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Biomedical subjects

J Rhodes

Publications and source records attributed to J Rhodes.

At least 127 records · Page 7Linked to original sources
PubMed1992

Longitudinal study of cortical bone loss in patients with inflammatory bowel disease.

Bone mineral density of the radius was measured by single-photon absorptiometry in 50 patients with inflammatory bowel disease. Thirty-three had Crohn's disease and 17 ulcerative colitis; 25 were women. The mean age was 45 years (range, 18-70 years). Measurements were repeated in 39 of them after a mean follow-up period of 7.9 years (range, 7.1-8.2 years). In female patients the mean (95% confidence interval) annual change in radial bone mineral density was -0.74% (-1.34% to -0.14%) (P = 0.022), the greatest bone loss occurring in postmenopausal women (mean, -1.16% (-2.01% to -0.30%)). In male patients the mean annual rate of bone loss was -0.07% (-0.41% to 0.28%) (P = NS). Patients with abnormally low values at the first measurement remained osteopenic at the second measurement, whilst some others with normal values initially showed increased rates of bone loss and had a subnormal bone mineral density after the follow-up period. These results show increased rates of cortical bone loss in some patients with inflammatory bowel disease and emphasize the need to monitor bone mass in these patients so that prophylactic measures can be instituted.

Absorptiometry, Photon↗
PubMed1992

Total parenteral nutrition-induced changes in gut mucosal function: atrophy alone is not the issue.

BACKGROUND: Total parenteral nutrition (TPN) has been implicated in gut atrophy and breakdown of barrier function leading to bacterial translocation (BT) in animals. BT during TPN, however, is not found consistently, and it has therefore been suggested that macromolecular permeability may occur independently of BT during TPN. METHODS: Male Sprague-Dawley rats were administered isocaloric standard TPN enterally, parenterally, or split equally between the two routes or allowed food ad lib. A second group of rats was administered isocaloric TPN with and without 4% lipids, and changes in gut barrier function were assessed by measuring lactulose permeability. RESULTS: Rats receiving TPN both enterally and parenterally maintained histologic intestinal structure to the same degree as rats fed enterally and those allowed food. Although parenteral feeding led to significant gut atrophy and cecal bacterial overgrowth, BT was not increased. Gut permeability to lactulose, however, was increased significantly in the TPN groups. Lipid content did not affect outcome. CONCLUSIONS: These results suggest that gut atrophy, BT, and permeability to macromolecules are not necessarily related. Gut-origin septic states during TPN or trauma may be caused by an increased escape of macromolecules from the gut, and BT may be an end result rather than a primary cause of such septic episodes.

Animals↗
PubMed1992

Are non-steroidal anti-inflammatory drugs always necessary? A general practice survey.

The number of patients receiving long-term 'repeat prescriptions' for non-steroidal anti-inflammatory drugs (NSAIDs) was examined in a General Practice; a group of them with osteoarthritis or musculoskeletal pain attempted to withdraw their NSAID treatment and substitute alternative analgesics. Thirty-eight randomly selected patients, with conditions other than rheumatoid arthritis, were interviewed and alternative analgesics prescribed to replace their NSAID therapy. After one month, 22 had very satisfactory pain relief without their NSAID but 16 had resumed therapy, with four of them on a reduced dosage; three others wished to try an alternative analgesic again. Five initially with gastro-intestinal symptoms were asymptomatic within a month of discontinuing their NSAID. After four months, 24 of the 38 had discontinued NSAIDs, including one who had an upper gastrointestinal haemorrhage during the study; two others were taking a reduced dosage.

Adult↗
PubMed1992

Inhibition of specific T-cell activation by monosaccharides is through their reactivity as aldehydes.

The effect of monosaccharides on the inductive interaction between antigen-presenting cells and T cells was investigated in a human system. Some monosaccharides, but not others, were found to inhibit antigen-specific T-cell activation. Responses to mitogen were unaffected. In order for inhibition to occur, a high concentration (approximately 50 mM) of monosaccharide was necessary. The role of monosaccharide aldehyde groups in inhibition was investigated using the alpha-methyl pyranoside and the alditol forms of inhibitory monosaccharides. Unlike the native monosaccharides, these molecular configurations possess the ring structure and the open chain structure respectively but do not contain aldehydes. Together they represent all the molecular characteristics of both forms of the monosaccharide except the possession of aldehyde groups. These two molecular species produced no significant inhibition. Modified forms of the sugar moiety of ribofuranosidoadenine (adenosine) were also tested. The periodate oxidized form of the molecule in which the ribose bears two aldehyde groups, was a potent inhibitor of antigen-induced T-cell activation whereas periodate-oxidized, borohydride-reduced ribofuranosidoadenine, in which the ribose aldehydes are converted to alcohols, produced no inhibition. The former was shown to form Schiff bases with ligands on peripheral blood mononuclear cells (PBMC) as predicted whereas the latter did not. Periodate oxidized dextran, but not native dextran, was also inhibitory. Together these data show that inhibition of T-cell activation by sugars requires reactive aldehydes and this is consistent with the Schiff base model of specific antigen-presenting cell (APC)-T cell inductive interaction in which exogenous aldehydes and other carbonyl donors prevent the necessary formation of Schiff bases between cellular ligands.

Aldehydes↗
PubMed1991

Human T cell recognition of influenza A nucleoprotein. Specificity and genetic restriction of immunodominant T helper cell epitopes.

The characterization of human T cell antigenic sites on influenza A nucleoprotein (NP) is important for subunit vaccine development for either antibody boosting during infection or to stimulate T cell-mediated immunity. To identify such sites, 31 synthetic peptides that cover more than 95% of the amino acid sequence from NP of influenza A/NT/60/68 virus were tested for their ability to stimulate PBL from 42 adult donors. The most frequently recognized region was covered by a peptide corresponding to residues 206-229 of NP, with 20/42 (48%) of responders. In many individuals this was also one of the peptides that stimulated the strongest T cell responses. Other regions that were also frequently recognized were 341-362 by 13/42 (30%), 297-318 by 10/42 (23%), and 182-205 by 9/42 (21%) of individuals. These peptides covered highly conserved regions in NP of influenza A viruses, suggesting that they could be useful in boosting cross-reactive immunity against the known type A virus strains. In order to define the class II restriction molecules used to present particular T cell epitopes, 22 persons from the donor panel were HLA-typed. The majority of persons who expressed DR2, and proliferated to NP also responded to the major immunodominant region 206-229. In addition, this peptide was also immunodominant in the one person expressing DRw13. The observation that recognition of this peptide is associated with DR2 was confirmed by using short term T cell lines and APC from a panel of typed donors. Further results with virus-specific T cell lines and clones and transfected L cells expressing DR molecules showed that DR1 could also present this peptide. Therefore the results suggest that recognition of 206-229 is associated with at least three different DR haplotypes and this may explain the high frequency with which this peptide is recognized in the population. The fine specificity of the response to peptide 206-229 was distinct when presented by DR1- or DR2-expressing APC. The DR1 response was dependent on the N terminus, and the DR2 response was directed to the C terminus of the peptide.

Adult↗
PubMed1991

Sensitivity and tolerance to nicotine in smokers and nonsmokers.

We studied the responses of smokers and lifelong non-smokers to transdermal nicotine patches over 24 h in three groups of subjects: non-smokers on a 15 mg patch (n = 8), non-smokers on a 30 mg patch (n = 8) and smokers on a 30 mg patch (n = 8). Unexpectedly, the non-smokers appeared to absorb nicotine more rapidly. The increase in blood nicotine concentrations of non-smokers over the first 2 h of patch use was double that of the smokers, with mean increases of 4.5 (SD = 3.7), 10.9 (SD = 4.2) and 4.1 (SD = 2.7) ng/ml in the three groups, respectively (P less than 0.005). The smokers had no pleasant or unpleasant effects from the 30 mg patch (X Cmax 13.9 ng/ml, SD = 4.9; Tmax 8.75 h) but all eight non-smokers experienced mild nausea and lightheadedness (P less than 0.01) within the first hour, and seven dropped out (P less than 0.01) at 3-8 h due mainly to severe nausea, vomiting or headache (X Cmax 18.4 ng/ml, SD = 4.9; Tmax 5.25 h). Only one non-smoker dropped out on the 15 mg patch, but five had transient nausea in the first hour (X Cmax 7.9 ng/ml, SD = 3.0; Tmax 8.0). Our study provides evidence of chronic pharmacodynamic nicotine tolerance in smokers, but does not address whether this is acquired or innate. The higher rate of transdermal nicotine absorption in non-smokers is unexplained and requires replication.

Administration, Cutaneous↗
PubMed1991

Hemodynamic correlates of exercise function in patients with primary pulmonary hypertension.

The purpose of this investigation was to study the hemodynamic correlates of exercise function in patients with primary pulmonary hypertension and to further define the role of exercise testing in the evaluation of these individuals. Data from the progressive exercise tests and subsequent cardiac catheterization in 16 consecutive patients, aged 16.9 +/- 10.4 years (range 6 to 35), with primary pulmonary hypertension were prospectively collected and analyzed. Exercise capacity averaged 40 +/- 36% (range 0 to 117%) of that predicted for age, height and gender. Statistically significant correlations existed between exercise capacity and 10 invasively measured hemodynamic variables. Mean right atrial pressure, a variable previously noted to be one of the best predictors of survival in patients with primary pulmonary hypertension, correlated best with exercise capacity (r = -0.83, p less than 0.0001). Exercise capacity greater than 75% of the predicted value identified the two patients who had a positive response to acute pulmonary vasodilator drug testing. Poor exercise capacity (less than 10% of the predicted value) identified the three patients who died during or soon after cardiac catheterization. The ability of exercise testing to identify patients at high risk for cardiac catheterization was superior to that of other noninvasive variables. Results of exercise testing may help guide decisions regarding the optimal timing of heart-lung or single lung transplantation.

Adolescent↗
PubMed1991

Total body calcium in patients with inflammatory bowel disease: a longitudinal study.

1. Serial measurements of total body calcium have been made by prompt gamma-neutron activation analysis in 13 patients with inflammatory bowel disease over a mean period of 23 months. Changes in spinal trabecular bone mineral density and radial shaft bone mineral content were also assessed by using quantitative computed tomography and single photon absorptiometry, respectively. 2. The mean annual decreases (95% confidence intervals) were: total body calcium, 7.8% (-12.0 to -3.7%; P less than 0.001); spinal trabecular bone mineral density, 2.5% (-5.0 to +0.1%; 0.05 less than P less than 0.1), radial bone mineral content, 2.1% (-3.4 to -0.8%; P less than 0.01). 3. No significant correlations were found between rates of change of the three variables. However, there were significant positive correlations between the baseline values for total body calcium and radial bone mineral content (r = 0.638, P less than 0.05), spinal bone mineral density and radial bone mineral content (r = 0.854, P less than 0.01), and total body calcium and spinal bone mineral density (r = 0.876, P less than 0.001). 4. These results demonstrate rapid decreases in total body calcium in patients with inflammatory bowel disease which, in conjunction with the significant decrease in radial shaft bone mineral content, indicate increased rates of cortical bone loss. Whilst values for bone mass at different skeletal sites showed positive correlations within individuals, no relationship was found between the rates of change in bone mass at these sites. 5. The rapid bone loss observed in some subjects emphasizes the importance of early detection of osteoporosis by bone densitometry and the need for effective prophylactic measures to be established in this group of patients.

Absorptiometry, Photon↗
PubMed1991

Protection from gastrointestinal side-effects by azapropazone by its incorporation into a glucose-sodium acid citrate formulation.

Addition of glucose and sodium citrate to azapropazone, in proportions of 1:1:1 by weight reduced gastric mucosal damage in rats and there was a trend towards reduction in radiolabelled faecal red cell loss in human volunteers compared with that with azapropazone alone. The glucose and citrate did not affect the pharmacokinetics of azapropazone, or its therapeutic efficacy. While no difference was observed in endoscopic injury and in symptomatic gastrointestinal complaints in a multicentre comparison in rheumatic patients, a striking reduction in symptoms was observed in those patients with a history of severe gastrointestinal intolerance to non-steroidal anti-inflammatory drugs.

Adolescent↗
PubMed1991

Smoking, humoral immunity, and ulcerative colitis.

Since ulcerative colitis predominantly affects non-smokers and ex-smokers we have examined the possibility that smoking modifies the humoral immune response to an antigenic challenge from the gut lumen. Gut lavage was used in healthy subjects and patients with ulcerative colitis, including both smokers and non-smokers. Antibodies in the intestinal fluid to Escherichia coli (five pooled serotypes), Candida albicans, gliadin, ovalbumin, and beta lactoglobulin were measured by ELISA to determine specific antibody concentrations of IgG, IgA, and IgM classes. Total IgG, IgA, and IgM were also measured in intestinal secretions and serum. In addition, circulating antibody concentrations of IgG, IgA, and IgM to three gut commensals - E coli (five pooled serotypes) C albicans, and Poroteus mirabilis were measured. There was a significant reduction in the IgA concentration in intestinal fluid of smokers with ulcerative colitis compared with healthy non-smoking controls. No other significant differences were found between the groups. Overall, these data are not consistent with the idea that smoking suppresses immune responses in the gut and suggest that the effect of smoking in colitis is mediated by another mechanism.

Adult↗
PubMed1991

Stress management for irritable bowel syndrome: a controlled trial.

Thirty-five patients with irritable bowel syndrome were randomized to receive treatment in a stress management programme or conventional therapy which included the antispasmodic Colpermin. The stress management programme involved a median of six 40-min sessions with a physiotherapist during which patients were helped to understand the nature of their symptoms, their relationship to stress and were taught relaxation exercises. Two thirds of those in the stress management programme found the programme effective in relieving symptoms and experienced fewer attacks of less severity. This benefit was maintained for at least 12 months. Few of those given conventional management had any benefit. A stress management programme would appear to be of value for patients with irritable bowel syndrome.

Adult↗
PubMed1991

A long-term clinical review of patients with oesophageal pain.

Oesophageal and cardiac chest pain are often difficult to distinguish on clinical grounds. The clinical course of 32 patients with recurrent chest pain due to oesophageal dysmotility has recently been assessed by questionnaire 9 years after diagnosis. Twenty-six of the 27 who replied continued to have pain, but despite this there was a significant reduction in the number of hospital admissions associated with chest pain. Repeat oesophageal manometry in nine showed that the disturbance in motility persisted. Three had died, one of them from a myocardial infarction; two patients could not be traced.

Adult↗
PubMed1990

Erythrocyte rosettes provide an analogue for Schiff base formation in specific T cell activation.

Human T cells spontaneously bind sheep E and this reflects physiologic interactions between specific adhesion molecules, principally T cell CD2, and the sheep equivalent of LFA-3. This interaction is important in T cell adhesion and in transmission of accessory activational signals. In this respect, E rosettes provide a partial analogue for T cell:accessory cell interaction and rosetting induces functional alterations in T cells. In studies of Ag-dependent T cell activation, we have obtained evidence that the formation of covalent Schiff bases between ligands on APC and T cell is an essential element. In our study, the specific chemical criteria defining Schiff base formation were applied to T cell E rosettes formed at room temperature, as follows: 1) Prior formation of Schiff bases on T cell epsilon-amino groups by glutaraldehyde inhibited E rosette formation. 2) Rosette formation was inhibited in the presence of exogenous lysine. 3) Reduction of constitutive T cell aldehydes by NaBH4 inhibited subsequent E rosette formation. In response to these chemical modifications of cellular ligands, T cell E rosette formation and T cell inductive interaction with APC were affected in the same way. 4) Oxidation of NaBH4-treated T cells by NaIO4 or galactose oxidase to regenerate cell-surface aldehydes on N-acetylneuraminic acid or galactose residues respectively, consistently restored E rosette formation. 5) Conversion of reversible Schiff bases to irreversible secondary amines by NaCNBH3 stabilized E rosettes against mechanical disruption. Together, these data demonstrate that E rosettes provide an analogue for the Schiff base-forming reactions that are essential in specific T cell activation.

Animals↗
PubMed1990

An essential role for constitutive Schiff base-forming ligands in antigen presentation to murine T cell clones.

The role of cell-surface Schiff base-forming ligands in the inductive interaction between class II+ APC and murine T cells was investigated. Schiff bases are produced by the condensation of an amine with the carbonyl group of an aldehyde or ketone in a reversible covalent reaction. Treatment of APC with low concentrations of glutaraldehyde to form Schiff bases on a small proportion of epsilon-amino groups consistently inhibited Ag presentation to primary T cells and T cell clones. Schiff base formation by glutaraldehyde was quantitated by specific reduction with the weak, selective reducing agent sodium cyanoborohydride. Aldehyde inhibition of presentation was observed with allo-, protein, and small peptide Ag, and T cell clones of Th1 and Th2 subtypes were equally susceptible. Large increases in the concentration of glutaraldehyde in brief pretreatments of APC resulted in substantial restoration of Ag-presenting function. Oxidation of T cell sialic acid to produce cell-surface aldehydes resulted in a vigorous proliferative response to class II-positive syngeneic accessory cells. This response was inhibited by preformation of Schiff bases on epsilon-amino groups of the accessory cells by glutaraldehyde. Dose response curves for inhibition of aldehyde-induced and Ag-induced T cell proliferation by glutaraldehyde treatment of accessory cells were similar. Reduction of constitutive aldehydes on cloned T cells by sodium borohydride resulted in inhibition of Ag-specific responses. This took the form of a substantial delay in the time-course of the response consistent with the eventual regeneration of cell-surface aldehydes. Only the presentation of Ag was inhibited. Ongoing established proliferative responses remained unaffected. Together, these data indicate that constitutive Schiff base-forming ligands on APC and T cells are essential in Ag presentation to murine T cells and are consistent with a model of Ag presentation in which reciprocal Schiff base formation is an essential element.

Animals↗
PubMed1990

3-Deazaadenosine--an inhibitor of interleukin 1 production by human peripheral blood monocytes.

3-Deazaadenosine (c3Ado) has been reported to have properties of an immunosuppressive and anti-inflammatory agent. This study was designed to investigate whether c3Ado might exert anti-inflammatory activities through inhibiting Interleukin 1 (IL-1). c3Ado was found to be a potent inhibitor of IL-1 production by LPS stimulated human peripheral blood monocytes and acted at the level of synthesis rather than secretion. c3Ado also had direct effects on IL-1 biological activity in two separate assays; thymocyte proliferation and induction of prostaglandin release. Further experiments indicated that c3Ado also inhibited growth factor dependent proliferation driven by both Interleukin-2 and Interleukin-3 as well as the proliferation of a number of non-growth factor dependent cells. However, short term exposure to c3Ado resulted in no inhibition of 3H-thymidine incorporation by cells but a significant inhibition of 3H-uridine uptake into TCA precipitable material. These results suggest that c3Ado is a selective inhibitor of RNA synthesis and inhibits IL-1 production and activity by blocking new messenger RNA production induced by LPS or IL-1. General inhibition of RNA synthesis would also account for its anti-proliferative activity.

Aminoglycosides↗
PubMed1990

Coarse mucosal folds in the duodenum: a twenty-year follow-up.

In a 20-year follow-up of 40 patients with coarse duodenal folds, details were obtained about 34 patients of whom 11 had died. Clinical details were reviewed from the remaining 23 patients, and recent barium meal examinations were reviewed from eight patients. Ten of the 23 surviving patients continued to have recurrent dyspepsia, and the radiological appearance in three of the eight recent barium meals showed that coarse mucosal folds persisted. The clinical course of those with coarse duodenal folds is similar to that of peptic ulcer, with recurrent symptoms in some patients continuing for many years, and in others complicated by development of peptic ulcer. Coarse mucosal folds in the duodenum are usually associated with a high acid secretion and treatment to reduce acid secretion is appropriate in view of the severity of symptoms and risk of ulceration.

Aged↗
PubMed1990

Tripotassium dicitrato bismuthate enemas in the treatment of ulcerative proctitis.

Eleven patients with active proctitis or proctosigmoiditis completed one month's treatment with tripotassium dicitrato bismuthate enemas administered at night. Symptoms, sigmoidoscopic appearances, and the histological grade of acute inflammation were assessed at the commencement of therapy and after one month. An overall score of these features showed improvement in 9 of 11 patients, which encourages further investigation of bismuth in controlled trials for patients with inflammatory bowel disease.

Adult↗