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Biomedical subjects

G Adams

Publications and source records attributed to G Adams.

At least 73 records · Page 4Linked to original sources
PubMed1994

Measles-mumps-rubella immunization of susceptible hospital employees during a community measles outbreak: cost-effectiveness and protective efficacy.

OBJECTIVE: To determine cost-effectiveness and protective efficacy of a program to identify and immunize susceptible hospital employees during a measles outbreak. DESIGN: A cost analysis was made of blind measles-mumps-rubella (MMR) immunization versus directed MMR immunization based on 2,000 employees born after December 31, 1956. A directed MMR immunization program for susceptible employees was instituted. Actual costs of the program were calculated at the conclusion of the program. SETTING: A medical center complex with more than 4,000 employees, two acute care community hospitals, and a tertiary care children's hospital. RESULTS: A directed MMR immunization program was projected to be less expensive than blind immunization ($23,106 versus $70,720). MMR vaccine was administered to 169 of 188 susceptible employees. Actual cost of the directed MMR immunization program was $25,384. CONCLUSIONS: The directed MMR immunization program was cost-effective and prevented secondary cases among hospital employees during a community measles outbreak.

Community-Acquired Infections↗
PubMed1993

Multi-level regulation of lysosomal gene expression in lymphocytes.

The expression of the gene coding for the lysosomal enzyme, beta-glucuronidase (Gus), was examined in functionally distinct T, B and plasma cell lines. Each of the different groups of cells had different intracellular levels of active Gus enzyme and numbers of Gus mRNA copies per cell. Analysis of the molecular forms of Gus mRNA and protein by Northern and Western blotting revealed that the different types of cells all produced a single mature 2.7 kb transcript and a 73 kDa polypeptide. However, the utilisation of the Gus mRNA to produce the Gus antigen, and the subsequent posttranslational processing of the polypeptide to generate the mature, enzymically active Gus, were found to be cell type-specific. Control of the functional expression of the Gus gene is thus exerted at both the transcriptional and translational levels, and appears to differ between different types of lymphocyte.

Animals↗
PubMed1993

Terazosin in the treatment of benign prostatic hyperplasia. Terazosin Benign Prostatic Hyperplasia Study Group.

OBJECTIVE: To evaluate the efficacy and tolerability of terazosin, a long-acting selective alpha 1-receptor antagonist, in patients with benign prostatic hyperplasia. DESIGN AND SETTING: Randomized, double-blind, multicenter (eight government and private facilities), placebo-controlled study. PATIENTS: Men aged 45 years or older, with qualifying signs and symptoms of benign prostatic hyperplasia (n = 160). INTERVENTIONS: Terazosin or placebo once daily, with terazosin dosage titrated to the patient's response. After a 4-week placebo lead-in, 1 to 10 mg of terazosin or placebo was administered for 24 weeks. OUTCOME MEASURES: Decreases in mean Boyarsky scores for obstructive and irritative symptoms and total scores and increases in peak urine flow rate. RESULTS: Terazosin-treated patients had decreases in Boyarsky obstructive, irritative, and total scores of 3.3 (52%), 1.3 (29%), and 4.6 (42%), respectively, compared with decreases of 0.7 (12%), 0.4 (9%), and 1.1 (11%), respectively, in the placebo group (P < .05). Peak urine flow increased by a mean of 2.6 mL/s (30%) in terazosin-treated patients and 1.2 mL/s (14%) in placebo-treated patients (P < or = .05). Adverse events that differed significantly in the two groups were dizziness (19% in the terazosin group vs 5% in the placebo group) and urinary tract infection (1% in the terazosin group vs 10% in the placebo group). CONCLUSIONS: These results suggest that terazosin given once daily in doses up to 10 mg alleviates symptoms and improves peak urine flow rate in men with benign prostatic hyperplasia and has an acceptable adverse event profile.

Adrenergic alpha-Antagonists↗
PubMed1993

Correction of a lysosomal deficiency by contact-mediated enzyme transfer after bone marrow transplantation.

The effectiveness of bone marrow transplantation for treating lysosomal deficiency diseases relies on the ability of bone marrow cells to provide the missing enzyme to various tissues of the recipient. This has been shown to occur in vitro by endocytosis of enzyme secreted by bone marrow-derived cells and also by direct cell-to-cell-contact. To investigate the mechanism of enzyme replacement therapy in vivo we have used, as enzyme donors, bone marrow cells from coat color mouse mutants that secrete very low or very high levels of a lysosomal enzyme, beta-glucuronidase. Our results show that the level of beta-glucuronidase activity acquired by the tissues of recipient, enzyme-deficient mice is not related to the ability of the donor bone marrow-derived cells to secrete the missing enzyme. This finding suggests that cell-to-cell transfer of lysosomal enzymes may play an important role in the correction of lysosomal diseases by bone marrow transplantation.

Alleles↗
PubMed1993

Duodenal juice total protein and pancreatic enzyme synthesis, turnover, and secretion in patients after acute pancreatitis.

It is controversial whether acute pancreatitis has longterm effects on pancreatic function. Pancreatic enzyme synthesis, turnover, and secretion were measured in 10 patients in clinical remission who had had one or more (one to six) attacks of acute alcoholic pancreatitis. The studies were done between two and 29 months after the most recent attack. A control group included five patients with no evidence of pancreatic disease. A four hour primed/continuous intravenous infusion of [14C]L-leucine tracer was given with secretin (2 U/kg/h) and cholecystokinin (0.5 U/kg/h) and secreted duodenal juice aspirated. Amylase and trypsin were extracted from duodenal juice by affinity chromatography, permitting measurement of the rate of isotope incorporation into total protein, amylase, and trypsin. The results showed non-parallel changes in enzyme synthesis and turnover with decreases in total enzyme protein and amylase synthesis and turnover but preservation of trypsin synthesis and turnover. The low turnover rates may be ascribed to continuing pancreatic cell malfunction after recovery from acute alcoholic pancreatitis and suggest that the decreased amylase secretion rates are partly a consequence of impaired amylase synthesis and not simply because of loss of pancreatic tissue.

Acute Disease↗
PubMed1993

Distribution of Helicobacter pylori colonisation and associated gastric inflammatory changes: difference between patients with duodenal and gastric ulcers.

AIMS: To determine the gastric distribution of Helicobacter pylori in patients with duodenal and gastric ulcers; and to examine the mucosal inflammatory response. METHODS: Patients with newly diagnosed, uncomplicated duodenal and gastric ulcers were endoscoped and two biopsy specimens each taken from the antrum and the body. Specimens were evaluated blind by one pathologist to determine H pylori activity (scored 0-3) and inflammatory changes (according to the Sydney classification). RESULTS: Adequate biopsy material was obtained from 40 and 44 patients with gastric and duodenal ulcers, respectively. Although antral colonisation with H pylori was more common in the antrum of the latter, the organism was equally likely to be found in the body of both sets of patients; the density of colonisation was higher in those with gastric ulcers. Active gastritis and mucosal atrophy were more common in the body of those with gastric ulcers; intestinal metaplasia was also more common in the antrum of these patients. CONCLUSIONS: Gastritis in patients with duodenal ulcers is mainly antral, but the incidence of gastric body colonisation with H pylori seems to be the same in patients with either type of ulcer. There is, however, a significant difference in colonisation density. The cause and importance of this are not obvious and may be related to either host or organism factors.

Adult↗
PubMed1993

Pulmonary sequestration with primary blastomycosis. Failure of ketoconazole therapy after resection.

Infection with Blastomyces dermatitidis developed in a girl with occult pulmonary sequestration. Six months after resection, while receiving ketoconazole, she developed an abscess due to B dermatitidis over the scar from thoracotomy, with a sinus tract to the eighth rib. This was successfully managed with débridement, rib resection, and amphotericin B. Contiguous bone involvement should be suspected in sequestra infected with this organism; débridement and therapy with amphotericin B might be indicated.

Blastomycosis↗
PubMed1993

[Use of fluorine-19 nuclear resonance spectroscopy for the measurement of changes induced in blood perfusion volume in experimental tumors in vivo].

The biological response of some anti-cancer therapeutic agents is probably mediated via the tumour vasculature. A novel approach using 19F NMR spectroscopy in vivo has been developed to directly measure changes in vascular perfusion volume in experimental tumours. A 100% w/v perfluorooctylebromide (PFOB) emulsion was used as a tracer. For a fixed position of a 7 mm surface coil placed over the tumour, the signal from the PFOB rapidly reached an equilibrium value remaining unchanged for at least 2 hours. Since the strength of the fluorine signal is directly proportional to the perfusion volume of the tumour vasculature, reduction of signal intensity should correspond directly to any reduction in volume which may be a manifestation of a change in the tumour blood flow. This hypothesis was investigated using hydralazine as a physiological modifier of tumour blood flow. Administration of 5 mg/kg of hydralazine following dosing with the PFOB emulsion reduced the 19F signal intensity from the murine tumors RIF-1 and KHT and from the human tumour HT29 with no or little reduction in the SCCVII/Ha murine and HX118 human tumours. Changes in blood volume in KHT tumour accompanied local changes in tumour blood flow rate as measured by the Xe-133 clearance rate technique. Thus, these data demonstrate the potential of the PFOB emulsion as a 19F NMR tracer of the vasculature to measure changes induced by therapeutic agents on blood volume in accessible tumours. This method may also be useful to detect early changes in blood volume produced during angiogenesis of solid tumours or angiostatic activity of anti-cancer drugs.

Animals↗
PubMed1993

Phase II evaluation of Taxol in advanced head and neck cancer: an Eastern Cooperative Oncology group trial.

The Eastern Cooperative Oncology Group (ECOG) is conducting a phase II trial of Taxol in patients with histologically confirmed, advanced squamous cell carcinoma of the head and neck. Patients entered in the study to date either had recurrent disease or were newly diagnosed with incurable local-regional disease or distant metastases. Prior chemotherapy was limited to induction or adjuvant chemotherapy at least 12 months prior to entry in the study. All patients had an ECOG performance status of 0 or 1 and measurable disease. The treatment schedule was Taxol 250 mg/m2 by 24-hour continuous intravenous infusion followed by r-met Hu granulocyte-colony stimulating factor 5 micrograms/kg/day subcutaneous injection day 3 to 15 or until the absolute neutrophil count was greater than 1500. Cycles were repeated every 3 weeks. As of September 1, 1992, 27 patients were registered in the study. Of these, three patients were determined to be ineligible, and three were too early to evaluate. There were two early deaths, one definitely and one possibly drug related. Two complete and five partial responses have been observed. Twenty-three patients receiving 83 courses were evaluable for toxicity. Myelosuppression was the primary toxicity observed with 17 (74%) patients experiencing grade 3 or 4 leukopenia and with 20 (87%) patients experiencing grade 3 or 4 neutropenia lasting an average of 2 days (range, 1-4). Peripheral neuropathy occurred in nine patients (grade 1, five patients; grade 2, three patients; grade 3, one patient). Other infrequent toxicities were stomatitis, nausea and vomiting, and myalgias. This trial will continue until 30 eligible patients are accrued.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Squamous Cell↗
PubMed1993

Disseminated herpes simplex virus infection during pregnancy. A case report.

Hepatitis due to herpes simplex virus (HSV) developed in a pregnant women at 38 weeks' gestation. She delivered a live-born infant who had serologically documented HSV 2 infection but did well with acyclovir therapy. The mother, however, died five days postpartum from fulminant hepatic failure despite antiviral treatment, and HSV was demonstrated in the liver. Twenty-three reported cases clearly establish pregnancy as a condition that can predispose to disseminated HSV infection. The majority of cases have been due to HSV 2, and primary infection in the latter part of pregnancy appears to constitute the greatest risk. The major disease manifestations appear to be hepatitis and encephalitis. Historically, maternal and fetal mortality rates have been high, but there is a trend toward improved survival in the acyclovir era.

Adult↗
PubMed1992

Isolation and partial purification of a melanocyte-stimulating hormone receptor from B16 murine melanoma cells. A novel approach using a cleavable biotinylated photoactivated ligand and streptavidin-coated magnetic beads.

The alpha-melanocyte-stimulating hormone (alpha-MSH) receptor of B16 mouse melanoma cells was characterized by photoaffinity labelling using radiolabelled photoactive derivatives of alpha-MSH. A doublet band of 43-46 kDa representing a ligand-receptor complex was identified. A novel adaptation of the streptovadin/biotin-based affinity system was used to isolate the alpha-MSH receptor. A probe was synthesized which contained biotin connected to a photolabelled alpha-MSH analogue via a cleavable disulphide linker and which displayed high affinity for the alpha-MSH receptor. Streptavidin-coated magnetic beads were used as a solid support instead of an affinity column. Covalently linked probe-receptor complexes solubilized in Triton X-100 were equilibrated with the beads, and after magnetic separation and washing, specifically bound complexes were treated with dithiothreitol to cleave the disulphide bridge in the biotin-peptide spacer arm and so release the receptor-ligand complex. The identity of the isolated protein was established by SDS/PAGE analysis. Methods to achieve purification to homogeneity and to allow quantitative isolation of the receptor are discussed.

Affinity Labels↗
PubMed1992

Long-term effects of bone marrow transplantation on lysosomal enzyme replacement in beta-glucuronidase-deficient mice.

This study uses bone marrow transplantation (BMT) between congenic strains of mice as an experimental model to examine enzyme replacement therapy of lysosomal storage diseases. Bone marrow cells from donor mice which have normal levels of the lysosomal enzyme beta-glucuronidase (Gus), which is heat-stable, rapidly repopulated the haematopoietic compartment of irradiated recipient mice which have only low levels of a thermolabile form of this enzyme. Gus activity was found to increase progressively in the tissues of the recipients, including the liver, heart and skeletal muscle. Elevated levels were also observed in the kidney and brain. The increase in enzyme activity in the host tissues was not due to the presence of contaminating blood cells, but rather to the acquisition of new, heat-stable enzyme from the donor bone marrow cells. High levels of Gus activity persisted for at least 72 weeks, showing the potential therapeutic value of BMT for enzyme deficiency diseases.

Animals↗
PubMed1992

Emergence and control of methicillin-resistant Staphylococcus aureus in a children's hospital and pediatric long-term care facility.

BACKGROUND: After a 6-year quiescence, methicillin-resistant Staphylococcus aureus (MRSA) was isolated from 30 patients in a children's hospital and a pediatric long-term care facility from November 1987 through April 1989. After six nosocomial cases had occurred at the children's hospital, increased infection control measures directed at MRSA were initiated in August 1988. Because MRSA had been identified in three patients in the pediatric long-term care facility within 24 hours of their admission to the children's hospital, other patients transferred from the pediatric long-term care facility to the children's hospital were isolated and screened for MRSA. METHODS: We reviewed the medical records of these patients and evaluated their response to therapy with rifampin alone or in combination with trimethoprim-sulfamethoxazole. RESULTS: In the 8-month period after initiation of infection control measures, MRSA was identified in 10 residents of the pediatric long-term care facility; there was also one nosocomial children's hospital case. Phage typing showed that one MRSA strain predominated in patients at the pediatric long-term care facility but did not implicate this strain as the source for MRSA introduction into the children's hospital. Of 16 patients with MRSA who completed therapy and were available for follow-up, 13 (81%) had elimination of colonization. CONCLUSION: Prompt institution of MRSA surveillance, barrier isolation, and therapy to eliminate colonization should be considered in hospitals with a new introduction of MRSA.

Adolescent↗