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Biomedical subjects

C Constantinou

Publications and source records attributed to C Constantinou.

At least 19 recordsLinked to original sources

Regulation of translation factors eIF4GI and 4E-BP1 during recovery of protein synthesis from inhibition by p53.

Activation of the tumour suppressor protein p53 rapidly inhibits protein synthesis. This is associated with dephosphorylation and cleavage of initiation factor eIF4GI and the eIF4E-binding protein 4E-BP1. When the activation of p53 is reversed within 16 h 4E-BP1 becomes rephosphorylated, the level of intact eIF4GI slowly increases and protein synthesis gradually recovers. The recovery of protein synthesis is partially blocked by rapamycin and wortmannin but not by the protein kinase inhibitors PD98059 and CGP74514A. Both rapamycin and wortmannin, but not PD98059 or CGP74514A, delay the reappearance of eIF4GI. In contrast, full-length 4E-BP1 rapidly becomes rephosphorylated and this process is partially inhibited by rapamycin, PD98059 and CGP74514A. Thus, activation of p53 results in the inhibition of distinct rapamycin- and wortmannin-sensitive pathways that target eIF4GI, and rapamycin-sensitive and -insensitive pathways that target 4E-BP1. Following inactivation of p53 the gradual recovery is determined largely by the kinetics of restoration of eIF4GI rather than by the rephosphorylation of full-length 4E-BP1. These findings suggest that the ability of cells to rephosphorylate 4E-BP1, resynthesise eIF4GI and restore the rate of protein synthesis after inactivation of p53 is an important aspect of recovery following the relief of physiological stress.

Adaptor Proteins, Signal Transducing↗

A comparison of outbreak- and nonoutbreak-related multidrug-resistant tuberculosis among human immunodeficiency virus-infected patients in a South African hospital.

Nosocomial multidrug-resistant tuberculosis (MDR-TB) in human immunodeficiency virus (HIV)-infected people is recognized in Europe and America. We report the first such outbreak in South Africa. Six hospitalized women, identified by DNA fingerprinting, were infected with an outbreak strain of MDR-TB while receiving treatment for drug-susceptible tuberculosis. The putative source case was identified as an HIV-positive woman who underwent prolonged hospitalization for chronic cavitary tuberculosis. Compared with other HIV-positive patients in the hospital, outbreak patients were more immunocompromised, had fewer cavitary lung changes, and were less likely to have been treated before. They had high fevers, infiltrative patterns on chest radiographs, and a mean survival of 43 days. When individual isolation is not possible, separating highly immunocompromised patients with first-time tuberculosis from previously treated patients with cavitary lesions and from those with established drug resistance may reduce nosocomial transmission.

AIDS-Related Opportunistic Infections↗

A mobile computed tomographic scanner with intraoperative and intensive care unit applications.

INTRODUCTION: A mobile computed tomographic scanner has been developed in which the scan plane is selected by means of gantry translation, rather than by translation of the patient table. This permits computed tomographic scanning in situ of any patient who is positioned on a radiolucent surface that fits within the inner diameter of the gantry. We report the design of and initial experience with this scanner as used with adapters for intraoperative and bedside computed tomography (CT). METHODS: The scanner is equipped with wheels, draws power from wall outlets (120 V, 20 A) in combination with batteries, and has a translating gantry. Preclinical studies of image quality were performed with phantoms. An operating table adapter was built for use with a radiolucent cranial fixation device. A bedside adapter was built that holds the head and shoulders of a patient in the intensive care unit. RESULTS: The preclinical phantom studies showed satisfactory image spatial resolution (0.8 mm) and low-contrast resolution signal-to-noise relative standard deviation (0.37%). Experience to date with 12 patients has confirmed the feasibility of intraoperative CT on demand. Experience to date with 26 patients has confirmed the feasibility of routine bedside CT in the intensive care unit. CONCLUSION: With these adaptations, mobile CT may increase the efficiency of intraoperative scanning by making it available to multiple operating rooms without committing it to any room for an entire operation and may increase the efficiency and safety of CT of critically ill patients who currently need to leave the intensive care unit to travel to a fixed CT installation and back.

Child↗

The treatment of relapsed or refractory intermediate grade non-Hodgkin's lymphoma with autologous bone marrow transplantation followed by cyclosporine and interferon.

In an effort to decrease the relapse rate following autologous bone marrow transplantation for non-Hodgkin's lymphoma, patients were given cyclosporine and interferon following autologous marrow transplantation. Forty patients with intermediate grade non-Hodgkin's lymphoma that was relapsed or refractory to standard chemotherapy underwent autologous marrow transplantation. The preparative regimen consisted of cyclophosphamide 6.8 g/m2, etoposide 1600 mg/m2, and carmustine 400 mg/m2 over 4 days followed by reinfusion of bone marrow. Intravenous cyclosporine was started on day -1 as a 16 mg/kg loading dose followed by 3.6 mg/kg/day for 28 days after transplant. Patients were begun on alpha-interferon (starting dose, 0.5 million units s.c. every other day) following platelet engraftment (median day 24 post-transplant) and continued on 1.5 million units s.c. daily for 2 years. Regimen-related toxicities resulted in four (10%) deaths. Twenty-one (53%) patients developed marked erythema of the palms, soles, and arms. Biopsies of the erythema were consistent with grade I GVHD. Patients who did not develop rashes were not biopsied. The erythema persisted for a median of 10 days and resolved in all cases without treatment. Visceral GVHD was not apparent. All patients have been followed for a median of 24 months (range 12-54 months). To date, only five patients (13%) have relapsed after bone marrow transplant. Multivariant analysis could not identify risk factors for relapse post-transplant. Disease-free survival of all patients is 77% (95% confidence interval, 67-93%). The results of this pilot study suggest that the administration of cyclosporine and interferon may decrease the relapse rate of relapsed/refractory non-Hodgkin's lymphoma following autologous bone marrow transplantation.

Adolescent↗

Evaluation of water-equivalent plastics as phantom material for electron-beam dosimetry.

This investigation evaluated samples of three phantom materials designed as substitutes for water for electron beam calibration and depth ionization measurements. Two of the materials are commercially available (photon-electron Solid Water and Plastic Water), while the third (Homat) is not. Applying the values for water for all factors used in the calibration protocol of the American Association of Physicists in Medicine [Task Group 21, Med. Phys. 10, 741-771 (1983)] results in a discrepancy in calculated peak dose rates. Eliminating this discrepancy requires the additional inclusion of a multiplicative correction factor of approximately 1.015 for beam energies below 10 MeV, 1.01 for beam energies between 10 and 12 MeV, and 1.005 for beam energies above 12 MeV. Measurements for R50 and extrapolated range may be made in these materials with no corrections. Some improvement can be made in the performance of the phantom material by optimizing the match to water specifically for electron beams without regard for photon beam response. As with all radiation oncology apparatus, calibration phantoms need acceptance testing before routine use.

Electrons↗

Voiding cystourethrography in children: value of digital fluoroscopy in reducing radiation dose.

Voiding cystourethrography is a commonly used fluoroscopic procedure in children that can directly irradiate the gonads. As a consequence, much attention has been given to reducing the dose of radiation received during the procedure. A digital fluoroscope, especially adapted for use in children, was evaluated for potential reduction of the dose of radiation during the procedure. Entrance and midplane doses were calculated on child-sized phantoms by using the digital fluoroscope, digital spot films, and 105-mm spot films. Subsequently, data were collected on 47 children, grouped by ages (neonate to 1 year, 1-5 years, and 5-7 years), in whom voiding cystourethrography was performed by using the same exposure factors as those for the phantoms. On the basis of the exposure doses for the phantoms and recorded clinical peak kilovoltages, milliamperes, milliseconds, and fluoroscopic time, average skin and ovarian doses were calculated for each group of children. These doses were compared with previously reported doses for fluoroscopic and radionuclide voiding cystourethrography. Results of line-pair resolution studies for the digital spot films and 105-mm spot films were similar. Images from the digital device and 105-mm images obtained on a conventional fluoroscope were considered equally adequate for clinical decision making. The average midplane and skin doses with digital spot films for children less than 5 years old were equal to or less than 0.66 and 2.37 mGy, respectively, as opposed to 1.37 and 5.32 mGy with the 105-mm spot films. Previously reported ovarian doses range from 2.52 to 10.0 mGy for fluoroscopic voiding cystourethrography and from 0.04 to 0.05 mGy for radionuclide voiding cystourethrography. The use of digital spot films reduced dose approximately 50% compared with 105-mm spot films; the ovarian dose was 0.62 mGy greater than that for radionuclide voiding cystourethrography.

Child↗

Value of dual-energy CT in differentiating focal fatty infiltration of the liver from low-density masses.

Focal (irregular, partial) fatty infiltration of the liver may simulate neoplastic or other hypodense masses on CT. On the basis of previous observations of the phenomenon that differences in X-ray attenuation diminish with increasing energy of X-rays used, we performed a preliminary study to determine if dual-energy CT could be used to discriminate between fatty infiltration and hypodense liver masses. Dual-energy CT at 140 and 80 kVp was performed in 14 patients undergoing liver biopsy and in seven control subjects with presumedly normal liver. Attenuation measurements were taken, and the changes in attenuation between 140 and 80 kVp were calculated. The mean changes in attenuation were 3.5 H for normal liver (n = 7), 2.5 H for hypodense liver masses (n = 6), 13 H for fatty liver (n = 5), 0.3 H for fatty liver combined with hemochromatosis or hemosiderosis (n = 3), and 2 H for the spleen (n = 18). The change in attenuation increased as the fat content in the liver increased. Analysis of variance showed a statistically significant difference (p less than .001) between fatty liver and the other groups. A difference greater than 10 H was unique to fatty infiltration. These results suggest that dual-energy CT may help to differentiate focal fatty infiltration of the liver from low-density neoplastic or other lesions, but only if the iron content of the liver is not increased.

Adult↗

Repellents for Escherichia coli operate neither by changing membrane fluidity nor by being sensed by periplasmic receptors during chemotaxis.

A long-standing question in bacterial chemotaxis is whether repellents are sensed by receptors or whether they change a general membrane property such as the membrane fluidity and this change, in turn, is sensed by the chemotaxis system. This study addressed this question. The effects of common repellents on the membrane fluidity of Escherichia coli were measured by the fluorescence polarization of the probe 1,6-diphenyl-1,3,5-hexatriene in liposomes made of lipids extracted from the bacteria and in membrane vesicles. Glycerol, indole, and L-leucine had no significant effect on the membrane fluidity. NiSO4 decreased the membrane fluidity but only at concentrations much higher than those which elicit a repellent response in intact bacteria. This indicated that these repellents are not sensed by modulating the membrane fluidity. Aliphatic alcohols, on the other hand, fluidized the membrane, but the concentrations that elicited a repellent response were not equally effective in fluidizing the membrane. The response of intact bacteria to alcohols was monitored in various chemotaxis mutants and found to be missing in mutants lacking all the four methyl-accepting chemotaxis proteins (MCPs) or the cytoplasmic che gene products. The presence of any single MCP was sufficient for the expression of a repellent response. It is concluded (i) that the repellent response to aliphatic alcohols can be mediated by any MCP and (ii) that although an increase in membrane fluidity may take part in a repellent response, it is not the only mechanism by which aliphatic alcohols, or at least some of them, are effective as repellents. To determine whether any of the E. coli repellents are sensed by periplasmic receptors, the effects of repellents from various classes on periplasm-void cells were examined. The responses to all the repellents tested (sodium benzoate, indole, L-leucine, and NiSO4) were retained in these cells. In a control experiment, the response of the attractant maltose, whose receptor is periplasmic, was lost. This indicates that these repellents are not sensed by periplasmic receptors. In view of this finding and the involvement of the MCPs in repellent sensing, it is proposed that the MCPs themselves are low-affinity receptors for the repellents.

Alcohols↗

AIDS-related beliefs and behaviours of Australian university students.

Parallel questionnaires that enquired into the beliefs and behaviours which related to the acquired immunodeficiency syndrome (AIDS) were administered by postal survey during August and September 1987 to two separate samples of students. Each sample comprised 300 students who were selected at random, were aged up to 30 years, and at the time were enrolled at The University of Sydney; the response rate was 70%. Results showed a high level of "correctness" of belief about AIDS and safer sexual practices. More than half the population had experienced sexual intercourse during 1987, 25% of whom had experienced sexual intercourse on a casual basis. A marked discrepancy was found between the knowledge of and the performance of safer sexual behaviours, as measured by two sets of key questions, which covered condom use in casual vaginal encounters and enquiry into a casual partner's history with regard to sexual experience, abuse of intravenous drugs and history of blood transfusions. A log-linear regression analysis showed no correlation between scores on the two sets of key questions on knowledge of safer sexual practices and the demographic variables of age, sex, sexual experience or religious commitment. It is suggested that an educational campaign that is directed at the problem of behavioural change will fail to be productive if it is focused narrowly on the knowledge of safer sexual techniques; in addition, it should take into account other attitudinal components, such as the perception of social pressures from peer-groups. Within this particular student population, the most-effective immediate stratagem may be to restructure the perceived personal and peer-group risks.

Acquired Immunodeficiency Syndrome↗

Tissue compensators made of solid water or lead for megavoltage X-ray radiotherapy.

Curvature of the body within the treatment field of a patient undergoing radiotherapy can result in a non-uniformity of the dose distribution within the tumor volume which, for a 20 cm X 20 cm field and 6 MV X-rays, could exceed 30% of the prescribed tumor dose. The use of bolus is usually not satisfactory as skin sparing is lost. The use of a compensator at the position of the block holder assembly attenuates the primary beam while not significantly effecting the scattered radiation in the patient's body. Consequently, the necessary compensator thickness depends on the type of material used, the field size, beam energy, and depth of the point of interest. Using a compensator with thickness equal to that of the missing tissue would result in significant underdosing of the tumor. In this paper, measurements of the necessary thickness of solid water and lead required to reduce the non-uniformity of dose on the central axis to within 3% of the prescribed dose are presented for 6 MV and 10 MV X-rays.

Humans↗

Physical measurements with a high-energy proton beam using liquid and solid tissue substitutes.

The measurement of the physical parameters of a high-energy proton beam, using a range of liquid and solid tissue substitutes, is described. The system, the detectors used and the experimental verification of the tissue equivalence of the new tissue substitutes is presented. The measurements with the scattered but uncollimated proton beam in muscle- and brain-equivalent liquids and in water are compared to similar data obtained from the scattered but collimated beam. The effect of lung, fat and bone on the dose distributions in composite phantoms is also investigated and the necessary corrections established. A simulated patient treatment indicated that the Bragg peak can be positioned with an error not exceeding +/- 0.5 mm.

Adipose Tissue↗

Statistical analysis and graphical representation the temporal and distributive properties of urodynamic data.

A collection of programs are described to analyze and display urodynamic data on a digital plotter. Utilizing a small programmable calculator, routines have been written to characterize the temporal and distributive properties of experimentally observed ureteral peristalses and associated urine output. The encoding pricipals used are designed to optimally use limited calculator memory.

Animals↗

A solid water phantom material for radiotherapy x-ray and gamma-ray beam calibrations.

The formulation, manufacture and testing of an epoxy resin-based solid substitute for water is presented. This "solid water" has radiation characteristics very close volumetrically to those of water. When it is used as a dosimetry phantom for x- and gamma-ray beams in the radiotherapy range, phantom-to-water corrections and density corrections are eliminated. Relative transmission measurements have shown that the transmission through 10 cm of solid water is within 0.2% of that through an equal thickness of water for x and gamma rays. The use of this material for calibration phantoms can help achieve the goal of radiotherapy beam calibrations within +/- 1.0% of the true dose rate, easier to achieve.

Calibration↗