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Biomedical subjects

C Murray

Publications and source records attributed to C Murray.

At least 145 records · Page 8Linked to original sources
PubMed1990

Natural history of mixed chimerism after bone marrow transplantation with CD6-depleted allogeneic marrow: a stable equilibrium.

Mixed hematopoietic chimerism (MC) is a common finding after allogeneic bone marrow transplantation (BMT), but the natural history of this phenomenon remains unclear. To understand the evolution and the implications of this finding, we performed a prospective analysis of the development of mixed chimerism in 43 patients with hematologic malignancies who received bone marrow (BM) from human leukocyte antigen (HLA)-identical sibling donors. T-cell depletion in vitro with anti-T12 (CD6) monoclonal antibody and rabbit complement was used as the only method of graft-versus-host disease (GVHD) prophylaxis. Overall, MC was identified in peripheral blood (PB) and BM in 22 of 43 (51%) patients evaluated. MC was found by restriction fragment length polymorphism (RFLP) analysis in 21 of 40 (53%) patients, by cytogenetic analysis in 6 of 29 (21%) patients, and by red blood cell phenotyping in 4 of 9 (44%) patients. RFLP studies were performed at 0.5, 1, 3, 6, 9, and 12 months post-BMT and then every 6 months, and showed a high probability of developing MC in the first 6 months after BMT followed by stabilization after 12 months. Cytogenetic analysis was less sensitive in detecting MC. Once MC was detected after BMT, the percentage of recipient cells increased very slowly over more than 3 years of follow-up, and no patient reverted to complete donor hematopoiesis (CDH). Thus, recipient and donor cells remained in a relative state of equilibrium for prolonged periods that seemed to favor recipient cells over donor cells. Patient's disease, remission status, or intensity of the transplant preparative regimen did not influence the subsequent development of mixed chimerism. Early immunologic reconstitution was the only factor that correlated with the subsequent chimeric status of the patients. The percentage and absolute number of T3 (CD3) and T4 (CD4) positive cells at day 14 after BMT were significantly higher in the patients who maintained CDH but NK cell reconstitution was similar in both groups, suggesting that early reconstitution with T cells may play a role in preventing recovery of recipient cells after BMT. GVHD was also associated with maintenance of CDH, but the probability of relapse, survival, and disease-free survival was identical in patients with MC and CDH.

Antigens, CD↗
PubMed1990

Vibroacoustic stimulation and fetal behavioral state in normal term human pregnancy.

Vibroacoustic stimulation may affect human fetal behavior. Continuous graphic records of simultaneous ultrasonographic observations of fetal activities and electronic fetal heart rate tracings of 30 normal term fetuses were examined visually for the occurrence of behavioral state 30 minutes before and after 3 seconds of vibroacoustic stimulation. After vibroacoustic stimulation, the total time spent in state 1 decreased significantly, that spent in state 4 increased significantly, and times spent in state 2 and indeterminate state (no state established for at least 3 minutes) were unchanged. No fetus exhibited state 3 before or after vibroacoustic stimulation. State 4 occurred in 22 fetuses after vibroacoustic stimulation with a duration of at least 30 minutes in four fetuses, and was noted in all fetuses in pre-vibroacoustic stimulation state 1 and 11 of 16 fetuses in pre-vibroacoustic stimulation state 2. Fetal heart rate accelerations occurred within 10 seconds after vibroacoustic stimulation in 94% of the fetuses studied regardless of their prior behavioral state. The variation in the onset and duration of behavioral state responses in most fetuses after vibroacoustic stimulation may depend on previous behavioral state and could be important for interpretation of antenatal assessment that uses this stimulus.

Acoustic Stimulation↗
PubMed1990

Phase I/II trial of granisetron: a novel 5-hydroxytryptamine antagonist for the prevention of chemotherapy-induced nausea and vomiting.

A new class of antiemetic agents, the 5-hydroxytryptamine (5-HT3) antagonists, have been shown to possess potent antiemetic properties in the ferret model. We conducted a phase I/II trial of the 5-HT3 antagonist BRL43694 (granisetron) in 24 chemotherapy-naïve patients who were receiving any combination of doxorubicin and/or cisplatin. The first 12 patients received 40 micrograms/kg and the second 12 received 80 micrograms/kg of granisetron intravenously before beginning chemotherapy. Nausea was assessed by a patient-completed visual analogue scale and episodes of retching recorded by the patient and an independent observer. Fifty-two percent of the 22 evaluable patients had no retching or vomiting and 32% had no nausea during the first 24 hours after chemotherapy. Pharmacokinetic measurements were performed. The disposition of granisetron was best described using a two-compartment model. The area under the plasma concentration curve (AUC) was 277 +/- 226 ng.h/mL and 359 +/- 282 ng.h/mL at 40 and 80 micrograms/kg, respectively. The total body clearance was 0.319 +/- 0.315 L/kg/hr and 0.483 +/- 0.504 L/kg/hr at the 40 and 80 micrograms/kg doses. Wide interpatient variation in model independent parameters was observed. There was no suggestion of dose-dependent efficacy at the two dose levels studied. We conclude that granisetron shows promise as a well-tolerated and effective antiemetic. Randomized trials comparing this drug with standard regimens are currently underway.

Antiemetics↗
PubMed1990

Autoimmune pancytopenia following allogeneic bone marrow transplantation.

A 47-year-old female developed autoimmune hemolytic anemia, autoimmune neutropenia, and autoimmune thrombocytopenia 19 months following allogeneic bone marrow transplantation for chronic myelogenous leukemia. Treatment with high-dose corticosteroids resulted in marked improvement in all three cell lines.

Autoimmune Diseases↗
PubMed1990

HLA antigen frequencies in HIV-1-related Kaposi's sarcoma.

In an ongoing study of genetic factors that might contribute to disease outcome in HIV-1-infected individuals, HLA antigen (A, B, C, DR and DQ) frequencies in 44 patients with Kaposi's sarcoma (KS) and/or 14 with KS and opportunistic infection (OI) were compared with the frequencies found in 83 HIV-1-seropositive (disease-free) and 87 seronegative homosexual men, or with 50 patients with OI. KS patients had higher frequencies of HLA-B35, -C4, -DR1, and -DQ1 and lower frequencies of HLA-C5 and -DR3 compared to the total control population (N = 170) and to the population at risk (HIV-1-seropositive, disease-free). HLA-DR5, reported by others to be increased in frequency in classical KS as well as HIV-1-related KS, was not found to be increased in the KS cohort. Antigen frequencies in the patients with KS differed from the frequencies in patients with OI by an increase in HLA-A23, -C4, -DR14, and -DR53. These results suggest that genetic factors controlled by the human major histocompatibility complex (MHC) may influence disease outcome in HIV-1-infected homosexual men.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Clonal evidence for the induction of NKH1 on activated human thymocytes. Functional changes associated with antigen expression.

Freshly isolated human thymocytes lack the NKH1 antigen and the ability to lyse target cells without major histocompatibility complex restriction. Short-term culture of human thymocytes in interleukin (IL) 2 results in the generation of non-major histocompatibility complex-restricted effector cells, all of which express NKH1. The mechanism by which these cells appear in culture has yet to be elucidated. In the present studies, we developed thymocyte clones and performed a molecular analysis of T cell receptor gene rearrangements to demonstrate that the expression of NKH1 antigen is induced on the surface of NKH1- thymocytes in the presence of IL2. In addition, we were able to show that the NKH1+ fraction consistently displayed an increased proliferative response to similar concentrations of IL2 when compared to NKH1- cells, for both clonal and polyclonal populations of thymocytes. Taken together, these studies demonstrate that the initial appearance of the NKH1 antigen following thymocyte culture in the presence of IL2 results from the induction of NKH1 expression on NKH1- thymocytes, while the subsequent predominance of this cell type also results from an enhanced proliferative response to IL2 which coincides with NKH1 expression.

Antigens, CD↗
PubMed1989

Interleukin-1 alpha gene intron containing variable repeat region coding for the SP1 transcription factor recognition sequence is polymorphic.

Interleukin-1 alpha (IL-1 alpha) is a cytokine produced by a number of cell types including macrophages, fibroblasts, keratinocytes, and mesangial cells. We were interested in identifying a DNA restriction fragment length polymorphism (RFLP) for the IL-1 alpha gene for use in studies of genetic alteration in various human cancers. Human genomic DNA from 32 unrelated individuals was digested with various restriction enzymes, alone and in combination, and subjected to Southern blot analysis. Hybridization to 32P-labeled IL-1 alpha cDNA revealed an insertion-deletion-type polymorphic pattern. After digestion with RsaI, insertion-deletion-type polymorphic bands with sizes of 3.4 kb, 3.1 kb, and 2.8 kb and one invariant band of 0.8 kb were observed. These three alleles, designated A1, A2, and A3, had relative frequencies of 0.18, 0.06, and 0.78 with heterozygosity observed in 38% of the unrelated individuals studied. Evaluation of nine related individuals for this RsaI polymorphism was consistent with a Mendelian inheritance. Comparison of restriction patterns following Southern analysis of DNA digested with several different enzymes showed that the polymorphic region resides within the sixth intron. Furthermore, this RFLP results from a variable length region containing multiple copies of a recognition sequence for SP1, an imperfect copy of viral enhancer elements, and an inverse and complementary sequence of the glucocorticoid receptor binding site. The identified polymorphism may be of value in analyses of chromosome 2 and may help to elucidate mechanisms by which IL-1 alpha transcription is regulated.

Binding Sites↗
PubMed1989

Autologous bone marrow transplantation for acute lymphoblastic leukemia.

Forty-four children with acute lymphoblastic leukemia (ALL) who had relapsed (N = 43) or had refractory disease (N = 1) were intensively treated with combination chemotherapy, had remission bone marrow (BM) harvested and purged in vitro with monoclonal antibodies specific for leukemia-associated antigens, underwent postharvest ablative chemotherapy and radiotherapy and subsequently were infused with their autologous marrow. Of the 44 patients treated between November 1980 and January 1988, 19 relapsed, 10 died of complications, and 15 remained in complete remission for a median of 28.5 months (range, 10+ to 94+). Event-free survival (EFS) (+/- SE) at 5 years after autologous transplantation was 29 +/- 8%. For the 26 patients whose initial remission was greater than 2 years, event-free survival was 51 +/- 10%. These results compare favorably with allogeneic transplantation and chemotherapy trials for patients with relapsed ALL, and provide an alternative transplantation option for children without histocompatible donors.

Adolescent↗
PubMed1989

Mechanism of graft failure in HLA-matched and HLA-mismatched bone marrow transplant recipients.

This report characterizes the mechanism of graft failure in five patients who received allogeneic marrow depleted of T cells in vitro using anti-T12 (CD6) monoclonal antibody and rabbit complement. This group of five patients represents all patients who experienced early graft failure in a larger group of 59 consecutive patients given T12 depleted marrow over a 5-year period. Although all patients received ablative pre-transplant conditioning including total body irradiation (12-14 Gy) graft failure was more frequent in patients without genetically HLA-identical donors (four of 11 patients) than in patients with HLA identical sibling donors (one of 48 patients). In patients without genotypically identical donors, graft failure was observed with variable degrees of genetic disparity including two patients with HLA haplotype-mismatched sibling donors, one patient with a phenotypically HLA-matched parental donor, and one patient with an HLA-matched unrelated donor. In patients with both HLA identical and non-identical donors, results of immunophenotypic analysis demonstrated that early graft failure was associated with peripheral lymphocytosis with T cells expressing CD2, CD3, CD5, CD6, CD8 and Ia antigens. Direct cytotoxicity studies demonstrated specific lysis of donor cells by circulating lymphocytes and further analysis indicated that effector cells were derived from the recipients and not donors. Taken together, these results suggest that these allogeneic grafts did not 'fail', but rather that residual host cytotoxic T cells were responsible for active rejection of donor marrow.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

School and the in-center pediatric hemodialysis patient.

Life "on the machine" can significantly disrupt the social and academic school experience of preadolescent and adolescent renal failure patients because of their frequent absences. When hemodialysis patients were offered treatments after school and on Saturday mornings, patients, families, and staff reported significant improvement in the patients' social integration and academic performance.

Adaptation, Psychological↗
PubMed1988

Phase I trial of the combination of 6-methylmercaptopurine riboside and 5-fluorouracil.

6-Methylmercaptopurine riboside (MMPR) and 5-fluorouracil (5-FU) were administered sequentially to 12 patients in a phase I clinical trial. Toxicities included mild nausea and vomiting, as well as reversible leukopenia and thrombocytopenia. Maximal accumulation of 6-methylmercaptopurine ribonucleoside 5'-monophosphate (MMPR-P), the active metabolite of MMPR, in patients' erythrocytes occurred between 2 and 6 h after the administration of MMPR and the degree of accumulation was dose-related. At 96 h after MMPR administration, MMPR-P was still detectable in patients' erythrocytes. Although no clinical responses were documented, a modified dosage schedule of these drugs should be pursued based on the pharmacokinetic data obtained.

Aged↗
PubMed1988

Attitudes of nonsecluded patients toward seclusion rooms.

This study investigated the attitudes toward seclusion rooms of a group of hospitalized psychiatric patients who were not at the time secluded. Those patients who had never been secluded endorsed more negative feelings about seclusion room use than did those who had actually been secluded during prior hospitalizations. Women were more critical of the seclusion process than were men.

Adult↗
PubMed1988

Plasmid profile analysis of a salmonellosis outbreak and identification of a restriction and modification system.

After an outbreak of salmonellosis in humans caused by Salmonella typhimurium bacteriophage type 135, 62 isolates from human, animal, and water sources were retained for further analysis. Most of the isolates (92%) could be placed in one of five plasmid pattern groups, with a majority containing a common 60-kilobase plasmid and a smaller 3.8-kilobase-pair plasmid. This small plasmid, pIMVS1, was labeled with [32P]phosphate and used as a probe in subsequent colony and Southern hybridization studies. We concluded that pIMVS1 from isolates obtained from humans was genetically different from plasmids of a similar size found in isolates from chickens. Studies to characterize pIMVS1 were undertaken to determine if it codes for known virulence factors. It did not appear to be associated with the formation of attachment pili or major outer membrane proteins. By using transposon mutagenesis techniques, Tn3(Apr) was inserted into pIMVS1, and the existence of a restriction and modification system was deduced.

Animals↗
PubMed1988

Neuroadaptation of rats to kappa agonists U-50,488 and tifluadom.

1. When U50 was given to rats over 5 d by twice-daily s.c. injection (but not when delivered by osmotic minipump), buprenorphine and naloxone each precipitated strong, qualitatively distinct, behavioral syndromes. 2. The same dose of buprenorphine provoked similar behaviors in rats given chronic U50 and chronic TIF (analogous s.c. injection protocols), suggestive of neuroadaptation to kappa agonists as a class. This adaptation clearly contrasts with that to chronic mu agonists. 3. The buprenorphine-induced syndrome was characterized by oral stereotypies which had an onset of about 5 min and a duration greater than 4 hr. The intensity was dependent on the dose of agonist injected. 4. The naloxone-induced syndrome was characterized by repetitive yawning and writhing. 5. If oral stereotypy, yawning and writhing are considered to represent an abstinence syndrome, then it will be necessary to use multiple or more selective kappa antagonists to fully unveil kappa dependence in the rat. 6. The present data indicate a strong trend toward the parallel development of tolerance in rats given a similar course of chronic U50 injections as those tested for physical dependence.

3,4-Dichloro-N-methyl-N-(2-(1-pyrrolidinyl)-cycloh↗
PubMed1988

DNA restriction fragment length polymorphisms at either end of the c-raf-1 locus at 3p25.

We report the identification and characterization of two restriction fragment polymorphisms (RFLPs) associated with the human c-raf-1 protooncogene located on chromosome 3 (3p25). EcoRI digestion produces an RFLP derived from the 5'flanking sequences with a heterozygosity of 28%, and TaqI produces an RFLP representing the 3' flanking sequences with a heterozygosity of 25%. The finding of RFLPs associated with a potential oncogene may provide a method of analysis for determining genetic susceptibilities to certain cancers.

Chromosome Mapping↗
PubMed1988

HLA antigen frequencies in HIV-1 seropositive disease-free individuals and patients with AIDS.

HLA-A, -B, -C, -DR, and -DQ antigen phenotypes were determined in 266 Caucasian homosexual men, 90 of whom were HIV-1 seronegative, 94 HIV-1 seropositive AIDS-free, and 82 with a diagnosis of AIDS [36 with Kaposi's sarcoma (KS), 34 with opportunistic infection (OI), and 12 with KS and OI]. No significant differences in HLA-A or -B antigen frequencies were found in any comparisons of these groups. However, in comparisons of seropositive AIDS-free men with the AIDS groups, HLA-Cw7 was increased in frequency in OI and HLA-DR1, -DRw14, and -DQw1 in KS. HLA-DR3 and -DQw3 frequencies were decreased in KS, and DRw53 was decreased in OI. In a cohort of 102 HIV seropositive individuals that were followed for a mean of 43 months, AIDS developed in HLA-DR1 positive men more frequently than in individuals with other HLA-DR phenotypes (p = 0.02). These results demonstrate probable genetic differences between individuals developing KS and OI and indicate that the HLA-DR1 phenotype is a risk factor in disease progression in human immunodeficiency virus (HIV)-infected individuals.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Phenotypic and functional deficiency of natural killer cells in patients with chronic fatigue syndrome.

Natural killer (NK)3 cells are large granular lymphocytes that appear to play a significant role in the host's defense against viral infection. We performed an extensive phenotypic and functional characterization of NK cells on 41 patients with the chronic fatigue syndrome (CFS), or "chronic active Epstein-Barr virus infection" syndrome, and on 23 age- and sex-matched asymptomatic control subjects in an attempt to further characterize this illness. These studies demonstrated that a majority of patients with CFS have low numbers of NKH1+T3- lymphocytes, a population that represents the great majority of NK cells in normal individuals. CFS patients had normal numbers of NKH1+T3+ lymphocytes, a population that represents a relatively small fraction of NK cells in normal individuals. When tested for cytotoxicity against a variety of different target cells, patients with CFS consistently demonstrated low levels of killing. After activation of cytolytic activity with recombinant interleukin 2, patients were able to display increased killing against K562 but most patients remained unable to lyse Epstein-Barr virus-infected B cell targets. Additional cytotoxicity experiments were carried out utilizing anti-T3 monoclonal antibody to block killing by NKH1+T3+ cells. These experiments indicated that the NK cell that appears to be responsible for much of the functional activity remaining in patients with CFS belongs to the NKH1+T3+ subset, which under normal circumstances represents only approximately 20% of the NK cell population.

Antibodies, Viral↗