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Biomedical subjects

C Wright

Publications and source records attributed to C Wright.

At least 289 records · Page 16Linked to original sources

Adrenocortical hormone concentrations in children during cardiopulmonary bypass with and without pulsatile flow.

Plasma cortisol and ACTH concentrations were measured in two groups of children (aged 1-16 yr). Ten children underwent routine (non-pulsatile) cardiopulmonary bypass and 10 underwent pulsatile bypass under moderate hypothermia (28-32 degrees C). Comparable increases in cortisol and ACTH concentrations were demonstrated at the onset of bypass and the concentrations of both hormones increased during bypass. In the post-bypass period plasma cortisol concentration increased sharply; there was no further increase in the plasma ACTH concentration. By 24 h the concentrations of both hormones had declined towards baseline values. There were no significant differences between the groups.

Adolescent↗

Labetalol in the treatment of stable exertional angina pectoris: a comparison with nifedipine.

Labetalol, a combined alpha- and beta-receptor antagonist, was compared with nifedipine in a placebo-controlled, randomized double-blind cross over study (four week treatment periods) of 11 normotensive patients with stable exertional angina pectoris. Standard recommended doses of both drugs (labetalol 200-400 mg twice daily, nifedipine 10-20 mg three times daily) were used. Angina frequency was similar during the placebo washout period and treatment with the two drugs. The duration of treadmill exercise to angina, ischaemia (greater than 1 mm ST segment depression), and end of exercise was increased by both labetalol and nifedipine when compared with placebo, but there was no difference between the two drugs. Ambulatory ST segment monitoring demonstrated that the frequency, duration and magnitude of ST segment depression, whether painful or silent, were unaffected by either drug. Labetalol is an effective agent in improving exercise tolerance in normotensive patients with stable exertional angina pectoris, with an efficacy similar to that of nifedipine.

Adult↗

Maternal adversity and recent stressful life events in anxious and depressed children.

Poor confiding relations in mothers' own lives, the presence of maternal distress and recent stressful life events focussed on children are all significantly and independently associated with emotional disorder in the school-age child. The probability of being a case is best predicted by considering the contribution of all three factors. When this is done, an additive rather than multiplicative interaction for the three variables is found. The association between these maternal factors and events focussed on the child varies with the presence or absence of caseness. There appears to be no greater probability of being anxious rather than depressed as a consequence of these three stressful factors occurring in the lives of school-age children.

Adaptation, Psychological↗

Silent myocardial ischaemia in chronic stable angina: a study of its frequency and characteristics in 150 patients.

One hundred and fifty unselected patients with documented coronary artery disease were studied to establish the frequency and characteristics of silent myocardial ischaemia. Patients underwent ambulatory ST segment monitoring off all routine antianginal treatment (total 6264 hours) and exercise testing (n = 146). Ninety one patients (61%) had a total of 598 episodes of significant ST segment change, of which 446 (75%) were asymptomatic. Twenty seven patients (18%) had only painless episodes; 14 (9%) patients only painful episodes; 50 patients (33%) had both painless and painful episodes. The mean number of ST segment changes per day was 2.58 (1.95 silent); however, 11 patients (7%) had 50% of all silent episodes, and 48 patients (32%) had 91% of all silent episodes. Fifty nine patients (39%) had no ST segment changes on ambulatory monitoring, and 73 patients (49%) had no evidence of silent ischaemia. Episodes of silent ischaemia occurred with a similar circadian distribution to that of painful ischaemia, predominantly between 0730 and 1930. There was a similar mean rise in heart rate at the onset of both silent and painful episodes of ischaemia. Silent ischaemia was significantly more frequent in patients with three vessel disease than in those with single vessel disease, and was also significantly related to both time to 1 mm ST depression and maximal exercise duration on exercise testing. There was a highly significant relation between the mean number and duration of episodes of silent ischaemia in patients with positive exercise tests when compared with those with negative tests. No episode of ventricular tachycardia was recorded in association with silent ischaemic change.

Adult↗

Somatostatin content and receptors in the cerebral cortex of depressed and control subjects.

Somatostatin-like immunoreactivity is reduced in the cerebrospinal fluid in depression and this is presumed to reflect alterations in cerebral somatostatinergic systems. We have examined this hypothesis by measuring this immunoreactivity and somatostatin receptors in post-mortem cortical tissue from depressed patients and control subjects. There was no significant difference in the temporal and occipital cortex in somatostatin-like immunoreactivity or in somatostatin receptor affinity and binding capacity between depressed and control groups. It is concluded that there may not be an alteration of cortical somatostatin function in depression.

Aged↗

Ontogeny of thyroid hormone effect on tissue 5'-monodeiodinase activity in fetal sheep.

Most of the thyroxine (T4) in fetal mammals is deiodinated to the inactive metabolite, reverse triiodothyronine (rT3), via an iodothyronine 5-monodeiodinase in fetal tissues. Maturation of the tissue 5'-monodeiodinase (MDI) enzymes required for conversion of T4 to active triiodothyronine (T3) in the rat, an altricial species, occurs in the postnatal period. To characterize fetal maturation of the enzymes for active T3 production in a precocial species, 5'-MDI activities were measured in liver, kidney, and brain tissue homogenates of ovine fetuses 13 days after total thyroidectomy (Tx) conducted at gestational ages of 99-107 or 129-132 days. Sham-operated twin fetuses served as controls. Hepatic type I 5'-MDI activity was not significantly lowered by Tx in group I but was significantly lower after Tx in group II fetuses. Renal type I 5'-MDI was not affected by Tx in either group. Type II 5'-MDI activity in cerebral cortex was significantly elevated after Tx in both groups I and II fetuses. Tissue sulfhydryl contents were similar in liver, kidney, and cerebral cortex from control and Tx fetuses in group I. These data indicate that hypothyroidism induced early in the third trimester is associated with increased brain type II 5'-MDI activity without significant change in liver or kidney type I 5'-MDI. Late third trimester hypothyroidism is associated with decreased type I 5'-MDI activity in liver homogenates as well as increased type II 5'-MDI activity in brain tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain↗

Disulfiram-induced fulminating hepatitis: guidelines for liver-panel monitoring.

Although psychiatrists have medical responsibility for many alcoholic patients, the psychiatric literature, in contrast with the general medical literature, contains few reports of disulfiram-induced hepatotoxicity. For that reason, the authors review the literature on disulfiram hepatitis and report a case of severe fulminating hepatitis associated with disulfiram use, despite careful and currently accepted standard-of-care clinical and biochemical monitoring. All but two of the 17 disulfiram-associated hepatotoxic cases reviewed developed symptoms after 2 weeks to 2 months of use. Six patients died. This article discusses strategies for avoiding that rare but life-threatening side effect. The strategies include more frequent initial measurements of liver enzymes than is now accepted. Currently, only two reports recommend liver-function studies on a regular schedule for patients taking disulfiram. The authors believe that liver-function tests should be administered before treatment, at 2-week intervals for 2 months, and at 3- to 6-month intervals thereafter. The authors emphasize that the hepatotoxicity reaction is rare and do not discourage the use of disulfiram in appropriate patients; rather, they wish to heighten the index of suspicion to disulfiram-induced hepatotoxicity.

Adult↗

Effects of chiropractic treatment on blood pressure and anxiety: a randomized, controlled trial.

This study examined the effects of chiropractic adjustments of the thoracic spine (T1-T5) on blood pressure and state anxiety in 21 patients with elevated blood pressure. Subjects were randomly assigned to one of three treatment conditions: active treatment, placebo treatment, or no treatment control. The adjustments were performed by a mechanical chiropractic adjusting device. Dependent measures obtained pre- and post-treatment included systolic and diastolic blood pressure, and state anxiety. Results indicated that systolic and diastolic blood pressure decreased significantly in the active treatment condition, whereas no significant changes occurred in the placebo and control conditions. State anxiety significantly decreased in the active and control conditions. Results provide support for the hypothesis that blood pressure is reduced following chiropractic treatment. Further study is needed to examine the long-term effects of chiropractic treatment on blood pressure.

Adult↗

Liver function testing in a working population: three strategies to reduce false-positive results.

A very high rate of mildly abnormal results on a liver panel of five serum chemistries was observed when these tests were performed on a group of asymptomatic, normal workers. These results often led to lengthy delays in hiring, which benefited neither worker nor employer. Three strategies which markedly reduce the number of false-positive examinations with little or no reduction in test sensitivity are available.

False Positive Reactions↗

Effects of progestins on growth of experimental breast cancer in culture: interaction with estradiol and prolactin and involvement of the polyamine pathway.

The role of progesterone either alone or in combination with other hormones in breast cancer growth is not well established. In these experiments, using the hormone-responsive N-nitrosomethylurea-induced rat mammary tumor grown in the soft agar clonogenic assay, we tested the colony-stimulating effect of progesterone and the synthetic progestin R5020 over a wide range of physiological and pharmacological concentrations (from 0.1 nM to 10 microM). Both progesterone and R5020 were found to have a significant colony-stimulating effect which was more pronounced in the absence of serum. The action of progesterone appeared to plateau at concentrations of 10 or 100 nM, whereas R5020 was maximally effective at lower concentrations (approximately 1 nM). A biphasic dose-dependent effect was occasionally seen both with progesterone and R5020 with a loss of colony-stimulating effect at high concentrations. The combined administration of varying doses of progesterone (0.1, 1, 10, and 100 nM) and estradiol (10(-10) M and 10(-9) M) was found at times to potentiate and at times to decrease colony formation over that observed with the individual treatments. The former effect, when present, was usually seen with low doses of progesterone, while the latter was frequently observed with high concentrations (100 nM). No major potentiation or suppression of colony formation over individual treatments was observed when varying doses of progesterone (1, 10, and 100 nM) were added together with prolactin (50 ng/ml). The administration of the polyamine biosynthesis inhibitor alpha-difluoromethylornithine completely blocked the colony-stimulating effect of progesterone. The inhibitory effect of alpha-difluoromethylornithine was completely reversed in a dose-dependent fashion by exogenous administration of spermidine, thus implying a critical involvement of the polyamine pathway in progesterone action.

Animals↗

lac repressor can regulate expression from a hybrid SV40 early promoter containing a lac operator in animal cells.

The E. coli lac operator and repressor were adapted for function in mammalian cells. Plasmids containing an SV40 early region (pSVlacO) or a chloramphenicol acetyl transferase gene (pSVlacOCAT) linked to a hybrid SV40 early promoter bearing a lac operator were tested for function. Identical plasmids lacking an operator (pX-8 and pX-8CAT) were controls. In vitro, early transcription from pSVlacO, but not from pX-8, was inhibited by lac repressor, and repression was overcome by IPTG. Repression of large T synthesis or CAT activity occurred in vivo only when the respective operator-containing plasmid was cotransfected with a plasmid encoding lac repressor, or when the recipient cells stably synthesized lac repressor. IPTG substantially relieved repression in both cases. CAT enzyme repression was paralleled by a decrease in CAT mRNA abundance. Thus regulatory elements of the lac operon function physiologically in mammalian cells.

Acetyltransferases↗

Prognostic factors in breast cancer: immunohistochemical staining for SP1 and NCRC 11 related to survival, tumour epidermal growth factor receptor and oestrogen receptor status.

It has been proposed that intense immunohistochemical staining using the monoclonal antibody NCRC 11 is indicative of a better prognosis in breast cancer, and that expression of pregnancy specific glycoprotein (SP1) and epidermal growth factor receptors (EGFR) are poor prognosis indicators. In order to evaluate the significance of staining for NCRC 11 to prognosis and to these other variables, we studied two series of breast cancer patients. In one series (n = 93), staining with NCRC 11 and for SP1 was correlated with prognosis: in neither case was there any overall relationship between staining and survival. However, when the patients were stratified by tumour histological (Bloom's) grade, SP1 expression was associated with a poorer prognosis in grade II tumours (p less than 0.025). In a further series (n = 94), NCRC 11 staining was carried out and fresh tumour samples were assayed biochemically for oestrogen receptor (OER) and EGFR. NCRC 11 showed a negative correlation with EGFR status (p = less than 0.05) but no significant association with OER status. Thus despite our demonstration of a negative correlation with an indicator of poorer prognosis, we were unable to demonstrate any direct relationship between staining with NCRC 11 and survival.

Antibodies, Monoclonal↗

Polyamines and the synthesis of estradiol-regulated growth factors in rat mammary cancer in culture.

We have recently provided evidence to suggest that the polyamine pathway plays an essential role in the expression of the growth-promoting effect of estradiol (E2) regulated growth factors in the N-nitrosomethylurea (NMU) induced rat mammary tumor cultured in vitro in the soft agar clonogenic assay. To further explore the interaction between the polyamine pathway and autocrine control of tumor growth by E2, we tested whether, in our system, polyamines play a role in the synthesis of E2-regulated growth factors. Conditioned medium (CM) obtained from tumors treated with E2 and the polyamine biosynthesis inhibitor alpha-difluoromethyl-ornithine (DFMO) (1 mM) no longer exhibited the colony-stimulating effect which was consistently observed with E2-CM. Such growth promoting activity was restored in a dose-dependent fashion with CM obtained from tumors treated with E2, DFMO, and increasing concentrations of spermidine (from 1 to 100 microM). Conditioned medium obtained from tumors treated with DFMO with and without spermidine in the absence of E2 had no discernible effects on colony formation. The colony stimulating effect of the CM employed could not be accounted for by the contaminating presence in the media of E2, DFMO, or polyamines. These results indicate that, in our system, the polyamine pathway plays an important role in the synthesis of E2-regulated growth factors.

Animals↗

Role of polyamines in the synthesis of prolactin-regulated growth factors by experimental breast cancer in culture.

The present experiments were designed to test whether polyamines play an essential role in the synthesis of growth factors induced by ovine prolactin (oPRL), using the N-nitrosomethylurea (NMU)-induced rat mammary tumor cultured in the soft agar clonogenic assay. Conditioned media (CM) obtained from tumors treated with oPRL and the polyamine biosynthesis inhibitor alpha-difluoromethylornithine (DFMO) (1 mM) no longer exerted the colony-stimulating effect which was observed with oPRL-CM. Such growth-promoting activity was restored with conditioned media obtained from tumors treated with oPRL, DFMO, and increasing concentrations of spermidine from 1 to 500 microM. The colony-stimulating effect of the CM employed could not be accounted for by the contaminating presence in the media of oPRL, DFMO, and polyamines. These results indicate that in our system polyamines play an important role in the synthesis of oPRL-regulated growth factors.

Animals↗

The role of ambulatory ST-segment monitoring in the diagnosis of coronary artery disease: comparison with exercise testing and thallium scintigraphy.

The value of ambulatory ST-segment monitoring in the detection of underlying coronary artery disease was investigated in one hundred consecutive patients who underwent exercise testing and coronary arteriography for chest pain. Forty-seven also had thallium-201 radioisotope imaging performed. Six of the 26 patients with normal coronary arteries and 52 of the 74 patients with significant coronary artery disease had ST-segment changes during 48 h of ambulatory monitoring (sensitivity 77%). In comparison, the sensitivity of conventional exercise testing was 73% and specificity was 81%. Previous myocardial infarction did not influence the results, but patients with poor left ventricular function more often had absence of ambulatory ST-segment changes. Three-vessel coronary artery disease was detected more efficiently (sensitivity 80%), compared with single vessel disease (sensitivity 50%). Thallium scintigraphy demonstrated defects of uptake in nine patients without ambulatory ST-segment changes (sensitivity 82%, specificity 71%). The majority of these patients had small inferior or posterior defects in thallium uptake. Only one patient with ambulatory ST-segment changes had normal coronary arteries and demonstrable spasm. Thus, ambulatory ST-segment monitoring is as valuable as stress testing in the detection of coronary artery disease and in addition helps detect patients with coronary spasm and normal coronary arteries.

Ambulatory Care↗

Jejunal interposition for benign esophageal disease. Technical considerations and long-term results.

Thirty patients with benign intractable or complicated esophageal disease were treated with esophageal resection and isoperistaltic jejunal interposition. There were three anastomotic leaks (2 radiologic only) and one postoperative death (3.5%). Long-term follow-up results were favorable in all but one patient who had scleroderma. Despite this, radionuclide transit studies with a standardized solid egg white bolus showed a delayed transit (3.6 +/- 0.4 minutes) compared with normal controls (10.4 +/- 2.6 seconds) (p less than 0.001). The time activity curves and condensed image computer analysis of the 1-second frames showed that the contractions of the interposed jejunum were segmental rather than peristaltic. This accounts for the delayed transit in the esophageal group. Histologic studies on endoscopic biopsies of the jejunal loops obtained after 12 months of the operation confirmed the retention of a normal villous architecture with Paneth cell hyperplasia but no evidence of metaplasia.

Adult↗