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Biomedical subjects

P Cahill

Publications and source records attributed to P Cahill.

At least 19 recordsLinked to original sources

Identification of the cystic fibrosis transmembrane conductance regulator domains that are important for interactions with ROMK2.

In addition to functioning as a cAMP-activated chloride channel, the cystic fibrosis transmembrane conductance regulator (CFTR) plays an important role in conferring regulatory properties on other ion channels. It is known, with respect to CFTR regulation of ROMK2 (renally derived K(ATP) channel), that the first transmembrane domain and the first nucleotide binding fold domain (NBF1) of CFTR are necessary for this interaction to occur. It has been shown that under conditions that promote phosphorylation, the ROMK2-CFTR interaction is attenuated. To elucidate the complex nature of this interaction, CFTR constructs were co-expressed with ROMK2 in Xenopus oocytes, and two microelectrode voltage clamp experiments were performed. Although the second half of CFTR can act as a functional chloride channel, our results suggest that it does not confer glibenclamide sensitivity on ROMK2, as does the first half of CFTR. The attenuation of the ROMK2-CFTR interaction under conditions that promote phosphorylation is dependent on at least the presence of the R domain of CFTR. We conclude that transmembrane domain 1, NBF1, and the R domain are the CFTR domains involved in the ROMK2-CFTR interaction and that NBF2 and transmembrane domain 2 are not essential. Lastly, the R domain of CFTR is necessary for the attenuation of the ROMK2-CFTR interaction under conditions that promote phosphorylation.

Animals↗

A novel sulfonylurea receptor family member expressed in the embryonic Drosophila dorsal vessel and tracheal system.

Sulfonylurea receptors (SURx) are required subunits of the ATP-sensitive potassium channel. SURx alone is electrophysiologically inert. However, when SURx is combined with an inward rectifier Kir6.2 subunit, ATP-sensitive potassium channel activity is generated. We report the identification, characterization, and localization of Dsur, a novel Drosophila gene that is highly related to the vertebrate SUR family. The Dsur coding sequence contains structural features characteristic of the ABC transporter family and, in addition, harbors 1.7 kilobases of a distinctive sequence that does not share homology with any known gene. When Dsur alone is expressed in Xenopus oocytes glibenclamide-sensitive potassium channel activity occurs. During Drosophila embryogenesis, the Dsur gene is specifically expressed in the developing tracheal system and dorsal vessel. Studies of the Drosophila genome support that only a single Dsur gene is present. Our data reveal conservation of glibenclamide-sensitive potassium channels in Drosophila and suggest that Dsur may play an important role during Drosophila embryogenesis. The lack of gene duplication in the Drosophila system provides a unique opportunity for functional studies of SUR using a genetic approach.

ATP-Binding Cassette Transporters↗

Oligosaccharides interfere with the establishment and progression of experimental pneumococcal pneumonia.

Oligosaccharides that block the adherence of bacteria to epithelial cells in vitro--lacto-N-neotetraose (LNnT) and its alpha2-3- and alpha2-6-sialylated derivatives--were tested for their abilities to attenuate the course of pneumococcal pneumonia and to prevent colonization of the nasopharynx in animal models. Intratracheal administration of these agents concurrently with bacteria dramatically decreased pneumococcal load in the lungs of rabbits and conferred protection from bacteremia. The oligosaccharides ameliorated pneumonia and bacteremia when given therapeutically 24 h after infection was established. When administered intranasally, neoglycoconjugates of the active oligosaccharides prevented colonization of the nasopharynx of infant rats. In addition to in vitro anti-adherence properties, LNnT acted directly on cultured lung epithelial cell lines to induce changes such that pneumococcal adherence was prevented for prolonged periods. These activities encourage continued development of oligosaccharides as a class of potentially preventive and therapeutic agents for infectious diseases.

Animals↗

Detection of Mycobacterium tuberculosis directly from sputum by using a prototype automated Q-beta replicase assay.

We have adapted an assay for the direct detection of Mycobacterium tuberculosis using a prototype automated instrument platform in which probes are amplified with Q-beta replicase. The assay was based on amplification of specific detector probe following four cycles of background reduction (reversible target capture) in a closed disposable pack. The assay signal was the time required for fluorescence to exceed background levels (response time [RT]). RT was inversely related to the number of M. tuberculosis rRNA target molecules in the sample. Equivalent signals and noises were observed in assays containing either sputum or buffer. All mock samples containing > or = 10 CFU of M. tuberculosis responded in the assay (average RT, 13.91 min), while most (83%) samples containing as many as 10(7) CFU of Mycobacterium avium gave no response during a 25-min amplification reaction. The samples containing M. avium which did respond had an average RT of 17.04 min. Seventy-five percent (167 of 223) of samples containing no target gave no responses; the remaining 25% had an average RT of 15.53 min. Eighty-three frozen sputum samples were tested to develop a candidate cutoff RT for the assay prior to more extensive clinical testing. After resolution of discrepant results and with a 14-min RT cutoff, 30 of 38 M. tuberculosis-positive samples were positive by the assay; 1 of 45 negative samples responded within 14 min. Assay sensitivity, specificity, and positive and negatives predictive values in this pilot study were 79, 98, 97, and 85%, respectively.

DNA Probes↗

Computed radiography in neonatal and pediatric intensive care units: a comparison of 2.5 K x 2 K soft-copy images vs digital hard-copy film.

OBJECTIVE: The goal of the study was to determine whether soft-copy images on high-resolution monitors (2.5 K x 2 K) are suitable for primary interpretation of images from pediatric and neonatal intensive care units. The hypotheses were that hard and soft images yield similar diagnostic information, and that both residents and faculty radiologists can use monitors effectively. Previous reports have produced conflicting results; the need for larger sample sizes has been emphasized. MATERIALS AND METHODS: One thousand one hundred and four images produced by computed radiography using the Kodak Ectascan Imagelink system were prospectively analyzed by two pediatric radiologists, one reading hard copy and the other soft copy of the same images. Bias was controlled by equal distribution of modalities between observers and by daily alternation of modality. Hard- and soft-copy observations of presence or absence of nine specific tubes and nine specific diagnostic findings were compared. Interobserver differences between pediatric radiologists and radiology residents were studied on additional images. The kappa statistic was used to evaluate the level of agreement for all observations. RESULTS: There was excellent agreement between hard and soft copy interpretation for each tube and diagnostic finding (kappa values 0.93-1.0) and excellent interobserver agreement between two pediatric radiologists (kappa values 0.84-1.0). The level of agreement between radiology residents and pediatric radiologist was excellent for the most objective findings. All results were statistically significant (p < 0.001). CONCLUSION: High resolution soft-copy images are suitable for primary interpretation in patients in pediatric and neonatal intensive care units.

Child↗

Penetration of the blood-brain barrier: enhancement of drug delivery and imaging by bacterial glycopeptides.

The blood-brain barrier restricts the passage of many pharmacological agents into the brain parenchyma. Bacterial glycopeptides induce enhanced blood-brain barrier permeability when they are present in the subarachnoid space during meningitis. By presenting such glycopeptides intravenously, blood-brain barrier permeability in rabbits was enhanced in a reversible time- and dose-dependent manner to agents < or = 20 kD in size. Therapeutic application of this bioactivity was evident as enhanced penetration of the antibiotic penicillin and the magnetic resonance imaging contrast agent gadolinium-diethylene-triamine-pentaacetic acid into the brain parenchyma.

Animals↗

Accuracy of mini peak flow meters in indicating changes in lung function in children with asthma.

OBJECTIVE: To assess whether mini flow meters used to measure peak expiratory flow can track changes in lung function and indicate clinically important changes. DESIGN: Comparison of measurements with a spirometer and different brands of mini flow meter; the meters were allocated to subjects haphazardly. SUBJECTS: 12 boys with asthma aged 11 to 17 attending boarding school. MAIN OUTCOME MEASURES: Peak expiratory flow measured twice daily for three months with a spirometer and at least one of four brands of mini flow meter. RESULTS: The relation between changes in lung function measured with the spirometer and those measured with the mini flow meters was generally poor. In all, 26 episodes (range 1-3 in an individual child) of clinically important deterioration in lung function were detected from the records obtained with the spirometer. One mini flow meter detected six of 19 episodes, one detected six of 15, one detected six of 18, and one detected three of 21. CONCLUSIONS: Not only are the absolute values of peak expiratory flow obtained with mini flow meters inaccurate but the clinical message may also be incorrect. These findings do not imply that home monitoring of peak expiratory flow has no place in the management of childhood asthma but that the values obtained should be interpreted cautiously.

Adolescent↗

Effect of radiation therapy on thoracic and lumbar bone marrow: evaluation with MR imaging.

Bone marrow suppression is often the limiting factor in the use of radiation therapy. In order to determine if MR imaging can be used to quantify bone marrow changes, we performed a serial prospective study of patients with lung cancer (six cases) and lymphoma (six cases). Quantitative and qualitative assessments of T1-weighted sagittal images, 750/33 (TR/TE), obtained at 0.6 T before, during, and after radiotherapy showed increased signal intensity in the radiated portions of the spine. These changes appeared as early as 2 weeks after the beginning of radiation, continued to increase until a maximum value was attained, and then persisted during the follow-up period of 2 years. A significantly higher (p less than .04) ratio of pretreatment to maximum posttreatment signal intensity was seen in patients with lymphoma than in those with lung cancer, and pretreatment values in patients with lymphoma were significantly lower (p less than .01). The lower pretreatment values found in the patients with lymphoma may have been due to the smaller amount of yellow marrow in these patients, who were significantly younger (33 vs 62 years). The higher ratio of pre- and posttreatment signal intensity may have been related to the larger amount of hematopoietic marrow available to undergo fatty replacement. The persistence of elevated signal intensity for as long as 2 years after radiation suggests an endpoint in the process of marrow conversion, but not reversal in the form of regeneration of hematopoietic bone marrow. Quantitative MR evaluation of bone marrow may be of considerable value as a noninvasive means of monitoring the effects of radiotherapy.

Adult↗

Polymerase chain reaction and Q beta replicase amplification.

The polymerase chain reaction (PCR) and Q beta replicase are two methods in which nucleic acid polymerases are used for amplification. Although these approaches share many similar problems concerning target contamination and probe specificity, they differ dramatically in their mechanisms of action and modes of application. The PCR method amplifies target sequences between two priming oligonucleotides and in essence amplifies a portion of the analyte. Q beta replicase, on the other hand, amplifies a specific template molecule hybridized to target sequences and therefore amplifies a signal component of the system. For this reason, Q beta replicase amplification has applications in areas other than for the detection of nucleic acid sequences. The requirements for application and the advantages of both PCR and Q beta replicase amplification are reviewed.

DNA-Directed DNA Polymerase↗

Effect of a psychiatric liaison program on consultation rates and on detection of minor psychiatric disorders in cancer patients.

Because only 2% of the 47% of cancer patients with psychiatric disorders receive psychiatric consultations, the authors investigated the impact of a psychiatric liaison program on improving consultation rates on a gynecologic oncology unit. Consultation rates for gynecologic cancer patients before and after introduction of the program were compared to rates from other cancer patients in the same hospital during the same 7-year period. Rates for the gynecologic patients were higher after the program (9%) than before (4%), as were rates for follow-up consultations, and the detection of minor DSM-III disorders improved. The authors conclude that liaison improves access to psychiatric treatments that often enhance the quality of life for seriously ill patients.

Female↗

Future tense.

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Delivery of Health Care↗

A system for on-line detection and resolution of radiolabeled DNA molecules and its application to automated DNA sequence analysis.

We describe a system for the real-time detection of radioactively labeled DNA molecules in gel matrix, and we demonstrate the application of this system to DNA sequence analysis. DNA sequencing reactions prepared by the Sanger chain termination method are resolved by electrophoresis on 8% polyacrylamide gels. During electrophoresis the 32P-labeled DNA fragments are detected by solid state detectors positioned 22 cm from the top surface of the gel. This system is able to resolve a DNA sequence of 300 bases or greater. Optimized protocols that allow sequence information to be obtained from single stranded and double-stranded templates are described. A linear relationship exists between the input dpm and the integrated peak values over a 20-fold range indicating that accurate DNA quantitation is also possible using this system.

Automation↗

Modeling faith, honesty, justice.

Administrators who model faith, which flows from an organization's values, will inspire employees and instill a sense of commitment. Actions that model faith include demonstrating hope and optimism, leading a prayer, discussing healing in biblical terms, and attesting to the importance of the ministry. If these behaviors are repeated at other managerial levels, ultimately employees will model them in their treatment of patients. In addition to faith, administration demands honesty, that is, a sharing of the whole story of an institution's activity. Managers need information not only about their own area of expertise but also about the activities of other hospital functions. Such information draws managers into a tighter circle of commitment, helps them to view their roles in a new light, and enables them to be more creative. Administration also demands a strong sense of justice, particularly the ability to terminate employees who are inappropriately placed in their jobs. Justice also calls administrators to assist bright, young colleagues in developing their gifts, for they will be the administrators of the future.

Christianity↗

Magnetic resonance imaging in the evaluation of leukocoria.

Leukocoria is an important clinical sign in ophthalmology. Conditions producing this white pupillary reflex must be differentiated from retinoblastoma to insure appropriate and timely treatment. Auxiliary diagnostic testing has been helpful in securing a clinical diagnosis. A new diagnostic modality, magnetic resonance imaging, provides similar morphologic information with the additional potential for biochemical characterization. A series consisting of 14 patients presenting with leukocoria as a result of retinoblastoma and simulating conditions was examined. The magnetic resonance imaging findings are discussed.

Child↗

Vascular specificity in differentiating adrenal carcinoma from renal cell carcinoma.

Cases of adrenal and renal cell carcinoma were reviewed to evaluate vascular origin and architecture. All 9 cases of adrenal carcinoma showed fine, sparse neovascularity. Coarse or at least extensive, neovascularity was demonstrated in 40 of 45 cases of renal cell carcinoma. An analysis of the angiographic features correlated with the known anatomical variations will nearly always enable one to ascertain the origin of the tumor.

Adenocarcinoma↗