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Biomedical subjects

D Bird

Publications and source records attributed to D Bird.

At least 19 recordsLinked to original sources

A comparison of blood gases and acid-base measurements in arterial, arterialized venous, and venous blood during short-term maximal exercise.

The purpose of this study was to determine the relationship between blood gases and acid-base measurements in arterial, arterialized venous, and venous blood measured simultaneously during short-term maximal exercise. Ten well-trained male cyclists performed a graded maximal exercise test on a cycle ergometer to determine the power output corresponding to their peak oxygen consumption (test I), and a short-term maximal test on a cycle ergometer at peak power output (test II). During test II arterial, arterialized venous and venous blood were sampled simultaneously for determination of partial pressures of oxygen and carbon dioxide, pH, bicarbonate (HCO3-), base excess (BE), and lactate (La). Samples were taken at rest, the end of 1 min of exercise (1 ME), at the end of exercise (EE), and at 2 min of recovery (REC). During test II, subjects maintained a peak power output of 370.6 (62.1) W [mean (SD)] for 4.5, SD 1.6 min. Except at rest venous and arterialized venous measurements tended to be the same at all sampling intervals, but differed significantly from measurements in arterial blood (P less than 0.05). BE was the only variable that rendered consistently significant correlations between arterial and arterialized venous blood at each sampling interval. The pooled correlation coefficient between arterial and arterialized venous BE was r = 0.83 [regression equation: BEa = (0.84 BEav)-0.51]. Arterial La was significantly higher than venous La at 1 ME (2.8, 0.7 vs 0.8, 0.3 mmol.l-1) and higher than both venous and arterialized venous La at EE.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

The effects of ingestion time of gliclazide in relationship to meals on plasma glucose, insulin and C-peptide levels.

The effect of altering the timing of gliclazide administration in relation to a meal was studied in ten type 2 (non-insulin dependent) chronically treated diabetics. Gliclazide was given 30 min before, at the start of and 30 min after breakfast or omitted altogether. Plasma gliclazide was present at greater than 2 mg/l throughout the study periods. Administration at 30 min after the meal significantly delayed the time to peak for plasma gliclazide. No significant difference was noted in plasma glucose, insulin or c-peptide patterns with any protocol. It is concluded that, in clinical practice, with chronically treated diabetics the timing of gliclazide ingestion in relation to meals is not critical.

Aged

Retinotopic representation of the bifoveate eye of the kestrel (Falco spraverius) on the optic tectum.

Like many diurnal raptors, the American kestrel or sparrow hawk, Falco sparverius, possesses two foveae in each eye. In this study, we used fundus photography and reversed ophthalmoscopy to plot the projection of these foveae onto the visual field, together with other retinal landmarks such as the pecten and ora terminali. From such data, it was determined that the central monocular fovea (CMF) and temporal binocular fovea (TBF) were separated by 36 deg and that the kestrel has 58 deg of binocular overlap when the eyes are appropriately converged. Single-cell and multi-unit recordings were used to systematically explore the tectal surface and map receptive fields (RF) onto a hemispheric screen. A retinotopic map of the tectal surface was produced from such data and revealed an expanded representation for each fovea on the tectum and a systematic increase in RF size from fovea to periphery. The functional significance of this organization is discussed.

Animals

Early experience with needle localization and biopsy of mammographic lesions.

Increasing awareness of the value of mammography by both physicians and the public has resulted in women presenting more commonly with impalpable breast lesions. This study reviews the radiology and pathology of 58 such lesions biopsied by the Monash Medical Centre Breast Unit between August 1987 and October 1988. Abnormal mammograms were reported by one of two independent radiologists in the normal course of practice and placed into one of five categories according to the radiological appearance. Those lesions scoring greater than or equal to 3 were then needle localized, excised and examined histologically. All mammograms were later reported as unknowns by the other radiologist and similarly scored. Sixteen (28%) of these lesions were invasive or in situ carcinoma and of these a significant number were scored differently by the two radiologists. The results indicate that needle localization biopsy of suspicious mammographic lesions is a safe, accurate method for the diagnosis of early breast cancer. The results also show significant variation between radiologists and demonstrate the need for double reading of screening mammographic films. It is suggested that doubtful lesions require more extensive work-up with compression/magnification and other special views, the aim being more accurate radiological assessment and a reduction in the benign biopsy rate.

Biopsy

The effects of long term gliclazide administration on insulin secretion and insulin sensitivity.

Gliclazide (80 mg bd) was administered to nine subjects with type 2 (non insulin dependent) diabetes inadequately controlled on diet only. Twenty-four hour glucose, insulin and c-peptide profiles were obtained before and after one week and four months of therapy. Insulin sensitivity was assessed by euglycemic hyperinsulinemic clamp before and after four months of treatment. Twenty-four hour glucose levels were significantly lowered after one week and four months. Insulin secretion, as assessed by the areas under the insulin and c-peptide curves, was enhanced after one week. The increase was most noted during the day in response to meals. The enhancement was maintained after four months of treatment with the increase in the postabsorptive phase becoming significant. Glucose utilisation rate was significantly increased at four months. It is concluded that both acute and prolonged gliclazide therapy directly or indirectly 1) enhances both meal stimulated and post absorptive insulin secretion and 2) increases insulin sensitivity. The relative contribution of each to improved diabetic control has not been established.

Adult

Adenine nucleotide concentrations in peripheral blood lymphocytes from patients with common variable hypogammaglobulinaemia and B-cell chronic lymphatic leukaemia.

The adenine nucleotide profiles (AMP, ATP, NAD and NADH2) of peripheral blood lymphocytes isolated from patients with common variable hypogammaglobulinaemia (CVH) were similar to those in control cells. AMP and ATP levels were also similar in the lymphocytes of patients with chronic lymphatic leukaemia (CLL). Since CVH and CLL patients have reduced activity of plasma membrane ecto-5'-nucleotidase, our data suggests that this enzyme does not regulate the levels of intracellular adenine nucleotides, at least in "resting" cells.

Adenine Nucleotides

The pathogenesis of virus-associated encephalopathies: a prospective study of immunological mechanisms.

Thirty-two patients, including 29 children, presenting with acute unexplained encephalopathies were studied prospectively for evidence of virus infection, immunodeficiency, and immunologic involvement in the pathogenesis of their illnesses. Twenty-five of these patients had a clinical diagnosis of encephalitis. Twenty-two of these 25 had laboratory evidence of active virus infection, the majority with viruses usually associated with self-limiting illness outside the central nervous system. In patients with encephalitis, immune competence, as reflected by T-cell numbers and subsets in peripheral blood, in vitro interferon production, natural killer activity, and specific antiviral antibody production, was normal. Transudation of albumin into the cerebrospinal fluid (CSF), a measure of blood-brain barrier breakdown, was seen in 40% of patients. Intrathecal antibody synthesis was suggested by an elevated IgG index in 9/20 CSF/serum pairs but was confirmed by an elevated specific IgG ratio in only 3. The serum IgG1 and IgG3 subclass levels were significantly elevated at the time of the illness and remained elevated 8 months later; IgG2 and IgG4 levels were normal. IgE levels were elevated in 50% of patients. Serum levels of IgM antibodies against Escherichia coli measured 8 months after the neurological illness were also significantly higher in encephalitis patients than in age-matched healthy controls. Human myelin basic protein did not induce proliferation in peripheral blood lymphocytes in any patient. We conclude that most encephalopathies associated with viral infections are not due to an underlying generalized immunodeficiency, and probably result from an inappropriately vigorous immune response.

Adolescent

IgG subclass levels in thermally injured children.

In the light of the recognition of Toxic Shock Syndrome occurring in burned children in our Unit, IgG subclass levels were monitored during the first week post burn in a group of 16 children. There were marked differences between some of the subclasses.

Burns

Spontaneous rupture of a liver cell adenoma after long term methyltestosterone: report of a case successfully treated by emergency right hepatic lobectomy.

A case of spontaneous rupture of a liver cell adenoma is reported in a female transexual treated with methyltestosterone 150 mg daily for 7 years. Emergency right hepatic lobectomy was performed successfully. Histology showed peliosis hepatis also. Emergency resection of a liver cell adenoma has been reported in a young woman taking oral contraceptives, and an elective resection in another female transexual treated with methyltestosterone. However, to the best of our knowledge this is the first case of emergency resection of a spontaneously ruptured liver cell adenoma in a transexual treated with long term methyltestosterone. Since there are numerous other patients similarly treated, it may be expected that this complication will be seen again.

Adult

Interrelation of the pituitary-thyroid system at birth in man.

Samples of cord blood derived from 105 normal babies after uncomplicated deliveries were assayed for thyroxine (T4), tri-iodothyronine (T3), reverse tri-iodothyronine (rT3), thyroxine-binding globulin (TBG) and thyrotrophin (TSH). The values for T3, rT3 and TSH were log-normally distributed (geometric means 0.62 nmol/l, 3.28 nmol/l and 10.9 mu./l respectively) and those for T4 and TBG were normally distributed (means 126 nmol/l and 13.7 mg/l), The data were systematically analysed and no evidence was obtained to suggest that the concentration of TSH, which varied widely, was regulated by any of the thyroid hormones alone or in combination. There was a direct relation between the concentrations of T4 and T3 in the cord blood at birth but not between either of these and rT3. There is thus no evidence of a functional interdependence of the hypothalamic-pituitary-thyroid system in man at birth.

Fetal Blood

Reverse triiodothyronine, thyroid hormone, and thyrotrophin concentrations in placental cord blood.

Reverse triiodothyronine (rT3), triiodothyronine (T3), thyroxine (T4), thyroxine binding globulin (TBG), and thyrotrophin (TSH) were measured in sera from placental cord blood in an unselected series of 272 deliveries. In this series the concentrations of rT3 (mean 3.33 nmol/l, 95% confidence limits 1.6--7.0 nmol/l), were log normally distributed and did not overlap the adult normal range (0.11--0.44 nmol/l). There were no correlations between the cord blood concentrations of rT3, T3, T4, and TSH. The cord serum rT3 concentration was not influenced by maturity, birth-weight, or neonatal risk factors, whereas these factors did affect the concentrations of T3, T4, AND TBG. There is no arteriovenous rT3 concentration difference across the placenta, therefore the cord rT3 reflects the systemic rT3 concentration in the baby at birth. As rT3 in the neonate largely, if not entirely, derives from thyroxine from the fetal thyroid, measurement of the cord rT3 concentration may be a good immediate screening test for neonatal hypothyroidism.

Fetal Blood

Regulation of thyrotrophin secretion by negative feedback of tri-iodothyronine on the hypothalamus.

Bilateral injections of tri-iodothyronine (T3, 2 ng in 2 microliter artificial cerebrospinal fluid, CSF) were made into the hypothalami of 15 hypothyroid rhesus monkeys (Macaca mulatta) prepared with chronically implanted intrahypothalamic cannulae. In 29 out of 96 such injections, the concentration of thyrotrophin (TSH) in the plasma fell rapidly by more than 30% and returned to the basal value over the succeeding 48 h, in 13 experiments the fall was 20-30% and in the remaining 54 experiments the level of TSH was unaltered. With [125I]T3, the extent of diffusion of T3 through the hypothalamus in these experiments was shown to be very limited. The hypothalamic injection sites were subsequently identified histologically and it was found that in those experiments in which the level of TSH in the plasma had fallen, T3 had been injected into either the dorsomedial nucleus or the lateral hypothalamic area extending into the preoptic region. Injection of artificial CSF alone into these areas of the hypothalamus did not affect the concentration of TSH. Direct intrapituitary injections of T3 (4 ng) resulted in small and inconstant changes in the concentration of TSH in the plasma and injections of T3 (400 ng) into the third ventricle were without any effect. These experiments demonstrate that T3 can rapidly inhibit the secretion of TSH by a direct action upon defined parts of the hypothalamus.

Animals

Non-clostridial gas gangrene in the diabetic lower limb.

Three cases of non-clostridial gas gangrene in diabetic lower limbs are reported. This rare condition occurs only in diabetes with peripheral neuropathy and is invariably fatal unless treated surgically. The clinical picture is deceptive with a slow, but insidiously progressive course, and the late appearance of skin necrosis. Antibacterial therapy is ineffective in preventing death. A serious delay may be fostered by inconclusive bacteriological investigations. Urgent radical amputation is required to save the patient's life.

Adult