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Biomedical subjects

S Rogers

Publications and source records attributed to S Rogers.

At least 127 records · Page 7Linked to original sources
PubMed1996

Multiple keratoses and squamous carcinoma after PUVA treatment of vitiligo.

PUVA is known to be carcinogenic when used in the treatment of psoriasis. To date skin cancer has not been demonstrated after PUVA treatment of vitiligo. We report a patient in whom multiple squamous cell carcinomata and keratoses developed in vitiligo areas after a prolonged course of PUVA. PUVA therapy of vitiligo induces repigmentation of affected skin in some patients. An increased frequency of cutaneous neoplasms in depigmented areas is a potential hazard, as in these sites the photoprotective effect of melanin is lacking.

Carcinoma, Squamous Cell↗
PubMed1996

Formaldehyde replaces glutaraldehyde in porcine bioprosthetic heart valves.

BACKGROUND AND AIMS OF THE STUDY: In the production of porcine bioprostheses, the initial glutaraldehyde treatment is often followed by a short incubation in formaldehyde to ensure sterility of the valve. It is assumed that the glutaraldehyde cross links are stable and that the formaldehyde step does not alter the glutaraldehyde incorporated. The objective of this study was to determine whether the formaldehyde interacts with the tissue to cause changes in the glutaraldehyde composition. MATERIALS AND METHODS: Two methods of tissue treatment were investigated: (i) fresh porcine leaflet tissue was treated with glutaraldehyde, followed by storage in formaldehyde, (ii) tissue processed in glutaraldehyde and transferred to formaldehyde for six hours was returned to glutaraldehyde for storage. The content of the two aldehydes was estimated by high performance liquid chromatography (HPLC), using an adaptation of the method developed by Hughes et al, which measures the acid labile Schiff bases formed between the collagen and the aldehyde. RESULTS: The initial content of glutaraldehyde in the tissue declined from 63 +/- 10 nmol/mg dry weight to 21 +/- 4 nmol/mg dry weight when the leaflets were placed in formaldehyde for 24 hours. The initial uptake of formaldehyde was 800 +/- 144 nmol/mg dry weight after 24 hours and this declined to 370 +/- 33 nmol/mg dry weight over a 16 week period of storage in formaldehyde. By this stage, the level of glutaraldehyde had decreased to 2.4 +/- 0.2 nmol/mg dry weight. There was a sharp decline in the glutaraldehyde concentration from 89 +/- 6 nmol/mg dry weight to 14 +/- 1 nmol/mg dry weight when the tissue was placed in 4% formaldehyde solution for six hours. The formaldehyde uptake was 770 +/- 54 nmol/mg dry weight. After return to 0.625% glutaraldehyde solution the formaldehyde concentration declined whilst the glutaraldehyde concentration initially increased. CONCLUSIONS: These results show that the formaldehyde reacts with the epsilon amino groups of lysine which had not reacted with glutaraldehyde, probably for steric reasons; and that formaldehyde replaces some glutaraldehyde in the tissue by a mass action effect. The tissue concentration of both aldehydes subsequently declined over the study period.

Animals↗
PubMed1995

Retinoic acid stimulates glucose transporter expression in L6 muscle cells.

Factors that regulate the tissue specific and developmental expression of the GLUT4 gene, whose transcribed protein is primarily responsible for mediating insulin stimulated glucose transport, are poorly defined. In this study we examined the effects of retinoic acid, a circulating factor that can promote cellular differentiation, on glucose uptake and glucose transporter expression in cultured L6 muscle cells. At the myoblast stage, treatment with 1 microM retinoic acid for 24 h increased both 1 h and 8 h insulin stimulated uptake of 2-deoxyglucose by more than twofold. A dose and time dependent effect of retinoic acid on 8 h insulin stimulated 2-deoxyglucose uptake was observed at both the myoblast and myocyte stage. Comparatively little effect from retinoic acid treatment was found on basal uptake at either stage. In myoblast cells, retinoic acid increased the content of GLUT4 mRNA in a dose and time dependent manner, an effect that was partially attenuated by insulin. In myocytes retinoic acid increased GLUT4 mRNA levels to 2.3 times basal. Nuclear run-on studies indicate that the increased GLUT4 mRNA represents enhanced transcriptional activity. The results suggest a role for retinoic acid in regulation of expression of the GLUT 4 gene in muscle cells.

Analysis of Variance↗
PubMed1995

Intestinal endometriosis: presentation, investigation, and surgical management.

The study was undertaken to identify the presenting features of intestinal endometriosis and to evaluate its investigation and surgical management. Twenty-six cases of intestinal endometriosis were identified during a fourteen year period. The commonest site of occurrence was the rectosigmoid region (11 cases) followed by the appendix (9 cases), and ileocaecal region (6 cases). Abdominal pain was the main presenting feature in 20 cases, with associated nausea and vomiting in 12 cases and altered bowel habit in ten. Other presenting features included rectal bleeding, abdominal bloating and tenesmus. Endometriosis was not suspected preoperatively in any of the patients without a past history of this condition. Accurate preoperative diagnosis proved very difficult, with only laparoscopy providing definite evidence of intestinal endometriosis prior to formal surgery. Colonic resections were performed in 12 cases, small bowel resection in six cases and appendicectomy in nine cases, together with resection of adjacent adherent structures. This series illustrates the difficulty of establishing an accurate preoperative diagnosis, and the propensity of intestinal endometriosis to mimic other gastrointestinal diseases, particularly carcinoma and inflammatory bowel disease.

Appendix↗
PubMed1995

A comparison of twice-weekly MPD-PUVA and three times-weekly skin typing-PUVA regimens for the treatment of psoriasis.

The most frequent PUVA treatment regimen in current use is three times weekly, using skin typing to estimate the starting dose. Recently, it was suggested that twice-weekly treatment, using the minimal phototoxic dose (MPD) to calculate suberythemal starting doses of UVA, achieved similar clearance rates with fewer treatments and a lower cumulative UVA dose. We have carried out a trial on 83 patients, comparing twice-weekly MPD-PUVA with three times-weekly skin typing-PUVA, in order to test this hypothesis. Although clearance rates were comparable between the two regimens, there was no overall significant difference in the number of treatments or in the cumulative UVA doses at clearance. However, for patients with skin types I and II the cumulative UVA dose was significantly higher using the twice-weekly MPD regimen (70.0 J/cm2 vs. 55.8 J/cm2; P < 0.05). Our results do not confirm that there is a reduction in cumulative UVA dosage with twice-weekly MPD-PUVA.

Adult↗
PubMed1995

Immunolocalization of adhesion molecules in psoriatic arthritis, psoriatic and normal skin.

Adhesion molecule expression in synovial membrane obtained from patients with psoriatic arthritis (PA) has previously been compared with rheumatoid arthritis (RA). Although expression of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) was similar in both psoriatic and rheumatoid synovium, in contrast, little or no endothelial leucocyte adhesion molecule-1 (ELAM-1) was observed in psoriatic synovium. In the present study, the expression of ICAM-1, ELAM-1 and VCAM-1 was examined in the involved and uninvolved skin from patients with PA (n = 15), patients with psoriasis (Ps) but no arthritis (n = 5) and in normal skin (n = 4). ICAM-1 was intensely expressed on endothelium and keratinocytes of involved skin from patients with Ps with or without arthritis. There was constitutive expression of ICAM-1 on endothelium only in uninvolved and normal skin. In contrast, ELAM-1 expression was restricted to endothelial cells; it was widespread and intense in involved skin, but was minimal in uninvolved and normal skin. VCAM-1 was expressed on endothelium, and also on some dendritic cells in involved psoriatic skin. There was minimal VCAM-1 staining on endothelial cells in uninvolved and normal skin. In conclusion, in involved psoriatic skin from patients with and without arthritis ICAM-1, ELAM-1 and VCAM-1 expression is up-regulated on vascular endothelium, and ICAM-1 is expressed on keratinocytes. However, ELAM-1 and VCAM-1 expression seen in dermal vessels is not found in psoriatic synovial vessels. These differences suggest a mechanism for controlling cellular traffic in Ps and in PA.

Adult↗
PubMed1995

Photosensitivity dermatitis/actinic reticuloid syndrome in an Irish population: a review and some unusual features.

Nine patients with photosensitivity dermatitis and actinic reticuloid syndrome are reported. The rash affected light-exposed skin only in 7 patients and extended to covered sites in 2. Seven were sensitive to UVB, UVA and visible light, one to UVA and one to visible light only. Two patients had significant clinical improvement in spite of both having suffered severe disease previously. Another patient remains exquisitely light-sensitive after 20 years and has developed two squamous cell carcinomas, one of which metastasized to local lymph nodes, and two keratoacanthomas on light-exposed skin.

Adult↗
PubMed1995

Survival, metastasis and recurrence of oral cancer in relation to pathological features.

The outcome of 123 patients with squamous cell carcinoma of the oral/oropharyngeal mucosa treated by primary radical surgery and simultaneous neck dissection and followed up for a maximum of 5 years is reported and related to the pathological features of the tumour. Actuarial survival analysis showed the overall 1-year survival probability was 84%, falling to 69% at 2 years, and 65% at 5 years. For patients without lymph node metastasis, the corresponding survival probabilities were 95%, 86% and 86%, respectively; and for patients with metastasis, 71%, 52% and 44%, respectively. In all, 30 patients (24%) died of their oral cancer; 16 (13%) of local recurrence, 10 (8%) of regional recurrence and 4 (3%) of systemic metastases. In addition to lymph node metastasis, survival was related to the site and stage of the primary tumour, histological pattern of invasion, status of the resection margins and, for patients with metastasis, the number and anatomical level of positive nodes and the presence and extent of extracapsular spread. These pathological features are important indicators of tumour behaviour and should be incorporated into protocols for assessment of prognosis.

Adolescent↗
PubMed1995

Cyclosporin-responsive hidradenitis suppurativa.

Hidradenitis suppurativa, a chronic inflammatory condition of the apocrine gland follicles, may rarely be complicated by pyoderma gangrenosum (PG). We report such a case, in which the immunosuppressant cyclosporin A (CyA) was given to treat PG and a dramatic improvement occurred in the patient's intractable perineal HS.

Cyclosporine↗
PubMed1995

Potential interventions for the prevention of childhood pneumonia in developing countries: a systematic review.

This article describes the background and framework for a systematic review of potential interventions for preventing pneumonia among under-5-year-olds in developing countries. Twenty-eight intervention areas are identified in six groups -- immunization, case management/chemoprophylaxis of high-risk children, improving nutrition, reducing environmental pollution, reducing transmission of pathogens, and improving child care practices. Calculation of the potential impacts is illustrated and the expected outcomes are also described.

Child Welfare↗
PubMed1994

Behavioral responses to intravenous meta-chlorophenylpiperazine in patients with seasonal affective disorder and control subjects before and after phototherapy.

A comparison of the baseline and post-infusion effects of the serotonin agonist meta-chlorophenylpiperazine (m-CPP) in 10 patients with seasonal affective disorder (SAD) and 11 healthy control subjects revealed significantly different subjective response profiles between the groups. Several baseline and m-CPP-stimulated responses in symptoms putatively related to serotonergic function changed significantly after a week's exposure to phototherapy in the SAD patients but not the control subjects. Before phototherapy, depressed patients with SAD reported activation-euphoria responses to m-CPP and significant decreases in carbohydrate hunger, but insignificant changes in feeling slowed or sleepy, while control subjects reported no mood or appetite changes but significant increases in feeling slowed down following m-CPP. After phototherapy, which led to a significant reduction in baseline depressive symptom rating to near-euthymic levels in the SAD patients, almost all of the patients' responses to m-CPP were normalized and no longer differed from the control subjects' responses. These results provide evidence of a possible dysregulation in serotonergic neurotransmission in depressed SAD patients that normalizes following treatment with phototherapy.

Adult↗
PubMed1994

Stimulation of oxidant generation by human sperm suspensions using phorbol esters and formyl peptides: relationships with motility and fertilization in vitro.

OBJECTIVES: To investigate the influence of reactive oxygen species generated by human spermatozoa and contaminating leukocytes on sperm movement and fertilization in vitro. DESIGN: A chemiluminescence technique, using luminol and peroxidase, was used to monitor the generation of reactive oxygen species by human sperm suspensions and the results were correlated with sperm movement and the fertilization of human ova in vitro. SETTING: Diagnostic Andrology Laboratory and IVF Clinic. PATIENTS: Infertile couples undergoing IVF therapy. RESULTS: An N-formyl-methionyl-leucyl-phenylalanine (FMLP) provocation test was used to demonstrate that the presence of leukocytes in 28.5% of the sperm preparations was associated with elevated levels of spontaneous reactive oxygen species production, impaired movement, and a reduced capacity for fertilization in vitro. In the absence of leukocytes, exposure to phorbol ester stimulated a burst of reactive oxygen species generation by human spermatozoa, the magnitude of which was correlated highly with a loss of sperm motility but not with fertilization rates observed in the concurrent IVF cycle. CONCLUSION: Leukocyte contamination of human sperm preparations can be detected readily by FMLP-induced, luminol-dependent chemiluminescence and the results have an important bearing on the fertilizing capacity of the spermatozoa in vitro.

Fertilization↗
PubMed1994

Classification of clinical subsets in psoriatic arthritis.

The classification of PsA is controversial. Two recent papers have suggested new subgroup classifications, however both have served only to expand the controversy. In this study the clinical and radiologic features of 100 patients with PsA are recorded in order to examine possible clinical or radiologic features which may be associated with functional disability and to examine the usefulness of recent reclassification proposals in our patient population. Results indicate that an asymmetric oligoarthritis (AO) pattern of disease is most common occurring in 43%. A symmetric polyarthritis (SP) was present in 33%, and this subgroup had the highest number of erosions and deformities, and a higher proportion of patients with grade III/IV ARA functional disability. While the DIP joints were involved in 46%, predominant DIP joint disease occurred in 16%. As the DIP group had the shortest duration of arthritis, it may be that this group represents recent onset PsA which will evolve into one of the other subgroups. Sacroiliitis was a feature in 14% with predominant spondylitis (SPON) in 4%. Arthritis mutilans (AM) was rare occurring in only 2% of this population, perhaps representing patients with end-stage SP disease. Finally, 2% of patients had features of the synovitis-acne-pustulosis-hyperostosis-osteomyelitis (SAPHO) syndrome. A classification comprising just three subgroups (AO, SP, SPON) is proposed as being of most use clinically though a long-term prospective study is needed for verification.

Acne Vulgaris↗