PubMed Health⌕ Search

Biomedical subjects

M E Bailey

Publications and source records attributed to M E Bailey.

At least 19 recordsLinked to original sources

Laparoscopic extraperitoneal excision of a nerve sheath tumor of the spermatic cord.

A 60-year-old male presented with a nontender irreducible mass in the right groin. Examination revealed swelling in the inguinal canal in the region of the deep inguinal ring. He underwent laparoscopic, extraperitoneal exploration of the spermatic cord, where a soft tissue tumor was identified and excised. Histological examination confirmed a nerve sheath tumor. Nerve sheath tumors are uncommon neoplasms of peripheral nerves, which theoretically can arise from any nerve fiber but have only been described in the spermatic cord in three reports in the literature. We are not aware of any reports describing their excision either laparoscopically or by the extraperitoneal route.

Genital Neoplasms, Male↗

Day-case laparoscopic Nissen fundoplication.

BACKGROUND: The aim was to assess the acceptability and safety of day-case laparoscopic fundoplication for gastro-oesophageal reflux disease (GORD). METHODS: This prospective study commenced in December 1999 and lasted for 18 months. All patients had proven symptomatic GORD. Inclusion criteria were American Society of Anesthesiologists grade I or II with adequate home support. A standard anaesthetic, analgesic and antiemetic protocol was used. Patients were contacted by telephone on the night of discharge and arrangements were made for a nurse to visit the following day. Postoperative pain and nausea were assessed using visual analogue scores (scale 0-10) on a self-completion questionnaire. RESULTS: Twenty patients were included. There were no postoperative complications. All patients were discharged on the day of surgery. Median time to discharge was 6 h 30 min (range 4.5 to 9 h). One patient reattended casualty the following morning but none required readmission. There was no significant difference in median pain or nausea scores the evening after surgery or the next morning. All patients were satisfied with the information given and aftercare provided. All would recommend it to a friend and 19 of 20 would undergo the procedure as a day case again. CONCLUSION: This study suggests that day-case laparoscopic fundoplication is feasible. Patients find it acceptable and it appears safe.

Adult↗

The Guildford MATTU TEP hernia model.

BACKGROUND: The totally extraperitoneal technique (TEP) is a well-established method for repairing inguinal hernias laparoscopically. It has a low recurrence rate with minimal morbidity. Good training is necessary to decrease the length of the learning curve. Laparoscopic training courses at the Guildford Minimal Access Therapy Training Unit (MATTU) include lectures, live demonstrations, and practical training. In the absence of a commercially available TEP hernia model, the Guildford MATTU, along with Limbs and Things, has developed a realistic artificial model. OBJECTIVE: The aim was to develop a model that would familiarize course participants with the different anatomical perspective and the steps needed to complete the TEP repair, in an effort to shorten their learning curve. EVALUATION: The MATTU model has been evaluated in terms of anatomic accuracy, realism, versatility, cost effectiveness, and ease of use. CONCLUSIONS: The MATTU model accurately replicates TEP repair. It is robust, easy to use, cost effective, and easy to maintain. It will be widely available.

Curriculum↗

Structure, mapping and expression of the human gene encoding the homeodomain protein, SIX2.

Vertebrate genes with sequence similarity to the Drosophila homeobox gene, sine oculis (so), constitute the SIX family. There is notable expression of members of this family in anterior neural structures, and several SIX genes have been shown to play roles in vertebrate and insect development, or have been implicated in maintenance of the differentiated state of tissues. Mutations in three of these genes in man (SIX5, SIX6 and SIX3) are associated with severe phenotypes, and therefore, the cloning of other human genes from this family is of interest. We have cloned and characterised the gene that encodes human SIX2, elucidated its gene structure and conducted expression studies in a range of tissues. SIX2 is widely expressed in the late first-trimester fetus, but has a limited range of expression sites in the adult. The expression pattern of SIX2 and its localisation to chromosome 2p15-p16 will be of use in assessing its candidacy in human developmental disorders.

Amino Acid Sequence↗

Mutation screening in Rett syndrome patients.

Rett syndrome (RTT) was first described in 1966. Its biological and genetic foundations were not clear until recently when Amir et al reported that mutations in the MECP2 gene were detected in around 50% of RTT patients. In this study, we have screened the MECP2 gene for mutations in our RTT material, including nine familial cases (19 Rett girls) and 59 sporadic cases. A total of 27 sporadic RTT patients were found to have mutations in the MECP2 gene, but no mutations were identified in our RTT families. In order to address the possibility of further X chromosomal or autosomal genetic factors in RTT, we evaluated six candidate genes for RTT selected on clinical, pathological, and genetic grounds: UBE1 (human ubiquitin activating enzyme E1, located in chromosome Xp11.23), UBE2I (ubiquitin conjugating enzyme E2I, homologous to yeast UBC9, chromosome 16p13.3), GdX (ubiquitin-like protein, chromosome Xq28), SOX3 (SRY related HMG box gene 3, chromosome Xq26-q27), GABRA3 (gamma-aminobutyric acid type A receptor alpha3 subunit, chromosome Xq28), and CDR2 (cerebellar degeneration related autoantigen 2, chromosome 16p12-p13.1). No mutations were detected in the coding regions of these six genes in 10 affected subjects and, therefore, alterations in the amino acid sequences of the encoded proteins can be excluded as having a causative role in RTT. Furthermore, gene expression of MECP2, GdX, GABRA3, and L1CAM (L1 cell adhesion molecule) was also investigated by in situ hybridisation. No gross differences were observed in neurones of several brain regions between normal controls and Rett patients.

Adolescent↗

Genetic linkage and radiation hybrid mapping of the three human GABA(C) receptor rho subunit genes: GABRR1, GABRR2 and GABRR3.

GABA(C) receptors mediate rapid inhibitory neurotransmission in retina. We have mapped, in detail, the human genes which encode the three polypeptides that comprise this receptor: rho1 (GABRR1), rho2 (GABRR2) and rho3 (GABRR3). We show that GABRR1 and GABRR2 are located close together, in a region of chromosome 6q that contains loci for inherited disorders of the eye, but that GABRR3 maps to chromosome 3q11-q13.3. Our mapping data suggest that the rho polypeptide genes, which are thought to share a common ancestor with GABA(A) receptor subunit genes, diverged at an early stage in the evolution of this gene family.

Amino Acid Sequence↗

Cloning and chromosomal localization of human Cdc42-binding protein kinase beta.

The p21 GTPases, Rho and Cdc42, regulate numerous cellular functions by binding to members of a serine/threonine protein kinase subfamily. These functions include the remodeling of the cell cytoskeleton that is a feature of cell growth and differentiation. Two of these p21 GTPase-regulated kinases, the myotonic dystrophy protein kinase-related Cdc42-binding kinases (MRCKalpha and beta), have been recently characterized in rat. Both of these proteins phosphorylate nonmuscle myosin light chain, a prerequisite for the activation of actin-myosin contractility. Here we report the cDNA cloning of the human homologue of MRCKbeta, CDC42BPB, which was found by Northern blot analysis to be expressed in a wide range of tissues. The human CDC42BPB gene maps to cytogenetic band 14q32.3 by FISH analysis.

Amino Acid Sequence↗

Initial experience with the use of N-butyl 2-cyanoacrylate glue for the fixation of polypropylene mesh in laparoscopic hernia repair.

The Minimal Access Therapy Training Unit at The Royal Surrey County Hospital Guildford (UK) reports on the initial success with the use of n-butyl 2-cyanoacrylate glue for fixing polypropylene mesh during laparoscopic hernia repair. We report our experience with seven such repairs and describe the prototype glue dispenser and mode of application used to fix the mesh. This is the first reported use of glue in laparoscopic hernia repair.

Adhesives↗

Regional workload induced changes in electrophysiology and immediate early gene expression in intact in situ porcine heart.

Cardiac remodelling and hypertrophy induced by chronic haemodynamic overload (stretch) eventually leads to a decrease in cardiac function, an increased incidence of ventricular arrhythmia and mortality. The mechanisms by which myocytes sense haemodynamic stress and activate growth signals are largely unknown. Nuclear immediate early genes may act as third messengers, converting the stretch stimulus into long-term changes of gene expression via cytoplasmic signal transduction. However, previous studies have used cell cultures and isolated hearts, neither of which are ideal models. We have developed a new in situ porcine heart model where local strain (stretch) can be applied, for several hours if required, thus allowing the comparison of changes in electrophysiology and gene expression with unstrained myocardium in the same preparation. A pneumatically controlled stretch-device was attached to a portion of the right ventricle of an anaesthetized animal using suction. Chronic stretch was applied for 30 min or 1 h. Regional loading produced (i) a transient decrease in monophasic action potential duration (3.5+/-0.8%; P<0.05), followed by (ii) an elongation by 15 min, despite maintained stretch (3.4+/-1.5%; P<0.05 compared to the pre-stretch situation). A control segment of the right ventricle did not show these changes. Northern blot analysis showed that both c-fos and c-myc were induced in the areas sampled, but they were 12-fold and three-fold higher, respectively, in stretched compared with control tissue after 30 min. Thus, prolonged regional stretch can produce complex changes in cardiac electrophysiology and increase expression of some immediate early genes. Our model may be useful for studying the cascade of events that lead to remodelling, hypertrophy, and arrhythmia.

Action Potentials↗

Reduced oxidation of fresh pork in the presence of exogenous hydrolases and bacteria at 2 degrees C.

Exogenous lipase and phospholipase A2 added to ground pork released free fatty acids (FFA) and reduced lipid oxidation as indicated by TBA values during storage at 2 degrees C. Bovine serum albumin (BSA) added to ground pork to bind FFA accelerated lipid oxidation. Both lipase and phospholipase-producing bacteria increased in numbers, and pseudomonads that produced lipase and phospholipase became the predominant bacteria growing in pork stored at 2 degrees C. The TBA values of ground pork, which were exposed to the growth of natural microbial flora, were reduced up to 84% during storage at 2 degrees C for 16 d. Pseudomonasfragi K1 inoculated into sterilized ground pork reduced TBA values and oxidation volatiles including saturated aldehydes, unsaturated aldehydes, alcohols and ketones.

Animals↗

Candidate gene study of eight GABAA receptor subunits in panic disorder.

OBJECTIVE: gamma-Aminobutyric acid type A (GABAA) receptor subunit genes are candidate genes for panic disorder. Benzodiazepine agonists acting at this receptor can suppress panic attacks, and both inverse agonists and antagonists can precipitate them. The human GABAA receptor subtypes are composed of various combinations of 13 subunits, each encoded by a unique gene. The authors tested eight of these subunits in a candidate gene linkage study of panic disorder. METHOD: In 21 U.S. and five Icelandic multiplex pedigrees of panic disorder, 104 individuals had DSM-III-R panic disorder (the narrowly defined affected phenotype) and 134 had either this diagnosis or subsyndromal panic disorder characterized by panic attacks that failed to meet either the criterion of attack frequency or the number of criterion symptoms necessary for a definite diagnosis (the broadly defined affected phenotype). The authors conducted lod score linkage analyses with both phenotypes using both a dominant and a recessive model of inheritance for the following loci: GABRA1-GABRA5 (alpha 1-alpha 5), GABRB1 (beta 1), GABRB3 (beta 3), and GABRG2 (gamma 2). RESULTS: The results failed to support the hypothesis that any of these genes cause panic disorder in a majority of the pedigrees. CONCLUSIONS: Within the limitations of the candidate gene linkage method, panic disorder does not appear to be caused by mutation in any of the eight GABAA receptor genes tested.

Adult↗

Exclusion of linkage between idiopathic generalized epilepsies and the GABAA receptor alpha 1 and gamma 2 subunit gene cluster on chromosome 5.

Hereditary factors play a major role in the etiology of idiopathic generalized epilepsies (IGEs). The pivotal function of ionotropic gamma-aminobutyric acid type A receptors (GABRs) in inhibitory neurotransmission in the mammalian central nervous system suggests that they may be involved in epileptogenesis and genetic predisposition to IGEs. Dinucleotide repeat polymorphisms associated with the human GABAA receptor alpha 1 (GABRA1) and gamma 2 subunit (GABRG2) gene cluster on chromosome 5q32-q35 offer the opportunity to test whether these candidate genes confer susceptibility to IGEs. Our linkage analyses in 63 families ascertained through IGE patients with either juvenile myoclonic epilepsy, juvenile absence epilepsy or childhood absence epilepsy do not support the hypothesis that variants within the GABRA1 and GABRG2 gene cluster contribute a frequent major gene effect to the expression of the common familial IGEs.

Base Sequence↗

Uncertain clinical significance of duodenal mucosal abnormalities in HIV-infected individuals. Results of a case-control study.

Previous research has described abnormalities of duodenal mucosal morphology in human immunodeficiency virus (HIV)-infected individuals. We wanted to determine the frequency of disturbed villus architecture and investigate its relationship to HIV-related chronic diarrhea. We conducted a case-control study of 120 HIV-infected men, 63 with and 57 without chronic diarrhea. Stools were cultured for bacteria and examined for ova and parasites; esophagogastroduodenoscopy and flexible sigmoidoscopy with mucosal biopsies were performed. Biopsy tissue was examined using light and electron microscopy to detect enteric pathogens and to evaluate mucosal morphology. The mean CD4+ cell count was 143/min3, and enteric pathogens were detected in 56 of 120 men (47%). In approximately half the study sample (57%), duodenal villus architecture was normal; complete villus flattening was not observed. We detected no association between chronic diarrhea and altered villus architecture. Although further study is needed to clarify the pathogenesis of altered duodenal mucosal morphology, our results suggest that the clinical significance of the abnormalities may be small.

Adult↗

Influence of the gut microflora and of biliary constituents on morphological changes in the small intestine in obstructive jaundice.

Increased amounts of intestinal endotoxin are absorbed in obstructive jaundice. The precise mechanism is not known but the increased absorption may arise from alterations in the luminal contents, in the intestinal flora, in the gut wall or in interactions between all three. To examine the effects of the intestinal flora we have compared the morphological changes in the small intestine in obstructive jaundice in germ free and conventional rats while the effects of bile constituents have been examined by addition of bile constituents to the diet of bile duct ligated rats. Changes in the intestine were examined, histologically, by enzyme histochemistry, and by transmission and scanning electron microscopy. The results showed no differences in response between germ free and conventional rats. Feeding of diets containing bile salts exacerbated the lesion. Feeding of diets containing cholesterol, however, reduced the degree of intestinal changes produced by cholestasis and completely antagonised the increase in damage caused by feeding of bile salts.

Animals↗

A novel homeodomain-encoding gene is associated with a large CpG island interrupted by the myotonic dystrophy unstable (CTG)n repeat.

Myotonic dystrophy (DM) is associated with a (CTG)n trinucleotide repeat expansion in the 3'-untranslated region of a protein kinase-encoding gene, DMPK, which maps to chromosome 19q13.3. Characterisation of the expression of this gene in patient tissues has thus far generated conflicting data on alterations in the steady state levels of DMPK mRNA, and on the final DMPK protein levels in the presence of the expansion. The DM region of chromosome 19 is gene rich, and it is possible that the repeat expansion may lead to dysfunction of a number of transcription units in the vicinity, perhaps as a consequence of chromatin disruption. We have searched for genes associated with a CpG island at the 3' end of DMPK. Sequencing of this region shows that the island extends over 3.5 kb and is interrupted by the (CTG)n repeat. Comparison of genomic sequences downstream (centromeric) of the repeat in human and mouse identified regions of significant homology. These correspond to exons of a gene predicted to encode a homeodomain protein. RT-PCR analysis shows that this gene, which we have called DM locus-associated homeodomain protein (DMAHP), is expressed in a number of human tissues, including skeletal muscle, heart and brain.

Amino Acid Sequence↗