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Biomedical subjects

M A Johnson

Publications and source records attributed to M A Johnson.

At least 19 recordsLinked to original sources
PubMed2007

Isomer-specific spectroscopy of the (H2O)8- cluster anion in the intramolecular bending region by selective photodepletion of the more weakly electron binding species (isomer II).

The vibrational predissociation spectra of the two more strongly electron binding forms of the (H2O)8- anion are obtained in the HOH intramolecular bending region. This is accomplished by deconvoluting the overlapping spectra obtained from a mixed ensemble using a population modulation scheme in which the low electron binding isomer (II) is removed from the ion packet prior to spectroscopic analysis. By choosing the energy of the photodepletion laser to lie between the vertical detachment energies of the two isomers, the contribution from isomer II can be quantitatively eliminated, leaving the population of I largely unaffected. The low binding energies involved in the application of the method to the water cluster anions necessitate that this should be carried out in the midinfrared, thus requiring two tunable ir laser systems for implementation. The isolated spectrum of isomer 1 displays a strong, redshifted feature associated with a double H-bond acceptor (AA) water molecule in direct contact with the excess electron and a large gap before higher energy features appear that are typically associated with (acceptor/donor) AD and ADD binding sites in the network. The more weakly binding isomer II does not display the AA feature and instead contributes broad structure at intermediate redshifts that merges with the region associated with neutral water cluster networks.

Journal Article↗
PubMed2006

Adverse events and treatment interruption in tuberculosis patients with and without HIV co-infection.

BACKGROUND: Serious treatment associated adverse events are thought to occur more frequently in individuals with tuberculosis (TB) who are co-infected with HIV. A study was undertaken to assess the frequency of serious (grade III/IV) adverse events and interruption of anti-TB treatment in the era of effective antiretroviral therapy. METHODS: The incidence of serious adverse events was retrospectively compared in 312 individuals treated for TB, 156 of whom were co-infected with HIV. RESULTS: 111 HIV infected individuals (71%) received highly active antiretroviral therapy at the same time as anti-TB treatment. Serious adverse events were recorded in 40% HIV infected and 26% HIV uninfected individuals (p = 0.008). Peripheral neuropathy and persistent vomiting were more common in co-infected patients (p<0.001; p = 0.006), although all cause interruption of anti-TB treatment occurred with similar frequency in the two groups (13% in HIV infected patients and 15% in HIV uninfected patients; p = 0.74). In 85% of HIV infected patients and 87% of HIV uninfected individuals this was due to hepatotoxicity, which typically presented within 2 months of starting treatment. The median delay in restarting treatment was 4 weeks, so most individuals required full TB re-treatment. CONCLUSION: Despite a greater rate of serious (grade III/IV) adverse events among HIV infected individuals, discontinuation of anti-TB treatment occurred with a similar frequency in HIV infected and HIV uninfected individuals.

Adult↗
PubMed2006

Infrared spectroscopy of water cluster anions, (H2O)n=3-24-)in the HOH bending region: persistence of the double H-bond acceptor (AA) water molecule in the excess electron binding site of the class I isomers.

We report vibrational predissociation spectra of water cluster anions, (H(2)O)(n=)()(3)(-)(24)(-) in the HOH bending region to explore whether the characteristic red-shifted feature associated with electron binding onto a double H-bond acceptor (AA) water molecule survives into the intermediate cluster size regime. The spectra of the "tagged" (H(2)O)(n)()(-).Ar clusters indeed exhibit the signature AA band, but assignment of this motif to a particular isomer is complicated by the fact that argon attachment produces significant population of three isomeric forms (as evidenced by their photoelectron spectra). We therefore also investigated the bare clusters since they can be prepared exclusively in the high binding (isomer class I) form. Because the energy required to dissociate a water molecule from the bare complexes is much larger than the transition energies in the bending region, the resulting (linear) action spectroscopy selectively explores the properties of clusters with most internal energy content. The (H(2)O)(15)(-) predissociation spectrum obtained under these conditions displays a more intense AA feature than was found in the spectra of the Ar tagged species. This observation implies that not only is the AA motif present in the class I isomer, but also that it persists when the clusters contain considerable internal energy.

Journal Article↗
PubMed2006

Virological response to highly active antiretroviral therapy is unaffected by antituberculosis therapy.

We compared 156 human immunodeficiency virus (HIV)-infected patients who had tuberculosis with control populations of similar size. Of 111 patients with HIV infection and tuberculosis who received highly active antiretroviral therapy (HAART) and therapy for tuberculosis concurrently, 92 (83%) achieved or maintained virus loads of <50 copies/mL, and 99 (89%) achieved or maintained a >or=2 log10 reduction in virus load after 6 months. Virological response and changes in CD4 cell count were equivalent to those in 111 matched HIV-infected subjects without tuberculosis starting HAART. Tuberculosis recurrence rates were similar to those found in an HIV-uninfected population of 156 subjects (3% and 1%, respectively). Treatment for HIV and tuberculosis does not compromise outcomes for either disease.

AIDS-Related Opportunistic Infections↗
PubMed2006

National review of maternity care for women with HIV infection.

OBJECTIVE: To assess adherence to the British HIV Association (BHIVA) 2001 guidelines for the management of HIV-infected pregnant women. METHODS: A survey and a case note review were carried out using structured questionnaires sent to providers of adult HIV care in the UK and Ireland. Participants were women with HIV infection who delivered a live or stillborn infant between October 2002 and September 2003. The main outcome measures were the appropriate use of antiretroviral therapy, the use and timing of elective Caesarean section, and support for the avoidance of breast-feeding. RESULTS: Of 186 centres, 100 (54%) responded with data on 501 eligible pregnancies. CONCLUSIONS: In general, practice was in accordance with the BHIVA 2001 guidelines. However, in a number of cases Caesarean sections were planned later than the recommended 38 weeks.

Adolescent↗
PubMed2005

Infrared spectrum and structural assignment of the water trimer anion.

The bending vibrational spectrum of the perdeutero isotopomer of the water trimer anion has been measured and compared with spectra calculated using the MP2, CCSD, and Becke3LYP electronic structure methods. Due to its low electron binding energy (approximately 150 meV), only the OD bending region of the IR spectrum of (D2O)3(-) is accessible experimentally, with electron ejection dominating at higher photon energies. The calculated spectrum of the isomer having three water molecules arranged in a chain agrees best with the experimental spectrum. In the chain isomer, the excess electron is bound to the terminal water monomer with two dangling OH groups. This is consistent with the electron binding mechanism established previously for the (H2O)n(-) (n = 2, 4-6) anions.

Journal Article↗
PubMed2005

Identification of two distinct electron binding motifs in the anionic water clusters: a vibrational spectroscopic study of the (H2O)6- isomers.

Photoelectron spectroscopy of the water cluster anions, (H2O)n-, has revealed that several isomeric forms are present for most sizes, and here, we use vibrational spectroscopy to address the structure of the (H2O)6- isomer that more weakly binds the extra electron. To overcome the severe line broadening that occurs in the OH stretching region of this isomer caused by fast electron autodetachment, we concentrate on the low-energy bending modes of the perdeutero isotopomer. Sharp spectroscopic signatures are recovered for two isomers using argon predissociation spectroscopy, and the resulting bands are heavily overlapped. To extract their independent contributions to the observed spectra, we exploit the substantial dependence of their relative populations on the number of attached argon atoms in the (D2O)6-.Ar(m) clusters, determined by photoelectron spectroscopy. The vibrational spectra of each isomer can then be isolated by spectral subtraction, which is implemented with a covariance mapping approach. The resulting band patterns establish that the more weakly binding isomer does not display the characteristic electron-binding motif common to the more strongly bound isomer class. Whereas the strongly binding isomer features a single water molecule pointing toward the excess electron cloud with both of its hydrogen atoms, the spectrum of the more weakly binding isomer suggests a structure where the electron is bound by a number of dangling OH groups corresponding to water molecules in acceptor-donor binding sites.

Journal Article↗
PubMed2005

An infrared investigation of the (CO2)n- clusters: core ion switching from both the ion and solvent perspectives.

The (CO2)n- clusters are thought to accommodate the excess electron by forming a localized molecular anion, or "core ion", solvated by the remaining, largely neutral CO2 molecules. Earlier studies interpreted discontinuities in the (CO2)n- photoelectron spectra to indicate that both the CO2- and C2O4- species were present in a size-dependent fashion. Here we use vibrational predissociation spectroscopy to unambiguously establish the molecular structures of the core ions in the 2 < or = n < or = 17 size range. Spectra are reported in the 2300-3800 cm(-1) region, which allows us to independently monitor the contribution of each ion through its characteristic overtone and combination bands. These signature bands are observed to be essentially intact in the larger clusters, establishing that the CO2- and C2O4- molecular ions are indeed the only electron accommodation modes at play. The size dependence of the core ion suggested in earlier analyses of the photoelectron spectra is largely confirmed, although both species are present over a range of clusters near the expected critical cluster sizes, as opposed to the prompt changes inferred earlier. Perturbations in the bands associated with the nominally neutral CO2 "solvent" molecules are correlated with the changes in the molecular structure of the core ion. These observations are discussed in the context of a diabatic model for electron delocalization over the CO2 dimer. In this picture, the driving force leading to the transient formation of the monomer ion is traced to the solvent asymmetry inherent in an incomplete coordination shell.

Journal Article↗
PubMed2005

Ocular structure and function in an aged monkey with spontaneous diabetes mellitus.

Diabetes mellitus develops spontaneously in middle-aged, obese rhesus monkeys, thus making them a good model for examining the effects of co-morbid factors on the development of end-organ damage. Changes in structure and function in the eyes of one monkey who spontaneously developed type 2 diabetes are reported here. This animal had concomitant hypertension, high levels of triglycerides and serum cholesterol, and a low fraction of high-density lipoprotein. The eyes showed intraretinal hemorrhages and large areas of retinal capillary nonperfusion. Indo-cyanin green (ICG) angiography revealed a large area of non- or poorly perfused choriocapillaris in one eye, and immunohistochemistry showed loss of viable choriocapillaries in this region. Both basal laminar deposits and hard drusen were present on areas of Bruch's membrane adjacent to nonviable choriocapillaris. Blood flow via the nasal posterior ciliary arteries to this section of choroid was not detectable by color duplex Doppler ultrasound, indicating contribution of extraocular vascular disease to ischemia in this eye. There was a severe decline in number of photoreceptor inner and outer segments, and corresponding reductions in the multifocal electroretinogram (ERG), in the areas of choriocapillaris loss. The ganzfeld ERG indicated loss in both inner and outer retinal function. Much of the ganglion cell layer was absent throughout the retina, possibly reflecting the effect of diabetes as well as chronic open angle glaucoma; the latter diagnosis supported by elevated intraocular pressures and excavated optic disks. In summary, high resolution, enzyme histochemical and histopathological analyses of a diabetic hypertensive monkey retina and choroid after serial functional in vivo analyses have demonstrated the relationship between vascular dysfunction and visual function loss. Choroidal vascular dysfunction in both large and small vessels was associated with age-related macular degeneration-like changes in Bruch's membrane and photoreceptor degeneration.

Aging↗
PubMed2004

Infrared signature of structures associated with the H+(H2O)n (n = 6 to 27) clusters.

We report the OH stretching vibrational spectra of size-selected H+(H2O)n clusters through the region of the pronounced "magic number" at n = 21 in the cluster distribution. Sharp features are observed in the spectra and assigned to excitation of the dangling OH groups throughout the size range 6 </= n </= 27. A multiplet of such bands appears at small cluster sizes. This pattern simplifies to a doublet at n = 11, with the doublet persisting up to n = 20, but then collapsing to a single line in the n = 21 and n = 22 clusters and reemerging at n = 23. This spectral simplification provides direct evidence that, for the magic number cluster, all the dangling OH groups arise from water molecules in similar binding sites.

Journal Article↗
PubMed2004

Comparison of first-line antiretroviral therapy with regimens including nevirapine, efavirenz, or both drugs, plus stavudine and lamivudine: a randomised open-label trial, the 2NN Study.

BACKGROUND: The 2NN Study was a randomised comparison of the non-nucleoside reverse-transcriptase inhibitors (NNRTI) nevirapine and efavirenz. METHODS: In this multicentre, open-label, randomised trial, 1216 antiretroviral-therapy-naive patients were assigned nevirapine 400 mg once daily, nevirapine 200 mg twice daily, efavirenz 600 mg once daily, or nevirapine (400 mg) and efavirenz (800 mg) once daily, plus stavudine and lamivudine, for 48 weeks. The primary endpoint was the proportion of patients with treatment failure (less than 1 log(10) decline in plasma HIV-1 RNA in the first 12 weeks or two consecutive measurements of more than 50 copies per mL from week 24 onwards, disease progression [new Centers for Disease Control and Prevention grade C event or death], or change of allocated treatment). Analyses were by intention to treat. FINDINGS: Treatment failure occurred in 96 (43.6%) of 220 patients assigned nevirapine once daily, 169 (43.7%) of 387 assigned nevirapine twice daily, 151 (37.8%) of 400 assigned efavirenz, and 111 (53.1%) of 209 assigned nevirapine plus efavirenz. The difference between nevirapine twice daily and efavirenz was 5.9% (95% CI -0.9 to 12.8). There were no significant differences among the study groups in the proportions with plasma HIV-1 RNA concentrations below 50 copies per mL at week 48 (p=0.193) or the increases in CD4-positive cells (p=0.800). Nevirapine plus efavirenz was associated with the highest frequency of clinical adverse events, and nevirapine once daily with significantly more hepatobiliary laboratory toxicities than efavirenz. Of 25 observed deaths, two were attributed to nevirapine. INTERPRETATION: Antiretroviral therapy with nevirapine or efavirenz showed similar efficacy, so triple-drug regimens with either NNRTI are valid for first-line treatment. There are, however, differences in safety profiles. Combination of nevirapine and efavirenz did not improve efficacy but caused more adverse events.

Adult↗
PubMed2004

Genetics of the DST-mediated mRNA decay pathway using a transgene-based selection.

mRNA sequences that control abundance, localization and translation initiation have been identified, yet the factors that recognize these sequences are largely unknown. In this report, a transgene-based strategy designed to isolate mutants of Arabidopsis thaliana that fail to recognize these sequences is described. In this strategy, a selectable gene and a screenable marker gene are put under the control of the sequence element being analysed and mutants are selected with altered abundance of the corresponding marker RNAs. The selection of mutants deficient in recognition of the DST (downstream) mRNA degradation signal is used as a test-case to illustrate some of the technical aspects that have facilitated success. Using this strategy, we report the isolation of a new mutant, dst3, deficient in the DST-mediated mRNA decay pathway. The targeted genetic strategy described circumvents certain technical limitations of biochemical approaches. Hence, it provides a means to investigate a variety of other mechanisms responsible for post-transcriptional regulation.

Hydrolysis↗
PubMed2004

Cardiovascular disease risk factors and antiretroviral therapy in an HIV-positive UK population.

AIM: Although the benefits of antiretroviral therapy (ART) have been dramatic, studies have started to report a variety of drug-related side effects and toxicities. We sought to characterize the risk factors for cardiovascular disease present in an HIV-positive population. METHODS: A total of 394 HIV-positive ambulant patients attending the Royal Free Hospital, London, were asked to complete a questionnaire. Questions focused on smoking habits and general health. RESULTS: In total, 38% of patients were aged >40 years, 37% had a family history of heart disease, 3% had diabetes, 14% suffered from raised blood pressure, 20% had a body mass index (BMI)>26 kg/m3, 7% had an alcohol consumption above the recommended UK limit, and 18% had total cholesterol levels >6.3 mmol/L [corrected]. The rate of smoking observed (45%) was much higher than that observed amongst the general population in the British Health Survey for England (34%). There were significant differences between those receiving and not receiving ART. Those on ART tended to be younger (P<0.0001) and less likely to smoke cigarettes (P=0.06) or have an alcohol consumption above the recommended limit (P=0.08), but were more likely to have diabetes (P=0.05). More patients receiving ART reported, and so perceived themselves to have, raised blood fats (P<0.0001). This was confirmed when considering blood lipid levels, where those on ART had significantly raised total cholesterol levels compared to those not currently receiving ART (P<0.0001). CONCLUSION: We have demonstrated an excess of cardiovascular risk factors in this cohort. These issues must be addressed if we wish to maintain the benefit of treating HIV infection.

Adult↗