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Biomedical subjects

T Smith

Publications and source records attributed to T Smith.

At least 469 records · Page 26Linked to original sources

Frequent constitutional C to T mutations in CGA-arginine codons in the RB1 gene produce premature stop codons in patients with bilateral (hereditary) retinoblastoma.

We have shown previously that the most common point mutation in the RB1 gene in retinoblastoma tumours is a C-->T transition and that the majority of these occur in CGAarg codons. As a result of this mutation, a TGAstop codon is generated directly. We have analysed the 14 CGAarg codons in the RB1 gene for mutations in 113 patients with bilateral retinoblastoma. At 6 of these sites, C-->T mutations in CGA codons alter a restriction enzyme site which makes their identification relatively straightforward. It was necessary, however, to analyse the other 8 CGA codons using single-strand conformation polymorphism (SSCP) analysis. A total of 18 C-->T mutations were found, which represents 16% of all patients. Of these 13 (73%) were at two particular CGA codons in exon 8 (codon 251) and exon 17 (codon 552). During the course of the SSCP analysis, mutations were identified in 7 other individuals. Thus, 20-25% of all mutations can be identified by a relatively quick survey of the CGA codons in the RB1 gene, which has important implications for genetic screening programmes. All of the mutations in the RB1 gene in these bilaterally affected patients would be predicted to result in the absence of a functional protein.

Arginine↗

A murine model of the eosinophilia-myalgia syndrome induced by 1,1'-ethylidenebis (L-tryptophan).

The eosinophilia-myalgia syndrome (EMS) is a recently described disease that has been associated with the ingestion of L-tryptophan containing trace amounts of several impurities. The first such contaminant to be identified and linked epidemiologically to the EMS epidemic was 1,1'-ethylidenebis(L-tryptophan) (EBT), but its role in the etiology and pathogenesis of the syndrome has been controversial. We report the development of inflammation and fibrosis affecting the dermis and subcutis, including the fascia and perimyseal tissues, after the daily intraperitoneal administration of EBT to female C57BL/6 mice. Such changes are accompanied by increased numbers of mast cells, many of which appear to be degranulating. Plasma levels of quinolinic acid, a metabolic product of L-tryptophan via the kynurenine pathway, are reduced initially, and then become elevated when inflammation and fibrosis are more pronounced. The nature and location of the inflammatory cell infiltrate and fibrosis, as well as the presence of mast cells and alterations of L-tryptophan metabolism, are consistent with findings reported in patients with EMS. This murine model suggests that EBT may have been one of the mediators of EMS and should facilitate studies of the pathogenesis of EMS.

Animals↗

Personality test scores as predictors of alcoholism almost a decade later.

OBJECTIVE: Comparisons of alcoholic and control subjects have revealed potential differences on a variety of personality tests. However, these results are difficult to interpret because subgroups of alcoholic subjects with antisocial personality disorder were often included in the overall analyses, and because testing was usually carried out while alcoholic subjects were in withdrawal. This article evaluates whether individuals' personality test scores at approximately age 20 predict their risk of subsequent development of alcohol abuse or dependence by about age 30. METHOD: As part of a larger prospective study of sons of alcoholic and control subjects, subsets of up to 78 subjects (39 matched pairs) out of a sample of 223 men took various personality tests that included the Eysenck Personality Inventory, subtests of the MMPI, and evaluations of locus of control and anxiety. An average of more than 9 years later, the incidence of alcohol abuse or dependence in these 223 subjects was determined by structured interviews. RESULTS: The 55 men who subsequently went on to develop alcohol abuse or dependence did not differ on any of the personality tests from the 168 men who did not develop alcoholism. CONCLUSIONS: These data are consistent with prospective studies indicating that except for antisocial personality disorder, it is difficult to identify a reliable personality profile associated with an individual's risk of alcoholism.

Adolescent↗

The changing pattern of mortality in young adults aged 15 to 34 in Scotland between 1972 and 1992.

Between 1972 and 1992 the death rate in Scotland in young adults aged 15 to 34 from heart disease fell by nearly a half (49%), from cancer by a third (32%) and from respiratory diseases by 45%, with substantial falls in deaths from most other "natural causes". All of this impressive improvement was wiped out, however, by a massive increase in deaths from drug abuse, suicides and undetermined causes as well as the emergence of AIDS. In view of the fact that many deaths due to drug misuse may be attributed instead to the immediate cause, there is an urgent need for a national agency to be set up to investigate all deaths in young adults in order to determine the number in which alcohol or drugs are the underlying cause. This agency would also monitor progress towards attaining Health of the Nation targets relating to suicide.

Adolescent↗

Blood warms as it flows retrograde from a femoral cannulation site to the carotid artery during cardiopulmonary bypass.

Hypothermia protects the brain from injury during cardiopulmonary bypass and hypothermic circulatory arrest. However, when the arterial cannula is at sites other than the ascending aorta, brain cooling before circulatory arrest may be incomplete, contributing to poor neurological outcome. The authors performed an experiment using a rabbit model of cardiopulmonary bypass with femoral arterial perfusion. Arterial perfusate and carotid artery temperatures were simultaneously measured in six rabbits undergoing cardiopulmonary bypass, three with femoral artery cannulation, and three with subclavian artery cannulation. The subclavian artery site was chosen as a surrogate for ascending aortic cannulation. Carotid blood temperature was 3.7 degrees C to 0.3 degree C warmer than arterial perfusate temperature during femoral arterial perfusion. The temperature difference decreased over time (p = 0.0007). The temperature gradient was significantly less (p = 0.002) when subclavian arterial perfusion was used. Carotid blood temperature was 1.1 degrees C to 0.0 degree C warmer than arterial perfusate temperature during subclavian cannulation. The authors conclude that when femoral perfusion cooling is used, blood is warmed as it flows in a retrograde direction in the descending aorta to the carotid artery.

Animals↗

Detection of cells bearing the t(14;18) translocation following myeloablative treatment and autologous bone marrow transplantation for follicular lymphoma.

PURPOSE: To use the polymerase chain reaction (PCR) technique for molecular assessment of the results of myeloablative treatment of follicular lymphoma with autologous bone marrow transplantation. PATIENTS AND METHODS: Seventy-six patients with follicular or transformed follicular lymphoma were treated with cyclophosphamide 60 mg/kg x 2 and total-body irradiation 12 Gy, supported by autologous bone marrow transplantation. The bone marrow mononuclear cell fraction was treated in vitro with CD20 monoclonal antibody and baby rabbit complement. The PCR technique was used to identify 50 patients with amplifiable t(14; 18) translocations in biopsy material from lymph nodes or bone marrow infiltrated by lymphoma. RESULTS: Following treatment of the harvested bone marrow in vitro, 29 samples were tested by PCR to assess the efficacy of purging. In 25 cases, the same t(14; 18) sequences were amplified as from the patients' original biopsies, while in four cases, the marrow became PCR-negative. Three of the four patients treated with PCR-negative marrow subsequently developed recurrent lymphoma, compared with 11 of 25 in the PCR-positive group. Bone marrow and peripheral-blood mononuclear cell samples from 27 patients were studied during the follow-up period. All but one had the presence of the lymphoma-related t(14; 18) clone detectable by PCR and confirmed by direct sequencing from at least one sample between 3 months and 7 years after reinfusion of the bone marrow. With a median follow-up duration of 3 years, 13 patients developed recurrent disease, 13 remained in remission with the t(14; 18) still detectable, and one died of acute myeloid leukemia. CONCLUSION: This form of therapy does not eliminate the lymphoma-related t(14; 18)-bearing clone of cells, although the significance of its continued presence is uncertain. Improved methods for both treatment of the bone marrow in vitro and treatment of the lymphoma in vivo are required.

Adult↗

Epidemiologic characteristics of leprosy reactions.

An 8-year prospective study of a cohort of 176 newly diagnosed leprosy patients was conducted to examine the possible influence of age, sex, multidrug therapy (MDT), and duration of illness on the risk of either type 1 or type 2 reactions. Patients were enrolled over a 5-year period (1984-1989) and followed for a minimum of 3 years. All reactions studied were severe enough to warrant hospital admission. Overall, 45% of this cohort developed a reaction; 32% of patients considered at risk developed type 1 reactions, and 37% of patients considered at risk developed type 2 reactions. Despite the predominance of men among the leprosy patients, type 1 reactions occurred with significantly greater frequency in women, and did not appear to be influenced by age of onset of leprosy. Individuals experiencing one type 1 reaction were not likely to experience a recurrence, suggesting that the immunologic mechanisms of this reaction may be limited or regulated by genetic or immunologic factors. Type 2 reactions, on the other hand, occurred with equal frequency in both males and females, but were highly associated with onset of leprosy in the second decade of life. Individuals who experienced type 2 reactions often had one or more recurrence of the reaction. No increased risk was seen for either reaction with longer duration of leprosy or longer duration of treatment. The mechanisms by which these differences relate to the pathogenesis of leprosy reactions remains unclear, but future studies of clinical and immunological parameters of leprosy reactions may benefit from stratification of data by gender and age of onset of leprosy in addition to the routine grouping of results by leprosy classification.

Adolescent↗

Maternal nutritional depletion in a rural area of Papua New Guinea.

In the Wosera area of Papua New Guinea, the nutritional status of 899 women of child-bearing age (measured by weight, body mass index, and skinfolds thickness) showed a strong negative correlation with parity, independent of age. This maternal depletion occurred despite a mean birth interval of three years. Average maternal weight gain during pregnancy was about 5 kg, thus the estimated weight gain from fat deposition, blood and extracellular volume expansion was only 650 g. Evidence of increasing fertility in recent years highlights the need for effective family planning to limit the impact on women of child-bearing age.

Adolescent↗

Pulsatile versus nonpulsatile cardiopulmonary bypass. No difference in brain blood flow or metabolism at 27 degrees C.

BACKGROUND: It is unclear whether nonpulsatile perfusion adversely affects the brain. This study compared cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRO2) betwen pulsatile and nonpulsatile cardiopulmonary bypass (CPB) in rabbits at 27 degrees C. METHODS: In experiment A, 24 anesthetized New Zealand white rabbits underwent pulsatile CPB at 27 degrees C, using alpha-stat acid-base management. Animals were randomized to three groups based upon the duration of the period of systolic ejection (100, 120, 140 ms) and were perfused for 20 min at each of three pulse rates (150, 200, 250 pulse/min), generating nine arterial pressure waveforms. Arterial pressure waveform, arterial and cerebral venous oxygen content, CBF (radiolabeled microspheres), and CMRO2 (Fick) were measured at the end of each 20-min period. In experiment B, 16 anesthetized rabbits were randomized to pulsatile (120-ms ejection period, 250 pulse/min) or nonpulsatile CPB at 27 degrees C. AFter 1 h, arterial pressure waveform, arterial and cerebral venous oxygen content, CBF and CMRO2 were measured. RESULTS: In experiment A, CBF and CMRO2 were independent of ejection period and pulse rate. Thus, all nine waveforms were physiologically equivalent. In experiment B, CBF did not differ between pulsatile and nonpulsatile bypass, 30 +/- 4 versus 32 +/- 5 ml.100 g-1.min-1, respectively. CMRO2 did not differ between pulsatile and nonpulsatile bypass, 1.7 +/- 0.2 versus 1.6 +/- 0.2 ml.100 g-1.min-1, respectively. CONCLUSIONS: During CPB in rabbits at 27 degrees C, neither CBF nor CMRO2 is affected by flow character.

Animals↗

Comparative QSAR studies of two series of 1,4-dihydropyridines as slow calcium channel blockers.

Quantitative structure activity analysis was applied to two series of dihydropyridine (DHP) calcium channel blocking agents. One series of compounds was composed of DHPs substituted in the 4-position with an ortho or meta nitro substituted phenyl ring. The second group consisted of DHPs substituted at the 4-position with a novel thieno [3,2-c] pyridine ring. Both series consisted of compounds with unsymmetrical ester substitutions on the dihydropyridine ring. The antihypertensive activity of the compounds were determined in a spontaneously hypertensive rat model. Regression analysis indicated the antihypertensive activity of an i.v. dose correlated with the calculated octanol/water coefficent (clogP). Regression analysis did not find correlation with the in vitro potency and the clogP values.

Animals↗

Resistance to cytosine arabinoside in acute leukemia: the significance of mutations in CTP synthetase.

The molecular events which confer cellular resistance to cytotoxic drugs such as cytosine arabinoside (ara-C) are poorly understood. Nevertheless, in a proportion of patients with acute leukemia, such events will be responsible for the failure of therapy. Mutations which cause ara-C resistance in a chinese hamster ovary (CHO) cell model have been identified as regulatory base substitutions, occurring in specific sites of the gene coding for an enzyme critical in pyrimidine metabolism, CTP synthetase (CTPs). These cells have elevated dCTP pools, a feature common to biochemical studies of other ara-C resistant leukemic cells. A 94% homology exists between the hamster and human ctps genes. In this study, similar mutations were sought in samples taken from 36 patients, with recurrent or resistant acute leukemia. No mutations were identified in the regions indicated by the CHO model using techniques capable of detecting mutations only if present in more than 10% of the cells studied. Thus, mutations in these sites within the human ctps gene do not appear to be a major mechanism of resistance to ara-C in acute leukemia. Further studies should be directed towards developing more sensitive methods of detection, and these then applied both to CTPs and to other enzymes involved in pyrimidine metabolism.

Acute Disease↗

Results of fludarabine and prednisone therapy in 264 patients with chronic lymphocytic leukemia with multivariate analysis-derived prognostic model for response to treatment.

Two hundred sixty-four patients with chronic lymphocytic leukemia were treated with fludarabine 30 mg/m2 intravenously for 30 minutes each day for 5 days and with prednisone 30 mg/m2 orally each day for 5 days. Courses were repeated monthly. Of the 264 patients. 125 patients (47%) had Rai stage III-IV disease; 169 patients (64%) were previously treated with a median of 3 prior regimens; and 138 of them (82%) were refractory to therapy with alkylating agents. The overall response (OR) and complete response (CR) rates in the 169 previously-treated patients were 52% and 37%; these were 74% and 63%, respectively, in Rai stage O-II patients and declined to 64% and 46%, respectively, in Rai III-IV disease. Among the previously untreated patients, the OR and CR rates were 79% and 63%, these being 85% and 70%, respectively, in Rai O-II patients, and declining to 64% and 46%, respectively, in Rai III-IV disease. The incidence of minor infections or fever of unknown origin was similar in all patient groups and occurred in 22% of courses. The incidence of sepsis and/or pneumonia was significantly correlated with the extent of prior therapy and with Rai stage, and ranged from 3% of courses in the previously untreated Rai O-II patients, to 13% of courses in the previously treated Rai III-IV patients. Listeria sepsis or Pneumocystis carinii pneumonia was noted in 14 patients. With therapy, CD4 levels were uniformly depressed from a median 1,015/microL pretreatment to a median 159/microL after 3 months of fludarabine therapy. Median time to progression in previously treated patients was 22 months. In previously untreated patients, median time to progression was 30 months for patients who achieved a partial remission and has not been reached in patients who achieved a CR with a median follow-up of 2 years. The median survival was 18 months for previously treated patients and has not been reached for previously untreated patients. Response rates in previously treated and untreated patients, as well as infection rates, were identical to those seen in 110 patients treated with the same dose schedule of fludarabine alone. Logistic regression analysis selected 4 factors to be significantly associated with worse response: Rai III-IV stage disease, prior therapy, older age, and low albumin levels. The regression equation was used to derive a probability of response based on the 4 characteristics. When the model was applied to the same population, patients could be divided into 4 prognostic groups with different outcomes.

Antigens, CD↗

G protein beta gamma subunit: physical and chemical characterization.

The beta gamma subunits of heterotrimeric G proteins play a central role in regulating the function of the G protein alpha subunits and in modulating the activity of several enzymes and ion channels. We have used the signature tryptic cleavage pattern of native beta gamma from bovine brain as a starting point for our analysis of its physical and chemical properties. Digestion of bovine brain beta gamma with trypsin yields only 2 beta-derived fragments, with relative mobilities on SDS-PAGE of 14 kDa (amino terminal) and 27 kDa (carboxyl terminal), despite the presence of 32 potential tryptic cleavage sites in the beta 1 subunit. Trypsin-cleaved beta gamma remains in a complex that has the same apparent sedimentation coefficient as intact beta gamma, and retains its ability to associate functionally with the alpha o subunit. Comparison of the incorporation of [14C]iodoacetamide into reduced denatured beta and unreduced denatured beta showed that there are no disulfide bonds in the molecule to hold the complex together. The brain beta and gamma subunits can be cross-linked by 1,6-bis(maleimido)hexane to form a 46-kDa product on SDS-PAGE, and trypsin cleavage of cross-linked beta gamma shows that gamma is cross-linked to the 14-kDa amino-terminal fragment of the beta subunit. On the basis of its primary sequence, the beta subunit is predicted to form a repetitive structure encompassing the 27-kDa fragment and part of the 14-kDa fragment. Analysis of the thermal denaturation of trypsin-cleaved beta gamma supports this prediction and confirms that both fragments retain stable tertiary structures following tryptic cleavage.(ABSTRACT TRUNCATED AT 250 WORDS)

Carbon Radioisotopes↗

Influence of socioeconomic factors on attaining targets for reducing teenage pregnancies.

OBJECTIVE: To determine the rate of pregnancy and outcome in teenagers in areas of different socioeconomic conditions, and to assess the implication for achievement of government and local targets in reducing unwanted pregnancies in teenagers. DESIGN: Records of pregnancies were obtained from hospital discharge files and rates of live and still births and abortions calculated for each postcode sector. Postcodes were grouped by categories of deprivation and by local government district. SETTING: Tayside, Scotland. SUBJECTS: Teenage girls admitted to National Health Service hospitals for delivery or abortion in 1980-90. MAIN OUTCOME MEASURES: Conception in girls aged under 16 by area of residence and relative proportion leading to live births or terminations. Rate of different outcomes in girls under the age of 20 by area of residence. RESULTS: The pregnancy rate in girls aged under 16 was three times as high, and in all girls under 20 six times as high in the most deprived areas as in the most affluent areas. The proportion of teenage pregnancies ending in abortions was higher in the affluent areas, where two out of three ended in abortion compared with one out of four in the deprived areas. CONCLUSIONS: Although there was a higher pregnancy rate in teenagers in more deprived areas, the proportion ending in abortion was greater in more affluent areas, possibly due to social and parental pressure. The wide geographical variation in patterns of teenage pregnancy indicates the need for a small area rather than a regional approach to setting targets and devising measures of achieving them.

Abortion, Legal↗