Biomedical subjects
J Wilkinson
Publications and source records attributed to J Wilkinson.
Guidelines on how to prepare and present a seminar.
The seminar is a popular teaching method in pre- and post-registration nursing courses. This article explores the values and limitations of this approach and offers guidelines to optimise its usefulness as both a teaching and learning strategy.
Fc epsilon RI-beta polymorphisms unlikely to contribute substantially to genetic risk of allergic disease.
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A novel method for the rapid separation of plasma lipoproteins using self-generating gradients of iodixanol.
We describe a new method for the rapid fractionation of plasma lipoproteins, which makes use of a new non-ionic, iodinated, density gradient medium, iodixanol, commercially available as Optiprep(TM). The method is simple: plasma or serum is mixed with iodixanol followed by centrifugation in a vertical or near vertical rotor. Separation of VLDL, LDL and HDL can be achieved in 3 h and the lipoprotein fractions are comparable in density and composition with those prepared using conventional salt based gradients. Each class of lipoprotein can be removed in a single fraction, or a profile of lipoprotein distribution can be obtained using a gradient fractionator. Because the medium is inert, fractions from the gradient can be analysed by agarose gel electrophoresis or assayed for lipid content or apolipoprotein composition by SDS-PAGE without removing the iodixanol. Small differences in electrophoretic mobility of HDL and LDL across several gradient fractions suggest that subfractionation of these classes may occur. The new method is simple, rapid and versatile with potential application for preparation of lipoproteins and for analysis of lipoprotein profiles in the research or clinical laboratory.
Non-invasive, optical measurement of absolute blood volume in hemodialysis patients.
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A novel method for the rapid separation of human plasma lipoproteins using self-generating gradients of Iodixanol.
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General practitioners' attitudes to variations in referral rates and how these could be managed.
BACKGROUND: Hospital referral rates have received widespread attention for both clinical and economic reasons. OBJECTIVE: This study was undertaken to find out the views of general practitioners in North Yorkshire on current arrangements for the feedback of routine referral data, perceived factors that influenced their referral behaviour and changes that might help their referral decisions. METHOD: Survey questions were chosen from the issues raised during semi-structured interviews with 11 selected practices. A postal questionnaire was sent to all 114 general practices in North Yorkshire. RESULTS: A 60% (68/114) response rate was obtained from the postal questionnaire. The majority of practices agreed that the referral information supplied by them was accurate (77%) and that the feedback of this data was useful (66%). Uncertainty of diagnosis/management and patient pressure were the two most commonly agreed factors that were suggested as influencing referral behaviour. Training in procedures and use of clinical guidelines were the most popular changes chosen as being helpful in referral decision making. CONCLUSIONS: The feedback of routine referral data is considered accurate and useful, and should continue. Expanding opportunities for the training of general practitioners in specific skills and the development of clinical guidelines for the management and referral of commonly suggested areas would be helpful to general practitioners in making referral decisions.
Candidate gene loci in asthmatic and allergic inflammation.
New techniques for scanning the human genome promise great advances in tracking the origins of disorders caused by multiple genes. However, it is clear from the studies presented in this overview that we are far from understanding the genetic basis of asthma and atopy and their interaction with the environment. It is also clear that agreement must be reached on definition of the phenotype and methods of ascertainment in order to carry out large multicentre collaborative studies. Positive findings need to be validated in different populations selected for the presence of the disease and then confirmed in a random population where the prevalence of asthma and atopy will also be expected to be significant.
Investigation of the association of intracellular apolipoprotein (a) with apolipoprotein B in human liver.
Plasma lipoprotein-a(Lp-a) consist of LDL-like particles in which apolipoprotein-a (apo-a) is linked by a disulphide bond to apolipoprotein B (apo-B). There is strong evidence that apo-a is synthesized in the liver. However, little is known of the intracellular transit of apo-a and the site and mechanism of its linkage to apo-B. In this investigation we have addressed the primary question--does apo-a become linked covalently to apo-B intracellularly in human liver? For this study, we have developed competition and capture ELISA to measure apo-a either free or in complex with apo-B and applied these to human liver samples. The levels of free apo-a ranged from 25 to 440 micrograms/g liver in nine individual liver samples; those of apo B ranged from 90-700 micrograms/g liver. However, it was not possible to detect an apo-a/apo-B complex suggesting that apo-a is secreted in the free form and binds with apo-B/LDL in the extracellular fluid or plasma.
Fragrance contact dermatitis: a worldwide multicenter investigation (Part I).
OBJECTIVE: The aim of this study was to determine the prevalence of responses to selected fragrance materials in patients with suspect fragrance allergy and to evaluate risk factors and associations with such responses. The validity of using specific fragrance ingredients versus a mixture of fragrances was evaluated in terms of predicting allergy to different fragrance ingredients. METHODS: One hundred sixty-seven subjects were evaluated in seven centers worldwide with a fragrance mix, the eight ingredients in the fragrance mixture, six other well-known fragrance allergens, balsam of Peru, and 15 lesser studied fragrance materials. RESULTS: The age of the patients was 44.9 +/- 17.5 years (mean +/- SD). More than 85% were women. A relatively high proportion gave a past history of atopic disease. Facial eruptions (40%) and hand involvement (26.7%) were the most common topographic sites. All but 4 of the 35 fragrance materials produced a positive response in > 1%. A reaction to fragrance mix occurred in 47.3%. Seven of the 34 ingredients tested produced an allergic response in more than 10% of those tested. Men were more likely than women to exhibit a positive response to five fragrance ingredients. White persons were more likely to react to perfume mix (52.8% versus 25.3%) and certain ingredients in the mix than Asian persons. Allergy to benzyl salicylate was more common in Japan than in Europe or the United States. CONCLUSION: The age at which patients with perfume allergy present for evaluation is similar to that of other contactants. Atopic individuals may be overrepresented in this group of patients. Face involvement is likely. White persons are more likely to react to fragrance mix, whereas in Asian patients benzyl salicylate was a more frequent allergen. Fragrance mix corrected with 85.6% of positive responses to fragrance ingredients. The addition of ylang ylang oil, narcissus oil, and sandalwood oil to fragrance mix would be expected to pick up 94.2% with positive responses to fragrance materials; adding balsam of Peru increases this to 96%.
Occupational health: undefined, under reported, and uncompensated. Prescribed diseases yield substantial compensation.
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Regulation of cholesterol synthesis in four colonic adenocarcinoma cell lines.
Colon tumor cells, unlike normal human fibroblasts, exhibited an uncoupling of low density lipoprotein (LDL)-derived cholesterol from cellular growth, when endogenous cholesterol synthesis was inhibited by mevinolin, a hydroxymethylglutaryl-CoA reductase (HMG-CoAR) competitive inhibitor [Fabricant, M., and Broitman, S.A. (1990) Cancer Res. 50, 632-636]. Further evaluation of cholesterol metabolism was conducted in two undifferentiated (SW480, SW1417) and two differentiated (HT29, CACO2) colonic adenocarcinoma (adeno-CA) cell lines and an untransformed human fibroblast, AG1519A. Cells grown in monolayer culture to near subconfluency were used to assess endogenous cholesterol synthesis by 14C-acetate incorporation, in response to the following treatments in lipoprotein-deficient serum (LPDS)-supplemented minimum essential medium (MEM): LPDS alone, LDL, mevinolin, mevinolin with LDL, and 25-hydroxy-cholesterol (25-OH-CH). Complete fetal bovine serum (FBS)-supplemented MEM was used as control. All colon tumor lines exhibited similarly high endogenous cholesterol synthesis in both FBS and LPDS relative to the fibroblasts which demonstrated low basal levels in FBS and maximal synthesis in LPDS. LDL treatment did not inhibit cholesterol synthesis in colon tumor cells, but suppressed that in the fibroblast by 70%. Sterol repression of cholesterol synthesis mediated by 25-OH-CH occurred in all cells. Mevinolin caused a reduction in cholesterol synthesis in the colonic cancer cell lines, which was not further decreased by concurrent addition of LDL. In contrast, in mevinolin-treated fibroblasts, LDL further inhibited cholesterol synthesis. When the effect of cell density on cholesterol synthesis regulation was evaluated under conditions of sparse density in SW480 and SW147, results indicated that (i) basal rates of cholesterol synthesis were higher, (ii) LDL inhibited cholesterol synthesis more effectively, and (iii) mevinolin or 25-OH-CH had a more pronounced effect than in subconfluent cells. Evaluation of LDL receptor activity through 125I-LDL binding and internalization studies demonstrated LDL receptor expression was reduced by 37% in normal density cells relative to the low density cultures. In contrast to cholesterol synthesis, exogenous LDL could inhibit LDL receptor activity at both densities. Thus subconfluent growing colonic adenoCA cell lines retain the capacity for sterol repression, but, in contrast to normal fibroblasts, exhibit a high endogenous cholesterol synthesis which LDL cannot regulate.
Cancer incidence in England and Wales and New Zealand and in migrants between the two countries.
Risks of cancer incidence in people born in England and Wales and New Zealand (non-Maoris) living in their home countries, and after migration between the two countries, were analysed using data from their national cancer registries. Since these populations are of similar genetic origin, any real differences in cancer incidence between them are likely to reflect the action of environmental or behavioural risk factors. The greatest differences in risk between the countries were for cutaneous melanoma and lip cancer. In each sex, relative risks of these malignancies were 4 or greater for the New Zealand-born in New Zealand compared with English and Welsh natives in their home country, and risks for migrants in each direction were generally intermediate between those born in the home country in the two countries. Sizeable significantly raised risks in the New Zealand-born in New Zealand compared with English and Welsh natives in England and Wales also occurred for cancers of the mouth, small intestine, colon, thymus, eye and thyroid, and non-Hodgkin's lymphoma in each sex, and for cancer of the prostate. For all of these sites except mouth, small intestine and colon there were also risks around or above New Zealand-born levels for English and Welsh migrants to New Zealand; for colon cancer these migrants had risks close to those in England and Wales. New Zealand migrants to England and Wales had risks of cancers of the colon and prostate that were similar to or above New Zealand levels. Risks of cancers of the stomach, lung, pleura and bladder, and Hodgkin's disease in each sex, and cancers of the cervix, ovary and scrotum and penis, were substantially and significantly lower in the New Zealand-born living in New Zealand than in English and Welsh natives in England and Wales. In English and Welsh migrants to New Zealand risks of bladder cancer in each sex, and of scrotal and penile and pleural cancer in males, approximated to England and Wales risks; cervical cancer risk approximated to the New Zealand risk; and stomach, lung and ovarian cancers showed intermediate risks. Migrants from New Zealand to England and Wales did not gain the lung cancer or clearly the stomach cancer risk of their host country, but did have bladder cancer risks approximating to those in England and Wales.(ABSTRACT TRUNCATED AT 400 WORDS)
Two novel mutations in the gene for copper zinc superoxide dismutase in UK families with amyotrophic lateral sclerosis.
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New models for emergency and ambulatory care at academic health centers--Part III: Boston and Alberta, Canada.
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Clinical standardization of the TRUE Test formaldehyde patch.
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Managed care: threat or opportunity?
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