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Biomedical subjects

J Gray

Publications and source records attributed to J Gray.

At least 55 records · Page 3Linked to original sources
PubMed2003

Glanular reconstruction and preputioplasty repair for distal hypospadias: a unique day-case method to avoid urethral stenting and preserve the prepuce.

OBJECTIVE: To report the early outcome of >200 boys who underwent a glanular reconstruction and preputioplasty (GRAP) repair for distal hypospadias, to assess the functional and anatomical outcome of the penis at least 10 years after surgery, and to compare these data with otherwise "normal" aged-matched controls. PATIENTS AND METHODS: The GRAP repair is a novel method for the day-case reconstruction of distal hypospadias, and uniquely allows the anatomical reconstruction of the prepuce as part of penile reconstruction for hypospadias. We retrospectively reviewed the notes of 205 consecutive cases of distal hypospadias who had a GRAP repair carried out by one surgeon. Of these, there were 63 consecutive patients who had been repaired using the GRAP > or = 10 years earlier. In these patients a questionnaire was used to assess their perception of the appearance of their penis, the urinary stream, any problems with the foreskin and their recollection of surgery. Similar questionnaire data, except for the latter, were obtained from aged-matched controls for comparison. RESULTS: Of the 205 patients, 183 (89%) were day cases; the remaining 22 remained in hospital overnight for medical or social reasons. Sixteen (7%) developed a urethral fistula, the incidence of which correlated positively with the length of the repair. Four children (2%) were circumcised, in two for phimosis resulting in a spraying stream, in a third for dribbling after voiding, and the fourth for a cosmetically unsatisfactory foreskin. Questionnaire responses were received from 45 boys (71%), while 18 were untraceable. The mean (sd) age at surgery and at survey was 3.25 (2.6) and 14.26 (2.8) years, respectively. Forty-two (95%) children felt their penis was normal or only slightly different in appearance, two (5%) felt it looked fairly different and only one mostly avoided communal situations because of this. On voiding three boys (7%) sprayed most of the time while the remainder either never or sometimes sprayed. One youth sometimes had to sit to void because of difficulties in directing the stream; the rest (98%) always stood to void. There were no further circumcisions. These results were not significantly different from those of the age-matched controls. Most children had no (68%) or only slight (30%) recollection of hypospadias surgery. CONCLUSION: The complication rate and patient satisfaction with GRAP is comparable with those of other techniques. GRAP is a simple day-case procedure with few complications, thus avoiding an overnight hospital admission for most patients. Importantly, the prepuce can be preserved and refashioned to give a good cosmetic result, with no phimosis, which is increasingly important as circumcision becomes less acceptable to both the general public and the medical profession.

Ambulatory Surgical Procedures↗
PubMed2003

Antibodies to HSP-70 in normal donors and autoimmune hearing loss patients.

OBJECTIVE: To evaluate serum antibody to heat shock protein (HSP) 70 as a marker for autoimmune sensorineural hearing loss (AISNHL). DESIGN: Sera from 20 patients with rapidly progressive sensorineural HL and 20 control volunteers without HL were tested for antibody reactivity against multiple HSP 70 substrates. Substrates included recombinant human HSP (rHuHSP) 72, purified bovine brain heat shock cognate (HSC) 73 and HSP 72, as well as heat-shocked and non-heat-shocked protein extracts from bovine kidney (MDBK) cells. All serum donors were previously tested for antibody to guinea pig inner ear supporting cells; 17 of 20 patients but none (0 of 20) of the controls were positive. METHODS: Sera were tested using Western blots. RESULTS: Reactivity with rHuHSP 70 was observed in 16 patients and 17 controls. Similarly, 15 of 20 patients and 17 of 20 controls stained for both HSP 72 and HSC 73 from the bovine brain. When tested against the heat-shock-induced and control MDBK extracts, six patients and nine controls had greater reactivity with the induced HSP 72. CONCLUSION: The frequency of antibodies to HSP substrates did not differ in patients and controls. Prior studies reported that HSP 72 is the 68 kD antigen commonly detected by AISNHL sera. However, we show that HSP 72 antibodies are no more prevalent in patients than in normal controls. Thus, it is unlikely that the 68 kD protein is HSP 72. Therefore, HSPs are not appropriate substrates for serodiagnosis of AISNHL.

Adult↗
PubMed2003

Experimental use of a gas sensor-based instrument for differentiation of Escherichia coli O157:H7 from non-O157:H7 Escherichia coli field isolates.

The rapid and economical detection of human pathogens in animal and food production systems would enhance food safety efforts. An instrument based on gas sensors coupled with an artificial neural network (ANN) was developed for the detection of and differentiation between laboratory isolates of Escherichia coli O157:H7 and non-O157:H7 E. coli. The purpose of this study was to use field isolates of E. coli to further evaluate the sensor system. This gas sensor-based, computer-controlled detection system was used to monitor gas emissions from 12 isolates of E. coli O157:H7 and 8 non-O157:H7 E. coli isolates. A standard concentration of each isolate was grown in 10 ml of nutrient broth at 37 degrees C for 16 h, and gas sampling was carried out every 5 min. Readings were continuously plotted to generate gas signatures. A back-propagation ANN algorithm was used to interpret the gas patterns. By analysis of the response of the ANN, the sensitivity and specificity of the instrument were calculated. Detectable differences between the gas signatures of the E. coli O157:H7 isolates and the non-O157:H7 isolates were observed. The instruments degree of sensitivity was high for E. coli O157:H7 isolates, but a lower degree of accuracy was observed for non-O157:H7 isolates because of increased strain variation. The sensitivity of the detection system was improved by the normalization of the data generated from the gas sensors. Because of its ability to detect differences in gas patterns, this instrument has a broad range of potential food safety applications.

Animals↗
PubMed2003

Utility of rapid staining of fine needle aspiration smears at the University Hospital of the West Indies.

In a prospective study at the University Hospital of the West Indies, 187 fine needle aspiration cytology (FNAC) specimens, comprising 100 breast, 75 head and neck, and 12 miscellaneous specimens, were subjected to rapid Papanicolaou staining and immediate assessment. Inadequate aspirates were repeated, and all cases were also evaluated after routine Papanicolaou staining. Histologic and clinical follow-up data were obtained. The overall concordance between rapid and routine cytologic diagnoses ranged from 79% to 87% for the three specimen cohorts. Sensitivity and specificity values were similar for rapid and routine-stained slides and ranged from 80% to 100%. There were no false positive or false negative diagnoses in the cases for which the outcome was known. Rapid staining of cytologic smears is a useful adjunct to the evaluation of aspirated material, improving adequacy rates and overall performance of the FNAC service, and should also result in significant savings in time and cost to patients.

Biopsy, Needle↗
PubMed2003

Viridans streptococcus bacteremia in children on chemotherapy for cancer: an underestimated problem.

The authors discuss the morbidity associated with viridans streptococcus bacteremia, and its implications on the choice of antibiotics used as prophylaxis and treatment. They retrospectively studied the case notes of 38 children who were being treated for various malignant conditions in their unit and developed 40 episodes of bacteremia with viridans streptococci between October 1995 and January 1999. Viridans streptococci were the third commonest blood culture isolate during this period, after coagulase-negative staphylococci and Staphylococcus aureus. The majority of the isolates were Streptococcus mitis (55%). Others were S. sanguis (25%), S. oralis (12.5%), S. salivarius (5%), and S. acidominimus (2.5%). Twenty-five percent of the patients had been treated with regimens that included cytosine arabinoside, 60% were receiving prophylactic co-trimoxazole, and 87.5% were neutropenic. Thirty percent of patients had abnormal chest X-rays, and 15% were hypotensive; 2 patients required admission to the intensive care unit. Initial antibiotic therapy was changed because of failure of clinical response in 60% of cases, despite the infecting organism being sensitive in vitro. This study confirms the importance of viridans streptococci as a cause of bacteremia in pediatric hematology and oncology patients, leading to significant morbidity. Further work is required to establish the optimal treatment for viridans streptococcus bacteremia.

Adolescent↗
PubMed2002

A randomized trial of specialist genetic assessment: psychological impact on women at different levels of familial breast cancer risk.

The aim was to compare the psychological impact of a multidisciplinary specialist genetics service with surgical provision in women at high risk and those at lower risk of familial breast cancer. Women (n=735) were randomized to a surgical consultation with (trial group) or without (control group) specialist genetic risk assessment and the possible offer of presymptomatic genetic testing. Participants completed questionnaires before and immediately after the consultation to assess anxiety, cancer worry, perceived risk, interest in genetic testing and satisfaction. Responses of subgroups of women stratified by clinicians as low, moderate, or high risk were analyzed. There were no significant main effects of study intervention on any outcome variable. Regardless of risk information, there was a statistically significant reduction in state anxiety (P<0.001). Reductions in cancer worry and perceived risk were significant for women at low or moderate risk (P<0.001) but not those at high risk, and satisfaction was significantly lower in the high risk group (P<0.001). In high risk women who received specialist genetic input, there was a marginally significant trend towards increased perceived risk. The effect of risk information on interest in genetic testing was not significant. Breast care specialists other than geneticists might provide assessments of breast cancer risk, reassuring women at reduced risk and targeting those at high risk for specialist genetic counselling and testing services. These findings are discussed in relation to the existing UK Calman-Hine model of service delivery in cancer genetics. DOI: 10.1038/sj/bjc/6600051 www.bjcancer.comCopyright 2002 The Cancer Research Campaign

Adult↗
PubMed2002

The impact of sporadic campylobacter and salmonella infection on health and health related behaviour: a case control study.

The aim of the work was to explore the impact on general and psychological health of those with a proven bacterial gastrointestinal infection and to compare this with controls from whom no bacterial pathogen was identified. A case control study was conducted using an interviewer-administered questionnaire. Thirty-nine cases from whose faeces salmonella or campylobacter had been cultured were compared with matched controls. Reported gastrointestinal symptoms, general health and self-reported hygiene practices were compared. At the time of acute illness the General Household Questionnaire suggested similar levels of morbidity, though by follow up the controls were substantially more likely to be distressed. Cases were more likely to have changed their food preparation practices, to avoid certain eating places and to have been given advice about food preparation. In this small study a positive diagnosis of salmonella or campylobacter seems to have had a reassuring effect when compared with those for whom no diagnosis was made.

Acute Disease↗
PubMed2002

Ethanol elicits and potentiates nociceptor responses via the vanilloid receptor-1.

The vanilloid receptor-1 (VR1) is a heat-gated ion channel that is responsible for the burning sensation elicited by capsaicin. A similar sensation is reported by patients with esophagitis when they consume alcoholic beverages or are administered alcohol by injection as a medical treatment. We report here that ethanol activates primary sensory neurons, resulting in neuropeptide release or plasma extravasation in the esophagus, spinal cord or skin. Sensory neurons from trigeminal or dorsal root ganglia as well as VR1-expressing HEK293 cells responded to ethanol in a concentration-dependent and capsazepine-sensitive fashion. Ethanol potentiated the response of VR1 to capsaicin, protons and heat and lowered the threshold for heat activation of VR1 from approximately 42 degrees C to approximately 34 degrees C. This provides a likely mechanistic explanation for the ethanol-induced sensory responses that occur at body temperature and for the sensitivity of inflamed tissues to ethanol, such as might be found in esophagitis, neuralgia or wounds.

Animals↗
PubMed2002

Comparison of effects of anandamide at recombinant and endogenous rat vanilloid receptors.

BACKGROUND: Anandamide, an endogenous lipid, activates both cannabinoid (CB(1)) and vanilloid (VR1) receptors, both of which are co-expressed in rat dorsal root ganglion (DRG) cells. Activation of either receptor results in analgesia but the relative contribution of CB(1) and VR1 in anandamide-induced analgesia remains controversial. Here we compare the in vitro pharmacology of recombinant and endogenous VR1 receptors using calcium imaging, in clonal and DRG cells, respectively. We also consider the contribution of CB(1) and VR1 receptors to anandamide-induced analgesia. METHODS: Using a Flurometric Imaging Plate Reader (FLIPR), calcium imaging has been used to study the effects of several vanilloid and cannabinoid ligands in rat VR1-transfected HEK293 (rVR1-HEK) cells and in DRG cells. The effect of pre-exposure of several vanilloid and cannabinoids has also been compared in DRG cells. RESULTS: The VR1 agonists capsaicin, olvanil, (N-(4-hydroxyphenyl-arachinoylamide) (AM404) and anandamide caused a concentration-dependent increase in intracellular calcium concentration ([Ca(2+)](i)), with similar temporal profiles in both rVR1-HEK and DRG cells, and potency (pEC(50)) values of 8.25 (SEM 0.11), 8.37 (0.04), 6.96 (0.06), 5.85 (0.01) and 7.45 (0.10), 7.55 (0.07), 6.10 (0.13), approximately 5.5, respectively. These responses were inhibited by the VR1 antagonist capsazepine (1 micro M). In contrast, application of synthetic cannabinoid antagonists failed to inhibit the anandamide-induced increase in [Ca(2+)](i). Reapplication of VR1 agonists significantly inhibited a subsequent challenge to either capsaicin or anandamide in either cell type, whilst pre-exposure to cannabinoid agonists were without effect. CONCLUSION: Here we provide evidence that the pharmacology of recombinant rVR1 receptors is similar to those endogenously expressed in DRG cells. Moreover, we have shown that VR1, but not CB(1), receptors are involved in anandamide-induced responses in dorsal root primary neurones in vitro. Therefore, the analgesic properties of anandamide are likely to be mediated, at least in part, by VR1 activation in DRG cells in vivo.

Animals↗
PubMed2002

Rotavirus gastroenteritis and central nervous system (CNS) infection: characterization of the VP7 and VP4 genes of rotavirus strains isolated from paired fecal and cerebrospinal fluid samples from a child with CNS disease.

Rotavirus RNA was detected in the cerebrospinal fluid (CSF) of a child with central nervous system disease symptoms associated with rotavirus gastroenteritis. The rotavirus isolates from the fecal and CSF samples were genotyped as G1P[8]. Sequence analysis of the VP7 and VP4 proteins derived from the fecal and CSF samples were remarkably similar to each other and to G1P[8] rotavirus strains commonly circulating in the community and associated with gastroenteritis.

Antigens, Viral↗
PubMed2002

Contamination of environmental surfaces by genital human papillomaviruses.

OBJECTIVE: To investigate contamination of environmental surfaces with human papillomaviruses (HPV) DNA in two genitourinary medicine (GUM) clinics and in an on-site staff leisure and fitness centre. METHODS: Samples were collected from the treatment rooms and patients' toilets of two GUM clinics situated at two hospital sites and from the toilets of the staff leisure and fitness centre on one of the sites. Samples were tested for the presence of HPV DNA by nested polymerase chain reaction (PCR), and HPV amplicons were typed by reverse line hybridisation using HPV type specific oligonucleotide probes complementary to 35 HPV types. All samples were also tested for beta globin DNA by PCR in order to assess their quality. RESULTS: HPV DNA was found to be present at more than 50% of the sites sampled in one of the GUM clinics, but was absent in the second, and also from the staff leisure and fitness centre. All HPV DNA detected was found to be cell associated. The most commonly found HPV types were 6, 11, and 16, respectively. HPV infected cells were found to be localised mainly to surfaces used predominantly by medical staff. CONCLUSIONS: This study has identified contamination of the environment of a GUM clinic. Possible sources for the contamination of the clinic toilets were from genital sites via hands to the environment. Within the treatment rooms the most likely route of HPV DNA contamination of the environment was via the doctor's gloved hands.

Ambulatory Care Facilities↗