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Biomedical subjects

C Peterson

Publications and source records attributed to C Peterson.

At least 127 records · Page 7Linked to original sources

Evaluation of clinical assays for measuring high-dose methotrexate in plasma.

Four routine assays commonly used for monitoring plasma methotrexate (MTX) during high-dose therapy were validated by HPLC as the comparison method. MTX and its main metabolite, 7-hydroxymethotrexate (7-OHMTX), were analyzed by HPLC with postcolumn derivatization and fluorometric detection. About 200 clinical plasma samples from 13 children with acute lymphoblastic leukemia who received 5-8 g/m2 MTX as 24-h infusions were analyzed. The fraction of measured concentrations of MTX that were within 75-125% of the values obtained by HPLC were 64.5% for enzyme inhibition assay, 56.4% for fluorescence polarization immunoassay with polyclonal antibodies (FPIA1; Abbott), 58.9% for FPIA2 (with monoclonal antibodies; Abbott), and 46.4% for enzyme-multiplied immunoassay (Emit; Syva). All nonchromatographic procedures were subject to interferences from MTX plasma metabolites or endogenous substances. The interference from 7-OHMTX was, however, somewhat less pronounced for FPIA2 (monoclonal) than for FPIA1 (polyclonal).

Child↗

Supression of telomerase activity in HL60 cells after treatment with differentiating agents.

The human promyelocytic leukemic HL60 cells are immortal and as such express high levels of telomerase activity. All-trans retinoic acid (ATRA) and 1 alpha, 25 dihydroxyvitamin D3 (VD3) induce differentiation of HL60 cells into CD11b+ mature granulocytes and monocytes, respectively. We studied telomerase activity after differentiation of HL60 cells. A marked inhibition of the enzyme activity was observed in the differentiated CD11b+ cells after 72-120 h treatment with either differentiating agent. In contrast, the VD3-treated CD11b- HL60 cells, which failed to undergo differentiation and human erythroleukemic cell line K562, exposed to ATRA retained high levels of telomerase activity. This finding suggests, that telomerase activity is repressed as a differentiation-associated event in HL60 cells. Our results provide the first evidence that immortal leukemic cells, like normal human cells, have a telomerase repressing mechanism which can be activated by differentiation and thus lead to the suppression of telomerase activity. This in vitro model may be useful for studies of the mechanisms controlling telomerase activity and in the search for physiological telomerase modulators.

Calcitriol↗

Children's memory for traumatic injury.

Children between 2 and 13 years who suffered traumatic injury necessitating hospital emergency room treatment were recruited as subjects. They (and adult witnesses) were interviewed a few days and 6 months later, using free and probed recall, about both injury and hospital treatment. Children at all ages were able to provide considerable information about both stressful events, although the amount of detail increased with age. They also made few commission errors. Surprisingly, children's distress at time of injury did not affect the amount or accuracy of their recall of that event, whereas distress during hospital treatment did decrease recall. A tripartite classification into 3 categories of detail was used: central, peripheral--inside the emotional events, or peripheral--outside those events. Children's recall differed depending upon detail category. Implications for children's testimony are discussed.

Adolescent↗

Immunohistochemical visualization of brain-derived neurotrophic factor in the rat brain.

A purified polyclonal antibody preparation was made against recombinant brain-derived neurotrophic factor (BDNF) in guinea pig and characterized for use in immunoassays and immunohistochemistry. The anti-BDNF antibodies specifically recognized BDNF in Western blots and immunoprecipitation. There was no cross-reactivity with the other known mammalian members of the neurotrophin family, nerve growth factor, neurotrophin-3 and neurotrophin-4/5. In immunohistochemical analysis, the anti-BDNF recognized exogenous BDNF injected into the brain of rats, whereas no signal was obtained with the other neurotrophins. Preabsorption with native BDNF abolished the immunoreactivity in brain sections. These studies identify the anti-BDNF as a tool for immunocytochemistry and the development of an immunoassay. Immunohistochemical analysis revealed widespread neuronal localization of BDNF in many brain areas. BDNF was localized in all subpopulations of hippocampal neurons. The distribution in the hippocampus suggests localization in the cytoplasm of cell bodies and dendrites.

Animals↗

High-performance liquid chromatography with fluorometric detection for monitoring of etoposide and its cis-isomer in plasma and leukaemic cells.

The podophyllotoxin derivative etoposide, extensively used in anticancer therapy, is highly protein-bound (95%) in plasma. It is a chiral drug and only the trans-isomer is pharmacologically active. Isomerisation to the inactive cis-lactone occurs in plasma. The cis-lactone is often present in ultrafiltrates of plasma from patients treated with etoposide, therefore it is important to separate the isomers when free etoposide concentrations are assayed. There is reason to believe that free and cellular concentrations are more important for the effect of etoposide therapy than total plasma concentrations. A high-performance liquid chromatographic (HPLC) method for quantification of etoposide and its cis-isomer in plasma, total and non-protein-bound concentrations, and in leukaemic cells is described. After addition of teniposide as internal standard the drugs were extracted with chloroform. Etoposide, its cis-isomer, teniposide and endogenous substances were separated isocratically on a Spherisorb phenyl reversed-phase column. Detection was performed fluorometrically, lambda ex/em = 230/330 nm. Non-protein-bound concentrations were determined after ultrafiltration. The detection limit for etoposide was 10 ng/ml plasma, 25 ng/ml ultrafiltrate and 10 ng/50 x 10(6) cells. The sensitivity of the assay for the cis-lactone was twice as high due to higher fluorescence. The protein binding of the cis-lactone in plasma from ten healthy blood donors was 54.5 +/- 4.8% (mean +/- S.D.). Thus, the free fraction was about ten-fold higher than that of the mother compound. The assay is convenient and sensitive enough for the determination of free and cellular fractions of etoposide.

Antineoplastic Agents↗

Artificial neural networks for recognition of electrocardiographic lead reversal.

Misplacement of electrodes during the recording of an electrocardiogram (ECG) can cause an incorrect interpretation, misdiagnosis, and subsequent lack of proper treatment. The purpose of this study was twofold: (1) to develop artificial neural networks that yield peak sensitivity for the recognition of right/left arm lead reversal at a very high specificity; and (2) to compare the performances of the networks with those of 2 widely used rule-based interpretation programs. The study was based on 11,009 ECGs recorded in patients at an emergency department using computerized electrocardiographs. Each of the ECGs was used to computationally generate an ECG with right/left arm lead reversal. Neural networks were trained to detect ECGs with right/left arm lead reversal. Different networks and rule-based criteria were used depending on the presence or absence of P waves. The networks and the criteria all showed a very high specificity (99.87% to 100%). The neural networks performed better than the rule-based criteria, both when P waves were present (sensitivity 99.1%) or absent (sensitivity 94.5%). The corresponding sensitivities for the best criteria were 93.9% and 39.3%, respectively. An estimated 300 million ECGs are recorded annually in the world. The majority of these recordings are performed using computerized electrocardiographs, which include algorithms for detection of right/left arm lead reversals. In this study, neural networks performed better than conventional algorithms and the differences in sensitivity could result in 100,000 to 400,000 right/left arm lead reversals being detected by networks but not by conventional interpretation programs.

Algorithms↗

Simultaneous quantitation of methotrexate and its two main metabolites in biological fluids by a novel solid-phase extraction procedure using high-performance liquid chromatography.

We have developed an assay for the simultaneous determination of methotrexate (MTX) and its main metabolites, 7-hydroxymethotrexate (7-OHMTX) and 2,4-diamino-N10-methylpteroic acid (DAMPA) in plasma, urine and saliva meeting the requirement of rapidity for routine use in high-dose MTX therapy and the requirement of sensitivity for its potential use in therapeutic drug monitoring in low-dose MTX therapy. Sample preparation is based on solid-phase extraction using C8 Isolute cartridges. Chromatographic separation was achieved with a reversed-phase column (C18), and quantitation by subsequent exposure to UV light of 254 nm, which converted MTX and its two metabolites by photolytic oxidation to fluorescent products. The recoveries of MTX, 7-OHMTX and DAMPA from plasma at 100 nmol/l were 85.8, 91.1 and 102.3%, respectively. The limits of detection for MTX, 7-OHMTX and DAMPA in plasma and saliva were 0.1 nmol/l. In urine the limit of detection was 10 nmol/l for all compounds. The limits of quantitation in plasma and saliva were 0.5 nmol/l for all compounds.

Chromatography, High Pressure Liquid↗

Optimistic explanatory style and the perception of health problems.

Eighty-six adults completed questionnaires that measure explanatory style and perception of health problems. Subjects on the average saw themselves as below average in risk for a variety of health problems. Those subjects with an optimistic explanatory style, who explained bad events with external, unstable, and specific causes, in particular saw themselves as less at risk (r = .30, p < .01). They also believed that they were more able to prevent these health problems. Partialling out perceived preventability reduced to nonsignificance the correlation between explanatory style and perceived risk, which suggests that perceived preventability may mediate this link.

Adaptation, Psychological↗

Methotrexate in juvenile rheumatoid arthritis. Evidence of age dependent pharmacokinetics.

Children with juvenile rheumatoid arthritis (JRA) have been reported to require higher doses (per kg body weight) of methotrexate (MTX) than adults with rheumatoid arthritis to control their disease. The purpose of the present study was to characterise the plasma pharmacokinetics of MTX and its major metabolite, 7-hydroxymethotrexate (7-OHMTX) in children, and to compare the results with those previously obtained in adults. Thirteen patients (age 5-16 y) with JRA (median disease duration 5.5 y) were studied after once weekly oral administration of MTX (median 0.21 mg.kg-1). The analytical method was sufficiently sensitive to permit determination of plasma and urinary concentrations of MTX and 7-OHMTX during the entire dose interval in most of the patients. The dose normalized area under the plasma concentration versus time-curve (AUC) of MTX increased with the age of the children and was lower than previously found in adults. The dose normalized AUC of 7-OHMTX was not dependent on age. No correlation was found between the AUCs of MTX and 7-OHMTX. The results suggest that the age-dependence of the pharmacokinetics of MTX might explain the observation that at least some children require higher doses of MTX than adults to obtain a sufficient therapeutic effect.

Adolescent↗

Increased cation transport in mdr1-gene-expressing K562 cells.

Cation-transport properties were compared in a human leukemic cell line (K562) and its vincristine-selected, mdr1-gene-expressing sublines (K562/Vcr30 and K562/Vcr150) by the capacity of the cells to accumulate the potassium analogue thallium (201Tl). Determination of the time course of thallium accumulation in the absence and presence of ouabain, an inhibitor of sodium-potassium adenosine triphosphatase (ATPase), showed that the initial (at 20 min) rate of ouabain-resistant uptake was about 70% higher in the K562/Vcr30 cells than in the parental line. The maximal rate (Vmax) of ouabain-resistant uptake was 78 mmol/h for K562 cells and 115 mmol/h for K562/Vcr30 cells, and the Michaelis constant (Km) was 0.37 and 0.18 mmol, respectively. Bumetanide (50 microM), a specific inhibitor of ouabain-resistant Na-K-Cl cotransport, inhibited the elevated 201Tl uptake in K562/Vcr150 cells but had no effect on cellular vincristine accumulation. Incubation with different multidrug resistance (MDR)-reversing agents (verapamil as well as cyclosporin A and its analogue PSC833) had no significant effect on 201Tl uptake. Membrane depolarization by an elevation of the potassium concentration in the incubation medium did not affect vincristine accumulation in any cell line, which indicated that the changed drug-transport properties in mdr1-gene-expressing cells were not due to membrane hyperpolarization. It was concluded that P-glycoprotein-positive cells have a more efficient ouabain-resistant cation-transport mechanism than to cells without P-glycoprotein. A functional relationship between this phenomenon and MDR was not identified.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Loss of [3H]kainate and of NMDA-displaceable [3H]glutamate binding sites in brain in thiamine deficiency: results of a quantitative autoradiographic study.

Previous studies suggest that alterations of brain glutamate synthesis and release occur in experimental thiamine deficiency. In order to assess the integrity of post-synaptic glutamatergic receptors in thiamine deficiency, binding sites for [3H]glutamate (displaced by NMDA), [3H]-kainate, and [3H]quisqualate (AMPA sites) were evaluated using Quantitative Receptor Autoradiography in rat brain following 14 days of treatment with the central thiamine antagonist pyrithiamine. Compared to pair-fed controls, brains of symptomatic thiamine-deficient animals contained significantly fewer NMDA-displaceable binding sites in cerebral cortex, medial septum and hippocampus. It has been suggested that NMDA-receptor mediated glutamate excitotoxicity plays a role in the pathogenesis of neuronal loss in thiamine deficiency. If such is the case, the selective loss of NMDA binding sites in cerebral cortex and hippocampus offers a possible explanation for the relative nonvulnerability of these brain regions to pyrithiamine-induced thiamine deficiency. [3H]quisqualate (AMPA) binding sites were unchanged in all brain regions of pyrithiamine-treated rats whereas [3H]kainate sites were significantly reduced in density in medial and lateral thalamus. The decline in these binding sites may be due to neuronal loss in pyrithiamine-induced thiamine deficiency. Alterations of glutamatergic synaptic function involving both NMDA and kainate receptor subclasses could contribute to the pathogenesis of neurological dysfunction in Wernicke's Encephalopathy in humans.

Animals↗

Eosinophil granule proteins in cardiopulmonary bypass with and without heparin coating.

Extracorporeal circulation with exposure of blood to foreign surfaces causes activation of different defense systems, eg, white cells. Several potent mediators are released into plasma, capable of causing harmful effects to different organs, contributing to postoperative morbidity after operations using cardiopulmonary bypass. The eosinophil granulocyte has not previously been investigated in this respect. We studied two of its activation products, eosinophil cationic protein and eosinophil protein X in coronary bypass patients. In 17 control patients, plasma levels of eosinophil cationic protein and eosinophil protein X increased considerably during cardiopulmonary bypass. In 19 patients with heparin-coated cardiopulmonary bypass equipment the levels were significantly reduced, indicating improved biocompatibility of the cardiopulmonary bypass circuit. The heparin-coated surface causes less activation of eosinophils; also released eosinophil cationic protein is bound to the heparinized surface.

Blood Proteins↗

Pharmacokinetics of mitoxantrone, etoposide and cytosine arabinoside in leukemic cells during treatment of acute myelogenous leukemia--relationship to treatment outcome and bone marrow toxicity.

Twenty-seven patients with acute myelogenous leukemia (AML) were given remission induction treatment with mitoxantrone, etoposide and cytosine arabinoside (ara-C). The pharmacokinetics in leukemic blood cells of mitoxantrone, etoposide and the active metabolite of ara-C, ara-CTP, were determined during the first day of treatment. There was a large interpatient variability of the area under the time versus concentration curve (AUC) for all three drugs. On the individual level, there was no correlation between the AUCs of the different drugs. Neither did the AUC of any individual drug nor the calculated total intracellular drug exposure have any association with the outcome of treatment or hematological toxicity, measured as duration of leukopenia/thrombocytopenia. In conclusion, when combination chemotherapy with mitoxantrone, etoposide and ara-C is given to patients with AML, intracellular drug concentrations, achieved after the first dose of each drug, do not seem to be predictive for treatment response or hematological toxicity.

Adult↗

Rheumatoid-factor-reactive sites on CH3 established by overlapping 7-mer peptide epitope analysis.

Polyclonal IgM rheumatoid factors (RF) from ten patients with rheumatoid arthritis and six monoclonal IgM RF were isolated from monomeric IgG affinity columns and studied for their reactivity with the entire CH3 domain of IgG synthesized as overlapping 7-mers using a pin-ELISA assay. All ten polyclonal IgM RF showed similar profiles of reactivity which included peptides with solvent accessible residues PREPQVY (residues 343-349), PQVYTLP (residues 346-352), TLPPRSE (350-356), DGSFFLY (401-407), WQQGNVF (417-423), CSVMHEG (425-430), EGLHNHY (430-436) and KSLSLSP (439-446) of the CH3 domain. Substitution of a neutral glycine or alanine for each residue within these RF-reactive epitopes indicated that tyrosine at position 349, prolines at 343, 346 and 352, glutamine 347, valine 348, threonine 350, leucine 351, arginine 354, aspartic acid 401, tyrosine 407, serine 426, histidine 429, leucine 432, tyrosine 436 and lysine 439 represented important single amino acids within CH3 for RF reactivity. Regions of CH3 primary sequence with and without the single allotype-specific amino acid substitutions of glycine for alanine 431 (Gmx) or aspartic acid for glutamic acid (356) and leucine for methionine (358) (Gma) often showed considerable differences in reactivity with individual polyclonal and monoclonal RF. However, these differences in RF reactivity did not correlate with the individual anti-Gm RF specificity. Assays using monoclonal IgM RF produced from RA synovial B cells or peripheral blood B cells frequently showed a much more restricted spectrum of reactive CH3 epitopes. 7-mer peptides representing RF-reactive sites on CH3 preincubated with polyclonal IgM RF showed strong inhibition (55-66%) of RF binding to whole IgG on the ELISA plate. These studies indicate that it is possible to define portions of the IgG CH3 domain participating in the reaction with IgM RF using reactive epitope-mapping with sequential linear peptides derived from the primary IgG CH3 sequence.

Amino Acid Sequence↗

Coping and depressive symptoms among Iranian students.

Five hundred sixty-eight junior and senior high school students in Tehran, Iran, completed measures of depressive symptoms and coping styles with regard to a difficult academic event. On average, the Iranian students reported more depressive symptoms than the U.S. adolescents did. Consistent with the results of studies with U.S. samples, the students who had an active coping style reported fewer depressive symptoms than the students who had a passive coping style did. These findings suggest that the Western construct of personal control functioned somewhat similarly in this non-Western sample.

Adaptation, Psychological↗

A moving experience: reconfiguring a special care unit for Alzheimer's patients.

Eight years after opening, the patient mix on a 64-bed Special Care Unit (SCU) for Alzheimer's residents had become too diverse to allow the intended programming to be carried out. The unit was carefully reconfigured with residents moving within, to, and from the unit. Successful moves typically involve residents in pre-move planning and preparation activities, but since this isn't feasible with dementia patients, extensive planning, training, and preparation of staff substituted for the involvement of residents. The move met its objectives: resident mix and programming are back to the original intent, and quality of life has improved. Improved discharge policies maintain homogeneity of resident levels on the unit. The change produced unexpected changes, and staff, particularly the Certified Nursing Assistants (CNAs), had to make immediate adjustments. Greater CNA involvement is recommended.

Activities of Daily Living↗