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Biomedical subjects

L Johnson

Publications and source records attributed to L Johnson.

At least 199 records · Page 11Linked to original sources

The effect of dietary fat level and quality on plasma lipoprotein lipids and plasma fatty acids in normocholesterolemic subjects.

This study examined the effect on the plasma lipids and plasma phospholipid and cholesteryl ester fatty acids of changing froma typical western diet to a very low fat (VLF) vegetarian diet containing one egg/day. The effect of the addition of saturated, monounsaturated or polyunsaturated fat (PUFA) to the VLF diet was also examined. Three groups of 10 subjects (6 women, 4 men) were fed the VLF diet (10% energy as fat) for two weeks, and then in the next two weeks the dietary fat in each group was increased by 10% energy/week using butter, olive oil or safflower oil. The fat replaced dietary carbohydrate. The VLF diet reduced both the low density lipoprotein (LDL)- and high density lipoprotein (HDL)-cholesterol levels; addition of the monounsaturated fats and PUFA increased the HDL-cholesterol levels, whereas butter increased the cholesterol levels in both the LDL- and HDL-fractions. The VLF diet led to significant reductions in the proportion of linoleic acid (18:2 omega 6) and eicosapentaenoic acid (20:5 omega 3) and to increases in palmitoleic (16:1), eicosatrienoic (20:3 omega 6) and arachidonic acids (20:4 omega 6) in both phospholipids and cholesteryl esters. Addition of butter reversed the changes seen on the VLF diet, with the exception of 16:1, which remained elevated. Addition of olive oil resulted in a significant rise in the proportion of 18:1 and significant decreases in all omega 3 PUFA except 22:6 compared with the usual diet. The addition of safflower oil resulted in significant increases in 18:2 and 20:4 omega 6 and significant decreases in 18:1, 20:5 omega 3 and 22:5 omega 3. These results indicate that the reduction of saturated fat content of the diet (< 6% dietary energy), either by reducing the total fat content of the diet or by exchanging saturated fat with unsaturated fat, reduced the total plasma cholesterol levels by approximately 12% in normocholesterolemic subjects. Although the VLF vegetarian diet reduced both LDL- and HDL-cholesterol levels, the long-term effects of VLF diets are unlikely to be deleterious since populations which habitually consume these diets have low rates of coronary heart disease. The addition of safflower oil or olive oil to a VLF diet produced favorable changes in the lipoprotein lipid profile compared with the addition of butter. The VLF diets and diets rich in butter, olive oil or safflower oil had different effects on the 20 carbon eicosanoid precursor fatty acids in the plasma.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Diets rich in lean beef increase arachidonic acid and long-chain omega 3 polyunsaturated fatty acid levels in plasma phospholipids.

Diets rich in meat are claimed to contribute to the high tissue arachidonic acid (20:4 omega 6) content in people in Westernized societies, but there are very few direct data to substantiate this assertion. Because meat contains a variety of long-chain polyunsaturated fatty acids (PUFA) that are susceptible to oxidation, we initially examined the effect of cooking on the long-chain PUFA content of beef, and then determined the effect of ingestion of lean beef on the concentration of long-chain PUFA in plasma phospholipids (PL). First, we examined the effect of grilling (5-15 min) and frying (10 min) different cuts of fat-trimmed lean beef on the long-chain PUFA content. Second, we investigated the effect of including 500 g lean beef daily (raw weight) for 4 wk on the fatty acid content and composition of plasma PL in 33 healthy volunteers. This study was part of a larger trial investigating the effect of lean beef on plasma cholesterol levels. In the first two weeks, the subjects ate a very low-fat diet (10% energy) followed by an increase in the dietary fat by 10% each week for the next 2 wk. The added fat consisted of beef fat, or olive oil (as the oil or a margarine) or safflower oil (as the oil or a margarine). This quantity of beef provided 60, 230, 125, 140 and 20 mg/d, respectively, of eicosatrienoic acid (20:3 omega 6), 20:4 omega 6, eicosapentaenoic acid (20:5 omega 3), docosapentaenoic acid (22:5 omega 3) and docosahexaenoic acid (22:6 omega 3).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Vitamin D metabolism and bone mineralization in children with juvenile rheumatoid arthritis.

OBJECTIVE: To examine bone mineralization and bone mineral content in a cross-sectional population of children with juvenile rheumatoid arthritis (JRA). METHODS: Bone mineral content was measured by single-photon absorptiometry in 44 children with JRA and 37 control children. Serum concentrations of minerals, vitamin D, parathyroid hormone, osteocalcin, bone alkaline phosphatase, and tartrate-resistant acid phosphatase, and urinary concentrations of minerals, were determined. RESULTS: Bone mineral content was decreased in children with JRA. Significantly lower concentrations of osteocalcin (7.4 +/- 3.4 vs 12.5 +/- 2.5 micrograms/L) and bone alkaline phosphatase (78.8 +/- 36.4 vs 123.0 +/- 46.0 IU/L) suggested reduced bone formation; lower levels of tartrate-resistant acid phosphatase (10.3 +/- 4.1 vs 14.4 +/- 5.8 IU/L) and a lower urinary calcium/creatinine ratio (0.07 +/- 0.06 vs 0.12 +/- 0.09) suggested decreased bone resorption. The serum calcium concentration was significantly lower (9.3 +/- 1.0 vs 10.0 +/- 0.4 mg/dl), as was the parathyroid hormone concentration (19.8 +/- 8.6 vs 26.7 +/- 9.3 ng/L); 1,25-dihydroxyvitamin D values (30.1 +/- 10.5 vs 30.4 +/- 9.3 pg/ml) were normal. CONCLUSION: These data suggest that decreased mineralization in JRA is related to low bone turnover; parathyroid hormone and 1,25-dihydroxyvitamin D levels may be inappropriately normal for the decreased serum calcium concentration in children with JRA.

Adolescent↗

Murine chronic tubulointerstitial nephritis: induction by human uveitis mycoplasma-like organisms.

Mycoplasma-like organisms (MLO) are non-cultivated intracellular cell wall deficient pathogenic bacteria with a distinctive ultrastructural appearance. Diagnosis of MLO disease rests on finding the organisms in parasitized cells using a transmission electron microscope. MLO are a well studied cause of transmissible chronic plant vascular disease responsive to antibiotics. MLO have recently been found to cause human chronic progressive ophthalmic disease including uveitis. In human uveitis MLO are readily found within parasitized intraocular fluid leucocytes. Inoculation of human uveitis MLO into mouse eyelids produced a high incidence of chronic progressive ophthalmic disease including uveitis. MLO also disseminated to produce randomly distributed lethal systemic inflammatory disease. MLO parasitized leucocytes and microvascular alterations were found in the disease sites by electron microscopy. This report describes the chronic progressive tubulointerstitial nephritis in 12 of 100 human uveitis MLO eyelid inoculated mice versus 0 in 200 control mice (p < 0.0001). MLO parasitized leucocytes accompanied by tubular and microvascular alterations were found by electron microscopy in all 12 inflamed kidneys versus 0 of 4 control kidneys. Pathobiology of the MLO-induced murine nephritis, resemblance of this nephritis to human idiopathic chronic tubulointerstitial nephritis, bacterial molecular biology, and antibiotic therapy of MLO disease are discussed.

Animals↗

An Eastern Cooperative Oncology Group phase II study of single agent DHAD, VP-16, aclacinomycin, or spirogermanium in metastatic pancreatic cancer.

There were 80 patients with measurable metastatic or unresectable pancreatic cancer randomly assigned to treatment with either DHAD, VP-16, aclacinomycin, or spirogermanium. There were no complete or partial responses. Two deaths from leukopenia occurred in patients treated with DHAD. One patient receiving spirogermanium experienced a seizure. No other life-threatening toxicities occurred. Maximal toxicities were not significantly more frequent with any treatment group. Median survival was 10 weeks, and median time to progression was only 6 weeks, with no difference among these four therapies.

Aclarubicin↗

Esophageal mucosal changes in children with an acutely ingested coin lodged in the esophagus.

An important factor in choosing the method to remove an ingested coin lodged in the esophagus (endoscopy with forceps extraction, Foley catheter extraction, or bougienage advancement) is the duration of the ingestion and the risk for compromise to the esophageal mucosal integrity. We reviewed 50 consecutive cases occurring during a five-year period of children with a witnessed acutely ingested coin (less than 24 hours duration) that was lodged in the esophagus to determine the degree of compromise of the esophageal mucosal integrity. All coins were removed by endoscopic forceps extraction, with direct inspection of esophageal mucosa. The duration of ingestion was less than eight hours in 22 patients, nine to 16 hours in 16 patients, and 17 to 24 hours in 12 patients. Endoscopy showed that the esophageal mucosa had no abnormalities in 42 patients, "minimal erythema" in six patients, and "minimal abrasion" in two patients. There were no symptoms or complications referable to the gastrointestinal tract reported subsequent to coin removal in any case. Ingested coins that are lodged in the esophagus for fewer than 24 hours do not cause significant compromise to the integrity of the esophageal mucosa. We discuss the implications of these findings in the context of choosing an appropriate method for removing esophageal coins.

Acute Disease↗

Trends in bacterial infections in febrile neutropenic patients: 1986-1992.

BACKGROUND: Bacterial infection is a major cause of morbidity and mortality in neutropenic patients. AIMS: (1) To review patterns and trends in bacterial infections in three cohorts of febrile neutropenic patients managed by a single unit over a seven year period. (2) To relate any changes to the use of central venous (Hickman's) catheters and high-dose cytosine arabinoside chemotherapy. METHODS: Retrospective review of the results of initial bacteriological work-up performed on 344 episodes of febrile neutropenia. The three cohorts were 1986-87 (n = 102), 1989-90 (n = 92) and 1991-92 (n = 150). RESULTS: (1) The ratio of gram-negative to gram-positive bacteraemias fell from 1.36 in the first cohort to 1.05 in the second and 0.40 in the third (p = 0.03). There was a fall in both percentage and number of gram-negative isolates coupled with a rise in the frequency of gram-positive isolates. (2) Coincidentally there was a rise in the frequency of positive cultures from Hickman catheter entry wounds and an increasing frequency of simultaneous isolation of the same organism from the catheter entry site and the blood. The types of organisms isolated from catheter entry wounds showed a trend towards fewer gram-negative and more gram-positive. (3) A relationship was observed between the use of high-dose cytosine arabinoside chemotherapy and the incidence of bacteraemia (p = 0.025) but not with the change in types of organisms. CONCLUSIONS: Over seven years we have documented a major change in the types of infections, particularly bacteraemias, seen in febrile neutropenic patients. In our institution the more widespread use of intravenous catheters and high-dose cytosine arabinoside chemotherapy have been identified as two possible contributing factors.

Bacteremia↗

A lipoprotein signal peptide encoded by the staphylococcal conjugative plasmid pSK41 exhibits an activity resembling that of Enterococcus faecalis pheromone cAD1.

The traH gene of the staphylococcal conjugative plasmid pSK41 has recently been shown to encode a lipoprotein (N. Firth, K. P. Ridgway, M. E. Byrne, P. D. Fink, L. Johnson, I. T. Paulsen, and R. A. Skurray, Gene 136:13-25, 1993). Here we report that traH encodes a product recognized as a pheromone by Enterococcus faecalis cells harboring the conjugative plasmid pAD1. The mature traH product is not essential for this phenomenon, as expression of pheromone-like activity was found to require sequences encoding only the pro-TraH signal peptide.

Amino Acid Sequence↗

Phenytoin for motion sickness: clinical evaluation.

Phenytoin has previously been shown to protect against motion sickness induced by Coriolis stimulation. The purpose of our series of investigations was to investigate further the efficacy of phenytoin for motion sickness prophylaxis and to gain insight into its mechanism of action. We tested participants with electronystagmography, off-vertical rotation, sea travel, and parabolic flight after they received phenytoin or placebo. Blood levels of at least 9 micrograms/mL were found to protect against motion sickness. Electronystagmography showed significant decreases in the gain of the vestibuloocular reflex in participants receiving phenytoin. Few side effects were seen with drug levels in the 9 to 15 micrograms/mL range. Phenytoin is an effective motion sickness countermeasure that may exert its effect through a combination of central nervous system and peripheral vestibular effects.

Adult↗

The relationship of daily sperm production with number of Sertoli cells and testicular size in adult horses: role of primitive spermatogonia.

The number of Sertoli cells is important in spermatogenesis as noted by significant correlations between the number of Sertoli cells and the number of germ cells observed as early as type B2 spermatogonia in the horse. However, the stage within spermatocytogenesis at which these relationships first occur is unclear. The relationships between the number of Sertoli cells and parenchymal weight and the number of germ cells during the mitosis of spermatogenesis were determined in 184 adult horses to identify the developmental stage (that is, the earliest germ cell) at which significant relationships are established. The total numbers of all types of A spermatogonia and of specific subtypes (A1, A2, A3, B1 or B2) of spermatogonia were correlated with the number of Sertoli cells and with parenchymal weight. The number of each cell type was calculated using stereology. The number of Sertoli cells was correlated (P < 0.01) with parenchymal weight (r = 0.85) and with daily sperm production (r = 0.83), and parenchymal weight was correlated (P < 0.01) with daily sperm production (r = 0.89). The number of Sertoli cells was correlated (P < 0.01) with the number of type A (r = 0.81) and A1 (r = 0.74) spermatogonia. Parenchymal weight was correlated with the number of type A (r = 0.80) spermatogonia and with the number of A1 (r = 0.67) spermatogonia.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Efficacy of feeding glucosinolate-extracted crambe meal to broiler chicks.

Glucosinolates and their breakdown products (nitriles) have long been implicated as toxic factors when feeding rapeseed (Brassica napus) meals and crambe (Crambe abyssinica) meals to poultry. Accordingly, various methods have been developed to remove these compounds from the meals to enhance their value as feed supplements. Glucosinolates and nitriles were extracted from commercially processed, defatted crambe meal by washing with water or various solvent-water mixtures: 50% isopropanol, 50% acetone, or 50% ethanol. In addition, crambe seed was extruded and extracted in the laboratory with isopropanol or hexane. Water washing of commercially defatted meal proved to be the most effective method of extraction, removing 95% of the glucosinolates and nitriles. Meals were fed to 7-d-old broiler chicks at 10% of the diet for 14 d. Weight gain decreased (P < .05) in most groups; however a greater decrease (P < .01) was observed in birds fed meals with high glucosinolate content. Feed intake also decreased (P < .05) in most groups; consequently, feed efficiencies were similar for all groups. No changes in serum chemistries, triiodothyronine, thyroxine, or tissue lesions were associated with glucosinolate or nitrile intake. A relationship (P < .05, r = .74) was found between weight gain and glucosinolate intake. No correlation was found between feed intake and meal glucosinolate or nitrile concentrations.

Alkenes↗

A review of rural health restructuring in the New South Wales.

In 1993 the delivery of rural health services in New South Wales was restructured by the establishment of 23 district health services with the aims of diverting resources from administration to clinical services and enhancing decision-making at the local level. Implementation of the restructuring in its infancy was examined by structured interviews conducted with five general managers and 15 of their second-tier appointees. The organisational structure of the districts, the managerial attributes required of senior staff and approaches to change were emphasised. Political constraints on organisational decision-making such as organisational design were acknowledged and the importance accorded to demonstrable achievement in managing change and incorporating consultative techniques was recognised.

Decision Making, Organizational↗

CHWs trained in ARI management.

Regular supervision and refresher trainings were the key to the success of a CHW (community health worker) training program in rural Bolivia. Since 1988, with the support of PLAN International, volunteer CHWs have been trained in 115 villages in Sucre, a rural health area lacking adequate health centers. CHWs educate the community, diagnose and treat pneumonia and refer severe cases to health centers or hospitals. CHWs who were already working on diarrheal disease control were chosen for the acute respiratory infection (ARI) case management training. A 3-day training program was organized for individual CHWs in their own homes and communities. The course included practicing on real ARI cases under the trainer's supervision. Since the program started, community respect for CHWs has risen. In one remote village, community leaders reported a marked improvement in child survival. Factors which explain the positive effects of CHWs include: a limited number of clearly defined tasks, provision of one-on-one appropriate training, periodic refresher courses, and continuous supervision. The main problems have been a lack of constant supply of essential drugs and some CHWs over-diagnosing pneumonia. However, once diagnosis is made, CHWs are careful about giving the correct antibiotic doses and instructions to mothers. Refresher training and supervision have helped to correct these initial problems. PLAN International and the Ministry of Health have organized supervision and training meetings every 2 months. The CHWs bring to these meetings reports of children treated and referred. Case management is analyzed, resupply of essential medicines is arranged and those with special problems are scheduled for a supervisory visit.

Americas↗

A randomised dosage study of ceftazidime with single daily tobramycin for the empirical management of febrile neutropenia in patients with hematological diseases.

A single-institution, randomised trial was conducted to compare the clinical and microbiological efficacy of two different doses of ceftazidime in combination with a single daily dose of tobramycin for the empirical management of febrile neutropenic patients with hematologic disorders (absolute neutrophil count < 1 x 10(9)/l). Upon the development of fever or signs of sepsis, patients received either 2 g ceftazidime every 8 h plus a single daily dose tobramycin (5 mg/kg/day) (C2T, n = 73) or 1 g ceftazidime every 8 h plus a single daily dose of tobramycin (C1T, n = 77). In addition, flucloxacillin (1-2 g every 4 h) could be added if there was clinical suspicion of staphylococcal infection. Analysis was performed for the whole group and for the subset which did not receive flucloxacillin. When evaluated at 96 h, 70% (95% CI, +/- 11%) of patients randomised to C2T and 60% (95% CI, +/- 11%) randomised to C1T had responded (chi 2 = 1.27, P = 0.26). The response rates at 96 h for those who did not receive flucloxacillin were 77% (+/- 12%) and 74% (+/- 13%), respectively (chi 2 = 0.01, P = 0.92). Overall, 68 (93% +/- 6%) and 72 (94% +/- 6%) patients, respectively, eventually became afebrile (chi 2 = 0.06, P = 0.81). Renal function, as judged by serum creatinine, was unaffected by either antibiotic schedule. Within 10 days of antibiotic commencement there was one death in each arm and overall there were five deaths in each arm.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Patient management in a tobacco-cessation program in the dental practice.

Smoking and smokeless tobacco can cause significant damage to the oral cavity, including life-threatening cancers. Consequently, dentists and their office staffs should and can play an influential role in advising their patients to quit using tobacco. The National Cancer Institute has developed the "Four A's" approach to tobacco-cessation counseling: (1) ask about tobacco use; (2) advise to quit; (3) assist with quitting; and (4) arrange for follow-up. With minimal expenditures of treatment time, the dentist and office staff can encourage patients to quit using tobacco through nonconfrontational messages that point out the clinical damage caused by smoking and smokeless tobacco. Besides behavior modification, dentists can prescribe several Food and Drug Administration-approved pharmaceutical agents as adjuncts to a tobacco-cessation program. Nicotine polacrilex (gum) and nicotine transdermal systems have proven very useful in helping tobacco users quit their habit.

Administration, Cutaneous↗

The role of an electronic mail system in the educational strategies of a residency in obstetrics and gynecology.

Computerized electronic mail (E-mail) systems provide a rapid means of data sharing and are used in a variety of commercial and industrial settings for the widespread distribution of memoranda. We adapted an E-mail system to our program to determine the feasibility of incorporating such a system into didactic resident education in obstetrics and gynecology and to assess resident response to this form of computer-based learning. The system was programmed to distribute one review question per day to 24 resident physicians for 60 days. Residents were given 24 hours to respond and comment. Each question was discussed and appropriate references distributed within 48 hours of presentation. All questions and responses were then stored in an electronic file folder for later review. An examination was given at completion of the project (post-test), and these scores were compared to performance during the project (pre-test). An anonymous questionnaire was distributed upon completion of the project to assess the residents' overall satisfaction with the program. The system was well received by the residents. On a scale of 1 to 6 (1 = lowest; 6 = highest), resident satisfaction was high, with an overall average rating of 5.0. Using this scale, residents assessed their frustration level as 1.5. Average daily participation was 85%. An average of 9 minutes was required to complete each question and review prior responses and discussion; this interval was not significantly different among the postgraduate years. Scores on the examination at project completion were significantly higher than performance during the project.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗