tobacco, alcohol, or recreational drugs; these two boys had different fathers. Gastroschisis in siblings has been reported only rarely, and has been noted in both identical and dizygotic twins. Our second set of siblings is the first documented case involving paternity by different fathers. Although a genetic factor cannot be excluded completely, teratogenic factors operative through the mother seem most probable. In conjunction with other reports of "epidemics" of gastroschisis, these two families amid our own recent outbreak of gastroschisis strongly suggest that the teratogenic factors may be environmental.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A wandering spleen is in constant danger of torsion and infarction. Splenectomy, the traditional treatment, leaves children in danger of postsplenectomy sepsis. Three children with wandering spleens were treated by a new splenopexy technique, the splenic snood. After detorsion, the spleens were wrapped in polyglycolic mesh and anchored by the mesh subdiaphragmatically in the left upper quadrant. All have retained their spleens which have remained where anchored up to a 4-year follow-up. The simplicity and technical ease of the splenic snood operation recommend it as an improved method to avoid splenectomy and safely normalize intraabdominal anatomy in the management of the wandering spleen.
Recent reports have attempted to compare the relative value of discography and MRI in the evaluation of lumbar degenerative disc disease. None has compared the accuracy of the two techniques in regard to the detection of disc herniation specifically, and none has offered surgical correlation. In this prospective study, both techniques were used to evaluate 264 disc levels in 90 patients with incapacitating low back pain or radicular pain. The results showed an 86% agreement level both between tests and between the orthopaedist and radiologist on each test. Surgical findings agreed with diagnostic studies at 63 of 76 levels in 57 patients who underwent operative treatment. An analysis of the relative sensitivity and specificity of each test in the diagnosis of degeneration and herniation revealed that the greater sensitivity of MRI in the detection of herniation was the only statistically significant difference (p < 0.05).