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Biomedical subjects

E Davies

Publications and source records attributed to E Davies.

At least 73 records · Page 4Linked to original sources

Susceptibility to melanoma: influence of skin type and polymorphism in the melanocyte stimulating hormone receptor gene.

Allelic variation at the melanocyte stimulating hormone receptor (MC1R) gene has been linked with sun-sensitive skin types, suggesting it is a susceptibility candidate for melanoma. We determined the frequency of the val92met, asp294his, and asp84glu MC1R alleles in 190 Caucasian controls and 306 melanoma cases and studied their association with skin type and hair color. The percentage of controls with at least one val92met, asp294his, or asp84glu allele was 17.3%, 6.8%, and 3.5%, respectively. Individually, frequencies of the val92met, asp294his, or asp84glu alleles in the controls with skin types 3 and 4 were similar to those with skin types 1 and 2. Trend analysis, however, did identify an association (exact p = 0.048, two-sided test) between skin type and MC1R variants in the group comprising all controls with any one or more of these alleles. There was no association between MC1R alleles and hair color. Allele frequencies were not different in melanoma cases and controls. There were no associations between skin types and the proportion of cases with the asp294his or asp84glu alleles, though the association between skin type and the val92met allele approached significance (exact p = 0.09, two-sided test). Unexpectedly, in the group comprising all cases with one or more variant alleles, the proportion of subjects with variant alleles increased with skin types associated with tanning rather than burning, although trend analysis showed that this association did not quite reach statistical significance (exact p = 0.08, two-sided test). Asp84glu (but not val92met or asp294his) variant alleles were more common in subjects with blonde hair, although the relationship between the asp84glu allele and hair color did not achieve statistical significance (chi(2)3 = 6.16, exact p = 0.10). We interpret the data presented as indicating that polymorphism at MC1R does not appear a major determinant of skin type, at least in terms of these allelic variants. Furthermore, considered alone, these alleles are not susceptibility candidates for malignant melanoma.

Adult↗

Rheumatoid factor isotypes, disease activity and the outcome of rheumatoid arthritis: comparative effects of different antigens.

The value of rheumatoid factor (RF) isotypes for assessing rheumatoid arthritis (RA) remains debatable. We investigated whether using different antigens to measure RF alters the relationships between RF isotypes and clinical variables. The association between IgA and IgM RF, disease activity, and cumulative anatomical joint damage in RA was studied in 140 patients. The RF isotypes were measured using both rabbit IgG and horse IgG as antigens. Cumulative anatomical damage was assessed radiologically using Larsen's score and disease activity was determined by C-reactive protein (CRP), the health assessment questionnaire (HAQ), and a combined disease activity score (DAS). Patients positive for IgA RF and IgM RF against rabbit IgG had significantly higher disease activity and more radiological damage than negative patients. With horse IgG as antigen these differences were smaller or absent. Patients positive for only IgM RF had milder disease than patients positive for IgA RF with or without IgM RF. The clinical relationships of RF isotypes are related to the antigen used. Measuring IgA RF against rabbit IgG provides most information about disease activity, functional impairment and joint damage.

Adult↗

Structure-function relationships of aldosterone synthase and 11 beta-hydroxylase enzymes: implications for human hypertension.

1. The genes encoding aldosterone synthase (CYP11B2) and 11 beta-hydroxylase (CYP11B1) are very similar at the nucleotide level (> 95% homology). Despite this and the corresponding similarity of amino acid sequence, there are considerable differences in functional and substrate specificity of the two enzymes. In the present study we have examined the role of two amino acids that differ between the two enzymes (147 and 248) to determine the difference between aldosterone synthase and 11 beta-hydroxylase capacity to 11-hydroxylate 11-deoxycorticosterone (DOC). 2. Plasmids containing cDNA encoding wild-type aldosterone synthase, wild-type 11 beta-hydroxylase and mutated forms of aldosterone synthase (D147E and I248T), in which the codons for residues 147 (aspartate exon 3) or 248 (isoleucine exon 4) had been altered to encode the corresponding amino acids (glutamate and threonine respectively) from 11 beta-hydroxylase were transiently expressed in non-steroidogenic COS-7 cells. All transfections were cotransfected with bovine adrenodoxin. Cells were then incubated with [3H]-DOC for 48 h and the production of corticosterone (B), 18-hydroxycorticosterone (18-OHB) and aldosterone measured by measuring tritriated products using thin layer chromatography. 3. Compared with wild-type aldosterone synthase, the mutated form (D147E) encoding amino acid 147 from 11 beta-hydroxylase was more efficient in 11 beta-hydroxylation of deoxycorticosterone (B:DOC ratio 0.53 +/- 0.05 (wild type) to 3.05 +/- 0.37 (mutant); P < 0.001). However, 18-hydroxylation of B and conversion of this steroid into aldosterone were unaffected. There was a 20% increase in the production of aldosterone from DOC (P < 0.05). However, in comparison with wild-type 11 beta-hydroxylase, the mutated aldosterone synthase (D147E) was still less efficient (B:DOC ratio 6.2 +/- 0.41). The mutated aldosterone synthase (I248T) encoding amino acid 248 from 11 beta-hydroxylase showed no changes in conversion of DOC to B or in the production of aldosterone. 4. These data demonstrate that position 147 has an important effect on the efficiency of 11 beta-hydroxylation of DOC and indicate that this is a key difference between the two enzymes in determining functional specificity. However, other residues must also contribute to efficiency of 11-hydroxylation of 11 beta-hydroxylase. In contrast, amino acid 248, which is one of the few differences between the two enzymes in exon 4, does not affect enzyme efficiency. As altered activity of aldosterone synthase and 11 beta-hydroxylase has been proposed as an important intermediate phenotype in essential hypertension, such studies will help our understanding of the structure-function relationships that will be necessary in order to understand how genetic changes may contribute to observed differences in phenotype.

18-Hydroxycorticosterone↗

Somatic variation during long-term subculturing of plant cells caused by insertion of a transposable element in a phenylalanine ammonia-lyase (PAL) gene.

We have identified a new En/Spm-like transposable element, Tdc1, in the 5' flanking region of a phenylalanine ammonia-lyase gene (gDcPAL1) that is normally induced by transferring cells of carrot suspension cultures to fresh liquid medium (transfer or dilution effect). The initial integration into gDcPAL1 occurred more than 4 years after culture initiation. Tdc1 was first detected in gDcPAL1 genomic clones of a genomic library made from cells of the same cultured cell line 7 years after its initiation and thus following repeated subculturing. Twelve years after initiation, about 5-10% of the cells had Tdc1 inserted into the gDcPAL1 gene, indicating that Tdc1 insertion into gDcPAL1 occurred in one (or more) cell(s) during the first 4-7 years of subculturing. These mutant cells did not disappear during numerous passages; instead the proportion of cells having this Tdc1 inserted into gDcPAL1 has been increasing over the last 5 years. The promoter activity and the inducibility by transfer/dilution of the gDcPAL1 gene harboring Tdc1 is reduced relative to wild type. Finally, we show that insertion of a transposable element is one of the mechanisms that can cause variation of plant cell cultures during repeated subculture.

Amino Acid Sequence↗

Rapid systemic up-regulation of genes after heat-wounding and electrical stimulation.

When one leaf of a tomato plant is electrically-stimulated or heat-wounded, proteinase inhibitor genes are rapidly up-regulated in distant leaves. The identity of the systemic wound signal(s) is not yet known, but major candidates include hormones transmitted via the phloem or the xylem, the electrically-stimulated self-propagating electrical signal in the phloem (the action potential, AP), or the heat-wound-induced surge in hydraulic pressure in the xylem evoking a local change in membrane potential in adjacent living cells (the variation potential, VP). In order to discriminate between these signals we have adopted two approaches. The first approach involves applying stimuli that evoke known signals and determining whether these signals have similar effects on the "model" transcripts for proteinase inhibitors (pin) and calmodulin (cal). Here we show that a heat wound almost invariably evokes a VP, while an electrical stimulation occasionally evokes an AP, and both of these signals induce accumulation of transcripts encoding proteinase inhibitors. The second approach involves identifying the array of genes turned on by heat-wounding. To this end, we have constructed a subtractive library for heat-wounded tissue, isolated over 800 putatively up-regulated clones, and shown that all but two of the fifty that we have analyzed by Northern hybridization are, indeed, up-regulated. Here we show the early kinetics of up-regulation of three of these transcripts in the terminal (4th) leaf in response to heat-wounding the 3rd leaf, about 5 cm away. Even though these transcripts show somewhat different time courses of induction, with one peaking at 30 min, another at 15 min, and another at 5 min after flaming of a distant leaf, they all exhibit a similar pattern, i.e., a transient period of transcript accumulation preceding a period of transcript decrease, followed by a second period of transcript accumulation.

Action Potentials↗

Analytical performance and clinical utility of a sensitive immunoassay for determination of human cardiac troponin I.

OBJECTIVES: To determine the serum and plasma level of human cardiac troponin I (cTnI) resulting from myocardial damage, we have developed a sensitive and specific one-step enzyme immunoassay to measure cardiac troponin I. DESIGN AND METHODS: The COBAS cTnI assay is a semi-automated one-step solid phase immunoassay compatible with the COBAS Core. The assay is performed in a sandwich type format using a polyclonal goat antibody capture and two highly specific horseradish peroxidase conjugated monoclonal antibody detectors directed against different epitopes of the cTnI molecule. Calibrators were made with purified recombinant cTnI. RESULTS: The level of cTnI was determined in 84 healthy donors with no evidence of myocardial injury, resulting in a lower limit of detection (LLD) of 0.09 microgram/L. The upper reference limit (URL) of the normal reference range was calculated as 0.20 microgram/L. The dynamic range of the consequent EIA was between 0.09 and 6.0 micrograms/L with a total assay time of 45 min. Intra-assay and inter-assay variances (CVs) were < or = 4%. Cross-reactivity with fast and slow skeletal troponin I was absent in concentrations up to 2.0 mg/L. Common interferents yielded negative results in the cTnI assay. Clinical utility was confirmed by measuring the circulating serum or plasma levels of cardiac troponin I in serial samples from marathon runners, clinical samples from trauma patients, and patients presenting to the Emergency Department with complaints of chest pain. Results were further evaluated using clinical diagnosis at discharge and quantified concentrations of other cardiac markers by a Stratus analyzer and ELISA procedures. CONCLUSIONS: Results from normal and clinical samples assayed in house for cTnI concentrations indicate that the Spectral EIA is a highly sensitive means of quantifying cTnI levels in serum and plasma for acute cardiac syndrome. The cardiac specificity of cTnI over other well-known cardiac markers is reflected in experimental results and parallel clinical diagnosis.

Animals↗

Why immunise. Care giver understanding of childhood immunisation.

Currently in Australia, both the National Health and Medical Research Council (NHMRC) and the Public Health Association have stated that our immunisation uptake levels are not of a high enough percentage within the population to prevent outbreaks of childhood vaccine preventable diseases (1996). While the literature discusses factors that are believed to influence care givers' decisions to vaccinate their children, few Australian studies focus on care giver understanding of childhood diseases and vaccination. The purpose of this descriptive study was to profile care givers who presented their children for vaccination at public health clinics regarding their level of understanding of childhood vaccine preventable diseases. Two hundred and forty eight care givers attending one of six public clinics were asked to respond verbally to a researcher administered questionnaire. Demographic information as well as information related specifically to immunisation was collected from each participant. The major findings of this preliminary study indicate a very low level of knowledge among careers presenting their child for vaccination at the public health clinic. Twenty-three percent of carers had no knowledge regarding the vaccinations that their child was receiving and the disease for which the vaccination was administered. In fact, 18 percent of care givers were unsure of the relationship between vaccination and the likelihood of their child contracting an infectious disease. The personal health record was not found to be useful as an educational resource. Although 99 percent of care givers had the booklet in their possession only 8 percent had referred to it as a source of information. The major sources of information were identified as child health nurses (44%) and hospital midwives (34%). The results of this study highlight the disparity in knowledge levels among care givers with regards to vaccination and the diseases they prevent and the important role of the midwife and child health nurse in disseminating information relating to immunisation.

Adolescent↗

Neutrophil superoxide and hydrogen peroxide production in patients with acute liver failure.

Defects in superoxide and hydrogen peroxide production may be implicated in the high incidence of bacterial infections in patients with acute liver failure (ALF). In the present study, oxygen radical production in patients with ALF due to paracetamol overdose was compared with that of healthy volunteers. Neutrophils from 14 ALF patients were stimulated via the complement receptors using zymosan opsonized with ALF or control serum. Superoxide and hydrogen peroxide production by ALF neutrophils stimulated with zymosan opsonized with ALF serum was significantly reduced compared with the control subjects (P < 0.01). This defect persisted when zymosan opsonized by control serum was used (P < 0.05). Superoxide and hydrogen peroxide production in neutrophils stimulated with formyl-methionyl-leucyl-phenylalanine (fMLP) from a further 18 ALF patients was unaffected compared with control neutrophils. Serum C3 complement levels were significantly reduced in ALF patients compared with control subjects (P < 0.0005). These results demonstrate a neutrophil defect in ALF due to paracetamol overdose, that is complement dependent but independent of serum complement, possibly connected to the complement receptor.

Acetaminophen↗

Good practice in the management of adults with malignant cerebral glioma: clinical guidelines. Working Group, Royal College of Physicians.

This paper proposes guidelines for good practice in the management of adults with malignant cerebral glioma. These guidelines were developed by a working group comprising representatives of the medical specialties involved in patient care, specialist nursing staff, purchasers, charitable bodies, and patient and relative representatives. Both the research literature on the effectiveness of medical intervention, and the views of patients and relatives about the care they had received were considered. The document proposes a consensus view about ways to improve patient care and considers several stages of the illness and its care: I, the diagnostic phase; II, deciding on an appropriate treatment plan; III, the organization of follow-up services; IV, the management of transitions from hospital to community settings; and V, purchasing care for patients with malignant brain tumours. An audit package derived from the guidelines is available which will enable staff within a treatment centre to compare their practice against these standards. A final section suggests topics which require further research, and sets out the core requirements for studies that will help answer questions about treatment and the benefits for patients in terms of improved quality of life.

Adult↗

Somatic mutations of the angiotensin II (AT1) receptor gene are not present in aldosterone-producing adenoma.

Angiotensin II stimulates aldosterone secretion from the adrenal zona glomerulosa and mediates most of its biological effects via G protein-coupled type 1 angiotensin II receptors (AT1). A number of G protein-coupled receptors are constitutively activated as a result of somatic mutations in the gene encoding the protein. It is, therefore, possible that primary hyperaldosteronism caused by an aldosterone-producing adenoma (APA) may be the result of constitutive activation of the AT1 receptor. The 1.1-kilobase coding region (exon 5) of the AT1 receptor gene was analyzed in APA and normal adrenal tissue for the presence of mutations using single stranded conformational polymorphism and sequencing techniques. In 17 APAs, no functional mutations were found that could account for the observed pathophysiology. However, three silent polymorphisms were detected in regions encoding the second extracellular loop, the intracellular arm preceding the COOH terminal, and the 3'-untranslated region. In conclusion, somatic mutations in the coding region of the AT1 receptor gene do not appear to play a role in primary hyperaldosteronism caused by an APA.

Adenoma↗

Clinical significance of IgA rheumatoid factor subclasses in rheumatoid arthritis.

OBJECTIVE: IgA rheumatoid factor (RF) is associated with greater disease activity and radiological progression in rheumatoid arthritis (RA). We examined whether measuring IgA RF subclasses gives additional clinically relevant information. METHODS: Total IgA RF plus IgA1 RF and IgA2 RF subclasses were estimated by ELISA using rabbit IgG as antigen in 144 patients with established RA. Disease activity was assessed by Disease Activity Score and Health Assessment Questionnaire; the acute phase response was assessed by C-reactive protein levels and joint damage by the Larsen score. RESULTS: Fifty percent of patients had elevated total IgA RF, 60% elevated IgA1 RF, and 50% elevated IgA2 RF. There were significant correlations between total IgA RF and both IgA RF subclasses (p < 0.0001). Measures of disease activity, the acute phase response, and joint damage were all significantly higher (p < 0.001 in each case) in patients with elevated total IgA RF and both IgA RF subclasses compared with RF negative cases. Disease duration influenced the relationship of IgA RF subclasses to joint damage. The Larsen score was only significantly higher in late disease (duration 5 years or more) in both IgA1 RF and IgA2 RF positive patients. CONCLUSION: We found IgA RF positive patients have more aggressive RA than negative cases. Measuring IgA1 RF and IgA2 RF subclasses did not give more information about clinical status than measuring total IgA RF alone.

Aged↗

Malignant cerebral glioma--I: Survival, disability, and morbidity after radiotherapy.

OBJECTIVE: To describe survival, disability, and morbidity after radiotherapy for malignant glioma. DESIGN: Two year prospective study with home interviews with patients and relatives. SETTING: Seven neurosurgical and radiotherapy centres in London. SUBJECTS: 105 patients aged 21 to 75: 59 had biopsy; 46 had partial macroscopic resection; 92 received radiotherapy; and 13 received steroids alone. MAIN OUTCOME MEASURES: Survival, time free from disability, and changes in disability after treatment. RESULTS: Six and 12 month survival for radiotherapy patients was 70% and 39%, respectively. Age, World Health Organisation clinical performance status, extent of surgery, and history of seizures before diagnosis each influenced survival. The Medical Research Council prognostic index was also significantly related to survival. Multivariate analysis showed that initial clinical performance status was the most important component of the index. Most (80%; 49/61) patients with a clinical performance status of 0, 1, or 2 lived at least six months before becoming permanently disabled. Most patients who had initially had a good clinical performance status (0-2) and who were alive six months after radiotherapy (68%; 36/52), however, had experienced either clinical deterioration or severe tiredness after treatment. In 17% (9/52) of these some permanent loss of function remained. These adverse effects were associated with increasing radiotherapy dose. Severely disabled patients (clinical performance status 3 or 4) gained little benefit. CONCLUSION: Severely disabled patients gain little physical benefit from radiotherapy, whereas those not so disabled may experience considerable adverse effects.

Activities of Daily Living↗

Malignant cerebral glioma--II: Perspectives of patients and relatives on the value of radiotherapy.

OBJECTIVE: To explore the experiences of patients and relatives after the diagnosis and treatment of malignant cerebral glioma. DESIGN: Two year prospective study with home interviews. SETTING: Six neurosurgery and radiotherapy centres in London. SUBJECTS: 75 patients and 66 close relatives interviewed at diagnosis, 58 patients interviewed after radiotherapy, and 27 interviewed after recurrence. MAIN OUTCOME MEASURES: Awareness of likely prognosis, distress, dissatisfaction with radiotherapy, and perception of severe problems in everyday life. RESULTS: As they began radiotherapy most patients understood that they suffered from a brain tumour (95%; 71/75), but only one quarter (19/75) seemed fully aware of the poor prognosis. Others were unaware (43%; 32/75) or only partly aware (32%; 24/75). The more aware patients were more distressed. Relatives were three times more likely to be aware of the prognosis (67%; 44/66) and were more distressed. Although 39% (29/75) of patients initially made negative comments about radiotherapy, only 17% (13/75) were completely dissatisfied. The decision to accept radiotherapy could be discussed directly with 19 fully aware patients. Twelve found radiotherapy acceptable if it were medically advised or if it improved survival. Assessed by their own reports of problems only 40% of patients achieved a period of stability or remission, yet dissatisfaction with treatment did not increase. CONCLUSIONS: Most patients with malignant glioma initially seemed unaware or only partly aware of the poor prognosis. Relatives were more aware, more distressed, and often concerned to protect patients from full awareness, which made it difficult to explore with patients directly the possible trade off between quality and length of life. Conceptualising the question as a rational choice ignores the social and emotional context of life threatening disease.

Activities of Daily Living↗

Both action potentials and variation potentials induce proteinase inhibitor gene expression in tomato.

Tomato plants (Lycopersicon esculentum) accumulate proteinase inhibitor 2 (pin2) mRNA in response to insect attack, crushing and flaming in leaves distant from those treated. Most earlier work suggests that the systemic wound signals are chemical; here we try to determine whether electrical or physical (hydraulic) signals can also evoke pin expression. We used a mild flame to evoke a systemic hydraulic signal and its local electrical aftermath, the variation potential (VP), and we used an electric stimulus to evoke a systemic electrical signal, the action potential (AP). We determined the kinetic parameters of both the VP and AP. Flame-wounded plants essentially always exhibited major electrical responses throughout the plant and a several-fold increase in pin2 mRNA within 1 h. Electrically stimulated plants that generated and transmitted a signal (AP) into the analyzed leaf exhibited similarly large, rapid increases in pin2 mRNA levels. Plants which generated no signal, or signals of just a few microvolts, had unchanged levels of pin2 mRNA. Since the AP and VP both arrived in the receiving leaf before accumulation of pin2 mRNA began, we conclude that, in addition to the previously shown chemical signals, both hydraulically induced VPs and electrically induced APs are capable of evoking pin2 gene expression.

Action Potentials↗

Hybridization and detection of digoxigenin probes on RNA blots.

This article describes nonradioactive probing of a Northern blot. The method employs digoxigenin-labeled probes. Antidigoxigenin antibody/alkaline phosphate conjugate, and a chemiluminescent substrate are subsequently used in the detection system.

Blotting, Northern↗

Thoracoscopic obliteration of the left atrial appendage: potential for stroke reduction?

BACKGROUND: In a review of all relevant articles describing the site of left atrial thrombus in patients with atrial fibrillation, the thrombus was localized to the left atrial appendage in 43% of patients with rheumatic heart disease and in 91% of patients with nonrheumatic atrial fibrillation. This study was designed to test the feasibility of thoracoscopic obliteration of the left atrial appendage as a means of reducing thromboembolic stroke. METHODS: Thoracoscopic obliteration of the left atrial appendage was undertaken in 10 dogs, 5 with staples and 5 with an endoloop. Obliteration also was attempted in 8 fresh human cadavers. RESULTS: In all dogs, the appendage was rapidly obliterated (21.3 +/- 7.6 minutes) and confirmed at euthanasia at 11 weeks. In 3 cadavers, anatomic and disease factors prevented visualization of the left atrial appendage; in 1 the appendage tore, and in the remainder the appendage was obliterated. CONCLUSIONS: Obliteration of the left atrial appendage is feasible and may be considered as an additional surgical procedure to reduce stroke. The group of patients in whom it offers the greatest potential are those with atrial fibrillation deemed ineligible for warfarin, those without atrial thrombus and with a free pericardial and pleural space.

Animals↗