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Biomedical subjects

M Watkins

Publications and source records attributed to M Watkins.

At least 19 recordsLinked to original sources
PubMed1995

Molecular cloning of the human ryudocan promoter.

The promoter region of human ryudocan was isolated from a human lambda dash genomic library and cloned into pBluescript. The 5'flanking region contained a classical TATA box and GC rich regions that are commonly found in constitutively expressed genes. Two fusion gene constructs, one of 898 bp and the other of 480 bp of the 5' flanking DNA coupled to the luciferase gene, were transiently expressed in a mouse endothelioma cell line and in human umbilical endothelial cell cultures. Both constructs were capable of driving luciferase expression; the 898 bp construct produced greater levels of luciferase activity than the 480 bp construct in both cell types examined. Analysis of the sequence revealed the presence of several potential sites for nuclear transcription factor binding; the relevance of these sites is presently unknown.

Base Sequence↗
PubMed1995

Improvement in cost recovery at an urban level I trauma center.

With escalating health care costs and health reimbursement reorganization, the greatest danger to trauma centers will remain expensive uncompensated care. This is caused primarily by costs incurred in treating complex, life-threatening injuries and to the large population of trauma patients with no, or inadequate, means of compensation. In 1986 and 1987, this urban level I trauma center experienced an operating loss totaling $2,335,200. To attempt to reverse this expense, annual tracking of the trauma service's financial performance was begun in 1989. In addition, changes were made. Early multidisciplinary baseline assessment of each admission was instituted for financial profiling and discharge planning. Attempts were made on admission to identify health and vehicular insurance information. Processing for Medicaid and Medicare reimbursement was begun as soon as possible, and coding for diagnoses was checked by medical records personnel and the trauma nurse coordinator. If appropriate, Missouri Crime Victims Compensation was sought. Base on costs incurred in providing trauma services, as required by the state of Missouri and the American College of Surgeons, a trauma response charge was developed and instituted. Over a 5-year period, 1989 to 1993, financial audits were conducted. The cost recovery ratio (CRR) (collections/cost) was utilized as the measure of financial success. The CRR improved from 0.74 in 1989 to 0.93 in 1993, and in 2 years, 1991 and 1992, was 1.03 and 0.99. Over this period, the acuity of injury, as measured by the Injury Severity Score, remained essentially the same, but length of hospital stay decreased from 10.0 to 8.7 days. The CRR was greatest for private insurance.(ABSTRACT TRUNCATED AT 250 WORDS)

Financial Audit↗
PubMed1994

Early profound jaundice following blunt hepatic trauma: resolution after lobectomy--case report.

The patient presented herein was seen and evaluated following a motor vehicle crash. Although hemodynamically stable, he was found to have a liver injury and orthopedic trauma. Following admission he developed rapidly deepening jaundice. Radiographic studies demonstrated biliary pooling in the left lobe without antegrade obstruction. After a left hepatic lobectomy steady improvement in his hyperbilirubinemia was seen. Despite our inability to identify a communication anatomically in the resected specimen, one explanation considered was a traumatic fistulization between a biliary radical and an hepatic vein.

Accidents, Traffic↗
PubMed1993

A radiation hybrid map of the BRCA1 region of chromosome 17q12-q21.

The chromosomal region 17q12-q21 contains a gene (BRCA1) conferring susceptibility to early-onset familial breast and ovarian cancer. An 8000-rad radiation-reduced hybrid (RH) panel was constructed to provide a resource for long-range mapping of this region. A large fraction of the hybrids (approximately 90%) retained detectable human chromosome 17 sequences. The complete panel of 76 hybrids was scored for the presence or absence of 22 markers from this chromosomal region, including 14 cloned genes, seven microsatellite repeats, and one anonymous DNA segment. Statistical analysis of the marker retention data employing multipoint methods provided both comprehensive and framework maps of this chromosomal region, including distance estimates between adjacent markers. The comprehensive RH map includes 17 loci and spans 179 cRays(8000). Likelihood ratios of at least 1000:1 support the 10-locus framework order: cen-D17S250-ERBB2-(THRA1, TOP2A)-D17S855-PPY-D17S190-MTBT1-GP3A++ +-BTR-D17S588-tel. The order obtained from RH mapping, when used in conjunction with other methods, will be useful in linkage analysis of breast cancer families and will facilitate the development of a physical map of this region.

Base Sequence↗
PubMed1993

Isolation and characterization of somatic cell hybrids with breakpoints spanning 17q22-->q24.

Somatic cell hybrid mapping panels have previously been constructed to assist in the regional assignment of anonymous DNA probes and cloned genes to human chromosome 17. While a substantial number of hybrids are available that subdivide the short arm of this chromosome and the proximal portion of its long arm into specific regions, relatively few exist with breakpoints in the distal portion of the long arm. To increase the resolution of this region, four additional human x rodent somatic cell hybrids have been constructed that include breakpoints spanning the region 17q22-->q24. Hybrid clones carrying the long-arm derivative of chromosome 17 were initially identified by fluorescence in situ hybridization. Hybrids were subsequently screened using the polymerase chain reaction with primer sets representing DNA markers previously mapped to chromosome 17. These hybrids expand the existing somatic cell hybrid panel for the distal portion of the long arm of chromosome 17.

Animals↗
PubMed1992

The role of early surgical intervention in civilian gunshot wounds to the head.

Surgical management of gunshot wounds of the head has remained a controversial issue in the care of civilian patients. In an attempt to determine who might benefit from aggressive surgical intervention, we examined 89 patients over a 3-year period who had suffered cranial gunshot wounds and had at least one computed tomographic scan of the head after admission. Patients were divided into those receiving early (less than 24 hours) surgical intervention (ES, n = 27), late (greater than 24 hours) surgical intervention (LS, n = 6) or no surgical intervention (NS, n = 56). Overall mortality was 63%. Ten of 27 patients (37%) in the ES group died compared with 46 of 56 patients (82%) in the NS group (p less than 0.0001). Glasgow Coma Scale (GCS) scores in the ES group averaged 7.86 +/- 4.72 and in the NS group 5.59 +/- 4.42 (p less than 0.05). The GCS scores in the LS group (all of whom survived) were significantly higher than those of the other two groups, 12.17 +/- 4.10. The number of patients with GCS scores of 3 or 4 on admission was significantly less in the ES (41%) than in the NS group (66%, p = 0.035) and survival was better with surgery (36%) than without (3%, p = 0.007). Patients with mass lesions (clot, ventricular blood) were more often found in the ES group (17/27) than in the NS group (18/56) (p = 0.008). Patients with bihemispheric injuries fared better with surgery (7 of 14 survivors) than without (2 of 33 survivors, p = 0.0003). Only one infectious complication (brain abscess) was encountered in the LS group. No delayed intracranial complications in survivors in the NS group were seen.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Use of a medical center's computerized health care database for notifiable disease surveillance.

The sensitivity of a medical center's inpatient and outpatient database to detect notifiable diseases was examined. Only 53 percent of inpatient and 7 percent of outpatient laboratory-confirmed cases of shigellosis, salmonellosis, giardiasis, and hepatitis were identified by an automated search for matching diagnosis codes. Reasons for lack of sensitivity include nonavailability of laboratory results at the time of diagnosis assignment, use of a standardized encounter form with limited preselected diagnosis codes, and pre-emptying of the infectious disease diagnosis by other diagnoses.

Communicable Diseases↗
PubMed1991

A multicentre controlled clinical trial of high-volume fresh frozen plasma therapy in prognostically severe acute pancreatitis.

Fresh frozen plasma (FFP) has been proposed as a specific therapy for acute pancreatitis. It may replenish important circulating proteins, particularly the naturally occurring anti-protease system. To investigate this potential therapy, 72 patients with predicted severe disease were selected from 301 admissions with acute pancreatitis using the modified Glasgow prognostic scoring system. They were randomised within 6 h of diagnosis to receive FFP (8 units daily for 3 days) or a similar volume of colloid control as part of their intravenous fluid therapy. Clinical progress was monitored and specific blood proteins were measured on days 1, 3 and 7. FFP therapy significantly increased the day 3 concentrations of some of the acute phase proteins (C1-reactive protein P less than 0.02, D-dimer P less than 0.05 and fibrinogen P less than 0.05) as well as some proteins which showed a fall in circulating concentration during the early stages of the disease (alpha 2 macroglobulin P less than 0.001, antithrombin III P less than 0.01 and fibronectin P less than 0.001). However, there was no significant difference between the two groups in terms of clinical outcome. Mortality was 20% in patients who received FFP and 18% in the colloid control group. Despite the ability of FFP therapy to supplement circulating concentrations of several potentially useful proteins during acute pancreatitis, it does not appear to improve clinical outcome.

Acute Disease↗
PubMed1991

Late arterial hemorrhage secondary to a Greenfield filter requiring operative intervention.

Retroperitoneal hematomas associated with Greenfield filters have been described and are generally characterized as clinically insignificant. We report a retroperitoneal hematoma that was associated with a Greenfield filter and that required operative intervention because of hemodynamic instability. At operation a lumbar arterial laceration apparently caused by a protruding filter prong was identified and ligated. The implications of this occurrence for filter placement indications are discussed. The potential life-threatening severity of filter-associated hematomas is emphasized.

Arteries↗
PubMed1989

SpermCheck: a simplified screening assay for immunological infertility.

SpermCheck (Bio-Rad Laboratories, Hercules, CA), a new screening test for regional surface antibodies on motile sperm, uses monodispersed latex microspheres of uniform size as a vehicle to link rabbit antihuman immunoglobulins (IgA, IgG, IgM) and provides both negative and positive control sera, as well as sufficient buffer for sperm preparation in ambient CO2 atmosphere. When compared with reference data available for the immunobead test (IBT), the direct protocol (semen) for SpermCheck yielded 94.4% sensitivity with 100% specificity; the indirect protocol (serum) provided a sensitivity of 100% with 94.7% specificity. The microspheres of SpermCheck maintain a nearly uniform concentration per volume, with none to negligible clumping. The greater difference between the optical densities of latex and cytoplasm allows use of a light microscope for the rapid assessment of the percent of regional binding rather than the phase-contrast microscope required for the IBT. SpermCheck eliminates many difficulties encountered with the IBT, making SpermCheck a convenient screening assay for use in the physician's office.

Antibodies↗