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Biomedical subjects

D Reed

Publications and source records attributed to D Reed.

At least 109 records · Page 6Linked to original sources
PubMed1988

Recombinant human tumor necrosis factor increases granulocyte cell-surface complement receptor number.

Exposure of human buffy-coat granulocytes to tumor necrosis factor (TNF) produced cellular activation as indicated by an increase in the neutrophil and monocyte cell-surface number of C3b receptors (measured by indirect immunofluorescence). The degree of receptor increase depended on the dose of TNF from 25 to 1250 pg/mL. Results of kinetic analysis confirmed this response: TNF, 250 pg/mL, caused an increase in the C3b receptor number within ten minutes. Purified neutrophils exhibited a similar increase in cell-surface C3b receptors dependent on the concentration of TNF. Tumor necrosis factor could be a mediator of granulocyte activation in patients.

Granulocytes↗
PubMed1988

Medical decisions and prognostications of pediatricians for infants with meningomyelocele.

To determine how pediatricians' prognostications and decisions about the treatment of infants with meningomyelocele are affected by varying degrees of hydrocephalus, we randomly selected a sample of pediatricians to receive written surveys. This questionnaire assessed the relationship between the decisions and the prognostications, and compared their accuracy with that of outcome studies. Each pediatrician completed a questionnaire for two of three possible cases, which were identically described as infants with meningomyelocele and complete paraplegia varying only in the degree of hydrocephalus at birth from none to moderate to severe. Recommendations for treatment and prognostications (the Prognostics Belief Scale of Impressions of adult functional capabilities and likely residential and vocational placements) were compared. Significantly fewer pediatricians would present information to parents in an encouraging light, and significantly fewer would treat their own child, if the case involved severe hydrocephalus in comparison with no hydrocephalus. Pediatricians' prognostications were the least optimistic for the infant with severe hydrocephalus and most optimistic for the infant without hydrocephalus, and they were considerably less optimistic than seems justified on the basis of follow-up studies. Last, physicians' less-than-optimistic prognoses were significantly related to their decisions concerning surgery for the infants with moderate and severe hydrocephalus. The major import of the findings is that pediatricians' prognoses reflect, in part, a misconception of the impact of hydrocephalus on children born with meningomyelocele and that these prognoses then have and impact on the pediatricians' decisions concerning treatment.

Decision Making↗
PubMed1988

Prognostic importance of antibodies to human immunodeficiency virus by recombinant immunoassay and Western blot techniques in HIV antibody-positive hemophiliacs.

Antibodies to specific HIV viral antigens were measured by ELISA recombinant proteins representing gag and env amino acid sequences of human immunodeficiency virus (HIV) (E. I. du Pont de Nemours, Wilmington, DE) and by a Western blot system using biotinavidin detection (Biotech Research Labs, Rockville, MD) on 36 HIV antibody-positive hemophiliacs (HTLV-III ELISA, du Pont) on whom date of seroconversion was known and on whom serial samples where available between 1977 and 1986, representing 2-8 years following seroconversion. The 36 included 9 acquired immunodeficiency syndrome (AIDS) and 27 non-AIDS (7 AIDS-related complex (ARC); 4 other HIV class IV, 16 asymptomatic) patients. The development of AIDS was preceded 1-4 years by loss or lack of antibody to gag (p15, 24, or 55) and/or to pol (p31, 53, or 64), each p less than 0.001, compared with non-AIDS patients. Correlation between Western blot and recombinant assays was good except in one Western blot p24 (gag) only seroconverter who showed strong reactivity to env by recombinant assay. In conclusion, HIV antibody patterns appear to show prognostic significance in HIV-infected hemophiliacs.

Antibodies, Viral↗
PubMed1988

Metabolic effects of fructose and glucose: implications for food intake.

Differential effects of fructose and glucose preloads on carbohydrate metabolism and later food intake were examined in both lean and obese subjects. In study 1, a preload of either 50 g of fructose or glucose was administered in solution, and food intake at a buffet lunch presented 2.25 h after preload was assessed. Significant differences in caloric intake were observed between load conditions with the fructose group consuming fewer calories than the glucose group. Obese subjects demonstrated significantly greater insulin responses to the preload compared with lean subjects, and insulin levels of obese subjects at 15, 30, and 45 min after preload were found to correlate significantly with amount consumed. Incorporation of fructose or glucose into a mixed meal format in study 2 revealed no differences in subsequent caloric intake as a function of either type of preload or percent overweight. Differing insulin levels are discussed as a possible mechanism for differential food intake.

Eating↗
PubMed1988

Upper gastrointestinal endoscopy after cardiac transplantation.

Three hundred four patients have undergone cardiac transplantation at the University of Pittsburgh since 1980. Twenty patients have required 27 upper gastrointestinal (GI) endoscopic procedures. After heart transplantation the primary indications for endoscopy were epigastric pain (six patients with gastritis, one with multiple shallow gastric ulcers, and one with normal test results), mild upper GI bleeding (four patients with esophagitis, two with gastritis, and two with multiple shallow gastric ulcers), dysphagia and odynophagia (two patients with esophagitis), persistent nausea and vomiting (one with normal test results), lower GI bleeding (one with normal test results), and routine follow-up (one with normal test results). After heart-lung transplantation the primary indications for the endoscopy were massive upper GI bleeding (three patients with actively bleeding duodenal ulcers), dysphagia and odynophagia (one patient with esophagitis), mild upper GI bleeding (one patient with gastritis), and routine follow-up (one patient with normal test results). No complications resulted from endoscopy. The procedures were performed in the GI suite without cardiac monitoring. Prophylactic antibiotics were not routinely administered. No patient had a fungal infection of the upper GI tract--a finding attributed to the prophylactic use of nystatin in all patients. Opportunistic viral infections were identified histologically in six patients, including two patients with actively bleeding duodenal ulcers. The possibility of opportunistic viral infections in this immunosuppressed group required aggressive diagnostic techniques, including endoscopy and biopsy, which can be safely performed after cardiac transplantation.

Adult↗
PubMed1987

Analysis of human serum antibodies to human immunodeficiency virus (HIV) using recombinant ENV and GAG antigens.

Recombinant proteins representing gag and env amino acid sequences of the Human Immunodeficiency Virus (HIV) (HTLV-IIIb) were produced in Escherichia coli and used to analyze sera for the presence of antibodies to HIV. ENV-9 is a protein representing the carboxy terminus of gp120 and part of gp41 which is highly immunoreactive. GAG-1 represents 83% and GAG-55 100% of the amino acids of the gag open reading frame. The purified proteins allow sensitive detection by enzyme linked immunosorbent assay (ELISA) of antibodies directed against either env or gag of HIV. We have determined the reactivity of sera from several HIV exposed individuals, either form high risk populations or with clinically defined conditions, in the ENV-9, GAG-55, and GAG-1 assays and found that two major seropositive groups are observed. The quantitative analysis of sera with env and gag antigens by ELISA showed AIDS patients had very low gag reactivity while retaining high env reactivity. Results obtained with authentic p24 viral protein in both ELISA and radioimmunoassay correlated to those from the GAG-55 ELISA. This correlation and the analysis of sera with both the ENV and GAG ELISAs indicate that the antibodies reactive to gag are specifically affected relative to env reactivity and that different levels of antibodies to separate viral components in these sera may correlate with disease state.

Acquired Immunodeficiency Syndrome↗
PubMed1987

A cohort study of amyotrophic lateral sclerosis and parkinsonism-dementia on Guam and Rota.

A prospective study of the incidence of new cases of amyotrophic lateral sclerosis and parkinsonism-dementia was conducted by follow-up of 899 Chamorros in the Mariana Islands who participated in a baseline medical examination and interview in 1968. During a 15-year follow-up period, 28 new neurologically confirmed cases occurred, including 23 with parkinsonism-dementia and five with amyotrophic lateral sclerosis. The low incidence of amyotrophic lateral sclerosis was consistent with the reported disappearance of this disease from the Mariana Islands. However, the continuing high incidence of parkinsonism-dementia was not in agreement with a similarly reported disappearance nor with the hypothesis of a common cause of both diseases. Of 23 selected baseline examination variables, only the preference for traditional Chamorro food was significantly associated with an increased risk of parkinsonism-dementia. A review of the accumulated epidemiologic data on these neurologic diseases in the Mariana Islands did not support the current hypothesis that a chronic nutritional deficiency of calcium is a cause of both amyotrophic lateral sclerosis and parkinsonism-dementia.

Adult↗
PubMed1987

Physiologic responses of pilots flying high-performance aircraft.

This study deals with the physiologic responses to stress in F-4 fighter pilots and aircrew engaged in surface attack training (SAT) missions. Blood levels of HDL-cholesterol, LDH and LDH isoenzymes, CPK, and myoglobin were determined before and after each mission. Continuous EKG and transcutaneous PO2 recordings were made during briefing, preflight, and inflight. The personal history and habits of each participant were recorded. Each mission consisted of six successive bomb deliveries at 80-s intervals and at increasingly steep dive angles, each terminating in 5.5-6 +Gz during pull-up. Results revealed no apparent effect on HDL, COP isoenzymes, and LDH isoenzymes. Many myoglobin levels dropped as much as 50%. EKG recordings revealed ST elevations, ST depressions, T wave inversions, and marked sinus arrhythmias in some, while others showed increases in cardiac rate. Pilots flying these SAT missions in F-4C aircraft were found not to be significantly physiologically stressed.

Adult↗
PubMed1986

Does obesity protect hypertensives against cardiovascular diseases?

Recent studies suggest that obesity may protect hypertensives against cardiovascular disease (CVD). This concept was investigated by the Honolulu Heart Program, a prospective epidemiologic study of CVD in a cohort of Japanese-American men aged 45 to 65 years who have been followed up for 12 years. The combined effect of body mass index (BMI), as a measure of obesity, and blood pressure on coronary heart disease and CVD incidence was examined in 7554 men who were free of CVD and cancer at baseline. Rates of coronary heart disease and CVD were higher in the most obese than in the nonobese men for both normotensives and hypertensives. Blood pressure-BMI interaction was not significant for any CVD end point. Hypertension was associated with higher rates of coronary heart disease and CVD at all levels of BMI. This study supports the conclusion that hypertension is associated with an increased risk of CVD in both obese and nonobese men and that the relationship of blood pressure to CVD incidence does not vary with level of BMI. The inclusion of prevalent cases of CVD and the collapsing of continuous data into two categories may explain the results of earlier studies.

Aged↗
PubMed1986

Evaluation of 4-methylpiperidine analogs of hemicholinium-3.

A series of substituted piperidine analogs of hemicholinium-3 was evaluated for their ability to inhibit neuromuscular transmission, to decrease acetylcholine content of caudate slices, to inhibit choline acetyltransferase activity, and to produce toxicity. Quaternary and tertiary amine derivatives of 4-methyl- and 4-hydroxyl-substituted piperidine analogs containing beta-carbonyl or beta-hydroxyl substitutions in the phenylethyl spacing moiety were tested. 4-Methyl piperidine derivatives maintained potent hemicholinium-3 like activity. Reduction of activity was seen with the 4-hydroxyl piperidine analogs. Compounds with beta-hydroxyl substitution were more potent than those with beta-carbonyl substitution. The tertiary amine, 4-methyl piperidine derivative with a hydroxyl group on the beta-carbon of the ethyl side chain also possessed hemicholinium-3 like activity. However, tertiary amine analogs were substantially less potent than hemicholinium-3 or their quaternary amine analogs.

Acetylcholine↗
PubMed1986

Demonstration of superior sagittal sinus thrombosis by indium-111 platelet scintigraphy.

Superior sagittal sinus thrombosis, documented by cerebral angiography, was demonstrated by indium-111 platelet scintigraphy in a 40-year-old man presenting with seizures and intracerebral hematoma. Early scintigraphy demonstrated focal increased indium-111 activity at the two ends of the thrombus, while later scintigraphy showed diffuse increased activity in the area of the sinus. This initial experience suggests that platelet scintigraphy may provide unique information regarding the natural history of intracranial venous thrombosis.

Adult↗
PubMed1986

Lipids and lipoproteins as predictors of coronary heart disease, stroke, and cancer in the Honolulu Heart Program.

A group of 2,122 healthy men in the Honolulu Heart Program who participated in the Cooperative Lipoprotein Phenotyping Study, 1970 to 1972, were followed for 10 years by repeated examinations and surveillance of hospital discharge and mortality records in order to diagnose new cases of coronary heart disease, stroke, cancer, and other deaths. Total cholesterol and low-density lipoprotein cholesterol were significantly associated with all clinical types of coronary heart disease in multivariate analyses, whereas high-density lipoprotein cholesterol was inversely associated with nonfatal myocardial infarction and total coronary heart disease, but not with fatal coronary heart disease nor angina. Triglyceride and very-low-density lipoprotein cholesterol were associated with total coronary heart disease by univariate but not multivariate analysis. None of the other specific chronic diseases were significantly associated with any lipid or lipoprotein, although there were trends of inverse associations of all noncardiovascular disease with total cholesterol and low-density lipoprotein cholesterol. Thus, for total disease (coronary heart disease, stroke, cancer, and other deaths), the optimal range for lowest disease incidence was about 200 to 220 mg/dl for total cholesterol and 120 to 140 mg/dl for low-density lipoprotein cholesterol. A strong inverse pattern of total disease with high-density lipoprotein cholesterol indicated that the highest levels were the optimal levels.

Age Factors↗
PubMed1985

The significance of hydronephrosis after aortofemoral reconstruction.

Hydronephrosis due to ureteral obstruction is a rarely reported complication of aortic bypass grafting. Patients who had undergone aortic reconstruction were screened using serial real-time ultrasound examination to detect ureteral obstruction. The clinical course and incidence of graft complications, renal impairment, amputation, and death were determined for hydronephrotic patients and compared with the incidence of similar complications in a control group. Hydronephrotic patients had an extremely high incidence of graft infection, anastomotic aneurysm, graft thrombosis, and amputation. Obstructed ureters were at high risk for intraoperative injury during removal of infected aortic grafts. A subgroup of hydronephrotic patients who developed multiple anastomotic aneurysms without graft infection was identified. Hydronephrosis was frequently silent, and detection required active investigation. After aortic reconstruction, routine screening with real-time ultrasound examination appears warranted to identify a high-risk subset of patients.

Aged↗
PubMed1985

The type A behavior pattern and coronary heart disease among Japanese men in Hawaii.

This is a study of the association of Type A behavior with the prevalence and 8-year incidence of coronary heart disease (CHD) among 2187 Japanese men in the Honolulu Heart Program cohort. Type A behavior was determined by the Jenkins Activity Survey questionnaire in 1970. The prevalence rate of total CHD was significantly associated with Type A behavior, and this association was independent of other major risk factors in multivariate analyses. With the incidence data, however, there was no significant association of any clinical type of CHD with Type A behavior. Examination of the relationship of Type A behavior to other risk factors showed significant associations with serum cholesterol, obesity, physical inactivity, and alcohol consumption. Pathologic findings among 48 men who died showed no association of Type A behavior with microscopic evidence of myocardial infarction or with grades of atherosclerosis in the coronary arteries and aortas.

Acculturation↗
PubMed1985

Biological and social predictors of health in an aging cohort.

A cohort of over 5000 men of Japanese ancestry, aged 46-69 and free of chronic disease at entry examination were studied for factors associated with remaining free of major chronic diseases during a 12 yr followup period. Over 1600 disease-free men were compared with 3400 individuals who developed coronary heart disease (CHD), stroke, cancer or a variety of other conditions. From more than 30 variables examined in multivariate analyses, blood pressure, obesity, cigarette smoking, alcohol consumption, serum glucose, uric acid and triglyceride, were inversely associated with staying healthy while forced vital capacity and years spent in Japan were directly associated with health. Of these nine variables, blood pressure was the strongest discriminator between healthy status and all categories of disease, while cigarette smoking and alcohol consumption were the next most important factors. This study suggests that the use of individuals who remain free of disease as a "standard" for health can facilitate the evaluation of risk factors for both total illness and a broad range of specific chronic diseases in a single population.

Aged↗