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Biomedical subjects

D Ward

Publications and source records attributed to D Ward.

At least 127 records · Page 7Linked to original sources
PubMed1993

Genomic structure and chromosomal mapping of the human CD22 gene.

The human CD22 gene is expressed specifically in B lymphocytes and likely has an important function in cell-cell interactions. A nearly full length human CD22 cDNA clone was used to isolate genomic clones that span the CD22 gene. The CD22 gene is spread over 22 kb of DNA and is composed of 15 exons. The first exon contains the major transcriptional start sites. The translation initiation codon is located in exon 3, which also encodes a portion of the signal peptide. Exons 4 to 10 encode the seven Ig domains of CD22, exon 11 encodes the transmembrane domain, exons 12 to 15 encode the intracytoplasmic domain of CD22, and exon 15 also contains the 3' untranslated region. A minor form of CD22 mRNA likely results from splicing of exon 5 to exon 8, skipping exons 6 and 7. A 4.6-kb XbaI fragment of the CD22 gene was used to map the chromosomal location of CD22 by fluorescence in situ hybridization. The hybridization locus was identified by combining fluorescent images of the probe with the chromosomal banding pattern generated by an Alu probe. The results demonstrate that CD22 is located within the band region q13.1 of chromosome 19. Two closely clustered major transcription start sites and several minor start sites were mapped by primer extension. Similarly to many other lymphoid-specific genes, the CD22 promoter lacks an obvious TATA box. Approximately 4 kb of DNA 5' of the transcription start sites were sequenced and found to contain multiple Alu elements. Potential binding sites for the transcriptional factors NF-kappa B, AP-1, and Oct-2 are located within 300 bp 5' of the major transcription start sites. A 400-bp fragment (bp -339 through +71) of the CD22 promoter region was subcloned into a pGEM-chloramphenicol acetyltransferase vector and after transfection into B and T cells was found to be active in both B and T cells. Further studies of the CD22 gene should lead to a greater understanding of the expression of CD22 during B cell development and differentiation.

Antigens, CD↗
PubMed1993

Autonomic correlates of late infarct artery patency after first myocardial infarction.

Occlusion of the infarct-related artery has recently been associated with an increased risk of sudden death, particularly in patients with poor left ventricular function. Depressed heart rate variability (HRV) also identifies postinfarction patients at an increased risk of sudden death. The correlation between infarct artery patency, left ventricular function, and HRV was therefore examined in 186 survivors of a first myocardial infarction. Predischarge coronary angiography and Holter monitoring were carried out in 186 patients with a first acute myocardial infarction. Coronary angiography was performed because of abnormal predischarge exercise test findings. Mean age (56 +/- 9 years) and the proportions of type and site of infarction did not differ between patients with occluded or patent arteries or between patients who did or did not undergo coronary angiography. The mean left ventricular ejection fraction (EF) was 55 +/- 15% in patients with patent and 49 +/- 14% in those with occluded infarct arteries (p < 0.001), and the EF was < 40% in 17% and 28% of the respective groups (p < 0.05). HRV was < 20 U in 7 (18%) of the 39 patients with an EF < 40% but in only 7 (5%) of the 147 patients with an EF > 40% (p < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Laryngo-tracheo-oesophageal cleft: a plea for early diagnosis.

Congenital laryngeal clefts are rare. This paper reports on the management of 3 patients with Type 2 laryngo-tracheo-oesophageal cleft. One patient died following tracheopexy after successful cleft closure. Prognosis is related to the presence of other major anomalies, the early diagnosis of the lesion and institution of appropriate respiratory and nutritional care prior to correction of the defect. A greater awareness of the condition combined with aggressive diagnostic endoscopy should result in early diagnosis and improved survival.

Abnormalities, Multiple↗
PubMed1993

Women and the work of caring.

In the U.S., care for chronically dependent people is done mostly by family and friends, with only sporadic community support. Though such unpaid caregiving work--the bulk of it performed by women--constitutes an enormous subsidy to the national welfare, the contribution is undervalued, and the negative practical consequences for caregivers seldom recognized.

Caregivers↗
PubMed1992

The physician and employee judgment system: reliability and validity of a hospital quality measurement method.

Hospitals engaged in quality improvement must measure and assess customer perceptions of hospital services. Hospital customers are either "external"--patients, their families, and payers--or "internal"--physicians and hospital employees. This article describes two measurement systems designed to gather information from internal customers about the quality of hospital services. One system targets physicians, the other hospital employees. This article describes how these systems were developed and pilot-tested, and how the results were analyzed. Analysis of results showed the systems to be reliable, valid, and representative. The article also addresses limitations of the research (focus on general acute-care hospitals), interesting findings and implications (the correlation between physicians' and employees' ratings of hospital quality), and uses of these measures in corporate-level and hospital-level quality improvement (measuring trends and identifying specific opportunities for improvement).

Attitude of Health Personnel↗
PubMed1992

Ventilatory effects of dexmedetomidine, atipamezole, and isoflurane in dogs.

Dexmedetomidine (DMED) is a novel alpha 2 adrenergic agonist that has been shown to have potent analgesic and anesthetic sparing effects. This study was designed to investigate the effects of DMED, both alone and combined with isoflurane, on resting ventilation, the hypercapnic response, and the hypoxic response in dogs. When given alone, 1 microgram/kg decreased resting ventilation by 22% but at larger doses (10, 20, and 100 micrograms/kg) resting ventilation increased, doubling at 100 micrograms/kg. Doses of 10 micrograms/kg and greater caused a maximum depression of 60% in the slope of the hypercapnic response, but no dose had a significant effect on the hypoxic ventilatory response. A dose of 3 micrograms/kg of DMED reduced isoflurane MAC from 1.3% to 0.37%, and the ventilatory effects of this 1 MAC combination were intermediate between the awake values and those of isoflurane-anesthetized (1.3%) dogs. Atipamezole is a specific centrally acting alpha 2 receptor antagonist and when given with DMED in isoflurane-anesthetized dogs prevented the ventilatory depression. However, atipamezole alone also ventilatory stimulating effects, which may indicate tonic alpha 2 adrenergic activity. The ventilatory depression caused by DMED, either alone or combined with isoflurane, at doses that significantly reduce anesthetic requirements are relatively mild.

Adrenergic alpha-Agonists↗