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Biomedical subjects

N Ward

Publications and source records attributed to N Ward.

At least 19 recordsLinked to original sources

Excitotoxic lesions of the pedunculopontine tegmental nucleus of the rat. II. Examination of eating and drinking, rotation, and reaching and grasping following unilateral ibotenate or quinolinate lesions.

The pedunculopontine tegmental nucleus (PPTg) contains a population of cholinergic neurons thought to be part of the ascending reticular activating system, and non-cholinergic neurons. In the previous study it was shown that various excitotoxins made effective lesions of cholinergic neurons in the PPTg but that quinolinate made smaller lesions in the non-cholinergic population, making it more selective than any other excitotoxin. The purpose of the present experiment was, first, to make lesions of cholinergic neurons throughout the length of the PPTg by infusing toxin at two different sites within it; and second, to examine simple motor activities in rats bearing either quinolinate or ibotenate lesions of the PPTg, and contrast these with the deficits seen after 6-hydroxydopamine (6-OHDA) induced lesions of mesostriatal dopamine (DA)-containing neurons. Post-mortem examination was carried out using choline acetyltransferase (ChAT) and tyrosine hydroxylase (TOH) immunohistochemistry, and routine Nissl staining. Both quinolinate and ibotenate destroyed approximately 75% of ChAT-positive neurons in the PPTg, but damage to non-cholinergic neurons (assessed by Nissl staining) was twice as great following ibotenate as quinolinate. 6-OHDA induced almost complete lesions of mesostriatal DA neurons, assessed by TOH immunohistochemistry. DA depleted rats showed deficits in drinking and spilled more food in the first 2 weeks after surgery, and were unable to reach or grasp food pellets in the staircase test. They also showed strong ipsilateral turning in response to amphetamine and contralateral turning to apomorphine. Quinolinate lesioned rats had no eating or drinking impairment in the home cage but showed a reaching (though not grasping) disability in the staircase test. They had a mild ipsilateral bias following amphetamine. Ibotenate lesioned rats, despite having larger lesions than the quinolinate, showed no deficits in eating or drinking in the home cage, or reaching or grasping disabilities in the staircase test. They did have a mild contralateral bias in response to amphetamine. This dissociation of the effects of quinolinate and ibotenate lesions of the PPTg is consistent with the suggestion that the PPTg has two functionally distinct components, and is attributed to the differential lesion of non-cholinergic neurons by the two excitotoxins.

Animals

Tissue aluminum concentrations stability over time, relationship to age, and dietary intake.

Aluminum concentration was measured in serum, whole blood, hair, and urine by neutron activation analysis. Seventy-six nondemented subjects were investigated. Not all assays were done on all subjects (e.g., serum aluminum on 76 subjects, whole blood aluminum on 42 subjects), but tissue aluminum concentrations were estimated on more than one occasion on 32 subjects. The mean +/- SD aluminum concentration in serum was 0.219 +/- 0.063 micrograms/ml (N = 76), in whole blood 0.368 +/- 0.091 micrograms/ml (N = 42), in urine 0.092 +/- 0.076 micrograms/ml (N = 42), and in hair 6.42 +/- 2.22 micrograms/g (N = 42). Using product moment correlation coefficient there was no significant correlation between age and tissue aluminum concentrations, nor between dietary intake of aluminum and tissue aluminum. The tissue aluminum concentrations were not stable over time even when dietary intake was constant. Tissue aluminum concentrations were measured in 14 patients after 7 days of dietary control and repeated approximately 6 weeks later, again after 7 days of dietary control. There was no significant correlation between the two estimations in any tissue measured. These results suggest that raised tissue aluminum concentrations reported in Alzheimer's disease are not an exaggeration of a normal ageing process, are not likely to be simply secondary to increased dietary aluminum intake, and that Alzheimer's disease does not represent the chronic toxic effect of moderately raised aluminum levels at the upper end of the normal distribution.

Adult

Rapid measurement of basic drugs in blood applied to clinical and forensic toxicology.

A gas chromatographic method is presented to measure blood, serum or plasma concentrations of more than 40 basic drugs. The sensitivity is 0.05 mg/L or less, which represents medium-high therapeutic and overdose concentrations, and in many instances the major active metabolites are also quantified. The paper describes a single step extraction from basic solution into n-butyl acetate containing maprotiline internal standard. Disposable glass tubes are used, with direct chromatography of the upper organic layer. GLC analysis is conducted for 10 min isothermally on a packed column (3% SP2250) with nitrogen-phosphorus detection. The coefficient of variation (CV) of the assay is between 2% and 5%, and data on the reproducibility of retention times are presented.

Calibration

Gas chromatographic measurement of cocaine in serum, plasma and whole blood.

A gas chromatographic method is presented to measure cocaine in serum, plasma or blood. To reduce the in-vitro chemical and enzymic hydrolysis of cocaine, samples should be collected into fluoride oxalate tubes, frozen immediately and stored at -20 degrees C until analysis. Extractions are carried out in disposable glass tubes immersed in an ice-bath. The method uses a single step extraction from a mildly basic solution into n-butyl acetate containing maprotiline internal standard. A portion of the upper organic layer is chromatographed for 5 min isothermally on a packed column (3% SP2250) with nitrogen-phosphorus detection. The coefficient of variation (CV) of the assay is below 6% at 0.1 mg/L and the limit of accurate measurement is 0.02 mg/L. A case of acute cocaine intoxication is described to illustrate the application of the method.

Adult

Ankyloglossia: a case study in which clipping was not necessary.

Following the birth of a baby with a short frenulum, the mother experienced pain from the infant's first feeding that was severe and persistent, despite usually effective interventions. The pain forced the mother to pump her breastmilk and use a feeding bottle and rubber nipple despite her determination to breastfeed. Because the baby's tongue could not extend over the lower gumline, suckling injured all tissue the tongue touched--both the mother's nipples and areolae. Nevertheless, even though this baby's frenulum extended to the tip of the tongue, he was able to adapt his suckling movements to provide good areolar stimulation without persistent nipple damage. Infant growth was not compromised and no surgical intervention was necessary.

Breast

Worldwide status of poliomyelitis in 1986, 1987 and 1988, and plans for its global eradication by the year 2000.

In 1986, a total of 28,951 cases of poliomyelitis were reported to WHO by 175 countries/areas. For 1987, 35,685 cases were reported by 168 countries/areas. Reporting is incomplete for 1988, based on data available as of December 1989. Trends in regional incidence rates for poliomyelitis over a 15-year period from 1974 to 1988 suggest a decline in the incidence of the disease, especially since 1982. However, the reported data underreport actual disease incidence. During 1986, 1987 and 1988, the Expanded Programme on Immunization (EPI) estimates that 200,000-250,000 cases of paralytic poliomyelitis occurred each year. With the current level of polio immunization coverage, it is estimated that 360,000 cases of paralytic poliomyelitis were prevented in 1988. In 1974, when the EPI was started, it was estimated that less than 5% of children in the developing world were adequately immunized against six common childhood diseases, including poliomyelitis. In 1988 (based on data available as of December 1989) 67% of children worldwide received a full course of polio vaccine before 12 months of age. The progress of the EPI has provided optimism that poliomyelitis can be eradicated. In May 1988, the Forty-first World Health Assembly committed WHO to the global eradication of poliomyelitis by the year 2000. The eradication of poliomyelitis will represent, along with the eradication of smallpox, a fitting gift from the XXth to the XXIst century. To reach this goal, action will be required in several main areas. Immunization coverage will need to be raised and sustained in every district. Vaccine quality must be assured by using vaccines which meet WHO requirements and maintaining the cold chain. Surveillance must be strengthened so that prompt, regular reporting of suspected cases leads to disease-containment measures. Additional actions include improving laboratory diagnostic capabilities, developing special training materials, increasing public awareness, supporting rehabilitation services and conducting essential research.

Forecasting

A study of physician preferences in the management of depression in the general medical setting.

Although more than 30% of ambulatory medical patients are depressed, little is known about how their depression is managed in the primary care setting. We surveyed 282 primary care physicians at two internal medicine and four family medicine programs. We asked these physicians to describe how they actually managed depression in their depressed medical patients and how they would manage ten hypothetical depressed medical patients. Demographic and attitudinal data were also obtained. Physicians reported that they utilized a wide variety of treatments for their depressed patients. They indicated that they would recommend counseling twice as many depressed patients as they would recommend medicating or referring. Over 30% of the variance in self-reported preferences to recommend particular treatments for depression was accounted for by physician characteristics. Prior experience with a treatment strategy was a significant factor in predicting a recommendation for future use of a treatment independent of other considerations such as endorsement of positive attitudes about the efficacy or benefits of a treatment. Prior experience was also more important than physician sociodemographics as a predictive variable. The clinical and educational implications of these findings for psychiatrists and primary care physicians are discussed.

Adult

Career orientations of medical and pediatric residents.

Educators have expressed concern about the declining percentage of graduating residents who choose an academic career. This study identifies characteristics of postgraduate physicians that are associated with intentions to pursue an academic career or a full-time private practice. Data were obtained from 299 residents in pediatrics and internal medicine at five academic medical centers in Southern California, using self-report questionnaires. Preference for an academic career was strongest among residents who were most satisfied with their work, were frequently sponsored by faculty, had published, or who either lived alone or were married to another professional. The likelihood of full-time private practice was strongest among residents who were less frequently sponsored by faculty, had not published, lived with others, were from certain medical schools, or were females. Training programs may wish to consider some of these factors in the selection of residents and in program development.

Academic Medical Centers

Antidepressants in concomitant chronic back pain and depression: doxepin and desipramine compared.

Doxepin and desipramine at final doses of 188 and 173 mg/day, respectively, were compared in 36 volunteers with major affective or dysthymic disorder and chronic back pain. Both drugs produced significant decreases in depression, with an overall response rate of 70%; no significant difference was seen between groups. Pain ratings also decreased significantly in both groups (overall response rate = 50%); pain severity showed a better response to doxepin than to desipramine. While baseline pain, depression, and anxiety were correlated, treatment changes in these measures did not correlate. CSF beta-endorphin levels did not change with treatment. The usefulness of an antidepressant with anxiolytic properties, such as doxepin, is discussed.

Adult

Thiothixene plasma levels and clinical response in acute schizophrenia.

Plasma levels of cis and trans thiothixene were compared to clinical response in 8 acutely schizophrenic inpatients. While absolute plasma levels did not appear to correlate with clinical condition, the data did suggest that increases or decreases in cis plasma levels correlated with corresponding improvements or deteriorations in clinical condition in thiothixene responsive patients. While the results are very preliminary, the authors suggest that future studies differentiate the cis and trans isomers, and analyze relative as well as absolute changes in plasma levels as compared to clinical changes.

Acute Disease

Effects of alcohol on biliary lipids in the presence of a chronic biliary fistula.

To investigate the effects of alcohol on bile volume and bile composition, dogs with a Thomas cannula and cannulated common ducts were given loading and maintenance doses of alcohol. Bile was analyzed for total bile salts, phospholipids and cholesterol. In dogs with partial interruption of the enterohepatic circulation, alcohol caused significant diminution of volume and outputs of bile salts and cholesterol. However, when a high bile flow was maintained by intravenous infusion of taurocholate sodium, the effects of alcohol on volume and total bile salts were no longer demonstrated. Fall in cholesterol output, nevertheless, persisted. These results show that alcohol causes significant changes in bile flow and biliary lipid composition and support the existence of a bile salt independent fraction of cholesterol secretion in the dog.

Animals

Caesium levels in manic depressive psychosis.

Concentrations of caesium were estimated in hair, whole blood, serum and urine by neutron activation analysis, in samples from manic patients, depressed patients, recovered manic patients, recovered depressed patients and normal controls. There was no difference in the concentration of caesium measured between the various diagnostic categories. These results contradict the findings of previous reports.

Bipolar Disorder