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Biomedical subjects

T Hawkins

Publications and source records attributed to T Hawkins.

At least 19 recordsLinked to original sources

Comparative genomics of the lactic acid bacteria.

Lactic acid-producing bacteria are associated with various plant and animal niches and play a key role in the production of fermented foods and beverages. We report nine genome sequences representing the phylogenetic and functional diversity of these bacteria. The small genomes of lactic acid bacteria encode a broad repertoire of transporters for efficient carbon and nitrogen acquisition from the nutritionally rich environments they inhabit and reflect a limited range of biosynthetic capabilities that indicate both prototrophic and auxotrophic strains. Phylogenetic analyses, comparison of gene content across the group, and reconstruction of ancestral gene sets indicate a combination of extensive gene loss and key gene acquisitions via horizontal gene transfer during the coevolution of lactic acid bacteria with their habitats.

Animals↗

Interferon-alpha-2b and oral cytarabine ocfosfate for newly diagnosed chronic myeloid leukaemia.

BACKGROUND: Treatment with interferon and subcutaneous cytarabine produces superior cytogenetic responses in chronic myeloid leukaemia (CML) than treatment with interferon alone, but at the expense of greater toxicity. Cytarabine ocfosfate (YNK01) is an oral precursor of cytarabine that may overcome some of the inconvenience and toxicities associated with subcutaneous cytarabine administration. PATIENTS AND METHODS: We studied the efficacy and tolerability of combination therapy with interferon-alpha-2b and YNK01 in patients with newly diagnosed, untreated CML. Forty patients were treated with interferon-alpha-2b (5 MU/m2/day) plus monthly courses of YNK01 (600 mg/day for 10 days) for 1 year. RESULTS: The 6-month complete haematological response rate was 63% and the 1-year major cytogenetic response rate was 30%, with 10% of cytogenetic responses being complete. With a median follow-up of 57 months, the estimated 5-year overall survival was 86% (95% confidence interval 70% to 94%). Treatment tolerability was poor, with toxicity leading to discontinuation of one or both drugs in 60% of cases. The median daily dose of interferon alpha-2b was 7.75 MU and the median dose of YNK01 was 600 mg/day for each 10-day treatment cycle. CONCLUSIONS: Interferon-alpha-2b and YNK01 produce cytogenetic responses comparable to those achieved with interferon-alpha-2b and parenteral cytarabine, although toxicity was excessive. Alternate dosing strategies may enhance the tolerability of YNK01.

Administration, Oral↗

Is decreased treatment time in hemodialysis patients harmful if solute clearance is maintained?

An association between decreased duration of hemodialysis and increased morbidity and mortality in patients has been suggested. Whether this is due only to decreased solute clearance is unclear. In this prospective randomised study the effect of reducing treatment time whilst maintaining constant solute clearance was examined in fourteen patients. The study lasted for a period of 36 weeks (3x12 week study periods) and used a crossover design. The patients dialysis prescription (KW) was not changed on entering the study and was maintained during short (150 minutes) and long dialysis (240 minutes) by varying blood flow, dialysate flow and dialyzer surface area. The delivered KW was kinetically assessed. Fractional urea clearance was also measured during each treatment period by measurement of urea concentration in spent dialysate and total body water using 3H2O. At the end of each treatment period a full biochemical and hematological profile, nutritional intake and status, 24 h ambulatory blood pressure, nerve conduction studies, and quality of life questionnaire were performed. Within patients the delivered single pool KW was uniform throughout the 3 treatment periods and fractional urea clearance did not vary. However, Kt/W assessed using equilibrated models (Daugardis and Smye) was significantly lower in the short dialysis period. No differences between short and long dialysis sessions were noted in any of the measured variables. Thus, over a 36 week period there is no evidence to suggest that hemodialysis patients are adversely affected by decreased duration of treatment provided that solute clearance is maintained.

Aged↗

Magnetic bead purification of labeled DNA fragments for high-throughput capillary electrophoresis sequencing.

We have developed an automated purification method for dye-terminator-based DNA sequencing products using a magnetic bead approach. This 384-well protocol generates sequence fragments that are essentially free of template DNA, salt, and excess dye-terminator products. In comparison with traditional ethanol precipitation protocols, this method uses no centrifugation, is rapid, completely automated, and increases the phred-20 read length by an average of 40 bases. To date, we have processed over 4 million samples with 94% averaging 641 phred-20 bases on the MegaBACE 1000 and 4000 and the ABI PRISM 3700 capillary instruments.

DNA↗

Human chromosome 19 and related regions in mouse: conservative and lineage-specific evolution.

To illuminate the function and evolutionary history of both genomes, we sequenced mouse DNA related to human chromosome 19. Comparative sequence alignments yielded confirmatory evidence for hypothetical genes and identified exons, regulatory elements, and candidate genes that were missed by other predictive methods. Chromosome-wide comparisons revealed a difference between single-copy HSA19 genes, which are overwhelmingly conserved in mouse, and genes residing in tandem familial clusters, which differ extensively in number, coding capacity, and organization between the two species. Finally, we sequenced breakpoints of all 15 evolutionary rearrangements, providing a view of the forces that drive chromosome evolution in mammals.

Animals↗

Initial sequencing and analysis of the human genome.

The human genome holds an extraordinary trove of information about human development, physiology, medicine and evolution. Here we report the results of an international collaboration to produce and make freely available a draft sequence of the human genome. We also present an initial analysis of the data, describing some of the insights that can be gleaned from the sequence.

Animals↗

A physical map of the human genome.

The human genome is by far the largest genome to be sequenced, and its size and complexity present many challenges for sequence assembly. The International Human Genome Sequencing Consortium constructed a map of the whole genome to enable the selection of clones for sequencing and for the accurate assembly of the genome sequence. Here we report the construction of the whole-genome bacterial artificial chromosome (BAC) map and its integration with previous landmark maps and information from mapping efforts focused on specific chromosomal regions. We also describe the integration of sequence data with the map.

Chromosomes, Artificial, Bacterial↗

Comprehensive genome sequence analysis of a breast cancer amplicon.

Gene amplification occurs in most solid tumors and is associated with poor prognosis. Amplification of 20q13.2 is common to several tumor types including breast cancer. The 1 Mb of sequence spanning the 20q13.2 breast cancer amplicon is one of the most exhaustively studied segments of the human genome. These studies have included amplicon mapping by comparative genomic hybridization (CGH), fluorescent in-situ hybridization (FISH), array-CGH, quantitative microsatellite analysis (QUMA), and functional genomic studies. Together these studies revealed a complex amplicon structure suggesting the presence of at least two driver genes in some tumors. One of these, ZNF217, is capable of immortalizing human mammary epithelial cells (HMEC) when overexpressed. In addition, we now report the sequencing of this region in human and mouse, and on quantitative expression studies in tumors. Amplicon localization now is straightforward and the availability of human and mouse genomic sequence facilitates their functional analysis. However, comprehensive annotation of megabase-scale regions requires integration of vast amounts of information. We present a system for integrative analysis and demonstrate its utility on 1.2 Mb of sequence spanning the 20q13.2 breast cancer amplicon and 865 kb of syntenic murine sequence. We integrate tumor genome copy number measurements with exhaustive genome landscape mapping, showing that amplicon boundaries are associated with maxima in repetitive element density and a region of evolutionary instability. This integration of comprehensive sequence annotation, quantitative expression analysis, and tumor amplicon boundaries provide evidence for an additional driver gene prefoldin 4 (PFDN4), coregulated genes, conserved noncoding regions, and associate repetitive elements with regions of genomic instability at this locus.

Animals↗

Effects of surgery for postinfarction ventricular tachycardia on parameters of left ventricular function.

Heart failure is the leading cause of death in patients after surgery for ventricular tachycardia. This study examines the effects of antiarrhythmic surgery on 4 parameters of left ventricular (LV) function. Global ejection fraction, segmental wall motion score, homogeneity of contraction, and diastolic function were measured in 32 patients by technetium-99m radionuclide ventriculography. Ejection fraction was measured from the left anterior oblique image. Wall motion score was assessed semiquantitatively for 11 LV segments from 3 projections. Homogeneity of contraction was expressed as the SD of the LV phase analysis curve during systole from the left anterior oblique image. Diastolic function was expressed in terms of peak and mean first time derivative of the action potential (dV/dt) of the LV function curve. Subgroup analyses were performed to distinguish the effects of aneurysmectomy, coronary artery bypass grafting, and changes in angiotensin converting enzyme inhibitor therapy. Mean systolic function improved after surgery (ejection fraction 22% vs 32%, p <0001; wall motion score 20 vs 13, p <0.0001; phase analysis 18 vs 12, p <0.03). Mean diastolic function also improved (peak dV/dt 0.83 +/- 0.32 vs 1.49 +/- 0.39, p = 0.006; mean dV/dt 0.41 +/- 0.15 vs 0.76 +/- 0.27, p = 0.006). Improvements were not confined to those who had aneurysmectomy or coronary bypass grafting and were not explained by changes in vasodilator therapy. Thus, antiarrhythmic surgery does not inherently damage LV function. Significant improvements were observed in most patients. Failure to improve indicated a poor longer term prognosis.

Aged↗

Mycobacterium-avium-intracellulare complex infection following 2-chlorodeoxyadenosine therapy for hairy cell leukaemia.

2-Chlorodeoxyadenosine (2-CdA) is associated with prolonged suppression of CD4 lymphocytes. Cases of tuberculosis or mycobacterium avium intracellulare complex (MAC) infection complicating 2-CdA administration have not been reported despite the low CD4 counts. We report a patient with Hairy Cell Leukaemia (HCL) who developed MAC infection one month following 2-CdA treatment. This patient had been previously treated with prednisone for Sweets Syndrome. It would appear that the combination of 2-CdA and prednisone predisposes patients to MAC infection, and if possible this combination of treatment should be avoided.

Anti-Inflammatory Agents↗

Characterisation of calcium signalling in DT40 chicken B-cells.

The chicken DT40 pre-B-cell line is becoming a potent experimental tool in the elucidation of higher organism cellular functions due to its unique genetic tractability. While several publications have described the effects of disruption of a range of genes in DT40 cells on calcium signalling, there has been no general overview of Ca2+ responses in wild-type cells. Here, we present experimental data comparing and contrasting the calcium responses to a range of agonists, such as alphaIgM, H2O2 and thapsigargin, applied singly or consecutively in the presence or absence of extracellular calcium. Briefly, we show that calcium release is from thapsigargin-sensitive and also -insensitive stores. This release results in, or is concomitant with, calcium entry across the plasma membrane through store-operated, receptor-operated and possibly L-type like Ca2+ channels. The agonists activate these pathways differentially producing a wide range of different sized and shaped Ca2+ signals. Furthermore, we report that Ca2+ responses in DT40 cells are dependent on the growth conditions. The presence of 1% chicken serum in the growth medium increased amplitudes of calcium responses and enhanced the sustained phase of the alphaIgM response, while 10 microM beta-mercaptoethanol in the medium (not, however, present during calcium measurements) resulted in more transient H2O2 responses and larger amplitude alphaIgM responses while failing to affect thapsigargin responses. The possible causes of these effects and their importance in comparing data from different studies on DT40 cells is discussed.

Animals↗

Successful allogeneic bone marrow transplant for chronic myeloid leukaemia despite previous interferon-induced cardiomyopathy.

We report a patient with CML who developed a reversible dilated cardiomyopathy with cardiac failure following 10 months of IFN therapy. Despite the previous cardiomyopathy, he tolerated subsequent allogeneic BMT without any adverse cardiac events. Reversible IFN-induced cardiomyopathy should not be considered a contraindication to bone marrow transplantation.

Adult↗

The safety of dipyridamole-thallium imaging in patients with critical aortic valve stenosis and angina.

Angina pectoris occurs in many patients with critical aortic valve stenosis, but in less than 50% of cases is it due to atherosclerotic coronary disease. Pre-operative coronary angiography is used to determine whether coronary revascularization is required in addition to aortic valve replacement. The aim of this study was to determine the safety and image quality of dipyridamole-thallium imaging (DPT) in excluding coronary artery disease requiring a coronary artery bypass graft in patients with aortic valve stenosis requiring aortic valve replacement. Dipyridamole-thallium imaging and coronary angiography were performed less than one month apart in patients with clinical and echo-Doppler evidence of aortic valve stenosis requiring aortic valve replacement. Coronary angiography and DPT were each interpreted by experienced observers blind to the other result. The safety of DPT was judged by symptoms, ECG changes, haemodynamic effects and the need for stress reversal. Image quality was determined from the myocardial-to-background thallium uptake ratio in a normal segment. Twelve patients with aortic valve stenosis (gradient 95 +/- 24 mmHg) were studied, all of whom had left ventricular hypertrophy. The dominant symptom was angina pectoris in eight patients, syncope in three and dyspnoea in one. None had previous myocardial infarction, but two were smokers, six were hyperlipidaemic and one was hypertensive. The patients tolerated DPT well and only one required stress reversal. The quality of the DPT images was good. The DPT image was entirely normal in eight (66%) patients, none of whom had coronary artery disease. Reversible defects were seen in four patients, all of whom had significant coronary artery disease. We conclude that DPT is safe in patients with aortic valve stenosis and angina pectoris. The image quality is good despite left ventricular hypertrophy. In patients with angina pectoris and aortic valve stenosis, coronary angiography can safely be restricted to those with abnormal myocardial perfusion results.

Aged↗

Disposition of L-732,531, a potent immunosuppressant, in rats and baboons.

L-732,531 is a semi-synthetic analog of the macrolide tacrolimus (Prograf(R)). Like tacrolimus, L-732,531 is a potent immunosuppressant. In this study, its absorption, distribution, metabolism, and excretion were studied in rats and baboons. In rats, its blood and plasma levels were similar, whereas in baboons, its blood levels were, on average, twice as high as those in plasma. This was consistent with the in vitro blood-to-plasma ratio of L-732, 531, which in these two species, as well as in humans, was much lower than that of tacrolimus and showed a minimal concentration dependence. After iv administration to rats, the blood and plasma clearance of L-732,531 decreased from approximately 60 ml/min/kg at 0.2 mg/kg to 30 ml/min/kg when dosed at 1 and 3 mg/kg. After oral administration, plasma area under the concentration vs. time curve (AUC) and maximal plasma concentration (Cmax) increased more than proportionally to the dose. At 1, 5, and 15 mg/kg, plasma AUC was 29, 466, and 2832 ng.hr/ml, respectively, and Cmax was 10, 129, and 304 ng/ml, respectively. Bioavailability, although compromised by nonlinear kinetics, was estimated to be between 8% and 18%. In baboons, the clearance of L-732,531 was lower than that in rats, especially when calculated from blood concentrations (12 ml/min/kg at 0.2 mg/kg and 8 ml/min/kg at 1 mg/kg). After oral dosing, baboon plasma AUC and Cmax were much lower than those in rats, but as in rats, they increased more than proportionally with increasing doses. The bioavailability of L-732,531 in baboons was estimated at 3%, 9%, and 24% when animals were dosed at 5, 15, and 26 mg/kg po, respectively. After oral administration of [3H]L-732,531 at 5 mg/kg, approximately 32% of the radioactivity was recovered in bile and urine of rats, compared with 9% in baboons. High-performance liquid chromatography profiles of rat and baboon plasma, bile, urine, and feces indicated that L-732,531 was metabolized extensively to a complex mixture of products. Some intact parent drug was observed in feces of orally dosed animals, indicating incomplete absorption. In vitro, L-732,531 was metabolized more extensively by baboon liver microsomes than rat or human microsomes. Its metabolism in human liver microsomes was shown to be catalyzed primarily by cytochrome P450 3A isozymes.

Animals↗

Serum from women with preeclampsia partially corrects the abnormal in vitro prostacyclin secretion of preeclamptic villous cytotrophoblasts but not that of prostaglandin E2 or endothelin-1.

OBJECTIVE: This study was conducted (1) to determine in vitro placental villous cytotrophoblast secretion of prostacyclin, prostaglandin E2, and endothelin-1, (2) to examine the effect of serum from normal and preeclamptic women on secretion of these vasoactive substances, and (3) to determine whether responses to these sera by cytotrophoblasts from preeclamptic pregnancies are different from those of normal pregnancies. STUDY DESIGN: Cytotrophoblasts isolated from human placentas collected at cesarean section from normal and preeclamptic women were incubated for 20 hours in 20% (vol/vol) sera from preeclamptic or gestational age-matched normal pregnant women. Levels of prostacyclin (measured as 6-keto-prostaglandin F1alpha), prostaglandin E2, and endothelin-1 were measured in cytotrophoblast supernatants. RESULTS: In normal pregnancy sera preeclamptic cytotrophoblasts secreted significantly lower amounts of prostacyclin and prostaglandin E2 but higher amounts of endothelin-1 than did normal cytotrophoblasts. In preeclamptic sera the abnormality of prostacyclin secretion by preeclamptic cytotrophoblasts was partially corrected, but there was no effect on prostaglandin E2 or endothelin-1 secretion. Preeclamptic sera had no effect on secretion by normal cytotrophoblasts. CONCLUSIONS: The differences between normal and preeclamptic cytotrophoblasts in prostacyclin, PGE2, and endothelin-1 secretion and in response to preeclamptic serum suggest altered arachidonic acid metabolism in preeclampsia.

Blood Physiological Phenomena↗

Haemopoietic stem cell transplantation in Australia, 1992-95: a report from the Australian Bone Marrow Transplant Recipient Registry.

BACKGROUND: Bone marrow and blood stem cell transplantation is increasingly utilised in Australia. The Australian Bone Marrow Transplant Recipient Registry was founded in 1991 to record this activity. AIM: To describe allogeneic and autologous bone marrow and blood stem cell transplantation in Australia during 1992-95. METHODS: Each bone marrow transplant programme in each State of Australia has been invited to contribute information to the Registry and all do. A single information sheet is compiled by the data manager in each programme when a marrow transplant is performed and mailed to the Registry office. An annual follow-up sheet is then mailed from the Registry to the contributing centre at the anniversary of each individual transplant. RESULTS: Australia-wide, haemopoietic cell transplants have increased in number from 478 in 1992 to 681 in 1995. The number of hospitals contributing registrations to the Australian Bone Marrow Transplant Registry has increased from 20 in 1992 to 25 in 1995. The main reason for the increased number of transplants is an increase in the number of autologous blood stem cell transplants including an increase in the number of staged autologous blood stem cell transplants. The most common indication for a single autologous transplant in 1995 was non-Hodgkin's lymphoma and for a staged autologous transplant was breast cancer. The commonest indication for an allogeneic family member transplant in 1995 was acute myeloid leukaemia and for an allogeneic unrelated donor transplant, acute lymphoblastic leukaemia. The three year actuarial overall survival for patients receiving a haemopoietic stem cell transplant between 1992 and 1994 was 54% with a median follow-up time of 2.04 years. Recurrence of the underlying malignant disease was the main cause of death during both the first and second year post transplant after both allogeneic (13.3% and 8.3%) and autologous (22.1% and 11.8%) transplantation. Treatment-related mortality was 13.1% after allogeneic transplantation and 3.3% after autologous transplantation. CONCLUSIONS: Trends in bone marrow and blood stem cell transplantation practice in Australia during 1992-1995 have been outlined and both practice and outcome can be compared with that in other countries. The main cause of treatment failure, recurrence of the underlying malignant disease, indicates that this is where current and future research needs to be focused.

Adolescent↗

The DAZ gene cluster on the human Y chromosome arose from an autosomal gene that was transposed, repeatedly amplified and pruned.

It is widely believed that most or all Y-chromosomal genes were once shared with the X chromosome. The DAZ gene is a candidate for the human Y-chromosomal Azoospermia Factor (AZF). We report multiple copies of DAZ (> 99% identical in DNA sequence) clustered in the AZF region and a functional DAZ homologue (DAZH) on human chromosome 3. The entire gene family appears to be expressed in germ cells. Sequence analysis indicates that the Y-chromosomal DAZ cluster arose during primate evolution by (i) transposing the autosomal gene to the Y, (ii) amplifying and pruning exons within the transposed gene and (iii) amplifying the modified gene. These results challenge prevailing views of sex chromosome evolution, suggesting that acquisition of autosomal fertility genes is an important process in Y chromosome evolution.

Amino Acid Sequence↗

An incremental response to high-dose therapy in multiple myeloma.

Results of conventional chemotherapy for multiple myeloma are disappointing. High-dose chemoradiotherapy with auto-transplantation is increasingly reported and some results are encouraging. We report the results of peripheral blood stem cell transplantation (PBSCT) for multiple myeloma at a single institution over a 6-year period. Forty patients, including 18 de novo patients, received debulking chemotherapy consisting of vincristine, adriamycin, and dexamethasone or methyl-prednisolone followed by stem cell mobilization with high-dose cyclophosphamide. Twenty-nine patients received PBSCT following high-dose chemoradiotherapy. Following PBSCT 92% of evaluable patients obtained at least a partial remission and 29% reached complete remission. Objective treatment responses, defined as at least a 50% reduction in serum paraprotein or marrow plasma cells, were observed following each treatment step of debulking chemotherapy, mobilization and PBSCT in 50, 42 and 71% of patients, respectively. The median overall survival from diagnosis in patients transplanted was 50 months and the median overall and progression-free survivals following transplant were 26 and 18 months, respectively. Median follow-up was 28 months. Overall treatment-related mortality was 20% but was significantly lower in de novo vs previously treated patients at 6 and 33% respectively (P = 0.027). De novo patients were more likely to obtain complete remission and had a longer overall survival following transplant but overall survival from diagnosis was similar to previously treated patients. A low serum B2M before mobilization predicted a longer progression-free survival. PBSCT needs to be considered early following diagnosis to maximise treatment response and reduce the high treatment-related mortality seen in heavily pretreated patients. In this treatment program a dose response effect in multiple myeloma was observed possibly suggesting that more intensive therapy than a single transplant may effect greater disease response.

Adult↗