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Biomedical subjects

A C Thompson

Publications and source records attributed to A C Thompson.

At least 19 recordsLinked to original sources

Gastric vagotomy blocks opioid analgesia enhancement produced by placenta ingestion.

Ingestion of amniotic fluid or placenta by rats has been shown to enhance opioid-mediated analgesia induced by morphine injection, footshock, vaginal/cervical stimulation, or late pregnancy. This enhancement by ingestion appears to be specific to the central actions of opioids. The present study was designed to examine the possibility that information traveling via the vagus nerve might be involved in mediating this effect. Rats that had undergone either selective gastric vagotomy or sham vagotomy were injected with either morphine sulfate or vehicle and fed either placenta or a meat control. Enhancement was observed in rats that had undergone sham vagotomy but not in those that had undergone gastric vagotomy. These results support an interpretation of vagal involvement in the enhancement of opioid-mediated analgesia by placenta.

Analgesia

Darier's disease of the external ear.

Darier's disease is a hereditary dermatological condition characterized by crusted papules distributed over the seborrhoeic areas of the trunk and head. A case of Darier's disease presenting to the Otolaryngology department because of severe involvement of the pinna is reported. The typical histological appearances are described and treatment discussed.

Darier Disease

Intra-tympanic injections in the treatment of tinnitus.

Prolonged reduction or abolition of tinnitus has been reported in about two-thirds of patients treated with a single or weekly-repeated injection through the tympanic membrane of either dexamethasone or lignocaine. In a small-scale trial of these treatments, dexamethasone gave 6 patients little benefit but few side-effects. Lignocaine gave 5 patients no lasting benefit but violent vertigo for several hours. A. Axelsson (personal communication) had similar experience with 6 patients treated with intra-tympanic lignocaine. It is concluded that this form of treatment does not seem sufficiently effective to offset its low acceptability.

Adult

Placental opioid-enhancing factor (POEF): generalizability of effects.

A substance in amniotic fluid and placenta (POEF for Placental Opioid-Enhancing Factor) has been shown to enhance opiate- or opioid-mediated analgesia in rats. Recent studies have only touched on the generalizability of the phenomenon. The present studies further tested the generalizability of the POEF effect: they examined sex specificity of the mechanism; whether POEF activity exists in afterbirth material of species other than the rat; whether POEF activity exists in tissue other than afterbirth material; whether POEF activity could be demonstrated after injection rather than ingestion of afterbirth material; and whether POEF enhances all opioid-mediated phenomena. We found that (a) POEF is effective in male rats as well as in female rats; (b) POEF activity exists in human and dolphin afterbirth material; (c) ingestion of pregnant-rat liver does not produce enhancement of opioid-mediated analgesia; (d) POEF does not seem to be effective when amniotic fluid is injected either IP or SC; and (e) POEF does not modify morphine-induced hyperthermia.

Animals

Amniotic fluid ingestion before vaginal/cervical stimulation produces a dose-dependent enhancement of analgesia and blocks pseudopregnancy.

A substance in amniotic fluid (AF) and placenta has been shown to enhance analgesia produced by morphine, late pregnancy, footshock, and vaginal/cervical stimulation (VS). When morphine-induced analgesia was assessed previously, the degree of enhancement by ingestion of AF or placenta was found to be a function of the amount of analgesia being generated. We have extended these results to include the analgesia produced by VS. Analgesia induced by 75, 125, 175, or 225 g of vaginal/cervical pressure was measured in rats pretreated with 0.25 ml (by orogastric infusion) of either AF or saline. AF infusion enhanced the analgesia produced by 125 g VS, but did not affect the analgesia produced by 75, 175, or 225 g VS. Unexpectedly, we also found that infusion of AF shortly before the application of VS prevents VS-induced pseudopregnancy (PsP). Whereas the incidence of PsP following 75, 125, or 175 g VS was less than 19% and not statistically different for AF and saline pretreatments, the incidence of PsP after 225 g VS was 44% in saline-pretreated rats, but only 10% in AF-pretreated rats. Protection from the induction of pseudopregnancy, which could be caused by mechanical stimulation of the cervical area during delivery, may be an additional benefit of parturitional ingestion of placenta and amniotic fluid (placentophagia).

Afferent Pathways

Amniotic-fluid ingestion enhances the central analgesic effect of morphine.

Amniotic fluid and placenta contain a substance (POEF) that when ingested enhances opioid-mediated analgesia produced by several agents (morphine injection, vaginal/cervical stimulation, late pregnancy, footshock), but not that produced by aspirin injection. The present series of experiments employed quaternary naltrexone, an opioid antagonist that does not readily cross the blood-brain barrier, in conjunction with either peripheral or central administration of morphine, to determine whether amniotic-fluid ingestion (and therefore POEF ingestion) enhances opioid-mediated analgesia by affecting the central and/or peripheral actions of morphine. The results suggest that POEF affects only the central analgesic effects of morphine.

Amniotic Fluid

Iatrogenic epidermoid cyst of the parotid region following ear surgery.

Iatrogenic implantation of squamous epithelium may result in formation of an epidermoid cyst. These cysts have been described in various sites around the head and neck following otological procedures. A case of iatrogenic epidermal cyst in the parotid region following repeated myringoplasty is reported. The clinical features and differential diagnosis are discussed.

Adult

Effect of nasal packing on eustachian tube function.

Sixty-three patients undergoing surgery to the nasal septum followed by bilateral packing had pre- and post-operative tympanometry in order to determine the effect on eustachian tube function. Fifty-five of the 126 ears tested (46 per cent) developed a reduction in middle ear pressure of at least 50 daPa; 76 per cent became normal within 24 hours of removing the nasal packs. All ears were asymptomatic and no patient had evidence of middle ear effusion. Nasal packing following septal surgery is a frequent cause of short-lasting eustachian tube dysfunction but rarely severe enough to cause symptoms or middle ear effusion. Tubal dysfunction is most likely due to a combination of surgical oedema and a direct effect of the nasal packing.

Bandages

Adult tonsillectomy--results and patient selection.

One hundred and thirty two patients who had undergone tonsillectomy for recurrent sore throats were evaluated by a questionnaire regarding the effectiveness of their operation. There were 98 respondents of whom 88.8 per cent were satisfied with the benefit gained. Smoking habit did not affect the post-operative satisfaction rate. Dissatisfied patients were more likely to have changed their General Practitioner recently and more likely to have had multiple hospital referrals in the past. Improved patient satisfaction rates may be achieved by more careful assessment of patients with the latter characteristics.

Adolescent

Amniotic-fluid ingestion by parturient rats enhances pregnancy-mediated analgesia.

Amniotic fluid and placenta contain a substance (POEF, for Placental Opioid-Enhancing Factor) that, when ingested, enhances opioid-mediated analgesia in nonpregnant rats; ingestion of the substance by rats not experiencing opioid-mediated analgesia, however, does not produce analgesia. It is highly likely that periparturitional analgesia-enhancement is a significant benefit of ingestion of the afterbirth (placentophagia) during delivery. Here we report that prepartum ingestion of amniotic fluid (via orogastric infusion) does indeed enhance the endogenous-opioid-mediated analgesia evident at the end of pregnancy and during delivery; that the degree of enhancement is greater with 0.75 ml than with 0.25 ml; and that the prepartum enhancement of analgesia can be blocked with the opioid antagonist naloxone.

Amniotic Fluid

Kawasaki syndrome in an adult.

Kawasaki syndrome is a panvasculitis occurring principally in childhood. Symptoms include fever, 'strawberry tongue', cervical lymphadenopathy and dermatological signs. A rare case of Kawasaki syndrome in an adult presenting to the Otolaryngology department is reported. The clinical features of the disease are described highlighting its systemic nature. Treatment options and possible complications are discussed.

Adult

Surgical reduction of the inferior turbinate in children: extended follow-up.

The effectiveness and safety of surgical reduction of the inferior turbinate was assessed in 22 children of 15 years and below. All were interviewed and assessed by means of a questionnaire seven to 51 months post-operatively. Sixty-eight per cent of the children reported a sustained improvement in their nasal airway. There were no significant post-operative complications in this series. In particular there were no cases of serious post-operative haemorrhage, excessive dryness or crusting of the nose. It is concluded that surgical reduction of the inferior turbinate is a safe and effective option in the treatment of children with severe nasal obstruction.

Adolescent

Minor aphthous oral ulceration: a double-blind cross-over study of beclomethasone dipropionate aerosol spray.

A double-blind crossover study is described of the effect of beclomethasone dipropionate aerosol spray in patients with recurrent (minor) aphthous oral ulceration. Patients included in the study had normal haematological parameters of haemoglobin, ferritin, vitamin B12 and corrected whole blood folate. The design of the study incorporated a washout period and duration of effect was evaluated up to six months. Beclomethasone dipropionate significantly reduced ulcer pain severity and ulcer frequency, but had no significant effect on recurrence of oral ulceration. The preparation was associated with a high patient compliance and has benefit in relieving symptoms in patients with recurrent minor aphthous ulceration.

Adult