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Biomedical subjects

G Morgan

Publications and source records attributed to G Morgan.

At least 55 records · Page 3Linked to original sources

Yeast nuclear pore complex assembly defects determined by nuclear envelope reconstruction.

Assembly of nuclear pore complexes (NPCs) is a critical yet poorly understood cellular function. One approach to studying NPC assembly is to identify yeast mutants defective in this process. This requires robust assays for NPC assembly that can be used for phenotypic analysis. We have previously reconstructed yeast nuclei from electron micrographs of serially sectioned cells to precisely determine the number of NPCs (Winey et al., 1997). Here we report the analysis of strains mutant in either of two nucleoporin-encoding genes, NIC96 (Zabel et al., 1996) and NUP192 (Kosova et al., 1999). Using conditional alleles of either gene, we have found that the NPC number falls significantly following shift to the restrictive temperature. We conclude that the drop in NPC number results from the failure to assemble new NPCs during cell divisions, leading to the dilution of NPCs that existed when the cells were shifted to the restrictive temperature. We are also able to document a subtle defect in NPC numbers in nup192-15 cells at their permissive temperature. The data presented here quantitatively demonstrate that NPC numbers fall in nic96-1 and nup192-15 strains upon shifting to the restrictive temperature, indicating that these gene products are required for NPC assembly.

Fungal Proteins↗

Isolated cutaneous response to granulocyte-monocyte colony stimulating factor in fatal idiopathic disseminated Bacillus-Calmette-Guerin infection.

UNLABELLED: Severe disseminated Bacillus-Calmette-Guerin (BCG) infection is very rare and has been regarded as idiopathic when no immunodeficiency is present. This entity seems to be due to several new types of inherited abnormalities in the pathways important in defence against Mycobacteria. Although improvement with interferon-gamma (IFN-gamma) has been reported in some patients, to our knowledge there are no reports on the effect of other cytokines in the treatment of these patients. We report here the clinical response to IFN-gamma and granulocyte-monocyte colony stimulating factor (GM-CSF) treatment in a patient with idiopathic disseminated BCG infection who failed to respond to multiple antimycobacterial agents. The patient showed partial and transitory response to IFN-gamma, however, GM-CSF treatment led to rapid improvement of skin lesions within 2 weeks without any effect on the progression of the disease in the other organ systems. CONCLUSION: The response of idiopathic disseminated Bacillus-Calmette-Guerin infection to granulocyte-monocyte colony stimulating factor treatment was limited to cutaneous lesions. Granulocyte-monocyte colony stimulating factor may have acted to promote wound healing or the levels of this factor achieved in other affected organs may have been inadequate.

BCG Vaccine↗

Three-dimensional dose distribution of tangential breast irradiation: results of a multicentre phantom dosimetry study.

BACKGROUND AND PURPOSE: One aspect of good radiotherapeutic practice is to achieve dose homogeneity. Dose inhomogeneities occur with breast tangent irradiation, particularly in women with large breasts. MATERIALS AND METHODS: Ten Australian radiation oncology centres agreed to participate in this multicentre phantom dosimetry study. An Alderson radiation therapy anthropomorphic phantom with attachable breasts of two different cup sizes (B and DD) was used. The entire phantom was capable of having thermoluminescent dosimeters (TLD) material inserted at various locations. Nine TLD positions were distributed throughout the left breast phantom including the superior and inferior planes. The ten centres were asked to simulate, plan and treat (with a prescription of 100 cGy) the breast phantoms according to their standard practice. Point doses from resultant computer plans were calculated for each TLD position. Measured and calculated (planning computer) doses were compared. RESULTS: The dose planning predictability between departments did not appear to be significantly different for both the small and large breast phantoms. The median dose deviation (calculated dose minus measured dose) for all centres ranged from 2. 3 to 5.3 cGy on the central axis and from 2.1 to 7.5 cGy for the off-axis planes. The highest absolute dose was measured in the inferior plane of the large breast (128.7 cGy). The greatest dose inhomogeneity occurred in the small breast phantom volume (median range 93.2-105 cGy) compared with the large breast phantom volume (median range, 100.1-107.7 cGy). There was considerable variation in the use (or not) of wedges to obtain optimized dosimetry. No department used 3D compensators. CONCLUSION: The results highlight areas of potential improvement in the delivery of breast tangent radiotherapy. Despite reasonable dose predictability, the greatest dose deviation and highest measured doses occurred in the inferior aspects of both the small and large breast phantoms.

Breast Neoplasms↗

Childhood chronic inflammatory demyelinating polyneuropathy: clinical course and long-term outcome.

We reviewed the clinical history, electrophysiologic and pathologic findings, and response to therapy of 16 children with chronic inflammatory demyelinating polyneuropathy. The majority presented with lower limb weakness. Sensory loss was uncommon. The illness was monophasic in seven children, relapsing in six, and three had a slowly progressive course. All patients were treated with immunosuppressive agents. In 11, the initial treatment was prednisolone. All had at least a short-term response but five went on to develop a relapsing course. Intravenous immunoglobulin was the initial treatment in four patients. Three responded rapidly, with treatment being stopped after a maximum of 5 months. In resistant chronic inflammatory demyelinating neuropathy, in addition to prednisolone and immunoglobulin, plasma exchange, azathioprine, cyclosporine, methotrexate, cyclophosphamide and pulse methylprednisolone were tried at different times in different patients. On serial neurophysiologic testing slowing of nerve conduction persisted for long periods after clinical recovery. Follow-up was for an average of 10 years. When last seen 14 patients were asymptomatic, two having mild residual deficits. Childhood chronic inflammatory demyelinating neuropathy responds to conventional treatment and generally has a favourable long-term outcome.

Adolescent↗

The cancer-preventive potential of Panax ginseng: a review of human and experimental evidence.

OBJECTIVE: We have reviewed the potential cancer-preventive and other relevant properties of Panax ginseng C. A. Meyer, which has been traditionally used as a natural tonic in Oriental countries. DATA IDENTIFICATION AND STUDY SELECTION: Publications on Panax ginseng and its relation to cancer were obtained from the Medline database (1983-1998) and by checking reference lists to find earlier reports. The reports cover experimental models and human studies on cancer-preventive activity, carcinogenicity and other beneficial or adverse effects. In addition, possible mechanisms of chemoprevention by ginseng were considered. RESULTS: Published results from a cohort and two case-control studies in Korea suggest that the intake of ginseng may reduce the risk of several types of cancer. When ginseng was tested in animal models, a reduction in cancer incidence and multiplicity at various sites was noted. Panax ginseng and its chemical constituents have been tested for their inhibiting effect on putative carcinogenesis mechanisms (e.g., cell proliferation and apoptosis, immunosurveillance, angiogenesis); in most experiments inhibitory effects were found. CONCLUSION: While Panax ginseng C. A. Meyer has shown cancer-preventive effects both in experimental models and in epidemiological studies, the evidence is currently not conclusive as to its cancer-preventive activity in humans. The available evidence warrants further research into the possible role of ginseng in the prevention of human cancer and carcinogenesis.

Animals↗

Autologous stem cell transplantation for malignancy: a systematic review of the literature.

A systematic review of the literature was undertaken to assess what published evidence is currently available to support the increasing use of autologous stem cell transplantation (ASCT), and to evaluate the published data with regard to the comparative cost of high-dose and conventional therapy. The review aimed to identify all published, randomized controlled trials (RCTs) comparing high-dose therapy (HDT) with ASCT versus conventional chemotherapy (CC) in acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin's disease, multiple myeloma, and breast, lung, testicular and ovarian cancer. The review also aimed to identify all studies that had compared the cost of the two treatment strategies. Reports were identified by systematic searches of Cancerlit, Embase and Medline, and handsearching of several conference proceedings. Where possible, pooled odds ratios (ORs) were calculated according to the fixed-effect model. A total of 18 randomized trials were identified in acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin's disease, multiple myeloma, and breast, lung and testicular cancer. Trials were generally small and no disease site had sufficient information to determine reliably whether high-dose therapy with autologous transplant is more effective than CC. Five studies were identified that compared the cost of the two treatments. These found the cost of HDT to be between one and four times higher than that of CC. Further randomized trials are required. Where appropriate, these should include economic assessment and assessments of long-term toxicity.

Antineoplastic Agents↗

Liver from bone marrow in humans.

It has been shown in animal models that hepatocytes and cholangiocytes can derive from bone marrow cells. We have investigated whether such a process occurs in humans. Archival autopsy and biopsy liver specimens were obtained from 2 female recipients of therapeutic bone marrow transplantations with male donors and from 4 male recipients of orthotopic liver transplantations from female donors. Immunohistochemical staining with monoclonal antibody CAM5.2, specific for cytokeratins 8, 18, and 19, gave typical strong staining of hepatocytes, cholangiocytes, and ductular reactions in all tissues, to the exclusion of all nonepithelial cells. Slides were systematically photographed and then restained by fluorescence in situ hybridization (FISH) for X and Y chromosomes. Using morphologic criteria, field-by-field comparison of the fluorescent images with the prior photomicrographs, and persistence of the diaminiobenzidene (DAB) stain through the FISH protease digestion, Y-positive hepatocytes and cholangiocytes could be identified in male control liver tissue and in all study specimens. Cell counts were adjusted based on the number of Y-positive cells in the male control liver to correct for partial sampling of nuclei in the 3-micron thin tissue sections. Adjusted Y-positive hepatocyte and cholangiocyte engraftment ranged from 4% to 43% and from 4% to 38%, respectively, in study specimens, with the peak values being found in a case of fibrosing cholestatic recurrent hepatitis C in one of the liver transplant recipients. We therefore show that in humans, hepatocytes and cholangiocytes can be derived from extrahepatic circulating stem cells, probably of bone marrow origin, and such "transdifferentiation can replenish large numbers of hepatic parenchymal cells.

Adult↗

Tuberculosis of the central nervous system in children: a 20-year survey.

OBJECTIVE: To review our experience of central nervous system (CNS) tuberculosis at a major British paediatric tertiary referral centre, following the introduction of CT Scan facilities. METHODS: This was a retrospective case survey (prospective in nine patients) of patients admitted to Great Ormond Street over a 20-year period (1977-1997), who fulfilled criteria for a diagnosis of CNS tuberculosis. Data were collected with regard to the clinical, laboratory and demographic characteristics of patients, as well as results of radiological investigations and data on clinical outcome. RESULTS: We identified 38 children with CNS tuberculosis: 23 with tuberculous meningitis (TBM), 10 with tuberculous meningitis and associated tuberculomas and five with tuberculomas alone. The mean age of this group was 3.7 years, ranging from 8 months to 16 years. Only 14 (37%) were of Caucasian origin. A contact source was identified in 18 patients (47%). Previous BCG had only been given to six (16%). The main clinical symptoms and signs present on admission were alteration in consciousness in 30 patients (79%), focal neurological signs in 25 (66%) and fever in 25 (66%). Seizures were observed in 20 patients (53%) and meningism in 18 (47%). Mycobacterium tuberculosis was either cultured or identified by acid-fast stain from CSF or brain tissue from 24 patients (63%). The Mantoux reaction was positive in 17/33 (51%); abnormalities of the chest X-ray were found in 15 (40%). Cranial CT scans of the patients presenting with TBM showed hydrocephalus in 31 patients (94%), and basilar enhancement in 27 (93%) out of the 29 patients who received intravenous contrast. Anti-tuberculous therapy administered varied according to current recommendations of the period; concurrent steroids were given to 31 patients (82%). Neurosurgical procedures were required in the majority of patients with TBM, 25 (76%). In five patients with TBM, new tuberculoma developed during treatment. The overall mortality for our group of patients was 13%, whilst permanent neurological sequelae were seen in 47% of the patients. None of the patients who received BCG either died or had severe sequelae. Mortality and morbidity rates were higher in the first 10 years of the study and amongst those patients admitted in Stage III disease. CONCLUSIONS: CNS tuberculosis continues to be a condition which carries significant morbidity and mortality. Early diagnosis and prompt initiation of treatment are essential to improve the poor outcome.

Adolescent↗

Separate sites and mechanisms for placental transport of calcium, iron and glucose in the equine placenta.

The placenta is the only channel for transport of nutrients to the conceptus and the fetal nutrient demands increase exponentially to term. The 9 kDa calcium binding protein (calbindin, 9CBP) and the iron binding protein uteroferrin (UF) are proving to be reliable markers for epithelia that mediate active transcellular calcium and iron transport and the glucose transporter proteins (GT1 and GT3) for glucose transport by facilitated diffusion. Light and electron microscope immunocytochemistry have been used on perfusion fixed resin embedded material to establish the distribution of 9CBP, UF, GT1 and GT3 in the equine placenta from 100 days of pregnancy to term (336 days). The equine placenta has two main structural components, flat areolae and microcotyledons. From 100 days of pregnancy to term immunoreactive 9CBP is found only in the cytoplasm of the maternal glands and the areolar trophoblast cells with none in the microcotyledons; whereas GT1 is present exclusively in the microcotyledons on the basolateral plasmalemma of both trophoblast and uterine epithelia with GT3 on the apical microvilli. The glands show neither GT1 nor GT3 expression. The areas of both areolae and microcotyledons increase enormously during gestation but there is no indication of increasing amounts of 9CBP, GT1 or GT3 protein per cell. Glucose transport through the placental cell cytoplasm is by diffusion of the free molecule, but calcium ions in transit must be sequestered in some way since the high calcium fluxes needed to support fetal bone growth in later pregnancy would be deleterious to calcium based homeostasis and cellular control systems. Electron microscope immunocytochemistry shows that 9CBP is uniformly distributed in the cytoplasm and nucleoplasm of the areolar trophoblast cells but excluded from all membrane bounded compartments such as mitochondria, Golgi saccules and pinocytotic transport vesicles. Such apical transport vesicles can be identified immunocytochemically by their content of uteroferrin, a component of the secretion from the uterine glands. It is suggested that transcellular calcium transport is therefore based on facilitated diffusion, not the vesicular method followed by the iron in the UF molecules, with 9CBP providing both transfer and sequestration functions for the transient calcium ions. These results show that the equine placenta has transport systems with restricted regional distribution similar to those recently shown for the ruminant placenta.

Acid Phosphatase↗

In vitro effects of Ginkgolide B on lymphocyte activation in atopic asthma: comparison with cyclosporin A.

The effects of Ginkgolide B (BN52021) on in vitro activation responses of human peripheral blood mononuclear cells (PBMC) from asthmatic patients was measured using 2-channel flow cytometric analysis of activation-associated cell surface antigens or ELISA assays for cytokines known to be expressed by PBMC during T1 or T2 immunological activation. BN52021 is an anti-inflammatory extract of Ginkgo biloba and has been used therapeutically. It is a known inhibitor of platelet activating factor (PAF), which is important in the pathogenesis of asthma, and may synergise with cyclosporin A (CyA) to inhibit pathogenic immune activation in asthmatics. We compared the inhibitory effects of BN52021 and CyA (1 microM each) on activation of PBMC of asthmatic patients stimulated by phorbol myristate acetate and calcium ionophore. Inhibition of production of the cytokines IL-4 and IL-5 by BN52021 was insignificant compared to CyA. However, BN52021 significantly reversed the increase in activation-associated CD45RA expression, with a trend towards decreased expression of HLA-DR. Lymphocyte activation markers were not significantly altered by CyA. Since they appear to have differing effects on activated cells, the anti-inflammatory effects of CyA and BN52021 in atopic asthma is potentially additive. The present approach may be useful for preliminary evaluation of novel therapeutic modalities for asthma treatment.

Adult↗

Assessment of quality of life in palliative care.

Assessment of palliative care and the evolution of interest in quality of life (QoL) measures are inextricably linked. Several validated QoL measures have become accepted for use, so it is increasingly unlikely that a 'gold-standard' measure will emerge. This range of current measures is potentially valuable because it provides the user with a degree of choice. However, such a range also brings to light methodological uncertainties. The aim of this article is not to identify the best measures, but to explore some of the factors that should guide that choice.

Humans↗

Projected requirements for radiation oncologists and trainees in Australia and New Zealand to 2007.

Workloads in radiation oncology facilities in Australia and New Zealand have been increasing steadily for many years and it is anticipated that this trend will continue. In the present paper the projected number of radiation oncologists required to meet this demand to the year 2007 are estimated, along with the number of trainees required. The estimates are based on data from regular surveys by the Royal Australian and New Zealand College of Radiologists (RANZCR) for the years 1988-97 (inclusive). From these surveys profiles of numbers, age and gender of specialists and trainees are documented together with increases from the training programme and losses from retirement. It is concluded that if the current trainee numbers are increased by 12 in Australia and two in New Zealand, there will be approximately 10 radiation oncologists per million of population by the year 2007. This number is considered appropriate considering the anticipated increase in demands and complexity of treatment. Because projections too far forward are unreliable, careful monitoring of progress is essential to obtain the appropriate balance between requirement and supply. Comparisons are made with other estimates of needs including the 1998 Australian Medical Workforce Advisory Committee (AMWAC) Report and the New Zealand Clinical Agency Workforce Project Report in 1997.

Adult↗

Non-steroidal anti-inflammatory drugs and chemoprevention of cancer.

Aspirin and other NSAIDs are showing promise in the chemoprevention of colorectal cancer. Ongoing trials will eventually provide still lacking information about the optimum dose and treatment duration. NSAIDs may also help to lower the risk of cancer in other organs such as the oesophagus, and possibly breast, stomach, and lung. The chemoprevention by NSAIDs should be seen not as the sole method of prevention, but as an additional tool which will be accompanied by other approaches such as stopping smoking, limiting alcohol consumption, and eating more fruits and vegetables. The chemoprevention by NSAIDs needs also to be balanced against the risks of toxicity (particularly in the stomach) and the other beneficial effects such as prevention of cardiovascular morbidity and mortality. Some of the NSAID induced gastric ulceration and bleeding will most likely be avoided by adopting the use of cyclooxygenase-2 (COX-2) selective NSAIDs, which will selectively inhibit COX-2 while sparing COX-1.

Adult↗

Polymorphisms in the methylenetetrahydrofolate reductase gene are associated with susceptibility to acute leukemia in adults.

Reduction of 5,10-methylenetetrahydrofolate (methyleneTHF), a donor for methylating dUMP to dTMP in DNA synthesis, to 5-methyltetrahydrofolate (methylTHF), the primary methyl donor for methionine synthesis, is catalyzed by 5,10-methylenetetrahydrofolate reductase (MTHFR). A common 677 C --> T polymorphism in the MTHFR gene results in thermolability and reduced MTHFR activity that decreases the pool of methylTHF and increases the pool of methyleneTHF. Recently, another polymorphism in MTHFR (1298 A --> C) has been identified that also results in diminished enzyme activity. We tested whether carriers of these variant alleles are protected from adult acute leukemia. We analyzed DNA from a case-control study in the United Kingdom of 308 adult acute leukemia patients and 491 age- and sex-matched controls. MTHFR variant alleles were determined by a PCR-restriction fragment length polymorphism assay. The MTHFR 677TT genotype was lower among 71 acute lymphocytic leukemia (ALL) cases compared with 114 controls, conferring a 4.3-fold decrease in risk of ALL [odds ratio (OR = 0.23; 95% CI = 0.06-0.81]. We observed a 3-fold reduction in risk of ALL in individuals with the MTHFR 1298AC polymorphism (OR = 0.33; 95% CI = 0.15-0.73) and a 14-fold decreased risk of ALL in those with the MTHFR 1298CC variant allele (OR = 0.07; 95% CI = 0.00-1.77). In acute myeloid leukemia, no significant difference in MTHFR 677 and 1298 genotype frequencies was observed between 237 cases and 377 controls. Individuals with the MTHFR 677TT, 1298AC, and 1298CC genotypes have a decreased risk of adult ALL, but not acute myeloid leukemia, which suggests that folate inadequacy may play a key role in the development of ALL.

Acute Disease↗

Isoprinosine does not protect against frequent respiratory tract infections in childhood.

UNLABELLED: Isoprinosine, an in vitro immuno-enhancing agent principally acting by stimulating T-lymphocytes, is one of a number of agents sometimes used in an attempt to prevent recurrent respiratory infections in children, although there are no formal trials for this particular drug. We performed a placebo-controlled double-blind trial to assess the efficacy of isoprinosine (50 mg/kg per day) for 6 weeks followed by 50 mg/kg per day twice weekly for 6 weeks in the prevention of frequent acute respiratory tract infections in 102 children aged 4-8 years. A total of 43 children treated with isoprinosine and 41 with placebo finished the study. Despite a transient increase in the total number of CD3+, CD4+ and CD8+ T-lymphocytes after 6 weeks of daily isoprinosine treatment, there was no difference in the number and length of duration of acute respiratory infections, number of antibiotic courses and number of days with cough, pharyngitis, rhinitis and increased body temperature (> or = 37.0 degrees C and > or = 38.0 degrees C). There were no changes in markers of T- or B-lymphocyte activation (CD25, HLA-DR, CD45RA/RO, CD23). CONCLUSION: Attempts at immunomodulation using isoprinosine in the dose and for the duration used may increase the total numbers of both CD4 and CD8 T-lymphocytes but is ineffective in prevention of respiratory tract infections in childhood.

Acute Disease↗