Biomedical subjects

S Freeman

Publications and source records attributed to S Freeman.

At least 37 records · Page 2Linked to original sources

PubMed2001

Report of 19 cases of photoallergic contact dermatitis to sunscreens seen at the Skin and Cancer Foundation.

We report on our experience with sunscreen allergy between 1992 and 1999 and also review the international literature on sunscreen allergy. There were a total of 21 allergic reactions to sunscreen chemicals observed in 19 patients over the 8 years. There were nine positive photopatch reactions to oxybenzone, eight to butyl methoxy dibenzoylmethane, three to methoxycinnamate and one to benzophenone. No positive reactions were observed to para aminobenzoic acid. Six patients also had positive patch tests to components of the sunscreen base. In our experience, sunscreen chemicals are the most common cause of photoallergic contact dermatitis.

Dermatitis, Photoallergic↗

PubMed2001

Vestibular end-organ impairment in an animal model of type 2 diabetes mellitus.

OBJECTIVES/HYPOTHESIS: To define and assess the functional impairment of the vestibular part of the inner ear in a diabetic state, using a direct and objective test for evaluating the vestibular end-organ and an animal model for diet-induced type 2 diabetes mellitus. STUDY DESIGN: Prospective controlled animal study. METHODS: Two groups of sand rats (Psammomys obesus) were maintained on two different diets. The experimental group received a specially designed high-energy diet known to induce a diabetic state, and the control group a low-energy diet maintaining these animals in a normal metabolic state. After 1 month of documented hyperglycemia in the experimental group, recordings of vestibular evoked potentials (VsEPs) and recordings of auditory brainstem response (ABR) were conducted in all animals. The latency and the amplitude of the first wave of both responses, shown to reflect end-organ activity, were compared between the two groups. RESULTS: The mean latency of the first wave of the VsEPs was significantly (P = .002) prolonged and the amplitude was significantly (P = .005) decreased in the diabetic group in comparison to the control group. The latency of the first wave of ABR was significantly (P = .02) prolonged, the amplitude was not significantly decreased, and threshold was significantly elevated (P = .01) in the diabetic group. CONCLUSION: For the first time, using an objective assessment test, functional impairment of the vestibular part of the inner ear has been demonstrated in the diabetic metabolic state. Despite this being an animal study, these findings would seem to indicate that the vestibular-end-organ should be added to the long list of organs and tissues adversely affected by diabetes.

Animals↗

PubMed2001

Objective method for differentiating between drug-induced vestibulotoxicity and cochleotoxicity.

HYPOTHESIS: An objective direct method is proposed to differentiate between drug-induced functional vestibulotoxicity and cochleotoxicity. BACKGROUND: Many substances are ototoxic. Although there are objective methods to directly evaluate functional cochlear toxicity (auditory nerve brainstem responses [ABR]), it is more difficult to assess direct functional ototoxicity to the various vestibular end organs. METHODS: Short-latency vestibular evoked potentials (VsEP) from different vestibular end organs and ABR, were used to assess functional impairment of the vestibular and cochlear end organs caused by daily injections of the aminoglycoside amikacin (known to be preferentially cochleotoxic) in guinea pigs. RESULTS: There was no significant change in the various VsEPs. whereas ABR thresholds were elevated, confirming the selective functional cochleotoxicity previously reported, as evaluated by other (mainly nondirect) methods. CONCLUSION: This study demonstrates the feasibility in general of using short-latency evoked potentials to evaluate functional cochleotoxicity and vestibulotoxicity of ototoxic drugs and to differentiate between them.

Amikacin↗

PubMed2001

The pathway for the transmission of external sounds into the fetal inner ear.

After at least 20 weeks gestation, the human fetus in utero is able to hear and respond to external and internal (maternal) sounds. The external sounds are attenuated by maternal tissues and fluids - higher frequencies by about 20 dB, and lower frequencies are only slightly reduced. The sounds in the amniotic fluid, which completely envelops the fetus, then reach the fetal inner ear by bone conduction. The sound pressure in the amniotic fluid induces skull vibrations which are transmitted directly into the contents of the cranial cavity (brain and CSF) and from there, presumably by fluid channels connecting them, into the cochlear fluids. A further stage of conductive attenuation is probably involved in this transmission. Since the fetus in utero receives oxygen by placental diffusion (less efficient than pulmonary diffusion), the fetal inner ear is hypoxic compared to that following birth (pulmonary oxygen diffusion). This leads to a reduction in the magnitude of the endocochlear potential, to a depression of cochlear transduction and amplification, and thus to an additional sensorineural component of threshold elevation in the fetus. Upon birth, these conductive and sensorineural attenuations are removed.

Amniotic Fluid↗

PubMed2001

Measles immunization acceptance in Southeast Asia: past patterns and future challenges.

Despite substantial increases in immunization rates, measles remains a major health problem in developing countries of Southeast Asia. The authors of this paper undertook separate investigations which examined factors influencing measles immunization acceptance in the rural Philippines, Central Java, Indonesia, and an impoverished neighborhood in Bangkok, Thailand. We briefly summarize the findings of our three field investigations before presenting a synthesizing analysis of the psychosocial and demographic factors which affect measles immunization. We then review trends influencing measles acceptance in industrialized countries to anticipate possible future challenges to measles immunization acceptance in Southeast Asia in an era of increasing globalization and information transfer. We suggest that parental perceptions of the risks and benefits of immunization, philosophical and religious convictions and state and social regulatory policies will profoundly influence measles immunization in the new millennium.

Asia, Southeastern↗

PubMed2000

Aerosol infection of mice with recombinant BCG secreting murine IFN-gamma partially reconstitutes local protective immunity.

To better understand the contribution of interferon-gamma (IFN-gamma) to the immune response during the first 60 days of mycobacterial infection in the lungs, IFN-gamma gene disrupted (IFN-gamma-/-) mice were infected via aerosol with recombinant Mycobacterium bovis Bacillus Calmette-Guerin (BCG) secreting murine IFN-gamma (BCG-IFN-gamma) and compared to mice infected with recombinant BCG containing the vector only (BCG-vector). When IFN-gamma-/- mice were infected with BCG-vector, increasing bacillary loads and large undifferentiated granulomas that did not express inducible nitric oxide synthase (iNOS) were observed in the lungs. In contrast, infection with BCG-IFN-gamma resulted in reduced bacillary load and better differentiated granulomas containing epithelioid macrophages expressing iNOS as well as reduced levels of interleukin 10 (IL-10) mRNA. However, local production of IFN-gamma by the recombinant BCG did not protect IFN-gamma-/- mice from subsequent challenge with M. tuberculosis. Infection of IFN-gamma-/- peritoneal macrophages in vitro with BCG-IFN-gamma led to induction of iNOS expression and lower IL-10 mRNA levels. Nevertheless, the growth of the intracellular BCG was unaffected. Since IFN-gamma induced-iNOS protein and reduced IL-10 production were insufficient to control mycobacterial growth in vitro, the results suggest that additional mediator(s) present in vivo are required for control of mycobacterial growth.

Aerosols↗

PubMed2000

American translation, modification, and validation of the St. George's Respiratory Questionnaire.

BACKGROUND: The St. George's Respiratory Questionnaire (SGRQ) is a 50-item health status survey specific for chronic obstructive pulmonary disease (COPD) and other respiratory diseases that is available in British English but not American English. The SGRQ's symptom-reporting component requires a 1-year reporting period, which may be too long for reliable and accurate patient recall. OBJECTIVES: The objectives of the present study were to translate the SGRQ from British to American English, modify the reporting period of the symptom-reporting component from 1 year to 1 month, and assess the reliability, validity, and sensitivity to change of this translated modified version in a sample of patients with COPD. METHODS: Based on input from American patients with COPD and health professionals, the SGRQ was translated into American English (SGRQ-A) and then translated back to British English. For SGRQ-A reliability and validity studies, patients were asked to report symptoms experienced over 1 year (reporting period in the original SGRQ) and 1 month (modification made to SGRQ-A). We evaluated 102 patients with COPD (50% female; mean age, 68 years; mean forced expiratory volume in 1 second [FEV1], 1.01 L) at an administrative session before and after completion of a pulmonary rehabilitation program. The SGRQ-A, Chronic Respiratory Disease Questionnaire (CRQ), 36-Item Short Form Health Survey (SF-36), 6-minute walk (6MW), Medical Research Council (MRC) Dyspnea scale, and pulmonary function tests (FEV1 and % predicted FEV1) were used in the assessment battery. RESULTS: The SGRQ-A showed good agreement with the original SGRQ when translated back to British English. Internal reliability (Cronbach alpha) was > 0.70 for all SGRQ-A components except the 1-year symptom-reporting component. Test-retest intraclass correlations were 0.795 to 0.900. Construct validity was strengthened when all SGRQ-A components (except 1-year symptoms and most 1-month symptoms) correlated (P < or = 0.01) with the MRC Dyspnea scale, 6MW, all SF-36 concept scores, and 80% of CRQ domains (r = 0.30-0.72). Discriminate validity was demonstrated when all components of the SGRQ-A with the modified 1-month symptom-reporting period were shown to discriminate better between disease-severity groups (based on patient self-reports of disease severity) than did pulmonary function tests and the 6MW. Responsiveness of the SGRQ-A to change in health status was demonstrated when scores on the Symptoms-1 month and Total-1 month components detected significant improvements in patients' health status (P = 0.02 and P = 0.04, respectively). CONCLUSION: The SGRQ-A with a modified 1-month symptom-reporting period demonstrated reliability and validity in this sample of patients with COPD. Key words: chronic obstructive pulmonary disease, St. George's Respiratory Questionnaire, American translation, reliability, validity, symptom recall.

Adult↗

PubMed2000

Bone conduction experiments in animals - evidence for a non-osseous mechanism.

Bone conducted stimuli are used to differentiate between conductive and sensori-neural hearing loss. It has been thought that the main route for the transfer of vibratory energy from the point of application of the bone vibrator on the skull to the inner ear is completely osseous. An additional mechanism may play a prominent role. In rats, a bone vibrator was applied to the skull and also directly on the brain, after removing bone (a craniotomy), exposing the brain. Auditory nerve-brainstem evoked response (ABR) could be elicited not only with the vibrator on bone, but also with the vibrator directly on the brain. Similar results were obtained in guinea-pigs and fat sand rats. Noise masked this ABR. Extensive removal of skull bone did not alter the ABR to bone-conducted stimuli delivered to the exposed brain. Experimental elimination of the ossicular chain inertial mechanism and of the occlusion effect did not greatly alter the bone conduction response. A reduction in the fluid volume of the cranial cavity induced threshold elevations of the bone conducted ABR but not of the air conducted ABR. These findings can be interpreted as evidence that the 'classical' bone conduction mechanisms should be modified to include a major pathway for cochlear excitation which is non-osseous: when a bone vibrator is applied to the skull, the bone vibrations may induce audio-frequency sound pressures in the skull contents (brain and cerebro-spinal fluid) which are then communicated by fluid channels to the fluids of the inner ear.

Animals↗

PubMed2000

Bone conduction experiments in humans - a fluid pathway from bone to ear.

Animal experiments in this laboratory have led to the suggestion that a major pathway in bone conduction stimulation to the inner ear is via the skull contents (brain and CSF). This hypothesis was now tested in humans. Auditory nerve brainstem evoked responses could be recorded in neonates to bone conduction stimulation over the fontanelle and audiometric responses were obtained in neurosurgical patients with the bone vibrator on the skin over a craniotomy. There were no differences in threshold between these responses and those obtained to bone conduction stimulation over skull bone in the same subjects. Audiometric thresholds in response to bone vibrator stimulation of the eye (a 'natural craniotomy') were no different from those to bone stimulation delivered to several sites on the head. Thus there is no need to vibrate bone in order to obtain 'bone conduction' responses. Bone vibrator thresholds to stimulation at the head region with thinnest bone (temporal) were better than those to stimulation at the forehead region which has much thicker bone, implying that the vibrations penetrate the skull at the site of the vibrator. In addition, the magnitude of vibration (acceleration) measured at various sites around the head in response to bone vibrator stimulation at a fixed point on the forehead generally decreased with distance from the point of vibration. Therefore it seems that the vibrations produced by a bone vibrator at a point on the head are also able to penetrate the skull, setting up audio-frequency pressures in the CSF which spread by fluid communications to the inner ear fluids, exciting the ear.

Adolescent↗

PubMed2000

Adult-onset atopic dermatitis.

Atopic dermatitis beginning in adult life is not mentioned in the medical literature. In a review of 2604 patients attending a contact dermatitis clinic, 243 patients (9%) were diagnosed with atopic dermatitis which began for the first time at 20 years of age or older with no contact factors present. This compares with 213 patients (8%) who had atopic dermatitis and contact dermatitis. Patients with purely atopic dermatitis had negative patch testing to relevant allergens and the diagnosis was based on a personal or family history of atopy as well as elevated IgE levels and multiple positive skin prick tests. A broad range of age of onset was found, as well as a female preponderance. The commonest sites of dermatitis were generalized involvement, dermatitis of the hands or eczema involving the face.

Adult↗

PubMed2000

Recurrent urinary tract infections and genitourinary tract abnormalities in the Imerslund-Gräsbeck syndrome.

Two Imerslund-Gräsbeck patients who presented with recurrent urinary tract infections and genitourinary abnormalities are described. The patients were evaluated with abdominal ultrasounds, voiding cystourethrograms, and Schilling tests. Each patient had large postvoid residual urine secondary to a motor-neurogenic bladder. One had a duplication of the distal urethra manifesting as two meatal openings. There was lack of urinary excretion of radioactive vitamin B12 on Schilling tests in both patients. Patients with Imerslund-Gräsbeck syndrome may be predisposed to urinary tract infections because of incomplete bladder emptying. Complete physical and radiological examinations of the genitourinary tract should be performed.

Child↗

PubMed2000

Expression of pectate lyase from Colletotrichum gloesosporioides in C. magna promotes pathogenicity.

To test the contribution of pectate lyase (PL) to promoting fungal pathogenicity, a pectate lyase gene (pel) from the avocado pathogen Colletotrichum gloeosporioides, isolate Cg-14, was expressed in C. magna isolate L-2.5, a pathogen of cucurbits that causes minor symptoms in watermelon seedlings and avocado fruits. Isolate L-2.5 was transformed with pPCPH-1 containing hph-B as a selectable marker and the 4.1-kb genomic pel clone. Southern hybridization, with the 4.1-kb genomic pel clone or 2.13-kb hph-B cassette as probes, detected integration of pel in transformed C. magna isolates Cm-PL-3 and Cm-PL-10. Western blot (immunoblot) analysis with antibodies against Cg-14 PL detected a single PL secreted by L-2.5 at a molecular mass of 41.5 kDa, whereas the PL of C. gloeosporioides had a molecular mass of 39 kDa. When PL activity was measured 4 days after inoculation in pectolytic enzyme-inducing media (PEIM), transformed isolates Cm-PL-3 and Cm-PL-10 showed additive PL activity relative to both Cg-14 and L-2.5. Transformed isolates also showed additive maceration capabilities on avocado pericarp relative to the wild-type C. magna alone, but did not reach the maceration ability of C. gloeosporioides. However, more severe maceration and damping off developed in watermelon seedlings inoculated with the transformed isolates compared with the two wild-type isolates, which showed no symptom development on these seedlings during the same period. Results clearly show the contribution of a single pel to the pathogenic abilities of C. magna and suggest that PL is a pathogenicity factor required for the penetration and colonization of Colletotrichum species.

Colletotrichum↗

PubMed2000

Vestibular and cochlear ototoxicity of topical antiseptics assessed by evoked potentials.

OBJECTIVES/HYPOTHESIS: To evaluate and compare the effect of chlorhexidine gluconate, povidoneiodine, and alcohol-three antiseptics used before ear surgery-on the function of the vestibular and cochlear parts of the sand rat's inner ear. The assessment of damage is based on the recording of vestibular evoked potentials (VsEPs) and auditory brainstem response (ABR). STUDY DESIGN: Prospective controlled animal study. METHODS: Fat sand rats were randomly assigned to five different groups, each receiving topical application of a different agent: saline (control), gentamicin (ototoxic control), chlorhexidine, povidone-iodine, and alcohol. Right-side total labyrinthectomy was performed, and a polyethylene tube was inserted into the left (contralateral) middle ear. After baseline recordings were taken of VsEPs and ABR, each animal received five consecutive daily applications of the specific agent into the left middle ear. Three days after the fifth application, evoked potential recordings (VsEPs and ABRs) were repeated and compared with baseline measurements. RESULTS: Administration of saline affected neither VsEPs nor ABR. In contrast, as expected, neither of these responses could be recorded after gentamicin application. After application of chlorhexidine all waves disappeared in all sand rats. Alcohol caused the waves to disappear in some of the animals only. Povidone-iodine did not affect VsEP recordings and had only a small effect on ABR. CONCLUSIONS: Chlorhexidine and alcohol had a clear toxic effect on the vestibular and cochlear function of the inner ear of the sand rat, whereas povidone-iodine did not. Thus, taking into consideration that this is an animal study, it appears that povidone-iodine might be preferable to the other agents tested in disinfecting ears with a perforated tympanic membrane.

Administration, Topical↗

PubMed2000

Characterization of Colletotrichum acutatum causing anthracnose of anemone (Anemone coronaria L.).

Anthracnose, or leaf-curl disease of anemone, caused by Colletotrichum sp., has been reported to occur in Australia, western Europe, and Japan. Symptoms include tissue necrosis, corm rot, leaf crinkles, and characteristic spiral twisting of floral peduncles. Three epidemics of the disease have been recorded in Israel: in 1978, in 1990 to 1993, and in 1996 to 1998. We characterized 92 Colletotrichum isolates associated with anthracnose of anemone (Anemone coronaria L.) for vegetative compatibility (72 isolates) and for molecular genotype (92 isolates) and virulence (4 isolates). Eighty-six of the isolates represented the three epidemics in Israel, one isolate was from Australia, and five isolates originated from western Europe. We divided these isolates into three vegetative-compatibility groups (VCGs). One VCG (ANE-A) included all 10 isolates from the first and second epidemics, and 13 of 62 examined isolates from the third epidemic in Israel, along with the isolate from Australia and 4 of 5 isolates from Europe. Another VCG (ANE-F) included most of the examined isolates (49 of the 62) from the third epidemic, as well as Colletotrichum acutatum from strawberry, in Israel. Based on PCR amplification with species-specific primers, all of the anemone isolates were identified as C. acutatum. Anemone and strawberry isolates of the two VCGs were genotypically similar and indistinguishable when compared by arbitrarily primed PCR of genomic DNA. Only isolate NL-12 from The Netherlands, confirmed as C. acutatum but not compatible with either VCG, had a distinct genotype; this isolate represents a third VCG of C. acutatum. Isolates from anemone and strawberry could infect both plant species in artificial inoculations. VCG ANE-F was recovered from natural infections of both anemone and strawberry, but VCG ANE-A was recovered only from anemone. This study of C. acutatum from anemone illustrates the potential of VCG analysis to reveal distinct subspecific groups within a pathogen population which appears to be genotypically homogeneous by molecular assays.

Australia↗

PubMed2000

Immunopathologic effects of tumor necrosis factor alpha in murine mycobacterial infection are dose dependent.

In experimental mycobacterial infection, tumor necrosis factor alpha (TNF-alpha) is required for control of bacillary growth and the protective granulomatous response, but may cause immunopathology. To directly examine the positive and detrimental effects of this cytokine, a murine model was used in which different amounts of TNF-alpha were delivered to the site of infection. Mice with a disruption in the TNF-alpha gene (TNF-KO) or wild-type mice were infected with low or high doses of recombinant Mycobacterium bovis BCG that secreted murine TNF-alpha (BCG-TNF). Infection of TNF-KO mice with BCG containing the vector (BCG-vector) at a low dose led to increased bacillary load in all organs and an extensive granulomatous response in the lungs and spleen. The mice succumbed to the infection by approximately 40 days. However, when TNF-KO mice were infected with low doses of BCG-TNF, bacillary growth was controlled, granulomas were small and well differentiated, the spleen was not enlarged, and the mice survived. Infection with high inocula of BCG-TNF resulted in bacterial clearance, but was accompanied by severe inflammation in the lungs and spleen and earlier death compared to the results from the mice infected with high inocula of BCG-vector. Wild-type mice controlled infection with either recombinant strain, but showed decreased survival following high-dose BCG-TNF infection. The effects of TNF-alpha required signaling through an intact receptor, since the differential effects were not observed when TNF-alpha receptor-deficient mice were infected. The results suggest that the relative amount of TNF-alpha at the site of infection determines whether the cytokine is protective or destructive.

Animals↗

PubMed2000

Use of evoked potentials to objectively differentiate between selective vulnerability of cochlear and vestibular end organ function.

Auditory nerve brainstem evoked responses (ABR) have been used for several decades to investigate cochlear function. Recently techniques have been developed to elicit similar recordings from the vestibular end organs - short latency vestibular evoked potentials (VsEPs). Both ABR and VsEP reflect appropriate end organ function and may therefore be used to investigate the vulnerability of these end organs to various experimental insults, such as noise exposure and ototoxic drugs.

Animals↗

PubMed2000

Basic and clinical physiology of the inner ear receptors and their neural pathways in the brain.

The six receptors of the inner ear (cochlea, two otolith organs and three semicircular canals) share a common transduction unit made up of a sensory hair cell, a first order sensory neuron and the synapse between them. Displacement of the stereocilia in a particular direction leads to excitation of the hair cell and activation of the neuron. Electrical and mechanical reflections of these stages of transduction can be recorded non-invasively in humans and in animals. These include cochlear microphonic potentials, otoacoustic emissions, auditory and vestibular evoked potentials. The ability to record these activities can be used to track the development of inner ear function in the fetus and neonate and to study the effects of various ototoxic agents (e.g. noise) and drugs.

Animals↗

PubMed2000

Influence of cranberry juice on attachment of Escherichia coli to glass.

An extract from fresh cranberries was shown to decrease the strength of attachment of Escherichia coli to glass coverslips when incubated together for 2 h. Pre-conditioning of the surface prior to biofilm formation also significantly weakened the strength of attached cells.

Bacterial Adhesion↗