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Biomedical subjects

J Davies

Publications and source records attributed to J Davies.

At least 271 records · Page 15Linked to original sources
PubMed1994

Differential effects of a graded selective suppression of insulin secretion with galanin on glucose production and removal in dogs.

The metabolic response to graded decreases in insulin concentration was evaluated by measuring the concentration, production, and metabolic clearance rate of glucose in response to the infusion of different galanin doses (1-12 micrograms/kg/h) in 18-h fasted dogs. Peripheral and portal concentrations of insulin and glucagon were measured simultaneously before, during, and after galanin infusions. No increases in portal or peripheral glucagon levels were seen at any dose of galanin infused but, in contrast, dose-dependent decreases of insulin levels occurred in both circulations. The metabolic clearance rate of glucose fell by approximately 25-30% at each dose of galanin infused; suggesting that the maximum effect was reached at the lowest dose. The rate of glucose production increased in a dose-dependent manner with integrated responses of 210 +/- 170, 620 +/- 80, 1,330 +/- 440, 1,920 +/- 310, 1,940 +/- 170, and 1,970 +/- 600 mg/kg at galanin doses of 1, 2, 4, 7, 10, and 12 micrograms/kg/h respectively; saturation of this response occurs at the 7 micrograms/kg/h dose of galanin. The changes in glucose production reflect most closely changes in the fractional decrease in insulin levels both in the portal and peripheral circulations. These changes appear to be mediated by insulin acting directly on the liver, because no alterations in the concentrations of the glucogenic substrates, lactate and glycerol, were seen.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

The effectiveness of components of University of Wisconsin solution in improving human pancreatic islet purification.

The purification of human pancreatic islets before transplantation relies on the density-dependent separation of islets from exocrine fragments after collagenase digestion of the donor pancreas. The results vary among pancreases despite increasing automation of the digestion and purification processes, reflecting variations in the overlapping densities of islets and contaminating exocrine tissue. Hypothermic storage of both the pancreas and the pancreatic digest alters cell volumes and tissue densities, thereby affecting islet purification. By biochemical analysis of the isopycnic distribution of islets and exocrine tissue fragments from 23 human pancreases on linear continuous density gradients, the effect of various solutions for cold storage of pancreatic digest was studied. The use of the University of Wisconsin cold storage solution, which resulted in a significant decrease in digest volume (P = 0.006) and increase in the densities of both exocrine tissue (P = 0.001) and islets (P = 0.005), produced a significant improvement in islet purity compared with tissue culture medium (P = 0.035), predominantly due to the inclusion of a colloid, which increased the difference in density between exocrine tissue and islets. The addition of large molecular weight cellular impermeants without alteration in the concentration of permeable anions produced no effect. The results of this study support the concept that the use of solutions that minimize cell swelling throughout the process of islet purification would result in significant improvements in density-dependent islet separation, and that such solutions should contain a colloid.

Adenosine↗
PubMed1994

Anti-tumor necrosis factor antibody treatment of recurrent bacteremia in a baboon model.

Timely intervention in recurrent episodes of sepsis poses a major problem in intensive care, because the diagnosis is often made after the onset of sepsis, delaying the initiation of treatment. There are only a few animal models that cover this situation. We have developed a baboon model of recurrent bacteremia (3 x 2 h intravenous infusion of 1 x 10(8) CFU Escherichia coli/kg), which leads to late organ failure. In this model (tested on 16 animals) we began anti-tumor necrosis factor antibody treatment (BAYX 1351; Bayer AG, 7.5 mg/kg or saline placebo) after the first bacteremic episode (+4 h), which significantly (p < .05) protected animals from death, none out of eight (100% survival), in the treatment group in contrast to four animals out of eight died (50% survival) in the placebo group. This effect was also reflected in improved organ function and in attenuated cytokine and plasminogen activator inhibitor release. From these studies we conclude that the delayed application of anti-tumor necrosis factor antibodies in recurrent bacteremia is a powerful tool for preventing septic death.

Animals↗
PubMed1994

An assessment of the contribution of visco-elastic factors in the aetiology of poor compliance in the human neuropathic bladder.

OBJECTIVE: To compare the mechanical properties of fullthickness bladder strips from poorly compliant neuropathic bladders with controls and to determine the overall contribution that mechanical factors might have in the aetiology of the poor compliance of medium-fill cystometry. PATIENTS AND METHODS: The visco-elastic properties of full-thickness bladder strips from 11 neuropathic patients (with poorly compliant bladders during medium-fill cystometry) were compared with strips from 11 control bladders. A strip (measuring 2 cm long and 0.5 cm wide) was mounted in an organ bath and stretched by 1 cm at a slow and at a fast rate. The stretches were repeated in modified Krebs solution containing zero calcium and 12 mM magnesium. The final experiment involved stretching the strip by 1 cm in < 1 s (instantaneous stretch). RESULTS: Only modest differences in the peak tensions of both tissues were uncovered by the slow and fast stretches (fast stretch: 14.6 +/- 5.5 in neuropaths vs 10.1 +/- 4.1 g in controls, P = NS; slow stretch: 9.6 +/- 3.5 in neuropaths vs 6.7 +/- 2.5 g in controls, P < 0.05). Stretches carried out in modified Krebs solution resulted in lower tensions. Fast, intermediate and slow components of viscous decay (derived from the rate of tension decay following the instantaneous stretch) were not significantly different in neuropaths compared to controls (P = NS). CONCLUSION: The differences in the mechanical properties between neuropathic and control bladder strips were small and could not alone have accounted for the large differences in bladder compliance that was observed between neuropathic and normal patients during medium-fill cystometry. This implied that neurogenic rather than mechanical factors were more important in the aetiology of the observed poor compliance in these patients.

Adolescent↗
PubMed1994

Hypogammaglobulinaemia associated with normal or increased IgM (the hyper IgM syndrome): a case series review.

The clinical and immunological aspects of 16 children with the syndrome of hypogammaglobulinaemia associated with normal or increased IgM (the hyper IgM syndrome) and their responses to treatment are reviewed. Increased concentrations of IgM, neutropenia, and recurrent infections could usually be controlled by antimicrobial and intravenous immunoglobulin treatment. Together with the bacterial infections characteristic of hypogammaglobulinaemia, these patients often developed opportunistic infections, including Pneumocystis carinii pneumonia, often presenting in the first year of life. The occurrence of sclerosing cholangitis, neurological complications, and neutropenia may be a result of an underlying cell mediated immune deficiency, autoimmunity, or infection. Despite a high incidence of opportunistic infections, immunological investigations did not show any abnormality of T cell function. These findings are discussed in the light of the recent demonstration that the lack of expression of a T lymphocyte activation antigen is the molecular basis of the X linked form of the disorder.

Agammaglobulinemia↗
PubMed1994

Preventing the scars of neonatal intensive care.

Two cases are reported of serious extravasation injuries due to parenteral nutrition in infants born at 24 and 28 weeks' gestation. Major scarring and the need for plastic surgery were prevented by using a technique of subcutaneous hyaluronidase and saline flushing.

Cicatrix↗
PubMed1994

Respiratory function after injection sclerotherapy of oesophageal varices.

Arterial oxygen tension (Pao2), carbon dioxide tension (PaCO2), and vital capacity were measured preoperatively and one day postoperatively in patients with chronic hepatic cirrhosis having elective oesophageal injection sclerotherapy under general anaesthesia. The results were compared with the same measurements made in patients with chronic cirrhosis anaesthetised and scheduled to have injection sclerotherapy under general anaesthesia but who, because of variceal obliteration, only had an oesophagogastroscopy. In the injected group PaO2 decreased by 9.3 (3.0) mm Hg (1.2 (0.4) kPa) (mean (SEM)) (p < 0.02) but in the controls did not change. The difference between the two groups was significant (p < 0.02). Vital capacity decreased by 0.39 (0.08) litres (BTPS) (p < 0.01) after injection sclerotherapy but in the controls did not change. Again the difference between the two groups was significant (p < 0.02). In the injected group there was a significant correlation between the change in PaO2 and the percentage change in vital capacity (r = 0.787, p < 0.01) but no such relation was seen in control subjects. These results suggest that oesophageal injection sclerotherapy is associated with a restrictive defect in respiratory function one day after the injection caused, possibly, by sclerosant embolising to the lung.

Esophageal and Gastric Varices↗
PubMed1994

Cytokine gene expression in Helicobacter pylori associated antral gastritis.

Infection of the gastric antrum by Helicobacter pylori is characterised by a cellular inflammatory infiltrate. Whether cytokines are involved in the pathogenesis of this gastritis has been investigated by studying the effect of eradicating H pylori on the expression of genes encoding the cytokines interleukin 8 (IL-8) and tumour necrosis factor alpha (TNF-alpha) in the antral mucosa. Gastric antral biopsy specimens were taken from nine patients with duodenal ulcers and cytokine transcripts were identified and quantified by northern blotting. After H pylori had been eradicated the chronic inflammatory infiltrate decreased in all the patients and the polymorphonuclear infiltrate virtually disappeared. Expression of genes also decreased. After eradication, the median TNF-alpha mRNA/rRNA fell to 48% (p = 0.02) and the median IL-8 mRNA/rRNA fell to 5% (p = 0.004) of initial values. These results support the role of increased synthesis of these cytokines in the pathogenesis of the gastritis.

Adult↗
PubMed1994

Leiomyosarcoma in leiomyomatosis of the small intestine.

Multiple leiomyomata of the small intestine are rare. We report one such case where a leiomyosarcoma had arisen from a leiomyoma in the small intestine 8 years after presentation. The possible origin of the leiomyomata is discussed and it is concluded that small intestinal leiomyomatosis should be regarded as a premalignant condition.

Adult↗
PubMed1994

The geographic variation of cancer incidence in Ontario.

OBJECTIVES: Our objectives were (1) to describe an analysis of the spatial pattern of cancer incidence in Ontario and (2) to discuss the quality of data in the Ontario Cancer Registry with respect to the accuracy of local cancer rates. METHODS: Cancer incidence rates were calculated for 22 cancer sites in 49 counties of Ontario during 1976 to 1986. Capture-recapture methods were used to estimate completeness of case registration, and completeness of residence information was also assessed. Spatial autocorrelation was used in measuring the geographic pattern of incidence rates. Comparisons were also made between sexes and with earlier data from 1966 to 1975. RESULTS: The quality of the geographic data in the registry appeared good, and corrections for incomplete or inaccurate registration had little impact. About one third of the sex-site combinations showed some evidence of spatial patterning in the cancer rate. Particularly strong regional variation was noted for cancers of the stomach, lung, uterus, and prostate. CONCLUSIONS: The analysis revealed a number of cancers with significant spatial patterning of risk. Further work is needed to relate the cancer data to other information on potential life-style and environmental factors.

Female↗
PubMed1994

Big-endothelin release in baboon bacteremia is partially TNF dependent.

Big-endothelin (big-ET) is one of the endothelium-derived vasoactive substances that plays an important role in regulating the vascular tone. Because the role of this agent in bacteremia remains unknown, we investigated whether bacteremia induces the release of big-ET in a subhuman primate model and whether tumor necrosis factor (TNF) is an important mediator of big-ET release. To study this, we infused 8 male baboons (17 to 19 kg body weight) intravenously for 2 hours with Escherichia coli (5 x 10(8) CFU/kg) and observed them for 72 hours. Plasma was obtained at various intervals and assayed for big-ET by using immunoassay. Four bacteremic animals given vehicle only showed a peak big-ET plasma concentration of 15.1 +/- 4.6 fmol/ml at 10 hours, as compared with a baseline concentration of 0.9 +/- 0.5 fmol/ml. Administration of anti-TNF monoclonal antibodies (CB6, 15 mg/kg) 2 hours before E. coli infusion in additional animals prevented the rise in plasma TNF levels (5.7 +/- 2.5 ng/ml versus nondetectable) and significantly (p < 0.01) attenuated the release of big-ET. Hemodynamic measurements revealed the typical pattern of sepsis, with generally more stable circulatory conditions in the anti-TNF-treated animals. Moreover, the mortality rate decreased from 100% to 0% with anti-TNF treatment. These studies, therefore, lead us to conclude that TNF, directly or indirectly through another mediator, plays an important role in the endothelin production/release during bacteremia and that neutralization of circulating TNF appears to be beneficial for improving the survival after bacteremia.

Animals↗
PubMed1994

Double-blind comparison of amlodipine and nifedipine retard in the treatment of mild to moderate hypertension.

The efficacy and safety profiles of amlodipine (5-10 mg once daily) and nifedipine retard (20-40 mg twice daily) were compared in 111 hypertensive patients (sitting DBP in 95-115 mmHg) during eight weeks of treatment in a randomised double-blind parallel group study. BP was measured 22-24 hours after the daily dose of amlodipine and 10-12 hours after a dose of nifedipine retard. Baseline sitting BPs of 175/105 mmHg and 168/104 mmHg were significantly reduced (P < 0.05) to 157/93 mmHg and 151/92 mmHg at the end of treatment in response to mean daily doses of amlodipine 7.3 mg and nifedipine retard 58.9 mg. There were no clinically significant changes in heart rate with either treatment. Three patients in the amlodipine group and five patients in the nifedipine retard group could not be considered in analysis. The total numbers of adverse events (considered related or possibly related to treatment) (42 vs. 36) as well as the numbers of patients experiencing such events (22 vs. 22) were similar in the amlodipine and nifedipine retard treated groups, respectively, but with a greater incidence of headaches in response to nifedipine retard and of oedema in response to amlodipine. Five patients in each treatment group discontinued therapy due to such events. Overall the results showed once daily amlodipine as equivalent to twice daily nifedipine retard in the management of mild to moderate hypertension.

Adult↗