Prevalence of a V2 epitope in clade B primary isolates and its recognition by sera from HIV-1-infected individuals.
Explore the source record for details and available documents.
Enzyme-Linked Immunosorbent Assay↗
Biomedical subjects
C Palmer
Publications and source records attributed to C Palmer.
The use of behavioural mapping in a study of seclusion.
As part of a larger study into the use of seclusion we set out to examine some of the antecedents that led to patients being secluded in one locked psychiatric ward. Behavioural mapping was used to chart the location of incidents that resulted in seclusion. Incidents were observed in several ward areas but most of these occurred in the day room and the dining room. This finding enabled us to question the ward policy of confining patients to these areas to facilitate nursing observation and management. The policy may have contributed to the number of disturbances by limiting personal space for patients. Literature on body buffer zones, crowding and territoriality is used to clarify and interpret the findings.
Female↗
Hospital at home. Research is needed into organisation and development as well as cost effectiveness.
Explore the source record for details and available documents.
Cost-Benefit Analysis↗
Functional characterization of the V1V2 region of human immunodeficiency virus type 1.
The level of proviral DNA sequence variation in the V1V2 region was monitored over time in six HIV-1-infected individuals. Substitutional and length variation was observed, where the majority of length changes, ranging from 28 to 49 amino acids, was located within the V1 region. Evidence for convergent evolution in the V2 region was found. The functional significance of this variation was assessed by cloning the V1V2 sequences into an infectious molecular clone, HXB2. The majority of chimeras replicated, demonstrating that the sequences, though genetically distinct, were capable of conferring a viable phenotype. Chimeras expressing closely related sequences in a constant genetic background displayed different biological phenotypes, with respect to both cytopathicity and cell tropism. However, no association between primary V1V2 amino acid sequence and viability or cytopathicity of the chimeric virus was observed, suggesting that predictions of virus phenotype based on sequences alone may be incorrect. The effect of V1V2 variation on the overall gp 120 conformation was measured by expressing the gp 20 from a number of viable and nonviable clones. No differences were observed, suggesting that misfolding of the chimeric gp 120 protein was not an explanation for the nonviability of some virus clones. Several chimeras were noncytopathic and only able to replicate in PBMC cultures, demonstrating that the V1V2 region, independent of the V3 sequence, is capable of defining both tropism and cytopathicity.
Amino Acid Sequence↗
Immunogenicity of full length and truncated forms of the human immunodeficiency virus type I envelope glycoprotein.
We have monitored the immunogenicity of a V1V2 sub-fragment of gp 120 in contrast to the full length protein and to a truncated form (PR12) where the V1, V2 and V3 regions were removed. In contrast to previously published work [1] these studies show that monomeric forms of envelope are capable of inducing antibodies specific for both linear and discontinuous epitopes. These antibodies are capable of neutralising HIV infectivity. The majority of neutralising antibodies were specific for epitopes within the V2 and V3 regions demonstrating the immunodominance of these regions in monomeric gp 120. Relatively few of the antibodies were specific for the CD4 binding site, suggesting that this region is poorly immunogenic. Immunisation of rats with the PR12 truncated protein did not significantly enhance the immunogenicity of the CD4 binding site. However, the immune response generated included antibodies capable of binding to diverse primary HIV-1 and HIV-2 envelope glycoproteins. We have shown that up to 30% of sera from HIV-1 infected individuals have antibodies that are capable of recognising conformation-dependent epitopes within the V1V2 region of the clone HXB10, suggesting the presence of conserved cross-reactive epitopes. Furthermore we have shown an association between the presence of V1V2 reactive antibodies and the neutralisation titre of the sera tested suggesting that antibodies to this region contribute to the cross-reactive neutralising response.
AIDS Vaccines↗
Epidural bupivacaine/fentanyl infusions vs. intermittent top-ups: a retrospective study of the effects on mode of delivery in primiparous women.
This study was designed to determine whether the introduction of epidural infusions containing fentanyl and bupivacaine has affected the mode of delivery in primiparous women attending our maternity department. We reviewed retrospectively the computerized records of 4362 consecutive primiparous women in labour. All the women were admitted with the expectation of a vaginal delivery. The results were analysed using logistic regression analysis adjusted for age, weight, gestation, cervical dilatation at epidural insertion, use of oxytocin, the year of entry into the study and the type of epidural block received. In women receiving an epidural block at 3-6 cm cervical dilatation (n = 1534), those who received an infusion were significantly less likely to have an emergency Caesarean section than those having intermittent 'topups' (P = 0.0019). In the same subgroup of women, the Caesarean section rate specifically for failure to progress followed the same trend, but just failed to reach statistical significance (P = 0.058). This provides evidence to support the theory that epidural infusions containing a low dose bupivacaine/fentanyl combination may reduce the risk of Caesarean section in primiparous women.
Analgesia, Obstetrical↗
Localization of a non-specific X-linked mental retardation gene, MRX23, to Xq23-q24.
More than 100 X-linked mental retardation syndromes have been described. We report the localization of the disease gene, MRX23, in one family to Xq23-24. Affected family members present with non-specific X-linked mental retardation with verbal disability (BDOAS 10, 1-100). MRX23 is tightly linked to the markers DXS1220 (Z = 3.76 at theta = 0.1) and DXS424 (Z = 3.9 at theta = 0.06). Multipoint linkage analysis, taking five loci (DXS1072-0.07-DXS1220-0.014-MRX23-0.01-DXS 424-0.08-DXS1001) at a time, gives a maximum LOD score of 6.7 between these two markers. The next most likely location, between DXS424 and DXS1001 is 120-fold less likely. Haplotype analysis also indicates the most likely location for the disease gene is between DXS1220 and DXS424.
Chromosome Mapping↗
Qualitative MRI segmentation in mesial temporal sclerosis: clinical correlations.
Magnetic resonance imaging (MRI) is reliable and sensitive in the detection of mesial temporal atrophy in patients with temporal lobe epilepsy. We investigated the MRI patterns of atrophy in 47 patients with histologically confirmed hippocampal sclerosis and correlated the imaging findings to the clinical features and surgical outcome. One hundred percent of patients had hippocampal body atrophy, 70% had hippocampal tail atrophy, 23% had amygdala atrophy, and 10% had focal hippocampal body atrophy without other segmental involvement. Correlative analysis of the segmented MRI findings with other clinical variables, including a previous history of childhood febrile convulsions, showed no significant associations except for younger age of seizure onset associated with hippocampal tail atrophy (p <0.03). No associations between surgical outcome and the patterns of mesial temporal atrophy were detected. Our results demonstrate that variable patterns of atrophy exist in mesial temporal atrophy, but invariably atrophy involves the hippocampal body segment. Segmental MRI analysis in mesial temporal atrophy provides added useful diagnostic information.
Adolescent↗
The expression of ferritin subunits and iron in oligodendrocytes in neonatal porcine brains.
Myelination is an essential component of normal development in the brain. Thus, the factors which influence the onset of myelination need to be identified and monitored during development to insure adequate myelination. These factors may also play a role in remyelination attempts which occur as a result of demyelinating diseases. One factor known to be involved in myelination is iron. In this study, the cellular deposition of iron and the intracellular iron storage protein ferritin are examined in the brains of 1-month-old piglets. Ferritin consists of 2 subunits (H and L chains) which occur in different ratios in different organs. The subunits are functionally distinct so their pattern of expression at the cellular level reveals information about the iron requirement of the cell and utilization versus storage. The H subunit of ferritin is expressed in abundance in oligodendrocytes within white-matter tracts whereas the L subunit in this region is found only in endothelial cells of blood vessels. H-ferritin-positive cells occur in clearly defined patches which are scattered throughout the white-matter tracts. The cellular distribution of iron is identical to that of H ferritin. H-ferritin-positive cells are identified as oligodendrocytes on the basis of immunofluorescent colocalization with CNPase. Also, some of the H-ferritin-positive cells are positive for myelin basic protein. However, the distribution of CNPase-positive cells is more even in the white matter than the patches of H-ferritin/iron-positive cells. The relationship between H-ferritin- and CNPase-positive cells indicates that the former are oligodendrocytes, but also reveals a subset of oligodendrocytes in the white matter. The results of this study provide insight into how the intracellular iron is managed in oligodendrocytes. The factors which initiate iron uptake and ferritin expression in a select population of oligodendrocytes, and the relationship of this select population to myelinogenesis and myelin maintenance, have yet to be identified.
Animals↗
Radiation-induced glioma of the spinal cord.
We report a case of a radiation-induced spinal cord glioma. A 20-year-old girl presented with neck pain and new significant neurological deficits 17 years after resection of a posterior fossa medullomyoblastoma and subsequent craniospinal irradiation. She was found to have a cervical intramedullary tumor that was resected using a standard microsurgical technique. The permanent histopathological diagnosis was anaplastic astrocytoma. Her neurological status was worse immediately following the operation. She improved to her pre-operative status, but then had a relentless neurological decline resulting in death 16 weeks following surgery. Because of the high incidence of malignancy in the few radiation-induced spinal cord gliomas reported in the literature, and the poor outcome independent of therapy in patients with malignant spinal cord gliomas, an initial strategy of biopsy only may be more appropriate than attempted resection for the patient with a suspected radiation-induced intramedullary spinal cord tumor.
Adult↗
Dentistry and government: evolution of a relationship.
Explore the source record for details and available documents.
American Dental Association↗
Molecular techniques reveal high prevalence of Legionella in dental units.
Legionella bacteria are ubiquitous in freshwater aquatic systems, and humans are infected by them primarily through inhalation of contaminated aerosols. This study analyzed a total of 47 water samples from dental lines in private dental offices and university and hospital dental clinics for Legionella using the polymerase chain reaction, direct fluorescent antibody staining and culture techniques. The typical temperature of dental waterlines (23 C) combined with Legionella's ability to form biofilms, stagnation of the water in the lines and a low chlorine residual all potentially create a unique niche for this microorganism.
Colony Count, Microbial↗
Is POCT cost effective for coronary bypass patients in ICUs?
Explore the source record for details and available documents.
Blood Chemical Analysis↗
Differences in mortality after fracture of hip.
Explore the source record for details and available documents.
Diagnosis-Related Groups↗
A histochemical study of iron-positive cells in the developing rat brain.
The establishment of normal iron levels in the neonatal brain is critical for normal neurological development. Studies have shown that both iron uptake and iron concentration in the brain are relatively high during neonatal development. This histochemical study was undertaken to determine the pattern of iron development at the cellular level in the rat forebrain. Iron-stained cells were observed as early as postnatal day (PND) 3, which was the earliest time point examined. At PND 3, there were four major foci of iron-containing cells: the subventricular zone and three areas within the subcortical white matter. These latter foci are associated with myelinogenic regions. The blood vessels were prominently stained for iron throughout the brain. At PND 7, as in PND 3, the majority of the iron-containing cells were in white matter. However, there were also patches of iron staining located specifically in the layer IV of the somatosensory cortex. These cortical patches were no longer visible by PND 14. At PND 14, numerous iron-stained cells were dispersed throughout white matter regions and the tanycytes aligning the third ventricle were prominently stained. The blood vessel staining was less prominent than at earlier time periods. By PND 28, the adult pattern of iron staining was emerging. Iron-stained cells were aligned in rows in white matter and had an apparent preference for a location near blood vessels. This clustering of iron-positive cells around blood vessels gave the white matter a "patchy" appearance. The pattern of development, cell distribution, and morphological appearance of the iron-stained cells are consistent with that reported for oligodendrocytes. That iron-positive cells in the neonate may be oligodendrocytes is consistent with the reports for iron staining in adult brains. The recent reports that oligodendrocytes are highly susceptible to oxidative damage would be consistent with the high iron levels found in these cells. These results indicate that oligodendrocytes play a major role in the development of iron homeostasis in the brain. The role of iron in oligodendrocytes may be associated with metabolic demands of myelinogenesis, including cholesterol and fatty acid synthesis. However, these cells may be a morphologically similar but functionally distinct subset of oligodendrocytes whose function is to regulate the availability of iron in the brain.
Animals↗
An evaluation of the effect of pentoxifylline on sperm function and treatment outcome of male-factor infertility: a preliminary study.
OBJECTIVE: Our objective was to study the effect of pentoxifylline (PF) on fertilization rates in couples with previous failure of fertilization and male-factor infertility and to determine the predictive value of conventional semen analysis parameters in selecting the couples who would benefit from the elective use of PF in IVF. DESIGN: This prospective controlled study was conducted in an assisted conception METHODS: Sixty-nine couples with previous failed IVF cycle, who had a low fertilization rate and/or male-factor infertility, were recruited to the study. Multiple follicular development was induced using the same protocol of human menopausal gonadotropin and gonadotropin releasing hormone analogue in both cycles. The oocytes were inseminated with spermatozoa treated with PF. The fertilization rates in the PF cycle were compared to the reference cycle based on semen analysis parameters and previous fertilization rates. RESULTS: In couples with male infertility, the fertilization rate improved significantly, from 17 to 50% in PF cycles (P < 0.001). A significant improvement in fertilization rate was also demonstrated in couples with previous poor fertilization, < 30% (P < 0.01), particularly in those with a very low fertilization rate, < 20% (P < 0.001). Although there was an overall improvement in fertilization rates in couples with male-factor infertility, there was no cutoff value in sperm motility that would make a significant difference in the impact of PF on fertilization rates. CONCLUSION: Couples with poor fertilization rates in vitro benefit with a significant improvement in fertilization by the elective use of PF. The improvement is most significant in couples with previous complete failure of fertilization and poor fertilization rates, < 30%.
Adult↗
Successful use of pentoxifylline in male-factor infertility and previous failure of in vitro fertilization: a prospective randomized study.
OBJECTIVE: Our objective was to determine whether the use of pentoxifylline (PF) would improve the in vitro fertilization (IVF) rate and outcome in couples with male factor infertility and previous failure of fertilization in vitro. DESIGN: This prospective randomized controlled study was conducted in an assisted conception unit. MATERIALS AND METHODS: Forty-nine couples with previous failed fertilization in vitro attributable to male factor or male-factor infertility without previous IVF were recruited for the study. Controlled ovarian hyperstimulation was performed using a combination of gonadotropin releasing hormone agonist and human menopausal gonadotropin. Oocytes of the same grade and maturity were inseminated with spermatozoa treated with PF or control spermatozoa. A maximum of three embryos was replaced after 48 hr and all other embryos were cryopreserved. Pregnancy outcome was followed up and evidence of fetal or neonatal anomalies reported. RESULTS: A significantly higher fertilization rate occurred in the group where oocytes were inseminated with spermatozoa treated with PF compared with controls (56.3 versus 30.7%; P < 0.05). Fertilization occurred in 45 of the 49 cycles (92%). In seven cycles, only the oocytes that were inseminated with spermatozoa treated with PF fertilized, in contrast to only one cycle where the oocytes inseminated with control sperm fertilized (P < 0.05). Fifty-seven PF and 31 control embryos were replaced and 11 clinical pregnancies occurred. Three of the pregnancies occurred in the seven cycles in which only PF embryos were replaced, one in the single cycle where control embryos were replaced and seven from the 37 cycles in which both PF and control embryos were replaced. There was no evidence of congenital malformations in any of the offsprings resulting from this study. CONCLUSION: This study suggests that PF improves the fertilization rate and outcome in couples with male factor infertility and poor fertilization rates. This study does not suggest any increase in teratogenicity or evidence of congenital malformations in pregnancies following IVF cycles where PF was used.
Adult↗