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S Coley

Publications and source records attributed to S Coley.

17 recordsLinked to original sources

Ammonia uptake and its effects on ionoregulation in the freshwater crayfish Pacifastacus leniusculus (Dana).

Exposure of adult crayfish Pacifastacus leniusculus to Artificial Freshwater (AFW) media containing 1.5 m and 0.15 mmol x l(-1) total ammonia [Tamm; 0.1 x acute lethal concentration (24 h LC50) and 0.01 x 24 h LC50] and adjusted to pH 6.5, pH 8.2 and pH 10.5 resulted in significant increases in haemolymph ammonia over a 24-h period. Ammonia accumulated most rapidly at pH 10.5. These media were chosen to expose animals to a range of different un-ionised ammonia (UIA) [NH3] and ionised ammonia [NH4+] concentrations. From comparisons of measured transepithelial potential differences (PDte) with calculated Nernst potentials (PDNH4+) for the known haemolymph-to-medium gradients of [NH4+], it was deduced that, in pH 8.2 and pH 6.5 AFW, NH4+ was not in thermodynamic equilibrium across the integument (presumably gill epithelium). In pH 10.5 AFW with 1.5 mmol x l(-1) Tamm (predominantly NH3), the accumulation of ammonia in the haemolymph was in the NH4+ form due to haemolymph pH regulation by the crayfish in this alkaline external medium. Measured net fluxes of ammonia (Jamm(net)) were inwardly directed and maximal when [NH3] was the main component externally, but were also significant at pH 8.2 with high [NH4+] ([NH4+]:[NH3] approximately 20:1). Haemolymph Na+ depletion was significant and, over the 24-h exposure period, most rapid in high [NH3] medium but [Cl-] was unaffected. However, paradoxically, sodium uptake (measured JNa(in) on immediate transfer to high Tamm medium) was not significantly inhibited when [NH3] was the predominant ammonia species. In 1.5 mmol x l(-1) Tamm (mainly [NH4+), VNa(in) (the active component of JNa(in)) was significantly inhibited, particularly at low external [Na+]. This inhibition could not be demonstrated as one of competition at an Na+/NH4+ apical gill exchange site. The resultant net efflux of sodium from the animal showed that the ability of the animals to balance sodium losses at low external [Na+] was severely affected. Longer exposure to pH 10.5 AFW with high [NH3] (12 h) resulted in significantly increased JNa(out), while not significantly affecting JNa(in). Analysis of urinary Na+ losses showed that, while urinary flow rate and water reabsorption was most likely unaffected by ammonia exposure, final urine [Na+] was significantly elevated. The resulting urinary Na+ loss accounted for 63% of the increased JNa(out) in high [NH3] medium.

Ammonia↗

Contrast-enhanced MR angiography in patients with carotid artery stenosis: comparison of two different techniques with an unenhanced 2D time-of-flight sequence.

Conventional time-of-flight (TOF) MR angiography (MRA) in carotid artery stenosis relies on flow-related enhancement to produce signal from vascular structures. Intravoxel phase dispersion, due to vortices, causes loss of signal and is the reason for the tendency to overestimate the degree of stenosis. In contrast-enhanced MRA, intravascular signal is mainly dependent on T1 shortening of the blood. We compared first-pass contrast-enhanced MRA (contrast-enhanced 3D gradient echo, ce3D GRE) and contrast-enhanced 2D TOF (ce2D TOF) sequences with an unenhanced 2D TOF in 13 patients with carotid artery stenosis, assessing delineation of the carotid bifurcation, enhancement of veins and grade of stenosis. The contrast-enhanced techniques produced more morphological detail, the ce3D GRE being superior to the ce2D TOF. Four carotid arteries were reclassified into lesser stenosis categories using the ce3D GRE technique. However, seven carotid arteries (27%) were rated as nondiagnostic on the ce3D GRE, mainly due to masking of the carotid bifurcation by veins. The latter can be avoided by decreasing the acquisition time; on our 1.5-T system we could achieve a minimum time of 23 s per 3D GRE. Further reduction of acquisition time would be necessary to incorporate this method into clinical routine, requiring higher-performance gradients, which are not available in many UK hospitals.

Aged↗

Leptomeningeal glioblastoma presenting with multiple cranial neuropathies and confusion.

Glioblastoma multiforme (GBM) is the commonest primary malignant neoplasm of the CNS. Usually, patients present with seizures and headache but in the elderly, confusion and generalised cognitive decline are more frequently the initial features. Multiple cranial nerve lesions as a manifestation of leptomeningeal meningitis is a rare presentation of GBM. The diagnosis is not often suggestive on either brain computed tomography (CT) or magnetic resonance imaging (MRI) and is usually confirmed by cerebrospinal fluid (CSF) cytology or histology. We describe the case of an 80-year-old man, who presented with multiple cranial nerve palsies and confusion secondary to leptomeningeal gliomatosis, in whom GBM was detected along the intra-ventricular lining of the left lateral ventricle at ventriculoscopy, in the absence of a distinct parenchymal lesion.

Age Factors↗

Profound motor blockade with epidural ropivacaine following spinal bupivacaine.

Ropivacaine, a relatively new amide local anaesthetic, reputedly produces less motor block than equivalent doses of bupivacaine, potentially combining high-quality analgesia with the ability to ambulate. We report two cases of prolonged, profound motor block with patient-controlled epidural analgesia using 0.1% ropivacaine, following spinal bupivacaine for Caesarean section. As there was no evidence of inadvertent intrathecal ropivacaine administration or of any neurological injury, we hypothesise that epidural ropivacaine may interact with intrathecal bupivacaine to prolong its effect.

Adult↗

Breast abscesses and cigarette smoking.

An 11-year retrospective review of women with breast abscesses presenting to a district general hospital was performed. A total of 122 women were identified with a breast abscess: 85 (70 per cent) with non-lactational abscesses and 37 (30 per cent) with an abscess in the puerperium. Six of 37 lactational and 24 of 85 non-lactational abscesses recurred. Sixteen mammillary fistulae developed, all following incision and drainage of non-lactational breast abscesses. Women with non-lactational breast abscesses were more likely to smoke cigarettes (P less than 0.005). Breast abscesses containing anaerobic bacteria were significantly more likely to occur in current cigarette smokers (P less than 0.05). Women with non-lactational breast abscesses who were heavy cigarette smokers were more likely to suffer recurrent abscesses (P less than 0.01). There was histological evidence of duct ectasia on biopsy in 25 women with non-lactational abscesses and 21 of 25 were current smokers. Mammillary fistulae developed more frequently in current smokers (P less than 0.03). Cigarette smoking is important in the natural history of non-lactational breast abscesses and may predispose to anaerobic breast infections and the development of mammillary fistulae.

Abscess↗

Parathyroid hormone related protein and hypercalcaemia in breast cancer.

OBJECTIVE: To see whether parathyroid hormone related protein has a humoral role in breast cancer. DESIGN: Plasma concentrations and tumour expression of parathyroid hormone related protein were determined (by two site immunoradiometric assay and immunohistochemistry respectively) in women with breast cancer and related to the presence of bone metastases and serum calcium concentrations. SUBJECTS: Plasma concentrations of parathyroid hormone related protein were measured in 57 women with early breast cancer without apparent bone metastases, 28 women with bone metastases, and 13 women with bone metastases and hypercalcaemia. Tissue positivity for parathyroid hormone related protein was determined retrospectively in 106 primary breast tumours from women without apparent bone metastases and 72 tumours from women with bone metastases, 25 of whom subsequently developed hypercalcaemia. RESULTS: Plasma parathyroid hormone related protein concentrations were detectable (greater than 0.23 pmol/l) in 12 (92%) of the 13 hypercalcaemic patients with bone metastases compared with 10 (36%) of the 28 normocalcaemic patients with bone metastases and five (9%) of the 57 normocalcaemic patients without bone metastases. Parathyroid hormone related protein concentrations were significantly higher in hypercalcaemic than normocalcaemic patients with bone metastases. Tumour staining was positive for parathyroid hormone related protein in 22 (88%) of the 25 primary breast cancers from patients with bone metastases. Tumour staining was positive for parathyroid hormone related protein in 22 (88%) of the 25 primary breast cancers from patients with bone metastases who later developed hypercalcaemia compared with 25 (53%) of the 47 from women in this group who remained normocalcaemic and 55 (52%) of the 106 early breast cancers from women without known metastases. CONCLUSION: Tumour derived parathyroid hormone related protein may have an important humoral role in hypercalcaemia associated with metastatic breast cancer.

Bone Neoplasms↗

Wound infiltration of local anaesthetic after lower segment caesarean section.

The analgesic efficacy of subcutaneous wound infiltration with 20 ml of 0.5% bupivacaine after elective lower segment section Caesarean section was studied in 28 patients in a double-blind randomised controlled manner using a patient-controlled analgesia system. The mean 24-hour morphine consumption of the placebo group and the bupivacaine group was similar (76 mg and 68 mg respectively). Analysis of the cumulative hourly morphine consumption failed to show any statistically significant differences between the groups. However, on a weight-adjusted basis statistically significant differences in morphine consumption were demonstrated, although these may not be clinically important. Subjective experiences of pain, nausea and drowsiness assessed by linear analogue scoring were similar in both groups.

Administration, Topical↗

A comparison of the effects of alfentanil/droperidol or fentanyl/droperidol on intra-ocular pressure.

The influence of two intravenous sedative regimens on intra-ocular pressure was investigated in conjunction with retrobulbar local anaesthesia. Forty patients were allocated randomly to either group A (alfentanil and droperidol) or group F (fentanyl and droperidol). Measurements of intra-ocular pressure, arterial pressure and oxygen saturation were made before operation, after premedication, after intravenous sedation and after surgery. Paco2 was also measured before and after operation. Each sedation technique caused a similar reduction in intra-ocular pressure. There was less effect on Paco2 and oxygenation in group A.

Aged↗

Pressor and catecholamine response to nasal intubation of the trachea.

The catecholamine and cardiovascular responses to nasal intubation of the trachea with and without laryngoscopy have been compared in 23 patients allocated randomly to each treatment. Arterial pressure, heart rate and plasma concentrations of adrenaline and noradrenaline were measured before and after induction and at 1, 3 and 5 min after intubation of the trachea. There were significant increases in systolic and diastolic pressures after tracheal intubation in both groups. The values at 1 min after intubation were significantly higher in the group undergoing laryngoscopy and intubation compared with the group undergoing blind nasal intubation.

Adult↗

Haemodynamic changes after induction of anaesthesia and tracheal intubation following propofol or thiopentone in patients of ASA grade I and III.

Thirty-six ASA I patients received either propofol 2.25 (0.07) mg kg-1 (mean (SEM] or thiopentone 4.8 (0.18) mg kg-1, for induction of general anaesthesia together with fentanyl and a neuromuscular blocking drug. This technique was repeated in 12 ASA III patients, using propofol 1.8 (0.18) mg kg-1 or thiopentone 4.7 (0.37) mg kg-1. There was a significant decrease in systolic arterial pressure following induction of anaesthesia with both drugs; this was more pronounced after propofol, and in ASA III patients. Plasma noradrenaline concentrations increased after tracheal intubation only in the thiopentone group, but the pressor response to tracheal intubation was not attenuated by the use of propofol.

Adult↗