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Biomedical subjects

P Ray

Publications and source records attributed to P Ray.

At least 91 records · Page 5Linked to original sources
PubMed1996

Clinical experience with preimplantation genetic diagnosis of cystic fibrosis (delta F508).

Preimplantation genetic diagnosis (PGD) was attempted in 12 couples in whom both parents carry the common delta F508 deletion causing cystic fibrosis (CF). In vitro fertilization (IVF) was followed by cleavage stage biopsy on days 2 and 3 and removal of one or two cells for genetic analysis by nested polymerase chain reaction (PCR) and heteroduplex formation. A total of 18 cycles resulted in 137 normally fertilized embryos, of which 115 developed to cleavage stages and 114 were successfully biopsied. Genetic analysis was successful in 83 embryos (73 per cent). With the remaining embryos, either results from two or more cells were discordant or amplification failed. In 15 cycles, one or two either normal or carrier embryos were transferred and five (33 per cent) clinical pregnancies were established. Five singletons have been born and at birth all five babies have been confirmed as homozygous for the normal allele. Our experience demonstrates that IVF and cleavage stage biopsy consistently provides sufficient embryos, diagnosed as unaffected, for transfer in this autosomal recessive disease and that pregnancy rates are comparable to those following IVF.

Adult↗
PubMed1996

A novel 70-kDa Triton X-114-soluble antigen of Plasmodium falciparum that contains interspecies-conserved epitopes.

In order to identify novel conserved integral membrane and other membrane-associated proteins of Plasmodium falciparum, lambda gt11-P. falciparum DNA library phages were immunoscreened with convalescent-phase mouse sera and rabbit antiserum against Triton X-114-soluble proteins of P. falciparum. One recombinant phage clone, L857, reacted with both of the antibody probes. Insert DNA (857 bp long) in L857 was 69% dA+dT rich and hybridized to a fragment of 1800 bp from mung bean nuclease-digested P. falciparum genomic DNA. The cloned parasite DNA did not show notable sequence homology with any known protein gene. The L857-encoded polypeptide, p34 (M(r) 34 kDa) was expressed in bacteria, fused to glutathione S-transferase (GST). The fusion peptide, GST-p34 (M(r) 62 kDa), was recognized by immune serum against Triton X-114-soluble antigens of P. falciparum and was reactive with anti-P. falciparum, anti-Plasmodium yoelii, and anti-GST sera. Rabbit antiserum raised against the fusion peptide recognized a 70-kDa protein from lysates of P. falciparum cells and a putative homologous 100-kDa protein from lysates of P. yoelii. The rabbit serum anti-fusion peptide antibodies bound to acetone-fixed P. falciparum-infected erythrocytes and, in immunofluorescent antibody tests, produced a punctate pattern of fluorescence suggesting that the 70-kDa native protein is associated with an apical organelle of the parasite.

Amino Acid Sequence↗
PubMed1996

Bacteriology of necrotizing infections of soft tissues.

BACKGROUND: Necrotizing infections of soft tissues (NIST) are being attributed to a large variety of organisms, besides the originally described beta-haemolytic Streptococcus. A detailed bacteriological study of these infections was thought worthwhile. METHODS: A prospective study of 55 patients with NIST was carried out. Analysis of surface swabs and debrided tissue for aerobic and anaerobic bacteria and fungal infection was performed. A detailed bacteriological profile was obtained in 50 patients. RESULTS: A total of 257 isolates (167 aerobic, 90 anaerobic) was obtained. One to nine strains of bacteria were isolated from each patient. Aerobic bacteria alone were isolated in 26 patients while the remaining patients grew both aerobic and anaerobic bacteria. Forty-two patients had at least one Gram-positive bacterium while 40 had at least one Gram-negative bacterium. Staphylococcus aureus was the organism isolated most frequently (52%), followed by Bacteroides fragilis (40%) and anaerobic cocci (38%). Group A beta-haemolytic streptococci were isolated in 16%. Blood cultures were positive in only eight patients. Fungal cultures were positive in six patients. Aspergillus fumigatus was the commonest pathogen. CONCLUSIONS: Necrotizing infections of soft tissues are polymicrobial and no single bacterium is associated with a specific clinical entity. Importance should be placed on early recognition and treatment of the disease rather than on isolation of bacteria.

Adolescent↗
PubMed1996

Would better adherence to guidelines improve childhood immunization rates?

OBJECTIVE: To evaluate the contribution of three provider practices to underimmunization of children with financial coverage for vaccines. DESIGN: Retrospective cohort study of children in a large health maintenance organization, based on computerized databases and chart review. SETTING: Large health maintenance organization in northern California. PATIENTS: The population included 24,268 children who had at least one immunization recorded in the health plan tracking system and had continuous health plan membership between 15 and 24 months of age in 1992 through 1993. The study group (N = 4691) were those who had missed one or more of the immunizations due during their second year. RESULTS: Most (57%) of the underimmunized children had made at least one clinic visit between 15 and 24 months of age. Among those underimmunized children who made well care visits, 90% had been partially immunized at the visit but had not been simultaneously given all vaccines for which they were eligible. When a provider did not give all possible vaccines simultaneously, there was a 9% chance that the child would go on to miss the remaining immunization. Simultaneous administration alone would have achieved full second year coverage of 30% of the underimmunized children in this population. Most underimmunized children (53%), including 35% of those children who had not made any well care visits, had made urgent visits between 15 and 24 months of age. Chart review of randomly sampled patients showed no obstacle or contraindication to immunization at 79% of urgent visits and at 71% of well care visits at which vaccines were withheld. A policy to use weekday urgent visits to promote immunization could potentially reach 27% of the underimmunized children. CONCLUSIONS: Provider practices play an important role in underimmunization of children who have insurance coverage for vaccines. Of the three guidelines evaluated, simultaneous administration of all possible vaccines has the greatest potential effectiveness to improve coverage rates in this population. Other guidelines, such as immunizing at urgent visits, are potentially effective but their costs and logistics need further study.

California↗
PubMed1996

Potential role of platelets and coagulation factors in the metastasis of prostatic cancer.

One of the common surgical procedures used in the management of prostate cancer is transurethral resection of the prostate in which the possibility of the escape of tumor cells and their encounter with the hemostatic system is reported to contribute to the threat of hematogenous dissemination. We are reporting about the role of the hemostatic system involving the platelets and coagulation factors in the dissemination process in a tumor model carrying Dunning's R3327 AT3 adenocarcinoma of the prostate whose metastatic behavior is similar to that of human prostatic cancer. Our data revealed that the number of circulating platelets dropped and their aggregation activity increased in tumor-bearing rats as compared to controls. Normal platelets when treated with tumor effusions and reacted with the exogenous aggregating agent collagen exhibited a significant increase in the aggregating activity suggesting that the tumor and its microenvironment were capable of activating the hemostatic system. Out of eight coagulation factors measured only factors XI and XII were significantly decreased in tumor-bearing rats. The role of platelets in the metastatic process is discussed.

Adolescent↗
PubMed1995

Improved biodistribution, tumor targeting, and reduced immunogenicity in mice with a gamma 4 variant of Campath-1H.

Radiolabeled antibodies have shown promise for the treatment of lymphoma and for solid tumor targeting. Campath-1H is a humanized monoclonal antibody that reacts with the CD52 antigen present on human lymphoid and myeloid cells. Campath-1H is a gamma1 (G1) isotype that induces lymphopenia via an Fc-mediated mechanism(s). Isotype switches were engineered, and the resulting antibodies were expressed in NS0 mouse myeloma cells and biosynthetically radiolabeled with [35S]methionine. The forms included G1, G4, and a G4 variant that contained alanine substitutions at (EU numbering) Leu-235, Gly-237, and Glu-318. All isotypes bound antigen equivalently as assessed by target cell binding in vitro. The G4 variant had a greatly reduced capacity to interact with Fc receptor by virtue of reduced binding to THP-1 human myeloid cells and by a 1000-fold increase in EC50 to intermediate antibody-dependent cellular cytotoxicity. The pharmacokinetics of the isotypes were compared in CD-1 (nu/nu) mice bearing an experimental antigen-expressing tumor. The plasma half-life and tumor uptake were increased for the G4 variant. The G4 variant showed significantly less spleen, liver, and bone uptake but similar uptake in the lung, kidney, and stomach and lower tissue-to-blood ratios. Immunogenicity was assessed after repeated monthly administrations of unlabeled antibody in BALB/c mice. A 50% reduction in the incidence of anti-globulin response was observed for the G4 variant. These properties suggest that antibodies with reduced Fc receptor interaction merit additional study as potential targeting vehicles relative to other isotypes for radioimmunotherapy or situations where diminished normal tissue binding contributes to efficacy.

Alemtuzumab↗
PubMed1995

The potential for normal tissue dose reduction with neoadjuvant hormonal therapy in conformal treatment planning for stage C prostate cancer.

PURPOSE: Preirradiation hormonal cytoreduction of prostate cancer has been proven to reduce exposure of normal structures by decreasing the size of the target volume. Dose-volume histogram (DVH) analysis, however, does not always appear to demonstrate a strong positive benefit with the use of neoadjuvant hormone therapy. This study analyzes various other factors influencing dose to normal organs, which may determine the success or failure of neoadjuvant hormonal therapy in achieving its goals. METHODS AND MATERIALS: Patients with bulky clinical Stage C adenocarcinoma of the prostate were given 3 months of hormone treatment consisting of oral Flutamide and monthly Zoladex injections prior to irradiation. Computerized tomography (CT) scans of the pelvis were obtained both prior to and following hormonal treatment. Treatment plans were generated by three-dimensional (3D) conformal treatment planning. The change in the volume of the prostate was assessed along with the percentage of prescribed dose delivered to the rectum and bladder. Various factors such as prostate size, bladder/rectum size, and organ shape were studied. Both dose-volume histograms (DVH) and dose-surface area histograms (DSH) were used for analysis. RESULTS: Six of seven patients had reduction in the size of their prostates. The mean volumes of the prostate before and after hormonal manipulation were 129.1 +/- 32.9 standard deviation (SD) cm3 and 73.0 +/- 29.5 SD cm3, respectively (p = 0.0059). The volume of rectum receiving 80% of the prescribed dose was reduced in five of seven patients from a mean of 83.2 to 59.9 cm3 (p = 0.045). The volume of bladder receiving 80% of the prescribed dose was also reduced in five out of seven patients from a mean of 74.5 to 40.2 cm3 (p = 0.098). Correlation between the size of the prostate and volume of rectum and bladder treated was not always consistent: greater reduction in prostate size did not necessarily result in large decreases in dose to bladder or rectum. The total size of the bladder and rectum were found to be important factors in normal tissue radiation exposure; the benefits of hormone therapy may be lost if the bladder and rectum are allowed to decrease in size. Also, the bladder may be prone to sagging into the pelvis of some patients following hormone therapy, resulting in a less optimal therapeutic ratio. CONCLUSION: Reduction in prostate size by neoadjuvant hormonal manipulation does decrease the amount of normal tissue irradiated in most patients. However, the correlation between the reduction in prostate size and amount of rectum or bladder treated is not linear if other variables are not controlled. Factors such as the shape of the organs, as well as the distensible nature of the bladder and rectum, play major roles in dose to normal tissues. These facts may mask the benefits of cytoreduction and could be obstacles in realizing consistent benefits from preirradiation hormonal treatment in the clinical setting if they are ignored.

Adenocarcinoma↗
PubMed1995

Activation of the interleukin-5 promoter by cAMP in murine EL-4 cells requires the GATA-3 and CLE0 elements.

Interleukin-5 (IL-5) plays a central role in the growth and differentiation of eosinophils and contributes to several disease states including asthma. Accumulating evidence suggests a role for cAMP as an immunomodulator; agents that increase intracellular cAMP levels have been shown to inhibit production of cytokines predominantly produced by T helper (Th) 1 cells such as IL-2 and interferon gamma (IFN-gamma). In contrast, the production of IL-5, predominantly produced by Th2 cells, is actually enhanced by these agents. In this report, we have performed transient transfection experiments with IL-5 promoter-reporter gene constructs, DNase I footprinting assays, and electrophoretic mobility shift assays to investigate the key regulatory regions necessary for activation of the IL-5 promoter by dibutyryl cAMP and phorbol esters in the mouse thymoma line EL-4. Taken together, our data demonstrate the critical importance of two sequences within the IL-5 5'-flanking region for activation by these agents in EL-4 cells: one, a highly conserved 15-base pair element present in genes expressed by Th2 cells, called the conserved lymphokine element 0 (CLE0; located between -53 and -39 in the IL-5 promoter), and the other, two overlapping binding sites for the transcription factor GATA-3 (but not GATA-4) between -70 and -59. Taken together, our data suggest that activation via the unique sequence combination GATA/CLE0 results in selective expression of the IL-5 gene in response to elevated levels of intracellular cAMP.

Animals↗
PubMed1995

Interleukin 4-inducible phosphorylation of HMG-I(Y) is inhibited by rapamycin.

The non-histone chromosomal protein HMG-I(Y) participates in repression of transcription directed by a promoter which confers interleukin 4 (IL-4)-inducible activation in transfected B cell lines. Metabolic labeling, phosphoamino acid analyses, and in vitro phosphorylation studies demonstrate that IL-4 induces serine phosphorylation of HMG-I(Y) in B lymphocytes. Phosphopeptide mapping shows that the predominant site of phosphorylation contains a casein kinase II consensus motif. The immunosuppressive agent rapamycin has been shown preferentially to inhibit IgE production by IL-4-treated human B cells. It is shown here that rapamycin inhibits both activation of the human germ line epsilon promoter by IL-4 and IL-4-inducible phosphorylation of HMG-I(Y). These findings demonstrate a rapamycin-sensitive pathway that transduces signals from the IL-4 receptor to nuclear factors that regulate inducible transcription. The affinity of normal nuclear HMG-I(Y) for DNA is increased by dephosphorylation in vitro, whereas in vitro kinase reactions using casein kinase II decrease recombinant HMG-I(Y) binding to DNA. These data further suggest a novel mechanism in which phosphorylation triggered by IL-4 or other cytokines could regulate the effects of HMG-I(Y) on gene transcription.

Amino Acid Sequence↗
PubMed1995

Infection of baboons with simian/human immunodeficiency viruses.

Baboons were evaluated for their utility to serve as a model for testing envelope-based vaccines against human immunodeficiency virus type 1 (HIV-1). The ability of HIV-1 strains IIIB, RF, and SF2 to infect baboons was compared with that of simian/human immunodeficiency virus (SHIV) recombinant viruses comprised of either HXB2 or SF2 env, tat, rev, and vpu genes inserted into the SIVmac239 backbone. Both SHIV recombinants replicated in baboon PBMC in vitro, while no evidence of replication was noted for HIV-1 strains (MN, IIIB, SF2). Infection of baboons in vivo correlated with the restriction of infection in vitro. Virus was recovered by cocultivation methods early after SHIV (HXBc2) infection of two baboons with seroconversion profiles that parallel those observed in simian immunodeficiency virus (SIV)mac-infected rhesus monkeys. One of two baboons inoculated with SHIV(SF2) also seroconverted within 4 weeks; however, the kinetics of infection in a second animal appeared much later, with seroconversion to gp120 not evident until 20 weeks and no virus recovery during 32 weeks following infection. Viral DNA was detected in the lymph nodes of the SHIV-inoculated animals by nested polymerase chain reaction (PCR) amplification. Histopathologic changes were evident in lymph nodes, yet no overt clinical disease was observed. When HIV-1 strains (IIIB, RF, and SF2) were inoculated into baboons, virus was not recovered and no seroconversion to the major HIV-1 antigens was observed. However, viral DNA from the lymph nodes of four animals inoculated with HIV-1 strains could be detected by nested PCR, indicating a persistent but diminutive infection of HIV-1. The baboon thus represents a new animal model for testing HIV-1 envelope-based vaccines including the evaluation of new immunogens, dosages, routes, and adjuvants that act in eliciting protective responses.

Animals↗
PubMed1995

Cloning of a differentially expressed I kappa B-related protein.

We have cloned a cDNA corresponding to a novel gene from a human epithelial cell line by subtractive hybridization and polymerase chain reaction techniques. This gene is expressed at the message level and at the protein level in a lung alveolar type II-like epithelial cell line but not in lung fibroblasts. In adult human tissues, the mRNA for this gene was detected only in the heart and the skeletal muscle, but not in the brain, placenta, whole lung, liver, or kidney. We have named this gene I kappa BR (for I kappa B-related) since its 52-kDa protein product has significant homology to the I kappa B family of proteins which function as inhibitory cytoplasmic retention proteins for the vertebrate rel/NF-kappa B transcription factors. Although the important role of NF-kappa B in gene activation in cells of the immune system is now well established, a similar role in other cell types or in vertebrate development is less clear. The deduced amino acid sequence of I kappa BR has the most significant homology to the Drosophila protein Cactus which inhibits the function of the NF-kappa B-like protein Dorsal. In electrophoretic mobility shift experiments, I kappa BR inhibited the ability of the p50:p65 NF-kappa B heterodimer to bind DNA. The DNA binding ability of the p50 homodimer but not the p65 homodimer was drastically inhibited by I kappa BR. In transfection experiments, overexpression of I kappa BR significantly inhibited NF-kappa B-dependent transcription from the Ig kappa enhancer. This new member of the I kappa B family of proteins, I kappa BR, may play an important role in regulation of NF-kappa B function in epithelial cells.

Amino Acid Sequence↗
PubMed1995

Western blot analysis of cerebrospinal fluid for detection of Aspergillus antigens.

Western-blot immunoassay of cerebrospinal fluid (CSF) specimens of patients with central nervous system (CNS) aspergillosis (3), CNS candidosis (1) and bacterial meningitis (2) was carried out using pooled serum from histopathologically proven deep-seated aspergillosis cases to detect unique antigenic fractions for aspergillosis in CSF. No reactivity was observed in patients with non-fungal meningitis. Four cross-reactive bands (40, 90, 200 and > 200 KD) were detectable in CSF from patients with both aspergillosis and candidosis of the CNS. Four additional bands (90-200 KD) were consistently present only in patients with aspergillosis. One prominent band (110 KD) was found only in the patient with aspergillosis who had a fatal outcome and raised the possibility of being a poor prognostic marker.

Adolescent↗
PubMed1995

Neoadjuvant chemotherapy of locally advanced non-small cell lung cancer.

Neoadjuvant chemotherapy was tested in non-small cell lung cancer in an attempt to increase the resectability of the tumor and to treat the microscopic metastatic disease known to be responsible for the majority of failures in surgically treated patients. This review deals with published trials. Most of them are feasibility studies in Stage III NSCLC. Obviously, the heterogeneity of eligibility criteria from one study to another prevents general conclusions on the usefulness of neoadjuvant chemotherapy. However, it is possible to conclude that neoadjuvant chemotherapy has an antitumor activity; the majority of the studies report a 60% objective response rate including a significant number of complete responses and a 50% complete resection rate. Neoadjuvant chemotherapy does not increase morbidity after surgery except when it is combined with preoperative radiation therapy. At the time of writing, one Phase III randomized study comparing neoadjuvant chemotherapy followed by surgery with surgery alone has been published. This study concludes that the combined modality treatment improves the survival of patients with locally advanced non-small cell lung cancer. Taken as a whole, the literature deserves further studies to determine the place of neoadjuvant chemotherapy in lung cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

[Evaluation of tumor response during chemotherapy of bronchial cancer].

Chemotherapy of lung cancer is still an experimental approach requiring careful evaluation. Tumour response (marker of anticancer activity) is not perfectly correlated to survival (marker of chemotherapy efficacy), but its evaluation remains a milestone inasmuch as reporting a wrong tumour response rate might lead to the rejection of active new treatments. This review deals with the method of tumour response measurements and its use during a chemotherapy protocol. Recommendations drawn from the analysis of the literature are: 1) to assess and classify all lesions which can be identified at the beginning of the treatment; 2) to define the target lesions, mainly the ones which can be bidimensionally measured; 3) to use the World Health Organization recommendations for reporting the overall response; 4) to confirm complete response by negative rebiopsies; 5) to avoid second fiberoptic bronchoscopy to patients with stable or progressive disease on CT-scan, and finally; 6) to assess response quality by evaluating response duration and improvement of quality of life.

Antineoplastic Agents↗
PubMed1995

Allelic drop-out and preferential amplification in single cells and human blastomeres: implications for preimplantation diagnosis of sex and cystic fibrosis.

Previously the diagnosis of sex and cystic fibrosis status has been studied on single cells using the polymerase chain reaction (PCR). It has been suggested that allelic drop-out (PCR failure of one allele) and/or preferential amplification (hypo-amplification of one allele) may contribute to poor reliability and misdiagnosis, although this remains controversial as some reports suggest that allelic drop-out does not occur. We investigated an improved method of diagnosing sex and cystic fibrosis in single cells using a new technology (fluorescent PCR) to determine the base level of PCR artefacts (allelic drop-out and preferential amplification) which, in combination with improved sensitivity, should improve PCR reliability and accuracy. Fluorescent PCR gives high reliability (approximately 97%) and accuracy rates (approximately 97%) in somatic cells for both sex and cystic fibrosis diagnosis and its lower detection threshold allows allelic drop-out and preferential amplification to be easily distinguished. We also achieved high reliability and accuracy in diagnosing cystic fibrosis in human blastomeres. This study confirms earlier reports of both allelic drop-out and preferential amplification in single cell analysis. We demonstrate that both allelic drop-out and preferential amplification occur in somatic cells and suggest these are separate phenomena. Preferential amplification appeared common in single cell PCR while allelic drop-out apparently occurred at random in each allele. Preferential amplification was mainly amplification of the larger allele. We suggest that some inaccuracy/misdiagnosis may be due to both preferential amplification as well as allelic drop-out. Other findings were variability in drop-out between PCR and that amplification of signals from human blastomeres may be linked to embryo quality. We suggest that allelic drop-out is dependent on the number of cells within the sample.

Alleles↗