Showing papers by "Saint Francis University published in 1990"
TL;DR: High levels of cortisol decrease skeletal IGF-I synthesis by reducing IGF- I transcript levels, and this effect probably contributes to the inhibitory influence of cortisol on bone formation.
Abstract: Supraphysiological levels of cortisol inhibit bone cell replication and matrix synthesis, but its mechanism of action is unknown and could be secondary to an inhibition of local growth factor synthesis. These inhibitory effects of cortisol are the converse of the observed anabolic influences of the endogenously produced insulin-like growth factor-I (IGF-I); therefore, cortisol was examined for its effect on the production of IGF-I in osteoblast (Ob)- and fibroblast/preosteoblast-enriched cell cultures prepared from fetal rat parietal bone. Synthesis of IGF-I was monitored by Northern blot analysis to determine steady state IGF-I mRNA levels and by an IGF-I-specific RIA to quantitate polypeptide levels in acidified and fractionated culture medium. Cortisol at 100 nM decreased IGF-I transcript levels by 60% or more in Ob cultures within 6 h of treatment, and the concentration of immunoreactive IGF-I by 50% after 24 h; these effects were observed in the absence of a change in cellular DNA content. In Ob cultures, PTH at 10 nM increased IGF-I transcripts at 6 h and polypeptide levels at 24 h by 2.5- and 4.1-fold, respectively, and cortisol opposed this effect. The inhibitory effect of cortisol was not specific for the Ob cell population, since at 100 nM it also decreased IGF-I transcript and immunoreactive IGF-I levels in fibroblast/preosteoblast cultures and opposed the stimulation of IGF-I synthesis after treatment with 100 ng/ml GH. In conclusion, high levels of cortisol decrease skeletal IGF-I synthesis by reducing IGF-I transcript levels, and this effect probably contributes to the inhibitory influence of cortisol on bone formation.
200 citations
TL;DR: It is demonstrated that isobutylmethylxanthine, forskolin, and dibutyryl cAMP, agents that elevate intracellular cAMP levels by discrete mechanisms, also enhanced the steady state transcript and polypeptide level of IGF-I in osteoblast-enriched cultures.
146 citations
TL;DR: The relative affinities of IGF-i and IGF-II for the primary IGF-I receptor correlate with their anabolic activities in bone cultures and suggest that the IGF- I receptor mediates the growth-promoting effects of both agents in bone.
Abstract: Insulin-like growth factors-I and -II (IGF-I and IGF-II) are produced by bone cells and stored in bone matrix, and stimulate bone cell DNA synthesis and type I collagen production. Earlier studies in cells from an assortment of tissues indicate that IGF-I binds to membrane receptors of various relative molecular mass (Mr), whereas IGF-II binds predominantly to the mannose-6-phosphate transferase. In the present studies we have examined the IGF receptor profile in osteoblastenriched cultures prepared from fetal rat parietal bone. Scatchard binding kinetics with either 125I-IGF-I or 125I-IGF-II were curvilinear, indicating high and low affinity receptor classes for each ligand. Chemical cross-linking and polyacrylamide gel analysis revealed that 125I-IGF-I bound at Mr 130,000, 240,000, and 260,000, whereas 126I-IGF-II bound predominantly at Mr 240,000. Unlabeled IGF-I displaced 125I-IGF-I with high affinity at Mr 260,000 and 130,000 and with lower affinity at Mr 240,000. Unlabeled IGF-II preferentially disp...
114 citations
TL;DR: Technetium 99m-hexakis- 2-methoxy-2-methylpropyl-isonitrile (Tc-MIBI) is a promising new myocardial perfusion imaging agent producing excellent rest images, but imaging will need to be performed with exercise or dipyridamole to detect ischemia and to differentiate salvaged but still ischemic myocardium from scar.
Abstract: Technetium 99m-hexakis-2-methoxy-2-methylpropyl-isonitrile (Tc-MIBI) is a promising new myocardial perfusion imaging agent producing excellent rest images Imaging, however, will need to be performed with exercise or dipyridamole to detect ischemia and to differentiate salvaged but still ischemic myocardium from scar Accordingly, 12 dogs were given mild-to-moderate left circumflex coronary stenoses (group 2), and 10 dogs were given severe stenoses (group 3) In five control dogs (group 1), there was no stenosis After an intravenous infusion of dipyridamole (008 mg/kg/min for 4 minutes), Tc-MIBI was injected into the right atrium Over the next 4-hour study period, myocardial Tc-MIBI activities were continuously monitored in both the left anterior descending (LAD) (normal) and left circumflex (LCx) (ischemic) coronary artery (ischemic) zones using miniature cadmium telluride radiation detectors and serial gamma camera images were acquired when necessary Tc-MIBI was rapidly taken up by nonischemic, mild-to-moderate, and severe ischemic myocardium The initial myocardial uptake of Tc-MIBI was linearly related (r = 097) to regional myocardial blood flow at rates up to 20 ml/min/g After the initial uptake, the mean 4-hour fractional myocardial clearance was similar between the control (009 +/- 003 [+/- SEM]) and group 2 (007 +/- 003) and group 3 (009 +/- 003) ischemic zones Tc-MIBI blood clearance was rapid and biexponential with an initial fast clearance phase followed by a slow clearance phase(ABSTRACT TRUNCATED AT 250 WORDS)
110 citations
TL;DR: It is concluded that continuous treatment with PTHrp inhibits, whereas transient treatment stimulates, collagen synthesis; the stimulatory effect appears mediated by an enhancement in the local production of IGF I.
Abstract: Parathyroid hormone-related peptide (PTHrp), a polypeptide synthesized by tumors associated with hypercalcemia and known to cause bone resorption, was examined for its effects on bone formation in cultures of 21-day fetal rat calvariae. Continuous treatment with PTHrp for 24-72 h stimulated DNA synthesis, but inhibited [3H]proline incorporation into collagen by about 50%. In contrast, transient exposure to PTHrp at 0.1-1.0 nM for 24 h followed by removal of the factor for 48 h caused an increase in [3H]proline incorporation into collagen and noncollagen protein by 2- and 1.6-fold, respectively. The stimulatory effect was seen in the periosteum-free bone, and was decreased, but not prevented by hydroxyurea. PTHrp at 1-10 nM for 24 h increased medium insulin-like growth factor (IGF) I levels by 2.5-4.4-fold, and the effect was sustained 48 h after the removal of the agent. An IGF I neutralizing antibody prevented the stimulatory effect of PTHrp on bone collagen synthesis. PTH had the same stimulatory effect...
66 citations
TL;DR: Within a 3-month period, the trauma unit diagnosed and treated two cases of abdominal aortic injury secondary to blunt trauma, one was a belted passenger in a motor vehicle accident, and one was secondary to a crush injury.
Abstract: Blunt trauma causing aortic injury is infrequent and primarily involves the thoracic aorta. Abdominal aortic injury after blunt trauma is much less frequent and has a varied presentation. Within a 3-month period, our trauma unit diagnosed and treated two cases of abdominal aortic injury secondary to blunt trauma. One was a belted passenger in a motor vehicle accident, and one was secondary to a crush injury. The addition of these two cases brings the number found in the literature to 46. Reviewing these cases has emphasized the need for prompt recognition and treatment of this vascular catastrophe.
66 citations
TL;DR: This patient with isosexual precocity has PCR, as indicated by functionally abnormal glucocorticoid receptors and hypercortisolism without other clinical or biochemical manifestations of Cushing's syndrome.
Abstract: Primary cortisol resistance (PCR) is a rare cause of hypercortisolism and usually does not produce clinical manifestations. This report describes primary cortisol resistance in a boy with isosexual precocity. A 6 7/12-yr-old boy had Tanner stage 3 pubic hair, accelerated linear growth, and advanced bone age (10 yr), but normal (for age) tests. There were no features of glucocorticoid excess. Serum androstenedione and dehydroepiandrosterone concentrations were 4.7 +/- 0.3 nmol/L (mean +/- SEM of four measurements; normal less than 1.2) and 13.5 nmol/L (single measurement; normal, 1.0-2.2), respectively. The serum testosterone concentration was 0.9 nmol/L (normal, less than 0.7), and FSH and LH were normal. Serum cortisol concentrations were 1590 +/- 110 nmol/L (normal, 190-630) and 580 +/- 60 nmol/L (normal, 50-410) at 0800 and 2000 h, respectively. Serum cortisol responded normally to insulin-induced hypoglycemia. Glucocorticoids and adrenal androgens were resistant to suppression by dexamethasone. The Kd of [3H]dexamethasone binding to the glucocorticoid receptors of mononuclear leukocytes was increased (6.4 +/- 0.8 nM; mean +/- SEM of four determinations; normal, 1.4-3.4; P less than 0.001), but the binding capacity was normal. This patient with isosexual precocity has PCR, as indicated by functionally abnormal glucocorticoid receptors and hypercortisolism without other clinical or biochemical manifestations of Cushing's syndrome. Excessive adrenal stimulation by ACTH caused increased secretion of both cortisol and adrenal androgens, and the latter caused the clinical manifestations. PCR should be considered in other male children with isosexual precocity or female children with heterosexual precocity.
56 citations
TL;DR: It is suggested that the incidence of ventricular fibrillation during coronary angiography can be significantly decreased by using low osmolar nonionic contrast media lacking calcium binding additives.
Abstract: Ventricular fibrillation during coronary angiography with Renografin-76 has been attributed to the high osmolar ionic and calcium binding additive properties. Isovue-370 is a new low osmolar nonionic contrast medium lacking calcium binding additives. The present investigation compared the incidence of contrast media-induced ventricular fibrillation in patients undergoing coronary angiography with Renografin-76 to that with Isovue-370. Group I consisted of 2,000 consecutive patients undergoing coronary angiography with Renografin-76, and group II consisted of 2,000 subsequent consecutive patients in whom Isovue-370 was employed as the contrast medium. There was no significant difference between groups I and II with respect to volume of contrast media used per patient (125 +/- 35 vs. 140 +/- 45 ml), age (63.5 +/- 15 vs. 60 +/- 17 years), sex (74% male vs. 76% male), ejection fraction (55% vs. 55%), valvular heart disease (8% vs. 9%), prior coronary artery bypass graft surgery (5.8% vs. 5%), or extent of coronary artery disease. Contrast media-induced ventricular fibrillation occurred in 20 patients in group I (incidence 1%), whereas eight episodes occurred in group II (incidence 0.4%) (P less than 0.03). Thus the present investigation suggests that the incidence of ventricular fibrillation during coronary angiography can be significantly decreased by using low osmolar nonionic contrast media lacking calcium binding additives.
44 citations
TL;DR: This study was designed to analyze the characteristics and behavior patterns of individuals involved in nonfatal, traumatic injuries and found that suicide patients tended to be white males and Penetrating injuries involved mostly young, single, black males.
Abstract: This study was designed to analyze the characteristics and behavior patterns of individuals involved in nonfatal, traumatic injuries. There were 547 patients included in the study with 363 sustaining blunt trauma injuries, 144 sustaining personal violence injuries, and 40 being burn victims. Motor vehicle accident victims tended to be young, single, white, employed males: substance use was detected in 32%, and 57% were unbelted. Motorcycle accident victims tended to be young, single, unemployed males: substance use was detected in 25% and 90% were not wearing helmets. Pedestrians struck tended to be single, unemployed males. Penetrating injuries involved mostly young, single, black males: substance use was detected in 35% of patients and most incidents occurred from 4:00 P.M. to 8:00 A.M. Assault victims were mostly young, single, black males with substance use detected in 48%. Suicide patients tended to be white males. The incidence of repeat victims was one out of ten for blunt trauma, and one out of five for personal violence injuries and burns.
29 citations
TL;DR: It is suggested that amino acids other than those of the C-terminal tetrapeptide also contribute to the binding affinity of ApoCII for lipoprotein lipase, enhancing the lipolysis process.
Abstract: In this study we have prepared peptides of the C-terminal domain of apolipoprotein CII (ApoCII) by a solid-peptide-synthesis technique and demonstrated that the C-terminal tetrapeptide, Lys-Gly-Glu-Glu, represents an inhibitor of lipoprotein lipase. The tetrapeptide not only inhibits the basal activity of lipoprotein lipase, but also blocks the activation effect of native ApoCII. The lengthening of this tetrapeptide resulted in a corresponding increase in affinity for lipoprotein lipase. This suggested that amino acids other than those of the C-terminal tetrapeptide also contribute to the binding affinity of ApoCII for lipoprotein lipase. On the basis of an essential requirement of the ApoCII terminal domain for binding to lipoprotein lipase, we suggest that the initial interaction of ApoCII, mediated via the C-terminal tetrapeptide, promotes the proper alignment of ApoCII with lipoprotein lipase, followed by the weak interaction of the ApoCII activator domain with the lipoprotein lipase activator site, enhancing the lipolysis process.
28 citations
TL;DR: Using the Wilcoxon rank-sum test, TAC was found to provide significantly better anesthesia than cocaine alone (P = .005) and the percentage of patients having good anesthesia in the TAC-treated group was approximately 72%, which is equivalent to the efficacy found in other studies.
TL;DR: In this paper, a three phase model for analyzing and facilitating the adjustment process following severe disability is proposed, where adjustment is analyzed along cognitive, emotional, and environmental dimensions, along with the sequence of associated irrational beliefs.
Abstract: Profound psychological reactions are frequently seen following the onset of severe disability. “Stage” models of adjustment, although limiting when used dogmatically, can serve as a helpful guideline for intervention when integrated within a framework that also addresses the sequence of associated irrational beliefs. This article proposes a three phase model for analyzing and facilitating the adjustment process which follows disability. Adjustment is analyzed along cognitive, emotional, and environmental dimensions.
TL;DR: A case of severe hypomagnesemia and concurrent hypocalcemia that occurred during therapy with intravenous pentamidine was reported and electrolyte imbalances were corrected after daily supplementation with high doses of magnesium and calcium.
Abstract: The use of pentamidine for treating Pneumocystis carinii pneumonia in AIDS patients has increased the awareness of pentamidine-induced adverse reactions. We report a case of severe hypomagnesemia and concurrent hypocalcemia that occurred during therapy with intravenous pentamidine. Pentamidine therapy was subsequently changed to the nebulized route. Electrolyte imbalances were corrected after daily supplementation with high doses of magnesium and calcium. Clinicians should monitor for electrolyte imbalances which can be severe in patients receiving prolonged courses of pentamidine therapy.
TL;DR: Recently, a small-for-gestational age infant with blepharophimosis, congenital contractures of elbows, hips, and knees, fixed facial expression, and hypotonia was examined, consistent with a diagnosis of the Marden-Walker syndrome.
Abstract: Recently, we examined a small-for-gestational age infant with blepharophimosis, congenital contractures of elbows, hips, and knees, fixed facial expression, and hypotonia. These congenital anomalies are consistent with a diagnosis of the Marden-Walker syndrome. The infant also had an omphalomesenteric duct, left hypoplastic kidney, hypoplastic right lower lobe of the lung, and displacement of the larynx to the right; these anomalies have not been described previously in this syndrome. A summary of the clinical manifestations of the previously reported patients is presented.
TL;DR: The data indicate that the expression of p55 alpha and p70 beta by radiolabeling correlates with their expression in flow cytometry, and that a large excess of p 55 alpha is required to construct high-affinity IL-2R.
TL;DR: A practical three-step approach involves identifying which abilities are particularly important to or endangered in a given patient, listing these on the Diabetes Data Flow Sheet and briefly reviewing them with the patient on a periodic basis, and using a functional problem list as a guide to effective and timely intervention and follow-up.
TL;DR: No difference was seen in the response of those receiving two doses compared with those receiving three doses among adults and adolescents, suggesting that a two‐dose regimen may be acceptable in these age groups in developing countries to reduce costs and improve compliance.
Abstract: A field trial of a plasma-derived hepatitis B vaccine in five rural villages in Zambia was analyzed to determine if adults in a rural African setting respond to this vaccine as well as adults in Western countries and to determine the immunogenicity of fewer than the recommended three doses; 255 residents, including 171 who were susceptible to hepatitis B, were vaccinated. Among those who received three vaccine doses, protective levels of antibody to hepatitis B surface antigen (anti-HBs) developed in 67% of adults (ages 21 to 70 years), 87% of adolescents (ages 12 to 19 years), and 100% of children (ages 0 to 11 years). The 67% of vaccinated adults who developed anti-HBs at the protective level was lower than the 96% reported among adults receiving the same vaccine at the same dose and dosage schedule in studies in Western countries. No difference was seen in the response of those receiving two doses compared with those receiving three doses among adults and adolescents, suggesting that a two-dose regimen may be acceptable in these age groups in developing countries to reduce costs and improve compliance. Use of hepatitis B vaccine in a region where prevaccination hepatitis B serologic screening was not available did not appear to increase the number of severity of adverse reactions.
TL;DR: Pasteurella multocida bacteremia/septicemia is seen most frequently in immunocompromised patients but the diagnosis should be considered in any patient with a febrile illness and exposure to cats or dogs.
Abstract: A case of Pasteurella multocida bacteremia in a previously healthy hospital employee is presented. The patient had sustained a scratch from his dog four days prior to being seen in the emergency department with adequate healing and no evidence of localized infection. He presented with an acute febrile illness, and was discharged from the emergency department with a diagnosis of viral syndrome. He was asked to return to the hospital the next day when a bacteriology report of gram negative rods in both aerobic and anaerobic blood culture bottles was received in the emergency department. Pasteurella multocida bacteremia/septicemia is seen most frequently in immunocompromised patients but the diagnosis should be considered in any patient with a febrile illness and exposure to cats or dogs.
Journal Article•
TL;DR: It is suggested that triamcinolone improves bronchial hyperreactivity as well as airways obstruction and higher compliers showed more improvement at 6 weeks than lower compliers in: delta PC20, delta FEV1, and delta FEF25-75%.
Abstract: We measured changes in methacholine bronchial hyperreactivity and airways obstruction in 37 asthmatics treated with inhaled triamcinolone for 6 weeks. All received regular bronchodilator therapy but not steroids or cromolyn. Initial studies included spirometry and the provocative concentration of methacholine required to decrease the FEV1 by 20% (PC20). Patients were randomized into two groups: those given inhaled triamcinolone, 200 micrograms four times daily (T) by metered dose inhaler, and those given a placebo inhaler (P). Daily AM and PM peak flow measurements were recorded, while PC20 and pulmonary function tests were obtained at 3 and 6 weeks. Change in canister weight was used to determine treatment compliance. The PC20 of T increased from a baseline 1.00 mg/mL to 2.90 mg/mL at 6 weeks, whereas in P it decreased from 1.15 mg/mL to 1.05 mg/mL. Percent change in PC20 (delta PC20) for each patient was defined as: [(PC20(week 6)--PC20(baseline]/PC20 (baseline)] X 100. At 6 weeks, this was 290% in T versus 65% in P (P less than .05). Likewise, at 6 weeks T was significantly greater than P with respect to: delta FEV1 (4.1% versus -3.8%, P less than .05) and delta FEF25-75% (20.3% versus -5.6%, P less than .01). Patients were further separated into higher and lower complier subgroups. In T, higher compliers showed more improvement at 6 weeks than lower compliers in: delta PC20 (533.3 versus 67.8%, P less than .05), delta FEV1 (8.7 versus -1.7%, P less than .01), and delta FEF25-75% (31.9 versus 1.1%, P less than .01). These data suggest that triamcinolone improves bronchial hyperreactivity as well as airways obstruction.(ABSTRACT TRUNCATED AT 250 WORDS)
TL;DR: An alarming increase in the incidence of syphilis in adolescent female patients is observed in Connecticut, with an average age of 18.6 years.
Abstract: For the third consecutive year, the incidence of syphilis has substantially increased in Connecticut. We observed how this statewide increase was reflected in patients seen in our outpatient adolescent clinic. All patients presenting to the outpatient adolescent clinic of a major urban medical center had serologic evaluation for syphilis whenever indicated, in addition to routine annual testing. From June 1982 to May 1988, only one case of syphilis (an adolescent female) was diagnosed. However, in the two years from June 1988 to May 1990, 14 cases of syphilis (12 adolescent females, two adolescent males) were diagnosed. Of the female patients, seven of them had secondary syphilis, three had early latent syphilis of less than 1 year's duration, and two had early latent syphilis of greater than 1 year's duration. Their average age was 18.6 years. Seven patients were black, four were Hispanic and one was white. Nine of the 12 had a history of other sexually transmitted diseases (STDs). Five patients admitted to illicit drug use and one to prostitution. Of these 12 patients, nine were tested for the human immunodeficiency virus and the results were negative. We observed an alarming increase in the incidence of syphilis in our adolescent female patients.
Journal Article•
TL;DR: The study shows that patients requiring supportive treatment in a critical care unit preoperatively had the same operative mortality but more postoperative complications and a longer mean hospital stay than the equal number of patients who were not in acritical care unitPreoperatively.
Abstract: Fifty-two patients with a mean age of 67.6 years underwent coronary artery bypass plus mitral valve replacement from 2 April 1984, through 6 February 1989. All but four of these 25 males and 27 females were in the New York Heart Association Functional Classes III and IV, with presenting symptoms of angina and/or dyspnea. Twenty-four patients (44.2%) presented with acute myocardial infarctions, and eleven patients (21.2%) had a past history of rheumatic fever or rheumatic heart disease. Forty-five patients (86.5%) had a diagnosis of coronary artery disease plus mitral regurgitation. Treatment included a mean of 2.3 bypass grafts per patient plus mitral valve replacement with Carpentier-Edwards (41), St. Jude (10), and Bjork-Shiley (1) prostheses. The four operative deaths (7.7%) were attributed to congestive heart failure (1), mediastinal bleeding (1), mediastinitis (1), and stroke (1). There were eight late cardiac deaths (16.7%) and six late noncardiac deaths (12.5%), a mean of 16.6 and 18.9 months postoperatively, respectively. Thirty-four patients have survived from 10 to 65 (mean 33.7) months postoperatively with a mean New York Heart Association Functional Class 1.6. Follow-up determination of patients' attitudes toward their surgery was ascertained in 28 of the 34 survivors, and 26 (92.8%) patients indicated that they were pleased with their surgery. These results compare favorably with data reported in the recent literature. In addition, the study shows that patients requiring supportive treatment in a critical care unit preoperatively had the same operative mortality but more postoperative complications and a longer mean hospital stay than the equal number of patients who were not in a critical care unit preoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
TL;DR: Two patients with pain referable to the low back and sacroiliac regions had bone scans with similar findings and rapid defervescence with antibiotics and drainage suggested that osteomyelitis was not involved in these cases.
Abstract: Two patients with pain referable to the low back and sacroiliac regions had bone scans with similar findings. In each, one sacroiliac joint was "warm" (uptake on that side was slightly greater than that in the contralateral area). Ga-67 imaging also demonstrated increased uptake in the same locale. Subsequent CT scanning revealed pelvic abscesses adjacent to the affected joints. Asymmetric uptake of bone imaging agent may have been related to hyperemia and "heating" of the sacroiliac joint. Rapid defervescence with antibiotics and drainage (and no CT evidence of bone involvement) suggested that osteomyelitis was not involved in these cases.
TL;DR: In this paper, the authors identify reasons we may hold mixed views about the body's worth and discuss relationships between the body and the human symbols of earth, air, fire, and water.
Abstract: A goal of hospice care is to help the terminally ill live most fully while dying. Health care professionals must appreciate the role of the physical body in palliative care. This article identifies reasons we may hold mixed views about the body's worth and discusses relationships between the body and the human symbols of earth, air, fire, and water. These relationships suggest interventions which support the mind/body/spirit integration which is beneficial for dying persons.