Biomedical subjects
Publications and source records attributed to M Scott.
Mike Scott, social worker with Liverpool Personal Service Society, describes his disquieting experiences with terminally-ill patients whose conditions became conspiracies between the medical profession, social workers and relatives.
Specimens of 387 nasopharyngeal suction smears obtained from 354 children hospitalized with acute respiratory infections during an eight-month period were examined for the presence of respiratory syncytial (RS) virus by the indirect immunofluorescence antibody technique (IFAT) and by conventional tissue culture infectivity techniques. Respiratory syncytial virus was identified in nasopharyngeal suction smear specimens from 123 of these specimens (32%) with the use of both techniques. Of the specimens positive on tissue culture 92% were also positive for RS virus by IFAT. However, eight specimens positive for RS virus by tissue culture were negative by IFAT, although three of the specimens were technically unsuitable. Six percent of the specimens negative for RS virus by tissue culture were positive for RS virus antigen when tested by IFAT. Using IFAT, identification of RS virus could be accomplished within four to six hours, whereas isolation by tissue culture took an average period of ten days. These data suggest that IFAT is a reliable means for the rapid diagnosis of RS virus infection in infants and children.
For the past five years a herd of work oxen, now numbering some 450 individuals, has been maintained under the protection of trypanocidal drugs on a settlement scheme in an area of western Ethiopia infested with tsetse. This paper describes the environmental conditions and the epizootiology of trypanosomiasis in the oxen and in the vector, Glossina morsitans. It is concluded that with the strategic use of drugs, oxen can be kept alive and perform useful agricultural work, in areas of high tsetse challenge, provided reasonable standards of veterinary supervision and management are maintained.
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Groups of infants and children with infections due to respiratory syncytial virus (RSV) were tested at the onset of illness and one, two, and five months later for the presence of RSV-specific cell-mediated immunity, as determined by in vitro lymphocyte transformation (LTF) activity, and for complement-fixing (CF) antibody. An LTF response specific for RSV was observed in 65 % of patients, and the response was largely associated with E-rosette-forming thymus-derived (T) lymphocytes. A significant cell-mediated immune response was observed in 78% of patients six months of age or younger, whereas only 46% of patients older than six months exhibited such responses. The difference between the mean stimulation index of the maximal LTF response in the two age groups was statistically significant (P less than 0.05). On the other hand, a fourfold or greater rise in titers of CF antibody was observed in only 22% of patients six months of age or younger, whereas significant rises in antibody activity were observed in 50% of subjects older than six months. In view of the fact that RSV infection is most severe in the young infant, these observations raise the possibility that cell-mediated hypersensitivity reactions may be related to the pathogenesis of RSV infection of infants.
Using a 2-hour 47Ca absorption test, significant depression of active calcium absorption was demonstrated in 48 vitamin D untreated haemodialysis patients. This malabsorption of calcium could be corrected by the daily oral administration of 1--2 microgram of 1alphaOHD3 and 1--1.5 microgram of 1,25(OH)2D3. 5 microgram daily for 2 weeks of 3-deoxy-1alphaOHD3 AND 16 and 64 microgram daily for 1 week of 24R,25(OH)2D3 proved ineffective. In 32 successfully transplanted patients, restoration of normal or near normal renal function (serum creatinine less than 1.9 mg/100 ml) was not always followed by an immediate improvement in active calcium absorption. Calcium absorption, especially in female patients, was adversely affected by the required immunosuppressive prednisone therapy and improvement was slow.
Monocyte insulin receptor binding has been shown to be inversely correlated with basal insulin concentrations in a variety of clinical conditions and is believed to reflect autoregulation of receptor properties of insulin. We examined the insulin receptor in the infant of the gestational diabetic mother (IGDM) where hyperinsulinism has been implicated in the attendant metabolical abnormalities. Insulin concentrations in plasma of cord blood of IGDM were significantly greater than in normals delivered between 36-38 weeks by elective cesarean section (101.3 +/- 9.8 vs. 59.9 +/- 9.4 microU/ml; P less than 0.005). [125I]Insulin binding to receptors of monocytes obtained from cord blood showed that IGDM had more receptor sites per monocyte than normal adults and normal infants. In normal infants of similar gestational age, a significant correlation was found between birthweight and binding which was not observed in IGDM. Monocytes from both normal infants and IGDM showed greater affinity for insulin than those from adults. At plasma insulin concentrations of 1 and 4 ng/ml, monocytes from IGDM had about 10 times and normal infants had about 4 times as many sites occupied as those from normal adults. Monocytes from IGDM seem to develop increased concentrations of insulin receptors with hyperinsulinemia. Thus, despite increased ambient levels of insulin, monocytes of IGDM seem to develop increased concentrations of insulin receptor as well as increased affinity for the hormone.
A retrospective review of 20 cases of testicular neoplasia in cryptorchid patients is presented. These cases serve to emphasize the need for more effective diagnosis and management of the undescended testis. The various clinical presentations, diagnostic modalities, prognostic indicators, and types of management are reviewed. Due to its inaccessibility and array of clinical presentations, the intraabdominal testies tumor continues to be a diagnostic challenge. Strict attention to diagnostic cues and adherence to the management practices presented here would hopefully result in an overall decrease in testis tumors in the post-pubertal male.
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The experience of the University of Colorado Medical Center affiliated hospitals with leukemic reticuloendotheliosis, hairy cell leukemia, during the past two years has been reviewed. Eight instances were found. The majority of patients in this study presented with fatigue, pancytopenia and splenomegaly. Diagnosis was based upon finding characteristic hairy cells in the blood, bone marrow or spleen. Treatment, unlike other hematopoietic malignant conditions, was primarily surgical, with splenectomy being the treatment of choice, which may lead to prolonged remission in the majority of instances.
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Tritiated N-hydroxysuccinimide acetate was prepared with specific activities up to 5 Ci/mmole and utilized to prepare tritiated triacetyl insulin. Binding of triacetyl insulin to liver plasma membranes was measured by its capacity to displace 125I-monoiodoinsulin. At low concentrations, less than 10 ng/ml triacetyl insulin appears to be as effective as native insulin in reducing the binding of 125I-monoiodoinsulin to plasma membranes. At concentrations of 20 ng/ml and higher, triacetyl insulin is significantly less effective than native insulin in displacing binding of 125I-monoiodoinsulin to plasma membranes. The properties of triacetyl insulin in this system are not ascribable to deacetylation and conversion of the substituted product to native insulin. Biologic activity of triacetylated insulin was studied in two other in vitro systmes. A comparison was made of the capacity of native beef insulin and its triacetyl derivative to stimulate glucose oxidation by epididymal fat pads. At all three concentrations tested (2, 6, and 18 ng/ml), triacetyl insulin exerted considerable activity, although its potency was significantly less than that of native insulin. Similar effects were observed when biologic activity was measured by induction of tyrosine-alpha-ketoglutarate transaminase in a cultured liver cell system where significant activity of triacetyl insulin was found at concentrations of 10(-9)-10(-7) M. In all systems tested, the activity of triacetylated insulin could not be accounted for by deacetylation and conversion to native insulin. In all systems studied, triacetyl insulin was more resistant to degradation than was monoiodoinsulin.
Triiodothyronine (T3) suppression and thyrotropin-releasing hormone (TRH) tests were used to study thyroid function in 50 patients with thyroid disease. The results of the thyroid function tests were compared with the levels of serum thyroid-stimulating immunoglobulins (TSI) measured by a radio-receptor assay. In euthyroid and hyperthyroid patients, the presence of TSI corresponded with the absence of TSH control of thyroid function. However, in two hypothyroid patients with serum TSI levels readily detectable in the receptor assay, T3 suppression and TRH tests indicated that thyroid function was under TSH control.
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A device, the enzyme thermistor, is described which is capable of measuring changes in heat due to enzymic reactions. The sensor, a thermistor, is in direct contact with the site of reaction through its placement in a microcolumn filled with an immobilised enzyme preparation. The substrate solution flows past the thermistor tip, and as much as approx. one half of the total heat evolved can be registered as temperature change, deltat. Glass-bound glucose oxidase (EC 1.1.3.4), penicillinase (EC 3.5.2.6), trypsin (EC 3.4.21.4) and urease (EC 3.5.1.5) were used for the determination of glucose, penicillin G, benzoyl-L-arginine ethyl ester and urea respectively. Linear relationships between the deltat recorded and the concentration of substrate were obtained in all cases.
In eight of 590 consecutive patients operated on by the author for a proven brain tumor, the preoperative diagnosis was complicated by a spontaneous intracerebral hematoma caused by the neoplasm. The presenting symptoms were those of hypertensive intracerebral hemorrhage or brain tumor. The pathology underlying spontaneous bleeding from a cerebral neoplasm is reviewed and diagnostic suggestions discussed.