Search PubMed⌕ Search

Biomedical subjects

C A Johnson

Publications and source records attributed to C A Johnson.

At least 163 records · Page 9Linked to original sources

Analogues of 10-deazaaminopterin and 5-alkyl-5,10-dideazaaminopterin with the 4-substituted 1-naphthoyl group in the place of 4-substituted benzoyl.

10-Deaza modifications of classical antifolate analogues bearing the 1,4-disubstituted naphthalene ring in place of the 1,4-disubstituted benzene ring were prepared and tested for antitumor activity. Naphthalene analogues (9a-c, respectively) of 10-deazaaminopterin, 5-methyl-5, 10-dideazaaminopterin, and 5-ethyl-5,10-dideazaaminopterin were prepared by a route consisting of C-alkylations of the anion derived from 4-carboxyl-1-naphthaleneacetic acid dimethyl ester (2) by 6-(bromomethyl)-2,4-diaminopteridine (1a) and 6-(bromomethyl)-2,4-diamino-5-methyl- and -5-deazapteridines (1b and 1c, respectively) followed by ester hydrolysis and subsequent decarboxylation to give naphthalene analogues (7a-c, respectively) of 4-amino-4-deoxy-10-deazapteroic acid and 4-amino-4-deoxy-5- methyl- and -5-ethyl-5,10-dideazapteroic acids. Peptide coupling of 7a-c with L-glutamic acid dialkyl ester followed by mild ester hydrolysis gave target compounds 9a-c. The key advantage of this route is circumvention of a hydrogenation step requiring selectivity as in earlier approaches involving 9,10-olefinic precursors. Steric limitations thwarted plans to prepare the naphthalene analogue of 10-ethyl-10-deazaaminopterin; attempted alkylations of 2-(4-carboxy-1-naphthyl)butyric acid dimethyl ester with 1a failed as did attempted further alkylation (by EtBr) of the product derived from 1a and 2. Growth inhibition tests against three tumor cell lines (L1210, S180, and HL60) showed 9a to be 4-6-fold more inhibitory than methotrexate but not as inhibitory as 10-ethyl-10-deazaaminopterin; 9b and 9c were no more inhibitory than MTX. In tests against the EO771 mammary adenocarcinoma in mice, 9a was less active than MTX.

Adenocarcinoma↗

Psychometric properties of the Weekly Stress Inventory (WSI): extension to a patient sample with coronary heart disease.

The psychometric characteristics of the Weekly Stress Inventory (WSI) were examined in a sample of medical patients (N = 84) diagnosed with coronary heart disease. In addition to the WSI, patients completed measures assessing recent depressive symptoms, physical symptoms, Type A behavior, and trait anxiety. Patients also monitored stress for 3 weeks (n = 46), completing the Daily Stress Inventory (a measure of minor stress) daily and the WSI at concurrent 1-week intervals. Results indicated that the WSI is an internally consistent and moderately stable measure. Validity of the WSI was supported by (a) strong correlations with a concurrently administered measure of minor stress (concurrent validity); (b) significant positive correlations with measures assessing recent depressive symptoms, physical symptoms, and Type A behavior; and (c) a lack of relationship with a measure of trait anxiety (discriminant validity).

Adult↗

The neutron therapy clinical programme at the National Accelerator Centre (NAC).

A total of 721 patients were treated in the neutron therapy programme at NAC from February 1989-March 1995 with a p(66)/Be isocentric unit. The preliminary results showed: 3-year local control and survival probabilities of 57 and 79% respectively for advanced salivary gland tumours; increased local control for twice-daily neutron therapy for advanced head and neck cancer compared with photon therapy; local control rates of 68 and 83% for locally advanced breast cancer treated with 17 and 19 Gy respectively; complete response rates of 67% for macroscopic residual soft tissue sarcomas and those with irresectable disease of less than 10 cm; complete response rate of 56% for macroscopic residual uterine sarcoma with a median follow up of 38 months; 2-year local control rate and survival of 44 and 38% respectively for advanced squamous carcinoma of the maxillary antrum; complete response rate of 38% for advanced osteosarcomas and chondrosarcomas.

Breast Neoplasms↗

A pilot study of intravenous ondansetron for hyperemesis gravidarum.

OBJECTIVE: We attempted to determine whether the antiemetic ondansetron would be more effective than promethazine in treating hyperemesis gravidarum. STUDY DESIGN: Patients with hyperemesis gravidarum who required hospital admission were randomized to receive either intravenous ondansetron (n = 15) or intravenous promethazine (n = 15) in a double-blind manner. Severity of disease was determined by electrolyte status, weight loss, ketonuria, and prior use of outpatient antiemetics. Outcome variables included degree of nausea, weight gain during treatment, days of hospitalization, and number of medication doses. RESULTS: In this preliminary investigation ondansetron offered no advantage when compared with promethazine in the relief of nausea, weight gain, days of hospitalization (4.5 +/- 2.3 vs 4.5 +/- 1.5), and total doses of medication per hospitalization (2.1 +/- 1.2 vs 1.9 +/- 1.3). CONCLUSION: This preliminary trial of ondansetron demonstrated no benefit over promethazine in patients hospitalized for hyperemesis gravidarum.

Adult↗

Premature luteinization during controlled ovarian hyperstimulation for in vitro fertilization-embryo transfer has no impact on pregnancy outcome.

OBJECTIVE: To determine if elevated serum P concentration on the day of hCG administration or P area under the curve (AUC) impacts on pregnancy rates (PRs) in IVF-ET cycles. DESIGN: Retrospective study. PATIENT(S): One hundred thirty-three couples underwent IVF-ET using luteal GnRH-agonist suppression followed by hyperstimulation with gonadotropins. Patient cycles were controlled for female age, ovarian reserve, male factor with intracytoplasmic sperm injection (ICSI), endometrial thickness and pattern, number of embryos, and number of high-quality embryos transferred, and cell stage at transfer. Pregnancy was defined as an ongoing pregnancy > 20 weeks. RESULT(S): Patients and cycle parameters did not differ significantly based on the control parameters. Similar numbers of severe male factors treated by ICSI were in each group with similar PRs. Pregnancy rates and implantation rates did not differ based on P levels < or = 0.9, < or = 1.1, and < or = 1.4 ng/mL (conversion factor to SI unit, 3.18). Serum P concentrations per total eggs retrieved or per mature egg retrieved did not influence pregnancy outcome. Efficiency curves for serum P levels and P AUC did not demonstrate any differences in PR. At very high serum P (P > 2.0 ng/mL) samples size limits the ability of these data to rule out a negative effect. CONCLUSION(S): Serum P levels (and P AUC) commonly encountered during cycles of IVF-ET have no impact on pregnancy outcome.

Adult↗

Analysis of the priming activity of lipids generated during routine storage of platelet concentrates.

BACKGROUND: Compounds generated during the routine storage of platelet concentrates may have deleterious effects on the transfusion recipient. STUDY DESIGN AND METHODS: Daily plasma samples from platelet concentrates, both apheresis platelets and those separated from whole blood, were obtained serially during routine storage. These plasma samples were assayed for their ability to prime the NADPH oxidase in isolated human neutrophils. Quantitative and qualitative analysis of the priming agents was completed by lipid extraction, high-pressure liquid chromatography separation, and gas chromatography/mass spectroscopy. RESULTS: Compounds were generated in both apheresis and whole-blood platelets that significantly primed the NADPH oxidase after 24 and 48 hours of storage, respectively. The priming activity was maximal by component outdate: 2.6-fold that of the buffer-treated control neutrophils (apheresis) and 3.9-fold that of the buffer-treated control neutrophils (whole blood). These agents were generated by cellular constituents, as stored plasma did not demonstrate such priming activity. Inhibition of this priming activity by WEB 2170, a specific platelet-activating factor receptor antagonist, suggested that the observed priming involved the platelet-activating factor receptor. A portion of the priming activity from platelet concentrates was organically extractable: 69 percent of that from apheresis platelets and 46 percent of that from whole-blood platelets. Further purification of the lipid's priming activity by normal-phase high-pressure liquid chromatography demonstrated a single peak of priming activity at the retention time of lysophosphatidylcholines. Because 46 percent of the priming activity from whole-blood platelets was chloroform insoluble and because it has been reported that interleukin 8 is generated during routine storage of whole-blood platelets, the effects of interleukin 8 on the NADPH oxidase were examined. Recombinant monocyte interleukin 8 rapidly primed the oxidase but was not inhibited by WEB 2170. CONCLUSION: Lipids were generated during the routine storage of platelet concentrates that prime the NADPH oxidase, and they may play a role in the severe complications of transfusion therapy. Other non-lipid compounds, such as interleukin 8, that are generated in whole-blood platelets may also contribute to the observed priming activity of plasma.

Adult↗

Diagnostic value of short-wavelength automated perimetry.

Short-wavelength automated perimetry (SWAP) uses a bright yellow background and a large blue stimulus to isolate and measure the sensitivity of short-wavelength-sensitive mechanisms throughout the central 30 degrees visual field. After more than 8 years of cross-sectional and longitudinal studies of patients with early glaucoma, ocular hypertensive patients, and age-matched control subjects, SWAP has been shown to be a sensitive indicator of early damage and progression of loss in glaucoma. It is now available as an optional visual test procedure for routine clinical use on the most widely distributed automated perimeter. Recent investigations have been directed toward refinement and standardization of the technique, as well as toward the influence of other clinical factors (ocular media opacities, macular pigment, statistical interpretation, and related issues) on SWAP. This paper provides a brief overview of current research on SWAP as a clinical diagnostic test procedure.

Glaucoma↗

Platelet-activating factor biosynthesis induced by various stimuli in human HaCaT keratinocytes.

Platelet-activating factor (PAF) is a potent inflammatory mediator that is thought to play a role in cutaneous inflammation. These studies used mass spectrometry to examine the molecular species of PAF precursor glycerophosphocholine lipids (GPC) as well as the biosynthesis of PAF and other sn-2 acetyl-GPC in a human keratinocyte-derived cell line (HaCaT keratinocytes). Approximately 28% of HaCaT keratinocyte GPC consisted of 1-alkyl species, and the relative amounts of the sn-1 alkyl constituents of the PAF precursor 1-alkyl-2-acyl-GPC were as follows: hexadecyl > octadecenyl > octadecyl. Ionophore (A23187)-stimulated HaCaT keratinocytes synthesized both PAF (1-hexadecyl, 1-octadecenyl, and 1-octadecyl species) and less potent 1-acyl analogs (1-palmitoyl, 1-oleoyl, and 1-stearoyl species). PAF production was rapid and maximal by 10 min. The major species of sn-2acetyl-GPC at 2.5 min were 1-hexadecyl-2-acetyl-GPC (2.2 ng/10(6) cells) and 1-palmitoyl-2-acetyl-GPC (2.4 ng/10(6) cells). HaCaT keratinocytes also synthesized PAF and 1-acyl PAF analogs when stimulated with the peptide growth factor endothelin-1 and the nonhydrolyzable PAF receptor agonist carbamyl-PAF. Both 1-hexadecyl-2- acetyl-GPC and 1-palmitoyl-2-acetyl-GPC stimulated intracellular calcium mobilization in HaCaT cells, indicating that these sn-2 acetyl-GPC act in autocrine fashion. These studies revealed that the human keratinocyte-derived cell line HaCaT can synthesize significant amounts of PAF and 1-acyl analogs in vitro from both nonspecific (A23187) and specific (endothelin-1, carbamyl-PAF) stimulation, suggesting a role for this inflammatory lipid mediator in keratinocyte pathophysiology.

Calcimycin↗

Clinical pharmacokinetics during continuous ambulatory peritoneal dialysis.

Peritoneal dialysis (PD) has gained recognition worldwide as an alternative to haemodialysis in the management of patients with end-stage renal disease. Because the peritoneal catheter provides direct access to the peritoneum, intraperitoneal drug administration has become widely used for the administration of certain drugs. The instillation and drainage of PD fluids contribute to the total body clearance of drugs given by other routes. For most drugs, peritoneal clearance is low. This paper provides an updated review of recently published pharmacokinetic studies involving the administration of selected drugs to patients receiving PD. Antibiotics continue to be extensively studied and administered in PD patients because of the frequent occurrence of infections. Epoetin (recombinant human erythropoietin) has become widely used and is the subject of ongoing pharmacokinetic investigation. Intraperitoneal insulin has become accepted for the treatment of patients with diabetes receiving PD; the pharmacokinetics of vitamin D analogues in PD patients continue to be explored.

Animals↗

Intraobserver, interobserver variation of sperm critical morphology: comparison of examiner and computer-assisted analysis.

OBJECTIVE: To examine intraobservational and interobservational variation in sperm critical morphology analysis between trained andrologists and a computer over the range of 0% to 15% normal forms. DESIGN: Retrospective. SETTING: Fertility center. PATIENTS: Twenty-four semen specimen slides were read five times in a randomized, blinded fashion by two andrologists and a computerized semen analyzer. Twenty-five samples were analyzed using a different stain and a centrifugation step. MAIN OUTCOME MEASURE: Sperm strict morphology. RESULTS: Mean average intraobserver deviation of normal forms was small (1.3% to 2.7%). Intraobserver deviation did not differ between andrologists, but both differed from the computer. Interobserver deviation for percent normal forms was similar for andrologists and computer. Mean average deviations were small over the variation was independent of the initial percent normal forms. The computer frequently evaluated significantly fewer cells than the andrologists. Updated software increased the number of cells read by the computer requiring more time than the andrologist. CONCLUSIONS: Trained andrologists and a computer determine sperm critical morphology similarly over the range of 0% to 15% normal forms. A single evaluation is highly predictive of multiple evaluations. Improvements in the speed of computer assessment are still necessary.

Diagnosis, Computer-Assisted↗

Short wavelength automated perimetry (SWAP) in ophthalmic practice.

BACKGROUND: Short Wavelength Automated Perimetry (SWAP) uses a two-color increment threshold procedure (blue-on-yellow) to assess the functional status of short-wavelength-sensitive (SWS) mechanisms. This functional test has been shown to detect visual field abnormalities in patients at high risk of developing glaucoma and in patients with optic neuritis when standard (white-on-white) visual fields are still within normal limits. Often times, damage uncovered by SWAP precedes standard field loss by three or more years. SWAP also reveals a greater spatial extent of visual field damage in glaucoma patients than standard perimetry and can herald progression of standard visual field damage into the areas already classified as abnormal by SWAP. METHODS/RESULTS: This paper describes the SWAP technique and briefly discusses the current theories that account for SWAP's ability to detect visual field damage at an earlier stage than standard perimetry. Several cases that demonstrate the usefulness of this technique are reported. CONCLUSIONS: SWAP testing appears to be the most sensitive functional test for early detection of glaucomatous damage currently available. Although SWAP testing has a few disadvantages, none of them significantly restrict the clinical application of SWAP for glaucoma evaluation.

Aged↗

Optimum parameters for short-wavelength automated perimetry.

PURPOSE: To determine the optimum parameters for short-wavelength automated perimetry (SWAP) and to recommend these for standardization of the procedure. METHODS: We used a variety of stimulus and background configurations to determine the optimum background spectral distribution and luminance, and the optimum target spectral distribution, maximum luminance, and duration. We measured threshold versus intensity curves to determine which combination provided (a) the greatest isolation of the short-wavelength sensitive mechanisms and (b) the largest dynamic range for perimetry. We also evaluated the effect of lens absorption and cataract on these two factors. RESULTS: A broad-band yellow background at 100 candela/m2 with a narrow-band 440-nm (27-nm half-bandwidth), 1.8 degrees diameter (Goldmann size V) stimulus presented for 200 ms was optimum at all retinal eccentricities. Specific recommendations for how to modify existing perimeters are given. CONCLUSION: Agreement regarding the optimum parameters for SWAP should lead to standardization of the test that will facilitate comparison of results from different centers. Normative data can be collected at several sites and incorporated into statistical analysis packages currently available with various perimeters. This will greatly improve the clinical utility of this test.

Aged↗

Human complement protein C2. Alternative splicing generates templates for secreted and intracellular C2 proteins.

Alternative splicing of the primary transcript for human complement protein C2 generates templates for translation of a secreted (C2 long) protein and an intracellular (C2 short) form in liver, bronchoalveolar macrophages, and fibroblasts. The approximate ratio of C2 long to C2 short mRNA is 2:1. The C2 short mRNA does not contain the 396-base pair encompassed by exons 2 and 3 of the full-length C2 long and thus lacks codons for the 5 carboxyl-terminal residues of the signal peptide. Synthesis of C2 in cells transfected with full-length RNA corresponding to each of the transcripts show that C2 long is secreted within a half-time of approximately 1 h and that C2 short is not secreted. Cell-free biosynthesis in the presence of microsomes demonstrate that this intracellular C2 protein (70 kDa) is apparently capable of traversing the membrane of the endoplasmic reticulum. Though the function of the intracellular C2 protein is unknown, it is abundant in all cell types that express the C2 gene.

Alternative Splicing↗

The effect of histone H1 and DNA methylation on transcription.

We have previously shown that DNA methylation acts as a focus for the formation of inactive chromatin in vivo. We have investigated the mechanism further by in vitro transcription of a template containing two tRNA genes and an extensive (G+C)-rich sequence characteristic of a CpG island. The extent of transcription from the unmethylated or fully methylated template was assayed in the presence of varied levels of histone H1. The transcriptional activity of both templates was inhibited by increasing amounts of histone H1, although inhibition with the methylated template occurs at a lower H1:DNA ratio. The H1c variant shows the greatest preferential inhibition of the methylated template. We demonstrated that histone H1 complexed to DNA is one of the factors that inhibits transcription by preventing the formation of initiation complexes, particularly on methylated template, rather than the formation of disordered H1.DNA aggregates.

Ammonium Sulfate↗

Short-wavelength automated perimetry in low-, medium-, and high-risk ocular hypertensive eyes. Initial baseline results.

OBJECTIVE: To examine the relationship between the prevalence of short-wavelength sensitivity losses in the central 30 degrees visual field and risk factors for development of glaucomatous visual field loss in ocular hypertension. DESIGN: A modified Humphrey Field Analyzer was used to perform standard automated perimetry and short-wavelength automated perimetry (SWAP), which is a technique that isolates the activity of short-wavelength-sensitive ("blue") mechanisms. In addition, an assessment of the risk of developing glaucomatous visual field loss was determined, based on a validated model that utilized intraocular pressure, a family history of glaucoma, age, and the vertical cup-to-disc ratio. PATIENTS: Both eyes of 232 ocular hypertensive patients were examined and compared with results from an age-matched control group of normal subjects. Both ocular hypertensive patients and normal subjects had to have normal visual fields on standard automated perimetry, good visual acuity, and no evidence of other ocular or neurologic disease or surgery. Intraocular pressure in the ocular hypertensive patients was 21 mm Hg or greater OU (without medication), and it was less than 20 mm Hg OU in normal control subjects. RESULTS: Less than 10% of the low-risk ocular hypertensive eyes had a SWAP deficit, as compared with 20% of the moderate-risk and 33% of the high-risk ocular hypertensive eyes. Intraocular pressure and a family history of glaucoma showed no meaningful relationship with the prevalence of SWAP deficits, but both age and the vertical cup-to-disc ratio demonstrated a strong association with the SWAP abnormalities. CONCLUSIONS: The SWAP results that were found in the ocular hypertensive eyes were associated with other risk factors that have been reported to be predictive of the development of glaucomatous visual field loss, especially the vertical cup-to-disc ratio and age. These findings support the notion that the SWAP deficits represent early glaucomatous damage and may be related to early changes that occur at the optic nerve head.

Adult↗

Short-wavelength automated perimetry in neuro-ophthalmologic disorders.

OBJECTIVE: To evaluate the efficacy of short-wavelength automated perimetry (SWAP) in the assessment of patients with neuro-ophthalmologic disorders, especially optic neuropathies. METHODS: A modified Humphrey field analyzer was used to perform standard automated perimetry and SWAP, a technique that isolates the activity of short-wavelength-sensitive ("blue") mechanisms. Forty patients (80 eyes) were evaluated by SWAP and standard automated perimetry. Thirteen patients (26 eyes) had recovered from optic neuritis and/or multiple sclerosis, 15 (30 eyes) were in various stages of treatment for pseudotumor cerebri, and 12 (24 eyes) had other miscellaneous neuro-ophthalmologic conditions. Six additional patients (12 eyes) with neuro-ophthalmologic conditions were tested twice on different days during a 2-week period, with the order of SWAP and standard perimetric testing being reversed on the second day. RESULTS: Of the 80 eyes tested, 38 (48%) had SWAP visual fields that were worse than standard automated perimetry results; 29 (36%) showed no difference between standard and SWAP visual fields; and 13 (16%) had standard automated perimetry results that were worse than SWAP visual fields. Of the 26 eyes in patients with optic neuritis and/or multiple sclerosis, 15 (58%) had SWAP results that were worse than standard visual fields. Ten (33%) of the 30 eyes with pseudotumor cerebri had SWAP results worse than standard automated perimetry results, and 13 (54%) of 24 eyes with miscellaneous neuro-ophthalmologic conditions had SWAP results worse than standard automated perimetry results. For the 12 eyes undergoing repeated testing, SWAP visual fields were worse when they were performed last, perhaps indicating that some fatigue effect was present. This was observed for standard visual fields as well, but to a smaller extent. CONCLUSIONS: Preliminary findings suggest that SWAP may be useful in detecting certain neuro-ophthalmologic deficits more readily than standard automated visual field testing, especially for optic neuritis and multiple sclerosis. Further evaluations will be necessary to define the effects of fatigue for SWAP visual fields in neuro-ophthalmologic disorders.

Adult↗