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Biomedical subjects

J S Cameron

Publications and source records attributed to J S Cameron.

At least 181 records · Page 10Linked to original sources
PubMed1987

Intraglomerular T cells and monocytes in nephritis: study with monoclonal antibodies.

Intraglomerular T cells, monocytes, total leucocytes and other mononuclear subsets were sought in renal biopsies from patients with glomerulonephritis, using monoclonal antibodies and immunoperoxidase techniques. Twenty-four biopsies with no significant glomerular proliferation on optical microscopy, thirty-two with only endocapillary hypercellularity, and twenty-one with extra capillary crescentic glomerular disease were studied. Few intra-glomerular leucocytes were seen in the non-proliferative group. In contrast, when compared with this group, biopsies with glomerular hypercellularity and particularly those with crescents showed increased numbers of intra-glomerular total leucocytes and monocytes/macrophages, as well as an excess of T lymphocytes and T cytotoxic/suppressor cells; T helper/inducer lymphocytes were significantly increased only in the crescentic group. Only small numbers of B lymphocytes and NK cells were found in all groups. The numbers of total glomerular T-cells and monocytes per glomerular cross section were highly correlated in the crescentic group. Only idiopathic IgA nephropathy failed to show a significant increase in the numbers of intra-glomerular leucocytes, in comparison with the non-proliferative group, Henoch-Schönlein purpura biopsies in contrast had an excess of both monocytes and T cell subsets. The finding of T lymphocytes as well as monocytes in glomeruli of proliferative nephritis suggests that cellular immune mechanisms may play a role in their pathogenesis, especially when crescents are present.

Antibodies, Monoclonal↗
PubMed1987

Rabbit nephrotoxic nephritis: effect of a thromboxane synthetase inhibitor on evolution and prostaglandin excretion.

Accelerated anti-glomerular basement membrane nephritis was induced in rabbits, and the immunological, clinical and histological evolution studied in relation to urinary immunoreactive thromboxane B2 (i-TXB2) and immunoreactive prostaglandin E2 (i-PGE2) excretion. In control nephritic animals, urinary i-TXB2 increased 5-fold on day +1, but was normal again by day +5. The urinary i-TXB2 showed a positive correlation with creatinine clearance (CCr), proteinuria and anti-sheep immunoglobulin antibody. Urinary i-PGE2 excretion increased by 50% on day +1, but was indistinguishable later from controls. The effects of the specific thromboxane synthetase inhibitor OKY-046 on this model was studied. In non-nephritic control animals, OKY-046 did not affect the CCr, the urinary protein excretion or the number of monocytes in glomeruli but reduced the excretion of i-TXB2. Although OKY-046 markedly inhibited the i-TXB2 excretion throughout the experiment in nephritic animals, the creatinine clearances were significantly worse, the proteinuria greater, and the number of infiltrating monocytes greater at day +5; by day +10 there was no difference from controls. There was no evidence that TXB2 is involved in the induction of proteinuria, and increased PGE2 synthesis did not protect against later proteinuria and fall in creatinine clearance. Inhibition of thromboxane synthetase appears to make this model of nephritis worse, rather than better.

Acrylates↗
PubMed1987

Abnormal podocyte CR-1 expression in glomerular diseases: association with glomerular cell proliferation and monocyte infiltration.

The expression of CR-1 complement receptors on glomerular epithelial cells, was studied in 77 renal biopsies from patients with (74) or without (3) glomerular diseases, employing an anti-CR-1 monoclonal antibody, and an indirect immunoperoxidase technique. Four patterns of CR-1 expression were recognised: normal (18); generally decreased (6); focal/segmental partial loss (44); and complete loss (9). Normal expression was detected in all three biopsies with non-glomerular diseases, and in glomerular diseases with normal glomeruli on light microscopy, but also in several glomerulonephritic biopsies (13), including diffuse proliferative lupus nephritis (1 of 7) and idiopathic membranous nephritis (5 of 14). However, the majority of biopsies from patients with glomerular diseases showed abnormal CR-1 expression (59 of 74), most evident in proliferative biopsies (43 of 49), with or without crescent formation (respectively, 18 of 20 and 25 of 29). Complete loss of CR-1 expression was almost restricted to crescentic biopsies (8 of 9). The abnormal CR-1 expression was unrelated to the presence of capillary immune deposits of Ig or C. More intraglomerular monocytes, assessed by monoclonal antibodies, were encountered in glomerulonephritic biopsies with partial CR-1 loss (median 6.2, P less than 0.05) or complete loss (median 14, P less than 0.03), than in biopsies with normal receptor expression (median 1.4). Thus, changes in glomerular CR-1 expression are frequently seen in many glomerular diseases and are associated with glomerular proliferative changes and monocyte infiltration, but not with the presence of capillary immune deposits.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Monoclonal↗
PubMed1987

Platelet hyperaggregability in the nephrotic syndrome which is not dependent on arachidonic acid metabolism or on plasma albumin concentration.

In 20 patients with nephrotic syndrome we confirm previous findings of in vitro platelet hyperaggregability to arachidonic acid, and describe similar hyperaggregability to ristocetin. As previously reported also, the addition of albumin to nephrotic platelet-rich plasmas corrected platelet hyperaggregability to arachidonic acid, but exerted little effect on ristocetin-induced aggregation, and there was no correlation between platelet aggregation thresholds to arachidonate and to ristocetin. Incubation with indomethacin abolished the generation of thromboxane B2 after stimulation with arachidonate, but had no effect on the stimulation with ristocetin, during which no TxB2 was produced. The nephrotic patients had elevated factor VIII-related antigen (Factor VIII R:Ag) concentrations in their plasma, but in addition both decreased serum IgG and platelet-associated IgG were found which were correlated. The hyperaggregability of nephrotic platelets to ristocetin may relate to the elevated factor VIII R:Ag levels, or to the low platelet-associated IgG, since platelet IgG Fc receptors and von Willebrand factor receptors are spatially close or identical.

Adult↗
PubMed1987

Histopathological changes in cyclosporin-treated renal allografts biopsied at one and twelve months.

Forty-four renal allograft recipients were biopsied routinely one month and one year after transplantation. All patients received cyclosporin and prednisolone. Fifteen patients had at least one rejection episode, while 29 patients never underwent rejection. At one year there were no specific histological features that enabled these two groups to be distinguished. Between one month and one year, interstitial cellular infiltrate and vascular pathology regressed, and renal function steadily improved. Interstitial fibrosis, however, was either unchanged or mildly increased in all patients. There was no correlation between the amount of interstitial fibrosis at one year and either the total dose of cyclosporin or the mean concentration during the first 3 months. Our results suggest that trough, whole blood cyclosporin concentrations, at the upper level of the therapeutic range (800-200 ng/ml), may be safely tolerated during the first 3 months, with little evidence of chronic damage at one year. At one year maintenance doses of cyclosporin can be achieved that are associated with almost normal plasma creatinine concentrations and minimal tubular atrophy and interstitial fibrosis. We expect that such doses may be continued indefinitely.

Adolescent↗
PubMed1987

Clinical applications of crossed immunoelectrophoresis to the study of complement activation.

The purpose of our study was to set up a reliable method for the measurement of complement activation by adapting the method of crossed immunoelectrophoresis. We utilised anti C3 antiserum and barbitone buffer, containing sufficient EDTA to prevent in vitro activation of complement. We studied 44 patients undergoing open heart surgery, with cardiopulmonary bypass (CPB) by the analysis of plasma samples taken during the operation, and also samples of plasma and dialysate effluent from patients with end stage renal failure undergoing continuous ambulatory peritoneal dialysis (CAPD). Measurements were also carried out on stored blood, aged serum and serum treated with varying doses of lipopolysaccharide (LPS). Complement activation occurs in 95% of patients during CPB with levels ranging from less than 4.5% to 11.3% of total C3, but there was no detectable activation in any pre-bypass sample. Negligible complement activation occurs in the plasma of CAPD patients, but the dialysate effluent gave results from undetectable levels to 31.7%, in the absence of clinical peritonitis. Variable in vitro complement activation occurs in aged serum, but it was not detectable in stored blood. Serum treated with LPS showed levels of activation directly proportional to the dose of LPS and measurable at a level of 0.1 microgram/ml of serum. The method had a coefficient of variation of 4.5%, and provides a reliable way of measuring complement activation in clinical situations such as cardiopulmonary bypass and peritoneal dialysis.

Cardiopulmonary Bypass↗
PubMed1987

Trial of platelet-derived growth factor antagonist, trapidil, in accelerated nephrotoxic nephritis in the rabbit.

The platelet-derived growth factor (PDGF) antagonist, trapidil, which also blocks the thromboxane and/or PG-endoperoxide receptor and is an inhibitor of thromboxane synthetase, was administered during rabbit accelerated nephrotoxic nephritis; the clinical and histological evolution was studied as well as urinary immunoreactive thromboxane (i-TXB2) and immunoreactive prostaglandin E2 (i-PGE2) excretion. Although the dose we used has been shown to be effective in vivo, and it inhibited the urinary i-TXB2 excretion on days 5 and 10, it neither inhibited the enhanced production of i-TXB2 on day 1, nor prevented the glomerular influx of monocytes on days 5 and 10. All clinical and histological data tend to be worse rather than better in trapidil-treated animals on days 5 and 10.

Animals↗
PubMed1986

Allopurinol in renal failure and the tumour lysis syndrome.

This paper illustrates several important points relating to the use of allopurinol in renal failure, or situations of purine overproduction: It is very easy to give too much allopurinol. Most of the side effects (bone marrow depression, exfoliative dermatitis, etc) are the result of overdosage due to the retention of oxipurinol, an effect exaggerated by thiazide diuretics. Monitoring of plasma oxipurinol levels (ideally less than 100 mumol/l) by high-pressure liquid chromatography is helpful for adjusting dosage in renal failure. Some estimate of the anticipated purine excess is equally vital in deciding dosage during tumour lysis if the risk of urate nephropathy is not to be substituted for the certainty of xanthine nephropathy. In this situation the use of allopurinol may even be questioned. Patients with HGPRT deficiency are exquisitely sensitive to allopurinol, and careful monitoring of the effect on urinary purine levels is essential if xanthine colic is to be avoided.

Adult↗
PubMed1986

Treatment of end-stage renal failure due to diabetes in the United Kingdom, 1975-84.

In 1975-84 762 new patients with end-stage renal failure (ESRF) due to diabetes mellitus were accepted onto renal replacement programmes in the United Kingdom. They formed 5.7% of the total intake of ESRF patients. This proportion rose from 1.4% in 1975 to 11.1% in 1984. 4.1% of the patients on renal replacement therapy at the end of 1984 were reported as having ESRF due to diabetic nephropathy. During 1983-84, 272 patients taken on were type I (76%) and 87 (24%) were type II diabetics. Continuous ambulatory peritoneal dialysis (CAPD) was most popular as both initial (51%, plus 24% on intermittent peritoneal dialysis in 1983-84) and long-term treatment (48% of 446 under treatment at Dec 31, 1984); 163 patients (36.5%) had successful allografts, and only 14% of patients were on haemodialysis. Actuarial survival was 49% at 3 years, irrespective of type of treatment; the death rate for type II diabetics approached the intake rate in 1983-84. There was considerable regional variation in the numbers of diabetics on treatment. Even though the proportion of diabetics entering British end-stage renal failure programmes is rising, many patients who may benefit from treatment are probably not receiving it.

Actuarial Analysis↗
PubMed1986

Clinical and immunological evolution of oligoanuric anti-GBM nephritis treated by haemodialysis.

Eight patients with oligoanuric anti-glomerular-basement-membrane (GBM), antibody-mediated glomerulonephritis without lung haemorrhage who were not treated with plasma exchange therapy were reviewed. All had severe crescentic nephritis and required dialysis. Circulating anti-GBM antibodies disappeared gradually and spontaneously in all patients. The autoantibodies became undetectable in five patients after an average of 11 months. No patient recovered renal function. Two patients have been successfully transplanted and anti-GBM nephritis has not recurred. One of these needed a pre-transplant course of plasma exchange and immunosuppression to reduce a slightly raised anti-GBM antibody titre. Of five patients who remain on dialysis, only two cannot be transplanted due to the persistence of circulating autoantibodies. One patient died from causes unrelated to renal disease. Oligoanuric patients with anti-GBM nephritis who need dialysis rarely benefit from aggressive therapy unless lung haemorrhage is present.

Acute Disease↗
PubMed1986

Effects of tocainide on Purkinje fibers from normal and infarcted ventricular tissues.

The left anterior descending coronary artery was occluded in anesthetized dogs. Dogs were sacrificed after 24 hours and the experimental preparations, which included both normal and infarcted tissues, were dissected from the left ventricles. Effects of tocainide in concentrations of 15-40 mg/l on action potentials of Purkinje fibers from normal and infarcted zones were studied using conventional microelectrode techniques. In the normal zone cells, tocainide superfusion produced a significant decrease in maximum diastolic potential, action potential amplitude, action potential duration to 50% and 90% repolarization and the rate of phase O depolarization, and no significant change in effective and functional refractory periods. In the infarct zone cells, it produced a significant decrease in action potential amplitude and the rate of phase O depolarization, a significant increase in effective and functional refractory periods, and no significant changes in the other parameters. The unequal actions of tocainide resulted in selective depression of maximum diastolic potential and action potential duration to 50% repolarization in the normal cells only, reducing the disparity in these parameters between normal and infarcted tissues. Tocainide increased the refractoriness (ratio of effective refractory period to action potential duration) in both cell types but this change was greater in the infarct zone. This decreased disparity of membrane potential and repolarization combined with increased refractoriness may help to block the arrhythmias observed in infarcted preparations following closely coupled stimuli.

Animals↗
PubMed1986

Systemic hypertension induces disparate localized left ventricular action potential lengthening and altered sensitivity to verapamil in left ventricular myocardium.

Previously, we demonstrated that acute exposure to superfusate containing verapamil suppresses action potential plateau to a greater degree in cells at the tip of the anterior papillary muscle compared to those at its base in normal cat left ventricle (LV) studied in tissue bath. To determine the effects of chronic pressure overload brought about by renal hypertension on papillary muscle electrophysiology and regional sensitivity to verapamil, LV were isolated from cats subjected to unilateral nephrectomy and contralateral kidney wrapping. After 3 months, systemic hypertension (mean increase = 60.2 +/- 1.4 mmHg) was associated with moderate LV hypertrophy of approximately equal to 18% (LV weight/body weight). Transmembrane action potentials recorded from the endocardial surface (including anterior papillary muscle) in pressure overloaded LV in vitro (800 ms stimulus cycle length) showed increased action potential duration at 25, 75 and 90% of repolarization (APD25, APD75 and APD90, respectively) relative to controls (LV from normal and sham operated cats). With respect to the anterior papillary muscle in pressure overloaded LV, APD25, APD75 and APD90 were increased to a greater extent in cells at the base of the muscle compared to those increases observed at the tip (P less than 0.05). In contrast to its effects in controls, verapamil (2 micrograms/ml) significantly reduced APD25 at both the base and the tip of the papillary muscle in pressure overloaded preparations, but particularly at the base; also, the disparities between the APD75 or APD90 at tip and base were decreased. Thus, regional electrophysiologic disparities were induced in systemic hypertension, and these differences were subsequently reduced by verapamil.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1986

Regional reduction in ventricular norepinephrine after healing of experimental myocardial infarction in cats.

Regional ventricular norepinephrine and myosin heavy chain concentrations were measured in two models of healed left ventricular myocardial infarction in cats. One model was characterized by a well-defined dense transmural scar (discrete myocardial infarction), while the other demonstrated a pattern of nontransmural diffuse patchy fibrosis in the infarct area (diffuse myocardial infarction). Norepinephrine and myosin heavy chain concentrations were measured in the scarred area, the non-infarcted zone surrounding the scar(s), and in sites remote from the scar. Corresponding tissue sites from unoperated animals and sham operated animals served as controls. Myosin heavy chain concentration was used as an index of surviving muscle mass to express norepinephrine concentration. Norepinephrine concentration, as a function of crude tissue mass, was significantly reduced in both the scarred tissues and the non-scarred tissues surrounding the scar in the discrete infarction model but was significantly reduced only in non-scarred tissues adjacent to the dense scar when expressed as a function of myosin heavy chain. The heavily scarred area of the discrete preparation approached normal values when corrected for myosin heavy chain content. The diffuse infarct preparation demonstrated normal norepinephrine concentration at all three sites studied, whether expressed as a function of tissue mass or myosin heavy chain. These data indicate a long-term regional reduction in norepinephrine concentration specific to non-infarcted tissues adjacent to a dense transmural myocardial infarction scar. This regional reduction in norepinephrine concentration corresponds to reported regions of increased sensitivity to sympathetic nerve stimulation in the discrete myocardial infarction model.

Animals↗
PubMed1986

Intracavernous drug-induced erections in the management of male erectile dysfunction: experience with 100 patients.

A total of 100 men with organic impotence underwent a trial of intracavernous drug-induced erections with a mixture of papaverine (25 mg./ml.) and phentolamine (0.8 mg./ml.). The response rates, that is functional erections, were 100 per cent in patients with neurogenic impotence, 65.7 per cent in those with vasculogenic impotence, 90 per cent in the undetermined group and 64.7 per cent in the neurogenic/vascular impotence group. Of the responders 79.5 per cent elected to practice self-injection as a method to restore erectile function. The dose required to obtain functional erections in the purely neurogenic impotence group was significantly lower than that required in other groups. Complications were few and included 4 patients with sustained erections that required intervention. Intracavernous injection of vasoactive drugs appears to have promising value in the treatment and differential diagnosis of erectile dysfunction.

Adult↗
PubMed1986

Cellular electrophysiologic changes and "arrhythmias" during experimental ischemia and reperfusion in isolated cat ventricular myocardium.

The cellular electrophysiologic consequences of both regional and global experimental ischemia and reperfusion were studied in the isolated cat myocardium, using conventional microelectrode techniques. Oxygenated Tyrode's solution was perfused through the left anterior descending and circumflex coronary arteries, while the preparation was superfused with Tyrode's solution gassed with 95% nitrogen and 5% carbon dioxide. Electrophysiologic characteristics of endocardial muscle cells were normal during coronary perfusion. When perfusion was discontinued for 30 minutes, resting membrane potential was decreased by 21.6 +/- 4.1%, action potential amplitude was decreased by 29.1 +/- 8.6% and action potential duration was decreased by 54.1 +/- 12.5% (p less than 0.001). Ectopic activity occurred after 5 to 10 minutes of ischemia and was more frequent in regional than in global ischemia (p less than 0.05). Rapid ventricular activity was observed in only 5 (17%) of 29 preparations during ischemia, whereas it occurred in 24 (83%) of 29 preparations during reperfusion. Rapid ventricular activity began 5 to 40 seconds (mean 19) after the start of reperfusion, stopped spontaneously after a mean of 113 +/- 211 seconds and occurred after both regional and global ischemia. The cellular electrophysiologic changes induced by ischemia returned to baseline values within the next 5 minutes. Repeated ischemia and reperfusion runs reproduced the same electrophysiologic changes and rapid ventricular activity. Coronary perfusion with procainamide (20 mg/liter) aggravated the ischemic depressions of action potential amplitude and action potential duration and increased conduction delay during ischemia, but it did not prevent rapid ventricular activity induced by reperfusion. In contrast, verapamil (1 mg/liter) perfusion did not affect the changes in action potential variables during ischemia but prevented reperfusion-induced rapid ventricular activity. Perfusion with calcium ion (Ca2+)-free Tyrode's solution just before ischemia and during reperfusion slowed or prevented reperfusion-induced rapid ventricular activity, without affecting the action potential changes during ischemia. It is concluded that, in these isolated perfused ventricular muscle preparations, different mechanisms may be operative in ischemic and reperfusion arrhythmias and Ca2+ may play an important role in the development of arrhythmias during the reperfusion phase of ischemia/reperfusion sequences.

Action Potentials↗