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Biomedical subjects

A J Smith

Publications and source records attributed to A J Smith.

At least 145 records · Page 8Linked to original sources
PubMed1999

Outcome in severe pediatric Guillain-Barré syndrome after immunotherapy or supportive care.

We reviewed duration of illness in 26 children with severe pediatric Guillain-Barré syndrome (GBS) during two contiguous 8-year periods that represent a "non-treatment era" of supportive care alone or a "treatment era" of supportive care plus either plasma exchange or intravenous immunoglobulin intervention. Our findings of similar recovery times in each treatment group suggest that immunotherapy in severe pediatric GBS may be less effective than in adult GBS, or effective only when given to certain patients very early in the course of the illness.

Adolescent↗
PubMed1999

Dibasic benzo[b]thiophene derivatives as a novel class of active site directed thrombin inhibitors: 2. Sidechain optimization and demonstration of in vivo efficacy.

Potent, subnanomolar thrombin inhibitors 4, 5, and 6 are developed through side chain optimization of novel, benzo[b]thiophene-based small organic entities 2 and 3 and through SAR additivity studies of the new structural elements identified. X-ray crystallographic studies of 4b-thrombin complex revealed a hydrophobic and an electrostatic interaction of these new elements with thrombin at the S2 and S3 binding sites. In vitro and in vivo pharmacological studies showed that 4, 5, and 6 are potent anticoagulants in human plasma with demonstrated antithrombotic efficacy in a rat model of thrombosis.

Animals↗
PubMed1999

Dental erosion--the problem and some practical solutions.

There has been a clinical impression among dental practitioners, particularly those working with children, that the problem of dental erosion is increasing. Is this really the case or are we more aware of the problem? What is causing this increase, if it really exists? Perhaps more importantly, what can we do about it? This article looks at the prevalence, and aetiology of dental erosion, particularly in children, and makes some practical suggestions for possible control.

Adolescent↗
PubMed1999

Water, water everywhere but not a drop to drink?

Biofilms are emerging as an increasing problem as medical technology advances. Dental practice is no exception and interest in the role of biofilms within dental units as a possible source of cross-infection is intensifying. It is difficult to quantitate the risks associated with aerosolised bacteria for the majority of patients seen in general practice. However, it seems prudent to eliminate this source of infection during treatment of compromised patients. This article attempts to provide a brief overview of current concepts and problems in this area of infection control.

Biofilms↗
PubMed1999

Stimulation of the dentine-pulp complex of rat incisor teeth by transforming growth factor-beta isoforms 1-3 in vitro.

Expression of transforming growth factor-beta (TGF-beta) isoforms by odontoblasts leads to their sequestration within dentine matrix. TGF-beta1 and -beta3 stimulate matrix secretion and also initiate odontoblast cytodifferentiation in vitro and in vivo. Using a recently established organ-culture model, the aim here was to examine the effects of TGF-beta isoforms on the response of the dentine-pulp complex during culture. Agarose beads were soaked in isoforms 1-3, and placed on the odontoblast area of slices of 28-day-old rat incisor tooth. The slices were maintained in Trowel-type cultures for 7 days. Both TGF-beta1 and -beta3 stimulated a local increase in predentine secretion at the site of the bead application when compared to control cultures. Mitogenic effects on the cells of the subodontoblast layer were also seen and occasionally small foci of newly differentiated odontoblast-like cells could be observed a little distant from the application site of TGF-beta3. TGF-beta2 had a minimal effect on the cultured tissues. These results demonstrate that TGF-beta1 and -beta3 can stimulate secretion of extracellular matrix by odontoblasts, are mitogenic to pulp cells, and that TGF-beta3 may have inductive effects on pulpal cells. Such activities might be important during reparative processes in the dentine-pulp complex after tissue injury.

Animals↗
PubMed1999

Regional differences in the inhibition of mouse in vivo [3H]Ro 15-1788 binding reflect selectivity for alpha 1 versus alpha 2 and alpha 3 subunit-containing GABAA receptors.

The benzodiazepines flunitrazepam, diazepam, and Ro 15-1788 and the beta-carboline DMCM bind with equivalent affinity to the benzodiazepine binding site of GABAA receptors containing different alpha subunits (i.e., alpha 1, alpha 2, alpha 3, or alpha 5); whereas, the triazolopyridazine CL 218,872 and imidazopyridine zolpidem have higher affinity for alpha 1 subunit-containing GABAA receptors. In the present study, the in vivo binding of [3H]Ro 15-1788 in mouse cerebellum and spinal cord was used to establish the occupancy of the benzodiazepine binding site of GABAA receptors containing primarily alpha 1 and alpha 2/alpha 3 subunits, respectively. Thus, the nonselective compounds flunitrazepam, diazepam, and DMCM all produced a similar inhibition of binding in cerebellum and spinal cord (respective ID50 values of 0.2 to 0.3 mg/kg, 2 mg/kg, and 10 mg/kg i.p.); whereas, the alpha 1 selective compounds CL 218,872 and zolpidem were more potent at inhibiting [3H]Ro 15-1788 binding in the cerebellum (ID50 values 4.5 mg/kg and 10 mg/kg i.p.) compared to the spinal cord (ID50 values 12 mg/kg and > 30 mg/kg i.p.). Thus, the reduction of in vivo f[3H]Ro 15-1788 binding in tissues containing alpha 1 and alpha 2/alpha 3 receptor populations reflects the in vitro affinities of subtype selective compounds and should help to interpret the behavioral profile of such compounds.

Animals↗
PubMed1999

Husbandry and nutrition of hedgehogs.

Hedgehogs are becoming increasingly popular as pets. This article provides a broad overview of those factors with which practitioners must be familiar to provide guidance to hedgehog owners. The taxonomy, anatomy, and natural history of the common pet species are presented along with commonly observed behaviors. Information on the reproduction and neonatal management is described. Current recommendations for handling, housing, and feeding these animals are also discussed.

Animal Diseases↗
PubMed1999

TGF-beta receptor expression in human odontoblasts and pulpal cells.

Transforming growth factor-beta (TGF-beta) isoform expression by odontoblasts leads to their sequestration within the dentine matrix, from where they may be released during caries and participate in the reparative processes. Two receptor types for TGF-beta have been implicated in TGF-beta induced signalling. The aim of this study was to characterise immunohistochemically the expression of these receptors in sound and carious human teeth to facilitate our understanding of the ability of these cells to respond to TGF-beta stimulation. Sound and carious human teeth were routinely processed and paraffin sections stained for TGF-beta receptors I and II, using the StrAviGen immunoperoxidase method. Strong specific staining for both receptor types was observed in the odontoblasts of healthy teeth with the greatest intensity seen with receptor I. Staining of weaker intensity was also observed for both receptors in the underlying cell rich area and pulp core. Similar patterns of staining were observed within carious tissues. We conclude that odontoblasts and other cells of the pulp of mature human molar teeth show the presence of both TGF-beta receptors I and II in health and disease with odontoblasts showing the strongest expression. Such findings may be important in the response of these cells to tissue injury.

Activin Receptors, Type I↗
PubMed1999

Proliferative effects of cholecystokinin in GH3 pituitary cells mediated by CCK2 receptors and potentiated by insulin.

1. Proliferative effects of CCK peptides have been examined in rat anterior pituitary GH3 cells, which express CCK2 receptors. 2. CCK-8s, gastrin(1-17) and its glycine-extended precursor G(1-17)-Gly, previously reported to cause proliferation via putative novel sites on AR4-2J and Swiss 3T3 cells, elicited significant dose dependent increases of similar magnitude in [3H]thymidine incorporation over 3 days in serum-free medium of 39 +/- 10% (P < 0.01, n = 20), 37 +/- 8% (P < 0.01, n = 27) and 41 +/- 6% (P < 0.01, n = 36) respectively. 3. CCK-8s and gastrin potentially stimulated mitogenesis (EC50 values 0.12 nM and 3.0 nM respectively), whilst G-Gly displayed similar efficacy but markedly lower potency. L-365,260 consistently blocked each peptide. The CCK2 receptor affinity of G-Gly in GH3 cells was 1.09 microM (1.01;1.17, n = 6) and 5.53 microM (3.71;5.99, n = 4) in guinea-pig cortex. 4. 1 microM G-Gly weakly stimulated Ca2+ increase, eliciting a 104 +/- 21% increase over basal Ca2+ levels, and was blocked by 1 microM L-365,260 whilst CCK-8s (100 nM) produced a much larger Ca2+ response (331 +/- 14%). 5. Insulin dose dependently enhanced proliferative effects of CCK-8s with a maximal leftwards shift of the CCK-8s curve at 100 ng ml(-1) (17 nM) (EC50 decreased 500 fold, from 0.1 nM to 0.2 pM; P < 0.0001). 10 microg ml(-1) insulin was supramaximal reducing the EC50 to 5 pM (P = 0.027) whilst 1 ng ml(-1) insulin was ineffective. Insulin weakly displaced [125I]BHCCK binding to GH3 CCK2 receptors (IC50 3.6 microM). 6. Results are consistent with mediation of G-Gly effects via CCK2 receptors in GH3 cells and reinforce the role of CCK2 receptors in control of cell growth. Effects of insulin in enhancing CCK proliferative potency may suggest that CCK2 and insulin receptors converge on common intracellular targets and indicates that mitogenic stimuli are influenced by the combination of extracellular factors present.

Animals↗
PubMed1999

Antihypertensive drug treatment: a comparison of usual care with self blood pressure measurement.

Blood pressure self-measurement is increasing in most communities and yet its role in the management of hypertension is poorly understood. This study was devised to evaluate the behaviour of doctors in general practice when treating patients with poorly controlled essential hypertension who use self-measurement. Patients, most of whom were already taking antihypertensive medications were commenced on perindopril or indapamide at their doctor's discretion and were randomly allocated to self-measurement (SM) using an OMRON HEM706 oscillometric device or a continuation of their usual care (UC) over an 8-week period. This was an observational study without any specific or set treatment goals for the doctor to follow. Sixty of 62 subjects completed the study and the two groups were equally matched for age, body mass index, gender, and blood pressure (BP). While additional perindopril or indapamide produced a significant fall in BP in both groups over the study period, the systolic pressure remained significantly higher in the SM group (sitting 148 +/- 3 compared with 142 +/- 3; 145 +/- 3 compared with 138 +/- 3 mm Hg respectively; P < 0.05). Twenty-four hour and daytime ambulatory monitor systolic pressures were also significantly higher in the SM group. Differences in diastolic BP were not statistically significant. Furthermore, SM patients were less likely to have their medications increased and more likely to have them reduced or ceased. Doctors and patients found self-measurement convenient and useful. This study suggests that doctors prescribing decisions are influenced by evidence from self-measurement of BP with consequential increases in office BP related to reduced drug use. While self-BP measurement can offer reassurance about adequacy of control when away from a physicians office, our best evidence of understanding target blood pressures comes from large randomised studies using office blood pressures as an end-point. There is an urgent need for further study to provide arbitration between self-measurement and office blood pressures although each measurement must contribute to the management of hypertension.

Antihypertensive Agents↗
PubMed1999

Hospital blood pressure measurement: staff and device assessment.

Evaluation of the ability of clinical staff to measure blood pressure as well as the functional state of hospital sphygmomanometers has consistently demonstrated marked deficiencies. In this study, the working order of all sphygmomanometers (manual and automated) in a teaching hospital was evaluated. Nursing staff were tested on their knowledge and use of such devices and were also asked to estimate the blood pressure from videotape. The accuracy of a commonly used automated device, Dinamap 8100, was also measured. Of 543 manual sphygmomanometers, 14% were in perfect working order although portable devices were more likely to be functional (47% of 36 units). In contrast, all 135 automated portable devices were in perfect working order although service requirements were seldom met. The mean time since last service was 18 months. There appeared to be an inverse correlation between the availability of automated and manual devices and the maintenance of wall-mounted bedside sphygmomanometers. Staff knowledge about manual devices was adequate as was their ability to accurately measure blood pressure using standardised videotape. Forty-two per cent of 31 nurses who completed the test were correct in 9 of 12 blood pressures. A comparison of this result with a comparable group of nurses tested in 1990 did not detect a significant change in competence. Direct evaluation of the commonly used Dinamap 8100 in 47 hospital patients demonstrated a poor correlation with a mercury sphygmomanometer with a D grade (fail) for systolic and a C grade for diastolic pressure. In summary, maintenance of manual sphygmomanometers was very poor, probably due to their lack of use by clinical staff. This was particularly true for units attached to bedside walls. Nursing staff demonstrated significant deficiencies in manual sphygmomanometer use although their skills were similar to those measured several years earlier. Because of the demonstrated inaccuracy of the Dinamap 8100 automated device, the strong trend towards the use of automated devices instead of manual sphygmomanometers within hospitals cannot be supported.

Adolescent↗
PubMed1998

Class III P-glycoproteins mediate the formation of lipoprotein X in the mouse.

Cholestasis is associated with hypercholesterolemia and appearance of the abnormal lipoprotein X (LpX) in plasma. Using mice with a disrupted Mdr2 gene, we tested the hypothesis that LpX originates as a biliary lipid vesicle. Mdr2-deficient mice lack Mdr2 P-glycoprotein, the canalicular translocator for phosphatidylcholine, and secrete virtually no phospholipid and cholesterol in bile. Bile duct ligation of Mdr2(+)/+ mice induced a dramatic increase in the plasma cholesterol and phospholipid concentration. Agarose electrophoresis, density gradient ultracentrifugation, gel permeation, and electron microscopy revealed that the majority of phospholipid and cholesterol was present as LpX, a 40-100 nm vesicle with an aqueous lumen. In contrast, the plasma cholesterol and phospholipid concentration in Mdr2(-)/- mice decreased upon bile duct ligation, and plasma fractionation revealed a complete absence of LpX. In mice with various expression levels of Mdr2 or MDR3, the human homolog of Mdr2, we observed that the plasma level of cholesterol and phospholipid during cholestasis correlated very closely with the expression level of these canalicular P-glycoproteins. These data demonstrate that during cholestasis there is a quantitative shift of lipid secretion from bile to the plasma compartment in the form of LpX. The concentration of this lipoprotein is determined by the activity of the canalicular phospholipid translocator.

ATP Binding Cassette Transporter, Subfamily B↗
PubMed1998

Benzodiazepine modulation of recombinant alpha1beta3gamma2 GABA(A) receptor function efficacy determination using the Cytosensor microphysiometer.

Gamma-aminobutyric acid (GABA) dose dependently increased extracellular acidification rate in Ltk cells stably expressing human recombinant alpha1beta3gamma2 GABA(A) receptors but had no effect in non-transfected controls. Cells seeded at 1 x 10(5) cells/cup, with 4-5 days induction, had basal acidification rates of 105+/-2 microVs(-1) at 37 degrees C (mean+/-standard error of mean, n=37). GABA responses had a characteristic time-course with an initial alkalinisation followed by a peak of acidification, which was optimized by increasing agonist exposure from 15 s to 25-30 s. The maximum concentration of GABA tested (100 microM) produced a 40+/-2% increase over basal acidification rate (n=3), with an EC50 of 15.5 microM and a Hill slope of 1.5. Responses were specifically antagonized by bicuculline and could be modulated by benzodiazepine ligands with varying efficacies. Full benzodiazepine agonists flunitrazepam (1 microM) and zolpidem (10 microM) significantly potentiated the response to 10 microM GABA by 124+/-15% (n=7) and 117+/-23% (n=3), respectively. The partial agonist bretazenil (100 nM) produced a 45+/-13% (n=3) potentiation whilst the inverse agonist DMCM (10 microM) (methyl 6,7-dimethoxy-4-ethyl-beta-carboline-3-carboxylate) inhibited the response to 20 microM GABA by 53+/-5%. The microphysiometer offers an alternative functional measure for GABA(A) receptors with the sensitivity to measure subtle modulatory effects of benzodiazepine site ligands and to determine their relative efficacy.

Animals↗