Biomedical subjects

Alan Smith

Publications and source records attributed to Alan Smith.

23 records · Page 2Linked to original sources

PubMed2003

Allogeneic mesenchymal stem cells regenerate bone in a critical-sized canine segmental defect.

BACKGROUND: Mesenchymal stem cells from adult bone marrow are multipotent cells capable of forming bone, cartilage, and other connective tissues. In a previous study, we demonstrated that autologous mesenchymal stem cells could repair a critical-sized bone defect in the dog. The objective of this study was to determine whether the use of allogeneic mesenchymal stem cells could heal a critical-sized bone defect in the femoral diaphysis in dogs without the use of immunosuppressive therapy. METHODS: A critical-sized segmental bone defect, 21 mm in length, was created in the mid-portion of the femoral diaphysis of twelve adult dogs that weighed between 22 and 25 kg. Each defect was treated with allogeneic mesenchymal stem cells loaded onto a hollow ceramic cylinder consisting of hydroxyapatite-tricalcium phosphate. A complete mismatch between donor stem cells and recipient dogs was identified by dog leukocyte antigen typing prior to implantation. The healing response was evaluated histologically and radiographically at four, eight, and sixteen weeks after implantation. The radiographic and histological results at sixteen weeks were compared with the historical data for the control defects, which included defects that had been treated with a cylinder loaded with autologous mesenchymal stem cells, defects treated with a cylinder without mesenchymal stem cells, and defects that had been left untreated (empty). The systemic immune response was evaluated by the analysis of recipient serum for production of antibodies against allogeneic cells. RESULTS: For defects treated with allogeneic mesenchymal stem cell implants, no adverse host response could be detected at any time-point. Histologically, no lymphocytic infiltration occurred and no antibodies against allogeneic cells were detected. Histologically, by eight weeks, a callus spanned the length of the defect, and lamellar bone filled the pores of the implant at the host bone-implant interface. Fluorescently labeled allogeneic cells were also detected. At sixteen weeks, new bone had formed throughout the implant. These results were consistent with those seen in implants loaded with autologous cells. Implants loaded with allogeneic or autologous stem cells had significantly greater amounts of bone within the available pore space than did cell-free implants at sixteen weeks (p < 0.05). CONCLUSIONS: The results of this study demonstrated that allogeneic mesenchymal stem cells loaded on hydroxyapatite-tricalcium phosphate implants enhanced the repair of a critical-sized segmental defect in the canine femur without the use of immunosuppressive therapy. No adverse immune response was detected in this model.

Animals↗

PubMed2002

Pneumococcal serotypes from acute otitis media in rural Kentucky.

OBJECTIVE: Acute otitis media (AOM) accounts for most infections caused by, but few data are available regarding the incidence of pneumococcal serotypes recovered from children with AOM in the United States. METHODS: Between January 1992 and March 1998, 777 middle ear pathogens from AOM were obtained from 701 patients by tympanocentesis (84.6%) or by culture of otorrhea (15.4%) from spontaneous perforation or draining tubes. The ambulatory patient population was mostly white and cared for by a sole private pediatric practice in rural Kentucky. RESULTS: Penicillin-nonsusceptible (penicillin MIC > or = 0.1 microg/ml) (PNSP) isolates accounted for 18% [6% resistant PNSP (rPNSP) and 12% intermediate resistant PNSP], and penicillin-susceptible strains accounted for 35% of the pathogens recovered from children with culture-proved AOM. Comparing the frequency of isolates between 1992 and 1993 with those between 1994 and 1998, overall rates of PNSP strains remained remarkably stable (32.2% 37.3%), but intermediate resistant PNSP strains doubled from 14% to 27% ( < 0.01), whereas rPNSP strains fell by one-third. Serotypes 19F (34%), 23F (30%), 6B (26%) and 14 (8%) accounted for nearly all rPNSP isolates. Two cross-reactive serotypes (6A and 19A) not included in the available pneumococcal conjugate vaccine comprised 8.4 and 15% of all serotypes and PNSP serotypes, respectively. Nearly all PNSP strains recovered in children < or =24 months are included in the vaccine serogroups. CONCLUSION: Depending on rates of efficacy and serotype cross-protection, the current pneumococcal conjugate vaccine could potentially protect against most PNSP strains in all ages, particularly in those < or =24 months.

Age Factors↗

PubMed2002

Intracellular accumulation of human immunodeficiency virus protease inhibitors.

Intracellular accumulation of the protease inhibitors (PIs) saquinavir (SQV), ritonavir (RTV), and indinavir (IDV) was determined in 50 human immunodeficiency virus-positive patients. Following extraction, PIs were quantified by mass spectrometry. Paired plasma and intracellular samples were collected over a full dosing interval from patients (13 on SQV, 6 on RTV, 8 on IDV, 16 on SQV plus RTV, 7 on IDV plus RTV) with a plasma viral load of <400 copies/ml. Data were expressed as intracellular/plasma drug concentration ratios. A hierarchy of intracellular accumulation was demonstrated by the following medians: 9.45 for SQV > 1.00 for RTV > 0.51 for IDV. Coadministration of RTV did not boost ratios of SQV or IDV within the cell or in plasma, although absolute plasma and intracellular SQV concentrations were increased by RTV. Seven individuals receiving SQV in hard-gel capsule form (median, 32 months) had higher intracellular/plasma drug ratios than all other patients receiving SQV (median, 17.62 versus 4.83; P = 0.04), despite consistently low plasma SQV concentrations. How this occurs may provide insight into the mechanisms that limit adequate drug penetration into sanctuary sites.

Adolescent↗

PubMed1996

Silver(I) Complexes of the Derivatized Crown Thioether Ligands 3,6,9,12,15,18-Hexathianonadecanol and 3,6,9,13,16,19-Hexathiaicosanol. Determination of Stability Constants and the Crystal Structures of [Ag(19-aneS6-OH)][CF(3)SO(3)] and [Ag(20-aneS6-OH)][BF(4)].

The derivatized 19- and 20-membered macrocyclic thio crowns 3,6,9,12,15,18-hexathianonadecanol C(13)H(26)OS(6) (19-aneS6-OH) (1) and 3,6,9,13,16,19-hexathiacycloicosanol C(14)H(28)OS(6) (20-aneS6-OH) (2) have been synthesized by [1 + 1] cyclization in about 30% yield. The ligands 1 and 2 react readily at room temperature with different silver(I) salts in water and in organic solvents to form in quantitative yields the complexes [Ag(19-aneS6-OH)](+) (3) and [Ag(20-aneS6-OH)](+) (4) for which crystals of X-ray quality were grown by slow diffusion of diethylether into methanol. [Ag(19-aneS6-OH)][CF(3)SO(3)] crystallizes in the triclinic space group P&onemacr; with Z = 2, a = 10.760(1), b = 10.853(2) and c = 11.326(2)Å, and alpha = 78.73(1), beta = 73.47(1), and gamma = 74.99(1) degrees. [Ag(20-aneS6-OH)][BF(4)] also crystallizes in the triclinic space group P&onemacr; with Z = 4. The unit cell constants were determined with a = 10.076(4), b = 10.525(3), and c = 22.135(8)Å, alpha = 93.32(2), beta = 102.43(2), and gamma = 100.32(2) degrees. The complex cations [Ag(19-aneS6-OH)](+) and [Ag(20-aneS6-OH)](+) are coordinated through only four sulfur atoms; thus, a distorted tetrahedral coordination geometry is exhibited. In addition we found a highly asymmetric Ag-S bond lengths distribution throughout all complex cations. The stability constants of [Ag](+) with 1 and 2 and, for comparison with [18-aneS6] (5), have been determined in methanol by potentiometric [Ag](+) measurements. Log K values for the formation of 3, 4, and [Ag(18-aneS6](+) (6) are 12.04 +/- 0.19, 11.49 +/- 0.15, and 12.67 +/- 0.13 respectively. Owing to a comparable macrocyclic effect, the similar log K values are reasonable but, since 6 coordinates octahedrally, not expected. (1)H and (13)C NMR investigations at various temperatures give evidence for fluxional coordinative behavior between all six sulfur atoms in solution. Consequently [Ag(19-aneS6-OH)](+), [Ag(20-aneS6-OH)](+), and [Ag(18-aneS6](+) seem to exhibit principally the same solution structures although the solid structures are very different.

Journal Article↗

PubMedDate not supplied

An experiential interdisciplinary quality improvement education initiative.

Seven learners, including 2 preventive medicine fellows, 2 family medicine residents, 1 internal medicine resident, and 2 master's-level nursing students participated in an experiential 4-week quality improvement rotation at a major academic medical center. Together they worked on a quality improvement project that resulted in enhanced medication reconciliation in a preventive medicine clinic. Learner knowledge measured on the QI Knowledge Application Tool increased from an average of 2.33 before the start of the rotation to 3.43 (P = .043) by the end of the rotation. At the conclusion, all learners said they were confident or very confident that they could make a change to improve health care in a local setting. Although this pilot supports the feasibility and potential benefits of interdisciplinary quality improvement education, further research is necessary to explore strategies to implement the same on a larger scale, and to examine the impact on patient outcomes.

Health Knowledge, Attitudes, Practice↗