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T Sullivan

Publications and source records attributed to T Sullivan.

At least 37 records · Page 2Linked to original sources

Trimethoprim/sulfamethoxazole incremental dose regimen in human immunodeficiency virus-infected persons.

BACKGROUND: The mechanism of tolerance to incremental doses of trimethoprim-sulfamethoxazole given to human immunodeficiency virus-infected persons who have had a prior intolerance to this agent has not been studied. OBJECTIVE: We prospectively evaluated a regimen of incremental doses of oral trimethoprim-sulfamethoxazole in human immunodeficiency virus-infected persons who had a prior trimethoprim-sulfamethoxazole-induced fever and nonexfoliative skin rash to investigate the mechanism by which it permits tolerance. METHODS: Oral trimethoprim (0.00004 mg)/sulfamethoxazole (0.00002 mg) was given to 22 human immunodeficiency virus-infected persons on day 1 and gradually increased over eight days to 1 double strength (DS) tablet/day in an outpatient setting. At study entry, skin tests and IgG antibodies to sulfa were performed; the latter was repeated at study week 4. RESULTS: Nineteen patients tolerated trimethoprim/sulfamethoxazole at the completion of the 8-day protocol (86% effective). Moderate toxicities occurred in eight persons during the desensitization protocol; five of these were able to continue trimethoprim/sulfamethoxazole with adjunctive prednisone. Skin tests to sulfa antigen were negative in all persons. Eleven patients at study entry had antibodies to sulfamethoxazole; IgG antibodies appeared at week 4 in 8 of the 11 patients who initially had no antibody detected. CONCLUSIONS: The mechanism of tolerance to the incremental doses of trimethoprim/sulfamethoxazole given to previously intolerant human immunodeficiency virus-infected persons is not due to desensitization and remains undetermined.

Administration, Oral↗

A novel in situ double-labeling method for simultaneous detection of mRNA and expressed protein or two different mRNAs.

We have developed a novel double-labeling method to investigate multiple gene expression in single cells. The method relies on the use of a radioactive probe followed by a colorimetric probe. Unique to this method, the radioactive signal is first captured on an emulsion pre-coated slide, which totally separates it from the process of color development and prevents any interference with the radiolabeled probe. We cite two applications of the new procedure: (1) to study the correlation between acetylcholine receptor (AChR) alpha-subunit mRNA and protein expression in cultured chick myoblasts and (2) to investigate the co-expression of (AChR) alpha and gamma mRNAs in nascent myotubes. In the former case, the radioactive signal is generated by incubation of live cells with 125I-alpha-bungarotoxin, in the latter, by an in situ hybridization (ISH) with 35S-labeled DNA probe. Colorimetric labeling is accomplished in a second step by ISH using digoxigenin-labeled oligos. Analysis of 203 myoblasts showed that AChR alpha-subunit protein and mRNA are co-expressed. Examination of 4-day-old myotubes suggested that most, but not all, nuclear clusters co-express alpha and gamma mRNAs. These results demonstrate that the described protocol has high sensitivity and specificity for detection of protein and message, or two different mRNAs on a single cell level.

Alkaline Phosphatase↗

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Cross-Sectional Studies↗

Myoblast and myotube nuclei display similar patterns of heterogeneous acetylcholine receptor subunit mRNA expression.

Muscle progenitor cells differentiate to myoblasts, and subsequently myotubes, upon expression of muscle specific genes. We and others have previously shown that myotube nuclei, even in the absence of nerve, express AChR alpha subunit RNA at varying levels, with a small subset (about ten percent) of the nuclei expressing at high levels. These findings raised two important questions: 1) is the observed heterogeneity a unique property of the alpha subunits, and 2) when does the heterogeneity begin? In particular, is it induced only at or after the time of fusion, or does it exist at the myoblast stage? We have, therefore, extended our observations to the gamma and delta subunits and we also have examined the distributions of AChR alpha, gamma, and delta subunit RNAs in both myoblasts and myotubes. We used intron and intron-exon probes to detect prespliced transcripts or mature mRNAs in the cells. Because intron-containing transcripts are not transported out of the nuclei, the distributions of these transcripts can indicate their expression patterns among nuclei in the same myotubes. Our results show that both myotubes and myoblasts have distributions of the AChR alpha, gamma, and delta subunit RNAs which differ sharply from that of the U1 RNA or Myo D. Thus, the heterogeneous expression of AChR genes is not only an intrinsic property of muscle cell nuclei (in the sense that it does not require the presence of nerves), but it also exists prior to fusion. Our results suggest that muscle nuclei attain individualized capacities for AChR subunit mRNA production early in their development. Conceptual models consistent with such individuality imply an additional level of regulation beyond the known diffusible transcriptional factors.

Animals↗

Encephalitogenic T lymphocytes develop from SJL/J hematopoietic cells transplanted into severe combined immunodeficient (SCID) mice.

Previously, we constructed chimeras by injecting hematopoietic cells from experimental autoimmune encephalomyelitis (EAE)-susceptible SJL (H-2s) strain mice into severe combined immunodeficient (SCID) C.B-17scid/scid (H-2d) mice. These SCID mouse-SJL mouse hematopoietic cell chimeras developed passive EAE following adoptive transfer of PLP S139-151-specific SJL T lymphocyte line cells, but were resistant to active EAE induced by primary immunization with PLP S139-151. In order to gain an understanding of the encephalitogenic potential of transplanted hematopoietic progenitors in SCID mouse-SJL mouse chimeras, we attempted to induce EAE in hematopoietic chimeras constructed with or without an additional SJL fetal thymus implant. Chimeras with the thymus implant were susceptible to passive and active EAE while chimeras without the thymus implant were susceptible to passive but not active EAE. Encephalitogenic, CD4+, TCR+ T lymphocytes were selected in vitro from PLP S139-151-immunized, thymus-implanted chimeras. These results showed that hematopoietic SJL progenitors developed into antigen-presenting accessory cells and immunocompetent encephalitogenic T lymphocytes following transplantation into SCID mice. The development of primary immune reactivity depended on a fetal thymus implant for expression in SCID mouse-SJL mouse chimeras.

Amino Acid Sequence↗

Primary extramedullary plasmacytoma of the orbit.

BACKGROUND: We report a case of extramedullary plasmacytoma of the orbit. This is a rare tumour which has uncommonly presented in the orbit. CASE REPORT: A 58-year-old woman presented with painless proptosis, upper lid swelling and ptosis. Incisional biopsy was performed. Clinical findings and investigations were correlated to establish the diagnosis. Treatment consisted of 35 Gy external beam radiotherapy. CONCLUSIONS: This condition is considered to be of low grade malignancy and as such can be regarded as a separate entity to multiple myeloma involving the orbit or solitary myeloma of bone in terms of treatment and prognosis.

Biopsy↗

Generalized nonconvulsive status epilepticus after electroconvulsive therapy.

Status epilepticus is a rare complication of conventional single-stimulus electroconvulsive therapy (ECT). We report a case of ECT-induced nonconvulsive generalized status epilepticus (NGS) that lasted 3.5 days. The patient showed regressed psychotic behavior coupled with waxing and waning mutism and unresponsiveness as well as subtle unilateral motor signs. The diagnosis of NGS requires electroencephalographic confirmation.

Adult↗

Evidence that CYP2C19 is the major (S)-mephenytoin 4'-hydroxylase in humans.

The present study assesses the role of members of the human CYP2C subfamily in the 4'-hydroxylation of (S)-mephenytoin. When recombinant CYP2C proteins were expressed using a yeast cDNA expression system, 2C19 stereospecifically 4'-hydroxylated (S)-mephenytoin with a turnover number at least 10 times higher than that of human liver microsomes. 2C9 (both Ile359 and Leu359 alleles) and 2C18 (Thr385 and Met385 alleles) metabolized this substrate at a rate 100-fold lower than 2C19, and metabolism by these 2C proteins was not stereospecific for the S-enantiomer. 2C8 exhibited very little mephenytoin 4'-hydroxylase activity. In contrast, the Ile359 allele of 2C9 had a high turnover number for the hydroxylation of tolbutamide, while the Leu359 allele was less active toward this substrate. Immunoblot analysis of 16 human liver donor samples indicated that (S)-mephenytoin 4'-hydroxylase activity correlated with the hepatic CYP2C19 content, but it did not correlate with the hepatic content of CYP2C9. Moreover, direct sequencing of the polymerase chain reaction (PCR) products of 2C9 mRNA from six of these human livers through areas of known allelic variations indicated that the identity of the allele of 2C9 (Cys144 vs Arg, Tyr358 vs Cys, Ile359 vs Leu, or Gly417 vs Asp) did not appear to influence (S)-mephenytoin 4'-hydroxylase activity in these samples. These data indicate that 2C19 is the principal determinant of (S)-mephenytoin 4'-hydroxylase activity in human liver.

Aryl Hydrocarbon Hydroxylases↗

Rat embryo cells immortalized with transfected oncogenes are transformed by gamma irradiation.

Cesium-137 gamma rays were used to transform rat embryo cells (REC) which were first transfected with activated c-myc or c-Ha-ras oncogenes to produce immortal cell lines (REC:myc and REC:ras). When exposed to 6 Gy of 137Cs gamma rays, some cells became morphologically transformed with focus formation frequencies of approximately 3 x 10(-4) for REC:myc and approximately 1 x 10(-4) for REC:ras, respectively. Cells isolated from foci of gamma-ray-transformed REC:myc (REC:myc:gamma) formed anchorage-independent colonies and were tumorigenic in nude mice, but foci from gamma-ray-transformed REC:ras (REC:ras:gamma) did not exhibit either of these criteria of transformation. Similar to the results with gamma irradiation, we observed a sequence-dependent phenomenon when myc and ras were transfected into REC, one at a time. REC immortalized by ras transfection were not converted to a tumorigenic phenotype by secondary transfection with myc, but REC transfected with myc were very susceptible to transformation by subsequent ras transfection. This suggests that myc-immortalized cells are more permissive to transformation via secondary treatments. In sequentially transfected REC, myc expression was high whether it was transfected first or second, whereas ras expression was highest when the ras gene was transfected secondarily into myc-containing REC. Molecular analysis of REC:ras:gamma transformants showed no alterations in structure of the transfected ras or of the endogenous ras, myc, p53, or fos genes. The expression of ras and p53 was increased in some isolates of REC:ras:gamma, but myc and fos expression were not affected. Similarly, REC:myc:gamma transformants did not demonstrate rearrangement or amplification of the transfected or the endogenous myc genes, or of the potentially cooperating Ha-, Ki-, or N-ras genes. Northern hybridization analysis revealed increased expression of N-ras in two isolates, REC:myc:gamma 33 and gamma 41, but no alterations in the expression of myc, raf, Ha-ras, or Ki-ras genes in any REC:myc transformant. DNA from several transformed REC:myc:gamma cell lines induced focus formation in recipient C3H 10T1/2 and NIH 3T3 cells. The NIH 3T3 foci tested positive when hybridized to a probe for rat repetitive DNA. A detailed analysis of the NIH 3T3 transformants generated from REC:myc:gamma 33 and gamma 41 DNA failed to detect Ha-ras, Ki-ras, raf, neu, trk, abl, fms, or src oncogenes of rat origin.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Watershed infarcts, Tc-99m HMPAO SPECT and CT correlation. Case reports.

We report on the use of Tc-99m hexamethylpropylene amineoxime (HMPAO) in watershed infarcts in five patients who had focal neurologic symptoms. Good correlation between Tc-99m HMPAO and CT was found in two patients. In three patients only Tc-99m HMPAO SPECT in a watershed distribution showed a perfusion abnormality that explained the clinical findings. Tc-99m HMPAO SPECT may be more sensitive than CT in the detection of infarctions in the watershed distribution.

Adult↗

Changes in the steady-state pharmacokinetics of theophylline during treatment with dirithromycin.

The steady-state plasma concentrations and pharmacokinetic characteristics of theophylline were studied during intermittent treatment with dirithromycin. The addition of dirithromycin (500 mg orally once daily at 7:00 AM) to a sustained-release theophylline dosing regimen (200 mg every 12 hours) elicited small changes in the steady-state pharmacokinetics of theophylline. Mean steady-state plasma theophylline trough concentrations (Cmin) were invariant before, during, and after dirithromycin treatment; however, mean average steady-state plasma theophylline concentrations (Cav) declined by 18% during dirithromycin treatment (P less than .05), and mean peak plasma concentrations (Css,max) declined by 26% (P less than .01). Theophylline clearance (CL/F) exhibited an increase of comparable magnitude during dirithromycin treatment, although the increase in CL/F was not statistically significant (.05 less than P less than .1). Dirithromycin treatment alters the steady-state pharmacokinetics of theophylline; however, the magnitude of the changes is small and is not likely to modify treatment outcomes.

Administration, Oral↗

Substance use in borderline personality disorder.

The authors investigated the prevalence of substance abuse in 137 inpatients with DSM-III borderline personality disorder. Ninety-two (67%) of these patients were given DSM-III substance use disorder diagnosis. The most frequently used substances were alcohol and sedative-hypnotics. When substance abuse was not used as a diagnostic criterion for borderline personality disorder, 32 (23%) of the 137 patients no longer met borderline criteria. These patients differed significantly from the rest of the patients in severity and course of illness. These data suggest that there might be a subgroup of borderline patients for whom substance use plays a primary role in the development of borderline psychopathology.

Adult↗

Effects of trihexyphenidyl on plasma chlorpromazine in young schizophrenics.

This study investigated the effects of trihexyphenidyl on chlorpromazine (CPZ) plasma levels and clinical state in 20 relatively young schizophrenic patients diagnosed using the DSM-III. Spontaneous changes in CPZ plasma levels over time were also examined. Trihexyphenidyl significantly increased CPZ plasma levels (average 41%) but did not produce clinical change. The trihexphenidyl-induced increase in CPZ plasma levels was independent of CPZ oral dosage and of CPZ plasma levels. Chlorpromazine plasma levels decreased non significantly (about 13%) over the four weeks following steady state, but there was marked inter-subject variability, and CPZ levels rose in some subjects. Although identical CPZ doses produced widely variable plasma levels, CPZ plasma levels correlated significantly with oral dose. The views that antiparkinsonian drugs interfere with neuroleptic efficacy, and do so by lowering neuroleptic plasma levels, are questioned.

Adolescent↗

Animal model for evaluating bone repair with and without adjunctive hyperbaric oxygen therapy (HBO): comparing dose schedules.

The effect of hyperbaric oxygen (HBO) on the healing of standardized metaphyseal defects in the cortices of rat femurs was studied. The question was whether a known total amount of HBO given twice a day (BID) would have a different effect than once a day (QD) treatments. A microvascular casting technique was developed whereby vessel ingrowth at the repair site could be monitored using scanning electron microscopy (SEM). Bone repair morphology was evaluated by light microscopy (LM) and various tissue components were quantified by histomorphometry (HM). Animals were sacrificed 1, 2, 3, or 5 weeks postoperatively. SEM revealed that endosteal bone ingrowth was totally responsible for the repair of the cortical defects. Moreover, endosteal vessel ingrowth did not differ between controls and either group of HBO treated animals. LM displayed enchondral ossification in controls and BID treated animals and a pronounced osteoclastic activity in the latter group throughout the repair process. By contrast the QD treated group healed by primary ossification. Judged by the HM data, QD treatment appeared to accelerate bone repair and vessel ingrowth compared to controls, while BID treatment seemed to retard these processes.

Animals↗