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Biomedical subjects

R Dawe

Publications and source records attributed to R Dawe.

14 recordsLinked to original sources

Topical 5-aminolaevulinic acid photodynamic therapy for cutaneous lesions: outcome and comparison of light sources.

BACKGROUND: Topical 5-aminolaevulinic acid (ALA) photodynamic therapy (PDT) is increasingly used for superficial non-melanoma skin cancers and their precursors. METHODS: We report our 3-year experience of topical ALA-PDT, with a preliminary comparison of the effects of broadband and laser light sources. RESULTS: We performed 688 treatments on 483 lesions in 207 patients. Complete clearance was achieved in 222/239 lesions of Bowen's disease (BD), superficial basal cell carcinoma (sBCC) and actinic keratosis (AK) (93%) - 117/129 BD (91%), 84/87 sBCC (97%) and 21/23 AK (91%), with a median follow up of 48 weeks. Broadband and laser light sources were of similar efficacy. Recurrences have occurred in 10.3% BD, 4.8% sBCC and 4.8% AK. Adverse effects from PDT were uncommon but included pigmentary change (2%) and minor scarring (2%). How-ever, severe pain was experienced in 16-21% of treatments using the high-output broadband and laser sources, but in only 2% with the low-output xenon arc source. CONCLUSION: Topical ALA-PDT is effective for BD, sBCC and AK and has been an invaluable addition to our dermatology service. Efficacy is similar for broadband and laser light sources, although treatment at higher surface irradiance may be painful, and excellent cosmetic results can be achieved.

Adult↗

Structure-activity studies of antitumor agent irofulven (hydroxymethylacylfulvene) and analogues.

Many analogues of the antitumor agent irofulven have been readily prepared by replacing the allylic hydroxyl with a variety of nucleophiles. Analogues of acylfulvene (the precursor to irofulven) were also prepared by Michael reaction with acrolein. The toxicity of the analogues was determined, as well as preclinical antitumor activity. Several analogues exhibited good activity in mouse xenografts. Structural requirements for activity are discussed.

Animals↗

New sunscreens confer improved protection for photosensitive patients in the blue light region.

BACKGROUND: Some patients with photosensitivity disorders are sensitive to visible radiation. As current commercial sunscreens do not significantly absorb in this region, there is a lack of effective topical photoprotection. To meet this need a new range of sunscreens has been developed incorporating zinc oxide and pigmentary grade titanium dioxide as active ingredients. OBJECTIVES: To determine the effectiveness of the new sunscreens in providing protection for patients with visible radiation photosensitivity. METHODS: In the first part of this study, an in vitro transmission spectrum was obtained. The properties of the new sunscreens, as well as a range of commercial agents, were compared, and a new parameter, photosensitivity protection factor (PPF), was developed. This was used to predict the likely degree of protection the various sunscreens would provide for patients with photosensitivity extending into the visible region. In the second in vivo part of the study, patients with known visible (blue) light photosensitivity were tested using light at 430 +/- 30 nm and the protection factor (PF) at this wavelength was determined. RESULTS: Mean +/- SD PPFs for the new sunscreens were between 5.4 +/- 0.3 and 9.6 +/- 0.3, compared with 4.1 +/- 0.1 for Sun E45 (sun protection factor, SPF 25) and 4.2 +/- 0.1 for RoC Total (SPF 25). The derived in vivo PF for Sun E45 ranged between 1 and 4 (median 2). For the new sunscreens the range was 3 to > 10 (median 8). CONCLUSIONS: This study demonstrates that the new sunscreens do provide protection for patients with sensitivity to visible light (blue light region).

Adult↗

Sesquiterpenes from the basidiomycete Omphalotus illudens.

A new sesquiterpene, omphadiol (4), has been isolated from cultures of Omphalotus illudens. Several known compounds, including illudosin (1), were also obtained. Structures were determined using MS, NMR, and X-ray techniques.

Basidiomycota↗

Phototoxicity in quinolones: comparison of ciprofloxacin and grepafloxacin.

Skin photosensitizing reactions have been reported during treatment with fluoroquinolone antibiotics. The incidence and severity of such reactions, however, appear to differ between agents. The photosensitizing effect of grepafloxacin 400 and 600 mg once daily was compared with that of ciprofloxacin 500 mg bd and placebo in a double-blind trial involving 32 healthy subjects. Skin photosensitivity, expressed as the minimal erythemal dose (MED), was measured before treatment and towards the end of the 7 day treatment period. Grepafloxacin showed a mild photosensitizing effect comparable to that of ciprofloxacin, with significant reductions in MED at 335+/-30 and 365+/-30 nm. However, few subjects showed MEDs outside the normal range, and MEDs consistently returned to baseline values within 1 week of stopping treatment. No significant differences between the effects of grepafloxacin and ciprofloxacin could be observed. It is concluded that grepafloxacin has a weak, UVA-dependent and rapidly reversible photosensitizing effect.

Adolescent↗

Implementing 'A Vision for the Future' targets in a hospice.

This article outlines the response of a palliative care unit to the targets set out in A Vision for the Future (DoH/NHSME 1992). The authors explain how the unit has evaluated the existing service, using audit and quality assurance techniques, and how changes have been implemented to the benefit of staff and patients alike.

Education, Nursing, Continuing↗

Immunomodulation at the initiation of phototherapy and photochemotherapy.

The numbers and function of circulating lymphocyte subsets are within normal ranges in patients with psoriasis and are not affected by 4 weeks of ultraviolet (UV) therapy, except for a suppression in natural killer (NK) cell activity. However, it is possible that immunomodulation might occur at the initiation of phototherapy with a return to control values on more prolonged UV exposure. Thus, in this study the responses of 15 patients with chronic plaque psoriasis undergoing broad-band UVB therapy, 10 narrow-band (311-313 nm) UVB therapy and 10 PUVA therapy were compared. In each case, samples were taken immediately before starting treatment and 1 week later. Broad-band UVB and PUVA therapy had no effect on NK activity, but a significant reduction was found in the group receiving narrow-band UVB. In vitro lymphoproliferative responses to mitogens and to herpes simplex virus antigens did not alter with therapy, except there was a significant increase in mitogen responses (at optimal mitogen concentrations only) in the narrow-band UVB group. Generally no alterations in overall percentages of circulating mononuclear cells were found in any group. Samples were taken from the epidermis of the forearm and back of the patients receiving narrow-band UVB for the quantification of urocanic acid (UCA) isomers. The total UCA concentration remained unchanged after 1 week of therapy, while the percentage of cis-UCA increased significantly at both sites in the majority of patients. However, this rise did not correlate with the decrease in NK cell activity and the two parameters may not be related causally.

Adult↗

Comparison of chemical analyses of hollow-fiber dialyzer extracts.

Hollow-fiber hemodialyzers containing cellulose-based membranes have been shown to produce positive results with the Limulus amebocyte lysate (LAL) test. This study was undertaken to determine whether endotoxin was causing the reaction. Rinses from 45 parallel-plate and hollow-fiber dialyzers from eight different manufacturers were tested using three lysates and four LAL methods. In addition, four in vitro cellular methods--human leukocytic pyrogen, lymphocytic activating factor, peritoneal macrophage, and arginase release--were used to evaluate endotoxin activity. The substance causing the reaction was identified using chromatographic methods. Results indicate that the LAL-reactive material is cellulose derived and is not pyrogenic.

Arginase↗

Characterization of Limulus amoebocyte lysate-reactive material from hollow-fiber dialyzers.

Hollow-fiber hemodialyzers containing cellulose-based membranes have been shown to produce positive results with the Limulus amoebocyte lysate test. This study was undertaken to determine whether endotoxin was causing the reaction. Rinses from 45 parallel-plate and hollow-fiber dialyzers from eight different manufacturers were tested before and after treatment with cellulase, using three lysates and four Limulus amoebocyte lysate methods. In addition, four in vitro cellular methods--human leukocytic pyrogen, lymphocytic activating factor, peritoneal macrophage, and arginase release--were used to evaluate endotoxin activity. The substance causing the reaction was identified by chromatographic methods. Results indicate that the Limulus amoebocyte lysate reactive material is cellulose derived and not pyrogenic.

Cellulose↗

Metabolism of methoxyphenamine in man and in monkey.

Metabolites of methoxyphenamine in the urine of human subjects and monkeys were separated by gas-liquid chromatography and identified by comparison of their chromatographic and mass spectrometric behavior with those of synthetic compounds. Aromatic O-demethylation, aromatic ring hydroxylation (both followed by glucuronide conjugation), and N-demethylation were shown to occur in man as well as in monkey. In man these were the principal metabolites, whereas in the monkey three additional unidentified major metabolites were formed.

Adult↗

In vitro metabolism of 1-phenyl-2-propanone oxime in rat liver homogenates.

1-Phenyl-2-propanone oxime is a known in vitro metabolite of amphetamine. Further in vitro metabolism of this oxime with the 12,000g supernatant fraction from homogenized rat liver gave one major and two minor metabolites which were identified as 2-nitro-1-phenylpropane, benzyl alcohol, and 1-phenyl-2-propanone, respectively, by means of combined gas chromatography and mass spectrometry, and by comparison with authentic samples of each product.

Animals↗