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Biomedical subjects

M J Alexander

Publications and source records attributed to M J Alexander.

At least 19 recordsLinked to original sources
PubMed2004

Chemical properties of urban waste ash produced by open burning on the Jos Plateau: implications for agriculture.

Urban centres produce most of the world's waste and between a third and a half goes uncollected. The answer to the problem of waste disposal lies partly in agriculture, as waste can be extremely nutrient-rich. In the last decade there has been a tremendous increase in the developing world in total city area under informal food production and there are many examples of waste recycling onto the urban or peri-urban plots. Farmers on the Jos Plateau, Nigeria, have developed a successful soil fertility management strategy based on the combination of inorganic fertilisers, manure and urban waste ash. This study sought to provide some preliminary data on urban waste ash produced by open burning and used in farming in a developing country. Ash samples were collected from different locations around Jos and tested for C, N, pH, P, Na, K, Ca, Mg, Fe, Mn, Zn, Cu, Ni, Cd and Pb. It was found that ash is an effective liming material (because of the high pH, and high Ca, Mg and K contents), and has the potential to contribute significant quantities of micro-nutrients such as Mn, Zn and Cu. Ash, however, is far from being a homogenous material and its variability means that its fertilising potential will vary between batches and that, even if mean and median levels are low, there is the risk of the formation of localised areas of soil with excessive heavy metal contents (this is particularly the case with Pb). Further research is required to determine the plant-availability of these elements in the ash and to assess the wider environmental and health implications of uncontrolled, open burning of waste as a means of producing ash for agricultural purposes.

Agriculture↗
PubMed2000

Chronic hepatitis B virus infection in Asian countries.

Of the estimated 50 million new cases of hepatitis B virus (HBV) infection diagnosed annually, 5-10% of adults and up to 90% of infants will become chronically infected, 75% of these in Asia where hepatitis B is the leading cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC). In Indonesia, 4.6% of the population was positive for HBsAg in 1994 and of these, 21% were positive for HBeAg and 73% for anti-HBe; 44% and 45% of Indonesian patients with cirrhosis and HCC, respectively, were HBsAg positive. In the Philippines, there appear to be two types of age-specific HBsAg prevalence, suggesting different modes of transmission. In Thailand, 8-10% of males and 6-8% of females are HBsAg positive, with HBsAg also found in 30% of patients with cirrhosis and 50-75% of those with HCC. In Taiwan, 75-80% of patients with chronic liver disease are HBsAg positive, and HBsAg is found in 34% and 72% of patients with cirrhosis and HCC, respectively. In China, 73% of patients with chronic hepatitis and 78% and 71% of those with cirrhosis and HCC, respectively, are HBsAg positive. In Singapore, the prevalence of HBsAg has dropped since the introduction of HBV vaccination and the HBsAg seroprevalence of unvaccinated individuals over 5 years of age is 4.5%. In Malaysia, 5.24% of healthy volunteers, with a mean age of 34 years, were positive for HBsAg in 1997. In the highly endemic countries in Asia, the majority of infections are contracted postnatally or perinatally. Three phases of chronic HBV infection are recognized: phase 1 patients are HBeAg positive with high levels of virus in the serum and minimal hepatic inflammation; phase 2 patients have intermittent or continuous hepatitis of varying degrees of severity; phase 3 is the inactive phase during which viral concentrations are low and there is minimal inflammatory activity in the liver. In general, patients who clear HBeAg have a better prognosis than patients who remain HBeAg-positive for prolonged periods of time. The outcome after anti-HBe seroconversion depends on the degree of pre-existing liver damage and any subsequent HBV reactivation. Without pre-existing cirrhosis, there may be only slight fibrosis or mild chronic hepatitis, but with pre-existing cirrhosis, further complications may ensue. HBsAg-negative chronic hepatitis B is a phase of chronic HBV infection during which a mutation arises resulting in the inability of the virus to produce HBeAg. Such patients tend to have more severe liver disease and run a more rapidly progressive course. The annual probability of developing cirrhosis varies from 0.1 to 1.0% depending on the duration of HBV replication, the severity of disease and the presence of concomitant infections or drugs. The annual incidence of hepatic decompensation in HBV-related cirrhosis varies from 2 to 10% and in these patients the 5-year survival rate drops dramatically to 14-35%. The annual risk of developing HCC in patients with cirrhosis varies between 1 and 6%; the overall reported annual detection rate of HCC in surveillance studies, which included individuals with chronic hepatitis B and cirrhosis, is 0.8-4.1%. Chronic hepatitis B is not a static disease and the natural history of the disease is affected by both viral and host factors. The prognosis is poor with decompensated cirrhosis and effective treatment options are limited. Prevention of HBV infection thorough vaccination is still, therefore, the best strategy for decreasing the incidence of hepatitis B-associated cirrhosis and HCC.

Asia↗
PubMed1999

Colocalization of neurotensin messenger ribonucleic acid (mRNA) and progesterone receptor mRNA in rat arcuate neurons under estrogen-stimulated conditions.

In the female rat, estrogen and progesterone directly or indirectly regulate the activity of neurotensin (NT)-synthesizing neurosecretory cells located in the hypothalamic arcuate nucleus (ARC). To determine whether these NT neurons are subject to direct regulation by ovarian steroids, estrogen-inducible messenger RNA (mRNA) encoding nuclear progesterone receptor (PR) was used as a cellular marker for nuclear estrogen receptor (ER) as well as PR, and double label in situ hybridization was employed to determine the extent to which NT/neuromedin N mRNA and PR mRNA are colocalized in ARC neurons under estrogen-stimulated conditions. In estradiol-treated ovariectomized rats, approximately 80% of NT/neuromedin N mRNA-expressing cells in sections through the dorsomedial division of the ARC and approximately 60% of such cells in sections through the ventrolateral division of the ARC were found to contain PR mRNA. Depending on the ARC division and rostrocaudal level, double labeled cells accounted for approximately 20-50% of PR mRNA-containing cells. These results indicate that under estrogen-stimulated conditions the majority of NT neurons in the ARC express both PR and ER, as previous studies of this region indicate that estrogen-inducible PR occurs only in cells that also express ER. In the rat, NT neurons appear to be a major ARC cell type subject to direct regulation by estrogen and progesterone.

Animals↗
PubMed1998

Widespread expression in adult rat forebrain of mRNA encoding high-affinity neurotensin receptor.

The peptides neurotensin (NT) and neuromedin N exert effects on neurons by means of a high-affinity NT receptor (NTRH) belonging to the superfamily of G-protein-coupled receptors. In the present study, we used in situ hybridization histochemistry with sensitive riboprobe methodology to investigate the distribution of NTRH mRNA in the forebrain of adult rats. Labeled cells were abundant in the hypothalamus, epithalamus, ventral thalamus, septum, amygdala, and pallidum, including many regions where NTRH mRNA had not been detected previously. In the hypothalamus, novel sites of NTRH mRNA expression included the arcuate, periventricular, paraventricular, supraoptic, medial preoptic, anterior, ventromedial, and posterior nuclei, as well as the lateral hypothalamic area. In the thalamus, novel sites of expression included the anterodorsal nucleus, lateral habenula, and zona incerta, where labeling was much more extensive than previously reported. Novel telencephalic sites of expression included most bed nuclei of the stria terminalis, most divisions of the amygdala, the main olfactory bulb, the endopiriform nucleus, the claustrum, many parts of retrohippocampal allocortex, and limited parts of most isocortical areas. Novel sites of expression were also observed in the midbrain and pons. Taking into account expected differences in the subcellular locations of receptor mRNA and protein, the regional distribution of NTRH mRNA agrees well with that of NTRH determined previously. Our results identify many novel sites of NTRH mRNA expression in adult brain and provide a basis for investigating involvement of NT and related peptides in regulating the activity of these diverse cells, whose phenotypes remain largely undetermined.

Animals↗
PubMed1998

Multiple radiation-induced intracranial lesions after treatment for pituitary adenoma. Case report.

This 53-year-old man presented with a syncopal episode 31 years after undergoing craniotomy and external-beam radiation for a pituitary macroadenoma. A gadolinium-enhanced magnetic resonance (MR) image of the brain demonstrated a 2.5-cm enhancing mass in the right caudate region that had not been seen on previous studies. A stereotactically guided biopsy procedure was performed to obtain specimens from the mass, which were consistent with ependymoma. The MR image also revealed two additional lesions that appeared to be within the radiation fields: a right temporal meningioma and a left frontal cavernous malformation. A review of the literature found three previous reports in which ependymomas presented after radiation therapy.

Adenoma↗
PubMed1997

Neurotensin and neuroendocrine regulation.

More than two decades of research indicate that the peptide neurotensin (NT) and its cognate receptors participate to a remarkable extent in the regulation of mammalian neuroendocrine systems, potentially at multiple levels in a given system. NT-synthesizing neurons appear to exert a direct or indirect stimulatory influence on neurosecretory cells that synthesize gonadotropin-releasing hormone, dopamine (DA), somatostatin, and corticotropin-releasing hormone (CRH). In addition, context-specific synthesis of NT occurs in hypothalamic neurosecretory cells located in the arcuate nucleus and parvocellular paraventricular nucleus, including distinct subsets of cells which release DA, CRH, or growth hormone-releasing hormone into the hypophysial portal circulation. At the level of the anterior pituitary, NT stimulates secretion of prolactin and occurs in subsets of gonadotropes and thyrotropes. Moreover, circulating hormones influence NT synthesis in the hypothalamus and anterior pituitary, raising the possibility that NT mediates certain feedback effects of the hormones on neuroendocrine cells. Gonadal steroids alter NT levels in the preoptic area, arcuate nucleus, and anterior pituitary; adrenal steroids alter NT levels in the hypothalamic periventricular nucleus and arcuate nucleus; and thyroid hormones alter NT levels in the hypothalamus and anterior pituitary. Finally, clarification of the specific neuroendocrine roles subserved by NT should be greatly facilitated by the use of newly developed agonists and antagonists of the peptide.

Adjuvants, Immunologic↗
PubMed1997

Mental illness among homeless individuals in a suburban county.

OBJECTIVE: This paper compares the prevalence of mental illnesses and alcohol and drug abuse and the residential histories of homeless individuals identified as having a mental illness and individuals who are not so identified. The cohort consisted of single persons applying for shelter over a 12-week period in Westchester County, a suburban county in New York State. METHODS: The sample of 201 persons (89 percent male, with a mean age of 37) represented 77 percent of consecutive single shelter applicants in a single-point-of-entry system over the study period. Information from an intake assessment was augmented by a semistructured interview to reconstruct subjects' residential history for the last five years, including periods of homelessness and time in institutions. RESULTS: Twenty-one percent of the cohort was classified as having mental illness. Seventy-two percent had a diagnosis of drug abuse or dependence, and 51 percent had alcohol abuse or dependence. For individuals with a mental illness, the use of cocaine and heroin was significantly lower, but alcohol use was somewhat greater, compared with other homeless persons. Persons with mental illness also experienced homelessness of some kind over a significantly longer period (a mean of seven years versus a mean of three years for other subjects), and they spent almost twice as many weeks during the previous five years literally homeless. Institutional time, most of which consisted of time in jail or prison, was equivalent for both groups. CONCLUSIONS: Not only is residential instability heightened among shelter users with mental illness, but over time public institutions play a critical role in their accommodations. For some homeless persons with mental illness, the circuit of shelters, rehabilitation programs, jails, and prisons may function as a makeshift alternative to inpatient care or supportive housing and may reinforce the marginalization of this population.

Adolescent↗
PubMed1997

Characterization of cerebral hemodynamic phases following severe head trauma: hypoperfusion, hyperemia, and vasospasm.

The extent and timing of posttraumatic cerebral hemodynamic disturbances have significant implications for the monitoring and treatment of patients with head injury. This prospective study of cerebral blood flow (CBF) (measured using 133Xe clearance) and transcranial Doppler (TCD) measurements in 125 patients with severe head trauma has defined three distinct hemodynamic phases during the first 2 weeks after injury. The phases are further characterized by measurements of cerebral arteriovenous oxygen difference (AVDO[2]) and cerebral metabolic rate of oxygen (CMRO[2]). Phase I (hypoperfusion phase) occurs on the day of injury (Day 0) and is defined by a low CBF calculated from cerebral clearance curves integrated to 15 minutes (mean CBF 32.3 +/- 2 ml/100 g/minute), normal middle cerebral artery (MCA) velocity (mean V[MCA] 56.7 +/- 2.9 cm/second), normal hemispheric index ([HI], mean HI 1.67 +/- 0.11), and normal AVDO(2) (mean AVDO[2] 5.4 +/- 0.5 vol%). The CMRO, is approximately 50% of normal (mean CMRO(2) 1.77 +/- 0.18 ml/100 g/minute) during this phase and remains depressed during the second and third phases. In Phase II (hyperemia phase, Days 1-3), CBF increases (46.8 +/- 3 ml/100 g/minute), AVDO(2) falls (3.8 +/- 0.1 vol%), V(MCA) rises (86 +/- 3.7 cm/second), and the HI remains less than 3 (2.41 +/- 0.1). In Phase III (vasospasm phase, Days 4-15), there is a fall in CBF (35.7 +/- 3.8 ml/100 g/minute), a further increase in V(MCA) (96.7 +/- 6.3 cm/second), and a pronounced rise in the HI (2.87 +/- 0.22). This is the first study in which CBF, metabolic, and TCD measurements are combined to define the characteristics and time courses of, and to suggest etiological factors for, the distinct cerebral hemodynamic phases that occur after severe craniocerebral trauma. This research is consistent with and builds on the findings of previous investigations and may provide a useful temporal framework for the organization of existing knowledge regarding posttraumatic cerebrovascular and metabolic pathophysiology.

Adolescent↗
PubMed1996

Women with co-occurring addictive and mental disorders: an emerging profile of vulnerability.

The heterogeneity of those with co-occurring addictive and mental disorders has only recently begun to be recognized, and treatment strategies for different segments of this population are still being developed. This article reviews the literature on alcohol and drug problems in women, and on women with severe mental illness who are at high risk for substance abuse--as well as other forms of abuse and deprivation--due to poverty and victimization. As public health and mental health agendas are threatened by budget cuts, it is critical that initial gains in acknowledging and addressing their needs not be lost or abandoned.

Female↗
PubMed1994

Estrogen-inducible neurotensin immunoreactivity in the preoptic area of the female rat.

Neurotensin (NT) neurons in the rat preoptic area are implicated in female-specific regulation of reproduction. Estrogen markedly increases expression of mRNA encoding the neurotensin/neuromedin N (NT/N) precursor in several cell groups of the preoptic area, including the anteroventral periventricular nucleus, periventricular preoptic nucleus, and medial preoptic nucleus. In the present study, immunohistochemistry was performed on tissue from ovariectomized females with or without estradiol treatment to test the hypothesis that increased levels of NT accompany hormonal induction of NT/N mRNA in these cell group. Since colchicine treatment is required for visualization of NT-immunoreactive cell bodies, an additional objective of this study was to determine whether colchicine alters expression of NT/N mRNA in this area. Estradiol caused a pronounced increase in the number of NT-immunoreactive cell bodies in the anteroventral periventricular nucleus, as well as adjacent parts of the periventricular preoptic nucleus and medial preoptic nucleus. In the absence of colchicine, estradiol increased the number of NT-immunoreactive fibers in these same regions. Surprisingly, NT-immunoreactive cell bodies with intense staining were abundant in certain parts of the medial preoptic nucleus regardless of hormonal condition. NT-immunoreactive cell bodies were also numerous in certain regions where NT/N mRNA-expressing cells are scarce, and in two of these regions, the median preoptic nucleus and vascular organ of the lamina terminalis, estradiol substantially reduced the number of immunoreactive cell bodies. Treatment of ovariectomized females with colchicine induced expression of NT/N mRNA in the same regions where NT-immunoreactive cell bodies were unexpectedly numerous, thus providing a compelling explanation for the discordant distributions of the mRNA and peptide. Together with previous findings, the present results indicate that increased levels of NT accompany hormonal induction of NT/N mRNA in the anteroventral periventricular nucleus, as well as adjacent parts of the periventricular preoptic nucleus and medial preoptic nucleus. In other regions of the preoptic area, colchicine-inducible expression of NT/N mRNA confounds assessment of hormonal influences on NT synthesis. Multiple populations of neurons capable of NT synthesis can be distinguished in the rostral preoptic area on the basis of differential responsiveness to estrogen or colchicine, thereby providing additional evidence for functional heterogeneity among NT-synthesizing neurons in this region.

Animals↗
PubMed1994

Regional cerebral blood flow trends in head injured patients with focal contusions and cerebral edema.

Focal contusions following head injury may be associated with focal or diffuse cerebral edema. Early global hyperemia and perifocal hyperemia may play a role in cerebral edema, although causal relationships have yet to be clearly been defined. We studied 27 patients with head injury (admission GCS 3-12) resulting in focal contusions (without evidence of subarachnoid, intraventricular or intraparenchymal hemorrhage by CT). Patients were studied with ICP monitors, head CTs, and intravenous 133Xenon regional cerebral perfusion studies serially over several days post injury. Low cortical blood flow and a low mean CBF15 flow were evident on the day of the injury. Additionally, F1 analysis indicated significantly (p < 0.05) greater cortical blood flow in the surrounding brain (mean 60 cc/100 g/min) compared to the contusion area (mean 43 cc/100 g/min) on the day of trauma. Mean regional CBF remained below normal in the contused areas (CBF15 < 35 cc/100 g/min), however the cortical flow increased in the first few days post-injury (peak F1 = 95 cc/100 g/min on day 3) then decreased to sub-normal levels. The mean CBF in the surrounding brain was low on the day of injury (CBF15 = 29 cc/100 g/min), although higher than the contused area, and increased to a peak of 45 cc/1009/min on day 3 posttrauma. Cortical flow in the surrounding brain, however, exhibited a different trend. The mean F1 was low on the day of trauma and significantly higher one day after trauma (mean 105 cc/100 g/min). Only 15 of the 27 patients with focal contusions had evidence of cerebral edema. Eleven of these exhibited focal edema and 4 exhibited diffuse edema. Focal edema developed over the first few days posttrauma as seen in followup CT, whereas patients with diffuse edema exhibited edema on the admission CT. Initial oligemia in the contused areas was associated with a subsequent hyperemic rim about the contusion. Focal hyperemia was associated with focal edema in 41% of the patients, whereas diffuse edema appeared to be independent of the hyperemic response in contusions.

Adolescent↗
PubMed1993

Emotional trade-offs of becoming a parent: how social roles influence self-discrepancy effects.

Why do some people suffer from becoming a parent, whereas others do not? New parents' actual selves were related to their own hopes for themselves (ideal self) and to their spouse's sense of their responsibilities (ought self). Prebirth actual-ideal discrepancies predicted increased sadness or dejection after birth (especially for couples in longer marriages), whereas prebirth actual-ought discrepancies predicted decreased nervousness or agitation after birth (especially for mothers and couples with a less "easy" child). Becoming a parent introduces new demands that both interfere with attaining one's own hopes (increasing dejection in parents high in ideal [own] discrepancy) and shift attention to the new parenting role (decreasing agitation in parents high in ought [spouse] discrepancy).

Adult↗
PubMed1993

Estrogen-regulated synthesis of neurotensin in neurosecretory cells of the hypothalamic arcuate nucleus in the female rat.

Neurotensin (NT) is implicated as a neurohormone in mammals, yet the peptide's neuroendocrine role remains to be determined. NT immunoreactivity has been observed in neurosecretory cells of the arcuate nucleus and paraventricular nucleus, and data suggest that NT release into hypophysial portal blood mediates a component of PRL secretion that is female specific and dependent on ovarian steroids. In the present study, in situ hybridization histochemistry and immunohistochemistry were used to investigate the regulation of NT gene expression in hypothalamic neurosecretory regions of adult rats. In ovariectomized females, estradiol induced expression of messenger RNA (mRNA) encoding NT and neuromedin N (NT/N mRNA) in the dorsomedial division of the arcuate nucleus. In contrast, estradiol did not appreciably alter NT/N mRNA expression in the ventrolateral division of the arcuate nucleus, where labeled cells were numerous, or in the paraventricular nucleus, where labeled cells were virtually absent. Estradiol also increased NT immunoreactivity in the external zone of the median eminence, confirming the neuroendocrine phenotype of NT cells in the dorsomedial division, as well as estrogen-regulated synthesis of NT in this system. In the dorsomedial division of cycling females, NT/N mRNA-expressing cells were significantly more numerous at proestrus than at diestrus, consistent with differences in plasma estradiol levels at these stages. In this same region, NT/N mRNA-expressing cells were significantly more numerous in proestrous females than in gonad-intact males. These results imply that estrogen-regulated release of NT at the median eminence subserves one or more sexually differentiated functions and are consistent with the involvement of tuberoinfundibular NT in estrogen-dependent secretion of PRL or GnRH on the afternoon of proestrus.

Animals↗
PubMed1991

Sexually dimorphic distribution of neurotensin/neuromedin N mRNA in the rat preoptic area.

Neurotensin release from estrogen-responsive neurons in the rostral preoptic area of the female rat may play an important role in triggering preovulatory secretion of gonadotropin-releasing hormone on proestrus. We investigated the possibility of sexually differentiated biosynthesis of neurotensin in the rostral preoptic area, using in situ hybridization histochemistry to detect neurotensin/neuromedin N (NT/N) mRNA in adult male rats and adult female rats at proestrus and the first day of diestrus. In sections through the anteroventral periventricular nucleus (AVPv), the number of labeled cells in proestrous females was four times that in males. Diestrus females exhibited half the number of labeled cells present at proestrus, and there was evidence for a significant correlation between circulating estradiol level and number of labeled cells in the AVPv. In the rostral portion of the medial preoptic nucleus (MPN), two contiguous groups of labeled cells were especially prominent. One group, in the medial half of the MPN, was located closer to the midline in females than in males and displayed greater labeling in males than in females. Furthermore, labeling in the rostral MPN was greater at proestrus than at diestrus. These results indicate that biosynthesis of neurotensin and neuromedin N in the rostral preoptic area may be sexually differentiated and, in the female, may vary across the estrous cycle in parallel with circulating estradiol levels, consistent with the view that neurotensin neurons in this area are involved in the regulation of preovulatory secretion of gonadotropin-releasing hormone. The sex- and region-specific expression of NT/N mRNA in the rostral preoptic area suggests functional heterogeneity of neurotensin neuronal populations in this area and implies complex regulation of NT/N gene expression in the rat brain.

Animals↗
PubMed1991

A survey of hospitals in New York State treating psychiatric patients with chemical abuse disorders.

Eighty-eight of 143 hospitals in New York State providing psychiatric inpatient treatment responded to a mailed questionnaire designed to determine the size of three subgroups of chemical abusers--alcohol abusers, drug abusers, and polychemical abusers--among inpatients with psychiatric diagnoses, as well as the availability of services for these patients. Data for New York City and its metropolitan area were analyzed separately. In 1987 almost one-third of psychiatric admissions both in and outside the metropolitan area had comorbid chemical abuse disorders. Seventy-five percent of patients in the metropolitan area with comorbid chemical abuse had a drug abuse disorder; in rural areas 88 percent of patients with chemical abuse disorders abused alcohol. Both hospital- and community-based aftercare services, especially in the metropolitan area, were less available to psychiatric patients with chemical abuse than to patients without these disorders.

Aftercare↗