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Biomedical subjects

L L Brown

Publications and source records attributed to L L Brown.

At least 55 records · Page 3Linked to original sources

Regional cerebral glucose utilization reveals widespread abnormalities in the motor system of the rat mutant dystonic.

Rats with an inherited movement disorder (dystonic, dt), their phenotypically normal littermates, and normal unrelated controls were studied using a metabolic mapping technique, 2-deoxyglucose autoradiography. This approach was used to identify potential sites of abnormality underlying the movement disorder, as no morphological abnormalities using light and electron microscopic techniques have been identified in this mutation. There was a significant overall glucose utilization (GU) reduction in the dt rats and their littermate controls when they were at rest and not displaying abnormal movements. Conversion of GU values to standard scores showed abnormalities in dt compared with both control groups in the following areas: deep cerebellar nuclei, locus coeruleus, pontine gray, ventrolateral-ventromedial thalamic complex, nucleus of the third nerve, lateral habenula, and basolateral amygdala. Littermates were different from nonlittermates in several regions, including the dentate and red nuclei. A study of relative GU performed in animals displaying dystonic movements also showed abnormalities in the deep cerebellar nuclei and locus coeruleus, and in the red nucleus, external cuneate, and medial septum. Correlations computed for GU in pairs of regions with known anatomical connections suggested that cerebellar, substantia nigra, and basal ganglia efferents may be abnormal. These studies complement existing biochemical and neuropharmacological data which show abnormalities in the cerebellum of the dt rat. Additionally, the function of brain stem and even basal ganglia nuclei is affected in this mutant, perhaps as a consequence of abnormal cerebellar activity. The partial effects in the littermates suggest that abnormalities in only a few regions are not sufficient to produce the movement disorder, and a gene dose effect may exist.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Human liver cell transplantation. Prolonged function in athymic-Gunn and athymic-analbuminemic hybrid rats.

Isolated cryopreserved human liver cells, attached to collagen-coated microcarriers, were injected intraperitoneally into mutant rat recipients genetically deficient in either bilirubin uridine diphosphoglucuronosyltransferase activity (Gunn rats) or albumin synthesis (Nagase analbuminemic rats). One group of the recipient Gunn and analbuminemic rats were made genetically immunodeficient by interbreeding with athymic rats with inherited T-cell deficiency. Injected microcarriers and cells formed aggregates on the surface of the pancreas. There was no morphologic evidence of rejection in athymic recipients, whereas immunocompetent recipients demonstrated rejection within 5 days of transplantation. Athymic-Gunn rat recipients demonstrated excretion of bilirubin glucuronides in bile for 30 days and reduction in their serum bilirubin levels. In recipient athymic-analbuminemic rats, plasma albumin levels increased from pretransplantation levels of 0.025-0.05 mg/ml to 3.9-4.8 mg/ml 8 days posttransplantation and remained nearly at that level throughout the 30 days of the study. A method of harvesting, attaching to microcarriers, cryopreserving, and in vivo testing of human hepatocytes with prolonged survival and function in athymic-Gunn and athymic-analbuminemic hybrid rats is reported. These rats are excellent animal models for testing xenograft function.

Animals↗

Effects of insulin-induced hypoglycemia on plasma and cerebrospinal fluid levels of ir-beta-endorphins, ACTH, cortisol, norepinephrine, insulin and glucose in the conscious dog.

This study was designed to assess effects of insulin-induced hypoglycemia on plasma and cerebrospinal fluid (CSF) levels of immunoreactive (ir) beta-endorphins, adrenocorticotropin (ACTH), cortisol, norepinephrine, insulin, and glucose in the conscious, overnight fasted dog. Dogs received either an intravenous infusion of saline or insulin (5 mU/kg/min) for 3 h. Infusion of saline alone in conjunction with acute sampling of CSF caused no measurable perturbations of glucose homeostasis. Insulin infusion caused a 60% drop in both plasma and CSF glucose. Plasma levels of ir-beta-endorphins, ACTH and cortisol rose markedly. CSF levels of ir-beta-endorphins and ACTH also increased. While the magnitude of the increase was smaller than that in the plasma, it was greater than would be expected if crossover of the peptides from the plasma were the sole source of the increase. Hypoglycemia also induced elevations in CSF cortisol and insulin. In addition, there was a 45% decrease in CSF norepinephrine in spite of large elevations of norepinephrine in the plasma. We conclude that hypoglycemia is associated with marked changes in central as well as peripheral levels of neuroendocrine factors. The importance of these changes in mediating acute and long-term responses to hypoglycemia remains to be established.

Adrenocorticotropic Hormone↗

Stimulation of glucose production through hormone secretion and other mechanisms during insulin-induced hypoglycemia.

To assess the role of counterregulatory hormones per se in the response to continuous insulin infusion, overnight-fasted dogs were given 5 mU.kg-1.min-1 insulin intraportally either alone (INS, n = 5), with glucose to maintain euglycemia (INS + GLU, n = 5), or with glucose and hormone replacement [i.e., glucagon, epinephrine, norepinephrine, and cortisol infusions (INS + GLU + HR, n = 6)]. The increases in counterregulatory hormones that occurred during insulin-induced hypoglycemia were simulated in the latter group. In this way, it was possible to separate the effects of hypoglycemia per se from those due to the associated counterregulatory hormone response. Glycogenolysis and gluconeogenesis were measured with a combination of tracer ([ 3-3H]glucose and [U-14C]alanine) and hepatic arteriovenous (AV) difference techniques during a 40-min control and a 180-min experimental period. Insulin levels increased similarly in all groups (to congruent to 250 microU/ml), whereas plasma glucose levels decreased in INS (115 +/- 3 to 41 +/- 3 mg/dl; P less than .05) and rose slightly in both INS + GLU (108 +/- 2 to 115 +/- 4 mg/dl; P less than .05) and INS + GLU + HR (111 +/- 3 to 120 +/- 3 mg/dl; P less than .05) due to glucose infusion. Glucagon, epinephrine, norepinephrine, and cortisol were replaced in INS + GLU + HR so that the increments in their levels were 102 +/- 6, 106 +/- 14, 117 +/- 9, and 124 +/- 37%, respectively, of their increments in INS. At no time was there a significant difference between the hormone levels in INS and INS + GLU + HR. The rise in the counterregulatory hormones per se accounted for only half (53 +/- 9% by the AV difference method and 54 +/- 10% by tracer method) of the glucose production associated with hypoglycemia resulting from insulin infusion. The rate and efficiency of alanine conversion to glucose in the hormone-replacement studies were only 29 +/- 10 and 50 +/- 27% of what occurred during hypoglycemia induced by insulin infusion. In conclusion, the counterregulatory hormones alone (i.e., without accompanying hypoglycemia) can account for only 50% of the glucose production that is present during insulin-induced hypoglycemia. The remaining 50%, therefore, must result from effects of hypoglycemia other than its ability to trigger hormone release.

Alanine↗

Functional neuroanatomic mapping of the rat striatum: regional differences in glucose utilization in normal controls and after treatment with apomorphine.

Glucose utilization was measured in 5 regions of rat striatum within four anterior-posterior levels. Areas of minimal and maximal glucose utilization were identified. Density-window image analysis was used to quantify areas of minimal and maximal glucose utilization, which were also apparent upon close visual inspection. In a normal control group, there were substantial regional variations in striatal glucose utilization (e.g. dorsal vs ventral; dorsomedial vs dorsolateral), revealing a detailed pattern, previously unavailable, which served as a baseline to study the effect of systemic apomorphine. The highest levels of glucose utilization were in small islands 0.01-0.25 mm2, and in what appeared to be dense clusters of islands that formed larger zones. Apomorphine treatment decreased glucose utilization in dorsomedial regions, increased it in a ventromedial region, and did not change it in others. The findings emphasize the importance of regional analysis of striatum in functional and physiological studies, and provide a new baseline for analyses of striatal glucose utilization in studies of development and aging, drug effects, external stimuli, and rat models of movement disorders.

Animals↗

Factors associated with psychological distress in cancer patients.

We studied the mental health of 1,278 patients with cancer and 645 family members of patients with cancer to delineate clinical and demographic characteristics associated with poor psychological status. For both patients and their matched relatives, there was a direct relationship between poorer mental health scores and younger age. Highly significant age differences emerged as well for subscale scores of anxiety, depression, and general positive affect in patients, and for depression, emotional ties, and loss of control in relatives. Treatment status, performance status, and sex also contributed significantly to mental health scores. Patients at greatest risk for psychological problems are young, female, receiving palliative or active treatment as opposed to follow-up care, and symptomatic or not fully ambulatory. Clinicians should be alert to the potential for psychological problems among patients in these categories.

Adaptation, Psychological↗

Retroperitoneal unilateral ileofemoral thromboendarterectomy.

This clinical series of 145 operative procedures is presented to demonstrate that an aggressive approach in the management of ileofemoral arterial insufficiency utilizing a retroperitoneal approach for thromboendarterectomy is useful and appropriate. Considering the overall risk factors associated with this patient population, we have demonstrated that this method is well tolerated as supported by the low morbidity and mortality figures presented. The native vascular tree has been preserved, and excellent early and long-term revascularization goals have been obtained.

Adult↗

Serotonin models of myoclonus in the guinea pig and rat.

Myoclonus could not be induced in rats with either L-5-HTP alone or hypoxia. Following amine depletion or destruction of the serotonin neurons with 5,7-DHT, myoclonus appeared as part of a complex serotonergic behavioral syndrome induced by serotonin agonists. On the other hand, in the guinea pig, L-5-HTP induces a pure myoclonic syndrome in a dose-dependent fashion. Myoclonus also was induced by injection of serotonin into the dorsal pons of the guinea pig. This is additional evidence confirming the importance of the brainstem structures in the L-5-HTP guinea pig model of myoclonus. Deoxyglucose (DG) autoradiography in guinea pigs following systemic L-5-HTP administration demonstrated increased glucose metabolism within thalamic and third nerve nuclei, with decreased metabolism in the cortex, and the molecular layer of the hippocampus. Since serotonin is an inhibitory transmitter, we hypothesize that the decreases observed in cortex may be the result of direct serotonergic inhibition, whereas the increases observed in the thalamus probably represent indirect effects via polysynaptic pathways.

5-Hydroxytryptophan↗

Psychosocial correlates of survival in advanced malignant disease?

Prospective studies of the general population have isolated specific social and psychological factors as independent predictors of longevity. This study assesses the ability of these factors, plus two others said to influence survival in patients with cancer, to predict survival and the time to relapse after a diagnosis of cancer. Patients with unresectable cancers (n = 204) were followed to determine the length of survival. Patients with Stage I or II melanoma or Stage II breast cancer (n = 155) were followed to determine the time to relapse. Analysis of data on these 359 patients indicates that social and psychological factors individually or in combination do not influence the length of survival or the time to relapse (P less than 0.10). The specific diagnosis (F = 2.0, P = 0.06), performance status (F = 0.66, P = 0.62), extent of disease (F = 1.12, P = 0.89), and therapy (F = 1.08, P = 0.35) were also unrelated to the psychosocial factors studied. Although these factors may contribute to the initiation of morbidity, the biology of the disease appears to predominate and to override the potential influence of life-style and psychosocial variables once the disease process is established.

Attitude↗

A psychological analysis of cancer patients and their next-of-kin.

A supportive family environment is thought to enhance the capacity of cancer patients to adapt to their illness and treatment. But families, like patients, vary in their ability to cope with the impact of a cancer diagnosis in a family member and in their ability to fulfill the patient's needs. Increased understanding of the interrelationships between the family's and patient's responses to illness is of fundamental importance to the care of the patient with cancer. A heterogeneous sample of 201 cancer patients and their relatives were studied to determine compatibility of psychological status and to isolate clinical and demographic variables associated with psychological distress. Self-report tests of anxiety, mood disturbance, and mental health were applied. Despite large individual variation, the psychological status of patients and their matched relatives was closely correlated. The patient's treatment status affected both patients and their next-of-kin. Psychological well-being worsened according to whether patients were receiving follow-up care, active treatment, or palliative therapy. These data suggest a mutuality of psychological response between patients and their families. Supportive intervention for the patient or relative who manifests distress, therefore, should benefit both. Because patients and relatives involved with palliative treatment are most in need of psychological assistance, particular attention should be paid to this group, as is attempted in hospice care.

Adult↗

Alterations of regional cerebral blood flow and oxygen metabolism in Parkinson's disease.

Regional cerebral blood flow (rCBF) and oxygen metabolism (rCMRO2) were determined in six normals, six unilateral Parkinson's disease (PD) patients, and eight bilateral PD patients. In the unilateral patients, rCBF and rCMRO2 in the basal ganglia contralateral to the symptomatic limbs was 13% higher than on the other side (p less than 0.01); in the frontal cortex it was 8% lower than the other side, suggesting abnormal neuronal function in both regions. The bilateral PD patients had a widespread decrease (20%) in rCBF unaccompanied by comparable changes in rCMRO2, suggesting vasoconstriction due to loss of dopaminergic innervation of blood vessels in more advanced PD patients.

Cerebrovascular Circulation↗

Anesthesia in the geriatric patient.

Geriatric anesthesia, or anesthesia in the aged, is no different from anesthesia in younger patients, except that it takes less and lasts longer. Both the anesthesiologist and the surgeon must treat the aged patient with care and gentleness. We must be ever aware that each vital system can be irreparably damaged by our slightest inattention to minute detail. Dr. Harold Griffith once said, "The straw which breaks the camel's back may be a very small one when the camel is nearing the end of its journey."

Aged↗

Psychosocial status in chronic illness. A comparative analysis of six diagnostic groups.

Assumptions that psychological attributes are specific to particular diagnoses characterize many investigations of chronically ill patients. We studied 758 patients, each of whom had one of six different chronic illnesses, to determine and compare their scores on the Mental Health Index. Five groups of physically ill patients (with arthritis, diabetes, cancer, renal disease, or dermatologic disorders) did not differ significantly from one another or from the general public, but all had significantly higher scores for psychological status when compared with the sixth group, patients under treatment for depression. There was a significant direct relation between higher mental-health scores and advancing age across all patient populations. Patients with recently diagnosed illness in all groups had poorer mental-health scores than did patients whose illness had been diagnosed more than four months previously. A direct relation between declining physical status and mental-health scores was observed. These results suggest that psychological adaptation among patients with chronic illnesses is remarkably effective and fundamentally independent of specific diagnosis.

Adult↗

The use of photographs of postoperative results prior to melanoma resection.

A total of 99 patients scheduled for resection of stage I melanoma were assigned randomly to be shown individually relevant photographs of anticipated postoperative results. All patients had received verbal information on this subject during discussions with their plastic surgeons. Anticipated and actual cosmetic impact or distress was measured with a self-report questionnaire given prior to and 6 months following surgery. Patients were least distressed postoperatively when their scars were not larger than anticipated. However, photographs failed to achieve the expected benefit of increasing the accuracy of patients' expectations of their postoperative appearance. Consequently, photographs had no effect on levels of preoperative or postoperative distress. Selective attention and preferences for limited information among some patients are suggested explanations for these results.

Adult↗

Intermolecular interactions in collagen self-assembly as revealed by Fourier transform infrared spectroscopy.

When a solution of collagen molecules, at neutral pH and moderate ionic strength, is warmed from 4 degrees to 30 degrees C, a spontaneous self-assembly process takes place in which native-type collagen fibers are produced. Events occurring during thermally induced fibrillogenesis process can be monitored, in aqueous media and in real time, by Fourier transform infrared spectroscopic techniques. Tentative assignments of observed spectral bands are given.

Animals↗