Biomedical subjects
Publications and source records attributed to R Walker.
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OBJECTIVE: To document airborne transmission of Actinobacillus pleuropneumoniae and porcine reproductive and respiratory syndrome virus (PRRSV) infection in nursery pigs. ANIMALS: 32 two-week-old pigs obtained from 3 farms, but with similar Landrace X Yorkshire genetics for trial 1 of each experiment; 16 pigs for trial 2 of the A pleuropneumoniae experiment; and 14 pigs for trial 2 of the PRRSV experiment. PROCEDURE: In experiment 1, pigs were inoculated with A pleuropneumoniae serotype 1 (6/8) or were left as contacts (2/8). At the beginning of trial 1, pigs were seronegative to A pleuropneumoniae serotypes 1 and 5 on the basis of results of an ELISA, but had positive results on the A pleuropneumoniae hemolysin I (Apx1)-neutralization test. Pigs in trial 2 had negative results on both tests. Pigs of trial 1 of experiment 2 were inoculated with a PRRSV virulent field isolate (MN-1b); pigs of trial 2 were inoculated with the virus reference strain VR-2332. Aerosol-exposed pigs were placed on the other side of the air duct and kept there for 2 to 7 weeks depending on evidence of airborne transmission. RESULTS: In trial 1 of experiment 1, evidence of airborne transmission was not found. In trial 2, most airborne-exposed pigs died as a result of A pleuropneumoniae infection 12 days after initiation of the experiment. In trial 1 of experiment 2, all inoculated pigs (8/8) seroconverted, but only 2 of 8 contact-exposed pigs seroconverted. Aerosol-exposed pigs did not seroconvert nor was virus isolated. In trial 2, all inoculated and contact-exposed pigs seroconverted. All aerosol-exposed pigs seroconverted after 21 days, and virus was isolated at 16 days. CONCLUSIONS: A pleuropneumoniae was transmitted by air at a distance of 1 m when pigs were fully susceptible to the organism. Transmission of PRRSV appeared to be strain dependent; when reference strain VR-2332 was used, airborne transmission of PRRSV was documented.
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To the already long list of existing tumor markers, a new marker has been recently added, the urinary gonadotropin peptide (UGP). This marker is determined in the urine of cancer patients and is considered to be particularly specific for ovarian carcinomas. The purpose of our study was to assess the specificity of UGP in a variety of malignancies other than ovarian carcinomas, e.g., breast, colonic, lung, and urogenital tumors (n = 50 each). The tumors were compared with benign lesions of the same organs. Urine samples of 50 healthy donors served as controls. The 450 urine samples were tested in duplicate using the UGP EIA-kit from Ciba Corning Diagnostics. All tumors were staged and histologically classified. For normalization in all samples, creatinine levels were determined. UGP was found in all tested tumors, however, with very low sensitivity of 20% in urogenital tumors, 46% in lung, and 30% or 27% in colon and breast carcinomas, respectively. The specificity of UGP was comprised between 100% (breast) and 88%. Clearly elevated UGP-concentrations were seen in postmenopausal women. A comparison of UGP with the optimal markers for each tumor system showed that UGP is not superior to these markers. However, we can confirm UGP as being an optimal marker for gynecological carcinomas.
Recently, sinusitis has been recognized as a frequent clinical problem in human immunodeficiency virus (HIV-1)-infected individuals. We hypothesized that quantitative defects in immune cells in the nasal mucosa of HIV-positive subjects might mirror those in the peripheral blood and explain a predisposition to sinus disease in this population. Nasal mucosa biopsies were obtained from three different groups of patients-HIV-1 seropositive with sinusitis, HIV-1 seronegative with sinusitis, and HIV-1 seronegative without sinusitis (normal volunteer)-and phenotyped for cluster of differentiation antigen (CD) markers. In this study, we found patients with HIV-1 and sinus disease to have significantly lower numbers of both CD3 and CD4 nasal mucosa lymphocytes than seronegative controls in the nasal mucosa (P < 0.05, P < 0.01, respectively). A correlation between nasal mucosal CD4 cells and peripheral-blood CD4 cells was noted (R = 0.67, P < or = 0.01). No deficiency in the number of nasal mucosa T or TC type mast cells was noted for the HIV-1-positive sinusitis group. Further study is warranted to define more completely the pathophysiology and microbiology of, and therapy for, this important clinical problem.
OBJECTIVE: 1. To identify risk factors associated with psychiatric rehospitalization within six months, using global clinical assessments and demographic information and; 2. To determine if risk factors for a hospital in a rural region are similar to those reported for urban hospitals. METHOD: The setting was a psychiatric unit within a general hospital. All adult admissions for one year were assigned scores on the North Carolina Functional Assessment Scale (NCFAS) and the Global Assessment of Functioning (GAF) scale. Patients were interviewed six months after discharge to determine if they had been rehospitalized and to assign new NCFAS and GAF scores. RESULTS: Significant risk of rehospitalization was predicted by: 1. NCFAS score > 90; 2. history of prior hospitalization; 3. nursing home residence; 4. referral from a small community hospital and; 5. non-compliance with outpatient appointments. CONCLUSIONS: Global assessments and demographic information collected during an index admission can generate factors to identify patients at risk for rehospitalization within six months. History of prior admissions and non-compliance with outpatient treatment, reported as risk factors in urban settings, were found also to be risk factors in a rural region.
The present study examined the eye movements made by patients with unilateral neglect under fixation gap and overlap conditions. The prior offset of fixation in a + 100 msec gap condition did not produce an increase in the numbers of contralesional saccades made by 3 out of 4 patients. This finding is incompatible with the view that the deficit in producing contralesional saccades reflects an inability to disengage visual attention from fixation. A significant reduction in saccade latency was, however, obtained in the gap condition ('gap effect'). The latency reduction in the gap condition is consistent with models which attribute the gap effect to warning signal effects and the release of an ocular rather than an attentional disengagement mechanism. Saccade latency was not increased when two targets were presented bilaterally and simultaneously in both hemifields (in contrast to the increase in latency shown by normal subjects). The lack of a normal 'bilateral target effect' in neglect is attributed to an imbalance in the level of activity in the saccadic system. Three patients showed visual 'extinction' and did not make saccades to the contralesional bilateral targets. In contrast R.R. who shows object-based neglect did not show extinction and made saccades to the contralesional bilateral targets. This suggests that visual extinction may be influenced by the form of neglect shown by the patient. The effects on saccade amplitude of presenting two targets in the same hemifield were also examined in a global effect task. One patient showed a much greater global effect than normal when pairs of targets were presented in his ipsilesional hemifield. In contrast R.R. showed a normal magnitude global effect. It appears that the form of neglect shown by a patient is a factor that influences their eye movement behaviour on simple saccade tasks and these eye movement abnormalities cannot be accounted for by a deficit of attentional disengagement.
Computed tomography (CT) is a valuable imaging tool in the examination of neonates and infants with nasal obstruction. At present, however, it is difficult to quantitatively evaluate the nasal fossa with CT as normative data and the relative significance of individual nasal fossa dimensions have not been established. A standardized CT image was proposed, and performed on a prospective cohort of 56 infants up to 1 year of age. A parental questionnaire was used to identify infants with nasal obstruction. Normative data for four nasal fossa dimensions are presented and analyzed. The statistical validity of these dimensions in the diagnosis of nasal obstruction was examined; only the maximal posterior bony diameter showed a significant difference between normal and nasally obstructed infants (t-test, P = 0.05). Examples of CT findings in the above-mentioned cases as well as past cases of "choanal stenosis' are demonstrated.
The mutagenicity of commercially available white grape juice was evaluated in the Ames mutagenicity test. Grape juice elicited a positive mutagenic, response in Salmonella typhimurium strain TA104 and a weaker response in strains TA97, TA98, TA100 and TA1530. The mutagenic response was evident in the absence of an activation system and inclusion of such a system did not influence mutagenicity. The grape juice-mediated mutagenic response was not due to histidine residues in the juice or likely treatment with sulfite. Moreover, freshly prepared grape juice displayed a similar mutagenic response. Three different brands of commercially available white grape juice were investigated in the Ames test; they all provoked a clear positive mutagenic response, but the degree of mutagenicity differed and could not be attributed to differences in the content of solids. It is concluded that grapes contain direct-acting genotoxic component(s).
Eye movements made by a patient with object-based neglect and no hemianopia, R.R., were recorded while he viewed whole, half, and chimaeric objects. When whole or chimaeric objects were presented centred on his initial fixation point, and when right half objects were presented, R.R. restricted his saccades to the right sides of the images. R.R.'s verbal identifications were consistent with these scan paths, since he correctly reported the identities of whole objects, right half objects, and the right sides of chimaeric objects, but failed to report objects on the left sides of chimaerics. When a left half object was presented to the left of initial fixation, however, R.R. made left saccades to scan the image and correctly named these objects; hence his failure to scan the left sides of chimaeric object cannot simply be attributed to an inability to make contralesional saccades. We examined the possibility of perceptual completion by testing R.R. with sets of whole and half shapes presented tachistoscopically and asking him to report what he had seen. When R.R. viewed whole shapes he correctly reported seeing a whole shape on every trial. However, R.R. often reported seeing right half objects as whole, whereas he was much less prone to report left half objects as perceptually whole. We discuss the nature of this perceptual completion, and conclude that both scan paths and completion are consequences of object-based neglect, not its causes.
A review of the development of clinical pharmacy in the UK reveals that its origins stem from the mid 70's when many undergraduates received short clinical attachments with physicians. The evolution was accelerated by the appointment of pharmacists who held joint university and hospital contracts. Innovative postgraduate diploma and masters programmes in clinical pharmacy established in the early 80's secured a steady supply of skilled individuals to undertake the various roles that arose. Acceptance within academia was marked by the establishment of a series of Chairs in clinical pharmacy in the late 80's and early 90's along with PhD research programmes in clinical pharmacy. As an emerging discipline the forthcoming university research assessment exercise will mark a milestone in the progress of clinical pharmacy. There is, however, concern that the assessment exercise will use criteria not entirely sympathetic to the uniqueness of clinical pharmacy.
The diversity of novel foods and novel ingredients covered by the scope of the EU regulation is such that a check list approach to safety evaluation is inappropriate. Rather, a case-by-case approach is required taking into account the composition of the novel food, its intake, its role in the diet and the intended target group. The SAFEST approach provides a means of targeting the safety evaluation on those aspects, nutritional or toxicological, of a novel food which are of particular concern. Using this approach, novel foods are assigned to one of three classes on the basis of certain background information. For those novel foods which can be shown to be in SAFEST class 1, namely those which are substantially equivalent to a traditional counterpart, no further information is required to demonstrate their safety. For those novel foods in SAFEST class 2, i.e. those sufficiently similar to a traditional counterpart or differing from it only in particular, well defined, characteristics, the evaluation will focus on those differences. Only in the case of novel foods which are not in class 1 or class 2 is extensive testing of the whole food likely to be required. Even in these cases, the testing should follow a scientifically-based hierarchical approach involving: literature reviews; chemical analysis; appropriate in vitro and in vivo tests; and, if necessary, confirmation of safety and nutritional value in humans. Examination of the causes of any adverse effects reported by consumers after the novel food or ingredient has been approved and is introduced into the market may provide additional reassurance of safety.
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This study quantified arterial anastomotic tension, evaluated subsequent patency rates, and examined the degree of tension reduction with vessel mobilization. The study was divided into two components. In part I, a mechanical analysis was undertaken to evaluate tension, based on the determination of the force required to deflect a cable (vessel) laterally, and its resulting lateral displacement. Six Sprague-Dawley rats with 12 femoral arteries were divided into two subgroups: 1) no mobilization; and 2) axial mobilization by ligation and transection of superficial epigastric and gracilis muscular branches. The tension of femoral arterial anastomoses was calculated in vessels with no segmental defect and with 1.5-, 3-, 4.5-, 6-, and 7.5-mm defects. In part II, patency was evaluated. Fifty-five rats with 110 femoral arteries were divided into two sub-groups as defined in part I: 1) no mobilization; and 2) axial mobilization by ligation and transection of superficial epigastric and gracilis muscular branches. Microvascular anastomoses were performed with no segmental defect and with 1-, 2-, 3-, 4-, 5-, 6-, 7-, 8-, 9-, and 10-mm segmental vessel defects. Patency was evaluated 24 hr postoperatively. Part I of the study revealed that anastomotic tension gradually increased along with an increase in the length of the vessel defect, from 1.9 to 11.34 g in the no-mobilization group and from 1.97 to 8.44 g in the axial-mobilization group. Comparison of tension linear regression coefficient showed a significant difference between the two groups (p < 0.05). In part II of the study, the maximum length of femoral artery defects still able to maintain 100 percent patency of anastomoses was 4 mm (tension approximately 6 g) in the no-mobilization group and 6 mm in the axial-mobilization group (tension approximately 6.48 g). Microanastomotic tension was related to the size of the vessel defect, with increasing tension leading to thrombosis. Axial mobilization significantly reduced the tension in vessels with segmental defects and decreased thrombosis rates.
Active cell death in hormone-dependent cells was studied using cultured human mammary carcinoma cells (MCF-7) treated with the anti-estrogens (AEs) tamoxifen (TAM), 4-hydroxy-tamoxifen (OH-TAM) or ICI 164 384 (10(-8)-10(-5) M) as a model. The following results were obtained. (i) In untreated MCF-7 cells a wave of replication occurred in the first 5 days of culture. All three AEs caused a dose-dependent inhibition of cell replication. (ii) TAM and OH-TAM at 10(-5) M, but not ICI 164 384, caused lytic cell death (necrosis) within 24 h, which was not inhibited by estradiol (10(-9)-10(-6)M). (iii) Lower concentrations of TAM or OH-TAM (up to 10(-6) M) or ICI 164 384 induced a more gradual appearance of cell death beginning at day 3. This type of cell death was inhibited by estradiol (10(-9) M), indicating its active nature. (iv) Nuclei showed two distinct patterns of alteration: (a) apoptosis-like condensation and fragmentation of chromatin to crescent masses abutting the nuclear envelope; (b) condensation of the chromatin to a single, pyknotic mass in the center of the nucleus, detached from the nuclear envelope. Quantitative histological evaluation revealed the predominance of pyknosis. (v) Biochemical DNA analysis revealed that only a relatively small amount of the total DNA was finally degraded into low molecular weight fragments (20 kb and less). (vi) Active cell death, with both apoptotic and pyknotic nuclear morphology, was associated with extensive formation of autophagic vacuoles (AV).3-Methyladenine, a known inhibitor of AV formation, partially prevented cell death as detected by nuclear changes. (vii) ICI 164 384 was about 10 times more effective than TAM or OH-TAM at inhibiting DNA synthesis, but had equal potency in inducing active cell death. It is concluded that AEs have anti-proliferative and anti-survival effects on MCF-7 human mammary cancer cells in culture. These two effects are under separate control because they differ by kinetics, dose dependence and sensitivity to the various AEs. Active cell death in MCF-7 cells seems to be initiated by autophagy, in contrast to concepts of apoptosis, and thus corresponds to autophagic/ lysosomal or type II death as previously defined. This may be important because of biochemical and molecular differences between these various subtypes of active cell death.
The present study was undertaken to compare the antimutagenic activity of aqueous extracts, at the concentrations used for human consumption, from green, black and decaffeinated black tea. Antimutagenic potential was evaluated against three indirect-acting dietary carcinogens, Glu-P-1, benzo(a)pyrene and nitrosopyrrolidine. All three types of tea gave rise to strong and concentration-dependent suppression of the mutagenicity of the three premutagens in the presence of an activation system. No major difference in the antimutagenic potential of the three types of tea could be discerned. Black tea, decaffeinated black tea and, to a lesser extent, green tea also antagonized the mutagenicity of the direct-acting mutagen 9-aminoacridine. All three types of tea inhibited markedly the NADPH-dependent reduction of cytochrome c and the O-dealkylations of ethoxy-, methoxy- and, to a much lesser extent, pentoxy-resorufin. When the microsomal metabolism was terminated, after the metabolic activation of the premutagens, incorporation of the aqueous tea extracts into the activation system caused a concentration-dependent suppression of mutagenic response. No significant difference in the antimutagenic activity of the three types of tea in this system was evident. Bearing in mind the much higher concentration of flavanols in green tea compared with the black teas, it may be concluded either that these compounds are unlikely to be the major tea components responsible for the antimutagenic, and possibly anticarcinogenic, properties of tea or that their fermentation products are similarly active.
Reports the results of a survey of 209 senior registrars and 269 consultants throughout Wales to identify the management development needs of doctors and ascertain their views of the value and utility of current management development course offerings in Wales. Finds that, currently, management development for doctors in Wales is unstructured and uncoordinated but, despite this, many doctors, especially senior registrars, appeared keen to increase their future involvement in management and held positive views regarding management and management development. The questionnaire also required doctors to rank order six managerial topics and their elements: financial, human resource, strategic, operational, service quality and self-management. Of these, self-management issues were rated highest and there was some congruity in the rankings of the six topics by senior registrars and the other three consultant categories. Overall, managing a budget, medical and clinical audit, negotiating skills and leadership skills were ranked highest for inclusion in management development while project management, quality circles and equal opportunities received the lowest ratings.
Antagonism against the grey mould pathogen Botrytis cinerea by Pseudomonas antimicrobica was demonstrated in vitro and in vivo. Cell-free filtrates showed activity against B. cinerea growing on Potato Dextrose Agar (PDA) in a media-dependent manner with the most distinct antagonism being produced in Czapek Dox Broth (CDB). Cell-free filtrates of CDB-grown cultures also significantly reduced conidial germination of B. cinerea. An assay based on the inhibition of conidial germination was compared with two assays measuring the antagonism of mycelial growth on PDA. The conidial germination bioassay was more sensitive in the detection of this antifungal activity than the Petri dish bioassay while a bioassay using Microdetection plates did not detect antagonism due to the small loading capacity of the latter. The conidial germination bioassay was modified for detection of antibiosis on the surface of strawberry leaves. Significant reductions in percentage conidial germination were recorded on the surface of leaves of both micropropagated and glasshouse grown strawberry plants when the antifungal compounds of Ps. antimicrobica were applied to the leaf tissue with the conidia. In addition, antifungal compounds were also detectable when conidia were applied to leaf tissue which had previously been sprayed with cells of Ps. antimicrobica. These tests indicate that Ps. antimicrobica would be a suitable biocontrol agent for the control of B. cinerea.