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Biomedical subjects

A R Bailey

Publications and source records attributed to A R Bailey.

At least 19 recordsLinked to original sources
PubMed2007

Peri-operative atrioventricular block as a result of chemotherapy with epirubicin and paclitaxel.

A 47-year-old woman presented for mastectomy and immediate latissimus dorsi flap reconstruction having been diagnosed with carcinoma of the breast 6 months previously. In the preceding months she had received neo-adjuvant chemotherapy with epirubicin, paclitaxel (Taxol) and cyclophosphamide. This had been apparently uncomplicated and she had maintained a remarkably high level of physical activity. She was found to be bradycardic at pre-operative assessment but had no cardiac symptoms. Second degree Mobitz type II atrioventricular block was diagnosed on electrocardiogram, and temporary transvenous ventricular pacing instituted in the peri-operative period. We discuss how evidence-based guidelines would not have been helpful in this case, and how chemotherapy can exhibit substantial cardiotoxicity that may develop over many years. We suggest that patients who have received chemotherapy at any time should have a pre-operative electrocardiogram even if they are asymptomatic.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2001

Growth hormone secretagogue receptor family members and ligands.

We have previously reported the cloning and characterization of a new orphan G-protein-coupled receptor (GPC-R), the growth hormone secretagogue receptor (GHS-R), and shown that this receptor mediates the activity of the growth hormone-releasing peptides (GHRPs) and nonpeptide ligands such as L-692,429 and MK-0677. Because the GHS-R obviously does not belong to any of the known GPC-R subfamilies, we searched for GHS-R family members by screening a human genomic library using low-stringency hybridization and screening a Pufferfish genomic library. The Pufferfish was selected because of its compact genome. From the human genomic library, a homolog, GPR38, with 52% identity to the GHS-R was isolated. From the Pufferfish library, three family members were isolated. The Pufferfish gene having 58% identity to the GHS-R, on expression in HEK293 cells, was activated with GHRP-6 and MK-0677. These results indicate that the GHS-R has been conserved for at least 400 million years and that the Pufferfish genome is appropriate for isolation of GHS-R family members. In our search for endogenous ligands for the orphan receptors GHS-R and GPR38, we showed that adenosine is a partial agonist of the GHS-R and that motilin is the endogenous ligand for GPR38. We also confirmed that the endogenous ligand ghrelin is a full agonist of the GHS-R.

Adenosine↗
PubMed2001

Central actions of the nonpeptide growth hormone secretagogue GHS-25.

Growth hormone secretagogues (GHSs) increase the activity of hypothalamic arcuate nucleus neurons thought to be involved in controlling the release of growth hormone (GH). The GHS receptor is also found in hypothalamic regions not associated with the release of GH, suggesting that GHSs may influence other hypothalamic systems. This study utilized double-labeling immunocytochemical techniques to examine the hypothalamic actions of a novel nonpeptide GHS, GHS-25. In common with other GHSs, GHS-25 induced significant amounts of Fos immunoreactivity in the arcuate nucleus of conscious male rats. However, unlike other GHSs, GHS-25 also induced Fos immunoreactivity in the supraoptic nucleus. Double labeling revealed that approx 66% of supraoptic nucleus cells that were Fos positive after the administration of GHS-25 were also immunoreactive for oxytocin. Thus, in addition to its actions on the GH axis, GHS-25 may influence the release of neurohypophyseal hormone.

Animals↗
PubMed2000

Growth hormone secretagogue activation of the arcuate nucleus and brainstem occurs via a non-noradrenergic pathway.

Noradrenergic systems are integrally involved in the release of growth hormone (GH) from the anterior pituitary gland and in regulating the activity of hypothalamic growth hormone-releasing hormone (GHRH) neurones. GH secretagogues act at both the pituitary and the hypothalamus to facilitate the release of GH. In male rats, using the induction of Fos protein as an indicator of neuronal activation, we examined whether neurones in the brainstem, the main noradrenergic input to the hypothalamus, were activated by systemic administration of peptide and non-peptide GH secretagogues. In addition, we examined the effects of chronic central noradrenaline depletion upon GH secretagogue-induced activation of the arcuate nucleus. Systemic injection of the GH secretagogues, GHRP-6 and MK-0677 induced Fos protein expression in a population of area postrema cells, but less than 10% of these cells were noradrenergic. Depletion of hypothalamic noradrenaline by the specific neurotoxin, 5-ADMP, did not alter GH secretagogue-induced activation of Fos protein in the arcuate nucleus compared to vehicle-treated controls. We conclude that the central actions of GH secretagogues involve the activation of non-noradrenergic cells in the area postrema and that GH secretagogue-induced activation of the arcuate nucleus occurs independently of noradrenergic tone.

Animals↗
PubMed2000

The false-positive in universal newborn hearing screening.

OBJECTIVES: Concern has been raised about the frequency and subsequent emotional effect of a false-positive result during universal newborn hearing screening (UNHS). This study describes: 1) the results of 1 UNHS program and a potential method to significantly reduce the false-positive rate, and 2) the effect a false-positive result has on lasting maternal anxiety toward their children as well as their views toward UNHS in general. METHODS: A retrospective analysis was conducted using data from 5010 infants screened with an automated auditory brainstem response (ABR) at the Women's Hospital of Greensboro (WHOG) from July 6, 1998 to June 30, 1999. In addition, a structured telephone survey was given to mothers of infants who had failed the initial hearing screen (stage 1) and who had completed an outpatient rescreen (stage 2). RESULTS: Confirmed hearing loss occurred in non-neonatal intensive care unit infants at a rate of 1.8/1000. A false-positive rate of 1.9% occurred during stage 1 of UNHS (screening before newborn discharge). We attribute this relatively low rate to rescreening of 51% of those newborns who failed the initial screen before hospital discharge. Eighty percent of these rescreened infants passed, thus needing no additional follow-up. If we had rescreened all infants before discharge, the false-positive rate would have approached.5%. Results of the survey were reassuring with regard to lasting emotional effects of false-positive tests. Only 9% of mothers said they "treated their child differently" before outpatient rescreening, and only 14% reported any lasting anxiety after their child passed the outpatient repeat screen. Although none reached statistical significance, potential risk factors for lasting anxiety include more educated mothers, lack of understanding of UNHS, and a false-positive result in both stage 1 and stage 2. Over 90% of all mothers believed that UNHS was a good idea. CONCLUSIONS: By rescreening all infants before hospital discharge, the false-positive rate of UNHS performed using automated ABR can be reduced to <1%. However, for the false-positive results that do occur, any long-lasting and detrimental emotional impact between mother and infant seems to be small and could be reduced even more with improved understanding about UNHS.

Anxiety↗
PubMed1999

An electrophysiological and morphological investigation of the projections of growth hormone-releasing peptide-6-responsive neurons in the rat arcuate nucleus to the median eminence and to the paraventricular nucleus.

Growth hormone-releasing peptide-6 injection induces c-fos messenger RNA expression in many arcuate nucleus neurons, and sub-populations of neurons in this region project to the hypothalamic paraventricular nucleus. We examined electrophysiologically whether arcuate nucleus neurons that project to the paraventricular nucleus also project to the median eminence, and whether these neurons are activated by systemic injection of growth hormone-releasing peptide-6. Of 116 arcuate nucleus neurons tested, 43 were antidromically-identified as projecting to the paraventricular nucleus and a further 30 as projecting to the median eminence; these populations displayed distinct electrophysiological characteristics, and contrasting patterns of orthodromic response to stimulation of the median eminence and paraventricular nucleus, indicating that these two populations are functionally distinct with limited communication between them. Only one cell was antidromically-identified as projecting to both these regions. Three of 10 arcuate nucleus neurons that projected to the paraventricular nucleus were activated by injection of growth hormone-releasing peptide-6. In parallel experiments, we examined whether Fos protein expression is induced in arcuate nucleus neurons that project to the paraventricular nucleus, as identified by retrograde-labelling with FluoroGold. Immunocytochemical studies revealed that 20% of arcuate nucleus neurons that were retrogradely-labelled from the paraventricular nucleus were Fos-positive following growth hormone-releasing peptide-6 injection, although cells that were both Fos-positive and retrogradely-labelled accounted for less than 5% of the total number of Fos-positive arcuate nucleus neurons. These results confirm that there is a direct projection from the arcuate nucleus to the paraventricular nucleus and indicate that growth hormone-releasing peptide-6 activates some of these neurons.

Animals↗
PubMed1999

Chronic central infusion of growth hormone secretagogues: effects on fos expression and peptide gene expression in the rat arcuate nucleus.

Growth hormone (GH) secretagogues induce GH release, in part, by direct actions upon anterior pituitary somatotropes and, in part, by actions upon the neuroendocrine circuitry that regulates GH secretion. In particular, acute systemic administration of GH secretagogues results in increased neuronal activity and Fos protein expression in the arcuate nucleus of the hypothalamus. Prolonged administration of GH secretagogues has been reported to have long-lasting effects upon GH release, promoting increased pulsatile secretion. Here, we investigated how chronic central infusion of GH secretagogues affects the response of arcuate nucleus neurons to acute systemic administration of GH secretagogues. In male rats, after central infusion of GH secretagogues for 5 days, there was no sustained expression of Fos in the arcuate nucleus, no significant induction of Fos expression in response to acute GH secretagogue challenge, and a greatly attenuated secretion of GH in response to acute GH secretagogue challenge, all reflecting loss of funtional responsiveness to GH secretagogues. In situ hybridisation revealed that, in the arcuate nucleus of GH secretagogue-infused rats, mRNA levels for GH-releasing hormone, neuropeptide Y and somatostatin were not different than in saline-infused animals. However, somatostatin mRNA levels in the periventricular nuclei of GH secretagogue-infused rats were significantly higher than those of saline-infused rats, indicating that this nucleus may play an important role in mediating the effects of chronic GH secretagogue administration.

Animals↗
PubMed1999

Growth hormone-releasing hormone and morphine attenuate growth hormone secretagogue-induced activation of the arcuate nucleus in the male rat.

Growth hormone secretagogues (GHS) administered systemically selectively induce growth hormone (GH) release from the pituitary and the expression of Fos protein in arcuate nucleus neurons. Both the control of GH release and the expression of the GHS receptor in the arcuate nucleus are thought to be regulated, at least in part, by the negative feedback actions of GH. In this study, we utilized the immunocytochemical detection of Fos protein to examine the effects of morphine- and GH-releasing hormone (GHRH)-induced GH release on the activation of arcuate nucleus neurons following GHS administration. Given alone, two structurally different GHS induced significant amounts of Fos-LI in the arcuate nucleus of male rats, suggesting activation of cells in this region. Prior administration of morphine or GHRH significantly reduced the number of Fos-positive cells in the arcuate nucleus of rats injected with either GHS, although when given together, morphine and GHRH did not produce a greater reduction in Fos expression than when given alone. In no case was there a complete reduction in Fos expression, indicating that some arcuate nucleus neurons are not subject to the feedback effects of endogenous GH. These results provide evidence that, in the male rat, GH can feedback to the hypothalamus, altering the responsiveness of neurons involved in the central response to GHS.

Animals↗
PubMed1998

The nonpeptide growth hormone secretagogue, MK-0677, activates hypothalamic arcuate nucleus neurons in vivo.

There is accumulating evidence that the hypothalamic arcuate nucleus plays an important role in mediating the effects of growth hormone secretagogues on growth hormone (GH) release from the anterior pituitary gland. One such nonpeptidyl secretagogue, MK-0677, has been shown to directly stimulate growth hormone release from isolated pituitary cells but its central actions remain to be established. Therefore, in the present study, we have employed both immunocytochemical and in vivo electrophysiological techniques to examine the effects of MK-0677 within the hypothalamic arcuate nucleus of the male rat. In conscious male rats, both central and systemic injection of MK-0677 induced fos-like immunoreactivity specifically within the arcuate nucleus indicating selective neuronal activation of neurons within this region. MK-0677 induced-activation was generally confined close to the wall of the third ventricle, whereas systemic injection of the peptide secretagogue, GHRP-6, also induced fos-like immunoreactivity in more lateral regions of the nucleus. In urethane anaesthetized rats, intravenous injection of MK-0677 increased the electrical activity of a population of antidromically identified (i.e. neuroendocrine) arcuate neurons with a similar electrophysiological profile to cells excited by GHRP-6. The activity of neuroendocrine arcuate neurons excited by MK-0677 injection could be attenuated by a subsequent systemic injection of somatostatin. However, the activity of neuroendocrine arcuate neurons unaffected by MK-0677 injection and the activity of non-neuroendocrine arcuate neurons was unaltered by somatostatin injection. Taken together, the immunocytochemical and electrophysiological results suggest that systemic and central administration of MK-0677 activates a population of neurons in the arcuate nucleus. Furthermore, the inhibitory effects of somatostatin on MK-0677-induced excitation of these neuroendocrine cells is consistent with an action of neurons involved in the regulation of GH release.

Animals↗
PubMed1997

Electrophysiological responses of neurones in the rat nucleus tractus solitarius to oxytocin-releasing stimuli.

Neurones in the nucleus tractus solitarius (NTS) of the rat are, at least partially, responsible for mediating the excitatory effects of systemic cholecystokinin (CCK) injection and parturition on oxytocin release. Utilising in vivo electrophysiological recordings in urethane-anaesthetised rats we examined the effects of systemic CCK injection and vaginal distension (VD) on NTS neuronal activity. Approximately 25% of neurones were excited by CCK injection and a population of neurones (24%) responded specifically to VD, but only one neurone responded to both oxytocin-releasing stimuli. NTS neurones that projected to the hypothalamus also responded in a specific manner to either CCK or VD. It is known that the excitatory effects of CCK and VD on oxytocin release are mediated by separate peripheral pathways and the results from this study suggest that separation of these two inputs persists at the level of the NTS.

Animals↗
PubMed1997

Effect of low-dose dopamine on serum concentrations of prolactin in critically ill patients.

Dopamine is a naturally occurring catecholamine with actions in the central nervous system and endocrine systems, including inhibition of prolactin release from the pituitary gland. Prolactin secretion has been shown to be increased in response to physiological stress, while hypoprolactinaemia is associated with a reduction in the cellular immune response. We have investigated the effects of low-dose infusion of dopamine 2.5 micrograms kg-1 min-1 on serum concentrations of prolactin in critically ill patients. Six hours after commencing the dopamine infusion, mean serum prolactin concentration had decreased from 746.95 to 128.9 mu. litre-1 (normal range 84-488 mu. litre-1). This represented a mean reduction of 79.2%, with 35% of patients exhibiting a subnormal concentration while receiving dopamine. This reduction was reversed after cessation of dopamine and reproducible on re-institution. This suppression of the release of dopamine may be a detrimental side effect of low-dose dopamine infusion in critically ill patients.

Adolescent↗
PubMed1997

Patients' memories of events during general anaesthesia.

Awareness remains a serious complication of general anaesthesia with potential adverse psychological sequelae. Even during seemingly adequate general anaesthesia, implicit memory may be retained along with the ability to subconsciously process auditory stimuli. As a result behaviour may be modified and postoperative progress influenced. We shall discuss the structure of memory and the effects of increasing doses of general anaesthesia on cognitive processes. In addition methods of assessing the depth of anaesthesia will be reviewed.

Anesthesia, General↗
PubMed1997

Attenuation of the growth hormone secretagogue induction of Fos protein in the rat arcuate nucleus by central somatostatin action.

We set out to determine whether the central action of growth hormone (GH) secretagogues to induce Fos protein expression in the arcuate nucleus is influenced by central somatostatin action. Conscious male rats were injected i.v. with 100 micrograms sandostatin (octreotide, a long-acting somatostatin analogue) or saline, 10 min before an i.v. injection of either 50 micrograms GH-releasing peptide (GHRP-6), 50 micrograms MK-0677 (a non-peptide GH secretagogue) or saline. In a separate study, conscious male rats were injected i.c.v. with either 2 micrograms sandostatin or artificial cerebrospinal fluid (aCSF) vehicle 20 min before an i.v. injection of 50 micrograms GHRP-6. In all studies, rats were anaesthetized 90 min following GH secretagogue injection, perfused with fixative and the brains processed for the immunocytochemical detection of Fos protein. The number of Fos-positive nuclei detected in the arcuate nucleus of the i.v. sandostatin/i.v. GHRP-6 treated rats (28 +/- 5 nuclei/section) and the i.v. sandostatin/i.v. MK-0677-injected rats (8 +/- 2 nuclei/section) was significantly less than the i.v. saline/i.v. GHRP-6-treated group (56 +/- 5 nuclei/section) and the i.v. saline/ i.v. MK-0677-treated group (20 +/- 2 nuclei/section) respectively. Intracerebroventricular sandostatin injection attenuated the GHRP-6-induced Fos response, from 53 +/- 6 nuclei/section in the i.c.v. aCSF/i.v. GHRP-6 group, to 39 +/- 5 nuclei/section in the i.c.v. sandostatin/i.v. GHRP-6 group. Thus, the central action of GH secretagogues to induce Fos protein expression in the arcuate nucleus appears to be subject to central inhibitory control by somatostatin.

Animals↗
PubMed1994

Inhibition of supraoptic vasopressin neurones following systemic clonidine.

Experiments were undertaken in urethane-anaesthetized rats to investigate the effects of systemic clonidine on the firing of supraoptic vasopressin (VP) neurones, which were identified by their characteristic phasic activity pattern. Injection of clonidine (50 micrograms/kg i.v.) reduced the firing of all 16 VP neurones tested, and their overall mean activity decreased from 5.09 +/- 1.01 to 1.63 +/- 0.64 spikes/second (P < 0.02). In VP cells which were already firing phasically before clonidine, the inhibition resulted in complete quiescence. In VP cells which were originally continuously active, the inhibition resulted in a switch to phasic activity. This inhibitory effect, which was prevented by prior injection of the alpha-2 antagonist idazoxan (0.5 mg/kg), had a mean duration of 11.8 +/- 1.8 min. Subsequent experiments revealed that i.v. clonidine (50 micrograms/kg) caused a transient rise in blood pressure, but this had a shorter time-course and was unlikely to account for the prolonged neuronal inhibition. It was concluded that systemic clonidine acts centrally to suppress the activity of hypothalamic VP neurones, thereby explaining the fall in plasma VP levels found in previous studies.

Animals↗