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Biomedical subjects

N Kenny

Publications and source records attributed to N Kenny.

At least 19 recordsLinked to original sources
PubMed2001

Lifelong learning in ethical practice: a challenge for continuing medical education.

BACKGROUND: Formal education in the identification, analysis, and resolution of ethical issues in clinical practice is now an essential component of undergraduate and postgraduate medical education. Physicians educated before the 1980s have had little or no formal education in ethics. This article describes a project for assessing the content and format appropriate for the continuing education needs of practicing physicians. METHODS: A questionnaire and follow-up facilitated small-group discussions with a physician ethicist around case-based problems were used to identify the ethical issues in practice where participants felt the need for continuing education. RESULTS: The project confirmed that practitioners had very little formal ethics in medical school and less since starting practice despite encountering ethical issues. The most frequently used method of learning about ethics was informal discussion among those who have the same lack of formal education. Physicians did not feel that they needed a "very high" level of confidence and competence in handling ethical issues, even those commonly encountered. Participants indicated strongly that they lacked a systematic approach to the identification and analysis of ethical issues and suggest incorporation of the ethical component into regular CME. FINDINGS: In spite of the small study population and the volunteer nature of the participants, the project demonstrated the identification of ethics content for CME similar to that used in medical education. Further work is needed to assess objective needs for ethics education in addition to the perceived needs of clinicians.

Education, Medical, Continuing↗
PubMed1999

Ethics in an aging society: challenges for oral health care.

Health and aging are deeply meaningful and complex realities. The demographic reality of the Canadian population in the 21st century requires an in-depth understanding of the health care goals of older people, an analysis of the attitudes toward older people that affect societal decision making and the educational and policy changes required to effect positive change. Viewing these issues through the lens of oral health care allows an analysis of health care goals for the older population. A look at representative cases where oral health needs were not met uncovers some of the attitudes and values about oral health, the goals of health care and the unique circumstances of older people that present barriers to appropriate care.

Aged↗
PubMed1998

Pediatricians' experience of ethical dilemmas in practice: implications for education.

OBJECTIVE: To determine Canadian pediatricians' experience with ethical dilemmas, to relate this information to proposed curriculum for residency training in Canada, and to determine pediatricians' self-assessment of adequacy of training in ethical issues and the means used in practice to resolve dilemmas. METHOD: A single-pass questionnaire was mailed to all 1,220 pediatrician members of the Canadian Pediatric Society. RESULTS: From the 363 questionnaires (30 per cent) that were returned, 43 per cent of respondents had received formal ethics education in their training. Approximately half of respondents judged their training as adequate. Responses confirmed the themes of futile treatment, demands for and refusal of treatment by parents, uncertainty regarding withdrawing or withholding treatments, conflicts over judgments about the right thing to do, and dilemmas regarding the role of the child and adolescent. Respondents relied mainly on informal discussion with colleagues to resolve their dilemmas in practice. CONCLUSIONS: Core residency and continuing physician education need a valid epidemiological description of ethical issues encountered in practice. Educational approaches to the development of ethical knowledge, skills, and attitudes must be validated as there is a tendency to rely on case precedent and peer judgment. Perceived competence in handling ethical issues and dilemmas must be tested against accepted standards. Emerging ethical issues such as resource allocation, peer review, managed care, and technological and scientific advances must be regularly incorporated into both residency education and continuing medical education.

Canada↗
PubMed1996

Tamoxifen induces TGF-beta 1 activity and apoptosis of human MCF-7 breast cancer cells in vitro.

We report here that the antiestrogen tamoxifen (TAM) induces cell death in human breast cancer cell line MCF-7. We assessed the type of cell death induced by TAM in this breast cancer cell line on the basis of morphological and biochemical characteristics. Dying cells showed morphological characteristics of apoptosis, such as chromatin condensation and nuclear disintegration. DNA isolated from these cells revealed a pattern of distinctive DNA bands on agarose gel. The DNA fragmentation in MCF-7 cells induced by TAM could also be detected by terminal deoxynucleotidyl transferase-mediated dUTP-biotin end labeling. Northern blot hybridization revealed a substantial increase in the amounts of TRPM-2 and TGF-beta 1 mRNAs in MCF-7 cells after treatment with TAM. In contrast, the mRNA level of the estrogen-induced pS2 gene was strongly suppressed. The biological activity of TGF-beta was increased at least fourfold in the media from MCF-7 cells treated with TAM. The results presented in this study suggest that TAM induces apoptosis of MCF-7 cells and it may be mediated by the secretion of active TGF-beta.

Apoptosis↗
PubMed1995

Rotational dynamics of luteinizing hormone receptors and MHC class I antigens on murine Leydig cells.

We have examined the molecular motions of luteinizing hormone (LH) receptor and the Major Histocompatibility Complex Class I antigen on murine Leydig cells. Using time-resolved phosphorescence anisotropy methods, erythrosin (ErITC)-derivatized ovine luteinizing hormone (oLH) bound to the LH receptor appears rotationally mobile with rotational correlation times of 19.6 +/- 1.3 microseconds, 13.3 +/- 2.4 microseconds, 9.5 +/- 0.7 microseconds and 4.7 +/- 0.5 microseconds at 4 degrees C, 15 degrees C, 25 degrees C and 37 degrees C, respectively. Rotational correlation times for human chorionic gonadotropin (hCG)-occupied LH receptors were similar to those of the ErITC-oLH occupied receptor at each temperature. In addition, both oLH- and hCG-occupied LH receptors were laterally mobile in fluorescence photobleaching recovery experiments with diffusion coefficients at 29 degrees C of (5.8 +/- 0.9) x 10(-10) cm2 s-1 and (2.9 +/- 0.4) x 10(-10) cm2 s-1, respectively. We also measured the rotational correlation time of Class I antigen on murine Leydig cells using ErITC-derivatized 34-12-2S, an anti-Class I monoclonal antibody. Because there was no decay of the anisotropy function at 4 degrees C, 15 degrees C, 25 degrees C or 37 degrees C in the absence of oLH or following preincubation of Leydig cells with 1 nM oLH, it appears that Class I is rotationally immobile on the 1 ms timescale of our experiments. This result is consistent with the presence of Class I antigen in large molecular weight structures and may be the result of Class I self-aggregation. Further, treatment of cells with anti-Class I antibody had no effect on either basal or oLH-stimulated testosterone secretion. Thus, it appears that this anti-Class I antibody is not LH-mimetic on murine Leydig cells.

Animals↗
PubMed1995

Rotational dynamics of luteinizing hormone receptors on bovine and ovine luteal cell plasma membranes.

To determine whether LH receptor rotational diffusion is similar in closely related species, we compared the rotational correlation times of LH receptors on bovine CL membranes with those of LH receptors on sheep small luteal cells and luteal cell plasma membranes using time-resolved phosphorescence anisotropy techniques. After binding of erythrosin isothiocyanate (ErITC)-derived bovine LH (bLH), ErITC-ovine LH (oLH), or ErITC-hCG, there was no difference in the initial and final anisotropy at 4 degrees C, 15 degrees C, 25 degrees C, and 37 degrees C, indicating that the bLH receptor was rotationally immobile on the time scale of our experiments. On these same membrane preparations, the epidermal growth factor (EGF) receptor occupied by ErITC-murine EGF exhibited temperature-dependent rotational correlation times of 80 +/- 5 microseconds, 111 +/- 7 microseconds, 254 +/- 4 microseconds, and > 1000 microseconds at 4 degrees C, 15 degrees C, 25 degrees C, and 37 degrees C, respectively. Slower rotational times for EGF receptor observed at higher temperatures suggested the occurrence of temperature-dependent receptor aggregation. Like the bLH receptor, the oLH receptor on intact cells and on CL plasma membranes was rotationally immobile on the time scale of our experiments when occupied by ErITC-hCG. However, the oLH-occupied receptors on small luteal cells and on luteal cell membranes had comparable rotational correlation times at 37 degrees C. These results suggest that bLH receptors are present in large, rotationally immobile structures, whereas the receptor-containing structure formed on ovine luteal cells depends on whether that receptor is occupied by hCG or oLH. Also, despite the similarities between reproductive function in these species, the LH-occupied receptor appears to be organized differently in the plasma membranes of these hormone-responsive luteal cells.

Animals↗
PubMed1994

Chronic fracture dislocations of the proximal interphalangeal joint. Treatment by the "S" Quattro.

The "S" Quattro has proved its value in the treatment of acute displaced comminuted intraarticular phalangeal fracture dislocations. We have used the system to treat five cases of chronic fracture-dislocation or subluxation of the PIP joint. At an average follow-up period of 16.4 months, there was a mean increase in the range of movement of the injured joint by 75 degrees. We recommend this technique for selected cases.

Adult↗
PubMed1993

Class I major histocompatibility complex antigens are not associated with the LH/CG receptor on ovine luteal cells.

We have examined the rotational dynamics of the luteinizing hormone (LH) receptor on day 10 intact ovine small luteal cells and isolated plasma membranes using polarized fluorescence depletion (PFD). This technique measures rotational correlation times which are proportional to the in-membrane volume of a protein and are useful for examining changes in protein size due to receptor aggregation or protein-protein interactions. Eosin isothiocyanate (EITC)-derivatized ovine LH (EITC-oLH) bound to the LH receptor on luteal cell plasma membranes had a rotational correlation time of 20 +/- 6 microseconds, while that for EITC-human chorionic gonadotropin (EITC-hCG)-occupied LH receptors was 46 +/- 13 microseconds. Slower rotational times for EITC-oLH and EITC-hCG, 63 +/- 19 and 87 +/- 20 microseconds, respectively, were obtained on intact ovine luteal cells. These results indicate that the LH receptor exists as a larger molecular mass complex when binding hCG than oLH, a difference which could be attributable to hCG-induced LH-receptor interaction with additional membrane protein(s). One candidate protein for such an interaction is the Major Histocompatibility Complex (MHC) Class-I antigen. However, the rotational correlation time of EITC-anti-MHC Class-I antibody (SBU I) Fab fragments was 247 +/- 34 microseconds, indicating that MHC Class I is located in complexes larger than those identified by EITC-OLH or EITC-hCG. Preincubation of plasma membranes with 1 nM unlabeled oLH or hCG had no significant effect on this rotational correlation time. Further, treatment of cells with SBU I had no affect on either basal or oLH-stimulated progesterone secretion. Thus it appears that the ovine luteal LH-receptor is not associated with MHC Class I and that antibody-induced aggregation of MHC Class I does not cause an LH-mimetic response.

Animals↗
PubMed1993

Nail gun injuries.

The nail gun is a potentially dangerous device that is commonly used in the construction industry to drive various sizes of nails into wood or concrete. These devices appear to be used without sufficient training and they can be easily obtained by the general public. We report a series of injuries caused by nail guns. The pattern of these injuries and the mechanism of their production suggest that the safety mechanisms on the guns and the protective clothing worn by operators of the guns do not prevent injuries. We call for a review of operator training and the design of both the safety mechanism of nail guns and the protective clothing worn by operators. If necessary, modifications should be introduced to reduce the likelihood and severity of such potentially serious injuries.

Accidents, Occupational↗
PubMed1992

Molecular dynamics of luteinizing hormone receptors on rat luteal cells.

To better understand the in situ organization of the luteinizing hormone receptor on rat luteal cells, we have examined the molecular motions of this receptor following binding of ovine luteinizing hormone (oLH) or human chorionic gonadotropin (hCG). Fluorescence photobleaching recovery (FPR) measurements of LH receptor lateral diffusion were performed using tetramethylrhodamine isothiocyanate (TRITC)-derivatized oLH or hCG as a probe. These experiments indicate that TRITC-oLH occupied LH receptors on luteal cells obtained from superovulated female rats have a lateral diffusion coefficient D of (1.7 +/- 0.6).10(-10) cm2s-1 at 27 degrees C with fluorescence recovery after photobleaching of 46 +/- 5%. In similar experiments, binding of TRITC-hCG caused a significant decrease in LH receptor lateral diffusion; fluorescence recovery after photobleaching was less than 20%. To determine whether hCG-occupied receptors might exist in large aggregates, we measured the rotational correlation times (RCT) of hCG and oLH bound to the LH receptor on intact cells using single cell polarized fluorescence depletion (PFD). At 4 degrees C, LH receptors occupied by eosin isothiocyanate (EITC)-hCG exhibited a slower RCT (64 microseconds) than did receptors occupied by EITC-oLH (43 microseconds). At this temperature both TRITC-oLH and TRITC-hCG occupied LH receptors were laterally immobile. These FPR and PFD results suggest that the molecular motions of the luteal cell LH receptor are significantly modulated by the subtle structural differences in various bound gonadotropins.

Animals↗
PubMed1992

Gonad protection in young orthopaedic patients.

OBJECTIVE: To determine whether gonad shields are correctly positioned on the pelvic radiographs of children with slipped capital femoral epiphysis. DESIGN: Retrospective study of radiographs taken of children treated by in situ pinning of slipped capital femoral epiphysis between 1 January 1983 and 31 December 1988. SETTING: Three teaching hospitals in north west England. PATIENTS: 32 patients with complete set of radiographs. RESULTS: An average of 10.8 anteroposterior pelvic radiographs plus 8.9 lateral hip radiographs had been performed per patient. Gonad shields had been completely omitted in 137 (40%) anteroposterior pelvic radiographs performed on the 32 patients at the time of completion of the study. In 100 (29%) the gonad shields were adequately protecting the gonads, but in 109 (31%) the gonad shields were not protecting the gonads due to incorrect positioning of the shield. The incorrect positioning of the gonad shields was more commonly found in girls than boys (64 vs 45; p less than 0.012), presumably because of the difficulty in determining gonadal position in relation to surface landmarks. Absence of gonad shields was also more commonly seen in girls (82 v 55; p less than 0.005), but this is not easily explained. CONCLUSIONS: Gonad shields are not protecting the gonads in a large percentage of anteroposterior pelvic radiographs (71%) because they have been omitted or inadequately placed. This avoidable excess radiation exposure to the gonads, combined with the inability to shield the gonads in lateral hip radiographs and the large number of radiographs performed, results in the gonads receiving a higher dose of radiation than may otherwise be the case, and may increase the potential for disease in the future offspring of these patients.

Adolescent↗