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J A Bryan

Publications and source records attributed to J A Bryan.

At least 19 recordsLinked to original sources
PubMed1998

Technetium-99m-sestamibi parathyroid scintigraphy: effect of P-glycoprotein, histology and tumor size on detectability.

UNLABELLED: The purpose of this study was to evaluate the effect of P-glycoprotein (P-gp) levels, predominant histology and tumor size on the detectability of parathyroid adenomas with 99mTc-sestamibi scans. Although previous studies have shown that positivity correlates with tumor size, false-negative studies have been reported with large tumors and true-positives reported with very small tumors. Recent investigations have reported rapid washout of sestamibi in malignant tumors because of high levels of P-gp, similar to that seen with multidrug chemotherapy resistance. Therefore, we postulated that this mechanism might account for false-negative studies in parathyroid tumors. Preliminary reports have suggested that the predominant histological subtype influences positivity on 99mTc-sestamibi parathyroid scans. METHODS: We studied 25 patients with surgically confirmed parathyroid adenomas with 99mTc-sestamibi parathyroid scans. The results of the imaging study were correlated with tissue P-gp levels, predominant histological subtype and size of the surgically removed glands. RESULTS: There were 21 true-positive and 4 false-negative results. The size of the adenomas ranged from 0.12 to 8.64 ml. We found no correlation between the results of the dual-phase 99mTc-sestamibi study and either the predominant cell type or the level of P-gp. Positivity did correlate with the size of the adenoma (p=0.73, p < 0.0001). We cannot exclude the possibility that P-gp and cell type may still play a role in individual cases, but we suspect that other yet to be determined factors may influence 99mTc-sestamibi detectability in addition to tumor size.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1997

Laboratory practices for reporting bacterial susceptibility tests that affect antibiotic therapy.

OBJECTIVE: To evaluate a laboratory-based process for integrating antimicrobial susceptibility, pharmacy, and clinical data with rapid physician notification to improve the care and outcome of patients with bacterial infections. DESIGN: Randomized case control study comparing standard microbiology reporting method with a targeted notification procedure. RESULTS: Of 254 cases studied, a discordance between antimicrobial susceptibility test results and antibiotic therapy was detected in 140 (55%) patients and confirmed after clinical review in 49 (19%). Appropriate changes in antibiotic therapy were made significantly sooner and in a significantly higher proportion of cases with targeted notification than with standard reporting procedures. CONCLUSIONS: Utilization of antimicrobial susceptibility results is improved by integrating clinical and therapeutic information to identify cases that require physician notification, as measured by the timeliness and appropriateness of antibiotic treatment.

Anti-Bacterial Agents↗
PubMed1994

Disseminated strongyloidiasis with cutaneous manifestations in an immunocompromised host.

Recognition of the characteristic cutaneous eruption of disseminated strongyloidiasis can be crucial for early diagnosis and treatment of this potentially fatal infestation. We describe a corticosteroid-dependent elderly man who had a purpuric eruption. Filariform larvae of Strongyloides stercoralis were found in dermal granulomas and also in the sputum.

Aged↗
PubMed1994

Comparable safety of blood collection in "high-risk" autologous donors versus non-high-risk autologous and directed donors in a hospital setting.

The safety of autologous blood donation by "high-risk" patients (those with some preexisting medical conditions) has been questioned. The authors reviewed 1393 consecutive blood donation records (207 high-risk autologous [HRA], 665 non-high-risk autologous [NHRA], and 521 directed donors [DD]) to determine the safety and outcome of blood donation by HRA patients as compared with other donors at their center. The HRA group included patients with a history of significant coronary artery on cerebral vascular disease, recent seizures, cardiac arrhythmia, chronic heart failure, valvular or congenital heart disease, symptomatic dyspnea, insulin-dependent diabetes and/or current therapy with two or more antihypertensive medications. Those designated NHRA were all other autologous donors; DD met all criteria for homologous donation. Donor characteristics including predonation hematocrit, pre- and postdonation mean arterial pressure and heart rates were similar in all groups. Eight HRA donors (3.9%) had reactions, compared with 21 NHRA (3.2%) and 23 DD (4.4%), a difference that was without statistical significance. The reaction rate in all autologous donors (HRA and NHRA) was 3.4%. No differences in symptoms reported, hemodynamics or reaction severity were observed among the three groups (P > .05). A multiple logistic regression was performed within and among the groups with the risk factor categories listed above and medication classes including beta blockers, cardiac glycosides, calcium-channel blockers, antihypertensive agents, nitrates, and antiarrhythmic agents (chi 2 = 14.9; P = .0006). Only first-time donation (P = .0001) and cardiac glycoside usage (P = .04) were positively associated with an untoward reaction. The authors conclude that donation by HRA donors is at least as safe as that by donors who meet homologous donation criteria in their population and setting.

Adult↗
PubMed1994

Detection of Chlamydia trachomatis by direct fluorescent antibody staining. Results of the College of American Pathologists Proficiency Testing Program, 1986-1992.

Since 1986 the College of American Pathologists has provided a proficiency testing program for laboratories that use the direct fluorescent antibody test for direct detection of Chlamydia trachomatis in clinical specimens. The number of survey participants increased from about 200 in 1986 to about 800 in 1992, and in all years the majority used reagents produced by Syva Co (Palo Alto, Calif), although the percentage decreased from 82% in 1986 to 68% in 1992. Performance on positive specimens varied based on specimen fixation method, number of elementary bodies present, serotype, and specific product used, and declined when the specimen was fixed with acetone prior to shipping or contained fewer than 50 elementary bodies, particularly when the elementary bodies were of serotype L2. Performance with negative specimens was also variable, with 79% to 96% of all participants, and over 90% since 1991, responding correctly. In the last 1992 survey, an ungraded specimen (a five-well slide containing latex beads incorporated with fluorescein isothiocyanate) and a questionnaire were included to assess the potential influence of laboratory operations on performance. Responses to the questionnaire and the ungraded specimen suggested that the level of experience of testing personnel affected performance. A test for trend in error rate across the number of years that a laboratory had offered the Chlamydia direct fluorescent antibody test indicated that error rate declined as degree of experience with the test increased.

Chlamydia trachomatis↗
PubMed1994

Madelung's disease: a case report.

A 44-year-old man with a history of alcoholism presented with tender bilateral neck swellings and hoarseness. Further history and a review of the literature are discussed.

Adult↗
PubMed1993

Diagnosis of pulmonary toxoplasmosis by bronchoalveolar lavage in cardiac transplant recipients.

We report two cases of fatal, clinically unsuspected disseminated toxoplasmosis that developed following orthotopic cardiac transplantation. Toxoplasma gondii trophozoites, pseudocysts, and cysts were best visualized on hematoxylin and eosin and Giemsa-stained cytospin preparations of bronchoalveolar lavage fluid. Post-mortem examination in both cases revealed disseminated toxoplasmosis with extensive involvement of the lungs and heart. The patients, who were seronegative for antibody to T. gondii prior to transplantation, received organs from donors whose serology status was unknown. Demonstration of anti-toxoplasma antibodies post-transplantation occurred in both cases. Bronchoalveolar lavage may be useful in diagnosis of pulmonary toxoplasmosis. Clinicians, pathologists, and cytopathologists must consider T. gondii in the differential diagnosis of pneumonia in the immunocompromised patient, especially cardiac transplant patients.

Adult↗
PubMed1993

Sensitivity of NCI-H292 human lung mucoepidermoid cells for respiratory and other human viruses.

NCI-H292 mucoepidermoid carcinoma cells from human lungs were shown in an earlier report to be a fully adequate substitute for primary rhesus monkey kidney (MK) cells for the isolation and propagation of the human paramyxoviruses. Although sensitivity for ortho- and paramyxoviruses was the principal reason for using MK cells, the cells were also sensitive to many other viruses, which constituted another important value of MK cells. That MK cells supported the initial isolation and growth of so many respiratory viruses made it a mandatory cell type for any clinical laboratory. We therefore felt it was imperative to evaluate the virus spectrum of NCI-H292 cells, which are being used as a substitute for MK cells in many laboratories. In the present report, we show that NCI-H292 cells are sensitive for vaccinia virus, herpes simplex virus, adenoviruses, BK polyomavirus, reoviruses, measles virus, respiratory syncytial virus, some strains of influenza virus type A, most enteroviruses, and rhinoviruses, in addition to the parainfluenza and mumps viruses originally reported. Furthermore, these viruses replicate in NCI-H292 cells to the same virus and antigen titers and at the same speed of replication as they do in their usually preferred cells. The NCI-H292 cells are therefore an excellent substitute for MK cells in terms of laboratory safety, ease of availability, paramyxovirus isolation, and broad virus spectrum but cannot substitute for MK cells for the isolation of influenza viruses.

Cell Line↗
PubMed1992

A drug story.

Explore the source record for details and available documents.

Aged↗
PubMed1987

The serologic diagnosis of viral infection. An update.

The traditional basis for the serologic diagnosis of a viral infection is demonstration of seroconversion or a significant increase in circulating homologous viral antibody over the course of illness. Conventional methods include neutralization, complement fixation, hemagglutination-inhibition, indirect hemagglutination, and indirect immunofluorescence tests. Although these methods are reliable, each suffers from limitations that include procedural complexity, substantial "hands-on" time, need for titrating reagents and serially diluting specimens, occasional false-positive or false-negative results, and lack of interlaboratory standardization. Because of these problems, improved methods and new techniques for serologic diagnosis have been developed and investigated. Many appear to be superior to conventional methods in sensitivity, specificity, cost, time required for completion, and potential for automation. The advent of hybridoma technology has provided an exceptional opportunity to improve serologic reagents for the diagnosis of viral disease. In addition, IgM-specific antibody tests for rapid and early diagnosis of many viral infections are being reevaluated to eliminate the interfering effects of rheumatoid factor and antinuclear antibodies. Many of the new methodologies employ immunofluorescence assay or enzyme immunoassay for detection of specific IgM antibody, and latex agglutination, in addition to immunofluorescence and enzyme immunoassays, to detect specific IgG antibody. Simplified kits employing these methods are now becoming available commercially.

Antibodies, Viral↗