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B Edwards

Publications and source records attributed to B Edwards.

At least 55 records · Page 3Linked to original sources
PubMed1995

The STING in the refluxing duplex system.

OBJECTIVE: To assess the efficacy of the subureteric Teflon injection (STING) procedure in the refluxing duplex ureter. PATIENTS AND METHODS: The STING procedure was performed in 23 patients (five boys and 18 girls, mean age 6.5 years, [range 1.5-14]) with six refluxing upper and 31 refluxing lower moieties. Teflon was injected separately into each moiety of the duplex. All patients were assessed by a micturating cystourethrogram and ultrasonography at least 3 months after treatment and the results were analysed retrospectively for the success rate of each refluxing unit and the overall cure rate of patients. RESULTS: No patient suffered ureteric obstruction. After the first STING the unit cure rate was 57% but only nine of 23 patients were completely cured. This improved to a unit cure rate of 68% and 11 patients cured after a second STING. CONCLUSION: Because the patient cure rate was poor we do not advocate using the STING to treat vesicoureteric reflux in the duplex kidney.

Adolescent↗
PubMed1995

Experimental hypersensitivity pneumonitis: effect of Thy1.2+ and CD8+ cell depletion.

We previously demonstrated that recipient CD4+ cells are necessary for expression of adoptive murine experimental hypersensitivity pneumonitis (EHP). In contrast, the acute inflammatory response to intratracheal (i.t.) administration of Micropolyspora faeni (direct EHP) is not CD4+ cell dependent (Am. J. Respir. Crit. Care Med. 1994;149:1286-1294). To further characterize the cells responsible for development of pulmonary inflammation in recipient animals, we depleted recipients of either Thy1.2+ or CD8+ cells before transfer of M. faeni-sensitized cultured C3H/HeJ spleen cells and i.t. challenge with M. faeni. We used the same depletion technique to determine the contribution of these cells to the pulmonary response to i.t. M. faeni in animals that did not receive cultured cells (direct EHP). The nature and extent of pulmonary inflammatory changes in these animals were assayed either 4 d after i.t. challenge with M. faeni in adoptive EHP or 2 d after i.t. challenge with M. faeni in direct EHP. We also tested the hypothesis that our previously demonstrated ablation of adoptive EHP caused by administration of anti-CD4 antibody was due to depletion of recipient CD4+ cells by allowing recovery of recipient CD4+ cells of anti-CD4-treated animals before i.t. challenge. In addition, we allowed Thy1.2+ cell recovery of anti-Thy1.2-treated animals before i.t. challenge. Cultured M. faeni-sensitized spleen cells could adoptively transfer EHP to animals treated with an irrelevant antibody or PBS. Depletion of Thy1.2+ but not CD8+ cells ablated the ability of recipient animals to express adoptive EHP. Direct EHP was not affected by depletion of Thy1.2+ or CD8+ cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Alveolitis, Extrinsic Allergic↗
PubMed1995

Experimental hypersensitivity pneumonitis: in vitro effects of interleukin-2 and interferon-gamma.

Cultured CD4+ cells are responsible for transfer of adoptive murine experimental hypersensitivity pneumonitis (EHP) (ARRD 1992; 146:1582-8). To characterize interactions that occur in vitro that result in cells able to transfer EHP, we added either antibody to IFN-gamma, antibody to IL-2, or 30 or 300 micrograms/ml IFN-gamma at the onset of 72-hour culture of C3H/HeJ spleen cells from either M. faeni or ovalbumin (control) sensitized donors with 30 micrograms/ml Micropolyspora faeni. We determined the phenotype of cells after culture and the amount of IL-2 or IFN-gamma in the culture supernatants, transferred cells to naive recipients, challenged the recipients intratracheally with M. faeni, and determined the extent of pulmonary inflammatory changes 4 days thereafter. Substantial amounts of IL-2 and IFN-gamma were detected in supernatants of cultures from M. faeni-sensitized animals, and lesser amounts were detected in culture supernatants from ovalbumin-sensitized donors. Treatment of cultures of M. faeni-sensitized cells with antibody to IL-2 or IFN-gamma blocked or reduced measurable IL-2 or IFN-gamma for the duration of culture. Treatment with IFN-gamma blocked increased levels of IL-2 at 48 and 72 hours of culture. Cultured M. faeni-sensitized cells adoptively transfer EHP. Cells from cultures depleted of either IL-2 or IFN-gamma or supplemented with IFN-gamma could transfer EHP equally well. We conclude that in vitro maturation of cells capable of adoptive EHP is not dependent on soluble IL-2 or IFN-gamma and is not altered by exogenous IFN-gamma.

Alveolitis, Extrinsic Allergic↗
PubMed1995

Neurocysticercosis: Report of fifteen cases.

BACKGROUND: Neurocysticercosis (NCC), which is caused by the encysted larvae of the porcine tapeworm Taenia solium, is uncommon in developed countries. METHODS: Fifteen cases were reviewed retrospectively from the medical records of patients admitted to Queens Hospital Center, a 550-bed acute care municipal hospital in New York City, from 1986 through 1992. All patients were immigrants from Central and South America. Nine were men and six were women; age range was 11-80 years, mean 33.8 years. Thirteen of the 15 patients (86%) were admitted with seizures. One patient had a strokelike syndrome with transient slurred speech and confusion. RESULTS: Diagnosis was based on clinical findings, CT or MRI studies (100%), and ELISA titers (81%). Cerebrospinal fluid abnormalities were noted in 5 of 7 samples obtained. Twelve adult patients with NCC were treated with praziquantel and steroids, and their courses were uncomplicated, except for one patient who required ventricular shunt placement for hydrocephalus. CONCLUSIONS: NCC should be suspected in immigrants from Central and South America who have seizures; it may complicate the differential diagnosis of various central nervous system syndromes. Available therapies entail risks and uncertainties. The ultimate approach is prevention of infestation.

Adolescent↗
PubMed1994

The National Institute on Aging and the National Cancer Institute SEER collaborative study on comorbidity and early diagnosis of cancer in the elderly.

BACKGROUND: An effect of comorbidity, or the coexistence of other diseases, on the stage of cancer at diagnosis and the appropriateness of therapy in older patients with cancer is hypothesized. The effect of comorbidity differs by cancer site and by type of comorbidity. Such variation could be due to the use of different populations or methods, or the natural history of the tumor being studied. METHODS: The National Institute on Aging (NIA) and the National Cancer Institute (NCI) have initiated a study using cancer patient populations in the NCI's SEER (Surveillance, Epidemiology and End Results) program. Five geographic locations participated in the NIA/NCI pilot study of comorbidity associated with seven cancer sites. Approximately 250 patients with each type of cancer, stratified by age (either 65-74 years of age or 75 years and older) had hospital records abstracted for comorbidity using a form derived from previously reported methods. RESULTS: After analyzing preliminary results for 1712 patients, it was ascertained that more and different chronic disease categories would be necessary, that it was not feasible to collect data on ability to perform certain physical functions from the medical records, and that the collection of data on current medications was possible. With these limitations, relationships of comorbid conditions with stage of cancer were analyzed. CONCLUSION: With the success of the pilot study, the full study is underway. In addition to the planned abstracting of approximately 7800 records, interviews assessing the behavior of illness in a sample of 1000 cancer patients will provide valuable information on the influence of comorbidity and age on stage at initial diagnosis and the treatment of older persons afflicted with cancer.

Aged↗
PubMed1994

Community-acquired soft-tissue infections caused by Flavimonas oryzihabitans.

Flavimonas oryzihabitans has rarely been implicated in human infections. Previously reported cases of infections caused by this bacterium were nosocomially acquired. We report two cases of community-acquired soft-tissue infections due to F. oryzihabitans. It remains unclear how the patients were exposed to the organism.

Abscess↗
PubMed1994

Telephone triage: how experienced nurses reach decisions.

The purpose of this study was to elicit the components of diagnostic reasoning utilized by experienced triage nurses when making triage dispositions via the telephone. Five first-level nurses triaged two simulated calls portrayed by the author. The resultant interactions were recorded on an answer-phone and subsequently replayed to the relevant participant. The tape was stopped after each question or comment made by the nurse who was then asked to say what s/he was thinking at the time. These verbalizations were audio-taped, transcribed and subjected to analysis using grounded theory. Although deprived of the opportunity for methodical deliberation, nurses, when making decisions, did so within a systematic and identifiable framework. The process was found to centre around five major considerations; the most likely cause of the presenting problem, the impact of the problem upon the caller, the accessibility of alternative sources of health care, the ability of the nurse to control the reactions of the caller and the nurses' perception of their vulnerability. The final triage disposition was made through balancing the most probable outcome against the worst possible outcome.

Adult↗
PubMed1994

Experimental hypersensitivity pneumonitis. Effect of CD4 cell depletion.

We previously demonstrated that Thy1.2+, CD4+, Ia-T cells are responsible for transfer of adoptive murine experimental hypersensitivity pneumonitis (adoptive EHP). To characterize the cells responsible for development of pulmonary inflammation in the recipient animals, we depleted recipients of CD4+ cells using monoclonal antibody GK1.5 before administration of Micropolyspora faeni-sensitized cultured C3H/HeJ spleen cells (SC) and intratracheal (i.t.) challenge with M. faeni. We also used the same depletion technique to determine the contribution of these cells to the pulmonary response to i.t. M. faeni in animals that did not receive cultured cells (direct EHP). The nature and extent of pulmonary inflammatory changes in these animals were assayed either 4 days after i.t. challenge with M. faeni in adoptive EHP or 2 days after i.t. challenge with M. faeni in direct EHP. Cultured M. faeni-sensitized SC could transfer EHP to naive animals or those treated with an irrelevant antibody. Depletion of CD4+ cells ablated the ability of recipient animals to express adoptive EHP. Two days after i.t. M. faeni (direct EHP), there was extensive neutrophilic infiltration of the lung that was not affected by depletion of CD4+ cells. We conclude that the ability to express adoptive EHP is dependent on the presence of CD4+ cells. In contrast, the acute inflammatory response to M. faeni is not CD4+ cell dependent.

Alveolitis, Extrinsic Allergic↗
PubMed1994

High-dose cyclophosphamide, thiotepa and hydroxyurea with autologous hematopoietic stem cell rescue: an effective consolidation chemotherapy regimen for early metastatic breast cancer.

Phase I and II trials have demonstrated that high-dose chemotherapy with autologous hematopoietic stem cell rescue is effective 'consolidation' chemotherapy for patients with responding metastatic breast cancer. In this study 26 women with metastatic breast cancer responding to lower dose combination chemotherapy were treated with 18 g/m2 of hydroxyurea added to the widely used combination of cyclophosphamide (CY) 6 g/m2 and thiotepa 600 mg/m2. Hematopoietic stem cell support was provided in the form of previously collected cryopreserved marrow or peripheral blood stem cells if there were malignant cells in the marrow. The patients ranged in age from 25 to 51 years with a median of 43 years. Three patients (12%) died of toxicity, one from Candida pneumonia and the other two from pulmonary and central nervous system bleeding secondary to platelet consumption associated with high fever and renal dysfunction, a syndrome we have seen with approximately the same frequency as a complication of other 'marrow transplant level' chemotherapy. The 1 and 2 year progression-free survivals are projected to be 42% and 27%, respectively. Patients in complete remission or with only residual radiographic abnormalities in bone prior to this therapy had 67% and 58% 1 and 2 year progression-free survival probabilities. High-dose hydroxyurea can safely be added to the CY and thiotepa combination.

Adult↗
PubMed1994

Chemiluminescent reporter gene assays: sensitive detection of the GUS and SEAP gene products.

Chemiluminescent assays are described for the secreted alkaline phosphatase (SEAP) and beta-glucuronidase (GUS) reporter gene products. These assays provide simple, sensitive, non-isotopic alternatives to existing detection methods and are performed in microplate or tube luminometers or in a scintillation counter. The SEAP reporter gene product is secreted from mammalian cells and is thus easily detected in a sample of culture medium. Sensitive detection of secreted placental alkaline phosphatase is performed with CSPD chemiluminescent alkaline phosphatase substrate, and approximately 3 fg of enzyme can be detected. GUS has become the major reporter gene used for the analysis of plant gene expression. Sensitive chemiluminescent detection of GUS activity can be performed with an assay system we have developed using Glucuron, a beta-glucuronidase substrate. This chemiluminescent assay detects 60 fg of GUS and is linear over six orders of magnitude of enzyme concentration. CSPD and Glucuron substrates have been incorporated into two new chemiluminescent reporter gene assay kits for SEAP and GUS.

Alkaline Phosphatase↗
PubMed1994

Adoptive transfer of experimental hypersensitivity pneumonitis: CD4+ cells are memory and naive cells.

We previously demonstrated that CD4+ cells are responsible for transfer of adoptive murine experimental hypersensitivity pneumonitis. To further characterize the CD4+ cells as naive or memory cells, we depleted Micropolyspora faeni-sensitized cultured C3H/HeJ spleen cells of surface IgM+ cells by panning and Ia+ cells by lysis. We measured the proportion of CD4+ cells that expressed CD45RB, CD44 or LECAM-1 (markers used to distinguish memory from naive CD4+ cells) in spleen cell populations able to transfer experimental hypersensitivity pneumonitis (M. faeni sensitized and cultured) and those unable to transfer experimental hypersensitivity pneumonitis (ovalbumin sensitized and M. faeni cultured). Planning reduced the proportion of B cells from 53% to 11% and of Ia+ cells from 54% to 11%. Further lysis of Ia+ cells from the SIgM(+)-depleted population reduced Ia+ cells to 6%. Thy1+ cells increased from 26% to 55% after panning and to 72% after Ia+ cell lysis. Cultured M. faeni-sensitized spleen cells could transfer experimental hypersensitivity pneumonitis. Depletion of SIgM+ cells enhanced and depletion of Ia+ cells did not affect the capacity to transfer experimental hypersensitivity pneumonitis. The CD4+ cells from M. faeni-sensitized animals were 47% CD45RBhi, 36% CD44+ and 0% LECAM-1hi before culture with M. faeni and 48% CD45RBhi. They were 34% CD44+ and 27% LECAM-1hi after culture. The origin of the cells (from M. faeni- or ovalbumin-sensitized animals) did not affect the phenotype of the CD4+ cells, either before or after culture with M. faeni. We conclude that the active cells in spleen cell cultures are SIgM-, Ia-, CD4+ T cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

An integrated software system for quality assurance-related kappa coefficient analysis of intraoperative transesophageal echocardiography interpretive skills.

This report describes the development of a quality assurance-oriented integrated software system designed for an anesthesiology-based intraoperative transesophageal echocardiography service. Entry data include patient and operation demographics, two-dimensional echocardiographic, saline-contrast, and color flow/pulsed Doppler assessments of the heart and great vessels, presented in a defined sequence. A statistical analysis component (kappa coefficient analysis) allows for comparison of intraoperative real-time interpretations with laboratory interpretations made by experienced full-time echocardiographers on a field-by-field basis. This provides a means of quantifying expertise in each individual aspect of the patient examination sequence. We believe that such self-appraisal data are essential for delineating the status and tracking the progress of service being provided.

Echocardiography, Transesophageal↗
PubMed1993

Toxicokinetics and structure-activity relationships of nine para-substituted phenols in rat embryos in vitro.

The purpose of this study was to examine the toxicokinetics of embryo uptake following exposure to a variety of chemically related phenols in rat embryo culture. The uptake of nine radiolabeled para-substituted phenols by day 10 (9-13 somite stage) rat embryos in vitro was determined from 1 to 42 hrs after being placed in culture media containing various phenols. Uptake was rapid, having a half-life of 3 hr or less, with 7 of the nine compounds having uptake half-times of less than one hour. The equilibrium concentration in the embryo ranged from 53 to 136% of the media concentration, indicating only a factor of 2 in maximum discrimination against the compound for any of the phenols studied. The fraction of radioactivity remaining unbound in the media decreased with increasing log P (octanol/water partition coefficient). The binding was calculated to be 50% for log P = 1.77 from the fitted regression equation and decreased by a factor of 5.9 for every decade increase in P. When hepatocytes were also present in the media the equilibrium concentration in the embryos was less than when hepatocytes were absent. With the limited data, four of the phenols appeared to have no (i.e., zero) equilibrium level when hepatocytes were present. Thus the metabolites produced by the hepatocytes appeared to have less affinity for the embryo than the parent phenol. Toxicodynamic information as given by the effective concentration of the phenol in the embryo to cause somite or tail teratological effects was best predicted by the measured unbound fraction.

Animals↗
PubMed1993

Technetium-99m-tetrofosmin as a new radiopharmaceutical for myocardial perfusion imaging.

A new cationic complex, [99mTc(tetrofosmin)2O2]+, where tetrofosmin is the ether functionalized diphosphine ligand 1,2-bis[bis(2-ethoxyethyl)phosphino]ethane, has been synthesized and evaluated for potential use in myocardial perfusion imaging. The structure of the complex has been determined by x-ray crystallography of the 99Tc analog. In comparison with previously reported 99mTc complexes of alkyl-phosphines, the tetrofosmin species shows substantially increased clearance from nontarget tissue, especially blood and liver. A freeze-dried kit formulation has been developed. The kit provides a product of high radiochemical purity up to 8 hr after reconstitution at room temperature.

Animals↗
PubMed1992

Zinc binding by retroviral integrase.

Zinc binding by integrase from Moloney murine leukaemia virus and a protein A fusion protein containing integrase from human immunodeficiency virus type 1 was demonstrated by a zinc blotting technique using 65ZnCl2. Autoradiography revealed a clear band that was absent from the appropriate controls. This band co-migrated with the major band in Coomassie-stained gels and in immunoblots. This binding activity was retained in the presence of competing divalent cations and was sensitive to oxidation. This is the first demonstration of zinc binding by intact retroviral integrase.

Amino Acid Sequence↗