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Biomedical subjects

L Robinson

Publications and source records attributed to L Robinson.

At least 19 recordsLinked to original sources
PubMed1998

Ab-normative data.

Explore the source record for details and available documents.

Evoked Potentials, Motor↗
PubMed1998

Pulmonary edema as a result of chronic upper airway obstruction.

This is the first case of an adult who developed recurrent pulmonary edema as a result of unrecognized chronic upper airway obstruction due to polyarticular juvenile rheumatoid arthritis. The case highlights the importance of considering upper airway involvement in the differential diagnosis of sedentary patients with arthritic joint disease and breathing difficulties.

Airway Obstruction↗
PubMed1998

Experiences with functional magnetic resonance imaging at 1 tesla.

Functional magnetic resonance imaging (fMRI) has been performed on a standard 1 T system using a pulse sequence developed to utilize blood oxygen level dependent (BOLD) contrast and an off-line analysis routine using correlation techniques. The sequence and the data analysis routine have been validated by reproducing the conventional hand movement paradigm studies reported by numerous other workers. Our work has then been extended to investigate cerebral foci for a tonic pain stimulus and the cortical representation of oesophageal stimulation. Both these studies relate to paradigms where the expected BOLD signal is significantly less than that encountered for motor or visual cortex paradigms. The results show good agreement with other modalities (positron emission tomography, magnetoencephalography and cortical evoked potentials). Performing fMRI at 1 T is slightly controversial. However, our successful study of demanding paradigms, using a standard clinical 1 T imaging system, has important implications for many other users operating at this field strength.

Brain↗
PubMed1998

Pain and cognitive status in the institutionalized elderly: perceptions & interventions.

The purposes of this study were to examine the relationship between: (1) nurses' ratings of pain and corresponding administration of pain medication to elderly long-term care residents, and (2) cognitive status of the elderly and pain medication orders/administration. Participants were 83 residents, 60 years of age and older, in two groups: cognitively impaired (n = 64), and cognitively intact (n = 19). For comparison purposes, 19 of the cognitively impaired subjects were matched on age and diagnosis to provide control for potentially painful conditions. A retrospective medication review of the resident's charts was conducted to compare medication orders and administration on analgesics that were scheduled and p.r.n. (given as needed). The pain ratings of 25 RNs using a visual analogue scale were correlated with pain medications given to the resident on the day of the rating. Results indicated that RNs' ratings of resident pain and the administration of pain medications were not significantly correlated. In addition, cognitively impaired residents were prescribed significantly less scheduled medication and received significantly less pain medication (either p.r.n. or scheduled) than the cognitively intact elderly. Implications for practice and research are discussed.

Aged↗
PubMed1998

Evaluation of death registers in general practice.

BACKGROUND: General practitioners (GPs) do not routinely receive information about the deaths of those patients whose death certificates they have not completed. We developed and evaluated a system for producing death registers for GPs. AIM: To evaluate GPs' and practice managers' views on, and uses of, the death register. METHOD: General practitioners in Newcastle (n = 161) and Sunderland Family Health Service Authority (n = 144) areas were sent a questionnaire on their sources and use of information about patients' deaths. Death registers were sent to Newcastle practices; Sunderland practices were the control group. A follow-up questionnaire was sent to Newcastle (n = 173) and Sunderland (n = 140) GPs after two years. Newcastle practice managers (n = 45) were interviewed after their practice had received death registers for one year. RESULTS: Ninety-two per cent of Newcastle responders had seen the death register. Seventy-three per cent saw it regularly. Of those who saw it, 92% found it useful for communication within the primary health care team, bereavement follow-up, and administration and medical audit. One fifth of GPs named the death register as their first source of information about their patients' deaths. Newcastle GPs reported greater levels of change in use of patient death information than the control group. Practice managers circulated, used, and recorded information from the death register. CONCLUSION: Death registers are valued and have demonstrable benefits with regard to administration, bereavement care, and medical audit.

Attitude of Health Personnel↗
PubMed1997

Measurement of vertebral rotation in adolescent idiopathic scoliosis using three-dimensional magnetic resonance imaging.

STUDY DESIGN: This report examines a technique for measurement of axial vertebral rotation using magnetic resonance imaging. OBJECTIVES: To assess the reproducibility of three-dimensional magnetic resonance imaging in the measurement of vertebral rotation at individual endplates in patients with adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: Deformity in the sagittal and coronal planes in patients with adolescent idiopathic scoliosis can be readily assessed from plain radiographs, but the degree of deformity in the axial plane is more difficult to determine. Plain film techniques have inherent inaccuracies because of loss of definition of anatomic landmarks, and the use of computed tomography is limited by the high radiation dose associated. Magnetic resonance imaging provides a means of imaging scoliotic deformity that allows multiplanar reconstruction and that involves no use of ionizing radiation. METHODS: Ten patients with adolescent idiopathic scoliosis were imaged in a Siemens 1-Tesla impact scanner. Three-dimensional volume images of the apical five vertebrae were obtained in the axial plane and were postprocessed through multiplanar reconstruction. Sections through the superior and inferior endplates of each vertebra were selected in the sagittal and coronal planes, allowing axial reconstructions to be obtained in the plane of each endplate. Vertebral rotation was measured by identifying datum points on the inner surfaces and at the junction of the laminas and comparing the angle subtended by these points with a vertical drawn by the computer. Measurements were obtained from the single scanning sequence on two occasions by one observer and on one occasion by a second observer. Interobserver and intraobserver error was evaluated and correlation with readings obtained from plain films using Perdriolle's torsiometer method assessed. RESULTS: The interobserver variation had a mean of 3.02 degrees (range, 0-10 degrees) and a 95% confidence interval of [2.51 degrees, 3.53 degrees]. The intraobserver variation had a mean of 2.56 degrees (range, 0-7 degrees) and a 95% confidence interval of [1.83 degrees, 3.29 degrees]. The mean difference between measurements obtained from magnetic resonance imaging and plain film was 3.29 degrees (range, 0-12 degrees) with a 95% confidence interval of [1.43 degrees, 5.15 degrees]. CONCLUSIONS: The degree of vertebral rotation can be accurately and reproducibly assessed by three-dimensional magnetic resonance imaging. Measurements can be made through individual endplates that allow assessment of the relative amount of intervertebral and intravertebral deformity.

Adolescent↗
PubMed1997

ETS target genes: identification of egr1 as a target by RNA differential display and whole genome PCR techniques.

ETS transcription factors play important roles in hematopoiesis, angiogenesis, and organogenesis during murine development. The ETS genes also have a role in neoplasia, for example in Ewing's sarcomas and retrovirally induced cancers. The ETS genes encode transcription factors that bind to specific DNA sequences and activate transcription of various cellular and viral genes. To isolate novel ETS target genes, we used two approaches. In the first approach, we isolated genes by the RNA differential display technique. Previously, we have shown that the overexpression of ETS1 and ETS2 genes effects transformation of NIH 3T3 cells and specific transformants produce high levels of the ETS proteins. To isolate ETS1 and ETS2 responsive genes in these transformed cells, we prepared RNA from ETS1, ETS2 transformants, and normal NIH 3T3 cell lines and converted it into cDNA. This cDNA was amplified by PCR and displayed on sequencing gels. The differentially displayed bands were subcloned into plasmid vectors. By Northern blot analysis, several clones showed differential patterns of mRNA expression in the NIH 3T3-, ETS1-, and ETS2-expressing cell lines. Sixteen clones were analyzed by DNA sequence analysis, and 13 of them appeared to be unique because their DNA sequences did not match with any of the known genes present in the gene bank. Three known genes were found to be identical to the CArG box binding factor, phospholipase A2-activating protein, and early growth response 1 (Egr1) genes. In the second approach, to isolate ETS target promoters directly, we performed ETS1 binding with MboI-cleaved genomic DNA in the presence of a specific mAb followed by whole genome PCR. The immune complex-bound ETS binding sites containing DNA fragments were amplified and subcloned into pBluescript and subjected to DNA sequence and computer analysis. We found that, of a large number of clones isolated, 43 represented unique sequences not previously identified. Three clones turned out to contain regulatory sequences derived from human serglycin, preproapolipoprotein C II, and Egr1 genes. The ETS binding sites derived from these three regulatory sequences showed specific binding with recombinant ETS proteins. Of interest, Egr1 was identified by both of these techniques, suggesting strongly that it is indeed an ETS target gene.

3T3 Cells↗
PubMed1997

FLI1 and EWS-FLI1 function as ternary complex factors and ELK1 and SAP1a function as ternary and quaternary complex factors on the Egr1 promoter serum response elements.

The ETS gene products are a family of transcriptional regulatory proteins that contain a highly conserved and structurally unique DNA binding domain, termed the ETS domain. Several ETS proteins bind to DNA as monomers, however it has been shown that the DNA binding activity is enhanced or modulated in the presence of other factors. By differential display and whole genome PCR techniques, we have recently shown that the Erg1 gene is a target for ETS proteins. The Egr1 promoter contains multiple ETS binding sites, three of which exist as parts of two serum response elements (SREI and SREII). The SRE is a cis-element that regulates the expression of many growth factor responsive genes. ELK1 and SAP1a have been shown to form ternary complexes with SRF on the SRE located in the c-fos promoter. Similarly, we examined whether the ELK1, SAP1a, FLI1, EWS-FLI1, ETS1, ETS2, PEA3 and PU.1 proteins can form ternary complexes with SRF on the Egr1 SREI and II. Our results demonstrate that indeed ELK1, SAPla, FLI1 and EWS-FLI1 are able to form ternary complexes with SRF on Egr1 SREs. In addition, ELK1 and SAP1a can also form quarternary complexes on the Egr1 SREI. However, the proteins ETS1, ETS2, PEA3 and PU.1 were unable to form ternary complexes with SRF on either the Egr1 or c-fos SREs. Our data demonstrate that FLI1 and EWS-FLI1 constitute new members of a subgroup of ETS proteins that can function as ternary complex factors and further implicate a novel function for these ETS transcription factors in the regulation of the Egr1 gene. By amino acid sequence comparison we found that, in fact, 50% of the amino acids present in the B-box of SAP1a and ELK1, which are required for interaction with SRF, are identical to those present in both FLI1 (amino acids 231- 248) and EWS-FLI1 proteins. This B-box is not present in ETS1, ETS2, PEA3 or PU.1 and these proteins were unable to form ternary complexes with SRF and Egrl-SREs or c-fos SRE. Furthermore, deletion of 194 amino terminal amino acids of FLI1 did not interfere with its ability to interact with SRF, in fact, this truncation increased the stability of the ternary complex. The FLI1 protein has a unique R-domain located next to the DNA binding region. This R-domain may modulate the interaction with SRF, providing a mechanism that would be unique to FLI1 and EWS-FLI1, thus implicating a novel function for these ETS transcription factors in the regulation of the Egr1 gene.

Animals↗
PubMed1997

Chromosome 3p14 homozygous deletions and sequence analysis of FRA3B.

Loss of heterozygosity (LOH) involving 3p occurs in many carcinomas but is complicated by the identification of four distinct homozygous deletion regions. One putative target, 3p14.2, contains the common fragile site, FRA3B, a hereditary renal carcinoma-associated 3;8 translocation and the candidate tumor suppressor gene, FHIT. Using a approximately 300 kb comsid/lambda contig, we identified homozygous deletions in cervix, breast, lung and colorectal carcinoma cell lines. The smallest deletion (CC19) was shown not to involve FHIT coding exons and no DNA sequence alterations were present in the transcript. We also detected discontinuous deletions as well as deletions in non-tumor DNAs, suggesting that FHIT is not a selective target. Further, we demonstrate that some reported FHIT aberrations represent normal splicing variation. DNA sequence analysis of 110 kb demonstrated that the region is high in A-T content, LINEs and MER repeats, whereas Alu elements are reduced. We note an intriguing similarity in repeat sequence composition between FRA3B and a 152 kb segment from the Fragile-X region. We also identified similarity between a FRA3B segment and a small polydispersed circular DNA. In contrast to the selective loss of a tumor suppressor gene, we propose an alternative hypothesis, that some putative targets including FRA3B may undergo loss as a consequence of genomic instability. This instability is not due to DNA mismatch repair deficiency, but may correlate in part with p53 inactivation.

Acid Anhydride Hydrolases↗
PubMed1997

A test of the fit between the Corbin and Strauss Trajectory Model and care provided to older patients after cancer surgery.

The Corbin and Strauss Trajectory Model proposed that nursing care should differ along a trajectory of eight phases to meet patients' and families' needs. Seventy-nine patients with breast, prostate, or gastrointestinal cancer were determined to be in either the stable or the unstable phase of their illness. Contrary to expectations, documented nursing interventions did not significantly differ between stable and unstable trajectory phases, although significant differences were found when comparisons were made across cancer sites. These findings suggest that the trajectory framework may require modification for use with oncology patients.

Aged↗
PubMed1997

Accuracy of levelling intraventricular collection drainage systems.

In neuroscience critical care units, patients may have ventricular drains placed to aid management of acutely elevated intracranial pressure from a variety of causes. Correct placement of the ventricular drainage collection system, a nursing responsibility, is key to the process, and has the potential to influence patient outcome. A two-part study investigated the accuracy with which registered nurses levelled a ventricular drainage collection system. Part 1 found that nurses (N = 33) were unable to accurately level using visual means only. Part 2 found that nurses' (N = 31) use of a tool (a carpenter's level or a newly developed laser levelling device) dramatically improved accuracy. However, demographic differences between nurses in Part 1 and Part 2 may have contributed to this outcome. While both tools were accurate, the laser levelling device was superior to the carpenter's level for speed of use, nurses' rating of ease of use and patient safety.

Catheters, Indwelling↗
PubMed1997

Characterization of short tandem repeats from thirty-one human telomeres.

Completion of genetic and physical maps requires markers from the ends (telomeres) of every human chromosome. We have searched for short tandem repeats (microsatellites) in cosmid and P1 clones and generated 661 sequence-tagged sites (STS) from the terminal 300 kb of 31 human chromosome ends. PCR assays were successfully designed for 58 microsatellites and mapped both genetically and on radiation hybrids (RHs) to confirm their telomeric location. Sequence analysis revealed marked variation in sequence composition, consistent with the hypothesis that even very highly GC-rich chromosome bands (the T bands) are not homogenous. The STSs that we have generated will be a necessary resource for the construction of physical maps of these complex regions of the genome.

Base Sequence↗
PubMed1997

Nursing intervention intensity and focus: indicators of process for outcomes studies.

Outcomes research has become increasingly important in the current health care environment and for informatics research efforts. Recent efforts in automating clinical data for use in outcomes studies has focused attention on the need to represent the processes of care in the classic structure-process-outcome models of care. This paper reports on use of the Nursing Intervention Lexicon and Taxonomy for classifying interventions to characterize two process of care variables: intervention intensity and intervention focus. Study results demonstrate that these variables are descriptive and provide promise for describing processes of nursing care for describing clinical care.

Breast Neoplasms↗
PubMed1997

Evidence that therapy works in clinically representative conditions.

This article reports a secondary analysis of past therapy outcome meta-analysis. Fifteen meta-analysis provided effect sizes from 56 studies in previous reviews that met 1 of 3 increasingly stringent levels of criteria for clinical representativeness. The effect sizes were synthesized and compared with results from the original meta-analyses. Effect sizes from more clinically representative studies are the same size at all 3 criteria levels as in past meta-analyses. Almost no studies exist that meet the most stringent level of criteria. Results are interpreted cautiously because of controversy about what criteria best capture the notion of clinical representativeness, because so few experiments have tested therapy in clinical conditions, and because other models for exploring the generalizability of therapy outcome research to clinical conditions might yield different results.

Humans↗