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Biomedical subjects

J K Davidson

Publications and source records attributed to J K Davidson.

At least 19 recordsLinked to original sources
PubMed1992

Immunological and metabolic responses of patients with history of antibody-induced beef insulin resistance to treatment with beef, pork, human, and sulfated beef insulin.

OBJECTIVE: We evaluated immunological and metabolic responses during therapy with beef (B), pork (P), human (H, rDNA), and sulfated beef (SB) insulins in patients with insulin-antibody-mediated insulin resistance. RESEARCH DESIGN AND METHODS: A randomized double-blind sequential crossover study was performed with each insulin administered for 56 days unless dose reached 200 U/day or allergy developed. Participants were 26 individuals with history of B-P insulin dosage greater than or equal to 200 U/day and insulin binding capacities greater than 0.216 nM (30 mU/ml serum). Twenty-one participants completed the study. Insulin dosage/day, fasting plasma glucose, percentage HbA1, insulin antibody binding capacity (IABC), bound insulin (BI), percentage binding of 125I-labeled B, P, and H insulins, and receptor inhibition factor (RIF) were assessed. RESULTS: Mean insulin dosage (U/day) was significantly greater on B (88.9) than on P (29.2), H (29.4), or SB (29.6). On B, dosage increased in 12 individuals and reached 200 U/day in 6 individuals. Mean fasting plasma glucose (12.1 mM) and HbA1 (11%) were significantly higher on B than on P, H, and SB. Mean IABC, bound insulin, RIF, and percentage of B, P, and H bound were significantly higher on B than on P, H, and SB. Prolonged treatment with SB before entry into the study (greater than 5 wk) resulted in a blunted anamnestic response to B insulin. CONCLUSIONS: Rechallenge with B results in anamnestic immunological response and deterioration of metabolic control. SB, H, and P insulins have equivalent effects in patients with insulin antibody-mediated immunologic resistance.

Animals↗
PubMed1991

The female sexual response revisited: understanding the multiorgasmic experience in women.

Although it has been almost 20 years since recorded evidence of multiple orgasms among women emerged, there have been few recent investigations of this phenomenon. The purpose of this study was to understand further the female multiorgasmic experience in relationship to the method of stimulatory activity, namely, masturbation, petting, and sexual intercourse. In addition, single-orgasmic and multiorgasmic women were compared by examination of various sexual and orgasmic behaviors, the role of sex partners, and perceptions of physiological and psychological sexual satisfaction. An anonymous 122-item questionnaire was utilized to obtain the responses of 805 college-educated female nurses, chosen for their perceived ability to verbalize data regarding the anatomical structures and physiological processes associated with sexual responsiveness. The findings indicated that 42.7% of the respondents had experienced multiple orgasms and that several significant differences existed between single-orgasmic and multiorgasmic women.

Adult↗
PubMed1991

Female sexual response and the timing of partner orgasm.

Although orgasm can be experienced in many ways with or without a partner, partner involvement continues to be a noted preference for many women. In order to examine the timing of partner orgasm in relationship to female sexual response, women who usually experience orgasm before, simultaneously, or after their male partner's first orgasm were examined in the context of their orgasmic behaviors, role of their partners in sexual interaction, and their level of sexual satisfaction. A survey research design, which utilized the responses of 709 adult women, indicated that those women who usually experienced orgasm after their male partners perceived less physiological and psychological sexual satisfaction. Furthermore, several other significant results were found regarding timing of partner orgasm. With the failure to reach orgasm through sexual intercourse being reported by women as a common sexual complaint, sex educators and therapists can use these findings to facilitate an increased awareness of timing factors influencing satisfying sexual relationships.

Adult↗
PubMed1990

Female ejaculation: perceived origins, the Grafenberg spot/area, and sexual responsiveness.

Despite earlier contrary claims, some researchers have recently reported a possible homologous female prostate gland that is potentially involved in a sudden spurt of fluid being released at the moment of orgasm. A number of medical authorities have speculated that this fluid is urine. To alleviate concerns about the possible release of urine during orgasmic response as well as to contribute to a further understanding of physiological and psychological sexual satisfaction, we examined a series of variables thought to be associated with female ejaculation [(expulsion of fluid during orgasm and its relationship, if any, to a sensitive anatomic area (Grafenberg spot)]. An anonymous questionnaire was distributed to 2350 professional women in the United States and Canada with a subsequent 55% return rate. Of these respondents, 40% reported having a fluid release (ejaculation) at the moment of orgasm. Further, 82% of the women who reported the sensitive area (Grafenberg spot) also reported ejaculation with their orgasms. A number of variables were associated with this perceived existence of female ejaculation.

Arousal↗
PubMed1990

Accident and emergency reporting in UK teaching departments.

A survey of 44 UK training departments shows that trainee radiologists commence accident and emergency (A & E) reporting after an average of 10.2 months in radiology and perform a considerable proportion of the A & E reporting workload. Most respondents consider that they supervise junior staff but only 11 departments directly check their work and only two departments offer supervision to staff with more than 2 years' experience. All A & E radiographs are reported in 79.9% of hospitals and the other hospitals operate selective reporting policies. The delay between the radiographic examination and the radiology report reaching the A & E department is less than 48 hours in about two-thirds of departments when the examination is performed Monday to Friday, but exceeds 48 hours in two-thirds of departments when it is performed at weekends. Misinterpretation of radiographs is one of the commonest errors in A & E. Improved supervision of less experienced trainees is required. Consultants should contribute and one should be responsible for this area. Radiological conferences are important and the secretarial services require major improvement.

Accidents↗
PubMed1989

Dysbaric disorders: aseptic bone necrosis in tunnel workers and divers.

Dysbaric osteonecrosis is a serious complication for those exposed to a hyperbaric environment, with prevalence of 17% amongst compressed air workers and 4.2% amongst divers. Bone lesions are characteristically multiple and bilateral, occurring frequently in the shafts of the femora or tibiae and the heads of the humeri or femora. A proportion of the lesions will lie next to the joint surface, the so called juxta-articular lesion, and these may progress to a structural failure and secondary osteoarthritis. These lesions can be severely disabling, especially in a young adult male. When related to the occupational history the prevalence of bone lesions, both in compressed air workers and divers, increases with age, experience and with greater pressures of air or at greater depths. Moreover, acute attacks of decompression sickness, the bends, are more liable to be associated with subsequent bone lesions. Current decompression schedules certainly reduce the bends rate but, no matter how strictly adhered to, will not prevent the development of dysbaric osteonecrosis. It is possible that bone necrosis could result solely from exposure to a high pressure of air, either from work in compressed air or diving. Those men with positive bone lesions should be advised to seek expert medical opinion and probably advised to discontinue work in compressed air or diving if a juxta-articular lesion is present. Detection of bone necrosis depends on good quality radiographs with reliable interpretation, preferably by double observation, especially in the early stages. Lesions, especially when early or doubtful, can be confirmed by CT or bone scintigraphy. MRI promises to detect osteonecrosis in the very early stages but is not yet readily available. To detect dysbaric osteonecrosis at an early stage it is important to monitor both compressed air workers and divers with regular radiological skeletal surveys or bone scintigraphy. In 1987, the Bone Necrosis Working Group of the Decompression Sickness Panel recommended that all divers should have a radiological survey on completion of their initial diving training and that bone scintigraphy should be used for subsequent surveillance for certain groups, including those diving deeper than 30 metres, where the time at depth exceeds 4 hours, when experimental decompression is used and in other situations.

Atmospheric Pressure↗
PubMed1989

The role of the Grafenberg Spot and female ejaculation in the female orgasmic response: an empirical analysis.

Despite earlier contrary claims, researchers have found evidence that a sensitive area (Grafenberg Spot) exists in the vaginal barrel. This area is a potential source of orgasm independent of clitoral stimulation. Other researchers have reported that some women experience a sudden spurt of fluid at the moment of orgasm. In the interest of contributing to further understanding of physiological and psychological sexual satisfaction, and alleviation of concerns about perceived urination during orgasm, the investigators explored a series of variables thought to be associated with perceptions of the Grafenberg Spot and its relationship, if any, to the female orgasmic response and female ejaculation. An anonymous questionnaire was distributed to 2,350 women in the United States and Canada, with a subsequent 55% return rate. A number of factors were found to be associated with perceived existence of a sensitive area in the vaginal barrel which, when properly stimulated, activates orgasm. Women who reported sensitive area orgasms were also more likely to report a spurt of fluid at moment of orgasm.

Body Fluids↗
PubMed1989

Single parents: interaction of parenting and sexual issues.

This study was designed to investigate how children affect the sexual lives of their single parents. More specifically, this study investigated how being a single mother or father affects parenting roles, partner relationships, sexual guilt, and sexual satisfaction. Data were collected from a sample of 155 parents who were members of a single-parenting organization. The findings revealed a significant difference between single mothers and single fathers regarding attitudes toward their relationship with their children. Although fathers more often reported being content in their parent-child relationships, they also were less frequently involved in the custodial care of the children. One of the major problems reported by single parents, especially mothers, was the relationship interference they perceived emanating from former spouses, children, and children of current partners. In addition, single parents also experienced guilt over their involvement with a relationship partner when it took time away from their children. Although the majority of single parents were satisfied with their sexual lives, there was a significant association between parent-child relationship and perceived sexual satisfaction for women. An increased awareness of the parenting roles and sexual lives of single parents can better enable family professionals to meet the needs of single parents as they act and react to changes in families and society.

Adult↗
PubMed1988

Radiographs in shoulder trauma.

It is difficult to establish the diagnosis of an injured shoulder if only one radiographic projection is used. We have compared two lateral projections, the Neer trans-scapular and the apical oblique in 80 patients; the radiographs were presented randomly to 10 casualty officers and nine radiologists. The apical oblique view was found to permit more accurate diagnosis of fractures and of dislocation by both groups.

Diagnostic Errors↗
PubMed1988

Effect of insulin immune complexes on human blood monocyte and endothelial cell procoagulant activity.

Insulin antibodies and immune complexes (ICs) are present in most patients with diabetes after initiation of conventional insulin therapy. We studied the ability of bovine insulin, porcine insulin, and human insulin ICs to stimulate the procoagulant activity (PCA) of human blood monocytes (HBMs) and human umbilical vein endothelium (HUVE) in vitro. Polyclonal insulin antibodies from patients with insulin antibody-mediated resistance were isolated by immunoabsorption. PCA expressed by isolated adherent HBMs or cultured HUVE was quantified by radioimmunoassay of fibrinopeptide A with a 1:80 dilution of human plasma. Beef, pork, and human insulin, in quantities determined from titration curves, were added to fixed amounts of antibody to obtain equivalent amounts of ICs. For four different antibodies, the ratios of PCA (expressed by HBMs exposed to ICs or to antibodies alone and normalized for cell numbers) to activity expressed by tissue culture medium were as follows: beef insulin ICs, 2.55 +/- 0.41; por insulin ICs, 1.47 +/- 0.16; human insulin ICs, 1.28 +/- 0.19; and antibody, 1.28 +/- 0.32. The differences between beef and pork insulin ICs and antibody controls were significant. For a fifth antibody, a dose response between beef insulin ICs and PCA expression was demonstrated. For a sixth antibody, HBMs could express PCA when stimulated with antibody of a relatively low binding capacity (0.35 ng bovine insulin per microgram of antibody) only in the presence of lymphocytes. Conditioned medium from these cells significantly stimulated endothelial cell procoagulant activity. These observations raise the possibility that insulin ICs, that is, beef insulin ICs, may generate increased PCA and thereby contribute to the vascular complications of diabetes mellitus.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Digital filtering of the bladder in SPECT bone studies of the pelvis.

A data processing technique for the removal of bladder activity from single photon emission computed tomographic bone studies of the pelvis has been developed. The method involves the replacement of count values in the bladder on all projection views by data which are representative of the activity in surrounding structures. Reconstruction is then performed using the amended set of projection views. The method was tested by examining a group of 13 patients referred for investigation of avascular necrosis of the femoral head. Significant improvements in image quality were observed, particularly with respect to the level of artifact production, which increased the number of cases in which a confident and correct diagnosis was made.

Femur Head Necrosis↗
PubMed1987

False localization of an aldosteronoma by dexamethasone-suppressed adrenal scintigraphy.

A patient with primary aldosteronism had bilateral adrenal tumours on computed tomography. Selenocholesterol scintigraphy showed uptake by the larger right adrenal gland and a tumour in the gland was also visualized by venography. In contrast, measurements of aldosterone concentrations in adrenal venous blood lateralized to the left side. At surgery the left adrenal gland contained an aldosteronoma and the right adrenal gland a large non-functioning adenoma. Thus, selenocholesterol scintigraphy incorrectly localized the functioning adrenal tumour.

Adenoma↗
PubMed1987

Rapid decrease of insulin-specific IgG antibody levels in insulin-dependent patients transferred to semi-synthetic human insulin.

A multicenter, open trial was designed to examine the efficacy and safety of semi-synthetic human insulin (SSHI; Novolin R and Novolin L, SQUIBB-NOVO) in patients with insulin-dependent diabetes mellitus who were transferred from other commercially-available insulins. Whether such a change in therapy would reduce circulating IgG antibodies to antibovine insulin was also evaluated. A total of 68 males and females, 8-62 yr of age, were maintained on their original insulin therapy for 4 weeks, when both glycosylated hemoglobin and fasting blood glucose were assessed. IgG antibody titers to antibovine insulin were also measured. All patients were then transferred to SSHI for a period of 20 weeks. The same variables were evaluated at Weeks 2, 4, 8, and 20. Mean fasting blood glucose levels rose monotonically from 189-226.3 mg/dl over the course of the 20-week clinical trial. There was a slight but insignificant increase in glycosylated hemoglobin by the end of the test period. The average value for antibovine insulin IgG antibodies decreased from 2.54 mu/ml at baseline to 1.32 mu/ml by the completion of the trial. Significant decreases were first observed 4 weeks after the patients were placed on SSHI therapy. After transfer to SSHI, 43.3% of the patients achieved some improvement in glycemic control and only 16.4% were worse than at baseline. A decrease in weekly hypoglycemic reactions occurred during the course of the SSHI therapy. It appears that SSHI provides safe and effective treatment for insulin-dependent diabetic patients and that its use results in a rapid and significant decrease in insulin antibody formation.

Adult↗
PubMed1986

Enhancing relationships: understanding the feminine mystique of pretending orgasm.

As individuals become increasingly aware of their sexuality and orgasmic responsiveness, concomitantly, the phenomenon of pretending orgasm is becoming a greater part of the sexual relationship for many couples. However, few studies exist concerning this phenomenon despite the fact that nearly two-thirds of all females have reported pretending orgasm. Therefore, the purpose of this study was to profile those females who have pretended orgasm by examining the dimensions of their sexual and orgasmic behaviors, the factors that inhibit their orgasm, the dynamics of partner interaction, and any desired changes in their sexual lives. A survey research design was employed utilizing the responses of 805 professional nurses who participated in a study concerning self-perceptions of the female sexual response. The findings indicate that those females who have ever pretended orgasm became sexually active at a younger age and have been more sexually explorative than those females who have not pretended orgasm. Furthermore, the role of their sex partners was a significant dimension in their orgasmic pretense. The resultant impact on coupled relationships has many critical implications for therapists.

Adult↗
PubMed1986

Coitally active university students: sexual behaviors, concerns, and challenges.

The past fifteen years, in particular, have seen a major increase in the extent to which both adolescents and young adults are engaging in sexual intercourse. While several studies call attention to the increasing incidence among college/university students, the concomitant shifts in the sociopsychological realms of sexuality are also important dimensions which impact upon sexual concerns of youth. Hence, the purposes of this study are to examine the behaviors, attitudes, and concerns of students who have engaged in coitus, as well as any changes they seek in their sex lives. The sample consisted of 123 never-married male and 205 never-married female undergraduate students from a state university. The data were obtained by utilizing an anonymous questionnaire administered to volunteers during regular university classes. Among the coitally active, 67.4% of males were psychologically satisfied after their first sexual experience, but only 28.3% of females. In contrast, 80.9% of males and 28.3% of females reported current psychological satisfaction with their sexual experiences. Significant differences between genders focused on male dissatisfaction with infrequent opportunities for sexual intercourse, lack of variety of sex partners, and insufficient oral-genital stimulation, whereas females expressed concerns relating to lack of stimulation to their breasts, painful sexual intercourse, lack of orgasm during sexual intercourse, and feelings of guilt and fear. An increasing awareness of current sexual behaviors, attitudes, and concerns of university students can help family life educators to meet student needs as they react to changes in interpersonal relationships, families, and society.

Adolescent↗
PubMed1986

Biliary tract dilatation in acquired immune deficiency syndrome.

Biliary tract dilatation without obstruction may result from sclerosing cholangitis, pyogenic cholangitis, or bile duct surgery. This case report describes a patient with AIDS whose biliary tract dilatation was due to cytomegalovirus infection. Such a diagnosis should now be considered in the immuno-suppressed patient who has dilated bile ducts.

Acquired Immunodeficiency Syndrome↗