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Biomedical subjects

S A Gall

Publications and source records attributed to S A Gall.

At least 109 records · Page 6Linked to original sources
PubMed1976

Severe combined immunodeficiency with leukopenia (reticular dysgenesis) in siblings: immunologic and histopathologic findings.

The hematologic and histologic features of two, nontwin, male siblings with severe combined immunodeficiency and variable granulocytopenia are compared to the four previously reported cases of reticular dysgenesis. These sibs died at 50 and 3 days of age, respectively, with Pseudomonas sepsis and congenital cytomegalovirus infection, respectively. A maternal uncle has selective IgA deficiency. Cord blood from the second sib contained a normal percentage of E-rosetting lymphocytes; however, these lymphocytes failed to respond to mitogenic stimulation in vitro. Erythrocyte and lymphocyte levels of adenosine deaminase were elevated in the father and the second sib. Serum immunoglobulin concentrations were low in both siblings.

Adenosine Deaminase↗
PubMed1975

A review of tumor antigens in gynecologic malignancies.

Evidence for the presence of tumor-associated gynecologic tumor antigens from our laboratory and others is presented. Tumor-associated antigens have been described for invasive carcinoma of the cervix and mucinous carcinoma of the ovary with cross-reacting antigens in malignant vulvar tissue. The provocative finding of a cross-reacting antigen in malignant cervical, vulvar and ovarian tissue raises the possibility of a common etiologic agent. The hope of the clinician is to utilize the tumor antigens in diagnosis and therapy. However, it is necessary to caution against overzealous acceptance so the carcinoembryonic antigen story is not repeated.

Adenocarcinoma, Mucinous↗
PubMedDate not supplied

Effect of three concentrations of intracervical prostaglandin E2 gel for cervical ripening.

To evaluate the efficacy and safety of three concentrations of prostaglandin E2 (PGE2) gel for preinduction cervical ripening. Two hundred ninety-one patients with an unfavorable cervix scheduled for induction of labor were eligible to participate in a prospective, randomized, double-blind study of one or two doses of intracervical PGE2 gel. Group 1 received a dose of 0.125 mg/2 ml; group 2 received 0.25 mg/2 ml; and group 3 received 0.5 mg/2 ml. Outcome variables included change in Bishop score, uterine tachysystole, oxytocin use, route of delivery, and maternal and neonatal complications. Two hundred twenty-nine patients were included in the study, 79 in group 1, 70 in group 2, and 80 in group 3. Among the three groups, no statistically significant differences were noted for change in Bishop score, uterine tachysystole, oxytocin use, route of delivery, or incidence of maternal or neonatal complications, Subsequent labors were frequently complicated by fetal heart rate abnormalities (24.3%) and uterine tachysystole (9.6%); 84 (38.9%) patients were delivered by cesarean section. A dose-dependent influence on outcome variables was not identified. Complications from PGE2-ripening within 4 hours of gel application were not dose dependent and occurred infrequently. This study demonstrates that there is no dose in the range tested that assures an absences of tachysystole, limiting the role of outpatient cervical ripening without some period of observation.

Adult↗
PubMedDate not supplied

Antibiotic prophylaxis at Cesarean delivery.

OBJECTIVE: Our aim was to compare the efficacy of ampicillin, cefotetan, and ampicillin/sulbactam in the prevention of post-Cesarean endomyometritis. METHODS: Consenting patients undergoing Cesarean delivery at the University of Louisville Hospital were enrolled in a prospective, double-blinded randomization to receive either ampicillin/sulbactam (Group 1), cefotetan (Group 2), or ampicillin (Group 3) single dose antibiotic prophylaxis following umbilical cord clamping. The primary outcome variable was the frequency of endomyometritis in the respective groups. RESULTS: Among 301 randomized patients, outcome data was available for 298 patients. Fourteen patients (4.7%), all of whom underwent non-elective Cesarean delivery, developed endomyometritis. The frequency of endomyometritis was not different among groups: Group 1, 4/101 (4%); Group 2, 4/96 (4.2%); and Group 3, 6/101 (5.9%). Wound infections were infrequently observed 4/298 (1.3%) without significant differences among groups. Stepwise discriminative analysis identified only last cervical dilatation as a significant predictor of endomyometritis (P = 0.006). CONCLUSION: Post-Cesarean endomyometritis occurs infrequently following single dose antibiotic prophylaxis after umbilical cord clamping. An advantage of broader spectrum antibiotics over ampicillin was not demonstrated.

Adult↗
PubMedDate not supplied

Assessment of the Frank-Starling relationship by two-dimensional echocardiography.

The Frank-Starling relationship between left ventricular stroke work and end-diastolic minor-axis cross-sectional area was evaluated as a load-insensitive measure of inotropic state by two-dimensional echocardiography in 10 conscious dogs. Stroke work was calculated as the product of systolic change in cross-sectional area and either (1) beat-to-beat mean arterial pressure or (2) initial systolic blood pressure. Both Frank-Starling relationships were highly linear during preload variation (mean r = 0.96), sensitive to the inotropic state (slope increase with calcium 51% +/- 43% and 62% +/- 53%, respectively), and insensitive to afterload (r < 0.4, slope or x intercept versus afterload). Thus the Frank-Starling relationships derived from two-dimensional echocardiographic images and peripheral arterial pressure may be a useful and practical means of assessing inotropic state with minimally invasive measurements.

Animals↗
PubMedDate not supplied

Expression and shedding of CD44 variant isoforms in patients with gynecologic malignancies.

OBJECTIVES: The presence of CD44 isoforms was evaluated in ascitic fluid and serum samples of patients with gynecologic malignancies. Previously, the shedding of tumor-associated cell surface antigens has been demonstrated in the blood and malignant effusions of gynecologic cancer patients. Thus, the shedding of CD44 was also studied in ascitic fluids and sera of these patients, to address variant isoform expression as a biomarker of gynecologic cancer. METHODS: The expression of CD44 isoforms by ovarian tumor cells was examined by flow cytometry using variant-specific monoclonal antibodies. The release of these isoforms into the peripheral circulation and ascites was assayed by Western immunoblot analysis. RESULTS: Flow cytometric analysis of ovarian tumor cell lines revealed a strong expression of CD44 with significant levels of v4/5 and v6 isoforms. The presence of circulating CD44 isoforms was detectable in the sera of six of eight cancer patients, as well as in 12 of 16 ascitic fluids. Of the CD44-positive specimens, all six positive sera expressed detectable levels of variant CD44. The CD44v6 was present in all of the positive sera samples tested. In the ascites, the "shed" CD44 appeared to be associated predominantly with shed particles (vesicles) of plasma membranes (membrane fragments). Of ten CD44-positive ascites samples, all expressed significant levels of variant CD44. CONCLUSIONS: In addition to mediating metastasis, the differential expression and shedding of CD44 isoforms into the circulation may represent important determinants in the escape of tumors from immune surveillance, and their detection may be a diagnostic or prognostic marker.

Aged↗
PubMedDate not supplied

Moxalactam therapy for obstetric and gynecologic infections.

Moxalactam, a new cephalosporin antibiotic with a broad spectrum of activity, was evaluated for safety and therapeutic efficacy in the treatment of genital tract infections in women. Fifty-three patients with postpartum endometritis or acute or chronic pelvic inflammatory disease were treated with 2 g of moxalactam iv every 8 hr, usually for five days or longer. Appropriate cultures of peripheral blood, endometrium, cul-de-sac aspirates, urine, wound, and endocervix (only for Neisseria gonorrhoeae) were performed. Overall, 90.6% (48 of 53) of the patients were successfully treated with moxalactam--86.2% (25 of 29) and 95.8% (23 of 24) of the patients with endometritis and pelvic inflammatory disease, respectively. Therapy failed in one of five bacteremic patients with endometritis. Of all the bacteria isolated from appropriate culture sites, 58% (224 of 383) were anaerobes, with anaerobic gram-negative rods--particularly Bacteroides bivius-and gram-positive cocci being predominant. Of 206 anaerobic strains tested with moxalactam by agar dilution techniques, 82% (169 of 206) were susceptible (minimal inhibitory concentration [MIC], less than or equal to 8 micrograms/ml), 11.6% (24 of 206) were moderately susceptible (MIC, 16-32 micrograms/ml), and 6.3% (13 of 206) were resistant (MIC, greater than or equal to 64 micrograms/ml). Among the aerobic isolates, enterococci were uniformly resistant. Thus, moxalactam performed well as a single agent in this open clinical trial for women with infections of the genital tract.

Anaerobiosis↗