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Biomedical subjects

A Rudd

Publications and source records attributed to A Rudd.

11 recordsLinked to original sources

Expression of IL-8 by cells of the odontoblast layer in vitro.

Due to their peripheral location in the dental pulp and their cellular extension into dentin, odontoblasts are the first pulpal cells to encounter dental pathogens. The association of odontoblasts with immunoglobulins and dendritic cells during microbial invasion of dentin implies that these cells may possess a role in the innate and adaptive pulpal immune responses, however this has not been examined. A pivotal step in the innate immune response is the detection of foreign antigen and the recruitment of immune effector cells to the area. IL-8 is a potent chemotactic cytokine that plays an important role in the inflammatory response. The purpose of this study was to determine if odontoblasts are capable of expressing the pro-inflammatory chemokine IL-8. Human odontoblasts from intact, noncarious third molars were maintained in culture and exposed to Escherichia coli lipopolysaccharide (LPS) (serotype 055:B5) on day 4 for 8-10 h in a humidified 5% CO2 incubator. Control and experimental samples were assayed by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot for the production of IL-8 mRNA and protein. Analysis of the PCR products revealed that cells of the odontoblast layer maintained in this culture model constitutively expressed low levels of IL-8, which were increased in response to E. coli LPS exposure. Western blotting confirmed that the mRNA was translated into protein. These results imply that odontoblasts are capable of producing of pro-inflammatory mediators, thereby actively participating in the recruitment of neutrophils in response to bacterial by-products.

Blotting, Western

Selection for long-term hospital care.

A formalized system for selecting patients requiring long-term hospital accommodation is described and our first two years' experience presented. Fifty patients were considered by the panel of whom 25 were designated as being suitable to be transferred to a long-term bed. Alternative solutions were considered more appropriate for the remaining 25; only 0.95% of all admissions to the unit finally required long-term hospital care.

Aged

Investigation of anterior pituitary function in elderly in-patients over the age of 75.

Dynamic pituitary function tests were carried out on 50 randomly selected in-patients, (30 women and 20 men) over the age of 75 during early convalescence. Twenty-five subjects also had CT scans of the pituitary fossa. One male patient had hypogonadotrophic hypogonadism; another had a large prolactinoma and hypothyroidism; these were excluded from the analysis. Of the remaining 48 subjects, 14 (29 per cent) had reduced TSH responses to TRH and 28 (64 per cent) decreased GH responses to L-dopa compared with our laboratory's reference ranges. Fifteen women (51 per cent) had low basal gonadotrophin levels of which 10 (34 per cent) gave a poor LH response to LHRH and eight (27 per cent) a poor FSH response. Forty-three subjects (93 per cent) gave a good ACTH response to metyrapone. Only six subjects (24 per cent) had an apparently normal pituitary fossa; 16 (64 per cent) had partially or completely empty fossas. There was no significant correlation between the diminished pituitary responses. Only one patient had responses which suggested panhypopituitarism. There was also no significant correlation between the appearance on CT scan of the pituitary fossa and the results of the dynamic tests. It is suggested that laboratory reference range for pituitary function which have been derived from young ambulatory subjects are not appropriate for hospital in-patients over the age of 75. A series of reference ranges for such subjects is proposed.

Aged

Tuberculosis in a geriatric unit.

All cases of tuberculosis admitted to a geriatric unit over five years were reviewed. The problems involved in diagnosing and managing the disease in the elderly are discussed, emphasizing the importance of diagnosing a treatable disease that may otherwise be fatal.

Aged

Malignant optic nerve gliomas in adults.

Two patients with malignant optic nerve gliomas are described. The clinical courses and radiographic appearances are discussed, with emphasis on the fact that this condition should be considered in the differential diagnosis of rapid visual failure. It can now be strongly suspected preoperatively on the basis of computed tomographic scan appearances.

Adult

A phase II clinical study of mAMSA in small cell carcinoma of the lung.

Thirteen patients with small cell carcinoma of the bronchus that had become resistant to conventional chemotherapy were given 4'-(9-acridinylamino)methanesulphon-m-anisidide (mAMSA) at a dose of 90 or 120 mg/m2 at 3-week intervals. Twenty percent of the courses at 90 mg/m2 produced marked myelosuppression. No responses were observed. Median survival from the start of treatment with mAMSA was 5 weeks.

Aged

Casemix and process indicators of outcome in stroke. The Royal College of Physicians minimum data set for stroke.

The emphasis on outcomes measurement requires that casemix is considered in any comparative studies. In 1996 the Intercollegiate Working Party for Stroke agreed a minimum data set to measure the severity of casemix in stroke. The reasons for its development, the evidence base supporting the items included and the possible uses of the data set are described. It is currently being evaluated in national outcome and process audits to be reported at a later date.

Cerebrovascular Disorders