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Biomedical subjects

G S Hall

Publications and source records attributed to G S Hall.

At least 19 recordsLinked to original sources
PubMed1992

Case report: acromegaly and Cushing's disease in a patient with synchronous pituitary adenomas.

A 40-year-old white woman presented with hirsutism, amenorrhea, generalized fatigue, diffuse weight gain, acral changes, and coarsened facial features. Physical examination revealed mild diastolic hypertension, acromegalic features, hirsutism, and seborrhea. The growth hormone concentration was elevated and did not suppress after glucose administration. Urinary free cortisol excretion was increased and was not suppressed during a 2 mg low-dose dexamethasone suppression test. Magnetic resonance imaging of the sella demonstrated a 1.3 x 1.2 x 0.8 cm pituitary adenoma. Trans-sphenoidal resection was performed, and portions of the resected tumor were analyzed by routine pathologic methods. Histopathologic and immunohistochemical findings indicated discrete growth hormone- and adrenocorticotropic hormone-producing pituitary adenomas. Coexisting acromegaly and Cushing's syndrome due to pituitary neoplasia was previously reported in two patients. However, to the authors' knowledge, this represents the first description of a patient with acromegaly and Cushing's disease resulting from discrete synchronous adenomas of the pituitary gland as defined by modern histopathologic techniques.

17-Ketosteroids↗
PubMed1992

Evaluation of radical prostatectomy specimens. A comparative analysis of sampling methods.

We evaluated 104 radical prostatectomies for clinical stage B (n = 93) and stage A (n = 11) prostate cancer. Seven (8%) stage B cases had no gross cancer. By submitting only gross stage B cancer along with standard sections of proximal and distal margins, base of seminal vesicles, and most apical section (next to distal margin), we identified 91% of capsular penetration and 96% of positive margins as compared with identification by complete microscopic examination. Although this method identified 100% capsular penetration and positive margins in stage A cases, 28% of all the cases were grossly normal. Stage A tumor was often difficult to identify because of its heterogeneous location, its gross similarity to nodular hyperplasia, and the confounding presence of post-transurethral resection scarring. In 98% of all stages B and A cases, this method identified to within 1, the Gleason sum of the totally embedded radical prostatectomy. Using this sampling method, key pathologic parameters were identified with an average of 13 blocks (range 7-36) as compared with totally embedding the prostate, using an average of 42 blocks (range 21-81). Based on our study and our understanding of stages A and B disease, we recommend that in grossly normal glands, alternate posterior sections (stage B) and alternate entire sections (stage A) be submitted. Use of this sampling method will achieve a greater uniformity in the processing of specimens and a more accurate pathologic analysis of radical prostatectomy specimens.

Adenocarcinoma↗
PubMed1992

Quantitative separation of bacteria in saline solution using lanthanide Er(III) and a magnetic field.

A trivalent lanthanide ion, erbium (Er3+), has been used in combination with a magnetic separation technique to isolate seven bacterial species from suspensions in 0.9% saline. Erbium has an exceptionally high atomic magnetic moment of 9.3 Bohr magnetons, and following addition as ErCl3 (final concentration 5 mM) to bacterial suspensions, it imparts the magnetic moment to the bacterial cells by ionic binding to the cell surface. Strains of Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus epidermidis, Staphylococcus saprophyticus and Enterococcus faecalis were obtained from the Quality Control Depository of The Cleveland Clinic Foundation, Cleveland, Ohio, USA as suspensions in 0.9% NaCl, in concentrations ranging from 10(2) to 10(8) c.f.u. ml-1. Bacteria were separated from solution inside a capillary flow cell exposed to a highly non-homogeneous magnetic field (maximum field intensity was 0.4 T) and quantified by a light scattering method. The quantity of cellular deposition in the magnetic field was correlated with the initial concentration of cells in the suspension, expressed in c.f.u. ml-1, and sample volume (1.5 and 3.0 ml), sample pH (prior to ErCl3 addition), affinity to Gram stain (negative vs positive) and species.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteriological Techniques↗
PubMed1992

Pneumocystis carinii shows DNA homology with the ustomycetous red yeast fungi.

Pneumocystis carinii causes life-threatening pneumonia in T-lymphocyte-immunodeficient subjects in transplant and oncology units or with acquired immune deficiency syndrome (AIDS). Recent DNA homology studies show P. carinii to be a fungus. To investigate the biology and epidemiology of this parasite further, we elected to determine for it a more precise taxonomic assignment within the fungal kingdom. We screened a wide range of organisms representing the major orders of fungi using DNA amplification and subsequently sequenced a portion of the mitochondrial gene encoding the large subunit ribosomal RNA. Our data show that the opportunistic pulmonary pathogen P. carinii is closely related to the ustomycetous red yeast fungi, a group which includes organisms that are extensively distributed throughout the environment and which release many widely dispersed airborne spores.

Animals↗
PubMed1991

Proposal of Afipia gen. nov., with Afipia felis sp. nov. (formerly the cat scratch disease bacillus), Afipia clevelandensis sp. nov. (formerly the Cleveland Clinic Foundation strain), Afipia broomeae sp. nov., and three unnamed genospecies.

On the basis of phenotypic characterization and DNA relatedness determinations, the genus Afipia gen. nov., which contains six species, is described. The type species is Afipia felis sp. nov. (the cat scratch disease bacillus). Afipia clevelandensis sp. nov., Afipia broomeae sp. nov., and three unnamed not associated with cat-borne disease. All but one strain (Afipia genospecies 3) were isolated from human wound and respiratory sources. All Afipia species are gram-negative, oxidase-positive, nonfermentative rods in the alpha-2 subgroup of the class Proteobacteria. They are motile by means of a single flagellum. They grow on buffered charcoal-yeast extract agar and nutrient broth, but rarely on MacConkey agar, at 25 and 30 degrees C. They are urease positive; but they are negative in reactions for hemolysis, indole production, H2S production (triple sugar iron agar), gelatin hydrolysis, esculin hydrolysis, and peptonization of litmus milk. They do not produce acid oxidatively from D-glucose, lactose, maltose, or sucrose. The major cell wall fatty acids are 11-methyloctadec-12-enoic (CBr19:1), cis-octadec-11-enoic (C18:1omega7c), and generally, 9,10-methylenehexadecanote and 11,12-methyleneoctadecanoate; and there are only trace amounts of hydroxy acids. The guanineplus-cytosine content is 61.5 to 69 mol%. A. felis is positive for nitrate reduction and is delayed positive for acid production from D-xylose, but it is catalase negative. A. clevelandensis is negative in all of these tests. A. broomeae is weakly positive for catalase production and acid production from D-xylose, but it is negative for nitrate reduction.

Bacterial Typing Techniques↗
PubMed1991

Comparison of the Vitek Immunodiagnostic Assay System with an indirect immunoassay (Toxostat Test Kit) for detection of immunoglobulin G antibodies to Toxoplasma gondii in clinical specimens.

The value and convenience of testing for specific anti-Toxoplasma gondii antibodies have led to the development of various antibody detection methods, such as the enzyme immunoassay. Two enzyme immunoassays, the Vitek Immuno-Diagnostic Assay System (VIDAS; Vitek Systems, Hazelwood, Mo.) and the Toxostat Test Kit (TST; Whittaker Bioproducts, Walkersville, Md.), were compared for their ability to detect T. gondii immunoglobulin G antibodies in fresh human sera. Specimens were tested according to the instructions of each manufacturer. Of 304 serum specimens tested, the results for 282 (93%) agreed in both assays (77 were positive and 205 were negative). The results for the remaining 22 (7%) specimens were discrepant; 20 of the 22 specimens tested low positive or equivocal by Toxostat and negative by VIDAS. Upon retesting, 8 of these 22 specimens were in concordance, increasing the level of agreement to 95.3%. Intra-assay reproducibility was tested with four to nine replicates of each of seven samples (four positive, one negative, and two equivocal) by both tests and six replicates of one standard by VIDAS. Coefficients of variation (CVs) for VIDAS were 6, 8, 10, 15, 18, 19, and 23% for the samples and 14% for the standard. For Toxostat the CVs were 2, 8, 10, 10, 13, and 16%. In general, CVs for VIDAS were slightly larger than the CVs for Toxostat. Day-to-day variability over 3 days was tested by VIDAS for only six samples (three positive, two negative, and one equivocal) and four standards; CVs ranged from 2 to 15% for the samples and from 6 to 13% for the standards. In conclusions, VIDAS is a rapid, convenient, non-labor-intensive, and easily performed test for the detection of immunoglobulin G antibodies to T. gondii in serum specimens.

Animals↗
PubMed1990

Case report and review of resolved fusariosis.

Erythematous macules, nonpalpable and palpable purpura, and flaccid pustules developed in a 59-year-old man with acute lymphocytic leukemia 8 days after reinduction chemotherapy with cytosine arabinoside and daunorubicin. Tissue and blood cultures grew Fusarium proliferatum, and a skin biopsy specimen revealed fungal vasculitis. Anemia and muscle weakness accompanied the disseminated infection, for which the patient received granulocyte transfusions and amphotericin B, ketoconazole, rifampin, and griseofulvin. Skin lesions and fungemia resolved with recovery of the bone marrow, and 51 days after the completion of his chemotherapy he returned home. If promptly recognized and aggressively treated, disseminated fusariosis is responsive to therapy. Infection with Fusarium species should be suspected in profoundly neutropenic patients in whom disseminated palpable purpura and myositis develop concomitantly.

Amphotericin B↗
PubMed1990

Collaborative investigation of variables in susceptibility testing of yeasts.

A multicenter study was performed to evaluate the effect of medium, incubation time (24 and 48 h), and temperature (30 and 35 degrees C) on intra- and interlaboratory variations in MICs of flucytosine, amphotericin B, and ketoconazole for yeasts. Testing was performed on coded isolates of Candida species (11 strains) and Cryptococcus neoformans (2 strains) by using a standard macrodilution protocol 11 laboratories. Four chemically defined media buffered to pH 7.0 with morpholinepropanesulfonic acid were evaluated, including buffered yeast nitrogen base, synthetic amino acid medium-fungal, RPMI 1640 medium, and high-resolution antifungal assay medium. Intralaboratory variability was less than or equal to fourfold for 97% of the replicate sets of data. The highest level of interlaboratory agreement, irrespective of antifungal agent or incubation conditions, was observed with RPMI 1640 medium. Intralaboratory variability was less than or equal to fourfold for 93% of the determinations with ketoconazole and 100% with flucytosine tested in RPMI 1640 medium at 35 degrees C for 24 h. Variability in amphotericin B results was less than or equal to fourfold for 81% of the determinations in RPMI 1640 medium at 35 degrees C for 48 h. The rank order of MICs within each antifungal test group was similar among the various laboratories and was generally in agreement with the reference rank order regardless of the test medium that we used.

Amphotericin B↗
PubMed1990

Kluyvera mediastinitis following open-heart surgery: a case report.

Reports of serious infections caused by Kluyvera spp. have been rare. A case of Kluyvera sp. mediastinitis and bacteremia in a man after open-heart surgery is described. The clinical significance of Kluyvera sp. isolates was debated in early descriptions of the organism. More recent reports, as well as the present case, suggest that the pathogenic potential of this organism is being increasingly recognized by clinicians and microbiologists.

Aged↗
PubMed1989

Systemic mycoses.

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Bibliographies as Topic↗
PubMed1988

Cilofungin (LY121019), an antifungal agent with specific activity against Candida albicans and Candida tropicalis.

Cilofungin (LY121019) is an antifungal agent that interferes with beta-glucan synthesis in the cells walls of fungi. The activity of this agent against 256 clinical isolates of yeasts was determined. It was found to be very active in vitro against Candida albicans (MIC for 90% of isolates [MIC90], less than or equal to 0.31 microgram/ml; minimal fungicidal concentration for 90% of isolates [MFC90], less than or equal to 0.31 micrograms/ml) and C. tropicalis (MIC90, less than or equal to 0.31 microgram/ml; MFC90, less than or equal to 0.31 microgram/ml) and moderately active against Torulopsis glabrata (MIC90 and MFC90, less than or equal to 20 micrograms/ml). All C. parapsilosis, Cryptococcus, and Saccharomyces cerevisiae strains were resistant. The activity of cilofungin was affected by medium and inoculum size. Antibiotic medium no. 3 was used as the standard medium. Isolates of C. albicans and C. tropicalis demonstrated a paradoxical effect in Sabouraud dextrose broth and yeast nitrogen base broth in that growth was partially inhibited at MICs equivalent to those in antibiotic medium no. 3, but growth continued, in many instances, throughout all concentrations tested. There was decreased activity of cilofungin with inocula greater than 10(5) CFU/ml. The temperature and duration of incubation did not affect its activity.

Antifungal Agents↗
PubMed1988

Detection of bacteria in the presence of antibiotics by using specific monoclonal antibodies to neutralize the antibiotics.

Inactivation of penicillin and gentamicin in cultures was achieved by using monoclonal antibodies against these antibiotics. A viridans group streptococcus (penicillin MIC, less than or equal to 0.06 micrograms/ml) and Escherichia coli ATCC 35218 (gentamicin MIC, less than or equal to 1 microgram/ml) were able to grow in broth containing 0.25 micrograms of penicillin per ml and 4 micrograms of gentamicin per ml, respectively, when the specific antibodies were added. This procedure may be useful to increase the yield of bacteria from body fluid specimens that contain antibiotics.

Anti-Bacterial Agents↗