An apology for AIDS.
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Acquired Immunodeficiency Syndrome↗
Biomedical subjects
C Ross
Publications and source records attributed to C Ross.
A controlled study to assess the use of in vitro fertilization with donor semen after failed therapeutic donor insemination.
OBJECTIVE: To assess the outcome of in vitro fertilization and embryo transfer (IVF-ET) with donor semen in patients who have failed to achieve conception with therapeutic donor insemination (TDI). DESIGN: Retrospective, controlled study. SETTING: All patients were managed and treated at the in vitro fertilization unit, John Radcliffe Hospital, Oxford, United Kingdom. PATIENTS, PARTICIPANTS: Thirty-eight patients undergoing 63 cycles of IVF with donor semen were compared with a control group of patients undergoing the same treatment during the same time period for tubal disease (the subgroup with the best success rates in our program), matched for age, type of infertility (primary or secondary), and number of attempts at treatment. MAIN OUTCOME MEASURES: We compared number of follicles produced, number of oocytes retrieved, fertilization rates, number of embryos obtained, number of embryos transferred, quality of embryos transferred, blastocyst formation in sibling embryos produced, clinical pregnancy rates (PRs), pregnancy loss, and pregnancy outcome. STATISTICS: Chi-squared test statistic with Yates' correction for continuity. RESULTS: There was a statistically significant difference between the number of livebirths in the donor IVF-ET group (37) and the control group (18). The cumulative PR after four cycles for the donor IVF-ET group (83%) was statistically greater than that of the control group (59%). There was no significant difference in all other parameters compared. CONCLUSION: Patients undergoing IVF-ET with donor semen have an excellent outcome. With the decline in PR after six cycles of TDI, early recourse to IVF-ET should be considered in this group of patients.
Adult↗
Trinucleotide repeat length instability and age of onset in Huntington's disease.
The initial observation of an expanded and unstable trinucleotide repeat in the Huntington's disease gene has now been confirmed and extended in 150 independent Huntington's disease families. HD chromosomes contained 37-86 repeat units, whereas normal chromosomes displayed 11-34 repeats. The HD repeat length was inversely correlated with the age of onset of the disorder. The HD repeat was unstable in more than 80% of meiotic transmissions showing both increases and decreases in size with the largest increases occurring in paternal transmissions. The targeting of spermatogenesis as a particular source of repeat instability is reflected in the repeat distribution of HD sperm DNA. The analysis of the length and instability of individual repeats in members of these families has profound implications for presymptomatic diagnosis.
Adult↗
Interferon treatment of cutaneous T-cell lymphoma.
In this report we have reviewed studies on the clinical effect of the interferon (IFN) treatment of 304 patients suffering from cutaneous T-cell lymphoma (CTCL). Intramuscular, subcutaneous or intralesional administration of recombinant IFN has been used as monotherapy or as part of combination therapy. In general, IFN has proved to be a relatively effective agent in the treatment of CTCL, and the best responses have been achieved in the early stages of the disease. In CTCL the overall response rate to IFN including complete, partial and minor responses is 70%. Neither the doses nor the routes of administration in these studies has any statistically significant influence on the clinical response to IFN treatment. Continuous low-dose IFN therapy, presumably in combination with psoralen and UVA light (PUVA), is recommended. This review concludes that the clinical stage of disease before treatment is the only known predictive parameter concerning the clinical response to IFN treatment in patients with CTCL.
Combined Modality Therapy↗
Validity of thermal dilution technique for measurement of cardiac output in rats.
The validity of the thermal dilution technique for the measurement of cardiac output was verified in experiments on a circulation model and on anesthetized rats under open- and closed-chest conditions. In the circulation model thermal dilution was compared with direct (Fdir) and electromagnetic (F(elm)) flowmetry. Flow values measured in the circulation model with the thermal dilution (Fth) technique correspond well with direct flowmetry (Fth = 0.92 Fdir + 7.0; r = 0.888) and with electromagnetic flowmetry (Fth = 0.95 F(elm) + 1.2; r = 0.990). In the anesthetized rat cardiac output was determined with thermal dilution and simultaneously with Fick's method and/or with electromagnetic flowmetry. Fick's method and electromagnetic flowmetry resulted in identical cardiac output values (COFick = 0.95 COelm; r = 0.865), whereas the thermal dilution technique yielded unequivocally higher values. The extent of overestimation is much more pronounced at low cardiac output than at a high output. The study clearly demonstrates that this overestimation is due to heat diffusion, which is obviously of greater significance in small animals than in large animals or humans. Therefore, the thermal dilution technique is not appropriate for the measurement of cardiac output in the rat.
Animals↗
Energy balance in stable malnourished patients with chronic obstructive pulmonary disease.
We have measured caloric intake, energy expenditure, and the thermogenic effect of food in ten patients with stable COPD who had a history of involuntary weight loss over several years and were malnourished (< 85 percent ideal body weight). Each patient completed a 7-day food record. Indirect calorimetry was performed in the resting postabsorptive state. After placement of a nasoenteric tube, patients were randomly assigned to be refed or sham-fed (mean +/- SD, 16 +/- 3 days), following which, metabolic measurements were repeated. Indirect calorimetry was also performed before and after a large meal in each patient. Home caloric intake was 135 +/- 23 percent of resting energy expenditure. Resting energy expenditure was 94 +/- 16 percent of that predicted by the Harris-Benedict equation and did not change significantly during inpatient refeeding. Refeeding resulted in weight gain (2.4 +/- 1.9 kg, p < 0.02). A large meal caused substantial increases in energy expenditure (24 +/- 18 percent), carbon dioxide production (39 +/- 18 percent), and oxygen consumption (23 +/- 16 percent). We conclude that stable malnourished COPD patients consume adequate calories to meet average energy requirements and are not hypermetabolic. Inpatient refeeding by nocturnal nasoenteric infusion is well tolerated and results in weight gain, but the thermogenic effect of a large meal poses a considerable metabolic and ventilatory load that could precipitate acute respiratory failure.
Aged↗
Fresh frozen plasma instead of higher than conventional dose of antivenom in viper envenoming.
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Animals↗
Transcriptional inhibition of the bacteriophage T7 early promoter region by oligonucleotide triple helix formation.
We have identified a purine-rich triplex binding sequence overlapping a -35 transcriptional early promoter region of the bacteriophage T7. Triplex-forming oligonucleotide designed to bind this target was annealed to T7 templates and introduced into in vitro transcription systems under conditions favoring specific initiation from this promoter. These templates demonstrated significant transcriptional inhibition relative to naked genomic templates and templates mixed with non-triplex-forming oligonucleotide. It is suggested that triplex formation along this target interferes with transcriptional initiation, and this mechanism may hold potential to disrupt bacteriophage T7 early transcription in vivo.
Bacteriophage T7↗
Platelet-activating factor levels in human follicular and amniotic fluids.
Platelet-activating factor (PAF) was estimated in extracts of human follicular and amniotic fluids using a commercially available 125I-radioimmunoassay. Levels obtained before and after purification of the extracts by thin-layer chromatography were similar and PAF could be estimated with high accuracy and reproducibility over a wide dilution range. PAF levels in fluid aspirated from mature (17 mm average diameter) follicles from in vitro fertilization patients were 1005 +/- 129 fmol/ml in successful (clinical pregnancy) cycles and 949 +/- 75 fmol/ml in unsuccessful (failure of implantation) cycles. PAF levels were also similar in follicles containing eggs and those where no egg was found, and in fluid from follicular cysts characterised by low oestradiol and progesterone levels. PAF was detected in midtrimester amniotic fluid (60 +/- 20 fmol/ml). At term, PAF was low or undetectable in amniotic fluid obtained at elective caesarean section before the onset of labour, but increased to 102 +/- 28 fmol/ml in samples obtained following spontaneous labour and vaginal delivery. The data suggest that PAF may be involved in ovulation and parturition but further studies into the mechanism of action of PAF are necessary. The good performance of the radioimmunoassay and the convenience of gamma-counting are strong advantages of this method over the available bioassays, but its expense remains a drawback.
Amniotic Fluid↗
Thyroid screening tests in psychiatric inpatients.
This study reports on a retrospective evaluation of the current practice of screening for thyroid dysfunction in an adult psychiatric inpatient program. Sixty-four percent of 342 admissions were tested during their hospital stay. Although 13.7% of tests yielded abnormal values on one or more of the thyroid indices, only 0.9% resulted in a diagnosis of hypothyroidism. None of the other abnormal test results led to any specific action being taken. The present pattern of use of thyroid function screening as observed in this study does not appear optimal. Issues in the selection of thyroid screening tests, and the value of the results obtained are discussed.
Adult↗
Heterogeneity of peripheral blood monocyte populations in human immunodeficiency virus-1 seropositive patients.
Monocytes from human immunodeficiency virus (HIV) patients have an increased heterogeneity of phenotype and function. In a study of 120 HIV patients we have demonstrated that they have normal monocyte differential counts but that with progression of the disease an increasing proportion of monocytes show phenotypic and functional evidence for activation or maturation. A proportion of the monocytes are larger, with increased expression of CD11b, HLA-DR, CD45 and CD16. Concomitantly there was increased expression of TNF-alpha, high constitutive synthesis of PGE2 and high plasma IL-6 levels. This suggested that there exists a more dynamic situation of recruitment, activation and maturation of peripheral blood monocytes driven by HIV infection which results in a broader phenotypic profile.
Antigens, CD↗
Basal metabolic rate, body weight and diet in primates: an evaluation of the evidence.
The relationship between basal metabolic rate (BMR), body weight and diet is examined for primates. Contrary to the results reported in several recent works, there is no strong evidence that diet is directly linked to BMR, although a low BMR, relative to body weight, may be found in species with folivorous diets. There is some evidence that nocturnal haplorhine species have a relatively low BMR, but strepsirhines appear to have a uniformly low relative BMR regardless of their primary activity period. The evolution of BMR in primates is discussed in the light of these findings. Some predictions are made about the relative BMRs that should be found for other species whose BMR is, as yet, unknown.
Animals↗
Antisnakevenom: an over-used medication.
Fifty-five cases of snakebite were retrospectively analysed for the indications for the use of anti-snakevenom (ASV). Sixty-seven per cent of patients received treatment with ASV. Of these, 47% had features of systemic envenoming, 30% had features of local envenoming and 22% had no features of envenoming, either systemic or local. When WHO guidelines were strictly applied, it was found that in 44% of cases, ASV was used without adequate indication.
Antivenins↗
Large and rapid changes of myofibrillar total calcium during the cardiac cycle. Electron probe microanalysis of voltage-clamped guinea-pig ventricular myocytes.
At 36 degrees C and 2 mM [Ca2+]o, single guinea-pig ventricular myocytes were voltage clamped with patch electrodes. When paired pulsing had potentiated the contraction to the maximum, the cells were shock-frozen for electron probe microanalysis (EPMA). Shock-freezing was timed at the end of diastole (-80 mV) or at different times during systole (+5 mV). The same paired-pulse protocol was applied to another group of myocytes from which contraction was recorded and [Ca2+]i was estimated by microfluospectroscopy (50 microMNa-Indo-1). In potentiated cells, during the first pulse, contraction peaked within 128 +/- 25 ms after start of depolarization. [Ca2+]i peaked within 25 ms to 890 /+- 220 nM (mean +/- SEM) and fell within 100 ms to about 450 nM. sigma Camyo, the total calcium concentration in the overlapping myofilaments (A-band), was measured by EPMA in 17 potentiated myocytes. During diastole, sigma Camyo was 2.6 +/- 0.4 mmol/kg dry weight (dw), which can be converted to 0.65 mM (mmoles per liter myofibrillar space). Since [Ca2+]i was 180 nM, we estimate that 99.97% of total calcium is bound. A time-course for systolic sigma Camyo was determined by shock-freezing 13 cells at different times after start of depolarization to +5 mV. sigma Camyo was 5.5 +/- 0.3 mmol/kg dw (1.4 mM) after 15-25 ms, 4.6 +/- 0.5 mmol/kg dw (1.1 mM) after 30-45 ms, and 3.1 mmol/kg dw (0.8 mM) after 60-120 ms. The fast time-course of sigma Camyo suggests that calcium binds to and unbinds from troponin C at a fast rate.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Follicular monitoring and outcome of in vitro fertilization in gonadotropin-releasing hormone-agonist-treated cycles.
Previous investigations of in vitro fertilization (IVF) cycles stimulated with gonadotropins have shown that it is possible to predict IVF outcome on the basis of the pattern of estradiol (E2) production in the terminal phase of follicular growth. This analysis looked at endocrine and ultrasound parameters in the late follicular phase of 320 patients in their first cycle of IVF. All cycles were stimulated by an association of gonadotropin-releasing hormone agonists (GnRH-a) and human menopausal gonadotropins (hMG). The pregnancy rate (PR) was not related to the E2 pattern in the 5 days before ovulation induction and was 33% and 39% even when E2 values fell during hMG administration. The PR was independent of the E2 level and the number of follicles greater than 14 mm on the day of human chorionic gonadotropin administration (day 0). The incidence of multiple pregnancy increased when E2 levels were greater than 1,000 pg/mL. It is concluded that follicular phase parameters used for cycle cancellation in hMG-stimulated IVF cycles cannot be extrapolated to GnRH-a/hMG cycles.
Analysis of Variance↗
The human blastocyst: morphology and human chorionic gonadotrophin secretion in vitro.
Micromanipulation of human oocytes and embryos has provided new opportunities for both the treatment of infertility and the preimplantation diagnosis of genetic disease. It is important to determine whether manipulated embryos develop normally in vitro, as an indication of their suitability for transfer. However, at present there is little information on the development of non-manipulated embryos in vitro for comparison. We have therefore monitored morphological changes and human chorionic gonadotrophin (HCG) secretion in 36 non-manipulated human embryos, including 26 blastocysts and 10 cavitating morulae, daily from day 3 to day 14 of culture. Hatching was observed in 10 (38.5%) blastocysts and five of these adhered to the culture dish and appeared viable until day 14. The secretion of HCG was first detected on day 8, peaked at day 10 (51.11 +/- 8.7 mIU/ml) and then declined but was still detectable in four blastocysts on day 14. There was no overall difference in HCG secretion by hatched blastocysts and those which remained within the zona. However, those hatched blastocysts which showed adherence had significantly increased (P less than 0.05) HCG secretion. For individual blastocysts, the pattern of HCG secretion correlated well with the assessment of morphology. These data provide the basis for comparative studies of morphological changes and HCG secretion in manipulated embryos.
Blastocyst↗
Clinical evaluation of ColdSpor, a glutaraldehyde-phenolic disinfectant.
UNLABELLED: Disinfecting solutions may vary in concentration and bactericidal activity with use, may have subjectively unpleasant characteristics, and may affect the appearance and physical condition of the equipment processed. We evaluated the high-level disinfectant ColdSpor (0.5% glutaraldehyde, 0.025% ortho-phenylphenol, and 0.005% para-tertiary amylphenol) by using it as the disinfecting agent in the processing of equipment for a large respiratory care service. MATERIALS & METHOD: The type and quantity of equipment disinfected and the physical condition of the equipment were observed and recorded. Samples of the disinfectant solution were analyzed each week, and the antimicrobial activity of the solution was tested against clinical isolates and test cultures of Pseudomonas aeruginosa. The odor of the solution and ease of use were subjectively evaluated by two equipment-processing technicians. RESULTS: More than 2,400 pieces of respiratory equipment were passed through the disinfectant solution during the 30-day study period. No changes in the appearance of the equipment were noted. Analysis revealed that 71% or more of the antimicrobial chemicals remained in the solution. Clinical isolates and test cultures of P aeruginosa showed no growth when cultured with samples of the solution in use up to 30 days. The two technicians subjectively judged the solution to have no noticeable odor and to produce no burning of the eyes. CONCLUSION: The concentration of components of the glutaraldehyde-phenolic solution maintained bactericidal activity for as long as 30 days. The solution produced no apparent physical change in equipment and was subjectively acceptable to those processing equipment.
Data Collection↗
A sensitive antiviral neutralization bioassay for measuring antibodies to interferons.
An improved bioassay for measuring neutralizing antibodies to interferons (IFN) is described. The assay is based upon an objective and precise quantification of the viral cytopathic effect. This effect is measured via the dehydrogenase-system in cells, and quantified spectrophotometrically. Virus-infected cells, in contrast to non-infected cells, possess low enzyme activity resulting in low OD signals. This fall in OD can be prevented by the addition of a small, but fixed amount of IFN before the addition of virus. Anti-IFN sera will neutralize the protective effect of IFN. This effect can be quantified by measurement of the reduction in the OD signals. Antibodies to recombinant IFN were found to cross-react with human leukocyte IFN although to a ten-fold lower degree. The assay requires no expensive reagents, it is performed in 96-well microtrays and the results can be measured in an ordinary ELISA scanner. The assay is highly reproducible, yielding inter- and intra-assay variability of less than 10%. The sensitivity is much higher than that reported previously for the CPE technique and that of ELISA techniques.
Animals↗