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Biomedical subjects

J A Lunn

Publications and source records attributed to J A Lunn.

At least 19 recordsLinked to original sources

Lysosome recruitment and fusion are early events required for trypanosome invasion of mammalian cells.

Trypanosoma cruzi invades most nucleated cells by a mechanism distinct from classical phagocytosis. Although parasites enter at the lysosome-poor peripheral cell margins, lysosomal markers are immediately incorporated into the parasitophorous vacuole. No accumulation of polymerized actin was detected around recently internalized parasites, and disruption of microfilaments significantly facilitated invasion. Lysosomes were observed to aggregate at the sites of trypanosome attachment and to fuse with the vacuole at early stages of its formation. Experimentally induced, microtubule-dependent movement of lysosomes from the perinuclear area to the cell periphery enhanced entry. Conditions that deplete cells of peripheral lysosomes or interfere with lysosomal fusion capacity inhibited invasion. These observations reveal a novel mechanism for cell invasion:recruitment of lysosomes for fusion at the site of parasite internalization.

Animals

Incidence of pulmonary tuberculosis by occupation of hospital employees in the National Health Service in England and Wales 1980-84.

Examination of occupational health records for National Health Service employees in hospitals in England and Wales for 1980-84 has shown that the incidence of pulmonary tuberculosis has fallen for all occupations. Levels for all occupational groups, except mortuary attendants, are now comparable to or lower than that for the general population. An average of 3 cases of pulmonary tuberculosis would be expected to occur annually amongst the 20,790 staff (including mortuary attendants) classified as being at higher risk and offered annual X-rays. Routine annual X-rays failed to identify 60 per cent of the cases found within this group in this study, the diagnosis being made after individuals presented with clinical symptoms. The falling incidence and low yield from chest X-rays found in this study suggest that the current policy of annual chest X-rays for NHS staff in the higher risk category no longer seems justified.

Cohort Studies

The sick doctor.

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Female

Multiple puncture tuberculin tests: relationship of false negative responses to variations in dried tuberculin coating.

Multiple puncture dried tuberculin tests compare favourably with the standard Mantoux test provided the tips of the metal prongs are thinly and uniformly coated with tuberculin. Unfortunately, surface tension, varying viscosity of the acacia solutions, and deeper dipping depths lead to increased quantities of tuberculin materials adhering to the metal prongs which results in thickening and retraction of the materials on the metal. Solutions of tuberculin in buffered phosphate produce thin and uniform coatings provided adequate cleaning of the metal--especially degreasing--is carried out. In the absence of this the coating layer may fragment. However, provided the distal 0.6-0.8 mm is covered, sufficient tuberculin will be deposited intradermally.

False Negative Reactions

Blood pressure lowering and potassium conservation by triamterene-hydrochlorothiazide and amiloride-hydrochlorothiazide in hypertension.

Effects of once-daily doses of 50 mg triamterene with 25 mg hydrochlorothiazide and 5 mg amiloride with 50 mg hydrochlorothiazide were compared in a randomized, multicenter study of 84 adult subjects with mild to moderate hypertension (diastolic blood pressure 90 to 114 mm Hg). After a 3-wk placebo lead-in period, the subjects entered a 6-wk treatment period. The two drug regimens were compared with respect to antihypertensive effects and effects on serum potassium and magnesium levels during the final week of drug therapy, with the use of the last week of placebo therapy as a covariate. Both drug regimens substantially reduced mean supine systolic and diastolic blood pressures to well within normal limits; there was no significant difference the two groups. Twenty-four of the 41 subjects receiving triamterene-hydrochlorothiazide (59%) and 29 of the 43 patients receiving amiloride-hydrochlorothiazide (67%) had diastolic blood pressure less than 90 mm Hg at week 9. Five subjects receiving amiloride-hydrochlorothiazide (12%) and two subjects receiving triamterene-hydrochlorothiazide (5%) had hypokalemia (serum potassium level less than 3.5 mEq/l) at week 9. The average decrease in serum potassium levels during amiloride-hydrochlorothiazide therapy (-0.33 +/- 0.08 mEq/l) was greater than that after triamterene-hydrochlorothiazide (- 0.08 +/- 0.07 mEq/l). Serum magnesium levels were not changed by either regimen. Weight loss was greater in the amiloride-hydrochlorothiazide group than in the triamterene-hydrochlorothiazide group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Comparison of the tine and Mantoux tuberculin tests. Report of the Tuberculin Subcommittee of the Researched Committee of the British Thoracic Association.

Intracutaneous (Mantoux 5 TU) and tine tuberculin tests were performed on the opposite arms of 307 people. The results of each test were read by two independent observers at either 48 or 72 hours. Positive readings were recorded in 59% of the Mantoux tests; induration was 10 mm or more in 34.7% of cases. Positive readings were recorded for 3.9% of the tine tests, and a further 15.5% were recorded in the doubtful category. The tine test is unsuitable for epidemiological use because of the high proportion of negative and doubtful results in people positive on the Mantoux test. For the same reasons its usefulness in clinical practice is very limited.

False Negative Reactions

Hospital hazards.

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Accident Prevention