Is there a role for thiamine supplementation in the management of heart failure?
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Diuretics↗
Biomedical subjects
D Leslie
Publications and source records attributed to D Leslie.
Lipaemia retinalis: a question of chylomicrons?
Lipaemia retinalis is a rarely described condition which occurs in certain types of both primary and secondary hyperlipidaemia. It presents with a striking fundal appearance. We report 7 cases of lipaemia retinalis and ocular manifestations in hyperlipidaemia which presented over a 12 year period to our hospitals. These illustrate the different presentations and stages of the disease, and other fundal abnormalities seen in hyperlipidaemia.
Adult↗
A rapid, highly sensitive method for the detection of Francisella tularensis in clinical samples using the polymerase chain reaction.
We have developed a highly sensitive method for detection of Francisella tularensis in clinical samples based on a nested polymerase chain reaction (PCR) for the FopA gene. Mice infected with F. tularensis were killed at 24-hr intervals, and the DNA from blood and spleens was extracted by a variety of methods and analyzed by PCR. The best method, based on the ability of DNA to bind to silica in the presence of guanidine thiocyanate, yielded amplifiable DNA without dilution of the murine tissue samples. Francisella tularensis in infected murine spleens and culture-positive blood samples was reliably detected by nested PCR following this extraction procedure. We believe this technique has significant advantages over traditional methods for diagnosing F. tularensis infection in terms of speed, ease of use, reproducibility, and safety.
Animals↗
Apoptosis abnormalities of splenic lymphocytes in autoimmune lpr and gld mice.
The murine gene lpr encodes an aberrant form of the apoptosis-inducing receptor Fas. The gene gld, which causes an autoimmune syndrome phenotypically identical to that caused by lpr, encodes a mutant Fas ligand. Because the lpr gene must be expressed in both T and B cells to produce autoimmune disease, it might be anticipated that apoptosis abnormalities would be present in both. Therefore, we quantitated apoptosis in T and B cells from lpr, gld, and normal mice in a short-term in vitro culture system. Freshly isolated spleen cells from normal, lpr, or gld mice showed little or no apoptosis as assessed by quantitative DNA flow cytometry. However, after overnight culture, both T and B cells showed substantial spontaneous apoptosis. Such apoptosis increased strikingly with age in normal but not in autoimmune B cells. CD23low B cells, which are prominent in lpr and gld mice, were particularly notable for high levels of programmed cell death in normal mice. The apoptosis caused by the gld defect could not be corrected by coculture with normal spleen cells. The persistence with age of low levels of B cell apoptosis in lpr and gld mice presumably reflects deficient Fas/Fas ligand interactions. The further localization of the B cell apoptosis defect to the unusual CD23low B cells, which accumulate in lpr and gld mice, adds to the evidence that these cells may be of critical importance to autoimmunity.
Animals↗
Transcranial Doppler analysis of cerebral hemodynamics in primary craniosynostosis: study in progress.
BACKGROUND: Regional elevations in intracranial pressure (ICP) have been monitored adjacent to areas of cranial stenosis by some authors [9,19,20]; however, noninvasive techniques such as transcranial Doppler (TCD) would be preferable if increased ICP could be detected just as reliably. METHODS: TCD examinations of basal cerebral arteries were performed in 31 children with skull deformities. Skull X rays and computed tomography (CT) scans or magnetic resonance imaging (MRI) were analyzed for degree of cranial vault abnormality, as well as for presence or absence of intracranial pathology. Neurodevelopmental examination and clinical signs of increased ICP, if any, were recorded. RESULTS: The overall incidence of increased resistivity indices (RI) was 70%. Patients with asymmetric skull deformities (plagiocephaly) or sagittal synostosis (scaphocephaly) were statistically more prone to exhibit increased RI compared to previously reported prevalences. CONCLUSIONS: Because TCD is a convenient, rapid, accurate, and noninvasive method by which to gauge ICP, it should be considered in the preliminary work-up of a patient with craniosynostosis.
Craniosynostoses↗
Pyomyositis in a patient with Crohn's disease.
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Adolescent↗
The recovery suture.
Continuous running sutures have several advantages in wound closure but can be difficult to remove. A loop tied around an exposed section of the running suture or an adjacent interrupted suture allows visualization and ease of removal.
Humans↗
Teledermatology in Scotland.
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Adolescent↗
The Nambour Skin Cancer and Actinic Eye Disease Prevention Trial: design and baseline characteristics of participants.
The Nambour Skin Cancer and Actinic Eye Disease Prevention Trial (the Nambour Trial) is a field trial conducted in an unselected adult population in Australia. Using a randomized 2 x 2 factorial design, the principal aim is to evaluate whether regular use of high-protection sunscreen and/or dietary supplementation with beta-carotene (30 mg daily) can alter the incidence rates of basal cell carcinomas and squamous cell carcinomas of the skin over a minimum follow-up time of 4.5 years. Changes in the incidence of solar keratoses and actinic eye disease and the rate of photoaging after intervention will also be investigated. In 1992, 1626 participants between the ages of 25 and 75 years were enrolled, all of whom had been randomly selected from residents of the southeastern Queensland township of Nambour for an earlier skin cancer prevalence survey. This paper describes the background to the trial and its design, with respect to evaluation of effects on actinic skin disease, and documents the baseline characteristics of participants recruited into the Nambour Trial.
Adult↗
Disseminated Mycobacterium avium-intracellulare infection in an HIV-negative male.
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Adult↗
Mohs surgery explained.
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Basal Cell Carcinoma↗
Rapid identification of flaviviruses based on conserved NS5 gene sequences.
Two conserved regions in the sequence of the NS5 gene of Flaviviruses were identified. Primers were designed from the consensus sequence of these regions and were used in a reverse transcription/polymerase chain reaction (RT/PCR) to amplify a region of the central european tick-borne encephalitis virus Kumlinge NS5 gene. The authenticity of the amplified fragment was confirmed by nucleotide sequencing. A band of the expected size was also obtained when this RT/PCR was applied to 13 other flaviviral RNAs. This method may be useful for characterisation of the NS5 genes of flaviviruses and as a potential pan-flavivirus diagnostic tool.
Base Sequence↗
Gene probe assays on a fibre-optic evanescent wave biosensor.
This report describes experiments to detect oligonucleotide hybridization at the surface of a fibre-optic evanescent wave biosensor. Conditions were optimized and the time course of hybridization reactions were found to be very rapid compared to conventional hybridization assays. Binding was easily reversed by heating and the sensor surface could be reused many times. Short (16- and 20-mer) oligonucleotides bound to the waveguide surface could be used to detect fluorescein-labelled complementary sequences at the nanomolar level. Polymerase chain reaction was used to generate a 204-base oligomer that was attached to the waveguide surface. Fluorescein-labelled oligos bound at either the proximal or distal ends of this probe were found to give similar outputs.
Base Sequence↗
Phospholipase C and haemolytic activities of Clostridium perfringens alpha-toxin cloned in Escherichia coli: sequence and homology with a Bacillus cereus phospholipase C.
The Clostridium perfringens alpha-toxin (phospholipase C) gene (cpa) has been cloned and expressed in Escherichia coli. The biological activities of the cloned gene product have been analysed and the complete nucleotide sequence of the cpa gene has been determined. The cloned cpa gene product, which is exported to the periplasm in E. coli, possesses both phospholipase C and haemolytic activities. Haemolysis is not apparent when cell extracts are incubated with isotonic suspensions of sheep erythrocytes, but can be detected and quantified readily when dilutions of the same extracts are placed in wells in sheep-blood agar plates. Like other sequenced clostridial genes, the cpa gene has a high AT content (66.4%), exhibits a strong bias for using codons with A or T in the wobble position, and the 350 base pairs upstream from the gene have a significantly higher AT content (79.5%) than the coding region. The cpa gene encodes a 398 amino acid polypeptide with a deduced molecular weight of 45,481 D. This is very similar to the estimated molecular weight (Mr) of the cpa primary gene product expressed in an in vitro transcription-translation system (Mr 46,000), but larger than the cpa gene product detected in E. coli minicells, E. coli whole cells or in C. perfringens cells (Mr 43,000), suggesting post-translational processing. The 28 N-terminal residues of the deduced alpha-toxin sequence possess the consensus features of a signal peptide and may be removed during secretion. The deduced alpha-toxin sequence shares significant structural homology with the phosphatidylcholine-preferring phospholipase C of Bacillus cereus.
Amino Acid Sequence↗
Diagnosis of skin cancer in the general population: clinical accuracy in the Nambour survey.
The accuracy and validity of diagnoses of skin cancer that were made by experienced dermatologists in a Queensland community survey have been investigated. Histological examination confirmed 54% of 100 clinical diagnoses of basal-cell carcinoma, squamous-cell carcinoma or intraepidermal carcinoma. Clinical accuracy was higher for basal-cell carcinoma (59%) than for squamous-cell carcinoma (39%) or intraepidermal carcinoma (38%). Such levels of diagnostic accuracy are to be expected when an unselected population is surveyed because of the relatively low prevalence of skin cancer compared with that in the patient population of a specialist practice. This reduction in diagnostic accuracy is unrelated to clinical skills, and should be borne in mind when conducting any skin-cancer screening programme in the general community.
Adult↗
Skin cancer in a Queensland population.
In the present study we have estimated the current prevalence of actinic skin disease in young and middle-aged adults in Queensland, Australia by surveying a representative community. It was found that 4.6% of persons aged 20 to 69 years had skin cancer, mostly basal cell carcinoma, and 40% had solar keratoses. The age distribution and site distribution of actinic lesions in this population were not as classically described; persons below age 40 years exhibited substantial sun-related skin damage, and a large proportion of actinic lesions occurred on sites other than the head, backs, of hands, or forearms. Allowing for age and sex, the strongest risk factors for skin cancer and solar keratoses were fair skin, as assessed by a dermatologist, and clinical signs of solar damage such as solar lentigines, facial telangiectasia, and actinic elastosis of the neck. Associations with self-reported tendencies toward sunburn, frequent painful sunburns, occupational sun exposure, and a previous history of skin cancer were confirmed.
Adult↗