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Biomedical subjects

Jeremy Lewis

Publications and source records attributed to Jeremy Lewis.

4 recordsLinked to original sources

Ligand-receptor-G-protein molecular assemblies on beads for mechanistic studies and screening by flow cytometry.

G protein-coupled receptors form a ternary complex of ligand, receptor, and G protein heterotrimer (LRG) during signal transduction from the outside to the inside of a cell. Our goal was to develop a homogeneous, small-volume, bead-based approach compatible with high-throughput flow cytometry that would allow evaluation of G protein coupled receptor molecular assemblies. Dextran beads were derivatized to carry chelated nickel to bind hexahistidine-tagged green fluorescent protein (GFP) and hexahistidine-tagged G proteins. Ternary complexes were assembled on these beads using fluorescent ligand with wild-type receptor or a receptor-Gialpha2 fusion protein, and with a nonfluorescent ligand and receptor-GFP fusion protein. Streptavidin-coated polystyrene beads used biotinylated anti-FLAG antibodies to bind FLAG-tagged G proteins for ternary complex assembly. Validation was achieved by showing time and concentration dependence of ternary complex formation. Affinity measurements of ligand for receptor on particles, of the ligand-receptor complex for G protein on the particles, and receptor-Gialpha2 fusion protein for Gbetagamma, were consistent with comparable assemblies in detergent suspension. Performance was assessed in applications representing the potential of these assemblies for ternary complex mechanisms. We showed the relationship for a family of ligands between LR and LRG affinity and characterized the affinity of both the wild-type and GFP fusion receptors with G protein. We also showed the potential of kinetic measurements to allow observation of individual steps of GTP-induced ternary complex disassembly and discriminated a fast step caused by RG disassembly compared with the slower step of Galphabetagamma disassembly.

Flow Cytometry↗

A blinded pilot study investigating the use of diagnostic ultrasound for detecting active myofascial trigger points.

Myofascial trigger points (MFTPs) have been cited by numerous authors as the cause of local and referred pain which arises from muscle and its surrounding fascia. At present there is no reliable objective test which is capable of determining their presence. It was the purpose of this pilot study to assess the use of diagnostic ultrasound in determining any soft tissue changes in the region of clinically identified active MFTPs. Eleven subjects with clinically identified, unilateral, active MFTPs were examined with diagnostic ultrasound at the site of the trigger point as well as the asymptomatic, contralateral side. The analysis of the results of this pilot study found no correlation between the clinical identification of active MFTPs and diagnostic ultrasound.

Adult↗

Physiotherapy exercise programmes: are instructional exercise sheets effective?

Effective compliance with physiotherapy exercises is only possible if patients remember the exercises accurately. The purpose of this study was to assess how well elderly in-patients remembered simple physiotherapy exercises, by comparing the ability to accurately reproduce a set of exercises in a group of patients that had received a written exercise sheet, with a group that had not. The study also aimed to investigate the relationship between memory for exercises and cognition. Sixty-four in-patients in an acute hospital were taught 3 exercises. Half of the subjects were randomised to receive exercise sheets to reinforce the teaching (Group 1). The rest of the subjects did not receive this memory aid (Group 2). Two to three days later subjects were asked to demonstrate their exercises. The accurate recall of the exercises was scored using a new assessment scale with a maximum score of 24. The mean exercise score was 17.19 for group 1 (SD = 5.91) and 16.24 for Group 2 (SD = 6.01). There was no significant difference in exercise score between groups (Mann Whitney U test p = 0.44). There was a statistically significant small positive correlation between exercise score and cognition (tau = 0.263). The study showed that older adult in-patients do not remember physiotherapy exercises effectively after a single teaching session and that their memory is not significantly improved by provision of an exercise sheet.

Aged↗

The reliability of one vs. three grip trials in symptomatic and asymptomatic subjects.

Grip strength is used in the assessment of hand and upper limb function. Current recommendations state that taking the mean of three repeated grip trials provides more reliable results than only one trial. A repeated measures, crossover design was used. Sixty-six subjects were recruited (22 asymptomatic subjects, 22 following carpal tunnel decompression, and 22 following flexor tendon repair). Grip strength testing was performed on a Jamar dynamometer using a standardized testing protocol. Pre- and post testing pain levels were recorded using a verbal analogue scale. Each subject's grip strength was tested four times, twice using a single trial protocol and twice using three grip trials in random order. Intraclass correlation coefficients (ICC) (2,1), 95% confidence intervals, and standard error of measurements were calculated. A two-tailed paired samples t-test was used to investigate the difference between the grip strength values obtained and the changes in verbal analogue scale. High levels of test-retest reliability (ICC>or=0.85) were found for the three methods of grip strength testing (one trial, the mean of three trials, and the best of three trials). The mean values of grip strength generated for each method of grip strength testing produced comparable results. A significant difference (p>or=0.0001) was observed in the verbal analogue scale scores following one trial and three in all three sample groups. Clinically acceptable levels of reliability (>or=0.91) were demonstrated by all three methods of grip strength testing other than the mean of three trials for the asymptomatic group. Distribution of the ICC results and the elevated verbal analogue scales associated with three trials suggest that the use of one grip trial may be appropriate. This study suggests that one maximal trial is as reliable as and less painful than either the best of, or, mean of three trials.

Adult↗