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Biomedical subjects

M K Jones

Publications and source records attributed to M K Jones.

At least 145 records · Page 8Linked to original sources

The circadian variation of thyrotrophin in patients with primary thyroidal disease.

We have used a highly sensitive immunochemiluminometric assay (ICMA) for human TSH to study the effect of thyroid status on the circadian variation in TSH levels. Three subjects with Graves' disease, three with toxic multinodular goitre and three with euthyroid multinodular goitre were sampled every hour for 24 h. The results obtained were compared to those from five euthyroid control subjects. It was found that some patients with hyperthyroidism and suppressed basal TSH levels exhibited a 24 h secretory pattern similar to that seen in normal subjects with peak TSH levels occurring at night. In addition two subjects with a euthyroid multinodular goitre demonstrated levels of TSH below the normal range despite being clinically and biochemically euthyroid. TSH suppression in these subjects is probably related to some degree of thyroid autonomy and possible development of hyperthyroidism in the future.

Adult↗

A phase I trial of dactinomycin intravenous infusion in patients with advanced malignancies.

Eighteen patients with advanced malignancies refractory to other forms of treatment were given dactinomycin (Act D) as continuous intravenous infusions. Their median age was 51 years (range, 36-67); their median performance status was 50 (range, 40-90) on the Karnofsky scale. Act D was administered continuously for 5 days, utilizing a central venous line and a perfusion pump. The starting dose was 0.1 mg/m2/24 hours X 5 days (total dose, 0.5 mg/m2) and was escalated according to a modified Fibonacci scale to 0.2, 0.33, and 0.5 mg/m2/24 hours X 5 days, respectively. Three, three, four, and eight patients were entered, respectively, in each dose level. Toxicities observed were: leukopenia in four patients (nadir leukocyte count less than 1000 cells/nm3 in one patient and 2000-3000 cells/mm3 in 3 patients); thrombocytopenia, with nadir platelet counts between 50,000 and 100,000 platelets/mm3 in 2 patients; stomatitis in four patients; and nausea in three patients. Vomiting was not observed during the infusions. Two patients may have had a radiation recall phenomenon. Blood count depression, nausea, and mucositis were transient, resolving after a few days. One patient at level IV died of sepsis, which was diagnosed on the fourth day of the infusion, before leukopenia intervened. No objective responses were seen. It was concluded that a higher dose of Act D can be given by continuous infusion than by a bolus injection; the authors recommended 0.5 mg/m2/day X 5 days (total dose, 2.5 mg/m2) for further studies.

Adult↗

Pituitary function with a solitary intrasellar plasmacytoma.

A solitary intrasellar plasmacytoma with marked pituitary fossa destruction and yet near normal pituitary gland function is described. We suggest that a minimal disturbance of endocrine function together with a radiologically abnormal pituitary fossa indicates that the primary lesion may lie outside the pituitary fossa.

Aged↗

Patient violence. Report of 200 incidents.

Studies of assaultive behavior in hospital settings are increasing. Results are often contradictory. These variances are dependent upon the type of hospital, the specific setting, and the disciplines involved in the reporting process. Open recognition that violent incidents occur, and the substitution of fact finding for finger pointing, are the first steps toward prevention and management.

Adult↗

Morphology of Baerietta hickmani n. sp. (Cestoda, Nematotaeniidae) from Australian scincid lizards.

Baerietta hickmani was described from Lampropholis challengeri, L. delicata, L. guichenoti, L. mustelina and Nannoscincus maccoyi (Reptilia: Scincidae) from Australia. Diagnostic features included hyperapolysis, mature segments longer than wide, gonads tandem and seminal receptacle present. The genus Baerietta was emended to include diagnostic features of B. hickmani and to extend the host range to included both amphibians and reptiles. Other morphological features of the new species included tandem paruterine capsules, allometric growth of segments and the investiture of paruterine capsules by numerous elongate calcareous corpuscles.

Animals↗

Pharmacokinetics of subcutaneously administered human, porcine and bovine neutral soluble insulin to normal man.

Highly purified neutral soluble human, porcine and bovine insulin (0.075 U/kg body weight) were administered randomly by subcutaneous injection to six normal men. Somatostatin by continuous intravenous infusion (100 micrograms/h) was used to suppress endogenous insulin secretion. The effects of the three species of insulins on plasma glucose, immunoreactive insulin (IRI), C-peptide and intermediary metabolite concentrations were essentially similar. The onset of hypoglycaemic action of bovine insulin was delayed compared to human and porcine insulin due possibly to a lower receptor binding of the bovine insulin. No local or systemic adverse reactions to the insulins were observed.

3-Hydroxybutyric Acid↗

Familial acromegaly.

An uncle and nephew with acromegaly are described. Two other families with acromegaly have been reported by others and three other possible cases are reviewed. Our patients are unlikely to form part of the multiple endocrine neoplasia (MEN) type 1 syndrome because of the absence of other endocrine disease at an advanced age. A family history of acromegaly should be considered in those presenting with the disease.

Acromegaly↗

A high sensitivity immunochemiluminometric assay for human thyrotrophin.

A two-site immunochemiluminometric assay (ICMA) has been developed for the measurement of human thyrotrophin (TSH). The procedure involves reaction of serum samples with monoclonal antibodies to TSH which have been labelled with a chemiluminescent acridinium ester followed by reaction with solid-phase polyclonal antibodies to TSH. The total reaction time is 2 h and bound labelled antibody is quantified luminometrically. The assay has an absolute sensitivity of 0.004 mU/l and a linear dose-response range up to 60 mU/l. Circulating TSH concentrations in 84 normal subjects were in the range 0.4 to 4.0 mU/l and in 16 hyperthyroid patients were less than 0.03 mU/l. This assay should thus prove useful as a first line test of thyroid function.

Antibodies, Monoclonal↗

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Aged↗

An automated immunoradiometric assay for human thyrotropin.

In this two-site immunoradiometric assay for thyrotropin, developed for use in the "Kemtek 3000" automated radioimmunoassay system, commercially available monoclonal antibody to thyrotropin is labeled with 125I, and the solid-phase antibody is an IgG fraction of sheep antiserum to thyrotropin, covalently coupled to reprecipitated aminocellulose. There are two incubations, totalling 3 h, the sensitivity is 0.03 milli-int. unit/L. The mean thyrotropin value for 82 healthy euthyroid subjects was 1.7 milli-int. units/L (range 0.4-3.6). For 19 overtly clinically and biochemically hyperthyroid subjects the values ranged from undetectable to 0.2 milli-int. unit/L. In this assay, euthyroid and hyperthyroid subjects can be distinguished with assay of a single basal sample. The assay appears suitable for routine use as a first-line test of thyroid function.

Antibodies, Monoclonal↗

A study of the comparative safety and efficacy of neutral soluble human (semi-synthetic) and porcine monocomponent insulin in non-diabetic subjects.

Neutral soluble human (semi-synthetic) and porcine insulin and diluting medium were administered subcutaneously in a randomized fashion to six fasting normal male subjects. The plasma glucose, C-peptide and insulin response was observed for a period of two hours before and six hours after injection of insulin (0.075 m/kg) into the anterior abdominal wall. The hypoglycaemic response was identical for the two insulins with the plasma glucose values reaching a nadir at 90--120 minutes and returning to within 10% of basal levels by six hours. Also similar peak plasma insulin values were achieved with human and porcine insulin by 50--60 minutes post-injection. The C-peptide response following the administration of both insulins suggested equal suppression of endogenous beta cell secretion. The two insulins were well tolerated with no immediate or delayed allergic reactions in any subject. These results suggest that human (semi-synthetic) and porcine soluble monocomponent insulins under the described experimental conditions are bioequivalent.

Adult↗

Comparative study of subcutaneous, intramuscular, and intravenous administration of human insulin.

Human insulin derived from porcine insulin was given subcutaneously (s.c.), intramuscularly (i.m.), and intravenously (i.v.) to normal men. The dosage for all three routes was 0 . 075 IU/kg body weight. Diluting medium was administered by s.c. injection to obtain control values. Somatostatin (100 microgram/h) was given to inhibit pancreatic beta cell secretion. The plasma glucose responses to s.c. injection of this insulin into the anterior abdominal wall and to i.m. injection into the thigh were similar with respect to the extent, onset, and duration of effect. Plasma glucose fell from mean (+/- SE) pre-injection values of 4 . 3 +/- 0 . 15 and 4 . 4 +/- 0 . 27 mmol/l, to 3 . 06 +/- 0 . 25 and 2 . 98 +/- 0 . 16 mmol/l by 90 to 105 min for s.c. and i.m. studies, respectively, thereafter returning to mean basal level by 6 h after i.m. injection, but remaining about 0 . 5 mmol/l below basal level after s.c. injection. A much more sudden, but short-lived, hypoglycaemic response occurred after i.v. insulin, with plasma glucose failing from 4. 50 +/- 0 . 42 to 1 . 45 +/- 0 . 16 mmol/l by 25 min, returning to mean basal value after 3 1/2 h. The mean (+/- SE) peak insulin levels after s.c. and i.m. injection were 0 . 13 +/- 0 . 01 and 0 . 18 +/- 0 . 04 pmol/ml at 90 and 60 min, respectively. After i.v. injection the maximum plasma insulin concentration of 6 . 9 +/- 0 . 73 pmol/ml was seen at 2 min. No adverse side-effects were observed.

Adult↗

Human insulin: study of safety and efficacy in man.

The safety and efficacy of a new highly purified neutral soluble human insulin produced by conversion of porcine insulin was compared with a highly purified neutral soluble porcine insulin in six normal men. The insulins were administered by subcutaneous injection at a dose of 0.075 U/kg body weight. Somatostatin was infused during the experiment to suppress endogenous insulin secretin. No difference was found in the plasma glucose, insulin, or metabolite responses. Thus the potency, onset, and duration of effect were identical with the two insulins. No short-term side effects to either insulin were observed. Highly purified, semi-synthetic human insulin offers a safe and effective means to explore the possible advantages of homologous human insulin in the management of diabetes mellitus.

Adult↗