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Biomedical subjects

J Rush

Publications and source records attributed to J Rush.

At least 19 recordsLinked to original sources
PubMed1992

The zickel nail in the treatment of metastatic bone disease in the upper end of the femur.

During a period of 5 years, 39 cases (37 patients) with metastatic bone disease in the proximal femur were treated by the insertion of a Zickel intramedullary nail using a 'closed' operative technique. The use of methyl methacrylate as an adjunct to fixation was not considered necessary. The results were satisfactory in terms of achieving stabilization of the fracture if present, relief of pain and the ability to commence early ambulation.

Adolescent↗
PubMed1991

A controlled trial comparing foscarnet with vidarabine for acyclovir-resistant mucocutaneous herpes simplex in the acquired immunodeficiency syndrome. The AIDS Clinical Trials Group.

BACKGROUND AND METHODS: Most strains of herpes simplex virus that are resistant to acyclovir are susceptible in vitro to both foscarnet and vidarabine. We conducted a randomized trial to compare foscarnet with vidarabine in 14 patients with the acquired immunodeficiency syndrome (AIDS) and mucocutaneous herpetic lesions that had been unresponsive to intravenous therapy with acyclovir for a minimum of 10 days. The patients were randomly assigned to receive either foscarnet (40 mg per kilogram of body weight intravenously every 8 hours) or vidarabine (15 mg per kilogram per day intravenously) for 10 to 42 days. In the isolates of herpes simplex virus we documented in vitro resistance to acyclovir and susceptibility to foscarnet and vidarabine. RESULTS: The lesions in all eight patients assigned to foscarnet healed completely after 10 to 24 days of therapy. In contrast, vidarabine was discontinued because of failure in all six patients assigned to receive it. The time to complete healing (P = 0.01), time to 50 percent reductions in the size of the lesions (P = 0.01) and the pain score (P = 0.004), and time to the end of viral shedding (P = 0.006) were all significantly shorter in the patients assigned to foscarnet. Three patients had new neurologic abnormalities while receiving vidarabine. No patient discontinued foscarnet because of toxicity. Although initial recurrences of herpes simplex infection after the index lesion had healed tended to be susceptible to acyclovir, acyclovir-resistant infection eventually recurred in every healed patient, a median of 42.5 days (range, 14 to 191) after foscarnet was discontinued. CONCLUSIONS: For the treatment of acyclovir-resistant herpes simplex infection in patients with AIDS, foscarnet has superior efficacy and less frequent serious toxicity than vidarabine. Once the treatment is stopped, however; there is a high frequency of relapse.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Morbidity and mortality of patients with AIDS and first-episode Pneumocystis carinii pneumonia unaffected by concomitant pulmonary cytomegalovirus infection.

To determine the significance of cytomegalovirus (CMV) pulmonary coinfection with Pneumocystis carinii pneumonia in AIDS, we examined the association of long- and short-term survival and morbidity (as defined by length of hospital stay) with recovery of CMV from bronchoscopy specimens and an indirect measure of virus titer in bronchoalveolar lavage fluid (the time to develop CMV cytopathology in culture) in 111 patients diagnosed with a first episode of P. carinii pneumonia. Compared with 57 individuals from whom CMV was not isolated, the 54 individuals from whom CMV were isolated did not differ in baseline characteristics, long-term survival (213 versus 275 days, p = 0.97), acute death rate (19% in both, p = 1.0), or length of hospital stay (19.7 versus 21.1 days, p = 0.68). Also, the time to develop CMV cytopathology in culture did not correlate with acute or long-term survival. Our observations thus do not support the use of CMV-specific antiviral therapy in AIDS patients with P. carinii pneumonia who also have evidence of pulmonary CMV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1991

4-Aminopyridine in multiple sclerosis: prolonged administration.

In an earlier study, we demonstrated efficacy of single oral doses of 4-aminopyridine (4-AP) in improving motor and visual signs in multiple sclerosis (MS) patients for a mean of 4.97 hours. We attempted to determine whether efficacy could safely be prolonged using multiple daily doses over several days by administering 7.5 to 52.5 mg 4-AP to 17 temperature-sensitive MS patients in one to three daily doses at 3- to 4-hour intervals over 1 to 5 days in a double-blind study. Nine of these patients were also tested with identically appearing placebo. Thirteen of the 17 patients (76%) given 4-AP showed clinically important motor and visual improvements compared with three of nine in the placebo group. Average peak improvement scores were 0.40 for 4-AP and 0.12 for placebo. Seventy percent of the daily 4-AP improvements lasted 7 to 10 hours. The improvements for two consecutive doses of 4-AP lasted a mean of 7.07 hours (83% of the average 8.53-hour treatment-observation period) compared with 2.36 hours for placebo (26% of the average 9.06-hour treatment-observation period). No serious side effects occurred. 4-AP is a promising drug for the symptomatic treatment of MS.

4-Aminopyridine↗
PubMed1991

Chiari osteotomy in the adult: a long-term follow-up study.

For almost 20 years the Chiari pelvic displacement osteotomy has been used as a method of providing cover to the femoral head in cases of acetabular dysplasia. The osteotomy is one of a number of procedures that have been used in an attempt to prevent the early development of secondary osteo-arthritis and the need for total hip replacement. More recently, the operation has been undertaken in cases where there is already some arthritic change. This long-term review of 18 Chiari operations shows that the procedure was successful in cases of acetabular dysplasia where there was minimal subluxation of the femoral head (i.e. with Shenton's line still intact). In more advanced cases where there was significant subluxation (i.e. with Shenton's line broken by more than 1 mm) and even early arthritic changes, the results were poor. It is concluded that the operation may be of value as an almost 'prophylactic' procedure but that it is of no value as a so-called 'salvage' procedure.

Acetabulum↗
PubMed1990

Photoaffinity labeling of the Klenow fragment with 8-azido-dATP.

The photoaffinity compound 8-azido-dATP was used as a probe for the deoxyribonucleoside triphosphate-binding site of the large fragment of DNA polymerase I. Azido-dATP specifically modified a saturable binding site within the Klenow fragment, and each of the four natural deoxyribonucleoside triphosphate substrates competed with labeling at this site in proportion to its binding constant, as previously defined by equilibrium dialysis. Analysis of tryptic peptides after azido-dATP modification revealed five major cross-linking products, which apparently arose from five distinct photoadducts formed near Tyr-766.

Adenosine Triphosphate↗
PubMed1990

Orally administered 4-aminopyridine improves clinical signs in multiple sclerosis.

4-Aminopyridine (4-AP), a potassium channel blocker, restores conduction in blocked, demyelinated animal nerve. Its administration to multiple sclerosis (MS) patients produces transient neurological improvements. Vision improves after either oral or intravenous administration, whereas motor function improvement has been reported only with the latter. To assess further its potential as a practical symptomatic treatment, we studied the efficacy of single, oral doses of 4-AP on both visual and motor signs in MS. Twenty temperature-sensitive male MS patients were given either 10 to 25 mg of 4-AP or identically appearing lactose placebo capsules. Static quantitative perimetry, critical flicker-fusion, visual acuity, visual evoked potentials, and videotaped neurological examinations were monitored. All of 15 MS patients given 4-AP mildly to markedly improved. Motor functions (power, coordination, gait) improved in 9 of 13 involved, vision in 11 of 13, and oculomotor functions in 1 of 2. Improvements developed gradually at doses as low as 10 mg, usually beginning within 60 minutes after drug administration, and reversed gradually over 4 to 7 hours. No serious adverse effects occurred. No significant changes were observed in 5 MS patients given placebo. We conclude that orally administered 4-AP produces clinically important improvements in multiple, chronic deficits in MS. Further studies are warranted to assess efficacy and safety of prolonged administration.

4-Aminopyridine↗
PubMed1990

A randomized controlled trial of a nursery ritual: wearing cover gowns to care for healthy newborns.

The routine wearing of individual cover gowns by nurses and visitors for direct care of healthy newborns was usual practice on the maternity ward of a regional referral center. We conducted a randomized trial in which cover gowns were not provided for care of infants in the experimental group (n = 222), but were maintained for control infants (n = 230). The principal outcome measured was Staphylococcus aureus colonization of the newborn nares or umbilicus on day 3 or day of discharge. Twenty percent (n = 51) of the experimental group (no gown) had a positive culture compared with 21 percent (n = 47) of the controls. Of the infants with positive cultures, two in each group exhibited symptoms of overt S. aureus infection. Experimental infants were similar to controls with respect to feeding method, route of delivery, amount of time spent rooming-in, and average number of visitors per day. In the group of positively cultured infants, the mothers experienced longer labor, and more vaginal examinations in labor, and the number of males undergoing circumcision was higher. We concluded that routine use of cover gowns was unwarranted, and we have altered the ward policy accordingly. This also has had a positive economic effect.

Ceremonial Behavior↗
PubMed1989

The 44P subunit of the T4 DNA polymerase accessory protein complex catalyzes ATP hydrolysis.

The genes encoding all three T4 DNA polymerase accessory proteins have been cloned into overexpression plasmids. Induction of cells harboring these plasmids results in the synthesis of each accessory protein at levels that approach 10% of the total cellular protein. The solubility of the accessory proteins after induction at 42 degrees C ranges from about 60% to greater than 95%. A plasmid that allows overexpression of the 44P/62P complex has been manipulated further to overexpress selectively the 44P subunit without 62P, permitting us to assess how each subunit contributes to the properties of the 44P/62P complex. A comparison of 44P and 44P/62P by conventional hydrodynamic techniques shows that 44P forms a subcomplex nearly as large as the 44P/62P complex. In addition, 44P catalyzes DNA-dependent ATP hydrolysis with a specific activity similar to that of the 44P/62P ATPase. However, unlike the 44P/62P complex, the ATPase activity of 44P alone is only slightly stimulated by 45P. This suggests that one role of the 62P subunit is to facilitate a productive interaction of 44P and 45P.

Adenosine Triphosphate↗
PubMed1989

Rapid purification of overexpressed T4 DNA polymerase.

A method for purifying T4 DNA polymerase from cells harboring overexpression plasmids is described. T4 DNA polymerase is precipitated from induced, lysed cells with polyethyleneimine, then extracted and fractionated further with (NH4)2SO4 before chromatography on a column of single-stranded DNA cellulose. This procedure can be completed in three days and consistently provides enzyme preparations which are at least 98% pure. When necessary, one further chromatography step provides T4 DNA polymerase suitable for recombinant DNA applications.

Ammonium Sulfate↗
PubMed1988

Primary structure of T4 DNA polymerase. Evolutionary relatedness to eucaryotic and other procaryotic DNA polymerases.

Bacteriophage T4 gene 43 codes for the viral DNA polymerase. We report here the sequence of gene 43 and about 70 nucleotides of 5'- and 3'-flanking sequences, determined by both DNA and RNA sequencing. We have also purified T4 DNA polymerase from T4 infected Escherichia coli and from E. coli containing a gene 43 overexpression vector. A major portion of the deduced amino acid sequence has been verified by peptide mapping and sequencing of the purified DNA polymerase. All these results are consistent with T4 DNA polymerase having 898 amino acids with a calculated Mr = 103,572. Comparison of the primary structure of T4 DNA polymerase with the sequence of other procaryotic and eucaryotic DNA polymerases indicates that T4 DNA polymerase has regions of striking similarity with animal virus DNA polymerases and human DNA polymerase alpha. Surprisingly, T4 DNA polymerase shares only limited similarity with E. coli polymerase I and no detectable similarity with T7 DNA polymerase. Based on the location of specific mutations in T4 DNA polymerase and the conservation of particular sequences in T4 and eucaryotic DNA polymerases, we propose that the NH2-terminal half of T4 DNA polymerase forms a domain that carries out the 3'----5' exonuclease activity whereas the COOH-terminal half of the polypeptide contains the dNTP-binding site and is necessary for DNA synthesis.

Amino Acid Sequence↗
PubMed1988

Failure of antiviral therapy for acquired immunodeficiency syndrome-related cytomegalovirus myelitis.

We report the first published case (to our knowledge) of histopathologically documented acquired immunodeficiency syndrome-related cytomegalovirus (CMV) myelitis in which antiviral drug therapy was administered. Despite sensitivity of the patient's CMV isolate to therapy with both ganciclovir and foscarnet, use of neither of these agents halted progression of central nervous system CMV disease. Higher doses of these drugs or combination therapy may be required to treat acquired immunodeficiency syndrome-related CMV myelitis effectively.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Comparison between clinician-rated and self-reported depressive symptoms in Italian psychiatric patients.

The Inventory for Depressive Symptomatology is a new scale for measuring depressive symptoms. The reliability, validity and correlations between self-report and clinician-rated versions of the scale were examined in 86 Italian psychiatric patients. Results confirmed the validity and internal consistency of the scales. Self-ratings and clinician ratings were highly correlated. Total score on the self-rating scale was generally higher than the corresponding clinician scale score. Item analysis revealed that most items were rated slightly higher by self-report, with the items contributing most to this discrepancy being psychomotor agitation and retardation, self-outlook, and irritable mood. Both quality of mood and psychomotor agitation were more frequently endorsed by self-report than by clinician rating.

Adult↗
PubMed1987

Effect of combinations of difluoromethylornithine (DFMO) and 9[(1,3-dihydroxy-2-propoxy) methyl]guanine (DHPG) on human cytomegalovirus.

Both the nucleoside analog 9[(1,3-dihydroxy-2-propoxy)methyl]guanine (ganciclovir; DHPG) and the polyamine synthesis inhibitor difluoromethylornithine (DFMO) have been reported to inhibit replication of cytomegalovirus (CMV) in vitro. In these studies, DHPG inhibited human CMV replication at concentrations of 0.1 microM or greater, while DFMO was active (and then only inconsistently) at 5 mM or greater. (DFMO was added to cells 3 days before virus to maximize polyamine depletion.) However, DHPG combined with DFMO synergistically inhibited the replication of CMV strain AD169 and one wild-type CMV strain in human foreskin fibroblasts; the effect was evident on both virus yield and plaque formation. The synergistic effect of these two drugs on CMV replication could potentially be exploited clinically to limit drug toxicity or increase efficacy.

Acyclovir↗
PubMed1987

Cloning and expression of T4 DNA polymerase.

The structural gene coding for bacteriophage T4 DNA polymerase (gene 43) has been cloned into inducible plasmid vectors, which provide a source for obtaining large amounts of this enzyme after induction. The T4 DNA polymerase produced in this fashion was purified by an innovative three-step procedure and was fully active.

Genes↗
PubMed1987

Closed nailing of the humerus--from down under.

Closed intramedullary nailing of the humerus using a curved clover-leaf nail (Pohl nail) is a relatively minor operative procedure and is associated with few complications. The technique of the operation when performed from below (29 cases) and also from above (7 cases) is that as described initially by Kuntscher and his colleagues. This paper presents the technique and the experience from 1978 to 1985 with 36 cases (20 for metastatic bone deposits, four in multiple injury patients, three in patients with a severe head injury, four in patients with multiple fractures in the same limb and five in other patients particularly elderly women with osteoporotic bones). This review demonstrates the efficacy of closed intramedullary nailing of the humerus particularly when the nail is inserted into the humerus from below just proximal to the olecranon fossa.

Aged↗