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Biomedical subjects

M C Ott

Publications and source records attributed to M C Ott.

8 recordsLinked to original sources

Intraoperative radioguided thoracoscopic removal of ectopic parathyroid adenoma.

Twenty-five percent of primary hyperparathyroidism is caused by ectopic mediastinal parathyroid glands, with 2% of these not accessible to standard cervical surgical approaches. Advancement in video-assisted thoracoscopic surgical techniques has decreased the need for sternotomy to successfully remove these ectopic glands. The thoracoscopic approach, however, is limited by the surgeon's inability to always accurately visualize ectopic glands. Intraoperative radionuclide-guided dissection, using a thoracoscopic approach, provides a novel adjunct to the removal of occult ectopic parathyroid glands. We report a case of an occult ectopic parathyroid adenoma removed thoracoscopically using an intraoperative handheld gamma probe.

Adenoma↗

Headache in divers.

The increasing popularity of scuba diving has added a new category to the differential diagnosis of headache. Headache in divers, while uncommon and generally benign, can occasionally signify serious consequences of hyperbaric exposure such as arterial gas embolism, decompression sickness, and otic or paranasal sinus barotrauma. Inadequate ventilation of compressed gases can lead to carbon dioxide accumulation, cerebral vasodilatation, and headache. Other types of headache encountered in divers include exertional headache, cold stimulus headache, migraine, tension-type headache, acute traumatic headache, cervicogenic headache, carbon monoxide poisoning headache, and headache associated with envenomation. Correct diagnosis and appropriate treatment require a careful history and neurologic examination as well as an understanding of the unique physiologic stresses of the subaquatic environment.

Animals↗

Tympanic membrane perforation in adults. How to manage, when to refer.

Tympanic membrane perforation is a common and potentially serious condition. One of the most important aspects of primary care for perforations is deciding which patients need to be seen by an otolaryngologist and how urgently they need to be referred. There are several indications for surgical repair, but most cases can be managed with conservative care and require no referral.

Adult↗

Laminins: structure and genetic regulation.

The laminins form a large family of modular proteins found in basement membranes, but also elsewhere. They function as structural components and are essential for morphogenesis, but in addition interact with cell surface receptors such as integrins and alpha-dystroglycan. By virtue of their receptor interactions, they initiate intracellular signalling events that regulate cellular organization and differentiation. The many interactions of laminins are mediated by binding sites, often contributed by single domains, which may differ between different forms of laminin. In the present article, we describe how the diversity of laminins and the genetic regulation of the expression of different laminin forms lead to the formation of extracellular matrices with variable laminin composition and thereby different biological properties.

Alternative Splicing↗

L-prolyl-l-leucyl-glycinamide and its peptidomimetic analog 3(R)-[(2(S)-pyrrolidylcarbonyl)amino]-2-oxo-1-pyrrolidineacetamide (PAOPA) attenuate haloperidol-induced c-fos expression in the striatum.

Acute treatment of rats with haloperidol results in a rapid and transient increase in striatal c-fos mRNA and Fos immunoreactivity. The induction of immediate early genes by haloperidol may be involved in the development of extrapyramidal side effects. L-Prolyl-L-leucyl-glycinamide (PLG, or MIF-1) has been observed to antagonize the development of haloperidol-induced D(2) receptor supersensitivity in rats. We investigated the modulatory effects of PLG on haloperidol-induced c-fos and Fos protein expression in the rat striatum. We report that coadministration of either PLG or the potent analog of PLG, 3(R)-[(2(S)-pyrrolidylcarbonyl)amino]-2-oxo-1-pyrrolidineacetam ide (PAOPA), attenuated haloperidol-induced c-fos and Fos expression. Haloperidol induced [2 mg/kg, intraperitoneally (i.p.)] c-fos and Fos expression by 500% and 100%, respectively. These responses were attenuated by 170% and 75%, respectively, when coadministered with PLG (20 mg/kg, i.p.) or by 79% by PAOPA (10 microg/kg, i.p.).

Animals↗

Cerebral embolization presenting as delayed, severe obtundation in the postanesthesia care unit after total hip arthroplasty.

Catastrophic neurologic events occur rarely postoperatively and must be diagnosed quickly. A 63-year-old woman who had undergone uneventful total hip arthroplasty experienced obtundation after admission to the postanesthesia care unit. Cranial magnetic resonance imaging revealed multiple lesions consistent with ischemia or infarction, and fat cerebral embolism was diagnosed. We describe the numerous complications that may occur in patients in the postanesthesia care unit and review the differential diagnosis of altered mental status in such patients. Paradoxical cerebral fat embolization must be considered in the differential diagnosis of altered mental status after pelvic or long bone fracture or lower extremity major joint replacement, and this condition may occur despite normal pulmonary function and no patent foramen ovale or right-to-left intracardiac shunt. Magnetic resonance imaging with T2-weighted sequences is the cranial imaging study of choice for early evaluation of patients with sudden multifocal neurologic deficits and suspected fat embolism syndrome.

Anesthesia Recovery Period↗

Design, synthesis, and dopamine receptor modulating activity of diketopiperazine peptidomimetics of L-prolyl-L-leucylglycinamide.

The diketopiperazine "C5" conformational mimic has been incorporated into the L-prolyl-L-leucylglycinamide (PLG, 1) structure and into the bicyclic lactam PLG peptidomimetic structure 3 to give compounds 5 and 6, respectively. These analogues were designed to explore the idea that the N-terminal "C5" conformation, which was found in the crystal structure of 2 and which was mimicked in 4 by the diketopiperazine function, was a factor in the high potency of these two agents. Through the use of the [3H]spiroperidol/N-propylnorapomorphine (NPA) D2 receptor competitive binding assay, both 5 and 6 were found to increase the affinity of the dopamine receptor for agonists and both were found to increase the percentage of D2 receptors which existed in the high-affinity state. These effects were observed when Gpp(NH)p was either absent or present, and they were analogous to the effects observed previously for PLG and the PLG peptidomimetics 2 and 4. However, the potency seen with 5 and 6 was less than that seen for 2 and 4, suggesting that while the N-terminal "C5" conformation may play a role in the potency of the gamma-lactam peptidomimetics of PLG, it does not appear to be the primary factor. In the 6-hydroxydopamine-lesioned animal model of Parkinson's disease, 5 altered apomorphine-induced rotational behavior in a dose-dependent manner. The maximum effect occurred at a dose of 0.01 mg/kg i.p. and resulted in a 52.27 +/- 13.96% (p < 0.001, n = 7) increase in rotations compared to apomorphine administered alone.

Animals↗

Modulation of dopaminergic neurotransmission in the 6-hydroxydopamine lesioned rotational model by peptidomimetic analogues of L-prolyl-L-leucyl-glycinamide.

Melanocyte stimulating hormone release inhibiting factor (MIF-1), also known as L-prolyl-L-leucyl-glycinamide (PLG), has previously been found to have the ability to modulate dopamine D2-receptor agonist binding both in the striatum and limbic regions. In the present study the 6-hydroxydopamine unilateral lesion model of apomorphine-induced rotational behaviour, in Wistar rats, was used to assess the dopaminergic modulatory activity of PLG and two novel analogues, L-prolyl-L-prolyl-L-prolinamide (analogue A) and (2S, 5R, 7R)-1-Aza-7[3'(S)-1-(2',5'-dioxo-pyrrolidino[2,1-c]piperazino++ +)] -8-oxo-4-thiabicyclo[3.30]octane-2-carboxamide (analogue B). PLG and the two novel analogues showed a bell-shaped dose-response relationship, suggesting that analogue A, B and PLG all manifest their effect through a similar mechanism and exhibit a window of therapeutic efficacy. Analogue A was a 100 times, while analogue B was 10 times, more potent than PLG in increasing the contralateral rotational response when given in combination with apomorphine. Analogue A was also more efficacious than PLG or analogue B at increasing apomorphine-induced contralateral rotations. Intrastriatal administration of either analogue A or B resulted in a greater increase in apomorphine-induced rotations than the most efficacious intraperitoneally delivered dose. The results of the present study suggest that PLG and its two novel analogues are able to modulate dopamine receptor activity and may be possible therapeutic agents for the treatment of Parkinsonian symptoms as well as tardive dyskinesia.

Animals↗