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1.
Phys Rev Lett ; 132(15): 152501, 2024 Apr 12.
Article in English | MEDLINE | ID: mdl-38683002

ABSTRACT

We report the first mass measurement of the proton-halo candidate ^{22}Al performed with the low energy beam ion trap facility's 9.4 T Penning trap mass spectrometer at facility for rare isotope beams. This measurement completes the mass information for the lightest remaining proton-dripline nucleus achievable with Penning traps. ^{22}Al has been the subject of recent interest regarding a possible halo structure from the observation of an exceptionally large isospin asymmetry [J. Lee et al., Large isospin asymmetry in Si22/O22 Mirror Gamow-Teller transitions reveals the halo structure of ^{22}Al, Phys. Rev. Lett. 125, 192503 (2020).PRLTAO0031-900710.1103/PhysRevLett.125.192503]. The measured mass excess value of ME=18 092.5(3) keV, corresponding to an exceptionally small proton separation energy of S_{p}=100.4(8) keV, is compatible with the suggested halo structure. Our result agrees well with predictions from sd-shell USD Hamiltonians. While USD Hamiltonians predict deformation in the ^{22}Al ground state with minimal 1s_{1/2} occupation in the proton shell, a particle-plus-rotor model in the continuum suggests that a proton halo could form at large quadrupole deformation. These results emphasize the need for a charge radius measurement to conclusively determine the halo nature.

2.
AJNR Am J Neuroradiol ; 34(5): 1091-7, 2013 May.
Article in English | MEDLINE | ID: mdl-23179651

ABSTRACT

BACKGROUND AND PURPOSE: HGPS is a rare disorder of segmental aging, with early morbidity from cardiovascular and cerebrovascular disease. The goal of this study was to identify the neurovascular features, infarct type, topography, and natural history of stroke in the only neurovascular imaging cohort study of HGPS. MATERIALS AND METHODS: We studied 25 children with confirmed diagnoses of HGPS and neuroimaging studies available for review. Relevant clinical information was abstracted from medical records. RESULTS: We identified features suggestive of a vasculopathy unique to HGPS, including distinctive intracranial steno-occlusive arterial lesions, basal cistern collateral vessels, and slow compensatory collateral flow over the cerebral convexities. The arterial pathology in the neck consisted of distal vertebral artery stenosis with prominent collateral vessel formation as well as stenosis and calcification of both the cervical internal and common carotid arteries. Radiographic evidence of infarction was found in 60% of patients, of which half were likely clinically silent. Both large- and small-vessel disease was observed, characterized by arterial territorial, white matter, lacunar, and watershed infarcts. CONCLUSIONS: We report a unique intracranial and superior cervical arteriopathy in HGPS distinct from other vasculopathies of childhood, such as Moyamoya, and cerebrovascular disease of aging, including atherosclerosis. Arterial features of the mid and lower neck are less distinctive. For the first time, we identified early and clinically silent strokes as a prevalent disease characteristic in HGPS. Longitudinal analysis of stroke incidence and vasculopathy may provide an outcome measure for future treatment interventions for children with HGPS.


Subject(s)
Angiography/methods , Cerebrovascular Disorders/diagnosis , Progeria/diagnosis , Stroke/diagnosis , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male
3.
AJNR Am J Neuroradiol ; 33(8): 1512-8, 2012 Sep.
Article in English | MEDLINE | ID: mdl-22460337

ABSTRACT

HGPS is a rare syndrome of segmental premature aging. Our goal was to expand the scope of structural bone and soft-tissue craniofacial abnormalities in HGPS through CT or MR imaging. Using The Progeria Research Foundation Medical and Research Database, 98 imaging studies on 25 patients, birth to 14.1 years of age, were comprehensively reviewed. Eight newly identified abnormalities involving the calvaria, skull base, and soft tissues of the face and orbits were present with prevalences between 43% and 100%. These included J-shaped sellas, a mottled appearance and increased vascular markings of the calvaria, abnormally configured mandibular condyles, hypoplastic articular eminences, small zygomatic arches, prominent parotid glands, and optic nerve kinking. This expanded craniofacial characterization helps link disease features and improves our ability to evaluate how underlying genetic and cellular abnormalities culminate in a disease phenotype.


Subject(s)
Craniofacial Abnormalities/diagnostic imaging , Progeria/diagnostic imaging , Adolescent , Child , Child, Preschool , Craniofacial Abnormalities/complications , Craniofacial Abnormalities/pathology , Female , Head/diagnostic imaging , Humans , Infant , Infant, Newborn , Male , Progeria/complications , Progeria/pathology , Radiography
4.
J Physiol ; 586(6): 1755-66, 2008 Mar 15.
Article in English | MEDLINE | ID: mdl-18238811

ABSTRACT

Peroxisome proliferator-activated receptors (PPARs) alter the expression of genes involved in regulating lipid metabolism. Rosiglitazone, a PPARgamma agonist, induces tissue-specific effects on lipid metabolism; however, its mode of action in skeletal muscle remains unclear. Since fatty acid translocase (FAT/CD36) was recently identified as a possible regulator of skeletal muscle fatty acid transport and mitochondrial fatty acid oxidation, we examined in this tissue the effects of rosiglitazone infusion (7 days, 1 mg day(-1)) on FAT/CD36 mRNA and protein, its plasmalemmal content and fatty acid transport. In addition, in isolated subsarcolemmal (SS) and intermyofibrillar (IMF) mitochondria we examined rates of fatty acid oxidation, FAT/CD36 and carnitine palmitoyltransferase I (CPTI) protein, and CPTI and beta-hydroxyacyl CoA dehydrogenase (beta-HAD) activities. Rosiglitazone did not alter FAT/CD36 mRNA or protein expression, FAT/CD36 plasmalemmal content, or the rate of fatty acid transport into muscle (P > 0.05). In contrast, rosiglitazone increased the rates of fatty acid oxidation in both SS (+21%) and IMF mitochondria (+36%). This was accompanied by concomitant increases in FAT/CD36 in subsarcolemmal (SS) (+43%) and intermyofibrillar (IMF) mitochondria (+46%), while SS and IMF CPTI protein content, and CPTI submaximal and maximal activities (P > 0.05) were not altered. Similarly, citrate synthase (CS) and beta-HAD activities were also not altered by rosiglitazone in SS and IMF mitochondria (P > 0.05). These studies provide another example whereby changes in mitochondrial fatty oxidation are associated with concomitant changes in mitochondrial FAT/CD36 independent of any changes in CPTI. Moreover, these studies identify for the first time a mechanism by which rosiglitazone stimulates fatty acid oxidation in skeletal muscle, namely the chronic, subcellular relocation of FAT/CD36 to mitochondria.


Subject(s)
CD36 Antigens/metabolism , Carnitine O-Palmitoyltransferase/metabolism , Lipid Peroxidation/physiology , Mitochondria, Muscle/metabolism , Thiazolidinediones/administration & dosage , Animals , Dose-Response Relationship, Drug , Lipid Peroxidation/drug effects , Male , Mitochondria, Muscle/drug effects , Oxidation-Reduction/drug effects , Rats , Rats, Sprague-Dawley , Rosiglitazone , Vasodilator Agents/administration & dosage
5.
QJM ; 101(2): 99-109, 2008 Feb.
Article in English | MEDLINE | ID: mdl-18194975

ABSTRACT

AIM: To identify case-mix variables measured shortly after admission to be included in a patient classification system (ACMEplus) that best explains hospital outcome for older people in different health care systems. DESIGN: Observational prospective cohort study collecting patient factors (sociodemographics, functional, mental, clinical, administrative and perceived health) at different time assessments. METHODS: Multicentre study involving eight hospitals in six European countries (United Kingdom, Spain, Italy, Finland, Greece and Poland). It included consecutive patients aged 65 years or older admitted to hospital for acute medical problems. MAIN OUTCOME MEASURES: discharge status, hospital readmission, mortality and length of stay. RESULTS: Of the 1667 included patients (mean age = 78.1 years; male gender = 43.5%) two-third had at least one 'Geriatric Giant' (immobility, confusion, incontinence or falls) on admission or shortly after. The most frequently affected system was cardiovascular (29.2%) and 31% of patients declared poor or very poor health. Mean length of stay was 17.9 days, 79% of patients were discharged to their usual residence; in-hospital and 1-month follow up mortality were 7.4% and 11.6%, respectively. Physical function explained the highest variation (between 8% and 21%), followed by cognitive status and number of Geriatric Giants, for almost all outcomes except readmission. CONCLUSION: Factors other than diagnosis (physical function, cognition and presenting problems) are important in predicting key outcomes of acute hospital care for older people and are consistent across countries. Their inclusion in a standardized system of measurement may be a way of improving quality and equity of medical care in older people.


Subject(s)
Diagnosis-Related Groups , Health Status , Hospitalization , Outcome Assessment, Health Care , Acute Disease , Aged , Aged, 80 and over , Diagnosis-Related Groups/classification , Diagnosis-Related Groups/statistics & numerical data , Europe , Female , Hospitalization/statistics & numerical data , Humans , International Cooperation , Male , Outcome Assessment, Health Care/classification , Outcome Assessment, Health Care/statistics & numerical data , Program Development , Prospective Studies , Socioeconomic Factors
6.
Vet Rec ; 160(14): 476-81, 2007 Apr 07.
Article in English | MEDLINE | ID: mdl-17416724

ABSTRACT

This paper describes a preliminary evaluation of particle-mediated bombardment via the Helios gene gun for the delivery of therapeutic genes to synovial cells in culture. A reporter gene, enhanced green fluorescent protein, was delivered to rabbit synovial fibroblasts (HIG-82) using gold particle (1.0 microm) bombardment to evaluate transfection efficiency at helium pressures of 100 and 150 psi. Transfection of cells occurred at these pressures despite some cell death. The in vitro delivery of gold particles to samples of synovial membrane and articular cartilage from a freshly euthanased dog was also studied to examine depth of penetration of gold particles (1.0 microm) at helium pressures of 250 and 500 psi. Light microscopical examination of histological sections of the synovial membrane showed that particles of gold had penetrated the lining cells of the synovium. However, no gold particles had penetrated the articular cartilage even at 500 psi.


Subject(s)
Dog Diseases/therapy , Gene Transfer Techniques/veterinary , Osteoarthritis/veterinary , Synovial Fluid/cytology , Synovial Membrane , Animals , Cartilage , Cells, Cultured , Dogs , Fibroblasts , Green Fluorescent Proteins , Immunohistochemistry/veterinary , Osteoarthritis/therapy , Particle Size , Pressure , Rabbits , Synovial Membrane/chemistry , Synovial Membrane/ultrastructure , Transfection/veterinary
7.
Am J Physiol Regul Integr Comp Physiol ; 291(5): R1539-44, 2006 Nov.
Article in English | MEDLINE | ID: mdl-16728465

ABSTRACT

To determine the relationship between total body water (TBW) fraction and local water content measured in the skin (SW) this study assessed eight anesthetized piglets in an overhydration model. TBW was assessed by deuterium oxide dilution and body mass measurements taken throughout the experiments, and by whole body carcass analysis at the end of each experiment. Additionally, extracellular water and plasma volume were assessed using bromide dilution and Evan's blue dilution, respectively. SW was assessed by tissue biopsies taken at 60-min intervals throughout the experiment. Lean body water (LBW) fraction and lean skin water (LSW) fraction were assessed by extracting the fat from the carcass and biopsy samples. A correlation does exist between TBW fraction and SW fraction with r2=0.58 (P<0.05); however, the strongest correlation occurred between the LBW fraction and LSW fraction with r2=0.87 (P<0.05) and an SE of prediction of 0.77%. These data demonstrate that LSW gives an accurate and precise estimate of LBW and could therefore be used to determine the hydration index in appropriate research settings.


Subject(s)
Body Water/chemistry , Drinking/physiology , Skin/chemistry , Animals , Biopsy , Body Composition/physiology , Body Weight/physiology , Diagnostic Techniques and Procedures , Female , Fluid Shifts/physiology , Skin/pathology , Skin Physiological Phenomena , Swine
8.
Rheumatology (Oxford) ; 44(6): 735-43, 2005 Jun.
Article in English | MEDLINE | ID: mdl-15757961

ABSTRACT

OBJECTIVES: The potential for undesirable systemic effects related to constitutive expression of certain therapeutic transgenes may be limited through the development of transcriptionally targeted disease- and cell-type-specific vectors. The objective of this study was to analyse the canine matrix metalloproteinase-9 (MMP-9) promoter and deletion constructs for its ability to drive expression in response to pro-inflammatory cytokines (interleukin-1beta and tumour necrosis factor-alpha). METHODS: Initial analysis of MMP-9 deletion constructs was made using a luciferase reporter system. The promoter was subsequently engineered to incorporate multiple NF-kappaB sites. In parallel experiments we used the mouse collagen type XI promoter to study cell-type-specific promoter activity in chondrocyte-specific cells (SW1353) and undifferentiated chondroprogenitor cells (ATDC5). RESULTS: Incorporation of multiple NF-kappaB sites into the MMP-9 promoter enhanced activity while maintaining disease specificity. Further, manipulation of the mouse collagen type XI (mColXI) promoter by the incorporation of SOX9 enhancer sites downstream of a reporter gene, increased gene activity while maintaining cell type specificity. CONCLUSIONS: Manipulation of promoter and enhancer regions can improve transcriptionally targeted genes. A combination of these systems, in the context of the canine model, has the potential to improve the safety of osteoarthritis gene therapy vectors.


Subject(s)
Genetic Therapy/methods , Matrix Metalloproteinase 9/genetics , Osteoarthritis/genetics , Transcription, Genetic/genetics , Animals , Base Sequence , Cell Line, Tumor , Collagen Type XI/genetics , Disease Models, Animal , Dogs , Gene Deletion , Genetic Vectors/genetics , High Mobility Group Proteins/genetics , Interleukin-1/genetics , Introns/genetics , Mice , Mutation/genetics , NF-kappa B/genetics , Osteoarthritis/therapy , Promoter Regions, Genetic/genetics , SOX9 Transcription Factor , Transcription Factors/genetics , Tumor Necrosis Factor-alpha/genetics
9.
QJM ; 97(8): 519-24, 2004 Aug.
Article in English | MEDLINE | ID: mdl-15256609

ABSTRACT

BACKGROUND: Many hospital admissions aim to optimize quality of life (QoL). However, the standard medical clerking does not systematically record QoL items. AIM: To examine whether the current disease-based clerking could be supplemented in older people with QoL information. DESIGN: Survey of non-elective admissions aged > or = 65 years. METHODS: Participants (n = 60) were interviewed on day 3-5 of their admission. QoL was measured using the SEIQoL-DW and the SF36 (version 2). Cognitive and physical function were also assessed. Aspects of feasibility and acceptability were explored, and the potential clinical benefits of the information investigated. RESULTS: Mean patient age was 81 years; 36 (60%) were female. Forty-five completed the SEIQoL-DW, (mean time 37.7 min), of whom 17 experienced practical difficulties drawing the cue levels, and 25 had difficulty manipulating the direct weighting device of the SEIQoL-DW. However, the assessment process was judged as acceptable, and elicited more subjective information than was recorded in medical and nursing notes. Doctors considered the individual QoL information potentially useful for planning discharge and follow-up. DISCUSSION: The SEIQoL-DW is probably too time-consuming for standard medical clerking. However, as it was judged acceptable by patients, and according to medical staff, gives potentially valuable information, there may be circumstances in which its use is worthwhile.


Subject(s)
Health Status , Medical Records/standards , Patient Admission/standards , Quality of Life , Aged , Aged, 80 and over , Attitude of Health Personnel , Female , Geriatric Assessment/methods , Health Status Indicators , Humans , Male , Reproducibility of Results , Surveys and Questionnaires/standards
10.
J Mol Endocrinol ; 31(1): 37-45, 2003 Aug.
Article in English | MEDLINE | ID: mdl-12914523

ABSTRACT

This study examined the actions of 17beta-estradiol (E(2)) and progesterone on the regulation of the peroxisome proliferator-activated receptors (PPARalpha and PPARgamma) family of nuclear transcription factors and the mRNA abundance of key enzymes involved in fat oxidation, in skeletal muscle. Specifically, carnitine palmitoyltransferase I (CPT I), beta-3-hydroxyacyl CoA dehydrogenase (beta-HAD), and pyruvate dehydrogenase kinase 4 (PDK4) were examined. Sprague-Dawley rats were ovariectomized and treated with placebo (Ovx), E(2), progesterone, or both hormones in combination (E+P). Additionally, sham-operated rats were treated with placebo (Sham) to serve as controls. Hormone (or vehicle only) delivery was via time release pellets inserted at the time of surgery, 15 days prior to analysis. E(2) treatment increased PPARalpha mRNA expression and protein content (P<0.05), compared with Ovx treatment. E(2) also resulted in upregulated mRNA of CPT I and PDK4 (P<0.05). PPARgamma mRNA expression was also increased (P<0.05) by E(2) treatment, although protein content remained unaltered. These data demonstrate the novel regulation of E(2) on PPARalpha and genes encoding key proteins that are pivotal in regulating skeletal muscle lipid oxidative flux.


Subject(s)
Estradiol/pharmacology , Gene Expression Regulation/drug effects , Lipid Metabolism , Muscle, Skeletal/physiology , Progesterone/pharmacology , Receptors, Cytoplasmic and Nuclear/genetics , Transcription Factors/genetics , Animals , Base Sequence , Body Weight , DNA Primers , Estradiol/physiology , Fatty Acids, Nonesterified/blood , Female , Lipids/genetics , Muscle, Skeletal/drug effects , Ovariectomy , Oxidation-Reduction , Progesterone/physiology , Protein Isoforms/genetics , RNA, Messenger/genetics , RNA, Messenger/metabolism , Rats , Rats, Sprague-Dawley , Receptors, Cytoplasmic and Nuclear/drug effects , Transcription Factors/drug effects
11.
Acta Physiol Scand ; 178(4): 347-56, 2003 Aug.
Article in English | MEDLINE | ID: mdl-12864739

ABSTRACT

It has been assumed that the uptake of long chain fatty acids (LCFAs) into skeletal muscle and the heart muscle, as well as other tissues, occurred via passive diffusion. In recent years our work has shown that the LCFA uptake into skeletal muscle is a highly regulated process. The use of giant sarcolemmal vesicles obtained from skeletal muscle and heart has been used to demonstrate that LCFA uptake into these tissues occurs via a protein-mediated mechanism involving the 40 kDa plasma membrane associated fatty acid binding protein (FABPpm) and the 88 kDa fatty acid translocase, the homologue of human CD36 (FAT/CD36). Both are ubiquitously expressed proteins and correlate with LCFA uptake into heart and muscle, consistent with the known differences in LCFA metabolism in these tissues. It has recently been found that FAT/CD36 is present in an intracellular (endosomal) compartment from which it can be translocated to the plasma membrane within minutes by muscle contraction and by insulin, to stimulate LCFA uptake. In rodent models of obesity and type 1 diabetes LCFA uptake into heart and muscle is also increased, either by permanently relocating FAT/CD36 to the plasma membrane without altering its expression (obesity) or by increasing the expression of both FAT/CD36 and FABPpm (type 1 diabetes). Chronic leptin treatment decreases LCFA transporters and transport in muscle. Clearly, recent evidence has established that LCFA uptake into heart and muscle is regulated acutely and chronically.


Subject(s)
Cell Membrane/metabolism , Fatty Acids/metabolism , Muscles/physiology , Animals , Biological Transport, Active/physiology , Diabetes Mellitus, Type 1/metabolism , Humans , Insulin/metabolism , Leptin/metabolism , Muscle Contraction/physiology , Muscle, Skeletal/metabolism , Muscles/metabolism , Myocardium/enzymology , Obesity/metabolism , Proteins/metabolism , Rats
12.
Am J Physiol Endocrinol Metab ; 282(5): E1139-46, 2002 May.
Article in English | MEDLINE | ID: mdl-11934680

ABSTRACT

This study examined the roles of the female sex steroids, 17beta-estradiol (E(2)) and progesterone (Prog), on glucose uptake and GLUT4 protein expression. Female Sprague-Dawley rats were either sham operated (C) or ovariectomized and treated with placebo (O), E(2) (E), Prog (P), or both hormones at physiological doses (P + E) or the same dose of Prog with a high dose of E(2) (P + HiE) via timed-release pellets inserted at the time of surgery, 15 days before metabolic testing. On the morning of day 15, animals received a 300-microCi injection (ip) of 2-deoxy-[(14)C]glucose and then either exercised on a motorized treadmill for 30 min at 0.35 m/s or remained sedentary in their cages for the same period. Basal glucose uptake was not different between the treatment groups in either the red or white quadriceps. However, glucose uptake was decreased (P < 0.05) in O, P, and P + E rats during exercise in the red quadriceps compared with C rats, whereas E and P + HiE treatment restored glucose uptake. Glycogen content in skeletal muscle followed similar trends, with no differences seen in resting animals. Postexercise red quadriceps glycogen levels were higher (P < 0.05) in the E and P + HiE rats compared with O and P. Treatment of ovariectomized rats with progesterone (P rats) decreased (P < 0.05) GLUT4 content in the red quadriceps by 21% compared with C rats. These data demonstrate that estrogen-deficient animals have a decreased ability for contraction-stimulated glucose uptake and increased glycogen use during aerobic exercise. However, changes in contraction-stimulated glucose uptake could not be explained by altered transporter protein content, since the absence of E(2) had no effect on GLUT4 protein.


Subject(s)
Estradiol/pharmacology , Glucose/pharmacokinetics , Monosaccharide Transport Proteins/biosynthesis , Muscle Contraction/physiology , Muscle Proteins , Progesterone/pharmacology , Animals , Deoxyglucose/pharmacokinetics , Female , Glucose Transporter Type 4 , Glycogen/metabolism , Insulin/blood , Lactic Acid/blood , Monosaccharide Transport Proteins/metabolism , Muscle, Skeletal/metabolism , Ovariectomy , Physical Exertion/physiology , Rats , Rats, Sprague-Dawley
13.
QJM ; 95(2): 83-7, 2002 Feb.
Article in English | MEDLINE | ID: mdl-11861955

ABSTRACT

BACKGROUND: The King's Fund and British Association of Parenteral and Enteral Nutrition recommend that all hospital patients should have height and weight recorded, to detect the need for nutritional support. Systematic review evidence also suggests that protein and energy supplementation of adults in hospital with a wide range of conditions improves outcome. AIM: To assess the recording of weight and height in hospitals. DESIGN: Survey (random sample). METHODS: As part of a survey on the provision of deep venous thrombosis prophylaxis, we collected information on height and weight recording from medical and nursing notes. We randomly selected five medical, five surgical, five orthopaedic, and five obstetrics and gynaecology directorates from across Scotland. Six hundred case notes were requested, and 88% were available for data extraction. Some 67% of hospital episodes provided information about weight, and 41% on both height and weight. General medicine directorates had the lowest recording of weight, and in medical and surgical directorates, both weight and height were rarely recorded in comparison with the other two directorates (p<0.001). DISCUSSION: Our survey suggests that recommendations to assess nutritional risk are not being followed, and that many patients at risk of malnutrition are not being detected or treated.


Subject(s)
Inpatients , Nutritional Status/physiology , Adult , Aged , Body Height/physiology , Body Weight/physiology , Female , Humans , Male , Middle Aged , Nutrition Disorders/prevention & control
14.
Curr Opin Clin Nutr Metab Care ; 4(6): 515-20, 2001 Nov.
Article in English | MEDLINE | ID: mdl-11706286

ABSTRACT

Growing evidence suggests that the ovarian hormones have major effects on lipid and carbohydrate metabolism, and may also play a major role in up-stream molecular signaling mechanisms for regulating substrate metabolism. It appears that the absence of estrogen can impair glucose uptake during exercise. In contrast, progesterone not only impairs contraction-mediated glucose uptake when solely administered, but impairs glucose uptake when physiological concentrations of both estrogen and progesterone are administered. Likewise, progesterone administered to rodents for 14 days decreases glucose transporter (GLUT) 4 protein content in skeletal muscle and adipose tissue. Furthermore removing the ovaries decreases the activity of key oxidative enzymes while estrogen treatment restores the activity of these enzymes. It appears, therefore, that estrogen increases the metabolic capacity for both carbohydrate and lipid metabolism, perhaps increasing the overall metabolic flexibility of skeletal muscle. Conversely, progesterone negates both these effects, and could therefore result in a state of relative metabolic inflexibility, similar to that observed in the metabolic syndrome.


Subject(s)
Carbohydrate Metabolism , Estrogens/physiology , Exercise/physiology , Lipid Metabolism , Muscle Proteins , Muscle, Skeletal/metabolism , Progesterone/physiology , Animals , Blood Glucose/metabolism , Estrogens/pharmacology , Female , Glucose Transporter Type 4 , Humans , Male , Mice , Monosaccharide Transport Proteins/metabolism , Monosaccharide Transport Proteins/physiology , Muscle Contraction/physiology , Ovariectomy , Progesterone/pharmacology , Rats
15.
J Public Health Med ; 23(3): 205-11, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11585193

ABSTRACT

BACKGROUND: The aim of the study was to review systematically the literature measuring the accuracy of routine UK hospital statistics that classify patients on discharge. METHODS: A systematic review was carried out of studies comparing routine discharge statistics about an episode of hospital care with the original medical record. Dual quality assessment and extraction was completed for included studies. Qualitative and descriptive analyses were undertaken. Additional comparisons of factors that could potentially introduce systematic variation in coding accuracy were also undertaken. RESULTS: Thirty studies were identified, of which 21 were included in the review. Twelve of these were conducted in England and Wales, and nine in Scotland. The majority assessed the accuracy of a single diagnosis, or selection of diagnoses in a limited range of hospital settings. The median coding accuracy rates were 91 per cent for diagnostic codes and 69.5 per cent for operation or procedure codes in studies in England or Wales; 82 per cent for diagnostic codes and 98 per cent for operation or procedure codes in Scottish studies. There were no significant differences in coding accuracy over time or in the type or rarity of the codes being assessed. Accuracy rates were higher for ICD7 codes (median 96.5 per cent) than for ICD8 (median 87 per cent) or ICD9 (median 77 per cent). CONCLUSIONS: Coding accuracy on average is high in the United Kingdom, especially for operations and procedures. However, policy-makers, planners and researchers need to recognize and account for the degree of inaccuracy in routine hospital information statistics. Further research is needed into methods of improving and maintaining coding accuracy.


Subject(s)
Disease/classification , Forms and Records Control/standards , Hospitals, Public/organization & administration , Medical Records/standards , Patient Discharge , Abstracting and Indexing/standards , Humans , Medical Records/classification , Quality Control , State Medicine , United Kingdom
16.
Skeletal Radiol ; 30(10): 570-8, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11685480

ABSTRACT

OBJECTIVE: To describe the MR appearance following autogenous osteochondral "plug" transfer for the treatment of focal chondral defects of the knee. DESIGN AND PATIENTS: Twenty-nine 1.5-T MR knee studies including dynamic gadolinium enhancement were performed on 21 patients following autogenous osteochondral "plug" transfer. Three musculoskeletal radiologists retrospectively reviewed images to evaluate graft and donor site appearance and MR findings were correlated with clinical outcomes. RESULTS: MR images demonstrated graft protuberance (n=12/21; range 1-2 mm), depression (n=2/21; range 1 mm), and surface incongruity: mild (n=17/21), moderate (n=2/21), marked (n=1/21). The T2 signal of graft cartilage was similar to that of adjacent cartilage in 25 of 29 examinations, and increased in four. Graft cartilage thickness relative to adjacent cartilage was <50% in six patients, 50-100% in 15. Graft enhancement in bone was absent at 2 weeks, but present at between 4 and 6 weeks following surgery. All patients had clinical follow-up examinations and knee outcome survey scores were obtained in 15 patients with follow-up greater than 3 months after surgery. All patients demonstrated the expected short-term progressive clinical improvement. CONCLUSION: MR images reveal a wide range of appearances following osteochondral "plug" transfer. Minor variations in graft orientation and surface congruity do not result in adverse clinical outcome in the short term.


Subject(s)
Cartilage, Articular/injuries , Cartilage, Articular/surgery , Knee Injuries/surgery , Magnetic Resonance Imaging , Adult , Bone Transplantation , Female , Follow-Up Studies , Humans , Male , Time Factors , Transplantation, Autologous
17.
Int J Qual Health Care ; 13(4): 309-16, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11560350

ABSTRACT

OBJECTIVE: The effectiveness of activities to promote routine prophylaxis to prevent thromboembolism is difficult to assess because information about the prevalence of prophylaxis is sparse. The aim of this study was to assess the prevalence of deep vein thrombosis (DVT) prophylaxis for patients at risk in general medicine, general surgery, orthopaedics and gynaecology in Scotland and the North of England. DESIGN: Retrospective case note review of a random sample of episodes of care in a stratified random sample of directorates in Scotland and a convenience sample in England. SETTING: Twenty acute hospital directorates in Scotland and eight in the North of England. PARTICIPANTS: Case notes of patients at risk of thrombosis and discharged from the selected directorates in a 12-month period (n = 742). MAIN OUTCOME MEASURES: The proportion of patients receiving prophylaxis in each directorate. RESULTS: Overall, 469/526 (89%) of patients in Scotland and 199/216 (92%) in England received prophylaxis. The proportion varied from 71% in general medicine to 100% in orthopaedics. The frequency of use of different forms of prophylaxis varied between directorates. Approximately 60% of the patients who received prophylaxis received more than one form. CONCLUSIONS: Prophylaxis for DVT is well established for procedures and conditions that are known to increase the risk of thrombosis and for which there are no contraindications. Additional efforts to promote prophylaxis for these conditions are unlikely to be cost effective. Further research is needed to establish whether rates are equally high in other conditions, and whether the high prophylaxis rates are due to clinical effectiveness initiatives.


Subject(s)
Anticoagulants/therapeutic use , Heparin, Low-Molecular-Weight/therapeutic use , Hospitals, Public/standards , Premedication/statistics & numerical data , Venous Thrombosis/prevention & control , Contraindications , England , Humans , Practice Guidelines as Topic , Retrospective Studies , Scotland , State Medicine/standards
18.
Am J Physiol Endocrinol Metab ; 281(4): E803-8, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11551858

ABSTRACT

To examine the roles of 17beta-estradiol (E(2)) and progesterone (Prog) in lipid metabolism, skeletal muscle enzyme activities were studied in female Sprague-Dawley rats. Groups included sham-operated rats (C) and ovariectomized rats treated with placebo (O), E(2) (E), Prog (P), both hormones at physiological doses (P + E), or both hormones with a high dose of E(2) (P + HiE). Hormone (or vehicle only) delivery was via time-release pellets inserted at the time of surgery, 15 days before metabolic testing. Results demonstrated that carnitine palmitoyltransferase maximal activity was 19, 21, and 19% lower (P < 0.01) in O, P, and P + E rats, respectively, compared with C rats. Conversely, activity in E and P + HiE rats was 14 and 19% higher (P < 0.01) than in C. beta-Hydroxyacyl-CoA dehydrogenase (beta-HAD) maximal activity was 20% lower (P < 0.01) in O than in C rats; similarly, P and P + E rats were 18 and 19% lower, respectively (P < 0.01); however, treatment with E(2) returned beta-HAD activity to C levels. These results suggest that E(2) plays a role in lipid metabolism by increasing the maximal activity of key enzymes in the fat oxidative pathway of skeletal muscle.


Subject(s)
Estradiol/pharmacology , Lipid Metabolism , Mitochondria, Muscle/enzymology , Muscle, Skeletal/metabolism , Ovary/physiology , Progesterone/pharmacology , 3-Hydroxyacyl CoA Dehydrogenases/metabolism , Animals , Body Weight , Carnitine O-Palmitoyltransferase/metabolism , Citrate (si)-Synthase/metabolism , Drug Implants , Estradiol/administration & dosage , Estradiol/blood , Fatty Acids, Nonesterified/blood , Female , Glycerol/blood , Insulin/blood , Muscle, Skeletal/drug effects , Ovariectomy , Oxidation-Reduction , Physical Exertion , Progesterone/administration & dosage , Progesterone/blood , Rats , Rats, Sprague-Dawley , Reference Values , Rest
19.
Am J Physiol Endocrinol Metab ; 281(4): E817-25, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11551860

ABSTRACT

To study the effect of menstrual cycle phase and carbohydrate ingestion on glucose kinetics and exercise performance, eight healthy, moderately trained, eumenorrheic women cycled at 70% of peak O(2) consumption for 2 h and then performed a 4 kJ/kg body wt time trial. A control (C) and a glucose ingestion (G) trial were completed during the follicular (F) and luteal (L) phases of the menstrual cycle. Plasma substrate concentrations were similar before the commencement of exercise. Glucose rates of appearance and disappearance were higher (P < 0.05) during the 2nd h of exercise in FC than in LC. The percent contribution of carbohydrate to total energy expenditure was greater in FC than in LC, and subjects performed better (13%, P < 0.05) in FC. Performance improved (19% and 26% in FG and LG compared with FC and LC, respectively, P < 0.05) with the ingestion of glucose throughout exercise. These data demonstrate that substrate metabolism and exercise performance are influenced by the menstrual cycle phase, but ingestion of glucose minimizes these effects.


Subject(s)
Blood Glucose/metabolism , Exercise/physiology , Glucose/metabolism , Menstrual Cycle/physiology , Physical Endurance/physiology , Physical Exertion/physiology , Adult , Dietary Carbohydrates , Dietary Fats , Energy Metabolism/physiology , Exercise Test , Fatty Acids, Nonesterified/blood , Female , Follicular Phase/physiology , Glucagon/blood , Glycerol/blood , Humans , Insulin/blood , Kinetics , Luteal Phase/physiology , Menstrual Cycle/blood , Metabolic Clearance Rate , Oxygen Consumption/physiology , Time Factors
20.
Gene ; 273(1): 81-7, 2001 Jul 25.
Article in English | MEDLINE | ID: mdl-11483363

ABSTRACT

This paper describes the cloning and characterization of the canine matrix metalloproteinase-9 (MMP-9) gene promoter. The 5' untranslated region was obtained by genome walking upstream of the canine MMP-9 translation start site using canine genomic DNA as template. A DNA fragment of 1894 bp was isolated and on analysis demonstrated regions of sequence homology with the MMP-9 promoter sequences already determined for other species. In general, conserved regions correlated with DNA binding motifs such as a TATA-like box, AP-1 sites, GC boxes and a nuclear factor-kappaB binding domain. The DNA promoter fragment was sufficient to drive basal expression of a luciferase reporter gene in Madin Darby canine kidney (MDCK) cells and to a lesser extent in feline embryonic fibroblast (FEA) cells. Activity of the promoter was enhanced by the treatment of transfected MDCK cells with phorbol 12-myristate 13-acetate but no effect was observed in the FEA cells. Promoter deletion studies revealed that regions of promoter were necessary for induction of reporter gene expression.


Subject(s)
Dogs/genetics , Matrix Metalloproteinase 9/genetics , Promoter Regions, Genetic , Amino Acid Sequence , Animals , Base Sequence , Cell Line , Cloning, Molecular , Codon, Initiator , Gene Expression , Molecular Sequence Data
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