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Biomedical subjects

K L Smith

Publications and source records attributed to K L Smith.

At least 55 records · Page 3Linked to original sources

Novel hippocampal interneuronal subtypes identified using transgenic mice that express green fluorescent protein in GABAergic interneurons.

The chief inhibitory neurons of the mammalian brain, GABAergic neurons, are comprised of a myriad of diverse neuronal subtypes. To facilitate the study of these neurons, transgenic mice were generated that express enhanced green fluorescent protein (EGFP) in subpopulations of GABAergic neurons. In one of the resulting transgenic lines, called GIN (GFP-expressing Inhibitory Neurons), EGFP was found to be expressed in a subpopulation of somatostatin-containing GABAergic interneurons in the hippocampus and neocortex. In both live and fixed brain preparations from these mice, detailed microanatomical features of EGFP-expressing interneurons were readily observed. In stratum oriens of the hippocampus, EGFP-expressing interneurons were comprised almost exclusively of oriens/alveus interneurons with lacunosum-moleculare axon arborization (O-LM cells). In the neocortex, the somata of EGFP-expressing interneurons were largely restricted to layers II-IV and upper layer V. In hippocampal area CA1, two previously uncharacterized subtypes of interneurons were identified using the GIN mice: stratum pyramidale interneurons with lacunosum-moleculare axon arborization (P-LM cells) and stratum radiatum interneurons with lacunosum-moleculare axon arborization (R-LM cells). These newly identified interneuronal subtypes appeared to be closely related to O-LM cell, as they selectively innervate stratum lacunosum-moleculare. Whole-cell patch-clamp recordings revealed that these cells were fast-spiking and showed virtually no spike frequency accommodation. The microanatomical features of these cells suggest that they function primarily as "input-biasing" neurons, in that synaptic volleys in stratum radiatum would lead to their activation, which in turn would result in selective suppression of excitatory input from the entorhinal cortex onto CA1 pyramidal cells.

Action Potentials↗

Automatic external defibrillators: changing the way we manage ventricular fibrillation.

OBJECTIVE: To discuss recent developments in automatic defibrillation and to review the evidence that first-responders equipped with automatic external defibrillators (AEDs) improve survival from out-of-hospital cardiac arrest. DATA SOURCES: MEDLINE search from 1966 to 1999 (articles in English only) and examination of bibliographies. STUDY SELECTION: Published studies of out-of-hospital cardiac arrest and first-responders equipped with AEDs. Studies had to have a control group and to report survival to hospital discharge from ventricular fibrillation (VF). DATA EXTRACTION: Six studies met the selection criteria (two prospective randomised trials, two prospective controlled trials, and one cohort study and one retrospective study, both with historical controls). DATA SYNTHESIS: A random effects meta-analysis of odds ratios for survival from VF. CONCLUSIONS: Meta-analysis suggests that equipping first-responders with AEDs increases the probability of survival to hospital discharge after out-of-hospital cardiac arrest (odds ratio, 1.74; 95% CI, 1.27-2.38; P < 0.001). However, most of the studies lacked sufficient power to draw definitive conclusions. Until the impact of wide deployment of AEDs is fully understood, first-responder defibrillation in Australia should only occur as part of coordinated multicentre research studies.

Australia↗

Blockade of neuronal activity during hippocampal development produces a chronic focal epilepsy in the rat.

During brain development, neuronal activity can transform neurons characterized by widely ranging axonal projections to ones with more restricted patterns of synaptic connectivity. Previous studies have shown that an exuberant outgrowth of local recurrent excitatory axons occurs in hippocampal area CA3 during postnatal weeks 2 and 3. Axons are remodeled with maturation, and nearly half of the branches are eliminated. Postnatal weeks 2 and 3 also coincide with a "critical" period of development, when CA3 networks have a marked propensity to generate electrographic seizures. In an attempt to prevent axonal remodeling, local circuit activity was blocked unilaterally in dorsal hippocampus by continuous infusion of tetrodotoxin (TTX). Field potential recordings from behaving animals were dramatically altered when TTX infusion was initiated at the beginning of the critical period, week 2, but not later in life. Spontaneous, synchronized spikes and electrographic seizures with behavioral accompaniments were observed after 4 weeks of TTX infusion and persisted into adulthood. When recordings were made during TTX infusion, synchronized spiking was recorded in ventral hippocampus as early as 2 weeks after infusate introduction. At this same time, extracellular field recordings from in vitro slices demonstrated spontaneous network-driven "mini-bursts" arising from ventral hippocampal slices. These were abolished by glutamate receptor antagonists. Whole-cell recordings from CA3 neurons revealed bursts of excitatory synaptic potentials coincident with the network bursts recorded extracellularly. Thus, local assemblies of mutually excitatory CA3 pyramidal cells are hyperexcitable in these rats. Whether alterations in developmental axonal remodeling mediate these effects awaits further studies.

Animals↗

Out-of-hospital cardiac arrest.

Out-of-hospital cardiac arrest (OHCA), with its high fatality rate, is a significant public health issue. The aetiology of OHCA is reviewed, and management strategies are discussed, including the "chain of survival", the Utstein method of data collection, and recent developments in advanced cardiac life support emphasising defibrillation.

Australia↗

Cross-species amplification, non-invasive genotyping, and non-Mendelian inheritance of human STRPs in Savannah baboons.

Twenty-nine human microsatellite primer pairs were screened for their utility in the cross-species amplification of baboon DNA derived from both blood and feces as part of a larger study to identify paternal half sisters in a population of wild baboons (Papio cynocephalus). Forty-one percent (12/29) of the human primers successfully amplified baboon DNA. Of these 12 primers, six amplified fragments that were both polymorphic and heterozygous (mean number of alleles = 6, mean heterozygosity = 87%) and yielded repeatable results. However, only five of these six simple tandem repeat polymorphisms (STRPs) showed patterns of Mendelian inheritance (i.e., mothers and offspring shared at least one allele at each locus), and were therefore useful for determining relatedness between individuals. Analysis of the sixth primer revealed non-Mendelian inheritance, i.e., three of the six known mother-daughter pairs had no shared alleles. This failure was probably due to non-specific fragment amplification, and may have resulted from a different STRP locus being amplified in mother and daughter. This finding highlights the importance of sampling DNA from known parent-offspring pairs when screening microsatellite primers for genetic studies. Multiple, independent replications of genotypes and Mendelian checks are both particularly important when using cross-species amplification or when using a low-quality source of DNA.

Alleles↗

The value of the axial view in assessing calcaneal fractures.

We studied the value of the axial view of the calcaneum in diagnosing fractures. Fifty sets calcaneal radiographs were studied by four senior trauma staff and four orthopeadic trainees on two occasions 2-3 weeks apart. On the first occasion only the lateral view was studied; on the second, both lateral and axial views were studied. The axial view did not improve the sensitivity or specificity of the lateral view alone. Senior staff were more accurate in assessing the radiographs. We suggest that the axial view should not be used routinely in assessing a patient with a possible calcaneal fracture.

Calcaneus↗

Controversies in sentinel lymph node biopsy for breast cancer.

Sentinel lymph node biopsy, validated in melanoma staging, is currently under investigation for breast cancer staging. Reports suggest that the sentinel lymph node has a high predictive value in determining the presence of axillary metastases. Identification of a sentinel lymph node that is free of metastatic tumor cells may eliminate the necessity of performing a standard axillary lymph node dissection with its attendant morbidity. Numerous techniques are utilized to identify the sentinel node with approximately the same success rate. This paper will address some of the controversial areas of sentinel lymph node biopsy and offer an option for physicians who want to develop a sentinel lymph node program in their hospital.

Breast Neoplasms↗

Fluvoxamine reduces physiologic reactivity to trauma scripts in posttraumatic stress disorder.

This study assessed the effect of open-label fluvoxamine treatment for posttraumatic stress disorder (PTSD), depressive symptoms, and physiologic arousal to trauma cues. Baseline psychometric ratings and physiologic assessments of heart rate and blood pressure responses to individualized, taped trauma scripts were determined for 16 patients with PTSD and 16 mentally healthy age- and gender-matched control subjects exposed to at least 1 serious trauma. Patients with PTSD had greater autonomic reactivity than control subjects at baseline, with physiologic measures correlating with the severity of the PTSD for the combined groups. Discriminant analyses indicated that systolic blood pressure best classified patients with PTSD (75% sensitivity) and control subjects (100% specificity), with a stepwise discriminant analysis showing that combined physiologic variables correctly classified 75% of patients with PTSD and 100% of control subjects. After 10 weeks of fluvoxamine treatment (100-300 mg/day), patients' PTSD, depression, and physiologic reactivity improved significantly. Medicated patients with PTSD could not be distinguished statistically from untreated control subjects in any physiologic measure. This dampening of autonomic reactivity after drug treatment corroborates subjective measures of improvement, validating the reported efficacy of fluvoxamine in this open trial.

Adult↗

The extended Segmüller flap.

A modification of the homodigital lateral V-Y advancement flaps described by Segmüller in 1976 for the treatment of fingertip injuries is described. The extended flap used in this series makes this flap more versatile in the treatment of injuries with considerable soft-tissue loss from the volar aspect of the fingertip. The Segmüller flap technique, its applications, and the results of 100 flaps are reported and discussed.

Adolescent↗

Multiple-locus variable-number tandem repeat analysis reveals genetic relationships within Bacillus anthracis.

Bacillus anthracis is one of the most genetically homogeneous pathogens described, making strain discrimination particularly difficult. In this paper, we present a novel molecular typing system based on rapidly evolving variable-number tandem repeat (VNTR) loci. Multiple-locus VNTR analysis (MLVA) uses the combined power of multiple alleles at several marker loci. In our system, fluorescently labeled PCR primers are used to produce PCR amplification products from eight VNTR regions in the B. anthracis genome. These are detected and their sizes are determined using an ABI377 automated DNA sequencer. Five of these eight loci were discovered by sequence characterization of molecular markers (vrrC(1), vrrC(2), vrrB(1), vrrB(2), and CG3), two were discovered by searching complete plasmid nucleotide sequences (pXO1-aat and pXO2-at), and one was known previously (vrrA). MLVA characterization of 426 B. anthracis isolates identified 89 distinct genotypes. VNTR markers frequently identified multiple alleles (from two to nine), with Nei's diversity values between 0.3 and 0.8. Unweighted pair-group method arithmetic average cluster analysis identified six genetically distinct groups that appear to be derived from clones. Some of these clones show worldwide distribution, while others are restricted to particular geographic regions. Human commerce doubtlessly has contributed to the dispersal of particular clones in ancient and modern times.

Bacillus anthracis↗

Bacillus anthracis diversity in Kruger National Park.

The Kruger National Park (KNP), South Africa, has a recorded history of periodic anthrax epidemics causing widespread disease among wild animals. Bacillus anthracis is the causative agent of anthrax, a disease primarily affecting ungulate herbivores. Worldwide there is little diversity among B. anthracis isolates, but examination of variable-number tandem repeat (VNTR) loci has identified six major clones, with the most dissimilar types split into the A and B branches. Both the A and B types are found in southern Africa, giving this region the greatest genetic diversity of B. anthracis worldwide. Consequently, southern Africa has been hypothesized to be the geographic origin of B. anthracis. In this study, we identify the genotypic types of 98 KNP B. anthracis isolates using multiple-locus VNTR analysis. Two major types are evident, the A branch and the B branch. The spatial and temporal distribution of the different genotypes indicates that anthrax epidemic foci are independent, though correlated through environmental cues. Kruger B isolates were found on significantly higher-calcium and higher-pH soils than were Kruger type A. This relationship between genotype and soil chemistry may be due to adaptive differences among divergent anthrax strains. While this association may be simply fortuitous, adaptation of A types to diverse environmental conditions is consistent with their greater geographic dispersal and genetic dissimilarity.

Animals↗

Herd characteristics and management practices associated with bulk-tank somatic cell counts in herds in official Dairy Herd Improvement Association programs in Ohio.

OBJECTIVE: To identify herd characteristics and management practices associated with bulk-tank somatic cell counts (BTSCC) in dairy herds in Ohio enrolled in official Dairy Herd Improvement Association (DHIA) programs. SAMPLE POPULATION: 186 dairies in Ohio. PROCEDURE: All herds in official DHIA programs in 9 counties were asked to participate. Extensive information regarding herd characteristics and management practices was obtained, using a standardized questionnaire. Bulk-tank milk samples were requested from all participating herds for bacterial culture. Official DHIA test-day records for January 1997 were obtained from all herds enrolled in official DHIA programs in the 9 counties. Potential associations were identified, using multivariable ANOVA. RESULTS: Participation was 186 of 479 (39%) herds. Streptococcus agalactiae and Mycoplasma spp were not isolated from bulk-tank milk samples. Staphylococcus aureus was isolated from 64 of 172 (37%) of the herds. The BTSCC were inversely associated with peak daily milk production, postmilking teat disinfection, percentage of eligible cows in the herd detected in estrus, and directly related to the extent to which BTSCC was perceived as a herd problem during the preceding 2 years. Type of housing for nonlactating cows and product used for treatment of nonlactating cows also were significantly associated with BTSCC. CONCLUSIONS AND CLINICAL RELEVANCE: Consideration of herd characteristics and implementation of management practices associated with BTSCC could result in increased milk yield and production of milk with lower BTSCC.

Animals↗

Care for older persons. Are divisional programs meeting needs?

BACKGROUND: A national forum on healthy ageing was convened for divisions of general practice in November 1998. OBJECTIVE: Views of delegates were sought regarding divisional programs for older people related to the following areas: working in collaboration; integration; the context of the older person; ageism; and structural barriers. These areas were felt to influence success of current prospects for future programs for older people. DISCUSSION: Further communication, collaboration and integration appears essential to realise the potential that general practice offers to programs for older people. Issues from the forum are discussed in relation to relevant National General Practice Strategy Review and the changes introduced into the Medical Benefits Schedule in November 1999. Consideration of these themes will aid future divisional programs for older people.

Aged↗

Functionally different GPI proteins are organized in different domains on the neuronal surface.

We have investigated the organization, on the plasma membrane and in detergent-insoluble membrane vesicles, of two neuronal glycosylphosphatidylinositol-anchored (GPI) proteins: Thy-1, a negative regulator of transmembrane signalling; and prion protein, whose rapid endocytosis and Cu(2+) binding suggest that it functions in metal ion uptake. Prion protein occurred on the neuronal surface at high density in domains, located primarily at the cell body, which were relatively soluble in detergent. Thy-1, although much more abundantly expressed on neurons, occurred at lower density over much of the surface of neurites (and in lower abundance at the cell body) in domains that were highly resistant to detergent solubilization. Detergent-insoluble membrane vesicles contained Thy-1 at a density similar to that on the neuronal surface. Vesicles containing each protein could be separated by immunoaffinity isolation; lectin binding showed that they were enriched in different glycoproteins. Our results demonstrate a structural diversity of the domains occupied by functionally different GPI proteins.

Animals↗

Rapid resetting of the mammalian circadian clock.

The suprachiasmatic nuclei (SCN) contain the principal circadian clock governing overt daily rhythms of physiology and behavior. The endogenous circadian cycle is entrained to the light/dark via direct glutamatergic retinal afferents to the SCN. To understand the molecular basis of entrainment, it is first necessary to define how rapidly the clock is reset by a light pulse. We used a two-pulse paradigm, in combination with cellular and behavioral analyses of SCN function, to explore the speed of resetting of the circadian oscillator in Syrian hamster and mouse. Analysis of c-fos induction and cAMP response element-binding protein phosphorylation in the retinorecipient SCN demonstrated that the SCN are able to resolve and respond to light pulses presented 1 or 2 hr apart. Analysis of the phase shifts of the circadian wheel-running activity rhythm of hamsters presented with single or double pulses demonstrated that resetting of the oscillator occurred within 2 hr. This was the case for both delaying and advancing phase shifts. Examination of delaying shifts in the mouse showed resetting within 2 hr and in addition showed that resetting is not completed within 1 hr of a light pulse. These results establish the temporal window within which to define the primary molecular mechanisms of circadian resetting in the mammal.

Animals↗

Asymmetric membrane capsules for osmotic drug delivery. I. Development of a manufacturing process.

This paper describes a novel non-disintegrating polymeric capsule and a manual and a semi-automatic process developed for its manufacture. The capsule wall was made by a phase inversion process in which the membrane structure was precipitated on stainless steel mold pins by dipping the mold pins into a coating solution containing a polymer-solvent-nonsolvent system followed by dipping into a quench solution. The resulting asymmetric membrane wall was composed of a thin dense region supported on a thicker porous region. The asymmetric membrane capsules can be filled with a blend of the active agent and excipients for use in osmotically modulated controlled drug delivery applications.

Capsules↗

Long-term depression of perforant path excitatory postsynaptic potentials following synchronous network bursting in area CA3 of immature hippocampus.

Various forms of synaptic long-term potentiation and depression have been studied in detail in hippocampus and neocortex. Each are produced by specific patterns of synaptic activation and rely on electrical stimulation of afferents for their induction. Few studies have explored the ability of activity produced by cortical networks themselves to generate similar long-term changes in synaptic efficacy. Experiments have shown that periods of synchronized network bursting in both slices and dissociated cultures of hippocampus can lead to persistent network discharges. Conversely, one study has reported that network discharging can disrupt the induction of long-term potentiation in hippocampus. Whether long-term depression can be induced by synchronous network discharging is unknown. In experiments reported here, we examined the long-term effects of synchronized activity within hippocampal CA3 networks on synaptic potentials produced by the converging perforant path. Prior to induction of network bursting, slices were incubated in a perfusate containing picrotoxin and elevated (4 mM) Ca2+ and Mg2+. To induce network discharges, the concentration of both divalent cations were reduced to normal levels (1.5 mM). Following 20 min of network bursting, perforant path synapses, that did not participate in network discharging, underwent a 30% non-decrementing long-term depression. At the same time, synchronized network discharges, that were absent prior to induction, persisted upon return to preinduction conditions. The antagonist of the N-methyl-D-aspartate receptor, D(-)2-amino-5-phosphonovalerate, blocked both long-term depression of perforant path excitatory postsynaptic potentials and persistent network discharging. Results suggest that activity generated by hippocampal networks is able to produce long-term depression of non-coincidentally active synapses.

2-Amino-5-phosphonovalerate↗