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Biomedical subjects

M A Jones

Publications and source records attributed to M A Jones.

At least 37 records · Page 2Linked to original sources
PubMed2001

Neurofibromatosis involving the urinary bladder.

We present two interesting cases of a 24-year-old man and a 14-year-old boy, uncle and nephew, with lower urinary tract symptoms, café au lait patches and subcutaneous nodules. Ultrasonography and computed tomography scans showed a large, irregular lobulated soft tissue mass between the bladder and sacrum. Cystoscopy, laparotomy and biopsies revealed neurofibromatosis involving the urinary bladder. No enlargement of the tumor or upper urinary tract obstruction has occurred during the long-term follow up. We recommend meticulous follow up of patients with giant intrapelvic neurofibromatosis.

Adolescent↗
PubMed2001

Variation in shoulder position sense at mid and extreme range of motion.

OBJECTIVE: To determine the effect of different joint positions on position sense of asymptomatic shoulders. DESIGN: Repeated-measures design. SETTING: Laboratory in an educational institution. PARTICIPANTS: Thirty-four asymptomatic, right-handed men. INTERVENTIONS: The ability of subjects to replicate 3 criterion positions was examined on subjects' right shoulders by using an isokinetic dynamometer. Three criterion positions were the 50th, 75th, and 90th percentiles of each individual's total passive shoulder rotation range measured from the full internal rotation position. MAIN OUTCOME MEASURE: Repositioning accuracy, indicating the difference in degrees between the criterion and matching positions. RESULTS: All subjects were able to reproduce the criterion position near the end of external rotation range more accurately and consistently than in the middle range of motion (ROM). CONCLUSIONS: Position sense acuity at the shoulder complex varied across the ROM and may be enhanced near the end of rotation range where there is more tension on the restraints to movement. Therefore, an individual's ROM should be factored into any attempt to assess or rehabilitate shoulder proprioception.

Adult↗
PubMed2001

Improved survival after endoluminal repair with second-generation prostheses compared with open repair in the treatment of abdominal aortic aneurysms: a 5-year concurrent comparison using life table method.

PURPOSE: The aim of this study was to compare the outcome of consecutive patients with abdominal aortic aneurysm (AAA) treated concurrently by means of open repair (OR) and endoluminal repair (ER) with second-generation prostheses by the same surgeons during a defined interval. METHODS: Between May 1995 and December 1998 second-generation (low profile, fully supported, modular) endoprostheses were implanted in 148 patients. These patients, together with 135 patients treated concurrently with OR during the same period, comprised the study group of 283 patients. Patient selection was based on aneurysm morphology. Those patients who were anatomically suitable for ER were treated with this method. The ER and OR groups were similar with regard to age, sex, and size of AAA. The ER group contained high-risk patients considered unfit for OR (n = 46), and the OR group contained high-risk patients who were anatomically unsuitable for ER (n = 19). Outcome criteria in both groups were survival and successful aneurysm repair. Success in the ER group was defined as exclusion of the aneurysm sac and stability or reduction in AAA maximum transverse diameter. Persistent endoleaks were classified as failures, regardless of whether they were subsequently corrected with secondary endovascular intervention. Data were analyzed with the life table method. The minimum period of follow-up for all patients was 18 months. RESULTS: The perioperative mortality rate was 5.9% in the OR group and 2.7% in the ER group (not significant). There was a statistically significant difference between the survival curves of the two groups in favor of the ER group when analyzed with the log-rank test (P =.004). The Kaplan-Meier curve for graft failure for the ER group revealed a 3-year graft success probability of 82%. Survival probability with successful repair in the OR group at 3 years was 85%. CONCLUSIONS: A concurrent comparison of ER with second-generation prostheses versus OR demonstrated a significant difference in survival in favor of the ER group. The probability of survival with successful repair at 3 years was similar in both groups.

Aged↗
PubMed2001

Mortality in rheumatoid arthritis: relationship to single and composite measures of disease activity.

BACKGROUND: Rheumatoid arthritis (RA) is a heterogeneous disease characterized by a variable course of remissions and relapses. Single measures of disease activity at only one point in time may not reflect the overall control of disease activity. OBJECTIVE: The aim was to determine (i) the predictive value of 20 baseline demographic and disease variables on mortality, and (ii) the relationship between serial measures of the Stoke index (SI; a validated index of disease activity in RA) and mortality in RA. METHODS: Mortality in 309 RA patients followed up for a median of 14 yr was analysed retrospectively. The standardized mortality ratio (SMR) was calculated for all causes of death. The predictive values of baseline and time-integrated variables were assessed using multivariate Cox proportional hazards regression analysis. RESULTS: The SMR was 1.65. At baseline, only nodules, erosions, RA latex titre, white cell count and globulin level were predictive of mortality after correction for age, sex and disease duration. Using a stepwise Cox proportional hazards regression model, the most powerful predictors of mortality were age, nodules and RA latex titre. Individual measures of disease activity and the SI at baseline were not predictive of mortality. However, the mean level of the SI over 12 months was related to mortality (P=0.039). CONCLUSIONS: At baseline, the demographic and disease variables most significantly related to mortality in RA are age, nodules and RA latex titre. Individual measures of disease activity at a single point in time are poor predictors of mortality in RA. However, measurement of the mean level of disease activity over time using the composite SI has a significant relationship with mortality. A high level of sustained inflammation appears to be an important predictor of premature death.

Adult↗
PubMed2001

Salmonella enterica serovar Gallinarum requires the Salmonella pathogenicity island 2 type III secretion system but not the Salmonella pathogenicity island 1 type III secretion system for virulence in chickens.

Salmonella enterica serovar Gallinarum is a host-specific serotype that causes the severe systemic disease fowl typhoid in domestic poultry and a narrow range of other avian species but rarely causes disease in mammalian hosts. Specificity of the disease is primarily at the level of the reticuloendothelial system, but few virulence factors have been described other than the requirement for an 85-kb virulence plasmid. In this work, by making functional mutations in the type III secretion systems (TTSS) encoded by Salmonella pathogenicity island 1 (SPI-1) and SPI-2, we investigated the role of these pathogenicity islands in interactions between Salmonella serovar Gallinarum and avian cells in vitro and the role of these pathogenicity islands in virulence in chickens. The SPI-1 mutant showed decreased invasiveness into avian cells in vitro but was unaffected in its ability to persist within chicken macrophages. In contrast the SPI-2 mutant was fully invasive in nonphagocytic cells but failed to persist in macrophages. In chicken infections the SPI-2 mutant was attenuated while the SPI-1 mutant showed full virulence. In oral infections the SPI-2 mutant was not observed in the spleen or liver, and following intravenous inoculation it was cleared rapidly from these sites. SPI-2 function is required by Salmonella serovar Gallinarum for virulence, primarily through promoting survival within macrophages allowing multiplication within the reticuloendothelial system, but this does not preclude the involvement of SPI-2 in uptake from the gut to the spleen and liver. SPI-1 appears to have little effect on virulence and survival of Salmonella serovar Gallinarum in the host.

Animals↗
PubMed2001

Quality of life assessment in patients undergoing endovascular or conventional AAA repair.

PURPOSE: To compare health-related quality of life outcomes in a cohort of abdominal aortic aneurysm (AAA) patients treated concurrently with either a conventional or endoluminal intervention. METHODS: Between December 1997 and April 1999, 51 AAA patients treated by either open or endovascular techniques were enrolled in this prospective study. Conventional therapy was performed in 26 patients (19 men; mean age 70.4 +/- 6.0 years) with anatomical features unsuitable for the endovascular approach. Twenty-five patients (23 men; mean age 70.7 +/- 7.2 years) underwent endoluminal AAA exclusion using either the Ancure or bifurcated Enduring stent-grafts. The Medical Outcomes Study Short-Form 36-item health survey was administered preoperatively and at 1, 4, 8, and > or = 52 weeks after discharge. RESULTS: At 1 week, both groups showed significant reductions (p < 0.001) in mean scores compared to baseline in 4 dimensions (physical function, social function, role-physical, and vitality), but the decline was more pronounced in patients having open repair. Endoluminal patients returned to their baseline scores by the 4th postoperative week, whereas complete recovery to baseline in the conventional patients was delayed to the 8th week. CONCLUSIONS: Patients treated endoluminally exhibit better physical and functional scores as early as 1 week after discharge; they also return to baseline status significantly earlier than the conventional group. These findings document the perceived advantage of endovascular therapy over conventional AAA treatment.

Aged↗
PubMed2000

Nitric oxide is a downstream mediator of agrin-induced acetylcholine receptor aggregation.

The synaptic basal lamina protein, agrin, is required for the formation of the neuromuscular junction. Agrin signals through a muscle-specific receptor tyrosine kinase (MuSK) initiating a cascade of events that lead to the aggregation of acetylcholine receptors (AChR) at the postsynaptic site. Another important synaptic signalling molecule is nitric oxide (NO), which is produced by the enzyme, nitric oxide synthase (NOS). We investigated the interaction between the agrin signalling cascade and the NO signalling cascade by treating cultured myotubes with agrin, NOS inhibitors, and NO donors. NOS inhibitors prevented agrin induced AChR aggregation and phosphorylation of the AChR beta subunit. Furthermore, NO donors induced AChR aggregation in the absence of agrin, as well as phosphorylation of the AChR beta subunit. These results demonstrate a role for NO as a downstream mediator of agrin induced AChR aggregation and AChR beta subunit phosphorylation at the neuromuscular junction.

Agrin↗
PubMed2000

EMG and strength correlates of selected shoulder muscles during rotations of the glenohumeral joint.

OBJECTIVE: To identify activation patterns of several muscles acting on the shoulder joint during isokinetic internal and external rotation. DESIGN: Combined EMG and isokinetic strength analysis in healthy subjects. BACKGROUND: EMG studies of the shoulder region revealed intricate muscular activation patterns during elevation of the arm but no parallel studies regarding pure rotations of the joint could be located. METHODS: Fifteen (n=30 shoulders) young, asymptomatic male subjects participated in the study. Strength production during isokinetic concentric and eccentric internal and external rotations at 60 and 180 degrees /s was correlated with the EMG activity of the rotator cuff, biceps, deltoid and pectoralis major. Analysis of the smoothed EMG related to the timing of onset of the signal and to the normalized activity at the angle of the peak moment. Determination of the association between the EMG and the moment was based on strength ratios. RESULTS: Findings indicated that for both types of rotations, the rotator cuff and biceps were active 0.092+/-0.038-0.215+/-0.045 s prior to the initiation of the actual movement and 0.112-0.034 s prior to onset of deltoid and pectoralis major activity. These differences were significant in all of the eight conditions (P<0.05). In terms of the strength ratios, strong association was found between electrical activity and moment production in the subscapularis and infraspinatus (r(2)=0.95 and 0. 72, respectively) at the low and high angular velocities. CONCLUSIONS: Prior to actual rotation of the shoulder joint, normal recruitment of the rotator cuff and biceps is characterized by a non-specific presetting phase which is mainly directed at enhancing the joint 'stiffness' and hence its stability. Once movement is in progress, the EMG patterns of these muscles become movement specific and are correlated with the resultant moment. RELEVANCE: Muscular dysfunction relating to delayed onset activity or altered activation patterns, due to pain, perturbed mechanics or disturbed neural activation have been implicated as concomitant factors in other joint associated pathologies. Through highlighting the role of the rotator cuff in shoulder joint rotations, this study lends further support to the argument that a parallel situation may prevail with respect to shoulder joint dysfunction. This could lead to the development of rehabilitation protocols aimed specifically at redressing such dysfunction.

Adolescent↗
PubMed2000

The secreted effector protein of Salmonella dublin, SopA, is translocated into eukaryotic cells and influences the induction of enteritis.

Salmonella-induced enteritis is associated with the induction of an acute intestinal inflammatory response and net fluid secretion into the lumen of infected mucosa. Proteins secreted by the Inv/Spa type III secretion system of Salmonella play a key role in the induction of these responses. We have demonstrated recently that the Inv/Spa-secreted SopB and SopD effector proteins are translocated into eukaryotic cells via a Sip-dependent pathway and act in concert to mediate inflammation and fluid secretion in infected ileal mucosa. Mutations of both sopB and sopD significantly reduced, but did not abrogate, the enteropathogenic phenotype. This indicated that other virulence factors are involved in the induction of enteritis. In this work, we characterize SopA, a secreted protein belonging to the family of Sop effectors of Salmonella dublin. We demonstrate that SopA is translocated into eukaryotic cells and provide evidence suggesting that SopA has a role in the induction of enteritis.

Amino Acid Sequence↗
PubMed2000

Mortality in a cohort of Norwegian patients with rheumatoid arthritis followed from 1977 to 1992.

This study aimed to describe the mortality pattern of Norwegian patients with rheumatoid arthritis (RA). The subjects were 149 patients (52 males(M)) who were discharged from a Norwegian rheumatology hospital in 1977 after their first admission for RA. 126 patients (85%) met the 1958 criteria for definite or classical RA. By the end of 1992, 2 patients, both with definite/classical RA, were lost to follow-up. Of the remaining 147 patients (51M), 68 (25M) had died. The overall standardised mortality ratio (SMR) was 149 (95% CI: 115-188). The mortality was significantly raised for females with SMR= 168 (120-223). The moderate increase in the male SMR of 126 (81-181) was restricted to the early years of follow up. Patients with definite/classical RA had a somewhat higher SMR (159 (120-202)). Excess deaths were due to malignant disease in males and cardiovascular disease in females. RA was mentioned on one third of the death certificates. This study supports previous findings that patients with RA have a reduced long term survival, most prominent in females.

Adolescent↗
PubMed1999

Protection of Escherichia coli cells against extreme turgor by activation of MscS and MscL mechanosensitive channels: identification of genes required for MscS activity.

Mechanosensitive channels are ubiquitous amongst bacterial cells and have been proposed to have major roles in the adaptation to osmotic stress, in particular in the management of transitions from high to low osmolarity environments. Electrophysiological measurements have identified multiple channels in Escherichia coli cells. One gene, mscL, encoding a large conductance channel has previously been described, but null mutants were without well-defined phenotypes. Here, we report the characterization of a new gene family required for MscS function, YggB and KefA, which has enabled a rigorous test of the role of the channels. The channel determined by KefA does not appear to have a major role in managing the transition from high to low osmolarity. In contrast, analysis of mutants of E.coli lacking YggB and MscL shows that mechanosensitive channels are designed to open at a pressure change just below that which would cause cell disruption leading to death.

Bacterial Proteins↗
PubMed1999

Utilization of psychotherapy by lesbians, gay men, and bisexuals: findings from a nationwide survey.

Based on a survey of the psychotherapy histories of 600 lesbians, gay men, and bisexuals, the number, duration, and circumstances of each therapy episode, and respondents' views of their therapists and of therapy, are reported. Findings suggest that lesbians and gay men are among the most active and satisfied--but least acknowledged--consumers of psychotherapy. Routine inclusion of sexual orientation as a demographic variable in mental health services research is proposed.

Bisexuality↗
PubMed1999

The re-use of irrigating equipment for flexible cystoscopy is not safe.

OBJECTIVE: To determine the incidence of fluid reflux from the lower urinary tract into the connecting tubing used for irrigation in patients undergoing flexible cystoscopy. PATIENTS AND METHODS: The study was conducted in 94 consecutive male and female patients attending routine outpatient flexible cystoscopy lists. A sensor was designed and constructed to determine the presence of any retrograde flow of irrigating fluid, and the volume of any reflux through the connecting tubing. The mean (sd) cystoscope internal channel volume was 2.56 (0.25) mL; the level of significant reflux was set at >/=2. 25 mL. RESULTS: Reflux of irrigating fluid occurred in 11 males (17%) and was significant in six (9%) of 65 male patients, with the irrigating fluid reservoir set at a height of 0.78 m above the patient's mid-coronal level. No reflux occurred in the 29 females studied. CONCLUSIONS: Significant reflux can occur in males and hence the connecting tubing should be regarded as contaminated. Infection-control measures must include the prevention of transmission of blood-borne infections, e.g. hepatitis B and C viruses, and human immunodeficiency virus, because of the risk that blood may contaminate urine, and they should be implemented in all cases regardless of patient risk factors. From the available evidence, flexible cystoscopy should always be performed with single-use irrigation systems.

Cystoscopes↗
PubMed1999

Aggregates of acetylcholine receptors are not observed under anti-agrin staining schwann cell processes at the frog neuromuscular junction.

The frog neuromuscular junction offers a unique structure in which to observe fine details in the relationship between the motor neuron, muscle, and Schwann cell, which together comprise the neuromuscular junction. Schwann cell processes that extended from the synapse stained positively with anti-agrin antibodies. Immunocytochemistry revealed strong anti-agrin staining of the extracellular matrix surrounding the entire Schwann cell and the Schwann cell processes come in close contact with the muscle fiber. Dual-labeling experiments revealed a lack of acetylcholine receptor (AChR) aggregates on the surface of the muscle fiber directly under these anti-agrin-staining Schwann cell processes. The cDNA that codes for the C-terminal portion of agrin in frog (Rana pipiens) was cloned and sequenced. Polymerase chain reaction of frog brain, nerve, and muscle cDNA revealed that like other species, agrin transcripts that contain the B8, B11, or B19 inserts were observed only in brain tissue. Unlike other species, the exact site of the B inserts in frog was slightly altered, with the B insertion site occurring within a codon sequence. Our data are consistent with the hypothesis that Schwann cells produce agrin which lacks inserts at the B region, and that agrin lacking B inserts does not direct the aggregation of AChRs in vivo under physiological conditions and concentrations.

Agrin↗
PubMed1998

The biosynthetic pathway of vitamin C in higher plants.

Vitamin C (L-ascorbic acid) has important antioxidant and metabolic functions in both plants and animals, but humans, and a few other animal species, have lost the capacity to synthesize it. Plant-derived ascorbate is thus the major source of vitamin C in the human diet. Although the biosynthetic pathway of L-ascorbic acid in animals is well understood, the plant pathway has remained unknown-one of the few primary plant metabolic pathways for which this is the case. L-ascorbate is abundant in plants (found at concentrations of 1-5 mM in leaves and 25 mM in chloroplasts) and may have roles in photosynthesis and transmembrane electron transport. We found that D-mannose and L-galactose are efficient precursors for ascorbate synthesis and are interconverted by GDP-D-mannose-3,5-epimerase. We have identified an enzyme in pea and Arabidopsis thaliana, L-galactose dehydrogenase, that catalyses oxidation of L-galactose to L-galactono-1,4-lactone. We propose an ascorbate biosynthesis pathway involving GDP-D-mannose, GDP-L-galactose, L-galactose and L-galactono-1,4-lactone, and have synthesized ascorbate from GDP-D-mannose by way of these intermediates in vitro. The definition of this biosynthetic pathway should allow engineering of plants for increased ascorbate production, thus increasing their nutritional value and stress tolerance.

Arabidopsis↗