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Biomedical subjects

J Russell

Publications and source records attributed to J Russell.

At least 145 records · Page 8Linked to original sources

Effects of fluvastatin on leukocyte-endothelial cell adhesion in hypercholesterolemic rats.

The overall objective of this study was to determine whether peroral treatment with the 3-hydroxy-3-methyl-glutaryl coenzyme A (HMG-CoA) reductase inhibitor fluvastatin influences the leukocyte-endothelial cell adhesion (LECA) observed in postcapillary venules of hypercholesterolemic rats. Rats were fed either normal chow or a chow supplemented with 1% cholesterol for 10 days. Leukocyte adherence and extravasation, leukocyte rolling velocity, red blood cell velocity, and vessel diameter were monitored in mesenteric venules superfused with either 100 nmol/L platelet-activating factor (PAF) or 20 nmol/L leukotriene B4 (LTB4). Hypercholesterolemic rats exhibited an exaggerated LECA response compared with their normocholesterolemic counterparts. In hypercholesterolemic rats, treatment with fluvastatin significantly attenuated the leukocyte-adherence responses to PAF and LTB4 as well as the leukocyte emigration response to LTB4. Fluvastatin treatment also inhibited the PAF- and LTB4-induced reductions in leukocyte rolling velocity. These findings indicate that fluvastatin blunts the inflammatory responses elicited in post-capillary venules by lipid mediators.

Animals↗

A comparison of three procedures for the detection of Bence-Jones proteinuria.

A traditional electrophoretic procedure for detection of Bence-Jones proteinuria, employing Amido black stain on 200-fold concentrated urine, has been compared to two procedures employing highly sensitive protein stains not requiring prior urine concentration. All three procedures were carried out on 80 random urine samples screened for Bence-Jones proteinuria and 10 samples were provided by patients attending a myeloma clinic. A new procedure employing modified Coomassie brilliant blue stain on unconcentrated urine showed comparable sensitivity to the established procedure (82% versus 88%, respectively) and specificity (77% versus 74%, respectively), when assessed against immunofixation as a reference method. However, the new method is considerably quicker and cheaper. A second method, employing Gold stain, showed enhanced sensitivity (94% versus 88% for Amido black) but lower specificity (62% versus 74% for Amido black). However, this method is labour intensive and relatively expensive. Our data suggest that the procedure employing modified Coomassie brilliant blue may be a suitable alternative to the traditional procedure commonly used in many clinical laboratories.

Amido Black↗

Ethical issues experienced by HIV-infected African-American women.

The epidemic of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) has led to many ethical problems. Most studies have focused on the ethical issues faced by nurses who provide care to persons with AIDS (PWA), rather than the ethical issues faced by PWAs themselves. The purpose of this study, therefore, was to explore the ethical issues faced by five HIV/AIDS-infected African-American women. An analysis of interview data revealed that these women deal with four broad categories of ethical issues: diagnosis; disclosure; treatment by, and of, others; and future pregnancies. The results of this study provide an initial description of the ethical issues faced by HIV/AIDS-infected African-American women, and begin to lay the foundation necessary for nurses appropriately to facilitate and support their decisions.

Adult↗

Paradox, persecution and the double game: psychotherapy in anorexia nervosa.

OBJECTIVE: In anorexia nervosa, the interface between psychotherapy and effective physical management continues to arouse dissent. For this reason, theoretical underpinnings and their practical applications were explored. METHOD: A selective review of the literature was based on the authors' clinical experience in hospital treatment settings. RESULTS: The psychosomatic paradigm, the threat to life, the reward characteristics and the developmental trajectory of anorexia nervosa necessitate a particular form of integrated psychotherapy. CONCLUSIONS: The approach is essentially that of self psychology but with an important departure which must be addressed in the therapeutic process. This is exemplifed in the paradox of persecution by refeeding and the curious double game that evolves.

Adolescent↗

The use of guardianship legislation for anorexia nervosa: a report of 15 cases.

OBJECTIVE: This paper investigates compulsory treatment under guardianship legislation for 15 anorexia nervosa patients admitted to four eating disorders units in New South Wales (NSW), Australia, between 1991 and 1994. METHODS: A retrospective follow-up was conducted. This involved an analysis of sociodemographic, clinical, eating and weight history, and Guardianship Order details obtained from medical records. This small sample was compared to a larger sample of anorexia nervosa patients admitted voluntarily to a specialised eating disorder unit in NSW. Further follow-up included a structured interview using the Morgan-Russell Assessment Outcome Schedule at least 1 year after admission for compulsory treatment. RESULTS: For those treated involuntarily, a larger number came from metropolitan Sydney and a larger percentage were unemployed, were purgers and required specialist medical consultations. A significantly higher proportion came from higher socioeconomic groups, and the duration of stay in hospital while patients were under guardianship was significantly greater. A high degree of comorbidity was noted. There were similarities between those treated involuntarily and those treated voluntarily for the source of referral, marital status and Body Mass Index on admission and discharge. Only three patients accepted a follow-up interview using the Morgan-Russell Outcome Schedule. Two of them had made a good recovery. CONCLUSIONS: It was noted that the guardianship sample comprised a more severely III group than anorexic patients treated voluntarily. The nature of guardianship legislation compared to mental health law was discussed and advice offered to clinicians contemplating and implementing compulsory treatment.

Adolescent↗

Experiences of physical and sexual abuse in Australian general practice attenders and an eating disordered population.

OBJECTIVE: To determine the reported rates of child physical and sexual abuse experienced by hospitalised eating disordered patients compared to a control group of women attending general practitioners. METHOD: A retrospective survey using the self-report Finkelhor Sexual Life Events Inventory and clinical reports. RESULTS: Nearly one-half of eating disordered patients reported a history of child sexual abuse and one-quarter reported child physical abuse. These rates were significantly higher than those reported by the control group. CONCLUSIONS: Direct questioning regarding trauma histories is warranted when assessing patients with eating disorders and attention to such issues should be incorporated into the total management plan.

Adolescent↗

Speciation and quantitation of underivatized and Ellman's derivatized biological thiols and disulfides by capillary electrophoresis.

Capillary electrophoresis (CE) methods have been developed for the speciation and quantitation of thiols and disulfides of biological interest, including the endogenous compounds glutathione, glutathione disulfide, cysteine, cystine, homocysteine, and homocystine and the therapeutic agents penicillamine, penicillamine disulfide, N-acetylcysteine, and captopril. Good speciation and quantitation were achieved for the underivatized thiols and disulfides using a detection wavelength of 200 nm; detection limits were in the range 20-90 microM (1-4 pmol) using a 50-microns-diameter capillary. To achieve lower detection limits, thiols were derivatized with the thiol-specific probe molecule, 5,5'-dithio-bis-(2-nitrobenzoic acid) (Ellman's reagent). Good speciation and quantitation were achieved for the Ellman's derivatized thiols using a detection wavelength of 357 nm; detection limits were in the range 5-50 microM (0.03-0.3 pmol) using a 25-microns-diameter capillary. Both the underivatized and derivatized methods were applied to the determination of glutathione in human erythrocytes. Glutathione concentrations of 2-3 mM were obtained for the erythrocyte samples analyzed, with good agreement between results obtained by the two methods.

Captopril↗

Detection of beta-human chorionic gonadotropin mRNA as a marker for cutaneous malignant melanoma.

The beta chain of human chorionic gonadotropin (hCG) hormone is produced by fetal cells, gonadal cell tumors and several types of non-gonadal carcinoma. hCG is composed of an alpha and a beta chain, the latter of which can be used to distinguish the molecule from other related gonadotropin hormones. Detection of beta-hCG mRNA transcripts can be potentially useful as a marker to identify tumor cells. We devised a highly specific and sensitive assay to detect the atavistic expression of beta-hCG in cutaneous melanoma by RT-PCR. Twenty-four melanoma cell lines and 43 melanoma biopsies were evaluated for beta-hCG mRNA expression. An RT-PCR assay was developed to specifically distinguish beta-hCG poly-A mRNA from other related gonadotropin beta chains. This was performed by endonuclease digestion of a unique Sty 1 site in the beta chain, followed by Southern blot analysis with a beta-hCG cDNA probe. Of the 24 melanoma cell lines analyzed, 18 expressed beta-hCG mRNA. Analysis of melanoma biopsy specimens revealed beta-hCG mRNA expression in 17/25 melanoma-positive TDLN, and in only 5/15 non-lymphoid melanoma metastases. Beta-hCG mRNA expression had a 53% correlation to tyrosinase mRNA, a predominant melanoma marker. Beta-hCG mRNA was not detected in normal donor PBL and normal lymph nodes. Detection of beta-hCG mRNA expression may be a useful molecular marker to define a subset of malignant melanoma.

Base Sequence↗

Insulin response in bulimia nervosa as a marker of nutritional depletion.

OBJECTIVE: The aim of this provocation study was to examine insulin, glucose, and cortisol levels in response to a glucose load in bulimia nervosa patients and to relate this to behavior, treatment status, and depressive symptomatology. METHOD: A 3-hr glucose tolerance test was performed in 15 female patients and in 4 controls. Tests were performed at different stages of treatment and following documented engagement in the patient's usual or previous repertoire of bulimic behaviors in the 24 hr prior to testing. Insulin, glucose, and cortisol levels were assayed at baseline and at 30-min intervals following the glucose load. Presence or absence of significant depressive symptomatology was ascertained. RESULTS: Three patterns of insulin response were identified: (1) an exaggerated response, (2) a normative response which resembled that of healthy controls, and (3) a blunted pattern. A reciprocal relationship between peak insulin and mean cortisol levels was seen with higher depression scores associated with blunted insulin response. Patients whose response was exaggerated binged and vomited relatively infrequently and were of stable weight. The insulin response of successfully treated patients, abstinent from binging and vomiting for 4 weeks, was similar to that of normal controls. A blunted response occurred in patients who binged and vomited more frequently, whose weight was unstable, and whose baseline eating was chaotic or nonexistent. DISCUSSION: The exaggerated insulin response was seen as a physiological adaptation to intermittent starvation reversible with treatment, while the blunted insulin response associated with higher cortisol levels was seen to result from more constant nutritional deprivation secondary to greater disturbance of behavior.

Adult↗

Doxorubicin encapsulated in liposomes containing surface-bound polyethylene glycol: pharmacokinetics, tumor localization, and safety in patients with AIDS-related Kaposi's sarcoma.

A study of the plasma pharmacokinetics, tumor localization, and safety of a single dose of doxorubicin encapsulated in liposomes containing surface-bound polyethylene glycol (PEG-liposomal doxorubicin) was conducted in patients with Kaposi's sarcoma (KS) as a manifestation of acquired immune deficiency syndrome (AIDS). Eighteen patients with AIDS-KS diagnosed by examination of biopsy specimens were randomly assigned to receive either standard doxorubicin or PEG-liposomal doxorubicin. Consecutive participants were entered at three dose levels (10, 20, and 40 mg/m2) in ascending fashion. Clearance of PEG-liposomal doxorubicin was 0.034 L/h/m2 to 0.108 L/h/m2, volume of distribution (Vd) was 2.2 L/m2 to 4.4 L/m2, and half-lives (t1/2) of the initial decline in the plasma concentration-time curve and of the terminal decline were 3.77 hours and 41.3 hours, respectively. Seventy-two hours after administration, doxorubicin levels observed in lesions of patients receiving PEG-liposomal doxorubicin were 5.2 to 11.4 times greater than those found in patients given comparable doses of standard doxorubicin. PEG-liposomal doxorubicin and standard doxorubicin were roughly equipotent in producing toxicity. Encapsulation in liposomes containing surface-bound PEG significantly limits the distribution and elimination of doxorubicin, results in greater accumulation of the drug in KS lesions 72 hours after dosing than does standard doxorubicin, and may improve drug efficacy and therapeutic index in the treatment of AIDS-KS.

Acquired Immunodeficiency Syndrome↗

Parathyroid hormone content distinguishes true normal parathyroids from parathyroids of patients with primary hyperparathyroidism.

The purpose of this study was to clarify the pathophysiology of primary hyperparathyroidism by looking for differences between parathyroids from eucalcemic patients and patients with primary hyperparathyroidism (HPT) with respect to the following parameters: intracellular parathyroid content of parathyroid hormone (PTH) and parathyroid hormone messenger RNA (PTH mRNA); and serum PTH and calcium levels of patients and patient age. Coded samples of human parathyroid biopsies were assayed for PTH content with a C-terminal-specific radioimmunoassay. Total cellular RNA was extracted, and PTH mRNA was quantified by dot-blot analysis. These results were tabulated along with associated data on patient age, preoperative serum PTH, and preoperative calcium levels. The content of PTH was significantly higher in true normal (TN) parathyroids than in parathyroids from patients with hyperparathyroidism. PTH content of adenomas and hyperplasias were similar. PTH content of normal parathyroids biopsied from patients with parathyroid adenomas (NA) was statistically higher than that of adenomas but statistically lower than that of TN parathyroids. PTH mRNA and PTH content were correlated (p < 0.001) for TN parathyroid glands; however, it was not true for glands (grossly normal or otherwise) in patients with HPT. Patient groups were similar with regard to mean patient age and intracellular PTH mRNA levels. Hypercalcemic patients were similar with regard to preoperative serum calcium and PTH levels. NA parathyroids, adenomas, and hyperplasias are different from TN parathyroids with regard to their PTH content. PTH mRNA was similar across all groups. The relation between intracellular PTH mRNA and PTH was significantly absent in patients with HPT compared with TN glands. Furthermore, we have found that PTH content of normal parathyroid in patients with adenoma is similar to that of hyperplastic and adenoma tissues. These data suggest that the PTH content of parathyroid tissues may be of use in differentiating normal from abnormal parathyroids.

Adenoma↗

Cleft palate speech dissected: a review of current knowledge and analysis.

In this review, normal speech and its development is described and compared with the patterns typical of cleft palate speech. Attention is drawn to the importance of measuring and analysing these factors adequately for research and audit purposes, and the need for agreed parameters for reporting outcomes.

Child↗

The genotype of the human cancer cell: implications for risk analysis.

An extremely large database describes genotypes associated with the human cancer phenotype and genotypes of human populations with genetic predisposition to cancer. Aspects of this database are examined from the perspective of risk analysis, and the following conclusions and hypotheses are proposed: (1) The genotypes of human cancer cells are characterized by multiple mutated genes. Each type of cancer is characterized by a set of mutated genes, a subset from a total of more than 80 genes, that varies between tissue types and between different tumors from the same tissue. No single cancer-associated gene nor carcinogenic pathway appears suitable as an overall indicator whose induction serves as a quantitative marker for risk analysis. (2) Genetic defects that predispose human populations to cancer are numerous and diverse, and provide a model for associating cancer rates with induced genetic changes. As these syndromes contribute significantly to the overall cancer rate, risk analysis should include an estimation of the effect of putative carcinogens on individuals with genetic predisposition. (3) Gene activation and inactivation events are observed in the cancer genotype at different frequencies, and the potency of carcinogens to induce these events varies significantly. There is a paradox between the observed frequency for induction of single mutational events in test systems and the frequency of multiple events in a single cancer cell, suggesting events are not independent. Quantitative prediction of cancer risk will depend on identifying rate-limiting events in carcinogenesis. Hyperproliferation and hypermutation may be such events. (4) Four sets of data suggest that hypermutation may be an important carcinogenic process. Current mechanisms of risk analysis do not properly evaluate the potency of putative carcinogens to induce the hypermutable state or to increase mutation in hypermutable cells. (5) High-dose exposure to carcinogens in model systems changes patterns of gene expression and may induce protective effects through delay in cell progression and other processes that affect mutagenesis and toxicity. Paradigms in risk analysis that require extrapolation over wide ranges of exposure levels may be flawed mechanistically and may underestimate carcinogenic effects of test agents at environmental levels. Characteristics of the human cancer genotype suggest that approaches to risk analysis must be broadened to consider the multiplicity of carcinogenic pathways and the relative roles of hyperproliferation and hypermutation. Further, estimation of risk to general human populations must consider effects on hypersusceptible individuals. The extrapolation of effects over wide exposure levels is an imprecise process.

Genetic Diseases, Inborn↗

Risk of heat-related injury to disaster relief workers in a slow-onset flood disaster.

Heat-related injury or illness (HRI) occurs when the body can no longer maintain a healthy core temperature. During the 1993 Midwest floods, several risk factors HRI were present for workers involved in sandbagging activities. Medical claims filed by Illinois National Guard troops were used to identify injuries. HRI was the most frequently reported injury diagnosis, at 19.3% (23 of 119 injuries). HRI represented 16.0% of injuries to men and 41.7% of injuries to women. HRI can be influenced by high ambient temperatures, high humidity, and prolonged exertion, all of which were present in Illinois. Our results indicate that HRI is a potential problem in disaster relief situations. Further investigation using more detailed data is needed to confirm these findings. Implementation of a few simple preventive measures may decrease the impact of this problem.

Adult↗

Working memory in children with autism and with moderate learning difficulties.

We asked whether children with autism are specifically impaired on tests of working memory. Experiment 1 showed that children with autism were at least as likely as normal children to employ articulatory rehearsal (criterion: evincing the "word length effect") and that they had superior spans to that of children with moderate learning difficulties. In Experiment 2, participants were given "capacity tasks" in order to examine group differences in the capacity of the central executive of working memory. The performance of the children with autism was inferior to that of the normally developing group and similar to that of the children with moderate learning difficulties.

Autistic Disorder↗