Biomedical subjects
Publications and source records attributed to J Malone.
We report the fifth case of a graft appendiceal fistula. The four previously reported cases are reviewed. This is the first report of the utility of the tagged red blood cell study in the evaluation of a patient with a graft appendiceal fistula.
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A person's network embodies "the good, the bad, and the ugly" of all social relationships. The nature of these relationships may be conceptualized as a continuum between social support and social dissupport. Social support, as a product of relationships that facilitate growth, generates self-esteem and assists in assuming appropriate societal roles. Social dissupport represents those relationships that hinder growth and/or promote disintegration. Clinically, nurses either formally or informally assess the degree of social support, but neglect the overall social support/dissupport ratio. The MSNI profiles the person's perception of social support/dissupport on four levels of social relationships and is an efficient instrument in assessing who is in the social network, what is provided, perceived helpfulness, and expectations. Preliminary use of the instrument with parents of the long-term mentally ill, acutely and long-term mentally ill clients, students, and a variety of clients of graduate students enrolled in a crisis intervention course are promising. Thus, nurses must be prepared to confront their clients' perceptions of the professional's role and to modify and adapt those interactions to facilitate goal achievement.
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A prospective trial was carried out comparing hospital-based chemotherapy with domiciliary chemotherapy. Fifteen women received cisplatin combination regimens to treat gynecologic cancers. The first course was given in a hospital inpatient setting, and subsequent courses were given to each patient in her domicile. Seventy-four courses were given at home under the direction of a nurse trained to administer chemotherapy. There were no extravasations or anaphylactic reactions. In the period immediately following the at-home administration, no patient required hospitalization for dehydration or for adverse reactions to the chemotherapy. Written interviews with patients and family members were conducted after completion of the course of treatment. No patient wanted to return to the hospital environment. All patients preferred to be treated at home, usually because of the increased privacy, convenience, and lessened anxiety.
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The galactose tolerance of individuals with mutant genotypes affecting the activities of galactokinase (GALK) and galactose-1-phosphate uridylyltransferase (GALT) was examined. Genotypes studied were heterozygotes for the GALK and GALT forms of galactosemia, the Duarte-variant GALT, and Philadelphia-variant GALK alleles. The measurements used were urinary concentration of galactose during pregnancy in adults and in infants from the newborn period through the first 5 months of life; the rate of elimination of an intravenous infusion of galactose; and slit-lamp examination of the lens for evidence of cataracts. No unusual urinary excretions of galactose were noted in any of the age groups studied. Intravenous galactose tolerance tests were normal in all but two women, a mother and daughter heterozygous for the GALK-deficient form of galactosemia (GALKG/GALKA). Six other GALKG/GALKA subjects had normal tolerance studies. The intrafamilial consistency and interfamilial differences in the galactose tolerance of GALKG/GALKA individuals suggest heterogeneity of the genes responsible for the GALK-deficient form of galactosemia. Although subclinical cataracts were observed in several individuals, their significance relative to the mutant genotype cannot be resolved with the available data.
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The generation of new antibodies for diagnostic applications using phage display could greatly decrease the time and expense of new assay development but, to be effective, the process must yield antibodies with desired specificity and affinity comparable to those obtained by monoclonal antibody technology. In order to evaluate the ability of the phage selection process to yield antibodies with the desired specificity and affinity, a family of anti-phenobarbital antibodies were cloned as scFvs and Fabs and displayed on M13 gene III fusion proteins. All of the antibodies are derived from similar germline VL and VH genes and exhibit extensive sequence homology except in VH CDR3. Despite these similarities, the range of panning efficiencies was observed to vary by two orders of magnitude for expressed scFvs. Unexpectedly, the scFv with the highest panning efficiency has the lowest affinity. In competitive panning experiments this scFv is preferentially isolated over higher affinity antibodies. This scFv expresses high levels of soluble binding protein while higher affinity scFvs express lower levels of protein or nonfunctional protein. These results suggest that the efficiency of functional expression of scFv proteins can greatly influence the type of antibody selected by phage display. The range of panning efficiency for functional Fabs was significantly less (four-fold) than that observed for scFvs and did not correlate to the expression level of the secreted proteins. Based on the results of the Fabs examined, it is concluded that the expression properties of Fabs may not exhibit the extent of variability observed for scFvs when displayed and use of an Fab architecture may provide an advantage over scFv architecture in the selection process. The feasibility of selecting against undesirable cross-reactivities has also been demonstrated by simple modification of phage panning conditions. These combined results support the concept of obtaining antibodies with desirable specificity and affinity for diagnostic applications through the use of phage display.
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Intact lenses from New Zealand white rabbits were incubated in tissue culture media containing either 5 mM glucose or 5 mM glucose plus 30 mM galactose. The standard media did not contain taurine. Lenses were also cultured in a third medium containing 30 mM galactose plus 0.2 mM taurine. The frequency of cataract formation was evaluated as a function of the culture media. One lens (1/10), in media containing 5 mM glucose, developed a lenticular opacification during a 72-h incubation. Lenses (12/15) incubated in 30 mM galactose, without taurine, developed cataracts; fewer lenses (2/13) exposed to 30 mM galactose plus 0.2 mM taurine developed cataracts (p < 0.005). Galactose cataracts have been associated with lens edema attributed to the osmotic stress of tissue polyol (galactitol) accumulation. The water content of the noncataractous and cataractous lenses in this experiment did not differ. Lens edema, therefore, was not thought to be important in cataract pathogenesis. Taurine, an organic osmolyte was lower (5.1 +/- 1.5 mumol/g protein) in cataractous lenses than in control lenses (10.0 +/- 1.0 mumol/g protein). Malondialdehyde, an indicator of lipid peroxidation, was higher (36.6 +/- 5.0 mumol/g protein) in lens-containing opacifications than in noncataractous lenses (10.1 +/- 1.9 mumol/gm protein) (p < 0.01). The levels of malondialdehyde suggest that lipid peroxidation was increased in the process of sugar cataractogenesis. The malondialdehyde content of all the lenses correlated inversely (r = -0.53, p < 0.01) with the coincident lens taurine levels. Taurine appears to protect the lens against the development of sugar cataracts; its inverse relationship with lens malondialdehyde suggests this is an antioxidant effect.
In study 1, laboratory and supervised blood or urine test data from actual cases were used to develop patient profiles. Seven diabetologists from the same institution rated the diabetic control of 125 profiles on a four-point scale (1 = poor, 2 = fair, 3 = good, 4 = excellent). Six of the 7 diabetologists demonstrated adequate intra- and interrater reliability. Study 2 assessed the reliability of judgments of diabetic control made by diabetologists working in two different settings. There were 9 raters from institution 1 and 8 from institution 2. The impact of the amount and type of information on judgment reliability was evaluated by developing two types of profiles. The test form contained only laboratory and supervised blood or urine test data similar to that utilized in study 1. The history form contained this information as well as other descriptive data typically available to diabetologists. The 17 diabetologists rated 125 anonymous profiles on each of two separate occasions approximately 1 wk apart. On one occasion they rated profiles presented on the test form. On the other occasion they rated profiles presented on the history form. As in study 1, the diabetologist raters demonstrated adequate intra- and interrater reliability. Intrarater reliability was somewhat better when rating test form profiles compared with history form profiles. Reliability was not higher within than between institutions. An analysis of the relative contribution of different diabetes control indices to the diabetologists' judgments indicated that HbA1 influenced raters' judgments at both institutions more than any other single variable.(ABSTRACT TRUNCATED AT 250 WORDS)
OBJECTIVE: There is strong evidence indicating that prostaglandins (PG) and their synthesizing enzyme cyclooxygenase-2 (COX-2) play an important role in tumorigenesis. The purposes of the present study were to determine the pattern of expression of COX-2 and the effect of PG treatment on proliferation and apoptosis in epithelial ovarian cancer cells. METHODS: Two epithelial ovarian cancer cell lines, MDAH-2774 and SKOV3, were grown in flasks to confluence. Cells were then treated with exogenous dimethyl prostaglandin E(2) (dmPGE(2)) at increasing concentrations of 0-10 microg/mL. Total RNA was extracted from cells at different treatment doses and subjected to reverse transcriptase-polymerase chain reaction for the semiquantitative analysis of COX-2, Bcl-2, and bax expression. Flow cytometry was performed to assess effect of treatment on the cell cycle. The TUNEL assay was used to assess apoptosis. RESULTS: We found that COX-2 was constitutively expressed in the MDAH-2774 and SKOV3 epithelial ovarian cancer cells as determined by detection of a 304-bp amplified fragment using specific primers for the COX-2 gene. Treatment of both cell lines with dmPGE(2) resulted in dose-dependently higher expression of COX-2, Bcl-2, and bax mRNA compared with untreated cells. These changes were associated with an increase in the proliferative fraction and with a simultaneous reduction in apoptosis. CONCLUSIONS: Prostaglandin E(2) stimulated proliferation and reduced apoptosis in epithelial ovarian cancer cells. These effects were associated with overexpression of COX-2 and an increase in the ratio of Bcl-2:bax mRNA.