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Biomedical subjects

D J Sullivan

Publications and source records attributed to D J Sullivan.

At least 55 records · Page 3Linked to original sources

Melatonin and a 21-aminosteroid attenuate shock after hemorrhage but differentially affect serum cytokines.

UNLABELLED: Melatonin and 21-aminosteroids (lazaroids) are potent antioxidants and may attenuate the increased membrane permeability associated with profound shock. Our purpose was to test the effect of melatonin and a lazaroid (U74389-G) on cytokine production and fluid requirements after shock. METHODS: Male C3H/HeN mice, 20-25 g, were hemorrhaged via a femoral artery catheter to a mean arterial pressure of 35 +/- 5 mm Hg, which was maintained for 1 hr, and then resuscitated with shed blood and crystalloid (2x vol of shed blood). Experimental mice received melatonin at 10 or 50 mg/kg, U74389-G at 3 mg/kg, or vehicle i.v. upon resuscitation, and blood was returned at 0.1 cc/min and crystalloid at 0.05 cc/min. The percentage of total crystalloid required to reach stabilization (mean arterial pressure remaining within 2 mm Hg for 5 min) was recorded. Animals were sacrificed at 1 hr postshock. Serum and anti-CD3-stimulated splenocyte culture supernatants were assayed for interleukin-6 (IL-6) and gamma-IFN by ELISA. RESULTS: Mice receiving lazaroid or melatonin (50 mg/kg) required significantly less fluid to reach stabilization, with lazaroid-treated animals requiring 24 +/- 1% and melatonin-treated animals requiring 28 +/- 2% of total crystalloid compared to 40 +/- 3% for untreated animals. Melatonin-treated mice (50 mg/kg) had lower serum IL-6 levels (368 +/- 154 vs 1078 +/- 146 pg/ml) and lazaroid-treated mice had lower gamma-IFN levels (7 +/- 6 vs 52 +/- 15 pg/ml) compared to those of the untreated group (P < 0.05). There were no differences in splenocyte cytokine production. CONCLUSIONS: Treatment with lazaroid and melatonin both reduced postshock fluid requirements. Melatonin reduced serum IL-6 levels, while lazaroid reduced serum gamma-IFN levels, suggesting different mechanisms of action.

Animals↗

Plasmodium hemozoin formation mediated by histidine-rich proteins.

The digestive vacuole of Plasmodium falciparum is the site of hemoglobin degradation, heme polymerization into crystalline hemozoin, and antimalarial drug accumulation. Antibodies identified histidine-rich protein II (HRP II) in purified digestive vacuoles. Recombinant or native HRP II promoted the formation of hemozoin, and chloroquine inhibited the reaction. The related HRP III also polymerized heme, and an additional HRP was identified in vacuoles. It is proposed that after secretion by the parasite into the host erythrocyte cytosol, HRPs are brought into the acidic digestive vacuole along with hemoglobin. After hemoglobin proteolysis, HRPs bind the liberated heme and mediate hemozoin formation.

Amino Acid Sequence↗

Molecular genetic approaches to identification, epidemiology and taxonomy of non-albicans Candida species.

The reported incidence of fungal infections associated with non-albicans species from the Candida genus is increasing. Most of these infections occur in immunocompromised patients, particularly those infected with HIV. The role of molecular genetic techniques alongside the existing techniques for the identification and typing of these organisms is discussed. Species-specific genomic DNA fragments cloned from C. tropicalis and C. krusei have been developed for identification and strain typing. Analysis of tRNA profiles has been shown to be effective for the identification of C. glabrata, C. guilliermondii, C. parapsilosis and C. tropicalis. A PCR method employing primers complimentary to large ribosomal subunit genes and the lanosterol-alpha-demethylase gene has been applied for several species, including C. glabrata, C. krusei and C. tropicalis. Strain typing by comparison of genomic DNA fingerprints has been demonstrated for C. tropicalis and C. krusei following hybridisation analysis with species-specific probes. Synthetic oligonucleotide probes--which do not have to be species-specific and which can detect minor polymorphisms--have also been used for strain typing of isolates of several non-albicans species. Random amplification of polymorphic DNA (RAPD) has also been used for analysis of C. glabrata, C. lusitaniae and C. tropicalis isolates. The potential for the application of these and other techniques to Candida spp. taxonomy--and the example of a recently discovered novel species, C. dubliniensis--is discussed.

Candida↗

Genomic DNA fingerprinting of clinical isolates of Helicobacter pylori using short oligonucleotide probes containing repetitive sequences.

The ability of oligonucleotide probes containing short repetitive sequence motifs to differentiate between isolates of Helicobacter pylori was investigated. Genomic DNA preparations from H. pylori were digested with the restriction enzyme HindIII, electrophoresed in agarose gels and transferred to nylon filters. Five separate oligonucleotide probes were tested for hybridization sequentially to fingerprint the digested DNA from a panel of 29 clinical isolates and one type strain of H. pylori, and their relative discriminatory abilities were assessed. Four probes, (GACA)4, (GT)8, (GTG)5 and (GGAT)4, were each shown to yield highly informative hybridization band profiles allowing differentiation of H. pylori isolates. The DNA fingerprints of individual isolates obtained with each probe were distinct and reproducible. Direct comparison with ribotyping revealed that oligonucleotide fingerprinting had far superior discriminatory power. Computer-assisted similarity analysis of (GGAT)4-generated hybridization profiles of pairwise combinations of H. pylori isolates revealed that there was no correlation between ribotype and oligonucleotide fingerprint patterns. The results of this study demonstrate that oligonucleotide probes containing microsatellite sequences provide a new and powerful tool for isolate discrimination of H. pylori.

DNA Fingerprinting↗

Effects of viscosity and surface moisture on bond strengths of resin-modified glass ionomers.

PURPOSE: To evaluate the effects of surface moisture and material viscosity on the shear bond strength of resin-modified glass ionomers to dentin. MATERIALS AND METHODS: Sixty human teeth were mounted in phenolic rings and ground to obtain flat facial and lingual dentin surfaces. The specimens were assigned to six treatment groups. Three groups were first conditioned with 10% polyacrylic acid. On one surface of each specimen, dentin was left visibly moist prior to application of the restorative material. On the opposite surface the dentin was dried, but not desiccated, after conditioning. For these three groups, Fuji II LC resin-modified glass ionomer was mixed at powder/liquid (P/L) ratios of 1.4, 3.0 and 3.6 and applied to the conditioned dentin in 2.5 mm diameter molds. The other three groups were treated with Vitremer primer. One surface of each specimen was "dry" and one surface was "moist" before primer application. Vitremer restorative material was mixed at P/L ratios of 2.2, 2.5 and 2.8 and applied to the primed surfaces. Shear bond strengths were measured using a universal testing machine. Data were subjected to three-way ANOVA and Tukey's multiple comparisons test. RESULTS: Mean shear bond strengths of the two materials ranged from 6.9 to 10.4 MPa and varied little regardless of the viscosity of the materials or the degree of surface moistness. The differences among viscosities and surface moistness were not statistically significant. IN this in vitro study, the shear bond strengths of two resin-modified glass ionomers were unaffected by the viscosity of the materials and the surface moisture of the dentin substrate.

Analysis of Variance↗

Candida dubliniensis sp. nov.: phenotypic and molecular characterization of a novel species associated with oral candidosis in HIV-infected individuals.

Atypical oral Candida isolates were recovered from 60 HIV-infected and three HIV-negative individuals. These organisms were germ-tube-positive and produced abundant chlamydospores which were frequently arranged in triplets or in contiguous pairs. They belonged to C. albicans serotype A and had atypical carbohydrate assimilation profiles. Fingerprinting the genomic DNA of a selection of these organisms with the C. albicans-specific probe 27A and five separate oligonucleotides, homologous to eukaryotic microsatellite repeat sequences, demonstrated that they had a very distinct genomic organization compared to C. albicans and C. stellatoidea. This was further established by random amplified polymorphic DNA (RAPD) and karyotype analysis. Comparison of 500 bp of the V3 variable region of the large ribosomal subunit genes from nine atypical isolates and the corresponding sequences determined from C. albicans, C. stellatoidea, C. tropicalis, C. parapsilosis, C. glabrata, C. kefyr and C. krusei showed that they atypical organisms formed a homogeneous cluster (100% similarity) that was significantly different from the other Candida species analysed, but was most closely related to C. albicans and C. stellatoidea. These genetic data combined with the phenotypic characteristics of these atypical organisms strongly suggest that they constitute a novel species within the genus Candida for which the name Candida dubliniensis is proposed.

AIDS-Related Opportunistic Infections↗

Molecular analysis of Helicobacter pylori populations in antral biopsies from individual patients using randomly amplified polymorphic DNA (RAPD) fingerprinting.

In the present study, randomly amplified polymorphic DNA (RAPD) fingerprinting has been used to analyse multiple single colony isolates of Helicobacter pylori from antral biopsies in an attempt to ascertain whether or not multiple strains are present in individual patients using single biopsy samples. The RAPD fingerprints derived from single colonies obtained from the same biopsy specimen were in all cases indistinguishable. The previously noted heterogeneity between H. pylori strains from different individuals was confirmed. RAPD fingerprinting, combined with a simple method of template preparation, was shown to be an excellent method for H. pylori strain differentiation. The results of this study indicate that the H. pylori population is homogeneous in individual patients at a single gastric site.

Bacterial Typing Techniques↗

Involvement of multiple Cryptococcus neoformans strains in a single episode of cryptococcosis and reinfection with novel strains in recurrent infection demonstrated by random amplification of polymorphic DNA and DNA fingerprinting.

We compared the abilities of random amplification of polymorphic DNA and DNA fingerprinting, with oligonucleotide probes, to type five pairs of Cryptococcus neoformans clinical isolates recovered from five separate human immunodeficiency virus-positive patients in London, England. The two techniques had comparable discriminatory abilities when applied to these isolates. A total of eight different isolate types were demonstrated in these patients. No isolate type was observed in more than one patient. Two of the isolate pairs recovered from single episodes of cryptococcosis within 1 day of each other were genotypically indistinguishable by both methods. The other three pairs of isolates were all distinguishable. One of these isolate pairs was obtained from a single episode of cryptococcosis, while the other two were obtained from recurrent infections. These results indicate that multiple strains of C. neoformans may be responsible for a single episode of cryptococcosis and that recurrent infection may occur as a result of reinfection with a novel strain.

Base Sequence↗

Non-congruent relationships between variation in emm gene sequences and the population genetic structure of group A streptococci.

To examine the molecular population genetics of the M protein family of Streptococcus pyogenes (group A Streptococcus), the 5' regions of polymerase chain reaction-amplified emm products from 79 M serotypes were sequenced and the phylogeny was compared to estimates of overall genetic relationships among strains determined by multilocus enzyme electrophoresis. Although the 5' emm sequences from several strains designated as distinct M types were identical or almost identical, the overall pattern is characterized by very extensive variation. The composition of distinct emm sequence clusters generally parallels the ability of strains to express serum opacity factor and in some cases historical associations of certain M types with acute rheumatic fever, but not with M types classified as nephritogenic. For many strains there is a lack of congruency between variation in 5' emm sequences and estimates of overall chromosomal relationships, which is undoubtedly due to horizontal transfer and recombination of emm sequences. The results of these studies provide insights into the nature and extent of emm sequence variation and describe how this variation 'maps' onto the population genetic structure of extant S. pyogenes lineages. The complexity of emm sequence and streptococcal cell lineage relationships revealed by this analysis has significant implications for understanding evolutionary events generating strain diversity and the epidemiology of S. pyogenes diseases.

Amino Acid Sequence↗

Recombinant human erythropoietin treatment: investigational new drug protocol for the anemia of the acquired immunodeficiency syndrome. Overall results.

BACKGROUND: Anemia associated with human immunodeficiency virus infection may be due to reduced erythropoiesis related to the disease itself or to concomitant medications (eg, zidovudine). Clinical studies have shown recombinant human erythropoietin (r-HuEPO) to be effective in correcting the anemia of zidovudine-treated patients infected with human immunodeficiency virus with baseline serum erythropoietin levels of 500 U/L or less. A treatment investigational new drug protocol that provided r-HuEPO to 1943 anemic patients with the acquired immunodeficiency syndrome was studied. METHODS: Enrollment criteria included a clinical diagnosis of acquired immunodeficiency syndrome, serum erythropoietin level of 500 U/L or less, hematocrit less than 0.300, and age of 12 years or more. The initial r-HuEPO dosage was 4000 U subcutaneously for 6 days each week. On the basis of response, the r-HuEPO dosage could be increased sequentially to 8000 U subcutaneously for 6 days per week. This was an open-label multicenter treatment protocol. A total of 1943 patients were treated by 510 investigators. Efficacy evaluations were based on the effect of r-HuEPO on hematocrit levels and transfusion requirements relative to baseline. Adverse experiences that were considered by the investigator to be possibly related to r-HuEPO therapy were collected to assess safety. RESULTS: Therapy with r-HuEPO resulted in an increase in mean hematocrit from a baseline of 0.280 to 0.331 at week 12 and 0.338 at week 24. This increase was sustained throughout the course of the study to week 54. Overall, 40% of patients (769/1943) required at least one transfusion in the 6-week interval immediately preceding study entry (baseline). After 12 and 24 weeks of r-HuEPO treatment, corresponding percentages were 22% (311/1387) and 18% (119/650), respectively. Response to therapy, defined as an increase of 0.060 from baseline in hematocrit, with no transfusions within 28 days before achieving that hematocrit, was observed in 44% of patients. Adverse experiences not clearly related to acquired immunodeficiency syndrome were reported by 11% of patients. CONCLUSION: In a study population of 1943 anemic patients with acquired immunodeficiency syndrome treated with r-HuEPO, the hematocrit increased and blood transfusion requirements decreased. Therapy with r-HuEPO was well tolerated.

Acquired Immunodeficiency Syndrome↗

Oral Candida in HIV infection and AIDS: new perspectives/new approaches.

Oral candidosis has become an increasingly important problem in HIV-infected individuals. At present, the small body of published literature on the characterization of the Candida strains and species found in HIV+ patients is full of confusion and contradictions. Some of these difficulties are the result of the methodological shortcomings of a number of the techniques that have been used. Examples of the problems that may be encountered on primary isolation and subculture are described and the drawbacks associated with the systems used to date for phenotyping Candida are quoted. While molecular characterization techniques would appear to offer a reliable and objective alternative, they too have their strengths and weaknesses. An attempt is made to summarize the progress that has been made recently in the detection and identification of Candida albicans and also the non-albicans species from HIV-infected individuals. What emerges is that the commensal Candida species that inhabit the oral cavities of HIV+ patients are subjected to a number of significant pressures that probably promote the selection of organisms with unusual phenotypes and genotypes. These Candida are more difficult to characterize and behave differently compared to their counterparts in HIV- individuals. It is clear that uncovering the factors that are important for the selection of treatment regimens and will be predictive of outcome will not be easy. Candida organisms are neither as benign nor as simple as once thought.

AIDS-Related Opportunistic Infections↗

Minors and emergency medicine.

This article reviews medical-legal issues with regard to minors as they apply to the practice of emergency medicine. The topics of consent to treatment, refusal of care, child abuse, and medical malpractice are addressed. A working knowledge of these areas helps the emergency physician to avoid confusion, avoid delays in management, and maintain the safety of children.

Adolescent↗

Staphylococcus aureus bacteriophages mediating the simultaneous lysogenic conversion of beta-lysin, staphylokinase and enterotoxin A: molecular mechanism of triple conversion.

A new group of serotype F bacteriophages of Staphylococcus aureus has been found which mediates the simultaneous triple-lysogenic conversion of enterotoxin A, staphylokinase and beta-lysin. The phages were recovered fro methicillin-resistant strains of S. aureus isolated in Irish hospitals between 1971 and 1988 and from strain PS42-D, which has been used as the propagating strain for the S. aureus typing phage 42D since before 1965. The molecular mechanism of triple conversion mediated by three of these phages was determined by molecular cloning, restriction endonuclease site mapping and hybridization analysis, and compared with the mechanism of beta-lysin and staphylokinase conversion mediated by the serotype F, double-converting phase phi 13. THe genetic determinants mediating expression of enterotoxin A (entA) and staphylokinase (sak) were cloned from the DNA of the triple-converting phage and expression of the cloned determinants detected in Escherichia coli and S. aureus. The entA and sak determinants were closely linked in the phage DNA adjacent to the phage attachment site (attP) in each case and furthermore, the sak determinant of phage phi 13 was also located near its attP. The restriction maps of the entA-, sak- and attP-containing DNA regions of the three triple-converting phages were very similar to each other and to the corresponding sak- and attP- containing DNA region of phage phi 13. Hybridization analysis using a cloned beta-lysin determinant (hlb) and cloned attP-containing DNA fragments as probes demonstrated that beta-lysin conversion mediated by the triple-converting phages and phage phi 13 was caused by insertional inactivation of the chromosomally encoded hlb determinant by orientation-specific integration of phage DNA following lysogenization.

Antimicrobial Cationic Peptides↗

Determination of roxatidine in human plasma, urine and milk by capillary gas chromatography using nitrogen-selective detection.

An assay is described for the determination of roxatidine in human plasma, urine and milk by gas chromatography. Roxatidine is extracted from the basified matrix with dichloromethane and esterified with propionic anhydride prior to analysis of the extracts by capillary gas chromatography using a nitrogen-specific detector. Detection limits are 5 ng/ml for plasma and milk and 1 microgram/ml for urine, making the assay suitable for obtaining pharmacokinetic data from volunteer trials.

Chromatography, Gas↗

The Amherst study of hospital marketing practices.

The study findings identify two major area of concern related to marketing and the direction the field is taking. First, health care marketing--though much discussed and expensive--is still in a stage of immaturity. As practiced in hospitals today, marketing is frequently synonymous with advertising. Second, marketing in health care will not ultimately be a "clone" of marketing practices in industry and retailing. Though hospitals are looking to those areas for knowledge and expertise, the unique character of the product will cause health care marketing to evolve into a practice uniquely different from that in other industries.

Data Collection↗