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Biomedical subjects

N Clarke

Publications and source records attributed to N Clarke.

At least 37 records · Page 2Linked to original sources
PubMed1995

A mother and three daughters with congenital dislocation of the hip and a characteristic facial appearance: a new syndrome?

We describe a mother and her three daughters who all have bilateral congenital dislocation of the hip. The mother has had no other medical problems and is on the 90th centile for height. Her three daughters resemble each other strongly with facial characteristics which include hypertelorism, epicanthic folds, puffiness around the eyes, a flat mid-face and a carp-shaped mouth. All three daughters are on the 3rd centile for height, with their head circumference on a higher centile and all had an ASD. Other features include congenital dislocation of one knee (one), congenital inguinal hernia (one) and vesico-ureteric reflux (one). They also have clinodactyly and hyperextensible finger joints, both features also seen in their father, whose height is on the 3rd centile and who had bilateral congenital inguinal herniae. Collagen studies of skin and ligament were normal. This family does not appear to fit with any of the recognized congenital dislocation syndromes and we suggest that they may represent a previously undescribed syndrome.

Adult↗
PubMed1995

Patient comfort in audiological testing.

A questionnaire survey was conducted to investigate the relative comfort of a comprehensive range of diagnostic procedures. The mean comfort ranking and variability in comfort were examined. Pure tone audiometry and speech audiometry are the most comfortable tests, while caloric testing and transtympanic electrocochleography are the least comfortable. However, caloric testing and glycerol dehydration are not significantly different in comfort to magnetic resonance imaging (MRI), and brainstem evoked response testing is more comfortable than other diagnostic tests, including MRI. The reasons for these differences and the implications for diagnostic management are discussed.

Adult↗
PubMed1994

Intermuscular bupivacaine infusion for control of pain after renal surgery: a preliminary report.

OBJECTIVE: To assess the value of continuous bupivacaine wound infusion for post-operative pain relief after renal surgery. PATIENTS AND METHODS: The analgesic efficacy of continuous intermuscular wound infusion with 0.25% bupivacaine was studied in 10 patients (four men, six women), with a mean age of 47.5 years (range 25-71) and a mean weight of 71.2 kg (range 44-99), after renal surgery in a single-blind randomized trial. The results were compared with those of an age- and weight-matched control group of 10 patients (five men, five women) with a mean age of 47.7 years (range 27-73) and a mean weight of 67.3 kg (range 51-85). Post-operative pain was studied objectively by assessing individual patient's morphine requirements administered via a patient controlled analgesia system, and subjectively with pain scores. Patient mobility was assessed by ward nursing staff using mobility score charts. RESULTS: There was a lower demand for post-operative analgesia in the bupivacaine group compared with the control. Although there was no significant difference in the pain scores between the two groups, the bupivacaine group was significantly more mobile than the control group after surgery. There was no significant difference in the mean post-operative hospital stay between the two groups. CONCLUSION: Continuous intermuscular bupivacaine wound infusion is a simple and safe procedure which lowers the patients' post-operative analgesic requirements, allows for earlier mobility and may promote more rapid discharge from hospital.

Adult↗
PubMed1992

Protein and nuclear changes in pig eggs at fertilization.

The nuclear restructuring that occurs between insemination and full pronuclear formation in pig eggs is accompanied by posttranslational changes to specific egg proteins. Sperm penetration begins in vitro at 3 hr postinsemination (hpi). By 5 hr, decondensing sperm heads and anaphase II plates are observed in 50% of eggs, and, by 8 hpi, both male and female pronuclei have formed. Three consistent changes to the pattern of newly synthesised proteins are triggered in this period; they affect the 46K, 25K, and 22K polypeptides. Changes are also triggered in the 180-200K polypeptides and in the 14K polypeptides, but these are highly variable. The same changes in the prefertilization pattern were observed when prelabelled eggs were used and new protein synthesis was suppressed. The first and most abrupt change involves the apparent catabolic elimination of a group of 46K unphosphorylated polypeptides (pl 7.3-6.4), whose synthesis was greatest before germinal vesicle breakdown but declined slowly in the final phase of maturation, then declined precipitously after activation. Ageing (beyond maturation) also leads to the disappearance of these polypeptides. The progressive disappearance of a set of 25K polypeptides and the concomitant appearance of a dominant 22K polypeptide is the most characteristic fertilization-induced modification to porcine egg proteins. These modifications begin within 1 hr of sperm penetration or activation, are specific to the pig, and involve heavily phosphorylated polypeptides (25K, pl 6.7-6.0) whose synthesis is begun in the early metaphase I stage. Dual ([35S] and [32P]) labelling, protein blocking experiments, and use of alkaline phosphatase suggest that dephosphorylation selectively affects these 25K polypeptides and is mainly or wholly responsible for converting them (completely within 6 hr) to a single, new (22K, pl 7.6) species that is positively charged. The 25K/22K polypeptide modification has a close temporal relationship with the formation of the male and female pronuclei.

Animals↗
PubMed1991

Improved outcomes from tertiary center pediatric intensive care: a statewide comparison of tertiary and nontertiary care facilities.

OBJECTIVE: To compare outcomes from pediatric intensive care in hospitals with different levels of resources. DESIGN: Prospective, blinded comparison of outcome and care. SETTING: Tertiary (n = 3) and nontertiary (n = 71) hospitals in Oregon and southwestern Washington. PATIENTS: All critically ill children admitted with respiratory failure and head trauma for 6 months. MEASUREMENTS AND MAIN RESULTS: Severity of illness adjusted mortality rates were determined using admission day, physiologic profiles (Pediatric Risk of Mortality score) and care modalities were assessed daily. The crude mortality rate of the tertiary patients was four times higher than for the nontertiary patients (23.4% vs. 6.0%, p less than .0001). In the tertiary patients, the numbers of outcomes were accurately predicted by physiologic profiles (observed: 30 deaths and 98 survivors; predicted: 29.3 deaths and 98.7 survivors, z = -.25, p greater than .4). However, for the nontertiary patients, the number of the deaths were significantly different than predicted (observed: 20 deaths and 315 survivors; predicted: 14.4 deaths and 320.6 survivors, z = -2.08, p less than .05). The odds ratios of dying in a nontertiary vs. a tertiary facility were about 1.1, 2.3, and 8 (p less than .05) for mortality risk groups of less than 5%, 5% to 30%, and greater than 30%. Patients in tertiary facilities received more (p less than .05) invasive (e.g., arterial catheters) and complex (e.g., mechanical ventilation) care, whereas patients in nontertiary facilities received more (p less than .05) labor-intensive care (e.g., hourly vital signs). CONCLUSIONS: Care of the most seriously ill children in tertiary pediatric ICUs could improve their chances of survival.

Adolescent↗
PubMed1990

Changes in the composition of the hamster zona pellucida after fertilization in vivo but not in vitro.

Hamster zonae pellucidae were obtained from follicular oocytes, superovulated eggs, and eggs fertilized in vivo or in vitro. Zonae were labelled with N-succinimidyl-3(4-hydroxy,5-[125I]iodophenyl)propionate, and compared on single- and two-dimensional SDS-PAGE. Single-dimensional electrophoresis showed considerable differences between zona categories in the amount of label that they incorporated; follicular zonae incorporated the least label and zonae from eggs fertilized in vivo the most. On two-dimensional electrophoresis, polypeptides from 3 of the 4 zona categories migrated into 4 major groups: two of these groups each with Mr 150,000-250,000 were within the Mr range of ZP1, and two others, at Mr 90,000 and 55,000, appeared to be analogous to ZP2 and ZP3, respectively. The fourth zona category (zonae from eggs fertilized in vivo) showed a changed polypeptide profile as well as incorporating the most label; one of the polypeptides, Mr 150,000-250,000, was undetectable, but a train of Mr 70,000-90,000 polypeptides and a discrete polypeptide at Mr 20,000 were new. Since this changed profile did not occur in zonae from superovulated eggs, or in zonae from eggs fertilized in vitro, a synergism between oviductal factors and factors from the spermatozoon or egg, or both, towards the zona in vivo is indicated.

Animals↗
PubMed1986

Epidemic free-base cocaine abuse. Case study from the Bahamas.

Beginning in 1983, a sharp increase was noted in the number of new admissions for cocaine abuse to the only psychiatric hospital and to the primary outpatient psychiatric clinic in the Bahamas. For the two facilities combined, new admissions for cocaine abuse increased from none in 1982 to 69 in 1983 and to 523 in 1984. Although there was some evidence for a rise in cocaine use during this time, as the drug became cheaper and more available, a primary cause of this medical epidemic seemed to be a switch by pushers from selling cocaine hydrochloride, which has a low addictive potential, to almost exclusive selling of cocaine free base, which has a very high addictive potential and causes medical and psychological problems. Although the use of free cocaine base is rising around the world, this is the first report of a nationwide medical epidemic due almost exclusively to this form of the drug, although similar problems are reported with smoking coca paste in South America.

Adolescent↗
PubMed1984

Effect of lactation on diurnal temperature patterns of dairy cattle in hot environments.

Vaginal temperature patterns were obtained from 15 Holstein cows through radiotelemetry. Animals were divided into three groups with five animals per group: 1) cows in early lactation, less than 100 days postpartum, 2) cows in late lactation, greater than 240 days postpartum, and 3) dry cows. Animal temperatures, dry bulb, wet bulb, and black globe temperatures were monitored every 15 min for 17 days. Analysis of variance showed no significant difference for daily mean vaginal temperature between lactation groups. However, on hotter days, lactating cows had higher temperatures than dry cows. Daily mean vaginal temperatures of cows in early lactation were correlated with daily mean dry bulb temperature, black globe temperature, and relative humidity. Comparison of group temperature patterns isolated differences to specific times of day. In groups with early and late lactations, temperatures were lower in either group after milking. Vaginal temperatures were higher in lactating cows than in dry cows through most of the day. Results were 1) diurnal temperature patterns differ among groups; 2) lactating cows are sensitive to environmental changes; and 3) animal management can affect patterns of animal temperature.

Animals↗
PubMed1983

Pulpal effect of citric acid applied topically to root surfaces.

Five beagle dogs were subjected to the raising of full-thickness flaps on the buccal aspects of premolar teeth. Approximately 7 mm. of buccal bone was removed to expose the root surfaces, which were treated with 20 percent citric acid. Saline was used as a control, and after periods of 1, 7, 14, 28, and 56 days, the animals were killed. Specimens were examined histopathologically when microscopic examination failed to detect any pulpal changes in either the experimental or the control specimens.

Administration, Topical↗
PubMed1980

The optical detection of platelets in plasma.

The attenuation of a light beam by a suspension of platelets in plasma was examined theoretically and experiments were performed to confirm this analysis. Interfering and modifying inputs were identified and their effects quantified. Recommendations for instrument design are made which minimise the effects of spurious inputs and enable platelet concentration in plasma to be estimated by simple optical methods. The most important recommendations are: (i) the use of light in the range 850--1000 nm so that water may be used instead of isologous platelet-free plasma as a blank and (ii) the emphasis on the need for the calibration of the system and the necessity for re-calibration if the optical system is disturbed or adjusted.

Humans↗
PubMed1978

rac-Glycerol 1:2-cyclic phosphate 2-phosphodiesterase, a new soluble phosphodiesterase of mammalian tissues.

1. A soluble phosphodiesterase is present in mammalian tissues which rapidly hydrolyses enantiomorphs of rac-glycerol 1:2-cyclic phosphate, producing rac-glycerol 1-phosphate. 2. The enzyme has been purified up to 1700-fold by a combination of acetone precipitation and chromatography on DEAE-Sephadex A-50, Sephadex G-150 and hydroxyapatite. 3. The Km with glycerol cyclic phosphate as substrate is 7.2 mM, and the pH optimum broad (6.9--7.5). The molecular weight (by gel filtration) of the enzyme is approx. 35500. 4. The phosphodiesterase has no requirement for Ca2+ or Mg2+, but is stimulated by reducing agents (cysteine, dithiothreitol) and Fe2+. 5. The purified phosphodiesterase preparation also hydrolysed 3':5'-cyclic AMP, producing 5'-AMP exclusively, and 2':3'-cyclic AMP, forming 3'-AMP and 2'-AMP in the ratio 7:3. Bis-(p-nitrophenyl) phosphate was slowly hydrolysed, but other phosphodiesters tested were not attacked. 6. The phosphodiesterase is inhibited by theophylline and o-phenanthroline. It is inhibited by Pi and by a variety of phosphomonoesters, of which certain aromatic primary phosphates are particularly effective.

Animals↗
PubMed1977

One pediatric burn unit's experience with sleepwear-related injuries.

Review of the records of 678 children with acute injuries referred during an eight-year period to this burn unit indicated that flame burns from a single ignition source (50%) outranked scalds (27%) or house fires (12%) as causes of injury. There was no temporal trend in the rank pattern. The majority of these single-source flame injuries were severe and involved ignition of the child's clothing. From 1969 through 1973, sleepwear was the clothing involved in 32% of the instances. Since that time and coincident with promulgation of strict federal and state standards for flammability of children's night clothing, a dramatic decline in the number of children, referred with injuries of this type has taken place. It is probable that the single factor most important to the decline, in our experience with these injuries, is lower fabric flammability but, because our data may not be representative, corroboration is needed before one can exclude factors such as altered garment design, fire safety-related practices at home, or changing patterns of hospital referral.

Age Factors↗
PubMed1976

Some observations on the preparation of platelet-rich plasma.

In order to prepare platelet-rich plasma a constant height and volume of citrated whole blood was centrifuged at different gravity forces and times. The supernatant plasmas were examined for platelet concentrations, plasma volumes and optical densities. Results are described showing that gravity force and time have an important influence on the platelet numbers and the plasma volumes recovered. The light attenuation by different concentrations of platelets in plasma, using light path lengths of 5 mm and 10 mm, was compared. The shorter light path provides greater linearity between optical density and platelet numbers especially at higher concentrations.

Blood Cell Count↗