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Biomedical subjects

J Sutherland

Publications and source records attributed to J Sutherland.

At least 37 records · Page 2Linked to original sources
PubMed2000

An exploratory study of information-giving used to promote chlamydial test-seeking by students at a college family planning clinic.

Partnership working, involving workers in various aspects of sexual health and a large UK further education college, took place to give information about genital tract chlamydial infection in order to promote chlamydial urine testing (LC(x) Chlamydia trachomatis Assay Abbott Diagnosis Division) for a limited period at the college's family planning clinic. Female students were more likely to report awareness about the availability of testing and to access the testing service. Uptake of testing was largely contemporaneous with information-giving work and sharply declined after information-giving had ceased. A small population of test seekers (including partners of index cases) was generated, which harvested a rate of genital tract chlamydial infection similar to that found in family planning and genitourinary medicine clinics.

Ambulatory Care Facilities↗
PubMed2000

Mutations in the genes for hepatocyte nuclear factor (HNF)-1alpha, -4alpha, -1beta, and -3beta; the dimerization cofactor of HNF-1; and insulin promoter factor 1 are not common causes of early-onset type 2 diabetes in Pima Indians.

OBJECTIVE: Maturity-onset diabetes of the young (MODY) is a genetically heterogeneous subtype of type 2 diabetes characterized by an early age at onset and autosomal dominant inheritance. MODY can result from heterozygous mutations in at least five genes. The purpose of this study was to determine whether alterations in known MODY genes and two MODY candidate genes contribute to the development of early-onset type 2 diabetes in Pima Indians. RESEARCH DESIGN AND METHODS: The coding regions of the known MODY genes hepatocyte nuclear factor (HNF)-1alpha, HNF-4alpha, HNF-1beta, and insulin promoter factor 1 and the coding regions of two MODY candidate genes, HNF-3beta and the dimerization cofactor of HNF-1, were sequenced in genomic DNA from Pima Indians. The primary "affected" study population consisted of 46 Pima Indians whose age at onset of type 2 diabetes was < or =20 years. DNA sequence variants identified in the affected group were then analyzed in a group of 80 "unaffected" Pima Indians who were at least 40 years old and had normal glucose tolerance. RESULTS: A total of 11 polymorphisms were detected in these genes. However, none of the polymorphisms differed in frequency among Pima Indians with an early age at onset of diabetes compared with older Pima Indians with normal glucose tolerance. CONCLUSIONS: Mutations in these known MODY or MODY candidate genes are not a common cause of early-onset diabetes in Pima Indians.

Adolescent↗
PubMed1999

Intramural anomalous left coronary artery from the right sinus of Valsalva supported with venoarterial extracorporeal membrane oxygenation.

We report the case of a 14-month-old girl with a wide complex dysrhythmia and cardiogenic shock due to abnormal coronary anatomy. She was kept alive for 20 days by full cardiocirculatory support, using venoarterial extracorporeal membrane oxygenation (VA ECMO). While she was on VA ECMO, a diagnosis was made of extensive myocardial infarction and an anomalous left main coronary artery. The patient was listed for heart transplantation and received a donor heart 20 days after beginning VA ECMO. We discuss the unusual presentation and course of the coronary arteries and the use of VA ECMO to support this patient before heart transplantation.

Arrhythmias, Cardiac↗
PubMed1999

Evaluation and comparison of three human monoclonal anti-S, two human polyclonal anti-S, and one murine anti-GPB.

Polyclonal anti-S react with Met29 of red blood cell (RBC)-bound glycophorin B (GPB) but may also require adjacent amino acids. Treatment of RBCs with certain enzymes and sodium hypochlorite-based bleach (NaClO) affect the interaction of GPB with anti-S. Some, but not all, anti-S react with hybrid glycophorin molecules associated with the TSEN antigen. The purpose of this study was to characterize monoclonal anti-S and to compare their reactivity to polyclonal anti-S in order to determine their potential as blood group reagents and research tools. Furthermore, through inhibition experiments, we attempted to define the epitope recognized by the antibodies. Three monoclonal (MS-93; MS-94; MS-95) and two polyclonal (A1958; X1960) anti-S and a monoclonal anti-GPB (Mab 148) were tested by standard hemagglutination with RBCs of known common and rare phenotype, with S+ RBCs treated with enzymes, with different concentrations of NaClO, and after incubation with synthetic peptides. The anti-S gave different patterns of reactivity. Reactivity with sialidase-treated RBCs showed that MS-93, MS-95, Mab 148, and X1960 recognize sialic acid independent epitopes, whereas MS-94 and A1958 require sialic acid for optimal reactivity. MS-95 and X1960 were strongly reactive with TSEN+ RBCs and only Mab 148 agglutinated S- Dantu+ and S- St(a+) RBCs. MS-94 and Mab-148 agglutinated S+ RBCs treated with NaClO. MS-93 was inhibited only by the 14-mer S-specific synthetic peptide whereas MS-95 was inhibited by all three synthetic peptides containing S-relevant residues. This study clearly demonstrates that different anti-S have different characteristics that should be analyzed before selecting monoclonal antibodies for the basis of reagents for use in the clinical laboratory. These anti-S, because of their varied characteristics, will be useful research tools.

Journal Article↗
PubMed1998

Niacin skin flush in schizophrenia: a preliminary report.

The aim of this pilot study was to evaluate a potential skin test for schizophrenia based on the effect of aqueous methyl nicotinate (AMN) on the production of prostaglandin D2 (PGD2) from skin macrophages and the resultant cutaneous capillary vasodilatation. Four concentrations of AMN were applied topically to the forearm skin in patients and controls, and any resulting vasodilatation was rated as redness after 5 min. The test was carried out on 38 patients with schizophrenia diagnosed according to DSM-III-R criteria, and 22 normal control subjects. At all concentrations of AMN, the schizophrenics were highly significantly different from the controls. One concentration gave the greatest degree of differentiation: at this concentration at 5 min, 83% of schizophrenics but only 23% of controls had a zero or minimal response to AMN. The skin flushing seen after oral administration of nicotinic acid is due to the same reaction, and this has been normal in those with affective illness and neurosis; cyclo-oxygenase inhibitors, e.g., aspirin, give a false-positive result (failure of vasodilatation). This result is consistent with the concept of reduced membrane arachidonic acid levels in schizophrenia. This test may contribute to the reliable diagnosis of schizophrenia.

Adult↗
PubMed1998

Impact of carrier status determination for Duchenne/Becker muscular dystrophy by computer-assisted laser densitometry.

Carrier status determination for Duchenne and Becker muscular dystrophies (D/BMD), disorders caused by mutations in the dystrophin gene at Xp21, is complicated by a number of factors. These include a high mutation rate and a 5-10% recombination frequency across the dystrophin gene. For these reasons, linkage analysis frequently gives an inconclusive result, and a direct mutation detection method for females at risk is desirable. Because 65% of the mutations that cause D/BMD are deletions of one or more exons of the dystrophin gene, diagnosis in most affected males is relatively easy using multiplex polymerase chain reaction (PCR) analysis. However, deletion analysis in females is more difficult because of the interference of the normal X chromosome in the deletion assay. We have developed a quantitative PCR-based analysis designated computer-assisted laser densitometry (CALD), which uses the automated fluorescent fragment analysis application of the Applied Biosystems (Foster City, California) automated sequencer. This method has proved to be 100% accurate in retrospective blind studies analysing a total of 351 samples. Subsequent analysis of more than 800 women from more than 400 D/BMD families has shown that a highly accurate carrier risk can be given in more than 90% of cases.

Densitometry↗
PubMed1998

Frequency of somatic and germ-line mosaicism in retinoblastoma: implications for genetic counseling.

Although mosaicism can have important implications for genetic counseling of families with hereditary disorders, information regarding the incidence of mosaicism is available for only a few genetic diseases. Here we describe an evaluation of 156 families with retinoblastoma; the initial oncogenic mutation in the retinoblastoma gene had been identified in these families. In 15 ( approximately 10%) families, we were able to document mosaicism for the initial mutation in the retinoblastoma gene, either in the proband or in one of the proband's parents. The true incidence of mosaicism in this group of 156 families is probably higher than our findings indicate; in some additional families beyond the 15 we identified, mosaicism was likely but could not be proven, because somatic or germ-line DNA from key family members was unavailable. Germ-line DNA from two mosaic fathers was analyzed: in one of these, the mutation was detected in both sperm and leukocyte DNA; in the other, the mutation was detected only in sperm DNA. Our data suggest that mosaicism is more common than is generally appreciated, especially in disorders such as retinoblastoma, in which a high proportion of cases represent new mutations. The possibility of mosaicism should always be considered during the genetic counseling of newly identified families with retinoblastoma. As demonstrated here, genetic tests of germ-line DNA can provide valuable information that is not available through analysis of somatic (leukocyte) DNA.

DNA↗
PubMed1998

Propofol maintenance to reduce postoperative emesis in thyroidectomy patients: a group sequential comparison with isoflurane/nitrous oxide.

The clinical benefit of propofol anaesthesia in the prevention of postoperative nausea and vomiting (PONV) is still being elucidated despite many studies to date. In this study 64 adult female patients scheduled for thyroidectomy received, in a randomized double-blind fashion, propofol with air or isoflurane with nitrous oxide for maintenance of anaesthesia. The primary response variable was the presence or absence of vomiting in the first six hours. A group sequential design was used to allow interim analysis. After 64 patients, the fourth analysis showed that fewer patients receiving propofol vomited or required an anti-emetic during the first six hours (P < 0.05). There was no significant difference detected in the 6 to 24 hour interval. In this group of female patients, total intravenous anaesthesia (TIVA) with propofol is associated with an early reduction in early postoperative vomiting compared with standard inhalational techniques. This reduction in vomiting does not appear to persist beyond the first six hours.

Adult↗
PubMed1998

The immunoglobulin molecule.

Antibodies, or immunoglobulins, have been used for many years in immunohematology and yet the complexity of these molecules is rarely considered. This review concentrates on IgG and IgM molecules, as these are most usually found in transfusion laboratories. The basic structure and function of the immunoglobulin molecule are addressed at both the protein and the gene level, and isotypes, allotypes, and idiotypes are introduced. Although the antibody molecules secreted by each B cell have a unique binding site, a diverse array of immunoglobulin is produced not only by random recombination of the genetic components during assembly of the molecules but also due to somatic mutation. These events, as well as gene restriction, which is often seen in IgM antibodies to blood group antigens, are discussed and some of the differences between monoclonal and polyclonal antibodies are addressed.

Journal Article↗
PubMed1997

Basal nitric oxide synthesis in essential hypertension.

BACKGROUND: There is indirect evidence that nitric oxide (NO) synthesis in vascular endothelium of patients with hypertension is altered. The aim of this study was to estimate more directly NO production in patients with untreated essential hypertension by measurement of synthesis of inorganic nitrate, which is the end product of NO oxidation in humans. Two separate studies were undertaken in patients with hypertension and appropriate healthy controls. METHODS: In the first study, ten patients and 13 controls were given a diet containing 82 mumoles nitrate per day for 2 days, with urinary and plasma nitrate measurement and 24 h ambulatory blood pressure monitoring on the 2nd day. In the second study, 11 patients and 11 controls were studied in the postabsorptive state; a bolus of 200 mg L[15N]2 arginine was administered intravenously over 10 min. 24 h ambulatory blood pressure monitoring was done and complete urine collections were made for the next 36 h. FINDINGS: In the first study, 24 h urinary nitrate excretion was lower in the hypertensive patients than in the control group (mean 450 [SEM 37] vs 760 mumoles [77] per 24 h; p < 0.001). There was an inverse correlation between average mean daytime ambulatory blood pressure and nitrate excretion (p = 0.007; r2 = -0.73). In the second study, mean 36 h urinary 15N nitrate excretion was significantly lower in the hypertensive than in the control group (1313 [50] vs 2133 [142] pmoles; p < 0.001). There was an inverse correlation also between average mean daytime ambulatory blood pressure and 24 h urinary 15N nitrate excretion expressed per mmole of creatinine (p = 0.002, r2 = -0.59). In addition, total urinary 15N nitrate excretion in the hypertensive group was significantly higher in women than in men (285 [16] vs 198 [14] micrograms 15N nitrate per kg; p = 0.026). INTERPRETATION: These data suggest that whole-body NO production in patients with essential hypertension is diminished under basal conditions. The origin of the NO we measured is not known, and we cannot tell whether the impaired synthesis is primary or secondary to a rise in blood pressure.

Adult↗
PubMed1997

A physical map at 1p31 encompassing the acute insulin response locus and the leptin receptor.

Recently, we reported genetic linkage in Pima Indians between the acute insulin response to an intravenous glucose challenge and the short tandem repeat marker D1S198, indicative of a genetic element in this region that controls the phenotypic variation in the first phase of insulin secretion. As a first step to isolating the gene responsible for the acute insulin response, we have constructed a yeast artificial chromosome (YAC) contig map that spans the DNA microsatellites D1S438 through D1S464. The contig comprises 34 YACs on which we have mapped 44 ends of the genomic DNA inserts from the 34 YACs, 13 short tandem repeats, eight expressed sequence tags, and six genes. In addition, we have used this contig to construct a physical map encompassing approximately 9 Mb of DNA in this region.

Carrier Proteins↗
PubMed1997

Suitability of preadmission blood samples for pretransfusion testing in elective surgery.

BACKGROUND: North American transfusion guidelines do not stipulate a time limit between drawing the specimen for pretransfusion testing and giving the transfusion to patients who have not received a transfusion or been pregnant in the preceding 3 months. British guidelines suggest that separated plasma and serum can be stored at -30 degrees C for up to 6 months, but they draw attention to the paucity of evidence concerning the use of stored samples. In Australia, transfusion guidelines recommend a maximum of 10 days' validity for pretransfusion specimens, which requires the patient to present for pretransfusion testing within 10 days of admission or to undergo retesting after admission, which in turn necessitates additional time in the hospital before operation. The study was performed to document the safety of using for pretransfusion testing a blood sample collected more than 10 days before surgery. STUDY DESIGN AND METHODS: Samples from 500 patients scheduled for elective surgery who had not been pregnant or received a transfusion in the previous 3 months were separately tested in blood group and antibody screens at an interval from 11 to 335 days before admission and again on admission. RESULTS: No clinically significant change was detected in the red cell antibody status of the paired samples of any patient. CONCLUSION: For patients who have not been transfused or pregnant in the previous 3 months, it is safe to crossmatch blood for transfusion by using a sample collected well in advance of elective surgery and stored at -30 degrees C.

Blood Grouping and Crossmatching↗
PubMed1997

An uplifting experience? Hospital passenger lifts and their suitability for disabled people.

Hospitals should be welcoming places, and disabled people should not expect difficulties when using a hospital's facilities. For some elderly and disabled people the passenger lift may be the only means of vertical movement within a building. We visited four hospitals and inspected their passenger lifts for use by disabled and elderly people. We compared our findings with those of an "ideal lift' drawn from recommendations by disabled support groups, National Health Services Estates Department and building regulations. We found that most hospital passenger lifts are inadequate for those with mobility, visual and hearing impairments. Consequently, disabled and elderly people might have problems using hospital passenger lifts, with a subsequent loss of independence. The provision of well-designed and accessible passenger lifts is central to imaginative hospital building design.

Persons with Disabilities↗
PubMed1997

Variegate porphyria in South Africa, 1688-1996--new developments in an old disease.

Variegate porphyria, an autosomal dominant inherited trait resulting in decreased activity of protoporphyrinogen oxidase, the penultimate haem biosynthetic enzyme, is characterised clinically by photosensitive skin disease and a propensity to acute neurovisceral crises. The disease has an exceptionally high frequency in South Africa, owing to a founder effect. The specific mutation in the protoporphyrinogen oxidase gene sequence which represents this founder gene has been identified. Genetic diagnosis is therefore now possible in families in whom the gene defect is known. However, the exact nature and degree of activity of the porphyria can only be determined by detailed quantitative biochemical analysis of excreted porphyrins. The relative contributions of the acute attack and the skin disease to the total disease burden of patients with variegate porphyria is not static, and in South Africa there have been significant changes over the past 25 years, with fewer patients presenting with acute attacks, leaving a greater proportion to present with skin disease or to remain asymptomatic with the diagnosis being made in the laboratory. The most common precipitating cause of the acute attack of VP is administration of porphyrinogenic drugs. Specific suppression of haem synthesis with intravenous haem arginate is the most useful treatment of a moderate or severe acute attack. Although cutaneous lesions are limited to the sun-exposed areas, management of the skin disease of VP remains inadequate.

Animals↗
PubMed1995

Truncated and catalytic isoforms of trkB are co-expressed in neurons of rat and mouse CNS.

Localization of mRNA encoding trkB indicates that two truncated isoforms of trkB, T1trkB and T2trkB, are differentially distributed in the rodent nervous system, and that each of these transcripts is co-expressed with catalytic trkB (TK+trkB) in adult motor neurons. In contrast to the prominent expression of T1trkB by non-neuronal cells, T2trkB expression appeared to be restricted to neurons and demonstrated significant overlap with the pattern of TK+trkB distribution. In developing spinal cord ventral horn, an age-related increase in hybridization was observed for truncated isoforms. These findings suggest that truncated trkB may modulate neuronal responses to neurotrophins which act via trkB.

Aging↗