Use of Shewart's technique.
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Analysis of Variance↗
Biomedical subjects
T Wilson
Publications and source records attributed to T Wilson.
Not again! Only ocular treatments should be packaged like eye drops.
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Drug Packaging↗
Clinical evaluation of a new recombinant antigen-based cytomegalovirus immunoglobulin M immunoassay in liver transplant recipients.
BACKGROUND: Human cytomegalovirus (CMV) is a significant cause of morbidity and mortality among transplant recipients. Monitoring transplant recipients by CMV IgM serology has been questioned by several studies due to the reported insensitivity of serologic tests relative to antigen detection methods. METHODS: In this retrospective study, we have evaluated the performance of the new recombinant antigen-based Abbott AxSYM CMV IgM assay and compared it with CMV culture technique in a cohort of 40 liver transplant recipients who did not receive antiviral prophylaxis. RESULTS: The sensitivity, specificity, and positive and negative predictive values for detection of CMV disease by the AxSYM CMV IgM assay were 90.0%, 60.0%, 69.2%, and 85.7%, respectively, and by culture the values were 100%, 55.0%, 69.0%, and 100%, respectively. Detection of CMV IgM occurred before or at the time of CMV disease in only R+ recipients. CONCLUSION: Although this assay is a sensitive test for CMV-specific IgM, detection of CMV IgM preceded detection of virus by culture in patients only when the liver transplant recipient was CMV immune before transplantation (R+).
Antibodies, Viral↗
Subtyping binge eating-disordered women along dieting and negative affect dimensions.
OBJECTIVE: Because etiologic and maintenance models of binge eating center around dieting and affect regulation, this study tested whether binge eating-disordered (BED) individuals could be subtyped along dieting and negative affect dimensions and whether subtypes differed in eating pathology, social functioning, psychiatric comorbidity, and response to treatment. METHOD: Three independent samples of interviewer-diagnosed BED women (N = 218) were subtyped along dieting and negative affect dimensions using cluster analysis and compared on the outcomes of interest. RESULTS: Cluster analyses replicated across the three independent samples and revealed a dietary subtype (63%) and a dietary-depressive subtype (37%). The latter subtype reported greater eating and weight obsessions, social maladjustment, higher lifetime rates of mood, anxiety, and personality disorders, and poorer response to treatment than did the dietary subtype. DISCUSSION: Results suggest that moderate dieting is a central feature of BED and that affective disturbances occur in only a subset of cases. However, the confluence of dieting and negative affect signals a more severe variant of the disorder marked by elevated psychopathology, impaired social functioning, and a poorer treatment response.
Adult↗
The AMA Residency Training in Adolescent Preventive Services Project: report of the working group. The American Medical Association.
PURPOSE: To improve resident education in provision of adolescent preventive health care. The American Medical Association (AMA) Residency Training in Adolescent Preventive Services Project Working Group convened to identify specific goals and objectives (G&Os) for pediatric and family medicine resident education in adolescent clinical preventive services and recommend strategies to achieve these G&Os. METHODS: Iterative review process involving members of the working group, nine experienced teaching faculty and 16 resident physicians from family medicine and pediatric training programs, and an advisory board. RESULTS: We achieved consensus on appropriate G&Os for pediatric and family medicine residency education in adolescent clinical preventive services. Faculty and residents expressed concerns about achieving G&Os because of challenges to implementing effective training and evaluation strategies. Suggestions for achieving G&Os included development of an adolescent clinical preventive services curriculum and evaluation program that could be adapted for use in a variety of training program structures. Faculty and residents anticipated the success of a training curriculum would be influenced by: (a) availability of adequate numbers of skilled teaching faculty; (b) availability of time and support for faculty development and teaching efforts; and (c) exposure of residents to adequate numbers of adolescent patients in settings where there are clear expectations for delivery of comprehensive preventive services. CONCLUSIONS: The AMA Residency Training in Adolescent Preventive Services Project Working Group presents G&Os for organizing training experiences in adolescent clinical preventive services in family medicine and pediatric residency training programs and recommends strategies to achieve these G&Os.
Adolescent↗
Miniaturized tests for computer-assisted identification of motile Aeromonas species with an improved probability matrix.
AIMS: To develop miniaturized tests for the phenotypic identification of motile Aeromonas species using an improved probability matrix. METHODS AND RESULTS: Conventional tests were miniaturized for use in 96-well plates, and their performance assessed using 60 aeromonads comprising type and reference strains as well as clinical, fish and water isolates. A revised probability matrix for Aeromonas hybridization groups 1-14, including A. allosaccharophila, A. bestiarum, A. encheleia and A. popoffii, was developed. Using 26 tests, all the reference strains were correctly identified with the revised probability matrix, and 80% of the isolates were correctly identified at a Willcox probability level of 95%. CONCLUSION: The compact test format, coupled with a robust identification matrix, provides a convenient basis for identifying motile aeromonads. SIGNIFICANCE AND IMPACT OF THE STUDY: The identification system for identifying aeromonads will be of use to medical and veterinary laboratories undertaking disease diagnosis.
Aeromonas↗
Time-domain whole-field fluorescence lifetime imaging with optical sectioning.
A whole-field time-domain fluorescence lifetime imaging (FLIM) microscope with the capability to perform optical sectioning is described. The excitation source is a mode-locked Ti:Sapphire laser that is regeneratively amplified and frequency doubled to 415 nm. Time-gated fluorescence intensity images at increasing delays after excitation are acquired using a gated microchannel plate image intensifier combined with an intensified CCD camera. By fitting a single or multiple exponential decay to each pixel in the field of view of the time-gated images, 2-D FLIM maps are obtained for each component of the fluorescence lifetime. This FLIM instrument was demonstrated to exhibit a temporal discrimination of better than 10 ps. It has been applied to chemically specific imaging, quantitative imaging of concentration ratios of mixed fluorophores and quantitative imaging of perturbations to fluorophore environment. Initially, standard fluorescent dyes were studied and then this FLIM microscope was applied to the imaging of biological tissue, successfully contrasting different tissues and different states of tissue using autofluorescence. To demonstrate the potential for real-world applications, the FLIM microscope has been configured using potentially compact, portable and low cost all-solid-state diode-pumped laser technology. Whole-field FLIM with optical sectioning (3D FLIM) has been realized using a structured illumination technique.
Animals↗
Rapid, high-throughput extraction of bacterial genomic DNA from selective-enrichment culture media.
AIMS: To create a fast, sensitive and inexpensive high-throughput method for the extraction of bacterial genomic DNA from selective-enrichment culture media. METHODS AND RESULTS: Lysis of bacteria was achieved using guanidinium isothiocyanate, and DNA was extracted using 96-well glass microfibre filtration plates. Extraction-PCR detected the presence of 1 cfu Yersinia ruckeri and 16 cfu Lactococcus garvieae 200 microl(-1) sample of selective-enrichment medium. CONCLUSION: An efficient method for high-throughput extraction of bacterial genomic DNA from selective-enrichment culture media was achieved. SIGNIFICANCE AND IMPACT OF THE STUDY: This method enables detection of covert bacterial infections in fish. The simultaneous extraction of large numbers of samples allows for its use in bacterial monitoring programmes and quarantine.
Bacteria↗
Reduced binding of progesterone receptor to its nuclear response element after human labor onset.
OBJECTIVE: There is indirect evidence of decreased progesterone-activated transcription after human labor onset. Binding of the progesterone receptor to its response element is a prerequisite of progesterone-activated transcription. We established an assay to investigate whether there is reduced binding of progesterone receptor to its nuclear response element after, compared with before, labor onset. STUDY DESIGN: The binding of progesterone receptor from the decidua to its nuclear response element was measured in gel shift assays. Tissues from 52 patients who were term, preterm, in labor, and not in labor were compared. RESULTS: A 9-fold decrease in progesterone receptor binding to its response element was observed in tissues obtained after, compared with before, the onset of labor (P = .0008). In both preterm and term not-in-labor tissues, binding was higher than for in-labor tissues (P = .0172 for preterm; P = .0147 for term, Mann-Whitney U test). CONCLUSION: These findings provide a mechanism for the effective withdrawal of progesterone in human parturition.
Cell Nucleus↗
Genetic mutations influencing ovulation rate in sheep.
Ovulation rate in mammals is determined by a complex exchange of endocrine signals between the pituitary gland and the ovary, and by paracrine signals within ovarian follicles between the oocyte and its adjacent somatic cells. One approach to identifying factors regulating ovulation rate is to find mutations that influence the target phenotype and, in this context, sheep are proving to be remarkable experimental models. Recently, in three sheep families, namely Inverdale, Hanna and Booroola, the inherited mutation was mapped to a specific region of the sheep X chromosome (Inverdale, Hanna) or sheep chromosome 6 (Booroola) and in each, a point mutation was identified in genes from the bone morphogenetic protein (BMP) relatives of the transforming growth factor beta superfamily or their receptors. In Inverdale (I) and Hanna (H) sheep, separate point mutations were identified in the BMP15 gene corresponding to sites in the mature peptide coding region of the BMP15 growth factor (also known as growth differentiation factor 9B; GDF9B). Expression of the BMP15 gene was located exclusively in oocytes from the primary stage of follicular growth. There is a complete block of normal follicular development in females carrying two copies of the Inverdale mutation (II), two copies of the Hanna mutation (HH), or one copy of each mutation (HI). Increased ovulation rates are found in females with only one copy of either mutation (I+ or H+). In Booroola sheep, a point mutation was identified in the highly conserved intracellular serine threonine kinase signalling domain of the BMP-1B receptor. Within the ovary, this gene is expressed in oocytes in primordial and pre-antral follicles and in granulosa cells from the primary stage of growth as well as in corpora lutea. The effect of the Booroola mutation is additive for ovulation rate: animals with one copy of the mutation have an ovulation rate of 3 or 4, whereas those with two copies have an ovulation rate of between 5 and 14. Physiological studies of the above mutations demonstrate that the oocyte plays an active role with respect to its adjacent somatic cells during follicular development and support the hypothesis that the oocyte has a significant influence on the number of follicles that proceed to ovulation.
Animals↗
Highly prolific Booroola sheep have a mutation in the intracellular kinase domain of bone morphogenetic protein IB receptor (ALK-6) that is expressed in both oocytes and granulosa cells.
The Booroola fecundity gene (FecB) increases ovulation rate and litter size in sheep and is inherited as a single autosomal locus. The effect of FecB is additive for ovulation rate (increasing by about 1.6 corpora lutea per cycle for each copy) and has been mapped to sheep chromosome 6q23-31, which is syntenic to human chromosome 4q21-25. Bone morphogenetic protein IB (BMP-IB) receptor (also known as ALK-6), which binds members of the transforming growth factor-beta (TGF-beta) superfamily, is located in the region containing the FecB locus. Booroola sheep have a mutation (Q249R) in the highly conserved intracellular kinase signaling domain of the BMP-IB receptor. The mutation segregated with the FecB phenotype in the Booroola backcross and half-sib flocks of sheep with no recombinants. The mutation was not found in individuals from a number of sheep breeds not derived from the Booroola strain. BMPR-IB was expressed in the ovary and in situ hybridization revealed its specific location to the oocyte and the granulosa cell. Expression of mRNA encoding the BMP type II receptor was widespread throughout the ovary. The mutation in BMPR-IB found in Booroola sheep is the second reported defect in a gene from the TGF-beta pathway affecting fertility in sheep following the recent discovery of mutations in the growth factor, GDF9b/BMP15.
Activin Receptors↗
Validity of lower extremity strength and power utilizing a new closed chain dynamometer.
PURPOSE: The purpose of this study was to compare selected variables measured on a traditional isokinetic dynamometer (Cybex II) with a new lower extremity, closed chain dynamometer (Omnikinetic, OmK). METHODS: Twelve subjects (6 male, 6 female, age = 28+/-5 yr, mean +/- SD) performed Cybex II knee flexion and extension at 1.05, 3.14, and 5.23 rad x s(-1). A maximal effort of 10 repetitions of lower extremity concentric extension and eccentric flexion at 36% of subject's 1-RM was performed on the OmK. Crank power and joint (ankle, knee, and hip) kinetics were recorded as a mean of 10 repetitions. RESULTS: t-Tests revealed right versus left leg differences (P < 0.05) for Cybex II peak torque flexion at 5.23 rad x s(-1), and OmK knee and hip peak power and hip root mean square power (RMS) power. Cybex peak knee torques were related (Pearson r values 0.78-0.92, P < 0.01) to OmK peak knee torques. Cybex average power was related to OmK knee power (Pearson r values 0.71-0.96, P < 0.01) and OmK crank power (r = 0.62-0.94, P < .01). Correlations tended to be stronger comparing the OmK with the fastest (5.23 rad x s(-1)) Cybex II speed. CONCLUSIONS: These results suggest that the OmK knee and crank kinetic data are comparable to Cybex It isokinetic dynamometry. The ability to evaluate lower extremity joint exercise at a subject's maximal movement speed, in addition to the use of a closed-chain, multi-joint motion, may allow for the OmK to provide a more global evaluation of lower extremity kinetics during seated concentric-extension, eccentric-flexion exercise.
Adult↗
Refractive-index-mismatch induced aberrations in single-photon and two-photon microscopy and the use of aberration correction.
We examine the effects of aberrations induced by a refractive index mismatch on the signal level and resolution of single-photon (1-p) and two-photon (2-p), conventional and confocal scanning microscopes. In particular, we consider the aberrations introduced by an interface between oil/glass and water. Resolution is defined in terms of enclosed fluorescence, rather than full-width half-maximum, revealing more useful information for heavily aberrated point spread functions (PSFs). It is shown that, at large focusing depths, the resolution of 2-p conventional and 1-p confocal microscopes are almost identical. The benefits of aberration correction are examined by removing Zernike aberration modes. With aberration correction, the best resolution is found for 1-p confocal and 2-p confocal modes. An approximation based upon geometrical optics is also introduced which shows that the axial resolution of heavily aberrated PSFs is roughly proportional to focusing depth.
Microscopy, Fluorescence↗
Longitudinal studies of Sin Nombre virus in deer mouse-dominated ecosystems of Montana.
Sin Nombre virus (SNV), hosted by the deer mouse (Peromyscus maniculatus), is the primary etiologic agent of Hantavirus pulmonary syndrome (HPS) in North America. To improve our understanding of the epidemiology of HPS in the western United States, we conducted studies of population dynamics and SNV antibody prevalence in deer mouse populations for 6 years on 12 mark-recapture grids in Montana. Monthly numbers of deer mice ranged from zero to over 170 on 1-hectare grids. SNV antibody prevalence was higher than observed in studies in other parts of the United States, averaging 13% (0% to 50%), and peaking in May or June each year. Antibody-positive mice were older (heavier) (78% of positives were adults versus 52% of negatives) and more likely to be males (61% of positives versus 53.4% of negatives). A higher proportion of antibody-positive deer mice of all age-mass classes had scars than did antibody-negative mice. Month-to-month survivorship of antibody-positive adult mice was similar to that of antibody-negative mice, but survival of young antibody-positive deer mice was lower than antibody-negative deer mice. This is the first study to clearly suggest a detrimental effect of SNV infection on deer mice.
Age Factors↗
Methods for achieving pneumoperitoneum at laparoscopy. 1999; 44(4):324-7.
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Humans↗
Demands for urgent care.
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Appointments and Schedules↗
Open reduction of a lateral femoral notch associated with an acute anterior cruciate ligament tear.
The lateral notch is a radiographic sign that describes a depression in the lateral femoral condyle near the terminal sulcus. The sign was first described in association with chronic instability in an anterior cruciate ligament-deficient knee. Recently, the senior author, after a prospective study, reported that these lateral notches might occur acutely at the time of anterior cruciate ligament injury. We report such a case in which the lateral femoral condylar depression fracture resulted in symptoms of lateral compartment incongruity. Open reduction and internal fixation were required. Anterior cruciate ligament reconstruction was performed as a staged procedure 2 months after fracture reduction. The postoperative result has been excellent for over 5 years. This case is an example that lateral femoral notches may be acute and a source of symptoms. In some cases, reduction and fixation of significant depressions in association with ligament reconstruction can alleviate these symptoms and may improve the patient's long-term result.
Adult↗
Congenital duodenal obstruction: early antenatal ultrasound diagnosis.
Twenty-nine patients with congenital duodenal obstruction (DO) detected as a "double bubble" (DB) on antenatal ultrasound (US) or diagnosed postnatally were seen at the Women's and Children's Hospital between 1985 and 1994; 24 (83%) had antenatal scans, with 21 (87%) DBs visualised. The 3 fetuses with normal scans who developed DO postnatally had duodenal "windsocks". Five of the 24 scanned patients (21%) were found to have a DB before 20 weeks' gestation: 1 simple duodenal atresia, 2 duodenal atresias with chromosomal abnormalities (1 trisomy 21 and 1 triploidy), 1 biliary atresia with a pre-pyloric vein, and 1 malrotation. Sixteen (67%) cases were detected with scans after 20 weeks (range 28-36 weeks); 12 (75%) of these were done for polyhydramnios. In response to a questionnaire to 9 of the 16 parents whose fetuses underwent a late scan, 5 had had normal early scans elsewhere and 4 did not respond (4 of the remaining 7 had died and 3 were lost to follow-up). Eleven of the 29 patients (38%) had abnormal karyotypes, and 4 (22%) of the 18 with a normal karyotype had associated anomalies. Two sets of familial cases were noted. Early antenatal diagnosis of DO is possible in a minority of cases, and this early diagnosis may be associated with an increased risk of other pathology. Furthermore, early demonstration of a DB at routine US prior to 20 weeks allows appropriate counseling and the option of mid-trimester termination, whereas this is more difficult later in the pregnancy. In all cases detected antenatally, planning of delivery and parent counseling should be achieved.
Abnormalities, Multiple↗