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Biomedical subjects

J S Samra

Publications and source records attributed to J S Samra.

At least 37 records · Page 2Linked to original sources
PubMed1996

Interstitial glycerol concentration in human skeletal muscle and adipose tissue is close to the concentration in blood.

1. The suggestion that the interstitial glycerol concentration in both adipose tissue and skeletal muscle is around 3 mmol/I (Maggs DG, Jacob R, Rife F, et al. J Clin Invest 1995; 96: 370-7), rather than close to the blood concentration as previously supposed, was tested by independent methods. 2. Free glycerol was infused, as part of a triacylglycerol emulsion, into six normal subjects and the arteriovenous difference for glycerol across the forearm was measured. In addition the relative interstitial glycerol concentration in subcutaneous adipose tissue was assessed simultaneously in four of the subjects by microdialysis. 3. During glycerol infusion the arterialized glycerol concentration rose from 52 +/- 5 mumol/I to 250-300 mumol/I (P < 0.001) in a square wave fashion. The net arteriovenous difference for glycerol across the forearm changed from negative (output) to positive (uptake) (P < 0.01). In subcutaneous adipose tissue the interstitial glycerol concentration rose during glycerol infusion (P < 0.001). 4. These observations are most easily explained by the movement of glycerol from plasma to interstitial fluid down a concentration gradient. We conclude that the interstitial glycerol concentration in skeletal muscle and adipose tissue is closer to the arterial concentration than to 3 mmol/I.

Adipose Tissue↗
PubMed1996

Effects of adrenaline infusion on the interstitial environment of subcutaneous adipose tissue as studied by microdialysis.

1. Adrenaline was infused at a rate of 25 ng min-1 kg-1 into seven healthy volunteers and its effects on adipose tissue were studied by microdialysis. 2. Adrenaline infusion led to a rapid rise in plasma adrenaline concentration from a basal value of 0.15 +/- 0.03 nmol/l to a peak value of 1.82 +/- 0.15 nmol/l within 30 min (analysis of variance: P < 0.001). Plasma noradrenaline levels increased from the basal value of 1.48 +/- 0.21 nmol/l to 1.78 +/- 0.20 nmol/l within 30 min of infusion (analysis of variance: P < 0.05). Once the infusion was stopped the plasma adrenaline and noradrenaline levels returned to basal values within 15 min. 3. The arterialized blood glycerol concentration increased from the basal value of 47 +/- 6 mumol/l to 101 +/- 8 mumol/l (analysis of variance: P < 0.001), and the interstitial glycerol concentration increased from 181 +/- 17 mumol/l to 350 +/- 47 mumol/l (analysis of variance: P < 0.001) within 30 min of adrenaline infusion. Thereafter the concentrations declined gradually towards basal values. When the infusion was discontinued the levels declined further, below the basal value. 4. Adrenaline infusion caused a significant increase in the plasma glucose and blood lactate concentration (analysis of variance: P < 0.001 and P < 0.001), but no such effect was observed in the interstitial concentrations. 5. The basal dialysate concentrations of adrenaline and noradrenaline were 43 +/- 37 pmol/l and 1170 +/- 430 pmol/l respectively. There were difficulties in estimating the absolute interstitial concentrations of adrenaline and noradrenaline which are discussed. The dialysate adrenaline concentration increased to a peak value of 112 +/- 48 pmol/l (analysis of variance: P < 0.05) within 30 min. The dialysate noradrenaline concentration increased to a peak value of 2830 +/- 1470 pmol/l, but the rise was not significant. 6. These results show that the interstitial concentrations of metabolites and hormones can be significantly different from those of blood and plasma and these differences reflect tissue specialization.

Adipose Tissue↗
PubMed1996

Subcutaneous abdominal adipose tissue blood flow: variation within and between subjects and relationship to obesity.

1. We assessed the variation in subcutaneous abdominal adipose tissue blood flow within and between subjects and investigated whether it is correlated with body mass index. 2. We measured body mass index and subcutaneous abdominal adipose tissue blood flow in 38 fasting subjects on the same day and on different days and, in a subgroup of 16 subjects, after a mixed meal. 3. In 190 measurements in the fasted state, subcutaneous abdominal adipose tissue blood flow was significantly more variable between subjects than could be accounted for by the within-subject variation alone. Subcutaneous abdominal adipose tissue blood flow was also significantly more variable between days within subjects than could be accounted for by within-day variation alone. Fasting and post-prandial subcutaneous abdominal adipose tissue blood flow were negatively correlated with body mass index, as was the post-prandial rise in subcutaneous abdominal adipose tissue blood flow. Multiple regression analysis showed that fasting blood flow was not dependent on insulin concentration after allowing for body mass index. There was no correlation between post-prandial subcutaneous abdominal adipose tissue blood flow and insulin concentration. 4. Insulin does not appear to have a direct vasodilatory effect in subcutaneous adipose tissue. Obese subjects have lower fasting and post-prandial subcutaneous abdominal adipose tissue blood flow. This may be because of a blunted response to sympathetic stimulation, or it may be another aspect of the insulin-resistant state.

Abdomen↗
PubMed1996

Is the growth hormone concentration regulated by the morning rise in the plasma cortisol concentration?

Exogenous steroids affect plasma growth hormone (GH) concentrations and hypothalamic somatostatin levels either directly, by stimulating the anterior pituitary gland, or indirectly by partially inhibiting the response of the pituitary gland to stimuli. The effect of the circadian rhythm of cortisol on plasma GH concentrations is unknown. In normal subjects, highest plasma GH concentrations are recorded within the first two hours of onset of sleep. During the early morning the plasma GH concentration decreases and the plasma cortisol concentration increases. We investigated the effect of the early morning rise in plasma cortisol concentration on plasma GH concentrations. We studied 12 healthy volunteers on two occasions. On one occasion the early morning rise in plasma cortisol concentrations was reduced by administering metyrapone (750 mg, 4 hourly from 03.00), while on the other occasion no intervention was made. Plasma GH and cortisol concentrations were measured every 30 and 60 minutes respectively from 22.00 until 14.00. Metyrapone caused a significant reduction in the rise of plasma cortisol concentration, but the GH concentration was identical on both occasions. We conclude that the morning rise in cortisol concentration has no acute regulatory effect on the plasma GH concentration.

Adult↗
PubMed1996

Postprandial lipemia: the origin of an early peak studied by specific dietary fatty acid intake during sequential meals.

Previous studies have noted the presence of an early postprandial peak in plasma triacylglycerol concentration, particularly when successive meals have been consumed. We tested the hypothesis that fat from a previous meal contributes to this early postprandial lipemia. We investigated the effect of consuming a lunch containing 61 g fat 5 h after a breakfast containing 54 g fat. The predominant fatty acids in the first meal, expressed as % by wt of total fatty acids, were 18:2 (linoleic acid), 68%, and 18:1 (oleic acid), 19%. The main fatty acids in the second meal were 18:1 (75%) and 18:2 (8%). After lunch, the early peak (at 50-60 min) in chylomicron triacylglycerol was found to contain a large proportion of 18:2, the main constituent of the first meal, whereas at later time points the chylomicron triacylglycerol fatty acid profile more closely resembled that of the second meal. Control studies in three subjects showed the complete absence of the early peaks in plasma and chylomicron triacylglycerol concentrations when either the lunch was omitted or the first meal was low in fat. The plasma nonesterified fatty acid profile also showed a corresponding peak in 18:2 at 50-60 min, which may represent the release into the plasma of fatty acids arising from the hydrolysis of chylomicron triacylglycerol by adipose tissue lipoprotein lipase.

Adult↗
PubMed1996

Regulation of lipid metabolism in adipose tissue during early starvation.

We studied changes in lipid metabolism in adipose tissue in 24 healthy adults during early starvation (14-20 h) by cannulating the venous drainage of the subcutaneous adipose tissue of the anterior abdominal wall. Net nonesterified fatty acid (NEFA) efflux from adipose tissue increased steadily from 1,790 +/- 300 to 2,360 +/- 290 nmol.100 g-1.min-1 (P = 0.03), due to increasing transcapillary efflux of NEFA (release from adipocytes; P < 0.01). The reesterification rate after an overnight fast was close to zero; thus, reduction in the rate of reesterification played no part in the increased transcapillary efflux of NEFA. One-quarter of the net efflux of NEFA after an overnight fast arose from the action of lipoprotein lipase (LPL), although this relative contribution decreased during the study (P < 0.02). The increased transcapillary efflux of NEFA reflected a significant increase in the rate of action of hormone-sensitive lipase (HSL; P = 0.03). There was a strong relationship between mean arterial NEFA concentration and net NEFA release from adipose tissue (P < 0.001), implying that the particular depot studied reflects the behavior of adipose tissue as a whole. Thus the increasing efflux of NEFA from adipose tissue observed during early starvation is due to an increased rate of action of HSL, which may in turn be regulated by a fall in the plasma insulin concentration.

Adipose Tissue↗
PubMed1996

Effects of epinephrine infusion on adipose tissue: interactions between blood flow and lipid metabolism.

Epinephrine has effects on both blood flow and metabolism in adipose tissue. To investigate how these effects might interact in vivo, epinephrine was infused into six healthy volunteers at a rate of 25 ng.kg-1.min-1. The rates of action of lipoprotein lipase and hormone-sensitive lipase in adipose tissue were calculated by measurement of arteriovenous differences across subcutaneous abdominal adipose tissue, and adipose tissue blood flow was measured. Epinephrine caused a significant rise in adipose tissue blood flow (P < 0.001), and the net efflux of nonesterified fatty acids (NEFA) from adipose tissue increased significantly (P < 0.05). Most of this efflux could be accounted for by hormone-sensitive lipase-derived NEFA efflux from cells (P < 0.05), but there was also a significant rise in the contribution of lipoprotein lipase-derived NEFA (P < 0.05). We conclude that adipose tissue blood flow plays an important role in the regulation of lipid metabolism, controlling substrate presentation for lipoprotein lipase and also preventing the local accumulation of fatty acids derived from both hormone-sensitive lipase and lipoprotein lipase.

Adipose Tissue↗
PubMed1996

Effects of morning rise in cortisol concentration on regulation of lipolysis in subcutaneous adipose tissue.

Cortisol has a well-defined circadian rhythm. The aim of the study was to examine the effect of the morning rise in cortisol concentration on lipolysis in adipose tissue. Ten healthy subjects were studied on two occasions, and six of these were studied on three occasions. During the first two occasions, either a control or cortisol suppression study was performed by using metyrapone, and on the third occasion exogenous cortisol replacement was given in addition to metyrapone. Lipolysis in the subcutaneous adipose tissue of the anterior abdominal wall was studied by measurement of arteriovenous differences. Reduction in the early morning rise in cortisol led to significantly decreased venoarterialized differences for nonesterified fatty acids (P < 0.05) and glycerol (P < 0.01), attributable in part to decreased hormone-sensitive lipase (EC 3.1.1.3) action (P < 0.05) in adipose tissue. At the same time the arterialized plasma triacylglycerol concentration increased (P < 0.005) with a significant reduction in the adipose lipoprotein lipase (EC 3.1.1.34) rate of action (P < 0.05). In the replacement study, values were identical to those of the control study, showing that metyrapone had no nonspecific effects on lipolysis. We conclude that the morning rise in plasma cortisol concentration plays an important role in the regulation of lipolysis in adipose tissue in normal healthy adults.

Adipose Tissue↗
PubMed1996

Release of individual fatty acids from human adipose tissue in vivo after an overnight fast.

The objective of this study was to investigate the mobilization of individual fatty acids from human subcutaneous adipose tissue in vivo. Concentrations of individual non-esterified fatty acids were measured in arterialized plasma and in the venous drainage from subcutaneous abdominal adipose tissue in eight normal subjects, after an overnight fast, and for the subsequent 6 h. Whilst the veno-arterial concentration difference for non-esterified fatty acids increased over this period, the relative proportions of different fatty acids remained constant. There was a close relationship between veno-arterial difference and arterialized concentration for the different fatty acids. The arterialized concentration of stearic acid consistently lay above the regression line drawn for unsaturated fatty acids (P = 0.001), probably reflecting lower clearance of stearic acid. The release of individual fatty acids was compared with their prevalence in adipose tissue triacylglycerol in biopsies taken from six subjects. Relative release decreased with increasing chain length, and for a given chain length increased with increasing unsaturation, in agreement with animal studies (P < 0.001 for differences in relative mobilization according to these two factors). The results suggest that the systemic plasma concentration of individual non-esterified fatty acids is determined by their release from adipose tissue, but that the relationship between release and systemic concentration for stearic acid is different from that for other fatty acids. The results confirm, in humans, differences in relative mobilization found previously in animal studies.

Adipose Tissue↗
PubMed1996

Sepsis and fat metabolism.

Sepsis is a common surgical problem which can induce profound changes in the plasma concentrations of cytokines and hormones, leading to a catabolic state. Hypertriglyceridaemia and increased fat oxidation are the main features of altered fat metabolism encountered in this state. The endogenous catabolism of sepsis can be reduced by administering exogenous lipid emulsions as a source of metabolic fuel, although the changes in lipid metabolism associated with sepsis may affect the handling of these exogenous lipids. An exciting area for future research is an examination of the ability of lipid emulsions to reduce the morbidity and mortality associated with sepsis by altering immune responses, in addition to limiting catabolism.

Adipose Tissue↗
PubMed1995

Modification and validation of a commercially available portable detector for measurement of adipose tissue blood flow.

Adipose tissue blood flow is measured from the clearance of radioactive xenon from a depot. Traditionally, a NaI detector has been used to measure the residual depot of xenon. However, this is sensitive to movement artefacts. We tested a commercially available lightweight CsI detector which can be strapped to the anterior abdominal wall. In pilot studies the CsI detector produced higher values for adipose tissue blood flow than did a conventional NaI detector. It was modified by inclusion of spacers to distance it from the skin. Flow results generated by the modified detector were similar to those generated by the NaI detector, both after an overnight fast and during the increased blood flow after a meal. Individual decay patterns generated by the CsI detector were, however, significantly smoother than those from the NaI detector.

Abdominal Muscles↗
PubMed1990

The second twin.

Explore the source record for details and available documents.

Cesarean Section↗
PubMed1990

Caesarean section for the birth of the second twin.

Twin pregnancies delivered after 28 weeks gestation between 1980 and 1988 were reviewed. Of 510 twin pregnancies, 184 (36%) were delivered by caesarean section. There were 22 (4.3%) combined vaginal/abdominal deliveries which comprised 12% of the 184 twin pregnancies delivered by caesarean section. Persistent transverse lie or a high breech presentation was the commonest indication for caesarean section for the second twin.

Breech Presentation↗