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Biomedical subjects

A Norris

Publications and source records attributed to A Norris.

48 records · Page 3Linked to original sources

Could it be myotonic dystrophy? Myotonic dystrophy presenting with atrial flutter.

Myotonic dystrophy is a well recognised and well defined multisystem disorder which is inherited in an autosomal dominant fashion through a locus on chromosome 19. The disease itself is characterised by rigidity and degeneration of skeletal muscle, cataract formation, gonadal atrophy, frontal baldness and mental retardation. Like many inherited disorders there is a variable expression and so diverse clinical presentations can occur.

Adult↗

T-cell dominated inflammatory reactions in the bronchi of asthmatics are not reflected in matched bronchoalveolar lavage specimens.

Samples of bronchoalveolar lavage (BAL) and endobronchial biopsies were obtained from five patients with clinically diagnosed asthma (ATS criteria). A comparison was made of the presence and distribution of immunocompetent lymphocytes and macrophages within each sample. Significantly raised numbers of T lymphocytes, CD45RO+ lymphocytes, RFD1+ macrophage-like cells and RFD7+ macrophages were seen in the bronchial biopsies. In contrast four out of five of the BAL specimens showed a normal differential cell count, the one exception being a patient exhibiting a degree of lymphocytosis. Further, immunocytological investigation demonstrated a normal distribution of T-cell subsets and macrophage subsets in asthmatic BAL with the exception that in four out of five of these patients a raised number of macrophage-like cells exhibiting phenotypic markers of monocytes was observed. Correlation between BAL and biopsy data was seen in the number of CD45RO+ T-cells present. No other parameters exhibited a significant correlation. Raised expression of HLA-DR was recorded in all asthmatic biopsies, yet lavage cells from the same patients failed to exhibit any increase of HLA-DR density over normal. It is concluded that the immune-associated inflammation present in endobronchial biopsies of clinically stable asthmatics is not reflected in bronchoalveolar lavage samples taken from the same patients.

Acute-Phase Reaction↗

Lung function and immunopathological changes after inhaled corticosteroid therapy in asthma.

Six patients with asthma (American Thoracic Society (ATS) criteria), maintained on inhaled beta 2-agonists alone, were treated with inhaled corticosteroid (budesonide 400 micrograms b.d.) for a period of three months. Prior to steroid therapy, baseline spirometry, bronchodilator response and bronchial hyperresponsiveness were documented and endobronchial biopsies were obtained for immunopathological analysis. Frozen sections of the biopsies were investigated using immunoperoxidase methods, with a panel of monoclonal antibodies selected to reveal the presence and distribution of lymphocyte and macrophage subsets and HLA-DR expression. After three months the studies were repeated. Studies before steroid therapy revealed a T-cell-dominated inflammation in the bronchial wall of all subjects. Baseline airway obstruction, median (range) forced expiratory volume in one second (FEV1) 78.5 (61-109)% of predicted, with a significant bronchodilator response 20.8 (14-33)% and bronchial hyperresponsiveness to histamine geometric mean (SD) PC20FEV1 0.69 (2.5) mg was documented. Steroid therapy caused a significant reduction in bronchial hyperresponsiveness to histamine, with an increase in geometric mean PC20FEV1 to 2.22 (3.2) mg post steroid (p less than 0.03). Concurrent with a reduction in bronchodilator response and an increase in spirometric variables (improved forced midexpiratory flow (FEF25-75) p less than 0.03), there were marked reductions observed in the overall numbers of T-lymphocytes (CD 2, 5, 8), the numbers of CD45RO+ T-cells, and the numbers of macrophages (RFD1+) with the phenotype of antigen presenting cells. In all six subjects, reductions in the quantitative expression of HLA-DR molecules were also seen.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗

T cell dominated inflammatory reactions in the bronchioles of asymptomatic asthmatics are also present in the nasal mucosa.

Endobronchial and nasal mucosa biopsies were obtained from 5 patients with clinically-stable, diagnosed asthma (ATS criteria). A comparison was made of the presence and distribution of immunocompetent lymphocytes and macrophages within each sample. The distribution of immunocompetent cells within the nasal biopsies of the asthmatic patients reflected a very similar inflammatory infiltrate to that seen in the bronchial biopsies. Significantly raised numbers of T lymphocytes, CD45RO + lymphocytes, RFD1 + macrophage-like cells and RFD7 + macrophages were seen in both the nasal mucosa and the bronchial biopsies. Increases in HLA-DR expression were also seen in the nasal mucosa biopsies from asthmatics although the increases over normal did not reach statistical significance. It is concluded that inflammation present in the nasal mucosa of asymptomatic asthmatics exhibits cellular characteristics also seen in endobronchial biopsies. This observation offers the possibility that mucosal biopsy may be an alternative and less invasive approach for studying the cells involved in the bronchial inflammatory reaction that possibly predisposes asthmatics to bronchial hyper-responsiveness.

Adolescent↗

How can you help employees give up?

A consultant clinical psychologist who has run smoking withdrawal clinics for the last ten years, believes he has developed a successful programme for smoking cessation based on his own research and clinical experience into the difficulties which thwart people when they try to give up. Dr Allan Norris offers advice to OH professionals on how to help such employees.

Humans↗

Urban African-American and Hispanic adolescents and young adults: who do they talk to about AIDS and condoms? What are they learning?

This paper reports on the first qualitative part of a study designed to investigate factors related to the use of condoms among African-American and Hispanic adolescents and young adults in Detroit. This paper describes who young, urban, African-American and Hispanic persons talk to about AIDS and condoms and what they are learning. The paper provides data on attitudes and beliefs about AIDS and condoms that are needed for further research and for prevention programs.

Acquired Immunodeficiency Syndrome↗

Smoking cessation workshops for GPs.

The prevention of smoking has been identified by the World Health Organisation as the most potentially effective preventive health measure that developed countries can take. The role of the GP in this process is crucial. A three-hour smoking cessation workshop attempts to improve counselling skills and includes a suggested role for the GP and a smoking withdrawal protocol.

Counseling↗

Effects of nedocromil sodium on antigen-induced conjunctivitis in guinea pigs.

We evaluated nedocromil sodium in a guinea pig model of allergic conjunctivitis. Ten days after the animals were passively sensitized to ovalbumin, nedocromil sodium (2 mg) or normal saline was instilled into the conjunctival sac, followed by antigen challenge with ovalbumin (100 micrograms or 300 micrograms/10 microL). Conjunctival hyperemia, edema, and eyelid edema were evaluated at 10 minutes and 4 hours in the 100-microgram ovalbumin group. Eyes with nedocromil sodium exhibited fewer early and late clinical signs of allergic conjunctivitis than control eyes. Infiltrating eosinophils were counted at 24 hours in the 300-microgram ovalbumin group. Nedocromil sodium inhibited antigen-induced eosinophil infiltration into the limbus, fornix, and eyelids by 77%, 66%, and 74%, compared with controls. Nedocromil sodium can effectively suppress early- and late-phase conjunctival hyperemia, conjunctival edema, eyelid edema, and eosinophil infiltration in the guinea pig passive-sensitization model. Nedocromil sodium may represent a versatile option for the treatment of allergic conjunctivitis.

Animals↗

Nedocromil sodium in two models of conjunctival immediate hypersensitivity.

The effects of intravenous administration of nedocromil sodium were investigated in active and passive models of conjunctival immediate hypersensitivity in rats. In the active sensitization model, animals were immunized with ovalbumin 21 days prior to ocular instillation of a solution containing ovalbumin. Nedocromil sodium administered prior to antigen challenge significantly inhibited emergence of conjunctival edema and erythema (P < .05) and reduced mast cell degranulation (P < .02). In the passive-sensitization model, the conjunctiva in one eye was injected with ovalbumin antiserum 48 hours prior to intravenous administration of ovalbumin. Nedocromil sodium administered prior to antigen challenge significantly and dose-dependently reduced appearance of the signs of conjunctivitis (P < .01) as well as vascular leakage (P < .05). These data indicate that intravenous nedocromil sodium is effective in animal models of allergic conjunctivitis and may have potential for wider therapeutic application. These data are also consistent with results of clinical studies in which nedocromil sodium relieved symptoms of allergic conjunctivitis and further support a role for nedocromil sodium in the prevention of allergic conjunctivitis.

Animals↗

Cyclotorsional diplopia following retinal detachment surgery.

Four patients reporting symptoms of torsional diplopia following retinal detachment repair were seen. One patient most likely had a pre-existing, partially compensated superior oblique palsy as the cause of her vertical deviation and excyclotorsion. A second was found to have the superior oblique tendon adherent anteriorly to the encircling band and buckle just behind the superior rectus insertion, resulting in incyclotorsion. Release of these restrictions reduced the torsion to a small, asymptomatic degree. The third and fourth patients had excyclotorsion for unexplained reasons. Removing the scleral exoplant and Harada-Ito type surgery on the superior oblique tendon did not relieve the symptoms and only minimally reduced the excyclotorsion in one patient. A second procedure, with advancement of the anterior portion of the superior oblique tendon, successfully eliminated cyclotorsional symptoms.

Adolescent↗