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Biomedical subjects

K Solomon

Publications and source records attributed to K Solomon.

At least 19 recordsLinked to original sources
PubMed2004

Clostridium difficile associated diarrhoea in hospitalised patients: onset in the community and hospital and role of flexible sigmoidoscopy.

OBJECTIVES: Clostridium difficile associated diarrhoea (CDAD) is a hospital acquired infection in which optimal methods for diagnosis and the scale of the problem in the community remain to be determined. In hospitalised patients with CDAD, we aimed to (i) study patients in whom the onset of diarrhoea was in the community and (ii) investigate the role of bedside flexible sigmoidoscopy in diagnosis. METHODS: Patients with CDAD (onset in hospital or community) were studied prospectively. In those with diarrhoea of unknown aetiology, flexible sigmoidoscopy was compared with stool assay for C difficile cytotoxin. RESULTS: Of 136 patients with CDAD (which was associated with antibiotic exposure in 96%), diarrhoea started in the community in 38 (28%; majority in own home) and while an inpatient in 98 (72%). The majority with CDAD onset in the community had been hospitalised over the preceding 12 months (86.8% v 57.1% in the hospital onset group; p<0.001). In 56 patients with pseudomembranous colitis at sigmoidoscopy, the stool C difficile cytotoxin test was negative in 29 (52%) but toxigenic C difficile was isolated from all of nine stool samples cultured. Of patients with pseudomembranous colitis, 30.4% relapsed over the subsequent 57.7(4.2) days. CONCLUSIONS: In a significant proportion of hospitalised patients with CDAD, diarrhoea started in the community. However, the majority of these had been hospital inpatients previously when they may have acquired C difficile, with the subsequent onset of diarrhoea in the community following exposure to antibiotics. Flexible sigmoidoscopy is superior to the stool C difficile cytotoxin test in a subgroup of patients with pseudomembranous colitis. Sigmoidoscopy should therefore be considered in all hospitalised patients with diarrhoea in whom the stool test for C difficile cytotoxin and enteric pathogens is negative.

Aged↗
PubMed2000

Brain-enriched hyaluronan binding (BEHAB)/brevican cleavage in a glioma cell line is mediated by a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) family member.

Brain-enriched hyaluronan binding (BEHAB)/brevican is a brain-specific extracellular matrix protein containing a cleavage site between Glu(395)-Ser(396), which bears remarkable homology to the "aggrecanase" site in the cartilage proteoglycan aggrecan. Expression of BEHAB/brevican is dramatically increased in human gliomas, notoriously invasive tumors. Recently, we showed that the rat 9L gliosarcoma cell line, which does not express BEHAB/brevican and forms non-invasive tumors when grown as intracranial grafts, can form invasive tumors when transfected with a 5' cDNA fragment of BEHAB/brevican, but not when transfected with the full-length cDNA. In marked contrast, the highly invasive CNS-1 glioma cell line expresses and cleaves BEHAB/brevican protein when grown as an intracranial graft. These results suggest that both synthesis and cleavage of BEHAB/brevican protein may play a role in the invasiveness of gliomas. We report here, using an antibody developed to the neoepitope created by BEHAB/brevican cleavage at the Glu(395)-Ser(396) site, that the CNS-1 cells are able to cleave the protein in vitro. We characterized the CNS-1-derived cleavage activity by assaying its ability to cleave BEHAB/brevican proteoglycan, and determined that the enzyme is a constitutively expressed, secreted activity. Using a variety of protease inhibitors, reverse transcriptase-polymerase chain reaction, and specific antibodies, we determined that this activity is likely to be a member of the ADAMTS family of metalloproteinases, specifically ADAMTS4. These results suggest a novel function for ADAMTS family members in BEHAB/brevican cleavage and glioma and indicate that inhibition of ADAMTS in glioma may provide a novel therapeutic strategy.

ADAM Proteins↗
PubMed1999

Purification and cloning of aggrecanase-1: a member of the ADAMTS family of proteins.

We purified, cloned, and expressed aggrecanase, a protease that is thought to be responsible for the degradation of cartilage aggrecan in arthritic diseases. Aggrecanase-1 [a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4)] is a member of the ADAMTS protein family that cleaves aggrecan at the glutamic acid-373-alanine-374 bond. The identification of this protease provides a specific target for the development of therapeutics to prevent cartilage degradation in arthritis.

ADAM Proteins↗
PubMed1999

An ELISA for brown trout (Salmo trutta) vitellogenin and its use in bioassays for environmental estrogens.

An enzyme linked immunosorbent assay (ELISA) was developed for the detection of the egg yolk precursor vitellogenin (Vg) in plasma of brown trout (Salmo trutta). Purified Vg from a 17 beta-estradiol-induced trout was used as the competing antigen in the ELISA which is based on polyclonal antibodies. The ELISA's performance was optimized and characterized. The assay's working range was (25-500 ng ml-1), its sensitivity was (10.5 ng ml-1), and it had an intra-assay coefficient of variation of less than 10% between 30 and 1000 ng ml-1. The ELISA was used in bioassays for the detection of environmental estrogens, including estrogen mimics, in whole and fractionated industrial waste waters. Those bioassays were based on intraperitoneal (i.p.) injection-, static renewal-, and flow through exposure systems. The response threshold of both bioassays is limited to 1-2 micrograms ml-1 Vg by a low level plasma interference that was regularly detected in plasma from non-induced male fish. The responsiveness of the bioassays was characterized using progressive doses of 17 beta-estradiol. The i.p.-based assay, which was responsive to at least 100 micrograms kg-1 of 17 beta-estradiol, was used to screen extracts of pulp mill effluent and black liquor for estrogenic effects. Neither extract induced Vg in our assay. The i.p. assay was also used to test 4-tert-octylphenol (OP) and the PAH derivative, retene, for estrogenic activity. OP induced Vg in the i.p.-exposed fish; no Vg induction was detected in the retene-exposed fish. The static renewal bioassay, which was responsive to at least 0.1 microgram ml-1 of 17 beta-estradiol over a 15-day exposure period, was used to screen whole pulp mill effluents for estrogenic effects. No Vg induction was detected in the effluent-treated fish.

Animals↗
PubMed1994

Cellular expression of a GPI-linked T cell activation protein.

A T cell activation protein was identified by generating a monoclonal antibody (anti-D2) against a gamma delta T cell receptor bearing gibbon ape T cell line (MLA144). Immunoprecipitation studies revealed three polypeptides of 180, 150, and 120 kDa. The antigen was also found to be expressed on endothelial cells in vivo and in vitro and on tumor cell lines from a variety of tissues. Studies performed using a variety of antibodies reveal this protein to be identical to an endothelial cell protein previously identified by several antibodies to T cell activation proteins (CDw109). We demonstrate that this protein is anchored in the membrane via a glycosylphosphatidylinositol (GPI) tail in T cells, tumor cells, and endothelial cells. An analysis of tissue sections reveals this protein to be normally highly expressed on vascular endothelial cells.

Animals↗
PubMed1993

Incidence and management of complications of transsclerally sutured posterior chamber lenses.

Thirty eyes with an average follow-up of 23 months following transscleral fixation of a posterior chamber intraocular lens (IOL) were retrospectively reviewed for complications. The most common complication was erosion of the polypropylene suture knots through half thickness scleral flaps (22 eyes, 73%). The average time for suture erosion through the sclera was 9.4 months (range one to 12). The polypropylene suture knots eroded through the conjunctiva in five eyes (17% incidence) at an average of 12 months postoperatively (range six to 18 months). All conjunctival erosions were surgically repaired. Other complications included clinically significant lens tilt/decentration (3/30, 10%), open angle glaucoma (5/30, 17%), and suprachoroidal hemorrhage (1/30, 3%). The complications associated with transscleral fixation of posterior chamber IOLs are distinctly different from those associated with anterior chamber IOLs. Prospective clinical trials may provide further information about pseudophakic rehabilitation in the absence of capsular support.

Adult↗
PubMed1993

Psychiatric manifestations of Pick's disease.

Pick's disease is a rare cause of dementia frequently misdiagnosed as Alzheimer's disease. Because patients with Pick's disease often present with psychiatric symptoms, the psychiatric aspects of this disorder are reviewed, as well as the pathology and epidemiology of the disease. Two case reports illustrate many of the clinical features of PD. A detailed examination of the psychiatric aspects of the disorder is followed by an elucidation of the many clinical differences between Pick's disease and Alzheimer's disease.

Activities of Daily Living↗
PubMed1993

Vision in aging and dementia.

PURPOSE: This study was designed to determine the extent of visual deficits in Alzheimer's disease (AD) patients relative to normal aging changes and to patients with other types of dementia. METHODS: Four groups of subjects were tested: patients with probable AD (N = 10), patients with other dementias (N = 10), age-matched controls (N = 11), and young controls (N = 10). Color vision was assessed with the L'Anthony D-15 desaturated color test, contrast sensitivity with the Pelli-Robson chart, and stereoacuity with the RAN-DOT test. RESULTS: Visual changes were found in AD patients that can be accounted for by age-related deficits (color vision), deficits found in other types of dementia (stereoacuity), and deficits specific to AD (low spatial frequency contrast sensitivity). CONCLUSION: We conclude that AD patients show a variety of visual deficits. With our tests, only deficits in contrast sensitivity were specific to AD.

Adult↗
PubMed1993

Alcoholism and prescription drug abuse in the elderly: St. Louis University grand rounds.

This Grand Rounds will review the problem of alcoholism and prescription drug abuse in the elderly. Several case vignettes will be presented. The pharmacology of alcohol and potentially addictive prescription medications will be reviewed. The clinical presentation of and psychiatric symptoms associated with these disorders will be discussed. The process of addiction and issues regarding the clinical evaluation of the elderly addict will be discussed. The medical complications of these disorders will be reviewed, followed by a discussion of guidelines for the appropriate use of these drugs in the elderly. The grand rounds will conclude with a discussion of the treatment of patients with these disorders.

Aged↗
PubMed1988

Lithium augmentation for treatment-resistant depression in the elderly.

Lithium has been used successfully to enhance the effectiveness of tricyclic and other antidepressants, monoamine oxidase inhibitors, and combinations of antipsychotics and antidepressants. The safety and efficacy of adding lithium to the treatment regimen was examined in 14 elderly patients with refractory depression. Seven of the 14 had a complete recovery, and three showed a partial response. Side effects, including peripheral weakness, severe fine tremor, and neurotoxicity, necessitated the discontinuation of lithium in three patients. In two other patients with side effects, lower dosages of lithium relieved their symptoms. Lithium augmentation appears to be a promising treatment for geriatric depressed patients who are unresponsive to or cannot tolerate other standard therapies.

Aged↗
PubMed1981

The masculine gender role and its implications for the life expectancy of older men.

The lifespan of men is shorter than that of women. This study is an effort to identify some causal factors. Six dimensions of the masculine gender role examined in relation to certain stress-related disorders more prevalent among older men than among older women. These dimensions are "No Sissy Stuff"; "The Big Wheel"; "The Sturdy Oak"; "Give 'Em Hell"; homophobia; and sexual dysfunctioning. Specific problems of retirement are also discussed. Only in recent years have the roles of men been studied more closely. The results may offer positive implications for the lifespan of men.

Aged↗