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Biomedical subjects

M J Roberts

Publications and source records attributed to M J Roberts.

At least 19 recordsLinked to original sources
PubMed1992

DNA polymorphisms of the human CD46 gene in fetal and adult tissues.

DNA polymorphisms of the CD46 gene were investigated using a full length cDNA probe and five different restriction enzymes in genomic DNA samples from human fetal tissues and adult peripheral blood leukocytes. A HindIII polymorphism was observed and was classed as Types I, II and III at a ratio of approximately 3.5:2:1, depending on the presence or absence of two polymorphic fragments of 4.5 and 2.0 kb. No variation of polymorphic distribution was evident between the fetal and adult samples. Whether variation in CD46 expression between maternal and fetal tissue is relevant to fetal viability in pregnancy remains to be established.

Adult↗
PubMed1992

Cancer presentation in the emergency department: a failure of primary care.

Emergency departments are intended to be the location of entry into the health care system for patients with acute problems, such as injuries and myocardial infarctions. In contrast, cancer should optimally be detected during periodic health examinations, either through screening procedures or by early detection from signs and symptoms which prompt a routine visit to a primary care physician. This study was undertaken to describe patients who present to an emergency department with urgent symptoms and signs, are hospitalized, and subsequently diagnosed with cancer (ED group). One hundred twenty-nine patients were retrospectively studied. When compared with patients diagnosed in a primary care setting (tumor registry patients), the ED group was significantly older, more often male, had a significantly lower survival rate, and more frequent metastatic disease at diagnosis (P less than .001). The ED group accounted for 5.3% of the new tumor registry patients for the study years. Only 3.1% of the ED group had no insurance, and 21% reported no personal physician. Strategies are needed for patients and physicians to reduce the number of late-diagnosed cancer cases presenting in emergency departments.

Aged↗
PubMed1992

The excretion of dothiepin and its primary metabolites in breast milk.

1. The excretion of dothiepin, nordothiepin, dothiepin-S-oxide and nordothiepin-S-oxide into breast milk was studied in eight women. Exposure to drug was measured in five of their infants, and possible drug-related effects were assessed in all eight infants. 2. Using pre-feed milk samples mean (+/- s.e. mean) milk:plasma (M:P) ratios were 0.78 +/- 0.12, 0.85 +/- 0.16, 1.18 +/- 0.29 and 1.86 +/- 0.29 for dothiepin, nordothiepin, dothiepin-S-oxide and nordothiepin-S-oxide, respectively. In post-feed milk samples, the mean M:P ratio for dothiepin (1.59 +/- 0.32) was significantly greater (P less than 0.05) but M:P ratios for the metabolites were similar. 3. Mean total calculated infant daily doses, (in dothiepin equivalents and as a percent of the maternal dose) were 0.58% for dothiepin, 0.23% for nordothiepin, 2.47% for dothiepin-S-oxide, and 1.17% for nordothiepin-S-oxide. 4. Plasma samples were obtained from five infants. In one, both dothiepin and nordothiepin were below their minimum quantifiable levels (2 micrograms l-1) while in four others both dothiepin-S-oxide and nordothiepin-S-oxide were below their minimum quantifiable levels (10 micrograms l-1). No adverse effects were found in any of the eight infants. 5. Use of dothiepin by depressed mothers is unlikely to be a significant hazard to their breast-feeding infants.

Adult↗
PubMed1992

Visual and profilometric wear measurements.

Wear of composites can be estimated by the degree of marginal discrepancy between the prepared cavity wall and the occlusal margins of composites. Such evaluations are done on casts by comparing and rating the marginal discrepancy with those on standard casts. We analyzed the reliability of this technique on metal and stone specimens. These specimens contained grooves of different width and depth. For the visual comparison we used stone casts of machined standards of known groove depth. We measured the depths of the metal specimens with a profilometer and made stone casts of these original specimens. Using the stone casts of the standards, five dentists estimated the unknown groove depths on the remaining stone casts. These estimates were done under standardized conditions and repeated by each dentist on five different occasions. The results showed that visual depth evaluations of die stone specimens underestimated the depths when compared with the values measured with a profilometer on the original metal models. One investigator gave significantly different (p less than 0.05) groove depth estimates at different occasions.

Calcium Sulfate↗
PubMed1991

Effectiveness of double bolus alteplase in the treatment of acute myocardial infarction.

Fifty-nine consecutive patients presenting within 6 hours of the onset of symptoms of an acute myocardial infarction were treated with 150 mg of soluble aspirin orally, and either 70 or 100 mg of alteplase divided into 2 intravenous bolus injections separated by 30 minutes. Dosage regimens were either 20 followed by 50 mg (group A), 50 followed by 20 mg (group B), or 50 followed by 50 mg (group C). Coronary angiography 60 minutes after the first bolus showed infarct-related coronary artery patency (Thrombolysis in Myocardial Infarction score 2 or 3) in 13 of 16 (81%) patients in group A, 12 of 17 (71%) in group B, and 10 of 11 (91%) in group C (overall patency rate at 60 minutes: 35 of 44 [80%] patients; 95% confidence interval 68 to 91%). At 90 minutes, patency rates were 15 of 20 (75%) patients in both groups A and B, and 18 of 19 (95%) in group C (overall patency rate 48 of 59 [81%] patients; 95% confidence interval 72 to 91%). Residual thrombus was identified with the 90-minute angiogram in 7 patients in group A, 5 in group B, and 3 in group C. Although there was no statistically significant difference in patency between the 3 dosage regimens at either 60 or 90 minutes there was a trend toward increased patency and more complete thrombolysis at 90 minutes in group C. No episodes of bradyarrhythmia, hypotension or cerebrovascular bleeding were observed after double bolus therapy. There were 7 episodes (12%) of reocclusion, and 3 deaths (5%) within 1-month follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

A cellular transtelephonic defibrillator for management of cardiac arrest outside the hospital.

A cellular transtelephonic defibrillator facilitates early defibrillation in remote areas and involves electrocardiographic diagnosis and defibrillation control by a physician remote from but in voice contact with the patient-unit operator. The patient unit contains a microprocessor, microphone, defibrillator, electrocardiogram/defibrillator electrode pads and cellular telephone. Activation of the patient-unit initiates automatic dialing and contact with the remotely sited base station within 35 to 50 seconds. The physician at the base station identifies the rhythm and controls defibrillator charging and discharge. The minimal interaction required between the system and the local operator makes it suitable for use by minimally trained first responders. The cellular transtelephonic defibrillator has been tested in 211 calls responded to by a physician-manned mobile coronary care unit over distances up to 15 miles in an urban area. Satisfactory electrocardiographic transmission and voice communication were established in 172 of 211 calls (81.5%). In 39 (18.5%), connection with the base station either could not be established or maintained mainly because of geographic location or battery failure. One hundred direct current shocks of 50 to 360 J were effectively administered to 22 patients with 48 episodes of ventricular fibrillation or ventricular tachycardia with successful correction of 46 of 48 episodes using 1 to 4 shocks per episode. Widespread distribution of such devices could improve survival in patients with cardiac arrest outside the hospital.

Ambulances↗
PubMed1991

Genetic epidemiology of Down's syndrome in Shetland.

Pedigrees of all known cases, on Shetland, of Down's syndrome, cytogenetically confirmed as trisomy 21, and of a control for each patient matched by birth date, sex and birth place, were traced over a minimum of eight generations. Mean kinship coefficients in all pairs of Down's syndrome patients and in all pairs of controls were similar. The kinship between the father and mother of each case shows that the parents are more closely related than the general level of relationship in the population, suggesting some recessive element in the etiology. It is argued that the effect of the resulting increased homozygosity would be to prevent the loss of the conceptus that occurs in the majority of trisomy 21 conceptions.

Adult↗
PubMed1991

Anistreplase in early acute myocardial infarction and the one-year follow-up.

Of consecutive patients seen with first myocardial infarction (88 of whom were treated out-of-hospital by mobile coronary care staff), 139 received 30 units of intravenous anistreplase at a mean of 101 minutes (range 35-180) from onset of symptoms. Thrombolysis in myocardial infarction patency grade 2 or 3 was found in 76/91 (83.5%) patients. At 3-4 months after hospital discharge, the mean global left ventricular ejection fraction and mean infarct-related regional third ejection fraction declined with increasing delay to anistreplase. For the first, second and third hour administrations, global ejection fraction was 54%, 50% and 45% (P = 0.002) and for regional third ejection fractions 49%, 43% and 41% (P = 0.02) respectively. Of the patients, 130 were reviewed at approximately 1 year: reinfarction had occurred in 9, 6 had undergone coronary angioplasty and 1 had coronary arterial bypass grafting performed since discharge. Mean global left ventricular ejection fraction was 52% and mean infarct-related regional third ejection fraction was 51%. Thus, intravenous anistreplase induces high rates of arterial patency. Global and regional third ejection fractions decline with increasing delay in the time of administration of anistreplase. Mortality and morbidity is low in the first year.

Adult↗
PubMed1991

Controlled release microparticles for vaccine development.

The primary and secondary sera IgG antibody responses to ovalbumin (OVA) entrapped in biodegradable poly(lactide-co-glycolide) (PLGA) microparticles were compared with the responses obtained with soluble OVA. In addition, OVA in PLGA microparticles was also administered after dispersion in an immunostimulatory vehicle, Freund's incomplete adjuvant (FIA). The primary IgG responses to OVA in microparticles/FIA were significantly greater than the responses to soluble OVA from day 14 to day 42, when booster immunizations were administered. From day 49 to the end of the study at day 84, the responses to OVA, both in microparticles alone and in microparticles/FIA, were significantly greater than the responses to soluble OVA. Nevertheless, the responses obtained for OVA in microparticles or microparticles/FIA were, in general, not as high as those obtained with OVA in Freund's complete adjuvant.

Animals↗
PubMed1991

Variables influencing the repair strength of dental composites.

Differences in the flexural strength of composites (P-30) repaired with four different adhesive techniques were determined and compared to the flexural strength of unrepaired specimens. Besides investigating the effects of differences in repair methods, both the effect of composite age at repair time and the effect of water storage on flexural strength were evaluated. No significant differences were found between specimens which had been stored for different times (1 or 60 days) before they were repaired. All specimens, including the unrepaired ones, became weaker with time in water. After both 90 and 360 days at 37 degrees C in water, the strength of the repaired specimens ranged between 25 and 50% of the strength of the unrepaired specimens. The weakest group was the one which had been repaired after acid etching, water rinsing, and air drying only.

Acid Etching, Dental↗
PubMed1991

Excretion of indomethacin in breast milk.

1. The excretion of indomethacin into breast milk and subsequent exposure of infants was studied in 16 women and seven of their infants. The median milk:plasma ratio in seven patients where there were measurable drug concentrations in both milk and plasma was 0.37. 2. Total infant dose, assuming a daily milk intake of 150 ml kg-1 and 100% absorption, ranged from 0.07% to 0.98% (median = 0.18%) of the weight adjusted maternal dose. 3. Plasma samples were obtained in seven infants. In six of these, indomethacin concentrations were below the sensitivity of the assay (less than 20 micrograms l-1), while one infant had a plasma indomethacin concentration of 47 micrograms l-1. 4. No adverse effects due to indomethacin were reported in the infants.

Adult↗
PubMed1990

Transient release of lipid peroxides after coronary artery balloon angioplasty.

Free radical production may cause myocardial damage during reperfusion of ischaemic myocardial tissue; when free radicals interact with polyunsaturated fatty acids or their esters, lipid peroxides are produced. A product of lipid peroxidation, malondialdehyde, was measured in 10 subjects with stable angina who underwent angioplasty of a proximal high-grade stenosis (over 90%) of the left anterior descending coronary artery. In all subjects the duration of balloon occlusion was 60 s. Blood was withdrawn from the great cardiac vein immediately before balloon inflation (T0), immediately after balloon deflation (T60), 15 s after balloon deflation (T75), and 1 min after balloon deflation (T120). There was a significant increase in malondialdehyde at T60 compared with T0 for the first balloon inflation (mean increase 0.3 mumol/l [95% confidence limits 0.1, 0.5]), and at both T60 (0.31 mumol/l [0.15, 0.47]) and T75 (0.22 mumol/l [0.04, 0.40]) for the second balloon inflation. This model could be used to assess antioxidant effects of drugs.

Adult↗
PubMed1990

Effects of tumor necrosis factor alpha and beta on resorption of human articular cartilage and production of plasminogen activator by human articular chondrocytes.

We examined the effects of recombinant human tumor necrosis factor (TNF) on human articular cartilage and chondrocytes in culture. Both TNF alpha and TNF beta stimulated cartilage matrix breakdown during prolonged culture and elevated the levels of plasminogen activator (PA) activity in both the supernatants and cell layers of cultured chondrocytes. Characterization of the PA activities by immunochemistry and by zymography following gel electrophoresis indicated that human chondrocytes produce both urokinase-type PA and tissue-type PA in response to TNF. The addition of both interleukin-1 and TNF alpha or TNF beta to chondrocyte cultures demonstrated a synergism between these cytokines in the generation of PA activity in the culture supernatants and cell layers. Our results suggest that both activated lymphocytes and monocytes may contribute to the cartilage destruction of inflammatory arthritis through their stimulation of chondrocytes with TNF beta and TNF alpha, respectively. Since PA is the only neutral proteinase reported to be elevated in TNF-stimulated chondrocyte cultures, it could have an important role in TNF-mediated cartilage destruction.

Cartilage, Articular↗
PubMed1990

Influence of water exposure on the tensile strength of composites.

The objective of this study was to investigate whether water storage causes permanent damage to composites by determining how the tensile strength of nine different composite materials changes with both water storage and water storage followed by dehydration. Eighteen samples (ASTM-D Specification 1708-66) of each of the nine materials were prepared and divided into three groups of six samples each. Group I was stored dry at 60 degrees C, while Groups II and III were stored in distilled water at 60 degrees C. After six months, Groups I and II were subjected to tensile testing, while Group III was transferred to a desiccator and dehydrated for two weeks at 60 degrees C before this group was tested in tension. Mean values, pooled by storage group independent of material, revealed a significant (p less than 0.05) reduction in strength for both Groups II and III relative to Group I. These findings prove that water has an irreversible effect on most dental composites. A comparison of Group II with Group III data revealed that the samples which were aged in water and tested (Group II) were significantly (p less than 0.05) weaker than the dehydrated samples (Group III). However, some products within Group III did not show any tendency to recover their strength after dehydration.

Composite Resins↗