Biomedical subjects
A B Shaw
Publications and source records attributed to A B Shaw.
"Futility" as a criterion in limiting treatment.
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Assessment of protein intake in early progressive renal disease.
Mean protein intake in a 4-day dietary survey of 34 patients with early renal disease was 1.2 +/- 0.27 g/kg ideal body weight daily. Nine subjects were taking over twice the recommended minimum intake. An increased protein intake was associated with a greater phosphate and sodium intake and an increased excretion of urea, phosphate, and sodium. Daily intake fluctuated markedly during the study (coefficient of variance 22.5 +/- 10.9%). Protein catabolic rate calculated from urea excretion correlated with protein intake, r = 0.60. Mean difference between the two estimates was 0.04 +/- 0.28 g/kg per day. It is proposed that if urea excretion exceeds 4.5 mmol/kg per day in a single collection (protein catabolic rate 0.98 g/kg per day), serial measurements should be made to determine protein intake more accurately and give dietary advice.
Which urine sample for detection of proteinuria?
The standard practice of screening for proteinuria in the concentrated early morning urine was examined. Protein concentration and dipstick readings were determined in early morning and daytime urines of 56 normal subjects and 110 patients with proteinuria attending a renal clinic. In normal subjects the protein concentration was similar in both urine samples and dipsticks gave the same frequency of false positive results, usually only trace positive. The protein concentration was higher in the daytime urine in 76% of patients. Dipstick readings were similar in 64.5% but higher in the daytime urine in 31% and in the early morning urine in only 4.5%. It is recommended that daytime urine should be screened for proteinuria in patients presenting in out-patient clinics.
Biological equivalence of natural bovine and recombinant human alpha-endothelial cell growth factors.
The cDNA encoding human alpha-endothelial cell growth factor (alpha-ECGF) has been engineered for high-level expression in Escherichia coli. Induction of bacterial cultures harboring the recombinant plasmid pMJ26 results in the appearance of a prominent 16-kDa polypeptide. This protein has been purified from bacterial lysates using a rapid, 2-step procedure employing heparin-Sepharose affinity based chromatography and reversed-phase high pressure liquid chromatography. Recombinant human alpha-ECGF was compared to bovine brain-derived alpha-ECGF in three biological assays: receptor binding on murine lung capillary endothelial cells (LE-II cells), stimulation of [3H]thymidine incorporation in LE-II cells, and stimulation of human umbilical vein endothelial cell proliferation. The results demonstrate that the recombinant human mitogen has the same biological potency as the bovine brain-derived material. Fluorescence spectroscopy was used to study the interaction between recombinant ECGF and heparin. Heparin-binding resulted in a 40% reduction in the intrinsic fluorescence of ECGF, consistent with a heparin-induced conformational change. The intrinsic fluorescence of ECGF also varied as a function of pH.
Alternate day corticosteroid causes alternate day hyperglycaemia.
Patients taking alternate day corticosteroid treatment have greater impairment of glucose tolerance on the corticosteroid day than on the alternate day. Allowance for this must be made in the detection and management of diabetes mellitus in these patients.
Two centuries of medical benevolence: the Norfolk and Norwich Benevolent Medical Society 1786-1986.
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Delayed onset of polymyalgia in polymyalgia rheumatica.
Four female patients presenting with systemic symptoms of polymyalgia rheumatica are described. They suddenly developed classical girdle pains up to a year after the onset of severe systemic symptoms, a course not often emphasized.
Protein creatinine index and Albustix in assessment of proteinuria.
The protein creatinine index in early morning and random urine specimens was compared with the 24 hour urinary excretion of protein in normal subjects and outpatients with abnormal proteinuria. A protein creatinine index (defined as (mg protein/1 divided by creatinine mmol/1) times 10) below 125 in a random specimen excluded abnormal proteinuria, whereas an index of more than 136 indicated the presence of pathological proteinuria. The index for random specimens provided a useful semiquantitative assessment of the 24 hour excretion of protein (mg protein/24 hours), but the index for early morning specimens was less reliable. Errors with Albustix were partly due to intra and inter observer variations in the interpretation of the colour formed when compared with the chart provided. It is proposed that the protein creatinine index on random urine samples should be used to supplement dipsticks in screening for proteinuria in cases where misclassification would be serious.
Renal artery thrombosis caused by antihypertensive treatment.
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Sir Thomas Browne: the man and the physician.
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Urography, cystography, and cystoscopy in women with urinary-tract infections.
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Knappers' rot. Silicosis in East Anglian flint-knappers.
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Bladder stones in children. The Norwich school of lithotomy.
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Cross linking of erythrocyte membrane proteins and phospholipids by chemical probes.
Membrane proteins and phosphatidylethanolamine (PE) in intact red cells and red cell ghosts were reacted with cross-linking probes, which differed in hydrophobicity and charge. Methylacetimidate (MA) cross-links more spectrin bands 1 and 2 in cells than in ghosts. Band 4.1 reacts readily with MA in both cells and ghosts, whereas band 3 and 5 undergo very little linking. However, band 3 and most membrane proteins except band 5 are extensively cross linked by difluorodinitrobenzene (DFDNB). Band 5 reacts with DFDNB more in ghosts than in cells. Isethionyl acetimidate (IA), a nonpenetrating probe, gives very little cross linking of membrane proteins in intact cells, whereas it extensively cross links proteins in ghosts in a similar fashion as does MA. MA reacts extensively with PE in both cells and ghosts. Depending on the concentration of MA, between 47 and 60% of the PE is cross linked to itself. At 20 mM MA, 94% of PE reacts in intact cells, whereas at 20 mM IA only 19% of PE reacts. Furthermore, 66% of the PE that reacts with IA is cross linked to itself. These studies suggest that hydrophilic imidoesters cross link peripheral membrane proteins such as bands 1, 2, and 4.1, but have restricted access to integral proteins such as band 3. However, the hydrophobic probe extensively cross links both integral and peripheral proteins in intact cells except band 5. These data suggest that rearrangement of some membrane proteins occurs when ghosts are prepared.