Complications associated with prophylactic oral kanamycin in preterm infants.
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Biomedical subjects
Publications and source records attributed to R Anderson.
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The lipid composition of the non-photosynthetic marine diatom, Nitzschia alba, has been quantitatively determined. Triglycerides accounted for 20% of the cell dry weight and 87% of the total lipids. Smaller amounts of 1,2- and 1,3-diglycerides, free sterol (24-methylene cholesterol), hydrocarbons and an unknown component were the remaining neutral lipids detected. Phosphatidylsulfocholine (phosphatidyl S,S-dimethylmercaptoethanol), present in amounts of 0.8% of cell dry weight (35% of total polar lipids), was the major polar lipid component. Other phospholipids were lysophosphatidylsulfocholine, phosphatidylglycerol, phosphatidylinositol and cardiolipin, but both phosphatidylcholine and phosphatidylethanolamine were completely absent. Another novel sulfolipid, deoxyceramide sulfonic acid, as well as the sulfate ester of the free sterol, were also present. Considerable amounts of the four lipids often associated with photosynthetic organisms, mono- and di-galactosyl diglycerides, sulfoquinovosyl diglyceride and phosphatidylglycerol, were identified in N. alba. However, the fatty acid components of the glycosyl diglycerides did not show the high amounts of polyunsaturated acids (18 : 2, 18 : 3) normally found in photosynthesizing organisms. All polar lipids were found to be associated with various cell membrane fractions in N. alba.
The four major sulfolipids in the non-photosynthetic marine diatom, Nitzschia alba, were isolated in pure form and their structures were established spectrometrically and by identification of their hydrolysis products as (a) 24-methylene cholesterol sulfate, (b) 1-deoxyceramide-1-sulfonate, (c) phosphatidyl sulfocholine (a sulfonium analogue of phosphatidylcholine) and (d) sulfoquinovosyl diglyceride. The major characteristic fatty acids of the sulfolipids were: for the deoxyceramide sulfonate, 16 : 0 (26%) and 16 : 1-delta3-trans (64%); for the sulfonium analogue, 14 : 0 (30%), 18 : 1 (12%), 18 : 2 (8%), 20 : 5 (27%) and 22 : 6 (4%); and for the sulfoquinovosyl diglyceride (two species, respectively), 14 : 0 (9%, 22%), 16 : 0 (16%, 28%), 18 : 1 (8%, 22%), 20 : 5 (42%, 23%) and 22 : 6 (14%, 2%). Traces of lyso-derivatives of sulfoquinovosyl diglyceride and phosphatidyl sulfocholine were also detected. The deoxyceramide sulfonate and the phosphatidyl sulfocholine represent novel membrane lipid components not previously detected in other organisms. They may however have a widespread distribution in marine diatoms and perhaps in marine organisms generally.
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A multidisciplinary team was assembled to design a cancer data management system that would meet the storage, retrieval and analysis NEEDS OF Mayo's clinical trials of anti-tumour drugs. To fulfill these requirements, a computerised data entry and retrieval system was developed, the primary patient health record used by the oncologists was redesigned and the clerical procedures and work flow within the Cancer Center Statistics Office were reorganised. The end result of this project is a system that has: (1) enabled Mayo to meet its reporting requirements as a Comprehensive Cancer Center; (2) provided the statisticians and the physicians with the capacity to perform more detailed and accurate analyses of clinical trials; (3) reduced the clerical effort needed for preparing reports and analyses; (4) provided the potential for expansion to meet the growing requirements of the future and (5) attained that often elusive goal of computer systems--user satisfaction.
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Investigation of an outbreak of contamination of dialysis drainage fluid with Acinetobacter calcoaceticus var. anitratus identified a previously unrecognized source for dialysis associated infections. Over a 4-month period, 25 peritoneal dialysis treatments were administered to 13 hospital patients. Of the 25 treatments for which culture results were available, 14 were associated with dialysis drainage fluid cultures positive for A. calcoaceticus. A water bath used to warm bottles of peritoneal dialysate before use was the reservoir for the bacteria, and investigation showed in vitro that bath water could contaminate the dialysate. It appears likely that the dialysate became contaminated when the prong of the fluid administration set was inserted through the rubber bung on the dialysate bottles. This outbreak illustrates the potential importance of environmental reservoirs in infections complicating peritoneal dialysis.
We present a case in which a full-thickness defect of the anterior chest wall was closed with a turnover, dermal-fat, deltopectoral flap--with split-skin grafts for the cover. This is a worthwhile alternative procedure to be added to the already numerous techniques currently available for the repair of such defects.
Polymorphonuclear leukocyte motility, both in vivo and in vitro, and reduction of Nitro Blue Tetrazolium was studied in tuberculoid and lepromatous leprosy patients and a group of lepromatous patients with erythema nodosum leprosum (ENL). A profound defect in random migration, chemotaxis, and chemokinesis was found in lepromatous patients with and without complicating ENL, and marked depletion of skin window migration confirmed these in vitro findings. Tuberculoid patients exhibited a mild defect in polymorphonuclear leukocyte motility. Serum inhibitors of normal polymorphonuclear leukocyte chemotaxis were found in all types of leprosy, but sera from lepromatous and ENL patients were most inhibitory. Resting levels of Nitro Blue Tetrazolium reduction were normal in all three groups. Reconstitution of polymorphonuclear leukocyte cells from normal and ENL patients with ENL serum, however, showed increased Nitro Blue Tetrazolium reduction well above the normal range, whereas reconstitution with normal, lepromatous, and tuberculoid sera failed to increase Nitro Blue Tetrazolium reduction above the normal values.
Echocardiographic findings are described in a patient with hypoplastic right heart syndrome (pulmonary atresia type with intact ventricular septum and small right ventricular cavity) who had an associated atrial septal aneurysm. An unusual appearance of echoes behind the aorta bulging into the left atrium in diastole on both the M-mode and cross-sectional echo suggested this diagnosis prior to cardiac catheterization. The angiographic findings confirmed the diagnosis of right ventricular hypoplasia, pulmonary atresia and the large atrial septal aneurysm. The infant died after surgery and the atrial septal aneurysm was observed at autopsy. The importance of the diagnosis of the atrial septal aneurysm and its association with restriction of right-to-left atrial shunting prompts this report.
Four hr veno-arterial cardiopulmonary bypass via a median sternotomy utilizing a membrane oxygenator was done in 15 baboons. A comparison of perfusion with and without anticoagulants was made. From this study systemic heparin had no advantage over no anticoagulants. These findings, in a clinically-relevant primate model, suggest that the scientific basis for the use of systemic heparin in membrane oxygenation is unclear.
The administration of intrapleural bacillus Calmette-Guérin (BCG) alone and intrapleural BCG plus levamisole was compared to placebo in patients with resectable, non-small cell cancer of the lung. This report is based on an interim analysis of 100 eligible patients with a median followup of 245 days. No significant treatment effects are apparent at the present time, although current trends are consistent with an approximate 30% reduction in recurrence rate in patients receiving intrapleural BCG. There is little evidence to suggest that the addition of levamisole will contribute to this effect. A relationship between purified protein derivative conversion and tumor recurrence is apparent. Failure to manifest purified protein derivative conversion following administration of intrapleural BCG is associated with a significantly greater risk of tumor recurrence.
An apparent excess of abnormal urine cytological findings in crime laboratory workers exposed to potentially carcinogenic aromatic amines was investigated by a cross-sectional epidemiologic study comparing these workers with an unexposed control group. The prevalence of atypical findings in the laboratory workers exceeded that in the control group; however, the results were not statistically significant. A number of serious problems were identified including a high prevalence of inflammatory changes (25% to 26%) and a moderately high percentage of atypical changes (2.5% to 5.4%) in the control population, failure to detect (on urological workup) evidence of neoplastic disease of the urinary tract in any of the laboratory workers whose urine examinations were cytologically interpreted as either atypical or neoplastic cells, and difficulty in determining proper referral criteria for urological workup.
Using Boyden chambers, Prostaglandin A1 (PGA1) was shown to inhibit directed movement of polymorphonuclear (PMN) leucocytes to the chemoattractants endotoxin-activated serum and casein, and in random migration systems. Depressed chemotaxis could not be entirely attributed to defective random migration, as the drug was shown to inhibit both chemokinesis (stimulated random migration) and "true chemotaxis". In addition, PGA1 inhibited the movement of neutrophils out of capillary tubes and substantially reduced hexose monophosphate shunt (HMPS) activity. Mice injected with PGA1 demonstrated significantly less PMN movement into trypticase-soy-broth-induced peritoneal exudates, and it is postulated that during inflammatory processes release of PGA1 increases cell accumulation at the site, thereby amplifying the inflammatory response.
The effects of two chemotactic factors, endotoxin activated serm (EAS) and casein and a number of drugs known to affect intracellular cyclic nucleotide levels and various froms of neutrophil movement, on neutrophil anaerobic glycolysis and hexose monophosphate shunt (HMPS) activity were assessed. EAS caused stimulation of glycolysis. HMPS activity and NBT reduction, but casein was without effect on glycolysis and NBT reduction and inhibited HMPS activity. Drug known to increase intracellular cAMP levels caused a depression of HMPS activity whereas those reported to elevate cGMP had a variety of effects. Glycolysis was not affected by any of these agents. These results indicate a lack of relationship between cyclic nucleotide effect on cell motility and neutrophil glycolysis and HMPS activity.
Eighteen patients with primary abnormalities of neutrophil chemotaxis are described. The most common clinical presentation was one of recurrent upper respiratory tract infection (nine patients) or recurrent pyoderma (seven patients), and two children had a history of oropharyngeal candidiasis and recurrent skin sepsis. Of these eighteen patients, sixteen had intrinsic polymorphonuclear leucocyte (PMN) defects as shown by diminished random migration and movement towards endotoxin-activated serum. PMN chemotaxis towards casein was, however, normal. In nine out of the latter patients, there was an associated inability of the serum to generate chemotactic factors. PMN from two adult patients, both suffering from recurrent boils, moved normally both in random and directed systems, but sera from these patients contained heat-stable inhibitors of neutrophil chemotaxis. In vitro levamisole treatment (10(-3) M) markedly improved the PMN function. When patients were treated with levamisole, however, no clinical response was noted, although PMN movement improved in a number of cases.
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