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Biomedical subjects

A Major

Publications and source records attributed to A Major.

At least 19 recordsLinked to original sources

Event-related brain potentials as a measure of performance on WISC-III and WAIS-R NI similarities sub-tests.

Communication difficulties are a common consequence of brain injury and neuropathological processes. Equally common is the inability to assess intellectual functioning in many communication-impaired populations because the aphasia and physical disability of such patients prevents measurable performance on traditionally administered tests of mental functioning. This study demonstrates that concept formation abilities can be assessed using event-related brain potentials. It also provides further evidence for the efficacy of this innovative assessment method in which standardized and validated psychometric tests are formatted for computer presentation and simultaneous recording of neural activity, which serves as the response measure in lieu of verbal/behavioral responses.

Adolescent↗

Multiple mechanisms for oxygen-induced regulation of the Clara cell secretory protein gene.

The Clara cell secretory protein (CCSP) imparts a protective effect to the lung during oxidant injury. However, exposure to supplemental oxygen, a common therapeutic modality for lung disease, represses the expression of CCSP in the adult mouse lung. We investigated the mechanisms of hyperoxia-induced repression of the mouse CCSP promoter. Deletion experiments in vivo and in vitro indicated that the hyperoxia-responsive elements are localized to the proximal -166 bp of the CCSP promoter. Electrophoretic mobility shift and supershift analyses demonstrated increased binding of c-Jun at the activator protein-1 site, increased binding of CCAAT/enhancer binding protein (C/EBP) beta at the C/EBP sites, and decreased binding at the Nkx2.1 sites. Western analyses revealed that hyperoxia exposure induced an increase in the expression of the C/EBPbeta isoform liver-inhibiting protein (LIP) and an increase in cytoplasmic Nkx2.1. Cotransfection of LIP or c-Jun expression plasmids decreased the transcriptional activity of the proximal -166-bp CCSP promoter. These observations suggest that hyperoxia-induced repression of the CCSP gene is mediated, at least in part, at the level of transcription and that multiple mechanisms mediate this repression. Moreover, these novel observations may provide insights for generation of therapeutic interventions for the amelioration of oxidant-induced lung injury.

5' Flanking Region↗

Characterization of virulence plasmid types in Rhodococcus equi isolates from foals, pigs, humans and soil in Hungary.

Rhodococcus equi isolates (204) obtained from foals (lung abscesses, lymph nodes, nasal discharge, rectal swabs) bred in 15 studs located throughout Hungary, isolates from soil samples, lymph nodes of pigs and from lesions of human patients were examined to determine genotypic diversity of virulence-associated plasmids. Isolates were tested for the presence of 15-17 kDa virulence-associated protein antigen (VapA) and 20k Da (VapB) genes by polymerase chain reaction (PCR). Plasmid DNAs were isolated and analysed by digestion with restriction endonucleases for estimation of size and comparison of polymorphisms. Of 146 clinical isolates from foals in 15 studs, 129 (88.3%) gave positive results for the VapA gene, showing a 564 bp product of the expected size in the PCR amplification. Of the 129 clinical isolates from foals, 123 contained an 85 kb type I plasmid and the remaining six contained an 87 kb type I plasmid. Of 48 soil isolates from two horse studs, 26 (54.2%) were positive for VapA gene and contained an 85 kb type I plasmid. Of three pig isolates, one was positive for VapA gene and contained an 85 kb type I plasmid, and the remaining two were positive for the VapB gene, showing a 827 bp product of the expected size in the PCR amplification and were R. equi of intermediate virulence which contained a 95 kb type S5 plasmid. Of the seven human isolates, five were positive for VapB gene by PCR, these were R. equi of intermediate virulence, which contained a 95 kb type S5 plasmid. These results revealed that virulent R. equi strains harbouring a virulence plasmid of 85 kb type I or 87 kb type I, which have been found in clinical isolates from Europe and North and South America, are widespread in Hungary. Furthermore, same intermediately virulence plasmid type was found in both human and pig isolates.

Actinomycetales Infections↗

Nd:YAG 1064 nm laser in the treatment of facial and leg telangiectasias.

BACKGROUND: Facial and leg telangiectasias are a frequent cosmetic concern for both females and males with various skin types and ages. To date the different treatments for these problems, in particular leg telangiectasias, have frequently failed or led to negative side-effects. OBJECTIVE: This study examines the clinical effects and safety of applications with a 1064-nm Nd:YAG laser system (SmartEpil II, DEKA M.e.l.a., Florence, Italy) to treat vessels on the face and legs. MATERIALS AND METHODS: Twenty-five subjects with facial telangiectasias underwent one treatment at 100 J/cm2, 10 ms and 2 Hz repetition rate. Thirty-two subjects with leg telangiectasias, measuring 0.1-3 mm in diameter, were treated at 125-200 J/cm2, 10-30 ms and 2 Hz repetition rate. Subjects in this group underwent one to five treatment sessions at 8 week intervals. RESULTS: All subjects showed visible improvement, with 95-100% clearing of the face telangiectasias after only one treatment, and 50-100% clearing of the lower extremity vessels after three to five treatments. Transitory hypopigmentation was seen in two cases subjected to leg vessel treatment. CONCLUSIONS: Treatment of facial and leg telangectasias using a true long pulse 1064 nm Nd:YAG laser is an effective and safe method. The relative lack of discomfort combined with a high degree of individual satisfaction should play a part in the fairly high level of acceptance of this new form of therapy for the treatment of leg and face telangiectasias.

Adult↗

Biopsy-based comparison of liquid-based, thin-layer preparations to conventional Pap smears.

OBJECTIVE: To evaluate and compare histologic diagnosis of squamous intraepithelial neoplasia and cancer of the cervix with cytologic diagnosis using the conventional Pap smear versus the AutoCyte PREP liquid-based, thin-layer preparation. STUDY DESIGN: Two randomly selected, large patient groups from the same population were studied using two different cervical cytology preparation techniques. Cytologic results were compared to histologic diagnosis to estimate the relative sensitivities and specificities of the preparations. RESULTS: AutoCyte's liquid-based, thin-layer preparation method demonstrated improved agreement with histologic diagnosis as compared to the conventional Pap smear. This result supported the previously reported finding that use of this thin-layer method reduced atypical squamous cells of undetermined significance cases and substantially increased the detection of squamous intraepithelial lesions (SILs). CONCLUSION: Our cytohistologic correlation for conventional Pap smears and the AutoCyte PREP liquid-based preparations demonstrate that the increased rate of both low and high grade SILs on AutoCyte PREP reflects real detection as opposed to overdiagnosis.

Biopsy↗

Performance on WISC-III and WAIS-R NI vocabulary subtests assessed with event-related brain potentials: an innovative method of assessment.

Assessment of intellectual functions is essential for rehabilitative interventions with traumatic brain injury and stroke patients. However, many of these patients are difficult or impossible to assess because of aphasia and physical disabilities that prevent their performance on traditionally administered tests of mental functioning. We present normative evidence obtained from healthy individuals for the efficacy of a new method of assessing such patients using standardized and validated tests formatted for computer presentation and using direct measures of brain activity (event-related brain potentials, ERP) as the measurable response instead of verbal or motor behavior.

Aphasia↗

Uptake of the photosensitizer benzoporphyrin derivative in human endometrium after topical application in vivo.

STUDY OBJECTIVE: To determine both the time leading to maximum endometrial drug uptake and distribution of the photosensitizer benzoporphyrin derivative-monoacid ring A (BPD-MA) after intrauterine instillation (Canadian Task Force classification ). DESIGN: Assessment of histology specimens (Canadian Task Force classification I). SETTING: University-based facility. PATIENTS: Twenty-two women scheduled for hysterectomy. INTERVENTIONS: We instilled 1.5 ml of a 2 mg/ml of BPD-MA-Hyskon solution into the uterine cavity of 22 women before hysterectomy. The fluorescence induced was measured by fluorescence microscopy on frozen sections of uterine samples from 20 of 22 patients. Systemic uptake of BPD-MA was determined in plasma of six patients by spectrofluorometry. MEASUREMENTS AND MAIN RESULTS: The BPD-MA-induced fluorescence was maximum 1 hour after instillation, with significantly higher uptake in endometrial glands than in underlying stroma. Hormonal endometrial stimulation correlated with fluorescence intensity: atrophy < secretory phase < proliferative phase. Strongest fluorescence was seen in endometrial cancer. Drug uptake by endometrial glands was found at a depth of 2 mm from the surface. Systemic uptake of BPD-MA was under the detection level of 2 ng/ml after application. CONCLUSION: Fluorescence in human endometrial glands suggests that selective destruction of human endometrium with photodynamic therapy may be possible 1 hour after topical application of BPD-MA for benign and malignant lesions. No systemic drug uptake, side effects, or major technical difficulties were detected. Limited penetration of the drug and selective uptake by endometrial glands provided a high degree of safety for endometrial ablation.

Administration, Topical↗

[Allo-transfusion saving measures in maxillofacial surgery].

In terms of a prospective clinical study between June 1994 and May 1996, in 204 patients undergoing maxillo-facial surgeries with a expected blood loss of more than 500 ml a protocol of bloodsaving measures was followed. By means of an additional retrospective study, the consumption of homologous blood and the amount of bloodsaving measures between June 1990 and May 1994 was evaluated. Bloodsaving measures were consisting from acute normovolemic hemodilution, controlled moderate hypotension, cell saving, preoperative autologous blood donation, and administration of rh-erythropoetine. The methoda were applied isolated as well as in combination. Special concerns were given to a stable intraoperative homeostasis and to the acceptance of a low hematocrit perioperatively. Aim of the study was to investigate if, following the protocol, even in major maxillofacial procedures homologous blood transfusions almost completely can be avoided. Out of the 204 patients in the prospective study, only 30 received homologous blood. For the period June 94 to May 96, the reduction of the number of patients receiving homologous blood in relation to the period June 90 to May 94 was 83%. The results indicate that in the years 94 to 96 twice as much patients received bloodsaving measures. These led to a reduction of homologous blood consumption for 427 units in 1990 to 56 units 1996 (p < 0.001). If three measures, i.e. normovolemic hemodilution, cell saving, and hypotension were combined, the need of blood transfusion was at the minimum level. The effective reduction of homologous blood transfusion by consequent application of bloodsaving measures can with these data obviously be demonstrated.

Adolescent↗

The effect of intravenous iron on the reticulocyte response to recombinant human erythropoietin.

We studied the effect of intravenous (i.v.) administration of 200 mg of iron sucrose following an i.v. bolus injection of recombinant human erythropoietin (r-HuEPO; 300 U/kg body weight) in seven subjects and compared it with seven subjects treated with r-HuEPO alone. Reticulocytes, serum erythropoietin (EPO) and ferritin levels were studied at baseline and daily for the following 8 d. Use of i.v. iron abolished the marked reduction in serum ferritin observed with r-HuEPO administration. Although the total number of reticulocytes was not affected by i.v. iron administration, the reticulocyte Hb content and retHb (a measure in g/l of the Hb contained in all reticulocytes) were increased in the i.v. iron/r-HuEPO group compared with the group who received r-HuEPO alone. Therefore i.v. iron significantly potentiates the haemopoietic response to r-HuEPO in normal subjects.

Adult↗

Optimal timing of repeated rh-erythropoietin administration improves its effectiveness in stimulating erythropoiesis in healthy volunteers.

We studied the effect of recombinant human erythropoietin (rhEPO) on erythropoiesis when given at different time intervals to healthy adults. 15 volunteers were randomly selected to receive rhEPO (2 x 300 U/kg) and parenteral iron (2 x 200mg) either within a 24 h or 72 h interval. Controls received parenteral iron only. Maximum EPO levels were found 24 h after the first intravenous injection (day 1) with a mean value of 364 and 390 U/l for the rhEPO-treated groups. When second rhEPO administration was after 72 h (group III), volunteers showed significantly higher absolute reticulocyte counts and a higher percentage of young RNA-rich reticulocytes (HFR ratio) over several days compared to those who received rhEPO within a 24 h interval (group II). Both rhEPO-treated groups showed an increase in the mean reticulocyte cell volume. Reticulocyte haemoglobin concentration was inversely correlated with the increasing cell size with a nadir on day 8. Reticulocyte haemoglobin content showed a significant decrease in group II after day 5. Serum ferritin levels showed an inverse pattern to the rate of erythropoiesis. After an initial rise, the serum ferritin decrease was most pronounced in group III. Contrary to previous reports with oral iron supplementation, functional iron deficiency was not seen during rhEPO stimulation, due to parenteral iron administration. Our data suggest that the time has interval between repeated administrations of rhEPO has an important influence on its pharmacodynamics. rhEPO given within an interval of 72 h was more effective in stimulating erythropoiesis than administration within 24 h interval for the same total dose.

Adult↗

Umbilical vein oxygen tension independent from gestational age at birth.

Umbilical venous oxygen tension (UVPO2) and gestational age are negatively correlated antepartum. To see if the negative correlation between UVPO2 and gestational age would still be present postpartum, a retrospective study of all 7522 births at the University of Zurich Hospital from 1989 through 1992 was performed. The 6612 infants with UVPO2 values were divided into low and higher risk groups. Singletons between the 10th and 90th weight percentiles, born vaginally with cephalic presentation after spontaneous onset of labor from healthy mothers were considered low risk. All other births were considered higher risk. No correlations between UVPO2 and gestational age were found in any group studied (low risk, higher risk or total population). The higher risk group had a lower mean UVPO2 than the low risk group (p < .0001). Since there is a negative correlation before birth and none after birth, this indicates that some preterm infants may be subject to greater drops in UVPO2 during delivery than term infants. The magnitude of the drop increases with additional complications and immaturity. However, not all preterms have normal UVPO2 values for gestational age antepartum. Some preterms already have a low UVPO2 in utero and experience a drop in UVPO2 during delivery as well.

Blood Gas Analysis↗

Recombinant human erythropoietin and parenteral iron in the treatment of pregnancy anemia: a pilot study.

Our aim was to correct severe iron deficiency anemia during pregnancy by using a combination therapy of recombinant human erythropoietin and parenteral iron. Eleven anemic pregnant women were treated once weekly until a hemoglobin value of 11.0 g/dl was reached. Red blood cell production was monitored by reticulocyte flow cytometry and hemoglobin increase. Iron status was assessed by serum ferritin values and transferrin saturation values. 8/11 patients showed an immediate response, noted by a continuous increase of reticulocytes, high fluorescent reticulocyte ratio and hemoglobin levels. Three patients who had lower serum ferritin values, low transferrin saturation and a lower reticulocyte count before treatment showed little response. The combination of rhEPO and parenteral iron is effective in stimulating erythropoiesis and in treating certain pregnancy anemias. This therapy could be an alternative for patients refusing blood transfusions or who are resistant to iron alone. Poor response to the treatment can be due to insufficient iron supplementation during therapy with rhEPO or due to factors that inhibit erythropoiesis during pregnancy, such as undetected infections.

Anemia↗

Validation of the Quick Cognitive Screening Test.

Reports in the literature suggest that 70% to 80% of cognitive deficits with probable organic basis are undetected in patients at risk, especially if symptoms are minimal. Studies have shown that clinically convenient beside screening tests show low sensitivity with a high rate of false-negative results. The purpose of this study was to validate a sensitive mid-range cognitive screening test to detect cognitive deficits, including those not usually identified by bedside mental status examinations. The Quick Cognitive Screening Test (QCST) was initially developed and subsequently adapted from original unpublished work by the late John McFie. The test was designed to detect global cognitive dysfunction and specific areas of cognitive dysfunction. Areas assessed included orientation, attention and concentration, memory, language, construction, perception, spatial ability, and abstract reasoning. Scoring is multidimensional, each subtest having a score, plus summary and global scores. Thirty-eight neurological patients with a cerebrovascular accident, traumatic brain injury, and other miscellaneous diagnoses, were recruited from a tertiary care center for physical rehabilitation. Fifteen residents from a psychiatric rehabilitation center were also recruited. Thirty-two healthy volunteers from the community served as age-matched controls. The Wechsler Adult Intelligence Scale-Revised (WAIS-R) was used to establish reliability and validity of the QCST. The National Adult Reading Test (NART) was used to estimate premorbid intellectual functioning. Results showed that the QCST identified cognitive impairment in all of the neurological and psychiatric patients assessed. Oneway analyses of variance of five summary scores showed significant differences between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

rh-erythropoietin stimulates immature reticulocyte release in man.

The pharmacodynamics of single intravenous dosing with recombinant human erthropoietin (rhEPO) was investigated in eight healthy volunteers (150 U/kg, n = 2; 300 U/kg, n = 6) with respect to reticulocyte subdivisions (by fluorescence flow cytometry) and serum ferritin over 6.5 d. The present study shows that bolus rhEPO injection produces an immediate release of high and middle fluorescence (immature) reticulocytes with a high RNA content from the marrow into the circulation, whereas the low fluorescence (more mature) reticulocytes were at first not affected. Serum ferritin decreased markedly within 24 h, reaching a nadir 50% of baseline after 120 h (5 d), with no increase in haemoglobin. Our data suggests that rhEPO triggers premature expulsion of immature reticulocytes from the bone marrow into the circulation independent of its effect in stimulating erythropoiesis and that rhEPO has an effect on serum ferritin concentration which in this dynamic situation is dependent not only on the iron stores.

Bone Marrow↗

Cloning and tissue-specific expression of the cDNA for the mouse Clara cell 10 kD protein: comparison of endogenous expression to rabbit uteroglobin promoter-driven transgene expression.

Uteroglobin (UG) is a hormonally regulated secretory protein produced in the lung and urogenital system of rabbits. It is homologous to rat and human Clara cell 10 kD protein (CC10); however, there are significant differences in the tissue-specific expression between these species. Mouse CC10 (mCC10) protein has been less well characterized. In this study, we cloned and sequenced the cDNA encoding the mCC10 protein. The mouse cDNA showed 90, 52, and 51% amino acid homology to rat and human CC10 and rabbit UG cDNA, respectively. The cellular and tissue-specific expression of mCC10 was examined in adult and developing mice. Endogenous mCC10 expression was compared with transgenic mice expressing a fusion gene of the rabbit 3.3 kb UG promoter linked to human growth hormone (hGH) as an easily detectable marker. Northern blot analysis detected mCC10 mRNA only in the lung. hGH mRNA was detected in the lung in levels similar to the endogenous mCC10 transcripts. However, it was also present in trace quantities in the uterus and ovary of normal adult female mice and in the epididymus of adult male mice. hGH and mCC10 proteins were identified in the trachea and lung, where they were localized to Clara cells. Ultrastructurally, hGH was present in secretory granules in the Clara cell cytoplasm and appeared to be secreted into the airways. hGH was initially detectable in 16 day gestation developing mice; however, CC10 was not detectable until the eighteenth day of gestation. We have created an attractive model for comparing the cis-acting DNA elements governing the interspecies variation in tissue-specific expression of CC10.

Amino Acid Sequence↗

Clinical and psychological correlates of somatic symptoms in patients on dialysis.

Somatic symptoms are common in patients on dialysis. Their causes are largely unknown and their therapy is unsatisfactory. To examine the relationship of psychological and clinical factors to these symptoms, 191 interviews were done in patients on hemo- and peritoneal dialysis. The severity of 8 somatic symptoms (tiredness, sleep disturbance, cramps, pruritus, headache, nausea, dyspnea, joint pain) of importance in dialysis patients was measured using previously validated scales. Indices of affect and quality of life were obtained, as was demographic, clinical and laboratory information. The severity of each symptom was significantly related to the indices of affect and quality of life. Using multiple logistic regression, poor affect score was the strongest correlate of each of the following somatic symptoms, tiredness, pruritus, sleep disturbance and cramps. It was ahead of any clinical or demographic variable and was also significantly correlated with the severity of the other symptoms. Indices of hyperparathyroidism were significantly associated with headache, joint pain, dyspnea and nausea. We conclude that the strongest correlate of common somatic symptoms in dialysis patients is affect disturbance, and that therapy aimed at improving the affect may improve the symptoms.

Affect↗

Intermittent hemodialysis therapy in the cancer patient.

The occurrence of renal failure in the cancer patient presents a series of medical, technical, philosophical, and logistic problems that are rarely found in other patient population groups. In a review of 70 cancer patients requiring intermittent hemodialysis therapy at Roswell Park Memorial Institute over the last 6 years for acute renal failure, 46 (65.7%) of the patients were salvaged from renal failure to allow the use of further therapeutic modalities for their neoplastic disease. Patient survival after successful intermittent hemodialysis therapy was comparable to that expected in the nonazotemic cancer patients submitted to similar anticancer therapy. Hemodialysis should, therefore, be considered and offered in selected cancer patients in acute renal failure.

Acute Kidney Injury↗