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Biomedical subjects

B J Boucher

Publications and source records attributed to B J Boucher.

At least 55 records · Page 3Linked to original sources

The production of immunoreactive alpha- and gamma-interferon by circulating mononuclear cells in type 1 diabetes.

Using a specific immunoradiometric assay method the in vitro alpha interferon response to polyinosinic:polycytidylic acid (poly-I:C) and the gamma interferon response to concanavalin A were measured in peripheral blood mononuclear cells from 11 healthy matched pairs of Type 1 diabetic patients and normal subjects. The alpha-interferon response to poly-I:C was significantly higher in the diabetic group (median 3.7 (range less than 1-25.7) u ml-1) than in the normal group (1.1 (less than 1-15.4) u ml-1, p less than 0.01). The mean gamma-interferon response to concanavalin A was 64.3 +/- 46.9 (+/- SD) u ml-1 in the diabetic patients and 49.4 +/- 18.5 u ml-1 in the normal group (NS). The higher alpha-interferon response to poly-I:C in the diabetic patients was not related to blood glucose concentration, HbA1, age of onset of diabetes, duration of diabetes, or islet cell antibody positivity, and may therefore indicate intrinsic hyper-responsiveness of circulating mononuclear cells in Type 1 diabetes.

Adult↗

Impact of conventional and three-dimensional thallium-technetium scans on surgery for primary hyperparathyroidism.

Twenty-nine patients with primary hyperparathyroidism underwent double-tracer subtraction scanning after injection of 201Tl as thallous chloride for thyroid and parathyroid images followed by 99mtechnetium as sodium pertechnetate for thyroid images prior to surgical exploration of the neck. The operative findings were correlated with the scans. All 23 adenomas (100%) and 13 of 18 (72%) hyperplastic glands were correctly localized. The ability of the scan to identify abnormal parathyroids was determined by the gland mass rather than whether the tissue was adenomatous or hyperplastic as all 32 (100%) abnormal glands weighing more than 180 mg were successfully localized in contrast to four of nine (44%) glands weighing less than 180 mg. An additional technique, in which emission tomography was carried out after subtraction scintigraphy, was used on 11 patients in the series. In all 11, the site of a single abnormal gland was predicted by the conventional subtraction scan: in nine of these patients, emission tomography provided additional localization of the gland in the anteroposterior plane.

Humans↗

2'-5' oligoadenylate synthetase and its relationship to HLA and genetic markers of insulin-dependent diabetes mellitus.

Cytokines and their related enzyme pathways may play a part in the development of insulin-dependent diabetes mellitus (IDDM). We have therefore studied the activity of the enzyme 2'-5' oligoadenylate synthetase (which is induced by both interferon and the tumour necrosis factors) in circulating mononuclear cells from 40 subjects with IDDM and 32 healthy control subjects. There was no difference in mean basal enzyme activity between the two groups. A polymorphism of the 2'-5' oligoadenylate synthetase gene, not previously described, was found using the restriction enzyme Bam HI. There was no association of 2'-5' oligoadenylate synthetase genotypes with IDDM, but there was a significant correlation between basal 2'-5' oligoadenylate synthetase activity and 2'-5' oligoadenylate synthetase genotypes. Significantly higher mean basal levels of 2'-5' oligoadenylate synthetase activity were associated with HLA-DQA 4.6 phenotype (determined using the restriction enzyme Taq 1 and a DQA probe) and HLA-DR3 (determined serologically), whereas significantly lower mean levels of enzyme activity were associated with HLA-DQA 5.5 and HLA-DR7, in both IDDM and control subjects. An analysis of variance confirmed that these associations were independent 2'-5' oligoadenylate synthetase genotype. Likewise, a significantly higher mean level of enzyme activity was associated with the heterozygous 1/3 insulin-related genotype in the IDDM subjects only. This study therefore suggests that the possession of certain HLA haplotypes might be associated with differing levels of basal 2'-5' oligoadenylate synthetase activity.

2',5'-Oligoadenylate Synthetase↗

Relationship between retinopathy and glycaemic control in insulin-dependent and non-insulin-dependent diabetes.

The possible relationship between antecedent diabetic control, as determined by serial glycosylated haemoglobin (HbA1) measurements, and diabetic retinopathy was examined in 40 insulin-dependent and 41 non-insulin-dependent diabetics selected consecutively from our clinic population. Multiple logistic regression analysis demonstrated a significant association between mean HbA1 and prevalence of retinopathy in both groups of patients. This association was independent of duration of diabetes which was also significantly associated with retinopathy prevalence. Hypertension and smoking were not obvious risk factors in this group of patients; an apparent association of hypertension and diabetes was entirely accounted for by a positive relationship between the presence of hypertension and duration of diabetes.

Blood Glucose↗

Do vitamin D supplements improve the physical capabilities of elderly hospital patients?

A randomized double-blind controlled trial of the effect of vitamin D supplementation on the abilities of elderly hospital patients to carry out basic activities of daily life is described. Those patients included in the trial had plasma 25-hydroxyvitamin D concentrations which were low or low normal as judged by the normal range in young adults. After 2 to 9 months on the trial there was no significant difference in the performance of the control and treatment groups.

Activities of Daily Living↗

Alteration of pituitary-thyroid function in patients with chronic renal failure treated by haemodialysis or continuous ambulatory peritoneal dialysis.

Pituitary-thyroid function was investigated in 60 patients with chronic renal failure and 18 normal subjects. Serum triiodothyronine and free thyroxine levels were lower in patients treated by either haemodialysis or continuous ambulatory peritoneal dialysis compared with the normal subjects. Serum thyroxine and free thyroxine index were significantly lower in the haemodialysis-treated patients than in the normal subjects. There were no differences in serum thyroxine and free thyroxine index between the continuous ambulatory peritoneal dialysis-treated and normal groups. Serum thyrotrophin was not raised in any of the groups but the serum thyrotrophin response to thyrotrophin-releasing hormone was blunted in both groups of patients. Basal serum prolactin and growth hormone were raised in both groups of patients but there was no significant difference between them. This study confirmed that pituitary-thyroid function is abnormal in patients receiving haemodialysis and established that a similar pattern of abnormalities occurs in patients undergoing continuous ambulatory peritoneal dialysis.

Adult↗

Incidence of metabolic bone disease in rheumatoid arthritis and osteoarthritis.

Bone biopsy specimens from the iliac crest were obtained during surgical operations from 45 patients with rheumatoid arthritis (RA) and 41 with osteoarthritis (OA). Control material was obtained from 20 cases of sudden death due to cardiovascular disease. By both conventional histology and image analysis techniques about a quarter of all patients showed some osteoporosis. This was equally common among the OA and RA patients. It was more common among those with transparent skin and those taking corticosteroids. The only case showing mild osteomalacia suffered from OA. No gross differences were apparent between the groups in relation to plasma biochemical studies, diet, or exposure to sunlight. These results are in striking contrast to the high incidence of osteomalacia in RA reported from the west of England; moreover they do not confirm reports of hypercalcaemia among rheumatoid subjects. We conclude that the differences regarding osteomalacia are due to selection of cases. We find no evidence that osteomalacia is specifically associated with RA.

Aged↗

A collaborative study of the measurement of glycosylated haemoglobin by several methods in seven laboratories in the United Kingdom.

A collaborative study compared methods for measuring glycosylated haemoglobin in seven laboratories in the United Kingdom. No satisfactory standard for general use was found. Satisfactory internal quality control systems were in use for each assay which allowed the maintenance of a normal range in each participating laboratory. No satisfactory quality control system suitable for general use could be identified. Costs and convenience of the assays are reported. The technical problems with each type of assay and precautions for their use were identified, such as the need for standardization in incubation times, the practicability of automation of colorimetric assays, and the precision of pH needed for buffers in column separation methods. The relevance of the technical problems to interpretation of measurements is also considered. It is concluded that laboratories measuring glycosylated haemoglobin should maintain a normal range, use 'in-house' quality controls to monitor assay performance and keep clinical colleagues informed of the findings and of any changes in methodology that might affect the interpretation of results.

Autoanalysis↗