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Stoner M, Vwalika B, Smid M, Dotters-Katz S, Kumwenda A, Stringer E, Stinger J. 14: The interaction between sulfadoxine-pyrimethamine for malaria prophylaxis and highly active antiretroviral therapy (HAART) on risk of low birth weight in a cohort of HIV positive pregnant women in Lusaka, Zambia. Am J Obstet Gynecol 2015. [DOI: 10.1016/j.ajog.2015.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bin W, Bruschi A, Cirant S, Erckmann V, Gandini F, Granucci G, Hollmann F, Laqua H, Mellera V, Muzzini V, Nardone A, Noke F, Piosczyk B, Purps F, Rzesnicki T, Schmid M, Sozzi C, Spies W, Spinicchia N, Stoner M. Advances in high power calorimetric matched loads for short pulses and CW gyrotrons. Fusion Engineering and Design 2007. [DOI: 10.1016/j.fusengdes.2007.05.055] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Brundage SI, Jurkovich GJ, Hoyt DB, Patel NY, Ross SE, Marburger R, Stoner M, Ivatury RR, Ku J, Rutherford EJ, Maier RV. Stapled versus sutured gastrointestinal anastomoses in the trauma patient: a multicenter trial. J Trauma 2001; 51:1054-61. [PMID: 11740250 DOI: 10.1097/00005373-200112000-00005] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Construction of gastrointestinal anastomoses utilizing stapling devices has become a familiar procedure. In elective surgery, studies have shown no significant differences in complications between stapled and sutured anastomoses. Controversy has recently arisen regarding the accurate incidence of complications associated with anastomoses in the trauma patient. The objective of this multi-institutional study was to determine whether the incidence of postoperative complications differs between stapled and sutured anastomoses following the emergent repair of traumatic bowel injuries. METHODS Using a retrospective cohort design, all trauma registry records from five Level I trauma centers over a period of 4 years were reviewed. RESULTS A total of 199 patients with 289 anastomoses were identified. A surgical stapling device was used to create 175 separate anastomoses, while a hand-sutured method was employed in 114 anastomoses. A complication was defined as an anastomotic leak verified at reoperation, an intra-abdominal abscess, or an enterocutaneous fistula. The mean abdominal Abbreviated Injury Scale score and Injury Severity Score were similar in the two cohort groups. Stapling and suturing techniques were evenly distributed in both small and large bowel repairs. Seven of the total 175 stapled anastomoses and none of the 114 hand-sewn anastomoses resulted in a clinically significant leak requiring reoperation (RR = undefined, 95% CI 1.08-infinity, p = 0.04). Each anastomotic leak occurred in a separate individual. Nineteen stapled anastomoses and four sutured anastomoses were associated with an intra-abdominal abscess (RR = 2.7, 95% CI 0.96-7.57, p = 0.04). Enterocutaneous fistula formation was not statistically associated with either type of anastomoses (stapled cohort = 3 of 175 and sutured cohort = 2 of 114). Overall, 22 (13%) stapled anastomoses and 6 (5%) sutured anastomoses were associated with an intra-abdominal complication (RR = 2.08, 95% CI 0.89-4.86, p = 0.076). CONCLUSION Anastomotic leaks and intra-abdominal abscesses appear to be more likely with stapled bowel repairs compared with sutured anastomoses in the injured patient. Caution should be exercised in deciding to staple a bowel anastomosis in the trauma patient.
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Affiliation(s)
- S I Brundage
- Department of Surgery, Baylor College Of Medicine, Houston, Texas 77030, USA.
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Yoon K, Pallaroni L, Stoner M, Gaido K, Safe S. Differential activation of wild-type and variant forms of estrogen receptor alpha by synthetic and natural estrogenic compounds using a promoter containing three estrogen-responsive elements. J Steroid Biochem Mol Biol 2001; 78:25-32. [PMID: 11530281 DOI: 10.1016/s0960-0760(01)00070-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Structure-dependent estrogen receptor alpha (ER alpha) agonist and antagonist activities of synthetic and natural estrogenic compounds were investigated in human HepG2, MDA-MB-231 and U2 cancer cell lines. Compounds used in this study include 4'-hydroxytamoxifen, ICI 182,780, bisphenol-A (BPA), 2',4',6'-trichloro-4-biphenylol (3Cl-PCB-OH), 2',3',4',5'-tetrachloro-4-biphenylol (4Cl-PCB-OH), p-t-octylphenol, p-nonylphenol, naringenin, kepone, resveratrol, and 2,2-bis(p-hydroxyphenyl)-1,1,1-trichloroethane (HPTE). Cells were transfected with a construct (pERE(3)) containing three tandem estrogen responsive elements (EREs) and either wild-type estrogen receptor alpha (ER-wt) or variants expressing activation function-1 (ER-AF1) or AF-2 (ER-AF2). The ER agonist activities of the synthetic mono and dihydroxy aromatic compounds are comparable in all three-cell lines, whereas the activities of naringenin, kepone and resveratrol are dependent on cell context and expression of wild-type or variant forms of ER alpha. In contrast, the ER antagonist activities for these compounds were highly complex and, with the exception of 3Cl-PCB-OH, all compounds inhibited E2-induced wild-type or variant ER action. Results of this in vitro study suggest that the estrogenic and antiestrogenic activity of structurally diverse synthetic and natural estrogenic compounds is complex, and this is consistent with published data that often give contradictory results for these compounds.
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Affiliation(s)
- K Yoon
- Department of Veterinary Physiology and Pharmacology, Texas A and M University, 4466 TAMU, College Station, TX 77843-4466, USA
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Samudio I, Vyhlidal C, Wang F, Stoner M, Chen I, Kladde M, Barhoumi R, Burghardt R, Safe S. Transcriptional activation of deoxyribonucleic acid polymerase alpha gene expression in MCF-7 cells by 17 beta-estradiol. Endocrinology 2001; 142:1000-8. [PMID: 11181512 DOI: 10.1210/endo.142.3.8022] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Treatment of MCF-7 human breast cancer cells with 17beta-estradiol (E(2)) results in increased DNA synthesis and cell proliferation and enhanced enzyme activities associated with purine/pyrimidine biosynthesis. The mechanism of enhanced DNA polymerase alpha activity was investigated by analysis of the promoter region of this gene. E(2) induced luciferase (reporter gene) activity in MCF-7 cells transfected with pDNAP1, pDNAP2, and pDNAP3 containing -1515 to +45, -248 to +45 and -116 to +45 inserts from the DNA polymerase alpha gene promoter, whereas no induction was observed with pDNAP4 (-65 to +45 insert). The induction response was dependent on cotransfection with estrogen receptor alpha (ER(alpha)), and transactivation was also observed with a mutant ER(alpha) that did not express the DNA-binding domain. Subsequent functional, DNA binding, and DNA footprinting studies showed that a GC-rich region at -106 to -100 was required for E(2)-mediated transactivation, and Sp1 protein, but not ER(alpha), bound this sequence. Transcriptional activation of DNA polymerase alpha by E(2) is associated with ER(alpha)/Sp1 action at a proximal GC-rich promoter sequence, and this gene is among a growing list of E(2)-responsive genes that are induced via ER(alpha)/Sp1 protein interactions that do not require direct binding of the hormone receptor to DNA.
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Affiliation(s)
- I Samudio
- Department of Veterinary Physiology and Pharmacology , Texas A&M University, College Station, Texas 77843, USA
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Asensio JA, Chahwan S, Forno W, MacKersie R, Wall M, Lake J, Minard G, Kirton O, Nagy K, Karmy-Jones R, Brundage S, Hoyt D, Winchell R, Kralovich K, Shapiro M, Falcone R, McGuire E, Ivatury R, Stoner M, Yelon J, Ledgerwood A, Luchette F, Schwab CW, Frankel H, Chang B, Coscia R, Maull K, Wang D, Hirsch E, Cue J, Schmacht D, Dunn E, Miller F, Powell M, Sherck J, Enderson B, Rue L, Warren R, Rodriquez J, West M, Weireter L, Britt LD, Dries D, Dunham CM, Malangoni M, Fallon W, Simon R, Bell R, Hanpeter D, Gambaro E, Ceballos J, Torcal J, Alo K, Ramicone E, Chan L. Penetrating esophageal injuries: multicenter study of the American Association for the Surgery of Trauma. J Trauma 2001; 50:289-96. [PMID: 11242294 DOI: 10.1097/00005373-200102000-00015] [Citation(s) in RCA: 106] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to define the period of time after which delays in management incurred by investigations cause increased morbidity and mortality. The outcome study is intended to correlate time with death from esophageal causes, overall complications, esophageal related complications, and surgical intensive care unit length of stay. METHODS This was a retrospective multicenter study involving 34 trauma centers in the United States, under the auspices of the American Association for the Surgery of Trauma Multi-institutional Trials Committee over a span of 10.5 years. Patients surviving to reach the operating room (OR) were divided into two groups: those that underwent diagnostic studies to identify their injuries (preoperative evaluation group) and those that went immediately to the OR (no preoperative evaluation group). Statistical methods included Fisher's exact test, Student's T test, and logistic regression analysis. RESULTS The study involved 405 patients: 355 male patients (86.5%) and 50 female patients (13.5%). The mean Revised Trauma Score was 6.3, the mean Injury Severity Score was 28, and the mean time interval to the OR was 6.5 hours. There were associated injuries in 356 patients (88%), and an overall complication rate of 53.5%. Overall mortality was 78 of 405 (19%). Three hundred forty-six patients survived to reach the OR: 171 in the preoperative evaluation group and 175 in the no preoperative evaluation group. No statistically significant differences were noted in the two groups in the following parameters: number of patients, age, Injury Severity Score, admission blood pressure, anatomic location of injury (cervical or thoracic), surgical management (primary repair, resection and anastomosis, resection and diversion, flaps), number of associated injuries, and mortality. Average length of time to the OR was 13 hours in the preoperative evaluation group versus 1 hour in the no preoperative evaluation group (p < 0.001). Overall complications occurred in 134 in the preoperative evaluation group versus 87 in the no preoperative evaluation group (p < 0.001), and 74 (41%) esophageal related complications occurred in the preoperative evaluation group versus 32 (19%) in the no preoperative evaluation group (p = 0.003). Mean surgical intensive care unit length of stay was 11 days in the preoperative evaluation group versus 7 days in the no preoperative evaluation group (p = 0.012). Logistic regression analysis identified as independent risk factors for the development of esophageal related complications included time delays in preoperative evaluation (odds ratio, 3.13), American Association for the Surgery of Trauma Organ Injury Scale grade >2 (odds ratio, 2.62), and resection and diversion (odds ratio, 4.47). CONCLUSION Esophageal injuries carry a high morbidity and mortality. Increased esophageal related morbidity occurs with the diagnostic workup and its inherent delay in operative repair of these injuries. For centers practicing selective management of penetrating neck injuries and transmediastinal gunshot wounds, rapid diagnosis and definitive repair should be made a high priority.
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Affiliation(s)
- J A Asensio
- Department of Surgery, Division of Trauma and Critical Care, University of Southern California School of Medicine, LAC+USC, 1200 State Street, Los Angeles, CA 90033-4525, USA.
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Wormke M, Stoner M, Saville B, Safe S. Crosstalk between estrogen receptor alpha and the aryl hydrocarbon receptor in breast cancer cells involves unidirectional activation of proteasomes. FEBS Lett 2000; 478:109-12. [PMID: 10922479 DOI: 10.1016/s0014-5793(00)01830-5] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is an environmental toxin that activates the aryl hydrocarbon receptor (AhR) and disrupts multiple endocrine signaling pathways. T47D human breast cancer cells express a functional estrogen receptor alpha (ERalpha) and AhR, and treatment of these cells with 17beta-estradiol (E2) or TCDD resulted in a rapid proteasome-dependent decrease in immunoreactive ERalpha and AhR proteins (>60-80%), respectively. E2 did not affect the AhR, whereas TCDD induced proteasome-dependent degradation of both the AhR and ERalpha in T47D and MCF-7 human breast cancer cells, and these responses were specifically blocked by proteasome inhibitors. Thus, TCDD-induced degradation of ERalpha may contribute to the antiestrogenic activity of AhR agonists and this pathway may be involved in AhR-mediated disruption of other endocrine responses.
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Affiliation(s)
- M Wormke
- Department of Veterinary Physiology and Pharmacology, and Department of Biochemistry and Biophysics, Texas A&M University, 77843-4466, College Station, TX, USA
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Stoner M, Wang F, Wormke M, Nguyen T, Samudio I, Vyhlidal C, Marme D, Finkenzeller G, Safe S. Inhibition of vascular endothelial growth factor expression in HEC1A endometrial cancer cells through interactions of estrogen receptor alpha and Sp3 proteins. J Biol Chem 2000; 275:22769-79. [PMID: 10816575 DOI: 10.1074/jbc.m002188200] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Treatment of HEC1A endometrial cancer cells with 10 nm 17beta-estradiol (E2) resulted in decreased vascular endothelial growth factor (VEGF) mRNA expression, and a similar response was observed using a construct, pVEGF1, containing a VEGF gene promoter insert from -2018 to +50. In HEC1A cells transiently transfected with pVEGF1 and a series of deletion plasmids, it was shown that E2-dependent down-regulation was dependent on wild-type estrogen receptor alpha (ERalpha) and reversed by the anti-estrogen ICI 182, 780, and this response was not affected by progestins. Deletion analysis of the VEGF gene promoter identified an overlapping G/GC-rich site between -66 to -47 that was required for decreased transactivation by E2. Protein-DNA binding studies using electrophoretic mobility shift and DNA footprinting assays showed that both Sp1 and Sp3 proteins bound this region of the VEGF promoter. Coimmunoprecipitation and pull-down assays demonstrated that Sp3 and ERalpha proteins physically interact, and the interacting domains of both proteins are different from those previously observed for interactions between Sp1 and ERalpha proteins. Using a dominant negative form of Sp3 and transcriptional activation assays in Schneider SL-2 insect cells, it was confirmed that ERalpha-Sp3 interactions define a pathway for E2-mediated inhibition of gene expression, and this represents a new mechanism for decreased gene expression by E2.
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Affiliation(s)
- M Stoner
- Department of Veterinary Physiology and Pharmacology, Texas A&M University, College Station, Texas 77843-4466, USA
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Dong L, Wang W, Wang F, Stoner M, Reed JC, Harigai M, Samudio I, Kladde MP, Vyhlidal C, Safe S. Mechanisms of transcriptional activation of bcl-2 gene expression by 17beta-estradiol in breast cancer cells. J Biol Chem 1999; 274:32099-107. [PMID: 10542244 DOI: 10.1074/jbc.274.45.32099] [Citation(s) in RCA: 199] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
bcl-2 gene expression is induced by 17beta-estradiol (E2) in T47D and MCF-7 human breast cancer cells, and the mechanism of E2 responsiveness was further investigated by analysis of the bcl-2 gene promoter. The -1602 to -1534 distal region (bcl-2j) of the promoter was E2-responsive; however, in gel mobility shift assays, the estrogen receptor alpha (ER(alpha)) did not bind [(32)P]bcl-2j, whereas Sp1 protein formed a retarded band complex. Further analysis demonstrated that the upstream region (-1603 to -1579) of the bcl-2 gene promoter contained two GC/GA-rich sites at -1601 (5'-GGGCTGG-3') and -1588 (3'-GGAGGG-5') that bound Sp1 protein. Subsequent studies confirmed that transactivation by E2 was dependent on ER(alpha)/Sp1 interactions with both GC-rich sites, and this was confirmed by in vitro footprinting. In contrast, a 21-base pair E2-responsive downstream region (-1578 to -1534) did not bind Sp1 or ER(alpha) protein; however, analysis of a complex binding pattern with nuclear extracts showed that ATF-1 and CREB-1 bound to this motif. These data coupled with results of transient transfection studies demonstrated that transcriptional activation by E2 of the -1578 to -1534 region of the bcl-2 gene promoter was dependent on induction of cAMP and subsequent activation through a cAMP response element. Thus, hormone regulation of bcl-2 gene expression in breast cancer cells involves multiple enhancer elements and E2-mediated transactivation does not require direct binding of the estrogen receptor with promoter DNA.
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Affiliation(s)
- L Dong
- Department of Veterinary Physiology, Texas A&M University, College Station, Texas 77843, USA
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Affiliation(s)
- M Stoner
- California State University, San Bernardino, Calif., USA
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Abstract
An illustration of the problems associated with the management of chronic wounds and a novel approach using autologous epidermal-derived factors
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Affiliation(s)
- F Wood
- Princess Margaret Hospital, Perth, Australia
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Abstract
There is increasing evidence from the scientific literature that the developing epithelial basement membrane has the potential to influence the underlying dermis. The most rapidly dividing and active cell within the skin complex is the basal cell of the epidermis. The basal cell is well known to produce numerous protein factors which influence cellular growth and differentiation. The underlying dermal fibroblasts, by comparison, are relatively static. The concept that basal cells have an influence on the dermal and overall skin environment via the extracellular expression of proteins in the extracellular matrix, is gaining increased interest. A hypertrophic scar is a dermal phenomenon resulting from an imbalance in collagen production and maturation. Although the collagen is produced by the fibroblast, the extracellular matrix is an area where the epidermal cells have a potential influence. It is therefore the purpose of this paper to explore the idea that the cultured epithelial autograft may have an influence on the quality of scarring.
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Affiliation(s)
- F M Wood
- Royal Perth and Princess Margaret Hospital, Burn Unit, University of Western Australia, Australia
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Abstract
With the increased acuity of patients and the resultant complexity of care required, effective and efficient communication among patients, nurses, and physicians is a critical variable in patient outcomes. In recognition of the need for rapid communication between health professionals, University Hospital in Denver, Colorado, instituted a wireless telecommunication system on two medical-surgical nursing units. Evaluation research of this innovation in practice revealed a significant time savings by both nurses and clerical staff members. This time savings translates into improved patient care because skilled personnel have more time available for direct patient care.
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Affiliation(s)
- P A Spurck
- University Hospital, Denver, Colorado, USA
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O'Reilly J, Meyer B, Stoner M, Erber W, Herrmann R, Davies J. Very early analysis of graft establishment after allogeneic bone marrow transplantation using the polymerase chain reaction. Br J Haematol 1993; 85:169-72. [PMID: 8251386 DOI: 10.1111/j.1365-2141.1993.tb08661.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We have used minisatellite polymorphisms flanking the apolipoprotein B locus and PCR to demonstrate the emergence of donor specific alleles in peripheral blood at 3-7 d post allogeneic bone marrow transplantation (BMT). This technique affords a very early indication of the establishment of stable engraftment, and may identify patients at risk of graft failure or leukaemic relapse. Patterns of T-cell chimaerism in the first 7-14 d following transplantation may be closely associated with the development of graft-versus-host disease (GVHD), the graft versus leukaemia (GVL) effect and graft rejection and future application of this technique to the investigation of early T-cell chimaerism may give further insights into these immunologically mediated events.
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Affiliation(s)
- J O'Reilly
- Haematology Department, Royal Perth Hospital, Western Australia
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Hefter LG, Hix MA, Stoner M, Cook CB. False negative hepatitis B surface antigen detection in dialysis patients due to excess surface antigen: postzone phenomenon. J Clin Pathol 1980; 33:993-4. [PMID: 6776153 PMCID: PMC1146301 DOI: 10.1136/jcp.33.10.993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Renal dialysis patients are well known to have a high incidence of hepatitis B carrier state. In studying a group of 63 long-term dialysis patients, 10 were found to be positive for hepatitis B surface antigen by radioimmunoassay (RIA). Surprisingly, however, only three of these RIA positive patients were positive by counter immunoelectrophoresis (CIEP). The discrepancy could not be accounted for by the difference in sensitivity of the two methods. The cause for the negative reactions by CIEP in seven patients was found to be the marked excess surface antigen in these sera which produced false negative results by the postzone phenomenon. After dilution all seven sera were positive by CIEP, requiring a dilution up to 1/20 to produce a positive result. Also, all seven sera were positive by the less sensitive Ouchterlony double diffusion.
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Hefter LG, Stoner M. Controls for slide differential tests for infectious mononucleosis. Am J Clin Pathol 1979; 72:1040. [PMID: 517455 DOI: 10.1093/ajcp/72.6.1040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Rucker RB, Lee I, Lefevre M, Heng Khoo CS, Goettlich-Riemann W, Stoner M. Inhibition of elastolysis by proteinase inhibitors from chick plasma and aorta. Biochim Biophys Acta 1978; 539:267-75. [PMID: 630001 DOI: 10.1016/0304-4165(78)90031-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Chick plasma contains inhibitor(s) against trypsin and elastase which also appear to retard the degradation of tropoelastin by arterial tissue extracts. Chick aorta extracts also contain similar inhibitors against elastase and trypsin. Both levels of the plasma inhibitor(s) and inhibitor(s) extracted from thoracic aorta increase during early stages of growth and maturation. There is a three- to four-fold increase in the levels of the inhibitor(s) in chick plasma and aorta between one to four weeks after hatching. Of particular interest are the observations that the presence of the inhibitor(s) retards the conversion of soluble elastin (tropoelastin) to smaller elastin peptides. Subsequently, it is speculated that in addition to other vital roles, such proteinase inhibitors may also act in regulating elastogenesis and elastin fiber formation.
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