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Biomedical subjects

J Welch

Publications and source records attributed to J Welch.

At least 19 recordsLinked to original sources
PubMed1992

Neglect and visual recognition.

B.Q., a right-handed woman who had suffered a stroke affecting the right parietal region, showed visuospatial neglect and problems in recognizing seen objects and faces. Investigation of her visual recognition problems revealed a striking inability to identify the left sides of chimaeric objects and faces. Often, B.Q. would deny that the stimulus was chimaeric at all, and she was remarkably poor (though above chance) at discriminating chimaeric from normal faces. Even when left-sided details had been accurately traced or described, they were often either ignored in reporting the identities of the constituent parts of a chimaeric or assimilated in some way to the information from the right side. Neglect of the left side was more pronounced for chimaerics which approximated an individual face or object. It occurred regardless of the chimaeric's position in B.Q.'s field of vision, and was found with brief (200 ms) presentations of stimuli confined to her (perimetrically intact) right visual field. When chimaeric faces were inverted, B.Q. continued to neglect the side of the chimaeric falling to her left, which implies that the neglect did not operate in entirely object-centered coordinates. However, left-sided information could be used if it was critical in determining the identity of an object or a face. We suggest that this could explain B.Q.'s lack of neglect of individual words, for which left-sided (initial) letters are often crucial to successful recognition. An account of her deficit is proposed, involving an interaction between moderately defective pick-up of left-sided information in an object-based coding system and preserved access to stored representations of familiar visual stimuli.

Attention↗
PubMed1991

Inflammatory pseudotumors of the spleen.

Inflammatory pseudotumors are uncommon benign lesions that have been found in numerous organ systems. However, their appearance within the spleen is decidedly rare. Grossly, pseudotumors appear as well-circumscribed, encapsulated masses, while microscopic examination reveals a polymorphous inflammatory cell infiltrate occurring variably with granulomatous reaction, fibrosis, and cell necrosis. Because they often present either as unexplained, asymptomatic masses or with vague constitutional symptoms, splenic inflammatory pseudotumors can raise suspicion for a primary splenic neoplasm, such as lymphoma. Splenectomy is the treatment of choice.

Female↗
PubMed1991

Disentangling neglect and hemianopia.

In this paper we report findings which question the diagnosis of a hemianopia in B.Q., a 66-year-old lady who shows unilateral spatial neglect following a lesion to the right parietal lobe. The presence of a hemianopia has been indicated following two independent assessments of B.Q.'s visual fields. We examined B.Q.'s performance on a visuo-spatial task in which single or double stimuli were displayed left and right of a central fixation point. B.Q. failed to report left stimuli when the fixation point was continuously displayed (OVERLAP CONDITION). This performance is consistent with the suggestion of a left hemianopia as indicated by perimetric field testing. In a further condition the fixation point was extinguished prior to stimuli onset (GAP CONDITION). B.Q. consistently responded to left stimuli in the gap condition and also showed improved performance to right stimuli. Eye movements were recorded on a separate testing session, in which B.Q. showed a normal saccadic response to left targets in the gap condition, but not during the overlap condition. These results suggest that B.Q.'s failure to report left stimuli during field plotting is due to her neglecting left stimuli and not because she has a visual field defect. By using a testing procedure which reduces the severity of neglect B.Q. is able to respond to left stimuli. Reducing the severity of B.Q.'s neglect also abolishes the apparent hemianopia. Standard field plotting techniques which use a consistently displayed fixation point may not be appropriate for the testing of neglect patients' visual fields.

Aged↗
PubMed1991

Head circumference and intellectual performance of patients with Duchenne muscular dystrophy.

The head circumferences of 64 patients with Duchenne muscular dystrophy were measured and found to be greater than those of a normal population. The patients had relative, and in 12 cases, absolute macrocephaly. 47 of the 64 patients underwent intelligence testing and were found to be significantly intellectually impaired, particularly in verbal and language skills. There was no correlation between head circumference or absolute macrocephaly and intellectual performance. The cause of macrocephaly in these patients is unknown and its relevance to the aetiology of intellectual impairment in Duchenne muscular dystrophy is not yet clear.

Adolescent↗
PubMed1991

Stress- and endotoxin-induced increases in brain tryptophan and serotonin metabolism depend on sympathetic nervous system activity.

Stressful treatments and immune challenges have been shown previously to elevate brain concentrations of tryptophan. The role of the autonomic nervous system in this neurochemical change was investigated using pharmacological treatments that inhibit autonomic effects. Pretreatment with the ganglionic blocker chlorisondamine did not alter the normal increases in catecholamine metabolites, but prevented the increase in brain tryptophan normally observed after footshock or restraint, except when the duration of the footshock period was extended to 60 min. The footshock- and restraint-related increases in 5-hydroxyindoleacetic acid (5-HIAA) were also prevented by chlorisondamine. The increases in brain tryptophan caused by intraperitoneal injection of endotoxin or interleukin-1 (IL-1) were also prevented by chlorisondamine pretreatment. The footshock-induced increases in brain tryptophan and 5-HIAA were attenuated by the beta-adrenergic antagonist propranolol but not by the alpha-adrenergic antagonist phenoxybenzamine or the muscarinic cholinergic antagonist atropine. Thus the autonomic nervous system appears to be involved in the stress-related changes in brain tryptophan, and this effect is due to the sympathetic rather than the parasympathetic limb of the system. Moreover, the main effect of the sympathetic nervous system is exerted on beta- as opposed to alpha-adrenergic receptors. We conclude that activation of the sympathetic nervous system is responsible for the stress-related increases in brain tryptophan, probably by enabling increased brain tryptophan uptake. Endotoxin and IL-1 also elevate brain tryptophan, presumably by a similar mechanism. The increase in brain tryptophan appears to be necessary to sustain the increased serotonin catabolism to 5-HIAA that occurs in stressed animals, and which may reflect increased serotonin release.

Animals↗
PubMed1990

Electron microscopic detection of human parvovirus (B19) in a patient with HIV infection.

We report the findings on an HIV-positive patient found to be infected with human parvovirus B19. In a comparative study of sequential sera, direct electron microscopy (EM) had the same sensitivity as DNA hydridization for the detection of the virus. EM did not require specific reagents and also yielded information on the state of the virus; i.e., whether random or complexed, and the type of antibody involved. The presence of parvovirus complicated the judgement as to drug treatment. This case also highlighted the importance of diagnosing the presence of opportunistic viral infections that have no, or low-grade, pathogenic activity.

Acquired Immunodeficiency Syndrome↗
PubMed1990

The distance to the stomach for feeding tube placement in children predicted from regression on height.

Nurses use several external measures referenced to the head and chest to gauge the insertion distance for orogastric and nasogastric (NG) tubes. Few of the measures have been tested. However, in previous studies height was the external measure most correlated with esophageal length both in children and adults. In this study, the ability of previously published regression equations on height to predict esophageal length for NG-tube insertion in 107 children was evaluated. The regression equations were examined for stability, predictive performance, and the likely positions of the tube. The data were heights and esophageal lengths obtained from esophageal manometry records and hospital charts. The predicted values for nasal insertions were biased and averaged 2.4 cm too long (R2prediction = .56, n = 30). Prediction errors greater than 5 cm in absolute value occurred in 25% of the nasally-referenced sample. The predicted values represented overestimates in 18 nasally referenced cases that were 11.5% longer on the average than the measured esophageal lengths. In contrast, the predicted values for the oral insertions were unbiased (R2prediction = .92, n = 77), and gave accurate predictions in the majority of cases. Eighty percent of the oral predictions were within +/- 1.5 cm of the measured esophageal length and represented percentage errors between 0 and 7% (M = 3%, n = 50).

Adolescent↗
PubMed1990

The use of fibrin glue in intracranial procedures: preliminary results.

Intracranial procedures always have the potential of cerebrospinal fluid (CSF) leakage postoperatively. Sealing all routes of CSF drainage to the outside of the intracranial contents is essential. This is usually achieved with muscle and fat plugs, homograft dura, fascia, and suture. The use of a fibrin glue might affect and lessen the likelihood of a CSF leak. Eight clinical cases of various intracranial procedures using a simple, two-part patient autologous cryoprecipitate fibrinogen and bovine thrombin glue are described. Preliminary results of up to 1 year show no CSF leakage nor adverse reactions to the fibrin glue. The production method and material characteristics are briefly compared with other currently described autologous fibrin glue formulations. This version is similar in strength to other formulations, yet is simpler and more convenient to produce. The use of this autologous fibrin glue appears to provide an adjunct to commonly employed packing techniques in a convenient and effective manner. With more experience, fibrin glue might become an even more important tool in intracranial procedures.

Adult↗
PubMed1989

Structure of droperidol-ethanol (1/1).

1-(1-[4-(4-Fluorophenyl)-4-oxobutyl]-1,2,-3,6-tetrahydro-4-pyridyl)-1,3- dihydro-2H-benzimidazol-2-one ethanol solvate, C22H22FN3O2.C2H6O, Mr = 426.3, triclinic, P1, a = 6.083 (3), b = 10.296 (1), c = 16.018 (2) A, alpha = 100.93 (1), beta = 92.72 (2), gamma = 96.27 (2) degrees, V = 976.7 A3, Z = 2, Dx = 1.45 g cm-3, Mo K alpha, lambda = 0.71073 A, mu = 0.97 cm-1, F(000) = 452, T = 90 (2) K, final R = 0.046 for 2261 observed reflections. The title compound crystallizes with the droperidol skeleton extended and a solvated ethanol molecule disordered about an inversion center. The ethanol molecule forms a hydrogen bond to the droperidol skeleton at ketone atom O(1) on the imidazole ring.

Chemical Phenomena↗
PubMed1989

Hepatitis B infections after gynaecological surgery.

When acute hepatitis B developed in 3 patients who had had gynaecological surgery, the surgeon was found to be a carrier of hepatitis B e antigen. Of 268 patients operated on by this surgeon in one hospital, 247 were screened for markers of recent or current hepatitis B. 22 (9%) had such markers, associated with symptoms in 5. The operations carrying greatest risk of infection were hysterectomy (10/42) and caesarean section (10/51). These findings strengthen the case for vaccination of all surgeons and medical students against hepatitis B.

Acute Disease↗
PubMed1989

The CUP2 gene product regulates the expression of the CUP1 gene, coding for yeast metallothionein.

The yeast CUP1 gene codes for a copper-binding protein similar to metallothionein. Copper sensitive cup1s strains contain a single copy of the CUP1 locus. Resistant strains (CUP1r) carry 12 or more multiple tandem copies. We isolated 12 ethyl methane sulfonate-induced copper sensitive mutants in a wild-type CUP1r parental strain, X2180-1A. Most mutants reduce the copper resistance phenotype only slightly. However, the mutant cup2 lowers resistance by nearly two orders of magnitude. We cloned CUP2 by molecular complementation. The smallest subcloned fragment conferring function was approximately 2.1 kb. We show that CUP2, which is on chromosome VII, codes for or controls the synthesis or activity of a protein which binds the upstream control region of the CUP1 gene on chromosome VIII. Mutant cup2 cells produced extremely low levels of CUP1-specific mRNA, with or without added copper ions and lacked a factor which binds to the CUP1 promoter. Integrated at the cup2 site, the CUP2 plasmid restored the basal level and inducibility of CUP1 expression and led to reappearance of the CUP1-promoter binding factor. Taken collectively, our data establish CUP2 as a regulatory gene for expression of the CUP1 metallothionein gene product.

Carrier Proteins↗
PubMed1989

Effect of colostrum intake on plasma glucose, non-esterified fatty acid and glucoregulatory hormone patterns in the neonatal pig.

The effect of colostrum on endocrine and metabolic factors affecting glucose homeostasis was evaluated in 60 neonatal pigs that were fasted, fed (nursed ad libitum) or limit-fed colostrum (25% ad libitum, 4-hr interval feeding). Plasma acquired at birth (t0), and after 10, 20 and 30 hr (t10, t20 and t30, respectively) was analyzed for glucose, non-esterified fatty acids (NEFA), and the glucoregulatory hormones--insulin, glucagon, cortisol, growth hormone and catecholamines. The concentration of glucose and NEFA was similar among treatment groups at birth and increased in proportion to the quantity of colostrum consumed. Pigs fed ad libitum achieved and maintained a higher (greater than or equal to 40%; P less than .01) glucose concentration when compared to fasted neonates. Limit-fed counterparts also achieved and maintained higher levels, with glucose concentration being approximately 20% higher throughout (P less than .05). Fed pigs maintained NEFA concentrations which were approximately 2.5-fold to 4-fold greater than that of fasted pigs (P less than .05). Likewise, limit-fed pigs tended (P = .19) to have elevated NEFA concentrations and a lower (P less than .05) insulin:glucagon molar ratio. An inverse relationship was observed between colostrum intake and plasma concentrations of cortisol and growth hormone. Concentrations of epinephrine and norepinephrine tended (P greater than .10) to be elevated in fed pigs, relative to those of fasted counterparts. Provision of even limited quantities of colostrum is therefore beneficial to the glucoregulatory response in newborn pigs.

Aging↗