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Biomedical subjects

H Miller

Publications and source records attributed to H Miller.

At least 91 records · Page 5Linked to original sources

Comparison of the VIDAS RSV assay and the Abbott Testpack RSV with direct immunofluorescence for detection of respiratory syncytial virus in nasopharyngeal aspirates.

The sensitivity and accuracy of the VIDAS RSV assay in testing fresh specimens were 82.7 and 87.1%, respectively, whereas specimens previously frozen at -70 degrees C gave a sensitivity of 96.2% and an accuracy of 95.4%. The sensitivity and accuracy of Abbott Testpack RSV were 92.6 and 91.3% for fresh specimens and 86.8 and 88.1% for frozen specimens. The advantages and drawbacks of the two assays are discussed.

Child↗

Post-ictal psychosis after right temporal lobectomy.

Of 298 patients who had temporal lobectomies for intractable epilepsy, 4 (1.3%) developed post-ictal psychosis for the first time after surgery. All were males of normal intelligence with no pre-operative psychiatric disorder. Psychosis followed both complex partial and generalised seizures. The psychotic symptoms showed polymorphic features. Right temporal lobectomy may increase the susceptibility to post-ictal psychosis in patients who are not seizure free after surgery, particularly in the first post-operative year.

Adult↗

Localization of rat tryptase to a subset of the connective tissue type of mast cell.

We examined the cellular distribution of rat tryptase in rat skin, lung, small intestine, and peritoneal lavage cells by immunohistochemical techniques. Tryptase purified to apparent homogeneity from rat skin was used to generate a goat polyclonal anti-rat tryptase antibody. Tryptase-containing cells were detected in lung, skin, and peritoneal lavage cells. Small intestine mucosa, on the other hand, showed few if any tryptase-positive cells. Sequential staining with Alcian blue and anti-tryptase antibody showed that tryptase is located only in mast cells. Sequential staining with safranin to identify the connective tissue type of mast cell and anti-tryptase antibody showed that tryptase resides only in this mast cell type. However, only a subpopulation of the safranin-stained mast cells contained tryptase. In lung, 53% of the mast cells stained with safranin; 94% contained tryptase. In skin, 80% stained with safranin; only 6% contained tryptase. In peritoneal cells, more than 95% of the mast cells were stained with safranin; 20% contained tryptase. In the bowel mucosa, where few cells are stained by safranin, no cells with tryptase were detected. The percentages of cells with chymase I that also contained tryptase were 80% and 84% for lung, 4% and 7% for skin, and 15% and 13% for peritoneal cells by respective simultaneous and sequential double labeling with anti-tryptase and anti-chymase I antibodies. This study suggests that the rat connective tissue type of mast cell is subdivided into two forms on the basis of the presence or absence of tryptase, whereas rat mucosal mast cells lack this enzyme. These results contrast with those in humans, in which tryptase is present in all mast cells, but are similar to mice, in which tryptase mRNA has been detected only in the connective tissue type.

Animals↗

Comparison of immunological reactivity to two major antigens of homologous and AD169 human cytomegalovirus strains during primary infection in renal transplant patients.

The IgG and IgM immunoblotting patterns for the major HCMV antigens p65 and p55/52 were studied in 5 renal transplant recipients during primary HCMV infections. Sequential sera from the 5 patients were tested in parallel with standardized antigens derived from the reference strain AD169 and from the patient'own isolates. The immunoblotting patterns differed from patient to patient as well as between strain AD169 and the patient's homologous isolates. The differences consisted in a better response to the antigens derived from the reference strain AD169, suggesting a delay of the IgM/IgG switch and of the affinity maturation of IgG antibodies to the homologous p65 and p55/52 antigens. The results suggest caution in the interpretation of immunoblotting data derived from laboratory strains such as AD169.

Adult↗

Drama: a medium to enhance social interaction between students with and without mental retardation.

Twenty-four fifth grade (or equivalent age) students were assigned to one of two treatment conditions consisting of equal numbers of students from regular and special education classes. One group was involved in a dramatic games condition culminating in a theatrical performance planned by the group. The second group was involved in a noncompetitive games condition culminating in a demonstration of games developed by the group. Observational data recording initiations and receptions of prosocial bids were collected for all subjects receiving special education services within both groups. A sociometric measure was used to assess the perceived quality of friendships both before and after the interventions. Results showed that students with mental retardation in the drama condition were targeted for positive social interactions by peers without mental retardation significantly more and were more highly regarded as friends than were those in the games condition.

Child↗

New monoclonal antibodies for the detection of immediate early antigens of cytomegalovirus.

Two new monoclonal antibodies, CIE-1 and CIE-2, were developed for the rapid detection of human cytomegalovirus (HCMV) infection. They were found to be reactive with immediate early protein of HCMV in the nuclei of infected fibroblasts, as early as 3 hours post-infection. By radioimmunoprecipitation, CIE-1 was found to react with a protein with an apparent molecular weight of 70,000, whereas CIE-2 precipitated 2 proteins of 70,000 and 72,000 daltons, respectively. Both monoclonal antibodies recognized three prototype strains of HCMV: AD-169, Towne, and Davis, and did not cross-react with other human herpesviruses. CIE-1 and CIE-2 were compared with four commercial anti-HCMV monoclonal antibodies (Clonab, Dupont, Sera-Lab and Syva) by testing 88 clinical isolates. Culture confirmation tests and shell vial assays showed that CIE-1 and CIE-2 were more sensitive than several of these reagents and equally sensitive to the Dupont reagent. Moreover, CIE-1 and CIE-2 produced a bright, sharp staining of the nuclei of infected cells. These monoclonal antibodies should thus be valuable in rapid diagnosis of HCMV.

Animals↗

Intraosseous infusion of resuscitative fluids and drugs: long-term effect on linear bone growth in pigs.

We studied the effects of intraosseous (IO) infusion of a standard fluid bolus and resuscitative drugs on long-term bone growth and epiphyseal closure in the "pediatric" swine model. Eighteen weanling pigs were randomly assigned to six groups as follows: three animals received two normal saline boluses, 20 mL/kg IO over 20 minutes; three received sodium bicarbonate, 1 mEq/kg IO; three received a 10% sodium bicarbonate infusion IO at maintenance rate over 1 hour; three received epinephrine 1:10,000, 0.1 mL/kg IO; three received an epinephrine infusion IO at 1 microgram/kg/min for 1 hour; and three received a dopamine infusion IO at 10 micrograms/kg/min for 1 hour. All infusions were given in the left hindleg; the right hindleg was used as a control. Lateral radiographs of the hind extremities were obtained at the beginning of the study and at 1 and 3 months after infusion. Linear radiographic measurements of the infused and control tibias were compared. At 6 months after infusion, the tibias were harvested, measured directly, and radiographed to determine the degree of epiphyseal closure. Analysis of variance for the first 3 months' data yielded a nonsignificant time-by-treatment interaction (P = .84) and a nonsignificant main effect for time (P = .22). Separate analysis of the direct measurements taken at 6 months revealed no difference in growth between experimental and control tibias. In addition, no radiographic difference in epiphyseal closure was noted between the two groups at the conclusion of the study, nor were any structural defects discovered. Intraosseous infusion of fluids and resuscitative drugs does not adversely affect subsequent bone growth and development in the swine model.

Animals↗

Asymmetrical cognitive differences associated with hemiparkinsonism.

The question of whether Parkinson's disease (PD) patients who have left (LPD) or right (RPD) motor predominance also exhibit cognitive differences is controversial. We examined this issue using a neuropsychological battery designed to provide a balanced sampling of both right- and left-hemispheric functions. RPD patients were impaired relative to LPD patients on verbally mediated tasks (left hemisphere function), but there was no group difference for visuospatial tasks (right-hemispheric function). In addition, there was a significant correlation between the extent of right side motor predominance and performance on verbal tasks, but there was no relationship between left side motor symptoms and performance on visuospatial tasks. The controversy related to cognitive differences in hemiparkinsonism may be due to the balance of the assessment procedure, the severity of motor asymmetry, or both.

Journal Article↗

Peroxide modification of monoalkylated glutathione reductase. Stabilization of an active-site cysteine-sulfenic acid.

Hydrogen peroxide reacts with two-electron reduced glutathione reductase (GR EH2 species) to give the native oxidized enzyme (E) without detectable intermediates. Prior alkylation of the EH2 interchange thiol with iodoacetamide, however, dramatically changes both the course and overall rate of the peroxide reaction. This oxidation, monitored spectrally, is characterized by an intermediate (EHRint) with enhanced long wavelength absorbance extending to 800 nm. This species decays in a second peroxide-dependent phase to an enzyme form (EHRox) easily distinguished from E. Quenching experiments with catalase allow the isolation of a stable mixture consisting of 36% monoalkylated GR (EHR), 60% EHRint, and 4% EHRox; NADPH titration and anaerobic dithiothreitol addition lead to quantitative reduction of EHRint to EHR, and there is an increase in thiol titer of 0.8-SH/FAD on NADPH reduction. Of the four titratable thiols present in EHR, 2.7 are lost on oxidation to EHRox and 0.7-0.8 mol of cysteic acid/FAD is formed. On the basis of these and other observations, we conclude that alkylation of the EH2 interchange thiol, which blocks disulfide formation, allows peroxide reaction at the remaining charge-transfer thiol to proceed via a stabilized cysteine-sulfenic acid intermediate (EHRint), which undergoes further oxidation to the corresponding cysteic acid (EHRox).

Alkylation↗

Isradipine: overall clinical experience in hypertension in the United States.

Isradipine is a new dihydropyridine calcium antagonist shown to be efficacious, safe, and well tolerated in the treatment of hypertension, regardless of patient age or race. There has been no evidence of negative inotropism, atrioventricular conduction delay, nor clinically significant changes in laboratory parameters associated with isradipine treatment. A total of 934 patients have been treated with isradipine in double-blind hypertension trials (involving 297 patients treated with placebo and 414 treated with active controls, such as hydrochlorothiazide and enalapril). Both the mean changes from baseline in diastolic and systolic blood pressures and the percentage of patients responding to treatment (blood pressure decrease of at least 10 mm Hg) were greater with isradipine than with placebo or active controls. Blood pressure response increases with increases in isradipine dose up to 10 to 15 mg daily; higher doses do not, on average, result in greater blood pressure reduction. The incidence of adverse reactions with isradipine is similar to that for active controls and slightly more than for placebo. There were fewer discontinuations with isradipine and, in addition, a decrease in the incidence of new adverse reactions with increasing duration of treatment, down to 1% at 24 months.

Antihypertensive Agents↗

Prospective study of cytomegalovirus antigenemia in allograft recipients.

A recently published technique for direct detection of cytomegalovirus (CMV) antigenemia was tested prospectively in 27 transplant recipients. Eighteen patients developed active CMV infections and 10 of the 18 experienced CMV syndrome. All of the infections were detected by classical virus isolation and/or serologic techniques. No antigenemia was demonstrated.

Antigens, Viral↗

Comparison of immunofluorescence and enzyme immunoassay for detection of measles-specific immunoglobulin M antibody.

During a measles outbreak, 283 serum specimens from 221 suspected cases of measles were tested by immunofluorescence and enzyme immunoassay for the presence of measles-specific immunoglobulin M (IgM) antibodies by using commercially available reagents. There was 97% agreement between the two assays; thus, the choice of the method for diagnostic testing is a matter of convenience and experience. In all 62 cases of measles from which a single blood sample was available, measles IgM-specific antibodies were detectable by both methods. Fifty percent of the 62 cases were positive within 3 days after onset of the rash. This increased to 91% 10 days after onset of the rash.

Adolescent↗

Blunt liver trauma at sunnybrook Medical Centre: a 13 year experience.

Between June 1, 1976 and June 30, 1989 The Regional Trauma Unit at Sunnybrook Medical Centre in Toronto, Ontario, Canada received 3730 patients. Of these 335 (9%) sustained a liver injury, 95% being due to blunt trauma. Open peritoneal lavage was performed on 80% of liver trauma patients (267/335), 99% being true positive. A laparotomy was performed on 97% of patients (324/335). Major surgical treatment was required in 132 patients (41%) and minor treatment in 192 patients (59%). The remaining 11 patients were treated conservatively (n = 3) or died during resuscitation (n = 8). Morbidity directly related to the liver injury was seen in 29 of 249 surviving patients (11%) although overall morbidity was 27% (67/249). Reoperation was required in 6% (14/249) with abscess or hematoma accounting for 11 of 14 operations. The overall mortality rate was 26% (86/335). Eighty two percent of patients (n = 276) had a grade I, II or III liver trauma according to Moore's classification with a mortality of 12% (n = 32). The remaining 18% of patients (n = 59) had a grade IV or V liver trauma with a mortality of 44% (n = 26). Of the 86 deaths, head injury accounted for 48 (56% of deaths); liver hemorrhage for 17 (20%), liver sepsis for 1 (1%) and other causes for 20 deaths (23%). Thus death due to the liver injury itself (hemorrhage and sepsis) occurred in 18 out of 335 patients (5% overall). Head injury accounted for the death of 48 out of 335 patients (14% overall). Over the past 13 years a trend has occurred at our institution whereby we are seeing less liver trauma in our population of multiply injured patients from 12% (1976-1983) down to 7% (1985-1989); with a gradual decline in overall mortality from 32% (1976-1983) to 19% (1985-1989), whereas the percentage of deaths due to head injuries and liver injury have increased.

Cause of Death↗

Heterogeneity among the flavin-containing NADH peroxidases of group D streptococci. Analysis of the enzyme from Streptococcus faecalis ATCC 9790.

Polyclonal antisera prepared against the purified NADH peroxidase from Streptococcus faecalis ATCC 9790 (Enterococcus hirae) do not cross-react with the ATCC 11700 enzyme. Comparative tryptic maps of the two proteins indicate that the differences in primary structures extend beyond those localized to respective antigenic epitopes. Alignments of the NH2-terminal and active-site cysteinyl peptide sequences of the two streptococcal peroxidases reveal identities of 50 and 67% in the respective overlap regions. Dithionite titrations of the ATCC 9790 enzyme reveal a separation in potentials (E2 - E1) for the nonflavin and flavin redox centers of 39 mV, a value nearly 50 mV lower than that observed with the ATCC 11700 peroxidase. Despite these changes in redox behavior NADH titrations of the ATCC 9790 enzyme give rise to both EH2 and EH2.NADH species as previously observed. The enzyme turnover number with hydrogen peroxide is approximately 60% that of the ATCC 11700 peroxidase; the ATCC 9790 peroxidase is also inhibited during turnover with ethyl hydroperoxide. These findings suggest that the flavoprotein NADH peroxidases may exhibit greater diversity among the group D streptococci than previously observed with the widely distributed enzymes of the related flavoprotein disulfide reductase class.

Amino Acid Sequence↗