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R R West

Publications and source records attributed to R R West.

At least 55 records · Page 3Linked to original sources

A model for microtubule-associated protein 4 structure. Domains defined by comparisons of human, mouse, and bovine sequences.

cDNAs encoding human and mouse microtubule-associated protein 4 (MAP 4) were isolated. MAP 4 is encoded by a single gene. Multiple MAP 4 mRNAs are transcribed that are differentially expressed among mouse tissues. Open reading frames for the human and mouse MAP 4 clones indicate three distinct regions consisting of related sequences with different motifs. Approximately 30% of the protein is tandem related repeats of approximately 14 amino acids. Another region contains clusters of serine and proline. Four 18-mer repeats characteristic of the microtubule-binding domains of MAP 2 and tau are located at the carboxyl-terminal portion of MAP 4. Amino acid sequence analysis revealed that human and mouse MAP 4 are homologs of the bovine 190-kDa MAP/MAP U (Aizawa, H., Emori, Y., Murofushi, H., Kawasakai, H., Sakai, H., and Suzuki, K. (1990) J. Biol. Chem. 265, 13849-13855). Mouse and human MAP 4 and the bovine 190-kDa MAP are approximately 75% similar, indicating that these proteins are all members of the same class. Domains with extremely high conservation (greater than or equal to 88%) are: 1) the extreme amino terminus; 2) a proline-rich region between the KDM and S,P domains; 3) the microtubule-binding domain; and 4) the extreme carboxyl terminus.

Amino Acid Sequence↗

Is there an increased risk of breast cancer in women who have had a breast cyst aspirated?

A consecutive series of 644 women who presented with breast nodularity between 1976 and 1982 have been followed up to determine their rate of subsequent breast cancer. Fifteen women have developed breast cancer, 14 of these were among 352 women with an aspirated cyst (relative risk 4.4). Women with multiple cysts had the highest risk and women with breast nodularity had no excess risk. Review of histology specimens from those women who had undergone biopsy showed an excess of florid epithelial hyperplasia in women who subsequently developed breast cancer and women with multiple aspirated cysts were more likely to have florid epithelial hyperplasia. Multiple cysts are clinical markers of histological breast proliferation and women who have had multiple breast cysts aspirated have an increased risk of breast cancer and should be advised to practice regular self examination.

Adult↗

Specificity of association in analysis of mortality and inference on causality.

Specificity of association between putative risk factor and disease under study is important to inference on causality. Nevertheless many studies investigate mortality of a single disease without comparison with a control. Age-standardized proportional mortality ratios make single disease studies into case-control studies and thus demonstrate whether or not associations are disease specific. Comparison of disease-specific with all-cause mortality experiences of whole populations classified by exposure, clearly distinguishes between exposures associated with more death and with earlier/younger death, thereby overcoming an important limitation of the familiar standardized mortality ratio (SMR). Smoking is associated with more death from lung cancer (lifetime cause-specific proportions, never 1%, light 6%, moderate 8% and heavy 12%) and with earlier/younger death from ischaemic heart disease (never 35%, light 34%, moderate 32% and heavy 29%).

Adult↗

Leukaemia mortality among relatives of cystic fibrosis patients.

A total of 219 families of patients with cystic fibrosis living in Wales were studied for the occurrence of other diseases and for cause of death, and the findings in relation to leukaemia are reported. There were eight deaths due to leukaemia, five of the myeloid type, in first and second degree relatives; this is significantly more than the expected on the basis of national age specific mortality rates. In comparison, mortality among siblings, parents, aunts and uncles, and grandparents from all causes was within the expected. Screening the five patients with myeloid leukaemia for the delta F508 mutation showed that four were carriers of this mutation. It is concluded that carriers of the delta F508 mutation may have an increased risk of developing acute myeloid leukaemia. This could happen through the direct effect of the cystic fibrosis gene itself, or through its influence on another gene, such as the met oncogene, or gene(s) involved in granulocyte function on the long arm of chromosome 7.

Adult↗

Post-infarction ventricular septal defect: the importance of right ventricular coronary perfusion in determining surgical outcome.

Mortality from a post-infarction ventricular septal defect (VSD) can be reduced by surgery, selection for which would be helped by knowledge of factors affecting the postoperative prognosis. We reviewed our 9-year experience (1978-1987) of 40 surgically treated patients, comparing preoperative characteristics in those who died postoperatively (n = 15, 37%) and those who survived (n = 25, 63%), all still alive. Sex, age, infarct size as assessed by peak serum creatine kinase values, left ventricular end-diastolic pressure and pulmonary/systemic flow ratio (2.9 +/- 0.2 vs 3.1 +/- 0.3) were similar. Survivors had a lower incidence of inferior infarct than those who died (6, 24% vs 9, 60%, P less than 0.05), a lower incidence of cardiogenic shock (7, 28% vs 10, 67%, P less than 0.05), less elevation of right ventricular end-diastolic pressure (10.1 +/- 0.9 vs 14.7 +/- 1.0 mm Hg, P less than 0.01) and less impairment of right ventricular coronary supply as determined by a coronary angiography-derived myocardial score (0.9 +/- 0.3 vs 4.7 +/- 0.7, P less than 0.001). The data suggest that right ventricular coronary perfusion influences prognosis. The proposed angiographic score may help to identify preoperatively those patients most likely to benefit from surgery.

Cardiac Catheterization↗

Coronary artery bypass surgery: current practice in the United Kingdom.

A survey of current clinical practice was carried out among the 84 consultant cardiac surgeons currently performing coronary artery bypass surgery in the United Kingdom. The 80 surgeons who returned the questionnaire performed an estimated total of 17,100 coronary artery bypass graft operations in 1987, a mean case load of 214 operations each. Sixty two of the 80 surgeons regarded the internal mammary artery as the graft conduit of choice, and seven preferred the saphenous vein. The internal mammary artery was used in 73% of bypass grafts to the left anterior descending coronary artery but in only 4% of grafts to the circumflex and right coronary systems. Contraindications to the use of the internal mammary artery included advanced age of the patient (51 surgeons), insufficient flow through the internal mammary artery (49), and endarterectomy (35). Seventy four of the 80 surgeons considered intraoperative damage to the saphenous vein to be a possible cause of vein graft failure, but there was no agreement about how it should be reduced. All surgeons advocated pharmacological measures to enhance graft patency. Dipyridamole and aspirin constituted the most popular regimen (58 surgeons), though only 28 started dipyridamole preoperatively. Warfarin was prescribed postoperatively on occasion by 22 surgeons, but 14 of these used it only after endarterectomy.

Aged↗

An epidemiological survey of primary tumours of the brain and spinal cord in South East Wales.

This survey is founded on 526 patients who presented with a primary tumour of the brain, spinal cord or their coverings over a seven year period. The patients resided in one of the three counties comprising South East Wales, which has a population of about 1.3 million. Each tumour type is classified according to age, sex and area of residence of the patient. Age and sex adjusted annual incidence rates were calculated for each tumour type. All types of glioma have a higher incidence in males, while meningiomas are twice as common in females. Gliomas are the most commonly occurring tumour with an average annual incidence of 3.6 per 100,000 and a peak incidence for malignant astrocytomas of 7.6 in the 55 to 64 year age group. The low grade astrocytoma is the most common tumour of childhood. Oligodendrogliomas occur most commonly in adults between the ages of 35 and 44 years. In this survey there is an unexplained relatively high incidence of oligodendrogliomas. The majority of primary tumours arose in the brain, but there were 24 tumours of the spinal cord, nerve sheath and meninges. Comment is made on the presence and possible aetiological significance of chemical industries within South East Wales.

Adolescent↗

Myelodysplasia, chemical exposure, and other environmental factors.

This paper describes a case-control study of the occupational and environmental exposures of patients with myelodysplasia. The methodology, first described in Canada for solid tumors, estimates lifetime exposures to a number of potential toxic hazards or carcinogens. This pilot study confirms that the methodology, with the use of questionnaires and interviews, can estimate exposures to specific chemicals and shows some significant associations with myelodysplasia, including exposure to petrol or diesel compounds.

Air Pollutants↗

Prevalence of Gardnerella vaginalis: an estimate.

To assess the prevalence of Gardnerella vaginalis in the community 300 women aged 16-59 were randomly selected from a general practice's age-sex register and invited to attend for a health check. Out of 282 women who were eligible to attend, 192 did so. They were asked whether they had any vaginal symptoms, and swabs were taken from 182 women for culture for G vaginalis. Sixty women were positive for G vaginalis, of whom 26 had symptoms. Infections with G vaginalis may be present in women who have no symptoms. By careful questioning, examination, and side room testing general practitioners may be able to diagnose these infections in such women consulting them for other reasons.

Adolescent↗

Perinatal and infant mortality in Wales: inter-district variations and associations with socio-environmental characteristics.

Stillbirth rates, perinatal death rates, early and late neonatal death rates and (post-neonatal) infant death rates are reported for Wales since local government and NHS reorganization in 1974. The time trends in these rates show declining mortality, in full weight and in low birthweight babies. Analysis of average rates for the period 1974-81 inclusive in the 37 local authority districts within Wales demonstrate wide variations, with PMRs ranging from 11.5 to 22.5 per 1000. Many highly statistically significant associations were evident between socioeconomic characteristics of the districts and stillbirth rates but few with neonatal death rates and none with infant death rates.

Environment↗