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Biomedical subjects

D L Brown

Publications and source records attributed to D L Brown.

At least 235 records · Page 13Linked to original sources
PubMed1989

Intrauterine shelves in pregnancy: sonographic observations.

Twenty-five shelves of tissue, all having a free edge within the uterine cavity, were identified by sonography in 24 singleton pregnancies. In no case did the shelf attach to the fetus or restrict fetal motion. The fetus was sonographically normal in 23 pregnancies, and no fetus developed amniotic-band syndrome. One fetus had anencephaly, probably unrelated to amniotic-band syndrome. Although these shelves may be due to synechiae, only eight (32%) of the patients had a history of dilatation and curettage or cesarean delivery, which predispose the patient to formation of synechiae. This experience suggests that when a shelf of tissue with a free edge is present within the pregnant uterus, there should be no concern for the development of amniotic-band syndrome as long as a complete sonographic survey of the fetus reveals no abnormalities.

Amniotic Band Syndrome↗
PubMed1989

The peripheral hypoechoic rim of the fetal heart.

The purpose of this study is to determine the origin of the hypoechoic rim around the fetal heart; this rim has been noted previously but there is disagreement as to its origin. Of 314 fetuses scanned, a four-chamber view was obtained in 290; a hypoechoic rim was present in 94% of these. In all cases in which a short-axis view could be obtained, the rim continued circumferentially through the ventricular septum. Because the rim continues through the septum, it cannot be pericardial fluid but is instead part of the myocardium. The presence as well as the origin of this normal hypoechoic rim around the fetal cardiac ventricles should be considered before diagnosing small pericardial effusions.

Diagnosis, Differential↗
PubMed1989

Ultrasound of the fetal thymus.

A prospective study was performed in 340 obstetric sonograms to evaluate the sonographic characteristics of the fetal thymus. The thymus was identified as a homogeneous structure in the anterior fetal mediastinum in 251 cases (74%). The thymus was categorized as either hyperechoic, isoechoic, or hypoechoic relative to fetal lung. Seventy one of 115 cases (62%) prior to 27 weeks gestation were hyperechoic relative to fetal lung whereas 100 of 136 cases (73%) after 27 weeks were hypoechoic relative to lung (p less than .0001). Thymic measurements and shape were also recorded. The anterior-posterior AP thickness, measured in the midline at the sternum, ranged from 2 mm at 14 weeks to 20.8 mm at term. This study demonstrates that the thymus can be imaged in most fetuses.

Female↗
PubMed1989

The sagittal sign. An early second trimester sonographic indicator of fetal gender.

The sagittal sign for sonographic prediction of fetal gender in the early second trimester is described and its sensitivity and accuracy evaluated. One hundred eighty-four ultrasound examinations with gestational ages between 10 weeks and 20.5 weeks were performed in 165 patients over a three month period. Of the 165 patients included in this prospective study, the gender of the fetus in 105 patients was known as a result of amniocentesis or chorionic villus sampling. These 105 patients with known results were used to compare gender prediction based on conventional views with prediction based on the sagittal sign. The results of this study reveal the superiority of the sagittal view for predicting gender in the gestational age group of 14 weeks to 20.5 weeks.

False Negative Reactions↗
PubMed1989

Optimal dosing of phenytoin: an evaluation of the timing and appropriateness of serum level monitoring.

The appropriateness of all serum phenytoin concentrations measured at this 294-bed, tertiary care institution over a 7-week period were evaluated. Each serum level was determined to be justified or unjustified based on either pharmacokinetic or clinical criteria. A total of 234 serum levels were measured in 58 patients. Thirty-eight (16%) of the levels were justified on a pharmacokinetic basis, whereas 70 (30%) were justified for clinical assessment of the patient. One hundred thirty (56%) of the serum levels could not be justified on any grounds. Also identified were distinct clinical situations for 13 patients for which monitoring of serum levels was warranted but not performed. Most phenytoin serum level measurements at this institution were not reasonably justified and may have been unnecessary. A yearly reduction in laboratory costs in excess of $9,000 was predicted if such serum levels had been ordered only when clearly indicated.

Adolescent↗
PubMed1989

Immune status and response to immunization with polysaccharide vaccines of a healthy, congenitally asplenic woman.

We describe the immune status of a congenitally asplenic, otherwise healthy and anatomically normal 30-year-old woman. As in surgically asplenic subjects, she had Howell-Jolly bodies in a blood smear, increased B lymphocyte and decreased T helper and suppressor lymphocyte percentages, and a slightly lower than average T helper/suppressor ratio. Because of the increased risk of infection with capsulate bacteria in asplenic patients, the subject was immunized with Pneumovax and meningococcal vaccine and her serum antibody responses were investigated. She was found to have subnormal IgG antibody titres which did not increase on immunization, although the subclass distribution of anti-pneumococcal antibody was normal with IgG2 predominating. IgM antibody titres were higher than in a pool of normal adult human sera, while IgA levels increased substantially as in normal subjects.

Adult↗
PubMed1989

Organization of the vimentin system and its spatial relationship to the microtubule complex during the division of mammalian cells growing attached and in suspension.

We have used immunofluorescence staining with antibodies that detect vimentin, tubulin and the centrioles to compare the distributions of these respective antigens during the division of several suspension and attached cultured cells. Our observations demonstrate that 1) from distinct interphase organizations in suspension and attached cells, the vimentin system consistently rearranges with the onset of mitosis into a filamentous cage-like structure enclosing the spindle, 2) during cytokinesis, the polar centrosomes relocalize near the midbody in suspension cells while they remain at the pole opposite to it in attached cells, and 3) the vimentin cage is disintegrated and aggregated on each side of the midbody during cytokinesis in lymphoid cells but may be retained in other suspension cells.

Animals↗
PubMed1989

Nuclear antigens in neoplastic lymphocytes of B cell and T cell non-Hodgkin's lymphomas.

Gross nuclear morphology is a major diagnostic feature in the identification of subtypes of non-Hodgkin's lymphoma (NHL). The authors have shown that the size, shape, and chromatin distribution of the lymphocyte nuclei vary extensively both within and between samples of a subtype, and have proposed that the variations may reflect qualitative and quantitative differences in extrachromatinic components. To test this hypothesis, the organization of individual nuclear antigens in NHL and in reactive hyperplasia biopsies was examined by immunofluorescence labeling of frozen sections with previously characterized monoclonal antibodies. The results have been correlated with observations of the staining patterns produced by the antibodies in mitogenically stimulated human peripheral blood lymphocytes. Labeling pattern and intensity with each antibody were consistent between preparations of blood lymphocytes, and all four antibodies labeled all blood lymphocyte samples tested. In contrast, only 15% of the 53 biopsies were labeled by all four antibodies, although all were stained by anti-peripherin, nearly 80% by I1, and almost 60% by PI1. Antibody PI2 labeling was detected in only 20% of the samples. Variation in labeling intensity was equally extensive both within and between biopsy samples. In general, there was little homogeneity between samples of an NHL subtype as to which antigens were detected, their labeling intensity, or their pattern of intranuclear distribution. These observations are consistent with earlier reports of significant diversity in the morphology of nonchromatin components in such samples. The data support the proposition that the heterogeneity of gross nuclear morphology in nuclei of NHL biopsies may be due in part to disordered expression or abnormal organization of nuclear proteins.

Antibodies↗
PubMed1988

Effects of methyl mercury on the microtubule system of mouse lymphocytes.

The effects of in vivo and in vitro methyl mercury (MeHg) treatments on the microtubule system of murine splenic lymphocytes were examined by immunofluorescence microscopy. In vitro exposures to 1 to 10 microM MeHg resulted in time- and concentration-dependent microtubule disassembly. Lymphocytes isolated from mice receiving a single 10 mg/kg injection displayed microtubule damage when examined 2 and 5 days post-treatment. The capacity of in vivo and in vitro treated lymphocytes to respond to the mitogen concanavalin A (Con A) was generally inhibited by MeHg. There was a good correlation between the degree of microtubule disassembly and the inhibition of mitogen responsiveness. In vivo and in vitro treatments that resulted in extensive microtubule damage suppressed the ConA response and blocked lymphocytes early in the stimulation sequence. In vitro MeHg treatment late in mitogenesis caused a rapid, concentration-dependent inhibition of [3H]thymidine incorporation. These results suggest that damage to the microtubule system can serve as an indicator of MeHg toxicity and may underlie the toxicant's effects on lymphocyte functions.

Animals↗
PubMed1988

The effects of methylmercury on the cytoskeleton of murine embryonal carcinoma cells.

Immunofluorescence staining with antibodies to tubulin and vimentin and staining with phalloidin have been used to examine the effects of methylmercury on the cytoskeleton of embryonal carcinoma cells in culture. Exposure of embryonal carcinoma cells to methylmercury (0.01 to 10 microns) resulted in concentration- and time-dependent disassembly of microtubules in interphase and mitotic cells. These effects were reversible when cultures were washed free of methylmercury. Spindle microtubules were more sensitive than those of interphase cells. Spindle damage resulted in an accumulation of cells in prometaphase/metaphase, which correlated with a temporary delay in the resumption of normal proliferation rate upon removal of methylmercury. Of the interphase cytoskeletal components, microtubules were the first affected by methylmercury. Vimentin intermediate filaments appeared relatively insensitive to methylmercury, but showed a reorganization secondary to the microtubule disassembly. Actin microfilaments appeared unchanged in cells showing complete absence of microtubules. Our results 1) support previous reports suggesting that microtubules are a primary target of methylmercury, 2) document a differential sensitivity of mitotic and interphase microtubule systems and 3) demonstrate the relative insensitivities of other cytoskeletal components.

Animals↗
PubMed1988

Effects of methylmercury on retinoic acid-induced neuroectodermal derivatives of embryonal carcinoma cells.

Immunofluorescence staining with antibodies to tubulin, neurofilaments and glial filaments was used to study the effects of methylmercury on the differentiation of retinoic acid-induced embryonal carcinoma cells into neurons and astroglia and on the cytoskeleton of these neuroectodermal derivatives. Methylmercury did not prevent undifferentiated embryonal carcinoma cells from developing into neurons and glia. Treatment of committed embryonal carcinoma cells with methylmercury doses exceeding 1 microM resulted in the formation of neurons with abnormal morphologies. In differentiated cultures, microtubules were the first cytoskeletal element to be affected. Their disassembly was time- and concentration-dependent. Microtubules in glial cells and in neuronal perikarya were more sensitive than those in neuronal processes. Neurofilaments and glial filaments appeared relatively insensitive to methylmercury treatment but showed reorganization after complete disassembly of the microtubules. The data demonstrate 1) the sensitivity of microtubules of both neurons and glia to methylmercury-induced depolymerization, and 2) the heterogeneous response of neuronal microtubules to methylmercury, presumably reflecting posttranslational modifications of different subpopulations of microtubules in the perikarya and neurite.

Animals↗
PubMed1988

Characterization of cytoskeletal proteins in basal cells of human parotid salivary gland ducts.

From previous immunofluorescent, immunohistochemical and ultrastructural studies, myoepithelial cells have been reported to be absent from the striated and excretory ducts of human salivary gland. Yet recently, certain anti-cytokeratin monoclonal antibodies which specifically label the myoepithelium of salivary gland acini and intercalated ducts have also been found to stain basally situated cells in both striated and excretory ducts. In this study, we have used eight samples of normal human parotid gland (methacarn-fixed and frozen sections) to establish if basal cells of striated and excretory ducts have the cytoskeletal protein complement (actin and cytokeratins) of myoepithelial cells. Using a muscle-specific actin, HHF35, not only is the myoepithelium of acini and intercalated ducts stained in all cases, but stellate and spindle shaped cells are also detected all along the inter- and intralobular striated ducts in four of the eight examples. With double-labeled frozen sections and fluorescent microscopy, the actin-specific probe, phalloidin, and the myoepithelial-selective anti-cytokeratin 14 antibody, 312C8-1, confirm that the striated duct does have a population of basal cells with the cytoskeletal protein make-up of myoepithelium. The monoclonal antibody 8.12 (specific for cytokeratin 13 and 16) also stains some basal cells of striated and excretory ducts, as well as luminal cells of ducts at all levels, but does not label the myoepithelium of acini and intercalated ducts. Both the anti-cytokeratin antibodies and the actin-detecting mechanisms reveal that the basal cell population of striated and excretory ducts is more heterogeneous, and likely functionally more complex, than has been realized previously. Such findings are not in agreement with certain aspects of current theories of the histogenesis of salivary gland tumours.

Actins↗
PubMed1988

Cardiopulmonary effects of one-lung ventilation in supine patients.

The cardiopulmonary effects of one-lung ventilation (OLV), with continuous positive airway pressure (CPAP, 5 cm H2O) to the nonventilated lung, were compared to the effects of two-lung ventilation (TLV) in 12 supine patients undergoing coronary artery bypass grafting (CABG). Monitoring was performed with electrocardiography (ECG), arterial, and pulmonary artery catheters. Measurements of cardiac index (CI), heart rate (HR), systemic (MAP) and pulmonary artery pressures (PAP), pulmonary artery occlusion pressure (PAOP), mixed venous oxygen saturation (SvO2), and arterial blood for pH, PaO2, PaCO2 and HCO3- were performed with stable maintenance of anesthesia during both one- and two-lung ventilation. Mean values for CI, HR, MAP, MPAP, PVR, and SvO2 demonstrated no significant changes between OLV and TLV; systemic vascular resistance (SVR) and pulmonary artery occlusion pressure (PAOP) were statistically (P < 0.05) different, but of minor clinical significance. The data suggest that OLV, accompanied by CPAP (5 cm H2O) to the nonventilated lung, produces minimal changes in cardiopulmonary measurements in supine patients.

Adult↗
PubMed1988

Isoflurane elimination via a bubble oxygenator during extracorporeal circulation.

It has been suggested that inhalational anesthetics should be discontinued at least 15 minutes prior to termination of extracorporeal circulation (ECC) to avoid myocardial depression. However, data regarding elimination of inhalation agents via a bubble oxygenator from hypothermic, hemodiluted patients have not been previously reported. The washout of isoflurane (ISF) from ten cardiac surgical patients using mass spectrometry was studied. The mean baseline oxygenator exhaust concentration of ISF was 0.85% prior to termination of ECC. Oxygenator concentration of ISF decreased to less than 0.05% in 8.8 +/- 2.5 minutes. Eight of ten patients had ISF washout curves best characterized by a one-compartment model, with a mean time constant of 1.94 minutes. Therefore, 95% washout of ISF should occur in 5.8 minutes (three time constants). It is suggested that ISF may be used closer to the termination of ECC than previously recommended without fear of significant myocardial depression.

Aged↗