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Biomedical subjects

J N Allen

Publications and source records attributed to J N Allen.

33 records · Page 2Linked to original sources
PubMed1991

Colchicine has opposite effects on interleukin-1 beta and tumor necrosis factor-alpha production.

To study the role of microtubules in cytokine production, the effect of the microtubule depolymerizing agent colchicine on lipopolysaccharide endotoxin (LPS)-induced interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) release by blood monocytes and alveolar macrophages were examined. Immunofluorescence microscopy demonstrated that LPS resulted in the appearance of microtubule-containing cytoplasmic appendages and that colchicine, which resulted in microtubule disruption in monocytes, blocked appendage formation. Colchicine resulted in approximately 50% increase in LPS-induced IL-1 beta release and a 50% decrease in LPS-induced TNF-alpha release by human monocytes at all doses of LPS tested. Although colchicine resulted in a statistically significant increase in LPS-stimulated human alveolar macrophage IL-1 beta release, the increase was not as great as that observed with monocytes. Northern blot analysis suggested that the colchicine effect occurs pretranslationally because colchicine caused an increase in LPS-stimulated IL-1 beta mRNA levels and a decrease in TNF-alpha mRNA levels. These results suggest that microtubules contribute to the regulation of endotoxin-stimulated mononuclear phagocyte cytokine production and that this regulation differs significantly between IL-1 beta and TNF-alpha.

Cells, Cultured↗
PubMed1990

Postoperative respiratory failure due to acute eosinophilic pneumonia.

A non-smoking 63-year-old man developed respiratory failure following surgical repair of a thoracoabdominal aortic aneurysm. He had severe hypoxemia and an elevated minute ventilation requiring prolonged mechanical support. Initial postoperative chest radiographs revealed new, transient, migratory infiltrates, and the patient received broad-spectrum antibiotic therapy. Chest radiographs subsequently demonstrated persistent, diffuse infiltrates, and bronchoalveolar lavage (BAL) analysis demonstrated significant eosinophilia (30%) with no evidence of infection. A diagnosis of acute eosinophilic pneumonia was made, and treatment with intravenous methylprednisolone resulted in rapid clinical improvement, and extubation. Acute eosinophilic pneumonia is not a previously recognized cause of postoperative respiratory failure and prolonged mechanical ventilation. It should be suspected in postoperative patients with unexplained diffuse lung infiltrates and acute respiratory failure.

Aorta, Abdominal↗
PubMed1990

Diagnostic significance of increased bronchoalveolar lavage fluid eosinophils.

We determined the incidence of increased bronchoalveolar lavage (BAL) fluid eosinophil percentages in 1,059 consecutive patients undergoing bronchoscopy with BAL over a 33-month period. Forty-eight (48) patients were found to have 5% or more BAL eosinophils. The most common causes for increased BAL eosinophils were interstitial lung diseases (40% of patients), acquired immunodeficiency syndrome (AIDS)-associated pneumonia (17% of patients), idiopathic eosinophilic pneumonia (15% of patients), and drug-induced lung disease (12% of patients). Together, these four diagnoses accounted for 84% of all patients. In contrast, eosinophils were uncommon in the BAL of patients with the adult respiratory distress syndrome, lung cancer, community-acquired pneumonia, or immunocompromising diseases other than AIDS. The finding of increased BAL eosinophils was most helpful in patients presenting with unexplained pulmonary infiltrates. In these patients, this finding was often an important clue to the final diagnosis. We conclude that although the finding of an increased percentage of BAL eosinophils is uncommon, when present it is relatively specific for a limited number of diseases.

Adolescent↗
PubMed1989

Acute eosinophilic pneumonia as a reversible cause of noninfectious respiratory failure.

Although chronic eosinophilic pneumonia is a well-known disorder, acute eosinophilic pneumonia has not been as well characterized. We describe the clinical features, results of bronchoalveolar lavage, and follow-up studies of four patients with acute eosinophilic pneumonia. The patients presented with an acute febrile illness, severe hypoxemia (partial pressure of arterial oxygen less than 60 mm Hg), diffuse pulmonary infiltrates, an increased number of eosinophils (mean +/- SEM, 42 +/- 4.8 percent) in bronchoalveolar-lavage fluid, and an absence of infection and previous atopic illness. The illness resolved rapidly after treatment with erythromycin and corticosteroids. The patients received doses of oral prednisone that were tapered over 10 days to 12 weeks, and none have relapsed since the steroids were discontinued. After a minimum follow-up period of five months, clinical evaluation, chest radiography, and pulmonary-function tests have shown no residual abnormalities attributable to the acute eosinophilic pneumonia. Follow-up bronchoalveolar lavage has demonstrated less than or equal to 1 percent eosinophils in all patients. We believe that we are describing an acute form of eosinophilic lung disease distinct from previously described syndromes. It can be diagnosed by bronchoalveolar lavage and seems to respond to treatment with corticosteroids.

Acute Disease↗
PubMed1989

HIV-associated bronchiolitis obliterans organizing pneumonia.

A man with serologic evidence of HIV infection and a depressed T-helper:suppressor ratio developed fever, pulmonary infiltrates, and respiratory failure. Bronchoalveolar lavage and transbronchial biopsy failed to reveal an infectious cause; however, an open lung biopsy demonstrated classic bronchiolitis obliterans organizing pneumonia. The patient responded completely to corticosteroids. To the best of our knowledge, this represents a previously undescribed and readily treatable cause of respiratory failure in patients with HIV infections.

Acquired Immunodeficiency Syndrome↗
PubMed1980

Associative learning in premature hydranencephalic and normal twins.

A hydranencephalic infant lacking cerebral hemispheres and a normal twin were tested for associative learning. After repeated trials in which two stimuli were temporally paired, test trials were given in which the second stimulus was omitted. Cardiac orienting responses to stimulus omission indicated that learning had taken place in both infants.

Anencephaly↗
PubMed1980

Coccidioidal meningitis complicated by cerebral arteritis and infarction.

A case of coccidioidal meningitis with cerebral arteritis in a nonendemic area is reported. Interesting clinical features were the difficulties in clinical diagnosis, hydrocephalus, and neurological deficits. An autopsy revealed chronic basal meningitis, cerebral arteritis, cerebral infarcts, hydrocephalus, and an old solitary pulmonary granuloma all due to Coccidioides immitis. The rare occurrence of cerebral arteritis due to C. immitis and clinicopathological correlations are discussed.

Arteritis↗
PubMedDate not supplied

Measurement of outcomes in adults receiving pharmaceutical care in a comprehensive asthma outpatient clinic.

We hypothesized that a pharmacist-provided comprehensive education program in conjunction with care provided by a pulmonologist would lead to improved economic, clinical, and humanistic outcomes in adults with asthma, compared with similar patients receiving care from a pulmonologist alone. The experimental group reported receiving more information about asthma self-management (p=0.001), were more likely to monitor peak flow readings (p=0.004), and had increased satisfaction with care, and perceived higher quality of care. Both groups had less lost productivity, fewer emergency department visits, fewer hospitalizations, and fewer physician visits, as well as improvement in symptoms scores within 45 days. Both groups improved in all functional status domains except the mental component score of the SF-12. Our results show a positive impact on outcomes in adults with asthma who received pharmaceutical care.

Adult↗