Professional liability--storm warning, professional liability--some solutions.
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Humans↗
Biomedical subjects
M A Braun
Publications and source records attributed to M A Braun.
Identification and molecular characterization of Hendra virus in a horse in Queensland.
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Animals↗
Immunohistochemistry in the identification of a number of new diseases in Australia.
Immunohistochemistry plays an important part in the diagnosis of some viral diseases. Demonstration of viral antigen in a lesion is an important contribution to diagnosis, either at the time of investigation or retrospectively. At the CSIRO Australian Animal Health Laboratory, the most frequent use of immunohistochemistry has been in the diagnosis of the important avian diseases, highly pathogenic avian influenza and Newcastle disease. The technology took key roles in the diagnoses of Hendra virus infections, and, later, an immunoperoxidase test gave the first indication of the existence of Australian bat lyssavirus. The test can often confirm that a virus isolated in an animal is the actual virus causing disease and not a coincidental isolation. Good examples of that in some more new diseases were the association of Wallal virus with blindness in kangaroos, and of the new porcine Menangle virus in natural and experimental cerebral disease in foetal piglets.
Animals↗
Phase II trial of chemoembolization for the treatment of metastatic colorectal carcinoma to the liver and review of the literature.
BACKGROUND: Hepatic artery chemoembolization represents an alternative treatment for patients whose neoplastic lesions are not amenable or have become refractory to other treatment modalities. This project was designed to test the feasibility of regional chemoembolization for patients with colorectal carcinoma metastasis to the liver who had experienced failure with one or more systemic treatments. METHODS: Thirty patients who met the study entry criteria underwent one to three hepatic artery chemoembolizations. The chemoembolization regimen consisted of an injection of a bovine collagen material with cisplatin (10 mg/mL), doxorubicin (3 mg/mL), and mitomycin C (3 mg/mL). Repeat treatments were performed at 6- to 8-week intervals. RESULTS: Radiologic responses, as measured by a decrease in lesion density of at least 75% of the lesion or a 25% decrease in the size of the lesion, occurred in 63% of the cases. A decrease of at least 25% of the baseline carcinoembryonic antigen level occurred in 95% of the cases. All responses were transient. Median survival for all 30 patients was 8.6 months after the initiation of chemoembolization and 29 months after the initial diagnosis of metastasis to the liver. Common toxicities included a "postembolization syndrome," which consisted of fever > 101 degrees F (83%), pain in the right upper quadrant (100%), nausea, and vomiting. Lethargy was a common occurrence (in 60+% of cases) and lasted up to 6 weeks. Hematologic toxicities included leukocytosis, anemia, and thrombocytopenia. CONCLUSIONS: Chemoembolization is a feasible treatment modality for patients with colorectal carcinoma metastasis to the liver who have experienced failure with other systemic treatments. It results in high response rates with transient mild-to-moderate toxicity. Responses are measured in months, however, and all patients have eventual progression of disease. Patients who are able to undergo three or more chemoembolization procedures may receive the most clinical benefit.
Antineoplastic Combined Chemotherapy Protocols↗
Radiographic appearance of intrathoracic complications of pregnancy.
The authors reviewed all chest radiographs obtained for pregnant women at a university hospital over a 15-year period to determine the intrathoracic complications of pregnancy and diseases occurring during pregnancy. The characteristic physiologic changes seen on chest radiographs during normal pregnancy are reviewed. Examples of intrathoracic diseases that may occur in pregnant patients include pulmonary embolism, amniotic fluid embolism, beriberi, aspiration pneumonia, community-acquired pneumonia, viral pneumonia, asthma, systemic disease, trophoblastic disease and peripartum pulmonary edema. The authors discuss the radiation biology implications of performing chest radiography during pregnancy and conclude that the benefit that the fetus receives from diagnosis and treatment of the mother's disease may be greater than the risk of radiation exposure.
Adolescent↗
Stimulation of human T cells by streptococcal "superantigen" erythrogenic toxins (scarlet fever toxins).
The pyrogenic (erythrogenic) exotoxins A and C (SPEA and SPEC) of Streptococcus pyogenes belong to the family of mitogenic toxins of which the staphylococcal enterotoxins are the prototypes. The erythrogenic toxin B (SPEB) is a proteinase precursor. All SPE have been reported to be superantigens. Here we have analyzed the human T cell response to these toxins. We used highly purified preparations of SPEA, SPEB, and SPEC from different S. pyogenes strains. These toxins were apparently homogenous in SDS-PAGE, IEF, and HPLC. In addition, recombinant SPEA and SPEC were produced in Escherichia coli. In cultures of PBMC, all three toxins expanded preferentially a fraction of T cells. Using mAb against V beta 2, -5, -6, -8, and -12, we investigated the phenotype of the stimulated cells. Natural SPEA, SPEB, and SPEC strongly stimulated V beta 8+ T cells, whereas recombinant SPEA and SPEC did not. Both natural and recombinant SPEA stimulated V beta 12+ cells and both natural and recombinant SPEC stimulated V beta 2+ cells. In accordance with these findings, a human V beta 8+ line responded to all three toxins derived from S. pyogenes but not to the recombinant proteins. An antiserum against natural SPEC neutralized specifically the V beta 2-stimulating activity of SPEC and the V beta 8-stimulating activity of all three toxins, but had no effect on the response to other superantigens. This shows that trace amounts of a potent novel V beta 8-stimulating activity not identical to SPEA and SPEC are responsible for the stimulation of V beta 8+ T cells by natural SPEA and SPEC reported previously. In a preliminary screening of S. pyogenes strains from patients, we found that this novel superantigen appears to be more widely distributed than SPEA and SPEC. Furthermore, we present evidence that also the superantigenic properties of SPEB are due to contaminations with this V beta 8 stimulator. The response to SPEB usually required 1000 times higher concentrations than to SPEA or SPEC. Antisera to SPEC but not to SPEB inhibited the response of PBMC and V beta 8+ Jurkat cells to SPEB. Furthermore, more stringent purification of SPEB yielded SPEB preparations devoid of mitogenic activity. These results indicate that the mitogenicity that is commonly attributed to SPEB is due to minute contaminations of the V beta 8 stimulator. These results raise two important caveats for the work with these highly potent T cell mitogens.(ABSTRACT TRUNCATED AT 400 WORDS)
Antigens, Bacterial↗
A simple method to reduce air-bubble artifacts during percutaneous extraction of biliary stones.
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Artifacts↗
Percutaneous retrieval of tandem right atrial Greenfield filters.
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Aged↗
A new DNA binding assay to study subclasses of SV40 large T antigen binding to individual binding sites on the SV40 DNA.
SV40 large T antigen interacts specifically with three different sequences, termed sites I, II or III, within the control region of the SV40 DNA to regulate transcription as well as the initiation and progress of SV40 DNA replication. We have biotinylated three different DNAs containing either site I, II or III and immobilized these constructs on a streptavidin agarose matrix. All three immobilized DNAs were shown to bind T antigen from a total cell extract of SV40 infected monkey cells although with different affinities. Pulse chase experiments revealed that newly synthesized T antigen bound efficiently to all three binding sites whereas mature T antigen bound only to site I and site III DNA. The analysis of non-binding and DNA-bound T antigen on sucrose density gradients showed that only low molecular weight forms of T antigen were bound to all three immobilized DNAs. However, incubation of T antigen in the total cell extract with site I DNA resulted in high molecular weight forms of T antigen, indicating that the presence of site I DNA influences the quaternary structure of T antigen which might result in a detachment from the DNA.
Animals↗
Lung cancer in patients seropositive for human immunodeficiency virus.
The authors describe the clinical and radiographic findings of lung carcinoma in six patients infected with the human immunodeficiency virus (HIV). These patients were in a younger age group than is commonly associated with lung cancer. The radiographic findings included mediastinal adenopathy (n = 5), hilar masses with distal atelectasis (n = 3), parenchymal masses (n = 3), pleural effusions (n = 2), and pleural thickening (n = 1). Recognition of any of these findings should raise the diagnostic possibility of lung cancer in this group of younger patients.
Acquired Immunodeficiency Syndrome↗
Pyriformis syndrome in a 10-year-old boy as a complication of operation with the patient in the sitting position.
We present a case of sciatic neuropathy due to the pyriformis syndrome after operation in the sitting position. Neither sciatic nerve injury nor the pyriformis syndrome has been reported after operation in the sitting position, although a low incidence of common peroneal nerve injury has been reported as a complication of operation on patients who are in the sitting position. The clinical findings of sciatic neuropathy, external rotation of the ipsilateral foot in the position of comfort, and a therapeutic response to local anesthetic injection into the pyriformis muscle are diagnostic of the syndrome. Nerve conduction studies should be performed to aid in the differentiation between a common peroneal and sciatic neuropathy. The syndrome may occur because of extreme flexion of the hips and prolonged pressure while in the sitting position, leading to pyriformis muscle trauma, resultant spasm, and sciatic compression. The prognosis is for complete recovery after symptomatic treatment with nonsteroidal antiinflammatory medication and physical therapy.
Astrocytoma↗
Occupational therapy management of the acute spinal cord-injured patient.
This report describes an occupational therapy program for the patient with an acute spinal cord injury. The program includes guidelines for evaluation and treatment, criteria for early orthotic selection, and psychological considerations. The program was developed by the occupational therapy staff at Northwestern Memorial Hospital, Chicago, in conjunction with a medical team and occupational therapy staff from the Rehabilitation Institute of Chicago. The intent of the program is to implement rehabilitation in the acute care environment immediately.
Activities of Daily Living↗
The jittery newborn and infant: a review.
Jitteriness is an involuntary movement that is particularly frequent in the newborn. Its hallmark is tremor. The pathogenesis is poorly understood. Jitteriness is often accompanied by other signs of central nervous system excitation, such as hypermotility, hypertonicity, and ease of startle. It must be differentiated from myoclonus and seizure, although they may coexist. Jitteriness can be caused by a variety of pre-, peri-, and postnatal insults, and it is the nature and treatability of these, rather than the tremor itself, that are the major determinants of the ultimate prognosis. "Coarse" tremor is probably more often abnormal than "fine" tremor, and appears to bear some relationship to the later development of a choreiform syndrome. The evaluation of the jittery infant must be individualized and management aimed at reversing any remediable causes.
Animals↗
[Effect of different doses of retinol acetate on the RNA and total protein content of rodent ovaries and endometrium].
The effects of different doses of retinol acetate (RA) on protein synthesis by the hamster ovaries and endometrium were studied. Two groups of CBA/C57BL mice aged 3-4 months were given 3.44% oily RA per os on a daily basis for 10 days. After completion of the experiments the paraffin sections 6 micron m thin were subjected to a histochemical assay for the content of RNA and total protein in the ovaries and endometrium. RA (50 000 IU) was found to stimulate RNA and protein synthesis in all the ovarian structures and endometrium. In the ovaries, vitamin primarily affected the follicular epithelium and internal the-ca of the follicles. Administration of RA in a dose of 80 000 IU inhibited protein synthesis in the ovaries and endometrium. As for the ovarian structures the greatest changes under toxic hypervitaminosis A (80 000 IU) were experienced by the follicular epithelium and ovocytes.
Animals↗
[Effect of high doses of retinol acetate on the 3-beta-ol-steroid dehydrogenase and alkaline phosphatase content in mouse ovaries].
The author reports on the effects of different doses of retinol acetate on ovarian steroidogenesis. Two groups of CBA/C57BL mice with a mean body weight of 18-20 g received 3.44% oily retinol acetate per os in daily doses of 50 000 and 80 000 IU for 10 days. After completion of the experiments the quick-frozen sections of the ovaries were subjected to a histochemical assay for the content of 3-beta-ol-steroid dehydrogenase and alkaline phosphatase. Administration of 50 000 IU vitamin A was found to stimulate ovarian steroidogenesis. The effect of vitamin A was the most demonstrable in the interstitial tissue, atretic corpora, and, in the internal theca of the follicles. Administration of 80 000 IU retinol acetate inhibited ovarian steroidogenesis. The estrous cycle in animals ceased. Administration of vitamin A (80 000) primarily affected the follicular apparatus of the ovaries, namely the epithelium of the follicles and yellow bodies. At the same time secretory function of atretic corpora and interstitial tissue remained within normal, which was regarded as a compensatory-adaptive mechanism under toxic hypervitaminosis A.
3-Hydroxysteroid Dehydrogenases↗
[Histofunctional state of mouse ovaries in normal conditions and during hypervitaminosis A].
Morphometry was used to analyze different histofunctional structures of mouse ovaries (follicles of varying maturation grades, yellow and atretic bodies, interstitial tissue) in health and hypervitaminosis A (80 000 IU). It was noticed that in the ovaries of female mice in health, there occurred consistent cyclic processes marked by the changes in the number and size of the morphofunctional structures during different stages of the estrous cycle. In hypervitaminosis A, female mice had no estrous cycle. The ovaries showed the impairment of the growth of the follicles and enhancement of atresia. As a result, the follicles did not reach the final stages of development, which led to the cessation of ovulation and formation of yellow bodies.
Animals↗
Contralateral loop snare removal of a ruptured and entrapped angioplasty balloon.
We describe a technique that extracted a ruptured angioplasty balloon which had become entrapped by a calcified left common iliac artery stenosis. The balloon catheter had been advanced crossover from the right and could not be retracted directly into a sheath across the aortic bifurcation. Therefore, a guidewire was inserted through the balloon catheter and captured by a loop snare advanced from the left femoral artery. The loop snare was also used to free the balloon wings from the stenosis. The balloon was then pulled into a 10 Fr sheath and removed as a unit with the sheath.
Aged↗