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Biomedical subjects

B J Ransil

Publications and source records attributed to B J Ransil.

At least 73 records · Page 4Linked to original sources
PubMed1986

Scanning electron microscopy of Barrett's epithelium and its correlation with light microscopy and mucin stains.

The surface epithelial cells of Barrett's esophagus were characterized using quantitative scanning electron microscopy and light microscopy with mucin histochemical stains. Fifty-one biopsy specimens of Barrett's esophagus from 15 patients and 31 control specimens of the stomach and intestines from 9 patients were examined. Three distinct surface cell types, in addition to the goblet cell, were recognized in Barrett's epithelium: the gastric-like cell in 31% of specimens, which was similar to the normal gastric surface cell by quantitative scanning electron microscopy; the intestinal-like cell in 41%, which was most similar to the normal small intestinal surface cell; and the variant cell in 80%, which had a range of surface features. By light microscopy, all specimens with variant and intestinal-like cells were classified as specialized columnar epithelium. The surface mucous cells in Barrett's epithelium displayed a variety of mucin staining patterns with acid nonsulfated (small intestinal-like) mucin present in 90% of specimens and acid sulfated (colonic-like) mucin in 43% of specimens. Quantitative scanning electron microscopy and mucin histochemical stains reveal a striking cellular heterogeneity not apparent by routine light microscopy.

Barrett Esophagus↗
PubMed1986

Natural killer cell response to interferons.

The availability of recombinant interferons has facilitated a comparison of the in vitro effects of interferon-alpha and -gamma upon human natural killer (NK) cells. In the absence of interferon high and low NK responders exist. Repeated testing of the same individuals revealed different but stable NK patterns to in vitro addition of interferon-alpha and -gamma Furthermore, the NK cell response patterns differed depending on whether the interferons were administered in combination or separately. These studies suggest new complexities that must be addressed in the planning and execution of clinical interferon trials. The pattern of responsiveness of human NK cells to interferon-alpha or -gamma or both is highly variable, but stable, within a given individual.

Cytotoxicity, Immunologic↗
PubMed1986

Survival of patients with severe congestive heart failure treated with oral milrinone.

The safety and efficacy of long-term oral milrinone therapy were evaluated over a 2 1/2 year period in 100 patients who had severe congestive heart failure despite conventional therapy. Long-term oral milrinone therapy (27 +/- 8 mg/day initial dose) was well tolerated; drug-related side effects occurred in only 11% of patients and led to drug withdrawal in only 4% of patients. Of 94 patients evaluated after 1 month of therapy, 51% had improved by at least one New York Heart Association functional class. Despite hemodynamic and clinical improvements, life table analysis showed a 39% mortality rate at 6 months and a 63% mortality rate at 1 year of therapy. Characteristics at study entry that predicted death within 6 months included more advanced functional class, impaired renal function, lower right ventricular ejection fraction, presence of nonsustained ventricular tachycardia on 24 hour ambulatory electrocardiography, more impaired baseline hemodynamic function and absence of clinical improvement after 1 month of milrinone therapy. Multivariate analysis selected lower baseline cardiac index and aortic systolic pressure as the most significant variables in predicting death; patients who died of progressive heart failure had less frequent use of antiarrhythmic drugs and greater increases in furosemide and milrinone doses during long-term follow-up than did those who died suddenly. Thus, although milrinone is well tolerated and produces early symptomatic benefits in approximately half of patients with congestive heart failure refractory to conventional therapy, there is no evidence that it improves the high baseline mortality in this disorder.

Administration, Oral↗
PubMed1986

Compartmental pressure monitoring after arterial reconstruction lacks clinical relevance.

Anterior compartmental intramuscular pressure was studied by the continuous-infusion technique during and after arterial reconstruction of the abdominal or lower extremity vessels in 23 patients. Although there were significant differences between the mean pressures in those patients who had proximal or distal arterial reconstruction, the mean pressure did not increase in the sequential preocclusion, occlusion, and postoperative periods during a mean follow-up of 26 hours in proximal reconstructions and 19 hours in distal reconstructions. One patient had pressures consistent with a borderline compartmental syndrome but died of a ruptured left ventricle before complete correlation of the clinical course and pressures could be made. We conclude from this study that although routine measurement of compartmental pressures during arterial reconstruction of the lower extremities yields interesting findings, it makes no important contribution to the clinical management of the patient.

Blood Pressure↗
PubMed1986

Effects of supine and lateral positions on cardiac output and intracardiac pressures: an experimental study.

Hemodynamic measurements in human subjects and in experimental animals are generally made in the supine position; not much attention is paid to potential beneficial or harmful effects of right or left lateral positions on cardiac output or other hemodynamic variables. To evaluate the potential influence of such positional changes on cardiac performance, we measured cardiac output and left and right ventricular pressures (with micromanometer catheters) in anesthetized experimental animals (eight dogs and nine pigs) in the supine, right lateral, and left lateral positions. Cardiac output increased from supine to left lateral (mean +/- SD, 2.6 +/- 0.9 to 3.1 +/- 1.0 liters/min; p less than .001) and from supine to right lateral positions (2.6 +/- 0.9 to 3.1 +/- 1.1 liters/min; p less than .001). There was an associated decrease in arteriovenous oxygen saturation difference from supine to left lateral position (31 +/- 8% to 24 +/- 4%; p less than .001) and from supine to right lateral position (32 +/- 9% to 25 +/- 6%; p less than .001). Left ventricular systolic and end-diastolic pressures increased from supine to left lateral (128 +/- 17/9 +/- 2 to 147 +/- 19/16 +/- 4 mm Hg; both p less than .001) and from supine to right lateral positions (128 +/- 19/9 +/- 2 to 141 +/- 16/16 +/- 7 mm Hg; p less than .01 and p less than .001, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

The relationship of semen parameters to fertilization in patients participating in a program of in vitro fertilization.

Approximately 80% of the patients in a program of in vitro fertilization (IVF) will fertilize an oocyte. The purpose of this study was to determine which parameters of the semen analysis influence fertilization in vitro. Of 120 patients participating in an in vitro fertilization program, 98 achieved fertilization of at least one mature oocyte and 22 did not. Ovulation induction was standardized and patients whose sperm was exposed to at least one mature oocyte (by light microscopy) were included in the study. Semen washing was accomplished using a "swim-up" technique. Semen parameters were assessed both before (raw) and after washing. Following insemination with 100,000 motile sperm, fertilization was determined by the presence of pronuclei or cleavage. Mean sperm count and motility were higher in patients who fertilized. However, morphology was similar. Fertilization was more likely to occur with a raw density greater than 104 million/ml and a motility greater than 64%, as well as with a density greater than 18 million/ml and a motility greater than 86% following washing. Furthermore, washing lowered sperm counts by 75% and increased motility by 25% but had no effect on morphology. This study demonstrates that sperm count and motility, but not morphology, influence fertilization in a program of in vitro fertilization and that patients with higher counts and motility have a greater probability of fertilization.

Female↗
PubMed1985

Comparison of follicular response in patients with one or two ovaries in a program of in vitro fertilization.

Some patients undergoing in vitro fertilization have had a previous oophorectomy. The purpose of this study was to provide a preliminary comparison of the follicular response to ovulation induction with sequential clomiphene citrate and human menopausal gonadotropin (hMG) in patients with one (n = 14) or two (n = 14) ovaries. No statistically significant differences were detectable in the following parameters: mean number of ampules of hMG required, mean number of days of hMG therapy, mean number of follicles greater than 15 mm on ultrasound, mean number of mature or number of immature oocytes, mean number of embryos transferred, and number of pregnancies. Patients with both ovaries in situ demonstrated a trend for greater numbers of follicles greater than 15 mm aspirated at laparoscopy (5.9 versus 3.4, P = 0.03). We conclude that the presence of a single ovary does not appear to influence the outcome of in vitro fertilization.

Clomiphene↗
PubMed1984

Accessory cell requirement for activation antigen expression and cell cycle progression by human T lymphocytes.

Stringent accessory cell (AC) depletion by a three-step procedure--plastic adherence, nylon wool adherence, followed by simultaneous treatment with two anti-AC monoclonal antibodies + complement--has allowed the demonstration of several AC-dependent stages in the T cell activation pathway. Simultaneous analysis of DNA content and cell surface immunofluorescence (correlation of activation antigen expression with cell cycle position) or DNA and RNA content (cell cycle position) of cultured cells was accomplished by dual parameter flow cytometry. AC-depleted, PHA-stimulated human peripheral blood T lymphocytes (PBTL) failed to exhibit "early" indicators of activation, including increased RNA content, expression of three activation-associated cell surface proteins (IL 2 receptor, transferrin receptor, and 4F2 protein), and the production of IL 2. The AC-depleted PBTL that failed to express these "early" markers of activation also failed to progress into the "late" phase of activation, DNA synthesis. All indicators of PHA responsiveness were fully replenished upon addition of AC but were only reconstituted to intermediate levels by addition of excess quantities of either highly purified IL 1 or crude AC-conditioned medium with lymphocyte-activating factor activity. These data suggest that the AC membrane plays a key and as yet undefined role in the stimulation of T cells by PHA.

Antigen-Presenting Cells↗
PubMed1984

Equilibration between breast surface and ambient temperature by liquid crystal thermography.

Controversy surrounds the need for a waiting period (equilibration, or cooling period) before obtaining a breast thermogram. Temperature differences between an intrinsic lesion (carcinoma) and the overlying skin are said to be amplified by cooling of the skin. Some investigators have found no qualitative difference between thermographic evaluations done 3-15 minutes after the patient disrobes; others assert that tests done within this period are invalid. We evaluated nine ovulatory women thermographically twice during a menstrual cycle (proliferative and secretory phases) to ascertain the significance of such a waiting period and to investigate when thermal equilibrium is achieved with the environment. Breast thermograms were obtained with a cholesteric liquid crystal contact plate at 1-minute intervals for a 20-minute period following exposure of the breast to a room temperature of 72 F (22 C). A significant drop in breast skin temperature was found to occur during the first 15 minutes before equilibrium takes place; this finding suggests that a waiting period is necessary for accurate evaluation.

Adult↗
PubMed1984

Classification of human senile cataractous change by the American Cooperative Cataract Research Group (CCRG) method: III. The association of nuclear color (sclerosis) with extent of cataract formation, age, and visual acuity.

Nineteen hundred and seventy-six immature human cataracts extracted intracapsularly were classified according to the Cooperative Cataract Research Group (CCRG) method of cataract classification. Data on cataract location and extent, nuclear color, preoperative visual acuity, age, and sex were organized and stored in the PROPHET system. The data were examined for relationships between nuclear color (sclerosis) and the age of the cataractous lens, the extent of opacification in seven anatomical regions including the degree of nuclear opacification and the preoperative visual acuity. Nuclear color correlates with age in a curvilinear manner. Nuclear yellowing increases gradually with increasing nuclear opacification, but the color change is so slight as to be useless for the purposes of inferring the intensity of nuclear opacification from the color of the nucleus. There is no association between the extent of anterior cortical, equatorial cortical, posterior cortical, subcapsular or supranuclear opacification, and nuclear color. Nuclear color impairs vision only for the range dark yellow through black. These data justify the recommendation that nuclear color be abandoned as the single index of the severity of any type of senile cataractous change.

Age Factors↗
PubMed1982

Hyperprolactinaemia in males with and without pituitary macroadenomas.

To ascertain whether in hyperprolactinaemic men pituitary macroadenomas represent the end stage of a disease process wherein the only early symptom is impotence, the features of 16 hyperprolactinaemic men with radiological evidence of pituitary macroadenomas were compared with those of 10 hyperprolactinaemic men without pituitary macroadenomas. All were impotent and 25 had low serum testosterone levels. The group with pituitary macroadenoma was older (48.1 vs 63.2 years) and had tolerated impotence for longer (10.4 +/- 6.0 vs 4.5 +/- 2.1 years). 6 of them had visual field defects (none in the other group), 14 had hypopituitarism (1 in the other group), and 14 were initially seen for problems other than sexual dysfunction (whereas all 10 without pituitary macroadenomas were seen primarily for evaluation of recent onset of impotence). In the macroadenoma group bromocriptine restored serum prolactin levels in 13 of the 16 and serum testosterone and potency in 5, whereas in the non-tumour group it restored serum prolactin levels in all 10 and serum testosterone and potency in 9.

Adenoma↗
PubMed1982

Serial first morning estriol determinations in evaluating the high-risk obstetric patient.

Over the past decade, 24-hour urinary estriol determination has become an integral part of the evaluation and monitoring of high-risk obstetric patients for fetal well-being. This study was undertaken to assess the utility of estriol determinations obtained by simpler collection methods: serum estriol and first morning urine specimens. Serum estriol proved to be an unreliable predictor of 24-hour urine values and of estriol fluctuations. Although the correlation between first morning and 24-hour primary estriol:creatinine ratios was statistically significant (P less than .0001), any single first morning specimen value chosen at random was a poor predictor of the corresponding 24-hour specimen value. However, in the monitoring of high-risk obstetric patients, it is the significant changes with respect to time rather than the absolute estriol levels that are of interest. As the plots of first morning and 24-hour specimen values with respect to time in 8 subjects exhibit time trends of equivalent diagnostic utility, it it concluded that first morning values may be used in place of 24-hour values to monitor high-risk obstetric patients, making the process simple and quicker.

Creatinine↗
PubMed1982

Vitreous variation in vitreous fluorophotometry.

Clinical vitreous fluorophotometry is a technique used to evaluate the early breakdown of the blood-retina barrier, which is often seen in diabetic retinopathy. However, the test does not take into account the possibility of individual variations of fluorescein diffusion in the vitreous body. This study undertook to follow the diffusion of a fluorescein solution in 20 different bovine vitreous bodies in a laboratory setting. The results showed a broad distribution of fluorescein diffusion in the sampled population. By statistical analysis, at least three subgroups, differing with respect to the fluorescein dye diffusion pattern, were identified. Further experiments suggest that variation in hyaluronic acid structure in vitreous bodies might account for these differences.

Animals↗
PubMed1981

The effect of hypophysectomy on experimental endothelial cell regrowth and intimal thickening in the rat.

We studied the influence of hypophysectomy on endothelial cell regrowth and intimal thickening following aortic endothelial removal. Modification of this influence by replacement doses of glucocorticoids, mineralocorticoids, thyroxin, and growth hormone also was investigated. Young adult male rats were used, and endothelial removal was achieved by the balloon catheter method. Percent endothelial regrowth and percent intimal thickening were quantified 1 or 2 weeks after injury (3 or 5 weeks after hypophysectomy). One week after injury, endothelial regrowth was 64% in hypophysectomized rats and only 54% in controls. At 2 weeks, values were 80% and 79% respectively. Intimal thickening (percent of wall thickness due to intima) at 1 week was 11% in hypophysectomized and 14% in control rats. At 2 weeks, values were 13% and 22%, respectively. All differences between hypophysectomized and control rats at 2 weeks were statistically significant. Neither endothelial regrowth nor intimal thickening in hypophysectomized rats was altered by hormone replacement. Comparison of areas in which endothelium had not regrown suggested that hypophysectomy had a direct effect on intimal smooth muscle cell proliferation. Thus, hypophysectomy suppresses intimal thickening and accelerates endothelial regrowth after wall injury. Neither effect depends on certain known hormones, and these effects are to some extent independent of one another. These findings are relevant to recent work on growth factors and atherogenesis.

Animals↗