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Biomedical subjects

J L Franklin

Publications and source records attributed to J L Franklin.

At least 19 recordsLinked to original sources
PubMed1992

Suppression of programmed neuronal death by sustained elevation of cytoplasmic calcium.

Chronic depolarization greatly increases the survival of many types of neurons in culture. In at least some cases this enhancement of survival consists of the suppression of programmed cell death, a type of death occurring in developing neurons deprived of sufficient neurotrophic factor support. Available evidence suggests that the effect of depolarization on survival is mediated by a sustained rise of cytoplasmic free Ca2+, apparently caused by influx of Ca2+ through voltage-gated channels. This review discusses what is known about the mechanism by which prolonged depolarization and increased intracellular Ca2+ promote survival.

Animals↗
PubMed1992

Long-term regulation of neuronal calcium currents by prolonged changes of membrane potential.

Although rapid-onset, short-term regulation of neuronal Ca currents by neurotransmitters and second messengers is well documented, little is known about conditions that can cause longer-lasting changes in Ca channel function. We report here that persistent depolarization is accompanied by slowly developing long-term reduction of neuronal Ca currents. Rat myenteric neurons grown in cell culture for 1-7 d were studied with the tight-seal whole-cell recording technique. Macroscopic Ca-channel currents had decaying and sustained components at all days studied. When the neurons were grown in medium containing 25 mM KCl, which depolarized them to -40 mV and caused significant elevation of intracellular Ca, the densities of both components of Ca-channel current decreased by 40-80%. Several results suggest that different mechanisms underlie the downregulation of the two components. (1) The density of the decaying component decreased approximately four times faster than did that of the sustained component. (2) When neurons were returned to control medium, which contained 5 mM KCl, the density of the sustained component returned to control levels within 24 hr, while that of the decaying component did not recover significantly. (3) Inhibitors of RNA and protein synthesis reduced or prevented downregulation of the sustained but not of the decaying component. (4) The dihydropyridine antagonist nitrendipine, which prevented the sustained elevation of intracellular Ca in neurons grown in 25 mM KCl, prevented downregulation of the sustained component but had no effect on downregulation of the decaying component. We suggest that these forms of regulation of Ca current density could help neurons adapt to altered levels of electrical activity and may contribute to changes in synaptic strength that occur during periods of increased or decreased electrical activity.

Animals↗
PubMed1992

Smoking cessation interventions by family physicians in Texas.

A survey of 1,292 family physicians in Texas indicates that most of them (99%) ask patients about their smoking behavior. Fewer physicians, however, participate in further activities recommended by the National Cancer Institute: arranging follow-up visits, providing self-help materials, prescribing nicotine gum, engaging patients in discussion, referring patients to a program for smoking cessation, and involving other office personnel in counseling. Almost 80% of the respondents cited such obstacles to their involvement in counseling/advising patients as patient attitudes or patient preferences for smoking. The survey was conducted to acquire baseline data on the involvement of family physicians in Texas in counseling their patients who smoke and the obstacles they meet in their efforts.

Adult↗
PubMed1991

Radiographic assessment of instability of the knee due to rupture of the anterior cruciate ligament. A quadriceps-contraction technique.

We compared the results of a radiographic technique for the measurement of instability of the knee with those obtained with a KT-1000 arthrometer. The study was conducted on both knees of sixty patients who had a ruptured anterior-cruciate ligament in one knee, as well as in ten control subjects. The radiographic technique included the examination of a true lateral radiograph, made while the knee was in full extension and the quadriceps was maximally contracted, with a 66.7-newton downward force produced by a 6.8-kilogram weight suspended from the ankle. As demonstrated by both techniques, the maximum difference between the displacements of the right and left knees in the control subjects was 2.5 millimeters and the mean difference between the displacements in the two knees in the patients was 7.5 millimeters. In fourteen of the sixty knees in which the ligament was ruptured, the injury was acute. The forward translation of the medial side in these fourteen knees was compared with that in the forty-six knees in which the injury was chronic. The mean difference in the displacement of the medial side in the right and left knees was 3.5 millimeters in the fourteen patients who had an acute injury and 5.0 millimeters in the forty-six patients who had a chronic injury. Thirteen of the sixty patients had disruption of the posteromedial corner of the injured knee, and the translation of the medial side in these knees was significantly increased compared with that in the intact knees of the same patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Glenoid loosening in total shoulder arthroplasty. Association with rotator cuff deficiency.

Seven cases of total shoulder arthroplasty exhibiting major glenoid radiolucent lines or actual translation of the glenoid component were evaluated to identify factors associated with glenoid loosening. The average time from arthroplasty was 30 months (range, 14-44 months). Six of the patients had severe, incompletely reconstructable rotator cuff tears present at the time of surgery, and one patient developed a cuff tear within 1 year of surgery. The amount of superior migration of the humeral component was closely correlated with the degree of glenoid loosening. With superior displacement of the humeral component, superior tipping of the glenoid component was observed: a "rocking horse" glenoid. For comparison, a contemporary group of 16 consecutive total shoulder arthroplasty patients with intact rotator cuffs were reviewed. The control group had no glenoid loosening an average of 5 years after operation. Upward riding of the prosthetic humeral head in patients with rotator cuff deficiency may contribute to loosening of the glenoid component in total shoulder arthroplasty.

Aged↗
PubMed1988

Social disability in the young adult mentally ill.

The social functioning of young mentally ill adults was assessed in relationship to that of older mentally ill adults. In terms of family and friends, the younger and older groups were found to experience similar social withdrawal, although the younger group was more likely to be employed. It is suggested that such withdrawal may be typical of young mentally ill adults not enrolled in programs emphasizing social involvement.

Adolescent↗
PubMed1988

Broken intramedullary nails.

Between 1962 and 1987, we treated fifty-six patients for sixty broken intramedullary nails, using a custom-made hook to extract the distal fragment of the nail. The charts and radiographs of all of the patients were reviewed. Thirty-nine of the nails had been inserted in a fresh fracture, which usually was comminuted; eight had been used for fixation of an osteotomy; nine, for fixation of a non-union; and four, for treatment of a pathological fracture. Several small-diameter intramedullary nails broke at the site of the fracture or non-union. In contrast, the sites of breakage in the interlocking nails were the interlocking holes and the welded junction of the top insertional portion and the proximal slot. Many of the breakages were in patients who had an unstable fracture pattern. The interval between insertion and breakage ranged from one to 120 months.

Adolescent↗
PubMed1987

An evaluation of case management.

This project explores the efficiency and effectiveness of case management as compared with the usual and customary services available to chronic mentally ill individuals in reducing readmissions to mental hospitals and improving the quality of life. A randomized pretest-posttest control group design was used to assign 417 individuals who had at least two discharges from a mental hospital to an experimental (E) group (N = 213) to receive case management services and a control (C) group (N = 204) who could receive any services but case management. After participation in the project for 12 months, 138 members of the E group and 126 members of the C group were reinterviewed. The E group received more services, cost more to maintain, and were admitted to mental hospitals more often, but concomitant improvement in quality of life indicators was not evident. Alternative explanations for the findings are discussed.

Activities of Daily Living↗
PubMed1987

Total shoulder arthroplasty.

A prospective study was done of fifty total shoulder replacements in forty-four patients who were followed for an average of 3.5 years (range, 2.0 to 7.5 years). The preoperative diagnosis was osteoarthritis in thirty-three shoulders, rheumatoid arthritis in eleven, and a previous fracture of the humeral head in six shoulders. Nine of the shoulders had a tear of the rotator cuff. The Neer-II system of total shoulder replacement with a non-metal-backed component was used in all fifty shoulders. At follow-up, forty-four shoulders (88 per cent) had no significant pain. Of the six painful shoulders, four had loosening of the glenoid component and one had malposition of both components. Three of the six shoulders had no significant pain after revision. The average range of active forward elevation in all of the shoulders improved from 71 to 100 degrees, and both external and internal rotation improved as well. Five specific activities of daily living were evaluated, and the patients' ability to perform them improved from 14 to 78 per cent. Thirty-five shoulders (68 per cent) were rated by the patients as much better; thirteen shoulders (26 per cent), as better; and three (6 per cent), as no better. An incomplete lucent line was noted around five (10 per cent) of the cemented humeral stems and around thirty-seven (74 per cent) of the glenoid prostheses. Four arthroplasties (8 per cent) required revision: three for loosening of the glenoid component and one for malposition of both components.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1986

Influence of body size and gender on control of ventilation.

Hypoxic (HVR) and hypercapnic (HCVR) ventilatory responses are influenced by both metabolic activity and hormonal factors. By studying 67 subjects of both sexes, including those at the extremes of stature, we examined the influence of gender, CO2 production (VCO2), O2 consumption (VO2), body surface area (BSA), and vital capacity (VC) on resting ventilation (VE), HVR, and HCVR. We measured resting VE, VO2, and VCO2 and then performed isocapnic progressive hypoxic and hypercapnic ventilatory responses. The effect of stature was reflected in higher VE and metabolic rate (both P less than 0.001) in tall men compared with short men that was ablated by correction for BSA. Perhaps because their heights vary less than those of the men, tall women were not statistically distinguishable from short women in any of these measured parameters. Tall men tended to have greater hypoxic chemosensitivity than short men but this was not significantly different (P = 0.07). Gender affected the control of ventilation in a number of ways. Men had higher VE (P less than 0.05) and metabolic rate (P less than 0.001) than women. Even after correction for BSA men still had higher metabolic rates. Women had higher VE/VCO2 than men (P less than 0.05) and lower resting end-tidal Pco2 (PETCO2) values (P less than 0.05). Both A, the shape parameter of the hyperbolic HVR curve, and HVR determined from mouth occlusion pressure (AP) were greater in women than in men, although only AP reached statistical significance. However, corrections of A for BSA (P less than 0.05), VCO2 (P less than 0.01), and VC (P less than 0.001) amplified these differences.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Immediate internal fixation of open ankle fractures. Report of thirty-eight cases treated with a standard protocol.

We reviewed thirty-eight cases of open ankle fractures that had been treated with a standard protocol: alignment and splinting of the fracture at the scene of injury if possible, antibiotics administered in the emergency room and continued for forty-eight hours, admission of the patient to the operating room as quickly as possible, copious irrigation and thorough débridement of the wound, immediate rigid anatomical internal fixation, and delayed primary closure at five days. All of the fractures united, but three patients required subsequent ankle fusion because of cartilage damage noted at the initial operation. Of the thirty-five ankles with complete follow-up, the functional result was excellent in twenty-six and fair or poor in nine.

Adolescent↗
PubMed1977

Estimating a population in need of alcoholism services: a new approach.

A new approach for estimating a population at risk of alcoholism and problem drinking is discussed. Its advantages include specification of planning-relevant social-demographic characteristics of a population at risk and the identification of a population base in terms of which alcoholism programs, services, and resources can be comparatively evaluated.

Adult↗
PubMed1975

A survey of factors related to mental hospital readmissions.

The authors followed up 107 patients selected at random from those discharged from a southern state mental hospital in fiscal year 1972-73. They attempted to differentiate those who were readmitted to the hospital from those who were not on the basis of 52 factors, both personal and environmental, and also compared those who misused alcohol with those who did not. In their sample, 36 of the patients returned to theinstitution, and 71 did not. One of the findings was that in both the total sample and in the nonalcoholic subsample, those readmitted more often received income ffrom sources other than their own employment or the employment of someone in their household. They also tended to be single, separated, or divorced. In both the alcoholic and nonalcoholic subsamples, those readmitted reported more contacts with the community mental health center after their discharge than those not readmitted. In the total sample, the readmitted patients engaged in fewer leisure-time activities and were more likely to report a drinking problem.

Adult↗