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Biomedical subjects

R McGraw

Publications and source records attributed to R McGraw.

18 recordsLinked to original sources

Pulsed dye laser efficacy as initial therapy for warts and against recalcitrant verrucae.

Pulsed dye (vascular) laser therapy is effective against verrucae (warts) that have not responded to other treatments. These observations suggest that vascular laser therapy might be particularly efficacious against verrucae not previously treated. Of the thirty-two patients with verrucae in this study, nineteen had been previously treated (recalcitrant group) and thirteen had not (no prior treatment group). All warts were treated an average of 1.72 times with the Candela vascular laser at 585 nm, 8 J/cm2. Patients were treated at one- to two-month intervals. Response rates were as follows: 68 percent of the recalcitrant warts were completely cleared, and 47.1 percent of the warts with no prior treatment were completely cleared. In the recalcitrant group, 45.9 percent were treated three times, the maximum number of treatments offered. In the no prior treatment group, only 5.9 percent of warts were treated at all three laser clinics offered. Vascular laser therapy appears to be effective as therapy in the treatment of verrucae, especially those that have not been eradicated by other treatments. Patients who had received no prior treatment for their warts were less likely to proceed with therapy, but had a satisfactory clearance rate with minimal treatment.

Adolescent↗

Hip arthrodesis: an important option for advanced disease in the young adult.

Despite increasing confidence in the intermediate and long-term results of total hip replacement, considerable and justifiable concern remains about its use in young, active adults. Hip arthrodesis is a valuable, although unpopular, option in this group of patients. The authors describe, step by step, the standardized technique of arthrodesis that they first used in 1981, and they review the results of their experience. The importance of precise positioning of the fusion is emphasized: 20 degrees of flexion, 5 degrees of external rotation and neutral abduction-adduction. Intraoperative radiography to check the positioning is strongly advised. Because total hip arthroplasty will likely be necessary at a later date, every effort should be made to preserve the abductors, and the greater trochanter should be fixed in place at its normal level. If these precautions are taken and if the patient is carefully selected and properly educated preoperatively, a high success rate can be expected for hip arthrodesis.

Adolescent↗

A bovine homolog to the human myogenic determination factor myf-5: sequence conservation and 3' processing of transcripts.

A bovine cDNA library from fetal skeletal muscle myoblasts. was screened with a 274 bp probe to a conserved region of the mouse MyoD1 cDNA. One positive recombinant, designated bmyf, was found to contain a 1931 bp insert with an open reading frame encoding a predicted protein highly related to the human myogenic factor myf-5 Human and bovine factors are 96% homologous in their predicted amino acid sequences. At the nucleotide level, bmyf and myf-5 are 92% identical in the coding region and 74 and 80% homologous in their 5'- and 3'-untranslated regions, respectively. The bmyf cDNA, nevertheless, extends 475 nucleotides beyond a polyadenylation signal common to both cDNAs. Bmyf transcripts are expressed exclusively in skeletal muscle where three transcripts of 1.5, 2 and 3 kb were detected. While the 1.5 kb transcript lacks sequences 3' to the polyadenylation signal at nt 1415 in the bmyf cDNA, both the 2 and 3 kb RNAs contain these sequences suggesting that bmyf transcripts are alternatively polyadenylated. Bmyf cDNA can activate the expression of the myogenic program in C3H10T1/2 fibroblasts as assayed by stable and transient transfection experiments.

Amino Acid Sequence↗

Antigenic determinant in human coagulation factor IX: immunological screening and DNA sequence analysis of recombinant phage map a monoclonal antibody to residues 111 through 132 of the zymogen.

As an approach to the study of structure-function relationships in the normal and defective forms of human coagulation factor IX, we have begun to develop a series of monoclonal antibodies against specific sites on the protein. Zymogen and activated forms of normal factor IX were used initially as antigen for the preparation of monoclonal antibodies. Recombinant phage were prepared by cloning small (50- to 500-nucleotide) random DNA fragments from the coding region of a factor IX cDNA clone into the expression vector lambda gt11. Immunological screening of these recombinants with mixtures of monoclonal antibodies identified several immunoreactive phage. Further analysis showed that the monoclonal antibody designated IX-30 was generating the positive signals at a frequency of approximately 1/2,500 recombinants. Subcloning and sequence analysis of the inserted DNA in the immunoreactive phage revealed overlapping in-frame insertions, from which it could be inferred that the site in factor IX recognized by IX-30 is confined to residues 111 through 132 in the light chain. Similar mapping with other monoclonal antibodies should provide additional probes for the protein structure of human factor IX.

Amino Acid Sequence↗

Clinical activities during a clerkship rotation in emergency medicine.

Clinical log books were completed by the 1995-1996 clinical clerks at Queen's University, Kingston, Ontario, Canada, during their 2-wk rotation in emergency medicine. To determine the clinical activities of the students and assess the educational effectiveness of our clerkship program, the information recorded in these log books was compared with the results of a survey of the emergency department (ED) staff physicians. This survey asked the physicians to identify five essential clinical presentations and procedural skills that they felt the clerks must observe during their rotation in the ED. To our knowledge, this is the first Canadian report using log books as a quality assurance tool for a clerkship program in emergency medicine. This study has highlighted specific weaknesses in the clinical activities of the clerks and will serve as a valuable resource for future assessments of the emergency medicine rotation at our institution.

Clinical Clerkship↗