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Biomedical subjects

J Sutton

Publications and source records attributed to J Sutton.

At least 19 recordsLinked to original sources
PubMed2005

Extensive myofascial necrosis: a delayed complication of botulinum toxin therapy.

Botulinum toxin is now an important therapeutic agent in various clinical specialties. Although a lot is known about its short-term effects, little is known about the long-term effects or delayed complications. Most of the therapeutic effects appear within a week and last for 10-12 weeks. In most cases, the side effects are mild and often self-limiting and tend to occur within the first week. Myofascial necrosis and delayed onset of side effects are rarely reported and present a new challenge for a drug that has been proclaimed as an anti-ageing drug by the lay press and is widely used outside the licensed indications.

Journal Article↗
PubMed2003

Developing clinically relevant and reproducible symptom-defined populations for cancer diagnostic research in general practice using a community survey.

BACKGROUND: In developing cancer diagnostic studies, there is a particular need for the population of patients with symptoms of possible oncological significance who consult the GP in 'real life' to be comparable with the group of individuals with symptoms constructed as part of a research project. OBJECTIVES: The objective of this study was to seek to assess whether a community-based symptom survey can be harnessed in order to produce clinically relevant and reproducible populations within which studies of more detailed indicants could be undertaken. METHOD: A total of 3629 patients registered with a general practice at Winterton, UK, were sent a questionnaire enquiring about 10 symptoms of possible oncological significance together with their consultation intention in relation to these symptoms. Up to 1 month later, an identical questionnaire was applied to all patients reporting at least one symptom, and more detailed information was obtained by research nurses on each symptom. RESULTS: The overall response rate was 64.4%, and 850 patients reported one or more symptoms. For the majority of symptom reports, there was moderate to substantial agreement between the two applications of the questionnaire. The question on blood in the motions/toilet pan or on the toilet paper demonstrated almost perfect agreement. Slight agreement was found for abdominal pain for longer than 4 weeks and for black/tarry motions. In relation to the reliability of the patient consultation intention, there was substantial/moderate agreement for actions related to the majority of symptoms. For all symptoms, there was also a greater level of agreement for past activity than future intent. CONCLUSION: The results of the study provide some support for a community survey as a mechanism to develop 'clinically relevant' populations for the iatrotropic symptoms rectal bleeding or indigestion/heartburn within which studies of more detailed indicants could be undertaken. There is also consistency with the work of others in relation to the numbers and characteristics of patients within the 'clinically relevant' population.

Aged↗
PubMed2002

Comparison between HIV- and CMV-specific T cell responses in long-term HIV infected donors.

The mechanisms underlying non-progression in HIV-1 infection are not well understood; however, this state has been associated previously with strong HIV-1-specific CD8+ T cell responses and the preservation of proliferative CD4+ T cell responses to HIV-1 antigens. Using a combination of interferon-gamma (IFN-gamma) ELISpot assays and tetramer staining, the HIV-1-specific CD8+ T cell populations were quantified and characterized in untreated long-term HIV-1-infected non-progressors and individuals with slowly progressive disease, both in relation to CD4+ T cell responses, and in comparison with responses to cytomegalovirus (CMV) antigens. High levels of CD8+ T cell responses specific for HIV-1 or CMV were observed, but neither their frequency nor their phenotype seemed to differ between the two patient groups. Moreover, while CMV-specific CD4+ T cell responses were preserved in these donors, IFN-gamma release by HIV-1-specific CD4+ T cells was generally low. These data raise questions with regard to the role played by CD8+ T cells in the establishment and maintenance of long-term non-progression.

Adult↗
PubMed2002

Rapid (partial) prescreening of cervical smears: the quality control method of choice?

Rapid rescreening of all negative and inadequate smears is the quality control method of choice in the UK. The sensitivity of primary screening of laboratory and individual screeners are major indicators of screening quality and are dependent on the number of false negative smears found by rapid screening for their calculation. High sensitivity may indicate good quality primary screening or poor quality rapid review. Quantifiably high quality rapid rescreening is essential if these sensitivity figures are to be meaningful. A 12-month study was undertaken in routine practice using the prescreening mode to ascertain the sensitivity of rapid (partial) screening in our department. The final results of smears were compared with those of rapid prescreening. The calculated sensitivity ranged from 92-54% for high-grade abnormalities and 75-33% for all grades, revealing a wide range of performance between individual prescreeners. Rapid prescreening can identify individuals best suited to rapid screening in routine practice. By using these prescreeners only, the sensitivity of cervical screening could be raised. Rapid (partial) prescreening should be considered as the quality control method of choice.

False Negative Reactions↗
PubMed2001

Signals that initiate somatic hypermutation of B cells in vitro.

Somatic hypermutation is initiated as B lymphocytes proliferate in germinal centers. The signals that switch on the mutation process are unknown. We have derived an in vitro system to define signals that will initiate mutation in normal, naive splenic B cells. We find that three signals are required to allow detection of somatic mutation in vitro; these are anti-Ig, anti-CD40, and anti-CD38. If any one of these is omitted, mutation remains off. We show that CD40 is obligatory in vivo, as CD40 knockout mice exhibit no Ag-driven mutation. In contrast, CD38 is not, as CD38 knockout mice mutate normally. We believe that, in vitro, CD38, in combination with other stimuli, drives extensive cell division, allowing the detection of mutated sequences. However, in germinal centers in vivo, proliferative activity is instigated by a different molecule. This is the first demonstration of the initiation of hypermutation in vitro with normal splenic B cells using defined stimuli.

ADP-ribosyl Cyclase↗
PubMed2000

Analysis of 4070A envelope levels in retroviral preparations and effect on target cell transduction efficiency.

A number of stable producer cell lines for high-titer Mo-MuLV vectors have been constructed. Development has previously centered on increasing end-point titers by producing maximal levels of Mo-MuLV Gag/Pol, envelope glycoproteins, and retroviral RNA genomes. We describe the production yields and transduction efficiency characteristics of two Mo-MuLV packaging cell lines, FLYA13 and TEFLYA. Although they both produce 4070A-pseudotyped retroviral vectors reproducibly at >1 x 10(6) LFU ml(-1), the transduction efficiency of unconcentrated and concentrated virus from FLYA13 lines is poor compared with vector preparations from TEFLYA lines. A powerful inhibitor of retroviral transduction is secreted by FLYA13 packaging cells. We show that the inhibitory factor does not affect transduction of target cells by RD114-pseudotyped vectors. This suggests that the inhibitory factor functions at the level of envelope-receptor interactions. Phosphate starvation of target cells shows a two-fold increase in Pit2 receptor mRNA and causes some improvement in FLYA13 virus transduction efficiency. Western blots show that FLYA13 viral samples contain an eight-fold higher ratio of 4070A envelope to p30gag than that of virus produced by TEFLYA producer cell lines. This study correlates overexpression of 4070A envelope glycoprotein in retroviral preparations with a reduction of transduction efficiency at high multiplicities of infection. We suggest that TEFLYA packaging cells express preferable levels of 4070A compared with FLYA13, which not only enables high-titer stocks to be generated, but also facilitates a high efficiency of transduction of target cells.

Animals↗
PubMed2000

Social competition in school: relationships with bullying, Machiavellianism and personality.

BACKGROUND: Bullying is investigated as part of the individual's general framework of attitudes towards interpersonal relationships, social competition and motivation in school. AIMS: It was hypothesised that bullying behaviour and pro-bullying attitudes would be associated with socially competitive attitudes in the classroom, Machiavellianism, and the personality constructs of Psychoticism and Extraversion. SAMPLES: 198 9- to 12-year-old children from two Glasgow primary schools. METHODS: Children completed several measures: a newly developed questionnaire assessing motivations behind social competition and effort in class, the Kiddie-Mach scale, the Pro-Victim scale, items from the Olweus Bullying Questionnaire, and the Junior Eysenck Personality Questionnaire. RESULTS: A 'Desire for social success' factor (incorporating a deliberate lack of effort) was negatively correlated with support for victims of bullying, even after partialling out Machiavellianism, Psychoticism, and social desirability. Pro-victim attitudes were in turn negatively correlated with Machiavellianism and Psychoticism, and positively correlated with Lie score. Finally, children categorised as bullies scored significantly higher than controls on Machiavellianism, and significantly lower in terms of pro-victim attitudes. CONCLUSIONS: Results are discussed in terms of further study and implications for classroom practice and anti-bullying policy.

Aggression↗
PubMed1999

Inadequate cervical cytology--the need to audit individual smear takers' inadequate rates.

In order to assess the performance of individual smear takers, their rates of inadequate smears, due to insufficient material, were monitored between 1992 and 1996. Although the yearly average clinic inadequate rates were all at acceptable levels, there was great variation of rates between smear takers, ranging from 0% to 19.5%. Identification of individuals with unacceptably high inadequate rates allowed them to undergo further training. Continuous monitoring of these inadequate rates can be used to measure levels of performance amongst all smear takers, but is particularly useful for new smear takers, or those who have required retraining.

Adult↗
PubMed1998

Acute results, complications, and effect of lesion characteristics on outcome with the solid-state, pulsed-wave, mid-infrared laser angioplasty system: final multicenter registry report. Holmium:YAG Laser Multicenter Investigators.

BACKGROUND AND OBJECTIVE: The solid-state, mid-infrared holmium:YAG laser (2.1 microm wavelength) is a relatively new percutaneous device that has recently been evaluated in a multicenter study. Because of its unique wavelength and photoacoustic effects on atherosclerotic plaques, this laser may be useful in treatment of symptomatic patients with coronary artery disease. This study sought to evaluate the safety and efficacy of mid-infrared laser angioplasty in the treatment of coronary artery lesions. PATIENTS AND METHODS: Laser angioplasty was performed on 2,038 atherosclerotic lesions in 1,862 consecutive patients with a mean age of 61 +/- 11 years. Clinical indications included unstable angina (69%), stable angina (20%), acute infarction (6%), and positive exercise test (5%). Complex lesion morphology included eccentricity (62%), thrombus (30%), total occlusion (27%), long lesions (14%), and saphenous vein grafts (11%). RESULTS: This laser catheter alone successfully reduced stenosis (>20%) in 87% of lesions. With adjunct balloon angioplasty, 93% procedural success was achieved. The presence of thrombus within the target lesion was a predictor of procedural success (OR = 2.0 [95% confidence interval 2.0, 4.0], P = .04). Bifurcation lesions (OR = 0.5 [95% confidence interval 0.2, 1.0], P = .05) and severe tortuosity of the treated vessel (OR = 0.4 [95% confidence interval 0.2, 0.9], P = .02) were identified as significant predictors of decreased laser success. Calcium within the lesion was associated with reduced procedural success (OR = 0.57 [95% confidence interval 0.34, 0.97], P = .03), and calcified lesions required significantly more energy pulses than noncalcified lesions (119 +/- 91 pulses vs. 101 +/- 86 pulses, respectively, P = .0002). Complications included in-hospital bypass surgery 2.5%, Q-wave myocardial infarction 1.2%, and death 0.8%. Perforation occurred in 2.2% of patients; major dissection in 5.8% of patients, and spasm in 12% of patients. No predictor of major complications was identified. Six-month angiographic restenosis was documented in 54% of patients, and clinical restenosis occurred in 34% of patients. CONCLUSION: Mid-infrared laser has a safety profile similar to that of other debulking devices. This laser may be useful in select patients presenting with acute ischemic syndromes associated with intracoronary thrombus; however, like other coronary lasers, it is limited by the need for adjunctive balloon angioplasty and/or stenting to achieve adequate final luminal diameter. No beneficial effects on reducing 6-month restenosis rates were observed.

Aluminum Silicates↗
PubMed1998

Forced expression of Genesis, a winged helix transcriptional repressor isolated from embryonic stem cells, blocks granulocytic differentiation of 32D myeloid cells.

We recently isolated and characterized a novel member of the winged helix (formerly HNF-3/Forkhead) transcriptional regulatory family, termed Genesis. Genesis was found to be a transcriptional repressor expressed almost exclusively in embryonic stem cells or embryonal carcinoma cells. This expression rapidly declined when these cells were stimulated to differentiate. This expression pattern suggested that Genesis may play a role in cellular differentiation. To explore that possibility in a heterologous system of differentiation, Genesis was stably transduced into the IL-3-dependent myeloid cell line 32D using a retroviral expression vector. 32D cells overexpressing Genesis failed to mature normally when stimulated with G-CSF but continued to proliferate and maintained a primitive phenotype. This finding implicates Genesis in the regulation of development, and also implies that there may be common transcription pathways for many developing tissues.

Blotting, Northern↗
PubMed1998

More hassle, more alone: adolescents with diabetes and the role of formal and informal support.

Informal support is a vital part of diabetes care, for adolescents in particular. However, we have a poor appreciation of how adolescents characterize informal support relationships, and how they change over time. This article is based on qualitative, in-depth interviews and focus groups with 21 adolescents (14-19 years old) in Leicestershire. We studied the content and substance of relationships between adolescents with diabetes and their families and friends, how they change and develop over time, and how they interact with formal support from health professionals. We identify a key problem--progressive independence from family life and progressive withdrawal of formal health service input leaves some older adolescents feeling isolated, with possible implications for likely maintenance of contact with routine services.

Adolescent↗