Massive osteolysis and tumoral calcinosis.
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Bone Diseases↗
Biomedical subjects
D C Mitchell
Publications and source records attributed to D C Mitchell.
Peripheral laser angioplasty with pulsed dye laser and ball-tipped optical fibres.
Laser angioplasty with the pulsed dye laser and integral ball-tipped optical fibres was used for primary treatment of occlusive femoropopliteal vascular disease in 26 limbs of 24 patients, all of whom warranted operative intervention. 19 had "critical ischaemia", 8 had pedal ulceration, and 4 had distal gangrene. The delivery device consisted of the laser fibre loaded retrogradely into a standard 6 mm balloon angioplasty catheter, and was introduced through a common femoral artery cutdown in an attempt to recanalise femoropopliteal occlusions of a mean length of 21 cm (range 3-49). Angiographic recanalisation was achieved with a mean energy of 250 J (range 38-727 J) in 23 of the 26 limbs; in each case the channel created by the laser fibre was augmented by balloon angioplasty. Technical failure occurred in 3 patients, due to wall dissection, persistent side-branch entry, and incomplete lesion penetration, respectively. Acute occlusion within 48 h occurred in 2 diabetic patients with very poor run-off and distal gangrene, and early failure occurred in another patient due to inadequate balloon dilatation. 1 patient with segmental tibial disease below a technically successful recanalisation did not show clinical improvement. Several patients had coexisting coronary artery disease, 3 of whom died of myocardial infarction--all with patent femoropopliteal vessels. In the 21 survivors, 14 vessels remained patent at a median of 7 months' follow-up.
Aged↗
The role of docosahexaenoic acid containing phospholipids in modulating G protein-coupled signaling pathways: visual transduction.
In order to understand the role of the high levels of docosahexaenoic acid (DHA) in neuronal and retinal tissue, a study of the effect of membrane lipid composition on the visual pathway, a G protein-coupled system, was undertaken. The level of metarhodopsin II (MII) formation was determined to be a function of phospholipid acyl-chain unsaturation, with the highest levels seen in DHA-containing bilayers. Similarly, the rate of coupling of MII to the retinal G protein, Gt, to form a MII-Gt complex, was enhanced in DHA bilayers relative to less unsaturated phospholipids. Complex formation initiates the first stage of amplification in the visual pathway. The activation of the cGMP phosphodiesterase (PDE), the effector enzyme, represents the integrated pathway function. DHA-containing bilayers were found to support PDE levels comparable to those of the rod outer segment (ROS) disk membranes. Inclusion of 30 mol% cholesterol in the reconstituted bilayers had an inhibitory effect on each step in the visual pathway studied. Inclusion of cholesterol reduced MII formation and PDE activity and increased the lag time between the appearance of MII and the formation of the MII-Gt complex. However, signaling in DHA bilayers was far less affected by the addition of cholesterol than in bilayers containing less unsaturated phospholipids. These studies point up the importance of DHA acyl chains in promoting optimal function in G protein-coupled signaling pathways. The results reported here suggest that visual and cognitive deficits observed in n-3 deficiency may result from decreased efficiency in related neurotransmitter and visual signaling pathways in the absence of DHA.
3',5'-Cyclic-GMP Phosphodiesterases↗