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Biomedical subjects

G O'Sullivan

Publications and source records attributed to G O'Sullivan.

At least 19 recordsLinked to original sources

Probiotic impact on microbial flora, inflammation and tumour development in IL-10 knockout mice.

BACKGROUND: The enteric bacterial flora has been implicated in the pathogenesis of enterocolitis and colon cancer in C57BL/6 IL-10 knockout mice. Probiotic Lactobacilli modify the enteric flora and are thought to have a beneficial effect on enterocolitis. We conducted a controlled feeding trial in IL-10 knockout mice using the probiotic Lactobacillus salivarius ssp. salivarius UCC118. AIM: To determine the effect of probiotic consumption on the gastrointestinal microflora, tumour development and colitis in IL-10 knockout mice. METHODS: Twenty IL-10 knockout mice were studied (10 consumed probiotic organisms in milk and 10 consumed unmodified milk) for 16 weeks. Faecal microbial analysis was performed weekly to enumerate excretion of the probiotic UCC118, total lactobacilli, Clostridium perfringens, bacteroides, coliforms, bifidobacteria and enterococci. At sacrifice, the small and large bowel were microbiologically and histologically assessed. RESULTS: L. salivarius UCC118 was detected in faeces from all mice in the probiotic fed group, but not the control group. Faecal coliform and enterococci levels were significantly reduced in probiotic fed animals compared to the controls (P < 0.05). At sacrifice, a significant reduction in C. perfringens numbers was observed in the test mice (P < 0.05). There were no fatalities in the test group compared to two deaths from fulminant colitis in the control group. Only one test mouse developed colonic adenocarcinoma compared to five in the control group. Test animal mucosal inflammation consistently scored lower than that of the control mice. CONCLUSION: In this placebo controlled trial, modification of enteric flora in IL-10 knockout mice by probiotic lactobacilli was associated with reduced prevalence of colon cancer and mucosal inflammatory activity.

Animals↗

Subdural haematoma after dural puncture headache treated by epidural blood patch.

Subdural haematoma is a well-documented complication of accidental dural puncture, and is thought to be preventable by prompt treatment with an epidural blood patch. An accidental dural puncture occurred in a 39-yr-old primagravida during the siting of an epidural catheter for pain relief in labour. Twenty hours after the puncture, the mother developed a typical postdural puncture headache, which increased in severity over the subsequent 24 h. An epidural blood patch was performed at 48 h, and this initially relieved the headache. After discharge from hospital, and 14 days after the dural puncture, the headache recurred, together with expressive dysphasia, poor co-ordination and sensory loss in the right arm. A magnetic resonance imaging scan demonstrated a left sided subdural haematoma, which was drained successfully with complete recovery.

Adult↗

True lateral dermoid cyst of the floor of the mouth.

Congenital dermoid cysts of the floor of the mouth are relatively rare but when they occur, they do so inevitably in the midline. We present a case of a true lateral dermoid cyst of this region without any intra-oral extension. We discuss the anatomical and histological classification of dermoid cysts within the floor of the mouth.

Adult↗

Pars tensa retraction pockets in children: treatment by excision and ventilation tube insertion.

Tympanic membrane retraction pockets involving the pars tensa are not uncommon in clinical practice. Recurrent infections, ossicular erosion and cholesteatoma are the recognized sequelae. The management options include surveillance, medical treatment and surgery. The surgical procedures range from grommet insertion to extensive tympanoplasty procedures. We report our experience with simple excision and grommet insertion, performed in 31 ears in 26 patients as day cases. The follow-up ranged from 8 to 34 months with a mean of 16 months. The procedure was successful in 23 ears (success rate of 74%). Recurrence of retraction occurred in seven ears and in one ear there was a persistent perforation. Age, previous grommet insertion and severity of retraction did not have a statistically significant influence on the final outcome. We conclude that excision and grommet insertion is a simple, safe and efficient procedure for the management of tympanic membrane retraction pockets and can be considered in preference to extensive tympanoplasty.

Adolescent↗

Surgical management of intractable epistaxis: audit of results.

We have audited our results after changing the management practice in patients with intractable epistaxis. These patients are offered trans-nasal endoscopic sphenopalatine artery diathermy with or without anterior ethmoid artery diathermy instead of conventional surgical procedures. During the first year after the change in practice, 145 patients were treated as inpatients for epistaxis. Ten patients (seven per cent) required a surgical procedure under general anaesthesia due to the recurrent nature of bleeding. All 10 patients had endoscopic sphenopalatine artery diathermy, whereas in four patients anterior ethmoid artery diathermy was also performed concurrently. The post-operative hospital stay ranged from one to three days (mean 2.1 days). The mean follow-up was 10 months. The epistaxis recurred in one patient and this was managed conservatively. There were no complications related to surgery. In the previous year, 132 patients were admitted for epistaxis and eight patients had surgical procedures, which included septoplasty, nasal packing and external carotid artery ligation. The post-operative stay ranged from three to six days (mean 3.9 days). Our audit shows that endoscopic sphenopalatine artery diathermy is a safe, successful and effective management option for patients with refractory epistaxis. The morbidity is reduced and the hospital stay is shortened. The sphenopalatine artery diathermy can be combined with anterior ethmoid surgery, when necessary.

Aged↗

An unusual case of stridor due to osteophytes of the cervical spine: (Forestier's disease).

Stridor is a noisy breathing caused by compromised airway in the larynx and trachea. The causes can either be due to intrinsic or extrinsic compression. Stridor resulting from extrinsic compression due to anterior cervical osteophytes is rare. We report an unusual case of acute stridor due to an osteophytic mass in the cervical vertebrae resulting in a mechanical upper airway obstruction. The underlying pathology was Forestier's disease or diffuse idiopathic skeletal hyperostosis (DISH). Stridor is a rare manifestation of DISH and it certainly represents the most life-threatening one. Only a few cases have been reported in the English literature and are mainly secondary to impaired function of the vocal folds, or postcricoid ulceration and oedema. We present such a case, in that stridor was the result of direct airway obstruction by the osteophytic mass and an emergency tracheostomy had to be performed to establish an airway.

Aged↗

Eating in labour. A randomised controlled trial assessing the risks and benefits.

The aim of this study was to determine whether permitting women in labour to eat a light diet would: (i) alter their metabolic profile, (ii) influence the outcome of labour, and (iii) increase residual gastric volume and consequent risk of pulmonary aspiration. Women were randomised to receive either a light diet (eating group, n = 48) or water only (starved group, n = 46) during labour. The light diet prevented the rise in plasma beta-hydroxybutyrate (p = 2.3 x 10(-5)) and nonesterified fatty acids (p = 9.3 x 10(-7)) seen in the starved group. Plasma glucose (p = 0.003) and insulin (p = 0.017) rose in the eating group but there was no difference in plasma lactate (p = 0.167) between the groups. There were no differences between the groups with respect to duration of first or second stage of labour, oxytocin requirements, mode of delivery, Apgar scores or umbilical artery and venous blood samples. Relative gastric volumes estimated by ultrasound measurement of gastric antral cross-sectional area were larger (p = 0.001) in the eating group. This was supported by the observation that those from this group who vomited, vomited significantly larger volumes than those in the starved group (p = 0.001). We conclude that eating in labour prevents the development of ketosis but significantly increases residual gastric volume.

3-Hydroxybutyric Acid↗

Further characterization of the latency-associated transcription unit of Marek's disease virus.

Previous studies have identified a large (L) and a small (S) RNA transcript antisense to the MDV homologue of the ICP4 gene of herpes simplex virus (HSV) in cells infected with Marek's disease virus (MDV) and in lymphoblastoid cell lines. In this study the 5' and 3' ends of the L RNA and of the sense ICP4 transcript of MDV were mapped by Northern hybridization and RNase protection assays. The results showed that L RNA is approximately 10.6 kb and that the ICP4 sense transcript is initiated in the region of genomic DNA where the L RNA terminates whereas L RNA is initiated where the ICP4 transcript terminates. L RNA was abundant in chick embryo fibroblasts (CEF) infected with virus strain HPRS16/attenuated whereas S RNA was predominant in CEF infected with oncogenic HPRS16 and in RPL-1 cell line. Results of cycloheximide experiments showed that the ICP4 gene of MDV was transcribed as an immediate-early gene in infected CEF whereas transcription of the L RNA required protein synthesis. Sequencing of cDNA and Northern hybridization using oligonucleotide probes showed that S RNA shared similar intron/exon boundaries as the cDNAs from several cell lines indicating that there might be a relationship between the S RNA and the antisense transcripts that generated the cDNAs.

Animals↗

Avascular necrosis of bone following an intensified chemotherapy regimen including high dose steroids.

We report the imaging findings and natural history of avascular necrosis of bone (AVN) that developed following a chemotherapy regimen including high dose steroid treatment. All patients had acute lymphoblastic (ALL) or non-Hodgkin's lymphoma (NHL). Symptoms followed the high dose steroid therapy and 28 joints in eight patients were involved, (11 knees, seven hips, five shoulders and five ankles). Plain radiographs at presentation were normal in most joints, whilst bone scintigraphy and magnetic resonance imaging (MRI) were positive. We believe that the development of AVN in these patients is most likely due to the high dose dexamethasone therapy as in all eight cases symptoms followed this stage of the regimen. Patients experiencing bone or joint pains while receiving high dose steroids as part of a chemotherapy regimen could be investigated by bone scintigraphy but MRI is preferable as it is more sensitive and specific for AVN. In this series of patients multiple joints were involved and all the male patients proceeded rapidly from bone infarction to joint collapse. If the MRI appearances are typical, an early diagnosis of AVN can be made enabling therapeutic interventions to prevent joint collapse and its associated morbidity.

Adolescent↗

Marek's disease virus EcoRI-Q gene (meq) and a small RNA antisense to ICP4 are abundantly expressed in CD4+ cells and cells carrying a novel lymphoid marker, AV37, in Marek's disease lymphomas.

Mature lymphomas produced in Rhode Island Red (RIR) chickens infected with the RB1B strain of Marek's disease virus (MDV) were examined for the presence of viral DNA and RNA and expression of viral antigens. In situ hybridization showed that all tumours examined contained viral DNA in areas of lymphoid infiltration. In 3/5 tumours, there was a correlation between the number and distribution of cells expressing the Marek's disease EcoRI-Q gene (meq) and those that carried the lymphoid cell marker AV37. Expression of the MDV-specific phosphoprotein pp38 was infrequent in lymphomas but abundant in a splenic tumour which also expressed the viral glycoprotein gB. Northern blot analysis of lymphocyte fractions purified by immunoaffinity showed that CD4+ and AV37+ fractions from lymphomas expressed meq and the small RNA antisense to ICP4 (SAR). The results are consistent with the notion that transformed cells are CD4+ cells, carrying the AV37 marker and expressing meq and SAR.

Animals↗

Prospective trial of the role of fine bore intubation of the cystic duct at the time of operative cholangiography.

BACKGROUND: The incidence of common bile duct calculi in patients selected for laparoscopic cholecystectomy is 4 to 6 percent. Management is controversial. We report our experience with fine bore cannulation of the cystic duct in patients found on operative cholangiography to have common bile duct stones. STUDY DESIGN: We performed a prospective study of 310 patients who underwent laparoscopic cholecystectomy to evaluate the role of fine bore intubation of the cystic duct at the time of operation. Operative cholangiogrphy was attempted on all patients. In 9 patients, the fine bore tube was left in situ for at least 6 weeks. RESULTS: Intubation was found to be safe and well-tolerated. It permitted biliary decompression and allowed repeat cholangiography. Thirty percent of patients had spontaneous clearance of the common duct stones, which was shown on repeat studies. CONCLUSIONS: Fine bore cannulation of the cystic duct is a safe procedure that allows repeat cholangiography, thus eliminating false-positive results. It reduces the need for intervention by demonstrating the spontaneous disappearance of retained calculi in up to a third of cases.

Cholangiography↗

Influence of chicken genotype on protection against Marek's disease by a herpesvirus of turkeys recombinant expressing the glycoprotein B (gB) of Marek's disease virus.

Two inbred lines of White Leghorn chickens which differ in B-haplotype were immunized at 2 days of age with a thymidine kinase negative (tk-ve) herpesvirus of turkeys (HVT) recombinant expressing the glycoprotein B (gB) gene of Marek's disease virus (MDV) and were challenged 6 days later with 1000 p.f.u. of the highly virulent RB1B strain of MDV. Mock-vaccinated chickens and chickens immunized with a spontaneous tk-ve HVT mutant served as controls. Genetically resistant B21 chickens were protected by immunization with the recombinant as well as by the tk-ve HVT, whereas highly susceptible B13 chickens were partially protected by the recombinant but were not protected by the tk-ve HVT. Rhode Island Red chickens (HPRS RIR), which differ from the White Leghorns at the B locus, were protected by both vaccines but the recombinant conferred a significantly higher level of protection than the tk-ve HVT. The results suggest that the gB gene of MDV serotype 1 has an important role in the induction of protective immunity against highly virulent MDV in genetically susceptible lines of chickens and that vaccinal immunity in White Leghorns might be influenced by the B haplotype.

Animals↗

Magnetic resonance imaging in macromelia and macrodactyly.

We report five cases presenting with soft tissue and bone overgrowth that demonstrate the ability of MRI to establish a diagnosis in the absence of specific clinical features. Disorders included macrodystrophia lipomatosa, angiolipomatosis, Klippel-Trenaunay-Weber syndrome, blue rubber bleb naevus syndrome and one case of segmental limited hypertrophy. The MRI appearances, and other radiological features of these conditions are discussed. MRI is recommended in all cases of macrodystrophy when the clinical features and plain film findings are indeterminate.

Adult↗

Behavioural aggression in panic disorder after 8 weeks' treatment with alprazolam.

23 patients with a diagnosis of panic disorder with agoraphobia were randomly assigned to 8 weeks' treatment with alprazolam or placebo. They filled in self-ratings before and after treatment and competed on a competitive reaction time task, designed to measure behavioural aggression, after 8 weeks' treatment. Patients taking both alprazolam and placebo rated decreased anxiety after 8 weeks' treatment but those on alprazolam also tended to report less hostility. On the behavioural task, patients on alprazolam behaved more aggressively in response to provocation. This is the first study to confirm clinical reports of benzodiazepine-induced dyscontrol on an objective laboratory measure. It is important that it is followed up in a larger group of patients.

Adult↗