Research increasingly aimed at prevention.
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Genetic Engineering↗
Biomedical subjects
R Montgomery
Publications and source records attributed to R Montgomery.
External fistulas arising from the digestive tract.
External abdominal fistulas that arise from the digestive tract are associated with high mortality and prolonged morbidity in terms of infection, malnutrition, and skin excoriation. Such external fistulas most commonly follow anastomotic leak after gastrointestinal surgery. We identified 58 patients seen over a 5-year period at the University of Louisville Hospitals because of external abdominal fistulas that arose from the stomach (8), duodenum (4), small intestine (26), colon (14), biliary tract (9), and pancreas (7). Fifteen patients had multiple fistulas and 32 had high-output fistulas (greater than 200 mL/day). Closure was achieved in 48 patients, and eight of the 10 patients whose fistulas remained open died. Overall mortality was 19%. Principles of management include control of infection, correction of fluid and electrolyte imbalance, nutritional support, proper wound care, and often operative intervention. Multiple staged operations over many months were particularly important in managing complex wounds with large abdominal wall defects and multiple fistulas. Fistula closure is the ultimate goal, and patience is important to achieve it.
Abdomen↗
Evaluation of cryopreserved bone and synthetic biomaterials in promoting spinal fusion.
The purpose of the study was to evaluate the use of cryopreserved allograft bone and tricalcium phosphate in promoting spinal fusion. Nine 20-30 lb swine underwent posterior spinal fusion at T5-T6, T13-T14, and L2-L3. Autogenous bone, cryopreserved allograft bone, or equal parts of allograft bone and tricalcium phosphate were added to the decorticated posterior elements. A total of 27 sites were prepared for fusion. The spines were retrieved at 6 months and evaluated for integrity and stability of the fusion sites by clinical examination, three-point bending tests, multiplanar radiographs, and undecalcified tetracycline-labeled and decalcified histologic sections. The nine sites that received autogenous bone were solidly fused. There were one clinical and two radiographic nonunions in the nine sites that received cryopreserved allograft bone. Sites that received a mixture of allograft bone and tricalcium phosphate demonstrated slight motion at two locations and radiographic evidence of fusion at all levels. The extent and degree of fusion was not site-specific. Three-point bending analysis did not demonstrate a significant trend as to site or materials specificity. No adverse histologic response was noted. Histologic sections and tetracycline labels confirmed abundant new bone formation at all sites at 6 months. Although autogenous bone remains the gold standard for use in spinal arthrodesis, this study demonstrates the value of cryopreserved allograft bone alone and in combination with tricalcium phosphate in promoting spinal fusion.
Animals↗
Experimental and clinical significance of endotoxin-dependent HLA-DR expression on monocytes.
For much of the last decade, an increasing number of surgeons have been interested in objective assessment of cellular contributors to host defense function. In order to study many of these processes, it is apparently desirable that the cells be isolated to the extent feasible for the purpose of analyzing a more or less pure population of cellular elements. The purpose of this paper is to describe the physiologic activation of mononuclear cells that occurs as a result of the isolation process. Therefore, it follows logically that such cells are therein intrinsically less responsive to further physiologic manipulation in vitro. Analyses of such data without an awareness of this intrinsic aberration will undoubtedly lead to misinterpretation of the capacity of such cells for further modulation by immunostimulants or by the intrinsic processes related to injury, anesthesia, and operation. Furthermore, it may indicate that certain agents, e.g., cytokines, are unable to stimulate cellular function when, in fact, the defense function of the cell has been initially stimulated by the isolation procedure. Fractionation of human peripheral blood over Hypaque-Ficoll and subsequent purification of monocytes by adherence to plastic lead to an increase in the relative density of HLA-DR on monocytes. This increase occurred when carried out in endotoxin lipopolysaccharide (LPS)-contaminated or LPS-depleted reagents. LPS, added experimentally to whole blood, enhanced HLA-DR expression on monocytes without further manipulation. Monocyte HLA-DR expression measured in whole blood was reduced in patients with major sepsis (n = 19) compared to normal subjects (n = 10).(ABSTRACT TRUNCATED AT 250 WORDS)
Antibodies↗
The comparative clearance rates of the pleural and peritoneal cavities.
We compared the rates of bacterial clearance from the pleural and peritoneal cavities of rats after contamination with 1 x 10(6) live Escherichia coli. Pleural clearance was enhanced beginning at 30 minutes after injection and extended to at least six hours. At 24 hours, the clearance was similar for both the pleural and peritoneal groups. Blood and organ bacterial cultures were similar between these two groups. White blood cell populations were similar at rest, but there was a greater increase in the leukocyte population in the pleural cavity six hours after E coli stimulation. We postulate that the increased clearance of E coli from the pleural cavity may be due to differences in lymphatic absorption, recruitment of leukocytes, or fibrin trapping of bacteria.
Animals↗
Serospecific antigens of Legionella pneumophila.
Serospecific antigens isolated by EDTA extraction from four serogroups of Legionella pneumophila were analyzed for their chemical composition, molecular heterogeneity by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and immunological properties. The antigens were shown to be lipopolysaccharides and to differ from the lipopolysaccharides of other gram-negative bacteria. The serospecific antigens contained rhamnose, mannose, glucosamine, and two unidentified sugars together with 2-keto-3-deoxyoctonate, phosphate, and fatty acids. The fatty acid composition was predominantly branched-chain acids with smaller amounts of 3-hydroxymyristic acid. The antigens contain periodate-sensitive groups; mannosyl residues were completely cleaved by periodate oxidation. Hydrolysis of the total lipopolysaccharide by acetic acid resulted in the separation of a lipid A-like material that cross-reacted with the antiserum to lipid A from Salmonella minnesota but did not comigrate with it on sodium dodecyl sulfate gels. None of the four antigens contained heptose. All of the antigen preparations showed endotoxicity when tested by the Limulus amebocyte lysate assay. The results of this study indicate that the serogroup-specific antigens of L. pneumophila are lipopolysaccharides containing an unusual lipid A and core structure and different from those of other gram-negative bacteria.
Antigens, Bacterial↗
Characterization of human interferon species using gel extraction and monoclonal antibodies: implications on clinical use of interferon preparations.
Human interferons from various sources have been characterized using sodium dodecyl sulfate polyacrylamide gel electrophoresis followed by electrotransfer onto nitrocellulose and reaction with specific polyclonal and monoclonal antibodies. When gel slices were extracted, alpha-interferon subspecies possessed antiviral activity predominantly in the 18.6-19.7K region bands, the beta-interferon in the 22.1K band, and gamma-interferon in the 16.5-18.0K bands. Three of the monoclonal antibodies (Ab 138, Ab 126, Ab 098) reacted with a characteristic triplet of biologically active bands (18.6K, 19.1K, 19.7K) obtained using the Namalwa cell interferons, while two (Ab 194 and Ab 232) reacted only with the 18.6K band and Ab 523 reacted with the 19.7K band. With the human leukocyte interferons, Ab 098, Ab 194, and Ab 232 reacted with the active 18.6K band. The Ab 138, Ab 126, and Ab 523 reacted specifically with certain lower molecular weight active bands (13K region). A comparison of the antiviral activity and reactivity towards monoclonal and polyclonal antibodies presents a differentiation of the subspecies of interferons in the wide array of closely related proteins in interferon preparations packaged for clinical use.
Antibodies, Monoclonal↗
Giant congenital nevus and melanoma.
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Humans↗
Peptidase activity of macromomycin apoprotein.
Macromomycin, an antibiotic and antitumor protein obtained from Streptomyces macromomyceticus, displayed specific aminopeptidase activity. Pure macromomycin degraded the beta-chain of insulin, a few synthetic di- and tripeptides, and a number of proteins of KB cell plasma membrane. The biological activity and the peptidase activity showed similar temperature-dependent patterns suggesting that one protein is responsible for both activities. The apoprotein contained the aminopeptidase activity while the chromophore, which displayed the antibiotic and antitumor activity, did not show any such activity.
Amino Acids↗
Proteolytic activity of largomycin.
Largomycin, an antibiotic and antitumor protein, purified from the culture broth of Streptomyces pluricolorescens, displayed specific proteolytic activity. Pure largomycin did not degrade a number of substrates commonly used for detection of aminopeptidase, endopeptidase and carboxypeptidase activity. Pure largomycin degraded angiotensin II, bradykinin, a few dipeptides and a number of proteins of KB cell plasma membranes. The biological activity and the proteolytic activity of largomycin showed similar temperature-dependent patterns, suggesting that one protein is responsible for both activities. The apoprotein of largomycin, which did not show antibiotic activity, contained the proteolytic activity.
Aminoglycosides↗
The impact of in-home services termination on family caregivers.
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Aged↗
Strand scission of DNA in KB cells by macromomycin.
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Antibiotics, Antineoplastic↗
Biological effects of cesalin, an anti-tumor protein, on cultured mammalian cells.
The effects of the protein cesalin were studied to determine the site of its toxic action in KB cells for which the ID50 is 0.9 pg/ml. Several effects have been noted: (i) respiration in KB cells was reduced by greater than 50% within 1 h after cesalin addition, which could not be explained on the basis of mitochondrial damage or from elevated intracellular ATP levels, since these did not rise significantly until about 3 h after cesalin addition; (ii) both DNA and RNA synthesis were inhibited, starting about 3 h after addition of cesalin to KB cells, but the transport of nucleosides and amino acids does not appear to be affected; (iii) no decrease is observed in protein synthesis for at least 5 to 6 h; (iv) cesalin can inhibit DNA synthesis and mitotic division independently of one another. The interaction of cesalin with the cell surface is rapid and after 5 min at 37 degrees C less than 10% of treated cells can be rescued by addition of excess antiserum to cesalin. The cell surface receptors are exposed throughout the cell cycle and the toxicity of cesalin is not restricted to a particular phase of this cycle.
Amino Acids↗
Effects of macromomycin on the ultrastructure and biological properties of cultured mammalian cells.
Macromomycin is shown to inhibit the biosynthesis of RNA, DNA, and protein in cultured cells of KB, HBL-100, SW-613, MCF-7, and A1Ab. There was no substantial increase in cell numbers in cultures containing macromomycin (5 microgram/ml), but after 24 to 48 hr the cells were two to three times the diameter of control cells with concomitant increase in cell protein. The ultrastructural changes induced by macromomycin in KB cells demonstrate an increase in nuclear size without similar changes in the size of other cytoplasmic subcellular units. It was of interest to note the general proliferation of cellular organelles and the increased occurrence of annulate lamellae followed, after prolonged treatment, by the appearance of larger numbers of lipid droplets and lysosomes; vacuoles developed to a significant extent after the cells detached from the monolayer. A1Ab cells show ultrastructural changes similar to those of KB cells when treated with macromomycin.
Antibiotics, Antineoplastic↗
Attitude changes following a sexual counseling program for spinal cord injured persons.
The attitudes of a sample of spinal cord injured outpatients toward a range of sexual behaviors were measured before and after participation in a counseling program. In comparison to the sexual attitudes of an untreated control group those of the sample group were found to be more permissive after than before the program. In addition, the counseling program, which operated in a workshop format over a period of 6 weeks, was favorably evaluated by participants on a number of criteria.
Adolescent↗
Interaction of ovalbumin and its asparaginyl-carbohydrate fractions with concanavalin A.
The interaction of ovalbumin and its asparaginyl-carbohydrate fractions with concanavalin A was studied. Relative affinities were obtained by competitive binding studies using p-nitrophenyl alpha-D-mannopyranoside. Ovalbumin was separated into two fractions, I and II, by chromatography on concanavalin A-Sepharose. Ovalbumin and its fractions I and II interacted with concanavalin A in solution with binding affinities at 10 degrees C of 2 . 10(5) M-1, 3 . 10(4) M-1 and 2 . 10(6) M-1, respectively. The seven asparaginyl-carbohydrate fractions, obtained by fractionation on Dowex 50W-X2 (H+) and Durrum DA-4 (borate)columns, bound to concanavalin A with approximately the same affinity as native ovalbumin, suggesting that the sugar residues for binding in the isolated carbohydrates are exposed in the native protein. The binding of ovalbumin to concanavalin A was minimal after treatment with alpha-D-mannosidase in spite of the fact that only one half of the available mannose residues were hydrolyzed when compared to those removed by similar treatment of the asparaginyl-carbohydrate before fractionation. It is concluded that those alpha-D-mannosyl residues in ovalbumin that are required for binding to concanavalin A are accessible to alpha-D-mannosidase while the residual mannosyl groups are "buried" from interaction with concanavalin A and the enzyme.
Asparagine↗
Studies on macromomycin, an antitumor protein.
Macromomycin is a protein isolated from the culture filtrate of Streptomyces macromomyceticus. It is an antibiotic and also cytotoxic to a broad spectrum of carcinoma cells, the ID50 for P388 leukemia cells being 1 X 10(-9) M. Macromomycin binds rapidly and tightly to the P388 cell membrane and the eventual death of the cell cannot be reversed by either washing the toxin away or treating the cell with trypsin. The cytotoxicity does not appear to be specific for any phase of the P388 cell cycle. Macromomycin is a single polypeptide, pI 5.38, devoid of methionine and arginine residues and contains 4 cysteine residues joined by two intramolecular disulfide bonds. The cytotoxicity results in inhibition of DNA, RNA, and protein synthesis in P388, the latter inhibition occurring a few hours after the inhibition of nucleic acid synthesis. The antibiotic and antitumor activities are destroyed rapidly by ultraviolet light, which gives a product that differs little in amino acid composition, molecular weight, and antigenic property, but can be separated from the native macromomycin by ion exchange chromatography. It is proposed that macromomycin has an ultraviolet-sensitive prosthetic group upon which much of the biological activity is based.
Amino Acids↗