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Biomedical subjects

J D Hamilton

Publications and source records attributed to J D Hamilton.

At least 73 records · Page 4Linked to original sources
PubMed1991

Murine cytomegalovirus gene amplification and culture after submaxillary salivary gland biopsy.

An important target tissue for murine cytomegalovirus (CMV) infection is the submaxillary salivary gland. Submaxillary salivary gland biopsy specimens from BALB/c mice latently infected with murine CMV were examined for murine CMV DNA by in vitro enzymatic amplification using the polymerase chain reaction preceding oligonucleotide hybridization. The amplified sequence was a 152-base pair segment from within the immediate early gene of murine CMV. Biopsy and whole gland specimens from acutely infected BALB/c mice and latently infected, immunosuppressed BALB/c mice were compared for active murine CMV infection. After acute infection with murine CMV, virus was recovered in all cultures of both biopsy and whole salivary gland specimens but from none of the latently infected animals. Reactivated virus was detected by culture of both biopsy (90%) and whole salivary gland specimens (100%) from latently infected mice that received antithymocyte serum. Viral nucleic acid was detected in 90% of biopsy specimens from latently infected animals. Hence, active murine CMV infection can be detected in biopsy specimens from mice with acute and reactivated infection and murine CMV DNA can be amplified and detected in salivary gland biopsy specimens from latently infected animals. Biopsy of this or other target tissues can be useful for obtaining tissue for viral studies where the survival of the animal is important and it is useful to distinguish latent from acute or reactivated infection.

Animals↗
PubMed1990

The accreditation of undergraduate medical education in Australia.

The Australian Medical Council was established in 1985 with one of its three functions being the accreditation of medical schools and of courses leading to basic medical qualifications. The Accreditation (Standing) Committee has developed guidelines for assessment and accreditation in Australia, and commenced its programme of visits to Australian medical faculties in March 1988, with the tenth faculty scheduled to be visited in September 1993. This article describes the process of assessment and accreditation developed in Australia by the Australian Medical Council. A later article will discuss the issues in medical education that have been identified during the process of accreditation.

Accreditation↗
PubMed1990

Persistence of antibody in healthcare workers vaccinated against hepatitis B.

A cross-sectional serological survey was undertaken in 82 randomly selected high-risk healthcare workers previously vaccinated with the hepatitis B vaccine. The study design allowed for the identification and testing for hepatitis B surface antibody in equal numbers of employees in six-month intervals up to five years after vaccination. The results showed a consistent decline in antibody level with time, and an increasing proportion of participants with antibody levels below the commonly accepted protective level of greater than or equal to 10 S/N (sample counts/negative control counts) radioimmunoassay units. The percent of vaccinees whose S/N ratio was greater than 10 fell from 10% at one year, to 25% at two years, to over 50% at four years. Based on these figures, as well as the financial costs of hepatitis B in employees and the predictability of booster immunization, it was possible to assess the cost benefit of a hospital policy for reimmunization. At our institution, a strategy of revaccination at fixed intervals could save up to $200,000 over a ten-year period if revaccination was not offered and vaccine efficacy declined. The information obtained should help determine the need for revaccination and the advantages and disadvantages of alternative revaccination strategies.

Adult↗
PubMed1990

Detection of mouse cytomegalovirus nucleic acid in latently infected mice by in vitro enzymatic amplification.

Transmission of human and murine cytomegalovirus (CMV) with transfusions and organ transplantation suggests that the latent virus is located in multiple organs and perhaps multiple cell types. The direct identification and localization of the latent virus in the normal host has been difficult using standard culture and hybridization techniques. In vitro amplification using the polymerase chain reaction followed by oligonucleotide hybridization can be used to detect murine CMV DNA. When this method was applied to DNA extracted from latently infected mice, it allowed detection of viral nucleic acid not detected by standard Southern hybridization. The results of these studies support the presence of latent murine CMV in multiple organs including the salivary gland, spleen, and kidney. Amplification and detection of viral DNA in purified renal tubule preparations suggest that this may be a site of viral latency and potential source of the virus during renal transplantation.

Animals↗
PubMed1990

Amplification of HIV-1 provirus from cerebrospinal fluid and its correlation with neurologic disease.

The polymerase chain reaction (PCR) was used to detect human immunodeficiency virus type 1 (HIV-1) proviral sequences (gag and env) in nucleated cells from the cerebrospinal fluid (CSF) of 31 HIV-1-positive patients, and the results were compared with clinical and radiologic evidence of neurologic disease. Provirus was detected in 21 patients, of whom 20 had neurologic abnormalities. Provirus was not detected in another 6, all of whom were neurologically normal. No neurologic disease has developed in 4 of these 6 patients for whom 12.8 months of follow-up is available. PCR of CSF nucleated cells from HIV-positive patients provides early, rapid, direct evidence of neurologic involvement.

AIDS Dementia Complex↗
PubMed1988

Medical education in China for the 21st century: the context for change.

A national conference on Medical Education in China for the 21st Century was convened in Beijing in November 1986. Over 6 days, leading medical educators and Ministry of Public Health officials from across China presented China's future health service needs and debated opportunities and constraints in meeting those needs by various innovations in medical education. Recent political upheavals have left many educators wary of innovation. There are major, conflicting demands between the needs of rural primary care service and the needs of medical schools to replenish medical school professional ranks depleted by the Cultural Revolution. Multiple and varied experiments in medical education will be encouraged among China's medical schools. China will probably amalgamate indigenous and foreign education experiments, offering the world community new and important innovations in medical education.

China↗
PubMed1988

Withholding medical treatment from the severely demented patient. Decisional processes and cost implications.

We performed an observational study to determine the prevalence of severe dementia in a general medicine unit, the categories of acute medical care provided to these patients, the process by which treatment decisions are made, and their cost implications. The prevalence of severe dementia was 4.4%. The patients from whom some form of acute medical care was withheld (26 [45.6%] of 57) were more severely ill at admission and had a mortality rate five times higher than those who received full care. Physicians cited family wishes in 75.9% of the decisions to limit care but in only 10.9% of the decisions to give full care. The only differences in charges incurred were due to differential mortality rates in individuals from whom care was withheld. We recommend that hospitals develop and implement protocols for decision making in the care of the severely demented to promote open discussions among providers and families and to increase family contributions to decision making. We believe that the extension of this consultative approach to decisions involving severely demented patients may have the virtue of combining more humane care with more cost-effective care.

Acute Disease↗
PubMed1987

Determinants of the source of cytomegalovirus in murine renal allograft recipients.

Cytomegalovirus is present in a latent state in renal allografts and may be reactivated in recipients. While human and murine strains are alike in that a primary infection occurs in seronegative recipients of a kidney from a seropositive donor, they may differ when the recipient is seropositive. In a murine transplant model, superinfection of a seropositive recipient with a second strain is unusual. Reports in human transplantation indicate that superinfection of a seropositive recipient does occur, however the frequency is unknown. Our studies examine the potential importance of specific viral strains in host and recipient, the contribution of prior humoral immunity in the recipient, and the technical ability to identify distinctive strains of virus in the presence of each other. Our results indicate that reversal of the viral strains in donor or recipient animals does not alter our previous observation that reactivation of the endogenous recipient viral strain predominates as the infecting strain in the posttransplant period. Further, the presence of antibody in nearly all donors and recipients confirms that all animals were originally infected prior to transplantation. Finally, we demonstrated the technical ability to detect one virus in the presence of the other, thus excluding this variable as possibly confounding. We conclude that the endogenous, latent recipient strain of cytomegalovirus in the murine model is preferentially reactivated in the posttransplant interval.

Animals↗
PubMed1987

Cytomegalovirus pneumonia.

Cytomegalovirus (CMV) is a common virus that asymptomatically infects the majority of the population by early adulthood. After initial infection, the virus remains in a latent state in the host and can be reactivated under a variety of conditions. In contrast to the normal host, both primary and reactivated symptomatic CMV infections are common in certain immunocompromised patients including organ transplant recipients and patients with the acquired immunodeficiency syndrome (AIDS). One of the more common manifestations of the virus in this setting is a severe and often fatal interstitial pneumonitis. In transplant patients, this predictably occurs in the second or third month after transplantation and is characterized by severe hypoxemia and bilateral, symmetric interstitial infiltrates on chest x-ray. While the most direct and specific means of diagnosing CMV pneumonia is isolation of the virus from lung tissue homogenates cultured on human fibroblasts, techniques have recently been introduced using specific monoclonal antibodies or CMV DNA probes to rapidly identify the virus in tissue biopsy, cytologic specimens, or in tissue culture. These rapid techniques will become particularly important as antiviral agents with activity against CMV become available.

Adult↗
PubMed1986

Yersinia enterocolitica inguinal lymphadenitis.

Inguinal lymphadenitis is associated with a well-defined group of etiologic agents including many sexually transmitted diseases and nonvenereal agents including Yersinia pestis (bubonic plague). We report herein the first case of a second Yersinia species--Yersinia enterocolitica--presenting like bubonic plague with bilateral inguinal lymphadenitis.

Aged↗
PubMed1986

The manipulative patient.

"Manipulative" is a popular but often misused description of behavior seen in some patients who come to psychiatric attention. The authors suggest a definition of "manipulation" which can impart helpful information about symptoms, diagnosis, and treatment. They survey the differential diagnosis of manipulative behavior and consider specific treatment strategies.

Antisocial Personality Disorder↗