Biomedical subjects
Publications and source records attributed to C May.
Creating a hospital environment which supports wellness is a concept which many hospital health professionals view as important but have little time and resources to pursue. However, the management of Moruya District Hospital on the Far South Coast of NSW, is taking on this challenge using laughter as the medium.
Marrow cells from previously established lines of transgenic mice expressing either of two different methotrexate (MTX)-resistant dihydrofolate reductases (DHFRs) were transplanted into recipient animals to determine the resultant in vivo protective effect against toxicity associated with MTX administration. Sublethally irradiated, untransplanted animals were first used to establish conditions of low-dose MTX administration resulting in substantial hematopoietic toxicity with undetectable gastrointestinal toxicity. Under these conditions, low survival rates were observed for normal or transgenic animals not expressing drug-resistant DHFR activity, whereas transgenic animals expressing either the arg22 (line 04) or trp31 (line 03) DHFR variants survived. Transplantation of 10(6) marrow cells from either transgenic lines 03 or 04 rescued normal FVB/N recipient animals from low-dose MTX administration, which was lethal for animals transplanted with 10(6) normal FVB/N marrow cells. Reduced survival of transgenic line 04 marrow recipients was observed when twofold or fourfold doses of MTX were administered. However, when 10(7) transgenic line 04 marrow cells were infused, the recipients were found to be resistant to a MTX dose that was not only lethal for animals transplanted with 10(7) normal FVB/N marrow cells, but also lethal for normal, untransplanted FVB/N mice. Histologic analysis showed protection of both marrow and gastrointestinal tissues from MTX toxicity in transgenic line 04 marrow transplant recipients. Thus, exclusive expression of MTX-resistant DHFR activity in the marrow had a substantial, systemic chemoprotective effect in animals, which could be applied for improved utilization of MTX for antitumor chemotherapy.
Recent evidence has implicated canine distemper virus (CDV) as a possible aetiologic agent in Paget's disease of bone and the canine bone disorder, metaphyseal osteopathy. We have therefore examined the effects of CDV on the formation of multinucleated osteoclast-like cells in cultures of canine bone marrow mononuclear cells. Marrow cells from a distemper-infected dog and from five uninfected dogs were cultured in the presence of 1 alpha, 25-(OH)2 vitamin D3 and the number of tartrate resistant acid phosphatase positive multinucleated cells (MNCs) was determined. The presence of calcitonin (CT) receptors was confirmed by autoradiography with 125I-labeled human CT. Cultures from the distemper-infected dog contained a higher level of MNCs than those from the normal dogs. The in vitro addition of CDV to the cultures from all the dogs produced a dose-dependent increase in the number of MNCs, and an increase in size of these cells in the cultures from the infected dog. Cells infected with CDV were hyperresponsive to 1 alpha,25-(OH)2 vitamin D3. The presence of the virus in the relevant samples was confirmed using molecular techniques. In situ hybridization studies also revealed a significant increase in the level of infection following in vitro addition of the virus to the culture from the distemper-infected dog, suggesting that further infection had taken place. Resorption pits were formed on bone slices, although the number of pits was not significantly altered by viral infection.(ABSTRACT TRUNCATED AT 250 WORDS)
Debate in the health care professions about the politics of interpersonal relationships between professionals and their patients or clients is increasingly organized around proxy measures of the quality of professional services such as patient satisfaction, or the extent to which the provision of care avoids routines and is genuinely individualized. This paper explores some of the problems which arise from this in relation to patients' autonomy and nurses' authority.
The nurse has an important role in helping the terminally ill patient come to terms with the imminence of death. Such work is highly demanding and often stressful, but is work which is accorded a high moral priority by respondents in the study reported in this paper. The paper explores the ways in which nurses work to respond to patients' expressed psychosocial problems and the emphasis that they placed on providing opportunities for patients to speak about their impending death.
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Bias in self-reports is one of the key problems which confronts researchers interested in using qualitative research techniques to understand individuals' cognitive and conceptual models of health behaviours. This is a problem that is especially apparent, for example, in research around addictive behaviours, where the fundamental trustworthiness of respondents' accounts may be in doubt. This research note discusses the problems associated with using conventional qualitative methods in health research and suggests a means of avoiding these.
Glycosaminoglycans (GAG) and keratan sulphate (KS) were measured in sera and synovial fluids from dogs with either osteoarthritis (OA) or rupture of the cranial cruciate ligament (CCL) and normal dogs. The dogs with OA had higher synovial fluid GAG levels (P < 0.002) and serum KS (P < 0.03) compared to the normal dogs. No significant differences in serum GAG were found in either group. In both OA and rupture of the CCL, GAG levels were increased in the synovial fluid from the affected joint compared with the clinically normal (inactive) contralateral joint. Neither GAG nor KS measurements correlated with serum and synovial fluid antibodies to collagen type II, synovial fluid white cell count or age of dog. It is unlikely that the measurement of these cartilage breakdown products is of value for diagnostic or prognostic use in canine arthropathies.
Soluble hyaluronan (HA), which has been considered as a marker for joint disease in man, was measured in serum and synovial fluid (SF) from dogs with osteoarthritis (OA), rheumatoid arthritis (RA), and rupture of the cranial cruciate ligament (CCL) and from normal dogs (control). Dogs with OA and RA had significantly increased serum HA (P < 0.001) and decreased synovial fluid HA (P < 0.001), as did dogs with CCL rupture (serum, P < 0.05; synovial fluid, P < 0.005). In OA, HA was lower in the SF from the affected joint than in that from the clinically normal (inactive) contralateral joint; no such difference was seen in dogs with CCL rupture. Dogs with liver disease (portocaval shunts, viral infectious hepatitis, metastatic neoplasm and disease secondary to diabetes mellitus) had increased serum HA concentrations (P < 0.001). There was a significant overlap of HA values in the diseased and normal dogs. Therefore, it is unlikely that the measurement of this cartilage breakdown product would be of value for diagnosis or prognosis in canine arthropathies.
Measurement of immune complexes, antibodies against canine distemper virus (CDV) and anti-CDV antibodies in immune complexes were made in sera and SF from 'normal' dogs and from dogs with joint diseases. These data were compared with cytological analyses of SF samples. In dogs with canine rheumatoid-like arthritis (CRA) there were correlations between circulating anti-CDV antibody levels and circulating immune complex levels (P < 0.001) and between SF anti-CDV antibody levels and SF immune complex levels (P < 0.01). Furthermore, the SF PMN count in dogs with CRA correlated with both the SF anti-CDV antibody levels (P < 0.001) and the SF immune complex anti-CDV antibody levels (P < 0.001). The results demonstrated a relationship between CDV and ongoing synovial inflammation in dogs with CRA.
Antibody levels (IgG and IgM) to Borrelia burgdorferi were measured in the sera and synovial fluids of UK horses. Western blotting against B. burgdorferi was also used on samples from seropositive horses. A low incidence of seropositivity was shown in horses from most parts of the UK. This increased in areas that have a high incidence of human and canine borreliosis (Norfolk and south coast). Leptospira infections of horses did not cause cross reactions in the B. burgdorferi ELISA. Most horses did not display clinical signs of Lyme disease. As with dogs and man, it is apparent that B. burgdorferi infection occurs in horses in the UK but clinical Lyme disease is uncommon.
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OBJECTIVE: To report two cases of fatal brown snake envenomation in adults despite the use of appropriate antivenom. CLINICAL FEATURES: Two men, aged 42 and 39, one with a history of hypertension, suffered fatal brown snake envenomation in Queensland. One believed he had been stung by a wasp. Both developed cardiorespiratory failure within one hour of the bite, followed by coagulopathy and pulmonary oedema. One patient developed fulminant multiorgan failure. INTERVENTION: Both patients died despite the administration of large doses of appropriate antivenom and full supportive care. CONCLUSION: Brown snake bites remain extremely dangerous despite the availability of specific antivenom. In severe cases associated with myocardial depression and gross coagulopathy, death may occur rapidly despite the use of conventional doses of antivenom. In such patients the antivenom requirement may be much greater than is currently recommended.
Activation of the multicomponent interleukin-2 receptor (IL-2R) complex leads to a rapid increase in tyrosine phosphorylation of a number of cellular proteins including the IL-2R beta and IL-2R gamma chains of the IL-2R and the RAF-1 serine threonine kinase. In addition, phosphatidylinositol 3-kinase (PI-3K) protein and activity can be immunoprecipitated with anti-phosphotyrosine and anti-IL-2R beta antibodies from IL-2-activated but not resting T lymphocytes. We have demonstrated that the SH2 (SRC homology 2) domains of the 85 kDa subunit of PI-3K are sufficient to mediate binding of the PI-3K complex to tyrosine phosphorylated, but not non-phosphorylated IL-2R beta, suggesting that tyrosine phosphorylation is an integral component of the activation of PI-3K by the IL-2R. Since none of the members of the IL-2R complex contains an intrinsic tyrosine kinase domain, IL-2-induced tyrosine phosphorylation must be the consequence of activation of intracellular tyrosine kinases. SRC family members including lck, lyn and fyn have been demonstrated to associate with IL-2R beta through binding of the kinase domain to the acidic domain of IL-2R beta. However, we have demonstrated that the serine rich (SD) region of the cytosolic domain of IL-2R beta is also required for association of a tyrosine kinase with the IL-2R complex and that IL-2 can induce proliferation and tyrosine phosphorylation in cell lines which lack the known SRC family kinases expressed by T lymphocytes. Thus members of other kinase families besides SRC may also be involved in mediating IL-2 signal transduction. Biochemical studies and studies of cells expressing mutant IL-2 receptors indicate that IL-2-induced tyrosine kinase activation initiates a complex signaling cascade. The cascade includes SRC family kinase members such as lck, fyn, and lyn, activation of Raf-1 and PI-3K, and ras, and increased expression of the fos, fra-1, and jun protooncogenes. In addition, ligation of the IL-2R leads to rapid increases in myc expression and more delayed increases in the expression of the cdc2 and cdk2 kinases and the cyclins through a tyrosine phosphorylation independent pathway. Whether other biochemical processes initiated by IL-2R ligation, including activation of the MAP2, p70S6 and p90RSK serine threonine kinases, activation of NF-kappa B, and increased expression of Raf-1, Pim-1, bcl-2, IL-2R alpha and IL-2R beta, are consequences of the IL-2-induced tyrosine kinase cascade remains to be determined.(ABSTRACT TRUNCATED AT 400 WORDS)
The development and implementation of new modes of organizing nursing work, such as primary nursing, stress the quality of interpersonal relationships between nurses and their patients. It is important to recognize, however, that such relationships are inherently problematic. This paper explores, from a sociological perspective, nurses' orientations to interpersonal relations with patients and examines some of the sources of their problematic features.
Earlier studies in rabbits revealed that in this species, in contrast to most other species studied, water intake was not influenced by injection or infusion of angiotensin II (ANG II). In order to establish whether ANG II has any role in the regulation of water intake of rabbits, a comprehensive study of the effect of converting enzyme inhibition was undertaken. Enalaprilat was given systemically in various doses to sodium- and water-replete, sodium-deplete, and water-deprived rabbits, and the intake and excretion of water and sodium was measured. In replete rabbits systemic injection of enalaprilat, 8 mg/kg and 8 micrograms/kg, but not 0.8 mg/kg, was followed by increased daily water intake. In sodium-deplete rabbits injection of enalaprilat, 80 mg/kg, was followed by water drinking within 1 h, and daily sodium intake was reduced. Systemic administration of ANG II increased, but did not restore to control level the sodium appetite of sodium-deplete rabbits attenuated by 80 mg/kg enalaprilat. Rabbits deprived of water for 24 h, however, drank the same amount of water after injection of vehicle or enalaprilat, 80 and 8 mg/kg. The efficacy of converting enzyme inhibition was also tested by measuring the blood pressure response to ANG I. Blood pressure responses revealed that in replete animals converting enzyme activity was depressed below control levels for 30 h after injection of 80 mg/kg enalaprilat. In sodium-deplete rabbits blood pressure fell following injection of 80 mg/kg enalaprilat and did not return to control level until 48 h after the injection.(ABSTRACT TRUNCATED AT 250 WORDS)