Biomedical subjects
Publications and source records attributed to C Anderson.
An unusual and unreported mixed type Zollinger-Ellison syndrome, including features of a Type I and II syndrome, is presented as a component of a neoplastic profile constituting a highly diverse multiple endocrine neoplasia Type I syndrome.
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A 54-year-old patient with fracturing dialysis osteomalacia and dementia demonstrated rapid deterioration following parathyroidectomy which was performed for sustained hypercalcemia. Reduction of the total body aluminum burden was attempted using desferrioxamine (DFO) as a chelating agent. After 6 months, DFO infusion resulted in sustained clinical remission of both neurological and skeletal symptoms, associated with an improvement in the EEG and improved mineralization of bone. A reduction in total body aluminum burden was reflected by reduced skeletal aluminum content, quantitated histochemically in iliac crest bone biopsies before and after DFO therapy. Dramatic increases in serum aluminum levels were documented in the initial weeks of DFO therapy leading to increased removal of aluminum during dialysis; in vitro studies indicated that the ultrafiltrable fraction of serum aluminum increased from 17 to more than 60% after initiating DFO treatment. However, after 6 months of therapy, serum aluminum levels remained unchanged after DFO infusion. These findings suggest that the serum aluminum response to DFO infusion might be a useful reflection of the total-body aluminum burden and also a reflection of the adequacy of a chelation program designed to reduce whole-body aluminum content.
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Sulconazole nitrate, a new imidazole derivative, was formulated at 1% concentration in a cream vehicle and compared with 2% miconazole nitrate cream in the treatment of tinea versicolor in a double-blind, multicenter, randomized, parallel clinical trial. At baseline, all of the 192 patients enrolled had a positive potassium hydroxide (KOH) preparation; itching was reported by 48% of the patients. The medications were applied twice daily for three weeks. Of 181 patients analyzed for efficacy at the end of the treatment trial, 93% of sulconazole-treated patients and 87% of miconazole-treated patients had become KOH negative. The complete clearing of tinea versicolor lesions occurred in 89% of sulconazole-treated patients and 82% of miconazole-treated patients. Both drugs were well tolerated with no systemic reactions reported. Drug-related adverse cutaneous reactions, predominantly transient itching, were reported in eight patients receiving sulconazole and in four patients receiving miconazole.
To investigate the possibility that aluminum (Al) salts might associate specifically with osteoid matrix in bone, an animal model was developed in which hyperosteoidosis was controlled independently by the vitamin D status. Nonuremic rats were weaned on a vitamin D-free diet (D-) and half were given intraperitoneal AlCl3 (9.25 mg Al over 33 days). At sacrifice, serum calcium was significantly higher in Al-treated D- rats compared to D- controls (9.4 +/- 0.3 vs. 6.9 +/- 0.8 mg/dl, p less than 0.01). Serum and bone Al content were measured by flameless atomic absorption spectroscopy; Al content was 318 +/- 38 micrograms/l in serum, and 248 +/- 11 mg/kg dry bone weight in Al-treated rats, compared to almost undetectable levels in D- controls. Al was identified histochemically in Al-treated rats by its heavy deposition in subepiphyseal trabecular bone; where it occupied almost 50% of the linear trabecular bone surface, usually sandwiched between bone and osteoid seams. Both groups of animals had severe osteomalacia, but there was no evidence that Al induced a more severe lesion in addition to vitamin D deficiency. Parenteral Al was also given to rats fed a similar diet, but supplemented with vitamin D3 (D+) (cumulative dose of Al, 37.25 mg over 70 days). At sacrifice, serum Al was 671 +/- 50 micrograms/l, but bone Al was only 142 +/- 10 mg/kg, significantly less than bone Al in D- Al-treated rats. There was no evidence of osteomalacia in D+ Al-treated rats in which histochemical staining for Al was essentially negative.(ABSTRACT TRUNCATED AT 250 WORDS)
Age-standardized comparisons of mortality rates from four causes in 14 Aboriginal reserves and communities in Queensland were examined. The 14 reserves were allocated to two groups within 10 socioenvironmental variables. The findings point to an association between Queensland government Aboriginal policy, the administration of reserves, and the consequent mortality rates of the residents of these reserves.
The stomach and small intestine of seven species of teleost fish were examined with both fluorescence and ultrastructural histochemical techniques for demonstrating monoamines. Fluorescence histochemistry demonstrated large numbers of yellow fluorescent neurons in the myenteric plexus of the intestine, but not the stomach, of four species. Varicose fibres arising from these neurons ran in the myenteric plexus, circular muscle layer and submucosa. Ultrastructural histochemistry of tissue fixed with a modified chromaffin reaction showed that some neurons in the myenteric plexus contained biogenic amines in vesicles of 40--100 nm diameter. It is concluded that 5-HT-containing neurons are present in the intestine of some teleost species.
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Aggregation of dissociated sponge cells has been proposed as a model for cell-cell recognition mediated by a specific proteoglycan aggregation factor (Microciona aggregation factor). To test whether sponge cells undergo stimulus-response coupling in which intracellular Ca is a messenger, aggregation of mechanically dissociated cells was studied. Changes in light transmission through cell suspensions paralleled aggregation as judged by microscopy. In the presence, but not absence, of Ca (>5 mM) partially purified Microciona aggregation factor aggregated both living and glutaraldehyde-fixed cells. Evidence for a messenger role of Ca was the following: (i) Addition of Ca to Ca-depleted cells induced aggregation that varied with [Ca]. (ii) Addition of Ca ionophores (A23187 and ionomycin) caused aggregation that varied with [Ca] and far exceeded that provoked by Ca alone. Glutaraldehyde-fixed cells did not respond to ionophores with or without Ca. (iii) Calcium antagonists inhibited aggregation. These included inhibitors of the Ca-calmodulin complex (N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide hydrochloride and 1-[bis(p-chlorophenyl)methyl]-3-[2,4-dichloro-beta-(2,4-dichlorobenzyloxyl)phenylethyl]imidazolinium chloride), Ca channel blockers (La, Co, Cd, and verapamil), and three nonsteroidal anti-inflammatory agents (indomethacin, ibuprofen, and piroxicam). Results indicated not only that early events of sponge aggregation can be quantified by continuous recording but that aggregation is not simply due to passive agglutination of inert cells by an extracellular proteoglycan. Rather, sponge cells recognize surface ligands to which they respond by Ca-dependent stimulus-response coupling.
Passive K transport, as modified by N-ethyl maleimide (NEM), was studied in erythrocytes of the low-K (LK) phenotype of sheep. Brief (5-min) treatment with NEM at less than 0.5 mM caused inhibition of passive K influx; NEM at concentrations greater than 0.5 mM caused stimulation of K influx. NEM had similar effects on K efflux. The treatments with NEM did not affect cell volumes (passive K transport in LK cells is sensitive to changes in cell volume). The stimulation of K transport by high [NEM] was also not a consequence of an effect on the metabolic state of the cells. Passive K transport in LK cells is dependent on Cl (it is inhibited in Cl-free media; it may be K/Cl cotransport). NEM had no effect on K influx in Cl-free (NO3-substituted) media. Pretreatment of the cells with anti-L antiserum (L antigen is found on LK cells and not on HK cells) prevented stimulation of K influx by NEM, but did not prevent inhibition. Therefore, NEM modifies the Cl-dependent K transport pathway at two separate sites, a low-affinity site, at which it stimulates, and a high-affinity site, at which it inhibits. Anti-L antibody prevents NEM's action, but only at the low-affinity site.
Sulconazole nitrate cream 1%, a new topical imidazole compound with a broad antifungal activity, was compared to its vehicle and to miconazole nitrate cream 2% in two double-blind parallel studies involving 96 patients with cutaneous candidiasis. Once daily application of sulconazole was as effective as twice daily application of miconazole and produced KOH and culture cures in 100% and 88% of patients, respectively. No systemic adverse reactions were reported. One vehicle-treated patient developed itching; six sulconazole- and three miconazole-treated patients developed erythema and/or pruritus, which was mild and transient. Sulconazole used bid was significantly superior to its vehicle and produced KOH and culture cures in 100% of patients.
Fetal visualization in utero can be routinely accomplished using noninvasive ultrasound techniques that do not administer ionizing radiation. Image resolution with real time sonography is sufficient to demonstrate details of possible congenital central nervous system malformations before delivery. The case reported illustrates the advantages of advance warning in an infant with occipital meningoencephalocele for determining prognosis, planning delivery by cesarean section, and preparing for immediate neurosurgical repair.
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This exploratory study was conducted over a 12-month period to describe the relationship between selected clinical variables and the occurrence of postoperative cardiac tamponade. Data were collected on 19 variables. A total of 739 patients were included in the study. A postoperative diagnosis of cardiac tamponade was made in nine of these patients who then comprised the tamponade group. A matched non-tamponade control group of 18 patients was identified for comparison. The following were found to be significantly different in a statistical comparison between variable values in the tamponade and non-tamponade groups: (1) serum creatinine level (p = 0.005), (2) chest tube drainage (p = 0.009), (3) sustained pressure plateau (p = .018), and (4) mediastinal widening (p = 0.039). Two additional variables, pulsus paradoxus and elevated BUN, appeared to be of value in the assessment of late tamponade. Discriminant analysis showed a high predictive accuracy of the above combined variables. Such results warrant the further investigation of these variables in other clinical settings. Both a replication and testing of a tamponade score system would be a fertile and necessary area of research for critical care nurses who provide care for post-cardiac surgery patients. These data suggest that equal weight be assigned to each of the four variables. Thus scores would range from 0 to 4; higher scores would represent greater risk (Table III). With further investigation of this area of clinical practice, the identification of patients at higher risk for tamponade could be greatly facilitated.
Infectious disease due to multiple organisms results from underlying disease or invasive procedures and is uncommon in the pediatric age group. We report a case of polymicrobial bacteremia in an infant in whom no underlying disease was substantiated despite extensive evaluation. The presence of Polle syndrome--an adult-induced illness--was subsequently proved. This diagnosis should be considered early in the evaluation of children for whom repeated blood culturing indicates polymicrobial bacteremia.
Two hundred one patients with high-risk pregnancy and 66 patients with term uncomplicated pregnancy underwent a nonstress test 7 days or less prior to delivery. The incidence of spontaneous fetal heart rate decelerations in the high-risk group was 5.5%. None of the fetuses in the normal group showed this finding. Among those infants presenting with spontaneous decelerations, there was an 18.2% mortality. Disturbances of intrauterine growth were found in 63.6% of cases. The possible metabolic mechanisms and clinical implications underlying this finding are discussed.