Consent for epidural anaesthesia.
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Anesthesia, Epidural↗
Biomedical subjects
J Price
Publications and source records attributed to J Price.
Chronic lead nephropathy in Queensland: alternative methods of diagnosis.
Indices of past lead absorption were measured and compared in patients with chronic renal failure from many causes, including some with chronic lead nephropathy. X-ray fluorescence (XRF) yielded finger bone lead concentrations by a new in vivo method. These correlated significantly with excess urinary lead following calcium di-sodium EDTA (ethylenediamine tetra-acetate) and erythrocyte lead concentration. Discriminant function analysis demonstrated that the patients in the study could be separated into two groups without any reference to the EDTA lead excretion test using the following variables, all of which contributed significantly to the discrimination. In order of importance, these were: a childhood history of acute lead poisoning, a history of gout, a family history of gout and detectable XRF finger bone lead. Although the XRF finger bone lead measurement is convenient and non-invasive, its lack of sensitivity (48%) limits its usefulness as a screening test for chronic lead nephropathy.
Aged↗
The Nottingham experiential day in psychotherapy: a new approach to teaching psychotherapy to medical students.
A prime objective in teaching psychotherapy to medical students is to convey a practical understanding of what happens and a sense of the pleasure and responsibility of working with another person to improve the quality of their relationships. In Nottingham an experiential day was developed during the psychiatry clerkship; the teaching is by doing rather than describing, while spontaneity and individual expression are encouraged; the experience is valued by most and forgotten by none; it would be improved by a second experiential day or by a weekly forum for discussion of the personal and patient-care issues raised.
Education, Medical, Undergraduate↗
Characterization of human pulmonary endocrine cells maintained in vitro.
Endocrine cells located in the epithelium of human fetal airways contain the amine, 5-hydroxytryptamine (5HT), and the peptide, bombesin (BOM), but difficulties in studying these cells experimentally have slowed progress in understanding their functional roles. This investigation describes an in vitro method to maintain pulmonary neuroendocrine cells (PNEC) in organ culture. Bronchial trees from human fetal lungs were dissected free of adherent blood vessels and lung tissue. Explants of the airways were placed in culture dishes containing defined tissue culture medium for five days. Using indirect immunofluorescence, 5HT- and BOM-like immunoreactive cells were observed both in nonincubated airways and in explants maintained for five days in organ culture. The number of 5HT-immunoreactive cells/0.1 mm2 of airway epithelium was not significantly different in the two groups, although there was a significant reduction in 5HT content measured by HPLC after the five-day culture period. The diameter of dense core vesicles and the number of dense core vesicles/micron2 of endocrine cell cytoplasm in cultures were not significantly different from non-incubated controls. Treatment of the explants with the 5HT-synthesis inhibitor p-chlorophenylalanine resulted in a significant reduction both in the number of 5HT-containing cells/0.1 mm2 of airway epithelium and in the 5HT content. These results demonstrate that both 5HT and BOM content in endocrine cells of explants from human fetal airways can be well maintained in organ culture for at least 5 days and that they are responsive to pharmacologic inhibition of 5HT synthesis.
Bombesin↗
Interstitial retinol-binding protein (IRBP) in subretinal fluid.
Antibodies against bovine interstitial retinol-binding protein (b-IRBP) were used to detect human IRBP (h-IRBP) on immunoblots of eight samples of subretinal fluid (SRF) from patients with retinal detachments of between 2 days' and more than 2 years' duration. Using this sensitive technique, it was found that seven of the samples contained h-IRBP in concentrations estimated to range from below 5% up to 19% of normal human IPM. One of these samples displayed two immunoreactive bands of roughly equal intensity, one at a molecular weight of 135,000 (h-IRBP), the other at 115,000. The latter may have been generated by proteolytic cleavage. No h-IRBP could be detected in an eighth sample from a patient with retrolental fibroplasia. It is concluded that the reduced concentration of h-IRBP in SRF may be due to a number of factors that include dilution, proteolytic degradation, and metabolic inactivation of photoreceptors at the detachment site.
Adolescent↗
The rapid decline in erythrocyte transketolase on cessation of high-dose thiamine administration in Korsakoff patients.
This paper reports two studies carried out on patients with the Wernicke-Korsakoff (W-K) syndrome and control subjects. All had been mental hospital inpatients for at least 12 months. In the first study the changes in the thiamine-dependent enzyme erythrocyte transketolase (TK) which followed the administration of oral thiamine are described. Essentially the two patient samples responded similarly. In the second study patients who had been maintained on high-dose thiamine for several months stopped this treatment abruptly. The subsequent decline in TK is described. In W-K patients this decline was rapid and virtually complete at four weeks. In control subjects the decline was much more gradual. These findings offer support to other evidence suggesting a difference between TK in W-K and control subjects.
Alcohol Amnestic Disorder↗
Selective abnormality of the cone B-wave in a patient with retinal degeneration.
A 44-year-old woman with midperipheral pigmentary changes that resemble retinitis pigmentosa (RP) is described; unlike typical patients with RP, her photopic b-wave was markedly attenuated as compared with her photopic a-wave. Otherwise, her electroretinogram (ERG) was typical of patients with early stages of photoreceptor degeneration. Scotopic and photopic a-wave amplitudes were reduced about 50%; her scotopic b/a appeared normal.
Adaptation, Physiological↗
A new bioassay for assessment of copper availability and its application in a study of the effect of molybdenum on the distribution of available Cu in ruminant digesta.
Investigations were carried out on the feasibility of using an oral repletion technique in the rat to assess the bioavailability of copper in experimental sources providing no more than 250 micrograms Cu from any one source. Preliminary studies on the response in plasma Cu of partially Cu-depleted rats given repletion doses of 20-50 micrograms Cu as CuSO4/d on four consecutive days indicated that this index of Cu status was insufficiently sensitive to Cu dose. In contrast, the activity of cytochrome c oxidase (EC I.9.3.I) in the duodenal mucosa of partially Cu-depleted rats showed a measurable and uniform response to 10 micrograms Cu as CuSO4/d given on three consecutive days. Furthermore, when the rats were given 0, 2.5, 5.0 or 10.0 micrograms Cu/d, the increase in cytochrome c oxidase activity above that of the unsupplemented control group was linearly related to Cu dose. The mean response in cytochrome c oxidase activity in groups of eight rats was therefore used to assess the availability of Cu from experimental sources relative to that of Cu as CuSO4, only 240 micrograms Cu being required from each experimental material. The assay was used to study the effect of the Cu-antagonist molybdenum on the distribution of available Cu in digesta from sheep given dried grass either untreated (1.6 mg Mo/kg dry matter (DM)) or treated with ammonium molybdate (11.6 mg Mo/kg DM). The relative availability of Cu in untreated dried grass (75%) was substantially higher than in rumen (12%), duodenal (43%) or ileal (28%) digesta. In all cases, addition of Mo to the diet resulted in a substantial reduction in Cu availability. The effects of Mo on availability of Cu are discussed with special reference to the possible involvement of thiomolybdates in the Cu-Mo antagonism.
Animal Feed↗
A case of cerebral systemic lupus erythematosus treated with methylprednisolone pulse therapy.
A case of cerebral systemic lupus erythematosus is presented. This was characterised by a combination of organic, persecutory and atypical hypomanic features. After a very stormy course on oral steroids, treatment with intravenous methylprednisolone pulse therapy was begun. Subsequently the patient experienced a prolonged remission. This outcome supports the value of such therapy in cerebral systemic lupus erythematosus.
Adult↗
Some observations on the Wernicke Korsakoff syndrome in Australia.
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Adult↗
Pituitary ACTH dependent Cushing's syndrome due to ectopic production of a bombesin-like peptide by a medullary carcinoma of the thyroid.
A 41-year-old man presented with Cushing's syndrome and the biochemical features of ectopic ACTH production. Investigation revealed mediastinal metastases from a medullary carcinoma of the thyroid. The peripheral plasma contained grossly elevated levels of bombesin-like immunoreactivity (irBombesin) as well as calcitonin; blood sampling via a venous catheter confirmed a gradient of irBombesin, but not of ACTH, in the mediastinal vein draining the tumour. On extraction the tumour contained a bombesin-like peptide, but not vasopressin or corticotrophin releasing factor and only very low levels of ACTH; immunohistochemical studies showed positive immunostaining for bombesin and calcitonin but none for ACTH or CRF. No ACTH was released from dispersed tumour cells in vitro. However an extract of the tumour stimulated ACTH release in vitro from perifused dispersed rat anterior pituitary cells. This is the first reported case of Cushing's syndrome due to ectopic production of a bombesin-like peptide, causing excessive pituitary ACTH secretion.
Adrenocorticotropic Hormone↗
Cerebellar calcification and lead.
In elderly subjects who were brought up in a known high lead environment in Queensland, Australia, childhood residence and occupational status provide circumstantial evidence of a relationship between excessive lead intake and cerebellar calcification as seen on computed tomography. This supports experimental and neuropathological studies demonstrating an association between exposure to lead and perivascular cerebellar calcification.
Basal Ganglia Diseases↗
Bombesin-like peptides in human endocrine tumors: quantitation, biochemical characterization, and secretion.
Bombesin-like immunoreactivity (BLI) in 20 human endocrine tumors was studied using an antiserum directed toward the C-terminal region of bombesin. Additionally, plasma BLI was assayed in normal subjects and patients with known BLI-containing tumors. In 7 tumors (medullary carcinoma of the thyroid, n = 2; carcinoid of the lung, n = 3; hepatic carcinoid, n = 1; pheochromocytoma, n = 1), the BLI content ranged from 6-2000 pg/mg wet wt of tissue. Sephadex G-50 gel chromatography of tumor extracts under acid-dissociating conditions revealed 2 peaks of BLI: 1 coeluting with porcine gastrin-releasing peptide (GRP) and 1 with bombesin. Reverse phase ODS silica HPLC analysis of the G-50 peaks using a methanol-trifluoroacetic acid gradient showed that human tumor BLI more closely resembled porcine GRP and its C-terminal fragment GRP-(14-27) than bombesin itself. Partial tryptic digestion of the tumor GRP-like peptide generated a product which, on HPLC, was similar to GRP-(14-27). Elevated plasma BLI was detected in the peripheral circulation of three subjects and in the vessels draining the tumor metastases of one of these patients. BLI was undetectable in normal subjects. These results indicate 1) that BLI is present in and may be secreted by various human endocrine tumors, and 2) that human tumor BLI closely resembles porcine GRP and its C-terminal fragment GRP-(14-27).
Animals↗
The measurement and characterisation by high pressure liquid chromatography of immunoreactive alpha-melanocyte stimulating hormone in human plasma.
Immunoreactive alpha-MSH was found in human plasma and in normal subjects ranged from less than 10-45 pg/ml. Plasma alpha-MSH concentrations were within the normal range in 13 out of 15 subjects during the last trimester of normal pregnancy and only just outside the normal range in the remaining two. Elevated plasma alpha-MSH concentrations were found in 6 of the 11 patients with Nelson's syndrome and in 10 of the 11 patients with pituitary dependent Cushing's disease. Separation on high pressure liquid chromatography (HPLC) revealed two major peaks of immunoreactivity. These peaks, which were identified as des-acetyl alpha-MSH and alpha-MSH were similar in size in normal subjects and Cushing's disease. In Nelson's syndrome, on the other hand, there was a greater proportion of des-acetyl alpha-MSH and it is possible that this peptide is secreted from tumour cells of anterior lobe origin. Although there was no correlation between the circulating alpha-MSH and the degree of pigmentation the high concentrations of plasma immunoreactive alpha-MSH in Cushing's disease and the HPLC profiles in Nelson's syndrome could provide useful information as to the localization of the defects in these particular disorders.
Adolescent↗
An immunohistochemical and quantitative examination of dorsal root ganglion neuronal subpopulations.
Sensory neurons of adult rat lumbar dorsal root ganglia were labeled in cryostat sections with antisera against tyrosine hydroxylase (TH), substance P (SP), and somatostatin (SOM), and with a monoclonal antibody (RT97) that labels the 145- and 200-kilodalton (kd) subunits of neurofilaments. These neurons were also histochemically stained for fluoride-resistant acid phosphatase (FRAP), and the size and distribution of each population were determined. In addition, the double-label immunoperoxidase technique of Sternberger and Joseph (Sternberger, L.A., and S.A. Joseph (1979) J. Histochem. Cytochem. 27: 1424-1429) was employed to determine whether these antibodies labeled distinct or overlapping populations of neurons. The results indicate that the dopaminergic (TH+) cells constitute a separate population from the SP+ and SOM+ neurons and that the size distributions of the SP+, SOM+, TH+, and FRAP+ cells are all different despite the fact that all of these subpopulations are part of the "small dark" subpopulation as indicated by their size and by the fact that they are RT97-. RT97 is a putative marker for the "large light" population (Anderton, B., H.B. Coakham, J. A. Garson, A.A. Harper, and S.N. Lawson (1982) J. Physiol. (Lond.) 334: 97-98P). Furthermore, the distribution data indicate that all of the "small dark" cell subpopulations are not evenly distributed within the ganglion, and the staining with RT97 and with another antibody which recognizes the 68-kd neurofilament subunit indicates heterogeneity among the "large light" population. These results are discussed in terms of the significance of the "small dark"-"large light" classification.
Acid Phosphatase↗
Wavelength discrimination deteriorates with illumination in blue cone monochromats.
Two types of incomplete congenital achromats were studied: one type (blue cone monochromats) has a conspicuous short wavelength cone mechanism, and the other type (deutan incomplete achromats) has a conspicuous long wavelength cone mechanism. The photoreceptor mechanisms were inferred from color matches and from test action spectra measured on rod-saturating backgrounds of different wavelengths. Interestingly, the illumination-dependency of color discrimination (for 5 degrees bipartite fields that were centrally fixated) differed between the two patient types, even though rhodopsin photoreceptors were common to both. As illumination level increased, the ability to discriminate wavelength differences deteriorated for the blue cone monochromats, whereas, for the deutan achromats, wavelength discrimination remained relatively constant even near 100,000 scotopic trolands. The performance decrement in the blue cone monochromats was probably not associated with rod saturation, as the field action spectrum to cause a just-noticeable-difference (jnd) decrement in discrimination was poorly fitted by a rhodopsin action spectrum. In addition, the blue cone monochromats had rhodopsin photoreceptors that did not saturate in bright illuminations. The authors hypothesize that the deterioration of wavelength discrimination at high illuminations is not an abnormality of blue cone monochromacy. Rather, it may be a property of the normal color mechanism through which signals from the short wavelength cones pass.
Adolescent↗
Contrast agent-induced thrombophlebitis following leg phlebography: lohexol compared with meglumine iothalamate.
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Adult↗
Astrocytes in culture synthesize and secrete a variant form of fibronectin.
Astrocytes in culture have very little cell surface fibronectin as detected by iodination or immunocytochemistry. Nonetheless, they synthesize and secrete this glycoprotein in amounts comparable with the production by fibroblasts. Astrocyte fibronectin has properties in common with other forms of the protein. It binds to gelatin- and heparin-coupled Sepharose and it is recognized by specific anti-fibronectin sera. It also exists as a dimer under non-reducing conditions. However, by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), astrocyte fibronectin appears larger, under both reduced and non-reduced conditions, than other cellular fibronectins. This apparent size difference is not the result of post-translational modifications. If the cultures are treated with tunicamycin, the astrocytes produce fibronectin that is unglycosylated, as shown by [3H]glucosamine labeling, and is neither sulfated nor phosphorylated as indicated by [35S]O4 and [32P]O4 labeling studies. This astrocyte-derived, carbohydrate-free fibronectin resolves on SDS-PAGE as four bands, of which the heavier ones predominate. Fibroblasts produce a similar set of four bands, but in this form of fibronectin the less heavy bands predominate. Thus, we conclude that fibronectin is a major secreted protein of astrocytes in vitro and that these cells produce a variant form of the protein which is enriched in the higher molecular weight subunits.
Animals↗