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Biomedical subjects

E D Cooke

Publications and source records attributed to E D Cooke.

At least 55 records · Page 3Linked to original sources
PubMed1984

A double blind trial of UK-38,485, an orally active thromboxane synthetase inhibitor, in the treatment of Raynaud's syndrome.

Ten patients with moderate to severe Raynaud's syndrome were recruited into a four week randomised double blind crossover study to compare the efficacy of UK-38,485 50 mg, a new thromboxane synthetase inhibitor with that of placebo. With the doses used there was no significant difference between the two treatment periods in the number, severity and duration of ischaemic attacks, the mean hand temperatures, forearm and digital blood flow and red blood cell rheology.

Adult↗
PubMed1981

Chlorpropamide alcohol flush and circulating met-enkephalin: a positive link.

Chlorpropamide-alcohol flushing may be due to sensitivity to endogenous opiates. To investigate this possibility the plasma met-enkephalin and beta-endorphin responses to sherry with and without chlorpropamide were studied in six patients with non-insulin dependent diabetes and in six normal subjects. After chlorpropamide all patients showed a rise in met-enkephalin concentrations from a basal level of 50 +/- 7.2 ng/l to a peak of 75 +/- 8.1 ng/l (p less than 0.001). In contrast, before chlorpropamide treatment was started met-enkephalin values did not change after alcohol. No significant changes in beta-endorphin values were observed. In six normal subjects pretreated with chlorpropamide the met-enkephalin concentration also rose from a basal level of 72 +/- 15 ng/l to a peak of 103 +/- 9.4 ng/l (p less than 0.002). Again, the met-enkephalin rise was not observed after placebo. Neither beta-endorphin concentrations nor facial temperature changed significantly. These data suggest that endogenous opiates may be implicated in CPAF. Furthermore, this is the first study in which a significant change in circulating met-enkephalin values has occurred.

Chlorpropamide↗
PubMed1981

Detection of immune complexes in systemic sclerosis and Raynaud's phenomenon.

Phagocytosed immune complexes in polymorphonuclear leukocytes of nineteen patients with Raynaud's phenomenon were detected by scoring the cells for IgG and C3 inclusions. Parallel estimations of circulating immune complexes were made by liquid phase C1q binding and polyethylene glycol (PEG) precipitation methods. The results were compared with the degree of cold stress-induced vasospasm measured by quantified infra-red thermography. Thirteen of nineteen patients with Raynaud's phenomenon compared with only one of seventeen normal controls showed significantly elevated levels of phagocytosed IgG. The correlation of IgG and C3 scores for individual patients was high and the IgG and C3 scores correlated well with the thermographic assessment of the severity of the Raynaud's phenomenon. Two of the patients had elevated levels of circulating immune complexes detectable by raised levels of C1q binding, four patients had raised IgG and three patients raised IgM complexes detectable by PEG precipitation. None of the controls had elevated levels of circulating immune complexes detectable by either method. There was no correlation between the levels of circulating and phagocytosed immune complexes.

Antigen-Antibody Complex↗
PubMed1981

Prostaglandin E1 infusions for vascular insufficiency in progressive systemic sclerosis.

Twelve patients with systemic sclerosis (SS) and severe Raynaud's phenomenon received infusions of prostaglandin E1 (PGE1) at a dose of 6-10 ng/kg/min, with either saline or 5% dextrose, for 72 hours in a single-blind cross-over study. The infusions were administered intravenously by centrally positioned catheters. Infusions were well tolerated with only mild side effects. Following the PGE1 infusion cold tolerance improved and attacks of Raynaud's phenomenon were less frequent, less severe, and shorter in duration. This subjective improvement was maintained for several weeks in most patients, and 2 noted healing of ischaemic ulcers. There was no significant change in objective measurements of hand function after either infusion. However, pain measured on a 10 cm visual analogue scale improved 2.19 cm with PGE1 and only 0.91 cm with normal saline (P less than 0.05). Temperature of the fingers and hands recorded by thermography did not change significantly with saline infusions, but did rise during PGE1 infusions (mean rise 2.0 degrees C at 48 hours, p less than 0.001), and was maintained when measured again 2 weeks later (mean rise 1.56 degrees C, p less 0.001). PGE1 may therefore be suitable treatment for Raynaud's phenomenon and the vascular insufficiency of systemic sclerosis and other connective tissue diseases.

Adult↗
PubMed1981

Dorsal column stimulation in multiple sclerosis: effects on bladder, leg blood flow and peptides.

9 patients with bladder disorder secondary to multiple sclerosis (MS) were treated by dorsal column stimulation (DCS). Detailed urodynamic tests were performed and leg blood flow was assessed on repeated occasions. Cerebrospinal fluid (CSF) met-enkephalin levels were estimated before and during DCS. The chief effect of DCS was improved urinary flow associated with reduced sphincter tone and lessened detrusor instability maximal at the 6th or 7th day of continuous stimulation. Considerable fluctuation in leg blood flow occurred unrelated to activation of the stimulator. No obvious change in CSF met-enkephalin levels took place, but it is suspected that the mode of action of DCS in via certain peptide hormones.

Electric Stimulation Therapy↗
PubMed1981

Problems with corneal arcus.

Corneal arcus presents many puzzling features. The correlation between its incidence and serum lipid levels is poor and, using immunoelectrophoresis, we have only been able to identify low-density lipoprotein inconsistently in corneae containing this deposition. Infrared thermography has shown us that arcus commences in the warmest regions of the cornea. We have considered the possible relevance of our biochemical and thermographic findings to other problems with corneal arcus such as its irreversibility, anatomical distribution, and clear zone.

Aged↗
PubMed1980

Identifying scoliosis in the adolescent with thermography: a preliminary study.

Early diagnosis of adolescent idiopathic scoliosis is essential to prevent severe deformity. The accuracy of thermographic examination of the spine in the detection of minor degrees of curvature has been assessed in 125 asymptomatic young persons mean age 13.4 +/- 0.8 years who were also examined clinically and by spinal X-ray. Assessment of thermograms selected at random from the group of 154 young subjects showed that thermography has a sensitivity of 98.2% and a specificity of 91.0% in the identification of scoliosis when compared with radiography. Thermographic examination of the spine is simple, noninvasive and provides a permanent recording which is easily interpreted. It may provide an ideal method for use in large-scale prospective surveys. The criteria used to detect the thermographic abnormality associated with idiopathic scoliosis was derived from the spinal thermograms of 29 patients, mean age 10.25 +/- 4.65 years with known scoliosis, mean angle of curve 27 degrees +/- 12 degrees. In contrast to the thermal symmetry of the normal spine, all the thermograms of these patients show asymmetry, characteristically an increase in thermal emission on the concave aspect of the curve. Eight of the 16 patients with scoliosis with minor curves and a characteristic thermogram were not detected clinically. There were 25 asymmetrical thermograms in the asymptomatic group. Three of these patients had a simple postural defect, 5 had dorsal kyphosis and 16 had idiopathic scoliosis. Postural defects and kyphosis were readily recognized on clinical examination and did not produce the characteristic scoliotic thermogram.

Adolescent↗
PubMed1979

Significance of popliteal reflux in relation to ambulatory venous pressure and ulceration.

Fifty-one patients (55 limbs) who had had deep venous thrombosis (DVT) extending into the femoral or iliofemoral segment three to five years earlier and ten limbs of ten healthy volunteers were studied. The ambulatory venous pressure (AVP) was measured by inserting a needle in a vein on the foot; the presence of reflux in the popliteal vein was determined by a directional Doppler ultrasonic blood velocity detector. All patients had ascending venography. The results suggest that the most important factor in determining the AVP and ulceration in postthrombotic limbs is the condition of the popliteal valves. Ulceration does not occur even in the presence of occlusion if the popliteal valves are competent. The extent of DVT and recanalization or the failure of recanalization is of secondary importance.

Humans↗
PubMed1978

After-exercise thermography for predicting postoperative deep vein thrombosis.

After-exercise thermography of the legs was carried out on 50 patients before undergoing major abdominal surgery (group 1) and on 59 patients before elective hip surgery (group 2). The incidence of postoperative deep vein thrombosis (DVT)--diagnosed by the 125I-fibrinogen uptake test in group 1 and phlebography in group 2--was significantly higher in patients whose after-exercise thermogram (AET) had been abnormal. Out of 19 patients in group 1 and 30 in group 2 with a normal AET, two and nine repsectively developed postoperative DVT. Among patients with a unilaterally abnormal AET the incidences were 12 out of 19 patients in group 1 and five out of nine in group 2. The incidences among patients with a bilaterally abnormal AET rose to 11 out of 12 patients in group 1 and 15 out of 20 in group 2. Preoperative after-exercise thermography is a simple, objective test that identifies patients at high risk of developing postoperative thromboembolic disease.

Abdomen↗
PubMed1977

Intravenous lignocaine in prevention of deep venous thrombosis after elective hip surgery.

Intravenous lignocaine is a possible means of preventing deep venous thrombosis (D.V.T.) after elective hip surgery. In 14 control patients the total incidence of D.V.T. was 78%, with a 57% incidence of thigh-vein thrombosis. In 14 patients treated at random with intravenous lignocaine during the first 6 postoperative days, there were only 2 calf-vein thrombi (14%; P less than 0-005). In a further 14 cases treated consecutively there were 4 unilateral calf-vein thrombi. No thrombi originated in the thigh veins (P less than 0-001). After intravenous lignocaine was stopped the total incidence of D.V.T. in the 28 patients rose to 53% with a 21% incidence of thigh-vein thrombi between the 7th and 14th postoperative days. There was no significant difference in postoperative coagulation and fibrinolytic activity between control and treated patients, and blood loss and transfusion requirements were similar. Immediate or delayed hypersensitivity reactions to lignocaine were not observed. The results support the view that damage to the vessel wall may be the initial event in the formation of a venous thrombus.

Adult↗
PubMed1977

Characterisation of serum fibrinogen degradation products using gel chromatography and radioimmunoassay.

Fibrin(ogen) degradation products (FDP) are detected by radioimmunoassay in the serum of all subjects. Some of these FDPs have considerable biological activity in vivo, and hence may play a significant part in the process of coagulation. Chromatography of serum samples from patients including those with pulmonary emboli and deep venous thrombosis indicates that the majority of non-clottable fibrin(ogen)-related antigen present is of high molecular weight--greater than that of fibrinogen--and that in pathological situations there is a quantitative increase not a qualitative alteration in the molecular species present.

Chromatography, Gel↗
PubMed1977

Failure of orally administered hydroxychloroquine sulphate to prevent venous thromboembolism following elective hip operations.

In a double-blind, randomized trial of orally administered hydroxychloroquine sulphate in the prevention of venous thromboembolism after elective surgery on the hip, the drug or a placebo was given to fifty consecutive patients. Therapy was commenced on the day before the operation and continued for fourteen days. The diagnosis of deep venous thrombosis was made by daily thermographic scanning of the legs and confirmed by phlebography. The diagnosis of pulmonary embolism was made by perfusion lung scanning. No significant difference in the incidence of thromboembolism was found between treated and control groups. The results provide evidence that substances which reduce the incidence of thromboembolism in general surgery may not be effective in operations on the hip.

Administration, Oral↗
PubMed1975

Serum fibrin(ogen) degradation products in diagnosis of deep-vein thrombosis and pulmonary embolism after hip surgery.

Levels of fibrin(ogen) degradation products (F.D.P.) have been measured by radioimmunoassay for degradation product E (FgE) and by tanned-red-cell haemagglutination-inhibition immunoassay (T.R.C.H.I.I.) in the serum of thirty-three patients undergoing total hip replacement. Levels of F.D.P. did not correlate with thermographic evidence of deep-venous thrombosis. However, in 34 patients with pulmonary embolism, levels of F.D.P. measured by the T.R.C.H.I.I. were transiently raised at the time of embolus, and FgE concentrations were increased for up to 5 days preceding the embolus. Since the measurments of FgE is simple, convenient, and cheap, this estimation might constitute a valuable screening test for major thromboembolic episodes in the postoperative period.

Aged↗