Biomedical subjects
Publications and source records attributed to M Hoffman.
Allo-anti-Chido (Ch) was detected in a patient whose red cells typed as Ch+. The C4 allotype of the patient was A4,B2 which associates strongly with the Ch phenotype Ch:1,-2,3,4,-5,6. Anti-Ch2 + Ch5 were the Ch specificities identified. Absence of only Ch2 and Ch5 determinants on the C4B protein allowed this unique immune response to blood transfusion.
Healthcare professionals, including physicians, nurses, and clergy, must know how to initiate the process of organ and tissue donation to fulfill a patient's or family's wishes and how to ensure that the organs and tissues recovered by transplant teams are medically acceptable. After Oct. 1, 1987, federal law requires that hospitals have an organ donation policy and a mechanism in place for contacting an organ procurement agency (OPA). Non-compliance could affect Medicare and Medicaid reimbursement. An OPA is responsible for educating its referral hospitals about donor criteria, the national donor-recipient matching system, and how to discuss donation with grieving families. As part of this process, healthcare professionals can be involved in formal educational sessions that address the following questions: What is meant by "organ" and "tissue"? Who can be an organ or tissue donor? Do healthcare professionals need to be able to recognize a potential donor and handle everything on their own? What procedures are followed in initiating the discussion about donation with the family? How should one offer the option of organ and tissue donation to a bereaved family? What are some common family concerns and questions? What does donor maintenance entail? What happens in the operating room? Is there any follow-up after transplantation?
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An 18-year-old patient who had recurrent attacks of acute pancreatitis was found on endoscopic retrograde cholangiopancreatography to have an aberrant pancreatic duct which communicated with a juxtagastric cyst. Excision of a gastric antral duplication cyst and the aberrant pancreas was curative. Of the five previously reported cases, none of which had endoscopic retrograde cholangiopancreatography before surgery, all but one required multiple operations before the correct diagnosis was made.
Antithrombin III (ATIII) is an anticoagulant protein which binds and inactivates thrombin and other serine proteinases. Little is known about regulation of its synthesis. We confirm that ATIII is synthesized by isolated rat hepatocytes, and that its synthesis is not altered by direct feedback of its complexes with proteinases. Neither is hepatocyte synthesis of ATIII altered by supernatants from macrophages cultured in the presence of ATIII-proteinase complexes. However, culture of macrophages with fibrinogen fragment D results in production of a factor(s) in the macrophage supernatants which stimulates hepatic fibrinogen synthesis, as previously described, and also stimulates the synthesis of ATIII and alpha 1-proteinase inhibitor (alpha 1PI). Synthesis of albumin and rat alpha 2-macroglobulin (alpha 2M) is not (alpha 2M) is not altered. Culture of macrophages in the presence of bacterial endotoxin also results in release of a factor(s) into the medium which stimulates the same changes in hepatocyte protein synthesis. These results show for the first time a mechanism by which synthesis of ATIII can be regulated during coagulation and fibrinolysis.
The cost of treating postepisiotomy pain and edema with foam containing 1% hydrocortisone acetate and 1% pramoxine hydrochloride and a spray with 20% benzocaine was compared in 200 postpartum patients. Treatment with foam was demonstrated to be more effective than benzocaine spray with greater pain relief and reduction of edema as shown by lower patient need of supplemental pain-relief measures. Treatment with foam was also determined to be less expensive than benzocaine spray when the cost of the supplemental pain-relief measures for benzocaine-treated patients were assessed. Methods used to determine actual hospital costs are presented, and supplemental pain relief treatments are discussed. Use of this type of cost analysis may be useful to the P & T Committee when determining actual cost-effectiveness of different treatment modalities.
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Affiliation preferences among 100 Israeli out-patients with major illness were assessed in waiting room interviews. Patients preferred healthy others over being with fellow sufferers or alone, and avoided illness as a discussion topic. Secondary preference for being alone rather than with co-patients rose slightly with reported anxiety. Findings contradict the emotional comparison hypothesis that misery seeks out co-sufferers.
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In order to obtain a more accurate picture of the prevalences of anaemia, iron deficiency anaemia, haematological iron deficiency and diminished iron stores, 240 Cape Coloured infants from the lower socio-economic groups were studied. Anaemia was diagnosed in 42 infants (17,5%), iron deficiency anaemia in 81 (34%), and haematological iron deficiency in 28%; 64 (27%) showed evidence of diminished iron stores. The findings indicate that iron deficiency was a common problem in the infants studied, and the same probably also applies to the community at large.
The reported incidence of hypotension after carotid reconstruction ranges from 21 to 50 percent. To evaluate baroreceptor dysfunction, 283 carotid reconstructions were studied. During 181 consecutive reconstructions, a transcutaneous Teflon catheter was positioned intraoperatively at the carotid bifurcation for postoperative injection of lidocaine as necessary. Of 283 reconstructions, 210 (74 percent) were not followed by hypotension. In the remaining 73 (26.5 percent), hypotension (systolic blood pressure less than 100 mm Hg) was seen. In 14 of the 73 cases of hypotension, vasoactive drugs, atropine, or a fluid bolus was administered with variable responses. In 27 of the 73, no treatment was instituted. In the remaining cases of hypotension, treatment consisted of 1 to 2 ml of lidocaine administered through the catheter. A prompt increase in systolic blood pressure from 93 to 139 mm Hg (means) within 30 minutes of treatment occurred in 29 of the 32 cases (91 percent). These data currently support routine catheter placement.
Monoclonal antibody panels selected in this and preceding studies were employed to begin to characterize the properties of human cytomegalovirus (CMV) glycoproteins. The results were as follows. (i) Four antigenically distinct CMV glycoproteins designated as gA, gB, gC, and gD have been identified. (ii) gA, gC, and gD each form several bands when immune precipitated from infected cell extracts by the corresponding monoclonal antibodies and electrophoretically separated in sodium dodecyl sulfate-polyacrylamide gels. In contrast, gB migrated at one broad band with an apparent molecular weight in the range of 116,000 to 123,000. Bands with different molecular weights were shown to share antigenic determinants by reactivity of monoclonal antibodies with electrophoretically separated polypeptides immobilized on nitrocellulose. (iii) A panel of 16 monoclonal antibodies to gA precipitated a family of glycoproteins 160,000-148,000, 142,000, 138,000, 123,000-107,000, 95,000, and 58,500 in apparent molecular weight designated as gA1 through gA6, respectively. (iv) To identify partially glycosylated precursors of gA, infected cells were treated with tunicamycin or deoxyglucose and reacted with different monoclonal antibodies. Tunicamycin-treated infected cells labeled for a short pulse or longer intervals contained only gA5. Whereas cells treated with deoxyglucose during a pulse contained gA4, those labeled for a longer interval contained gA6 and an additional band approximately 56,500 in apparent molecular weight designated gA7. (v) Precipitates of gA from infected cells labeled for a short pulse contained gA2 and gA3 which appear to be products of rapid glycosylation. After a chase, trace amounts of gA1 and gA6 were also precipitated suggesting that these are products of slow post-translational processing. (vi) Endo-beta-N-acetylglucosaminidase H was used to identify the forms of gA which contain high-mannose oligosaccharide chains. After treatment, the electrophoretic mobility of gA2, gA3, and gA6 increased significantly suggesting that these forms contain high-mannose chains cleaved by the enzyme. A hypothesis for processing gA is presented.
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