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Biomedical subjects

W H Smith

Publications and source records attributed to W H Smith.

At least 37 records · Page 2Linked to original sources

Forest occurrence of Trichoderma species: emphasis on potential organochlorine (Xenobiotic) degradation.

Fungi of the genus Trichoderma are recognized as "keystone or controller" organisms in forest soils due to their involvement in decomposition and nutrient cycling and their regulation of associated mycoflora. Recent evidence has identified additional potential importance in the decomposition of xenobiotics. Both T. harzianum and T. viride have been shown capable of organochlorine degradation in vitro. During the 1990 growing season soil immersion tubes were employed to sample Trichoderma species growing in the forest floors of the Hubbard Brook Experimental Forest and of near-by Mount Moosilauke in New Hampshire. At Hubbard Brook, sample sites included a mature forest (100 years old) and a regenerating forest (5 years old). On Mount Moosilauke, sample sites included haplorthod and cryofolist soil types and low, medium, and high elevation. T. harzianum was isolated from both sites in relatively high amount. T. viride was also present at both sites but in relatively low amount. T. polysporum was consistently isolated at all elevations but in relatively low amount. The abundance of T. harzianum decreased with increasing elevation, while the abundance of T. viride increased with increasing elevation. The evidence presented is consistent with other studies stressing the high spatial variability of members of this genus. Causes of this variability are presumed to be numerous and involve abiotic and biotic forces. Persistence of organochlorine contaminants in northern forest soils may be influenced by the abundance of fungal degraders such as T. harzianum and viride.

Biodegradation, Environmental↗

Evaluation of the allergic/irritant potential of air pollutants: detection of proteins modified by volatile organic compounds from oilseed rape (Brassica napus ssp. oleifera) using electrospray ionization-mass spectrometry.

BACKGROUND: Upward trends in allergy and asthma rates have been reported in most western societies, including the UK, where around 15-20% of the population now suffer from allergy or asthma. Scientific proof of the causes of these increases relies on accurate assessment of exposure and standardized diagnostic tests, such as for specific IgE in blood serum and skin testing. For many air pollutants it has proven difficult to assess an individual's exposure outside an occupational environment and reliable test development is hampered by not knowing whether an allergic or irritant mechanism is involved. These problems are particularly evident in the controversial issue of whether airborne releases from oilseed rape can cause health effects. OBJECTIVE: To develop a method for evaluating the allergic/irritant potential of air pollutants and to assess whether the volatile organic compounds emitted by oilseed rape have this potential. METHODS: Proteins were exposed in vitro to volatile organic compounds emitted by oilseed rape. Electrospray ionization-mass spectrometry was used to detect any resultant protein modifications. RESULTS: Dimethyl disulphide, thiocyanic acid methyl ester and 2-methyl-propanenitrile were able to modify human proteins. In addition, two isothiocyanates which can be emitted by damaged oilseed rape also have this ability. The major products emitted by undamaged oilseed rape, terpenes, a sesquiterpene and a terpene alcohol did not have this property, but the possible role of their oxidized products is discussed. CONCLUSION: Some of the volatile organic compounds emitted by oilseed rape have the potential to be allergens/irritants. Standardized modified proteins produced by this method should prove useful for biomonitoring human exposure in molecular epidemiological studies as well as in diagnostic tests. This method should find further application in investigations into the possible health effects of other environmental pollutants.

Air Pollutants↗

Myocardial technetium-99m-teboroxime uptake during adenosine-induced hyperemia in dogs with either a critical or mild coronary stenosis: comparison to thallium-201 and regional blood flow.

UNLABELLED: Experimental studies have shown 99mTc-teboroxime to have a higher first-pass myocardial extraction, exceeding that of 201Tl with nearly linear initial myocardial uptake over a wide range of coronary flows. The goal of this study was to quantitatively compare teboroxime with 201Tl for the assessment of a regional coronary flow imbalance when administered during adenosine vasodilation in dogs with either critical or mild LAD stenoses. METHODS: Twenty-four anesthetized dogs with either critical (n = 10) or mild (n = 14) LAD stenoses were given an i.v. infusion of adenosine (300 micrograms/kg/min). When LCx flow was maximal, 201Tl, teboroxime and microspheres were simultaneously injected and the dogs were killed either 2 or 4 min later. Regional 201Tl, teboroxime activities and myocardial blood flow were determined by gamma well counting and ex vivo imaging of 99mTc-teboroxime activity in myocardial heart slices was performed. RESULTS: In both the critical and mild stenosis groups, the LAD/LCx zone ratios in dogs killed 2 min after tracer injection for both 201Tl (0.31 +/- 0.07, 0.63 +/- 0.05) and teboroxime (0.38 +/- 0.09, 0.72 +/- 0.04) significantly underestimated the microsphere flow ratio (0.18 +/- 0.05, 0.43 +/- 0.05) (p < or = 0.01), but the degree of underestimation was greater for teboroxime compared with Tl (p < or = 0.05). CONCLUSION: In dogs with either critical or mild LAD stenoses, as early as 2 min after tracer injection, the 201Tl activity ratio more accurately assessed the adenosine-induced regional flow heterogeneity than did teboroxime. These results highlight the importance of an ultra-fast imaging protocol when using teboroxime with pharmacologic stress.

Adenosine↗

Redistribution of 99mTc-sestamibi and 201Tl in the presence of a severe coronary artery stenosis.

BACKGROUND: 99mTc-labeled methoxyisobutyl isonitrile (99mTc-sestamibi) is a myocardial perfusion agent that clears slowly from the myocardium. This study evaluates the early and late myocardial distributions of 99mTc-sestamibi and 201Tl in the presence of low-flow ischemia to determine whether 99mTc-sestamibi demonstrates rest "redistribution." METHODS AND RESULTS: Low-flow ischemia was produced in 18 anesthetized, open-chest dogs by partial occlusion of the left anterior descending coronary artery. Dogs were injected intravenously with 99mTc-sestamibi, 301Tl, and radiolabeled microspheres during sustained low-flow ischemia. The hearts were excised either 20 minutes (group 1, 10 dogs) or 2.5 hours (group 2, 8 dogs) after injection for gamma well counting to evaluate the early and late myocardial distributions of these radiotracers, relative to microsphere flow. The early myocardial distributions of 99mTc-sestamibi and 201Tl were comparable and correlated with the flow deficit (group 1). We observed a significant difference in myocardial 201Tl (P = .005) and 99mTc-sestamibi (P < .0001) activities between groups 1 and 2 dogs relative to flow, suggesting some redistribution of both tracers. Myocardial slices were imaged postmortem with a gamma camera, and 99mTc-sestamibi defect intensity was quantified. There was excellent correlation (r = .97) between the early relative 99mTc-sestamibi defect intensity on postmortem images and the flow deficit (group 1). Among group 2 dogs, the correlation was good (r = .87), but the 99mTc-sestamibi defect was less severe than the flow deficit, again suggesting redistribution. CONCLUSIONS: The myocardial distributions of 99mTc-sestamibi and 201Tl early after injection are comparable and proportional to flow. Under conditions of sustained low flow, there was detectable rest "redistribution" of 99mTc-sestamibi verified by both gamma well counting and high-resolution postmortem imaging of myocardial slices. Whether this degree of 99mTc-sestamibi rest redistribution will be detectable by serial clinical imaging remains uncertain. Nevertheless, these data suggest that imaging should be delayed after the resting injection of 99mTc-sestamibi when assessing myocardial viability in the presence of a critical stenosis.

Animals↗

Dipyridamole thallium-201 imaging versus dobutamine echocardiography for the evaluation of coronary artery disease in patients unable to exercise.

The present study used 51 patients in a prospective, crossover, blinded comparison of dipyridamole thallium-201 imaging and dobutamine echocardiography for (1) detection of coronary artery disease (CAD), (2) detection of inducible ischemia, and (3) determination of myocardial viability. The detection of CAD was based on quantitative defects on initial planar thallium-201 images and resting or inducible wall motion abnormalities on echocardiography. Detection of ischemia was based on redistribution on delayed thallium-201 images and inducible wall motion abnormality on echocardiography. The myocardium in a region with resting wall motion abnormality was considered viable if it showed either redistribution or > 50% activity on delayed thallium-201 images, and if regional function either improved or worsened on echocardiography. The tests were comparable for the detection of CAD (53 and 59%, respectively, p = 0.23). Thallium-201 was superior to echocardiography for the detection of ischemia (35 vs 14%, respectively, p = 0.01). Although the incidence of viable myocardium was equivalent by the 2 tests (100 and 96%, respectively, p = 0.99) for each abnormally moving segment in the 24 patients with resting wall motion abnormality on echocardiography, it was greater on thallium-201 imaging (98 vs 68%, p < 0.01). It is concluded that because of its better ability to detect inducible myocardial ischemia and determine viability in myocardial segments showing reduced function, dipyridamole thallium-201 imaging appears to be superior to dobutamine echocardiography for the evaluation of CAD in patients unable to exercise.

Adult↗

Photodynamic action of aluminium phthalocyanine tetrasulphonate (A1PcS4) on smooth muscle: effects of thiols and a cyclic GMP analogue.

1. The smooth muscle system of the guinea-pig taenia caeci has been used in vitro to characterize the photodynamic action of aluminium phthalocyanine tetrasulphonate (A1PcS4) in the presence or absence of the thiol reductants L-cysteine (Cys), N-acetyl-L-cysteine (NAC), DL-dithiothreitol (DTT) or reduced glutathione (GSH). 2. In all photodynamic experiments the muscle was exposed to A1PcS4 (10(-5) M) for 30 min, followed by a 30 min washout period before photon irradiation at 32,000 lux (lambda > 570 nm) for 30 min. Photodynamic contractions were measured relative to the contractile response to carbachol (5 x 10(-5) M) and relaxation responses were determined in muscle precontracted with either carbachol 5 x 10(-5) M or KCl 23.5 mM. 3. Photon-activation of A1PcS4-sensitized smooth muscle evoked a triphasic response: an initial transient contraction and subsequent relaxation followed by a secondary sustained contraction. Cys 10 mM, NAC 10 mM and DTT 5 mM had no effect on the initial photodynamic contraction but significantly decreased the magnitude of the sustained contraction from mean values of 98% to 18%, 95% to 72% and 93% to 6% of the standard carbachol contraction (5 x 10(-5) M), respectively; GSH 10 mM was without significant effect on either the initial or sustained contraction. 4. In the absence of extracellular calcium the A1PcS4-sensitized smooth muscle did not respond to photon activation but re-introduction of calcium after cessation of illumination produced a sustained contraction which was markedly inhibited by Cys 10 mM. 5. In precontracted AlPcS4-treated muscle preparations photon activation produced a triphasic relaxation response, i.e. a rapid relaxation followed by a transient contraction and a secondary more sustained relaxation. The sustained phase of photodynamic relaxation was potentiated significantly by Cys 10 mM,NAC 10 mM, DTT 5 mM and GSH 10 mM, the relaxation being approximately doubled in magnitude from mean values of 34% to 68%, 30% to 73%, 34% to 68%, and 48% to 77%, respectively, relative to the standard carbachol (5 x l0-5 M) response.6. The cyclic GMP analogue, 8-(4-chlorophenylthio)-guanosine-3':5'-cyclic monophosphate (8-PCPTcGMP)(2 x 10-4 M) alone caused a triphasic relaxation response similar to that produced by photon activation of an AIPcS4-sensitized precontracted preparation in the presence of thiol reductants. The pattern of 8-PCPT-cGMP-induced relaxation was similar in muscle precontracted with carbachol 5 x 10-5M or KCI 23.5 mM.7. It is concluded that the rapid generation of reactive intermediates by photon-activation of boundAlPcS4 leads to membrane permeabilization, calcium entry and muscle contraction. These effects may be opposed by a direct stimulatory action of singlet oxygen on guanylate cyclase which is enhanced by the action of thiol reagents and mimicked by the cyclic GMP analogue, 8-PCPT-cGMP.

Animals↗

Diagnosing dissociative disorders.

The increasing prevalence of dissociative disorders has spawned a range of diagnostic tools. The authors describe the use of several current methods--screening instruments, structured interviews, psychological testing, and hypnosis--and they advocate enlisting the patient as an active collaborator in the diagnostic process.

Amnesia↗

Incorporating hypnosis into the psychotherapy of patients with multiple personality disorder.

Psychotherapeutic treatment of persons with multiple personality disorder frequently includes judicious use of hypnosis. The author outlines widely accepted essential features of this form of treatment: developing self-soothing techniques, "mapping" the system of alternate personalities, facilitating communication between alters and with the therapist, managing abreaction, and--when possible and appropriate--aiding the process of fusion. The author shows how dissociative processes that originally were used for sheer psychic survival can be drawn on to improve psychological health.

Communication↗

Airway secretion clearance by mechanical exsufflation for post-poliomyelitis ventilator-assisted individuals.

Pulmonary complications from impaired airway secretion clearance mechanisms are major causes of morbidity and mortality for post-poliomyelitis individuals. The purpose of this study was to review the long-term use of manually assisted coughing and mechanical insufflation-exsufflation (MI-E) by post-poliomyelitis ventilator-assisted individuals (PVAIs) and to compare the peak cough expiratory flows (PCEF) created during unassisted and assisted coughing. Twenty-four PVAIs who have used noninvasive methods of ventilatory support for an average of 27 years, relied on methods of manually assisted coughing and/or MI-E without complications during intercurrent respiratory tract infections (RTIs). Nine of the 24 individuals were studied for PCEF. They had a mean forced vital capacity (FVC) of 0.54 +/- 0.47L and a mean maximum insufflation capacity achieved by air stacking of ventilator insufflations and glossopharyngeal breathing of 1.7L. The PCEF were as follows: unassisted, 1.78 +/- 1.16L/sec; following a maximum assisted insufflation, 3.75 +/- 0.73L/sec; with manual assistance by abdominal compression following a maximum assisted insufflation, 4.64 +/- 1.42L/sec; and with MI-E, 6.97 +/- 0.89L/sec. We conclude that manually assisted coughing and MI-E are effective and safe methods of airway secretion clearance for PVAIs with impaired expiratory muscle function who would otherwise be managed by endotracheal suctioning. Severely decreased maximum insufflation capacity but not vital capacity indicate need for a tracheostomy.

Aged↗

Role of quantitative planar thallium-201 imaging for determining viability in patients with acute myocardial infarction and a totally occluded infarct-related artery.

We studied 57 patients with a recent infarction and an occluded infarct-related artery to test the hypothesis that the amount of 201Tl on delayed planar images correlates with the extent of viable myocardium after acute myocardial infarction. There was a significant (p < 0.001) correlation between mean 201Tl activity in the infarct zone and regional wall motion score in that zone both at baseline (r = -0.60, n = 57) and 1 mo after attempted angioplasty (r = -0.67, n = 48), with better function being associated with greater 201Tl uptake in the delayed images. There was no correlation between the number of segments showing redistribution and the wall motion score. We conclude that in patients with recent myocardial infarction and an occluded infarct-related artery, the average 201Tl activity within the infarct zone on delayed planar imaging correlates well with the extent of viable myocardium in that zone. The presence or absence of redistribution does not influence these results.

Adult↗

ST-segment depression during dipyridamole infusion, and its clinical, scintigraphic and hemodynamic correlates.

The goal of this study was to determine whether dipyridamole-induced ST-segment depression reflects more severe or extensive myocardial hypoperfusion than the absence of this electrocardiographic finding. The clinical, hemodynamic and scintigraphic correlates of ST-segment depression during intravenous dipyridamole infusion were studied in 204 consecutive patients undergoing dipyridamole stress thallium-201 (Tl-201) imaging for evaluation of coronary artery disease. Of 182 patients with a diagnostic baseline electrocardiogram, 28 (15%) developed ST depression after dipyridamole. Patients with ST depression, compared with those without, were older (64 +/- 1 vs 60 +/- 1 years; p less than 0.03) and had a higher frequency of chest pain (57 vs 23%; p less than 0.001) and a higher heart rate-blood pressure product (12.7 +/- 0.6 vs 11.2 +/- 0.2 x 10(3); p less than 0.008) after dipyridamole. Patients with ST depression were more likely to have Tl-201 redistribution (64 vs 38%; p less than 0.02) and a greater number of redistribution defects (2.3 +/- 0.04 vs 0.9 +/- 0.1, p less than 0.001) than were those without ST depression. By multivariate logistic regression analysis, the most powerful correlate of ST depression was the number of segments having Tl-201 redistribution (p less than 0.001). Other independent correlates were presence of chest pain, heart rate at Tl-201 injection, and age. Thus, the determinants of dipyridamole-induced ST-segment depression include the scintigraphic extent of reversible hypoperfusion, as well as indexes of myocardial oxygen demand.

Aged↗

Blinded evaluation of planar technetium-99m-sestamibi myocardial perfusion studies.

Sestamibi planar myocardial perfusion studies were performed at Hotel-Dieu de Montreal on 28 patients with documented coronary artery disease and 16 normal subjects. Stress and rest studies were performed on separate days. These studies were sent to Virginia for interpretation while blinded as to age, sex, and other clinical information. Studies were quantitated independently by two operators (using a computer program modified for Sestamibi), and interpreted independently by two experienced interpreters. Computer quantitation of 2816 segments gave an average interoperator deviation of 2.2%. Pure quantitative criteria were applied for computer interpretation. By varying the detection threshold, we produced the entire ROC curve relating sensitivity and specificity as a function of detection threshold. Using only computer criteria for normal or abnormal, interoperator agreement by patient was 98% and 93% by view. The computer could achieve equal positive and negative predictive accuracy of 87%. Interpreters, allowed both quantitative and subjective judgment, agreed on 91% of 44 patients, 90% of 132 views, and 92% of 660 segments. Interpreters averaged 94% positive and 86% negative predictive accuracy.

Adult↗

Contemporary issues in the psychotherapy of women.

According to current research findings, women are more likely than men to suffer from depression, eating disorders, and multiple personality disorder. The authors review recent advances in the understanding of female psychology, family systems theory, and psychoanalytic theory to show how women's unique developmental challenges and complex social conditions interact to determine the form and expression of these disorders. After discussing contributing factors, the authors suggest appropriate approaches to diagnosis and treatment. They conclude that therapists of both genders must appreciate the complex causes of these disorders to be most helpful to their female patients.

Depressive Disorder↗

Alterations in Alzheimer's disease-associated protein in Alzheimer's disease frontal and temporal cortex.

Alzheimer's disease (AD)-associated protein is present in brain and cerebrospinal fluid of patients with AD but not in adult, nondemented, normal controls. This protein may represent an abnormal epitope of the "tau" microtubule-associated protein and has been detected before the appearance of senile plaques and neurofibrillary tangles. The amount of AD-associated protein in the frontal and temporal cortices in 93 cases of neuropathologically confirmed AD was compared with the amount that was present in 20 cases without AD. The amount of AD-associated protein was significantly increased in the cases of AD for both brain regions compared with that in the cases without AD. The presence of high levels of this protein is a useful adjunct, postmortem marker of the presence of AD and may eventually lead to tests that allow early detection of individuals at risk for this disease.

Alzheimer Disease↗

Antecedents of posttraumatic stress disorder: wasn't being raped enough? A brief communication.

Many rape victims, like those traumatized by war, accidents, and natural disasters, are able to recover from their ordeal with supportive, crisis-oriented treatment. For others, however, symptoms may persist and require more intensive treatment. Hypnosis allows a modulated re-experiencing and abreaction of the traumatic event that can help to provide the victim with a relieving sense of mastery, and it fosters a receptive context for reassurance and interpretation regarding the irrational or exaggerated thoughts and feelings involved. 2 case examples are presented in which earlier conflicts appeared to play a role in perpetuating the patients' symptoms. Detecting and addressing these antecedents resulted in complete alleviation of long-standing problems through relatively brief treatment using hypnosis.

Adult↗

Prevalence and correlates of increased lung/heart ratio of thallium-201 during dipyridamole stress imaging for suspected coronary artery disease.

There is little information concerning the prevalence and clinical correlates of increased pulmonary thallium-201 uptake during dipyridamole thallium-201 stress imaging. Accordingly, the clinical characteristics and quantitative thallium-201 findings were correlated with quantitative lung/heart thallium-201 ratio in 87 patients undergoing dipyridamole thallium-201 stress testing. Nineteen patients (22%) had an elevated ratio (greater than 0.51). These patients were more likely to have had an infarction, to be taking beta blockers, and have a lower rate-pressure product after dipyridamole administration than those with a normal ratio (p less than 0.03). An elevated ratio was associated with a greater likelihood of initial, redistribution and persistent defects, as well as left ventricular cavity dilatation on thallium-201 imaging (p less than 0.05). In addition, the number of myocardial segments demonstrating initial, redistribution and persistent defects was also greater in patients with increased ratios (p less than 0.03). Multivariate analysis demonstrated that the presence of redistribution and left ventricular cavity dilatation were the most significant correlates of lung/heart thallium-201 ratio. It is concluded that the prevalence of increased lung/heart thallium-201 ratio with dipyridamole thallium-201 stress imaging is similar to that seen with exercise stress imaging. As with exercise thallium-201 imaging, increased pulmonary thallium-201 uptake may be a marker of functionally more significant coronary artery disease.

Adult↗

Technical aspects of myocardial planar imaging with technetium-99m sestamibi.

Fundamental quantitative planar imaging techniques, evolved over the years, have been adapted to maximize the efficiency and clinical effectiveness of technetium-99m (Tc-99m) sestamibi imaging. To ensure reproducible image interpretation, the Society for Motion Picture and Television Engineers test pattern is used to obtain the necessary standardization of video and hard copy images. A standardized intensity scale intuitively relates count density to perceived brightness. Data are accumulated via standard 16-frame multiple gated acquisition and can be viewed in cine mode to assess wall motion. The images are then automatically summed for quantitative analysis of myocardial perfusion. Excessive extracardiac Tc-99m activity is automatically suppressed by the computer program to prevent suboptimal display of the heart. Due to the difference in heart background ratio and shape of the extracardiac background between resting and exercise Tc-99m sestamibi images, a modified interpolative background subtraction algorithm was developed. Image registration is necessary for accurate comparison of the rest and exercise images to detect redistribution. This is automatically accomplished by adjusting the position of the background-subtracted and centered images so as to maximize the cross-correlation coefficient. Profiles are generated to sample the myocardial count distribution and can be compared to a normal database, subject to confirmation by a competent interpreter. Rest redistribution is defined by a change in the myocardial distribution of Tc-99m sestamibi between exercise and rest images. Flashback display is used to identify subtle regions of redistribution that often signify residual viability within an infarct zone.(ABSTRACT TRUNCATED AT 250 WORDS)

Heart↗