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Biomedical subjects

S McMillan

Publications and source records attributed to S McMillan.

At least 19 recordsLinked to original sources
PubMed2001

Effects of cyclosporin A administered into the airways against antigen-induced airway inflammation and hyperreactivity in the rat.

The immunosuppressant cyclosporin A given orally has anti-asthma properties but carries an undesirable risk of systemic effects. We administered cyclosporin A to Brown Norway rats either orally (p.o.) or topically by intratracheal (i.t.) instillation into the airways before inhaled antigen. Cyclosporin A suppressed the antigen-induced accumulation of activated (CD25+) CD4+ T lymphocytes and eosinophils in the lung, interleukin-5 mRNA expression in lung tissue and airway hyperreactivity. Intratracheal cyclosporin A suppressed cell accumulation at a 10-fold lower dose than that required orally. Minimum effective doses were 3 mg x kg(-1) i.t. and 30 mg x kg(-1) p.o. Intratracheal administration reduced the plasma concentration and systemic exposure compared with an equieffective oral dose, but the reduction (4-5-fold) was not as large as anticipated. Our data suggests that although topical administration to asthmatics would provide some potential for an improved safety margin, it may not offer any major advantage over existing oral therapy. However, the data clearly demonstrate that a novel immunosuppressant with similar anti-inflammatory properties but reduced potential for systemic effects would offer an attractive therapy for severe asthma.

Administration, Inhalation↗
PubMed2001

Predicting patient visits to an urgent care clinic using calendar variables.

OBJECTIVE: To develop a prediction equation for the number of patients seeking urgent care. METHODS: In the first phase, daily patient volume from February 1998 to January 1999 was matched with calendar and weather variables, and stepwise linear regression analysis was performed. This model was used to match staffing to patient volume. The effects were measured through patient complaint and "left without being seen" rates. The second phase was undertaken to develop a model to account for the continual yearly increase in patient volume. For this phase daily patient volume from February 1998 to April 2000 was used; the patient volume from May 2000 to July 2000 was used as a validation set. RESULTS: First-phase prediction equation was: daily patient volume = 66.2 + 11.1 January + 4.56 winter + 47.2 Monday + 37.3 Tuesday + 35.6 Wednesday + 28.2 Thursday + 24.2 Friday + 7.96 Saturday + 10.1 day after a holiday. This equation accounted for 75.2% of daily patient volume (p<0.01). Inclusion of significant weather variables only minimally improved the predictive ability (r(2) = 0.786). The second-phase final model was: daily patient volume = 57.2 + 0.035 Newdate + 52.0 Monday + 44. 2 Tuesday + 39.2 Wednesday + 30.2 Thursday + 26.5 Friday + 10.9 Saturday + 12.2 February + 3.9 March, which accounted for 72.7% of the daily variation (p<0.01). The model predicted the patient volume in the validation set within +/-11%. When the first-phase model was used to predict patient volume and thus staffing, the percentage of patients who left without being seen decreased by 18. 5% and the number of patient complaints dropped by 30%. CONCLUSIONS: Use of a prediction equation allowed for improved accuracy in staffing patterns with associated improvement in measures of patient satisfaction.

Colorado↗
PubMed2000

Comparison between African-American and white women in their beliefs about breast cancer and their health locus of control.

The purpose of this study was to examine the health beliefs of African-American and white women about breast cancer and locus of control, using the health belief model and the health locus of control construct. The Health Screening Questionnaire, developed by Sugarek, Deyo, and Holmes, was used to collect self-report data about health beliefs related to breast cancer and health locus of control. Participants included 197 white and 152 African-American women, between the ages of 19 and 93, recruited from various settings in central Florida. Significant differences were found between the two groups on all of the health beliefs about cancer items. The African-American women were significantly more likely to believe in chance, or to depend on powerful others for their health. Perceived susceptibility to cancer, doubts about the value of early diagnosis, and beliefs about the seriousness of breast cancer all were significantly associated with powerful other scores among African-American women. There was no relation between health beliefs and years of education for African-American women, but for white women, those with the least education were more likely to believe that death was inevitable with a cancer diagnosis. These results add to the information needed for the development of effective programs aimed at increasing breast cancer screening among African-American women.

Adult↗
PubMed1999

Integrated STS/YAC physical, genetic, and transcript map of human Xq21.3 to q23/q24 (DXS1203-DXS1059).

A map has been assembled that extends from the XY homology region in Xq21.3 to proximal Xq24, approximately 20 Mb, formatted with 200 STSs that include 25 dinucleotide repeat polymorphic markers and more than 80 expressed sequences including 30 genes. New genes HTRP5, CAPN6, STPK, 14-3-3PKR, and CALM1 and previously known genes including BTK, DDP, GLA, PLP, COL4A5, COL4A6, PAK3, and DCX are localized; candidate loci for other disorders for which genes have not yet been identified, including DFN-2, POF, megalocornea, and syndromic and nonsyndromic mental retardation, are also mapped in the region. The telomeric end of the contig overlaps a yeast artificial chromosome (YAC) contig from Xq24-q26 and with other previously published contigs provides complete sequence-tagged site (STS)/YAC-based coverage of the long arm of the X chromosome. The order of published landmark loci in genetic and radiation hybrid maps is in general agreement. Combined with high-density STS landmarks, the multiple YAC clone coverage and integrated genetic, radiation hybrid, and transcript map provide resources to further disease gene searches and sequencing.

Chromosome Mapping↗
PubMed1996

AIDS and ethnicity.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Instruments that measure beliefs about cancer from a cultural perspective.

Understanding beliefs about cancer from a cultural perspective is of great importance as the population mix of this country continues to shift and change. In order to assess the cancer beliefs held by diverse populations, culturally specific tools are needed. The purpose of this article is to identify and describe instruments that have been used to assess beliefs about cancer. Eight published and unpublished instruments were identified from a review of the literature. These tools address attitudes and beliefs toward cancer, cancer prevention, and cancer treatment within a variety of age groups and ethnic populations. One tool was related to adolescents, whereas the remainder focused on adults; three were translated into other languages; four tools involved questionnaire format and four interview format. Although it is encouraging to report that culturally specific tools are being developed, there is a demonstrated need to increase the expertise in developing such instruments.

Attitude to Health↗
PubMed1991

Validity and reliability of a pediatric hematology oncology patient acuity tool.

Appropriate use of nursing resources in the pediatric hematology and oncology inpatient settings demands a patient acuity system that is easy to use and accurate, and that objectively measures nursing care needs of a specialized patient population. Structured survey of 13 comprehensive cancer centers and a review of the literature show no valid and reliable acuity tools for this pediatric population. The purpose of this project was to study the validity and reliability of a newly developed pediatric hematology and oncology acuity system designed to quantify patient care needs. A new acuity tool for this pediatric population was developed based on the patient classification tool used at Johns Hopkins Hospital Oncology Center (JHHOC). The levels of care from the JHHOC tool were adopted, with therapeutic indicators modified to reflect nursing diagnoses relevant to the pediatric inpatient. Nursing care hours required for each level of care were also identified. Validity was studied using a content validity index (CVI). Experts from the pediatric unit where the tool would be used were asked whether each therapeutic indicator was assigned to the correct level of care (1 thru 5) based on patient care hours. CVIs for items ranged from .5 to 1.0; the overall CVI for the tool was .93. Interrater reliability was studied using two raters from the unit. Data were collected for 150 patient observations on a 12-bed pediatric hematology and oncology inpatient and short-stay outpatient unit. The resulting Pearson correlation coefficient was r = .97 (P less than .001).(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1991

Altered neuropeptide Y concentrations in specific hypothalamic regions of obese (fa/fa) Zucker rats. Possible relationship to obesity and neuroendocrine disturbances.

Neuropeptide Y (NPY) concentrations were measured by radioimmunoassay in eight microdissected hypothalamic regions of obese (fa/fa) and lean (Fa/?) Zucker rats. Freely fed obese rats showed significant (40-100%) increases in NPY concentrations in several regions, notably the paraventricular, ventromedial, and dorsomedial nuclei and the arcuate nucleus/median eminence, compared with lean rats. Hypothalamic NPY concentrations were not affected in either obese or lean rats by food restriction, which caused 25% weight loss over 3 wk. Refeeding to initial weight significantly increased NPY levels in the ventromedial and dorsomedial nuclei in lean rats but did not significantly alter NPY concentrations in any hypothalamic region in obese rats. These observations indicate fundamental differences in the regulation of hypothalamic NPY between obese and lean Zucker rats. NPY injected into the paraventricular nucleus and other regions causes hyperphagia, obesity, and increased secretion of insulin, glucagon, ACTH, and corticosterone. These behavioral and neuroendocrine abnormalities all occur in the obese Zucker syndrome and may be due to increased NPY-ergic activity in the hypothalamus.

Adrenocorticotropic Hormone↗
PubMed1990

Hb Iowa or alpha 2 beta 2(119)(GH2)Gly----Ala.

Hb Iowa with a Gly----Ala mutation at position beta 119(GH2) was observed in a Black infant and her mother. The baby was also heterozygous for Hb S; Hb Iowa was confused with Hb F at birth because its electrophoretic mobility was similar to that of Hb F1. The beta chain of Hb Iowa could be readily separated from the beta A, alpha, and gamma chains by polyacrylamide gel electrophoresis and by reversed phase high performance liquid chromatography. Structural characterization was through amino acid analyses of peptides isolated from a tryptic digest of the aminoethylated beta-Iowa chain. The Gly----Ala replacement in Hb Iowa does not affect its stability and oxygen carrying properties; hematological data for mother and child were within normal ranges.

Adult↗
PubMed1990

Increased interleukin 2 receptor expression in post-gestational women: relationship to impaired glucose tolerance and islet cell antibodies in pregnancy.

Fifteen women with positive islet cell antibodies were identified in a group of 115 consecutive patients found to have impaired glucose tolerance in pregnancy. These subjects were postulated to be at increased risk of later developing type 1 diabetes mellitus. They were examined post--partum for HLA types known to be associated with this disease and for any increase in Interleukin 2 receptor expression or alteration of T cell subsets of possible relevance to its pathogenesis. Fifteen women negative for islet antibodies and with normal glucose tolerance during previous pregnancy and 15 women with a normal fasting plasma glucose who had never been pregnant were studied as controls. Using flow cytometric techniques a significant increase in both the number and proportion of activated (Interleukin 2 receptor, CD25) lymphocytes in the peripheral blood of women who had islet cell antibodies and previous impaired glucose tolerance in pregnancy was found (0.14 +/- SE 0.03 x 10(9)/l; 7.1 +/- 1.1%) when compared with normal parous controls (0.09 +/- 0.01 x 10(9)/l; 4.2 +/- 0.6%), p less than 0.01 x 10(9)/l; showed significant increases when compared with nulliparous controls (0.04 +/- 0.01 x 10(9)/l; 2.1 +/- 0.2%), p less than 0.01. No differences were detected between the three groups with respect to total T-lymphocytes (CD3), helper T-lymphocytes (CD4), suppressor cytotoxic T-lymphocytes (CD8), or the inducer of suppressor (Leu 3+/Leu 8+) subset of T-lymphocytes. Three women persistently islet cell antibody positive, two of whom were HLA DR4, showed impaired glucose tolerance at the time of lymphocyte subset analysis, while two further patients, one DR3 and the other DR4, had developed type 1 (insulin-dependent) diabetes. No correlation between increased Interleukin 2 receptor expression and glucose intolerance was demonstrated. We conclude that islet cell antibody positive women with impaired glucose tolerance during pregnancy are at increased risk of later developing type 1 diabetes but that heightened immune activation present in these women is in part a post-pregnancy phenomenon.

Adolescent↗
PubMed1989

Pressure recovery distal to a stenosis: potential cause of gradient "overestimation" by Doppler echocardiography.

Doppler ultrasound is currently being widely applied to measure intracardiac pressure gradients noninvasively. In comparative invasive studies, it is generally assumed that pressure is effectively uniform distal to the stenosis. As the poststenotic jet expands, however, its velocity decreases, and pressure is recovered to the extent permitted by turbulence, so that the measured gradient will be lower if the distal catheter is positioned downstream from the vena contracta. This can lead to apparent Doppler "overestimation" of the pressure gradient because of this phenomenon of pressure recovery. This study demonstrates that pressure recovery can be important in a variety of clinical settings studied by in vitro models. Although most prominent in streamlined tunnels modeled after the obstruction in patients with hypertrophic cardiomyopathy, these effects are important even for central stenoses at physiologic flow rates. Because precise catheter position is not always known or controlled, these findings suggest an important advantage for Doppler gradient estimation, because it provides the maximal gradient at the vena contracta, which determines the load on the proximal chamber.

Cardiomyopathy, Hypertrophic↗
PubMed1988

Doppler flow velocity mapping in an in vitro model of the normal pulmonary artery.

Pulsed Doppler pulmonary artery velocity measurements are useful in evaluating a number of cardiac conditions including pulmonary hypertension, pulmonary stenosis and insufficiency, intracardiac shunts and other congenital abnormalities. However, variations in sample location relative to the arterial wall and valve have been thought to affect pulmonary artery velocity and acceleration measurements clinically. Therefore, pulsed Doppler and color flow mapping were performed in a pulsatile flow apparatus connected to a glass or Plexiglas model of the main pulmonary artery and its bifurcation, which contained a Hancock 29 mm pericardial tissue valve (5.35 cm2 orifice). Doppler sample volumes were placed at four sites: 1) at the pulmonary valve leaflet tips, centrally; 2) 2 cm distal to the leaflet tips, centrally; 3) 2 cm distal but laterally near the pulmonary artery wall; and 4) at the pulmonary artery bifurcation, centrally. Doppler peak flow velocity and acceleration time were measured. There was no difference between sites 1 and 2 in peak flow velocity or acceleration time. At site 3, peak flow velocity and acceleration time were both less than at site 1 (mean +/- SD, 85 +/- 44 versus 105 +/- 39 cm/s, p less than 0.005, and 162 +/- 65 versus 188 +/- 46 ms, p less than 0.03, respectively). Moreover, the pulmonary artery velocity contour at site 3 exhibited increased spectral dispersion and notching and increased variance on the color spectrum. At site 4, peak flow velocity was less than at site 1 (85 +/- 31 versus 105 +/- 39 cm/s, p less than 0.005), whereas pulmonary artery acceleration time was not significantly different. In this model, Doppler pulmonary artery flow velocity was best recorded within 2 cm of the valve and in the center of the vessel. Similar studies should be performed in the human pulmonary artery to standardize the recording technique and sample sites for Doppler measurements of velocity and acceleration.

Blood Flow Velocity↗
PubMed1986

Nucleotide sequence and derived amino acid sequence of a cDNA encoding human muscle carbonic anhydrase.

We report the nucleotide (nt) sequence of a full length cDNA clone, pCA15, which encodes the human muscle-specific carbonic anhydrase, CAIII. pCA15 identifies a 1.7-kb mRNA, which is present at high levels in skeletal muscle, at much lower levels in cardiac and smooth muscle and which appears to be developmentally regulated. The CAIII mRNA is distinguished by a 887-nt long 3'-untranslated region, containing two AAUAAA signal sequences and is longer than either of the mRNAs encoding the erythrocyte CAs, CAI and CAII, which each have relatively shorter 3'-untranslated regions, 360 and 670 nt long, respectively. The derived amino acid (aa) sequence for human CAIII shows 85% homology with ox CAIII, 62% homology with human CAII and 54% with human CAI when simple pairwise aa comparisons are made. We describe an allelic variation at a TaqI restriction site for CAIII which occurs at high frequency in the European population.

Amino Acid Sequence↗
PubMed1986

Hypervariable region peptides variably induce specific anti-idiotypic antibodies: an approach to determining antigenic dominance.

Rats and rabbits were immunized with synthetic peptides corresponding to the VH hypervariable regions of several alpha (1----3) dextran-specific antibodies from mice to study the efficacy of synthetic peptides in the generation of site-specific anti-idiotypic reagents. Synthetic peptides were made which corresponded to the HV1, HV2, and HV3 hypervariable regions of the heavy chain of M104 (IdX+, IdI-(M104)+), HV2 of HDex 14 (IdX-), and HV3 of J558 (IdX+, IdI(J558)+). The HV1(M104) peptide sequence is found in all dextran-specific immunoglobulins examined and the HV2 and the HV3 peptides span the regions implicated in IdX and IdI expression, respectively. Sera from many rabbits and rats indicate that all five peptides are immunogenic. Antisera to HV3 peptides show excellent binding to the appropriate myeloma proteins, with antisera to the HV3(M104) peptide demonstrating little binding to proteins that differ in HV3 sequence. Antisera generated against HV1(M104) and both HV2 peptides show weak cross-reaction to the appropriate proteins; however, these sera are not idiotypic because they cross-react with immunoglobulins with very limited sequence homology. Thus, it appears that some, but not all synthetic peptides from hypervariable regions will be capable of generating antisera with useful anti-idiotypic specificities. This may reflect differences in the intrinsic antigenicity of various parts of the VH region.

Amino Acid Sequence↗