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Biomedical subjects

C Ritchie

Publications and source records attributed to C Ritchie.

At least 19 recordsLinked to original sources

Clostridium perfringens type A enterotoxin forms mepacrine-sensitive pores in pure phospholipid bilayers in the absence of putative receptor proteins.

Clostridium perfringens enterotoxin (CPE) is an important cause of food poisoning with no significant homology to other enterotoxins and its mechanism of action remains uncertain. Although CPE has recently been shown to complex with tight junction proteins, we have previously demonstrated that CPE increases ionic permeability in single Caco-2 cells using the whole-cell patch-clamp technique, thereby excluding any paracellular permeability. In this paper we demonstrate that CPE forms pores in synthetic phospholipid membranes in the absence of receptor proteins. The properties of the pores are consistent with CPE-induced permeability changes in Caco-2 cells suggesting that CPE has innate pore-forming ability.

Bacterial Toxins↗

Effects of the nicotinic antagonist mecamylamine on inspection time.

RATIONALE: Several lines of evidence suggest that nicotinic acetylcholine receptors (nAchRs) are involved in speed of information processing, and inspection time appears to be particularly sensitive to nicotinic manipulation. OBJECTIVE: The present study sought to examine the effects of the nAchR antagonist mecamylamine on inspection time. Furthermore, the extent to which the anticholinesterase donepezil would reverse the effects of mecamylamine on inspection time was also examined. METHODS: A double-blind, repeated measures design was employed. Subjects (n = 6) received placebo, mecamylamine (20 mg PO) or mecamylamine (20 mg PO) and donepezil (5 mg PO). Inspection time and physiological measures were then assessed. RESULTS: The mecamylamine condition and the mecamylamine and donepezil condition were associated with an increase in heart rate, when compared to the placebo condition. There was a significant slowing of inspection time in the mecamylamine condition; compared to placebo, which was partly reversed by donepezil. CONCLUSIONS: The slowing of inspection time following mecamylamine is consistent with the role of nAchRs in speed of information processing, and add to the evidence that IT may in part index nAchR system integrity.

Adolescent↗

Splenectomy during partial remission in thrombotic thrombocytopenic purpura with prolonged plasma exchange dependency.

Some patients with thrombotic thrombocytopenic purpura (TTP) remain plasma-exchange-dependent for prolonged periods of time. This exposes patients to risk, uses substantial resources, and requires prolonged hospitalization. We have splenectomized 7 such patients following 25-42 plasma exchanges while patients were in partial remission only and were clinically stable. In 6 patients, including 1 with TTP secondary to mitomycin C, thrombocytopenia promptly resolved. Relapse has not occurred during 18 or more months of observation. The seventh patient did not respond. We conclude that splenectomy should be considered as an alternative to continued plasma-exchange therapy in such patients.

Adrenal Cortex Hormones↗

Counting mitoses.

Explore the source record for details and available documents.

Breast Neoplasms↗

Papillary endothelial hyperplasia in a TEC coronary atherectomy specimen.

Angiography in a 37 year old female with a three week history of typical crescendo angina found an 80% stenosis of the proximal left anterior descending (LAD) artery. The patient underwent percutaneous transluminal coronary angioplasty involving TEC artherectomy of the LAD artery. The specimen removed by atherectomy was found to have the appearance of papillary endothelial hyperplasia. This is an unusual histological diagnosis that occurs in association with thrombus. It is rarely found within arterial vessels and has not been reported in a coronary artery. Papillary endothelial hyperplasia is now thought to be a form of organising thrombus, probably dependent on the production of basic fibroblast growth factor by the endothelium.

Adult↗

Evidence of a correlation of estrogen receptor level and avian osteoclast estrogen responsiveness.

Isolated osteoclasts from 5-week-old chickens respond to estradiol treatment in vitro with decreased resorption activity, increased nuclear proto-oncogene expression, and decreased lysosomal enzyme secretion. This study examines osteoclasts from embryonic chickens and egg-laying hens for evidence of estrogen responsiveness. Although osteoclasts from both of these sources express estrogen receptor mRNA and protein, estradiol treatment had no effect on resorption activity. In contrast to the lack of effect on resorption, estradiol treatment for 30 minutes resulted in steady-state mRNA levels of c-fos and c-jun increasing in osteoclasts from embryonic chickens and decreasing in osteoclasts from egg-laying hens. These data suggest that a nuclear proto-oncogene response may not be involved in estradiol-mediated decreased osteoclast resorption activity. To examine the influence of circulating estrogen on osteoclast estrogen responsiveness, 5-week-old chickens were injected with estrogen for 4 days prior to sacrifice. Estradiol treatment of osteoclasts from these chickens did not decrease resorption activity in vitro. Transfection of an estrogen receptor expression vector into osteoclasts from the estradiol-injected chickens and egg-laying hens restored estrogen responsiveness. Osteoclasts from 5-week-old chickens and estradiol treated 5-week-old chickens transfected with the estrogen receptor expression vector contained significantly higher levels of estrogen receptor protein and responded to estradiol treatment by decreasing secretion of cathepsins B and L and tartrate-resistant acid phosphatase. In contrast, osteoclasts from embryonic chickens, egg-laying hens, and estradiol-treated 5-week-old chickens either untransfected or transfected with an empty expression vector did not respond similarly. These data suggest that modulation of osteoclast estrogen responsiveness may be controlled by changes in the osteoclast estrogen receptor levels.

Aging↗

Comparison of mean cerebral transit time and single-photon emission tomography for estimation of stroke outcome.

Mean cerebral transit time (MCTT) scanning is a possible alternative to cerebral single-photon emission tomography (SPET) for early assessment of cerebral perfusion after acute ischaemic stroke. Although MCTT is rapid, inexpensive and does not require sophisticated equipment, the relationship between MCTT and functional outcome is unknown. This study aimed to compare the effectiveness of SPET and MCTT in the prediction of functional outcome. Sixty-three patients undergoing cerebral computed tomography (CT), technetium-99m MCTT, and technetium-99m-labelled hexamethylpropylene amine oxime SPET soon after acute ischaemic stroke had outcome assessed after 3 months. Cerebral CT, SPET and MCTT scans were interpreted without reference to the clinical data; a single independent observer assessed outcome using the Barthel Index. The 3-month Barthel score in survivors was significantly correlated with volume of lesion on SPET (Spearman's r=-0.425, P<0.005) and with the ratio of mean affected hemisphere transit times to mean unaffected hemisphere transit times (Spearmen's r=-0.356, P <0.01), but not with CT lesion volume (Spearman's r = -0.175, P >0.1). Stepwise logistic regression identified volume of lesion on SPET as the only significant predictor of good functional outcome (Barthel score>70). The overall predictive accuracy was 73%. It is concluded that MCTT, although significantly correlated with functional outcome, failed to predict good functional recovery in individual stroke survivors. Since SPET provides more detailed localisation of perfusion deficits, and since SPET lesion volume can be used to predict functional outcome, SPET remains preferable to MCTT when perfusion imaging is required.

Aged↗

A pilot study of streptokinase for acute cerebral infarction.

We evaluated intravenous streptokinase in the treatment of cerebral infarction. Following neurological assessment and cerebral computed tomography (CT), patients aged 40-80 years with symptoms of anterior circulation acute ischaemic stroke were given 1.5 M units streptokinase or saline placebo in a double-blind randomized study. Twenty patients (10 streptokinase, 10 placebo), 11 males, 9 females, aged 57-79 years, were treated out of 512 consecutive admissions to the acute stroke unit over a 2-year period. Initial CT was normal in 11 (6 placebo, 5 streptokinase) and showed early signs of cerebral infarction in nine (4 placebo, 5 streptokinase). Median times from symptom onset to treatment were 5.2 h (placebo) and 5.8 h (streptokinase). Streptokinase treatment was associated with symptomatic hypotension in one patient. Repeat CT at 72 h demonstrated intracerebral haematoma in two patients and haemorrhagic infarction in one patient in the streptokinase group; the two cases of haematoma formation were associated with neurological deterioration and death. One patient in the placebo group had evidence of haemorrhagic infarction at 72 h. There were three deaths in each treatment group, all within the first 14 days. Patients with acute stroke can be evaluated with CT and treated with streptokinase within 6 h, but the opportunity for treatment is currently limited to few patients. Streptokinase treatment is not without risk, but potential clinical benefit justifies ongoing multicentre randomized trials.

Acute Disease↗

Becoming a successful division psychiatrist: guidelines for preparation and duties of the assignment.

Little attention is given in psychiatry residency programs to preparing graduates to occupy division psychiatry slots. The first part of this paper discusses several guidelines: preparations to make before leaving for a new post; immediate steps to take upon arrival; the place of the Division Mental Health Service in a division structure; and general observations about how best to obtain credibility with line soldiers. The second part focuses on general and specific duties of the assignment, and discusses some common clinical problems. The paper is intended to help the new division psychiatrists have an effective and productive tour. Many sections will be applicable to general medical officers and other health care workers leaving for a division assignment.

Adolescent↗

Quantitation of skeletal alkaline phosphatase isoenzyme activity in canine serum.

Pursuing the hypothesis that quantitation of skeletal alkaline phosphatase (ALP) activity in canine serum would provide an index of the rate of bone formation, we compared three methods for isoenzyme-specific identification of skeletal ALP activity in canine serum: heat inactivation, wheat germ agglutinin (WGA) precipitation, and concanavalin A (ConA) precipitation. ALP isoenzyme activities were extracted from canine bone, intestine, and liver, diluted into heat-inactivated canine serum (i.e., serum without ALP activity), and used as calibrators of ALP isoenzyme activities. Differential sensitivity to inhibition by 10 mM L-homoarginine was used to distinguish intestinal ALP activity from hepatic and skeletal ALP activities (i.e., 9, 80, and 72% inhibition, respectively). To allow resolution of skeletal ALP activity from hepatic ALP activity, we tested two established methods (heat inactivation and WGA precipitation) and a novel method, ConA precipitation. The organ-derived skeletal and hepatic ALP isoenzyme activities were used to compare these three methods with respect to linearity, isoenzyme separation, and precision. All three methods were linear, but the WGA and ConA methods afforded greater isoenzyme separation and precision. The relative extent of isoenzyme separation (i.e., the difference in percentage remaining skeletal and hepatic ALP isoenzyme activities) averaged 23, 40, and 47% remaining ALP activity for the heat, WGA, and ConA methods, respectively. However, when these methods were applied to the quantitation of skeletal ALP activity in sera from 10 young and 10 adult beagles, the WGA method was found to be unacceptable because most of the results fell outside the range of the WGA assay calibrators (i.e., greater than 100% skeletal ALP activity). The heat and ConA methods showed that the amount of skeletal ALP activity in the beagle sera decreased with age, both as ALP activity per liter and as percentage of total serum ALP activity (p less than 0.001 for each). Skeletal ALP activity levels determined by ConA were correlated with values determined by heat inactivation (r = 0.87, p less than 0.001) but not with WGA-determined levels (r = 0.26). Intestinal ALP activity was detected in only 1 of these 20 sera. We conclude that ConA precipitation can be used for quantitation of skeletal ALP activity in beagle serum.

Alkaline Phosphatase↗