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Biomedical subjects

Richard Wilson

Publications and source records attributed to Richard Wilson.

At least 37 records · Page 2Linked to original sources

Arsenic in drinking water and bladder cancer mortality in the United States: an analysis based on 133 U.S. counties and 30 years of observation.

This study analyzes the relationship between arsenic exposure through drinking water and bladder cancer mortality. The county-specific white male bladder cancer mortality data (1950-1979) and county-specific groundwater arsenic concentration data were obtained for 133 U.S. counties known to be exclusively dependent on groundwater for their public drinking water supply. No arsenic-related increase in bladder cancer mortality was found over the exposure range of 3 to 60 microg/L using stratified analysis and regression analyses (both unweighted and weighted by county population and using both mean and median arsenic concentrations). These results, which provide a direct estimate of arsenic-related cancer risk for U.S. residents, exclude the National Research Council's 2001 risk estimate that was based on Southwest Taiwan data and required adjusting for differences between the body mass and water consumption rates of U.S. and Taiwanese residents.

Adult↗

Falling down and falling out: management and outcome analysis.

BACKGROUND: This study compares young (< 65 years old) and elderly (> or = 65 years old) patients who fall secondary to syncope and seeks to determine whether syncope workups are being appropriately performed and whether they contribute new information that results in a change in management. METHODS: A retrospective review of patients who fell and were admitted to a Level I trauma center was performed. Data included mechanism of injury, comorbidities, and severity scores in addition to details regarding a syncope workup in patients who had unclear reasons for falling. Outcome variables were mortality, intensive care unit and hospital lengths of stay, and whether each test resulted in a change in management. RESULTS: The data set included 387 patients. Elderly patients who fell (n = 157) had significantly higher Injury Severity Scores and mortality, lower Glasgow Coma Scale scores, and longer intensive care unit and hospital lengths of stay than the younger cohort (n = 230). When a fall occurred secondary to syncope, however, there was no difference in injury severity or outcome. Patients who fell secondary to syncope (n = 61) had zero to six of the recommended tests ordered. Nineteen tests in the young group and 79 tests in the elderly patients had abnormal results. Overall, 37.8% of patients had specific interventions performed because of the abnormal test results CONCLUSION: Syncope workups were erratically performed in both young and older groups. These workups frequently resulted in abnormal findings that required intervention. Protocols are currently being developed at our institution to ensure complete assessment of trauma patients who fall for unknown reasons.

Accidental Falls↗

Integrated and sequence-ordered BAC- and YAC-based physical maps for the rat genome.

As part of the effort to sequence the genome of Rattus norvegicus, we constructed a physical map comprised of fingerprinted bacterial artificial chromosome (BAC) clones from the CHORI-230 BAC library. These BAC clones provide approximately 13-fold redundant coverage of the genome and have been assembled into 376 fingerprint contigs. A yeast artificial chromosome (YAC) map was also constructed and aligned with the BAC map via fingerprinted BAC and P1 artificial chromosome clones (PACs) sharing interspersed repetitive sequence markers with the YAC-based physical map. We have annotated 95% of the fingerprint map clones in contigs with coordinates on the version 3.1 rat genome sequence assembly, using BAC-end sequences and in silico mapping methods. These coordinates have allowed anchoring 358 of the 376 fingerprint map contigs onto the sequence assembly. Of these, 324 contigs are anchored to rat genome sequences localized to chromosomes, and 34 contigs are anchored to unlocalized portions of the rat sequence assembly. The remaining 18 contigs, containing 54 clones, still require placement. The fingerprint map is a high-resolution integrative data resource that provides genome-ordered associations among BAC, YAC, and PAC clones and the assembled sequence of the rat genome.

Animals↗

Socioeconomic differences in health: how much do health behaviors and health insurance coverage account for?

As evidence accumulates that both unhealthy behaviors and inadequate access to health care are responsible in part for poor health, there is a tendency to attribute the differences in health status between the poor and the affluent to the higher prevalence of unhealthy behaviors and inadequate access to health care among people of low socioeconomic status (SES). The purpose of this study is to determine quantitatively how much health behaviors and health insurance coverage account for the SES disparity in health. The study employed secondary analysis of data collected through the Kentucky Behavioral Risk Factor Surveillance System for 2000. After adjusting for health behaviors and health insurance coverage, the differences in health among different levels of SES (measured by education and income) remained strong and significant. Health behaviors and health insurance coverage accounted for 10-16% of the socioeconomic differences in health.

Adolescent↗

Pharmacokinetic and pharmacodynamic effects of oral eniluracil, fluorouracil and leucovorin given on a weekly schedule.

PURPOSE: To determine the toxicities and pharmacokinetic effects of eniluracil (EU) given on two weekly dosing schedules with 5-fluorouracil (5-FU) and leucovorin (LV). METHODS: A group of 26 patients received a single 24-h i.v. infusion of 5-FU 2300 mg/m(2) to provide a pharmacokinetic reference. After 2 weeks, patients received oral EU 20 mg plus LV 30 mg on days 1-3 with a single dose of 5-FU 15-29 mg/m(2) on day 2, or LV 30 mg on days 1-2 with a single dose of EU at least 1 h prior to 5-FU 29 mg/m(2) on day 2 weekly for 3 of 4 weeks. RESULTS: Diarrhea was the most common dose-limiting toxicity. The recommended dose of 5-FU is 29 mg/m(2) per day. EU on either schedule decreased 5-FU plasma clearance by 48 to 52-fold, prolonged the half-life to >5 h, and increased the percentage of 5-FU excreted in the urine from 2% to 64-66%. With EU, plasma fluoro-beta-alanine was not detected while urinary excretion was reduced to <1% of that seen with i.v. 5-FU alone. Marked increases in both plasma and urinary uracil were seen. Thymidylate synthase ternary complex formation was demonstrated in bone marrow mononuclear cells isolated 24 h after the first oral 5-FU dose; the average was 66.5% bound. CONCLUSIONS: Either a single 20-mg dose of EU given prior to or for 3 days around the oral 5-FU dose led to comparable effects on 5-FU pharmacokinetic parameters, and inhibition of dihydropyrimidine dehydrogenase and thymidylate synthase.

Administration, Oral↗

The DNA sequence and analysis of human chromosome 14.

Chromosome 14 is one of five acrocentric chromosomes in the human genome. These chromosomes are characterized by a heterochromatic short arm that contains essentially ribosomal RNA genes, and a euchromatic long arm in which most, if not all, of the protein-coding genes are located. The finished sequence of human chromosome 14 comprises 87,410,661 base pairs, representing 100% of its euchromatic portion, in a single continuous segment covering the entire long arm with no gaps. Two loci of crucial importance for the immune system, as well as more than 60 disease genes, have been localized so far on chromosome 14. We identified 1,050 genes and gene fragments, and 393 pseudogenes. On the basis of comparisons with other vertebrate genomes, we estimate that more than 96% of the chromosome 14 genes have been annotated. From an analysis of the CpG island occurrences, we estimate that 70% of these annotated genes are complete at their 5' end.

5' Untranslated Regions↗

Disability and rehabilitation research. Opportunities for participation, collaboration, and extramural funding for psychologists.

The National Institute on Disability and Rehabilitation Research (NIDRR) funds research and related activities that promote new knowledge that helps individuals with disabilities to perform regular activities in the community and increases the capacity of society to provide full opportunities and supports for individuals with disabilities. NIDRR achieves this goal by promoting interdisciplinary research and related activities. Psychologists play a key role in many of these activities and assist with improving understanding of disability and rehabilitation by participating in peer review of research proposals or by reviewing NIDRR's proposed research priorities. Psychologists also contribute by taking advantage of training and the many other opportunities for support outlined in this article.

Capital Financing↗

A randomized, double-blind, 24-week study comparing the efficacy and tolerability of mirtazapine and paroxetine in depressed patients in primary care.

Primary care patients with a major depressive disorder and 17-item Hamilton Rating Scale for Depression (17-HAM-D) score >18 were randomized to 24 weeks of treatment with mirtazapine 30-45 mg/day (n=99) or paroxetine 20-30 mg/day (n=98). Both treatments were efficacious in improving depressive symptomatology, as assessed by group mean 17-HAM-D scores, percentages of HAM-D responders and remitters and Clinical Global Improvement responders. The mirtazapine group showed statistically significantly larger decreases from baseline in group mean 17-HAM-D scores at weeks 1, 2 and 4, and the difference with the paroxetine group reached the level of clinical relevance at weeks 2 and 4. Antidepressant efficacy was maintained throughout both the acute and continuation phase of treatment. Both treatments were well tolerated. The only adverse event with a statistically significantly higher incidence in the mirtazapine group was fatigue. Statistically significantly more paroxetine-treated patients complained of increased sweating, headache and nausea. The results demonstrate that both mirtazapine and paroxetine were efficacious and well tolerated when used for 24 weeks in depressed patients treated in primary care. An observed difference in efficacy favouring mirtazapine between weeks 1 and 4 indicates that mirtazapine patients had improved earlier compared to those on paroxetine, and corroborates similar findings in other comparisons of mirtazapine versus selective serotonin reuptake inhibitors.

Administration, Oral↗

The multistage model of cancer development: some implications.

The multistage model, introduced by Armitage and Doll, was very successful at describing many features of cancer development. Doll and Peto noted a significant departure below the prediction of the model and suggested that this could be due to undercounting of cases at older ages, or to the 'biology of extreme old age.' Moolgavkar pointed out that it could also be due to the approximation used. The recent observation that cancer incidence falls rapidly above age 80 has stimulated new modelling investigations, such as the Pompei-Wilson beta model (which does reproduce the rapid fall). In the present paper, we argue that Moolgavkar's criticisms, while mathematically correct, do not affect the conclusions, particularly the constancy of the number of stages across different cancer registries (Cook, Doll and Fellingham. 1969: A mathematical model for the age distribution of cancer in man. International Journal of Cancer 4, 93-112). We discuss several exact solutions, compare them with the most recent data, and prove rigorously that the standard Armitage-Doll multistage model can never reproduce the sharp turnaround in cancer incidence at old age seen in the data. We discuss in detail multistage processes which have a property observed in many laboratory studies, namely that some stages progress much faster than the others. We verify mathematically the intuition that sufficiently fast stages do not appreciably affect the incidence rate of cancer, and discuss implications of this fact for cancer treatment strategies. We also show that the simplest possible modification of the Armitage-Doll model to incorporate cellular senescence just leads to the Pompei-Wilson beta model.

Aged↗

Collagen X chains harboring Schmid metaphyseal chondrodysplasia NC1 domain mutations are selectively retained and degraded in stably transfected cells.

Collagen X is a short chain, homotrimeric collagen expressed specifically by hypertrophic chondrocytes during endochondral bone formation and growth. Although the exact role of collagen X remains unresolved, mutations in the COL10A1 gene disrupt growth plate function and result in Schmid metaphyseal chondrodysplasia (SMCD). With the exception of two mutations that impair signal peptide cleavage during alpha1(X) chain biosynthesis, SMCD mutations are clustered within the carboxyl-terminal NC1 domain. The formation of stable NC1 domain trimers is a critical stage in collagen X assembly, suggesting that mutations within this domain may result in subunit mis-folding or reduce trimer stability. When expressed in transiently transfected cells, alpha1(X) chains containing SMCD mutations were unstable and presumed to be degraded intracellularly. More recently, in vitro studies have shown that certain missense mutations may exert a dominant negative effect on alpha1(X) chain assembly by formation of mutant homotrimers and normal-mutant heterotrimers. In contrast, analysis of cartilage tissue from two SMCD patients revealed that the truncated mutant message was fully degraded, resulting in 50% reduction of functional collagen X within the growth plate. Therefore, in the absence of data that conclusively demonstrates the full cellular response to mutant collagen X chains, the molecular mechanisms underlying SMCD remain controversial. To address this, we closely examined the effect of two NC1 domain mutations, one frameshift mutation (1963del10) and one missense mutation (Y598D), using both semi-permeabilized cell and stable cell transfection expression systems. Although able to assemble to a limited extent in both systems, we show that, in intact cells, collagen X chains harboring both SMCD mutations did not evade quality control mechanisms within the secretory pathway and were degraded intracellularly. Furthermore, co-expression of wild-type and mutant chains in stable transfected cells demonstrated that, although wild-type chains were secreted, mutant chains were largely excluded from hetero-trimer formation. Our data indicate, therefore, that the predominant effect of the NC1 mutations Y598D and 1963del10 is a reduction in the amount of functional collagen X within the growth cartilage extracellular matrix.

Base Sequence↗

The effect of different tumor groupings on findings of anticarcinogenic responses in long-term rodent bioassays.

Many investigators have found that there is a decrease in tumor rates at some sites when rodents are exposed to some chemicals. The generality of this finding of anticarcinogenicity has been questioned. In this study, we evaluate the effect of several alternative ways of grouping the 3000 tumor types in the Cancer Bioassay Data System (CBDS) database of carcinogenesis test results into a limited number of classes on findings of anticarcinogenicity. We also study the influence of random variation of tumor rate on the apparent anticarcinogenic effects of specific chemicals. We compare the numbers of chemicals classified as anticarcinogenic in (1) our "standard" classification system, (2) a modification of that system to correct some deficiencies in the CBDS database pointed out by Dr. J. Haseman, (3) an alternative classification system developed by Dr. K. S. Crump and colleagues, (4) the number of animals displaying at least one tumor, or (5) the total number of tumors appearing in all animals in control and dosed groups. Although there is a difference in the number of chemicals classified as anticarcinogens by these alternative classification schemes, all of them show a statistically significant increase in the number of anticarcinogenic responses above the random rate predicted by a Monte Carlo simulation of the rodent bioassay. The number of anticarcinogenic responses is similar in our standard classification, our modified classification, and a classification scheme developed by Crump, though specific site/organs may differ. This arises because these schemes use approximately the same number of tumor groups (about 100). If the number of tumor groups decreases (for example, in the total tumors or tumor-bearing animal schemes), the number of anticarcinogenic responses decreases because of the decrease in overall sensitivity of the test. A scheme which combines tumor types can be useful by integrating carcinogenic and anticarcinogenic responses to exposure. At the same time, combination may hide important biological information. We urge consideration of both increases and decreases when evaluating the likely human effects of exposure.

Animals↗

Absolute risk or relative risk? A study of intraspecies and interspecies extrapolation of chemical-induced cancer risk.

We have used the CBDS database of the National Toxicology Program to study the difference between absolute risk and relative risk models for interspecies and intersex predictions of cancer risk. For no combination (class) of tumor and site is the prediction good for all chemicals. The variation in predicted risk between chemicals exceeds the difference in risks resulting from application of these two models. On the whole, it appears that relative risk is a better model.

Animals↗

A quantitative model of cellular senescence influence on cancer and longevity.

Contrary to the paradigm that cancer incidence increases indefinitely with age, significant data now suggest cancer incidence may markedly reduce beyond age 80 years for humans and beyond 800 days for mice, and is not inevitable. We show that increasing cellular senescence with age is a possible cause of this reduction, since senescent cells are removed from the pool of cells that retain proliferative ability necessary for cancer. We further show that animal interventions appearing to alter senescence, p53 mutation and melatonin dosing, support the prediction that increasing senescence rate reduces cancer while reducing lifespan, and vice versa. Studies of environmental agents associated with increased cancer might be re-examined to find if there is an association with longevity increases, which may markedly alter our view of such agents. We also show that if an agent functions by slowing both senescence and carcinogenesis, longevity is increased while reducing cancer. Dietary restriction is the only known intervention that accomplishes this, but there may be others.

Aging↗

Surgical treatment of advanced chronic angle closure glaucoma in Weill-Marchesani syndrome.

PURPOSE: To describe the surgical treatment of advanced chronic angle closure glaucoma in Weill-Marchesani syndrome. PATIENTS AND METHODS: Two children with Weill-Marchesani syndrome (4 eyes) undergoing lensectomy, anterior vitrectomy, and sutured intraocular lens (IOL) and Molteno tube shunt surgery at Wills Eye Hospital were prospectively studied. Visual acuity and intraocular pressure (IOP) were recorded. RESULTS: Both patients presented with increasing myopia and advanced glaucomatous damage. Laser iridotomy was ineffective in deepening the anterior chamber. The first patient developed a flat anterior chamber after trabeculectomy. At the 12-month follow-up visit, all 4 eyes had an important decrease in IOP and cupping after combined lensectomy, anterior vitrectomy, and sutured IOL and Molteno tube shunt placement. One eye had a transitory postoperative choroidal effusion and retinal detachment that resolved spontaneously. CONCLUSIONS: Advanced chronic angle closure glaucoma in Weill-Marchesani syndrome may be treated with a combination of lensectomy, anterior vitrectomy, and sutured IOL and Molteno tube shunt surgery. In early cases, prophylactic peripheral iridotomies should be stressed.

Abnormalities, Multiple↗

Healthy profit.

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Financial Management↗