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Biomedical subjects

D Kane

Publications and source records attributed to D Kane.

At least 37 records · Page 2Linked to original sources
PubMed1998

Quantitative microscopic analysis of inflammation in rheumatoid arthritis synovial membrane samples selected at arthroscopy compared with samples obtained blindly by needle biopsy.

OBJECTIVE: To evaluate microscopic measures of inflammation in rheumatoid arthritis synovial tissue samples selected at arthroscopy compared with those obtained blindly by needle biopsy from the suprapatellar pouch (SPP) of the same joint. METHODS: Samples were selected at knee arthroscopy from the SPP and the lateral and medial gutters. Immediately following arthroscopy, a biopsy needle was inserted through the same portal into the SPP by a second investigator, and 3 further samples were obtained blindly. Using standard immunohistologic methods, all samples were analyzed by a single investigator without knowledge of the original tissue location and biopsy technique. Following staining with anti-CD3 and anti-CD68 monoclonal antibodies, T lymphocyte and macrophage infiltration were measured by quantitative analysis. RESULTS: Synovial tissues from 14 patients were analyzed. In comparing microscopic measures of inflammation using the 2 procedures, mean scores of lining cell depth and the percentage of CD68+ cells in the lining layer correlated positively (tau = 0.59, P = 0.003 and tau = 0.73, P = 0.0003, respectively). In the sublining layer, CD3+ cell counts also correlated significantly (tau = 0.71, P = 0.0004). Sublining CD68+ cell counts did not correlate. This was explained by the observation that CD68+ cell infiltration in areas adjacent to articular cartilage was significantly greater than in the SPP (P = 0.01), suggesting preferential trafficking to this site by macrophages, but not by T lymphocytes. Macroscopic appearance at arthroscopy did not predict microscopic features. CONCLUSION: Most microscopic measures of inflammation in synovial tissue samples obtained blindly from the SPP were similar to those determined in samples selected at arthroscopy. However, measurements in samples from the SPP may underestimate the intensity of macrophage infiltration in areas more adjacent to cartilage. These observations have important implications for future study of macrophage function in synovial tissue.

Arthritis, Rheumatoid↗
PubMed1998

Ultrasound guided injection of recalcitrant plantar fasciitis.

OBJECTIVE: To determine the effect of ultrasound guided injection in recalcitrant idiopathic plantar fasciitis. METHODS: Four patients with a clinical diagnosis of idiopathic plantar fasciitis, who were unresponsive to palpation guided injection with triamcinolone acetonide and local anaesthetic, underwent ultrasonographic examination of the heel. RESULTS: The following ultrasonographic features were noted:- (a) increased thickness of plantar fascia in symptomatic heels compared with asymptomatic heels, (b) loss of distinction of the distal plantar fascia borders, (c) reduced echogenicity of the plantar fascia. Ultrasound guided injection of the enlarged, hypoechoic plantar fascia resulted in complete relief in four of five heels (mean duration of follow up = 24 months) in three cases. One patient developed a recurrence of symptoms after six months. CONCLUSION: Ultrasound allows for confirmation of the clinical diagnosis and ultrasound guided injection produces a good clinical response when unguided injection is unsuccessful. The technique is quick, inexpensive, and entails no radiation exposure.

Anesthetics, Local↗
PubMed1998

Catastrophic antiphospholipid antibody syndrome in primary systemic sclerosis.

We describe the first case of catastrophic antiphospholipid antibody syndrome (APS) in a patient with progressive systemic sclerosis (SSc). After initial presentation with digital gangrene the patient developed rapidly progressive multiorgan failure and died within 19 hours. Postmortem examination revealed extensive multiorgan arterial microthrombi of days' to months' duration. This suggests that a subclinical state of thrombosis existed before onset of catastrophic APS. Given the poor prognosis of established catastrophic APS there is a need for a means to detect subclinical thrombosis and treat "at risk" patients before clinically apparent thrombosis occurs.

Adult↗
PubMed1997

Clinical, immunopathogenic, and therapeutic aspects of psoriatic arthritis.

Psoriatic arthritis is a common chronic rheumatic disease that may result in considerable joint damage if left untreated. Recent clinical studies have focused on the identification of poor prognostic factors. Early, aggressive treatment is indicated in patients with significant joint inflammation and certain HLA antigens. Immunopathogenic evidence continues to point toward an HLA class I-mediated disease with perhaps an important role for CD8+ T cells. Although few basic research publications discuss psoriatic arthritis, studies in the areas of spondyloarthropathy and psoriasis continue to shed light on disease mechanisms. Greater collaboration is advocated among researchers in these areas and those interested in achieving a better understanding of the disease pathogenesis of psoriatic arthritis.

Arthritis, Psoriatic↗
PubMed1997

Isoform-specific expression and function of neuregulin.

Neuregulin (also known as NDF, heregulin, ARIA, GGF or SMDF), induces cell growth and differentiation. Biological effects of neuregulin are mediated by members of the erbB family of tyrosine kinase receptors. Three major neuregulin isoforms are produced from the gene, which differ substantially in sequence and in overall structure. Here we use in situ hybridization with isoform-specific probes to illustrate the spatially distinct patterns of expression of the isoforms during mouse development. Ablation of the neuregulin gene in the mouse has demonstrated multiple and independent functions of this factor in development of both the nervous system and the heart. We show here that targeted mutations that affect different isoforms result in distinct phenotypes, demonstrating that isoforms can take over specific functions in vivo. Type I neuregulin is required for generation of neural crest-derived neurons in cranial ganglia and for trabeculation of the heart ventricle, whereas type III neuregulin plays an important role in the early development of Schwann cells. The complexity of neuregulin functions in development is therefore due to independent roles played by distinct isoforms.

Animals↗
PubMed1997

Parvovirus B19 infection in AIDS patients.

Bone marrow of 61 HIV-1-infected patients and 23 control patients was examined to determine the incidence of B19 infection and its clinical impact in HIV-1-infected persons. Of the 61 HIV-infected patients studied, ages ranged from 22-47 years with a mean of 33.2 years. There was a man:woman ratio of 3.8:1. With regard to staging of HIV disease at the time of bone marrow sampling, 52 patients were CDC group 4, 5 patients were CDC group 3, and 4 patients were CDC group 2. Control patients, were not known to be HIV-1-infected, and had one of the following conditions: lymphoma, leukaemia, thrombocytopenia, thrombocytosis, anaemia, multiple myeloma, raised serum IgM. Thirteen of 61 HIV-infected patients and 0 of 23 control patients were positive for B19 DNA in bone marrow (two-tailed P value = 0.016). Within the HIV-infected group, the average haemoglobin among persons testing B19 DNA positive (n = 13) was 11.1 g/dl, compared with 11.5 g/dl among persons testing B19 DNA negative (n = 48). In conclusion, B19 persistence may be common and frequently subclinical in AIDS patients.

Adult↗
PubMed1996

Evaluation of tuberculosis control policies using computer simulation.

OBJECTIVE: To develop more effective methods to assess tuberculosis (TB) control strategies so we can meet national goals for the elimination of TB in the United States. DESIGN: Using a semi-Markov model that divided the US population into 3 age groups and 18 clinical states based on disease status and risk for TB and human immunodeficiency virus (HIV) infection, we measured the effects of 5 changes in TB policy, introduced singly and in combination: (1) increased coverage and (2) improved efficacy of preventive therapy, (3) increased coverage and (4) improved efficacy of treatment, and (5) introduction of BCG vaccination. RESULTS: A BCG vaccination program that reached 10% of eligible children and 1% of eligible adults each year would produce a 17% reduction in cases and an 11% decline in deaths over 10 years. Preventive therapy programs among the general population would have little effect on the number of TB cases, but a program targeting HIV-infected patients would reduce HIV-associated TB cases and deaths 14% to 20%. A 10% improvement in the coverage and efficacy of both preventive therapy and treatment, coupled with the BCG vaccination program, would lead to a 47% decline in TB cases and a 50% decline in TB deaths relative to baseline over 10 years. CONCLUSIONS: Improvements in treatment coverage or effectiveness alone are unlikely to reach established national goals for the elimination of TB. These goals can be achieved through a combination of improvements in current programs with targeted preventive therapy and BCG vaccination programs.

Adolescent↗
PubMed1996

Renal ultrasonic findings in sulphadiazine-induced renal failure.

The increased incidence of cerebral toxoplasmosis in AIDS has led to a resurgence in the use of sulphadiazine. One complication of this is acute renal failure secondary to sulphadiazine-induced crystalluria. Three cases are described which demonstrate a spectrum of ultrasound findings ranging from echogenic foci in the renal parenchyma to echogenic material in both dilated and non-dilated collecting systems. In patients with AIDS having sulphadiazine treatment, these ultrasonic findings suggest that sulphadiazine is the cause of the renal failure.

AIDS-Related Opportunistic Infections↗
PubMed1991

A practical approach to teaching nursing research.

Nurse educators often struggle to take the mystique out of research for undergraduate students. A learning experience to implement the research process at a level appropriate for senior nursing baccalaureate students presented itself during a community clinical practicum. Students who had completed a health assessment of a seniors retiree club identified lack of membership growth as a concern. Their instructor encouraged and helped them to investigate this problem further by applying research concepts. The experience demonstrates that nursing research can be incorporated successfully in the clinical area.

Aged↗
PubMed1989

Expenditures for nonspecific back injuries in the workplace.

This study reports results based on the 29,421 Tennessee Workers' Compensation claims that were closed in 1986. The study encompasses over $160 million in paid claims. Nearly 8000 cases (27%) involved back injuries, of which more than 90% were nonspecific. Forty percent of the total expenditures were for these nonspecific back injuries. Counterpart data on 8696 injuries involving extremities are included for comparison. Medical expenses account for about 40% of all payments. Data concerning time intervals between injury and return to work are provided. Separate analyses reveal characteristics of those subjects in the highest total expenditure decile, the 2941 subjects who received 57% of total dollar payments. This report provides fiscal data supporting recent appeals for a reappraisal of the clinical management of nonspecific back problems.

Back Injuries↗
PubMed1981

Effects of colchicine or cytochalasin B on pulmonary macrophage endocytosis in vivo.

Pulmonary macrophages defend lung surfaces by ingesting deposited particles. We investigated to what extent this uptake of particles can be modulated in vivo by two drugs, colchicine and cytochalasin B (CytB). 198Au colloidal gold, in isotonic saline carrier fluid, was intratracheally instilled into male Syrian golden hamsters. The uptake of these particles by pulmonary macrophages was measured when the carrier fluid contained only colloidal gold and when this test particle was combined with graded doses of either drug. We found that macrophage uptake of the particles 1 h after instillation was depressed 37% when colchicine was added to the instillate (150 micrograms/100 g BW). Depression of particle uptake was also seen with CytB at 15 micrograms/100 g BW. Experiments with tritiated colchicine and CytB showed that both drugs were rapidly cleared from the lungs early in the 1 h phagocytic period. The effect of intravenous colchicine and CytB on the clearance of intravenously injected gold colloid by the liver and spleen reticuloendothelial system was negligible. The results of these experiments, in conjunction with in vitro effects of colchicine and CytB, provide insight into the components of cell function active in particle uptake in situ.

Animals↗