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Biomedical subjects

J Adams

Publications and source records attributed to J Adams.

At least 145 records · Page 8Linked to original sources

Lack of multicellular drug resistance observed in human ovarian and prostate carcinoma treated with the proteasome inhibitor PS-341.

Almost all known conventional cytotoxic anticancer drugs are less effective in killing tumor cells grown as multicellular spheroids than in killing tumor cells grown as monolayer cell cultures. This "multicellular resistance" reflects the relative intrinsic drug-resistant phenotype of most solid tumors growing in vivo and is due to factors such as limited drug penetration or reduced fractions of proliferating cells. Proteasome inhibitors such as PS-341, a dipeptide boronic acid analogue, represent an interesting new class of potential anticancer drugs, which are entering early-phase clinical trials. PS-341 has been found to have good broad-spectrum cytotoxic activity in the 60-monolayer cell line National Cancer Institute screen. However, because its relative potency has not been tested in spheroid systems, we analyzed the activity of PS-341 in a spheroid/solid tumor context using four different human ovarian carcinoma cell lines and three prostate carcinoma cell lines, respectively. We found, with one exception, that PS-341 showed equal or greater activity in spheroids than in the respective monolayer cell cultures, even in a prostate cancer spheroid model with a very low growth fraction. PS-341 induced apoptotic cell death in carcinoma cells in both culture systems. We also noted a decrease in XIAP protein, a member of the inhibitor of apoptosis (IAP) family of apoptosis inhibitors, and phosphorylation of Bcl-XL in PS-341-treated ovarian carcinoma cells. Furthermore, DNA fragmentation, a hallmark of apoptosis (in this case, induced by PS-341), was completely inhibited by the caspase inhibitor N-benzyloxycarbonyl-Val-Ala-Asp-fluoromethylketone (Z-VAD). Taken together, the results indicate that unlike most other known anticancer cytotoxic drugs, PS-341 appears to be as effective in killing tumor cells grown in the form of multicell spheroids as in killing tumor cells grown in monolayer cell culture. Hence, this compound has the potential to circumvent multicellular drug resistance and, as such, may show promising activity against solid tumors with low growth fractions in vivo, which are frequently intrinsically resistant to conventional cytotoxic anticancer drugs.

Antineoplastic Agents↗

Bridging research and practice: community-researcher partnerships for replicating effective interventions.

Long-term collaborations among researchers, staff and volunteers in community-based agencies, staff in institutional settings, and health advocates present challenges. Each group has different missions, procedures, attributes, and rewards. This article reviews areas of potential conflict and suggests strategies for coping with these challenges. During the replication of five effective HIV prevention interventions, strategies for maintaining mutually beneficial collaborations included selecting agencies with infrastructures that could support research-based interventions; obtaining letters of understanding that clarified roles, responsibilities, and time frames; and setting training schedules with opportunities for observing, practicing, becoming invested in, and repeatedly implementing the intervention. The process of implementing interventions highlighted educating funders of research and public health services about (a) the costs of disseminating interventions, (b) the need for innovation to new modalities and theories for delivering effective interventions, and (c) adopting strategies of marketing research and quality engineering when designing interventions.

Centers for Disease Control and Prevention, U.S.↗

Orientation and training: preparing agency administrators and staff to replicate an HIV prevention intervention.

Effective orientation and training are fundamental to the successful implementation of any intervention because they communicate the critical first impressions of the intervention and the skills needed to conduct it. When research-based HIV prevention interventions are translated into practice, issues arise that require adaptation and expansion of the basic functions of orientation and training. This article identifies some of these issues by drawing on the experience of researchers in the Replicating Effective Programs (REP) project. The purpose, structure, and instructional approach of the orientation and training for administrators, staff, and volunteers are described in depth for one project, with comparisons and additional examples from others. Based on these descriptions, critical issues for orientation and training for replication are presented. These include extending orientation and training to a broad audience within the adopting agency, allocating sufficient time to ensure understanding of the intervention, and planning for staff turnover.

Community Health Services↗

The role of technical assistance in the replication of effective HIV interventions.

This article examines the role of technical assistance (TA) in supporting the replication of proven HIV interventions. A case study of the replication of the VOICES/VOCES intervention elucidates the level and types of TA provided to support new users through the adoption process. TA included help in garnering administrative support, identifying target audiences, recruiting groups for sessions, maintaining fidelity to the intervention's core elements, tailoring the intervention to meet clients' needs, strengthening staff members' facilitation skills, troubleshooting challenges, and devising strategies to sustain the intervention. Two to four hours per month of TA were provided to each agency adopting the intervention, at an estimated monthly cost of $206 to $412. Findings illustrate how TA supports replication by establishing a conversation between the researcher TA providers experienced with the intervention and new users. This communication helps preserve key program elements and contributes to ongoing refinement of the intervention.

Community Health Services↗

Smokeless tobacco and smoking cessation: a program evaluation.

During the 1998 mid-winter Board of Directors meeting in Tampa, Florida, the leaders of the Society of Otorhinolaryngology-Head and Neck Nurses (SOHN) discussed the vision and mission of SOHN. Part of the vision that emerged was a long-overdue educational program on smoking cessation. SOHN members wanted a self-contained program to use in their clinical practice or in the community that was simple, easy, and comprehensive. In response to this request, a program was developed and presented at the 1999 SOHN Spring Seminar and repeated at the 1999 SOHN Annual Congress. Program participants increased their knowledge on the subject and expressed positive attitudes about utilizing their knowledge as assessed by two novel evaluation tools. This paper discusses the process of tool development and use as well as the detailed responses of the participants. Directions for future training programs and strategies for increasing implementation of smoking cessation programs in otorhinolaryngology (ORL) nursing practice are also discussed.

Head and Neck Neoplasms↗

Proteasome inhibitors: a novel class of potent and effective antitumor agents.

The ubiquitin-proteasome pathway plays a critical role in the regulated degradation of proteins involved in cell cycle control and tumor growth. Dysregulating the degradation of such proteins should have profound effects on tumor growth and cause cells to undergo apoptosis. To test this hypothesis, we developed a novel series of proteasome inhibitors, exemplified by PS-341, which we describe here. As determined by the National Cancer Institute in vitro screen, PS-341 has substantial cytotoxicity against a broad range of human tumor cells, including prostate cancer cell lines. The PC-3 prostate cell line was, therefore, chosen to further examine the antitumor activity of PS-341. In vitro, PS-341 elicits proteasome inhibition, leading to an increase in the intracellular levels of specific proteins, including the cyclin-dependent kinase inhibitor, p21. Moreover, exposure of such cells to PS-341 caused them to accumulate in the G2-M phase of the cell cycle and subsequently undergo apoptosis, as indicated by nuclear condensation and poly(ADP-ribose) polymerase cleavage. Following weekly i.v. treatment of PS-341 to mice bearing the PC-3 tumor, a significant decrease (60%) in tumor burden was observed in vivo. Direct injection of PS-341 into the tumor also caused a substantial (70%) decrease in tumor volume with 40% of the drug-treated mice having no detectable tumors at the end of the study. Studies also revealed that i.v. administration of PS-341 resulted in a rapid and widespread distribution of PS-341, with highest levels identified in the liver and gastrointestinal tract and lowest levels in the skin and muscle. Modest levels were found in the prostate, whereas there was no apparent penetration of the central nervous system. An assay to follow the biological activity of the PS-341 was established and used to determine temporal drug activity as well as its ability to penetrate tissues. As such, PS-341 was shown to penetrate PC-3 tumors and inhibit intracellular proteasome activity 1.0 h after i.v. dosing. These data illustrate that PS-341 not only reaches its biological target but has a direct effect on its biochemical target, the proteasome. Importantly, the data show that inhibition of this target site by PS-341 results in reduced tumor growth in murine tumor models. Together, the results highlight that the proteasome is a novel biochemical target and that inhibitors such as PS-341 represent a unique class of antitumor agents. PS-341 is currently under clinical evaluation for advanced cancers.

Algorithms↗

Standardized lifetime risk.

The authors propose the use of two new standardized measures of risk, the standardized lifetime risk and the standardized number of years of life lost. These measures maintain the advantages of standardized rates but are more readily understood without special training. In this paper, standardizing weights based on 1992 data from England and Wales are provided, and the new measures are illustrated with a variety of examples. The new standardized rates are useful for examining trends over time; for comparing the impact of various diseases on public health; and for comparing rates of a given disease in several different countries. The authors think it is far more informative to say that 41 out of every 1,000 women die of breast cancer than to say that the standardized mortality rate is 51 per 100,000 women per year.

Female↗

Liver transplantation for metastatic hemangiopericytoma associated with hypoglycemia.

We report a case of successful liver transplantation in a young man with metastatic hemangiopericytoma confined to the liver. He had a primary retroperitoneal hemangiopericytoma removed in 1982 and was diagnosed as having liver metastases 8 years later. Subsequently, he developed hypoglycemia, which did not respond to chemotherapy. Hepatectomy and transplantation resolved his hypoglycemic attacks. He remained well and symptom free for 4 years. Liver transplantation can provide effective palliation and should be considered in carefully selected patients with localized metastatic cancer.

Adult↗

Cardioprotective effects of a novel proteasome inhibitor following ischemia and reperfusion in the isolated perfused rat heart.

Ischemia followed by reperfusion in the presence of polymorphonuclear leukocytes (PMNs) results in cardiac contractile dysfunction as well as myocardial injury. These effects are due in large part to endothelial dysfunction leading to an upregulation of cell adhesion molecules and subsequent neutrophil induced cardiac injury. The proteasome inhibitor, PS-519, has been shown to attenuate leukocyte-endothelial cell interactions. We tested the effects of PS-519 on neutrophil mediated cardiac dysfunction in ischemia/reperfusion. This study examines the effects of PS-519 in a neutrophil dependent isolated perfused rat heart model of ischemia (I) (20 min) and reperfusion (R) (45 min). Administration of PS-519 (0.01, 0.1, 0.3, 1.0 mg/kg) to I/R hearts perfused with PMNs improved coronary flow, and preserved left ventricular developed pressure (LVDP) and + dP/dt max as indices of cardiac contractile function. At 1.0 mg/kg, PS-519 treated hearts exhibited a final LVDP of 98 +/- 3% of initial compared to 52 +/- 8% in I/R hearts receiving only vehicle (P < 0.001). In addition, PS-519 significantly reduced PMN accumulation in the ischemic myocardium from 25.1 +/- 2.1 PMNs/mm2 in untreated hearts to 7.3 PMNs/mm2, and attenuated P-selectin surface expression on coronary vascular endothelium from 7.1 +/- 0.3% to 1.4 +/- 0.2% (P < 0.01). These results provide evidence that PS-519 is a potent and effective cardioprotective agent that inhibits P-selectin leukocyte-endothelial cell interactions and preserves cardiac contractile function and coronary perfusion following myocardial ischemia and reperfusion.

Animals↗

Emergency MR imaging of orthopedic trauma. Current and future directions.

Fast MR imaging protocols pave the way for more widespread use of MR imaging to evaluate emergency room trauma patients. This article reviews technical developments and protocols facilitating rapid imaging, conventional applications of MR imaging to evaluate soft tissue injuries, and newer applications in which MR imaging is used to image both axial and appendicular fractures.

Emergency Treatment↗

Inhibition of NF-kappa B activation in vitro and in vivo: role of 26S proteasome.

It is becoming increasingly apparent that NF-kappa B plays a critical role in regulating the inflammatory response. Data obtained from studies in our laboratories demonstrate that the proteasome plays an important role in the inflammatory cascade by regulating the activation of NF-kappa B. Indeed, the availability of selective and orally active proteasome inhibitors should prove useful in delineating the roles of the proteasome and NF-kappa B in other pathophysiological conditions such as cancer and heart disease.

Acetylcysteine↗

Proteasome inhibition: A novel mechanism to combat asthma.

BACKGROUND: Nuclear factor-kappaB (NF-kappaB) is a critical transcription factor required for the regulation of many genes involved in inflammatory responses to noxious stimuli. On activation, NF-kappaB induces the transcription of numerous proinflammatory cytokines, enzymes, and cellular adhesion molecules. Blockade of the proteasome with selective inhibitors attenuates the effects of NF-kappaB, leading to suppression of the inflammatory response. OBJECTIVE: We sought to determine whether proteasome inhibitors would be active in a model of asthma. METHODS: The mouse delayed-type hypersensitivity model was used to screen a panel of compounds for in vivo activity. The proteasome inhibitor, PS-519, was shown to be the most active in this model and was selected for further development. Allergen-induced pulmonary eosinophilia in Brown Norway rats was used subsequently to determine anti-inflammatory activity in an animal model. RESULTS: Direct administration of PS-519 into the lungs significantly reduced leukocyte numbers, particularly the selective increase in eosinophils. Because steroids are the mainstay anti-inflammatory therapy in asthma, and data is available to suggest their possible interaction to suppress the activation of NF-kappaB, rats were also treated by inhalation with combinations of a steroid and the proteasome inhibitor. In both the delayed-type hypersensitivity and the animal eosinophil model, low doses of proteasome inhibitors were shown to be effective when given with low doses of steroids. CONCLUSION: Taken together, the present data suggest that proteasome inhibition may represent a novel strategy for the treatment of inflammatory lung diseases such as asthma.

Animals↗

Eya1-deficient mice lack ears and kidneys and show abnormal apoptosis of organ primordia.

Haploinsufficiency for human EYA1, a homologue of the Drosophila melanogaster gene eyes absent (eya), results in the dominantly inherited disorders branchio-oto-renal (BOR) syndrome and branchio-oto (BO) syndrome, which are characterized by craniofacial abnormalities and hearing loss with (BOR) or without (BO) kidney defects. To understand the developmental pathogenesis of organs affected in these syndromes, we inactivated the gene Eya1 in mice. Eya1 heterozygotes show renal abnormalities and a conductive hearing loss similar to BOR syndrome, whereas Eya1 homozygotes lack ears and kidneys due to defective inductive tissue interactions and apoptotic regression of the organ primordia. Inner ear development in Eya1 homozygotes arrests at the otic vesicle stage and all components of the inner ear and specific cranial sensory ganglia fail to form. In the kidney, Eya1 homozygosity results in an absence of ureteric bud outgrowth and a subsequent failure of metanephric induction. Gdnf expression, which is required to direct ureteric bud outgrowth via activation of the c-ret Rtk (refs 5, 6, 7, 8), is not detected in Eya1-/- metanephric mesenchyme. In Eya1-/- ear and kidney development, Six but not Pax expression is Eya1 dependent, similar to a genetic pathway elucidated in the Drosophila eye imaginal disc. Our results indicate that Eya1 controls critical early inductive signalling events involved in ear and kidney formation and integrate Eya1 into the genetic regulatory cascade controlling kidney formation upstream of Gdnf. In addition, our results suggest that an evolutionarily conserved Pax-Eya-Six regulatory hierarchy is used in mammalian ear and kidney development.

Animals↗

Unilateral pulmonary interstitial emphysema following pneumonia in a preterm infant successfully treated with prolonged selective bronchial intubation.

We describe a ventilated preterm infant (26 week's gestation) who developed severe right-sided pulmonary interstitial emphysema following Staphylococcus aureus pneumonia. Prolonged selective bronchial intubation (10 days) resulted in a marked clinical improvement and resolution of the emphysema. Resolution of unilateral pulmonary interstitial emphysema may require a longer course of selective bronchial intubation than currently recommended.

Bacteremia↗