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Biomedical subjects

C E Wheeler

Publications and source records attributed to C E Wheeler.

At least 19 recordsLinked to original sources

Phosphocreatine protects ATP from a fructose load in transgenic mouse liver expressing creatine kinase.

The effects of an intraperitoneal dose of fructose on hepatic metabolism in transgenic mice expressing creatine kinase in liver were investigated using phosphorus-31 nuclear magnetic resonance (31P-NMR). Transgenic mice were fed diets containing varying amounts of creatine (Cr; 0-12%). It has previously been shown that 31P-NMR spectra of transgenic mice have a peak due to phosphocreatine (PCr), the intensity of which was proportional to the amount of Cr in the diet. No PCr peak was detected in control mice or transgenic mice not fed Cr. In the present study NMR spectra were collected before and for a 1-h recovery period after infusion of 0.15 mmol/10 g body wt fructose. In all mice infusion of fructose resulted in a two- to threefold elevation of phosphomonoesters. In control and non-Cr-fed transgenic mice this was accompanied by a 60% reduction of the inorganic phosphate (Pi) and a 50% fall in ATP. In transgenic mice fed Cr, the extent of reduction of Pi was dependent on the level of PCr and was markedly reduced compared with controls. Falls in Pi of 46, 24, and 6% were detected 12.5 min after fructose infusion in low, intermediate, and high PCr-containing livers, respectively. The presence of PCr also protected hepatic ATP levels from a fructose load. Transgenic mice fed on high or intermediate Cr diets showed no significant loss of ATP. However, livers with low levels of PCr lost ATP during a fructose challenge. From the equilibrium established by creatine kinase, free ADP levels were calculated throughout the fructose dose. Fructose caused a 2.5-fold increase in free ADP. This rise in ADP was independent of the total Cr or whether Pi and ATP were reduced by fructose infusion. These results indicate that an increase in ADP is not sufficient to cause depletion of ATP during a fructose challenge.

Adenosine Triphosphate

Blue rubber bleb nevus syndrome in a black patient: a case report.

Blue rubber bleb nevus syndrome is an uncommon hereditary systemic disorder characterized by localized vascular ectasia of the skin and gastrointestinal system. Review of patients reported to date with this disorder indicates that it has been described in only one black patient. We report a case of this syndrome in a young black man with a significant gastrointestinal bleeding and small numbers of distinct skin lesions. Early diagnosis of this disorder is essential so that patients can be referred to appropriate medical specialists in a timely manner.

Adult

The herpes simplex problem.

Most of the world's population is eventually infected with herpes simplex virus type 1, type 2, or both. Most infected persons harbor latent virus in nerve ganglia for the rest of their lives. True primary infections, nonprimary first-episode infections, and recurrent infections can be asymptomatic or clinical, but all of these are contagious. Past estimates of recurrent herpes affecting 20% to 40% of the population are probably low because of inadequate studies of asymptomatic shedding and genital recurrences. Herpes infections are spread primarily by close personal contact but some are contracted by fomites and medical-dental procedures. Latent virus harbored by almost everyone with frequent reactivation to produce symptomatic or asymptomatic, infectious recurrent disease poses a huge problem for control or eradication of herpes simplex infections. Public health measures will probably fail because they require too much alteration of the public's life-styles. So far, antiviral drugs do not eliminate latent virus from infected ganglia. That naturally infected persons can be reinfected, superinfected, or autoinoculated raises serious questions whether vaccines will eradicate the disease, although they might control some serious manifestations and limit some spreading. The problem of eradicating herpes is different from that of eradicating smallpox, where latent infections with infectious recurrences did not exist.

Antibodies, Viral

Comments on vaccines, August 1987.

Because of latency and infectious recurrences, eradication of herpes simplex and herpes zoster from the world by vaccines is likely to be much more difficult to accomplish than eradication of smallpox. For some time we may have to settle for control of these diseases rather than their eradication. The live, attenuated varicella vaccine protects immunocompromised and normal persons against clinical chickenpox but it does not completely prevent subsequent infection with natural chickenpox virus or latency. With herpes simplex vaccines we may have to be satisfied with amelioration or control of clinical infections and diminution of latency and recurrent disease. Varicella zoster immune globulin plays a useful role in attenuation of varicella in immunocompromised or special-risk persons exposed to varicella zoster virus. Passive immunization for herpes simplex (herpes simplex immune globulin or other antibody preparations) has been studied very little. Maybe passive immunization will have a place in future therapies, especially for serious herpes simplex virus infections in immunocompromised hosts.

Animals

Multiple clear cell acanthomas. Case report and delineation of basement membrane zone antigens.

A case of multiple clear cell acanthomas is described with a review of the literature. This benign glycogen-rich epidermal tumor is generally unable to accept melanin and lacks phosphorylase or cytochrome oxidase activity. However, the basement membrane zone appears antigenically normal, as documented by the presence of epidermolysis bullosa acquisita antigen, bullous pemphigoid antigen, heparan sulfate proteoglycan, type IV collagen, and laminin by immunofluorescence microscopy.

Antigens

Survival of herpes simplex virus during cryosurgery with liquid nitrogen.

Because many viruses can survive extremely cold temperatures for extended periods of time, transmission of viral diseases from person to person using improper cryosurgical techniques might conceivably occur. To investigate the survivability of herpes simplex virus during cryotherapy, virus was first inoculated onto cotton-tipped applicators from either tissue cultures or from active lesions on patients, and then frozen for variable times in liquid nitrogen (-196 degrees C). After thawing, the applicators were cultured for the virus. The virus survived 12 hours of freezing (the maximum time of freezing in the study), which suggests that herpes simplex could be transmitted between cryosurgical patients if care is not taken to use separate cotton-tipped applicators and liquid nitrogen containers for each case.

Cryosurgery

Hyperpigmentation in megaloblastic anemia.

Generalized hyperpigmentation developed over 2 years in a 65-year-old woman. A diagnosis of pernicious anemia was made, and treatment with vitamin B12 led to complete reversion of her hyperpigmentation to normal. Literature pertinent to hyperpigmentation and its association with megaloblastic anemias is reviewed and several possible mechanisms are mentioned.

Aged

Quality care, costs, market share, and income purposes of the American Academy of Dermatology Blue Ribbon Committee.

Definitions are offered for quality of health care, reasonable costs or fees, an appropriate share of the dermatologic market, and reasonable income or profit for dermatologists. Physician control of these items was almost complete in the recent past, but control is now passing rapidly to government in the form of regulations and to large health care corporations in the form of unbridled competition in the marketplace. Physicians, including dermatologists, must mobilize and unite to retain reasonable controls, especially over quality care and personal income. The Academy (as an organization of all of us) can help in this process, but individual dermatologists at local, regional, and national levels must play major roles in retention of controls.

Academies and Institutes

The American Journal of Nursing and the socialization of a profession, 1900-1920.

The editorial position and content of each issue of the first 20 years of the American Journal of Nursing were explored in relation to the emergence of nursing as a profession. Themes identified reflect professional issues, socialization of nurses, and the influences between other major social/political movements. The evidence of the study reveals strong nursing leadership toward (1) legitimatizing nursing as a self-controlled profession and (2) generating reform in nursing and society at large. The evidence of this study contradicts many prevalent popular views about the history of nursing.

History of Nursing

Urticarial vasculitis: report of a case and review of the literature.

A woman with cutaneous vasculitis had a severe bullous eruption that was suggestive of erythema multiforme. The patient also had a history of recurrent urticaria that continued intermittently for over a year of follow-up examination. Skin biopsy specimens of both urticarial and erythema and multiforme lesions showed leukocytoclastic vasculitis. An illness resembling systemic lupus erythematosus (SLE) is suggested by transient, low-titer, positive antinuclear antibody tests, persistent deposits of immunoglobulin and complement in normal skin, arthralgias, circulating immune complexes, and chronic hypocomplementemia. This case is similar to cases previously reported as "hypocomplementemic vasculitis," an "unusual SLE-related syndrome," and "urticaria with vasculitis."

Adult

Immunology of human warts.

Rapid advances have occurred in the characterization of human papilloma virus (HPV) types applying the new advanced techniques of restriction endonuclease analysis and molecular hybridization to human wart virus. Human papilloma virus can no longer be viewed as a single, homogeneous virus producing all varieties of clinical warts. At least three antigenically heterogeneous HPV types have been associated with common and plantar warts. Two additional HPV types have been found in patients with epidermodysplasia verruciformis. Condylomata acuminata and laryngeal papillomas contain viruses which are also distinct from the preceding viruses and may represent additional HPV types. This antigenic heterogeneity of HPV has important implications concerning the immunology of human warts which have not been taken into account in most previously published studies. Both antibody and cell-mediated responses may be seen in patients with active warts, but many patients with warts have no demonstrable immune reactions. The role of immunity in wart regression remains poorly understood. Nevertheless, the increased frequency of warts in patients receiving immunosuppressive drugs and with immune deficiency states and the immunologic alterations which occur in patients with regressing or cured warts compared to patients with active warts, particularly the increased frequency of cell-mediated responses and antibodies specific for viral antigens, support a possible role for immunity in the resolution of warts. The evidence to date, however, does not prove that immune mechanisms are directly responsible for the elimination of warts.

Adolescent