PubMed HealthSearch

Biomedical subjects

C G Jackson

Publications and source records attributed to C G Jackson.

At least 19 recordsLinked to original sources

Design and synthesis of some substrate analogue inhibitors of phospholipase A2 and investigations by NMR and molecular modeling into the binding interactions in the enzyme-inhibitor complex.

A series of substrate analogue inhibitors of pancreatic phospholipase A2 has been designed and synthesized. The compounds were tested in a novel dual-screening system based on parallel assays with monomeric and micellar substrates. Intermolecular nuclear Overhauser effects between vinylic protons on one inhibitor and identified active site residues on the bovine pancreatic enzyme have been observed in solution NMR studies of the enzyme-inhibitor complex. It can be deduced from both the biochemical results and the NMR data that the mode of interaction between this type of inhibitor and the active site of phospholipase A2 is essentially the same, irrespective of the presence or absence of an aggregated phospholipid surface. A model of the binding between the enzyme and inhibitor which incorporates the two-dimensional NMR data has been developed. The model can account for the activity of modified inhibitor structures and can be extrapolated to an assessment of the mode of binding of the natural substrate itself.

Animals

Bombesin stimulates the rapid activation of phospholipase A2-catalyzed phosphatidylcholine hydrolysis in Swiss 3T3 cells.

In Swiss 3T3 fibroblasts bombesin stimulated the release of arachidonic acid in a time- and dose-dependent manner. Arachidonate levels were significantly elevated after only a 2-s stimulation with the agonist. Furthermore, by measuring the arachidonate content of cellular phospholipids after cell activation, it was shown that there was selective depletion from phosphatidylcholine over the same time course. The corresponding production of lysophosphatidylcholine suggested the involvement of a phosphatidylcholine-specific phospholipase A2. Initial arachidonic acid release was not dependent on the presence of extracellular calcium, not activated by treatment of the cells with thapsigargin, and was unaffected by down-regulation of protein kinase C activity, or by treatment of the cells with the protein kinase C inhibitor staurosporine. These data strongly suggest that occupation of the bombesin receptor is closely coupled to activation of phospholipase A2 which results in the rapid release of arachidonic acid from phosphatidylcholine.

3T3 Cells

Swallowing problems after excision of tumors of the skull base: diagnosis and management in 12 patients.

Acute-onset dysphagia can be a debilitating complication of operative intervention in skull base surgery. A retrospective study performed at Baptist Hospital investigated the oropharyngeal deficits, compensatory swallow techniques, and diet modifications of 12 patients who had undergone excision of skull base tumors. Oropharyngeal dysfunction, reduced laryngeal elevation, and copious pharyngeal retention were the most prominent swallowing deficits. Aspiration occurred in 75% of the patients studied. The most frequently employed compensatory swallow techniques were head turns to the affected side, supraglottic swallow, double swallows, alternating liquids and solids, carbonated beverage swallows, and small bolus size. Approximately 2 weeks following skull base surgery, 58% of the patients were able to tolerate oral intake with the aid of compensatory swallow techniques and diet modifications. Only 1 patient in this group remained unable to tolerate food by mouth. This paper focuses on identification of the disordered components of the swallow and the therapeutic management techniques characteristic of the patient who has undergone excision of a skull base tumor.

Adult

Postoperative radiographic evaluation after acoustic neuroma and glomus jugulare tumor removal.

The role of postoperative radiographic follow-up of patients after acoustic neuroma or glomus jugulare tumor removal is unclear and not standardized. The incidence of both lesions is rare and recurrence thought to be unusual. However, a patient with an acoustic neuroma arising in the same ear afflicted with a glomus jugulare tumor removed 5 years earlier prompted a retrospective review of 999 acoustic neuroma and 98 glomus jugulare tumor patients. This review helps to determine the role and frequency of postoperative follow-up, not only to assess recurrence of these lesions but to monitor for the possible development of potential clinically silent new lesions.

Adult

Defect reconstruction and cerebrospinal fluid management in neurotologic skull base tumors with intracranial extension.

Intracranial extension (ICE) is the spread of tumor into the subarachnoid space through dura or along cranial nerve roots. The single-stage removal of the skull base tumor with its ICE has been confounded by cerebrospinal fluid management and defect reconstruction. The purpose of this report is to review a current protocol for managing the cranial base tumor and its ICE as a unit. The ventricular shunting paper of 1987 is retracted. All tumors were managed at a single stage. Defect reconstruction was size dependent. Ninety-eight neurotologic skull base tumors with ICE were managed from 1971 to 1991. The new protocol was initiated in 1987. Results specific to this group are highlighted. For glomus tumors, cerebrospinal fluid leak rates have been dramatically reduced overall from 14.5% to 4%. The leak rates for nonglomus tumors, overall, have improved slightly. Complications are discussed. The development of this surgical approach protocol improves the functional outcome in patients of surgeons who aspire to disease "cure" rather than "control."

Adolescent

An analysis of the retrolabyrinthine vs. the retrosigmoid vestibular nerve section.

Vestibular neurectomy is gaining widespread acceptance as a primary means of controlling medically refractory vertigo. However, debate continues over the adequacy of vestibular neurectomy within the cerebellopontine angle, long-term control, and the most appropriate surgical approach. To address these issues, we retrospectively reviewed 118 patients who underwent vestibular neurectomy between October 1984 and January 1988. Forty-two patients who underwent a retrolabyrinthine approach and 44 patients who underwent a retrosigmoid approach completed a written questionnaire and provided a recent audiogram. According to American Academy of Otolaryngology-Head and Neck Surgery guidelines, complete or substantial vertigo control was achieved and maintained in 95% of patients in both surgical groups. Hearing, tinnitus, and fullness results over the long term are variable. The advantages and disadvantages of the various vestibular neurectomy approaches will be detailed. On review of our results and surgical experience, we now prefer the retrosigmoid approach.

Adult

Cranial nerve preservation in lesions of the jugular fossa.

The most significant objection to the proposal of lateral transtemporal cranial base surgery for the treatment of jugular foramen tumors is the perceived lasting morbidity attendant to aggregate cranial nerve loss. As techniques become more standardized and earlier diagnosis generates smaller tumors for treatment, outcome has become more predictable. Surgery has become the recognized management preference for these cranial base lesions. The purpose of this article is to assess the role of surgery in the treatment of jugular foramen lesions, as well as to review some of the technical highlights of conservation surgery, its clinical prerequisites, and reasonable expectations. We review 100 lateral skull base surgical cases of lesions involving the jugular foramen. The majority of these lesions--77 of 100--were paragangliomas. For these glomus tumors, cranial nerve preservation correlated well to tumor size and location. The diversity of the remaining 23 cases prevented any substantive conclusions.

Adolescent

Skeletal muscle fiber area alterations in two opposing modes of resistance-exercise training in the same individual.

The purpose of this study was to observe fiber area changes that might occur in the same subject from two opposing resistance-exercise training regimes isolating the quadriceps muscle group. Twelve college-age men divided into two groups participated in each of two 7.5-week regimens; one performed a muscular strength program (high-resistance, low-repetition) 4 days a week on a resistance-exercise apparatus, while the other performed a muscular endurance (low-resistance, high-repetition) program. After a 5.5-week hiatus, the groups changed regimens for the second 7.5 weeks. Closed-needle biopsies of the dominant vastus lateralis and isokinetic dynamometer evaluations were made before and at the end of each training period. The muscle samples were analyzed for area changes. In both groups the initial exercise stimulus, whether for strength or endurance, increased the area of fibers of all three major types (I, IIA, and IIB). Subjects doing strength exercises as their second treatment showed a further increase in the area of type I and IIB fibers, whereas those doing endurance exercises showed a decrease in all fiber types. From the first to the last biopsy all fiber areas were decreased (P less than 0.05) in the control-strength-endurance group and increased (P less than 0.05) in the control-endurance-strength group. These results suggested that endurance exercise preceding strength exercise in an isolated muscle group maximized fiber area adaptations to exercise stress. Consideration should thus be given in exercise and rehabilitation programs to the muscle cellular adaptations evidenced in different orders of training, particularly if muscular strength is considered important.

Adenosine Triphosphatases

Scalene muscle abnormalities in traumatic thoracic outlet syndrome.

Thoracic outlet syndrome (TOS) is not a single disorder but a collection of abnormalities in the same anatomic area that elicit similar symptoms. The many causes of TOS are best classified into one of three groups: osseous, traumatic, and nontraumatic. Although patients with traumatic TOS constituted 86% of our last 600 patients with TOS who underwent surgical treatment, the precise mechanism underlying the condition remains obscure. To determine if there was microscopic abnormalities, 45 anterior and middle scalene muscles from patients with traumatic TOS were studied by means of histochemical stains applied after freezing of the muscles. The results revealed a consistent abnormal histologic pattern in patients with traumatic TOS: type II fibers were atrophied; there was an increase in the average number of type I fibers (78% versus 53% in muscles from control patients); and there was a significant increase (mean: 36%) in connective tissue (muscles from control patients averaged less than 15%). Although type II fiber atrophy and type I fiber predominance are seen in a variety of other conditions, their association with fibrosis is rare. Following neck injuries, the changes in the anterior and middle scalene muscles are compatible with trauma, suggesting that fibrotic scalene muscles are an important cause of symptoms in traumatic TOS.

Adult

Diagnosis and management of paragangliomas of the skull base.

In appropriately selected patients, glomus tumors of the head and neck are best treated surgically. Unresectability is not a factor in therapeutic planning for local disease control. Existing techniques and exposures for tumor removal can be reliably applied to these paragangliomas, with acceptable morbidity and mortality. A team approach to this problem is mandatory.

Adult

Liver histology in patients receiving low dose pulse methotrexate for the treatment of rheumatoid arthritis.

The liver histology of 52 patients treated with intermittent low dose pulse methotrexate for rheumatoid arthritis was evaluated using a modification of the Roenigk grading system. Patients studied had had an average of 3.2 years of treatment or had received 1.7 g methotrexate. No patient had cirrhosis; 15 (29%) patients had evidence of mild fibrosis. Histological abnormalities were not predicted by liver function test changes, with the exception that hypoalbuminaemia occurred in 60% of those with grade IV (modified criteria) findings. The need for liver biopsy in patients with rheumatoid arthritis treated with methotrexate before two years or 1500 mg of treatment has not been established. Whether serial liver biopsies will be needed beyond this time has yet to be determined.

Adult

Pathologic findings in the labyrinthine segment of the facial nerve in a case of facial paralysis.

The histopathologic findings for a patient with acute facial paralysis caused by herpes zoster oticus who obtained no return of active facial function after 1 year are presented. All imaging studies were nondiagnostic. Biopsy of the labyrinthine segment was performed. Histopathologic analysis showed a sharp line of demarcation between sclerotic nerve proximal to and necrotic nerve distal to the meatal foramen area of the fallopian canal. This finding is consistent with observations that the lesion producing Bell's palsy and herpes zoster oticus usually is situated at the meatal foramen.

Adult

Acoustic neuroma: a cost-effective approach.

A cost-effective approach to the diagnosis and treatment of acoustic neuromas continues to evolve as diagnostic methods improve. In the past 7 months, since gadolinium-enhanced magnetic resonance imaging (MRI) has become available in our practice, our screening and presurgical workup has changed. The purpose of this article is to outline the current philosophy of the senior authors in relation to acoustic neuroma management on the basis of 72 patients diagnosed from July 1988 to February 1989. With more sensitive diagnostic means, older less sensitive studies may be eliminated from the routine workup, thus maintaining cost-effectiveness while preserving the highest standard of patient care. The body of this article will review our current use of the many available diagnostic options and emphasize a cost-effective approach.

Adult

Management of large dural defects in skull base surgery: an update.

The use of a ventriculoatrial shunt for long-term CSF diversion for reconstruction after resection of large skull base tumors with intradural extension has been discontinued. The concern about placing a permanent foreign body in a wound open for 12 to 18 hours is our primary reason for changing the technique. Our present approach uses a rectus abdominis microvascular free flap over the fascial closure of the dural defect. Although our experience with this technique is limited, the advantages over the technique used previously warrant its continued use.

Abdominal Muscles

Conservation surgery for glomus jugulare tumors: the value of early diagnosis.

The results of lateral cranial base surgery for glomus jugulare tumors are gratifying when normal anatomy and function can be preserved. The goal of conservation surgery is to preserve normal ear anatomy and cranial nerve function. In general, conservation surgery is tumor-size dependent. Thus, excellent states of functional recovery depend upon accurate early diagnosis. This paper reviews the technical aspects of transtemporal conservation skull base tumor surgery while also reviewing our experience with nearly 100 glomus jugulare patients. Adjuvants to early diagnosis will be highlighted from a review of presenting symptoms, clinical signs, and related diagnosis. Our objective is to provoke a high index of suspicion in physicians charged with the responsibility of diagnosing these tumors. Diagnostic guidelines are proposed.

Deglutition Disorders

Recurrent hemangioma of the external auditory canal.

Hemangiomas of the external auditory canal rarely occur. These lesions have been reported to involve men in their sixth decade. This case report represents the fourth such lesion reported in the literature and the first to be seen in a woman. The clinical presentation, surgical therapy, and pathology are discussed. This tumor represents an unusual cause of hearing loss.

Ear Canal

A paraneoplastic syndrome associated with glomus tumors of the skull base? Early observations.

Independent secretion of vasoactive substances by glomus tumors of the skull base is widely recognized. Surgical removal of these tumors often results in an unexplained prolonged postoperative ileus, even in cases in which the vagus nerve is preserved. There is evidence that these tumors may secrete neuropeptides, such as cholecystokinin, in addition to catecholamines. A retrospective analysis of cases of glomus tumors of the skull base operated on at The Otology Group was carried out to correlate preoperative neuropeptide levels, vagus nerve status at surgery, and duration of postoperative ileus. High circulating levels of cholecystokinin associated with these tumors may be responsible for the unexplained phenomenon of prolonged postoperative ileus. The relevance of neuropeptides to the postoperative management of these patients is discussed. Preventive measures that may avert the potentially lethal complications of aspiration and negative nitrogen balance are described.

Catecholamines