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Biomedical subjects

M Gray

Publications and source records attributed to M Gray.

At least 163 records · Page 9Linked to original sources
PubMed1989

Elevated maternal serum alpha-fetoprotein values. How low is high?

Most maternal serum alpha-fetoprotein (MSAFP) screening programs are set up with the goal of prenatal detection of fetal neural tube defects. It is also commonly accepted that MSAFP testing yields many false-positive results. Screening programs commonly utilize schemata that identify abnormal levels of MSAFP as greater than 2.5 multiples of the median (MOM) and also recommend two abnormal values before initiating ultrasound evaluation. Our pilot program evaluating obstetric outcomes found that 21 of the 29 women with elevated MSAFP values (greater than 2.0 MOM) eventually developed significant pregnancy management changes or complications of pregnancy. Thus, we believe that the use of MSAFP screening solely for the purpose of detecting fetal neural tube defects is inconsequential relative to its usefulness in detecting other pregnancy abnormalities. We also believe that ultrasound evaluation should be accomplished after the first abnormal value and that the cutoff of 2.5 MOM should be lowered to at least 2.0.

Adult↗
PubMed1989

An unusual presentation of colorectal carcinoma.

The skin is rather an unusual site of metastasis from carcinoma of the rectum. When the skin is involved, it tends to be part of the picture of widespread terminal malignant disease. Consequently, survival after the appearance of skin metastases is usually short. It is uncommon for skin metastases to be a presenting feature, and especially so if the involved skin is on the distal part of a limb. We would, therefore, like to present such a case.

Adenocarcinoma↗
PubMed1988

Identification of an amber nonsense mutation in the rosy516 gene by germline transformation of an amber suppressor tRNA gene.

Seven xanthine dehydrogenase and cross-reacting material negative Drosophila melanogaster rosy stocks were screened for amber and ochre nonsense mutations. Amber and ochre nonsense suppressors were created by site-directed mutagenesis starting from a wild-type tRNA(Tyr) gene. The suppressor tRNA genes were subcloned into a pUChsneo transformation vector providing heat-shock controlled neomycin resistance. The seven rosy stocks were germline transformed with amber and ochre tDNA(Tyr), and the G1 generation was screened for Geneticin resistance. Surviving rosy516 flies transformed with the amber suppressor showed an eye colour intermediate between the original ry516 stock and the wild-type, suggesting that ry516 is an amber nonsense mutant. This was confirmed by sequencing the relevant part of the ry516 gene; the analysis revealed a C-to-T transition in a CAG glutamine codon at nucleotide 1522 of the wild-type rosy gene.

Animals↗
PubMed1987

Promoting prevention in primary care: controlled trial of low technology, low cost approach.

A study is described in which three general practices were provided with low cost, low technology support from a "facilitator" and were compared with control practices in the ascertainment of major risk factors for cardiovascular disease in middle aged patients. Patients who were attending for a consultation with their general practitioners were recruited to make an appointment with a practice nurse for a health check, and this was compared with ordinary consultations in the control practices. Practices were helped by the facilitator to develop the nurse's role. During the study the increase between intervention and control practices in blood pressure recording was doubled and in the recording of smoking habit it was quadrupled, and there was a fivefold increase in the recording of weight. This model can be applied to other aspects of prevention and general practice care.

Blood Pressure↗
PubMed1987

Scottish validation study of Cancer Registration data childhood leukaemia 1968-1981--I.

This study attempted to validate central registration data on all childhood leukaemia cases in Scotland between 1968 and 1981 in line with the Black Enquiry concerning West Cumbria. Missing files precluded a complete verification, but minor errors of registration were found in 44% of cases. A small number of important mistakes of omission (eight cases), wrong diagnosis (six cases) and postal code errors (nine cases) were found which might affect epidemiological studies of these relatively rare diseases. Precise and verified prospective data collection at the time of diagnosis is essential if the spatial distribution of childhood cancers is being studied.

Adolescent↗
PubMed1987

Scottish validation study of Cancer Registration data childhood leukaemia 1968-1981. Bone marrow review--II.

Following a review of central leukaemia registration data for Scottish children 1968-1981 a retrospective assessment of leukaemia type was made by inspection of bone marrow slides. Only 57% of slides were still available and in 72% of these the review panel confirmed the initial diagnosis of leukaemia and its type. In eight cases the panel disagreed with the diagnosis or the type of leukaemia designated. Central slide review at diagnosis in childhood leukaemia is essential if subsequent epidemiological studies are to be meaningful.

Adolescent↗
PubMed1987

Esophageal atresia and ante-thoracic skin tube esophageal conduits: squamous cell carcinoma in the conduit 44 years following surgery.

Prior to 1941, a small group of patients born with esophageal atresia had esophageal continuity reestablished by creation of an ante-thoracic skin tube conduit. This conduit was constructed in stages using tubed bipedicle grafts of thoracic skin. William E. Ladd reported on seven such patients. M.H., a 45-year-old married female, was the first patient to undergo this procedure and had maintained a normal existence until 6 months prior to admission to this hospital in 1985. She was a nonsmoker and nondrinker who had married and borne 2 children and had maintained adequate nutrition. Six months prior to admission, the patient noticed increasing dysphagia and the presence of a firm area in the upper third of the subcutaneous esophagus. Esophagoscopy demonstrated two polypoid lesions within the conduit. Multiple biopsies did not show any evidence of malignancy. Despite this, it was felt that the subcutaneous skin tube should be removed. A substernal colonic esophageal conduit was established and the subcutaneous skin tube removed. Histologic examination revealed extensive areas of benign pseudoepitheliomatous hyperplasia with foci of well-differentiated microinvasive squamous cell carcinoma within the wall of the tube. Ultimately, excision of overlying skin, subcutaneous tissue, and muscle under the skin tube site was done. This area was covered with a skin graft. The therapeutic approach as well as the implications concerning the long-term use of skin in heterotopic locations was discussed.

Carcinoma, Squamous Cell↗
PubMed1987

Mutations affecting expression of the rosy locus in Drosophila melanogaster.

The rosy locus in Drosophila melanogaster codes for the enzyme xanthine dehydrogenase (XDH). Previous studies defined a "control element" near the 5' end of the gene, where variant sites affected the amount of rosy mRNA and protein produced. We have determined the DNA sequence of this region from both genomic and cDNA clones, and from the ry+10 underproducer strain. This variant strain had many sequence differences, so that the site of the regulatory change could not be fixed. A mutagenesis was also undertaken to isolate new regulatory mutations. We induced 376 new mutations with 1-ethyl-1-nitrosourea (ENU) and screened them to isolate those that reduced the amount of XDH protein produced, but did not change the properties of the enzyme. Genetic mapping was used to find mutations located near the 5' end of the gene. DNA from each of seven mutants was cloned and sequenced through the 5' region. Mutant base changes were identified in all seven; they appear to affect splicing and translation of the rosy mRNA. In a related study (T. P. Keith et al. 1987), the genomic and cDNA sequences are extended through the 3' end of the gene; the combined sequences define the processing pattern of the rosy transcript and predict the amino acid sequence of XDH.

Animals↗
PubMed1987

Low serum B12 levels in a hematologically normal elderly subpopulation.

Serum Vitamin B12 levels were determined on 378 patients ranging in age from 56 to 104 years with a median age of 77 for both males and females. A radiodilution method was employed for these determinations. This screening procedure identified 26 patients with low serum B12 levels. Nineteen of these patients had no other symptoms and were hematologically normal. The B12 binding proteins, transcobalamins (TC) I, II, and III were quantitated employing QUSO and DEAE cellulose batch separations. The total number of TC II binding/affinity sites for B12 were elevated in both the normal and low B12 elderly groups. About 17% of the total serum B12 was carried by TC II in the control group while only 4% of the total was carried on TC II in both the normal and low B12 elderly. This was accompanied by an increase in unsaturation in TC II for these two groups. The findings suggest that an alteration in the TC II-B12 delivery system has occurred in the elderly.

Adult↗
PubMed1986

Why are patients with acute stroke admitted to hospital?

Data on 515 consecutive patients registered with the Oxfordshire Community Stroke Project were used to compare the characteristics of those patients who were admitted to hospital within one month after their first stroke with those who remained in the community during that time. Twenty eight patients had their stroke while in hospital for other conditions, and of the remaining 487, 266 were admitted. Though patients with a severe neurological deficit were significantly more likely to be admitted, 47 out of 202 such patients were managed in the community. In a substudy of 162 consecutive patients the general practitioners' reasons for either arranging admission to hospital or continuing with community care in the first week after the stroke were ascertained. Sixty patients were admitted. The only reason for admission was diagnostic uncertainty in five cases (though this was a contributing factor in 25) and to provide nursing or general, non-medical care in 25. Patients who lived alone were more likely to be admitted. All 12 patients who presented directly to the casualty department were admitted, though only five had had a severe stroke. A stroke service that provides a facility for rapid outpatient and domiciliary diagnosis as well as a rapidly acting domiciliary nursing team might reduce the number of patients with stroke admitted to hospital without adversely affecting the quality of patient care: this should be properly evaluated.

Acute Disease↗
PubMed1986

Upper genital tract changes and infertility in diethylstilbestrol-exposed women.

A possible relationship of upper genital tract abnormalities in the diethylstilbestrol-exposed woman and infertility was studied. Six hundred thirty-two women had roentgenography performed. Three hundred sixty-seven of these women were not using contraception and were actively trying to become pregnant. One hundred thirty-four (36%) of these women reported difficulties conceiving for a period of 1 or more years. Seventy-three percent of these women had abnormal hysterosalpingograms. The frequency of abnormal x-ray films in the women who did conceive within 1 year was essentially the same (74%). Furthermore, a similar number of women with normal x-ray films (37%) had difficulty conceiving as did women with abnormal x-ray films (36%). When specific hysterosalpingographic abnormalities were related to the presence or absence of infertility, it was observed that the presence of a constriction of the upper uterine cavity resulted in a 2.26-times greater likelihood that a woman would not be able to conceive. If a T-shaped uterus was found in association with constriction of the upper uterine cavity, the odds ratio for inability to conceive was found to be 2.63.

Abnormalities, Drug-Induced↗