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Biomedical subjects

P Wynn

Publications and source records attributed to P Wynn.

At least 19 recordsLinked to original sources

Spinal cord stimulation: a seven-year audit.

OBJECTIVE: To evaluate the outcome and complications of spinal cord stimulation (SCS) for chronic neuropathic pain in an Australian population. MATERIALS AND METHODS: An independent researcher retrospectively examined the records of 138 patients trialing SCS between 1995 and 2002 at our institution. Information collected included pain relief, ability to perform activities of daily living (ADLs), return to work and reduction in opiate analgesia. Clinical, psychological, demographic and financial data were also collected. RESULTS: Of 138 patients who trialed SCS, 103 (74.7%) achieved a greater than 50% reduction in their pain and proceeded to permanent implantation. At 1 year following permanent implantation, 84.4% of these still had a reduction in their pain by greater than 50%. The majority of patients, 59.1%, stated that their analgesia was good (50-74% pain reduction). All patients required opiate analgesics prior to SCS implantation, but this fell to 54.6% after SCS implantation. Additionally, 73.6% had a significant improvement in their ability to perform ADLs and 24% of patients were able to return to work. CONCLUSION: SCS is an effective treatment in the control of chronic neuropathic pain, particularly in combination with comprehensive medical management within a multidisciplinary pain management centre.

Activities of Daily Living↗

Inhibition of corticotropin releasing hormone type-1 receptor translation by an upstream AUG triplet in the 5' untranslated region.

The influence of an upstream open reading frame (ORF) in the 5'-untranslated region (UTR) of the mRNA on corticotropin-releasing hormone receptor type 1 (CRHR1) translation was studied in constructs containing the 5'-UTR of CRHR1, with or without an ATG-to-ATA mutation in the upstream ORF, and the main ORF of luciferase or CRHR1. Upstream mutation in luciferase constructs increased luciferase activity when transfected into COS-7 or AtT20 cells compared with the native 5'-UTR. Transfection of CRHR1 constructs containing the upstream mutation into AtT20 or LVIP2.0zc reporter cells, resulted in higher (125)I-Tyr-oCRH binding and corticotropin-releasing hormone-stimulated cAMP production, without changes in CRHR1 mRNA levels (measured by RNase protection assay). In vitro translation of luciferase or CRHR constructs with or without mutation of the upstream ATG, and Western blot analysis with anti-luciferase and anti-CRHR1 antibodies confirmed that mutation of the upstream ATG increases translation of the main ORF. The mechanism by which the upstream ORF inhibits translation may involve translation of the upstream peptide, because in vitro translation, or transfection into LVIP2.0zc cells of a fusion construct of the upstream ORF and green fluorescent protein (GFP) yielded a band consistent with the molecular size of GFP protein. The study shows that the upstream AUG in 5'-UTR of CRHR1 mRNA inhibits receptor expression by inhibiting mRNA translation and suggests the short open reading frame in the 5'-UTR plays a role in regulating translation of the CRH receptor.

5' Untranslated Regions↗

Pretreatment with follicle stimulating hormone promotes the numbers of human oocytes reaching metaphase II by in-vitro maturation.

The objective of this study was to investigate the effect of follicle stimulating hormone (FSH) priming on the in-vitro maturation (IVM) of human oocytes from healthy ovaries using a chemically defined culture system. Seventeen patients donating oocytes for research received a truncated course of 600 IU FSH over 5 days and a further control group of nine patients received no FSH treatment. Mid-follicular phase cumulus-enclosed oocytes (n = 160) were aspirated from follicles < or =4 mm diameter under transvaginal ultrasound guidance and were cultured for 48 h in microdrops of medium containing 10 mIU/ml FSH and 100 mIU/ ml human chorionic gonadotrophin (HCG). The results demonstrated that human oocytes will efficiently undergo IVM under serum-free conditions. After mild FSH stimulation, a greater number of cumulus-enclosed oocytes was collected, and following culture, a lower rate of degeneration was observed. Significantly more oocytes completed nuclear maturation to metaphase II following FSH stimulation (71.1 versus 43.5%). In conclusion, a truncated course of FSH stimulation in vivo improved the oocyte maturation rate in vitro, giving a mean of 4.8+/-0.7 metaphase II oocytes per patient compared with only 2.1+/-0.7 from control patients, thus yielding more mature oocytes for future IVF treatment.

Adult↗

What quality measurements miss.

Measurable indices of health care quality are all the rage these days. But physicians know that not everything in health care can be quantified. If reportable numbers become our principal focus, what is in danger of falling through the cracks?

Asthma↗