Letter: Enhancement of bilirubin clearance and hepatic haem turnover by ethanol.
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Biomedical subjects
Publications and source records attributed to D Samson.
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The incorporation of [15N] glycine into early labelled bilirubin and haemoglobin haem was measured in four haematologically normal subjects, using the clearance of [14C] bilirubin to measure total bilirubin production rate. Hepatic haem turnover was calculated from the incorporation of [15N]=sigma-aminolaevulinic acid into early labelled bilirubin. From the exprimental data previously published data in normal subjects a method is derived for the quantitation of ineffective erythropoiesis which can be applied to similar studies in patients with haematological disorders.
The incorporation of [15N]delta-aminolaevulinic acid and [15N glycine into haemoglobin haem and early labelled bilirubin was measured in subjects with various haematological disorders. The clearance of [14C bilirubin was used to measure bilirubin production rate, and the magnitude of the various sources of bilirubin production and the percentage ineffective erythropoiesis were calculated. Ineffective erythropoiesis was found to be a major factor in the production of the anaemia in patients with the following disorders: megaloblastic anaemia associated with the Lesch-Nyhan syndrome, thalassaemia intermedia, sideroblastic anaemia, and the anaemia of chronic disorders. In three patients with iron-deficiency anaemia ineffective erythropoiesis was increased, but was of minor importance in the production of the anaemia, while in two patients with aplastic anaemia and one with macrocytosis of alcoholism there was no increase in ineffective erythropoiesis.
A 63-year-old man with erythraemia was found to have a high affinity haemoglobin which was subsequently identified as Hb San Diego beta 109 (G11) Val leads to Met, recently described in a Filipino family (Nute et al, 1974). The oxygen affinity of the haemolysates was increased approximately two-fold at pH values between 6.04 and 7.90. The n value was nearly normal (2.5-2.9) in the upper range of saturation (70-95% oxygenation) but was somewhat diminished (1.9-2.1) below this range. In vitro biosynthesis of globin by reticulocytes showed that there was balanced synthesis of alpha and beta chains (alpha:beta ratio = 1).
An intramuscular injection of 100 mug of anti-Rh, given 13 days after an intravenous injection of 1 ml of Rh-positive red cells appeared to suppress primary Rh immunization: at 6 months, none of thirteen subjects so treated had detectable anti-Rh in their plasma, whereas anti-Rh was present in five out of twelve control subjects injected with Rh-positive cells alone (P equals 0.015, Fisher's exact test, one-tailed). Primary immunization was not suppressed in all treated subjects since, following a second injection of Rh-positive cells, 7-day survival was subnormal in three subjects, all of whom had anti-Rh in their plasma after a further 2 weeks. In three other treated subjects, primary Rh immunization appeared to be completely suppressed: survival was normal, or initially normal, following a second injection of Rh-positive cells and anti-Rh was detectable only after a third injection.
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To test different hypotheses about age-related slowing of word and picture naming, response latencies of young and older adults were compared in 2 experiments using the same 4 tasks: picture naming, written word pronunciation, and picture and word categorization. In each case, the target word or picture was presented with a distractor word that had to be ignored. Analyses showed the expected main effects of age, modality, and interference conditions but no consistent interaction between age and other factors. More particularly, age-related slowing was similar in word and picture processing and interference was proportional to overall speed of responding. Thus, no support was found for the hypotheses assuming either declining inhibitory mechanisms or task-specific deficits in older adults. These results were discussed in relation to characteristics of the experimental tasks.
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Urine samples for assay, temperature, heart rate, and blood pressure were collected daily at 2-h intervals from 11 consenting subjects undergoing abdominal surgery, as well as 10 age-and sex-matched control subjects. Alterations in level, and timing of circadian excretion of catecholamine metabolites, adrenal cortical hormones, sodium, potassium, creatinine, and vital signs following surgery were measured. Data were examined to determine if a relationship exists between the degree of circadian alteration and the subject's return to typical circadian profiles. The data suggest that certain circadian rhythms of hospitalized subjects were altered and uncoupled from external stimuli. In addition, subjects with less disruption in some variables following surgery regained rhythmicity more quickly than more disrupted subjects. These findings suggest that health professionals should individualize patient care to promote rhythmicity. In addition, patient assessment should consider individual circadian patterns and disruption following surgery.
Alterations in level, timing, and coupling of circadian excretion of catecholamine metabolites, adrenal cortical hormones, sodium, potassium, creatinine, and vital signs in acute-care surgical patients were measured. Data were examined to determine if a relationship exists between the degree of circadian alteration and the subject's reentrainment to typical circadian profiles. Urine samples for assay, temperature, heart rate, and blood pressure were collected daily at 2-hour intervals from 11 consenting surgery subjects and 10 age- and sex-matched control subjects. The data indicate that certain circadian rhythms of hospitalized subjects were altered and uncoupled from external stimuli. These findings suggest that nurses (1) give individualized patient care to promote reentrainment recovery; and (2) refine nursing assessment to consider individual circadian patterns.