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Biomedical subjects

A Steel

Publications and source records attributed to A Steel.

At least 37 records · Page 2Linked to original sources

Dissection of discrete kinetic events in the binding of antibiotics and substrates to the galactose-H+ symport protein, GalP, of Escherichia coli.

GalP is the membrane protein responsible for H(+)-driven uptake of galactose into Escherichia coli. It is suggested to be the bacterial equivalent of the mammalian glucose transporter, GLUT1, since these proteins share sequence homology, recognise and transport similar substrates and are both inhibited by cytochalasin B and forskolin. The successful over-production of GalP to 35-55% of the total inner membrane protein of E. coli has allowed direct physical measurements on isolated membrane preparations. The binding of the antibiotics cytochalasin B and forskolin could be monitored from changes in the inherent fluorescence of GalP, enabling derivation of a kinetic mechanism describing the interaction between the ligands and GalP. The binding of sugars to GalP produces little or no change in the inherent fluorescence of the transporter. However, the binding of transported sugars to GalP produces a large increase in the fluorescence of 8-anilino-1-naphthalene sulphonate (ANS) excited via tryptophan residues. This has allowed a binding step, in addition to two putative translocation steps, to be measured. From all these studies a basic kinetic mechanism for the transport cycle under non-energised conditions has been derived. The case of genetical manipulation of the galP gene in E. coli has been exploited to mutate individual amino acid residues that are predicted to play a critical role in transport activity and/or the recognition of substrates and antibiotics. Investigation of these mutant proteins using the fluorescence measurements should elucidate the role of individual residues in the transport cycle as well as refine the current model.

Amino Acid Sequence↗

Assessment of the response to chemotherapy in oesophageal cancer.

Thirty-eight patients with localised oesophageal carcinoma have been studied by computed tomography (CT) and barium swallow before and after preoperative chemotherapy and the results correlated with the pathological findings in the resected specimen. Overall 48% of patients showed a complete or partial response to chemotherapy on CT, compared with 50% on barium and 94% on pathological examination. This study highlights deficiencies in CT scanning and barium swallow as methods of assessing the regression of tumor bulk following chemotherapy for oesophageal carcinoma. We suggest that strict and specific criteria will have to be laid down before the results of chemotherapy in this disease can be reliably and accurately evaluated.

Aged↗

A phase II study of 5-fluorouracil, adriamycin and mitomycin-C in adenocarcinoma of the oesophagus.

We have evaluated the effect of 5-fluorouracil 600 mg/m2, doxorubicin ('Adriamycin') 40 mg/m2, and Mitomycin-C 4 mg/m2 (FAM) in two groups of patients with adenocarcinoma of the oesophagus, as either a preoperative or primary treatment. Response was assessed by barium swallow, CT scan, and measurement of metastases where present. Toxicity was as reported for FAM in gastric cancer. In the operated group 8 of 22 patients (36%) showed a partial response following two courses of FAM. Resection was completed in 20 patients, with six hospital deaths (30%). Of the 14 patients who were discharged from hospital, 8 have died (median 8 months) and 6 are alive at 12 to 27 months, with known recurrence in 1. In the non-operated group 6 of 17 patients (35%) showed a response, one complete, following one to six (mean 4.2) courses of FAM. Fifteen patients have died (median 5 months), and 2 are alive and free from disease at 12 and 17 months. Neoadjuvant therapy with FAM in adenocarcinoma of the oesophagus offers no advantage over surgery alone, although with inoperable disease FAM may be of use in palliation.

Adenocarcinoma↗

Cervical Crohn's disease with oesophago-pulmonary fistula.

We report what we believe to be the first case of Crohn's disease involving the cervical oesophagus with an oesophago-pulmonary fistula to the apex of the lung. The proximal location of the disease prevented radical therapy and the patient eventually died from chronic sepsis.

Crohn Disease↗

Left-sided subtotal oesophagectomy for carcinoma.

Oesophageal resection for carcinoma has been performed using a two-part left-sided approach with cervical anastomosis in 75 patients, all of whom have been followed up to death or for a minimum of 5 years. Operative mortality was 12 per cent, but long-term survival was 28 per cent for all squamous tumours and 12 per cent for all adenocarcinomas, irrespective of node status. It is suggested that this approach offers significant advantages.

Adenocarcinoma↗

An unusual case of necrotising fasciitis.

A case of subcutaneous necrotising ulceration presenting on the chest wall following a dental abscess is described. The course, surgical treatment, chemotherapy and successful outcome of the case are annotated. The bacteriological findings in this and other cases presenting similarly are discussed, and the possible implication of bacteroides species, alone or in conjunction with Str. milleri, as an aetiological factor in this condition is discussed.

Adult↗

Small-bowel mucosa in asymptomatic children with celiac disease. Mucosal changes with gluten-free diets.

Even though children with celiac disease may appear to be progressing satisfactorily while taking gluten-free diets, dietary lapses and persisting mucosal abnormalities are common. Of 32 children with celiac disease proven by biopsy only ten kept regularly to their diet, and 11 continued to ingest gluten regularly. Despite satisfactory clinical progress, intestinal biopsy specimens obtained after at least one year of a gluten-free diet were markedly abnormal in eight and were normal in only 14 children. Laboratory criteria also failed to detect those with persisting mucosal abnormalities. The only way to ensure that the small-bowel mucosa returns to normal and remains so is by intestinal biopsy.

Adolescent↗

Secretory otitis media due to a hair-bearing dermoid of the mastoid cavity.

A case of persistent unilateral secretory otitis media occurring in an elderly patient is described. The aetiology of the condition proved to be due to a dermoid lying in the mastoid cavity. The clinical, radiological and histological features are described, with comments as to the association which might have existed linking these two conditions. Comment is made concerning the aetiology of dermoid cysts within the mastoid antrum.

Aged↗