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Biomedical subjects

C Law

Publications and source records attributed to C Law.

At least 19 recordsLinked to original sources

Delineation of two distinct 6p deletion syndromes.

Deletions of the short arm of chromosome 6 are relatively rare, the main features being developmental delay, craniofacial malformations, hypotonia, and defects of the heart and kidney, with hydrocephalus and eye abnormalities occurring in some instances. We present the molecular cytogenetic investigation of six cases with 6p deletions and two cases with unbalanced translocations resulting in monosomy of the distal part of 6p. The breakpoints of the deletions have been determined accurately by using 55 well-mapped probes and fluorescence in situ hybridization (FISH). The cases can be grouped into two distinct categories: interstitial deletions within the 6p22-p24 segment and terminal deletions within the 6p24-pter segment. Characteristics correlating with specific regions are: short neck, clinodactyly or syndactyly, brain, heart and kidney defects with deletions within 6p23-p24; and corneal opacities/iris coloboma/Rieger anomaly, hypertelorism and deafness with deletions of 6p25. The two cases with unbalanced translocations presented with a Larsen-like syndrome including some characteristics of the 6p deletion syndrome, which can be explained by the deletion of 6p25. Such investigation of cytogenetic abnormalities of 6p using FISH techniques and a defined set of probes will allow a direct comparison of reported cases and enable more accurate diagnosis as well as prognosis in patients with 6p deletions.

Adult

A general practitioner STD training programme: meeting education and service provision needs.

This paper discusses the development, implementation and evaluation of a training programme in sexually transmitted diseases (STDs) for general practitioners (GPs) belonging to the Divisions of General Practice in the Sydney metropolitan area. The aims of the project were to involve GPs in the management of STDs, sexual health issues and the prevention of human immunodeficiency virus (HIV) infection and to ensure a consistent and high quality of care in the management of STDs and HIV. The strategy used was a two-stage programme consisting of a series of 3 educational modules (total 15 h) and an intensive clinical training programme for selected GPs for 12 times 4 h clinical sessions. Needs assessment of the participating GPs was conducted to ensure that the content of the theory modules was appropriate. Evaluation of the modules was conducted to examine both perceived quality of the actual presentations and changes in knowledge or skills as a result of participation in the project.

Australia

In vitro suppression of transforming growth factor-beta induced stimulation of glycosaminoglycan synthesis by acetylsalicylic acid and its reversal by misoprostol.

OBJECTIVE: To determine if acetylsalicylic acid (ASA) suppresses the stimulatory effects of transforming growth factor-beta (TGF-beta) and insulin-like growth factor-1 (IGF-1) on glycosaminoglycan (GAG) synthesis by cultured bovine articular chondrocytes (BAC), and whether such a suppression can be counteracted by the addition of misoprostol, a prostaglandin (PG) E1 analog. METHODS: Confluent cultures of BAC were pre-incubated for 2 days with ASA (Aspirin) (250 microg/ml), TGF-beta (10 ng/ml), IGF-1 (150 ng/ml), and misoprostol (80 ng/ml), separately and in different combinations, and for 2 more days with fresh medium and the same test agents in the presence of 35S-sulfate (10 microCi/ml). The radiolabelled GAG in the medium were then isolated, separated by cellulose acetate electrophoresis, and assayed for incorporated radioactivity, as a measure of GAG synthesis. RESULTS: TGF-beta, IGF-1, at their optimal concentrations, and misoprostol (80 ng/ml) stimulated GAG synthesis 2.6, 1.8, and 2.4-fold, respectively, of the control value, but ASA (250 microg/ml) showed no significant effect. ASA in combination with TGF-beta or misoprostol markedly suppressed the stimulation of GAG synthesis observed with either TGF-beta or misoprostol alone, but had no effect on the stimulation of GAG synthesis by IGF-1. Addition of misoprostol together with TGF-beta potentiated the stimulation of GAG synthesis by TGF-beta and abolished the suppressive effect of ASA on the stimulation of GAG synthesis by TGF-beta. Also, the magnitude of the stimulatory effect of misoprostol varied from batch to batch of misoprostol as well as for the same batch when it was added to the cultures either directly or after diluting with serum-free medium. CONCLUSION: In BAC cultures, ASA suppresses and misoprostol potentiates the stimulation of GAG synthesis by TGF-beta. Misoprostol also counteracts ASA induced suppression of the stimulation of GAG synthesis by TGF-beta.

Animals

High-dose intravenous immune globulin and the response to splenectomy in patients with idiopathic thrombocytopenic purpura.

BACKGROUND: High-dose intravenous immune globulin produces a temporary rise in the platelet count in patients with idiopathic thrombocytopenic purpura. Splenectomy may also be effective, but it is not possible to predict which patients will have a good response. We hypothesized that the response to intravenous immune globulin predicts the response to splenectomy. METHODS: We studied retrospectively 30 patients with idiopathic thrombocytopenic purpura who had first been treated with immune globulin and then undergone splenectomy. The responses to the two treatments were classified on the basis of the platelet count as poor (<50,000 per cubic millimeter), good (50,000 to 150,000 per cubic millimeter), or excellent (>150,000 per cubic millimeter). RESULTS: All nine patients who had poor responses to intravenous immune globulin also had poor responses to splenectomy at one year. Of the 21 patients with good or excellent responses to intravenous immune globulin, 19 had good or excellent responses to splenectomy. CONCLUSIONS: Patients with idiopathic thrombocytopenic purpura who have good or excellent responses to intravenous immune globulin are likely to have good or excellent responses to splenectomy, whereas patients who have poor responses to intravenous immune globulin are unlikely to have good or excellent responses to splenectomy.

Adolescent

A three-state receptor model of agonist action.

The concept that receptors can exist in multiple conformational states is becoming a physical reality. A fundamental question is how many active states need to be proposed in order to account for pharmacological observations, in particular, the finding that the same receptor type can exhibit a different agonist pharmacology when coupled to different effector pathways. In this article, Paul Leff, Clare Scaramellini, Clare Law and Ken McKechnie propose and develop a three-state receptor model in which two active conformations are assumed to exist. They show that this relatively simple theoretical model provides a basis for predicting variable agonist and inverse agonist behaviour in different systems containing the same receptor, and that it is able to account for emerging data obtained on promiscuously coupled receptors. It is argued that, while these new theoretical considerations challenge the fundamental assumptions and concepts of traditional receptor theory, the general principles of pharmacological receptor classification are largely preserved.

Animals

Combined therapy trial with interferon alpha-2a and ablative therapy in the treatment of anogenital warts.

OBJECTIVE: To determine whether the combination of systemically administered interferon alpha-2a and ablative surgery for the treatment of genital and/or perianal warts produces a 30% or greater improvement in lasting response rate compared with a control group receiving a combination of placebo and ablative therapy. DESIGN: Randomised, triple-blind, placebo-controlled trial using 1 or 3 MIU of interferon alpha-2a or placebo administered subcutaneously three times weekly for 10 weeks in combination with ablative surgery. SETTING: International, multicentre study in 10 genitourinary medicine clinics. PATIENTS: Two hundred and fifty patients with anogenital warts. MAIN OUTCOME MEASURES: Lasting response at week 38. RESULTS: Standard efficacy analysis at week 38 showed a lasting response in 51% (35/68) of 3 MIU interferon-treated patients, 48% (30/63) of 1 MIU interferon-treated patients and 43% (29/67) of placebo-treated patients. CONCLUSIONS: With the doses and regime described, treatment with interferon alpha-2a in combination with ablative therapy is not significantly superior in the treatment of anogenital warts than placebo and ablative therapy.

Adult

Mental health services: critical component of integrated primary care and substance abuse treatment.

The documented high incidence of mental health disorders among individuals in substance abuse treatment argues for the importance of studying the provision of mental health services to this population. This survey documents how the Linkage Programs assembled an array of mental health services based on the assessed health care needs of clients. Specialty and nonspecialty personnel addressed the extensive mental health needs of ethnically diverse, multiproblem clients with substance abuse problems. The innovative use of nonconventional providers, however, did not eliminate the shortfall between the number of clients with mental health problems and the number who were referred to and received mental health services; nor did it enable all Linkage Programs to address the mental health needs of the most severely ill clients. There is a continuing need to forge relationships between mental health providers and integrated providers of primary care and substance abuse treatment.

Community Mental Health Services