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Biomedical subjects

R E Murphy

Publications and source records attributed to R E Murphy.

15 recordsLinked to original sources
PubMed2001

Age related neural adaptation following short term resistance training in women.

BACKGROUND: This study examined the influence of age on neural facilitation and neural cross-education following short term unilateral dynamic resistance training with the hypothesis that older women may have a diminished ability for adaptation. METHODS EXPERIMENTAL DESIGN: This was a prospective, repeated measures design. The non-dominant left arm served as a control limb and follow-up testing was performed two weeks after pretesting. SETTING: Testing was conducted in the Neuromuscular Research Laboratory at the University of Oklahoma. PATIENTS: 20 females (n=10, young (YF) 20.8+/-0.1 yrs; n=10, older (OF) 58.1+/-0.14) were assessed. INTERVENTIONS: 14 days of training of the right elbow flexors only. On each day, subjects performed four sets of ten repetitions using 70 percent of maximal strength of the biceps brachii. MEASURES: The following variables in both right and left elbow flexor muscle groups were evaluated; isometric strength (IMS), efficiency of electrical activity (EEA) and estimated upper arm cross-sectional area (CSA). RESULTS: There were significant increases (p<or=0.01) in IMS of both the right (28 percent) and left (12-15 percent) muscle groups for both age groups. Strength improvements were explained by neural adaptation since there were no changes in upper arm CSA but consistent decreases in EEA (12-16 percent). While OF had consistently lower values for all variables, there were no significant age effects. CONCLUSIONS: Short term unilateral dynamic resistance training is a sufficient stimulus to induce significant strength increases in both trained and untrained contralateral limbs and that a neural mechanism is responsible for the muscular adaptation in both young and older women. Implication exists for unilateral stroke victims, individuals with single hip or knee replacements, or single limb casts.

Adaptation, Physiological↗
PubMed2000

Clinical benefits of endoscopic vein harvesting in patients with risk factors for saphenectomy wound infections undergoing coronary artery bypass grafting.

OBJECTIVE: The influence of endoscopic harvesting techniques on the prevalence of leg-wound complications after coronary artery bypass grafting remains to be defined for patients at high risk for the development of wound infections. METHODS: Among 1473 patients undergoing coronary artery bypass grafting who had the saphenous vein harvested by either a continuous incision or skip incisions leaving intact skin bridges, we determined the prevalence of wound infections to be 9.6%. The following variables were entered into logistic regression analysis to identify significant risk factors that might be predictive of wound infection: diabetes, peripheral vascular disease, obesity, renal failure, steroid use, age, sex, and type of closure. We then prospectively randomized 132 patients found to be at high risk of wound infection to either endoscopic vein harvesting or a continuous open incision. RESULTS: Univariate analysis showed female sex (P =.04), diabetes (P <.001), and obesity (P <.001) to be predictors of wound infection. In a multivariate model diabetes (P =.02) and obesity (P =.001) were independent predictors. In patients at high risk, the prevalence of wound infection was 4.5% for the endoscopic group versus 20% for the open group (P =.01). Vein procurement time was greater in the endoscopic group (65 minutes vs 32 minutes, P <.001), as was the number of vein repairs required (2.5 vs 0.6, P <.001). CONCLUSION: The use of endoscopic vein harvesting decreases the prevalence of postoperative leg-wound infections in high-risk patients with diabetes and obesity. Whether this translates into an economic benefit that justifies the additional cost of that technology requires further analysis.

Aged↗
PubMed2000

Anti-sense oligonucleotides, for progestin receptors in the VMH and glutamic acid decarboxylase in the VTA, attenuate progesterone-induced lordosis in hamsters and rats.

Immunocytochemical (ICC) staining for progesterone (P) receptors (PRs) and glutamic acid decarboxylase (GAD), the enzyme responsible for GABA production, reveal that there are many PRs in the ventral medial hypothalamus (VMH) and many GAD containing neurons in the ventral tegmental area (VTA). To investigate P's action on lordosis in the VMH and VTA, anti-sense oligos specific to PRs and GAD(65&67) were intracerebrally infused into the VMH and VTA of 24 ovariectomized hamsters and 40 ovariectomized rats. Estradiol benzoate (2 microg) primed hamsters and rats were infused to the VMH and the VTA with either PR (250 ng/1.0 microl infusion) or GAD (500 ng/1.0 microl infusion) anti-sense oligos, their scramble controls, or saline vehicle at hour 0 and again at hour 24. At hr 44, rodents were subcutaneously injected with P (500 microg) and were tested for sexual receptivity with a male 4 h later. There were significant reductions in lordosis of hamsters and rats following PR anti-sense infusions to the VMH compared to scrambled or vehicle control infusions. Effects of PR anti-sense to the VMH were not different from combined VMH and VTA PR anti-sense infusions; however, VMH infusions reduced lordosis compared to VTA-only anti-sense infusions. GAD anti-sense infusions reduced lordosis when infused into the VTA, compared to scrambled or saline vehicle infusions. Lordosis responsiveness following VTA GAD anti-sense infusions was not different from combined VMH and VTA infusions, but VTA infusions of GAD anti-sense reduced lordosis compared to VMH-only anti-sense infusions. These data suggest that in the VMH, PRs are important for P-facilitated lordosis, whereas in the VTA, GABAergic neurons may be an important substrate for mediating P's actions on lordosis of rodents.

Animals↗
PubMed1997

Carotid occlusive disease and stroke risk in coronary artery bypass graft surgery.

To clarify the perioperative stroke risk in patients with carotid stenosis or occlusion having coronary artery bypass graft (CABG) surgery, we retrospectively reviewed the records of 1,022 patients who had CABG during a 2-year period (1992, 1993). Of these, 224 had preoperative carotid duplex studies, usually for bruit or remote symptoms. We analyzed clinical and neuroimaging findings for all patients who had strokes to determine infarct topography and presumed mechanism, either low perfusion or embolism. Perioperative stroke was always ipsilateral to severe (> or = 70%) carotid disease, and occurred in 2 (8.0%) of 25 patients with carotid occlusion, 3 (50.0%) of 6 patients with 70 to 99% stenosis, and 9 (4.7%) of 193 patients with less than 70% stenosis. Borderzone infarcts occurred with all degrees of carotid stenosis. Stroke frequency had a positive correlation with the degree of carotid stenosis. Eight (1.0%) of the 798 patients not studied by carotid duplex had stroke in various vascular distributions. Overall, stroke occurred in 22 (2.2%) of the 1,022 patients having CABG surgery. Our results suggest that while the overall risk of perioperative stroke in CABG surgery is low, the risk is increased in patients with severe extracranial carotid stenosis or occlusion. The role of carotid disease and the mechanism of borderzone infarction in CABG surgery remain unsettled.

Aged↗
PubMed1996

Surgical treatment of systemic atheroembolism from the thoracic aorta.

BACKGROUND: Surgical procedures performed exclusively for atheroembolic events arising from the thoracic aorta rarely have been reported. Presented here are 2 patients who underwent successful operation for these problems. METHODS: The clinical presentation, diagnostic evaluation and surgical approach to 2 patients with different embolic sources in the thoracic aorta are presented. One patient had experienced three strokes and was noted by multiplane transesophageal echocardiography to have protruding atheromas with ulcerations in the transverse arch and origin of the brachiocephalic vessels. The transverse arch was replaced using hypothermic circulatory arrest with individual reimplantation of the brachiocephalic vessels. The second patient presented with "blue toe" syndrome from mobile atheromas in the mid-descending thoracic aorta defined by transesophageal echocardiography. A localized debridement was performed using simple aortic cross-clamping. RESULTS: Both patients had uneventful postoperative courses and had no further atheroembolic events. CONCLUSIONS: When standard diagnostic modalities do not delineate an embolic source for either stroke or peripheral embolization, transesophageal echocardiography is recommended as an excellent means of identifying atheromas in the thoracic aorta that could be the source for emboli. Once these lesions are identified, a surgical procedure should be performed to prevent further embolization.

Aorta↗
PubMed1995

Viscous effects in capillary electrophoresis: theory and experiment.

Simple theory which relates the viscous effects of additives used in capillary electrophoresis (CE) to resolution and resolution per unit time are developed for small molecule separations in the absence of sieving effects. The resolution theory shows that there is no advantage to using viscous additives for resolution improvement unless either a binding energy difference exists between the solutes and additive, or viscous effects cause a reduction in the vector sum of electrophoretic and electroosmotic velocities when these are of opposite sign. In general, increasing the viscosity is shown to result in a loss of resolution per unit time. Theory demonstrates that in cases where only binding is considered to be present, the maximum resolution increase is found to be at relatively small amounts of additive. In addition, specific regions of the elecctrophoreogram may demonstrate resolution enhancement at a specific concentration while other regions exhibit a resolution decrease, as compared to no additive present. CE separations of the components in a Triton surfactant, conducted using a polyethylene glycol (PEG) additive, demonstrate that improved resolution for some of the peaks exists at a specific PEG concentration. These results are mostly explained through the reduction in electroosmotic flow velocity that takes place through additive adsorption to the capillary wall, although some binding is present.

Electrophoresis, Capillary↗
PubMed1989

A protocol for pediatric trauma receiving units.

Management of the child with multiple injuries is among the most challenging problems in pediatric surgery. The first 20 minutes are crucial in determining the outcome. Our conceptual model of accomplishing 60 minutes' work in 20 minutes by the additive efforts of three teams working together is a simple, practical, and proven method for a pediatric trauma receiving unit. The checklist approach is recommended as the surest way to organize treatment and accomplish a thorough evaluation while effectively stabilizing pediatric trauma patients.

Child↗
PubMed1987

The crucial hour.

Explore the source record for details and available documents.

Airway Obstruction↗
PubMed1986

Pediatric trauma. Part II: Development of an emergency care system.

Treatment of pediatric trauma begins at the moment of injury (with the arrival of the first person who assists the victim), continues through transport of the patient to the hospital and administration of definitive medical care, and concludes with a rehabilitation program that is aimed at returning the child to a pre-accident life-style. Community hospitals can reduce morbidity and mortality associated with pediatric trauma by implementing specific organizational concepts and procedures used at established pediatric trauma centers. These include swift and accurate assessment at the scene of the accident, pre-arrival coordination between rescue team and emergency room personnel, a preestablished contact network for essential hospital staff, emergency equipment in a broad range of sizes, and charts specifying pediatric dosages of necessary medications. Morbidity and mortality could be further reduced with a national system of comprehensive regional treatment centers designed specifically for children. PAs who are familiar with the specific needs of seriously injured children can significantly influence community and professional responses to this growing area of medicine.

Child↗
PubMed1984

Virilizing malignant lipid cell tumor producing erythropoietin.

Paraneoplastic erythrocytosis associated with production of erythropoietin and testosterone by a malignant lipid cell tumor is demonstrated in this case report. Several chemotherapeutic regimens failed to halt the progression of this aggressive metastatic lipid cell tumor. The scant literature on malignant lipid cell tumors is reviewed. Possible mechanisms for paraneoplastic erythrocytosis are presented. Adequate control of polycythemia preoperatively will reduce thromboembolic and hemorrhagic complications.

Combined Modality Therapy↗