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Biomedical subjects

J Sullivan

Publications and source records attributed to J Sullivan.

At least 145 records · Page 8Linked to original sources
PubMed1992

Development of a polymorphic strain of Plasmodium vivax in monkeys.

A strain of Plasmodium vivax from Thailand with a polymorphic repeat unit of the circumsporozoite protein was established in Saimiri sciureus boliviensis and 3 species of Aotus monkeys. All 11 attempts to transmit infection via sporozoite inoculation, 4 times to splenectomized S. sciureus boliviensis, 2 times to splenectomized Aotus nancymai, and 5 times to intact Saimiri monkeys, were successful. Anopheles freeborni, Anopheles stephensi, Anopheles dirus, and Anopheles gambiae mosquitoes were infected by feeding on parasitemic blood from a chimpanzee and an Aotus azarae boliviensis monkey. Our results indicate that this strain may be useful in antisporozoite vaccine trials.

Amino Acid Sequence↗
PubMed1991

A randomized trial of intravesical doxorubicin and immunotherapy with bacille Calmette-Guérin for transitional-cell carcinoma of the bladder.

BACKGROUND: In carcinoma of the bladder, both intravesical chemotherapy and immunotherapy can induce tumor regression and reduce the rate of recurrence, but the relative merits of these two therapies are unclear. We conducted a multi-institutional study to address this question. METHODS: Patients with rapidly recurrent (stage Ta and T1) or in situ transitional-cell carcinoma of the bladder were randomly assigned to receive either doxorubicin administered intravesically or bacille Calmette-Guérin (BCG) administered both intravesically and percutaneously. The 262 eligible patients were followed for a median of 65 months. Complete responses to treatment of carcinoma in situ were confirmed by biopsy and cytologic analysis of the urine. RESULTS: For patients with Ta and T1 tumors without carcinoma in situ, the estimated probability of being disease free at five years was 17 percent after doxorubicin, as compared with 37 percent after immunotherapy with BCG (P = 0.015). The median times to treatment failure (termination of treatment, due to persistence, recurrence, or progression of disease) were 10.4 and 22.5 months, respectively. For patients with carcinoma in situ the complete-response probability estimates (i.e., the estimated probability of documented disappearance of disease) were 34 percent for doxorubicin (23 of 67 patients) and 70 percent for BCG (45 of 64 patients) (P less than 0.001); the median times to treatment failure were 5.1 and 39 months, respectively. The probability of being disease-free at five years survival among the patients with carcinoma in situ was 18 percent after treatment with doxorubicin and 45 percent after BCG therapy. Patients treated with BCG had a higher incidence of toxic systemic effects and a larger number of local irritative symptoms than patients treated with doxorubicin, but few of these adverse reactions were severe. CONCLUSIONS: As compared with intravesical doxorubicin, immunotherapy with BCG provides improved protection against the recurrence of superficial bladder cancer.

Administration, Cutaneous↗
PubMed1991

Lack of effect of peroral acyclovir for the treatment of acute infectious mononucleosis.

Perorally administered acyclovir was evaluated in the therapy of acute infectious mononucleosis in a multicentered, randomized, double-blind, placebo-controlled trial. A total of 120 patients received 600 mg of acyclovir or placebo five times daily for 10 days. All patients were entered into the study within 7 days of symptom onset and had a positive Monospot test. Analysis of mean values and time to resolution of fever, lymphadenopathy, weight change, hepatomegaly, splenomegaly, liver function tests, atypical lymphocytes, hours of bed rest, sense of well-being, and return to normal activities revealed no significant differences. There was a trend toward suppression of Epstein-Barr virus excretion in the oropharynx in acyclovir recipients. No toxicity was detected in patients treated with acyclovir. Under the conditions of the study, there was no evidence that treatment with perorally administered acyclovir affected the course of infectious mononucleosis.

Acyclovir↗
PubMed1991

Clinical nursing research priorities: a Delphi study.

Using the delphi technique, a group of clinical nurse specialists was surveyed regarding delineation of clinical nursing research priorities. Upon completion of the four-round survey, the results suggested that the top priorities for nursing research are: (1) factors which influence longevity in clinical nursing practice, (2) patient care delivery systems as related to nurse satisfaction, and (3) indicators of quality nursing care.

Attitude of Health Personnel↗
PubMed1991

Intraperitoneal sensitization and the transplanted mouse heart.

Intradermal or skin-graft sensitization always results in accelerated rejection of subsequent MHC-disparate mouse heart transplants; intravenous or intrasplenic sensitization almost always results in prolonged survival. The survival time after intraperitoneal sensitization is unpredictable: hyperacute or accelerated rejection, as well as normal or prolonged survival, occurs suggestive of a delicate balance between suppressive and rejecting immune responses. We have observed a positive correlation between transplant survival and the distribution of 51Cr-labeled antigenic cells early after i.v., i.d., i.p., and intrasplenic injection. Label recovery from the viscera was already high 2 hr after i.v. injection, while after i.d. injection virtually all label was still confined to the carcass, even at the end of a 24-hr period. After i.p. injection label recovery varied significantly from mouse to mouse, from very low to a level approximating that seen after i.v. injection. This close correlation suggests that the fate of a subsequent transplant is decided within a few hours after antigen deposition, well before placement of the transplant itself.

Animals↗
PubMed1991

Failure to confirm the presence of a retrovirus in cultured lymphocytes from patients with Kawasaki syndrome.

We and others previously reported DNA polymerase activity in culture supernatants of peripheral blood mononuclear cells from patients with acute Kawasaki syndrome (KS). In the present study, we further characterized the previously detected polymerase activity and attempted to confirm its presence in cultured peripheral blood mononuclear cells from additional patients with KS. Characterization experiments indicated that the polymerase activity was typical of a DNA-dependent DNA polymerase rather than viral reverse transcriptase. Peripheral blood mononuclear cell cultures from 17 additional KS patients were negative for reverse transcriptase activity in three laboratories. Our findings do not provide support for a retroviral etiology of KS. Further studies should continue to focus on infectious agents in efforts to elucidate the etiology of KS.

Cells, Cultured↗
PubMed1991

Effect of rate of change of luteinizing hormone concentration on in-vitro progesterone secretion within rat corpora lutea during differentiation.

Immature rats were injected with pregnant mares' serum gonadotrophin followed by human chorionic gonadotrophin (hCG). Ovaries were removed 0, 2, 5 or 8 days after hCG and either prepared for morphometric analysis or perifused with 0, 5 or 30 ng luteinizing hormone (LH)/min. In a second study, ovaries were removed on Day 2 or 8 and perifused with 0.1 mg 8-br-cyclic adenosine 5'-phosphate/ml (8-br-cAMP). On Day 0, the granulosa cells of the preovulatory follicles were small (53 +/- 0.5 microns2) with a cytoplasmic to nuclear (Cy:Nu) ratio less than or equal to 1.5. By Day 2, corpora lutea (CL) were present and composed of 95% small luteal cells (diameter less than 125 microns2, Cy:Nu greater than or equal to 3.0) and 5% large luteal cells (diameter greater than 125 microns2, Cy:Nu ratio greater than or equal to 3.0). The percentage of large luteal cells increased to 36 +/- 7% by Day 5, suggesting that they are derived from a select population of small luteal cells. Basal progesterone secretion increased from 38 +/- 5 on Day 0 to 1010 +/- 48 pg/mg/ml on Day 8. The rate of 5 ng LH/min stimulated progesterone secretion on Days 0, 2 and 8; 30 ng LH/min stimulated progesterone secretion on Days 0, 2 and 8, but not on Day 5; 8-br-cAMP stimulated progesterone secretion on both Days 2 and 8. These data demonstrate that once granulosa cells are induced to luteinize they lose their capacity to secrete progesterone in response to 5 ng LH/min and do not regain their responsiveness to LH rate until they completely differentiate. The loss of this LH responsiveness appears to be due to an inability to stimulate sufficient intracellular cAMP concentrations, since cAMP stimulates progesterone secretion on both Days 2 and 8.

Animals↗
PubMed1990

Neutral endopeptidase from nuchal ligament of fetal calves.

The nuchal ligament of unborn calves contains a neutral endopeptidase that is biochemically and immunologically similar to the neutral endopeptidase (NEP), or enkephalinase, from human kidney. Enzymatic activity was inhibited more than 90% by phosphoramidon (1 microM). The specific activity in membrane fractions, as determined by hydrolysis of the dansylated substrate, DAPGN, was similar in tissue from fetuses of gestational ages ranging from 100 to 280 days. NEP activity in adult ligament tissue, however, was less than 10% of that in fetal tissue. Fibroblasts dissociated from ligament tissue by collagenase displayed less NEP activity than did preparations of intact ligament, and activity was even lower in cultured cells. By contrast, fibroblasts cultured from fetal calf lungs had NEP activity comparable to that in the ligament tissue. When ligament fibroblasts were cultured on subcellular matrices derived from fetal lung fibroblasts the NEP activity increased relative to those cultured on plastic alone. These studies confirm the presence of neutral endopeptidase (NEP) in the nuchal ligament of the fetal calf. The consistent activity through a range of gestational ages and the influence of the subcellular matrix suggest that this enzyme might be involved in growth of the ligament during fetal life.

Animals↗
PubMed1990

A randomized trial of indirect calorimetry-based feedings in thermal injury.

To assess the superiority of indirect calorimetry (IC)-based enteral nutrition in burned patients, 49 adults with mean burns of 47% TBSA received feedings based either on the Curreri formula (CURR), or on IC, using enteral formulas with nonprotein calorie:nitrogen ratios of either 86:1, or 125:1. Intake in CURR patients was a mean 3,490 kcal/day, which exceeded resting energy expenditure (REE) by 43%, while IC patients received 3,530 kcal/day (1.2 x REE; p less than 0.05). Both groups maintained body weight and lymphocyte counts; survival was equal. Complications (diarrhea, nausea, hyperglycemia) were frequent in both groups, but their incidence did not differ. Patients fed the lower calorie:nitrogen ratio had greater cumulative nitrogen balance, with no increase in nitrogen excretion. It appears advisable to nourish burned patients with the minimal effective intake. While use of IC facilitates this goal, use of the Curreri formula provides acceptable approximation of caloric requirements in the early postburn period.

Adult↗
PubMed1990

Demographic characteristics, risk behaviors, and HIV seroprevalence among intravenous drug users by site of contact: results from a community-wide HIV surveillance project.

We investigated differences in behaviors important for human immunodeficiency virus (HIV) transmission and HIV antibody status among 927 recent needle users enrolled in a multi-site HIV surveillance project in Worcester, Massachusetts. Subjects were enrolled at drug abuse treatment centers reported less risky injection practices unexplained by demographic variables. Risky sexual practices were in general reported more frequently by men at the jail than men at other sites. However, HIV status showed little relation to enrollment site. These results have implications both for targeting of acquired immunodeficiency syndrome (AIDS) prevention programs to needle users not in drug abuse treatment and for potential selection bias in studies of intravenous drug users.

Adult↗
PubMed1990

The continuing challenge of burn care in the elderly.

Recent improvements in survival have stimulated interest in the care of elderly patients with burn injuries. We reviewed 278 patients aged 45 years and older treated during a 10-year period. The survival rate was 80% overall and 67% for patients over 75 years of age. Mortality rates correlated with patient age, burn size, presence of inhalation injury, number of complications of care, and fluid resuscitation requirements, but not with the number of preexisting medical problems. Burn wound excision and skin grafting were performed frequently and were well tolerated. During this period, hospital charges increased fourfold and were twice as great in nonsurvivors. Reimbursements based on diagnosis-related groups during the last 3 years of the review (75 patients) resulted in a total deficit of $1.2 million. Aggressive care for most elderly patients with burn injuries appears justified by the improved outcomes demonstrated. This has increased the difficulty of decisions regarding patient salvability and the allotment of resources. Elderly patients with burn injuries illustrate many contemporary dilemmas in patient care in this era of cost consciousness.

Aged↗
PubMed1990

Studies with digital hearing aids.

Digital hearing aids offer many advantages over conventional hearing aids. These include signal-processing capabilities that are superior to those of a conventional analog hearing aid, methods of signal-processing and control that are unique to digital systems and which cannot be implemented in conventional analog hearing aids, and innovative new techniques that are changing our way of thinking about hearing aids. An example of the first of these advantages is the extremely high precision with which the frequency-gain characteristic can be specified and the use of this capability to study the effects of frequency response irregularities commonly encountered with hearing aids. An example of the second advantage is the use of memory and logical operations in the implementation of multivariate adaptive paired-comparison techniques for more effective hearing-aid prescription. Another example is the use of powerful new signal processing techniques for noise reduction. The third advantage is the most important. The digital hearing aid can be viewed as a generalized hearing instrument which can be used for simulation, testing and prescription, as well as amplification. The use of the digital hearing aid as a simulator of other hearing aids is discussed and an illustrative example provided in which a new form of amplitude compression, orthogonal-polynomial compression, has been simulated using a digital master hearing aid.

Equipment Design↗
PubMed1990

Neurologic assessment.

Neurologic nursing assessment requires the knowledge of anatomic and physiologic principles as well as the mastery of complex assessment skills. The nurse who is often the first and most consistent health team member interacting with clients may provide the key to the early recognition, prevention, and treatment of neurologic problems. The nurse, as the dynamic member of the health team, may then be the first line of defense in initiating cost-effective and perhaps life-saving measures in neurologically impaired clients.

Brain↗
PubMed1990

Individual and family responses to acute spinal cord injury.

This article discusses individual and family responses to acute spinal cord injury from both research and clinical practice perspectives. Investigations concerning individuals' physical reactions, psychologic adjustment, and occurrence of depression are reviewed. Research studies on the demographics of and adjustment and role changes within families of patients with spinal cord injuries are critiqued. Suggestions and guidance emerging from these studies are discussed and applied to clinical practice. Clinical practice perspectives are further developed in a discussion of the needs and resources of these patients and their families. Grief, powerlessness, positive manipulation, and quality-of-life issues are also explored.

Adaptation, Psychological↗
PubMed1989

Detection and analysis of neutral endopeptidase from tissues with substrate gel electrophoresis.

Neutral endopeptidase from human or bovine tissues retains enzymatic activity following electrophoresis and immobilization in polyacrylamide gels. Infiltration of the gel with a fluorogenic substrate permits identification of the active enzyme by fluorescence associated with a distinct protein band. This technique both separates and identifies the enzymatically active species from a crude cell membrane fraction or from partially purified extracts that contain contaminating proteins. Enzymatic activity is quantitated by photographing the fluorescent bands and scanning the negatives with a laser densitometer. Because as little as 25 ng of enzyme can be detected by this method, it could be used where the amount of material is limited.

Animals↗
PubMed1989

Effect of praziquantel on the eggs of Schistosoma mansoni, with a note on the implications for managing central nervous system schistosomiasis.

The morphology of Schistosoma mansoni eggs in intestinal tissues (oograms), and egg hatching in faeces, were studied after parenteral administration of praziquantel (PZQ) to infected mice. PZQ was given parentally in doses of 60 mg kg-1 for one day, five days or 10 days. Eleven days after initiation of therapy, oograms from all groups receiving PZQ showed more dead eggs than controls; a dose response was also observed. Depression of faecal egg hatching occurred within 24 hours of PZQ administration. Our observations suggest that PZQ kills most S. mansoni eggs in host tissues when administered in higher doses than are routinely recommended for treatment of intestinal schistosomiasis mansoni. In order to reduce the lifespan of metabolically active eggs in sensitive tissues, prolonged courses of PZQ could be used when treating central nervous system schistosomiasis.

Animals↗