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Biomedical subjects

G Burke

Publications and source records attributed to G Burke.

At least 73 records · Page 4Linked to original sources
PubMed1996

Twelve years' experience with non-heart-beating cadaveric donors.

From 1983 to August 1995, the University of Miami Organ Procurement Organization evaluated 41 candidates for non-heart-beating cadaveric donation and determined that 34 patients met the criteria. All patients had irreversible brain injury incompatible with survival. All families gave permission for withdrawal of life support and for tissue and organ donation after cardiac arrest. Thirteen donors died in the operating room, and 9 died in the ICU or emergency department. Four of the 9 patients who died in the ICU had undergone femoral cannulation. The remaining 12 donors were brain-dead but had an unpredicted cardiac arrest before laparotomy. All kidneys were preserved by using machine pulsatile perfusion, and 21 kidneys were transported to other centers. Of the 35 transplanted kidneys, 26 (74%) had immediate function, 6 (17%) had delayed graft function, and 3 (9%) were not used for other reasons. Five of the six transplanted livers had immediate function.

Adolescent↗
PubMed1995

De novo membranoproliferative glomerulonephritis in hepatitis C virus-infected renal allograft recipients.

Hepatitis C virus (HCV) is the leading cause of non-A, non-B hepatitis among renal allograft recipients. We sought to identify and describe a proteinuric renal disease occurring in our HCV-infected renal transplant patients. Patients with proteinuria exceeding 1 g/day were identified from a cohort of 98 HCV-infected kidney recipients. Qualitative and quantitative reverse transcriptase polymerase chain reaction (RT-PCR) and restriction fragment-length polymorphism of the amplified RT-PCR product was performed to detect circulating HCV RNA, viral titer, and strain type, respectively. An immune complex nephritis (ICN) of the membranoproliferative pattern (MPGN) was found on five of eight biopsies. Two patients infected with the Hutch strain-type developed nephrotic-range proteinuria within three months posttransplant while the remaining three MPGN patients had been transplanted greater than 5 years prior to the onset of proteinuria. Testing for rheumatoid factors, cryoglobulins, hypocomplementemia, and circulating immune complexes failed to show a consistent pattern. Sucrose density gradient (SDG) equilibrium centrifugation was used to determine the buoyant-density of HCV virions from control (HCV-infected nonproteinuric recipients; n = 5) and nephrotic patients (n = 5). Whereas HCV virions from the control patients had a low buoyant density on sucrose gradients, a substantial percentage of the circulating HCV RNA from the MPGN patients was present in the high-density fractions in association with IgM and IgG. Treatment of the pooled high-density layers with NP40 followed by recentrifugation resulted in a shift of the HCV RNA to the medium-density layers. In conclusion, MPGN developed in five HCV-infected kidney recipients despite pharmacologic immunosuppression. Both the physicochemical properties of the HCV virions on SDG and their association with IgG and IgM in the high-density layers provide indirect evidence for the presence of circulating complexes of anti-HCV antibody and HCV antigen(s).

Adult↗
PubMed1995

Rethinking PHOs.

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Capitation Fee↗
PubMed1995

Transmission of hepatitis C virus by kidney transplantation: impact of perfusion techniques and course of viremia post transplant.

Hepatitis C virus (HCV) infection is the leading cause of post-transplant non-A, non-B hepatitis. Although many end-stage renal disease patients present for transplantation already infected with HCV, some recipients acquire the infection by transmission from the donor organ. We have detected serological evidence for HCV infection in 6.8% of our organ donors using second-generation anti-HCV assays. Approximately one-third of the patients who received an organ from a HCV carrier donor developed chronic transaminasemia and 8 of 14 (56%) patients converted from HCV RNA negative to positive in the posttransplant period. Demonstration of the course of viremia and transaminasemia is presented for 2 patients in whom transmission of HCV occurred. Using pulsatile machine perfusion, we were able to demonstrate that a standard perfusion of 20 h reduced the viral load in the kidney by 75%, additional flushes and a subsequent perfusion reduced the total viral titer by more than 99%. Thus, although transmission of HCV does occur with solid-organ transplantation, differences in the incidence of transmission between centers may be related to techniques of organ preservation.

Hepacivirus↗
PubMed1995

Characterization of symptoms in children with recurrent abdominal pain: resemblance to irritable bowel syndrome.

We sought to prospectively characterize and compare the symptoms of children > or = 5 years of age with recurrent abdominal pain to previously established criteria for irritable bowel syndrome (IBS) in adults. For all eligible subjects, a detailed questionnaire concerning characteristics of abdominal pain and defecatory pattern was completed at presentation. In addition, a battery of screening tests was performed and additional evaluation was done at the discretion of their physician. In all, 227 subjects fulfilled the entrance criteria, but 56 were subsequently excluded because of diagnoses of inflammatory bowel disease (nine cases), lactose malabsorption (46 cases), or celiac disease (one case). Of the remaining 171 patients, 117 had IBS symptoms. In the IBS subjects, lower abdominal discomfort (p < 0.001), cramping pain (p < 0.0009), and increased flatus (p < 0.0003) were more common, whereas dyspeptic symptoms such as epigastric discomfort (p < 0.003), pain radiating to the chest (p < 0.009), and regurgitation (p < 0.02) were more common in the non-IBS subjects. Our study not only confirms the clinical heterogeneity of children with recurrent abdominal pain but also concomitantly demonstrates that most children with this disorder have symptoms that fulfill the standardized criteria for IBS in adults. The identification of subgroups of children with recurrent abdominal pain can provide a framework for the diagnosis of functional bowel disease as well as establish the need for invasive and expensive tests.

Abdominal Pain↗
PubMed1995

Gray-to-white matter ratios of HMPAO in the human brain.

The gray-to-white matter ratio of technetium 99m-hexamethylpropyleneamine oxime (99mTc-HMPAO) in 14 anesthetized patients undergoing partial brain resection for treatment of complex partial seizures. The gray-to-white matter ratio of 99mTc-HMPAO was 1.8:1 (standard deviation 0.6) in the temporal lobe. Many of the biopsied specimens demonstrated histopathological abnormalities.

Adult↗
PubMed1995

Ethnic differences in stroke: black-white differences in the United States population. SECORDS Investigators. Southeastern Consortium on Racial Differences in Stroke.

The US Black (African-American) population has a higher stroke incidence and mortality than the US White population. This article reviews the English language literature relating to observed racial and ethnic differences in stroke mortality, incidence, and risk factors. In addition, Black-White differences in stroke subtype, pathophysiology, outcome, recurrence, and treatment are reviewed. The significance of these racial and ethnic differences and directions for future research are explored.

Adult↗
PubMed1995

Effect of infant formula on stool characteristics of young infants.

BACKGROUND: Many infants are switched between multiple formula preparations early in life because of perceived abnormalities in stooling pattern as well as gastrointestinal symptoms. OBJECTIVE: To investigate the relationship between the type of formula consumed and the stooling characteristics and gastrointestinal symptoms of young infants. METHODS: Healthy 1-month-old infants were fed one of four commercial formula preparations (Enfamil, Enfamil with Iron, ProSobee, and Nutramigen) for 12 to 14 days in a prospective double-blinded (parent/physician) fashion. Parents completed a daily diary of stool characteristics as well as severity of spitting, gas, and crying for the last 7 days of the study period. A breast-fed infant group was studied as well. RESULTS: Two hundred eighty five infants were enrolled and 238 completed the study. Infants receiving breast milk or Nutramigen had twice as many stools as other formula groups (P < .001). Infants receiving ProSobee had hard/firm stools more often than breast-fed or other formula-fed groups (P < .00001). Watery stools were more common in infants fed Nutramigen than other formula groups (P < .04). Green stools were more common in 12 mg/L iron preparations (Enfamil with iron, ProSobee, Nutramigen) than in those with 1 mg/L (Enfamil, breast milk) (P < .00001). Spitting, gassiness, and crying were of equal severity in all formula groups. CONCLUSIONS: The interpretation of stool frequency, color, and consistency must take into account the infant's formula type as significant variations in normal infants occur. Parental education on the range of infant stooling characteristics as well as the common occurrence of spitting, gas, and crying may alleviate concern for formula intolerance and underlying gastrointestinal disease.

Analysis of Variance↗
PubMed1994

Characterization of a monoclonal antibody recognizing an epitope designated as canine leukocyte-associated antigen.

An IgG1 monoclonal antibody (mAb), designated as 15F1.5, was generated against surface determinants of a dog peripheral blood-derived PHA-induced IL-2-dependent T cell line. It reacted with 65-80% of peripheral blood mononuclear cells (PBMCs), 90-95% of polymorphonuclear cells (PMNs), 65-70% of thymocytes, 85-95% of Thy-1 positive cells and 85-95% of IL-2-dependent T lymphoid cells in flow cytometry. It was nonreactive with peripheral blood red cells and platelets. It immunoprecipitated 95 and 150 Kd proteins derived from detergent solubilized lymphocyte membranes. Indirect immunofluorescent and immunoperoxidase staining of frozen tissue sections demonstrated positive reactivity to cells in lymphoid but not nonlymphoid tissues. The 15F1.5 antibody was not directly mitogenic for PBMC's. It caused significant decrease (P < or = 0.05) in the lymphoproliferative response to T-dependent B cell mitogens, such as pokeweed mitogen (PWM) and staphage lysate (SPL), without significant effects on responses to the T cell mitogens, phytohemagglutinin (PHA), and concanavalin A (Con A). The mixed lymphocyte culture (MLC) response and both the proliferative and effector arms of the cell-mediated cytotoxicity reactions (CMC) were inhibited in a dose-dependent manner. The mAb also inhibited the auto- and allolymphoproliferative reactivity of mixed lymphocyte kidney or islet cell cultures (MLKC and MLIC), and the adhesion of T lymphoblasts and PMA-treated PMNs to endothelial cells. In vivo administration of the 15F1.5 (20 mg/day for 5 days) caused an immediate and prolonged reduction in MLC responses, associated with cell binding of the mAb to PBMC and epitope modulation during the course of treatment, as indicated by flow cytometry. These results suggest that 15F1.5 is an immunomodulating antibody reacting with canine LFA-1. Thus, this mAb would be useful in studying the role of LFA-1/ICAM-1 in graft rejection as well as other inflammatory responses. It would also allow the use of an animal model to investigate the immunoregulatory effects of in vivo administration of anti-CD11/CD18 antibodies in organ/tissue transplants.

Animals↗