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Biomedical subjects

P Hudson

Publications and source records attributed to P Hudson.

At least 19 recordsLinked to original sources
PubMed2002

Functional vitamin B(12) deficiency and Alzheimer disease.

Moderately elevated total serum homocysteine is associated with an increased risk of atherothrombotic vascular events. Accordingly, serum homocysteine is increased in patients with vascular dementia but is also increased in clinically diagnosed and histologically confirmed AD. It is generally considered that homocysteine potentiates endothelial and neuronal oxidative injury in these diseases. A complementary model of oxidative stress-induced hyperhomocystinemia is proposed by the authors. The hypothesis accounts for several unusual features relating to single-carbon metabolism and AD, including the absence of macrocytic anemia in these patients. It is suggested that cerebral oxidative stress augments the oxidation of an intermediate form of vitamin B(12) (cob[I]alamin) generated in the methionine synthase reaction, thereby impairing the metabolism of homocysteine. Oxidative stress also compromises the intraneuronal reduction of the vitamin to its metabolically active state. Currently available pharmaceutic forms of vitamin B(12) are unlikely to be utilized by neurons under these conditions. Glutathionylcobalamin might be preferential for the treatment of such patients.

5-Methyltetrahydrofolate-Homocysteine S-Methyltran↗
PubMed2001

Neurons reduce glial responses to lipopolysaccharide (LPS) and prevent injury of microglial cells from over-activation by LPS.

The microenvironment of the CNS has been considered to tonically inhibit glial activities. It has been shown that glia become activated where neuronal death occurs in the aging brain. We have previously demonstrated that neurons tonically inhibit glial activities including their responses to the bacterial endotoxin lipopolysaccharide (LPS). It is not clear whether activation of glia, especially microglia in the aging brain, is the consequence of disinhibition due to neuronal death. This study was designed to determine if glia regain their responsiveness to LPS once the neurons have died in aged cultures. When cultured alone, glia from postnatal day one rat mesencephalons stimulated with LPS (0.1-1000 ng/mL) produced both nitric oxide (NO) and tumor necrosis factor alpha (TNFalpha), yielding a sigmoid and a bell-shaped curve, respectively. When neuron-containing cultures were prepared from embryonic day 14/15 mesencephalons, the shape of the dose-response curve for NO was monotonic and the bell-shaped curve for TNFalpha production was shifted to the right. After 1 month of culture under conditions where neurons die, the production curves for NO and TNFalpha in LPS-stimulated glia shifted back to the left compared to mixed neuron-glia cultures. Immunostaining of rat microglia for the marker CR3 (the receptor for complement component C3) demonstrated that high concentrations of LPS (1 microg/mL) reduced the number of microglia in mixed-glial cultures. In contrast, reduction of CR3 immunostaining was not observed in LPS-stimulated mixed neuron-glia cultures. Taken together, the results demonstrate that disinhibition of the glial response to LPS occurs after neurons die in aged cultures. Once neurons have died, the responsiveness of glia to LPS is restored. Neurons prevented injury to microglia by reducing their responsiveness to LPS. This study broadens our understanding of the ways in which the CNS microenvironment affects cerebral inflammation.

Animals↗
PubMed2001

Randomized controlled trials in palliative care: overcoming the obstacles.

Problems associated with conducting randomized controlled trials (RCTs) in palliative care are well documented. Palliative care researchers commonly report difficulties with recruitment, attrition, and randomization. Despite these difficulties, there is a crucial need to enhance the evidence base of palliative care and RCTs are a recognized method for achieving this. Few publications to date have provided clear strategies for researchers considering RCTs in palliative care. This article presents an overview of the features of the RCT and reasons for using this research method. Problems with conducting RCTs are considered with discussion focusing on an approach for managing these hurdles. Examples are provided from an ongoing RCT investigating a support and information programme for lay caregivers of people receiving palliative care at home. The aim of the article is to provide a guide to conducting RCTs and to promote their use in palliative care when researchers are evaluating new interventions.

Humans↗
PubMed2001

Microdentistry: current pit-and-fissure caries management.

The systemic application of fluoride has rendered enamel more resistant to decalcification and decay. While the incidence and severity of dental caries has decreased, the diagnosis of caries in this enamel environment has created significant new challenges and dilemmas. Traditional diagnostic methodology and treatment philosophy no longer seem appropriate. This article describes the historical perspectives, current diagnostic challenges, and the treatment dilemmas of occlusal pit-and-fissure systems currently facing the dental profession.

Air Abrasion, Dental↗
PubMed2000

Immune modulatory effects of neural cell adhesion molecules on lipopolysaccharide-induced nitric oxide production by cultured glia.

Activation of glial cells often occurs at sites of neuronal injury or death and where there is disruption of communication between glia and neurons. We have previously reported that neurons exert an inhibitory influence on LPS-stimulated nitric oxide (NO) production in glial cells. We hypothesized that neural cell adhesion molecules (NCAM) might mediate this inhibitory effect, and this study was designed to elucidate the role of NCAM on lipopolysaccharide (LPS)-induced NO production. We found that soluble NCAMs reduced LPS-stimulated NO production by cultured glia. A monoclonal antibody that recognizes the third immunoglobulin (Ig) domain and can mimic the functions of NCAMs reduced LPS-stimulated NO production, whereas another antibody that binds to other regions of the NCAM did not modulate NO production. Using a 10-amino acid peptide from the third Ig domain of the NCAM, a peptide fragment within the region recognized by the NCAM antibody, mimics the effect of the molecule in reducing NO production. This study demonstrated that NCAMs could modulate LPS-stimulated NO production, most likely via interaction between NCAMs. These results suggest that neuron-glia interactions via NCAMs play an important role in regulating the activities of glial cells in the brain.

Adjuvants, Immunologic↗
PubMed2000

Blood donation by healthy individuals with haemochromatosis.

AIM: To determine how many individuals with haemochromatosis undergoing therapeutic venesections in our department might be eligible for blood donation. METHODS: Patients with genetic haemochromatosis were assessed with respect to complications of their disorder, the presence of other medical conditions and their suitability to be blood donors. RESULTS: Of 74 patients, 53 have been tested and shown to be homozygous for the Cys282Tyr mutation, and 30 of these (40%) fulfilled criteria for blood donation. This group is having 409 units of blood removed annually or 13-units per individual that is currently discarded. Of these 30 patients, all (100%) were keen to be blood donors. CONCLUSION: It is timely to review the policy regarding use of this wasted blood for transfusion.

Blood Banks↗
PubMed2000

Influence of neurons on lipopolysaccharide-stimulated production of nitric oxide and tumor necrosis factor-alpha by cultured glia.

Cerebral inflammation often originates in a region where neuronal death occurs and thereafter slowly spreads outward. This study aimed to elucidate the roles of neurons in modulating the production of inflammatory factors stimulated by the bacterial endotoxin lipopolysaccharide (LPS). Culturing neurons with mixed glia reduced nitrite and tumor necrosis factor-alpha (TNF-alpha) production compared to cultures with only mixed glia, and shifted the dose-response curve to the right. The decreased nitrite and TNF-alpha production were not due to the cytotoxicity of LPS. Immunocytochemical analysis of glia-neuron co-cultures revealed the morphological changes in the activated microglia. Culturing PC12 cells with rat mixed-glia also reduced nitrite production. The influence of neurons on glial inflammation was partly due to the cell-cell contacts between neurons and glia via neural cell adhesion molecules (NCAM) because NCAM significantly reduced LPS-stimulated nitrite production. These results demonstrate that neurons reduce the production of inflammatory factors by glia. Since cerebral inflammation is important in many neurological disorders, this study might provide insight about the role of glia-neuron interactions in inflammatory responses in the brain.

Animals↗
PubMed1999

Long-term increase of Sp-1 transcription factors in the hippocampus after kainic acid treatment.

Systemic administration of kainic acid (KA), a glutamate receptor agonist, causes robust seizures and has been used as an excellent rodent model for human temporal lobe epilepsy. Recently, we have demonstrated that a single injection of KA increases the steady-state levels of proenkephalin (PENK) mRNA in the rat hippocampus for at least one year. However, the molecular mechanisms underlying this long-term increase in PENK mRNA levels have not been clearly defined. To determine the possible involvement of the Sp-1 transcription factors in this regulation, electrophoresis mobility-shift assays were used to study the expression of Sp-1 factors in the hippocampus after KA treatment. The results showed that there are long-lasting increases in Sp-1 DNA-binding activity. The Sp-1 DNA-binding complexes were only competed by the non-radioactive Sp-1 element and not by ENKCRE2, AP-1 or CRE elements, indicating the specificity of Sp-1 DNA-binding activity. Since the expression of Sp-1 parallels the time course of long-lasting increase in the expression of PENK mRNA and mossy fiber sprouting after KA treatment, we hypothesize that the increase in Sp-1 activity may be associated with the long-term changes in the plasticity of hippocampal function after KA-induced seizures.

Animals↗
PubMed1999

Intensity of nematode infections in cyclic and non-cyclic rock partridge (Alectoris graeca saxatilis) populations.

Populations of rock partridge (Alectoris graeca saxatilis), in the Trentino province of Italy, exhibit cyclic fluctuations in abundance associated with relatively dry habitat. One of the hypothesis to explain these cycles is that survival of some free living parasitic stages and rates of infection are greater in these areas leading to higher parasite burden. This hypothesis was examined by investigating the intensity of parasite infection in cyclic and non cyclic rock partridge populations. Analyses of 87 intestine samples collected from shot rock partridges during 1994 and 1995 identified 8 species of helminths parasites: Ascaridia compar (P = 33.33%; I = 9.28 +/- 1.78), Heterakis tenuicauda (P = 19.54%; I = 10.29 +/- 4.58), Heterakis gallinarum (P = 1.15%; I = 1.0 +/- 0.0), Heterakis altaica (P = 1.15%; I = 17 +/- 0.0), Aonchoteca caudinflata (P = 6.89; I = 2.17 +/- 0.65), Postharmostomum commutatum (P = 5.75; I = 7.0 +/- 3.48), Brachylaema fuscata (P = 1.15; I = 7.0 +/- 0.0), Platynosomum alectoris (P = 2.29; I = 5.5 +/- 1.5). Cestoda, recorded with a prevalence of 5.75, were not identified to species level. A. compar and H. tenuicauda were prevalent in the rock partridge populations and there was no positive association between these species. Intensity of infection in both species was not influenced by host age, sex or year of study but levels of infection with A. compar burdens were significantly greater in cyclic populations than in non cyclic populations and there was a tendency for H. tenuicauda to be greater in cyclic populations. There was no negative relationship between intensity of infection with A. compar or H. tenuicauda and host body mass. These data provide some support for the hypothesis that these parasites may play a role in generating rock partridge population cycles.

Animals↗
PubMed1998

Synergistic neurotoxic effects of combined treatments with cytokines in murine primary mixed neuron/glia cultures.

Activation of brain glial cells with the bacterial endotoxin lipopolysaccharide (LPS), the HIV-1 coat protein gp120, or beta-amyloid-derived peptides, stimulates the expression of several cytokines, including tumor necrosis factor-alpha (TNFalpha), interleukin-1 (IL-1) and IL-6. and nitric oxide (NO) which have been proposed as causes of neurodegeneration in the brain. In the present study, the neurotoxic effects of several cytokines, alone or in various combinations, and the correlations of the release of lactate dehydrogenase, the loss of neurons, and the secretion of NO in brain neuronal cell injury were investigated in murine primary mixed neuronal/glial cell cultures. A specific combination of cytokines, i.e., IL-1 (1 ng/ml)+ TNFalpha (10 ng/ml)/interferon-gamma (IFNgamma) (200 u/ml), induced a dramatic neuronal cell injury in the neuron/glia cultures, and its cytotoxic profile was very similar to that seen with the LPS/IFNgamma-induced neuron injury. This indicates that among the many toxic immune mediators secreted in response to LPS, IL-1 and TNFalpha can mimic LPS as the triggering signals and primary mediators for glia-mediated neuron injury in the presence of IFNgamma. This study provides new insights about the cytotoxic mechanism(s) for cytokine-mediated neuron injury.

Animals↗
PubMed1998

Total serum homocysteine in senile dementia of Alzheimer type.

OBJECTIVE: The main hypothesis was that subtle vitamin B12 deficiencies occur more commonly in senile dementia of Alzheimer type (SDAT) that in healthy elderly individuals, and may be revealed by elevated total serum homocysteine (tHcy). A subsidiary hypothesis was that such deficiencies would be nutritionally independent as determined by retinol binding protein (RBP). DESIGN: A prospective case-controlled survey. SETTING: A Welsh urban psychogeriatric assessment centre and local general practice. PATIENTS: Thirty patients, aged 65 or over, seen consecutively in 1994 with features compatible with DSM-III-R criteria for primary degenerative dementia of Alzheimer type and 30 cognitively intact age-matched control subjects. MEASURES: Diagnosis was assessed using the CAMDEX. Cognitive scores were evaluated with the CAMCOG scale for patients and MMSE scores for control subjects. THcy was measured using high performance liquid chromatography (HPLC), and RBP assayed by a radial immunodiffusion method. RESULTS: Patients had a highly significant elevation of tHcy compared with control (p < 0.0001). Multiple regression highlighted the interrelated effects of tHcy and total serum cobalamin on cognitive scores. RBP did not differ between groups. Macrocytosis was absent, and neutrophil hypersegmentation uncommon, in hyperhomocysteinaemic patients. CONCLUSIONS: SDAT patients have significantly elevated tHcy. This is independent of RBP determined nutritional status. 'Classical' haematological changes of cobalamin or folate deficiency are poor predictors of tHcy in these patients. Aberrant cobalamin tissue delivery appears to contribute to SDAT cognitive decline. Relative contributions of other tHcy determinants require further investigation.

Aged↗
PubMed1998

Treatment with finasteride preserves usefulness of prostate-specific antigen in the detection of prostate cancer: results of a randomized, double-blind, placebo-controlled clinical trial. PLESS Study Group. Proscar Long-term Efficacy and Safety Study.

OBJECTIVES: To evaluate prostate cancer detection and prostate-specific antigen (PSA) among men with benign prostatic hyperplasia treated with finasteride. METHODS: Three thousand forty men 45 to 78 years of age with PSA less than 10 ng/mL and no history of prostate cancer were randomized in a double-blind, placebo-controlled trial to finasteride (n = 1524) or placebo (n = 1516) for up to 4 years. A prerandomization biopsy negative for prostate cancer was obtained in 98% of patients with a screening PSA of 4.0 ng/mL or more, and an end-of-study biopsy was requested of all such patients without a recent second negative biopsy or a prostate cancer diagnosis. RESULTS: Overall, 644 patients (21%) underwent biopsy and 201 (6.6%) underwent transurethral resection of the prostate. Prostate cancer was diagnosed in 4.7% of men on finasteride and 5.1% on placebo (P = 0.7). Elevated PSA prompted diagnosis in 35% of cases on finasteride and 34% on placebo. The area under the receiver operating characteristic curve for last PSA was 0.84 on finasteride and 0.79 on placebo (P = 0.07). Use of an upper limit of normal for last PSA of 2.0 ng/mL for finasteride and 4.0 ng/mL for placebo yielded similar sensitivity (66% versus 70%, P = 0.6), higher specificity (82% versus 74%, P < 0.0001), and a higher likelihood ratio (3.6 versus 2.7, P < 0.05) for finasteride than for placebo. CONCLUSIONS: In men treated with finasteride, multiplying PSA by 2 and using normal ranges for untreated men preserves the usefulness of PSA for prostate cancer detection.

Aged↗
PubMed1998

Expansion rates of small abdominal aortic aneurysms.

BACKGROUND: The present study was carried out in order to examine those factors that influence the rate of expansion of small abdominal aortic aneurysms. METHODS: A retrospective study was undertaken of 112 patients who attended the St George Vascular Laboratory between 1987 and 1997. These patients had abdominal aortic aneurysms that were considered to be too small to warrant surgical repair at the time of presentation. Sequential ultrasound examinations were used to measure maximal anteroposterior aneurysm diameter. From these data, annual growth rates were calculated. Growth rate per annum was then compared with gender, age, initial aortic aneurysm diameter, presence of hypertensive disease, cardiac disease, family history of aneurysmal disease, diabetes mellitus, smoking, beta-adrenergic blockade and lipid lowering drugs. RESULTS: Univariate analysis showed that three factors were significantly related to growth rate: the initial size of the aortic aneurysm, the presence of cardiac disease and the presence of beta-adrenergic blockade. CONCLUSIONS: The presence of beta-adrenergic blockade appeared to have an independent effect on aneurysm growth rate, and suggests a possible role for beta-adrenergic blockade as a therapeutic strategy in controlling expansion rates of small abdominal aortic aneurysms. A controlled double-blind clinical trial is required to demonstrate this conclusively.

Adrenergic beta-Antagonists↗