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Biomedical subjects

D M Graham

Publications and source records attributed to D M Graham.

At least 19 recordsLinked to original sources
PubMed2002

Episodic gross hematuria in association with allergy symptoms in a child.

BACKGROUND: A relationship between allergy and the development of various renal diseases has been postulated, but never proven. MATERIALS AND METHODS: We present the case of a child with idiopathic episodic gross hematuria. The child also has significant environmental allergies, and his episodes of hematuria coincide with flares of his allergic symptoms. The available literature on hematuria and allergy was reviewed in order to further explore the potential role that allergy may play in the pathogenesis of genitourinary tract disease. CONCLUSIONS: This case, as well as others reported in the literature, suggest that allergy should be considered as a possible diagnosis in children with otherwise unexplained hematuria.

Child, Preschool↗
PubMed2000

Complementary/alternative medicine in the treatment of asthma.

OBJECTIVE: This review will familiarize clinical allergists/immunologists with the common forms of complementary/alternative medicine (CAM) that are being used frequently by their patients. It reviews reasons that patients seek alternative health care therapies and the most common illnesses that are treated with this form of medicine. Cultural differences in CAM are also reviewed. The article focuses on specific therapies used to treat asthma and reviews the efficacy of these therapies based on the available scientific literature. The reader will also learn about views of other physicians on CAM and how this topic is being addressed in US medical schools. DATA SOURCES: Computer-assisted MEDLINE searches for articles on "complementary/alternative medicine" or "herbal therapy" and "asthma" or "atopy." STUDY SELECTION: Pertinent abstracts and articles in the above areas were selected. Articles selected for detailed review included review articles of the subjects along with randomized, double-blind placebo-controlled studies in animals and humans. RESULTS: Complementary/alternative medicine is commonly used by patients with chronic conditions including asthma. One-third of the US population has tried CAM. The literature supporting the efficacy of these therapies is lacking. Some reports elucidate the mechanism of action of certain herbal therapies that could possibly be helpful in the treatment of allergic diseases. There are, however, few well-controlled studies that support the efficacy of CAM in the treatment and clinical improvement of human subjects with asthma or atopic disorders. CONCLUSION: Available scientific evidence does not support a role for CAM in the treatment of asthma. The studies in the literature often have significant design flaws that weaken the conclusions such as insufficient numbers of patients, lack of proper controls, and inadequate blinding. Further studies are needed to prove or disprove the efficacy of CAM. Physicians often find CAM intimidating because they are unaware of the clinical evidence and feel uncomfortable advising their patients on its efficacy. There is definitely a need for more education among physicians in this area. It is also important that physicians inquire and discuss the use of CAM with their patients since the majority of patients are using some form of CAM.

Asthma↗
PubMed2000

Emergency physician attitudes concerning intervention for alcohol abuse/dependence delivered in the emergency department: a brief report.

Emergency Medicine (EM) physicians frequently see patients with alcohol abuse or dependence (AA/AD). Brief interventions delivered in the Emergency Department (ED) have been advocated for these patients, however, little is known regarding EM physician willingness to support such interventions. We conducted a study to determine EM physicians' attitudes toward the use of interventions for AA/AD in the ED. All members of the Michigan College of Emergency Physicians (n = 569) were mailed a survey to assess their attitudes toward the use of intervention for AA/AD in the ED. Of the 257 respondents (45.9%), a total of 76% agreed that AA/AD is a treatable illness and only 15% would not agree to support of ED interventions. Both supporters and non-supporters thought that the lack of sufficient time was an impediment to treating AA/AD in the ED. Our study suggests that the majority of ED physicians would support the implementation of brief intervention for AA/AD in the ED.

Adult↗
PubMed1994

Low level CD20 expression on T cell malignancies.

Although initially thought to be a B lineage restricted antigen, low "density" or antibody binding capacity (ABC) CD20 has recently been detected on subset(s) of normal T lymphocytes (Hultin et al.: Cytometry 14:196-204, 1993). We report low ABC CD20 expression in three (two children, one adult) cases of T-acute lymphoblastic leukemia (T-ALL). CD20 and other pertinent antigens were detected using a direct dual color method with a Becton Dickinson FACScan flow cytometer and Simulset software. Only one cell population based on light scatter was noted in each case that immunophenotypically represented almost a pure population of malignant cells expressing T lymphocyte antigens (for example, CD7 98%, 92%, and 100%, respectively). A total of 95%, 87%, and 79% of the cells from the three cases expressed CD20 with an unusual low ABC compared to the customary "bright" CD20 expression on normal B lymphocytes. Other B lymphocyte associated antigens, such as CD19, CD22, Dr, and immunoglobulin light chains, were negative. Eleven other T lymphocytic malignancies from 1991 to 1993 were CD20 negative, including three other case of T-ALL (one adult and two children). One unusual case of intestinal small lymphocytic non-Hodgkin's lymphoma with a natural killer/T lymphocytic immunophenotype not described in this report appeared to be CD20"dim"+. Low ABC CD20 expression by T lymphocytic malignancies may provide a more unique immunophenotypic "fingerprint" to help support the diagnosis of T cell neoplasia vs. normal/reactive T cells (for example, low ABC CD20 cells represent only 2.4 +/- 1.5% of normal peripheral blood lymphocytes). This characteristic might also facilitate monitoring patients for residual or recurrent disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Comparison of type I and type II Chlamydia psittaci strains infecting koalas (Phascolarctos cinereus).

The native Australian marsupial Phascolarctos cinereus, otherwise known as the koala, is prone to infection by the obligate intracellular parasite Chlamydia psittaci, which causes ocular 'pink eye' and urogenital 'dirty tail' diseases. Several chlamydial DNA probes to both chromosomal and plasmid sequences were used to type by Southern blot analysis 51 samples taken from wild and captive koalas from habitats on the eastern seaboard of Australia as far apart as Queensland and Victoria. Two types of C. psittaci were observed and called types I and II. Type II was found more frequently than type I and occurred in both ocular and urogenital samples, while type I showed a strong but not absolute preference for ocular sites. Cross-hybridization analyses indicated that type I and type II had about 10% DNA sequence identity to each other. DNA analyses showed that type II was very closely related to some ovine and bovine chlamydiae but type I could not be related to any other C. psittaci strain available. Light and electron microscopic analyses of infected BGM monolayers revealed that the two strains were similar in morphological characteristics. The type I strain was considerably more infectious than the type II strain in BGM cells and in the yolk sacs of embryonated eggs. A PCR based assay detected both type I and type II koala chlamydiae in samples that had been negative by Southern blot and tissue culture and provided the first evidence that both types can occur simultaneously at the one site of infection.

Animals↗
PubMed1992

Recurrence of hepatitis B and delta hepatitis after orthotopic liver transplantation.

The clinical course of 10 liver transplant recipients who had hepatitis B virus (HBV) and five recipients with HBV and D (delta) infection before transplantation is described. Six patients who underwent eight transplants died. The estimated one and two year survival rates in patients with HBV only before transplantation were 74% and 67% respectively. The estimated one and two year survival in patients with HBV and HDV infection beforehand was 100%. Graft infection by HBV occurred in 8 of 10 patients infected with HBV only; and in 4 of 5 patients with previous HBV and HDV infection. There was a widely variable time from transplantation to the appearance of HBV markers in liver or serum, ranging from 6-331 days. Hepatitis D antigen (HDAg) appeared in three grafts very rapidly after transplantation at 4, 8, and 37 days respectively. Graft infection by HBV was accompanied by significant liver injury in six allografts in five recipients. In particular, there was a striking morphological appearance in five infected livers in which the hepatocytes became progressively enlarged and distorted as they accumulated huge amounts of hepatitis B surface and core antigens (HBsAg, HBcAg). These features were accompanied by pericellular fibrosis and cholestasis but little associated inflammation. This syndrome carried a poor prognosis. A gradual progression to cirrhosis occurred in one additional liver. Finally, recurrent HBV infection was a principal or a contributing factor in all deaths. The presence of HBcAg and inflammation in he native liver increased the risk of HBV induced tissue damaged in the graft whereas HDV infection in the host liver seemed to reduce the risk of significant HBV induced tissue damage in the allograft. These data suggest that post transplant HBV infection is accompanied by a variety of changes in the liver allograft, some of which are unique to the transplanted liver and may result in impaired allograft function.

Adolescent↗
PubMed1991

Detection of estrogen receptor in paraffin-embedded sections of breast carcinoma by immunohistochemistry and in situ hybridization.

Biopsy specimens of small breast carcinomas are often insufficient for both diagnosis and the biochemical determination of estrogen receptor (ER) protein. Recent reports from various laboratories have shown the utility of immunohistochemical detection of ER protein in paraffin-embedded tissue sections. We used immunohistochemical (IHC) staining with the Abbott ER antibody (H222) and in situ hybridization (ISH) analysis with a 35S-labeled and a biotinylated oligonucleotide probe to detect ER protein and messenger RNA (mRNA) in tissue sections of 53 breast carcinomas. The dextran-coated charcoal (DCC) assay of these same cases revealed positive receptor levels in 31 of 53 cases, whereas the IHC method was positive in 33 of 53 cases. ISH for detection of ER mRNA was more sensitive than IHC or the biochemical assay for estrogen binding proteins, as the isotopic probe detected ER mRNA in 47 of 53 cases, whereas the biotinylated probe detected ER mRNA in 46 of 53 cases. These results indicate that ER protein can be readily detected in enzyme-treated paraffin tissue sections and that the IHC detection of ER protein correlates highly with the DCC assay. ISH with isotopic and biotinylated probes detects ER mRNA in most cases found to be positive for ER protein and also in many cases without detectable ER protein. Although detection of ER protein in paraffin sections correlates highly with the biochemical assay in this report and in other reported studies, the clinical significance of increased sensitivity by ISH is unknown and must await clinical correlative follow-up studies.

Breast Neoplasms↗
PubMed1990

Crohn's-like lymphoid reaction and colorectal carcinoma: a potential histologic prognosticator.

A distinctive Crohn's disease-like reaction (CLR) consisting of discrete lymphoid aggregates, some with germinal centers, and surrounding stellate fibrosis is commonly found around colorectal adenocarcinomas in the absence of clinical or pathologic evidence of prior Crohn's disease. Most lymphoid aggregates are located one or more millimeters beyond the advancing tumor fronts, mainly in muscularis propria and pericolic adipose tissue. The intensity of this reaction was graded as absent, mild, or intense for 100 consecutive colorectal carcinomas. These tumors also were evaluated for invasion beyond muscularis propria, lymphoid infiltrates at the tumor margin, and nodal metastases. The degree of CLR was correlated with survival. Results indicated that CLR is more likely to occur in transmurally invasive carcinomas than in those confined to the colonic wall, especially in the right side. An intense CLR is associated with an intense lymphoid infiltrate at the tumor edge, a lower incidence of nodal metastases, and a statistically significant increase in 10-yr survival. These results suggest that the Crohn's-like reaction around colorectal carcinomas may be a favorable host response, similar to lymphocytic infiltrates at the advancing tumor edge. Analysis of more cases should clarify whether this CLR is independent of other variables.

Adenocarcinoma↗
PubMed1986

Pneumonia associated with infection with pneumocystis, respiratory syncytial virus, chlamydia, mycoplasma, and cytomegalovirus in children in Papua New Guinea.

Paired serum samples were collected from 94 children with pneumonia admitted to Goroka Hospital, Papua New Guinea. All but three of the children were aged 1-24 months. Only nine children were malnourished, with weight for age less than 70% of the Harvard median (three had weight for age less than 60% of the Harvard median). Pneumocystis carinii antigen was detected in the serum of 23 children. Twenty two children had serological evidence of recent infection with respiratory syncytial virus. Five children were probably infected with Chlamydia trachomatis at the time of the study, and there was less convincing serological evidence of current infection in a further 11 children. Five children showed a fourfold rise in antibody to Mycoplasma pneumoniae. Although only one child showed a fourfold rise in antibody to cytomegalovirus, 86 children had this antibody. No child showed a fourfold rise in antibody to Ureaplasma urealyticum or Legionella pneumophila. P carinii, respiratory syncytial virus, C trachomatis, M pneumoniae, and cytomegalovirus may be important causes of pneumonia in children in developing countries.

Child, Preschool↗
PubMed1985

The chemiluminescence response of normal human leukocytes to chlamydia trachomatis.

The aim of the present study was to investigate the phagocytic response of normal human polymorphonuclear leukocytes (PMN) and monocytes (MN) to eight serotypes of C trachomatis (B,C,D,E,F,I,J, and L2) using a chemiluminescence (CL) assay, with luminal and lucigenin as amplifiers. The magnitude of the phagocytic cell CL response was proportional to the phagocyte-to-chlamydiae ratio, with a poor CL response detected at a ratio of 1:125 and progressively larger CL responses up to ratios of 1:50,000. The durations of the CL responses to all chlamydiae serotypes tested were considerably longer than that for zymosan. The PMN demonstrated a relatively greater CL response to all chlamydiae serotypes tested when compared with MN. The PMN and MN CL responses to "genital serotypes" (D,E,F,I, and J) (as well as lymphogranuloma venereum serotype L2) were greater than that for "ocular" serotypes (B and C). Inactivation of serum complement and specific chlamydial antibody absorption reduced the CL responses of both PMN and MN. This is the first study to characterize the CL responses of normal human PMN and MN cells to C trachomatis, and it indicates the important role of oxygen dependent antimicrobial systems in the phagocytosis of this common human pathogen.

Animals↗