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Biomedical subjects

J Roche

Publications and source records attributed to J Roche.

At least 91 records · Page 5Linked to original sources

Renal oncocytomas--an Australian experience.

A review was made of 24 cases of renal oncocytoma seen between 1978 and 1989. There was considerable overlap between the clinical presentation of renal oncocytomas and renal carcinomas. Although pre-operative radiological, cytological and pathological investigations may suggest the presence of an oncocytoma, these studies cannot make a definitive diagnosis. We recommend that these tumours be treated as potential renal carcinomas until post-operative microscopic evaluation proves otherwise.

Adenoma↗

Endemic human paragonimiasis in Equatorial Guinea. Detection of the existence of endemic human paragonimiasis in Equatorial Guinea as a result of an integrated sanitary programme.

Between February and April 1990 the first five cases of human paragonimiasis, tentatively due to Paragonimus africanus, have been detected in Equatorial Guinea, thanks to the normal activities of the National Schistosomiasis Project and its coordination with the National Tuberculosis Project.

Equatorial Guinea↗

Diabetes prevalence in Alaska, 1984-1986.

The prevalence of diabetes in Alaska from 1984 to 1986 was determined through medical records review. Cases were identified from hospital and physician discharge forms and from financial abstracts. As of December 1986, 3,719 Alaskans met the criteria for physician diagnosis of diabetes. The overall age-adjusted prevalence of diagnosed diabetes mellitus, 1,357/100,000, was lower than the U.S. rate of 2,470/100,000. The overall age-adjusted prevalence rates of specific complications and pregnancy among Alaskans with diabetes were retinopathy--167.5/1,000; blindness--24.3/1,000; amputations--19.4/1,000; end stage renal disease--9.7/1,000; pregnancy--50.7/1,000. Limitations in available data sources such as death certificates, hospital records, and subspecialists' medical records provided serious problems in identifying persons with diabetes, especially those in the 30- to 69-year age group who have not yet developed complications requiring hospitalization or subspecialty care. This population perhaps is most in need of services to prevent future complications of diabetes.

Adolescent↗

[Control of human African trypanosomiasis in Luba in equatorial Guinea:evaluation of three methods].

The object of this study was to (a) reduce the prevalence of sleeping sickness by serological testing, parasitological examination, and treatment of every infected person; (b) determine the maximum acceptable interval between serological surveys; and (c) define the impact of vector control, using monopyramidal non-impregnated traps, on the transmission. For this sero-parasitological survey, the focus in Luba was divided into three zones as follows: Epicentre A (with high prevalence, 27.5%), Epicentre B (with average prevalence, 8.3%), and Peripheral C (with moderate prevalence, 3.0%). Differences in the prevalence rates in the Epicentres and Peripheral zone permitted the use of three different approaches for control and epidemiological follow-up of the disease: (1) Serological examination of the entire population was carried out by the indirect immunofluorescent antibody test (IFAT), with six-month intervals in Epicentres A and B and once a year in the Peripheral zone C. (2) DIAGNOSIS AND TREATMENT: all IFAT seropositives were examined in Luba hospital for parasites, and every parasitologically confirmed patient was treated according to the WHO protocol of 1983. Another serological test (CATT) was applied to cases in which trypanosomes were not present and if this was positive, the CSF was examined. Cases with parasites and abnormal CSF were treated with melarsoprol, and those with a normal CSF received pentamidine. CATT-negative and parasite-negative cases were considered to be false-positives by IFAT and free of the disease. (3) Vector control: 74 monopyramidal traps (18 traps per km2) were set up in Epicentre A. The flies captured were collected once a month and sent to the programme's laboratory where they were identified and counted.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Costs of magnetic resonance imaging services in public hospitals.

Audited cost data from two public hospital installations participating in a trial of the utilisation and efficacy of magnetic resonance imaging are presented. The data cover the period July 1987 to June 1988 when both installations had attained stable patterns of operation. One hospital operated a superconductive system and the other a resistive magnetic resonance imaging unit. Depreciation and salaries represented the major components of cost.

Australia↗

Osteoporosis and skeletal fractures in chronic liver disease.

In order to determine the prevalence and severity of hepatic osteodystrophy by non-invasive means we compared 115 consecutive ambulant patients with histologically proven chronic liver disease to 113 age and sex matched control subjects. Methods used included the assessment of fracture prevalence rates, spinal radiography, and measurements of bone mineral density in the spine and the forearm. Spinal and peripheral fractures were more prevalent in the patients than in the control subjects (p less than 0.03 and p less than 0.01 respectively). The type of the underlying liver disease did not significantly affect the fracture prevalence rates, but alcoholic patients sustained more peripheral fractures than patients with other hepatic disorders (p less than 0.05). The bone mineral densities of the spines and the forearms were significantly reduced in male patients of all age groups and in female patients aged 60 years or more (p less than 0.001 for men and p less than 0.01 for women for both measurements). The prevalence rates of spinal and forearm osteoporosis were twice as high among patients with liver disease than in control subjects regardless of the definitions used. The presence of cirrhosis and hypogonadism were major risk factors for development of both spinal (Beta coef = 0.190 and 0.176; SE = 0.079 and 0.086 respectively) and forearm osteoporosis (Beta coef = 0.20 and 0.29; SE = 0.073 and 0.80 respectively). Spinal bone density was the predominant determinant of spinal fractures (Beta coef = -0.007; SE = 0.001), while hypogonadism (Beta coef = 0.363; SE = 0.075) and cirrhosis (Beta coef = 0.185; SE = 0.068) were the major predictors of peripheral fractures. The concentrations of serum calcium and serum vitamin D metabolites and the use of corticosteroids were apparently without effect on the prevalence of skeletal fractures or bone density.

Adrenal Cortex Hormones↗

Dietary modification with dairy products for preventing vertebral bone loss in premenopausal women: a three-year prospective study.

The effect of dietary calcium on vertebral bone mass in women is controversial. In a randomized study we have investigated the effect of dietary modification in the form of dairy products on vertebral bone mass in 30- to 42-yr-old premenopausal women over a 3-yr period. Twenty women increased their dietary calcium intake by an average of 610 mg/day (P less than 0.03) for 3 yr, while 17 age- and weight-matched women served as controls. Calcium intake was monitored by 3-day diet histories and 24-h urinary calcium excretion. The consumption of the dairy products did not alter serum calcium or PTH levels or the fasting urinary calcium to creatinine ratio. Twenty-four-hour urinary calcium excretion increased by 28% (P less than 0.03) in the supplemented women. Dairy product intake was accompanied by increased dietary fat intake, but there were no statistically significant changes in serum cholesterol, low density lipoprotein cholesterol, or high density lipoprotein cholesterol levels. The vertebral bone density in the women consuming increased calcium did not change over the 3-yr period (-0.4 +/- 0.9%). In contrast, the vertebral bone density in the control women declined (-2.9 +/- 0.8%; P less than 0.001) and was significantly lower than that in the supplemented group at 30 and 36 months. The study suggests that dietary modification in the form of dairy products retards vertebral bone loss in premenopausal women. Therefore, increased calcium intake in estrogen-replete premenopausal women may prevent age-related bone loss.

Adult↗

[Is there a double pathway for the secretion of thyroglobulin: a "short circuit" weakly glycosyl-iodinated and a "long circuit" strongly glycosyl-iodinated?].

Intact rat thyroid lobes incubated in vitro release recently synthesized thyroglobulin (Tg) into the media at a faster rate than they release thyroglobulin stored in follicular structures. Differential release of this Tg fraction cannot be explained by morphological alterations in thyroid architecture during incubation. This rapidly excreted fraction exhibits a low density on rubidium chloride gradients characteristic of poorly sialylated and poorly iodinated thyroglobulin, comigrating on rubidium chloride gradients with thyroglobulin isolated from tunicamycin treated glands. This poorly sialylated and poorly iodinated thyroglobulin is itself unaffected in its density or release into the media by tunicamycin treatment. Tg isolated from the media of tunicamycin treated glands has nearly the same low iodine and low sialic acid content as rat serum thyroglobulin and does not incorporate radiolabelled glucosamine. This fraction thus appear to duplicate properties of low glycosylated-low iodinated thyroglobulin released from thyroid cells in organisms that have no follicular structures and no follicular storage process as well as from thyroid tissue in patients with thyroid disease states, particularly thyroid tumors. Thus it is proposed a "short loop" pathway of low-glycosylated low-iodinated thyroglobulin directly into circulation, that bypasses and is not stored in the follicular lumen, the "long loop".

Animals↗

[Naloxone doesn't determine the response of growth hormone to clonidine in obese patients].

The effect of naloxone (opioid receptor blocker) on the impairment of growth hormone (GH) release after clonidine (alfa 2-adrenergic agonist) was investigated in 10 volunteer obese subjects. The patients (4 males and 6 females, 16-22 year old) with fat excess (15 +/- 2 kg) estimated by bioelectrical impedance analysis (BIA) were studied repeatedly. The patients, were perfused by a slow saline infusion. 30 min later they received a bolus dose of clonidine (150 micrograms p.o.), followed 30 min later by a bolus dose of naloxone (10 mg i.v.) or a corresponding volume of isotonic sodium cloride (I.S.) for control. No significant changes occurred in blood GH concentration after clonidine administration and naloxone did not induce GH response at clonidine. These results suggest that in obese subjects the impairment of GH release after clonidine is not mediated via receptors sensitivity to naloxone.

Adolescent↗

[Partial deficiency in 21-hydroxylase in certain forms of hirsutism].

The ACTH test is important when hirsutism occurs in women with a slight 21-hydroxylase deficiency, and normal basal 17-OH Progesterone (17-OH-P/plasma levels). Extensive hormonal assays: LH, FSH, Prolactin, 17 beta-estradiol (E2), Estrone, 17OH-P, Androstenedione, Testosterone, Cortisol (C), Dehydroepiandrosterone-S (DEA-S) were carried out in 36 hirsute women. 13 of these presented hormone levels as found in polycystic ovary syndrome (PCOS), 6 women presented a slight 21-hydroxylase deficiency (increased plasma 17-OH-P and decreased C after ACTH test with significant, p less than 0.01, increase of 17-OH-P/C and 17 women presented idiopathic hirsutism (IH). The hormonal pattern, in the basal condition, is not different in IH or in slight 21-hydroxylase deficiency. The ACTH test is able to differentiate between IH and adrenal hirsutism.

17-alpha-Hydroxyprogesterone↗

Ultrasound attenuation of the os calcis in women with osteoporosis and hip fractures.

Bone ultrasound attenuation of the calcaneus, and vertebral and femoral bone density measured by dual photon absorption were determined in 22 women with osteoporosis, 10 women with hip fractures, and 29 normal, age-matched controls to determine the utility of the ultrasound technique as an indicator of axial osteopenia. Vertebral and femoral neck density and bone ultrasound attenuation were significantly decreased (P less than 0.01) in the women with osteoporosis and those with hip fractures. The sensitivity and specificity of bone ultrasound attenuation was 80% at a value of 50 dB/MHz. At 90% specificity the sensitivity of bone ultrasound attenuation was 65%. The results of this pilot study suggest that ultrasound attenuation, a safe, simple, and radiation-free procedure, may be utilized as an indicator of decreased axial bone mass.

Aged↗

Fibrolamellar carcinoma as a cause of bile duct obstruction.

Obstructive jaundice due to growth within bile ducts of hepatocellular carcinoma is uncommon and usually a manifestation of advanced, lethal tumour. We report a case of fibrolamellar carcinoma of the liver presenting with obstructive jaundice, caused by tumorous permeation of the left hepatic duct with migration of tumour fragments into the common bile duct. Immunocytochemical and ultrastructural features are described. Two and a half years after complete surgical resection the patient is free of tumour. The importance of accurate diagnosis of such tumours is emphasized.

Adolescent↗