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Biomedical subjects

A M Samuel

Publications and source records attributed to A M Samuel.

At least 19 recordsLinked to original sources

Differential kinetics of parotid and submandibular gland function as demonstrated by scintigraphic means and its possible implications.

Is the differential kinetics of secretion of saliva between the parotid and submandibular glands responsible for the relative difference in radiosensitivity? Radiation-induced dysfunction is more often noted in the parotid glands than the submandibular glands. This difference in susceptibility is often attributed to the difference in the cellular composition of these glands. During our studies using 99Tcm-pertechnetate to quantitate salivary gland function in patients treated with radioiodine, we noted frequent unstimulated discharge of saliva from the submandibular glands compared with parotid secretion. We hypothesize that the relative resistance of the submandibular glands could be due to the differential kinetics of the parotid and submandibular glands, as evidenced by using 99Tcm-pertechnetate to study their function.

Humans

Effect of radioiodine therapy on pulmonary alveolar-capillary membrane integrity.

UNLABELLED: The effects of large doses of radioiodine on the pulmonary alveolar-capillary membrane using 99mTc-DTPA clearance as an index of pulmonary damage in subjects with pulmonary metastases of differentiated thyroid carcinoma were studied. METHODS: Technetium-99m-DTPA radioaerosols were generated by a dry aerosol generator. Data were acquired and analyzed for clearance half-time from the lungs with a scintillation camera. The study was carried out on 35 thyroid cancer patients with pulmonary metastases and on 32 patients without metastases; the results were compared to those of a control group comprising 52 subjects. The radiation dose delivered to the lungs from the therapeutic dose was calculated using MIRD methodology. RESULTS: Cumulative radioiodine doses varied from 5.9 to 44.2 GBq (158-1194 mCi). The half-time clearance of 99mTc-DTPA was comparable in both patient groups and was not related to the total administered radioiodine dosage or to the radiation dose delivered to the lungs. No changes were observed for periods up to 5 yr after receiving the last radioiodine dosage. Seven patients followed at regular intervals from 6 mo to 2 yr did not show abnormal 99mTc-DTPA clearance values. One patient did show low 99mTc-DTPA clearance half-time values, which were symptomatic radiation pneumonitis. She had received a total dose of 34 GBq (922 mCi) over a 4-yr period. CONCLUSION: The incidence of pulmonary damage resulting from radioiodine therapy for lung metastases of differentiated thyroid cancer is negligible, as evidenced by the normal pulmonary clearance half-time of 99mTc-DTPA aerosols.

Adult

Detection of antibodies to defined M. tuberculosis antigen (38 kDa) in cerebrospinal fluids of patients with tuberculous meningitis.

Antibodies to the 38 kDa antigen of M. tuberculosis which is serospecific to the tuberculosis complex group of organisms was studied in CSF samples of patients with tuberculosis meningitis. Patients were classified into four groups, viz. post-mortem-proved, culture-proved, clinically suspected and tuberculoma. Anti-38 kDa antibody was detected by ELISA and was positive in 60%, 80% 62.5% and 0%, respectively in the four groups. Controls showed a false-positive detection of 5%. Follow-up of patients was done up to 6 weeks and antibody levels dropped in all the patient groups.

Antibodies, Bacterial

Measurement of serum thyrotropin levels using sensitive immunoradiometricassays in patients with chronic renal failure: alterations suggesting an intact pituitary thyroid axis.

Serum thyroid stimulating hormone (TSH) levels were measured in 127 patients with varying grade of chronic renal failure (CRF). Sensitive immunoradiometricassays (IRMA) were used so that small changes in TSH levels if any, could be appreciated, and to see if such alterations exhibit some relationship with those in thyroid hormone levels. Mean serum TSH levels in the patient group of 2.33 microU/ml (0.07-7.3) was significantly higher in comparison to 1.73 microU/ml (0.25-4.6) in normal subjects (p < 0.001). However, they were not significantly different when measured by radioimmunoassay (RIA) as compared to normals. Serum triiodothyronine (T3), thyroxine (T4) and free triiodothyronine (FT3) levels of 72 +/- 32 ng/dl, 7.4 +/- 2.6 micrograms/dl and 2.9 +/- 0.9 pg/ml were significantly lower than in normal subjects, whereas serum free thyroxine (FT4) showed a slight though not significant elevation. When patients were divided in three subgroups according to the degree of renal insufficiency, TSH levels showed a gradual rise with corresponding depression in their T3, FT3 and T4 levels. In 19 patients who were on hemodialysis (HD) and subsequently received successful renal transplantation, most of the thyroid function parameters returned towards the normals with TSH undergoing significant depression from their pretransplant levels as well as from normal levels. The results indicated that a slight but significant elevation in TSH levels could be revealed by sensitive IRMA in patients with CRF. Rising TSH levels with increasing renal insufficiency and its inverse relationship with T3 and T4 levels suggest maintenance of pituitary thyroid axis.(ABSTRACT TRUNCATED AT 250 WORDS)

Combined Modality Therapy

Radioimmunoscintigraphic approach for the in vivo detection of tuberculomas--a preliminary study in a rabbit model.

Radioimmunoscintigraphic approach could provide a viable non-invasive alternative for the diagnosis of deeply situated tuberculomas. We have evaluated this in a rabbit model constructed to give a characteristic localized tubercular lesion, with complimentary morphological, histological and antigenic profiles. 131I-anti Myobacterium bovis (BCG) antibody was shown to localize at the lesion, where as 131I-bovine serum albumin and 99mTc-red blood cell scans were negative. The clearance of intradermally-injected tuberculous antigen could be traced into ascending lymph nodes using 131I-anti M. bovis (BCG) antibody.

Animals

A study of tubercular antigen and antibody in childhood tuberculosis.

A radioimmunoassay for the detection of tubercular (TB) antigen (Ag) and antitubercular antibody (Ab) was evaluated for the serodiagnosis of childhood tuberculosis. Children with primary complex, progressive primary complex, miliary tuberculosis, and calcified lung lesions without clinical evidence of active tuberculosis were studied. Significantly elevated levels of TB Ag and TB Ab isolated from the circulating immune complexes were obtained in primary, progressive primary, and miliary tuberculosis patients as compared to controls (P less than 0.01). The majority of patients with calcified lung lesions and without active tuberculosis demonstrated high levels of antibody. It was observed that elevated levels of TB Ag and/or antibodies were present in 54 per cent of patients with primary complex, 94 per cent of patients with progressive disease and 69 per cent of patients with miliary tuberculosis. It is possible that is suspected patients with the above mentioned diseases, a diagnosis can be established by using these techniques.

Antibodies, Bacterial

Isotope angiography and blood pool imaging as a procedure for assessing radiation-induced injuries to the hands.

The authors discuss radioisotope angiography and blood pool imaging for assessing radiation-induced injuries to the hands and the deterioration or improvement in status during follow-up. Two industrial radiographers in two separate accidents were exposed to 22 Ci to 25 Ci of a Co-60 for 2 to 3 minutes each in February 1985. Subsequently, besides routine clinical examinations and other tests, they underwent a series of amputations and grafts in the digits of the hands. A first-pass study with Tc-99m sodium pertechnetate followed by delayed RBC labeled blood pool imaging was performed in September 1988 in both patients. Both had a reduced flow of tracer to the more affected hand and the affected digits. A repeat study performed in March 1989 revealed improvement in perfusion to the more affected hand in the first patient and no change in the second. Delayed blood pool imaging did not reveal any change. The improvement in flow also coincided with the reduction of pain in the affected digits of the first patient. The authors conclude that isotope angiography followed by delayed blood pool imaging is a simple, noninvasive procedure to assess radiation-induced damage to extremities and to evaluate deterioration or improvement during follow-up.

Accidents, Occupational

Differentiated thyroid carcinomas in children and adolescents.

An analysis of differentiated thyroid carcinomas in children and adolescents revealed that the incidence was 3.05% of total number of patients with differentiated thyroid cancers in all age groups. There was a female preponderance. The incidence of papillary, follicular and papillary with follicular elements was equal. There were no papillary carcinomas observed in children younger than 10 years. The predominant mode of presentation was a solitary nodule of thyroid and some of them had associated cervical adenopathy. A considerable number presented with only cervical adenopathy. The incidence of nodal metastases was 50% at time of presentation and lung involvement was present in 15% of children at the time of diagnosis. Radioiodine treatment was given in 70% of children. Ablation was achieved in 86% of patients given two doses of radioiodine (200 millicuries). The more resistant cases were those with lung and nodal metastases. There was complete ablation in 100% with only residual thyroid tissue, 83% in those with associated nodal metastases, and 57% in those with lung involvement. Average duration of follow-up was 10.3 years (range, 2 to 19 years). Recurrence rate or relapse was observed in 8.5% and was in the regional nodes. There was no recorded mortality due to the disease.

Adenocarcinoma

Regional distribution study of brain perfusion and metabolic agents in normal and tumour bearing rat brains using autoradiographic technique.

Regional distribution of brain perfusion imaging agents, [131I]N,N,N'-trimethyl-N'-[2-hydroxy-3-methyl-5-iodobenzyl]1,3 propanediamine (HIPDM) and [131I]-N-isopropyl-p-iodoamphetamine (IMP), was compared with the distribution of patterns of [14C]L-methionine and [14C]D-glucose in normal and tumour bearing rat brains using autoradiographic technique. There was higher concentration of the radiopharmaceutical in grey than white matter in normal rat brain. Autoradiographs of brain tumour sections showed very low uptake of [131I]HIPDM and [131I]IMP as compared to normal brain tissue. There was moderate concentration of [14C]D-glucose and avid uptake of [14C]L-methionine in tumours. Autoradiographic study is useful for evaluating distribution patterns of radiopharmaceuticals.

Amphetamines

Total and free thyroid hormone levels in chronic renal failure.

The levels of serum total thyroxine (TT4), triiodothyronine (TT3), free T3, (FT3) free T4 (FT4) and thyrotropin (TSH) were measured in 127 clinically euthyroid patients with varying grades of chronic renal failure (CRF); and 97 healthy individuals. They were grouped as: Group I containing 93 patients on conservative management; Group II containing 34 patients on regular dialysis therapy; and Group III (normals). Group I patients showed significant decrease in TT3, TT4 and FT3 levels (p less than 0.001) as compared to Group III, whereas FT4 and TSH values in group I were not significantly altered. TT3, TT4 and FT3 levels reduced as the severity of renal damage increased. Variations in TT3, TT4, FT3, FT4 and TSH levels in Group II patients were similar to those in Group I, except for a decrease in TSH levels (p less than 0.05) as compared to normals. Several thyroid function tests are abnormal in CRF patients, however, finding of normal FT4 and TSH levels would indicate functional euthyroid status.

Humans

Determination of free thyroxine in serum using column chromatography & radioimmunoassay.

A simple method for measurement of free thyroxine (FT4) levels in serum by adsorption chromatography and subsequent radioimmunoassay (RIA) is described. Assay sensitivity observed by this method was 1.2 pg/ml. Intra-assay variability was 11.2 per cent for FT4 concentrations of 7.9 pg/ml (n = 10), while interassay variability was 23.3, 9.7 and 12.9 per cent respectively for concentrations of 2.66, 12.06 and 23.96 pg/ml (n = 16). Serum FT4 concentration estimated by this method in 79 euthyroid patients was found to be 10.8 +/- 3.1 pg/ml. Values of FT4 obtained in hypothyroid and hyperthyroid patients were outside the normal range. FT4 values obtained by this method correlated well with the standard Liso-phase FT4 kit (r = 0.8) as well as free FT4 index (r = 0.93).

Chromatography

Monumental masons: lead and other hazards of an old trade re-visited.

A survey of lead exposure amongst gravestone inscription writers was undertaken in 12 firms of monumental masons in London and one in the East Midlands. The mean blood lead concentration in the 25 men studied was 35 micrograms/dl, with six workers exceeding 40 micrograms/dl. The four highest levels were 49, 57, 78 and 89 micrograms/dl respectively, indicating that substantial occupational exposure to lead was occurring. The men were unaware of the risks of lead exposure and the importance of not smoking or eating in their workshops. The stonemasons understood the hazards of granite stone dust, but an unexpected and common finding was an unacceptably high exposure to marble dust.

Dust

Etiology of childhood hypothyroidism.

This study prospective without any selection bias included 80 of the 152 hypothyroid infants and children seen over the past six years. The clinical diagnosis was confirmed by TSH and thyroid hormone (T3, T4) studies. Scanning for thyroid with TC99m pertechnetate was carried out in all except seven older children with grade II and III goiters where 131I uptake studies were done. Serum thyroglobulin (RIA) was estimated and antithyroglobulin and antimicrosomal antibodies were tested. Based on thyroid 131I scan or 131I uptake, 52.5% had no demonstrable thyroid tissue except one with hypoplasia (Group I, n = 42), 25% had ectopic thyroid (Group II, n = 20), and 22.5% had normal or enlarged thyroid gland (Group III, n = 18). One hypothyroid patient of Group III had thyroiditis with high antibody titre and one was proved to have iodine deficiency). The mean age at time of diagnosis was lowest in Group I (age in months--30.3 +/- 36.2; 60.6 +/- 53.9; 106.2 +/- 69.3 in Groups I, II and III respectively. The intergroup differences in age were significant. The mean serum Tg levels increased progressively from Groups I to III. In the present series thyroid dysgenesis led to hypothyroidism in 77.5%, with athyreosis in 52.5% and ectopia in 25%. Dyshormonogenesis was noted in 20% and thyroiditis in 1.5%.

Adolescent

Biological monitoring of occupational exposure in the chromate pigment production industry.

A survey of occupational exposure to hexavalent chromium in chromate pigment production was undertaken in factories producing lead chromate (PbCrO4) and strontium chromate (SrCrO4). Sampling pre and post-shift in a factory where SrCrO4 production had just started showed the optimum strategy for biological monitoring is the measurement of urinary chromium, in urine samples taken at the end of Friday shift and pre-shift the following Monday. However, short-term uptake may be assessed under these circumstances by the increase in urinary chromium over a shift. Body burden, representing long-term chromate exposure is best assessed by measuring chromium in whole blood or pre-shift urinary chromium at the beginning of the working week. Exceptionally high levels of chromium in blood (387-4160 nmol l-1) and urine (41-1250 nmol nmol-1 creatinine) as well as skin and nasal lesions, were discovered amongst the workforce at the strontium chromate plant. These contrasted with occupationally unexposed levels of less than 20 nmol l-1 and less than 1 nmol nmol-1 creatinine, respectively, and led to the continuation of the biological monitoring programme. At the same time, improved working practices and respiratory protection equipment were introduced. A steady elimination of chromium from whole blood with a half-life of approximately 24 days was found. This elimination rate was confirmed over a 14 day period when the workforce were completely removed from exposure. The study confirms the usefulness of biological monitoring in assessing the uptake of hexavalent chromium and control of exposure.

Chromates

Interactions of m-xylene and aspirin metabolism in man.

In a series of experiments to investigate interactions between industrial solvents and common medications the interaction between m-xylene and aspirin was studied. As both these substances are metabolised and excreted as glycine conjugates there would possibly be competition for this conjugation pathway. Five male volunteers were exposed on separate occasions to m-xylene by inhalation (100 ppm), aspirin (1500 mg) by mouth, and m-xylene and aspirin together under controlled conditions in an exposure chamber. Urine and blood samples were collected and analysed for m-xylene, aspirin, and their metabolites. The amounts of the major glycine conjugates produced from m-xylene (m-methylhippuric acid) and aspirin (salicyluric acid) were significantly reduced by about 50% when m-xylene and aspirin were coadministered. There appears to be a mutual inhibition on the formation of the respective glycine conjugates. It is suggested that the inhibition is due to competition for either the enzymes, acyl-CoA synthetase, or glycine N-acylase. These findings have implications in the biological monitoring of workers exposed to m-xylene.

Adult