Thoracic aorta tear repair.
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Biomedical subjects
Publications and source records attributed to C Bateman.
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We report the use of remifentanil as part of a general anaesthetic technique for a patient with mixed mitral valve disease, asthma and pre-eclampsia presenting for an emergency Caesarean section. The use of remifentanil was associated with stable haemodynamic variables during general anaesthesia. No clinically significant respiratory depression was noted in the neonate.
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The airway response to histamine has been shown to be related to the 24 hour urinary excretion of sodium. To assess whether this relation is likely to represent a direct causal association a randomised double blind crossover trial of slow sodium (80 mmol/day) was compared with placebo in 36 subjects having a low sodium diet. The dose of histamine causing a 20% fall in FEV1 (PD20) was 1.51 doubling doses lower when the men were taking sodium than when they were taking placebo (p less than 0.05). On the basis of PD10 values, the difference in men was 1.66 doubling doses of histamine (p less than 0.05). There was no corresponding effect in women. Regressing PD10 against urinary excretion of electrolytes with data from the two occasions during the trial and the measurements made before the trial showed a significant association with sodium excretion after allowance had been made for any effect associated with potassium or creatinine excretion, the latter being a marker of the completeness of the urine collection. Again there was no corresponding effect among women. These findings are compatible with the differences in regional mortality data for England and Wales, which show a relation between asthma mortality and regional per person purchases of table salt for men but not for women.
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In vitro methylation of Bluescribe plasmid DNA (pBS) with human placental DNA methyltransferase to 6% 5-methylcytosine (mC) reduced transformation efficiencies in rglB+ host strains C600 and DS410 by almost 2 orders of magnitude. By contrast, the rglB- derivative of DS410 showed no reduction in transformation efficiency with methylation while the rglB- derivative of C600 was partially tolerant to methylation. Further, we show that the 1.8 kilobase (kb) and 1.2 kb KpnI fragments derived from the human L1 repeat have respectively 18.3% and 2.3% mC in vivo. Using these hyper- and hypo-methylated genomic segments ligated into the pBS plasmid, transformants with the highly methylated 1.8 kb L1 insert were recovered at 17 to 40 fold higher frequency with the rglB- host strains than with the rglB+ hosts. In addition, recombinant phage (lambda 2001) containing inserts of plant genomic DNA with 26.7% mC (from Petunia hybrida) when plated on rglB- hosts gave titres up to 222 times higher than on the rglB+ strains.
The initiation and maintenance of thyroid autoimmunity by professional antigen-presenting cells were assessed by observing thyroiditis and induction of IgG antibodies to thyroglobulin (Tg). Dendritic cells (DC) were purified from spleens of CBA mice and T cells removed with anti-Thy 1 and complement. Some DC were pulsed with 25-500 micrograms/ml of mouse Tg in vitro and normal syngeneic mice received injections of 10(5) cells intravenously. In untreated animals only 1 thyroid out of 40 showed a lymphocyte infiltrate and antibody to Tg was rarely seen. In animals receiving normal DC without Tg, lymphocyte infiltration was seen 2-6 weeks later in 5 out of 33 thyroids and some animals produced low levels of antibody to thyroglobulin (8 of 33 animals). DC pulsed with 500 micrograms Tg/ml in vitro caused thyroid infiltration in 6 out of 15 animals but did not increase the incidence of anti-Tg antibodies. Lower doses had no effect. When 10(5) DC were given from animals with experimental allergic thyroiditis (EAT, induced with Tg in complete Freund's adjuvant, CFA) more than half of the recipient animals showed thyroiditis (8 out of 15) and autoantibody production (12 of 15 animals). DC may therefore play a role in the initiation and maintenance of autoimmunity by providing a stimulus for antigen-specific T cells.
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The influence of dietary composition on the unconjugated hyperbilirubinaemia of Gilbert's syndrome was studied in 29 patients. After a period on a normal diet (10 MJ) an intravenous infusion of 40% glucose (8-4 MJ) together with a 1-6 MJ oral diet for two days resulted in an increment in plasma bilirubin concentration of 127 +/- 18% (mean +/- SEM) above the basal level. Both the administration of intravenous Intralipid 20% and the return to a normal diet caused a prompt reversal of this glucose effect. An increment of 135 +/- 10% in plasma bilirubin concentration was obtained when a standard "fasting" diet (1-6 MJ) was given for two days. When the lipid content of this "fasting" diet was increased from 33% to 85%, the rise in plasma bilirubin was only 49 +/- 19%. A 10 MJ oral diet for three days, which contained most of its energy content as carbohydrate and only 0-6% as lipid, produced a 76 +/- 12% increase in plasma bilirubin concentration. When the lipid content of the diet was increased to 9% of the energy intake no significant change from the basal level was observed. These findings support the hypothesis that the hyperbilirubinaemia associated with both carbohydrate feeding and fasting is attributable, at least in part, to lipid withdrawal. Although a restricted dietary intake or the parenteral administration of lipid-free solutions has a marked effect on the hyperbilirubinaemia of patients with Gilbert's syndrome, normal daily variation in dietary composition is unlikely to cause a significant change. The influence of different feeding regimes on neonatal hyperbilirubinaemia requires investigation.
Lungs of unselected cadavers were fixed at necropsy using a formalin vapour technique. "Band shadows" were identified in the excised lungs and these were correlated with in vivo radiographs and with the morphological changes in the lung. Persistent shadows were produced by pulmonary infarction, subsegmental atelectasis, and septal fibrosis singly and in combination. Potentially transient shadows were seen in association with atelectasis and pulmonary oedema.
Using in vitro incubation, human placental slices have been shown to synthesize lipid from 14-C fructose, but to a lesser extent than from 14-C glucose. Diabetic placentae did not incorporate more of either sugar into lipid than did placentae from normal pregnancies; nor did insulin in the incubation medium enhance lipogenesis. There was a correlation between the extent of incorporation of 14-C fructose and 14-C glucose into triglyceride, suggesting a linked enzyme system for phosphorylation of the two hexoses.