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Biomedical subjects

J A Stone

Publications and source records attributed to J A Stone.

At least 37 records · Page 2Linked to original sources

High-resolution MR imaging of the auditory pathway.

MR imaging is a valuable tool in the evaluation of the auditory pathway. The current techniques in high-resolution MR imaging of the temporal bone are presented followed by a review of normal anatomy. Several diseases involving the middle ear, inner ear, internal auditory canal, and cerebellopontine angle are then presented. A radiologic-pathologic approach is used to illustrate the nature of these diseases and their appearance on MR imaging.

Auditory Diseases, Central↗

Electrospray mass-spectrometric, spectrophotometric and electrochemical methods do not provide evidence for the binding of nitric oxide by pyocyanine at pH 7.

In several recent publications on pyocyanine, its mechanism of action has been attributed to an ability to react with nitric oxide (NO), resulting in the formation of an adduct. We examined the chemical interaction of pyocyanine and NO using electrospray (ES) MS, spectrophotometry and voltammetry at neutral pH and with 10-100 microM pyocyanine. No binding of NO to pyocyanine was observed. Alternative mechanisms for the inhibition of NO-induced vasorelaxation by pyocyanine should be sought.

Binding Sites↗

Comparison of hemodynamic and sympathoneural responses to adenosine and lower body negative pressure in man.

Adenosine increases heart rate and sympathetic nerve activity reflexively in conscious humans through several mechanisms. The purpose of this study was to assess the relative contributions of arterial baroreceptor unloading, carotid chemoreceptor stimulation, and other adenosine-sensitive afferent nerves to these responses. In 12 healthy men, the effect on blood pressure, heart rate (HR), and muscle sympathetic nerve activity (MSNA; peroneal nerve) of lower body negative pressure (LBNP; -15 mmHg (1 mmHg = 133.3 Pa)) was compared with the effect of intravenous adenosine (35, 70, and l40 micrograms.kg-1.min-1). In eight subjects, the highest dose was reinfused during 100% oxygen to suppress arterial chemoreceptors. Blood pressure reductions during LBNP and adenosine (140 micrograms.kg-1.min-1) were similar. HR did not change significantly during LBNP (+2 +/- 2 beats/min; mean +/- SE) but increased at the highest adenosine dose (+25 +/- 3 beats/min; p < 0.05). MSNA increased significantly (p < 0.05) during both interventions (+255 +/- 82 and +247 +/- 58 units/100 beats for adenosine and LBNP, respectively), and there was no difference in the MSNA response to these two stimuli (p > 0.1). Oxygen inhibited adenosine-induced increases in HR and MSNA (from +305 +/- 99 to +198 +/- 75 units/100 beats and from +26 +/- 4 to +18 +/- 3 beats/min; p < 0.05 for both comparisons). The MSNA response to these combined stimuli was similar to that observed during LBNP. In contrast, the residual HR response (+18 +/- 3 beats/min) was significantly greter than the response to LBNP (+2 +/- 2 beats/min; p < 0.05). These data indicate that arterial baroreceptor unloading cannot account for the marked adenosine-induced increase in HR, but may be sufficient to explain its effect on MSNA. The effect of 100% oxygen confirms that stimulation of carotid chemoreceptors accounts for approximately one-third of the HR and MSNA response to adenosine. However, other mechanisms, such as stimulation of adenosine-sensitive afferent nerves in other vascular beds, are involved in the HR and possibly the MSNA response.

Adenosine↗

Alpha 1-antitrypsin deficiency: evaluation of bronchiectasis with CT.

PURPOSE: To assess bronchiectasis depicted with computed tomography (CT) in patients with alpha 1-antitrypsin deficiency and to examine associated clinical correlates. MATERIALS AND METHODS: CT scans in 14 patients with alpha 1-antitrypsin deficiency were evaluated by two thoracic radiologists for the presence and extent of bronchiectasis and emphysema. The findings were correlated with numeric infection scores on the basis of symptoms of sputum production and respiratory infection and with a history of conditions that may predispose to development of bronchiectasis. RESULTS: Six (43%) of 14 patients had CT evidence of bronchiectasis. Patients with bronchiectasis had significantly higher infection scores than did patients without bronchiectasis (P < .005). Two patients had diffuse cystic bronchiectasis, and neither reported a history of illness that may have predisposed them to this condition. CONCLUSION: Bronchiectasis may be more common in patients with alpha 1-antitrypsin deficiency than has been previously recognized. The diagnosis of alpha 1-antitrypsin deficiency should be considered in patients with emphysema and diffuse cystic bronchiectasis.

Bronchiectasis↗

Identical-twin bone marrow transplants for leukemia.

OBJECTIVE: To compare outcomes of identical-twin with HLA-identical sibling bone marrow transplants for leukemia. DESIGN: Matched-pair analysis comparing relapse, treatment-related mortality, and leukemia-free survival in cohorts matched for disease and variables correlated with transplant outcome, with and without adjustment for graft-versus-host disease. SETTING: 163 institutions worldwide between 1978 and 1990, reporting to the International Bone Marrow Transplant Registry. PARTICIPANTS: 103 identical-twin transplants: 24 for acute lymphoblastic leukemia (ALL) in first remission, 45 for acute myelogenous leukemia (AML) in first remission, and 34 for chronic myelogenous leukemia (CML) in first chronic phase. Results were compared with those in 1030 concurrent HLA-identical sibling transplants matched for prognostic factors. RESULTS: Three-year probabilities of relapse after identical-twin compared with HLA-identical sibling transplants were as follows: ALL, 36% (95% CI, 17% to 55%) compared with 26% (CI, 20% to 32%); AML, 52% (CI, 37% to 67%) compared with 16% (CI, 12% to 20%); and CML, 40% (CI, 23% to 57%) compared with 7% (CI, 4% to 10%). Increased relapse risks in AML and CML persisted after adjusting for graft-versus-host disease (relative risk, 3.1 [CI, 1.9 to 5.1] and 5.5 [CI, 2.8 to 11.0], respectively). Although twins had less treatment-related mortality than HLA-identical siblings, leukemia-free survival was similar. Three-year leukemia-free survival probabilities after twin compared with HLA-identical sibling transplants were as follows: ALL, 57% (CI, 37% to 77%) compared with 58% (CI, 52% to 64%); AML, 42% (CI, 27% to 57%) compared with 55% (CI, 50% to 60%); and CML, 59% (CI, 42% to 76%) compared with 61% (CI, 56% to 66%). CONCLUSIONS: Identical-twin transplants in AML and CML are associated with increased relapse risk compared with HLA-identical sibling transplants. A similar trend was observed in ALL but was not statistically significant. Increased relapse in twin transplants is not explained by lack of graft-versus-host disease. Leukemia-free survival after twin and HLA-identical sibling transplants is similar because increased relapse in twins is offset by decreased treatment-related mortality.

Bone Marrow Transplantation↗

Upper extremity proprioceptive training.

Proprioception following lower extremity injuries is commonly recommended, but there is little information on proprioception training following upper extremity injuries. No studies have evaluated whether proprioception programs for athletes in open kinetic chain activities (throwing, shot putting) should be different than programs for athletes in closed kinetic chain activities (gymnastics, swimming, kayaking, or rowing). In this paper, we provide a rationale for proprioception training for upper extremity injuries in athletes and the importance of analyzing the athlete's sport and activity for specificity of proprioception exercises. We then discuss one popular proprioception exercise, rhythmic stabilization, and propose several additional upper extremity proprioception exercises, along with instructions for the athletic trainer on how to direct the athlete through these exercises.

Journal Article↗

Content of notification: exposure to the pesticide chlordimeform.

A notification about exposure requires a detailed search of records and interviews with personnel to properly identify potentially exposed groups. Next, these potentially exposed groups must be examined to determine which groups had the potential for highest exposures. The notification should address three key questions: Why am I receiving this notification? What problems are associated with exposure to the chemical? What am I supposed to do? Consideration should be given to notifying lesser-exposed groups, as to why they are not considered to be at increased risk.

Chlorphenamidine↗

Maximal migration of human smooth muscle cells on fibronectin and type IV collagen occurs at an intermediate attachment strength.

Although a biphasic dependence of cell migration speed on cell-substratum adhesiveness has been predicted theoretically, experimental data directly demonstrating a relationship between these two phenomena have been lacking. To determine whether an optimal strength of cell-substratum adhesive interactions exists for cell migration, we measured quantitatively both the initial attachment strength and migration speed of human smooth muscle cells (HSMCs) on a range of surface concentrations of fibronectin (Fn) and type IV collagen (CnIV). Initial attachment strength was measured in order to characterize short time-scale cell-substratum interactions, which may be representative of dynamic interactions involved in cell migration. The critical fluid shear stress for cell detachment, determined in a radial-flow detachment assay, increased linearly with the surface concentrations of adsorbed Fn and CnIV. The detachment stress required for cells on Fn, 3.6 +/- 0.2 x 10(-3) mu dynes/absorbed molecule, was much greater than that on CnIV, 5.0 +/- 1.4 x 10(-5) mu dynes/absorbed molecule. Time-lapse videomicroscopy of individual cell movement paths showed that the migration behavior of HSMCs on these substrates varied with the absorbed concentration of each matrix protein, exhibiting biphasic dependence. Cell speed reached a maximum at intermediate concentrations of both proteins, with optimal concentrations for migration at 1 x 10(3) molecules/micron2 and 1 x 10(4) molecules/micron2 on Fn and CnIV, respectively. These optimal protein concentrations represent optimal initial attachment strengths corresponding to detachment shear stresses of 3.8 mu dyne/micron2 on Fn and 1.5 mu dyne/micron2 on CnIV. Thus, while the optimal absorbed protein concentrations for migration on Fn and CnIV differed by an order of magnitude, the optimal initial attachment strengths for migration on these two proteins were very similar. Further, the same minimum strength of initial attachment, corresponding to a detachment shear stress of approximately 1 mu dyne/micron2, was required for movement on either protein. These results suggest that initial cell-substratum attachment strength is a central variable governing cell migration speed, able to correlate observations of motility on substrata differing in adhesiveness. They also demonstrate that migration speed depends in biphasic manner on attachment strength, with maximal migration at an intermediate level of cell-substratum adhesiveness.

Cell Adhesion↗

Fifteen years of amateur boxing injuries/illnesses at the United States olympic training center.

We examined the incidence of health problems in elite-level amateur boxing athletes who sparred, trained, or competed at the United States Olympic Training Center in Colorado Springs, Colorado from January 1, 1977 through June 30, 1992. We think this is the first study to examine both injuries and illnesses in a population of elite-level athletes. We collected data on 1,776 reported problems (1219 injuries, 557 illnesses) from standard medical report forms completed by the permanent and volunteer sports medicine staff. We classified the information based on type, body region, location, description, and occurrence. There were significant differences between the frequency of injuries and illnesses and between the classifications and regions for each type of problem. Collectively, serious injuries represented only a relatively small percentage (6.1%) of all problems. We concluded that illnesses comprised a small but important portion of problems, that most illnesses involved respiratory tract infections (71%), that there is only a small risk for serious injury, and that injuries occur in a hierarchy of upper extremity (441, 25%), head/face (344, 19%), lower extremity (267, 15%), and spinal column (167, 9%) for amateur boxers.

Journal Article↗

Evaluation of the mass balance assumption with respect to the two-resistance model of intestinal absorption by using in situ single-pass intestinal perfusion of theophylline in rats.

Methods of analyzing drug absorption data from rat intestinal-perfusion experiments are discussed in terms of mass-transfer resistances, or reciprocal permeabilities, and mass balances. Typically, a two-resistance model is used to determine the dimensionless effective permeability (P*eff) by measuring the disappearance of drug from the perfusing solution. Unstated assumptions in two-resistance models are (1) the portal blood is under sink conditions and (2) complete transfer of drug occurs from the intestinal perfusate to the portal vein. The assumption of sink conditions is generally acceptable, because the drug concentration in portal blood is approximately two orders of magnitude less than in the perfusate. Single-pass intestinal-perfusion experiments were performed on rats with theophylline as a model compound. The drug mass leaving the intestinal perfusate was substantially less than the drug mass appearing in the portal plasma; that is, the assumption of complete transfer did not hold for theophylline in this experimental system. These data indicate that models based on the two-resistance theory can lead to overestimation of P*eff by the ratio of the drug mass leaving the perfusate to the drug mass appearing in the plasma. For compounds for which the assumption of complete transfer does not hold, a more accurate estimate of P*eff may be determined by dividing the value derived from perfusate data by the mass balance ratio (i.e., the drug mass leaving the perfusate divided by the drug mass appearing in the plasma).

Animals↗

Discrepancies between sodium concentrations measured by the Kodak Ektachem 700 and by dilutional and direct ion-selective electrode analyzers.

We have identified rare (approximately 0.2% of all samples), but clinically significant, discrepancies between serum or plasma sodium concentrations measured with the Kodak Ektachem 700's direct ion-selective electrode (ISE) method and concentrations measured with two other analyzers: the Beckman Synchron CX3's dilutional ISE instrument and the Radiometer KNA2 instrument for sodium-potassium analysis by the direct ISE method. The differences do not appear to be related to any previously identified sources of discrepancy, such as variations in triglycerides, bicarbonate, total protein, albumin, or gamma-globulin, the presence of paraproteins, or interference by benzalkonium chloride from heparinized catheters. They occurred despite the use of Gen 04 reference fluid on the Ektachem. We could not identify any drug or family of drugs that the patients had taken in common and that might influence the results. Until this problem is resolved, Ektachem users should be aware of the potential for discrepancies of > 6 mmol/L in measurements of sodium concentrations.

Adolescent↗

The use of the pressure cuff test in the diagnosis of decompression sickness.

Records at the Hyperbaric Medicine Division, United States Air Force School of Aerospace Medicine, were reviewed to determine the utility of the pressure cuff test as an aid in the diagnosis of Type I decompression sickness (DCS). Applying local pressure with a blood pressure cuff has been described as a useful test to differentiate the pain of DCS from that of other musculoskeletal conditions. Records were reviewed from January 1985 to December 1989. During this period 179 patients were treated with recompression for extremity pain. Application of a blood pressure cuff to the painful area was used as a diagnostic aid in 87 patients. Only 53 patients (61%) with DCS had a positive test (relief of pain with local pressure). Results did not correlate with the rapidity of relief of symptoms during recompression. We conclude that the failure to respond to the application of local pressure should not be used to rule out the presence of DCS-this must be done with a test of pressure in a hyperbaric chamber.

Adult↗

The effect of atrial natriuretic factor on force development in rat cardiac trabeculae.

Studies in single cardiac muscle cells have demonstrated that atrial natriuretic factor decreases the L-type calcium current. Recent investigations in human atrial cells have also demonstrated that atrial natriuretic factor causes a voltage-dependent reduction in sodium channel activity and thus may reduce intracellular calcium via decreased activity of the sodium-calcium exchange mechanism. By reducing intracellular calcium, atrial natriuretic factor may have a negative inotropic effect on cardiac muscle. To characterize the effect of atrial natriuretic factor on the development of force, we studied the force-sarcomere length relationship in 11 right ventricular rat trabeculae, both before and after exposure of the muscles to increasing concentrations of atrial natriuretic factor. Sarcomere length was measured by laser diffraction techniques and controlled by a servomotor system. The addition of atrial natriuretic factor to the superfusion solution, at concentrations of 10(-9)-10(-7) M, increased stimulus threshold, reduced peak twitch force in a dose-dependent manner by 38% (maximum), and reduced time to peak twitch force by 15% (maximum). Incubation of muscle preparations with concentrations of atrial natriuretic factor below 10(-9) M had no effect on force generation. The negative inotropic effect of atrial natriuretic factor was associated with a change in the shape of the force-sarcomere length relationship, similar to a reduction of the extracellular calcium concentration. ANF (10(-7) M) had no effect on the rate of decay of force following post extra-systolic potentiation. These observations are consistent with the assumption that the negative inotropic effect of atrial natriuretic factor is mediated by reduction of calcium entry into the cardiac cell.

Animals↗

Pericardial pressure attenuates release of atriopeptin in volume-expanded dogs.

The role of the pericardium in the release of atriopeptin (AP) was examined, utilizing two separate protocols, in alpha-chloralose-anesthetized dogs. Protocol I consisted of an experimental group (9 dogs), in which the pericardium was incised to allow instrumentation and reapproximated, and a control group (6 dogs), in which the pericardium was left undisturbed. In the experimental group, mean right atrial pressure (Pra) was elevated from a control value of 1.8 +/- 0.9 mmHg (mean +/- SD) to 8.3 +/- 0.8 mmHg for 40 min by volume expansion with isoncotic, lactated Ringer solution. After this period of volume expansion, the pericardium was removed while holding Pra at 8 mmHg. During volume expansion, arterial blood samples for AP analysis were taken at 5, 10, 15, 20, 30, and 40 min, pre- and postpericardiectomy. A similar protocol was followed in the control group. At a Pra of 8 mmHg prepericardiectomy, the plasma AP concentration was 76 +/- 17 pM/l and 74 +/- 38 pM/l in the experimental and control groups, respectively. However, after pericardiectomy, AP levels increased significantly in both the experimental group (136 +/- 41 pM/l; P less than 0.001) and the control group (107 +/- 53 pM/l; P less than 0.025). In protocol II (6 dogs), the pericardium was removed before volume expansion, and Pra was elevated by 2- to 3-mmHg increments and maintained for periods of 13 min at each pressure. AP concentration did not increase until Pra reached 3-4 mmHg.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗