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Biomedical subjects

H Epstein

Publications and source records attributed to H Epstein.

At least 19 recordsLinked to original sources

Health needs of the Roma population in the Czech and Slovak Republics.

In the growing literature on the human rights of Roma people in Central Europe, their relatively poor health status is often mentioned. However, little concrete information exists about the contemporary health status of the Roma in this region. We sought information on the health of the Roma in two of countries with significant Roma minorities, the Czech and Slovak Republics, by means of systematic searches for literature on the health of Roma people published in Czech or Slovak or by authors from the two countries. Published research on health of the Roma population is sparse. The topics that have received attention suggest a focus on concepts of contagion or social Darwinism, indicating a greater concern with the health needs of the majority populations with which they live. What limited evidence exists indicates that the health needs of the Roma population are considerable. With very few exceptions, the health status of Roma is worse than that of non-Roma population in both countries. The burden of communicable disease among Roma is high and diseases associated with poor hygiene seem to be particularly important. Evidence on health care suggests poor communication between Roma and health workers and low uptake of preventative care. The health needs of Roma lack visibility, not only because of the absence of research but also the absence of advocacy on their behalf. Since 1989, Czech and Slovak researchers have largely turned away from health research on particular ethnic groups. This probably reflects a growing sensitivity about stigmatising Roma, but it also makes it difficult to know how their circumstances might be improved. There is a need for further research into the health of Roma people with particular emphasis on non-communicable disease and for interventions that would improve their health.

Czech Republic↗

Lack of association between anti-V3 loop antibodies and perinatal transmission of HIV-1 in Kampala, Uganda.

This study evaluated the association between reactivity of maternal antibody to human immunodeficiency virus type 1 (HIV-1) V3 loop peptides and perinatal transmission in Uganda. Plasma from 40 HIV-1-infected mothers (20 transmitting and 20 nontransmitting mothers) and 31 uninfected mothers in Uganda were tested for reactivity and antibody titer to synthetic peptides representing V3 loop sequences from HIV-1 strains MN, SF2, LAI, ZR6, and CM235 and consensus peptides CA, CB, and CD. No significant differences were found between 20 transmitting mothers and 20 nontransmitting mothers in terms of percent reactivity or titer of antibody to any of the V3 loop peptides tested. Use of a multivariable logistic model to adjust for beta-2 microglobulin level as a confounding variable of stage of infection did not help demonstrate an association except possibly for the ZR6 peptide. These data suggest that neither reactivity nor maternal antibody titer to V3 loop peptides are protective against perinatal transmission of HIV-1 in Uganda.

Acquired Immunodeficiency Syndrome↗

Terazosin in the treatment of benign prostatic hyperplasia. Terazosin Benign Prostatic Hyperplasia Study Group.

OBJECTIVE: To evaluate the efficacy and tolerability of terazosin, a long-acting selective alpha 1-receptor antagonist, in patients with benign prostatic hyperplasia. DESIGN AND SETTING: Randomized, double-blind, multicenter (eight government and private facilities), placebo-controlled study. PATIENTS: Men aged 45 years or older, with qualifying signs and symptoms of benign prostatic hyperplasia (n = 160). INTERVENTIONS: Terazosin or placebo once daily, with terazosin dosage titrated to the patient's response. After a 4-week placebo lead-in, 1 to 10 mg of terazosin or placebo was administered for 24 weeks. OUTCOME MEASURES: Decreases in mean Boyarsky scores for obstructive and irritative symptoms and total scores and increases in peak urine flow rate. RESULTS: Terazosin-treated patients had decreases in Boyarsky obstructive, irritative, and total scores of 3.3 (52%), 1.3 (29%), and 4.6 (42%), respectively, compared with decreases of 0.7 (12%), 0.4 (9%), and 1.1 (11%), respectively, in the placebo group (P < .05). Peak urine flow increased by a mean of 2.6 mL/s (30%) in terazosin-treated patients and 1.2 mL/s (14%) in placebo-treated patients (P < or = .05). Adverse events that differed significantly in the two groups were dizziness (19% in the terazosin group vs 5% in the placebo group) and urinary tract infection (1% in the terazosin group vs 10% in the placebo group). CONCLUSIONS: These results suggest that terazosin given once daily in doses up to 10 mg alleviates symptoms and improves peak urine flow rate in men with benign prostatic hyperplasia and has an acceptable adverse event profile.

Adrenergic alpha-Antagonists↗

Effect of total parenteral nutrition on amino acid and glucose transport by the human small intestine.

OBJECTIVE: The effect of total parenteral nutrition (TPN) on small intestinal amino acid transport activity was studied in humans. SUMMARY BACKGROUND DATA: Studies in humans receiving TPN indicate that a decrease in the activities of the dissacharidase enzymes occurs, but morphologic changes are minimal with only a slight decrease in villous height. METHODS: Surgical patients were randomized to receive TPN (n = 6) or a regular oral diet (controls, n = 7) for 1 week before abdominal surgery. Ileum (5 controls, 5 TPN) or jejunum (2 controls, 1 TPN) were obtained intraoperatively and brush-border membrane vesicles (BBMV) were prepared by magnesium aggregation/differential centrifugation. Transport of L-MeAlB (a selective system A substrate), L-glutamine, L-alanine, L-arginine, L-leucine, and D-glucose was assayed by a rapid mixing/filtration technique in the presence and absence of sodium. RESULTS: Vesicles demonstrated approximately 18-fold enrichments of enzyme markers, classic overshoots, transport into an osmotically active space, and similar 1-hour equilibrium values. TPN resulted in a 26-44% decrease in the carrier-mediated transport velocity of all substrates except glutamine across ileal BBMVs. In the one patient receiving TPN from whom jejunum was obtained, there was also a generalized decrease in nutrient transport, although glutamine was least affected. Kinetic studies of the system A transporter demonstrated that the decrease in uptake was secondary to a reduction in carrier Vmax, consistent with a decrease in the number of functional carriers in the brush-border membrane. CONCLUSIONS: TPN results in a decrease in brush-border amino acid and glucose transport activity. The observation that glutamine transport is not downregulated by 1 week of bowel rest may further emphasize the important metabolic role that glutamine plays as a gut fuel and in the body's response to catabolic stresses.

Adult↗

Kinesins in the spindle: an update.

Eukaryotes contain a superfamily of microtubule-based motor proteins comprising kinesin and a number of related proteins that are thought to participate in various forms of intracellular motility, including cell division and organelle transport. The role of various members of the kinesin superfamily in chromosome segregation and spindle morphogenesis was described in TCB last year in parts of a series on cytoplasmic motor proteins. In this brief update, Helen Epstein and Jon Scholey comment on new findings that have improved our understanding of the functions of kinesin-related proteins in mitosis and meiosis.

Journal Article↗

Cloning and expression of Drosophila HP1 homologs from a mealybug, Planococcus citri.

The mealybug chromosome cycle is one of the most dramatic examples of genomic imprinting known. In embryos that are to become male the entire paternal chromosome set becomes heterochromatic and inactive at the blastoderm stage, while the maternal set remains active and euchromatic. HP1 is a protein from Drosophila melanogaster, which binds preferentially to heterochromatin on polytene chromosomes and is likely to be a modifier of position effect variegation. This paper describes the isolation and sequencing of two cDNA clones encoding HP1 homologs from the mealybug, Planococcus citri. The protein product of the cDNA clone that was closer to HP1 in sequence was expressed as a fusion protein in Escherichia coli, and polyclonal rat antibodies were raised against it. Immunohistochemistry to mealybug squash preparations showed that this protein was a male-specific nuclear protein, but that it was not specifically associated with the heterochromatic set of chromosomes.

Amino Acid Sequence↗

Acute reversible hypoxemia in systemic lupus erythematosus.

OBJECTIVE: To determine the frequency of unexplained reversible hypoxemia in patients with systemic lupus erythematosus and to assess the relation between hypoxemia and elevated plasma levels of complement split products. DESIGN: Cohort study. SETTING: Inpatient and outpatient facilities of the New York University Medical Center/Bellevue Hospital and the Hospital for Joint Diseases. PATIENTS: Case patients were 22 patients hospitalized with disease exacerbation and no evidence of parenchymal lung disease on chest roentgenogram. Four patients with stable disease were followed in the outpatient clinic, and five healthy normal volunteers served as controls. MEASUREMENTS: Plasma levels of complement split products (C3a, factor Bb fragment), alveolar-arterial (A-a) Po2 gradients, and pulmonary function were measured. MAIN RESULTS: Nine episodes of hypoxemia or hypocapnia (mean A-a gradient, 30.4 +/- 4.8 mm Hg) or both (despite normal chest roentgenogram results) were noted in six hospitalized patients (group 1). Gas exchange improved within 72 hours of steroid therapy (mean A-a gradient, 11.6 +/- 4.3 mm Hg; P less than 0.01). These patients had an elevated initial mean C3a level (938.4 +/- 246.8 ng/mL) that decreased within 72 hours (407.8 +/- 80.9 ng/mL; P less than 0.01), concomitant with improved oxygenation. Ventilation-perfusion scans, obtained for four of six group 1 patients, excluded pulmonary emboli. Four hospitalized patients (group 2) had a normal A-a gradient (mean, 7.5 +/- 2.7 mm Hg). The mean C3a level of this group (358.3 +/- 39.2 ng/mL) was lower than that of group 1 (P less than 0.05). Four patients with stable disease (group 3) had a mean A-a gradient and a mean C3a level of 3.3 +/- 2.7 mm Hg and 237.8 +/- 105.7 ng/mL, respectively, similar to values found in five normal volunteers, in whom the mean A-a gradient was 3.7 +/- 1.7 mm Hg and the mean C3a level was 124.8 +/- 9.2 ng/mL. CONCLUSION: A syndrome of reversible hypoxemia, unassociated with parenchymal lung disease, is unexpectedly common in acutely ill, hospitalized patients with systemic lupus erythematosus. The pathogenesis of this syndrome is unclear, although the data are compatible with the hypothesis that hypoxemia may be related to pulmonary leukoaggregation.

Acute Disease↗

The human class I MHC gene HLA-F is expressed in lymphocytes.

Genomic and cDNA clones encoding a human, non-classical class I gene, Dew3, have been isolated. The complete coding sequence has been determined. The sequence is capable of directing expression of a protein with high sequence homology to HLA-A,B,C molecules but with a shortened cytoplasmic tail. Sequence comparisons demonstrate that this gene is from a separate locus to the 'classical' HLA-A,B,C and 'non-classical' HLA-E and HLA-G loci. Dew3 is equally distantly related to all of these previously described, functional class I genes. It is, however, extremely homologous to a third 'non-classical' gene, HLA-5.4, and to the chimpanzee gene, Ch28. The RNA species it transcribes is shorter than that of the classical genes, due to an altered acceptor splice site which results in the loss of exon 7. The transcription of Dew3 RNA shows a unique pattern of tissue distribution, being expressed in B cell lines and peripheral blood lymphocytes and absent from T cell lines, fibroblasts and a myelomonocytic leukaemia. A Dew3 protein product was detected after transfection into a human EBV-transformed B cell line but was located intracellularly. The HLA-5.4 gene has been recently designated HLA-F. The Dew3 and X5.1 clones thus represent two new alleles of the HLA-F locus in man. Sequence comparison with its chimpanzee homologue suggests that selective pressure for conservation of amino acid sequence is still maintained at this locus.

Amino Acid Sequence↗

Expression and function of HLA-A2.1 in transgenic mice.

We have derived a number of transgenic mouse lines which express the human major histocompatibility complex class I gene HLA-A2.1. Two lines carry the complete human HLA-A2.1, the others bear a recombinant gene in which the HLA-A2.1 coding regions are fused to the H-2Kb promoter. Analysis of transgenic spleen cells by immunofluorescence demonstrates that these mouse cells express HLA-A2.1 on their surface in association with mouse beta 2-microglobulin (beta 2m), confirming that HLA-A2 does not require human beta 2m to be expressed at the cell surface. The cells contain more HLA mRNA than endogenous H-2 class I mRNA. There is also a large pool of non-beta 2m-associated HLA heavy chain inside the cell. In contrast the amount of HLA:beta 2m complex is low. Thus, in transgenic mice HLA-A2 seems to compete poorly with H-2 heavy chains for mouse beta 2m. The HLA-A2.1 transgenic mice do not produce influenza-virus-specific cytotoxic T cells (CTL) restricted to the HLA transgene, at least in sufficient numbers to be measured in a direct bulk CTL assay. The dominance of H-2-restricted clones may be the result of quantitative rather than qualitative factors. However, HLA-A2.1 transgenic spleen cells are effective in stimulating an allogeneic CTL response in normal mice. This response is not H-2 restricted. Cold target inhibition studies show that there are at least two populations of CTL, one of which is specific for HLA-A2.1 on mouse cells. This result suggests that at least some allo-CTL are directed against major histocompatibility complex plus "self-peptide".

Animals↗

An insertion mutation in the pol gene of Moloney murine leukemia virus results in temperature-sensitive pol maturation and viral replication.

An insertion mutation in the pol gene of Moloney murine leukemia virus (M-MuLV) was found to render the virus temperature-sensitive for replication. A provirus containing a 12-bp insertion at the boundary between the reverse transcriptase (RT) and integrase (IN) domains induced the formation of mutant virions containing a partially processed RT-IN fusion protein. Some proteolytic processing to form mature RT and IN was observed at 32 degrees, but only aberrantly processed proteins were detected at 39 degrees. The uncleaved precursor was found to exhibit DNA polymerase activity, even though it could not support replication of the virus in vivo at 39 degrees.

Animals↗

Volume adjustment of mechanics and diffusion in interstitial lung disease. Lack of clinical relevance.

Relationships of lung mechanics and diffusion to lung volume were examined in 38 patients with interstitial lung disease to determine whether patterns of reduction relate to severity of disease, distinguish histologic characteristics or predict prognosis for reversibility. Normal volume-related values for both mechanics and diffusion were seen throughout the range of severity of disease. The ratio of mechanics to lung volume did not correlate with the ratio of diffusion to lung volume in the same patient. Volume relationships of mechanics and diffusion failed to distinguish pathologic predominance of fibrosis or inflammation/granulomas. These ratios failed to predict reversibility in patients who had repeated tests. These results suggest that in patients with interstitial lung disease the significance of "volume-adjustment" of mechanics and diffusion should be viewed with caution; these parameters do not appear to contribute to the assessment of pathophysiology or correlate with clinical spectrum of interstitial lung diseases.

Female↗

BioSYNTHESIS: bridging the information gap.

BioSYNTHESIS is a prototype intelligent retrieval system under development as part of the IAIMS project at Georgetown University. The aim is to create an integrated system that can retrieve information located on disparate computer systems. The project work has been divided in two phases: BioSYNTHESIS I, development of a single menu to access various databases which reside on different computers; and BioSYNTHESIS II, development of a search component that facilitates complex searching for the user. BioSYNTHESIS II will accept a user's query and conduct a search for appropriate information in the IAIMS databases at Georgetown. For information not available at Georgetown, such as full text, it will access selected remote systems and translate the search query as appropriate for the target system. The search through various computer systems and different databases with unique storage and retrieval structures will be transparent to the user. BioSYNTHESIS I is complete and available to users. The design work for BioSYNTHESIS II is under development and will continue as a multiyear technical research effort of the proposed Georgetown IAIMS implementation project.

Computer Communication Networks↗

Diagnostic amniocentesis and bacteraemia.

Thirty antenatal patients with intact membranes were studied to determine the incidence of bacteraemia induced by transabdominal amniocentesis. No bacteraemias were detected following the procedure. Antibiotic prophylaxis is probably not warranted for immunocompetent hospitalized patients undergoing amniocentesis.

Adult↗

A novel method of electrophoresis for the separation of individual human serum glycoproteins.

A method for the isolation of protein components by a combination of polyacrylamide gel electrophoresis and electro-extraction of slices of gel contained in cellophane dialysis tubing, using the H tube electrophoresis apparatus, is described. The method was applied to the purification of individual human serum glycoproteins. Although the glycoproteins have widely differing electrophoretic mobilities, they appeared to be antigenically interrelated judging from their complex "spurring" in Ouchterlony double gel diffusion tests.

Blood Protein Electrophoresis↗