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Biomedical subjects

B Greenberg

Publications and source records attributed to B Greenberg.

At least 163 records · Page 9Linked to original sources

Generation of deletions in pneumococcal mal genes cloned in Bacillus subtilis.

The pneumococcal recombinant plasmid pLS70, which contains two strong promoters for transcription of the malM and malX genes, is unstable when transferred to Bacillus subtilis, and it gives rise to deleted derivatives. Analysis of proteins produced by the deleted plasmids and restriction mapping of 29 different deletions showed that stabilization in B. subtilis was accompanied by deletions affecting both promoters. Plasmids containing even a single strong promoter were at a selective disadvantage. Nucleotide sequences surrounding the deletions in 10 plasmids were determined. Six different deletions occurred between directly repeated sequences of 3-13 base pairs in length, presumably by a recombination mechanism involving short homologies. Four deletions occurred between sites not contained within repeated sequences. A weak but significant similarity of an 11-base sequence was found surrounding these deletions and the corresponding points of junction in the progenitor plasmids. It is suggested that this sequence may be the recognition site for a topoisomerase-like enzyme that can produce deletions.

Bacillus subtilis↗

The adverse consequences of heavy Trichuris infection.

Sixty-seven children with heavy Trichuris trichiura infection (Group A) were compared to 73 control children of similar socio-economic status but with light or no T. trichiura (Group B), for nutritional status, rates of concomitant bacterial and protozoal, and symptoms and clinical signs associated with heavy T. trichiura infection. Anoscopy was used to determine heavy T. trichiura infection. Measurements and physical examination were done on Group A on admission to and discharge from hospital; 46% were seen on follow-up visit two to eight months later. Children in Group B were seen only once. There were significant differences for nutritional status (p less than 0.01) and rates of bacterial and protozoal co-infection (p less than 0.01) and a significantly greater rate of invasive amoebiasis in Group A. After treatment, nutritional parameters of Group A children improved significantly, symptoms and clinical signs decreased and there was also a significant decrease in the rate of concomitant bacterial and protozoal infection. Subgroups of Group A children, with and without concomitant enteropathogens, revealed that infection with Entamoeba histolytica and bacterial enteropathogens had had no significant impact on clinical and nutritional status.

Amebiasis↗

Lymphocyte abnormalities in preleukemia--I. Decreased NK activity, anomalous immunoregulatory cell subsets and deficient EBV receptors.

The development of acute non-lymphocytic leukemia is preceded by a set of symptoms described as the preleukemia syndrome. Six patients who fulfilled the criteria for this preleukemia syndrome have been evaluated for abnormalities in the lymphocyte population. The NK cell activity was reduced, the immunoregulatory cell populations were numerically abnormal, and the B cell subpopulation was deficient in EBV receptors. Thus, in addition to the abnormalities in the myeloid populations, there are serious defects in the lymphoid systems of preleukemic patients.

Adult↗

Body image perception of children and adolescents with psychiatric disorders.

Interviews with 75 adolescents and children in a South Florida psychiatric hospital showed that patients expressed significantly less dissatisfaction with both height and weight than a group of 565 adolescents from the same geographical area. The dissatisfaction expressed by patients was more like that of a sub-group of the students with comparable ethnic characteristics. Patients reported that significant others concurred with their own judgements of body size. One half of patients who were judged by the researcher to be of normal weight wanted to be thinner. The recommendation is made that patients need help with body image perception and management because of the high percentage of dissatisfaction (85 per cent) even though hospitalization for psychiatric disorders does not appear to increase body-image problems.

Adolescent↗

Deleterious effects of hydralazine in patients with pulmonary hypertension.

Thirteen consecutive patients with primary and secondary pulmonary hypertension who had normal left ventricular function were treated with hydralazine in an effort to reduce pulmonary vascular resistance and clinical symptoms. Despite marked decreases in systemic vascular resistance (40 per cent; P less than 0.001), hydralazine produced only moderate decreases in pulmonary arteriolar resistance (21 per cent), without improving stroke volume or pulmonary-artery pressure. Instead, mean arterial pressure fell markedly (17.5 mm Hg, P less than 0.01) in association with a reflex increase in heart rate (11 beats per minute, P less than 0.01). Four patients became symptomatically hypotensive within 24 hours of the initiation of treatment; two of these four required pressors for circulatory support, and one died. Progressive renal insufficiency developed in one patient, and a symptomatic decrease in systemic arterial oxygen saturation occurred in another; both changes were reversed upon discontinuation of the drug. In conclusion, hydralazine fails to produce consistent hemodynamic and clinical benefits in patients with primary and secondary pulmonary hypertension, and it frequently causes serious adverse reactions.

Adult↗

Identification of base mismatches recognized by the heteroduplex-DNA-repair system of Streptococcus pneumoniae.

The susceptibility to repair of particular base mismatches by the hex system of Streptococcus pneumoniae was examined by comparison of the nucleotide sequence of the wild-type and eight mutant alleles of the malM gene. A detailed restriction map was constructed for pLS70, and the nucleotide sequence was determined for its 3475 bp chromosomal insert, which contains the entire malM gene (encoding amylomaltase), portions of malX and malP (encoding a membrane protein and a phosphorylase, respectively) and a control region. Transition mismatches were highly susceptible to repair; transversion mismatches, much less so. A mismatch caused by a single-nucleotide deletion was reparable, but mismatches with longer deletions were not. The hex system also reduced spontaneous reversion of mutations corresponding to transitions. It is suggested that recognition of donor or nascent DNA strands by the hex system depends on single-strand breaks in the target strand, and that the role of DNA methylation in mismatch repair of Escherichia coli can be accommodated to this model.

Amino Acid Sequence↗

Anatomical and immunological responses of rabbit gallbladders to bacterial infections.

To study the sequential morphological and immunological response of the rabbit gallbladder to bacterial infection and to compare the inflammatory responses with different pathogens, gallbladders were infected with Streptococcus faecalis and two strains of Escherichia coli, one of which produced enterotoxin. Gallbladder infection was produced either by intravenously injecting bacteria into rabbits with a small liver infarct or by injecting bacteria directly into the gallbladder of normal rabbits. The percentage of gallbladders infected intravenously with a nonenterotoxigenic E. coli strain was 86% at 1 week, 70% at 3 weeks, and 15% at 6 weeks. Epithelial necrosis and leukocyte infiltration were prominent 1 week after infection. At 3 and 6 weeks after infection, there was crypt distortion and increased mucus secretion in the epithelium as shown by periodic acid-Schiff staining. The lamina propria was infiltrated with mononuclear cells, many of which were plasma cells. Myofibroblasts (contractile fibroblasts) were also identified on transmission microscopy, In addition to these changes, toxigenic E. coli produced subepithelial capillary dilation in the villus core. Morphological changes (excluding toxin-associated changes) were related to the duration of infection rather than to the specific species of infecting bacteria. Infected gallbladders studied by immunofluorescence had a greater than 50-fold increase in plasma cells compared with control cells. In addition, the number increased with the duration of infection. Immunoglobulin A cells were the major cell type in gallbladders infected by intravesical injection, whereas immunoglobulin G cells predominated in gallbladders infected intravenously. The gallbladder appears to mount a local immune response to bacterial infection.

Animals↗

Transformation of restriction endonuclease phenotype in Streptococcus pneumoniae.

The genetic basis of the unique restriction endonuclease DpnI, that cleaves only at a methylated sequence, 5'-GmeATC-3', and of the complementary endonuclease DpnII, which cleaves at the same sequence when it is not methylated, was investigated. Different strains of Streptococcus pneumoniae isolated from patients contained either DpnI (two isolates) or DpnII (six isolates). The latter strains also contained DNA methylated at the 5'-GATC-3' sequence. A restrictable bacteriophage, HB-3, was used to characterize the various strains and to select for transformants. One laboratory strain contained neither DpnI nor Dpn II. It was probably derived from a DpnI-containing strain, and its DNA was not methylated at 5'-GATC-3'. Cells of this strain were transformed to the DpnI restriction phenotype by DNA from a DpnI-containing strain and to the DpnII restriction phenotype by DNA from a DpnII-containing strain. Neither cross-transformation, that is, transformation to one phenotype by DNA from a strain of the other phenotype, nor spontaneous conversion was observed. Extracts of transformants to the new restriction phenotype were shown to contain the corresponding endonuclease.

Bacteriophages↗

[Humeral fracture caused by arm wrestling].

Humeral shaft fractures may occur as a result of arm wrestling ("Indian wrestling," "iron arm"), a contest in which the antagonists sit face-to-face, grip hands with their elbows on a table, and try to force the opponent's arm back. A case of this type is reported.

Adult↗

Biological effects of a 765-kV transmission line: exposures and thresholds in honeybee colonies.

Honeybee colonies exposed under a 765-kV, 60-Hz transmission line at 7 kV/m show the following sequence of effects: 1) increased motor activity with transient increase in hive temperature; 2) abnormal propolization; 3) impaired hive weight gain; 4) queen loss and abnormal production of queen cells; 5) decreased sealed brood; and 6) poor winter survival. When colonies were exposed at 5 different E fields (7, 5.5, 4.1, 1.8, and 0.65-0.85 kV/m) at incremental distances from the line, different thresholds for biologic effects were obtained. Hive net weights showed significant dose-related lags at the following exposures: 7 kV/m, one week; 5.5 kV/m, 2 weeks; and 4.1 kV/m, 11 weeks. The two lowest exposure groups had normal weight after 25 weeks. Abnormal propolization of hive entrances did not occur below 4.1 kV/m. Queen loss occurred in 6 of 7 colonies at 7 kV/m and 1 of 7 at 5.5 kV/m, but not below. Foraging rates were significantly lower only at 7 and 5.5 kV/m. Hive weight impairment and abnormal propolization occur at lower E-field intensity than other effects and limit the "biological effects corridor" of the transmission line to approximately 23 m beyond a ground line projection of each outer phase wire. Intrahive E fields of 15-100 kV/m were measured with a displacement current sensor. Step-potential-induced currents up to 0.5 microA were measured in an electrically equivalent bee model placed on the honeycomb in a hive exposed at 7 kV/m. At 1.8 kV/m body currents were a few nanoamperes, or two orders of magnitude lower, and these colonies showed no effects. E-field versus electric shock mechanisms are discussed.

Animals↗

Preoperative criteria predictive of late survival following valve replacement for severe aortic regurgitation.

Forty-five patients underwent aortic valve replacement (AVR) for severe isolated aortic regurgitation from 1973 to 1979. There were two (4.4%) hospital deaths, both functional class IV. Six patients with mechanical prosthesis not receiving anticoagulants were excluded from further analysis. These data relate to 39 patients; the two operative deaths, 35 patients with mechanical prosthesis receiving anticoagulants, and two with bioprosthesis. There were three late cardiac deaths with 5-year survival 85%; average annual mortality rate of 3%. The 5-year survival with pre-AVR left ventricular (LV) ejection fraction greater than or equal to 0.45 was 87% vs 54% less than 0.45, (p less than 0.04); cardiac index greater than or equal to 2.5 L/min/m2 92% vs 66% less than 2.5 (p less than 0.04); mean VCF greater than or equal to 0.75 vs less than 0.75 circ/sec (p less than 0.09); end-diastolic pressure less than or equal to 20 vs greater than 20 mm Hg (p less than 0.08). Late survival was not significantly different between pre-AVR functional class I and II vs class III and IV; LV end-diastolic volume index greater than or equal to 210 vs less than 210 ml/m2; LV end-systolic volume index greater than or equal to 110 vs less than 110 ml/m2; and LV mass greater than or equal to 240 vs less than 240 gm/m2. With ejection fraction greater than or equal to 0.50 there was only one operative death (functional class IV) and no late cardiac deaths. Thus late survival following aortic valve replacement for severe isolated aortic regurgitation is better predicted preoperatively by the LV systolic pump function variables of ejection fraction and cardiac index than by LV diastolic parameters and clinical status.

Adolescent↗

Determining health insurance coverage of technology: problems and options.

By deciding which medical procedures are eligible for reimbursement, health insurance programs possess the potential to affect significantly technology use and health care spending. Traditionally, insurers have adopted a passive stance and made relatively few negative coverage determinations. However, resistance to rapidly rising costs has created a powerful inducement for third-party payors to become more prudent purchasers of health care services. Consequently, both Medicare and Blue Cross--Blue Shield are considering the implementation of changes that may ultimately result in more restrictive coverage decisions. This article examines the coverage process of Medicare and Blue Cross--Blue Shield and the policy changes that both programs are considering. In addition, it discusses the strengths and drawbacks of four coverage policy options: restricting insurance coverage of unproven procedures, introducing cost-effectiveness criteria, educating physicians and educating consumers.

Blue Cross Blue Shield Insurance Plans↗

Twelve-year history of gastrointestinal bleeding in a patient with calcific aortic stenosis and hemorrhagic telangiectasia.

A case has been presented of a patient with a 12-year history of unexplained gastrointestinal bleeding who developed severe aortic stenosis. Small telangiectasia were finally noted on his lip and gastroscopy revealed gastric and duodenal telangiectasia though he had no history of epistaxis and an unremarkable family history. Patients with aortic stenosis and unexplained gastrointestinal bleeding should be carefully evaluated for hemorrhagic telangiectasia in spite of a negative family history and no visible evidence of telangiectasia.

Aged↗

The influence of left ventricular filling pressure on atrial contribution to cardiac output.

The influence of left ventricular filling pressure on the atrial contribution filling pressure and atrial contribution was seen in studies done at baseline (PCW (r=-.53, p less than .025), as well as in studies done after PCW was modified by volume expansion and/or nitrates (r=-.53, p less than .005). At baseline, atrial contribution averaged 9.3 +/- 1.3 c.c./M.2 in patients with PCW less than 20 mm. Hg, while it was only 2.4 +/- 1.2 c.c./M.2 in patients with PCW greater than or equal to 20 mm. Hg (p less than .005). Atrial contribution was significantly greater in patients who had no history of heart failure when they were volume loaded to a PCW above 20 mm. Hg than in patients with impaired ventricular function whose baseline PCW was above 20 mm. Hg. Thus, atrial contribution tends to be less effective in augmenting cardiac output when filling pressure is already elevated, particularly in patients with impaired left ventricular function.

Adolescent↗

Serotoninergic activation and inhibition: effects on carbohydrate tolerance and plasma insulin and glucagon.

Glucose and arginine infusion tests were performed on 12 healthy volunteers (8 males, 4 females) before and after serotoninergic activation [oral administration of L-5-hydroxytryptophan (5-HTP-) for 6 days] and serotoninergic inhibition (oral treatment with D,L-p-chloropenylalanine for 6 days). 5-HTP treatment markedly increased urinary 5-hydroxyindoleacetic acid excretion, increased the mild hyperglycemic effect of arginine infusion, and lowered the glucose disposal rate constant. The adverse effect of serotoninergic activation on glucose tolerance is not sufficiently explained by the observed changes in insulin and glucagon secretion during the fasting state and after intravenous glucose and arginine infusions. Serotoninergic inhibition did not affect the carbohydrate tolerance of normal individuals. The results of this work supports the idea that excessive indoleamine production is probably the main cause for carbohydrate intolerance in carcinoid tumors.

5-Hydroxytryptophan↗

Relationship of regional myocardial perfusion to segmental wall motion: a physiologic basis for understanding the presence and reversibility of asynergy.

Experimental work has shown that even small reductions in myocardial perfusion impair contractile performance. We, therefore, studied the relationship between regional perfusion, assessed by thallium-201 scintigraphy and segmental wall motion, quantitated on biplane contrast ventriculograms, in patients with coronary artery disease. We evaluated 270 segments in 54 patients, including 27 without evidence of myocardial infarction. Most normally perfused regions (125 of 140) contracted normally, whereas those with scintigraphic defects at rest were usually asynergic (42 of 46). Surprisingly, 57% (48 of 84) of regions with exercise-induced perfusion defects were also asynergic, including 48% (25 of 52) of those in patients without myocardial infarction. In 22 patients who had intervention ventriculograms, improvement of perfusion abnormalities at rest correlated closely with reversibility of asynergy. Although there was an association between the location and severity of coronary artery stenosis and segmental wall motion, myocardial perfusion during exercise was a significantly better predictor of asynergy. These findings suggest that resting asynergy may occur even in patients without previous infarction, predominantly in regions with jeopardized perfusion. Asynergy in regions with exercise-induced perfusion abnormalities may, therefore, be an indicator of resting ischemia and may be reversible by coronary artery revascularization.

Adult↗

Production of mesenchymal tumors in nude mice by Ph1 negative fibroblasts obtained from a Ph 1 positive CML patient: a preliminary report.

An experimental model system is presented for the investigation in humans of the role of hematopoietic stromal elements in the regulation of hematopoiesis as well as in the pathogenesis of myelofibrosis in myeloproliferative disorders. The model is based on the simultaneous application of three experimental techniques: (1) growth of bone-marrow derived fibroblastic colonies in vitro, (2) cytogenetic demonstration of marker chromosomes associated with hematopoietic malignancies, and (3) the transplantation of isolated stromal elements into athymic (nude) mice. Using this model, we describe the induction of mesenchymal tumors in nude mice by Ph1 negative fibroblasts obtained from the bone marrow of a patient with a Ph1 positive chronic myelogenous leukemia. Mesenchymal tumors also were induced in nude mice with bone marrow-derived fibroblasts from a patient with aplastic anemia, who was successfully treated with bone marrow transplantation, and from a normal human volunteer. Morphologic, cytogenetic and electron microscopic studies of bone marrow mesenchymal elements in culture and of tumors induced in nude mice from the CML patient indicate the cells composing the tumor are of human origin and are negative for the Ph1 chromosome. The results provide the first in vivo morphological and cytogenetic support using human materials, of the hypothesized relationship of progenitors of in vitro fibroblastic colonies to marrow stromal elements.

Animals↗