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Biomedical subjects

J Sullivan

Publications and source records attributed to J Sullivan.

At least 127 records · Page 7Linked to original sources
PubMed1994

An unusual pattern of growth disturbance of the hip in juvenile rheumatoid arthritis.

OBJECTIVE: An unusual deformity in the hip in juvenile rheumatoid arthritis (JRA) consisting of a small femoral head in a capacious acetabulum has been described as an isolated finding, but no explanation as to the cause of the deformity has been proposed. We have also observed this deformity and the objective of this investigation was to determine the cause. METHODS: In 1987, a review of hip disease in JRA was carried out at the Wellesley Hospital. Nine hips in 5 patients were identified as having a mismatch in size between the femoral head and acetabulum. Six of these hips came to surgery during the growth phase. RESULTS: The 6 hips undergoing surgery between the ages of 16-19 showed an identical picture at the time of surgery. The pattern of pathology consisted of a femoral head devoid of articular cartilage and an acetabulum that showed an intact triradiate cartilage. Each of the 6 hips was treated with a resurfacing arthroplasty. CONCLUSION: The femoral head grows in circumference by endochondral ossification of the articular cartilage. If the rheumatoid process destroys that articular cartilage, growth of the femoral head ceases. The intact triradiate cartilage permits continuing acetabular growth and the deformity of a small femoral head in a large capacious acetabulum results.

Adolescent↗
PubMed1994

Long term results of subtotal parathyroidectomy in patients with end-stage renal disease.

This is a retrospective, clinical study evaluating the long-term outcome of subtotal parathyroidectomy (PTX) in 60 patients with chronic renal failure and severe secondary hyperparathyroidism. Patients were 41 +/- 2 years old (mean +/- SE) at the time of PTX, and followed for 69 +/- 6 months since the procedure. At the time of PTX, three patients had chronic renal failure, 53 had been on chronic hemodialysis, and four had received successful kidney transplants. In more than 80 per cent of patients, symptoms of hyperparathyroidism (bone pain and muscle weakness) resolved within weeks, and biochemical signs (hypercalcemia, and high plasma alkaline phosphatase and parathyroid hormone concentrations) returned to normal ranges within a year. Subperiosteal resorption, bone fractures, and soft tissue calcification frequently improved. Osteosclerosis (rugger-jersey spine), cystic bone changes, osteopenia, and vascular calcifications were, however, often unchanged or progressive. Five patients (8%) who had either persistent or recurrent hyperparathyroidism required additional surgical procedures, and two had subsequent improvement. Twelve patients who had aluminum associated bone disease diagnosed later continued to progress with a high incidence of bone fractures and severe osteopenia. Cystic bone changes, especially of the carpal bones, in association with carpal tunnel syndrome, probably representing amyloid bone disease, also did not respond to PTX. In conclusion, PTX is an effective surgical procedure to reverse complications of hyperparathyroidism in patients with end-stage renal disease, provided that other causes of osteodystrophy, such as aluminum or amyloid-associated bone diseases, are adequately excluded. We feel that subtotal PTX, leaving a small remnant in place, is the procedure of choice.

Adolescent↗
PubMed1993

Erythrocyte membrane structure in bipolar affective disorder: a non-replication.

Fifteen bipolar patients were compared with sixteen controls in an attempt to replicate the findings of Pettegrew et al. in 1982 of decreased fluidity in the hydrocarbon core of the erythrocyte membrane. No significant differences were seen between groups. The present control group shows very similar membrane characteristics to the original control series; however, the bipolar patient group is not similar. Possible explanations are discussed.

Adult↗
PubMed1993

Zinc potentiates agonist-induced currents at certain splice variants of the NMDA receptor.

We have determined the gene structure for the NMDA receptor subunit gene NMDAR1. We found eight splice variants that arise from different combinations of a single 5' terminal exon insertion and three different 3' terminal exon deletions, relative to NMDAR1. We analyzed the modulation by Zn2+ of currents through homomeric receptors assembled from these splice variants and found that, in addition to its well-known inhibitory effect at high concentrations, Zn2+ potentiates agonist-induced currents at submicromolar concentrations (EC50 = 0.50 microM). This potentiation is observed only with a subset of NMDAR1 splice variants that show additional differences in pharmacological properties. Zn2+ potentiation is rapidly reversible, noncompetitive with either glutamate or glycine, and voltage independent. Zn2+ potentiation is mimicked by Cd2+, Cu2+, and Ni2+, but not by Mn2+, Co2+, Fe3+, Sn2+, or Hg2+. Our results suggest a possible role for Zn2+ as a positive modulator of NMDA receptors in certain regions of the brain.

Animals↗
PubMed1993

Management of the cataract patient with significant retinal disease.

Cataract surgery has influenced the course of certain retinal diseases just as vitreoretinal procedures have led to the de novo presentation or progression of cataracts. We review nearly 100 articles from the recent literature to determine the prevailing data and opinions concerning these vital issues.

Cataract↗
PubMed1993

Epstein-Barr virus recombinants with specifically mutated BCRF1 genes.

Epstein-Barr virus (EBV) recombinants with specifically mutated BCRF1 genes were constructed and compared with wild-type BCRF1 recombinants derived in parallel for the ability to initiate and maintain latent infection and growth transformation in primary human B lymphocytes. A stop codon insertion after codon 116 of the 170-codon BCRF1 open reading frame or deletion of the entire gene had no effect on latent infection, B-lymphocyte proliferation into long-term lymphoblastoid cell lines (LCLs), or virus replication. LCLs infected with the stop codon recombinant were indistinguishable from wild-type recombinant-infected LCLs in tumorigenicity in SCID mice. However, mutant BCRF1 recombinant-infected cells differed from wild-type recombinant-infected cells in their inability to block gamma interferon release in cultures of permissively infected LCLs incubated with autologous human peripheral blood mononuclear cells. This is the first functional assay for BCRF1 expression from the EBV genome. BCRF1 probably plays a key role in modulating the specific and nonspecific host responses to EBV infection.

Animals↗
PubMed1993

Data collection in the Adult Day Health Care Evaluation Study.

This report presents data collection measures and methods for the evaluation of Adult Day Health Care (ADHC) in the Department of Veterans Affairs (VA). Measures of patient health were survival, the Sickness Impact Profile, self-rated health, the Mini-Mental State Exam, Psychological Distress Scale, Social Support Scale, and Problem Behaviors Scale. Measures of health for the care giver were: Activities of Daily Living, Instrumental Activities of Daily Living, health perceptions, Psychological Distress Scale, life satisfaction, Social Support Scale, and Caregiver Burden Scale. We also assessed patient and care giver satisfaction with the care received by the patient. Measures of health status and outcomes were assessed primarily through patient and care giver interview at study enrollment, 6 months, and 12 months. Utilization and cost both within and outside VA were assessed for hospital, ambulatory care, nursing home, ADHC, home care, pharmacy, laboratory, and other forms of health care. Sources of utilization data included VA's computerized patient database, VA medical records, patient questionnaires, care giver questionnaires, and health care providers outside VA. Costs were obtained from VA's cost accounting system, VA Central Office, VA's contracts with outside providers, and directly from outside providers. Utilization and cost were assessed for each patient for a period of 1 year after entry into the study.

Activities of Daily Living↗
PubMed1993

Experimental infection of Anopheles gambiae s.s., Anopheles freeborni and Anopheles stephensi with Plasmodium malariae and Plasmodium brasilianum.

Susceptibility to infection of 2 strains of Anopheles gambiae s.s., An. freeborni and An. stephensi, was determined for 2 closely related malaria parasites, Plasmodium malariae and P. brasilianum. Neither strain of An. gambiae supported development of oocyst densities as great as the other 2 anopheline mosquitoes. The ZAN strain of An. gambiae s.s. from Zanzibar was more susceptible to infection with the strain of P. malariae from Uganda than the G-3 strain of An. gambiae s.s. from The Gambia. All species and strains of mosquitoes supported complete development to the presence of sporozoites in the salivary glands.

Animals↗
PubMed1992

Inter-organizational responses to AIDS: a case study of the Worcester AIDS Consortium.

This case study focuses on development and community coordination of AIDS-related services and on coalition building. Its subject is the Worcester (Massachusetts) AIDS Consortium. The objectives are to: (1) describe the environmental conditions and pre-existing networks which facilitated the formation of the Worcester AIDS Consortium; (2) articulate processes which occurred during the formative, organizational and operational phases of the Worcester AIDS Consortium's development; (3) explore social and community goals and Consortium activities; and (4) document Consortium accomplishments. Data were collected through key informant interviews and review of archival materials. Information about the Worcester AIDS Consortium experience is compared with concepts and principles suggested by organizational theories and frameworks.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Analysis of HLA class II allogenotyping in Australian aborigines and Papua New Guinea populations.

Human leukocyte antigen (HLA) class II allogenotyping has been applied to investigate the polymorphism of the DRB, DQB1, DQB2, DQA1, and DQA2 genes in Aborigines from the East Coast of Australia and in Melanesians from the Papua New Guinea North-East Coast and Highlands. Three new DR/DQ arrangements were observed, DRw14/DQB1-2b/DQA1-1a and DRw5Nauru/DQB1-3a/DQA1-2 (n Australian Aborigines), and DRw5Nauru/DQB1-1a/DQA1-1b (in Madang). DQA2 and DQB2 allogenotyping with TaqI and PstI digested genomic DNA revealed little polymorphism among the Papua New Guineans, with DQA2-Xa1 and DQB2-Xb1 the most common alleles in all the groups. However, the presence of DQA2-Xa2 in Papuans and Australian Aborigines reflects the degree of admixture with Caucasoids while the DQA2-Xa4 allele in Madang is probably a marker of Mongoloid origin.

Asian People↗
PubMed1992

Measurement of HLA class I expression in ankylosing spondylitis.

The importance of HLA-B27 in the pathogenesis of ankylosing spondylitis is uncertain: current evidence favours a role for the B27 molecule itself. The possibility that quantitative differences in HLA-B27 expression may exist between patients with ankylosing spondylitis, family members, and control subjects positive for B27 was examined using appropriate monoclonal antibodies, flow cytometry, and a 'model lymphocyte' coated with a known number of mouse immunoglobulin binding sites. No differences were found between the groups. HLA-A2, examined for comparison, was expressed in greater amounts than HLA-B27, but each contributed only 10-20% of the total class I antigens. Homozygotes expressed twice the amount of antigen expressed by heterozygotes. Synovial lymphocytes expressed more class I antigens than peripheral lymphocytes.

Family↗
PubMed1992

Continuous measurement of left ventricular performance during and after maximal isometric deadlift exercise.

BACKGROUND: Isometric exercise produces a reflex increase in arterial blood pressure that is proportional to the intensity and mass of muscle used during contraction. Little is known about the transient effects of heavy weight lifting on left ventricular performance. In this study, we measured continuous changes in left ventricular performance during maximal large-muscle isometric exercise using the standing deadlift position. METHODS AND RESULTS: Ten healthy young men performed serial deadlifts at 50% of maximal voluntary effort for 90 seconds and 100% of maximal effort for 30 seconds. Echocardiographic imaging (apical four-chamber view), arterial blood pressure (brachial artery catheter), and electrocardiographic monitoring were recorded throughout the deadlift and for 30 seconds of recovery. Aortic flow velocity was also monitored during a separate series of deadlifts. During 100% maximal deadlift, mean arterial pressure increased from 108 +/- 4 to 164 +/- 6 mm Hg. Left ventricular ejection fraction declined initially (from 57 +/- 2% to 49 +/- 3%) at 15 seconds into the lift and recovered (56 +/- 1%) due to significant increases in end-diastolic volume (104 +/- 11 ml to 132 +/- 16 ml) by the end of the lift. The peak systolic pressure/end-systolic volume ratio did not change during the deadlift. After cessation of the deadlift, mean arterial pressure declined precipitously (to 88 +/- 4 mm Hg) within 5 seconds and gradually returned to baseline after 30 seconds. Left ventricular performance indexes all increased significantly during the recovery phase (ejection fraction to 68 +/- 3%, peak systolic pressure/end-systolic volume ratio to 5.9 +/- 0.9). Findings were qualitatively similar for the 50% deadlift. CONCLUSIONS: During an intense isometric deadlift, left ventricular performance declines initially but is restored by the Frank-Starling mechanism. Upon release of the deadlift, increased left ventricular performance develops in conjunction with a rapid decrease in arterial pressure. The combined effects of increased wall stress during the lift phase and enhanced contractility during the release phase probably contribute to left ventricular hypertrophy associated with repetitive weight training.

Adult↗
PubMed1992

Time trends in high-risk injection practices in a multi-site study in Massachusetts: effects of enrollment site and residence.

Time trends in needle sharing and bleach use were examined among needle users enrolled at drug abuse treatment and nontreatment sites in greater Worcester, MA, from 1987 through 1989. Substantial declines in high-risk behavior were found, with different trends at drug treatment versus nontreatment sites. The percentage of individuals sharing needles declined at treatment facilities but not at nontreatment sites. Among those sharing, the proportion using bleach increased at both drug treatment and nontreatment sites. The bleach distribution program in Worcester appears to be associated with increased bleach use among residents. Bleach use was associated with residence in Worcester, after controlling for age, gender, race, enrollment site, time period, and frequency of sharing. Risk reduction in the subpopulation of needle users entering treatment was greater than that among those not in treatment. As avoidance of sharing is likely to be more effective than bleaching for the prevention of human immunodeficiency virus (HIV) transmission, the subpopulation not in treatment should be targeted for prevention programs.

Adolescent↗
PubMed1992

Link between the ciliary process and lens equatorial current.

Circadian and seasonal rhythmic changes in the intraocular pressure are modulated by the nervous system and expressed in the eye by the release of norepinephrine at adrenergic nerve endings. This study links seasonal changes and the effects of the topical application of norepinephrine with changes in the equatorial current of the lens in frogs. A vibrating probe and microelectrodes were used to study the segment of the K+ electrical loop extending between the internal microelectrode, used for measuring potential difference (PD), and the external vibrating electrode, measuring the equatorial current (J). Changes were noted in the electrophysiological parameters of 270 normal frog lenses (Rana pipiens) at different times of the year. Threefold seasonal variations were observed in the amplitude of equatorial current (J) and the resistance associated with the equatorial current (RJ). J was greatest in the winter and RJ was greatest in late spring. Norepinephrine applied directly to the lens did not affect the equatorial current. Norepinephrine applied topically, increased the equatorial current of the lens. It is concluded that the magnitude of the equatorial current of the lens is mediated in part by the ciliary process epithelium.

Administration, Topical↗