Veterinary prescription diets.
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Biomedical subjects
Publications and source records attributed to J Sullivan.
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Human leukocyte antigen (HLA) class II allogenotyping has been applied to investigate the polymorphism of the DRB, DQB1, DQB2, DQA1, and DQA2 genes in Aborigines from the East Coast of Australia and in Melanesians from the Papua New Guinea North-East Coast and Highlands. Three new DR/DQ arrangements were observed, DRw14/DQB1-2b/DQA1-1a and DRw5Nauru/DQB1-3a/DQA1-2 (n Australian Aborigines), and DRw5Nauru/DQB1-1a/DQA1-1b (in Madang). DQA2 and DQB2 allogenotyping with TaqI and PstI digested genomic DNA revealed little polymorphism among the Papua New Guineans, with DQA2-Xa1 and DQB2-Xb1 the most common alleles in all the groups. However, the presence of DQA2-Xa2 in Papuans and Australian Aborigines reflects the degree of admixture with Caucasoids while the DQA2-Xa4 allele in Madang is probably a marker of Mongoloid origin.
The importance of HLA-B27 in the pathogenesis of ankylosing spondylitis is uncertain: current evidence favours a role for the B27 molecule itself. The possibility that quantitative differences in HLA-B27 expression may exist between patients with ankylosing spondylitis, family members, and control subjects positive for B27 was examined using appropriate monoclonal antibodies, flow cytometry, and a 'model lymphocyte' coated with a known number of mouse immunoglobulin binding sites. No differences were found between the groups. HLA-A2, examined for comparison, was expressed in greater amounts than HLA-B27, but each contributed only 10-20% of the total class I antigens. Homozygotes expressed twice the amount of antigen expressed by heterozygotes. Synovial lymphocytes expressed more class I antigens than peripheral lymphocytes.
BACKGROUND: Isometric exercise produces a reflex increase in arterial blood pressure that is proportional to the intensity and mass of muscle used during contraction. Little is known about the transient effects of heavy weight lifting on left ventricular performance. In this study, we measured continuous changes in left ventricular performance during maximal large-muscle isometric exercise using the standing deadlift position. METHODS AND RESULTS: Ten healthy young men performed serial deadlifts at 50% of maximal voluntary effort for 90 seconds and 100% of maximal effort for 30 seconds. Echocardiographic imaging (apical four-chamber view), arterial blood pressure (brachial artery catheter), and electrocardiographic monitoring were recorded throughout the deadlift and for 30 seconds of recovery. Aortic flow velocity was also monitored during a separate series of deadlifts. During 100% maximal deadlift, mean arterial pressure increased from 108 +/- 4 to 164 +/- 6 mm Hg. Left ventricular ejection fraction declined initially (from 57 +/- 2% to 49 +/- 3%) at 15 seconds into the lift and recovered (56 +/- 1%) due to significant increases in end-diastolic volume (104 +/- 11 ml to 132 +/- 16 ml) by the end of the lift. The peak systolic pressure/end-systolic volume ratio did not change during the deadlift. After cessation of the deadlift, mean arterial pressure declined precipitously (to 88 +/- 4 mm Hg) within 5 seconds and gradually returned to baseline after 30 seconds. Left ventricular performance indexes all increased significantly during the recovery phase (ejection fraction to 68 +/- 3%, peak systolic pressure/end-systolic volume ratio to 5.9 +/- 0.9). Findings were qualitatively similar for the 50% deadlift. CONCLUSIONS: During an intense isometric deadlift, left ventricular performance declines initially but is restored by the Frank-Starling mechanism. Upon release of the deadlift, increased left ventricular performance develops in conjunction with a rapid decrease in arterial pressure. The combined effects of increased wall stress during the lift phase and enhanced contractility during the release phase probably contribute to left ventricular hypertrophy associated with repetitive weight training.
Time trends in needle sharing and bleach use were examined among needle users enrolled at drug abuse treatment and nontreatment sites in greater Worcester, MA, from 1987 through 1989. Substantial declines in high-risk behavior were found, with different trends at drug treatment versus nontreatment sites. The percentage of individuals sharing needles declined at treatment facilities but not at nontreatment sites. Among those sharing, the proportion using bleach increased at both drug treatment and nontreatment sites. The bleach distribution program in Worcester appears to be associated with increased bleach use among residents. Bleach use was associated with residence in Worcester, after controlling for age, gender, race, enrollment site, time period, and frequency of sharing. Risk reduction in the subpopulation of needle users entering treatment was greater than that among those not in treatment. As avoidance of sharing is likely to be more effective than bleaching for the prevention of human immunodeficiency virus (HIV) transmission, the subpopulation not in treatment should be targeted for prevention programs.
Circadian and seasonal rhythmic changes in the intraocular pressure are modulated by the nervous system and expressed in the eye by the release of norepinephrine at adrenergic nerve endings. This study links seasonal changes and the effects of the topical application of norepinephrine with changes in the equatorial current of the lens in frogs. A vibrating probe and microelectrodes were used to study the segment of the K+ electrical loop extending between the internal microelectrode, used for measuring potential difference (PD), and the external vibrating electrode, measuring the equatorial current (J). Changes were noted in the electrophysiological parameters of 270 normal frog lenses (Rana pipiens) at different times of the year. Threefold seasonal variations were observed in the amplitude of equatorial current (J) and the resistance associated with the equatorial current (RJ). J was greatest in the winter and RJ was greatest in late spring. Norepinephrine applied directly to the lens did not affect the equatorial current. Norepinephrine applied topically, increased the equatorial current of the lens. It is concluded that the magnitude of the equatorial current of the lens is mediated in part by the ciliary process epithelium.
A strain of Plasmodium vivax from Thailand with a polymorphic repeat unit of the circumsporozoite protein was established in Saimiri sciureus boliviensis and 3 species of Aotus monkeys. All 11 attempts to transmit infection via sporozoite inoculation, 4 times to splenectomized S. sciureus boliviensis, 2 times to splenectomized Aotus nancymai, and 5 times to intact Saimiri monkeys, were successful. Anopheles freeborni, Anopheles stephensi, Anopheles dirus, and Anopheles gambiae mosquitoes were infected by feeding on parasitemic blood from a chimpanzee and an Aotus azarae boliviensis monkey. Our results indicate that this strain may be useful in antisporozoite vaccine trials.
BACKGROUND: In carcinoma of the bladder, both intravesical chemotherapy and immunotherapy can induce tumor regression and reduce the rate of recurrence, but the relative merits of these two therapies are unclear. We conducted a multi-institutional study to address this question. METHODS: Patients with rapidly recurrent (stage Ta and T1) or in situ transitional-cell carcinoma of the bladder were randomly assigned to receive either doxorubicin administered intravesically or bacille Calmette-Guérin (BCG) administered both intravesically and percutaneously. The 262 eligible patients were followed for a median of 65 months. Complete responses to treatment of carcinoma in situ were confirmed by biopsy and cytologic analysis of the urine. RESULTS: For patients with Ta and T1 tumors without carcinoma in situ, the estimated probability of being disease free at five years was 17 percent after doxorubicin, as compared with 37 percent after immunotherapy with BCG (P = 0.015). The median times to treatment failure (termination of treatment, due to persistence, recurrence, or progression of disease) were 10.4 and 22.5 months, respectively. For patients with carcinoma in situ the complete-response probability estimates (i.e., the estimated probability of documented disappearance of disease) were 34 percent for doxorubicin (23 of 67 patients) and 70 percent for BCG (45 of 64 patients) (P less than 0.001); the median times to treatment failure were 5.1 and 39 months, respectively. The probability of being disease-free at five years survival among the patients with carcinoma in situ was 18 percent after treatment with doxorubicin and 45 percent after BCG therapy. Patients treated with BCG had a higher incidence of toxic systemic effects and a larger number of local irritative symptoms than patients treated with doxorubicin, but few of these adverse reactions were severe. CONCLUSIONS: As compared with intravesical doxorubicin, immunotherapy with BCG provides improved protection against the recurrence of superficial bladder cancer.
Perorally administered acyclovir was evaluated in the therapy of acute infectious mononucleosis in a multicentered, randomized, double-blind, placebo-controlled trial. A total of 120 patients received 600 mg of acyclovir or placebo five times daily for 10 days. All patients were entered into the study within 7 days of symptom onset and had a positive Monospot test. Analysis of mean values and time to resolution of fever, lymphadenopathy, weight change, hepatomegaly, splenomegaly, liver function tests, atypical lymphocytes, hours of bed rest, sense of well-being, and return to normal activities revealed no significant differences. There was a trend toward suppression of Epstein-Barr virus excretion in the oropharynx in acyclovir recipients. No toxicity was detected in patients treated with acyclovir. Under the conditions of the study, there was no evidence that treatment with perorally administered acyclovir affected the course of infectious mononucleosis.
Using the delphi technique, a group of clinical nurse specialists was surveyed regarding delineation of clinical nursing research priorities. Upon completion of the four-round survey, the results suggested that the top priorities for nursing research are: (1) factors which influence longevity in clinical nursing practice, (2) patient care delivery systems as related to nurse satisfaction, and (3) indicators of quality nursing care.
Intradermal or skin-graft sensitization always results in accelerated rejection of subsequent MHC-disparate mouse heart transplants; intravenous or intrasplenic sensitization almost always results in prolonged survival. The survival time after intraperitoneal sensitization is unpredictable: hyperacute or accelerated rejection, as well as normal or prolonged survival, occurs suggestive of a delicate balance between suppressive and rejecting immune responses. We have observed a positive correlation between transplant survival and the distribution of 51Cr-labeled antigenic cells early after i.v., i.d., i.p., and intrasplenic injection. Label recovery from the viscera was already high 2 hr after i.v. injection, while after i.d. injection virtually all label was still confined to the carcass, even at the end of a 24-hr period. After i.p. injection label recovery varied significantly from mouse to mouse, from very low to a level approximating that seen after i.v. injection. This close correlation suggests that the fate of a subsequent transplant is decided within a few hours after antigen deposition, well before placement of the transplant itself.
We and others previously reported DNA polymerase activity in culture supernatants of peripheral blood mononuclear cells from patients with acute Kawasaki syndrome (KS). In the present study, we further characterized the previously detected polymerase activity and attempted to confirm its presence in cultured peripheral blood mononuclear cells from additional patients with KS. Characterization experiments indicated that the polymerase activity was typical of a DNA-dependent DNA polymerase rather than viral reverse transcriptase. Peripheral blood mononuclear cell cultures from 17 additional KS patients were negative for reverse transcriptase activity in three laboratories. Our findings do not provide support for a retroviral etiology of KS. Further studies should continue to focus on infectious agents in efforts to elucidate the etiology of KS.
Immature rats were injected with pregnant mares' serum gonadotrophin followed by human chorionic gonadotrophin (hCG). Ovaries were removed 0, 2, 5 or 8 days after hCG and either prepared for morphometric analysis or perifused with 0, 5 or 30 ng luteinizing hormone (LH)/min. In a second study, ovaries were removed on Day 2 or 8 and perifused with 0.1 mg 8-br-cyclic adenosine 5'-phosphate/ml (8-br-cAMP). On Day 0, the granulosa cells of the preovulatory follicles were small (53 +/- 0.5 microns2) with a cytoplasmic to nuclear (Cy:Nu) ratio less than or equal to 1.5. By Day 2, corpora lutea (CL) were present and composed of 95% small luteal cells (diameter less than 125 microns2, Cy:Nu greater than or equal to 3.0) and 5% large luteal cells (diameter greater than 125 microns2, Cy:Nu ratio greater than or equal to 3.0). The percentage of large luteal cells increased to 36 +/- 7% by Day 5, suggesting that they are derived from a select population of small luteal cells. Basal progesterone secretion increased from 38 +/- 5 on Day 0 to 1010 +/- 48 pg/mg/ml on Day 8. The rate of 5 ng LH/min stimulated progesterone secretion on Days 0, 2 and 8; 30 ng LH/min stimulated progesterone secretion on Days 0, 2 and 8, but not on Day 5; 8-br-cAMP stimulated progesterone secretion on both Days 2 and 8. These data demonstrate that once granulosa cells are induced to luteinize they lose their capacity to secrete progesterone in response to 5 ng LH/min and do not regain their responsiveness to LH rate until they completely differentiate. The loss of this LH responsiveness appears to be due to an inability to stimulate sufficient intracellular cAMP concentrations, since cAMP stimulates progesterone secretion on both Days 2 and 8.
The nuchal ligament of unborn calves contains a neutral endopeptidase that is biochemically and immunologically similar to the neutral endopeptidase (NEP), or enkephalinase, from human kidney. Enzymatic activity was inhibited more than 90% by phosphoramidon (1 microM). The specific activity in membrane fractions, as determined by hydrolysis of the dansylated substrate, DAPGN, was similar in tissue from fetuses of gestational ages ranging from 100 to 280 days. NEP activity in adult ligament tissue, however, was less than 10% of that in fetal tissue. Fibroblasts dissociated from ligament tissue by collagenase displayed less NEP activity than did preparations of intact ligament, and activity was even lower in cultured cells. By contrast, fibroblasts cultured from fetal calf lungs had NEP activity comparable to that in the ligament tissue. When ligament fibroblasts were cultured on subcellular matrices derived from fetal lung fibroblasts the NEP activity increased relative to those cultured on plastic alone. These studies confirm the presence of neutral endopeptidase (NEP) in the nuchal ligament of the fetal calf. The consistent activity through a range of gestational ages and the influence of the subcellular matrix suggest that this enzyme might be involved in growth of the ligament during fetal life.
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To assess the superiority of indirect calorimetry (IC)-based enteral nutrition in burned patients, 49 adults with mean burns of 47% TBSA received feedings based either on the Curreri formula (CURR), or on IC, using enteral formulas with nonprotein calorie:nitrogen ratios of either 86:1, or 125:1. Intake in CURR patients was a mean 3,490 kcal/day, which exceeded resting energy expenditure (REE) by 43%, while IC patients received 3,530 kcal/day (1.2 x REE; p less than 0.05). Both groups maintained body weight and lymphocyte counts; survival was equal. Complications (diarrhea, nausea, hyperglycemia) were frequent in both groups, but their incidence did not differ. Patients fed the lower calorie:nitrogen ratio had greater cumulative nitrogen balance, with no increase in nitrogen excretion. It appears advisable to nourish burned patients with the minimal effective intake. While use of IC facilitates this goal, use of the Curreri formula provides acceptable approximation of caloric requirements in the early postburn period.
We investigated differences in behaviors important for human immunodeficiency virus (HIV) transmission and HIV antibody status among 927 recent needle users enrolled in a multi-site HIV surveillance project in Worcester, Massachusetts. Subjects were enrolled at drug abuse treatment centers reported less risky injection practices unexplained by demographic variables. Risky sexual practices were in general reported more frequently by men at the jail than men at other sites. However, HIV status showed little relation to enrollment site. These results have implications both for targeting of acquired immunodeficiency syndrome (AIDS) prevention programs to needle users not in drug abuse treatment and for potential selection bias in studies of intravenous drug users.
Recent improvements in survival have stimulated interest in the care of elderly patients with burn injuries. We reviewed 278 patients aged 45 years and older treated during a 10-year period. The survival rate was 80% overall and 67% for patients over 75 years of age. Mortality rates correlated with patient age, burn size, presence of inhalation injury, number of complications of care, and fluid resuscitation requirements, but not with the number of preexisting medical problems. Burn wound excision and skin grafting were performed frequently and were well tolerated. During this period, hospital charges increased fourfold and were twice as great in nonsurvivors. Reimbursements based on diagnosis-related groups during the last 3 years of the review (75 patients) resulted in a total deficit of $1.2 million. Aggressive care for most elderly patients with burn injuries appears justified by the improved outcomes demonstrated. This has increased the difficulty of decisions regarding patient salvability and the allotment of resources. Elderly patients with burn injuries illustrate many contemporary dilemmas in patient care in this era of cost consciousness.