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Biomedical subjects

G Watson

Publications and source records attributed to G Watson.

At least 37 records · Page 2Linked to original sources

A glycyl radical solution: oxygen-dependent interconversion of pyruvate formate-lyase.

Pyruvate formate-lyase (PFL) catalyses the non-oxidative dissimilation of pyruvate to formate and acetyl-CoA using a radical-chemical mechanism. The enzyme is enzymically interconverted between inactive and active forms, the active form contains an organic free radical located on a glycyl residue in the C-terminal portion of the polypeptide chain. Introduction of the radical into PFL only occurs anaerobically, and the activating enzyme responsible is an iron-sulphur protein that uses S-adenosyl methionine as cofactor and reduced flavodoxin as reductant. As the radical form of PFL is inactivated by molecular oxygen it is safeguarded during the transition to aerobiosis by conversion back to the radical-free, oxygen-stable form. This reaction is catalysed by the anaerobically induced multimeric enzyme alcohol dehydrogenase. The genes encoding PFL and its activating enzyme are adjacent on the chromosome but form discrete transcriptional units. This genetic organization is highly conserved in many, but not all, organisms that have PFL. Recent studies have shown that proteins exhibiting significant similarity to PFL and its activating enzyme are relatively widespread in facultative and obligate anaerobic eubacteria, as well as archaea. The physiological function of many of these PFL-like enzymes remains to be established. It is becoming increasingly apparent that glycyl radical enzymes are more prevalent than previously surmised. They represent a class of enzymes with unusual biochemistry and probably predate the appearance of molecular oxygen.

Acetyltransferases↗

Are contact laser, interstitial laser, and transurethral ultrasound-guided laser-induced prostatectomy superior to transurethral prostatectomy?

BACKGROUND: In order to assess the value of various new therapeutic modalities in the management of benign prostatic hyperplasia (BPH), we performed a prospective study comparing transurethral resection of the prostate (TURP) to contact Laser, interstitial Laser, and transurethral ultrasound-guided laser-induced prostatectomy (TULIP). METHODS: The following parameters were evaluated preoperatively as well as 3, 6, and 12 months after surgery: prostatic volume, urinary flow rate, postvoid residual volume, and the AUA symptom score. The diagnosis of bladder outlet obstruction was established preoperatively by means of pressure/flow studies which were repeated 1 year after the operation. RESULTS AND CONCLUSIONS: In conclusion, TURP is still the gold standard in the treatment of BPH. The results of TULIP, contact laser, and interstitial laser are about the same. The time intervals within which the patients become free of symptoms, however, vary widely. Contact laser is limited to prostates below 50 cc, while interstitial laser is ideal for patients in poor general health who present with large prostates. Furthermore, our results demonstrate that the only reliable data for determining the degree of posttherapeutic disobstruction can be provided by urodynamic investigations including pressure/flow diagrams.

Humans↗

Comparison of the Chiron Quantiplex branched DNA (bDNA) assay and the Abbott Genostics solution hybridization assay for quantification of hepatitis B viral DNA.

Several assays for quantification of DNA have been developed and are currently used in research and clinical laboratories. However, comparison of assay results has been difficult owing to the use of different standards and units of measurements as well as differences between assays in dynamic range and quantification limits. Although a few studies have compared results generated by different assays, there has been no consensus on conversion factors and thorough analysis has been precluded by small sample size and limited dynamic range studied. In this study, we have compared the Chiron branched DNA (bDNA) and Abbott liquid hybridization assays for quantification of hepatitis B virus (HBV) DNA in clinical specimens and have derived conversion factors to facilitate comparison of assay results. Additivity and variance stabilizing (AVAS) regression, a form of non-linear regression analysis, was performed on assay results for specimens from HBV clinical trials. Our results show that there is a strong linear relationship (R2 = 0.96) between log Chiron and log Abbott assay results. Conversion factors derived from regression analyses were found to be non-constant and ranged from 6-40. Analysis of paired assay results below and above each assay's limit of quantification (LOQ) indicated that a significantly (P < 0.01) larger proportion of observations were below the Abbott assay LOQ but above the Chiron assay LOQ, indicating that the Chiron assay is significantly more sensitive than the Abbott assay. Testing of replicate specimens showed that the Chiron assay consistently yielded lower per cent coefficients of variance (% CVs) than the Abbott assay, indicating that the Chiron assay provides superior precision.

DNA, Viral↗

Problems with double-J stents and nephrostomy tubes.

Double-J stents and nephrostomy tubes are used both to temporize prior to definitive treatment and for long-term relief of ureteral obstruction. Nephrostomy tubes that are correctly placed guarantee relief of obstruction and facilitate intrarenal manipulations but have a number of disadvantages, not least of which is the need for an external collecting bag. Double-J stents obviate the external bag but do not ensure relief of obstruction and have adverse functional and histopathologic effects on the ureter. Despite improvements in materials, no stent is totally resistant to encrustation, and frequent changes are required.

Animals↗

The effects of anabolic steroids on driving performance as assessed by the Iowa Driver Simulator.

The effect of physiologic (100 mg/wk) and supraphysiologic (250 and 500 mg/wk) doses of testosterone cypionate (TC) on automobile driving were studied using the Iowa Driver Simulator. Six normal subject volunteers were studied off TC and on TC once steady-state concentrations were achieved after at least three weeks of dosing. Despite the administration of supraphysiologic testosterone doses, an increase in aggressive driving behavior was not detected. Likewise, corresponding psychometric testing using the Buss-Durkee Hostility Inventory to assess aggression was unable to detect any change in aggression in the test subjects. Although aggressive driving behavior may be increased by testosterone administration, the drug itself may not be responsible for these effects. Supraphysiologic doses greater than 500 mg/wk and a semi-controlled research environment may be necessary to produce this effect since case reports of AAS abuse causing altered driving behavior may be multifactorial in nature.

Adult↗

Sodium picosulphate compared with polyethylene glycol solution for large bowel lavage: a prospective randomised trial.

Mechanical efficiency, patient acceptability and minimal biochemical perturbation are important factors in the choice of lavage solution for bowel preparation. This prospective randomised trial of 59 patients compared a polyethylene glycol bowel lavage solution (Klean Prep) to a sodium picosulphate solution (Picolax) considering their efficacy from both colonoscopists' and radiologists' points of view, patient acceptibility, and plasma biochemical changes. The sodium picosulphate solution was more acceptable to patients than the polyethylene glycol, and resulted in significantly less nausea and vomiting (p = 0.0025), and far fewer consumption difficulties (p < 0.0001). Mean plasma biochemical changes were significantly different for magnesium (p < 0.001), chloride (p < 0.01) and potassium (p < 0.02). Because neither lavage solution displayed a marked advantage for the colonoscopist or radiologist, and sodium picosulphate was more acceptable to patients, sodium picosulphate is the preferred solution for bowel preparation. The changes in plasma biochemistry values are unlikely to cause clinical problems.

Adolescent↗

Contact laser prostatectomy.

Laser prostatectomy is a recent technique that is evolving rapidly. As new techniques develop, it is important to discriminate between those that merely coagulate the prostate, those that vaporise the prostate and those that do a combination of both. Coagulation of the prostate alone results in prolonged obstruction and an increased incidence of urinary tract infection and post-operative dysuria. Vaporisation alone can result in much more rapid dis-obstruction but the procedure is relatively slow. For small prostates this is the treatment of choice. It has not been compared with transurethral incision of the prostate to date. This trial is indeed indicated. Hybrid procedures are increasing in popularity because they have the potential to combine the best aspects of both coagulation and vaporisation. There is relatively rapid coagulation of the bulk of the tissue but the vaporised channel allows more rapid dis-obstruction. This allows the patient to void more rapidly, thereby reducing the catheter time. The duration of dysuria appears to be reduced. These distinctions in the techniques of laser application and the treatment of prostatic outflow obstruction are important.

Follow-Up Studies↗

Spinal phobia: survey results of patient attitudes and preferences regarding anesthesia.

STUDY OBJECTIVE: To determine unbiased patient preferences for either spinal or general anesthesia for upcoming surgeries. DESIGN: Prior to contact with anesthesia personnel, a simple questionnaire was completed by surgical patients to determine their demographic characteristics and previous anesthetic experiences. Their concerns regarding a list of complications of general and spinal anesthesia and their preferences for general or spinal anesthesia if either method could be used were also determined. SETTING: University-affiliated suburban community hospital. MEASUREMENTS AND MAIN RESULTS: The survey was completed by 254 patients. A preference for general over spinal anesthesia was expressed by 80.2% of the patients responding. They expressed significantly more concerns regarding nausea/vomiting, sore throat, feeling sleepy, and death with general anesthesia than with spinal anesthesia. Concerns of back pain, nerve damage and paralysis were statistically related to spinal anesthesia. CONCLUSIONS: This survey shows a strong patient preference for general anesthesia and a phobia for spinal anesthesia.

Anesthesia, General↗

A multicenter, randomized, prospective study of endoscopic laser ablation versus transurethral resection of the prostate.

OBJECTIVES: To assess the safety and efficacy of endoscopic laser ablation of the prostate (ELAP), performed with the Urolase fiber and the neodymium:yttrium-aluminum-garnet laser, compared to transurethral resection of the prostate (TURP) in patients with bladder outflow obstruction secondary to benign prostatic hyperplasia (BPH). METHODS: In this multicenter, prospective, randomized study, a total of 151 patients were treated (ELAP, 76; TURP, 75) of whom 137 completed 1 year follow-up (ELAP, 67; TURP, 70). Safety parameters included measurement of preoperative and 24-hour postoperative sodium, hematocrit, and hemoglobin values and careful monitoring of adverse events. Efficacy was assessed with the American Urological Association symptom score (6), urinary flow rates, and residual urinary volume measurements. RESULTS: There was 1 death in each group during the study period unrelated to the treatment procedure. There was a clinically significant improvement in all efficacy parameters in both groups. Between group comparisons favored TURP in maximum flow rate, residual urinary volume, and symptom score. ELAP had a better safety profile than TURP in the defined safety parameters of drop in hemoglobin and hematocrit values. In 16% of patients, a blood transfusion was required after TURP compared with no transfusions in the ELAP group. Urinary tract infections and dysuria were more frequent in the ELAP group. CONCLUSIONS: ELAP performed with the Urolase fiber is a useful alternative therapy to TURP in patients presenting with bladder outflow obstruction secondary to BPH.

Aged↗

Laser prostatectomy: where are we now, and where should we be going?

Sidefire coagulation of the prostate has been a very successful introduction of laser technology to the treatment of prostate disease. Although bleeding has been reduced, the delayed relief of urinary obstruction and the postoperative dysuria are of concern. Laser vaporization, on the other hand, is probably as good as electrical incision of the bladder neck and is less likely to produce bleeding. The hybrid technique, a combination of vaporization of the gland substance with laser prostatotomies and coagulation, provides early disobstruction with later bulk removal of prostatic tissue. Interstitial coagulation seems to be effective in treating a greater bulk of gland tissue. Urologists need to subdivide prostates according to their size and configuration for a series of clinical trials of various types of laser prostatectomy and comparison with established treatments.

Forecasting↗

A comparative optical analysis of laser side-firing devices: a guide to treatment.

OBJECTIVE: To compare the optical characteristics of five different laser side-firing fibres used to perform deep laser coagulation of the prostate. MATERIALS AND METHODS: The intensity profile, angle of exit and beam divergence from the launch fibre were measured underwater (to simulate endoscopic conditions) for each fibre using both the Helium Neon(633 nm) and Nd:YAG(1064 nm) lasers. RESULTS: The intensity profiles and spot sizes varied among fibres but broadly fell within two groups characterized by large and small footprints (low and high power density). There was a maximum 5.5 fold difference in average power densities between the fibres. CONCLUSIONS: Not all side-firing devices are the same. Variations in the power density profiles among the fibres suggest that the choice of fibre is of critical importance in determining the type of laser tissue interaction (i.e. coagulation or vaporization) that will follow the use of that fibre.

Laser Coagulation↗

A randomized trial of the effectiveness of computer-generated telephone messages in increasing immunization visits among preschool children.

OBJECTIVE: To assess the effectiveness of computer-generated telephone reminder and recall messages in increasing preschool immunization visits. DESIGN: Randomized, controlled trial. SETTING: Fourteen counties in urban and rural Georgia. STUDY PARTICIPANTS: Children (N = 8002) who were younger than 2 years; had telephone numbers listed in preexisting computerized immunization databases; and were due or late for immunization(s) during the 4-month enrollment period. INTERVENTION: Households of children were randomized to receive or not receive a general or vaccine-specific computer-generated telephone reminder or recall message the day before the child was due, or immediately after randomization if the child was late. MAIN OUTCOME MEASURE: The rates of immunization visits during the 30-day follow-up period. RESULTS: Of the 4636 children whose households were randomized to receive a message, 1684 (36.3%) visited the health department within 30 days compared with 955 (28.4%) of the 3366 children whose households were not contacted (risk ratio [RR] = 1.28; 95% confidence interval [CI] = 1.20 to 1.37; P < .01). Immunization visits were more frequent (41.1%) among the 3257 children whose households actually received the message (RR = 1.45; 95% CI = 1.36 to 1.56; P < .01). Improvement in immunization visits was similar for general and specific messages, greater for recall than reminder messages, and greatest for children who were late for the third dose of the diphtheria-tetanus-pertussis vaccine and the measles-mumps-rubella vaccine. CONCLUSION: These data suggest a simple and effective way to increase preschool immunization visits, particularly for vaccines associated with the lowest immunization rates.

Catchment Area, Health↗

Use of somatic cell hybrids and fluorescence in situ hybridization to localize the functional serum amyloid A (SAA) genes to chromosome 11p15.4-p15.1 and the entire SAA superfamily to chromosome 11p15.

The serum amyloid A (SAA) superfamily consists of two acute phase genes, SAA1 and SAA2; a pseudogene, SAA3; and a constitutively expressed gene, SAA4. The SAA proteins, which are found associated with high-density lipoprotein, are believed to have an essential function. Chronic infection, inflammation, or trauma causes very high levels of the acute phase SAA proteins. This may result in the potentially fatal condition, amyloidosis, in which amyloid fibrils are deposited in the essential organs. Somatic cell hybrids have been used by several groups to map one or more of the SAA genes to chromosome 11p. We used FISH analysis and PCR amplification of DNA from 17 somatic cell hybrids carrying all or part of chromosome 11 as their only human component to fine map systematically the chromosomal location of the entire SAA superfamily. We demonstrate by these methods that the location of the entire SAA superfamily is at 11p15. Furthermore, we have demonstrated that SAA1, SAA2, and SAA4, i.e., all of the functional genes of the superfamily, map within this region to chromosome 11p15.4-p15.1.

Animals↗

A strategy for trauma debriefing after railway suicides.

Following an increase in the incidence of railway suicide from an average of four events a year up to 1989 to 12 in 1990 an initiative was developed between the District Department of Clinical and Community Psychology, Exeter Health Authority and British Rail, Western Region. Traincrew leaders and management had become increasingly aware of the severity of the short- and long-term effects on drivers of experiencing a suicide. Although a management strategy had been developed over time to deal with what had been a rare phenomenon it was clear that such a dramatic increase in suicides warranted a more professional approach to debriefing and trauma counselling. This paper describes the strategies adopted by psychologists in developing an understanding of the stresses of experiencing suicides and other major incidents. The outcome of small group sessions with affected drivers is outlined. An account of the strategy developed through workshops with traincrew leaders is detailed and a three-stage debriefing (shock, search, adjustment) and follow-up protocol is discussed. This process is proposed for adoption as normal procedure following suicides or similar traumas for drivers and line managers.

Adaptation, Psychological↗

The fifth serum amyloid A-related gene sequence, GSAA4, is SAA3.

The human serum amyloid A (SAA) gene family consists of two acute phase genes, SAA1 and SAA2; a pseudogene, SAA3 and a fourth gene, SAA4. The existence of SAA4 was first described in this laboratory. Subsequently, Sack & Talbot isolated a clone, designated GSAA4, which had homology to SAA3. The clone was described as the same as SAA4 and was characterized as a pseudogene. However, our restriction site and sequence analyses of SAA4 demonstrated that SAA4 and GSAA4 are separate entities. SAA4 encodes a functional, constitutively expressed protein. Recently, the GSAA4 clone has been reported by Sellar & Whitehead as constituting a fifth SAA-related sequence. However, we have demonstrated that GSAA4 has striking homology with the 3' terminus of SAA3 in the reverse orientation. Furthermore, computer analyses strongly indicate that the GSAA4 or fifth SAA-related sequence is in fact, a clone from the SAA3 locus. We have amplified, isolated and sequenced fragments from genomic DNA which demonstrate that the GSAA4 sequence is the correct sequence of the 3' region of SAA3. The SAA family must therefore still be viewed as consisting of four SAA loci at present.

Amino Acid Sequence↗

ANTAGONISTIC FREQUENCY TUNING OF HAIR BUNDLES BY DIFFERENT CHEMORECEPTORS REGULATES NEMATOCYST DISCHARGE

Sea anemones capture prey by discharging nematocysts into them. Chemical and mechanical cues identify suitable prey to sensory receptor systems on the anemone. Conjugated N-acetylated sugars from prey bind to chemoreceptors on cnidocyte/supporting cell complexes to tune hair bundles on the complexes to lower frequencies matching prey movements. The hair bundles regulate discharge of microbasic p-mastigophore nematocysts into vibrating targets. Provided that proline receptors are activated after those for N-acetylated sugars, nematocyst discharge is tuned to much higher frequencies. Thus, anemone hair bundles are tuned to either higher or lower frequencies by antagonistic chemoreceptors. Chemoreceptors for proline can adapt to 10(-8) mol l-1 proline and yet respond to increases in proline concentration of less than 10(-15) mol l-1. Under these conditions, too few molecules of proline are added to activate chemoreceptors on all responding cnidocyte/supporting cell complexes. Evidence indicates that the extreme sensitivity of anemones to proline may be attributed, in part, to intercellular communication.

Journal Article↗