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Biomedical subjects

A J Davis

Publications and source records attributed to A J Davis.

At least 73 records · Page 4Linked to original sources

Female genital mutilation: some ethical questions.

This paper provides some basic information about female genital mutilation (FGM) as a social problem and as a health problem. It includes selected actions taken over the last 45 years by the United Nations regarding FGM. The focus here is on the ethics of individuals and institutions, such as the World Health Organization, attempting to intervene in traditional cultural practices like FGM. This discussion raises some questions about ethical universals and ethical relativism with regards to FGM and the attempts to change or eradicate this practice.

Circumcision, Female↗

Congenital absence of the uterus and vagina is not commonly transmitted as a dominant genetic trait: outcomes of surrogate pregnancies.

OBJECTIVE: To determine the inheritance pattern of congenital absence of the uterus and vagina in affected women undergoing surrogacy IVF with this disorder. DESIGN: Retrospective study. SETTING: A hospital-based reproductive endocrinology and infertility center. PATIENT(S): Women diagnosed with congenital absence of the uterus and vagina undergoing IVF with subsequent transfer of embryos to a surrogate uterus. INTERVENTION(S): Questionnaires were sent to all infertility treatment centers performing surrogate procedures. MAIN OUTCOME MEASURE(S): Number, gender, and frequency of congenital anomalies in progeny. RESULT(S): Thirty-two of 53 surveyed programs responded (60%). One hundred sixty-two IVF cycles were performed, and 34 liveborn children were delivered (half female). No congenital anomalies were found, except for one male child with a middle ear defect and hearing loss. CONCLUSION(S): These results strongly suggest that congenital absence of the uterus and vagina, if genetically transmitted, is not inherited commonly in a dominant fashion.

Congenital Abnormalities↗

The Evi1 proto-oncogene is required at midgestation for neural, heart, and paraxial mesenchyme development.

The ecotropic viral integration site-1 (Evi1) locus was initially identified as a common site of retroviral integration in myeloid tumors of the AKXD-23 recombinant inbred mouse strain. The full-length Evi1 transcript encodes a putative transcription factor, containing ten zinc finger motifs found within two domains of the protein. To determine the biological function of the Evi1 proto-oncogene, the full-length, but not an alternately spliced, transcript was disrupted using targeted mutagenesis in embryonic stem cells. Evi1 homozygous mutant embryos die at approximately 10.5 days post coitum. Mutants were distinguished at 10.5 days post coitum by widespread hypocellularity, hemorrhaging, and disruption in the development of paraxial mesenchyme. In addition, defects in the heart, somites, and cranial ganglia were detected and the peripheral nervous system failed to develop. These results correlated with whole-mount in situ hybridization analyses of embryos which showed expression of the Evi1 proto-oncogene in embryonic mesoderm and neural crest-derived cells associated with the peripheral nervous system. These data suggest that Evi1 has important roles in general cell proliferation, vascularization, and cell-specific developmental signaling, at midgestation.

Animals↗

Gut mucosal perfusion in infants undergoing cardiopulmonary bypass: effect of preoperative captopril.

We have studied gut mucosal perfusion in 24 infants, aged 0.7-45 weeks, requiring cardiopulmonary bypass (CPB). Group 2 patients (n = 12) had received the angiotensin converting enzyme inhibitor captopril 0.8-0.9 mg kg-1 orally, 45 min before induction of anaesthesia. Group 1 infants were of similar age and size and required a similar duration of CPB, but did not receive any preoperative medication. An orogastric tonometer allowed intermittent calculations of gastric intramucosal pH (pHi), and rectal mucosal perfusion ("flux") was monitored using laser Doppler flowmetry. Measurements of arterial base deficit and lactate and pyruvate concentrations were made intermittently. We found no significant difference in femoral arterial pressure between the groups at any time before, during or after surgery. Similarly, we found no significant differences in our measures of regional or global tissue perfusion between the groups at any time before, during or after surgery. We conclude that preoperative administration of captopril produced no beneficial effect on gut mucosal perfusion in infants undergoing hypothermic, non-pulsatile CPB.

Angiotensin-Converting Enzyme Inhibitors↗

Dietary protein and amino acid levels alter threonine dehydrogenase activity in hepatic mitochondria of Gallus domesticus.

Experiments were conducted to determine if hepatic threonine dehydrogenase (TDH) activity is influenced by dietary protein or specific amino acid concentrations. In an initial experiment, young chicks were deprived of feed for 60 h or had access for 72 h to a 22% protein basal diet, a protein-free diet or a 51% high protein diet. TDH activity was determined as aminoacetone and glycine accumulation during incubation of liver mitochondria. TDH activity was significantly (P < 0.01) lower in chicks fed the protein-free diet and significantly greater in chicks fed the high protein diet compared with chicks fed the basal diet. Food deprivation had no effect on TDH activity. A second experiment was conducted using the 22 and 51% protein diets, the 22% protein diet plus 1.14 g/100 g diet threonine (equivalent to the free plus protein-bound threonine content of the high protein diet), and the 51% protein diet containing 0.15 g/100 g diet less threonine. TDH was increased in chicks fed either high protein diet (P < 0.05). There were no significant differences in TDH activity, however, between chicks fed the basal diet and the threonine-supplemented diet or between chicks fed the two high protein diets. In two other experiments, the activity of TDH was investigated in chicks fed for 9 d dietary supplements of either serine or glycine (5.5 or 4 g/100 g basal diet, respectively). The supplements were added to the basal diet or the basal diet imbalanced by the addition of 6% branched-chain amino acids. Neither the serine nor the glycine supplement significantly altered TDH activity or the increased activity associated with a branched-chain amino acid-induced threonine imbalance. The results suggest that hepatic TDH activity is influenced by protein level or other amino acids more than by threonine itself.

Alcohol Oxidoreductases↗

Arteriovenous fistula of the scalp secondary to punch autograft hair transplantation: angioarchitecture, histopathology, and endovascular and surgical therapy.

Arteriovenous fistula of the scalp secondary to punch autograft technique is a relatively uncommon occurrence, similar to traumatic scalp arteriovenous fistulas from other causes. A pulsatile subcutaneous mass with an associated thrill or bruit and symptoms including pain or headache is a common presentation. Angiography is required for full diagnostic evaluation. Angioarchitecture may appear complex, even with a single-hole fistula. Super-selective angiography and embolization facilitate surgery and provide essential information regarding angioarchitecture. Complete excision of the lesion is curative. Identification and resection of the draining vein is mandatory to ensure a complete resection. The lesion may extend across traditional anatomic planes. Ligation of proximal feeding arteries is inadequate and potentially harmful. Histopathology of the traumatic arteriovenous fistula may appear similar to that of an arteriovenous malformation. Acquired arteriovenous fistulas and congenital arteriovenous malformations are markedly similar in their ultimate histopathology, angioarchitecture, angiographic appearance, hemodynamics, and treatment requirements. They should be considered to represent a spectrum of the same disease state rather than discrete entities.

Alopecia↗

Murine gammaherpesvirus 68 encodes tRNA-like sequences which are expressed during latency.

Murine gammaherpesvirus 68 (MHV-68) is a virus of wild rodents and is a convenient small animal model for studies of gammaherpesvirus pathogenesis. We have sequenced 6162 bp at the left end of the MHV-68 genome and identified two unique open reading frames (ORFs) (ORF2 and ORF3) and an ORF (ORF1) which displays similarity to poxvirus members of the serpin family. Interspersed with the ORFs is a family of eight novel tRNA-like sequences sharing tRNA-like predicted secondary structures and RNA polymerase III promoter elements. These sequences are expressed to high levels during lytic infection and are processed into mature tRNAs with post-transcriptionally added 3' CCA termini, indicating their recognition as tRNAs by cellular machinery. Acidic Northern analysis of four tRNAs tested has demonstrated that they are not aminoacylated by aminoacyl-tRNA synthetases present in the infected cell. Thus, it is currently unclear what biological function these uncharged viral tRNA-like sequences may fulfil. In situ hybridization analysis has shown that in addition to being expressed within productively infected tissues during acute stages of infection, the tRNA-like sequences are abundantly expressed within splenic germinal centres of latently infected mice. Therefore, the MHV-68 viral tRNAs represent a marker for latent infection and constitute the first report of tRNA-like sequences encoded by a virus of eukaryotes.

Acylation↗

Kinetics of viral RNA synthesis following cell-to-cell transmission of human immunodeficiency virus type 1.

The temporal appearance and levels of human immunodeficiency virus type 1 (HIV-1) tat, rev, nef, env and gag mRNA species were examined using a synchronized, one-step, cell-to-cell HIV-1 infection model involving HUT-78 cells and HIV- 1 persistently infected H3B cells. Individual mRNAs were quantified by RT-PCR using RNA standards transcribed in vitro from cDNA clones. Consistent with an infection that produces high yields of virus, significant levels of env and gag mRNAs were detected in the cytoplasm of infected cells late in the infection cycle. However, at no time after infection did levels of tat, rev and nef mRNA, which encode the regulatory proteins of HIV-1, exceed their levels present in the persistently infected virus donor H3B cells. The absence of early phase induction of these mRNAs is in contrast to what is observed in cell-free HIV-1 infections or in PMA-stimulated HIV-1 chronically infected cell lines. Our results suggest that tat and rev mRNAs are already present in the cytoplasm of the persistently infected virus donor cells at levels sufficient for initiation and establishment of a highly productive infection in HIV-1 fusion-mediated infected cells. Thus, lack of sufficient Tat and Rev proteins is not likely to be the limiting factor for virus production in H3B cells, nor is increased production of these proteins likely to be the cause of the increased virus production seen following cell-to-cell transmission.

Cell Line↗

Selected ethical issues in planned social change and primary health care.

This paper discusses two interrelated concepts: (1) the ethics of planned social change and (2) primary health care. It takes the World Health Organization's definition of primary health care as a point of departure to examine four identified potential areas where ethical dilemmas may occur. In addition, questions are raised about nursing education, as well as about the class and status differences between nurses and patients and communities. It takes the position that our first task is to encourage more discussion and examination of ethical issues in the planned social change of primary health care.

Developing Countries↗

The Ca2+-dependent lipid binding domain of P120GAP mediates protein-protein interactions with Ca2+-dependent membrane-binding proteins. Evidence for a direct interaction between annexin VI and P120GAP.

The CaLB domain is a 43-amino acid sequence motif found in a number of functionally diverse signaling proteins including three Ras-specific GTPase activating proteins (GAPs). In the Ras GTPase activating protein, P120(GAP), this domain has the ability to confer membrane association in response to intracellular Ca2+ elevation. Here we have isolated three proteins, p55, p70, and p120, which interact with the P120(GAP) CaLB domain in vitro. We identify p70 as the Ca2+-dependent phospholipid-binding protein annexin VI. Using co-immunoprecipitation studies, we have shown that the interaction between P120(GAP) and annexin VI is also detectable in rat fibroblasts, suggesting that this interaction may have a physiological role in vivo. Thus, the CaLB domain in P120(GAP) appears to have the ability to direct specific protein-protein interactions with Ca2+-dependent membrane-associated proteins. In addition, annexin VI is known to have tumor suppressor activity. Therefore, it is possible that the interaction of annexin VI with P120(GAP) may be important in the subsequent modulation of p21(ras) activity.

Animals↗

The quality of clinical serum teicoplanin assays: an experimental European EQA distribution.

Two sets of six samples of human serum spiked with predetermined concentrations of teicoplanin were circulated, 6 months apart, to 22 European laboratories for the purposes of external quality assessment (EQA). The laboratories returned assay results using either bioassay, high-performance liquid chromatography (HPLC) or fluorescence polarization immunoassay (FPIA). FPIA was the most popular method and performance was generally satisfactory. Some laboratories using HPLC or microbiological assay performed satisfactorily but others did not. Only seven laboratories (32%) showed consistently satisfactory performance. There appears to be a need for continuing EQA of clinical teicoplanin assays.

Anti-Bacterial Agents↗

Substance P and capsaicin-induced mechanical hyperalgesia in the rat knee joint; the involvement of bradykinin B1 and B2 receptors.

1. Substance P (SP) and capsaicin induced a mechanical hyperalgesia when injected into rat knee joints. 2. The NK1 receptor antagonists CP 99994 (10-100 nmol) and RP 67580 (0.1-1 nmol) blocked the development of, and also reversed, SP-induced hyperalgesia. Capsaicin (10 nmol)-induced hyperalgesia was blocked by capsazepine (0.5-5 nmol). 3. Capsaicin-induced hyperalgesia was prevented and reversed by the NK1 receptor antagonists CP 99994 (100 nmol) and RP 67580 (1 nmol). 4. The bradykinin B2 receptor antagonist icatibant (5 pmol) blocked the development of both SP and capsaicin-induced hyperalgesia. Icatibant (100 pmol kg-1, i.v.) also reversed an established SP and capsaicin-induced hyperalgesia. 5. Both low dose SP (1 nmol) and capsaicin (1 nmol)-induced hyperalgesia were potentiated by the kininase II inhibitor captopril (100 micrograms). 6. The B1 receptor antagonists desArg9Leu8-bradykinin (BK) (0.5-5 nmol) and desArg10[Hoe 140] (5-50 pmol) only blocked the development of SP-induced hyperalgesia for 30 min after administration. desArg9Leu8-BK (10 nmol kg-1 i.v.) did not reverse an established SP-induced hyperalgesia. 7. Capsaicin-induced hyperalgesia was blocked by desArg9Leu8-BK (0.5 nmol) and this antagonist also reversed an established capsaicin-induced hyperalgesia. 8. Interleukin-1 receptor antagonist (IL-1ra 0.1 microgram) reduced the development of SP-induced hyperalgesia up to 4 h after administration, but did not reverse an established hyperalgesia. IL-1ra (0.1 microgram) also blocked the development of and reversed an established capsaicin-induced hyperalgesia. 9. Indomethacin pretreatment (1 mg kg-1, s.c.) did not reduce the development of either SP- or capsaicin-induced hyperalgesia but following indomethacin-pretreatment desArg9Leu8-BK (10 nmol kg-1, i.v.) failed to reverse a capsaicin-induced hyperalgesia. 10. In conclusion, both SP and capsaicin can induce behavioural hyperalgesia when injected into the knee joint of rats. In addition, blockade of NK1, bradykinin B1, B2 and IL-1 beta receptors can substantially modulate this hyperalgesia.

Animals↗

Use of depot medroxyprogesterone acetate contraception in adolescents.

More than 1 million teen pregnancies occur each year in the United States. DMPA offers several distinct advantages over other contraceptive methods in adolescents. The duration of effectiveness and convenience of DMPA are appealing to teens. Most teens who are current users view amenorrhea as a positive feature of DMPA. Although most young women are able to tolerate the irregular bleeding, some find the cycle disruption concerning. Satisfaction rates among adolescent DMPA users is high.

Adolescent↗

Angiography of cerebral aneurysms.

Magnetic resonance and computed tomographic angiography have been increasingly applied to the study of disease affecting the cerebral vasculature. Despite these advances, however, conventional cerebral angiography clearly remains the diagnostic gold standard and essential guide to any microneurosurgical or endovascular therapeutic decision concerning cerebral aneurysms. Detailed cerebral angiography is a dynamic study and is influenced by prior axial imaging. It should be tailored to the specific circumstance to obtain information required for selection of the most beneficial treatment.

Aneurysm, Ruptured↗

Ideal residency curriculum in reproductive endocrinology and infertility.

OBJECTIVE: Knowledge in reproductive endocrinology and infertility is fundamental to the delivery of quality women's health care. In 1991, the American Fertility Society formed a resident education committee to gather data on the current status of reproductive endocrinology and infertility training and develop an ideal curriculum. METHODS: Program directors and reproductive endocrinology and infertility faculty from 288 residencies in obstetrics and gynecology were surveyed about training in reproductive endocrinology and infertility; 257 (89%) of the program directors (survey I) and 203 (82%) of the reproductive endocrinology and infertility faculty (survey II) responded. An ideal curriculum has been developed from consensus discussions, review of survey data, and polling of experienced educators. The curriculum was reviewed and approved by the board of directors of both the Society for Reproductive Endocrinologists and the American Fertility Society. RESULTS: The curriculum is divided into subject matter and therapeutics, which are prioritized into three levels of knowledge: critical core curriculum, less critical material, and material with which residents should have familiarity and general knowledge. In addition, other recommendations and suggestions are made regarding the number of rotations, duration of rotations, and teaching methods. CONCLUSION: The ideal curriculum may serve as a guide to assist program directors in the formulation of the most effective residency training in reproductive endocrinology and infertility. The curriculum can help prioritize what should be taught and where an emphasis can be placed. There is not enough time or resources to teach residents all aspects of reproductive endocrinology and infertility.

Curriculum↗

Regulation of insulin-like growth factor-I and progesterone synthesis by insulin and growth hormone in the ovine ovary.

Insulin-like growth factor-I (IGF-I) is an intraovarian regulator of follicular development in the rat, but it is uncertain how applicable this model is to other species. Ovine granulosa and luteal cells were cultured for 2 wk in defined medium to investigate the regulation of ovarian IGF-I synthesis. IGF-I was measured by RIA of concentrated media extract, and progesterone production was also assessed. In granulosa cell cultures from preovulatory follicles, IGF-I output was initially undetectable with the output rising from about Day 6, whereas midcycle luteal cells produced low concentrations of IGF-I throughout the culture period. In granulosa cells, insulin in the range of 0.1-10 micrograms/ml stimulated a dose-dependent increase in output per day of IGF-I and also caused IGF-I production to start at an earlier time in culture, but a lower dosage (10 ng/ml) consistently increased progesterone synthesis. High dosages of estradiol (10(-6) M) caused a small increase in IGF-I production whereas lower dosages had no effect. Growth hormone (GH) alone (10 ng/ml-10 micrograms/ml) did not stimulate either progesterone or IGF-I output. In the presence of insulin, GH caused a marked increase in progesterone but had no effect on IGF-I. These results suggest that IGF-I is not a major product of granulosa cells in the ewe, although there is low luteal production. Furthermore they indicate that the actions of the metabolic hormones insulin and GH on ovarian progesterone synthesis are probably mediated directly through their own receptors rather than through either ovarian IGF-I synthesis or the type 1 IGF receptor.

Animals↗

Principle-based ethics and nurses' attitudes towards artificial feeding.

Nurses often institute artificial feeding for patients who would otherwise starve. Recently, the courts in the United States have favoured withholding or withdrawing feedings from patients who currently refuse or previously gave some indication they would refuse artificial nutrition and hydration. This paper investigates under what circumstances nurses feel justified in withholding artificial nutrition and hydration. Structured interviews were conducted with 40 cancer care nurses from two sites, and 40 dementia care nurses from two sites. The interviews were based on two vignettes, one involving an alert patient with terminal cancer, the other a patient suffering end-stage Alzheimer's dementia, and were analysed for themes coinciding with principles of deontological ethics. Investigators found that autonomy, beneficence and non-maleficence most often guided nurses' decisions to withhold or implement artificial feeding.

Arizona↗