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Biomedical subjects

N D Gallagher

Publications and source records attributed to N D Gallagher.

At least 37 records · Page 2Linked to original sources
PubMed1989

Decision-making in 100 patients referred to the Australian National Liver Transplantation Unit.

One hundred patients were referred to the Australian National Liver Transplantation Unit between January 1986 and August 1987. The commonest disorders for referral were chronic active hepatitis in adults (22 cases), fulminant hepatic failure (14), primary biliary cirrhosis (PBC) (12) and primary sclerosing cholangitis (PSC) (10). Of the 100 patients 31 were activated for transplantation while 35 were deferred and 34 were found to be unsuitable. The decision-making in these patients is discussed according to disease category. Timing of transplantation in PBC and PSC seemed clearcut, with 50% of referred patients being activated. However, major difficulties in timing of transplantation were found, particularly in patients with chronic active hepatitis (CAH) and fulminant hepatic failure (FHF). Of 36 patients with CAH (22) or FHF (14) only five were put on the active waiting list and only two were transplanted. Overall, 25 of the 31 patients underwent orthotopic liver transplantation, with 16 alive two-30 months later.

Adult↗
PubMed1988

The role of nuclear medicine in liver transplantation.

The role of hepatobiliary isotopic scanning after liver transplantation was assessed in the first 12 adult patients in the Pilot National Liver Transplantation Programme who underwent this procedure at the Royal Prince Alfred Hospital. Iminodiacetic-acid derivative (HIDA) studies were useful in the non-invasive assessment of hepatic function and biliary excretion. The following four clinical situations were assessed by hepatobiliary scans: early graft function; rejection episodes; vascular complications; and biliary-tract problems. Nuclear medicine has an important and valuable role in the postoperative monitoring of patients after liver transplantation. The studies are non-invasive and can be performed readily at the bedside in the intensive care unit.

Adolescent↗
PubMed1987

Initial report of the Australian National Pilot Liver Transplantation Programme.

Our group began a National Pilot Liver Transplantation Programme in January, 1986, for which this report documents the results of the first 15 months' work. Seventy potential recipients (55 adults, 15 children) were referred for consideration for liver transplantation either directly or by state selection committees that had been established in most Australian states. The most common conditions for referral of adults were chronic active hepatitis, primary sclerosing cholangitis and primary biliary cirrhosis; 11 patients had fulminant hepatic failure. In children, the most common condition for referral was biliary atresia. Twenty-nine (41%) patients were considered unsuitable candidates for liver transplantation, 25 patients (21 adults and four children) were accepted for transplantation at a later time, and 16 patients (11 adults and five children) were selected for immediate transplantation. Of these 16 patients, three patients died before a donor could be found. Of the 13 patients to receive transplants (one patient received two transplants), 10 patients (seven of nine adults; three of four children) are alive and well; nine patients have good liver function and one patient has impaired liver function. The additional costs of the Programme to the hospitals were estimated at approximately $2 million a year. It is concluded that for those persons who require liver transplantation in Australia, worthwhile survival after this procedure can be obtained.

Adolescent↗
PubMed1985

Long-term survival with tumor regression in androgen-induced liver tumors.

Two patients with androgen-induced liver tumors, one of whom had been partially treated by a liver resection, are reported. Hepatocellular carcinoma was diagnosed on histologic grounds. The patients had been receiving androgen therapy for primary diagnoses of either hypopituitarism or paroxysmal nocturnal hemoglobinuria. After androgen withdrawal, both are alive and well with no evidence of residual tumor 10 and 14 years after diagnosis, respectively.

Adult↗
PubMed1985

Intrinsic factor-cobalamin accumulates in the ilea of mice treated with chloroquine.

Chloroquine, which interferes with the degradation of a number of transport proteins, impedes the exit of cobalamin from the small intestine of the mouse. This study was designed to determine if treatment with the drug led to the retention of cobalamin in the form of intrinsic factor-cobalamin in the ileal mucosa. Solubilized homogenates were prepared 2-4 h after an oral dose of [57Co]cobalamin and were examined by gel chromatography. There was a progressive transfer of [57Co]cobalamin from a protein identified as intrinsic factor to transcobalamin II in control mice. In chloroquine-treated mice, the major radioactive protein peak 2-4 h after an oral dose corresponded with the position of intrinsic factor. Only a small amount of the radioactivity was associated with transcobalamin. Cobalamin binding proteins were also identified by polyacrylamide gel electrophoresis and by their reaction with specific antibodies. It is concluded that chloroquine interferes with the release of cobalamin from intrinsic factor and thus slows the release of cobalamin from the intestine.

Animals↗
PubMed1985

In vivo evidence that cobalamin is absorbed by receptor-mediated endocytosis in the mouse.

This study examines the mechanism of cobalamin absorption in the context of receptor-mediated endocytosis. Uptake, the amount of cobalamin that left the intestinal lumen, and transport, the component that was located in organs beyond the intestine, were measured after feeding saturating doses of [57Co]cobalamin to mice. Uptake from a 40-ng dose of [57Co]cobalamin at 1 h was 18.6 +/- 6.3 ng (mean +/- SD; n = 6). When the dose was given 1 h after 40 ng of unlabeled cobalamin, uptake was 18.5 +/- 1.5 ng, n = 6, indicating rapid clearance of the surface receptors. Transport of the initial and of a subsequent dose of cobalamin could not be detected for 2 h but the amounts and rates of transport were similar. Oral chloroquine and intraperitoneal cycloheximide reduced transport at 4 h to 4.3 +/- 1.6 ng, n = 8 and 5.6 +/- 2.4 ng, n = 7, respectively. Control values were 14.3 +/- 1.3 ng, n = 8. These results indicate that the transport of cobalamin involves a series of compartments, one of which may be lysosomal, and that there is a requirement for new protein synthesis.

Animals↗
PubMed1985

Mesenteric node enlargement as a cause of intestinal variceal hemorrhage in nodular lymphoid hyperplasia.

Jejunal varices were a cause of recurrent gastrointestinal hemorrhage in an 18-year-old man with common variable immunodeficiency and nodular lymphoid hyperplasia of the small intestine. Despite numerous procedures, including upper gastrointestinal endoscopy, colonoscopy, arteriography, and exploratory laparotomy no active bleeding site was identified until superior mesenteric angiography demonstrated thrombosis of the superior mesenteric vein with an extensive collateral circulation through mesenteric varices. At laparotomy, mesenteric lymph nodes up to 4 cm in diameter seemed to be compressing the superior mesenteric vein. Histological examination of a node revealed reactive hyperplasia with prominent germinal centers. After resection of varices in a 20-cm length of proximal jejunum, there has been delayed, but complete resolution of bleeding in a 17-month follow-up.

Adolescent↗
PubMed1985

Risk factors associated with hepatitis B infection in antenatal patients.

Risk factors associated with HBsAg carriers were prospectively examined in 1821 women attending the Antenatal Clinic of an inner-city obstetrics hospital. Of the sample, 3.2% were HBsAg carriers and 28.7% of 725 tested for anti-HBs were positive. Birth in a country where the prevalence of HBsAg is high and Aboriginal ancestry were the major associated factors rather than a past history of hepatitis or intravenous drug use. Women from Indochina or the Pacific region, if HBsAg-positive, were more likely than other carriers to have markers of viral replication including HBeAg, hepatitis B virus (HBV) DNA, and DNA polymerase. Evidence of past infection with HBV also varied with country of birth, but 11% of women with no apparent risk factors for prior HBV infection were anti-HBs positive. This study indicates the need for a screening programme for HBsAg in antenatal populations.

Australia↗
PubMed1983

Increased intestinal uptake of cobalamin in pregnancy does not require synthesis of new receptors.

Increased intrinsic factor cobalamin binding to receptors present in ileal mucosa from mice in the late stages of pregnancy is regulated by placental lactogen. In mice at day 18-20 of pregnancy given an intraperitoneal injection of cycloheximide, 0.5 mg/kg, receptor binding was reduced from 0.42 ng/mg protein to 0.18 ng/mg protein 4 h later. Intestinal mucosal protein synthesis was less than 20% of control values after this dose of cycloheximide. Although this result could be interpreted to mean that the increase in receptors in pregnancy was due to new protein synthesis, cycloheximide-treated mice also had reduced concentrations of placental lactogen in serum. Supplementation with the hormone in cycloheximide-treated mice maintained receptor binding at pregnant levels. Analysis of binding data showed receptor number to be 3.1 X 10(11)/mg protein and the binding constant (Ka) to be 0.5 X 10(12) M-1, which were similar to values found in untreated pregnant mice. It is concluded that, because the increase in receptors cannot be explained on the grounds of new protein synthesis, placental lactogen may recruit cryptic intrinsic factor cobalamin receptors.

Animals↗
PubMed1983

Importance of vitamin B12 and folate metabolism in malabsorption.

The risk of developing folate deficiency is greatest in patients who have a poor diet and malabsorption secondary to disease of the jejunal mucosa or drugs which interfere with its metabolism. In contrast to cobalamin deficiency, in which body stores delay the onset of major metabolic complications, folate deficiency may develop in a matter of months. It is frequently possible to predict these deficiencies and always possible to reverse them by supplementation.

Diet↗
PubMed1982

Evolution of fascioliasis after eating wild watercress.

Fascioliasis is rarely reported in humans although it is endemic in sheep and cattle. We describe the illness of a 60-year-old widow who ate wild watercress which is the usual source of infestation. Laparotomy for suspected liver abscesses revealed necrotic tracts on the surface of the liver left by the invasion of numerous flukes. Diagnosis was made during the latent phase by the detection of serum antibody to fasciola hepatica antigen obtained from a sheep. Symptoms returned during the cholestatic phase. Mature flukes were then present in the large bile ducts and ova appeared in the stools. Symptoms resolved twelve weeks after presentation.

Australia↗
PubMed1981

Evaluation of a commercial enzyme radioimmunoassay kit for serum carcinoembryonic antigen.

An enzyme immunoassay kit for carcinoembryonic antigen (CEA) that uses plastic beads coated with guinea-pig anti-CEA as first antibody and goat anti-CEA conjugated with horseradish peroxidase as second antibody has been evaluated. The method does not involve perchloric acid extraction and therefore avoids a dialysis procedure. It is accurate, sensitive, and inexpensive to operate, and provides values comparable to those obtained with the Roche-CEA Z-Gel radioimmunoassay.

Carcinoembryonic Antigen↗