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Biomedical subjects

Michael Young

Publications and source records attributed to Michael Young.

At least 19 recordsLinked to original sources

A macroporous hydrogel for the coculture of neural progenitor and endothelial cells to form functional vascular networks in vivo.

A microvascular network is critical for the survival and function of most tissues. We have investigated the potential of neural progenitor cells to augment the formation and stabilization of microvascular networks in a previously uncharacterized three-dimensional macroporous hydrogel and the ability of this engineered system to develop a functional microcirculation in vivo. The hydrogel is synthesized by cross-linking polyethylene glycol with polylysine around a salt-leached polylactic-co-glycolic acid scaffold that is degraded in a sodium hydroxide solution. An open macroporous network is formed that supports the efficient formation of tubular structures by brain endothelial cells. After subcutaneous implantation of hydrogel cocultures in mice, blood flow in new microvessels was apparent at 2 weeks with perfused networks established on the surface of implants at 6 weeks. Compared to endothelial cells cultured alone, cocultures of endothelial cells and neural progenitor cells had a significantly greater density of tubular structures positive for platelet endothelial cell adhesion molecule-1 at the 6-week time point. In implant cross sections, the presence of red blood cells in vessel lumens confirmed a functional microcirculation. These findings indicate that neural progenitor cells promote the formation of endothelial cell tubes in coculture and the development of a functional microcirculation in vivo. We demonstrate a previously undescribed strategy for creating stable microvascular networks to support engineered tissues of desired parenchymal cell origin.

Animals↗

The equivalence of the Child Behavior Checklist/1 1/2-5 across parent race/ethnicity, income level, and language.

This study examined the equivalence of the Child Behavior Checklist/1 1/2-5 (CBCL/1 1/2-5) in 682 parents of 2- to 4-year-old children stratified by parent race/ethnicity (African American, Latino, and non-Latino White), family income (low vs. middle-upper), and language version (Spanish vs. English). Externalizing Scale means differed by income and child gender. Internalizing Scale means differed by income and parent race/ethnicity. Differential item analyses showed that few items functioned differently by racial/ethnic, language, and income group. A confirmatory factor analysis demonstrated that the Externalizing Scale provided a good fit with the data across racial/ethnic and income groups. However, model fit was improved for the Internalizing Scale when factor weights were allowed to vary. Findings support the equivalence of the CBCL/1 1/2-5 when used with parents of low-income preschool children from African American and Latino backgrounds, although further study of the factor structure for the Internalizing Scale is recommended.

Adult↗

Muralytic activity of Micrococcus luteus Rpf and its relationship to physiological activity in promoting bacterial growth and resuscitation.

The culturability of several actinobacteria is controlled by resuscitation-promoting factors (Rpfs). These are proteins containing a c. 70-residue domain that adopts a lysozyme-like fold. The invariant catalytic glutamate residue found in lysozyme and various bacterial lytic transglycosylases is also conserved in the Rpf proteins. Rpf from Micrococcus luteus, the founder member of this protein family, is indeed a muralytic enzyme, as revealed by its activity in zymograms containing M. luteus cell walls and its ability to (i) cause lysis of Escherichia coli when expressed and secreted into the periplasm; (ii) release fluorescent material from fluorescamine-labelled cell walls of M. luteus; and (iii) hydrolyse the artificial lysozyme substrate, 4-methylumbelliferyl-beta-D-N,N',N''-triacetylchitotrioside. Rpf activity was reduced but not completely abolished when the invariant glutamate residue was altered. Moreover, none of the other acidic residues in the Rpf domain was absolutely required for muralytic activity. Replacement of one or both of the cysteine residues that probably form a disulphide bridge within Rpf impaired but did not completely abolish muralytic activity. The muralytic activities of the Rpf mutants were correlated with their abilities to stimulate bacterial culturability and resuscitation, consistent with the view that the biological activity of Rpf results directly or indirectly from its ability to cleave bonds in bacterial peptidoglycan.

Animals↗

An evaluation of an abstinence-only sex education curriculum: an 18-month follow-up.

The article examines the results from an 18-month follow-up evaluation of an abstinence education curriculum series. Participants were students from 15 school districts recruited to participate in the project. The intervention was the Sex Can Wait curriculum series, consisting of upper elementary, middle school, and high school components. The 5-week curriculum was implemented by teachers who had participated in a special teacher training workshop. Both intervention and comparison students were surveyed before and after the curriculum intervention and at 18-month follow-up. Results indicated short-term effects as follows. Upper elementary intervention students indicated higher level of knowledge, more hopefulness for the future, and greater self-efficacy than did the comparison group. Middle school intervention students did not differ from comparison students. High school intervention students reported lower participation rates than the comparison group students in sexual intercourse (ever and last month), a more positive attitude toward abstinence and a greater intent to remain abstinent. Long-term (18 month) benefits were noted as follows: upper elementary intervention students had greater knowledge and were less likely than comparison students to report participation in sexual intercourse in the last month. Middle school intervention students were less likely than comparison students to report participation in sexual intercourse ever and sexual intercourse in the last month. High school intervention students evidenced greater knowledge and greater intent to remain abstinent than did comparison students. Results indicate that the program did have some positive benefits that should be considered by those interested in abstinence education programming.

Adolescent↗

Propylene glycol-induced lactic acidosis in a patient with normal renal function: a proposed mechanism and monitoring recommendations.

OBJECTIVE: To report a case of severe propylene glycol-induced lactic acidosis not attributable to renal dysfunction that was secondary to administration of high-dose intravenous lorazepam. CASE SUMMARY: A 24-year-old female with community-acquired pneumonia presented with severe acute respiratory distress syndrome. To maintain adequate sedation and ventilation and reduce airway pressure, several relaxation strategies were used including high-dose intravenous lorazepam, fentanyl, and cisatracurium. After 18 days of high-dose continuous infusion of lorazepam (maximum dose 50 mg/h), the patient developed severe lactic acidosis secondary to propylene glycol toxicity, the main diluent of lorazepam. The acidosis temporarily resolved with bicarbonate administration and discontinuation of lorazepam. Her renal function remained stable for a time (serum creatinine 0.5 mg/dL, blood urea nitrogen 10 mg/dL, urine output 100-200 mL/h). However, after several more days, the patient's condition deteriorated, and she ultimately died. DISCUSSION: Previous cases of propylene glycol toxicity secondary to high-dose lorazepam infusion have occurred in patients with compromised renal function. Our patient's renal function remained stable throughout the hospital course, which caused us to look further for an explanation for the propylene glycol-induced lactic acidosis. Based on the Naranjo probability scale, propylene glycol was determined to be the probable cause of lactic acidosis. Since this case occurred, our intensive care unit has instituted recommendations for the prevention of lorazepam-associated propylene glycol toxicity. CONCLUSIONS: Our case highlights the development of propylene glycol-induced lactic acidosis secondary to high-dose lorazepam infusion not associated with renal dysfunction.

Acidosis, Lactic↗

A novel firmicute protein family related to the actinobacterial resuscitation-promoting factors by non-orthologous domain displacement.

BACKGROUND: In Micrococcus luteus growth and resuscitation from starvation-induced dormancy is controlled by the production of a secreted growth factor. This autocrine resuscitation-promoting factor (Rpf) is the founder member of a family of proteins found throughout and confined to the actinobacteria (high G + C Gram-positive bacteria). The aim of this work was to search for and characterise a cognate gene family in the firmicutes (low G + C Gram-positive bacteria) and obtain information about how they may control bacterial growth and resuscitation. RESULTS: In silico analysis of the accessory domains of the Rpf proteins permitted their classification into several subfamilies. The RpfB subfamily is related to a group of firmicute proteins of unknown function, represented by YabE of Bacillus subtilis. The actinobacterial RpfB and firmicute YabE proteins have very similar domain structures and genomic contexts, except that in YabE, the actinobacterial Rpf domain is replaced by another domain, which we have called Sps. Although totally unrelated in both sequence and secondary structure, the Rpf and Sps domains fulfil the same function. We propose that these proteins have undergone "non-orthologous domain displacement", a phenomenon akin to "non-orthologous gene displacement" that has been described previously. Proteins containing the Sps domain are widely distributed throughout the firmicutes and they too fall into a number of distinct subfamilies. Comparative analysis of the accessory domains in the Rpf and Sps proteins, together with their weak similarity to lytic transglycosylases, provide clear evidence that they are muralytic enzymes. CONCLUSIONS: The results indicate that the firmicute Sps proteins and the actinobacterial Rpf proteins are cognate and that they control bacterial culturability via enzymatic modification of the bacterial cell envelope.

Actinobacteria↗

Determination of critical parameters among elite female shot putters.

The aim of this study was to determine if critical parameters for elite performance could be identified among a population of female shot putters. The performance of seven of the top women shot putters competing at the 2002 USA National Championships was examined. Video data were captured using two Panasonic 60 Hz cameras and the best throws of each athlete were digitized and analyzed using a Peak Motus three-dimensional motion analysis system. Thirty variables were examined for their effect on the distance of the throw. Correlation analysis indicated that measured distance was positively correlated with release speed (r = 0.97, p < 0.0003) and shoulder-hip separation (r = 0.72, p < 0.06) and negatively correlated with release angle (r = -0.74, p < 0.056), rear knee angle at rear foot touchdown (r = -0.93, p < 0.003) and rear knee angle at release (r = -0.76, p < 0.047). Greater knee flexion angle at both rear foot touch down and release along with a neutral shoulder-hip angle at release were identified as the most critical parameters for success among this sample of elite women shot putters. The unique observation about the knee positions at specific events should assist in new training and coaching developments.

Biomechanical Phenomena↗

Interpersonal discrimination and the health of illicit drug users.

Although discrimination has been shown to adversely affect the health of marginalized populations, there is a paucity of research on the health impacts of discrimination experienced by illicit drug users. The purpose of this study was to examine the association between interpersonal discrimination and the mental and physical health of illicit drug users taking into account several potential confounding factors. A sample of 1,008 active illicit substance users (defined as having used cocaine, crack, or heroin in the previous 2 months) were recruited in three New York City neighborhoods between August 2000 and January 2001 using street-outreach techniques. Discrimination due to illicit drug use was the most common form of interpersonal discrimination experienced and more than one-half the study participants reported experiencing discrimination due to more than one attribute. Discrimination was significantly associated with poor mental health (measured by the SF-36 mental health score), depression (measured by the CES-D), and the number of self-reported chronic physical health conditions. The presence of multiple stigmatizing characteristics was associated with poorer mental and physical health. Discrimination may contribute to poor mental and physical health in this marginalized population, potentially complicating the provision of substance abuse treatment.

Adult↗

A survey of patients with inflatable penile prostheses for satisfaction.

PURPOSE: We assessed patient satisfaction with 3 types of penile prostheses, namely the AMS 700 Series(R), Mentor Alpha 1(R) and Mentor Alpha NB(R). MATERIALS AND METHODS: The subjects consisted of 330 patients selected by stratified, systematic random sampling from among 1,298 subjects undergoing virgin 3-piece inflatable penile implant surgeries performed by the same surgical team at 1 hospital between January 1992 and December 1998. Data were collected by computer assisted telephone interviewing with a survey developed by the authors. The survey consisted of 37 questions in 7 sections, including 1 demographic section and 6 patient satisfaction sections. RESULTS: Of the 330 patients selected 248 (75%) could be contacted. Of these, 199 (80%) responded to the full survey and the remaining 49 (20%) agreed to respond only to the question, "How satisfied are you with the prosthesis?" Of the 199 full responders 12 (6%) had AMS implants and 187 (94%) had Mentor implants. Of the 49 single question responders 5 (10%) had AMS implants and 44 (90%) had Mentor implants. Of the 248 patients the overall satisfaction rate was 69%. Although there was no significant difference at the 5% level in patient satisfaction by implant type, responses tended to favor the Alpha IPPs in terms of overall sexual satisfaction (p =0.058), natural feeling of the prosthesis (p =0.061), flaccid appearance of the penis when deflated (p =0.054), and education with demonstration of inflation and deflation (p =0.075). CONCLUSIONS: There was a high degree of overall patient satisfaction across implant types.

Humans↗

Loss of testicular volume associated with intratesticular varicocele.

Intratesticular varicocele is a rare entity and its clinical significance is not well established. We report a case of left-sided intratesticular varicocele associated with a significant reduction in left testicular volume at follow up. This association has not been previously reported. Incidentally, our patient is also the youngest case reported in the literature to date.

Adolescent↗

Mutants of Mycobacterium tuberculosis lacking three of the five rpf-like genes are defective for growth in vivo and for resuscitation in vitro.

Mycobacterium tuberculosis contains five genes, rpfA through rpfE, that bear significant homology to the resuscitation-promoting factor (rpf) gene of Micrococcus luteus, whose product is required to resuscitate the growth of dormant cultures of M. luteus and is essential for the growth of this organism. Previous studies have shown that deletion of any one of the five rpf-like genes did not affect the growth or survival of M. tuberculosis in vitro. In conjunction with the results of whole-genome expression profiling, this finding was indicative of their functional redundancy. In this study, we demonstrate that the single deletion mutants are phenotypically similar to wild-type M. tuberculosis H37Rv in vivo. The deletion of individual rpf-like genes had no discernible effect on the growth or long-term survival of M. tuberculosis in liquid culture, and the ability to resuscitate spontaneously from a nonculturable state in a most probable number assay was also unaffected for the three strains tested (the DeltarpfB, DeltarpfD, and DeltarpfE strains). In contrast, two multiple strains, KDT8 (DeltarpfA-mutation DeltarpfC DeltarpfB) and KDT9 (DeltarpfA DeltarpfC DeltarpfD), which lack three of the five rpf-like genes, were significantly yet differentially attenuated in a mouse infection model. These mutants were also unable to resuscitate spontaneously in vitro, demonstrating the importance of the Rpf-like proteins of M. tuberculosis in resuscitation from the nonculturable state. These results strongly suggest that the biological functions of the five rpf-like genes of M. tuberculosis are not wholly redundant and underscore the potential utility of these proteins as targets for therapeutic intervention.

Animals↗

Hamstring muscle kinematics during treadmill sprinting.

INTRODUCTION/PURPOSE: The objective of this study was to characterize hamstring muscle kinematics during sprinting, so as to provide scientific data to better understand injury mechanisms and differences in injury rates between muscles. METHODS: We conducted three-dimensional motion analyses of 14 athletes performing treadmill sprinting at speeds ranging from 80 to 100% of maximum. Scaled musculoskeletal models were used to estimate hamstring muscle-tendon lengths throughout the sprinting gait cycle for each speed. We tested the hypothesis that the biceps femoris (BF) long head would be stretched a greater amount, relative to its length in an upright posture, than the semitendinosus (ST) and semimembranosus (SM). We also tested the hypothesis that increasing from submaximal to maximal sprinting speed would both increase the magnitude and delay the occurrence of peak muscle-tendon length in the gait cycle. RESULTS: Maximum hamstring lengths occurred during the late swing phase of sprinting and were an average of 7.4% (SM), 8.1% (ST), and 9.5% (BF) greater than the respective muscle-tendon lengths in an upright configuration. Peak lengths were significantly larger in the BF than the ST and SM (P < 0.01), occurred significantly later in the gait cycle at the maximal speed (P < 0.01), but did not increase significantly with speed. Differences in the hip extension and knee flexion moment arms between the biarticular hamstrings account for the intermuscle variations in the peak lengths that were estimated. CONCLUSIONS: We conclude that intermuscle differences in hamstring moment arms about the hip and knee may be a factor contributing to the greater propensity for hamstring strain injuries to occur in the BF muscle.

Adolescent↗

Report of altered sensation in patients with cleft lip.

OBJECTIVE: To determine whether patients with cleft lip have normal perioral sensation. DESIGN: Each subject was carefully questioned about the following: sensation in the face at rest, light touch of different areas, and sensation in natural situations (e.g., exposure to cold weather) that reveal sensory abnormalities. A cotton-tip applicator stick was stroked lightly across the facial skin. The subject's descriptions of the evoked sensations were used to identify and outline areas with abnormal sensation. SETTING: Data were obtained from subjects participating in a longitudinal, university-based study of the functional outcomes of lip revision surgery. PATIENTS: Seventeen patients with cleft lip and 12 control subjects (aged 7 to 22 years, mean 12.9 years) participated. RESULTS: In contrast to control subjects, 9 of 16 patients (56%) reported loss in sensation, described as decreased touch, scratch, tickle, or tingle intensity. Six other patients (38%) reported additional sensation, described as increased scratch, tickle, or tingle intensity. In eight patients, the altered sensation was restricted to the skin area flanking and including the visible scar, encompassing no more than 25% of the total area bound by the inferior nose, nasolabial grooves and inferior vermilion. In seven patients (unilateral cleft), the altered area extended to the contralateral, noncleft side of the upper lip or onto the philtrum. CONCLUSIONS: In contrast to the literature, sensation in the upper lip of many patients with cleft lip is not normal. Loss in sensation is exhibited most commonly and limited largely to the skin overlying tissues traumatized during reconstructive surgery.

Adolescent↗

Thermal tissue damage caused by ultrasonic cement removal from the humerus.

BACKGROUND: Ultrasound devices can selectively remove cement during revision arthroplasty. These instruments initially were designed for the hip and knee but also have been applied to the upper extremity. We describe a patient in whom a radial nerve palsy and a pathologic humeral fracture developed after ultrasonic cement removal was performed because of an infection at the site of a total elbow arthroplasty. Biopsies of the humerus, the triceps muscle, and the radial nerve showed widespread necrosis consistent with thermal injury. METHODS: A study involving six human cadaveric specimens was conducted to measure temperature elevations in bone and adjacent soft tissue during cement removal with use of an ultrasound device with and without irrigation. RESULTS: While temperature increased only minimally during cement polymerization, ultrasonic melting and removal of cement with use of constant energy delivery led to markedly elevated temperatures in the humeral cortex, the triceps muscle, and the radial nerve. These temperatures were above the known thresholds for thermal injury and necrosis. Subsequently, strategies designed to allow for safe ultrasonic cement removal from the humerus were applied, including intermittent delivery of energy and the use of cold irrigation between probe passes. These strategies resulted in markedly lower maximum temperatures in all tissues tested. CONCLUSIONS: Temperatures in the humerus, triceps, and, most importantly, the radial nerve can reach potentially dangerous levels when ultrasound technology is used to remove cement from the humerus. We suggest intermittent cold irrigation of the humeral canal, no tourniquet use, education of surgeons with regard to proper techniques designed to limit heat generation, and consideration of exposure and protection of the radial nerve when ultrasound devices are used.

Aged↗