Biomedical subjects
D H Jones
Publications and source records attributed to D H Jones.
Treatment of extramammary Paget's disease by radiotherapy.
Extramammary Paget's disease (EMPD) is a rare cutaneous malignancy, which usually occurs in the elderly. Wide local excision is the recommended treatment, although this may not always be feasible. We report our experience of EMPD treated by radiotherapy in five patients. The radiotherapy was well tolerated in each case, and there were no signs of recurrence during follow-up (6 months-8 years). This study shows that radiotherapy is a useful alternative therapy for EMPD, and should be considered particularly in elderly patients who may not tolerate surgery.
Teledermatology in Scotland.
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The quality of proxy-respondent data in NCHS surveys.
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The epidemiology of nonfatal injuries among US children and youth.
OBJECTIVES: National data are not routinely available regarding the incidence of and associated risk factors for nonfatal injuries in children and youth. The Child Health Supplement to the 1988 National Health Interview Survey provided an opportunity to determine accurate national estimates of childhood injury morbidity by demographic factors, location, external cause, nature of injury, and other factors. METHODS: The closest adult for 17,110 sampled children was asked whether the child had had an injury, accident, or poisoning during the preceding 12 months and about the cause, location, and consequences of the event. An analysis for potential underreporting from 12 months of recall provided adjustments of annual rates to those for a 1-month recall period. RESULTS: On the basis of 2772 reported injuries, the national estimated annual rate for children 0 to 17 years of age was 27 per 100 children after adjustment to 1-month recall. Boys experienced significantly higher rates than girls (risk ratio [RR] = 1.52, 95% confidence interval [CI] = 1.37, 1.68), and adolescents experienced the highest overall rate (38 per 100 children) and proportion of serious injuries. CONCLUSIONS: Approximately one fourth of US children experience a medically attended injury each year, but the risks vary considerably depending on the characteristics of subgroups and the injury cause.
The hospice wage index: reslicing the reimbursement pie.
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The spirit of hospice.
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Purification and characterization of simian immunodeficiency virus (SIVmac) envelope glycoprotein gp130 from virus-infected cells.
A non-denaturing method has been developed for the purification of the envelope glycoprotein gp130 of the simian immunodeficiency virus (SIV) using infected cells as starting material. The procedure involves solubilization of cells infected with SIV (SIVmac251), enrichment of glycoproteins by lectin affinity chromatography, fractionation by reverse phase chromatography and purification by immunoaffinity chromatography. This procedure results in a greater than 95% purification of gp130 as assessed by polyacrylamide gel electrophoresis. There is no evidence for the presence of other virus-derived proteins after Western blot analysis using antibodies specific for virus proteins. Lectin-binding studies suggest that carbohydrate groups on the infected-cell-derived gp130 may differ from those on recombinant counterparts expressed in Chinese hamster ovary cells and Baculovirus-infected insect cells. The purified gp130 is highly immunogenic in rabbits and maintains the capacity to bind the CD4 receptor. A sufficient quantity of the infected-cell-derived gp130 has been prepared for immunization studies and subsequent live virus challenge studies in macaques.
In vitro splicing of concanavalin A is catalyzed by asparaginyl endopeptidase.
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Molecular analysis of the operon which encodes the RNA polymerase sigma factor sigma 54 of Escherichia coli.
The rpoN gene (encoding the sigma factor sigma 54) of Escherichia coli was cloned and its nucleotide sequence determined. Promoter probe analysis confirmed the presence of a promoter in a 350 bp fragment covering the start of rpoN. The likely promoter was identified. The nucleotide sequence of the region extending 2.1 kb downstream of rpoN was also determined. This region contained four open reading frames encoding potential polypeptides of 10750, 17959, 32492 and 9810 Da; maxicell and T7 promoter studies showed that four polypeptides of similar molecular masses were expressed from this region. The amino acid sequence of the 17959 Da polypeptide showed homology to the enzyme IIA domains of several proteins of the bacterial sugar phosphotransferase system (PTS), and the 9810 Da polypeptide showed homology to the HPr proteins of the bacterial PTS. The proteins encoded downstream of rpoN are known to negatively regulate sigma 54 activity. The homologies therefore suggest that this effect on sigma 54 may be mediated by sequential protein phosphorylation and suggest that there is a link between signal transduction and transcription of sigma 54-dependent genes.
PCR mutagenesis and recombination in vivo.
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Pharmacokinetics of ketamine in mules and mammoth asses premedicated with xylazine.
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The effects of recall on estimating annual nonfatal injury rates for children and adolescents.
OBJECTIVES: This study used a recent national population survey on childhood and adolescent non-fatal injuries to investigate the effects of recall bias on estimating annual injury rates. Strategies to adjust for recall bias are recommended. METHODS: The 1988 Child Health Supplement to the National Health Interview Survey collected 12-month recall information on injuries that occurred to a national sample of 17,110 children aged 0 through 17 years. Using information on timing of interviews and reported injuries, estimated annual injury rates were calculated for 12 accumulative recall periods (from 1 to 12 months). RESULTS: The data show significantly declining rates, from 24.4 per 100 for a 1-month recall period to 14.7 per 100 for a 12-month recall period. The largest declines were found for the 0- through 4-year-old age group and for minor injuries. Rates of injuries that caused a school loss day, a bed day, surgery, or hospitalization showed higher stability throughout recall periods. CONCLUSIONS: Varying recall periods have profound effects on the patterns of childhood injury epidemiology that emerge from the data. Recall periods of between 1 and 3 months are recommended for use in similar survey settings.
Production of a vector to facilitate DNA mutagenesis and recombination.
Most methods for the generation of site-specific mutants and recombinant constructs require primer extension in vitro. These methods include the Kunkel method and PCR-based methods. Such methods to manipulate DNA are prone to sequence error because they take place outside the complex in vivo mechanisms that increase sequence fidelity during plasmid replication in Escherichia coli. Sequence errors are of particular concern when using PCR-based methods. We have constructed two new plasmids that facilitate the generation of site-specific mutants and recombinant constructs. The plasmids we have constructed are designed to maximize the number of unique restriction enzyme recognition sites in inserts that have been cloned into either plasmid. This was accomplished by eliminating extraneous sequence and many restriction enzyme recognition sites. New recombinant circle and recombination PCR protocols for multiplex site-specific plasmid mutagenesis were used to make these plasmids. These plasmids permit small portions of an insert sequence to be readily removed by restriction enzyme digestion. A small DNA segment, containing the targeted sequence alteration, can subsequently be ligated into a plasmid construct that has not been subjected to primer extension in vitro, diminishing the probability of encountering a sequence error and reducing the amount of DNA sequencing necessary to assess for errors.
Recent trends in the identification and treatment of high blood cholesterol by physicians. Progress and missed opportunities.
OBJECTIVE: To investigate recent trends in the percentage and characteristics of patients being treated by a physician for high blood cholesterol (HBC) and to assess missed clinical opportunities to screen for HBC. DESIGN, SETTING, PARTICIPANTS: Telephone interviews of 154,735 adults in 37 states that participated in the Behavioral Risk Factor Surveillance System during 1988-1990 to assess trends in the percentage of patients treated for HBC by a physician. An opportunity was considered missed if a person did not report being screened for HBC despite seeing a physician for preventive care in the last 2 years. RESULTS: Between the first quarter of 1988 and the last quarter of 1990, the percentage of persons treated by a physician for HBC increased from 7.6% to 11.7% (P < .001). However, since an estimated 36% of US adults need treatment for HBC, fewer than one third of persons who need treatment are receiving it. Persons with two or more cardiac risk factors were more likely to be treated, while men, blacks, persons in lower socioeconomic groups, and persons between 20 and 34 years of age were less likely to be treated. Among the 126,571 persons who had seen a physician for preventive care within the last 2 years, missed opportunities to screen for HBC were most common among persons aged 20 through 34 years (59%) and among women who had seen obstetricians/gynecologists for preventive care (43%). CONCLUSIONS: Fewer than one third of persons who need treatment for HBC as estimated by data from the second National Health and Nutrition and Nutrition Examination Survey are receiving treatment. Better use of clinical opportunities to screen for HBC could substantially accelerate the progress in identifying persons, young adults in particular, who are likely to benefit from cholesterol reduction.
Spontaneous compartment syndrome in a patient on long-term anticoagulation.
The case is reported of a 35-year-old lady on long-term anticoagulation with warfarin who developed a spontaneous acute compartment syndrome in the forearm. Despite a delay in diagnosis, an extensive decompression resulted in complete recovery.
Peptide YY ameliorates cerulein-induced pancreatic injury in the rat.
Peptide YY (PYY), a known inhibitor of both pancreatic secretion and the release of cholecystokinin (CCK), may play a role in the pathophysiology of acute pancreatitis (AP). Supramaximal stimulation of the pancreas with CCK, or its analogue cerulein, induces edematous AP. We previously documented significant decreases in plasma PYY in sodium taurocholate-induced AP in the anesthetized pig, with exogenous PYY suppressing plasma amylase activity. We hypothesized that PYY may ameliorate cerulein-induced pancreatic injury in a conscious animal model. Thirty-two male Sprague-Dawley rats underwent chronic cannulation of the jugular vein and carotid artery for drug infusion and blood sampling. The animals were allowed to recover from anesthesia for a minimum of 16 hours, after which they were randomized to one of four (n = 8) treatment groups (cerulein 10 micrograms/kg/h, PYY 400 pmol/kg/h, cerulein+PYY, and control-saline 2 mL/kg/h). All treatments were administered by intravenous infusion over the first 6 hours of the experiment. Blood samples were taken prior to infusion and at 1, 3, 6, 9, and 24 hours into the study; the rats were then killed and the pancreata removed for weighing and histologic examination. All pancreatic specimens were graded in a blinded fashion for vacuolization, edema, inflammation, and necrosis. The mean basal plasma amylase level for all animals was 1,171 +/- 100 U/L and was not significantly different between groups. Infusion of cerulein resulted in significant increases in plasma amylase levels at 3, 6, 9, and 24 hours (4,827 +/- 1,022 U/L at 24 hours). In the group receiving both cerulein and PYY, the hyperamylasemia was attenuated with a return to basal values at 24 hours (1,206 +/- 103 U/L). There was significant pancreatic weight gain (1.99 +/- 0.07 g versus 1.03 +/- 0.07 g) and a worsened histologic picture in cerulein-treated animals compared with control animals (worsened edema, necrosis, and vacuolization). The addition of PYY to cerulein resulted in significantly lower pancreatic weight (1.27 +/- 0.11 g) than in the non-PYY-treated rats receiving cerulein. Pancreatic weight was not significantly different in this group compared with the control group. In addition, pancreatic histologic findings were significantly improved in those rats receiving PYY (decreased vacuolization and necrosis). Amylase levels, pancreatic weight, and morphologic findings were not significantly changed compared with basal values in the control or PYY alone treated groups. e conclude that as an inhibitor of pancreatic exocrine secretion, PYY ameliorates cerulein-induced pancreatic injury in the conscious rat.
Lingual tonsillar hypertrophy causing failed intubation and cerebral anoxia.
Hypertrophy of the lingual tonsils is an unusual condition that may cause complications such as airway obstruction, abscess, sleep apnea, and recurrent epiglottitis. There have been reports of difficult anesthesic intubation in children with enlarged lingual tonsils. We describe a 24-year-old woman whose markedly hypertrophied lingual tonsils prevented intubation after anesthesic relaxation during preparation for appendectomy.