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Biomedical subjects

R L Anderson

Publications and source records attributed to R L Anderson.

574 records · Page 32Linked to original sources
PubMedDate not supplied

Gentamicin treatment associated with later nosocomial gentamicin-resistant Serratia marcescens infections.

During a hospital epidemic of infections with gentamicin-resistant Serratia marcescens (GRS), we studied the relation between receiving antibiotics and acquiring GRS. In a five-month period, 22 patients acquired GRS, whereas 18 patients acquired gentamicin-sensitive Serratia (GSS). When compared with patients with nosocomial GSS infection, patients with nosocomial GRS had been in the hospital (p = 0.04) and the intensive care unit (p = 0.003) longer before infection and more had received gentamicin (p = 0.001) or ampicillin (p = 0.02) before infection. To control for the influence of underlying disease, we matched all 12 ICU patients with GRS infection and 12 patients without GRS infection for underlying illness and duration of intensive care. Use of any antibiotic (p = 0.04), or a combination of gentamicin plus ampicillin or cephalosporin (p = 0.047) was more common among patients with GRS infection. The hospital had not significantly increased the use of aminoglycosides from the previous year. We conclude that for the individual patient antimicrobial therapy, especially with gentamicin or ampicillin, creates a risk for later infection by GRS that is independent of the severity of the underlying illness.

Aged↗
PubMedDate not supplied

Pseudomonas cepacia typing systems: collaborative study to assess their potential in epidemiologic investigations.

To determine the utility of available Pseudomonas cepacia typing systems for confirming the relatedness of isolates, we applied these methods to isolates associated with previously investigated nosocomial outbreaks. We compared chromosome analysis, serologic reactions, biochemical tests, bacteriocin production and susceptibility, and antimicrobial susceptibility in their ability to determine outbreak relatedness. Chromosome analysis, serologic reactions, and biochemical tests were each demonstrated to be epidemiologically useful methods for typing isolates. Determination of the sensitivity and specificity of these typing techniques will facilitate their application in the epidemiologic study of this increasingly important nosocomial pathogen.

Chromosomes, Bacterial↗
PubMedDate not supplied

Double balanced chromosomal translocation carrier (6;8), (13;14)--a case report.

This paper reports the identification of a carrier of two different balanced chromosomal translocations (45,XX,-13,-14, + t(13q;14q), t(6;8) (p11;p12]. Ascertainment occurred during family studies following prenatal diagnosis performed because of advanced maternal age. Family pedigree and past reproductive difficulties also are reviewed, and the theoretical probability of producing a phenotypically normal offspring is explored. We are unaware of previously published observations in which two different balanced autosomal translocations are found in the same individual.

Adult↗
PubMedDate not supplied

Nosocomial fungemia in neonates associated with intravascular pressure-monitoring devices.

In the period from January, 1982, to March, 1983, eight infants in the neonatal intensive care unit at one hospital had blood cultures positive for Candida parapsilosis; six cases had occurred after December, 1982. Epidemiologic investigation included a case-control study comparing the 8 cases with 29 birth weight-matched controls. Logistic regression analysis indicated that the model that best fit the observed data included the following risk factors for fungemia: duration of umbilical artery catheterization; duration of receipt of parenteral nutrition; and estimated gestational age. Parenteral nutrition therapy was often administered through the umbilical artery catheters, which were also used for monitoring arterial pressure; transducer domes thus contained parenteral nutrition fluid. Transducers were usually disinfected with alcohol. Laboratory investigation showed that the heads of 6 of 11 in-use blood pressure transducers and 1 of 4 transducers in storage after cleaning were culture-positive for C. parapsilosis. After control measures were instituted no further cases occurred.

Blood↗
PubMedDate not supplied

Hyperlipemic response of young trained and untrained men after a high fat meal.

To test the hypothesis that endurance training is associated with a decreased lipemia after a high fat meal, 16 young men [22 to 34 years old, nine of whom were trained (T) and seven of whom were untrained (UT)] were recruited. T ran greater than 30 or biked greater than 100 miles a week, while UT had been sedentary for at least the preceding 3 months. Daily caloric intake and daily caloric expenditure during exercise were 35% and 704% greater, respectively, in T than in UT. VO2max was 31% greater, while percent body fat was 36% lower in T than in UT. Dietary composition and body height and weight were similar. After a fasting blood sample was taken, the men ate a high fat meal (approximately 56% of total calories as fat in 1100 kcal adjusted to body weight), and additional blood samples were taken hourly for 8 hours. Fasting lipids were similar. Postprandial peak triglyceride (TGmax), percent TG increase (%TGI), and total lipemic response (TLR, the area under the lipemia curve in excess of fasting TG) were 42%, 54%, and 75% greater, respectively, in UT vs. T. Stepwise regression analysis showed that the same three-variable model (training status, fasting TG, and VO2max) described the variation in TGmax (R2 = 0.97), %TGI (R2 = 0.75), and TLR (R2 = 0.92). Furthermore, this same analysis showed that after adjustment for fasting TG and VO2max, the UT group had a significantly greater postprandial lipemia whether expressed as TGmax (p less than 0.0001), %TGI (p = 0.0002), or TLR (p = 0.0002).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Sudden blindness following facial trauma.

Blindness following facial trauma may occur with what appears to be a minor insult to the periorbital area. This report deals with our experience in treating five patients who had sudden blindness following frontal head trauma. Unselected optic nerve decompression was in general unrewarding in reversing blindness. However, the early administration of pharmacologic doses of corticosteroids does appear effective in reversing blindness in this select patient population and may indicate which patient is a good candidate for decompression. Examination of holographic experiments performed on dried skulls, in addition to clinical findings, appears to suggest that the cause of blindness associated with frontal head trauma may be related to stretching of the optic nerve and not necessarily to compression.

Adolescent↗
PubMedDate not supplied

Cholesterol content and heat sensitivity of nine mammalian cell lines.

The cholesterol, phospholipid and protein contents of nine mammalian cell lines, three lymphoid and six attached cell lines, were measured, along with the sensitivity of the cells to hyperthermia at 42 degrees and 44 degrees C. The free cholesterol content and the protein content per cell correlated positively with the time required to kill 99 per cent of the cells at 44 degrees C. The phospholipid content showed a less significant positive correlation whilst the cholesterol ester content and the cholesterol:phospholipid molar ratio did not correlate with heat sensitivity. There were no correlations observed when the levels of these cell components were compared to heat survival at 42 degrees C. As the three lymphoid lines are small, very heat sensitive cells, the six monolayer lines were analysed separately. In this case, only the protein and the free cholesterol content maintained a significant correlation (at the 5 per cent level). It is concluded that the levels of cholesterol or phospholipid cannot be used as reliable indicators of the heat sensitivity of a cell.

Animals↗
PubMedDate not supplied

An immunoassay for heat shock protein 73/72: use of the assay to correlate HSP73/72 levels in mammalian cells with heat response.

An enzyme-linked immunosorbent assay (ELISA) for measurement of levels of heat shock proteins 73 and 72 (HSP73/72) in cultured cells and tissues is described. The assay involves detection of HSP73/72 in cell homogenates in 96-well plates using a specific monoclonal antibody. The assay has been used to explore the relationship between the amount of HSP73/72 in a cell and its response to heat shock, both before and after the development of thermotolerance. Six mammalian cell lines with differing responses to heat were characterized with respect to their response to heat treatments at 44 degrees C and concentrations of HSP73/72. Contrary to the widely expressed idea that the amount of HSP73/72 dictates the degree of heat resistance, no positive correlation between levels of HSP73/72 and heat resistance was found for the six lines tested here: if one particular line, a mutant selected for heat resistance, was excluded from the analysis, there was a negative correlation between HSP73/72 levels and heat resistance. A different result was, however, obtained when thermotolerant (transiently resistant) cells were compared to control cells. Here, we found a good correlation between the extent of thermotolerance and the amount of HSP73/72, suggesting that an increase in HSP73/72 level is important for the development of thermotolerance. The validity of the ELISA technique was checked using a second method for quantifying levels of HSP73/72. This involved uniform radiolabeling of cellular proteins, separation on two-dimensional gels and radioscanning to quantify radioactivity in each protein. The second technique is more powerful in that different isoforms of HSP73/72 can be distinguished, but it is more difficult to perform, is more labour intensive and requires an expensive device for gel scanning. The results using the second technique agreed well with those from the immunoassay and indicated that the level of the highly inducible HSP72 correlated best with the extent of thermotolerance.

Animals↗
PubMedDate not supplied

Characterization of novel hsp70 in mammalian cells.

A new protein detected in heat resistant mutants of a murine fibrosarcoma has been identified as a member of the hsp70 family. The protein is similar to the constitutive hsp70 of the parent cells with regard to its antibody cross-reactivity, its ability to bind to an ATP affinity column and partial amino acid sequencing. It is present in addition to, and in similar amounts to, the constitutive isoform of the heat resistant mutant cells and the parent cell line. The lack of either of two post-translational modifications common to other hsps, phosphorylation and ADP-ribosylation, and the demonstration of mRNA for the novel protein suggest that it is a separate gene product and not a post-translational modification of the constitutive hsp70. To our knowledge, this protein has not been described in other systems and may be important in the expression of the heat resistant phenotype of these cells. The in vivo phosphorylation patterns also show that hsp90 and hsp28 are heavily phosphorylated in the heat resistant mutant, but that two other stress proteins reported to be phosphorylated under some conditions are not phosphorylated in these cells.

Adenosine Triphosphate↗
PubMedDate not supplied

The diagnosis and management of the superior rectus suspension syndrome.

The diagnosis and management of patients having had superior rectus suspension procedures for the correction of blepharoptosis can be quite difficult. Patients who have had these procedures frequently present with a syndrome which included 1) history of an unknown type of ptosis surgery performed at least ten years ago, 2) good eyelid excursion, 3) minimal lid lag associated with marked lagophthalmos, 4) hypotropia, and 5) corneal scarring. One must evert the upper eyelid to demonstrate the pathognomonic adhesion between tarsus and the superior rectus muscle. The correct management of this condition is virtually impossible until the diagnosis is made. To correct the corneal and motility problems that result from superior rectus suspension procedures, the adhesion between the superior rectus muscle and the upper eyelid must be released. It is very easy to overlook this syndrome if one is unaware of its presentation. We present five patients who illustrate the superior rectus suspension syndrome.

Blepharoptosis↗
PubMedDate not supplied

Nodular fasciitis presenting as a rapidly enlarging episcleral mass in a 3-year-old.

A rapidly enlarging periocular mass in a child obligates the treating physician to rule out a malignancy, especially a rhabdomyosarcoma. A 3-year-old girl presented with a 5-day history of a rapidly growing episcleral mass superonasal to the globe, adjacent to the superior rectus muscle insertion. The lesion was locally excised. A sarcoma could not be excluded on frozen sections. Permanent sections and electron microscopy revealed nodular fasciitis, a benign lesion with a pseudosarcomatous histologic appearance. No recurrence has been noted at 9 months follow-up. Nodular fasciitis is a benign proliferation which should be considered in the differential diagnosis of a rapidly enlarging subconjunctival or orbital mass in a child.

Child, Preschool↗
PubMedDate not supplied

Nodular cutaneous amyloid tumors of the eyelids in the absence of systemic amyloidosis.

A patient was referred with recurrent bilateral, slow-growing, painless, nodular tumors of the upper eyelid margins. The tumors were excised and the base of each lesion was ablated with the CO2 laser. Histological examination of the excised tissue revealed amyloid. Despite the fact that cutaneous, amyloid lesions of the eyelid have been previously described as essentially pathognomonic for systemic amyloid disease, no evidence of systemic amyloidosis was found in this patient. We believe that this represents only the second reported case of bilateral cutaneous amyloid of the eyelids without systemic involvement. We agree with previous authors that this lesion be added to the list of painless slow-growing bilateral eyelid tumors.

Amyloidosis↗
PubMedDate not supplied

Eyelid reconstruction with irradiated human tarsal plate and aorta.

Reconstruction of posterior lamellar eyelid defects requires a tissue substitute that is either identical to the tissue lost (ex. surrounding or nearby tarsus) or donor tissue from another site that serves the same supportive role. Irradiated homologous tarsal plate and irradiated homologous aorta are potential posterior lamellar substitutes. Each provides a structural framework for the surrounding lid tissues to grow upon and are incorporated into the normal eyelid anatomy. Both the tarsal plate and aorta can be harvested, irradiated and stored in a refrigerator, ready to be utilized in those selected cases with severe tissue loss. They may also be utilized as a donor material in more routine lid reconstruction as an alternative. We discuss our experience with these materials.

Adult↗