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Biomedical subjects

J McCready

Publications and source records attributed to J McCready.

At least 19 recordsLinked to original sources
PubMed1998

Measles outbreaks in Micronesia, 1991 to 1994.

BACKGROUND: Several islands in Micronesia experienced large measles outbreaks, during 1991 through 1994. Except for Guam, none of the islands had reported measles outbreaks during the previous 20 years. METHODS: To characterize the outbreaks, measles surveillance data, hospital records and death certificates were reviewed. Preoutbreak vaccination coverage rates were assessed by reviewing public health vaccination records. Viral isolates were genetically sequenced to determine the source of transmission. Linear regression analysis was performed to assess the effectiveness of outbreak control measures. RESULTS: Between 1991 and 1994 more than 1300 measles cases and 16 measles-related deaths were reported in Micronesia. Preoutbreak vaccination coverage rates among 2-year-old children were 55 to 94%. Genetic sequencing of the viral isolates and epidemiologic investigations suggested transmission between islands and new importations from outside of Micronesia. The highest attack rates were among children ages < 5 years (20/1000) and 10 to 19 years (38/1000). Compared with attack rates among children ages < 1 and 10 to 19 years, attack rates were lower among those ages 5 to 9 years, in whom 2-dose vaccination coverage rates were highest (P < 0.001). Early and rapid implementation of mass vaccination campaigns was significantly associated with shorter duration of outbreaks (P = 0.049). CONCLUSION: The measles outbreaks in Micronesia show that island populations may be highly susceptible to measles. High two-dose vaccination coverage levels must be maintained to prevent such outbreaks. Early and rapidly implemented mass measles vaccination campaigns were effective in control of island outbreaks. Strengthening public health infrastructure and surveillance is necessary for early identification of outbreaks and rapid implementation of mass campaigns.

Adolescent↗
PubMed1997

The role of calcium in UVB-induced damage in irradiated ocular lenses.

The purpose of this study was to evaluate the role of altered calcium homeostasis in the development of irreversible membrane damage in the UVB-irradiated ocular lens. In particular, experiments were designed to determine whether restricting calcium influx could prevent membrane damage that typically leads to ion imbalances and lens opacification following short-term exposure to ultraviolet light (UVB). The influx of calcium was reduced by culturing lenses in a low-calcium culture medium containing 0.3 mM Ca2+ rather than physiological concentrations of 1.6 mM. This low-calcium protocol retarded calcium accumulation in UVB-irradiated lenses for 2 days of culture, and opacification was delayed by 24 h. Loss of transparency did occur during the second day of culture, but more slowly than in irradiated lenses cultured in normal-calcium medium. Membrane damage was assessed by evaluating loss in cation transport activity, assessed by measuring 86Rb uptake into cultured lenses. Uptake was markedly inhibited in UVB-irradiated lenses and low-calcium culture did not prevent this inhibition of cation transport, a finding that explains why low-calcium protocol did not help maintain sodium homeostasis in irradiated lenses. Inhibition of cation transport and sodium accumulation eventually caused lens hydration and light scattering during extended culture in the absence of significant calcium elevation. Additional experiments were done to establish whether initial damage sustained by membranes could be repaired through the biosynthesis of new membrane proteins. Incorporation of 14C-histidine in membranes of the UVB-exposed lens was measured to assess membrane synthesis essential for repairing membrane damage. The rate of membrane protein synthesis, assessed by measuring incorporation of labeled amino acids, declined in UVB cataract, despite the prevention of calcium accumulation. These results suggest that one explanation for irreversible gain in sodium and calcium content accompanying opacification is the inability of lenses to replenish damaged membrane proteins comprising ion channels or transporters.

Calcium↗
PubMed1996

Measles vaccine effectiveness and duration of vaccine-induced immunity in the absence of boosting from exposure to measles virus.

BACKGROUND: It is unknown whether vaccine-induced immunity is lifelong in the absence of periodic exposure to measles virus. After 27 years of no known exposure to measles, an outbreak in Palau in 1993 offered the opportunity to study this issue and the measles vaccine effectiveness. METHODS: Household contacts of a sample of confirmed cases were interviewed for exposure, symptoms and vaccination status verified by records. Serum from symptomatic contacts was tested for measles antibodies. RESULTS: Among 78 contacts 4 of 5 (80%) unvaccinated, 4 of 35 (11%) 1-dose vaccine recipients and none of 38 (0%) > 1-dose recipients developed measles. Effectiveness of 1-dose vaccine was 86% (95% confidence interval, 60 to 95%). An additional dose significantly reduced the risk of measles (P = 0.048). Time since vaccination was not a significant risk factor for developing measles (relative risk, 1.6; 95% confidence interval, 0.3 to 9.4; persons vaccinated > 15 years ago vs. < 5 years ago). CONCLUSIONS: Similar to the estimates previously obtained in the area, measles vaccine effectiveness in Palau was lower than the estimates obtained in the US. A second dose of vaccine further reduced the risk for developing measles. We found no evidence that waning immunity was an important problem in this limited population with no known previous exposure to measles virus. The small number of vaccinated contacts precludes a definitive assessment.

Child↗
PubMed1994

Selenite-induced damage to lens membranes.

The present study focuses on three aspects of membrane damage to explain selenite-induced loss of ion homeostasis: membrane transport processes, i.e. cation pump; biosynthesis of membrane proteins and membrane permeability. Cation pump activity, assessed by both 86Rb uptake and Na-K-ATPase activity in the epithelium, was observed to decline gradually after exposure to selenite and subsequent culture for 2 days in a selenite-free medium. In fact, the major loss of transport and ATPase activity occurred during culture of lenses after transfer from selenite to a selenite-free medium. The delay between selenite presentation to the lens and final inhibition of the cation pump (47%) corresponds to the delay in the observed loss of Na-K-ATPase activity (50%). Initial loss of cation transport and Na-K-ATPase activity may be due to the oxidative capacity of selenite. Oxidation, however, might not explain the delayed, progressive loss of transport activity after selenite removal. A plausible cause for this sustained loss might be a depleted supply of Na-K-ATPase due to impaired biosynthesis. Evidence for such a possibility comes from the observation that the rate of synthesis of total membrane protein is impaired by 44% in selenite-treated lenses. Membrane permeability to Na+ was not affected at the end of day 1, a conclusion based on the following observation: ouabain-treated lenses exposed to selenite did not gain any more Na+ than did ouabain-treated lenses. With the pump blocked by ouabain in both groups of lenses, the passive influx of Na+ was unchanged by selenite, indicating little damage to membrane permeability.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Comparative effect of UVA and UVB on cultured rabbit lens.

Effects on lens physiology of UVB and UVA used separately and sequentially were investigated using 4 week old rabbit lenses in organ culture. Narrowband UVB at 0.3 J/cm2 = joules/lens (1 h exposure) has little effect on sodium and calcium concentrations in the lens interior or transparency of lenses subsequently cultured for 20 h after a 1 h exposure. With an incident energy of 3 J/cm2 of broadband UVB (295-330 nm), lenses become opaque and slightly swollen with significant ion imbalances during culture over a 1 day period. In contrast, lenses exposed to approximately 6-24 J/cm2 of UVA (330-400 nm) remain transparent after 1 day of culture. Extended culture up to 4 days reveals no signs of opacification. Ion homeostasis and normal lens hydration are also maintained in UVA-irradiated lenses. The presence of 95% oxygen during UVA irradiation is also without effect. Broadband UVA irradiation is damaging, however, if lenses are first exposed to subthreshold doses of narrowband UVB (307 +/- 5 nm) irradiation, viz. 0.3 J/cm2. Thus, sequential UVB/UVA irradiation at subthreshold doses causes impaired active cation transport and accumulation of sodium and calcium accompanying lens opacification.

Animals↗
PubMed1992

Mechanisms involved in cataract development following near-ultraviolet radiation of cultured lenses.

Cultured rabbit lenses were irradiated with UV (311 nm peak; 295-340 nm) for 30 to 60 min. The entire spectrum lies in the near-UV, the major component is UVB, with a minor portion (25%) of UVA, and is henceforth referred to as near-UV(B). Posterior irradiation caused no cataract and no significant ionic imbalances compared to anterior irradiation, which caused opacification and marked changes in sodium and calcium concentrations. Anterior irradiation also resulted in reduced Na/K-ATPase activity in the epithelium. ATPase activity was not immediately inhibited; rather, only after culture was enzyme activity reduced. The concentration of reduced glutathione (GSH) decreased rapidly in the epithelium and more slowly in the underlying lens fibers. Loss of GSH was more rapid and extensive when irradiation occurred in the presence of oxygen. Irradiation under anaerobic conditions resulted in opacification but was considerably less extensive than when irradiation of lenses occurred in the presence of 7% oxygen. Near-UV(B) damage following anaerobic irradiation and 20 hrs of culture resulted in an increase in sodium levels and loss of GSH; calcium levels were not significantly elevated. Since irradiation of tryptophan solutions produced small amounts of hydrogen peroxide, the possibility of hydrogen peroxide-mediated damage was investigated but no role could be substantiated. Peroxide detoxification by the epithelium of near-UV(B) cataracts was observed, as measured by its ability to eliminate hydrogen peroxide added as a bolus.

Animals↗
PubMed1992

Physiological effects of UVB irradiation on cultured rabbit lens.

The purpose of this study was to investigate the physiological effects of irradiation in the spectral range 295-340 nm in cultured rabbit lenses. Ultraviolet B cataract was produced in lenses exposed to low levels of irradiation, 1-2 mW/cm2. Opacification was assessed by laser transmittance measurements. The changes observed during lens culture after a 1 hr dose (4 J/cm2) include a gradual increase in hydration, sodium concentration, and calcium levels. Loss in membrane voltage and a rise in 36Cl accumulation indicate that membrane permeability was increased. The cation pump was impaired within 20 hr of irradiation, as concluded by an observed fall in 22Na efflux. Availability of glucose for cation transport was diminished based on the reduced rate of uptake of tritiated 3-o-methylglucose in irradiated lenses, but this reduced accumulation was observed much later than was sodium elevation. Ionic imbalances and opacification required less than 1 d of culture for 4-12-wk-old lenses and required nearly 7 d of culture for 100-wk-old lenses.

Animals↗
PubMed1991

Effect of thiol reagents on Ca-ATPase in rabbit lens epithelium.

The inhibitory effects of sulfhydryl reagents on Ca-ATPase activity in the rabbit lens epithelium were assessed. Test compounds used in this study were selected on their ability to cause a calcium increase in cultured lenses. Under conditions in which lenses were cultured in the presence of the test compound, epithelial Ca-ATPase was inhibited markedly by diamide, t-BHP, IAA and slightly by selenite. The findings demonstrated that hydrogen peroxide caused little inhibition of Ca-ATPase in the lens epithelium, both when the intact lens was cultured in the presence of the oxidant or when the epithelial homogenate contained peroxide during the assay of enzyme activity. The study suggests that if a thiol-modifying compound can reach Ca-ATPase or its critical SH groups, inhibition is likely.

Animals↗
PubMed1989

Regional distribution of calcium in alloxan diabetic rabbit lens.

A diabetic rabbit model was developed for investigation of cataractogenesis and other changes in the anterior segment. Rabbits were fasted, injected with 0.7 mg/kg alloxan, fed 1% glucose solution for 24 hrs and returned to a normal diet. Animals showing and maintaining blood glucose of greater than 300 mg% within two days were used in this study. Concomitant with increase in blood glucose was a rise in aqueous humor glucose and osmolality, together with a decrease in ascorbate concentration. Vacuoles and small discrete opacities developed, and in some cases, at longer time periods complete opacity of anterior or posterior aspects was found. Total calcium content of the whole lens increased up to 2-fold, especially after 60 days, and was correlated with a decrease in lens transmittance of a He/Ne laser beam and also with high osmolality of the aqueous humor. Free calcium was six-fold higher in opaque areas than clear areas, and was 100-fold higher in vacuoles. It is suggested that, in addition to the recognized role in sugar cataractogenesis of osmotic stress due to sorbitol accumulation in the lens, changes of intracellular calcium in localized areas of the lens and stresses imposed by changes in aqueous humor osmolality may also be important.

Alloxan↗
PubMed1984

Varying bioactive to immunoactive ratios of the human chorionic gonadotropin-like substance present in normal human tissues.

To further characterize the hCG-like substance found in normal nonpregnant human tissues, we compared the biological (B) and immunological (I) activities of the substance in extracts of 40 nontrophoblastic tissues and 7 placentas. B was measured in an in vitro mouse testicular interstitial cell bioassay, and I was measured in the beta hCG RIA. Highly purified hCG (CR 119) was used as a standard. B was detected in 92% of the nontrophoblastic nonpituitary tissues. Parallelism between serial dilutions of extracts and the hCG standard was found for 75% of the pituitary extracts, 86% of the placental extracts, and 53% of the other tissues. The correlation between B and I activities in the nontrophoblastic nonpituitary tissues was good (r = 0.8; P less than 0.001). Preincubation of the tissue extracts with anti-hCG serum before bioassay significantly reduced the B activity. There was wide variation in the B to I ratio between tissues and within the same tissues from different individuals. A B to I ratio less than 1 was found in 50% of the tissues, excluding placenta and pituitary, and may have been due to the presence of incomplete or altered hCG molecules, which are immunologically active but have reduced B activity.

Animals↗
PubMed1982

On the recording of mental illness for civil commitment.

The survey of 102 consecutive certificates for involuntary admission and a review of the case material demonstrated that in 78 cases the form was completed adequately. In 13 cases full description of evidence of mental disorder was lacking on the certificate but after reviewing the cases it would appear that clear evidence of mental disorder was probably present at the time of certification. In this survey, suicidal or homicidal risk alone was not considered evidence of mental disorder. In the full 11 cases the grounds for diagnosing mental disorder rested upon the presence of phenomena like anger, alcoholism, or mild mental retardation or the presence of a personality disorder, all of these being associated with risk to the patient or another person. Compelling evidence for the necessity of psychiatric commitment in these complex situations cannot be described briefly; thus it does not appear that an altered certification form would solve the problem.

Adolescent↗
PubMed1981

Compliance by physicians with the 1978 Ontario Mental Health Act.

In a survey of 102 patients admitted involuntarily to a psychiatric hospital, a statement of potential danger, required by law, was found to be provided on all the committal forms. Closer enquiry suggested that although 89% of these patients were admitted involuntarily in accordance with strict legal requirements the legal justification for involuntary admission was questionable in 11 cases. Of these 11 admissions, 10 were thought to be warranted if medical considerations were given priority and on humane grounds. For 6 of the 10 patients treatment was clearly beneficial. One patient suffered hardships as a result of his involuntary admission that were not compensated for by any likelihood that he could have benefited medically from psychiatric care. Apparently humane considerations and the possibility that a mentally ill person could benefit from treatment led to some committals that were legally uncertain. It is concluded that the Mental Health Act should be revised to take account of such situations.

Adolescent↗
PubMed1978

Modification of the choriogonadotropin beta-subunit radioimmunoassay for determination of urinary choriogonadotropin.

The choriogonadotropin beta-subunit radioimminoassay has been used extensively to measure human choriogonadotropin in the sera of pregnant women and individuals with trophoblastic and nontrophoblastic tumors. Unmodified, this method cannot be used to measure choriogonadotropin in urine because of interfering substances. We circumvented the non-parallelism between the standards and serial dilutions of urine containing choriogonadotropin by adding pooled urine from men to the standard tubes and limiting the volume of urine to 100 microliter. This modified assay has a sensitivity of 3 int. units/liter of urine and is specific for choriogonadotropin concentrations of 40 int. units/liter of urine. Analytical recovery of choriogonadotropin added to urine ranged from 96 to 105%. The within-assay CV was 7.6%; the between-assay CV was 11.8%. Concentrations of choriogonadotropin in concurrently collected serum and urine samples from pregnant women correlated well. The test can be performed within 24 h by using the double-antibody method for separating bound from free hormone, or in 3 h with a dioxane method. The assay is about 20-fold more sensitive than the 2-min or 2-h slide and tube pregnancy tests, and seven-to 12-fold more sensitive than the radioreceptor assay.

Adult↗