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Biomedical subjects

P Stewart

Publications and source records attributed to P Stewart.

At least 55 records · Page 3Linked to original sources
PubMed1999

Effect of heparin-stimulated plasma lipolytic activity on VLDL APO B subclass metabolism in normal subjects.

Heparin given intravenously enhances lipolysis, although fasting lipids are not markedly altered in long-term administration. In the present study we investigated heparin-induced acute perturbation of VLDL subclass metabolism. Eight men were examined during a control study and during an 8.5 h infusion of heparin. 2H3-leucine was used as tracer and kinetic constants derived using a non-steady-state model. Heparin infusion increased both plasma lipoprotein and hepatic lipase activity and raised plasma FFAs two-fold (P < 0.001). The fractional catabolic rate (FCR) of VLDL1 apo B increased on heparin (25.7 +/- 4.2 and 10.8 +/- 1.7 pools/d, heparin vs. control, P < 0.02). The FCR of VLDL2 apo B increased to 12.6 +/- 1.9 pools/d on heparin vs. 8.8 +/- 1.1 pools/d during the control (NS). Total VLDL apo B production was not significantly changed (824 +/- 45 and 692 +/- 91 mg/d, heparin vs. control, NS). We conclude that during heparin infusion, the catabolism of especially large triglyceride-rich VLDL1 apo B is greatly increased. However, although the FFA levels were high during the heparin study, the production of total VLDL apo B did not rise. These findings are consistent with the known action of heparin on lipoprotein lipase but indicate that acute increase in plasma FFA levels does not lead to a rise in VLDL apo B production.

Adult↗
PubMed1999

Data needs for occupational epidemiologic studies.

Data needs in an epidemiologic study can appear to be substantial in light of the other responsibilities of an industrial hygienist. Many of the data needed for this type of investigation, however, are already collected for other exposure assessment purposes. To increase understanding of this concept, the data needs for the major purposes for conducting an exposure assessment are identified. The purposes include determining compliance; implementing industrial hygiene programs, such as personal protective and respiratory equipment, hazard communication training, and medical surveillance; investigating health complaints and worker concerns; investigating tasks or engineering control effectiveness; investigating toxic tort or worker compensation claims; and conducting epidemiologic studies. A comprehensive exposure assessment system is then described that incorporates the data needs for all these purposes, including epidemiologic studies. The data needs of epidemiologic studies and how the data are used are then described and illustrated with examples taken from published epidemiologic studies.

Data Collection↗
PubMed1999

A strategy for detection of viruses in groundwater by PCR.

We evaluated the use of the PCR for detection of enteric viruses in groundwater. To do this, we used an improved sample-processing technique and a large-volume amplification protocol. The objective of this study was to use advanced molecular techniques to develop a rapid and simple method which can be used by the water industry for detection of viral contamination in a variety of water samples. The strategy described here fulfills the water industry's need for a rapid, reliable, easily performed method for analyzing groundwater for virus contamination. Viruses were detected after concentration from at least 400 gallons (1,512 liters) of water by a filter adsorption and elution method, which resulted in a concentrate containing viruses. A total of 150 samples were analyzed by performing cell culture assays for enteroviruses and by performing reverse transcription PCR (RT-PCR) analyses for enteroviruses, hepatitis A virus, and rotavirus. Thirteen samples (8.7%) produced cellular cytopathic effects when the Buffalo green monkey cell line was used. When primers specific for enteroviruses were used in RT-PCR, 40 of 133 samples (30.1%) tested positive for the presence of enterovirus RNA. When hepatitis A virus-specific primers were used, 12 of 139 samples (8.6%) were considered positive for the presence of hepatitis A viral RNA. The RT-PCR analysis performed with rotavirus-specific primers identified 18 of 130 samples (13.8%) that were positive for rotavirus RNA sequences. Our sample-processing technique and large-volume PCR protocol (reaction volume, 300 microliter) resulted in sufficient removal or dilution of inhibitors so that more than 95% of the samples could be assayed by PCR. Because of its sensitivity for detecting viral nucleic acid sequences, PCR analysis should produce more positive results than cell culture analysis. Since either cell culture analysis or PCR can reveal only a "snapshot" of the quality of the groundwater being sampled, PCR seems to be a desirable rapid initial screening tool.

Animals↗
PubMed1999

Organization and differential regulation of a cluster of lignin peroxidase genes of Phanerochaete chrysosporium.

The lignin peroxidases of Phanerochaete chrysosporium are encoded by a minimum of 10 closely related genes. Physical and genetic mapping of a cluster of eight lip genes revealed six genes occurring in pairs and transcriptionally convergent, suggesting that portions of the lip family arose by gene duplication events. The completed sequence of lipG and lipJ, together with previously published sequences, allowed phylogenetic and intron/exon classifications, indicating two main branches within the lip family. Competitive reverse transcription-PCR was used to assess lip transcript levels in both carbon- and nitrogen-limited media. Transcript patterns showed differential regulation of lip genes in response to medium composition. No apparent correlation was observed between genomic organization and transcript levels. Both constitutive and upregulated transcripts, structurally unrelated to peroxidases, were identified within the lip cluster.

Carbon↗
PubMed1999

Challenges to retrospective exposure assessment.

Retrospective exposure assessment has become a crucial component in the interpretation of occupational epidemiologic results. Many advances have been made over the last 2 decades, but substantial progress is still necessary to reduce the misclassification of exposure. The efforts needed include evaluating the validity and reliability of assessment methods, better documentation of the methods, use of exposure determinants to estimate exposure levels more accurately and reliably, and an increase in the understanding of industrial hygiene and biological measurement data and questionnaires, their limitations, and how to use them best. In addition, better characterization of exposures is necessary. This need includes evaluating dermal and ingestion hazards, incorporating nonoccupational sources of exposures, particularly hobbies, evaluating the effect of multiple chemicals, and exploring different exposure metrics.

Data Collection↗
PubMed1999

Parental occupational exposure to hydrocarbons and risk of acute lymphocytic leukemia in offspring.

Parental exposure to hydrocarbons at work has been suggested to increase the risk of childhood leukemia. Evidence, however, is not entirely consistent. Very few studies have evaluated the potential parental occupational hazards by exposure time windows. The Children's Cancer Group recently completed a large-scale case-control study involving 1842 acute lymphocytic leukemia (ALL) cases and 1986 matched controls. The study examined the association of self-reported occupational exposure to various hydrocarbons among parents with risk of childhood ALL by exposure time window, immunophenotype of ALL, and age at diagnosis. We found that maternal exposure to solvents [odds ratio (OR), 1.8; 95% confidence interval (CI), 1.3-2.5] and paints or thinners (OR, 1.6; 95% CI, 1.2-2.2) during the preconception period (OR, 1.6; 95% CI, 1.1-2.3) and during pregnancy (OR, 1.7; 95% CI, 1.2-2.3) and to plastic materials during the postnatal period (OR, 2.2; 95% CI, 1.0-4.7) were related to an increased risk of childhood ALL. A positive association between ALL and paternal exposure to plastic materials during the preconception period was also found (OR, 1.4; 95% CI, 1.0-1.9). The ALL risk associated with parental exposures to hydrocarbons did not vary greatly with immunophenotype of ALL. These results suggest that the effect of parental occupational exposure to hydrocarbons on offspring may depend on the type of hydrocarbon and the timing of the exposure.

Adolescent↗
PubMed1998

Occupational risk factors and prostate cancer in U.S. blacks and whites.

Although prostate cancer is a major disease, causal factors are only partially understood. We examined occupational risk factors for this disease in a large case control study among U.S. blacks and whites. The study included 981 new pathologically confirmed prostate cancer cases (479 blacks and 502 whites) diagnosed between 1986 and 1989, and 1,315 population controls (594 blacks and 721 whites) who resided in Atlanta, Detroit, and 10 countries in New Jersey, covered by population-based cancer registries. Information on occupation, including a lifetime work history, was collected by in-person interview. No clear patterns of risk were found for U.S. whites versus blacks, nor for white-collar versus blue-collar jobs. Farming was related to prostate cancer (OR = 2.17; 95% CI = 1.18-3.98). Risk was restricted, however, to short-term workers and workers in crop production. Risk was not limited to those farming after 1950, when widespread use of pesticides started. Risks increased with increasing years of employment in firefighting (chi 2trend, p = 0.02) and power plant operations (chi 2trend, p = 0.03), and were elevated among long-term railroad line-haulers (OR = 5.85; 95% CI = 1.25-27.4); jobs with potential polycyclic aromatic hydrocarbon (PAH) exposures. Risk was elevated among athletes (OR = 5.38; 95% CI = 1.48-19.6). However, most of the cases were athletes before 1960, so the potential use of anabolic steroids was excluded. Although some clues about potential occupational associations were found, the overall results show that occupation is not a major determinant of prostate cancer risk.

Black or African American↗
PubMed1998

Diet design for a multicenter controlled feeding trial: the DELTA program. Delta Research Group.

OBJECTIVE: To describe the process and results of diet standardization, diet validation, and monitoring of diet composition, which were key components of protocol 1 of Dietary Effects on Lipoproteins and Thrombogenic Activity (DELTA-1), the initial protocol in a program of multicenter human feeding studies designed to evaluate the effects of amount and type of fat on lipoproteins and hemostasis parameters in various demographic groups. DESIGN: DELTA-1 was based on a randomized, blinded, crossover experimental design. Three diets were fed for 8 weeks to 103 healthy men and women aged 22 to 67 years at 4 field centers. Diet A, an average American diet, was designed to provide 37% of energy from fat, 16% of energy from saturated fatty acids (SFAs); diet B (step 1 diet) was designed to provide 30% of energy from fat, 9% of energy from SFA; and diet C (low SFA diet) was designed to provide 26% of energy from fat, 5% of energy from SFA. Key features of diet standardization included central procurement of fat-containing foods, inclusion of standard ingredients, precision weighing of foods--especially sources of fat and cholesterol--and use of standardized written procedures. SETTING: For menu validation, a set of 12 menus for each diet was prepared in duplicate and chemically assayed. For monitoring of diet composition during the study, an 8-day diet cycle (6 weekday and 2 weekend menus) was sampled by every field center twice during each of 3 feeding periods. STATISTICAL ANALYSES: Means (+/- standard error) were calculated and compared with target nutrient specifications. RESULTS: DELTA-1 was able to provide a standardized diet that met nutrient specifications across 4 field centers over 24 weeks of participant feeding spanning a total of 8 months. APPLICATIONS: Prestudy chemical validation of menus and continuous sampling and assay of diets throughout the study are essential to standardize experimental diets and to ensure that nutrient target goals are met and maintained throughout a controlled multicenter feeding study.

Adult↗
PubMed1998

N-terminal sequence polymorphism in the coagulase gene of Staphylococcus aureus and its potential use as an epidemiological marker.

N-terminal DNA sequences of the coagulase gene were amplified from Staphylococcus aureus strain ISP8 (NCTC 8325-4) DNA using the polymerase chain reaction. The amplified DNA product (984 bp) was used to probe SmaI and DraI digested total DNA of methicillin- and multi-resistant S. aureus (MRSA) type strains, methicillin-sensitive S. aureus (MSSA) clinical isolates, and community (commensal) isolates. A SmaI fragment of a similar size in all the isolates examined hybridized with the coagulase gene fragment probe. All MRSA isolates, representing closely related (clonal) types, revealed identical coagulase hybridization patterns with DraI digested DNA. MSSA and community isolates closely related to ISP8 by SmaI fragment analysis shared closely related DraI/coagulase hybridization patterns, differing from that identified for the MRSAs. In contrast, the community and MSSA isolates not related to ISP8 as judged by total SmaI fragment polymorphisms, were also diverse in their DraI/coagulase hybridization patterns. In addition, the intensity of the hybridization signal obtained with the MRSA isolates varied significantly (less than) from the other isolates, indicating the presence of multiple and probably different coagulase genes between the isolates. The findings reported here indicate that hybridization analysis using single genes as DNA probes is less discriminant than restriction fragment length polymorphism analysis of the total genome of different isolates.

Biomarkers↗
PubMed1998

A comparison of medical and surgical termination of pregnancy: choice, emotional impact and satisfaction with care.

OBJECTIVE: To investigate whether women having medical or surgical terminations of pregnancy differ in their emotional distress before or after the procedure. To evaluate whether choice of procedure occurs, the factors influencing type of procedure and the effect of choice on emotional responses and satisfaction with care. DESIGN: A prospective comparative study. SETTING: A termination of pregnancy unit in a University Teaching Hospital. PARTICIPANTS: Two hundred and seventy-five women attending for medical or surgical first trimester termination of pregnancy. METHODS: Interviews concerning choice and measures of emotional status were completed prior to terminations. Four weeks after termination emotional functioning was reassessed together with satisfaction with care. RESULTS: Women having a surgical termination waited longer for the procedure and were at more advanced gestation than those having the medical termination. There were no differences in emotional responses related to type of procedure or gestation. One-quarter remained highly anxious at four weeks. Medical and surgical groups did not differ in emotional status prior to termination. Those having the medical procedure rated it as marginally more stressful and experienced more post-termination physical problems and disruption to life. Seeing the fetus was associated with more intrusive events (nightmares, flashbacks, unwanted thoughts related to the experience). One-quarter of the medical and 67% of the surgical group reported having no choice in type of procedure. Only 53% of the medical group would choose the same procedure again compared with 77% of the surgical group. CONCLUSIONS: Termination method did not influence emotional adjustment. Many women were not offered genuine choice of procedure. Having choice was considered very important but was unrelated to emotional distress or satisfaction with care.

Abortifacient Agents↗
PubMed1998

Effects of reducing dietary saturated fatty acids on plasma lipids and lipoproteins in healthy subjects: the DELTA Study, protocol 1.

Few well-controlled diet studies have investigated the effects of reducing dietary saturated fatty acid (SFA) intake in premenopausal and postmenopausal women or in blacks. We conducted a multicenter, randomized, crossover-design trial of the effects of reducing dietary SFA on plasma lipids and lipoproteins in 103 healthy adults 22 to 67 years old. There were 46 men and 57 women, of whom 26 were black, 18 were postmenopausal women, and 16 were men > or =40 years old. All meals and snacks, except Saturday dinner, were prepared and served by the research centers. The study was designed to compare three diets: an average American diet (AAD), a Step 1 diet, and a low-SFA (Low-Sat) diet. Dietary cholesterol was constant. Diet composition was validated and monitored by a central laboratory. Each diet was consumed for 8 weeks, and blood samples were obtained during weeks 5 through 8. The compositions of the three diets were as follows: AAD, 34.3% kcal fat and 15.0% kcal SFA; Step 1, 28.6% kcal fat and 9.0% kcal SFA; and Low-Sat, 25.3% kcal fat and 6.1% kcal SFA. Each diet provided approximately 275 mg cholesterol/d. Compared with AAD, plasma total cholesterol in the whole group fell 5% on Step 1 and 9% on Low-Sat. LDL cholesterol was 7% lower on Step 1 and 11% lower on Low-Sat than on the AAD (both P<.01). Similar responses were seen in each subgroup. HDL cholesterol fell 7% on Step 1 and 11% on Low-Sat (both P<.01). Reductions in HDL cholesterol were seen in all subgroups except blacks and older men. Plasma triglyceride levels increased approximately 9% between AAD and Step 1 but did not increase further from Step 1 to Low-Sat. Changes in triglyceride levels were not significant in most subgroups. Surprisingly, plasma Lp(a) concentrations increased in a stepwise fashion as SFA was reduced. In a well-controlled feeding study, stepwise reductions in SFA resulted in parallel reductions in plasma total and LDL cholesterol levels. Diet effects were remarkably similar in several subgroups of men and women and in blacks. The reductions in total and LDL cholesterol achieved in these different subgroups indicate that diet can have a significant impact on risk for atherosclerotic cardiovascular disease in the total population.

Adult↗
PubMed1998

Effects of insulin and acipimox on VLDL1 and VLDL2 apolipoprotein B production in normal subjects.

The objective of the study was to examine the potential differential effect of insulin and acipimox (both of which reduce free fatty acid [FFA] availability) on VLDL apolipoprotein (apo) B metabolism. We studied eight healthy men (age 40 +/- 4 years, BMI 25.8 +/- 0.9 kg/m2, plasma triglycerides 1.30 +/- 0.12 mmol/l) after an overnight fast (control study, n = 8), during inhibition of lipolysis with an antilipolytic agent, acipimox (n = 8), and under 8.5-h euglycemic-hyperinsulinemic conditions (n = 5). Plasma FFAs were similarly suppressed in the acipimox and insulin studies (approximately 70% suppression). 2H3-leucine was used to trace apo B kinetics in VLDL1 and VLDL2 subclasses (Svedberg flotation rates: 60-400 and 20-60), and a non-steady-state multicompartmental model was used to derive the kinetic constants. The mean rate of VLDL1 apo B production was 708 +/- 106 mg/day at the beginning and 602 +/- 140 mg/day at the end of the control study. Production of the lipoprotein decreased to 248 +/- 93 mg/day during the insulin study (P < 0.05 vs. control study) and to 375 +/- 92 mg/day (NS) during the acipimox study. Mean VLDL2 apo B production was significantly increased during the acipimox study (399 +/- 42 vs. 236 +/- 27 mg/day, acipimox vs. control, P < 0.05) but not during the insulin study (332 +/- 51 mg/day, NS). The fractional catabolic rates of VLDL1 and VLDL2 apo B were similar in all three studies. We conclude that acute lowering of FFAs does not change the overall production rate of VLDL particles, but there is a shift toward production of smaller and denser VLDL2 particles, and, thus, the amount of total VLDL particles secreted remained constant. Insulin acutely suppresses the total production rate of VLDL apo B by decreasing the production of large triglyceride-rich VLDL1 particles. Based on these findings, we postulate that insulin has a direct suppressive effect on the production of VLDL apo B in the liver, independent of the availability of FFAs.

Adult↗
PubMed1997

Marrow transplantation for chronic myeloid leukemia: the influence of plasma busulfan levels on the outcome of transplantation.

The influence of busulfan (BU) plasma concentration on outcome of transplantation from HLA identical family members for the treatment of chronic myelogenous leukemia (CML) was examined in 45 patients transplanted in chronic phase (CP) (n = 39) or accelerated phase (AP) (n = 6). All patients received the same regimen of BU, 16 mg/kg orally and cyclophosphamide (CY), 120 mg/kg intravenously. Plasma concentrations of BU at steady state (C(SS)BU) during the dosing interval were measured for each patient. The mean C(SS)BU was 917 ng/mL (range, 642 to 1,749; median, 917; standard deviation, 213). Of patients with C(SS)BU below the median, seven (five of 18 in CP and two of four in AP) developed persistent cytogenetic relapse and three of these patients died. There were no relapses in patients with C(SS)BU above the median. The difference in the cumulative incidence of relapse between the two groups was statistically significant (P = .0003). C(SS)BU was the only statistically significant determinant of relapse in univariable or multivariable analysis. The 3-year survival estimates were 0.82 and 0.64 for patients with C(SS)BU above and below the median (P = .33). There was no statistically significant association of C(SS)BU with survival or nonrelapse mortality, although the power to detect a difference in survival between 0.82 and 0.64 was only 0.24, similarly C(SS)BU above the median was not associated with an increased risk of severe regimen-related toxicity. We conclude that low BU plasma levels are associated with an increased risk of relapse.

Adult↗
PubMed1997

O6-alkylguanine DNA alkyltransferase activity in student embalmers.

O6-Alkylguanine-DNA alkyltransferase (AGT) activity was assessed in peripheral blood lymphocytes among 23 mortuary science students before and after 9 weeks in a laboratory course in techniques of embalming. Formaldehyde exposure was established by environmental monitoring. The average air concentration of formaldehyde during embalming was about 1.5 ppm. At the pre-exposure sampling, baseline DNA repair capacity tended to be reduced in subjects who reported a prior history of embalming (p = 0.08). From pre- to post-exposure, 17 subjects decreased in DNA repair capacity, while only 6 increased (p < 0.05). Analysis of variance, including adjustment for age, sex, and smoking status, confirmed these findings. Among the eight subjects who had no embalming experience during the 90 days before study, seven had decreased and one had increased AGT activity during the period of study (p < 0.05). For those with prior embalming experience, 10 subjects decreased in AGT activity, while 5 increased (p < 0.05). Although the major chemical exposure in embalming practice was to formaldehyde, no clear link was established between amount of formaldehyde exposure and AGT activity.

Adult↗
PubMed1997

Defective regulation of triglyceride metabolism by insulin in the liver in NIDDM.

Insulin administration to healthy subjects inhibits the production of very low density lipoprotein (VLDL)1 (Svedbergs flotation (Sf) rate 60-400) without affecting that of VLDL2 (Sf 20-60) sub-class. This study was designed to test whether this hormonal action is impaired in non-insulin-dependent diabetes mellitus (NIDDM). We studied six men with NIDDM (age 53 +/- 3 years, body mass index 27.0 +/- 1.0 kg/m2, plasma triglycerides 1.89 +/- 0.22 mmol/l) during an 8.5 h infusion of saline (control) and then in hyperinsulinaemic (serum insulin approximately 540 pmol/l) conditions during 8.5 h infusions of glucose and insulin to give either hyper- and normoglycaemic conditions. [3-2H]-leucine was used as tracer and kinetic constants derived using a non-steady-state multicompartmental model. Compared to the control study, patients with NIDDM reduced VLDL1 apo B production by only 3 +/- 8% after 8.5 h of hyperinsulinaemia (701 +/- 102 vs 672 +/- 94 mg/day respectively, NS) in hyperglycaemic conditions and by 9 +/- 21% under normoglycaemic conditions (603 +/- 145 mg/day). In contrast, in normal subjects insulin induced a 50 +/- 15% decrement in VLDL1 apo B production (p < 0.05). Direct synthesis of VLDL2 apo B in patients with NIDDM was not markedly affected by insulin. We conclude that a contributory factor to hypertriglyceridaemia in NIDDM is the inability of insulin to inhibit acutely the release of VLDL1 from the liver, despite efficient suppression of serum nonesterfied fatty acids.

Apolipoproteins B↗