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Biomedical subjects

S E Martin

Publications and source records attributed to S E Martin.

At least 109 records · Page 6Linked to original sources

High-grade mantle zone lymphoma.

A 66-year-old man with a 6-month history of sweating at night, generalized lymphadenopathy, hepatosplenomegaly, and paraproteinemia was diagnosed to have a Stage IV mantle zone lymphoma (MZL), which behaved aggressively. The neoplasm rapidly disseminated to extranodal sites--the skin, lungs, pleural cavity, and the central nervous system. The neoplasm did not respond to initial double-agent chemotherapy, but it did partially respond to multi-agent chemotherapy. In addition, the neoplasm had histopathologic features not reported previously in MZL--vascular invasion, massive extranodal infiltration, high mitotic count, and convoluted nuclei.

Aged↗

Esophageal carcinoma with prominent spindle cells.

Eight cases of esophageal carcinoma with prominent spindle cells (carcinosarcoma or pseudosarcoma) were studied using the avidin-biotin immunoperoxidase method and monoclonal antibodies to various keratins and vimentin. In all eight cases positive immunoreactivity for keratin was found in carcinomatous areas and for vimentin, in the spindle cells. It is interesting that five cases demonstrated focal immunoreactivity to keratin in the spindle cell component. Trace positivity to vimentin was seen in the carcinomatous areas in one case. These findings are consistent with the hypothesis that esophageal carcinoma with prominent spindle cells is of epithelial origin and may represent a morphologic variant of squamous cell carcinoma.

Aged↗

A role for the laminin receptor in leukocyte chemotaxis.

Previous studies on the mechanism of leukocyte traversal of basement membranes showed that rabbit peritoneal exudate polymorphonuclear cells (PMN) preferentially used laminin, a major constituent of basement membrane, to attach to another component, type IV collagen. PMN also responded chemotactically to nanomolar levels of laminin. We have now determined that PMN possess a receptor for laminin. Scatchard analysis using 125I laminin indicates a single class of saturable high affinity binding sites (kd = 6.15 nM/L) on PMN and 3.6 X 10(4) sites per cell. A chymotryptically derived fragment of laminin, C1, which lacks both the long arm and the globular end regions of the short arm (i.e., matrix binding sites) but retains the laminin receptor binding region, gave similar results. Immunoperoxidase studies using monoclonal antibodies to the laminin receptor (mAbLR) indicated the presence of the receptor on the surface of PMN. These cells responded chemotactically to nanomolar levels of C1 and laminin, a result consonant with binding data. PMN chemotaxis to a formyl peptide was markedly inhibited by mAbLR, suggesting that the laminin receptor may be required for PMN chemotaxis in general. Our results suggest that PMN extravasation across basement membranes is aided both by reversible attachment of the cells to laminin in the matrix and by chemotaxis to a gradient of soluble intact and possibly degraded laminin. These characteristics have much in common with those of highly metastatic tumor cells.

Animals↗

Malignant melanoma metastatic to the ovary.

The clinical and pathologic features of 10 patients with malignant melanoma metastatic to the ovary were studied. Seven were from surgical patients who presented with possible primary ovarian neoplasms and three were autopsy cases. Six had unilateral involvement, and all but one of the metastases were grossly cystic. Two predominant histologic patterns were identified: the more common (six cases) consisted of small oval to spindle-shaped cells with inconspicuous or absent melanin pigment and a focal storiform architecture. Three of these six were initially misinterpreted as ovarian stromal neoplasms. The other four tumors had large epithelioid cells with abundant cytoplasm and melanin pigment, and were readily classified as metastatic melanoma. Six of the seven surgical cases were reactive with antibodies to S-100 protein and vimentin but nonreactive with antibodies to keratin.

Adult↗

Nursing home rounds as a format for teaching residents and medical students.

The nursing home has become a focus for education as well as patient care. A format was devised for nursing home rounds that provides for discussion among staff members and specialists and is aimed at teaching and the resolution of specific patient-care and administrative issues. This format is outlined, and records from these twice-weekly rounds are reviewed. The nursing home rounds were consistently attended by members of the nursing and medical staffs, trainees, and nursing and medical directors. As is apparent from the records of these rounds, many complex medical problems were handled without transferring the patients to an acute-care facility. The discussion among participants of specific clinical problems at nursing home rounds has proven invaluable as a tool for education and delivery of patient care.

California↗

Lysostaphin lysis procedure for detection of Staphylococcus aureus by the firefly bioluminescent ATP method.

The objective of this study was to examine the use of lysostaphin as an ATP-extracting agent for the estimation of Staphylococcus aureus cell number by a rapid bioluminescent ATP method. The results of the study showed that lysostaphin (22 U/ml) was able to lyse most of the S. aureus cells (greater than 99.9%) at room temperature in 1 min; ATP of S. aureus cells extracted by the lysostaphin lysis procedure was stable for 24 h in the presence of EDTA; there was a linear relationship between the ATP content and the number of S. aureus cells (ranging from 10(4) to 10(6) CFU/ml); and the lysis of S. aureus cells by lysostaphin allowed estimation of the number of S. aureus cells in mixed cultures and in meat samples.

Adenosine Triphosphate↗

Synthesis of catalase in Staphylococcus aureus MF-31.

During the growth of Staphylococcus aureus MF-31, initial catalase activity dropped to a reduced level at the onset of exponential phase before increasing. When S. aureus was grown at 25, 32, or 37 degrees C, catalase activity was found to decrease by 80 to 90% within 1 h of inoculation. Two catalase-negative mutants and wild-type S. aureus MF-31 cells were exposed to exogenous 20 mM H2O2 for 15 min. For wild-type S. aureus, there was no effect from H2O2 until min 15, at which time a 10% decrease in CFU was observed. Both mutants showed increased sensitivity to the H2O2, with 56 and 71% reductions in the CFU for mutants C3 and C4, respectively, after a 15-min exposure. Cells of mutant and wild-type S. aureus were subjected to sublethal heating at 52 degrees C for 20 min. The lack of catalase activity in the mutants resulted in large decreases in enumeration.

Catalase↗

Adult respiratory distress syndrome in patients with severe neutropenia.

Most investigators believe that the pulmonary endothelial damage that is characteristic of the adult respiratory distress syndrome (ARDS) requires the action of neutrophils. In a retrospective review of patients with ARDS, we looked for cases that had developed in patients who already had neutropenia. Four clinical criteria were required for the diagnosis of ARDS: the occurrence of a precipitating event, diffuse bilateral pulmonary infiltrates on a chest x-ray film, a normal intravascular volume (as reflected by a wedge pressure of less than 18 mm Hg), and arterial hypoxemia. During 2 1/2 years, 11 patients fulfilled these clinical criteria, had severe neutropenia that antedated the onset of ARDS, and had pulmonary histologic specimens obtained during the early stages (less than seven days) of clinical respiratory distress. Five of these specimens showed diffuse alveolar damage without evidence of infectious pneumonitis (the histopathological finding characteristic of ARDS), and none had a neutrophil infiltrate. We conclude that ARDS can occur in the setting of severe neutropenia, without pulmonary neutrophil infiltration.

Adult↗

Organizing an academic nursing home. Impacts on institutionalized elderly.

In March 1984, a program for an academic nursing home was established at the Sepulveda Veterans Administration Medical Center. The program was designed to improve care of nursing home patients, provide interdisciplinary training for medical house staff and allied health students, and stimulate research. Geriatric faculty physicians were appointed, medical house staff were assigned as primary physicians to groups of patients, and geriatric nurse practitioners were hired to provide day-to-day care. A two-phase evaluation of the impact of the academic nursing home on patient care was conducted. Beneficial developments associated with the program in concurrent comparison with the standard nursing home unit included a significant decrease in patient transfers to the acute-care hospital and significant improvements in functional status, patient satisfaction, and morale. A trend toward improved survival was nonsignificant. Longer-term follow-up revealed a significantly increased rate of discharge for patients completing long-term rehabilitation. Overall, the costs of nursing home care were only minimally increased by the program. Results suggest that programs like the academic nursing home can lead to improved process and outcomes of nursing home care.

Academic Medical Centers↗

Identification of adenocarcinoma in cytospin preparations of effusions using monoclonal antibody B72.3.

Metastatic adenocarcinoma in human effusions can be difficult to distinguish from reactive mesothelial cells, particularly if the malignant cells are rare, have bland cytologic features, or occur as single cells rather than clusters of cells. Monoclonal antibody (MAb) B72.3, generated against a membrane-enriched fraction of breast carcinoma, has been shown to be reactive with formalin-fixed, paraffin-embedded tissue sections of human breast and colon carcinomas but not with sarcomas, melanomas, hematopoietic neoplasms, or a variety of normal adult tissues. The authors have adapted the avidin-biotin-immunoperoxidase method using MAb B72.3 to evaluate cytospin preparations of pleural and peritoneal effusions for the presence of adenocarcinoma cells. The cytospin method was selected because it provides a rapid, efficient, and inexpensive means of evaluating effusions for cellular content. Reactive effusions from patients with no history of adenocarcinoma as well as obviously malignant effusions from patients with documented adenocarcinoma were studied. MAb B72.3 demonstrated no reactivity with any of the variety of cell types in the reactive specimens from patients without a history of adenocarcinoma. In contrast, in all of the malignant effusions studied, 10-90% of the nonhematopoietic cells demonstrated reactivity with MAb B72.3. In addition, MAb B72.3 highlighted occult adenocarcinoma cells in cytospin preparations of effusion fluids from patients with a primary diagnosis of adenocarcinoma in which no definite malignant cells could be identified using standard cytologic criteria.

Adenocarcinoma↗

Adenosine regulates blood flow and glucose uptake in adipose tissue of dogs.

Intravenous norepinephrine increases glycerol release and blood flow in adipose tissue. The vasodilation may be an indirect effect of norepinephrine through the production of adenosine. Adenosine increases glucose uptake and inhibits lipolysis in vitro. To test whether adenosine regulates blood flow and/or metabolism in vivo, adenosine deaminase (ADA) was infused intra-arterially into the inguinal fat pads of anesthetized dogs. In unstimulated tissues, ADA (n = 7) significantly increased vascular resistance and significantly decreased glucose uptake compared with the effects of a control (boiled deaminase, n = 6) infusion. ADA completely blocked the norepinephrine-induced vasodilation (n = 6). No potentiation of basal or catecholamine-stimulated lipolysis was observed with ADA. The presence of ADA in the interstitial space was verified by analysis of lymph effluents. Interstitial levels of ADA were inversely correlated with the tissue contents of adenosine. These data support the hypothesis that adenosine is a regulator of blood flow in basal and stimulated adipose tissue. Adenosine also appears to regulate glucose uptake, but not lipolysis, in vivo.

Adenosine↗

Evidence against high pressure, arterial baroreceptors in the abdominal viscera of cats.

The abdominal viscera of cats have been postulated to contain a site of cardiovascular regulation. In particular, a baroreceptive function has been ascribed to splanchnic afferent nerves. We wished to determine whether afferents with a cardiac-rhythmic discharge functioned as arterial baroreceptors. Nineteen afferents with a cardiac rhythmic discharge were studied. All afferents were A fibers, whose endings were located in either the pancreas, mesentery, or porta hepatis region. We examined their characteristics of discharge with regard to changes in mean pressure, pulse pressure, and dP/dt of the arterial pulse. Hemodynamic alterations were achieved by intravenous administration of isoproterenol, norepinephrine, or phenylephrine and by occlusion of the descending thoracic aorta. After isoproterenol, increases in nerve activity occurred when pulse pressure and dP/dt were increased but while mean pressure was decreasing, indicating that mean pressure was not the stimulus for discharge of these afferents. Additionally, under similar hemodynamic conditions, afferents did not demonstrate reproducible patterns of activity. The afferents generally discharged with one impulse per cardiac cycle, rarely with two to three impulses per cycle. None demonstrated a bursting pattern even when arterial blood pressure was quite elevated. The spontaneous pattern of discharge changed frequently, often after the viscera were repositioned, and sometimes remained even after complete occlusion of the aorta. The data indicate that these visceral afferents do not respond as high pressure, arterial baroreceptors. All afferents adapted extremely rapidly and exhibited a low gain (0.02 +/- 0.00 impulses X s-1 X mmHg-1), indicating that these fibers would be ineffective in signaling physiologically significant changes in hemodynamic variables. The data from this study do not support the existence of baroreceptors in the abdominal viscera of cats.

Afferent Pathways↗

Lymph node aspiration in the management of Hodgkin's disease.

Diagnosing recurrent Hodgkin's disease is an important oncologic problem. When relapse does not occur in peripheral nodal sites, then a major surgical exploration is often considered. Lymph node aspiration is proposed as a less invasive approach capable of establishing a diagnosis in some instances. In this retrospective study, 19 patients with Hodgkin's disease underwent 64 lymph node aspirations. Of these patients, 17 had suspected Hodgkin's disease with involvement at an inaccessible site. Two patients with a primary diagnosis of Hodgkin's disease underwent aspiration of a peripheral site. Of these 19 patients, five (26.3%) had a positive aspirate and only two (10.5%) had an unsatisfactory aspirate. No patient had a false-positive aspirate. Of 15 patients with a negative aspirate, five (33%) had a false-negative aspirate. In no case did a false-negative aspirate delay appropriate therapy. In those patients with a positive aspirate, surgical exploration was avoided. We conclude that lymph node aspiration cytology is useful as an initial step to document clinical relapse of Hodgkin's disease at a site that might require a major surgical procedure for diagnosis.

Adult↗

Lupus anticoagulants.

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Blood Coagulation Disorders↗

Markedly decreased expression of class I histocompatibility antigens, protein, and mRNA in human small-cell lung cancer.

We have found markedly deficient expression of the class I major histocompatibility antigens HLA-A,B,C and beta 2m on human small-cell lung cancer (SCLC) lines and fresh tumor samples. The deficit of HLA-A,B,C and beta 2-microglobulin (beta 2m) antigen expression was demonstrated with both radiobinding assays and indirect immunofluorescence assays. Immunoprecipitation of metabolically labeled cells with antibodies to class I antigens showed most SCLC lines to have synthesized almost no beta 2m and HLA-A,B,C proteins. Northern blot analysis, using human HLA-A,B, and beta 2m cDNA probes, showed that almost all SCLC lines tested had markedly decreased amounts of HLA and beta 2m mRNA, but both gene products could be induced with interferon treatment of SCLC lines. We conclude that human SCLC, in contrast to other lung cancer types, is characterized by greatly reduced transcription of HLA-A,B,C and beta 2m genes, which suggests the existence of a mechanism for evading the host immune response to the tumor and of an E1a-like product in this type of tumor cell.

Antigens, Surface↗

Monoclonal antibodies against squamous cell carcinoma.

We report on a monoclonal antibody reactive with squamous carcinoma cell lines and with frozen sections from squamous cell carcinomas of the oral cavity but not with frozen sections of normal squamous epithelium of the oral cavity, esophagus, and skin. In addition, we identified other monoclonal antibodies with restricted specificity as reflected by their binding to a panel of established tumor cell lines. Subsequent testing of these monoclonal antibodies against a panel of normal and tumor tissue sections revealed two types of reactivity patterns: binding to normal tissue and binding to normal and tumor tissue.

Animals↗

Effect of pH, temperature, and potassium sorbate on amino acid uptake in Salmonella typhimurium 7136.

The effect of sorbate on L-serine and L-histidine uptake in Salmonella typhimurium was studied at various pH levels, temperatures, and amino acid and sorbate concentrations. Low pH had an apparent synergistic effect on amino acid uptake inhibition caused by sorbate. The relationship between sorbate concentration and the amount of amino acid uptake inhibition was not linear. Compared with L-histidine, L-serine uptake was more sensitive to changes in pH, temperature, and sorbate concentration. Various degrees of amino acid uptake inhibition by sorbate may be related to differences between amino acid transport systems. The results of this study suggest that sorbate acts as a noncompetitive inhibitor of amino acid uptake in S. typhimurium.

Amino Acids↗