Biomedical subjects

S Thomas

Publications and source records attributed to S Thomas.

At least 577 records · Page 32Linked to original sources

PubMed1990

Fine needle aspiration biopsy in clinical management of head and neck tumors.

Ninety-five percent (195) of 203 fine needle aspiration biopsies (FNAB) of head and neck specimens contained adequate tissues for histologic evaluation. No complications or needle tract recurrences were identified. Out of 135 patients whose surgical excision followed FNAB, 5% (7/135) of the biopsies were nondiagnostic. Correlation of cytologic and histologic findings of the remaining 128 FNAB revealed a sensitivity rate of 82% (46/56), a specificity rate of 99% (71/72), and a positive predictive of value of 98% (46/47). The diagnostic accuracy of FNAB was better with salivary gland and cervical node specimens than with thyroid, skin, and subcutaneous specimens. Fine needle aspiration biopsy may be considered as the first diagnostic step in the evaluation of the mass of the head and neck region, if the nondiagnostic aspiration rate is low and the diagnostic accuracy is high.

Adenocarcinoma↗

PubMed1990

Spontaneous gallbladder perforation--an unusual presentation of carcinoma of the pancreas.

A 50 year old man with a two month history of upper abdominal pain and a one month history of anorexia and weight loss, presented with icterus and evidence of peritonitis. Laparotomy revealed biliary peritonitis which had been caused by a rupture of the fundus of the gallbladder. The common bile duct was dilated and there was a large growth in the head of the pancreas with multiple hepatic metastases. A cholecystojejunostomy and gastrojejunostomy were done and the patient had an uneventful recovery.

Adenocarcinoma↗

PubMed1990

Hyperostosis induced by the bisphosphonate (2-PEBP) in the oophorectomized rat.

To prevent the high turnover bone remodeling associated with acute estrogen deficiency, the bisphosphonate [2-(2-pyridinyl) ethylidene-BP] (2-PEBP) was administered to oophorectomized (OX) rats. Three groups of 15 rats each (250 g) were studied. Group (Gp) A was sham operated, Gp B was OX, and Gp C received 2-PEBP (1.72 mg/kg/day) intraperitoneally for 3 days commencing 4 days postoophorectomy. Oophorectomy was confirmed with serum estradiol measurements. Blood samples were collected on days -7, 0, 7, 14, 21, and 28 for ionized calcium (Ca2+), PTH, and serum bone gla protein (BGP). Rats received tetracycline for bone histomorphometric labeling. All results were compared to Gp A. Body weight increased significantly in Gps B and C (P less than 0.005 by day 28). There was no significant difference in Ca2+, and PTH levels in Gps B and C were similar to Gp A. BGP levels were significantly higher on day 28 in Gp B (P less than 0.05). In Gp C, BGP levels were significantly decreased on days 7, 21, and 28 (P less than 0.03). Gp B revealed increased bone turnover without loss of bone volume (BV/TV). BV/TV was significantly increased in Gp C despite a decrease in parameters of bone formation and normal osteoclast number. In conclusion, 2-PEBP in the OX rat inhibited bone resorption more than formation with resultant hyperostosis. Serum BGP appeared to be a good marker of the changes observed on bone histomorphometry.

Animals↗

PubMed1990

The effect of high-dose salmon calcitonin on bone mineral metabolism in the normal rat.

The paucity of information on the effect of long-term high-dose salmon calcitonin administration on normal bone mineral metabolism and histology prompted an investigation of the influence of high-dose synthetic calcitonin in the rat. Serum ionized calcium, osteocalcin or BGP (bone gla protein), and immunoreactive PTH were measured serially during calcitonin administration and bone histomorphometry analyzed at 6 weeks (after sacrifice). Daily injections of salmon calcitonin, 0.4 IU/100 g (group B) and 2 IU/100 g (group C), resulted in significant hypocalcemia at 4 hours for both experimental groups (P less than 0.004). Serum iPTH was significantly higher over the study period for both groups administered calcitonin. Serum BGP levels were significantly lower than controls during the study in group C (P less than 0.002) and to a lesser extent in group B (P less than 0.05). In group C, bone histomorphometry revealed increased resorption (osteoclast count), decreased trabecular bone volume, and decreased double-labeled tetracycline surface (bone formation). In group B an increase in osteoclast count but no alteration in bone formation was observed. To assess the role of PTH in the above findings, high-dose calcitonin was administered to parathyroidectomized rats. All of the above changes in bone histomorphometry were not observed in this group of animals. In conclusion, high doses of calcitonin promote hypocalcemia, secondary hyperparathyroidism, and osteoclastosis in the normal rat in a dose-dependent manner with very high-dose calcitonin impairing bone formation.

Animals↗

PubMed1990

1,25 Dihydroxyvitamin D3 modifies cyclosporine-induced bone loss.

We have previously shown that cyclosporin A (CsA) produces high bone remodeling with resorption exceeding formation and loss of bone volume in the rat. This may have important clinical implications where CsA is widely used in organ transplantation. 1,25 dihydroxyvitamin D3 (1,25(OH)2D3) is a bone mineralizing hormone which also has immune modifying properties. Consequently, we studied the effect of combined CsA and 1,25(OH)2D3 administration over 28 days in four groups of rats. Group A received vehicle (n = 10), group B CsA (15 mg/kg) (n = 10) alone, group C 1,25(OH)2D3 plus CsA (n = 15), and group D 1,25(OH)2D3 alone (20 ng/100 g) (n = 15). Rats were bled periodically at day 0, 7, 14, and 28 and Ca, parathyroid hormone (PTH), 1,25(OH)2D, osteocalcin (bone Gla-protein, BGP), BUN, and creatinine were measured. Rats were sacrificed on day 28 and bones were examined histomorphometrically. Compared to controls, CsA resulted in significant elevation of BGP and a transient increase in 1,25(OH)2D with excess bone remodeling and loss of bone volume. 1,25(OH)2D3 administration produced hypercalcemia, a significant rise in BGP, with suppression of PTH and increased osteoid volume. Combined therapy prevented the loss of bone volume probably due to increased osteoid tissue and enhanced osteoblast activity. Renal dysfunction, a side-affect of CsA, was not a factor. In conclusion, 1,25(OH)2D3 combined with CsA restores bone volume which is accompanied by increases in serum calcium and BGP.

Animals↗

PubMed1990

The response of circulating parameters of bone mineral metabolism to ethanol- and EDTA-induced hypocalcemia in the rat.

The mechanism of the acute hypocalcemia that follows acute ethanol administration has not been established. Measurements of parathyroid hormone (PTH) performed during this hypocalcemia reveal conflicting results. We compared the response of ionized calcium (Ca2+), immunoreactive PTH and bone Gla protein (BGP) after ethanol- and EDTA-induced hypocalcemia. 103 male Sprague Dawley rats each weighing approximately 300 g received ethanol and 100 rats of similar weight received EDTA. In each of these studies the animals were divided into experimental and control groups. The ethanol-treated rats received ethanol, 2 g/kg body weight, by ip injection and the EDTA-treated rats received 100 mg EDTA/kg body weight by im injection. Controls received normal saline by the corresponding route of administration. Rats were sacrificed at 0, 30, 60, 90, 180 and 360 min for the measurement of the above parameters. In both experimental groups Ca2+ levels were significantly reduced to the same degree by 30 min with return to control values by 360 min. There was no significant difference in immunoreactive PTH, and BGP between control and ethanol-treated groups. In the EDTA-treated rats, however, PTH values were significantly increased at 30 (P less than 0.005) and BGP at 60 and 90 minutes (P less than 0.005) vs. control. Therefore acute ethanol administration appears to blunt the PTH response to hypocalcemia. A direct inhibitory effect of ethanol on osteoblast function ie BGP production cannot be excluded. In addition, PTH may stimulate BGP.

Animals↗

PubMed1990

The urea cycle in the Rett syndrome.

The in vivo functioning of the urea cycle in the Rett syndrome (RS) was investigated using alanine load test. The test was carried out in girls with RS and their mothers. These results were compared with those on normal females, males and obligate carriers for ornithine carbamoyltransferase deficiency. Post load hyperammonaemia was not seen in any of the RS girls who were not on medication (valproate). Increased orotate excretion was found in some of the RS girls and mothers. The pattern of urinary excretion of orotate in RS girls and their mothers after a standardised alanine load was similar to that found in female carriers of OCT deficiency. This finding can be explained by a mutant OCT, subject to the Lyon effect, and linked to the gene abnormality in RS or by the presence of an abnormal X-linked mitochondrial protein synthesised in cytoplasma and positioned in close proximity to OCT. Such a protein abnormality could also affect mitochondrial functions in other cells, e.g. in the developing brain.

Adult↗

PubMed1990

Effect of lime composition on the formation of reactive oxygen species from areca nut extract in vitro.

Lime, representative of that used by betel quid chewers, was collected in a region of Papua New Guinea where the incidence of oral cancer is high. The free calcium hydroxide content and pH of 25 lime samples were highly correlated with the generation of reactive oxygen species from areca nut extract in vitro, and DNA damage in vitro, measured as 8-hydroxy-2'-deoxyguanosine. Fe2+ and Mg2+ levels in the lime samples were too low to modify formation of reactive oxygen species, but hydrogen peroxide formation was almost entirely inhibited by addition of Mg2+ to the reaction mixture. These results suggest that the calcium hydroxide content of lime in the presence of areca nut is primarily responsible for the formation of reactive oxygen species which might cause oxidative damage in the DNA of buccal mucosa cells of betel quid chewers.

8-Hydroxy-2'-Deoxyguanosine↗

PubMed1990

Age dependency of the lactase persistence and lactase restriction phenotypes among children in Sri Lanka and Britain.

All neonates are born with intestinal lactase activity. In most of them the intestinal lactase activity is lost during childhood (lactase restriction phenotype). In a minority of children normal intestinal lactase activity is retained (lactase persistence phenotype). In this study the progression of the lactase restriction phenotypes has been studied in 94 Sri Lankan children by oral lactose loads and 162 British children by intestinal lactase estimation (adult Sri Lankans and British predominantly belong to the lactase restriction and lactase persistence phenotypes, respectively). Lactase was present in infancy at birth in all Sri Lankan children and declined around the age of eight years, the majority (59 per cent) of the 10-15-year-olds belonging to the lactase restriction phenotype. In contrast the majority of the British children (95 per cent of all the British children studied) demonstrated the lactase persistence phenotype. The low prevalence rate of the restriction phenotype found among British children was largely contributed by children of African and Asian origin.

Age Factors↗

PubMed1990

Oncogenes, malignant transformation, and modern medicine.

During the past decade there have been remarkable strides in the understanding of the basic mechanism of cancer. It is now clear that there is a set of genes, known as oncogenes, that can cause cells to become malignant if their expression is altered, either by mutation or overexpression. The products of these genes include growth factors, growth factor receptors, signal tranduction proteins, and DNA binding proteins. The normal cellular counterparts of these genes play very important roles in the regulation of growth and proliferation by normal cells. Another set of genes, anti-oncogenes, also play an important role in preventing abnormal cell proliferation. The remarkable explosion of understanding of the pathophysiology of malignancy has led to a common unifying concept of malignant transformation that applies to all tumors. It is likely that these new insights will lead to improved and more specific treatments for malignant disease in the next decade.

Animals↗

PubMed1990

Mithramycin selectively inhibits the transcriptional activity of a transfected human c-myc gene.

The G-C specific DNA binding drug mithramycin selectively inhibits expression of the c-myc gene in a number of cell types. We have tested the ability of this agent to inhibit the expression of a transfected human c-myc gene in a murine fibroblast cell line. Expression of c-myc is inhibited in the first 24 hours of mithramycin exposure (in contrast to actin gene expression, which is unaffected). Nuclear runon transcription of c-myc by nuclei isolated from mithramycin treated cells is decreased, indicating inhibition of transcription initiation. However, treatment of isolated nuclei with mithramycin also results in decreased c-myc transcription. Thus, inhibition of c-myc expression by mithramycin in these cells appears to occur at the transcriptional level and is most likely mediated at both the transcription initiation and elongation level. This suggests that mithramycin selectively interacts with the G-C rich c-myc promoter, preventing formation of the c-myc transcription initiation complex.

Animals↗

PubMed1990

Bilateral sacroiliac joint fracture-dislocation: a case report.

Bilateral sacroiliac joint fracture-dislocation of the sacrum with displacement is a rare injury. We found only four such injuries previously reported in the literature. Nonoperative management in this case led to complete functional return and acceptable alignment.

Accidents, Traffic↗

PubMed1990

Deficient T cell granulocyte-macrophage colony stimulating factor production in allogeneic bone marrow transplant recipients.

The proliferation and differentiation of donor hematopoietic progenitor cells in bone marrow transplantation (BMT) recipients is influenced by hematopoietic growth factors, which could derive from either T cells or adherent stromal bone marrow cells, or both. In this study of 20 BMT recipients, we asked whether T lymphocytes arising from donor bone marrow grafts were able to express normal levels of granulocyte-macrophage colony stimulating factor (GM-CSF) mRNA, and to secrete normal levels of soluble GM-CSF in response to the mitogen phytohemagglutinin. We have found that T cells obtained up to 18 months following BMT express little or no PHA-induced GM-CSF message. T cell GM-CSF secretion in response to PHA is also reduced or absent. This T cell GM-CSF defect was observed in all patients studied, whether or not donor bone marrows had undergone T cell depletion. This defect likely reflects a broader deficit in mitogen-induced lymphokine production. This defect likely contributes to BMT recipients' blunted responses to infections, and contributes to graft failure in T cell-depleted transplants.

Adolescent↗

PubMed1990

Severe intravascular haemolysis in a renal transplant recipient due to anti-B of donor origin.

A group B recipient of a group 0 kidney developed severe intravascular haemolysis due to the formation of anti-B. Immunoglobulin allotyping of donor serum, recipient serum and 'unexpected' anti-B antibody showed the antibody to be of donor origin. The patient and donor genotypes were Gm 3;5/3;5 and Gm 1,2;21/1;21, respectively, and the anti-B antibody allotype was Gm 1;21. The group B recipient of the other donor kidney showed no evidence of haemolysis. Possible factors influencing the occurrence and severity of post-transplantation haemolysis are discussed. The production of anti-A or anti-B antibodies in non-group 0 patients who receive group 0 organ transplants is well described [1-8]. We report a case of severe intravascular haemolysis in a group B patient who received a group 0 kidney, together with immunoglobulin allotyping studies which show conclusively that the antibody responsible for the haemolysis was of donor origin.

ABO Blood-Group System↗

PubMed1990

Treatment of recurrent desmoid tumour with tamoxifen.

A 30 year old woman with aggressive fibromatosis (desmoid) of the left upper arm and scapular region was treated with wide excision. Two years later she presented with extensive local recurrence of the scapular and deltoid regions. She was treated with tamoxifen (20 mg daily) and, over the next 6 months, the tumour regressed. She has been recurrence-free for the past year. We suggest that, in patients with desmoid tumours, hormone receptor determination and hormone therapy be attempted before subjecting patients to any form of radical treatment with surgery, radiotherapy or chemotherapy.

Adult↗

PubMed1990

Pulmonary deposition of nebulised pentamidine isethionate: effect of nebuliser type, dose, and volume of fill.

An estimate of the absolute pulmonary deposition of nebulised pentamidine isethionate was obtained in nine patients with AIDS. Two nebuliser systems were compared, System 22 Mizer (Medic-Aid) and Respirgard II (Marquest), with 50 and 150 mg doses of pentamidine in a 3 ml solution driven by an air flow of 6 l/min with the patient in the sitting position. The 50 mg pentamidine dose was repeated with a 6 ml fill with both devices. The nebuliser cloud was labelled with technetium-99m human serum albumin (Ventocol) and lung deposition was measured with a gamma camera. Of the two nebulisers studied, System 22 Mizer delivered more drug to the lungs as a whole and to each individual lung region, including the peripheral and upper zones. For the 50 mg dose the mean (SEM) total pulmonary deposition with the 3 and the 6 ml fill respectively was 2.63 (0.34) and 3.71 (0.41) mg for the System 22 Mizer and 1.37 (0.26) and 1.45 (0.18) mg for the Respirgard II. For the 150 mg dose the System 22 Mizer delivered 7.16 (1.02) mg and the Respirgard II 4.34 (0.57) mg. Increasing the volume of fill from 3 to 6 ml increased pulmonary deposition with System 22 Mizer, and this was related to an increase in nebuliser output. Neither pulmonary deposition nor nebuliser output was increased by using a 6 ml solution in the Respirgard II. Increasing the volume of fill prolonged the time required for nebulisation with both nebulisers. The System 22 Mizer produced more nonpulmonary (gastric and oropharyngeal) deposition of drug, more frequent local adverse effects (cough, burning in the throat, and a metallic taste), and small reductions in lung function, particularly with the 150 mg pentamidine dose. Thus nebuliser type, volume of fill, and nebuliser dose affect the pulmonary deposition of pentamidine. A 300 mg dose of pentamidine via a Respirgard II is generally recommended as providing effective prophylaxis; our results suggest that similar pulmonary deposition can be produced with System 22 Mizer and 150 mg pentamidine. A clinical trial would be needed to show whether this regimen provides similar prophylactic benefit.

Acquired Immunodeficiency Syndrome↗

PubMed1990

Characterization of red blood cell metabolism in rainbow trout.

Red blood cell metabolism was studied in vitro using whole blood obtained by catheter from resting rainbow trout (Oncorhynchus mykiss). Preparations were viable as shown by stable NTP, metabolite and catecholamine levels and acid-base status, all of which remained at in vivo levels over the 2 h incubation period. Enzymes diagnostic of glycolysis, the tricarboxylic acid (TCA) cycle and phosphagen metabolism were all present in significant amounts in red blood cells. In direct comparisons of 14C-labelled substrates at normal resting plasma concentrations, rates of CO2 production were in the order: glucose greater than lactate greater than alanine greater than oleate. Total CO2 production rates from these four oxidative substrates did not equal directly measured O2 consumption rates, indicating that other substrates may also be important in vivo. Oxidative pathway Km values for glucose (8.4 mmol l-1), lactate (3.3 mmol l-1) and alanine (0.8 mmol l-1) were well within the normal physiological ranges of plasma concentrations. Glucose concentration did not affect lactate oxidation rates, but there was some inhibition (27%) of glucose oxidation by high lactate concentrations (20 mmol l-1). The observed Km values and competitive interactions suggest that changes in plasma concentrations associated with environmental stresses can considerably alter the relative rates of oxidation of glucose and lactate in vivo. Considerable pentose-phosphate shunt activity was detected in red cells, as indicated by high activities of glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase and high CO2 production rates from (1-14C)-labelled glucose. Even in the presence of normal O2 levels, a significant percentage (28%) of glucose metabolism was directed to lactate production. Taken together, these results demonstrate that rainbow trout whole blood incubated in vitro constitutes a dynamic and viable system for metabolic studies at the pathway level.

Alanine↗

PubMed1990

Control of red blood cell metabolism in rainbow trout after exhaustive exercise.

Metabolic responses (rates of CO2 production from 14C-labelled glucose or lactate, and total O2 consumption) of red blood cells were monitored in rainbow trout (Oncorhynchus mykiss) at rest and during 12 h of recovery from exhaustive exercise. Extracellular acid-base status, red blood cell intracellular pH (pHi), and plasma metabolite and catecholamine levels were recorded simultaneously. Despite a post-exercise rise in plasma glucose level, glucose oxidation was depressed, at least partly because of a rise in plasma lactate level. However, lactate oxidation was stimulated markedly, especially at 0-2 h post-exercise. Subsequent multifactorial experiments in vitro demonstrated that augmentation of lactate oxidation was due partly to increased plasma lactate, and partly to separate stimulatory effects of elevated PCO2 and catecholamine levels. Changes in pH and HCO3- level were not directly involved, but the stimulatory effects of catecholamines occurred only under acidotic conditions. Total red cell O2 consumption (MO2) remained generally stable after exercise. Similar multifactorial experiments in vitro demonstrated that respiratory, metabolic and mixed acidoses all inhibited MO2, an effect largely attributable to the lowered pH. This inhibition was reversed by typical post-exercise levels of epinephrine and norepinephrine; again, catecholamines had no effect under control conditions. Red cell pHi regulation was achieved without an increase in MO2 above resting levels. Our results indicate a complex sensitivity of red cell metabolism to acid-base status and a shift in substrate preference for oxidation after strenuous exercise. The mobilization of catecholamines plays an important coordinating role and helps sustain normal rates of oxidative metabolism by red cells in the face of post-exercise blood acidosis.

Acid-Base Equilibrium↗