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Biomedical subjects

M Cummings

Publications and source records attributed to M Cummings.

At least 55 records · Page 3Linked to original sources

1H NMR of A beta amyloid peptide congeners in water solution. Conformational changes correlate with plaque competence.

To begin to examine the structural basis for the deposition of soluble A beta amyloid peptide onto senile plaques in Alzheimer's disease, we have prepared A beta congeners and measured their activity in an in vitro plaque growth assay. The N-terminal fragment, A beta (1-28)-OH, was inactive at all pH values tested. While the central fragment, A beta (10-35)-NH2, and the full length peptide, A beta (1-40)-OH, were inactive below pH 4, both were active (plaque competent) between pH 5 and 9. The active and inactive fragments were studied by nuclear magnetic resonance spectroscopy in water at submillimolar concentrations at pH 2.1 and 5.6. Changes in chemical shifts, coupling constants, and nuclear Overhauser enhancements indicate a pH dependent folding transition in A beta (10-35)-NH2 as it becomes active. The conformation of the active fragment is not helical, and preliminary data indicate the presence of several turns and at least two short strands. In contrast, the inactive fragment A beta (1-28)-OH did not undergo a similar folding transition. Earlier nuclear magnetic resonance studies of amyloid peptides in fluorinated alcohols or detergent micelles at low pH described a helical conformation and proposed a helix to sheet transition in plaque formation; the present study demonstrates that no such conformations are present in water under conditions where the peptides can adhere to authentic amyloid plaques.

Alzheimer Disease↗

Increased c-fos expression associated with hyperthermia-induced apoptosis of a Burkitt lymphoma cell line.

Hyperthermia (42 - 44 degrees C for 30 min to 1 h) can induce apoptosis in a variety of cell types and tumour cell lines. This process is usually, but not invariably unaffected by RNA and protein synthesis inhibition. C-fos expression has been implicated in the regulation of apoptosis occurring under diverse circumstances. By heating the Burkitt lymphoma cell line, BM 13674, for 43 degrees C for 30 min, approximately 60% of cells underwent apoptosis within 6h of treatment. Co-ordinate with the massive induction of apoptosis, a 10-fold increase in the steady state c-fos mRNA expression occurred.

Apoptosis↗

A model for improving generalist physician output: the osteopathic experience.

Osteopathic medicine is identified closely with primary care. Approximately one-half of all doctors of osteopathy (DOs) are family practitioners. The educational model responsible for producing such a high percentage of generalist physicians should be better understood for its achievements. Colleges of osteopathic medicine are unique in sharing a common mission of producing primary care physicians, and their methodologies reflect a similarly shared educational emphasis. Compared to allopathic medical schools, colleges of osteopathic medicine are the highest producers of generalist physicians because of several common features. This article evaluates colleges of osteopathic medicine by profiling each institution according to characteristics that have a potential impact on the output of generalist physicians: (1) institutional ownership; (2) age; (3) class size; (4) leadership; (5) educational focus; (6) whole-time as opposed to adjunct clinical faculty; (7) clinical educational settings; (8) clinical training sites; and (9) reliance on MD rather than DO clinical faculty. Comparisons between colleges of osteopathic medicine according to these characteristics yield mixed results but also highlight many differences from allopathic educational models. Factors separating the highest from lowest producers of generalist physicians vary at colleges of osteopathic medicine, and other characteristics or circumstances beyond their control may affect the number of graduates pursuing careers in primary care.

Career Choice↗

DNA substrate specificity of pea DNA methylase.

DNA methylase, present in low-salt extracts of nuclei prepared from Pisum sativum shoot tips, methylates model DNA substrates containing CNG trinucleotides or CI dinucleotides only. The binding to the hemimethylated trinucleotide substrates is very much stronger and more persistent than the binding to the unmethylated substrates or to the hemimethylated dinucleotide substrate. When the DNA concentration is limiting, the rate of methyl-group transfer with the hemimethylated CNG substrate is much greater than that with the unmethylated CNG. However, the Vmax. is similar for the two CNG substrates. On fractionation using Q-Sepharose, two peaks of activity are seen with different relative activities using the di- and trinucleotide substrates. The relative activity with these substrates changes during purification, during plant growth and on heating at 35 degrees C as well, indicating that more than one enzyme or more than one form of the enzyme may be present.

Chromatography, Gel↗

Mycoplasma hominis and Ureaplasma urealyticum in neonates with suspected infection.

The role of genital mycoplasmas in the pathogenesis of neonatal infection is incompletely understood. We performed nasopharyngeal, blood and cerebrospinal fluid (CSF) cultures for Mycoplasma hominis and Ureaplasma urealyticum in 69 neonates who underwent a diagnostic workup for suspected sepsis. The mean gestational age was 35.9 weeks (range, 25 to 42 weeks) with a mean birth weight of 2386 g (range, 652 to 4420 g). Twenty-seven infants (39.1%) had positive nasopharyngeal cultures; 6 were positive for M. hominis, 10 for U. urealyticum and 11 for both organisms. Seven (26%) of these 27 patients developed chronic lung disease compared with 2 (4.7%) infants in the non-colonized group. Nine infants had positive CSF cultures for M. hominis and one infant had a positive CSF culture for U. urealyticum. All blood cultures were sterile. One of the infants with a positive CSF culture for M. hominis had clinical evidence of systemic infection. All of the infants were treated with antibiotic agents that were not active against mycoplasmas. These data indicate that genital mycoplasmas can be found commonly in the CSF and nasopharynx of infants with suspected sepsis. Their etiologic role in the causation of infection and chronic lung disease, however, remains unclear.

Cerebrospinal Fluid↗

Management of chronic urethral symptoms in men.

We describe 20 men who were referred because of chronic urogenital symptoms. They had been previously seen by zero to six physicians (mean, 1.8 physicians) and had been treated with zero to five courses of antimicrobial agents (mean, 2.4 courses) without relief of their symptoms. Results of physical examinations of all patients were normal. An extensive evaluation failed to reveal any objective evidence of urethral inflammation. Cultures for Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma urealyticum, and Trichomonas vaginalis were uniformly negative. No additional antimicrobial agents were prescribed. Data from follow-up questionnaires filled out by 10 of these men 5-28 months later (mean, 11.8 months) disclosed the disappearance of symptoms in three and the reduction of symptoms in four. Chronic urethral symptoms may occur in the absence of objective evidence of inflammation and infection with known urethral pathogens. Observation without antimicrobial therapy is the treatment of choice for such patients.

Chronic Disease↗

In vitro activity of temafloxacin compared with those of other agents against 100 clinical isolates of Neisseria gonorrhoeae.

The activity of temafloxacin hydrochloride was evaluated by agar dilution against 100 clinical isolates of Neisseria gonorrhoeae and compared with the activities of penicillin, tetracycline, ceftriaxone, ciprofloxacin, and ofloxacin. Temafloxacin inhibited 100% of study isolates at a concentration of 0.015 microgram/ml or less and was highly active against penicillin- and tetracycline-resistant strains. The in vitro activity of temafloxacin was nearly identical to that of ceftriaxone and was slightly less than that observed with ciprofloxacin and ofloxacin. Temafloxacin represents a promising alternative agent for investigation in the treatment of infection due to N. gonorrhoeae.

Anti-Infective Agents↗

Sexually transmitted diseases in postpubertal female rape victims.

Seventy-six postpubertal women were referred from a municipal hospital emergency room within 60 h of sexual assault for evaluation. Of the 76 victims, 20 (26%) had active Chlamydia trachomatis infection detected by culture (11 subjects), a fourfold serologic titer rise (6), or both (3). The risk of acquiring C. trachomatis infection after sexual assault was 3%-16%. Pelvic inflammatory disease was detected in 8 (11%) of the 76 victims. Bacterial vaginosis was diagnosed in 38 women (50%), at least 8 of whom appeared to have been infected during the assault. Trichomoniasis was found in 17 victims (22%), at least 5 of whom may have acquired the infection at the time of the assault. In view of the high rates of these infections and the poor compliance with follow-up (76% [58/76] kept their appointments), all postpubertal victims of sexual assault should be offered treatment with ceftriaxone, 250 mg intramuscularly, followed by 100 mg of oral doxycycline and 500 mg of oral metronidazole twice daily for 7 days.

Adolescent↗

Comparison of ofloxacin and ceftriaxone in the treatment of uncomplicated gonorrhea caused by penicillinase-producing and non-penicillinase-producing strains.

Eighty-nine patients with uncomplicated gonorrhea, including 31 patients (34.8%) infected with penicillinase-producing strains of Neisseria gonorrhoeae, were treated with oral ofloxacin (single 400-mg dose) or intramuscular ceftriaxone (250-mg dose). All 47 patients who received ofloxacin and 41 of 42 patients who received ceftriaxone were cured.

Adult↗

The pull toward the vacuum: osteopathic medical education in the 1980s.

During the 1980s, the two major influences in osteopathic medical education were the increasingly large number of new DOs seeking internships and residencies and the loss of training sites as a result of the shrinking osteopathic hospital network. Owing mainly to a declining interest in primary care by young MDs, allopathic postdoctoral program directors, particularly in primary care specialties, began to actively recruit osteopathic physicians. An oversupply of positions on the allopathic postdoctoral side and an undersupply of residency positions in osteopathic postdoctoral programs contributed to a crossover trend. The programs approved by the Accreditation Council for Graduate Medical Education have made significant inroads in attracting DOs. It has reached the point where two out of every three DOs currently training in a primary care residency can be found in an allopathic program. If it continues, this pattern will have a significant impact on the character of osteopathic medical education.

Accreditation↗