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Biomedical subjects

K M Allen

Publications and source records attributed to K M Allen.

At least 37 records · Page 2Linked to original sources
PubMed1994

Effects of small angle discrepancies on interpretations of subtraction images.

The present study examines interpretations of subtraction images of pairs of radiographs taken at 0 degrees, 1 degree, or 2 degrees of angle discrepancy. The radiographs were taken at each of 48 alveolar crestal sites on 15 dried human skulls. Computer-simulated lesions were induced at the sites on three fourths of the radiographs. Ten instructed dentists were asked to interpret the subtraction images as to the presence or absence of crestal change. A 2-degree angle discrepancy between radiographs resulted in a significant difference in sensitivity from that of radiographic pairs with a 0-degree discrepancy. However, we found no significant difference in sensitivity between 1-degree and 0-degree pairs of radiographs. In conclusion, a 1-degree geometric difference between pairs of radiographs does not significantly contribute to errors in interpretation of subsequent subtraction images.

Alveolar Bone Loss↗
PubMed1994

Detection of experimentally induced lesions in subtraction images of cancellous alveolar bone.

Cancellous bone lesions of varying sizes were made in specimens of human mandibles and radiographed under geometrically reproducible conditions and observed by viewing of before and after radiographs and subtraction images. Of 178 lesions, traditional comparison of before and after radiographs resulted in 108 correct diagnoses. Analysis of the same lesions by subtraction radiography resulted in 162 (91%) correct diagnoses. This difference in diagnostic accuracy with the use of these two methods of radiographic analyses was significant at the p = 0.0001 level.

Alveolar Bone Loss↗
PubMed1994

Algorithm for the automated alignment of radiographs for image subtraction.

The results of this study indicate that automated alignment of pairs of radiographs produces subtractions that are indistinguishable in quality from subtractions aligned manually by an experienced aligner. In developing the algorithm for automated alignment, care was taken that the criteria used for establishing a window appropriate for testing the quality of alignment were the same for both alignment techniques.

Algorithms↗
PubMed1994

Genetic analysis of nucleotide triphosphatase activity in the mouse brain.

A Ca(2+)- or Mg(2+)-stimulated ecto-ATPase is thought to regulate the hydrolysis of extracellular ATP in nervous tissues. The hydrolysis of nucleotide triphosphates (NTPs) was analyzed in brain microsomal fractions from crosses of DBA/2J (D2) and C57BL/6J (B6) mice. The nucleotide triphosphatase (NTPase) activity was significantly reduced in D2 mice as compared to B6 mice, and B6D2F1 hybrids had activities intermediate to the parentals. A significant positive correlation was found between the hydrolysis of four NTPs (ATP, CTP, GTP and UTP) in 24 B6 x D2 (BXD) recombinant inbred (RI) strains of mice and in 80 B6D2F1 x D2 backcross mice. The RI strains and backcross mice fell into two distinct groups with respect to the NTPase activity. Linkage of NTPase activity was suggested with the chromosome 2 markers, D2Mit6 and Ass-1, in the RI strains, and was confirmed by analysis of other markers in the backcross population. These data suggest that the Ca(2+)- or Mg(2+)-stimulated hydrolysis of NTPs, designated Ntp, is regulated by a single gene located on proximal chromosome 2. Although an association was observed previously between Ca(2+)-ATPase activity and susceptibility to audiogenic seizures (AGS), no significant association was observed for the expression of Ntp and AGS susceptibility.

Animals↗
PubMed1994

Studies of the angular reproducibility of positioning patients adjacent to an x-ray tube: 1. Stent-rod based and extra-oral systems.

The usefulness of subtraction radiography for detecting small changes in crestal bone is dependent upon achieving reproducible geometry between x-ray beam and patient structures when serial radiographs are taken. This study evaluates 2 methods currently employed to maintain geometric correspondence: 1) a stent-based system which rigidly fixes a custom-made stent to the x-ray tube by the use of a rod and 2) an extra-oral system which positions a patient in the x-ray unit by means of ear rods. The projection of a light beam from a fixed subject reference was used to measure the change of the orientation of the reference at 2 different measurement times. The rod-stent system was able to maintain a discrepancy of less than 2 degrees 75% of the time over a time period of 6 months. For the extra-oral system this ranged from 72% to 92% during a 1-month period.

Alveolar Bone Loss↗
PubMed1994

Evaluation of a simple modified radiographic alignment system for routine use.

Radiographic frames used for longitudinal studies may be in part unreadable for measuring crestal bone change. Sites may not be present on the film, or the measurement reliability may be compromised because of dissimilar geometry. Several techniques used to address this problem are expensive, time-consuming, and required great skill. For the present study a commercially-available alignment system was simply modified by addition of a reference pin in the bite block, facilitating the repositioning of the film holder for a second exposure. This study determined the ability of the modified instrument to: 1) improve the geometrical correspondence between serial radiographs; and 2) reduce the frequency of missed sites in the film. Two pairs of x-rays were taken for each of 40 subjects, 1 pair with the standard alignment instrument of an assigned site and 1 pair with the modified instrument of the contralateral site. Measurements of alveolar bone height were performed using the "side by side" technique. The modified instrument yielded significantly smaller measurement differences and a significantly better geometrical correspondence than the conventional system (P < 0.05). Also, the modified instrument yielded significantly greater (P < 0.01) readable sites (86%) as compared to the conventional instrument (62%). The simply-modified instrument facilitates the correct interpretation of serial radiographs.

Acrylic Resins↗
PubMed1993

Relationships between expectancies and adolescent dieting behaviors.

Dieting expectancies are cognitive variables pertaining to anticipated outcomes individuals expect to obtain from dieting to lose weight. This investigation examined the factor structure of dieting expectancies in an adolescent population, age 10-18, and tested the ability of factors to distinguish among types of dieter, diet pill user, and vomiter groups. Emerging from a principal components analysis were five reliable expectancy factors: Social Confidence, Social Approval, Self-Worth, Positive Performance, and Negative Consequences. Results indicate dieting expectancies and gender are important in distinguishing among adolescents who engage in different dieting practices. Gender and Self-Worth were particularly important in distinguishing frequent dieters from nondieters. Social Approval was best at separating frequent dieters from occasional dieters, diet pills users from nonusers, and vomiters from nonvomiters.

Adolescent↗
PubMed1993

A comparison of clinical assessment and home oximetry in the diagnosis of obstructive sleep apnea.

In order to determine whether measurement of arterial oxygen saturation (SaO2) could identify patients with obstructive sleep apnea (OSA), 98 consecutive patients referred for assessment of snoring and/or daytime somnolence were assessed clinically and then underwent both unsupervised oximetry in their homes and formal polysomnography. Clinical assessment identified patients with an apnea+hypopnea index (AHI) > or = 15 events per hour with a sensitivity of 79% and a specificity of 50%. Home oximetry analyzed by counting the number of arterial oxygen desaturations recorded was inferior to clinical assessment. For desaturations of 2% or more from baseline, desaturation index (DI) > or = 15 per hour identified patients with AHI > or = 15 with sensitivity 65% and specificity 74%; for 3% desaturations, sensitivity was 51% and specificity 90%; and for 4% desaturations, sensitivity was 40% and specificity 98%. From the oximetry data, the percentage of time spent at SaO2 below 90% (CT90) was also calculated. CT90 > or = 1% identified patients with AHI > or = 15 with sensitivity 93% and specificity 51%; for patients with AHI > or = 15 ultimately given nasal continuous positive airway pressure (CPAP), the sensitivity of a CT90 > or = 1% was 100%. We concluded that home oximetry with CT90 < 1% practically excludes clinically significant OSA. Conversely, home oximetry with DI > or = 15 for 4% desaturations makes OSA likely: the positive predictive value for OSA is 83% if the pretest probability of OSA is 30% and over 90% if the pretest probability is at least 50%.

Adult↗
PubMed1992

Hypokalemic paralyses: a review of the etiologies, pathophysiology, presentation, and therapy.

Acute hypokalemic paralysis is an uncommon cause of acute weakness. Morbidity and mortality associated with unrecognized disease include respiratory failure and death. Hence, it is imperative for physicians to be knowledgeable about the causes of hypokalemic paralysis, and consider them diagnostically. The hypokalemic paralyses represent a heterogeneous group of disorders with a final common pathway presenting as acute weakness and hypokalemia. Most cases are due to familial hypokalemic paralysis; however, sporadic cases are associated with diverse underlying etiologies including thyrotoxic periodic paralysis, barium poisoning, renal tubular acidosis, primary hyperaldosteronism, licorice ingestion, and gastrointestinal potassium losses. The approach to the patient with hypokalemic paralysis includes a vigorous search for the underlying etiology and potassium replacement therapy. Further therapy depends on the etiology of the hypokalemia. Disposition depends on severity of symptoms, degree of hypokalemia, and chronicity of disease.

Acidosis, Renal Tubular↗
PubMed1991

Presence of human friends and pet dogs as moderators of autonomic responses to stress in women.

Autonomic responses were measured while 45 adult women performed a standard experimental stress task in the laboratory with only the experimenter present and 2 weeks later at home in the presence of a female friend, pet dog, or neither. Results demonstrated that autonomic reactivity was moderated by the presence of a companion, the nature of whom was critical to the size and direction of the effect. Ss in the friend condition exhibited higher physiological reactivity and poorer performance than subjects in the control and pet conditions. Ss in the pet condition showed less physiological reactivity during stressful tasks than Ss in the other conditions. The results are interpreted in terms of the degree to which friends and pets are perceived as evaluative during stressful task performance. Physiological reactivity was consistent across the laboratory and field settings.

Adaptation, Psychological↗
PubMed1991

Problems and coping strategies of individuals with traumatic brain injury and their spouses.

A pilot investigation is reported on the problems and coping strategies of 20 married men and 11 married women with traumatic brain injury (TBI) and their able-bodied spouses. All injured subjects experienced severe head injury at least one and a half years earlier. A structured, small-group discussion process was used to elicit a prioritized list of problems and a similar list of coping strategies. Individuals with TBI and their spouses identified problems in living as most important; loss of employment and restrictions on autonomy were reported as the most problematic. Men with TBI placed priority on controlling their anger, whereas, women with TBI were concerned with their mood disorders, particularly depression. Women with TBI and able-bodied wives of men with TBI placed high priority on the use of support groups as a coping strategy. Men placed higher priority on individualistic approaches to adjustment, such as suppression of feelings. A number of testable hypotheses resulted from the pilot study.

Activities of Daily Living↗
PubMed1990

Estimation of the probability of disturbed breathing during sleep before a sleep study.

We have investigated the ability of a statistical model developed from clinical data and questionnaire responses to predict disturbance of breathing during sleep. Data from 100 consecutive patients referred for sleep study for suspected sleep apnea were used to develop the model using logistic regression analysis. For each subject, the model predicted the probability of having an apnea-hypopnea index (AHI) greater than 15; this probability was compared with the AHI measured from sleep study. A probability cutoff point (= 0.15) was decided on that minimized the number of subjects with false-negative predictions. Four terms--apneas observed by bed partner, hypertension, body mass index, and age--were found to contribute significantly to the model with observed apneas being by far the most predictive term of the four (adjusted odds ratio 19.7). When the model was tested to estimate the probability of an AHI greater than 15 for 105 patients from a second group of consecutive patients referred for sleep study, the model correctly classified 33 of 36 patients with a measured AHI greater than 15 (sensitivity = 92%) and 35 of 69 patients with a measured AHI less than or equal to 15(specificity = 51%). This study shows that analysis of clinical features of patients presenting with suspected sleep apnea may reduce the need for sleep studies by about one-third yet still lead to the identification of the great majority of patients with abnormal breathing during sleep.

Female↗
PubMed1990

Computerized generation of lesion models for evaluating subtraction radiography.

Digital subtraction radiography is a technique that has been shown to provide greater sensitivity and specificity in detecting bur-induced crestal bone change than the traditional comparison of two radiographs. It is questionable, however, to what extent these reports relate to clinical situations. A computerized method of extracting lesion areas from clinical subtraction images and imposing them on radiographs of experimental sites has been developed with the goal of producing a more relevant model for evaluating subtraction radiography. Observers were unable to distinguish between natural lesions and those produced by this method.

Alveolar Bone Loss↗
PubMed1990

Immunohistochemical localization of peptide-containing nerves in human airways: age-related changes.

Bronchial reactivity changes during childhood, indicating possible changes in neural control. Nerves supplying the intrapulmonary airways were therefore studied in autopsy tissue from 14 normal infants (0 to 3.5 yr), 3 children (8.3 to 10.75 yr), and 4 adults (17 to 24 yr). An indirect immunofluorescence technique was used to study the distribution and relative number of nerve fibers containing the general neuronal markers protein gene product 9.5 and synaptophysin. Nerve subpopulations were identified using antisera to neuropeptide tyrosine, vasoactive intestine polypeptide, somatostatin, substance P, calcitonin gene-related peptide, and the enzyme tyrosine hydroxylase. Between birth and 3 yr, the distribution and relative number of immunoreactive nerves shown by both the general neuronal markers and specific antisera did not change. Neuropeptide tyrosine-immunoreactive nerves were the most common peptide-containing nerve subpopulation identified in the human lung, supplying bronchial smooth muscle, submucosal glands, cartilage, and submucosa. Other peptide-containing nerves exhibited distinct distribution patterns. Two differences in the airway innervation were identified between cases aged 0 to 3.5 yr and the older age groups. Relatively fewer peptide-containing nerves occurred in the adult bronchioli and respiratory unit, but the relative number of vasoactive intestinal polypeptide-containing nerves supplying the bronchial and bronchiolar smooth muscle was greater in the two older age groups. Given these apparent age-related differences in the number of peptide-containing nerves supplying the human airway, studies on the development of peptide receptors are indicated.

Adolescent↗
PubMed1989

Cytoskeletal features of immature pulmonary vascular smooth muscle cells: the influence of pulmonary hypertension on normal development.

Using an immunohistochemical technique, the development of the cytoskeletal proteins desmin, vimentin, and actin (using alpha isotype and non-isotype specific antibodies) was assessed using a semi-quantitative grading system in the pulmonary vascular smooth muscle of nine normal pigs and 19 normal humans at different ages, and in 13 children with pulmonary hypertensive congenital heart disease. In the normal of both species, immunostaining for vimentin decreased after birth and then increased gradually while immunostaining for desmin and alpha actin increased steadily with age. In pulmonary hypertension, immunostaining for alpha actin and vimentin showed an accelerated increase at between 2 and 8 months. Also, the media showed regional differences in immunostaining which preceded the development of intimal proliferation. The inner media showed less immunoreactivity for all cytoskeletal proteins studied than did the outer media. Within areas of intimal proliferation many cells were immunonegative. These results suggest that the cytoskeletal features of medial smooth muscle cells are remodelled in the normal infant; that this process is altered from at least 2 months in the pulmonary hypertensive infant; and that the smooth muscle cells immediately beneath the internal elastic lamina are remodelled before migrating to form intimal proliferation. Changes in cytoskeletal composition can be related to the previously described postnatal maturation of pulmonary vascular smooth muscle cells.

Actins↗
PubMed1989

The diet and gastrodermal ultrastructure of polystomatid monogeneans infecting chelonians.

All polyopisthocotylean monogeneans previously studied, including representatives of the Polystomatidae infecting anuran amphibians, feed on host blood. However, the present analysis of species of Polystomoides, Polystomoidella and Neopolystoma, polystomatids which infect chelonian reptiles, has shown that this group has diverged nutritionally from related parasites. Histochemical tests failed to demonstrate haemoglobin in the gut caeca, and X-ray microanalysis confirmed the absence of haematin (or high concentrations of bound iron) in the gastrodermis. The chelonian polystomatids (and also the single monogenean which infects a mammal, Oculotrema hippopotami) feed on epithelial cells and mucus, the diet typical of monopisthocotyleans. Transmission electron microscopy revealed the same gastrodermal architecture in representatives of Polystomoides from Africa, N. America and S.E. Asia. The organization of the caecal epithelium conforms with that of blood-feeding polyopisthocotyleans, with two components: lamellated cells responsible for intracellular digestion interspersed with elements of a non-lamellated connecting syncytium. In other polyopisthocotyleans, the syncytium probably has a skeletal, supportive role, related to the problems of intracellular accumulation of haematin, but in polystomatids infecting chelonians the syncytium is extremely reduced and its presence probably reflects an ancestry amongst blood-feeding relatives. The utilization of the presumably more primitive monogenean diet of epithelial cells and mucus by chelonian polystomatids may be related to the scarcity of superficial blood vessels in their oral and urinary bladder habitats.

Animals↗
PubMed1989

A study of nerves containing peptides in the pulmonary vasculature of healthy infants and children and of those with pulmonary hypertension.

Nerves containing peptides that supply the human intrapulmonary vasculature were studied in 21 controls aged one month to 24 years and in 13 patients with pulmonary hypertension aged 11 days to eight years. An indirect immunofluorescence technique was used to study the distribution and relative density of nerve fibres containing the general neuronal marker, protein gene product 9.5; tyrosine hydroxylase; synaptophysin; neuropeptide tyrosine; vasoactive intestinal polypeptide; substance P, somatostatin; and calcitonin gene related peptide. At all ages in normal and hypertensive lungs neuropeptide tyrosine was the predominant neuropeptide associated with the pulmonary vascular nerves. In normal lungs the relative density of nerve fibres increased during childhood only in the arteries of the respiratory unit. Pulmonary hypertension was associated with the premature innervation of these arteries during the first year of life. Innervation of small, abnormally thick-walled pre-capillary vessels by predominantly vasoconstrictor nerves may help to explain the susceptibility of infants to pulmonary hypertensive crises.

Age Factors↗