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Biomedical subjects

S Wright

Publications and source records attributed to S Wright.

At least 145 records · Page 8Linked to original sources

Effect of the position of TAR on transcriptional activation by HIV-1 Tat in vivo.

Efficient expression of the human immunodeficiency virus (HIV) genome requires the viral-encoded transactivator Tat. Tat interacts with the highly structured trans-activation-response (TAR) RNA that is found at the 5' end of all viral transcripts, and mediates the formation of transcription complexes that are capable of elongation through the entire length of the viral genome. By placing TAR immediately downstream from the P2 promoter of the mouse c-myc gene, we have previously shown that Tat can also direct transcriptional elongation through potential sites of premature termination within c-myc in transfected HeLa cells. We now demonstrate that Tat can activate c-myc transcription when TAR is positioned internally within the c-myc transcript at distances up to 353 nt downstream from the P2 promoter. We show that Tat can also activate transcription from the c-myc P1 promoter, which is located 165 nt upstream from P2 in these hybrid gene constructs. These novel findings show that Tat can activate transcription in vivo when TAR is positioned at distances up to 518 nt downstream from the site of transcriptional initiation. The ability of TAR to mediate Tat-activated transcription over distances greater than previously appreciated has important implications for the mechanism of action of Tat.

Animals↗

Decoquinate and the control of experimental ovine toxoplasmosis.

Decoquinate was tested for its ability to reduce the effect of experimentally induced toxoplasmosis in pregnant ewes. Sheep were given decoquinate in their feed daily at either 2 mg or 1 mg/kg bodyweight from 10 days before an oral challenge with Toxoplasma gondii oocysts at 90 days of gestation, until lambing. Feeding decoquinate at the higher rate caused a delay in the onset of the febrile response to infection, reduced the overall severity of the fever and delayed the production of antibodies to the parasite. This treatment also reduced the placental damage caused by the parasite, lengthened the mean gestation period and increased the number and weight of live lambs, in comparison with ewes not fed decoquinate but challenged with T gondii oocysts. The treatment with 1 mg of decoquinate had smaller effects.

Abortion, Veterinary↗

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Forecasting↗

Apoptosis sensitivity in chronic lymphocytic leukemia is determined by endogenous endonuclease content and relative expression of BCL-2 and BAX.

Therapeutic agents used in the treatment of chronic lymphocytic leukemia (CLL) are capable of inducing apoptosis in some (but not all) patient isolates. It is not yet clear whether cells that are resistant to one agent will also be resistant to others, and the mechanisms contributing to differential apoptosis sensitivity are not known. Here we report that glucocorticoid hormone and a clinically relevant chemotherapy combination (fludarabine plus mitoxantrone) fail to induce apoptosis in four of 24 CLL patient isolates. Apoptosis resistance was associated with elevated BCL-2 and BAX expression. Interestingly, incubation in vitro led to down-regulation of BCL-2 expression in both apoptosis-sensitive and apoptosis-resistant cells, whereas parallel down-regulation of BAX occurred only in the resistant samples. Evaluation of nuclear endonuclease content indicated that all of the apoptosis-sensitive samples contained appreciable levels of activity, whereas the endonuclease was not detected in the four populations of resistant cells. Our results indicate that nuclear endonuclease activity represents an excellent prognostic indicator of CLL apoptosis sensitivity that may be controlled by differential BCL-2 family polypeptide expression and signals from the in vivo microenvironment.

Antineoplastic Combined Chemotherapy Protocols↗

Angiotensin converting enzyme inhibition modulates endogenous endothelin in chronic canine thoracic inferior vena caval constriction.

Endothelin (ET) is a potent vasoconstrictor peptide which is elevated in plasma in congestive heart failure. Recent studies suggest an important role for angiotensin II (AII) in the activation of ET in cultured cardiomyocytes. Chronic thoracic inferior vena caval constriction (TIVCC) is a model of reduced cardiac output that mimics the neurohumoral activation observed in congestive heart failure. We hypothesized that activation of the renin-angiotensin system in TIVCC plays a role in the activation of ET and that the elevation of endogenous ET contributes to the systemic and renal vasoconstriction that characterizes this model of venous congestion. We studied conscious dogs after 7 d of TIVCC in the presence or absence of chronic angiotensin converting enzyme inhibition with enalapril. TIVCC resulted in marked activation of plasma AII and ET in plasma, right atrium, lung, and renal medulla which was further localized to cardiomyocytes, pulmonary, and renal epithelial cells. Chronic angiotensin converting enzyme inhibition abolished the increases in plasma AII and ET during TIVCC. Acute endothelin A receptor blockade with FR-139317 resulted in significant decreases in mean arterial pressure and systemic vascular resistance in TIVCC. We conclude that activation of the renin-angiotensin system contributes to the activation of circulating and local ET in TIVCC and that this activation plays an important role in the regulation of arterial pressure and systemic vascular resistance in this model of congestive failure.

Angiotensin-Converting Enzyme Inhibitors↗

Acute lymphoblastic leukemia with myeloperoxidase activity.

The French-American-British (FAB) classification of acute leukemias is based on the light microscopic detection of myeloperoxidase (MPO) activity in blast cells. Cells with MPO activity in > 3% of cells are classified as acute myeloid leukemia (AML) and usually express myeloid cell surface antigens. We describe a case of acute leukemia in which the blast cells have lymphoid morphology, ultrastructure, immunophenotype, and molecular rearrangements, but express significant amounts of MPO. We discuss the incidence, features, and outcome of MPO-positive acute lymphoblastic leukemia (ALL).

Adult↗

Underprediction of human skin erythema at low doses per fraction by the linear quadratic model.

BACKGROUND AND PURPOSE: The erythematous response of human skin to radiotherapy has proven useful for testing the predictions of the linear quadratic (LQ) model in terms of fractionation sensitivity and repair half time. No formal investigation of the response of human skin to doses less than 2 Gy per fraction has occurred. This study aims to test the validity of the LQ model for human skin at doses ranging from 0.4 to 5.2 Gy per fraction. MATERIALS AND METHODS: Complete erythema reaction profiles were obtained using reflectance spectrophotometry in two patient populations: 65 patients treated palliatively with 5, 10, 12 and 20 daily treatment fractions (varying thicknesses of bolus, various body sites) and 52 patients undergoing prostatic irradiation for localised carcinoma of the prostate (no bolus, 30-32 fractions). RESULTS AND CONCLUSIONS: Gender, age, site and prior sun exposure influence pre- and post-treatment erythema values independently of dose administered. Out-of-field effects were also noted. The linear quadratic model significantly underpredicted peak erythema values at doses less than 1.5 Gy per fraction. This suggests that either the conventional linear quadratic model does not apply for low doses per fraction in human skin or that erythema is not exclusively initiated by radiation damage to the basal layer. The data are potentially explained by an induced repair model.

Aged↗

High response rates with short infusional 2-chlorodeoxyadenosine in de novo and relapsed low-grade lymphoma. Australian and New Zealand Lymphoma Study Group.

Thirty-five patients (eight de novo, 27 relapsed disease) with low-grade non-Hodgkin's lymphoma (diffuse small lymphocytic, follicular small cleaved cell, follicular mixed cell, and lymphoplasmacytoid) were treated with 2-chlorodeoxyadenosine (2CdA) at a daily dose of 0.14 mg/kg for 5d (2 h infusion) for an average of three cycles. Minor treatment delays, generally due to haematological toxicities, occurred in nine of 105 cycles. Major toxicities were lymphopenia, neutropenia and thrombocytopenia. Opportunistic infections occurred in seven patients. Overall response rate was 69% (five complete, 19 partial) reaching 88% for de novo patients (two complete, five partial). Elevated beta 2-microglobulin level was negatively predictive of response (P = 0.0014). Eight of 24 responders relapsed, with a median follow-up of 13 months. 2CdA administered as an intermittent infusion shows considerable single-agent activity in low-grade lymphomas achieving high response rates of prolonged duration. Consideration of schedules where 2CdA is alternatively administered with combination chemotherapy appears warranted.

Adult↗

Amyloid beta-mediated oxidative and metabolic stress in rat cortical neurons: no direct evidence for a role for H2O2 generation.

H2O2 and free radical-mediated oxidative stresses have been implicated in mediating amyloid beta (1-40) [A beta (1-40)] neurotoxicity to cultured neurons. In this study, we confirm that addition of the H2O2-scavenging enzyme catalase protects neurons in culture against A beta-mediated toxicity; however, it does so by a mechanism that does not involve its ability to scavenge H2O2. A beta-mediated elevation in intracellular H2O2 production is suppressed by addition of a potent H2O2 scavenger without any significant neuroprotection. Three intracellular biochemical markers of H2O2-mediated oxidative stress were unchanged by A beta treatment: (a) glyceraldehyde-3-phosphate dehydrogenase activity, (b) hexose monophosphate shunt activity, and (c) glucose oxidation via the tricarboxylic acid cycle. lonspray mass spectra of A beta in the incubation medium indicated that A beta itself is an unlikely source of reactive oxygen species. In this study we demonstrate that intracellular ATP concentration is compromised during the first 24-h exposure of neurons to A beta. Our results challenge a pivotal role for H2O2 generation in mediating A beta toxicity, and we suggest that impairment of energy homeostasis may be a more significant early factor in the neurodegenerative process.

Adenosine Triphosphate↗

Chemokine levels in human liver homogenates: associations between GRO alpha and histopathological evidence of alcoholic hepatitis.

Alcoholic hepatitis is characterized by parenchymal neutrophil infiltration. Hepatic synthesis of the neutrophil chemokine interleukin-8 (IL-8) is highly elevated in alcoholic hepatitis and levels correlate with the degree of neutrophil infiltration. The aim of this study was to further determine the spectrum of synthesis of chemokines in liver tissue from patients with alcoholic liver disease and a range of disease control subjects. Subjects were composed of 24 patients with alcoholic liver disease of whom 15 had histopathological evidence of alcoholic hepatitis (10 cirrhotic) and 9 no evidence of alcoholic hepatitis (5 cirrhotic); other controls included; normal liver (n = 6), viral hepatitis (n = 16), primary biliary cirrhosis (n = 5), acute liver failure (n = 4), and miscellaneous liver disease (n = 13). Levels of the C-X-C neutrophil chemokine GRO alpha and the mononuclear cell C-C chemokines: macrophage inflammatory protein 1 alpha, macrophage chemotactic protein 1 and RANTES, were determined by ELISA in liver homogenates. Levels of the neutrophil chemokine GRO alpha were specifically elevated (mean 46 pg/mg, compared with normal liver 11 pg/mg) in patients with alcoholic hepatitis. GRO alpha levels correlated with IL-8 levels and were higher in patients with alcoholic liver disease and parenchymal neutrophil infiltration. Hepatic RANTES was elevated in diseased liver, with the highest levels found in viral hepatitis (mean 117 pg/mg, compared with 24 pg/mg in normal liver). No significant changes in hepatic levels of macrophage inflammatory protein 1 alpha (MIP-1 alpha) or macrophage chemotactic protein 1 (MCP-1) were found. These data provide further supportive evidence that parenchymal neutrophil infiltration in alcoholic hepatitis may be determined by selective upregulation of C-X-C chemokine synthesis.

Chemokine CCL2↗

Examining what residents look for in their role models.

PURPOSE: Identifying positive role models and emulating them is a significant component of medical education. This study sought to determine which characteristics were deemed most important by residents regarding their physician role models. METHOD: a 50-item questionnaire about role models was developed and pilot tested. The questionnaire was then administered in the spring of 1994 to 230 residents in various specialty programs at McGill University. RESULTS: A total of 195 residents (85%) responded. Most of the residents (144, 74%) were satisfied with the proportions of positive role models in their current residency training programs. Clinical skills, personality, and teaching ability were rated the three most important factors in selecting a staff physician as a role model. When the residents were asked to recall the positive role models encountered while in medical school, attending physicians in internal medicine received the highest scores. CONCLUSION: Knowing what residents look for in their role models should help to identify which staff physicians are excellent role models. These physicians should be selected to spend more time with medical students and residents, and they should be rewarded for improving medical education.

Attitude of Health Personnel↗

Population pharmacokinetics of caffeine in neonates and young infants.

The population pharmacokinetics of caffeine were investigated in 60 neonates and young infants using data collected during routine therapeutic drug monitoring. Clearance was influenced by body weight and postnatal age, and increased in the presence of dexamethasone. No clinical factors were identified that influenced volume of distribution. The population pharmacokinetic parameter estimates were then tested prospectively in a further 20 neonates. Although they produced unbiased results, the dexamethasone effect could not be identified. A final analysis using all 80 patients found clearance (L/day) = 0.14 x weight (kg) + 0.0024 x postnatal age (days) (+/- 20%) and volume of distribution = 0.82 L (+/- 24%). Simulations based on these results indicated that the current dosage guidelines of 20 mg/kg loading dose of caffeine citrate followed by a 5 mg/kg/day maintenance dose should achieve concentrations within the traditional target range in > 70% of neonates.

Administration, Oral↗

Effect of systemic administration of isotretinoin on blood lipids and fatty acids in acne patients.

BACKGROUND: In many studies, an increase in total cholesterol and triglycerides with isotretinoin therapy have been shown and investigators have commented on potential cardiovascular risk. A low intake of linoleic acid, the main essential fatty acid in man, may act as an independent risk factor for coronary heart disease. In vitro etretin alters both the incorporation of extracellular fatty acids into cell membranes and the fatty acid composition of the cell membrane itself. It is, therefore, important to establish whether isotetinoin has any effect on the metabolism of polyunsaturated fatty acids. METHODS: The effect of treatment with isotretinoin for 4 months on the metabolism of polyunsaturated fatty acids in patients with acne was assessed. Quantitative total cholesterol and triglycerides as well as plasma phospholipid, triglycerides, and cholesteryl ester fatty acids were measured in 12 patients and red cell phosphatidylethanolamine, phosphatidylcholine, and phosphatidylinositol fatty acids were measured in 13 patients before and after isotretinoin therapy. RESULTS: There was a significant increase in the concentrations of cholesterol (P < 0.02) and triglycerides (P < 0.04) during treatment. There was no significant difference is plasma phospholipids, triglycerides, and cholesterol esters, or in the red cell phosphatidylethanolamine, phosphatidylcholine, and phosphatidylinositol during isotretinoin therapy. CONCLUSIONS: This study failed to demonstrate any effect of isotretinon on the metabolism of polyunsaturated fatty acids. There was a significant increase in total cholesterol and triglyceride levels following isotretinoin therapy supporting the findings of many previous studies.

Acne Vulgaris↗

Skin surface lipids in HIV-positive patients with and without seborrheic dermatitis.

BACKGROUND: Seborrheic dermatitis (SD) is a frequent complication of infection with the human immunodeficiency virus (HIV). Most studies examining the cause of SD have concentrated on the roles of Pityrosporum ovale and sebaceous lipids. Previous studies of skin surface lipid from patients with SD have produced conflicting results, with some authors reporting an abnormal lipid composition and others finding little or no abnormality. METHODS: The composition of skin surface lipid was studied in 15 HIV-positive and 10 HIV-negative men with SD, in 14 HIV-positive men without SD, and in 16 unaffected controls. Total lipids were extracted from unaffected forehead skin into petroleum ether and separated into lipid classes by thin layer chromatography. The lipid classes were quantitated by densitometry after charring with sulfuric acid. RESULTS: Patients, HIV-positive with SD, had significantly lower proportions of free fatty acid (FFA) and higher levels of triglyceride than normal controls. Patients, HIV-positive without SD, had a significantly increased proportion of FFA compared to HIV-positive patients with SD. Patients with SD, both HIV-positive and HIV-negative, had a similar pattern of skin surface lipid. Levels of FFA were lower and those of triglyceride higher than in the patients unaffected by SD, whether HIV-positive or not. There was no significant difference found between groups in free cholesterol, wax esters, and squalene. CONCLUSIONS: Abnormalities of skin surface lipid composition may play a part in the development of SD in both HIV-positive and HIV-negative men.

Adult↗

A case of Munchausen syndrome with claims of trauma and haemophilia.

A case of Munchausen syndrome presented with both factitious trauma and factitious haemophilia. He was treated inappropriately with factor VIII concentrate before the history of the presenting complaint could be validated. Clinical suspicion remains the most important aid to diagnosis.

Accidents, Traffic↗

Detection of alcohol misusing patients in accident and emergency departments: the Paddington alcohol test (PAT)

OBJECTIVE: To develop an effective but practical screening questionnaire for use by accident and emergency (A&E) staff to detect alcohol misuse early on in its natural history, without unreasonably prolonging patient waiting times; and to integrate an alcohol health worker (AHW) into A&E to provide counselling for referred patients. METHODS: Two pilot studies for adult patients were undertaken to develop the 1 min Paddington alcohol test (PAT), which has only three compulsory questions for detecting alcohol misuse: two cover peak consumption and frequency of possible binge drinking, and the third asks whether in the patients' view their attendance at A&E was alcohol related. The use of the PAT was validated in "appropriate" adult patients over a one year period. Patients found to be positive were invited to attend the A&E review clinic for counselling by the AHW. RESULTS: The development of the PAT resulted in a referral rate of one patient per 158 A&E adult attenders, facilitating a counselling rate of one patient per 263 A&E adult attenders by the AHW. This counselling rate is a 10-fold increase on the rate of one patient per 2610 adult attenders found in a study undertaken during 1988-90. CONCLUSIONS: The use of the PAT is one practical method for A&E staff to detect the alcohol misusing patient for referral to a departmental alcohol health worker.

Adult↗