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Biomedical subjects

R J Johnson

Publications and source records attributed to R J Johnson.

At least 307 records · Page 17Linked to original sources

Influence of method of model fitting and gender on estimated parameters for the relationship between starvation heat production and body size in the domestic fowl.

The relationship between starvation heat production (SHP) in kJ/d and body weight (W) in kg for domestic fowl was examined with compiled calorimetric data for 294 fowls (Johnson and Farrell, 1985). Linear regression analyses using ordinary least squares methods were performed before and after transformation of the data to a logarithmic scale (base = 10). Coefficients of determination (R2) were similar for untransformed and log-transformed data (R2's = .56 and .53, respectively). The slopes for untransformed data of males and females were different (P less than 0.033). When the model parameters for: SHP = b0 Wb1 were derived from log-transformed data, there were no significant differences in exponents for males vs. females (P greater than .95). However, when the coefficients were estimated using non-linear regression techniques, a difference was detected at the level of P = 0.072. It was determined that there is no advantage in describing the relationship of SHP as a non-linear function of W, nor is it appropriate to express physiological variables as a ratio of weight raised to some mass exponent without statistical justification. Using W or W2 as a covariable for the statistical analysis of physiological data would produce equally acceptable determinations of significance.

Animals↗

Epidemiology and prevention of skiing injuries.

Between 1972 and 1987, the authors prospectively evaluated all 5701 injuries which were reported to the injury clinic operating in the base lodge of a ski area in northern Vermont, USA. During that time approximately 1,690,000 skier visits were estimated to have occurred at the ski area. The total injury population was divided into 28 groups and sub-groups and examined by regression analysis for long term trends. Among upper body injuries, only lacerations showed a positive improvement. Among lower extremity injuries, virtually all injuries below the knee improved dramatically, some groups by more than 80%. Knee injuries, although improved as a group, showed a marked 2.7-fold increase in serious (third degree) sprains usually involving the anterior cruciate ligament. Clavicular fractures were the only upper extremity injury which increased significantly in incidence.

Athletic Injuries↗

How to treat knee ligament injuries?

Indications for conservative treatment of knee ligament injuries can be established for all grade I or II sprains (partial tears), as well as isolated grade III sprains (complete tears) of the posterior cruciate ligament (PCL) and medial collateral ligament (MCL). These injuries should be treated with immediate mobilization. Only in isolated partial anterior cruciate ligament (ACL) tears without a positive pivot shift phenomenon is conservative treatment justified. However, many of these injuries may require operative reconstruction later. In complete ACL tears the surgical treatment consists of primary reconstruction or augmented primary repair. Today, the middle third of the patella tendon with the bone blocks is regarded as the "gold standard" for augmented repairs and late reconstructions. For the present, there is no place for synthetic prostheses in the treatment of an acute ACL rupture. Allograft replacement of the ACL must now be considered an experimental procedure. In the reconstruction of the PCL the above mentioned patella tendon graft is also preferable. Lateral collateral ligament (LCL) tears, especially if they are combined with ruptures of posterolateral ligament complex, should be repaired immediately after the injury. In these injuries late reconstructions are difficult and the results are poor. Conservative treatment of partial tears and postoperative treatment of reconstructed ligaments is twofold: on the one hand, the healing tissue should be protected and on the other hand, atrophy and wasting of uninjured tissue should be avoided. Overload and stretching of the injured ligaments should be eliminated with the aid of a suitable knee brace, but early range of motion exercises of the knee are allowed immediately.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

Mechanisms of clearance of immune complexes from peritubular capillaries in the rat.

These experiments evaluated extraglomerular sites of renal immune complex (IC) deposition and specific features of host capability to remove these IC. Ex vivo perfusion of rat kidneys with the endothelium binding lectin concanavalin A (con A) followed by rabbit anti con A IgG results in a subendothelial IC nephritis in glomerular capillaries (GC) and diffuse IC formation with complement (C3) deposition in peritubular capillaries (PC). Histologic, immunofluorescence, and ultrastructural studies were performed at 10 minutes and 1, 4, and 24 hours after perfusion. At 10 minutes, strong linear binding of con A, rabbit IgG, and rat C3 to the endothelium was detected by immunofluorescence in both GC and PC. In GC this was followed by endothelial cell swelling and denudation (1 hour) with platelet and neutrophil infiltration and formation of subendothelial IC deposits which persisted at 4 and 24 hours. In contrast, some PC endothelial swelling was also present at 10 minutes and 1 hour, but ICs (IgG, con A, C3) were capped and shed into capillary lumina at 1 to 2 hours with complete clearance of IC by 4 hours. Selective neutrophil depletion, by antisera and irradiation, and complement depletion with cobra venom factor, delayed clearance of PC IC by several hours but complete clearance of IC with restored structural integrity of PC was still achieved by 24 hours. Platelet depletion had no effect on PC IC clearance. These studies demonstrate a model for study of PC IC. Such a model may aid our understanding of lupus nephritis in which extensive GC IC deposits associated with severe inflammatory injury may coexist with PC deposits. Efficient clearance of IC in PC compared with GC may be due to differences in hemodynamic forces, amounts of IC formed in each of these sites, differences in binding of IC to subendothelial basement membrane, or phenotypic specialization of the endothelium lining these two different capillary beds.

Animals↗

Urinary excretion of the C5b-9 membrane attack complex of complement is a marker of immune disease activity in autologous immune complex nephritis.

The urinary excretion of the C5b-9 membrane attack complex of complement correlates with glomerular deposition of antibody in the passive Heymann nephritis (PHN) model of membranous nephropathy (MN). To determine if this parameter can be correlated with antibody deposition in a model of MN induced by an autologous mechanism and thus more analogous to human MN, the relationship of urinary C5b-9 to ongoing glomerular immune complex formation late in autologous immune complex nephritis (AICN) was studied. Based on urinary C5b-9, the animals were divided into two groups at 12 weeks after induction of AICN, those with persistently high urinary C5b-9 excretion and those in whom urinary excretion of C5b-9 returned to undetectable levels. While all rats developed glomerular deposition of rat IgG and significant proteinuria, high C5b-9 excretors had greater proteinuria and prolonged positive staining for glomerular C3. When normal syngeneic kidneys were transplanted into rats (n = 3) from each group, only those with persistent C5b-9 excretion developed subepithelial immune deposits of rat IgG in the transplanted kidney. As in the PHN model of MN, proteinuria was dissociated widely from urinary C5b-9 excretion, glomerular C3 staining, and evidence of circulating antibody. Thus these findings demonstrate that urinary excretion of C5b-9 serves as an index of on-going immunologic disease activity in the AICN model of MN, while proteinuria does not.

Animals↗

Chicken insulin-like growth factor-I: amino acid sequence, radioimmunoassay, and plasma levels between strains and during growth.

Insulin-like growth factor-I (IGF-I) has been purified from chicken serum and sequenced. The peptide has eight amino acid substitutions when compared with human IGF-I: serine26, leucine38, histidine39, histidine40, lysine41, glutamine50, isoleucine64, and proline67. Chicken IGF-I (cIGF-I) has been measured using a radioimmunoassay with a human IGF-I (hIGF-I) standard and an antibody raised against hIGF-I. In this assay the cross-reactivity of cIGF-I was approximately 50% with respect to hIGF-I and the cross-reactivity of chicken IGF-II was 1.7% with respect to chicken IGF-I. To determine whether binding proteins in chicken plasma can artifactually interfere with IGF-I measurements as they do in mammals, chicken plasma was fractionated by molecular sieve chromatography at acid pH. When the fractions corresponding to the binding protein region were included in the IGF-I radioimmunoassay, essentially no apparent IGF-I was detected, indicating that the binding proteins did not interfere. This result, together with the finding that IGF-I in acid-ethanol extracts of chicken plasma produced parallel dose-response curves to pure cIGF-I and hIGF-I, allows the reliable measurement of cIGF-I in such extracts. The concentrations of IGF-I in plasma from male birds increased two- to threefold between 1 and 7 weeks after hatching to achieve 30-45 ng/ml. Smaller increases were found in female chickens from a higher value at 1 week. No diurnal pattern of IGF-I levels could be detected. In 4-week-old birds, the plasma concentration of the peptide fell from nearly 40 to 15 ng/ml after 24 hr of starvation and to 9 ng/ml 20 hr later. These effects are very similar to those described for mammals and strongly suggest that the regulation of IGF-I is conserved during evolution, notwithstanding the lower plasma concentrations of the growth factor in chickens.

Amino Acid Sequence↗

Arthroscopic strain gauge measurement of the normal anterior cruciate ligament.

This article describes a new arthroscopic technique to study the anterior cruciate ligament (ACL) in vivo. A Hall effect strain transducer (HEST) is inserted arthroscopically into the anterior medial band (AMB) of the ACL. The strain is calculated from HEST displacement data. This method determines a reference length of the AMB when it becomes taut and load bearing. Data from HEST implantation in five patients with normal ACLs are reported. The HEST was implanted in the AMB with patients under local anesthesia. Strain was calculated during anterior-posterior shear testing and isometric quadriceps contractions at 30 and 90 degrees of knee flexion. The results demonstrate that this technique is safe and reliable. Lachman testing (anterior shear testing at 30 degrees) caused significantly higher strain in comparison to the drawer tests (anterior shear testing at 90 degrees). A significant increase in strain occurred during isometric quadriceps contraction when the knee was flexed at 30 degrees. No significant change in strain was measured, however, during isometric quadriceps contraction at 90 degrees of flexion. These results confirm previous studies showing that the Lachman test is a more sensitive clinical method for evaluating the AMB. They suggest that isometric quadriceps activity at 90 degrees of knee flexion can be prescribed for rehabilitation without risk of increased strain of the AMB.

Adult↗

Intrasplenic metastases from carcinoma of the ovary.

Intrasplenic metastases are an uncommon manifestation of malignant disease. The relative paucity of splenic metastases is thought to be due to the properties of the spleen as an organ of immune surveillance. We report five cases of splenic metastases from carcinoma of the ovary demonstrated by CT scanning and ultrasound examination. In this series, splenic metastases were associated with bulk disease and more anaplastic tumours. Increased availability of magnetic resonance imaging may improve the recognition of splenic metastases.

Adenocarcinoma↗

Radiological changes in the gastrointestinal and genitourinary tract following radiotherapy for carcinoma of the cervix.

The radiological examinations of 67 patients who had previous radiotherapy for carcinoma of the cervix uteri were reviewed. All had evidence of radiation damage proven surgically or histologically. Patients with known recurrent or metastatic disease were excluded. The commonest abnormalities (36 patients) were in the urinary tract, where hydronephrosis due to distal ureteric stricture was the most frequent finding. Changes observed in the bladder included mural thickening, mucosal irregularity, focal ulceration and reduction in size. Thirty-one patients had abnormalities of their large bowel. The majority of these had strictures of the recto-sigmoid which showed a smooth mucosa, fine surface ulceration, focal ulceration or a 'cobble-stone' appearance. Lesions observed in the small bowel included fixity of bowel loops, thickening of the wall, coarsening of the mucosal pattern and strictures. Two new features are described; the development of high ureteric strictures and the presence of a stricture within a large bowel stenosis. These findings are significant since they show the variation in appearance which can be produced by radiotherapy damage. The differentiation of these changes from recurrent malignancy can be difficult and the differential diagnosis is discussed.

Adult↗

Accuracy in staging carcinoma of the bladder by magnetic resonance imaging.

Thirty-four patients with a presumptive diagnosis of carcinoma of the bladder diagnosed at EUA and cystoscopy have been staged by MRI and the findings correlated with pathology in 15 patients and clinical follow-up, including repeat cystoscopy, in the remainder. MRI is accurate in identifying tumours confined to the bladder wall or extending beyond the wall to involve perivesical fat or adjacent organs. Whilst it is not possible to distinguish between T1, T2 or early T3a tumours they can be distinguished from advanced T3a lesions and this may affect management. MRI is superior to clinical staging, particularly in detecting lymphadenopathy and provides information for optimal radiotherapy planning. The problem of distinguishing between the effects of radiotherapy and suspected recurrent tumour is discussed.

Aged↗

Percutaneous nephrostomy: its value in obstructive uropathy complicating carcinoma of cervix uterus.

Percutaneous nephrostomies (PCN) were performed in 25 patients with uterine cervical malignancy between November 1982 and December 1987 at the Christie Hospital and Holt Radium Institute. Group 1 consisted of eight patients with untreated disease; group 2 consisted of eight cases with recurrent tumour; and group 3 consisted of nine patients with obstructive uropathy related to previous treatment. Six patients in group 1 subsequently received radical radiotherapy, and two of them were alive and disease free (33%) ten months later. Further active treatment was only possible in two of the patients with recurrence and overall median survival was only 51 days. All patients in group 3 had normalization of their renal function post-nephrostomy and prior to definitive management of the obstruction. We conclude that the technique should be considered in patients who had no previous treatment and in patients with treatment-related complications. Its value in recurrent disease is limited.

Adult↗

Recombinant interleukin-2 (rIL-2) with flavone acetic acid (FAA) in advanced malignant melanoma: a phase II study.

Recombinant interleukin 2 (rIL-2) and flavone acetic acid (FAA) were used to treat 34 patients with progressing metastatic melanoma. Five patients had solely non-visceral disease and the median number of organ sites involved was two. Five doses of rIL-2 were given, the first dose intrasplenically via a femoral artery catheter with a further dose 4 h later i.v. and the other doses i.v. on alternate days. The rIL-2 dose was 11 x 10(6) Cetus units m-2; the day before rIL-2, FAA (4.8 G m-2) was given as a 6 h i.v. infusion, in order to enhance further killer cell activity. A total of three courses at 21-day intervals was planned and 74 courses in all were given. Despite the high dose of rIL-2 and the potential overlapping toxicity affecting blood pressure with the addition of FAA, side-effects were generally mild. There were only five episodes of grade 4 toxicity: one of ventricular tachycardia and four other episodes of transient biochemical or haematological disturbance. Grade 3 hypotension or hypertension occurred on 22 courses but again was transient. No patient required intensive care facilities. Five patients had tumour response, one being complete. Responses occurred in pulmonary and hepatic metastases, but mainly in non-visceral sites. Eleven patients remain alive at 6-17 months and in five there is no relapse or progression of disease. Despite the impressive results in animal tumour models, the addition of FAA to rIL-2 in the present study has not markedly improved results over rIL-2 alone.

Adjuvants, Immunologic↗

Skiing and snowboarding injuries. When schussing is a pain.

Downhill and cross-country skiing and snowboarding are growing rapidly in popularity. With the ever-increasing number of participants, physicians must be prepared to deal with the injuries specific to these sports. More important, physicians need to use epidemiologic data to advise patients of methods to minimize the risk of injury as they participate in these healthy and vigorous winter sports.

Adolescent↗

A cytotoxic monoclonal anti-leukemia antibody binds to histone H1.

Monoclonal antibody (MAb) AP64 is a mouse IgM MAb raised against human acute non-lymphocytic leukemia (ANLL) cells. It has been shown to bind to a wide variety of cell lines and is capable of initiating complement (C) dependent cytotoxicity. Other studies indicated that MAb AP64 can effect long term cure in a leukemia minimal residual disease model. By using various techniques we have determined the identity of a protein which is bound by this MAb. Immunofluorescent studies have shown that MAb AP64 stains the nuclei of fixed cells as well as metaphase chromosomes, indicating that this MAb binds to a component of chromatin. Biochemical characterization revealed that MAb AP64 western blots a 31 and 32 kilodalton doublet from NP-40 extracts from both rat and human leukemia cells. The mobility of this doublet is identical under reducing and non-reducing conditions. Further studies have shown that the bands detected by western blot analysis using MAb AP64 as a probe have a similar migration to those of bovine histone H1. Also, 1 nanogram of bovine histone H1 can be detected by MAb AP64 when spotted onto nitrocellulose. These data demonstrate that MAb AP64 binds to a conserved epitope present on molecules coded for by the histone H1 gene family.

Antibodies, Monoclonal↗

A modification of cellulose that facilitates the control of complement activation.

Complement activation by Cuprophan hemodialysis membranes has been linked to a variety of pathological sequelae (neutropenia and various cardiopulmonary manifestations) seen in the clinical setting. The modification of reactive surface hydroxyl groups on regenerated cellulose with various dicarboxylic-acid anhydrides has been found to significantly limit the complement-activating potential of these materials. Of the anhydrides tested, maleic anhydride appears to display the most dramatic and consistent diminution of complement activation compared to unmodified cellulose (0-10% of control values for C3b deposition and C3a/C5a production). Current evidence suggests that this maleated derivative facilitates the factor-H control of C3 and C5 convertase activity and thus may help limit complement activation by normal regulatory mechanisms. In addition, this modification may help limit the production of other inflammatory mediators that may result in diminished levels of cellular activation.

Biocompatible Materials↗