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Biomedical subjects

C R Stiller

Publications and source records attributed to C R Stiller.

At least 73 records · Page 4Linked to original sources
PubMed1985

Emotionally related donors and renal transplantation.

Published medical and psychological evidence now available strongly supports the widening of donor sources to include the emotionally related donor. Irrespective of the benefit conferred by a living related over an unrelated donor, it now seems indefensible to refuse the donation of a kidney from an emotionally related individual to a recipient who meets the required criteria. An absence of other donor sources, the existence of preformed antibodies, or priority on the transplant list all seem to us to be compelling reasons to consider the use of the emotionally related donor. This is especially true when the psycho-social assessment reveals a true volunteer who is likely to derive psychological benefit from the donation and where "donation consensus" exists within the family.

Altruism↗
PubMed1985

Donor transportation.

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Health Services Accessibility↗
PubMed1984

Effects of cyclosporine immunosuppression in insulin-dependent diabetes mellitus of recent onset.

Type I diabetes may be an autoimmune disorder, although the evidence is largely circumstantial. The natural history of the disease after diagnosis includes partial remission in most patients, but only about 3 percent achieve transient insulin independence. beta Cell function, as indicated by the plasma concentration of C-peptide, is lost over 6 to 30 months and islet cell antibodies disappeared over 1 to 2 years. This article describes a pilot study in which 41 patients were treated with the immunosuppressive agent cyclosporine for 2 to 12 months. Of 30 patients treated within 6 weeks of diagnosis, 16 became insulin independent with concentrations of plasma C-peptide in the normal range and decreasing titers of islet cell antibodies. Of 11 patients who entered the study 8 to 44 weeks after diagnosis, two achieved this state. These results indicate that a controlled trial of the effects of cyclosporine in type I diabetes should be conducted.

Adolescent↗
PubMed1984

Circulating lymphocyte subpopulations in experimental allergic neuritis.

T-cell subsets in the peripheral blood were analyzed using monoclonal antibodies during the development of experimental allergic neuritis in Lewis rats. Percentages of helper and suppressor cells and ratios of helper/suppressor cells did not exceed normal limits during the development of the disease.

Animals↗
PubMed1984

Evaluation of cyclosporin-phenytoin interaction with observations on cyclosporin metabolites.

We have observed that patients on concurrent cyclosporin and phenytoin therapy required increased doses of cyclosporin to maintain therapeutic concentrations of this novel immunosuppressive drug. We have, therefore, studied the influence of phenytoin on the pharmacokinetics of oral cyclosporin in six healthy male subjects. Cyclosporin concentrations in serum and whole blood were measured by high pressure liquid chromatography (h.p.l.c.) and radioimmunoassay (RIA). Concentrations of cyclosporin in whole blood were consistently higher than corresponding values in serum. Concentrations of cyclosporin determined by RIA were also consistently higher than those determined by h.p.l.c. Irrespective of the biological fluid (serum or whole blood) or the type of drug analysis (h.p.l.c. or RIA), changes in cyclosporin kinetics following phenytoin administration exhibited similar patterns. Phenytoin significantly reduced the maximum concentration and the area under the concentration-time curve and significantly increased total body clearance of cyclosporin. There was a statistically significant reduction of cyclosporin half-life (t 1/2) in whole blood using h.p.l.c. analysis. However, there was no significant change in cyclosporin t 1/2 in serum following phenytoin administration, using either form of drug analysis. Cyclosporin metabolites 17 and 18 were measured by h.p.l.c. in whole blood samples only, since these metabolites were found almost entirely in red blood cells. Phenytoin significantly reduced the Cmax and AUC of both metabolites, but no significant change was observed in the t 1/2 of either. Phenytoin enhanced the metabolism of antipyrine which was co-administered with cyclosporin to assess oxidative enzyme activity. We conclude that patients undergoing organ transplantation should be carefully monitored if they require phenytoin or other drugs known to accelerate oxidative metabolism.

Adult↗
PubMed1984

HLA antigens in systemic lupus erythematosus: relationship to disease severity, age at onset, and sex.

Sixty-two Caucasian patients with systemic lupus erythematosus (SLE) were studied to determine whether any significant clinical correlations existed with various HLA antigens. While HLA-B8 and DR3 were significantly increased among the SLE population in general, these or other HLA antigens did not correlate with the severity of renal disease. HLA-B8 was significantly higher only in SLE males compared to male controls. The age of onset of disease in females was clustered into 2 groups, one with early age of onset (mean = 21.6 years, range 12-32 years) and another with later age of onset (mean = 48 years; range 38-60 years). SLE females with later age of onset showed an increased frequency of HLA-DR3 compared to sex and age matched controls, while those with early onset SLE showed no significant increase in any HLA antigens. Therefore any risk conferred by the presence of genes associated with HLA-B8 or DR3 is significant only in SLE males and SLE females whose disease onset was over the age of 35. Despite the greater frequency of HLA-B8, DR3 in SLE females with later onset of disease, this group did not have a greater frequency of anti-Ro antibodies compared to females with early age onset of SLE.

Adolescent↗