Biomedical subjects
Publications and source records attributed to J R Morgan.
Technetium labelled, negatively charged, unilamellar liposomes were given by intravenous injection to patients with rheumatoid arthritis and the joints scanned 20-22 hours later. Positive scintigraphy was obtained in all six patients with active disease, and, with the exception of the small interphalangeal joints, all clinically involved joints could be visualised.
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Cystic fibrosis patients with Pseudomonas aeruginosa chest infections were treated with ceftriaxone alone or ceftriaxone plus tobramycin. P. aeruginosa strains isolated before and after treatment were studied for changes in sensitivity to ceftriaxone. After therapy with either the single agent or the combination six strains from five patients were found to be resistant to ceftriaxone. No resistant strains were isolated before therapy. Resistance was mediated by excess production of Id beta-lactamase which in five of six strains was permanently derepressed. Bacterial resistance appearing during therapy reduces the value of this antibiotic in cystic fibrosis chest infections.
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Fifteen patients with acute exacerbation of rheumatoid arthritis each received a 1 g bolus intravenous injection of ceftriaxone. Serum and synovial fluid was sampled at intervals between 1 h and 24 h later and assayed for ceftriaxone. Synovial fluid leucocyte counts and albumin content were measured concomitantly. Detectable levels of ceftriaxone were found in synovial fluid and serum 24 h after injection. Synovial fluid ceftriaxone concentration ranged between 66% and 100% of the concomitant serum levels. No correlation was observed between synovial fluid ceftriaxone concentration and synovial fluid leucocyte count and albumin concentration.
Negatively charged phospholipid liposomes were labelled with technetium 99m and used as a radioisotopic tracer to detect focal inflammatory lesions in deep-seated sepsis and rheumatoid arthritis. Patients received an intravenous injection of the radiolabelled liposome preparation and were submitted to scintigraphy on the following day. Both the human volunteer and patients showed uptake in liver and spleen but no radioactivity was observed associated with the intestines. Radioactive uptake was visualised in infected prosthetic joints, tubo-ovarian abscess and osteomyelitis. In a patient with active rheumatoid arthritis radioactive uptake was confined to clinically affected joints. The preliminary findings suggest potential for technetium labelled liposomes as a diagnostic tracer.
The detailed organization of the RNAs transcribed from an early gene cluster encoded by vaccinia virus has been determined from the information derived from several complementary techniques. These include hybrid selection coupled with cell-free translation to locate DNA sequences complementary to mRNAs encoding specific polypeptides; RNA filter hybridization to size and locate on the DNA mature RNAs as well as higher-molecular-weight RNAs; S1 nuclease mapping to precisely locate the 5' and 3' ends of the RNAs; S1 nuclease mapping to precisely locate the 5' and 3' ends of the RNAs; and fractionation of hybrid-selected mRNAs in an agarose gel containing methyl mercury hydroxide followed by the cell-free translation of these mRNAs to definitively ascertain the size of the mRNA encoding each polypeptide. The early gene cluster is located between 21 and 26 kilobases from the left end of the vaccinia virus genome and is encoded by a 5.0-kilobase EcoRI fragment which spans the HindIII-N, -M, and -K fragments. Transcribed towards the left terminus are four mature mRNAs, 1,450, 950, 780, and 400 nucleotides in size, encoding polypeptides of 55, 30, 20, and 10 kilodaltons, respectively. These mRNAs are colinear with the DNA template and are closely spaced such that the 5' terminus of one mRNA is within 50 base pairs of the 3' terminus of the adjacent RNA. In addition to the mature size mRNAs, there are higher-molecular-weight RNAs, 5,000, 3,300, 2,350, 2,300, 1,800, 1,700, and 1,350 nucleotides in size. The 5' and 3' termini of the high-molecular-weight RNAs are coterminal with the 5' and 3' termini of the mature size mRNA. The implications of this arrangement and the biogenesis of these early mRNAs are discussed.
The DNA sequences encoding the large subunit of the mRNA-capping enzyme of vaccinia virus were located on the viral genome. The formation of an enzyme-guanylate covalent intermediate labeled with [alpha-32P]GTP allowed the identification of the large subunit of the capping enzyme and was used to monitor the appearance of the enzyme during the infectious cycle. This assay confirmed that after vaccinia infection, a novel 84,000-molecular-weight polypeptide corresponding to the large subunit was rapidly synthesized before viral DNA replication. Hybrid-selected cell-free translation of early viral mRNA established that vaccinia virus encoded a polypeptide identical in molecular weight with the 32P-labeled 84,000-molecular-weight polypeptide found in vaccinia virions. Like the authentic capping enzyme, this virus-encoded cell-free translation product bound specifically to DNA-cellulose. A comparison of the partial proteolytic digestion fragments generated by V8 protease, chymotrypsin, and trypsin demonstrated that the 32P-labeled large subunit and the [35S]methionine-labeled cell-free translation product were identical. The mRNA encoding the large subunit of the capping enzyme was located 3.1 kilobase pairs to the left of the HindIII D restriction fragment of the vaccinia genome. Furthermore, the mRNA was determined to be 3.0 kilobases in size, and its 5' and 3' termini were precisely located by S1 nuclease analysis.
Twenty-four quantitative cineangiographic studies were performed in 19 patients with congenitally corrected transposition of the great arteries to assess right and left ventricular size and function. Ages ranged from 7 days to 44 years and associated lesions included ventricular septal defect (13 of 19), pulmonary stenosis (9 of 19), and systemic (tricuspid) valvular insufficiency (7 of 19). Systemic (anatomically right) ventricular end-diastolic volume was within normal limits in most patients and averaged 119% of predicted normal. Pulmonary (anatomically left) ventricular end-diastolic volume also was normal in most patients, averaged 112% of predicted, and was not different from systemic (right) ventricular end-diastolic volume. Systemic ventricular ejection fraction (RVEF) averaged 0.61 +/- 0.02 and was not different from pulmonary ventricular ejection fraction (LVEF) (0.65 +/- 0.02), but important differences were apparent when age was considered. With exclusion of 2 patients with hypoplastic systemic ventricles and 2 studies performed less than 6 months after open heart surgery, all 12 patients aged less than 10 years had a normal RVEF, whereas 2 of 5 patients aged greater than 17 years had a definitely low RVEF and 1 of 5 had a value at the lower limit of normal. In children, systemic and pulmonary ventricular pump function is usually normal in congenitally corrected transposition of the great arteries and any deviation from normal should suggest ventricular hypoplasia or an increase in afterload. After childhood, systemic ventricular dysfunction is more common and may reflect the inability of the anatomic right ventricle to function as the systemic pumping chamber over a normal lifetime in most patients with congenitally corrected transposition of the great arteries.
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The accumulation of 99mTc-technetium-labelled liposomes in abscesses was studied. Abscesses were produced in the thighs of albino rats by intramuscular injection of Staphylococcus aureus. After 4 days these abscesses were used to determine the localisation of 99mTc-technetium-labelled anionic, cationic and neutral liposomes in the abscess area. This was achieved by radionuclide images produced by a gamma camera and an associated data-processing system. There was a pronounced uptake of 99mTc-technetium-labelled anionic liposomes in the abscess area compared with the corresponding unaffected thigh. Similar uptake was not shown by the 99mTc-technetium-labelled cationic and neutral liposomes. Abscess uptake of anionic liposomes was maximal at or before 30 min after injection and was not enhanced by prior opsonisation with aggregated rat immunoglobulin.
Gentamicin was successfully incorporated into neutral, anionic, and cationic liposomes, and the percentage of gentamicin incorporated was found to be a function of lipid concentration. Gentamicin did not leak out of the liposomes over a 3-week period at 4 degrees C. When liposome-associated gentamicin was administered intravenously to rabbits, its serum half-life was greatly prolonged. Intragastric administration of dipalmitoylphosphatidylcholine liposomes containing gentamicin resulted in the appearance of gentamicin in serum. Liposome-associated gentamicin, when administered intravenously, led to the appearance of gentamicin in the liver and spleen, which was not observed when rabbits were injected with free gentamicin.
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A prospective randomized study of the treatment of postpartum endometritis was conducted with 43 patients. The bacterial origin of the infection was determined by uterine aspiration. Treatment was successful in 17 of the 19 patients receiving ampicillin (12 g/d) and in 21 of the 24 patients receiving clindamycin (2.4 g/d) plus gentamicin (5.1 mg/kg daily).
In order to investigate the effects of a difficult vs. easier task on state-trait anxiety in emotionally disturbed children (N = 30 boys and girls), older (mean age 12.81) and younger (mean age 9.89) groups were exposed to two lists of nonsense syllables, varying on meaningfulness (0% vs. 100%) with measures of A-State and A-Trait anxiety being obtained during a no-stress period and immediately after each list. The results indicated that the younger group did not show any difference in A-State following the two lists, while the older group showed significantly more A-State increase following the difficult list. Results were discussed in terms of previous research, and in terms of possible explanations for the differences between the reactions of the older and younger children.