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Biomedical subjects

J McCullough

Publications and source records attributed to J McCullough.

At least 109 records · Page 6Linked to original sources
PubMed1991

The role of the blood bank in transplantation.

Blood transfusion supportive care is essential to successful organ, tissue, and bone marrow transplantation, thus making the blood bank an integral part of these programs. The impact of clinical transplantation on the blood bank can be considered in the following categories: (1) use of blood and blood components for transfusion support; (2) special blood component needs; (3) red blood cell serologic needs; (4) collection, processing, and preservation of bone marrow and peripheral blood stem cells; (5) hemotherapy for bone marrow donors, (6) recruitment of bone marrow donors; and (7) the special procedures that must be available for managing patients undergoing transplantation therapy.

Blood↗
PubMed1990

Transfusion-related acute lung injury caused by an NB2 granulocyte-specific antibody in a patient with thrombotic thrombocytopenic purpura.

HLA and granulocyte-specific antibodies have been implicated in the production of transfusion-related acute lung injury (TRALI). Reported here is a case that suggests that the patient's preexisting condition may play an important role in determining whether TRALI develops upon transfusion of blood products containing anti-white cell (WBC) antibodies. A 29-year-old woman with thrombotic thrombocytopenic purpura (TTP) underwent an uneventful 1.5-volume plasma exchange, which was followed by the transfusion of 2 red cell (RBC) units. At the end of the second RBC transfusion, the patient developed clinical signs and symptoms of noncardiogenic pulmonary edema. Serologic studies demonstrated that the serum from the second RBC donor had no HLA antibodies but did have a granulocyte-specific antibody (anti-NB2) that caused the agglutination of the recipient's granulocytes, which were NB2 positive. Serum from the donor of the first RBC unit and serum from the donors of units used in the exchange had no HLA or granulocyte-specific antibodies that reacted with the recipient's WBCs. Because the donor implicated in this reaction had a history of 21 blood donations, none of which had been associated with a transfusion reaction, we suggest that the patient's preexisting condition played a significant role in this episode of TRALI, owing to the granulocyte-specific antibody.

Acute Disease↗
PubMed1990

Janthinocins A, B and C, novel peptide lactone antibiotics produced by Janthinobacterium lividum. I. Taxonomy, fermentation, isolation, physico-chemical and biological characterization.

Janthinocins A, B and C are novel antibacterial agents produced by Janthinobacterium lividum. They were isolated from fermentation broths and characterized by UV, IR, NMR and mass spectroscopy. They are cyclic decapeptide lactones with marked activity against aerobic and anaerobic Gram-positive bacteria and are 2 to 4 times more potent in vitro than vancomycin. Janthinocins A and B were also found to be effective in a Staphylococcus aureus systemic infection in mice.

Animals↗
PubMed1989

Successful allogeneic cryopreserved marrow transplantation.

Cryopreservation has been used extensively in autologous marrow transplantation (BMT), but there has been limited use in allogeneic BMT. We describe here 6 cases of successful engraftment following allogeneic BMT with cryopreserved marrow. Patients suffered from Wiscott-Aldrich syndrome, osteopetrosis, aplastic anemia, and acute lymphocytic, acute non-lymphocytic, and chronic myelogenous leukemia, and ranged in age from 5 mos to 35 yrs. Marrow was collected using standard techniques. In one case T-cells were removed to prevent graft-vs-host disease. Marrow was frozen for a variety of reasons. Buffy coat cells were frozen at controlled rate in 10% DMSO, and stored in liquid nitrogen for 6 to 49 d. Engraftment (WBC greater than 1000/uL x 3 d) occurred from 13 to 37 d post BMT. In 4 of 4 cases in which data are available, donor origin of engraftment was documented, 1 with cytogenetics, 2 with red cell typing, and 4 with restriction fragment length polymorphisms. 3 patients are alive and well 21, 21, and 42 months post BMT. These results suggest frozen marrow can be successfully used for allogeneic BMT.

Adolescent↗
PubMed1989

Attitudes and physical condition of unrelated bone marrow donors immediately after donation.

Annually, over 3000 bone marrow transplants are performed worldwide involving HLA-identical sibling donors. However, only 30 percent of those patients who need a bone marrow transplant have a matched sibling donor. Programs have been developed to provide volunteer unrelated bone marrow donors for patients without sibling donors. Because bone marrow donation requires a high level of altruism, especially on the part of a donor unrelated to the patient, it is important to determine the effect of donation on the donor. Serious medical complications during the collection of marrow from related donors have been reported only rarely, but there have been no reports on the psychosocial and physical effects of the bone marrow donation process on volunteer unrelated bone marrow donors. The first 20 unrelated volunteers who donated bone marrow through the authors' volunteer bone marrow donor program were surveyed. They suffered no serious emotional or physical aftereffects. Seventeen of 20 donors reported that making the decision to donate was easy, and 16 reported making the decision to donate right away. Nine of 20 donors, however, stated that a friend or family member discouraged them from donating. All 20 donors thought that they were well prepared for the donation process. Four donors thought that the donation process required more time than they expected, but four donors thought the reverse. One person thought the process was more painful than they expected; however, 12 found the process to be less painful than expected.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

The National Marrow Donor Program: how it works, accomplishments to date.

As the use of bone marrow transplantation increases, the lack of a suitable matched sibling donor for approximately 60% of patients is a growing problem. Recently, marrow transplantation has been done successfully using HLA-matched unrelated donors. In an effort to provide more donors, the National Marrow Donor Program (NMDP) was established. It involves 50 blood banks and 20 marrow transplant centers throughout the United States. More than 20,000 HLA-typed apheresis donors from these blood banks have agreed to be listed in the NMDP registry. A preliminary search for donors has been carried out for 1,116 patients. Donors suitably matched for HLA-A and B antigens were located for 99% of the patients.

Bone Marrow Transplantation↗
PubMed1988

Effectiveness of a regional bone marrow donor program.

Because many potential bone marrow transplant patients lack HLA-matched siblings, there is growing interest in carrying out transplantations using matched, unrelated volunteer donors. We developed a local registry of 2147 informed donors who consented to be listed in the Bone Marrow Donor Registry. This registry was used to carry out 420 donor searches for 351 patients. The initial computer search involved matching for HLA-A and HLA-B locus antigens only because most donors had not been typed for HLA-DR antigens. Depending on the degree of HLA-A and HLA-B antigen mismatching allowed, suitably matched (HLA-DR-identical, mixed lymphocyte culture nonreactive) donors were located for 6% to 16% of patients. This resulted in 13 bone marrow transplants. This study shows that a small, local bone marrow donor registry can locate donors for a few patients; however, a large network involving an expanded number of donors will be necessary to allow an extensive evaluation of unrelated bone marrow transplantation.

Bone Marrow Transplantation↗
PubMed1988

Antibody responses in watermelon sensitivity.

Watermelon-specific IgE (WM-IgE) appears to mediate the oropharyngeal symptoms after watermelon ingestion. However, less than one fourth of watermelon-sensitive individuals (i.e., those with detectable WM-IgE) develop such symptoms after watermelon ingestion. In an attempt to separate symptomatic from asymptomatic persons, we measured watermelon-specific-IgE and IgG4 concentrations in the sera of 29 watermelon-sensitive patients, 6 of whom were symptomatic. Although the mean WM-IgE level of the symptomatic group exceeded that of the asymptomatic group (p = 0.04), individual WM-IgE values failed to distinguish symptomatic from asymptomatic persons. No differences in WM-IgG4 levels between the two groups could be found. Watermelon extract proteins were separated by isoelectric focusing and blotted to nitrocellulose membranes. The membranes were reacted with the individual sera of 14 watermelon-sensitive patients and then stained for IgE, IgG1, and IgG4 binding. Great variations in IgE, IgG1, and IgG4 binding patterns were found, but no subtype restrictions were discovered. Although the pattern of IgE-stained bands in the absence of corresponding IgG1-stained bands was seen more frequently in symptomatic individuals, immunoblot patterns failed to separate symptomatic from asymptomatic persons. We conclude that the pattern of IgE, IgG1, and IgG4 responses to separated watermelon allergens was not predictive of clinical symptoms in a group of watermelon-sensitive patients.

Adolescent↗
PubMed1988

Passive exposure to cigarette smoke does not increase allergic sensitization in children.

The purpose of this study was to learn whether children passively exposed to parental cigarette smoke would be more frequently sensitized to common allergens or would have higher concentrations of allergen-specific IgE. To evaluate this question, we studied two groups of children aged 2 to 17 years. The first group consisted of 100 children selected from a general pediatric group practice. These children were being observed for well-child care, and the only selection criteria were the need for a venous blood sample for a reason unrelated to the study. The second group of 91 patients were consecutively referred, from the same pediatric group, for allergy evaluation because of respiratory tract symptoms. Parental smoking histories were obtained, and total serum IgE, IgD, and IgE specific for cat, dog, mite, ragweed, grass, and cockroach were measured by ELISA. Children of smoking mothers had significantly greater IgD concentrations (p = 0.03) and were more likely to be referred for allergy evaluation (p = 0.0001), but these children did not have increased concentrations of total or allergen-specific IgE. Exposed children were not more likely to be serologically sensitive to any of the allergens tested. We conclude that children passively exposed to cigarette smoke do not produce more IgE to common allergens nor are they more likely to produce IgE to any particular allergen.

Adolescent↗
PubMed1988

A heat recovery system for air conditioning which allows disposal of wet cooling towers.

The combined run-around coil heat recovery and cooling plant has been in full operation for about four months at the time of writing and appears to be performing as predicted. The predicted energy saving was 19,000 GJ/year and the actual is around 18,000 GJ/year. It provides a general limited cooling facility of 6 degrees K where previously cooling existed for operating theatres only. The capital cost of the total project was 390,000 pounds and disregarding fuel price fluctuations the heat recovery scheme should pay for itself in about seven years. In addition to the heat recovery and cooling provisions offered the scheme also enabled correction of a frost protection problem plus disposal of an existing wet cooling tower and hence should reduce the risk of Legionnaires Disease. Had these two projects been implemented separately the cost would have been 80,000 pounds but without heat recovery. The advantages of the scheme may be summarised as follows. Energy Cost Savings Frost Protection Elimination of Wet Cooling Tower Cooling Facility It is believed that a scheme as described in this paper would be of benefit to other existing hospitals and should be considered at the design stage of future new hospitals. At IRH it was possible to dispense completely with a wet cooling tower; for other schemes this may also be possible or at least the size and capacity of cooling towers could be reduced.

Air Conditioning↗
PubMed1987

Watermelon and ragweed share allergens.

A biotin-avidin amplified ELISA was used to measure antigen-specific IgE for ragweed, representative members of the gourd family (watermelon, cantaloupe, honeydew melon, zucchini, and cucumber), and banana in the sera of 192 allergic patients, each with an IgE greater than or equal to 180 microns/ml. Sixty-three percent (120/192) of the sera contained antiragweed IgE, and of these patients, 28% to 50% contained IgE specific for any single gourd family member. In contrast, no greater than 11% of the sera positive for a given gourd or banana were negative for ragweed. Correlations between ragweed and gourd-specific IgE levels were significant (p less than 0.001), and correlation coefficients between any two gourds exceeded 0.79. In an ELISA system, the extracts of watermelon and ragweed inhibited each other in a dose-dependent manner; the resulting nonparallel inhibition curves indicate that some, but not all, of the allergens in the two extracts are cross-reactive. Isoelectric focusing of watermelon and ragweed extracts in narrow range gel (pH 4 to 6) followed by immunoblotting demonstrated six watermelon allergen bands with isoelectric points identical to those of ragweed allergens. Several remaining bands in the two extracts had differing isoelectric points, however. Six of 26 patients interviewed with watermelon-specific IgE reported developing oropharyngeal symptoms (itching and/or swelling of the lips, tongue, or throat) after ingesting at least one of the study foods, whereas only one of 25 patients interviewed without detectable watermelon-specific IgE reported similar symptoms (p = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Granulocyte antigens and antibodies.

Granulocyte-specific antigens defined by human alloantisera are clinically important in neonatal neutropenia, autoimmune neutropenia, transfusion reactions, drug-induced immune neutropenia, and poor response to granulocyte transfusions. Many different antigens have been defined by human alloantisera using different assays. Only antigens of the N system of Lalezari are commonly studied today. The composition and location of these antigens within the granulocyte membrane are not known, but work is now proceeding on those issues. It also appears that these antigens may have some structural or functional role in the granulocyte. Although many myeloid MoAbs have been developed, there are very few reports to establish whether these identify structures that are related to the N series of granulocyte antigens. However, these MoAbs can serve as excellent reagents for better understanding the granulocyte membrane. It appears that studies during the next several years will provide exciting information about the structure-function relationships in the granulocyte membrane.

Antibodies↗