Frequencies of the Jk(a-b-) phenotype in Polynesian ethnic groups.
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Blood Group Antigens↗
Biomedical subjects
S Henry
Publications and source records attributed to S Henry.
Nonoperative salvage of computed tomography-diagnosed splenic injuries: utilization of angiography for triage and embolization for hemostasis.
OBJECTIVES: The aims of this study were to determine if angiographic findings can be used to predict successful nonoperative therapy of splenic injury and to determine if coil embolization of the proximal splenic artery provides effective hemostasis. METHODS: Splenic injuries detected by diagnostic imaging between 1981 and 1993 at a level I trauma center were prospectively collected and retrospectively reviewed after management by protocol that used diagnostic peritoneal lavage, computed tomography (CT), angiography, transcatheter embolization, and laparotomy. Computed tomography was performed initially or after positive diagnostic peritoneal lavage. Angiography was performed urgently in stabilized patients with CT-diagnosed splenic injuries. Patients without angiographic extravasation were treated by bed rest alone; those with angiographic extravasation underwent coil embolization of the proximal splenic artery followed by bed rest. RESULTS: Patients (172) with blunt splenic injury are the subject of this study. Twenty-two patients were initially managed operatively because of associated injuries or disease (11 patients) or because the surgeon was unwilling to attempt nonoperative therapy (11 patients) and underwent splenectomy (17 patients) or splenorrhaphy (5 patients). One hundred fifty of 172 consecutive patients (87%) with CT-diagnosed splenic injury were stable enough to be considered for nonoperative management. Eighty-seven of the 90 patients managed by bed rest alone, and 56 of 60 patients treated by splenic artery occlusion and bed rest had a successful outcome. Overall splenic salvage was 88%. It was 97% among those managed nonoperatively, including 61 grade III and grade IV splenic injuries. Sixty percent of patients received no blood transfusions. Three of 150 patients treated nonoperatively underwent delayed splenectomy for infarction (one patient) or splenic infection (two patients). CONCLUSIONS: (1) Hemodynamically stable patients with splenic injuries of all grades and no other indications for laparotomy can often be managed nonoperatively, especially when the injury is further characterized by arteriography. (2) The absence of contrast extravasation on splenic arteriography seems to be a reliable predictor of successful nonoperative management. We suggest its use to triage CT-diagnosed splenic injuries to bed rest or intervention. (3) Coil embolization of the proximal splenic artery is an effective method of hemostasis in stabilized patients with splenic injury. It expands the number of patients who can be managed nonoperatively.
Adolescent↗
Lewis histo-blood group system and associated secretory phenotypes.
This review summarises present knowledge of the chemistry, immunology, genetics and clinical significance of antibodies in the Lewis and secretor histo-blood group systems. Although red cell serology has laid the foundations for these systems, more recent advances have been made by studying Lewis and related glycoconjugates with monoclonal antibodies, determining structures by mass spectrometry and NMR spectroscopy, identifying enzymes and their specificities, and identifying the genes by molecular biology. The expression of Lewis system antigens is dependent on Lewis and secretor loci. Fucosyltransferases coded by genes at these loci compete and interact with each other and with other transferases to determine an individual's Lewis and secretor phenotype. Exocrine epithelial cells, mostly of endodermal origin, synthesise the Lewis antigens which, as plasma glycolipids, are secondarily acquired by cells of the peripheral circulation. Phenotyping red cells is often regarded as a simple way of determining the Lewis and sometimes the secretor status of an individual; however, the red cell phenotype is influenced by many factors and may not necessarily reflect someone's Lewis and secretor genotypes. Two main red cell Lewis groups are usually found, Lewis negative and Lewis positive. In Lewis-negative individuals, the secretor genotype does not affect the Lewis phenotype, but in Lewis-positive individuals, the non-secretor genotype generates the Le(a+b-) phenotype, the secretor genotype causes the Le(a-b+) phenotype, and the partial secretor genotype gives rise to the Le(a+b+) phenotype.
Carbohydrate Sequence↗
[Detection of Chlamydia trachomatis infection by PCR in first voided urines in men].
The goal of this study was to evaluate whether the new commercially available PCR-based assay Amplicor C. trachomatis (Roche Molecular Systems) could improve the diagnosis of chlamydial urogenital infections in men, compared with cell culture of C. trachomatis considered as the reference method. A total of 466 men attending the STD clinic were tested by the Amplicor test in urine and by cell culture in urethra. The prevalence of C. trachomatis was 13.7% (64/466) by cell culture and 14.4% (67/466) by the Amplicor test. After resolution of the discrepant results, the sensitivity of culture was 91.4% in male urethral specimens. The resolved sensitivity of the PCR assay was 92.7% in male urine and the specificity was 99.5%. We concluded that this rapid PCR-based assay showed an improvement in quality for diagnosing C. trachomatis infections in men.
Adolescent↗
Porcine pleuropneumonia.
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Actinobacillus Infections↗
HLA class I gene, antigen and haplotype frequencies in New Zealand Maori and Europeans.
AIM: To determine class I HLA gene, antigen and haplotype frequencies for New Zealand Maori and Europeans. METHODS: Statistical analysis was performed using accumulated data from Maori (n = 576) and European (n = 1747) parentage studies. RESULTS: HLA class I gene, antigen and haplotype frequencies are as tabulated. Significant statistical differences were shown to exist between New Zealand Maori, New Zealand Europeans and Europeans. Gene frequencies of HLA A1, 3, 9, 11, 19 and HLA B7, 8, 12, 16, 22, and 40 differed significantly between New Zealand Maori and New Zealand European data. Gene frequencies of HLA A1 and B12 differed significantly between New Zealand European and European data. CONCLUSIONS: This HLA frequency data can be used for calculating more reliable indices of paternity or for determining the potential availability of matched organs for transplantation, as well as for anthropological studies. The data may also be useful in forensic investigations.
Europe↗
Effects of infused fructose on endogenous glucose production, gluconeogenesis, and glycogen metabolism.
To determine the mechanisms that prevent an increase in gluconeogenesis from increasing hepatic glucose output, six healthy women were infused with [1-13C]fructose (22 mumol.kg-1.min-1), somatostatin, insulin, and glucagon. In control experiment, non-13C-enriched fructose was infused at the same rate without somatostatin, and [U-13C]glucose was infused to measure specifically plasma glucose oxidation. Endogenous glucose production (EGP, [6,6-2H]glucose), net carbohydrate oxidation (CHOox, indirect calorimetry), and fructose oxidation (13CO2) were measured. EGP rate did not increase after fructose infusion with (13.1 +/- 1.2 vs. 12.9 +/- 0.3 mumol.kg-1.min-1) and without (10.3 +/- 0.5 vs. 9.7 +/- 0.5 mumol.kg-1.min-1) somatostatin, despite the fact that gluconeogenesis increased. Nonoxidative fructose disposal, corresponding mainly to glycogen synthesis, was threefold net glycogen deposition, the latter calculated as fructose infusion minus CHOox (14.8 +/- 1.1 and 4.3 +/- 2.0 mumol.kg-1.min-1). It is concluded that 1) the mechanism by which EGP remains constant when gluconeogenesis from fructose increases is independent of changes in insulin and 2) simultaneous breakdown and synthesis of glycogen occurred during fructose infusion.
Adult↗
Loss of anionic sites on the glomerular basement membrane in transplant glomerulopathy.
We studied anionic sites on the glomerular basement membrane in patients with chronic renal transplant rejection having clinical and histological features of transplant glomerulopathy. All patients had significant proteinuria (greater than 1 g/24 h as well as light- and electron-microscopic features very like focal segmental glomerulosclerosis, though no patient had that disease in the native kidney. A significant reduction in the density and absolute number of anionic sites was observed compared with controls and with patients having stable graft function. The findings suggest that the loss of anionic sites may play an important part in the pathogenesis of transplant glomerulopathy.
Anions↗
Fixation with bioabsorbable screws for the treatment of fractures of the ankle.
One hundred and fifty-five patients who had a closed, displaced medial malleolar, bimalleolar, or trimalleolar fracture of the ankle were managed with medial malleolar fixation with use of either 4.0-millimeter orientruded polylactide screws (eighty-three patients, study group) or 4.0-millimeter stainless-steel screws (seventy-two patients, control group). All lateral malleolar fractures were stabilized with standard metallic implants. At an average of thirty-seven months (range, twenty-one to fifty-nine months), the radiographic and functional results in the two groups were equivalent. Differences between the two groups with regard to the rates of operative and postoperative complications were not statistically significant. Late spontaneous drainage of the hydrolyzed polylactide was not noted in any patient in the study group. The prevalence of late tenderness over the medial malleolar implant was lower in the patients in whom the fracture had been stabilized with polylactide screws. We conclude that polylactide screws are a safe and effective alternative to stainless-steel screws for the fixation of displaced medial malleolar fractures.
Adult↗
Serum lipid profile determines platelet reactivity to native and modified LDL-cholesterol in humans.
The effects of thrombin (0.2 U/ml) and native (n-LDL), malondialdehyde-modified (MDA-LDL) and auto-oxidized (ox-LDL) low-density lipoproteins (20 micrograms of protein/ml) on platelet activation were evaluated in seven hyperlipidemic patients and compared to seven controls (fasting serum cholesterol 8.49 +/- 0.5 and 4.61 +/- 0.4 mM, respectively). Basal and thrombin-induced increases in platelet intracellular free calcium ion concentration ([Ca2+]i; fura-2) were similar in hyperlipidemic patients and controls (45 +/- 5 vs 42 +/- 3 and 635 +/- 51 vs 599 +/- 69 mM, respectively). n-LDL, MDA-LDL and ox-LDL increased basal [Ca2+]i (16, 36 and 81 percent, p < 0.01 between LDL-types), increases were consistently smaller in patients. There was an inverse relationship between LDL-induced responses and fasting serum LDL cholesterol as well as LDL/HDL ratio. In conclusion, modified LDL activated platelets to a greater extent than n-LDL, suggesting different types of LDL-receptors. Their agonistic effect was inversely related to the fasting serum lipid profile, suggesting that blunting of platelet responses to LDL could represent a protective mechanism in hyperlipidemic patients.
Adult↗
[Typing of human papillomaviruses in intra-epithelial malpighian lesions of the cervix uteri: correlation with cytohistologic grade and progression of the lesions].
The clinical course of condylomas of the cervix, and more generally of all cervical dysplasias whether associated with koilocytosis or not, remains unpredictable. Based on a series of earlier publications, we undertook a routine typing for human papillomaviruses in intraepithelial malpighian lesions of the cervix. We examined the real usefulness of such typing to determine prognosis of the lesions and correct clinical management. We determined the correlations between human papillomaviruses, as detected by the in situ hybridization method, with the histological grade of 125 cervical lesions (in 106 patients) and the clinical course (mean follow-up = 24 months) in 56% of them. Viruses 16/18 and/or 31/33/55, considered to be potential oncogenes, predominated, whatever the grade, in in situ hybridization positive intraepithelial malpighian lesions (57 out of 59 cases; 97%). In the follow-up cases, there was no difference in the clinical course of the lesions in terms of grade (simple condyloma mild or moderate dysplasia) based on the hybridization results (detection and typing). These findings suggest that routine viral typing cannot be proposed to determine the therapeutic attitude (abstention, destruction) for the management of intraepithelial lesions of the cervix.
Condylomata Acuminata↗
Continuous aerosolised tribavirin for respiratory syncytial virus infection in lung transplant recipients.
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Aerosols↗
Risk assessment for aflatoxin: an evaluation based on the multistage model.
Lifetime cancer potency of aflatoxin was assessed based on the Yeh et al. study from China in which both aflatoxin exposure and hepatitis B prevalence were measured. This study provides the best available information for estimating the carcinogenic risk posed by aflatoxin to the U.S. population. Cancer potency of aflatoxin was estimated using a biologically motivated risk assessment model. The best estimate of aflatoxin potency was 9 (mg/kg/day)-1 for individuals negative for hepatitis B and 230 (mg/kg/day)-1 for individuals positive for hepatitis B.
Adult↗
Phrenic nerve pacing--an alternative to positive pressure ventilation: the required nursing care.
Phrenic nerve pacing as a method of ventilation was first recognized in 1783. For years, this technique was not used because of the lack of practical technology. Interest in phrenic nerve pacing was renewed in the 1960s with the development of a radio frequency transmission system. Applicable to a limited patient population, phrenic nerve pacing has several benefits over positive-pressure ventilation. Benefits include greater patient mobility, verbal articulation, less mechanical noise, and breathing by natural negative-pressure. This article provides information for nurses who care for patients ventilated by phrenic nerve pacing.
Diaphragm↗
Alpha-3-fucosyltransferases and their glycoconjugate antigen products in the developing human kidney.
BACKGROUND: Three patterns of alpha-3-fucosyltransferase activity have been described in human adult tissues with different acceptor specificity: myeloid, plasma and Lewis. Five- to ten-week embryos express the myeloid enzyme in all tissues tested, then this enzyme is replaced by plasma or Lewis enzymes, with the exception of leukocytes that continue to express the myeloid form of the enzyme in the adult. These enzymes have not been studied as yet in the developing human kidney. EXPERIMENTAL DESIGN: The three different alpha-3-fucosyltransferases were studied in homogenates of mesonephros and metanephros with synthetic oligosaccharide acceptors. The oligosaccharide precursors and products of these enzymes (precursor, H, Le(a), sialyl-Le(a) and Le(b) for type 1 and precursor, H, Le(x), sialyl-Le(x) and Le(y) for type 2) were localized by immunofluorescence with specific antibodies. RESULTS: Only the myeloid alpha-3-fucosyltransferase is detected at 5 weeks in mesonephros and it disappears at 8 weeks. In metanephros, the myeloid enzyme alone is detected between weeks 6 and 8. The plasma enzyme then appears and only at the last trimester of gestation does the Lewis enzyme appear. Three histologic patterns that are concordant with the expression of the alpha-3-fucosyltransferases are observed: I. Inducer, S-shaped body, Bellini and calyce express Le(x) at an early stage when, only the myeloid alpha-3-fucosyltransferase is detected; II. Later, the proximal tubules and descending limbs of Henle's loop express Le(x) (week 9) and sialyl-Le(x) (week 16) when the plasma alpha-3-fucosyltransferase appears; III. Calyceal and collecting systems always express Le(x) and after week 12 Le(a) and Le(b) appear, in accordance with the late appearance of Lewis alpha-3/4-fucosyltransferase. CONCLUSIONS: The sequential appearance of enzymes and their products suggests that during renal organogenesis the myeloid alpha-3-fucosyltransferase is progressively replaced by the plasma enzyme in the proximal tubules and later by the Lewis enzyme in Bellini's ducts and calyce.
Adult↗
Clinical outcome of Epstein-Barr viremia in transplant patients.
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Drug Therapy, Combination↗
Evaluation of a chemiluminometric immunoassay for detection of Chlamydia trachomatis in the urine of male and female patients.
A chemiluminometric immunoassay (Magic Lite Chlamydia) for detection of Chlamydia trachomatis antigens in first-void urine samples was compared with cell culture using urogenital swabs from 221 men and 242 women. The rate of isolation of Chlamydia trachomatis was 23.5% in men, nearly 80% of whom had symptoms of urethritis, and 8.3% in women, in whom both cervix and urethra samples were tested. In urine sediments from men and women respectively the chemiluminometric assay showed a sensitivity of 80.8% and 70%, a specificity of 97% and 95%, a positive predictive value of 89.4% and 58.3%, and a negative predictive value of 94.3% and 97.2%. Discrepancies between results obtained with the chemiluminometric assay and cell culture were resolved using two polymerase chain reaction techniques to test urogenital samples. The detection of Chlamydia trachomatis in urine samples with the chemiluminometric assay was confirmed to be superior for screening symptomatic men with urogenital infections than women as a lower prevalence population.
Adolescent↗
Human immunodeficiency virus infection in intravenous drug users: a model for primary care.
PURPOSE: Intravenous drug users (IVDUs) often encounter barriers to primary care. To improve access, we developed a primary care clinic--Central Medical Unit (CMU)--for substance abusers in drug treatment. We report outcomes for services offered to IVDUs with human immunodeficiency virus (HIV) infection. PATIENTS AND METHODS: During 1990, 24% (120 of 509) of IVDUs eligible for CMU were HIV positive. Diagnostic therapeutic and preventive goals for IVDUs with HIV infection were evaluated for acceptance and compliance by chart review for these 120 patients. RESULTS: On admission, 65% (78 of 120) of patients reported having no source of primary care, 64% (77 of 120) were male, and 77% (92 of 120) were in methadone maintenance. All were screened for tuberculosis, syphilis, and hepatitis; 94% (15 of 16) of eligible patients accepted tuberculosis prophylaxis and 83% (5 of 6) accepted syphilis treatment, but only 36% (5 of 14) accepted hepatitis B vaccine. Of those who accepted therapy, 87% (13 of 15) were compliant with tuberculosis prophylaxis, and 100% (5 of 5) were compliant with syphilis treatment. Influenza vaccine was accepted by 49% (59 of 120) and pneumococcal vaccine by 81% (97 of 120). Ninety-eight percent (118 of 120) accepted T-cell testing: 61% had T-helper counts less than 500/mm3 and 25% were less than 200/mm3. Of those eligible, 89% (70 of 79) accepted antiretroviral therapy, and 100% (35 of 35) accepted Pneumocystis carinii pneumonia prophylaxis. Six-month compliance rates for these therapies were 84% (59 of 70) and 77% (27 of 35), respectively. CONCLUSION: By offering primary care services with drug treatment, the CMU model may be an effective way of providing access to primary care for HIV-infected IVDUs and for facilitating compliance.
Adult↗