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Biomedical subjects

M Blake

Publications and source records attributed to M Blake.

At least 19 recordsLinked to original sources

Sperm deposition site during ICSI affects fertilization and development.

OBJECTIVE: To evaluate the effects of sperm placement during ICSI relative to the M-II spindle location on fertilization and preimplantation development. DESIGN: Retrospective analysis of oocyte fertilization and embryo development with respect to sperm deposition site during ICSI. SETTING: A program of IVF-ET. PATIENT(S): Seven hundred seventy-six patients. INTERVENTION(S): Egg quality, sperm deposition site, and polar-body position were recorded during ICSI; fertilization was assessed on day 1; embryo development was evaluated on days 2 and 3. MAIN OUTCOME MEASURE(S): Fertilization, embryo development, and implantation rates. RESULT(S): Normal fertilization is not affected by polar-body orientation, with the exception of a significantly lower fertilization rate from a 9 o'clock polar-body orientation. Injections with the polar-body positioned at 7 or 11 o'clock result in the greatest number of high-quality embryos, significantly more than the adjacent 6 or 12 o'clock polar-body orientations and irrespective of oocyte anomaly frequency. Embryos originating from the 7 or 11 o'clock polar-body category implant at a higher rate, although the data are not significant. CONCLUSION(S): The placement of the sperm during ICSI relative to the presumed location of the meiotic spindle significantly impacts fertilization and high-quality embryo development. Sperm deposition in the M-II spindle area should be avoided. It appears that development, and not fertilization, is improved by decreasing the distance between the sperm cell and the spindle.

Cell Nucleus↗

Analysis of diffusion changes in posttraumatic bone marrow using navigator-corrected diffusion gradients.

OBJECTIVE: This study was undertaken to analyze diffusion characteristics of normal and posttraumatic bone marrow. MATERIALS AND METHODS: Fifty consecutive patients with knee pain underwent both conventional and diffusion-weighted MR imaging (b values, 0-980 sec/mm2). Diffusion maps derived from source data were analyzed on a workstation using region-of-interest techniques. Apparent diffusion values recorded in normal marrow were compared with values recorded in abnormal posttraumatic bone marrow (square centimeters per second). RESULTS: Normal bone marrow identified in 35 patients showed minimal diffusion, with a mean value of 0.15x10(-5) cm2/sec. Bone marrow in 15 patients sustaining direct traumatic injury (21 bone bruises) showed markedly increased diffusion, with a mean value of 0.8x10(-5) cm2/sec (range, 0.4-1.3 cm2/sec). CONCLUSION: Marrow injury after trauma with trabecular damage allows increased movement or diffusion of interstitial water relative to normal marrow. The magnitude of diffusion change appears to reflect the severity of marrow injury.

Adult↗

Cleidocranial dysplasia: radiological appearances on dental panoramic radiography.

OBJECTIVE: To report the effectiveness of dental panoramic radiography in identifying features pathognomonic for cleidocranial dysplasia. METHODS: Panoramic radiographs of nine male Caucasian patients with cleidocranial dysplasia are analysed. RESULTS: In addition to the established dental complications of failure of eruption of the permanent dentition and multiple supernumerary teeth, morphological abnormalities of the maxilla and mandible, particularly in the ascending ramus and coronoid process were present. CONCLUSION: Dental panoramic radiography is a valuable adjunct in confirming the diagnosis of cleidocranial dysplasia.

Adolescent↗

Gadd45, a p53-responsive stress protein, modifies DNA accessibility on damaged chromatin.

This report demonstrates that Gadd45, a p53-responsive stress protein, can facilitate topoisomerase relaxing and cleavage activity in the presence of core histones. A correlation between reduced expression of Gadd45 and increased resistance to topoisomerase I and topoisomerase II inhibitors in a variety of human cell lines was also found. Gadd45 could potentially mediate this effect by destabilizing histone-DNA interactions since it was found to interact directly with the four core histones. To evaluate this possibility, we investigated the effect of Gadd45 on preassembled mononucleosomes. Our data indicate that Gadd45 directly associates with mononucleosomes that have been altered by histone acetylation or UV radiation. This interaction resulted in increased DNase I accessibility on hyperacetylated mononucleosomes and substantial reduction of T4 endonuclease V accessibility to cyclobutane pyrimidine dimers on UV-irradiated mononucleosomes but not on naked DNA. Both histone acetylation and UV radiation are thought to destabilize the nucleosomal structure. Hence, these results imply that Gadd45 can recognize an altered chromatin state and modulate DNA accessibility to cellular proteins.

Animals↗

Whole-body MR imaging. Practical issues, clinical applications, and future directions.

Whole-body MR imaging is in evolution, and although accepting and recognizing limitations, it is likely that both technique and incurred acquisition times will shorten over the next decade. Although the development of dedicated whole-body MR scanners appears to offer the greatest promise for the future, the development of moving table tops, optimized pulse sequences, and advances in gradient technology now facilitate practical whole-body MR imaging using existing clinical systems.

Adult↗

Supernumerary teeth--an overview of classification, diagnosis and management.

Most supernumerary teeth are located in the anterior maxillary region. They are classified according to their form and location. Their presence may give rise to a variety of clinical problems. Detection of supernumerary teeth is best achieved by thorough clinical and radiographic examination. Their management should form part of a comprehensive treatment plan. This article presents an overview of the clinical problems associated with supernumerary teeth and includes a discussion of the classification, diagnosis and management of this difficult clinical entity.

Humans↗

Retention and stability: a review of the literature.

Long-term posttreatment stability is an issue of great concern to all orthodontists. This article highlights the factors reported to play a role in posttreatment crowding and reviews the long-term retention studies evaluating the stability of various treatment modalities. Recommendations, based on well-documented basic principles, are made to try to insure greater posttreatment stability of our orthodontically treated cases.

Adaptation, Biological↗

The use of an orthodontic thermoplastic retainer as a provisional anterior restoration: a case report.

Children who present with extensive fractures of anterior teeth pose a difficult clinical problem. Pulpal and periodontal injuries must be carefully assessed and managed. Rapid restoration of the form and contour of the extensively fractured tooth is advisable, not only to improve esthetics but also to prevent unwanted tipping or tilting of adjacent teeth and overeruption of opposing teeth. A modified Essix retainer, simply constructed in the laboratory, can be used to provisionally restore the extensively fractured anterior tooth.

Child↗

Rationale for retention following orthodontic treatment.

UNLABELLED: Maintaining the treatment result following orthodontic treatment is one of the most difficult aspects of the entire treatment process. Normal maturational changes, together with post-treatment tooth alterations, conspire against long-term stability. This article discusses the need for retention and provides an overview of retainers which enjoy widespread use. CLINICAL SIGNIFICANCE: Permanent retention is increasingly being recommended as the only way to ensure long-term stability of an orthodontic treatment result. Dental practitioners should be familiar with the rationale for retention and the design of the appliances worn by the their patients.

Humans↗

Census tract analysis of lead exposure in Rhode Island children.

There has been increasing interest in a targeted approach to the screening and prevention of lead exposure in children. Targeted screening requires an understanding of variation in lead exposure in individual children or by region. In order to better understand variation by region, we studied Rhode Island lead poisoning screening data, examining average lead exposure to children living in 136 Providence County census tracts (CTs). The study population included 17,956 children aged 59 months and under, who were screened between May 1, 1992, and April 30, 1993. We evaluated the relationship between the percentage of children with blood lead > or = 10 micrograms/dL (pe10) and sociodemographic and housing characteristics, derived from United States 1990 Census data, of these CTs. CT descriptors included population density, percentage of households receiving public assistance income, median per capita income, percentage of households female headed, percentage of houses owner occupied, percentage of houses built before 1950, percentage of houses vacant, percentage of population Black, percentage of recent immigrants, and intraurban mobility. On average, 109 children were screened in each census tract; mean screening rate was 44%. There was wide variation in average lead exposure among census tracts, with pe10 ranging from 3 to 60% of screened children (mean 27%). Individual census variables explained between 24 and 67% of the variance in pe10 among CTs. A multiple regression model including percentage screened, percentage of households receiving public assistance, percentage of houses built before 1950, In (percentage of houses vacant), and percentage of recent immigrants explained 83% of variance in pe10. The percentage of houses built before 1950, a variable which models the presence of lead paint in old houses, displayed the largest adjusted effect on pe10 over the range observed for that variable in RI CTs. The percentage of houses vacant was also a highly significant and robust predictor; we suggest that vacancy is an ecological marker for the deterioration of leadbased paint, with higher vacancy neighborhoods containing houses in poorer condition. In Rhode Island, census tracts with high vacancy rates also have high rates of recent immigration, making immigrant groups vulnerable to lead exposure. Small-areas analysis may be useful in directing resources to high risk areas, explaining the sociocultural forces which produce such exposure and analyzing the effects of housing policy over time in states with high screening penetration.

Child, Preschool↗

The frail elderly in the family.

Longer life expectancy, better health and higher levels of financial independence will characterise the elderly of the future. These will result in a greater variety of living and care arrangements including an increasing proportion of older people who will choose to live on their own. Caring for a frail elderly person in the family requires a change of family roles, a process often accompanied by emotional upheavals. The degree of difficulty experienced will be linked to the level of economic and physical dependence of the elderly person. Demographic changes will add new dimensions to the problems of care. In four generation families, which will be more common, the burden of care will shift to adult grand children. Fewer children and grand-children will be available to share care responsibilities. A range of commercial and welfare services will be required to meet the increasing range of needs. Careful evaluation is needed in monitoring both improvements and the risks to the frail elderly and the family in the changing scenario.

Aged↗

Selection and expansion of peripheral blood CD34+ cells in autologous stem cell transplantation for breast cancer.

Cytopenia after high-dose chemotherapy and autologous stem cell reinfusion is a major cause of morbidity. Ex vivo cultured expansion and differentiation of CD34+ peripheral blood progenitor cells (PBPC) to neutrophil precursors may shorten the neutropenic period further. We explored the use of these ex vivo cultured PBPCs in nine patients with metastatic breast cancer. All underwent PBPC mobilization with cyclophosphamide, VP-16, and G-CSF. Subsequently, they underwent four to five apheresis procedures. One apheresis product from each patient was prepared using the Isolex 300 Magnetic Cell Separation System (Baxter Immunotherapy, Irvine, CA) to obtain CD34+ cells. These cells were then cultured in gas permeable bags containing serum-free X-VIVO 10 (BioWhittaker, Walkersville, MD) medium supplemented with 1% human serum albumin and 100 ng/mL PIXY321. At day 12 of culture the mean fold expansion was 26x with a range of 6 to 64x. One patient's cells did not expand because of a technical difficulty. The final cell product contained an average of 29.3% CD15+ neutrophil precursors with a range of 18.5% to 48.1%. The patients underwent high-dose chemotherapy with cyclophosphamide, carboplatin, and thiotepa. On day 0, the cryopreserved PBPCs were reinfused and on day +1 the 12-day cultured cells were washed, resuspended, and reinfused into eight of nine patients. One patient was not infused with cultured cells. The mean number of cultured cells reinfused was 44.6 x 10(6) cells/kg with a range of 0.8 to 156.6 x 10(6) cells/kg. No toxicity was observed after reinfusion. The eight patients have recovered absolute neutrophil counts > 500/microL on a median of 8 days (range 8 to 10 days); the median platelet transfusion independence occurred on day 10 (range 8 to 12 days) and platelet counts > 50,000/microL were achieved by day 12 (range 9 to 14) for the seven patients whose platelet counts could be determined. Expanded CD34+ selected PBPC can be obtained and safely reinfused into patients.

Adult↗

Large-scale selection of CD34+ peripheral blood progenitors and expansion of neutrophil precursors for clinical applications.

Hematopoietic recovery after high-dose chemotherapy is characterized by an obligate period of neutropenia of approximately 8-10 days. It is postulated that if a pool of neutrophil precursors and progenitors were expanded in vitro and reinfused, the duration of neutropenia may be substantially shortened by these cells capable of providing mature neutrophils within days of reinfusion. In this study, peripheral blood progenitor cell products were obtained from six normal donors mobilized with rhG-CSF and two patients mobilized with cyclophosphamide and rhG-CSF. CD34+ cells were isolated using the Isolex immunomagnetic bead method. A mean of 8.26 x 10(7) CD34+ cells with a mean purity of 74.5% were seeded at a concentration of 1 x 10(5)/ml into a 12 day stroma-free liquid culture using gas-permeable bags. A serum-free growth medium supplemented with PIXY321 was used. On day 7, there was a mean cellular expansion of fourfold, at which time the cells were resuspended at the initial concentration, yielding a mean culture volume of 3L (1-6 L). On day 12, there was an additional mean fold cellular expansion of 10 x, achieving an overall mean fold expansion of 41 +/- 16. Cellular characterization of the expanded cells revealed predominantly neutrophil precursors by morphology (mean 70.1%) and flow cytometric analysis. A mean of 52.3% of the expanded cells expressed CD15. Immunohistochemical staining revealed a mean of 7.1% CD41a+ megakaryocytic progenitors in the final cultured cell product. Detectable CD34+ cells were maintained only in those cultures initiated with greater than 90% CD34+ cells. Colony-forming units-granulocyte-macrophage (CFU-GM) were maintained in the 12 day culture at a level similar to the preculture number, whereas CFU mixed were depleted in all samples. On day 0, there were few CFU clusters (colonies containing fewer than 50 cells) identified, but by day 12, a mean total of 8.3 x 10(6) CFU clusters were identified. On day 12, the expanded cells were harvested and pooled using the Fenwal CS3000 Plus blood cell separator and resuspended in Plasma-Lyte-A with 1% human serum albumin. The mean harvest recovery of expanded progenitors was 91%, with a mean viability of 86%.

Adult↗

Interactions of the transcription factors MIBP1 and RFX1 with the EP element of the hepatitis B virus enhancer.

We previously demonstrated that MIBP1 and RFX1 polypeptides associate in vivo to form a complex that binds to the MIF-1 element in the c-myc gene and the major histocompatibility complex class II X-box recognition sequence. We now show that the EP element, a key regulatory sequence within hepatitis B virus enhancer I, also associates with MIBP1 and RFX1. Using polyclonal antisera directed against either oligonucleotide-purified MIBP1 or a peptide derived from the major histocompatibility complex class II promoter-binding protein RFX1, we showed that MIBP1 and RFX1 are both present in the DNA-protein complexes at the EP site. In addition, while the EP element can act cooperatively with several adjacent elements to transactivate hepatitis B virus expression, we demonstrated that the EP site alone can repress transcription of simian virus 40 promoter in a position- and orientation-independent manner, suggesting a silencer function in hepatocarcinoma cells.

Base Sequence↗