526
|
Calabresi PA, Fields NS, Maloni HW, Hanham A, Carlino J, Moore J, Levin MC, Dhib-Jalbut S, Tranquill LR, Austin H, McFarland HF, Racke MK. Phase 1 trial of transforming growth factor beta 2 in chronic progressive MS. Neurology 1998; 51:289-92. [PMID: 9674825 DOI: 10.1212/wnl.51.1.289] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Transforming growth factor (TGF)-beta2 is a pleiotropic cytokine associated with remissions in multiple sclerosis (MS) and amelioration of allergic encephalomyelitis. We assessed the safety of TGF-beta2 in an open-label trial of 11 patients with secondary progressive (SP) MS. Five patients had a reversible decline in the glomerular filtration rate. There was no change in expanded disability status scale or MRI lesions during treatment. Systemic TGF-beta2 may be associated with reversible nephrotoxicity, and further investigation of its therapeutic potential in MS should be performed with caution.
Collapse
|
527
|
Kennedy M, Moore J, Schuman P, Schoenbaum E, Zierler S, Rompalo A, Chu SY. Sexual behavior of HIV-infected women reporting recent sexual contact with women. JAMA 1998; 280:29-30. [PMID: 9660354 DOI: 10.1001/jama.280.1.29-a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
528
|
Moore J. Senior housing. Learning from the ones that got away. CONTEMPORARY LONGTERM CARE 1998; 21:37, 39. [PMID: 10185258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
|
529
|
Vigoreaux JO, Hernandez C, Moore J, Ayer G, Maughan D. A genetic deficiency that spans the flightin gene of Drosophila melanogaster affects the ultrastructure and function of the flight muscles. J Exp Biol 1998; 201:2033-44. [PMID: 9622575 DOI: 10.1242/jeb.201.13.2033] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We have developed a reverse-genetic approach to study the function of flightin, a unique protein of the flight muscle myofibril of Drosophila melanogaster. We describe the generation and characterization of Df(3L)fln1, a lethal genetic deficiency in the 76BE region of the third chromosome which deletes several genes, including the gene for flightin. We show that heterozygous flies harboring the Df(3L)fln1 mutation exhibit both impaired flight and ultrastructural defects in their flight muscle myofibrils. We found that the mutation does not interfere with assembly of the myofibril but leads to disorganization of peripheral myofilaments in adult myofibrils. Most myofibrils, nevertheless, retain an intact core that represents approximately 80 % of the normal lattice diameter. Mechanical analysis of single skinned flight muscle fibers demonstrates that the mutation has no significant effect on net power output but increases the frequency at which maximum power is delivered to the wings, potentially reducing the overall performance of the flight system. The results suggest that flightin is an indispensable part of the flight muscle contractile mechanism.
Collapse
|
530
|
Carpenter RL, Hogan QH, Liu SS, Crane B, Moore J. Lumbosacral cerebrospinal fluid volume is the primary determinant of sensory block extent and duration during spinal anesthesia. Anesthesiology 1998; 89:24-9. [PMID: 9667290 DOI: 10.1097/00000542-199807000-00007] [Citation(s) in RCA: 157] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
UNLABELLED BACKGROUND. Injection of local anesthetic into cerebrospinal fluid (CSF) produces anesthesia of unpredictable extent and duration. Although many factors have been identified that affect the extent of spinal anesthesia, correlations are relatively poor and the extent of spread remains unpredictable. This study was designed to determine whether variability in the volume of lumbosacral CSF among individuals is a contributing factor in the variability of spinal anesthesia. METHODS Spinal anesthesia was administered to 10 healthy volunteers with 50 mg lidocaine in 7.5% dextrose. The technique was standardized to minimize variability in factors known to affect the distribution of spinal anesthesia. The extent of sensory anesthesia was assessed by pin-prick and by transcutaneous electrical stimulation. Motor blockade was assessed in the quadriceps and gastrocnemius muscles by force dynamometry. Duration of anesthesia was assessed by pinprick, transcutaneous electrical stimulation, and duration of motor blockade. Lumbosacral CSF volumes were calculated from low thoracic, lumbar, and sacral axial magnetic resonance images obtained at 8-mm increments. Volumes of CSF were correlated with measures of extent and duration of spinal anesthesia using the Kendall rank correlation test. RESULTS Lumbosacral CSF volumes ranged from 42.7 to 81.1 ml. Volumes of CSF correlated with pin-prick assessments of peak sensory block height (P = 0.02) and duration of surgical anesthesia (as assessed by the duration of tolerance to transcutaneous electrical stimulation at the ankle (P < 0.05). CONCLUSIONS Variability in lumbosacral CSF volume is the most important factor identified to date that contributes to the variability in the spread of spinal sensory anesthesia.
Collapse
|
531
|
Moore J. Competing with nursing homes for market share. CONTEMPORARY LONGTERM CARE 1998; 21:39-40. [PMID: 10185952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
|
532
|
Dasgupta A, Appenzeller P, Moore J. Gas chromatography-electron ionization and chemical ionization mass spectrometric analysis of serum mexiletine concentration after derivatization with 2,2,2-trichloroethyl chloroformate: a novel derivative. Ther Drug Monit 1998; 20:313-8. [PMID: 9631929 DOI: 10.1097/00007691-199806000-00012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Mexiletine (Mexitil) is an antiarrhythmic agent used in the treatment of ventricular arrhythmia. The drug has a narrow therapeutic window, and monitoring its serum concentration is recommended. The authors describe a gas chromatography-mass spectrometric (GC/MS) assay of mexiletine using selected ion monitoring. Mexiletine was extracted from alkaline serum with dichloromethane followed by derivatization with 2,2,2-trichloroethyl chloroformate. The reaction was completed in 30 minutes at 70 degrees C. N-propylamphetamine was used as the internal standard. The ions monitored were m/z 58, 102, 122, 232, and 234 for derivatized mexiletine and m/z 56, 91, 131, 260, and 262 for the derivatized internal standard. The within-run precision at a serum mexiletine concentration of 1 mg/l was 1.7% (mean = 0.981, SD = 0.017 mg/l, n = 8) and the between-run precision was 3.3% (mean = 0.983, SD = 0.033 mg/l, n = 6). The assay was linear for serum mexiletine concentrations of 0.2 to 2.5 mg/l. The detection limit was 0.1 mg/l. The authors observed no carry-over problem in their assay. They observed a good correlation between mexiletine concentrations measured by a reference laboratory (Associated Regional University Pathologists, Salt Lake City, UT, U.S.A.) and by the new GC/MS assay.
Collapse
|
533
|
Ratajczak MZ, Pletcher CH, Marlicz W, Machalinski B, Moore J, Wasik M, Ratajczak J, Gewirtz AM. CD34+, kit+, rhodamine123(low) phenotype identifies a marrow cell population highly enriched for human hematopoietic stem cells. Leukemia 1998; 12:942-50. [PMID: 9639424 DOI: 10.1038/sj.leu.2401027] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We hypothesized that human hematopoietic cells displaying a CD34+, kit-, rhodamine123(low) phenotype would be highly enriched for cells with stem-like properties. To test this hypothesis, we employed fluorescence activated cell sorting (FACS) to isolate cells with this phenotype from normal light density marrow mononuclear cells (MNC). CD34+, kit+, rhodamine123(low) cells comprised from 0.05-0.01% of the total MNC population. They were small, had scant cytoplasm, and contained nuclei with dense, hyperchromatic chromatin and inconspicuous nucleoli. Additional immunophenotyping revealed that these cells were CD33-, CD38-, CD20-, and glycophorin A-. When plated in semisolid cultures containing optimal concentrations of IL-3, GM-CSF, KL, EPO, IL-6, and IL-1 these cells did not form colonies. However, when cultured over irradiated stromal cells, cobblestone areas were observed to form after 3 weeks, and harvested cells were able to initiate long-term cultures. To further demonstrate that these cells were indeed stem like, we also tested their ability to engraft and mature in immunocompromised (SCID) mice. Irradiated (400 cGy) SCID mice were transplanted with 2 x 10(3) candidate stem cells which were then injected with recombinant human growth factors every other day. Two months post-transplant the animals were sacrificed. PCR and FACS analysis of marrow and spleen cell samples revealed the presence of cells expressing human CD45 consistent with engraftment of human stem cells and the establishment of murine-human chimerism. Moreover, MNC isolated from transplanted mice formed unambiguously human BFU-E, CFU-GM and B cell colonies when stimulated with the appropriate growth factors. Accordingly, we have identified a relatively rapid and simple mechanism for isolating primitive human hematopoietic cells with stem cell-like properties. We anticipate that this strategy will be useful for experimental and therapeutic applications that require human stem cells in quantity.
Collapse
|
534
|
Sullivan N, Sun Y, Sattentau Q, Thali M, Wu D, Denisova G, Gershoni J, Robinson J, Moore J, Sodroski J. CD4-Induced conformational changes in the human immunodeficiency virus type 1 gp120 glycoprotein: consequences for virus entry and neutralization. J Virol 1998; 72:4694-703. [PMID: 9573233 PMCID: PMC109994 DOI: 10.1128/jvi.72.6.4694-4703.1998] [Citation(s) in RCA: 244] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Human immunodeficiency virus type 1 (HIV-1) entry into target cells involves sequential binding of the gp120 exterior envelope glycoprotein to CD4 and to specific chemokine receptors. Soluble CD4 (sCD4) is thought to mimic membrane-anchored CD4, and its binding alters the conformation of the HIV-1 envelope glycoproteins. Two cross-competing monoclonal antibodies, 17b and CG10, that recognize CD4-inducible gp120 epitopes and that block gp120-chemokine receptor binding were used to investigate the nature and functional significance of gp120 conformational changes initiated by CD4 binding. Envelope glycoproteins derived from both T-cell line-adapted and primary HIV-1 isolates exhibited increased binding of the 17b antibody in the presence of sCD4. CD4-induced exposure of the 17b epitope on the oligomeric envelope glycoprotein complex occurred over a wide range of temperatures and involved movement of the gp120 V1/V2 variable loops. Amino acid changes that reduced the efficiency of 17b epitope exposure following CD4 binding invariably compromised the ability of the HIV-1 envelope glycoproteins to form syncytia or to support virus entry. Comparison of the CD4 dependence and neutralization efficiencies of the 17b and CG10 antibodies suggested that the epitopes for these antibodies are minimally accessible following attachment of gp120 to cell surface CD4. These results underscore the functional importance of these CD4-induced changes in gp120 conformation and illustrate viral strategies for sequestering chemokine receptor-binding regions from the humoral immune response.
Collapse
|
535
|
Nyland J, Caborn DN, Johnson DL, Moore J, Slone K. Patellar tendon ACL reconstruction and rehabilitation practices and opinions (autograft versus allograft): orthopaedic sports medicine fellowship program survey. JOURNAL OF THE SOUTHERN ORTHOPAEDIC ASSOCIATION 1998; 7:13-8. [PMID: 9570727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We wanted to determine the bone-patellar tendon-bone (BPTB) anterior cruciate ligament (ACL) reconstruction practices of accredited orthopaedic sports medicine fellowship programs and their opinions about whether differences should exist in rehabilitation protocol, bracing, and timing of release to cutting/agility sports between autogeneic and allogeneic grafts. Our survey showed most programs did 51 to 100 BPTB ACL reconstructions during the 12 months before survey completion. Standard rehabilitation protocols were used without differences based on BPTB graft type or fixation concerns. Programs were equally divided regarding whether BPTB graft type should be a timing of release to cutting/agility sports factor. Programs were almost equally divided regarding routinely prescribed derotation braces. More programs used autograft rather than allograft BPTB tissue for ACL reconstruction, without rehabilitation protocol differences based on graft type or fixation concerns. Conflicting results regarding protocol and timing of release to cutting/agility sports indicate that several factors may contribute to the clinical decision-making process. Equivocal results regarding derotation brace prescription raises concerns regarding their necessity.
Collapse
|
536
|
Moore J. Fine-tuning foodservice. CONTEMPORARY LONGTERM CARE 1998; 21:33. [PMID: 10185943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
|
537
|
Messmer PR, Jones S, Moore J, Taggart B, Parchment Y, Holloman F, Quintero LM. Knowledge, Perceptions, and Practice of Nurses Toward HIV+/AIDS Patients Diagnosed With Tuberculosis. J Contin Educ Nurs 1998; 29:117-25. [PMID: 9652265 DOI: 10.3928/0022-0124-19980501-07] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Tuberculosis (TB) continues to be a major health problem in the United States. Nurses may be exposed to TB and not realize their risks for becoming infected. The presentation of HIV-associated TB is somewhat different from "standard TB." PURPOSE The purpose of this study was to determine if an educational program could improve nurses' attitudes, level of knowledge, and compliance with infection control standards for HIV/AIDS patients diagnosed with TB. METHOD Participants included 50 staff nurses. The experimental group (35) and control group (15) completed a knowledge test and an attitude survey. Researchers observed participants for compliance with infection control standards pretest and posttest. RESULTS Following an educational program, the experimental group demonstrated a greater knowledge of TB than the control group who did not participate in the educational program (F [1.47] = 14.43, p = .000). In addition, the experimental group had a greater improvement in their Nursing Intervention Observation Tool adherence to respiratory isolation and universal precaution protocols scores as compared to the control group (F [1.47] = 8.95, p = .004). However, there was not a tangible increase in knowledge level of AIDS, attitudes or concerns about caring for these patients. CONCLUSION This nursing research study supports the need for an ongoing educational program with continual monitoring of infection control practices to positively affect client and caregiver outcomes.
Collapse
|
538
|
Hirth C, Ma H, Moore J, Chance B, Rosen B. Dynamic assessment of hemoglobin oxygenation and hemoglobin concentration during functional activation. Neuroimage 1998. [DOI: 10.1016/s1053-8119(18)31102-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
539
|
Bell RL, Harris RR, Bouska JB, Hulkower KI, Moore J, Bhatia P, Malo PE, Kalosa T, Brooks CD, Carter GW. Characterization of A-93178, an iminoxy-quinoline inhibitor of leukotriene biosynthesis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 1998; 433:91-4. [PMID: 9561111 DOI: 10.1007/978-1-4899-1810-9_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
540
|
Johnston SR, Constenla DO, Moore J, Atkinson H, A'Hern RP, Dadian G, Riches PG, Gore ME. Randomized phase II trial of BCDT [carmustine (BCNU), cisplatin, dacarbazine (DTIC) and tamoxifen] with or without interferon alpha (IFN-alpha) and interleukin (IL-2) in patients with metastatic melanoma. Br J Cancer 1998; 77:1280-6. [PMID: 9579834 PMCID: PMC2150174 DOI: 10.1038/bjc.1998.214] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The purpose of this study was to evaluate in a randomized phase II trial the efficacy and toxicity of combination biochemotherapy compared with chemotherapy alone in patients with metastatic melanoma. Sixty-five patients with metastatic melanoma (ECOG performance status 0 or 1) were randomized to receive intravenous BCNU 100 mg m(-2) (day 1, alternate courses), cisplatin 25 mg m(-2) (days 1-3), DTIC 220 mg m(-2) (days 1-3) and oral tamoxifen 40 mg (BCDT regimen) with (n = 35) or without (n = 30) subcutaneous interleukin 2 (IL-2) 18 x 10(6) iu t.d.s. (day - 2), 9 x 10(6) iu b.d. (day - 1 and 0) and interferon 2 alpha (IFN-alpha) 9 MU (days 1-3). Evidence for immune activation was determined by flow cytometric analysis of peripheral blood lymphocytes. Treatment was repeated every 4 weeks up to six courses depending on response. The overall response rate of BCDT with IL-2/IFN-alpha was 23% [95% confidence interval (CI) 10-40%] with one complete response (CR) and seven partial responses (PR), and for BCDT alone 27% (95% CI 12-46%) with eight PRs; the median durations of response were 2.8 months and 2.5 months respectively. Sites of response were similar in both groups. There was no difference between the two groups in progression-free survival or overall survival (median survival 5 months for BCDT with IL-2/IFNalpha and 5.5 months for BCDT alone). Although 3 days of subcutaneous IL-2 resulted in significant lymphopenia, evidence of immune activation was indicated by a significant rise in the percentage of CD56- (NK cells) and CD3/HLA-DR-positive (activated T cells) subsets, without any change in the percentage of CD4 or CD4 T-cell subsets. Toxicity assessment revealed a significantly higher incidence of severe thrombocytopenia in patients treated with combination chemotherapy than with chemotherapy alone (37% vs 13%, P = 0.03) and a higher incidence of grade 3/4 flu-like symptoms (20% vs 10%) and fatigue (26% vs 13%). The addition of subcutaneous IL-2 and IFNalpha to BCDT chemotherapy in a randomized phase II trial resulted in immune activation but did not improve response rates in patients with metastatic melanoma, and indeed may increase some treatment-related toxicity.
Collapse
|
541
|
Froggatt M, Moore J. High-spatial-resolution distributed strain measurement in optical fiber with rayleigh scatter. APPLIED OPTICS 1998; 37:1735-40. [PMID: 18273081 DOI: 10.1364/ao.37.001735] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
A method of measuring strain over 30-cm intervals to an accuracy of10 microstrain in unaltered low-loss communications-grade single-modeoptical fiber is presented. The method uses a tunable external cavity diode laser to measure the reflected intensity of a reflector-fiber system as a function of wavelength. This measurement is performed with no strain applied to the fiber to produce a reference and then again after a strain has been induced. Cross correlation of the Rayleigh scatter spectra from a selected section of fiber in the strained and unstrained states determines the spectral shift resulting from the applied strain.
Collapse
|
542
|
Blaauboer BJ, Balls M, Barratt M, Casati S, Coecke S, Mohamed MK, Moore J, Rall D, Smith KR, Tennant R, Schwetz BA, Stokes WS, Younes M. 13th meeting of the Scientific Group on Methodologies for the Safety Evaluation of Chemicals (SGOMSEC): alternative testing methodologies and conceptual issues. ENVIRONMENTAL HEALTH PERSPECTIVES 1998; 106 Suppl 2:413-418. [PMID: 9599687 PMCID: PMC1533381 DOI: 10.1289/ehp.98106413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Substantial world-wide resources are being committed to develop improved toxicological testing methods that will contribute to better protection of human health and the environment. The development of new methods is intrinsically driven by new knowledge emanating from fundamental research in toxicology, carcinogenesis, molecular biology, biochemistry, computer sciences, and a host of other disciplines. Critical evaluations and strong scientific consensus are essential to facilitate adoption of alternative methods for use in the safety assessment of drugs, chemicals, and other environmental factors. Recommendations to hasten the development of new alternative methods included increasing emphasis on the development of mechanism-based methods, increasing fundamental toxicological research, increasing training on the use of alternative methods, integrating accepted alternative methods into toxicity assessment, internationally harmonizating chemical toxicity classification schemes, and increasing international cooperation to develop, validate, and gain acceptance of alternative methods.
Collapse
|
543
|
Froggatt M, Moore J. Distributed measurement of static strain in an optical fiber with multiple bragg gratings at nominally equal wavelengths. APPLIED OPTICS 1998; 37:1741-1746. [PMID: 18273082 DOI: 10.1364/ao.37.001741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The Fourier transform relationship between the reflected light froma Bragg grating and the complex spatial modulation of the Bragg grating is used to produce a distributed strain sensing system. A tunable external cavity diode laser along with a reference reflector in anoptical fiber are used to produce a measurement of the phase and amplitude of the reflected light from the modulated Bragg grating as a function of wavelength. The system is demonstrated with 22 Bragg gratings in a single fiber on a cantilever beam and compared with foil strain gauge readings.
Collapse
|
544
|
Dezube BJ, Von Roenn JH, Holden-Wiltse J, Cheung TW, Remick SC, Cooley TP, Moore J, Sommadossi JP, Shriver SL, Suckow CW, Gill PS. Fumagillin analog in the treatment of Kaposi's sarcoma: a phase I AIDS Clinical Trial Group study. AIDS Clinical Trial Group No. 215 Team. J Clin Oncol 1998; 16:1444-9. [PMID: 9552050 DOI: 10.1200/jco.1998.16.4.1444] [Citation(s) in RCA: 100] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Angiogenesis is a major component of Kaposi's sarcoma (KS) and a critical process in tumor growth. The present study was designed primarily to test the toxicity and pharmacokinetics (PK) of the angiogenesis inhibitor TNP-470 and secondarily to evaluate tumor response in patients with early AIDS-related KS. PATIENTS AND METHODS Patients with AIDS-related KS were required to have cutaneous disease with > or = 5 measurable lesions and no evidence of pulmonary, symptomatic gastrointestinal, or acutely life-threatening KS. Thirty-eight patients received TNP-470 by weekly intravenous infusion over 1 hour at one of six dose levels for up to 24 weeks. RESULTS The dose levels tested included 10, 20, 30, 40, 50 and 70 mg/m2. Median CD4 count was 24 cells/microl (range, 0 to 460). Fourteen patients (36%) had > or = 50 cutaneous lesions and 19 (49%) had oral lesions. Adverse events included neutropenia (n = 2), hemorrhage (n = 3), and urticaria (n = 1). PK studies showed wide interpatient and intrapatient variability. Elimination half-life values were short (range, 0.01 to 0.61 hours). Seven patients (18%) achieved a partial response. The median time to partial response was 4 weeks (range, 2 to 25), and the median duration of response was 11 weeks (range, 3 to 26+). CONCLUSION TNP-470, administered as a weekly, 1-hour infusion to patients with early AIDS-KS is well-tolerated at doses up to and including the highest dose tested. Tumor responses were observed in a substantial number of cases and occurred at various dose levels. TNP-470 should be evaluated further in patients with AIDS-KS as a single agent and in combination with other biologic response modifiers in early disease or after initial response to cytotoxic chemotherapy.
Collapse
|
545
|
Moore J. Turning failing properties into singular senior housing. CONTEMPORARY LONGTERM CARE 1998; 21:34, 39. [PMID: 10178944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
|
546
|
Moore J. Bridging the gap. Seniors with moderate incomes are vastly underserved. CONTEMPORARY LONGTERM CARE 1998; 21:71, 73. [PMID: 10177830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
|
547
|
Solomon L, Stein M, Flynn C, Schuman P, Schoenbaum E, Moore J, Holmberg S, Graham NM. Health services use by urban women with or at risk for HIV-1 infection: the HIV Epidemiology Research Study (HERS). JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY : OFFICIAL PUBLICATION OF THE INTERNATIONAL RETROVIROLOGY ASSOCIATION 1998; 17:253-61. [PMID: 9495226 DOI: 10.1097/00042560-199803010-00011] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To characterize health services use by urban women with or at risk for HIV-1 infection enrolled in a prospective multicenter study. METHODS 1310 women 16 to 55 years of age who were at risk for HIV-1 infection were recruited between April 1993 and January 1995 at four urban centers (Baltimore, Maryland; The Bronx, New York; Detroit, Michigan; and Providence, Rhode Island). HIV-1-seropositive women without AIDS-defining illness were oversampled in a ratio of 2:1 in comparison with HIV-1-seronegative women. At a baseline study visit, the women received physical and laboratory examinations, including CD4+ counts, and were interviewed regarding HIV risk behavior, health services use, and clinical data. RESULTS 863 women were HIV-1-seropositive and 430 were HIV-1-seronegative. Fifty-two percent of the women reported injection drug use (IDU) since 1985, and 48% acquired HIV through sexual contact. Seventy-seven percent were African American, 23% were white, and 16% were Hispanic. The median age was 35 years. HIV-seronegative women were significantly less likely to have health insurance (19%) than were HIV-seropositive women (30%; p < .001). Among the HIV-seropositive women, 68% had CD4+ cell counts of <500/microl, and 64% were asymptomatic. Sixty-four percent of the HIV-seronegative women had had an outpatient hospital visit in the past 6 months, as had 86% of HIV-seropositive women (p < 0.001). Hospitalization in the past 6 months was also higher in HIV-seropositive women (22% vs. 12%; p < .001). Despite heavy use of health services, only 49% of women with CD4+ counts of <200/microl reported current use of antiretroviral therapy, and only 58% reported current use of Pneumocystis carinii pneumonia (PCP) prophylaxis. Among HIV-seropositive women, and after adjusting for CD4+ count, HIV symptoms, race, and study site, IDUs were significantly less likely to have a regular doctor and a recent outpatient visit and more likely to be hospitalized and use the emergency department (ED) than were non-IDUs. In multivariate analyses of HIV-seropositive persons, African American women had similar access to care and use of antiretroviral therapy and PCP prophylaxis than did white women but were less likely to have an outpatient department visit in the previous 6 months and to be taking PCP and opportunistic infection (OI) prophylaxis. Health services access and use of HIV-related therapies did not significantly differ between Hispanic and white women with HIV infection. CONCLUSION Although both HIV-seropositive and HIV-seronegative women had high levels of use of medical services, current use of antiretrovirals and OI prophylaxis was low throughout, and IDUs used HIV-related primary health services less and were more likely to receive emergency or episodic care. IDU and African American race were independently associated with decreased use of medical services.
Collapse
|
548
|
Estberg L, Stover SM, Gardner IA, Johnson BJ, Jack RA, Case JT, Ardans A, Read DH, Anderson ML, Barr BC, Daft BM, Kinde H, Moore J, Stoltz J, Woods L. Relationship between race start characteristics and risk of catastrophic injury in thoroughbreds: 78 cases (1992). J Am Vet Med Assoc 1998; 212:544-9. [PMID: 9491163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate relationships of several racehorse characteristics and race conditions with risk of a catastrophic musculoskeletal injury (CMI) resulting in euthanasia in Thoroughbreds during racing in California in 1992. DESIGN Retrospective longitudinal study. ANIMALS Thoroughbreds that incurred CMI during racing and all California race entrants in 1992. PROCEDURE Necropsy records were reviewed, and race start information was obtained. Incidence risk of CMI/1,000 race entrants was estimated. Relationships between CMI during racing and race-meet, entrant age and sex, race type and length, and racing surface type and condition were evaluated by use of logistic regression. RESULTS Incidence risk of CMI was 1.7/1,000 entrants. A higher risk of CMI was found at 2 fair race-meets, with incidence risks of 4.9 and 5.5/1,000 entrants. Risk of injury in male horses was 1.7 times greater than that in female horses, and influence of age on risk depended on race type. Risk of injury for horses 2 to 5 years old was two times greater for claiming horses than for maiden horses. Race length or racing surface type (dirt vs turf) or condition (fast, muddy, yielding) were not significantly associated with risk of CMI. CLINICAL IMPLICATIONS Incidence of CMI was similar among 12 of 14 major and fair race-meets and among various race lengths and racing surface types and conditions, whereas incidence of CMI was influenced by entrant age and sex as well as race type. Investigators should consider controlling for age and sex, race-meet, and race type whenever possible in studies of risk of CMI.
Collapse
|
549
|
Schallreuter KU, Zschiesche M, Moore J, Panske A, Hibberts NA, Herrmann FH, Metelmann HR, Sawatzki J. In vivo evidence for compromised phenylalanine metabolism in vitiligo. Biochem Biophys Res Commun 1998; 243:395-9. [PMID: 9480820 DOI: 10.1006/bbrc.1997.8107] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Human epidermal melanocytes and keratinocytes express mRNA for all enzymes involved in de novo synthesis/recycling of the cofactor (6R) L-erythro 5,6,7,8 tetrahydrobiopterin (6BH4) in normal healthy individuals. An enhanced epidermal de novo synthesis was identified in association with decreased epidermal phenylalanine hydroxylase and 4a carbinolamine dehydratase in patients with vitiligo. The latter event leads to an accumulation of the nonenzymatic isomer (7R) L-erythro 5,6,7,8 tetrahydrobiopterin (7BH4) inhibiting phenylalanine hydroxylase (PAH) with an apparent Ki = 10(-6) M. One consequence of decreased epidermal PAH activities would be a build-up of L-phenylalanine. To substantiate this consideration, FT-Raman spectroscopy was utilised to study in vivo total phenylalanine levels at 1004 cm-1 in involved and uninvolved skin of 23 patients with vitiligo, showing in all cases increased levels of phenylalanine in involved compared to uninvolved skin of the same individual. Additionally the peripheral blood L-phenylalanine turnover was determined over time after a single oral loading with L-phenylalanine in 32 patients (100 mg/kg body weight). All patients demonstrated slower kinetics from L-phenylalanine to L-tyrosine, but 41% of the group showed significantly slower kinetics under these conditions. None of the patients presented peripheral hyperphenylalaninemia without loading. Our results demonstrate for the first time a phenylalanine build-up in the involved epidermis of patients with vitiligo. These data support the earlier observation of a defective epidermal pterin metabolism in this disease.
Collapse
|
550
|
Moore J. Assisted living. Back to basics in the new year. CONTEMPORARY LONGTERM CARE 1998; 21:33-4. [PMID: 10177547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
|