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Biomedical subjects

C Selby

Publications and source records attributed to C Selby.

At least 55 records · Page 3Linked to original sources
PubMed1989

Oestrogen dosage in prostatic cancer: the threshold effect?

We present the results of a prospective randomised trial of Estradurin, a long-acting oestrogen preparation (polyoestradiol phosphate), 160 mg per month, compared with bilateral orchiectomy in patients with advanced prostatic carcinoma (T3M1; T4MO/M1). The dose was lower than that usually recommended to induce a consistent fall in serial plasma testosterone levels to within the castrate range. Most patients treated with oestrogen showed an initial clinical and biochemical response equal to that obtained for patients undergoing orchiectomy. The inevitable relapse in hormone sensitivity sometimes occurred very soon after the start of oestrogen treatment. Many patients had poorly suppressed plasma testosterone expressed as a mean of monthly serial measurements, but then responded to secondary orchiectomy. These data only suggest that, in the treatment of hormone-sensitive prostatic carcinoma, it may be necessary to reduce plasma testosterone to midway between castrate and normal ranges. The data support the theory that response to androgen withdrawal is qualitative rather than quantative. The effective dose of oestrogen may therefore be reduced and the risk of thrombo-embolic complications minimised.

Delayed-Action Preparations↗
PubMed1988

Sex hormone binding globulin in saliva.

Measurement of salivary steroid hormone concentrations has frequently been advocated as a convenient alternative to plasma measurements. This is partly due to the belief that salivary steroid concentrations are a reliable reflection of the plasma free hormone level, a belief reinforced by earlier inability to demonstrate the presence of significant quantities of steroid binding proteins. Recent reports confirm that such quantities of these proteins are present in saliva and that they retain their steroid binding activity. We have measured sex hormone binding globulin (SHBG) and albumin in saliva from 14 men, 21 non-pregnant women and 36 pregnant women. No differences in the concentration of salivary albumin was evident in any of the groups studied whereas a significant difference in the concentration of SHBG was evident between men and non-pregnant women, and non-pregnant and pregnant individuals. Although much lower, salivary SHBG and albumin concentrations broadly reflect those found in plasma. Furthermore, a highly significant correlation existed between salivary SHBG and albumin concentrations in all groups studied. It now seems generally accepted that the albumin present in saliva arises from contamination by either traces of blood or gingival fluids. The close relationship between the concentrations of albumin and SHBG in saliva suggests that they both gain entry by a similar route. Furthermore, their presence may significantly influence the concentration of certain steroids in saliva, and this may explain the occasional failure of salivary steroid concentrations to accurately reflect the plasma free hormone levels.

Albumins↗
PubMed1988

Radioimmunoassay artifact associated with circulating anti-rabbit antibodies.

A 30 year old woman presenting with infertility was found to have elevated serum immunoreactive prolactin, TSH and total T3. These findings were eventually attributed to assay artifact when she was shown to have anti-rabbit antibodies in her serum. The possibility of laboratory artifact should be considered in clinical practice when abnormal immunoassay results are unsupported by clinical or radiographic data.

Adult↗
PubMed1988

Imaging of pancreatic and colorectal cancer using antibody fragments: a preliminary evaluation.

Imacis-1 is a combination of F (ab')2 antibody fragments, of two monoclonal antibodies, anti-CEA and 19.9, radiolabelled with Iodine-131. Thirteen patients with 14 tumours (eight pancreatic, six colorectal) were imaged to evaluate the ability of this radiopharmaceutical to detect both pancreatic and colorectal cancer. Positive tumour uptake was demonstrated by external gamma camera imaging in six patients with pancreatic cancer and in three with colorectal cancer. The results of this preliminary study confirm the ability of this antibody cocktail to localise in colorectal cancer and suggest that it may be of value in the detection of pancreatic cancer.

Antibodies, Monoclonal↗
PubMed1987

Serum C-peptide after 6 months on glibenclamide remains higher than during insulin treatment.

Serum C-peptide was measured fasting and 6 minutes after glucagon (1 mg given intravenously) in 49 patients with non-insulin-dependent diabetes mellitus, after 4 and 6 months of successive periods of treatment with insulin and oral hypoglycaemics (glibenclamide and metformin), given in random order. Glycaemic control was not significantly different on the two treatments, but C-peptide was much higher while the patients were on glibenclamide. We conclude that glibenclamide stimulates pancreatic insulin production even after 6 months treatment.

Adult↗
PubMed1987

Bacteraemia in adults after splenectomy or splenic irradiation.

Between 1980 and 1985 eight patients who had had splenectomy or were hyposplenic were admitted to University Hospital, Nottingham with pyrexia and bacteraemia. Three of these patients died from fulminant sepsis, and one patient who had meningitis was left with serious neurological sequelae. All eight patients had had splenectomy or splenic irradiation for haematological disease. Str. pneumoniae was the commonest infecting organism. There were 1579 other bacteraemic episodes seen at University Hospital, Nottingham during the same period.

Adult↗
PubMed1986

Correlation between anxiety and serum prolactin in humans.

The organised social structure of primate species largely determines individual behaviour. Moreover Keverne et al. in Advanced Views in Primate Biology, Springer, Berlin (1982) [1] have demonstrated that social interaction among confined male talapoin monkeys may result in endocrine changes, and that these in turn may modify behaviour. We have undertaken a study to determine whether similar endocrine changes can be induced in confined human volunteers. Five men were confined on a boat for fourteen days. Repeated plasma samples were taken under controlled conditions for assay of testosterone, prolactin and cortisol. After each sample the men completed a questionnaire to document self-perceived anxiety. The men were also secretly ranked for dominant/aggressive behaviour towards the other males. Significant correlation was found between day-to-day changes in anxiety and stress hormones, cortisol and prolactin. Significant correlation was found also between plasma prolactin, testosterone and rank position for dominance/aggression. It is concluded that under some circumstances social interaction may modify endocrine status in humans.

Adult↗
PubMed1986

Prolactin and stress: some endocrine correlates of pre-operative anxiety.

An attempt was made to correlate the serum concentration of PRL, GH and cortisol with anxiety experienced before elective surgery. A significant direct correlation was observed between cortisol and anxiety (P = 0.028), and between GH and anxiety (P = 0.001) although the latter correlation may have reflected the confounding effects of sex and age on GH levels. No correlation was observed between anxiety and PRL and we conclude that psychosocial stress cannot be invoked as an occasional cause of hyperprolactinaemia.

Aged↗
PubMed1985

Restoration of dexamethasone suppression by incomplete adenomectomy in Cushing's disease.

Two cases of pituitary-dependent Cushing's disease are described. Selective transphenoidal adenomectomy was attempted in each, but proved incomplete. Although both patients had persistent Cushing's disease after the operation, both were shown to have been rendered fully dexamethasone suppressible. The pathophysiological basis of partial suppressibility is discussed, as are the criteria for the diagnosis of cure in Cushing's disease treated by selective adenomectomy.

Adenoma↗
PubMed1985

Plasma hormone levels in patients with prostatic carcinoma treated with diethylstilboestrol and estramustine.

Plasma testosterone, oestradiol, luteinising hormone (LH) growth hormone and prolactin were measured serially in 140 patients with advanced prostatic carcinoma (T3, T4, MI and MO) randomised in a trial of diethylstilboestrol 3 mg/day against estramustine 560 mg/day. Both drugs suppressed plasma testosterone and LH and increased plasma growth hormone and prolactin, though estramustine induced a greater rise in prolactin. Oestradiol levels fell on stilboestrol but were considerably elevated on estramustine. Initial hormone levels reflected neither the extent of disease nor the response to treatment. The data also showed that close attention should be given to plasma LH in identifying patients who are unreliable, since intermittent hormone dosage caused an exaggerated rise even when plasma testosterone remained at castrate levels.

Aged↗
PubMed1985

Sex steroid hormone concentrations in preterm labour and the outcome of treatment with ritodrine.

Peripheral plasma concentrations of unconjugated oestradiol-17 beta, progesterone and total oestriol were measured in patients presenting with uncomplicated preterm labour. Control samples were obtained from normal healthy women matched for maternal age, parity and duration of pregnancy. Oestrogen concentrations were often higher and progesterone concentrations often lower in patients presenting in preterm labour, and in particular, in those presenting in advanced labour and those failing to respond to treatment with ritodrine, but the differences were not statistically significant.

Adult↗
PubMed1985

The effect of anaesthetic induction with etomidate on the endocrine response to surgical trauma.

In order to investigate the effects of anaesthetic induction with a single bolus dose of etomidate on the endocrine response to a standard surgical stress, five patients were randomly allocated to receive etomidate and five to receive thiopentone as an induction agent prior to elective inguinal hernia repair. The group receiving etomidate showed a significant suppression in the circulating level of cortisol at 90 and 120 min post-induction (P less than 0.001) and an elevation in their plasma adrenocorticotrophic hormone at 240 and 360 min post-induction (P less than 0.001). The effect of a bolus dose of etomidate upon circulating cortisol levels was transient and no cardiovascular instability was noted during the study. The etomidate group also showed suppression of their circulating testosterone levels at 90 min post-induction (P less than 0.001), suggesting that etomidate inhibits steroidogenesis at a site other than 11 beta-hydroxylase.

Adrenocorticotropic Hormone↗