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J A Rankin

Publications and source records attributed to J A Rankin.

71 records · Page 4Linked to original sources
PubMed1984

Hermansky-pudlak syndrome and interstitial lung disease: report of a case with lavage findings.

Clinical and pathologic evidence for interstitial pulmonary fibrosis occurring in some patients with the Hermansky-Pudlak syndrome is well described in the literature, but data on immunologic mechanisms operating in this form of lung disease have not been published. In this case report, we describe bronchoalveolar lavage (BAL) findings in a patient with this syndrome. Recovered alveolar macrophages (AM) contained the characteristic ceroidlike material previously described in interstitial macrophages in pathologic specimens. The BAL analysis was similar to that seen in idiopathic pulmonary fibrosis, with increased levels of immunoglobulins and numbers of IgG and IgA secreting cells, and normal percentages of putative helper and suppressor T-cell subsets. In addition, superoxide production by stimulated AM was increased, possibly secondary to phagocytosis of the ceroidlike material. The lavage in this patient was compatible with a mild inflammatory process that was consistent with gallium scan results and the patient's clinical course.

Adult↗
PubMed1984

Bronchoalveolar lavage. Its safety in subjects with mild asthma.

It has been suggested that fiberoptic bronchoscopy may induce life-threatening bronchospasm in persons with asthma. The safety of bronchoscopy and bronchoalveolar lavage (BAL) with bilateral installation of 300 ml of saline solution was assessed prospectively in ten adults with mild asthma as a part of a study of the lower respiratory tract in bronchospastic disease. Asthmatic subjects had pretreatment with intravenous aminophylline prior to bronchoscopy. Pulmonary function tests were performed prior to and immediately after the procedure, and values were compared to results in 12 normal adults undergoing bronchoscopy with BAL. One subject had mild bronchospasm (the third subject) before BAL could be performed. There were no major complications in the remaining asthmatic or normal subjects. Mean forced expiratory volume in one second (FEV1) did not change significantly in either group, and the mid-flow rate at 50 percent of vital capacity (Vmax 50%) decreased significantly only in normal subjects (p = 0.002). Moreover, none of the nine asthmatic subjects completing bronchoscopy with BAL had clinically significant bronchospasm. These results suggest that elective fiberoptic bronchoscopy and BAL can be performed safely in subjects with mild asthma.

Adult↗
PubMed1984

IgE immune complexes induce immediate and prolonged release of leukotriene C4 (LTC4) from rat alveolar macrophages.

Alveolar macrophages obtained by lung lavage from rats were incubated with monoclonal mouse anti-DNP IgE and specific antigen (DNP-HSA) and were found to release a slow reacting substance (SRS), which was characterized by high performance liquid chromatography as leukotriene C4 (LTC)4. Alveolar macrophages incubated with 1 microM A23187 (calcium ionophore) released similar amounts of SRS (6.0 +/- 2.2 and 5.7 +/- 3.7 X 10(-10) mol of LTC4 per 5 X 10(6) alveolar macrophages, respectively). The optimal conditions and mechanism of LTC release by IgE and antigen were examined. LTC4 release was maximal when freshly retrieved alveolar macrophages were incubated for 20 min with 10 micrograms/ml IgE and then for 20 min with 100 ng/ml antigen or for 20 min with IgE and antigen that had been preincubated together for 30 min at room temperature. In addition, LTC4 release was maximal when cells were challenged with IgE and antigen in a protein-free balanced salt solution and when the cells were tumbled to prevent adherence. Dose response experiments revealed that macrophages released LTC4 when stimulated with as little as 10 ng IgE and 100 ng DNP-HSA. Alveolar macrophages did not release LTC when challenged with IgE or DNP-HSA alone. Activation of LTC4 release by IgE and antigen was rapid in onset (2.5 to 5 min), and washing to remove fluid phase IgE and antigen revealed that once activated, alveolar macrophages were capable of prolonged and continuous release of LTC4. Peritoneal lavage cells stimulated with IgE and antigen did not release SRS but could release SRS when incubated with A23187 (5.7 +/- 1.3 X 10(-10) mol LTC4/5 X 10(6) macrophages). A large variability existed between individual rats in the ability of their alveolar macrophages to be activated by IgE and antigen to release LTC4. DNP-HSA labeled with 125I was used to show formation of immune complexes of IgE and antigen when IgE and antigen were incubated together before macrophage challenge. IgE immune complexes containing as little as 2 ng of antigen elicited the release of LTC4 from alveolar macrophages. These data indicate that rat alveolar macrophages release primarily LTC4 when challenged with IgE immune complexes, and that the alveolar macrophage may differ in this respect from peritoneal macrophages that do not release detectable quantities of LTC4 when challenged under identical conditions.

Animals↗
PubMed1984

New library building: Mercer University School of Medicine, Macon, Georgia.

The Mercer University School of Medicine (MUSM) enrolled its charter class in 1982. The curriculum is problem-based and adaptable to the learning needs of each student. MUSM is housed in a new building designed to support this unique educational program. Its library is an example of a comparatively small, but fully functional, medical school library. The planning process, design, and layout of the new library facility are described. Among its unique features are an integrated print and non-print collection, current periodical display space, and extensive use of task lighting.

Facility Design and Construction↗
PubMed1983

Air-space immunoglobulin production and levels in bronchoalveolar lavage fluid of normal subjects and patients with sarcoidosis.

The purpose of this study was to examine the relationship between immunoglobulin production and immunoglobulin levels in bronchoalveolar lavage (BAL) fluid and serum of normal subjects and patients with sarcoidosis. Eleven normal volunteers and 17 patients were studied. In normal subjects, no important relationship existed between the number of immunoglobulin-secreting cells and immunoglobulin levels in BAL or serum. By contrast, in patients with sarcoidosis, a highly significant correlation existed between the number of IgG secreting cells and IgG/alb% in BAL (p = 0.008) and between the number of IgG secreting cells in BAL and serum IgG mg/ml (p = 0.002). Similar associations did not exist for IgA and IgM. These data demonstrate for the first time the relationship between immunoglobulin production and immunoglobulin levels in normal persons, and convincingly show that immunoglobulin production at sites of disease activity is responsible for hypergammaglobulinemia in BAL and serum of patients with sarcoidosis.

Adult↗
PubMed1983

Immunologic alterations in bronchoalveolar lavage fluid in the acquired immunodeficiency syndrome (AIDS).

The association of Pneumocystis carinii pneumonia and cytomegalovirus infection in apparently healthy intravenous drug abusers or homosexual males recently has been described. Two patients with this syndrome were seen recently at our institution. Bronchoalveolar lavage samples from these two patients, taken at the time of bronchoscopy, were analyzed. In both patients a significant increase in inflammatory cells (polymorphonuclear cells) and evidence for polyclonal B cell activation, as measured by a reverse hemolytic plaque assay was seen compared to normal persons (p less than 0.01 both comparisons). IgM and IgG anti-Pneumocystis carinii antibody titers were elevated in the lavage fluid of one patient each. One patient, originally diagnosed as having "Hamman-Rich Syndrome," demonstrated unequivocal chest X-ray improvement with prednisone therapy alone. These observations suggest that the lungs of these two patients were the site of an intense inflammatory response, which was not reflected in studies with peripheral blood.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Speech-prompt catatonia: a case report and review of the literature.

The clinical picture of speech-prompt catatonia, one of the six catatonic subtypes in Leonhard's classification, is demonstrated by a case report. The Leonhardian catatonic subtypes offer a radically different way of approaching the problem of catatonia. The need for a reevaluation of Leonhard's intricate, clinically oriented system, rich in psychopathological details, is emphasized.

Adult↗
PubMedDate not supplied

Atypical presentation of acute myocardial infarction in 3 age groups.

OBJECTIVE: The purpose of this study was to compare the clinical manifestations of first-time acute myocardial infarction (AMI) in 3 age groups of men and women who presented to the emergency departments of 3 acute tertiary care hospitals. DESIGN: An exploratory, descriptive design was used, and there were 2 phases to the project. Phase 1 was a retrospective chart audit of a systematic random sample of patient charts, and phase 2 included a structured interview of a prospective random sample of emergency and intensive care unit nurses and physicians. The data were collected by using a chart audit tool and a semistructured interview, respectively. SETTING: The study took place at a western Canada university affiliated with acute tertiary care centres. SAMPLE: A systematic random sample of 153 (105 men and 48 women) patient charts were audited from the health records departments of 3 acute care hospitals. All of the patients had experienced a first-time AMI. In addition, a random sample of emergency/intensive care unit nurses (n = 60) and physicians (n = 18) was interviewed. RESULTS: The results indicate that a statistically significant number of the oldest (75 years or older) male patients present with atypical manifestations of AMI compared with the men in the younger age groups (P =.005). The same trend was not noted for female patients. The results of the study are limited with respect to the small number of women in each age category. Caution must therefore be exercised in generalizing the results to the target population of women with AMI. The atypical manifestations are described. The results of the interviews revealed that many clinicians do not look for different clinical manifestations when assessing older patients. CONCLUSIONS: It is essential that nurses and physicians accurately assess patients with AMI, especially patients in the older age groups who may be presenting atypically. It is also important that professional and nonprofessional public health education initiatives include information regarding both typical and atypical presentation of AMI, particularly in the older patient.

Activities of Daily Living↗
PubMedDate not supplied

Pathophysiology of the rheumatoid joint.

The precise cause of rheumatoid arthritis (RA) is, as yet, unknown. But with more sophisticated techniques in the fields of immunogenetics and molecular biology, there is increasing knowledge of the pathophysiology of the rheumatoid joint. Pathophysiologic knowledge should be part of the orthopaedic nurse's repertoire when dealing with the "whole" patient; therefore orthopaedic nurses who care for patients with rheumatoid disease should understand certain pathophysiologic concepts. This article reviews the pathophysiology of the rheumatoid joint and describes the changes that take place in the joint with specific reference to the cells of the immune system, the synovium, and articular cartilage.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Comparison of stress and coping in male and female dentists.

This study was designed to examine how female dentists withstand the pressures of dental practice in comparison to male dentists. Two-hundred thirty-eight dentists responded to a national survey that collected demographic data, information about the kinds and degree of stress experienced, coping strategies used and coping effectiveness. The greatest amount of stress experienced was attributed to interactions with patients. The business aspects of dentistry were also associated with significant amounts of stress. In general, male and female dentists' responses to stress were similar, although female dentists experienced more personal/domestic stress. The coping styles of males and females were similar in most respects, except that females were more inclined to discuss their problems. Coping strategies were seen as moderately effective by both sexes. It was suggested that dental students receive training in interpersonal skills, stress management and practice management along with technical training to better prepare them to cope with the realities of dental practice. An alternative suggestion was to address these nontechnical topics through continuing education programs designed for dentists beginning their practice.

Adaptation, Psychological↗
PubMedDate not supplied

Stress and health problems in dentists.

Dental literature has suggested that dentists are particularly vulnerable to health problems due to stress associated with dental practice. However, much of the literature on this subject has been based on anecdotes or opinions rather than systematic research. This study provides current data based on a national sample of 238 dentists. The study compared the degree of stress experienced by male and female dentists and their ability to cope with stress, and then related stress and coping to various somatic and psychologic health problems, workdays missed, and alcohol and drug use. Results indicated that, in general, dentists were reasonably healthy and missed few days of work because of illness. Male and female dentists seemed about equally vulnerable to health problems, although women reported more headaches. Most dentists used alcohol and/or drugs in moderation, but men were more likely to consume alcohol. Both sexes used alcohol more frequently than other drugs.

Adult↗
PubMedDate not supplied

Pulmonary renal syndromes. II. Etiology and pathogenesis.

Numerous systemic diseases share immunopathogenic mechanisms. This article reviews the proposed etiologies and immunopathogenic mechanisms of a group of diseases which share pulmonary and renal abnormalities. Specifically, we discuss the following diseases: Good-pasture's syndrome, systemic lupus erythematosus, progressive systemic sclerosis, Wegener's granulomatosis, lymphomatoid granulomatosis, and Churg-Strauss syndrome.

Animals↗