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Biomedical subjects

H Davies

Publications and source records attributed to H Davies.

At least 19 recordsLinked to original sources

Induction of cytotoxic T lymphocytes with peptides in vitro: identification of candidate T-cell epitopes in human papilloma virus.

A set of overlapping peptides corresponding to the L1, E6, and E7 proteins of human papilloma virus 16 was tested for their ability to bind to major histocompatibility complex class I molecules and to stimulate cytotoxic T-lymphocyte (CTL) responses in vitro. A class I binding assay using intact RMA-S cells showed that 20 of the 99 human papilloma virus peptides bound to H-2Kb and/or Db molecules. Fifteen of the 20 class I-binding peptides stimulated primary CTL responses, whereas peptides that were negative in the binding assay failed to do so. Peptide-induced CTLs recognized the immunizing peptide very efficiently, requiring no more than 1-10 nM peptide for target cell lysis. However, two observations were made that have important implications for the design of peptide-based vaccines for inducing CTLs. (i) Not all major histocompatibility complex-binding peptides that contained known motifs characteristic of naturally processed peptides induced CTLs. (ii) The efficiency of CTL lysis was strongly decreased when the size of the target peptide differed by only one amino acid residue from that of the immunizing peptide. We conclude that peptides chosen for vaccination must correspond in length to naturally processed peptides.

Animals

Evaluation of the immunogenicity of attenuated feline calicivirus vaccines by ELISA.

An ELISA test was developed to measure the levels of IgG antibody in specific-pathogen-free (SPF) cats immunised with two doses of an attenuated feline calicivirus (FCV) vaccine. All eight vaccinates were protected from virus challenge, but four out of five non-vaccinates were not. There was a significant difference in respect of protection from virus challenge between SPF cats with and without three-fold or greater increase in antibody units (P = 0.01). Each serum absorbance was standardised against the reference positive which has an arbitrary value of 100 antibody units. In SPF cats, the 99% confidence level for seropositivity to FCV was determined as greater than or equal to 2.5 antibody units. The results suggest that the sensitive ELISA test can be used to monitor the antibody status of SPF cat colonies prior to FCV vaccine trials, and to measure the immunogenicity of attenuated FCV vaccines. Thus, the ELISA test may replace the need for virus challenge, with consequent reduction in animals used in future FCV vaccine trials.

Animals

The Achilles Functional Index.

The literature regarding the management of spontaneous rupture of the Achilles tendon is controversial and confusing. The relative infrequency of the condition in any one center prohibits the completion of well-designed clinical studies. Many of the disputes could be addressed and innovations tested if an appropriate animal model were available. We present a method for evaluating Achilles tendon function from measurements of the prints, preserved in bromphenol-blue-impregnated photocopying paper, of the hindfeet of walking rats. The stimulus for this study was derived from de Medinaceli's method for assessing the functional condition of rat sciatic nerves (de Medinaceli L, Freed WJ, Wyatt RJ: An index of the functional condition of rat sciatic nerve based on measurements made from walking tracks. Exp Neurol 77:634-643, 1982). Four variables were measured from these walking tracks, and comparisons between the damaged (experimental) and intact (normal) side were converted to proportional deficits. The relative contribution of each parameter to the overall deficit was determined by multiple linear regression analysis, and the variables were weighted accordingly to obtain an "Achilles Functional Index" (AFI). A sham operation produced no functional deficit, whereas animals subjected to a 0.5-cm midsubstance Achilles tendon defect demonstrated a markedly impaired AFI. Animals with repaired transected Achilles tendons also demonstrated a significant, but less severely impaired AFI. The functional deficit in this repair group returned to control values by postoperative day 15, whereas animals with a defect remained impaired at day 15. Furthermore, an excellent correlation was found between the functional recovery and biomechanical properties (ultimate failure load) of the healing tendon (r = 0.94; p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Achilles Tendon

The functional recovery of peripheral nerves following defined acute crush injuries.

This study evaluates the effect of crushing load on functional recovery of the sciatic nerve. Male Sprague-Dawley rats were divided into five groups: sham operation, resected sciatic nerve, and 100 g (13 mm Hg/mm2), 500 g (50 mm Hg/mm2), and 15,000 g (1,000 mm Hg/mm2) of sciatic crush load (groups 1-5). In groups 3-5, a 5-mm segment of sciatic nerve was crushed for 10 min using a specially designed crushing device. Motor functional recovery was assessed from hind-limb walking tracks by calculating a sciatic functional index. There was no detectable functional deficit in the group receiving sham operations, while the resected sciatic nerve group exhibited complete dysfunction for the full duration of the experiment. All groups subjected to crush exhibited an initial deficit that gradually recovered to normal by day 14 (100-g crush), day 39 (500-g crush), and day 53 (15,000-g crush). Histological changes were also related to the initial crushing load and the length of the recovery period. Results indicate that the crushing device described is able to administer an adjustable, defined crush injury to the rat sciatic nerve, and that the functional deficit resulting from such an injury can be easily monitored with a sciatic functional index. The rate of recovery of crushed nerves was directly related to the initial load. All crushed nerves recovered in this experiment, even after the application of a 15,000-g load for 10 min.

Animals

Effect of posture on regional ventilation in children.

Little information has been published concerning the pattern of regional ventilation in children, yet many differences in lung and chest wall mechanics in childhood, supported by clinical observation, have led to the hypothesis that the pattern of regional ventilation seen in children may not be the same as in adults. Forty-three children and 16 adult volunteers underwent Krypton (Kr) 81m radionuclide ventilation lung scans in the supine and right and left decubitus postures. In children aged 2-10 years mean fractional ventilation to the right lung (VfR) was 46.1%. This fell to 36% when dependent and rose to 56.1% in the uppermost position. Redistribution of ventilation away from the dependent towards the uppermost lung was seen in all children. In children aged 10-18 years VfR was 57.2% (supine), 48.0% (dependent), and 62.9% (uppermost). An identical pattern was seen in children with normal or abnormal pulmonary function tests (peak expiratory flow rate, and FEV1: FVC ratio). In subjects over 18 years of age a different pattern was seen: mean VfR was 52.4% (supine), rising to 53.4% (dependent), and falling to 48.9% (uppermost). Postural redistribution of ventilation, as assessed by Kr81m ventilation imaging, changes late in the second decade of life. This will have clinical consequences in the management of children with unilateral lung disease.

Adolescent

Definition of linear antigenic regions of the HPV16 L1 capsid protein using synthetic virion-like particles.

Mice of three haplotypes (H-2d, H-2b, and H-2d/b) were immunized with synthetic HPV16 virus-like particles (VLPs), produced using a vaccinia virus doubly recombinant for the L1 and L2 proteins of HPV16. The resultant anti-VLP antisera recognized HPV16 capsids by ELISA assay and baculovirus recombinant HPV16 L1 and L2 protein on immunoblot. Overlapping peptides corresponding to the HPV16 L1 amino acid sequence were used to define the immunoreactive regions of the L1 protein. The majority of the L1 peptides were reactive with IgG from the mice immunized with the synthetic HPV16 capsids. A computer algorithm predicted seven B epitopes in HPV16 L1, five of which lay within peptides strongly reactive with the murine antisera. The murine anti-VLP antisera failed to react with the two peptides recognized by anti-HPV16L1 monoclonal antibodies raised by others against recombinant L1 fusion protein. We conclude that the immunoreactive epitopes of HPV16 defined using virus-like particles differ significantly from those defined using recombinant HPV16 L1 fusion proteins, which implies that such fusion proteins may not be the antigens to look for HPV16L1 specific immune responses in HPV-infected patients.

Amino Acid Sequence

An analysis of paediatric diagnostic decision-making: how should students be taught?

This study assesses the relative importance of history, examination and investigations in paediatric diagnosis, in the Paediatric Out-patient Department of the Central Middlesex Hospital, London, by means of a questionnaire-based record of 94 consecutive referrals. A diagnosis identical to the final diagnosis was made in 76% of referrals after taking a history. The general practitioner had proposed a diagnosis in 45% in the referral letter. Clinical examination changed the diagnosis in only 15% but increased diagnostic confidence in 33%. Ninety-one per cent of cases were diagnosed without recourse to investigations. Forty-two per cent of children referred had investigations performed. In the majority of paediatric cases the provisional diagnosis reached after taking a history was identical to that after examination or results of investigations were known. Although examination provided a final diagnosis in only 15% of all cases it played an important role in adding confidence in 33%. More educational effort should therefore be directed at clinical history-taking skills and the subsequent purpose of examination.

Clinical Competence

Can dynamic krypton-81m imaging separate regional ventilation and volume?

This study explores the assumption that 81mKr static images represent regional ventilation. Dynamic acquisition of 81mKr ventilation images permits creation of time-activity curves and the possible separation of the confounding influences of ventilation and volume. By using a two-compartment gas mixing lung phantom, the results demonstrate that both total and tidal 81mKr are closely related to regional ventilation. In 61 children and 15 adult volunteers, there was good agreement between fractional ventilation assessed by total and tidal 81mKr. The dynamic steady-state ventilation image can be analyzed to separate tidally exchanged and resident 81mKr. This may allow regional ventilation to be distinguished from regional volume.

Adolescent

Adenine photodimerization in deoxyadenylate sequences: elucidation of the mechanism through structural studies of a major d(ApA) photoproduct.

The mechanism of the photodimerization of adjacent adenine bases on the same strand of DNA has been elucidated by determining the structure of one of the two major photoproducts that are formed by UV irradiation of the deoxydinucleoside monophosphate d(ApA). The photoproduct, denoted d(ApA)*, corresponds to a species of adenine photodimer first described by Pörschke (Pörschke, D. (1973) J.Am.Chem.Soc. 95, 8440-8446). From a detailed examination of its chemical and spectroscopic properties, including comparisons with the model compound N-cyano-N1-(1-methylimidazol-5-yl)formamidine, it is deduced that d(ApA)* contains a deoxyadenosine unit covalently linked through its C(8) position to C(4) of an imidazole N(1) deoxyribonucleoside moiety bearing an N-cyanoformamidino substituent at C(5). On treatment with acid, d(ApA)* is degraded with high specificity to 8-(5-amino-imidazol-4-yl)adenine whose identity has been confirmed by independent chemical synthesis. It is concluded that the primary event in adenine photodimerization entails photoaddition of the N(7)-C(8) double bond of the 5'-adenine across the C(6) and C(5) positions of the 3'-adenine. The azetidine species thus generated acts as a common precursor to both types of d(ApA) photoproduct which are formed from it by competing modes of azetidine ring fission.

Adenine

The induction of cytotoxic T-lymphocyte precursor cells by recombinant vaccinia virus expressing human papillomavirus type 16 L1.

Expression of the major coat protein L1 of human papillomavirus type 16 by recombinant vaccinia viruses using a vaccinia late promoter and their use in generating antibodies have already been reported (Zhou et al., 1990). We have now constructed recombinant vaccinia viruses (VVs) which express the L1 protein from an early promoter with the intention of inducing cell-mediated immunity. This necessitated the removal of sequence motifs (TTTTTNT) from the L1 gene which would otherwise have caused transcription termination when expressed from a vaccinia virus early promoter. The nucleotide sequence was mutated to retain the correct amino acid sequence of the L1 protein. Full-length mRNA and L1 protein were generated in cells infected with the recombinant virus containing the mutant sequence, whereas the wild-type sequence generated only truncated mRNA and no detectable protein. Mice were immunized with VV expressing L1 from the mutant sequence and from the wild-type sequence in constructs with either early or late vaccinia virus promoters. Only the early promoter constructs were effective in priming cytotoxic T lymphocytes (CTL). Moreover the mutant sequence was significantly more effective than the wild-type sequence. The same L1 sequences, expressed from a vaccinia virus late promoter or coexpressed with MHC Class I molecules also expressed from a late promoter, produced high levels of L1 protein in both cases but nevertheless failed to elicit CTL activity. This is the first report of an HPV-specific CTL response and we have reaffirmed the importance of choosing the correct promoter and sequence expressed when using recombinant vaccinia viruses to induce cytotoxic T lymphocytes. These data are relevant for the design of vaccines to generate cell-mediated immunity against human papillomavirus infection.

Animals

The coronary arteries of the transplanted human heart: studies of the development of disease based on serial angiography.

291 coronary angiograms were performed routinely 1 to 8 years after cardiac transplantation in 116 patients operated on at Papworth Hospital between January 1979 and September 1986. In this setting, as in others, angiography tends to underestimate the amount of disease present, and the patterns of angiographic abnormality are various. The actuarial probability of freedom from angiographic evidence of coronary occlusion is 79% at 2 years, 76% at 3 years, 60% at 4 years, 57% at 5 years. We have defined two disparate groups designated 'fast disease' and 'slow disease', being respectively those who have angiographic and/or pathologic evidence of disease at two years, and those who have normal coronary angiograms at 5 years. In comparing features of these two groups, donor age, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglyceride level differ, though significantly only for the high density fraction.

Adult

Three wall orbital decompression for Graves' ophthalmopathy via a coronal approach.

Ten patients with dysthyroid eye disease who underwent a three wall orbital decompression procedure performed via a coronal approach were reviewed. The indications, results, complications and surgical techniques involved in this surgery are discussed. We believe that this approach offers a number of advantages over other techniques and has a role in the management of carefully selected patients with dysthyroid eye disease who have severe unilateral or bilateral proptosis, with or without dysthyroid optic neuropathy.

Adult

Cytogenetic studies of leukemic recurrence in recipients of bone marrow allografts.

Cytogenetic studies were made in 20 leukemic patients who relapsed after treatment by allogeneic bone marrow transplantation (BMT). Seven of the eight patients in whom no chromosomal abnormalities were detected in leukemic cells before BMT developed clonal abnormalities after BMT, and in two of these patients two independent clones were observed. Most patients in whom clones were detected before BMT showed evidence of clonal evolution after BMT. Nonclonal abnormalities were also observed in clonal cells. These additional abnormalities, both clonal and nonclonal, were attributed to the effects of total body irradiation received by the patient before BMT. There was no evidence of recurrence of leukemia in donor cells among these patients. We concluded that the cells found in leukemic recurrence were derived from the original leukemic clone.

Adolescent

Atherogenesis and the coronary arteries of childhood.

The coronary arterial intima undergoes a sequence of changes following injury, before the appearance of lipids. Studies of the evolution of coronary arterial pathology in the transplanted human heart defines a pattern which is the stereotype of the artery's response to insult. The first stage is that of intimal hyperplasia and disruption of the internal elastic lamina; the second the migration into the thickened intima of medial smooth muscle cells; the third the incursion of lipids. The end result is atheroma, indistinguishable morphologically from that which is found in the usual setting. The same sequence of arterial events can be sought, and found, in the general population (at least in coronary-prone societies), the first being identifiable commonly in infancy and childhood. These changes, reported in the literature over many years, have been generally assumed to be benign accompaniments of growth and development. They are likely to be the precursors of atherosclerosis and the seat of later lipid deposition, without which that deposition would not occur. The cause(s) of coronary arterial disease are therefore concerned more with these pre-lipid stages than with the lipids themselves, which are complicating rather than causative factors.

Animals

Developing collaborative research between clinical agencies: a consortium approach.

Collaborative research is receiving increased attention because it maximizes scarce resources and can increase research productivity. One form of collaboration, the consortium approach, was used by six hospitals in northern California and Nevada to increase research activity among the agencies. Our experience with this consortium approach is described. Advantages and disadvantages of this approach to facilitate collaborative research are presented. This approach is recommended for clinical agencies in geographic proximity with similar clinical concerns and administrators supportive of research activity.

Humans