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Biomedical subjects

D Carter

Publications and source records attributed to D Carter.

At least 109 records · Page 6Linked to original sources
PubMed1996

Trifluoperazine as a modulator of multidrug resistance in refractory breast cancer.

Overexpression of P-glycoprotein (P-gp) has been implicated as the mechanism of multidrug resistance (MDR) in a number of human cancers, including carcinoma of the breast. We conducted a clinical trial to determine whether the P-gp inhibitor, trifluoperazine, could sensitize patients with refractory breast cancer to vinblastine chemotherapy. Adult patients with histologically confirmed, refractory, advanced breast cancer were treated with vinblastine at a dose of 1.7 mg/m2 per day by continuous infusion for five consecutive days. Patients who did not respond after two cycles were subsequently treated with vinblastine plus trifluoperazine at a dose of 8 mg twice daily during the five days of chemotherapy. In patients from whom tumor samples were available, the expression of P-gp was determined by immunocytochemistry. Of 35 patients enrolled, 30 were evaluable, 2 of whom (7%) achieved a partial response to vinblastine alone. Among the 16 patients treated with vinblastine plus trifluoperazine there was one response (6%) which lasted 16 weeks. Tumor samples were available from 16 patients, and 14 (87%) were immunoreactive for P-pg. P_pg expression was detected both in the patient who responded to vinblastine plus trifluoperazine and in one of the two patients who responded to vinblastine alone. Continuous-infusion vinblastine demonstrated limited activity in this study. Furthermore, trifluoperazine did not effectively reverse established resistance to vinblastine. This failure may be related the presence of multiple mechanisms of drug resistance in the heavily pretreated population, or because ineffective concentrations of the modulator were achieved in vivo. Future studies should evaluate more effective modulators, and attempt to reverse MDR earlier in the course of treatment, before other forms of resistance can develop.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1996

Functional assay for HER-2/neu demonstrates active signalling in a minority of HER-2/neu-overexpressing invasive human breast tumours.

Overexpression of HER-2/neu in human breast carcinomas correlates with poor prognosis, although its strength as a prognostic indicator varies widely in different reports. Variability may be due to active signalling by HER-2/neu in a subset of the tumours in which it is overexpressed. To study this hypothesis, we have developed an activation state-specific anti-HER-2/neu monoclonal antibody. In this report, we use this antibody to analyse the signalling status of HER-2/neu in a large series of invasive breast carcinomas. Overexpression of HER-2/neu was detected in 9% of 223 cases. Of the cases demonstrating overexpression, active signalling by HER-2/neu was detected in only 35%. The clinicopathological characteristics of these cases are described. This functional assay is predicted to improve the utility of HER-2/ neu as a prognostic indicator.

Antibodies, Monoclonal↗
PubMed1996

Crystal structures of Toxoplasma gondii HGXPRTase reveal the catalytic role of a long flexible loop.

Crystal structures of substrate-free and XMP-soaked hypoxanthine-guanine-xanthine phosphoribosyltransferase (HGXPRTase) of the opportunistic pathogen Toxoplasma gondii have been determined to 2.4 and 2.9 A resolution, respectively. HGXPRTase displays the conserved PRTase fold. In the structure of the enzyme bound to its product, a long flexible loop (residues 115-126) is located away from the active site. Comparison to the substrate-free structure reveals a striking relocation of the loop, which is poised to cover the catalytic pocket, thus providing a mechanism by which the HG(X)PRTases shield their oxocarbonium transition states from nucleophilic attack by the bulk solvent. The conserved Ser 117-Tyr 118 dipeptide within the loop is brought to the active site, completing the ensemble of catalytic residues.

Animals↗
PubMed1996

Halothane acts as a partial agonist of the alpha6 beta2 gamma2S GABA(A)receptor.

Whole-cell patch clamp recording was performed on human embryonic kidney 293 cells stably transfected with rat cDNAs for the alpha6, beta2, and gamma2S subunits of the GABA(A) receptor. The volatile anesthetic halothane directly activated a current in the absence of the ligand gamma-aminobutyric acid (GABA). Both the current amplitude and the rate of desensitization increased in a dose-dependent manner with an EC50 of 1.0+/-0.2 mM and a Hill coefficient (nh) of 1.5+/-0.1. The EC50 and nh for GABA to activate the receptor were 1.0+/-0.3 microM and 1.4+/-0.2, respectively. The peak amplitude of the halothane-activated current was about 4% of the maximal GABA response, which was not changed when the concentration of Ca2+ in the external solution was decreased from 2 mM to 0.2 mM. The reversal potential of both halothane- and GABA-activated currents changed with the external Cl- concentration as predicted by the Nernst equation for chloride ions. The halothane- and GABA-activated currents were blocked by both the noncompetitive GABA(A) receptor antagonist picrotoxin and the competitive GABA(A) receptor antagonist bicuculline. Schild plots revealed that the K(i)s for bicuculline to competitively antagonize the currents activated by halothane and GABA are similar (0.69 and 0.72 microM, respectively). These results indicate that halothane activates the alpha6 beta2 gamma2S GABA(A) receptor to induce a current similar to the GABA-induced current.

Animals↗
PubMed1996

Reassessing medical students' willingness to treat HIV-infected patients.

BACKGROUND: Past research has demonstrated that some physicians do not feel obligated to care for patients infected with the human immunodeficiency virus (HIV). This study sought to characterize the attitudes that affect medical students' willingness to treat HIV-infected patients and to determine which attitudes are most amenable to intervention. METHOD: All 414 matriculating medical students at three Chicago schools were surveyed in 1994. After reliability-testing the attitudinal scales, the authors created a predictive model by using multiple regression analysis. RESULTS: A total of 297 (72%) of the matriculating students responded. Ninety-two percent of the students agreed that patients with HIV would be welcome in their medical practices. As in past studies, a strong sense of professional obligation was associated with willingness to treat, and fear of infection and homophobia were associated with decreased willingness to treat. The authors' measure of concern about social stigma was also associated with decreased willingness. Together, these factors accounted for 53% of the variance in the Willingness to Treat scale. CONCLUSION: In addition to confirming the predictors found in previous studies, this study demonstrated that perceived social stigma is a measurable predictor of decreased willingness to treat (with the understanding that willingness to treat is influenced by both personal and social factors). A comprehensive approach, not only in curriculum design but also in admission and policy, might better prepare students to treat HIV-infected patients.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Stereotaxic core needle biopsy of breast microcalcifications: correlation of target accuracy and diagnosis with lesion size.

PURPOSE: To determine if lesion size or number of calcifications affects the ability to obtain microcalcifications or a specific histologic diagnosis at stereotaxic core needle biopsy (SCNB). MATERIALS AND METHODS: Mammographic findings and histopathologic reports of 138 lesions in 124 patients (aged 30-87 years; mean age, 56.2 years) who underwent SCNB of calcifications were reviewed. Calcifications in the specimen and attainment of a specific diagnosis were correlated with lesion size and number of calcifications. RESULTS: Calcifications were obtained in 118 cases (86%). A specific diagnosis was reported in 72 cases (52%). Differences in retrieval of calcifications or ability to establish a specific diagnosis with decreasing lesion size or decreasing number of calcifications were not statistically significant. Attainment of a specific diagnosis was significantly related to retrieval of calcifications (P<.005). CONCLUSION: SCNB was successful in obtaining calcifications in a high percentage of cases regardless of lesion size or number of calcifications. When calcifications were retrieved, a specific diagnosis was attained in most cases (72 of 118).

Adult↗
PubMed1996

Anterior pituitary vasoactive intestinal peptide mRNA is colocalised with prolactin mRNA in hyperoestrogenised rats.

It is well established that oestrogens can stimulate prolactin (PRL) secretion as well as the expression of the vasoactive intestinal peptide (VIP) gene whose product is also a potent PRL secretagogue. Previous evidence has supported both an autocrine and a paracrine role for pituitary VIP in PRL release in vitro; however, the cellular origin of VIP in pituitary tissue still remains poorly defined. In these studies, we have demonstrated by in situ hybridisation that VIP RNA is detected in the anterior pituitaries of chronically hyperoestrogenised rats, but not in those of untreated animals. Using a double-probe labelling procedure, VIP RNA has been shown to be present in a subpopulation of PRL-producing cells, while colocalisation of VIP and GH RNA was not observed. VIP gene expression in the rat anterior pituitary gland was characterised by the presence of two alternatively polyadenylated transcripts, 1.7 kb and 1.0 kb in size. We have generated a probe specific for the 1.7 kb transcript and double-labelling studies also showed definitive colocalisation with PRL mRNA. Our results demonstrating the presence of VIP RNA in PRL-producing cells thus suggest that VIP may play an autocrine role in PRL hypersecretion under conditions of oestrogen-induced hyperplasia.

Animals↗
PubMed1996

Macrophage activation with phorbol myristate acetate is associated with cellular lipid peroxidation.

The present study analyzed the association between two major processes that occur during atherogenesis: macrophage activation and peroxidation of the cellular lipids. Macrophage activation was achieved by cell incubation with phorbol myristate acetate (PMA) for 24 h at 37 degrees C, and was determined as: a) PMA concentration-dependent increment in the release of beta-glucuronidase, b) decrement in the procoagulant activity, and c) increment in the release of superoxides from the cells. PMA-induced macrophage activation was accompanied by cellular lipid peroxidation, as measured by increased formation of lipid peroxides (by 435%), thiobarbituric acid-reactive substances (TBARS) (by 26%), and conjugated dienes (by 77%) in comparison with control nonactivated cells. The maximal effect of PMA on lipid peroxidation in macrophages was achieved within 1 h of cell incubation with PMA. This effect was demonstrated in J-774 A.1 macrophages, as well as in mouse peritoneal, macrophages, U-937 and P-338 macrophage cell lines. Upon incubation of macrophages with 4 alpha phorbol 12, 13 didecanoate, an analogue of PMA (which, unlike PMA, does not activate protein kinase C), macrophage lipid peroxidation was lower compared with PMA, suggesting a role for protein kinase C in cellular lipid peroxidation. Analysis of cellular antioxidants under PMA-induced macrophage activation revealed a decrease of 50% in total glutathione, and in catalase levels following treatment with 100 nM PMA compared with control cells. In summary, our study demonstrates that PMA-activated macrophages undergo significant lipid peroxidation, which is associated with reduced activity of the cellular antioxidative system.

Animals↗
PubMed1995

Single cell analysis of cytokine gene coexpression during CD4+ T-cell phenotype development.

CD4+ T cells from alpha beta-T-cell receptor transgenic mice were analyzed for coexpression of cytokine mRNAs during phenotype development using a double-label in situ hybridization technique. T cells that produced cytokines in the primary response were a fraction of the activated population, and only a minority of the cytokine-positive cells coexpressed two cytokines. In secondary responses, frequencies of double-positive cells increased, although they remained a minority of the total. Of the cytokine pairs examined, interleukin (IL)-4 and IL-5 were the most frequently coexpressed. IL-4 and interferon gamma showed the greatest tendency toward segregation of expression, being rarely coexpressed after the primary stimulation. These data indicate that there is significant heterogeneity of cytokine gene expression by individual CD4+ T cells during early antigenic responses. Coexpression of any pairs of cytokines, much less Th1 and Th2 cytokines, is generally the exception. The Th0 phenotype is a population phenotype rather than an individual cell phenotype.

Animals↗
PubMed1995

Characterization of a postjunctional 5-HT receptor mediating relaxation of guinea-pig isolated ileum.

The 5-HT receptor mediating postjunctional relaxation of precontracted guinea-pig ileum has been characterized using several agonists and antagonists. Substance P precontracted tissues were potently relaxed by 5-HT (5-hydroxytryptamine, serotonin), 5-CT (5-carboxamidotryptamine) and several other indoles. The rank order of potency, with pEC50 values in parentheses, was 5-CT (7.6) > 5-methoxytryptamine (5.7) > 5-HT (5.5) > alpha-methyl-5-HT (4.7) > 2-methyl-5-HT (< 4.0) = tryptamine (< 4.0) = N,N-dimethyl-tryptamine (< 4.0) = N,N-dimethyl-5-HT (< 4.0) = dipropyl-5-CT (< 4.0) = sumatriptan (< 4.0). 8-OH-DPAT (8-hydroxy-2-(di-n-propylamino)-tetralin) acted as a potent (6.3), but partial, agonist with respect to 5-HT. The responses to 5-CT were antagonized by several compounds with the following rank order of affinity, with pKB values in parentheses: LSD (lysergic acid diethylamide; 8.1) = mesulergine (7.8) > methysergide (7.6) = spiperone (7.6) > clozapine (7.3) >> (-)-pindolol (< 6.0) > ketanserin (< 6.0) = ondansetron (< 6.0) = GR 113808 ([1-(2-methane-sulphonamido-ethyl)-piperidin-4-yl]-methyl-in dole-3- carboxylate maleate; < 6.0). The relaxant responses to 5-HT were also resistant to tetrodotoxin. These data are consistent with a functional 5-HT receptor, mediating relaxation of guinea-pig ileum, which exhibits an operational profile similar to that of the cloned guinea-pig 5-ht7 receptor. This study, therefore, provides evidence for a functional correlate of the 5-ht7 gene product.

5-Methoxytryptamine↗
PubMed1995

Isolation and characterization of an immortal neoplastic cell line (KS Y-1) from AIDS-associated Kaposi's sarcoma.

BACKGROUND: Acquired immunodeficiency syndrome (AIDS) is associated with the occurrence of tumors such as Kaposi's sarcoma (KS) and B-cell lymphoma. However, no evidence exists yet that human immunodeficiency virus type 1, the causative agent of AIDS, is directly responsible for cell transformation. It is also not clear whether KS lesions, which are of complex cellularity, contain tumor cells derived from a true monoclonal malignancy (originating from a single malignant cell) or whether the lesions are just polyclonally hyperplastic in nature (containing increased numbers of normal cells). In fact, the presence of malignant KS cells has never been unequivocally shown in AIDS-associated KS, and previously isolated KS cell cultures were not immortal or malignant. PURPOSE: Our purpose was to (a) utilize technology that could facilitate isolation and enrichment of tumor cells from AIDS-associated KS lesions, (b) establish and characterize an immortalized KS cell line, and (c) test the malignant potential of such a cell line in animal models. METHODS: Mononuclear cells were isolated from 2.5 L of pleural effusion from an AIDS-associated KS patient. T-lymphocytes, B-lymphocytes, monocytes/macrophages, and fibroblasts were removed by a cytotoxicity method, using monoclonal antibodies specific for cell surface markers and baby rabbit complement. KS cells were cultured in the absence of exogenous growth factors in an effort to select for transformed cells capable of self-sustained growth. The karyotype abnormalities were detected by G-banded marker studies, and phenotypic markers were determined by indirect immunofluorescence and immunocytochemical methods. Beige nude XID and severe combined immunodeficient mice were used to evaluate the tumorigenic, angiogenic, and metastatic potentials of cells. RESULTS: An immortalized cell line, named KS Y-1, was isolated. Its phenotype is similar to that of endothelial cells with positive CD34 and CD31 markers. Tetraploid chromosomal abnormalities were found in primary fresh KS tissue and in vitro passages of KS Y-1 cells. These cells promoted tumorigenesis, angiogenesis, and metastasis in immunodeficient mice. Tumors produced at the site of injection as well as metastases in the lung, spleen, pancreas, gastrointestinal tract, and skin showed a human tetraploid karyotype. KS Y-1 cells show high plating efficiency. CONCLUSION: The KS Y-1 cell line could be the first evidence of AIDS-associated KS cells that may develop clones with an indisputable malignant cell phenotype. IMPLICATIONS: KS Y-1 cells in the in vivo mouse model can be used to study the effects of therapeutic compounds in advanced KS.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Fluoxetine in the treatment of premenstrual dysphoria. Canadian Fluoxetine/Premenstrual Dysphoria Collaborative Study Group.

BACKGROUND: Premenstrual dysphoria shares certain features with depression and anxiety states, which have been linked to serotonergic dysregulation. We evaluated the efficacy and safety of fluoxetine (which selectively inhibits the reuptake of serotonin) in the treatment of premenstrual dysphoria. METHODS: The trial consisted of a single-blind, placebo washout period lasting two menstrual cycles, followed by a randomized, double-blind, placebo-controlled trial of fluoxetine at a dose of either 20 mg or 60 mg per day or placebo for six menstrual cycles. Healthy women meeting criteria for what was then called late-luteal-phase dysphoric disorder were recruited at seven university-affiliated women's health clinics in Canada. The primary outcome measure consisted of visual-analogue scales for tension, irritability, and dysphoria during the late luteal phase of each cycle. RESULTS: Of 405 women enrolled in the placebo washout period, 313 subsequently entered the randomized phase of the study, which lasted six menstrual cycles, and 180 completed it. Fluoxetine at a dose of 20 or 60 mg per day was significantly superior to placebo in reducing symptoms of tension, irritability, and dysphoria, as measured by the visual-analogue scales (P < 0.001). The women who received 60 mg of fluoxetine per day reported significantly more side effects than those who received 20 mg per day or placebo (P < 0.001). CONCLUSIONS: Fluoxetine is useful in the treatment of premenstrual dysphoria. Treatment with fluoxetine at a dose of 20 mg per day reduces the potential for side effects while maximizing therapeutic efficacy.

Adolescent↗
PubMed1995

Microsatellite instability in ovarian neoplasms.

Microsatellite instability has been observed in a variety of sporadic malignancies, but its existence in sporadic ovarian cancer has been the subject of conflicting reports. We have performed a polymerase chain reaction-based microsatellite analysis of DNAs extracted from the neoplastic and non-neoplastic tissues of 41 ovarian cancer patients. Tumour-associated alterations were observed in seven (17%) of these cases. Clinicopathological correlations revealed that: (1) alterations among tumours classified as serous adenocarcinomas occurred with relatively low frequency (2/24 or 8%); (2) most of the tumours with microsatellite alterations (5/7 or 71%) were of less common histopathological types (epithelial subtypes such as endometrioid and mixed serous and mucinous, or non-epithelial types such as malignant mixed Müllerian or germ cell tumours); (3) tumour-associated alterations were observed in 3/4 (75%) of the patients with stage I tumours vs 4/37 (11%) of the patients with stage II, III and IV tumours (P = 0.01); (4) tumour-associated microsatellite instability was found to occur with similar frequencies among patients with and without clinical features suggestive of familial disease, including positive family history, early onset, or multiple primary tumours. In summary, we have observed microsatellite alterations in the neoplastic tissues of ovarian cancer patients with diverse genetic backgrounds and clinicopathological features. The pattern of alterations is consistent with the possibility that multiple mechanisms may be responsible for microsatellite instability in ovarian neoplasms.

Adult↗
PubMed1995

Detecting residual tumor after excisional biopsy of impalpable breast carcinoma: efficacy of comparing preoperative mammograms with radiographs of the biopsy specimen.

OBJECTIVE: The purpose of this study was to ascertain whether a comparison of preoperative mammograms with radiographs of biopsy specimens is useful for determining the presence of residual breast tumor after an initial excision of impalpable breast cancer. MATERIALS AND METHODS: Radiographs of tissue specimens obtained at the initial biopsy of 125 impalpable breast cancers were compared with the preoperative mammograms to determine if the lesion seen on the mammogram was completely excised. All tumors were impalpable, necessitating preoperative wire localization. The biopsies were usually excisional, and no special efforts were made to remove additional surrounding tissue. Specimen radiographs were rated as showing no residual tumor if the lesion appeared to be completely excised, showing residual tumor if the lesion did not appear to be completely removed, or indeterminate for residual tumor if adequacy of excision was uncertain. The presence or absence of tumor at the margins of the surgical specimen was determined by histologic examination. These results were correlated with the presence or absence of residual breast cancer at subsequent mastectomy (n = 71) or reexcision (n = 54). RESULTS: The specimen radiograph showed complete excision of the mammographic lesion in 79 (63%) of the 125 cases. Tumor was found at mastectomy or reexcision in 35 of these cases, giving a false-negative rate for residual tumor of 44%. Incomplete excision was shown on 39 specimen radiographs. Eight of these 39 had no residual tumor, giving a false-positive rate of 21%. The sensitivity of the specimen radiograph for predicting the presence of residual tumor was 49%, specificity was 77%, and overall accuracy was 62%. The accuracy of pathologic examination of the margins of the biopsy specimen for predicting residual breast cancer was 58%. The specimen radiograph alone correctly identified 18 cases of residual tumor in which biopsy margins were indeterminate or negative for the presence of tumor. CONCLUSION: The specimen radiograph is not reliable enough to be used alone for determining the presence or absence of residual breast cancer after the initial excision of impalpable breast cancer. However, it can be of value in predicting the presence of residual tumor in those cases in which results of pathologic examination of biopsy specimen margins are either indeterminate or negative for the presence of tumor but the specimen radiograph shows incomplete excision of the mammographic lesion.

Biopsy↗
PubMed1995

Administration of a perfluorochemical emulsion plus carbogen breathing does not alter radiation pneumonitis.

The effects of treatment with a perfluorochemical emulsion plus carbogen on radiation pneumonitis were examined in a rat model system. Rats received thoracic irradiation (15 Gy) and radiation reactions in the lungs were assessed 25 and 35 days later using bronchoalveolar lavage and histologic assessments. The irradiated lungs showed the expected evidence of acute radiation pneumonitis, including protein leaks and also alveolar infiltrates and interstitial infiltrates. Administration of a perfluoro-chemical emulsion (Fluosol; 15 ml/kg) plus carbogen breathing for 30 min before and during irradiation did not enhance the reactions seen in the irradiated lungs.

Animals↗