Biomedical subjects
Publications and source records attributed to S Berman.
Breast calcification is an important mammographic finding. The appearance and pattern of calcification may be quite specific, reflecting either benign or malignant disease. This article describes an unusual pattern of calcification seen in secondary hyperparathyroidism, which is necessary to recognize because of its benign nature.
Explore the source record for details and available documents.
A stable mouse-cell hybridoma was obtained that secretes an IgA monoclonal antibody reactive with the fraction 1 (F1) envelope antigen of Yersinia pestis. Titres of the antibody typically ranged from 1:32 768 to 1:65 536 in mouse ascitic fluids.The monoclonal antibody formed a line of precipitation when run against F1 antigen in Ouchterlony gel diffusion tests. In tests of 235 strains of Y. pestis, lines of identity occurred between the precipitates formed with a solution of purified F1 antigen and the F1 antigen produced by the plague strains. No precipitates formed for 65 strains that were incapable of elaborating F1 antigen. Specificity of the monoclonal antibody for strains of Y. pestis producing F1 was also indicated by negative results for 50 yersinia strains other than Y. pestis tested by an ELISA that used the antibody to capture antigen.Experiments to determine the shelf-life of the antibody were conducted over 3-4 years. When the monoclonal antibody was freeze-dried in vials, titre was retained for three years when the vials were stored at -70 degrees C but only for two months when they were stored at ambient temperatures. When the antibody was freeze-dried in wells of ELISA plates, sensitivity of the plates for capture of F1 antigen was preserved for four years when the plates were stored at -70 degrees C compared with two weeks for plates stored at room temperature. When a solution of the antibody was sealed in wells of ELISA plates and refrigerated at 4 degrees C, reactivity of the antibody and sensitivity of the plates were retained for a year.Alternatives for the application of this monoclonal antibody in ELISA and other plague diagnostic procedures are discussed.
Explore the source record for details and available documents.
A 10.9-cm diameter, copper ellipsoid was electrically heated to provide a simulation of sensible heat transfer from a newborn infant. The use of this simulator to determine mean radiant temperature and convective heat-transfer coefficient was demonstrated in three commercial incubators: the Isolette (Model C-86, Narco/Air Shields); the Armstrong Care-ette (Ohio Medical Products); and the I. C. (Ohmeda). The relative performance of these environmental therapeutic devices in shielding an infant against radiant heat loss was judged by the deviation of mean radiant temperature from incubator air temperature, which was varied from 32-36 degrees C. Whereas the I. C. incubator exhibited a radiant temperature always 0.5 degrees C less than air temperature, the Care-ette incubator showed radiant temperatures of 4.0-5.5 degrees C below air temperature, and the Isolette displayed radiant temperatures of 2.7-4.7 degrees C (inner wall removed) and 2.0-3.8 degrees C (inner wall inserted) below air temperature. The relative performance of the incubators in preventing convective heat loss was judged from the magnitude of the convective heat-transfer coefficient, hv. The I. C. incubator had an hv = 4.52 W/m2/degrees C; the Care-ette, 5.55 W/m2/degrees C; and the Isolette 7.19 W/m2/degrees C (inner wall removed) and 6.23 W/m2/degrees C (inner wall inserted). Although an ellipsoid simulator is not an anatomically correct substitute for an infant, it does provide a reliable and convenient comparison of steady-state heat transfer characteristics of alternative environmental devices.
Prednisone for seven days plus the combination drug sulfamethoxazole and trimethoprim for 30 days was assessed in treating chronic middle-ear effusion present for at least eight weeks. Pneumatic otoscopy, tympanometry, and audiology at entry into the study, and one week and one month after therapy, documented the status of the middle-ear effusion. Clearing in both ears or in one when only one was involved was called complete resolution; clearing in one of two affected ears was called partial resolution. In the initial open trial, 13 of 24 patients experienced partial or complete resolution one month after therapy. Subsequently, 28 patients were enrolled in a randomized, double-blind, placebo-controlled clinical trial in which patients whose effusion failed to clear were crossed over to the alternative regimen. In this trial, ten treated children (71%) experienced partial or complete resolution one month after therapy compared with three (21%) in the control group. Patients enrolled in both trials whose effusion cleared were followed up monthly for six months. Seven of 29 patients required referral for ventilation tubes.
Explore the source record for details and available documents.
We genetically modified attenuated Salmonella typhi strain Ty21a to express the form I O polysaccharide antigen of Shigella sonnei. Three doses of this bivalent, live oral vaccine strain (1-8 X 10(9) organisms/dose) were given to young adults who, along with unvaccinated controls, were challenged one month later with pathogenic S. sonnei. The vaccinees had 40% protection against diarrhea and 56% against Hematest-positive diarrhea. Two of three vaccine lots provided higher levels of protection (53% against diarrhea and 71% against Hematest-positive diarrhea), but the third lot, prepared for a large-scale field trial, demonstrated no protective efficacy. Vaccinees had serum and local intestinal immune responses to S. sonnei lipopolysaccharide, and the presence of specific serum IgA or IgG antibody before challenge with pathogenic S. sonnei was correlated with protection from illness. Some lots of this bivalent vaccine strain provide significant protection against S. sonnei disease, but the problem of lot-to-lot variability must be overcome.
Explore the source record for details and available documents.
Anti-CRP and complement treatment of human peripheral blood lymphocytes significantly reduces natural killer (NK) cell-mediated cytotoxicity to K562 target cells as well as to MOLT-4 target cells. Although not all activity is eliminated by treatment of effector cells with antibody and complement, the reduction of NK function indicates that C-reactive protein (CRP) is present on a significant proportion of NK cells. Higher concentrations of anti-CRP or anti-CRP F(ab')2 fragments also reduce NK function; this suggests that CRP is not only present on these effector cells but may also play a role in NK-mediated killing. We initially suspected that CRP-ligand interactions might be involved in effector-target cell recognition. Several lines of evidence suggest that this is not the case. While F(ab')2 anti-CRP will block NK function, Fab anti-CRP will not, suggesting that the NK response is not impaired when surface CRP (S-CRP) is blocked but is only inhibited when the S-CRP is cross-linked and modulated. Neither CRP-C polysaccharide complexes (CRP-CPS) nor concentrations of CPS ranging from 0.1 microgram/ml to 200 micrograms/ml have any effect on NK cell-mediated killing. Treatment of target cells with a ligand for CRP or CRP prior to co-culture with NK effectors does not augment NK function. Single cell assays clearly demonstrate that high concentrations of anti-CRP have no effect on the formation of effector-target cell conjugates. Although these concentrations of anti-CRP do not block effector-target cell conjugation in the single cell assay, they do block the killing of conjugated target cells. In total, this evidence strongly suggests that although CRP appears to be involved in NK-mediated killing, it is not involved in effector-target cell-mediated recognition.
C-reactive protein (CRP) is an acute-phase reactant that is found bound to cells at sites of inflammation. We have passively sensitized HEp-2 cells for CRP binding and examined the effect of this treatment on complement activation and cell lysis. When cells were treated with protamine sulfate and CRP and were incubated with normal human serum in a 4-hr 51Cr-release assay, no significant lysis was noted. In contrast, HEp-2 cells treated with antibody and normal human serum were lysed. The consumption of complement components in normal human serum after incubation with cells treated with protamine and CRP was measured by hemolytic assays. CRP-treated cells consumed over 80% of C1, C4, and C2 and about 40% of C3 present. No significant consumption of C5 through C9 components was observed. Cells treated with antibody and complement showed consumption of C1 through C9. Cells were also sensitized for CRP binding by using diazophenylphosphocholine. This treatment also led to CRP binding and activation of the early classical pathway (C1, C4, C2, and to a lesser extent C3). The components of the membrane attack complex (C5 through C9) were not activated. Both a mouse monoclonal IgM and a human IgG antibody to phosphocholine activated the entire classical pathway. These results indicate that CRP activation of the classical complement pathway is restricted to the early part of the pathway. In the absence of activation of the membrane attack complex, complement-mediated cell lysis cannot occur.
Explore the source record for details and available documents.
Children with mild acute gastroenteritis have not been observed for specific evidence of lactose intolerance yet are frequently fed a nonlactose formula. To determine whether such intervention is justified, 85 infants with mild acute gastroenteritis were followed prospectively. Infants were blindly and randomly assigned to 20 calorie/oz formula containing one of four carbohydrates: lactose, sucrose, polycose, or combined sucrose-polycose. Daily diaries were kept by parents, and patients were reexamined on days 2, 7, and 14 of the study. Evidence for rotavirus was detected in 23 infants, and five had bacterial pathogens. Symptoms resolved in most patients within 7 days, but five infants were subsequently hospitalized. Stool frequency, weight gain, and need for hospitalization did not differ significantly among the groups. Recovery from mild acute gastroenteritis occurred within 2 weeks irrespective of carbohydrate ingested.
The form-1 antigen of Shigella sonnei was transferred to the avirulent Salmonella typhi strain 21a and the resulting 5076-1C transconjugate strain was tested for safety and immunogenicity as a candidate oral vaccine. The transconjugant strain was shown to be well tolerated and safe in 19 human volunteers who were fed from 1 X 10(7) to 1 X 10(10) organisms. Only two of 10 volunteers tested had developed a rise in antibody titer to the lipopolysaccharide of the hybrid 5076-1C strain.
The records of off-hours calls received by the University of Colorado Pediatric Group Practice from 4:30 p.m. throughout 8:00 a.m. weekdays and all day Saturday, Sunday, and holidays were audited. An answering service and pageboy system ensured 24-hour, 7-day-a-week accessibility through a single telephone number. The four practices received 2386 after-hours calls from November 1978 to October 1980. An average of 104 calls per month were received with approximately four calls per day on weekday evenings and six calls per day on Saturday, Sunday, and holidays. Five concerns accounted for 49 percent of all after hours calls: fever, vomiting and/or diarrhea, upper respiratory infection (URI), earache, and rash. While 75 percent of families made fewer than four calls per year, 4 percent made at least 12 calls per year, accounting for 18 percent of all calls. Families calling three or more times a month were defined as "frequent users" and accounted for 22 percent of a given month's calls. Most calls from the same families (55%) occurred within a 24-hour period and dealt chiefly with parental concerns about fever, vomiting and diarrhea, URIs, ear infection, accident, and rashes. The additional responsibility that residents assume in taking calls for the Pediatric Group Practice while on other off-hour assignments was not excessively demanding, and cost of the answering service was easily absorbed by group practice revenues.
Because the illness erodes and destroys an individual's humanness and personality, patients and families affected by Alzheimer's Disease have particularly critical needs for help with its psychosocial sequelae. This article develops a model of psychosocial management and details specific interventions to help patients and caregivers develop and maintain adaptations during the long course of the disease.
The otitis-prone child is frequently encountered by the family practitioner. Current concepts of epidemiology, pathophysiology, and management of persistent and recurrent middle ear effusions are reviewed.
The relationships between age, religious orientation, and perception of death are investigated utilizing a sample of 1428 respondents randomly selected from two larger representative national samples. Although a statistically significant relationship is found between religion and perception of death, when age is introduced as a control the relationship remains only among young adults. The finding that religion mitigates concerns about death concurs with results found in previous studies. The data relative to young adults, however, suggest the need for a broader conceptualization of the relationship between death anxiety and religion, which incorporates developmental influences over the adult life cycle.