These doctors pay their patients' bills.
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Biomedical subjects
Publications and source records attributed to K Hunt.
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1. A range of compounds has been tested for excitatory amino acid agonist or antagonist activity and for effects on synaptic activity on isolated hemisected spinal cords of frogs. 2. L-Monoamino dicarboxylic acids of chain length up to 8 carbon atoms (L-alpha-aminosuberate) were all agonists. 3. Within a series of D-monoamino dicarboxylic acids, and with diamino dicarboxylic acids (mainly unresolved mixtures of diasteroisomers), there was a progression from agonist activity, for compounds of chain length equal to or shorter than glutamate, to antagonist activity, for compounds of longer chain length equal to or shorter than glutamate, to antagonist activity, for compounds of longer chain length, D-alpha-Aminosuberate (D alpha SD) was the most potent antagonist. 4. The antagonist actions of these substances showed a Mg2+--like selectivity with respect to depolarizations produced by different excitants. N-methyl-D-aspartate (NMDA) was the most susceptible agonist and quisqualate and kainate the least susceptible. Responses to other excitatory amino acids, including L-glutamate and L-aspartate, showed intermediate sensitivity to the antagonists. 5. A parallelism was observed between the relative potencies of mono- and diamino dicarboxylic acids as NMDA antagonists and their relative potencies as depressants of synaptic responses. 6. The results support the concept of different types of excitatory amino acid receptors, with NMDA and its antagonists acting predominantly on one type. These NMDA receptors are probably transmitter receptors activated by an excitatory amino acid transmitter.
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A new substnace, quisqualamine, the decarboxylated analogue of quisqualic acid, predictably depressed electrical activity of neurons of the frog and rat spinal cord in vitro and of the mouse spinal cord in vivo. In the in vitro preparations, the action of quisqualamine was associated with a prolonged depolarization of primary afferent terminals which was sensitive to blockade by picrotoxin and bicuculline and which was also depressed by strychnine. This suggests an interaction of quisqualamine with presynaptic receptors for both GABA and beta-alanine. Post-synaptic actions of quisqualamine, which were less marked than those at presynaptic sites, also appeared to be predominantly GABA-mimetic in vitro, though a sensitivity to the GABA-antagonist bicuculline could not be demonstrated in vitro.
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OBJECTIVES: Previous work has shown low levels of psychological distress among UK South Asians, but some argue that the distress is under-reported. The present paper assesses distress on one clinically validated measure (the 12-item General Health Questionnaire), a psychosomatic measure and a self-report measure. METHODS: Interviews of 159 South Asians in Glasgow aged 30-40 years, mean age 35 years and 319 from the general population, all aged 35 years. RESULTS: The three distress measures were moderately correlated and at the thresholds chosen there was no hierarchy of severity between them. Distress on the GHQ12 was at similar levels for all the social groups assessed, but distress on the psychosomatic measure and self-assessment was higher for women, Muslims and limited English speakers. CONCLUSIONS: Clinical measures may have under-estimated distress in several South Asian groups. The results may be due to a preference for a particular language of emotion in the affected groups or to a higher frequency of stressful situations which provoke distinctive reactions.
OBJECTIVES: To assess survival in people who are at apparent high risk who do not develop coronary heart disease ("unwarranted survivals") and mortality in people at low risk who die from the disease ("anomalous deaths") and the extent to which these outcomes are explained by other, less visible, risk factors. DESIGN: Prospective general population survey. SETTING: Renfrew and Paisley, Scotland. PARTICIPANTS: 6068 men aged 45-64 years at screening in 1972-6, allocated to "visible" risk groups on the basis of body mass index and smoking. MAIN OUTCOME MEASURES: Survival and death from coronary heart disease by age 70 years. RESULTS: Visible risk was a good predictor of mortality: 13% (45) of men at low risk and 45% (86) of men at high risk had died by age 70 years. Of these deaths, 12 (4%) and 44 (23%), respectively, were from coronary heart disease. In the group at low visible risk other less visible risk factors accounted for increased risk in 83% (10/12) of men who died from coronary heart disease and 29% (84/292) of men who survived. In the high risk group 81/107 who survived (76%) and 19/44 (43%) who died from coronary heart disease had lower risk after other factors were considered. Different risk factors modified risk (beyond smoking and body mass index) in the two groups. Among men at low visible risk, poor respiratory function, diabetes, previous coronary heart disease, and socioeconomic deprivation modified risk. Among men at high visible risk, height and cholesterol concentration modified risk. CONCLUSIONS: Differences in survival between these extreme risk groups are dramatic. Health promotion messages would be more credible if they discussed anomalies and the limits of prediction of coronary disease at an individual level.
Of all markers associated with cellular proliferation in breast carcinoma, Ki-67 has more often been correlated with prognosis in patients with these tumors than others. To investigate the relevance of Ki-67 determination at each phase of the cell cycle in the biological assessment of mammary carcinoma we applied bivariate Ki-67/DNA content analysis on samples from 154 resected primary lesions. Three Ki-67-derived indices including an overall and G1 and S+G2M indices were generated. These values were correlated with similar indices derived from flow cytometric DNA/RNA analysis and traditional clinicopathologic factors. The results show that overall Ki-67 indices do not correlate with flow cytometric values and clinicopathologic factors. Flow-derived Ki-67 and DNA S+G2M indices were positively correlated (p<0.0001, r=0.58). High indices for the S+G2M phase derived by both Ki-67 and DNA analysis were significantly correlated with DNA aneuploidy, high tumor grade, and negative hormonal status. We conclude that the proliferative fraction (S+G2M) by either Ki-67 or DNA analyses offers more practical and clinically relevant information in assessing the proliferative activity in mammary carcinoma.
This study of 35 orthopaedic nurses assessed attitudes to pain and its relief. Using an anonymous questionnaire, nurses gave their views on a range of issues from what patients' expectations of post-operative pain should be, to the use and effectiveness of pain assessment tools. The findings suggest that nurses require re-education in various aspects of pain and analgesia provision to ensure that patients do not feel pain unnecessarily and receive appropriate pain relief promptly. The study recommends that pain assessment tools are used by orthopaedic nurses and that further training is required in the pharmacology of analgesic agents.
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The health status of Indian teenagers in the United States is below that of the general population. The usual barriers to the use of health care services that young people, including young Indians, encounter are compounded in rural areas by distance, isolation, and lack of appropriate services. To overcome these barriers in rural New Mexico, a public health demonstration project (a) established a single location where adolescents can receive multiple, integrated health care services free of charge; (b) set up the initial program of services at a rural school; (c) established links with existing agencies; and (d) incorporated community action toward creating change. The project began as a joint effort of three communities, the University of New Mexico (UNM), and the Albuquerque Area Indian Health Service (IHS) of the Public Health Service; a secondary level public school soon became a participant. The project is being replicated in two other communities that have formed separate partnerships with UNM and the area IHS; also the New Mexico Health and Environment Department has joined the effort in one community. Preliminary data suggest that the services are being used by a majority of the target population, with the proportions of boys and girls about equal.
Recombinant adenovirus (AdV) vectors are highly efficient at in vitro and in vivo gene delivery. In vivo therapy of established murine fibrosarcoma and mammary carcinomas was attempted with intratumoral injections of a recombinant AdV vector in which the human interleukin-2 (IL-2) gene was driven by the cytomegalovirus enhancer/promoter. Delayed growth and rejection of some tumors could be achieved with a cumulative virus dose of 2 to 6 x 10(9) plaque-forming units in two or three divided doses. Lower viral doses were ineffective, and higher doses resulted in animal death due to IL-2 toxicity. Using AdV vectors with the marker genes beta-galactosidase and luciferase, it is clear that even small volume (10 to 20 microL) intratumoral injections result in substantial systemic delivery of a portion of the virus dose. These findings define the potential and limitations of in vivo AdV-based cancer gene therapy and provide support for strategies to develop tumor-specific vectors.