95 results on '"Fraser, RB"'
Search Results
2. A randomised trial of timed delivery for the compromised preterm fetus: short term outcomes and Bayesian interpretation
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Van Bulck, B, Kalakoutis, GM, Sak, P, Schneider, KTM, Major, T, Karpathios, SE, Todros, T, Arduini, D, Tranquilli, A, Tenore, AC, Roncaglia, N, Frusca, T, van Roosmalen, J, van der Slikke, JW, van Geijn, H, Pernet, PJM, Wolf, H, Stitger, RH, Wilczynski, J, Vasco, E, Rashid, M, Novak-Antolic, Z, Danielian, P, Jenkinson, SD, Welch, CR, Griffin, C, Gee, H, Tuffnell, D, Cresswell, J, Tariq, T, Sengupta, B, Tydeman, G, Kumarendran, M, Churchill, D, Bewley, S, Fusi, L, Lindow, SW, Johal, W, Neales, K, Thornton, JG, Scudamore, [No Value], Konje, J, Walkinshaw, SA, Griffiths, M, Dawson, A, Mires, G, Johanson, R, Fraser, RB, Hendy, P, Steel, SA, and Faculteit Medische Wetenschappen/UMCG more...
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WEEKS GESTATION ,AGE ,BIRTH ,INFANTS ,EXPECTANT MANAGEMENT ,SEVERE PREECLAMPSIA - Abstract
Objectives To compare the effect of delivering early to pre-empt terminal hypoxaemia with delaying for as long as possible to increase maturity. Design A randomised controlled trial. Setting 69 hospitals in 13 European countries. Participants Pregnant women with fetal compromise between 24 and 36 weeks, an umbilical artery Doppler waveform recorded and clinical uncertainty whether immediate delivery was indicated. Methods The interventions were 'immediate delivery' or 'delay until the obstetrician is no longer uncertain'. The data monitoring and analysis were Bayesian. Main outcome measures 'Survival to hospital discharge' and 'developmental quotient at two years of age', this latter to be reported later. Results Of 548 women (588 babies) recruited, outcomes were available on 547 mothers.(587 babies). The median time-to-delivery intervals were 0.9 days in the immediate group and 4.9 days in the delay group. Total deaths prior to discharge were 29 (10%) in the immediate group versus 27 (9%) in the delay group (odds ratio 1.1, 95% CI 0.61-1.8). Total caesarean sections were 249 (91%) in the immediate group versus 217 (79%) in the delay group: (OR 2.7; 95% CI 1.6-4.5). These odds ratios were similar for those randomised at gestational ages above or below 30 weeks. Interpretation The lack of difference in overall mortality suggests that clinicians participating in this trial were on average prepared to randomise at about the correct equivocal threshold between delivery and delay. However, there was insufficient evidence to convince enthusiasts for either immediate or delayed delivery that they were wrong. more...
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- 2003
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3. Cancellous bone loss during pregnancy is a consequence of high bone remodelling
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Naylor, KE, primary, Iqbal, P, additional, Fraser, RB, additional, and Eastell, R., additional
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- 1998
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4. Length of gestation and polycystic ovaries in adulthood
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Cresswell, JL, primary, Barker, DJP, additional, Phillips, DIW, additional, and Fraser, RB, additional
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- 1998
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5. Are the benefits of the ‘Healthy Start’ food support scheme sustained at three months postpartum? Results from the Sheffield ‘before and after’ study.
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Mouratidou T, Ford FA, Wademan SE, and Fraser RB
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- 2010
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6. Effect of the introduction of 'Healthy Start' on dietary behaviour during and after pregnancy: early results from the 'before and after' Sheffield study.
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Ford FA, Mouratidou T, Wademan SE, and Fraser RB
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- 2009
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7. Validation of a food-frequency questionnaire for use in pregnancy.
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Mouratidou T, Ford F, Fraser RB, Mouratidou, Theodora, Ford, Fiona, and Fraser, Robert B
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Objectives: As a part of an ongoing project to develop a nutritional screening tool, we evaluated the performance of a semi-quantitative food-frequency questionnaire (FFQ) in terms of validity in a Sheffield Caucasian pregnant population using two different statistical approaches--the correlation coefficient and the limits of agreement (LOA). The FFQ was designed specifically for pregnant women and previously used in a large-scale study.Design: A validation study.Setting: A community-based field study of a general population of pregnant women booked for their first antenatal appointment at the Jessop Wing, Royal Hallamshire Hospital, Sheffield, UK.Subjects: One hundred and twenty-three women of different socio-economic status, aged between 17 and 43 years, provided complete dietary data.Results: The validity of the FFQ was tested against a series of two 24-hour recalls. As expected, the intakes of all examined nutrients, except for iodine, carotene, vitamin E, biotin, vitamin C and alcohol, were higher when determined by the FFQ than when determined by 24-hour recall. Pearson's correlation coefficient between the two methods ranged from 0.19 (added sugar, zinc) to 0.47 (Englyst fibre). The LOA were broader for some of the nutrients, e.g. protein, Southgate fibre and alcohol, and an increasing lack of agreement between the two methods was identified with higher dietary intakes.Conclusions: The FFQ gave useful estimates of the nutrient intakes of Caucasian pregnant women and appears to be a valid tool for categorising pregnant women according to dietary intake. The FFQ performed well for most nutrients and had acceptable agreement with the 24-hour recall. [ABSTRACT FROM AUTHOR] more...- Published
- 2006
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8. Selected coping strategies in labor: an investigation of women's experiences.
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Spiby H, Slade P, Escott D, Henderson B, and Fraser RB
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BACKGROUND: Antenatal education classes offer women information about labor and birth and ways of coping with pain and emotional distress. The purpose of this paper was to describe women's experiences of using, starting, and discontinuing three coping strategies in labor that were taught in antenatal education classes. METHODS: An exploratory research design was used in which 121 women were interviewed within 72 hours of the birth of their first child. Information was obtained on why women initiated and discontinued their use of three coping strategies (breathing technique, postural changes, relaxation technique) and the reported effects of use. RESULTS: The effects of the coping strategies investigated varied widely among participants. Common aspects of care, changes of environment, and use of pharmacological pain relief affected women's discontinuation of coping strategies. CONCLUSIONS: The implications of study findings for clinical practice include the need for caregivers to provide women with accurate information about the effects of coping strategies and to be alert to aspects of care that may disrupt women's use of strategies. [ABSTRACT FROM AUTHOR] more...
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- 2003
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9. Antenatal predictors and use of coping strategies in labour.
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Slade P, Escott D, Spiby H, Henderson B, and Fraser RB
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- 2000
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10. A longitudinal study of maternal anthropometric changes in normal weight, overweight and obese women during pregnancy and postpartum [corrected] [published erratum appears in BR J NUTR 2000 Dec; 84(6): 947].
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Soltani H and Fraser RB
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- 2000
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11. Strategies for coping with labour: does antenatal education translate into practice?
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Spiby H, Henderson B, Slade P, Escott D, and Fraser RB
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PSYCHOLOGICAL adaptation ,LABOR (Obstetrics) ,PRENATAL diagnosis - Abstract
Strategies for coping with labour: does antenatal education translate into practice? ¶ There is little evidence to associate attendance at antenatal classes with a reduction in psychological distress or increased satisfaction with the experience of labour. There may be several reasons for this, including failure to implement coping strategies. A within-subjects research design explored the use in labour of coping strategies taught in antenatal classes and the role of practice. Women's views about using these strategies and their expectations of their midwives and birth companions were also identified. Following Ethics Committee approval and providing informed consent, 121 nulliparous women completed a questionnaire at their final antenatal class. This included questions on confidence and the amount of effort required to use coping strategies, the involvement hoped for from birth companions and midwives in using coping strategies in labour and satisfaction with the amount of practice of coping strategies. Within 72 hours of delivery, women were interviewed to obtain a narrative of the events of labour and their use of the coping strategies (sighing-out-slowly breathing, Laura Mitchell relaxation and postural change). A questionnaire obtained information on the involvement of the midwife and birth companion. Women used the three coping strategies to different extents. Midwives were not involved to the extent that women had hoped for antenatally. Birth companions achieved a level of involvement closer to women's hopes than that achieved by midwives. A significant proportion of women expressed dissatisfaction with the amount of practice of coping strategies during antenatal classes. The findings of this study of a group of well-prepared women raise questions about the correct components of antenatal classes and how midwives and birth companions can be involved optimally in this aspect of a woman's labour. Further research is required to determine how women can best be helped to cope with the experience of labour. [ABSTRACT FROM AUTHOR] more...
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- 1999
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12. Insulin sensitivity in third trimester pregnancy. A randomized study of dietary effects
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Fraser, RB, primary, Ford, FA, additional, and Lawrenece, GF, additional
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- 1989
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13. Workload Measurement in Subspecialty Placental Pathology in Canada.
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Wright JR Jr, Chan S, Morgen EK, Maung RTA, Brundler MA, El Demellawy D, Fraser RB, Kurek KC, Magee F, Nizalik E, Oligny LL, Somers GR, Stefanovici C, and Terry J
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- Female, Pregnancy, Humans, Child, Canada, Workload, Placenta, Pathology Department, Hospital
- Abstract
Background: Workload measurement is important to help determine optimal staffing and workload distribution for pathology laboratories. The Level 4 Equivalent (L4E) System is the most widely used Anatomical Pathology (AP) workload measurement tool in Canada. However, it was initially not developed with subspecialties in mind., Methods: In 2016, a Pan-Canadian Pediatric-Perinatal Pathology Workload Committee (PCPPPWC) was organized to adapt the L4E System to assess Pediatric-Perinatal Pathology workload. Four working groups were formed. The Placental Pathology Working Group was tasked to develop a scheme for fair valuation of placental specimens signed out by subspecialists in the context of the L4E System. Previous experience, informal time and motion studies, a survey of Canadian Pediatric-Perinatal Pathologists, and interviews of Pathologists' Assistants (PA) informed the development of such scheme., Results: A workload measurement scheme with average L4E workload values for examination and reporting of singleton and multiple gestation placentas was proposed. The proposal was approved by the Canadian Association of Pathologist - Association canadienne des pathologistes Workload and Human Resources Committee for adoption into the L4E System., Conclusion: The development of a workload measurement model for placental specimens provides an average and fair valuation of these specimen types, enabling its use for resource planning and workload distribution. more...
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- 2022
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14. "Ectopic acanthosis nigricans" in inguinal skin grafted to the hands of a child.
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Burke E, DeCoste RC, Wright GR, Fraser RB, Walsh NM, and Bezuhly M
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Competing Interests: None disclosed.
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- 2022
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15. Parental views on tissue banking in pediatric oncology patients.
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McMurter B, Parker L, Fraser RB, Magee JF, Kozancyzn C, and Fernandez CV
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- Adolescent, Biomedical Research ethics, Child, Child, Preschool, Female, Humans, Infant, Male, Pediatrics ethics, Health Knowledge, Attitudes, Practice, Neoplasms, Parental Consent ethics, Parents psychology, Tissue Banks ethics
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Purpose: Research using banked tissue is key to advancing risk-stratification and treatment of children with cancer. Knowledge of parental attitudes to ethical issues arising in tissue banking is very limited but essential in obtaining respectful consent., Methods: One hundred parents of consecutively diagnosed children with cancer were offered a validated 34-item questionnaire., Results: Respondents (n = 54) included 10 of 16 parents of deceased children. The majority (89%; n = 48) would agree to have tissue sent anywhere in the world but prefer pediatric aims (69%). Most (98%; n = 53) would permit genetic research, if it might improve the child's health, and 76% (n = 41) would permit it, even if no impact was anticipated. A minority (41%) would not allow painful, strictly research procedures, while 15% would regardless of the child's dissent. Just over half (54%; n = 29) wish to renew consent if stored tissue is used for another purpose. Most (98%) believe their child should confirm consent by the age of majority, but only 71% believe the mature child should be able to withdraw consent. A minority (n = 40; 74%) claim few or no rights to research profits; 83% believe these should be used to fund childhood cancer research., Conclusions: Parents are very supportive of tissue research, including genetic research. A majority of parents would prefer restricting research to pediatric conditions, and to be informed of results, even if of uncertain significance. These findings may assist Institutional Review Boards in assessing parentally perceived risks of research, and researchers in providing consent elements that support parents and adolescents in making fully informed choices., (Copyright © 2011 Wiley Periodicals, Inc.) more...
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- 2011
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16. Reproducibility and validity of a food frequency questionnaire in assessing dietary intakes of low-income Caucasian postpartum women living in Sheffield, United Kingdom.
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Mouratidou T, Ford FA, and Fraser RB
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- Adult, Cross-Sectional Studies, Diet Surveys, Female, Humans, Mental Recall, Postpartum Period, Reproducibility of Results, Sensitivity and Specificity, Statistics, Nonparametric, United Kingdom, Young Adult, Energy Intake physiology, Nutrition Assessment, Poverty, Surveys and Questionnaires standards, White People statistics & numerical data
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The aim of this study was to examine the reproducibility and validity of a semi-quantitative food frequency questionnaire (FFQ) for assessing dietary intakes of low-income, Caucasian, English-speaking, postpartum women living in Sheffield, United Kingdom. Data was obtained from a cross-sectional sample of the 'Healthy Start' study; a population-based survey of mothers and infants. Participants completed two FFQs at 4 and 8 weeks postpartum. Measures from 24-hour dietary recalls (24HDRs) were collected at 4, 6, 8 and 12 weeks postpartum. In the reproducibility study, crude Pearson's correlation coefficients ranged from 0.40 (riboflavin) to 0.73 (thiamine), mean value 0.54. In the validation study, crude Pearson correlation coefficients between the FFQ and the measures from the 24HDRs ranged from 0.10 (B12) to 0.55 (manganese), mean value 0.34. Energy-adjustments and corrections for attenuation had no significant effect on the strength of the correlation both observed in the reproducibility and validity study. On average, 68% of the participants were classified correctly, and 3% were misclassified into the extreme opposite quintile of the distribution. The authors conclude that the questionnaire performed well for the majority of nutrients examined and that is a valid tool for ranking individuals according to nutrient distribution., (© 2009 Blackwell Publishing Ltd.) more...
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- 2011
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17. Screening for gestational diabetes mellitus: cost-utility of different screening strategies based on a woman's individual risk of disease.
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Round JA, Jacklin P, Fraser RB, Hughes RG, Mugglestone MA, and Holt RI
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- Cost-Benefit Analysis, Female, Humans, Pregnancy, Risk Factors, Diabetes, Gestational diagnosis, Mass Screening economics
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Aims/hypothesis: The cost-effectiveness of eight strategies for screening for gestational diabetes (including no screening) was estimated with respect to the level of individual patient risk., Methods: Cost-utility analysis using a decision analytic model populated with efficacy evidence pooled from recent randomised controlled trials, from the funding perspective of the National Health Service in England and Wales. Seven screening strategies using various combinations of screening and diagnostic tests were tested in addition to no screening. The primary outcome measure was the incremental cost per quality-adjusted life-year (QALY) over a lifetime., Results: The strategy that has the greatest likelihood of being cost-effective is dependent on the risk of gestational diabetes mellitus for each individual woman. When gestational diabetes mellitus risk is <1% then the no screening/treatment strategy is cost-effective; where risk is between 1.0% and 4.2% fasting plasma glucose followed by OGTT is most likely to be cost-effective; and where risk is >4.2%, universal OGTT is most likely to be cost-effective. However, acceptability of the test alters the most cost-effective strategy., Conclusions/interpretation: Screening for gestational diabetes can be cost-effective. The best strategy is dependent on the underlying risk of each individual and the acceptability of the tests used. The current study suggests that if a woman's individual risk of gestational diabetes could be accurately predicted, then healthcare resource allocation could be improved by providing an individualised screening strategy. more...
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- 2011
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18. Melanotic Xp11 translocation renal cancers: a distinctive neoplasm with overlapping features of PEComa, carcinoma, and melanoma.
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Argani P, Aulmann S, Karanjawala Z, Fraser RB, Ladanyi M, and Rodriguez MM
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- Adenocarcinoma metabolism, Basic Helix-Loop-Helix Leucine Zipper Transcription Factors genetics, Basic Helix-Loop-Helix Leucine Zipper Transcription Factors metabolism, Biomarkers, Tumor metabolism, Child, Epithelioid Cells metabolism, Epithelioid Cells pathology, Fatal Outcome, Female, Gene Fusion, Humans, In Situ Hybridization, Fluorescence, Kidney Neoplasms genetics, Kidney Neoplasms metabolism, Male, Melanins metabolism, Melanoma metabolism, Neoplasms, Multiple Primary, Perivascular Epithelioid Cell Neoplasms genetics, Perivascular Epithelioid Cell Neoplasms metabolism, Adenocarcinoma secondary, Chromosomes, Human, Pair 11 genetics, Chromosomes, Human, X genetics, Kidney Neoplasms pathology, Melanoma secondary, Perivascular Epithelioid Cell Neoplasms secondary, Translocation, Genetic
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We describe 2 cases of malignant melanotic epithelioid renal neoplasms bearing TFE3 gene fusions. Both neoplasms occurred in children (an 11-y-old boy and a 12-y-old girl), and presented with disseminated metastatic disease including mediastinal and mesenteric adenopathy. Both neoplasms featured sheets of epithelioid cells with clear to finely granular eosinophilic cytoplasm set in a branching capillary vasculature. The neoplastic cells contained variable amounts of finely brown pigment confirmed to be melanin by histochemical stains. By immunohistochemistry, the neoplastic cells labeled for melanocytic markers HMB45 and Melan A, but not for S100 protein, MiTF, or any epithelial marker (cytokeratins, epithelial membrane antigen), renal tubular marker (CD10, PAX8, PAX2, RCC Marker) or muscle marker (actin, desmin). Both neoplasms demonstrated nuclear labeling for TFE3 protein by immunohistochemistry, and the presence of TFE3 gene fusions was confirmed by TFE3 fluorescence in situ hybridization analysis. These distinctive neoplasms combine morphologic features of perivascular epithelioid cell neoplasms (PEComas), Xp11 translocation carcinoma, and melanoma, though the phenotype most closely approaches PEComa. These neoplasms represent the first documented examples in which TFE3 gene fusions coexist with melanin production, and their identification raises the possibility that TFE3 gene fusions may underlie an aggressive subset of lesions currently classified as PEComa in young patients. more...
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- 2009
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19. Carboxypeptidase A5 identifies a novel mast cell lineage in the zebrafish providing new insight into mast cell fate determination.
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Dobson JT, Seibert J, Teh EM, Da'as S, Fraser RB, Paw BH, Lin TJ, and Berman JN
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- Animals, Stem Cells cytology, Stem Cells enzymology, Carboxypeptidases A metabolism, Cell Lineage, Mast Cells cytology, Mast Cells enzymology, Zebrafish metabolism
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Mast cells (MCs) play critical roles in allergy and inflammation, yet their development remains controversial due to limitations posed by traditional animal models. The zebrafish provides a highly efficient system for studying vertebrate hematopoiesis. We have identified zebrafish MCs in the gill and intestine, which resemble their mammalian counterparts both structurally and functionally. Carboxypeptidase A5 (cpa5), a MC-specific enzyme, is expressed in zebrafish blood cells beginning at 24 hours post fertilization (hpf). At 28 hpf, colocalization is observed with pu.1, mpo, l-plastin, and lysozyme C, but not fms or cepbalpha, identifying these early MCs as a distinct myeloid population arising from a common granulocyte/monocyte progenitor. Morpholino "knock-down" studies demonstrate that transcription factors gata-2 and pu.1, but not gata-1 or fog-1, are necessary for early MC development. These studies validate the zebrafish as an in vivo tool for studying MC ontogeny and function with future capacity for modeling human MC diseases. more...
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- 2008
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20. Impact of hyperglycemia on early embryo development and embryopathy: in vitro experiments using a mouse model.
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Fraser RB, Waite SL, Wood KA, and Martin KL
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- Animals, Animals, Outbred Strains, Apoptosis drug effects, Blastocyst drug effects, Cell Differentiation drug effects, Cell Division drug effects, Embryo Culture Techniques, Female, Glucose pharmacology, Mice, Pregnancy, Pregnancy in Diabetics, Teratocarcinoma metabolism, Teratocarcinoma pathology, Blastocyst metabolism, Blastocyst pathology, Embryonic Development physiology, Hyperglycemia metabolism, Hyperglycemia pathology
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Background: The aim of this study is to model the processes of early embryopathy seen in human pregnancy complicated by maternal hyperglycemia secondary to maternal diabetes using a mouse embryo culture system., Methods: Female mice were superovulated and mated in pairs. Two-cell embryos were harvested from the oviducts and cultured in vitro in KSOM medium (synthetic oviductal medium enriched with potassium) supplemented with 0.2, 5.56, 15.56 or 25.56 mM d-glucose. Cell proliferation, differentiation and apoptosis were assessed. Experiments were performed in constant, embryos exposed to a particular concentration of glucose (0.2, 5.56, 15.56 or 25.56 mM) from harvest to either Day 5 post fertilization (pf) or Day 8 pf, and fluctuating, embryos exposed to alternate high 25.56 mM and normal 5.56 mM concentrations of glucose between harvest and Day 5 pf, glycemic culture., Results: Expected levels of blastocyst formation and hatching were seen at 0.2 and 5.56 mM concentrations of glucose but both were impaired at higher concentrations (chi(2), P < 0.005; P < 0.001). Total cell numbers (P < 0.002) and cell allocation to the inner cell mass (P < 0.01) were reduced, but with no evidence of enhanced apoptosis in the hyperglycemic cultures. Variation in hyperglycemic exposure of the embryos on Days 2, 3 and 4 showed no adverse effects of hyperglycemia up to 24 h, but 48 and 72 h exposures were equally embryopathic (P < 0.01)., Conclusions: Hyperglycemic exposure for >24 h is toxic to early embryo development. These findings may explain the lower than expected implantation rates and higher than expected rates of congenital abnormality and early pregnancy loss seen in patients with diabetes, particularly those with poor diabetic control. more...
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- 2007
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21. Continuous subcutaneous insulin infusion vs intensive conventional insulin therapy in pregnant diabetic women: a systematic review and metaanalysis of randomized, controlled trials.
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Mukhopadhyay A, Farrell T, Fraser RB, and Ola B
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- Administration, Cutaneous, Adult, Diabetic Ketoacidosis epidemiology, Diabetic Retinopathy epidemiology, Female, Glycated Hemoglobin, Humans, Hypoglycemia, Insulin Infusion Systems, Odds Ratio, Pregnancy, Pregnancy Trimester, Third, Randomized Controlled Trials as Topic, Hypoglycemic Agents administration & dosage, Infusion Pumps, Implantable, Insulin administration & dosage, Pregnancy Outcome, Pregnancy in Diabetics drug therapy
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The objective of the study was to study the effects of continuous subcutaneous insulin infusion (CSII) vs multiple-dose insulin (MDI) therapy on glycemic control and pregnancy outcome in diabetic women. Randomized, controlled trials comparing CSII vs MDI in pregnant diabetic women were included after an electronic database search. Studies were rated for quality independently by 2 reviewers in accordance with the Quality of Reporting of Metaanalyses statement. Summary weighted mean difference and odds ratio were estimated for insulin dose, birthweight, gestational age, mode of delivery, hypoglycemic/ketotic episodes, worsening retinopathy, neonatal hypoglycemia, and rates of intrauterine fetal death. Six randomized clinical trials met the inclusion criteria. Pregnancy outcomes and glycemic control were not significantly different among treatment groups. Higher number of ketoacidotic episodes and diabetic retinopathy found in the CSII group did not reach statistical significance. This systematic review does not show any advantage or disadvantage of using CSII over MDI in pregnant diabetic women. Large multicenter, randomized, controlled trials addressing the quality of life/cost effectiveness are required. more...
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- 2007
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22. Fetal size and growth velocity in the prediction of the large for gestational age (LGA) infant in a glucose impaired population.
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Kernaghan D, Ola B, Fraser RB, Farrell T, and Owen P
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- Anthropometry methods, Female, Forecasting, Humans, Hypoglycemia diagnosis, Predictive Value of Tests, Pregnancy, Pregnancy Trimester, Third, Prospective Studies, ROC Curve, Ultrasonography, Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 2 complications, Fetal Development physiology, Fetal Macrosomia diagnostic imaging
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Objectives: To evaluate the performances of estimated fetal weight (EFW) and fetal growth velocity (FGV) in the prediction of birth weight>95th centile amongst women with impaired glucose tolerance (IGT); the prediction of neonatal hypoglycaemia was a secondary endpoint., Study Design: Two hundred and forty-two consecutive women (61 type 1 diabetes mellitus, 14 type 2 diabetes mellitus, 49 gestational diabetics and 118 with impaired glucose tolerance) receiving routine care at the combined diabetes/antenatal clinic, Jessop Hospital for Women, Sheffield. EFW was routinely calculated at approximately two-week intervals in the third trimester with the last EFW prior to delivery used in the analysis. FGV was calculated from two estimates of fetal weight between 21 and 35 days apart. EFW and FGV were both expressed as standard deviation (Z) scores., Results: The mean gestational age at delivery was 37 weeks (range 26-40 weeks). Sixty-five (27%) infants were of birth weight>95th centile. Mean EFW Z scores were 2.7 and 0.99 for >95th and <95th centile, respectively (p<0.001). Receiver operator characteristics (ROC) curve analysis gave area under the curve 0.8; using a cut-off Z score of 1.7 (=95.5 centile), EFW has sensitivity 80% and specificity 72% in predicting an LGA neonate (likelihood ratios 2.8 and 0.27 for positive and negative test). Mean FGV Z scores were 0.85 and 0.4 for >95th and <95th centile, respectively (p>0.05); ROC curve analysis indicated no discriminatory capacity. Estimates of fetal size and growth performed poorly in the prediction of neonatal hypoglycaemia., Conclusion: In routine clinical practice, EFW has limited utility in the prediction of the LGA infant. FGV does not identify the LGA infant. EFW and FGV do not predict neonatal hypoglycaemia. more...
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- 2007
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23. Congenital placental-cerebral adhesion: an unusual case of amniotic band sequence. Case report.
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Merrimen JL, McNeely PD, Bendor-Samuel RL, Schmidt MH, and Fraser RB
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- Adult, Amniotic Band Syndrome diagnosis, Amniotic Band Syndrome pathology, Female, Head Protective Devices, Humans, Infant, Newborn, Placenta pathology, Placenta surgery, Postoperative Complications diagnosis, Postoperative Complications therapy, Pregnancy, Reoperation, Scalp pathology, Scalp surgery, Tissue Adhesions, Amniotic Band Syndrome surgery, Placenta abnormalities, Scalp abnormalities
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Amniotic band sequence is a disruption sequence having a broad spectrum of clinical manifestations ranging from partial amputations to major craniofacial and limb-body wall defects. Most reported cases of placental-cerebral adhesion pertain to patients with severe craniofacial defects who were either stillborn or who died a few hours after birth. The authors present a case of a male infant born with a placental-cerebral adhesion through a cranial defect. This adhesion was separated at birth, and duraplasty and primary scalp closure were performed. A detailed examination of the placenta revealed the presence of multiple amniotic bands. The case demonstrates that survival and normal early post-natal development are possible if the condition is treated promptly. more...
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- 2006
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24. Two lucky escapes-placenta previa.
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Prabha S, Fraser RB, and Cohen M
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- Adult, Cesarean Section, Female, Humans, Oxytocics therapeutic use, Oxytocin therapeutic use, Placenta blood supply, Pregnancy, Amnion surgery, Diagnostic Errors, Labor, Induced, Placenta Previa diagnosis, Pregnancy, Prolonged therapy
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- 2006
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25. C-Kit-positive metastatic malignant pigmented clear-cell epithelioid tumor arising from the kidney in a child without tuberous sclerosis.
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Yu W, Fraser RB, Gaskin DA, Fernandez CV, and Wright JR Jr
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- Angiomyolipoma diagnosis, Angiomyolipoma pathology, Child, Female, Humans, Kidney Neoplasms diagnosis, Kidney Neoplasms pathology, Retroperitoneal Neoplasms pathology, Retroperitoneal Neoplasms secondary, Thoracic Neoplasms pathology, Thoracic Neoplasms secondary, Tuberous Sclerosis, Angiomyolipoma metabolism, Kidney Neoplasms metabolism, Proto-Oncogene Proteins c-kit metabolism
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We report the first pediatric case of malignant pigmented epithelioid clear-cell tumor arising from kidney; the lesion occurred in a 12-year-old girl without tuberous sclerosis. The tumor was widely metastatic to the retroperitoneum and chest, and the patient died of the disease 9 months after diagnosis, despite active chemotherapy. Pigmented epithelioid clear-cell tumor of the kidney is a rare variant of epithelioid angiomyolipoma and a member of the family of perivascular epithelioid cell tumors (PEComas). The tumor demonstrated overlapping features between clear-cell sugar tumor and epithelioid variant of angiomyolipoma. Tumor cells were positive for HMB-45 expression, negative for any evidence of muscular differentiation, and contained melanin pigment and premelanosomes in the cytoplasm. Diffuse C-Kit (CD117) positivity was identified throughout the tumor. This is the first report of C-Kit-positive malignant PEComas. more...
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- 2005
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26. The crucial role of tumour specimen handling in childhood cancer outcomes.
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Fernandez CV, Magee F, and Fraser RB
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The significant advances achieved in the care of children with cancer have been the result of carefully conducted clinical trials in international cooperative group settings. Specialized biological testing of tumour specimens is now an essential component of risk and treatment assignment for many childhood cancers. Thus, the appropriate collection and handling of tumour specimens is crucial to maintaining and further advancing the excellent outcomes that we have achieved. We recommend that all children with a strongly suspected malignancy, or cases in which the situation is unclear, be discussed with a paediatric oncologist before obtaining a tumour specimen. When a tumour is discovered incidentally at surgery, we recommend that the tumour be placed in a saline-soaked gauze and a paediatric pathologist or oncologist contacted immediately. Further progress in understanding and treating childhood cancer is intimately linked to basic studies of biology, translational research and determining the role of biological markers in risk stratification. Early and careful collaboration between front-line physicians and tertiary care oncology specialists is essential to the continuing success of treatment of children with cancer. more...
- Published
- 2005
27. Preliminary evaluation of a coping strategy enhancement method of preparation for labour.
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Escott D, Slade P, Spiby H, and Fraser RB
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- Adult, Anxiety etiology, England, Female, Humans, Infant, Newborn, Labor Stage, First psychology, National Health Programs standards, Nurse-Patient Relations, Nursing Methodology Research, Pain etiology, Patient Education as Topic methods, Pregnancy, Stress, Psychological prevention & control, Surveys and Questionnaires, Adaptation, Psychological, Anxiety prevention & control, Midwifery standards, Mothers education, Mothers psychology, Pain prevention & control, Prenatal Care standards
- Abstract
Objectives: To compare the use and effects of enhanced pre-existing coping strategies with the use and effects of coping strategies usually taught in National Health Service (NHS) antenatal education on women's experience of pain and emotions during labour., Design: A between-group comparison of women who chose to attend NHS antenatal education where courses of preparation were randomly assigned to include either a new method of coping strategy enhancement (CSE) or standard taught coping strategies., Setting: Two large maternity units in one city in the North of England., Participants: 20 women participated in antenatal classes incorporating the CSE method and 21 women participated in antenatal classes incorporating the standard approach to developing coping strategies for labour., Findings: Women who attended CSE classes used enhanced coping strategies for a larger proportion of their labour than women who attended standard classes who used taught coping strategies. Birth companions were more involved in women's use of enhanced than taught strategies. Self-efficacy for use of coping strategies and subsequent experiences of pain and emotions during labour were equivalent between groups., Key Conclusions and Implications for Practice: An approach based on enhancing pre-existing coping strategies was associated with greater coping strategy use and involvement from the birth companion, and provided benefits to women's overall experience of labour at least equivalent to that associated with standard preparation. Further research should explore this novel approach in larger groups, and for women who may choose not to attend group antenatal preparation. more...
- Published
- 2005
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28. The range of coping strategies women use to manage pain and anxiety prior to and during first experience of labour.
- Author
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Escott D, Spiby H, Slade P, and Fraser RB
- Subjects
- Adolescent, Adult, Anxiety etiology, England, Female, Humans, Infant, Newborn, Nursing Methodology Research, Pain etiology, Patient Education as Topic methods, Patient Satisfaction, Pregnancy, Prenatal Care methods, Stress, Psychological etiology, Stress, Psychological prevention & control, Surveys and Questionnaires, Time Factors, Women's Health, Adaptation, Psychological, Anxiety prevention & control, Labor Stage, First psychology, Mothers education, Mothers psychology, Pain prevention & control
- Abstract
Objectives: To investigate whether nulliparous women, during pregnancy, can identify their own pre-existing coping strategies for managing pain and anxiety and whether the range of coping strategies used in Labour by women who do not attend antenatal classes can be described., Design: Qualitative semi-structured interviews., Setting: Two large maternity units in a city in the North of England., Participants: Twenty-three nulliparous women were interviewed during their third trimester of pregnancy (prior to any antenatal class attendance) regarding strategies used to cope with previous experiences of pain and anxiety. A separate sample of 20 women, who had not attended any form of antenatal education, were interviewed within 72h of their first experience of labour regarding the coping strategies used to manage pain and anxiety during labour., Findings: Template Analysis was used to code data from transcribed interviews. The findings indicate that as women approach their first experience of labour they can identify coping strategies that they have employed to manage pain and anxiety in their past. Equally women who have not attended antenatal classes use a wide range of strategies in labour. The range of identified coping strategies is described and comprises thoughts and behaviours with positive and negative consequences., Key Conclusions and Implications for Practice: It is possible to help nulliparous women to identify, in pregnancy, a range of strategies that they have previously employed to manage pain and anxiety. This range reflects the coping strategies that women may potentially use in labour to manage pain and anxiety. Women may benefit from assistance in pregnancy to develop strategies for labour that are based on knowledge of their own coping repertoire, which includes enhancing positive strategies and finding alternatives to negative strategies. more...
- Published
- 2004
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29. Serum osteoprotegerin as a determinant of bone metabolism in a longitudinal study of human pregnancy and lactation.
- Author
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Naylor KE, Rogers A, Fraser RB, Hall V, Eastell R, and Blumsohn A
- Subjects
- Adult, Bone Density, Carrier Proteins metabolism, Estrogens blood, Female, Humans, Infant, Newborn, Longitudinal Studies, Membrane Glycoproteins metabolism, Osteoprotegerin, Postpartum Period metabolism, RANK Ligand, Receptor Activator of Nuclear Factor-kappa B, Receptors, Tumor Necrosis Factor, Bone and Bones metabolism, Glycoproteins blood, Lactation physiology, Pregnancy metabolism, Receptors, Cytoplasmic and Nuclear blood
- Abstract
Osteoprotegerin (OPG) is a soluble decoy receptor that inhibits bone resorption by binding to receptor activator of nuclear factor kappa B ligand. Murine studies suggest that OPG is elevated in pregnancy, but its role in human pregnancy is unknown. We evaluated the relationship among OPG, bone turnover, and bone density in a longitudinal study of planned human pregnancy and lactation (n = 17; age, 20-36 yr). Samples were collected before conception; at 16, 26, and 36 wk gestation; and at 2 and 12 wk postpartum. Indexes of bone resorption included serum beta C-terminal and urinary N-terminal (uNTX) telopeptides of type I collagen. OPG increased by 110 +/- 16% (mean +/- SEM) at 36 wk (P < 0.001), followed by a rapid postpartum decline in both lactating and nonlactating women. Bone resorption was elevated at 36 wk (serum beta C-terminal telopeptides by 76 +/- 17%; urinary N-terminal telopeptides by 219 +/- 41%; P < 0.001). The tissue source of OPG in pregnancy is unknown. Human breast milk contains large amounts of OPG (162 +/- 58 ng/ml in milk vs. 0.42 +/- 0.03 ng/ml in nonpregnant serum). However, the rapid postpartum decline in serum OPG and the low serum OPG in neonates suggest a placental source. There was no correlation between change in OPG and bone turnover or bone mineral density (P > 0.05), and the physiological importance of elevated OPG in human pregnancy remains uncertain. more...
- Published
- 2003
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30. Acute myelogenous leukemia and glycogen storage disease 1b.
- Author
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Pinsk M, Burzynski J, Yhap M, Fraser RB, Cummings B, and Ste-Marie M
- Subjects
- Female, Glycogen Storage Disease Type I diagnostic imaging, Humans, Infant, Leukemia, Myeloid, Acute diagnostic imaging, Radionuclide Imaging, Radiopharmaceuticals, Recombinant Proteins, Technetium Tc 99m Exametazime, Glycogen Storage Disease Type I complications, Glycogen Storage Disease Type I drug therapy, Granulocyte Colony-Stimulating Factor therapeutic use, Leukemia, Myeloid, Acute complications, Leukemia, Myeloid, Acute drug therapy
- Abstract
Glycogen storage disease 1b (GSD 1b) is caused by a deficiency of glucose-6-phosphate translocase and the intracellular accumulation of glycogen. The disease presents with failure to thrive, hepatomegaly, hypoglycemia, lactic acidosis, as well as neutropenia causing increased susceptibility to pyogenic infections. We present a case of a young woman with GSD 1b who developed acute myelogenous leukemia while on long-term granulocyte colony-stimulating factor therapy. The presence of two rare diseases in a single patient raises suspicion that GSD 1b and acute myelogenous leukemia are linked. Surveillance for acute myelogenous leukemia should become part of the long-term follow-up for GSD 1b. more...
- Published
- 2002
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31. Association between Breus' mole and partial hydatidiform mole: chance or can hydropic villi precipitate placental massive subchorionic thrombosis?
- Author
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Kim DT, Riddell DC, Welch JP, Scott H, Fraser RB, and Wright JR Jr
- Subjects
- Adult, Blotting, Southern, Chromosome Aberrations, Female, Fetal Diseases mortality, Humans, Hydatidiform Mole mortality, Infant, Newborn, Male, Ploidies, Pregnancy, Chorion pathology, Fetal Diseases diagnosis, Fetal Diseases genetics, Hydatidiform Mole diagnosis, Hydatidiform Mole genetics, Placenta pathology, Thrombosis pathology
- Abstract
Breus' mole (massive subchorionic hematoma) is a rare entity most often found in the placentae of macerated stillborn fetuses. Previously considered to represent a postmortem event, recent evidence suggests that it occurs prior to fetal demise. A 23-week gestation male neonate was delivered of a 23-year-old gravida 3, para 2 woman and survived for 49 min. An autopsy with chromosomal studies resulted in a diagnosis of triploidy. Placental examination showed the presence of both Breus' mole and also partial hydatidiform mole. DNA samples extracted from portions of the fresh hematoma and from the fetal spleen were compared using molecular techniques. PCR analysis showed the presence of Y chromosome specific DNA in the placental clot, but a semiquantitative Southern blot demonstrated that roughly 85% of the clot DNA was of maternal origin. These findings suggest that Breus' mole represents primarily maternal thrombosis rather than fetal hemorrhage. We hypothesize that the partial mole could have contributed to the formation of the Breus' mole as some of the hydropic villi may have focally obstructed the maternal venous return from the intervillus space causing sluggish flow and promoting thrombosis. A review of the literature on Breus' mole shows that the majority of reported cases have not included cytogenetic findings. However, several authors have reported an association with triploidy and other chromosomal anomalies characterized by scattered placental hydropic villi. Thus, we suggest that obstruction of maternal venous return by hydropic villi may have played a contributory role in some of these other reported cases. more...
- Published
- 2002
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32. Eosinophilic/T-cell chorionic vasculitis.
- Author
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Fraser RB and Wright JR Jr
- Subjects
- Antigens, CD, Chorion metabolism, Eosinophilia metabolism, Eosinophilia pathology, Eosinophils metabolism, Female, Humans, Placenta Diseases metabolism, Placenta Diseases pathology, Pregnancy, Pregnancy Complications metabolism, Pregnancy Complications pathology, T-Lymphocytes metabolism, Vasculitis metabolism, Chorion pathology, Eosinophils pathology, T-Lymphocytes pathology, Vasculitis pathology
- Abstract
Chorionic vasculitis is the hallmark of a fetal response in chorioamnionitis. There are five highly characteristic findings: (1) leukocyte migration is not concentric but rather radiates toward the infected amniotic fluid; (2) the infiltrate is primarily neutrophils; (3) multiple chorionic vessels, first veins and then arteries, are usually involved; (4) the infiltrate never extends into the vasculature of stem villi; and (5) it is rare in the absence of chorioamnionitis (or its precursors). Here we describe a new form of chorionic vasculitis characterized by an infiltrate composed primarily of eosinophils and CD3+ T lymphocytes that very focally involves a single chorionic vessel (artery or vein), that radiates away from the amniotic fluid (i.e., toward the intervillous spaces), and that may extend into the stem villous vasculature; this lesion occurs in the absence of any evidence of chorioamnionitis. During the past 7+ years, using accepted placental review criteria, we have examined 7104 placentas and identified 14 cases of eosinophilic/T-cell chorionic vasculitis (or related lesions). Although the frequency of diagnosis in the placentas examined was 0.197%, its true incidence cannot be estimated because of its very focal nature and the limited nature of placental disk sampling. Its etiology and significance are unknown, but it may represent a focal immune-mediated vasculitis. more...
- Published
- 2002
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- View/download PDF
33. T-cell/periodic acid-Schiff stain: a useful tool in the evaluation of tubulointerstitial infiltrates as a component of renal allograft rejection.
- Author
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Resch L, Yu W, Fraser RB, Lawen JG, Acott PD, Crocker JF, and Wright JR Jr
- Subjects
- Basement Membrane metabolism, Basement Membrane pathology, Biopsy, Needle, Graft Rejection metabolism, Humans, Immunoenzyme Techniques, Kidney Transplantation, Kidney Tubules metabolism, Nephritis, Interstitial metabolism, T-Lymphocytes metabolism, Graft Rejection pathology, Kidney Tubules pathology, Nephritis, Interstitial pathology, Periodic Acid-Schiff Reaction, T-Lymphocytes pathology
- Abstract
Distinguishing between tubulitis and tubulointerstitial mononuclear cell infiltrates and determining the severity of tubulitis are critical components of diagnosing and grading renal allograft rejection using the 1993 Banff schema, the revised 1997 Banff schema, or the Cooperative Clinical Trials in Transplantation grading system. We describe a novel staining method, the T-PAS stain (CD3 and periodic acid-Schiff), which removes some of the subjectivity in the evaluation of tubulointerstitial infiltrates in renal allograft biopsies. The method simply combines two routine stains, immunoperoxidase staining for T cells (CD3) and periodic acid-Schiff (PAS) staining for tubular basement membrane, on the same section., (Copyright 2002, Elsevier Science (USA). All rights reserved.) more...
- Published
- 2002
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34. Cutaneous ciliated cyst of the abdominal wall: a case report with a review of the literature and discussion of pathogenesis.
- Author
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Fontaine DG, Lau H, Murray SK, Fraser RB, and Wright JR Jr
- Subjects
- Adolescent, Cilia pathology, Epidermal Cyst surgery, Female, Humans, Skin Diseases surgery, Abdominal Muscles pathology, Epidermal Cyst pathology, Skin Diseases pathology
- Abstract
A cutaneous ciliated cyst is a rare lesion typically found on the lower extremity of young girls shortly after puberty. Here, we report a case involving a previously unreported site (i.e., abdominal wall) in a 14-year-old girl. We also describe immunohistochemical and ultrastructural findings, review and analyze the world literature, and offer insights as to the pathogenesis of this lesion. more...
- Published
- 2002
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- View/download PDF
35. Immunohistochemical tissue controls, cost-effective convenience with quality control.
- Author
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Fraser RB and Rowden G
- Subjects
- Animals, Cost-Benefit Analysis, False Negative Reactions, False Positive Reactions, Humans, Immunohistochemistry standards, Pathology, Surgical economics, Pathology, Surgical standards, Quality Control, Tissue Embedding economics, Tissue Embedding methods, Tissue Embedding standards, Immunohistochemistry methods, Pathology, Surgical methods
- Published
- 2001
36. Antenatal corticosteroids: is more better?
- Author
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Fraser RB and Stewart P
- Subjects
- Case-Control Studies, Female, Humans, Infant, Newborn, Pregnancy, Research Design, Adrenal Cortex Hormones adverse effects, Respiratory Distress Syndrome, Newborn prevention & control
- Published
- 2000
- Full Text
- View/download PDF
37. The effect of pregnancy on bone density and bone turnover.
- Author
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Naylor KE, Iqbal P, Fledelius C, Fraser RB, and Eastell R
- Subjects
- Adult, Biomarkers, Calcium physiology, Confounding Factors, Epidemiologic, Female, Homeostasis, Humans, Insulin-Like Growth Factor I metabolism, Longitudinal Studies, Osteocalcin blood, Parathyroid Hormone blood, Pregnancy blood, Prolactin blood, Bone Density, Bone Resorption, Pregnancy physiology
- Abstract
During pregnancy, the mother adapts to meet the calcium demands of the fetus. The effect of this adaptation on the maternal skeleton is not fully understood. Our objectives were to evaluate changes in bone mineral density (BMD) and bone turnover during pregnancy. We studied 16 women longitudinally, with baseline measurements before pregnancy; then at 16, 26, and 36 weeks of pregnancy; and postpartum. We measured total-body BMD and biochemical markers of bone resorption (urinary pyridinium crosslinks and telopeptides of type I collagen) and bone formation (serum bone alkaline phosphatase, propeptides of type I procollagen [PINP] and osteocalcin). We also measured parathyroid hormone (PTH), insulin-like growth factor I (IGF-I), and human placental lactogen. Postpartum, BMD increased in the arms (2.8%, P < 0.01) and legs (1.9%, P < 0.01) but decreased in the pelvis (-3.2%, P < 0.05) and spine (-4.6%, P < 0.01) compared with prepregnancy values. All biochemical markers, with the exception of osteocalcin concentration, increased during pregnancy. The change in IGF-I at 36 weeks was related to the change in biochemical markers (e.g., PINP, r = 0.72, P = 0.002). Pregnancy is a high-bone-turnover state. IGF-I levels may be an important determinant of bone turnover during pregnancy. Elevated bone turnover may explain trabecular bone loss during pregnancy. more...
- Published
- 2000
- Full Text
- View/download PDF
38. Observational study of maternal anthropometry and fetal insulin.
- Author
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Soltani-K H, Bruce C, and Fraser RB
- Subjects
- Birth Weight physiology, Blood Glucose metabolism, Body Mass Index, C-Peptide blood, Female, Follow-Up Studies, Humans, Infant, Newborn, Male, Pregnancy blood, Anthropometry, Fetal Blood metabolism, Insulin blood, Pregnancy physiology
- Abstract
Aims: To examine the relation between maternal body fat and fetal metabolism., Methods: In this observational study, cord blood samples were collected from 60 infants of healthy women for the measurement of insulin and C peptide concentrations. Maternal weight, height, body mass index (BMI) and body composition (skinfold thickness measurements and bioelectrical impedance) were assessed at 13-15 weeks of gestation. Twenty five of the volunteers agreed to have a 75 g oral glucose tolerance test at 28-31 weeks of gestation., Results: Positive correlations were observed with both cord insulin or C peptide concentrations and maternal early pregnancy BMI (r=0.44, p=0.002 and r=0.33, p=0.008, respectively). There was no significant correlation between cord insulin or C peptide concentrations and birthweight or birth weight centiles., Conclusion: Maternal BMI could be a predictor of fetal cord insulin concentration. more...
- Published
- 1999
- Full Text
- View/download PDF
39. Amniotic fluid insulin levels identify the fetus at risk of neonatal hypoglycaemia.
- Author
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Fraser RB and Bruce C
- Subjects
- Birth Weight, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Humans, Infant, Newborn, Predictive Value of Tests, Pregnancy, Radioimmunoassay, Reference Values, Risk Factors, Amniocentesis, Amniotic Fluid chemistry, Diabetes, Gestational, Fetal Macrosomia diagnosis, Hypoglycemia diagnosis, Insulin analysis, Pregnancy in Diabetics
- Abstract
Aims: To investigate the use of amniotic fluid insulin (AFI) as a predictor of neonatal morbidity in the macrosomic newborn of the diabetic mother, in view of the fact that raised AFI levels are a marker for fetal hyperinsulinaemia., Methods: AFI was measured by radioimmunoassay in a group of pregnant diabetic women (n = 63) with normal (n = 41) or accelerated fetal growth (n = 22)., Results: Using log transformed data, liquor insulin was found to be significantly higher in pregnant women with Type 1 and Type 2 diabetes mellitus (17.6 mU/l; 95% confidence interval (CI) 11.7-26.4) compared with women with gestational diabetes mellitus (GDM) (8.2 mU/l; 95% CI 4.8-13.8, P = 0.02) or impaired glucose tolerance (IGT) (6.2mU/l; 95% CI 4.9-8.0, P = 0.0001). In the group with macrosomic fetuses (birth weight > 90th centile for gestational age), there was a significantly higher incidence of elective Caesarean section (CS) and emergency CS (12/22) compared to those with appropriate for gestational age (AGA) fetal weights (birth weight > 10th and < 90th centiles for gestational age) (9/41, P = 0.009). There was no significant correlation between raised AFI and macrosomia except in the Type 1 diabetic women, in whom the AGA group mean was 13.2 mU/l (95% CI 7.4-23.3), and 34.6mU/l (95% CI 17.5-68.4 P = 0.022) in macrosomia. In the latter group, hypoglycaemia requiring treatment was significantly more common in the macrosomic hyperinsulinaemic neonates (8/13), compared to normoinsulinaemic neonates in the same group (0/9, P = 0.005)., Conclusions: Identification of the hyperinsulinaemic fetus before delivery might allow the intensification of maternal insulin therapy leading to a reduction in incidence and severity of diabetic fetopathy. Pregnancy with a normoinsulinaemic fetus could be allowed to continue to the onset of spontaneous labour, which might result in a lower CS rate. more...
- Published
- 1999
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40. Perforated lymphoma of the colon in an immunosuppressed child.
- Author
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Webber EM, Fraser RB, Henry M, and Giacomantonio M
- Subjects
- Child, Colonic Neoplasms pathology, Colonic Neoplasms surgery, Humans, Immunosuppression Therapy, Intestinal Perforation surgery, Lymphoma, Large B-Cell, Diffuse pathology, Lymphoma, Large B-Cell, Diffuse surgery, Male, Colonic Neoplasms complications, Lymphoma, Large B-Cell, Diffuse complications, Precursor Cell Lymphoblastic Leukemia-Lymphoma complications
- Published
- 1999
- Full Text
- View/download PDF
41. Nodular fasciitis in the parotid region of a child.
- Author
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Carr MM, Fraser RB, and Clarke KD
- Subjects
- Child, Preschool, Fasciitis pathology, Humans, Male, Parotid Diseases pathology, Parotid Gland surgery, Fasciitis surgery, Parotid Diseases surgery
- Abstract
Background: Nodular fasciitis is a common pathologic entity in the limbs of adults but rare in the head and neck of children. It is defined by the World Health Organization as a benign and probably reactive fibroblastic growth extending as a solitary nodule from superficial fascia into subcutaneous tissue. Treatment is local excision, and recurrence is rare., Method: Case Report, Results: A 3.5-year-old boy was initially seen with a 1-year history of gradually enlarging but otherwise asymptomatic right facial mass. On examination, a firm nodule was palpable anterior to the right ear, and facial movement was symmetrical. Computed tomography showed a rounded, well-defined solid mass continuous with the parotid fascia. The patient underwent superficial parotidectomy without complication. The pathology was reported as nodular fasciitis, and the child has had no clinical recurrence over 2 years., Conclusion: Benign lesions in this region in children may present similarly to malignancies but require much more-conservative treatment. more...
- Published
- 1998
- Full Text
- View/download PDF
42. Immunophenotyping of insulitis in control and essential fatty acid deficient mice treated with multiple low-dose streptozotocin.
- Author
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Fraser RB, Rowden G, Colp P, and Wright JR Jr
- Subjects
- Animals, CD4-Positive T-Lymphocytes immunology, CD8-Positive T-Lymphocytes immunology, Immunophenotyping, Islets of Langerhans pathology, Male, Mice, Streptozocin administration & dosage, Time Factors, Diabetes Mellitus, Experimental immunology, Fatty Acids, Essential deficiency, Islets of Langerhans immunology, Lymphocytes immunology, Macrophages immunology
- Abstract
Multiple injections of low-dose streptozotocin induce lymphocytic insulitis and autoimmune diabetes in male CD-1 mice. Prior to the onset of insulitis, macrophages infiltrate the islets (single cell insulitis) and presumably help initiate the lymphocytic response directed at streptozotocin-induced neoantigens on islet beta cells. Essential fatty acid deficiency ameliorates the lymphocytic insulitis and prevents diabetes in this model. We hypothesize that essential fatty acid deficiency, which perturbs eicosanoid pathways and blocks the production of inflammatory mediators such as leukotriene B4, might prevent or diminish the single cell insulitis and, thus, abrogate the lymphocytic response. The purpose of the study was to determine whether essential fatty acid deficiency causes any differences in the immunophenotype or the time course of single cell insulitis or insulitis after low-dose streptozotocin. Three to five essential fatty acid deficient and 3-5 control mice were treated with low-dose streptozotocin and killed on days 0, 3, 5, 8, 10, 12 and 15. Frozen sections of the pancreata were stained using an immunoperoxidase method with antibodies against mouse macrophages, CD4T-lymphocytes and CD8 T-lymphocytes. Sections were assessed for the presence and severity of single cell insulitis and insulitis. Based on cell counts in the most severely involved islet from each pancreas, there was no difference in the single cell insulitis in control and essential fatty acid deficient mice. Islets from control pancreata had a higher mean grade of lymphocytic insulitis. These findings suggest that autoimmune diabetes following low-dose streptozotocin in control mice is the result of both lymphocytic and histiocytic infiltrates with subsequent beta-cell destruction. Our results do not support the hypothesis that the protective effect of essential fatty acid deficiency is due to diminished influx of macrophages into the islets. It is, however, possible that essential fatty acid deficiency deleteriously affects macrophage function and, thus, blunts the lymphocytic response. more...
- Published
- 1997
- Full Text
- View/download PDF
43. Is the age of menopause determined in-utero?
- Author
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Cresswell JL, Egger P, Fall CH, Osmond C, Fraser RB, and Barker DJ
- Subjects
- Adult, Aged, Aging physiology, Female, Humans, Middle Aged, Pregnancy, Birth Weight, Menopause physiology
- Abstract
Objective: To determine whether age at menopause is related to size at birth., Design: A follow-up study of two groups of women whose size at birth was recorded., Setting: Hertfordshire and Sheffield, England., Population: 755 women aged 60-71 years born in Hertfordshire; 235 women aged 40-42 years born in the Jessop Hospital, Sheffield., Main Outcome Measures: Age at natural menopause or serum follicle stimulating hormone concentration greater than 25 IU/ml., Results: Age at menopause was unrelated to birth weight. However, it occurred at a younger age in women who had low weight at 1 year. This was independent of their body weight and smoking habits. In the population of younger women those who had had an early menopause tended to have been short at birth, with a high ponderal index (birth weight/length3)., Conclusion: Growth retardation in late gestation, leading to shortness at birth and low weight gain in infancy, may be associated with a reduced number of primordial follicles in the ovary leading in turn to an earlier menopause. more...
- Published
- 1997
- Full Text
- View/download PDF
44. Monoamniotic twins delivered liveborn with a forked umbilical cord.
- Author
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Fraser RB, Liston RM, Thompson DL, and Wright JR Jr
- Subjects
- Adult, Female, Humans, Infant, Newborn, Pregnancy, Umbilical Arteries pathology, Umbilical Cord blood supply, Amnion, Chorion, Twins, Monozygotic, Umbilical Cord abnormalities
- Abstract
Monoamniotic twins are rare and are associated with high intrauterine mortality rates. This case appears to represent the first report of liveborn monoamniotic monochorionic twins delivered with a bifurcated umbilical cord. Pathological and angiographic studies of the placenta demonstrated a marginally inserted two-vessel umbilical cord that bifurcated at 8.4 cm from the disk into three-vessel umbilical cords supplying each twin. This probably represents the last opportunity for cleavage of the embryo prior to the formation of conjoined twins. A review of eight prior reports of monoamniotic twins with a single, bifurcating umbilical cord is provided. more...
- Published
- 1997
45. Perianal ependymoma presenting in the neonatal period.
- Author
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Webber EM, Fraser RB, Resch L, and Giacomantonio M
- Subjects
- Anus Neoplasms surgery, Anus Neoplasms ultrastructure, Diagnosis, Differential, Ependymoma surgery, Ependymoma ultrastructure, Epidermal Cyst pathology, Epidermal Cyst surgery, Humans, Infant, Newborn, Lipoma pathology, Lipoma surgery, Male, Pelvic Neoplasms surgery, Pelvic Neoplasms ultrastructure, Sacrococcygeal Region, Anus Neoplasms pathology, Ependymoma pathology, Pelvic Neoplasms pathology
- Abstract
Extraspinal ependymomas are a rare type of glioma that may arise in the sacrococcygeal region, presenting as a pelvic mass in an infant or child. Ependymoma presenting in the newborn period has not been described previously. Herein we describe a case of a newborn boy who presented with a perianal ependymoma, which was subsequently found to have presacral extension. The major diagnostic challenge this case presented was to rule out the alternative diagnosis of sacrococcygeal teratoma or a developmental malformation/heterotopia. more...
- Published
- 1997
46. Immunophenotyping fish-to-mouse islet xenograft rejection: a time course study.
- Author
-
Wright JR Jr, Kearns H, Yang H, Fraser RB, Colp P, and Rowden G
- Subjects
- Animals, Blood Glucose metabolism, Cells, Cultured, Graft Rejection pathology, Immunophenotyping, Islets of Langerhans cytology, Islets of Langerhans Transplantation pathology, Islets of Langerhans Transplantation physiology, Mice, Mice, Inbred BALB C, T-Lymphocytes immunology, T-Lymphocytes pathology, Tilapia, Time Factors, Transplantation, Heterologous pathology, Transplantation, Heterologous physiology, Diabetes Mellitus, Experimental surgery, Graft Rejection immunology, Islets of Langerhans Transplantation immunology, Transplantation, Heterologous immunology
- Abstract
Unlabelled: Tilapia islets, Brockmann bodies (BBs), transplanted under the kidney capsule (KC) of diabetic nude mice provide long-term normoglycemia, but, when transplanted into euthymic mice, reject in about one week., Objectives: The present study characterizes the cellular infiltrates at several time points during the xenograft rejection process., Methods: Tilapia BBs were harvested, fragmented, cultured overnight, and then transplanted under the KC of streptozotocin-diabetic Balb/c mice. Glucose levels were measured daily until the mice were killed at 1 (n = 2), 2 (n = 2), 3 (n = 3), and 5 days (n = 3) post transplantation and at the time of BB graft rejection (n = 6). Serial frozen sections of graft-bearing kidneys were stained for murine macrophages (MOMA-2, F4/80, M170), CD4+ (L3T4) T-cells (YTS 191.1), and CD8+ (Ly-2) T-cells (YTS 169.4) by indirect immunoperoxidase; the presence of granulocytes and plasma cells was assessed with H&E stained sections., Results: At 1 day, the grafts have undergone some central necrosis with macrophage infiltration. By 2 days, these changes are very well-developed and granulocytes, almost exclusively eosinophils, begin to surround the graft. At 3 days, rare CD4+ and CD8+ T-cells are seen at the graft kidney interface. Macrophages massively infiltrate the necrotic foci and pepper the graft. At 5 days and at rejection, macrophages and eosinophils predominated in the center of rejecting grafts while CD8+ T-cells and CD4+ T-cells were present at the periphery. Plasma cells were rare., Conclusion: We conclude that cell-mediated processes and eosinophils play roles in the rejection of cellular xenografts across this very wide phylogenetic barrier. more...
- Published
- 1997
47. Helicobacter pylori is not associated with nonspecific abdominal pain in children.
- Author
-
Yoshida NR, Webber EM, Fraser RB, Ste-Marie MT, and Giacomantonio JM
- Subjects
- Adolescent, Child, Female, Gastritis diagnosis, Gastritis microbiology, Gastroscopy, Helicobacter Infections diagnosis, Humans, Male, Pyloric Antrum pathology, Recurrence, Retrospective Studies, Abdominal Pain microbiology, Helicobacter Infections complications, Helicobacter pylori
- Abstract
Nonspecific abdominal pain is a significant problem in the pediatric population, and there has been much recent interest in the role that Helicobacter pylori (HP) might play in this disorder. A retrospective review was conducted at our center to determine its prevalence among children with otherwise undiagnosed abdominal pain. The study was conducted over a 45-month period during which 47 patients underwent gastroscopy and antral biopsies in the workup of this problem. Of the 37 patients who did not have a history of acid-pepsin disease (APD), only one (2.7%) tested positive for HP. In contrast, of the 10 who had a history of APD, three (30%) tested positive (P < .03). There were no distinguishing features among the HP-positive patients except for the presence of associated antral gastritis. Based on the current endoscopic results, of the nine patients with current evidence of APD, four (44%) were positive for HP; of the other 38 patients, none was positive for HP. Therefore, HP appears to be associated with antral gastritis, and HP does not play a role in nonspecific abdominal pain in this population. more...
- Published
- 1996
- Full Text
- View/download PDF
48. Migration of macrophage-like cells within encapsulated islets of Langerhans maintained in tissue culture.
- Author
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Fraser RB, MacAulay MA, Wright JR Jr, Sun AM, and Rowden G
- Subjects
- Animals, Cell Death, Glucose metabolism, Immunohistochemistry, Islets of Langerhans growth & development, Phagocytosis, Rats, Cell Movement, Culture Techniques methods, Islets of Langerhans cytology, Macrophages physiology
- Abstract
Islets of Langerhans isolated from the pancreas and encapsulated in alginate-polylysine-alginate micro-spheres can potentially serve as a self-regulating supply of insulin in response to glucose loads. A longitudinal ultrastructural and immunohistochemical study of encapsulated rat islets cultured in CMRL-1969 media at a constant glucose concentration of 5.5 mmol/L (100 mg%) allowed several observations. First, acinar cells, which remain attached to isolated islets, disappeared within 1 wk in tissue culture. Damaged endocrine cells also disappeared at this time. Phagocytic cells having ultrastructural features suggesting that they are macrophages emerged from the islets within about a week and ingested portions of the inner layer of capsule polymer. These macrophage-like cells retained these polymers until their death which occurred at around 1-2 mo after isolation; at no time did we observe phagocytic cells actually breaching the microsphere capsules. Beta cells remained well-granulated over 90 days of culture but accumulated lipofuscin-like residual bodies. Under these conditions, these bodies began to accumulate appreciably after about one week in culture. more...
- Published
- 1995
- Full Text
- View/download PDF
49. Essential fatty acid deficiency prevents multiple low-dose streptozotocin-induced diabetes in naive and cyclosporin-treated low-responder murine strains.
- Author
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Wright JR Jr, Fraser RB, Kapoor S, and Cook HW
- Subjects
- Animals, Blood Glucose metabolism, Diabetes Mellitus, Experimental blood, Diabetes Mellitus, Experimental pathology, Disease Susceptibility, Islets of Langerhans immunology, Islets of Langerhans pathology, Lymphocytes pathology, Male, Mice, Mice, Inbred BALB C, Mice, Inbred C57BL, Mice, Inbred DBA, Mice, Inbred Strains, Species Specificity, Streptozocin, Time Factors, Cyclosporine pharmacology, Diabetes Mellitus, Experimental prevention & control, Fatty Acids, Essential deficiency
- Abstract
We have previously shown that essential fatty acid (EFA) deficiency prevents diabetes and ameliorates insulitis in low-dose streptozotocin (LDS)-treated male CD-1 mice. The effects of EFA deficiency on the incidence of diabetes after LDS treatment has not been examined in other strains. In contrast to highly susceptible CD-1 mice, several other strains of mice are only partially susceptible to LDS treatment and do not develop appreciable insulitis; however, the susceptibility of these strains can be markedly increased by cyclosporin A (CsA) pretreatment to reduce suppressor cell function. Weanling male BALB/cByJ, DBA/2J, and C57BL/6J mice were placed on EFA-deficient (EFAD) or control diets for 2 months and then divided into experimental and control groups. Ten EFAD and 10 control mice from each strain received LDS treatment (40 mg/kg/d 5 d); an additional 10 EFAD BALB/cByJ and another 10 control BALB/cByJ mice received subcutaneous CsA injections (20 mg/kg/d) for 14 days prior to and for 5 days simultaneous with LDS treatment (40 mg/kg/d 5 d). Plasma glucose levels for all mice were determined 3 times per week for 3 weeks after LDS treatment. Mean plasma glucose levels (+/- SEM) at the end of the experiment were significantly lower in the EFAD groups vs control groups in BALB/cByJ (P < 0.001), DBA/2J (P < 0.00001), and C57BL/6J (P = 0.012) mice. CsA supplementation increased the severity of diabetes in LDS-treated BALB/cByJ mice (P < 0.0005); however, EFA deficiency also prevented diabetes in CsA-supplemented BALB/cByJ mice.(ABSTRACT TRUNCATED AT 250 WORDS) more...
- Published
- 1995
- Full Text
- View/download PDF
50. A study exploring midwives' education in, knowledge of and attitudes to nutrition in pregnancy.
- Author
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Mulliner CM, Spiby H, and Fraser RB
- Subjects
- Female, Humans, Surveys and Questionnaires, Health Knowledge, Attitudes, Practice, Nurse Midwives education, Nurse Midwives psychology, Nutritional Physiological Phenomena, Pregnancy
- Abstract
Objective: to explore midwives' education in, knowledge of and attitudes to nutrition in pregnancy., Design: survey using questionnaire and interview schedule., Participants: a randomly selected sample of 77 Registered Midwives., Setting: one English regional health authority., Measurements and Findings: qualitative and quantitative data collection methods. Midwife teachers were responsible for 95% of teaching in nutrition. 86% of midwives had received no education in nutrition following qualification. 46% of midwives achieved a poor score in nutrition knowledge. Considerable numbers of midwives felt unprepared to offer dietary advice to women from ethnic minority groups (36%), vegetarians (66%) and to women with pre-existing medical conditions (41%)., Key Conclusion: midwives require more education in nutrition both during basic education and following qualification. IMPLICATIONS FOR EDUCATION PRACTICE: nutritional issues should be included in continuing education programmes available to qualified midwives. more...
- Published
- 1995
- Full Text
- View/download PDF
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