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Biomedical subjects

M Solomon

Publications and source records attributed to M Solomon.

At least 55 records · Page 3Linked to original sources

Characterization of a mammalian homolog of the Escherichia coli MutY mismatch repair protein.

A protein homologous to the Escherichia coli MutY protein, referred to as MYH, has been identified in nuclear extracts of calf thymus and human HeLa cells. Western blot (immunoblot) analysis using polyclonal antibodies to the E. coli MutY protein detected a protein of 65 kDa in both extracts. Partial purification of MYH from calf thymus cells revealed a 65-kDa protein as well as a functional but apparently degraded form of 36 kDa, as determined by glycerol gradient centrifugation and immunoblotting with anti-MutY antibodies. Calf MYH is a DNA glycosylase that specifically removes mispaired adenines from A/G, A/7,8-dihydro-8-oxodeoxyguanine (8-oxoG or GO), and A/C mismatches (mismatches indicated by slashes). A nicking activity that is either associated with or copurified with MYH was also detected. Nicking was observed at the first phosphodiester bond 3' to the apurinic or apyrimidinic (AP) site generated by the glycosylase activity. The nicking activity on A/C mismatches was 30-fold lower and the activity on A/GO mismatches was twofold lower than that on A/G mismatches. No nicking activity was detected on substrates containing other selected mismatches or homoduplexes. Nicking activity on DNA containing A/G mismatches was inhibited in the presence of anti-MutY antibodies or upon treatment with potassium ferricyanide, which oxidizes iron-sulfur clusters. Gel shift analysis showed specific binding complex formation with A/G and A/GO substrates, but not with A/A, C.GO, and C.G substrates. Binding is sevenfold greater on A/GO substrates than on A/G substrates. The eukaryotic MYH may be involved in the major repair of both replication errors and oxidative damage to DNA, the same functions as those of the E. coli MutY protein.

Amino Acid Sequence↗

Risk factors for gonorrhoea, syphilis, and trichomonas infections among women attending family planning clinics in Nairobi, Kenya.

OBJECTIVE: To identify the risk factors for gonorrhoea, syphilis, and trichomonas infections among low risk women in Nairobi, Kenya. METHOD: In a cross-sectional study, 4,404 women attending two peri-urban family planning clinics between 1989 and 1991 were interviewed using a structured questionnaire and examined for signs of sexually transmitted disease (STD) infection. Cervical cultures for gonorrhoea, PAP smear (including microscopy for trichomonas), RPR and HIV testing were done. RESULTS: Positive cervical cultures for gonorrhoea were found in 3.2% of women, positive syphilis serology in 1.9%, and positive trichomonas microscopy in 5.2%. Genital ulcers were found in 1.9% of women. Although unmarried status and reporting more than one sex partner in the previous year were both significantly associated with each disease in the crude analysis, these associations were attenuated after controlling for each other and for other risk factors. The population attributable risks (PARs) for these factors were low (7-16%) owing to the high proportion of cases who were married and monogamous. The majority of women with microbiological evidence of infection had normal pelvic examinations. Clinical diagnostic algorithms for STDs in this population had a low sensitivity and positive predictive value. Nevertheless, a strong association between HIV seropositivity and STDs was observed. CONCLUSION: The low population attributable risks found in this study suggest that behaviour change messages directed to women, particularly if they are married have a low potential for preventing STDs. The poor performance of clinical diagnostic algorithms illustrates the desirability of testing these algorithms in a variety of populations and reinforces the need for low-cost methods of microbiologic diagnosis if populations with relatively low prevalences of these infections are to be included in programmes to diagnose and treat STDs.

Adolescent↗

Surgical management of radiated scalp in patients with recurrent glioma.

Patients with malignant brain tumors requiring multiple craniotomies and external beam radiotherapy are at risk of scalp wound breakdown secondary to fibrosis and radiation damage. We present three cases to illustrate the nature of the problem and the surgical approaches to scalp repair. When a bicoronal incision has been used for the initial craniotomy, the plastic repair can be performed with a bipedicle visor scalp flap and split-thickness skin graft to cover the pericranium at the donor site. When a curvilinear (U-shaped or horseshoe) flap has been used for the initial craniotomy, a single-pedicle flap may be rotated to achieve closure without tension. In anticipation of the risk of scalp wound breakdown in patients with malignant brain tumors, the planning of the operative incision for the first craniotomy needs to take into account the long-term viability of the scalp. We recommend linear scalp incisions parallel to the arterial distribution instead of the traditional curvilinear (U-shaped or horseshoe) flaps; linear incisions are less likely to break down, and in the event of breakdown, linear wounds offer better therapeutic surgical options for plastic repair.

Adult↗

Cotton fiber annexins: a potential role in the regulation of callose synthase.

Cotton fibers contain a characteristic set of proteins which interact with plasma membranes in a Ca(2+)-dependent manner. The association of these proteins with the membrane is correlated with a reduced level of UDP-glucose: (1-->3)-beta-glucan (callose) synthase activity. Analysis of the proteins released from membranes by EDTA treatment shows that the most abundant proteins comprise a family of at least three polypeptides (p34) which resemble annexins. This resemblance includes similarity in size (about 34 kDa), sequence homology, Ca(2+)-dependent precipitation or interaction with the plasma membrane, and ability to serve as a substrate for phosphorylation by endogenous protein kinase(s) which also bind to the membranes in a Ca(2+)-dependent manner. A purified fraction of these annexins binds to, and inhibits, the activity of a partially purified cotton fiber callose synthase. These findings suggest that one possible function of annexin(s) in plants is to modulate the activity and/or localization of callose synthase.

Amino Acid Sequence↗

811 Charnley hips followed for 3-17 years.

10-12 year survivorship analysis of 811 primary or conversion Charnley arthroplasties showed 89 percent probability of mechanical survival (revision excluding sepsis). The mechanical failure rate was 7 percent, and more stems required revision than sockets. The anterio-posterior radiographs of 630 unrevised hips, with a minimum 3-year follow-up, were evaluated using the CART system of terminology. Cement-bone radiolucency was present in 50 percent of sockets and 18 percent of stems. Substantial loosening was present in 6 percent with 94 percent probability of survival at 10-12 years.

Adolescent↗

Peritoneal dialysis with trained home nurses in elderly and disabled end-stage renal disease patients.

This study was designed to investigate trained home nurses in the care of elderly and disabled end-stage renal disease (ESRD) patients receiving peritoneal dialysis (PD) in all the patients who entered our home program between January 1989 and December 1992. We trained nursing staff from nursing agencies to do PD. A weekly nursing summary including daily vitals, PD flow sheet, medications, and progress notes was sent to the home program. The trained nurses were also utilized temporarily during acute deterioration of patients or partners resulting in the inability to do PD. Eleven patients were female, 10 were male, with a mean age of 62 years (range 30-81 years). Ten patients (48%) had diabetes mellitus. Thirteen patients performed continuous ambulatory peritoneal dialysis (CAPD) and 8 patients continuous cycling peritoneal dialysis. Five patients required home nurses temporarily for a period of 1-8 weeks until the patients became independent. Two patients were transferred to incenter hemodialysis, one because of insurance and one because of fungal peritonitis. One patient recovered renal function after 22 months of PD. Thirty-three episodes of peritonitis occurred over 417 patient-months (one episode/13 patient-months). Three patients needed catheter removal secondary to Candida peritonitis. Hospitalization rate and duration of stay were lower (1 admission/6 patient-months) than patient-months without home nurses (1/4 patient-months). The main causes of these admissions were diabetic complications (38%), cardiac disease (20%), and peritonitis (14%). In conclusion, our experience suggests that elderly and disabled patients on PD with home nurses have a favorable outcome even with multiple, comorbid conditions.

Adult↗

Peritoneal dialysis in elderly end-stage renal disease patients.

This study was designed to investigate the outcome of all elderly patients older than 65 who started peritoneal dialysis (PD) between January 1989 and December 1992. One hundred and twenty end-stage renal disease (ESRD) patients commenced PD at our institution between January 1989 and December 1992. All the patients who started, completed PD training, and remained on PD for more than one month were included in the study. Of these, 30 patients were elderly (more than 65 years old) with a mean age of 72 years (range 66-81 years). The total number of patient-months observed was 2035, of which the elderly represented 454 patient-months. Twenty-five percent (30 of 120 patients) were elderly. The causes of ESRD were diabetes mellitus in 6 patients (20%), glomerulonephritis in 6 (20%), atheroembolic disease in 4 (13.3%), hypertension in 2 (6.7%), and unknown etiology in 10 (33.3%) patients. Sixteen patients performed continuous ambulatory peritoneal dialysis (CAPD) and 14 patients continuous cycling peritoneal dialysis (CCPD). Five patients required private home nurses for multiple medical problems and for PD. Mean duration of peritoneal dialysis per patient was 15 months. Four patients were transferred to incenter hemodialysis, one each because of failure to thrive, insurance, catheter malfunction, and fungal peritonitis. One patient recovered renal function after 22 months of PD. Twenty-one episodes of peritonitis occurred over 454 patient-months (1 episode/22 patient-months). In conclusion, the elderly patients on PD have a favorable outcome even with multiple comorbid conditions.

Adolescent↗

Thrombocytosis in diabetic and nondiabetic end-stage renal disease patients on peritoneal dialysis.

This study was designed to measure blood platelet levels in patients on peritoneal dialysis (PD) and to compare platelet levels between diabetic and nondiabetic PD patients. Serial blood platelet levels were measured in 53 stable PD patients (32 male, 21 female; mean age 55 years; mean duration of PD 19 months) and 45 stable hemodialysis (HD) patients (30 male, 15 female; mean age 53 years; mean duration of HD 9 months) between January 1991 and July 1992. Twenty-four patients were diabetics, and 29 patients were nondiabetics receiving PD. Ten patients were diabetics, and 35 were nondiabetics receiving HD. Serial blood platelet levels were measured with an automated Coulter counter. Eighteen of 53 PD patients (34%) had platelet counts exceeding 300,000/mm3 for 6 months or longer. Thirteen of 24 diabetic PD patients (54%) had thrombocytosis. Blood platelets were significantly (p < 0.01) higher in diabetic (324 +/- 27 x 10(3)/mm3) than nondiabetic PD (236 +/- 11 x 10(3)/mm3) patients. No significant difference was observed in platelet count between diabetic type I (366 +/- 43 x 10(3)/mm3) and type II (282 +/- 29 x 10(3)/mm3) PD patients. A positive correlation was observed between blood platelet and serum cholesterol (r = 0.5, p < 0.001), blood platelet, and serum calcium (r = 0.4, p < 0.002), and blood platelet and WBC (r = 0.7, p < 0.001). No correlation was found with age or duration of PD. In conclusion, diabetic PD patients have elevated blood platelet levels that may contribute to occlusive vessel disease.

Calcium↗

Pulse intravenous calcitriol therapy of secondary hyperparathyroidism in peritoneal dialysis patients.

This study was undertaken to evaluate high-dose intravenous (IV) calcitriol therapy in chronic peritoneal dialysis (PD) patients. Nine stable chronic PD patients (7 male, 2 female, mean age 54 years) with secondary hyperparathyroidism and a mean duration of PD of 33 months, were studied for 6 months. Pulse calcitriol was administered IV in dosages of 4-8 micrograms every 2 weeks. Eight patients received oral calcitriol prior to IV pulse. Five patients were on continuous ambulatory peritoneal dialysis, and 4 patients were on continuous cycling peritoneal dialysis. Seven patients were on low-calcium dialysate (2.5 mEq/L) and 2 on high-calcium dialysate (3.5 mEq/L). All patients received calcium acetate or calcium carbonate to control hyperphosphatemia during the study. Mean serum parathyroid hormone N-terminal (PTHN) levels (35.4 +/- 9.5 pg/mL) decreased significantly from premean serum PTHN levels (79.7 +/- 10.4 pg/mL). No significant changes were observed in premean serum total calcium, ionized calcium, and phosphorus levels and posttherapy levels. No correlation was observed between serum PTHN and serum calcium, 1,25(OH)2D3, serum aluminum, and duration of dialysis. No significant difference in total body calcium and total body bone mineral density (BMD) was observed between pre and post study periods. In conclusion, biweekly IV calcitriol therapy is effective in suppressing secondary hyperparathyroidism in PD patients.

Adult↗

Happy now?

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Hospital-Patient Relations↗

A scoring system to determine radiological loosening in cemented total hip arthroplasty.

A radiological scoring system was developed to identify grades of loosening of the components of a cemented hip replacement. In grade 1, there are mild changes, usually of minor significance; in grade 2 moderate changes which need regular observation, and in grade 3 severe changes which indicate impending failure. Three parameters are used for the socket, giving a score of 10 points, and 5 for the stem, with a score of 15 points. This method can be used to provide a comparison between different series with a long-term follow up.

Evaluation Studies as Topic↗

Unilateral leg edema caused by abdominoscrotal hydrocele: elegant diagnosis by MRI.

A 5-month-old boy presented with bilateral hydroceles since birth and right leg edema. An ultrasound of the pelvis showed a 4-cm cystic mass that was diagnosed as a teratoma or cystic hygroma. Magnetic resonance imaging was performed, which showed a dumbbell shaped contiguous, fluid filled mass extending intraabdominally through the inguinal canal from the scrotum. The cystic portion in the right iliac fossa was lying on the right iliac vessels, which were patent. A bilateral hydrocelectomy was performed, and the intraperitoneal sac was completely excised through the inguinal incision. The edema of the right leg disappeared a few days after surgery.

Humans↗

Partial trisomy 19p: case report and natural history.

Partial trisomy 19p was noted in an infant delivered at 39 weeks gestation with intrauterine growth retardation (IUGR), bilateral club feet, renal abnormalities, hearing deficit, and multiple dysmorphic features. Chromosomes obtained following amniocentesis at 32 weeks gestation revealed that the fetus was partially trisomic for 19p and partially monosomic for a portion of the terminal band of 3q, having inherited a derivative chromosome 3 from her father [46,XX,-3,+der(3)t(3;19)(q29;p13.2)pat]. The father was found to be the carrier of a balanced translocation between chromosomes 3 and 19 [46,XY,t(3;19)(q29;p13.2)]. The only other case of partial trisomy 19p previously reported was an infant with partial trisomy 19p and partial monosomy 13q who died at 59 days of age. This report by Byrne et al. [(Am J Hum Genet 1980: 32:64A] is similar to our case with respect to IUGR, small palpebral fissures, and ear anomalies.

Adult↗