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Biomedical subjects

R Worth

Publications and source records attributed to R Worth.

35 records · Page 2Linked to original sources
PubMed1983

Glycosylated haemoglobin in cord blood following normal and diabetic pregnancies.

Cord and maternal blood samples were obtained at delivery in 25 normal and 14 diabetic pregnancies (13 insulin-dependent, one gestational). Total glycosylated haemoglobin, measured by the colorimetric thiobarbiturate method (mmol hydroxymethylfurfural/mol haemoglobin), was lower in cord than maternal blood (mean 18.7 +/- 1.7 versus 26.5 +/- 2.1, mean +/- SD, p less than 0.001). Glycosylated haemoglobin was higher following diabetic pregnancies, both in cord (diabetic 19.9 +/- 1.6 versus normal 17.9 +/- 1.4, p less than 0.001) and maternal samples (diabetic 27.7 +/- 1.5 versus normal 25.6 +/- 2.1, p less than 0.005). Cord and maternal glycosylated haemoglobin correlated in the normal (r = 0.60, p less than 0.01) but not in the diabetic group (r = 0.02, NS). Birth weight ratio was higher in infants of diabetic than of normal mothers (1.10 +/- 0.16 versus 0.99 +/- 0.13, p less than 0.05) but failed to correlate with cord or maternal glycosylated haemoglobin or, in the diabetic group, with mean blood glucose.

Birth Weight↗
PubMed1982

Intensive attention improves glycaemic control in insulin-dependent diabetes without further advantage from home blood glucose monitoring: results of a controlled trial.

Forty-six diabetics treated with twice-daily insulin were seen every two weeks for six months in an intensive education programme aided by regular home urine glucose testing. Control was improved with a decrease in 24-hour urinary glucose excretion (median 138 mmol/24 h (24.8 g/24 h) falling to 70 mmol/24 h (12.6 g/24 h); p less than 0.002), glycosylated haemoglobin concentration (mean 11.4 +/- SD 2.3% falling to 10.4 +/- 1.5%; p less than 0.001), and Diastix score (median 3.0 falling to 1.3; p less than 0.001). There was no reported increase in hypoglycaemia. Thirty-eight of the diabetics proceeded to a nine-month randomised cross-over study of the effect on blood glucose control of monitoring urinary glucose or blood glucose measured visually or by a reflectance meter using appropriate reagent strips. No further improvement in control was observed after home blood glucose monitoring. Nevertheless, 29 out of 37 patients preferred blood to urine glucose monitoring. During both the education and cross-over studies there was evidence of an initial improvement in control followed by deterioration. This was independent of the monitoring method used in the cross-over period and may have been due to waning enthusiasm. Despite patient enthusiasm and other reports to the contrary, home blood glucose monitoring offered no improvement in control over intensive attention and conventional urine glucose monitoring.

Adolescent↗
PubMed1982

Systemic candidiasis: diagnosis from cutaneous manifestations.

Three patients are described who developed systemic candidiasis. Each had either leukaemia or lymphoma, and developed a similar erythematous maculopapular rash which, in places, was purpuric. In the first patient the nature of the rash was not appreciated during life, but postmortem histology revealed candida within the lesions. In the other two patients, a diagnosis of systemic candidiasis was successfully established by skin biopsy. This paper emphasizes that a maculopapular rash can be relatively characteristic clinical manifestation of systemic candidiasis and that skin biopsy can be diagnostic.

Adolescent↗
PubMed1982

Paraganglioma of the cauda equina. Case report.

An unusual, well demarcated, and encapsulated neoplasm of the cauda equina is presented. At first, the tumor was considered to be a variant of myxopapillary ependymoma, but the reaction for glial fibrillary acidic protein was negative. At the ultrastructural level, the neoplastic cells contained many small dense core vesicles, and the diagnosis of paraganglioma was established. The literature and histogenesis of paraganglioma of the cauda equina is reviewed.

Aged↗
PubMed1981

Simple filter paper method for home monitoring of blood glucose, lactate, and 3-hydroxybutyrate.

Previous methods for assessing the control of diabetes at home have concentrated on the measurement of glucose concentrations in urine and, more recently, blood. These levels reflect only one aspect of deranged metabolism in the disease. A technique is described whereby glucose, lactate, and 3-hydroxybutyrate can be measured in capillary blood samples dried on boric acid impregnated filter paper. The technique is sufficiently sensitive to measure 0.05 mmol/l glucose, 0.02 mmol/l lactate, and 0.004 mmol/1 3-hydroxybutyrate with precisions of 4.0%, 4.5%, and 8.0%, respectively. This method could prove useful in the broader metabolic assessment of the diabetic state.

3-Hydroxybutyric Acid↗
PubMed1981

Glucose controlled insulin infusion system (Biostator) application during surgery for a presumed pancreatic microinsulinoma.

A glucose controlled insulin infusion system has been used during and after surgery for organic hyperinsulinism in a 37 year old woman. During surgery the system was used to monitor the blood glucose and, in order to avoid insulin hypersecretion, glucose was not infused. A strict correlation was observed between surgical procedures and metabolic behaviour, suggesting the resection of a microinsulinoma despite negative frozen section histology. After surgery plasma insulin was undetectable and an abnormal glycaemic level was observed during an IV glucose load. To ensure an adequate intake of fluid and calories 10% glucose was infused at a rate of 130 mg/min for 16h and blood glucose was clamped at 6.6 mmol/l by feedback insulin infusion. The gradual recovery of residual pancreatic tissue activity was demonstrated by the progressive decrease in exogenous insulin requirement, and confirmed by the normal glycaemic and insulinaemic response to an IV glucose load 20h after surgery.

Adenoma, Islet Cell↗
PubMed1981

Carotid artery aneurysms: another approach to therapy.

A patient had a large internal carotid artery aneurysm with extension to the base of the skull. Resection and reconstitution of flow was thought to be hazardous because of the difficulty in obtaining distal control. After assessment of collateral flow to the brain, placement of a Selverstone clamp resulted in gradual occlusion of the aneurysm. The aneurysm was subsequently resected.

Aneurysm↗
PubMed1980

Automated colorimetric estimation of glycosylated haemoglobins.

The measurement of glycosylated haemoglobin is now widely used as a guide to glycaemic control in patients with diabetes mellitus. Present methods for measurement of glycosylated haemoglobin are either laborious, expensive or both. We describe a precise and inexpensive method for the automated analysis of glycosylated haemoglobin based on a colorimetric technique. The within-batch coefficient of variation ranged from 2.0 to 4.8% and between-batch was less than 11.0%. At least 200 samples can be analysed per day.

Colorimetry↗
PubMed1980

Block of axoplasmic transport in vitro by vinca alkaloids.

The three potent antimitotic vinca alkaloids: vincristine (VCR), vinblastine (VLB), and vindesine (VDS) were compared for their effect in blocking axoplasmic transport in vitro using a desheathed preparation of the peroneal branch of cat sciatic nerve. A range of vinca alkaloid concentrations from 1-100 microM was examined. The relative order of potency in blocking axoplasmic transport was VCR greater than VLB greater than VDS at a concentration of 25 microM. At the higher concentrations block occurred so rapidly that a statistically significant difference between these agents could not be obtained. The relation of vinca block to the transport mechanism is discussed.

Animals↗
PubMed1975

Batrachotoxin block of fast axoplasmic transport in mammalian nerve fibers.

Batrachotoxin (BTX) irreversibly blocks fast axoplasmic transport in nerve in concentrations as low as 0.2 micromolar. The action of BTX was studied in cat sciatic nerves in vitro by measuring the rate of the crest outflow after injection of the L7 dorsal root ganglion with [3-H]leucine. Tetrodotoxin, which in itself does not affect fast axoplasmic transport, inhibited the blocking action of BTX. Unlike the BTX block of nerve and muscle membrane excitability brought about through increased permeability to sodium ion, the BTX block of fast axoplasmic transport occurs with or without sodium ion in the medium. High concentrations of calcium ion protected against the blocking action of BTX, while magnesium ion did not. An action of BTX on the transport mechanism inside the fibers was indicated by the small reduction of adenosine triphosphate plus creatine phosphate, which in itself did not account for the block of axoplasmic transport.

Animals↗
PubMedDate not supplied

MRI of temporal lobe pleomorphic xanthoastrocytoma.

Pleomorphic xanthoastrocytomas (PXA) are classically supratentorial, peripherally located, well-circumscribed, partially cystic neoplasms, which can enhance on CT following the administration of intravenous contrast agents. Focal calcification may also be seen. Although the CT appearance has been described, we report the MR findings in two cases of histologically documented temporal lobe PXA. The two well-circumscribed lesions were predominantly cystic and both contained a Gd-DTPA enhancing mural nodule. The latter was isointense with gray matter on T1-weighted images and hyperintense on T2-weighted scans. Minimal surrounding edema was present. Histologically, PXA may be confused with glioblastoma multiforme (GBM) due to the pronounced cellular pleomorphism. Because of their potentially more indolent behavior compared with GBM, it is important to recognize the gross morphologic characteristics of this rare tumor on MR. The MR pattern of a cystic lesion with enhancing mural nodule is characteristic of PXA, but not diagnostic, and other lower grade gliomas such as ganglioglioma and pilocytic astrocytoma need to be considered. The MR and CT appearance of PXA can provide critical information for the pathologist, especially when only a small amount of tissue is obtained for histologic evaluation.

Adult↗
PubMedDate not supplied

A crossover comparison of continuous subcutaneous insulin infusion (CSII) against multiple insulin injections in insulin-dependent diabetic subjects: improved control with CSII.

Ten insulin-dependent C-peptide-negative diabetic subjects, whose control had been optimized on twice-daily injection therapy, were treated for periods of 10 wk in a crossover study, with either a thrice-daily subcutaneous insulin injection regimen (Actrapid + Ultratard) or by continuous subcutaneous insulin infusion (CSII). On CSII insulin dose stabilized at 51 +/- 5 U/day, compared with 80 +/- 9 U/day (P = 0.004) on the thrice-daily injection regimen, having been 60 +/- 6 U/day on twice-daily therapy. After 10 wk glycosylated hemoglobin was 11.7 +/- 0.6% on injection therapy and 10.0 +/- 0.7% (P = 0.026) on CSII. Mean blood glucose concentration and urinary glucose excretion were lower at most points during the study on CSII than on injection therapy. Patients on pumps gained weight compared with the thrice-daily injection regimen (P = 0.023 at 10 wk) and the previous twice-daily regimen, despite the reduction in insulin dose. Considering individual patients, four markedly improved on CSII compared with the previous twice-daily regimen and five compared with Actrapid + Ultratard. No patient showed impaired control on CSII compared with either injection regimen. The benefits of portable insulin infusion pumps over injection therapy are thus clearly demonstrable under outpatient conditions even with equal and intensive medical attention.

Adult↗