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Biomedical subjects

K Turner

Publications and source records attributed to K Turner.

At least 91 records · Page 5Linked to original sources
PubMed1993

Development of embryos from natural cycle in-vitro fertilization: impact of medium type and female infertility factors.

Single embryos derived from natural cycle in-vitro fertilization (IVF) were graded during the pre-transfer culture period using morphological criteria. Most embryos developed well in culture with 96% showing continuing division and 68% showing good morphological appearance, although embryo quality tended to decline with an increased incidence of fragmentation and uneven cleavage as division proceeded. Both the pregnancy rate and the distribution of embryo grades were similar among four different culture media used, suggesting that choice of medium had little impact on outcome. In contrast, there were marked differences in pregnancy rate according to the type of infertility, which was not reflected in a decrease in embryo quality. However, although embryos from patients with tubal infertility implanted and formed viable pregnancies irrespective of morphological appearance, only 'good' quality embryos from patients with non-tubal (or 'unexplained') infertility were able to implant. Thus the appearance of the embryo derived from natural cycle IVF in women with unexplained infertility may be of clinical relevance.

Adult↗
PubMed1993

Human chorionic gonadotrophin: embryonic secretion is a time-dependent phenomenon.

Of 48 spare human pre-embryos achieving the expanded blastocyst stage, 22 (45.6%) secreted significant amounts of human chorionic gonadotrophin (HCG) (> 5 IU/l/day). Of these, nine remained intrazonal, seven partially hatched and six fully hatched. Embryonic production of HCG in vitro appeared to be time-dependent, starting after a certain minimum time (approximately 160 h post-insemination) and rising exponentially, with maximal HCG production around day 10. Hatching was not a prerequisite for HCG secretion, since similar amounts were produced by intrazonal blastocysts. Blastocysts derived from abnormally fertilized oocytes also began secreting HCG exponentially but secretion was delayed and the upper limit of maximum HCG secretion rate was comparatively low. The actual amount of HCG is thought to reflect the number of viable trophectoderm cells producing the hormone. HCG doubling times for blastocysts in vitro were rapid when compared to implanting blastocysts of a similar age in vivo, with 19/22 (86.4%) blastocysts having a doubling time of < 10 h. Provided a pre-embryo can secrete HCG and maintain an adequate doubling time, sufficient HCG should be produced for initial stages of embryonic recognition in vivo. Since intrazonal blastocysts are capable of fulfilling both of these criteria, the limiting factor in realizing their full potential may be escaping from the zona pellucida.

Blastocyst↗
PubMed1993

The effect of intravenous saline loading on plasma levels of brain natriuretic peptide in man.

OBJECTIVE: Recent evidence suggests the presence of a dual natriuretic peptide system consisting of atrial natriuretic factor (ANF) from the atrium and brain natriuretic peptide (BNP) from the ventricle. Discrete roles have been postulated for these two natriuretic peptides in the control of circulatory homeostasis. We have therefore compared the release of ANF and BNP in response to an acute saline load to explore a differential pattern of release for the two natriuretic peptides in man. DESIGN: The effects of an acute saline infusion on plasma ANF and BNP concentrations were studied in 10 normal male volunteers. METHODS: Subjects were studied on two study days in the semirecumbent position. An acute intravenous saline infusion (250 ml/min) of 18 ml/kg isotonic sodium chloride-potassium chloride solution was administered on one of the two study days. No infusion was administered on the other day as a control. RESULTS: Plasma ANF concentrations increased significantly (P < 0.01) with saline loading without any detectable changes in plasma BNP concentrations up to 60 min following infusion. Heart rate and systolic and diastolic blood pressure were unchanged after saline loading. CONCLUSIONS: We have shown that an acute intravenous saline load causes an increase in plasma ANF concentrations with no detectable increase in plasma BNP at least up to 60 min after the acute saline load in man. These results support the view that the release of ANF and BNP may be regulated differently, especially with regard to the time required for the acute release of each peptide.

Adult↗
PubMed1993

Computerized management of respiratory care.

Respiratory care as an organized discipline is only about 45 years old, and the management of this dynamic allied health profession has usually been characterized by a demand-for-service mentality. As pressure continues to control costs, those departments that maximize quality patient care cost-effectively with thoroughly documented outcomes are in a better position to compete for future resources. The practice of respiratory care is changing as is the practice of medical care in general. Accountability for resource consumption and the quality of the product delivered are essential elements in the delivery of respiratory modalities. We have developed and implemented a comprehensive patient-data-based approach to the management of respiratory care. The essential elements of this approach are (1) relative-value-unit procedure base; (2) individual, shift, and department productivity that is attached to the annual performance review process; (3) management reporting on a 24-hour basis, with biweekly review at the management level; (4) development and implementation of a comprehensive patient-data-documentation system that permits automatic patient billing and 100% data review for quality-assurance documentation; (5) the development of a medical alerting system that alerts the Medical Director and Respiratory Care staff to potentially harmful events that, if untreated, may result in increased morbidity or mortality; and (6) the development of concurrent and retrospective tools for patient-outcomes research. These functions are supported by an active Medical Informatics Department that is nationally recognized in medical computing and logic application.

Cost-Benefit Analysis↗
PubMed1993

Review of a novel hematopoietic cytokine, interleukin-11.

The novel stromal cell factor, IL-11, has been reported to have diverse effects on the lymphopoietic and myeloid/erythroid cells in vitro. These include expansion of T cell-dependent Ig-secreting B cells, proliferation and differentiation of megakaryocytic progenitors and of a variety of myeloid and erythroid precursor cells, and multiplication of pluripotential hematopoietic progenitors. In addition, IL-11 inhibits adipogenesis in vitro. In vivo administration of IL-11 elevated the number of circulating neutrophils and platelets and increased the number of megakaryocytes in the spleens of normal mice.

Adipose Tissue↗
PubMed1992

Interleukin-11 stimulates multiple phases of erythropoiesis in vitro.

Interleukin-11 (IL-11), a pleiotropic cytokine originally isolated from a primate bone marrow stromal cell line, has been shown to stimulate T-cell-dependent B-cell maturation, megakaryopoiesis, and various stages of myeloid differentiation, but to inhibit adipogenesis. Because stromal cells are essential for the maintenance of early hematopoietic progenitor cells in long-term culture, we investigated the effects of IL-11 on multipotent and erythroid precursors from murine bone marrow in vitro in suspension and semisolid cultures. Our results show that in the presence of IL-3 or c-kit ligand (KL), IL-11 has profound stimulatory effects on primitive multilineage hematopoietic progenitors, pre-CFC(multi), as well as on precursors representing various stages of erythroid differentiation observable in vitro, including CFC(multi), BFU-E, and CFU-E. In addition, the combination of KL with IL-11 also stimulated highly proliferative erythroid progenitors that yield remarkable macroscopic erythroblast colonies in culture. These results indicate that IL-11 is likely to play a pivotal role in early hematopoiesis and at multiple stages of erythropoiesis.

Animals↗
PubMed1992

Are we educating a medical professional who cares?

We examined four domains in which physicians must demonstrate their capacity for caring. These include the knowledge base that forms the foundation for the practice of medicine, the personal characteristics and attributes that a physician brings to the profession, the individual patients for whom the physician accepts responsibility, and the society in which the physician lives. We conclude that the system of medical education does produce caring physicians. The profession's history of self-evaluation and criticism should not obscure medicine's real success in meeting its responsibility to care as well as to cure.

Education, Medical↗
PubMed1992

Leukemia inhibitory factor and interleukin-11 promote maturation of murine and human megakaryocytes in vitro.

The growth-promoting activities of optimally stimulating concentrations of leukemia inhibitory factor (LIF) and interleukin-11 (IL-11), a stromal cell-derived cytokine, on megakaryocytes in liquid marrow cultures were compared to interleukin-6 (IL-6), a known megakaryocytes maturation factor. Maximally stimulating concentrations of LIF (25 ng/ml), IL-11 (10 ng/ml), or IL-6 alone (10 ng/ml) promoted an 81, 157, and 153% increase, respectively, in acetylcholinesterase (AchE) activity in murine serum-free cultures compared with controls (n = 5). In combination with 25 U/ml murine interleukin-3 (IL-3), LIF, IL-6, and IL-11 showed increases, respectively, of 35%, 49%, and 174% in AchE activity compared with IL-3 alone (n = 4). Flow cytometric analysis of 4-day-old cultures showed that LIF alone had minimal effect on megakaryocytic ploidy, whereas IL-11 and IL-6 alone markedly augmented high ploidy cells. Enumeration of cells stained for AchE showed that IL-11 increased the numbers of Mks in comparison to LIF, IL-6 or controls by up to 59%. Moreover, a twofold increment in Mk number was noted when IL-11 was used in combination with IL-3 (compared with either IL-3 alone of IL-3+IL-6). Flow cytometric ploidy analysis of 8-day-old human liquid marrow cultures showed that either LIF, IL-11, or IL-6 alone markedly augmented the percentage of 32N cells compared with cultures containing only human IL-3. The data suggest that LIF and IL-11 promote murine and human Mk maturation in vitro, although the effect of IL-11 exceeds that of LIF in mice. Despite the comparable influence of IL-11 and IL-6 on Mk ploidy, IL-11 has the additional characteristic of enhancing the number of Mks, particularly in combination with IL-3.

Acetylcholinesterase↗
PubMed1992

In vitro fertilization in the natural cycle.

In vitro fertilization in the natural or spontaneous reproductive cycle was first described by Edwards and his colleagues in 1980 following the birth of their first natural cycle IVF baby 2 years earlier. Many groups attempted to follow their lead but it was almost ten years later that the next publication of success appeared (Foulot et al, 1989). The concept of IVF in the natural cycle is particularly attractive and so in 1987 our group also started evaluating the technique. Initial success in the patients with tubal lesions was not translated to patients with other infertility indications. Unfortunately the technique as initially developed was relatively inefficient with significant procedural losses at each stage. Over the succeeding four years a number of changes have been introduced and the efficiency considerably improved. Although these changes have improved take-home baby rates, overall pregnancy rates per embryo have not altered and are still lower than spontaneous in vivo pregnancy rates. It is likely that in the future, with current developments in culture techniques and greater understanding of gamete biology, this situation will change significantly.

Female↗
PubMed1992

Variation in the dry mass of mouse embryos throughout the preimplantation period.

Information on the net balance of embryonic metabolism during the preimplantation period is provided by measurements of embryo dry mass. The dry mass of mouse embryos at 10 defined stages of preimplantation development was measured using the Vickers M86 scanning microinterferometer. The results demonstrate that there is an overall loss of dry mass from the unfertilized ovum (39.10 +/- 0.6 ng) to the late blastocyst stage (32.80 +/- 0.53 ng) with these differences being highly significant. However, there is a significant increase in embryonic dry mass from the 1-cell (36.88 +/- 0.34 ng) to 2-cell stage (40.48 +/- 0.40 ng). These results suggest that protein synthesis exceeds degradation during the 2-cell stage but that from the 4-cell to morula stage the reverse is true. In addition, the variation in dry mass between embryos at the same developmental stage is extremely small, suggesting that this may be a useful indicator of embryonic viability.

Animals↗
PubMed1992

Does catheter immobilization reduce exit-site infections in CAPD patients?

This study was undertaken to ascertain the effectiveness of an immobilization device in reducing exit site infections (ESI) in CAPD patients, and whether immuno-suppressive therapy, diabetes, disconnect system and Staphylococcus aureus nasal carriage had any bearing on the incidence of ESI. Sixty-six patients having a Tenckhoff catheter placement were randomly allocated into one of three groups; immobilizer, tape and non-immobilized group. The groups were monitored for the incidence of ESI over a total period of 347 patient months. The results show no significant difference in infection rates between the three groups, nor do the factors mentioned have any bearing on ESI rate. Whilst immobilization is important, the ineffectiveness of this device was probably related to its design problem.

Bacterial Infections↗
PubMed1991

Antimicrobial peptides in the stomach of Xenopus laevis.

Antimicrobial peptides are widely distributed in nature and appear to play a role in the host defense of plants and animals. In this study we report the existence of antimicrobial peptides in the stomach of the vertebrate Xenopus laevis, an animal previously shown to store high concentrations of antimicrobial peptides in its skin. Antimicrobial activity was detected in extracts of X. laevis stomach tissue and nine antimicrobial peptides were then purified. A novel 24-amino acid peptide, designated PGQ, was isolated from these extracts, and has the following amino acid sequence: GVLSNVIGYLKKLGTGALNAVLKQ. PGQ is relatively basic and has the potential to form an amphipathic alpha-helix. The other peptides isolated are members of the magainin family of antimicrobial peptides, and include magainins I and II, PGLa, xenopsin precursor fragment, and four caerulein precursor fragments. None of these peptides had been previously identified in tissues other than the skin. The purification of the peptides from stomach extracts and subsequent protein sequence analysis reveals that the peptides have undergone the same processing as their dermal counterparts, and that they are stored in their processed forms. Northern blot analysis indicates that the magainin family of peptides are synthesized in the stomach, and immunohistochemical studies demonstrate that magainin is stored in a novel granular multinucleated cell in the gastric mucosa of Xenopus. This study demonstrates that the magainin family of antimicrobial peptides is found in the gastrointestinal system of X. laevis and offers an opportunity to further define the physiological role of these defense peptides.

Amino Acid Sequence↗
PubMed1991

Zona pellucida modifications in the mouse in the absence of oocyte activation.

Mouse oocytes arrested in metaphase II exhibit zona hardening and a reduced fertilization rate after exposure to the cryoprotectant dimethylsulfoxide (Johnson J, In Vitro Fertil Embryo Transfer 6:168-175, 1989) but do not undergo parthenogenetic activation (Johnson and Pickering, Development 100:313-324, 1987). This paper shows that dimethylsulfoxide causes proteolytic modification of the zona pellucida glycoprotein ZP2 and inhibition of sperm binding. These effects of dimethylsulfoxide are caused by premature exocytosis of the cortical granules, a process that is initiated usually on fertilization. A model for the mechanism of action of dimethylsulfoxide is proposed based on the combined effects of cytoskeletal modification and osmotic shock. The presence of serum before and during the exposure to dimethylsulfoxide was found to reduce significantly these deleterious effects on the mouse zona pellucida without inhibiting the cortical granule release. These results highlight the suitability of dimethylsulfoxide as a tool to study the mechanisms leading to cortical granule release. Use of dimethylsulfoxide allows the separation of oocyte parthenogenetic activation from cortical granule release, and addition of serum allows separation of cortical granule release from the action of the cortical granule contents. Their use allows a dissection of the mechanisms underlying each of these three related events.

Animals↗
PubMed1990

Aneurysms of the inferior vena cava.

Aneurysms of the inferior vena cava are very rare. We describe a case of a saccular aneurysm of the inferior vena cava that thrombosed after vigorous exercise. This presented as deep venous thrombosis associated with a retroperitoneal mass. Laparotomy with biopsy confirmed the benign nature of this lesion, and symptoms gradually resolved. It is hypothesized that the increased intraabdominal pressure during exercise led to the thrombosis of what is presumed to be a congenital aneurysm of the inferior vena cava.

Adult↗