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Biomedical subjects

M Harding

Publications and source records attributed to M Harding.

At least 55 records · Page 3Linked to original sources
PubMed1994

Fatness in relation to substrate oxidation during exercise.

The aim of this study was to test the hypothesis that differences in fuel utilisation during exercise, determined by muscle fibre-type profile, are an aetiological factor for obesity as proposed by Wade et al. (Lancet 1990, 335, 805-8). An investigation was carried out of relationships between body fatness (assessed by skinfolds, densitometry and dual X-ray absorptiometry) and fuel utilisation represented by the respiratory exchange ratio (RER, assessed by indirect calorimetry) during three cycle ergometer exercises. Exercise 1 was an exact replication of the Wade protocol (fixed 100 Watt load and unstandardised with respect to antecedent diet and activity). Exercises 2 (fasted) and 3 (fed) were highly standardised and adjusted to represent the same relative workload for each subject (45% VO2max). The subjects were 37 randomly-selected untrained men. None of the exercises yielded significant correlations between fatness and RER. The results refute the initial hypothesis linking substrate oxidation and body fatness. Inspection of the body composition data for Wade's subjects reveals that they were abnormally lean. This suggests that their findings may have been confounded by coincident correlations between fitness and fatness, and may not represent a true causal relationship.

Absorptiometry, Photon↗
PubMed1993

Calbindin D28K expression in transfected mouse NIH3T3 cells.

Calbindin D28K (formerly known as vitamin D-dependent calcium binding protein and referred to here as calbindin) is found in a wide variety of tissues, but only in certain cells within those tissues. Apart from its ability to bind calcium, nothing is known about its function in these cells. To investigate its role we have transfected the chick calbindin cDNA into mouse NIH3T3 fibroblasts and established a new cell line where calbindin is permanently expressed. Immunofluorescence studies show that calbindin is distributed throughout the cytoplasm, and treatment of the cells with cycloheximide shows that it has a relatively long half-life within the cell. Measurements of intracellular calcium concentration using Fura-2 suggest that the presence of calbindin within the cells does not affect the increase in intracellular calcium levels which occurs in response to serum stimulation or the rate at which these return to the basal level, but that it may act as a buffer for the entry of extracellular calcium.

3T3 Cells↗
PubMed1993

A pilot study of cisplatin based combination chemotherapy in gastric cancer.

A pilot study evaluating cisplatin in combination with 5-fluorouracil, methotrexate and epirubicin in advanced gastric cancer was initiated. Twenty patients were treated, eight with locally advanced or recurrent disease, and 12 with metastatic gastric cancer. The overall response rate was 35% (95% confidence interval 14%-56%).

Adult↗
PubMed1993

Longitudinal assessment of energy expenditure in pregnancy by the doubly labeled water method.

Twelve women were studied before pregnancy and at 6-wk intervals from 6 to 36 wk gestation. Total energy expenditure (TEE) by the doubly labeled water method, basal metabolic rate (BMR), energy intake, and body composition were assessed on each occasion. There was substantial interindividual variation in the response to pregnancy. Mean total energy costs were as follows: delta BMR 112 +/- 104 MJ (range -53 to 273), delta TEE 243 +/- 279 MJ (range -61 to 869 MJ), and fat deposition 132 +/- 127 MJ (range -99 to 280 MJ). The mean total cost of pregnancy (cumulative TEE above baseline+energy deposited as fat and as products of conception) was 418 +/- 348 MJ (range 34-1192 MJ). This was much higher than current recommendations for incremental energy intakes. Self-recorded incremental intakes (208 +/- 272 MJ) seriously underestimated the additional costs. The variability in response emphasizes the problems in making prescriptive recommendations for individual women, because there is no way of predicting metabolic or behavioral responses to pregnancy.

Adult↗
PubMed1993

Measurement of fat digestion in early life using a stable isotope breath test.

13C breath tests are a safe, non-invasive way of assessing nutrient digestion and absorption that can be used repeatedly in infancy and childhood. The aim of this study was to assess their value for measuring fat digestion in infants and young children with cystic fibrosis, and healthy controls whose pancreatic exocrine function is immature, and to monitor pancreatic enzyme supplementation. Six infants with cystic fibrosis (aged 10-18 months) and nine healthy controls (aged 6-19 months) were studied. After an overnight fast each child ingested 7.5 mg/kg 13C trioctanoin (99 atom % excess) followed by a known volume of milk. Breath samples were collected before and at 30 minute intervals thereafter for five hours. The 13C enrichment of expired carbon dioxide was measured by gas isotope ratio mass spectrometry. The mean (SD) percentage dose recovery of 13C was 13.5 (5.3) for the cystic fibrosis group and 24.2 (6.7) for the healthy controls. When those with cystic fibrosis were studied after supplementary pancreatic enzymes, the mean percentage dose recovery rose to 17.1 (6.9). Total intraluminal lipolysis was diminished by 44% in young children with cystic fibrosis. Pancreatic enzyme supplements improved digestion by 27%. The 13C trioctanoin breath test was effective in detecting fat maldigestion and can be used to measure the benefits of enzyme supplements in early life.

Breath Tests↗
PubMed1993

The outcome of school dental screening in two suburban districts of Greater Manchester, UK.

School dental screenings have been carried out in the community dental service for over eighty years but there have been very few evaluations of their outcome. The community dental service is now required to provide treatment only for those who have experienced difficulty in obtaining treatment in the general dental service. A follow up procedure to school dental screenings was designed to ensure that as many children in need of treatment as possible attended a general dental practitioner. The objective of this study was to evaluate the effectiveness of this procedure in persuading school children to attend a general dental practitioner. Data on the outcome of this follow up procedure were collected between May 1990 and March 1991 in Oldham and Tameside and Glossop. Of the 47,776 pupils screened, 10,925 were considered to require treatment. General dental practitioners confirmed subsequent attendance by 2,083 (19 per cent) and attendance at community dental service clinics was confirmed for a further 363 (3 per cent). A further 2,161 (20 per cent) were found to have received treatment at a rescreening held two to three months later. Of those referred for treatment, 4,607 children (42 per cent) had received it within the three months following the screening, the majority having received care in the general dental service.

Child↗
PubMed1992

High-dose chemotherapy and autologous bone marrow transplantation for relapsed and refractory Hodgkin's disease.

The results of high-dose chemotherapy with melphalan or melphalan (carmustine) etoposide for 66 consecutive patients with relapsed or resistant Hodgkin's disease are described. 55 patients were evaluable for response and 22% of these achieved complete remission and 59% partial remission. The actuarial survival at 2 years was 45% and the principal factors determining survival were the sensitivity of the disease to therapy given before high-dose chemotherapy and the type of treatment received. Intensive chemotherapy with autologous bone marrow transplantation can produce long-term survivors among patients for whom long-term survival would otherwise be improbable. However, this treatment remains toxic with an uncertain place in management.

Adolescent↗
PubMed1992

How does angioplasty work? Serial analysis of human iliac arteries using intravascular ultrasound.

BACKGROUND: Previous studies regarding the mechanism by which balloon angioplasty increases luminal patency have generally used animal models or postmortem specimens from occasional fatal cases of angioplasty performed in human patients. In either case, conclusions regarding participatory mechanisms have relied exclusively on nonserial, postangioplasty histopathological examination. METHODS AND RESULTS: In the present study, intravascular ultrasound examination was performed before and after balloon angioplasty in 40 consecutive patients with iliac artery stenoses. The areas of the arterial wall, plaque, lumen, and areas resulting from angioplasty-induced plaque fractures were measured immediately after angioplasty in vivo and compared with findings recorded immediately before angioplasty. Angioplasty increased luminal cross-sectional area (CSA) from 11.5 +/- 0.6 mm2 before angioplasty to 25.4 +/- 1.2 mm2 after angioplasty (p = 0.0001). CSA of the portion of the postangioplasty neolumen contained within angioplasty-induced plaque fractures measured 10.0 +/- 0.8 mm2; the neolumen excluding the area contributed by these plaque fractures measured 15.4 +/- 0.8 mm2. Thus, the area contained within plaque fractures accounted for 10.0 mm2 (71.9%) of the 13.9-mm2 increase in luminal CSA after angioplasty. Analysis of CSA occupied by atherosclerotic plaque disclosed that plaque CSA decreased from 33.8 +/- 1.8 mm2 before angioplasty to 22.5 +/- 1.5 mm2 after angioplasty (p = 0.0001). Plaque CSA was thus reduced ("compressed") by 11.3 +/- 1.1 mm2. Total artery CSA increased ("stretched") slightly from 45.3 +/- 2.6 mm2 before angioplasty to 47.8 +/- 2.0 mm2 after angioplasty (p = 0.0025). CONCLUSIONS: In vivo analysis of iliac stenoses by intravascular ultrasound immediately before and after angioplasty demonstrates that plaque fractures and "compression" of atherosclerotic plaque are the principal factors responsible for increased luminal patency resulting from balloon angioplasty. "Stretching" of the arterial wall provides an additional, but minor, contribution.

Aged↗
PubMed1991

Determinants of one-year outcome from balloon aortic valvuloplasty.

Balloon aortic valvuloplasty (BAV) has been a therapeutic alternative treatment for severe symptomatic aortic stenosis. Previous studies have been unable to predict 1-year outcome because of limited acute and follow-up clinical, invasive and echocardiographic data. The purpose of this study was to predict long-term outcome based on comprehensive data obtained at the time of valvuloplasty and at 3 and 6 months after the procedure. Of 170 consecutive patients undergoing BAV, 108 (mean age 78 years) were at least 1 year from their procedure. Prospective clinical, micromanometer hemodynamic, digital ventriculographic and echocardiographic/Doppler data were collected at baseline and immediately after the procedure. Echocardiographic data were also obtained at 3 and 6 months. With use of Cox model analysis, major events (defined as cardiac death [n = 30], aortic valve replacement [n = 21] or repeat BAV [n = 13]) were predicted by advanced age, baseline heart failure class, and baseline echocardiographic-determined diastolic left ventricular diameter. Only baseline left ventricular ejection fraction proved to be a significant predictor of cardiac death (p = 0.002) in a multivariate model. Absolute values after BAV (stroke work, first derivative of left ventricular pressure, valve area, end-systolic volume, Fick cardiac output, transvalvular gradient) and acute changes measured by catheterization or echocardiography did not provide additional predictive information over that of post procedure ejection fraction. Similarly, echocardiographic valve area and transvalvular gradient at 3 months added no further prognostic data. With an ejection fraction greater than or equal to 45% (n = 63), cardiac survival at 1 year was 80%, irrespective of age, sex, congestive heart failure class or severity of coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

The use of the sugar clock in dental health education.

An important factor in the prevention of dental caries is limiting the number of times in a day that sugar enters the mouth. This can be simply illustrated by using the sugar clock. The effectiveness of this as a technique for teaching 9-11-year-old children the importance of limiting frequency of sugar intakes was tested in a controlled study. Four weeks and 4 months after sugar clocks were used with a study group of children, they showed a significant increase over baseline in the number of correct answers given to a questionnaire. A control group showed no significant increase. It was concluded that the sugar clock is an effective method of teaching the importance of limiting frequency of sugar intake to this age group.

Child↗
PubMed1991

Long term results of cyclophosphamide, adriamycin and platinum chemotherapy in advanced epithelial ovarian cancer.

Between January 1980 and December 1983, 57 consecutive patients with advanced epithelial ovarian cancer (FIGO Stage IIc n = 5; III n = 45; IV n = 7) were treated with 6 cycles of cyclophosphamide 600 mg/m2, adriamycin 30-45 mg/m2 and platinum 50 mg/m2 (CAP) at 3 weekly intervals. Pathological complete remission (CR) was documented in 10 (18%) and 4 with no residual disease after primary cytoreductive surgery were free from progression (FFP). There were 19 partial remissions (PR) giving a 51% overall response rate. The median duration of CR was 33 months from second look surgery. Median survival (MS) for all patients was 22 months. Multivariate analysis indicated that response to chemotherapy was the most important prognostic factor, with MS for CR of 53 months, PR 23 months and stable or progressive disease 11 months (p = 0.001). Most CR (8 of 10) occurred in patients with minimal residual disease (no single lesion greater than 2.0 cm), but extent of disease, though significant in univariate analysis of prognostic factors was not an independent predictor of survival. Six patients (11%) are alive and tumour free with a minimum follow-up of 7 years. All had FIGO Stage III disease at presentation and four had no residual tumour after primary surgery.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Plain abdominal radiography in the detection of acute medical and surgical disease in children: a retrospective analysis.

A retrospective review was performed to determine the utility of plain abdominal radiographs in evaluating children presenting to the emergency department. Clinical features, radiographic interpretation, and final diagnoses of 431 patients seen over one year were recorded. One hundred three (24%) patients had major diseases (ventriculoperitoneal shunt malfunction, foreign body ingestion, appendicitis, intussusception, bowel obstruction, necrotizing enterocolitis, toxic megacolon, blunt abdominal trauma, pyloric stenosis, and Hirschsprung's disease), while the remaining 328 (76%) had minor diseases. Radiographs were categorized as diagnostic, suggestive, normal, incidental, or misleading, with respect to the patient's final diagnosis. No single clinical feature was able to detect all diagnostic radiographs in patients with major diseases. Limiting radiographs to patients with prior abdominal surgery, suspected foreign body ingestion, abnormal bowel sounds, abdominal distention, or peritoneal signs identified all patients with radiographs diagnostic of a major disease while eliminating 48% of studies ordered. Our results suggest that restricting abdominal roentgenograms to patients with at least one of these features will detect most diagnostic radiographs in children with acute abdominal diseases.

Abdomen, Acute↗
PubMed1991

The effect of CCKB/gastrin antagonists on stimulated gastric acid secretion in the anaesthetized rat.

1. The urethane-anaesthetized, vagotomised rat preparation was used to investigate the effects of the histamine H2-antagonist ranitidine, the proton pump inhibitor omeprazole and the CCKB/gastrin antagonists CI-988, PD 136450 and L-365,260 on pentagastrin-, histamine- and bethanechol-induced gastric acid secretion. 2. The novel CCKB/gastrin antagonists CI-988 and PD 136450, and L-365,260 dose-dependently inhibited pentagastrin-induced secretion. The ED50 value for PD 136450 was 0.05 mumol kg-1, the same following intravenous or subcutaneous administration. 3. CI-988 and PD 136450 administered subcutaneously at dose levels highly effective for antagonism of pentagastrin responses had no effect on basal acid secretion. 4. Ranitidine inhibited pentagastrin-, bethanechol-, and histamine-induced acid secretion, whereas the CCKB/gastrin antagonists inhibited only the secretory response to pentagastrin. 5. The selective CCKA antagonist, devazepide, was inactive at up to 300 mumol kg-1 i.p. against the three stimulants of acid secretion. 6. CI-988 and PD 136450 will be useful research tools with which to investigate the role of CCKB/gastrin receptors in gastric acid secretion and the trophic activities of gastrin and cholecystokinin (CCK) on the gastrointestinal tract.

Animals↗
PubMed1990

'Invisible disability'.

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Dental Care for Persons with Disabilities↗