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Biomedical subjects

R Richards

Publications and source records attributed to R Richards.

At least 19 recordsLinked to original sources
PubMed1992

Three-dimensional CT imaging of the wrist. A practical system.

Three-dimensional computerized tomography provides a new approach to radiological imaging. Raw data from sequential two-dimensional scans have been reconstructed as a three-dimensional model of the carpal area using the Medical Graphics and Imaging Workstation. This study demonstrates the anatomical accuracy and potential diagnostic qualities of a reconstruction of the carpus using this system. The advantages, pitfalls and suggested applications of this technique of carpal imaging are discussed. Three-dimensional imaging is shown to provide a great deal of information which cannot be viewed on conventional radiographs or CT images.

Humans↗
PubMed1992

Inhaled histamine increases the rate of absorption of sodium cromoglycate from the lung.

Since many factors may alter lung epithelial permeability (LEP) to water soluble molecules, the effect of histamine on the absorption and clearance of inhaled sodium cromoglycate was examined in seven mildly asthmatic patients with hyperresponsive airways and eight normal subjects. The subjects underwent histamine challenge to determine the provocative concentration of histamine required to reduce the forced expiratory volume in one second (FEV1) by 20% (PC20) from baseline. On two further visits they inhaled either saline placebo or histamine and 5 min later inhaled an aerosol containing sodium cromoglycate. Measurements of FEV1 were made and blood samples taken for analysis of plasma sodium cromoglycate concentration at intervals for 3 h. In the asthmatic group histamine inhalation led to a 24 +/- 4% reduction in FEV1 but had no effect on the normal subjects. When compared with inhaled saline, histamine increased the initial pulmonary absorption of SCG without influencing the total amount of drug absorbed in both asthmatics and normals. These observations suggest that the pharmacokinetics of inhaled sodium cromoglycate may be altered significantly by inflammatory mediators present at the site of drug absorption from the airways.

Adolescent↗
PubMed1992

Exertion-induced heat exhaustion. An often overlooked diagnosis.

Exertion-induced heat exhaustion is a potentially lethal condition. The earliest signs include unsteady gait and confusion. Recording of rectal temperature is essential. Skin colour, blood pressure and heart rate are not reliable diagnostic signs. The mainstays of therapy are rapid rehydration and cooling. Prompt diagnosis and rapid effective therapy will minimise the risk of death.

Adult↗
PubMed1991

Vision research in departments of ophthalmology. An Association of University Professors of Ophthalmology perspective.

A research committee of the Association of University Professors of Ophthalmology disseminated a survey questionnaire to determine the state of research in departments of ophthalmology across the United States. The questionnaire contained 71 questions that were designed to assess attitudes and trends within members' departments and to solicit suggestions from the membership. Of the 145 members and affiliates queried, 140 responded. While the results of the survey indicate significant diversity among departments, departmental chairpersons view research as a major priority in the goals of their departments, and they envision maintenance or expansion of research over the next decade. The survey results have been collated and serve now as the basis for this Association of University Professors position article.

Humans↗
PubMed1991

A mathematical method for the comparison of three-dimensional changes in the facial surface.

Many attempts have been made to measure and compare the changes in the facial surface brought about by facial reconstructive surgery. Three-dimensional (3-D) analyses have largely consisted of qualitative descriptions rather than a quantitative treatment of these changes. Until recently, the lack of availability of 3-D data for the face and head has limited the advancement of these techniques. However, with 3-D information readily available from a laser scanning system which we have constructed, a technique has been applied which describes mathematically the facial shape and changes occurring in the face in terms of fundamental surface types. The method is described and used to compare the faces of two patients (one a cleft palate patient and the other a long-face, Class II malocclusion patient) before and after surgery along with the clinical description of the surgery, the resulting facial changes, the actual surgery performed, and the predicted surgical expectation. A strong relationship is found between the surface type description and the clinical observations. The implications of the method for surgery, facial aesthetics, and other disciplines are discussed.

Cleft Lip↗
PubMed1991

Autocrine/paracrine regulation of prolactin release from human decidual cells.

Studies from this laboratory indicate that the synthesis and release of prolactin from human decidual cells are regulated by factors released by the placenta, decidua and fetal membranes. A 23.5 kD protein (decidual prolactin-releasing factor, PRL-RF) has been purified to homogeneity from human placental tissue and placental conditioned medium. The releasing factor stimulates an acute release of prolactin that occurs within the first few minutes of exposure and a prolonged release, secondary to new hormone synthesis, that begins about 6-8 hours later. In addition, the synthesis and release of decidual prolactin are stimulated by IGF-I, insulin and relaxin, each acting through distinct plasma membrane receptors. In contrast, the synthesis and release of decidual prolactin are inhibited by arachidonic acid, lipocortin I and a 35-45 kD decidual protein (prolactin-releasing inhibitory factor) that has been partially purified from decidual conditioned medium. Studies of the second messengers involved in the regulation of decidual prolactin release strongly suggest that decidual prolactin release may be mediated, at least in part, by activation of phosphoinositide metabolism and stimulation of adenylate cyclase. The demonstration that the synthesis and release of decidual prolactin are regulated by PRL-RF, IGF-I, insulin, relaxin, arachidonic acid, PRL-IF and lipocortin I strongly suggests that there is novel autocrine/paracrine feedback regulation between the placenta, fetal membranes, and decidua in the regulation of decidual prolactin.

Decidua↗
PubMed1991

Guidewire catheter change in central venous catheter biofilm formation in a burn population.

This study was designed to assess the risk of colonization and biofilm formation of central venous catheters left in situ for seven days vs those changed over a guidewire at three days and removed at seven days. Colonization was determined using scanning and transmission electron microscopy and compared to a special scraping/sonication culture method. Thirty-one catheters were examined, and no difference was found between catheters left in situ (9 of 16 colonized) and those changed over a guidewire (11 of 15 colonized). Colonization rates rose significantly from 4 of 15 catheters at the time of guidewire change to 11 of 15 at 7 days (p less than 0.001). Of the catheters defined as colonized by SEM, the special culture technique showed bacterial growth in only 35 percent, making a negative culture result of dubious value in ruling out catheter colonization. No beneficial effect of guidewire changes in reducing colonization could be demonstrated.

Bacterial Adhesion↗
PubMed1990

Disposition, pharmacokinetics, and metabolism of 14C-fotemustine in cancer patients.

The pharmacokinetics and metabolism of intravenously infused 14C-fotemustine (about 100 mg/m2) were examined in 2 cancer patients. Plasma levels of radioactivity increased to a maximum of 4.1 and 5.5 micrograms equivalents per g when the infusion stopped then declined triexponentially with mean half-lives of about 1/2, 10 and 80 h for the initial, mid and terminal phases, respectively. Plasma levels of intact drug were lower, with maximum levels of 1.1 and 2.8 micrograms/ml, and declined monophasically with a half-life of about 24 min. Plasma clearance was high (1426 and 764 ml/min) with the volume of distribution based on areas of 47.7 and 26.4 l. Most of the radioactivity was eliminated in urine (50.1 and 61.3%) over 7 days with smaller amounts in the feces (6.8 and 0.3%) and only minimal quantities (under 0.1%) as expired carbon dioxide. Metabolites of fotemustine were identified as chloroethanol and N-nitroso-1-imidazolone-ethyl-diethylphosphonate in plasma and as 1-hydantoin-ethyl-diethyl-phosphonate and acetic acid in urine.

Aged↗
PubMed1990

Evidence that mammalian ribonucleotide reductase is a nuclear membrane associated glycoprotein.

Epitope-specific antibodies to the M1 and M2 subunits of mammalian ribonucleotide reductase were prepared using peptides predicted to have a high antigenic index. Western blotting demonstrated that the anti-M1 antibody was specific for the 89-kilodalton M1 subunit (and its degradation fragments) and the anti-M2 antibody specifically recognized the 45-kilodalton M2 subunit. Both antibodies inhibited the CDP-reductase activity of the holoenzyme. Using these antibodies, both the M1 and M2 subunits were shown to be localized in the cytoplasm and in the nuclear regions of a number of cell types, including B77 avian sarcoma virus transformed NRK cells, T51B rat liver cells, 5123tc hepatoma cells, and rat liver cells in vivo. In addition, the M1 subunit was found to be localized as a halo around isolated rat liver nuclei. Biochemical analysis of the cytoplasmic fraction of liver cells and a Triton X-100 wash of nuclei from these cells confirmed the location of the enzyme activity in these cellular compartments. The M1 subunit appears to be glycosylated, as indicated by its retention on a Affi-Gel-concanavalin A affinity column. Therefore, in mammalian cells ribonucleotide reductase appears to be not only in the cytoplasm, but is also associated with the nuclear membrane or nuclear lamina. The activity of the enzyme in the membrane fraction changes dynamically during the cell cycle.

Animals↗
PubMed1990

Operative treatment of palsy of the posterior interosseous nerve of the forearm.

The cases of forty patients who were operated on consecutively for palsy of the posterior interosseous nerve were analyzed. The injury was iatrogenic in sixteen patients, traumatic in fifteen, and nontraumatic in nine. Persistent paralysis (partial or complete) was the only indication for operation. Operative neurolysis was done in twenty-three patients; interfascicular nerve-grafting, in twelve; internal neurolysis, in one; and tendon transfer, in four. An excellent or good functional result was documented for all but three patients, of whom two had had neurolysis and one, nerve-grafting.

Adolescent↗
PubMed1989

Non-neurogenic soft tissue tumours of the axilla: prospective review of 16 cases.

Sixteen consecutive patients entered in a prospective study of non-neurogenic soft tissue tumours had lesions in the axilla. Delayed diagnosis and inappropriate biopsy prior to referral to a surgical oncologist were frequent findings. Sarcoma and fibromatosis were diagnosed in 14 cases, and the approaches used for these two diseases were fundamentally different. The functional outcome with limb salvage surgery in these patients is presented.

Adolescent↗
PubMed1989

Ribonucleotide reductase--new twists in an old tale.

Although they are proliferatively quiescent, the cells in the intact adult rat liver express the gene coding for the M1 subunit of ribonucleotide reductase. But since they do not need deoxyribonucleotides, they promptly inactivate the 88 to 90 kDa M1 products and degrade them into 40 kDa fragments. Partial hepatectomy signals the remaining cells to start proliferating. Two hours before the onset of DNA replication, around 16 to 18 hr after partial hepatectomy, the cells start accumulating a large pool of functional ribonucleotide reductase M2 subunits. Near the end of the G1 build-up the cells step up M1 gene expression, stop inactivating, and reduce the degradation of the M1 products. The accumulating functional 88 to 90 kDa M1 subunits, each with more than one catalytic site, couple with functional M2 subunits to produce active ribonucleotide reductase holoenzyme which accumulates in the outer nuclear membrane from which they supply deoxyribonucleotide precursors to intranuclear replication enzymes. At the end of the S phase, the cell reduces M1 gene expression and resumes degrading 88 to 90 kDa M1 subunits. At least some of the 40 kDa M1 fragments are still active and can form partially active "holoenzymes" when mixed with a standard preparation of functional M2 subunits. The M1 control mechanism appears not to operate in hepatoma cells and Ehrlich ascites tumor cells, both of which maintain a pool of undegraded 88 to 90 kDa M1 components.

Animals↗
PubMed1989

Airway refractoriness to adenosine 5'-monophosphate after repeated inhalation.

Adenosine-5'-monophosphate (AMP) is a bronchoconstrictor agonist in subjects with atopic and nonatopic asthma. In this study we have investigated the effect of repeated airway challenge with AMP in 10 atopic, subjects without asthma. At the first visit, subjects had repeated inhalation challenges with increasing doubling concentrations of AMP, and the provocation concentration required to reduce FEV1 by 20% of baseline was determined (PC20 AMP). When the FEV1 had returned to within 5% of the baseline, the AMP challenge test was repeated on a further one or two occasions. When the maximum concentration of AMP (400 mg/ml) failed to produce a PC20, a bronchial provocation test with histamine was performed and the PC20 was determined. On the second visit, the effect of three consecutive inhalation challenge tests with histamine on the airway response to this agonist was determined. On the third visit, the duration of induced refractoriness to AMP was assessed. With the first AMP challenge, all subjects demonstrated bronchoconstriction with a geometric mean (GM) PC20 of 332 mg/ml. With a second AMP challenge, five of the 10 subjects became refractory and failed to achieve a PC20. In the remaining five subjects, the GM PC20 increased from 110 to 583 mg/ml. With a third AMP challenge, these subjects also failed to achieve a PC20. The initial GM PC20 histamine for the group was 22.9 mg/ml, which did not change significantly with two further histamine challenges or when the airways were refractory to AMP, suggesting that loss of AMP effect was not related to loss of contractility of airway smooth muscle or down regulation of H1-histamine receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Monophosphate↗
PubMed1989

Application of 3-D computer graphics for facial reconstruction and comparison with sculpting techniques.

Facial reconstruction has until now been carried out by the sculpting technique. This method involves building a face with clay or other suitable material on to a skull or its cast, taking into account appropriate facial thickness measurements together with information provided by anthropologists such as approximate age, sex, race and other individual idiosyncrasies. A method for facial reconstruction is presented using 3-D computer graphics and is compared with the manual technique. The computer method involves initially digitising a skull using a laser scanner and video camera interfaced to a computer. A face, from a data bank which has previously digitised facial surfaces, is then placed over the skull in the form of a mask and the skin thickness is altered to conform with the underlying skull. The advantage of the computer method is its speed and flexibility. We have shown that the computer method for reconstructing a face is feasible and furthermore has the advantage over the manual technique of speed and flexibility. Nevertheless, the technique is far from perfect. Further facial thickness data needs collecting and the method requires evaluation using both known control skulls and later unknown remains.

Computer Graphics↗
PubMed1989

Deep inspiration increases the absorption of inhaled sodium cromoglycate.

The plasma concentrations of sodium cromoglycate were measured for 4 h following a single dose of 20 mg given by inhalation to six normal volunteers. A series of forced expiratory manoeuvres was performed 2 h after the dose, which resulted in a rapid and marked increase in the plasma concentrations of the drug. A similar increase was found in three volunteers who undertook a single deep inspiration at 4 h. These data indicate that the absorption of cromoglycate from the airways can be affected by manoeuvres used to assess lung function.

Absorption↗
PubMed1989

Nedocromil sodium is more potent than sodium cromoglycate against AMP-induced bronchoconstriction in atopic asthmatic subjects.

Nedocromil sodium is a new chemical entity which shows similar properties to sodium cromoglycate (SCG) and in addition exhibits a preferential activity in stabilizing mucosal mast cells. We have compared the effect of inhalation of nebulized placebo, SCG and nedocromil sodium on the bronchoconstrictor response to inhaled adenosine monophosphate (AMP) in eight atopic asthmatic subjects aged 25 yr (range 21-32 yr). The geometric mean provocation doses of AMP required to produce a 20% decrease in FEV1 (PD20FEV1) and a 40% decrease in Vmax30 (PD40 Vmax30) following placebo were 4.9 (0.3-14.2) and 1.8 (0.1-8.4) mumol respectively. Prior inhalation of both SCG and nedocromil sodium significantly inhibited the bronchoconstrictor response to AMP with PD20FEV1s of 36.6 (4.0-132.7) and 134 (12.4-560), and PD40 Vmax30 values of 20.5 (1.4-110) and 101.6 (5-560) mumol respectively (P less than 0.001). Nedocromil sodium was 3.9 (FEV1) and 8.0 (Vmax30) times more potent than SCG (P less than 0.001). In conclusion, both drugs inhibit the bronchoconstrictor response to inhaled AMP, and nedocromil is at least 4-8 times more potent than SCG.

Adenosine Monophosphate↗
PubMed1989

Effect of nedocromil sodium and sodium cromoglycate against bronchoconstriction induced by inhaled adenosine 5'-monophosphate.

In this randomized, double-blind, placebo controlled study, the effect of prior inhalation of nebulized sodium cromoglycate (SCG) (7.3 +/- 0.6 mg) and nedocromil sodium (NED) (7.5 +/- 0.6 mg) was observed on adenosine 5'-monophosphate (AMP)-induced bronchoconstriction in 11 non-atopic asthmatic subjects. The geometric mean provocation doses of methacholine and AMP required to produce a 20% decrease in forced expiratory volume in one second (FEV1) (PD20FEV1) were 0.6 (0.1-18.8) and 5.1 (0.8-130.7) mumole respectively. The repeatability of the AMP challenge procedure for PD20FEV1 was within one doubling dose difference. SCG and NED, administered 30 min prior to bronchoprovocation with AMP, displaced the AMP dose-response curve to the right by 9.6 (1.5-41.6) (p less than 0.01) and 22.2 (3.7-89.1) (p less than 0.01)-fold, respectively, the difference between the two drugs being significant (p less than 0.05). There was a significant correlation (r = 0.7, p = 0.02) between the log dose ratios for PD20FEV1 for SCG and NED. We conclude that both SCG and NED protect against AMP-induced bronchoconstriction, NED being at least 2.3 (0.7-11.5)-fold more potent than SCG, and that they achieve this effect by a similar mechanism(s).

Adenosine Monophosphate↗