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Biomedical subjects

James McCarthy

Publications and source records attributed to James McCarthy.

26 records · Page 2Linked to original sources
PubMed2002

Molecular and biochemical characterisation of two aspartic proteinases TcAP1 and TcAP2 from Theobroma cacao seeds.

Aspartic proteinase (EC 3.4.23) activity plays a pivotal role in the degradation of Theobroma cacao L. seed proteins during the fermentation step of cacao bean processing. Therefore, this enzyme is believed to be critical for the formation of the peptide and amino acid cocoa flavor precursors that occurs during fermentation. Using cDNA cloning and northern blot analysis, we show here that there are at least two distinct aspartic proteinase genes ( TcAP1 and TcAP2) expressed during cacao seed development. Both genes are expressed early during seed development and their mRNA levels decrease towards the end of seed maturation. TcAP2 is expressed at a much higher level than TcAP1, although the expression of TcAP1 increases slightly during germination. The proteins encoded by TcAP1 and TcAP2 are relatively different from each other (73% identity). This, and the fact that the two corresponding genes have different expression patterns, suggests that the TcAP1 and TcAP2 proteins may have different functions in the maturing seeds and during germination. Because the TcAP2 gene is expressed at a much higher level during seed development than TcAP1, it is likely that the TcAP2 protein is primarily responsible for the majority of the industrially important protein hydrolysis that occurs during cacao bean fermentation. Finally, TcAP2 has been functionally expressed in the yeast Yarrowia lipolytica. The secreted recombinant protein is able to hydrolyse bovine haemoglobin at acidic pH and is sensitive to pepstatin A, confirming that TcAP2 encodes an aspartic proteinase, and strongly suggests that this gene encodes the well-characterized aspartic proteinase of mature cacao seeds.

Amino Acid Sequence↗
PubMed2002

Analysis of renal bone disease treatment in dialysis patients.

End-Stage Renal Disease Network 11 initiated a renal osteodystrophy quality improvement activity in 1999. One component was the collection and assessment of dialysis facility renal osteodystrophy protocols, whereas another component was the analysis of bone disease-related medication use. Two hundred eighty-eight facilities were invited to submit protocols. A model bone disease and mineral metabolism protocol was developed as the standard for comparison. From the model protocol, an instrument was created to evaluate eight key areas (baseline screening of key laboratory data, dietary intervention, phosphate-binder use, vitamin D use, monitoring of key laboratory indicators, management of hypercalcemia, oversuppression of parathyroid hormone [PTH], and guidelines for both hemodialysis and peritoneal dialysis patients). A bone disease-related prescription survey was completed for 749 randomly selected patients. Survey information included vitamin D and phosphate-binder use and related laboratory values (calcium, phosphorus, intact PTH [iPTH], and calcium x phosphorus product). Although 45% of facilities had six or more points on the evaluation tool, protocols were still incomplete compared with the model. Mean facility-specific scores among the five states in the Network ranged from 1.0 to 5.9 (possible scores, 0 to 8). Most patients were prescribed a phosphate binder; however, 31.8% had average phosphorus levels greater than 6.0 mg/dL during the 3-month period. Only 58% of patients with average iPTH concentrations greater than 260 pg/mL were prescribed vitamin D. Of patients treated with vitamin D, 39% had iPTH concentrations less than 130 pg/mL. There is opportunity to improve renal osteodystrophy protocols in Network 11 and reinforce potential hazards of sustained hyperphosphatemia and hyperparathyroidism.

Algorithms↗
PubMed2002

An outbreak of mediastinitis among heart transplant recipients apparently related to a change in the united network for organ sharing guidelines.

OBJECTIVE: To describe an outbreak of mediastinitis in heart transplant recipients. DESIGN: Retrospective and contemporaneous cohort SETTING: Urban tertiary-care university hospital with a large cardiac transplantation program. PATIENTS: Heart transplant recipients. INTERVENTIONS: Modifications of donor harvest technique; procedures aimed at decreasing skin and mucosal bacterial colonization; strict aseptic technique in the intensive care unit; and aggressive policing of established infection control practices. RESULTS: In April 1999, mediastinitis rates among heart transplant recipients increased abruptly from a baseline of 6 cases per 100 procedures to sequential quarterly rates of 22, 31, and 50 cases per 100 procedures, whereas infection rates in other cardiac operations were unchanged. Bacteria causing these infections were multidrug-resistant "nosocomial" organisms. The epidemic occurred 2 months after a change in the United Network for Organ Sharing organ allocation algorithm. This change resulted in an increase in the duration of preoperative hospitalization from a median of 52 to 79 days (P = .008) and may have promoted prolonged hospitalization of patients with high illness severity. Aggressive multidisciplinary interventions were temporally associated with a return to preoperative mediastinitis rates without changing length of hospitalization prior to transplantation. CONCLUSIONS: Changes in organ allocation for transplant that prolong waiting time in the hospital and alter illness acuity may lead to increased rates of postoperative infection. Measures to limit bacterial colonization may be a helpful countervailing strategy.

Cohort Studies↗
PubMed2002

Bilateral congenital subtalar dislocation: a case report.

Fixed bilateral congenital subtalar dislocations were identified in a 2.5-year-old boy. The patient had been treated previously with a short-leg cast on each foot for 2 months. On presentation the patient ambulated on the medial malleoli and medial aspects of his feet. The patient's activity was limited by pain. At 2.5 years of age, open reduction and pinning of bilateral subtalar joints with soft tissue release and lengthening of the achilles, peroneal, and extensor tendons was done. A thick fibrous band connected the talus and calcaneus laterally. Postoperative treatment included casting for 12 weeks and wearing rigid ankle-foot orthoses which he used for 8 years. There was no recurrence at 10-year followup. The patient has been brace-free for 2 years and is able to ambulate and play school sports without pain. The patient's subtalar range of motion is normal. Radiographic alignment is near normal without degenerative changes. To the authors' knowledge, there has been no previous report of this condition in the literature.

Child, Preschool↗
PubMed2002

Evaluation of force-sensing resistors for gait event detection to trigger electrical stimulation to improve walking in the child with cerebral palsy.

Force-sensing resistors (FSRs) were used to detect the transitions between five main phases of gait for the control of electrical stimulation (ES) while walking with seven children with spastic diplegia, cerebral palsy. The FSR positions within each child's insoles were customized based on plantar pressure profiles determined using a pressure-sensitive membrane array (Tekscan Inc., Boston, MA). The FSRs were placed in the insoles so that pressure transitions coincided with an ipsilateral or contralateral gait event. The transitions between the following gait phases were determined: loading response, mid- and terminal stance, and pre- and initial swing. Following several months of walking on a regular basis with FSR-triggered intramuscular ES to the hip and knee extensors, hip abductors, and ankle dorsi and plantar flexors, the accuracy and reliability of the FSRs to detect gait phase transitions were evaluated. Accuracy was evaluated with four of the subjects by synchronizing the output of the FSR detection scheme with a VICON (Oxford Metrics, U.K.) motion analysis system, which was used as the gait event reference. While mean differences between each FSR-detected gait event and that of the standard (VICON) ranged from +35 ms (indicating that the FSR detection scheme recognized the event before it actually happened) to -55 ms (indicating that the FSR scheme recognized the event after it occurred), the difference data was widely distributed, which appeared to be due in part to both intrasubject (step-to-step) and intersubject variability. Terminal stance exhibited the largest mean difference and standard deviation, while initial swing exhibited the smallest deviation and preswing the smallest mean difference. To determine step-to-step reliability, all seven children walked on a level walkway for at least 50 steps. Of 642 steps, there were no detection errors in 94.5% of the steps. Of the steps that contained a detection error, 80% were due to the failure of the FSR signal to reach the programmed threshold level during the transition to loading response. Recovery from an error always occurred one to three steps later.

Adolescent↗
PubMed2002

Bender Gestalt Recall as a measure of short-term visual memory in children and adolescents with psychotic and other severe disorders.

To investigate the short-term visual memory ability of children and adolescents with severe psychiatric disorders, 82 child and adolescent inpatients and day hospital patients in a state psychiatric hospital were administered the Bender Gestalt Test as part of a psychological assessment and then asked to reproduce the designs from memory. No significant differences were found between groups on either the Bender Gestalt Recall, or the WISC-III IQs and the Digit Span and Symbol Search subtests for Psychotic Disorders (Schizophrenia, Schizoaffective Disorder, Psychosis Not Otherwise Specified), Attention Deficit Hyperactivity Disorder, Mood Disorders or Mood Disorders with co-morbid Attention Deficit Hyperactivity Disorder. The Coding subtest scores of the Psychotic Disorders group were significantly lower than the ADHD group. Analyses showed that the Bender Gestalt Recall was significantly related to age. Performance IQ, and sex. The results were discussed in terms of both the poor cognitive functioning of children and adolescents with persistent, severe mental illness, and the importance of developmental level when using the Bender Gestalt Recall as a rough measure of short-term visual memory.

Adolescent↗