Prematurity and risk of childhood cancer.
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Child↗
Biomedical subjects
C C Johnson
Publications and source records attributed to C C Johnson.
Lower respiratory tract infection.
The most important lower respiratory infection is pneumonia, the fourth leading cause of death. Most cases of bronchitis are of viral etiology and are not major problems. Empyema can present an important problem in management. Although the diagnosis of pneumonia is usually relatively straightforward, the specific etiologic diagnosis remains a major problem. Availability of empyema fluid or a positive blood culture result can be helpful in making the etiologic diagnosis, but these are unavailable in most patients. Screening of sputum Gram stains under 100 X magnification is very important; there should be fewer than 10 squamous epithelial cells, more than 25 polymorphonuclear leukocytes, or both per field of this size. The major causes of pneumonia are Streptococcus pneumoniae, Mycoplasma pneumoniae, anaerobic bacteria, Staphylococcus aureus, various gram-negative aerobic or facultative bacilli and Legionella. However, many other organisms are capable of causing pneumonia, even in the immunocompetent host. Further adding to the problem is the fact that a number of different organisms are manifesting increasing resistance to antimicrobial agents. Our study with ticarcillin plus clavulanic acid included seven patients with pneumonia, one with empyema, and one with purulent tracheobronchitis. Organisms recovered from pleural fluid, transtracheal aspiration and sputum or tracheostomy aspirate included multiple anaerobes, pneumococci, S. aureus, Hemophilus influenzae, Klebsiella pneumoniae, K. ozaenae, Pseudomonas aeruginosa, Acinetobacter, Enterobacter cloacae, Proteus mirabilis, beta-hemolytic streptococci, Neisseria meningitidis and Branhamella catarrhalis. Several of the organisms were ticarcillin resistant. Eight of the patients had cures and the other patient showed improvement. Only minor side-effects were encountered--Coombs' positivity (without hemolysis), eosinophilia, drug fever and one case of questionable neutropenia.
Anti-Bacterial Agents↗
Safety and efficacy of ticarcillin plus clavulanic acid in the treatment of infections of soft tissue, bone, and joint.
The efficacy and safety of ticarcillin plus clavulanic acid in the treatment of patients with infections of soft tissue, bone, and joint were evaluated in this open study. Clinical diagnoses included osteomyelitis, soft tissue abscess or ulcer, cellulitis, bite wound, traumatic or postoperative cellulitis, necrotizing fasciitis, septic arthritis, septic bursitis, and septic thrombophlebitis. Trauma or underlying disease such as diabetes mellitus or vascular insufficiency was common (more than 50 percent) in the patient population. Clinical efficacy was evaluable in 66 patients who received 3 g of ticarcillin and 0.1 g of clavulanic acid every four or six hours for a mean of 23.4 days. A satisfactory clinical response was observed in 92 percent of the patients. Major pathogens isolated were Enterobacteriaceae, anaerobic cocci, Staphylococcus aureus, and beta-hemolytic Streptococcus. Of the 143 isolates recovered from 55 bacteriologically evaluable cases, 87 percent were eradicated by therapy. Overall, a satisfactory bacteriologic outcome occurred in 93 percent of the patients, and the pathogen(s) persisted in 7 percent. More than 98 percent of the isolates were susceptible to ticarcillin plus clavulanic acid in vitro. Emergence of resistance during therapy occurred with three strains of Pseudomonas aeruginosa. Adverse drug-related reactions required discontinuation of treatment in two patients, although other minor abnormal laboratory findings were common. These results indicate that ticarcillin plus clavulanic acid offers safe and effective therapy for infections of soft tissue, bone, and joint.
Adult↗
Hyaluronic acid synthesis in articular cartilage: an inhibition by hydrogen peroxide.
The synthesis of hyaluronic acid by bovine articular cartilage in culture was inhibited after treatment with xanthine oxidase and hypoxanthine. Through the use of catalase, superoxide dismutase and the specific iron chelator diethylenetriaminepentaacetic acid, the active species responsible for inhibition was shown to be hydrogen peroxide. Hydrogen peroxide generated by glucose oxidase was also inhibitory. Some recovery of hyaluronic synthesis was evident after a further period of culturing. Proteoglycan synthesis was inhibited in parallel with hyaluronic acid synthesis.
Animals↗
Inhibition of proteoglycan synthesis by hydrogen peroxide in cultured bovine articular cartilage.
Oxygen-derived reactive species, generated enzymatically by the action of xanthine oxidase upon hypoxanthine, significantly inhibit proteoglycan synthesis by cultured bovine articular cartilage (Bates, E.J., Lowther, D.A. and Handley, C.J. (1984) Ann. Rheum. Dis. 43, 462-469). Here we extend these investigations and show, through the use of catalase and the specific iron chelator diethylenetriaminepentaacetic acid, that the active species involved is H2O2 and not the hydroxyl radical. Incubations of cartilage with H2O2 at concentrations of 1 X 10(-4) M and above are also inhibitory to proteoglycan synthesis. Subsequent recovery of the tissue is dependent upon the initial dose of xanthine oxidase or H2O2. Xanthine oxidase at 84 mU per incubation results in a prolonged inhibition of proteoglycan synthesis which is still apparent after 14 days in culture. Lower concentrations of xanthine oxidase (21-66 mU) are inhibitory to proteoglycan synthesis, but the tissue is able to synthesise proteoglycans at near normal rates after 3 days in culture. The inhibition of proteoglycan synthesis by 1 X 10(-4) M H2O2 is completely reversed after 5 days in culture, whereas 1 X 10(-3) M H2O2 results in a more prolonged inhibition. The synthesis of the proteoglycan core protein is inhibited, but the ability of the newly formed proteoglycans to aggregate with hyaluronic acid is unimpaired.
Animals↗
Antipyretic use among children during the 1983 influenza season.
We conducted a telephone survey in Houston in March 1983 to assess the level of aspirin use among children during the influenza season. We completed interviews of 200 households with 346 children aged 12 years or younger. Fifty-two percent of the 346 children experienced at least one acute illness in the preceding three months. Fever was measured with a thermometer in 114 ill children, 103 of whom had at least one measured temperature of 37.7 degrees C or greater. Fourteen percent of these 103 children received aspirin only, 61% received acetaminophen only, and 20% received both. Among a subgroup of 44 children with temperatures of at least 39.4 degrees C, 11% received aspirin only, 59% received acetaminophen only, and 27% received both. Only 60% of the 200 parents interviewed had heard of Reye's syndrome. Forty-two percent knew of the association between Reye's syndrome and aspirin use. The survey suggests that acetaminophen has replaced aspirin as the major antipyretic used by children in Houston. If the decline in aspirin use in Houston is representative of the population in the United States, and if aspirin is causally related to Reye's syndrome, the incidence of Reye's syndrome may decline.
Acetaminophen↗
Neuroblastoma and paternal occupation. A case-control analysis.
The peak incidence of neuroblastoma during early infancy suggests that prezygotic or prenatal exposures to carcinogens could be implicated. Several recent epidemiologic studies have suggested an association between parental exposure to petrochemicals and ionizing radiation and the development of cancer in the offspring. This paper is a population-based case-control analysis of the birth certificate data of 157 children who died in Texas from neuroblastoma in 1964-1978 and 314 controls randomly selected from all live births in Texas. Children of fathers employed in occupations with electromagnetic field exposure were at significantly increased risk (odds ratio = 2.13). The odds ratio was 11.75 for children of fathers who reported themselves to be electronics workers (6 cases, 1 control).
Adolescent↗
Bacteroides gracilis, an important anaerobic bacterial pathogen.
Clinical isolates of agar-pitting, formate-fumarate-requiring, anaerobic gram-negative bacilli were recharacterized in consideration of the species descriptions of Bacteroides ureolyticus and the newly described B. gracilis, Campylobacter concisus, and Wolinella sp. During an 11-year period, 7.5% (101 of 1,341) of all specimens yielding anaerobes were found to contain an organism in this group. Of the 71 isolates that were available for study, 43 were B. ureolyticus, 23 were B. gracilis, and 5 were in the Wolinella-C. concisus group. The role in infection and patterns of antimicrobial susceptibility for B. ureolyticus and B. gracilis were studied. Review of the clinical data indicated that 83% of B. gracilis strains were recovered from patients with serious visceral or head and neck infection, whereas 73% of B. ureolyticus isolates were recovered from superficial soft-tissue or bone infections. The strains of B. ureolyticus were uniformly susceptible to the tested antimicrobial agents. B. gracilis, however, showed some striking resistance, with penicillin active against only 67% and the cephalosporins active against 67 to 84% of the isolates tested. The association of B. gracilis with serious deep-tissue infection, coupled with the relatively high frequency of antibiotic resistance, indicates that it is an important, previously unrecognized, pathogen.
Bacillus↗
Neuroblastoma: case-control analysis of birth characteristics.
The peak incidence of neuroblastoma during early infancy indicates that prenatal factors may play a role in the pathogenesis of this disease. A population-based case-control study was conducted comparing birth certificate data of 157 children who later died from neuroblastoma in Texas with 314 controls randomly selected from all Texas live births. Analysis of birth certificate data revealed a protective relative risk estimate for preterm births (less than 37-wk gestation), with an overall odds ratio of 0.29 (95% confidence limits of 0.10-0.86). This effect was independent of birth weight and ethnic group. A statistically significant odds ratio of 3.22 was detected for term babies whose birth weight was low. The findings suggest that the fetus is susceptible to an in utero oncogenic initiator or promoter during the last 4 weeks of gestation.
Adolescent↗
A five-year analysis of antimicrobial susceptibility testing profiles for beta-lactam antimicrobials, with inter-hospital and susceptibility method comparisons within a medical school affiliated hospital system.
A comparative study of antimicrobial susceptibility patterns was performed for a five-year period in four hospitals affiliated with the University of Utah School of Medicine due to concern that susceptibility testing method and results differences between hospital units might complicate training and comprise initial antimicrobial therapy. Few significant pattern changes were detected within or between the individual hospitals during the five-year period, and variances between hospitals were in general no greater than variances demonstrated within individual service units within the University Hospital.
Anti-Bacterial Agents↗
"Super-maximum levator resection for severe unilateral congenital blepharoptosis".
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Blepharoptosis↗
The Marcus Gunn phenomenon. A review of 71 cases.
We have reviewed the clinical findings, natural course, pathologic observations, and management of 71 patients with the Marcus Gunn phenomenon. We found individuals with this syndrome to have a significant incidence of amblyopia (59%), double elevator palsy (25%), anisometropia (25%), and superior rectus muscle palsy (23%). Long-term follow-up did not reveal a case that improved with age. In most patients requiring surgery, we recommend a unilateral levator excision on the affected side plus a bilateral frontalis suspension.
Adolescent↗
Methylation of ribosomal RNA genes in the macronucleus of Tetrahymena thermophila.
We have investigated the occurrence of methylated adenine residues in the macronuclear ribosomal RNA genes of Tetrahymena thermophila. It has been shown previously that macronuclear DNA, including the palindromic ribosomal RNA genes (rDNA), of Tetrahymena thermophila contains the modified base N-6-methyladenine, but no 5-methylcytosine. Purified rDNA was digested with restriction enzymes Sau 3AI, MboI and DpnI to map the positions and levels of N-6-methyladenine in the sequence 5' GATC 3'. A specific pattern of doubly methylated GATC sequences was found; hemimethylated sites were not detected. The patterns and levels of methylation of these sites did not change significantly in different physiological states. A molecular form of the rDNA found in the newly developing macronucleus and for several generations following the sexual process, conjugation, contained no detectably methylated GATC sites. However, both the bulk macronuclear DNA and palindromic rDNA from the same macronuclei were methylated. Possible roles for N-6-methyladenine in macronuclear DNA are discussed in light of these findings.
Animals↗
An outbreak of acute fever among steam turbine condenser cleaners.
Ten of twelve men who participated in the cleaning of an electric power steam turbine condenser clogged with freshwater sponge experienced an acute febrile illness. Two similar outbreaks have been previously described, one of which has been attributed to the Legionnaires' Disease bacterium. Epidemiologic studies of this case showed a syndrome very similar to the two previously reported episodes. However, the exact etiology for this outbreak has not been identified. Environmental sampling was not initiated until after the cleaning was completed. Subsequent testing did not reveal any likely cause for the outbreak. The delayed onset of symptoms and the nature of the illness pointed to an infectious agent. In the absence of any suitable criteria for employee exposure evaluation, it is suggested that crews cleaning condensers under unusually dirty conditions, especially if eye or respiratory symptoms are reported, should be provided with respiratory protection.
Adult↗
HLA-DR antigen on human trophoblast.
To assess the presence of human leukocyte antigens (HLA) on first trimester human trophoblast cells, frozen sections of villous trophoblast and monolayer cultures of isolated cells from placental villi were prepared and exposed to a mouse monoclonal antibody directed against HLA-DR and then incubated with fluorescein-conjugated goat antimouse antibodies. Fluorescence microscopy demonstrated that HLA-DR antigens were present on only the small polygonal epithelioid cells of the monolayer culture. The crescentic staining pattern was consistent with widespread distribution of antigen on the cell membrane. There was no staining over giant multinucleated structures or on fibroblasts of such cell cultures. No HLA-DR was detected when this indirect immunofluorescent technique was applied to tissue sections of villous trophoblast. Existence of high concentrations of hCG in culture supernatants and coincident localization of both hCG and HLA-DR using antibodies conjugated with rhodamine or fluorescein on the polygonal epithelioid cells indicate the trophoblastic origin and expression of HLA-DR antigen under in vitro monolayer culture conditions.
Cells, Cultured↗
The response of serum lipids and plasma androgens to weight training exercise in sedentary males.
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Adult↗
Repair of the lacerated canaliculus using a modified silver wire lacrimal rod.
Several techniques have been used to repair lacerated canaliculi with varying success in achieving functional results. In this communique, we describe a new procedure using a modified Johnson silver wire lacrimal rod.
Humans↗