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Biomedical subjects

J A Scott

Publications and source records attributed to J A Scott.

At least 163 records · Page 9Linked to original sources

Magnetic resonance imaging of the extremities.

MRI offers the best soft-tissue contrast of any radiographic modality. It provides better delineation of soft-tissue tumors and bone tumors than CT, but several different pulse sequences may be needed to make optimum use of this potential. MRI is also well suited to evaluation of abnormalities of the bone marrow, as it is not subject to the dense bone artifact that may occur with CT. Changes in signal intensity may be used to gain some appreciation of blood flow in the major vessels. Examples of each of these applications are discussed.

Bone Diseases↗

Down-regulation of serotonin2, but not of beta-adrenergic receptors during chronic treatment with amitriptyline is independent of stimulation of serotonin2 and beta-adrenergic receptors.

Antidepressant drugs down-regulate beta-adrenergic, alpha 2-adrenergic and serotonergic 5-HT2 receptors with a time course that parallels their clinical efficacy, i.e. chronic administration is required (Crews and Smith, 1978; Svensson and Usdin, 1978; Banerjee, Kung, Riggi and Chanda, 1979; Bergstrom and Keller, 1979; Peroutka and Snyder, 1980). In the present study, it was found that the 5-HT2 receptor antagonist, nefazadone (50 mg/kg per day) did not prevent the downregulation of 5-HT2 receptors in the cerebral cortex produced by amitriptyline (10 mg/kg per day), when administered for 3 weeks. Moreover, treatment with nefazadone (50 mg/kg per day) alone for 3 weeks decreased binding to 5-HT2 receptors in cerebral cortex. In contrast, administration of propranolol, the beta receptor antagonist, (10 mg/kg per day) with amitriptyline (10 mg/kg per day) for 3 weeks prevented the down-regulation of beta receptors, but did not alter the decrease in binding to 5-HT2 receptors. In addition, the depletion of central stores of norepinephrine and serotonin by a 4-day treatment with reserpine (5 mg/kg per day) increased binding to beta receptors in the cerebral cortex and hippocampus, but did not affect binding to 5-HT2 receptors in either region. These results suggest that the 5-HT2 receptor is not down-regulated by direct stimulation by serotonin agonists and that the down-regulation of 5-HT2 receptors by amitriptyline is independent of down-regulation of beta-adrenergic receptors.

Amitriptyline↗

The effect of phenothiazines upon maintenance of membrane integrity in the cultured myocardial cell.

The cultured myocardial cell provides a defined model for examining factors which are responsible for maintaining cellular viability and sarcolemmal integrity. Our data indicates that the spontaneous loss of myocyte membrane integrity is a calcium-dependent process and thus provides a method for examining the mechanism through which calcium exerts this effect. Antimyosin antibody staining and propidium iodide uptake were used to quantitate membrane integrity. The integrity of the cell membrane was inversely related to the calcium concentration in the culture medium. This loss of membrane integrity was calmodulin-dependent as demonstrated by the following: phenothiazines (trifluoperazine greater than chlorpromazine greater than promethazine) and structurally dissimilar calmodulin-inhibitors prevented the formation of sarcolemmal defects at concentrations similar to those known to inhibit calmodulin; phenothiazines and calcium demonstrated a competitive interaction with respect to this effect on membrane integrity. Electron microscopy confirmed the integrity of the sarcolemma of the cells exposed to high phenothiazine concentrations although metabolic alterations occurred in these cells as evidenced by an increased membrane permeability to the low molecular weight probe propidium iodide, degenerative changes in the fine structure of the mitochondria, the accumulation of autophagic vacuoles in the cytoplasm and the loss of contractile ability. These findings indicate that calmodulin inhibitory compounds are capable of preserving the membrane integrity of cardiac myocytes, interfering with a calcium-dependent process that is associated with the spontaneous attrition of these cells in culture. Significant intracellular alterations appear at high doses of these agents even while the sarcolemma is free of gross defects.

Animals↗

Evaluation of Gaucher disease using magnetic resonance imaging.

Magnetic resonance imaging was used to study the skeletal involvement in a series of twenty-four patients with Gaucher disease. Many sites in the marrow of these patients were characterized by an abnormally low signal intensity that reflected shortened T1 and markedly shortened T2 values in the replaced marrow. The abnormality was non-homogeneous in distribution. In the lower extremity, the proximal (femoral) areas were more frequently affected than the distal (tibial) sites. The epiphyses were generally spared unless the involvement of bone was extensive. Lack of epiphyseal involvement on the magnetic resonance images generally precluded any suspicion of osteonecrosis. The extent of involvement, as suggested by the magnetic resonance data, appeared to correlate well with the occurrence of musculoskeletal complications. Magnetic resonance imaging is more sensitive than computerized tomography in demonstrating the extent of abnormalities in patients with Gaucher disease, and it may have prognostic value.

Adolescent↗

Needle electrode connectors for EMG testing: a new technique.

Subcutaneous needles as reference and ground electrodes in electromyography are clinically and practically more advantageous than surface electrodes. A functional and inexpensive set of electromyography needle electrode connectors is easily fabricated. The necessary components are readily available at approximately $4.00 and manufacture is simple. The life span of each electrode set is more than two years with standard care.

Electrodes↗

Biosynthesis and secretion of proatrial natriuretic factor by cultured rat cardiocytes.

Rat atrial natriuretic factor (ANF) is translated as a 152-amino acid precursor preproANF. PreproANF is converted to the 126-amino acid proANF, the storage form of ANF in the atria. ANF isolated from the blood is approximately 25 amino acids long. It is demonstrated here that rat cardiocytes in culture store and secrete proANF. Incubation of proANF with serum produced a smaller ANF peptide. PreproANF seems to be processed to proANF in the atria, and proANF appears to be released into the blood, where it is converted by a protease to a smaller peptide.

Amino Acid Sequence↗

Pitfalls of computed tomography in diagnosis of discitis.

Sixteen patients with discitis from January 1980 through December 1983 underwent 18 CT scans for initial evaluation. In six scans the study produced a false negative result (sensitivity 63%, 11/16). In three of these six the scan was performed at the wrong disc level, and in three the error was interpretive. During the same time period 6 patients had a CT diagnosis of discitis which proved incorrect (positive predictive value 63%), three of which had fractures, two had normal post discectomy changes, and one had a neuropathic arthropathy. These studies were reviewed in a blinded fashion along with 30 CT scans of post operative patients without clinical or laboratory evidence of discitis. The CT findings in the discitis patients were: (a) anterior paravertebral soft tissue swelling with obliteration of paravertebral fat planes, (b) fragmentation or erosions of vertebral end plates, and (c) paravertebral fluid collection (abscess). Both (a) and (b) were seen in 13/15 patients, (a) alone in 1/15, (b) alone in 1/15, and all three (a, b, c) in 2/15. The CT scan is diagnostic of discitis in those with all three findings. In those patients with only (a) or both (a) and (b), the CT can be suggestive of discitis in the proper clinical setting when correlated with plain film findings: however, these CT findings are also observed in other conditions. Involvement of the spinal canal by inflammatory mass was seen in 6/16 patients with discitis. Low attenuation (hypodensity) of the affected disc was not observed.

Adolescent↗

Portal hypertension due to jejunal vascular malformation.

We report a case of hepatic portal venous hypertension secondary to a small-bowel vascular malformation in a 24-year-old man with anemia. Preoperative diagnostic evaluation included gastrointestinal barium studies and endoscopy (showing esophageal varices), hepatic panangiography, peroral small-bowel biopsy, percutaneous transhepatic portal venography, and manometry. Preoperative injection of methylene blue dye into the jejunal arteries supplying the malformation resulted in easy localization of the lesion at surgery. Direct manometry at the time of segmental jejunal resection yielded a portal pressure of 35 mmHg, with subsequent reduction to 21 mmHg.

Adult↗

Biogenic amine uptake by nerve cords from the American cockroach and the influence of amidines on amine uptake and release.

Uptake of 5-hydroxytryptamine (5-HT) by isolated whole nerve cords of the American cockroach, Periplaneta americana (L.), involved a dual component system, with one component consisting of rapid active uptake and the other of passive diffusion. Using high performance liquid chromatography with electrochemical detection, it was shown that nerve cords contained 5-HT levels of about 350 ng/g and an equivalent amount of 5-hydroxyindoleacetic acid (5-HIAA), a 5-HT metabolite not previously reported in cockroach nerve cords. Amidines had no discernable effect on uptake of 5-HT or octopamine by nerve cords or on endogenous levels of 5-HT and 5-HIAA in cords.

Amidines↗

Cerebral venous angiomas: MR imaging.

Seven patients with angiographically proved cerebral venous angiomas were imaged by magnetic resonance. The venous angioma was identified in all cases. The most characteristic feature was an enlarged transcerebral draining vein (86%), followed by increased signal on T2-weighted images (57%) and decreased signal on T1-weighted images (40%) in adjacent parenchyma. Mass effect was absent in all cases. T2 imaging was more successful in showing the lesions than was T1 imaging.

Adolescent↗

The role of free radical-mediated processes in oxygen-related damage in cultured murine myocardial cells.

A new approach to quantifying myocyte cell death utilizing fluorescence-activated sorting of antimyosin antibody-labeled cells was used to study the effects of oxygen-generated free radicals on cell survival. Uptake of antimyosin, reflecting sarcolemmal damage, increased under conditions which promoted elevated free radical formation and decreased in the presence of increased levels of free radical-scavenging agents. Superoxide dismutase decreased antimyosin uptake at pH 6.7 and 7.5. Mannitol decreased antimyosin uptake at pH 6.5 and 6.7 but not at pH 7.5, and dimethyl sulfoxide decreased antimyosin uptake at pH 6.4 but not at pH 7.5. These data suggest that a greater portion of hydroxyl radicals are produced at higher concentrations of hydrogen ion. Mannitol, a scavenger of hydroxyl radicals, was effective in reducing antimyosin uptake at pH 7.5 in the presence of ferrous sulfate, but had no effect on antimyosin uptake in the absence of ferrous sulfate, suggesting possible iron-mediated catalysis of hydroxyl radical formation. The data suggest that oxygen-derived free radicals can cause significant loss of membrane integrity in cultured myocytes, that the species of radical formed is dependent both on pH and the concentration of iron salts, and that this injury is, at least in part, preventable by the administration of exogenous radical scavenging agents.

Animals↗

Sacrococcygeal chordoma: magnetic resonance imaging and computed tomography.

Magnetic resonance imaging (MRI) was compared to computed tomography (CT) in four cases of sacrococcygeal chordoma. Both techniques yielded important anatomic information and represented important advances over early radiologic imaging methods. MRI provides superior contrast with surrounding soft tissues because of the prolonged T1 and T2 times of the tumors. This was especially important in a case of recurrent chordoma. The direct sagittal images obtained by MRI were valuable in determining the extent of lesions. Either MRI or direct CT coronal images were needed for the demonstration of tumor involving the sacral nerve roots. It was not possible to reliably distinguish between tumor adherent to bowel wall and bowel wall invasion by either technique. It is concluded that MRI is at least equal to CT for demonstration of these lesions and seems likely to become the imaging method of choice.

Adult↗

Complaints arising from the exercise of clinical judgement. A report by the English Regional Medical Officers.

The investigation of complaints arising from the Exercise of Clinical Judgement has been subject to new procedures since September 1981. Early in 1984 the Regional Medical Officers set in hand a review of their experience in operating the procedures. The review is presented in two parts: The first part records the number of complaints received in relation to the total number of patients treated, followed by a brief description of the means employed to pursue these complaints with particular attention to the revised three stage procedure, introduced in September 1981. The second part reviews certain aspects of the 36 complaints referred to Regional Medical Officers between 1 September 1981 and 31 December 1983 under the new procedure. It demonstrates the efforts made by all those involved to ensure the success of the system. It also describes some of the difficulties encountered in operating the system and makes suggestions for its future management.

Clinical Competence↗