Three years' experience of the east New Britain project for the disabled.
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Biomedical subjects
Publications and source records attributed to J Hamilton.
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The chain origins of subunits M1, M2*, and M3 previously described (Butkowski, R. L., Wieslander, J., Wisdom, B.J., Barr, J.F., Noelken, M.E., and Hudson, B.G. (1985) J. Biol. Chem. 260, 3739-3747) of the globular domain of basement membrane collagen were identified, by amino-terminal amino acid sequence analysis, with respect to their relationship to the chains of collagen IV. M1 comprises two polypeptides which correspond to the noncollagenous segments (NC1) of the alpha 1 ad alpha 2 chains of collagen IV. M2*, containing the Goodpasture epitope, and M3 are distinct from these two constituents and from each other but have Gly-X-Y triplets and hydroxyproline at their amino terminus, reflecting the fact that each has a collagen chain origin. These results indicate the presence of two new collagen chains in basement membrane. These new chains appear to be integral components of collagen IV molecules. Alternatively, they could represent new molecular species of basement membrane collagen containing a globular domain, comprising M2* and M3, with physicochemical properties very similar to those of collagen IV.
The effects of cytomegalovirus (CMV) infection on patient and allograft survival were determined in 1245 renal transplant recipients from 46 transplant centers. When an antilymphocyte preparation was administered to cadaveric allograft recipients, those at risk for primary CMV had a worse outcome than similar patients treated with prednisone and azathioprine (53.1% alive at 6 months with a functioning allograft vs. 70.8%, P = .05) or patients at risk for reactivation CMV (53.1% vs. 71.1%, P = .035). Patients at risk for reactivation CMV had a better outcome if they received an antilymphocyte preparation (71.1% vs. 60.8%, P less than .01). The type of immunosuppression had no effect on patients without CMV. Living-related donor transplantation was not significantly influenced by CMV or type of immunosuppression. We conclude that CMV infection is strongly influenced by the form of immunosuppression employed, and that both are important determinants of the outcome of cadaveric renal transplantation.
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The use of the diving reflex to terminate a case of paroxysmal supraventricular tachycardia (PST) is described in a 2-week-old infant who presented in severe congestive heart failure with supraventricular tachycardia at a rate of 300. The infant's face was placed in a basin of ice water at 5 degrees C. for 5 seconds with manual occlusion of the infant's nostrils to prevent aspiration. The PST converted to a sinus rhythm of 120 within 3 seconds of facial immersion. The physiology of the diving reflex is reviewed and the uses and hazards of this reflex in terminating attacks of PST in infants is discussed.
Previous work has shown that although both alpha- and beta-agonists stimulate brown fat heat production, the beta agonist is quantitatively more effective. The finding in the present study that isoproterenol, a beta-agonist, significantly stimulates net glycerol release from isolated hamster brown adipocytes while the alpha-agonist, phenylephrine does not, may account (at least in part) for the differential thermogenic response to the two types of agents. The present study also compared lipolytic responses to AMP, cAMP, cGMP and theophylline, with the results indicating a greater rate of net glycerol release being induced by AMP and by cAMP than by theophylline or cGMP plus theophylline.
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This paper describes the experiences of seven women mental health professionals who met in a leaderless group over a period of a year and a half. There is a discussion of the conflicts for women in four major areas--competition, dependency needs, economic success and the search for role models, and the suggestion of possible successful resolutions in these conflict areas. The resolutions are a result of individual experiences and discussions in the group.
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Hepatitis B immune globulin (HBIG) and immune serum globulin (ISG) were examined in a randomized, double-blind trial to assess their relative efficacies in preventing type B hepatitis after needle-stick exposure to hepatitis B surface antigen (HBsAG)-positive donors. Clinical hepatitis developed in 1.4% of HBIG and in 5.9% of ISG recipients (P = 0.016), and seroconversion (anti-HBs) occurred in 5.6% and 20.7% of them respectively (P less than 0.001). Mild and transient side-effects were noted in 3.0% of ISG and in 3.2% of HBIG recipients. Available donor sera were examined for DNA polymerase (DNAP) and e antigen and antibody (HBeAg; anti-HBE). Both DNAP and HBeAg showed a highly statistically significant correlation with the infectivity of HBsAg-positive donors. Hepatitis B immune globulin remained significantly superior to ISG in preventing type B hepatitis even when the analysis was confined to these two high-risk subgroups. The efficacy of ISG in preventing type B hepatitis cannot be ascertained because a true placebo group was not included.
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The synthesis and secretion of plasminogen activator by cultured macrophages can be induced and stimulated by concanavalin A and by phorbol myristate acetate, and inhibited by such agents as glucocorticoids, mitotic inhibitors and compounds affecting cAMP metabolism. By the manipulation of stimulatory and inhibitory influences, enzyme production can be modulated continuously over a 200 fold range. In the same way, the proportion of cells that secrete detectable levels of enzyme can be varied from 1-90%. No comparable modulation of lysozyme or acid hydrolase production is observed under the same conditions. These results suggest that the physiological control of macrophage plasminogen activator production is achieved by the interacting effects of mutually antagonistic stimuli; this emphasizes the utility of this enzyme for the study of regulatory phenomena, including those relating to inflammation.
Intraperitoneal injection of asbestos fibres into mice induces the formation of exudates containing macrophages that produce plasminogen activator. Like-wise, in vitro addition of asbestos to macrophage cultures stimulates plasminogen activator secretion; the synthesis and secretion of lysozyme and lysosomal enzymes are not changed under these conditions. The enhanced secretion of plasminogen activator by macrophages exposed to asbestos is suppressed by low concentrations of anti-inflammatory steroids.
This paper describes a simple method of assessing the constituent features of flexion deformities of the proximal interphalangeal joints in Hansen's disease, and a simple operation to correct the anterior displacement of the lateral band and the associated contractures.
Plasminogen activator production by cultured mouse peritoneal macrophages can be modulated in vitro by low concentrations of various pharmacologically active molecules. Glucocorticoid hormones and their synthetic derivatives, as well as cholera toxin, colchicine, and vinblastine markedly inhibit production of this enzyme without affecting other important macrophage functions. The effect of glucocorticoids is of particular interest, both because their relative in vivo anti-inflammatory potencies correlate exactly with their effect on plasminogen activator production in culture and because this effect occurs at near physiological concentrations. In view of the correlations established in other systems between plasminogen activator production and cell migration, we have also examined the age of the macrophages in thioglycollate-induced exudates. Confirming the results of Van Furth and Cohn (1968), we have found that the majority of these cells are young, having recently replicated and arrived in the peritoneal cavity. Using a fibrinagar overlay technique which allowed us to determine the production of plasminogen activator by individual cells. we have found that the majority of these cells produce the enzyme. The potential roles of plasminogen activator in monocyte migration and the relationship of this enzyme to the anti-inflammatory effect of gluccorticoids are correlated and emphasized.
Early radiological changes in ulcerative colitis include (a) finely granular mucosa due to hyperemia and edema, (b) mucosal stippling due to adherence of barium to superficial ulcers, and (c) coarsely granular mucosa due to ingrowth of granulation tissue. In granulomatous colitis, early changes include discrete, superficial ulcers, often against a background of normal mucosa, seen best en face. All of these changes can be demonstrated by the double-contrast technique. The radiological and endoscopic findings were in agreement in 95% of the examinations in the authors' series. The importance of the technical aspects of the examination is stressed.
Five of the seven cases of hepatic infarction that compose this study were encountered in a series of 442 consecutive autopsies, giving an incidence of one in 88 autopsies. The clinical and laboratory features were suggestive of hepatocellular dysfunction, although in only three cases was the diagnosis considered prior to death. Morphologically, in four of the seven patients, the infarcts were regarded as massive or of submassive proportions and were directly responsible for the patients' death. The majority of infarcts were of recent origin, with the estimated ages ranging from 18 to 72 hours. One was of about two weeks' duration and was the only example in this series associated with cirrhosis.