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Biomedical subjects

D L Smith

Publications and source records attributed to D L Smith.

At least 307 records · Page 17Linked to original sources

Somatic embryogenesis of carrot in hormone-free medium: external pH control over morphogenesis.

Cultures of preglobular stage proembryos (PGSPs) were initiated from mechanically wounded mature zygotic embryos of carrot, Daucus carota, on a hormone-free, semisolid medium. These PGSPs have been maintained and multiplied for extended periods without their progression into later embryo stages on the same hormone-free medium containing 1 mM NH4+ as the sole nitrogen source. Sustained maintenance of cultures comprised exclusively of PGSPs was dependent on medium pH throughout the culture period. Best growth and multiplication of PGSP cultures occurred when the pH of unbuffered, hormone-free medium fell from 4.5 to 4 over a 2-week period or when buffered medium was titrated to pH 4. If the hormone-free medium was buffered to sustain a pH at or above 4.5, PGSPs developed into later embryo stages. Maintenance with continuous multiplication of PGSPs occurred equally well on medium containing NH4+ or NH4+ and NO3-, but growth was poor with NO3- alone. Additional observations on the effects of medium components such as various nitrogen sources and levels, sucrose concentration, semisolid supports, type of buffer, borate concentration, activated charcoal, and initial pH that permit optimum maintenance of the PGSPs or foster their continued developmental progression into mature embryos and plantlets are reported. The influence of the pH of the hormone-free medium as a determinant in maintaining cultures as PGSPs or allowing their continued embryonic development are unequivocally demonstrated by gross morphology, scanning electron microscopy, and histological preparations.

Cells, Cultured↗

Angle-closure glaucoma as initial presentation of myelodysplastic syndrome.

A 57-year-old man presented with proptosis of the right eye and findings consistent with bilateral angle-closure glaucoma. Subsequent evaluation revealed severe bilateral uveal effusions and associated nonrhegmatogenous retinal detachments, which were felt to be related to orbital pseudotumour and associated scleritis. Hematologic studies were consistent with a diagnosis of myelodysplastic syndrome. Although myelodysplastic syndrome has been reported in one patient with orbital inflammation and myositis, to our knowledge ciliochoroidal effusion and secondary angle closure have not previously been reported in myelodysplastic syndrome.

Exophthalmos↗

Long-term amphotericin B therapy for disseminated histoplasmosis in patients with the acquired immunodeficiency syndrome (AIDS).

STUDY OBJECTIVE: To assess the efficacy and toxicity of long-term maintenance amphotericin B therapy in preventing relapses after treatment in patients with the acquired immunodeficiency syndrome (AIDS) and disseminated histoplasmosis. DESIGN: Open, nonrandomized pilot study. SETTING: Three private, university-affiliated community hospitals. PATIENTS: We studied 22 consecutive patients with disseminated histoplasmosis and human immunodeficiency virus (HIV) infection. Sixteen patients completed the study, 5 patients died before completing the initial intensive phase of treatment, and 1 patient received a different treatment regimen. INTERVENTIONS: Seven patients were treated with an initial intensive course of 1000 mg of amphotericin B, followed by weekly infusions of 50 to 80 mg until a cumulative dose of 2000 mg was attained; biweekly infusions of 50 to 80 mg were then continued indefinitely. Nine patients received an initial amphotericin B course of 2000 mg followed by weekly infusions of 80 mg. MEASUREMENTS AND MAIN RESULTS: Of the 7 patients in the 1000-mg intensive regimen group, 6 patients have survived without clinical or laboratory evidence of a histoplasmosis relapse, and 1 died of unrelated causes. Of the 9 patients in the 2000-mg intensive regimen group, 7 patients have survived, 1 patient died of a histoplasmosis relapse, and 1 patient died of other causes. Thus, 13 of 14 patients (93%) who did not die of other causes remained relapse-free. The median follow-up period was 14 months (range, 2 to 23 months). No apparent differences in outcome were observed between patients treated with weekly maintenance regimens and those treated with biweekly maintenance regimens. Sixty-three percent of patients developed intravascular device-related complications. CONCLUSIONS: Long-term, intermittent maintenance amphotericin B therapy in HIV-infected patients with disseminated histoplasmosis is well tolerated and is highly effective in suppressing relapses after treatment.

Acquired Immunodeficiency Syndrome↗

2.8-A-resolution crystal structure of an active-site mutant of aspartate aminotransferase from Escherichia coli.

The three-dimensional structure of a mutant of the aspartate aminotransferase from Escherichia coli, in which the active-site lysine has been substituted by alanine (K258A), has been determined at 2.8-A resolution by X-ray diffraction. The mutant enzyme contains pyridoxamine phosphate as cofactor. The structure is compared to that of the mitochondrial aspartate aminotransferase. The most striking differences, aside from the absence of the lysine side chain, occur in the positions of the pyridoxamine group and of tryptophan 140.

Aspartate Aminotransferases↗

Calcium absorption in children estimated from single and double stable calcium isotope techniques.

In order to determine whether the specific activity in a single serum sample estimates calcium absorption, six healthy children participated in a study using stable isotopic calcium tracers, one given orally and the second intravenously. High-resolution, fast atom bombardment mass spectrometry was used to quantify the 44Ca and 42Ca tracers in serum and urine. Subjects ingested 250 mg of calcium (215 mg calcium enriched with 35 mg 44Ca) in the form of a chewable calcium citrate malate tablet with a standard meal, followed 30 min later with an i.v. injection of 42Ca tracer. Blood for tracer determinations was obtained at 90, 120, 150, 180, and 300 min after oral ingestion, and a urine sample was obtained 24 h after oral calcium tracer administration. The average calcium absorption estimated from the ratio of urinary tracers was 41.4 +/- 8.2%. This study indicates that the level of oral tracer in serum taken 150 min post-ingestion is significantly correlated (r = 0.85, p less than 0.05) with calcium absorption, as determined by the tracer levels in the urine. These results show that an oral stable isotopic tracer coupled with a single blood sample can be used to estimate calcium absorption in children.

Absorption↗

Alterations in serotonin binding sites after 5,7-dihydroxytryptamine treatment in the rat spinal cord.

The 5-HT1B subtype of serotonin (5-HT) receptor regulates the release of 5-HT in the rat spinal cord. In an attempt to confirm the presynaptic location of the 5-HT1B receptor, serotonergic nerves were destroyed neurochemically with 5,7-dihydroxytryptamine (5,7-DHT) administered intrathecally. At 3, 7 and 14 days post 5,7-DHT, competitive radioligand binding assays were performed using 2 nM [3H]5-HT and varying concentrations of trifluoromethylphenylpiperazine (TFMPP), a drug which interacts with 5-HT1B and 5-HT1A binding sites (affinity of 5-HT1B site greater than 5-HT1A site for TFMPP). The decrease in 5-HT1B sites that was expected was not observed at any time following the lesion. However, the binding capacity of the 5-HT1B site, as well as the 5-HT1A site, increased significantly by 7 and 14 days postlesion, respectively. Thus, it appears that an up-regulation of 5-HT1B sites occurred that may have obscured the ability to observe a reduction in a small population of sites located on the serotonergic nerve terminals.

5,7-Dihydroxytryptamine↗

Septic and nonseptic olecranon bursitis. Utility of the surface temperature probe in the early differentiation of septic and nonseptic cases.

Forty-six consecutive cases of olecranon bursitis were prospectively analyzed during a 1-year period. Eleven cases were septic; 35 cases were nonseptic. In addition to bursal fluid analysis, the surface temperature over the involved olecranon bursa and the contralateral (control) olecranon process was obtained by using a surface temperature probe. We compared the temperature difference between the involved and control sides in all septic and nonseptic cases. In nonseptic cases, the mean surface temperature difference was 0.7 degree C vs 3.7 degrees C in septic cases. In all septic cases, the temperature difference was 2.2 degrees C or greater (range, 2.2 degrees C to 5.1 degrees C; SD, 1.1). Use of the surface probe temperature difference proved 100% sensitive and 94% specific in discriminating septic from nonseptic cases. It seems to be more helpful than the bursal fluid leukocyte count, the predominant cell type, or Gram's stain in the early differentiation of septic and nonseptic olecranon bursitis.

Adult↗

Central nervous system toxicity associated with weekly low-dose methotrexate treatment.

Central nervous system (CNS) toxicity from low-dose methotrexate (MTX) has been reported rarely, and reported symptoms consist primarily of dizziness and headache. We reviewed the records of 25 consecutive patients treated with low-dose MTX, and found 5 who had spontaneously reported unpleasant cranial sensations, mood alteration, or memory impairment. Rechallenge with MTX on 5 occasions in 3 patients led to recurrent CNS symptoms in all cases. CNS toxicity was the sole reason for discontinuation of MTX in 2 patients. These 5 patients differed from the 20 without CNS toxicity in age (mean 68 versus 50) and baseline serum creatinine level (1.3 mg/dl versus 0.9 mg/dl), but not in weekly dosage of MTX (12 mg versus 16 mg). These results suggest that CNS toxicity is more common than previously reported, particularly in older patients with mild renal insufficiency.

Adolescent↗

Eskimo plasma constituents, dihomo-gamma-linolenic acid, eicosapentaenoic acid and docosahexaenoic acid inhibit the release of atherogenic mitogens.

Studies in man and laboratory animals suggest that omega 3 polyunsaturated fatty acid constituents of fish oils have antiatherosclerotic properties. We have studied the effects of several such polyunsaturated fatty acids for ability to modify the in vitro release of mitogens from human platelets. Such mitogens may produce the fibro-proliferative component of atherosclerotic plaques. Both 5,8,11,14,17-eicosapentaenoic acid (20:5 omega 3) and 4,7,10,13,16,19-docosahexaenoic acid (22:6 omega 3), major constituents of fish oils, inhibited adenosine diphosphate-induced aggregation of platelets and the accompanying release of mitogens. These effects are dose dependent. Linolenic acid (18:3 omega 3), the biosynthetic precursor of eicosapentaenoic acid, also inhibited platelet aggregation and mitogen release. Eicosapentaenoic acid also inhibited mitogen release from human monocyte-derived macrophages, which, in vivo, are an additional source of mitogens during atherogenesis. Potent inhibition of human platelet aggregation and mitogen release was also seen with dihomo-gamma-linolenic acid (8,11,14-eicosatrienoic acid 20:3 omega 6), whose levels are reportedly elevated in Eskimos subsisting on marine diets. We conclude that diets that elevate plasma and/or tissue levels of eicosapentaenoic acid, docosahexaenoic acid and dihomo-gamma-linolenic acid precursor gamma-linolenic acid (18:3 omega 6) may exert antiatherosclerotic effects by inhibiting the release of mitogens from platelets and other cells.

8,11,14-Eicosatrienoic Acid↗

Bilateral hypothenar hammer syndrome: an unusual and preventable cause of digital ischemia.

Unilateral ischemia of hand digits is usually caused by thoracic outlet obstruction, arterial emboli from a cardiac source, or atherosclerosis. The case of a metal press worker with unilateral ischemia due to hypothenar hammer syndrome, a condition caused by the repetitive use of the hypothenar eminence as a hammer with resultant damage to the ulnar artery, is described. Most such patients present with unilateral ischemia in the ulnar artery distribution of the dominant hand. This patient had used both hands repeatedly to pound the edges of large steel plates and presented with nondominant-hand ischemia, but was found to have the syndrome bilaterally by angiography. The distinctive features of this syndrome, a preventable and treatable cause of digital ischemia, are emphasized.

Adult↗

Compliance packaging: a patient education tool.

As a direct response to the profound negative impact that the high rate of noncompliance is having on therapeutic efficacy and total health-care costs, some pharmaceutical manufacturers have taken steps to develop compliance packaging for some products prescribed for ambulatory patients. The purpose of compliance packaging is to serve as a patient-education tool for health professionals and to make it easier for patients to remember to take their medications correctly at home. The ideal compliance package will be developed according to patient-education guidelines. Compliance packaging holds promise as a significant patient-education tool when health professionals combine it with personalized patient counseling and well-written medication instructions. Well-controlled cost-effectiveness studies are needed to determine the impact of compliance packaging on reducing total health-care costs.

Drug Labeling↗

Evaluation of the Phadebact ETEC-LT test for the heat-labile enterotoxin of Escherichia coli.

The Phadebact ETEC-LT is a rapid method of identifying enterotoxigenic Escherichia coli (ETEC), producing the heat-labile enterotoxin (LT). It uses staphylococcal coagglutination as a means of identifying the LT released from ETEC. In this investigation both known strains of ETEC from a variety of sources as well as strains from patients were tested. Good agreement was found between the Phadebact ETEC-LT test and established tests for LT. The test was found easy to use in the clinical laboratory environment, and revealed that LT producing ETEC may be more common causes of diarrhoea in Australia than had been anticipated.

Agglutination Tests↗

Effects of atenolol vs diltiazem on the haemodynamic effects of an inhaled beta 2-adrenoceptor agonist.

To determine the effects of concurrent beta 1-adrenoceptor blocker or calcium channel antagonist administration on the haemodynamic sequelae of an inhaled beta 2-selective adrenoceptor agonist bronchodilator, we examined echocardiographically the effects of fenoterol (400 micrograms) by metered dose inhaler following oral pre-treatment with (a) placebo, (b) atenolol or (c) diltiazem. Following placebo, fenoterol produced significant decreases in diastolic blood pressure (14% +/- 6%), total peripheral vascular resistance (TPR) (31% +/- 9%) and end-systolic stress (ESS) (15% +/- 21%). Cardiac output rose significantly (42% +/- 23%) as did heart rate (25% +/- 13%). After atenolol, responses to fenoterol were significantly blunted. Post-fenoterol heart rate, systolic blood pressure, % fractional shortening, stroke volume, ejection fraction, cardiac output and pressure/volume ratio increased significantly less after atenolol pre-treatment as compared to placebo pretreatment. TPR decreased significantly less. After diltiazem pre-treatment, the response to inhaled fenoterol was not different from that following placebo pre-treatment. We conclude that atenolol blunts the haemodynamic changes induced by fenoterol inhalation whereas diltiazem has little effect.

Adult↗

Ethylene-associated phase change from juvenile to mature phenotype of daylily (Hemerocallis) in vitro.

Hemerocallis plantlets maintained in vitro for extended periods of time in tightly closed culture vessels frequently show a phenotype, albeit on a miniaturized scale, typical of more mature, field-grown plants. The positive relationship of elevated ethylene in the headspace of such vessels to the phase shift from juvenile to mature form is established. Rigorous restriction in air exchange with the external environment by means of silicone grease seals hastens the phase change and improves uniformity of response. Although some plantlets may take longer to accumulate enough ethylene in sealed jars to undergo change, added ethylene and ethylene-releasing agents promote it. Ethylene adsorbants (e.g. mercuric perchlorate) block the shift of juvenile to mature form. Critical ambient ethylene level for the shift is ca 1 microliter l-1. Levels up to 1000 microliters l-1 do not hasten the response but are not toxic. The phase change is fully reversible when air exchange permits ethylene to drop below 1 microliter l-1. At least 1 microliter l-1 ethylene is required to sustain the mature phenotype. The ethylene synthesis inhibitor aminoethoxyvinylglycine (AVG) prevents the phase change, while the ethylene biosynthesis intermediate 1-aminocyclopropanecarboxylic acid (ACC) improves it. KOH, as a CO2 absorbent, does not prevent the phase change. Histology sections demonstrate subtle changes in the form of shoot tips of plantlets undergoing phase change.

Abscisic Acid↗

Selective anti-platelet aggregation synergism between a prostacyclin-mimetic, RS93427 and the nitrodilators sodium nitroprusside and glyceryl trinitrate.

1. Citrated platelet-rich plasma from human donors was used to examine turbidometrically the platelet aggregation response to collagen (2.5 micrograms ml-1) and ADP (1.6 microgram ml-1). 2. With collagen as an aggregating agent, the limited (35% maximal inhibition) inhibitory effects of glyceryl trinitrate (GTN, 0.78-50 micrograms ml-1) were markedly potentiated by threshold (3.3-10 ng ml-1) concentrations of RS93427, an orally active prostacyclin-mimetic. Almost complete inhibition of aggregation could then be produced. 3. A threshold concentration of RS93427 (3.3 ng ml-1) similarly potentiated the ability of sodium nitroprusside (NaNp, 0.78-10 micrograms ml-1) to inhibit collagen-induced platelet aggregation. There was an 8 fold reduction in the IC25 concentration of NaNp. 4. Threshold concentrations of the nitrodilators were also able to potentiate the anti-aggregatory effects of RS93427 (0.03-30 ng ml-1) on collagen-induced platelet aggregation. With threshold concentrations of either GTN (6.3-25 micrograms ml-1) or NaNp (0.3-1.3 microgram ml-1), the mean IC50 concentration of RS93427 was reduced 4 or 6 fold, respectively, while the IC25 concentration was reduced 6 or 10 fold, respectively. 5. No similar synergistic interactions were seen between RS93427 and the nitrodilators when ADP was used as an aggregating agent. 6. In spontaneously hypertensive rats, the dose-response for the hypotensive response to bolus doses of RS93427 was not altered by concomitant steady state infusion of a threshold dose (1 micrograms kg-1 min-1) of GTN. 7. Possible therapeutic implications of these findings are discussed.

Adenosine Diphosphate↗