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Biomedical subjects

M West

Publications and source records attributed to M West.

At least 163 records · Page 9Linked to original sources
PubMed1988

Hypermetabolism/organ failure: the role of the activated macrophage as a metabolic regulator.

Multiple organ failure continues as the main cause of death after burns, trauma and sepsis. This clinical syndrome represents the transition from a hypermetabolic response to injury to a setting of clinical organ failures and death. Risk factors include: perfusion deficits, persistent foci of dead or injured tissue, an uncontrolled focus of infection, the presence of the respiratory distress syndrome, persistent hypermetabolism, and preexisting fibrotic liver disease. Once in the organ failure syndrome, most treatment modalities become progressively ineffective, including: ventilation, antibiotics, nutrition, and surgery. The best treatment remains prevention with rapid control of the source and restoration of oxygen transport. The response to injury involves alterations in physiology and in the metabolism of carbohydrate, fat and amino acids. These changes seem to reflect the modulation of the end-organs by the mediator systems activated in response to the stress stimulus. The transition from hypermetabolism to organ failure appears to reflect the clinical appearance of liver failure. It is currently hypothesized that this liver failure represents a state of regulatory dysfunction induced by the activated hepatic macrophage, the Kupffer cell. This same process may also influence metabolic failure in other organs where this cell-cell regulation can occur, e.g. kidney, lung. The activation of these macrophages is hypothesized to represent the final stage of a series of continuous stimulating events, eg. hypoxia, endotoxin, bacteria, and gut translocated toxins. The precise monokine(s) responsible are not yet completely characterized. Treatment consists of the modalities outlined above and the employment of aggressive metabolic (nutritional) support.

Humans↗
PubMed1987

Effect of hypoglycin A on insulin release.

Thirty experimental and fifteen control Wistar rats were studied to determine whether hypoglycin A influences insulin levels in the body to contribute to the state of hypoglycemia usually observed in Jamaican vomiting sickness, a condition arising after ingestion of unripe ackees. This fruit also grows in other Caribbean islands, as well as North and Central America. Hypoglycin A is one of the toxic compounds found in unripe ackees and is capable of inducing hypoglycemia. A fall in blood glucose occurred after administration of hypoglycin A. The lowest level of 42.60 +/- 4.84 mg/dl was attained 3 hr after administration of the drug. This alteration of blood glucose from the fasting level of 80.31 +/- 5.20 mg/dl was significant (P less than 0.01). The blood glucose level in the control rats showed no significant change from the fasting level. The insulin level in portal and peripheral blood showed no significant change. Results showed that, although hypoglycin A induced severe hypoglycemia after intravenous application, there was no significant change in insulin levels. This observation suggests that hypoglycin A has a mechanism of action other than an alteration in insulin levels to induce hypoglycemia.

Animals↗
PubMed1987

Multiple intracerebral arteriovenous malformations. A case report and literature review.

The presence of multiple intracerebral arteriovenous malformations (AVMs) in a single patient has only been very rarely reported. We present a patient with three separate angiographically demonstrable intracerebral AVMs, all of which were radiologically demonstrated and surgically removed without residual neurological deficit. A literature survey was conducted and all the previously described cases of multiple intracerebral AVMs are discussed, along with the potential diagnostic and therapeutic implications.

Abnormalities, Multiple↗
PubMed1987

Carotid endarterectomy without indwelling shunts and intraoperative electrophysiologic monitoring.

Although carotid endarterectomy is a common surgical procedure in North America, controversies exist regarding the type of anesthesia, the use of indwelling shunts and the need for intraoperative cerebral monitoring. We present a prospective study of 100 carotid endarterectomies performed over a three year period by a single surgeon without the use of indwelling shunts, patch grafts, or EEG monitoring. The combined stroke and mortality rate was 1%. Our results confirm those of other authors; that indwelling shunts and EEG monitoring are not absolutely essential for a satisfactory outcome in carotid endarterectomies.

Aged↗
PubMed1987

Prototypicality ratings of DSM-III criteria for personality disorders.

Although DSM-III personality disorder criteria have demonstrated acceptable reliability, the question of validity has not been adequately addressed. A first step in establishing the validity of diagnoses is to establish the validity of the criteria used to assess each diagnosis. The content validity of diagnostic criteria was investigated in relation to the larger set of potential criteria culled from the psychiatric literature. For each DSM-III axis II diagnosis, a panel of clinicians rated how prototypical each potential criterion was of the diagnosis in question. The results reveal problems with the organization and content of the criteria for most diagnoses. Many DSM-III criteria are composed of several statements linked by conjunctions or disjunctions. These component statements often received markedly different ratings, suggesting that criteria should be single statements. For most diagnoses, traits not included in DSM-III received higher ratings than did some DSM-III criteria. Suggestions are made to improve the distinctiveness and content validity of paranoid, schizoid, antisocial, borderline, avoidant, dependent, and compulsive personality disorders. The results for schizotypal personality disorder suggest that many clinicians are uncertain about this diagnosis. These findings provide a systematic way to modify definitions that contrasts with the more arbitrary ways in which diagnoses have previously been defined and redefined.

Diagnosis, Differential↗
PubMed1987

An approach to the delineation of adult attachment. Scale development and reliability.

The authors present the results of a project to develop scales to measure the features of adult attachment using a construct-oriented approach. Adult attachment is defined in terms of eight features: proximity seeking, secure base effect, separation protest, feared loss of the attachment figure, reciprocity, availability, responsiveness of the attachment figure, and use of the attachment figure. Each feature was defined and a large item pool to tap all dimensions was derived from item nominations by clinicians, researchers, and lay subjects. The resultant scales were administered to a small sample for preliminary empirical testing. Analyses of internal reliability for each scale resulted in the elimination of items that detracted from reliability. After editing, all scales had satisfactory internal consistency. A discriminant-functions analysis provided suggestive evidence that this method of defining and measuring adult attachment would have relevance for identifying psychopathology.

Adult↗
PubMed1987

Do pressor neurons in the ventrolateral medulla release amines and neuropeptides?

Activation of neurons arising in the rostral ventrolateral medulla evokes a pressor response in the rat and the rabbit. This region of the medulla gives rise to bulbospinal neurons containing many different neurotransmitters, including amines such as adrenaline, noradrenaline and serotonin, and neuropeptides such as substance P and neuropeptide Y. Colocalization of amines and neuropeptides has been described in some neurons descending from the rostral ventrolateral medulla. In this paper we discuss the evidence that bulbospinal serotonin-containing neurons (B3) and adrenaline-containing neurons (C1) arising from this part of the medulla exert pressor effects by distinct central pathways and conclude that they do. We also consider the possibility that the pressor effects of activating these two groups of neurons are associated with release of neuropeptides and highlight evidence that substance P is released into the spinal cord by activation of descending serotonin-containing neurons, while neuropeptide Y may be released by activation of bulbospinal adrenaline-containing neurons.

Animals↗
PubMed1987

Adenylate cyclase stimulation and [3H]thymidine incorporation in human thyroid tissues and thyrocyte cultures: the effect of IgG preparation from patients with different thyroid disorders.

Primary cell cultures of normal and adenomatous human thyroid tissues were incubated with TSH or ammonium sulphate precipited IGG fractions (1 mg/ml) of sera from patients with different thyroid diseases (Graves' disease: active n = 7 in remission n = 12; thyroid autonomy n = 39; simple euthyroid goitre n = 15) and were compared to controls (n = 26). [3H]thymidine incorporation in primary thyrocyte cultures demonstrated a typical bell shape curve after incubation with EGF and TSH with a maximal effect at 10-100 microIU/ml. This effect, however, was inconsistent and positive only in 2 of 7 primary cultures. Only TSH positive cultures were used for IgG studies. 16-28% of IGG fractions from sera of thyroid patients caused high (more than X + 5 SD of controls) stimulation of [3H]thymidine incorporation. Dose response curves of IgG fractions of 19 additional patients (Graves' disease in remission n = 15; thyroid autonomy n = 4) showed an increase in [3H]thymidine incorporation at 0.1 mg protein/ml for 10 patients and at low concentrations of 10-5 mg/ml for 5 patients. There was a good correlation (r = 0.72) (P less than 0.0001) between positive findings in TSH-binding inhibition (TBII) and AC-stimulation (TSI) IGG fractions but none between stimulation of [3H]thymidine incorporation and any other thyroid specific immunoglobulin nor thyroid function nor any other available data. Immunoglobulins stimulating [3H]thymidine incorporation differ therefore from TBII and TSI. The growth effect of these immunoglobulins, however, has yet to be determined.

Adenoma↗
PubMed1987

Felodipine compared to prazosin as additional therapy to a beta-blocking drug.

Felodipine was compared with prazosin in patients with essential hypertension whose blood pressure was not controlled by a beta-blocking drug. One hundred patients with a supine diastolic blood pressure greater than or equal to mm Hg after 4 weeks or more on a beta-blocking drug and placebo were randomly assigned to felodipine or prazosin tablets. The drugs were titrated at 2-week intervals if diastolic BP was greater than or equal to 90 mm Hg. Titration steps of felodipine were 5, 10, 20 mg b.i.d. and of prazosin were 1, 2, 4 mg b.i.d. The fall in blood pressure with felodipine 32/21 mm Hg was greater than the fall with prazosin 16/12 mm Hg (p less than 0.001); 36 patients achieved a diastolic blood pressure of less than 90 mm Hg with felodipine, which was a significantly greater number than the 20 patients who obtained such a level with prazosin (p less than 0.01). Both drugs were well tolerated, but more patients complained of vascular type side effects (flushing, peripheral edema) with felodipine than with prazosin. There was significant weight gain with prazosin but not with felodipine. Felodipine was shown to be a well-tolerated, effective antihypertensive agent when used with a beta-blocking drug and to be suitable for people with hypertension who fail to be controlled with a beta-blocking drug.

Adrenergic beta-Antagonists↗
PubMed1986

Formation of 8-hydroxydeoxyguanosine, hydroxyl free radical adduct of DNA in granulocytes exposed to the tumor promoter, tetradecanoylphorbolacetate.

The exposure of human granulocytes to the tumor promoter, tetradecanoylphorbolacetate (TPA), resulted in the accumulation of 8-hydroxydeoxyguanosine (8-OHdG) in the DNA of the treated cells. Hydroxyl free radicals react with DNA causing the hydroxylation of guanine at the C-8 position. The modified nucleoside (8-OHdG) cleaved from DNA, was quantitated at subpicomole levels utilizing high pressure liquid chromatography with electrochemical detection (LCED). Superoxide dismutase and catalase caused a marked decrease in the levels of 8-OHdG in the cellular DNA. The level of 8-OHdG formed by TPA stimulation of granulocytes was equivalent to one modified guanine for about every 600 possible guanines in the cellular DNA.

8-Hydroxy-2'-Deoxyguanosine↗
PubMed1986

Circulating antibody response of mice exposed to 9-GHz pulsed microwave radiation.

Female CD-1 mice immunized against the bacterium Streptococcus pneumoniae type III were exposed to 9-GHz pulsed microwaves (pulse repetition rate 970-1,000, pulse width 1.0 microseconds, peak power 1 W/cm2) at an average incident power density of 1 mW/cm2 (calculated SAR congruent to 0.47 W/kg) for 2 h per day for 5 days. Circulating antibody titers for the microwave-exposed animals were not significantly different from those of the sham-irradiated animals, and there were no differences in any of the hematological parameters analyzed, indicating that 9-GHz pulsed microwaves at 1 mW/cm2 do not alter the immune response of mice immunized against S pneumoniae.

Animals↗