Search PubMed⌕ Search

Biomedical subjects

J Mann

Publications and source records attributed to J Mann.

At least 289 records · Page 16Linked to original sources

[Conversion enzyme inhibitors in the antihypertensive treatment of patients with renal insufficiency].

Changes in serum creatinine concentration and proteinuria over a period of 12 months were analysed retrospectively in hypertensives in renal failure, 39 treated with conversion-enzyme inhibitors and 41 treated with other antihypertensives. The occasionally recorded blood pressures were comparable in the two groups. Median serum creatinine levels in the patients treated with conversion-enzyme inhibitors rose from 2.33 mg/100 ml (range 1.5-5.5) after one month acutely by 0.4 mg/100 ml and then remained essentially constant. In nine patients the level was higher by greater than or equal to 0.5 mg/100 ml after 12 months than at the beginning of treatment. Proteinuria did not show any identifiable changes. On the other hand, in those patients treated with other antihypertensives, median serum creatinine concentration rose gradually over 12 months from 2.4 mg/100 ml (range 1.5-6.0) to 3.45 mg/100 ml (1.5-12.9). In 18 patients the serum creatinine level rose by less than or equal to 0.5 mg/100 ml. Five patients developed side effects to conversion-enzyme inhibitors, but none required discontinuation of treatment. It is concluded that the use of conversion-enzyme inhibitors in patients with renal failure is effective and largely safe. It apparently causes less of a rise in serum creatinine than other antihypertensives.

Adrenergic beta-Antagonists↗

Effect of dietary cholesterol on plasma cholesterol concentration in subjects following reduced fat, high fibre diet.

One hundred and sixty eight subjects participated in a randomised crossover study to determine whether halving or doubling the present dietary cholesterol intake from eggs had any influence on blood cholesterol concentration in people following current dietary recommendations. During the first eight weeks all participants were advised to follow a reduced fat diet (26% total energy for hyperlipidaemic patients, 35% total energy for normolipidaemic volunteers) with an increased ratio of polyunsaturated to saturated fatty acids. This background diet was continued throughout the 16 week experimental period, during which participants ate either two or seven eggs a week. A small but significant increase in total cholesterol was seen after four weeks in the group eating seven eggs a week compared with that in the group eating two eggs a week, but this was no longer apparent after eight weeks. Previous studies suggesting that dietary cholesterol has a greater effect on the serum cholesterol concentration either have been carried out against a background of a higher fat intake or have contrasted extreme cholesterol intakes. A further reduction in dietary cholesterol seems to be unnecessary in those people who have already reduced their intake of saturated fat and increased the ratio of polyunsaturated to saturated fatty acids and fibre rich carbohydrate.

Cholesterol↗

Influence of hypertension on serum concentration of type IV collagen antigens in streptozotocin-diabetic and non-diabetic rats.

The serum concentration of 7S collagen was measured radioimmunologically as a marker of basement membrane type IV collagen synthesis in diabetic and nondiabetic rats with Goldblatt hypertension. In non-diabetic rats the 7S collagen level was significantly raised after induction of hypertension (51%; p less than 0.001), and showed a positive correlation with relative heart weight as an integral parameter of hypertension (r = 0.63; p less than 0.01). In diabetic rats, which displayed a 7S collagen concentration roughly 2.5 times as high as the metabolically normal animals, the 7S collagen level was 27% higher in the hypertensive animals (p less than 0.01). There was no correlation with blood pressure or heart weight, but only a positive correlation with blood glucose (r = 0.51; p less than 0.05). The results indicate that haemodynamic alterations may alter basement membrane collagen metabolism. However, type IV collagen metabolism in diabetes is influenced to a greater extent by metabolic than by haemodynamic factors.

Animals↗

Synergistic effects of diabetes mellitus and renovascular hypertension on the rat heart--stereological investigations on papillary muscles.

The effects of combined renovascular hypertension and diabetes mellitus on the rat heart were investigated in order to detect possible synergistic effects of the two conditions. Hypertensive diabetic and hypertensive nondiabetic young male Wistar rats were compared with diabetic and non-diabetic controls. Since the normal body weight increase of the diabetic animals was markedly suppressed a weight-matched nondiabetic control group was introduced in addition. Hypertension was established for eight weeks by a surgical stenosis of the left renal artery, diabetes mellitus was maintained for four weeks after a single intraperitoneal injection of 75 mg/kg streptozotocin. Light and electron microscopic stereological parameters were obtained for the left ventricular papillary muscles. The whole hearts were also investigated histologically. Qualitative morphology failed to substantiate synergistic effects in the hypertensive diabetic rats. Vascular abnormalities were not observed. The stereological parameters, however, revealed microstructural reactions which were observed exclusively in the hypertensive diabetic group: the volume ratio of mitochondria-to-myofibrils was decreased, the surface-to-volume ratio of mitochondria was increased (reduction of mitochondrial size) and the mean cross sectional area of capillaries was decreased. Similar quantitative mitochondrial changes have been frequently described in long-standing hypertension, but in the present investigation, they were not found in the nondiabetic hypertensive group. It is therefore concluded that diabetes mellitus potentiates the effects of chronic pressure overload on myocardial cells. However, the myocardial fibrosis which has been found by other groups at later stages of hypertension and/or diabetes mellitus was not detected in the present study. The reduced mean cross sectional area of capillaries in hypertensive-diabetic rats may be correlated with early molecular changes of the myocardial interstitium or with early abnormalities of small arteries. Thus our stereological results support the hypothesis that a non-coronary hypertensive diabetic cardiomyopathy occurs in mammalian hearts.

Animals↗

A matched pairs comparison of cycle ergometry and treadmill exercise testing in the evaluation of coronary heart disease.

In 105 patient pairs, matched for sex, aged within a ten-year range and with closely similar coronary disease, the sensitivity and specificity of treadmill testing using the Bruce Protocol was compared to cycle ergometry using the 100 kpm/min (16 W/min) increment protocol, and found to be similar. The parameters of use were ST segment depression (sensitivity of 52% for treadmill and 61% for cycle), test angina (65% and 61%), significant work impairment (66% and 68%) and impaired blood pressure response (31% and 20%). The sensitivity was increased (treadmill to 84%, cycle to 89%) if the four parameters were grouped, and abnormality in any one of them was regarded as a positive test. The equivalent severity of coronary disease resulted in more severe work impairment on the cycle than on the treadmill. The mean work level of the treadmill group was 80%, and of the cycle group, 61% of their respective, nomographically predicted, normal values. The difference was similar for the zero, single and multivessel disease groups. This difference should be recognised when comparing the two techniques.

Angina Pectoris↗

Fluorosis and caries prevalence in a community drinking above-optimal fluoridated water.

Fluorosis levels and caries prevalence were evaluated in 182 adolescents aged 15-16 yr residing from birth in an area with 5 ppm fluoride in the drinking water. The mean number of surfaces affected by caries in the total study population was 5.46 DMFS. The teeth most susceptible to caries were the first molars. The prevalence of fluorosis was 100% with 53 subjects demonstrating mild fluorosis (according to Dean's index), 83 demonstrating moderate fluorosis, and severe fluorosis diagnosed in 46 subjects. A statistically significant positive association was found between caries prevalence and fluorosis; the more caries experienced, the more severe the fluorosis level. Boys experienced significantly higher fluorosis levels than girls. Further research will investigate the possible variables which may explain this difference in fluorosis by sex.

Adolescent↗

Clinical evaluation of patients with hypertension and exercise-induced renal dysfunction.

An exercise-mediated renal omicron-iodohippurate transport abnormality was recently identified in patients with hypertension. The disturbance was not observed in normotensive controls. To learn more about this transient functional disturbance of the kidney, we obtained gamma camera hippurate renograms in 45 patients with hypertension. The final diagnoses indicated that 27 patients had essential hypertension, 15 had renal parenchymal or renovascular hypertension, 2 had malignant hypertension, and 1 had hypertension of pregnancy. We documented age, height, weight, global and unilateral renal function, blood pressure status, and antihypertensive medication used at time of scintigraphy. We also noted the serum catecholamine, sodium, and potassium levels. All patients were scintigraphed at rest and during exercise. The scintigraphic examination documented exercise-induced renal dysfunction in 28 (62%) patients (abnormal exercise renogram), while 17 (38%) had renograms not noticeably influenced by the exercise protocol (normal exercise renogram). When the results of scintigraphy were compared with the clinical data, a weak correlation was found between patient overweight and an abnormal response to exercise. There was no significant difference between groups with normal and abnormal exercise renograms with respect to the other parameters assessed. Exercise renography was not useful for differentiating renal and essential hypertension. Renography appears to demonstrate an exercise-mediated, transient, renal perfusion disturbance in certain patients with hypertension. The examination appears to assess a new parameter in hypertensive disease. Thus, the gamma camera renogram should be reevaluated in the patient with hypertension.

Adolescent↗

Control strategies.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗

[Bronchial cancers with morphologic and immunohistochemically diversely differentiated metastases].

We report on two unusual adenocarcinomas of the lung. The primary of the first case could be classified as a "solid adenocarcinoma" of the lung, whereas the metastases were undifferentiated and contained syncytiotrophoblast-like tumor cells. The primary of the second case consisted of diversely differentiated cells including adenocarcinomatous and syncytiotrophoblast-like cells, while the metastases were either adenocarcinomatous or syncytiotrophoblastic-like differentiated. Immunohistochemically, both primaries showed abundant CEA and little beta-HCG, while the metastases exhibited little CEA and abundant beta-HCG. The implications of such differences between the primaries and their metastases for tumor-cell heterogeneity and tumor classification are discussed.

Adenocarcinoma↗

Podophyllotoxin analogues: synthesis and computer modelling investigation of structure-activity relationships.

The conformations of four 2-substituted-4-deoxy-analogues of podophyllotoxin have been studied using data obtained from X-ray structure determinations and molecular modelling studies. In these, root mean square differences between these structures and those of the cytotoxic agents 6'-bromopodophyllotoxin and colchicine were determined. Attempts have been made to correlate structure with the available biological activity data.

Antineoplastic Agents↗