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Biomedical subjects

E M Smith

Publications and source records attributed to E M Smith.

320 records · Page 18Linked to original sources
PubMedDate not supplied

Phenytoin-induced thrombocytopenia treated with intravenous immune globulin.

PURPOSE: To describe the use of intravenous immune globulin (IVIG) in an 8-year-old girl with phenytoin-induced thrombocytopenia and leukopenia. PATIENTS AND METHODS: An 8-year-old girl had fever, rash, thrombocytopenia, and leukopenia 18 days after initiation of phenytoin therapy. The phenytoin level was elevated. She was treated with 1 g/kg of IVIG. RESULTS: The thrombocytopenia improved dramatically after IVIG therapy. There was a slower response to the leukopenia. CONCLUSIONS: Phenytoin hypersensitivity can present with thrombocytopenia and leukopenia. Treatment with IVIG was associated with a rapid rise in the platelet count in the patient in this report. IVIG should be considered for patients with phenytoin-induced thrombocytopenia.

Anticonvulsants↗
PubMedDate not supplied

ACTH receptor distribution and modulation among murine mononuclear leukocyte populations.

Murine mononuclear leukocytes express adrenocorticotropin (ACTH) receptors that were recognized by a monospecific antiserum to the ACTH receptor on Y-1 adrenal cells. The antiserum was utilized in an immunofluorescence (IF) assay to characterize the distribution of ACTH receptors on resting murine mononuclear leukocyte populations. Forty-seven percent of spleen cells, 32% of lymph node cells, and 1% of thymocytes constitutively expressed ACTH receptors. Separation of lymphocytes into purified B cell and T cell populations, followed by IF analysis revealed that 47% of B cells and 23% of T cells possessed ACTH receptors. Helper T cells (CD4+ T cells) constituted the majority of ACTH receptor-positive T lymphocytes. Furthermore, 47% of resident peritoneal macrophages, purified by adherence to plastic, expressed ACTH receptors. The T-lymphocyte mitogen, concanavalin A, interferon gamma, and ACTH enhanced ACTH receptor expression. The differential distribution of ACTH receptor-positive cells among specific leukocyte populations explains in part why differential cellular responses are observed and implies important regulatory functions for these receptors in the generation or regulation of immune responses.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

Corticotropin (ACTH) induction of tumor necrosis factor alpha by monocytes.

The finding that monocytes possess specific ACTH receptors led us to determine the effect of ACTH on monokine production. Here, we report that ACTH 1-39 will induce TNF-alpha from the adherent fraction of peripheral blood leukocytes. In addition, we also found that ACTH 1-39 will potentiate IFN-gamma's induction of TNF-alpha from these cells. Since previous reports showed that ACTH inhibits IFN-gamma's activation of macrophages to a cytocidal state, our data raise questions concerning the relative role of TNF-alpha in macrophage mediated cytolysis.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

Presence of ACTH and its receptor on a B lymphocytic cell line: a possible autocrine function for a neuroendocrine hormone.

A mouse B lymphocytic cell line, designated BCL1, was found to produce immunoreactive ACTH and to secrete this molecule into culture supernates. The BCL1-derived ACTH induced Y-1 adrenal cells to undergo a steroidogeneic response and was eluted from gel filtration columns at a molecular weight similar to that expected for pituitary-derived ACTH. Furthermore, ACTH receptors were detected on the surface of BCL1 cells using indirect immunofluorescence and 125I-ACTH binding studies. Scatchard analysis demonstrated the presence of high and low affinity binding sites with dissociation constants of 4.5 x 10(-12) M and 2.8 x 10(-9) M, respectively. The production of both ACTH and its receptor by this B lymphocyte cell line suggests that an autocrine mechanism might be important for the maintenance of the transformed phenotype.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

The Indian Health Service approach to alcoholism among American Indians and Alaska Natives.

The transfer to the Indian Health Service (IHS) of 158 alcohol treatment programs that had been administered by the National Institute on Alcohol Abuse and Alcoholism began in 1978. Today, approximately 300 alcohol and substance abuse treatment programs offer services to American Indians, among them primary residential treatment, halfway houses, outreach, and aftercare. This system provides a national network upon which additional activities may be established. Along with increasing its attention to health promotion and disease prevention, the IHS has moved toward the prevention of alcoholism. A variety of preventive programs are in place that emphasize improved self-image, value and attitude clarification, decision-making, and physical and emotional effects of alcohol and substance abuse. Many begin as Head Start programs and continue through adulthood. In 1986, after consulting with both academic and tribal experts, the IHS devised a strategic plan for alcoholism control that stresses comprehensive care and prevention activities; it serves as a guide for further program development. The Secretary of Health and Human Services created a Task Force on Indian Alcoholism in 1986 to serve as a coordinating body for activities carried out by the IHS and other agencies and units of the Department. Passage of the Anti-Drug Abuse Act in 1986 added resources for the development of adolescent treatment centers and, more importantly, for community-based pre- and post-residential care for youths and their families. Concomitant with these initiatives have been several instances of increased attention by various tribes to the problem of alcoholism. The IHS strategic plan, together with the Secretary's initiative, the Anti-Drug Act, and tribal actions, has added substantial momentum to efforts directed at controlling alcoholism among American Indians. Although the mortality rate from alcoholism is about four times greater for the American Indian population than for the entire U.S. population, it decreased from 54.5 per 100,000 population to 26.1 between 1978 and 1985-a reduction of 52 percent.The philosophy of the IHS in emphasizing prevention of disease and promotion of wellness provides an opportunity for continuing the considerable progress already made. The critical and decisive role played by the Indian communities themselves will determine whether ultimate success can be achieved.

Adolescent↗
PubMedDate not supplied

A pattern classification system for automated cervical cytologic screening based on flow microfluorometric analysis.

A data analytic technique is described for use in automated cervical cytology. The method entails the application of a two-dimensional Fourier transform to histogram data obtained by flow microfluorometry and the subsequent use of the Fourier coefficients as parameters for pattern classification. Analyses were performed on 186 samples including material from 62 positive and 124 negative cases. Cell suspensions were stained with propidium iodide and fluorescein isothiocyanate, and red and green cytofluoresence were measured simultaneously. The two-dimensional histogram data were normalized, the Fourier transform was applied, and a multivariate classifier based on 30 coefficients was assembled using a training set of half the original series. Performance was then assessed on the remaining cases. Overall accuracy was 79.6%, with a false-positive rate of 14.8% and a false-negative rate of 31.2%. The potential applicability of this approach as the basis of a practical screening system is discussed.

Adolescent↗
PubMedDate not supplied

Comparison of astigmatic axis in the seated and supine positions.

BACKGROUND: Refractive error is assessed in the seated position while keratorefractive procedures are performed in the supine position. Since position-induced ocular torsion could yield suboptimal results from improper axis alignment, this study was undertaken to ascertain whether ocular cyclotorsion occurs when a subject moves from a seated to supine position. METHODS: Fifty eyes of 29 subjects with refractive cylinder greater than 0.50 diopters were enrolled. Refraction was done with a phoropter and the correction was placed in a trial frame using plus cylinder. Astigmatic axis was determined in the seated and supine positions for 32 eyes by utilizing the "rocking the cylinder" technique and for 32 eyes using the Jackson cross cylinder. Both techniques were used for 14 eyes. RESULTS: No statistically-significant difference for cylinder axis measured in the seated versus supine position was observed using the rocking the cylinder (4.3 degrees standard deviation [SD], 3.5 degrees, range 0 degrees to 13 degrees, p = NS) or the Jackson cross cylinder methods (2.3 degrees, SD, 1.9 degrees, range 0 degrees to 7 degrees, p = NS). Approximately 25% of eyes had a change in axis of 7 degrees to 16 degrees. CONCLUSIONS: These data suggest that the cylinder axis does not change significantly or predictably when most subjects move from the seated to supine position. The Jackson cross cylinder method seems more accurate and reproducible than the rocking the cylinder technique in determination of astigmatic axis under these circumstances.

Adult↗
PubMedDate not supplied

Effect of bacterial toxins in serum on the chromosomes of WI-38.

Two batches of foetal calf serum, free from detectable bacterial, mycotic, mycoplasmal and bovine viral conta mination and possessing good growth-promoting properties induced an abnormally high number of chromatid breaks in WI-38 cells to the extent that the cells were unacceptable as a vaccine substrate. This phenomenon, immediately reversible on changing to a different batch of serum, was unaffected by pasteurisation, suggesting that it was caused by some unidentified toxic factor(s). It was found that the same effect could be brought about by the addition of subcytotoxic concentrations of some bacterial toxins to the culture media. These findings re-emphasise the importance of improved methods for the collection and the maintenance of sterility throughout the processing of such sera, especially when they are intended to be incorporated in media used to establish vaccine substrates.

Bacterial Toxins↗
PubMedDate not supplied

Use of the erythrocyte sedimentation rate in the elderly.

Measurement of the erythrocyte sedimentation rate was introduced more than 70 years ago and is widely used as a simple test of chronic inflammatory activity. However, opinion is varied as to its usefulness in the elderly. In this paper the value and limitations of the test are examined and some guidelines for its use are suggested.

Acute Disease↗