Biomedical subjects
M Shahmanesh
Publications and source records attributed to M Shahmanesh.
The place of lung 99mTc DTPA aerosol transfer in the investigation of lung infections in HIV positive patients.
Pneumocystis carinii pneumonia (PCP) is the most common cause of pneumonia in HIV antibody positive patients, but other pneumonias remain important, i.e. streptococcal and mycobacterial infections. A definitive diagnosis relies on obtaining samples from the lung either noninvasively (induced sputum), or invasively (bronchoalveolar lavage, transbronchial or open lung biopsy). We have used the noninvasive technique of nebulized 99mTc DTPA transfer, to assess patients with PCP (n = 30) and other lung infections (n = 20) to see whether this test will distinguish between the various infections. The presence of a biphasic, rapid transfer curve indicates severe extensive alveolar damage and is seen in PCP or legionella pneumonia. The mean transfer time (T50 +/- SEM) for patients with PCP (whether smokers or nonsmokers) was 2.1 +/- 0.2 min, and for two of the patients with legionella 3.2 min. In PCP effective treatment causes the transfer to slow (mean T50 22.7 +/- 3.3 min, n = 24) and become monoexponential. Other causes of these changes in transfer are discussed. The other pneumonias (streptococcal, mycobacterial, and staphylococcal) did not result in biphasic curves or very rapid times, their T50 values are indistinguishable from cigarette smokers. In this patient group the DTPA transfer is a useful noninvasive investigation with a very rapid, biphasic curve indicating a high probability of PCP.
Characteristics of inflammatory cells in urethral smears from men with non-gonococcal urethritis.
Differential cell counts in inflammatory exudates were undertaken in urethral smears from men with non-gonococcal urethritis (NGU) for the first time, recurrent NGU (presumably reinfection) after a new sexual contact, or persistent NGU (in patients with no recent history of sexual exposure). Patients experiencing first episodes of NGU had significantly higher macrophage counts, both in relative and absolute terms, than the other two groups, regardless of the presence or absence of Chlamydia trachomatis in the urethral culture. The estimated total inflammatory cell count (ETICC) in the urethral exudate was assessed by counting the number of inflammatory cells in the first voided urine. The ETICC was significantly lower in patients with persistent NGU but no recent history of sexual exposure than in patients with NGU for the first time or with NGU presumably caused by a new infection. The ETICC in all three groups of patients was significantly higher than in controls. A more precise definition of NGU or more reproducible methods of diagnosis may possibly differentiate patients without an infective cause.
A forgotten factor in pelvic inflammatory disease: infection in the male partner.
Explore the source record for details and available documents.
Alveolar permeability in HIV antibody positive patients with Pneumocystis carinii pneumonia.
Pulmonary permeability was assessed using the technique of 99mTc (technetium-99m) diethylene triamene pentacetic acid (DTPA) aerosol transfer in 10 patients who had antibodies to human immunodeficiency virus (HIV) and were non-smokers and in 20 HIV antibody positive smokers. Five patients had Pneumocystis carinii pneumonia (PCP) proved by transbronchial lung biopsy; four were non-smokers and one a smoker. Two findings emerged: patients with PCP had greater epithelial permeability than non-smokers and smokers; and the permeability curves were monophasic in smokers and non-smokers, but biphasic in patients with PCP. The biphasic curve observed is indicative of diffuse alveolar damage and might be useful to predict PCP in patients with antibodies to HIV who have normal chest radiographs. As the study was of only five patients with PCP, however, further studies are necessary to confirm this observation.
Penicillinase producing Neisseria gonorrhoeae in the United Kingdom.
Following the isolation of the first penicillinase-producing gonococcus in 1976 the number of such isolates rose rapidly in the United Kingdom until 1982. There was a smaller increase in 1983. At St. Thomas' Hospital, the largest clinic serving the population of South London, there was a parallel rise with stabilisation from 1982 to 1984. While for some years relatively more infections diagnosed at St Thomas' Hospital appeared to originate abroad than in the country as a whole, this proportion has gradually declined to approximately the national figure. With a gradual decline in the total numbers of gonococcal infections in the United Kingdom the proportion of infections by PPNG has continued to rise. It is important to monitor this closely, to review therapy recommendations where indicated and to maintain a vigilant watch for local epidemics.
Antispermatozoal antibodies in men with urethritis.
Antispermatozoal antibodies have been measured by the tray agglutination test (TAT) in three groups of patients with urethritis attending a clinic for sexually transmitted diseases and in one control group of men without urethritis. In 3 of 17 (17.6%) patients with acute nongonococcal urethritis (NGU) the serum TAT was positive at titers of 1:16 or more; and in 1 of these patients in whom Chlamydia was grown, the TAT titer rose from 1:4 before treatment, to 1:8 at 2 weeks, and 1:16 at 4 weeks, indicating probable immunization against sperm antigens at the time of infection. A rise in titer from 0 to 1:8 occurred in a second patient with NGU. Six (15.6%) of 39 patients with recurrent NGU and 2 (16.6%) of 12 patients with gonorrhea followed by postgonococcal urethritis also had positive antisperm antibody titers of 1:16 or more. None of 27 control subjects had positive antisperm antibody titers. These observations indicate that development of antisperm antibodies can be stimulated in some individuals by NGU.
Ciprofloxacin for treating urethral gonorrhoea in men.
The effectiveness of a single oral dose of ciprofloxacin in eradicating urethral gonorrhoea was assessed in 18 men who received 250 mg and 26 men who were given 100 mg. All patients, including two infected with beta lactamase (penicillinase) producing strains of Neisseria gonorrhoeae (PPNG), were cured. The drug had no effect on infection with Chlamydia trachomatis or on the incidence of post gonococcal urethritis. Ciprofloxacin may be useful in patients hypersensitive to penicillins and cephalosporins, and the drug may also be useful in urethral gonorrhoea caused by PPNG strains.
Pituitary function tests in Sheehan's syndome.
Fourteen patients with a typical history of Sheehan's syndrome underwent pituitary function tests with simultaneous injections of 100 micrograms LH-RH, 200 micrograms TRH and 0.05--0.1 units of soluble insulin per kg body weight. Serum prolactin levels remained unchanged in all of eleven subjects given TRH. GH levels did not rise after hypoglycaemia in five subjects. In contrast serum LH and FSH rose significantly in twelve out of fourteen subjects given LHRH and serum TSH rose significantly in five out of seven subjects given TRH. It is concluded that pituitary function is relatively preserved for LH and FSH but not for prolactin and GH in Sheehan's syndrome. It is further suggested that absence of a rise in prolactin following TRH stimulation may provide the most sensitive test of pituitary hypofunction in postpartum haemorrhage.
Feedback control of FSH secretion in the male rat.
Site of feedback control of FSH secretion in the male rat was studied by measuring changes in serum LH, FSH and hypothalamic LH-RH by radioimmunoassay in rats after castration and after 500 rad X-irradiation to the testis. The rise in serum LH and FSH in castrated animals was associated with a significant fall in hypothalamic LH-RH 16 and 24 days after castration. Serum FSH rose significantly after X-irradiation without a significant change in serum LH or hypothalamic LH-RH content up to 30 days after irradiation. When pituitary halves from X-irradiated animals were incubated in vitro in the presence or absence of synthetic LH-RH, there was a significant rise in FSH (but not LH) released in the incubation medium in the absence of added LH-RH. The response of the pituitaries to LH-RH was, however, not different between control and irradiated rats. It is concluded that the testicular FSH-inhibitory substance acts predominantly at the pituitary gland on the LH-RH independent release of FSH.
Radioligand receptor assay of FSH.
The assay of FSH by a radioligand receptor assay (RLA) using homogenates of rat testicular tissue incubated for 17 h at 21 degrees C has been assessed. Chloramine-T or lactoperoxidase were used for iodination. The assay gave linear dose-response lines between 30 and 2000 ng sheep FSH/tube, and there was usually no major interference by LH. Two batches of labelled FSH, however, gave assays in which LH showed a striking interaction with FSH. When these batches were avoided and FSH and LH were mixed in ratios that differed less than fourfold, the assay was combined successfully, in the same tubes, with an RLA for LH, using LH and FSH labelled with 131I and 125I respectively. The RLA for FSH was not suitable for assay of FSH in rat serum because of apparent non-specific interference. Assay by RLA of rat FSH, in pituitary homogenates or released during incubation in vitro, gave results which were not closely correlated with those of either conventional bioassay or radioimmunoassay.
Absence of an immunologically distinct follicle-stimulating hormone releasing factor in rat stalk median eminence extracts.
Rat stalk median eminence (SME) extract was incubated with various quantities of an antiserum raised against synthetic luteinizing hormone (LH-RH) and the resulting material was used at two or more dose levels to stimulate release of LH and FSH from anterior pituitary tissue, obtained from male rats, incubated in vitro. The resulting dose-response lines were use to obtain the LH- and FSH-releasing potency of the material, expressed as a percentage of SME extract pre-incubated with normal rabbit serum. Treatment with various doses of antiserum reduced LH-releasing and FSH-releasing potencies to a similar extent. Stalk median eminence extract and synthetic LH-RH were incubated with antiserum and directly compared in the same experiment in vitro. The changes in LH and FSH release caused by pre-treatment with antibody were similar for SME extract and synthetic LH-RH. In a final experiment, SME extract was passed through a column of Sepharose 2B particles to which was coupled anti-LH-RH antibody. The resulting material, when mixed with synthetic LH-RH and used to stimulate rat pituitary tissue in vitro caused a similar increase in the LH- and FSH-releasing potencies of the synthetic decapaptide. It is concluded that rat SME extract contains a single releasing factor for LH and FSH immunologically indistinguishable from synthetic LH-RH.
The response to luteinizing hormone-releasing hormone in normal men.
Explore the source record for details and available documents.
Discrepancy between radioimmunoassay and radioligand-receptor assay of luteinizing hormone released in vitro by pituitary tissue from male rats of different ages.
Anterior pituitary glands from male rats aged 21, 40, 60 or 95 days were incubated in medium containing 0, 2 or 20 ng luteinizing hormone-releasing hormone (LH-RH)/ml. Incubates were assayed for LH by radioimmunoassay (RIA), by the radioligand-receptor assay (RLA) using testicular homogenates as the source of receptor and, in some instances, by the ovarian ascorbic acid depletion assay (OAAD). Irrespective of the dose of added LH-RH, glands from rats aged 40 and 60 days always showed a higher release of LH, as determined by RLA, than glands from animals aged 21 or 95 days. Measurement by RIA showed a similar pattern to RLA in the basal release of LH, but in the presence of LH-RH showed little difference in LH release by glands from rats aged 40, 60 or 95 days. The LH release caused by the higher concentration of LH-RH was always greater when measured by RLA than by RIA. Assay of comparable incubates by OAAD showed close agreement with RLA estimates in four incubations (mean index of discrimination 1.07; range 0.86-1.18) and consistent disagreement with RIA estimates (1.64; range 1.38-1.99). In contrast to the results with incubates, homogenates of pituitary glands from male rats of various ages showed close agreement of estimates by RLA, RIA and OAAD. These results suggest that RIA underestimates the LH-RH-stimulated release of LH in vitro from the male rat pituitary during some stages of sexual maturation.
Release of follicle-stimulating hormone in vitro from pituitary tissue of mal rats or various ages.
Explore the source record for details and available documents.
Proceedings: Response to luteinizing hormone releasing hormone in vitro by pituitary tissue from male rats of different ages.
Explore the source record for details and available documents.
Blood lipids in treated diabetics.
Explore the source record for details and available documents.
Plasma prolactin, GH, LH, FSH, TSH and testosterone during treatment of prostatic carcinoma with oestrogens.
Explore the source record for details and available documents.