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Biomedical subjects

M Woods

Publications and source records attributed to M Woods.

At least 19 recordsLinked to original sources
PubMed1999

Diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae. Genitourinary infections in males by the Amplicor PCR assay of urine.

The Amplicor CT/NG polymerase chain reaction (PCR) test on urine specimens from males was prospectively evaluated against established specimens and laboratory methods for diagnosing Chlamydia trachomatis and Neisseria gonorrhoeae genitourinary infections, in patients from a remote region of Western Australia. Seventy-three males who were tested for both C. trachomatis and N. gonorrhoeae by both conventional methodology and Amplicor PCR on urine were enrolled in the study. Established testing comprised enzyme immunoassay/immunofluorescence antigen testing (EIA/IF) for C. trachomatis and microscopy and/or culture for N. gonorrhoeae on urethral swabs. Positive test results were confirmed using a set of criteria that included supplemental PCR testing and clinical history. Overall, 13.7% of patients were resolved as positive for C. trachomatis and 52.1% as positive for N. gonorrhoeae. The sensitivity and specificity of the Amplicor CT/NG PCR on male urine specimens for C. trachomatis were 80.0% (8/10) and 95.2% (60/63), compared with 60.0% (6/10) and 100.0% (63/63) for EIA/IF on urethral swabs. For N. gonorrhoeae, the sensitivity and specificity of the Amplicor CT/NG PCR on male urine specimens were both 100% (38/38 and 35/35, respectively) compared with 86.8% (33/38) and 100% (35/35) for microscopy and/or culture on urethral swabs. The results of this study indicate that the Amplicor CT/NG multiplex PCR test for C. trachomatis and N. gonorrhoeae performed on urine in males provides a highly sensitive, specific, and robust method for the diagnosis of both C. trachomatis and N. gonorrhoeae, for the early detection of both symptomatic and asymptomatic infected individuals.

Chlamydia Infections↗
PubMed1998

A humanised therapeutic CD4 mAb inhibits TCR-induced IL-2, IL-4, and IL-10 secretion and expression of CD25, CD40L, and CD69.

The actions of a humanised therapeutic CD4 mAb YHB.46 on T cell activation were investigated in vitro. Soluble YHB.46 IgG or YHB.46-derived F(ab')2 fragments caused inhibitions of up to 100% of the proliferation of purified CD4+ T cells activated with immobilised CD3 mAb. The inhibitory effects of the CD4 mAb were equally potent in both CD45RA+ and CD45RO+ T cell subset proliferation assays. Inhibitory effects on DNA synthesis were nto explicable by increased T cell apoptosis. YHB.46 was inhibitory even when added 70 h after exposure of cells to immobilised CD3 mAb, but it had little effect on IL-2 receptor-driven proliferation signals. The CD4 mAb inhibited the CD3-induced expression of the CD25 and CD69 activation markers on the T cell surface and suppressed CD40 ligand expression, but not that of CD25 and CD69, when their expression was induced by phorbol ester plus ionomycin. YHB.46 also exerted a profound inhibitory effect on the production of IL-2, IL-4, and IL-10, irrespective of whether T cells were activated with CD3 mAb or with phorbol ester plus ionomycin. The inhibitory effects of YHB.46 on CD4+ T cell proliferation were partially prevented by the addition of exogenous IL-2 or autologous monocytes and were completely prevented by activating T cells with a novel CD3-CD28 bivalent F(ab')2 reagent. However, the inhibitory effects of YHB.46 on T cell proliferation were equipotent in the presence or the absence of CTLA-4Ig, showing that the CD4 mAb was not acting on CD28-induced activation signals per se. Our results show that the inhibitory effects of YHB.46 on T cell activation do not involve CD28 or IL-2 receptor signalling, but are directed at the TCR-mediated G0-G1 transition. These findings in vitro predict that YHB.46 may act as a potent immunosuppressant in the clinical context.

Animals↗
PubMed1998

Limbal vernal keratoconjunctivitis in the tropics.

OBJECTIVE: This study aimed to describe the pathology of vernal keratoconjunctivitis (VKC) in children from Kenya. DESIGN: Case series. PARTICIPANTS: Ten patients with clinically active and untreated limbal VKC and five age-matched control subjects without external eye disease were recruited from a district eye hospital in Kenya. MAIN OUTCOME MEASURES: Paraffin sections of limbal and tarsal conjunctiva were examined by tinctorial and immunocytochemical methods to characterize the inflammatory infiltrate. RESULTS: In comparison with control subjects, patients with VKC were more likely to show squamous metaplasia of the tarsal conjunctiva. The patients with VKC had cellular infiltration of both the stroma and epithelium consistent with chronic inflammation, particularly in the biopsy specimens taken from the limbus. In tarsal conjunctiva, the stromal infiltrate consisted of a diffuse T-lymphocyte reaction with clustering of B-lymphocytes; mast cells, immunoglobulin E (IgE) plasma cells, and eosinophils also were prominent. Mast cells and eosinophils were found within the epithelium in the more severely inflamed biopsy specimens. CONCLUSIONS: These features are similar to those in reports of VKC in temperate regions, although the degree of B-lymphocyte clustering is greater in tropical patients with VKC. Although none of the patients had other symptoms of atopy, the authors findings are consistent with those for an allergic basis for this disease.

Adolescent↗
PubMed1998

Characteristics of new referrals to twenty-seven lymphoedema treatment units.

Lymphoedema affects 25-28% of patients who have undergone axillary surgery or radiotherapy in the treatment of cancer. The prevalence of primary lymphoedema or of lymphoedema secondary to non-cancer causes is unknown. In addition, basic demographic and disease characteristics of the lymphoedema population remain undocumented. We conducted a prospective survey to determine these characteristics. Lymphoedema treatment clinics in the UK were invited to participate at the British Lymphology Society 1996 Annual Conference. Twenty-seven clinics collected a standard data set for all new referrals in a 3-month period in 1997. The sample size was 603. The mean number of new referrals was 7.4 patients per unit per month. Eighty per cent of patients had cancer-related lymphoedema, and 86% of patients were female. Patients' mean age was 61.0 years. Thirty-seven per cent of the sample had suffered lymphoedema for less than 3 months, and 15% for 5 years or more. Patients with non-cancer related oedema had suffered the condition disproportionately longer than the cancer-related group (chi 2 = 102.2, P < 0.001). Sixty-six per cent of patients were reported as having lymphoedema at more than one site. Seventy-four per cent of all patients suffered unilateral limb oedema, and 23% bilateral limb oedema. Bilateral swelling was recorded for 67% of the non-cancer related group and 13% of the cancer related group (chi 2 = 153.4, P < 0.001). Median percentage excess volume (PCEV) for all patients with unilateral limb oedema was 16.4%. There was a positive relationship between PCEV and duration of the condition (H = 24.0, P < 0.001), and PCEV and non-cancer related lymphoedema (H = 10.5, P < 0.05). These results suggest that patients with non-cancer related lymphoedema and those with cancer-related lymphoedema form two distinct groups. The former present substantial management problems which are made more complex by late referral.

Adolescent↗
PubMed1998

Excessive rates of childhood mortality in the Northern Territory, 1985-94.

OBJECTIVES: To estimate the post-infant/childhood mortality rate (1-14 years) in the Northern Territory (NT) of Australia. METHODS: A retrospective study of post-infant death in the 10 years 1985-94 inclusive in the NT. RESULTS: Two hundred and forty-four deaths were identified. Compared to a non-Aboriginal, an Aboriginal child was twice as likely to die from accidents, 11 times more likely to die from infection and 3.2 times more likely to die from all causes. Road traffic accidents were the leading cause of accident mortality in Aboriginal children. All children who died in collisions or rollovers were unrestrained. Drowning was the major cause of death amongst non-Aboriginal children aged 1-4 years; none of the residential pools in which drowning occurred had fencing which complied with the recommended Australian fencing standards. Mortality rates from infection were highest in Aboriginal children aged 1-4 years. The overall mortality rate decreased over the 10-year period with a significant reduction in non-Aboriginal but not in Aboriginal children. CONCLUSIONS: NT children aged 1-14 years have higher mortality rates than their Australian counterparts and these are significantly higher in Aboriginal compared to non-Aboriginal children. Legislation and enforcement of isolation pool fencing, car seat restraints and safer driving on rural roads could have a significant impact on reducing accident mortality.

Accidents↗
PubMed1998

Cytokine and lipopolysaccharide stimulation of endothelin-1 release from human internal mammary artery and saphenous vein smooth-muscle cells.

Many pathologic conditions are associated with elevations in the production of endothelin-1 (ET-1) in the blood vessel wall. Because many of these conditions are cytokine-driven we examined the effects of a mixture of cytokines and lipopolysaccharide on ET-1 production in human vascular smooth-muscle (VSMC) cells derived from the internal mammary artery (IMA) and saphenous vein (SV). Incubation of VSMCs from IMA and SV with a combination of tumor necrosis factor-alpha (10 ng/ml), interferon-gamma (1,000 U/ml), interleukin-1 beta (500 U/ml) and lipopolysaccharide (10 micrograms/ml) for up to 48 h markedly elevated the expression of mRNA for ET-1 and the release of ET-1 into the culture medium. We conclude that low levels of ET-1 mRNA and peptide production in human VSMCs are markedly increased by exposure to cytokines and LPS. This suggests that during inflammatory states the VSMC, as well as the endothelium, may be a site of significant ET-1 production in the blood vessel wall.

Cells, Cultured↗
PubMed1997

Individual variability in lipoprotein cholesterol response to National Cholesterol Education Program Step 2 diets.

The effects of National Cholesterol Education Program (NCEP) Step 2 diets on plasma lipoprotein profiles in 72 men [mean (+/- SD) age: 44 +/- 15 y, range: 19-81 y] and 48 women (mean age: 50 +/- 21 y, range: 21-78 y) participating in five previously published studies were examined. Subjects were placed on a baseline diet similar to an average American diet (35-41% total fat, 13-16% saturated fat, 31-45 mg cholesterol/MJ) and then on an NCEP Step 2 diet (18-29% total fat, 4-7% saturated fat, 11-20 mg cholesterol/MJ) under isoenergetic conditions. All food and drink were provided. Compared with the baseline diet, consumption of the NCEP Step 2 diets was associated with significant decreases in concentrations of low-density-lipoprotein (LDL) cholesterol (-18.9% and -15.6%, respectively) and high-density-lipoprotein (HDL) cholesterol (-17.0% and -11.2%, respectively) in both men and women. Men with the apolipoprotein (apo) E 3,4 phenotype had a significantly greater decrease in LDL cholesterol (-24.2%) with the NCEP Step 2 diets than men with the apo E 3,3 phenotype (-17.7%). Men with the apo A-IV 1,2 phenotype tended to have less LDL cholesterol lowering (-12.8%) than men with the apo A-IV 1,1 phenotype (-19.6%), but this difference was not significant. No differences were seen by apo E and A-IV phenotype in women. A large variability in lipid response to the diet was observed, with changes in LDL cholesterol ranging from +3% to -55% in men and and from +13% to -39% in women. Forty-eight percent of the variability in LDL-cholesterol response (in mmol/L) to the diet could be accounted for by baseline LDL concentrations and age in men, and 13% by age in women.

Adult↗
PubMed1997

Surgically-assisted maxillary expansion.

A combined surgical and orthodontic technique for management of transverse maxillary deficiencies in mature patients is described and discussed. Special references are made to the surgical release of several circummaxillary articulations to facilitate the use of a fixed expansion device, and to the authors' addition of an osteotomy below the nasal spine, to ensure that the nasal septum remains independent of the maxillary segments. Indications for the use of this surgically-assisted maxillary expansion technique, and its advantages when compared with segmented surgical expansion, are also presented.

Bone Lengthening↗
PubMed1997

Lansoprazole and ranitidine affect the accuracy of the 14C-urea breath test by a pH-dependent mechanism.

OBJECTIVES: To determine the effect of lansoprazole and high dose ranitidine on the accuracy of the 14C-urea breath test (UBT). Using intragastric pH recordings, we correlated the effect of these agents on the UBT with their potency of gastric acid suppression. METHODS: Patients with active Helicobacter pylori infection underwent a baseline UBT before receiving 14 days of lansoprazole (30 mg/day) or ranitidine (300 mg b.i.d.). During therapy, patients were asked to undergo 24-h intragastric pH monitoring. Repeat breath testing was performed 1 day after completion of the study drugs. If the UBT was equivocal or negative (14CO2 excretion was < 200 dpm), further UBTs were completed until the 14CO2 excretion was > 200 dpm. RESULTS: Thirteen patients received lansoprazole. Eight of thirteen patients developed a negative or equivocal UBT. All patients had 14CO2 excretion > 200 dpm 5 days after the cessation of lansoprazole. Eleven patients received ranitidine. Ranitidine led to equivocal or false negative UBTs in 2 of 11 cases. This effect resolved within 5 days of stopping ranitidine. Intragastric pH recordings revealed that the patients who experienced the most profound gastric acid suppression were those that developed equivocal or false negative UBTs. CONCLUSIONS: Lansoprazole significantly affected the accuracy of the UBT, causing equivocal or false negative results in 61%. High dose ranitidine affected the breath test in only 18%. The ability of these drugs to suppress gastric acid secretion predicted those patients who developed equivocal or false-negative UBTs. The effect on the accuracy of the UBT resolved within 5 days of drug cessation.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1996

Comparison of transrectal ultrasound prostatic volume estimation with magnetic resonance imaging volume estimation and surgical specimen weight in patients with benign prostatic hyperplasia.

There are relatively few reports in the literature comparing transrectal ultrasound (TRUS) to magnetic resonance imaging (MRI) in estimating the volume of the prostate in the management of benign prostatic hyperplasia (BPH). In this study, we compared volumes determined by TRUS with MRI and TRUS-estimated weights with surgical specimen weights. The main findings of this study were (a) TRUS and MRI measurement of prostate volumes are quite similar; and (b) TRUS underestimates (by 10%) the prostatic weight as determined from the surgical specimens. A better volume estimate can thus be obtained by multiplying the TRUS measurement by a factor of 1.10. We conclude that because TRUS is cheap, user-friendly, noninvasive, and equally as accurate as MRI, it should be the preferred modality in the follow-up of BPH patients.

Humans↗
PubMed1995

Validity of 24-hour dietary recall interviews conducted among volunteers in an adult working community.

There is considerable uncertainty regarding the validity of dietary data collected from free-living populations. Nevertheless, few attempts have been made to validate dietary assessment instruments. To address this issue, we compared average daily protein intake estimated from 24-hour dietary recall interviews to protein intake estimated from urinary nitrogen excretion in 24-hour samples. Among 244 community-dwelling adults who volunteered for a hypertension study, men (n = 139) overreported dietary protein intake by 12 to 19%. In contrast, women (n = 105) reported a dietary protein intake almost exactly in agreement with estimates based on urinary nitrogen levels. Thin men reported about one-third more protein intake than was reflected in their urinary nitrogen measurements. Our results suggest that the accuracy of dietary recall estimates may vary across subgroups of the population. Additional information from sufficiently large validation studies would be helpful in determining the role of dietary assessment instruments which are already in wide use in epidemiologic research. Until such information is obtained, doubts will remain regarding the validity of inferences drawn from nutritional epidemiologic studies.

Adult↗