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Biomedical subjects

K Cooper

Publications and source records attributed to K Cooper.

At least 91 records · Page 5Linked to original sources
PubMed1996

Morphologic alterations in esophageal squamous cell carcinoma after preoperative high dose rate intraluminal brachytherapy.

BACKGROUND: Total esophagectomy specimens from 4 patients given preoperative high dose rate intraluminal brachytherapy (HDRILBT) of 20 Gray (GY) in 2 fractions of 10 Gy each week were reviewed for radiation changes. METHODS: In all patients, preoperative biopsy specimens showed moderate to poorly differentiated squamous cell carcinoma with minimal to negligible keratin production. The esophagectomy specimens were sampled at the resection margins, the edge of irradiated length, 1 cm from the proximal and distal edge of visible tumor, the center of the tumor, and the lymph nodes. RESULTS: Radiation change in the form of fibrosis was limited to the submucosa at the resection margins, the circular muscle layer at the edge of irradiated length, and full thickness at 1 cm from the edge of the visible tumor and the center of the tumor. Surface epithelium did not show any changes at the resection margins but did show basal cell hyperplasia at the edge of the irradiated length and ulceration at 1 cm from the edge of the visible tumor and the center of the tumor. Endarteritis obliterans was seen only 1 cm from the edge of the visible tumor and the center of the tumor. Necrosis, intense keratin formation, and giant cell reaction were observed at the center of the tumor. When compared with the preradiotherapy biopsies, the amount of keratin in the postradiotherapy specimens was extensive. HDRILBT may cause induction of the keratin gene in the irradiated cells to stimulate differentiation toward better differentiated cells. CONCLUSIONS: HDRILBT may cause the keratin gene in the irradiated cells to induce differentiation toward better differentiated cells. Preoperative high dose rate intraluminal brachytherapy may have a role in improving the prognosis of patients with early esophageal cancer treated with a combination of radiotherapy and surgery.

Adult↗
PubMed1996

Radiofrequency catheter ablation of right ventricular outflow tachycardia in children and adolescents.

OBJECTIVES: The current study reviews the safety and efficacy of radiofrequency catheter ablation for the treatment of right ventricular outflow tachycardia in children and adolescents and describes a modified method for mapping the tachycardia focus. BACKGROUND: Although radiofrequency catheter ablation has proved highly effective for the treatment of supraventricular tachycardia during childhood and adolescence, its application in children with idiopathic right ventricular outflow tachycardia has been limited. METHODS: Six children (mean [+/- SD] age 10.6 +/- 2.4 years, range 6 to 16) with right ventricular outflow tachycardia underwent seven radiofrequency catheter ablation procedures. The mean tachycardia cycle length was 323 +/- 24 ms (range 300 to 360). Two multipolar catheters were positioned in the right ventricular outflow tract to map the tachycardia focus. RESULTS: Radiofrequency catheter ablation was successful in five (83%) of the six children (95% confidence interval 36% to 99%). At successful ablation sites, local endocardial activation time preceded the surface QRS onset by 46 +/- 5 ms (range 37 to 57), and there was concordance of the 12-lead pace map and the electrocardiogram (ECG) in 11 (one patient) to 12 ECG leads (four patients). One patient developed complete right bundle branch block during radiofrequency catheter ablation. There were no additional complications and no clinical recurrences over a mean follow-up period of 12.7 +/- 3.8 months (range 9 to 22). CONCLUSIONS: These results suggest that radiofrequency catheter ablation is a safe and effective treatment for right ventricular outflow tachycardia during childhood and adolescence. In addition, tachycardia mapping may be enhanced by use of a multipolar right ventricular outflow catheter technique.

Adolescent↗
PubMed1996

Biarylcarboxylic acids and -amides: inhibition of phosphodiesterase type IV versus [3H]rolipram binding activity and their relationship to emetic behavior in the ferret.

In addition to having desirable inhibitory effects on inflammation, anaphylaxis, and smooth muscle contraction, PDE-IV inhibitors also produce undesirable side effects including nausea and vomiting. In general, compounds that inhibit PDE-IV also potently displace [3H]rolipram from a high-affinity binding site in rat cortex. While this binding site has not been identified, it has been proposed to be an allosteric binding site on the PDE-IV enzyme. Preliminary studies have suggested that the emetic potency of PDE-IV inhibitors is correlated with affinity for the brain rolipram binding site rather than potency at inhibiting PDE-IV enzyme activity. Efforts to eliminate the emetic potential of PDE-IV inhibitors were directed toward developing compounds with decreased [3H]rolipram binding affinity while retaining PDE-IV potency. Thus, a novel series of 4-(3-alkoxy-4-methoxyphenyl)benzoic acids and their corresponding carboxamides were prepared and evaluated for their PDE-IV inhibitory and rolipram binding site properties. Modification of the catechol ether moiety led to phenylbutoxy and phenylpentoxy analogues that provided the desired activity profile. Specifically, 4-[3-(5-phenylpentoxy)-4-methoxyphenyl]-2-methylbenzoic acid, 18, was found to exhibit potent PDE-IV inhibitory activity (IC50 0.41 microM) and possessed 400 times weaker activity than rolipram for the [3H]rolipram binding site. In vivo, compound 18 was efficacious in the guinea pig aerosolized antigen induced airway obstruction assay (ED50 8.8 mg/kg, po) and demonstrated a significant reduction in emetic side effects (ferret, 20% emesis at 30 mg/kg, po).

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1996

Discovery of the hemifumarate and (alpha-L-alanyloxy)methyl ether as prodrugs of an antirheumatic oxindole: prodrugs for the enolic OH group.

Ether, ester, and carbonate derivatives of the antirheumatic oxindole 1 were prepared and screened as potential prodrugs of 1. This effort led to the discovery of the (alpha-L-alanyloxy)-methyl ether and hemifumarate derivatives of 1 which deliver the drug efficiently into the circulation of test animals, are stable in the solid state, and possess good stability in solution at low pH as required to ensure gastric stability. Success in achieving acceptable bioavailabilities of 1 across species (rats, dogs, and monkeys) followed the inclusion of ionizable functionality within the promoiety to compensate for masking the polar enolic OH group of the free drug. However, the introduction of ionizable functionality was often associated with decreased stability, as demonstrated by the hemisuccinate, hemiadipate, hemisuberate, and alpha-amino ester derivatives of 1 which could not be isolated. A clear exception was the hemifumarate derivative of 1 which was not only isolable but actually more stable at neutral pH than the nonionizable ester analogues. The solution and solid state stability of the hemifumarate, together with its activity as a prodrug of 1, suggests that hemifumarate be considered as an alternative to hemisuccinate as a prodrug derivative for alcohols, particularly in situations where solution state stability is an issue.

Animals↗
PubMed1996

Aneurysms due to intimomedial mucoid degeneration.

OBJECTIVE: Review management of patients presenting with aneurysms due to intimomedial mucoid degeneration (IMMD). DESIGN: Retrospective analysis. SETTING: Metropolitan Vascular Service, Departments of Haematology and Pathology, University of Natal. MATERIALS AND METHODS: Case records reviewed over an 11 year period. Twenty-two patients were submitted for surgery. All had histological confirmation of disease. All patients were black African (Negro) descent and nineteen were female. Average age was 52 years. RESULTS: Fifteen patients had involvement of descending aorta and seven patients had extra-aortic involvement. Hypertension was noted in half of the patients. Seven patients presented acutely with rupture (4) and ischaemic lower limbs due to dissection (3). Total absence of clot within aneurysm lumen was a distinctive finding on ultrasound, CT-scan and angiography. Treatment followed standard vascular surgical principles. Three patients died following emergency aortic replacement. Three patients developed severe intraoperative bleeding problems following elective aortic aneurysm resection due to primary fibrinolysis. All had normal preoperative coagulation profiles. CONCLUSION: IMMD is a rare disease affecting the intima and media of vessel wall involving aortic and extra aortic vessels, predominantly in younger African females with hypertension. Lack of clot within aneurysm lumen should alert surgeon to predisposition toward bleeding diathesis. Meticulous suture technique is essential as aortic wall is friable. Medium to long term results are satisfactory.

Adult↗
PubMed1996

School-based tuberculosis testing and treatment program: comparing directly observed preventive therapy with traditional preventive therapy.

A high-school-based health center instituted a tuberculosis testing and treatment program. Compliance of purified protein derivative (PPD) positive students with isonicotine hydrazine (INH) preventive therapy was compared for two groups of students: those in directly observed preventive therapy (DOPT) and those in traditional therapy. Four hundred thirty six students were tested and 429 returned for a reading: 209 (49 percent) students had a positive PPD test. The rate of positivity did not vary by age, sex, or years in the United States. There was no relationship between bacille Calmette-Guérin (BCG) vaccination and rate of positivity or mean size of induration. The compliance rate for all courses of DOPT was significantly higher (54 percent) than that for traditional therapy (26 percent). The compliance rates for the first and second attempts to complete a course of DOPT was 71 percent. Completion of therapy did not differ by age, sex, or years in the United States. Haitian students completed therapy more often than students from Jamaica. We believe it is effective and efficient to base tuberculosis testing and treatment with DOPT in the school setting.

Adolescent↗
PubMed1996

Detection of integrated high risk human papillomavirus in adenoid cystic carcinoma of the uterine cervix.

AIM: To investigate the role of human papillomavirus (HPV) in adenoid cystic carcinoma of the uterine cervix. METHODS: Eleven archival, paraffin wax embedded specimens were analysed by non-isotopic in situ hybridisation (NISH) for HPV types 6, 11, 16, 18, 31, and 33 using digoxigenin labelled probes. The polymerase chain reaction (PCR) was carried out on each of the cases using consensus primers to HPV. RESULTS: A total of eight adenoid cystic carcinomas harboured the HPV genome by NISH, of which five were PCR positive. Integrated HPV 16 DNA was demonstrated in seven of the eight NISH positive cases. One adenoid cystic carcinoma showed integrated HPV 31. HPV DNA was not detected in the three remaining cases. CONCLUSIONS: Integrated high risk HPV genome, in particular type 16, is associated with this uncommon type of primary cervical cancer.

Aged↗
PubMed1996

Inflammatory pseudotumor (plasma cell granuloma) of the heart. Report of two cases and literature review.

We report pathologic findings in two patients with inflammatory pseudotumor of the heart. The first patient was a 15-year-old-boy who died suddenly and unexpectedly of myocardial ischemia caused by an angiocentric inflammatory pseudotumor affecting all of the major coronary arteries and some of their branches. Inflammatory pseudotumor was also centered around some intrasplenic arteries. The second patient was a 5-month-old girl who had subtotal resection of a mass in the right atrial free wall. Her inflammatory pseudotumor was confined to the myocardium and showed no angiocentricity. The patient is doing well 22 months after surgery. Inflammatory pseudotumor is a benign inflammatory response evoked by an unknown agent(s). In both patients, the inflammatory cells comprised a mixture of B and T lymphocytes. Among B cells, a mixture of kappa and lambda plasma cells was evident. A moderate number of tissue macrophages was also observed. The process is usually self-limited but may cause death if vital structures are involved.

Adolescent↗
PubMed1996

Autopsy prevalence of Wernicke's encephalopathy in alcohol-related disease.

OBJECTIVE: To determine the autopsy prevalence of Wernicke's encephalopathy (WE) in patients dying from alcohol-related diseases. DESIGN: Prospective postmortem macroscopic and microscopic examination. SETTING: Adult autopsies at King Edward VIII Hospital. METHODS: Thirty-one consecutive autopsies were performed on patients who had died from alcohol-related diseases; these formed the study group. The control group comprised 10 patients with a negative history of alcohol and alcohol-related diseases. After examination of the brain, samples for histology were taken from the mamillary bodies and the wall of the third ventricle. Two subjects were excluded on account of additional unrelated brain pathology. RESULTS: Of the 29 patients studied, 17 (59%) were confirmed histologically to have WE. The histological lesions were classified as either acute (5), acute on chronic (9) or chronic (3) according to defined pathological criteria. Macroscopic abnormalities were not obvious in any of the patients in the study group. Chart analysis revealed that a disturbance of the mental state was the commonest neurological finding (9/17). Ocular palsy was not present in any of the subjects. Although 2 patients had been given thiamine prior to death, a clinical diagnosis of WE was not made in any of the cases studied. CONCLUSION: This study proves that WE is a frequent finding in blacks with alcohol-related diseases. The high prevalence of WE found in adult autopsies (6.6%) without documented clinical evidence may have contributed to the mortality in these cases.

Adult↗
PubMed1995

Novel antagonists of platelet-activating factor. 1. Synthesis and structure-activity relationships of benzodiazepine and benzazepine derivatives of 2-methyl-1-phenylimidazo[4,5-c]pyridine.

Following the discovery of moderately potent antagonist activity platelet-activating factor (PAF) in 2-methyl-1-phenylimidazo[4,5-c]pyridine (2) (IC50 = 840 nM), 19 derivatives (3-21) were prepared which incorporated various lipophilic groups attached to the phenyl 4-position. Structure-activity relationships were evaluated where PAF antagonist activity was measured in vitro by determining the concentration of compound (IC50) required to inhibit the PAF-induced aggregation of rabbit washed platelets and in vivo by determining the oral dose (ED50) which protected mice from a lethal injection of PAF. [1,5]Benzodiazepines, e.g., 14 (2,3-dihydro-1-methyl-4-[4-(2-methylimidazo[4,5-c] pyrid-1-yl)phenyl]-1H-[1,5]benzodiazepin-2-one) (IC50 = 4.9 nM, Ed50 = 0.03 mg/kg po), were found to possess equivalent or superior potency to the 1,4-dihydropyridine PAF antagonist UK-74,505 (1,4-(2-chlorophenyl)-1,4-dihydro-3-(ethoxycarbonyl)-6-methyl-2- [4-(2-methylimidazo[4,5-c]pyrid-1-yl)phenyl]-5-[N-(2-pyridyl) carbamoyl]pyridine) in vitro and in vivo. Furthermore, a potent benzazepine, 21 (7,8-dichloro-1-methyl-4-[4-(methylimidazo[4,5-c]pyrid-1-yl) phenyl]-2,3,4,5-tetrahydro-1H-1-benzazepin-2-one) (IC50 = 0.5 nM, ED50 = 0.03 mg/kg po), was discovered. These investigations prompted the synthesis and evaluation of additional diazepine derivatives, which are described in the following paper. The relationship between the key PAF antagonist pharmacophores of 2-methyl-1-phenylimidazo[4,5-c]pyridine, a triazolothienodiazepine (WEB2170), and a pyrrolothiazolidine (RP-52,770) is discussed.

Animals↗
PubMed1995

Novel antagonists of platelet-activating factor. 2. Synthesis and structure-activity relationships of potent and long-acting heterofused [1,5]benzodiazepine and [1,4]diazepine derivatives of 2-methyl-1-phenylimidazo[4,5-c]pyridine.

The optimization of in vitro activity and oral potency and duration of action in vivo is described for three novel structural types of platelet-activating factor (PAF) antagonist: [1,5]benzodiazepines 5-12 onto which a variety of other heterocyclic rings were fused, pyrido[2,3-b][1,4]-diazepinones 13-26, and pyrazolo[3,4-b][1,4]diazepinones 27-46. Compounds 5-12 were prepared by elaboration of the [1,5]benzodiazepine-2-thiones 47 and 48, and 13-46 were prepared by cyclocondensation reactions of a variety of 2,3-diaminopyridine and 4,5-diaminopyrazole derivatives with ethyl 4'-(2-methylimidazo[4,5-c] pyrid-1-yl)benzoylacetate (53). The presence of imine-enamine tautomerism was observed in certain diazepine derivatives and is discussed. Structure-activity relationships were evaluated where PAF antagonist activity was measured in vitro by determining the concentration of compound (IC50) required to inhibit PAF-induced aggregation of rabbit washed platelets and in vivo by determining the oral dose (ED50) which protected mice from a lethal injection of PAF. In addition, the duration of action in conscious dogs as measured by determining the oral dose of selected compounds required to inhibit completely PAF-induced whole blood aggregation ex vivo. The most potent compound was 1,6,7,8-tetrahydro-1,8-dimethyl-5-[4-(2-methylimidazo [4,5-c]pyrid-1-yl)phenyl]-7-oxo-3-(3-pyridyl) pyrazolo[3,4-b][1,4]diazepine (43, UK-91,473) (IC50 = 2.4 nM, ED50 = 0.01 mg/kg po), which was found to be significantly more potent in vivo (murine lethality) than the dihydropyridine PAF antagonist 4-(2-chlorophenyl)-1,4-dihydro-3-(ethoxycarbonyl)-6-methyl- 4-[(2-methylimidazo[4,5-c]pyrid-1-yl)phenyl]-5- [N-(2-pyridyl)carbamoyl]pyridine (4, UK-74,505) (ED50 = 0.26 mg/kg po). Compound 43 also possessed a longer duration of action than compound 4 in the conscious dog at one-fourth of the dose. The crystal structure of compound 43, established by X-ray diffraction, is reported.

Animals↗
PubMed1995

Molecular events underlying schistosomiasis-related bladder cancer.

Twenty-one invasive squamous-cell carcinomas (SCC) of the bladder from Schistosoma-hematobium-infected patients were examined immunohistochemically for the expression of p53, Rb, EGFR and c-erbB-2 proteins; and screened by single-strand conformation polymorphism and sequencing for mutations in the ras (H, N, K) codon hotspots (12, 13, 61) and p53 (exons 4-9) genes. Positive staining for p53, EGFR and c-erbB-2 was reported in 38, 67 and 28% of tumors respectively. Only one of the tumors, the only one that was poorly differentiated, displayed an absence of nuclear Rb staining. Ras alterations were detected in the H-ras gene in 3 tumors, 2 of which harbored a codon-13 (Gly-->Arg) and one a codon-12 (Gly-->Ser) point mutation. p53 mutations were recorded in 12 tumors (57%), 6 of which stained positively for p53. Four tumors had exon-7 mutations (codons 235, 241 and 249; one tumor had 2 exon-7 mutations). Eight tumors were mutated in exon 8 (codons 264, 271, 273, 285, 286, 288 and 294), 5 of which harbored multiple mutations. One tumor had an insertion/deletion event in exon 9. The frequency of detection of over-expression of EGFR and c-erbB-2 in bilharzial-bladder lesions is comparable to that reported in TCC, contrasting with the infrequent loss of Rb expression found in invasive lesions associated with schistosomiasis infection. However, the detection of multiple p53 mutations in these lesions is suggestive of the involvement of a carcinogenic agent with maintenance of preferential activation of the H-ras gene.

Animals↗
PubMed1995

Human papillomavirus DNA in oesophageal carcinomas in South Africa.

Using morphological criteria, the presence of human papillomavirus (HPV) in oesophageal carcinomas has been inferred in patients from Finland and South Africa. However, studies to demonstrate the viral antigen in tissue sections of these tumours have proved disappointing. This study investigates 48 archival oesophageal carcinoma biopsies from South Africa for the presence of HPV DNA using non-isotopic in situ hybridization (NISH) with HPV DNA probes to HPV 6, 11, 16, 18, 31, and 33. HPV DNA sequences were detected in 25/48 (52 per cent) oesophageal cancers. HPV 16 was present in 84 per cent of the HPV-positive cancers. A NISH type 2 signal pattern (punctate/dot) was present in all HPV-positive tumours. This signal pattern was previously shown to represent integrated HPV DNA within host chromosome. Integrated HPV DNA in oesophageal cancers has also been demonstrated in patients from China and Japan. In addition, the prevalence of HPV DNA in oesophageal cancers from high-risk countries like South Africa (52 per cent) and China (49 per cent) would appear to be consistent.

Base Sequence↗
PubMed1995

Interphase cytogenetics: analysis of numerical chromosome aberrations in isolated cells.

Probes which recognize pericentromeric repetitive sequences can be used to determine numerical chromosome aberrations in interphase nuclei. Under appropriate stringency conditions, these probes decorate only the chromosome from which they were derived. It has been assumed that abnormalities of signal number in interphase nuclei reflect aneuploidy rather than proliferation, but this has not been clearly demonstrated. In this paper, three alphoid probes (D3Z1, D11Z1, and DXZ1) were localized to the appropriate chromosomes and the factors governing the production of reproducible signal distributions from three aneuploid cervical carcinoma-derived epithelial cell lines were investigated. Abnormalities of signal number represent numerical chromosome aberrations rather than changes associated with proliferation. Using four simple rules of interpretation, reproducible results can be obtained with minimal technical variation and selection bias. These results demonstrate that pericentromeric repetitive probes can be used reproducibly to determine numerical chromosome aberrations independent of cell proliferation in interphase nuclei, a necessary prerequisite for the application of this approach to the analysis of human tumours.

Aneuploidy↗