Search PubMed⌕ Search

Biomedical subjects

D Wray

Publications and source records attributed to D Wray.

106 records · Page 6Linked to original sources
PubMed1980

Coeliac disease associated with recurrent aphthae.

Fifty patients presenting sequentially with a history of recurrent aphthae were investigated for evidence of nutritional deficiencies and coeliac disease. In the group, two patients were found to have coeliac disease and their recurrent aphthae cleared soon after starting a gluten free diet. This study confirms the presence of an increased prevalence of nutritional deficiency and of coeliac disease in aphthous patients. However, it is recommended that jejunal biopsy be carried out in these cases only where there is evidence of malabsorption.

Adolescent↗
PubMed1978

Nutritional deficiencies in recurrent aphthae.

A series of 330 patients with recurrent aphthae was screened for deficiencies of iron, folate and vitamin B12. In 47 patients (14.2%) such deficiencies were found; 23 were deficient in iron, seven in folic acid, six in vitamin B12 and in addition 11 patients had combined deficiencies. Clinical examination of the aphthae was not helpful in identifying individual patients with a nutritional deficiency although patients with an associated glossitis or angular cheilitis were more likely to suffer from such deficiencies. Screening of the patients by examination of their peripheral blood alone (estimation of haemoglobin and absolute values, and blood film examination) detected only a proportion of those with deficiencies of iron or folic acid, although in this series such screening was able to identify the small number of cases with vitamin B12 deficiency. The 33 patients with a proven nutritional deficiency who were available for follow-up showed a favourable response to corrective therapy; 23 showed a complete remission of ulcers, 11 were improved and five were not helped. The significance of these findings is discussed. It is suggested that the results indicate the need for full haematological screening of all patients with recurrent aphthae.

Adolescent↗
PubMed1975

Recurrent aphthae: treatment with vitamin B12, folic acid, and iron.

A series of 130 consecutive outpatients with recurrent aphthous stomatitis were screened at the oral medicine department, Glasgow Dental Hospital, for deficienciesin vitamin b12, folic acid, and iron. In 23 patients (17.7%) such deficiencies werefound; five were deficient in vitamin B12, seven in folic acid, and 15 in iron. Four had more than one deficiency. Out of 130 controls matched for age and sex 11 (8.5%) were found to have deficiencies. The 23 deficient patients with recurrent aphthaewere treated with specific replacement therapy, and all 130 patients were followed up for at least one year. Of the 23 patients on replacement therapy 15 showed complete remission of ulceration and eight definite improvement. Of the 107 patientswith no deficiency receiving local symptomatic treatment only 33 had a remission or wereimproved. This difference was significant (P less than 0.001). Most patients withproved vitamin B12 or folic acid deficiency improved rapidly on replacement therapy;those with iron deficiency showed a less dramatic response. The 23 deficient patientswere further investigated to determine the cause of their deficiencies and detect the presence of any associated conditions. Four were found to have Addisonian perniciousanaemia. Seven had a malabsorption syndrome, which in five proved to be a gluten-induced enteropathy. In addition, there were single patients with idiopathic proctocolitis, diverticular disease of the colon, regional enterocolitis, and adenocarcinoma of thecaecum. We suggest that the high incidence of deficiencies found in this series andthe good response to replacement therapy shows the need for haematological screening of such patients.

Adenocarcinoma↗
PubMedDate not supplied

Congenital myasthenia: further evidence of disease heterogeneity.

The findings in two cases of congenital myasthenia investigated by intercostal muscle biopsy are presented. The first case, a 16-year-old boy, showed reduced miniature endplate potential amplitude and normal 125I-alpha-bungarotoxin binding to postsynaptic acetylcholine receptors. Muscle biopsy and endplate ultrastructure were normal. Tubocurarine affinity, ion channel properties, and passive membrane properties were normal. Limited data showed reduced effectiveness of applied acetylcholine in opening ion channels. The second case was an 18-year-old girl with consanguineous parents. Type 2 muscle fiber atrophy was seen in both limb and intercostal muscle. Intercostal endplates were elongated, although ultrastructure was normal. Negligible postsynaptic alpha-bungarotoxin binding suggested an abnormality of the acetylcholine receptor macromolecule.

Adenosine Triphosphatases↗
PubMedDate not supplied

Measurement of the movement of the S4 segment during the activation of a voltage-gated potassium channel.

Voltage-gated ion channels contain a positively charged transmembrane segment termed S4. Recent evidence suggests that depolarisation of the membrane potential causes this segment to undergo conformational changes that, in turn, lead to the opening of the channel pore. In order to define these conformational changes in structural terms, we have introduced single cysteine substitutions into the S4 segment of the prototypical Shaker K+ channel at various positions and expressed the mutants in Xenopus oocytes. The cells were depolarised to induce K+ currents and the effect of application of 100 microM parachloromercuribenzenesulphonate (PCMBS) on these currents was examined by the two-electrode voltage-clamp technique. PCMBS inhibited K+ currents elicited by mutants L358C, L361C, V363C and L366C, but not those by V367C and S376C. Since PCMBS is a membrane-impermeable cysteine-modifying reagent, the data suggest that depolarisation must have caused the S4 segment to move out of the lipid bilayer into the extracellular phase rendering the residues at positions 358, 361, 363 and 366 susceptible to PCMBS attack. The lack of effect of PCMBS on V367C suggests that the exposure of S4 terminates at L366. Detailed analysis of L361C mutant revealed that the S4 movement can occur even below the resting potential of the cell, at which potential voltage-gated K+ channels are normally in a non-conducting closed state.

4-Chloromercuribenzenesulfonate↗
PubMedDate not supplied

NHS Direct: examining the challenges for nursing practice.

This article examines the impact of the launch of NHS Direct which was part of the Government's vision for a modern and dependable NHS. In particular, the challenges for nursing practice are detailed within a healthcare strategy which seeks to provide fast access primary health care to the whole population. The strengths and weaknesses of NHS Direct are discussed and its interface with other agencies explored. As NHS Direct will cover the whole of England by October 2000, the evidence to underpin its effectiveness must be considered in the light of media criticisms which indicate that the quality of advice given to callers is sometimes less than optimum.

Critical Pathways↗
PubMedDate not supplied

NHS Direct: issues for education, management and research.

The NHS Plan (Department of Health (DoH), 2000) specifically highlights the role of NHS Direct in its vision of a health service designed around the patient. Despite this, the new nurse-led service has come under critical attack. NHS Direct is in the process of developing an evidence base to underpin its practice. It is recognized that telephone management skills are important clinical skills and while decision support computer software can help elicit an appropriate client history, the interpersonal skills necessary to establish a professional telephone relationship are commensurate with the suitability of the appropriate education programme. This article will explore the ramifications of NHS Direct for curriculum development and evaluation. Factors such as skill mix, career pathways, recruitment and research and development will also be discussed. In a previous article the implications of NHS Direct for practice were examined (Glasper et al, 2000).

Education, Nursing↗
PubMedDate not supplied

A method for determining transmembrane protein structure.

A simple and rapid protein chemical approach for determining the transmembrane structure of membrane proteins is described. The method involves single substitutions of consecutive amino acid residues, within putative transmembrane segments, to cysteine. This is followed by the analysis of their susceptibility to modification by maleimides with different physico-chemical properties. Fluorescein-5-maleimide (FM), being hydrophilic, modified only residues located in the aqueous environment, while the hydrophobic reagent, benzophenone-4-maleimide (BM) modified residues exposed to the lipid phase. These probes are large enough to cause an increase in the molecular weight of relatively small membrane proteins or polypeptide fragments, which is detectable by SDS-PAGE. Modification by much smaller probes, such as N-ethylmaleimide (NEM), could also be monitored indirectly by the ability to prevent SDS-solubilized protein from being modified with fluorescein-5-maleimide. The approach is demonstrated with the proteolipid complex of the vacuolar H(+)-ATPase expressed in yeast and with the putative Isk K(+)-channel expressed and radiolabelled in E. coli. The advantages of this approach are: (1)it is rapid, easy and inexpensive, (2) detection of the modification of engineered cysteines is simple, (3) it requires only minute quantities of the protein, (4) the protein does not require purification, (5) a broad range of maleimides with different physico-chemical properties can be used, (6) the structure can be investigated under native conditions and does not require protein reconstitution into artificial bilayers.

Amino Acid Sequence↗