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Biomedical subjects

R A Levy

Publications and source records attributed to R A Levy.

At least 55 records · Page 3Linked to original sources

IgG but not IgM anti-phospholipid antibody binding is temperature dependent.

We examined the effect of temperature on the measurement of enzyme-linked immunosorbent assay (ELISA)-defined human polyclonal antiphospholipid antibody. Both IgG and IgM antibodies were easily demonstrable when sera were incubated on phospholipid-coated ELISA plates at 4-22 degrees C. When incubations were done at 37-45 degrees C IgG antibody binding markedly decreased but IgM antibody binding did not. Warming the phospholipid-coated ELISA plate alone, the serum alone, the buffer alone, or the blocking reagent alone had no effect. When the antigen content of the wells was increased fourfold the effect of warming still occurred. The effect of warmth was reversible and was seen with affinity-purified antibody as well as with whole serum. Phospholipid vesicles in suspension, however, absorbed antibody in a dose-dependent fashion at 4, 22, and 42 degrees C. These results indicate that antibody binding to phospholipid is temperature dependent when phospholipid is adherent to the solid phase. Whether the change in IgG-phospholipid interaction results from a change in antigen or in antibody remains unknown.

Antigen-Antibody Reactions↗

A method for the recovery of mishap related events lost to amnesia.

The author describes a non-hypnotic, non-pharmacologic method employed in the recovery of memories blocked by amnesia following an aircraft accident. A detailed account of the method used during the investigation of two mishaps is provided. Memories were fully recovered. In addition, a description of the use of this technique in enhancing the recall of a witness to a fatal aircraft accident is provided.

Accidents, Aviation↗

Herpes simplex virus testing of an obstetric population with an antigen enzyme-linked immunosorbent assay.

Commercial herpes simplex virus antigen enzyme-linked immunosorbent assay kits were compared to conventional culture for herpes simplex virus with 3237 genital specimens from obstetric patients. These rapid enzyme-linked immunosorbent assay tests had a sensitivity of 34.3% and specificity of 98.1% with primarily cervical specimens from asymptomatic patients. Specimens from vulvar swabs had higher positive rates than those from cervical swabs from the same patient, whether symptomatic or asymptomatic with both culture and enzyme-linked immunosorbent assay. Fifty-six women had enzyme-linked immunosorbent assay false positive tests; use of enzyme-linked immunosorbent assay testing alone could have resulted in 1.7% unnecessary cesarean deliveries. Six cases of neonatal herpes simplex virus infection were identified; two of the mothers had negative cervical cultures the week of delivery preceded by positive vulvar cultures.

Amniotic Fluid↗

Long-term changes in cholesterol biosynthesis and the effect of plasmapheresis therapy in a hypercholesterolemia homozygote.

Synthesis of cholesterol was measured in a familial hypercholesterolemia homozygote on four occasions from age 1.1 to 9.9 years by the sterol balance technique. Both the fecal neutral steroid and fecal bile acid components of sterol balance were elevated initially. Over the decade of study, neutral steroid excretion/kg declined 61% whereas bile acid excretion/kg was unchanged. Chronic plasmapheresis therapy every two weeks for 3.4 years reduced plasma low-density lipoprotein cholesterol 54% but had little effect on the rate of cholesterol biosynthesis.

Bile Acids and Salts↗

Comparison of two commercial enzyme-linked immunosorbent assays for detection of herpes simplex virus antigen.

Two commercial enzyme-linked immunosorbent assays (ELISA) for detection of herpes simplex virus (HSV) antigen in direct clinical specimens were compared with cell culture in primary rabbit kidney and MRC-5. With a total of 238 specimens, the sensitivity and specificity of the Dako ELISA method were determined to be 70.1% and 82.4%, respectively, and 60.4% and 88.2%, respectively, for the Ortho Antigen ELISA.

Antigens, Viral↗

Evaluation of the modified Chlamydiazyme immunoassay for the detection of chlamydial antigen.

The modified Chlamydiazyme enzyme immunoassay (EIA) was compared with McCoy cell culture with 336 paired genital swabs collected from patients attending gynecology and urgent care clinics and transported to the regional laboratory for testing. Of the 299 female and 37 male genital specimens, 47 (15.7%) cervical and 14 (37.8%) urethral specimens were positive. All 60 specimens positive for Chlamydia trachomatis also were EIA reactive (sensitivity, 100%). The specificity was 91.3%, with 24 paired swab specimens positive by EIA only. A number of factors may have contributed some culture false negatives, as 91.7% of the EIA only positive patients were symptomatic. The reproducibility of the EIA method was evaluated with different washing technics. The Chlamydiazyme EIA was found to be a cost-effective, rapid, and sensitive test for detection of chlamydial antigen in genital specimens.

Adolescent↗

Diversity in expression of heterozygous familial hypercholesterolemia. Characterization of a unique kindred.

Clinical and biochemical characteristics of familial hypercholesterolemia (FH) heterozygotes possessing an abnormally high molecular weight low density lipoprotein receptor (HMWR) are reported. The disorder is transmitted as an autosomal dominant trait and is not distinguishable from classic heterozygous FH on clinical grounds. The average plasma low density lipoprotein (LDL) level is 360 mg/dl and tendon xanthomata and early coronary disease are present. LDL receptor activity is higher than expected. In skin fibroblast cultures two types of functional LDL receptors are present, one with a normal apparent native molecular weight of 140,000, and the other of 176,000. When immobilized on nitrocellulose paper both receptors bind LDL. Maximum 125I-LDL binding capacity of fibroblast monolayers is reduced only 20%, compared with 50% in typical heterozygous FH. Affinity for 125I-LDL is increased and a 38% reduction in the Michaelis constant for LDL is observed. When autologous 125I-LDL was injected intravenously, the fractional catabolic rate of LDL was 205% and the LDL apoprotein B production rate was 328% of that found in a typical heterozygous FH subject. Thus, both in vitro and in vivo testing indicated only a modest deficiency of LDL receptor activity. Kindred members possessing the HMWR had an associated abnormality of cholesterol biosynthesis. Cholesterol balance studies in three individuals with the HMWR trait demonstrated elevated cholesterol biosynthesis of two to three times the mean of normal subjects. These findings suggest that increased LDL production and increased cholesterol production may assume a significant role in the pathologic manifestations of heterozygous FH. Functional abnormalities in LDL receptor activity as measured in fibroblast culture may be relatively small.

Apolipoproteins B↗

Comparison of two transdermal nitroglycerin systems.

In a study conducted by office-based cardiologists at eight sites, 115 patients using transdermal nitroglycerin for treatment of angina pectoris participated in a four-week comparison of two transdermal nitroglycerin patches: Transderm-Nitro (TDN) and Nitro-Dur II (ND II). Patients wore two patches, one of each brand, each with half their normal prescribed daily dose of 10 mg (release rate per 24 hours) to compare patch adherence properties, patient preference, and local side effects. More ND II than TDN patches fell off (5% versus 0.1%), and fewer TDN than ND II patches became loose (1.7% versus 8.4%); 98.2% of the TDN and 86.7% of the ND II patches adhered totally. Significantly more patients expressed a preference for TDN over ND II in four of eight assessment variables, including the choice of their next prescription. The frequency of problems at the site of patch application was similar with both patches.

Adhesiveness↗

The effects of amphotericin B on lipid metabolism in cultured human skin fibroblasts.

Amphotericin B inhibits hydroxymethylglutarylcoenzyme A (HMGCoA) reductase activity and incorporation of [3H]acetate into sterols and fatty acids of human skin fibroblasts. Delivery of cholesterol to cells via the low density lipoprotein receptor pathway is not altered. The effects of amphotericin B on cell lipid metabolism are partially reversed by both potassium and insulin.

Amphotericin B↗

Use of sonication for viral isolation.

A viral passage method using sonication to obtain cell-free virus was compared with the conventional viral cell culture passage technic. The recovery of 121 varicella zoster virus and cytomegalovirus isolates in human fibroblast vials from sonicated versus nonsonicated passage suspensions was studied. These fibroblast vials with cytopathic effect were identified using monoclonal fluorescent antisera. Twenty-eight (29%) of cytomegalovirus isolates were recovered only from sonicated passages, and an additional 28 isolates had faster recovery and/or a greater number of viral plaques from sonicated passages. Sonication did not increase significantly the varicella zoster virus recovery rate.

Antibodies, Monoclonal↗

Comparison of sonicated and nonsonicated specimens for the isolation of Chlamydia trachomatis.

Cultures of sonicated and nonsonicated chlamydial specimens were compared using a Heat Systems sonicator with a cup-horn attachment for sonication. Chlamydial inclusions were detected in 71 of 780 cultures tested; 44 (62%) were positive from both, while 12 (16.9%) were positive in nonsonicated only, and 15 (21.1%) in sonicated specimens only. The mean number of inclusions from sonicated specimens was more than double that from nonsonicated specimens. The cultures of sonicated specimens could be screened more quickly because of statistically significant higher inclusion counts, less toxicity, and the absence of overlying epithelial cells.

Bacteriological Techniques↗

Self-control of psychophysiologic response to motion stress: using biofeedback to treat airsickness.

Investigators of the Neuropsychiatry Branch, Clinical Sciences Division, U.S. Air Force School of Aerospace Medicine (USAFSAM), provided biofeedback-moderated behavioral treatment to 53 fliers grounded for chronic, severe motion sickness, and followed each flier for 2 years after treatment completion. Success was defined as returning to and maintaining satisfactory operational flying status. Of these, 42 fliers (79%) met this criterion; 3 (6%) were partially successful, and 8 (15%) were subsequently grounded for recurrent airsickness. Follow-on studies will investigate psychophysiological mechanisms through which this method of treatment works.

Aerospace Medicine↗

Sucrose phosphate glutamate for combined transport of chlamydial and viral specimens.

Sucrose phosphate glutamate (SPG) was evaluated as a transport medium for specimens submitted to the virology laboratory. The recovery rate in SPG and minimum essential medium (MEM) was compared at different temperatures and incubation times using herpes viruses. The results showed a successful recovery of viruses from clinical specimens and that SPG is equal to or better than MEM for maintaining herpes virus stability during transport.

Chlamydia↗

Interaction of plasma proteins and lipoproteins with amphotericin B.

Amphotericin B (AmB) binds to the cholesterol in lipoproteins, as determined by comigration in density gradient ultracentrifugation and changes in the circular dichroic spectrum. The saturation curve and Scatchard plots obtained with circular dichroism suggest that four to 10 cholesterol molecules in low-density lipoproteins bind to one molecule of AmB. AmB interacts more rapidly with low- and very-low-density lipoproteins than with high-density lipoproteins, but the circular dichroic spectrum of the complexed species is the same in all three cases. AmB also binds to other proteins in blood, but much higher concentrations of these proteins than of lipoproteins are needed for comparable binding. Interaction with lipoproteins stabilizes the antifungal activity of AmB. Interaction with lipoproteins and with much higher concentrations of other proteins in blood can also inhibit the effects of AmB on red blood cells, which contain cholesterol in their plasma membranes, but not the effects on Candida albicans, whose membranes contain ergosterol. An appropriate inference is that, when used clinically, AmB circulates in blood bound to lipoproteins and other proteins. The toxic and therapeutic effects of AmB in clinical situations are thus contingent on competitive interactions between sterol-containing cellular membranes of the host and the parasite and components of blood, such as lipoproteins and proteins.

Amphotericin B↗