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Biomedical subjects

J Sullivan

Publications and source records attributed to J Sullivan.

At least 199 records · Page 11Linked to original sources

Is a Klebsiella plasmid involved in the aetiology of Ankylosing Spondylitis in HLA-B27-positive individuals?

The possibility that plasmid genes, carried by enteric organisms previously indirectly implicated as disease agents, play a role in the pathogenesis of Ankylosing Spondylitis (AS) was explored. A particular Klebsiella isolate (K21) previously found to cross-react with cells from HLA-B27 positive (B27+) patients with AS, but not with cells from normal individuals, was found to contain a plasmid(s). This coded for the organism's ability to produce a factor which could modify B27+ normal cells (AS-) rendering them lysable by the anti-Klebsiella serum. Curing of this isolate resulted in the loss of the plasmid concerned and a loss of ability of its culture filtrate to modify B27+ lymphocytes of clinically healthy subjects. When plasmids from K21 were transferred to a plasmid free laboratory strain, E. coli JP995, the recipient strain acquired the ability to elaborate modifying factor. These data suggest that plasmids, harboured by some enteric bacteria, and their products, may be implicated in modifying cells bearing certain Major Histocompatibility Complex genes, and that such modification may be an important factor in the pathogenesis of a number of diseases including the seronegative arthropathies.

Cross Reactions↗

Evaluations of Blom-Singer tracheoesophageal puncture prostheses performance.

Empirical and theoretical approaches to the assessment of Blom-Singer tracheoesophageal puncture prosthesis performance are described in this paper. The results of empirical studies provide new insights about the behavior of Blom-Singer devices. Namely, the overall average resistance (about 126 cm H2O/LPS) of these devices stems from two major factors: air entrance and air exit effects. The magnitudes of airway resistance for each of these factors and the relative contribution each factor makes to the total airway resistance of these prostheses are delineated. The performance of these devices and modifications thereof are shown to be characterized and predicted quite well using a one-dimensional, spring-constant mathematical model.

Airway Resistance↗

Quantitative assessment of psychologic state of patients with anorexia nervosa or bulimia: response to caloric stimulus.

Hospitalized patients with anorexia nervosa (N = 17) or bulimia (N = 11) were given a standard liquid meal containing 400 calories. Using analogue scales, bulimic patients were found to have greater anxiety, lower mood, lower sexual arousal, and more fear of fatness than either control or anorectic patients. This finding of increased general "dysphoria" in bulimic patients persisted after the meal without any significant premeal to postmeal changes. Anorectic patients also differed from controls, but less than the bulimic patients. Some measures of anxiety correlated significantly with body mass index before the meal in bulimic patients, whereas in anorectic patients the correlation was significant only after the meal.

Anorexia Nervosa↗

Work in progress: transcatheter embolization of renal cell carcinoma with radioactive infarct particles.

Treatment by radioactive infarct implant is advocated for patients who have renal cell carcinoma with distant metastases. The radioactive infarct implants were placed into the primary tumor, and when feasible into metastases, by transcatheter embolization. Metastases to the skeleton, liver, lungs, adrenals, and retroperitoneal muscles were also seeded; metastases to the central nervous system, pancreas, and spleen, as well as most pulmonary metastases, proved inaccessible to this approach. The effectiveness of this treatment modality was shown by improved cumulative survival rates (59% for patients with metastases and at risk at two years and 50% for those at risk at five years). The best results were obtained when treating patients who had skeletal metastases (90% survival of those at risk at two years and 60% at five years). Measurable palliation factors, such as decrease in the size of the primary lesion, weight gain, and control of bleeding and pain, were indicators of treatment response and were observed in the majority of patients. Remissions were signaled by weight gain, normalization of the erythrocyte sedimentation rate, and disappearance or decrease of tumor markers. Some evidence suggests that the salutary results may be based on significant reduction of tumor burden, temporary local control of tumor, and improved general immunocompetence.

Adenocarcinoma↗

Histiocytic lymphoma and malignant angioendotheliomatosis: one disease or two?

The case history of a patient with diffuse histiocytic lymphoma and skin lesions characteristic of malignant angioendotheliomatosis is reported. The patient initially responded to aggressive chemotherapy but quickly had a relapse, CNS disease developed, and the patient died one year after diagnosis. Microscopic, ultrastructural, and surface membrane studies showed that the intravascular tumor cells were not of endothelial origin. The morphologic similarity of the malignant intravascular cells and peripheral blood cells, as well as the demonstration of surface membrane immunoglobulin on malignant blood cells suggested that, in some cases, unusual features of malignant lymphoma may be confused with malignant angioendotheliomatosis.

Diagnosis, Differential↗

Immunochemical characterization of Klebsiella antigens which specifically modify an HLA-B27-associated cell-surface component.

Culture filtrates of some Klebsiella isolates contain a factor(s) capable of specifically modifying the HLA-B27-positive lymphocytes of normal individuals, resulting in a phenotypic change similar to that seen on lymphocytes from patients with ankylosing spondylitis (AS). To further delineate the nature of the interaction between HLA-B27 and some Klebsiella products we have undertaken a chemical characterization of B27+AS+-cross-reactive Klebsiella antigens from the culture filtrate and the bacterial cell-membrane. Biogel P-100 chromatography of the Klebsiella K43-derived modifying factor from the culture filtrate and from an NP-40-solubilized membrane extract gave a molecular weight of 26,000-30,000. Isoelectric focusing revealed that the modifying factor had an isoelectric point of approximately 5.4. Membrane-associated modifying factor activity was found only in outer-membrane preparations indicating that the cross-reactivity between Klebsiella K43 and B27+AS+ cells is defined, at least in part, by outer-membrane antigens. These studies demonstrate that membrane components of Klebsiella K43 share antigenic determinants with a modifying factor, which is released into the culture medium, and that these components are capable of specifically altering the HLA-B27 antigen or an associated cell-surface structure. Such a modification occurring in vivo following exposure to Klebsiella, or to antigenically related organisms, could explain the triggering of the B27-associated arthropathies such as AS.

Antigens, Bacterial↗

Stress, symptom proneness, and general adaptational distress during pregnancy.

Symptom proneness (SP), the 20 psychiatric items of the Cornell Medical Index, here called the Cornell Psychiatric Items (CPI), and a test developed partially from the Schedule of Recent Experiences called the Utah Stress Scales (STRESS) were used to predict general adaptational distress (GAD) symptoms during pregnancy on a sample of 1306 primigravidas. The causal model explored in seven path analyses developed for months 3-9 of pregnancy is that SP and STRESS affect CPI, and that SP, STRESS, and CPI directly affect GAD symptoms. Results suggest that CPI is most predictive of GAD symptoms until the ninth month when SP and STRESS become more predictive. It is suggested that GAD pregnancy symptoms are affected by situational stress, symptom proneness, and level of psychological upset and that this system of relations changes over the course of pregnancy. This information should have important implications for anticipating potential problems and improving the quality of nursing care of pregnant women.

Adaptation, Psychological↗

Cd branding studies in a homologous Robertsonian 13;13 translocation.

A phenotypically normal female with a history of two miscarriages was found to have the karyotype 45,XX,t(13p:13p). C banding showed the translocation to have two regions of centromeric constitutive heterochromatin, silver staining showed an active NOR in 60% of the cells screened, and Cd banding studies showed a single Cd band with absence of the Cd band at the suppressed centromere.

Chromosome Banding↗