Burst fracture of the first lumbar vertebra.
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Accidents, Traffic↗
Biomedical subjects
M Ho
Publications and source records attributed to M Ho.
Red blood cell-bound C3d in selected hospital patients.
A radioactive anti-antiglobulin technique was used to measure C3d bound to the red blood cells of 227 hospitalized patients in 129 patients, with a wide variety of diseases, normal levels of RBC-bound C3d were found. Seventy-two patients had moderately elevated RBC-bound C3d; they generally did not have autoimmune hemolytic anemia but had diseases in which complement is thought to be activated. Patients with markedly elevated RBC-bound C3d (26 patients) usually had autoimmune hemolytic anemia with a positive antiglobulin test. Some patients with only moderately elevated levels of RBC-bound C3d had autoimmune hemolytic anemia and a negative antiglobulin test in individual patients the level of RBC-bound C3d correlated with both the severity of disease and the response to treatment. RBC-bound C3b was detected in two patients with a very high level of RBC-bound C3d. This study provides background data for assessing the significance of complement activation and fixation to RBC in health and disease.
Anemia, Hemolytic, Autoimmune↗
In vitro characterization of Ac-RYYRWK-NH(2), Ac-RYYRIK-NH(2) and [Phe1Psi(CH(2)-NH)Gly2] nociceptin(1-13)NH(2) at rat native and recombinant ORL(1) receptors.
The pharmacology of ORL(1) compounds, [Phe1Psi(CH(2)-NH)Gly2]nociceptin(1-13)NH(2) (F/GNC13), Ac-RYYRIK-NH(2) and Ac-RYYRWK-NH(2) was evaluated at rat ORL(1) receptors in frontal cortex (CTX), transfected chinese hamster ovary (CHO) cells, vas deferens (VD) and anococcygeus (AC). Ranked affinities for the inhibition of [3H]nociceptin binding to CTX and CHO's were: Ac-RYYRWK-NH(2) identical withAc-RYYRIK-NH(2) identical withnociceptin>F/GNC13>Dynorphin A>naloxone. The full agonist, nociceptin stimulated [35S]GTPgammaS binding in CTX (E(max)=174%) and CHO's (E(max)=311%); all other ORL(1) peptides acted as partial agonists with the following rank order for E(max) values: Ac-RYYRWK-NH(2) (96% (CTX), 202% (CHO))>F/GNC13 (44% (CTX), 136% (CHO)) identical withAc-RYYRIK-NH(2) (44% (CTX), 115% (CHO)). Schild analysis generated pA(2) values in CTX of 8.59 (F/GNC13) and 9.13 (Ac-RYYRIK-NH(2)). cAMP production in CHO's was inhibited by 77% (nociceptin), 58% (Ac-RYYRWK-NH(2)), 55% (F/GNC13) and 49% (Ac-RYYRIK-NH(2)). Nociceptin inhibited electrically evoked contractions in isolated tissues by 95% (VD) and 98% (AC); partial inhibition was observed with Ac-RYYRWK-NH(2) (72% (VD), 66% (AC)) and Ac-RYYRIK-NH(2) (54% (VD); 37%(AC)). Ineffective in the VD, F/GNC13 caused a small inhibition in the AC that was reversed at higher concentrations. Schild analysis gave pA(2) affinities of 7.32(VD) and 7.34(AC) for F/GNC13 and 8.69(AC) for Ac-RYYRIK-NH(2).
Animals↗
Treatment of septicemic patients with cefoxitin: pharmacokinetics in renal insufficiency.
Experience with cefoxitin in the treatment of septicemia of diverse etiologies in 11 patients is reviewed. Results of a small study of the pharmacokinetics of cefoxitin in patients with renal insufficiency, which was used as a guideline for determining the dosage of cefoxitin for severely ill patients with renal insufficiency, are included. In addition, a summary of data on file at Merck Sharp and Dohme Research Laboratories (Rahway, New Jersey) that concern 135 bacteremic patients who were treated with cefoxitin and evaluated is presented. Although information derived from septicemic patients is among the most difficult to interpret in regard to the efficacy of an investigational antibiotic, both our experience and the summary of data confirm that cefoxitin is a potent antibiotic suitable for use in septicemic patients when the etiologic agent is susceptible; the data also demonstrate that cefoxitin has a significantly expanded spectrum of activity as compared with that of cephalothin.
Cefoxitin↗
Epidemiology of cytomegalovirus infections.
The determinants of cytomegalovirus (CMV) infection and disease can now be understood from studies of newborns, recipients of organ or bone marrow transplants, subjects infected with human immunodeficiency virus, and recipients of blood transfusions. CMV is transmitted to the neonate transplacentally, by passage through a contaminated birth canal, or by ingestion of infected breast milk; to the adult by heterosexual and homosexual sex with an infected partner; and to the transplant recipient by infected organs. A major unsolved problem in the study of CMV is the nature of viral latency. Knowledge regarding the requirements for activation of latent infection at the molecular, cellular, or host level is incomplete. Both viral and host factors may contribute to the successful transmission of CMV by latently infected cells in transplanted organs and transfused blood.
Antibodies, Viral↗
Tolerance to the induction of interferons by endotoxin and virus: role of a humoral factor.
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Animals↗
Polymicrobial outbreak of intermittent peritoneal dialysis peritonitis during external wall renovation at a dialysis center.
OBJECTIVE: To investigate an outbreak of peritonitis in intermittent peritoneal dialysis (IPD) patients. DESIGN: An outbreak investigation was performed to identify the etiology of the polymicrobial outbreak, and a retrospective case-control study was conducted to assess the risk factors for development of peritonitis. SETTING: Renal dialysis center. PATIENTS: Ten episodes of peritonitis occurred in 8 of 61 patients over a 6-month period in which 669 IPD procedures were analyzed. INTERVENTIONS: Field visit to renal dialysis center to examine the entire IPD procedure, inspect the hospital environment, and perform air bacterial count. MAIN OUTCOME MEASURES: The environmental factors and risk factors contributing to the polymicrobial peritonitis outbreak in IPD patients. The incidence of IPD peritonitis was determined before and after interventions. RESULTS: The causative organisms included Acinetobacter baumanii (6), Stenotrophomonas maltophilia (2), Pseudomonas aeruginosa (1), Candida albicans (1), C. tropicalis (1), Enterococcus (3), and Enterobacteriaceae (2). Four episodes of peritonitis involved infection by more than one organism. Air sampling of the environment detected a median of 110 colony forming units of bacteria per cubic meter of air, 10% of which were found to be Acinetobacter baumanii. The source of this polymicrobial outbreak was attributed to the bamboo scaffolding structure covering the external wall of the hospital during renovation. A retrospective case-control study indicated that the absence of the flush-before-fill step was a risk factor for development of peritonitis. CONCLUSION: In addition to invasive aspergillosis in transplant or oncology patients, Acinetobacter peritonitis in dialysis patients should be considered another microbial cause of outbreak associated with hospital renovation.
Aged↗
Children's use of patient-controlled analgesia after spine surgery.
Using a convenience sample of children ranging in age from 10 to 19 years, a retrospective chart audit was conducted on those who received patient-controlled analgesia (PCA) following surgery. PCA was found to be safe, effective, and appropriate for most subjects.
Adolescent↗
Seasonal differences in serum vitamin D binding protein in exclusively breast-fed infants: negative relationship to sunshine exposure and 25-hydroxyvitamin D.
Vitamin D binding protein (DBP) is the major carrier for vitamin D and its metabolites in serum. DBP increases in pregnancy and decreases in cirrhosis; no seasonal variation has been reported in adults. We observed significant seasonal differences in 41 exclusively breast-fed infants who were less than 6 months of age. Winter DBP concentrations exceeded summer DBP concentrations: 398 +/- 22 versus 297 +/- 20 micrograms/ml (mean +/- SEM). The mean concentration for spring and fall was 329 +/- 25 micrograms/ml. Maternal DBP concentrations did not differ by season. A sunshine exposure score, previously verified, was used to document time and body surface exposed to the sun. DBP was inversely related to sun exposure (r = -0.46, p = 0.005). Infant DBP was significantly and negatively correlated with 25-hydroxyvitamin D concentrations (r = - 0.38, p = 0.02). We speculate that serum DBP fluctuations are a response to varying vitamin D needs: increased serum DBP occurs in low vitamin D status to maximize uptake of vitamin D from skin.
Breast Feeding↗
Induction of the interferon protein in the animal: general considerations.
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Animals↗
Factors influencing survival after gamma knife radiosurgery for patients with single and multiple brain metastases.
PURPOSE: Radiosurgery has been reported to yield high local control rates for brain metastases. However, further work is needed to define which subgroups of patients may benefit from this treatment modality. PATIENTS AND METHODS: We reviewed 116 patients who underwent stereotactic radiosurgery for initial management or recurrence of solitary or multiple brain metastases from September 1991 through December 1994 at the University of California, San Francisco. Survival time and time to local-regional failure were calculated using the Kaplan-Meier method. Univariate and multivariate analyses were performed using the Cox proportional hazards model. RESULTS: Median survival was 40 weeks from radiosurgery. In multivariate analysis, smaller total tumor volume, absence of extracranial metastases, higher Karnofsky score, and age < or = 70 had a positive effect on survival. In patients initially managed for brain metastases, the addition of whole brain radiotherapy to radiosurgery had no significant effect on survival. Although the presence of multiple metastases was associated with a significantly worse survival rate in patients initially managed with radiosurgery in univariate analysis, it was not as a significant factor in multivariate analysis. An analysis of patients within this series treated with radiosurgery who would have been eligible for Patchell's study on the role of surgery in the treatment of solitary brain metastasis revealed a favorable median survival of 70 weeks. CONCLUSIONS: We conclude that radiosurgical treatment of brain metastases results in survival times that compare favorably with the historic experience in patients treated with whole brain radiotherapy alone or with surgical resection. In patients presenting initially with brain metastases, radiosurgery alone may yield survival results equivalent to radiosurgery with whole brain radiotherapy, but intracranial control and quality of life also need to be evaluated. Also, the presence of multiple brain metastases should not be a contraindication for the use of radiosurgery given the good survival achieved with such patients in this series. Each such case should therefore be evaluated based on other factors such as patient's age, Karnofsky score and systemic disease.
Adolescent↗
Regulation of insulin-like growth factor binding protein-1 during the 24-hour metabolic clock and in response to hypoinsulinemia induced by fasting and Sandostatin in normal women.
OBJECTIVE: To establish the relation of insulin-like growth factor-I (IGF-I) and IGF-binding protein-1 (IGFBP-1) with 24-hour metabolic excursions in normal healthy women and in response to acute interruption of metabolic homeostasis by hypoinsulinemia. METHODS: Hourly blood samples during the 24-hour metabolic clock were obtained from seven normally cycling women. Uniform dietary composition (50% carbohydrate, 35% fat, and 15% protein) and timing of meals (8 AM, 12 PM, and 6 PM) were prescribed. Daytime hypoinsulinemia was induced by omitting meals and by Sandostatin (100 micrograms) administration. Changes in serum levels of glucose, insulin, cortisol, IGF-I, and IGFBP-1 were measured. RESULTS: The diurnal pattern of serum IGFBP-1 levels during the 24-hour metabolic clock was characterized by a rapid fall during the feeding phase of the day and a progressive 3.5-fold rise during nocturnal fasting; IGF-I levels were unchanged. Changes in IGFBP-1 levels were in parallel to those of cortisol and were inversely related to increases in glucose (80%) and insulin (tenfold) levels after each meal and to their decline during nocturnal fasting. Daytime fasting and administration of Sandostatin were accompanied by rapid and sustained increases in IGFBP-1 when insulin levels declined to 54 +/- 20 pmol/L. CONCLUSIONS: With constant levels of IGF-I, the diurnal rhythm of IGFBP-1 may subserve a physiologic function by coordinating insulin and IGF-I action with substrate availability. Fluctuations of insulin levels during the 24-hour metabolic clock in normal women appear to serve as a signal, with an inhibitory effect on IGFBP-1 production when levels are above 70 pmol/L and a stimulatory effect at levels below 70 pmol/L. These findings provide a basis for future investigations in women with nutritionally related reproductive disorders.
Adult↗