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Biomedical subjects

D Watson

Publications and source records attributed to D Watson.

At least 55 records · Page 3Linked to original sources
PubMed2000

Sequence and diversity of the rat delta T-cell receptor.

The cDNA sequence of the delta T-cell receptor (TCRD) in the adult Lewis rat thymus was determined using the technique of rapid amplification of cDNA ends. Sixteen variable region genes (TCRDV), two diversity regions (TCRDD), two joining regions (TCRDJ), and a single constant region gene (TCRDC) were identified. The sixteen unique TCRDV genes identified represented eight different subfamilies in the rat and were highly conserved (>80% nucleotide identity) to corresponding mouse sequences. Extensive junctional diversity was observed in the rat, with both TCRDD regions (TCRDD1 and TCRDD2) utilized in the majority of cDNA clones identified. The two TCRDJ genes were highly conserved and corresponded to TCRDJ1 and TCRDJ2 in the mouse; the majority of clones utilized TCRDJ1. The TCRDC region in the rat was 91.1% identical to the mouse TCRDC gene and was highly conserved to other species. Although extensive sequence information about mouse gamma-delta T-cell receptor genes is available, current knowledge of rat gamma-delta T-cells is limited. The sequence analysis presented in this study adds to our understanding of gamma-delta T-cells in general, and it may be utilized to study the role of gamma-delta T-cells in immune-mediated disease and transplantation models previously established in the rat.

Amino Acid Sequence↗
PubMed2000

Single nucleotide primer extension (SNuPE) analysis of the G6PD gene in somatic cells and oocytes of a kangaroo (Macropus robustus).

cDNA sequence analysis of the X-linked glucose-6-phosphate dehydrogenase (G6PD) gene has shown a base difference between two subspecies of the kangaroo, Macropus robustus robustus (wallaroo) and M. r. erubescens (euro). A thymine residue in the wallaroo at position 358 in exon 5 has been replaced by a cytosine residue in the euro, which accounts for the previously reported electrophoretic difference between the two subspecies. This base difference allowed use of the Single Nucleotide Primer Extension (SNuPE) technique to study allele-specific expression of G6PD at the transcriptional level. We began by examining G6PD expression in somatic cells and observed complete paternal X inactivation in all somatic tissues of adult female heterozygotes, whereas we found partial paternal allele activity in cultured fibroblasts, thus confirming previous allozyme electrophoresis studies. In late dictyate oocytes from an adult heterozygote, the assay also detected expression of both the maternal and paternal alleles at the G6PD locus, with the maternal allele showing preferential expression. Thus reactivation of the inactive paternally derived X chromosome occurs during oogenesis in M. robustus, although the exact timing of reactivation remains to be determined.

Amino Acid Substitution↗
PubMed2000

Self-other agreement in personality and affectivity: the role of acquaintanceship, trait visibility, and assumed similarity.

Self- and other-ratings on the Big Five and a comprehensive inventory of trait affect were obtained from 74 married couples, 136 dating couples, and 279 friendship dyads. With the exception of Surprise, all scales showed significant self-other agreement in all 3 samples, thereby establishing their convergent validity. Consistent with the trait visibility effect, however, the Big Five consistently yielded higher agreement correlations than did the affectivity scales. Conversely, the affective traits consistently showed stronger evidence of assumed similarity (i.e., the tendency for judges to rate others as similar to themselves) than did the Big Five. Cross-sample comparisons indicated that agreement was significantly higher in the married sample than in the other 2 groups; however, analyses of 3 potential moderators in the dating and friendship samples failed to identify the source of this acquaintanceship effect.

Adult↗
PubMed2000

The image of the children's nurse: a study of the qualities required by families of children's nurses' uniform.

Traditional views of the nurse see 'her' in a nurse's uniform, whether she be a 'sex symbol', 'angel of mercy' or 'battle axe'. Children's nursing has, over recent years, moved away from the idea of the uniform into more child friendly clothes, though the traditional uniform is still presented to the public by the media. The staff members of a Children's Outpatients Department (COPD) of a large acute hospital requested knowledge of the qualities families required from the uniform of nurses caring for them, prior to any change in uniform. This study aimed to develop an understanding of these qualities via the use of a survey presented to those attending the COPD. The findings indicate that there is a complex relationship between the qualities that families wish the uniform to present. A balance is needed between presenting a professional authority figure, providing security for families and suggesting an approachable figure, to allow effective communication between staff and families.

Adult↗
PubMed2000

Clinical value of real-time tertiary fetal ultrasound consultation by telemedicine: preliminary evaluation.

Congenital fetal abnormalities are major causes of perinatal mortality and morbidity. The performance of ultrasound in the diagnosis and assessment of fetal anomalies varies enormously between tertiary referral centers and general units. Telemedicine offers a chance for tertiary realtime ultrasound consultations using standard telephone lines for remote sites. Preliminary investigations by our group have shown that real-time transmission of fetal ultrasound images over long distances via telephone (integrated systems digital network [ISDN]) lines is technically feasible. A live link of up to 2 Mb/s was established between Mater Mothers Hospital in Brisbane and Kirwan Hospital for Women in Townsville, which are 1,500 km apart. The objective of the current study was to evaluate the clinical value of a tertiary teleultrasound consultation service. Patients requiring tertiary ultrasound consultations were recruited from North Queensland. Clinicians from the referral site established an initial diagnosis and management plan. Using standard ISDN lines, the real-time ultrasound images were transmitted to the maternal fetal medicine subspecialists in Brisbane. The ultrasound examination was completed under the direction of the subspecialist. The subspecialist explained the findings to the patient at the end of the session, and discussed the diagnosis and management plans with the clinicians involved. Any diagnosis and management variations were classified into minor and major upon agreement by the two teams of clinicians involved. The clinicians and patients in Townsville rated the value of the consultation, and the subspecialists rated the confidence of their diagnoses on five-point scales. Pregnancy outcomes were obtained and the data analyzed. Over a 3-month period, 24 teleultrasound consultations were carried out. The indications for referral were: assessment of growth restriction/fetal wellbeing in the third trimester (6); detailed assessment for high-risk patients (5); evaluation of markers for anomalies (5); isolated fetal anomalies (1); and complex fetal problems such as twin/twin transfusion, multiple anomalies, etc. (7). Overall, the consultations resulted in some modifications to the clinical diagnosis in 45.8% of the cases, and modifications to the management plan in 33.3% of the cases (about half of which were minor variations). The clinicians rated the teleconsultations highly (mean rating 4.7, SD 0.44). The patients also rated the consultations highly, and were comfortable that their privacy and confidentiality were maintained during the consultation. The subspecialists were confident in making their diagnoses by telemedicine (mean score for confidence 4.2, SD 0.43). All the pregnancies have now been completed, with all antenatal diagnoses confirmed to be correct postnatally. Tertiary real-time ultrasound consultation by telemedicine is not only technically feasible, it is welcomed by the clinicians and patients involved. It also contributes to diagnostic and management differences. Larger scale clinical trials are needed to evaluate the true benefits and costs involved. The social benefits in bridging the healthcare gap between the country and the city, and in enabling patients in remote areas to stay close to their family under times of stress is well recognized by all involved.

Congenital Abnormalities↗
PubMed2000

False alarms and sensitivity of conventional pulse oximetry versus the Masimo SET technology in the pediatric postanesthesia care unit.

UNLABELLED: We compared the incidence and duration of false alarms (FA)and the sensitivity of conventional pulse oximetry (CPO) with Masimo Signal Extraction Technology (Masimo SET; Masimo Corporation, Irvine, CA) in children in the postanesthesia care unit. Disposable oximeter sensors were placed on separate digits of one extremity. Computerized acquisition of synchronous data included electrocardiograph heart rate, SpO(2), and pulse rate via CPO and Masimo SET. Patient motion, respiratory, and other events were simultaneously documented. SpO(2) tracings conflicting with clinical observations and/or documented events were considered false. These were defined as 1) Data dropout, complete interruption in SpO(2) data; 2) False negative, failure to detect SpO(2) </= 90% detected by another device or based on observation/intervention; 3) FA, SpO(2) </= 90% considered artifactual; and 4) True alarm (TA), SpO(2) </= 90% considered valid. Seventy-five children were monitored for 35 +/- 22 min/patient (42 h total). There were 27 TAs, all of which were identified by Masimo SET and only 16 (59%) were identified by CPO (P < 0.05). There was twice the number of FAs with CPO (10 vs 4 Masimo SET; P < 0.05). The incidence and duration of data dropouts were similar between Masimo SET and CPO. Masimo SET reduced the incidence and duration of FAs and identified a more frequent incidence of TAs compared with CPO. IMPLICATIONS: Pulse oximetry that incorporates Masimo Signal Extraction Technology (Masimo Corporation, Irvine, CA) may offer an advantage over conventional pulse oximetry by reducing the incidence of false alarms while identifying a higher number of true alarms in children in the postanesthesia care unit.

Anesthesia↗
PubMed2000

Plastic bronchitis occurring late after the Fontan procedure: treatment with aerosolized urokinase.

OBJECTIVE: To describe the use of aerosolized urokinase in a patient with plastic bronchitis after a Fontan procedure. DESIGN: Case report. SETTING: Pediatric intensive care unit in a university-affiliated children's hospital. PATIENTS: Report of one patient with acute respiratory failure secondary to plastic bronchitis. INTERVENTIONS: Aerosolized urokinase, multiple bronchoscopies, corticosteroids, mucolytics, bronchodilators, and atrial pacing. MEASUREMENTS AND MAIN RESULTS: Airway obstruction secondary to recurring casts improved with the treatments. Histologic analysis of the casts demonstrated less fibrin after treatments with aerosolized urokinase. No adverse events were noted. CONCLUSIONS: The addition of aerosolized urokinase to this patient's treatment regimen helped to resolve life-threatening airway obstruction secondary to fibrin casts.

Acute Disease↗
PubMed2000

Kawasaki syndrome in Jamaica.

OBJECTIVE: To determine the epidemiology, management and outcome of Kawasaki syndrome in patients presenting to the major referral centers in Jamaica (population, 2.5 million) from May, 1986, through June, 1998. DESIGN AND METHODS: Retrospective review of all cases of Kawasaki syndrome in major referral centers island wide. American Heart Association diagnostic criteria were used in case definition. Demographic, clinical diagnostic and laboratory data, management and outcome findings were analyzed. RESULTS: Of 98 probable cases 57 were diagnosed with definite Kawasaki syndrome. The average annual incidence was 2.7 per 100,000 children in the 0- to 5-year age group, in a predominantly black population. Eighty-one percent of cases were from the Kingston Metropolitan area (population, 800,000). Children in the first 3 years of life were represented by 67% of cases, with a mean age of presentation of 32 months (range, 5 to 120 months). There was a male preponderance (M:F ratio, 1.71:1). The mean time between onset of illness and diagnosis was 9.1 days (SD 3.9 days). The most common presenting clinical features included fever, anorexia, vomiting, conjunctivitis, exanthema and oropharyngeal and peripheral extremity changes (>45% of patients). Only 7 children received treatment with intravenous gamma-globulin. Overall 38.8% of patients had cardiovascular changes and 28% had coronary artery abnormalities. Girls (8 of 21, 38.1%) were significantly more likely to have coronary changes than boys (8 of 36, 28.5%) [P < 0.05]. Two (3.5%) patients experienced a recurrence. CONCLUSION: There is a tendency for late recognition and, hence, failure of treatment of Kawasaki syndrome in Jamaica. Greater awareness of the condition needs to be implemented. The finding of female children with an increased occurrence of coronary abnormalities warrants further investigation.

Child, Preschool↗
PubMed2000

General traits of personality and affectivity as predictors of satisfaction in intimate relationships: evidence from self- and partner-ratings.

Self- and partner-ratings on trait affect and the Big Five were obtained from 74 married and 136 dating couples. The relationship satisfaction of each person (the "target") was correlated with four sets of ratings: (a) target's self-rated personality, (b) target's partner-rated personality, (c) partner's self-rated personality, and (d) partner's target-rated personality. Self- and partner-ratings of the target's personality yielded very similar results. Negative and positive affectivity were consistent predictors of satisfaction in both samples. Conscientiousness and agreeableness were reliably related to satisfaction in the dating couples, whereas extraversion consistently correlated with satisfaction in the married couples. These traits jointly predicted as much as 34% (self-ratings) and 26% (partner-ratings) of the variance in satisfaction. In contrast, the partner's personality played a lesser role in satisfaction.

Adult↗
PubMed2000

A three-factor model of trait anger: dimensions of affect, behavior, and cognition.

The structure of trait anger was tested in a study of 24 self-report scales. Exploratory factor analyses in an undergraduate sample (N = 457) yielded a two-factor model (comprising cynicism and aggression) and a three-factor model (representing angry emotions, aggressive behaviors, and cynicism). Subsequent evaluations, including confirmatory factor analyses, indicated that the three-factor model provided the best characterization of the trait anger domain. The three-factor solution was consistent with an "ABC" conceptualization of trait anger, consisting of the dimensions of affect, behavior, and cognition. The three factors showed strikingly different associations with the Big Five personality traits. Angry Affect was most strongly related to Neuroticism, whereas Behavioral Aggression was associated with low Agreeableness. Cynical Cognition represented a blend of neurotic and disagreeable characteristics. Modest mean-level differences were observed between the genders for each factor.

Adolescent↗
PubMed2000

Personality traits and self-care in adults awaiting renal transplant.

This article reports the pretransplant findings of the first phase of a three-phase, longitudinal study examining relationships among personality traits and self-care abilities and behaviors of Ontario adults pre- and post-renal transplant. A consortium of Ontario nurse researchers representing three of Ontario's five renal transplant centers conducted this research. All adults on the cadaver transplant lists of 15 Ontario dialysis centers were invited to participate. One hundred ninety-eight adults awaiting renal transplant were enrolled in the study, representing a 70% response rate. A cross-sectional, correlational design was used for the pretransplant phase. Self-report measures with known psychometric properties were used; validity and reliability of the measures were supported by the sample. Data were analyzed using descriptive approaches, correlational analyses, multiple regression, and path analysis. Relationships were supported among selected personality traits, health state and self-care abilities and behaviors. Further research to examine personality traits and health state in relation to adult self-care is warranted.

Activities of Daily Living↗
PubMed2000

Effect of ozone treatment on airway reactivity and epithelium-derived relaxing factor in guinea pigs.

Ozone (O(3)) is toxic to respiratory epithelium and causes airway inflammation and hyperreactivity. To evaluate the role of the epithelium in the development of hyperreactivity, we examined in guinea pigs the effects of inhaled O(3) (3 ppm for 1 h; 0-24 h after exposure) on 1) reactivity to inhaled methacholine (MCh), 2) reactivity of the isolated, perfused trachea (IPT) to MCh, 3) epithelium-derived relaxing factor (EpDRF)-mediated relaxations of IPT induced by mucosal hyperosmolar solutions, 4) neurogenic contraction and relaxation responses, 5) transepithelial potential difference, and 6) microscopic analysis of nitrotyrosine immunofluorescence, substance P fiber density, and tracheal morphology. At 0 h, O(3) caused hyperreactivity to inhaled MCh and mucosally but not serosally applied MCh in IPT (only in the presence of the epithelium) and a decrease in transepithelial potential difference. Inhibition of EpDRF-induced relaxation responses occurred at 2 h. All of these changes returned to control by 12 to 18 h. O(3) had no effect on neurogenic responses. Nitrotyrosine immunofluorescence appeared in the trachea at 0 h in detached epithelial cell ghosts and in intrapulmonary airways by 6 h. Substance P fiber density was elevated in smooth muscle at 0 and 18 h but not in epithelium or lamina propria of intrapulmonary and extrapulmonary bronchi. Loss of cilia and mucosubstances in the mucosa occurred at 0 h; the epithelium became markedly attenuated over 12 to 24 h. A reversible increase in epithelial permeability and a decrease in EpDRF production may contribute to O(3)-induced hyperreactivity to MCh.

Animals↗
PubMed1999

Pharmacokinetics of the nitric oxide synthase inhibitor L-NG-methylarginine hydrochloride in patients with septic shock. Glaxo Wellcome International Septic Shock Study Group.

OBJECTIVES: To characterize the pharmacokinetics of L-NG-methylarginine in patients with septic shock. METHODS: This was an international, uncontrolled, open-label study of L-NG-methylarginine (546C88) therapy given to 32 patients with septic shock. It was conducted in hospital-based intensive care units that admit general surgical and medical patients. Patient cohorts received an infusion of L-NG-methylarginine at fixed dose rates of 1, 2.5, 5, 10, and 20 mg/kg/h for up to 8 hours. The 5 dosing regimens were administered sequentially to separate groups of patients. RESULTS: Of the 32 patients studied, 23 received complete 8-hour infusions. In the other 9 patients, the infusion was terminated prematurely within the first 1/2 to 4 hours. Median clearance of L-NG-methylarginine averaged 485 mL/h/kg for the 1 and 2.5 mg/kg/h dosing cohorts combined but decreased to 283, 181, and 98 mL/h/kg for the 5, 10, and 20 mg/kg/h dosing cohorts, respectively. Median renal clearance was similar at 9 to 26 mL/h for the 1, 2.5, and 5 mg/kg/h dosing cohorts but increased to 156 and 284 mL/h for the 10 and 20 mg/kg/h dosing cohorts, respectively. Median steady-state volume of distribution was similar in all 5 dosing cohorts, averaging 0.66 to 0.82 L/kg. CONCLUSIONS: The 80% decrease in clearance from 485 to 98 mL/h/kg with the increase in dose suggests that a predominant metabolic pathway(s) of L-NG-methylarginine, accounting for at least 80% of clearance, is becoming progressively saturable in association with L-NG-methylarginine infusion rates > or = 5 mg/kg/h. Therefore the use of L-NG-methylarginine infusion rates > or = 5 mg/kg/h are typically expected to result in progressive inhibition of nitric oxide synthase activity. Consequently, patient hemodynamics should be monitored closely to avoid an excessive increase in vasomotor tone, which would be manifest by either an increase in mean arterial pressure or a decrease in cardiac output. The infusion rates of conventional vasopressor(s) (eg, norepinephrine [BAN, noradrenaline]) or L-NG-methylarginine or both may need to be reduced accordingly.

Adult↗
PubMed1999

Dedicated psychiatric care within general practice: health outcome and service providers' views.

Health service reforms have led to relocation of care of the chronic mentally ill from institutions to the community, with subsequent demands on the primary health care team. Few studies have attempted to identify satisfactory models of care for this patient group. This study explores the impact of the employment of a community psychiatric nurse (CPN) by a general practice in Aberdeen city to co-ordinate care of discharged long-stay psychiatric patients resettled in hostels. A similar general practice with a comparable group of registered patients was selected as a control group. Patient health outcome was measured using the Health of the Nation Outcome Scales (HoNOS) and service providers' views on dedicated psychiatric care within general practice were explored using qualitative methods. Improvements in communication, liaison and drug management were reported in the intervention practice. A primary care-based CPN service dedicated to the care of the chronic mentally ill promoted a smooth transfer of care from long-term institutionalized care to the community setting.

Adult↗
PubMed1999

Improving the social responsiveness of medical schools: lessons from the Canadian experience.

The recent Canadian experience in promoting social accountability and social responsiveness of medical schools has been one of steady improvement in certain institutions, against a background lacking overall national policy direction. Canada has several distinct advantages in trying to devise means of enhancing social accountability of medical training and health services, including a strong national system of publicly supported and financed health care of high quality, a network of excellent academic medical centers, and well-established accreditation bodies. A review of the literature, complemented by a new survey of Canadian medical schools, confirms that some of the centers, conscious of the need to promote social responsiveness, are developing innovative programs to do so. Future progress toward the goal of social responsiveness of medical schools on a pan-Canadian basis will require a more cohesive approach involving systematic sharing of best practices among academic health centers, effective alliances with other health professionals to promote these objectives, and support by federal and provincial ministries of health. Canadian awareness of an international movement tending to similar objectives would support the efforts of Canadian health professionals engaged in practices of enhanced accountability.

Canada↗
PubMed1999

An open-label dose escalation study of the nitric oxide synthase inhibitor, N(G)-methyl-L-arginine hydrochloride (546C88), in patients with septic shock. Glaxo Wellcome International Septic Shock Study Group.

OBJECTIVE: To assess the effects of the nitric oxide synthase inhibitor, 546C88, in patients with septic shock and to evaluate the range of dose rates that sustain mean arterial pressure (MAP) of > or =70 mmHg. DESIGN: Multicenter, open-label, uncontrolled, dose range finding study. SETTING: Ten intensive care units in Europe and the United States. PATIENTS: Thirty-two patients with septic shock diagnosed within <24 hrs. INTERVENTIONS: Patients received a fixed dose rate of 546C88 at either 1(n = 6), 2.5 (n = 6), 5 (n = 4), 10 (n = 5), or 20 mg/kg/hr (n = 11) by intravenous infusion for up to 8 hrs. Conventional vasoactive therapy was restricted to norepinephrine and/or dobutamine. During 546C88 therapy, MAP was to be maintained between 70 and 90 mm Hg, while attempting to withdraw any concurrent norepinephrine. MEASUREMENTS AND MAIN RESULTS: Systemic and pulmonary hemodynamics, blood gases, and plasma nitrate were assessed. Infusion of 546C88 (1-20 mg/kg/hr) for up to 8 hrs enabled a 60 to 80% reduction of the norepinephrine dose rate in all cohorts, while MAP was sustained at >70 mm Hg. There was an increase in vascular tone and a decrease in cardiac index within the 1st hr of therapy. Systemic vascular resistance returned toward baseline with reduction of concomitant administration of norepinephrine. The decline in oxygen delivery was associated with an increase in extraction and, therefore, the maintenance of oxygen consumption. There was a sustained reduction of venous admixture within the 1st hr of therapy. 546C88 was not associated with any major or dose-dependent adverse effect on pulmonary, hepatic, or renal function. CONCLUSIONS: Treatment with the nitric oxide synthase inhibitor, 546C88, can restore the balance of vasomotor tone, thereby, maintaining blood pressure and reducing or eliminating the requirement for norepinephrine therapy in patients with septic shock. Infusion of 546C88 (1-20 mg/kg/hr) appears to have a satisfactory overall safety profile.

Adult↗