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Biomedical subjects

W Shaw

Publications and source records attributed to W Shaw.

At least 19 recordsLinked to original sources
PubMed1992

Renal handling of enalaprilat.

Most converting enzyme inhibitors share a predominantly renal dual elimination pathway consisting of glomerular filtration and tubular secretion. Since enalaprilat has two functional acidic groups, it is likely that it may be secreted via the proximal tubule organic acid system and, thus, its clearances would exceed that of glomerular filtration rate markers. We therefore examined the renal clearance of enalaprilat in normal volunteers and compared it with simultaneously measured inulin and creatinine clearances to explore the contribution of tubular secretion to the renal elimination of the drug. Twelve healthy male subjects with an age range of 24 to 58 years (mean +/- SE, 33.1 +/- 2.8) were studied. They had representative height (178.6 +/- 1.99 cm) and weight (73.3 +/- 2.1 kg) and had normal renal function as judged by blood urea nitrogen (BUN) (6 +/- 0.3 mmol/L [17 +/- 0.8 mg/dL]), plasma creatinine (88 +/- 3 mumol/L [1.0 +/- 0.03 mg/dL]), and creatinine clearance determined by a prestudy 24-hour urine collection (123.2 +/- 6.2 mL/min). Results are as follows: mean creatinine clearance, 2.12 mL/s (127 mL/min); mean inulin clearance, 119.1 ml/min mean creatinine clearance/inulin clearance, 1.07 mean enalaprilat protein binding, 37.9% unbound enalaprilat clearance, 222.4 ml/min; and the mean fractional enalaprilat clearances were: enalaprilat clearance/creatinine clearance, 1.72 (P less than 0.05, difference from 1.0); enalaprilat clearance/inulin clearance, 1.85, (P less than 0.05, difference from 1.0). Our results demonstrate that the clearance of free enalaprilat exceeds that of inulin and creatinine, suggesting that elimination of the drug proceeds through two complementary pathways, namely glomerular filtration and tubular secretion.

Adult↗
PubMed1992

The use of diarrhoeal management counselling cards for community health volunteer training in Indonesia: the HealthCom Project.

The Indonesian Ministry of Health relies on a network of over a million kader (community health volunteers) to bring primary health care to the village level. In West Java, the Department of Health's Control of Diarrhoeal Disease (CDD) Program recently carried out an extensive research and development effort to produce effective job aids for the kader in CDD and a training programme to teach their use. A set of counselling cards was produced to provide kader with a tool to diagnose and treat diarrhoea and teach the proper use of ORS. Researchers conducted a controlled evaluation in which they measured the cards' effectiveness through observations of kader performance and interviews with mothers they had counselled. In the intervention group, 15 kader underwent two days training in the use of the cards when diagnosing and advising treatment for cases of diarrhoea in their villages. The 16 control kader received comparable CDD training without the cards. Each group provided lists of local mothers they pledged to counsel during the coming weeks. Follow-up interviews were held with these mothers to test their level of knowledge on CDD and to observe their ability to mix ORS properly. Significant performance differences between the intervention kader and mothers, and the control kader and mothers, were demonstrated. The intervention kader were consistently more accurate in their diagnoses and recommendations for treatment with a mean of 83% accuracy vs 68% for the control kader. Mothers counselled by the intervention kader also prepared ORS significantly better than the mothers counselled by the control kader, with 97 vs 74% accuracy.

Community Health Services↗
PubMed1991

The deep inferior epigastric rectus abdominis muscle and myocutaneous free tissue transfer: further applications for head and neck reconstruction.

The rectus abdominis muscle and myocutaneous free tissue transfer is a well-recognized donor site for reconstruction of complex head and neck defects. Four composite deformities were successfully managed using this donor site. The rectus abdominis myocutaneous "sandwich" flap was used for closure of a pharyngocutaneous fistula and to provide intraoral lining and external coverage for a composite mandibular defect. The rectus muscle flap was used to obliterate a compound frontal sinus injury and an orbitomaxillary defect. All flaps were based on the deep inferior epigastric vascular pedicle.

Abdominal Muscles↗
PubMed1991

The psychological benefit of orthodontic treatment. Its relevance to dental health education.

In March 1989 the third stage of a major longitudinal survey examining the psychological, social and dental effects of malocclusion and the effectiveness of orthodontic treatment was undertaken. The aim of the research was to assess the benefit of receiving dental treatment with a particular interest in orthodontic treatment. The benefits investigated were dental, psychological and social. The project has involved researchers in several professional disciplines from locations in Britain and Europe.

Child↗
PubMed1990

A clinical trial of aligning archwires.

The physical properties of a super-elastic archwire alloy (Titanol) and Nitinol were investigated by the means of a bending test. It was found that the alloy possessed super-elastic properties. A clinical trial was then carried out to compare the properties of two types of aligning archwire. Two groups of 20 patients with crowded dentitions were randomly allocated either Titanol or Nitinol, a conventional nickel-titanium alloy aligning archwire. High quality alginate impressions were taken after archwire placement in Edgewise fixed appliances and were repeated after a mean period of 35 days. The impressions were cast in dental stone and digitized using the Reflex Metrograph. The contact points of the teeth of the labial segments, together with four stable points in the rugae were recorded. This enabled the co-ordinates for the sequential study models to be superimposed upon one another, allowing tooth movement in three dimensions to be calculated. The measurement error expressed as error variance was 0.028 mm. The coefficient of reliability was 97 per cent. When tooth movement was analysed the mean movement per contact point for Titanol was 1.7 mm and for Nitinol 1.42 mm. This difference was not statistically significant (P less than 0.05, t-test). However, a clinical impression was that the super-elastic archwire proved superior to the Nitinol, because it was more readily engaged into grossly displaced teeth.

Adolescent↗
PubMed1989

An evaluation of the psychological and social effects of malocclusion: some implications for dental policy making.

Initial findings are reported from a longitudinal study investigating the effects of malocclusion on dental health and psychological well-being and the effectiveness of orthodontic treatment. Implicit in the orthodontic intervention decision process is the view that there are discernible social and psychological benefits of good occlusion. This view has not been adequately validated. The primary psychological question addressed by this study concerns the relationship between adolescents' orthodontic status and their psychological status and well-being. Empirical evidence allowed an examination of the major hypothesis that children with poor occlusion are likely to be socially and psychologically disadvantaged. Ratings of dental status and physical attractiveness, and measures of psychosocial well-being were obtained for sample of 1018, 11-12-year-old children and the associations between these variables were examined. The results provide little support for the major hypothesis that children 'suffer' psychologically from having poor dentition. Several points of caution are made with regard to this conclusion and some implications for dental policy making are considered.

Adolescent↗
PubMed1989

The effects of social class on the uptake of orthodontic treatment.

The relationship between social class and uptake of orthodontic treatment was investigated in a longitudinal cohort study of 1018 children living in South Glamorgan, Wales. Previous studies have shown that working class people make less use of dental services and receive inferior dental care than middle class people. The present investigation examined the role of one factor which appears likely to contribute to this effect: namely, the uptake of orthodontic treatment by families from different social classes. If a significant association were shown then findings relating to the effectiveness of orthodontic treatment might be confounded by this social class factor.

Adolescent↗
PubMed1986

Functional evaluation of nonsensate free flaps to the sole of the foot.

Free flap transfer for soft tissue defects involving the sole of the foot have been important in limb salvage. The functional capacity of 16 patients is documented. From our data, free flaps to weightbearing surfaces of the foot give satisfactory results in patients less than 40 years old and salvage is rewarding. Older patients had less than satisfactory results. When the only alternative is an amputation, free flap salvage may still be indicated.

Activities of Daily Living↗
PubMed1985

Lymphedema in the replanted limb of the rat: scintigraphic evaluation.

The sequence of scintigraphic patterns in resolving lymphedema in the replanted hind limb of the rat is reported. Compared to simple observation of the limb, scintigraphy using 99mTc-antimony trisulfide colloid (99mTc SbSC) provides multiple qualitative parameters for assessing lymphedema, ie, diffuse uptake in the implanted limb, focal uptake at the site of surgical repair, accumulation in the popliteal node, and activity in the liver. Quantitative analysis in this model was not helpful. Scintigraphic criteria may be utilized to study the effect of alteration in the animal model described. It is hoped that this model can be used to clarify the clinical factors influencing the resolution of lymphedema.

Animals↗
PubMed1985

Possible role of lysolecithins and nonesterified fatty acids in the pathogenesis of Reye's syndrome, sudden infant death syndrome, acute pancreatitis, and diabetic ketoacidosis.

In vitro denaturation and (or) alteration of protein function by detergents have been extensively documented. I suggest that similar biochemical and clinical features of Reye's syndrome, sudden infant death syndrome, acute pancreatitis, and diabetic ketoacidosis may be explained as sequelae of the toxic detergent effects of nonesterified fatty acids and lysolecithins. These diseases may be provoked by a drug-induced diminution of the detergent-buffering capacity of blood or tissue proteins; by excess detergents produced in vivo, consequent to lipase activity induced by viral infection or metabolic disease; or by some combination of these factors.

Acute Disease↗
PubMed1977

Linearization of data for saturation-type competitive protein binding assay and radioimmunoassay.

Most of the commonly-performed competitive protein-binding radioassay methods utilized in the clinical laboratory are based on the principle of saturation analysis. Although many different methods for linearization of saturation-type assays have been proposed, the algebraic equivalency of all of these methods has not been adequately documented. In this manuscript we have shown the physical and mathematical basis for various methods for linearlization of saturation type assays and the algebraic equivalency of these linearization methods. We have also shown that key parameters such as slope and intercept may be dependent on different components of the assays system with differnt linearization methods. An understanding of these key parameters can help the analyst to evaluate changes in these key parameters and to integrate these parameters in a complete quality control system.

Binding, Competitive↗
PubMed1977

The changes produced by presurgical orthopedic treatment of bilateral cleft lip and palate.

A serial cephalometric analysis (with the aid of metallic implants) and an analysis of the models of 10 children with complete bilateral clefts, who received presurgical orthopedic treatment, was done. It revealed that such therapy can successfully reduce the protrusive deformity of the premaxilla, when forward growth of this structure is restrained so as to allow the remainder of the face to "catch up." Our other observations include the accentuation of the columella during treatment, but an absence of growth at the cleft margins. Orthopedic treatment which fails to achieve the desired aims in 12 weeks of active therapy should be discontinued then in favor of such surgical setback as may be necessary to allow a satisfactory lip repair.

Cephalometry↗
PubMed1977

Factors affecting T3 and T4 proficiency testing.

Problem areas within a proficiency testing (PT) program are performance evaluation and sample stability. The different units used in the various T3 uptake methodologies make performance evaluation complex. To facilitate this evaluation, a normalization method for T3 uptake performance evaluation has been developed. Sample stability studies for T3 uptake indicate that, at room temperature, sample values increase after storage for about seven days. Room temperature sample stability studies for T4 using a competitive protein binding (CPB) method indicate that the apparent T4 content of pooled serum increases after about one week. Fatty acids are shown to be an interfering substance in the T4 CPB method as well as the T4 radioimmunoassay (RIA) method. This interference increases with a decrease in carbon chain length from C18 to C12 and with an increase in unsaturation of fatty acids. The B/B0 ration for arachidonic acid at a concentration of 0.48 micronMoles per tube is 17.4 in a CPB method and 87.1 in a radioimmunoassay method indicating that the greater effect is in the CPB method. The increase in T3 uptake values are probably also due to the interfering effect of fatty acids.

Blood Preservation↗