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Biomedical subjects

J M Scott

Publications and source records attributed to J M Scott.

At least 145 records · Page 8Linked to original sources

The recovery of quadriceps function in patients treated by cast bracing.

The recovery of quadriceps function in patients treated by cast bracing has been assessed in fifty-four patients. The isometric strength and dynamic endurance of the quadriceps muscle were measured at an average of 2 years 8 months after the fracture. The literature is reviewed and a simple method of measurement is described. The results indicate that the recovery of quadriceps function after cast bracing in an unselected group of patients compares favourably with that after open and closed nailing techniques.

Adolescent↗

Changes in activities of calmodulin-mediated enzymes in rat brain during aging.

Components of the calmodulin system, (i.e. calmodulin levels and activities of the following calmodulin-dependent enzymes: (Ca2+ + Mg2+)-ATPase, adenylate and guanylate cyclases, cyclic AMP and cyclic GMP phosphodiesterases, and Ca2+-dependent protein kinase) were studied in brains from rats of three different ages: 3 weeks old, 3 months old and 1 year old. With the exception of adenylate cyclase activity, all components measured were found to significantly decrease with increasing age. Adenylate cyclase activity was significantly higher in brains from the 3-month-old rats than in those from 3-week-old rats. Brains from year-old rats had adenylate cyclase activity that was intermediate between the two younger ages and was significantly different from both groups. The study provides evidence for important changes in the activity of this fundamental cell regulatory system in the central nervous system during the aging process.

3',5'-Cyclic-AMP Phosphodiesterases↗

Evidence for a direct action of insulin to increase renal reabsorption of calcium and for an irreversible defect in renal ability to conserve calcium due to prolonged absence of insulin.

Male rats were injected with streptozotocin (STZ), 60 mg/kg, i.p., on 2 successive days. Six hours after the last STZ injection, some STZ-diabetic rats began receiving daily injections of insulin that were insufficient to control blood glucose. Another group of STZ-diabetic rats received insulin injections after 2 wk duration of untreated diabetes. Still other STZ-diabetic rats received no insulin treatment. Under sodium pentobarbital anesthesia, kidneys from each treatment group were isolated and perfused with an artificial "plasma" containing 45Ca. As urine was collected, urine-to-perfusate ultrafiltrate (U/P) ratios for 45Ca were determined. The results of the studies showed that: STZ diabetes reduced 45Ca reabsorption by the kidney; the increased urinary excretion of calcium was not due to an osmotic effect or to a direct nephrotoxic action of STZ; and insulin therapy instituted early, but insufficient to control blood glucose, reduced the diabetes-induced calcium loss via a direct action on the kidney, whereas insulin therapy instituted late failed to reverse renal loss of calcium.

Animals↗

A prospective study of three biochemical fetoplacental tests: serum human placental lactogen, pregnancy-specific beta 1-glycoprotein, and urinary estrogens, and their relationship to placental insufficiency.

The relationship between abnormal biochemical fetoplacental test results and placental insufficiency was studied in a group of high-risk obstetric patients. The urinary estrogen: creatinine ratio and serum human placental lactogen (hPL) and pregnancy-specific beta 1-glycoprotein (SP1) were measured in more than 1,600 patients. Fifty-one patients were found to have abnormal biochemical results, and the placentas from these patients were sent for the assessment of placental insufficiency by pathologic examination, which was expressed as a placental insufficiency score. Low hPL was found to be the best biochemical indicator of placental insufficiency, and 84% of the patients with a low level of hPL had an elevated placental insufficiency score. The combination of low levels of hPL and urinary estrogen was found to be the best indicator of placental insufficiency associated with retarded intrauterine growth, and 83% of the patients who had low results in both of these tests had elevated placental insufficiency scores and were delivered of light-for-dates infants. The measurement of SP1 was found to be of limited value in detecting retarded growth, but patients with low SP1 values showed an increased incidence of fetal hypoxia. Attention is drawn to the fact that the discrepancies that occur in the various estimations are not necessarily due to artifact, and specific pathologic processes which could account for some of the anomalous results are identified.

Apgar Score↗

The role of methionine in the intracellular accumulation and function of folates.

It is suggested that mammalian cells have evolved to respond to methionine deficiency since in such circumstances vital methylation reactions are put at risk, due to decreased levels of S-adenosyl-methionine. Enzymatic changes occurring as a result of decreased methionine, S-adenosylmethionine and S-adenosylhomocysteine, optimize the remethylation of homocysteine to methionine by decreasing homocysteine catabolism and channelling cellular folates into 5-methyltetrahydropteroylglutamate (5-CH3-H4 PteGlu). The latter, in addition to optimising the remethylation cycle, directs the folate cofactors away from purine and pyrimidine biosynthesis and decreases the rate of proliferation of rapidly dividing cells thus reducing competition for methionine incorporation into proteins. Decreased cellular homocysteine, as a result of decreased methionine, would also restrict cell division by decreased conversion of plasma 5-CH3-H4PteGlu into intracellular polyglutamates. Cobalamin deficiency, either nutritional or due to exposure to the Co (I) cobalamin inactivating agent nitrous oxide, prevents the demethylation of 5-CH3-H4PteGlu, which even in the presence of adequate amounts of homocysteine and methionine prevents rapidly proliferating cells from converting enough of the plasma 5-CH3-H4 PteGlu into folylpolyglutamate forms to permit normal DNA biosynthesis and cell replication. This, together with the trapping of the cellular folate cofactors in the 5-CH3-H4PteGlu form, results in megaloblastic changes occurring in tissues such as the marrow. The vital role of the methylation reactions was demonstrated by exposing monkeys to nitrous oxide which inactivated their methionine synthetase. The resultant ataxia and severe demyelination was prevented and diminished by methionine supplementation. When methionine synthetase was similarly inactivated in mice it was shown that while 5-CH3-H4PteGlu enters mammalian cells, it is not converted into a polyglutamyl form and subsequently leaves the cell unmetabolised. In similar experiments in rats methionine was found to have only a small effect in restoring folylpolyglutamate biosynthesis, contrary to previous reports using nutritionally cobalamin deficient animals. It was found that a decrease in the deoxythymidine salvage pathway by methionine, under the experimental conditions used, has led others to the mistaken conclusion that methionine has an 'anti-folate' effect in bone marrow, i.e. that it decreases folate availability for thymidylate synthetase.

Animals↗

Increased folate catabolism in mice with ascitic tumours.

Folate deficiency is reported in association with certain malignant tumours, and it has been suggested that this arises from increased folate turnover and catabolism in such circumstances. Using an experimental animal model to determine the rate of catabolism of [3H]pteroylglutamate (folic acid) by the quantitative estimation of the two urinary catabolites p-[3H]aminobenzoylglutamate and [3H]acetamidobenzoylglutamate, we have measured the rate of folate catabolism in mice with ascitic tumours. There was a significant increase in the rate of catabolism in the mice with tumours compared with controls over a 10 day period. This was associated with the accumulation of ascitic fluid and an increase in the number of tumour cells in the treated animals. The increase in catabolism appeared to be due to increased cell turnover of the tumour rather than an increase in cell mass, as the increase in mass of the tumour was negligible.

Animals↗

Calmodulin levels and divalent cation pump activities in kidneys of streptozotocin-diabetic rats.

Levels of calmodulin and activities of calcium and magnesium ATPases were determined in renal tissues of age-matched male rats after increasing durations of the following conditions: untreated streptozotocin (STZ) induced diabetes; STZ-diabetic rats which received daily insulin (NPH) treatment beginning 24 hours after STZ administration; and STZ-diabetic rats which began receiving NPH after having endured untreated diabetes for 1, 2, and 3 weeks. Results were compared with those of age-matched control animals. Calmodulin levels were the same in renal tissues from all groups of rats as were magnesium-ATPase activities. Calcium-ATPase activities were significantly higher than control activities after 2 weeks of untreated STZ-diabetes and in tissues from all rats that received insulin treatment which was instituted after 1, 2 and 3 weeks of STZ-diabetes. Calcium ATPase activities of tissues from rats which received insulin treatment 24 hrs after STZ injections were no different from control values. The data indicate that prolonged deficiency of insulin results in insufficient passive transport of calcium from urine into tubular cells. Thus, the increased activity of calcium-ATPase on the contraluminal membrane of kidney cells represents a futile attempt to conserve calcium.

Adenosine Triphosphatases↗

Sterile microenvironment in prevention of wound infection.

A prospective controlled trial was carried out to assess the effect of using a wound isolator on reducing postoperative infection. A total of 291 patients undergoing hip pinning for fractures of the neck of femur entered the trial and were allocated at random to have their wound contained in a wound isolator (study group) or dressed with a standard gamma-irradiated adhesive dressing (control group). The bacteriological flora of the patient was monitored before, during, and after operation and that of the ward before and after. No significant difference was found in the flora of the wards in which the patients were nursed. On several occasions the source of the infective organism was traced to the ward but never to the theatre. The isolator prevented direct contamination and airborne cross-infection of the wound and appreciably reduced the rate of infection.

Air Microbiology↗

Anaplasmosis and babesiosis in El Salvador.

A serological survey was carried out in the Central American state of El Salvador to determine the distribution and prevalence of Anaplasma marginale, Babesia bigemina and Babesia bovis. the results suggest that the parasites are widely distributed throughout the country and prevalence rates of 78.5% for A. marginale, 70.5% for B. bigemina and 73.5% for B. bovis were obtained. Tick counts suggest that boophilus microplus is the main blood parasite vector. Epidemiological studies showed that initial infection with the 3 blood parasites occurs in most animals during the first 7 months of life. Notwithstanding these facts which indicate an area of enzootic stability outbreaks of clinical disease were frequently reported. Twenty-two such outbreaks were investigated and management factors predisposing to outbreaks of clinical disease are discussed.

Anaplasmosis↗

Kernicterus at low levels of serum bilirubin: the impact of bilirubin albumin-binding capacity. A 10-year retrospective survey.

A retrospective survey of neonatal post-mortems over a 10-year period was made to establish the incidence of kernicterus and the associated laboratory abnormalities. Cases with evidence of kernicterus without hyperbilirubinaemia were found to have significantly lower reserve albumin-binding capacity (RABC) than the control group. The results suggest that RABC estimation is a necessary adjunct in the assessment of the jaundiced, low birthweight neonate.

Bilirubin↗

Pathogenesis of subacute combined degeneration: a result of methyl group deficiency.

Four pairs of monkeys were maintained in an atmosphere of nitrous oxide under conditions which had previously been shown to produce subacute combined degeneration (SCD) of the spinal cord. The diet of one of each pair was supplemented with methionine. In every case the monkey with the unsupplemented diet became ataxic at around 10 weeks and the disorder progressed over a period of 2-3 weeks until the animal was moribund. During this period there was no detectable clinical change in the monkeys receiving methionine supplementation. Microscopical examination of the spinal cord and peripheral nerves of the unsupplemented monkeys showed the classical changes of SCD. The histological changes correlated with the clinical observations. Sections form the methionine-supplemented monkeys showed no change or only slight changes. These results suggest that, in these animals, inability to resynthesise methionine from homocysteine leads to SCD. It seems probable that the primary lesion producing SCD in human beings with pernicious anaemia is also inability to maintain methionine biosynthesis.

Animals↗

The methyl folate trap. A physiological response in man to prevent methyl group deficiency in kwashiorkor (methionine deficiency) and an explanation for folic-acid induced exacerbation of subacute combined degeneration in pernicious anaemia.

It is suggested that in man the methyl folate trap is a normal physiological response to impending methyl group deficiency resulting from a very low supply of methionine. This decreases cellular S-adenosyl-methionine (SAM), which puts at risk important methylation reactions, including those required to maintain myelin. In order to protect these methylation reactions, the cell has evolved two mechanisms to maintain supplies of methionine and SAM as a first priority. (a) Decreased SAM causes the folate co-factors to be directed through the cycle involving 5-methyl-tetrahydrofolate (5-methyl-THF) and methionine synthetase and away from the cycles that produce purines and pyrimidines for DNA synthesis. This enhances the remethylation of homocysteine to methionine and SAM. In addition, by restricting DNA biosynthesis and with it cell, division, competition for methionine for protein synthesis is reduced. Thus, whatever methionine is available is conserved for the vital methylation reactions in the nerves, brain, and elsewhere. (b) 5-methyl-THF, the form in which almost all folate is transported in human plasma, must react with intracellular homocysteine before it can be retained by the cell as a polyglutamate. Since homocysteine is derived entirely from methionine, methionine deficiency will cause intracellular folate deficiency, and the rate of mitosis of rapidly dividing cells will be reduced. although these two processes have evolved as a response to methionine deficiency, they also occur in B12 deficiency, which the cell mistakenly interprets as lack of methionine. the resulting response is inappropriate and gives rise to a potentially lethal anaemia. In these circumstances the methylation reactions are also partly protected by the reduced rate of cell division. This explains why administration of folic acid, which induces cell division and use of methionine in protein synthesis, impairs methylation of myelin and precipitates or exacerbates subacute combined degeneration (SCD). During folate deficiency methionine biosynthesis is also diminished. As in methionine deficiency, the body responds to decreasing availability of SAM by diverting folate away from DNA biosynthesis towards the remethylation of homocysteine to methionine and SAM. The selective use pf available folate to conserve methionine, together with the ability of nerve tissue to concentrate folate form the plasma, explains the absence of SCD in folate deficiency.

Acute Disease↗

Evidence that the decreased liver folate status following vitamin B-12 inactivation in the mouse is due to increased loss rather than impaired uptake.

Using N2O to inactivated B-12, mouse liver polyglutamate distribution has been examined at short time intervals after injection of [3H]pteroyglutamate. An increased monoglutamate pool is found initially which is lost by 24 h. This finding strongly supports the suggestion that the reduction in total liver folate in vitamin B12 deficiency is due to increased loss rather than decreased uptake.

Animals↗

Human bone marrow biochemical function and megaloblastic hematopoiesis after nitrous oxide anesthesia.

Prolonged exposure to nitrous oxide (N2O) inhibits bone marrow function. The duration of exposure to nitrous oxide necessary to induce these changes and their permanence is unknown. The possible prophylactic effect of prior treatment with folinic acid has not been examined previously. Bone marrow function in patients receiving nitrous oxide was assessed by the deoxyuridine (dU) suppression test. Morphologic changes in the bone marrow were also studied. One group was exposed for under 6 h, the next for between 12 and 24 h and a control group who received nonitrous oxide. The control group and the short exposure group showed no abnormality of bone marrow function. The long exposure group had abnormal dU supression tests and a megaloblastic hematopoiesis. The changes observed in this group resolved 12 h after discontinuance of the anesthetic. The changes observed could be prevented by the preoperative administration of folinic acid. The absence of either morphologic or dU suppression test abnormalities following N2O anesthesia for periods of less than 6 h confirms the safety of this anesthetic for the majority of operations for which it is used. It has been confirmed that prolonged exposure to the gas causes impaired marrow function which is of a temporary nature and may be prevented by the prior administration of folinic acid.

Anemia, Aplastic↗