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Biomedical subjects

D W Gray

Publications and source records attributed to D W Gray.

136 records · Page 8Linked to original sources

What do family physicians see in practice?

Health care problems dealt with in their practices were recorded by seven family physicians over a period of 1 year (two others recorded for 3 months), each diagnosis being coded according to the Canuck Disease Classification Index. Problems were classified into four types: physical, psychosocial, diseases of choice (or lifestyle) and diseases of social impact. More than 85% of the 23 108 problems recorded were physical in origin and had physical manifestations. More time was spent on routine checkups and treatment of respiratory disease than on any other activity. Venereal disease and alcoholism were infrequent problems. The family physician is in a favourable position to act as health educator and counsellor and must be throughly trained in the physical aspects of disease.

British Columbia↗

Type 1 diabetes: the facts fit a deficient inhibitory signal given by MHC class II.

This paper presents a hypothesis regarding the aetiology of Type 1 (autoimmune) diabetes, which suggests that autoimmunity is normally prevented by an inhibitory or negative signal delivered by MHC molecules, and that in Type 1 diabetes it is the inability of beta cells to deliver sufficient negative signal from MHC Class II that drives the underlying autoimmune process. Based on a broad survey of the diabetes literature, a list of clinical, pathological, experimental and epidemiological 'facts' about Type 1 diabetes is presented which are considered to be widely accepted as proven. The new theory is then compared to other recent theories on the aetiology of diabetes with regard to its ability to explain these accepted 'facts'.

Animals↗

Islet isolation assessment in man and large animals.

Recent progress in islet isolation from the pancreas of large mammals including man, accentuated the need for the development of precise and reproducible techniques to assess islet yield. In this report both quantitative and qualitative criteria for islet isolation assessment were discussed, the main topics being the determination of number, volume, purity, morphologic integrity and in vitro and in vivo function tests of the final islet preparations. It has been recommended that dithizone should be used as a specific stain for immediate detection of islet tissue making it possible to estimate both the total number of islets (dividing them into classes of 50 mu diameter range increments) and the purity of the final preparation. Appropriate morphological assessment should include confirmation of islet identification, assessment of the morphological integrity and of the purity of the islet preparation. The use of fluorometric inclusion and exclusion dyes together have been suggested as a viability assay to simultaneously quantitate the proportion of cells that are intact or damaged. Perifusion of islets with glucose provides a dynamic profile of glucose-mediated insulin release and of the ability of the cells to down regulate insulin secretion after the glycemic challenge is interrupted. Although perifusion data provides a useful guide to islet viability the quantity and kinetics of insulin release do not necessarily predict islet performance after implantation. Therefore, the ultimate test of islet viability is their function after transplantation into a diabetic recipient. For this reason, in vivo models of transplantation of an aliquot of the final islet preparation into diabetic nude (athymic) rodents have been suggested. We hope that these general guidelines will be of assistance to standardize the assessment of islet isolations, making it possible to better interpret and compare procedures from different centers.

Animals↗

Successful reversal of diabetes by single donor isologous islet transplantation in a mouse model.

A method for isolating mouse islets which consistently gives a high yield with good purity is described. Using a bovine serum albumin gradient, the mean yield of islets per pancreas is 425 (SEM +/- 15) with a consistent purity of over 90%. Single donor to single recipient of islets transplanted under the renal capsule restores normoglycemia in the diabetic recipients within 2 to 5 days of transplantation.

Animals↗