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Biomedical subjects

G S Basran

Publications and source records attributed to G S Basran.

34 records · Page 2Linked to original sources
PubMed1986

The effect of methylprednisolone on the pulmonary accumulation of transferrin in the adult respiratory distress syndrome.

Plasma protein accumulation (PPA) was monitored in the lungs of patients with the adult respiratory distress syndrome (ARDS). Transferrin radiolabelled in vivo with indium-113m was used as the plasma protein marker. Ten patients with clinically defined ARDS, exhibiting increased PPA indices (greater than 1.0 X 10(-3) min-1), were given intravenous infusion of methylprednisolone (MP; 30 mg kg-1 over 10 min). The four patients in whom the PPA indices were reduced to below 0.5 X 10(-3) min-1 within 1 h of completion of MP infusion all survived. In the remaining six patients PPA indices remained above 0.5 X 10(-3) min-1 and five of them died. The PPA indices prior to administration of MP were not significantly different in the survivors (n = 5) and non-survivors (n = 5); however, after MP they were significantly lower in the survivors compared with the non-survivors (P less than 0.02). Thus the response to an infusion of MP, monitored as PPA, may provide a predictor of survival in ARDS.

Adolescent↗
PubMed1985

A noninvasive technique for monitoring lung vascular permeability in man.

Increased microvascular permeability resulting in increased plasma protein extravasation is the hallmark of acute inflammatory oedema and hence radiolabelled proteins can be used to monitor this process. The adult respiratory distress syndrome (ARDS) is characterized by acute inflammatory oedema and thus provides an ideal model for studying this type of oedema in the human lung. A noninvasive technique applicable to the intensive care unit has been developed for monitoring the pulmonary accumulation of the plasma protein transferrin. Transferrin was radiolabelled in vivo with indium-113m and its accumulation was monitored using a portable probe radiation detector. After correcting for changes in intrathoracic blood distribution, by simultaneously monitoring the accumulation of technetium-99m-labelled red blood cells, an index of plasma protein accumulation was calculated. In all patients with established ARDS (n = 10) the index values were greater than 1.0 X 10(-3) min-1 and these were clearly separate from the values of less than 0.5 X 10(-3) min-1 in all healthy volunteers (n = 5; P less than 0.001). The technique can clearly detect raised plasma protein accumulation indices in the lungs of patients with established inflammatory oedema of ARDS and hence may provide a pharmacological tool for the rapid evaluation in these conditions of the effects of drugs (like corticosteroids) which are known to modulate inflammatory oedema.

Capillary Permeability↗
PubMed1985

Abdominal tuberculosis in urban Britain--a common disease.

Between 1973 and 1983 abdominal tuberculosis was responsible for the admission of 90 patients to a west London district general hospital. Over the same period Crohn's disease was newly diagnosed in 102 hospitalised patients. In contrast with Crohn's disease, the majority (75) of tuberculous patients were Asian immigrants. Mean duration of residence in the United Kingdom was 4 +/- 0.9 (SD) years, and mean age at presentation was 34.9 +/- 1.1 years. Forty per cent of tuberculosis patients presented as an acute emergency to physicians, surgeons, or gynaecologists while the remainder presented a more insidious, chronic picture. Five groups of tuberculous patients were recognised. Forty two subjects had intestinal tuberculosis characterised by pain (100%), abdominal mass (43%) and abnormal contrast radiology (100%). Ten of these underwent emergency laparotomy for intestinal obstruction or perforation. Twenty seven patients had tuberculous peritonitis although only 16 had ascites. Eight patients presented with pyrexia and granulomatous hepatitis. Five had pulmonary and abdominal tuberculosis. The remaining eight patients represented a miscellaneous group. The diagnosis of abdominal tuberculosis was established histologically (60 cases), bacteriologically (six cases) or radiologically (24 cases). Chest radiograph, tuberculin skin testing and paracentesis were usually unhelpful. Five severely ill patients died. The remainder recovered completely after specific triple chemotherapy and response to treatment was usually evident within 14 days. In urban Britain tuberculosis is an important cause of abdominal disease. Prognosis is excellent following specific therapy.

Abdomen↗
PubMed1984

Synergism between platelet-activating factor (PAF-acether) and prostaglandin E2 in man.

In animal experiments the oedema in the acute inflammatory response is dependent on both increased blood flow and increased vasopermeability (the two component hypothesis). We have confirmed the validity of this hypothesis in man by demonstrating synergistic interaction between PAF-acether (a permeability agent) and prostaglandin E2 (a vasodilator). The mixture of PAF-acether and PGE2 (50 ng; 0.5 micrograms) produced a larger cutaneous wheal volume response than could be accounted for either by summation of the responses to the individual mediators or by the slopes of their dose response curves.

Adult↗
PubMed1984

Platelet-activating factor: a possible mediator of the dual response to allergen?

Certain allergic asthmatic patients exhibit a dual response in the lung following bronchial challenge with the appropriate allergen. Often this is paralleled by a cutaneous dual response when the antigen is injected intradermally. The mechanisms underlying such phenomena are not established, but some evidence suggests that the late response is a consequence of the early response. Since platelet activation has been observed following antigen challenge in asthmatic subjects, we have studied the ability of platelet activating factor (PAF-acether, AGEPC) to induce cutaneous inflammatory responses in man. In a time course study over 24 hr, PAF-acether produced a biphasic response: an immediate weal and flare reaction, which resolved within 1-2 hr and was followed some 3-6 hr later by a delayed reaction in which erythema associated with hyperalgesia was evident. These observations suggest that PAF-acether should be considered in the context of allergic asthma as a possible mediator of the dual response to allergen.

Adult↗
PubMed1984

Beta-adrenoceptor agonist responses in the skin and lungs of asthmatic subjects.

Concomitant intradermal injection of salbutamol inhibits histamine-induced weal volume in the skin of atopic asthmatic subjects and the degree of this inhibition (index of beta-adrenergic effect in the skin) correlates with the bronchodilator effect of inhaled salbutamol in the same subjects (index of beta-adrenergic effect in the lung).

Adrenergic beta-Agonists↗
PubMed1984

Circulating beta-adrenoceptor blocking factors in asthma.

The hypothesis that a generalized defect in beta-adrenoceptor function characterized asthma and atopy has been proposed by Szentivanyi. Such a defect may be intrinsic to the beta-adrenoceptor mechanism or could be attributed to circulating factors which interfere with the binding of catecholamines to beta-adrenoceptors. This study shows that sera from a proportion of the asthmatic population studied contain beta-adrenoceptor blocking activity and that the degree of inhibition correlates with some of the clinical indices of asthma.

Adrenal Cortex Hormones↗
PubMed1984

Inhaled lactose-free sodium cromoglycate powder in the treatment of recurrent asthma.

Sodium cromoglycate is widely used in many countries as a first-line drug in the prevention of bronchial asthma, but in others, particularly the United States, there are doubts about its role. It has been suggested that the lactose, which was used as a carrier substance in the earlier preparation, might have contributed to the apparent efficacy of the drug. In view of this a double-blind controlled trial comparing inhaled lactose-free sodium cromoglycate powder (C) with placebo (P) has been undertaken in patients with chronic asthma not adequately controlled by bronchodilators. Thirty adult patients (15 C, 15 P) with demonstrable reversibility of their airflow obstruction of at least 20% and who were not taking corticosteroids or sodium cromoglycate were admitted to the study. The C patients had, on average, more severe asthma in the 4-week pretrial assessment period and were taking more bronchodilators. After 12 weeks on trial therapy the results for the C group were significantly better than for the P group in terms of changes in symptom scores, the amount of inhaled bronchodilator used and morning and evening peak flow rates. There was already evidence of greater improvement in the C group by 4 weeks. These results indicate that in this group of atopic patients with frequent asthma symptoms despite bronchodilator therapy, inhaled lactose-free sodium cromoglycate powder provided improved control of asthma symptoms.

Adolescent↗
PubMed1982

Evidence in man of synergistic interaction between putative mediators of acute inflammation and asthma.

The two-component hypothesis of acute inflammation postulates that the acute inflammatory response depends on both increased local blood flow and increased microvascular permeability: the validity of this concept has previously been established in animals and was tested here in man. A mixture of the mediators prostaglandin E2 and bradykinin produces a larger cutaneous wheal (volume) response than can be accounted for either by summation of the responses to the individual substances or by the slopes of their dose-response curves. This enhanced response is inhibited by noradrenaline (consistent with the vasoconstrictor property of noradrenaline) and by salbutamol (consistent with the anti-permeability property of salbutamol). These observations indicate that the two-component hypothesis of acute inflammation applies to man as well as animals; this finding is important in the evaluation of the role of putative mediators in the pathogenesis of asthma and other diseases in which inflammation plays a part.

Acute Disease↗