Abnormalities of glutathione peroxidase and glutathione reductase in four patients with Friedreich's disease.
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Adolescent↗
Biomedical subjects
R Hurd
Publications and source records attributed to R Hurd.
Abnormalities of antioxidant metabolism in a case of Friedreich's disease.
We report a patient with Friedreich's disease (FD) who exhibited abnormalities of antioxidant metabolism, including decreased levels of glutathione peroxidase, glutathione reductase, and selenium, and an increased lipid peroxide index. These abnormalities became normal after treatment with N-acetylcysteine, selenium, and low-dose vitamin E therapy. Treatment was associated with a decreased rate of clinical decline. FD is a neurodegenerative disorder that may be related to disturbed antioxidant metabolism; the disorder may be treatable with antioxidant compounds.
Acetylcysteine↗
Short TE phosphorus spectroscopy using a spin-echo pulse.
In vivo phosphorus spectroscopy requires very short acquisition delays in order to capture the signal from components with short transverse relaxation times (T2). The echo time typical of standard slice selective spin-echo pulses are too long for this application, so hard pulse, free induction decay (FID) acquisitions have frequently been used instead. With FID, however, there is an interval between the time of coherence and data acquisition (acquisition delay), with resulting baseline distortions. In this paper we describe the design of a new short TE, slice-selective, composite spin-echo pulse with echo times as short as 2.5 ms. With a long TR, fully relaxed, multislice spectra can be collected. This technique will be useful for assessing in vivo, changes in brain phospholipid activity associated with psychiatric and neurological diseases.
Brain↗
19F relaxation rate enhancement and frequency shift with Gd-DTPA.
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Contrast Media↗
19F magnetic resonance imaging of the reticuloendothelial system.
In this study sequential 1H and 19F magnetic resonance imaging methods were used to map the distribution of fluorinated compounds in vivo. An intravenously administered emulsion of perfluorooctylbromide (PFOB), an agent known to localize in the reticuloendothelial system, was detected in the liver and spleen of all studied hamsters and mice using 19F MRI. Lungs and salivary glands were also affected in some animals. Using a G. E. NMR CSI 2-T spectroscopy/imaging system, projection 19F images were obtained in 4 to 8 min. Subsequent mouse studies using a thick-slice driven equilibrium pulse sequence produced 19F images with an improved signal-to-noise ratio in a shorter acquisition time. With PFOB, 19F MRI has the capability of detecting macrophages in the reticulo-endothelial system and in other sites where macrophages congregate. This is the first report where the reticuloendothelial system was specifically imaged in live animals and where driven equilibrium imaging techniques have been applied to 19F MRI.
Animals↗
Selective peritoneal lavage in the management of comatose blunt trauma patients.
Comatose blunt trauma patients undergo diagnostic peritoneal lavage to aid in the management of severe injuries. In deference to routine performance of lavage, patients felt to be a risk for abdominal injury were prospectively studied by using selective criteria for lavage. One hundred consecutive comatose blunt trauma patients were studied; five underwent urgent celiotomy for refractory hypotension. Five criteria for lavage were: history of postinjury hypotension, abdominal physical findings suggestive of underlying abdominal injuries, evidence of fracture of the bones of the trunk and/or femur, blunt trauma of unknown etiology, and operative general anesthesia required for nonabdominal injuries. Fifty-five patients satisfied at least one of the above criteria and underwent peritoneal lavage. Forty patients not satisfying the criteria were observed without peritoneal lavage, as it was felt they had a decreased probability of serious abdominal injury. One of these patients had a minor liver laceration found at the time of autopsy following his death from severe head injury. None of the other patients had evidence of intra-abdominal injury by autopsy or subsequent clinical course. Utilizing the selective criteria, none of the 100 consecutive blunt trauma patients had major delay in abdominal diagnosis or missed significant abdominal pathology defined by operation, clinical course, or autopsy. Routine peritoneal lavage in all comatose blunt trauma patients may subject the patient to unnecessary risk, waste valuable time, increase the cost of care, and alter subsequent diagnostic procedures. Based on this small study, it appears that comatose blunt trauma victims not fulfilling the criteria may be effectively evaluated without the use of peritoneal lavage.(ABSTRACT TRUNCATED AT 250 WORDS)
Abdominal Injuries↗
Major pelvic fractures.
Pelvic fractures associated with blunt trauma contributed significantly to morbidity and mortality in 593 patients with high-velocity deceleration injuries. Those with open, hemorrhagic pelvic fractures required massive blood volume replacement and intensive care for long periods of time and had a 60% mortality. Patients with hemorrhagic pelvic fractures also had a notable blood replacement requirement (mean, 29 units) and a 50% mortality. Patients with open pelvic fractures without significant hemorrhage had a 25% mortality and were at an increased risk of pelvic sepsis. The overall mortality associated with pelvic fractures following high-velocity deceleration accidents was 16.6%. The identifiable causes of death in patients with pelvic fractures were associated injuries, particularly closed head injury, hemorrhage from pelvic vessels, and sepsis. An improved survival rate requires better, more prompt use of available treatment, as well as development of new and better methods of caring for severely injured patients with blunt trauma.
Adolescent↗
Folic acid and vitamin D status of young children receiving minimal anticonvulsant drug therapy.
The effects of long term, low dosage anticonvulsant drug therapy on the vitamin D and folacin status of young children was studied. Biochemical and dietary parameters including serum calcium, phosphorous and alkaline phosphatase; serum and red blood cell folacin; serum drug concentrations; hematocrits; and dietary intakes of vitamin D and folacin were measured in seven subjects. All subjects were taking low dosages of medication. Four subjects were considered at risk for developing a folacin deficiency based on red blood cell folacin concentrations. Two of these subjects had inadequate dietary intakes of folacin. Serum calcium and alkaline phosphatase levels were within normal ranges for all subjects; two subjects had subnormal levels of serum phosphorous. Dietary intake of vitamin D was below fifty percent of the Recommended Dietary Allowance for four subjects. The data of the present study suggest that young children undergoing chronic anticonvulsant drug therapy of minimal dosage are susceptible to developing folacin deficiency especially if dietary intake of folacin is inadequate. These children do not appear to be at risk for developing vitamin D deficiency probably due to the low dosage of medication coupled with adequate sunlight exposure.
Alkaline Phosphatase↗