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Biomedical subjects

R J Hooper

Publications and source records attributed to R J Hooper.

At least 19 recordsLinked to original sources

Increases in serum concentrations of cardiac proteins and the prediction of early postoperative cardiovascular complications in noncardiac surgery patients.

We investigated the use of measurements of serum concentrations of the cardiac proteins troponins I and T as biochemical markers of myocardial cell damage in 80 patients undergoing vascular or major orthopaedic surgery. Holter electrocardiographic monitoring was carried out before surgery and for 3 days after surgery. Blood samples for troponins I and T and creatine kinase-MB isoenzyme were taken on each of these 4 days. Outcome was assessed at 3 months using a patient questionnaire, general practitioner follow-up and case notes review. Silent postoperative myocardial ischaemia was detected in 21 patients; increases in troponins I and T and creatine kinase-MB occurred in four, six and 17 of these patients, respectively. Eight patients suffered major postoperative complications (cardiac death, myocardial ischaemia, congestive cardiac failure, unstable angina and cerebrovascular accident) and 21 minor complications (poorly controlled hypertension needing increased or new additional treatment, palpitations, increased tiredness or shortness of breath in the absence of known respiratory disease). There were no associations between postoperative ischaemia and cardiac protein concentrations. The relative odds for the associations of major adverse outcome at 3 months after surgery and postoperative ischaemia or increased serum concentrations of the three proteins were 5.39 [95% confidence intervals 1.16-27.67] for postoperative ischaemia; 5.64 [1.07-31.00] for creatine kinase-MB isoenzyme; 17.00 [2.20-116.54] for troponin T and 13.20 [1.12-135.00] for troponin I. We found troponin T to be the only prospective marker for both major and minor cardiovascular complications (relative odds 10.65 [1.26-252.88]).

Aged↗

Clinical case-based multimedia tutorials as a solution to some problems facing medical education.

Medical education faces many challenges as curricula become crowded and teacher numbers fall. In addition, there are moves to reduce factual overload and to concentrate more on pathophysiological principles illustrated by relevant clinical cases. We describe one means of addressing these problems, using computer-aided learning programs which are based on clinical cases, are interactive and which incorporate multimedia elements. These CD-ROM programs include student assessments, a resource of background material and support self-managed and distance learning.

CD-ROM↗

Racial variation in serum creatine kinase unrelated to lean body mass.

In a group of 30 black and 30 white healthy workers, matched for age, sex and body weight, serum creatine kinase was significantly higher in black males than in white males (P less than 0.01). Seventeen blacks but only four whites had levels above the accepted upper limit of normal of 195 IU/l. There was no correlation with lean body mass. Elevation of serum creatine kinase need not signify disease in blacks, for whom a separate reference range should be established. Two cases are reported of physically healthy black men subjected to unnecessary investigation on the basis of persistently elevated serum creatine kinase.

Adult↗

Optimisation of conditions for solubilisation of the bovine dopamine D2 receptor.

Solubilisation of the dopamine D2 receptor from a membrane preparation of bovine corpus striatum using cholate and NaCl was independently optimised with regard to cholate (0.2%, wt/vol), NaCl (1.5 M), and membrane protein (4 mg/ml) concentrations. A maximum solubilisation yield of 58% was obtained and receptors were measured using a [3H]spiperone binding assay incorporating a polyethylene glycol precipitation step. Solubilisation was confirmed by ultracentrifugation studies, passage of the receptor through fine-pore filters, increased thermolability, and by retention of the prelabelled receptor on gel filtration. The soluble receptor showed saturability and reversibility of binding. Displacement of [3H]spiperone from the soluble receptor by competing compounds correlated closely with displacement from the membrane-bound receptors. [3H]Spiperone binding was found to be pH-dependent, with maximum binding occurring at pH 7.8. A comparison of solubilisation was made with six other agents both with and without added NaCl and it was concluded that the cholate/NaCl solubilisation system provides an efficient, inexpensive, and reliable method for the preparation of functional bovine dopamine D2 receptors.

Animals↗

Melatonin, the pineal gland and human puberty.

Animal experiments have suggested that the pineal gland produces an anti-gonadotropic hormone. The hamster, for example, undergoes reproductive collapse when kept in short-day periods, an effect which is abolished by pinealectomy. Although there is little direct evidence about the endocrine role of the pineal gland in man, it has been noted that tumours of the pineal gland in young boys are associated with precocious puberty and the human pineal gland has been suggested to produce a substance that holds sexual maturation in check. This observation has been extended by Kitay, who has shown that destructive tumours are associated with precocious puberty whereas hyperactive tumours are associated with delayed puberty. However, no studies have described any change of pineal function with normal puberty. Because two pineal indoles, melatonin and methoxytryptophol, have been shown to be antigonadotropic when administered to animals, we have now measured them in schoolchildren. Our findings show that in young boys there is an abrupt fall in the concentration of melatonin with advancing development suggesting that it may play an important physiological role in the control of human puberty.

Adolescent↗

A sensitive and specific assay for 5-methoxytryptophol in plasma.

5-Methoxytryptophol (ML) is found in the pineal gland and is known to have biological activity especially as an antigonadotrophic agent, but methods have been lacking for its measurement in the circulation. A gas chromatography-mass spectrometry assay using a trimethylsilyl derivative has been developed for the routine measurement of ML in plasma. The assay is of great specificity and has a sensitivity of 20 pmol/l. Studies on the levels of pineal indoles in the circulation, however, have been hampered by the possibility that extraneous compounds are being cross-measured. Thus the specificity of the routine assay has been further validated by comparing it with an alternative assay system where all the major parameters were changed, i.e. derivatizing reagent, internal standard and mass number. Results that were obtained using both assay systems were closely comparable.

Chromatography, Gas↗

Changes in the concentration of 5-methoxytryptophol in the circulation at different phases of the human menstrual cycle.

The pineal indole 5-methoxytryptophol (ML) has been shown to have an antigonadal activity when administered to experimental animals, but data on its normal pattern of secretion have been lacking. Using a new gas chromatography-mass spectrometry assay, the concentration of ML at various phases of the human menstrual cycle has been studied. Daily samples were obtained throughout the month from five women with a normal cycle and two women taking an oral contraceptive. In women with a normal cycle levels of ML were found to be significantly lower in the last third of their cycle; this change was not seen in women taking an oral contraceptive who had low levels throughout the month. The changes in concentration of ML did not correlate with the changes in concentration of gonadotrophins.

Adult↗

Immediate response of 5-methoxytryptophol in the circulation to hypoglycaemic stress induced by insulin.

Pineal indoles have been shown to affect the release of anterior pituitary hormones but details of the interrelationships are lacking. Using a new gas chromatography-mass spectrometry (g.c.-m.s.) assay the concentration of 5-methoxytryptophol (ML) was measured in plasma samples obtained from 16 children undergoing investigation of pituitary function for delayed growth. All the children received an insulin tolerance test (ITT) to study their endocrine response to stress. Some children received luteinizing hormone releasing hormone (LH-RH) and/or thyrotrophin releasing hormone (TRH). The change in concentration of ML during an ITT was similar to the change in concentration of blood sugar; a drop at 20 min followed by a rise at 30 min. This was not significantly altered by the administration of LH-RH or TRH, nor was there a different pattern of response in children who were deficient in growth hormone as opposed to those with idiopathic delayed growth. The fall in concentration of ML with stress may mediate the increased secretion of pituitary hormones. Alternatively, the pineal gland may respond directly to insulin.

Adolescent↗

Concentration of 5-methoxytryptophol in pineal gland and plasma of the rat.

5-Methoxytryptophol, a serotonin metabolite, was measured by gas chromatography-mass spectrometry in pineal glands, plasma and control tissues (cerebral cortex and salivary glands) from male rats kept in a controlled lighting environment. In the pineal gland the level of 5-methoxytryptophol was significantly higher during the dark period than during the light, the absolute levels being an order of magnitude less than those of melatonin. In the plasma, the levels showed a reverse situation with respect to lighting conditions. No correlation was found between the 5-methoxytryptophol levels in plasma and the pineal gland in individual animals. These results suggest that there is no obvious correlation between pineal content and pineal activity. This may be due to a combination of rapid turnover, secretion and/or peripheral conversion of another 5-methoxyindole to 5-methoxytryptophol.

Animals↗