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Biomedical subjects

C Mills

Publications and source records attributed to C Mills.

At least 37 records · Page 2Linked to original sources

Partial deletion of both the spermine synthase gene and the Pex gene in the X-linked hypophosphatemic, gyro (Gy) mouse.

Gy, along with Hyp, is a dominant mutation of the normal gene Pex causing X-linked hypophosphatemia in the mouse. Hemizygous Gy male mice, however, have greater defects in survival, bodily growth, skeletal mineralization, and neurological function than those found in heterozygous Gy females or in Hyp mice. Since the gene for spermine synthase is immediately upstream of the homologous human gene PEX, we compared the effects of the Gy and Hyp mutations on both the spermine synthase gene and the Pex gene. Barely detectable levels of spermine (< 5% of normal) with elevated levels of its precursor, spermidine, were found in organs of Gy male mice compared to normal male littermates. Neither Gy females nor Hyp male mice were significantly affected. Four missing introns of the spermine synthase gene were identified in Gy male mice, suggesting extensive gene disruption. A pseudogene for spermine synthase was also identified in the mouse genome. Pex mRNA was found in several but not all tissues studied in adult normal mice. Pex mRNA was altered in both Gy and Hyp mice. All male Hyp mice were lacking the 3' end of the Pex message, whereas all male Gy mice were deficient at the 5' end. In summary, the Gy mutation is associated with a recessively expressed mutation of the spermine synthase gene, leading to spermine deficiency, and a dominantly expressed mutation of the Pex gene, leading to hypophosphatemia. Alterations in two contiguous genes in Gy may explain the additional phenotypic abnormalities present in the Gy male mouse.

Animals↗

The past, present, and future of lung transplantation.

BACKGROUND: The history of lung transplantation from the first human transplant performed in 1963 to the present is reviewed with particular focus on the added challenges because of the contaminated bronchus, exposure of the graft to airborne organisms, the poor blood supply to the bronchus, and the problem of reperfusion pulmonary edema. METHODS: The technical aspects of single and double sequential lung transplantation are reviewed, as are the current indications for single, double sequential, and heart/lung transplantation. Criteria for lung transplant recipients, in addition to their primary disease are noted, as are absolute and relative contraindications. The standard criteria for donor selection are also reviewed. RESULTS: The results of single, double sequential, and heart-lung transplantation over the past 10 years as reported by the International Society for Heart and Lung Transplantation Database are reviewed. In addition, the statistics of the lung and heart-lung transplantation program at the University of Colorado Health Sciences Center are reviewed, including the current immunosuppressive regimens and early and late monitoring for infection and rejection. This experience includes 3 early deaths in the first 53 patients for an operative mortality of 5.6%, with a 1-year actuarial survival of 90%. CONCLUSIONS: During the past decade remarkable improvement in the result of single and double sequential lung transplantation have occurred. As 1-year, actuarial survival is now approaching 90% at some institutions. Living related lobar transplantation, new antirejection agents, chimerism, and xenograft transplantation are areas for continuing and future investigation. The shortage in donor organ supply continues to be a very significant factor in limiting human lung transplantation.

Forecasting↗

S-adenosylmethionine decarboxylase activity is decreased in the rat cortex after traumatic brain injury.

S-Adenosyl-L-methionine decarboxylase (SAMdc) and L-ornithine decarboxylase (ODC) are major enzymes regulating polyamine synthesis. Following ischemia, putrescine content increases as a result of posttraumatic activation of ODC and inhibition of SAMdc. These alterations are thought to mediate edema and cell death. The purpose of this study was to quantify SAMdc activity and edema in the brain following controlled cortical impact injury. Anesthetized adult male rats underwent a right parietal craniectomy and were subjected to cortical impact injury. Tissues were obtained from three bilateral regions: parietal cortex, motor area (CPm); parietal cortex, somatosensory area (CPs); and the pyriform cortex (CPF). SAMdc activity was determined in the postmitochondrial fraction from homogenates of fresh, unfrozen tissues by measuring the decarboxylation of S-adenosyl-L-[carboxyl-14C]methionine. Basal SAMdc activity was determined in unoperated rats, and regional differences were noted: Activity was lower in the CPF than in the CPm and CPs. SAMdc activity decreased to the greatest extent in the ipsilateral CPm (impact site) from 1 to 72 h following traumatic brain injury. Significant edema was found in the ipsilateral CPm 1, 8, 16, 24, and 48 h after injury. Decreased SAMdc activity impairs the conversion of putrescine to polyamines and may contribute to delayed pathological changes in the brain after traumatic injury.

Adenosylmethionine Decarboxylase↗

A new keratin 2e mutation in ichthyosis bullosa of Siemens.

Ichthyosis bullosa of Siemens (IBS) is a rare autosomal dominant skin condition with features similar to epidermolytic hyperkeratosis (EH). Clinical symptoms are characterized by mild hyperkeratosis with an acral distribution. Histology shows epidermolysis of upper spinous and granular cells, whereas ultrastructurally, tonofilaments form perinuclear aggregates. IBS has been linked to the type II keratin cluster on chromosome 12q, and K2e mutations have recently been identified in IBS patients. We have studied genomic DNA from two IBS families and in both cases heterozygous point mutations were found in the 2B helical domain of K2e. One family had an established mutation in codon 493 (E493K), whereas the other had an unreported mutation in the adjacent codon (E494K). Both mutations were confirmed by allele-specific PCR. These data reinforce the hypothesis that mutations in the TYRKLLEGEE motif of the 2B helix are deleterious to keratin filament network integrity and provide further evidence for the involvement of K2e mutations in IBS.

Adolescent↗

Financing long-term care in Canada.

Financial policies relating to long-term care in Canada are changing rapidly in response to demands for health care reform. This chapter focuses on the financial structure of institutional care, primarily nursing homes, in the western provinces of Alberta and British Columbia. Community-based long-term care is discussed briefly.

Activities of Daily Living↗

Canadian beef quality audit.

A study was conducted in 4 Canadian processing plants in 1995-96 to determine the prevalence of quality defects in Canadian cattle. One percent of the annual number of cattle processed in Canada were evaluated on the processing floor and 0.1% were graded in the cooler. Brands were observed on 37% and multiple brands on 6% of the cattle. Forty percent of the cattle had horns, 20% of which were scurs, 33% were stubs, 10% were tipped, and 37% were full length. Tag (mud and manure on the hide) was observed on 34% of the cattle. Bruises were found on 78% of the carcasses, 81% of which were minor in severity. Fifteen percent of the bruises were located on the round, 29% on the loin, 40% on the rib, 16% on the chuck, and 0.02% on the brisket. Grubs were observed in 0.02% of the steers, and injection sites were observed in 1.3% of whole hanging carcasses. Seventy percent of the livers were passed for human food and 14% for pet food; 16% were condemned. Approximately 71% of the liver condemnations were due to liver abscesses. Four percent of the heads, 6% of the tongues, and 0.2% of whole carcasses were condemned. The pregnancy rate in female cattle was approximately 6.7%. The average hot carcass weight was 357 kg (s = 40) in steers, 325 kg (s = 41) in heifers, 305 kg (s = 53) in cows, 388 kg (s = 62) in virgin bulls and 340 kg (s = 39) in mature bulls. The average ribeye area in all cattle was 84 cm2 (s = 12); range 29 cm2 to 128 cm2. Grade fat was highly variable and averaged 9 mm (s = 4) for steers and heifers, 6 mm (s = 6) for cows, 5 mm (s = 1) for virgin bulls, and 4 mm (s = 0.5) for mature bulls. The average lean meat yield was 59.7% in cattle (s = 3.4); range 39% to 67%. One percent of the carcasses were devoid of marbling, 1% were dark cutters, and 0.05% of the steer carcasses were staggy. Six percent of the carcasses had poor conformation, 3.7% were underfinished, and 0.7% were overfinished. Yellow fat was observed in 4% of the carcasses; 10% of carcasses were aged. Based on January 1996 prices, the economic analysis showed that the Canadian beef industry lost $70.52 per head or $189.6 million annually from quality nonconformities. Methods identified to reduce these nonconformities included improvements in management, animal identification, handling, genetic selection, marketing, grading, and information transfer.

Abattoirs↗

Cervical cancer screening: are the 1989 recommendations still valid? National Workshop on Screening for Cancer of the Cervix.

Although screening for cervical cancer has been shown to be effective in reducing the morbidity and mortality associated with this disease, and despite many attempts to encourage the development of provincial programs, as of 1995 no province had a comprehensive screening program for cervical cancer. Participants at the Interchange '95 workshop, held in Ottawa in November 1995, reviewed the recommendations of the 1989 National Workshop on Screening for Cancer of the Cervix and identified factors that have impeded their implementation. Participants discussed the need for comprehensive information systems, quality control and strategies to increase recruitment of unscreened and underscreened women. They concluded that the formation of a Cervical Cancer Prevention Network involving key stakeholders will facilitate the development and implementation of provincial programs to ensure optimal screening. They agreed that, in the interim, recommendations for practising physicians should remain as they were following the 1989 workshop.

Canada↗

The kinetics of skin thinning induced by topical fluticasone propionate 0.05% cream in volunteer subjects.

Fluticasone propionate (FP) 0.05% (CutivateTM) cream is a novel corticosteroid used for the treatment of corticosteroid-responsive dermatoses. To date there are no published data concerning its effect on cutaneous atrophy. This randomized, double-blind study of 40 volunteer subjects was performed to investigate the kinetics of skin thinning induced by topical 0.05% FP cream vs. placebo after once-daily application for 2-8 weeks. The results of this study showed no significant effect on the skin thickness of subjects after 8 weeks' treatment with 0.05% FP cream compared with placebo.

Administration, Cutaneous↗

An evaluation of the effect of pentoxifylline on sperm function and treatment outcome of male-factor infertility: a preliminary study.

OBJECTIVE: Our objective was to study the effect of pentoxifylline (PF) on fertilization rates in couples with previous failure of fertilization and male-factor infertility and to determine the predictive value of conventional semen analysis parameters in selecting the couples who would benefit from the elective use of PF in IVF. DESIGN: This prospective controlled study was conducted in an assisted conception METHODS: Sixty-nine couples with previous failed IVF cycle, who had a low fertilization rate and/or male-factor infertility, were recruited to the study. Multiple follicular development was induced using the same protocol of human menopausal gonadotropin and gonadotropin releasing hormone analogue in both cycles. The oocytes were inseminated with spermatozoa treated with PF. The fertilization rates in the PF cycle were compared to the reference cycle based on semen analysis parameters and previous fertilization rates. RESULTS: In couples with male infertility, the fertilization rate improved significantly, from 17 to 50% in PF cycles (P < 0.001). A significant improvement in fertilization rate was also demonstrated in couples with previous poor fertilization, < 30% (P < 0.01), particularly in those with a very low fertilization rate, < 20% (P < 0.001). Although there was an overall improvement in fertilization rates in couples with male-factor infertility, there was no cutoff value in sperm motility that would make a significant difference in the impact of PF on fertilization rates. CONCLUSION: Couples with poor fertilization rates in vitro benefit with a significant improvement in fertilization by the elective use of PF. The improvement is most significant in couples with previous complete failure of fertilization and poor fertilization rates, < 30%.

Adult↗

Successful use of pentoxifylline in male-factor infertility and previous failure of in vitro fertilization: a prospective randomized study.

OBJECTIVE: Our objective was to determine whether the use of pentoxifylline (PF) would improve the in vitro fertilization (IVF) rate and outcome in couples with male factor infertility and previous failure of fertilization in vitro. DESIGN: This prospective randomized controlled study was conducted in an assisted conception unit. MATERIALS AND METHODS: Forty-nine couples with previous failed fertilization in vitro attributable to male factor or male-factor infertility without previous IVF were recruited for the study. Controlled ovarian hyperstimulation was performed using a combination of gonadotropin releasing hormone agonist and human menopausal gonadotropin. Oocytes of the same grade and maturity were inseminated with spermatozoa treated with PF or control spermatozoa. A maximum of three embryos was replaced after 48 hr and all other embryos were cryopreserved. Pregnancy outcome was followed up and evidence of fetal or neonatal anomalies reported. RESULTS: A significantly higher fertilization rate occurred in the group where oocytes were inseminated with spermatozoa treated with PF compared with controls (56.3 versus 30.7%; P < 0.05). Fertilization occurred in 45 of the 49 cycles (92%). In seven cycles, only the oocytes that were inseminated with spermatozoa treated with PF fertilized, in contrast to only one cycle where the oocytes inseminated with control sperm fertilized (P < 0.05). Fifty-seven PF and 31 control embryos were replaced and 11 clinical pregnancies occurred. Three of the pregnancies occurred in the seven cycles in which only PF embryos were replaced, one in the single cycle where control embryos were replaced and seven from the 37 cycles in which both PF and control embryos were replaced. There was no evidence of congenital malformations in any of the offsprings resulting from this study. CONCLUSION: This study suggests that PF improves the fertilization rate and outcome in couples with male factor infertility and poor fertilization rates. This study does not suggest any increase in teratogenicity or evidence of congenital malformations in pregnancies following IVF cycles where PF was used.

Adult↗

We're all human.

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Adolescent↗

Stimulation of oxidant generation by human sperm suspensions using phorbol esters and formyl peptides: relationships with motility and fertilization in vitro.

OBJECTIVES: To investigate the influence of reactive oxygen species generated by human spermatozoa and contaminating leukocytes on sperm movement and fertilization in vitro. DESIGN: A chemiluminescence technique, using luminol and peroxidase, was used to monitor the generation of reactive oxygen species by human sperm suspensions and the results were correlated with sperm movement and the fertilization of human ova in vitro. SETTING: Diagnostic Andrology Laboratory and IVF Clinic. PATIENTS: Infertile couples undergoing IVF therapy. RESULTS: An N-formyl-methionyl-leucyl-phenylalanine (FMLP) provocation test was used to demonstrate that the presence of leukocytes in 28.5% of the sperm preparations was associated with elevated levels of spontaneous reactive oxygen species production, impaired movement, and a reduced capacity for fertilization in vitro. In the absence of leukocytes, exposure to phorbol ester stimulated a burst of reactive oxygen species generation by human spermatozoa, the magnitude of which was correlated highly with a loss of sperm motility but not with fertilization rates observed in the concurrent IVF cycle. CONCLUSION: Leukocyte contamination of human sperm preparations can be detected readily by FMLP-induced, luminol-dependent chemiluminescence and the results have an important bearing on the fertilizing capacity of the spermatozoa in vitro.

Fertilization↗

Human cumulus cell complexes studied in vitro by light microscopy and scanning electron microscopy.

Various researchers describe the morphology of cumulus cells (CC) in vitro, but few have investigated their behaviour on plastic. Knowledge concerning the behaviour of human CC could be useful in improving the success of in vitro fertilisation procedures. This study aimed to describe the morphology and behaviour of CC in vitro and to investigate movement on a collagen-coated substrate. Following collection some cumulus were mechanically dissected from those surrounding the oocyte. Cumulus aggregates were cultured over 24 h using Earle's medium supplemented with 8% albumin. Substrata were plastic coverslips coated with collagens I, IV, or mixed collagens. Cumulus cultured over corresponding time periods on uncoated coverslips served as controls. Specimens were fixed and prepared for scanning electron microscopy. Over 24 h the controls began exhibiting the morphological features associated with cell movement: cell surface protrusions changed from blebs to microridges, lamellipodia and leading lamellae; cell shape altered from rounded and upright, to flattened. Extracellular matrix (ECM) transformed from a thick, sheet-like substance to a thin, fibrous material. By 24 h, cells contacting ECM remained rounded showing few features of movement. Collagens enhanced attachment of CC as a monolayer on the substrate. Cell morphology varied according to the collagen type used. On mixed collagens, cells attached rapidly, appearing to be predominantly non-motile. On collagen type I there was less attachment of cells but increased motility. On collagen type IV there was decreased attachment and the cells remained spherical. In conclusion, collagens enhance the settling of cumulus cells on a plastic substrate and the cells exhibit some specificity in attaching to collagens.

Adult↗

Factors influencing the outcome of in-vitro fertilization with epididymal spermatozoa in irreversible obstructive azoospermia.

Microsurgical epididymal sperm aspiration (MESA) and in-vitro fertilization (IVF) were found to offer limited opportunity for fatherhood to 45 men with obstructive azoospermia, due principally to poor embryo implantation. Adequate sperm preparations were obtained in 46/50 treatment cycles (92%), with the best motility found in the caput epididymis in 89% of cases. The mean fertilization rate was 11.2% and fertilization occurred in 23 cycles (50%), with embryo transfer arising from 12/26 men with vas aplasia (CAV), 4/9 with genital tract obstruction (EV) and 7/11 with irreversible vasectomy (VV). The overall implantation rate was low, 8.7% per embryo transfer (11.7% per 2-3 embryo transfers) and was not improved by Fallopian transfer. There were two pregnancies (4% per cycle), both in the EV group where embryo formation and implantation (2/4, 50% per cycle) were optimum even though sperm preparations were paradoxically inferior to the CAV and VV groups. The spermatozoa retrieved in the two successful EV cycles were appreciably blood contaminated. Analysis of the 21 failed embryo transfers showed delayed fertilization in 10 cycles, cystic fibrosis (CF) mutation or familial disease in 7/12 CAV men and the VV men were older (P < 0.001). A pregnancy which miscarried arose from a case of Young's syndrome, a carrier of CF mutation DF508. Male factors could thus be implicated in the high embryo wastage of MESA cycles and might also be influencing implantation in other IVF procedures. Where feasible, male reconstructive surgery is preferable unless fertilization can be improved, possibly by speedier retrieval techniques or by permitting sperm capacitation in vitro, but probably more effectively by micro-assisted insemination.

Adult↗

Summary report of the workshop on data for monitoring tobacco use.

Health Canada convened a workshop in Ottawa in March 1994 in order to consider existing measures of tobacco use in Canada and to develop consensus on a standard set of measures for monitoring tobacco use in the future. The impetus for the workshop was the growing awareness of inconsistencies in definition and approach that have arisen over many years of monitoring, and a concern that future efforts to control tobacco use could be hampered by inadequate data. This report proposes standard definitions of key terms, identifies core topics, briefly discusses major data quality issues and offers a set of survey questions to monitor the elements of tobacco use.

Canada↗