Biomedical subjects
Publications and source records attributed to J Black.
Renal calculi have rarely been cited as a major manifestation of cystinosis. We report a case history of a child with multiple urate calculi and a calcium oxalate stone resulting from proximal tubular dysfunction that was not associated with bicarbonate wastage.
The effect of delayed reinforcement on the acquisition of lateral hypothalamic self-stimulation was investigated. Brain stimulation reinforcement minimizes cues associated with reinforcement delivery (secondary reinforcement) and, by eliminating consummatory responses, permits precise temporal control of the interval between the operant response and reinforcement. Different groups were trained in daily 1-h sessions for brain stimulation reinforcement at one of 4 delay intervals (1, 2, 3 or 6 s). Responses made during the delay interval were not reinforced and reset the delay timer. Control groups (IMMEDIATE) were reinforced immediately, but were required to space responses--according to a delayed reinforcement of low rates (DRL) schedule--for an interval corresponding to one of the delay of reinforcement intervals. The DRL schedule equalized opportunities for reinforcement and non-reinforcement. At all intervals, rats trained with delayed reinforcement had significantly lower bar-press rates than controls trained with immediate reinforcement under DRL. When reinforcement schedules were switched (DELAY groups now get IMMEDIATE and vice versa), response rates rapidly shifted to levels appropriate to the new schedule. The pre-switch results indicate that delays even as short as 1 s markedly impede the acquisition of self-stimulation behavior. The post-switch results suggest that delay of reinforcement, like stimulation intensity, may determine the strength of hypothalamic reinforcement and hence final levels of performance.
Phosphatidylglycerol (PG) was extracted from 54 human amniotic fluids for the assessment of fetal lung maturity. The PG values were derived from an enzymatic assay involving initial conversion of PG to glycerol by phospholipase C and alkaline phosphatase with subsequent analysis of the glycerol formed. This method proved to be reliable when compared with a method for two-dimensional thin layer chromatographic (2D TLC) analysis of amniotic fluid phospholipids. The results revealed that in all but one of 27 amniotic fluids in which no PG was detected by 2D TLC, enzymatic PG concentrations were less than or equal to 1.5 mumol/l and out of these, from 10 newborn infants delivered within 72 h of sampling, 4 developed respiratory distress syndrome (RDS). Conversely, in all but one of 27 amniotic fluids found to contain PG by 2D TLC, enzymatic PG concentrations were greater than 1.5 mumol/l and except for one subject from non-identical twins, no infants developed RDS.
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Aneurysm contents were cultured in 275 patients out of a series of 546 cases undergoing infrarenal aortic aneurysm repair between 1961 and 1981. The incidence of positive cultures was 8 per cent. Cultures were more likely to be positive if taken from ruptured (16.7 per cent) and acute (9.1 per cent) aneurysms than from elective (4.2 per cent) cases (X2 = 6.69, P less than 0.01). Gram-positive organisms predominated with Micrococcus being the commonest isolate. Positive cultures were seen at an annual rate of 1-3 cases up to 1976 since which time all have been negative and we believe this may be due to prophylactic antibiotics being given preoperatively rather than postoperatively. The incidence of subsequent graft sepsis was greater in patients with positive aneurysm contents cultures (7 out of 22) than in those with negative cultures (6 out of 253) (X2 = 32.7, P less than 0.001). We recommend the routine culture of aneurysm contents to identify patients who are at high risk of developing graft sepsis and suggest that those cases with positive cultures receive prolonged organism-specific antibiotic therapy. In addition, there is evidence that pre-operative antibiotics may eliminate organisms from aneurysms, thus reducing the subsequent risk of graft sepsis.
Studies of electrical stimulation of osteogenesis with stainless steel electrodes have previously established a dose-response relationship between current and bone growth. Examination of the effect of differing geometric current densities resulted in the conclusion that very little electrode surface area was involved in stimulation and led to the design of a multiport "distributive" cathode. A series of experiments were performed to extend these results to wire and multiport platinum electrodes. As before, a current-bone growth dose-response relationship was found. Peak bone growth was greater than for stainless steel. However, peak bone growth occurred at 2.0 microA (versus 20 microA for stainless steel). Correlation studies suggest that small changes in cathodic potential affect bone growth more than similar size changes in current. Finally, the generally benign local host response to platinum suggests that platinum may be a suitable material for chronic indwelling anodes for stimulation of osteogenesis.
Reactive, post-traumatic bone formation in response to intramedullary insertion of a polytetrafluorethylene-coated, 28 gauge stainless steel wire was compared with the sequential bone formation seen in response to an identical intramedullary stainless steel cathode delivering 20 microA constant direct current. Animals were studied at days 1, 2, 3, 4, 5, 7, 9, 11, 14, 17, and 21 after wire insertion. Point count analysis revealed progressive bone formation beginning as early as day 3 on the constant direct current-stimulated side, progressing steadily through day 21. Control tibia, however, began to show bone formation on day 5 with peaking at day 9 and subsequent bone resorption. The osteogenic response at the 20 microA cathode was statistically elevated above that seen at the control on days 11, 17, and 21.
Chromium released from implant alloys may be incorporated into organometallic complexes as Cr3+ [Cr(III)] or CR6+[Cr(VI)]. Since Cr(VI) is far more biologically active than Cr(III), there is considerable interest in identifying the valence state that predominates in corrosion products, either in vitro or in vivo. It is known that erythrocytes display a unidirectional uptake of Cr(VI) while effectively excluding Cr(III). Thus it was felt that a study of the chromium content of blood clot, in comparison to chromium concentrations in serum and urine, could shed light on the valency question. Fourteen patients who received conventional polymethylmethacrylate cemented cobalt-chromium alloy/ultra high molecular weight polyethylene total hip replacements as well as seven control patients who underwent orthopaedic procedures without implantation were studied. Blood and urine specimens were obtained preoperatively, post-operatively and, for total hip patients, at routine early follow up. Chromium content was determined by electrothermal atomic absorption spectroscopy. A significant post-operative rise in serum chromium content was observed for total hip replacement patients, as previously reported, but not for control patients. Unexpected day-to-day variations in clot chromium content, without significant increases, were also observed. Longer time studies are required to determine chromium valence states in corrosion products in this model.
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We compared the effects of pretreatment with saline, ipratropium bromide, and disodium cromoglycate (DSCG) on bronchoconstriction induced by methoxamine--an alpha-adrenoceptor agonist, in asthmatic subjects. All 12 patients bronchoconstricted in response to methoxamine after saline. The PD20 (the dose of methoxamine causing a 20% fall in forced expiratory volume in 1 s [FEV1]) ranged from 0.3-18 mumol. Ipratropium bromide (200 micrograms administered by aerosol) significantly inhibited (P less than 0.05) the response to methoxamine in all patients without producing significant changes in the mean baseline lung function. The mean PD20 for methoxamine after saline was 6.8 mumol and 95% confidence limits (CL) were 3.6, 12.7 mumol. The mean PD20 for methoxamine after ipratropium bromide was 35.4 (95% CL 28.8, 43.6) mumol. DSCG also produced significant (P less than 0.05) shifts to the right in the methoxamine dose response curves, but did not affect resting airway calibre as measured by the FEV1. The mean PD20 for methoxamine increased from 3.3 mumol (95% CL 1.1, 10.0 mumol) after saline to 25.1 mumol (95% CL 14.1, 44.6) after DSCG pretreatment. These findings suggest that alpha-adrenoceptors in the airways of asthmatic subjects may be located at sites other than smooth muscle--possibly on mast cells but more likely on nerve endings and/or parasympathetic ganglia.
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