PubMed Health⌕ Search

Biomedical subjects

P J Ward

Publications and source records attributed to P J Ward.

At least 19 recordsLinked to original sources
PubMed1998

Increased hepatic iron concentration in nonalcoholic steatohepatitis is associated with increased fibrosis.

BACKGROUND & AIMS: Nonalcoholic steatohepatitis (NASH) is a chronic liver disease that occasionally progresses to cirrhosis but usually has a benign course. The aim of this study was to investigate the role of the hemochromatosis mutation Cys282Tyr in development of the mild hepatic iron overload found in some patients with NASH and its association with hepatic damage in these patients. METHODS: Fifty-one patients with NASH were studied. The presence of the Cys282Tyr mutation was tested in all patients, and the data were analyzed with respect to the histological grade of steatosis, inflammation, Perls' staining, hepatic iron concentration (HIC), and serum iron indices. RESULTS: Thirty-one percent of patients with NASH were either homozygous or heterozygous for the Cys282Tyr mutation. This mutation was significantly associated with Perls' stain grade (P < 0.005), HIC (P < 0.005), and transferrin saturation percentage (P < 0.005) but not with serum ferritin levels. Linear regression analysis showed that increased hepatic iron (Perls' stain or HIC) had the greatest association with the severity of fibrosis (P < 0.0001). CONCLUSIONS: The Cys282Tyr mutation is responsible for most of the mild iron overload found in NASH and thus has a significant association with hepatic damage in these patients. Heterozygosity for the hemochromatosis gene mutation therefore cannot always be considered benign.

Adult↗
PubMed1997

Covariate effects on linkage and association using a general pair method.

The "general pair method" (GPM) is a nonparametric, identity-by-state (IBS) method of assessing linkage between a chromosomal marker and a binary phenotype. It is applicable to any pedigree structure, and uses marker information from affected as well as unaffected individuals. Results obtained here from nuclear families (Problem 2A) are contrasted with those from extended pedigrees (Problem 2B). Test statistics for chromosomal linkage between each marker and disease status are contrasted with tests for "direct association" which test the hypothesis that a particular allele is associated disease status across all pedigrees. A novel extension of the GPM is presented here for testing whether the strength of linkage (and/or association) depends on the levels of a covariate (i.e., dependency on gender, age, the levels of the "environmental factor," or the levels of the "quantitative phenotypes" supplied). The GPM is seen to have some power to detect major gene 1 on chromosome 5, and major gene 3 on chromosome 4. The gender interaction effects proved too small to detect. No direct associations are found.

Analysis of Variance↗
PubMed1997

Laryngeal and oropharyngeal cancer, and alcohol dehydrogenase 3 and glutathione S-transferase M1 polymorphisms.

In this study the GSTmu phenotype and ADH genotype at the ADH3 locus were investigated in a group of 39 alcoholic men with upper respiratory/digestive tract cancer: 21 with oropharyngeal cancer and 18 with laryngeal cancer. The results are compared with those of a control group of 37 alcoholic men without alcohol-related medical complications. Of the control subjects, 48% were found to be GSTmu deficient [GSTmu(-)] and 19% carried the ADH(3)1/ADH(3)1 genotype. In the laryngeal cancer patients, a significantly elevated frequency of both the GSTmu(-) (78%) and ADH(3)1/ADH(3)1 genotype (56%) was observed, relative to the control group. On the basis of this result, the risk of laryngeal cancer associated with the GSTmu(-) and ADH(3)1/ADH(3)1 genotypic combination within the population of alcoholics was estimated to be 12.9 with a 95% confidence interval of 1.8-92 (P < 0.01) relative to alcoholic individuals who have GSTmu [GSTmu(+)] and are not ADH(3)1/ADH(3)1. Thus, alcoholics who are GSTmu(-) and ADH(3)1/ADH(3)1 have at least an 80% greater risk of developing laryngeal cancer than alcoholics who are GSTmu(+) and who are not ADH(3)1/ADH(3)1. In addition, the oropharyngeal cancer patients had excess frequencies of both GSTmu(-) (62%) and ADH(3)1/ADH(3)1 (43%) relative to the control group, but these excess frequencies were not statistically significant. The GSTmu(-) and ADH(3)1/ADH(3)1 genotypic combination may be a constitutional risk factor for laryngeal cancer among alcoholics.

Adult↗
PubMed1997

Biochemistry and pharmacology of 7alpha-substituted androstenediones as aromatase inhibitors.

The inhibition of aromatase, the enzyme responsible for converting androgens to estrogens, is therapeutically useful for the endocrine treatment of hormone-dependent breast cancer. Research by our laboratory has focused on developing competitive and irreversible steroidal aromatase inhibitors, with an emphasis on synthesis and biochemistry of 7alpha-substituted androstenediones. Numerous 7alpha-thiosubstituted androst-4-ene-3,17-diones are potent competitive inhibitors, and several 1,4-diene analogs, such as 7alpha-(4'-aminophenylthio)-androsta-1,4-diene-3,17-di one (7alpha-APTADD), have demonstrated effective enzyme-activated irreversible inhibition of aromatase in microsomal enzyme assays. One focus of current research is to examine the effectiveness and biochemical pharmacology of 7alpha-APTADD in vivo. In the hormone-dependent 7,12-dimethylbenz(a)anthracene (DMBA)-induced rat mammary carcinoma model system, 7alpha-APTADD at a 50 mg/kg/day dose caused an initial decrease in mean tumor volume during the first week, and tumor volume remained unchanged throughout the remaining 5-week treatment period. This agent lowers serum estradiol levels and inhibits ovarian aromatase activity. A second research area has focused on the synthesis of more metabolically stable inhibitors by replacing the thioether linkage at the 7alpha position with a carbon-carbon linkage. Several 7alpha-arylaliphatic androst-4-ene-3,17-diones were synthesized by 1,6-conjugate additions of appropriate organocuprates to a protected androst-4,6-diene or by 1,4-conjugate additions to a seco-A-ring steroid intermediate. These compounds were all potent inhibitors of aromatase with apparent Kis ranging between 13 and 19 nM. Extension of the research on these 7alpha-arylaliphatic androgens includes the introduction of a C1-C2 double bond in the A-ring to provide enzyme-activated irreversible inhibitors. The desired 7alpha-arylaliphatic androsta-1,4-diene-3,17-diones were obtained from their corresponding 7alpha-arylaliphatic androst-4-ene-3,17-diones by oxidation with 2,3-dichloro-5,6-dicyano-1,4-benzoquinone (DDQ). These inhibitors demonstrated enzyme-mediated inactivation of aromatase with apparent k(inact)s ranging from 4.4 x 10(-4) to 1.90 x 10(-3) s(-1). The best inactivator of the series was 7alpha-phenpropylandrosta-1,4-diene-3,17-dione, which exhibited a T(1/2) of 6.08 min. Aromatase inhibition was also observed in MCF-7 human mammary carcinoma cell cultures and in JAr human choriocarcinoma cell cultures, exhibiting IC50 values of 64-328 nM. The 7alpha-arylaliphatic androgens thus demonstrate potent inhibition of aromatase in both microsomal incubations and in choriocarcinoma cell lines expressing aromatase enzymatic activity. Additionally, the results from these studies provide further evidence for the presence of a hydrophobic binding pocket existing near the 7alpha-position of the steroid in the active site of aromatase. The size of the 7alpha-substituent influences optimal binding of steroidal inhibitors to the active site and affects the extent of enzyme-mediated inactivation observed with androsta-1,4-diene-3,17-dione analogs.

Androstenedione↗
PubMed1995

Measuring gene-disease association using a general pair method.

The general-pair-method (GPM) was applied to the analysis of the Problem 1 data set. GPM is a nonparametric, identity-by-state method for associating variation at a chromosomal locus with disease status. It can accommodate information from all pairs of individuals across any degree of genetic relatedness, including genetically unrelated individuals, within a single test statistic. Pairwise contrasts between members of different pedigrees, including "control" pedigrees containing no affected individuals, can therefore be exploited in order to increase the power of the test statistic. Such a strategy makes sense within the context of a candidate gene (direct association) study, where the alleles or genotypes of high disease risk are assumed to be the same ones within all families. Applied to the Problem 1 data set in this way, the GPM successfully identified the effect on disease status of locus 31 on chromosome 1, and of locus 23 on chromosome 5. The observed strength of gene-disease association at the other chromosomal loci was compatible with the null hypothesis.

Case-Control Studies↗
PubMed1993

Some developments on the affected-pedigree-member method of linkage analysis.

Some improvements are presented for the affected-pedigree-member method of linkage analysis, which is a generalization of the sib-pair method. The test statistic is extended to include contrasts between affected and unaffected pedigree members, so that it now utilizes marker information from all typed pedigree members rather than just the typed affected members. Computer simulation using a sample pedigree of 14 individuals shows that this modification can substantially increase statistical power where there is a direct association between marker variation and disease and where disease risk is elevated in carriers of the disease allele. Data on Huntington disease in 16 British families, which were analyzed previously using only the affected individuals, are reanalyzed with the unaffected individuals included. Strong rejection of the null hypothesis of no association between Huntington disease and the HindIII polymorphism is confirmed, but the particular families in which the association is significant differs from that obtained through an analysis based only on affected individuals and reflects more closely the results obtained from a lod-score analysis. The test statistic is also modified here to incorporate contrasts between individuals of zero kinship, if needed. This enables contrasts between individuals from different pedigrees, as well as contrasts involving individuals sampled from the general population, to be incorporated into the test of association. For population data, the methodology reduces to a type of contingency-table analysis, in which the rows of the table correspond to different marker-locus genotypes and in which the two columns categorize subjects into an "affected" group versus an "unaffected," or control, group. This aspect of the methodology is illustrated using two population data sets, the first relating APO-E genotype to the frequency of individuals undergoing maintenance hemodialysis and the second relating APO-B genotype to the frequency of coronary artery disease. The present methodology confirms the lack of association between marker and disease in the former data set and confirms the presence of association in the latter. Finally, the methodology is formulated here in terms of ordinary, multiperson kinship coefficients rather than in terms of the generalized kinship coefficients originally proposed. This greatly reduces the number of coefficients to be calculated, thereby enhancing the computational efficiency of the computer program.

Apolipoproteins B↗
PubMed1993

The freckle plot (daily turnaround time chart): a technique for timely and effective quality improvement of test turnaround times.

Test turnaround times are often monitored on a monthly basis. However, such an interval usually means that not all causes for delay in test reporting can be unequivocally identified for institution of remedial action. We have devised a daily chart--the freckle plot--that graphically displays the test turnaround times by laboratory receipt time. Different symbols are used to designate specimens reported within the test's turnaround time limit, those within 10 min beyond that limit, and those well outside the limit. These categories are adjustable to suit different limits of stringency. Freckle plots are produced on a daily basis and can be used to track down causes for test delays. Using the 1-h turnaround time "stat" potassium test as a model, we found 16 causes for test delay, of which 9 were potentially remediable. By applying these remedies, we were able to increase test compliance, in the day shift, from 91.5% (95% confidence interval 88.8%-93.7%) to 97.6% (95% confidence interval 96.4-98.55%), which is significant at P < 10(-7). This daily plot is a useful quality assurance tool, supplementing the more conventional tests used to ensure laboratory quality improvement.

Chemistry, Clinical↗
PubMed1990

The protease inhibitory properties of the Alzheimer's beta-amyloid precursor protein.

We have expressed the 57-amino acid Kunitz domain of the Alzheimer's beta-amyloid precursor protein (APP751) as a bacterial fusion protein. The protease inhibitory properties of the purified fusion protein, BX9, were virtually identical in all respects tested to those of purified secreted APP751. Both proteins strongly inhibited pancreatic trypsin (Kis = 0.2 and 0.3 nM) and less well epidermal growth factor-binding protein (Kis = 1 and 3.5 nM), alpha-chymotrypsin (Kis = 3 and 6 nM), and the gamma-subunit of nerve growth factor (Kis = 8 and 9 M). Neither protein appreciably inhibited plasma and pancreatic kallikreins, thrombin, lung tryptase, neutrophil elastase, or cathepsin G. The remarkable similarity of the protease inhibitory profile of BX9 to that of secreted APP751 suggests that proper intramolecular disulfide bond formation has occurred in the bacterial fusion protein and leads to the conclusion that the amyloid precursor protein Kunitz domain is a relatively specific inhibitor of only a few trypsin-like arginine esterases.

Amino Acid Sequence↗
PubMed1990

Cleavage of amyloid beta peptide during constitutive processing of its precursor.

The amyloid beta peptide (A beta P) is a small fragment of the much larger, broadly distributed amyloid precursor protein (APP). Abundant A beta P deposition in the brains of patients with Alzheimer's disease suggests that altered APP processing may represent a key pathogenic event. Direct protein structural analyses showed that constitutive processing in human embryonic kidney 293 cells cleaves APP in the interior of the A beta P, thus preventing A beta P deposition. A deficiency of this processing event may ultimately prove to be the etiological event in Alzheimer's disease that gives rise to senile plaque formation.

Amino Acid Sequence↗
PubMed1990

The Alzheimer amyloid precursor protein. Identification of a stable intermediate in the biosynthetic/degradative pathway.

The amyloid forming beta-peptide of Alzheimer's disease is synthesized as part of a larger integral membrane precursor protein (beta APP) of which three alternatively spliced versions of 695, 751, and 770 amino acids have been described. A fourth beta APP form of 563 amino acids does not contain the beta-peptide region. Recent experiments using transient expression in HeLa cells (Weidemann, A., Konig, G., Bunke, D., Fischer, P., Salbaum, J.M., Masters, C.L., and Beyreuther, K. (1989) Cell 57, 115-126) indicate that the beta APP undergoes several posttranslational modifications including the cleavage and secretion of a large portion of its extracellular domain. The nature and fate of the fragment that remains cell-associated following this cleavage has not heretofore been described. The metabolism of this fragment may have particular significance in Alzheimer's disease since it must contain at least part of the beta-peptide. To study the metabolic fate of this fragment, we have established cell lines overexpressing the 695- and 751-amino acid versions of beta APP. Pulse-chase studies show that this system is similar to the HeLa cell system in that both proteins are synthesized first as membrane-bound proteins of approximately 98 and 108 kDa carrying asparagine-linked sugar side chains and are subsequently processed into higher molecular mass forms by the attachment of sulfate, phosphate, and further sugar groups including sialic acid, adding approximately 20 kDa in apparent molecular mass. The mature form of beta APP is cleaved and rapidly secreted, leaving an 11.5-kDa fragment with the transmembrane region and the cytoplasmic domain behind in the cell. This fragment is stable with a half-life of at least 4 h.

Alzheimer Disease↗
PubMed1990

The inheritance of metabolic flux: expressions for the within-sibship mean and variance given the parental genotypes.

Recent developments have related quantitative trait expression to metabolic flux. The present paper investigates some implications of this for statistical aspects of polygenic inheritance. Expressions are derived for the within-sibship genetic mean and genetic variance of metabolic flux given a pair of parental, diploid, n-locus genotypes. These are exact and hold for arbitrary numbers of gene loci, arbitrary allelic values at each locus, and for arbitrary recombination fractions between adjacent gene loci. The within-sibship, genetic variance is seen to be simply a measure of parental heterozygosity plus a measure of the degree of linkage coupling within the parental genotypes. Approximations are given for the within-sibship phenotypic mean and variance of metabolic flux. These results are applied to the problem of attaining adequate statistical power in a test of association between allozymic variation and inter-individual variation in metabolic flux. Simulations indicate that statistical power can be greatly increased by augmenting the data with predictions and observations on progeny statistics in relation to parental allozyme genotypes. Adequate power may thus be attainable at small sample sizes, and when allozymic variation is scored at a only small fraction of the total set of loci whose catalytic products determine the flux.

Animals↗
PubMed1989

The secreted form of the Alzheimer's amyloid precursor protein with the Kunitz domain is protease nexin-II.

The A4 protein (or beta-protein) is a 42- or 43-amino-acid peptide present in the extracellular neuritic plaques in Alzheimer's disease and is derived from a membrane-bound amyloid protein precursor (APP). Three forms of APP have been described and are referred to as APP695, APP751 and APP770, reflecting the number of amino acids encoded for by their respective complementary DNAs. The two larger APPs contain a 57-amino-acid insert with striking homology to the Kunitz family of protease inhibitors. Here we report that the deduced amino-terminal sequence of APP is identical to the sequence of a cell-secreted protease inhibitor, protease nexin-II (PN-II). To confirm this finding, APP751 and APP695 cDNAs were over-expressed in the human 293 cell line, and the secreted N-terminal extracellular domains of these APPs were purified to near homogeneity from the tissue-culture medium. The relative molecular mass and high-affinity binding to dextran sulphate of secreted APP751 were consistent with that of PN-II. Functionally, secreted APP751 formed stable, non-covalent, inhibitory complexes with trypsin. Secreted APP695 did not form complexes with trypsin. We conclude that the secreted form of APP with the Kunitz protease inhibitor domain is PN-II.

Alzheimer Disease↗
PubMed1988

Total intravenous anaesthesia for military surgery. A technique using ketamine, midazolam and vecuronium.

Ketamine and midazolam were used for induction of anaesthesia and by continuous intravenous infusion for maintenance to assess their suitability for use in a total intravenous anaesthetic technique in the management of battle casualties. Muscular relaxation was provided by vecuronium and the patients' lungs ventilated with air. Ketamine was infused at a rate of 2 mg/kg/hour. This was achieved by mixing ketamine 200 mg, midazolam 5 mg and vecuronium 12 mg in 50 ml normal saline. The rate of infusion of the mixture (ml/hour) was then equal to 50% of the body weight in kg. The technique proved to be simple, effective and versatile and should be adaptable for use in the management of battle casualties.

Adolescent↗
PubMed1988

Verapamil SR and propranolol LA: a comparison of efficacy and side effects in the treatment of mild to moderate hypertension.

The efficacy, safety and toleration of sustained release verapamil (Securon SR, Knoll) and long acting propranolol (Inderal LA, ICI) in the treatment of mild to moderate hypertension were compared in a randomized, double-blind, parallel group study. Both drugs were of similar efficacy and were well tolerated in the majority of patients. However, in the verapamil SR treated group side-effects resulted in significantly fewer drug-related withdrawals.

Adult↗
PubMed1987

Beta 2 microglobulin enhances the infectivity of cytomegalovirus and when bound to the virus enables class I HLA molecules to be used as a virus receptor.

We have previously demonstrated that human cytomegalovirus (CMV) binds the host protein beta 2 microglobulin (beta 2m) from body fluids or from cell culture media. In this report we have examined the effect of the beta 2m on viral infectivity. We have shown that the addition of human purified beta 2m, or a fraction of foetal calf serum corresponding to bovine beta 2m, to culture medium increased the amount of infectious extracellular CMV, compared to that from cells grown in serum-free medium. Metabolic labelling experiments demonstrated that this effect was not due to an increase in the amount of extracellular virus but to an increase in the infectivity of the virus present in extracellular fluids. We concluded that the binding of beta 2m by CMV increased its infectivity. We have shown that CMV and beta 2m compete for binding sites on fibroblasts. As the main binding site on cells for beta 2m is the class I HLA heavy chain we compared the binding of CMV to the Raji and Daudi cell lines which express or lack expression of class I HLA molecules. The binding of radiolabelled beta 2m-coated CMV was significantly higher to Raji cells than to Daudi cells. Furthermore, CMV could compete with beta 2m for binding to Raji cells, although the reverse was not true. These results demonstrate that CMV can use class I HLA molecules as a virus receptor. We propose that when coated with beta 2m, CMV has the capacity to displace beta 2m from the class I HLA heavy chain-beta 2m dimer on the cell surface and bind to cells. The fact that beta 2m enhances infectivity suggests that such binding leads to productive infection of cells.

Cell Line↗