Biomedical subjects
M Grace
Publications and source records attributed to M Grace.
Quality development.
The problem with improving quality in dental practice is not so much a difficulty with understanding exactly what quality means, but more a lack of clear guidance as to how to take the simple, practical steps to achieving that improvement in the daily pressures of practice life. This article describes Quality Development, a simple and practical method that can be used in general practice to help the dental team achieve the objectives in quality care that are appropriate to them.
The hygienist's dilemma.
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What more do we have to do?
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Somatic reenactment in the treatment of posttraumatic stress disorder.
Somatic reenactments, like other intrusive symptoms in post-traumatic stress disorder, such as flashbacks and nightmares, reproduce the mental content of traumatic events. Four cases are presented from survivors of military trauma and civilian catastrophes. The patients were part of larger research projects carried out by the University of Cincinnati Traumatic Stress Study Center. Understanding such symptoms as repetitions of the trauma itself proved useful therapeutically, especially in consolidating the working alliance.
Effective periodontal control.
One of the major difficulties in periodontal care is that knowing the principles is of very little practical help when it comes to treating individual patients. This article discusses the identification of susceptible patients, the measurements of sites of disease and identification of active bursts of disease when the patient is on a maintenance programme that can be easily performed by the dental practitioner.
Comparison of PT and aPTT values drawn by venipuncture and arterial line using three discard volumes.
BACKGROUND: Blood samples obtained through heparinized arterial catheters are used routinely for a variety of laboratory tests. Accuracy of coagulation studies performed from samples obtained in this fashion continues to be questioned, particularly in regard to the minimum discard volume necessary to clear the catheter of heparinized solution. OBJECTIVE: To examine differences between prothrombin time and activated partial thromboplastin time values obtained from blood drawn by venipuncture and from an indwelling intra-arterial line using three discard volumes. METHODS: Prothrombin time and activated partial thromboplastin time samples were drawn by venipuncture from 41 critically ill adult patients. Simultaneously, three consecutive blood samples of 2.3 mL were drawn from the arterial line after an initial discard volume of 3 mL (discard volumes of 3.0, 5.3 and 7.6 mL). RESULTS: Significant differences were found between arterial and venous prothrombin time values for the 3-mL discard volume group, as well as between arterial and venous activated partial thromboplastin time values for all three discard volume groups (paired t-test, Bonferroni correction). CONCLUSION: We recommend that when drawing prothrombin time and activated partial thromboplastin time samples from an arterial line, a 5.3-mL discard volume be used.
Central administration of the opioid antagonist, LY255582, decreases short- and long-term food intake in rats.
A variety of opioid antagonists have been reported to decrease short-term food intake, but few appear to reduce long-term intake. In the present study we evaluated the effect of a relatively new class of opioid antagonists, 3,4-dimethyl-4-phenylpiperidines, on short-term and long-term food intake after central administration. We also evaluated their affinities for the mu and kappa opioid receptor sites in synaptosomal membranes derived from rat whole brain tissue (minus cerebellum) and guinea-pig cortex, respectively. The affinities for the mu receptor sites were LY255582 greater than LY217273 greater than LY256897 greater than naloxone greater than LY227444. The affinities for the kappa receptor sites were LY255582 greater than LY256897 = LY217273 greater than LY227444. LY255582 reduced food intake for up to 24 h after a single intraventricular injection. Doses as low as 1 microgram of LY255582 decreased food intake for up to 4 h. All other drugs were much less powerful. Naloxone and LY256897 only decreased food intake after injection of the 100 microgram dose. LY227444 and LY217273 failed to decrease intake at all doses tested. LY255582 (100 micrograms) decreased food intake over a 7 day period when injected intraventricularly once per day. The body weight of the rats also decreased during the 7 day period. Upon cessation of drug administration body weights and food intake approached control levels. Thus, LY255582 appears to be a very potent and long-acting anorectic agent which may be useful in the treatment of obesity. The mu and kappa binding profile of the phenylpiperidines does not seem to clearly correlate with their anorectic activity.
Beta-funaltrexamine (beta-FNA) decreases deprivation and opioid-induced feeding.
We studied the effect of the mu antagonist, beta-funaltrexamine (beta-FNA) on deprivation and opioid-induced feeding. Intracerebroventricular pre-treatment of 20 h deprived rats with 0.1, 1, 10 and 20 nmol of beta-FNA decreased feeding by 24%, 50%, 50% and 38% during the first hour. Central administration of beta-FNA (0.1, 1 and 10 nmol) also decreased feeding induced by the mu opioid agonist, DAMGO by 57%, 60% and 71%. Feeding induced by the delta agonist, DSLET, was decreased by pre-treatment with beta-FNA; but only during the 1-2 h time points, a time when relatively little food was ingested. Intraventricular injection of beta-FNA failed to alter feeding stimulated by the kappa opioid agonist, U-50,488H. These data further substantiate a role for the opioid receptor in deprivation and opioid-induced feeding.
Adverse reactions to the preschool (fifth) dose of adsorbed diphtheria-pertussis-tetanus vaccine in Canadian children.
OBJECTIVE: To quantify accurately the rate of adverse reactions after the preschool (fifth) dose of adsorbed diphtheria toxoid-pertussis vaccine-tetanus toxoid (DPT) vaccine and to test the hypothesis that large local reactions are attributable to the diphtheria toxoid. DESIGN: Double-blind randomized controlled trial. SETTING: Suburban community public health unit. PARTICIPANTS: Healthy children 4 to 5 years of age with a history of having received four doses of adsorbed DPT vaccine. INTERVENTIONS: Subjects were given either the standard DPT vaccine (with 25 Lf units of diphtheria toxoid) or a modified DPT vaccine (with 10 Lf units of diphtheria toxoid). They were assessed 24 hours later by a nurse. Serum samples obtained before vaccination were tested for diphtheria and tetanus antitoxin levels by means of neutralization assay and enzyme-linked immunosorbent assay. MAIN OUTCOME MEASURES: Rates of large local reactions (an area of redness or swelling or both of 5 cm or greater) 24 hours after vaccination in the two groups. Relation between serum antitoxin levels before vaccination and the rate of large local reactions in each group. RESULTS: Of the 250 subjects enrolled 124 received the standard vaccine and 126 the modified one. Large local reactions occurred in 71% of the subjects receiving the standard vaccine and 52% of those receiving the modified one (p less than 0.01). In the former group large erythematous reactions occurred significantly more often in those with an elevated prevaccination diphtheria antitoxin level than in those without an elevated level; no relation was found between such reactions and the prevaccination tetanus antitoxin level. Reduced arm movement was evident in 45% of the children in the two groups. Few had systemic adverse reactions. CONCLUSIONS: Large local reactions occur frequently after the preschool administration of the DPT vaccine. These reactions are uncomfortable but not serious. They result in part from the large amount of diphtheria toxoid in the standard DPT vaccine.
The carboxyl-terminal region of human interferon gamma is important for biological activity: mutagenic and NMR analysis.
Deletion of nine amino acids from the carboxyl terminus of human IFN gamma (residues 138--146; LFRGRRASQ) resulted in a 7-fold increase in specific antiviral activity. Similar increases in receptor binding affinity were seen. Deletion of residues 136 and 137 (QM) had little additional effect, but removal of Ser135 resulted in a sharp drop in antiviral activity. Further removal of residues 133 and 134 (KR) lowered antiviral activity to 1% of the peak value. Comparison of the proton NMR spectra of selected deletions down to residue 132 showed that there was no significant change in the core protein structure. Deletions down to residue 125 had the same antiviral activity as those to 132, but changes could now be seen in the aromatic proton NMR spectrum of this shorter derivative. Substitution of the homologous murine sequence between residues 124 and 130 (human SPAAKTG; murine LPESSLR) resulted in only a small decrease in antiviral activity, further suggesting that the precise sequence in this region was not critical for activity. Ser135 was substituted with a number of other amino acids with little or no change in activity. The importance of the residues between 131 and 134 for biological activity was corroborated by mutagenesis, although some substitutions in this region were tolerated.
Five-year survival of women with breast cancer in northern Alberta.
Five-year survival rates for all 519 women with breast carcinoma in northern Alberta in 1971 and 1972 were analysed with the use of data from the computerized northern Alberta breast registry and the Alberta cancer registry. The relative 5-year survival was 73%, which is higher than most rates reported from other centres. Lymph node involvement was significant as a prognostic factor, with the relative 5-year survival falling from 92% in the group without lymph node involvement to 58% in the group with three or more involved nodes. The prognosis was also significantly affected by the stage of the disease according to the 1973 TNM classification: the 5-year survival rates ranged from 88% for patients with stage 1 disease to 17% for those with stage IV disease. Women 40 to 59 years of age had a higher survival rate (79%) than those under 40 years (65%) or over 60 years (66%) of age. Analyses by 5-year age groups showed that women 35 to 39 years old had a particularly poor survival rate (59%). Postmenopausal women less than 55 years old had a higher survival rate than did perimenopausal or premenopausal women in the same age group. Further follow-up is indicated to correlate possible high-risk factors with survival.
Cancer of the bladder in Alberta: a urologic audit review.
A review was conducted of 660 cases of cancer of the bladder diagnosed in two periods, 1960--62 and 1968--70. A significant increase in the incidence of bladder cancer in both sexes, paralleling the trends in other parts of North America, was found. During the second period the disease was diagnosed earlier and, once diagnosed, was apparently treated more successfully. Overall 5-year survival rates increased from 57% to 70% for patients with stage O or A disease, but were relatively constant, at about 36%, for patients with stage B1 or B2 disease. The survival rate for patients with stage O or A disease appeared to improve without clearly defined changes in treatment. Prospective randomized treatment trials are needed to properly assess the value of definitive and adjunctive methods of treatment.
Protein synthesis in rabbit reticulocytes: mechanism of protein synthesis inhibition by heme-regulated inhibitor.
Partially purified Met-tRNAf binding factor, eIF-2, was phosphorylated by using heme-regulated inhibitor (HRI). Phosphorylated eIF-2 was freed from HRI by phosphocellulose column chromatography. Analysis by isoelectric focusing showed 100% phosphorylation of the 38,000-dalton subunit of eIF-2. Both eIF-2 and eIF-2(P) formed ternary complexes with Met-tRNAf and GTP with almost the same efficiency, and in both cases the ternary complex formation was drastically inhibited by prior addition of Mg2+. However, whereas the ternary complexes formed with eIF-2 could be stimulated by Co-eIF-2C at 1 mM Mg2+ and dissociated by Co-eIF-2B at 5 mM Mg2+, the ternary complexes formed with eIF-2(P) were unresponsive to both Co-eIF-2B and Co-e-IF-2C. Also, under conditions of eIF-2 phosphorylation, HRI drastically inhibited AUG-dependent Met-tRNAf binding to 40S ribosomes. However, HRI (in the presence of ATP) had no effect on the joining of preformed Met-tRNAf . 40S . AUG complex to the 60S ribosomal subunit to form Met-tRNAf-80S . AUG complex. These studies suggest that HRI inhibits protein synthesis initiation by phosphorylation of the 38,000-dalton subunit of eIF-2. HRI-phosphorylated eIF-2 does not interact with at least two other protein factors, Co-eIF-2B and Co-eIF-2C, and is thus inactive in protein synthesis initiation.
Protein synthesis in rabbit reticulocytes: characteristics of a postribosomal supernatant factor that reverses inhibition of protein synthesis in heme-deficient lysates and inhibition of ternary complex (Met-tRNAfMet.eIF-2.GTP) formation by heme-regulated inhibitor.
During heme deficiency in reticulocyte lysates, a translational inhibitor (heme-regulated inhibitor, HRI) that blocks polypeptide chain initiation is activated. HRI is a protein kinase that specifically phosphorylates the 38,000-dalton subunit of the Met-tRNAfMet binding factor, eIF-2. Phosphorylation of eIF-2 by HRI prevents its interaction with at least two additional factors, resulting in a net reduction in formation of ternary complex (Met-tRNAfMet.eIF-2.GTP) and AUG-dependent transfer of Met-tRNAfMet to 40S ribosomal subunits. A factor (sRF) that reverses protein synthesis inhibition in heme-deficient lysates has been purified from reticulocyte postribosomal supernatant. sRF also reverses the inhibition of ternary complex formation by HRI in a fractionated system. The ternary complex inhibition reversal activity and the protein synthesis inhibition reversal activity cosediment at 12.5 S upon glycerol density gradient centrifugation, and both activities are sensitive to heat or N-ethylmaleimide. Purified sRF does not dephosphorylate eIF-2 whose phosphorylation has been catalyzed by HRI, nor does the sRF prevent the phosphorylation of eIF-2 by HRI in a fractionated system. sRF stimulates ternary complex formation by both phosphorylated and nonphosphorylated eIF-2. These observations suggest that the sensitivity of protein synthesis to phosphorylation of eIF-2 by HRI may be modulated by the concentration and activity of sRF.
Estrogen use and cancer of the uterine corpus in Alberta.
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Oral contraceptives and breast disease in premenopausal Northern Albertan women.
The results of a prospective study on oral contraceptive use and breast disease in northern Alberta are presented. The study groups comprised all women aged 30 to 49 examined in diagnostic breast clinics at the Cross Cancer Institute between 1971 and 1974. Three hundred and one patients had breast cancer, 692 had a subsequent biopsy for a benign breast condition, and 548 had no subsequent biopsy. A tendency for an increased relative risk (RR) of breast cancer in women taking oral contraceptives for periods of 1 to 5 years was evident, with relative risk decreased or unaffected in users of less than 12 months (RR = 0.6) or more than 5 years (RR = 1.0). A slightly increased risk was apparent in patients using oral contraceptives within a year prior to attendance at the clinic (recent users); this increase was emphasized when recent users with a prior biopsy for benign breast disease were analyzed alone (RR = 5.0). In women with a prior breast biopsy, use of oral contraceptives for more than 5 years increased risk of breast cancer nine-fold. Former users who had taken oral contraceptives for less than a year showed a significant reduction in breast cancer risk (RR = 0.3). The risk of benign breast disease was also reduced in former users (RR = 0.6) as well as in long-term users (RR = 0.5).