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Biomedical subjects

J M Lawrence

Publications and source records attributed to J M Lawrence.

At least 19 recordsLinked to original sources

Lattice disorder and size-induced kondo behavior in CeAl2 and CePt(2+x).

When the size of CeAl2 and CePt(2+x) particles is reduced to the nanometer scale, antiferromagnetism is suppressed and Kondo behavior predominates, with the Kondo temperature T(K) either decreasing (CeAl2) or increasing (CePt(2+x)) relative to the bulk. Local structure measurements show that these nanoparticles are significantly distorted. While such distortions should strongly affect magnetic and electronic properties, we find they cannot explain the observed changes in T(K). Other size-induced changes to the electronic structure must, therefore, play a significant role.

Journal Article↗

Localized excitation in the hybridization gap in YbAl3.

The intermediate valence compound YbAl3 exhibits a broad magnetic excitation in the inelastic neutron scattering spectrum with characteristic energy E1 approximately 50 meV, equal to the Kondo energy (T(K) approximately 600-700 K). In the low temperature (T < T(coh) approximately 40 K) Fermi liquid state, however, a new peak in the scattering occurs at E2 approximately 33 meV, which lies in the hybridization gap that exists in this compound. We report inelastic neutron scattering results for a single-crystal sample. The scattering at energies near E1 qualitatively has the momentum (Q) dependence expected for interband scattering across the indirect gap. The scattering near E2 has a very different Q dependence: it is a weak function of Q over a large fraction of the Brillouin zone and is smallest near (1/2,1/2, 1/2). A possibility is that the peak at E2 arises from a spatially localized excitation in the hybridization gap.

Journal Article↗

Current prospects for adult stem cell-based therapies in ocular repair and regeneration.

Recent advances in stem cell biology have led to the exploration of stem cell-based therapies to treat a wide range of human diseases. In the ophthalmic field, much hope has been placed on the potential use of these cells to restore sight, particularly in those conditions in which other established treatments have failed and in which visual function has been irreversibly damaged by disease or injury. At present, there are many limitations for the immediate use of embryonic stem cells to treat ocular disease, and as more evidence emerges that adult stem cells are present in the adult human eye, it is clear that these cells may have advantages to develop into feasible therapeutic treatments without the problems associated with embryonic research and immune rejection. Here we discuss the current prospects for the application of various adult ocular stem cells to human therapies for restoration of vision.

Adult↗

The effect of high dose atorvastatin therapy on lipids and lipoprotein subfractions in overweight patients with type 2 diabetes.

Few data are available on the effects of high dose statin therapy on lipoprotein subfractions in type 2 diabetes. In a double blind randomised placebo-controlled trial we have studied the effects of 80 mg atorvastatin over 8 weeks on LDL, VLDL and HDL subfractions in 40 overweight type 2 diabetes patients. VLDL and LDL subfractions were prepared by density gradient ultracentrifugation. Triglycerides, cholesterol, total protein and phospholipids were measured and mass of subfractions calculated. HDL subfractions were prepared by precipitation. Atorvastatin 80 mg produced significant falls in LDL subfractions (LDL(1) 66.2 mg/dl:36.6 mg/dl, LDL(2) 118:56.6 mg/dl, LDL(3) 36.9:19.9 mg/dl all P < 0.01 relative to placebo) and VLDL subfractions (VLDL(1) 55:22.1 mg/dl, VLDL(2) 40.1:19.1 mg/dl, VLDL(3) 52.6:30 mg/dl all P < 0.01 relative to placebo). There was no change in the proportion of LDL present as LDL(3). There was a reduction in the proportion of VLDL as VLDL(1) and a reciprocal increase in the proportion as VLDL(3). Changes in VLDL subfractions were associated with changes in lipid composition, particularly a reduction in cholesterol ester and a reduction in the cholesterol ester/triglyceride ratio. Effects on HDL subfractions were largely neutral. High dose atorvastatin produces favourable effects on lipoprotein subfractions in type 2 diabetes which may enhance antiatherogenic potential.

Aged↗

Dependence of the effective masses in YbAl3 on magnetic field and disorder.

The susceptibility and specific heat--and hence the effective mass--of the intermediate valence compound YbAl3 show anomalous enhancement below the Fermi liquid temperature T(coh) approximately 40 K. We show that these anomalies are suppressed by alloying in Yb1-xLuxAl3 indicating high sensitivity to lattice coherence. The de Haas-van Alphen effective masses for key branches of the Fermi surface are reduced by magnetic fields B>40 T. We argue that this reduction does not arise from 4f polarization but reflects renormalization of the quasiparticle states by the field.

Journal Article↗

Evolving neurovascular relationships in the RCS rat with age.

PURPOSE: To examine the course of development of vascular disorders in the Royal College of Surgeons (RCS) rat and how these may lead to retinal ganglion cell loss. METHODS: Whole-mount retinae from RCS rats were first stained for neurofilament protein and then for NADPH-diaphorase staining. A separate group of RCS rats was injected with Type II Peroxidase and the retinae were subsequently processed for peroxidase histochemistry. RESULTS: The first changes in the deep vascular plexus occur as the photoreceptor layer is lost and it comes into close proximity to the retinal pigment epithelial (RPE) cell layer. RPE cells migrate onto retinal vessels, and at such locations vascular complex develop. These are first found ventral to the optic nerve head and then gradually progress over most of the retina. The inner retinal vessels that supply the complexes cross the optic nerve fiber layer and appear to be under tension. They ligate axons, which leads to retinal ganglion cell loss. CONCLUSIONS: These observations show vascular changes can have secondary repercussions for neurons distant from the primary lesion.

Aging↗

Retinal transplantation: progress and problems in clinical application.

There is currently no real treatment for blinding disorders that stem from the degeneration of cells in the retina and affect at least 50 million individuals worldwide. The excitement that accompanied the first studies showing the potential of retinal cell transplantation to alleviate the progress of blindness in such diseases as retinitis pigmentosa and age-related macular degeneration has lost some of its momentum, as attempts to apply research to the clinic have failed so far to provide effective treatments. What these studies have shown, however, is not that the approach is flawed but rather that the steps that need to be taken to achieve a viable, clinical treatment are many. This review summarizes the course of retinal transplant studies and points to obstacles that still need to be overcome to improve graft survival and efficacy and to develop a protocol that is effective in a clinical setting. Emphasis is given particularly to the consequences of introducing transplants to sites that have been considered immunologically privileged and to the role of the major histocompatibility complex classes I and II molecules in graft survival and rejection.

Animals↗

Two energy scales and slow crossover in YbAl3.

Experimental results for the susceptibility, magnetization, specific heat, 4f occupation number, Hall effect, and magnetoresistance for single crystals of the intermediate valence (IV) compound YbAl3 show that, in addition to the Kondo temperature scale T(K) approximately 670 K, there is a low temperature scale T(coh) approximately 30-40 K for the onset of Fermi liquid coherence. Furthermore, the crossover from the low temperature Fermi liquid regime to the high temperature local moment regime is slower than predicted by the Anderson impurity model. We suggest that these effects are generic for IV compounds and we discuss them in terms of the theory of the Anderson lattice.

Journal Article↗

Fluvastatin.

Fluvastatin was the first wholly synthetic statin to the market and is effective in reducing total and low density lipoprotein cholesterol, which translates into reductions in coronary heart disease events. The Lescol Intervention Prevention Study has established the effectiveness of the early use of statins in reducing recurrent events in high-risk patients with coronary heart disease post percutaneous coronary interventions. Fluvastatin is well-tolerated with few side effects. The occurrence of significant abnormalities in liver enzymes is infrequent, and the risk of myositis and rhabdomyolysis seems to be less than with other statins. There have been no reports of fatal rhabdomyolysis to date. The potential for drug interactions with fluvastatin is low. It seems safe in combination with cyclosporin and there have been few reports of rhabdomyolysis when using fluvastatin in combination with other lipid-lowering agents. It is nevertheless important to be vigilant for this potentially important side effect and, as with other statins, inform patients of the potential risk and suggestive symptoms. Fluvastatin provides a useful option in treating hypercholesterolaemia in patients at high risk of coronary heart disease.

Anticholesteremic Agents↗

Screening for diabetes in general practice: cross sectional population study.

OBJECTIVE: To assess the policy proposed by the American Diabetes Association of universal screening in general practice of all patients aged over 45 years for diabetes. DESIGN: Cross sectional population study. SETTING: Local general practice in the United Kingdom. PARTICIPANTS: All patients aged over 45 not known to have diabetes. MAIN OUTCOME MEASURES: Prevalence of diabetes in the screened population, cardiovascular risk profile of patients diagnosed as having diabetes after screening. RESULTS: Of 2481 patients aged over 45 and not known to have diabetes, 876 attended for screening. There were no significant demographic differences between the screened and unscreened patients. Prevalence of diabetes in patients with age as a sole risk factor was 0.2% (95% confidence interval 0% to 1.4%). Prevalence of diabetes in patients with age and one or more other risk factors (hypertension, obesity, or a family history of diabetes) was 2.8% (1.6% to 4.7%). Four hours a week for a year would be needed to screen all people over 45 in the practice's population; about half this time would be needed to screen patients with risk factors other than age. More than 80% of patients newly diagnosed as having diabetes had a 10 year risk of coronary heart disease >15%, 73% (45% to 92%) were hypertensive, and 73% (45% to 92%) had a cholesterol concentration >5 mmol/l. CONCLUSIONS: Screening for diabetes in general practice by measuring fasting blood glucose is feasible but has a very low yield in patients whose sole risk factor for diabetes is age over 45. Screening in a low risk population would best be targeted at patients with multiple risk factors.

Aged↗

Lattice disorder in strongly correlated lanthanide and actinide intermetallics.

Lanthanide and actinide intermetallic compounds display a wide range of correlated-electron behavior, including ferromagnetism, antiferromagnetism, nonmagnetic (Kondo) ground states, and so-called 'non-Fermi liquid' (NFL) behavior. The interaction between f electrons and the conduction band is a dominant factor in determining the ground state of a given system. However, lattice disorder can create a distribution of interactions, generating unusual physical properties. These properties may include NFL behavior in many materials. In addition, lattice disorder can cause deviations from standard Kondo behavior that is less severe than NFL behavior. A review of the lattice disorder mechanism within a tight-binding model is presented, along with measurements of the YbBCu4 and UPd(x)Cu(5-x) systems, demonstrating the applicability of the model. These measurements indicate that while the YbBCu4 system appears to be well ordered, both site interchange and continuous bond-length disorder occur in the UPd(x)Cu(5-x) series. Nevertheless, the measured bond-length disorder in UPdCu4 does not appear to be enough to explain the NFL properties simply with the Kondo disorder model.

Journal Article↗

Columns of Schwann cells extruded into the CNS induce in-growth of astrocytes to form organized new glial pathways.

Our previous work showed that stereotaxic microextrusion of columns of purified peripheral nerve-derived Schwann cells into the thalamus of syngeneic adult rats induces host axons to grow into the column and form a new fiber tract. Here we describe the time course of cellular events that lead to the formation of this new tract. At 2 h postoperation, numerous OX42-positive microglia accumulated at the graft-host interface, after which donor columns became progressively and heavily infiltrated by microglia/macrophages that took on an elongated morphology in parallel with the highly orientated processes of the donor Schwann cells. The penetration of host astrocytic processes into the Schwann cell columns was substantially slower in onset, being first detected at 4 days postoperation. This event was contemporaneous with the in-growth of host thalamic axons. Between 7 and 14 days postoperation, GFAP-positive astrocytes became fully incorporated into the transplants, where they too adopted an elongated form, orientated in parallel with the longitudinal axis of the graft. Thus, the columns became a mosaic of elongated and highly orientated donor Schwann cells intimately mingled with host microglia, astrocytes, and numerous, largely unbranched 200-kDa neurofilament-positive axons from the adjacent thalamus. Electron microscopy demonstrated that the processes of donor Schwann cells and host astrocytes within the column formed tightly packed bundles that were surrounded by a partial or complete basal lamina. Control columns, formed by extruding freeze-thaw-killed Schwann cells or purified peripheral nerve fibroblasts induced a reactive injury response by the adjacent host microglia and astrocytes, but neither host astrocytes nor neurofilament-positive axons were incorporated into the columns. A better understanding of the mechanisms that regulate the interactions between donor and host glia should facilitate improved integration of such grafts and enhance their potential for inducing tissue repair.

Animals↗

Progressive visual sensitivity loss in the Royal College of Surgeons rat: perimetric study in the superior colliculus.

The Royal College of Surgeons rat has a retinal pigment epithelial cell defect which causes a progressive loss of rods occurring primarily over the first few months of life. We have studied the consequences of this degenerative process on visual sensitivity across the visual field. Sensitivities were determined in the superior colliculus for unit responses recorded from 22 days up to one year of age from sites encompassing the whole visual field representation. Following visual sensitivity assessment, retinae were examined anatomically at the light and electron microscopic level. At 22 days of age, sensitivities in dystrophic rats were comparable to those of non-dystrophics at any age (40+/-1 and 41+/-1dB, respectively), despite the fact that signs of degenerative events were clear at the electron microscopic level, including presence of pyknotic photoreceptor nuclei, disorganised outer segments and accumulation of debris. However, loss in sensitivity was first detected only at 28-36 days of age (27+/-4dB). From then on, sensitivities progressively decreased to reach a plateau by 180-240 days (4+/-2dB). Starting around 90 days and onward, there was a positive gradient of sensitivities from temporal to nasal field. Drops in visual sensitivity were parallelled by several changes in visual response properties, including prolonged latency, inconsistent responsiveness, appearance of bursting spontaneous activity and activation of units by stimuli presented outside their classical receptive fields. The measure of visual sensitivities by recording visual responses at specific sites in the superior colliculus provides a reliable point-to-point assessment of retinal function comparable to visual perimetry testing in humans. This experimental approach provides the background for answering questions arising during the development of potential experimental therapies for retinal degeneration using animal models like the Royal College of Surgeons rat.

Animals↗

Cell transplantation as a treatment for retinal disease.

It has been shown that photoreceptor degeneration can be limited in experimental animals by transplantation of fresh RPE to the subretinal space. There is also evidence that retinal cell transplants can be used to reconstruct retinal circuitry in dystrophic animals. Here we describe and review recent developments that highlight the necessary steps that should be taken prior to embarking on clinical trials in humans.

Animals↗

Difficult insulinoma.

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Drug Therapy, Combination↗

Actos (pioglitazone): a new treatment for type 2 diabetes.

Type 2 diabetes is increasingly common and can be difficult to control. By directly targeting insulin resistance, the thiazolidinediones offer a new mode of treatment. Here, the pharmacology, clinical trial evidence, side-effects and current clinical uses of pioglitazone are reviewed.

Adult↗

What can we do about domestic violence?

Domestic violence is a complex issue at both an individual and public health level. Barriers to disclosure often lie with the doctor rather than the victim. Assessment of risk and devising a safety plan are important steps for the doctor to undertake with the victim. Recommendations for joint counselling or marriage guidance for the couple are usually not appropriate. The efficacy of population screening for domestic violence has not yet been demonstrated. More limited opportunistic screening is recommended, especially in the emergency department, mental health and obstetric settings, and general practice. Health professionals can be a bridge to resources within the community, but this requires knowledge of and liaison with those services.

Adult↗