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Biomedical subjects

M McCullough

Publications and source records attributed to M McCullough.

At least 19 recordsLinked to original sources
PubMed2006

Craniofacial identification by computer-mediated superimposition.

Mass disasters are associated with a large number of fatalities, with victims being visually unidentifiable in most cases. Dental identification, although being an important and valuable identification method, is subject to the availability and quality of antemortem and postmortem dental records. This paper presents a simple-to-use method of human identification using an antemortem photograph showing anterior teeth with superimposition onto a postmortem image using specific features of Adobe Photoshop. We present cases and discuss the benefits and difficulties of this method.

Anodontia↗
PubMed2002

Oral yeast carriage correlates with presence of oral epithelial dysplasia.

Previous studies have suggested a link between the presence of Candida albicans and the development of oral squamous cell carcinoma (OSCC). The aim of the present study was to assess the presence and level of colonisation of oral yeast in patients undergoing an incisional oral mucosal biopsy in order to assess whether the amount of oral yeast present correlated with the presence and degree of oral epithelial dysplastic or neoplastic change. Two hundred and twenty-three patients who were undergoing an incisional biopsy for the diagnosis of an oral mucosal lesion were enrolled in this study. Mouth swills were obtained from each patient for the presence and amount of oral yeast present. Some of the patients (44.6%) had a histopathological diagnosis of either oral epithelial dysplasia (OED) or OSCC and the frequency of oral yeast carriage was significantly greater (P<0.001) in these patients than those without histopathologically detected dysplastic or neoplastic oral lesions. Furthermore, significantly (P<0.001) more patients with OED or OSCC had a higher number of yeast (over 1000 cfu/ml) in their oral cavity than patients without any evidence of epithelial dysplasia or neoplasia histopathologically. The degree of epithelial dysplasia present in these patients also correlated with higher amounts of yeast in the oral cavity (P=0.017). The results of the present study reveal that there is an interaction between oral carriage of yeast and oral epithelial dysplasia, however it remains unclear how yeast infection influences the development and progression of dysplasia.

Adult↗
PubMed1999

Hypospadias repair in the 1990s.

Hypospadias is a congenital anomaly in which the urethral meatus is abnormally located anywhere from the glans to the perineum. Refinements in pediatric anesthesia, surgical technique and instrumentation, and a greater understanding of the psychologic and emotional issues related to hypospadias repair have led to this procedure being performed at an earlier age. The goal of reconstruction is to bring the urethral meatus to the tip of the penis, to correct associated penile curvature if present, to create a conical-shaped glans, and to achieve cosmetically acceptable penile shaft skin coverage. The surgical technique employed varies with the penile anatomy and surgeon's preference. Complications may occur both immediately and long after the surgical procedure, and thus follow-up is necessary.

Child Development↗
PubMed1999

Age, renal perfusion and function in island-dwelling indigenous Kuna Amerinds of Panama.

BACKGROUND/AIMS: Among possible contributors to a progressive fall in renal perfusion and function with increasing age, some hypotheses have invoked the rise in blood pressure that occurs with age, and a high-protein diet typical of urban cultures. Kuna Amerinds residing in isolated islands off the Panamanian Coast have a very low protein intake and show no tendency for blood pressure to rise with age, thus providing an opportunity to test these hypotheses. METHODS: We measured renal plasma flow and glomerular filtration rate (PAH and inulin clearance) in 16 Kuna Indians ranging in age from 18 to 86 years (51 +/- 6 years) who have resided on Ailigandi, an isolated Panamanian island for all of their lives. Inulin and PAH were infused with a battery-driven pump for 60 min, and a metabolic clearance rate used to calculate inulin and PAH clearance. For comparison, we employed identical techniques in 29 residents of Boston, ranging in age from 19 to 79 years (52 +/- 4 years), all normotensive and free of disease or medication use. Twenty-four were Caucasian. RESULTS: The Bostonian controls showed the anticipated fall in PAH clearance with age (y = 806 - 4.9 x; r = -0.82; f = 38.0; p < 0.0001). Our hypothesis was that the absence of a blood pressure rise with age and the low protein intake would flatten the slope relating renal perfusion to Kuna age. Our finding was a numerically steeper slope relating age and renal plasma flow in the Kuna (y = 936 - 6.48x; r = -0.81; p < 0.001). Filtration fraction rose with age in both populations, and again the rise was steeper in the Kuna. GFR in the Kuna, on the other hand, was very much higher at any age (139 +/- 4 ml/min/1.73 m2) than in Bostonians (112 +/- 3 ml/min/1.73 m2; p < 0.001). CONCLUSION: The findings are not in accord with the hypothesis that age-related changes in renal perfusion and glomerular filtration rate reflect an important contribution from blood pressure rise and a high protein intake, typical of modern, urban life.

Adolescent↗
PubMed1998

Outbreak of sterile peritonitis among continuous cycling peritoneal dialysis patients.

BACKGROUND: Approximately 30,000 patients receive peritoneal dialysis in the United States. In August 1996, several dialysis centers from different states reported sterile peritonitis among CCPD patients using sterile peritoneal dialysis solution (PDS) from a single manufacturer. The manufacturer recalled 53 lots of PDS that had passed established industry guidelines and Food and Drug Administration (FDA) approved quality control tests [including endotoxin levels <0.5 endotoxin units (EU)/ml], but had pre-sterilization bacterial colony counts >1 cfu/ml. METHODS: At one outpatient dialysis center, Hospital of the University of Pennsylvania (HUP), we conducted a retrospective cohort study of all CCPD patients treated during July 15 to August 30, 1996. A case-patient was defined as any HUP patient with culture-negative peritoneal fluid with a white blood cell count >100/mm3, cloudy peritoneal fluid, and/or abdominal pain. PDS and tubing were cultured for bacteria and assayed for endotoxin. RESULTS: Overall, 14 of 28 patients had sterile peritonitis. The only risk factor identified was exposure to > or =1 lot of recalled PDS (14 of 22 vs. 0/6, P = 0.02); the more recalled lots received, the higher the attack rate (P = 0.0001). Five of 47 PDS bags had detectable endotoxin; recalled lots were more likely to have measurable endotoxin than nonrecalled lots (5/19 vs. 0/17, P = 0.05). When case-patients resumed CCPD using PDS from non-recalled lots, no further cases were reported. CONCLUSIONS: Our results suggest that this outbreak was caused by intrinsic PDS contamination with endotoxin. Pre-sterilization colony counts may be an important quality control indicator for CCPD fluids in conjunction with endotoxin levels.

Adult↗
PubMed1998

Family-of-origin interaction and adolescent mothers' potential for child abuse.

This study examined the relationship between family-of-origin interaction and environment and the potential for young mothers to abuse their children. Females aged 14 to 21 from three teen parenting programs completed the Teen Parenting Questionnaire, the Family Environment Scale, and the Child Abuse Potential Inventory. Low scores on family cohesion were found to correlate with high scores on child abuse potential. This suggests that providing the teenager with an accepting and supportive atmosphere may assist her in building a positive identity as a mother. Increased understanding of how family-of-origin issues contribute to young mothers' potential to abuse their children will aid school and community professionals in providing better services for this population.

Adolescent↗
PubMed1997

Aging, acculturation, salt intake, and hypertension in the Kuna of Panama.

The indigenous Kuna who live on islands in the Panamanian Caribbean were among the first communities described with little age-related rise in blood pressure or hypertension. Our goals in this study were to ascertain whether isolated island-dwelling Kuna continue to show this pattern, whether migration to Panama City and its environs changed the patterns, and whether the island-dwelling Kuna have maintained their normal blood pressure levels despite partial acculturation, reflected in an increased salt intake. We enrolled 316 Kuna participants who ranged in age from 18 to 82 years. In 50, homogeneity was confirmed by documentation of an O+ blood group. In 92 island dwellers, diastolic hypertension was not identified and blood pressure levels were as low in volunteers over 60 years of age as in those between 20 and 30 years of age. In Panama City, conversely, hypertension prevalence was 10.7% and exceeded 45% in those over 60 years of age (P < .01), blood pressure levels were higher in the elderly, and there was a statistically significant positive relationship between age and blood pressure (P < .01). In Kuna Nega, a Panama City suburb designed to maintain a traditional Kuna lifestyle but with access to the city, all findings were intermediate. Sodium intake and excretion assessed in 50 island-dwelling Kuna averaged 135 +/- 15 mEq/g creatinine per 24 hours, exceeding substantially other communities free of hypertension and an age-related rise in blood pressure. Despite partial acculturation, the island-dwelling Kuna Indians are protected from hypertension and thus provide an attractive population for examining alternative mechanisms.

Acculturation↗
PubMed1996

Salt sensitivity of hypertension and responses to angiotensin converting enzyme inhibition with benazepril.

Salt intake, and the sensitivity of blood pressure (BP) to excessive salt intake is thought to contribute to the pathogenesis of essential hypertension in some patients. This study was designed to ascertain whether salt sensitivity of BP is a determinant of BP and renal vascular responsiveness to angiotensin converting enzyme (ACE) inhibition. In 24 patients with essential hypertension, ranging in age from 30 to 68 years, renin status, renal hemodynamics, and sensitivity of BP to steady state changes in salt intake were assessed. Twenty-four hour ambulatory BP monitoring (ABPM) was employed to measure baseline BP and BP response to 4 weeks' treatment with benazepril at 20 or 40 mg/day. Benazepril induced a highly-significant reduction in BP (P < .001) and increase in renal plasma flow (530 +/- 17 to 580 +/- 19 mL/min/1.73 m2; P < .001). Systolic BP fell from 143 +/- 2 to 129 +/- 2 mm Hg (P < .001), and diastolic BP fell from 91 +/- 1.6 to 80 +/- 2 mm Hg (P < .001). The magnitude of the BP and renal vascular response to ACE inhibition was not influenced by the sensitivity of BP to salt intake. In a multivariate analysis neither body mass index nor age influenced the BP response to ACE inhibition or the relationships between salt intake and a BP response to ACE inhibition. We conclude that the factors that influence sensitivity of BP to salt intake do not influence the systemic or renal hemodynamic response to ACE inhibition.

Adult↗
PubMed1995

Rationale and design of the Dietary Approaches to Stop Hypertension trial (DASH). A multicenter controlled-feeding study of dietary patterns to lower blood pressure.

Epidemiologic studies have found that dietary patterns characterized by high intakes of certain minerals and fiber are associated with low blood pressure. Dietary Approaches to Stop Hypertension (DASH) is a multicenter, randomized, controlled-feeding trial designed to test the effects on blood pressure of two such dietary patterns consumed for 8 weeks. The two experimental diets will be compared with each other and with a control dietary pattern that is relatively low in potassium, magnesium, calcium, and fiber, and has a fat and protein profile mirroring current consumption. The first experimental diet, arguably termed "ideal," is high in fruits, vegetables, whole cereal products, low-fat dairy products, fish, chicken, and lean meats designed to be low in saturated fat and cholesterol; moderately high in protein; and high in minerals and fiber. The second experimental diet tests the effect of fruits and vegetables alone. Its potassium, magnesium, and dietary fiber content will be at the same high levels as the ideal dietary pattern, while its fat, protein, and calcium content will resemble that of the control dietary pattern. The study population will consist of 456 healthy men and women, aged 22 years or older, with systolic blood pressure less than 160 mm Hg and diastolic blood pressure 80 to 95 mm Hg. African-American and other minority groups will comprise 67% of the population. Participants will eat one of the three dietary patterns. The DASH trial has unique features. First, dietary patterns rather than single nutrients are being tested. Second, all food for the experimental diets is provided to the participants using a standardized multicenter protocol. Because the dietary patterns are constructed with commonly consumed food items, the results, if positive, may be conveniently implemented in dietary recommendations to the general public.

Adult↗
PubMed1995

Oral Candida albicans from patients infected with the human immunodeficiency virus and characterization of a genetically distinct subgroup of Candida albicans.

Candida albicans has been shown to vary in its phenotypic expression with the progression of human immunodeficiency virus (HIV) infection. This study was designed to investigate whether in Category IV HIV infected patients (CDC, Atlanta, USA) these phenotypic changes were related to changes in the genetic strain of the organism. Isolates of C. albicans were obtained from 45 patients with HIV infection during the progression of their disease as determined by percentage T4 lymphocyte count. Isolates were strain differentiated using two methods. In 67 per cent of the patients a single strain of C. albicans, as determined by the DNA analysis, was isolated from each individual over the experimental period. The phenotypic expression of the genetically identical strains isolated from each patient varied considerably over the experimental period with the morphotype 754 being predominant. These results showed that the genotype of C. albicans isolated persisted in the majority of HIV infected individuals, but that the phenotypical expression of this strain changed. A finding in this study was that 18 strains of C. albicans had DNA which did not hybridize to the probe used. These strains were analysed for the presence of two other C. albicans specific DNA segments using PCR. The probe 27A hybridizing strains yielded PCR products which differed from the non-hybridizing strains. Five of these genetically atypical C. albicans strains and 98 of the C. albicans strains were then analysed for purported virulence factors.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Related Opportunistic Infections↗
PubMed1995

Characterization of genetically distinct subgroup of Candida albicans strains isolated from oral cavities of patients infected with human immunodeficiency virus.

During the course of a study of oral Candida albicans strains from 60 human immunodeficiency virus-infected patients over a 2.5-year period, 18 of the 295 C. albicans isolates had genomes that failed to hybridize with a C. albicans-specific DNA probe (27A). These strains were germ tube positive and chlamydospore positive and were identified as C. albicans by the ID 32C test (API Systems, Montlieu, France). These strains were analyzed for the presence of two other C. albicans-specific DNA segments by PCR. The first was a C. albicans 1,348-bp species-specific sequence, and the second was a 1,059-bp C. albicans repetitive element. The probe 27A-hybridizing strains yielded PCR products which differed from those of the nonhybridizing strains. Five of these genetically atypical C. albicans strains and 98 of the C. albicans strains were then analyzed for purported virulence factors. The genetically atypical C. albicans strains, in comparison with typical C. albicans strains, produced greater amounts of extracellular proteinase (P = 0.038, Student's t test), adhered to a greater degree to buccal epithelial cells (P = 0.018, Student's t test), and were less susceptible to the antifungal drug 5-flucytosine (P = 0.0003, Mann-Whitney test). Analysis of these strains with other common antifungal drugs showed no statistically significant variation in susceptibility. The results of this study indicated that these genetically atypical C. albicans strains possess increased virulence in comparison with typical C. albicans strains.

AIDS-Related Opportunistic Infections↗
PubMed1994

Snoring may be linked to culture.

The estimates of the incidence of snoring in adults that have been provided by four epidemiological studies vary from 16-89% of the population. Collectively, these data are completely confounded by country of origin and thus may reflect cultural differences that contribute to snoring. While the etiology of snoring is not fully known, speculation has focused on gender and age as primary factors that contribute to this behavior. Within the limitations imposed by the designs of these four studies, we compared the relative strength of the relationships between snoring and gender, age, and culture. These analyses suggest that certain variables associated with cultures appear to be more salient than both gender and age, as determinants of snoring.

Adult↗
PubMed1994

Effect of foot position on gastrocnemius/soleus stretching in subjects with normal flexibility.

Following injury to the ankle or lower extremity, stretching of the gastrocnemius/soleus complex is commonly prescribed. Many authors recommend stretching the gastrocnemius/soleus complex with the foot placed in a supinated position. No research is available, however, that supports the efficacy of stretching in the supinated vs. the pronated position. Therefore, the purpose of this study was to compare the effect of stretching the gastrocnemius/soleus complex in two foot positions: supinated and pronated. Eleven female and eight male subjects completed 10 stretching sessions with one foot supinated and the other foot pronated. Each stretching session consisted of four 20-second stretches. On pretest and posttest measurements, maximum dorsiflexion range of motion and stretching force exerted through the foot were recorded for each subject. Foot position for the testing procedures and the stretching phase was standardized with individually constructed footprint templates. A two-way analysis of variance (stretching position and time) was used to compare pretest and posttest ankle dorsiflexion measurements. Results indicated a significant increase in dorsiflexion (p = 0.01, pronation + 6.36%, supination + 6.24%) but no significant difference between stretching positions (p = 0.23). We concluded that gastrocnemius/soleus complex stretching in either foot position is effective for increasing dorsiflexion range of motion in healthy subjects with normal flexibility of the gastrocnemius/soleus complex.

Adult↗
PubMed1992

Possible association of the extended MHC haplotype B44-SC30-DR4 with autism.

We previously reported that the complement C4B null allele appears to be associated with infantile autism. Since the C4B null allele is known to be part of the extended or ancestral haplotype [B44-SC30-DR4], we investigated the incidence of [B44-SC30-DR4] in 21 autistic children and their parents. This extended haplotype was increased by almost six-fold in the autistic subjects as compared with healthy controls. Moreover, the total number of extended haplotypes expressed on chromosomes of autistic subjects was significantly increased as compared with those expressed on chromosomes of healthy subjects. We conclude that a gene related to, or included in, the extended major histocompatibility complex may be associated with autism.

Adolescent↗
PubMed1991

Blood pressure and renal blood flow responses to dietary calcium and sodium intake in humans.

This study was designed to determine the interaction between salt and calcium intake on blood pressure (BP) and renal blood flow (RBF) in a predominantly white population. We measured BP and RBF (P-aminohippurate [PAH] clearance) in hypertensive patients after 7 days on a low salt/low calcium diet and again after either a high salt/high calcium diet (HS/HC) or a high salt/low calcium (HS/LC) diet for another 7 days. Compared to low salt BP, both high salt diets increased BP, but the increase with high salt/low calcium was significantly greater than with high salt/high calcium (+14.6 +/- 3.9/+8.2 +/- 1.7 mm Hg v +7.5 +/- 1.9/+2.5 +/- 1.4 mm Hg; systolic/diastolic, both P less than or equal to .05). PAH clearance increased 26 +/- 13 mL/min/1.73 m2 on the HS/HC diet but only 10 +/- 17 mL/min/1.73 m2 on HS/LC (P = .05 between groups). These data suggest that a low calcium diet may contribute to the phenomenon of salt sensitivity in a white population. The low calcium intake appears to affect both the systemic and renal vasculature.

Administration, Oral↗
PubMed1991

Adolescent pregnancy: contributing factors and strategies for prevention.

A questionnaire was administered to pregnant adolescents and adolescent mothers to assess both basic needs and factors that may have contributed to their becoming teen parents. Family background and composition, history of sexual abuse, vocational plans and aspirations, and self-esteem were examined. Results and implications for prevention programs and counseling are discussed.

Adolescent↗
PubMed1990

Altered operant behavior of adult rats after perinatal exposure to a 60-Hz electromagnetic field.

Rats were sham exposed or exposed perinatally to a 60-Hz electromagnetic field, 22 days in utero and the first 8 days post partum. Each of the 30 once-daily exposures was 20 h in duration. The electric component of the field was vertical 30 kV/m rms, and the magnetic field component was 100 microTG rms. Later, as adults, male rats were trained to emit an operant response when reinforced with food on a multiple, random-interval schedule. Exposed rats (N = 21) gradually came to respond at significantly lower rates than did sham-exposed controls (N = 20). This finding was confirmed and extended in a second, independently performed experiment. After a sequence including operant conditioning followed by experimental extinction of responding and then by a suspension of conditioning and finally by more than a month of reconditioning, slower rates of responding were found to persist in the adult animals. The evidence of altered behavior several months after combined, fetal-neonatal exposure to an electromagnetic field presents an interesting contrast with other findings: Field-exposed rats did not differ from sham-exposed rats in terms of body mass, physical appearance, grossly observed activity level, or incidence of disease.

Animals↗