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Biomedical subjects

R Baughman

Publications and source records attributed to R Baughman.

60 records · Page 4Linked to original sources
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Molecular genetic distinction of Pneumocystis carinii from rats and humans.

Pneumocystis carinii from rats and from humans were compared with respect to electrophoretic karyotype, presence of DNA sequences known to be repeated in rat-derived P. carinii, overall DNA sequence homology, and the sequences at two genetic loci. The organisms from each host species were different in each respect. Neither of two repeated DNAs from rat-derived P. carinii was found in the genome of human-derived organisms, and total DNA from rat-derived P. carinii failed to hybridize to human-derived P. carinii DNA. The sequences of the alpha-tubulin genes from the two P. carinii were strikingly different and the base composition of the alpha-tubulin gene from rat-derived P. carinii was rich in adenine and thymine, while the base composition of this gene from human-derived P. carinii was rich in guanine and cytosine. The sequence from the 18S rRNA gene of human-derived P. carinii was twice as divergent from that of rat-derived P. carinii as the sequence from the corresponding region of Candida albicans was from that of Candida tropicalis. These data show that rats and humans can harbor distinct types of P. carinii that are sufficiently different to suggest that P. carinii from the two hosts could be different species.

Amino Acid Sequence↗
PubMedDate not supplied

Nasal and sinus manifestations of sarcoidosis.

Nasal and sinus diseases are considered uncommon manifestations of sarcoidosis. We evaluated 159 consecutive patients with sarcoidosis for nasal symptoms. Sixty-three patients (39%) denied any nasal symptoms. Thirty-six patients (23%) had intermittent symptoms that lasted less than three weeks and required continuous intervention with nasal steroids or normal saline. Sixty patients (38%) were treated with nasal steroids and antibiotics for symptoms that lasted more than three weeks. Thirty-three patients (21%) had resolution of their symptoms after treatment with nasal steroids and antibiotics. Twenty-seven patients (17%) had symptoms that were unresponsive to three weeks of oral antibiotics and nasal steroids, and underwent CT scan. Based on the CT results, five patients underwent biopsy, which confirmed sarcoidosis. An additional patient who had a normal CT scan underwent a biopsy that was consistent with sarcoidosis. A retrospective review of 733 sarcoidosis patients was then performed, and an additional 12 patients were identified with biopsy-proven sarcoidosis. All of these patients required long-term therapy with prednisone (14 patients), methotrexate (13 patients), and/or azathioprine (8 patients). Our clinical study reveals a higher incidence of nasal and sinus disease in patients with sarcoidosis than has previously been described, and the recalcitrance of sarcoidosis when there is sinus involvement.

Adult↗
PubMedDate not supplied

Cytologic evaluation of bronchoalveolar lavage specimens in immunosuppressed patients with suspected opportunistic infections.

The role of bronchoalveolar lavage cytology in the diagnostic evaluation of immunosuppressed patients with suspected opportunistic pulmonary infections was evaluated by comparing two groups of patients who underwent fiberoptic bronchoscopy. Bronchoalveolar lavage specimens were compared with other available diagnostic techniques, including bronchial washings, bronchial brushings, transbronchial lung biopsies and open lung biopsy. Prior to the initiation of a protocol for bronchoalveolar lavage, a specific etiology for the pulmonary infiltrate using the above combined modalities was identified in 23 of 47 cases, for an overall diagnostic rate of 49%. The combined bronchial washings and brushings (cytologic procedures) identified a specific etiology in 9 of 47 (19%) of the cases. There were ten cases in which a cytologically identifiable organism (Pneumocystis, virus or fungus) was not present in the bronchial washings and brushings and one missed case of malignancy, for a false-negative rate of 23%. With the addition of the lavage technique and better sampling of the distal airways, a specific etiology for the pulmonary infiltrate was identified in 32 of 48 (67%) of the cases. This is comparable to the values of 40% to 65% cited in the literature for diagnosis of infectious disease by open lung biopsy. The lavage cytologic procedure identified a specific etiology in 22 of 48 (46%) of the cases, and the false-negative rate was reduced to 6%. With the excellent sampling of the bronchoalveolar lavage and the improved cytology results, the need for transbronchial or open lung biopsy has been eliminated in immunosuppressed patients with suspected opportunistic pulmonary infections. This allows these patients to be studied on an outpatient basis.

Biopsy↗