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Biomedical subjects

K Ward

Publications and source records attributed to K Ward.

At least 199 records · Page 11Linked to original sources
PubMed1976

Beneficial effects of a high carbohydrate, high fiber diet on hyperglycemic diabetic men.

High carbohydrate diets rich in dietary fiber were fed to 13 hyperglycemic diabetic men; five men required 15 to 28 units of insulin per day, five men required sulfonylureas, and three men required 40 to 55 units of insulin. All 13 men were fed weight maintaining American Diabetic Association diets containing 43% of calories as carbohydrate for 1 week and then were fed 75% carbohydrate diets with 15 g of crude dietary fiber for approximately 2 weeks. After 2 weeks on the 75% carbohydrate diet, sulfonylureas were discontinued in all five men, insulin was discontinued in four men and decreased from 28 to 15 units in 1 man from the group requiring less than 30 units per day. Fasting plasma glucose values were significantly lower (P less than 0.001) in all 10 men. However, insulin requirements and fasting plasma glucose values were not changed in the three men requiring 40 to 55 units of insulin. Fasting serum cholesterol values were significantly (P less than 0.001) lower and mean fasting serum triglyceride values were 15% lower on the high carbohydrate diet than on the American Diabetic Association diet in these 13 men. Thus, a high carbohydrate diet with generous amounts of dietary fiber may be the treatment of choice of diabetic patients requiring sulfonylureas or less than 30 units of insulin per day.

Adult↗
PubMedDate not supplied

Subcellular distribution of aldehyde dehydrogenase activities in human liver.

The subcellular distributions of aldehyde dehydrogenase activities towards acetaldehyde have been determined in wedge-biopsy samples of human liver. A form with Km values of less than 1 microM and 285 microM towards acetaldehyde and NAD+ respectively was present in the mitochondrial fraction. This enzyme had no detectable activity towards N-tele-methylimidazole acetaldehyde, the aldehyde derived from the oxidation of N-tele-methylhistamine. The activity in the cytosol was more sensitive to inhibition by disulfiram and had Km values of 270 microM and 25 microM for acetaldehyde and NAD+, respectively. It was active towards N-tele-methylimidazole acetaldehyde with a Km value of 2.5 microM and a maximum velocity that was 40% of that determined with acetaldehyde. Both these cytosolic activities had alkaline pH optima.

Aldehyde Dehydrogenase↗
PubMedDate not supplied

Chronic alcoholic skeletal myopathy--common and reversible.

Although musculoskeletal symptoms are common in alcoholics, little is known of the prevalence of muscle pathology in this group. Quadriceps muscle biopsies were performed in 151 alcoholics (105 men). Ninety patients showed type 2 fibre atrophy predominantly affecting the type 2b anaerobic glycolytic fibres. In contrast, 7 biopsies revealed some muscle necrosis and only 1 patient had acute rhabdomyolysis. Amongst those alcoholics with muscle atrophy the quantity of alcohol consumed in the year prior to biopsy correlated significantly with the severity of the atrophy. Atrophy was not associated with vitamin B12, folate, pyridoxine, riboflavin or thiamine deficiencies. Although patients with severe liver disease, peripheral neuropathy or malnutrition were more likely to have muscle atrophy, nerve conduction studies showed that atrophy and neuropathy each occurred independently. Sequential studies in abstaining alcoholics showed a significant improvement within 3 months and often complete recovery within a year. Continued consumption of alcohol was associated with persistence or progression of the atrophy. This study shows that reversible type 2b muscle fibre atrophy is a frequent finding in alcoholics and suggests that it is directly related to alcohol consumption and is not a consequence of malnutrition, vitamin deficiency or peripheral neuropathy.

Adenosine Triphosphatases↗
PubMedDate not supplied

Lateral placental growth occurs by trophoblast cell invasion of decidual veins.

During human pregnancy, growth of the placenta is proportionally greater than the growth of the decidual surface, suggesting that trophoblast cells invade the decidua at the placenta's margin. We hypothesized that a method of lateral placental growth was trophoblast cell invasion of decidual veins. This was investigated in two in situ pregnancies and in tissues from 100 women undergoing elective termination at 8-12 weeks of gestation. Decidua was compared to normal secretory endometrium. Histological sections were stained by immunohistochemistry to identify trophoblast cell and vascular antigens, as well as vascular cell adhesion molecule (VCAM), integrin subunits beta(1)and beta(4), and oncofetal fibronectin. Dilated veins were observed in all decidua but not in the secretory endometrium. Decidual and myometrial veins contained villi, trophoblast cell islands and syncytial elements. Decidual endothelial cells expressed vascular cell adhesion molecule (VCAM). Villous trophoblast cells were integrin subunits beta(4)positive and beta(1)negative. Trophoblast cell islands in the placenta and within decidual veins were integrin subunits beta(1)positive and beta(4)negative. Trophoblast cell islands and villi attached to veins, and mononuclear cells, invaded decidual stroma. Oncofetal fibronectin was present at sites of trophoblast invasion. These findings suggest that a method of lateral placental growth is trophoblast cell invasion of veins.

Cell Movement↗
PubMedDate not supplied

Treatment of superior vena cava syndrome with recombinant tissue plasminogen activator in a sickle cell patient undergoing bone marrow transplantation.

Superior vena cava (SVC) syndrome is a well-recognized clinical entity seen with mediastinal malignancies and intraluminal venous thrombosis. The role of recombinant tissue plasminogen activator (rt-PA) in the resolution of SVC syndrome caused by thrombosis in the bone marrow transplant settings has not been described. The authors report a case of SVC syndrome with good clinical response in a 16-year-old female with sickle cell disease undergoing an allogeneic bone marrow transplant (BMT) from her HLA identical sibling. Shortly after her transplant, she was found to have significant facial edema and swelling above the neck. Concomitantly, her renal function deteriorated with progressive elevation of serum urea nitrogen and creatinine levels, requiring the use of continuous veno-venous hemofiltration. An upper extremity venogram showed complete SVC obstruction (type III) with apparent inferior reflux into the azygos system. rt-PA was started at a dose of (0.5 mg/kg/day) for 2 days. There was a dramatic resolution of her symptoms, including significant improvement in renal function with increase in urine output. A repeat venogram showed free flow from the distal tip of the central line consistent with a patent superior vena cava. There was no evidence of any bleeding manifestations with rt-PA. This report highlights the usefulness of rt-PA as a treatment modality for SVC syndrome in the BMT settings.

Adolescent↗
PubMedDate not supplied

Long-term effects of high-carbohydrate, high-fiber diets on glucose and lipid metabolism: a preliminary report on patients with diabetes.

High-carbohydrate, high-fiber (HCF) diets have beneficial therapeutic effects for selected patients with diabetes mellitus. We have treated 10 patients with HCF diets on a metabolic ward and followed them for an average of 15 months while they were on maintenance diets at home. The HCF diets containing 70 per cent of calories as carbohydrate were accompanied by significant reductions in requirements for insulin or sulfonylureas. Fasting plasma glucose, serum cholesterol, and triglyceride values were significantly lower on the HCF diet than on a 43 per cent carbohydrate diet. On the HCF diet, insulin therapy was discontinued for five patients and sulfonylurea therapy for three. After an average of 15 months on the maintenance diet containing 55 per cent to 60 per cent carbohydrate, seven patients were still managed without insulin or sulfonylureas. Average fasting plasma glucose values during maintenance diets at home were identical to values on the HCF diets in the hospital. On the maintenance diet, serum cholesterol values were similar to initial values but serum triglyceride values were significantly lower than values on the 43 per cent carbohydrate diet. These studies indicate that moderately high-carbohydrate, high-fiber diets can be successfully followed at home and that improvements in glucose metabolism achieved in the hospital can be sustained outside the hospital.

Adult↗
PubMedDate not supplied

Composition of foods commonly used in diets for persons with diabetes.

Information on the carbohydrate, protein, fat, kilocalorie, and plant fiber content of 152 common foods has been collated. These data are based on information currently available and will need to be modified and updated as more information emerges. These data are presented in six tables that follow the format of the commonly used Exchange Lists for Meal Planning for patients with diabetes mellitus.

Calorimetry↗