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Biomedical subjects

L Wood

Publications and source records attributed to L Wood.

At least 127 records · Page 7Linked to original sources
PubMed1991

Refractory ascites in the chronic myeloproliferative syndrome: a case report.

In a patient with myelofibrosis, tense ascites refractory to conventional therapy resulted from extensive seeding of the peritoneum with colonies of extramedullary haematopoiesis. Whole abdominal radiation was found to be effective and well tolerated, and brought about prompt and lasting resorption of the exudate, with weight reduction and improvement in performance status from 50% to 90% on the Karnofsky rating.

Abdomen↗
PubMed1991

Reactivity of pretransplant cytotoxic antibodies to a selected HLA panel is not influenced by cyclosporin A, with or without plasma exchange.

The influence of 6 weeks of cyclosporin A (CYA), followed by a further 6 weeks of this agent in combination with plasma exchange (PE), was defined on panel reactivity and titre of preformed cytotoxic antibodies in stable patients on haemodialysis awaiting renal transplantation. Nine individuals with antibodies to 30% or more of the donor panel were entered into the study, but three failed to complete the programme. Comprehensive data are available on the remaining six patients, one of whom was studied twice. The pattern of reactivity to the panel was unaltered, but antibody titres were significantly reduced (P less than 0.006). In one patient, a lymphocytoxic crossmatch performed between the patient and an HLA-haploidentical sibling in the last week of the trial was positive, suggesting that neither procedure was successful in removing an antibody directed against the HLA antigens of a family donor. Three cadaver renal transplants were performed during or after the trial, and while two of the grafts were unsuccessful, one survives at 60 months, with good function. From these data it is concluded that neither cyclosporin A nor its combination with plasma exchange have any effect on the panel reactivity of preformed cytotoxic antibodies, whereas the titres were significantly reduced. An important and serious side effect of the apheresis procedure was the loss of fistulae in two patients.

Cyclosporins↗
PubMed1991

Collection and cryopreservation of human stem and progenitor cells for bone marrow transplantation.

Bone marrow collection was undertaken from human organ donors (Group 1: n = 7) to develop a closed-system single-step technique for stem and progenitor cell enrichment, using the Cobe 2997 continuous-flow blood-cell separator. The effects of programmed freezing, storage in liquid nitrogen, and thawing were then defined using these grafts. Once standardised, this method was extended to autografting following cryopreservation of a comparable fraction (Group 2: n = 8) and then to allogeneic transplantation after ex vivo exposure to the lytic monoclonal antibody. Campath-1 IgM and human complement, but without cryopreservation (Group 3; n = 9). The median number of mononuclear cells harvested was 5.0 x 10(6)/mL (n = 24), and this was not significantly different in the three groups. The ex vivo graft, composing marrow rich anticoagulated whole blood, was recirculated in the separator at a flow rate of 60 mL/minute, with a centrifuge speed of 1,100 r.p.m., and the mononuclear cell fractions were collected at the rate of 1.5 mL/minute. The average procedure time from formation of the interface in the single disposable channel to achievement of the final volume was 90 minutes. The mean recovery of the mononuclear cells was 101.4% (SD 38.0) and the GM:CFUc was 91% (SD 43.86). These figures were not significantly influenced by subsequent cryopreservation (Group 1; n = 7 and Group 2; n = 8) or following exposure to the monoclonal antibody. Campath-1 IgM (Group 3; n = 9).(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Marrow Transplantation↗
PubMed1991

Clinical and virological observations of a mucosal disease outbreak with persistently-infected seropositive survivors.

A group of 14 four to nine month old calves, clinically healthy but persistently infected with bovine virus diarrhoea virus (BVDV), was obtained from a single farm, and reared as a group. Ten of them were male and were castrated soon after arrival. Signs of mucosal disease (MD) developed within a month and eight of the males had died or been killed on humane grounds by 2 months after purchase. The other two males and one of the females developed more chronic but progressive signs of MD and were killed during the next four months. The remaining three females showed only transient signs of MD followed by clinical recovery. They subsequently remained healthy up to slaughter at 2, 2.5 and 5 years respectively. These three survivors were persistently infected with BVDV, and shed virus in their mucous secretions, although two of them were also seropositive to the virus with fluctuating neutralizing antibody titres (at times as high as 1/960) to a range of BVDV strains including their own persisting virus.

Animals↗
PubMed1991

Diagnosis of measles by fluorescent antibody and culture of nasopharyngeal secretions.

An indirect fluorescent antibody test (IFA) was evaluated using commercial mouse anti-measles monoclonal antibody and FITC-labeled goat anti-mouse immunoglobulin. For measles isolation, specimens were inoculated into Rhesus monkey kidney (RMK) cells and, when available, CV-1 cells. 381 specimens were tested by IFA and 408 specimens were cultured from patients suspected of having measles. For the 381 specimens tested by both methods, IFA and culture were positive for 31%, culture alone for 14%, IFA alone for 15%, and both negative for 40%. This study indicates that both IFA and culture are required for maximum measles virus detection. Of the positive specimens, 48% were detected either by IFA only (24%) or culture only (24%). IFA was positive in 69% of the culture-positive specimens and therefore, provided rapid diagnosis for many patients.

Antibodies, Monoclonal↗
PubMed1991

Different forms of chronic childhood thrombocytopenic purpura defined by antiplatelet autoantibodies.

To determine whether detection of antiplatelet autoantibodies (AAb) to glycoproteins IIb/IIIa and Ib/IX may be useful in defining different forms of chronic thrombocytopenic purpura (TP) in children, we analyzed for AAb the platelet and plasma samples from 36 children with chronic TP (mean duration 4.4 years), from 31 children with normal platelet counts at the time of blood sampling but with chronic TP in the past (mean duration 2.9 years), and from 23 adults with chronic TP; the results were correlated with the clinical data. Antiplatelet autoantibodies were detected in 26 (72.2%) of 36 children with ongoing TP, 15 (48.4%) of 31 children with TP in the past, and 12 (66.7%) of 18 adults with TP. All children with high AAb ratios (greater than 5 times the control mean + 3 SD) were more than 8 years of age at diagnosis (mean age 12.4 years compared with 7.1 years in children with moderate or negative AAb levels; p = 0.003). The results suggest that the outcome for adolescents with high platelet-associated AAb levels may be similar to that of adults, whereas younger children may have a greater chance of spontaneous remission. The children with chronic TP in the past and elevated platelet-associated AAb levels may have a "compensated" TP and therefore may be at risk for relapses. Future studies aimed at serial AAb determination throughout the patients' courses may further define TP subgroups.

Adolescent↗
PubMed1991

The relationship of early versus two-minute recovery echocardiographic values following maximal effort resistance exercise.

Two-dimensionally directed M-mode echocardiography was used to measure left ventricular systolic function following maximal dynamic resistance exercise (RE). Upright measurements were made from the long axis parasternal view at rest, 20 seconds post-exercise, and two minutes post-exercise. Thirty-two successful studies were recorded from a total of 37 trained and untrained male subjects who were heterogeneous as to mode and level of training. Resistance-trained men averaged 3.8 +/- 2.4 yrs of training for 9.7 +/- 3.0 hr/wk, and endurance-trained men averaged 6.4 +/- 3.9 yr of training at 202.5 +/- 112.6 km/wk of cycling, running, and swimming. The trained men competed at the state or regional level. The RE protocol (knee extensions) was performed as follows: Set 1 (10 s rest) Set 2 (10 s rest) Set 3 60% 1-RM@8 reps 60% 1-RM@8 reps 60% 1-RM to fatigue. The RE protocol produced significant post-exercise reductions in end-systolic diameter (p less than 0.0002) and significant post-exercise increases in fractional shortening (p less than 0.0001) and velocity of circumferential fiber shortening (p less than 0.0002). The inotropic variables were still significantly different at two minutes post-exercise compared to the 20 second measure, suggesting that early recovery is a better approximation of maximal values. Velocity of circumferential fiber shortening at 20 seconds and two minutes was significantly correlated (r = 0.39) and fractional shortening was not (r = 0.34) at these serial measurement times.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Expression of calcyclin, a calcium-binding protein, in the keratogenous region of growing hair follicles.

Changes in calcium levels control the differentiation of skin epithelial cells and thus may also affect the epithelial cells of the hair follicle. We have isolated a murine cDNA clone, pCAL-F559, for the calcium-binding protein calcyclin by differential screening of a cDNA library made from RNA isolated from hair follicles of 6-d-old mice. The identity of our cDNA clone was established by comparing the DNA sequence with the sequence of the human calcyclin gene. That the authentic calcyclin mRNA encoded by pCAL-559 is present in skin of 3-d-old mice was confirmed by S1 nuclease protection assays. As measured by RNA dot blots, calcyclin mRNA levels in the skin change in accordance with the hair cycle and reaches a peak a few days prior to the mRNA for structural hair proteins. Although we can demonstrate by in situ hybridization that mRNA for calcyclin is localized in the post-mitotic keratogenous region of the hair follicle we can only assume that this calcium binding protein is involved in the control of differentiation of these cells by regulating their Ca++ levels.

Animals↗
PubMed1991

Learning style preferences: a comparison of younger and older adult females.

This study explored the learning styles of older adult females (65 + years) as compared to younger adult females (35-55 years) in the areas of immediate environment, emotionality, sociological needs and physical needs. At recreation community centers, 80 subjects were selected on a non-random basis, with one-half falling in each age category. Each subject was individually questioned using the Productivity Environmental Preference Survey, which analyzes a personal preference for each of 20 elements and identifies how adults prefer to function, learn, concentrate and perform in their educational or occupational activities. An analysis by t test showed a significant difference between the two groups in the elements of light, learning alone--peer oriented, authority figures present, and evening--morning. When the elements were combined and treated by discriminant analysis, most of these findings were confirmed, showing a significant difference in five elements: light, motivation, responsibility, learning alone--peer oriented, evening--morning. These findings might be useful to nutrition educators when developing nutrition programs for the elderly.

Adult↗
PubMed1991

Autotransfusion in the postanesthesia care unit.

During the postoperative period, blood loss after major orthopedic surgery can be significant. Until recently, there was no way to salvage this loss and return it to the patient. Increased demands on blood bank supplies and risk of blood-transmitted diseases have stimulated interest in the development of a relatively compact and portable machine that it salvages the blood loss and processes it for retransfusion. The PACU at Green Hospital of Scripps Clinic has begun using this technique with a significant increase in blood salvaging and return to the patient.

Blood Transfusion, Autologous↗
PubMed1990

Serine-rich ultra high sulfur protein gene expression in murine hair and skin during the hair cycle.

To study the regulation of hair differentiation, a murine genomic clone, gUHS-SER-M16, was isolated that contained two members of the family of serine-rich ultra high sulfur protein genes. One of the genes, gUHS-SER-1, encodes 230 amino acids with 40% cysteine and 23% serine; the other gene, gUHS-SER-2, encodes 223 amino acids with 41% cysteine and 21% serine. The similarity between the two genes is 73%, and both have several 10-amino acid repeats within their coding regions. In the prospective promoter region, there are several regions of similarity including a "TATA" box, with neither gene having a "CAT" box. At the 3' untranslated region, there is no similarity, and thus a fragment from this region was used as a hybridization probe for RNA dot-blots and for in situ hybridizations. The RNA dot-blot showed elevated levels of mRNA during the active phases of hair growth and low levels during the resting phases. In situ hybridizations show that mRNA for the ultra high sulfur protein gene is found during the active phases of the hair cycle not only in the medulla and the inner root sheath of the forming hair but also in upper layers of the epidermis of skin.

Amino Acid Sequence↗
PubMed1990

Treatment of adult acute lymphoblastic leukaemia.

Eighty-five consecutive patients with acute lymphoblastic leukaemia (ALL), having a median age of 24 years (range 10-69 years), underwent induction and consolidation chemotherapy with weekly parenteral vincristine, Adriamycin, l-asparaginase and daily oral prednisone (VAAP), followed by standard (CNS) prophylaxis. Maintenance therapy was given for 3 years and consisted of daily 6-mercaptopurine, weekly methotrexate and monthly intrathecal therapy, with drug intensification comprising either vincristine, Adriamycin and l-asparaginase (VAA) or cyclophosphamide, vincristine, cytosine arabinoside and prednisone (COAP). Complete remission (CR) was obtained in 59 patients (69%) and only the French-American-British (FAB) L1 morphology was a significant predictive factor (P = 0.048). Twenty-three patients failed to achieve CR and of these 12 had primary drug resistance. Median follow-up is currently 260 weeks, median predicted survival of all patients is 58 weeks and for those who achieved CR it is 104 weeks. Median duration of CR is 70 weeks. Of the prognostic factors for survival, only FAB L1 subtype was significant. Bone marrow relapses occurred in 29 patients, and of these 9 (31%) achieved CR. There has been CNS relapse in two patients and both have died. Eleven patients continue in CR off therapy, with a median of 152 weeks. This regimen is effective, with acceptable toxicity, and a number of patients are potentially cured. The incidence of resistant and relapsing disease is an argument for further intensifying both induction and postinduction therapy.

Adolescent↗
PubMed1990

Three different schedules of low-density lipoprotein apheresis compared with plasmapheresis in patients with homozygous familial hypercholesterolemia.

PURPOSE: To determine the biochemical and clinical response of two patients with homozygous familial hypercholesterolemia to three different schedules of low-density lipoprotein apheresis compared with plasmapheresis. PATIENTS AND METHODS: Two female patients aged 17 years, both affected by homozygous familial hypercholesterolemia, underwent low-density lipoprotein apheresis using a dextran-sulfate/cellulose affinity column on successive twice-weekly, weekly, and biweekly schedules. Plasmapheresis was carried out only at biweekly intervals. Plasma lipids and apolipoproteins A1 and B were assayed before and after each procedure. Cardiac status was assessed before and after the study. RESULTS: On schedule 1 of apheresis, the immediate post-procedure low-density lipoprotein cholesterol levels declined to 60 mg/100 dL plasma. Quasi-steady-state values of low-density lipoprotein cholesterol and apolipoprotein B were also markedly reduced, with levels approaching the upper limits of normal for age and sex. This response was attenuated as the intervals between procedures were prolonged. No advantage of low-density lipoprotein apheresis over plasmapheresis was observed during the biweekly protocol except that after plasmapheresis high-density lipoprotein cholesterol levels declined by 50% or more compared with less than 10% after apheresis. The latter procedure, especially on schedules 1 and 2, caused an increase in the quasi-steady-state concentrations of both high-density lipoprotein cholesterol and apolipoprotein A1. Thus, mean low-density lipoprotein cholesterol/high-density lipoprotein cholesterol and apolipoprotein B/apo A1 ratios were reduced by more than three- to four-fold during twice-weekly apheresis. Other laboratory parameters remained stable throughout except for iron and hemoglobin levels, which were reduced with both plasmapheresis and apheresis. Xanthomas regressed significantly in the one patient who had not been treated prior to the current trial. Cardiac changes were minor in both patients. CONCLUSION: Low-density lipoprotein apheresis proved safe and effective on an accelerated protocol as well as during more conventional schedules. Owing to its simplicity, selectivity, and safety, apheresis using a dextran-sulfate/cellulose column is possibly the optimum means currently available for the extracorporeal removal of low-density lipoprotein cholesterol.

Adolescent↗
PubMed1990

Fourier analysis of the relation between the discharge of quadriceps motor units and periodic mechanical stimulation of cat knee joint receptors.

It has been widely assumed that joint receptors contribute to the reflex regulation of movement and posture, although there have been few clear demonstrations of joint-mediated reflex actions on alpha-motoneurones other than those attributable to flexor reflex afferents. The present study extends our recent work on joint-mediated reflexes by using Fourier analysis of spike train interactions to demonstrate that restricted mechanical activation of a small number (one to five) of knee joint receptors by localized indentation of the joint capsule can modify the firing pattern of quadriceps motoneurones in decerebrated cats. The modulation of this discharge pattern can be reversibly abolished by application of droplets of lignocaine directly to the joint nerve and consequently can be attributed unambiguously to articular afferents. Activation of single joint afferents could on occasion produce changes in motor unit firing patterns, but usually activation of two or more was required before secure effects were observed. Increasing the intensity of indentation (resulting in activation of greater numbers of joint receptors) increases the strength of coupling between joint afferent input and motor unit responses, although the relationship is not linear. The relation between the discharge patterns of pairs of motor units was also examined, and it was found that significant coupling occurred at the stimulus frequency, superimposed on a 'background' coupling from unidentified sources. The phase relationship between pairs of motor units was not affected by the periodic stimulus. However, it was observed that if two motor units were firing independently of one another in the absence of capsule probing, maintained capsular indentation produced a striking synchronization between the discharges of the two motor units. These experiments show strong joint-mediated reflex effects on motor unit firing indicating that joint receptors may have an important role to play in motor control.

Action Potentials↗