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Biomedical subjects

B Grimberg

Publications and source records attributed to B Grimberg.

10 recordsLinked to original sources
PubMed2000

Genetic analysis of azole resistance in the Darlington strain of Candida albicans.

High-level azole resistance in the Darlington strain of Candida albicans was investigated by gene replacement in C. albicans and expression in Saccharomyces cerevisiae. We sequenced the ERG11 gene, which encodes the sterol C(14)alpha-demethylase, from our copy of the Darlington strain. Both alleles contained the histidine for tyrosine substitution at position 132 (Y132H) reported in Darlington by others, but we also found a threonine-for-isoleucine substitution (I471T) not previously reported in the C. albicans ERG11. The encoded I471T change in amino acids conferred azole resistance when overexpressed alone and increased azole resistance when added to the Y132H amino acid sequence in an S. cerevisiae expression system. Replacement of one copy of ERG11 in an azole-susceptible strain of C. albicans with a single copy of the Darlington ERG11 resulted in expression of the integrated copy and a modest increase in azole resistance. The profound azole resistance of the Darlington strain is the result of multiple mutations.

Amino Acid Substitution↗
PubMed1999

Cloning, sequencing, expression and allelic sequence diversity of ERG3 (C-5 sterol desaturase gene) in Candida albicans.

The C-5 sterol desaturase gene (ERG3), essential for yeast ergosterol biosynthesis, was cloned and sequenced from Candida albicans by homology with the Saccharomyces cerevisiae ERG3. The ERG3 ORF contained 1158bp and encoded 386 deduced amino acids. The clone was used to transform a gal1 mutant derived from the Darlington strain of C. albicans, using galactose selection. The Darlington strain is known to lack Delta(5,6) sterols, i.e. to have an erg3 phenotype (Howell, S.A., et al., 1990. J. Appl. Bacteriol. 69, 692-696). The transformant (CDTR1) contained six tandem integrated ERG3GAL1 repeats, had double the abundance of ERG3 transcript found in the host strain, and synthesized ergosterol, a Delta(5,6) sterol.The Darlington strain was noted to have an abundance of ERG3 transcript. Both ERG3 alleles in Darlington were cloned and sequenced in order to look for changes that might explain the erg3 phenotype. One allele, called Dar-2, contained a stop codon in place of tryptophan-292. The other ERG3 allele, called Dar-1, had changes in three amino acids, two of which were conserved in three fungal and one plant species. EcoRI genomic fragments containing ERG3 from the Dar-1 allele and from B311, the wild-type strain, were inserted into the plasmid pRS316 and used to transform a Saccharomyces cerevisiae erg3,ura3 mutant using uracil selection. The 4.1kb ERG3 fragments from the B311 and Dar-1 both contained 1. 4kb 5' and 1.5kb 3' flanking sequences around the coding region. Transformants with ERG3 from B311 but not from Dar-1 showed restored ergosterol synthesis. One or more of these three deduced amino acids in the Dar-1 allele of ERG3 appeared critical for function.

Amino Acid Sequence↗
PubMed1999

[Nerve palsies in a soldier with penetrating injuries following prolonged use of limb tourniquets].

Nerve paralysis following the use of tourniquets, regular or pneumatic, for limb surgery is rare. We describe a 19-year-old male soldier who had tourniquets applied for 3 1/4 hours to his arm and both legs due to penetrating injuries. As a result, he suffered palsy of the radial nerve and both common peroneal nerves. Nerve palsy in such cases has not been described in the literature. It is not clear whether the cause is direct mechanical pressure on the nerve, nerve ischemia, or a combination of both. We recommend that tourniquets should not be used continuously for more than 2 hours. If evacuation of the injured is delayed, the medical team should consider loosening tourniquets for short intervals or changing for a pressure bandage. This is providing the patient's condition is stable and bleeding does not start again on release of the tourniquet.

Adult↗
PubMed1999

Intraarticular fentanyl compared with morphine for pain relief following arthroscopic knee surgery.

PURPOSE: To compare the analgesia produced by comparable doses of intra-articular (IA) morphine and fentanyl. METHODS: Sixty-nine healthy patients undergoing arthroscopic surgery received a standardized general anesthetic of 4 mg x kg(-1) thiopental and 2 microg x kg(-1) fentanyl followed by 2 mg x kg(-1) succinylcholine prior to tracheal intubation and controlled ventilation. Maintenance of anesthesia was achieved with N2O/O2 and isoflurane. At the conclusion of surgery intra-articular injection was: Group I (n=23) 50 microg fentanyl in 20 ml saline; Group II (n=24) 3 mg morphine in 20 ml saline; Group III (n=22) 20 ml saline. Pain scores at rest using a visual analogue scale were recorded by a separate blinded observer at one, two, four, and eight hours postoperatively. RESULTS: Pain scores at one, two, four, and eight hours were 36, 26.3, 20.9, and 12.8 vs 35.8, 33.8, 28.8, and 21.9 vs 70.5, 57.7, 58.4, and 53.6 for the IA-fentanyl, IA-morphine, and control groups respectively. Pain scores were greater at all times for Group III. Pain scores for Groups I and II were similar at one hour, but thereafter were less (P < 0.001) for the IA-fentanyl group. CONCLUSION: Better postoperative analgesia was achieved with 50 microg intraarticular fentanyl than with 3 mg intraarticular morphine.

Adolescent↗
PubMed1998

Hand infections due to non-cholera Vibrio after injuries from St Peter's fish (Tilapia zillii).

We report 49 patients with a wide variety of hand infections, which developed after injuries from St Peter's fish (Tilapia zillii). Twenty-eight of 36 patients who had been operated on had non-cholera Vibrio infections, all identified as Vibrio vulnificus. The course in these patients was characterized by rapid spread of the infection with progressive necrosis of the tendon sheath, subcutaneous tissues and the skin. Two of them required amputations but the others had satisfactory functional results. Thirteen other patients were managed nonoperatively with intravenous antibiotics and all of them recovered completely.

Adolescent↗
PubMed1997

Treatment of open tibial fractures with primary suture and Ilizarov fixation.

Thirty-two open tibial fractures were treated by irrigation, debridement, antibiotic therapy, primary closure when possible, and fixation with Ilizarov device. In the Gustilo classification, 11 were Grade I, 10 Grade II, 8 Grade IIIA, and 3 were Grade IIIB. No Grade IIIC fractures were treated in the period studied. Fifteen were in patients with multiple trauma, and in 17 patients the fracture was a single injury. All fractures healed with good anatomic alignment, except for 1 with 5 degrees angulation and another with 1-cm shortening. The healing time was 21.9 weeks in the single injury and 25.7 weeks in the patients with multiple trauma. Eleven patients had pin tract infection, and in 4 the pin had to be replaced. One patient had dermatitis near the fracture site. This treatment of open tibial fractures proved to be successful for anatomic restoration of the tibia and had a low complication rate. Primary closure should be considered a possible method of treatment in Types I to IIIA open fractures, together with the Ilizarov external fixator, if the wound edges can be approximated easily with no tension at the suture line.

Adolescent↗
PubMed1996

[Magnuson-Stack operation for chronic anterior shoulder instability].

Between the years 1975-1992 we operated on 30 cases of recurrent anterior dislocation of the shoulder by the Magnuson-Stack procedure, using the subscapularis tendon. 23 patients (25 shoulders) have since been followed for an average of 5 years. We developed a comprehensive shoulder rating scale to evaluate functional status of involved shoulders. By this rating system the results were excellent in 73.9% of the cases, good in 17.4% and fair in 8.7%. The operation is technically simple, rapid, had no complications and is at least as effective as other operations.

Adolescent↗
PubMed1993

[Intramedullary nailing of mid-femoral fractures].

75 consecutive cases of mid-shaft femoral fractures were treated by open intramedullary nailing, using the solid, diamond-shaped Hansen-Street nail. The average age was 32.5 years; road accidents accounted for 43 cases; average operative time was 40 minutes. There were 2 systemic complications but no infections. 56 of the 75 were studied after an average of 5 years and 19 were followed for at least 6 months. At 4 months all fractures were united except 1. Average time to sound bone union was 4 months. There was no residual deformity in varus-valgus or in the sagittal plane. Malrotation was rare and did not exceed 10 degrees. There was shortening of 2 cm in 3 cases of comminuted fractures. All patients followed up returned to regular daily function. The Hansen-Street nail used in an open procedure is an accurate method of anatomic reduction. As opposed to close techniques, we found the procedure to be simple and quick, without undue exposure of the surgical team to radiation and without other complications, such as nerve damage due to traction. This device is indicated for use only in fractures of the middle third of the femoral shaft.

Adult↗
PubMed1993

The use of the Hansen-Street intramedullary nail in midshaft fractures of the femur.

A retrospective study was conducted on 75 consecutive femoral midshaft fractures treated with intramedullary nailing using the solid-diamond-shape Hansen-Street nail with an open technique. The average age of patients was 32.5 years. Road accidents accounted for 43 cases. The average operative time was 40 minutes. There were two systemic complications. No infection occurred. Fifty-six cases could be gathered for this study, with an average follow-up of 5 years; 19 were followed for at least 6 months. At 4 months, all the fractures were united except one. The average time to sound bony union was 4 months. There was no residual deformity in varus-valgus or in the sagittal plane. Malrotation was rare and did not exceed 5 degrees. Shortening of 2 cm was found in 3 patients where the fracture was comminuted. All followed patients returned to regular daily function. The use of the Hansen-Street nail in an open procedure is an accurate method for anatomic reduction. As opposed to closed techniques, the procedure proved in our hands to be simple and quick, without undue exposure to radiation of the surgical team, and without such other complications as nerve complications due to traction. The procedure with this device is indicated for mid-third fractures of the femoral shaft only.

Adult↗