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Biomedical subjects

D H Brown

Publications and source records attributed to D H Brown.

At least 91 records · Page 5Linked to original sources

Changes in glutathione in intact erythrocytes during incubation with penicillamine as detected by 1H spin-echo NMR spectroscopy.

1H spin-echo NMR spectroscopy was used to study changes in glutathione status in intact erythrocytes. The concentration of glutathione in suspensions of erythrocytes in 2H2O saline is significantly different in cells from patients with rheumatoid arthritis than in controls from normal healthy volunteers. It is observed that the methods of separation and suspension affect lactate metabolism in red cells. Incubation of erythrocytes with solutions of the therapeutic agent D-penicillamine in 2H2O saline produced a change in glutathione resonances which is indicative of an increase in diglutathione concentration. Signals from the methyl groups of penicillamine decreased at a commensurate rate. Incubation of normal cells with plasma from patients with rheumatoid arthritis who had the same blood group as the normal volunteer indicated a much larger fall in glutathione signal with plasma from a patient treated with penicillamine than from a patient on non-steroidal anti-inflammatories.

Anti-Inflammatory Agents↗

Performance of a new enzyme-linked immunoassay urine pregnancy test for the detection of ectopic gestation.

An enzyme-linked immunoassay urine pregnancy test was used on a group of patients suspected of having an ectopic pregnancy. Patients were seen in the county hospital emergency department and had the urine test correlated with a serum beta-hCG level determined by radioimmunoassay. There were 884 patients with urine ICON-serum beta-hCG correlations. The ICON was positive in each of the 247 patients whose serum value was over 50 mIU/mL, and was negative in each of the 619 patients whose serum level was below 5 mIU/mL. Eighteen patients had a serum level between 10 and 50 mIU/mL and the ICON was positive in 13. The five patients with a low serum beta-hCG level and a negative ICON had dilute urine when tested. Using a modified testing procedure, each of these produced a positive ICON. Of the 27 patients with an ectopic pregnancy the urine ICON was positive in 26. The urine ICON is an improved assay for hCG in patients suspected of having an ectopic pregnancy, and is ideally suited for ED use.

Chorionic Gonadotropin↗

Endotracheal administration of epinephrine and atropine.

A case history of a seven-month-old girl arriving at the emergency department in cardiac arrest from an inhalation injury without venous access is described. The patient was resuscitated with endotracheal administration of epinephrine and atropine. A review of the literature of endotracheal administration of medications in pediatrics subsequently follows.

Atropine↗

Early and late changes in sulphydryl group and copper protein concentrations and activities during drug treatment with aurothiomalate and auranofin.

Superoxide dismutase activity (SOD), plasma and lysate thiol concentrations (PSH and LSH), and caeruloplasmin oxidase activity (CP) reflect the underlying reduction-oxidation imbalance associated with rheumatoid arthritis (RA), and are believed to be involved in the protection of the cell against free radical activity. The early and late changes in these parameters have been observed and compared with standard clinical and biochemical assessments of disease activity in 90 patients with active RA, randomly assigned to receive either sodium aurothiomalate, auranofin, or auranofin placebo. An index based on clinical criteria was used to identify patients as responders or non-responders after 24 weeks of therapy. In the first six weeks of treatment a change in SOD activity and LSH concentration in a direction away from controls was followed by a return towards control levels in responders only. This suggests that in RA evidence of clinical improvement induced by gold drugs is preceded by an initial biochemical response in an inflammatory direction. The extracellular parameters PSH and CP did not show the same early response, but PSH levels in responders showed a slower change towards normal values, though at no time were values obtained that might suggest a complete remission. Thus the intracellular parameters appear to reflect an early effect of the drugs on cells which may possibly be of use in predicting the outcome of therapy, whereas the extracellular parameters provide confirmatory evidence for an eventual improvement.

Arthritis, Rheumatoid↗

Senescent changes in and about the oral cavity and pharynx.

Gradual morphologic and physiological changes in mucosa, bone and salivary glands in and about the oral cavity and pharynx bring about certain pathologic conditions occurring with greater frequency in the elderly than in the general population. The paper's intent is to summarize these changes and where possible provide some guidance in the management of the symptoms.

Aged↗

Genital injury and implied consent to alleged rape.

A review of 440 cases of reported rape was undertaken to see if sustaining injury to the genital area was an inevitable consequence of being raped. Injuries to areas other than the genital were taken as objective evidence that the victim did not consent to the encounter, while sperm found in her vagina that could not be accounted for by voluntary coitus was taken as objective evidence that penile penetration of the vagina had occurred. Of the 75 victims with objective evidence of both noncompliance and vaginal penetration, 28% sustained genital injury. The absence of genital injury does not imply consent by the victim or the absence of vaginal penetration by the assailant.

Expert Testimony↗

Laryngeal chondrosarcoma: gross pathological, histologic and electron microscopic characteristics.

Chondrosarcoma is an uncommon cartilaginous tumour of the upper respiratory tract, and its morphology and clinical course vary widely. Few reports have evaluated the clinicopathological findings of this tumour in the larynx. This paper reports on a low-grade chondrosarcoma in a 44-year-old woman who required laryngectomy for cure. The gross pathological, histologic and electron microscopic features of the tumour are analysed with respect to its clinical course, using histopathological criteria.

Adult↗

Prolonged life and improved quality for stored skin grafts.

This study is presented as both a follow-up and an extension of previous work on storage techniques for the preservation of skin by refrigeration. Rabbit skin grafts were used to compare the merits of various storage media. One of the media, McCoy's 5A plus serum, gave improved skin graft take and storage half-life. The ability to improve skin graft storage techniques is most beneficial to all aspects of plastic and reconstructive surgery where skin grafting is required. Prolonged graft viability and improved graft quality are of major clinical importance.

Animals↗

Studies of the residual glycogen branching enzyme activity present in human skin fibroblasts from patients with type IV glycogen storage disease.

Human skin fibroblasts from patients with Type IV glycogen storage disease, in which there is a demonstrable deficiency of glycogen branching enzyme, were shown to be able to synthesize [14C]glycogen containing [14C]glucose at branch points when sonicates containing endogenous glycogen synthase a were incubated with UDP[14C]glucose. The branch point content of the glycogen synthesized by the Type IV cells was essentially the same as that formed by normal cells, but the total synthetic capacity of the Type IV cells was lower. A new assay for the branching enzyme using glycogen synthase as the indicator enzyme has been developed. Using this assay it has been shown that the residual branching enzyme of affected children and of their heterozygote parents is less easily inhibited by an IgG antibody raised in rabbits against the normal human liver enzyme than is the branching enzyme of normal fibroblasts.

1,4-alpha-Glucan Branching Enzyme↗

Gold levels produced by treatment with auranofin and sodium aurothiomalate.

Sixty-three patients with rheumatoid arthritis were randomly divided into 3 groups, and treated with either sodium aurothiomalate (Myocrisin), auranofin, or placebo. Gold levels in whole blood, plasma, and haemolysate were measured serially along with clinical and laboratory parameters of efficacy. Auranofin produced a higher ratio of haemolysate to plasma gold than Myocrisin, and it appears that the affinity of the red cell for gold is reduced during therapy with auranofin. Gold levels did not correlate with changes in the pain score, erythrocyte sedimentation rate, and C-reactive protein, nor with the development of toxicity. In the Myocrisin group the haemolysate gold level achieved was dependent on the number of cigarettes smoked. In the auranofin group there was no such correlation, but the haemolysate gold level was higher for smokers than non-smokers. The likely action of gold is discussed.

Adult↗

Altered thiol status in patients with rheumatoid arthritis.

The thiol status of patients with rheumatoid arthritis is significantly different from that of controls. Plasma thiol levels are lower, albumin thiol reactivity is altered and intracellular thiol levels measured after hemoglobin precipitation are increased. These variations correlate with other indices of disease severity and are one measure of a disturbance in the degree of oxidation of the blood. Penicillamine, in common with other effective therapeutic agents, produces an increase in serum thiol concentration. It causes a greater effect on serum thiol reactivity than other drugs and in particular it increases 'fast reacting' thiol levels without significantly altering the 'slow reacting' thiol level.

Adult↗

Vasospasm control by intra-arterial reserpine.

Vascular spasm may complicate both traumatic injuries and disease processes. It may be severe enough that thrombosis and vascular compromise occur, causing tissue necrosis. Transient relief may be obtained by proximal sympathetic blocks, but these are not well tolerated by the patient and require repeated injections. This study shows that a single intra-arterial injection of 1.25 mg of reserpine into the branchial artery of human volunteers with a No. 25 needle produces a prolonged sympathectomy distal to the site of injection, with cutaneous flushing, increased temperature, and increased digital pulse wave recordings. It also eliminates the vasoconstriction normally caused by a cold stimulus. Using this dose, the side effects were minimal. No complications were encountered as a result of the technique. Low-dose intra-arterial reserpine is recommended for the treatment of reversible vascular spasm.

Hand↗

Serum copper and erythrocyte superoxide dismutase in rheumatoid arthritis.

Serum copper and thiol levels an caeruloplasmin activity were determined and compared with measurements of articular index, erythrocyte sedimentation rate, and zinc and haemoglobin levels in patients with rheumatoid arthritis. Superoxide dismutase activity, thiol, zinc, and copper levels of haemolysate were measured and compared with each other and to the above parameters. In serum, caeruloplasmin activity increased and thiol levels decreased, whereas in the haemolysate superoxide dismutase activity decreased and thiol levels increased. It is suggested that the changes in copper levels and in the activities of process which may be copper-dependent between plasma and cytosol in patients with rheumatoid arthritis reflect a change in oxidative status of the blood which may have implications in the pathogenesis of the disease.

Adult↗