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Biomedical subjects

E Johnson

Publications and source records attributed to E Johnson.

At least 253 records · Page 14Linked to original sources
PubMed1991

Open versus closed nailing of femoral fractures in the polytrauma patient.

Thirty-four patients with severe multiple injuries underwent either open or closed nailing of 35 femoral fractures. Open nailing was performed in 17 femurs and closed nailing in 18 femurs. The average abbreviated injury score was 27 in both the open group (range: 17-45) and closed group (range: 22-36). Soft tissue injuries were present in eight (47%) cases in the open group compared to three (16%) in the closed group. The treatment protocol was similar in both groups. Intramedullary nailing was delayed an average of 11 days in the closed group. This was significantly different than the open group where the average time to nailing was less than 24 hours (p less than 0.001). Reamed nails were used in all cases except for two in the closed group. The median time to fracture healing was 5.0 months in the open group and 4.1 months in the closed group, with an average follow-up of 18 months in both groups. Two cases required reoperation (one nonunion and one shortening at the fracture site). Both these cases were in the open group. There were no superficial or deep infections in either group. Closed reamed intramedullary nailing is recommended for treatment of diaphyseal femur fractures in patients with severe coexistent injuries. Open nailing should be reserved for cases in which an adequate reduction cannot be achieved by closed methods.

Adult↗
PubMed1990

Characterization of nuclear proteins which bind to interferon-inducible transcriptional enhancers in hematopoietic cells.

Nuclear proteins isolated from untreated lymphoid cells formed complexes with the interferon-inducible transcriptional enhancer (IITE) containing a 73- and an 84-kDa protein, whereas the nuclear proteins of untreated myeloid cells formed complexes with the IITE which contained 50-, 65-, and 73-, but not 84-kDa nuclear proteins. The difference in the molecular masses of the nuclear proteins binding to the IITE in lymphoid and myeloid cells was due to a phosphatase present in the cytoplasm of the myeloid cells. Induction of transcriptional activation by interferon was accompanied by the binding of a 95-kDa nuclear protein to the IITE 1-4 h after the start of exposure to interferon. Cycloheximide did not inhibit the binding of the 95-kDa nuclear protein or the transcriptional activation of alpha-interferon-inducible genes. These data suggest that the induction of gene transcription by alpha-interferon in hematopoietic cells may be associated with post-translational changes in a 95-kDa nuclear protein that binds to IITE, thereby leading to transcriptional activation.

Base Sequence↗
PubMed1990

Improving state-funded child psychiatric care: reducing protracted hospitalizations through changes in treatment planning.

In late 1986, Millcreek Psychiatric Center for Children changed several of its treatment practices in an attempt to decrease needlessly prolonged hospitalizations. The changes included initiating discharge planning shortly after admission, increasing contacts with community and judicial agencies, improving family therapy services, and educating the community about appropriate use of hospital treatments. The fraction of children hospitalized more than 180 days decreased significantly, as did the average length of stay. Mental health professionals should keep community agencies informed about the nature and limitations of inpatient treatment and about children's needs for adequate after-care services.

Adolescent↗
PubMed1990

S protein binds to serum-treated agarose beads independently of complement activation and the formation of the terminal complement complex on the beads.

Comparison of initial (early-phase) and terminal (late-phase) sequence activation of complement by agarose beads and endotoxin was evaluated in an enzyme immunoassay (EIA) of serum levels of C3c and C9 neoepitopes, respectively. EIA and Western blotting with anti-S protein monoclonal antibody revealed lower S protein values and weaker S protein bands in serum activated by agarose beads than by endotoxin, implying that S protein was removed from serum by binding to agarose. The binding of S protein to the beads was confirmed by radioimmunoassay and was found to be equal in normal and heat-inactivated serum. In contrast, the terminal complement complex was formed only on agarose beads incubated with normal serum and not with inactivated serum.

Blood Proteins↗
PubMed1990

Synthesis of complement by alveolar macrophages from patients with sarcoidosis.

Sarcoidosis is a granulomatous disorder of unknown aetiology. Alveolar macrophages (AM) in sarcoidosis release a variety of mediators important to the pathogenesis of the disease. Complement is essential for the inflammatory response and we investigated whether there were any major defects in the potential for sarcoidosis AM to synthesize complement in vitro. AM from 11 patients with active sarcoidosis and three healthy controls were cultured under serum-free conditions. There was a significant binding of polyclonal (anti-C5, -C6, -C7, -C8) and monoclonal anti-complement antibodies (anti-C3c and anti-C9 neoepitope (aE11] to agarose beads incubated with unstimulated AM for 24, 48, or 72 h. A significant and inhibitable production of soluble C3c, C5, C9, and S-protein was found in the harvested medium as detected by enzyme immunoassays. Activated C3 and C9 were also detected based on neoepitope expression. Presence of co-cultured agarose beads reduced the amount of soluble S-protein due to deposition on the agarose. We argue that the C9 neoepitope is an integral part of the terminal complement complex (TCC), both in the fluid and solid phase when bound to the agarose. In the fluid phase, SC5b-9 was generated, whereas the agarose-bound S-protein is assumed not to be associated with TCC on the beads. The results demonstrate for the first time that AM from sarcoidosis patients synthesize the functional alternative and terminal pathway of complement.

Adult↗
PubMed1990

Quantification of non-activated (native) complement component C9 synthesized by alveolar macrophages from patients with sarcoidosis.

Alveolar macrophages (AM) from sarcoidosis patients synthesize the functional alternative and terminal pathways of complement, and increased complement production may be one of multiple factors in the pathogenesis of sarcoidosis. We thus examined whether AM from sarcoidosis patients produced quantitatively more C9 in vitro than AM from healthy controls. AM from 16 patients with active sarcoidosis and seven healthy controls were cultured under serum-free conditions for 6, 12, 24, 48, or 72 h. A quantitative production of C9 was found in the harvested medium in 10 of 16 sarcoidosis patients. There were no detectable levels of C9 in the seven controls. Activated C9 was found in all patients and in the majority of the controls. C9 was quantified by an enzyme immunoassay based on a monoclonal antibody (M1) to non-activated C9. Our results indicate greater production of C9 by sarcoidosis AM than by their healthy counterparts.

Adult↗
PubMed1990

Phagocytosis of agarose beads by receptors for C3b (CR1) and iC3b (CR3) on alveolar macrophages from patients with sarcoidosis.

Alveolar macrophages (AM) from sarcoidosis patients exhibit no detectable defect in their potential to synthesize the functional alternative and terminal pathway of complement. They also synthesize more C9 than AM from healthy controls. Various authors have suggested that sarcoid AM have decreased phagocytic ability. In the present work we studied whether there was any difference in C3 receptor-mediated phagocytosis of serum-treated and native agarose beads by AM recovered from patients with active sarcoidosis compared with controls. AM from seven patients with active sarcoidosis and seven healthy controls were cultured under serum-free conditions for 2, 12, 24, and 48 h. We found a significantly increased CR1 and CR3 receptor-mediated phagocytosis of native agarose beads by AM from the seven patients. CR1 and CR3 were also detected on AM directly recovered from bronchoalveolar lavage fluid using fluorescein-conjugated monoclonal anti-receptor antibodies. The percentage of AM expressing CR appeared to be increased in sarcoidosis. The reason for the enhanced phagocytosis of agarose beads by the sarcoid AM is probably the result of both increased synthesis and receptors of complement. Altered complement production and complement receptors may be important for the pathogenesis of this granulomatous disorder.

Adult↗
PubMed1990

"White coat" versus "sustained" borderline hypertension in Tecumseh, Michigan.

During a survey of young subjects not receiving treatment for hypertension in Tecumseh, Michigan, clinic and self-monitored blood pressures taken at home (14 readings in 7 days) were obtained in 737 subjects (387 men, 350 women, average age 31.5 years). Hypertension in the clinic was diagnosed if the clinic blood pressure exceeded 140 mm Hg systolic or 90 mm Hg diastolic. In the absence of firm criteria for what constitutes hypertension at home, subjects whose average home blood pressure was in the upper decile of the whole population were considered to have hypertension at home. By these criteria, 7.1% of the whole population had "white coat" hypertension (i.e., high clinic but not elevated home readings). The prevalence of "sustained" hypertension (i.e., high readings in the clinic and at home) was 5.1%. Subjects with white coat and sustained borderline hypertension in Tecumseh were very similar. Both groups showed, at previous examinations (at ages 5, 8, 21, and 23 years), significantly higher blood pressure readings than the normotensive subjects. As young adults (average age 33.3 years), the parents of both hypertensive groups had significantly higher blood pressure readings than the parents of normotensive subjects. Both hypertensive groups had faster heart rates, higher systemic vascular resistance, and higher minimal forearm vascular resistance. Both hypertensive groups were more overweight, had higher plasma triglycerides, insulin, and insulin/glucose ratios than normotensive subjects. The white coat hypertensive group also had lower values of high density lipoprotein than the normotensive group. White coat hypertension is a frequent condition.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

A phosphatase activity present in peripheral blood myeloid cells of chronic myelogenous leukemia patients but not normal individuals alters nuclear protein binding to transcriptional enhancers of interferon-inducible genes.

Cytoplasmic protein from peripheral blood myeloid cells of chronic myelogenous leukemia (CML) patients altered the electrophoretic mobility of complexes formed between nuclear proteins and interferon-inducible transcriptional enhancers. Immature myeloid marrow cells (blasts and promyelocytes) have a higher level of this activity than do mature myeloid marrow cells (bands and polys). This activity, which is not detectable in the peripheral blood cells of normal individuals, is at least 50-fold higher in CML marrow blasts and promyelocytes than that found in marrow blasts and promyelocytes of normal individuals. This activity was inhibited by in vivo incubation of immature myeloid cells with the phosphatase inhibitor, sodium orthovanadate (0.2 mM), and by adding orthovanadate (20 mM) directly to cytoplasmic proteins of myeloid cells. Interferon-alpha (1,000 U/ml) reduced the effects of the CML myeloid cell cytoplasmic protein on the electrophoretic mobility of nuclear protein-DNA complexes. These data suggest that a unique phosphatase may be involved in the abnormalities in CML which are modulated by interferon-alpha.

Acid Phosphatase↗
PubMed1990

Corynebacteria: incidence among samples submitted to a clinical laboratory for culture.

Over the period of one year, 83 corynebacteria isolates were identified in our laboratory, and their clinical relevance assessed by reference to patients whose clinical notes were available. Eleven species of corynebacteria were identified including four biotypes of C. jeikeium; six organisms were non-typeable; C. jeikeium and C. xerosis predominated. Species identified in the literature as causing clinical infection were also isolated--though in smaller proportions--as were strains of C. jeikeium which were not multi-resistant to antibiotics. Immuno-compromised patients and those with renal impairment had an increased frequency of corynebacteria. The isolation of C. jeikeium from the blood of a neonate suggests that this may be a potential pathogen in these patients. Antibiotic susceptibility of an organism was not a reliable marker of significance, and a reliable biotyping scheme should be adopted.

Bacterial Typing Techniques↗
PubMed1990

Strategic planning: collaboration and empowerment.

This article describes a strategic planning process for the redesign of patient care delivery based on a systems approach. The process included an assessment of internal hospital strengths and weaknesses matched with external opportunities and threats in the community that the hospital serves. An essential component of the strategic planning process was collaboration. Two types of collaboration emerged, interdisciplinary and intradisciplinary. The outcome of involving all disciplines in the hospital as well as multiple levels and roles within nursing was a comprehensive implementation plan based on the empowerment of the health care provider, health care recipient, and the health care system.

Health Planning↗
PubMed1989

S-protein is synthesized by human monocytes and macrophages in vitro.

Human monocytes and alveolar and peritoneal macrophages were cultured in serum-free medium with or without endotoxin (ET), agarose beads, or cycloheximide. The cell culture supernatants were collected after various intervals and examined by a monoclonal anti-S-protein antibody in Western blot and in a solid-phase enzyme immunoassay. We found that the phagocytes synthesize and secrete S-protein. ET stimulation or prolonged incubation of the cells did not favour S-protein production, which was inhibited by cycloheximide. Agarose stimulation increased the S-protein level in supernatants from monocyte but not from macrophage cultures.

Adult↗
PubMed1989

Substance P: mechanism of action and receptor distribution at the feline ileocecal sphincter region.

The purpose of this study was to determine the mechanism of action of substance P at the distal ileum, ileocecal sphincter (ICS), and proximal colon in the cat and to determine the localization of substance P receptors at these sites by autoradiography. Intraluminal pressures and myoelectric activity were recorded at the feline distal ileum, ICS, and colon. Substance P caused a tonic and phasic spike-dependent contractile response at all three sites. The antagonists propranolol, phentolamine, and naloxone did not affect the contractile response to substance P at the ileum, ICS, or colon. The ganglionic blocker trimethaphan camsylate potentiated the response to substance P at all three sites, P less than 0.05. Both atropine and tetrodotoxin reduced the response of substance P at the ileal site. At the ICS, atropine or tetrodotoxin reduced, but did not obliterate, the effect of substance P. Neither atropine nor tetrodotoxin reduced substance P-induced colonic contractions. By use of autoradiography, specific binding for substance P was determined to be present at all three sites with the greatest concentration of substance P receptors in the circular muscle layer. In conclusion, these studies suggest multiple sites of action of substance P. At the ileum, substance P causes contraction via a cholinergic pathway. At the ICS, substance P has an excitatory action through a cholinergic pathway and also at smooth muscle receptors. In the proximal colon, the excitatory action of substance P is via smooth muscle receptors. An inhibitory ganglionic pathway also exists at all three sites. Substance P receptors exist predominantly in the circular muscle region of the ileum, ICS, and the proximal colon.

Animals↗