Mutation detection in long QT syndrome: a comprehensive set of primers and PCR conditions.
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Cation Transport Proteins↗
Biomedical subjects
A Murray
Publications and source records attributed to A Murray.
Analogue VLSI for probabilistic networks and spike-time computation.
The history and some of the methods of analogue neural VLSI are described. The strengths of analogue techniques are described, along with residual problems to be solved. The nature of hardware-friendly and hardware-appropriate algorithms is reviewed and suggestions are offered as to where analogue neural VLSI's future lies.
Algorithms↗
Combined risk factors contributing to cerebral venous thrombosis in a young woman.
Cerebral venous thrombosis is a rare condition affecting predominantly adolescents or young adults. The presentation is often non-specific, and delay in diagnosis is common. The otolaryngologist may be consulted about the radiological findings of lateral sinus thrombosis and mastoid changes. The association of congenital thrombophilia with unusual presentations of venous thrombosis, especially in young individuals is now well documented. We present a case of lateral and sagittal sinus thrombosis complicated by cerebral venous infarction in a girl with protein C deficiency and masked mastoiditis. Unusual forms of venous thrombosis, including cerebral venous thrombosis may develop in association with a single risk factor for thrombosis, but additional risk factors should be sought especially when thrombosis presents in very young individuals. This case draws attention to the multi-causal nature of cerebral venous thrombosis in young adults, and highlights the issue of masked mastoiditis. A coordinated approach by otolaryngological and haematological teams is recommended in such cases.
Adolescent↗
Low-frequency heart rate variability: reproducibility in cardiac transplant recipients and normal subjects.
Heart rate variability is a measure of autonomic nervous influence on the heart. It has been suggested that it could be used to detect autonomic reinnervation to the transplanted heart, but the reproducibility of the measurement is unknown. In the present study, 21 cardiac transplant recipients and 21 normal subjects were recruited. Three measurements of heart rate variability were performed during the day: in the morning, in the early afternoon and in the late afternoon. These tests were then repeated 1 week later and then again 1 week after that, making nine tests in all. The within-subject S.D. was 0.49 log units in normal subjects and 0.79 log units in transplant recipients. In both cases, this is about 15% of the population range. There was significant variation in heart rate variability between different times of day in both groups, and from day to day in transplant recipients. It was concluded that the reproducibility of measurements of heart rate variability is low, and that differences between measurements performed at different times of day should be interpreted with caution.
Adult↗
On becoming a virtual editor.
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Peer Review↗
Production and characterization of 188Re-C595 antibody for radioimmunotherapy of transitional cell bladder cancer.
UNLABELLED: Bladder cancer was responsible for >12,000 deaths in the United States in 1999. The high-molecular-weight glycoprotein MUC1 mucin is overexpressed on bladder tumors and represents a useful target for radioimmunoscintigraphy and radioimmunotherapy. We report on the production and initial tracer studies of a 188Re-antibody complex directed against this target and intended for intravesical radioimmunotherapy of superficial bladder cancer. METHODS: 188Re perrhenate was eluted from a 188W/188Re generator. C595 antibody was reduced with 2-mercaptoethanol and was labeled in the presence of stannous tartrate. The final reaction mixture contained high-molecular-weight contamination, which was removed from the complex using an affinity separation technique. The specificity and integrity of the antibody complex were tested by radioimmunoassay and size exclusion chromatography. Tumor localization was investigated using an ex vivo model in human cystectomy specimens. Tracer amounts of the complex were also administered intravesically to three patients with bladder cancer, who were then imaged by gamma scintigraphy. RESULTS: The complex was immunoreactive (70% +/- 17%) and specific for MUC1 antigens. A peak corresponding to a protein of 150 kDa was observed on size exclusion chromatography, showing that the complex was homogeneous. Binding to bladder tumors was observed in an ex vivo model in which tumors were successfully imaged in four specimens. The mean tumor-to-normal tissue ratio in ex vivo bladders was 7:1. Tumor uptake after intravesical administration was confirmed in three patients with bladder cancer (mean tumor-to-normal tissue ratio, 4:1). CONCLUSION: The C595 antibody was labeled with 188Re, providing a radioimmunoconjugate with high immunoreactivity and specificity. Its ability to localize in tumors both in an ex vivo model and after intravesical administration to patients has been shown. This approach will now be extended for the therapy of superficial bladder cancer.
Antibodies, Monoclonal↗
Identification, cloning and expression of sodC from an alkaline phosphatase gene fusion library of Mycobacterium avium subspecies paratuberculosis.
The phoA gene technology was used to investigate secreted proteins of the intracellular pathogen Mycobacteriumn avium subspecies paratuberculosis. This led to the identification of sodC, a gene which codes for a copper and zinc cofactored superoxide dismutase (Cu,ZnSOD) which has been implicated as a virulence factor for some pathogens. The predicted protein possessed a 76% identity with Cu,ZnSOD of Mycobacterium tuberculosis. To characterize Cu,ZnSOD from M. avium subspecies paratuberculosis, the gene was cloned and overexpressed in Escherichia coli. The renatured, affinity-purified recombinant protein possessed enzymatic activity that was inhibited by the presence of cyanide, which is characteristic of a Cu,ZnSOD.
Alkaline Phosphatase↗
Assisting people with a low income to start and maintain their own community kitchens.
Q'wlut tu cicut ("My Parents Are Cooking") is a community kitchen program designed to help low-income people to facilitate their own cooking groups. Participants attended 20 weeks of instruction and received practical experience in topics such as meal planning, cooking, communication, and team building. At the end of 20 weeks, each participant was assisted in recruiting other people to start their own cooking group. To support the formation of these secondary groups, program staff and cooking group leaders met every second week for a further ten weeks. Another 30-week session has taken place since the initial session. The program had a high rate of completion. Each of the 24 participants who completed the program recruited an additional two to four people and started a cooking group with these people. Four months after completion of the first session, 80% of participants were facilitating their own cooking groups. After eight months, 50% of participants were still cooking in groups. All participants who completed the program stated that they had met their food- and nutrition-related goals, and they cited numerous program benefits to themselves and their families.
Budgets↗
Dead or alive: immunogenicity of human melanoma cells when presented by dendritic cells.
Uveal melanoma is an aggressive malignancy with a poor prognosis despite current therapeutic intervention. These tumors have been shown to be antigenic because they express a number of melanoma-associated antigens and are therefore attractive targets for immunotherapy. Here, we investigated the immunogenicity of uveal melanoma cells that have undergone apoptosis and compared this with their necrotic or live counter-parts. The fate of the tumor antigens in these cells largely depends on their ability to be processed and phagocytosed by dendritic cells (DCs). Flow cytometric analysis shows that human DCs form conjugates more efficiently with dead uveal melanoma cells, and consequently these are effective stimuli of lymphocyte proliferation. However, only DCs pulsed with apoptotic cells were able to induce proliferation of CD8+ cytotoxic T cells and stimulate antigen-specific T cells. This study demonstrates for the first time that DCs derived from melanoma patients process and present antigens derived from both HLA-matched or HLA-mismatched human apoptotic tumor cells stimulating both CD4+ and CD8+ T cells. This approach may be important to the development of DC-based immunotherapies for melanoma.
Antigen Presentation↗
Synthesis of FF-MAS from lithocholic acid.
An effective synthesis of 4,4 dimethyl-cholest-8,14,24-trien-3beta-ol (FF-MAS) from lithocholic acid is described, utilising a double oxidation and regioselective Wittig reaction as key steps.
Biochemistry↗
Periorbital cellulitis secondary to ethmoiditis in a 5-week-old child.
Periorbital cellulitis is a condition primarily affecting young children. We present a 5-week-old boy who developed periorbital cellulitis and had a CT scan which identified acute ethmoiditis as the source of the sepsis. His clinical course is outlined, and the relevant literature is discussed. We believe this patient is the youngest case of periorbital cellulitis due to confirmed ethmoiditis reported. This emphasises the possibility of an underlying sinusitis in patients with periorbital cellulitis, even in this very young age group.
Anti-Bacterial Agents↗
Explaining the T-wave shape in the ECG.
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Action Potentials↗
Part-time physicians. Physician workload and patient-based assessments of primary care performance.
OBJECTIVE: To examine the relationship between the number of hours physicians work and patients' assessment of the physician. DESIGN: Cross-sectional study with physician and patient surveys. SETTING: Primary care practices in Massachusetts. PARTICIPANTS: A random sample of 6810 Massachusetts state employees in 15 different health plans. MAIN OUTCOME MEASURES: Eleven summary scales measuring 7 essential elements of primary care. Information was derived from the Primary Care Assessment Survey, a validated patient-completed questionnaire. RESULTS: Physicians were classified into 3 groups according to their reported hours of work: "overtime" (> 65 h/wk), "full time" (40-65 h/wk), and "part time" (< 40 h/wk). There was no statistically significant difference between the 3 groups of physicians in 10 of the 11 measures of primary care performance. Physicians who worked more than 65 hours per week were found to score significantly higher in the visit-based continuity of care category than physicians working fewer hours. Physicians working more than 65 hours per week were also found to be significantly less satisfied with the amount of time they had for family and personal life than the other 2 groups. CONCLUSIONS: Part-time physicians perform as well as full-time physicians in most aspects of primary care, including all interpersonal aspects of care, as reported by patients. Patients of physicians working more than 65 hours per week experienced higher levels of visit-based continuity of care than patients of physicians working fewer hours, but this appears to carry a cost to those physicians in the area of personal and professional satisfaction. Subsequent research should examine the relationship between physician workload and technical aspects of care.
Adult↗
The effectiveness of tonsillectomy in diagnosing lymphoproliferative disease in pediatric patients after liver transplantation.
OBJECTIVE: To determine the effectiveness of diagnosing forms of lymphoproliferative disease by performing tonsillectomy in pediatric patients who develop symptomatic or asymptomatic tonsillar hypertrophy during immunosuppressive therapy after liver transplantation. DESIGN: Retrospective chart and pathological review. SETTING: Urban tertiary referral children's hospital. MAIN OUTCOME MEASURES: The presence of a pathological stage of lymphoproliferative disease or Epstein-Barr virus (EBV) diagnosed using tonsillar specimens, resulting in a change in therapy. RESULTS: Of 275 pediatric patients who underwent liver transplantation, 13 had tonsillectomy performed with histopathological review of the tonsillar specimens. The specimens from 5 patients (39%) demonstrated pathological changes thought to be consistent with EBV-related changes or a form of lymphoproliferative disease. Histological changes ranged from tonsillar hyperplasia associated with EBV infection to large cell lymphoma. Immunosuppressive therapy was reduced or discontinued, and antiviral therapy was initiated. CONCLUSION: Children who have undergone liver transplantation and develop tonsillar hypertrophy should undergo a diagnostic tonsillectomy, regardless of the clinical presentation, to rule out a form of posttransplant lymphoproliferative disease. Arch Otolaryngol Head Neck Surg. 2000;126:1444-1447
Antiviral Agents↗
Clinical comparability of ventolin formulated with hydrofluoroalkane or conventional chlorofluorocarbon propellants in children with asthma.
BACKGROUND: Aerosolized asthma medications with chlorofluorocarbon (CFC) propellants are being phased out because of environmental concerns about the ozone layer. Medications are being reformulated with non-ozone-depleting propellants. OBJECTIVE: To evaluate the clinical comparability of albuterol sulfate formulated in a new hydrofluoroalkane-134a (HFA) propellant (Ventolin HFA Inhalation Aerosol), and conventional CFC-containing albuterol (Ventolin Inhalation Aerosol) in children with asthma. DESIGN: Randomized, double-blind, placebo-controlled 2-week clinical trial with a 1- to 2-week run-in period. During the run-in, patients took Ventolin CFC as needed. Patients (n = 135) aged 4 to 11 years with asthma then were assigned randomly to treatment with Ventolin HFA, Ventolin CFC, or placebo administered 4 times daily via metered-dose inhaler for 2 weeks. All patients were allowed rescue albuterol use in matching propellant as needed for relief of breakthrough symptoms. The main outcome measure was the mean percentage of predicted peak expiratory flow (PEF) after the morning dose of study drug on day 1 and after 2 weeks as assessed by results of 6-hour serial tests. RESULTS: At day 1, the mean (+/- SE) percentage of predicted PEF increased postdose by 14% (+/- 1%) in the Ventolin HFA group and 13% (+/- 1%) in the Ventolin CFC group compared with 6% (+/- 2%) in the placebo group (P</=.006). At week 2, mean postdose increases were 11% (+/- 1%) in the Ventolin HFA and CFC groups compared with 5% (+/- 1%) in the placebo group (P<.001). There were no significant differences between the Ventolin HFA and CFC groups in postdose increases in pulmonary function, time to onset of response, duration of response, or peak effects. Safety profiles were similar among the 3 groups. CONCLUSION: Ventolin HFA is clinically comparable to Ventolin formulated with the conventional CFC-containing propellant when administered to children with asthma. Arch Pediatr Adolesc Med. 2000;154:1219-1225.
Aerosols↗
Failure of founder transgenic male mice to transmit an attenuated HSV thymidine kinase transgene results from mosaicism and sperm competition.
Previously we found that male mice carrying either of two attenuated herpes simplex virus thymidine kinase reporter transgenes displayed low level ectopic expression of the reporter gene in the testis and, although fertile, exhibited reduced fecundity. In contrast to males of later generations, many of the founder males failed to transmit the transgene to their progeny. This led to the suggestion that these fertile non-transmitting males are mosaic, with the sperm developing from the non-transgenic lineage outperforming those from the heterozygous transgenic lineage. Here we present the results of artificial insemination (AI) and in vitro fertilization (IVF) experiments designed to test this hypothesis. Albino CF(1) hybrid females were inseminated with mixtures of equal numbers of sperm from heterozygous transgenic (HT) males (equivalent to C57BL/6 x CBAF(2)) and CF(1) males. Similar mixed inseminations were carried out in parallel with sperm from non-transgenic (NT) siblings of the HT mice and 13-day fetuses were scored by eye color to determine their paternity. The pooled data from five experiments gave ratios of CF(1) to HT and CF(1) to NT offspring of 8.13 and 0.22 respectively, implying a calculated HT to NT ratio of 0.027. This indicates that, in competition with each other, the NT sperm would be almost 40 times more successful in fertilization than the HT sperm. Smaller differences were observed between HT and NT when AI was performed with unmixed sperm, consistent with the fertility of HT non-founder males. However, in five IVF experiments carried out with unmixed sperm, 142/212 oocytes exposed to NT sperm were activated and divided, while only 8/226 oocytes treated with HT sperm reached the two-cell stage. This confirms that HT sperm are defective and indicates that the IVF method employed amplified these deficiencies, which may have only a small effect upon natural reproduction when the HT sperm are not in competition with normal sperm.
Animals↗
Low-dose continuous-infusion ceftazidime monotherapy in low-risk febrile neutropenic patients.
One hundred and thirty-five cancer patients admitted with low-risk neutropenic fever received a low-dose schedule of ceftazidime as infusional monotherapy over a total of 180 episodes. Ceftazidime was administered as a 1-g bolus followed by a continuous infusion of 2 g per day. In this patient population the ceftazidime was both practical and well tolerated. Sixty-eight percent of patients responded with clinical improvement and complete resolution of fever within 48 h. Overall, 95% of patients responded, although 18% subsequently required antibiotic modification for persistent fever. Only 5% of episodes were considered failures due to clinical deterioration, and over the study period there was only 1 fatality due to respiratory failure. The median duration of hospitalisation was only 4 days (2-20). In conclusion, monotherapy with low-dose infusional ceftazidime appears safe and highly effective in this low-risk population of neutropenic patients and may reduce antibiotic costs appreciably.
Adult↗
Effect of mating system, flushing procedure, progesterone dose and donor ewe age on the yield and quality of embryos within a MOET program in sheep.
Multiple ovulation and embryo transfer (MOET) has the potential to increase the rates of genetic improvement in sheep. However, better realization of this potential requires a higher yield of transferable embryos. Thus we investigated some factors that may contribute to high embryo yield and quality under field conditions, as part of an ongoing MOET program. Comparison of the effects of 2 breeding systems (natural service plus laparoscopic intrauterine AI vs natural service only) on embryo yield and quality indicated that while AI did not affect embryo recovery, it significantly (P < 0.05) improved fertilization rate and embryo quality, and increased (P < 0.05) embryo survival rate after transfer to recipients. Two flushing procedures (the original semi-laparoscopic and a modified version) were compared for effects on embryo recovery. The modifications made to the original collection method increased (P < 0.001) embryo recovery from 69.0 +/- 2.4 to 83.2 +/- 0.6%. The effects of the progestagen priming dosage during superovulatory treatment and ewe age on MOET outcome were also investigated. Donor ewes primed with 30-mg progestagen sponges came into estrus 1.9 h earlier (P < 0.05) than those primed with 45-mg sponges, but there was no difference in ovulation rate or embryo recovery, or in embryo survival after transfer between the 2 regimens. However, Chi-square analysis indicated a significant benefit in favor of the higher progesterone dose on both fertilization (P < 0.01) and embryo quality (P < 0.001). Age of donor ewe did not significantly affect the timing of estrus, fertilization rate or embryo survival after transfer. While adult ewes had higher (P < 0.05) ovulation rates and embryo yields, shearling ewes produced a much higher proportion of Grade 1 embryos (P < 0.05).
Aging↗