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1.
Women Birth ; 37(2): 403-409, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38155062

ABSTRACT

BACKGROUND: Working with bereaved parents in co-designed stillbirth research, policy and practice is essential to improving care and outcomes. PROBLEM: Effective parent engagement is often lacking. This may be due to bereaved parents not feeling adequately and appropriately supported to be involved. AIM: To consult bereaved parents with the aim to understand their experiences, attitudes, and needs around involvement in stillbirth research and gain feedback about the usefulness and appropriateness of a proposed co-designed guide to support their involvement, including content and design aspects of this resource. METHODS: An online co-designed survey was disseminated via Australian parent support organisations social media in August 2022. FINDINGS: All 90 respondents were bereaved parents, 94% (n = 85) were female. Two-thirds (67%, n = 60) had never participated in stillbirth research, 80% (n = 72) agreed involvement of bereaved parents in research was important or extremely important and 81% (n = 73) were interested in future research involvement. Common motivations for involvement were wanting to leave a legacy for their baby and knowing research outcomes. Common barriers included not having been asked to participate or not knowing how. Most (89%, n = 80) agreed the proposed guide would be useful. Highly valued topics were the importance of bereaved parents' voices in stillbirth research and how they can make a difference. CONCLUSION: The majority of bereaved parents we surveyed want to be involved in stillbirth research and would value a resource to support this. The proposed concept and content for a co-designed guide to aid engagement was well supported.


Subject(s)
Bereavement , Stillbirth , Pregnancy , Humans , Female , Male , Australia , Parents , Surveys and Questionnaires
2.
Sci Rep ; 13(1): 10071, 2023 Jun 21.
Article in English | MEDLINE | ID: mdl-37344550

ABSTRACT

We performed a preliminary study of neutron resonance absorption imaging to investigate the spatial distribution of constituent elements in borosilicate glasses containing simulated high-level radioactive waste, in which elemental inhomogeneities affect the physical and chemical stabilities of the glass. Dips generated by the resonance absorptions of Rh, Pd, Na, Gd, Cs, and Sm were observed in the neutron transmission spectra of the glass samples. The spatial distributions of these elements were obtained from the neutron transmission images at the resonance energies. The distributions of Rh and Pd visualized the sedimentation of these platinum group elements. In contrast, the lanthanides (Gd and Sm) and Cs were uniformly dispersed. These results show that neutron resonance absorption imaging is a promising tool for characterizing borosilicate glasses and investigating the vitrification mechanism of high-level radioactive waste.

3.
J Appl Crystallogr ; 55(Pt 3): 592-600, 2022 Jun 01.
Article in English | MEDLINE | ID: mdl-35719302

ABSTRACT

Micromagnetic small-angle neutron scattering theory is well established for analyzing spin-misalignment scattering data of bulk ferromagnets. Here, this theory is extended to allow for a global uniaxial magnetic anisotropy (texture) of the material, in addition to the already included random zero-average local anisotropy. Macroscopic cross sections and spin-misalignment response functions are computed analytically for several practically relevant mutual anisotropy and external magnetic field orientations in both parallel and perpendicular scattering geometries for field magnitudes both above and below the rotational saturation. Some of these expressions are tested on published experimental data of magnetic-field-annealed Vitroperm and plastically deformed Ni, allowing determination of the corresponding global uniaxial anisotropy quality factors.

4.
Sci Adv ; 6(49)2020 12.
Article in English | MEDLINE | ID: mdl-33268373

ABSTRACT

The color of firefly bioluminescence is determined by the structure of luciferase. Firefly luciferase genes have been isolated from more than 30 species, producing light ranging in color from green to orange-yellow. Here, we reconstructed seven ancestral firefly luciferase genes, characterized the enzymatic properties of the recombinant proteins, and determined the crystal structures of the gene from ancestral Lampyridae. Results showed that the synthetic luciferase for the last common firefly ancestor exhibited green light caused by a spatial constraint on the luciferin molecule in enzyme, while fatty acyl-CoA synthetic activity, an original function of firefly luciferase, was diminished in exchange. All known firefly species are bioluminescent in the larvae, with a common ancestor arising approximately 100 million years ago. Combined, our findings propose that, within the mid-Cretaceous forest, the common ancestor of fireflies evolved green light luciferase via trade-off of the original function, which was likely aposematic warning display against nocturnal predation.

6.
Gene ; 509(1): 68-76, 2012 Nov 01.
Article in English | MEDLINE | ID: mdl-22835697

ABSTRACT

Teleostean 20ß-hydroxysteroid dehydrogenase (20ß-HSD) is involved in final oocyte maturation and steroid hormone metabolism. It has structural and functional similarities to mammalian carbonyl reductases that are involved in the metabolism of endogenous carbonyl and xenobiotic compounds. To understand the transcriptional regulation of 20ß-HSD, here we report the cloning of 20ß-HSD promoter from two fish species, rainbow trout and air-breathing catfish. Analysis of the promoter motifs, in silico identified the presence of several sites for transcription factor binding including cAMP, xenobiotic and steroid hormone responsive elements. Luciferase reporter assays with progressive deletion constructs demonstrated that 20ß-HSD type B of trout has no promoter activity while 20ß-HSD type A of trout and catfish 20ß-HSD promoters showed basal promoter activity. A TATA box flanked by a CAAT box is important for basal transcription. Deletion of cAMP responsive element in the promoter decreased basal promoter activity significantly. Reporter assays with forskolin and IBMX, drugs that increase intracellular cAMP induced the promoter activity over the basal level. Intriguingly, ß-nafthoflavone, an arylhydrocarbon receptor ligand, induced the 20ß-HSD promoter activity and is further evidenced by the induction of 20ß-HSD expression in the livers of catfish, in vivo. These results demonstrate for the first time that 20ß-HSD expression is not only modulated by cAMP but also by xenobiotics and further studies may provide significance to the ubiquitous distribution and broad substrate specificity of this enzyme.


Subject(s)
Catfishes/genetics , Cortisone Reductase/genetics , Oncorhynchus mykiss/genetics , Promoter Regions, Genetic , 1-Methyl-3-isobutylxanthine/pharmacology , Animals , Base Sequence , Catfishes/metabolism , Colforsin/pharmacology , Cyclic AMP/metabolism , DNA/genetics , DNA/metabolism , Female , Gene Expression/drug effects , HEK293 Cells , Humans , Molecular Sequence Data , Oncorhynchus mykiss/metabolism , Ovary/metabolism , Phosphodiesterase Inhibitors/pharmacology , Promoter Regions, Genetic/drug effects , Recombinant Proteins/genetics , Species Specificity , Xenobiotics/metabolism , beta-Naphthoflavone/pharmacology
7.
Insect Mol Biol ; 19(6): 737-43, 2010 Dec.
Article in English | MEDLINE | ID: mdl-20609019

ABSTRACT

We isolated a luciferase gene (LbLuc) from the non-luminous diurnal firefly, Lucidina biplagiata, with high similarity to that from the nocturnal firefly, Photinus pyralis. The recombinant LbLuc showed luminescence activity comparable to that of the luciferases from P. pyralis and Luciola cruciata. To understand the non-luminosity of L. biplagiata, we determined the amount of luciferase in the adult specimen using the luciferin-luciferase reaction and found that the content of luciferase in L. biplagiata was estimated to be only 0.1% of that in L. cruciata. As previously reported, the content of luciferin in L. biplagiata was less than 0.1% of that in L. cruciata. Thus, the non-luminosity of L. biplagiata might be explained by low levels of both luciferase and luciferin.


Subject(s)
Fireflies/enzymology , Fireflies/genetics , Luciferases, Firefly/genetics , Luciferases, Firefly/metabolism , Amino Acid Sequence , Animals , Fireflies/chemistry , Fireflies/classification , Firefly Luciferin/metabolism , Luciferases, Firefly/analysis , Male , Molecular Sequence Data , Phylogeny , Sequence Alignment
8.
J Periodontal Res ; 42(1): 15-22, 2007 Feb.
Article in English | MEDLINE | ID: mdl-17214635

ABSTRACT

BACKGROUND AND OBJECTIVE: Differential expression of genes in human periodontal ligament (PDL) under mechanical stress, such as orthodontic force, is thought to be involved in the remodeling of PDL cells and periodontal tissues. However, little is known about the genes expressed in PDL cells under mechanical stress. MATERIAL AND METHODS: We employed microarray analysis to assess, in a comprehensive manner, the gene expression profiles in PDL cells compressed by a static force using an in vitro three-dimensional culture system. Six genes were selected and validated by quantitative real-time polymerase chain reaction analysis, consistent with the microarray data. RESULTS: The microarray data revealed that 108 of 30,000 genes tested were differentially expressed by mechanical force loading. Among them, 85 genes were up-regulated by mechanical stress, while 23 genes were down-regulated, judging by the thresholds of a two-fold increase/decrease compared with the controls. Thirty-two of the up-regulated and eight of the down-regulated genes, well-characterized in protein function, were involved in numerous biological processes including cell communication, cell signaling, cell cycle, stress response, and calcium release. However, several genes differentially expressed in our microarray data have not been well defined as stress-response molecules. CONCLUSION: Our microarray is the first to show the gene profile in PDL cells caused by mechanical stress; however, further studies to clarify the physiological function of these molecules in PDL cells are required.


Subject(s)
Gene Expression Profiling , Oligonucleotide Array Sequence Analysis , Periodontal Ligament/metabolism , Calcium/metabolism , Cell Communication/genetics , Cell Culture Techniques , Cell Cycle/genetics , Cells, Cultured , Cyclooxygenase 2/genetics , Dinoprostone/genetics , Down-Regulation/genetics , Glyceraldehyde-3-Phosphate Dehydrogenase (Phosphorylating)/genetics , Heat-Shock Proteins/genetics , Humans , Periodontal Ligament/cytology , Reverse Transcriptase Polymerase Chain Reaction , Signal Transduction/genetics , Stress, Mechanical , Up-Regulation/genetics
9.
Insect Mol Biol ; 15(3): 293-9, 2006 Jun.
Article in English | MEDLINE | ID: mdl-16756548

ABSTRACT

Three homologous genes of firefly luciferase were cloned from the non-luminous beetle Tenebrio molitor. Three gene products for homologues, TmLL-1, TmLL-2 and TmLL-3, showed fatty acyl-coenzyme A (acyl-CoA) synthetic activity, but not luciferase activity with firefly luciferin. The transcripts were detected through the developmental stages in T. molitor. These results suggested that firefly luciferase was evolved from a fatty acyl-coenzyme A synthetase by gene duplications in the insect.


Subject(s)
Genes, Insect , Tenebrio/genetics , Amino Acid Sequence , Animals , Biological Evolution , Coenzyme A Ligases/metabolism , Gene Expression Regulation, Developmental , Larva/metabolism , Luciferases, Firefly/genetics , Luminescence , Molecular Sequence Data , Sequence Analysis, DNA , Sequence Homology , Tenebrio/enzymology
10.
J Pept Res ; 64(3): 110-7, 2004 Sep.
Article in English | MEDLINE | ID: mdl-15317501

ABSTRACT

Mu-conotoxin GIIIA, a peptide toxin from the cone snail, blocks muscle-type sodium channels. Thr-5 of mu-conotoxin GIIIA, located on the opposite side of the active site in the globular molecule, was replaced by Cys to which the bulky tags were attached. The tagged mu-conotoxin GIIIA derivatives, except for the phospholipid-tagged one, exerted the biological activity with a potency slightly weaker than natural mu-conotoxin GIIIA. When the biotinylated tags of various lengths were added, the presence of avidin suppressed the action of the biotinylated toxins of <4 nm, but not with 5 nm. The bulky biotinylated tags are useful as a caliper to measure the depth of receptor sites in the channels.


Subject(s)
Conotoxins/chemistry , Conotoxins/toxicity , Amino Acid Sequence , Amino Acid Substitution , Animals , Avidin/chemistry , Biotin/chemistry , Circular Dichroism , Conotoxins/chemical synthesis , Conotoxins/genetics , Diaphragm/drug effects , Diaphragm/physiology , Electric Stimulation , In Vitro Techniques , Male , Models, Biological , Molecular Sequence Data , Muscle Contraction/drug effects , Rats , Rats, Wistar , Structure-Activity Relationship
11.
J Clin Invest ; 108(12): 1833-41, 2001 Dec.
Article in English | MEDLINE | ID: mdl-11748267

ABSTRACT

We recently identified macrophage inflammatory protein 1-alpha (MIP-1alpha) as a factor produced by multiple myeloma (MM) cells that may be responsible for the bone destruction in MM (1). To investigate the role of MIP-1alpha in MM bone disease in vivo, the human MM-derived cell line ARH was stably transfected with an antisense construct to MIP-1alpha (AS-ARH) and tested for its capacity to induce MM bone disease in SCID mice. Human MIP-1alpha levels in marrow plasma from AS-ARH mice were markedly decreased compared with controls treated with ARH cells transfected with empty vector (EV-ARH). Mice treated with AS-ARH cells lived longer than controls and, unlike the controls, they showed no radiologically identifiable lytic lesions. Histomorphometric analysis demonstrated that osteoclasts (OCLs) per square millimeter of bone and OCLs per millimeter of bone surface of AS-ARH mice were significantly less than in EV-ARH mice, and the percentage of tumors per total bone area was also significantly decreased. AS-ARH cells demonstrated decreased adherence to marrow stromal cells, due to reduced expression of the alpha(5)beta(1) integrin and diminished homing capacity and survival. These data support an important role for MIP-1alpha in cell homing, survival, and bone destruction in MM.


Subject(s)
Antisense Elements (Genetics)/therapeutic use , Bone Diseases/prevention & control , Macrophage Inflammatory Proteins/physiology , Multiple Myeloma/therapy , Animals , Antigens, CD/analysis , Bone Diseases/etiology , CD18 Antigens/analysis , Chemokine CCL3 , Chemokine CCL4 , Humans , Integrin alpha5 , Integrin beta1/analysis , Macrophage Inflammatory Proteins/antagonists & inhibitors , Mice , Mice, SCID , Multiple Myeloma/complications , Osteoclasts/physiology
12.
J Bone Miner Res ; 16(10): 1804-11, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11585344

ABSTRACT

Osteoclast inhibitory peptide 2 (OIP-2) is a novel autocrine/paracrine factor produced by osteoclasts (OCLs) that inhibits bone resorption and OCL formation in vitro and in vivo. It is identical to the asparaginyl endopeptidase legumain. During maturation of OIP-2, a signal peptide and a 17-kDa C-terminal fragment (CTF) are cleaved to produce the mature enzyme. To determine if enzyme activity is required for inhibition of OCL formation or if only the CTF is responsible for these effects, we synthesized His-tagged complementary DNA (cDNA) constructs for the CTF of OIP-2, the proform of OIP-2, and the "mature enzyme" form of OIP-2. The proform or the CTF portion of OIP-2 inhibited OCL formation in a dose-dependent manner in murine bone marrow cultures stimulated with 1,25-dihydroxyvitamin D3 [1,25(OH)2D3]. The mature form of OIP-2, which was enzymatically active, did not inhibit OCL formation. In addition, OIP-2 inhibited OCL formation in cultures of highly purified human OCL precursor cells or RAW264.7 cells stimulated with 10 ng/ml of receptor activator of NF-kappaB (RANK) ligand. Binding studies with His-tagged OIP-2 showed expression of a putative OIP-2 receptor on RAW264.7 cells treated with RANK ligand for 4 days and human marrow cultures treated with 1,25(OH)2D3 for 3 weeks. These data show that the CTF of OIP-2, rather than the mature enzyme, mediates the inhibitory effects of OIP-2 through a putative receptor on OCL precursors.


Subject(s)
Cysteine Endopeptidases/metabolism , Osteoclasts/cytology , Plant Proteins , Animals , Bone Marrow Cells/cytology , Bone Marrow Cells/metabolism , Bone Resorption , Calcitriol/pharmacology , Carrier Proteins/genetics , Cysteine Endopeptidases/genetics , Female , Glycoproteins/genetics , Humans , Membrane Glycoproteins/genetics , Mice , Mutagenesis , Oligopeptides/genetics , Osteoprotegerin , Peptides/genetics , Peptides/metabolism , Protein Structure, Tertiary , RANK Ligand , Rats , Receptor Activator of Nuclear Factor-kappa B , Receptors, Cytoplasmic and Nuclear/genetics , Receptors, Tumor Necrosis Factor
13.
FEBS Lett ; 503(1): 107-10, 2001 Aug 10.
Article in English | MEDLINE | ID: mdl-11513864

ABSTRACT

mu-Conotoxin GIIIA, a peptide toxin isolated from the marine snail Conus geographus, preferentially blocks skeletal muscle sodium channels in vertebrates. In this study, analogs of mu-conotoxin GIIIA in which essential Arg-13 was replaced with arginine analogs consisting of a piperidyl framework to regulate length and direction of the side chain were synthesized. Synthesized analogs exhibited similar CD and NMR spectra to that of GIIIA, suggesting a three-dimensional structure identical to that of the native toxin. The biological activities of piperidyl analogs were decreased or lost despite the small change in the side chain of Arg-13. The investigated structure-activity relationships in inhibiting electrically stimulated muscle contraction suggest that the guanidinium group at amino acid position 13 interacts best when spaced with three to four carbons and placed in a vertical direction from the peptide loop. Thus, the position of the guanidinium group at Arg-13 of GIIIA must be located in a certain range for its strong interaction with the channel protein.


Subject(s)
Arginine/chemistry , Conotoxins/chemistry , Conotoxins/pharmacology , Piperidines/chemistry , Sodium Channel Blockers , Amino Acid Sequence , Animals , Circular Dichroism , Male , Molecular Sequence Data , Muscle Contraction/drug effects , Nuclear Magnetic Resonance, Biomolecular , Rats , Rats, Wistar
14.
Comp Biochem Physiol B Biochem Mol Biol ; 129(2-3): 441-8, 2001 Jun.
Article in English | MEDLINE | ID: mdl-11399478

ABSTRACT

We have cloned and characterized, for the first time in fish, two different gonadotropin receptors (GTHR) and a single thyrotropin receptor (TSHR) from amago salmon (Oncorhynchus rhodurus) and Nile tilapia (Oreochromis niloticus). Phylogenetic analyses and intron/exon structure suggest that the two GTHRs in fish are comparable to tetrapod follicle stimulating hormone and luteinizing hormone receptors. Temporal and spatial expression patterns, examined by Northern blot analysis and in situ hybridization, paralleled those seen in mammals and birds. Consequently, genetic and functional divergence of two GTHRs and TSHR probably occurred before the teleost and tetrapod split.


Subject(s)
Evolution, Molecular , Fishes/genetics , Receptors, Gonadotropin/genetics , Receptors, Thyrotropin/genetics , Vertebrates/genetics , Animals , Gene Expression Regulation, Developmental , Phylogeny , Polymorphism, Restriction Fragment Length , Receptors, Gonadotropin/chemistry , Receptors, Gonadotropin/metabolism , Receptors, Thyrotropin/chemistry , Receptors, Thyrotropin/metabolism
15.
Blood ; 97(11): 3349-53, 2001 Jun 01.
Article in English | MEDLINE | ID: mdl-11369623

ABSTRACT

A complementary DNA expression library derived from marrow samples from myeloma patients was recently screened and human macrophage inflammatory protein-1alpha (hMIP-1alpha) was identified as an osteoclastogenic factor expressed in these samples. hMIP-1alpha enhanced osteoclast (OCL) formation in human marrow cultures and by highly purified OCL precursors in a dose-dependent manner (5-200 pg/mL). Furthermore, hMIP-1alpha enhanced OCL formation induced by human interleukin-6 (IL-6), which is produced by marrow stromal cells when they interact with myeloma cells. hMIP-1alpha also enhanced OCL formation induced by parathyroid hormone-related protein (PTHrP) and receptor activator of nuclear factor kappaB ligand (RANKL), factors also implicated in myeloma bone disease. Time-course studies revealed that the hMIP-1alpha acted during the last 2 weeks of the 3-week culture period. Reverse transcription-polymerase chain reaction analysis showed that the chemokine receptors for hMIP-1alpha (CCR1 and CCR5) were expressed by human bone marrow and highly purified early OCL precursors. Furthermore, hMIP-1alpha did not increase expression of RANKL. These data demonstrate that hMIP-1alpha is an osteoclastogenic factor that appears to act directly on human OCL progenitors and acts at the later stages of OCL differentiation. These data further suggest that in patients with myeloma, MIP-1alpha produced by myeloma cells, in combination with RANKL and IL-6 that are produced by marrow stromal cells in response to myeloma cells, enhances OCL formation through their combined effects on OCL precursors. (Blood. 2001;97:3349-3353)


Subject(s)
Carrier Proteins/physiology , Macrophage Inflammatory Proteins/pharmacology , Membrane Glycoproteins/physiology , Multiple Myeloma/metabolism , NF-kappa B/metabolism , Osteoclasts/cytology , Bone Marrow Cells/cytology , Bone Marrow Cells/metabolism , Carrier Proteins/genetics , Cell Differentiation/drug effects , Cells, Cultured , Chemokine CCL3 , Chemokine CCL4 , Gene Expression , Humans , Interleukin-6/pharmacology , Kinetics , Membrane Glycoproteins/genetics , Osteoclasts/metabolism , Parathyroid Hormone-Related Protein , Proteins/pharmacology , RANK Ligand , Receptor Activator of Nuclear Factor-kappa B , Receptors, CCR1 , Receptors, CCR5/genetics , Receptors, Chemokine/genetics , Reverse Transcriptase Polymerase Chain Reaction , Stem Cells/cytology , Stem Cells/metabolism
17.
Biochem Biophys Res Commun ; 276(1): 258-63, 2000 Sep 16.
Article in English | MEDLINE | ID: mdl-11006115

ABSTRACT

Two thyrotropin receptor cDNAs (sTSH-Ra and sTSH-Rb) were cloned from thyroid tissue of the amago salmon, Oncorhynchus rhodurus. sTSH-Ra and sTSH-Rb showed the highest degrees of sequence homology to mammalian TSH receptors. Functional characterization in COS-7 cells transiently transfected with sTSH-Ra or sTSH-Rb showed the largest increase in cAMP when exposed to bovine TSH. RT-PCR analysis demonstrated that sTSH-Ra and sTSH-Rb were expressed in the basibranchial region, but not in the ovary, testis, liver, kidney or brain. In situ hybridization revealed that sTSH-Ra and sTSH-Rb were exclusively expressed in thyroid follicular epithelial cells of amago salmon undergoing smoltification. These results indicated that the cloned cDNAs encode functional TSH receptor proteins. This is the first report of isolation of TSH receptor molecules from nonmammalian vertebrates.


Subject(s)
Oncorhynchus/genetics , Receptors, Thyrotropin/genetics , Amino Acid Sequence , Animals , Cattle , Cloning, Molecular , DNA, Complementary/genetics , DNA, Complementary/isolation & purification , Gene Expression , In Situ Hybridization , Molecular Sequence Data , Organ Specificity , Receptors, Thyrotropin/biosynthesis , Sequence Alignment
18.
Biochem Biophys Res Commun ; 275(1): 121-8, 2000 Aug 18.
Article in English | MEDLINE | ID: mdl-10944452

ABSTRACT

We previously demonstrated in vitro that mammalian follicle-stimulating hormone (FSH) stimulates the proliferation of newt secondary spermatogonia and their differentiation into primary spermatocytes. In the current study, we isolated a cDNA from newt testis that encodes a FSH receptor (FSH-R). The total sequence homology in the deduced protein of the newt was approximately 70% with mammalian FSH-Rs. Mammalian cells, transiently transfected with the cloned newt FSH-R cDNA, displayed specific binding to [(125)I] human FSH and cAMP accumulation, indicating that the cloned cDNA encodes a functional newt FSH-R protein. Northern blot analysis revealed a single transcript of approximately 3.0 kb length that was synthesized in testicular somatic cells (mainly Sertoli cells) from spermatogonial to spermatid stages with the highest level expressed during the primary spermatocytes stage. These results demonstrate that FSH stimulates newt spermatogenesis through the FSH-R. This study, as far as we know, reports for the first time the cloning of an amphibian FSH-R cDNA.


Subject(s)
Receptors, FSH/genetics , Salamandridae/genetics , Testis/metabolism , Amino Acid Sequence , Animals , COS Cells , Cloning, Molecular , Follicle Stimulating Hormone/metabolism , Gene Expression Regulation, Developmental , Humans , Male , Molecular Sequence Data , Organ Specificity , Phylogeny , Protein Binding , RNA, Messenger/genetics , RNA, Messenger/metabolism , Receptors, FSH/chemistry , Sequence Alignment , Sequence Analysis, DNA , Sequence Homology, Amino Acid , Spermatogenesis/genetics , Testis/chemistry , Testis/cytology , Transfection
19.
Respir Care ; 45(4): 401-6, 2000 Apr.
Article in English | MEDLINE | ID: mdl-10780035

ABSTRACT

BACKGROUND: Long-term oxygen therapy improves survival and quality of life in hypoxemic patients with chronic obstructive pulmonary disease (COPD). The need for long-term oxygen therapy should be determined when patients are medically stable. The Third Oxygen Consensus Conference recommended reevaluating patients 1-3 months after continuous oxygen therapy (COT) is initiated, if initiated when the patient is medically unstable. METHODS: A cross-sectional study was performed to examine how often orders for COT are reevaluated pursuant to the guidelines promulgated by the Third Oxygen Therapy Consensus Conference, and to assess the impact that following these guidelines would have on the cost of COT. RESULTS: Of 226 patients prescribed home oxygen therapy, 92 had COPD as a primary diagnosis and 57 were prescribed COT. Only 19 (35%) of 55 patients who returned to the clinics were appropriately reevaluated. The rate of appropriate reevaluation was significantly higher among pulmonary physicians than among primary care physicians (65% vs 17%; odds ratio: 9.0; 95% confidence interval: 2.5-32). Of 19 patients who were appropriately reevaluated, 11 (58%) were discontinued from COT. The patients who were discontinued from COT had a significantly higher percent of predicted forced expiratory volume in the first second than those who were not (34 +/- 8.6% vs 25 +/- 8.8%; p = 0.04). CONCLUSIONS: In our study, most patients were clinically unstable when COT was prescribed, and a significant number of patients remained on COT without reevaluation. Up to 60% of those patients could potentially be discontinued from COT if appropriately reevaluated. Referring a patient initiated on COT to a pulmonary specialist for the proper use of oxygen is strongly recommended. Reevaluating such patients in a timely fashion and discontinuing unnecessary oxygen concentrators could possibly save $106-153 million per year in the United States.


Subject(s)
Home Care Services/economics , Lung Diseases, Obstructive/diagnosis , Lung Diseases, Obstructive/therapy , Oxygen Inhalation Therapy/standards , Patient Compliance , Aged , Cross-Sectional Studies , Female , Humans , Insurance, Health/economics , Male , Middle Aged , Missouri , Oxygen Inhalation Therapy/economics , Retrospective Studies
20.
Rinsho Ketsueki ; 41(1): 61-4, 2000 Jan.
Article in Japanese | MEDLINE | ID: mdl-10695401

ABSTRACT

A 55-year-old man was admitted to our hospital because of leukocytosis and microcytic anemia with hypochromia, target cells, and increased levels of hemoglobin A2 and hemoglobin F. The results of a gene analysis yielded a diagnosis of chronic myelogenous leukemia and beta-thalassemia minor. A gradual increase in hemoglobin was observed during hydroxyurea therapy, which was performed over a 12-week period. This increment appeared to be due to suppressed production of myeloid cells. It was been reported that hydroxyurea increases total hemoglobin due to increased hemoglobin F synthesis in patients with beta-thalassemia. However, hydroxyurea had no clear influence on hemoglobin concentration in this case.


Subject(s)
Antineoplastic Agents/administration & dosage , Hydroxyurea/administration & dosage , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications , beta-Thalassemia/diagnosis , Globins/genetics , Hemoglobins/metabolism , Humans , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Male , Middle Aged , Mutation , beta-Thalassemia/blood , beta-Thalassemia/complications
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