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Biomedical subjects

E M Smith

Publications and source records attributed to E M Smith.

At least 109 records · Page 6Linked to original sources
PubMed1993

Human papillomavirus infection in papillomas and nondiseased respiratory sites of patients with recurrent respiratory papillomatosis using the polymerase chain reaction.

We examined human papillomavirus (HPV) infection in biopsy specimens and cellular scrapes that were taken from respiratory papillomas and six nondiseased sites from the respiratory tract of seven patients. Human papillomavirus was detected by polymerase chain reaction amplification, followed by DNA hybridization with probes for specific HPV types. All papillomas (100.0%, n = 5) were positive only for HPV type 6 or 11. In the nondiseased site specimens, 61.3% (19/31) of the specimens were positive, again only for HPV type 6 or 11. Among the nondiseased site specimens from the cervical trachea, intrathoracic trachea, and bronchus, 80% to 100% were HPV positive compared with only 25% to 50% of HPV infection detected in the nasopharynx, posterior tonsillar pillar, and aryepiglottic fold. These results support the tenet that HPV infection is present in clinically normal respiratory tract tissue and that the reservoir site of reinfection is more commonly in the lower airway. However, patients with upper-airway involvement were more likely to be diagnosed as having severe disease.

Adult↗
PubMed1993

Selective effects of human immunodeficiency virus (HIV) gp120 on invertebrate neurons.

1. HIV gp120 selectively reduces the glutamate-induced inward current and the acetylcholine-induced outward current in specific and identified Aplysia neurons without affecting dopamine (DA)- and serotonin (5-HT)-induced responses. 2. gp120 specifically decreases DA levels without significantly altering norepinephrine and 5-HT levels in Mytilus pedal ganglia. 3. The gp120-associated decrease in DA levels in Mytilus is dose dependent and exhibits a threshold level. 4. The alteration of in vitro DA levels is specific for gp120 since anti-gp120 blocks the effect. 5. gp120 and its effects appear to be stable due to the duration of treatment and the failure of secondary effects to materialize following antibody treatment.

Acetylcholine↗
PubMed1993

A comparison of homeless men and women: different populations, different needs.

Homeless women are very different from homeless men, but few studies have reported data separately on them or compared them directly with men. This report on a study of 600 homeless men and 300 homeless women in St. Louis presents comparison data on these populations. The pivotal difference between homeless men and women was that unlike men, most women had young children in their custody. The women were also younger than men, more likely to be members of a minority group, and more often dependent on welfare. They had been homeless for a shorter period and spent less time in unsheltered locations. Compared to men, they had less frequent histories of substance abuse, incarceration, and felony conviction. Solitary women (without children with them), compared to women with children in their custody, were more likely to be white, had been homeless longer, and more often had a history of alcoholism or schizophrenia. On most variables, values for solitary women lay somewhere between those for men and for women with children. The population of homeless women is therefore heterogeneous, with at least two subgroups. These groups are likely to benefit from intervention programs that are designed to address their specific problems and needs, which are not necessarily the same as those of homeless men.

Adolescent↗
PubMed1993

A systematic study of mental health services utilization by homeless men and women.

Psychiatric illness is overrepresented among the homeless, but mental health services are underutilized in this population in proportion to their needs. The current study was concerned with 900 homeless men and women randomly sampled and systematically interviewed with the Diagnostic Interview Schedule; it focuses on psychiatric and substance abuse rehabilitation service patterns and stated needs of this population in relation to specific psychiatric disorders. Although rates of lifetime treatment utilization were fairly high in comparison with general population utilization patterns, rates of treatment in the current year were low. In particular, outpatient services have been neglected for reliance upon inpatient services. Although the major reason cited for not obtaining treatment by homeless persons with mental illness was lack of insurance and inability to pay for it, having health insurance was not associated with mental health services utilization, nor were other important predictors apparent. Mental health professionals serving mentally ill homeless populations would best serve them by focusing on creative and innovative ways to improve the availability and attractiveness of ambulatory care services.

Adolescent↗
PubMed1993

HIV gp120 alteration of DAMA and IL-1 alpha induced chemotaxic responses in human and invertebrate immunocytes.

The effects of a synthetic peptide fragment of human immunodeficiency virus gp120 (HIV gp120) on opioid (D-ala2-D-met5 enkephalinamide; DAMA) and interleukin-1 (IL-1) induced chemotactic responses in human granulocytes and monocytes and invertebrate (Mytilus edulis) immunocytes were studied. Both DAMA and IL-1 increased the velocity of cell migration from both species and the response is chemotactic (e.g. directed). Non-treated control cells move randomly or not at all. The addition of gp120 to DAMA or IL-1 treated human granulocytes or monocytes results in a slower movement which is chemokinetic (loss of directionality or random) in nature. A similar phenomenon occurs in the invertebrate immunocytes. If gp120 alone is added, it inhibits the movement of spontaneously active human granulocytes and Mytilus edulis immunocytes. In contrast, it stimulates chemokinesis of spontaneously active human monocytes. These responses occur immediately after addition of the peptide. Based on experiments with the selective calcium channel antagonist nimodipine, it appears that the gp120 causes its effects by irreversible binding to a calcium channel. Our results suggest a universal inhibitory mechanism is occurring since the invertebrate immunocytes must recognize HIV gp120 peptide to result in this effect, possibly through a CD4 or other type of surface determinant.

Animals↗
PubMed1993

Race or racism? Addiction in the United States.

Data are presented contrasting racial and ethnic differences in the use of alcohol and other drugs, and in the morbidity and mortality consequent to substance abuse and dependence. In a review of recent studies, whites were found to have higher rates of use, abuse, and dependence than other racial and ethnic groups, despite the common perception that substance abuse is a "minority problem." Epidemiologists are challenged to use appropriate methodologies to study this discrepancy and delineate the roles of both race and racism in addiction.

Adolescent↗
PubMed1993

Placental protein 14 secretion during in vitro fertilization cycles with and without human chorionic gonadotropin for luteal support.

OBJECTIVE: To investigate levels of placental protein 14 (PP14) in in vitro fertilization (IVF) patients with and without exogenous human chorionic gonadotropin (hCG) for luteal support. DESIGN, PATIENTS: Thirty-one women undergoing IVF were studied. For 18 women, hCG was administered in the luteal phase, and 12 became pregnant. Five pregnancies occurred in 13 women not receiving exogenous hCG. SETTING: All the patients attended the University of Southampton/Chalybeate Hospital IVF program. RESULTS: There was no change in PP14 levels 2 days after embryo transfer (ET), but small significant rises were noted by day 8 in all patients. Thereafter, levels rose further in pregnant subjects but showed no change in nonpregnant patients. The highest level of PP14 was seen in the group of women on hCG support, but there was no overall statistical difference between those on support and those not. In the nonpregnant group, there was no significant correlation between progesterone (P) and PP14 8 days from ET, whereas a highly significant correlation was noted in the pregnant group. CONCLUSIONS: Neither hCG nor P are primary factors in the control of endometrial PP14 secretion, but PP14 and P may have common underlying control mechanisms.

Adult↗
PubMed1993

Influence of vas deferens mobilization on rat fertility: implications regarding orchiopexy.

Children who undergo bilateral orchiopexy often have oligospermia or azoospermia in adulthood. This subfertility generally has been attributed to histological alterations in the cryptorchid testis. However, the possibility that an iatrogenic factor, such as mobilization of the vas deferens during orchiopexy, may have an adverse effect on fertility has not been studied. Six groups of mature Sprague-Dawley rats underwent right orchiectomy and the following procedures on the left side: group 1--sham operation, group 2--2 cm. of vas mobilized, group 3--4 cm. of vas mobilized, group 4--2 cm. of vas mobilized and deferential artery stripped off of vas, group 5--4 cm. of vas mobilized and deferential artery stripped off of vas and group 6--vasectomy. Each rat was then housed with 2 female rats for 24 days. Mobilization of the vas with disruption of the mesentery resulted in slight but statistically insignificant reduction in fertility. However, when the deferential artery was dissected off the vas, there was a marked reduction in fertility and fecundity. Histologically the vasa were normal without evidence of ischemic necrosis. The testes in groups 2 to 5 showed variable depletion of germ cells with shedding of germinal epithelium, and the testes and epididymides in group 5 were similar to the changes seen in vasectomized rats (group 6). No testes were necrotic. These data suggest that extensive mobilization of the vas causes subfertility in this animal model and may be secondary to a functional obstruction resulting from vas denervation. Whether a similar effect occurs during orchiopexy in humans deserves study.

Animals↗
PubMed1993

Spinal cord compression secondary to prostate carcinoma: treatment and prognosis.

Of 35 patients with prostate carcinoma and suspected spinal cord compression 26 (74%) had myelograms and/or magnetic resonance imaging studies demonstrating epidural spinal cord compression. In 5 of 26 patients (19%) spinal cord compression was the first indication of prostate cancer. All patients were initially treated with radiation, steroids and androgen deprivation therapy. Three patients underwent laminectomy. Of 12 patients (100%) ambulatory at presentation 12 remained ambulatory. Of 12 patients (83%) who were paraparetic at presentation 10 were ambulatory after treatment. However, 2 of these patients subsequently had recurrent compression and became paraplegic. Overall, 7 of 26 patients (27%) had recurrent compression. Of 5 patients who either presented with paraplegia or in whom paraplegia developed secondary to recurrent spinal cord compression 4 remained paraplegic despite treatment. The average survival of these 5 patients after treatment was 3.9 months versus 18 months for the group as a whole. In ambulatory or paraparetic patients radiation, androgen deprivation therapy and steroids are effective palliative therapy. However, patients who present with paraplegia or in whom paraplegia developed secondary to recurrent compression are often not palliated by this combination therapy. Prophylactic radiation of vertebral metastases discovered concurrently with compressive metastases may be valuable in preventing paraplegia.

Aged↗
PubMed1993

Major blunt renal trauma in the pediatric population: is a nonoperative approach indicated?

We evaluated and treated at our institutions 22 consecutive patients with major blunt renal trauma: 20 had major renal lacerations (grades 3 to 5) as defined by initial computerized tomography, and 2 had vascular pedicle injuries without parenchymal injury and were excluded. An attempt was made to treat all children with a nonoperative approach. Two patients (10%) required renal exploration: 1 for persistent bleeding and 1 in whom a renal neoplasm could not be excluded. The remaining 18 patients (90%) were stabilized and observed. No child required delayed renal exploration. All traumatized renal units demonstrated function on followup studies. Hypertension did not occur in the 13 patients available for long-term followup. We conclude that nonoperative management is a suitable alternative to early exploration in children with major blunt renal lacerations.

Adolescent↗
PubMed1993

Posterior urethral obliteration treated by endoscopic reconstitution, internal urethrotomy and temporary self-dilation.

Five patients with complete posterior urethral obliteration (less than 3 cm.) underwent endoscopic reconstitution of the urethra followed by planned direct vision internal urethrotomy and temporary self-dilation. Of these patients 3 complied with the treatment regimen and are currently free of voiding complaints (average followup 31 months), while 2 failed to perform self-dilation and required repeat internal urethrotomy. Of the latter 2 patients 1 then performed self-dilation and has a stable urethra (followup 2 years). The youngest patient refused to perform self-dilation and underwent successful perineal urethroplasty. Major complications did not occur. The treatment regimen as described is a suitable alternative to surgical urethroplasty in select patients with short urethral defects (less than 3 cm.) who are willing to perform temporary urethral self-dilation.

Adult↗
PubMed1993

Atrial natriuretic factor potentiating and hemodynamic effects of SCH 42495, a new, neutral metalloendopeptidase inhibitor.

Neutral metalloendopeptidase (NEP) inhibitors delay atrial natriuretic factor (ANF) catabolism and potentiate biological responses to ANF. We describe biochemical and pharmacological profiles of a novel NEP inhibitor, SCH 42354 (N-[2(S)-(mercaptomethyl)-3-(2-methylphenyl)-4-oxopropyl]-L-methionine and its orally active ethylester prodrug, SCH 42495. SCH 42354 selectively inhibited hydrolysis of leu-enkephalin and ANF (IC50 of 8.3 and 10.0 nmol/L, respectively) in vitro. Plasma levels of exogenous ANF were augmented and ANF clearance from plasma was delayed by oral SCH 42495 (3 to 30 mg/kg) in normotensive rats. Plasma ANF levels in volume expanded rats were higher in SCH 42495-treated rats. Diuretic and natriuretic effects of ANF were increased in rats treated with SCH 42495. Oral doses of 1, 3, or 10 mg/kg of SCH 42495 produced significant reductions in blood pressure in DOCA-Na hypertensive rats of 22 +/- 6, 43 +/- 7, and 62 +/- 12 mm Hg, respectively, which were not associated with increases in heart rate. These doses did not alter urine flow, salt excretion, or plasma ANF. SCH 42495 produced significant elevation of urinary excretion of ANF and cGMP. In Dahl-S hypertensive rats, SCH 42495 (1 to 10 mg/kg orally) produced falls in blood pressure of a magnitude similar to that observed in DOCA-Na hypertensive rats. Significant hypotensive activity was observed 18 h after a single 10 mg/kg oral dose in Dahl-S hypertensive rats. In DOCA-Na hypertensive rats, a single dose of SCH 42495 significantly decreased cardiac output and did not lower systemic vascular resistance, a profile similar to that of ANF. The hypotensive response to SCH 42495 was not ascribable to ACE inhibition. Pithed rat preparations revealed no interaction of the drug with autonomic cardiovascular function. The antihypertensive effect of SCH 42495 likely results from potentiation of endogenous ANF via NEP inhibition.

Animals↗
PubMed1993

Is antisocial personality a valid diagnosis among the homeless?

OBJECTIVE: It has been argued that among the homeless many of the features of antisocial personality may be artifacts of homelessness and that strict application of the diagnostic criteria may be insensitive to social and cultural factors in this group. The authors studied a large group of homeless men and women to investigate the appropriateness of the diagnosis of antisocial personality disorder among the homeless. METHOD: Six hundred homeless men and 300 homeless women were randomly selected from shelters and street locations in St. Louis and interviewed with the National Institute of Mental Health Diagnostic Interview Schedule. RESULTS: In this sample of homeless men and women, most, but not all, adult symptoms of antisocial personality disorder were significantly associated with number of childhood conduct disorder symptoms. The onset of symptoms of antisocial personality disorder usually preceded the onset of homelessness. The rates of antisocial personality disorder were not significantly affected by discounting the antisocial disorder symptoms thought to be confounded with homelessness. CONCLUSIONS: Overall, the data support the appropriateness of the diagnosis of antisocial personality disorder among homeless populations. It cannot be said from these data that homelessness often leads to antisocial behaviors.

Adolescent↗
PubMed1993

Sexual dysfunction after spinal cord injury.

Treatment of sexual dysfunction is an integral part of the rehabilitation of the patient with spinal cord injury. The degree of sexual dysfunction varies with the level and completeness of injury. A multidisciplinary approach is necessary to evaluate and treat these patients. Intracorporeal injections of vasoactive medications or vacuum devices are effective means of restoring erections in selected patients with spinal cord injury. Penile prostheses are rarely indicated for this purpose.

Adult↗
PubMed1993

Alcohol, drugs, and psychiatric comorbidity among homeless women: an epidemiologic study.

BACKGROUND: Very little is known about the mental health of homeless women. The present study is one of the first to focus on psychiatric diagnosis and comorbidity in a population of homeless women systematically interviewed with a structured instrument. METHOD: Three hundred homeless women randomly selected from St. Louis shelters were interviewed using the Diagnostic Interview Schedule (DIS). RESULTS: The population of homeless women in St. Louis is predominantly young adult, single, and black; most have young children and average nearly a high school education. Schizophrenia and bipolar affective disorder account for only a small portion of the mental illness in these women. Nearly one in three has a history of substance abuse, with drug abuse being more prevalent than alcoholism. One third of the sample met lifetime criteria for posttraumatic stress disorder. One fourth of the women have received inpatient psychiatric care, and the majority with a nonsubstance Axis I diagnosis have received some mental health treatment. CONCLUSION: Although major mental illness is overrepresented among these homeless women, the majority do not suffer from major mental illness. Despite the severity of the stressors these women face, the large numbers escaping psychiatric disorders speak to their resilience and to the likelihood that important factors other than mental illness contribute to their homelessness. Future studies to examine positive outcomes and investigate protective factors might provide a valuable source of information on coping with the stresses associated with homelessness and point to more effective interventions.

Adolescent↗
PubMed1992

Evidence for the conservation of an immunoreactive monokine network in invertebrates.

Mytilus edulis, a marine bivalve mollusc, contains hemocytes that share certain properties with cells of the human monocyte-macrophage lineage. Because of this and previously reported similar responses to opioids between Mytilus hemocytes and human granulocytes, we determined whether Mytilus might also possess monokines or an immune monokine-like network. We chose to study two monokines, interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF). We found that Mytilus hemocytes respond to recombinant human IL-1 and TNF in a fashion similar to human granulocytes. Furthermore, we show that as in the human system, it appears that IL-1 mediates at least part of its effects through immunoreactive (ir) TNF in Mytilus. Finally, we show that Mytilus hemolymph contains ir IL-1 and TNF. To our knowledge, this is the first demonstration of these substances in this system.

Animals↗
PubMed1992

Immunosuppression in the definitive and intermediate hosts of the human parasite Schistosoma mansoni by release of immunoactive neuropeptides.

Evidence supporting the concept that the parasitic trematode Schistosoma mansoni may escape immune reactions from its vertebrate (man) or invertebrate (the freshwater snail Biomphalaria glabrata) hosts by using signal molecules it has in common with these hosts was obtained by the following experiments. The presence of immunoactive proopiomelanocortin (POMC)-derived peptides [corticotropin (ACTH), beta-endorphin] in, and their release from, S. mansoni was demonstrated. Coincubation of adult worms with human polymorphonuclear leukocytes or B. glabrata immunocytes led to the appearance of alpha-melanotropin (MSH) in the medium. The conclusion that this alpha-MSH resulted from conversion of the parasite ACTH by neutral endopeptidase 24.11 (NEP) present on these cells was supported by the fact that the alpha-MSH level in the medium was markedly reduced by addition of the specific NEP inhibitor phosphoramidon. This interpretation is substantiated by the fact that no conversion was observed in comparable tests with human monocytes, which exhibit no NEP activity. alpha-MSH has the capacity to inactivate formerly active immunocytes not only from the definitive host (man, hamster) but also from the intermediate host (B. glabrata), as determined by microscopic computer-assisted examination of conformational changes. POMC-derived peptides have been detected in B. glabrata hemolymph 2, 10, and 24 days after infection by S. mansoni miracidia. Immunocytes from infected snails were found to be inactivated, and this inactivation was prevented by antibodies directed against ACTH and alpha-MSH. The immunoactive beta-endorphin released from S. mansoni does not appear to be subject to enzymatic conversion. Since it is active at lower concentrations, it may be used for distant signaling.

Adrenocorticotropic Hormone↗