Search PubMedSearch

Biomedical subjects

J L White

Publications and source records attributed to J L White.

At least 19 recordsLinked to original sources

Exploiting methyl groups as motional labels for structure analysis in solid polymers.

We report results of magic-angle spinning (MAS) nuclear Overhauser experiments on solid polymers. Specifically, the focus of this work is to demonstrate that methyl groups provide unique motional labels in crystalline and amorphous materials that may be exploited to provide spatial information. The motivation for this work stems from the fact that recently developed techniques for distance determination in organic solids, e.g. REDOR and related spin-echo methods, typically require isotopic labelling. Comparison of heteronuclear MAS 13C-1H NOE growth rates for bis-phenol A (a crystalline organic solid), polycarbonate, chloral polycarbonate, polystyrene, poly(4-methylstyrene), and poly(alpha-methylstyrene) confirms that methyl groups are the only sources of cross-relaxation in these rigid polymers. The experiments are straightforward, and have the advantage that no isotopic labelling is required. In general, decreased growth rates and increased induction periods for carbons distant from methyl groups are observed. Critical analysis of the data suggests that the rates are sensitive to packing density, and we address the contribution of intrachain and interchain interactions to the observed rates. We expect that methyl-stimulated NOE's are general to all rigid solids, and that these experiments could prove useful for local structure characterization of polymers in cases where isotopic labelling is not practical.

Magnetic Resonance Spectroscopy

Effect of sorbitol on the phosphate adsorptive capacity of ferrihydrite suspensions.

The purpose of this study was to stabilize the phosphate adsorptive capacity of aqueous suspensions of ferrihydrite, a potential phosphate binder. Ferrihydrite was precipitated by the addition of 1 N NaOH to 1 M FeCl3 until pH 8.0 was reached. The ferrihydrite suspension was divided into three portions and an amount of sorbitol was added to produce sorbitol concentrations of 0, 1, or 5% w/v, respectively. The phosphate adsorptive capacity and X-ray diffraction pattern were periodically determined during aging at room temperature. The phosphate adsorptive capacity of the ferrihydrite suspension containing 0% sorbitol decreased steadily from 0.012 mgP/mg to 0.007 mgP/mg during the 1-year aging period. In contrast, suspensions containing 1 or 5% sorbitol exhibited constant phosphate adsorptive capacities during this period. X-ray diffraction patterns revealed that ferrihydrite transformed to hematite and goethite during aging of the control suspension. The presence of 1 or 5% sorbitol prevented the transformation of ferrihydrite to more crystalline iron oxides. This study suggests that the phosphate adsorptive capacity of ferrihydrite suspensions can be stabilized by the incorporation of small amounts of sorbitol into the formulation.

Adsorption

Treatment of aluminium hydroxide adjuvant to optimize the adsorption of basic proteins.

Aluminium hydroxide adjuvant has an isoelectric point (i.e.p.) of ca 11 and is a good adsorbent for acidic proteins due to the contribution of electrostatic attractive forces. However, electrostatic repulsive forces reduce its ability to adsorb basic proteins. Pretreatment of aluminium hydroxide adjuvant with carefully selected concentrations of phosphate anion reduces the positive surface charge which exists at pH 7.4. Treatment with higher concentrations of phosphate anion produces a negative surface charge. The adsorption of lysozyme (i.e.p = 11.1) was found to be directly related to the concentration of phosphate anion used to pretreat the aluminium hydroxide adjuvant.

Adjuvants, Immunologic

Structure and properties of aluminum-containing adjuvants.

This chapter is concerned with the identification, characterization, and behavior of aluminum-containing adjuvants with proteins and anions similar to those occurring in vaccines and interstitial fluid. Aluminum-containing adjuvants referred to commercially as aluminum hydroxide have been identified as poorly crystalline aluminum oxyhydroxide with the structure of the mineral boehmite. Relevant properties of this material include its high surface area and its high pI, which provide the adjuvant with a high adsorptive capacity for positively charged proteins. Aluminum phosphate and alum-precipitated adjuvants may be classified as amorphous aluminum hydroxyphosphate with little or no specifically adsorbed sulfate. Variations in the molar PO4/A1 ratio of amorphous aluminum hydroxyphosphates result in PI values that range from 5 up to 7; the materials are negatively charged at a physiological pH of 7.4. The amorphous nature of these compounds gives them high surface area and high protein adsorptive capacity for positively charged proteins. Observations on the interactions of anions and charged proteins with charged adjuvant surfaces have provided a framework for predicting behavior of complex systems of vaccines and for designing specific combinations of adjuvants and antigens to optimize the stability and efficacy of vaccines.

Adjuvants, Immunologic

The replication of a necrogenic cucumber mosaic virus satellite is temperature-sensitive in tomato.

Lethal necrosis development in tomato plants infected with cucumber mosaic virus (CMV) strain D containing the necrogenic satellite D-CARNA 5 and held at 32 degrees C is shown to be impaired. CARNA 5 accumulation in tomato at 32 degrees C is reduced about 100-fold compared to accumulation in plants held at 24 degrees C, while viral RNA accumulation is reduced about 5-fold. CMV-infected tomato held for 3 days at 24 degrees C prior to shift to 32 degrees C do not develop lethal necrosis. Longer incubations at 24 degrees C prior to shift to 32 degrees C allow necrosis to develop. CMV-infected plants held for up to 4 weeks at 32 degrees C required an additional 8-10 days at 24 degrees C to develop necrosis. Necrogenic CMV-infected plants held at 24 degrees C and analyzed 3 days p.i. contained detectable amounts of ss- and ds-CARNA 5; upon shift to 32 degrees C, such CARNA 5 declined to undetectable levels and lethal necrosis did not occur. There appear to be temperature-sensitive factors that are required for efficient satellite replication which are not required for efficient viral RNA replication. Whether these factor(s) are of host or satellite origin is uncertain.

Cucumovirus

Contribution of electrostatic and hydrophobic interactions to the adsorption of proteins by aluminium-containing adjuvants.

The effect of ionic strength and ethylene glycol on the adsorption of bovine serum albumin (BSA) or lysozyme by a commercial aluminium hydroxide or aluminium phosphate adjuvant was studied at pH 7.4 and 25 degrees C. The adsorption of BSA by aluminium hydroxide adjuvant and lysozyme by aluminium phosphate adjuvant was found to be inversely related to ionic strength. This indicates that electrostatic attractive forces contribute to adsorption. The adsorption of lysozyme by aluminium phosphate adjuvant was reduced by the addition of ethylene glycol. However, no change in the adsorption of BSA by aluminium hydroxide adjuvant was noted when up to 40% ethylene glycol was present. This behaviour indicates that hydrophobic forces contribute to the adsorption of lysozyme but not of BSA. However, virtually no adsorption was observed when the protein and the adjuvant had the same surface charge. Thus, attractive forces may not be sufficient to produce adsorption of an antigen by an aluminium-containing adjuvant if electrostatic repulsive forces are present.

Adjuvants, Immunologic

Does spinal anesthesia result in a more complete sympathetic block than that from epidural anesthesia?

BACKGROUND: Spinal and epidural injection of local anesthetics are used to produce sympathetic block to diagnose and treat certain chronic pain syndromes. It is not clear whether either form of regional anesthesia produces a complete sympathetic block. Spinal anesthesia using tetracaine has been reported to produce a decrease in plasma catecholamine concentrations. This has not been demonstrated for epidural anesthesia in humans with level of anesthesia below C8. One possible explanation is that spinal anesthesia results in a more complete sympathetic block than epidural anesthesia. To examine this question, a cross-over study was performed in young, healthy volunteers. METHODS: Ten subjects underwent both spinal and epidural anesthesia with lidocaine (plain) on the same day with complete recovery between blocks. By random assignment, spinal anesthesia and epidural anesthesia were induced via lumbar injection. Before and 30 min after local anesthetic injection, a cold pressor test (CPT) was performed. Blood was obtained to determine epinephrine and norepinephrine plasma concentrations at four stages: (1) 20 min after placing peripheral catheters, (2) at the end of a 2-min CPT (before conduction block), (3) 30 min after injection of epidural or spinal lidocaine, and (4) at the end of a second CPT (during anesthesia). Mean arterial pressure, heart rate, noninvasive cardiac index, and analgesia to pin-prick were monitored. RESULTS: Neither spinal nor epidural anesthesia changed baseline resting values of catecholamines or any hemodynamic variable, except heart rate, which was slightly decreased during spinal anesthesia. Median level of analgesia was T4 during spinal and T3 during epidural anesthesia. CPT before conduction block reliably increased heart rate, mean arterial pressure, cardiac index, epinephrine, and norepinephrine. Conduction block attenuated the increase in response to CPT only in mean arterial pressure (spinal and epidural) and cardiac index (spinal only). Neither technique blocked the increase in heart rate, norepinephrine, or epinephrine to CPT. CONCLUSIONS: Spinal anesthesia did not result in a more complete attenuation of the sympathetic response to a CPT than did epidural anesthesia. In response to the CPT, spinal anesthesia blocked the increase in cardiac index, and epidural anesthesia resulted in a decrease in total peripheral resistance compared to the pre-anesthesia state. The differences between the techniques are not significant and are of uncertain clinical implications.

Adult

Early central nervous system response to HIV infection: sleep distortion and cognitive-motor decrements.

OBJECTIVE: To repeat and extend findings suggesting that sleep disturbance, excessive daytime sleepiness, and degraded cognitive-motor abilities may be early markers of central nervous system (CNS) involvement in HIV infection. DESIGN: A controlled, cross-sectional, prospective analysis. SETTING: Clinical research center at a teaching hospital and a military health research center. SUBJECTS: Twenty-three HIV-positive (mean CD4+ count, 387 +/- 162 x 10(6)/l) and 13 seronegative men who were Naval personnel or participants of the University of California, San Diego HIV Neurobehavioral Research Center. MAIN OUTCOME MEASURES: Nocturnal and daytime sleep electroencephalogram, electromyogram, and electrocardiogram. Simple and complex cognitive-motor performance assessed via computerized tasks. RESULTS: Comparison of sleep parameters based on HIV status, length of time infected, zidovudine use, and CD4+ count indicated that CD4+ T cells > 400 x 10(6)/l were associated with a distortion in nocturnal sleep characterized by increased stages 3 and 4 non-rapid eye movement (i.e., slow-wave) sleep in the latter portion of the night and reduced nocturnal awakenings. HIV-positive patients were no sleepier in the daytime than controls. Cognitive-motor performance revealed deficits in both accuracy and efficiency for HIV-positive patients. CONCLUSION: Asymptomatic HIV-positive patients with CD4+ counts > 400 x 10(6)/l demonstrate a statistically significant increase in slow-wave sleep during the latter portion of the night and less arousability. CD4+ lymphocyte count in the early phases of HIV infection appears to differentiate between various levels of HIV disease progression with respect to certain CNS measurements of nocturnal sleep and cognitive-motor performance. Sleep structure distortion remains one of the earliest and most consistently replicable physiological signs of HIV infection. This distortion may provide a link to immune function, disease progression, and cognitive-motor disability in HIV infection.

AIDS Dementia Complex

Orthopedic management of knee dislocations. Comparison of surgical reconstruction and immobilization.

Thirty-nine patients with 43 complete knee dislocations managed between 1973 and 1990 were reviewed retrospectively to compare the results of surgical reconstruction to nonreconstructive treatment of these injuries. The average patient age was 34 years and the average follow-up was 5 years (range: 1 to 18 years). Patients were evaluated by physical examination and the Lysholm knee scoring scale. Fourteen knees (33%) sustained popliteal vessel injury and five (9%) required amputation. Peroneal and tibial nerve injuries involved 13 knees (30%). Twenty-five of 39 patients (64%) sustained other associated fractures. Three patients sustained associated paraplegia and nine were lost to follow-up, leaving 25 knees available for follow-up examination. Thirteen knees were managed by surgical reconstruction of their ligamentous injuries and 12 were managed by nonreconstructive means. The surgically treated group had an average Lysholm knee score of 80 compared with the nonreconstructive group with an average score of 66. Average range of motion of was 106 degrees for the surgical group and 95 degrees for the nonreconstructive group. Despite the severity of the initial injury and the potential presence of vascular/nerve injuries, surgical reconstruction provides superior results to immobilization alone in the management of these injuries.

Adolescent

Relationship between protein adsorptive capacity and the X-ray diffraction pattern of aluminium hydroxide adjuvants.

Thermal treatment during the preparation of aluminium hydroxide adjuvants affects the primary crystallite size of the adjuvant. The primary crystallite size can be characterized by the line broadening of the (020) reflection of the X-ray diffraction pattern. Studies of protein adsorption using bovine serum albumin as a model protein revealed a direct relationship between the albumin adsorptive capacity and the width at half height (WHH) of the (020) reflection in the X-ray diffraction pattern.

Adjuvants, Immunologic

Effect of protein adsorption on the surface charge characteristics of aluminium-containing adjuvants.

The effect of adsorbing two model proteins, bovine serum albumin and lysozyme, on the point of zero charge of aluminium-containing vaccine adjuvants was studied. At physiological pH, the adsorption of the negatively charged albumin (isoelectric point = 5.0) by aluminium hydroxide adjuvant (point of zero charge = 11.1) resulted in a decrease in the point of zero charge. In contrast, the adsorption of positively charged lysozyme (isoelectric point = 9.6) by the negatively charged aluminium phosphate adjuvant (point of zero charge = 5.0) resulted in an increase in the point of zero charge. The surface charge characteristics of the aluminium-containing adjuvant dominated at low protein coverage. In contrast, the surface charge characteristics of the adsorbed protein dominated at high protein coverage. Therefore, the physicochemical properties of the antigen-adjuvant complex and not the adjuvant alone should be considered during vaccine preparation.

Adjuvants, Immunologic

Endoscopic urethroplasty of posterior urethral avulsion.

OBJECTIVES: Traumatic avulsion of the posterior urethra represents a challenging reconstructive problem that traditionally has been managed by the transpubic or transperineal approach. We report the advantages of endourologic techniques to reconstruct short posterior urethral disruptions based on the principles of establishing proximal urethral control and balloon dilation of the newly constructed urethra. METHODS: Endourologic urethroplasty consists of: (1) antegrade flexible cystoscopy or antegrade passage of a Goodwin sound, (2) retrograde urethrotomy to light or to tip of Goodwin sound, facilitated by C-arm fluoroscopy, (3) establishment of urethral continuity by passage of a guide wire, (4) balloon dilation of the newly established urethra to 24 to 30 F over a length of 4 cm, and (5) long-term urethral stenting (4 to 8 weeks) with a silicone Foley catheter. RESULTS: In four men initially managed by suprapubic cystostomy, endourologic reconstruction was performed. The mean blood loss was 250 mL, and mean length of hospitalization was 5.4 days. All patients were continent and three were potent over a mean follow-up of 10.5 months. Uroflowmetric monitoring showed satisfactory voiding patterns with subsequent minor endoscopic revisions required in three patients. CONCLUSIONS: The technical advantages of this method include stabilization and identification of the proximal urethra, intraoperative shortening of the urethral gap to facilitate the urethrotomy, and radial distention of the urethra by balloon dilation. We conclude that endourologic methods provide a safe and effective initial treatment of urethral avulsion.

Adolescent

Measuring impulsivity and examining its relationship to delinquency.

A multimethod, multisource assessment of impulsivity was conducted in a sample of more than 400 boys who were members of a longitudinal study of the development of antisocial behavior. Exploratory and confirmatory factor analysis of the 11 different impulsivity measures revealed two impulsivity factors: Cognitive and Behavioral. Cognitive and behavioral impulsivity had similar correlations with socioeconomic status. Cognitive impulsivity was more strongly related to IQ than was behavioral impulsivity. Behavioral impulsivity was more strongly related to delinquency at ages 10 and 12-13 than was cognitive impulsivity. Consistent with theoretical prediction, our results also indicate that behavioral impulsivity was especially related to serious delinquency that is stable over time.

Adolescent

Functional recovery of stunned myocardium is greater with halothane than fentanyl anaesthesia in dogs.

We have compared the effects of halothane or fentanyl on recovery of regional myocardial function in the postischaemic ventricle in dogs. The animals were followed for 120 min during reperfusion after 15-min of occlusion of the left anterior descending coronary artery. After 120 min of reperfusion, the fentanyl group had recovered only 54% and 50% of regional contractility and systolic shortening (P < 0.05), respectively, compared with halothane (63% and 86%). Intramyocardial tissue pressure was less than baseline 60 min after reperfusion in the fentanyl group (P < 0.05), whereas the halothane group had returned to control values. We conclude that halothane is more effective than fentanyl in attenuating regional myocardial dysfunction associated with transient episodes of ischaemia.

Anesthesia, General

Sex-related differences in patients undergoing direct angioplasty for acute myocardial infarction.

Important sex-related differences have been recognized in several coronary artery disease presentation and treatment subsets. Little data exist describing the relative findings and outcome in women versus men who received direct percutaneous transluminal coronary angioplasty for acute myocardial infarction. We studied 670 such patients of whom 464 (69%) were men and 206 were women. The women were significantly older (67 +/- 11 years vs 61 +/- 11, p < 0.001) but had undergone less prior coronary artery bypass graft surgery (6% vs 12%, p = 0.02), whereas prior myocardial infarction (17% women vs 22% men) and coronary artery disease distribution were not significantly different. Forty-one percent of women and 43% of men had single-vessel disease (p = NS). Both women and men had 1.5 lesions/patient dilated acutely, with similar success rates (95% women, 91% men; p = 0.08). Mean ejection fractions were similar (48% in both groups), and a similar percentage in each group had an ejection fraction < 30% (10% women vs 13% men). Over a mean follow-up period of 86 weeks, the need for repeat catheterization was frequent and was similar in both groups (44% women, 47% men; p = NS), whereas documented restenosis was less common in women (20% vs 28% of patients, p < 0.05). The need for coronary artery bypass grafting was similar (15% women, 17% men; p = NS), as was the need for repeat percutaneous transluminal coronary angioplasty in the infarct vessel (14% women, 18% men; p = NS) and overall mortality (7% women, 9% men; p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

Screening for occult nodal metastasis in localized carcinoma of the prostate.

Metastatic involvement of pelvic lymph nodes in carcinoma of the prostate alters the prognosis and treatment of this disease. Our goal was to determine if additional techniques, such as immunohistochemical staining, could detect occult microscopic metastatic nodal disease not seen with routine hematoxylin and eosin staining. We examined paraffin embedded lymph nodes from 43 patients with clinical stage A or B carcinoma of the prostate who were candidates for radical prostatectomy and who underwent modified pelvic lymph node dissection with frozen section hematoxylin and eosin staining. Immunohistochemical staining for prostate specific antigen and prostate specific acid phosphatase was performed on the lymph nodes. Monoclonal antibodies to cytokeratins were used to confirm the epithelial origin of the prostate cells. An average of 9 lymph nodes and 42 histological sections per patient were stained. Based on routine hematoxylin and eosin staining the pathological staging was stage A in 3, stage B in 20, stage C in 9 and stage D1 in 11 cases. There were 17 well, 16 moderately and 10 poorly differentiated carcinomas. In 31 of 32 patients with negative nodes no occult metastases could be identified. One patient with poorly differentiated stage C cancer demonstrated occult nodal deposits by prostate specific acid phosphatase and not by prostate specific antigen. In the 11 stage D1 cancer patients immunohistochemical staining confirmed all malignant deposits and additional metastatic lesions were detected in only 1 patient. Unlike other carcinomas, such as breast, in which immunohistochemical staining yields a 14 to 37% occult metastasis rate, these data suggest that occult nodal metastases are infrequently seen in carcinoma of the prostate.

Acid Phosphatase

Characterization of antacid compounds containing both aluminum and magnesium. II. Codried powders.

The composition and antacid properties of six samples of codried antacids containing both aluminum and magnesium were determined. Aluminum hydroxide-magnesium carbonate codried gel and aluminum hydroxide-magnesium hydroxide codried gel were non-homogeneous, as the samples contained combinations of hydrotalcite, amorphous aluminum hydroxide, magnesium hydroxide, magnesium hydroxycarbonate, and magnesium carbonate. All samples passed the preliminary antacid test and had high acid neutralizing capacities. However, the rate of acid neutralization varied between samples. In some cases the rate of acid neutralization at a dose of 400 mg was too slow to raise the pH to 3.0 as required by the Rossett-Rice test.

Aluminum

Characterization of antacid compounds containing both aluminum and magnesium. I. Crystalline powders.

The composition and antacid properties of 10 samples of crystalline antacids containing both aluminum and magnesium were determined. The composition was found to vary significantly, even within the same type of antacid. For example, three of four hydrotalcite samples exhibit evidence of the presence of a minor phase of amorphous aluminum hydroxide. Almagate and almagcit, which are claimed to be unique compounds, were found to be composed of hydrotalcite, magnesium hydroxycarbonate, and/or magnesium carbonate and amorphous aluminum hydroxide. All three magaldrate samples examined contained a minor phase of amorphous aluminum hydroxide. All 10 samples passed the preliminary antacid test and had high acid neutralizing capacities. However, the rate of acid neutralization varied between samples. In some cases the rate of acid neutralization at a dose of 400 mg was too slow to raise the pH to 3.0 as required by the Rossett-Rice test.

Aluminum