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Biomedical subjects

N A Nelson

Publications and source records attributed to N A Nelson.

At least 37 records · Page 2Linked to original sources

Solvent nephrotoxicity in humans and experimental animals.

Evidence from human case reports, epidemiologic studies and animal experiments have suggested that exposure to organic solvents is associated with a wide spectrum of renal disorders, including tubular necrosis, interstitial disease, glomerulonephritis and neoplasia. This review summarizes what is known about solvent-induced renal damage in humans and experimental animals, with emphasis on hypothesized mechanisms by which this broad range of disorders may occur.

Animals↗

Does family history of breast cancer improve survival among patients with breast cancer?

Overall cancer mortality to December 1985 among 291 patients whose breast cancer was diagnosed between 1971 and 1974 and who were interviewed shortly after diagnosis was 39.9% (116 deaths). In this study population a positive maternal family history was strongly associated with breast cancer: The odds ratio for patients versus controls of having a mother with breast cancer was 3.32 (95% confidence limits 1.64 and 6.72); the odds ratio of having a mother, sister, or maternal aunt with breast cancer was 1.92 (95% confidence limits 1.27 and 2.91). However, family history was not associated with stage at diagnosis, which is the most important survival factor (53.6% of patients with a family history and 51.7% without were at a local stage at diagnosis). Survival was better, although not significantly so, among women with maternal relatives with breast cancer. The relative risk of dying of cancer, adjusted for confounding factors, was 1.40 for women without versus with a family history; the difference in survival was not statistically significant.

Adult↗

Optimal use of the cytocentrifuge for recovery and diagnosis of Pneumocystis carinii in bronchoalveolar lavage and sputum specimens.

To facilitate the diagnosis of Pneumocystis carinii from bronchoalveolar lavage and sputum specimens, we have defined conditions for optimal use of the cytocentrifuge for this purpose. Centrifugation in the cytocentrifuge at 1,200 rpm for 10 min yielded the best recovery of P. carinii. To reliably ensure complete absorption of the fluid specimen from the cytocentrifuge chamber, it was necessary to use two absorption filters simultaneously. Different methods of treating induced sputum with mucolytic agents to process sputum with the cytocentrifuge were tried. Results of these studies and our current method for treating sputa are discussed. Comparisons of slides prepared by traditional centrifugation and by cytocentrifuge processing showed the latter to be equally effective for detecting P. carinii. The most prominent advantage of the cytocentrifuge was the much smaller area to review and consequently the shortened time required to read the slides.

Animals↗

Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease.

The effects of broad-spectrum antibiotic and placebo therapy in patients with chronic obstructive pulmonary disease in exacerbation were compared in a randomized, double-blinded, crossover trial. Exacerbations were defined in terms of increased dyspnea, sputum production, and sputum purulence. Exacerbations were followed at 3-day intervals by home visits, and those that resolved in 21 days were designated treatment successes. Treatment failures included exacerbations in which symptoms did not resolve but no intervention was necessary, and those in which the patient's condition deteriorated so that intervention was necessary. Over 3.5 years in 173 patients, 362 exacerbations were treated, 180 with placebo and 182 with antibiotic. The success rate with placebo was 55% and with antibiotic 68%. The rate of failure with deterioration was 19% with placebo and 10% with antibiotic. There was a significant benefit associated with antibiotic. Peak flow recovered more rapidly with antibiotic treatment than with placebo. Side effects were uncommon and did not differ between antibiotic and placebo.

Aged↗

Mortality in a recent oil refinery cohort.

A retrospective cohort mortality study of 10,763 Amoco Corporation oil refinery workers employed between 1970 and 1980 showed low overall mortality; the standardized mortality ratio for all causes of death was 73 for white males and 68 for black males. White male mortality was examined by several exposure classifications devised for group cohort members by potential for exposure to refinery processes and exposure to two components of petroleum (light aromatic hydrocarbons and heavy oils). Statistically significant elevations were found in various exposure groups for skin cancers, digestive system cancers, and benign neoplasms. Of these, skin cancer mortality appeared to increase with increasing exposure.

Environmental Exposure↗

Determining exposure categories for a refinery retrospective cohort mortality study.

This paper describes and compares two methods used to assign exposure categories to 10,766 petroleum refinery employees included in an epidemiological study. The first scheme grouped individuals into six organization (OR) job groups: Administrative, Maintenance, Operations, Laboratory, General and Other. This scheme used "most common administrative department," as determined by computerized job histories. For the second classification scheme, "most common job title" and "most common plant location" were used to group individuals in four ways (IH codes): 1)job type (administrative, maintenance, operations and unknown); 2) contact with refinery processes; 3) exposure to light aromatics; and 4) exposure to heavy oils. Exposure categories for the latter three were none, occasional, routine and unknown. Comparison of the two schemes showed that OR job groups developed from administrative job histories were sometimes useful in classifying employees according to refinery exposures. While OR job groups were acceptable for employees clearly in managerial, maintenance or operations positions, IH codes provided more precise exposure profiles for these three relatively homogeneous groups. For individuals in laboratory positions and those with vague or unspecified department codes (23% of this cohort), the IH classification codes were necessary to group employees by job and exposure.

Humans↗

The pulmonary index. Assessment of a clinical score for asthma.

We used a clinical score, the pulmonary index (PI), in the emergency room assessment of children with acute asthma. The PI was derived from respiratory rate, wheezing, inspiratory-expiratory ratio, and use of accessory muscles. Patients were treated with a beta-adrenergic drug and were assessed before and at 15-minute intervals after treatment using clinical examination, PI, and spirometry. The PI before treatment correlated significantly with the mean percent of forced expiratory volume in the first second to forced vital capacity ratio. The PI 30 minutes after treatment correlated significantly with all tests of pulmonary function performed. The PI is a simple score that is easily derived from clinical observation.

Acute Disease↗

Additional studies on pregnancy termination and inhibition of the monkey corpus luteum with 5-oxa-17-phenyl-18,19,20-trinor-PGF1 alpha methyl ester and structurally related prostaglandins.

Oral administration of 5-oxa-17-phenyl-18,19,20-trinor-PGF1 alpha methyl ester (PGF-analog) resulted in a consistent and dose-dependent inhibition of corpus luteum progesterone production in nonpregnant rhesus monkeys concomitantly treated with human chorionic gonadotropin. Similarly, vaginal suppositories containing PGF-analog also inhibited the monkey corpus luteum. Side effects by the oral route of administration were minimal, whereas side effects following vaginal treatment with PGF-analog were higher. Five prostaglandins with structural similarity to PGF-analog were studied for their ability to inhibit the monkey corpus luteum, but none showed an advantage over the parent molecule. PGF-analog did not synergize with 9-deoxo-16,16-dimethyl-9-methylene-PGE2 for the inhibition of the monkey corpus luteum, nor did it synergize with (15S)-15-methyl-PGF2 alpha methyl ester for the interruption of early pregnancy in the monkey. 9-Deoxo-9-methylene-5-oxa-17-phenyl-18,19-20-trinor-PGE1 methyl ester did not terminate early gestation in the monkey at doses of 8 or 24 mg.

Abortifacient Agents↗

Use of company stock ownership records to locate subjects lost to follow-up.

When 10,766 members of a refinery retrospective cohort study were assessed for vital status using conventional company and Social Security Administration records, the status of 370 remained unknown. Computerized corporate files of shareholder information yielded current addresses for 243 of those lost to follow-up, and through Directory Assistance, telephone numbers were obtained for 152. Vital status was ascertained by telephone for 146 of the 370 members of the cohort whose status had been unknown.

Computers↗

Inhaled salbutamol (albuterol) vs injected epinephrine in the treatment of acute asthma in children.

In a double-blind trial we compared the efficacy and safety of inhaled salbutamol (albuterol), nebulized with oxygen by face mask, and subcutaneous epinephrine in 40 children with acute asthma. No significant difference between salbutamol and epinephrine was seen at any time for clinical score, respiratory rate, heart rate, blood pressure. PaO2, PaCO2, FVC, FEV1, FEV1/FVC, or FEF25-75%. PaO2 remained unchanged after salbutamol but increased significantly (P less than 0.05) after epinephrine. No significant difference occurred between the groups for repeat treatment, admission on initial visit, return to emergency room, admission on return, or total admissions. Significantly (P less than 0.01) increased adverse effects were seen within the group given epinephrine. We conclude that inhaled nebulized salbutamol and subcutaneous epinephrine are equally effective. In view of the lack of adverse effects and noninvasiveness of inhaled salbutamol, we recommend its use for the treatment of acute asthma in children.

Acute Disease↗

Cell-mediated immune response in gonococcal infection.

A peripheral leukocyte migration inhibition test has been used to demonstrate cellular immunity to a protein component of Neisseria gonorrhoeae. Human leukocytes served as effector cells in an agarose method to distinguish antigen-sensitive from nonsensitive individuals. Leukocytes, preincubated with antigen, were placed in wells in medium 199 agarose. After 18 h of incubation the migration index was calculated by dividing the area of migration of cells preincubated with antigen by the area of migration of the control cells. Significant migration inhibition was demonstrated for 16 of the 30 patients with uncomplicated gonorrhoea. Maximum inhibition was obtained 7-10 days following the onset of symptoms and the duration of the response varied from 14 to more than 40 days. There was a statistically significant positive correlation between the number of previous infections and migration inhibition. A control group, which included individuals with Neisseria meningitidis infection, showed an insignificant response to this gonococcal antigen. Although these results indicate the presence of cell-mediated immunity, the significance of this response in the protection of the host or in the pathogenesis of gonococcal disease has yet to be determined.

Adolescent↗

The maximum expiratory flow-volume curve with air and a low-density gas misture. An analysis of subject and observer variability.

The subject and intra- and inter-observer variability of three measurements derived from the maximal expiratory flow-volume (MEFV) curve with air and helium-oxygen (HeO2) mixture was determined in ten normal subjects who produced curves in the morning and afternoon of three consecutive days and again on one day a month later. The measurements examined were the maximum flow at 50% vital capacity (V50), the percentage increases in V50 when breathing the He-O2 mixture (delta V50), and the volume at which the curves on air and He-O2 first meet or intersect (VisoV). The delta V50 and VisoV were shown to have a greater degree of variability than the V50 and, in the case of VisoV, this was contributed to significantly by the observer variability. The within-subject variability of the delta V50 and VisoV was so great that the usefulness of these tests in following changes in lung function of individual patients must be questioned.

Adult↗

Evidence for the role of the maternal immune system in balancing the sex ratio in mice.

Two experiments have been conducted to verify the effect of maternal preimmunization to H-Y antigen on the secondary sex ratio in C57Bl/6 mice. In accord with the theoretical model previously proposed, it was found that extensive immunization to H-Y antigen following splenectomy resulted in a significant increase in sex ratio (males/females) without affecting litter size. Litter size was also not correlated to sex ratio. The data from both experiments suggest that splenectomy alone or restimulation to H-Y antigen (after 30 days) both act to decrease sex ratio. It is concluded that the maternal immune system plays a limited, but significant, role in maintaining the normal sex ratio in mice.

Animals↗

Synthesis and biological activity of 9-deoxo-9-methylene and related prostaglandins.

A number of PGE analogs have been synthesized in which the C-9 carbonyl group has been replaced by an exo-methylene group. These chemically stable 9-deoxo-9-methylene-PGEs exhibit biological profiles very similar to their less stable PGE relatives. 9-Deoxo-16,16-dimethyl-9-methylene-PGE2 (7) retains the useful uterine-stimulating potency of 16,16-dimethyl-PGE2 but is approximately 300 times less enteropooling in the rat. In preliminary clinical trials, 7 has shown efficacy for pregnancy termination by the oral and vaginal routes of administration, as well as relative freedom from gastrointestinal side effects.

16,16-Dimethylprostaglandin E2↗