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Biomedical subjects

J Brown

Publications and source records attributed to J Brown.

At least 487 records · Page 27Linked to original sources
PubMed1995

Novel production of interleukin-1 receptor antagonist peptides in normal human cornea.

Interleukin-1 receptor antagonist (IL-1ra) is an important modulator of IL-1 activity in a variety of tissues. IL-1ra is differentially produced by different cell types as a 22-26-kD secreted peptide (sIL-1ra) and/or a smaller 16- or 18-kD intracellular peptide (icIL-1ra). This study was undertaken to evaluate the production of IL-1ra in the human cornea. IL-1ra mRNA can be detected in early passage human corneal epithelial cells and corneal stromal fibroblasts and is significantly enhanced by IL-1. Corneal endothelial cells do not express IL-1ra mRNA. Immunohistochemical studies of cultured corneal cells and whole human cornea demonstrate IL-1ra protein production by both the epithelial and stromal cells but not the endothelial cells. Reverse transcriptase polymerase chain reaction, ELISA, and immunoprecipitation studies indicate that corneal epithelial cells are capable of producing both icIL-1ra and sIL-1ra forms of IL-1ra whereas the corneal stromal cells produce only icIL-1ra. In addition to the larger 18-kD icIL-1ra, both corneal epithelial and stromal cells are also capable of producing a smaller recently described 16-kD icIL-1ra. Thus, the differential production of IL-1ra in the human cornea is unique; whereas both epithelial and stromal cells produce icIL-1ra (type 1 and type 2), the epithelial cells appear to also produce sIL-1ra. It is proposed that these IL-1ra proteins may play an important role in regulating IL-1-induced corneal inflammation.

Adult↗
PubMed1995

Placebo-controlled trial of fluoxetine as an adjunct to relapse prevention in alcoholics.

OBJECTIVE: The authors tested the hypothesis that fluoxetine, when used in combination with relapse prevention psychotherapy, directly reduces relapse frequency and severity for alcoholics. METHOD: The authors conducted a randomized, placebo-controlled trial of fluoxetine (up to a maximum of 60 mg/day) for 12 weeks in combination with weekly psychotherapy for 101 alcohol-dependent subjects who were not selected on the basis of comorbid major depression. Outcomes were measured at the end of treatment and 6 months after treatment. RESULTS: Placebo-treated subjects were more complaint with the medication regimen and remained in the study longer than fluoxetine-treated subjects. There was significantly less alcohol consumption in both groups during treatment than before treatment. These effects persisted during the posttreatment period. Although fluoxetine treatment had no significant effects on alcohol consumption, it reduced Hamilton Depression Rating Scale scores more than placebo treatment among subjects with current major depression. CONCLUSIONS: Fluoxetine at a dose of 60 mg/day is probably not of use for relapse prevention in alcoholics with mild to moderate alcohol dependence and no comorbid depression. In alcoholics with major depression, the drug may reduce depressive symptoms. Subsequent studies with fluoxetine should probably focus on more severely alcohol-dependent subjects or those with comorbid depression.

Adult↗
PubMed1995

Rapid in vitro assay for predicting response to fluorouracil in patients with metastatic breast cancer.

PURPOSE: To determine if a rapid 3H-uridine uptake assay using breast tumor cells from biopsy specimens could predict clinical response to fluorouracil (5FU) in patients with metastatic breast cancer. PATIENTS AND METHODS: A double-blind prospective study was conducted of 60 patients with measurable, metastatic breast cancer who had failed to respond to at least one prior chemotherapy regimen. Patients received 5FU 300 mg/m2/d by continuous infusion and were monitored for response. Tumor cells from biopsy specimens were grown in microwells and exposed for 3 days to 0.1, 1.0, 10.0, and 100.00 micrograms/mL of 5FU on strips coated with drug and extracellular matrix. Cells were pulsed with 3H-uridine overnight. Incorporated radioactivity was compared for wells with and without drug. Results were available 4 days from specimen submission. RESULTS: Of 45 eligible patients, 11 (24%) were not assessable in vitro. Nine patients were assessable in vitro, but not clinically. Of the remaining 25 patients, who were assessable both clinically and in vitro, there was one complete response (CR), five partial responses (PRs), five cases of stable disease, and 14 cases of progressive disease, for an objective response rate of 24%. Response in vitro was significantly correlated with clinical response (P = .002). Of six clinical responders, five also responded in vitro, for an assay sensitivity of 83%. Of 19 nonresponders, 17 were nonresponders in vitro, for a specificity of 89%. The positive predictive value of the test was 71% (five of seven), and the negative predictive value was 94% (17 of 18). CONCLUSION: Results of an in vitro assay were significantly correlated with clinical response in patients with metastatic breast cancer treated with continuous infusion 5FU.

Breast Neoplasms↗
PubMed1995

Overuse injuries in classical ballet.

Successful management of classical ballet dancers with overuse injuries requires an understanding of the art form, precise knowledge of anatomy and awareness of certain conditions. Turnout is the single most fundamental physical attribute in classical ballet and 'forcing turnout' frequently contributes to overuse injuries. Common presenting conditions arising from the foot and ankle include problems at the first metatarsophalangeal joint, second metatarsal stress fractures, flexor hallucis longus tendinitis and anterior and posterior ankle impingement syndromes. Persistent shin pain in dancers is often due to chronic compartment syndrome, stress fracture of the posteromedial or anterior tibia. Knee pain can arise from patellofemoral syndrome, patellar tendon insertional pathologies, or a combination of both. Hip and back problems are also prevalent in dancers. To speed injury recovery of dancers, it is important for the sports medicine team to cooperate fully. This permits the dancer to benefit from accurate diagnosis, technique correction where necessary, the full range of manual therapies to joint and soft tissue, appropriate strengthening programmes and maintenance of dance fitness during any time out of class with Pilates-based exercises and nutrition advice. Most overuse ballet conditions respond well to a combination of conservative therapies. Those dancers that do require surgical management still depend heavily on ballet-specific rehabilitation for a complete recovery.

Ankle Injuries↗
PubMed1995

Osteosynthesis of the cervical spine with an anterior plate.

Osteosynthesis with an anterior plate is indicated for stabilization of the cervical spine. It is used for reconstruction of the vertebral body following corpectomy and for cervical instability due to fractures, fracture-dislocations, and post-laminectomy. In these situations, a well-keyed anterior graft or posterior fusion alone may be inadequate to attain stability. The authors retrospectively review 25 cases of osteosynthesis of the cervical spine using the AO H-plate. All the patients were stable enough postoperatively to allow early mobilization with a cervicothoracic orthosis. Average follow up was 31.2 months. All the grafts fused; however, complications occurred in 36% of the cases. The majority of these complications did not affect the long-term clinical result. This method involves potential risks to the spinal cord, esophagus, carotid structures, and laryngeal nerve. It should therefore be used in carefully selected cases.

Adult↗
PubMed1995

Microorganisms isolated from the corneal surface before and during topical cyclosporine treatment in dogs with keratoconjunctivitis sicca.

The effect that topical administration of cyclosporine would have on the number and type of microorganisms isolated from the corneal surface of dogs with keratoconjunctivitis sicca was studied. Schirmer tear test wear performed on and corneal swab specimens were collected from 61 eyes of 31 dogs with keratoconjunctivitis sicca prior to and after 3, 6, and 12 months of treatment with cyclosporine. In eyes that responded to cyclosporine treatment (Schirmer tear test value increased by > or = 5 mm/min, compared with pretreatment value), the percentage of eyes from which bacteria were isolated 3, 6, and 12 months of treatment was significantly (P < 0.001) less than the percentage from which bacteria were isolated prior to treatment. However, among eyes that did not respond to treatment, we did not detect a significant change over time in prevalence of bacteria or type of bacteria isolated. The percentage of eyes from which fungi were isolated decreased during treatment; however, the small number of eyes in which fungal culture results were initially positive precluded demonstration of a significant differences over time in the frequency with which specific bacterial genera were isolated, with the exception of beta-hemolytic Streptococcus spp. Opportunistic corneal infections were not detected even though none of the dogs received antibiotics. An increase in production of tears, which contain anti-infection, proteins, was believed to be the primary factor responsible for the decrease in the percentage of eyes from which microorganisms could be isolated.

Animals↗
PubMed1995

The surgical management of tuberculosis.

Due to unpredicted factors, the incidence of tuberculosis is increasing in the United States. Despite excellent anti-tuberculous medication, some patients will require surgical management. The majority of these patients present with multi-drug-resistant tuberculosis (MDRTB). Surgery is indicated, but only after the best possible anti-tuberculous regime has been instituted. In those patients who become sputum-negative and have a destructive pulmonary process, or in those patients with persistent positive sputum and destroyed pulmonary parenchyma, operative management may be beneficial. Surgery can be done with a low mortality and morbidity incidence. Muscle flaps are useful in minimizing postoperative complications. Continued postoperative medical therapy combined with surgery offers a cure in more than 90% of patients. In patients with MDRTB and localized parenchyma disease, surgery combined with continued medical therapy is the treatment of choice in the majority of patients.

Antitubercular Agents↗
PubMed1995

Extrapleural pneumonectomy for tuberculosis.

Tuberculosis has infected the human race for thousands of years. The best medical therapy in this country failed to eradicate the disease. In its current most virulent form it is drug resistant and will affect the practice of thoracic surgery once again. The most common indications for resection in patients with tuberculosis are drug resistance and localized disease. Pneumonectomy for tuberculosis, now necessary in more than 50% of operative cases, represents the highest risk operation. The risk is related directly to patient debilitation, the preoperative presence of positive sputum, and intraoperative contamination of the pleural space. Complications can be minimized and an acceptable mortality rate can be achieved with an extrapleural approach supplemented by muscle flap or omentum for reinforcement of the bronchial stump.

Bronchi↗
PubMed1995

The treatment of attention-deficit hyperactivity disorder in Tourette's syndrome: a double-blind placebo-controlled study with clonidine and desipramine.

OBJECTIVES: Because psychostimulants can exacerbate preexisting motor/phonic tics in individuals with Tourette's syndrome (TS), a clinical trial was performed to examine the ability of clonidine and desipramine to modify attention-deficit hyperactivity disorder (ADHD) behaviors in children with TS + ADHD. METHODS: A double-blind, placebo-controlled protocol was used in which each subject served as his or her own control and received, in a randomly assigned fashion, 6-week medication cycles with clonidine (0.05 mg four times daily), desipramine (25 mg four times daily), and placebo. RESULTS: Thirty-seven children with TS+ADHD between the ages 7 to 13 years and of normal intellect were recruited, and 34 (31 males, 3 females) completed the entire protocol. Outcome measures for ADHD included Parent and Teacher Child Behavior Checklists (CBCL), continuous performance tests, and neuropsychologic tests of executive function. Several markers for ADHD were shown to improve significantly (P < .05) after treatment with desipramine (parent linear analogue rating, parent CBCL "hyperactivity" subscale, and teacher CBCL subscales "nervous/overactive," "anxious," and "unpopular"). Improvement with desipramine was always superior to that noted with clonidine. Clinical improvement did not correlate with drug blood levels. On measures of tic severity, neither drug made tics worse. Desipramine showed a statistically significant improvement on a global linear analogue scale, but not on the Hopkins Motor/Vocal Tic Severity Scale, the Tourette Syndrome Severity Scale, or the Yale Global Tic Severity Scale. Clonidine did not significantly alter tic severity on any measure. CONCLUSION: The results of this study suggest that desipramine may be a useful alternative for the treatment of symptoms of ADHD in children with TS.

Adolescent↗
PubMed1995

["Them" and us].

Explore the source record for details and available documents.

Humans↗
PubMed1995

Colorado pediatricians' involvement in community activities.

To determine Colorado American Academy of Pediatrics (AAP) pediatricians' involvement in community-based activities and awareness of and interest in the AAP Community Access to Child Health (CATCH) program, a 22-item survey was mailed to all general pediatrician AAP fellows and candidate fellows practicing in Colorado (n = 434). The return rate was 65%. Of the respondents, 73% provide direct patient care as their primary professional activity, 58% reported either current or past involvement in community-based programs outside of their practices, 91% of this community-based work was voluntary, and 80% of the respondents described this work as moderate to very rewarding. Half of the respondents (51%) were aware of the AAP CATCH program, and 68% were interested in attending a statewide CATCH meeting. We conclude that Colorado AAP pediatrician survey respondents participate heavily in community programs outside of their clinical practices and that among this group there is substantial interest in the AAP CATCH program.

Adult↗
PubMed1995

A longitudinal in vitro antimicrobial evaluation of two silver polymer surface treatments for peritoneal dialysis catheters.

The oligodynamic effect of silver has been utilized in medicine for many decades. This study evaluated the antimicrobial properties of two silver polymer surface treatments over 9 months to assess their usefulness for chronic percutaneous access. Silicone catheters were either dip-coated with micronized silver oxide in a silicone matrix (AgX) or impregnated with silver using an ion beam deposition process (Spire Argent I). Four-inch (10-cm) segments were shaken continuously in 10 mL minimum essential media (MEM) with 2% fetal bovine serum (FBS) at 25 degrees C. The medium was replaced weekly. Monthly eluate samples were assayed for Ag+ concentration using ICP atomic emission spectroscopy. Bimonthly, segments were removed, placed in fresh medium inoculate with 10(5) colony-forming units (cfu)/mL Staphylococcus aureus ATCC 25923 and quantitated over 24 hours for bacterial survival/growth. Relative to control catheters, there was a mean log10 reduction of S. aureus of 4.4 with AgX and 1.7 with Spire Argent I persisting over the 9-month study period. Silver ion elution followed a biphasic pattern with both coatings establishing a steady state of 0.2 ppm at 4 months. These data suggest that the test surface coatings employed will deliver long-term oligodynamic activity when implanted percutaneously.

Catheters, Indwelling↗
PubMed1995

Icterus in bob veal calves and its association with lack of colostrum intake and high serum creatine kinase activity.

Icterus condemnations compose a substantial proportion (41%) of total condemnations of bob veal, the class of veal composed of calves < 3 weeks old and weighing up to 68 kg. At postmortem examination, bob veal condemned because of icterus have generalized yellow discoloration of tissues, which is commonly associated with large, yellow liver (fatty liver), and a paucity of other gross pathologic changes. To establish that the generalized yellow discoloration was attributable to high tissue bilirubin concentrations and to examine the underlying mechanism(s) that might be responsible, blood samples and tissue specimens were obtained from clinically normal and icteric bob veal calves at slaughter. For comparison, blood samples were collected from clinically normal, 1- to 5-day-old Holstein calves being raised on local dairy farms. Hematologic and serum biochemical analyses were obtained for the 3 groups of calves (normal local, normal slaughter, and icteric slaughter), and tissues of slaughter calves were examined for histologic evidence of inflammatory or degenerative changes. Mean +/- SD total bilirubin concentration and creatine kinase (CK) activity in icteric bob veal (3.3 +/- 0.8 mg/dl; 869 +/- 788 U/L), normal bob veal (1.4 +/- 0.7 mg/dl; 486 +/- 890 U/L), and normal local calves (0.5 +/- 0.2 mg/dl; 156 +/- 158 U/L) were significantly different. When data for both normal and icteric bob veal calf groups were combined for analysis, total bilirubin concentration regressed significantly on hepatic lipid scores (P = 0.00003) and CK activity (P = 0.00049). Colostrum consumption was determined by measuring serum total protein concentration and serum gamma-glutamyltransferase activity. Bob veal calves that had not consumed colostrum had significantly higher total bilirubin (P = 0.00005) and CK (P = 0.0008) values. It was concluded that normal and icteric bob veal calves have significant increase in total bilirubin concentration, and icterus of bob veal calves is secondary to unconjugated hyperbilirubinemia. Lack of colostrum consumption was strongly correlated with icterus in bob veal calves.

Analysis of Variance↗