[Evaluation of the effects of diacerhein in the sheep model of arthritis].
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Animals↗
Biomedical subjects
C Little
Publications and source records attributed to C Little.
Is it allergy?
BACKGROUND: 'Allergy' refers to disorders involving IgE antibody. The cross linking of IgE molecules on mast cells by an allergen releases mediators that produce the typical allergic reaction. OBJECTIVE: To distinguish allergies from other disorders, particularly those where mast cells are also involved. DISCUSSION: Many non allergic processes can mimic allergy. A careful history and examination and discriminate use of investigations is important to make the distinction.
Allergens↗
High definition 3D ultrasound imaging.
We have demonstrated high definition and improved resolution using a novel scanning system integrated with a commercial ultrasound machine. The result is a volumetric 3D ultrasound data set that can be visualized using standard techniques. Unlike other 3D ultrasound images, image quality is improved from standard 2D data. Image definition and bandwidth is improved using patent pending techniques. The system can be used to image patients or wounded soldiers for general imaging of anatomy such as abdominal organs, extremities, and the neck. Although the risks associated with x-ray carcinogenesis are relatively low at diagnostic dose levels, concerns remain for individuals in high risk categories. In addition, cost and portability of CT and MRI machines can be prohibitive. In comparison, ultrasound can provide portable, low-cost, non-ionizing imaging. Previous clinical trials comparing ultrasound to CT were used to demonstrate qualitative and quantitative improvements of ultrasound using the Sandia technologies. Transverse leg images demonstrated much higher clarity and lower noise than is seen in traditional ultrasound images. An x-ray CT scan was provided of the same cross-section for comparison. The results of our most recent trials demonstrate the advantages of 3D ultrasound and motion compensation compared with 2D ultrasound. Metal objects can also be observed within the anatomy.
Computer Simulation↗
Histomorphological and immunohistochemical evaluation of joint changes in a model of osteoarthritis induced by lateral meniscectomy in sheep.
OBJECTIVE: To evaluate the histomorphological and immunohistochemical changes induced in cartilages of ovine stifle (knee) joints 6 months after unilateral lateral meniscectomy. METHODS: Osteochondral sections were obtained from 8 distinct regions of knee joints of 6 adult Merino wethers that 6 months earlier had undergone lateral meniscectomy. Joint regions of 6 age matched sheep housed under identical conditions were used for controls. Serial sections were stained with toluidine blue or immunolocalized with monoclonal antibodies (Mab) 3B3(-), 7D4, and 5B10, which recognize epitopes on proteoglycans. RESULTS: In control joints the cartilage from the region of the tibial plateau not protected by the meniscus had significantly (p < 0.005) more structural abnormalities than other joint regions. After meniscectomy, only cartilages in the lateral femorotibial compartment showed histomorphological changes consistent with osteoarthritis (OA). The nature and severity of the lesions differed between the topographical regions within the joint. The most severe were found on the lateral femoral condyles and tibial plateaus. Reactivity with Mab 3B3(-), 7D4, and 5B10 was increased only in the lateral compartment cartilages, and was stronger in mild rather than moderate OA. CONCLUSION: Six month lateral meniscectomy in sheep produces histomorphological and immunohistochemical cartilage changes analogous to those described for early human OA and in other animal models. The severity and type of lesions obtained were dependent on the topographical joint location, but were most evident in cartilages from the lateral compartment.
Animals↗
Analgesic effects of cranial laser treatment in two rat nociception models.
The present experiments sought to establish dose dependency and time course for effects of cranial laser irradiation in two rodent models of pain. These were the hot plate and tail flick tests, which are both widely used to quantify analgesic drug effects. The laser used was an Omega Biotherapy 3ML (wavelength 820 nM, average power output 100 mW, pulse frequency 5 kHz) and irradiation was applied to rats' shaved heads above the midbrain. In the first experiment, four groups of 10 rats received doses of 0, 6, 12, 18, and 24 J/cm2 in random orders prior to hot plate testing either immediately, 30 min, 1 h or 24 h postlaser. The second study employed three groups of 10 rats receiving 0, 12, and 18 J/cm2 in random orders prior to tail flick testing at the three shorter times above. Latency to lick hind paws on the hot plate was highly significantly prolonged by laser treatment across all doses and time periods, F(4, 126) = 4.51, p < 0.01. There was good dose dependency for immediate observations, but at 24 h 18 J/cm2 was the most effective dose. Laser treatment also delayed tail flick responses at both doses and all time periods, F(2, 54) = 10.60, p < 0.001, but 12 and 18 J/cm2 doses were similar in efficacy.
Analgesia↗
Predicting the prognosis after proximal femoral fracture.
In 338 patients with proximal femoral fractures, age, sex, residence and mobility on admission were found to predict mortality, mobility and housing requirements after 1 year. Application of these data should permit better targeting of rehabilitation and earlier initiation of rehousing arrangements after proximal femoral fracture.
Age Factors↗
Emotional availability in mother-twin dyads: effects on the organization of relationships.
The term "emotional availability" has evolved primarily in therapeutic contexts where it refers to the sensitive engagement of the therapist in the patient's narrative of life experiences and openness to the patient's emotional expressions (Emde 1980). In the therapeutic situation, emotional availability refers to the quality of the therapist in supporting the growth or development of the patient. It is anticipated that the outcome of the therapeutic experience will include an enhanced capacity for reciprocal emotional availability with others.
Child, Preschool↗
Effect of sugar and acid on the acceptability of frozen yogurt to a student population.
One hundred and forty-one college students tasted and rated on a nine-point hedonic scale their degree of liking for nine samples of vanilla frozen yogurt varying in sugar and lactic acid. Subjects were also asked to complete a questionnaire about consumption of frozen yogurt and other dairy products. Degree of liking differed significantly among samples, and the samples best liked were those with the lowest acidity, .23 to .29%, independent of sugar concentration. Degree of liking of frozen yogurt failed to correlate with dairy product consumption or hunger at the time of testing. No significant difference existed between male and female students for overall degree of liking of frozen yogurt or overall dairy product intake, yet the questionnaire revealed a significantly higher consumption of frozen yogurt among female students. The results of this study suggest that, for the student population tested, frozen yogurt should combine the sensory properties of ice cream (low acidity) with the nutritional properties of yogurt (low fat, active enzyme culture).
Adolescent↗
Severe toxicity limits intensification of induction therapy for acute lymphoblastic leukemia.
Fourteen adult patients with newly-diagnosed acute lymphoblastic, leukemia (ALL), and lymphoblastic lymphoma, were treated with a dose-intense induction regimen. This regimen was designed to increase the fraction of patients achieving an early complete remission, in an attempt to increase the fraction of patients who are long-term disease-free survivors. The induction regimen included vincristine, prednisone, intermediate-dose cytarabine (Ara-C), and idarubicin, all given during the first week of therapy. This combination led to significant hepatic, gastro-intestinal, infectious, and neurologic toxicity. There was unacceptable treatment-related mortality (29%). After the first eight patients, the study was modified, omitting the Ara-C from the induction phase. Gastrointestinal morbidity was less in the cohort treated without Ara-C; however, infectious morbidity persisted at unacceptable levels and this program was terminated as too toxic to administer. There were nine complete remissions, three early deaths, and two patients with resistant disease. There have been six relapses, three of which occurred in patients who, because of protracted grade III/IV toxicity, were no longer receiving chemotherapy. With a minimum follow-up of 20 months, only three patients are still alive. We conclude that this combination of vincristine, prednisone, Ara-C, and idarubicin, is too toxic to be used as induction therapy for adult patients with ALL and lymphoblastic lymphoma.
Adult↗
High incidence of disseminated intravascular coagulation during remission induction of adult patients with acute lymphoblastic leukemia.
We determined the incidence and complications of disseminated intravascular coagulation (DIC) at presentation and during remission induction of previously untreated adults with acute lymphoblastic leukemia (ALL) or de novo Philadelphia chromosome-positive ALL (PCALL) seen at Memorial Hospital between January 1, 1978 and December 31, 1989. DIC was diagnosed in the presence of (1) low fibrinogen (less than or equal to 160 mg/dL), (2) prolonged prothrombin time (PT) and falling fibrinogen, or (3) prolonged PT and positive fibrin split products (FSP). L-Asparaginase was not used during remission induction. Among adequately screened patients with ALL, DIC was detected in 7 of 58 (12%) before initiation of chemotherapy and in 35 of 45 (78%) during remission induction. DIC was not simply the result of infection because clinical and laboratory signs of infection were absent in 16 patients, whereas only 2 of the 22 febrile patients with DIC had positive cultures. Among the 38 patients with DIC at presentation or during remission induction, serious complications were seen in 13 in temporal association with DIC (pulmonary embolus in one, sagittal sinus thrombosis in three, and serious hemorrhage in nine) and were major factors in the deaths of three patients. Among the 10 patients with thorough screening but no evidence of DIC there was only one hemorrhage during the same time interval. In patients with PCALL, DIC was detected in 9% at presentation and in 80% during remission induction. We conclude that DIC is rare at presentation but common during remission induction of adult ALL and PCALL and may be associated with significant thrombotic and hemorrhagic complications. We suggest daily screening for DIC during the first 14 days of remission induction. The treatment of DIC in ALL and PCALL should be a subject of future clinical studies.
Adult↗
Reasons that patients with acute myelogenous leukemia do not undergo allogeneic bone marrow transplantation.
BACKGROUND: Numerous reports suggest that allogeneic bone marrow transplantation prolongs the survival of adult patients with acute myelogenous leukemia (AML) in first remission. However, it is unclear how many such patients actually undergo this procedure. METHODS: We reviewed the case records of 350 consecutive adult patients with AML treated with chemotherapy at a single institution from 1979 (when the policy of offering allogeneic transplantation to all such patients in first remission was introduced) through 1990. The criteria for exclusion before transplantation included age greater than 40 and, beginning in 1984, a diagnosis of acute promyelocytic leukemia. RESULTS: One hundred forty-two patients (41 percent of the study population) were 40 years of age or under. HLA testing was performed for 120 of these patients (85 percent). Sixty-seven patients (47 percent) had an HLA-identical sibling as a potential donor. One hundred three patients (73 percent) entered remission during treatment according to one of five chemotherapy protocols. Of the 52 patients who both entered remission and had an HLA match, 30 underwent transplantation while they were in first remission. These 30 patients constituted 21 percent of all study patients 40 years old or under, 29 percent of all patients 40 or under who entered remission, 45 percent of all patients with an HLA match, 58 percent of all patients who had both a remission and a match, and 9 percent of all patients treated according to a protocol. Among patients with a match who did not undergo transplantation, those with primary refractory disease were the largest subgroup. CONCLUSIONS: These findings suggest that allogeneic bone marrow transplantation is performed in less than 60 percent of adult patients with AML who are potentially eligible for the procedure.
Adult↗
Brief intensive chemotherapy for metastatic non-small-cell lung cancer: a phase II study of the weekly CODE regimen.
Fifty-three patients, 17 with stage IIIB and 36 with stage IV non-small-cell lung cancer, were given CODE (cisplatin, vincristine, doxorubicin, and etoposide) plus antibiotic prophylaxis and an antiemetic regimen in an intensive chemotherapy program emphasizing weekly treatment and a planned brief duration (9-12 weeks); for 45 of these patients, the CODE program also included antifungal prophylaxis and supportive corticosteroids. Of the total study population, 33 patients (62%) responded to treatment, including five (9%) with complete response. The median survival for the entire group was 42 weeks (55 weeks for those with stage IIIB and 39 weeks for those with stage IV). More than 40% were alive at 1 year. Comparison of granulocyte counts of patients receiving prednisone with those of the subgroup to whom no corticosteroids were given showed less granulocytopenia for those receiving prednisone. Use of prednisone thus allowed improved delivery of myelosuppressive drugs. CODE was halted in nine patients because of disease progression. Although more constitutional side effects are associated with weekly chemotherapy than with standard chemotherapy, only 12 of the remaining 44 patients (27%) failed to receive at least 9 weeks of treatment. Serious toxicity was uncommon: There were no treatment-related deaths and only three episodes of neutropenia with fever. CODE is a novel treatment for non-small-cell lung cancer that this pilot study provided entirely in an outpatient setting over a 9-12 week period with an acceptable incidence of toxicity and a promising level of efficacy. Additional testing and comparison with other regimens or supportive care alone are warranted.
Adenocarcinoma↗
The distal lacrimal ductal system and traumatic epiphora.
While transient epiphora is well documented in the literature, the incidence of permanent epiphora associated with maxillofacial procedures (Le Fort I, II, III, osteotomies, nasal atrostomies and mid-face fractures) is rare. However, little attention has been paid to the distal lacrimal ductal system and its relationship to permanent epiphora. The distal nasolacrimal ductal system was studied in adult dry skulls and cadaver specimens. These findings were correlated by clinical observation. Specific areas of emphasis within this complex include the length, width, and angulation of this system. Clinical applications are discussed based on an anatomical rationale for the limitation of the superior repositioning of the maxilla as well as for proper placement of the antral window in nasal antrostomy procedures and what anticipated post-residual effects of mid-facial trauma are on the ductal system.
Adult↗
Importance of long-term follow-up in evaluating treatment regimens for adults with acute lymphoblastic leukemia.
During the past 20 years, we have treated 250 previously untreated adults (greater than age 15 years) with acute lymphoblastic leukemia (ALL) with five successive multidrug protocols: L2, L10, L10M, L17/17M, and L20. The L10 and L10M protocols had the highest percentage of long-term (greater than 5 years) remissions (52% and 40% respectively) compared with the L2 and more recent protocols (24%-32%); this is partly attributable to a greater prevalence of adverse risk factors among the latter protocols. The overall long-term survival of the first 199 patients with minimum 3 years follow-up is now 31%, with 35% of the 163 patients achieving complete remission (CR) remaining free of relapse for greater than 5 years. The disease-free survival of the 163 patients reaches a plateau of 33% after 6 years. The percentages of patients subsequently relapsing after remaining in continuous CR for 1.5, 3, and 5 years are 42%, 28%, and 6%, respectively; no relapses have yet occurred after 6 years in this series. Postrelapse survival improved progressively with longer duration of first remission. The results of treatment in second or later remission with either chemotherapy or bone marrow transplantation (BMT) were unsatisfactory and there were only a few long-term survivors. Recently we have attempted to select patients at highest risk of early relapse for BMT in first remission, but the number of eligible patients actually having BMTs has been low for a variety of reasons, including early death, failure to reach CR, early relapse, patient refusal, or medical contraindications.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
The effect of the plasticizers TBEP (tris-(2-butoxyethyl)-phosphate) and DEHP (di-(2-ethylhexyl)-phthalate) on beta-adrenergic ligand binding to alpha 1-acid glycoprotein and mononuclear leukocytes.
The plasticizers tris-(2-butoxyethyl)-phosphate (TBEP) and di-(2-ethylhexyl)-phthalate (DEHP) and the beta-adrenergic receptor-blockers [3H]-(-)-dihydroalprenolol ([3H]-(-)-DHA) and [3H]-(-)-CGP 12177 were tested for their ability to interact with beta-adrenergic binding to alpha 1-acid glycoprotein (AAG) and mononuclear leukocytes (MNL). The IC50-values, obtained by displacement of [3H]-(-)-DHA bound to AAG, were 3.5 nM, 2 microM and 4 microM for TBEP, (-)-alprenolol and DEHP, respectively. (+/-)-CGP 12177 had virtually no effect on radioligand binding to AAG. The [3H]-(-)-CGP 12177 binding to MNL consisted of beta-adrenergic receptor binding (Kd = 210 pM) and non-saturable binding. [3H]-(-)-DHA was bound to two different classes of binding sites on MNL, the beta-adrenergic receptors (Kd = 440 pM) and a secondary class of binding sites (Kd = 64 nM). (+/-)-CGP 12177 displaced about 30% of [3H]-(-)-DHA from MNL with an IC50-value of 190 pm. (-)-ALP displaced about 85% of total bound radioligand and gave a biphasic displacement curve with IC50-values of 320 pM and 690 mM, respectively. TBEP displaced a considerable fraction of [3H]-(-)-CGP 12177 and [3H]-(-)-DHA bound to MNL beta-adrenergic receptors, whereas DEHP had no effect. In contrast, DEHP caused displacement of [3H]-(-)-DHA from the MNL low affinity sites, but was a markedly less potent displacer compared to TBEP. The present study shows that TBEP and DEHP interact with beta-adrenergic transport proteins, non-specific tissue binding sites and beta-adrenergic receptors coupled to adenylate cyclase. Plasticizers may thus affect the biology and pharmacology of the beta-adrenergic signal system.
Adult↗
Addison's disease in the dog.
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Addison Disease↗
High-resolution (1.5 A) crystal structure of phospholipase C from Bacillus cereus.
Both the phosphatidylinositol-hydrolysing and the phosphatidylcholine-hydrolysing phospholipases C have been implicated in the generation of second messengers in mammalian cells. The phosphatidylcholine-hydrolysing phospholipase C (PLC) from Bacillus cereus, a monomeric protein containing 245 amino-acid residues, is similar to some of the corresponding mammalian proteins. This, together with the fact that the bacterial enzyme can mimic the action of mammalian PLC in causing, for example, enhanced prostaglandin biosynthesis, suggests that B. cereus PLC can be used as a model for the hitherto poorly characterized mammalian PLCs. We report here the three-dimensional structure of B. cereus PLC at 1.5 A resolution. The enzyme is an all-helix protein belonging to a novel structural class and contains, at least in the crystalline state, three Zn2+ in the active site. We also present preliminary results from a study at 1.9 A resolution of the complex between PLC and inorganic phosphate (Pi) which indicate that the substrate binds directly to the metal ions.
Bacillus cereus↗