Showing papers by "Jewish Hospital published in 1987"

Chemotactic activity in inflammatory bowel disease. Role of leukotriene B4

Abstract: An important histologic feature of inflammatory bowel disease (IBD) is infiltration of the colonic mucosa with neutrophils. To investigate the nature of the chemotactic agents responsible for this infiltration, colonic mucosa from three normals and nine patients with inflammatory bowel disease (seven ulcerative colitis, two Crohn's colitis) was assayed for chemotactic activity for human neutrophils in vitro in a Boyden chamber. There was more (greater than 10-fold more) chemotactic activity in homogenates of inflammatory bowel disease mucosa than in homogenates of normal colonic mucosa. Analysis of the chemotactic activity in the inflammatory bowel disease mucosa revealed that most was lipid extractable. Moreover, when the lipid extract was fractionated by reverse-phase high-pressure liquid chromatography, the only fraction with significant chemotactic activity was the fraction that coeluted with leukotriene B4. The chemotactic response to IBD mucosa was blocked by anti-LTB4 antisera. The amount of chemotactic activity in lipid extracts of different inflammatory bowel disease specimens correlated well with the concentration of leukotriene B4 measured by UV absorbance (250 ng/g of mucosa). These data suggest that leukotriene B4 is an important stimulus to neutrophil chemotaxis in inflammatory bowel disease and, thus, may play a major role in the amplification of the inflammatory response in this condition.

Current laser dentistry

Abstract: Current laser dentistry since our initial studies in 1964 is reviewed. Three areas are considered: routine dental office practice, tooth restoration, and oral surgery. For tooth restoration and oral surgery, CO2 and neodymium:YAG lasers are used and lasers are used in photodynamic therapy for oral cancer. Dental office practice today is concerned mostly with uncontrolled studies of biostimulation and requires more basic research and controlled clinical studies. The laser industry in the United States should take a more active interest in defining the applications of lasers in dentistry.

A Controlled Double-Blind Study of High-Dose Dihydroergotoxine Mesylate (HydergineR) in Mild Dementia

Abstract: In a double-blind study of 41 outpatients aged 55 to 80 years with mild memory impairment, the efficacy of dihydroergotoxine mesylate (DEM, Hydergine) at 6 mg per day, administered orally, was tested during a twelve-week period. Specific etiologies for the amnesic syndrome were ruled out by history, physical examination, and laboratory tests. Subjects with a Hamilton Depression Scale rating above 18, ie, possible pseudodementia, were excluded. Physician rating of memory, employing the Inventory of Psychic and Somatic Complaints in the Elderly (IPSC-E), indicated statistically significant improvement of memory function in DEM treated subjects (N = 22) v those on placebo (N = 19), (F = 3.34; df = 1,39; P less than .04). In contrast, structured testing of recent memory using digit symbol substitution and Zahlenverbindungs test (ZVT) showed improvement in both groups (P less than .001) with no significant intergroup differences (P less than .10). Out results indicate that in cases of mild, though subjectively distressing impairment, DEM at higher dosages may help to enhance short-term memory function.

The Aging Thyroid: I. A Description of Lesions and an Analysis of Their Age and Sex Distribution

Abstract: Two types of follicular change in the thyroid are described. The first represents an involutional change in which colloid cysts (macrofollicles) are often found. The second represents a hyperplastic-dysplastic (microfollicular) lesion. Two types of change in calcitonin (C) cells are also described, one of which may represent an involutional process, although this is not certain. The second is a hyperplastic (micronodular) lesion, but without evidence of dysplasia. An infiltration of lymphocytes is also commonly encountered. Only about 15% of cases after age 60 are free of the follicular and lymphoid lesions. Both the macro- and microfollicular lesions show a statistically significant increase with age, as do the lymphoid lesion and its derivative Hashimoto's thyroiditis. C cell micronodules also appear to increase with age, but there are too few such cases for a reliable statistical analysis. An analysis of combinations of the follicular and lymphoid lesions show a particularly frequent association of the microfollicular and lymphoid lesions. Evidence is presented suggesting that many microfollicular lesions may represent clones of mutated cells, and that the lymphocytes may be targeted to these microfollicles. Lymphocytes were rarely found in association with C cell micronodules. Within individual thyroids there is considerable variation in the proportion of each lesion when combinations are present. Thus with advancing age there is. an increasing heterogeneity of thyroid structure that may confound attempts to correlate structural and physiological changes with age. J Am Geriatr Soc 35:843–854, 1987

Hormonal regulation of gluconeogenesis in cultured proximal tubular cells: role of cytosolic calcium

Abstract: Gluconeogenic competence of primary cultures of canine renal proximal tubular cells has been examined. Cells grown in 5 mM glucose media or in glucose-free media exhibited pyruvate-stimulated glucose production, as opposed to cells grown in 20 mM glucose media. By 72 h after the last media change, confluent cells grown in 5 mM glucose medium turn from a predominantly glycolytic to an oxidative type of metabolism. By this time, glucose production exhibited pH, 3-mercaptopicolinate, and insulin sensitivity. Parathyroid hormone, angiotensin II, and phenylephrine stimulated glucose production in a nonadditive fashion. Single-cell cystolic Ca2+ measurements using microspectrofluorometric techniques revealed that all three hormones elicited Ca2+ transients in proximal tubular cells. Ionomycin stimulated glucose production by proximal tubular cells, suggesting that Ca2+ transients could represent a sufficient stimulus for glucose production. When hormone-induced Ca2+ transients were curtailed by a pretreatment with the membrane-permeant Ca2+ chelator, Maptam, hormonal stimulation of glucose production was abolished, suggesting that Ca2+ transients represent not only a sufficient, but a necessary event in the stimulation of glucose production by these hormones.

Split hand, obstructive urinary anomalies and spina bifida or diaphragmatic defect syndrome with autosomal dominant inheritance.

Abstract: Three members of a nuclear family were affected by split hands and feet or syndactyly, obstructive urinary anomalies and spina bifida or diaphragmatic defect

The aging thyroid. II. An immunocytochemical analysis of the age-associated lesions.

Abstract: This study utilizing immunocytochemical techniques consists of two segments, 1) an analysis of the changes with age in the hormone content of normal, involuting, macro- and microfollicles, as well as calcitonin (C) cells, and 2) an analysis of the components of the lesion characteristic of lymphocytic thyroiditis. Involuting and macro- (cystic) follicles show a decline in hormone content with age, while microfollicles show a variable pattern with some showing a high and others a low content, as well as some showing an absence of hormone. There also appears to be an increase with age in hormone-containing C cell micronodules, but we were unable to demonstrate a decline in hormone content of individual C cells. Studies on the in vivo binding of immunoglobulins, as an indicator of thyroid antibody binding, showed an increase with age in IgG and IgM binding to follicular epithelium. Much stronger reactions were observed in the epithelium of microfollicles than in that of involuting or macrofollicles. There were also examples of presumptive in vivo antibody binding by C cell micronodules. We were unable to demonstrate an imbalance of helper/suppressor T cell ratio in the thyroiditis lesion, but did find that some lymphocytes contain thyroid hormones, suggesting that the latter may act as cytokines and assist in the perpetuation of the lesion. The epithelial expression of human lymphocyte antigens (HLA) was strong in microfollicles and weak or absent in involuting or macrofollicles in sections with lymphocytic thyroiditis. It was also strong in the epithelium of a microfollicular adenoma without a lymphocytic infiltrate while weak or absent in the epithelium of adjacent normal follicles.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of the optical transmission properties of pulsed and continuous wave light in biological tissue.

Abstract: The purpose of this study is to compare the optical transmission of the pulsed gold vapor laser (628 nm) to that of the continuous wave argon-pumped dye laser (630 nm) in a homogenous tissue model. Gluteal muscle was taken from a rabbit, and sections of varying thicknesses were made. The tissue samples were positioned at the aperture of an integrating sphere. The laser light was passed through an optical attenuator, coupled to a 600-microns fiber, and then directed onto the surface of the tissue. Transmitted light was collected by the integrating sphere. Light measurements were made with a radiometer. This procedure was repeated for samples of differing thickness using the gold vapor laser as the light source. The identical procedure was performed using the argon-pumped dye laser. No significant difference was found in percent transmission of light using the gold vapor laser as compared to the argon-pumped dye laser.

Involvement of Human Immunodeficiency Virus (HIV) in Gingiva of Patients with AIDS

Abstract: The acquired immune deficiency syndrome, “AIDS”, is characterized by a reduction in the number and function of helper-inducer T cells, leading to severe immune suppression and allowing numerous opportunistic infections and neoplasms. Since the first reported case in July, 1982 (1), AIDS has achieved pandemic proportions, causing major health and socio-economic problems in several parts of the world. So far, AIDS remains an incurable disease which is fatal usually within three years.

A multilevel comparison of child abusers with nonabusers

Abstract: An integrative, ecological model developed by Belsky (1980) implies that to understand child abuse researchers must examine factors at four levels: the individual, the family, the environment, and the culture. This study compared abusive and nonabusive parents at three of these four levels. At the individual level, abusers were found to have lower self-esteem than controls. Also, male abusers were likely to be relatively impulsive and hostile. At the level of the family, abusers described their children as more troublesome than control parents, but they did not perceive them as developmentally delayed. At the level of the environment, abusers identified more intense life stressors than nonabusers. Results of this investigation supported Belsky's argument that child abuse involved multiple factors and levels.

Surfactant in adult respiratory distress syndrome.

Abstract: Adult Respiratory Distress Syndrome is a catastrophic disease which is characterized by tachypnoea, arterial hypoxemia, reduced pulmonary compliance, and diffuse alveolar infiltrates. The pathology is that of diffuse alveolar damage which includes injury to both endothelial cells and type I epithelial cells. The major physiological abnormality is reduced pulmonary compliance. The available data indicate that one of the causes for the reduced compliance is altered surface tension in the distal airspaces. Pulmonary surface material isolated from patients with Adult Respiratory Distress Syndrome has an altered phospholipid composition. Part of the current therapy is to overcome the reduced compliance by mechanical ventilation while allowing the lung time to heal. In the future, exogenous surfactant may also be used as part of the therapy in selected severely ill patients.

Cell density-dependent vitamin D effects on calcium accumulation in rat osteogenic sarcoma cells (ROS 17/2).

Abstract: Rat osteogenic sarcoma cells have been used widely as a model system to study actions of 1,25(OH)2D3 and other hormones in osteoblastlike cells. However, some of the pleiotypic manifestations of hormones in these cells vary greatly dependent upon the cell population density and other conditions of culture. Therefore, we have studied the effect of cell density on the relationship between 1,25(OH)2D3 and the initial45Ca accumulation in ROS 17/2 cells in order to establish conditions suitable for studying the effect of 1,25(OH)2D3 on calcium fluxes in these cells. Cells were grown in the presence and absence of 1,25(OH)2D3 for 48 hours and then incubated for 4 min in the culture medium containing 0.5 μCi/ml of45CaCl2. In high population density cultures, 0.25–1.0 pg/ml of 1,25(OH)2D3 stimulated the intracellular accumulation of45Ca (cpm/mg protein), whereas 80 pg/ml or higher concentrations inhibited accumulation of45Ca. In low density cultures, concentrations less than 80 pg/ml had no effect, 80–120 pg/ml increased the intracellular accumulation, and as much as 200 pg/ml failed to show the inhibitory effect. These results indicate that the ROS 17/2 cell responses to 1,25(OH)2D3 are biphasic—low concentrations stimulating and high concentrations inhibiting45Ca accumulation. The sensitivity of the cells to 1,25(OH)2D3 increases as the cell population density increases. These observations suggest that the culture density and dose-response relationship must be carefully defined inin vitro studies utilizing osteogenic cell culture systems.

The role of suppressor T cells in the expression of immune response gene function.

Abstract: Mechanisms underlying major histocompatibility complex (MHC)-linked immune response (Ir) gene regulation of immune responses have been the subject of considerable interest and debate in recent years. Two general mechanisms have been proposed to account for antigen-specific, Ir gene-mediated unresponsiveness. In one, defective antigen presentation resulted from the failure of processed nominal antigen and Ia antigen to associate on the antigen presenting cell membrane in a manner sufficient for helper T cell (Th cell) activation. By contrast, it has been proposed that selected Th cell clones were deleted from the repertoire during ontogeny or otherwise rendered unresponsive to the antigen-Ia complex, i.e., functionally deleted. Either of these mechanisms would account for the deficient activation of antigen-specific, Th cells observed in genetic low or nonresponder mice. In addition, the failure of mice to respond to certain antigens under Ir gene control has been attributed to the activation of specific suppressor T (Ts) cells. The latter mechanism might be considered a corollary or subset of the clonal deletion model. However, an important distinction exists. In the case of active, Ts cell-mediated Ir gene regulation, genetic low responder animals should retain the capacity for antigen-induced activation of Th cells, or Th cell activity should be demonstrable in these mice. In this communication, experiments are described which are designed to evaluate the possibility that active Ts cell-mediated regulatory mechanisms were of general importance in mediating Ir gene-related unresponsiveness.(ABSTRACT TRUNCATED AT 250 WORDS)

Early manifestations of vitamin D effects in rat osteogenic sarcoma cells

Abstract: We have recently demonstrated that 48 hour exposure of ROS 17/2 cells to low concentrations of 1,25-dihydroxycholecalciferol (1,25-(OH)2D3) (1.0 pg/ml) stimulated the cellular accumulation of45Ca, and exposure to high concentrations (160 pg/ml) inhibited such accumulation. In the present study, short-term (15 min) effects of the sterol on45Ca accumulation in ROS 17/2 cells were compared with the long-term (48 hours) effects in order to clarify mechanisms responsible for 1,25(OH)2D3 control of calcium metabolisms in ROS 17/2 cells. ROS 17/2 cells were grown for 48 hours in the presence and absence of 1,25(OH)2D3 and then incubated for an additional 15 min in the presence and absence of 1,25(OH)2D3 immediately before measuring45Ca accumulation. Cellular45Ca was measured after incubating the cells in the medium containing 0.5 μCi/ml of45CaCl2 for 4 min at 25°C. The effect of actinomycin D was determined by preincubating the cells in 0.1 μg/ml of actinomycin D for 45 min at 25°C. Exposure to low concentrations (1.0 pg/ml) of 1,25(OH)2D3 for either 48 hours or 15 min increased45Ca in the cells by 10–20%. An additional 15 min exposure following 48 hour exposure yielded an increase in the cellular45Ca similar to that after 48 hours or 15 min exposure. Exposure to high concentrations (160 pg/ml) for either 48 hour or 15 min decreased cell45Ca by approximately 20%.An additional 15 min exposure to the high concentrations did not change the 48 hour effect. Actinomycin D reversed early inhibitory effects of high concentrations, but had no effect on the early stimulatory effects of low concentrations. These results suggest that the mechanisms underlying the 15 min and 48 hour effects of 1,25(OH)2D3 are the same. Moreover, the mechanism responsible for the inhibitory effect of high concentrations is dependent onde novo protein synthesis whereas that for the stimulatory effects of low concentrations is not.

Tricuspid incompetence resulting from retrograde aortic dissection.

Abstract: This paper presents a 51 year old black female with known hypertension and an acute illness characterized by aortic regurgitation, cerebrovascular insufficiency, renal insufficiency, aortic valvular insufficiency, mediastinal widening and other features characteristic of acute Type I aortic dissection. An unusual feature in this individual is dissection extending into the membranous septum of the heart and into the aorto-atrial space with large hematoma, which partially disrupted the conduction system as well as dislodging the tricuspid septal leaflet in such fashion that major tricuspid regurgitation was present and interfered with termination of cardiopulmonary bypass. This patient presents a very unusual complication of which we wish to inform the readers.

Azlocillin, cephalothin, and tobramycin therapy in febrile solid tumor patients with chemotherapy-induced leukopenia.

Abstract: Although the semisynthetic broad-spectrum acylureido-penicillin, azlocillin has been demonstrated to have significant antibiotic activity in leukemic patients, its role in combination therapy of febrile granulocytopenic patients with chemotherapy-treated solid tumors has not been clearly delineated. Thirty-five solid tumor patients with chemotherapy-induced absolute granulocytopenia (less than 1000 granulocytes/ml) associated with fever (greater than 38.3 degrees C) were treated on a prospective study with a combination of azlocillin 4 g intravenously (IV) every 6 hours, cephalothin 2 g IV every 6 hours, and tobramycin 80 to 100 mg IV every 8 to 12 hours. Prior chemotherapy included doxorubicin combinations in 18 patients and other combinations in 17 patients. Granulocyte counts preantibiotic therapy were greater than 100 granulocyte/ml in 14 patients, 100 to 499 in nine patients, and 500 to 1000 in 12 patients. Granulocyte nadirs were less than 100 in 20 patients, 100 to 499 in nine patients, and 500 to 1000 in six patients. Times for granulocytes to rise towards normal were 1 to 3 days in eight patients, 4 to 6 days in 18 patients, and 7 or more days in nine patients. Tobramycin levels were primarily in the peak range of 3 to 6 micrograms/ml and trough range of 0 to 1.9 micrograms/ml. The site and pathogen were identified in nine patients, the infection site clinically documented without isolated pathogen in three patients, and no site or pathogen identified in 23 patients. Of the 35 patients, 34 had good responses to the antibiotic combination (complete disappearance of fever and other evidence of infection). Serum creatinine rose 0.4 to 0.6 mg/dl in nine patients, 0.7 to 1.5 in four patients, and 1.5 in one patient (obstructive uropathy). The only other noted antibiotic-related side effect was hypokalemia. This antibiotic combination had little toxicity with marked efficacy.