Asthma--expiratory dyspnoea?
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Adolescent↗
Biomedical subjects
M J Morris
Publications and source records attributed to M J Morris.
alpha 1- and alpha 2-adrenoceptors in rat cerebral cortex: effect of frontal lobotomy.
Surgical noradrenergic denervation of the cortex via frontal lobotomy was used to destroy the noradrenergic nerve endings and thus give some insight into the distribution of alpha-adrenoceptors. Frontal lobotomy caused a reduction in noradrenaline content in rat cerebral cortex (2.1 +/- 0.4 ng/mg protein for lesioned side, 6.0 +/- 0.3 mg/mg protein for non-lesioned side), indicating an effective noradrenergic denervation. The differences in 3H-clonidine and 3H-prazosin binding observed following surgery were a significant decrease in the number of alpha 2-adrenoreceptors (115.0 +/- 4.5 to 91.7 +/- 3.2 fmol/mg protein, n = 7, P less than 0.001) and a smaller but significant increase in the number of alpha 1-adrenoceptors (119.7 +/- 2.5 to 131.6 +/- 5.4 fmol/mg protein, n = 7, P less than 0.05) in the lesioned cortex. Results of this study indicate that alpha 2-adrenoceptors located on presynaptic noradrenergic terminals represent only a small proportion of the total alpha 2-adrenoceptors in rat cerebral cortex.
Animals↗
Tidal expiratory flow patterns in airflow obstruction.
Tidal expiratory flow pattern was analysed in 99 subjects with a view to assessing it as a quantitative measurement of airflow obstruction. Fifteen normal volunteers, nine patients with dyspnoea referred for investigation in whom airway resistance was within normal limits, 24 patients with restrictive lung disorders, and 51 patients with airway obstruction were studied. The expiratory flow pattern against time had a quadrilateral configuration in airway obstruction, which differed from the more sinusoidal form that is seen in subjects without airflow obstruction. The rapid rise to tidal peak flow was analysed in two ways, percentage of volume expired at tidal peak flow (delta V/V) and percentage of expiratory time to tidal peak flow (delta t/t). Both these indices correlated significantly with conventional measurements of airway obstruction. The pattern of expiratory flow in airflow obstruction during quiet breathing resembles that of a forced expiratory maneuver at similar lung volumes. In some cases this may be caused by dynamic compression occurring during tidal breathing. In others, the pattern may result from the static recoil of the lung being permitted to drive flow freely in expiration, rather than being braked by postinspiratory contraction of inspiratory musculature.
Adolescent↗
Improved survival in severely burned animals using intravenous Corynebacterium parvum vaccine post injury.
This study was designed to determine the potential benefit or toxicity of an immunomodulator, Corynebacterium parvum vaccine, when it is given after severe burn injury. Forty conditioned beagles received a 33% total body surface 3-degree flame burn and were resuscitated with Ringer's lactate solution (3 ml/kg/% burn). Wounds were treated daily for 10 days with silver sulfadiazine cream. Two days and nine days after burn, 21 of the animals received C. parvum vaccine (10 mg/kg IV) in a saline infusion, while 19 control animals were given only saline infusion according to a double-blind protocol. Serial measurements were made of temperature, weight, food intake, hematocrit, hemoglobin, red blood count, white blood count, differential, platelet count, fibrin degradation products, activated partial thromboplastin time, clot retraction, C3, blood cultures, neutrophil function, monocyte function, opsonic index, Na, K, Cl, BUN, glucose creatinine, total protein albumin, albumin/globulin ratio, alkaline phosphatase, SGPT, and SGOT. During 45 days of observation, only 16% of the saline control dogs survived compared to 47% of the treated animals. Total white counts and neutrophil function were the only values which were significantly better in animals receiving C. parvum. However, their correlation with increased survival was marginal This preclinical trial suggests that C. parvum is an effective immunodulator for prevention of fatal infection following burn injury. There were no demonstrable toxic effects of the material in this study.
Animals↗
Ontogeny of alpha 1 and alpha 2-adrenoceptors in rat brain.
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Aging↗
Isocyanate-induced asthma in a car factory.
In a car factory employing 203 women machinists making seat covers more women complained of respiratory symptoms after the introduction of a new seat cover fabric, cropped nylon backed with flame-bonded polyurethane foam (CNPF). 68 women working in the trim shop were studied on the first day back at work after a week's holiday and then at the end of a working week; the incidence of wheezing and/or shortness of breath was greater than expected but there was no difference between peak flow rates. A second study of 192 of the 203 women working in the trim shop confirmed this recent increase in incidence of asthmatic symptoms and showed that significantly more machinists who had worked with this new fabric had a reduced peak flow rate than machinists who had not. Asthma developed in one subject when she was working in the factory sewing CNPF, when she was handling this fabric in the challenge cabinet in the laboratory, and on challenge with toluene di-isocyanate in the laboratory. Airways resistance increased in 3 other workers after exposure to CNPF in the laboratory. Low concentrations (between 0.0003 to 0.003 ppm) of toluene di-isocyanate were found in the air around this fabric. 4 of 9 women with symptoms had IgE antibodies to toluene di-isocyanate.
Asthma↗
Beneficial effects of aggressive protein feeding in severely burned children.
To determine any potential benefit of feeding increased amounts of protein to hypermetbolic burned patients, 18 children with burns averaging 60% total surface area were randomized into two matched groups and studied serially for at least six weeks: the first group was given a normal diet with a balanced nutritional supplement, and the second group was supplemented with milk whey protein. The normal protein group received 87.1% of their desired caloric intake with 16.5% of calories from protein compared to 77.7% of desired caloric intake with 23.0% of calories from protein for the high protein group. Despite a higher caloric intake, the normal protein group had a worse opsonic index compared to the high protein group (0.42 +/- 0.04 vs. 0.62 +/- 0.05, p < 0.0007), lower levels of C3 (1371 +/- 55 vs. 1585 +/- 64 micrograms/ml, p < 0.01), lower levels of IgG (805 +/- 52 vs. 975 +/- 56 micrograms/ml, p < 0.03), lower levels of transferrin (200 +/- 10 vs. 283 +/- 18 mg/dl, p < 0.0001), lower levels of total serum protein (5.5 +/- 0.1 vs. 6.3 +/- 0.2 g/dl, p < 0.005), more bacteremic days (11% vs. 8%, p < 0.005) and worse survival (5/9--56% vs. 9/9--100%, p < 0.03). Patients receiving the high protein diet had significantly higher plasma levels of valine, lysine, threonine, leucine, aginine, isoleucine, proline, serine, asparagine, tryptophane, and tyrosine. Asparagine levels were significantly (p < 0.01) associated with better neutrophil function and opsonic index. Except for phenylalanine, significant associations were found for serum levels of each of the amino acids with concentrations of one or more serum proteins. These studies provide evidence that many immunologic functions are dependent upon optimal availability of specific amino acids, and that routine diets do not provide sufficient protein to satisfy the needs of seriously burned children.
Age Factors↗
Distribution of Serratia marcescens serotypes in cancer patients.
A study of 1314 patients with malignancies was made to determine the prevalence of Serratia marcescens in surveillance, diagnostic, and environmental cultures. Sera obtained from a commercial source were used to determine serotypic distributions of the S. marcescens strains isolated during a 51-month period. S. marcescens was isolated from 19% of patients with haematological neoplasms, from 5% of patients with lymphoma, and from 6% of those with solid tumours. Among carriers, rectal cultures were the commonest source in patients with lymphoma (32%); rectal and gingival cultures in patients with leukaemia (43% and 39%, respectively), and gingival cultures in patients with solid tumours (30%). Bacteraemias (.07%) were infrequent sources. Although seldom isolated from environmental or food samples, S. marcescens may occasionally be abundant in fresh fruit and vegetables. Serotyping of 220 strains of S. marcescens demonstrated 38 distinct antigenic types. The predominant serotype, O14:H12, was present in the upper respiratory tract of half of the persons who carried this serotype. Serotyping is a readily reproducible method of subspeciating S. marcescens; it can be satisfactorily used as an epidemiological tool.
Bacteriuria↗
Phase variation in the genus Serratia.
During an investigation of the serotypes of Serratia marcescens present in a cancer centre, it was found that 8.7% of 241 strains had more than one H antigen. There were 19 diphasic and two triphasic strains. Antigen H1 was a component of the phases in the approximately half of the strains with multiple phases. This is the first report of such phases in the genus Serratia.
Antigens, Bacterial↗
HLA-A, B and C and HLA-DR antigens in intrinsic and allergic asthma.
Some 103 patients with asthma and 100 healthy volunteers have been typed for HLA-A, B and C and HLA-DR antigens. The 103 patients consisted of thirty-three with intrinsic asthma, thirty-four with extrinsic asthma, and thirty-six known to have precipitins to Aspergillus fumigatus. No increase in frequency of any of the A, B, C, or DR antigens was found to be significant after correction for the number of comparisons was made. However certain trends comparable to findings in other immunopathic disorders were noted. For example B12 was increased in the allergic asthmatics (46 vs 29% controls) and it is suggested that B12 is associated with the ability to produce the IgE antibodies. A3/B7/DRw2 (which are in linkage disequilibrium) all show a decreased frequency in intrinsic asthma (24, 12 and 9% vs 32, 26 and 24% respectively in controls). Finally B8 and DRw3, which showed a moderate increase in frequency in all three groups of asthmatics, were found in five of seven patients with low atopy but persisting antibodies to A. fumigatus. Further detailed studies of these asthmatic subgroups is warranted.
Adult↗
In vitro activities of miconazole, miconazole nitrate, and ketoconazole alone and combined with rifampin against Candida spp. and Torulopsis glabrata recovered from cancer patients.
A total of 440 fresh clinical isolates of yeasts from cancer patients were tested by an agar dilution technique against miconazole, miconazole nitrate, and ketoconazole individually and combined with 5 micrograms of rifampin per ml. Most strains of Candida albicans were susceptible to 0.5 microgram or less of the imidazoles per ml. Candida tropicalis required 2 to 4 micrograms of miconazole and its nitrate base per ml for inhibition and was resistant to ketoconazole. The 100% minimal inhibitory concentration of the imidazoles for Candida krusei was 1 microgram/ml. Susceptibility to 4 micrograms of miconazole and miconazole nitrate per ml occurred in 73 and 87% of Torulopsis glabrata strains, respectively, and none was susceptible to ketoconazole. Miconazole was most effective against the Candida spp., whereas its nitrate base was most active against T. glabrata. Synergy was observed when rifampin was combined with miconazole and miconazole nitrate but was not observed when rifampin was combined with ketoconazole. Synergy occurred most frequently when rifampin was combined with miconazole nitrate.
Antifungal Agents↗
Lung mechanics after cardiac valve replacement.
Fourteen patients undergoing single aortic or mitral valve replacement had measurements made of lung volumes, static pressure-volume (P-V) relationships, and conductance-pressure relationships during deflation before operation and again between one and two years later. At follow-up, total lung capacity (TLC), functional residual capacity (FRC), residual volume (RV), and static tidal compliance (slope of static P-V deflation line for one litre above FRC) had increased significantly, in association with a decrease in heart size. There was a change in the shape and position of some P-V curves both in the aortic and mitral patients. In the patients with aortic disease P-V deflation curves shifted to the left after operation. In the patients with mitral disease the P-V deflation curves before operation crossed those measured after operation, so that at high lung volumes recoil became less after operation, but at low lung volumes recoil increased. Conductance had increased at high lung volumes. The data suggest that in longstanding pulmonary congestion, airways are more rigid making them less distensible at high and less compressible at low transpulmonary pressures than after operation when congestion has been at least partly relieved.
Adult↗
The effects of dietary fibre on glucose tolerance in healthy males.
Previous studies have shown that the addition of non-absorbable carbohydrate (NAC) to test meals decreases the glucose and and insulin response both in normal and diabetic subjects. However, these studies appear to have used brain in the basic test meal without a knowledge of the effect of bran itself or of the added NAC alone. In the present investigation bran alone, pectin alone, guar alone and pectin with guar have been studied. Guar alone added to the test meal significantly lowered blood glucose at 90 minutes. Pectin alone did not have a significant effect. Pectin and guar together resulted in a blood glucose lower at 30 minutes and greater at 120 minutes. No significant changes in insulin response were noted to our study. It appears that NAC alters the glucose response to a given meal, but the extent to which this occurred in the present study was less than in previous studies. The differences may reflect synergism between bran and other NAC's to lower blood glucose response after a meal.
Adult↗
Evidence against the presence of circulating immune complexes in chronic inflammatory bowel disease.
Several investigators have reported the presence of circulating immune complexes in serum from patients with Crohn's disease and chronic ulcerative colitis. Because previous assays employed conditions which might have caused immunoglobulin aggregates to form in vitro, thus falsely suggesting the presence of immune complexes in vivo, we tested inflammatory bowel disease sera for immune complexes using four assays designed to minimize in vitro immunoglobulin aggregation. In three assays immune complexes were not detectable, while in a fourth, the Clq precipitin test, positive reactions occurred. These precipitin reactions did not have characteristics of immune complexes. Our data suggest that circulating immune complexes are either not present in patients with inflammatory bowel disease or that they occur infrequently or in low concentration.
Antigen-Antibody Complex↗
Studies on the nature of heat-labile anti-complementary activity in normal human serum.
Heat-labile anti-complementary activity (ACA) appears in normal human serum during storage or heating as endogenous haemolytic activity disappears. Following gel filtration of unheated serum, two peaks of heat-labile ACA are present. The ACA of both whole and fractionated serum has previously been attributed to the presence of heat-labile immunoglobulin aggregates or immune complexes. Our data demonstrate that the heavy peak of ACA obtained by gel filtration does not bind to 125I-C1q or to Raji cells, and that its effect is abolished to C1INH, suggesting that it represents C1 rather than immunoglobulin aggregates or immune complexes. The lighter peak of ACA in fractionated serum has the functional characteristics of C1s and free C1s is demonstrable in fractions containing this activity. The ACA of whole serum likewise has functional characteristics of C1. The anti-complementary effect of C1 on guinea-pig complement would not be evident in the complement fixation assay until most endogenous haemolytic activity in human serum has been inactivated, either by heat or by storage. C1INH only partially inhibits this ACA in serum or in solutions containing isolated C1 in high concentrations. These observations indicate that heat-labile ACA in whole or fractionated sera is due to the presence of C1 and C1s and that this activity cannot be taken as evidence for the presence of immune complexes.
Agammaglobulinemia↗
A comparison of immunologic profiles and their influence on bacteremia in surgical patients with a high risk of infection.
Prospective sequential studies of the antibacterial function of neutrophils, lymphocyte responsiveness, opsonic capacity of serum and serum levels of C3(B), properdin, factor B, IgG, and albumin were made in 32 patients with severe burn injury (greater than or equal to 45%), 21 patients with severe multisystem traumatic injury, 20 high-risk, infected patients, and 22 renal transplant patients. Fifty-five episodes of bacteremia occurred in 37 of the 95 patients. Abnormal neutrophil function was clearly associated as a predisposing factor to these episodes, whereas there was no association between bacteremia and low serum levels of C3, IgG, factor B, or properdin. C3, factor B, and IgG usually rose following bacteremia as acute phase proteins, but there was evidence of a consumptive opsoninopathy in 11% of episodes. Defective opsonization was associated with a high risk of bacteremia only when there was a coexisting abnormality of neutrophil function (88% of such patients became bacteremic). None of 27 nonburned patients tested with delayed hypersensitivity antigens responded normally, and there was regularly depression of lymphocyte responsiveness to phytohemagglutinin-A and concanavalin-A in a whole blood assay related to serum immunosuppressive factors, but poor responsiveness was not associated with bacteremia.
Adolescent↗
The effect of heat inactivation of serum on aggregation of immunoglobulins.
Heating serum at 56 degrees is used to inactivate complement in several immunological assays. During heating, both heat-labile and heat-stable anticomplementary activity (ACA) develop. While heat-labile ACA can be completely inactivated, heat-stable ACA increases progressively with continued heating. Heat-stable ACA develops in deaggregated IgG and in normal, but not in hypogammaglobulinaemic, human and porcine serum heated at 56 degrees suggesting that this ACA is due to formation of immunoglobulin aggregates. These aggregates would produce false-positive tests for immune complexes and could inhibit a variety of cell-mediated reactions in assays which incorporate heat-inactivated serum. Other temperatures were tested to determine whether endogenous haemolytic activity could be destroyed without forming immunoglobulin aggregates. At 53 degrees both endogenous haemolytic activity and heat-labile ACA were inactivated and formation of heat-stable ACA in normal serum was minimal. ACA, however, could be induced in deaggregated IgG at 53 degrees. Moreover, the degree of heat-induced aggregation of IgG in vitro at either temperature was directly proportional to IgG concentrations and inversely related to albumin concentrations. Thus, pathological sera with these protein alterations might form more aggregates during heating than normal sera. These data suggest the following: (1) heat inactivation of complement at 53 degrees for 90 min is preferable to the traditional 56 degrees; (2) in any assay where immunoglobulin aggregates might interfere, normal serum may be an inadequate control and correlations will need to be made between serum IgG and albumin concentrations and the results obtained in these assays.
Adult↗