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Biomedical subjects

J T Manning

Publications and source records attributed to J T Manning.

At least 55 records · Page 3Linked to original sources
PubMed1994

Mucocutaneous and soft tissue infections caused by Xanthomonas maltophilia. A new spectrum.

OBJECTIVE: To describe the mucocutaneous and soft tissue infections caused by Xanthomonas maltophilia in patients with cancer. DESIGN: A retrospective 15-month clinical study. SETTING: Academic, referral-based cancer center. PATIENTS: Of 237 patients with X. maltophilia isolated from all sites during the 15-month study period, 114 patients were judged to have true X. maltophilia infections. Only patients with mucocutaneous and soft tissue infections were included in the study. RESULTS: 17 (15%) of the 114 patients with X. maltophilia infection had mucocutaneous and soft tissue infections: Six patients had metastatic cellulitis, 5 had primary cellulitis usually associated with catheter use, and 6 had infected mucocutaneous ulcers. The metastatic cellulitis consisted of previously undescribed multiple, hard, tender nodules with surrounding and distant cellulitis (5 patients) or ecthyma gangrenosum (1 patient). Four of these patients died of the infection. Metastatic cellulitis and mucocutaneous infections occurred in hospitalized, neutropenic patients who received broad-spectrum antibiotics (beta-lactams, quinolones), often with in vitro activity against the infecting organisms. Response usually correlated with recovery from myelosuppression and administration of trimethoprim-sulfamethoxazole with or without ticarcillin-clavulanate. Catheter removal contributed to response in the treatment of primary cellulitis. CONCLUSIONS: Mucocutaneous and soft tissue infections caused by X. maltophilia are not uncommon, and X. maltophilia can cause metastatic nodular skin lesions that mimic disseminated fungal infections. It also causes serious morbidity and high mortality in patients with metastatic skin nodules and can cause superinfections in patients receiving broad-spectrum beta-lactam or quinolone antibiotics to which the organisms are susceptible when the infections develop. Catheter removal contributes to a favorable outcome in patients with catheter-associated cellulitis without bacteremia. Xanthomonas maltophilia infection should be added to the differential diagnosis of mucocutaneous or soft tissue infection in patients with cancer. Trimethoprim-sulfamethoxazole with or without ticarcillin-clavulanate is the current treatment of choice for culture-proven infections, but early empiric therapy may improve outcome.

Adult↗
PubMed1994

Sib competition and sperm competitiveness: an answer to 'why so many sperms?' and the recombination/sperm number correlation.

Sperm, or inter-ejaculate, competition leads to the evolution of many sperm per ejaculate. However, sperm competition theory does not predict the correlation between sperm number and chiasma, or that between sperm number and haploid chromosome number. Firstly, we show that phylogenetic inertia cannot account for at least the latter relation, and secondly, a model is presented which incorporates sib competition (intra-ejaculate competition) and sperm competitiveness to explain the relation between sperm numbers and recombination and the question 'Why so many sperms?'. It is argued that if there are deleterious mutations which affect sperm competitiveness this will lead to sib or intra-ejaculate competition. If inter-ejaculate competition also exists, then there will be selection for increased recombination. A chiasmate male heterozygous for n mutations which reduce sperm competitiveness can produce gametes with 0...n mutations. The proportion of gametes with 0 mutations per ejaculate is s = 0.5n, which is a small fraction. This means that to ensure on average one sperm with 0 mutations per ejaculate, a chiasmate male must produce 1/s sperm. We may therefore expect that 1/s will be positively correlated with sperm numbers. If inter-ejaculate competition leads to an optimum sperm number of x, then the optimum number of sperm per ejaculate is x/s. Sperm numbers will be increased by: (i) the number of loci which affect sperm competitiveness in the haploid state; (ii) the mutation rate; and (iii) the recombination rate. A correlation between recombination rates and sperm numbers is therefore to be expected.

Animals↗
PubMed1994

Fluctuating asymmetry in gorilla canines: a sensitive indicator of environmental stress.

Populations of the western lowland gorilla (Gorilla gorilla gorilla) have decreased markedly as a result of human encroachment. The species is therefore likely to have been exposed to substantial environmental stress. Fluctuating asymmetry (FA) is one measure of environmental stress. We examined the expression of FA in the canines and second premolars of the upper jaw of western lowland gorillas. The canines had patterns of FA typical of secondary sexual characters, whereas the expression of premolar FA was typical of non-sexually selected traits. We found that FA in male canines was positively correlated with year of collection (YOC) or year of collection and acquisition (YOCA) of the specimen. This suggested a sustained environmental deterioration. However, there was no relation between FA and YOC, or FA and YOCA, in female canines. There was a correlation between FA and YOC in male premolars, but this was relatively weak and disappeared when FA and YOCA were considered. There was no correlation between FA and YOC or YOCA in the premolars of females. We conclude that these patterns of FA support the argument that sexually selected structures are sensitive to environmental stress but non-sexually selected structures are not.

Animals↗
PubMed1994

Lateral cradling preferences in humans (Homo sapiens): similarities within families.

Women (Homo sapiens) tend to cradle infants on the left side of the body. We report the results of a survey of family photograph albums. We found that left-side cradling frequencies (LCFs) are higher in women than in men and that there are strong significant correlations between the LCFs of mothers and daughters, sisters, and maternal grandmothers and granddaughters. There may be a genetic influence on lateral cradling tendencies; women's left-side cradling preferences were found to be repeated with subsequent children. Heritability of women's LCF has an upper limit of 0.82, and the regression of daughters' mean LCF on mothers' LCF gives a heritability of 0.93 +/- 0.29. The data may be interpreted in two ways: There may be sex-limited genes (i.e., genes that express themselves only in women) for lateral cradling preferences, or women may learn cradling preferences from their mothers and other female relatives.

Animals↗
PubMed1994

Terminal deoxynucleotidyl transferase staining in acute leukemia and normal bone marrow in routinely processed paraffin sections.

Terminal deoxynucleotidyl transferase (TdT) is a nuclear protein widely used as a marker for the diagnosis and classification of acute leukemia. The usual methods for detecting TdT require smears, imprints, or cryostat sections of unfixed tissue. A polyclonal rabbit anti-TdT serum was used to immunostain 54 routinely processed bone marrow sections from patients with acute leukemic disorders, using a recently described antigen-unmasking technique based on microwave oven heating. The specificity of this method of TdT analysis was confirmed by comparing the results obtained with conventional TdT analysis by indirect immunofluorescence. Terminal deoxynucleotidyl transferase reactivity was also evaluated in 44 nonmalignant and normal bone marrow specimens. All cases that were TdT-positive by immunofluorescence (41 of 42 "pre-B" and T-cell acute lymphoblastic leukemia, 2 of 5 acute myeloid leukemia, and 1 of 5 chronic myeloid leukemia in blast crisis) were also positive in paraffin sections. The percentage fluorescence positivity correlated with the percentage of immunoperoxidase stained cells in 44 of 45 cases. The remaining nonneoplastic and normal bone marrow biopsy specimens were TdT-negative. These results show that TdT immunoperoxidase staining of conventionally processed bone marrow specimens can be readily achieved by the use of a simple antigen-unmasking technique and may provide useful diagnostic information particularly in cases in which fresh tissue samples are unavailable.

Acute Disease↗
PubMed1994

Long-term prognostic importance of primary Ki-1 (CD30) antigen expression and anaplastic morphology in adult patients with diffuse large-cell lymphoma.

BACKGROUND: We retrospectively assessed the long-term prognostic importance of primary CD30 antigen expression and of anaplastic large-cell morphology (ALCL) in adult patients with previously untreated diffuse large-cell lymphoma (DLCL), including cases of immunoblastic lymphoma, and identified their clinical features. MATERIALS AND METHODS: We examined available archival paraffin-embedded or frozen pathologic material and medical records of adult patients with previously untreated DLCL seen at M.D. Anderson Cancer Center (MDACC) between January 1978 and May 1989. RESULTS: Sixty-seven cases of DLCL and seven cases of IBL (a total of seventy-four heretofore referred to as DLCL) were identified. Twenty-two of the 74 patients were positive for the CD 30 antigen. For these 22 patients the rates of complete remission, survival, and time to treatment failure (TTF) were 86%, 82%, and 77%, respectively, at 81 months. When compared with the group of 54 patients which stained negative for CD 30, the long term survival of CD 30-positive DLCL was favorable (82% vs. 49%, p = 0.08). ALCL morphology was present in two-thirds of the patients with CD 30-positive DLCL but did not affect survival and TTF rates. Among patients with CD 30-positive DLCL, 16 patients without skin involvement were younger and had a low failure rate (13%) compared with six patients with skin involvement who were older and had a high failure rate (50%); however, the latter group had a more indolent course after failure and thus both groups had similar survival rates. CONCLUSIONS: Primary CD 30 positivity is associated with a favorable long-term prognosis in adult patients with DLCL treated with doxorubicin-containing chemotherapy. ALCL morphology among these patients does not affect the outcome. Patients with CD30-positive DLCL and skin involvement have a higher failure rate than those without skin involvement, but similar overall survival.

Adolescent↗
PubMed1994

Mediastinal lymphoblastic lymphoma with non-lymphoblastic histologic features.

The clinical and pathologic features of an unusual case of mediastinal lymphoma in a 46-yr-old man are presented. Histology of the tumor was that of a diffuse, non-large cell lymphoma. The nuclear chromatin was coarse, suggesting a relatively mature stage of lymphocyte maturation, and the lymphoma was provisionally classified as diffuse small-cleaved cell lymphoma. Immunohistologic study and cell surface marker analysis revealed a common thymocytic phenotype (CD3, CD1a, CD4, CD8, and TdT positive), however, and DNA flow cytometric analysis revealed a high S+G2 M fraction of 29%. With the immunostaining profile accepted as definitive for lymphoblastic lymphoma, histologic features were reassessed in retrospect. Cells having nuclear features typical of lymphoblasts were not recognized. Occasional cases of lymphoblastic lymphoma may not be recognizable when evaluated only by histology using the generally accepted criteria for diagnosis.

Cell Cycle↗
PubMed1993

Fluctuating asymmetry, sexual selection and canine teeth in primates.

Fluctuating asymmetry arises as small deviations from symmetry which can be expressed on either side of the body. Increases in fluctuating asymmetry can suggest genomic stress such as results from directional selection. It has been argued that epigamic structures and weapons should show high levels of fluctuating asymmetry because sexual selection is essentially directional in nature. We tested this prediction by examining the expression of fluctuating asymmetry in the upper canines of 21 species of Old World primates. We found, for males but not for females, that asymmetry was correlated with measures of sexual selection including canine dimorphism, canine size, mass dimorphism, and intra-male competition. However, there was no significant correlation with diet type and body mass, which are only weakly associated with sexual selection. Phylogenetic inertia did not account for the association between fluctuating asymmetry and sexual selection. We also found that species with high values of canine dimorphism and intra-male competition tended to have a negative correlation between asymmetry and mean canine height, and this latter effect was present in both males and females. The implications of these findings for sexual selection theory are discussed.

Animals↗
PubMed1993

Waldenström macroglobulinemia: MR imaging of the spine and CT of the abdomen and pelvis.

Twenty-three consecutive patients with Waldenström macroglobulinemia were studied with magnetic resonance (MR) imaging of the spine and computed tomography (CT) of the abdomen and pelvis. MR imaging studies included sagittal T1-weighted and gradient-recalled-echo sequences performed with and without contrast material enhancement. Marrow involvement was identified with MR imaging in 21 of 23 (91%) patients. Diffuse involvement was noted in 13 patients (56%), and a variegated pattern in eight (35%). CT demonstrated enlarged nodes in 10 of 23 (43%) patients. Correlation of MR imaging patterns and presence of adenopathy at CT with standard laboratory values for Waldenström macroglobulinemia revealed an association of the diffuse MR imaging pattern of marrow involvement and the presence of enlarged nodes at CT with more advanced disease. MR imaging of the spine and CT are reliable means of evaluation of disease status in Waldenström macroglobulinemia. They may be employed as additional means in the staging of Waldenström macroglobulinemia and may be helpful in the follow-up of patients with this rare hematologic malignancy.

Abdomen↗
PubMed1991

Inflammatory pseudotumor of the spleen. Report of two cases with a review of the literature.

This study reports two cases of inflammatory pseudotumor of the spleen. The first case was a 57-year-old woman in whom the splenic mass was an incidental finding during evaluation for an acute abdomen due to a perforated, lithiasic gallbladder. The mass in the spleen measured 12.7 cm in greatest dimension. The second case was of a 46-year-old woman with a palpable, left upper quadrant mass. A computed tomography scan revealed a splenic mass and the spleen was removed. The mass measured 12 cm in greatest dimension. In a review of the literature, 13 examples of splenic inflammatory pseudotumor were reported. The age range was 19 to 75 years, with a median age of 50 years. The splenic lesions were either discovered incidentally or manifested by left upper quadrant discomfort and/or mass. Inflammatory pseudotumor of the spleen, although rare, is being increasingly recognized and should be considered in the differential diagnosis of mass lesions of the spleen.

Diagnosis, Differential↗
PubMed1991

Salivary-type neoplasms of the sinonasal tract.

Salivary-type neoplasms of the nasal cavity and paranasal sinuses are numerically dominated by adenoid cystic carcinomas and pleomorphic adenomas. All others, benign or malignant, are rarely encountered and are usually biologically and histologically low-grade. Sites of origin in the sinonasal tract conform to the density and distribution of the seromucous glands and hence are most often nasal (septum and turbinates) or ostial.

Humans↗
PubMed1989

Effect of age and renal function on cefonicid pharmacokinetics.

Cefonicid (15 mg/kg) was administered intravenously at a constant rate of infusion over 15 min to 10 geriatric patients (mean age, 77 years) and to 4 young subjects (mean age, 35 years). Model-dependent and noncompartmental pharmacokinetic parameters were calculated and found to be congruous; noncompartmental data are reported. Significant differences in the values for area under the curve, mean residence time, total body clearance, and renal clearance were observed between the geriatric and young groups. Mean elimination half-life values were 9.59 and 4.88 h for the geriatric and young groups, respectively. Total body and renal clearances were inversely correlated to age and directly correlated to creatinine clearance. Free fraction was not correlated to albumin concentration but was correlated exponentially to total cefonicid concentration. Despite the prolonged half-life values observed in our geriatric patients, the difference in mean trough concentrations was slight. Daily administration of a 15-mg/kg dose should provide adequate concentrations in serum and should not produce appreciable accumulation in geriatric patients.

Adult↗
PubMed1989

Relapsing polychondritis.

Inflammatory destruction of cartilages, presumably on an autoimmune basis, characterizes relapsing polychondritis, a disease of varying severity and outcome. The otolaryngologist-head and neck surgeon is often the first physician contact, because the preponderance of signs and symptoms are in the head and neck, ie, auricular and nasal chondritis, ocular and auditory manifestations, and laryngotracheobronchial involvement.

Humans↗
PubMed1988

Effect of trypsinization on the immunostaining of formalin-fixed, paraffin-embedded tissues.

We have investigated the action of trypsin treatment on formalin-fixed, paraffin-embedded tissue sections prior to immunostaining with a variety of commercially available poly- and monoclonal antibodies commonly used in surgical pathology. Although enzymatic predigestion often markedly reduced the background and enhanced the immunoreaction for certain antibodies, false negative staining or no enhancement of the staining was observed with other antibodies. We conclude that the indiscriminate practice of trypsinization in immunohistochemical procedures could be a significant cause of false negative results and of discrepancies between laboratories. Therefore, each laboratory must develop its own quality control program for variables such as enzymatic predigestion.

Antigen-Antibody Reactions↗
PubMed1988

Paraimmunoblastic variant of small lymphocytic lymphoma/leukemia.

We report 16 cases of a distinctive, biologically aggressive variant of small lymphocytic lymphoma/leukemia (SLL/L) that is characterized by the diffuse proliferation of cells normally comprising the pseudoproliferation centers (so-called paraimmunoblasts). Demographically, the patients differed in no significant regard from patients with SLL/L of usual type. Rapidly progressive, generalized lymphadenopathy was the dominant clinical finding in 15 of the 16 patients; one patient presented with symptoms related to lymphomatous involvement of the stomach and regional lymph nodes. Splenomegaly was observed in five patients. Seven patients, two of whom had a history of indolent-phase chronic lymphocytic leukemia, had an absolute lymphocytosis at diagnosis. In most patients, bone marrow involvement was noted at diagnosis. It consisted predominantly of small lymphocytic infiltrates indistinguishable from those observed in SLL/L of usual type; significant paraimmunoblastic infiltration was infrequent and generally occurred late in the disease course. Immunohistochemical and cytogenetic study further substantiated the hypothesized relationship of these cases to SLL/L. Findings included (a) coexpression of sIg and Leu-1 antigen in the majority of cases and (b) the presence of a t(11;14) (q13;q32) chromosome translocation in two of three cases with analyzable metaphases. Although treatment protocols were not uniform, follow-up data indicated an accelerated clinical course. Eleven patients have died of their disease between 3 and 39 months after diagnosis; the median survival was 28 months.

Adult↗
PubMed1988

Disposition of cefonicid in orthopedic surgery patients.

Ten patients undergoing hip reconstructive procedures were given a single prophylactic dose of cefonicid 15 mg/kg to evaluate intraoperative and perioperative drug disposition in the surgical setting. Timed postinfusion serum samples were collected over 24 hours and resulting concentration versus time data were subjected to noncompartmental pharmacokinetic analysis. Bone samples were obtained in eight of ten patients with mean bone concentrations of 13.3 micrograms/g (range 8.2-25.1). Postinfusion serum concentrations at five minutes postinfusion ranged from 200.8 to 316.7 micrograms/ml; the 12-hour mean was 19.1 micrograms/ml (range 4.0-48) and the 24-hour mean was 4.3 micrograms/ml (range 0.0-13.8). Protein binding at three sampling times ranged from 88 to 96.5 percent, increasing over time as total cefonicid concentrations fell. The mean half-life in our patients was 3.5 hours, compared with 4.8 hours in our four controls. These data indicate that altered protein binding and intraoperative events alter the disposition of cefonicid. Although differences in disposition parameters between patients and controls were not statistically significant, suboptimal serum cefonicid concentrations were observed in four orthopedic patients.

Adult↗