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Biomedical subjects

J Turner

Publications and source records attributed to J Turner.

At least 271 records · Page 15Linked to original sources
PubMed1989

Phase II trial of a new biological response modifier (ImuVert) in advanced prostate cancer.

ImuVert, a new biological response modifier of bacterial origin, was evaluated in a Phase II trial of patients with metastatic prostate cancer. Sixteen patients with hormone refractory measurable or evaluable disease were treated with ImuVert 1.0 mg subcutaneously once weekly for 5 weeks. After a 1 week rest period, the dose was escalated to 3.0 mg weekly for 5 additional weeks. Eleven patients received the full 10 weeks of therapy. Toxicity consisted of mild transient flu-like symptoms as well as the development of tenderness and induration at injection sites. No patient responded to treatment. ImuVert at this dose and schedule is inactive in advanced prostate cancer.

Aged↗
PubMed1989

Aerosolized pentamidine as second line therapy in patients with AIDS and Pneumocystis carinii pneumonia.

The use of aerosolized pentamidine was investigated in ten patients with the acquired immunodeficiency syndrome (AIDS) and Pneumocystis carinii pneumonia (PCP) who had previous or concurrent severe adverse reactions or contraindications to trimethoprim-sulfamethoxazole or parenteral pentamidine. A dose of 600 mg pentamidine in 6 ml sterile water, aerosolized in a small-particle producing jet nebulizer was administered for 25 minutes once daily for an average of 10.5 days to these ten patients. All patients improved their arterial O2 saturation and showed clinical and roentgenographic improvement within six to 21 days of aerosol pentamidine therapy. No adverse systemic reactions occurred. The results of this small open trial indicate that aerosolized pentamidine is effective and can be given safely to AIDS patients with PCP who have had adverse reactions to trimethoprim-sulfamethoxazole or parenteral pentamidine.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Doing well with AIDS: three case illustrations.

This report focuses on the abilities of three people diagnosed with acquired immune deficiency syndrome (AIDS) to maximize their state of well-being. The purpose of this ongoing investigation is to identify factors that may help enhance AIDS patients' states of well-being, ultimately achieving the provision of holistic and life-giving nursing care. A naturalistic approach was used to generate an understanding of the concept, "doing well." Five themes regarding "doing well" with AIDS emerged from the interview data. These themes include: autonomy/mastery over the disease; existential/spiritual journey toward understanding; self-acceptance; staying active and involved; and positive thinking. Nursing implications of these themes are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Expression and characterization of a functional human insulin-like growth factor I receptor.

Stable transfectants of Chinese hamster ovary (CHO) cells were developed that expressed the protein encoded by a human insulin-like growth factor I (IGF-I) receptor cDNA. The transfected cells expressed approximately 25,000 high affinity receptors for IGF-I (apparent Kd of 1.5 X 10(-9) M), whereas the parental CHO cells expressed only 5,000 receptors per cell (apparent Kd of 1.3 X 10(-9) M). A monoclonal antibody specific for the human IGF-I receptor inhibited IGF-I binding to the expressed receptor and immunoprecipitated polypeptides of apparent Mr values approximately 135,000 and 95,000 from metabolically labeled lysates of the transfected cells but not control cells. The expressed receptor was also capable of binding IGF-II with high affinity (Kd approximately 3 nM) and weakly recognized insulin (with about 1% the potency of IGF-I). The human IGF-I receptor expressed in these cells was capable of IGF-I-stimulated autophosphorylation and phosphorylation of endogenous substrates in the intact cell. This receptor also mediated IGF-I-stimulated glucose uptake, glycogen synthesis, and DNA synthesis. The extent of these responses was comparable to the stimulation by insulin of the same biological responses in CHO cells expressing the human insulin receptor. These results indicate that the isolated cDNA encodes a functional IGF-I receptor and that there are no inherent differences in the abilities of the insulin and IGF-I receptors to mediate rapid and long term biological responses when expressed in the same cell type. The high affinity of this receptor for IGF-II also suggests that it may be important in mediating biological responses to IGF-II as well as IGF-I.

Animals↗
PubMed1988

Necrotizing otitis externa due to Aspergillus in an immunocompetent patient.

An 85-year-old, nondiabetic man is described with necrotizing (malignant) otitis externa. The patient developed facial nerve paralysis in the presence of a progressive cellulitis and chondritis of the external auditory meatus. Destruction of the bony meatus and mastoid and obliteration of normal soft-tissue planes at the skull base were documented by computed tomographic scans. Aspergillus fumigatus was isolated from the external meatus and deep tissue specimens. Fungal invasion of bone and soft tissue was confirmed histopathologically. Pseudomonas aeruginosa was never isolated. This case is unusual from both the standpoint of etiology and host susceptibility in that the patient had no apparent underlying disease. Amphotericin B and rifampin therapy following radical mastoidectomy halted the progression of disease. Finally, this case illustrates the pitfalls of empiric antibacterial therapy for necrotizing otitis externa without cultural confirmation of the etiologic agent.

Aged↗
PubMed1988

Resolution of amyloidosis (AA type) complicating chronic ulcerative colitis.

A 36-yr-old woman was admitted for the investigation of diarrhea, fever, weight loss, and a recurrent painful, red eruption on her forearms. She was found to have total colonic involvement with a nonspecific ulcerative colitis. Vascular and extravascular amyloid (AA type) was present in biopsy specimens of the colon, duodenum, and stomach. There was clinical and radiographic evidence of splenic and hepatic amyloidosis. Moreover, the presence of extravascular colonic amyloid, the absence of renal involvement, the relatively early detection of amyloid, and the resolution of amyloid after treatment make this case unique.

Adult↗
PubMed1988

The excretion of large vitamin C loads in young and elderly subjects: an ascorbic acid tolerance test.

An ascorbic acid tolerance test is described for assessing vitamin C status. The test is simple to administer and suitable for elderly patients. It involves giving an oral load of 1 g ascorbic acid in water and then measuring urinary excretion of vitamin C over the next 6 h. The excretion pattern at dosing has been studied in ten young subjects. The result of the ascorbic acid tolerance test in these young subjects was significantly different after supplementation with 1 g ascorbic acid daily for 1 month. Two series of elderly patients were also studied with the ascorbic acid tolerance test. They had low initial plasma ascorbic acid levels and much less vitamin C was excreted in the urine after dosing. Seven of these elderly patients were then supplemented with 1 g ascorbic acid for 1 month. After supplementation the initial plasma levels and their response to the ascorbic acid tolerance test became similar to that seen in younger subjects.

Administration, Oral↗
PubMed1988

Does the MMPI predict chemonucleolysis outcome?

Ninety-one patients with lumbar disc herniation were treated by chemonucleolysis with intradiscal chymopapain injection and evaluated at least 1 year after surgery (average, 18 months). There were 54 good, 10 fair, and 27 poor results after chemonucleolysis. Good versus fair/poor outcome groups differed preoperatively on the Minnesota Multiphasic Personality Inventory (MMPI) Hypochondriasis (Hs), Hysteria (Hy), Psychopathic Deviate (Pd), Paranoia (Pa), Hypomania (Ma), and Social Introversion (Si) scales. Presence of compensation issues at the time of surgery was significantly related to outcome, and the MMPI scales provided additional predictive power. Nineteen patients who did not show improvement with chemonucleolysis subsequently underwent lumbar laminectomy and discectomy, and the ultimate outcome for the entire series including these laminectomy patients was 66 good, 10 fair, and 15 poor results. Good versus fair/poor ultimate outcome patients differed significantly on preoperative MMPI Hypochondriasis, Hysteria, Psychopathic Deviate, Paranoia, Psychasthenia, Schizophrenia, Hypomania, and Social Introversion scales. After controlling for the effects of compensation issues, MMPI scales added significantly to the ability to predict ultimate surgical outcome. However, the MMPI could not be used with confidence to predict the outcome for a given patient and should serve only to alert the surgeon to the presence of psychological risk factors and the possible need for referral for psychological evaluation and treatment.

Adolescent↗
PubMed1988

Bedside nuclear probe for detection and quantification of left to right intracardiac shunts.

A cadmium telluride nuclear probe with an Elscint gamma camera was used to detect and measure left to right intracardiac shunts at the bedside in 34 patients. Fifteen also had right heart catheterisation and oximetric measurement of the shunt. For the nuclear technique 740 MBq (20 mCi) of technetium-99m pertechnetate was injected into the right antecubital vein and the pulmonary to systemic flow ratio (QP:QS) was measured by the gamma variate technique. Data were not obtained in four patients because the nuclear probe failed in three patients and one storage disc was corrupted. Data from the gamma camera were lost in another patient. When the size of the shunt measured by the nuclear probe was compared with that measured by the oximetric technique the mean difference (SD of mean difference) was 0.36 (SD 0.78) and when it was compared with the gamma camera it was 0.08 (SD 0.67). Analysis of scatter plots showed that the larger the shunt, the larger the discrepancy. Twenty four of 29 data sets showed complete agreement between the nuclear probe and gamma camera on the size of the shunt. Any differences were small. These data indicate that left to right intracardiac shunts may be measured accurately by a nuclear probe at the bedside in either the coronary care unit or outpatient department.

Adolescent↗
PubMed1988

Alveolar-capillary block in patients with AIDS and Pneumocystis carinii pneumonia.

To determine the value of subdividing diffusing capacity for carbon monoxide (DL) in diagnosing and monitoring the course of Pneumocystis carinii pneumonia (PCP), we measured DL, membrane diffusing capacity (DM), and pulmonary capillary blood volume (VC) in 20 control subjects, 20 patients with a low DL (less than 75% predicted) and newly diagnosed PCP, and 16 patients with a low DL in most of whom PCP had been suspected and excluded. Ten patients with PCP were restudied approximately 60 days after treatment. When clinically indicated, lung biopsies were obtained for histologic examination. Compared with mean values in control subjects (DL = 92%, DM = 101%, and VC = 35 ml/m2), all values were decreased (p less than 0.01) in patients with PCP (DL = 58%, DM = 33%, and VC = 26 ml/m2) and in those without PCP (DL = 61%, DM = 56%, and VC = 22 ml/m2). Values of DM were significantly less (p less than 0.05) in patients with, than in those without, PCP. Analysis of lung biopsies by light and electron microscopy showed overlapping morphologic abnormalities in the 2 groups of patients. In the 10 patients with PCP restudied after successful treatment, the mean DL increased from 60 to 80% (p less than 0.0005), the DM increased from 35 to 108% (p less than 0.006), and the VC did not change. These results suggest that in contrast to most disorders in which DL is decreased, PCP causes reversible alveolar-capillary block.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Selective delivery of pentamidine to the lung by aerosol.

In 8 patients with diffuse infiltrates on chest radiograph undergoing fiberoptic bronchoscopy for suspected Pneumocystis carinii pneumonia, bronchoalveolar lavage sediment and supernatant concentrations of pentamidine were compared 18 to 24 h after administration of 4 mg/kg intravenous (n = 3) and aerosolized (n = 5) pentamidine isethionate. Aerosol was inhaled for 35 to 40 min with 300 mg of pentamidine isethionate in a jet nebulizer, baffled to decrease the particle size to 1.42 micron +/- 1.88 (mass median aerodynamic diameter +/- geometric standard deviation). Bronchoalveolar pentamidine concentrations were: In sediment, 9.34 +/- 1.74 postintravenous versus 705 +/- 242 ng/ml postaerosol (mean +/- SEM, p less than 0.05); supernatant, 2.64 +/- 0.73 postintravenous versus 23.2 +/- 7.75 ng/ml postaerosol (mean +/- SEM, p less than 0.05). Serum pentamidine levels were low or undetectable after aerosolization. Aerosol administration delivers significantly higher concentrations of pentamidine to the air spaces than does intravenous delivery in patients with diffuse alveolar infiltrates.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Ineffectiveness of high-dose methylprednisolone in preventing parenchymal lung injury and improving mortality in patients with septic shock.

We conducted a prospective, randomized, double-blind study to determine whether high-dose methylprednisolone could prevent parenchymal lung injury, including the adult respiratory distress syndrome (ARDS), or improve mortality when administered early in septic shock. All patients already hospitalized in or newly admitted to the medical and surgical intensive care units at San Francisco General Hospital between September 1, 1983 and August 29, 1986 were eligible for admission to the study if they had either (1) an increase in temperature of 1.5 degrees C and a decrease in systolic blood pressure of 20 mm Hg or more from baseline values (in already hospitalized patients), or (2) a temperature greater than 38.5 degrees C or less than 35.5 degrees C and a systolic blood pressure of less than 90 mm Hg (in newly admitted patients). Patients meeting these criteria were excluded if they (1) had severe immunodeficiency, (2) were less than 18 or greater than 76 yr of age, (3) had multilobar roentgenographic infiltrates, or (4) were already receiving corticosteroids. Eighty-seven patients enrolled in the study received either methylprednisolone, 30 mg/kg per dose, or mannitol placebo for a total of 4 doses every 6 h, following the presumptive diagnosis of septic shock. Of these patients, 75 ultimately were determined on the basis of culture results to have actually had septic shock at the time of entry. Thirteen of the patients who received methylprednisolone developed ARDS, compared to 14 patients who received placebo. Lesser degrees of parenchymal lung injury did not differ between the 2 groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Verbal and nonverbal abstracting--problem-solving abilities and familial alcoholism in female alcoholics.

Women alcoholics (N = 54) had significantly worse performance on clusters of verbal and nonverbal abstracting - problem-solving tasks than peer nonalcoholic controls (N = 48). On the nonverbal cluster, alcoholic women with an alcoholic parent or sibling (FH+) performed significantly poorer than peer alcoholics without such a family history (FH-) and nonalcoholic FH+ and FH- groups. On the verbal cluster, FH+ alcoholics performed significantly worse than the nonalcoholic groups. FH- alcoholics did not differ significantly from the nonalcoholic groups on either of the clusters. There were no differences between FH+ and FH- nonalcoholics on the two types of tasks. The results suggest that female alcoholics have a generalized deficit on cognitive tasks involving abstracting and problem-solving, and that these deficits tend to be more pronounced in alcoholic women with a positive family history of alcohol abuse. Whether these deficits are due to a premorbid lowering of abstracting - problem-solving abilities in the FH+ individuals who subsequently become alcoholics, or are the result of a selective vulnerability of these cognitive processes to the effects of alcohol abuse in such subjects, or some combination of these factors, remains to be investigated.

Adult↗