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Biomedical subjects

M Parker

Publications and source records attributed to M Parker.

At least 19 recordsLinked to original sources
PubMed2006

Assessing reliability of microsatellite genotypes from kit fox faecal samples using genetic and GIS analyses.

Noninvasive faecal DNA sampling has the potential to provide a wealth of information necessary for monitoring and managing endangered species while eliminating the need to capture, handle or observe rare individuals. However, scoring problems, and subsequent genotyping errors, associated with this monitoring method remain a great concern as they can lead to misidentification of individuals and biased estimates. We examined a kit fox scat data set (353 scats; 80 genotypes) for genotyping errors using both genetic and GIS analyses, and evaluated the feasibility of combining both approaches to assess reliability of the faecal DNA results. We further checked the appropriateness of using faecal genotypes to study kit fox populations by describing information about foxes that we could deduce from the 'acceptable' scat genotypes, and comparing it to information gathered with traditional field techniques. Overall, genetic tests indicated that our data set had a low rate of genotyping error. Furthermore, examination of distributions of scat locations confirmed our data set was relatively error free. We found that analysing information on sex primer consistency and scat locations provided a useful assessment of scat genotype error, and greatly limited the amount of additional laboratory work that was needed to identify potentially 'false' scores. 'Acceptable' scat genotypes revealed information on sex ratio, relatedness, fox movement patterns, latrine use, and size of home range. Results from genetic and field data were consistent, supporting the conclusion that our data set had a very low rate of genotyping error and that this noninvasive method is a reliable approach for monitoring kit foxes.

Animals↗
PubMed2006

Competence by consequence: ambiguity and incoherence in the law.

There is an ambiguity of principle delivered by those legal judgements which have considered the issue of whether the level of patients' decision-making capacity should vary in accordance with the seriousness of risks associated with the procedure subject to decision, particularly in decisions to refuse life-saving treatment. There appears to be support for (1) a risk-related standard of capacity, although some judgements could also be interpreted as (2) a procedural standard, subject to a rigorous standard of evidence of capacity. I argue that a risk-related standard of capacity itself is incoherent. This would lend weight to the second interpretation. However, I argue that the wording of the judgements belies an allegiance to the first interpretation, which is also consistent with how medical practitioners generally view capacity in these situations. I consider the implications of the dissonance between the two ways of interpreting the judgments, and make suggestions aimed at clarifying the issue of risk-related competence for clinicians.

Humans↗
PubMed2005

Antimicrobial activity of cinnamon and clove oils under modified atmosphere conditions.

Mixtures of cinnamon and clove oils were tested for inhibitory activity against important spoilage microorganism of intermediate moisture foods. Four fungal species (Aspergillus flavus, Penicillium roqueforti, Mucor plumbeus and Eurotium sp.), four yeasts species (Debaryomyces hansenii, Pichia membranaefaciens, Zygosaccharomyces rouxii and Candida lipolytica), and two bacteria species (Staphylococcus aureus and Pediococcus halophilus) inoculated separately on agar plates were sealed in a barrier pouch and exposed to essential oil volatiles under a modified atmosphere of low O2 (<0.05-10%) and high CO2 (20% or 40%), with the balance being N2. A. flavus and Eurotium sp. proved to be the most resistant microorganisms. Cinnamon and clove oils added between 1000 and 4000 microL at a ratio of 1:1 were tested for minimum inhibitory volume (MIV) against molds and yeasts. The gas phase above 1000 microL of the oil mixture inhibited growth of C. lipolytica and P. membranaefaciens; 2000 microL inhibited growth of A. flavus, P. roqueforti, M. plumbeus, Eurotium sp., D. hansenii, and Z. rouxii, while inhibition of A. flavus required the addition of 4000 microL. Higher ratios of cinnamon oil/clove oil were more effective for inhibiting the growth of A. flavus.

Bacteria↗
PubMed2005

False dichotomies: EBM, clinical freedom, and the art of medicine.

According to numerous commentators, clinical freedom, the art of medicine, and, by implication, a degree of patient welfare, are threatened by evidence based medicine (EBM). As EBM has developed over the last fifteen years, claims about better evidence for medical treatments, and improvements in healthcare delivery, have been matched by critiques of EBM's reductionism and uniformity, its problematic application to individual patients, and its alleged denial of the continuing need for clinical interpretation, insight, and judgment. Most of these attacks on EBM and defences of clinical freedom fail. They are based on erroneous understandings of the relationships between inductive knowledge, clinical uncertainty, and action. Evidence based medicine is a necessary condition for clinical freedom, not a threat to it, and EBM is not something to be balanced with either clinical experience or patient preferences. The art and science of medicine are more conceptually and practically connected than the defenders of clinical freedom, whatever they conceive that to be, are willing to admit.

Biomedical Research↗
PubMed2005

Effects of azadirachtin on mortality, fertilization, and swimming speed in larvae of the cane toad, Bufo marinus (Anura: Bufonidae).

Experiments were conducted to assess the effects of azadirachtin (AZ) on survival capacity, fertilization success, and swimming speed in larval stages of the cane toad, Bufo marinus . LC50 values (96-hr) for various larval stages exposed to 0.50 mg/l AZ were as follows: 5.35 (stage 12), 5.77 (stage 16), 787 (stage 20), 13.43 (stage 24), and 21.54 (stage 30). Tadpoles did not exhibit any apparent disorientation or production of mucous in response to AZ concentrations ranging from 0.3 to 0.5 mg/l. Mortality was significantly higher at 0.50 mg/l AZ than at lower concentrations. At 0.50 mg/l, mortality rate decreased significantly from 36% for stage 12 tadpoles, to 24% for stage 20 tadpoles. Mortality for early stages (stage 12) dropped significantly, from 36% at 0.50 mg/l, to 21% at 0.40 mg/l AZ There were no significant differences in percent mortality for any developmental stage at an AZ concentration of 0.3 mg/l, or for controls (no AZ). Exposure of gametes to 0.30 mg/l AZ did not reduce fertilization success as compared to controls (89.8 vs. 83.7%). At 0.40 mg/l, percent fertilization decreased significantly (68.8%). This effect was even more pronounced at 0.50 mg/l. No significant difference was found in swimming speeds between controls and subjects exposed to 0.30 mg/l AZ. However, at a concentration of 0.40 mg/l, tadpoles required a significantly longer period of time to swim a distance of 140 cm as compared to controls. The potential impact of AZ on amphibian populations is discussed.

Age Factors↗
PubMed2004

Osteoclastic cortical erosion as a determinant of subperiosteal osteoblastic bone formation in the femoral neck's response to BMU imbalance. Effects of stance-related loading and hip fracture.

Femoral neck fractures have previously been shown to be associated with increased cortical and endocortical remodeling, reduced wall thickness of endocortical packets and cortical porosity. Femoral neck width is associated positively with history of lifetime physical activity; so we hypothesized that exposure to mechanical loading may influence the subperiosteal osteoblastic response to the weakening effect of intracortical bone resorption. In 21 femoral neck biopsies from female subjects (13 with hip fracture), there was a positive association between osteoblastic periosteal alkaline phosphatase expression shown in frozen sections and the percentage of cortical canals internal to the subperiosteal surface showing evidence of osteoclastic erosion (Goldner's stain; p =0.03). This was stronger in the plane of locomotor loading and particularly strong in the inferior (compression) cortex ( p =0.002). In 35 cases and 23 age/gender-matched postmortem controls, osteoid-bearing cortical canals (%) were significantly elevated in the fracture cases compared with the controls within the anterior region. There was also a significant correlation between cortical and endocortical %OS/BS (percentage osteoid surface to bone surface) (fracture, n =12; control, n =12) over the whole biopsy ( p =0.041). Generally, these associations of intracortical with endocortical remodeling were consistent with both envelopes being regulated by common processes. These results support the concept that the slow growth of femoral neck width by subperiosteal apposition of bone occurs directly or, otherwise, in response to the weakening of the cortex as it is "trabecularized" by imbalance of bone multicellular units (BMU). This process, in turn, depends on cortical thinning and enlargement of canals with the formation of giant, composite osteons, the whole being more marked in cases of future hip fracture.

Aged↗
PubMed2004

Discrimination between cases of hip fracture and controls is improved by hip structural analysis compared to areal bone mineral density. An ex vivo study of the femoral neck.

In vivo bone densitometry is affected by measurement inaccuracies arising from the assumptions made about soft tissue and marrow composition. This study tested the hypothesis that section modulus (SM, a measure of bending resistance) when measured ex vivo, would discriminate cases of hip fracture from controls better than areal bone mineral density (aBMD). The biopsies were from (n = 22, female) subjects that had suffered an intracapsular hip fracture. The control material (n = 24, female) was from post-mortem subjects. Serial peripheral quantitative computed tomography (pQCT) 1-mm thick cross-sectional images of femoral neck previously embedded in methacrylate were obtained with the Densiscan 1000 pQCT densitometer and matched for lateral location. The image voxels were converted to units of bone mass, which were then used to derive the section modulus. The data were used to derive means from which receiver operating characteristic (ROC) curves could be generated. The area under the curves (AUC) showed that discrimination between the fracture cases and controls was better for SM than aBMD [SM: AUC = 0.83 (95% confidence interval: 0.71, 0.96), aBMD: AUC = 0.70 (0.54, 0.85); P = 0.034]. To simulate the forces experienced during a sideways fall, the model's neutral axis was rotated by 210 degrees. The results for section modulus were predictable from those at 0 degrees (r(2) = 0.97). We conclude that biomechanical analysis of the distribution of bone within the femoral neck may offer a marked improvement in the ability to discriminate patients with an increased risk of intracapsular fracture. Progress towards implementing this form of analysis in clinical densitometry should improve its diagnostic value, but may depend in part on better image resolution and more accurate corrections for the variability between subjects in regional soft tissue composition.

Absorptiometry, Photon↗
PubMed2004

Congruence between veno-occlusive parameters during dynamic infusion cavernosometry: assessing the need for cavernosography.

While dynamic infusion cavernosometry (DIC) is being performed with increasing rarity, some centers continue to use this investigation modality. Cavernosography may be utilized to identify the location of patent venous channels in men with venous leak. In an era when venous ligation surgery is being performed with less frequency, the role of cavernosography has been questioned. This study was conducted to define the congruence between the three parameters (flow-to-maintain (FTM), pressure decay (PD) and cavernosography) used in the diagnosis of venous leak during DIC. Established values for the three parameters were utilized and the diagnosis of venous leak was based upon the FTM measurement. All studies were performed using a vasoactive agent-redosing schedule. Cavernosography was conducted using a nonionic contrast agent at an intracorporal pressure of 90 mmHg. In patients with an elevated FTM value, 24% had a normal PD recorded, all of whom had FTM values <10 ml/min. The Pearson correlation coefficient for the relationship between FTM and PD was 0.58 (P=0.025). In all, 36 patients (54%) had an abnormal cavernosogram (CG). All patients who had positive findings on CG had elevated FTM values. On the other hand, 46% of patients with abnormal FTM values had a normal CG. This analysis indicates that almost one-half of men with venous leak diagnosed at the time of DIC based on FTM measurement will fail to have any veins visualized on cavernosography. These data further undermine the value of cavernosography, particularly in men with low-grade venous leak.

Adult↗
PubMed2004

Ocular manifestations of mosaic trisomy 22: a case report and review of the literature.

Mosaic trisomy 22 is rare, but can be compatible with prolonged life. Patients with mosaic trisomy 22 usually present with intrauterine growth retardation, mental retardation, failure to thrive, and craniofacial asymmetry. We report the case of a five-year-old boy who had a birth weight of 3.8 kg and normal developmental milestones. He presented with unilateral ocular manifestations of ptosis, double elevator palsy, high myopia, and choroidal coloboma involving the macula. Cytogenetic evaluation showed a low level of trisomy 22 in peripheral blood lymphocytes (1 in 100) and in cultured fibroblasts from a conjunctival biopsy of the affected eye (1 in 60). Our case demonstrates the value of chromosomal analysis of the tissues involved rather than just karyotyping of the blood lymphocytes to detect mosaicism in patients with localised and unilateral congenital malformations.

Abnormalities, Multiple↗
PubMed2004

The impact of sildenafil citrate on sexual satisfaction profiles in men with a penile prosthesis in situ.

OBJECTIVE: To assess the efficacy of sildenafil in increasing penile glans tumescence and improving patient satisfaction in men with a penile prosthesis, as this remains a major treatment for erectile dysfunction but a common complaint is the lack of glans engorgement. PATIENTS AND METHODS: To determine whether sildenafil combined with a penile prosthesis improves satisfaction, patients used an implant alone for at least 1 month, after which they completed the International Index of Erectile Function (IIEF) questionnaire. The same patients were then given sildenafil citrate and completed the IIEF questionnaire after using the sildenafil/implant combination. RESULTS: Patients who responded to sildenafil with glans engorgement reported significantly greater satisfaction scores than with an implant alone. CONCLUSION: We currently offer sildenafil citrate after implantation to all men who have a penile prosthesis placed.

Adult↗
PubMed2004

Response to Orr and Siegler--collective intentionality and procreative desires: the permissible view on consent to posthumous conception.

Orr and Siegler have recently defended a restrictive view concerning posthumous sperm retrieval and conception, which would limit insemination to those cases where the deceased man has provided explicit consent for such a procedure. The restrictive view dominates current law and practice. A permissible view, in contrast, would allow insemination and conception in all but those cases where the posthumous procedure has been explicitly refused, or where there is no reasonable evidence that the deceased person desired children. I describe a phenomenology of procreative desires which supports the permissible view, and which is compatible with requirements concerning the interests of the decedent, concepts of medical infertility, and the welfare of the future child. The account illustrates how our current obsession with individual rights and autonomy can be self-defeating and repressive.

Attitude to Death↗
PubMed2003

Effect of a novel 5-HT3 receptor agonist MKC-733 on upper gastrointestinal motility in humans.

BACKGROUND: Although 5-HT3 antagonists have been used to treat chemotherapy-induced emesis and diarrhoea-predominant irritable bowel syndrome, the effects of 5-HT3 agonists in humans are unknown. AIM: To determine the effect of MKC-733, a selective 5-HT3 receptor agonist, on upper gastrointestinal motility. METHODS: Oral MKC-733 (0.2, 1 and 4 mg) was compared with placebo in three randomized, double-blind, cross-over studies in healthy males. Antroduodenal manometry was recorded for 8 h during fasting and 3 h post-prandially (n = 12). Gastric emptying and small intestinal transit were determined by gamma-scintigraphy (n = 16). Gastric emptying, accommodation and antral motility were determined by echoplanar magnetic resonance imaging (n = 12). RESULTS: MKC-733 (4 mg) increased the number of migrating motor complexes recorded in the antrum and duodenum (P < 0.001), but had no effect on post-prandial motility. MKC-733 delayed scintigraphically assessed liquid gastric emptying (P = 0.005) and accelerated small intestinal transit (P = 0.038). Echoplanar magnetic resonance imaging confirmed the delayed gastric emptying (P < 0.001) and demonstrated a significant increase in cross-sectional area of the proximal stomach (P < 0.01). CONCLUSIONS: MKC-733 delays liquid gastric emptying in association with relaxation of the proximal stomach, stimulates fasting antroduodenal migrating motor complex activity and accelerates small intestinal transit.

Adolescent↗
PubMed2003

Evidence for bone formation on the external "periosteal" surface of the femoral neck: a comparison of intracapsular hip fracture cases and controls.

Age-related expansion of the external surface of the femoral neck in order to offset generalized bone loss is potentially an important mechanism whereby hip strength and hence resistance to hip fracture is maintained. However, it has been widely assumed that bone formation is precluded from this external interface due to the presence of a synovial membrane associated with the hip joint. In this study we have demonstrated histologically that bone formation does indeed occur on the outer "periosteal" surface of the proximal femoral neck. It was therefore hypothesized that an impairment or reduction in periosteal bone formation might be seen in cases of femoral neck fracture compared with age-matched controls. Qualitative analysis of whole femoral neck samples from female subjects and age- and sex-matched post-mortem controls demonstrated that these groups expressed similar distributions of the bone formation marker, alkaline phosphatase (AP), at the periosteal surface [whole biopsy mean % periosteal AP-positive surface: control=16.0 (range=0.5-43.0), fracture=13.4 (range=1.0-34.6), p=0.44]. In conclusion, despite a wide intersubject variation, bone formation at the femoral neck periosteum is a feature of elderly women even if they have had a hip fracture.

Aged↗
PubMed2003

Bilateral microphthalmia with cyst, facial clefts, and limb anomalies: a new syndrome with features of Waardenburg syndrome, cerebro-oculo-nasal syndrome, and craniotelencephalic dysplasia.

We report a patient with bilateral microphthalmia with cyst, limb anomalies, and multiple facial malformations. This patient has clinical features similar to Waardenburg ophthalmo-acromelic syndrome, cerebro-oculo-nasal syndrome, and craniotelencephalic dysplasia. Although all of these syndromes are characterized by microphthalmia, the presently reported patient does not have the complete pattern of any of these syndromes, It is possible that he has a previously undescribed syndrome, most closely related to the cerebro-oculo-nasal syndrome with malformations outside the craniofacial region. More case reports are needed to further delineate this possibly new syndrome.

Abnormalities, Multiple↗
PubMed2003

The ratio of osteocytic incorporation to bone matrix formation in femoral neck cancellous bone: an enhanced osteoblast work rate in the vicinity of hip osteoarthritis.

Recently it has been shown that an inactivating mutation in the TGFb-SMAD3 signaling pathway, which increases the conversion of osteoblasts to osteocytes, is accompanied by bone loss combined with increased osteocyte density. We hypothesized that increased matrix TGFb, known to occur in osteoarthritis, might cause the reverse of these effects in man. Because coxarthrosis (cOA) is associated with a reduced risk of femoral neck fracture, whole cross-section femoral neck biopsies were obtained from 11 patients with femoral neck fracture, 14 patients with cOA, and 22 age-and sex-matched controls. Lacunar density (Lc x mm2), osteocyte density (Ot x mm2), and cancellous wall width (Cn x W x Wi), were compared between cases of coxarthrosis, femoral neck fracture (FNF) and controls. In cOA, Lc.mm2 was reduced by 24% (P <0.001) while in FNF it was increased by 20% (P <0.001). Cn x W x Wi was increased in cOA by 22% (P <0.05) and in FNF was reduced by 27% (P <0.001). Lc x mm2 was inversely related to percentage cancellous bone area (adj. r2 = 0.373; P <0.01) and wall widths, r2 = 0.382, P <0.001. The reduction in osteocyte lacunar density coupled with increased wall width is consistent with a model of cOA effects on bone in which increased levels of matrix TGFb might prolong the effective lifespan or work rate of the osteoblast and delay its incorporation into the matrix as an osteocyte. One possible approach to strengthening bone in osteoporosis might be to enhance the effective lifespan of the osteoblast by modulating TGFb-related pathway activity in its local environment.

Aged↗