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Biomedical subjects

J A Butler

Publications and source records attributed to J A Butler.

At least 37 records · Page 2Linked to original sources
PubMed1999

Quantitative significance of measuring trimethylselenonium in urine for assessing chronically high intakes of selenium in human subjects.

The purpose of the present study was to investigate the effects of Se restriction on the excretion of Se in men who had consumed high levels of this element during their entire lives. With the use of stable isotopes of Se as selenite, the excretion of methylated Se in urine was investigated in Chinese men (n 10) who had habitual chronic high intakes of this element. The relationship between either urine Se or trimethylselenonium (TMSe) to the estimated long-term Se intake was not linear over the entire range of intake, which was also true for the infusion of labelled selenite. A non-linear relationship was also found between urine TMSe and urine Se both for TMSe arising from catabolism of endogenous body Se and that from infused selenite. The data suggest a close precursor-product relationship of urine Se and its TMSe component based on the nearly identical specific activities for these two selenocompounds. Although dimethylselenide in breath was not measured in the present study, combining urinary TMSe with this breath test may be more useful in the assessment of long-term Se status.

Adult↗
PubMed1998

An evidence-based approach to the treatment of esophageal variceal bleeding.

Esophageal varices are a life threatening cause of gastrointestinal bleeding. Management includes both primary prevention of variceal bleeding and treatment of actively bleeding varices. Evidence from randomized controlled trials indicates that beta blockers and nitrates may prevent the initial episode of bleeding varices. Ample data from randomized controlled trials indicate that band ligation is more effective than scleropathy for the treatment of bleeding esophageal varices. Somatostatin may decrease rebleeding rates with or without endoscopic therapy. No effective treatment has been developed for the treatment of patients who fail endoscopic therapy.

Adult↗
PubMed1998

Distribution of selenium between plasma fractions in guinea pigs and humans with various intakes of dietary selenium.

The distribution of selenium between the plasma fractions was investigated in guinea pigs fed various levels (basal, 0.5, 1.0, 2.0, 4.0, 6.0 and 8.0 mg Se/kg) of dietary selenomethionine (Semet) and in humans living in different areas of China with different selenium status. There was a corresponding increase of selenium concentration in liver, kidney, brain, testis, spleen, heart and muscle with each increase of dietary selenium, but there were no increases of glutathione peroxidase (GPX) activity in liver, brain, testis, heart or muscle in pigs fed any of the selenium levels as compared to controls fed a basal commercial diet. On a percentage distribution basis, the selenium in selenoprotein P decreased and that in the albumin fraction increased with increased dietary intakes of selenium as Semet. The ratios of selenium to albumin in either the plasma or the albumin fractions increased with each increase in dietary selenium. The greatest percentage of selenium was in the albumin fraction of Chinese living in the high selenium areas whereas the greatest amount was in the selenoprotein P fraction in subjects living in deficient and adequate areas of China. Increases in the ratios of selenium to albumin in either the plasma or the albumin fraction also occurred with increases of selenium intake of these subjects. The results indicate that the distribution of selenium in plasma fractions reflect the levels of dietary intakes of Semet.

Adult↗
PubMed1998

Organic and inorganic selenium supplementation to lactating mothers increase the blood and milk Se concentrations and Se intake by breast-fed infants.

The aim of this study was to determine the effect of selenium (Se) supplementation to lactating women on Se concentrations and glutathione peroxidase (GSH-Px) activities in blood components of mothers and breast-fed infants and on milk Se levels and Se intake by breast-fed infants. Lactating mothers were supplied for 3 months with 200 micrograms Se/day in the form of yeast-Se (Y-Se) and sodium selenite. Initial blood and plasma Se levels of all women (n = 67) were 76.6 and 53.2 micrograms/L, respectively. After 3 months Se concentrations both in whole blood and in plasma from mothers and infants were significantly higher than the initial values. Y-Se exerts a stronger effects than selenite on blood and plasma Se levels. Initial milk Se concentration was 8.9 micrograms/L and after 1 month in both groups in reached a plateau at 14-16 micrograms/L. This resulted in an increase of Se intake in breast-fed infants from 6.1 to a plateau of 11-13 micrograms Se/day. GSH-Px activities in plasma and red cells of Y-Se group increased significantly and reached a plateau after 1 and 2 months, respectively, while in the selenite group the enzyme activities increased steadily throughout the entire period of the study. Selenite exerts a stronger effect on GSH-Px both in maternal and in infant blood components as compared with Y-Se. In milk the GSH-Px activity in the Y-Se group did not change during the study, while in the selenite group after 3 months it increased almost 2-fold compared to the initial value. In conclusion, this study shows that organic Se causes higher Se deposition than did the inorganic form.

Adult↗
PubMed1997

Dietary selenium increases selenoprotein W levels in rat tissues.

Two experiments were conducted to evaluate the influence of dietary selenium (Se) on tissue levels of selenoprotein W (Se-W) in rats. Se dependent glutathione peroxidase (GPX) activity and Se levels were also determined for comparative measurements. In the first experiment, rats were fed a basal diet deficient in Se or supplemented with either 0.1 or 4.0 mg Se (as selenite) per kg diet for 6 wk. Se-W levels were significantly higher in muscle, spleen and testes of rats fed 0.1 mg Se per kg diet compared to those fed the deficient diet (controls), and those fed 4.0 mg Se per kg diet had significantly higher levels in muscle, brain and spleen (P < 0. 05) than those fed 0.1 mg Se per kg diet. No further increases, however, occurred in the tests. There was a significant increase (P < 0.05) of mRNA encoding Se-W in muscle with each increase of dietary Se. In the second experiment rats were fed the basal diet or this diet plus 0.01, 0.03, 0.06, 0.1, 1.0, 2.0 or 4.0 mg Se per kg diet. The levels of Se-W in muscle did not increase (P < 0.05) until 0.06 mg Se per kg diet were fed to rats. A very marked increase (P < 0.05) occurred when 1.0 mg Se per kg diet was fed with no further increases with higher levels. There was a linear increase of Se-W in brain (r = 0.89) and spleen (r = 0.98) with the Se concentration in the diet up to 0.1 mg Se per kg where a plateau was reached. The testes showed a different pattern in that a very marked increase (P < 0.01) occurred when only 0.01 mg Se per kg diet was fed where an inflection was reached. Except for muscle, GPX activities reached a plateau in all tissues when diets containing 0.06 to 0.1 mg supplemental Se per kg were fed. The Se concentration in these tissues increased at a linear rate with the Se concentration in the diets up to 0.1 mg Se per kg where it continued to rise at a different rate. The results indicate that in rats, the regulation of Se-W by Se is different for various tissues and differs from that for GPX.

Administration, Oral↗
PubMed1997

Hormone replacement therapy and the risk of breast lesions that predispose to cancer.

To determine whether postmenopausal individuals being treated with hormone replacement therapy (HRT) have an increased risk for lesions that predispose to breast cancer, 156 women with benign breast lesions were retrospectively studied. Their ages ranged from 43 to 88. Each patient underwent a breast biopsy from 1991 to 1995. It was determined from chart review whether each of these patients had been treated with HRT. Fifty-seven of these patients had a biopsy finding that predisposed the patient to future breast cancer. The predisposing lesions included sclerosing adenosis, intraductal papilloma, and epithelial hyperplasia with atypia. Of these 57 patients, 36 (63%) were being treated with HRT. Only 30 of the 99 patients (30%) with nonproliferative lesions were treated with HRT (odds ratio, 3.9; P < 0.0005). On the basis of the results of this study, we believe that the use of HRT may promote lesions that predispose to cancer. This suggests that patients treated with HRT require vigilant surveillance by way of examination and mammography.

Adult↗
PubMed1994

Uptake of selenite, selenomethionine and selenate by brush border membrane vesicles isolated from rat small intestine.

The uptake of selenite, selenate and selenomethionine (SeMet) was performed with brush border membrane vesicles (BBMV) prepared from rats fed selenium-deficient and supplemented diets. At equilibrium (60 min), the uptake of 75Se from [75Se]selenite ranged from 16.5 to 18.9 nmol mg-1 protein. There was a curvilinear relationship in the uptake of selenite over a concentration range of 10-1000 microM. About 2 nmol mg-1 protein was obtained with selenomethionine (SeMet) which occurred between 90 and 180 s. In contrast to selenite, there was a linear relationship in the initial uptake of SeMet over a concentration range of 10-1000 microM. The uptake of selenate was approximately 50-fold lower than selenite, reaching 350 pmol mg-1 protein. Dietary selenium level had no effect on the rate of 75Se accumulation by BBMV. Dramatic differences are found in the uptake and binding of selenium by BBMV incubated with different selenocompounds.

Animals↗
PubMed1994

Goblet cell carcinoid of the appendix.

BACKGROUND: Over the past 15 years, a variant of appendiceal carcinoid has been recognized which is not widely known to the general surgeon. This tumor, variously labeled adenocarcinoid or goblet cell carcinoid, has a more aggressive natural history than classic appendiceal carcinoids and requires a different surgical approach. PATIENTS AND METHODS: A survey of the tumor registries of 10 hospitals identified 7 female and 2 male patients with goblet cell carcinoid of the appendix between 1983 and 1993. The clinical data of these patients were reviewed. RESULTS: Median age was 58 years (range 31 to 73). Clinical presentation followed two distinct patterns: acute onset suggestive of appendicitis or chronic symptoms associated with a pelvic mass. In no case was the diagnosis suspected preoperatively or established intraoperatively. Four patients with discrete distal appendiceal tumors treated with appendectomy are alive without evidence of disease 2 to 11 years since their diagnoses. The 5 patients with diffuse appendiceal involvement all had intra-abdominal metastases. Four are dead of disease at intervals from 5 months to 2 years postdiagnosis. CONCLUSIONS: Goblet cell carcinoids are a distinct clinical and pathologic entity with variable malignant potential. Patients with diffuse appendiceal involvement require aggressive surgery as part of multimodal therapy.

Adult↗
PubMed1994

Endoscopic ultrasound-guided fine needle aspiration of pancreatic carcinoma.

Endoscopic ultrasound (EUS) is reported to be the single best modality for visualizing small pancreatic carcinomas. Whereas tissue diagnosis by fine needle aspiration (FNA) can be performed with computed tomography (CT) or transabdominal ultrasound guidance, the diagnostic accuracy is limited by the ability of these modalities to visualize the lesion. Real time EUS-guided fine needle aspiration has recently been reported as a new diagnostic modality. The application of EUS-guided FNA in the diagnosis of small pancreatic carcinoma has not been reported. We present a case in which transduodenal EUS-guided FNA was successful in establishing a definitive tissue diagnosis of pancreatic carcinoma in a 1.6-cm lesion in the head of the pancreas. This case along with a review of the literature highlights the great potential of this new modality in the diagnosis of pancreatic carcinoma.

Adenocarcinoma↗
PubMed1993

Determination of the distribution of selenium between glutathione peroxidase, selenoprotein P, and albumin in plasma.

A chromatographic method is described to determine the distribution of selenium between selenoprotein P, glutathione peroxidase (GSH-Px), and albumin in plasma, using two small columns of heparin-Sepharose and reactive blue 2-Sepharose linked together in tandem. One milliliter of plasma was diluted to 12 ml with 0.02 M sodium phosphate buffer, pH 7.0 (the equilibration buffer), applied to the heparin-Sepharose column, and eluted at a flow rate of 30 ml per hour. GSH-Px was not retained by either of these columns but selenoprotein P was retained by heparin-Sepharose and albumin by reactive blue. After the two columns were separated, selenoprotein P was eluted with heparin from heparin-Sepharose and albumin eluted from reactive blue with high salt. Analytical work confirmed the presence of selenoprotein P, GSH-Px, and albumin in the respective fractions. When rats were injected with 75Se as either selenite or selenomethionine most of the radioactivity was incorporated into the selenoprotein P fraction, with the next greatest amount into GSH-Px, and the least amount into albumin. Slab gel electrophoresis was used to determine that most of the selenium in each of the three fractions was associated with each of these selenium containing proteins. This method indicated that the majority of the selenium in plasma is associated with selenoprotein P, and the only time this was found not to be true was with high levels of dietary selenomethionine.

Animals↗
PubMed1993

Omphalocaval shunt: an alternative procedure for portal decompression.

We report a case in which umbilical vein was used to construct an omphalocaval shunt in a patient with a long history of alcoholic liver disease and recurrent esophageal and gastric variceal bleeding episodes. The indication for the choice of this procedure included the presence of dense adhesions in the porta hepatis, arteriographic documentation of continuity with the portal venous system, and an umbilical vein 12 mm in internal diameter. The hypertensive portal system was successfully decompressed and proved patent 6 months postoperatively.

Adult↗
PubMed1993

Long-term supplementation with selenate and selenomethionine: selenium and glutathione peroxidase (EC 1.11.1.9) in blood components of New Zealand women.

Thirty-three New Zealand women aged 18-23 years received daily for 32 weeks, 200 micrograms Se as Se-enriched yeast (selenomethionine), or brewer's yeast mixed with selenate, or no added Se (placebo) in a double-blind trial. Se supplementation raised (P = 0.001) platelet glutathione peroxidase (EC 1.11.1.9; GSHPx) activity, and also Se and GSHPx in whole blood, erythrocytes and plasma. Selenomethionine was more effective in raising blood Se concentrations than selenate, but both were equally effective in raising GSHPx activities in whole blood, erythrocytes and plasma, indicating a similar bioavailability for the two forms. These observations and those of gel filtration studies of erythrocytes and plasma proteins reported elsewhere (Butler et al. 1991) are consistent with the incorporation of Se from selenomethionine into a general tissue protein pool while selenate is directly available for GSHPx synthesis, and explain the poorer correlation between Se and GSHPx in individuals with higher Se status. However, selenate raised platelet GSHPx activities to a greater extent than did selenomethionine suggesting some other effect of selenate on platelets which needs further investigation. A response of GSHPx activity in these New Zealand subjects indicates that their dietary Se intake is insufficient to meet recommended intakes based on the criterion of saturation of GSHPx activity, and could reflect a marginal Se status. The level of blood Se necessary for saturation of GSHPx of about 100 ng Se/ml whole blood confirms observations in earlier studies.

Adolescent↗
PubMed1992

Guidelines for surgical residents' working hours. Intent vs reality.

To comply with voluntary California medical school guidelines, our general surgery residency program reduced in-house call to 1 in 4 nights, and scheduled a 72-hour work-week. We assessed the effectiveness of these changes by prospectively surveying the actual working hours of surgical house staff through completion of a daily schedule for 1 month. Actual in-hospital hours averaged 98 per week, significantly exceeding the scheduled hours, and were greater for interns (100 hours) and junior residents (97 hours) than for chief residents (95 hours). Twenty hours (22%) of nonconference waking hours were spent on so-called scut work. Significant reduction of intern work hours could be accomplished by expansion of ancillary care, allowing more time for direct patient care. The effect on senior house staff hours would be less dramatic but might be sufficient to bring hours into compliance with proposed limits.

General Surgery↗