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Biomedical subjects

J Goldman

Publications and source records attributed to J Goldman.

At least 307 records · Page 17Linked to original sources
PubMedDate not supplied

Production of human warm-reacting red cell monoclonal autoantibodies by Epstein-Barr virus transformation.

Monoclonal antibody technology has been used in both murine and human systems to produce a variety of antibodies that react with the human red cell (RBC). RBC monoclonal autoantibodies have been obtained from animal models of autoimmune hemolytic anemia (AIHA), but to date no warm-reactive monoclonal autoantibodies have been generated from human B cells. Using the Epstein-Barr virus (EBV) transformation method, clones of RBC autoantibodies were generated from two patients with AIHA. These antibodies reacted preferentially at 37 degrees C, agglutinated or bound to a variety of different RBC phenotypes, and were IgM in nature. The serologic reactivity of one clone showed a relative specificity to e+ RBCs that was similar to that seen in the patient's serum. These results are the first to demonstrate that warm-reactive RBC autoantibodies can be obtained from patients with AIHA using the technique of EBV transformation, and they further substantiate the existence of warm-reactive IgM RBC autoantibodies in the spectrum of warm AIHA.

Adult↗
PubMedDate not supplied

Anti-idiotypic antibodies specific for a pathologic anti-Pr2 cold agglutinin.

The heterogeneity of human red cell (RBC) autoantibodies may be assessed by using anti-idiotypic antibodies. In this study, mouse monoclonal anti-idiotypic antibodies were produced against a pathologic RBC autoantibody with anti-Pr2 specificity. Epstein-Barr virus-transformed B-cell clones were established from a patient who had splenic lymphoma and associated immune hemolysis due to an anti-Pr2 cold autoantibody. Two of the eight clones producing this autoantibody were used to immunize mice for the establishment of hybridomas, and four monoclonal anti-idiotypic antibodies were isolated (2 IgG1 kappa and 2 IgM kappa). By the use of these anti-idiotypic antibodies, strong crossreactivity was seen on enzyme-linked immunosorbent assay with other anti-Pr2-producing clones from the same patient, but no cross-reactivity was seen with RBC autoantibodies from other individuals having anti-Pr or different specificities. Each of the anti-idiotypic antibodies inhibited hemagglutination (HA) by the patient's anti-Pr2 but failed to inhibit HA by antisera of a different RBC specificity. Cross-competition experiments indicated that all of the anti-idiotypic antibodies may recognize the same or a closely related idiotope on the anti-Pr2 autoantibody. These studies suggested that the four anti-idiotypic antibodies are directed against the same (or closely related) idiotypic determinant(s), unique to this patient's anti-Pr2 and located at or near the antigen-binding site. These anti-idiotypic antibodies may be useful tools for the study of this autoimmune response or for the development of immune therapeutic agents.(ABSTRACT TRUNCATED AT 250 WORDS)

Agglutinins↗
PubMedDate not supplied

Clinical impact and prognostic value of metaiodobenzylguanidine imaging in children with metastatic neuroblastoma.

PURPOSE: The clinical value of metaiodobenzylguanidine (mIBG) scintigraphy in patients with disseminated neuroblastoma (NB) at the time of diagnosis and after induction chemotherapy was evaluated. PATIENTS AND METHODS: The medical records and imaging studies of 30 patients with stage 4 NB who underwent mIBG scintigraphy and 99mTc hydroxy methylene diphosphonate bone scintigraphy at the time of diagnosis were reviewed. Scores were calculated for the mIBG and bone scintigrams, and outcome according to the initial and follow-up imaging studies was determined. RESULTS: Discrepancies between bone scintigraphy and mIBG osteomedullary localization were seen in six patients. For the entire cohort, 2-year event-free survival did not significantly differ for the group of patients with initial mIBG or bone scintigraphy scores > or = 10 compared to those with scores < 10 (P = 0.23 and 0.61, respectively). However, for patients older than 1 year, a trend associating worse outcome with mIBG scores > or = 10 at diagnosis was seen (P = 0.08). A trend correlating abnormal mIBG scintigraphy after induction therapy and poor outcome was also observed (P = 0.09). Outcome did not correlate with the results of the bone scintigram studies performed after induction chemotherapy (P = 0.68). CONCLUSION: Because a discordance between mIBG and bone scintigraphy results were seen in a subset of stage 4 NB patients, both imaging studies should be performed at the time of diagnosis. mIBG imaging studies performed at the time of diagnosis and after induction chemotherapy may be of prognostic value, particularly in stage 4 patients older than 1 year.

3-Iodobenzylguanidine↗
PubMedDate not supplied

Role of children's sex in mixed mother-child lymphocyte culture reactivity.

One-way mixed mother-child lymphocyte cultures (MMCLC) 4 to 20 years after the last delivery were studied with maternal responding and children's or fathers' stimulating cells (MMFLC) in 14 multiple child families with 18 sons and 20 daughters. HLA antigen typing locus A, B, DR was performed for all family members. As reported previously for newborn cells, a significantly increased maternal response could be observed in MMCLC with male as compared to female children's stimulating cells. Although the number of cases studied was small, it seems that the increased stimulating effect of male children's cells could also be observed when MMCLC values from children of different sex, and identical A,B,DR haplotypes were compared. In contrast to this, A,B,DR haploidentical children of the same sex seem to have a similar stimulating effect on the maternal response in MMCLC. The results suggest that male children's Y-chromosome-correlated minor histocompatibility antigens may additionally stimulate the maternal immune response in MMCLC.

Birth Order↗
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Protecting privacy to improve health care.

No comprehensive federal law now protects the privacy of people's medical records. The Health Insurance Portability and Accountability Act of 1996 mandates that if Congress fails to enact such legislation by August 1999, the secretary of health and human services must promulgate regulations. This paper argues that health privacy legislation is necessary both to improve patient care and to enhance the reliability of the health information used for research and public health initiatives. Within this framework I review pending federal health privacy legislation and make recommendations for moving forward.

Humans↗
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Substance P immunoreactive sensory axons as a subset of the total axonal population in the maxillary sinus of the rabbit: a characterization of normal and infected mucosa.

Substance P (SP), one of the neuropeptides released from sensory nerves, is thought to mediate neurogenic inflammation. Although SP immunoreactive axons have been described in the sinus mucosa, no attempt has been made to characterize SP fibers as a subset of all axons present in the sinus mucosa. In addition, no study to date has characterized the changes in infected sinus mucosa. The maxillary sinus mucosa of New Zealand white rabbits was harvested from control animals and in animals with induced maxillary sinusitis. Immunohistochemical staining of the sinus mucosa for both Protein Gene Product 9.5 (PGP), a nonspecific marker for all nerves, and for SP was performed on 11 animals: 3 controls and 8 infected. In sinus mucosa from the control rabbits, <50% of all axons labeled by PGP were immunoreactive for SP. In infected mucosa, the absolute number of axons found by PGP staining decreased and nearly all of these remaining fibers were also immunoreactive for SP. We conclude that the phenotypical labeling of nerve fibers seen in normal mucosa is altered by bacterial-induced infection.

Animals↗
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Oncogene RNA expression in three human lymphoblastic leukemia cell lines lymphocytes.

We have explored the RNA oncogene expression by three human acute lymphoblastic leukemia lines, NALM-6, MOLT-3, and REH. We compared such expression with that of normal human lymphocytes. Marked differences in the RNA expression of the third exon of c-myc, v-myb, v-Hras, N-ras, v-fes, and v-fos were found. We noted minimal or no differences in the RNA expression of v-abl, B-lym, v-erb-B, c-ets, v-fms, v-kras, v-mos, v-raf, and v-sis.

Cell Line↗
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H-ras and c-myc RNA expression in human T-cell ALL and in normal human lymphocytes.

We have compared the RNA expression of two oncogenes, H-ras and c-myc, with normal human lymphocytes, normal human T-cells, and human T-cell acute lymphoblastic leukemia (ALL). T-cell ALL RNA was derived from two human T-cell lines (MOLT-3 and CEM) and from five children with T-cell ALL. The RNA expression of H-ras and the third exon of c-myc was determined by northern hybridization. RNA from both MOLT-3 and CEM overexpressed both H-ras and the third exon of c-myc compared to normal lymphocytes and normal T-cells. T-cell ALL samples from four of five children overexpressed H-ras, while three of five patient samples overexpressed the third exon of c-myc when compared to normal lymphocytes and normal T-cells. Additional information on the oncogene expression of T-cell ALL may prove to be useful in the diagnosis and treatment of T-cell ALL.

Blotting, Northern↗
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Disseminated histoplasmosis presenting as bilateral adrenal masses.

Histoplasma capsulatum is a universal dimorphic fungus found mainly in soil contaminated with excrement of birds and bats. Bilateral adrenal masses with massive tissue destruction are a rare primary presentation of disseminated histoplasmosis. As it behaves as an opportunistic pathogen there is a higher susceptibility for dissemination on those patients with immunodeficiency or immunosuppression. We report a case in an elderly diabetic patient with bilateral adrenal enlargement, diagnosed as histoplasmosis only after surgical exploration, with symptoms probably occurring at least 60 years after the original infection. She was successfully treated with itraconazole.

Adrenal Gland Diseases↗
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Effect of smoking on the course of essential hypertension: a follow-up study of a group composed predominantly of women.

BACKGROUND: The aim of this study was to compare the clinical course of essential hypertension between tobacco smokers and non-smokers. MATERIAL AND METHODS: 64 health service workers with essential hypertension were studied. The assessment consisted of anamnesis, physical examination, fundoscopic examination, ECG, echocardiography, routine laboratory investigations including lipid status, fasting insulin level, and urine analysis for microproteinuria. The efficacy of antihypertensive therapy was also evaluated. The period of observation was 18 months. Both subgroups were compared using the unpaired Student's t-test. RESULTS: The subgroups did not differ significantly in sex structure (70% dominance of women), body mass index, BP values, or the duration of hypertension. The smokers were significantly younger, which points to the earlier origin of the disease in smokers (at the age of 42.1 +/- 11.0 years vs 50.8 +/- 8.5 years; p<0.001). The two subgroups did not differ in the frequency of left ventricular hypertrophy, stable angina pectoris, microproteinuria, or the degree of retinopathy. The smokers were characterized by higher serum total cholesterol (6.23 +/- 1.22 mmol/l vs 5.57 +/- 1.01 mmol/l; p<0.05) and triglyceride (2.53 +/- 1.72 mmol/l vs 1.6 +/- 1.21 mmol/l) concentrations. No other differences were found in laboratory investigations. BP normalization was attained in both subgroups, but the smokers required more drugs than the non-smokers (2.1 +/- 1.0 vs 1.7 +/- 0.6; p<0.01), though there were no significant differences in the dosage of particular agents. CONCLUSIONS: We suggest that tobacco smoking causes earlier manifestation of essential hypertension, produces unfavorable changes in the lipid status, and decreases the efficacy of antihypertensive therapy.

Adult↗
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Corneal infiltrates associated with disposable extended wear soft contact lenses: a report of nine cases.

We report nine cases of corneal infiltrates and/or ulceration in patients using disposable extended wear contact lenses. None of the nine patients had worn the lenses more than the recommended 7 days. Cultures were performed on six of the patients; all cultures were negative. One of the six cultured patients had been treated with topical antibiotics prior to culture. All responded promptly to cessation of lens wear and topical antibiotic therapy. Although all of the infiltrates/ulcers were paracentral, none of the patients sustained any permanent visual loss.

Adult↗
PubMedDate not supplied

Resistant cases of polycystic ovarian disease successfully treated with a combination of corticosteroids, clomiphene, and bromocriptine.

Eight successively examined anovulatory women with polycystic ovarian disease (PCOD) who had remained resistant to treatment with clomiphene and dexamethasone (DEX) (and some to hMG/hCG) and had mildly elevated prolactin levels were treated with a combination of clomiphene, DEX, and bromocriptine. There was a decrease in the LH:FSH ratio and androgen and prolactin levels to normal values; within five to eleven treatment cycles, all were pregnant. These results were probably achieved because of the inhibition of prolactin secretion by the dopamine agonist, but may also be due to repletion of a suggested possible functional depletion of dopamine within hypothalamic nuclei in PCOD. This combination treatment is therefore highly recommended before resorting to hMG/hCG therapy or surgery, both of which have intrinsic disadvantages.

Adult↗
PubMedDate not supplied

Effect of glyburide on metabolic control and insulin binding in insulin-dependent diabetes mellitus.

The extrapancreatic effects of the sulfonylurea drug glyburide in insulin-dependent diabetes mellitus were examined in a double-blind, prospective study involving 28 patients. Administration of glyburide in addition to the usual diet and insulin dose for 6 mo led to a minimal and transient decrease in hemoglobin A1c and total glycosylated hemoglobin. Insulin receptors of peripheral monocytes were initially normal in both number and affinity in this group of insulin-dependent diabetic patients, but, after 6 mo of glyburide therapy, binding to insulin receptors declined at the lower insulin concentration range without falling out of the normal range. No changes could be demonstrated in plasma triglycerides, cholesterol, or lipoprotein-cholesterol fractions. We conclude that the extrapancreatic effects of the sulfonylurea glyburide in insulin-deficient diabetic subjects are small. These effects may be mediated through a postinsulin receptor mechanism.

Adult↗