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Biomedical subjects

S MacKenzie

Publications and source records attributed to S MacKenzie.

34 records · Page 2Linked to original sources

Orogastric magnet removal of ingested disc batteries.

Ingestion of disc batteries by infants and small children is an increasing problem. Batteries that remain in the stomach can corrode and damage mucosa and/or produce poisoning. Between 1989 and 1992, 37 children who had swallowed a total of 46 disc batteries presented to the Royal Hospital for Sick Children, Edinburgh, and were referred for battery removal by use of an orogastric magnet under fluoroscopy. Thirty-nine batteries were removed successfully (without anesthesia) from 32 children, using a magnet attached to an orogastric tube. In three cases the battery had passed into the small bowel. In one case, magnet extraction failed, but the two batteries the child had ingested subsequently passed into the small bowel. In two cases the patients refused to swallow the tube. In one of these cases the battery was removed successfully by the magnet, with the patient under general anesthesia; in the other it passed spontaneously into the small bowel. The authors conclude that orogastric magnet removal is a minimally invasive, well-tolerated method of removing ingested disc batteries.

Child↗

Alpha 2-adrenergic receptor gene polymorphism and hypertension in blacks.

alpha 2-Adrenergic receptors are found on presynaptic neurons of the central and peripheral nervous systems, on blood vessels, on platelets, on adipocytes, and in the kidney and pancreas. Activation of these ubiquitous adrenoreceptors results in decreased neuronal norepinephrine release, vasodilation, a fall in blood pressure, platelet aggregation, increased sodium excretion, and decreased insulin release. We hypothesized that defects in alpha 2-adrenergic receptors, or postreceptor defects, could explain the increased prevalence of hypertension in blacks. To test our hypothesis, we first determined whether or not a polymorphism of the alpha 2-adrenergic receptor gene was associated with pathologic elevations in blood pressure in American blacks. Dra-I identified a restriction fragment-length polymorphism (RFLP) of 6.3 and 6.7 kb of the alpha 2-adrenergic receptor gene on chromosome 10 in humans. Of 227 patients studied, 13/107 hypertensive subjects were homozygous for the 6.3-kb allele, whereas only 3/120 normotensive volunteers were homozygotes (P = .008). When analyzed by race, 13/82 black hypertensive subjects were homozygous for the 6.3-kb allele, whereas only 2/59 normotensive blacks were homozygous for the 6.3-kb alleles (P = .02). However, only 1/61 white normotensive and 0/25 white hypertensive subjects were homozygous for the 6.3-kb allele (P = 1.00). Ethnic variation among blacks may explain our findings. Alternatively, a genetic polymorphism in, or near, the alpha 2-adrenergic receptor on chromosome 10 can contribute to the development of hypertension in blacks.

Alleles↗

Management options in malignant obstruction of the left colon.

Three of every 20 patients with carcinoma of the colon present with obstruction. The prognosis in the patient with malignant left colon obstruction is worse than for those with nonobstructing lesions, without adding the burden of a colostomy. Whenever feasible, acute obstruction should be treated by definitive resection with primary anastomosis and staged procedures reserved for only a few. How the former is achieved is open to debate. Whether or not the removal of all fecal matter from the colon is necessary before anastomosis is questionable and needs further appraisal. The risk of a metachronous lesion developing is highest in young patients with polyps or a previously resected carcinoma. The high risk patients would be best served by a subtotal colectomy. The choice of procedure must be tailored to each patient and the final decision made at the time of operation. An experienced colonic surgeon is needed to judge which option is most appropriate.

Carcinoma↗

Successful clonazepam treatment of neuroleptic-induced akathisia in older adolescents and young adults: a double-blind, placebo-controlled study.

In a double-blind, placebo-controlled trial of clonazepam in the treatment of neuroleptic-induced akathisia in older adolescents, clonazepam was significantly more effective at reducing akathisia scores at the end of the first treatment week than placebo (p less than 0.0001). Clonazepam may be a safe and effective treatment for neuroleptic-induced akathisia in this age group.

Adolescent↗

Dietary restriction, tyramine, and the use of monoamine oxidase inhibitors.

The aim of this study is to provide clearer guidelines for rational, safe, and practical dietary restriction for use with monoamine oxidase inhibitors. Tyramine levels were assayed in over 100 of the controversial foods that have been associated with hypertensive reactions or reported to contain high levels of tyramine. Only a very limited number of foods appear to require absolute restriction. These include all aged cheeses, concentrated yeast extracts (e.g., Marmite), sauerkraut, and broad bean pods. Alcoholic beverages, including Chianti wine consumed in moderation, appear to be safe. Some aged meats contain relatively high levels of tyramine and require closer investigation.

Food Analysis↗

Neutrophil lactoferrin content: variation among mammals.

Lactoferrin (Lf) in blood and/or marrow neutrophils was semiquantified using indirect immunofluorescence technique in nine mammalian species. Neutrophil iron-binding reactivity (NFeBR), which corresponds primarily to Lf, was also visualized and semiquantified using functional cytochemical (FeNTA-AF) technique at the light microscopic level in these nine and in an additional fifteen mammalian species, and in selected species at the ultrastructural level. Neutrophil immunoreactive Lf was positively correlated with total cellular and granule content of NFeBR among these nine species, and with previously reported concentrations of neutrophil Lf quantified by radioimmunoassay. Relative levels of Lf in neutrophil extracts from rat, hamster, and human were confirmed using SDS-polyacrylamide gel electrophoresis and immunoblotting. Relatively high levels of immunoreactive neutrophil Lf and/or NFeBR were observed in carnivores (ten species) and primates (six species). Among rodents (five species), the levels were variable, and the artiodactyls (four species) studied had low levels. These results demonstrate that neutrophil Lf levels vary widely among mammalian species. In addition, FeNTA-AF technique provides a rapid means of evaluating animals for relative quantities of neutrophil Lf.

Animals↗

Functional characteristics of intraepithelial lymphocytes from mouse small intestine. III. Inability of intraepithelial lymphocytes to induce a systemic graft-versus-host reaction is because of failure to migrate in vivo.

In this study we have investigated whether addition of bone marrow accessory cells or concurrent administration of recombinant IL-2 would allow intraepithelial lymphocytes (IEL) to induce a systemic, lethal GvHR in irradiated hosts. In addition we have studied the ability of IEL to migrate into lymphoid tissues after intravenous injection and compared this with their locomotor capacity in vitro.

Animals↗

Functional characteristics of intraepithelial lymphocytes from mouse small intestine. II. In vivo and in vitro responses of intraepithelial lymphocytes to mitogenic and allogeneic stimuli.

Although isolated intraepithelial lymphocytes (IEL) have been shown to have specific and non-specific cytolytic functions, their ability to proliferate in response to T-cell mitogens or alloantigens is controversial. Here we show that IEL from mouse small intestine do not respond to mitogens such as concanavalin A and phytohaemagglutinin A or in mixed lymphocyte reactions unless an accessory spleen cell is also present. Adherent spleen cells possess the most potent helper function, but a dividing accessory cell may also be required. Supernatants from stimulated lymphocytes also assist IEL to proliferate in vitro, particularly in the presence of adherent accessory cells. IEL could not mediate lethal graft-versus-host disease in irradiated hosts, but could produce popliteal lymph node hypertrophy or splenomegaly in unirradiated hosts. Thus, IEL have the potential for proliferative activities characteristic of T cells, but they require accessory cells and/or factors such as interleukin-2 for their function in vitro and in vivo.

Animals↗

Divergent effects of bacterial lipopolysaccharide on immunity to orally administered protein and particulate antigens in mice.

We have investigated whether bacterial lipopolysaccharide (LPS) influences immune responses to dietary protein antigens in experimental animals. Simultaneous intravenous administration of LPS to normal mice fed ovalbumin (OVA) prevented the induction of tolerance for serum IgG antibody responses but did not alter the tolerance of systemic delayed-type hypersensitivity (DTH). In addition, exogenous LPS did not enhance the ability of spleen accessory cells to present OVA to primed T cells. LPS-unresponsive C3H/HeJ mice developed full tolerance of both humoral and cell-mediated immunity after feeding a range of doses of OVA that was equal in degree and persistence to that seen in normal, congenic C3H/HeOla mice and also had normal antigen-presenting cell (APC) activity for OVA. In contrast, C3H/HeJ mice were primed by feeding SRBC instead of developing the systemic tolerance found in normal C3H mice. Our results indicate the complexity of mechanisms that may regulate systemic immunity to orally administered antigens of different forms. Nevertheless, LPS does not modulate DTH responses to fed OVA and does not enhance APC activity, and we conclude that bacterial LPS may be unable to influence hypersensitivity to dietary proteins in man.

Animals↗

Analysis of the effector functions of different populations of mucosal lymphocytes.

Lymphocytes separated from the epithelial layer of mouse small intestine, IEL, were tested for their NK cytotoxicity against Yac-1 targets. There was little NK activity in a 4 hour assay, but high activity in an 18 hour assay, and the NK activity of IEL did not parallel that in the spleen in any of the mouse strains tested. Furthermore, IEL exerted a suppressor activity on mouse spleen NK activity. Specific T-cell cytotoxicity appeared in IEL in mice immunized with an intraperitoneal injection of P-815 tumor cells. By contrast with IEL, LPL had little NK or NK suppressor activity, but higher levels of specific T-cell cytotoxicity in tumor-immunized mice than intraepithelial lymphocytes. A high proportion of IEL had granules that stained with Giemsa and Astra blue. Furthermore many IEL carried Lyt-2+ phenotype and no other T-cell surface antigen. Intraepithelial lymphocytes appeared, therefore, to have staining and phenotype characteristics of both granular NK cells and suppressor cells. It was clear that the intestinal mucosa contained populations of immune effector cells that were heterogeneous in nature and function.

Animals↗

Analysis of natural killer effector and suppressor activity by intraepithelial lymphocytes from mouse small intestine.

Intraepithelial lymphocytes (IEL) are morphologically similar to NK cells in other tissues and we have studied the NK activity of IEL isolated from mouse small intestine. In contrast to spleen NK cells, IEL showed little activity against YAC-1 over 4 h but had high levels of NK activity when the assay was extended to 18 h. IEL from nude mice did not show the enhanced NK activity found in other tissues. IEL were also found to suppress the NK activity of spleen cells and this suppressor function was not mediated by T lymphocytes or macrophages. The results indicate that the intestinal epithelium contains a population of potent NK cells which may represent a type of NK cell different to that found in other tissues. In addition, there are also cells capable of regulating NK cell function in the epithelial layer.

Animals↗

A comparison of four methods of bowel preparation for barium enema.

A retrospective trial was carried out comparing four methods of bowel preparation on a randomly selected group of 503 patients. The methods of bowel preparations were: (1) X-prep alone, (2) X-prep plus three-day diet, (3) X-prep plus high colonic washout, (4) X-prep plus high colonic washout and three day diet. Faecal content was assessed independently by three radiologists and recorded on a linear analogue scale. Statistically significant differences were shown between the results obtained by each method; 97% of patients prepared by method (4) were acceptable, 89% of method (2), 83% of method (3) and 71% of method (1). It was also found that in-patients exposed to the same method of preparation as out-patients showed inferior bowel cleanliness although not to a statistically significant degree.

Anthraquinones↗

Can I get there from here? Wayfinding systems for healthcare facilities.

Because people seldom visit hospitals unless they have to, they are generally unfamiliar with the facilities and have trouble finding their way on their own. Moreover, patients and families in a hospital are often distracted by other concerns. This makes a well-designed wayfinding system particularly important. Two facilities' dealings with professional designers illustrate some solutions which help both hospital and patients.

Canada↗