.I 54711
.U
88000001
.S
Alcohol Alcohol 8801; 22(2):103-12
.M
Acetaldehyde/*ME; Buffers; Catalysis; HEPES/PD; Nuclear Magnetic Resonance; Phosphates/*PD; Protein Binding; Ribonuclease, Pancreatic/AI/*ME; Support, U.S. Gov't, Non-P.H.S.; Support, U.S. Gov't, P.H.S..
.T
The binding of acetaldehyde to the active site of ribonuclease: alterations in catalytic activity and effects of phosphate.
.P
JOURNAL ARTICLE.
.W
Ribonuclease A was reacted with [1-13C,1,2-14C]acetaldehyde and sodium cyanoborohydride in the presence or absence of 0.2 M phosphate. After several hours of incubation at 4 degrees C (pH 7.4) stable acetaldehyde-RNase adducts were formed, and the extent of their formation was similar regardless of the presence of phosphate. Although the total amount of covalent binding was comparable in the absence or presence of phosphate, this active site ligand prevented the inhibition of enzymatic activity seen in its absence. This protective action of phosphate diminished with progressive ethylation of RNase, indicating that the reversible association of phosphate with the active site lysyl residue was overcome by the irreversible process of reductive ethylation. Modified RNase was analysed using 13C proton decoupled NMR spectroscopy. Peaks arising from the covalent binding of enriched acetaldehyde to free amino groups in the absence of phosphate were as follows: NH2-terminal alpha amino group, 47.3 ppm; bulk ethylation at epsilon amino groups of nonessential lysyl residues, 43.0 ppm; and the epsilon amino group of lysine-41 at the active site, 47.4 ppm. In the spectrum of RNase ethylated in the presence of phosphate, the peak at 47.4 ppm was absent. When RNase was selectively premethylated in the presence of phosphate, to block all but the active site lysyl residues and then ethylated in its absence, the signal at 43.0 ppm was greatly diminished, and that arising from the active site lysyl residue at 47.4 ppm was enhanced. These results indicate that phosphate specifically protected the active site lysine from reaction with acetaldehyde, and that modification of this lysine by acetaldehyde adduct formation resulted in inhibition of catalytic activity.
.A
Mauch TJ; Tuma DJ; Sorrell MF.
.I 54712
.U
88000002
.S
Alcohol Alcohol 8801; 22(2):113-6
.M
Adult; Alcohol, Ethyl/*AN; Breath Tests/*; Human; Irrigation; Male; Middle Age; Mouth/*; Temperature; Water.
.T
Reductions in breath ethanol readings in normal male volunteers following mouth rinsing with water at differing temperatures.
.P
JOURNAL ARTICLE.
.W
Blood ethanol concentrations were measured sequentially, over a period of hours, using a Lion AE-D2 alcolmeter, in 12 healthy male subjects given oral ethanol 0.5 g/kg body wt. Readings were taken before and after rinsing the mouth with water at varying temperatures. Mouth rinsing resulted in a reduction in the alcolmeter readings at all water temperatures tested. The magnitude of the reduction was greater after rinsing with water at lower temperatures. This effect occurs because rinsing cools the mouth and dilutes retained saliva. This finding should be taken into account whenever breath analysis is used to estimate blood ethanol concentrations in experimental situations.
.A
Gaylarde PM; Stambuk D; Morgan MY.
.I 54713
.U
88000003
.S
Alcohol Alcohol 8801; 22(2):117-9
.M
Alcoholism/*PP; Animal; Diprenorphine/PD; Female; Morphine/*PD; Naloxone/PD; Naltrexone/PD; Narcotic Antagonists/*PD; Rats; Rats, Inbred Strains; Receptors, Endorphin/*DE/PH; Seizures/PP; Substance Withdrawal Syndrome/PP.
.T
Does the blockade of opioid receptors influence the development of ethanol dependence?
.P
JOURNAL ARTICLE.
.W
We have tested whether the opioid antagonists naloxone (2 mg/kg), naltrexone (2 mg/kg) and diprenorphine (0.2 mg/kg), and the agonist morphine (4-8 mg/kg) given subcutaneously (10 min before ethanol for 7 days) modify the ethanol withdrawal syndrome (audiogenic seizures) following chronic ethanol intoxication in rats. We found that naloxone, naltrexone and diprenorphine modified the ethanol withdrawal syndrome. These findings do not rule out the possibility of a biochemical link between the action of ethanol and opiates at the level of opioid receptors.
.A
Kotlinska J; Langwinski R.
.I 54714
.U
88000006
.S
Alcohol Alcohol 8801; 22(2):147-54
.M
Adult; Alcohol Drinking/*PH; Alcoholism/*BL/CO; Erythrocyte Indices/*; Female; Follow-Up Studies; Gamma-Glutamyltransferase/*BL; Hepatomegaly/ET; Human; Male; Middle Age; Predictive Value of Tests; Sex Factors.
.T
Drinkwatchers--description of subjects and evaluation of laboratory markers of heavy drinking.
.P
JOURNAL ARTICLE.
.W
Clinical examination and measurement of MCV and GGT were carried out on 124 self-referred 'healthy' Drinkwatchers, all of whom had consumed at least 80 g alcohol/day for more than 2 years. The majority (66.1%) were in social classes II and III. Sixty-three subjects (54.1%) had a raised MCV, GGT or hepatomegaly. A raised MCV was significantly more likely to occur in men. Forty-five subjects (36.3%) had an enlarged liver of whom 17 had a normal MCV and GGT. This study shows that MCV and GGT are poor screening tests for excessive alcohol consumption in 'healthy' subjects but, if used at all, MCV appears to be more sensitive in women and GGT in men. Neither test is an adequate substitute for a careful history and full clinical examination.
.A
Barrison IG; Ruzek J; Murray-Lyon IM.
.I 54715
.U
88000007
.S
Alcohol Alcohol 8801; 22(2):155-9
.M
Adult; Alcoholism/*BL; Blood Platelets/*ME; Erythrocyte Indices; Gamma-Glutamyltransferase/BL; Human; In Vitro; Kinetics; Middle Age; Serotonin/*BL; Support, Non-U.S. Gov't.
.T
Platelet affinity for serotonin is increased in alcoholics and former alcoholics: a biological marker for dependence?
.P
JOURNAL ARTICLE.
.W
The kinetics of 3H serotonin platelet uptake were studied in alcoholics and former alcoholics to see whether differences found between alcohol-preferring and non-preferring rats could be reproduced in man. Three groups of patients were studied: 10 dependent alcoholics on admission for treatment; 10 dependent alcoholics after 20 days of treatment; 8 former dependent alcoholics, abstinent for 1-11 years. Controls were non-alcoholics, matched for age and sex. The Km for 3H serotonin uptake in platelets was lower in patients from all three groups compared to 15 controls. This phenomenon could be congenital or induced by the previous excessive intake of alcohol. We believe that this increased platelet affinity for serotonin, in the absence of cirrhosis of the liver and/or depression could be a marker for alcohol dependence, enabling the therapeutic effort to be focussed on these patients.
.A
Boismare F; Lhuintre JP; Daoust M; Moore N; Saligaut C; Hillemand B.
.I 54716
.U
88000008
.S
Alcohol Alcohol 8801; 22(2):161-6
.M
Adult; Affective Symptoms/DT; Alcoholism/*PP/PX; Clonidine/AD/*TU; Human; Infusions, Intravenous; Male; Substance Withdrawal Syndrome/*DT/PX; Support, Non-U.S. Gov't.
.T
Clonidine in alcohol withdrawal: a pilot study of differential symptom responses following i.v. clonidine.
.P
JOURNAL ARTICLE.
.W
The effects of an i.v. bolus of clonidine (1.5 mg/kg) on withdrawal symptoms were studied in 7 male alcoholics, and compared with 7 normal controls. Clonidine reduced both subjective and objective measures of withdrawal but this only reached significance for scores of depression and muscle tension. In comparison with controls alcoholics in withdrawal showed reduced sedative effects of clonidine.
.A
Glue P; Nutt D.
.I 54717
.U
88000009
.S
Alcohol Alcohol 8801; 22(2):167-79
.M
Adult; Alcohol Drinking/*; Female; Great Britain; Human; Interviews; Male; Population Surveillance/*; Recall; Support, Non-U.S. Gov't.
.T
Bias in a survey of drinking habits.
.P
JOURNAL ARTICLE.
.W
This paper presents data from a general population survey of three areas of Britain which manifest considerable differences in official rates of problem drinking, yet show similar patterns and levels of alcohol consumption. Consideration of various sources of bias (non-response, forgetting, selective under-reporting, and interviewer) suggest that they do not differentially influence self-reported alcohol consumption in the three areas.
.A
Crawford A.
.I 54718
.U
88000010
.S
Alcohol Alcohol 8801; 22(2):181-92
.M
Adult; Alcohol Drinking; Alcoholism/*PX; Family/*; Female; Gender Identity/*; Human; Identification (Psychology)/*; Male; Questionnaires; Regression Analysis; Sex Factors; Students/*PX; Support, U.S. Gov't, P.H.S.; Texas; Universities.
.T
Factors associated with young adult alcohol abuse.
.P
JOURNAL ARTICLE.
.W
The present study examined correlates of alcohol abuse among university students which have been conceptually linked to the developmental transitions faced by this population. Individual and family developmental theories led to the hypothesis that sex role identity conflict and stresses within the student's family of origin would be positively related to alcohol abuse scores. As expected, an accumulation of family stresses was related to alcohol abuse scores for both men and women. However, for each sex only one of the four sex role conflict variables which were considered was significantly related to alcohol abuse scores. For women, this variable was femininity conflict, while for men it was affiliation conflict.
.A
Koch-Hattem A; Denman D.
.I 54719
.U
88000011
.S
Alcohol Alcohol 8801; 22(2):193-8
.M
Age Factors; Aged; Aged, 80 and over; Alcohol Drinking; Alcoholism/CO/*EP/PX; Cognition/DE; Depression/EP; Health Status; Human; Life Style; Male; Mental Status Schedule; Smoking/*EP; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Alcohol and the elderly: relationships to illness and smoking.
.P
JOURNAL ARTICLE.
.W
A group of 33 semi-independent living nonagenarian men and a group of 32 65-75 year-old men of similar demographic characteristics, living at the California Veterans' Home, were compared in terms of alcohol use, past and present, and relationships to several somatic, mental and lifestyle aspects including smoking. The younger group had a higher prevalence of alcohol abuse and higher current alcohol intake (P less than 0.004). Higher alcohol intake related to greater smoking of cigarettes in the younger group. Alcohol tended to be related to an increased number of medical illnesses, and to increased use of major medications (P less than 0.005). There was an interactive effect between classes of alcohol use and scores on a mental status examination used to assess cognitive function (P less than 0.05).
.A
Jensen GD; Bellecci P.
.I 54720
.U
88000012
.S
Alcohol Alcohol 8801; 22(2):99-101
.M
Publishing; Research Design; Statistics/*.
.T
Concerning the probability of our confidence in statistics [editorial]
.P
EDITORIAL.
.A
Tittmar HG.
.I 54721
.U
88000305
.S
Br J Anaesth 8801; 59(8):1011-6
.M
Action Potentials/DE; Alcuronium/*PD; Dose-Response Relationship, Drug; Drug Synergism; Enflurane/*PD; Female; Halothane/*PD; Human; Isoflurane/*PD; Muscles/PH; Neuromuscular Junction/*DE; Support, Non-U.S. Gov't; Time Factors; Toxiferine/*AA.
.T
Potentiation of the neuromuscular blockade produced by alcuronium with halothane, enflurane and isoflurane.
.P
JOURNAL ARTICLE.
.W
The potentiation of alcuronium by halothane, enflurane and isoflurane was investigated using electromyography. In the first study, cumulative dose-response curves were constructed in four groups of 10 patients anaesthetized with one of the inhalation agents and nitrous oxide, or with fentanyl and droperidol (control). All three agents reduced the ED50 of alcuronium; the effect was marked with isoflurane (P less than 0.005) but less so with halothane (P less than 0.05) and enflurane (ns). In the second part of the investigation, designed primarily to test the duration of action of alcuronium with each agent, a single bolus dose of alcuronium 0.2 mg kg-1 was given to four similar groups (n = 5). The duration of action was significantly prolonged by enflurane (P less than 0.01) and isoflurane (P less than 0.05), but not by halothane. The possible reasons for this are discussed.
.A
Keens SJ; Hunter JM; Snowdon SL; Utting JE.
.I 54722
.U
88000306
.S
Br J Anaesth 8801; 59(8):1017-21
.M
Burns/*PP; Child; Depression, Chemical; Electromyography; Human; Muscles/DE; Succinylcholine/*PD; Time Factors.
.T
Electromyographic responses to small doses of suxamethonium in children after burns.
.P
JOURNAL ARTICLE.
.W
Integrated electromyographic studies in burned patients, and in normal controls, during the administration of small doses of suxamethonium (0.1 or 0.2 mg kg-1) have shown that the level of paralysis and the duration of paralysis are significantly increased in burn patients and that the effect is greater with larger burns. Repeated studies on patients using these small doses have shown that patients with burns pass through a phase of extreme sensitivity to the effects of suxamethonium, usually sometime between 4 and 12 days after the burn.
.A
Brown TC; Bell B.
.I 54723
.U
88000307
.S
Br J Anaesth 8801; 59(8):1022-6
.M
Anesthesia, Inhalation/*VE; Animal; Bronchi/*DE; Enflurane/*PD; Expiratory Reserve Volume; Female; Halothane/*PD; Horses/*PH; Isoflurane/*PD; Male; Support, Non-U.S. Gov't; Tidal Volume; Time Factors.
.T
Effect of halothane, enflurane and isoflurane on bronchomotor tone in anaesthetized ponies.
.P
JOURNAL ARTICLE.
.W
The effects of halothane, enflurane and isoflurane on bronchial calibre were investigated in five anaesthetized ponies using a computer-aided forced airflow oscillation technique to derive specific lower airways conductance (s.Glaw) and expiratory reserve volume (ERV). All the agents tended to increase s.Glaw (indicating bronchodilatation), but ERV was reduced by halothane and enflurane, and increased by isoflurane. It was concluded that the effects of these agents on bronchomotor tone were similar to those which occur in man. However, the reasons for the differences in their effects on ERV compared with those found in man remain to be determined.
.A
Watney GC; Jordan C; Hall LW.
.I 54724
.U
88000309
.S
Br J Anaesth 8801; 59(8):1035-9
.M
Adolescence; Adult; Aged; Blood Cell Count; Blood Transfusion, Autologous/*ST; Comparative Study; Erythrocytes/PH; Female; Heart Surgery; Heparin/BL; Human; Hydrogen-Ion Concentration; Leukocytes/PH; Male; Middle Age; Potassium/BL; Support, Non-U.S. Gov't.
.T
Autotransfusion: quality of blood prepared with a red cell processing device.
.P
JOURNAL ARTICLE.
.W
The quality of blood salvaged at operation and prepared with the Dideco Autotrans BT 795 autotransfusion device was compared with that of donor blood in 41 patients having cardiac surgery involving cardiopulmonary bypass. Saved blood had a higher haemoglobin concentration (17.3 v. 13.1 g dl-1; P less than 0.001), a higher 2,3-diphosphoglycerate concentration (5.3 v. 1.1 mmol litre-1; P less than 0.00001), higher white cell count (17.1 X 10(9) litre-1 v. 4.1; P less than 0.00001), higher pH (7.5 v. 6.6; P less than 0.00001) and a more physiological potassium concentration (5.4 v. 8.8 mmol litre-1; P less than 0.00001) than donor blood. Saved blood platelet count was 34.5 X 10(9) litre-1 compared with 146.24 X 10(9) litre-1 (P less than 0.00001) and its heparin concentration was 0.64 u. ml-1. We conclude that this autotransfusor is a useful aid to blood conservation, producing good quality red cells with relatively normal pH and potassium values. However, modification of the centrifugation and washing is required to lessen the high white cell count and heparin concentrations found in the saved blood.
.A
McShane AJ; Power C; Jackson JF; Murphy DF; MacDonald A; Moriarty DC; Otridge BW.
.I 54725
.U
88000310
.S
Br J Anaesth 8801; 59(8):1040-3
.M
Air; Animal; Female; Fetus; In Vitro; Liver/EM/*EN; Methyltransferases/*AI; Nitrous Oxide/*PD; Oxygen/PD; Pregnancy; Rats; Rats, Inbred Strains; Support, Non-U.S. Gov't; Support, U.S. Gov't, Non-P.H.S.; Tetrahydropteroylglutamate Methyltransferase/*AI; Time Factors.
.T
Inhibition of rat fetal methionine synthase by nitrous oxide. An in vitro study.
.P
JOURNAL ARTICLE.
.W
The effect of in vitro exposure to nitrous oxide on rat fetal and maternal methionine synthase activity was investigated. Enzyme solutions were prepared from livers of fetuses and mothers on day 19 of gestation and exposed to air, 50% oxygen or 50% nitrous oxide in oxygen for periods up to 24 h. Normal activity of methionine synthase in the fetus was about 65% of that in the mother. Activity decreased by about 25% over 24 h when the enzyme was incubated at 37 degrees C in the presence of either air or 50% oxygen. Nitrous oxide produced a time-dependent decrease in activity which generally was similar for both fetal and maternal enzyme. After 24 h exposure to nitrous oxide, activity has decreased to 14 and 17% of fetal and maternal control values, respectively.
.A
Baden JM; Serra M; Mazze RI.
.I 54726
.U
88000312
.S
Br J Anaesth 8801; 59(8):1052-5
.M
Cholinesterases/GE; Drug Hypersensitivity/EP/ET/*GE; England; Female; Gene Frequency; Genotype; Human; Male; Phenotype; Pregnancy; Succinylcholine/*AE; Support, Non-U.S. Gov't.
.T
Phenotyping of individuals sensitive to suxamethonium. The Cholinesterase Research Unit at the Royal Postgraduate Medical School.
.P
JOURNAL ARTICLE.
.W
Four hundred and thirty blood samples from suxamethonium-sensitive individuals have been phenotyped by the Cholinesterase Research Unit following its transfer from Exeter to the Hammersmith Hospital. The distribution of genotypes has been shown to be similar to that found in Exeter. Screening for the Elk and Elj genes has not yielded any major differences in the gene frequencies of sensitive individuals, even during pregnancy. The uneven sex distribution of the patients, as well as other unusual points that have arisen, are discussed. A new gene for the biosynthesis of cholinesterase has probably been identified.
.A
Whittaker M; Britten JJ.
.I 54727
.U
88000313
.S
Br J Anaesth 8801; 59(8):1056-8
.M
Axillary Artery/*PH; Blood Pressure/*; Case Report; Cerebral Aneurysm/*SU; Human; Intraoperative Complications; Male; Middle Age; Monitoring, Physiologic/*; Thromboangiitis Obliterans/*CO.
.T
Monitoring of axillary arterial pressure in a patient with Buerger's disease requiring clipping of an intracerebral aneurysm.
.P
JOURNAL ARTICLE.
.W
A 45-yr-old male with advanced Buerger's disease required surgical clipping of an intracerebral aneurysm. This case report emphasizes considerations of arterial pressure monitoring in a patient with advanced Buerger's Disease requiring a major surgical intervention.
.A
Yacoub OF; Bacaling JH; Kelly M.
.I 54728
.U
88000314
.S
Br J Anaesth 8801; 59(8):1059-62
.M
Bladder/*SU; Case Report; Child; Female; Human; Intraoperative Complications; Pulmonary Embolism/*ET.
.T
Massive intraoperative pulmonary embolism in a child.
.P
JOURNAL ARTICLE.
.W
An 11-yr-old girl suffered a massive pulmonary embolus during an operation to insert an artificial bladder sphincter. Forty minutes after the induction of anaesthesia, the heart rate increased and she became hypotensive and deeply cyanosed. A definitive diagnosis was not made during surgery, but she improved after 45 min of resuscitation with 100% oxygen, infusion of normal saline, ephedrine (total 45 mg) and intermittent external cardiac massage. The diagnosis was proved the next day by lung perfusion scan. There were no apparent risk factors.
.A
Goodman NW; Falkner MJ.
.I 54729
.U
88000315
.S
Br J Anaesth 8801; 59(8):949-53
.M
Abdomen/PH; Anesthesia/*AE; Atelectasis/*ET; Blood Volume; Diaphragm/PH; Functional Residual Capacity; Human; Pulmonary Gas Exchange; Thorax/PH.
.T
Anaesthesia, and atelectasis: the role of VTAB and the chest wall.
.P
JOURNAL ARTICLE.
.A
Jones JG.
.I 54730
.U
88000317
.S
Br J Anaesth 8801; 59(8):961-5
.M
Adult; Alcohol, Ethyl/BL/*PD; Human; Male; Psychomotor Performance/*DE; Time Factors.
.T
Effects of ethanol on psychomotor performance.
.P
JOURNAL ARTICLE.
.W
Three separate doses of alcohol (0.2, 0.4 and 0.8 g kg-1) were given to eight volunteers and compared with the effects of a placebo. The order of administration was randomized and the study performed double-blind. A battery of psychometric tests sensitive to central nervous system depression was repeatedly performed for 3.5 h. Alcohol, even in the highest dose, had little effect on psychomotor performance.
.A
Fagan D; Tiplady B; Scott DB.
.I 54731
.U
88000318
.S
Br J Anaesth 8801; 59(8):966-9
.M
Adult; Aged; Aged, 80 and over; Anesthesia, General/*; Atropine/*PD; Cognition/*DE; Comparative Study; Female; Glycopyrrolate/*PD; Human; Male; Middle Age; Postoperative Period; Pyrrolidines/*PD.
.T
Comparison of the effects of atropine and glycopyrrolate on cognitive function following general anaesthesia.
.P
JOURNAL ARTICLE.
.W
Tests of orientation, concentration and short-term visual memory were used to assess 72 patients 1 day before, and 2 days after, elective major surgery. Patients were premedicated with papaveretum and either atropine or glycopyrrolate, before receiving a standard general anaesthetic. Those who had received atropine showed significant postoperative short-term memory deficit (P less than 0.01), but no change in orientation or concentration. Those who had been given glycopyrrolate showed no significant cognitive changes after surgery. As glycopyrrolate does not cross the blood-brain barrier freely, these findings support the involvement of central cholinergic mechanisms in the deterioration of cognitive function in the postoperative period.
.A
Simpson KH; Smith RJ; Davies LF.
.I 54732
.U
88000320
.S
Br J Anaesth 8801; 59(8):978-82
.M
Adult; Anesthesia Recovery Period/*; Anesthesia, General/*; Anesthesia, Obstetrical/*; Buprenorphine/*; Cesarean Section/*; Female; Fentanyl/*; Human; Postoperative Period/*; Pregnancy.
.T
Use of simple tests to determine the residual effects of the analgesic component of balanced anaesthesia.
.P
JOURNAL ARTICLE.
.W
In order to evaluate simple means of determining the rate of recovery after general anaesthesia, the usefulness of the critical flicker fusion threshold test, the Maddox wing apparatus and the visual analogue scale were compared. The postanaesthetic recovery score was used as a reference. Two patient groups (n = 15 in each) received, in a randomized double-blind study, a similar balanced anaesthesia for Caesarean section, except that the analgesic component was either fentanyl 2.5 micrograms kg-1 i.v. or buprenorphine 7.5 micrograms kg-1 i.v. Maddox wing apparatus and visual analogue scale were sensitive enough to differentiate between the postanaesthetic residual effects of the two opioids, but critical flicker fusion threshold and, especially, postanaesthetic recovery score were insensitive in this respect. There was no difference between the two patient groups in mean arterial pressure and heart rate. Our results show that the residual effects of different kinds of opioids as an analgesic component of balanced anaesthesia can be differentiated using simple means like Maddox wing apparatus and visual analogue scales.
.A
Manner T; Kanto J; Salonen M.
.I 54733
.U
88000321
.S
Br J Anaesth 8801; 59(8):983-8
.M
Adult; Aged; Edrophonium/PD; Electromyography; Human; Middle Age; Muscle Contraction/DE; Neostigmine/PD; Neuromuscular Junction/*DE; Time Factors; Vecuronium/AI/*PD.
.T
Electrical and mechanical responses after neuromuscular blockade with vecuronium, and subsequent antagonism with neostigmine or edrophonium.
.P
JOURNAL ARTICLE.
.W
Six unpremedicated patients who had given their informed consent were given vecuronium 0.08 mg kg-1 before elective surgery. Recovery from neuromuscular blockade was measured electrically and mechanically. Neuromuscular blockade was antagonized 1 h after the administration of vecuronium with two doses of neostigmine 2.5 mg (three patients) or edrophonium 0.5 mg kg-1 (three patients). Although the onset of initial recovery was similar, subsequent recovery was faster when measured electrically (EMG) than when measured mechanically. Recovery appeared to be faster in younger patients. Reintroduction of neuromuscular blockade occurred after the second dose of neostigmine 2.5 mg, given to antagonize the block. This did not occur after either dose of edrophonium 0.5 mg kg-1.
.A
Astley BA; Katz RL; Payne JP.
.I 54734
.U
88000322
.S
Br J Anaesth 8801; 59(8):989-94
.M
Adolescence; Adult; Aged; Arm; Atracurium/*PD; Electric Stimulation/MT; Human; Middle Age; Muscle Contraction/DE; Muscles/PH; Neuromuscular Junction/*DE; Succinylcholine/*PD; Time Factors.
.T
Onset and recovery of atracurium and suxamethonium-induced neuromuscular blockade with simultaneous train-of-four and single twitch stimulation.
.P
JOURNAL ARTICLE.
.W
Single twitch and train-of-four stimulation were applied at 0.08 Hz to each ulnar nerve and the force of contraction of the adductor pollicis was recorded during onset of and recovery from neuromuscular blockade by suxamethonium 1 mg kg-1 or atracurium 0.4 mg kg-1. Times to 90% first twitch blockade of train-of-four were (mean +/- SEM) 0.82 +/- 0.08 and 1.98 +/- 0.18 min for suxamethonium and atracurium, respectively, compared with times to 90% single twitch blockade of 1.00 +/- 0.07 and 3.35 +/- 0.37 min, respectively (P less than 0.05 in both cases). Apparent onset time also depended on how long train-of-four stimulation had been applied before injection of atracurium. The mode of stimulation had little effect on time to 10% recovery. The results are consistent with stimulation-induced augmentation in muscle blood flow, which increased delivery of the drug to the neuromuscular junction.
.A
Curran MJ; Donati F; Bevan DR.
.I 54735
.U
88000323
.S
Br J Anaesth 8801; 59(8):995-1003
.M
Adolescence; Adult; Atracurium/*PD; Azathioprine/PD; Dose-Response Relationship, Drug; Drug Interactions; Female; Human; Kidney Failure, Chronic/*PP; Male; Middle Age; Neuromuscular Junction/*DE; Pancuronium/*PD; Vecuronium/*PD.
.T
Atracurium, vecuronium and pancuronium in end-stage renal failure. Dose-response properties and interactions with azathioprine.
.P
JOURNAL ARTICLE.
.W
Dose-response relations for atracurium, vecuronium and pancuronium were determined in patients in end-stage renal failure for the initial neuromuscular blockade (using three cumulative doses) and for the maintenance of stable 90% response (during continuous infusion). All measurements were during renal transplant surgery, and the interaction of azathioprine on neuromuscular blockade was estimated. Mean ED95 doses were (microgram kg-1): atracurium 375.6, vecuronium 67.2, pancuronium 86.6; the initial blockade required significantly larger doses than in normal patients (37%, 20% and 45%, respectively, using ED50 values). Mean infusion rates for 90% sustained blockade in renal failure were (microgram kg-1 h-1): atracurium 409.4, vecuronium 78.3, pancuronium 14.2. The atracurium dose was not influenced by renal function, whereas vecuronium and pancuronium requirements were significantly reduced by 23.2% and 61.5%, respectively, compared with normal patients (previous study). Azathioprine was injected at the rate of 1 mg kg-1 min-1 for 3 min at stable 90% neuromuscular blockade with constant-rate infusion of the neuromuscular blocking drug. This produced a relatively small and transient antagonism of blockade--probably of negligible clinical significance.
.A
Gramstad L.
.I 54736
.U
88000425
.S
Br J Dermatol 8801; 117(1):1-9
.M
Animal; Antigen-Presenting Cells/*IM; Antigens/*IM; Dermatitis, Contact/*IM; Dinitrochlorobenzene/*IM/PK; Female; Langerhans Cells/AN; Mice; Mice, Inbred BALB C; Nitrobenzenes/IM/PK; Skin/AN/*IM; Skin Absorption.
.T
Control of the immune response to contact sensitizing chemicals by cutaneous antigen-presenting cells.
.P
JOURNAL ARTICLE.
.W
The fate of 2,4-dinitrochlorobenzene, a potent contact sensitizing chemical, and 2,4-dichloronitrobenzene, a non-sensitizer, was compared following their application to the skin of BALB/c mice. Although both chemicals were able to bind to protein in vitro and were capable of being absorbed across mouse skin in vivo, only 2,4-dinitrochlorobenzene was able to bind to cells in the skin and to induce the movement of these cells from the epidermis into the dermis and ultimately into the draining lymph nodes. The sensitization potential of a chemical may therefore be dependent on its ability to associate with and stimulate the efflux of cutaneous antigen-presenting cells.
.A
Botham PA; Rattray NJ; Walsh ST; Riley EJ.
.I 54737
.U
88000426
.S
Br J Dermatol 8801; 117(1):107-9
.M
Adult; Androgens/TU; Blood Platelet Disorders/DT/ET; Case Report; Human; Klinefelter's Syndrome/*BL/CO; Leg Ulcer/*BL/DT/ET; Male; Platelet Aggregation/*; Platelet Function Tests.
.T
Platelet hyperaggregability in a patient with Klinefelter's syndrome and leg ulcers.
.P
JOURNAL ARTICLE.
.W
We describe a patient with Klinefelter's syndrome complicated by recalcitrant leg ulcers, in whom marked platelet hyperaggregability was demonstrated and venous disease excluded. Androgen replacement therapy appeared to bring about healing of the patient's ulcers and was associated with reversal of the platelet abnormality. The possible role of androgen deficiency in the pathogenesis of leg ulceration is discussed.
.A
Norris PG; Rivers JK; Machin S; Dowd PM; Griffiths WA.
.I 54738
.U
88000428
.S
Br J Dermatol 8801; 117(1):111-5
.M
Adult; Case Report; Female; Human; Melanosis/*ET/PA; Skin/PA; Spectrum Analysis; Ultraviolet Rays/*AE.
.T
UVA-induced melanocytic lesions.
.P
JOURNAL ARTICLE.
.W
The occurrence of melanocytic lesions following PUVA therapy is well documented. We describe a patient who developed similar lesions after cosmetic use of a home sun-bed without psoralen administration. Histological examination showed increased numbers of large and sometimes atypical melanocytes, which may theoretically act as precursors for melanoma.
.A
Jones SK; Moseley H; Mackie RM.
.I 54739
.U
88000429
.S
Br J Dermatol 8801; 117(1):117-9
.M
Adult; Case Report; Facial Dermatoses/*ET; Human; Male; Occupational Dermatitis/*ET; Photosensitivity Disorders/*ET; Ultraviolet Rays/*AE; Welding/*.
.T
Photodermatitis due to spot welding.
.P
JOURNAL ARTICLE.
.W
The case of a patient with a 1-year history of recurrent, severe facial dermatitis is reported. The role of ultraviolet radiation from arc welding or other equipment at work in inducing dermatitis is discussed.
.A
Shehade SA; Roberts PJ; Diffey BL; Foulds IS.
.I 54740
.U
88000430
.S
Br J Dermatol 8801; 117(1):121-4
.M
Administration, Topical; Adult; Case Report; Clobetasol/AA/AD; Human; Male; Pigmentation Disorders/DT/*PA; Prurigo/DT/*PA; Skin/*PA.
.T
Prurigo pigmentosa.
.P
JOURNAL ARTICLE.
.W
Prurigo pigmentosa is a rare dermatosis which is most common in Japan. Although the histological features are non-specific, the clinical appearance is striking and is dominated by gross reticular pigmentation. A Chinese patient with prurigo pigmentosa is described.
.A
Cox NH.
.I 54741
.U
88000431
.S
Br J Dermatol 8801; 117(1):125-7
.M
Adult; Basement Membrane/IM; Case Report; Female; Goodpasture's Syndrome/*IM; Human; IgG/*IM; Skin/IM.
.T
Circulating anti-skin basement membrane zone antibodies in a patient with Goodpasture's syndrome.
.P
JOURNAL ARTICLE.
.W
We report the case of a patient with atypical bullous pemphigoid and haemoptysis in whom circulating IgG skin basement membrane zone antibodies were demonstrated. Six years later she developed acute renal failure due to Goodpasture's syndrome. This is the first case to raise the possibility of a link between epidermal and glomerular basement membrane antibodies.
.A
Davenport A; Verbov JL; Goldsmith HJ.
.I 54742
.U
88000432
.S
Br J Dermatol 8801; 117(1):131-2
.M
Acne/*ME; Human; Superoxide/*ME; Tetracyclines/*ME.
.T
Tetracyclines are potent scavengers of the superoxide radical [letter]
.P
LETTER.
.A
van Barr HM; van de Kerkhof PC; Mier PD; Happle R.
.I 54743
.U
88000433
.S
Br J Dermatol 8801; 117(1):132
.M
Aged; Comparative Study; Etretinate/*TU; Human; Keratosis Palmaris et Plantaris/*DT; Male; Paraneoplastic Syndromes/*DT.
.T
Usefulness of etretinate treatment in paraneoplastic plamoplantar hyperkeratosis [letter]
.P
LETTER.
.A
Berardesca E; Del Forno C; Vignini M.
.I 54744
.U
88000434
.S
Br J Dermatol 8801; 117(1):21-7
.M
Amyloid P Component/AN; Elastic Tissue/AN/*PA; Elastin/AN; Human; Muramidase/AN; Protease Inhibitors/AN; Skin/AN/*PA; Skin Diseases/*IM/PA; Sunlight/*AE; Support, Non-U.S. Gov't.
.T
Elastic fibres in normal and sun-damaged skin: an immunohistochemical study.
.P
JOURNAL ARTICLE.
.W
Sun-exposed and sun-protected skin obtained at post mortem from the nape of the neck in 14 subjects was immunostained using antisera to elastin, lysozyme, amyloid P component, and the plasma protease inhibitors alpha-I antitrypsin, alpha-I antichymotrypsin and alpha-2 macroglobulin. Both the normal elastic fibres in sun-protected skin, and elastosis in sun-exposed skin were positively immunostained for elastin, lysozyme and amyloid P component. Collagen fibres were unstained. No immunostaining of normal elastic fibres or elastosis in the skin was obtained with antisera to alpha-I antitrypsin, alpha-I antichymotrypsin or alpha-2 macroglobulin. It was concluded that the elastosis in sun-exposed skin does contain elastic fibres. The absence of immunostaining for plasma protease inhibitors probably indicates that the elastic material is mature, and not newly-formed.
.A
Mera SL; Lovell CR; Jones RR; Davies JD.
.I 54745
.U
88000435
.S
Br J Dermatol 8801; 117(1):29-36
.M
Adolescence; Adult; Aged; Female; Formaldehyde/DU; Human; Male; Mast Cells/*CL/PA; Middle Age; Skin/*CY/PA; Skin Diseases/PA; Stains and Staining; Support, Non-U.S. Gov't.
.T
Formalin sensitivity and differential staining of mast cells in human dermis.
.P
JOURNAL ARTICLE.
.W
The characteristics of the human dermal mast cell population with respect to formalin fixation sensitivity, toluidine blue staining and alcian blue/safranin staining were studied. Thirty-seven specimens of normal human skin were bisected. One half was fixed in 10% neutral buffered formalin and the other in Carnoy's fixative. Sections were cut and stained with either toluidine blue or alcian blue/safranin. Significantly more mast cells were visualized with alcian blue/safranin than with toluidine blue. With both stains, only approximately 50% of the mast cells observed in the Carnoy's fixed tissue could be visualized in the formalin-fixed tissue. Alcian blue/safranin staining revealed three patterns of mast cell granule staining: mast cells containing only alcian blue-positive granules, mast cells containing only safranin-positive granules, and mast cells containing a mixture of alcian blue-positive granules and safranin-positive granules. Mast cells containing only alcian blue-positive granules constituted the majority of the dermal mast cell population and 73% of these mast cells were formalin-sensitive. Mast cells containing only safranin-positive granules and those containing a mixture of alcian blue-positive granules and safranin-positive granules showed no evidence of formalin sensitivity. The human dermal mast cell population, therefore, displays heterogeneity with respect to formalin fixation sensitivity and alcian blue/safranin staining. Dermal mast cells were visualized in significantly greater numbers in skin from the head compared with that from the body or limbs.
.A
Marshall JS; Ford GP; Bell EB.
.I 54746
.U
88000436
.S
Br J Dermatol 8801; 117(1):37-41
.M
Adolescence; Adult; Cataract/*ET/ME; Child; Eczema/CO; Galactose/ME; Galactosemia/*CO/ME; Human; Lens, Crystalline/ME.
.T
Galactose tolerance in patients with atopic cataracts.
.P
JOURNAL ARTICLE.
.W
Galactosaemia has been suggested as a contributory factor in the pathogenesis of some presenile and senile cataracts. To assess whether galactosaemia plays any part in the development of atopic cataracts a galactose tolerance test was carried out in eight atopic dermatitis patients whose cataracts had appeared between the ages of 12 and 39 years. In seven patients a normal result was obtained and in one the result was just above normal. Impaired galactose tolerance appears to have no role in the pathogenesis of atopic cataract.
.A
Muhlemann MF; Mount JN; Cream JJ.
.I 54747
.U
88000437
.S
Br J Dermatol 8801; 117(1):43-7
.M
Acne/ME/*PP; Female; Human; Male; Sebaceous Glands/ME/*PP; Sebum/ME/*PH; Skin Appendage Diseases/PP; Support, Non-U.S. Gov't.
.T
Functional blockage of open comedones.
.P
JOURNAL ARTICLE.
.W
Sebum excretion rate was measured by a photometric technique. We demonstrated a high correlation between sebum excretion rates on the left and right sides of the upper back and between back and forehead skin. Sebum excretion rate measurements overlying an open comedone (blackhead) were significantly lower than those obtained from normal skin. This observation demonstrates a functional obstruction to the outflow of sebum and would suggest that the lack of involvement of open comedones in inflammatory acne is not because of the maintenance of a free flow of sebum.
.A
Simpson NB.
.I 54748
.U
88000439
.S
Br J Dermatol 8801; 117(1):57-66
.M
Adult; Blood Flow Velocity/RE; Dose-Response Relationship, Radiation; Erythema/*ET/PP; Female; Human; Male; Skin/BS/*RE; Time Factors; Ultraviolet Rays/*AE.
.T
Quantitative studies on UVA-induced erythema in human skin.
.P
JOURNAL ARTICLE.
.W
The erythemal response of normal human skin to UVA and UVB radiation was measured objectively using a reflectance instrument in seven subjects, and a laser Doppler velocimeter in two subjects. UVA radiation was produced using a newly-developed high-intensity UVA lamp. The slope of the log dose-erythemal response curve for UVA at 24 h after irradiation was found not to differ significantly from that for UVB. The time course of UVA erythema was biphasic; erythema was present immediately after irradiation, fell to a minimum at about 4 h and then rose to a broad plateau between 6 and 24 h. The intensity of the early phase was dose-rate dependent, whereas that in the later phase depended on dose only.
.A
Diffey BL; Farr PM; Oakley AM.
.I 54749
.U
88000440
.S
Br J Dermatol 8801; 117(1):67-72
.M
Anthraquinones/*TO; Cell Division/DE; Cell Line; Collagen/BI; Dose-Response Relationship, Drug; Fibroblasts/DE; Human; Proline Hydroxylase/*AI; Skin/CY/*DE/ME; Support, Non-U.S. Gov't.
.T
Toxicity of the anthraquinone glycoside P-1894B for human skin fibroblasts.
.P
JOURNAL ARTICLE.
.W
P-1894B inhibits prolyl hydroxylase in vitro and has been proposed as a topical treatment for dermal fibrosis. The drug had similar effects on two fibroblast lines from normal human skin and one line from a patient with lichen sclerosus et atrophicus. Exposure of logarithmically-growing cell monolayers for 72 h caused dose-dependent inhibition of proliferation at 0.05-0.5 microgram/ml but time-dependent cell death at 1-50 micrograms/ml. The epithelial cell line NCTC 2544 gave a similar result. Collagen lattices containing normal fibroblasts contracted more slowly in the presence of the drug at 0.1-0.5 microgram/ml, but this was clearly related to loss of viability. Collagen synthesis by monolayer cultures was unaffected at 0.05 and 0.1 microgram/ml P-1894B in one line of normal fibroblasts, but was reduced by 40% and 15%, respectively, in the other. The concentrations of P-1894B reported to be active against prolyl hydroxylase are therefore lethal to cultured skin cells. Although the effective use of dithranol as a topical anti-psoriatic agent, despite its cytotoxicity in vitro, is encouraging for P-1894B, further toxicological studies are imperative.
.A
Priestley GC.
.I 54750
.U
88000444
.S
Br J Dermatol 8801; 117(1):89-97
.M
Case Report; Chromatography, Thin Layer; Collagen/*DF; Ehlers-Danlos Syndrome/*GE/PA; Endoplasmic Reticulum/UL; Female; Fibroblasts/UL; Human; Male; Microscopy, Electron; Pedigree; Skin/PA/*UL.
.T
Ehlers-Danlos syndrome type I: a clinical and ultrastructural study of a family with reduced amounts of collagen type III.
.P
JOURNAL ARTICLE.
.W
Ehlers-Danlos syndrome (EDS) type I was diagnosed in an 18-year-old girl on the basis of marked skin hyperextensibility with generalized loose-jointedness, pigmented paper-tissue scars, and a pronounced tendency to bruising. Her father and one of her sisters showed a similar phenotype. Her mother was normal. Light microscopy of skin biopsies showed large, irregular collagen fibres in the father and daughter, with normal findings in the mother. Electron microscopy of the skin sections revealed a variation in diameter and shape of the collagen fibrils as well as slight dilatation of the rough endoplasmic reticulum of fibroblasts in father and daughter, but normal findings in the mother. Cultured fibroblasts did not show these changes. Measurements of collagen synthesis by fibroblast cultures showed that type III collagen levels were reduced to 50% of normal in the father and daughter, and were normal in the mother. The alpha I (III) proteins had a normal molecular weight, determined by SDS-PAGE electrophoresis. The phenotypes and biochemical results in the family members tested were compatible with autosomal dominant transmission. To our knowledge, this is the first report of a type III collagen deficiency in Ehlers-Danlos syndrome type I. The findings in this family, especially the pronounced bruising tendency, illustrate the heterogeneity within type I EDS.
.A
De Paepe A; Nicholls A; Narcisi P; De Keyser F; Quatacker J; Van Staey M; Matton M; Pope FM.
.I 54751
.U
88000445
.S
Br J Dermatol 8801; 117(1):99-105
.M
Dose-Response Relationship, Radiation; Human; Infrared Rays/*TU; Light Coagulation/*; Skin/PA/*SU; Tattooing/*.
.T
Tattoo removal using infra-red coagulation: a dose comparison.
.P
JOURNAL ARTICLE.
.W
Using an infra-red coagulator, 42 tattoos were treated using pulses of 1.125 s (27 tattoos) or 1.25 s (15 tattoos). Treatment failures occurred only in three professional tattoos. Amateur tattoos were satisfactorily treated in over 80% of cases regardless of dose. Deeper collagen necrosis occurred with 1.25 s, but scarring was clinically similar. Pre-treatment biopsy to assess pigment depth was of no value in selection of the optimum pulse duration and increased the complication rate. The possible mechanism of pigment removal is discussed.
.A
Venning VA; Colver GB; Millard PR; Ryan TJ.
.I 54752
.U
88000449
.S
Br J Dermatol 8801; 117(2):161-7
.M
Arthritis/BL; Cell Movement; Chemotaxis, Leukocyte; Female; Human; In Vitro; Male; Neutrophils/*PH; Psoriasis/*BL.
.T
Polymorphonuclear leukocyte function in psoriasis vulgaris.
.P
JOURNAL ARTICLE.
.W
Polymorphonuclear leukocyte (PMN) migration was assessed in vitro using the agarose plate method in patients with psoriasis vulgaris, and compared with an age- and sex-matched control group. No significant difference was found between the two groups in the PMN response to the chemotactic substances F-Met-Leu-Phe (FMLP) or zymosan activated serum (ZAS). Equally, the chemokinetic or chemotactic potential of psoriatic serum did not differ from control serum. Our results do not support a primary abnormality of PMN function in psoriasis.
.A
Pease CT; Fennell M; Staughton RC; Brewerton DA.
.I 54753
.U
88000450
.S
Br J Dermatol 8801; 117(2):169-74
.M
Aneuploidy/*; DNA/*AN; Flow Cytometry/*MT; Human; Skin Diseases/*GE/PA; Skin Neoplasms/AN/PA.
.T
A flow cytometric study of the significance of DNA aneuploidy in cutaneous lesions.
.P
JOURNAL ARTICLE.
.W
Aneuploidy has not to date been demonstrated in any entirely benign condition and thus is held to be implicit of neoplasia. DNA flow cytometry can be used to detect DNA aneuploidy rapidly. A technique has been developed to make possible flow cytometric analysis of formalin-fixed skin. The technique was validated by study of benign and pre-malignant dermatoses. Further studies were performed on skin conditions of questionable malignant potential. DNA aneuploidy was demonstrated in lichen sclerosus et atrophicus. Flow cytometry was unable to distinguish keratoacanthomas from squamous cell carcinomas.
.A
Newton JA; Camplejohn RS; McGibbon DH.
.I 54754
.U
88000451
.S
Br J Dermatol 8801; 117(2):175-83
.M
Acne/MI; Biological Assay; Chromatography, Thin Layer; Fatty Acids/ME/PD; Histamine/ME/PD; Human; Inflammation/*ME; Muscle, Smooth/DE; Propionibacterium acnes/*ME; Prostaglandins/ME; Staphylococcus epidermidis/*ME; Tryptamines/ME/PD.
.T
The production of inflammatory compounds by Propionibacterium acnes and other skin organisms.
.P
JOURNAL ARTICLE.
.W
Culture supernatants from four species of skin microorganisms (P. acnes, P. avidum, P. granulosum and S. epidermidis) were assayed for smooth muscle contracting substances which are indicative of inflammatory activity. At least three types of smooth muscle contracting substances were detected. These were: first, a substance active on a rat fundic strip preparation and antagonized by N,N-DMT. Activity was enhanced when cultures were grown in the presence of tryptophan. This substance was probably tryptamine. Second, a substance active on a guinea-pig ileum preparation and antagonized by mepyramine. Activity was enhanced when cultures were grown in the presence of histidine. This substance was probably histamine. Third, a substance active on a rat fundic strip preparation but not antagonized by N,N-DMT, mepyramine, atropine or indomethacin. Activity was enhanced when cultures were grown in the presence of glucose. This activity was probably due to acetate, propionate or other short-chain fatty-acid salts. Chromatographic analysis confirmed the presence of histamine, tryptamine and short-chain fatty acids in the culture supernatants. These substances if produced in vivo may cause or contribute to inflammation and pain directly without the prior mediation of the immune system. Cell extracts of Propionibacterium species were analysed by bioassay for the presence of prostaglandin-like compounds. These could not be detected in any of the eight strains of organisms tested.
.A
Allaker RP; Greenman J; Osborne RH.
.I 54755
.U
88000452
.S
Br J Dermatol 8801; 117(2):185-91
.M
Adolescence; Adult; Antibodies/*AN; Dermatitis Herpetiformis/DH/*IM/PA; Dietary Proteins/AD; Gliadin/IM; Gluten/AD; Human; IgA/*; Jejunum/PA; Middle Age.
.T
IgA anti-endomysial antibodies in dermatitis herpetiformis: correlation with jejunal morphology, gluten-free diet and anti-gliadin antibodies.
.P
JOURNAL ARTICLE.
.W
Circulating IgA-class anti-endomysium antibodies (EmA) can be detected by indirect immunofluorescence on monkey oesophagus sections. We found EmA in 22 (76%) of 29 patients with dermatitis herpetiformis (DH) on a normal, gluten-containing diet. The highest frequency (100%) of EmA was observed in patients with sub-total villous atrophy. IgA-class antigliadin antibodies (AGA) were found using an ELISA method in 59% of 29 DH patients and in 86% of those with sub-total villous atrophy. There was a significant correlation between EmA titres and AGA levels in individual patients. Gluten-free diet (GFD) treatment caused a rapid decrease in EmA titres; only three of the 12 patients still showed raised EmA after 6-12 months on a GFD and two of these three had failed to adhere to a strict diet. In contrast, no decrease in EmA titres occurred in four patients maintained on a normal diet, and two of the three patients with initially negative EmA developed positive titres when continuing on a normal diet. These results show that both IgA-class EmA and AGA are good indicators of jejunal damage in DH. The rapid fall of EmA titres after gluten withdrawal indicates that this test is also useful for monitoring a patient's adherence to a GFD.
.A
Reunala T; Chorzelski TP; Viander M; Sulej J; Vainio E; Kumar V; Beutner EH.
.I 54756
.U
88000453
.S
Br J Dermatol 8801; 117(2):193-201
.M
Adult; Aged; Female; Flowmeters; Human; Male; Middle Age; Psoriasis/PA/*PP/TH; Regional Blood Flow; Skin/*BS/PA; Support, Non-U.S. Gov't.
.T
Blood flow in psoriatic skin lesions: the effect of treatment.
.P
JOURNAL ARTICLE.
.W
Laser Doppler velocimetry (LDV) was used to assess the effect of treatment upon cutaneous blood flow in psoriatic skin lesions. The resolution of two separate plaques in each of seven subjects was followed. Six of the subjects received the Goeckerman regimen, the seventh was treated with psoralen-ultraviolet A (PUVA) therapy. Control LDV readings were taken from uninvolved skin sites during the treatment period. Cutaneous blood flow in the psoriatic lesions of the Goeckerman-treated patients decreased to levels comparable to those in uninvolved skin early in the course of treatment and significantly preceeded the observed clinical resolution from 4 to 8 days after initiation of therapy (P less than 0.05). Visible flare-ups sometimes appeared when patients were untreated (over a weekend, for example) and these eruptions were accompanied by a transient elevation of LDV readings. Perfusion of the lesions of the PUVA-treated patient remained consistently higher than perfusion of uninvolved skin despite clinical healing. In a separate series of experiments, blood flow at the extensor surface of the forearm was measured in the skin of normal subjects, the uninvolved skin of psoriatic patients and the untreated lesional skin of psoriatic patients. While the lesional skin had significantly higher perfusion levels than uninvolved psoriatic or normal control skin (P less than 0.01), there was no significant difference between blood flow to the uninvolved psoriatic skin of psoriatics and that to the skin of healthy controls.
.A
Khan A; Schall LM; Tur E; Maibach HI; Guy RH.
.I 54757
.U
88000455
.S
Br J Dermatol 8801; 117(2):207-15
.M
Binding Sites; Blister/ME; Blood Proteins/*ME; Diazepam/PD; Erythrocytes/*ME; Erythromycin/PD; Human; Indomethacin/PD; Methoxsalen/*ME; Protein Binding/DE; Salicylic Acids/PD; Support, Non-U.S. Gov't; Warfarin/PD.
.T
Binding of 8-methoxypsoralen to human serum proteins and red blood cells.
.P
JOURNAL ARTICLE.
.W
Serum binding of 8-methoxypsoralen (8-MOP) was studied by equilibrium dialysis. In therapeutic concentrations, 8-MOP binding in serum was high, 91.4%, and constant, indicating concentration-independent kinetics. This binding involved the two main proteins, human serum albumin and alpha 1-acid glycoprotein, in a saturable process with one class of binding sites (n) and affinity constants (Ka) of 1.295 X 10(4) mol/l and 2.115 X 10(4) mol/l, respectively. Binding to lipoproteins and gamma globulins was negligible and non-saturable in therapeutic concentrations, with nKa values of 0.35, 0.024, 0.013 and 0.0004 mumol/l for VLDL, LDL, HDL and gamma globulins, respectively. Inhibition of 8-MOP serum binding was observed with salicylic acid and indomethacin, but not with diazepam, warfarin or erythromycin. Over a range of therapeutic concentrations, the ration of 8-MOP concentration in red blood cells (RBCs) and in serum was constant at 20.3% and three times higher than would be expected if a simple diffusion of the 8-MOP plasma free fraction (fu) occurred. According to the measured and calculated parameters, simulations of 8-MOP blood binding in pathological states (hypoalbuminaemia with or without inflammation) showed variations of fu which were partially 'buffered' by RBCs. Simulation of 8-MOP protein binding at cutaneous interstitial fluid level showed that fu is approximately 30% and permitted prediction of a decrease of fu available to the epidermis in case of local or systemic inflammation. This may imply an increase in the minimum phototoxic dose relevant for PUVA and explain some cases of 'poor' responsiveness of psoriatic patients to PUVA therapy.
.A
Pibouin M; Zini R; Nguyen P; Renouard A; Tillement JP.
.I 54758
.U
88000457
.S
Br J Dermatol 8801; 117(2):225-30
.M
Adolescence; Adult; Dermatitis, Atopic/*PA; Dermatoglyphics; Female; Fingers/*PA; Human; Male; Middle Age; Sweat Glands/*PA.
.T
Sweat pore density on the fingertips of atopic patients.
.P
JOURNAL ARTICLE.
.W
Investigation of 18 patients with atopic eczema and 22 normal controls showed that women in both groups had significantly more sweat pore openings on their fingertips than men and that there were more glands per unit area on fingers 3 and 4 compared with the thumb and the first and second fingers. There was no significant difference in the number of sweat pores between normal and atopic individuals, although fingertip topography in the latter was disturbed.
.A
Andersen LB; Thestrup-Pedersen K.
.I 54759
.U
88000458
.S
Br J Dermatol 8801; 117(2):231-6
.M
Acne/*EP/ET/PA; Age Factors; Aged; Aged, 80 and over; Female; Great Britain; Human; Hyperplasia; Male; Sebaceous Glands/*PA; Sunburn/CO.
.T
Sebaceous gland hyperplasia and senile comedones: a prevalence study in elderly hospitalized patients.
.P
JOURNAL ARTICLE.
.W
Two hundred and eighty-six patients over the age of 65 (age range 65-102, mean age 82 years), who were hospitalized in geriatric wards, were examined clinically for the presence of sebaceous gland hyperplasia and senile comedones. The degree of solar elastotic change present was scored on a visual analogue scale. The prevalence rate of sebaceous gland hyperplasia and of senile comedones was found to be 26% in each case. Approximately one third of patients had both lesions. Neither of these lesions was related to either the degree of solar elastotic change or the skin type with regard to tanning ability. It was concluded that chronic solar exposure was not a likely cause of these common conditions.
.A
Kumar P; Marks R.
.I 54760
.U
88000460
.S
Br J Dermatol 8801; 117(2):243-5
.M
Biological Availability; Comparative Study; Human; Male; Ointments; Petrolatum; Salicylic Acids/ME/*PD; Skin/*DE; Urea.
.T
In vivo measurement of the keratolytic effect of salicylic acid in three ointment formulations.
.P
JOURNAL ARTICLE.
.W
The release and activity of salicylic acid from different ointment formulations was studied in vivo by staining the horny layer with silver nitrate and measuring the light reflectance profile over 56 h, after application of the ointment for 4 h. The peeling effect of an ointment containing 5% salicylic acid and 10% urea was tested and compared with 5% and 10% salicylic acid in petrolatum. It was shown that shedding from the stained sites was faster with the urea-containing preparation than with the classic petrolatum ointments. The method described can be used to assess the bioavailability of keratolytic agents incorporated in topical formulations.
.A
Nook TH.
.I 54761
.U
88000462
.S
Br J Dermatol 8801; 117(2):255-9
.M
Bone Neoplasms/CN/*GE; Case Report; Fibroma/CN/*GE; Human; Infant; Infant, Newborn; Leiomyoma/CN/*GE; Male; Prognosis; Skin Neoplasms/CN/*GE.
.T
Infantile myofibromatosis. Report of two cases in one family.
.P
JOURNAL ARTICLE.
.W
Two brothers with infantile myofibromatosis are reported. Both had cutaneous and skeletal myofibromas with spontaneous and complete healing of their cutaneous lesions. These cases suggest autosomal recessive inheritance of this rare disorder.
.A
Venencie PY; Bigel P; Desgruelles C; Lortat-Jacob S; Dufier JL; Saurat JH.
.I 54762
.U
88000463
.S
Br J Dermatol 8801; 117(2):261-2
.M
Carcinoma, Squamous Cell/*ET; Human; Keratosis/*CO; Remission, Spontaneous; Skin Neoplasms/*ET; Sunlight/*AE.
.T
Solar keratosis: fallacies in measuring remission rate and conversion rate to squamous cell carcinoma [letter]
.P
LETTER.
.A
Commens C.
.I 54763
.U
88000464
.S
Br J Dermatol 8801; 117(2):262-3
.M
Human; Mycosis Fungoides/GE/*IM; Phenotype; Skin Neoplasms/GE/*IM.
.T
Immunophenotypic analysis of early mycotic lesions [letter]
.P
LETTER.
.A
Slater DN.
.I 54764
.U
88000465
.S
Br J Dermatol 8801; 117(2):264
.M
Case Report; Child; Etretinate/*AE; Female; Human; Keratosis Palmaris et Plantaris/*DT; Nails, Malformed/CO; Syndrome.
.T
Failure of etretinate therapy in pachyonychia congenita [letter]
.P
LETTER.
.A
Soyuer U; Candan MF.
.I 54765
.U
88000481
.S
Br J Ophthalmol 8801; 71(7):485
.M
Aged; Female; Glaucoma, Open-Angle/*PP; Human; Intraocular Pressure/*; Male; Middle Age; Visual Fields/*.
.T
An enigma variation [editorial]
.P
EDITORIAL.
.A
Smith RJ.
.I 54766
.U
88000482
.S
Br J Ophthalmol 8801; 71(7):486-8
.M
Aged; Chronic Disease; Female; Glaucoma, Open-Angle/CO/*PP; Human; Intraocular Pressure/*; Male; Middle Age; Perimetry; Retrospective Studies; Scotoma/ET/*PP; Support, Non-U.S. Gov't; Visual Fields/*.
.T
Some observations on the relation between intraocular pressure reduction and the progression of glaucomatous visual loss.
.P
JOURNAL ARTICLE.
.W
A quantitative measure of visual field loss associated with kinetic perimetry in chronic open-angle glaucoma (COAG) is discussed. With this new technique an analysis of covariance is applied to a retrospective study of 41 COAG patients. It suggests that reduction of intraocular pressure may not be uniformly effective in controlling the progression of the disease.
.A
Schulzer M; Mikelberg FS; Drance SM.
.I 54767
.U
88000484
.S
Br J Ophthalmol 8801; 71(7):494-6
.M
Aged; Aged, 80 and over; Chronic Disease; Female; Glaucoma, Open-Angle/PP/*SU; Human; Intraocular Pressure/*; Male; Methods; Middle Age; Postoperative Period; Posture/*; Trabecular Meshwork/*SU.
.T
Postural response of intraocular pressure in chronic open-angle glaucoma following trabeculectomy.
.P
JOURNAL ARTICLE.
.W
Forty-six eyes with chronic open-angle glaucoma (COAG) and 24 eyes which had previously undergone trabeculectomy for COAG were studied and the postural response of the intraocular pressure compared with that of 70 normal eyes. In all three groups the greatest rise in intraocular pressure (IOP) occurred when the subject changed from the sitting to the lying position. In the control group this was never more than 2 mmHg in any subject. The rise was greater than 2 mmHg in 93% of the patients suffering from COAG who were treated medically and in 100% of the eyes of those on which trabeculectomy had been performed. The well recognised abnormal postural response of intraocular pressure in COAG appears both to be retained and to be unaffected in those eyes which have undergone trabeculectomy.
.A
Parsley J; Powell RG; Keightley SJ; Elkington AR.
.I 54768
.U
88000487
.S
Br J Ophthalmol 8801; 71(7):504-9
.M
Adolescence; Adult; Child; Child, Preschool; Cleft Palate/GE; Connective Tissue Diseases/*GE; Eye Diseases/*GE; Female; Human; Joint Diseases/GE; Lens Diseases/GE; Male; Middle Age; Myopia/GE; Physiognomy; Retinal Diseases/GE; Syndrome; Vitreous Body.
.T
Stickler's syndrome: a study of 12 families.
.P
JOURNAL ARTICLE.
.W
Stickler's syndrome is a congenital disease of connective tissue with considerable ocular and non-ocular lesions. This study reports 12 pedigrees (10 families and two isolated cases) and evaluates some peculiar ocular aspects not previously reported in the syndrome.
.A
Spallone A.
.I 54769
.U
88000488
.S
Br J Ophthalmol 8801; 71(7):510-5
.M
Adult; Aged; Anterior Chamber/PA; Aqueous Humor/*PH; Cornea/PA; Female; Fluorometry; Human; Intraocular Pressure; Male; Middle Age; Postoperative Period; Retina/*SU; Retinal Detachment/*SU; Scleral Buckling.
.T
Effects of the encircling procedure on the aqueous flow rate in retinal detachment eyes: a fluorometric study.
.P
JOURNAL ARTICLE.
.W
Fluorophotometry was carried out in nine cases of unilateral non-traumatic rhegmatogenous retinal detachment successfully treated by a combination of local buckling and an encircling procedure with a silicone band. After topical instillation of fluorescein the change in its concentration in the anterior chamber was followed, from which the loss rate of the dye from the anterior chamber (k0) and the cornea-aqueous transfer coefficient (kc.ca) were estimated. The thickness of the cornea and the anterior chamber volume were also measured, and the aqueous flow rate and the corneal endothelial permeability were calculated in individual eyes. The examinations performed 4-18 months after operation showed that the aqueous flow rate in the operated eye fell to 85 (SD 12)% of that in the fellow control eye (p less than 0.005). In the operated eye the anterior chamber volume also fell significantly, and the corneal endothelial permeability may have decreased. Ocular hypotension after the detachment surgery with encirclement was attributable to a decrease in the aqueous flow rate.
.A
Araie M; Sugiura Y; Minota K; Akazawa K.
.I 54770
.U
88000489
.S
Br J Ophthalmol 8801; 71(7):516-20
.M
Adenocarcinoma/*DI/PA; Adult; Case Report; Choroid Neoplasms/DI; Diagnosis, Differential; Eye Neoplasms/*DI/PA; Fluorescein Angiography; Fundus Oculi; Human; Male; Melanoma/DI; Pigment Epithelium of Eye/*/PA.
.T
Adenocarcinoma of retinal pigment epithelium [published erratum appears in Br J Ophthalmol 1988 Jan;72(1):80]
.P
JOURNAL ARTICLE.
.W
This report describes a 41-year-old man with an intraocular tumour misinterpreted clinically as choroidal melanoma. The fluorescein angiographic features were not fully characteristic of uveal malignancy, and indeed histopathology revealed the diagnosis of adenocarcinoma of the retinal pigment epithelium. It is suggested that, in cases with the fundus and angiographic findings described here, the rare possibility of adenocarcinoma of retinal pigment epithelium should be kept in mind. Of particular interest were the changing pathological findings in the various parts of the tumour, which paralleled the fluorescein angiographic pattern.
.A
Ramahefasolo S; Soubrane G; Dhermy P; Godel V; Regenbogen L; Coscas G.
.I 54771
.U
88000490
.S
Br J Ophthalmol 8801; 71(7):521-5
.M
Adult; Aged; Diplopia/*ET/SU; Eyeglasses; Human; Middle Age; Postoperative Complications/*; Retina/*SU; Retinal Detachment/*SU; Scleral Buckling/AE/MT.
.T
Diplopia after retinal detachment surgery.
.P
JOURNAL ARTICLE.
.W
Diplopia following retinal detachment usually responds to simple measures. Fifteen out of 311 cases developed diplopia lasting more than three months after conventional retinal detachment surgery. Binocular single vision was restored in 12 of the 15 cases (80%). The mean follow-up was four years. Diplopia was eliminated stepwise. If prisms were ineffective, our first surgical procedure was removal of the scleral buckle. If the retina was flat, we were prepared to remove the buckle early. When diplopia persisted after buckle removal, we proceeded to strabismus surgery. Our most consistent results followed strabismus surgery on the untreated eye. Prisms alone restored binocular single vision in six patients (40%), one of whom preferred to adopt a compensatory head posture. Removal of the scleral buckle restored binocular single vision in three patients (20%), with the help of a prism in one case and a compensatory head posture in another. Binocular single vision was restored after buckle removal and strabismus surgery in three further patients (20%), one requiring a prism in addition. Binocular single vision was not restored in three patients (20%).
.A
Fison PN; Chignell AH.
.I 54772
.U
88000492
.S
Br J Ophthalmol 8801; 71(7):531-6
.M
Adolescence; Adult; Biopsy; Case Report; Human; Male; Microscopy, Electron; Mitochondria, Muscle/EN/*UL; Muscles/ME/*UL; Optic Nerve Diseases/*GE/ME/PA.
.T
Leber's hereditary optic neuropathy: mitochondrial and biochemical studies on muscle biopsies.
.P
JOURNAL ARTICLE.
.W
Two patients with Leber's hereditary optic neuropathy underwent morphological and biochemical investigations of muscle biopsy samples from the biceps brachii. Although clinically there was no muscle weakness or atrophy, specific histochemical and electron microscopic examinations showed mild but distinct myopathic changes, including abnormal oxidative enzyme activities, aggregates of enlarged mitochondria in the subsarcolemmal regions, and disruptions of myofilaments. Biochemical analyses of mitochondria isolated from muscle samples did not show and deficiency in respiratory-chain enzyme complexes or defect in content of cytochromes. Leber's hereditary optic neuropathy is assumed to be a multisystem disorder involving skeletal muscle also.
.A
Uemura A; Osame M; Nakagawa M; Nakahara K; Sameshima M; Ohba N.
.I 54773
.U
88000493
.S
Br J Ophthalmol 8801; 71(7):537-9
.M
Case Report; Female; Human; Middle Age; Optic Disk/*; Optic Nerve Diseases/ET; Retinal Diseases/CO; Vision Disorders/*ET; Visual Fields.
.T
Optic disc drusen and episodic visual loss.
.P
JOURNAL ARTICLE.
.W
A case is reported in which recurrent episodes of visual loss occurred over a period of 26 years in a patient with bilateral optic disc drusen. Visual field loss was associated with episodes of ischaemic optic neuropathy. The possible mechanism is discussed.
.A
Sarkies NJ; Sanders MD.
.I 54774
.U
88000494
.S
Br J Ophthalmol 8801; 71(7):540-5
.M
Adolescence; Adult; Anemia, Sickle Cell/*CO; Female; Fluorescein Angiography; Fovea Centralis/PA; Human; Ischemia/*DI/ET; Macula Lutea/*BS; Male; Middle Age; Perimetry; Retinal Diseases/*CO; Sickle Cell Trait/*CO; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Visual Fields.
.T
Quantification of macular ischaemia in sickle cell retinopathy.
.P
JOURNAL ARTICLE.
.W
Macular ischaemia has a central role in the pathophysiology and prognosis of retinal macular disease. We attempted to quantitate two of its major components as follows: vascular nonperfusion, by measuring the foveal avascular zone (FAZ), using fluorescein angiography; and functional damage, using automated perimetry of the central 30 degrees. Sickle cell disease was chosen for study because it was considered a prototype for a purely ischaemic retinopathy without an exudative component. We found that the FAZ measurement was reproducible and that the patients with maculopathy had statistically larger FAZs than the normal controls (p = 0.016, Wilcoxon rank sum test). In addition, scotomas measured by visual field perimetry were significantly larger in the sickle cell patients with maculopathy than in those without maculopathy. Our results showed that angiography and perimetry of the central 30 degrees were more sensitive tests for the detection of ischaemic macular disease than visual acuity and that macular ischaemia could be quantified by their use.
.A
Lee CM; Charles HC; Smith RT; Peachey NS; Cunha-Vaz JG; Goldberg MF.
.I 54775
.U
88000496
.S
Br J Ophthalmol 8801; 71(7):549-52
.M
Aged; Animal; Carcinoma, Ehrlich Tumor; Cell Survival/DE/RE; Electron Spin Resonance; Eye/*AN; Eye Color/*; Female; Human; Hydrogen Peroxide; Male; Melanins/*AN/PD/RE; Middle Age; Superoxide; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Is there any difference in the photobiological properties of melanins isolated from human blue and brown eyes?
.P
JOURNAL ARTICLE.
.W
Investigations were carried out to determine whether the melanin present in the blue and brown eyes were eumelanin, the melanin present in black hair and dark skin, or pheomelanin, the melanin present in red hair and the skin of people with red hair. Our results showed that UV-visible irradiation of blue or brown eye melanin did not produce any superoxide. Irradiation of 51Cr-labelled Ehrlich ascites carcinoma cells in the presence of blue or brown eye melanin did not produce significant cell lysis. The electron spin resonance (ESR) signals of blue and brown eye melanins were very similar to those of eumelanin. Comparison of these findings with our previous results indicated that the blue and brown eye melanins are essentially eumelanin. The ESR signals further suggested that in the case of both blue and brown eye melanins the iris, ciliary body, choroid, and retinal pigment epithelium did not differ.
.A
Menon IA; Basu PK; Persad S; Avaria M; Felix CC; Kalyanaraman B.
.I 54776
.U
88000497
.S
Br J Ophthalmol 8801; 71(7):553-8
.M
Adolescence; Case Report; Dexamethasone/TU; Electroretinography; Female; Fluorescein Angiography; Human; Retinal Diseases/DI/DT; Retinal Vessels/*; Visual Fields.
.T
A case of frosted branch angiitis.
.P
JOURNAL ARTICLE.
.W
We report a case of frosted branch angiitis in a 16-year-old-girl. She noted a sudden and severe visual disturbance in both eyes, without other systemic symptoms. Diffuse retinal oedema and unusual sheathing of retinal veins were characteristic in both fundi. Fluorescein angiography showed no occlusion of the sheathed retinal veins, but some paravenous extravasation of dye was found in the late phase. With high doses of systemic corticosteroids her fundi and visual acuity improved greatly, though the vessels continued to show severe narrowing. At three months the pattern visually evoked cortical potentials were found to be normal, while flash electroretinograms were absent. No systemic abnormality has been found to explain the aetiology of this condition.
.A
Watanabe Y; Takeda N; Adachi-Usami E.
.I 54777
.U
88000498
.S
Br J Ophthalmol 8801; 71(7):559-62
.M
Age Factors; Case Report; Cryosurgery; Female; Fundus Oculi; Human; Infant, Newborn; Light Coagulation; Retina/SU; Retinopathy of Prematurity/*DI/SU.
.T
'Rush' type retinopathy of prematurity: report of three cases.
.P
JOURNAL ARTICLE.
.W
Three premature infants observed to develop severe stage III retinopathy of prematurity (ROP) at 3 to 5 weeks of age received immediate treatment by cryoablation and photocoagulation, with good results. The critical importance of the ophthalmic examination of premature babies from the age of 2 weeks, so as not to overlook such cases of 'rush' type ROP is stressed and the difficulty involved in treating such small neonates is discussed.
.A
Nissenkorn I; Kremer I; Gilad E; Cohen S; Ben-Sira I.
.I 54778
.U
88000499
.S
Br J Ophthalmol 8801; 71(7):563
.M
Caucasoid Race; Human; Macula Lutea/*; Retinitis/*ET; Sunlight/*AE.
.T
Foveomacular retinitis [letter]
.P
LETTER.
.A
Jacobs NA.
.I 54779
.U
88000500
.S
Br J Ophthalmol 8801; 71(8):565-9
.M
Acquired Immunodeficiency Syndrome/*CO; Adult; AIDS-Related Complex/CO; Cytomegalic Inclusion Disease/CO; Eye Diseases/*ET/PA; Fundus Oculi; Human; Male; Middle Age; Opportunistic Infections/CO; Prognosis; Prospective Studies; Retinal Diseases/ET/PA; Support, Non-U.S. Gov't.
.T
Ophthalmic findings in a group of ambulatory patients infected by human immunodeficiency virus (HIV): a prospective study.
.P
JOURNAL ARTICLE.
.W
Twenty-eight patients with either the acquired immune deficiency syndrome (AIDS) or persistent generalised lymphadenopathy (PGL) were studied prospectively as outpatients for up to one year. Six patients had fundal cotton wool spots at some stage of their follow-up and all six suffered opportunistic infections associated with AIDS. We suggest that ocular abnormalities may be prognostic for opportunistic infection in AIDS and discuss the wide range of ophthalmic complications consequent to HIV infection.
.A
Humphry RC; Weber JN; Marsh RJ.
.I 54780
.U
88000501
.S
Br J Ophthalmol 8801; 71(8):570-7
.M
Animal; Cornea/*AH/UL; Culture Media/*; Microscopy, Electron, Scanning; Organ Culture; Organ Preservation/*MT; Rabbits; Support, U.S. Gov't, P.H.S.; Time Factors.
.T
Histological study of corneas preserved in two new media.
.P
JOURNAL ARTICLE.
.W
A new corneal preserving medium (K-Sol), developed by Kaufman and others, contains purified chondroitin sulphate, TC 199, HEPES buffer, and gentamicin. Another new medium (JM) containing bicarbonate-free glucose-phosphate Ringer solution and dextran 70 has been developed in Japan. New Zealand white rabbit corneas with scleral rims were stored in each medium at 4 degrees C for one or two weeks. The condition of the endothelium was evaluated histologically. Corneas preserved in both media were in good condition at the end of one week. Corneas preserved in K-Sol for two weeks showed fewer endothelial changes than similar tissue stored in JM for two weeks. Corneal swelling was also less in corneas preserved in K-Sol, than in corneas preserved in JM.
.A
Tamaki K; Yamaguchi T; Varnell ED; Kaufman HE.
.I 54781
.U
88000502
.S
Br J Ophthalmol 8801; 71(8):575-84
.M
Adolescence; Birth Weight; Blindness/*ET/GE; Cataract/*CN; Child; Child, Preschool; Human; Infant, Newborn; Infant, Premature/*; Intelligence; Optic Atrophy/CO; Probability; Retinopathy of Prematurity/CO.
.T
Blindness in schoolchildren: importance of heredity, congenital cataract, and prematurity.
.P
JOURNAL ARTICLE.
.W
Of 99 children in the Royal Blind School, Edinburgh (which serves Scotland and part of N E England), 15 had optic atrophy (hydrocephalus 4, intracranial haemorrhage 2, prematurity 2, fetal distress 2, birth asphyxia 2, cerebral atrophy 1, cardiac arrest during hernia operation 1, and leukaemia 1). Fourteen had congenital cataract, 12 congenital retinal aplasia (Leber's congenital amaurosis) and 11 retinopathy of prematurity. There were small numbers in many other diagnostic categories, including three with non-accidental head injury. Mental retardation, spasticity, and nystagmus were frequent other correlates in all diagnostic categories. 'Very probably hereditary' was a conservative attribution in 36, while 'probable' seemed appropriate for 12-that is, almost 48% were hereditary. Only about 11 cases might have been prevented through genetic counselling, which testifies to the frequency of autosomal recessive hereditary disease, although no parents were consanguineous.
.A
Phillips CI; Levy AM; Newton M; Stokoe NL.
.I 54782
.U
88000503
.S
Br J Ophthalmol 8801; 71(8):585-92
.M
Animal; Antibodies/AN; Antigens; Disease Models, Animal; Eye Proteins; Fluorescein Angiography; Male; Rats; Support, Non-U.S. Gov't; Time Factors; Uveitis/IM/*PA.
.T
Experimental posterior uveitis. I: A clinical, angiographic, and pathological study.
.P
JOURNAL ARTICLE.
.W
The clinical, angiographic, and histopathological features of experimental posterior uveitis in the black hooded Lister rat are described. This mild form of experimental allergic uveoretinitis (EAU) is induced by sensitisation with retinal S antigen in Freund's complete adjuvant, and the inflammation produced is confined to the posterior segment of the eye. This allows for the first time precise photographic and angiographic documentation of the evolution of clinical signs, because there is minimal clouding of the vitreous by inflammatory cells. Clinically the disease is characterised by the appearance of disc oedema and periphlebitis, followed by focal infiltrates in the deep retinal layers, with eventual atrophy of the pigment epithelium. Histologically, retinal vasculitis is associated with focal mononuclear cell infiltration and necrosis of the photoreceptor layers. This model closely resembles the clinical features of idiopathic retinal vasculitis seen in man.
.A
Stanford MR; Brown EC; Kasp E; Graham EM; Sanders MD; Dumonde DC.
.I 54783
.U
88000505
.S
Br J Ophthalmol 8801; 71(8):598-601
.M
Absorption; Administration, Topical; Animal; Aqueous Humor/*ME; Cornea/*ME; Epithelium/ME; Fusidic Acid/AD/*PK; Injections; Male; Rabbits; Vitreous Body/*ME.
.T
Corneal and intraocular penetration of topical and subconjunctival fusidic acid.
.P
JOURNAL ARTICLE.
.W
Corneal tissue absorption and intraocular penetration of fusidic acid were assessed in the rabbit after topical or subconjunctival application. Corneal tissue levels of fusidic acid one hour after the last topical application of the drug were well above the minimum inhibitory concentrations (MICs) for most Gram-positive and many Gram-negative organisms. Adequate levels were achieved in the aqueous at one hour following the last topical application, but no significant levels were detected in the vitreous. The corneal tissue and aqueous levels declined at 12 and 24 hours following the last drug application, however, corneal tissue levels at 24 hours were considered to be above the MICs for most Gram-positive organisms. A single subconjunctival injection of 100 mg of fusidic acid produced levels above the MICs of most organisms in the cornea, aqueous, and vitreous which persisted over 24 hours, but subconjunctival injection of fusidic acid at this concentration resulted in conjunctival necrosis and corneal decompensation. Fusidic acid penetrates well into avascular tissue and fully penetrates corneas with both intact and debrided epithelium, as evidenced by the intracameral drug levels. Good corneal penetration and absence of known topical toxicity make fusidic acid suitable for the treatment of microbial keratitis caused by susceptible organisms.
.A
Taylor PB; Burd EM; Tabbara KF.
.I 54784
.U
88000506
.S
Br J Ophthalmol 8801; 71(8):602-8
.M
Adolescence; Adult; Color Perception; Evoked Potentials, Visual/*; Female; Human; Male; Middle Age; Optic Neuritis/*PP; Pattern Recognition, Visual; Space Perception; Vision/*PH; Visual Acuity; Visual Fields.
.T
Visual function and pattern visual evoked response in optic neuritis.
.P
JOURNAL ARTICLE.
.W
The disparity between clinical visual function and pattern visual evoked response (VER) was studied in 53 patients who had suffered an attack of optic neuritis (ON) more than six months before. The visual functions tested included Snellen visual acuity, colour vision, visual field, and contrast sensitivity. The effect of pattern presentation, check size, and luminance was tested by recording VERs with several stimulus configurations. VER amplitudes were found to be associated with the outcome of all four clinical tests, independently of check size, luminance, or the presentation method used. On the other hand VER latencies were hardly ever related to the results of any of the four clinical visual tests. These findings support the idea that VER amplitude provides information about visual spatial perception, while VER latency is more related to the extent of demyelination.
.A
Sanders EA; Volkers AC; van der Poel JC; van Lith GH.
.I 54785
.U
88000510
.S
Br J Ophthalmol 8801; 71(8):618-22
.M
Adult; Animal; Case Report; Female; Glaucoma/*ET/PA; Gnathostoma; Human; Middle Age; Nematode Infections/*/PA; Support, Non-U.S. Gov't; Uveitis, Anterior/*ET/PA.
.T
Intracameral gnathostomiasis: a cause of anterior uveitis and secondary glaucoma.
.P
JOURNAL ARTICLE.
.W
Recognition of parasitic diseases by Western physicians is becoming increasingly important because of increased international travel and the recent influx of refugees from South east Asia. We describe two patients who presented with acute anterior uveitis and secondary glaucoma caused by intracameral third stage larvae of Gnathostoma spinigerum. The parasites were successfully removed, with preservation of good visual acuity. The initial infection may occur through consumption of contaminated water and/or raw or undercooked foods, while the eyes may be involved even years later. Accurate diagnosis and surgical removal of the parasites may save life.
.A
Kittiponghansa S; Prabriputaloong A; Pariyanonda S; Ritch R.
.I 54786
.U
88000511
.S
Br J Ophthalmol 8801; 71(8):623-8
.M
Aged; Female; Human; Iris/PA/*SU/UL; Laser Surgery/*; Microscopy, Electron; Middle Age; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Histopathological characteristics of neodymium-YAG laser iridotomy in the human eye.
.P
JOURNAL ARTICLE.
.W
Light and electron microscopic studies of YAG laser iridotomies were performed in two human iridectomy specimens. Full-thickness defects were created and showed stromal and vascular necrosis. The light and electron microscopic configuration of the lesions was compatible with mechanical disruption from shockwaves. Thermal changes were absent in contrast to iridotomies created by argon laser photocoagulation.
.A
Goldberg MF; Tso MO; Mirolovich M.
.I 54787
.U
88000513
.S
Br J Ophthalmol 8801; 71(8):635-8
.M
Anophthalmos/*SU; Eye, Artificial; Female; Human; Male; Orbit/SU; Surgery, Plastic/*.
.T
Clinical anophthalmos.
.P
JOURNAL ARTICLE.
.W
We report on 15 patients (10 boys, 5 girls) with clinical anophthalmos. Two of them had bilateral anophthalmos, 10 had systemic anomalies, and six had abnormalities of their remaining eye. Only two appeared to have an associated underlying aetiology. Fourteen patients underwent orbital reconstruction or socket enlargement with varying degrees of success. Our own experience suggests that unnecessary lid procedures should be avoided, but we recommend early prosthetic fittings. We feel that a multidisciplinary approach is necessary to attain useful rehabilitation.
.A
O'Keefe M; Webb M; Pashby RC; Wagman RD.
.I 54788
.U
88000514
.S
Br J Ophthalmol 8801; 71(8):639-40
.M
Androgen Antagonists/*AE; Dark Adaptation/*DE; Human; Imidazoles/*AE; Male.
.T
Ocular toxicity of anandron [letter]
.P
LETTER.
.A
Brisset JM; Bertagna C; Proulx L.
.I 54789
.U
88000979
.S
Blood 8801; 70(4):1006-13
.M
Alleles; Antibodies, Monoclonal/DU; Christmas Disease/*GE; Factor IX/*GE; Female; Heterozygote Detection/*MT; Human; Male; Pedigree; Polymorphism (Genetics)/*; Radioimmunoassay; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Carrier testing in hemophilia B with an immunoassay that distinguishes a prevalent factor IX dimorphism.
.P
JOURNAL ARTICLE.
.W
Immunoassays with a monoclonal antibody (A-1) detect a prevalent dimorphism in plasma coagulation factor IX. The antibody was shown to react with a dimorphic segment of the normal factor IX sequence as follows. First, A-1 bound to isolated activation peptide (residues 146 through 180) prepared from activated factor IX from a normal plasma pool. Second, binding of recombinant factor IXs with A-1 or factor IX from normal individuals was strong only when they had Threonine (Thr) at position 148; factor IXs with the Alanine (Ala) allele at that position were far less reactive. Third, immunoblot reactivity of Escherichia coli fusion proteins containing known segments of the factor IX sequence restricted the epitope to residues 147 through 153. In 120 hemophilia B pedigrees, the Ala immunoassay allele frequency was 0.19 and did not differ from the Ala frequency in normal males. In 22 of 49 families, immunoassay testing was informative for classification of obligate or possible carriers. In one large family, 4 obligate carriers were heterozygous for the dimorphism and 3 of their 7 daughters were classified as carriers. In other families, when the affected member had less than 1 nmol/L factor IX antigen, heterozygosity for Thr/Ala alleles excluded the carrier state even when DNA studies were not informative. Strong linkage disequilibrium of Thr/Ala alleles with the common TaqI DNA polymorphism was found. Nineteen of 75 normal and hemophilic factor IX genes had the 1.3-kilobase (kb) fragment and coded for the Ala allele; the rest had the 1.8-kb fragment and coded for Thr. In selected families, the A-1 immunoassay is an inexpensive and rapid method to confirm and supplement restriction fragment length polymorphism analyses of DNA for carrier testing.
.A
Smith KJ; Thompson AR; McMullen BA; Frazier D; Lin SW; Stafford D; Kisiel W; Thibodeau SN; Chen SH; Smith LF.
.I 54790
.U
88000982
.S
Blood 8801; 70(4):1035-9
.M
Acid-Base Equilibrium; Adenosine Triphosphatase/ME/PH; Animal; Microscopy, Electron; Proteins/AN; Rabbits; Receptors, Transferrin/*ME; Reticulocytes/AN/EN/*ME/UL; Subcellular Fractions/AN/ME; Support, Non-U.S. Gov't; Support, U.S. Gov't, Non-P.H.S.; Support, U.S. Gov't, P.H.S.; Transferrin/*ME.
.T
Rabbit reticulocyte coated vesicles carrying the transferrin-transferrin receptor complex: I. Purification and partial characterization.
.P
JOURNAL ARTICLE.
.W
Coated vesicles bearing the transferrin-transferrin receptor complex were isolated from rabbit reticulocytes by freeze-thaw cell lysis, followed by differential centrifugation with pelleting of vesicles at 100,000 g. Electronmicroscopy demonstrated the vesicles to have the characteristic morphology of coated vesicles, including the appearance of triskelions. The protein composition of the vesicles as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis included transferrin, transferrin receptor, and proteins of apparent mol wt of approximately 180,000, 140,000, 100,000, and 47,000 daltons. The 180,000 and 100,000 mol wt proteins were identified as clathrin and coated vesicle assembly factor proteins, respectively, by Western blot analyses. The vesicles had a Mg2+-dependent ATPase with a specific activity of approximately 8.5 nmoles ATP converted/min/mg vesicle protein. The vesicles could acidify the intravesicular space, as evidenced by the stimulation of the Mg2+-ATPase by the protonophore FCCP. Reticulocytes appear to be an excellent source of coated vesicles and as such should provide a model for studying the endocytosis of transferrin and the steps of iron uptake that proceed in these vesicles.
.A
Choe HR; Moseley ST; Glass J; Nunez MT.
.I 54791
.U
88000983
.S
Blood 8801; 70(4):1040-5
.M
Autoantibodies/*AN; Blood Platelets/*IM; Chronic Disease; Glycoproteins/*IM; Human; Immunologic Diseases/BL/*IM; Plasma/*IM; Purpura, Thrombocytopenic/BL/*IM; Splenectomy; Support, U.S. Gov't, P.H.S.; Thrombocytopenia/IM.
.T
Platelet-associated and plasma anti-glycoprotein autoantibodies in chronic ITP.
.P
JOURNAL ARTICLE.
.W
Chronic immune thrombocytopenic purpura (ITP) is due to platelet destruction by circulating antiplatelet antibody. Although autoantibodies against the platelet glycoprotein IIb/IIIa (GPIIb/IIIa) complex and GPIb have been demonstrated using various methods, practical assays for detection of platelet-associated or plasma autoantibodies have not been available. We studied 59 patients with chronic immune thrombocytopenic purpura in whom platelet-associated and plasma autoantibodies against the GPIIb/IIIa complex and GPIb were measured using a newly developed immunobead assay and a previously reported microtiter-well assay. Platelet-associated autoantibody was detected using the immunobead assay in 21 of 28 patients (75.0%; 13 with anti-GPIIb/IIIa, 8 with anti-GPIb). Plasma autoantibodies were noted in 34 of 59 patients (57.6%; 21 with anti-GPIIb/IIIa, 11 with anti-GPIb, and 2 with both). Positive results were noted in 30 of 59 patients using the immunobead assay and in only 14 of 59 using the microtiter-well assay, suggesting that solubilization of the platelets prior to antibody addition, as in the microtiter-well assay, alters epitope stability. Of the 31 thrombocytopenic control patients studied, all gave negative results using both assays. We conclude that these clinically adaptable assays allow detection of autoantibodies in most patients with chronic ITP, confirming the presence of an autoimmune process.
.A
McMillan R; Tani P; Millard F; Berchtold P; Renshaw L; Woods VL Jr.
.I 54792
.U
88000984
.S
Blood 8801; 70(4):1046-52
.M
Adolescence; Adult; Anemia, Aplastic/*DT/MO/PP; Antilymphocyte Serum/*TU; Child; Child, Preschool; Female; Forecasting; Human; Male; Middle Age; Severity of Illness Index.
.T
Survival after antilymphocyte globulin therapy for aplastic anemia depends on disease severity.
.P
JOURNAL ARTICLE.
.W
Sixty-four patients with aplastic anemia were treated with antilymphocyte globulin (ALG Merieux) between 1980 and 1985. The actuarial survival for all patients was 53% at 6 years, with 79% survival for nonsevere aplastic anemia (NSAA) and 36% for severe aplastic anemia (SAA). The neutrophil and platelet counts before treatment with ALG were highly predictive of survival, whereas sex, age, and etiology were not. Duration of disease prior to ALG treatment was inversely related to survival, although this was not statistically significant. Survival was closely associated with response to ALG, especially for patients with SAA. The response to one course of ALG was 33%. Eighteen patients who did not respond to an initial course of ALG received a second course; of these, four (22%) responded. The overall response to one or two courses of ALG was 40%. The mean RBC volume (MCV) measured after ALG treatment was a useful early indicator of response. Both the minimum lymphocyte count during ALG therapy and the mean lymphocyte count after therapy, however, were not significantly different between responders and nonresponders. The disappointing survival of patients with SAA in this study may reflect the poor clinical condition of severely affected patients referred to us and/or the presence of longstanding aplasia. The importance of studying a large series of patients with long-term follow-up to assess ALG in the treatment of aplastic anemia is shown by this investigation.
.A
Marsh JC; Hows JM; Bryett KA; Al-Hashimi S; Fairhead SM; Gordon-Smith EC.
.I 54793
.U
88000994
.S
Blood 8801; 70(4):1111-8
.M
Anemia, Sickle Cell/*BL; Chemistry; Erythrocyte Deformability/DE; Erythrocytes/*DE/PA; Human; Osmosis; Phosphatidylcholines/*PD; Reference Values; Sickle Cell Trait/*BL/PA; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
The molecular species composition of phosphatidylcholine affects cellular properties in normal and sickle erythrocytes.
.P
JOURNAL ARTICLE.
.W
The phosphatidylcholine specific transfer protein (PCTP) from bovine liver was used to retailor the molecular species composition of phosphatidylcholine (PC) in the membrane of normal (AA) and sickleable (SS) human erythrocytes. Changes in molecular species composition of PC altered morphology as well as cellular deformability and stability as measured with ektacytometry. In normal cells, replacement of native PC with 1-palmitoyl,2-arachidonoyl PC (PAPC) resulted in a decrease in osmotic fragility with no change in hydration, whereas replacement with 1,2-dipalmitoyl PC (DPPC) led to an increased osmotic fragility and cellular hydration. Replacement of native PC by 1-palmitoyl,2-oleoyl PC (POPC) in normal cells had no apparent effect on these parameters. In contrast, replacement of native PC in sickle cells with either PAPC, DPPC or POPC led to cellular hydration. Facilitation of PC exchange between subpopulations of SS cells separated on buoyant density also led to cellular hydration. These observations suggest that the state of hydration of sickle cells can be modified by the fatty acyl composition of PC and illustrate a a role for the lipid core in the observed permeability changes in sickle erythrocytes. They also raise the interesting possibility that the state of cellular hydration of sickle cells may be modulated by altering the molecular species composition of the membrane phospholipids.
.A
Kuypers FA; Chiu D; Mohandas N; Roelofsen B; Op den Kamp JA; Lubin B.
.I 54794
.U
88000997
.S
Blood 8801; 70(4):1131-5
.M
Aging/ME/*PH; Animal; Calcium/ME; Cells, Cultured; Cytosol/ME; Hematopoietic Stem Cells/*PH; Mice; Mice, Inbred C57BL; N-Formylmethionine Leucyl-Phenylalanine/PD; Neutrophils/ME/*PH; Osmolar Concentration; Support, U.S. Gov't, Non-P.H.S.; Support, U.S. Gov't, P.H.S..
.T
Evidence that microenvironmental factors account for the age-related decline in neutrophil function.
.P
JOURNAL ARTICLE.
.W
We measured the function of neutrophils harvested from the supernatant of long-term marrow cultures in which stromal cell cultures derived from young mice were recharged with hematopoietic cells from old mice and vice versa. The functions measured were superoxide generation and enzyme secretion (lysozyme and glucuronidase), following cell activation by either phorbol myristate acetate (PMA) or Formyl-methionyl-leucyl-phenylalanine (FMLP). In addition we measured cytosolic calcium concentration and its increase following activation by FMLP. In all culture combinations recharge resulted in the recovery of greater than 2 X 10(6) cells/flask (95% neutrophils, 98% viable). Histologic studies of cytoplasmic markers indicated that recovered neutrophils were derived from the stem cell population employed for recharge. For each neutrophil parameter measured, function was markedly improved when old hematopoietic stem cells were recharged onto a young stroma and was significantly diminished when young stem cells were recharged onto an old stroma. This applied to superoxide generation, basal and stimulated enzyme levels, and to basal cytosolic calcium concentration and its increase following activation by FMLP. These results indicate that when old hematopoietic stem cells proliferate in a young microenvironment, neutrophil function returns virtually to normal. Conversely, function diminishes when young stem cells proliferate in an old stroma. These findings demonstrate, for the first time, that neutrophil function is modulated by microenvironmental factors, hormonal, cellular, or matrix, which are decreased in the elderly. That an age-related decline in function is extrinsic to the cell and is reversible has significance for the study of neutrophil function and of cellular aging and has potential therapeutic implications.
.A
Lipschitz DA; Udupa KB; Boxer LA.
.I 54795
.U
88001001
.S
Blood 8801; 70(4):1161-4
.M
Adenosine/*AA/PD; Cell Differentiation/*DE; Cell Division/DE; Cell Line; Cycloleucine/PD; Human; Hydrolases/AI; Nitrous Oxide/*PD; Osmolar Concentration; S-Adenosylhomocysteine/ME; S-Adenosylmethionine/ME; Support, Non-U.S. Gov't.
.T
Adenosine dialdehyde and nitrous oxide induce HL-60 differentiation.
.P
JOURNAL ARTICLE.
.W
Adenosine dialdehyde and nitrous oxide, specific S-adeno-sylhomocysteine hydrolase and methionine synthetase inhibitors, respectively, induced differentiation of the human promyelocytic cell line HL-60. Their effect did not appear to be mediated through changes in transmethylation or decreased S-adenosylmethionine synthesis because (1) there was little correlation between the concentrations of adenosine dialdehyde that induced differentiation and those that changed the ratio of the intracellular concentrations of S-adenosylmethionine to S-adenosylhomocysteine, and (2) inhibition of methionine adenosyltransferase by cycloleucine did not induce differentiation. The differentiation induced by adenosine dialdehyde was prevented by homocysteine and that by nitrous oxide was inversely related to the medium methionine concentration. This suggested that differentiation was secondary to decreased methionine synthesis.
.A
Pilz RB; Van den Berghe G; Boss GR.
.I 54796
.U
88001004
.S
Blood 8801; 70(4):1180-5
.M
Animal; Bacteria/*ME; Bone Marrow/*DE; Cell Division/DE; Cell Survival/DE; Chloramphenicol/AA/ME/*PO; Hematopoietic Stem Cells/CY/DE; Human; Mice; Mice, Inbred C57BL; Mitochondria/ME; Proteins/ME; Support, U.S. Gov't, P.H.S..
.T
Chloramphenicol-induced bone marrow injury: possible role of bacterial metabolites of chloramphenicol.
.P
JOURNAL ARTICLE.
.W
To explore the potential role of some bacterial metabolites of chloramphenicol (CAP) in CAP-induced hematotoxicity, we examined their cytotoxic effects on bone marrow cells in vitro using a number of cytotoxicity parameters. Among the metabolites tested, dehydro-CAP (DHCAP) and p-nitrophenyl-2-amino-3 hydroxypropanone-HCI (NPAP) were more toxic than CAP. DHCAP was at least as toxic as nitroso-CAP. At concentrations of less than or equal to 10(-4) mol/L, DHCAP caused total irreversible inhibition of myeloid colony (CFU-GM) growth and 80% inhibition of DNA synthesis in human bone marrow. Incubation of human bone marrow cells with 10(-4) mol/L nitroso-CAP or DHCAP for 24 hours resulted in 75% and 65% cell death respectively. Although DHCAP was 10- to 20-fold more cytotoxic than CAP, it was only one third as effective in inhibiting mitochondrial protein synthesis, indicating that DHCAP exerts its toxic effect by alternate mechanisms. The cytotoxicity of DHCAP and its relative stability, compared to the unstable nitroso CAP, suggest that this bacterial metabolite of CAP, and possibly others, may play a significant role in CAP-induced hematotoxicity.
.A
Jimenez JJ; Arimura GK; Abou-Khalil WH; Isildar M; Yunis AA.
.I 54797
.U
88001007
.S
Blood 8801; 70(4):1203-7
.M
Comparative Study; Electrophoresis; Histones/*BI; Human; Leukemia, Lymphocytic/*ME/PA; Reference Values; Support, Non-U.S. Gov't.
.T
Histone H1 degrees is synthesized by human lymphocytic leukemia cells but not by normal lymphocytes.
.P
JOURNAL ARTICLE.
.W
Using a two-dimensional gel electrophoresis system (sodium dodecyl sulphate/acetic acid-urea-hexadecyltrimethylammonium bromide) coupled with fluorography, we investigated the synthesis of H1 isoproteins in leukemic cells obtained from peripheral blood of eight children suffering from acute lymphoblastic leukemia (ALL) (four T-ALL, three common ALL, and one B-ALL) and in normal peripheral lymphocytes. H1 degrees was synthesized in leukemic cells but not in normal lymphocytes. Inhibition of DNA synthesis with hydroxyurea and 1-beta-D-arabinofuranosylcytosine induced an increase of relative synthesis of H1 degrees in leukemic cells but did not induce any detectable synthesis of H1 degrees in normal lymphocytes. H1 degrees synthesis was also undetectable in peripheral lymphocytes of leukemic children in complete remission after chemotherapy and in lymphocytes of a homozygotic twin of a leukemic patient. H1 degrees may be a marker of malignant transformation of lymphocytes and as such could be of use for early detection of relapse in patients with acute lymphocytic leukemia in apparent complete remission.
.A
Mannironi C; Rossi V; Biondi A; Ubezio P; Masera G; Barbui T; D'Incalci M.
.I 54798
.U
88001012
.S
Blood 8801; 70(4):1222-4
.M
Bone Marrow/CY/*ME; Cell Count; Cell Differentiation; Human; N-Formylmethionine Leucyl-Phenylalanine/PD; Receptors, Immunologic/*BI; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Acquisition of formyl peptide receptors during normal human myeloid differentiation.
.P
JOURNAL ARTICLE.
.W
By using a newly developed immune rosetting technique to isolate highly purified populations of myeloid precursor cells from normal human bone marrow and then inducing their differentiation with granulocyte and macrophage colony-stimulating factors (G/M-CSFs) in vitro, we studied the surface expression of chemotactic peptide receptors as the cells matured from the stage of the myeloblast to that of the mature, segmented neutrophil. We used ethylene glycol bis(succinimidyl succinate) to link N-formyl-Nle-Leu-Phe-Nle-[125I]iodo-Tyr-Lys to chemotactic peptide receptors on the surface of myeloid cells at sequential stages of maturation and then determined the density of receptor-radioligand complexes by autoradiography after sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Specific, saturable formyl peptide receptors were not detectable at the level of the myeloblast but gradually emerged through progressive stages of neutrophil maturation. The specific receptors for formyl peptide that appeared during cellular maturation had a mol wt of 55 to 70 kiloDalton (kD), corresponding to those present on the surface of peripheral blood neutrophils, and binding of the radioligand was highly specific in that it was completely inhibited by a 1,000-fold excess of F-Met Leu Phe. These data correlate with and provide insight into our recent observation that F-Met Leu Phe-induced membrane depolarization and transient increases in cytosolic free calcium are gradually acquired as neutrophils mature. This report represents to our knowledge the first description of the maturational development of chemotactic peptide receptor expression in normal human myeloid cells.
.A
Sullivan R; Griffin JD; Malech HL.
.I 54799
.U
88001013
.S
Blood 8801; 70(4):1225
.M
Animal; Bone Marrow/*PA; Etoposide/*PD; Mice.
.T
VP-16 in bone marrow purging [letter]
.P
LETTER.
.A
Stiff PJ.
.I 54800
.U
88001014
.S
Blood 8801; 70(4):1225-7
.M
Blood Platelets/*PH; Human; Models, Biological/*.
.T
Models of platelet formation [letter]
.P
LETTER.
.A
Trowbridge EA.
.I 54801
.U
88001015
.S
Blood 8801; 70(4):1227-8
.M
Antigens, Surface/*AN; Human; Megakaryocytes/*IM.
.T
Expression of immunologic markers in megakaryoblasts [letter]
.P
LETTER.
.A
San Miguel JF; Gonzalez M; Orfao A; Ojeda E; Canizo MC.
.I 54802
.U
88001018
.S
Blood 8801; 70(4):909-14
.M
Animal; Erythrocytes/*DE/EN; Female; Glutathione Peroxidase/ME; Hemoglobins/*PH; Hemolysis/*; Human; Hydrogen Peroxide/*PD; Male; Malondialdehyde/ME; Mice; Mice, Inbred Strains/*GE; Recombination, Genetic; Support, U.S. Gov't, P.H.S..
.T
Genetic differences in hemoglobin influence on erythrocyte oxidative stress hemolysis.
.P
JOURNAL ARTICLE.
.W
The RBC from mice of certain inbred strains hemolyzed under oxidative stress (2.0 mmol/L hydrogen peroxide), whereas red cells from mice of other strains did not. In the experimental system human erythrocytes did not hemolyze. The rate of formation of malonyldialdehyde (a fatty acid oxidative breakdown product) was fourfold higher in hemolytic v nonhemolytic red cells. There was insufficient variation in the levels of glutathione, peroxidase activity or its substrate, reduced glutathione, to explain these hemolysis differences. On the other hand, the antioxidants butylated hydroxyanisole and hydroxytoluene, and histidine protected the hemolysis-prone red cells from breaking open. The hemolysis trait demonstrated autosomal recessive Mendelian inheritance. When using inbred, recombinant inbred, and congenic inbred mice, this hemolysis/nonhemolysis trait correlated 1:1 with the type of hemoglobin beta chain in the RBC. This experimental system is a potential model for investigating the role of hemoglobin in prehemolytic events.
.A
Kruckeberg WC; Doorenbos DI; Brown PO.
.I 54803
.U
88001020
.S
Blood 8801; 70(4):921-5
.M
Abortion, Habitual/*CO/PC; Adult; Case Report; Chromosome Abnormalities/*CO/GE; Female; Fibrinogen/*BL/TU; Human; Karyotyping; Pedigree; Pregnancy; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Translocation (Genetics).
.T
A unique 7p/12q chromosomal abnormality associated with recurrent abortion and hypofibrinogenemia.
.P
JOURNAL ARTICLE.
.W
Recurrent first trimester abortions led to evaluation of a 25-year-old woman. Studies revealed she had hypofibrinogenemia (68 mg/dL) without evidence of dysfibrinogenemia or increased fibrinogen turnover. She was also found to have a unique 46,XX, t(7;12) (p 15.2;q24.31) karyotype. Hypofibrinogenemia and identical chromosomal abnormalities were found in other members of her kindred. Southern blots of genomic DNA from the patient, her mother, and her daughter hybridized to human fibrinogen probes showed alpha, beta, and gamma fibrinogen genes to be present and without structural alterations when compared to normal controls. We conclude that the chromosomal abnormality and the hypofibrinogenemia are related but in an unclear manner. Because fibrinogen infusion in the proposita was associated with successful gestation, we also concluded that the chromosomal abnormality itself was not responsible for the repeated abortions but that fibrinogen concentration may be critical in securing implantation.
.A
Kitchens CS; Cruz AC; Kant JA.
.I 54804
.U
88001270
.S
Br J Surg 8801; 74(8):668-70
.M
Adrenergic Fibers/*PH; Adult; Anus/DE/*IR/PH; Bupivacaine/PD; Electric Stimulation; Electromyography; Female; Human; Hypogastric Plexus/*PH; Labetalol/PD; Male; Middle Age; Muscle Relaxation; Rectum/IR/PH; Reflex/PH; Support, Non-U.S. Gov't; Sympathetic Nervous System/DE.
.T
Neural control of internal anal sphincter function.
.P
JOURNAL ARTICLE.
.W
The effect on anal tone of electrical stimulation of the presacral (hypogastric) sympathetic nerves has been studied in eight patients during abdominal rectopexy or restorative proctocolectomy. A sharp fall in anal pressure occurred in seven patients (mean fall 59 cmH2O; range 35-80 cmH2O). In one patient given a beta- and alpha-sympathetic blocking drug (labetalol 200 mg) intra-operatively, the anal pressure decreased by 15 cmH2O. These observations show that stimulation of the presacral sympathetic nerves causes relaxation of the internal anal sphincter and implies that these nerves may induce relaxation of the sphincter in vivo. The pathway of the recto-anal reflex has been studied intra-operatively in three patients undergoing rectal excision. The recto-anal reflex is present after presacral nerve blockade and after full mobilization of the rectum, but is abolished by circumferential rectal myotomy. The reflex has a local intramural pathway. This observation validates the assumption that absence of this reflex is a feature of aganglionosis, as in Hirschsprung's disease.
.A
Lubowski DZ; Nicholls RJ; Swash M; Jordan MJ.
.I 54805
.U
88001271
.S
Br J Surg 8801; 74(8):671-4
.M
Adolescence; Adult; Aged; Child; Colectomy; Crohn Disease/MO/*SU; Female; Human; Ileostomy; Male; Middle Age; Prognosis; Rectum/SU; Recurrence; Reoperation.
.T
Results of proctocolectomy for Crohn's disease.
.P
JOURNAL ARTICLE.
.W
Seventy-four patients have had a one-stage proctocolectomy for the management of Crohn's disease. Indications for operation were: acute colitis 28 per cent, chronic colitis 39 per cent, perianal disease 13 per cent, proctitis and perianal disease 8 per cent, bleeding 5 per cent, coexisting colonic malignancy 7 per cent. There were two hospital deaths (2.7 per cent), both associated with sepsis. Late deaths (n = 13) were most commonly associated with reoperations for recurrent disease (n = 3), cardiovascular disease (n = 4) and colorectal carcinoma (n = 1). Postoperative complications were principally associated with sepsis. Cumulative reoperation rates at 5 and 10 years were 19 and 24 per cent respectively. Recurrence was unrelated to the age of the patients, the duration of disease, or the presence of ileal disease at the time of colectomy.
.A
Scammell BE; Andrews H; Allan RN; Alexander-Williams J; Keighley MR.
.I 54806
.U
88001272
.S
Br J Surg 8801; 74(8):675-8
.M
Adult; Age Factors; Aged; Cholecystectomy/*AE; Colonic Neoplasms/*ET; Female; Human; Male; Middle Age; Rectal Neoplasms/*ET; Risk; Support, Non-U.S. Gov't.
.T
Unaltered risk of colorectal cancer within 14-17 years of cholecystectomy: updating of a population-based cohort study.
.P
JOURNAL ARTICLE.
.W
The incidence of colorectal cancer after cholecystectomy was analysed in a historical population-based cohort study comprising 16,439 patients who were completely followed up for 14-17 years after operation. The observed number of colorectal cancers (150) was lower than the expected number of 166.3 (relative risk (RR) = 0.90:95 per cent confidence limits 0.77-1.05) and the overall risk for colon cancer (RR = 0.95) did not differ significantly from that of rectal cancer (RR = 0.82). Separate analyses by sex, age at operation and duration of follow-up revealed relative risks close to or lower than unity. Some deviations indicating a substantially reduced risk might have been due to the play of chance alone. Our results contradict the idea both of a causal and of a non-causal association-through common aetiological factors-between surgically confirmed gallbladder disease and colorectal cancer.
.A
Adami HO; Krusemo UB; Meirik O.
.I 54807
.U
88001273
.S
Br J Surg 8801; 74(8):679-82
.M
Adult; Constipation/CO; Defecation; Female; Follow-Up Studies; Human; Male; Middle Age; Prognosis; Rectal Prolapse/*ET/PP/TH.
.T
Natural history of anterior mucosal prolapse.
.P
JOURNAL ARTICLE.
.W
Case notes of 250 patients (M:F, 1:2.7; age 48.7 +/- 16.5 years) in whom anterior mucosal prolapse had been diagnosed, at one hospital between 1974 and 1976, were reviewed. The commonest symptoms were bleeding (56 per cent), pain (32 per cent) and a sense of prolapse (32 per cent). The prevalence of constipation was significantly higher among women (47 per cent) than men (29 per cent). Perineal descent was present in 20 per cent of cases and was significantly more frequently associated with excessive straining at defaecation (28 per cent) compared with patients in whom there was no history of excessive straining (12 per cent). Sixty-six patients (26 per cent) experienced recurring symptoms over the 10 year period following presentation but did not deteriorate, while 28 patients (11 per cent) deteriorated. Deterioration was associated with a history of symptoms for longer than 1 year at the time of presentation, female sex, and the presence of perineal descent on clinical examination. The risk of developing perineal descent was less than 10 per cent over the 5 years after presentation while that of developing sphincter laxity among patients who had already developed perineal descent was 30 per cent over this period. Complete rectal prolapse occurred in 20 per cent (3/15) of patients with clinical perineal descent and sphincter laxity but was not seen in the absence of these signs. The results of treatment by submucosal phenol injection, mucosal rubber banding, or glycerine suppositories were the same.
.A
Allen-Mersh TG; Henry MM; Nicholls RJ.
.I 54808
.U
88001274
.S
Br J Surg 8801; 74(8):683-4
.M
Animal; Deglutition Disorders/ET; Esophagogastric Junction/*SU; Gastroesophageal Reflux/*SU; Implants, Artificial/*/AE; Pressure; Support, Non-U.S. Gov't; Swine.
.T
Implantation of a pressure cuff around the subphrenic oesophagus.
.P
JOURNAL ARTICLE.
.W
The possibility of implanting a pressure cuff around the subphrenic oesophagus as a barrier to reflux was tested in six pigs. The oesophagus tolerated cuff pressures from 48 to 95 cmH2O, corresponding to intra-oesophageal pressures from 27 to 75 cmH2O. The pigs with the perioesophageal cuff swallowed a solid diet without difficulty. However, dysphagia occurred in pigs kept alive for more than a month and the main reason was malfunction of the device because of surrounding fibrosis. This problem should be solved before implantation of the device in humans is attempted.
.A
Miskowiak J; Burcharth F; Olesen HP; Baden H; Hald T; Aggestrup S.
.I 54809
.U
88001275
.S
Br J Surg 8801; 74(8):685-7
.M
Adenocarcinoma/SU; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell/SU; Cardia; Esophageal Neoplasms/*SU; Esophagus/*SU; Female; Human; Male; Methods; Middle Age; Postoperative Complications; Sternum/*SU; Stomach Neoplasms/*SU.
.T
Partial and complete sternotomy for blunt oesophagectomy.
.P
JOURNAL ARTICLE.
.A
Kirk RM.
.I 54810
.U
88001276
.S
Br J Surg 8801; 74(8):688-9
.M
Adolescence; Adult; Aged; Edrophonium/*DU; Esophageal Diseases/*DI; Evaluation Studies; Human; Manometry; Middle Age; Spasm/DI.
.T
Edrophonium provocation test in the diagnosis of diffuse oesophageal spasm.
.P
JOURNAL ARTICLE.
.W
Criteria for diffuse oesophageal spasm(DOS) are dysphagia and chest pain with oesophageal manometry showing retention of peristalsis with the presence of synchronous contractions in response to wet swallows. Because of the intermittent nature of the symptoms, edrophonium was used as a provocative agent to increase diagnostic yield. Three hundred and ninety-six patients underwent transnasal manometry using a Gaeltec system of six internal transducers arranged at 5 cm intervals from the catheter tip; the majority of these patients received 10 mg edrophonium as an intravenous bolus. Reproduction of symptoms with typical manometry of DOS indicated a positive provocation test. There were no significant side effects. DOS was diagnosed in 34 patients who had either the typical manometry or a positive provocation test. Thirty of these patients received edrophonium. Twenty patients had baseline manometry which was diagnostic and ten of this group had a positive provocation test. The remaining 10 patients, who had normal baseline manometry, had positive provocation tests following the injection of edrophonium. Without edrophonium provocation testing, about a third of patients would not have been diagnosed as having DOS.
.A
Linsell J; Owen WJ; Mason RC; Anggiansah A.
.I 54811
.U
88001277
.S
Br J Surg 8801; 74(8):690-1
.M
Abdominal Neoplasms/TH; Adolescence; Biological Products/*AD; Child, Preschool; Female; Head and Neck Neoplasms/TH; Human; Infant; Lymphangioma/*TH; Male; Picibanil/*AD/TU; Retroperitoneal Neoplasms/TH; Sclerosing Solutions/*AD/TU.
.T
Intracystic injection of OK-432: a new sclerosing therapy for cystic hygroma in children.
.P
JOURNAL ARTICLE.
.W
Nine patients with cystic hygroma were treated with a new sclerosing therapy consisting of intracystic injection of OK-432 (group A Streptococcus pyogenes of human origin). Favourable results including complete regression in eight patients and marked regression in one were observed within 2-3 months without serious side-effects except for fever of 2-3 days' duration and local inflammatory reaction lasting for 3-4 days. Local inflammatory reaction did not cause any damage to the overlying skin and did not lead to scar formation.
.A
Ogita S; Tsuto T; Tokiwa K; Takahashi T.
.I 54812
.U
88001278
.S
Br J Surg 8801; 74(8):692-3
.M
Adolescence; Cecal Diseases/CO/*TH; Child; Child, Preschool; Follow-Up Studies; Human; Ileal Diseases/CO/*TH; Intussusception/CO/*TH; Recurrence.
.T
Intussusception in children 5-15 years of age.
.P
JOURNAL ARTICLE.
.W
Twenty cases of intussusception in children between the ages of 5 and 15 years were compared with intussusception in infancy and early childhood. They accounted for 18.5 per cent of all 108 children treated for intussusception in two large hospitals from 1964 to 1984. Diagnosis of intussusception was delayed, probably due to an unusual presentation. Fifty-five per cent had a definite predisposing factor precipitating the intussusception and 45 per cent had a small bowel intussusception, which warranted early surgical intervention. In the absence of contraindications no child should be disqualified from an attempt at hydrostatic reduction. After hydrostatic reduction careful follow-up is required to exclude an organic lesion, possibly by a small bowel follow-through meal. Surgery is indicated after hydrostatic reduction in case of chronically recurrent abdominal complaints.
.A
Reijnen JA; Joosten HJ; Festen C.
.I 54813
.U
88001280
.S
Br J Surg 8801; 74(8):696
.M
Bronchi/*; Bronchial Diseases/ET; Case Report; Foreign Bodies/*/CO; Hemorrhage/ET; Human; Plastics; Surgical Instruments.
.T
Serious hazard of plastic coding tape on surgical instruments.
.P
JOURNAL ARTICLE.
.A
Kraayenbrink M; Baer ST; Jenkins JG; Moore-Gillon V.
.I 54814
.U
88001282
.S
Br J Surg 8801; 74(8):700
.M
Breast/*BS; Breast Neoplasms/*CO; Case Report; Female; Human; Middle Age; Phlebitis/*CO; Skin/BS; Syndrome.
.T
Mondor's disease as a presenting symptom of breast cancer.
.P
JOURNAL ARTICLE.
.A
Levi I; Baum M.
.I 54815
.U
88001284
.S
Br J Surg 8801; 74(8):704
.M
Aged; Aged, 80 and over; Case Report; Cholelithiasis/CO/*PA; Female; Gallbladder/*PA; Gallbladder Neoplasms/CO/*PA; Human.
.T
Record number of gallstones.
.P
JOURNAL ARTICLE.
.A
Martin KW; Jackson BT.
.I 54816
.U
88001286
.S
Br J Surg 8801; 74(8):711-4
.M
Adult; Aged; Amputation/*; Bone Neoplasms/*RA/SU; Buttocks/SU; Histiocytoma/*RA/SU; Human; Middle Age; Sarcoma/*RA/SU; Soft Tissue Neoplasms/*RA/SU; Thigh/SU; Tomography, X-Ray Computed/*.
.T
Role of computed tomography in selecting patients for hindquarter amputation.
.P
JOURNAL ARTICLE.
.W
Nine patients with soft tissue sarcomas close to the pelvic girdle and one patient with a primary malignant bone tumour of the pelvis were referred for consideration of hindquarter amputation. Patients were considered unsuitable for hindquarter amputation on clinical grounds if malignant disease infiltrated into the perineum or across the sacro-iliac joint. If disease in the femoral triangle extended above the inguinal ligament the tumour's operability was seriously questioned. Buttock tumours which had passed through the greater sciatic notch to become palpable on pelvic examination were also considered likely to be inoperable. On computed tomographic (CT) examination, tumours were considered inoperable if the psoas muscle was involved above the inguinal ligament, or if malignant disease involved the sacro-iliac joint, sacrum or perineal structures. Soft tissue tumours of the buttock extending significantly through the greater sciatic notch were also considered likely to be inoperable. Five patients thought suitable for hindquarter amputation on clinical assessment had no excluding features on CT; four undergoing hindquarter amputation were proven on histological examination to have good clearance of their tumours. In another patient, considered suitable for hindquarter amputation on clinical grounds, CT suggested that en bloc wide excision of the tumour was feasible enabling the affected limb to be preserved. Four patients after clinical examination were considered unsuitable for hindquarter amputation and in all cases inoperability was confirmed by CT. CT complements clinical examination and provides an objective and reliable means of selecting patients for hindquarter amputation which should avoid unnecessary surgical exploration.
.A
Watkins RM; Thomas JM.
.I 54817
.U
88001287
.S
Br J Surg 8801; 74(8):715-20
.M
Adenocarcinoma/DT/*MO/SU; Antineoplastic Agents/*TU; Female; Human; Male; Neoplasm Metastasis; Neoplasm Recurrence, Local; Prognosis; Retrospective Studies; Stomach/SU; Stomach Neoplasms/DT/*MO/SU; Support, Non-U.S. Gov't.
.T
Evaluation of the prognostic factors in gastric cancer: the effect of chemotherapy on survival.
.P
JOURNAL ARTICLE.
.W
This is a retrospective review of 328 consecutive patients with histologically confirmed gastric adenocarcinoma diagnosed in one centre between 1974 and 1984. Of these patients, 128 (39 per cent) had a curative resection, 32 (9.8 per cent) had a palliative resection, 33 (10.0 per cent) had a gastro-enterostomy, 26 (7.9 per cent) had a Celestin tube inserted, 58 (17.7 per cent) had a laparotomy alone, and 51 (15.5 per cent) had no surgical procedure. The 5 year survival was 11 per cent but all long term survivors were patients who had a curative resection. Using multivariate analysis the best predictor of survival after curative resection was the presence or absence of serosal involvement (P = 0.0004). Patients with a long history of presenting symptoms (greater than 6 months) survived longer than those with a short history (P = 0.001). The impact of chemotherapy on the survival of 202 patients with advanced gastric cancer was analysed by multivariate analysis. The median survival of the 50 patients receiving combination chemotherapy was better than that of the 152 who did not (median survivals 160 versus 71 days; P less than 0.001). When deaths occurring within 14 days of diagnosis were excluded, the significance value dropped to P = 0.02. Comparison of the groups treated between 1974 and 1979, when 8 per cent of 92 patients received chemotherapy, with 1980-1984, when 45 per cent of 110 patients received chemotherapy, showed no significant difference in survival.
.A
Cunningham D; Hole D; Taggart DJ; Soukop M; Carter DC; McArdle CS.
.I 54818
.U
88001288
.S
Br J Surg 8801; 74(8):721-5
.M
Adult; Aged; Bile Acids and Salts/*AN; Cholelithiasis/*CO/ME; Duodenogastric Reflux/*CO/ME; Female; Gastric Acidity Determination; Human; Male; Middle Age; Phospholipases/*ME; Phospholipases A/*ME; Stomach/ME; Stomach Ulcer/*ET/ME.
.T
Relative contribution of bile and pancreatic juice duodenogastric reflux in gastric ulcer disease and cholelithiasis.
.P
JOURNAL ARTICLE.
.W
Bile acid concentrations, phospholipase A2 activity and pH in the stomach were measured in the fasting state and for 2 h after a fat-containing test meal in patients with an active gastric ulcer (GU), in patients with gallstones before and after cholecystectomy and in normal subjects. Fasting and peak postprandial bile acid concentrations in the stomach were low in all normal controls. Although high concentrations were found in many patients with GU (P less than 0.01), similar concentrations were found in many patients with radiologically non-functioning gallbladders containing gallstones (NFG) (P less than 0.01) and also after cholecystectomy (AC) (P less than 0.01). Fasting intragastric phospholipase A2 activities were similar, and very high in GU and NFG patients compared with control subjects (P less than 0.01). High values were not found after cholecystectomy. There was no difference in pH profile or in postprandial phospholipase A2 between patient groups. Since patients with cholelithiasis or after cholecystectomy are not known to have an increased incidence of gastric ulceration, the significance of duodenogastric reflux in the aetiology of gastric ulcers must be questioned. If reflux does produce ulcers in GU patients then factors in addition to bile acid are probably involved. However, neither patterns of phospholipase A2 reflux nor pH profiles can explain the absence of gastric ulceration in those patients with gallstones who reflux large quantities of bile acid.
.A
Eyre-Brook IA; Smythe A; Bird NC; Mangnall Y; Johnson AG.
.I 54819
.U
88001290
.S
Br J Surg 8801; 74(8):728-30
.M
Adult; Aged; Aged, 80 and over; Bile Duct Diseases/DI/TH; Bile Duct Neoplasms/DI; Cholelithiasis/*DI/TH; Cholestasis/*DI/TH; Drainage/MT; Endoscopy/*MT; Female; Human; Male; Middle Age.
.T
Percutaneous transhepatic cholangioscopy.
.P
JOURNAL ARTICLE.
.W
Since 1983, percutaneous transhepatic cholangioscopy has been performed in 50 patients for both therapeutic and diagnostic purposes. Percutaneous transhepatic cholangioscopy was used to evaluate the nature of obstructive jaundice in 15 patients and bile duct stones were removed in 35 patients, 27 of whom also had intrahepatic duct stones. The overall success rate for stone removal was 80 per cent. Complications were few with no mortality. Emergency surgery was necessary in two patients, one for subphrenic haematoma, the other for a bile leak. Percutaneous transhepatic cholangioscopy is an effective and safe method for management of biliary stones and is a useful procedure for establishing the diagnosis of obstructive jaundice.
.A
Chen MF; Jan YY; Lee TY.
.I 54820
.U
88001291
.S
Br J Surg 8801; 74(8):731-3
.M
Aged; Bile Duct Neoplasms/PA/RA/*SU; Bile Ducts/PA/*SU; Case Report; Cholangiography; Female; Human; Male; Middle Age; Prosthesis/*.
.T
Loss of substance in bile ducts treated by a new surgical endoprosthesis.
.P
JOURNAL ARTICLE.
.W
Three cases of loss of substance of the common bile duct in patients with neoplastic disease treated by a new surgical endoprosthesis are reported. In all patients a good biliary drainage was obtained without a biliary fistula. There were no complications related to this method. Long-term follow-up showed persistence of the good immediate results. Surgical endoprostheses might be an alternative in cases with peroperative loss of substance of the common bile duct in patients with neoplastic disease to hepato-enteric anastomoses.
.A
Sezeur A; Kracht M; Rey P; Leandri J; Malafosse M.
.I 54821
.U
88001292
.S
Br J Surg 8801; 74(8):734-5
.M
Animal; Disease Models, Animal; Guinea Pigs; Polyglactin 910/AE; Polyglycolic Acid/AE; Polymers/*AE; Polypropylenes/AE; Polytetrafluoroethylene/AE; Support, Non-U.S. Gov't; Surgical Wound Infection/*ET; Sutures/*.
.T
Suture materials in contaminated wounds: a detailed comparison of a new suture with those currently in use.
.P
JOURNAL ARTICLE.
.W
The relationship between five different suture materials (expanded polytetrafluoroethylene (PTFE), polypropylene, polyglycolic acid, polydioxanone and polyglactin 910) and infection has been studied in 540 guinea-pig wounds contaminated with synergistic enteric organisms. The recently introduced expanded PTFE suture has been studied because, unlike the others, it has not previously been studied under these contaminated conditions. The incidence of wound infection in the control series was 26 per cent and all suture materials increased this figure significantly. The infection rate using expanded PTFE of 51 per cent was similar to all other sutures except polyglycolic acid, which produced an infection rate of 41 per cent. This difference was not statistically significant at the 5 per cent level. This confirms other studies including our own which show that the presence of most suture materials in contaminated wounds increases the incidence of infection. It further demonstrates that expanded PTFE is no different from other materials in this regard.
.A
Paterson-Brown S; Cheslyn-Curtis S; Biglin J; Dye J; Easmon CS; Dudley HA.
.I 54822
.U
88001295
.S
Br J Surg 8801; 74(8):741
.M
Dumping Syndrome/PC; Enterostomy/*; Filtration; Human; Ileostomy; Infusion Pumps; Infusions, Parenteral/*IS; Jejunostomy/*; Methods.
.T
Pumping device for re-infusion excretions derived from a proximal jejunostomy or high output fistula.
.P
JOURNAL ARTICLE.
.A
Gouma DJ; de Bruyn H; Rinsema W; Soeters PB.
.I 54823
.U
88001297
.S
Br J Surg 8801; 74(8):748-9
.M
Animal; Appendicitis/*ET/PS; Cecum/PS; Enterobius/IP; Female; Human; Male; Oxyuriasis/*CO/PS.
.T
Role of Enterobius vermicularis in the aetiology of appendicitis.
.P
JOURNAL ARTICLE.
.W
An evaluation was made of the histological material obtained from all 1529 appendices removed during the last 5 years at Southmead Hospital, Bristol, in order to elucidate possible relationships between the incidence of Enterobius vermicularis and the origin of inflammation in the appendix. In total, 1419 appendices were removed as cases of clinical appendicitis and 110 in the course of another surgical procedure. E. vermicularis was identified in 2.7 per cent of patients with clinical appendicitis and was most commonly seen in appendices with either chronic inflammation or where the appendix was histologically normal. E. vermicularis was rarely associated with histological changes of acute appendicitis. No cases of E. vermicularis infestation occurred in appendices removed during the course of other surgical procedures. The results suggest that, although E. vermicularis may have a causal role in appendicular pain and chronic inflammation, it is rarely related to acute appendicitis.
.A
Budd JS; Armstrong C.
.I 54824
.U
88001298
.S
Br J Surg 8801; 74(8):750-2
.M
Abdomen; Human; Mortality/*; Severity of Illness Index; Suppuration/*.
.T
Comparison of the local and systemic effects of sepsis in predicting survival.
.P
JOURNAL ARTICLE.
.W
Progress in the study of sepsis has been hampered by the lack of a suitable system for grading its severity. Systems suggested for scoring sepsis have been based either on its systemic effects (APACHE II) or on a mixture of local and systemic variables (sepsis score). The APACHE II and sepsis scores were applied to patients with intra-abdominal sepsis of more than 3 days' duration, to determine if local or systemic factors were more important in predicting survival. Of 45 patients studied, 14 died. The sepsis score for non-survivors (median 21.5, range 11-32) was significantly higher than for survivors (median 14, range 10-26, P less than 0.05). There was overlap between the two groups, such that an individual score had no predictive value. The local component of the sepsis score was not significantly increased in non-survivors (P less than 0.05), but the systemic component was (P less than 0.05). The APACHE II score for non-survivors (median 24, range 15-38) was significantly higher than for survivors (median 12, range 3-21), and correctly identified 13 of the 14 fatalities. Both the systemic and non-systemic components (age and chronic disease) were significantly higher among the latter. The APACHE II was more effective than the sepsis score in predicting survival. We conclude that any system used for scoring sepsis should be based on systemic rather than local effects. At present the APACHE II score is preferred.
.A
Ponting GA; Sim AJ; Dudley HA.
.I 54825
.U
88001299
.S
Br J Surg 8801; 74(8):753-4
.M
Bile Duct Diseases/RA; Cholangiography/AE/*MT; Cholelithiasis/RA; Fluoroscopy/*; Human; Intraoperative Care/*MT; Radiation Dosage; Radiographic Image Enhancement.
.T
Fluoroscopic peroperative cholangiography: technique and associated radiation hazards.
.P
JOURNAL ARTICLE.
.W
The techniques specific to peroperative fluorocholangiography are discussed based on an experience of 632 cholangiograms and an estimation has been made of the associated radiation doses to staff and patients. Rapid and accurate information can be obtained during fluorocholangiography using appropriate techniques with acceptably low radiation hazards.
.A
Faulkner K; Gunn A; Harrison RM; Perry EP.
.I 54826
.U
88001300
.S
Br J Surg 8801; 74(8):755-7
.M
Aorta/*SU; Blood Coagulation; Blood Transfusion, Autologous/*; Disposable Equipment/*; Hemolysis; Hemorrhage; Human; Support, Non-U.S. Gov't.
.T
Salvage autotransfusion in aortic surgery: initial studies using a disposable reservoir.
.P
JOURNAL ARTICLE.
.W
Transmission of disease by allogeneic transfusion can be avoided using several techniques by which a patient receives his own blood. Sixty patients undergoing aortic surgery consented to salvage interoperative autotransfusion. A mean of 895 ml shed blood was reinfused under full heparinization, representing 12-74 per cent of total blood loss. Bank blood requirements fell from 4.9 units to 3.4. No important haematological or clinical complications were noted (including coagulation studies) but haemolysis was detected 4 h postoperatively by plasma haemoglobin levels of 0.05 +/- 0.03 g/dl. This preliminary study confirms the applicability of salvage autotransfusion during elective vascular surgery by demonstrating an appreciable saving in bank blood transfusion (70 per cent).
.A
Clifford PC; Kruger AR; Smith A; Chant AD; Webster JH.
.I 54827
.U
88001301
.S
Br J Surg 8801; 74(8):758
.M
Esophagus/*PH; Human; Hydrogen-Ion Concentration; Monitoring, Physiologic/*.
.T
Twenty-four-hour ambulatory oesophageal pH monitoring [letter]
.P
LETTER.
.A
McLauchlan G; Lucas ML; McColl KE.
.I 54828
.U
88001302
.S
Br J Surg 8801; 74(8):758-9
.M
Abdomen/*; Child; Child, Preschool; Human; Pain/*ET.
.T
Non-specific acute abdominal pain [letter]
.P
LETTER.
.A
Jones PF.
.I 54829
.U
88001303
.S
Br J Surg 8801; 74(8):759
.M
Anti-Inflammatory Agents, Non-Steroidal/*AE; Duodenal Ulcer/*CI; Human; Peptic Ulcer Perforation/*CI.
.T
Perforated duodenal ulcers [letter]
.P
LETTER.
.A
Blower AL; Armstrong CP.
.I 54830
.U
88001304
.S
Br J Surg 8801; 74(8):759-60
.M
Colitis/*PA; Colon/*BS; Human; Ischemia/PA.
.T
Colon "cast" in a patient with ischaemic colitis [letter]
.P
LETTER.
.A
Phillips RK; Armitage NC.
.I 54831
.U
88001305
.S
Br J Surg 8801; 74(8):760
.M
Adrenergic Beta Receptor Blockaders/AE; Gangrene/*CI; Human.
.T
Peripheral gangrene associated with beta-blockade [letter]
.P
LETTER.
.A
Kynaston HG; Roberts DH; Davies WT.
.I 54832
.U
88001306
.S
Br J Surg 8801; 74(8):760
.M
Aged;