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PubMed1988

The analysis of immature lymphoid precursors stored in longterm bone marrow culture.

The long-term bone marrow culture system developed by Dexter (MBMC) is known to store immature lymphoid precursors capable of differentiating into mature B cells in irradiated or immunodeficient mice. It has been suggested that pre-B cells are not generated under such culture conditions, but that opinion was not based on any systematic analyses. In the present study under carefully controlled conditions, we observed that pre-B and pro-B cells were eliminated from the late stage of primary MBMC, and the former were not generated in recharged MBMC. Under appropriate conditions, these immature precursors in recharged MBMC generated in vitro immunoglobulin-positive (Ig+) cells to differentiate into antibody-forming cells upon stimulation with lipopolysaccharide (LPS). LPS-reactive B cells were observed in every 10th of the Ig+ cells, the frequency being essentially the same as that observed in normal B cells in different tissues. The immature B cell precursors generating LPS reactive cells were expressed in recharged MBMC at the frequency of 4.2 x 10(-6). A staining experiment showed that cells bearing AA4.1 were stored at the frequency of 10(-4)-10(-5). This frequency is thought to be similar to that of lymphoid precursors in recharged MBMC committed to differentiate along B lineage cells. Based on these results, we discussed the stage, nature, and mode of differentiation of immature lymphoid precursors stored in MBMC.

Animals↗

PubMed1989

Propofol-induced anaesthesia. Double-blind comparison of recovery after anaesthesia induced by propofol or thiopentone.

Postoperative psychomotor and cognitive recovery were assessed after anaesthesia induced by either propofol or thiopentone, and maintained with nitrous oxide and halothane in 40 unpremedicated dental patients. Performance was shown to be impaired one hour postoperatively for the whole sample in hand-eye coordination (p less than 0.001), reaction time (p less than 0.001) and digit span (p less than 0.05). There was evidence of impairment at 3 hours postoperatively in reaction time (p less than 0.05) and ataxia (p less than 0.01). Performance also deteriorated in the dexterity and aiming tasks. Patients reported significantly less clumsiness by 24 hours in blurred vision and shivering (p less than 0.05) and by 48 hours less coughing (p less than 0.05). However, there was no significant difference between groups. No evidence showed that recovery in the propofol group was faster, so it was concluded that induction with propofol offered no advantage when anaesthesia is maintained with nitrous oxide and halothane for the periods of time reported in this study.

Adolescent↗

PubMed1991

Propofol in short gynaecological procedures. Comparison of recovery over 2 days after anaesthesia with propofol or thiopentone as sole anaesthetic agent.

Recovery was assessed over 48 hours after anaesthesia with propofol or thiopentone as sole anaesthetic agent in 36 unpremedicated gynaecological patients. Immediate recovery, as measured by the Steward scale, was shown to be quicker for the patients given propofol. At one hour postoperatively the thiopentone group showed impaired visual-motor coordination on the aiming test (p less than 0.01) and dexterity task (p less than 0.05), and a slowing of reaction time (p less than 0.01). Patients given propofol showed only an increase in reaction time (p less than 0.05). By 2 hours the thiopentone group showed impairment only in the aiming task (p less than 0.05). No further significant impairment was detected at 4, 24 or 48 hours. However, patients reported symptoms throughout the 48 hours indicative of residual drug effects. There was a substantial practice effect with some tests which may have obscured impairment. It can be argued therefore that the better recovery profile after propofol is still evident at 24 hours.

Adolescent↗

PubMed1991

Objective outcome criteria in trials of anti-parkinsonian therapy in the elderly: sensitivity, specificity and reliability of measures of brady- and hypo-kinesia.

1. We compare the sensitivity and specificity of chosen outcome criteria in a placebo-controlled, randomised cross-over study of the efficacy of maintenance therapy with the levodopa/carbidopa combination (Sinemet Plus) alone. Patients were characterised by having idiopathic Parkinsonism with no overt fluctuations in control in relation to individual doses of medication. 2. The effect of omission of a morning dose of maintenance therapy on simple timed tests of mobility and manual dexterity, and on distance/time parameters of gait was studied in fourteen patients (aged 64 to 88 years). Measurements made 2, 4 and 6 h after morning active and placebo treatments were standardised by taking the pre-treatment measurement on that day as baseline. 3. In a linear model, which allowed for the structure of the study, neither the total time taken by each patient to get up from a chair, walk an individually set distance, turn, return to and sit in the chair, nor the rate of progress at fastening the same set of buttons, was sensitive to the treatment effect. 4. Three of the gait parameters, free walking speed, mean stride length and mean double support time, were sensitive to the treatment effect. Correction for the speed of each walk, caused some reduction in the sensitivity of stride length to treatment effect, but that of double support time remained. Speed, and double support time or stride length, appeared to be complementary in defining the treatment effect. 5. The linear modelling revealed the complexity of the treatment effect. Although active treatment, by comparison with placebo, increased free walking speed (P = 0.019), the more levodopa found in the plasma following treatment, (P = 0.0005) and the greater the increment in the concentration of its peripheral metabolite, 3-O-methyldopa (P = 0.006), the less the beneficial effect. This model may reflect reduced uptake into the brain and/or an adverse effect of parent drug or a metabolite. 6. The specificity of free walking speed for the treatment effect was good, as was that of mean stride length, after it had been corrected for speed of each walk, and of mean double support time, after correction for speed and incorporation of the change in lying blood pressure accompanying treatment into the model. 7. The measurements of gait parameters were ranked according to reliability.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗

PubMed1982

Differentiation of human bone marrow-derived fibroblastoid colony forming cells (CFU-F) and their roles in haemopoiesis in vitro.

Human bone marrow-derived fibroblastoid colonies have been quantitatively developed in a liquid culture. A linear relationship between cell number plated and colony number formed supports their clonal origin and hydroxyurea killing indicates that the fibroblastoid colony forming cell (CFU-F) is not in cell cycle in normal bone marrow. Adipose cells were induced in the fibroblastoid colonies by the addition of hydrocortisone (optimal concentration: 10(-6) M). Furthermore, adherent layers with adipocytes provided a more favourable condition for maintaining haemopoiesis in Dexter-system cultures. These results indicate that CFU-F belongs to stromal precursor cells intimately involved in the formation of the haemopoietic microenvironment. Colony incidence of CFU-F was almost normal in most patients with aplastic anaemia, haemopoietic dysplasia and chronic myelogenous leukaemia. However, in acute myelogenous leukaemia, it varied with the stage of the disease. It is concluded that the colony assay is useful for investigating stroma/haemopoietic cell interactions.

Adipose Tissue↗

PubMed1995

Interferon-alpha (IFN-alpha) inhibits granulocyte-macrophage colony-stimulating factor (GM-CSF) expression at the post-transcriptional level in murine bone marrow stromal cells.

Recently it has been shown that IFN-alpha inhibits expression of GM-CSF in adherent cells of human long-term bone marrow cultures (LTBMC) stimulated with interleukin-1 (IL-1), tumour necrosis factor-alpha (TNF-alpha) or endotoxin. The murine bone marrow stromal cell line +/+(-1).LDA11 was used to further define regulatory mechanisms of IFN-alpha inhibition on GM-CSF expression. This cell line originated from a murine Dexter type culture and exhibits a preadipocytic phenotype. As in human LTBMC, we could demonstrate a inhibitory effect of IFN-alpha co-incubation on GM-CSF activity in serum-free supernatants of +/+(-1).LDA11 stromal cell cultures stimulated with IL-1 or TNF-alpha or the combination of IL-1 plus TNF-alpha. IFN-alpha inhibitory effect on GM-CSF expression was shown to be dose dependent with minimal response at 10 U/ml and maximal inhibition at a dose of 500 U/ml. Northern blot analysis confirmed these data at the mRNA level. Reprobing of Northern blots for interleukin-6 (IL-6) mRNA showed increased expression after IFN-alpha incubation, demonstrating specific and differential regulatory effects of IFN-alpha on cytokine production in bone marrow stromal cells. Inhibition of GM-CSF mRNA by IFN-alpha was time dependent, starting at about 90-120 min post-treatment. Cycloheximide (CHX) incubation abolished the inhibitory effect of IFN-alpha on GM-CSF expression, suggesting the requirement of a labile protein. Reporter gene studies were used in order to evaluate the effect of IFN-alpha incubation on GM-CSF mRNA transcription in stromal cells. For this purpose, GM-CSF promoter fragments were subcloned into a luciferase expression vector. Neither constitutive nor TNF-alpha stimulated GM-CSF transcription was inhibited by IFN-alpha coincubation. On the other hand, actinomycin-D chase experiments revealed a reduced GM-CSF mRNA stability after IFN-alpha incubation. The induction of a RNAase, possibly a 2-5A-dependent RNAase, by IFN-alpha may be a possible cause for the increased GM-CSF mRNA decay. These results show a regulatory role for IFN-alpha in the bone marrow microenvironment possibly involved in the myelosuppressive effect of IFN-alpha therapy or viral infections.

Animals↗

PubMed2005

Anaesthetists should wear gloves--touch sensitivity is improved with a new type of thin glove.

BACKGROUND: Sterile gloves should be worn for all invasive procedures. However, loss of touch sensitivity when wearing gloves leads to poor compliance among anaesthetists in the UK. Our aim was to investigate whether new surgical glove types, such as extra-thin or latex-free gloves, offer any advantage in touch sensitivity. METHODS: The skin-pressure sensibility threshold of the gloved pulp of the dominant index finger was established in 24 anaesthetists using nine self-made modified von Frey hairs. The range of forces generated by nylon monofilaments was evenly distributed between 0.5 and 17 mN. The gloves tested were latex Biogel standard, latex-free Biogel Neotech, and extra-thin latex Ansell microthin surgical gloves. The different glove types were assessed in a counterbalancing algorhithm, the individual was blinded, and the filaments were applied in random order. RESULTS: The median threshold force to touch was significantly lower for the extra-thin surgical gloves in comparison to the standard latex (P = 0.014) and latex-free gloves (P = 0.001). There was no significant difference between the standard latex and latex-free gloves (P = 0.166). CONCLUSION: We have demonstrated that wearing extra-thin surgical gloves offers increased touch sensitivity. This may improve dexterity when carrying out delicate invasive procedures. Latex-free surgical gloves performed similar to standard latex gloves. Our findings should encourage more widespread glove use among anaesthetists.

Anesthesia↗

PubMed2005

The arterial vascularization of septum interventriculare in donkeys (Equus asinus L.).

In this study, arteries that supply the septum interventriculare in donkeys, their course and variations, if present, were defined. Six hearts belonging to donkeys of varying age and sex constituted the material of the study. In order to expose the arteries, latex coloured with Rotring ink was injected into a. coronaria sinistra and a. coronaria dextra and dissection was performed. The arterial vascularization of the heart in donkeys is supplied by a. coronaria sinistra and a. coronoria dextra, which have their origin at the aorta. A. coronaria sinistra gives off two branches: one is ramus interventricularis paraconalis, which extends into the sulcus interventricularis paraconalis and the other is ramus circumflexus sinister, which lies within the sulcus coronarius. A. coronaria dextra is formed by the union of ramus interventricularis subsinuosus and ramus circumflexus dexter. Septum interventriculare is supplied by rr. septales, which originate from ramus interventricularis paraconalis, a branch of a. coronaria sinistra, as well as rami septales which have their origin in ramus interventricularis subsinuosus, a branch of a. coronaria dextra.

Animals↗

PubMed1987

Intractable epilepsy and disturbed visuomotor performance.

The factors relevant to intractability, types of epilepsy and impairment of dexterity in patients with intractable epilepsy were studied independently in different groups of patients. The factors relevant to intractable epilepsy that were disclosed in 202 patients, who required hospitalization more than twice, were as follows: strong seizure propensity, neuropsychiatric disorders including mental deterioration of various degrees, ataxia, personality changes and psychotic episodes, intolerance to antiepileptic drugs due to acute or chronic side effects, idiosyncrasy and internal disorders, self-induced seizure, misdiagnosis and mistreatment, and breakdown of family care of patients. The types of epilepsy in 224 patients with intractable epilepsy whose seizures were not adequately controlled and recurred on a monthly basis in spite of hospitalization were classified as follows: 101 patients with localization-related epilepsies or syndromes, 106 with generalized epilepsies or syndromes, 16 with undetermined epilepsies or syndromes and one with specific syndrome. In regard to partial epilepsies, frontal lobe epilepsy and partial epilepsy with multiple foci were at least partially intractable as temporal lobe epilepsy. With respect to intractable generalized epilepsies, miscellaneous symptomatic generalized epilepsies like intractable grand mal epilepsy with progressive mental retardation in childhood were as important as Lennox-Gastaut or West syndrome though it defies classification into any established syndromes. The proposed International Classification of Epileptic Syndromes and Epilepsies was found adequate for analysis of intractable epilepsy. The disturbance of fine motor performance found in 84 patients who participated in occupational therapy was investigated by test programs comprising nine subbatteries.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1995

In situ perfusion by retrograde cannulation of a tumor artery for nephron-sparing surgery.

BACKGROUND: Although ice slush cooling or ex situ perfusion with bench surgery is most widely used for protecting ischemic renal damage which possibly accompanies complicated nephron-sparing surgery, each has its own disadvantages. The former does not allow excessively long ischemia and the latter requires complicated procedures as autotransplantation. In order to mitigate against these problems, we devised a novel method of in situ renal perfusion with intracellular hyperosmolar solution. METHODS: One renal segmental artery mainly supplying a tumor was isolated and cannulated with a small feeding tube. The tube was introduced through a small arteriotomy incision directed towards the proximal side, advanced until its tip remained in the main or first branch of the renal artery, and then it was anchored to that artery. After the main renal artery and vein were clamped, the kidney was perfused with cold Euro-Collins' solution through the tube, while the venous blood and perfusate were drained from the left gonadal vein or small venotomy incision of the right renal vein. RESULTS: In one case of renal cell carcinoma and three cases of angiomyolipoma, two of which ruptured, nephron-sparing surgery was carried out under in situ hyperosmolar perfusion. Ischemic time of these four cases was an average of 96 minutes, varying from 45 to 145 minutes. All the kidneys functioned well postoperatively. CONCLUSIONS: The method presented here is very simple, requires no unusual dexterity and safely allows for a long period of renal ischemia. This method is best indicated in cases where simple clamping of the renal pedicle with ice-slush cooling appears insufficient, yet ex situ surgery with autotransplantation seems excessive.

Angiography↗

PubMed1981

Bladder neck closure for neurogenic incontinence.

Some female patients with neurogenic bladders are treated by means of an indwelling urethral catheter, which, in the long term, commonly leads to marked urethral dilatation, such that, despite the use of larger catheters with bigger balloons bypassing incontinence occurs with distressing frequency. This problem has been overcome by operation to close the bladder neck and drain the bladder with a suprapubic catheter. Two techniques are described. Provided that there is correct catheter placement with unobstructed drainage, continence is total. Patients with sufficient dexterity have been taught to change their own catheters, and catheter problems have been nil. A technique for males is also described.

Adult↗

PubMed2004

Prospective study of glove perforation in obstetrical and gynecological operations: are we safe enough?

OBJECTIVES: To assess the glove perforation rate, efficacy of double gloving, effect of duration of surgery, expertise of surgeon and operative urgency on the glove perforation rate in obstetrical and gynecologic operations. METHODS: From February to September 2002, double glove protocol was made necessary for all major obstetrical and gynecologic procedures. The operating surgeon, first and second assistant were included in the study. Gloves damage was noted (overt by inspection, occult by hydroinsufflation technique). RESULTS: Of the 156 procedures included in study, 32 procedures were performed (all emergency operations) single-gloved because surgeons found double gloving clumsy (56%), made it difficult to tie knots due to lack of dexterity (24%), or were too tight (20%). One thousand one hundred and twenty single gloves were examined after each procedure by hydroinsufflation. The overall perforation rate was 13.6% (single versus double outer gloves, 13.8% versus l3.2%, P > 0.05). Matching perforations were found in six cases (4.6%). Thus, the protection offered by double gloves was 95.4% even if the outer gloves were perforated. Four inner gloves had preexisting perforations. Sixty unused gloves checked similarly revealed a perforation rate of 1.6%. Emergency cases had higher perforation rate compared to elective surgeries (16.6% versus 10.8%, P < 0.00 1). Surgeries lasting for more than 40 min had a higher perforation rate compared to those finished in less than or equal to 40 min (18.6% versus 7.6%, P < 0.001). The middle finger of the left hand was the most commonly involved. The surgeon, first assistant and second assistant were involved in 73.6, 23.3 and 3.2% cases, respectively. CONCLUSION: Double gloving offers considerable protection against exposure to contaminants in the blood and body fluids of the patient and should be made routine, especially in developing countries where HIV, hepatitis B and C are widely prevalent. Double gloving should be made mandatory in emergency procedures, which have a higher perforation rate due to operative urgency, and gloves should be changed in operations lasting for more than 40 min to ensure integrity of barrier.

Equipment Failure↗

PubMedDate not supplied

Comparison of the effect of hypertonic hydroxyethyl starch and mannitol on the intraocular pressure in healthy normotensive dogs and the effect of hypertonic hydroxyethyl starch on the intraocular pressure in dogs with primary glaucoma.

PURPOSE: The purpose of this study was to determine if intravenous hypertonic hydroxyethyl starch (7.5%/6%) (HES) could decrease the intraocular pressure (IOP) in healthy normotensive dogs, and compare its effect with that of mannitol (20%) (experimental study). In addition, the potential IOP-lowering effect of hypertonic HES was evaluated in six dogs with primary glaucoma (clinical study). MATERIAL AND METHODS: Experimental study: eight male ophthalmoscopically and clinically healthy Beagles were included in this study. The IOP of each dog was measured by applanation tonometry in both eyes to obtain control values at 10:00, 10:15, 10:30, 10:45, 11:00 a.m., and then every hour until 6:00 p.m. prior to the first treatment (control period). Each dog received, with at least 2-week intervals and in a random order, an intravenous (IV) infusion of 4 mL/kg hypertonic HES (1.2 g/kg NaCl; 0.96 g/kg HES) and 4 mL/kg mannitol 20% (1 g/kg) over a period of 15 min starting at 10:00 a.m. IOP was measured oculus uterque (OU) at the same time intervals as in the control study. The differences in IOP between the treatment groups and the baseline IOP (before the start of infusion), between oculus sinister (OS) and oculus dexter (OD) and between the same time points of all groups were determined with a Student's t-test for paired samples (P = 0.05). Clinical study: six dogs with primary glaucoma (representing seven eyes) received an IV infusion of 4 mL/kg hypertonic HES over a period of 15 min. IOP was measured before and 15 and 30 min after starting the infusion. RESULTS: Experimental study: no significant difference between IOP of both eyes was found. A significant decrease in IOP from baseline value was recorded at 15, 30, 45, and 60 min after the start of mannitol infusion (mean amplitude in IOP decrease 3.21 mmHg; P < 0.05) and at 15 and 30 min in dogs treated with HES (mean amplitude in IOP decrease 2.43 mmHg; P < 0.05). At 120 and 180 min there was a significantly higher IOP (P < 0.05) in HES treatment group compared to the values of the control group. Clinical study: in 5/7 eyes diagnosed with primary glaucoma a maximum decrease in IOP of an average of 24% from the baseline value (IOP before start of the infusion) was observed (range of decrease 2-21 mmHg). In three of these five cases the maximum decrease was reached at 15 min and in two cases at 30 min. In one case an increase in IOP of 35% (+ 18 mmHg) was seen after 15 min and 26% (+ 13 mmHg) after 30 min. Case 4 showed an increase in IOP of 5% (+ 3 mmHg) after 15 min and a decrease of 6% (- 4 mmHg) after 30 min. CONCLUSIONS: Intravenous hypertonic HES is comparable to intravenous mannitol 20% in lowering the intraocular pressure in healthy normotensive dogs. But this effect lasted half an hour longer after mannitol. In 6/7 eyes with primary glaucoma, hypertonic HES decreased IOP.

Animals↗

PubMed2006

Action planning in young children's tool use.

Tool use consists of at least two coupled phases of activities, involving multi-step problem solving. It therefore provides an interesting window on the development of planning in goal-directed behavior. This study investigated 2-year-olds' and 3-year-olds' hand use in picking up and subsequently using a tool for displacing a target-object towards a specified goal location. The children had to use a stick (Experiment 1; N = 41 in total) or a cane (hooked stick) that was lying in varying starting orientations (Experiment 2; N = 32 in total). Age differences were found in the way goal-related information in combination with tool-related information influenced the choice of which hand to use in different phases of the task. A view on action planning is developed as a dynamic action-selection process for which actions to take. This process integrates factors that are internal to the child's action system (e.g. motor preferences and dexterity) with external (i.e. sensory) sources of information.

Child↗

PubMed2006

Clinical value of botulinum toxin in neurological indications.

Botulinum toxin type-A (BoNT-A) prevents the release of acetylcholine at cholinergic junctions, thereby causing temporary muscle weakness lasting 3-4 months. It is now widely used to treat a broad range of clinical disorders characterized by muscle hyperactivity. BoNT-A has proved effective in the management of several neurological conditions and, in particular, in the management of movement disorders (e.g. blepharospasm, cervical dystonia, laryngeal dystonia, limb dystonia, hemifacial spasm, focal tics, tremor and other hyperkinetic disorders). As a treatment of spasticity, BoNT-A can improve mobility and dexterity as well as preventing the development of distressing and costly secondary complications. In cerebral palsy, BoNT-A is of value, being able to delay or even avoid surgery until motion patterns have become established.

Adult↗

PubMed1980

Handedness, clumsiness and cognitive ability.

An unselected group of 170 children aged between eight and nine years was given tests of intelligence, reading ability and manual dexterity. A 'target' group of children was selected on the basis of very poor performance with the non-preferred hand. Using an extension of Satz's pathological left-handedness model, it is argued that there should be a higher proportion of left-handers in the target group than in the remainder of the sample: this prediction was confirmed. It was also predicted that the target group should have a higher incidence of neurological disorder, and that left-handers in the target group should have a lower incidence of familial sinistrality than other left-handers. Partial confirmation of these predictions was obtained. The target group was impaired on cognitive tasks. It is argued that skill with the non-preferred hand may be more meaningful than direction of hand preference as a basis for understanding relationships between handedness and ability.

Birth Order↗

PubMed1981

Maternal thyroid function and motor competence in the child.

Serum thyroid hormone levels were measured in women living in an area of severe dietary iodine deficiency in a remote region of Papua New Guinea. Levels of maternal hormone were found to be related to the motor competence of the women's offspring, who were aged between six years and 11 years 10 months at the time of assessment. Motor competence in the children was measured by two tests of manual dexterity which demanded speed and accuracy in performance. A significant correlation was obtained between the children's motor performance and maternal serum thyroxine levels, but not with maternal serum triiodothyronine levels. The implications of the findings for the pathogenesis of some forms of cerebral palsy are considered.

Child↗

PubMed1983

Evidence for differential hemispheric function in children with hemiplegic cerebral palsy.

Eight children with right infantile hemiplegia and eight with left infantile hemiplegia were compared with each other and with 13 sibling controls on a test of manual dexterity, an extended neurological examination and a battery of neuropsychological tests. Right-hemiplegic children performed significantly less well than left-hemiplegic children and the controls on measures of syntactical awareness and the repetition of semantically coherent materials, despite similar verbal IQs. Both hemiplegic groups tended to perform less well than the controls, although not significantly so, on the short-term memory task, repetition of digits, and on a task of confrontation naming. There was also a strong correlation between left-hand impairment and poor arithmetical computation skill in both hemiplegic groups, which conforms with present views as to right-lateralization of certain mathematical functions. The results as a whole support the premise that there is innate hemispheric organization for some language tasks.

Adolescent↗