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D J Tiller

Publications and source records attributed to D J Tiller.

At least 91 records · Page 5Linked to original sources
PubMed1981

A disarmed world.

Explore the source record for details and available documents.

Acetaminophen↗
PubMed1981

Testicular function after renal transplantation.

Gonadal function was assessed in seventeen adult male renal transplant recipients, with well established good homograft function, for a mean of 4.9 years. Patients were assessed clinically and by measurement of basal concentrations of FSH, LH, prolactin, testosterone and oestradiol, FSH and LH responses to bolus injections of LHRH and semen analysis. Retrospectively all had symptoms consistent with marked hypogonadism prior to transplantation but in nine out of sixteen this was reversed with transplantation. Residual hypogonadism was evident in seven of sixteen patients and correlated with duration of haemodialysis longer than 1 year (P less than 0.01). Even among patients with clinically normal gonadal function, defects in the hypothalamic--pituitary--testicular axis remained. Elevated basal serum FSH, excessive FSH responses to LHRH and lowered basal serum testosterone were found. In the group with residual hypogonadism more marked changes, including elevated basal LH and excessive LH responses to LHRH, were also found. Fertility was recorded in two men on three occasions since transplantation. Sperm counts were normal in five and abnormal in four patients. Testicular volume and sperm density were inversely correlated with basal and stimulated FSH and LH levels.

Adult↗
PubMed1981

The diagnosis of renal osteodystrophy: a comparison of Technetium-99m-pyrophosphate bone scintigraphy with other techniques.

In order to determine the place of Technetium-99m-pyrophosphate bone scintigraphy in the assessment of renal osteodystrophy, 17 patients with chronic renal failure requiring hemodialysis underwent bone scans and these were compared to results of biochemical, radiological and histologic studies. Bone histology was abnormal in all patients with most having evidence of osteomalacia and hyperparathyroid bone disease. Using semi-quantitative scan scores and regional bone-standard ratios, isotope uptake was increased in 16 patients, while 15 had elevated alkaline phosphatase levels and 7 had X-ray changes. An osteoid-osteoclast index combining histological osteomalacia and hyperparathyroid disease was derived and was found to correlate more closely with alkaline phosphatase and parathyroid hormone levels than with scan parameters. It was concluded that bone scans did not provide therapeutically useful information that could not be obtained from biochemical and radiological studies. It appeared that only bone histology could differentiate osteomalacia and hyperparathyroid bone disease.

Adult↗
PubMed1981

Regional differences in peroxidatic activation of paracetamol (acetaminophen) mediated by cytochrome P450 and prostaglandin endoperoxide synthetase in rabbit kidney.

Microsomes from renal cortex, outer medulla, and inner medulla of rabbit kidneys were found to catalyze the metabolic activation of paracetamol (acetaminophen), leading to covalent binding to protein when incubated with cumene hydroperoxide and T-butyl hydroperoxide. Differential distribution of cytochrome P450 and prostaglandin endoperoxide synthetase and each enzyme's preference for either cumene hydroperoxide or T-butyl hydroperoxide enabled the present investigation to distinguish their respective contributions in the cooxidative activation of paracetamol. Addition of methemoglobin caused enhancement of prostaglandin endoperoxide synthetase mediated activation of paracetamol when initiated by both arachidonic acid and the hydroperoxides. Aspirin and indomethacin inhibited the protein covalent binding of the reactive metabolite of paracetamol only when its formation was initiated by arachidonic acid. This study demonstrates the differences in the peroxidation metabolic activation of paracetamol mediated by cytochrome P450 (cortex greater than outer medulla greater than inner medulla) and prostaglandin endoperoxide synthetase (inner medulla greater than outer medulla greater than cortex) in rabbit kidney.

Acetaminophen↗
PubMed1980

Uremic cardiomyopathy--effect of hemodialysis on left ventricular function in end-stage renal failure.

Left ventricular ejection fraction was measured by radionuclide left ventriculography before and immediately after hemodialysis in 20 uremic patients, 11 of whom presented with congestive heart failure. Ejection fraction and contraction were normal in 15 patients (Group A), six of whom had signs of congestive failure; they were abnormal in five patients (Group B), all of whom were in clinical heart failure. Mean arterial pressure and body weight decreased by a similar amount after dialysis in both groups, and heart rate did not change. In Group A ejection fraction was unchanged by dialysis (0.63 +/- before vs. 0.62 +/- 0.09 after) (mean +/- S.D.), but in Group B it was improved significantly (0.32 +/- 0.04 before vs. 0.44 0.08 after) (P less than 0.01). In three patients in Group B cardiomegaly and ejection fraction returned to normal with long-term hemodialysis. In end-state renal failure, radionuclide left ventriculography can separate patients with circulatory congestion due to fluid overload from patients with left ventricular dysfunction in whom hemodialysis can provide immediate and long-term improvement.

Adolescent↗
PubMed1980

Incidence of cancer in renal transplant recipients.

In summary, the susceptibility of transplant recipients to the development of cancer is dramatically revealed by the oncogenic effects of sunlight. Skin and other forms of carcinoma are aggressive and develop particularly in patients doing well from the immunological point of view post transplantation. Patients with cancer are less susceptible to rejection than those without. Patients with malignancy survive significantly better in the early post transplant years than do those without cancer, but fare much worse later on because of deaths caused by cancer and because of the need to withdraw immune suppressive therapy in those patients with proliferating cancer. Almost 40% of long survivors have cancer, an incidence which continues to increase. Cancer has become a major cause of mortality in long survivors. It seems that, with time, most carcinomas which occur in the general population will occur with increased frequency in renal transplant recipients.

Adenocarcinoma↗
PubMed1979

Labetalol and bendrofluazide: comparison of their antihypertensive effects.

A randomized double-blind crossover trial of labetalol, bendrofluazide and placebo was carried out in 18 patients with mild to moderate hypertension. The reduction in blood pressure observed with labetalol and bendrofluazide was similar. The plasma levels of labetalol showed a significant correlation with changes in blood pressure (r = 0.07; P less than 0.021); and plasma level determinations of this drug may be of value in the management of patients who receive antihypertensive agents.

Adult↗
PubMed1979

Cancer following renal transplantation.

Ninety-nine (21%) of 471 patients who survived with functioning grafts for at least six months following renal transplantation developed cancer. Of these 76 (77%) had skin malignancy, 29 (29%) had malignancy affecting other organs, and six had cancer of both skin and other organs. In patients with skin cancer squamous cell carcinoma (SCC) was three times as frequent as basal cell carcinoma (BCC). SCC tended to be multiple, recurrent and aggressive. Seven (12%) patients with SCC developed metastases of whom five died. Cancers other than skin included reticulum cell sarcoma (9), acute leukaemia (2) and cancers involving the gastrointestinal (5), genitourinary (11) and respiratory (2) systems. Incidence of cancer in patients surviving beyond one, five and nine years after operation was 98/428 (23%), 70/179 (39%) and 20/45 (44%) respectively. In 31 patients who died more than five years after transplantation cancer was the major cause in eight (26%). For the types of cancers recorded estimates show allograft recipients to be at increased risk when compared with the age-matched Australian population by factors which varied from 300 times for reticulum cell sarcoma to 1.8 times for invasive carcinoma of the cervix. The full extent of the threat of cancer in immune suppressed transplant recipients remains to be determined.

Adolescent↗
PubMed1978

Trimethoprim/sulfamethoxazole and renal function in transplant patients.

Twenty-two patients with functioning renal allografts took part in a double-blind crossover trial during which placebo, sulfamethoxazole, and trimethoprim/sulfamethoxazole were given for periods of 14 days. The patients were divided into 2 groups. The first group consisting of 12 patients had serum creatinine levels less than 0.18 mmol/L and the second group of 10 patients had serum creatinine levels between 0.18 mmol/L and 0.35 mmol/L. Renal function at the end of each period was assessed by clearance of inulin (CIn), p-aminohippurate (CPAH) and endogenous creatinine (CCr). The second group also had a pitressin concentration test as a measure of distal tubule function. There was no change in inulin or creatinine clearance or in maximum concentration after pitressin in any of the patients in any of the phases. In the first group there was an increase in PAH clearance during the sulfonamide and trimethroprim/sulfamethoxazole phases. This change was not seen in the second group of patients with significantly impaired renal function.

Adult↗