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Biomedical subjects

S Golding

Publications and source records attributed to S Golding.

33 records · Page 2Linked to original sources
PubMed1997

Is routine diagnostic laparoscopy for infertility still justified? A pilot study assessing the use of hysterosalpingo-contrast sonography and magnetic resonance imaging.

We assessed the value of hysterosalpingo-contrast sonography (HyCoSy) and magnetic resonance imaging (MRI) as alternatives to laparoscopy and dye insufflation with or without hysteroscopy in the investigation of infertility. A total of 19 women had all three procedures, in addition, one became pregnant after HyCoSy alone. The findings were: uterine fibroids (n = 5), minimal-mild endometriosis (n = 4) and moderate-severe endometriosis (n = 3) including one case of bilateral endometriomas, endometrial polyp (n = 1), polycystic ovaries (n = 2), bilateral dermoid cysts (n = 1), haemorrhagic corpus luteal cyst (n = 1) and minimal adhesions (n = 3). At laparoscopy, 31/37 tubes were patent and there was 84% concordance with the tubal patency findings at HyCoSy. The uterine fibroids and ovarian cysts were detected using transvaginal scanning; the endometrial polyp and a congenital uterine anomaly were identified using HyCoSy. These findings were detected using MRI, but in addition the technique distinguished the dermoid cysts from the endometriomas, identified the two other cases of moderate-severe endometriosis, fibroids <2 cm (n = 2) and adenomyosis (n = 5), and interpreted the haemorrhagic corpus luteum as an endometrioma. Our data suggest that women with normal HyCoSy and MRI findings have a normal pelvis and may not need routine surgical investigation.

Adult↗
PubMed1995

Tenidap-modulated proinflammatory cytokine activation of a monocyte cell line.

Dysregulated cytokine production, in particular of the monokines IL-1, IL-6, and TNF, has been implicated in the inflammatory response in rheumatoid arthritis and in promoting the ensuing tissue destruction. The 3-substituted 2-oxindole tenidap has proven anti-inflammatory actions both in vivo and in vitro, among which is the inhibition of TNF and IL-1 production by monocytes following activation by LPS. We have investigated this ability to modulate cytokine activity by studying its effects on cytokine-monocyte interactions and in particular IL-6 production, with the THP-1 monocyte cell line. Tenidap inhibited IL-6 production in a dose-dependent manner when cells were stimulated with a combination of TNF-alpha and IFN-gamma. It also inhibited the priming effect of IFN-gamma, preventing the super-induction of IL-6 production following subsequent stimulation with TNF-alpha and IFN-gamma. These effects occurred under conditions in which the cells were not irreversibly altered with respect to their protein synthetic activity. IFN-gamma-induced up-regulation of HLA-DR was also inhibited by tenidap. Tenidap appears to affect some aspect of the IFN-gamma activation pathway, possibly the differentiation of these immature monocytes to a more mature phenotype. The data presented here indicate that tenidap has the potential to modulate the cytokine network in chronic disease.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1995

Iron requirements of human lymphocytes: relative contributions of intra- and extra-cellular iron.

A supply of iron is of vital importance if lymphocyte proliferation is to proceed successfully and two major sources of iron are available, intracellular stores and serum transferrin. We have investigated the relative importance to the human T lymphocyte of these two sources of iron by depleting them of intracellular iron with the chelator desferrioxamine and by culturing them in medium completely depleted of transferrin iron. The chelator decreased mitogen-stimulated proliferation of human peripheral blood T cells, in a dose-dependent manner, in the absence of extracellular transferrin-iron. By culturing the cells in iron-depleted medium, we found that normal lymphocytes proliferated, to a degree, in the absence of extracellular transferrin-iron. We also observed that transferrin receptor mRNA expression was sustained in mitogen-stimulated, iron-deprived lymphocytes, compared with untreated cells suggesting that up-regulation of transferrin receptor may occur in these cells through stabilization of the mRNA. We propose that intra- and extra-cellular iron may contribute to early and late activation processes and that a low level of intracellular iron in lymphocytes, chronically activated in the iron-deficient environment associated with chronic inflammatory diseases such as rheumatoid arthritis, may be a factor in the abnormal cell-mediated immunity associated with such diseases.

Cells, Cultured↗
PubMed1994

A comparison of iopromide with iopamidol and iohexol for contrast-enhanced computed tomography.

RATIONALE AND OBJECTIVES: Iopromide is a new monomeric, nonionic contrast agent that exhibits low osmolality and low viscosity in high concentration in aqueous solutions. Double-blind, randomized clinical trials have established the efficacy, safety, and tolerance of iopromide for excretory urography, coronary angiography, routine and digital subtraction angiography, and phlebography. However, iopromide had not previously been evaluated in blinded clinical trials for contrast-enhanced computed tomography (CECT). Thus, a double-blind, prospective randomized trial was performed to compare the efficacy, safety, adverse experience profile, and tolerance of iopromide to that of iopamidol and iohexol in patients requiring CECT of the head or body. METHODS: Of 190 patients entered into the study, 95 received iopromide and 95 received a comparator (iopamidol, n = 55; and iohexol, n = 40) at 300 mg I/mL. Efficacy, adverse experiences (AEs), and tolerance were measured, and a safety profile was obtained that monitored changes at 24 hours in physical examination, vital signs, hematologic profile, and blood chemistries. RESULTS: Efficacy was similar for all drugs with excellent/good visualization in 98.4% of studies. The total number of patients reporting AEs was equivalent (iopromide 13.8%, comparators 12.6%; P > .10). However, although 2.5% of patients in the iopromide and iopamidol groups had possibly related mild AEs, 15% receiving iohexol had related AEs, one of which was severe. Excellent tolerance was noted, with no patients reporting localized pain; there were low rates of mild to moderate warmth on injection (8.5% for iopromide versus 9.5% for comparators; P > .10). Safety profiles were comparable. Postprocedure, there were no significant changes or significant differences between groups, except for a significantly increased incidence of systolic blood pressure decrease by greater than 20 mm Hg at 24 hours in the comparator group. CONCLUSIONS: Iopromide has an efficacy, safety, and tolerance profile comparable to that of iopamidol and iohexol at 300 mg I/mL for head and body CECT. It may have a superior adverse experience profile to iohexol, but is similar to iopamidol. Thus, iopromide is a reasonable choice of nonionic contrast medium for all CECT procedures.

Angiography, Digital Subtraction↗
PubMed1992

CT evaluation of lymph node status at presentation of prostatic carcinoma.

Computed tomographic (CT) studies performed within a general oncology service in 104 consecutive patients with prostatic carcinoma were reviewed retrospectively to assess the incidence and distribution of lymphadenopathy. All patients were staged with CT at initial presentation, had normal skeletal scintigrams and were candidates for radical radiotherapy. The likelihood of lymphadenopathy was associated with increasing T-stage. 57 of the 92 (62%) patients without lymph node enlargement had local disease confined to the prostate (T2 or less) compared with only two of the 12 (17%) patients with enlarged nodes. Lymph node enlargement was more likely with a primary tumour of poorly differentiated histology. 12 patients (11.5%) had lymphadenopathy by established CT criteria; six with pelvic nodal enlargement alone and six with enlargement of pelvic and retroperitoneal nodes. In all patients pelvic nodal enlargement predominated and no patient had isolated retroperitoneal lymphadenopathy. Our findings indicate that CT staging studies of prostatic cancer do not need to include the retroperitoneum if there is no lymphadenopathy at or below the aortic bifurcation.

Adult↗
PubMed1991

Styloid apparatus anomaly causing dysphagia.

An unusual case of dysphagia due to anomalous styloid apparatus anatomy is presented. Clinical and radiological findings are documented. Variations in anatomy and clinical syndromes are discussed together with management.

Cervical Vertebrae↗
PubMed1991

Body composition in myelomeningocele.

Body composition and measures of obesity were evaluated in 59 subjects with myelomeningocele (MMC), aged 0.3-29 y, by anthropometry and measures of body cell mass (BCM) and intra- and extracellular water (ICW and ECW), derived from total body potassium and deuterium-isotope dilution; these results were compared with reference data. Body composition was normal in preambulatory children with MMC. Beyond ages 3-4 y there was significant depletion of BCM and total body water, with maldistribution of water (increased ECW and decreased ICW) and increased percentage body fat above that expected for age and sex. These findings were more pronounced in females and in those with high lesions, and were less pronounced in those who remained ambulatory. These changes may result in metabolic and nutritional maladaption during stress. The relation of BCM, total body water depletion and increased ECW to decreasing ambulatory activity suggests that early nutritional and mobility programs warrant further study.

Adipose Tissue↗
PubMed1987

An evaluation of procedures for assessing competency to stand trial.

In a field experiment involving 120 defendants at Bridgewater State Hospital in Massachusetts, the authors evaluated three instruments for assessing competency to stand trial: the Competency Screening Test (CST), Competency Assessment Instrument (CAI), and Interdisciplinary Fitness Interview (IFI). The CST (a paper-and-pencil test) was administered by a research assistant and scored by trained graduate students. Lawyers, psychologists, and social workers were recruited and trained in the use of the other instruments, then assigned as individuals (CAI) or teams (IFI) to conduct interviews and assess subjects. The performance of the project interviewers was compared against two yardsticks: (1) actual decisions reached by the regular Bridgewater staff, and (2) a consensus of two nationally respected experts who reviewed the cases and formed independent competency judgments. Both the CAI and IFI performed well under these conditions, indicating that one-time interviews by well-trained persons can lead to accurate competency decisions in the majority of cases. The authors conclude that hospitalization for competency assessment is rarely necessary.

Forensic Psychiatry↗
PubMed1983

Unilateral computerised tomography guided coeliac plexus block: a technique for pain relief.

Twelve patients have undergone unilateral coeliac plexus block using needle localisation by computed tomography and the technique is described. Computed tomography has the advantage that the needle route to the coeliac axis can be accurately planned, avoiding damage to other organs. In this study nine out of twelve patients had significant pain relief. Most success was achieved in patients with carcinoma of the pancreas.

Abdominal Neoplasms↗
PubMed1983

The role of computed tomography in the detection of bone metastases in breast cancer patients.

Computed tomography (CT) of bone was carried out in 20 patients with breast cancer, all of whom had abnormal radionuclide uptake on skeletal scintigrams but normal conventional radiographs. Twenty-eight sites were examined and 13 showed metastases in 11 patients. Five of these patients had no evidence of extra-skeletal recurrent disease. Follow-up at eight of these sites showed healing, sclerosis or progression, all of which correlated well with clinical findings. CT showed benign causes of radionuclide accumulation in three patients (7 sites) but no abnormality in six patients (8 sites). None of these patients has subsequently developed bone metastases. CT is superior to conventional radiographs in the diagnosis of skeletal metastases and should be carried out when skeletal scintigraphy is positive and conventional examinations are normal.

Adult↗
PubMed1982

Computed tomography in the diagnosis of parotid gland tumours.

Twenty patients with swelling of the parotid region have been examined by computed tomography (CT). CT correctly demonstrated a mass in eleven patients and correctly excluded a mass in nine patients. Five patients had primary parotid neoplasms, all of which showed higher attenuation values than normal salivary tissue. The other masses included cystic hygroma, branchial cyst, carotid sheath hamartoma and metastases in the region of the gland. Neither intravenous nor intraglandular contrast medium was necessary for diagnosis. CT is superior to sialography in demonstrating the total extent of a mass, particularly when there is involvement of the deep lobe of the gland or the parapharyngeal space. The appearance at CT following sialography with oily contrast media suggest that oil persists in the gland despite apparent complete clearing at sialography. CT should be regarded as the investigation of choice in patients with clinical features suggesting a mass in the region of the parotid.

Adenoma↗
PubMedDate not supplied

Targeting neuronal nitric oxide synthase with gene transfer to modulate cardiac autonomic function.

Microdomains of neuronal nitric oxide synthase (nNOS) are spatially localised within both autonomic neurons innervating the heart and post-junctional myocytes. This review examines the use of gene transfer to investigate the role of nNOS in cardiac autonomic control. Furthermore, it explores techniques that may be used to improve upon gene delivery to the cardiac autonomic nervous system, potentially allowing more specific delivery of genes to the target neurons/myocytes. This may involve modification of the tropism of the adenoviral vector, or the use of alternative viral and non-viral gene delivery mechanisms to minimise potential immune responses in the host. Here we show that adenoviral vectors provide an efficient method of gene delivery to cardiac-neural tissue. Functionally, adenovirus-nNOS can increase cardiac vagal responsiveness by facilitating cholinergic neurotransmission and decrease beta-adrenergic excitability. Whether gene transfer remains the preferred strategy for targeting cardiac autonomic impairment will depend on site-specific promoters eliciting sustained gene expression that results in restoration of physiological function.

Adenoviridae↗