PubMed HealthSearch

Biomedical subjects

M Cowan

Publications and source records attributed to M Cowan.

At least 19 recordsLinked to original sources

Antisense inhibition of 85-kDa cPLA2 blocks arachidonic acid release from airway epithelial cells.

Inflammatory cytokines play a critical role in the initiation and perpetuation of inflammation. Several cytokines are known to increase the production of arachidonic acid (AA) metabolites, which may mediate cytokine-induced acute and chronic inflammation. Although cytokines upregulate phospholipase A2 (PLA2) in several target cells, the contribution of individual PLA2 to cytokine-induced AA release and eicosanoid production remains unclear because of the existence of various forms of cellular PLA2. To examine the role of 85-kDa cytosolic PLA2 (cPLA2) in cytokine-induced AA release, a system was developed to inhibit the expression of cPLA2 in a human bronchial epithelial cell line (BEAS-2B cells) by antisense RNA. Cells stably expressing antisense cPLA2 exhibited decreased cPLA2 protein levels as well as decreased cPLA2 activity assayed in vitro. The effects of cytokines interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha), and interleukin-1 alpha (IL-1 alpha) on the release of prelabeled [3H]AA were then tested in cells stably transfected with vector alone as well as cells transfected with cPLA2 antisense plasmid. IFN-gamma (300 U/ml), TNF-alpha (20 ng/ml), and IL-1 alpha (20 ng/ml) all induced a significantly increased release of prelabeled [3H]AA after 15 min to 2 h of treatment in control cells, and their effects were significantly reduced in cells transfected with cPLA2 antisense vector. These results demonstrate a critical role of cPLA2 in inflammatory cytokine-induced AA metabolism.

Antisense Elements (Genetics)

Gender, gender role, and drawing skill.

Separate bodies of research suggest that performance in spatial reasoning covaries with gender and with gender role. Typically studies employ a spatial task whose variance is then used to account for differences in scores between gender groups or variance in a measure of gender role. A methodological issue in such research is that the tasks used to represent spatial reasoning may be differentially available or differentially appealing as a function of gender. Also, authors tend to analyze data in terms of either gender or gender role but rarely both. A collection of personality assessments administered to 204 college students each contained a completed Minnesota Multiphasic Personality Inventory (MMPI-2) and a drawing of a human figure. Within MMPI-2 are three measures of gender role. Drawing talent is unquestionably spatial and has the advantage of being equally available and encouraged among the two genders. Male gender predicted drawing skill. Within both genders, self-perceived masculinity in gender role also predicted higher scores on the drawing skill. Outcomes are seen as compatible with Geschwind and Galaburda's 1987 formulation regarding the behavioral manifestations of fetal androgenization.

Adult

Clinical nursing management of sickle cell disease and trait during pregnancy.

Sickle cell-related hemoglobinopathies present challenges for clinical management during pregnancy, labor, delivery, and the postpartum course because perinatal morbidity remains a significant practice concern. Nursing strategies that strive for synthesis of knowledge pertaining to pathophysiology, genetic counseling, life events that have affected the patient's health history, treatment modalities, and psychosocial needs may improve obstetric and neonatal outcomes. Clinical management strategies for the prenatal, intrapartum, and postpartum courses are provided. Nursing intervention strategies such as follow-up teaching, involvement of the partner and support network in aspects of care, and patient advocates, in conjunction with independent nursing practice activities involving emotional support and measures to alleviate symptoms associated with disease manifestations, are cornerstones in the contribution of nursing to the multidisciplinary care of the pregnant woman with sickle cell disease and trait.

Ambulatory Care

Radiofrequency catheter ablation of multiple morphologies of ventricular tachycardia by targeting a single region of the left ventricle.

INTRODUCTION: As treatment options for ventricular tachycardia (VT) continue to evolve, the use of radiofrequency catheter ablation is rapidly expanding. However, in the presence of multiple morphologies of VT, achieving successful results may seem less likely. We report two patients with multiple morphologies of VT who underwent successful radiofrequency ablation by application of radiofrequency energy to a single region in the left ventricle. METHODS AND RESULTS: Two patients, each without any apparent cardiac dysfunction and a history of documented VT, were referred to our institution for further management. They underwent an electrophysiologic study and were found to have easily inducible VT, of three morphologies in one patient and two in the other. Using a transaortic approach, left ventricular mapping was performed for detecting a site with presystolic potentials, earliest ventricular activation, or both. Application of radiofrequency energy to a single area in the left ventricle resulted in the elimination of all previously inducible VT in each patient. CONCLUSION: VTs with distinctly different morphologies can occur in patients with no detectable structural heart disease. These VT circuits may share a common pathway and, therefore, may readily be amenable to therapy with radiofrequency catheter ablation.

Adult

Aminosulfonic acid buffer preserves myocardium during prolonged ischemia.

Prevention of myocardial acidosis during global ischemia in operative cardiopreservation was explored in two series of dogs where acid-base control was the only variable. A specifically designed aminosulfonic acid buffer composition, 3:1 molar equivalents NaMOPS to HEPES, 0.2 mol/L, was compared with NaHCO3 (pH 8). Dissolved in standard cardioplegic solution it was given every 30 minutes by coronary infusion at 20 degrees C during 3 hours of global ischemia. Glass electrode intramyocardial pH, adenosine triphosphate (ATP) level, left ventricular contractility (Dp/Dt) and compliance (-Dp/Dt), and other cardiovascular parameters were measured frequently throughout ischemia and for 75 minutes thereafter. In the buffer group (n = 6) myocardial pH remained above entry levels throughout the study period, adenosine triphosphate level remained normal during ischemia, and Dp/Dt and -Dp/Dt at 75 minutes of reperfusion were above entry levels. In the NaHCO3 group (n = 6) pH declined and remained depressed throughout ischemia, adenosine triphosphate level fell steadily and significantly throughout the experiment, and Dp/Dt and -Dp/Dt never regained entry levels. The difference in each parameter between the two groups was statistically significant (p < 0.05). We conclude that control of myocardial acid-base equilibrium alone during global ischemia will preserve myocardial function and minimize reperfusion injury.

Acidosis

Nycthemeral profile of nonspectral heart rate variability measures in women and men. Description of a normal sample and two sudden cardiac arrest subsamples.

Heart rate variability (HRV), a noninvasive systemic index of the central autonomic nervous system, demonstrates considerable within-subject variability, including a strong systematic 24-hour nycthemeral (or less precisely, circadian) component. Recent interest in the timing of sudden cardiac arrest (SCA), especially the pronounced morning rise in sudden deaths, has motivated research into coincident dynamic phenomena in HRV indices of central autonomic nervous system activity. In this study, statistical (nonspectral) HRV measures (SD and %RR50) were summarized for consecutive 15-minute blocks from 24-hour Holter electrocardiogram tapes. Six subgroups were scrutinized: women and men respectively in three clinical strata (normal subjects [n = 85 women and 40 men], SCA with no current or prior myocardial infarction [MI] [n = 9 women and 31 men], SCA with old MI [n = 7 women and 48 men]). Significant nycthemeral effects were observable for all HRV measures in five of the six groups, with a dramatic fall in HRV during the hours of the morning with the highest phenomenologic incidence of SCA. Both strata of SCA subjects had much lower HRV than the normal subjects. This effect was strongest during the night-time hours, particularly for a purported index of vagal tone (%RR50). For reasons that are not known, the nine female SCA survivors who had no current or previous MI presented very distinct 24-hour patterns for the HRV measures studied. Twenty-four-hour profiles of short-term statistical HRV provide a rich field for the observation of within-subject adaptations of the central autonomic nervous system inputs to the heart in both normal and clinical subgroups.

Circadian Rhythm

Diagnosing and managing unstable angina. Agency for Health Care Policy and Research.

This Quick Reference Guide for Clinicians contains recommendations on the care of patients with unstable angina based on a combination of evidence obtained through extensive literature reviews and consensus among members of an expert panel. Principal conclusions include the following. (1) Many patients suspected of having unstable angina can be discharged home after adequate initial evaluation. (2) Further outpatient evaluation may be scheduled for up to 72 hours after initial presentation for patients with clinical symptoms of unstable angina judged at initial evaluation to be at low risk for complications. (3) Patients with acute ischemic heart disease judged to be at intermediate or high risk of complications should be hospitalized for careful monitoring of their clinical course. (4) Intravenous thrombolytic therapy should not be administered to patients without evidence of ST segment elevation and acute myocardial infarction. (5) Assessment of prognosis by noninvasive testing often aids selection of appropriate therapy. (6) Coronary angiography is appropriate for patients judged to be at high risk for cardiac complications or death based on their clinical course or results of noninvasive testing. (7) Coronary artery bypass surgery should be recommended for almost all patients with left main disease and many patients with three-vessel disease, especially those with left ventricular dysfunction. (8) The discharge care plan should include continued monitoring of symptoms; appropriate drug therapy, including aspirin; risk-factor modification; and counseling.

Ambulatory Care

Wegener's granulomatosis. Typical symptoms in an atypical patient.

Wegener's granulomatosis classically involves the respiratory tract and kidneys, and the disorder may be confused with any of a number of diseases having similar symptoms. Although most common in middle-aged whites, Wegener's granulomatosis may occur in atypical patients, as in the case described here. Accurate diagnosis depends on lung biopsy, and prompt treatment prevents permanent damage and significant sequelae.

Adult

Flow chamber study of the adhesion of Prevotella intermedia to glass after preconditioning with mutans streptococcal species: kinetics and spatial arrangement.

The adhesion kinetics and spatial arrangement of a clinical isolate of Prevotella intermedia on bare glass and on glass which had been previously exposed to Streptococcus rattus or Streptococcus cricetus were studied using a parallel plate flow system and image analysis. When S. cricetus was the preconditioning organism the initial deposition rate and efficiency of P. intermedia were reduced even though very few S. cricetus adhered during flow with P. intermedia. Preconditioning with S. rattus had less effect on the adhesion behaviour of P. intermedia despite the fact that more S. rattus cells adhered than S. cricetus cells. Small differences in both the stationary state adhesion and in the final spatial arrangements were evident under the three experimental conditions. S. cricetus negatively influences initial deposition of subsequent P. intermedia adhesion possibly by the production of a biosurfactant or by leaving 'microbial footprints'. This interference is eventually overcome resulting in a similar stationary state adhesion of P. intermedia as found without S. cricetus preconditioning. Furthermore, the flow chamber system employed here proved uniquely suited for studying cell-cell interactions in initial adhesion.

Bacteria, Anaerobic

Microgranulomatous aspergillosis after shoveling wood chips: report of a fatal outcome in a patient with chronic granulomatous disease.

Chronic granulomatous disease is characterized by recurrent infections that result from an inability of phagocytes to kill organisms effectively. We describe a patient with this disease who developed aspergillus pneumonia after shoveling moldy cedar wood chips. Despite aggressive therapy, the patient's condition deteriorated and he died. At autopsy, the lungs revealed diffuse granulomas, all of the same age, with aspergillus organisms confined to the granulomas. We propose the term "microgranulomatous aspergillosis" for this response, which does not conform to the commonly described aspergillus syndromes. We conclude that susceptible immunosuppressed patients should be advised to avoid occupational situations where high spore concentrations are generated.

Adult

Developmental intervention in the newborn intensive care unit.

Developmental intervention for infants with perinatal asphyxia requires an individualized therapeutic plan. A team approach incorporating developmental goals and intervention strategies into the nursing care of these infants is essential for optimal developmental outcome. Therapeutic management must always be appropriate for the infant's health status, gestational age, and organizational capabilities. An understanding of the neurophysiologic basis for intervention and the therapeutic management techniques for infants who are sick, recuperating, or convalescing will help the nurse to promote optimal development when caring for the asphyxiated infant.

Asphyxia Neonatorum

Inhibition of rate of tumour growth in rodent species by inoculation of herpesviruses and encephalomyocarditis virus.

Inoculation of herpesviruses and encephalomyocarditis virus into subcutaneous tumours in hamsters and mice reduced the rate of tumour growth compared to untreated tumours or secondary tumours which had arisen following surgical excision of the primary tumour; in addition, survival times were increased in animals whose tumours were inoculated with virus. It is suggested that the role of virus in the modification of tumour growth merits further exploration.

Animals

Inhibition of some spontaneous tumors by 4-hexylresorcinol in F344/N rats and B6C3F1 mice.

4-Hexylresorcinol (4-HR) is used as an anthelmintic and antiseptic in human and veterinary medicine. Toxicology and carcinogenesis studies were conducted by administering 4-HR in corn oil by gavage at 0, 62.5, or 125 mg/kg to F344 rats and B6C3F1 mice of each sex for 2 years. The nonneoplastic lesions associated with 4-HR exposure were nephropathy and osteosclerosis in dosed male and female mice. The only evidence of neoplasia associated with 4-HR was marginally increased incidences of adrenal gland pheochromocytomas and harderian gland tumors in male mice. Decreases were observed in the incidences of mononuclear cell leukemia in dosed male and female rats, hepatocellular adenomas or carcinomas in dosed male mice, and circulatory system tumors in high-dose male and female mice. These negative tumor trends in rats and mice, along with an indication of reduced overall incidences of benign and malignant tumors in treated groups compared to controls, suggest that 4-HR may deserve further study as a possible antineoplastic agent.

Animals

Reduced tumorigenicity of rodent tumour cells and tumour explants following infection with wild type and mutant herpes simplex virus, bovine mammillitis virus and encephalomyocarditis virus.

The tumorigenicity of neoplastic hamster and mouse cell lines and tumour explants was reduced by infection with herpes simplex virus (HSV-1), a thymidine-kinaseless mutant of herpes simplex virus, namely 'MDK', encephalomyocarditis virus (EMC) and bovine mammillitis virus (BMV). There was an approximate relationship between duration of virus infection in vitro and reduction in incidence and/or rate of tumour development. The rate of tumour development was also reduced by 'site inoculation' of virus (HSV-1) at various time intervals following inoculation of tumorigenic BHK 21 cells indicating that virus was capable of reducing the rate of tumour development in a situation where the neoplastic cells were already transplanted into the susceptible host species. It is suggested that the therapeutic role of wild type, mutant or recombinant viruses merits further exploration towards prevention and treatment of human cancer.

Animals

Follow-up report on 50 subjects vaccinated against herpes genitalis with Skinner vaccine.

Fifty subjects at risk of herpes genitalis received 109 immunizations with Skinner herpes vaccine and were assessed after a follow-up period of 4-48 months, representing a total follow-up period of 694 patient months. There was no evidence of contraction of herpes genitalis in 49 subjects. The risk of virus transmission and rate of contraction of disease was quantified by construction of two functions, namely a unit of exposure risk calculated per year (UYE) and standard contraction rate (SCR); in this study the SCR was 0.02. There was no evidence of significant side-effects from vaccination. Administration of Alhydrogel adjuvant with vaccine induced temporary granuloma formation in most subjects but was only detectable beyond 1 year of follow-up in one subject, in whom a painless swelling of 0.2 cm was detected 3 years after vaccination. There was no evidence of immunological reactivity to host cell or calf serum antigens in any of the subjects vaccinated.

Adolescent