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Biomedical subjects

C J Edmonds

Publications and source records attributed to C J Edmonds.

At least 19 recordsLinked to original sources
PubMed1992

Deficiency of 17 alpha-hydroxylase associated with absent gonads.

A phenotypic female presented initially at the age of 17 years with amenorrhoea and delay of sexual development. Karyotype was male, 46 XY, and as gonads were absent, a diagnosis of congenital anorchia was made. The patient was treated with oestrogen. At the age of 23 years, she re-presented with tall stature and hypertension. She then had normal female habitus but absent pubic and axillary hair. Re-investigation showed that sex steroids and cortisol were absent and established the diagnosis as 17 alpha-hydroxylase deficiency. Treatment with hydrocortisone rapidly corrected the hypertension. Ultrasound examination confirmed the absence of gonads but showed that a small uterus was present. Measurement of serum cortisol is important for recognition of such patients, but further measurements of sex steroids, particularly progesterone, are needed to prove the diagnosis. We have found no previous reports of absent gonads in 17 alpha-hydroxylase deficiency. The association remains unexplained.

Adolescent↗
PubMed1991

A pre-eclamptic-like syndrome associated with hypothyroidism during pregnancy.

Hypothyroidism presenting during pregnancy is rare, probably due to the lower incidence of hypothyroidism during the reproductive years, and because myxoedema causes anovulatory cycles. We report an unusual case of hypothyroidism during a 34-year-old woman's fifth pregnancy, complicated by hypertension, oedema, pericardial effusion and severe nephrotic syndrome. This is the first report of renal biopsy abnormalities under these circumstances. Review of the literature regarding hypothyroidism presenting during pregnancy leads us to suggest that hypothyroidism during pregnancy may mimic pre-eclampsia.

Adult↗
PubMed1990

The effect of dietary sodium and potassium intake on potassium secretion and kinetics in rat distal colon.

1. Potassium secretion by the distal colon was examined in relation to the secretion of chloride and absorption of sodium and to the epithelial turnover of 86Rb+ (as an analogue of potassium) in vivo in rats fed a standard, a potassium-rich or a sodium-depleted diet. 2. An acute intravenous potassium load stimulated potassium secretion two- to threefold. In rats fed the standard diet, sodium secretion was also increased but no significant change in the lumen-to-plasma sodium flux was detected. The potassium and sodium secretions were accompanied by increased chloride secretion which occurred even when the intravenous load contained no chloride. In rats fed the potassium-rich diet, there was a small increase in sodium absorption and a less marked increased of chloride secretion. In the sodium-depleted rats, however, about 70-80% of the increased potassium secretion was balanced by increased sodium absorption. 3. The epithelial turnover rate of 86Rb+ in the rats fed the potassium-rich (t1/2 12-14 min) and the sodium-depleted (t1/2 11-13 min) diets was faster than that of those of the standard diet (t1/2 22-27 min). 4. The epithelial potassium content was 304 +/- 9 nmol (mg dry weight)-1 and was not significantly altered despite considerable variations in potassium secretion rate induced by dietary changes and acute potassium loading. 5. It is concluded that epithelial potassium turnover rate is increased during chronic states of increased potassium secretion and that the rise in potassium secretion is consistent with increased activity of the basolateral Na(+)-K+ pump. Whether the increased potassium secretion is associated with chloride secretion or with increased sodium absorption appears to depend on the absence or presence of the amiloride-sensitive sodium pathway in the apical membrane.

Amiloride↗
PubMed1990

Comparison of fine needle aspiration cytology, radioisotopic and ultrasound scanning in the management of thyroid nodules.

In 175 patients presenting with thyroid nodules, the diagnostic value in management of fine needle aspiration and cytology (FNAC), pertechnetate (99mTc) scanning and ultrasound imaging was examined. In 82 patients, the diagnosis was confirmed at operation; in the remaining 93, there was a follow-up period of at least 2 years. Thyroid cancer was found in 13 patients. For FNAC the sensitivity, specificity and positive predictive value for thyroid cancer were 92%, 85% and 41% respectively compared with 82%, 34% and 11% for 99mTc pertechnetate scanning, 75%, 61%, 19% for ultrasound and 73%, 58% and 19% for combined pertechnetate and ultrasound scanning. In 14% of patients, the aspirates were inadequate for cytology at the first examination. FNAC is therefore the preferable initial investigation and usually gives results adequate for a decision on surgical or medical management. With medical management and follow-up, ultrasound is of value in defining the nodule and the appearance of the rest of the gland.

Biopsy, Needle↗
PubMed1979

Changes in fat, fat-free mass and body water in human normal pregnancy.

Measurements of body weight, total body water and total body potassium (40K) were made serially on three occasions during pregnancy and once post partum in 27 normal pregnant women. Skinfold thickness and fat cell diameter were also measured. A model of body composition was formulated to permit the estimation of changes in fat, lean tissue and water content of the maternal body. Total maternal body fat increased during pregnancy, reaching a peak towards the end of the second trimester before diminishing. Serial measurements of fat cell diameter showed poor correlation, whilst total body fat calculated from skinfold thickness correlated well with our estimated values for total body fat in pregnancy.

Adipose Tissue↗
PubMed1979

Epithelial transport pathways of rat colon determined in vivo by impulse response analysis.

1. A method is described for studying transepithelial pathways for the movement of different solutes and water. Using the blood and the secretory curves of changing tracer activity following an intravenous bolus, the rate of transit of molecules together with their impulse response functions, which reflect the transfer processes can be examined. 2. Movements of Na, Cl, I, urea and water from blood to lumen across rat colonic epithelium were all consistent with simple diffusion through a paracellular route. Most of the secreted K, however, passed through a K selective route associated with a significant K epithelial pool. 3. Adding cyanide to the luminal solution caused a reversible fall of transepithelial potential difference associated with changes in the impulse response functions of water, urea and K indicating reduction of the restriction on diffusion. Cellular K content was unaffected. 4. K entered the bulk of the epithelial cellular K almost exclusively from the blood side. A small epithelial K pool, identified by studies with a miniature GM counter, had kinetic characteristics like those of the K selective pathway observed in the studies of impulse response functions.

Animals↗
PubMed1979

Selenium 75 contamination in iodine 131 solutions.

During investigations on athyreotic patients given large test doses of 131I, whole-body counting has shown the presence of 75Se contamination in some patients. The investigations were carried out to measure the small long-term component of 131I retention in such patients. In an earlier paper (Smith and Edmonds, 1977), we concluded that the effects of 75Se contamination were negligible in the patients described. Subsequent studies on a further small group of similar patients, however, have indicated that the levels of contamination are variable, and this report is intended as a warning of the possibility of measurement error due to this contamination in metabolic studies similar to those to be described. The effects of 75Se contamination observed in two out of five patients studied have been assessed.

Drug Contamination↗
PubMed1978

Hyperthyroidism induced by secondary carcinoma in the thyroid.

A young women presenting with hyperthyroidism proved to have diffuse infiltration of the thyroid with carcinoma probably from a primary breast adenocarcinoma. The gland was diffusely infiltrated with tumour although the thyroid follicles were intact. Blood thyroid hormone levels were raised but thyroid uptake of iodine was undetectable. It is suggested that the tumour released a locally active agent which stimulated hormone release but not iodine uptake, the latter being very low due to suppression of TSH.

Adenocarcinoma↗
PubMed1977

A slow component of iodine turnover in athyreotic individuals.

1. Whole-body retention and plasma values of 131I after a test dose were measured for up to 32 days in patients previously rendered athyreotic by surgery, and 131I treatment for thyroid carcinoma, and who were without detectable functioning tissue at the time of study. 2. About 99-8% of the administered 131I was rapidly excreted, consistent with renal iodide excretion. The remainder (about 0-2%) was eliminated slowly, with mean half-life 15 days; we call this the slow-turnover component. 3. By the sixth day after the 131I dose, very little [131I]iodide remained in the plasma. The average protein-bound 131I was only 0-0035% of dose/l, with mean half-life 14-1 days; 90% was non-extractable in butanol. Labelled albumin accounted for about 80% of the non-extractable fraction. 4. The distribution space estimated from the slow-turnover component and protein-bound 131I was 34 l, indicating that most of the slow-turnover component is extravascular. 5. Stable potassium iodide administration, starting 2 days after giving 131I, had no observable effect on the variables measured. 6. Impairment of renal function delayed [131I]iodide excretion and increased both slow-turnover component and plasma protein-bound 131I. 7. A simple model describing iodine kinetics in athyreotic individuals is suggested. It predicts that the slow-turnover component contains only about 4 micrograms of iodine and, since this is distributed widely in body tissues, it is unlikely to be of biological significance.

Blood Proteins↗
PubMed1977

Potassium and magnesium depletion in patients with cirrhosis on maintenance diuretic regimens.

Total body potassium (40K) and leucocyte potassium measurements were carried out on 19 patients with stable but decompensated cirrhosis maintained on diuretics for previous ascites. Of 13 patients receiving spironolactone alone none had a total body potassium below the expected lower limit of normal, whereas, of six receiving additional frusemide, two had low values. The results for leucocyte potassium were in agreement and simultaneous measurements of leucocyte magnesium showed a close correlation, those with intracellular potassium depletion also having magnesium depletion. One such patient was treated with magnesium supplements without effect on the potassium, although intracellular magnesium was improved. It is concluded that spironolactone alone is the treatment of choice in the maintenance management of such patients; that additional potassium would be unnecessary; and that additional frusemide should be avoided if possible.

Drug Therapy, Combination↗
PubMed1977

Measurement of serum TSH and thyroid hormones in the management of treatment of thyroid carcinoma with radioiodine.

1. Serum levels of TSH, thyroxine (T4) and triiodothyronine (T3) have been measured during treatment and follow-up of patients with thyroid carcinoma. 2. Serum TSH and thyroid hormone levels were initially normal. Three weeks after total thyroidectomy, TSH was elevated in about 50% of patients and after a subsequent therapy dose of 131I it exceeded 30 mU/l in 90% of patients. Occasionally, TSH did not rise until after the second dose of 131I. Low serum T4 and T3 concentrations were associated with the increase of TSH. 3. Withdrawal of l-thyroxine replacement treatment in athyreotic patients for four weeks before test doses of 131I, led to falls of serum T4 and T3 concentration and a progressive rise of serum TSH after the first weeks but there was considerable variation in the final level reached. In the majority, values greater than 30 mU/l were attained despite some patients having received l-thyroxine for many years. A few patients on prolonged thyroxine maintenance had little or no increase in TSH despite considerable reduction in serum T4 and T3 concentrations. 4. The 131I concentration (muCi/g) developed in tumour tissue was also examined in relation to the serum TSH level. In general a tumour should not be considered as incapable of concentrating 131I adequately until serum TSH levels have exceeded 30 mU/l.

Humans↗
PubMed1976

Spironolactone in essential hypertension: evidence against its effect through mineralocorticoid antagonism.

The effect of a six-week course of spironolactone 300 mg/day was examined in 25 unselected patients with essential hypertension. In the blood spironolactone produced a significant rise in urea and potassium concentrations and a fall in sodium and bicarbonate concentrations. In six patients blood pressure was normal at the end of the course, while in five patients there was almost no change. Studies of the effects of spironolactone on various indices usually affected by mineralocorticoids-namely, blood electrolytes, total body potassium, and rectal electrical properties-showed no differences between responding and non-responding patients. Mineralocorticoid excess therefore seems to be rarely responsible for essential hypertension and the influence of spironolactone cannot at present be fully explained.

Adult↗
PubMed1976

Potassium transport across the distal colon in man.

1. The mechanism of potassium transport across human distal colon was investigated in twenty-two individuals without evidence of bowel disease, by using a dialysis method in conjunction with measurements of the transepithelial potential difference (p.d.). 2. Whether potassium was absorbed or secreted depended on its initial concentration in the lumen. The potassium net flux was approximately zero when the luminal potassium concentration was between 30 and 50 mmol/l. 3. Potassium secretion rate was little affected by sodium absorption rate, or by the luminal sodium concentration or by the osmolality of the luminal solution. 4. Potassium secretion rate was increased by partial substitution of other cations for sodium, in the descending order Li greater than NH4 greater than Rb greater than Na. Potassium concentration increased on average to over 80 mmol/l when lithium was in the lumen. 5. The observed transepithelial p.d. was inadequate to account for the intraluminal potassium concentrations attained, the discrepancy being most marked when ammonium or lithium was in the lumen. It is suggested that some potassium is secreted by the epithelial cells and this component of the total potassium flux into the lumen is increased when rubidium, ammonium or lithium is substituted for sodium.

Adult↗
PubMed1976

Lithium transport by the colon of normal and sodium-depleted rats.

1. The transport of Li by colonic epithelium has been examined in normal and Na-depleted rats. 2. Substitution of Li for Na with lumen of the conon causes the transepithelial electrical potential difference (p.d.) and short-circuit current to fall to low levels and the electrical resistance of fall moderately. Recovery occurs by fairly slowly after removal of Li. 3. Li absorption increases linearly with increasing concentration in the lumen and is significantly faster in Na-depleted rats. Increasing the luminal Na concentration reduces Li absorption from solutions of low Li concentration. 4. Comparison of absorption rates with secretion rates in rats given Li systemically, together with measurements of Li distribution across the epithelium in relationship to the transepithelial p.d. indicate that Li transport is predominatly or entirely passive. Interference with Li absorption by Na suggests, however a mucosal membrane carrier which, since Li absorption rises after Na depletion, may be increased in the Na-depleted state.

Animals↗