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Biomedical subjects

M Mulligan

Publications and source records attributed to M Mulligan.

12 recordsLinked to original sources
PubMed1990

Oral structure nonspeech motor control in normal, dysarthric, aphasic and apraxic speakers: isometric force and static position control.

This study investigated the isometric force and static position control of the upper lip, lower lip, tongue, jaw, and finger in four subject groups (normal control, apraxia of speech, conduction aphasia, and ataxic dysarthria) at two force and displacement levels. Results from both the force and position tasks suggested that the apraxic and dysarthric groups tended to produce significantly greater instability than the normal group, although the pattern of instability across articulators was not systematic within or across the force and position experiments for subjects within or between groups. The conduction aphasic group produced force and position stability that typically was not significantly different from any of the remaining three groups, suggesting that their force and position stability as indexed in the present study fell somewhere between that of the normal group and the apraxic and dysarthric groups. It is suggested that other analyses of force and position control, such as descriptive accounts of the trial-by-trial time histories, might shed additional light on the speech and orofacial sensorimotor control deficits in persons with apraxia, dysarthria, and conduction aphasia.

Adult↗
PubMed1990

Mechanisms of improved physical performance of chronic hemodialysis patients after erythropoietin treatment.

Correction of the anemia that is common among chronic hemodialysis patients by treatment with human recombinant erythropoietin (rHuEPO), even if incomplete, improves physical performance of patients. Oxygen uptake and physical work capacity at maximal work loads and at the anaerobic threshold increase by approximately 20%. Analysis of underlying mechanisms by pulmonary function tests and ergospirometry demonstrate that improved oxygen transport in the blood and its concomitant changes of the anaerobic threshold and heart rate appear to be main causes of improvement. Parameters of respiratory mechanics and gas exchange remain essentially unaltered.

Adult↗
PubMed1989

Serologic evidence of Cryptosporidium infection in US volunteers before and during Peace Corps service in Africa.

To obtain prevalence data on Cryptosporidium infection in healthy US adults and to determine how often Cryptosporidium infection occurs after relocation to a situation of potentially great exposure, an enzyme-linked immunosorbent assay for anti-Cryptosporidium IgM or IgG was used to examine serum from 75 US Peace Corps volunteers before overseas service and after up to two years in West Africa. Of the volunteers, 32% had detectable anti-Cryptosporidium IgG initially, suggesting that infection sometime in life is common. After six weeks, one year, or two years overseas, 5% (1/19), 14% (8/56), and 13.6% (3/22), respectively, became newly IgG positive. This implies that the risk of acquiring Cryptosporidium infection and its associated diarrhea is real for travelers and temporary workers in endemic areas. Persistence of IgG and/or IgM response for 12 months or more occurred in some volunteers, although the significance is unclear.

Adult↗
PubMed1988

Diethylcarbamazine prophylaxis for human loiasis. Results of a double-blind study.

To determine whether infection with Loa loa could be prevented in temporary residents of endemic areas, we conducted a randomized, double-blind, placebo-controlled trial of diethylcarbamazine as a chemoprophylactic agent. Diethylcarbamazine (300 mg) or placebo was taken orally once a week by Peace Corps volunteers serving in Gabon, Cameroon, and the Central African Republic. The participants were assessed clinically and with serologic and parasitologic testing before and yearly during their two years of service. One hundred one persons satisfactorily completed the study. In Gabon (where exposure to the parasite was heaviest), 6 of 20 volunteers (30 percent) in the placebo group had clinical disease, as compared with none of 16 (0 percent) in the diethylcarbamazine-treated group (P less than 0.02). Of those taking placebo, 10 of 20 (50 percent) became seropositive for antifilarial IgG antibody, as compared with 2 of 16 (12 percent) in the drug-treated group (P less than 0.02). Exposure to the parasite appeared to be much lower among the 65 Peace Corps volunteers in Cameroon and the Central African Republic. No volunteer in either group in these countries had overt loiasis; 2 of 40 (5 percent) in the placebo groups in Cameroon and the Central African Republic seroconverted, as compared with none of 25 (0 percent) of those receiving diethylcarbamazine. Occasional nausea was the only symptom significantly associated with the prophylactic drug regimen. We conclude that diethylcarbamazine given orally once weekly can be an effective, acceptable chemoprophylactic agent to prevent loiasis in temporary residents of regions of Africa where Loa loa is endemic.

Adult↗
PubMed1988

Clostridium difficile plasmid isolation as an epidemiologic tool.

A large hospital outbreak of Clostridium difficile diarrhea at the Minneapolis Veterans Administration Medical Center (MVAMC) was studied by plasmid profile typing. Plasmids were obtained from 30 (37%) of 82 clinical isolates from MVAMC patients and 10 (67%) of 15 non-MVAMC isolates. While bacteriophage plus bacteriocin typing and polyacrylamide gel electrophoresis (PAGE) plus bacterial agglutination typing proved more universally applicable, plasmid profiles may be useful for tracing isolated epidemic outbreaks, reinfections and relapses caused by plasmid-bearing strains.

Bacteriocins↗
PubMed1988

Early colonic anastomotic edema. Evaluation of stapled vs. hand-sewn anastomoses.

Early dysfunction of intestinal anastomoses is sometimes blamed on anastomotic edema. This study compares stapled and hand-sewn anastomoses for the development of early anastomotic edema. After segmental colon resections, one group of dogs was reconstructed with two-layered handsewn anastomoses, and the other group had stapled anastomoses. Controls were untouched small bowel in each operated animal and untouched colon in a separate group of dogs. At 24 hours postoperatively, all animals were given 125I albumin and at 28 hours the animals were killed, venous blood was obtained, and the anastomoses were harvested. Tissue levels of 125I albumin were measured at 1-mm and 1-cm distances from each anastomosis and compared with controls. This quantitative measure of edema was compared with the histologic appearance of the tissue specimens. The results show significant edema formation in both stapled and handsewn anastomoses compared with control tissues (P less than .05 for each animal). Although quantitative and histologic results demonstrate less edema in the stapled group, the difference is not significant by the Wilcoxin rank test. These and similar studies may allow improvement in surgical technique.

Anastomosis, Surgical↗
PubMed1986

Non-ferritin, non-heme iron pools in rat tissues.

Concentrations of intracellular, low molecular weight (LMW) and desferrioxamine B (DF) chelatable Fe, in tissues of normal, Fe-deficient and Fe-loaded female rats, were determined. Ice cold, high speed supernatants were rapidly fractionated on Ultrogel AcA202 or by filter centrifugation. After correction for residual blood and DF effects on Fe proteins, liver, kidney, heart and spleen contained 3-8 micrograms/g LMW Fe, brain 20 micrograms/g, with DF; two-thirds of this was detected without DF. There was little variation with Fe status. MW standardization and fractionation on Sephadex G-25 indicated components of apparent MW 13,000, 1400 and 350; the latter two were rapidly labeled with in vivo 59Fe.

Animals↗
PubMed1986

Loa loa infection in temporary residents of endemic regions: recognition of a hyperresponsive syndrome with characteristic clinical manifestations.

Loiasis in residents of endemic areas is generally manifested by microfilaremia, episodic angioedema, periocular migration of adult worms, modest eosinophilia, and variable antibody levels. In 20 temporary residents who acquired loiasis in West Africa, however, the clinical presentations were markedly different. Only three of the 20 had detectable microfilaremia. Furthermore, these patients often showed a state of marked immunological hyperresponsiveness manifested by very high titers of antibody to filariae, increased levels of serum IgE, and profound hypereosinophilia--to levels greater than 3,000/mm3 in 18 of the 20. These patients were also notable for the increased severity, frequency, and pruritic nature of their angioedema. Also, significant complications occurred in seven of the 20; one patient developed endomyocardial fibrosis and six, renal disease after treatment with diethylcarbamazine. Thirteen of the 20 developed subcutaneous nodules; adult parasites were recovered from three of five of these patients who underwent biopsy. All of the patients responded to therapy with diminution of their clinical symptoms and decreases in levels of eosinophils, IgE, and antibody to filariae.

Adult↗
PubMed1985

Emergency intravenous pyelography in the trauma patient. A reexamination of the indications.

Because of the high incidence of abnormal intravenous pyelograms (IVPs) in victims of blunt trauma undergoing resuscitation, a retrospective review of the Trauma Registry at the University of California, San Diego Medical Center, was undertaken to evaluate the indications for ordering this test. The charts of 216 patients were reviewed, all of whom had formal IVPs (four films) done as an emergency procedure at the time of admission. In this study, special attention was directed toward comparing both the degree of hematuria and the anatomic site of injury with the results of the IVP. A total of 20 renal injuries was detected by IVP. Of these injuries, all but one had hematuria that was greater than 50 red blood cells per high-power field. All but one of the abnormal IVPs were associated with obvious abdominal injuries. The results of the IVP influenced the clinical course of only one patient in the entire series. We conclude that the use of the formal IVP (four films) in the resuscitation phase of treating the multiply traumatized patient be reserved for those patients with penetrating abdominal injury or with hematuria consisting of greater than 50 red blood cells per high-power field. For any major blunt abdominal trauma without significant hematuria, a more simple and rapid study (one-shot IVP) to demonstrate bilateral nephrograms is probably adequate to rule out occult renal artery thrombosis.

Emergencies↗