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Biomedical subjects

J Wilde

Publications and source records attributed to J Wilde.

At least 19 recordsLinked to original sources
PubMed2001

An anatomical variant of the extensor carpi radialis brevis muscle.

BACKGROUND: Variations in musculature are of interest not only to the anatomist but also to the surgeon, insofar as they can be a source of error in both diagnosis and treatment. Muscular anomalies in the lower arm and in the hand have frequently been described in the literature; some of the lesions they can be confused with are ganglia and other soft tissue tumors. CASE REPORT: In the course of preparation of a small, fine-jointed right upper extremity, an accessory muscle was discovered in the forearm and hand region; it branched off from the extensor carpi radialis brevis (ECRB) muscle. Its tendon crossed over the extensor retinaculum and attached to the dorsal digital expansion of the index finger. Both muscles were innervated by a branch of the deep branch of the radial nerve. The observations made here supplement our knowledge of variations in the antebrachial and dorsal regions of the arm and hand, which should be quite useful in hand surgery.

Female↗
PubMed2001

CASIG: a consumer-centered assessment for planning individualized treatment and evaluating program outcomes.

This paper reports the psychometric characteristics of a measure that assesses the treatment outcomes of individuals with serious and persistent mental illness. Unlike other outcome measures, this one is designed to be embedded in the clinical process of planning and evaluating treatment. It collects individualized data, structures how the data are used to plan and evaluate a client's treatment, and produces aggregate information relevant for research and program purposes. Two parallel versions were developed: one for the client's self-report, and one for an informant's report. The self-report measure was administered by peer-interviewers to 244 community interviewees, and by inpatient peer-interviewers to 93 inpatient interviewees. The community interviewees also completed the BASIS-32 and SF-36. Informants for 103 of the community interviewees completed the informant version of the measure, and the CCAR. Inpatient staff completed the informant version for 161 inpatient residents without regard for matching the 93 inpatient interviewees. The two versions had acceptable internal consistency, test--retest, and interrater reliabilities. Correlations of the community interviewees' and informants' results with the BASIS-32, SF-36, and CCAR provided evidence of convergent and discriminant validity, as did contrasts between community and inpatients interviewees. The usefulness of the instrument for clinical, program and research purposes is discussed, with emphasis on the characteristics that enhance its value in clinical practice --- assessment of meaningful outcomes, operationalization of client empowerment, comprehensiveness, easy administration, and continuity across time and provider. Also discussed is a computer-based program to summarize and present the results in a rapid, clinically meaningful manner.

Activities of Daily Living↗
PubMed2001

Atomic force microscopy imaging of the human trigeminal ganglion.

This paper describes an investigation of gangliocytes via imaging semithin sections of two human trigeminal ganglia with an atomic force microscope (AFM). Whereas semithin sections are usually employed for transmission electron microscopy, we adopted this special type of sample preparation for our AFM studies to extract topographical data from the gangliocyte itself and from the nucleus, the nucleolus, the crystal-arranged lipofuscin granules, and the cell-surrounding mantle cells; simultaneously we characterized the samples with error signal mode. This AFM-related technique revealed no information concerning friction force and elasticity due to the presence of the embedding material (epoxy), but it gave additional topographical contrast. These are the first images of the human trigeminal ganglion by AFM.

Adult↗
PubMed2001

Use of recombinant factor VIIa (NovoSeven) in patients with Glanzmann thrombasthenia.

Recombinant factor VIIa (rFVIIa; NovoSeven, Novo Nordisk, Bagsvaerd, Denmark) appears effective and relatively safe for the treatment of bleeding and for surgical prophylaxis in patients with Glanzmann thrombasthenia as reported to the International Registry on rFVIIa and Congenital Platelet Disorders. One of the shortcomings of the Registry data is the heterogeneity of treatment protocol, including dosage, number of doses used, duration of treatment before declaration of failure, and mode of rFVIIa administration (bolus v continuous infusion). The data are not yet sufficient to define optimal regimens for various indications such as the type of bleeding or the type of procedures. The place of this drug compared to platelet transfusion in the overall management of patients with Glanzmann thrombasthenia will need to be determined in relationship to a number of challenges and unresolved issues in the clinical care of these patients. These issues include: how to improve local measures for patients with mucosal bleeds, optimal management of young women during menarche, optimal platelet transfusion regimens for various indications, the relationship between antiplatelet antibodies detected by monoclonal antibody-specific immobilization of platelet antigens (MAIPA) and effectiveness of platelet transfusion, whether there are other biological tests that may correlate with effectiveness of platelet transfusion, and management of pregnancy and delivery regarding antiplatelet immunization.

Coagulants↗
PubMed2001

The role of ITAM- and ITIM-coupled receptors in platelet activation by collagen.

The major activation-inducing collagen receptor glycoprotein VI (GPVI) has been cloned within the last two years. It is a member of the Ig superfamily of proteins and is constitutively associated with the ITAM-bearing Fc receptor gamma-chain (FcR gamma-chain). GPVI signals through a pathway that involves several of the proteins used by Fc, B- and T-lymphocyte receptors and which takes place in glycolipid-enriched membrane domains in the plasma membrane known as GEMs. Responses to GPVI are regulated by PECAM-1 (CD31) and possibly other ITIM-bearing receptors. Despite a pivotal role for GPVI, there are important differences between signalling events to collagen and GPVI-specific ligands. This may reflect a role for co-receptors in the response to collagen.

Amino Acid Motifs↗
PubMed2000

Rare variant of the brachial artery: superficial lateral inferior type VII EAB.

This study concerns a variant of the brachial artery with a modified origin and course. The artery was studied in 418 upper limbs removed from cadavers. In one upper limb the left brachial artery bifurcated into: (1) a superficial brachial a. (the variant) crossing superficially to the bicipital aponeurosis in the cubital region and assuming the course, position, and supply area of the radial artery, and (2) the deep brachial a. (another variant). An embryologic interpretation of this anomaly is based on a variant vascular development derived from the eighth intersegmental artery. The variant is termed according to Adachi's classification schedule as arteria brachialis superficialis lateralis inferior Type VII with the addition EAB (epiaponeurosis bicipitalis, i.e., superficial to the bicipital aponeurosis). Accurate information concerning unusual patterns of the arteries in the upper limbs is clinically relevant, especially in the avoidance of accidental intra-arterial injection with reflectory vascular occlusion leading to necrosis.

Aged↗
PubMed2000

Management of anticoagulation in patients with prosthetic heart valves undergoing oral and maxillofacial operations.

There is wide variation in the management of patients with mechanical prosthetic valves who are taking anticoagulants and who require non-cardiac surgery. In this paper, we outline a pragmatic, practical approach to the adjustment of anticoagulation in relation to both the degrees of surgical trauma during oral and maxillofacial surgery and the risk of thromboembolism associated with the prosthetic valve. For minor surgery, no adjustment of anticoagulation is undertaken if the International Normalized Ratio is less than 4.0, if local haemostatic methods and tranexamic acid mouthwashes are used. For major surgery, warfarin is stopped preoperatively and low-molecular-weight heparin is used. For emergency surgery, partial reversal of anticoagulation with low-dose parenteral vitamin K is obtained.

Administration, Oral↗
PubMed1999

Efficacy of a self-esteem module in the empowerment of individuals with schizophrenia.

To enhance empowerment and improve self-esteem among individuals with severe and persistent mental illness, a 12-week "module" (a self-contained program of activities) was created and tested in a randomized clinical trial. Fifty-one individuals with schizophrenia were assigned to the experimental group in addition to regular treatment, and 44 individuals participated in a control group that continued with regular treatment only. Psychosocial, diagnostic, neurocognitive, and symptomatology measures were taken for all 95 subjects before treatment (T0), after treatment (T1), and at a 6-month follow-up (T2). Results indicated module effects on coping skills (active coping skills significantly increased) and psychotic symptoms (positive symptoms significantly decreased), demonstrating the efficacy of this particular type of intervention. Interpretation of the results highlighted the significance of the environment and the role it could potentially play in supporting the empowerment of severely mentally ill individuals.

Adaptation, Psychological↗
PubMed1998

Molecular confirmation of germ line mosaicism for a submicroscopic deletion of chromosome 22q11.

Submicroscopic deletions of chromosome 22q11 have been reported in a multiple anomaly syndrome variously labelled as velocardiofacial syndrome, conotruncal anomaly face syndrome, and Di George syndrome. Most 22q11 microdeletions occur sporadically, although in some cases the deletion may be transmitted. We describe two affected sibs with confirmed 22q11 deletions from unaffected parents who are not deleted. Haplotype analysis demonstrates that the deletion in the affected sibs has occurred on the same maternal chromosome 22. Furthermore, an unaffected sib was found to have inherited the same maternal haplotype at 22q11 in an undeleted form. This is the first molecular demonstration of germ line mosaicism for a microdeletion at chromosome 22q11 and highlights the need for caution in estimation of recurrence risks, even when constitutional deletions have been excluded on parental analysis.

Chromosome Deletion↗
PubMed1998

Multiple mechanisms of block by the anesthetic isoflurane of a gamma-aminobutyric acid activated chloride channel in crayfish.

Outside-out patches were excised from the membrane of the deep extensor abdominal muscle (DEAM), containing gamma-aminobutyric acid (GABA)-activated chloride channels, in the crayfish Astacus astacus. GABA and isoflurane (iso) were applied in pulses by a liquid filament switch, and their effects on the GABA-elicited chloride currents were investigated. Application of iso alone elicited no current responses and pre-application of iso prior to GABA had no effects on the GABA-elicited current. Co-application of GABA and iso resulted in a reduction of the initial chloride current and subsequent decline of the current to a steady state, indicating that iso binds to the receptor after GABA has bound. Recovery currents at the end of the co-application pulse, their amplitudes decreasing with pulse duration, confirmed this suggestion. Open-time distributions of the blocked channel showed a shift of the long open-time towards a new time constant, indicating a second block mechanism via the long open state A5Os of the channel. Removal of GABA and iso after reaching the equilibrium state of the block resulted in recovery currents containing exclusively openings from the long open state A5Os, confirming the suggestion of an open channel block only at one of the open states.

Anesthetics↗
PubMed1998

Endoleakage after stent-graft treatment of abdominal aneurysm: implications on pressure and imaging--an in vitro study.

BACKGROUND: Endoleakage is a fairly common problem after endovascular repair of abdominal aortic aneurysm and may prevent successful exclusion of the aneurysm. The consequences of endoleakage in terms of pressure in the aneurysmal sac are not exactly known. Moreover, the diagnosis of endoleakage is a problem because visualization of endoleaks can be difficult. METHOD: With an ex vivo model of circulation with an artificial aneurysm managed by means of a tube graft, studies were performed to evaluate precisely known diameters of endoleaks with both imaging techniques (computed tomography and digital subtraction angiography) and pressure measurements of the aneurysmal sac. The experiments were performed without endoleak (controls) and with 1.231-French (0.410 mm), 3-French (1 mm), and 7-French (2.33 mm) endoleaks. Pressure and imaging were evaluated in the absence and presence of a simulated open lumbar artery. The pressure in the prosthesis and in the aneurysmal sac were recorded simultaneously. Digital subtraction angiography with and without a Lucite acrylic plate, computed tomographic angiography, and delayed computed tomographic angiography were performed. For the first experiments, the aneurysmal sac was filled with starch solution. All tests were repeated with fresh thrombus in the aneurysmal sac. RESULTS: Each endoleak was associated with a diastolic pressure in the aneurysmal sac that was identical to diastolic systemic pressure, although the pressure curve was damped. At digital subtraction angiography without a Lucite acrylic plate, the 1.231-French (0.410 mm) endoleak was visualized without an open lumbar artery. When a Lucite acrylic plate was added, the endoleak was not visible until a lumbar artery was opened. In the presence of thrombus within the aneurysmal sac, all endoleaks were not visualized at digital subtraction angiography. At computed tomographic angiography, all endoleaks were not visualized in the absence of a thrombus mass in the aneurysmal sac. In the presence of thrombus within the aneurysmal sac, the 1.231-French (0.410 mm) endoleak became visible after opening of a simulated lumbar artery. At delayed computed tomographic angiography, all endoleaks were visualized without and with thrombus. CONCLUSION: Every endoleak, even a very small one, caused pressure greater than systemic diastolic pressure within the aneurysmal sac. However, small endoleaks were not visualized with digital subtraction angiography and computed tomographic angiography, whereas all endoleaks were visualized with a delayed computed tomographic angiography protocol. We believe that follow-up examinations after stent graft placement for aortic aneurysms should focus on pressure measurements, but until this is clinically feasible, delayed computed tomographic angiography should be performed.

Angiography, Digital Subtraction↗
PubMed1997

Acute elevation of coronary venous pressure does not affect left ventricular contractility in the normal and stressed swine heart: implications for the Fontan operation.

OBJECTIVE: After the Fontan operation the right atrium and, thus, the coronary sinus are connected to the pulmonary arterial system, which causes the coronary venous pressure to increase. We investigated the acute effects of elevation of coronary venous pressure on baseline hemodynamics, coronary venous flow, and left ventricular contractility. METHODS: In acutely instrumented pigs, during complete right heart bypass and during constant cardiac output, pressure in the right atrium, right ventricle, and coronary sinus was altered by a height-adjustable reservoir. At various levels of coronary venous pressure (up to 4 kPa or up to 30 mm Hg), flow from the reservoir was measured and left ventricular hemodynamics and contractility were measured from catheter-derived left ventricular pressure and (conductance) volume data. Contractility of the left ventricle was assessed by the end-systolic pressure-volume relationship derived during an unloading intervention by adjusting the bypass pump speed. RESULTS: Left ventricular end-diastolic pressure increased slightly (about 5%) with each kilopascal increase in coronary venous pressure, most likely related to diastolic ventricular interaction. No other changes in hemodynamic parameters occurred. Neither coronary venous flow nor left ventricular contractility was influenced by changes in coronary venous pressure. Imposing myocardial stress with dobutamine, 10 microg/kg per minute, did not change these findings. CONCLUSION: Increasing coronary venous pressure to 4 kPa in the intact circulation with intact autoregulation does not affect coronary flow or left ventricular contractility. We found no experimental evidence for the usefulness of diversion of the coronary sinus to the left atrium during Fontan-type operations

Adrenergic beta-Agonists↗
PubMed1996

Clinical spectrum, investigations and treatment of Budd-Chiari syndrome.

The clinical presentation, investigations, therapeutic modalities, prognosis and outcome of 44 patients with Budd-Chiari syndrome (BCS) were reviewed. There were 27 women and 17 men. Median age at presentation was 37 years (range 14-60). Possible aetiological factors were identified in 31 patients (70%). Myeloproliferative disorders were the commonest aetiology. Abdominal pain and swelling were the commonest presenting symptoms. Sixteen patients underwent a shunt operation (14 mesocaval, 2 mesoatrial). Ten patients had liver transplantation. Eleven patients had angioplasty/stent as their only treatment, and seven were treated medically or died before any treatment was instituted. Radiological intervention was comparable to mesocaval shunt in relieving patients' symptoms and in achieving good long-term results. Medical treatment and liver transplantation both yielded poor results. Radiological intervention in the form of balloon angioplasty or stent placement gives good results in a subgroup of BCS patients, and should be tried first to relieve the hepatic outflow obstruction. Mesocaval shunts provide good results in selected cases. Underlying haematological causes should be intensively investigated and promptly treated.

Adult↗
PubMed1996

Supernumerary tendons of the abductor pollicis.

During a study of variants of the tendon of the abductor pollicis longus (APL) muscle, in 1 of 110 upper extremities prepared, we recorded the rare finding of a division of the APL muscle tendon into 7 sections in the first tunnel. Whereas the actual main tendon inserted at the base of the first metacarpal bone, as depicted in the textbooks, the supernumerary tendons attached to the fascia of the opponens pollicis muscle to the radial edge of the abductor pollicis brevis muscle and to the dorsoradial third of the base of the first metacarpal bone. All accessory tendons were arranged in a radial formation around the main tendon within the same synovial sheath, but the main tendon occupied a separate compartment. In 80% of the upper extremities prepared for this study, the classical description of the abductor tendon did not apply. The classical representation of a single abductor tendon applied to only 20% of the upper extremities examined. In about one third of the wrists prepared, the first tunnel was clearly divided by a septum, so that 2 or more osteofibrous tunnels were present within the main tunnel. The number, thickness and length of such accessory tendons have a functional significance in the development of de Quervain's stenosing tendovaginitis and possibly also have a practical significance, as they may be regarded as a source of transplant material for plastic reconstructions.

Aged↗
PubMed1995

Dietary guidance workshop helps tribal program cooks make changes.

Nutrition educators need to view tribal program cooks as important food and nutrition gatekeepers for their clients, families, and communities. They need to train these cooks using a variety of educational techniques, including culturally sensitive food preparation sessions and classroom activities to increase cooks' knowledge and skills, enhance their self-esteem, and improve their attitudes about cooking more healthfully.

Adult↗
PubMed1994

Eye movements in baboons performing a matching-to-sample task presented in a divided-field format.

We examined eye saccades in a baboon solving a video-formatted matching-to-sample (MTS) task. In that task, the animal had to place a cursor by way of joystick manipulation within the boundaries of a fixation point (FP) displayed on a monitor. A sample stimulus was then flashed in either the left or right of FP. Immediately thereafter, two comparison forms were displayed and the animal had to select the comparison form matching the sample. A new video technique requiring no specific head or body constraints was employed to monitor eye movements. Expt. 1 indicated that the gaze was centered on FP during the fixation procedure. However, some goal-directed express saccades, with mean latencies of 100 ms, were observed during sample presentation. Expt. 2 used an overlap procedure in which FP remained visible during sample presentation. Latencies of express saccades increased by approximatively 20 ms. Expt. 3 showed in four baboons that the overlap procedure did not affect scores. It is concluded that the computerized MTS task is a valuable tool for the assessment of hemispheric lateralization in visual processing in intact primates, as long as the sample is not displayed longer than 120 ms.

Animals↗