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Biomedical subjects

J R Willis

Publications and source records attributed to J R Willis.

9 recordsLinked to original sources

Repeated low-level formaldehyde exposure produces cross-sensitization to cocaine: possible relevance to chemical sensitivity in humans.

Sensitivity to chemicals in humans has been proposed to be an acquired disorder in which individuals become increasingly sensitive to chemicals in the environment. A possible link between the manifestation of psychiatric symptoms in individuals claiming sensitivity to chemicals was investigated based on a leading hypothesis put forth by Bell and co-workers (1992) to explain the amplification of symptoms after chemical exposure. The hypothesis is that chemical sensitivities may be akin to sensitization observed in rodents after repeated psychostimulants. Repeated exposure to psychostimulants enhances behavioral activity and the underlying neurochemical responses in specific limbic pathways; a similar sensitization of limbic pathways has been proposed to occur in individuals who become sensitive to chemicals. To test this hypothesis, female Sprague-Dawley rats were exposed to either air or formaldehyde (Form) for 1 h/day for 7 days or 20 days (5 days/week x 4 weeks). Two to 4 days after the last exposure, rats were given a cocaine challenge (= early withdrawal) followed by an additional cocaine challenge 4-6 weeks later (= late withdrawal). No differences in cocaine-induced locomotor activity were noted between groups after 7 days of exposure. However, after 20 days of exposure to Form, vertical activity was significantly elevated at both early and late withdrawal times. These studies demonstrate that behavioral sensitization occurs after long-term, but not short-term, low-level exposure to Form, and lends support to the limbic system sensitization hypothesis of sensitivity to chemicals in humans.

Anesthetics, Local

Enteroscopy-enteroclysis: experience with a combined endoscopic-radiographic technique.

BACKGROUND: Video enteroscopy provides high-quality diagnostic and therapeutic capabilities in the proximal small bowel. Enteroclysis remains an essential diagnostic technique in the distal small bowel. We report our experience with the combination of these techniques. METHODS: Seventy-one patients with obscure gastrointestinal bleeding (group A, 54 patients) or abnormal radiologic studies (group B, 17 patients) were evaluated with enteroscopy. Enteroclysis via a tube inserted on withdrawal of the enteroscope was performed in all patients with nondiagnostic enteroscopy. RESULTS: Enteroscopy identified bleeding sites in 29 of 54 (54%) group A patients (12 angiodysplasia, 10 ulcers, 7 gastric erosions, 1 vessel, 1 aortoenteric fistula), and lesions in 11 of 17 (65%) group B patients (7 ulcers, 3 benign strictures, 2 radiation enteritis, 1 mass). In group A, 13 (24%) patients had findings detectable by standard esophagogastroduodenoscopy. Enteroclysis identified masses in 2 of 24 (8%) group A patients, and lesions in 5 of 10 (50%) group B patients (3 strictures, 1 mass, 1 large diverticulum). No complications occurred. CONCLUSIONS: The combination of enteroscopy and enteroclysis is safe and offers quality small bowel examinations in more comfortable and convenient single diagnostic sittings. This combination detected bleeding sources in 57% and lesions in 70% of patients. Though enteroclysis identified bleeding sources in only 8% of patients, this study excluded lesions other than angiodysplasia.

Diagnosis, Differential

Proposed animal neurosensitization model for multiple chemical sensitivity in studies with formalin.

A potentially promising line of animal research relevant to multiple chemical sensitivity (MCS) is that of sensitization in the central nervous system (CNS), particularly limbic pathways in the brain. Sensitization is the progressive and enduring enhancement in behavioral and neurochemical responses that occurs after repeated exposure to psychostimulants or environmental stressors. Since the onset and progression of sensitization has many parallels with that of MCS, it has been proposed that MCS may be initiated through a mechanism similar to the sensitization of CNS components occurring in the rodent. To test this hypothesis, female Sprague-Dawley rats were exposed to formalin vapors (FORM, 11 ppm) or water vapor (control) 1 h/day for 7 days. The next day, a saline injection was given followed by a cocaine injection (15 mg/kg, i.p.) 24 h later, and locomotor activity was monitored. Animals pretreated with repeated FORM inhalation demonstrated a significantly enhanced locomotor response to cocaine compared to controls, an indicator that specific limbic pathways may have been sensitized. At 4 weeks of withdrawal from FORM exposure, a subset of animals remained sensitized to a cocaine challenge. No differences were found between groups after a saline injection. In a second experiment, animals were screened prior to FORM or water exposure for their response to a novel situation, a measure believed to reflect an animal's general responsiveness to stimuli. Rats were divided into high responders (HR) or low responders (LR), based on their locomotion in a novel cage. Results from three behavioral tests demonstrated that HR and LR were differentially affected by exposure to FORM. In a passive avoidance test, HR and LR appeared to be different in their distribution of responses, while HR and LR responses in the FORM group were nearly identical. On the elevated plus maze test of anxiety, HR spent more time on the open arms than LR in both treatment groups, with significant differences between HR and LR in the FORM, but not water, treated group. On a hot plate test to measure nociceptive levels, no differences occurred between HR and LR in the control group, whereas nociception of LR tended toward an increase compared to HR in the FORM-exposed group. Results from the second experiment suggest that the effects of FORM exposure may be obscured by examining behavior in a heterogeneous population (HR and LR). This approach using animal models may help define neural substrates that mediate the amplification of responses of a subpopulation of individuals to chemicals in the environment.

Animals

Enteroscopy with enteroclysis.

The authors conclude that their experiences support the conclusion that the combination of enteroscopy and enterocysis is safe and offers quality small bowel examinations in a more comfortable and convenient single diagnostic setting. Although enteroclysis has identified bleeding sources in only 8% of patients who underwent this study, other lesions than angiodysplasia were confidently excluded in the remainder of patients. The combined procedure is well tolerated in the outpatient setting, more comfortable, and safer by decreasing radiation exposures than enteroclysis alone. Use of small bowel enteroscopy at an earlier stage in the evaluation of patients with obscure gastrointestinal bleeding increases cost effectiveness without compromising quality.

Barium Sulfate