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PubMed1996

Modified technique to recover microsporidian spores in sodium acetate-acetic acid-formalin-fixed fecal samples by light microscopy and correlation with transmission electron microscopy.

Microsporidia are an emerging cause of significant disease, particularly in the immunocompromised host. Until recently, the diagnosis of enteric infections has required invasive sampling, the use of expensive technology, and considerable technological expertise. The purpose of the present study was to examine three modifications to the processing of fecal specimens for light microscopy (LM) examination for microsporidian spores: the use of pretreatment with potassium hydroxide, modified centrifugation conditions, and a modified staining technique. A sodium acetate-acetic acid-formalin-fixed fecal sample containing numerous microsporidian spores confirmed to be positive by transmission electron microscopy (TEM) was used in all studies performed. A simulation of a heavy to lightly infected individual was used. The results of LM were correlated with those of TEM. Duplicate smears were stained with Weber's modified trichrome and Giemsa (GS) stains. The stained slides were randomized and examined blindly by LM at x 625 and x 1,250 magnifications. A portion of the dilutions after centrifugation were fixed for TEM. The Weber modified trichrome stain performance rating was higher than the Giemsa stain rating because of ease of interpretation, and material stained with Weber modified trichrome stain required less examination time at a lower magnification. The number of positive smears and the quantity of spores detected were significantly higher following pretreatment of the sample with KOH. TEM was positive only when numerous spores were present, but the quality of the photomicrographs was superior after pretreatment with KOH. Pretreatment of sodium acetate-acetic acid-formalin-fixed fecal samples with 10% KOH and then a 5-min centrifugation time and staining with Weber modified trichrome stain provide for the excellent recovery of microsporidia in the routine diagnostic parasitology laboratory.

AIDS-Related Opportunistic Infections↗
PubMed2004

Evaluation of a modified gen-probe amplified direct test for detection of Mycobacterium tuberculosis complex organisms in cerebrospinal fluid.

Laboratory evidence for tuberculous meningitis is difficult to acquire due to the low numbers of organisms present in cerebrospinal fluid (CSF) and the presence of nucleic acid amplification inhibitors. The Amplified Mycobacterium tuberculosis Direct Test (MTD) is sensitive and specific for the direct detection of M. tuberculosis complex in respiratory samples but has not been approved for CSF. We evaluated a modified version of the current MTD, optimized for use with CSF samples. Samples were prepared by spiking CSF with various numbers of M. tuberculosis complex organisms. The modified MTD performance was compared with results obtained using a purified RNA sample extracted using the Qiagen RNeasy Protect Bacteria Mini Kit. By use of CSF artificially spiked with M. tuberculosis complex, the sensitivity of the modified MTD was 100% (six of six) for CSF samples containing approximately 600 CFU/ml, 78% (seven of nine) for approximately 60 CFU/ml, 50% (three of six) for 6 CFU/ml, and 17% (one of six) for samples with <1 CFU/ml. The specificity of the modified MTD method was 100% (22 of 22). The sensitivity of the Qiagen MTD method was 100% for CSF samples containing approximately 600 CFU/ml (six of six) and approximately 60 CFU/ml (nine of nine), 50% for samples with approximately 6 CFU/ml (three of six), and 50% for samples with <1 CFU/ml (three of six). The specificity of the Qiagen MTD method was 86% (19 of 22). With the Qiagen MTD method, however, initial results were equivocal for 14 of the 27 (52%) positive samples, requiring repeat analysis, whereas with the modified MTD, only 1 of 27 (4%) was equivocal. The modified MTD for CSF samples was less time-consuming and less expensive and resulted in considerably fewer equivocal results than the Qiagen MTD method did.

Cerebrospinal Fluid↗
PubMed2001

Nonmyeloablative immunosuppressive regimen prolongs In vivo persistence of gene-modified autologous T cells in a nonhuman primate model.

The in vivo persistence of gene-modified cells can be limited by host immune responses to transgene-encoded proteins. In this study we evaluated in a nonhuman primate model whether the administration of a nonmyeloablative regimen consisting of low-dose total-body irradiation with 200 cGy followed by immunosuppression with mycophenolate mofetil and cyclosporin A for 28 and 35 days, respectively, could be used to facilitate persistence of autologous gene-modified T cells when a transgene-specific immune response had already been established or to induce long-lasting tolerance in unprimed recipients. Two macaques (Macaca nemestrina) received infusions of T cells transduced to express either the enhanced green fluorescent protein and neomycin phosphotransferase genes or the hygromycin phosphotransferase and herpes simplex virus thymidine kinase genes. In the absence of immunosuppression, both macaques developed potent class I major histocompatibility complex-restricted CD8(+) cytotoxic T-lymphocyte (CTL) responses that rapidly eliminated the gene-modified T cells and that persisted long term as memory CTL. Treatment with the nonmyeloablative regimen failed to abrogate preexisting memory CTL responses but interfered with the induction of transgene-specific CTL and facilitated in vivo persistence of gene-modified cells in an unprimed host. However, sustained tolerance to gene-modified T cells was not achieved with this regimen, indicating that further modifications will be required to permit sustained persistence of gene-modified T cells.

Animals↗
PubMed1999

Retrospective comparison of the Amplatz thrombectomy device with modified pulse-spray pharmacomechanical thrombolysis in the treatment of thrombosed hemodialysis access grafts.

PURPOSE: To retrospectively evaluate the Amplatz thrombectomy device (ATD) in the treatment of thrombosed hemodialysis grafts and compare it with modified pulse-spray pharmacomechanical thrombolysis (PPT). MATERIALS AND METHODS: During a 4-month period, 79 patients presented with 126 episodes of graft occlusion. Percutaneous recanalization was performed by using the ATD (n = 57) or the modified PPT technique (n = 69). Evaluation included the technical success, complications, and primary patency rates. RESULTS: Technical success was achieved in 93% (53 to 57) of the cases treated with the ATD and in 96% (66 of 69) of the cases treated with modified PPT (P = .70). Complications occurred in 6% (four of 69) of modified PPT procedures and 16% (nine of 57) of ATD procedures. This difference was not statistically significant (P = .08); however, there were significantly more local complications in the ATD group (P = .04). The primary patency rates at 30, 90, and 180 days were 65% and 65%, 36% and 50%, and 26% and 33% for modified PPT and ATD, respectively. Survival curves were found not to differ significantly (P = .49). CONCLUSION: The ATD and modified PPT were similarly successful in the recanalization of thrombosed hemodialysis access grafts and achieved comparable primary patency rates. The higher rate of local complications and technical difficulties encountered with use of the 8-F ATD limit its usefulness for this indication.

Adult↗
PubMed2005

Modifiable risk factors for cardiovascular disease in CKD patients.

Risk factors for cardiovascular disease (CVD) have been studied extensively in CKD patients. It can be differentiated between modifiable, potentially-modifiable and non-modifiable risk factors. Nonetheless, even for easily modifiable risk factors there is still a lack of data demonstrating the benefit of common interventions, such as statin treatment for dyslipidemia, improvement of HbA1c levels in diabetic patients, implementation of physical exercise, normalization of Hgb and achievement of adequate dry weight in dialysis patients. This article gives an overview of modifiable and potentially modifiable risk factors and available modification strategies.

Cardiovascular Diseases↗
PubMed1983

Antibodies against polyethylene glycol produced in animals by immunization with monomethoxy polyethylene glycol modified proteins.

Antibodies to polyethylene glycol (PEG) were raised in rabbits by immunization with monomethoxy polyethylene glycol modified ovalbumin (OA), bovine superoxide dismutase (SOD), and ragweed pollen extract (Rag), given in Freund's complete adjuvant (FCA). Immunogenicity depended on the nature of the protein and the degree of modification. With modified OA, in the presence of FCA, the majority of animals showed an anti-PEG response. With modified SOD and Rag only a small proportion of animals responded. In the absence of FCA, modified OA, given s.c., did not elicit any anti-PEG antibody response in rabbits and only a weak response in mice. PEG of MW 10,000 and 100,000 given in FCA was found nonimmunogenic in rabbits, and PEG of MW 5.9 X 10(6), given s.c. to mice, showed no or very poor immunogenic properties. Gel diffusion, heterologous passive anaphylaxis and passive hemagglutination were used to demonstrate anti-PEG antibodies raised to PEG-modified proteins. Specificity was confirmed by hapten inhibition of precipitation, inhibition of passive hemagglutination and cross-reactivity tests. PEG of MW greater than or equal to 4,000 produced specific precipitates, smaller molecules acted as monovalent haptens. From hapten inhibition of precipitation by PEG of MW 300 it appears that the antigenic determinant of PEG may be a sequence of 6-7 -CH2CH2O-units. Anti-PEG antibodies can be used analytically. By gel diffusion, Peg was detected in minimal concentrations of 0.1-1 microgram/ml. The clinical relevance of these findings with regard to therapy with PEG-modified enzymes and allergens in humans remains to be established.

Animals↗
PubMed1998

Accuracy of ICD-9-CM coding for the identification of patients with acute ischemic stroke: effect of modifier codes.

BACKGROUND AND PURPOSE: Discharge ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) codes have been used to identify patients with acute stroke for epidemiological, quality of care, and cost studies. The aim of this study was to determine if the accuracy of the primary ICD-9-CM codes for ischemic stroke is improved by modifier codes and how specific codes reflect stroke subtype diagnoses. METHODS: Available hospital charts for all patients discharged from a single hospital between May 1995 and June 1997 with ICD-9-CM codes 433 (occlusion and stenosis of precerebral arteries), 434 (occlusion of cerebral arteries), or 436 (acute but ill-defined cerebrovascular disease) listed in the first position were reviewed. The primary discharge diagnosis was verified, and a presumed stroke subtype was assigned on the basis of information provided in the medical record. RESULTS: Charts were available for 175 of the 198 identified patients (88%). Of these, 61% had an acute ischemic stroke (code 433, 4%; 434, 82%; 436, 79%) with the remaining patients having other conditions. Of the 130 patients with a modifier code indicating cerebral infarction, 79% had an acute stroke; of the 45 patients with a modifier code indicating an absence of cerebral infarction, 7% had acute stroke (sensitivity, 0.97; specificity, 0.60). The codes with the highest proportions of ischemic stroke cases were 434.11 (embolic occlusion of cerebral arteries with infarction, 85%), 434.91 (unspecified occlusion of precerebral arteries with infarction, 82%), and 436 (79%), with a combined sensitivity of 0.81 and specificity of 0.90. On review, 73% of patients with code 434.11 had embolic strokes, and 47% of those with code 436 had an identified stroke cause. Of patients with code 434.91, 39% had stroke of uncertain cause, 25% "lacunar," 17% atherothrombosis, and 15% embolism. CONCLUSIONS: Despite the use of modifier codes, 15% to 20% of patients with the indicated primary ICD-9-CM codes have conditions other than acute ischemic stroke. Although the proportion of patients with acute stroke increased from 61% to 79% with the use of modifier codes, the inclusion of modifier codes did not have an appreciable effect on the accuracy of the coding if patients with code 433 are excluded. Assignment of presumed ischemic stroke subtype is particularly inaccurate.

Acute Disease↗
PubMed2001

Rat osteoblast functions on the o-carboxymethyl chitosan-modified poly(D,L-lactic acid) surface.

In this study, the functions of rat osteoblasts on o-carboxymethyl chitosan-modified poly(D,L-lactic acid) (PDLLA) films were investigated in vitro. The surface characterization was measured by contact angle and electron spectroscopy for chemical analysis (ESCA). Cell adhesion and proliferation were used to assess cell behavior on the modified surface and control. The MTT assay was used to determined cell viability and alkaline phosphatase (ALP) activity was performed to evaluate differentiated cell function. Compared to the control films, cell adhesion of osteoblasts on o-carboxymethyl chitosan-modified PDLLA films was significantly higher (p < 0.05) after 6 and 8 h culture, and osteoblast proliferation was also significantly higher (p < 0.01) between 4 and 7 days. The MTT assay suggested cell viability of osteoblasts cultured on o-carboxymethyl chitosan modified PDLLA films was significantly greater (p < 0.05) than that seeded on control one, and the ALP activity of cells cultured on modified PDLLA films was significantly higher (p < 0.01) than that found on control. These results give the first evidence that o-carboxymethyl chitosan could be used to modify PDLLA surface for improving biocompatibility.

Alkaline Phosphatase↗
PubMed1997

Synthesis of silane coupling agents containing fluorocarbon chain and applications to dentistry: plaque-controlling surface modifiers.

Silane coupling agents containing a fluorocarbon chain were prepared in high yields. It was found that silanes can be useful modifiers of the surfaces of glass, metals, and resin composites for dental use. The silane coupling agent CF3(CF2)9CH2CH2Si(OCH3)3 was the best modifier of these surfaces in terms of water and oil repellency. Colorants and experimental bacterial plaque detached much more easily from, and adhered less well to, surfaces modified with this silane coupling agent compared with unmodified surfaces. The surfaces of four teeth of a denture were modified with this silane coupling agent by spreading the agent on the surfaces with a small brush followed by brief drying with a hair drier. The modified tooth surfaces of the denture, which was worn for four months in a heavy smoker's oral cavity, were more stain-resistant than the unmodified tooth surfaces. It is expected that silane coupling agents containing a fluorocarbon chain will be surface modifiers for enhancement of oral health.

Biocompatible Materials↗
PubMed2003

Electrocatalytic reduction of chloramphenicol at multiwall carbon nanotube-modified electrodes.

A multiwall carbon nanotube-modified glassy carbon (GC) electrode was employed for the investigation of chloramphenicol (CAP) reduction. Carbon nanotube coating can greatly lower the overpotential of the electrochemical reduction of CAP and promote the electrode reaction. CAP undergoes an irreversible reduction process in phosphate buffer by the modified electrode. The reduction peak current (Ip) was significantly increased. Effects of some important factors, including pH, scan rate, and amount of modifier, on the determination of CAP were investigated. In the range of 3 x 10(-7) to 1.2 x 10(-5) M, the reduction peak current (Ip) has a good linear relationship with the concentration of CAP. When the signal-to-noise ratio is 3, the detection limit is 4.5 x 10(-8) M. The relative standard deviation of 10 measurements for 3 x 10(-6) M CAP is 5.3%, suggesting an excellent reproducibility of the modified electrode. Interfering experiments show that the modified electrode has excellent selectivity for the detection of CAP. The modified electrode was used to determine CAP in eyedrops, and the recoveries were approximately 100%.

Biosensing Techniques↗
PubMed2006

Fabrication and electrocatalysis of self-assembly directed gold nanoparticles anchored carbon nanotubes modified electrode.

A self-assembly directed approach was adopted to modify glassy carbon electrode (GC) with gold nanoparticles incorporation and the electrocatalytic performance of self-assembly modified electrode, GC/SA-Au-ME was critically evaluated for the oxidation of ascorbic acid (AA). The modification involves the dispersion of multi-wall carbon nanotube (MWNT) and an inclusion complex, beta-cyclodextrin-4-aminothiophenol on the surface of GC electrode in the presence of cetyltrimethylammonium bromide (CTAB). Gold nanoparticles were deposited into the self-assembled sites to fabricate the modified electrode, GC/SA-Au-ME. Another electrode (GC-Au-ME) was fabricated under similar conditions in the absence of CTAB. The electrocatalytic activity of the modified electrodes (GC/SA-Au-ME and GC-Au-ME) towards the oxidation of AA was critically compared. Cyclic voltammetry, chronoamperometry, and double potential chronoamperometry were used to evaluate the characteristics of the modified electrodes. The self-assembled electrode (GC/SA-Au-ME) shows excellent electrocatalytic activity over the other electrode, GC-Au-ME. Augmented current response, faster electron transfer kinetics (with a rate constant for electron transfer process as 3.25 x 10(4) cm3 mol(-1) s(-1)), linear range of response for the analyte (1-50 mM with an extended detection limit to 1 microM), better sensitivity, and selectivity were witnessed for the self-assembly directed modified electrode.

Catalysis↗
PubMed2006

Surface-modified mesoporous silicas as recyclable adsorbents of an endocrine disrupter, bisphenol A.

Surface-modified mesoporous silicas (MSs) were investigated for recyclable adsorption of an endocrine disrupter, bisphenol A (BPA). Surface-modified MSs were prepared by (i) post-synthesis surface modification of MSs using surface hydroxyl groups and organosilanes (m-MS) and by (ii) co-condensation of tetraethoxysilane and the corresponding organosilanes (d-MS). Infrared measurements indicated that organic groups mainly existed on the surface of m-MS, which resulted in a surface characterized by high hydrophobicity. Both organic groups and isolated hydroxyl groups existed on the surface of d-MS, resulting in both hydrophobicity and hydrophilicity on the surface. The amount of BPA adsorbed on surface-modified MSs per organic group was similar for m-MS and d-MS, however, the d-MS established equilibrium for BPA adsorption faster than m-MS, as measured by UV-vis spectra. A larger amount of BPA per surface area could be adsorbed on carbon materials than on the surface-modified MSs, however, the regeneration of carbon materials by washing could not be done easily. The surface-modified MSs retain adsorption capacity for BPA after several regeneration cycles, demonstrating that the surface-modified MSs are effective recyclable adsorbents of the endocrine disrupter, bisphenol A.

Adsorption↗
PubMed1994

Stimulation with a monoclonal antibody (mAb4E4) of scavenger receptor-mediated uptake of chemically modified low density lipoproteins by THP-1-derived macrophages enhances foam cell generation.

mAb4E4, a murine monoclonal antibody that is specific for acetylated LDL and malondialdehyde-treated LDL, binds specifically to modified LDL present in human atherosclerotic lesions. It is directed against an epitope that is poorly exposed in delipidated and solubilized apolipoprotein B-100 from modified LDL. mAb4E4, as well as its F(ab')2 and Fab fragments, enhanced the uptake of both acetylated LDL and malondialdehyde-treated LDL by THP-1-derived macrophages resulting in a sixfold increase of cytoplasmic cholesteryl ester levels. The increased uptake of modified LDL/mAb4E4 complexes did not occur via the Fc receptor and did not depend on aggregation of modified LDL particles. However, their uptake was inhibited by blocking the scavenger receptors with fucoidin or by downregulation of receptor expression with endotoxins or interferon-gamma, indicating that their uptake is mediated via these receptors. Thus, generation of autoimmune antibodies against modified LDL and subsequent endocytosis of soluble modified LDL/antibody complexes via scavenger receptors may enhance foam cell generation. This mechanism may contribute to the progression of atherosclerotic lesions.

1,2-Dipalmitoylphosphatidylcholine↗
PubMed1995

Malondialdehyde-modified low density lipoproteins in patients with atherosclerotic disease.

The murine monoclonal antibody mAb-1H11 raised against malondialdehyde (MDA)-modified LDL, was used to detect cross-reacting material in human atheromatous tissue and in plasma. MDA-modified LDL levels in plasma were 0.19 +/- 0.02 mg/dl (mean +/- SEM) in 44 control subjects, 0.24 +/- 0.02 mg/dl in 15 patients with chronic stable angina pectoris (P = NS vs LDL cholesterol matched controls), 1.4 +/- 0.1 mg/dl in 60 patients with acute myocardial infarction (P < 0.001 vs controls), and 0.86 +/- 0.11 mg/dl in 22 patients with carotid atherosclerosis (P < 0.001 vs controls). Modified LDL, isolated from pooled LDL of 10 patients, showed a higher electrophoretic mobility on agarose gels, a higher content of thiobarbituric acid reactive substances, and a higher cholesterol/protein ratio than native LDL and had a similar reactivity (antigen/protein ratio) in the assay as the in vitro MDA-modified LDL used for calibration. Its apo B-100 moiety was not fragmented. Uptake of this modified LDL by macrophages resulted in foam cell generation. In conclusion, elevated plasma levels of atherogenic MDA-modified LDL may be a marker for unstable atherosclerotic cardiovascular disease.

Aged↗
PubMedDate not supplied

Modified release tizanidine: a review.

The pharmacokinetic and clinical properties of a modified release formulation of the alpha 2-adrenergic agonist tizanidine are reviewed. Therapy with conventional tizanidine tablets is effective in the relief of spasticity, but it has a short half-life, resulting in it having to be administered three or four times daily. The modified release capsules have retard characteristics which allow the drug to be given as a once-daily dosage. Single- and multiple-dose pharmacokinetic studies in healthy volunteers have shown that the relative bioavailability of the modified release formulation is similar to that of conventional tablets and is unaffected by food. Clinical studies have shown that modified release tizanidine improved spasticity and disability in approximately 94% and 79%, respectively, of spastic patients. Adverse effects were observed in about 33% of patients. Mild, transient muscular weakness was the most common effect, but it did not require termination of treatment. Body weight, blood pressure, heart rate and haematological or biochemical measures were not adversely affected. The initial recommended dose of modified release tizanidine is one capsule per day of 6 mg, which may be increased gradually to 24 mg. A daily dose of 12 mg modified release tizanidine was used in 50% of patients studied.

Biological Availability↗
PubMed1997

Use of the Modified Mini-Mental State Examination with children.

The validity and reliability of the modified version of the Mini-Mental State Examination with children was examined. The Modified Mini-Mental State Examination was administered to 99 children between 4 and 12 years of age (45 males and 54 females) to assess expected scores for nonclinical children and with a clinical sample. Concurrent validity was assessed through correlations of Modified Mini-Mental State Examination scores with Wechsler Intelligence scores and Child Behavior Checklist scores. The Modified Mini-Mental State Examination was administered to 26 children on two occasions to determine test-retest reliability. Means and standard deviations of scores are reported by age and grade level. Test-retest reliability coefficients were positively significant. For the nonclinical sample, Modified Mini-Mental State Examination scores were significantly and positively correlated with Verbal IQ and Child Behavior Checklist scores. Modified Mini-Mental State Examination scores were significantly correlated with Verbal IQ scores in the total and clinical samples.

Child↗
PubMed2003

A biomechanical investigation into the validity of the modified Ashworth Scale as a measure of elbow spasticity.

OBJECTIVE: To investigate the criterion validity of the modified Ashworth Scale. POPULATION: Volunteers from a stroke population admitted to a district general hospital stroke unit diagnosed with a first ever stroke less than 26 weeks previously. OUTCOME MEASURES: Resistance to passive movement about the elbow was simultaneously quantified (biomechanically) and graded (modified Ashworth Scale). Passive range of movement and peak instantaneous velocity during passive movement were also measured. ANALYSIS: Criterion validity was investigated as convergent construct validity (using the Spearman's correlation coefficient) and concurrent validity (using analysis of variance). RESULTS: One hundred measurements were taken on 63 subjects. Correlation between the modified Ashworth Scale and resistance to passive movement was 0.511. Resistance to passive movement and velocity showed significant differences between the modified Ashworth score of '0' and a modified Ashworth score greater than '0' (p < 0.01). There were no significant differences between MAS '1', '1+' and '2'. Resistance to passive movement in the impaired arm was significantly higher than in the nonimpaired arm (p < 0.01). CONCLUSION: The modified Ashworth Scale does not provide a valid measure of spasticity at lower grades but it may provide a measure of resistance to passive movement.

Biomechanical Phenomena↗
PubMed1989

Microtubules rich in modified alpha-tubulin characterize the tail processes of motile fibroblasts.

The organisation of microtubules rich in post-translationally modified alpha-tubulin has been investigated in a fibroblast cell line (NIH-3T3-T15) that can be reversibly transformed. An immunofluorescence microscopy study of the static non-transformed cells has revealed a central distribution of wavy microtubules showing post-translational modifications. When transformed there is a marked increase in cell motility and the appearance of long thin cytoplasmic 'tails'. These tails have been found to contain conspicuous bundles of post-translationally modified microtubules that run down the length of the processes and terminate close to the plasmalemma. Both detyrosinated and acetylated alpha-tubulin are present as major species in these modified microtubules. Such a pattern of modified microtubules is only occasionally seen in the untransformed NIH-3T3-T15 cells. We have also found them to be present in other transformed fibroblast lines. The presence of bundles of microtubules rich in modified alpha-tubulin in the cell tails is correlated with a marked reduction in the numbers of F-actin stress fibres. The possible role of these modified stable microtubules in cell motility is discussed.

Cell Line↗