I am a vascular surgeon. My research is centred on the following problems relevant to my patients: 1. The management of aortic aneurysm. 2. The management of occlusive atheroma, particularly unstable atheroma, aortic calcification, intermittent claudicati
The Adverse Effects Of Diabetes On Stroke: An Echoplanar MRI Study
Funder
National Health and Medical Research Council
Funding Amount
$278,418.00
Summary
Stroke is the most common, major brain disease in Australia. It is the third most common cause of death and the most common cause of adult disability. There is a close link between diabetes and stroke. Firstly, diabetes is an important risk factor for the development of stroke. Secondly, about one third of stroke patients have diabetes. In general, their outcome is much worse than other patients. In fact little is known about the cause of this adverse effect in stroke patients and there is uncer ....Stroke is the most common, major brain disease in Australia. It is the third most common cause of death and the most common cause of adult disability. There is a close link between diabetes and stroke. Firstly, diabetes is an important risk factor for the development of stroke. Secondly, about one third of stroke patients have diabetes. In general, their outcome is much worse than other patients. In fact little is known about the cause of this adverse effect in stroke patients and there is uncertainty whether intensive control of blood sugar in acute stroke improves outcome. Our pilot work suggests that raised brain lactate, together with larger stroke size, might together be responsible for the worse outcome in diabetic patients. We can now measure brain lactate and stroke size with new MRI techniques called echoplanar MRI, which can allow measurements of brain chemistry, blood flow, potentially viable and dead tissue. A new monitoring device allows non-invasive measurement of blood sugar every 5 minutes. Using these strategies, we are planning a comprehensive study of the causes of the worse stroke outcome with diabetes. In addition, we are incorporating a study to determine whether intensive control of blood sugar in the first 3 days after stroke, compared with standard treatment, reduces brain lactate and growth of the actual stroke. An understanding of these effects will have important implications for the acute treatment of stroke patients. If we can show that rigorous control of blood sugar reduces brain lactate and stroke growth, our study will lay the ground work for a large clinical trial. This could have important implications, both in Australia, and overseas.Read moreRead less
Improving Health Outcomes For Aboriginal Australians With Chronic Disease Thru Strategies To Reduce Systems Barriers To
Funder
National Health and Medical Research Council
Funding Amount
$2,997,256.00
Summary
The research aims to improve outcomes for Aboriginal people with chronic disease, through strategies of care that address health system barriers. The project aims to understand barriers and then to develop, implement and evaluate appropriate models of care that incorporate policy development and engagement. The project is to incorporate research partnerships and Indigenous sector capacity development.
Clinical Trial Of Intravitreal Injections Of Dexamethasone Vs Bevacizumab In Diabetic Foveal Oedema Resistant To Laser
Funder
National Health and Medical Research Council
Funding Amount
$336,398.00
Summary
Diabetic macular oedema (swelling in the back of the eye) occurs in 20% of patients who have had diabetes for 10 years, and causes progressive vision loss. This project aims to determine whether there may be a difference between treatment with bevaciumab -VEGF inhibitor- and steroids used as eye injections inpatients with diabetic macular oedema losing vision despite standard laser treatment.
Resistant forms of childhood acute lymphoblastic leukaemia (ALL) constitute a leading cause of cancer-related deaths in children. Despite tremendous improvements in therapy, 25-30% of patients still experience a relapse and many of them occur in patients stratified as low risk. Further treatment is often toxic, frequently unsuccessful and carries the risk of significant long-term morbidity. For the design of more appropriate therapy, information on the biology of relapsed ALL is urgently require ....Resistant forms of childhood acute lymphoblastic leukaemia (ALL) constitute a leading cause of cancer-related deaths in children. Despite tremendous improvements in therapy, 25-30% of patients still experience a relapse and many of them occur in patients stratified as low risk. Further treatment is often toxic, frequently unsuccessful and carries the risk of significant long-term morbidity. For the design of more appropriate therapy, information on the biology of relapsed ALL is urgently required. The sequencing of the human genome and advanced screening technology (microarrays) allow the detailed analysis of expression patterns in large numbers of specimens. We propose to study the genetic features of this disease by investigating 28 childhood ALL patients from whom we have stored specimens received at two time points, one at diagnosis and one at relapse. The hypothesis of this study is that relapsed leukaemias display genetic features which are correlated to their resistance to therapy. The specific questions we will be asking are: (1) Which genes are expressed at high levels in leukaemia specimens at the time of relapse while not expressed (or expressed at lower levels) at the time of diagnosis and vice versa? (2) What is the function of differentially expressed genes? (3) Is the pattern of gene expression correlated with resistance to the particular drug therapy used? (4) Is the leukaemia clone at relapse related or unrelated to the clone present at diagnosis, as determined by receptor rearrangement? The expression levels of identified discriminator genes will be confirmed by real-time quantitative polymerase chain reaction (PCR). The quality of this set of specimens makes them particularly suited to achieve the stated goals, providing a unique opportunity to investigate drug resistance in childhood ALL. The data generated will provide the basis for the examination of genes suitable as new therapeutic targets.Read moreRead less
Genetic Dissection Of The Biogenesis And Function Of Type IV Fimbriae Of Pseudomonas Aeruginosa
Funder
National Health and Medical Research Council
Funding Amount
$407,545.00
Summary
Pseudomonas aeruginosa is a common bacterium which causes serious life-threatening infections of individuals with cystic fibrosis, AIDS or who have suffered severe burns or are undergoing cancer chemotherapy. This pathogen, and a number of other important infectious bacteria use surface filaments, called fimbriae, like grappling hooks to attach to the cells of the body and to move across host tissues. These fimbriae are produced in response to environmental conditions, and are assembled by a pro ....Pseudomonas aeruginosa is a common bacterium which causes serious life-threatening infections of individuals with cystic fibrosis, AIDS or who have suffered severe burns or are undergoing cancer chemotherapy. This pathogen, and a number of other important infectious bacteria use surface filaments, called fimbriae, like grappling hooks to attach to the cells of the body and to move across host tissues. These fimbriae are produced in response to environmental conditions, and are assembled by a process that is also used in the export of toxins and other pathogenic molecules. This project will characterise genes which specify and control this system, as a means to design better treatments against such bacteria, many of which are resistant to antibiotic treatment.Read moreRead less
Life Threatening Cancer Across The Lifespan: Examining The Relevance Of Music To Patients And Their Companions
Funder
National Health and Medical Research Council
Funding Amount
$137,000.00
Summary
Although music is widely used, scant discussion about its therapeutic merit exists when compared to the spoken word. Throughout the Ages, ritualized music promoted health and loss adjustment, however, music is not pivotal in modern medicine. The research will examine people’s intuitive music usage when experiencing life threatening cancer and the relationship between music therapy participation and one’s later music experience. Findings will inform specific recommendations for music therapists a ....Although music is widely used, scant discussion about its therapeutic merit exists when compared to the spoken word. Throughout the Ages, ritualized music promoted health and loss adjustment, however, music is not pivotal in modern medicine. The research will examine people’s intuitive music usage when experiencing life threatening cancer and the relationship between music therapy participation and one’s later music experience. Findings will inform specific recommendations for music therapists and generic guidelines to extend music’s therapeutic effect in palliative care.Read moreRead less
Protein Topogenesis And The Assembly/disassembly Of The Enveloped Hepatitis B Virus.
Funder
National Health and Medical Research Council
Funding Amount
$197,884.00
Summary
An estimated 350 million people worldwide, and 250,000 in Australia, are chronically infected with the hepatitis B virus (HBV). Without intervention, one third will die as a direct result of this infection through cirrhosis, liver failure and liver cancer, but current treatments are inadequate. A major obstacle to the study of this virus is the lack of a cell culture infection system. We have used the duck hepatitis B virus (DHBV) model to study the events leading up to assembly of the virus in ....An estimated 350 million people worldwide, and 250,000 in Australia, are chronically infected with the hepatitis B virus (HBV). Without intervention, one third will die as a direct result of this infection through cirrhosis, liver failure and liver cancer, but current treatments are inadequate. A major obstacle to the study of this virus is the lack of a cell culture infection system. We have used the duck hepatitis B virus (DHBV) model to study the events leading up to assembly of the virus in a way which prepares the viral envelope or outer coat for its foray into a new host cell. The project will examine the specific interactions of two proteins, the large and the small envelope protein, in addition to a third envelope protein we have recently discovered, which together make up the viral envelope. This will reveal which envelope components are required to make up the specific structures known to be essential for the disruption of the host cell membrane and subsequent entry of the virus to a new cell. An understanding of the changes that occur to the viral envelope upon entry will enable development of strategies for the inhibition or blocking of this change, thus identifying targets for the development of new antiviral agents. Because HBV is just one of many viruses which have an envelope, all of which must enter the cell in some way, our studies of HBV will also provide new clues with respect to the replication of other viruses such as measles, influenza and HIV. A related part of the study will examine the orientation of the large envelope protein within the virus particle and how it changes its orientation to assume its many important functional roles, in the late stages of particle assembly. Expanding on our finding that the small protein is essential to the orientation of the large protein, this study will reveal the mechanism of a unique method of protein transport which may have wider implications in cell biology.Read moreRead less
Analysis Of A Chemosensory Complex That Controls Twitching Motility And Virulence In Pseudomonas Aeruginosa
Funder
National Health and Medical Research Council
Funding Amount
$346,250.00
Summary
Pseudomonas aeruginosa is a common bacterium which causes serious life-threatening infections of individuals with cystic fibrosis, AIDS or who have suffered severe burns or are undergoing cancer chemotherapy. Infection by this pathogen requires the controlled expression of a large number of virulence factors including extracellular enzyme, toxins and structures for the attachment and colonisation of host tissues. We have identified a complex multicomponent regulatory system which coordinates the ....Pseudomonas aeruginosa is a common bacterium which causes serious life-threatening infections of individuals with cystic fibrosis, AIDS or who have suffered severe burns or are undergoing cancer chemotherapy. Infection by this pathogen requires the controlled expression of a large number of virulence factors including extracellular enzyme, toxins and structures for the attachment and colonisation of host tissues. We have identified a complex multicomponent regulatory system which coordinates the expression of many of the virulence determinants of this pathogen. This project aims to dissect the intermolecular interactions and signalling events which input into, occur within, and output from this regulatory system. This knowledge will provide a platform for developing rational strategies for the production of new antimicrobials for fighting infections by this and related pathogens.Read moreRead less