Biomedical subjects

J R Drake

Publications and source records attributed to J R Drake.

6 recordsLinked to original sources

PubMed1992

Cytoplasmic domain heterogeneity and functions of IgG Fc receptors in B lymphocytes.

B lymphocytes and macrophages express closely related immunoglobulin G (IgG) Fc receptors (Fc gamma RII) that differ only in the structures of their cytoplasmic domains. Because of cell type-specific alternative messenger RNA splicing, B-cell Fc gamma RII contains an insertion of 47 amino acids that participates in determining receptor function in these cells. Transfection of an Fc gamma RII-negative B-cell line with complementary DNA's encoding the two splice products and various receptor mutants indicated that the insertion was responsible for preventing both Fc gamma RII-mediated endocytosis and Fc gamma RII-mediated antigen presentation. The insertion was not required for Fc gamma RII to modulate surface immunoglobulin-triggered B-cell activation. Instead, regulation of activation involved a region of the cytoplasmic domain common to both the lymphocyte and macrophage receptor isoforms. In contrast, the insertion did contribute to the formation of caps in response to receptor cross-linking, consistent with suggestions that the lymphocyte but not macrophage form of the receptor can associate with the detergent-insoluble cytoskeleton.

Amino Acid Sequence↗

PubMed1989

Endocytosis of antigen, anti-idiotype, and anti-immunoglobulin antibodies and receptor re-expression by murine B cells.

The endocytosis of Ag mediated by membrane-associated Ig (mIg) molecules has been spectrophotometrically monitored using a cell line (2C3) specific for the hapten phthalate (Xmp) and employing conjugates of Xmp and horseradish peroxidase (HRP) as the labeled ligand. Approximately 50% of both Xmp-HRP, or the larger ligand, Xmp-keyhole limpet hemocyanin-HRP, are internalized rapidly, reaching an initial plateau by 30 min. The rate of endocytosis of anti-idiotype-HRP is similar to the rates that were observed for the hapten-bearing ligands, while a slower rate of endocytosis of anti-Ig-HRP was observed. The percent of ligand bound that is internalized and the rate of endocytosis appear to be largely independent of the size and amount of ligand bound per cell. However, mIg-mediated endocytosis is markedly reduced when mIg-ligand complexes are more extensively cross-linked by the binding of a second antibody. In addition to the initial rapid phase of endocytosis, there is a prolonged phase during which more of the bound ligand is internalized, and up to 90% of the internalized ligand is degraded. Re-expression of Ag-binding receptors by the 2C3 cells is independent of new protein synthesis and is accomplished in part by the translocation of a presynthesized pool of mIg molecules from the cytoplasm to the plasma membrane of the cell. The kinetics of endocytosis of HRP-labeled anti-Ig antibodies by BALB/c splenic B-lymphocytes and other B-lymphocyte cell lines is very similar to the endocytosis of Ag and anti-idiotype observed with the 2C3 cell line. Light and electron microscopy are also performed to visually confirm that the HRP-labeled ligands are being internalized and to determine the percentage of cells involved in this process. Finally it was determined that the transmembrane and cytoplasmic domains of the mIg molecules are required for endocytosis since the secreted form of the molecule (which lacks these domains) fails to mediate the internalization of bound ligand.

Animals↗

PubMed1985

Time and financial analysis of an academic general internal medicine unit.

A detailed time and financial analysis of an academic general internal medicine unit was used to examine financial, educational, and research issues. The residents' outpatient service possessed the greatest patient visit and revenue capacity, but revenue recovery was limited by low productivity and collection rate. Outpatient revenue production could be improved but would still be less than current inpatient revenues. Full financial self-sufficiency would require improvements in several aspects of revenue production and would severely limit faculty time for teaching, personal study, and research. Indirect financial contributions to the medical center through hospitalizations and referrals dwarfed direct revenues. Several strategies for academic general internal medicine units to achieve financial and academic survival are possible, each with its own set of trade-offs. Because local circumstances differ, strategies and outcomes are likely to vary among units.

Efficiency↗

PubMed1984

Lack of effect of vitamin E therapy on the anemia of patients receiving hemodialysis.

We conducted a prospective, randomized, double-blind therapeutic trial of vitamin E as an erythropoietic agent in a group of patients with chronic renal failure who were undergoing chronic hemodialysis. Sixteen patients received 400 IU of vitamin E (d-alpha-tocopheryl acetate) by mouth twice daily and 19 patients received a placebo twice daily for 20 wk. The serum vitamin E concentration increased from 1.3 to 2.6 mg/dl in the treated group and decreased from 1.3 to 1.1 in the placebo group. For the treated group the initial hematocrit was 24.8 +/- 3.0 (mean +/- SD) and the final hematocrit was 25.8 +/- 3.8. For the placebo group the initial hematocrit was 24.9 +/- 3.0 and the final hematocrit was 23.5 +/- 2.7. The treated group received a total of 40 blood transfusions, and the placebo group received a total of 35 blood transfusions. Thus, vitamin E had no effect on the anemia or transfusion requirements of patients undergoing chronic hemodialysis for chronic renal failure.

Anemia↗

PubMed1982

Cost-effectiveness of thyroid function tests.

The cost-effectiveness of thyroid function tests (serum thyroxine concentration, triiodothyronine [T3]-resin uptake, free thyroxine index, serum T3, and serum thyrotropin concentration) was assessed in 135 ambulatory patients suspected of hypothyroidism or hyperthyroidism who did not have a history of thyroid disease requiring medication or thyroid surgery within the preceding two years. Of patients with five or more signs and symptoms compatible with thyroid dysfunction, 50.0% had biochemical abnormalities substantiating hypothyroidism or hyperthyroidism, while only 1.5% of patients with fewer than two signs and symptoms had either disease. The cost of thyroid function tests was twice as much per patient evaluated by residents as for those evaluated by faculty physicians. These results suggest that interventions to reduce the number and type of tests in patients without multiple signs and symptoms of thyroid disease could improve the cost-effective use of these tests.

Cost-Benefit Analysis↗

PubMed1980

Status of vitamin E as an erythropoietic factor.

There is now convincing evidence that vitamin E is a specific erythropoietic factor for nonhuman primates and swine. There is no evidence, however, that vitamin E is normally required as an erythropoietic factor for humans and many species of animals. We propose that the lack of a requirement for vitamin E in erythropoiesis in humans is due to a metabolic adaptation that circumvents the need for the role that the vitamin otherwise would serve. There is reason to believe that this metabolic adaptation is deranged in patients with protein-calorie malnutrition. These patients respond with reticulocytosis and a limited increase in hemoglobin concentration when vitamin E is given before their metabolic derangement is reversed by correcting their other nutritional deficiencies. Given this information, we may predict that other acquired or congenital abnormalities of metabolism could impair the adaptation that circumvents the role of vitamin E in erythropoiesis. Therefore, vitamin E should be viewed as a potential erythropoietic factor for humans, and it should receive further carefully controlled therapeutic trials in patients with anemia of obscure etiology, particularly in those with erythroid hyperplasia and unexplained ineffective erythropoiesis.

Adaptation, Physiological↗