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Biomedical subjects

W Smith

Publications and source records attributed to W Smith.

At least 397 records · Page 22Linked to original sources

Listeriosis.

Four patients with Listeria monocytogenes infection are presented; three of whom had associated lymphoproliferative disorders. Two of the four patients had Listeria meningitis. Meningitis is the most common manifestation of listeriosis in humans. Specific diagnosis depends on demonstrating Listeria monocytogenes in the cerebral spinal fluid; differentiation from other forms of acute meningitis cannot be made clinically. Although listeriosis is recognized as a major global problem in both human and animal health, the epidemiology of human infection is poorly understood. Animals and animal products may serve as reservoirs for human infection. Antibiotic therapy resulted in recovery in three of the patients. The history, epidemiology, laboratory diagnosis, clinical manifestations, and therapy of listeriosis are reviewed.

Africa↗

Fiber optic pressure sensor for biomedical applications.

In vivo measurement of blood pressure is critical in many settings, including patient care, medical research, and control of cardiovascular assist and replacement devices. This article describes a pressure sensor based on fiber optic, white light interferometry. An optical interference filter formed between the end face of an optical fiber and the sensing diaphragm selectively reflects a wavelength component. A low cost, thin film optical wedge interferometer placed at the output end detects the wavelength of the reflected signal, which represents a unique cavity length of the interference filter directly related to the diaphragm deflection and, therefore, pressure. Several key features of this sensing scheme include low drift, high accuracy, and insensitivity to light loss factors along the length of the optical fiber. This fiber optic pressure sensor promises significant advances as a medical monitoring tool, a research instrument, and a component of cardiovascular assist and replacement devices. A prototype pressure gauge has been built, and the feasibility of the optical approach verified. Experimental results of the prototype gauge for resolution, repeatability, and drift and a preliminary design for a high resolution, low drift, miniature fiber optic pressure probe are presented herein.

Biomechanical Phenomena↗

Errors caused by combination of Di-4 ANEPPS and Fluo3/4 for simultaneous measurements of transmembrane potentials and intracellular calcium.

Intracellular calcium concentration and transmembrane potentials are two important measurements used to study the mechanisms of cardiac activity. Fluorescent dyes have been used to measure these separately but not simultaneously in cardiac tissue. Fluo-3 and Fluo-4 (a recently improved version of Fluo-3) have been used to measure changes in intracellular calcium concentration and Di-4 ANEPPS has been used to measure transmembrane potentials. This paper addresses the feasibility of using these fluorescent dyes together in order to measure transmembrane potentials and intracellular calcium concentration simultaneously. For the dyes to be used simultaneously, their respective fluorescence spectra must be sufficiently separated in wavelength in order to allow them to be separated by optical filters or spectrographs. An apparatus was constructed to measure the dyes' spectra in a fluorescence imaging chamber as well as in an isolated perfused rabbit heart. The measured spectra were mathematically modeled in order to assess the spectral overlap error under different conditions. Error graphs were constructed which may help researchers select optical filters and dye concentrations that will result in an acceptable error.

Aniline Compounds↗

Sensitisation to the lipid-binding apolipophorin allergen Der p 14 and the peptide Mag-1.

BACKGROUND: The IgE-binding peptides Mag 1 and Mag 3 and the high-molecular-weight protein M-177 have been identified as parts of the apolipophorin-like group 14 house dust mite allergen. By analogy with the homologous insect proteins, apolipophorins are hydrophobic proteins found in lipid bodies and lipid transport particles. This explains why they degrade and are poorly represented in extracts. METHODS: We have examined the T cell stimulation induced by a 341-residue recombinant Der p 14 peptide equivalent to the Mag 1 polypeptide examined by others. RESULTS: Peripheral blood mononuclear cells from both allergic and non-allergic donors responded strongly in in vitro proliferation assays to the Der p 14 peptide to induce markedly more (3)H-thymidine incorporation than Der p 2 and the release of Th2 cytokines. CONCLUSIONS: The apolipophorin-like group 14 allergens, despite their predicted hydrophobicity and lipid-binding activity, can induce high IgE responses and T cell stimulation. They appear to be important mite allergens unsuited to representation by aqueous extracts of mites.

Allergens↗

Functional effects of polymorphisms of house dust mite allergens.

BACKGROUND: Sequence polymorphisms have been found in cDNA clones of commercial house dust mites. Here we report on the polymorphisms of Der p 1 found in environmental mites and the effect of the polymorphisms on T cell proliferation. METHODS: Sequences were obtained from DNA amplified from single mites by PCR. Synthetic peptides were used to stimulate peripheral blood cells. RESULTS: The polymorphism was limited to a few residues, but regional differences were detected in mites in Wagga. T cells were specific for the polymorphisms, so that in 16 of 17 responses, stimulation was achieved with one form of the peptide. This included peptides with Ala and Val at position 124 in the immunodominant 110-133 region. Peptide 45-63 also stimulated frequently, but only with Tyr at position 50 and not His, a residue only found in commercial mites. CONCLUSIONS: Polymorphisms of Der p 1 are found in the environment and have a profound effect on polyclonal T cell stimulation to frequently recognised epitopes.

Allergens↗

Medial collateral ligament knee sprains in college football. Brace wear preferences and injury risk.

In this prospective, multiinstitutional analysis of medial collateral ligament sprains in college football players, we categorized 987 previously uninjured study subjects according to frequency of wearing preventive knee braces, studied the patterns by which 47 of 100 injuries occurred to unbraced knees, and identified several extrinsic, sport-specific risk factors shared for both braced and unbraced knees. The attendance, brace wear choice, position, string, and session of each participant were recorded daily; medial collateral ligament sprains were reported whenever tissue damage was confirmed. Both the likelihood of wearing braces and risk of injury without them was highly dependent on session (games/practices), position group (line, linebacker/tight end, skill), and string group (players/nonplayers). Subjects wearing braces often faced a high injury risk to their unbraced knees, a finding compatible with the opinion that braces were a necessary evil, best worn when concern over danger of injury outweighed desire for speed and agility. It is concluded that to avoid misinterpretations due to the confounding influence of brace wear selection bias, accurate investigation of daily brace wear patterns is required. Then, before considing the impact of preventive knee braces, a repartitioning of the data base is essential to assure that only similar groups will be compared.

Athletic Injuries↗

Medial collateral ligament knee sprains in college football. Effectiveness of preventive braces.

This is the second of 2 articles on a 3-year investigation of medial collateral ligament sprains of the knee to assess the effectiveness of prophylactic knee braces in NCAA Division I college football players. Position, string, type of session, and daily brace wear were recorded. The injury rates for braced and unbraced knees were used to create an incidence density ratio. The data were stratified and simultaneously controlled for position, string, and session and evaluated for their statistical significance. The 987 Big Ten players generated 155,772 knee exposures over the study period (50% braced). Noticeable differences existed in the rates of injury for the braced and unbraced knees in almost every position during practices, depending on player or nonplayer status. When the influential factors of position, string, and session are considered, there is a consistent but not statistically significant tendency for the players wearing preventive knee braces to experience a lower injury rate than for their unbraced counterparts. For starters and substitutes in the line positions, as well as the linebackers and tight ends, there was a consistent trend toward a lower injury rate in both practices and games. The braced players in the skill positions (backs/kickers), at least during games, exhibited a higher injury rate.

Athletic Injuries↗

Managed care.

Health-care reform has become a national mandate. Managed care and managed competition have been reinforced by the Clinton health-care reform plan. What type of health-care delivery system can laboratory managers expect to be part of in the near future? We asked laboratory managers who are currently involved in those types of systems. The result is a two-part As We See It. In part one, we will cover physician partnerships and the system laboratory as we ask: What can the laboratory community expect from a managed-care environment?

Administrative Personnel↗

Chemical emergencies and the Health Advisory Group on Chemical Contamination Incidents (HAGCCI).

The Health Advisory Group on Chemical Contamination Incidents (HAGCCI) (pronounced 'Hag-C'), is an independent advisory group which was established to advise Directors of Public Health throughout the United Kingdom (UK) and the Chief Medical Officers of the UK Health Departments on the medical aspects of major chemical contamination incidents involving air, soil or water. Separate arrangements exist for the provision of advice on chemical contamination of food. HAGCCI comprises a core group of three individuals, supported by a multidisciplinary panel of experts, and a secretariat provided by the Department of Health. We describe the role of HAGCCI within the overall framework of preparedness for the public health aspects of chemical emergencies.

Decontamination↗

Recombinant human acid alpha-glucosidase enzyme therapy for infantile glycogen storage disease type II: results of a phase I/II clinical trial.

PURPOSE: Infantile glycogen storage disease type II (GSD-II) is a fatal genetic muscle disorder caused by deficiency of acid alpha-glucosidase (GAA). The purpose of this study was to investigate the safety and efficacy of recombinant human GAA (rhGAA) enzyme therapy for this fatal disorder. METHODS: The study was designed as a phase I/II, open-label, single-dose study of rhGAA infused intravenously twice weekly in three infants with infantile GSD-II. rhGAA used in this study was purified from genetically engineered Chinese hamster ovary (CHO) cells overproducing GAA. Adverse effects and efficacy of rhGAA upon cardiac, pulmonary, neurologic, and motor functions were evaluated during 1 year of the trial period. The primary end point assessed was heart failure-free survival at 1 year of age. This was based on historical control data that virtually all patients died of cardiac failure by 1 year of age. RESULTS: The results of more than 250 infusions showed that rhGAA was generally well tolerated. Steady decreases in heart size and maintenance of normal cardiac function for more than 1 year were observed in all three infants. These infants have well passed the critical age of 1 year (currently 16, 18, and 22 months old) and continue to have normal cardiac function. Improvements of skeletal muscle functions were also noted; one patient showed marked improvement and currently has normal muscle tone and strength as well as normal neurologic and Denver developmental evaluations. Muscle biopsies confirmed that dramatic reductions in glycogen accumulation had occurred after rhGAA treatment in this patient. CONCLUSIONS: This phase I/II first study of recombinant human GAA derived from CHO cells showed that rhGAA is capable of improving cardiac and skeletal muscle functions in infantile GSD-II patients. Further study will be needed to assess the overall potential of this therapy.

Age Factors↗

Does evidence of inflammation on Papanicolaou smears of pregnant women predict preterm labor and delivery?

BACKGROUND: Preterm delivery is the most common cause of neonatal morbidity and mortality in the United States. There is evidence that cervicovaginal infection could predispose to preterm labor. This study explored a possible association of evidence of inflammation on an otherwise normal Papanicolaou smear obtained during pregnancy with subsequent preterm labor and preterm delivery. METHODS: Using a retrospective matched cohort design, we studied women who gave birth to live singleton infants at the University of Missouri Hospital and Clinics during a 21-month period. Papanicolaou smears were obtained from 1 to 8 months before delivery and were interpreted in the same cytopathology laboratory. Data pertaining to outcome variables and potential confounding variables were collected from hospital charts. RESULTS: Incidence rates were 14.4 percent for labor < 37 weeks' gestation (preterm labor), 12.3 percent for hospitalization for preterm labor, 9.9 percent for delivery < 37 weeks (preterm delivery), 2.6 percent for delivery < 34 weeks, and 7.5 percent for birth weight < 2500 g. On univariate and multivariate analyses, there were no significant differences in any outcome between the 293 women with inflammation and the 284 women without inflammation on Papanicolaou smear. Results were unchanged when the analysis was limited to the 412 women who received no antibiotics during pregnancy. Among the 38 women with a history of preterm labor or preterm delivery, those with cervical inflammation had a higher rate of preterm labor than those without inflammation. CONCLUSIONS: In the sample as a whole, there was little evidence that findings of inflammation on Papanicolaou smear constituted a risk factor for preterm labor or preterm delivery. The data suggest that inflammation could be associated with an increased risk in a subgroup of women at higher risk by virtue of their obstetric history.

Adult↗

Platelet preservation during cardiopulmonary bypass with iloprost and Duraflo-II heparin-coated surfaces.

To test the hypothesis that temporary platelet inhibition during cardiopulmonary bypass (CPB) with surface heparinized systems may result in platelet preservation, nine Yorkshire pigs were placed on CPB for 3 hours. Platelet labeling was done in all pigs with Indium-111 tropolone. CPB was instituted with a roller pump, a hollow fiber membrane oxygenator (Bentley CM-50 [Baxter-Bentley Laboratories, Irvine, CA]), and an arterial filter. The extracorporeal perfusion systems were surface-coated with the Duraflo-II heparin complex. Group A pigs (n = 5) were systemically heparinized (activated coagulation time longer than 400 sec). Group B pigs (n = 4) were placed on CPB without systematic heparinization, but have received the stable prostacyclin-analog Iloprost (ZK36374) at 1 ng/kg/min i.v. from 30 min before and during CPB. Platelet counts declined in group A pigs at 5 min, 1 hr, 2 hr, and 3 hr of CPB to 79.8% (mean), 66.5%, 71.3%, and 69.0% of pre-CPB values, respectively (p less than 0.05). In group B pigs, mean platelet count during CPB was higher than 90% of control value. Percentage of injected radioactivity detected in the oxygenator was 2.82% in group A pigs versus 0.73% in group B pigs (p = 0.0541). Surface heparinization with the Duraflo II heparin coating complex in combination with Iloprost-induced temporary platelet inhibition resulted in platelet count preservation during CPB in the pig model.

Animals↗