Biomedical subjects
Publications and source records attributed to P J Dunn.
Heating alkyl vinyl ketones and N-tert-butylarylmethylideneamine N-oxides in the presence of HfCl4 results in the formation of 4-methylene-4,5-dihydroisoxazoles in good yield.
We report on the quality of a whole-genome assembly of Drosophila melanogaster and the nature of the computer algorithms that accomplished it. Three independent external data sources essentially agree with and support the assembly's sequence and ordering of contigs across the euchromatic portion of the genome. In addition, there are isolated contigs that we believe represent nonrepetitive pockets within the heterochromatin of the centromeres. Comparison with a previously sequenced 2.9- megabase region indicates that sequencing accuracy within nonrepetitive segments is greater than 99. 99% without manual curation. As such, this initial reconstruction of the Drosophila sequence should be of substantial value to the scientific community.
A major challenge in genetics research is defining and dissecting the diversity of developmental and physiological pathways that lie between genes and traits. New functional genomics methods are transforming these studies by providing comprehensive and systematic approaches that complement traditional methods of formal genetics, biochemistry, and cell biology. Together, these complementary approaches will test whether reductionism can account for the complex web of interactions that lead from genetic variation to morphological, physiological, and behavioral traits in health and disease.
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AIMS: To report on current degree of metabolic control achieved in diabetic patients in a New Zealand diabetes clinic. METHODS: All metabolic data were reviewed for patients attending the Waikato diabetes clinic from 1 January 1992 to 1 January 1995. Values were obtained from 409 insulin treated patients (IDDM), with a mean age of 39 (SD 15 yr); 200 patients who transferred from diet or pills to insulin (NIDDM-I) with a mean age of 59 (SD 12 yr); and 290 noninsulin dependent patients (NIDDM), mean age 54 (SD 13 yr). Results. Percentage of fructosamine values in the normal range: IDDM 10%, NIDDM-I 12.5% and NIDDM 37.9%. Mean values (SD). IDDM group: fructosamine 376 (78) mmol/L, cholesterol 5.24 (1.1) mmol/L, HDL cholesterol 1.47 (0.45) mmol/L, triglycerides 1.71 (1.35) mmol/L. NIDDM-I group: fructosamine 359 (67) mmol/L, cholesterol 5.82 (1.1) mmol/L, HDL cholesterol 1.21 (0.45) mmol/L, triglycerides 2.92 (3.8) mmol/L. NIDDM group: fructosamine, 312 (73) mmol/L, cholesterol 5.83 (1.24) mmol/L, HDL cholesterol 1.1 (0.33) mmol/L, triglycerides 3.11 (3.59) mmol/L. Percentage of smokers in each group: IDDM 24%, NIDDM-I 8.5%, NIDDM 17.2%. CONCLUSIONS: the majority of patients fail to achieve normal fructosamine values. Lipid control is poor, other than in the IDDM group. A significant number of patients continue to smoke. Considerable scope for improvement is noted.
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AIM: To evaluate a diabetic retinopathy screening programme for rural people with diabetes. METHOD: A retinal camera was transported to rural Waikato communities. Colour slide photographs were taken of the retina and lens of diabetic patients who had not had a previous review of their eyes by an ophthalmologist. The photographs were reviewed by an ophthalmologist, and those patients with an abnormality were referred back to their general practitioner who arranged further specialist assessment. RESULTS: Three hundred and ninety six patients have been screened and 116 patients have been referred on for specialist review. Fifty two of these patients had evidence of diabetic retinopathy, eight have been treated with laser treatment and one patient has had retinal surgery. No patients had to be recalled for repeat photographs. CONCLUSION: Retinal photography is an effective method of screening for sight threatening pathology in rural people with diabetes. Transportation of the retinal camera by station wagon is a practical way of making the service accessible.
Polynesian (59 Maori and 30 Pacific Island) patients were identified from two diabetes clinic registers and followed for a mean of 4.8 years, in order to determine the prognostic significance of urinary albumin excretion. Events were defined as death or entry onto a renal replacement programme. Fourteen events occurred during the period of follow-up. Urinary albumin/creatinine ratio was treated as a continuous variable in a proportional hazards analysis. A 10-fold increase in albumin/creatinine ratio was associated with a 5-fold increase in the risk of an event (95% C.I. = 2.05-12.09). In conclusion, elevated urinary albumin/creatinine predicted mortality and renal morbidity in Maori and Pacific Island patients with non-insulin-dependent diabetes.
AIMS: Free screening for diabetes mellitus was offered, in three rural communities as part of an initiative of the Waikato Area Health Board to improve the detection and management of type 2 diabetes. METHOD: An organised campaign promoted glucose testing as an important preventative health measure for 'at risk' members of the community. At risk was defined as being either Maori over 20 years of age, European over 40 years of age, obese or having a family history of diabetes. The testing method was a random capillary glucose test followed by an oral glucose tolerance test for those with a result > or = 8 mmol/L. RESULTS: Five thousand five hundred and eighty nine people voluntarily attended screening at various sites. Sixty of these people were already known to have diabetes and were subsequently excluded. One thousand and four people had no recognised risk factors. Four thousand five hundred and twenty one people with risk factors for type 2 diabetes had a capillary blood glucose test and 162 were found to have a capillary glucose greater than 8 mmol/L. Four patients did not have their glucose result recorded. One hundred and forty one oral glucose tolerance tests were performed and 56 new patients with diabetes were identified based on WHO criteria for diabetes. The prevalence of previously undiagnosed diabetes was higher in those over 50 years of age, particularly if they were Maori. It was also higher in obese Maori in the 30-49 year age group. CONCLUSIONS: Although over 5000 patients attended screening, this testing included only 34% of the at risk age group. Thus voluntary testing, despite a major investment in promotion, proved ineffective as a population screening tool. A random capillary glucose test proved to be a simple and sensitive method of helping to identify previously undiagnosed disease. This could be effectively used by general practitioners, targeting all adults over 50 years of age, and all adult Maori with obesity as defined by a BMI > or = 30.
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We have evaluated a semi-quantitative dry immunochemical screening method (Micral-Test) for the detection of low concentrations of albumin in urine. The stability of Micral-Test strips on storage was good, especially with regard to temperature, light and humidity. Changes in urine osmolality (urea and creatinine concentration), pH and sodium and potassium concentration did not have a significant analytical effect on the Micral-Test measurement; extremes of temperature altered the rate of colour development. The depth of dipping the strip into the sample and the timing of reading colour development were critical. We measured the albumin concentration in 184 urine samples from diabetic outpatients by the Micral-Test and by our in-house immunoturbidimetric method; a Micral-Test result of 20 mg/L had a sensitivity of 91% and specificity of 97% to predict a discriminating urine albumin concentration greater than 30 mg/L by the in house method. The Micral-Test is suitable for use by non-laboratory personnel and is capable of producing analytically acceptable results for use in diabetes clinics and by general practitioners.
UNLABELLED: Serial random urine samples have been collected from 167 insulin treated diabetic patients attending the Waikato diabetes clinic from 1984 to 1989 and albumin/creatinine ratios measured as a screening test for diabetic microalbuminuria. The group ranged in age from 12 to 50 years and comprised 79 males and 88 females. Where the initial test was normal (less than 2.5), as found in 117 patients, 86.7% of all tests over the five year period (1032) remained normal. Of 50 patients with an initial elevated value, 39% of a total of 575 values taken over the five year period were subsequently normal. CONCLUSION: a random urine albumin measurement taken at yearly intervals is an adequate screening programme for patients with an initial normal value.
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TUR chips from 89 men were analysed prospectively for androgen and oestrogen nuclear and cytoplasmic receptors (ANR, ACR, ONR, OCR). Patients were selected on the basis of suspicion of neoplastic change on clinical feel of the prostate. A control group of benign cases was also collected prospectively. Histological examination showed that 46 patients had prostatic carcinoma and 43 had benign prostatic hyperplasia. No difference was found between the 2 groups in terms of prevalence of any of the receptors or in levels of receptor in those who were positive. The patients with neoplastic changes were followed up for a median of 53 months (range 47-64). No significant effect on duration of survival was noted with any of the receptor variables but there was a beneficial association between cytoplasmic oestrogen receptor positivity and progression-free interval. Patients with T category 3 or 4 had a significantly higher chance of being ANR positive than those of lower T category and this may reflect sampling error. There appears to be some evidence to suggest that cytosol oestrogen receptor positivity has a prognostic role in prostate cancer, in terms of time to progression on hormone therapy. Receptor status did not influence survival.
We describe the clinical features of members of a family with an atypical form of thyroid hormone resistance syndrome, affecting thyroxine predominantly. Relevant diagnostic clinical and biochemical investigations are outlined and discussed.