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Biomedical subjects

C Holmes

Publications and source records attributed to C Holmes.

At least 109 records · Page 6Linked to original sources
PubMed1993

Water balance in elderly people: is there a deficiency of vasopressin?

Since elderly people are prone to develop both hypo- and hyper-natraemia, we have investigated the biochemical and hormonal responses to overnight (9 h) abstinence from fluids and subsequent oral water load (20 ml/kg) in a group of healthy elderly (E) (mean age 68 years) and young (Y) (mean age 28 years) volunteers. The elderly subjects had significantly higher baseline plasma osmolality (E 293.5 +/- 0.5, Y 290.5 +/- 0.8 mOsm/kg, p < 0.05) but lower urinary osmolality (E 508 +/- 47, Y 842 +/- 52 mOsm/kg, p < 0.001) and lower plasma vasopressin (E 0.5 +/- 0.1, Y 2.3 +/- 0.6 pmol/l, p < 0.001) than the young. There was a significant difference in the mode of excretion, particularly maximum free water clearance (E 6.0 +/- 0.6, Y 10.1 +/- 0.8 ml/min) but no difference in the overall ability to excrete the water load (at 4 h E 93 +/- 8%, Y 92 +/- 5%, p > 0.05). The biochemical and hormonal results suggest that the elderly subjects were in a state similar to partial cranial diabetes insipidus which may predispose them to dehydration and hypernatraemia. The reduction in maximum free water clearance may predispose them to hyponatraemia if excess fluid is administered.

Adolescent↗
PubMed1993

Oral yohimbine increases blood pressure and sympathetic nervous outflow in hypertensive patients.

Yohimbine is an alpha 2-adrenoceptor antagonist that is FDA approved for treatment of impotence. The drug is an indolalkylamine alkaloid chemically similar to reserpine and is believed to act through sympatholysis. We examined effects of oral yohimbine on blood pressure (BP) and plasma levels of catechols in patients with essential hypertension, a condition in which most drug treatments can produce impotence. In 25 unmedicated hypertensive subjects, vital signs were measured and blood samples were obtained through an indwelling antecubital venous catheter at baseline and 1 and 2 h after subjects ingested 4 5.4-mg tablets of yohimbine. Mean blood pressure (MBP) increased by an average of 5 mm Hg (p < 0.01), plasma norepinephrine (NE) levels increased by 66% (p < 0.001), and plasma dihydroxyphenylglycol (DHPG) levels increased by 25% (p < 0.01) at 1 h after drug administration. The magnitude of the pressor response was unrelated to baseline MBP but positively correlated with the baseline NE level (r = 0.61, p < 0.01) and with the yohimbine-induced increment in plasma NE (r = 0.4, p < 0.01). The results indicate that yohimbine does not inhibit and actually stimulates sympathetically mediated NE release in humans and that the increased NE release produces a pressor response. Yohimbine should be administered with caution to patients with high BP, especially in individuals with evidence for increased basal sympathetic outflow or those undergoing concurrent treatment with tricyclic antidepressants or other drugs that interfere with neuronal uptake or metabolism of NE.

Administration, Oral↗
PubMed1993

Experimental peritoneal dialysis solutions.

A survey of the literature suggests continued interest in modifying the composition of peritoneal dialysis solutions. Osmotic agents such as glucose polymers and short-chain polypeptides may find a role in peritoneal dialysis fluids as partial substitutes for dextrose. New solutions containing amino acids should serve as more than sinks for uremic toxins by providing nutritional support and by ameliorating uremic lipid abnormalities. Increasing emphasis is being paid to biocompatibility during the development of new peritoneal dialysis fluids.

Amino Acids↗
PubMed1993

Out of hours emergency dental service provision in Scotland--a survey of Health Boards.

Dental practitioners are a source of out of hours emergency dental care, but Health Boards in Scotland have been encouraged to make certain additional provision. A survey carried out in July 1991 has shown that ten of the 15 Scottish Health Boards operate a centralised, out of hours emergency dental service. The areas without such a service are mainly rural and with a small population, where setting up a scheme would be expensive and difficult. Only one Health Board operates a weekday service, but all of the Boards which provide a service operate it at weekends and on public holidays. There is considerable variation in the extent and use of the services provided by the different health boards. The greatest use of emergency dental services is in areas where the dentist:population ratio is good.

Appointments and Schedules↗
PubMed1993

Changes in the characteristics of patients attending an out-of-hours emergency dental service in Edinburgh.

A daily out-of-hours emergency dental service was established in Edinburgh in 1977. An analysis of some recent annual surveys carried out by the service shows that there has been an increasing trend for the patients to have experienced their dental problem for more than three days, to have travelled more than 10 miles to attend the clinic and not to have attended the dentist for more than a year. This analysis also reveals an increasing trend for people who seek treatment at the emergency service to have received routine treatment rather than emergency treatment on their last dental visit. There is evidence that the Lothian emergency dental service is developing its own clientele.

Adolescent↗
PubMed1992

Effects of alprazolam on pituitary-adrenal and catecholaminergic responses to metabolic stress in humans.

Concurrent effects of benzodiazepines on stress-induced activation of the three classical "stress" systems: pituitary-adrenal, adrenomedullary, and sympathoneural systems have not been extensively investigated in humans. In the present study, the effects of alprazolam (1.5 mg) on plasma levels of adrenocorticotropin hormone (ACTH), epinephrine, norepinephrine, dihydroxyphenylglycol (DHPG, the intraneuronal metabolite of norepinephrine), and mood states were examined in 10 healthy volunteers undergoing glucoprivic stress. Glucoprivic stress was induced by intravenous administration of the glucose analog, 2-deoxyglucose (2DG), at a dose (50 mg/kg) that impairs cellular glucose metabolism and produces a state comparable to hypoglycemia. Alprazolam and 2DG were administered in a double-blind, placebo-controlled manner. 2DG produced robust elevations in plasma ACTH and epinephrine levels, modest elevations in plasma norepinephrine levels, and decreases in plasma DHPG levels. Alprazolam significantly attenuated the 2DG-induced increases in plasma ACTH and epinephrine, but did not significantly effect plasma norepinephrine and DHPG. These data suggest that benzodiazepines attenuate metabolic stress-induced activation of the pituitary-adrenal and adrenomedullary systems but do not effect 2DG-related effects on peripheral sympathoneural function. The possible mechanisms involved are discussed.

Adrenocorticotropic Hormone↗
PubMed1992

Effects of handling or immobilization on plasma levels of 3,4-dihydroxyphenylalanine, catecholamines, and metabolites in rats.

In conscious animals, handling and immobilization increase plasma levels of the catecholamines norepinephrine (NE) and epinephrine (EPI). This study examined plasma concentrations of endogenous compounds related to catecholamine synthesis and metabolism during and after exposure to these stressors in conscious rats. Plasma levels of 3,4-dihydroxyphenylalanine (DOPA), NE, EPI, and dopamine (DA), the deaminated catechol metabolites 3,4-dihydroxyphenylglycol (DHPG), and 3,4-dihydroxyphenylacetic acid (DOPAC), and their O-methylated derivatives methoxyhydroxyphenylglycol (MHPG) and homovanillic acid (HVA) were measured using liquid chromatography with electrochemical detection at 1, 3, 5, 20, 60, and 120 min of immobilization. By 1 min of immobilization, plasma NE and EPI levels had already reached peak values, and plasma levels of DOPA, DHPG, DOPAC, and MHPG were increased significantly from baseline, whereas plasma DA and HVA levels were unchanged. During the remainder of the immobilization period, the increased levels of DOPA, NE, and EPI were maintained, whereas levels of the metabolites progressively increased. In animals immobilized briefly (5 min), elevated concentrations of the metabolites persisted after release from the restraint, whereas DOPA and catecholamine levels returned to baseline. Gentle handling for 1 min also significantly increased plasma levels of DOPA, NE, EPI, and the NE metabolites DHPG and MHPG, without increasing levels of DA or HVA. The results show that in conscious rats, immobilization or even gentle handling rapidly increases plasma levels of catecholamines, the catecholamine precursor DOPA, and metabolites of NE and DA, indicating rapid increases in the synthesis, release, reuptake, and metabolism of catecholamines.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1992

Hypercortisolemia inhibits yohimbine-induced release of norepinephrine in the posterolateral hypothalamus of conscious rats.

Chronic hypercortisolemia attenuates yohimbine (YOH)-induced increments in plasma levels of the sympathetic neurotransmitter norepinephrine (NE). The present study used in vivo microdialysis to study the effects of hypercortisolemia on YOH-induced release of NE in the brain. Cortisol (25 mg/kg.day) or saline was infused sc into rats for 7 days via an osmotic minipump. Microdialysate and plasma concentrations of NE and its metabolites dihydroxyphenylglycol and methoxyhydroxyphenylglycol were measured before and after YOH (1 mg/kg, iv) administration in conscious animals, with microdialysate and plasma collections beginning 20-24 h after probe implantation. Chronic cortisol treatment resulted in attenuated NE, dihydroxyphenylglycol, and methoxyhydroxyphenylglycol responses in both microdialysate and plasma. The results indicate that YOH increases central neural as well as peripheral release, reuptake, turnover, and metabolism of NE and that hypercortisolemia suppresses these responses.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1992

Plasma dopa responses during stress: dependence on sympathoneural activity and tyrosine hydroxylation.

Dihydroxyphenylalanine (dopa), the precursor of all the endogenous catecholamines, circulates in plasma at a concentration higher than that of the sympathetic neurotransmitter, norepinephrine (NE). Sources of dopa in plasma and the meaning of plasma dopa levels in terms of sympathoneural function have been unclear. Plasma concentrations of dopa, the catecholamines NE, epinephrine and dopamine, the deaminated catechol metabolites dihydroxyphenylglycol and dihydroxyphenylacetic acid, and the O-methylated metabolites methoxyhydroxyphenylglycol and homovanillic acid were measured during immobilization stress in conscious rats. Animals were pretreated with chlorisondamine to block ganglionic neurotransmission or with alpha-methyl-para-tyrosine to inhibit tyrosine hydroxylation. Immobilization produced rapid, sustained increases in plasma levels of dopa, catecholamines and catecholamine metabolites. Chlorisondamine decreased base-line plasma dopa and NE levels and abolished the increases in plasma dopa and NE levels during immobilization. alpha-Methyl-para-tyrosine administration produced sustained decreases in plasma dopa levels and markedly attenuated immobilization-induced increases in plasma dopa levels. Bilateral adrenalectomy augmented base-line plasma levels of dopa and NE and augmented dopa and NE responses during immobilization. The results indicate that during immobilization stress, increased postganglionic sympathoneural outflow stimulates the synthesis of dopa in sympathetic neurones and enhances release of dopa into the circulation. The data generally support the view that changes in plasma dopa levels during stress reflect in vivo changes in the rate of catecholamine biosynthesis in sympathetic nerve terminals.

Adrenalectomy↗
PubMed1991

Effect of neural transplants on seizure frequency and kindling in immature rats following kainic acid.

To study the hypothesis that neural transplantations can alter seizure susceptibility in a chronic animal model of epilepsy 260 immature rats (30- to 32-days-old) were administered a convulsant dosage of kainic acid (KA). Ten days later rats that had severe seizures following KA received either bilateral intracerebroventricular transplants of hippocampal (n = 27), neocortical (n = 29), cerebellar (n = 30), or locus ceruleus (n = 32) tissue, or underwent sham transplantation (n = 66). Spontaneous seizure frequency was assessed for 230 days following which the rats underwent entorhinal kindling. The percentage of rats developing spontaneous recurrent seizures was similar in the 4 transplant groups and the sham-operated controls. Rats receiving hippocampal and locus ceruleus transplants had fewer spontaneous seizures than the sham-operated controls or other transplant groups. However, there were no differences in afterdischarge thresholds or kindling rates in the 5 groups. This study demonstrates that the anticonvulsant effects of neural transplants, using this animal model are mild. Tissue type of the graft appears to be an important variable in the alteration of seizure frequency.

Animals↗
PubMed1991

Anti-inflammatory effects of pentoxifylline in claudication.

We measured neutrophil elastase/alpha 1 proteinase inhibitor complex (E/alpha) levels by ELISA in plasma samples drawn from 19 patients with claudication, before and at 1 and 2 months after initiation of pentoxifylline (PTF), 400 mg. p.o. tid. Plasma E/alpha levels declined in all eight patients whose initial values were more than 300 ng elastase per ml. Whole blood viscosity (wbv) was reduced by two months' treatment in 12 of 14 patients tested. The relative change in wbv was significantly related to the relative change in E/alpha (R2 = 0.8), for patients with elevated initial E/alpha levels, suggesting a common or related mechanism for the two effects. Plasma crosslinked fibrin D-dimer fragments (XDP) measured by ELISA as indicators of coagulation activity were lower compared to pretreatment levels in 9 of 10 samples drawn when symptoms were improved on PTF, whereas they were increased in 6 of 9 samples drawn when symptoms were worse or unchanged. Plasma viscosity, C-reactive protein and alpha 1-acid-glycoprotein did not change significantly with PTF treatment. Together these findings are consistent with the possibility that reduced microvascular neutrophil activation and coagulation play a role in the clinical efficacy of PTF in intermittent claudication.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1991

Host defense mechanisms in the peritoneal cavity of continuous ambulatory peritoneal dialysis patients. 2. Humoral defenses.

This is the second of a 2-part series reviewing host defense mechanisms of the peritoneal cavity of continuous ambulatory peritoneal dialysis (CAPD) patients. This article discusses humoral aspects of host defenses and accompanies the first article that focused upon cellular defenses. The purpose of this review is to provide a critical analysis of studies that have investigated the importance of peritoneal humoral immunity of CAPD patients in the pathogenesis of peritonitis. Specific attention is given to how CAPD alters normal humoral defenses of the peritoneal cavity and the clinical significance of such alterations.

Antibody Formation↗
PubMed1991

Host defense mechanisms in the peritoneal cavity of continuous ambulatory peritoneal dialysis patients. 1.

This article provides a review of studies on peritoneal white blood cells (WBC) in CAPD patients. To some extent these studies support the concept that the peritoneal cavity of these patients contains adequate-functioning WBC that can provide effective antimicrobial defenses when they are studied in dialysate-free media. Commercially available dialysis solutions significantly impair WBC function. In some patients with high incidences of peritonitis, there appears to be reduced bactericidal capacity of their peritoneal macrophages. CAPD seems to contribute to a state of both macrophage and lymphocyte activation in the peritoneal cavity. The clinical consequences of this chronic activation are not known.

Cytokines↗
PubMed1990

The independence of horizontal and vertical dimensions in handwriting with and without vision.

The purpose of this study was to investigate the relationship between horizontal and vertical components of handwriting production when subjects were instructed to vary the size of these components separately or together. The effect of vision on these instructed size transformations also was examined. Eight female adults participated in the experiment. The basic task was to write the words 'poppy' and 'wood' cursively five times, the first time in their normal size and then with four size transformations. These transformations--one-fourth, one-half, double, and four-times their normal size--were made under three different sets of instructions (width only, height only, both) and in two visual conditions (normal, blindfolded), for a total of six sets of five repetitions. The individual slopes (changes in actual values across the transformation values) for width and height under instructions to change both parameters were almost identical to the width and height slopes under instructions to change only the single parameter, supporting the notion of the independence of the horizontal and vertical components. Further, an analysis of these individual slopes indicated that the size transformations were significantly greater (p less than 0.05) (and closer to the instructed values) with vision than without vision.

Adult↗
PubMed1989

Monoclonal antibodies to the membrane domain of the human erythrocyte anion transport protein. Localization of the C-terminus of the protein to the cytoplasmic side of the red cell membrane and distribution of the protein in some human tissues.

(1) We have prepared murine monoclonal antibodies to the membrane domain of the human erythrocyte anion transport protein (band 3). (2) All of these antibodies react with regions of the protein located at the cytoplasmic surface of the red cell. (3) One of the antibodies reacts with an epitope present on a cytoplasmic loop of the protein located between the C-terminus and a point 168 amino acids from the C-terminus. The other antibodies recognize different epitopes on the C-terminal tail of the protein and the sequences likely to be involved in these epitopes are defined. (4) Our results show that the C-terminus of the red-cell anion transport protein is located on the cytoplasmic side of the red-cell membrane. (5) None of the antibodies inhibited sulphate exchange transport when introduced into resealed red-cell membranes; however, the bivalent form of one of the antibodies reduced the inhibitory potency of 4-acetamido-4'-isothiocyanatostilbene disulphonate on sulphate exchange transport in resealed erythrocyte membranes. (6) Immunostaining of human kidney sections with the antibodies showed strong staining of the basolateral membrane of some but not all of the epithelial cells of distal tubules and the initial connecting segment of collecting tubules. With human liver, only the haematopoeitic cells of fetal liver reacted with all the antibodies.

Amino Acid Sequence↗