Biomedical subjects
Publications and source records attributed to D Milne.
A case is presented of pulmonary Langerhans' cell granulomatosis which recurred following lung transplantation and responded to cyclophosphamide. This suggests that the primary abnormality in this condition lies in the Langerhans' cell or precursor dendritic cell.
Explore the source record for details and available documents.
Although the association between celiac disease and progressive myoclonic ataxia is well recognized, in each of the reported cases the neurologic features began in middle adult life and usually in patients who had clinical or laboratory evidence of malabsorption. We report a case of progressive myoclonic ataxia and epilepsy (Ramsay Hunt syndrome) that began in childhood. In this patient there were no features suggestive of gluten intolerance. The presence of antigliadin antibodies in the serum and CSF suggested celiac disease was the cause of the patient's neurologic syndrome. Duodenal morphologic abnormalities reversed with treatment but no major changes were noted in the patient. Celiac disease should be considered in the differential diagnosis of myoclonic ataxia at any age, even in the absence of clinical evidence of gluten-sensitive enteropathy.
The p53 tumour suppressor protein plays a central role in the cellular defence against agents which cause genetic damage. The activity of p53 is regulated at different levels and is subject to multi-site phosphorylation by a variety of different protein kinases. In this paper we have characterised p53 N-terminus-targeted protein kinase (p53NK) activities, present in a range of cell lines, following fractionation of cellular lysates by ion exchange chromatography on HiTrap Q and Mono Q resins. Three peaks of p53NK activity were observed following fractionation of HeLa cell lysates; these activities were each able to catalyse phosphorylation of up to three residues (serines 4, 6 and 9 in murine p53) within the N-terminus of the p53 protein. Similarly, multiple p53NK activities were detected in the MethAp53(ts) cell line (which expresses the valine 135 temperature-sensitive p53 protein). Strikingly, when these cells were shifted from 38 degrees C (the non-permissive temperature) to 28 degrees C, at which the p53 adopts a wild type conformation, a fivefold stimulation of kinase activity was detected. Moreover, when the DNA damage-inducing drugs etoposide or camptothecin were added to the cells, a further stimulation of kinase activity was observed following growth at 28 degrees C, but not 38 degrees C. These data are consistent with a regulatory model in which p53 is sensitive to stress or DNA damage through phosphorylation at its N-terminus.
Reports on a three-month period of evaluation of changes in the perceived life stress, coping and strain of 60 consecutive new attenders at a community mental health centre, which served to monitor performance. Emphasizes the need to incorporate good measurement into a systematic approach to quality assurance.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Young students find extra-terrestrial life one of the most intriguing of all topics. A project funded by the National Science Foundation and NASA, and administered by the SETI Institute, is underway to devise science lessons for grades 3-9 that draw upon this fascination. The lessons are designed by teachers and persons with long experience at curriculum design, tested in classrooms, revised and retested. Six guides, each containing some 6-10 science lessons, will be finished by summer, 1994. The theme Life in the Universe lends itself naturally to integrated treatment of facts and concepts from many scientific disciplines. The lessons for two completed guides span the origin of planet systems, evolution of complex life, chemical makeup of life, astronomy, spectroscopy, continental drift, mathematics and SETI (Search for Extra-Terrestrial Intelligence). All lessons are hands-on, interesting, and successful.
Reports on a small-scale quality assurance analysis of rural mental health drop-in centres. Within a cross-sectional research design, measures were taken of the centres' structure, process and outcome. The instruments used to take these measures were structured interviews, questionnaires and direct observation, which were applied to clients, staff and referrers. It was found that the centres achieved their objectives with considerable success, including high levels of client and referrer satisfaction. Concludes that the three centres provided a quality service which complements the formal options (i.e. NHS and Social Services). Draws implications for the extension of NHS staff roles in relation to the voluntary sector.
A 1-day workshop was evaluated in terms of its effectiveness in enhancing nurse (N = 70) understanding of child abuse. Measures of their knowledge and attitudes concerning abuse were administered before and after the workshop. The results indicated that the workshop led to a significant improvement in these two areas, in particular, a sub-sample (N = 25) who received an additional teaching aid (a programmed learning script) did better than their colleagues. Finally, a teaching evaluation form indicated a high degree of consumer satisfaction. It is concluded that the brief workshop was successful in enhancing knowledge and attitudes, and that it illustrates the kind of 'professional approach' recently advocated in the literature.
Seeks to enhance the measurement of training; describes the development of psychometrically sound and practical measures to assess outcomes relating to in-service management training within a National Health Service District. Develops legitimate measurement tools and demonstrates the positive effects of two specific programmes in relation to behavioural change and participant satisfaction. Further work is required to establish how to monitor the effects of the action learning process in terms of cognitive development.
Explore the source record for details and available documents.
We carried out a two-phased study comparing the effectiveness of first-catch early morning urine (FCU) samples against urethral swabs for the detection of C. trachomatis in men. Four hundred and seventeen new and re-booked consecutive men, who attended the Department of Genito-Urinary Medicine, Bristol, having held their urine overnight, were recruited. Patients who had received antimicrobial chemotherapy in the preceding 2 months were excluded. Early morning FCU samples were obtained from 208 men followed by urethral swabs for the detection of C. trachomatis (phase I) and this order of collection was reversed for the remaining 209 patients (phase 2). A last-catch urine (LCU) was also obtained from all patients. All urethral and urine samples were examined by an amplified enzyme immunoassay (IDEIA, Dako Diagnostics Ltd). Initially, discordant samples were critically examined by direct immunofluorescence (Syva, 'Microtrak') which was used as the 'gold' standard in this study. We have shown that overall 42 and 4.7% of our symptomatic and asymptomatic male patients respectively were positive for C. trachomatis antigen by IDEIA. Furthermore 86.4 and 91.0% (phases 1 and 2) of the total C. trachomatis positive samples were detected by examination of an FCU sample. In contrast only 66.0 and 65.5% (phases 1 and 2) of the total positives were identified by examination of an urethral swab. These results show that an FCU sample not only has the advantage of being a non-invasive procedure but is also a very sensitive method, compared to swabbing the urethra for the detection of C. trachomatis.(ABSTRACT TRUNCATED AT 250 WORDS)
In order to assess the impact of changes in the Licensing Laws in England, a prospective study was undertaken of patients attending the Accident and Emergency Department of the Newcastle General Hospital. Patients were breathalysed in October 1986, before the liberalisation of the Licensing Laws in England and Wales and again in October 1988, after this change. A blood alcohol level of greater than 50 mg/100 ml was detected in 13% of all attenders in 1986 and 14% in 1988. A comparison of the two years revealed no significant change in the number of patients who had ingested alcohol prior to attendance, although there was a trend towards increased frequency of alcohol ingestion in nighttime attenders.
This study compared the ability of foetal thymic epithelium depleted of lymphocytes and dendritic cells, by low temperature or deoxyguanosine (dGuo) treatment in organ culture, to reconstitute T-cell function in nude mice. It is shown that renal capsule grafts of either type could promote the development of functional T lymphocytes in the periphery, as judged by in vivo assays. Both syngeneic and allogeneic thymic epithelium endowed nude mice with the capacity to mount IgG antibody and delayed-type hypersensitivity (DTH) responses to the T-dependent antigen ovalbumin (OVA). Functional reconstitution was accompanied by the appearance of Thy-1-bearing cells in the spleens of thymic grafted nude mice. The results from allogeneically grafted recipients show that a substantial population of peripheral T cells was present that collaborated with B cells and other antigen-presenting cells (APC) which do not express major histocompatibility complex (MHC) molecules of the thymus donor haplotype.
Not all mothers who smoke during pregnancy deliver small infants. Nutritional supplementation during pregnancy apparently protects the fetuses of some mothers. Our previous studies showed that plasma levels of carotene and cholesterol were correlated with birth weight. The present study examined the association between mid-pregnancy plasma levels of carotene and cholesterol and subsequent birth weight. In a prospective study of 388 women (47.8% smokers), levels of plasma nutrients and demographic and anthropometric measurements were obtained at 19 and 36 weeks' gestation and related to indices of infant size at birth. In non-smokers, the level of plasma cholesterol at mid-pregnancy correlated positively with birth weight. In contrast, in mothers who smoked more than ten cigarettes daily, the relationship of cholesterol to birth weight was dependent on the simultaneously observed level of plasma carotene. When plasma cholesterol and carotene concentrations were both low at mid-pregnancy, birth weight was low. On the other hand, when the carotene level was high and the cholesterol level low, birth weight was at least equivalent to that of non-smokers. The interactive effect of smoking, cholesterol, and carotene on birth weight was significant (P = .017) after adjusting for gestational age, sex, prenatal care, race, previous low birth weight infants, parity, weight at mid-pregnancy, and total weight gain during pregnancy. Among smokers, the smallest infants were born to mothers having the greatest decrease in plasma carotene between 19-36 weeks' gestation. Smokers whose plasma carotene remained constant or increased had larger infants; a similar association was not observed for cholesterol.(ABSTRACT TRUNCATED AT 250 WORDS)
The case for the formative and summative evaluation of training courses is presented prior to focusing upon the development of two new measures designed to gauge the effectiveness of a short course of training. Results derived from these two measures are presented from two successive English National Board 953 courses ('Developments in Psychiatric Nursing'). The findings indicated that our measures were reliable and valid indices of learning and so could facilitate formative evaluation. However, in terms of summative evaluation the post-course scores were low and so the case for a revised course was presented. Implications were drawn for the routine evaluation of post-qualification courses.
Research is needed into the scientific basis for psychologists' 'specialist' model of service to general practitioners. This study evaluated two predictions of this service to general practitioners. This study evaluated two predictions of this model: firstly, that patients with psychological problems can be identified reliably; secondly, that they tax GPs' resources and ability disproportionately. To test these, psychologists observed 448 GP consultations. The GP and psychologist independently rated the involvement of psychological factors; the GP recorded his satisfaction with, and the psychologist the duration of, the consultation. Patients completed scales of psychiatric and social dysfunction. Both predictions were confirmed. Agreement between GPs' and psychologists' ratings of the presence of psychological factors was higher than reported previously, and not explained by the small correlation of psychiatric morbidity with each. Problems identified by GPs as psychological were associated with longer, repeated and less satisfying consultations.