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Biomedical subjects

J Cunningham

Publications and source records attributed to J Cunningham.

At least 217 records · Page 12Linked to original sources

Apolipoprotein B subspecies in chylomicrons isolated from a patient with chyluria.

The diagnosis and the clinical course of a 17-year-old white male with chyluria are reported. Cloudy, milky urine appeared spontaneously, in the absence of edema or any signs or symptoms of parasitic infection. Pedal lymphangiography demonstrated the presence of a lymphatic renal fistula, and digital subtraction angiography showed aneurysmal dilatation of the aorta at the level of the renal arteries. This case provided an opportunity to ascertain which of the forms of apolipoprotein B were present in lymph chylomicrons. Apolipoprotein B is needed for chylomicron secretion. It exists in several forms--B-100, B-74, B-48, and B-26. After a meal consisting of fat, chylomicrons in which apolipoprotein B-48 was virtually the only apolipoprotein B present appeared in the urine, while apolipoprotein B-100 was the only apolipoprotein B present in the plasma very low-density lipoproteins. Chyluria disappeared two weeks after institution of a low-fat diet. This case illustrates an interesting, rare cause of chyluria. Because of the presence of chyluria, it was also demonstrated that chylomicrons in which apolipoprotein B-48 is virtually the only apolipoprotein B present are a physiologically normal product of the intestine.

Adolescent↗

Laser techniques for the evaluation of wear in Class II restorations.

A technique for the quantitative determination of the changes in surface topography of restorations during wear has been developed. This involves the optical contouring of the surface using a laser, and the generation of contour maps. Several different methods for interpreting these maps are discussed. A computer-aided method is the most consistently accurate and measures wear volume to an accuracy of 2--5%.

Computers↗

Energy expenditure in obesity in fasting and postprandial state.

Resting metabolic rate (RMR) was determined in 10 obese and 10 nonobese women after an overnight fast and for 3 h after the ingestion of an 800-kcal liquid meal. In the fasting state, absolute energy expenditure in the obese (4.8 +/- 0.2 kJ/min) was 25% greater than in the nonobese (P less than 0.005), but was comparable with the nonobese when expressed in relation to body surface area or lean body mass and was reduced by 20% when expressed per kilogram body weight3/4 (P less than 0.005). Meal ingestion resulted in a 14-16% increase in RMR (postprandial thermogenesis) that was similar in the two groups, so that absolute energy expenditure in the obese remained 22-25% higher than in the nonobese throughout the postprandial period. The estimated overall (fasting and postprandial) increase in resting caloric expenditure in the obese as compared with the nonobese was 350-375 kcal/day.

Adult↗

Abnormal 24-hydroxylation of 25-hydroxyvitamin D in the X-linked hypophosphatemic mouse.

The effect of extracellular phosphate on the control of 25-hydroxyvitamin D3 24-hydroxylase was studied in normal mice and littermates with X-linked hypophosphatemic rickets (Hyp). 24-Hydroxylase activity and plasma concentrations of 24,25-dihydroxyvitamin D3 were significantly higher in Hyp mice than in normal mice when both groups were fed a normal diet containing 1.22% calcium (Ca) and 0.8% phosphorus (Pi). The differential in 24-hydroxylase activity was exaggerated when serum phosphate was reduced in normal mice by means of a low Pi diet or increased in Hyp mice by means of a high Pi diet. Differences in 24-hydroxylase activity between the two groups of mice were also demonstrated in the presence of varying Pi concentrations in vitro. Thus, in both Hyp and normal mice, 24-hydroxylase activity is influenced in a qualitatively similar manner by serum Pi. Plasma concentrations of 1,25-dihydroxyvitamin D3 were the same in normal and Hyp mice. The data are consistent with the hypothesis that control the renal metabolism of 25-hydroxyvitamin D3 in Hyp mice is reset such tht 24-hydroxylase activity is inappropriate high for the prevailing serum phosphate over a wide range of concentrations.

24,25-Dihydroxyvitamin D 3↗

Increased efficiency of weight gain and altered cellularity of brown adipose tissue in rats with impaired glucose tolerance during diet-induced overfeeding.

We examined the relationship among glucose tolerance, efficiency of weight gain, and cellularity of brown adipose tissue (BAT) in rats (initial weight: 362 +/- 1 g) made hyperphagic and obese by feeding on a highly palatable "cafeteria" (CAF) diet for 4-8 wk. As compared with chow-fed controls, CAF feeding resulted in a 45-60% increase in caloric intake (P less than 0.01), a 40-50% increase in weight gain (P less than 0.01), and hyperinsulinemia. Glucose disposal rate (K) on intravenous glucose tolerance test (IVGTT) was greater than or equal to 1.4% in all chow-fed rats, but fell to less than or equal to 1.3 in 10 of 23 CAF-fed rats. As compared with the chow-fed controls, rats with normal glucose tolerance demonstrated a 12% decline in efficiency of weight gain (g/100 kcal of food consumed) in response to CAF feeding (P less than 0.05). In marked contrast, in rats with impaired glucose tolerance, efficiency of weight gain failed to decline in response to overfeeding and was 18% higher than in the overfed group with normal glucose tolerance (P less than 0.01). Although CAF feeding increased the mass of interscapular BAT by 110-130% in rats with normal as well as impaired glucose tolerance, DNA content of BAT rose only in the normal-K CAF-fed rats (0.19 +/- 0.01 mg DNA/100 mg versus 0.12 +/- 0.02 in chow-fed controls and 0.12 +/- 0.01 in low-K rats).(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue, Brown↗

Immune complexes in systemic sclerosis; detection by C1q binding, K-cell inhibition and Raji cell radioimmunoassays.

Thirty-four patients with systemic sclerosis (SS) were investigated for the presence of circulating immune complexes by means of a fluid phase C1q binding assay, K-cell inhibition assay and a Raji cell radioimmunoassay and the results compared with those obtained in 21 patients with systemic lupus erythematosus (SLE) and 52 normal healthy controls. Patients with SS showed an incidence of circulating immune complexes comparable to that found in SLE, with 20 patients (58.5%), giving a positive result with at least one of the assays. The presence of circulating immune complexes in patients with SS was found to be associated with both elevation of serum IgG and IgA levels and extensive visceral involvement by the disease. These findings raise the possibility that circulating immune complexes could be involved in the pathogenesis of SS.

Adult↗

Serum-induced enhancement of peripheral blood mononuclear cell-mediated cytotoxicity towards human target cells in systemic sclerosis.

Sera from 7 of 37 patients with systemic sclerosis (SS) were found to markedly enhance cytotoxicity in several established human target cell lines when co-cultured with normal human peripheral blood mononuclear cells (PBM). Fractionation studies indicated that the cytotoxicity-inducing activity resided in the IgG-containing fractions of serum and that the effector cells were Fc-receptor positive. By contrast, sera from 27 normal controls produced little or no cytotoxicity when co-cultured with the same target cell lines and normal PBM. Any slight enhancement of cytotoxicity that occurred with a single target cell line was, on fractionation, either labile or associated with albumin containing fractions. These findings raise the possibility that antibody-dependent cellular cytotoxicity (ADCC) could provide a pathogenetic mechanism in some patients with SS.

Adult↗

Giant esophageal carcinoma.

Carcinoma of the esophagus is a devastating disease that produces various degrees of esophageal obstruction by virtue of its circumferential, constricting type of growth pattern. Because of the relatively small diameter of the esophageal lumen, a limited-sized tumor can produce severe obstructive symptoms. Carcinoma of the esophagus is, as a rule, fairly well localized to its wall or the immediate mediastinal parietes in cases where there is extension beyond the esophageal musculature.(1) Large, bulky, exophytic types of esophageal carcinomas that produce symptoms mainly as a result of extrinsic pressure are unusual.

Carcinoma, Squamous Cell↗

Serum-induced enhancement of peripheral blood mononuclear cell mediated cytotoxicity towards human target cells in systemic lupus erythematosus.

Sera from 6 out of 18 patients with systemic lupus erythematosus (SLE) were found to be capable of producing marked increases of cytotoxicity in several established human target cell lines when co-cultured with normal human peripheral blood mononuclear cells (PBM). Fractionation studies indicated that the cytotoxicity-inducing activity resided in IgG containing fractions and that the effector cells were Fc-receptor positive. By contrast, sera from 27 normal controls produced little or no cytotoxicity when similarly co-cultured with the same target cell lines and normal PBM. Any slight reactivity that occasionally occurred against a single cell line was, on serum fractionation, either labile or associated with albumen containing fractions. These findings raise the possibility that antibody-dependent cellular cytotoxicity could provide an additional pathogenetic mechanism in patients with SLE.

Adult↗

Hypernatremia induced by maximal exercise.

A short burst of intensive exercise (100-m swim lasting one minute and resulting in a 12-fold rise in the level of blood lactate) resulted in frank hypernatremia (serum sodium level, greater than 150 mEq/L) in 30% to 40% of well-trained athletes. In contrast, less intensive exercise (800-m swim lasting ten minutes and resulting in a sevenfold rise in the level of blood lactate) failed to cause a rise in serum sodium level despite comparable elevations in hematocrit reading and serum protein levels. Hypernatremia induced by intensive exercise cannot be explained by losses in body fluid or solute ingestion, but is probably a consequence of a shift of hypotonic fluid from the extracellular to the intracellular compartment. Thus, the mechanism of exercise-induced hypernatremia may be unique, as compared with other clinically recognized forms of hypernatremia.

Adolescent↗

Chronic acidosis with metabolic bone disease. Effect of alkali on bone morphology and vitamin D metabolism.

Chronic metabolic acidosis and osteomalacia developed in two patients following urinary diversion. Good clinical, biochemical, and histologic responses were seen following treatment with alkali alone (vitamin D was not given), despite the presence of markedly impaired glomerular filtration in one of the patients. Plasma 25-hydroxyvitamin D and 1 alpha, 25-dihydroxyvitamin D concentrations were normal before and during treatment in one of the patients and in the other were low before and normal during treatment. The results show that successful treatment of the osteomalacia of chronic acidosis is not necessarily accompanied by changes in the plasma levels of vitamin D metabolites and that even when marked glomerular dysfunction coexists with acidosis and osteomalacia, treatment with alkali may be more appropriate than the administration of vitamin D analogues.

Acidosis↗

Cyclic GMP concentration in ovarian tissue after administration of gonadotrophin to prepubertal rats.

The weights, protein concentrations, and concentrations of cyclic AMP and cyclic GMP in the ovaries of prepubertal rats have been measured after induction of follicular growth by administration of pregnant mare serum gonadotrophin (PMSG). Three phases of ovarian growth, the follicular growth phase, the preovulatory phase and the luteal phase were investigated. Ovulation was induced by administration of human chorionic gonadotrophin (hCG). During the follicular phase, ovarian weight, protein content and the content of both cyclic AMP and cyclic GMP increased 2-3 days after administration of PMSG. Administration of hCG 65h after PMSG caused a rapid rise in the concentration of cyclic AMP but the concentration of cyclic GMP tended to fall. During the luteal phase the concentrations of both cyclic nucleotides decreased.

Animals↗

Long-term complications of MOPP chemotherapy in patients with Hodgkin's disease.

Two hundred and sixty-three patients in long-term remission from Hodgkin's disease were evaluated for complications of chemotherapy. All patients were interviewed by telephone conversation and reported complications were documented by chart review. Treatment consisted of mantle and para-aortic irradiation in 127 patients, total nodal irradiation (TNI) in 32, TNI and MOPP in 34, and mechlorethamine, vincristine, prednisone, and procarbazine (MOPP) chemotherapy alone or with lesser irradiation in 70. In this study, greater than 90% of the men who received MOPP remain infertile. In contrast, a substantial portion of female patients treated with MOPP chemotherapy have retained normal menses (58%) and only a small proportion have had persistent amenorrhea (9%). Five of eight female patients desiring families after MOPP chemotherapy have had normal children. The risk of developing a major infection requiring hospitalization was greatest in those patients who had received TNI and MOPP chemotherapy. The risk of developing a herpes zoster infection was greatest during or within the first year following therapy and was greatest in those patients receiving combined radiation therapy and chemotherapy. Nearly 100% of patients continue to lead normal lives following treatment for Hodgkin's disease. Only a small percent of patients (1.5%) have been totally disabled following treatment.

Adolescent↗

Influence of mediastinal adenopathy on site and frequency of relapse in patients with Hodgkin's disease.

Between April 1969 and July 1979, 267 patients with surgically staged IA-IIB Hodgkin's disease and 31 with clinically staged IIE or IV Hodgkin's disease were treated; disease was limited to the area above the diaphragm. Three separate groups of patients with mediastinal adenopathy were identified. Patients with disease limited to the mediastinum had a favorable prognosis, and treatment with mantle followed by para-aortic irradiation has resulted in 85% relapse-free survival and 100% overall survival at 8 years. Surgically staged patients with large diameter mediastinal adenopathy (greater than 0.33 of the thoracic diameter) have a high relapse rate with radiation therapy alone. The use of combined modality therapy has reduced the risk of relapse in these patients, but the survival remains higher whether MOPP is used initially or at relapse. Clinically staged IIE patients or stage IV patients with extensive extranodal disease limited to the thoracic cavity were treated with chemotherapy and involved- or extended-field irradiation. These patients had a 5-year survival of 66% with large mediastinal adenopathy and 90% with lesser mediastinal disease.

Hodgkin Disease↗