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Biomedical subjects

K Browne

Publications and source records attributed to K Browne.

At least 19 recordsLinked to original sources

Familial mesothelioma. Details of 17 cases with histopathologic findings and mineral analysis.

Nine new cases of mesothelioma clustering in four families are described, and additional information is provided on four previously reported families. All of the members of these families had some exposure to asbestos. Diagnoses were confirmed histologically, and the relevance of the histologic pattern is discussed after the literature review. The lung mineral fiber burden was quantified in patients by transmission electron microscopic examination and energy-dispersive x-ray analysis, and this confirmed significant exposure to amphibole asbestos in all patients. Evidence supporting an increased incidence of mesothelioma in family members is discussed.

Aged

Effect of external beam irradiation on neointimal hyperplasia after experimental coronary artery injury.

Human coronary artery restenosis after percutaneous revascularization is a response to mechanical injury. Smooth muscle cell proliferation is a major component of restenosis, resulting in obstructive neointimal hyperplasia. Because ionizing radiation inhibits cellular proliferation, this study tested in a porcine coronary injury model the hypothesis that the hyperplastic response to coronary artery injury would be attenuated by X-irradiation. Deep arterial injury was produced in 37 porcine left anterior descending coronary artery segments with overexpanded, percutaneously delivered tantalum wire coils. Three groups of pigs were irradiated with 300-kV X-rays after coil injury: Group I (n = 10), 400 cGy at 1 day; Group II (n = 10), 400 cGy at 1 day and 400 cGy at 4 days and Group III (n = 9), 800 cGy at 1 day. Eight pigs in the control group underwent identical injury but received no radiation. Treatment efficacy was histologically assessed by measuring neointimal thickness and percent area stenosis. Mean neointimal thickness in all irradiated groups was significantly higher than in the control groups and thickness was proportional to X-ray dose. X-irradiation delivered at these doses and times did not inhibit proliferative neointima. Rather, it accentuated the neointimal response to acute arterial injury and may have potentiated that injury.

Angioplasty, Balloon, Coronary

Asbestos-related mesothelioma: evidence for a threshold in animals and humans.

A threshold for mesothelioma for the major asbestos fiber types becomes not only plausible but also very likely in view of the existence of a distinct background incidence of spontaneously occurring and non-asbestos-related mesotheliomas; the high occupational doses associated with the appearance of mesotheliomas in humans; and the large number of "tumorigenic" fibers required to produce significant numbers of mesotheliomas in animals. Even when the duration of exposure associated with the appearance of mesotheliomas in humans has been brief, the exposure itself has been intense. The review of the relevant animal and human literature cited herein supports the concept of mesothelioma threshold.

Animals

Mechanisms of hypochlorite injury of target cells.

HOCl, which is produced by the action of myeloperoxidase during the respiratory burst of stimulated neutrophils, was used as a cytotoxic reagent in P388D1 cells. Low concentrations of HOCl (10-20 microM) caused oxidation of plasma membrane sulfhydryls determined as decreased binding of iodoacetylated phycoerythrin. These same low concentrations of HOCl caused disturbance of various plasma membrane functions: they inactivated glucose and aminoisobutyric acid uptake, caused loss of cellular K+, and an increase in cell volume. It is likely that these changes were the consequence of plasma membrane SH-oxidation, since similar effects were observed with para-chloromercuriphenylsulfonate (pCMBS), a sulfhydryl reagent acting at the cell surface. Given in combination pCMBS and HOCl showed an additive effect. Higher doses of HOCl (greater than 50 microM) led to general oxidation of -SH, methionine and tryptophan residues, and formation of protein carbonyls. HOCl-induced loss of ATP and undegraded NAD was closely followed by cell lysis. In contrast, NAD degradation and ATP depletion caused by H2O2 preceded cell death by several hours. Formation of DNA strand breaks, a major factor of H2O2-induced injury, was not observed with HOCl. Thus targets of HOCl were distinct from those of H2O2 with the exception of glyceraldehyde-3-phosphate dehydrogenase, which was inactivated by both oxidants.

Animals

Pseudo-occupational asthma.

A case is reported in which a pattern of work related asthma in a record of peak expiratory flow was artefactual. The patient had pronounced morning dips, which she recorded on working days, when she made the first recording at 0700 h, but not on holiday, when she stayed in bed longer. The case emphasises the need for clear instructions to patients about peak flow records.

Asthma

The health visitor's role in screening for child abuse.

Health visitors have a vital role in identifying potential child abuse in high-risk families. Screening should be in three stages over the first nine months of the child's life; looking first at the broad checklist of social factors, later at the parents' perceptions of their child and family stress, and later still at the infant's behaviour and attachment. The abusive pattern is set in the first year. We need to intervene very early in parenting if we are going to have a preventive effect.

Child Abuse

International classification trial of AIA set of 100 radiographs of asbestos workers.

A series of 100 full size radiographs illustrating the range of asbestos related radiographic changes was collected by the Asbestos International Association to provide a demonstration and teaching supplement to the ILO 1980 International Classification of the Radiographic Appearances of Pneumoconioses. Each film was read by 12 experienced readers from ten countries; the readings have been summarised by a median reading, with the range covered by two thirds of the readers. The occupational histories and some relevant clinical information are also available. It is proposed that, in the use of this set, readers should classify each film using the ILO classification rules, particularly without reference to the summary reading or the additional information. Comparing the individual readings by the 12 readers, most of the variation in reading the profusion of small opacities was ascribable only to random variation, with little consistent bias between readers. By contrast, two readers recorded pleural changes much more frequently than their colleagues. This illustrated a major problem with the ILO 1980 Classification. Several others which occurred in this reading trial are also discussed.

Asbestos

Hyposensitisation in the management of recurring vaginal candidiasis.

Hyposensitisation with a commercially available antigen has been attempted in the treatment of women suffering from recurring monilial vaginitis. Ten women entered the trial, each being used as her own control. Eight of them showed undoubted improvement and the average interval between relapses increased from 5.1 to 15.7 months (p. less than .01). Reasons are given for believing that allergic reactions play a part in recurrent vaginal thrush.

Adult

Isolation of Mycoplasma hominis from blood cultures in patients with postpartum fever.

Eight women with postpartum fever are presented in whom Mycoplasma hominis was isolated from cultures of their blood. Clinical disease consisted of a mild although often prolonged febrile illness, and all but one recovered without appropriate antimicrobial therapy. Five patients demonstrated elevated convalescent titers of mycoplasmacidal antibodies. The isolates of M. hominis were recovered from routine blood cultures in the diagnostic bacteriology laboratory using blind subcultures to blood agar plates. These cases lend support to the concept that endometritis with M. hominis is a cause of postpartum fever and suggest that these organisms may be recovered with increased frequency if minor changes in standard bacteriologic technique are introduced.

Bacteriological Techniques