Biomedical subjects
Publications and source records attributed to C Ward.
Mean platelet phenolsulphotransferase activity was significantly increased in L-dopa-treated parkinsonian patients compared with controls. The degree of rise was associated with dose of and duration of treatment with L-dopa and may thus represent an adaptive increase to circulating dopamine. Alternatively, the increase may reflect changes supervening with duration of illness.
Thirty-six patients with Crohn's disease were entered into a double-blind trial to assess any beneficial effect that cimetidine might have on immunological and clinical status. Eighteen patients were randomized to receive cimetidine, 1 g orally for 28 days, and the other 18 patients to receive a placebo. There was no alteration in clinical status in the cimetidine-treated group. Although 64% of the patients were anergic, augmentation of skin tests to candida, mumps, tuberculin, streptokinase/streptodornase and trichophyton antigens, was not observed in the cimetidine-treated patients. The patients with Crohn's disease, as a whole had higher absolute numbers of suppressor T-lymphocytes, 0.70 X 10(9)/litre (0.21-2.36, n = 35) compared to control values, 0.5 X 10(9)/litre (0.16-1.55, n = 25) (P less than 0.05). However, there was no significant difference in proportions of suppressor and helper T-lymphocytes, lymphocyte activation and humoral immunity after cimetidine treatment. The lack of any clear modulation of immunity by cimetidine, would be against trying H2 antagonists in a long term clinical trial.
A prognostic index for predicting significant coronary artery disease was established using multiple logistic regression analysis of clinical data from 643 patients with valvular heart disease who had undergone routine coronary arteriography before valve replacement. The index or equation obtained incorporated the presence of angina, a family history of ischaemic heart disease, age, cigarette smoking habits, mitral valve disease, sex, and electrocardiographic evidence of myocardial infarction. The equation was validated using prospective data from 387 patients with valvular disease and shown to enable almost a third of routine coronary arteriograms to be omitted while maintaining 95% sensitivity for patients with coronary artery disease. Similar analysis of the more detailed prospective data produced a second discriminant function incorporating diastolic blood pressure, total cigarettes smoked in life, the severity of angina, family history of ischaemic heart disease, age, current cigarette smoking habits, and the ratio of total to high density lipoprotein cholesterol. This method improved the discrimination between patients with and without coronary artery disease, allowing omission of 30% of routine coronary arteriograms with 100% sensitivity for patients with coronary disease and omission of 41% with a 96% sensitivity level.
Although (-)-deprenyl is known to be metabolized to methamphetamine and amphetamine, two small-scale double-blind trials indicate that neither metabolite contributes to all therapeutic benefit conferred by this drug in certain patients with Parkinson's disease: the manipulation of urinary pH, which alters the rate of excretion of these metabolites, failed to change the response pattern; substitution of a metabolite mixture for active drug caused a falling off in benefit.
Pain relief in acute myocardial infarction (AMI) by the beta-adrenoceptor antagonist, atenolol, was demonstrated by three separate studies. First, 18 patients were randomized to double-blind intravenous atenolol (5 mg) or saline immediately after admission, followed by oral atenolol (50 mg) or placebo 10 minutes later. In patients receiving atenolol, pain relief coincided with reduction in heart rate (HR), systolic blood pressure (SBP), and HR X SBP product (p less than 0.05); however, pain and these parameters were unchanged by placebo. The degree of pain relief was related to the reduction in cardiac work achieved (r = 0.725; p less than 0.001). A second open study involving 22 patients receiving intravenous atenolol (5 to 15 mg) early after AMI showed ischemic pain relief in 17 patients. They achieved a more significant reduction in HR X SBP product than those whose pain remained unchanged (p = 0.004). Finally, a retrospective study of 163 patients randomized to either atenolol or no beta blockade early after AMI revealed that patients receiving atenolol needed less opiate analgesia after admission (p less than 0.001). The safety of this therapy was illustrated by a decreased incidence of left heart failure and atrial fibrillation and no tendency to second- and third-degree heart block.
In two separate experiments, male rats received septal lesions and were compared to operated controls on the acquisition of a two-way active avoidance task. In both experiments, an automated active avoidance apparatus (Lafayette Instrument Co.) was used, and the animals were tested 10 trials each day, 6 days/week. The CS was a tone, and the US was a 0.7 mA shock; the CS-US interval was 7 seconds. In Experiment 1, the rats (N = 6/group) were tested under conventional conditions. The two compartments of the avoidance apparatus were identical in all respects. In Experiment 2, the rats (N = 6/group) were tested in the same apparatus, but with differential intrabox cues. The inside of the left compartment was lined with black contact paper, while the inside of the right compartment was lined with white contact paper. Irrespective of the conditions, the septal rats were facilitated in the acquisition of shuttle-avoidance. In both tasks, the septal subjects required fewer trials to reach criterion, and showed better orientation in the shuttle-box compared to controls. The response latencies of the septal subjects also tended to be faster, but neither septal nor control subjects showed differential response latencies related to the direction of the shuttle response. Previous findings have shown that the addition of external cues to purported spatial tasks can reduce the behavioral effects produced by damage to the septohippocampal axis on such tasks. The present results suggest that such a cue-addition procedure does not influence the behavioral effects produced by septal lesions in shuttle-avoidance.
Delayed hypersensitivity skin testing was performed at weekly intervals on 95 patients with major surgical illness. Patients with abnormal reactions on initial skin testing had a higher mortality than those who were normal initially (p less than 0.01), but this was not due to a greater rate of major septic complications. Significantly higher rates of sepsis (p less than 0.001) and mortality (p less than 0.001) were found in patients with abnormal reactions at any stage of their illness compared with patients who remained normal throughout. However, careful study of the temporal relationship between skin reactions and clinical events in individual patients suggested that these differences were not of value in clinical practice. Abnormal reactions usually followed obvious complications, such as sepsis or secondary hemorrhage, rather than predicted them. Deterioration of skin reactions from normal to abnormal was observed on 32 occasions in 25 patients but preceded the development of sepsis in only four patients.
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The experiment is focused on the relationship between spirit possession and neuroticism as assessed by psychometric techniques. Twenty subjects who were regular members of a West Indian Pentecostal congregation were interviewed and tested with the EPI and the hysteria scale of the MMPI. Analysis of data indicated that the 10 subjects who were defined as spirit possessed scored significantly high in both neuroticism (P less than 0.05) and hysteria (P less than 0.005) than did the control group. In light of these data and others it was suggested that possession constitutes a culture-bound neurotic disorder.
Marked, abrupt and disabling oscillations in motor performance--the "on-off" phenomenon--frequently occur in the course of long-term levodopa therapy for Parkinson's disease. Although these fluctuations are usually refractory to available medications it has recently been suggested that electroconvulsive therapy (ECT) may be beneficial Five Parkinsonian patients with incapacitating and unpredictable "on-off" changes who were free of significant depression were given conventional bilateral ECT while usual drug regimens were maintained. While ECT was well tolerated, after a total of six treatments no significant improvement in Parkinsonian disabilities or "on-off" changes were seen.
Monoclonal antibodies to the hemagglutinin molecule of the Hong Kong variant, Mem/1/71 (H3N2), influenza virus were used to study antigenic drift in the H3N2 subtype of influenza viruses. Antigenic variants of Mem/1/71 (H3N2) were selected after a single passage of the virus in chick embryos in the presence of monoclonal antibody. The variants showed a marked reduction in the ability to react with the monoclonal antibody used in selection. The monoclonal antibodies could be divided into three groups based on their reactions with the variants, providing evidence for at least three nonoverlapping antigenic areas on the hemagglutinin molecule. Amino acid analysis of tryptic peptides of the hemagglutinin from these variants showed that a single amino acid substitution in the heavy polypeptide chain (HA1) of the hemagglutinin molecule accounted for the reduced antibody interactions, and that variants from each group exhibited sequence changes in different areas of the molecule. Sequence changes were also detected in the HA1 polypeptides of naturally occurring H3N2 variants, but in most cases the changes in the monoclonal antibody selected variants were different from the field strains. Antigenic analysis showed that most of the variants selected with monoclonal antibody could not be distinguished from parental viruses with heterogeneous sera, suggesting that they are probably epidemiologically irrelevant. One variant, however, could be distinguished from parental virus with heterogeneous sera. This variant showed a change in sequence at residue 144 of the HA1 polypeptide from glycine in the parent to aspartic acid in the variant. Similar substitutions have been found in naturally occurring variants at this position. These studies suggest that some amino acid substitutions are more important than other for producing viruses with epidemiological potential. Antigenic analysis of naturally occurring H3N2 strains with monoclonal antibodies established that two variants co-circulated in 1968; Hong Kong/1/68 being distinguishable from Aichi/2/68 in at least two antigenic areas. It would appear that there may have been two separate lineages of H3N2 viruses, Hong Kong/1/68 giving rise to variants in England and Aichi/2/68 to variants in USA and Australia.
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A radioimmunoassay (RIA) was developed for measurement of phencyclidine (PCP) and its monohydroxy metabolites in urine. Anti-PCP serum was generated in rabbits and the labeled antigen was prepared by radio-iodination (125I) by the Hunter-Greenwood procedure. Adjustment of the antiserum and 125I-antigen concentrations resulted in a dynamic response from 0 to 200 ng/ml and as little as 2 ng/ml was detected. Reagents were stable for at least three months at 2 to 8 degrees C. Most (95%) urine specimens from presumed nonusers contained less than 5 ng/ml and urine specimens from suspected abusers usually exceeded 100 ng/ml. Comparison of RIA with other methods for detection of PCP showed good agreement. Cross-reactivity with other commonly prescribed drugs was not encountered. The recovery of PCP was 93 to 109% over the 20 to 175 ng/ml concentration range and the reproducibility (average coefficient of variation) was +/- 13%. Development of the RIA for PCP has resulted in a rapid procedure that can be adapted to automated processing and is also suitable for small-scale testing.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.