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Biomedical subjects

D Hamilton

Publications and source records attributed to D Hamilton.

At least 91 records · Page 5Linked to original sources

Pergolide for the treatment of pituitary tumors secreting prolactin or growth hormone.

We gave pergolide mesylate, a new long-acting ergot derivative with dopaminergic properties, to 47 patients with hypersecretion of prolactin or growth hormone. Single doses produced long-lasting reductions of serum prolactin levels; after 24 hours, the values remained depressed at a mean of 28.8 per cent of the base-line value. Among 41 patients (22 women and 19 men) with hyperprolactinemia who took pergolide for three months or more, prolactin levels fell to normal in 37 and remained slightly elevated in 2. In the two patients in whom the levels fell to only 38 to 52 per cent of base line, treatment was regarded as a failure. The level of growth hormone fell to a mean of 52.8 per cent of base line in patients with acromegaly who were taking 100 micrograms of pergolide per day. Among patients for whom adequate CT scans were available, definite tumor shrinkage occurred in 10 of 13 with macroadenomas and definite or probable shrinkage in 5 of 9 with microadenomas. Menses returned in 76 per cent of treated women and testosterone levels rose in 10 of 14 men. We conclude that pergolide reduces hypersecretion and shrinks most prolactin-secreting macroadenomas. In some patients long-term pergolide therapy may be superior to surgery and x-ray treatment.

Acromegaly

Naloxone eye drops reverse the miosis in runners--implications for an endogenous opiate test.

Naloxone 0.16% ophthalmic drops or placebo drops were self-administered to one eye by 13 runners 250 times in a double-blind fashion over three weeks of various intensities and durations of running. An increasing incidence of miosis after running and ipsilateral mydriasis after the naloxone eye drops were administered was noted to correlate with increased run durations. During 34 runs of over 30 minutes duration, 20 subject runs (59%) developed miosis in both eyes and mydriasis in the eye treated with naloxone, but none of 10 subject runs over 30 minutes (9 of which showed miosis) developed mydriasis after placebo drop administration. Calculations (means, SEM) of pupil sizes in various run durations revealed an increased occurrence of miosis which was reversed with naloxone in over 30 minute runs at a significance level greater than 0.005 (single tailed "t" test). It is suggested that exercise generated endogenous opiates cause pupillary miosis, and that ophthalmic naloxone to one eye can block this exercise pupillary effect resulting in ipsilateral mydriasis. Suggestions are given for a simple "Naloxone Anisocoria Test" for the presence or absence of elevated endogenous opiates.

Adolescent

Myotonic dystrophy: HLA antigens and mitogen stimulated lymphocyte responses of a black American family.

A Black American family of four generations with 29 members was studied. Six family members spanning two generations were affected with myotonic dystrophy. HLA A, B, C and DR antigen specificities were determined for each family member using local typing trays. Twelve HLA haplotypes were identified in the family. No significant association was found between the disease and any HLA antigenic type or haplotype. This finding suggests that the involvement of the major histocompatibility complex in the etiology of myotonic dystrophy is unlikely. The cellular responses to twenty-eight family members and 20 unrelated Black Americans to phytohemagglutinin (PHA), Concanavalin A (Con A) and pokeweed mitogen (PWM), each in three concentrations, were tested with mononuclear cells prepared from peripheral blood. There was a significant difference in responses of the affected family members as compared to the unaffected family members and the unrelated Black Americans. The PHA and PWM responses of the unaffected family members are not significantly different from those of the unrelated Black American controls; however, the Con A responses of the unaffected family members are significantly higher than those of the control group at the lowest Con A dosage. The possible systemic defects of cytoskeletal structures of the affected family members are discussed.

Black People

Bethanechol or cimetidine in the treatment of symptomatic reflux esophagitis: a double-blind control study.

We conducted a double-blind study to compare the effectiveness of oral bethanechol chloride or cimetidine in treating reflux esophagitis to evaluate the drugs' effects on the symptoms of esophagitis and its verification by endoscopy. Forty-three patients were treated with either 300 mg of cimetidine or 25 mg of bethanechol chloride, each administered four times a day for six weeks. In addition to this drug treatment, the patients all received conventional medical therapy. Patients who were treated with either of the two drugs experienced a decrease in symptoms and less severe endoscopic lesions. While cimetidine treatment resulted in complete endoscopic healing in 15 of 22 patients, bethanechol treatment resulted in the same healing in 11 of 21 patients. During therapy, neither endoscopic lesions or symptoms worsened. Our study indicated that either cimetidine or bethanechol is an effective drug in treating reflux esophagitis. The effects of the two drugs can be favorably compared.

Administration, Oral

Successful tumour immunotherapy with cimetidine in mice.

Cimetidine significantly slowed metastatic development and prolonged survival in tumour-bearing mice, in association with inactivation of suppressor cells. Pharmacological blockade of the suppressor cell system may represent a new strategy for successful immunotherapy of human neoplasia.

Animals

Echocardiography in combined discrete and hypertrophic subaortic stenosis.

A 10-year-old boy with discrete subaortic stenosis had coexisting abnormal systolic anterior motion of the mitral valve, demonstrated by echocardiography, a sign normally taken as indicating the presence of idiopathic hypertrophic subaortic stenosis. Surgical removal of a fibromuscular diaphragm abolished the echocardiographic signs of discrete subaortic stenosis but abnormal systolic anterior motion of the mitral valve persisted. A severe low cardiac output state complicated immediate recovery after removal of the left ventricle outflow obstruction, and was overcome only with considerable difficulty. The presence of hypertrophied septal muscle, and the associated small left ventricular cavity size, was thought to be the immediate cause of these problems, so that recognition of marked septal hypertrophy, together with abnormal anterior systolic movement of the mitral valve, should serve as a warning that similar difficulties are likely to bae encountered by other patients, after removal of the obstruction in subaortic stenosis. In our experience other forms of left ventricle outflow tract obstruction have not been found to show such a marked degree of asymmetric septal hypertrophy, but this does not mean it may not occur.

Aortic Stenosis, Subvalvular

Cutaneous metastases from a follicular thyroid carcinoma.

A 56-year-old man developed several deep cutaneous nodules in the pelvic area and on the upper extremities, trunk, and scalp. Biopsy revealed cutaneous metastases from a follicular carcinoma of the thyroid, for which the patient had been treated two and one-half years previously.

Adenocarcinoma