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Biomedical subjects

T D O'Leary

Publications and source records attributed to T D O'Leary.

At least 19 recordsLinked to original sources

Direct laparoscopic venous sampling to diagnose a small Sertoli-Leydig tumor.

BACKGROUND: Sertoli-Leydig cell tumors (SLCT) constitute only 0.5% of all primary ovarian neoplasms. We report a unique diagnostic method (selective laparoscopic venous sampling) and a rare case of a contralateral second primary tumor. CASE: A 14-year-old female presented with hyperandrogenic complaints and an increased serum testosterone. Ovarian origin was confirmed by direct laparoscopic ovarian blood sampling. A right salpingo-oophorectomy was performed. The pathological diagnosis was SLCT of intermediate differentiation. Three years later, the patient presented again with an increased serum testosterone. A solid tumor in the left ovary was excised. The pathology was SLCT of intermediate differentiation. The patient remains disease-free. CONCLUSIONS: Direct laparoscopic venous sampling is used to diagnose a small SLCT in a teenage patient.

Adolescent↗

Sulindac to prevent recurrent preterm labor: a randomized controlled trial.

OBJECTIVE: To assess the efficacy of oral sulindac in low doses for prolonged duration to decrease the risk of recurrent preterm labor and extend gestation. METHODS: This was a randomized, double-blind, placebo-controlled study of patients between 24 and 34 weeks' gestation with preterm labor treated with intravenous magnesium sulfate. After successful tocolysis, patients were randomized by the pharmacy to receive either oral sulindac (100 mg) or placebo orally every 12 hours until 34 weeks' gestation. A power analysis required 43 patients in each group. RESULTS: Ninety-five patients were enrolled (46 in the sulindac group, 49 controls). No significant differences were found with respect to time gained in utero (39 +/- 25 versus 45 +/- 26 days, P = .29), delivery at more than 35 weeks' gestation (61% versus 74%, P = .29), recurrent preterm labor (20% versus 18%, P = .86), birth weight (2562 +/- 623 versus 2624 +/- 543 g, P = .62), or time spent in the neonatal intensive care unit (2.8 +/- 9.2 versus 2.4 +/- 8.6 days, P = .83) for the sulindac and control groups, respectively. CONCLUSION: The use of oral sulindac until 34 weeks' gestation after successful parenteral tocolysis failed to reduce the incidence of readmission for preterm labor.

Administration, Oral↗

Outpatient oral sulindac to prevent recurrence of preterm labor.

OBJECTIVE: To assess the efficacy and safety of oral sulindac in preventing the recurrence of preterm labor. METHODS: This was a randomized, double-blind, placebo-controlled study of patients between 24-34 weeks' gestation with preterm labor treated with intravenous magnesium sulfate. After successful tocolysis, patients were randomized by the pharmacy to receive either oral sulindac (200 mg) or placebo (once orally every 12 hours) for 7 days. RESULTS: Sixty-nine patients were enrolled (34 in the sulindac group, 35 controls). No significant differences were found with respect to time gained in utero (40 +/- 4.4 versus 31 +/- 3.4 days, P = .1), delivery at more than 35 weeks' gestation (20 versus 18, P = .70), recurrent preterm labor (11 versus 13, P = .88), birth weight (2528 +/- 646 versus 2459 +/- 707 g, P = .68), or time spent in the neonatal intensive care unit (4.2 +/- 12.9 versus 5.7 +/- 13.5 days, P = .63) for the sulindac and control groups, respectively. However, in women who failed therapy (ie, those who delivered before 37 weeks' gestation or required readmission for tocolysis), there was a significantly longer interval between the start of therapy and failure in the sulindac group (25.9 +/- 3.4 days, n = 26) than in the control group (15.2 +/- 2.8 days, n = 25; P < .05). CONCLUSION: The use of oral sulindac for 1 week after successful parenteral tocolysis failed to reduce the overall rate of preterm birth. In women who delivered prematurely or required readmission for tocolysis, oral sulindac significantly prolonged the interval from the start of therapy until delivery or readmission. Moreover, this benefit was achieved without observable adverse effects on the fetus.

Administration, Oral↗

Education and clinical biochemistry in Australia.

Education of clinical biochemists within Australia occurs primarily after the individual has attained a primary degree (Science or Applied Science) and is employed within a clinical laboratory, public or private. In the case of medical graduates, professional education is conducted under the auspices of the Royal College of Pathologists of Australia and results in the successful candidate obtaining the status of Fellow of that professional body. While scientists have a number of means of obtaining postgraduate qualifications in clinical biochemistry it is the Membership and Fellowship examinations of the Australian Association of Clinical Biochemists (AACB) which have greatest recognition within the profession. The majority of the continuing education of, and training programmes for, clinical biochemists are undertaken by the AACB. Currently, there are no formal registration requirements for laboratory scientists within Australia.

Australia↗

Identification and quantitation of human urine proteins by capillary electrophoresis.

Capillary electrophoresis, as a fully automatable, powerful analytical technique, has the potential for use in clinical laboratories for separation and identification of protein types in normal and abnormal human urine specimens. Abnormal urine specimens containing previously identified proteins, anion-exchange resin treatment and addition of known components were used to identify and determine migration times of the peaks found in the electropherogram of human urine. The correlation coefficients between capillary electrophoresis and the currently used method of high-resolution agarose gel electrophoresis for Bence Jones protein and albumin were found to be 0.95 and 0.93, respectively.

Albuminuria↗

The effect of acetaminophen on prostacyclin production in pregnant women.

OBJECTIVE: The purpose of this study was to determine if acetaminophen decreased prostacyclin production by endothelial cells in culture and by pregnant women. STUDY DESIGN: The effect of acetaminophen on endothelial cells in culture was determined by the addition of acetaminophen in concentrations of 10 and 100 micrograms/ml with comparison to control and indomethacin at 10 micrograms/ml. Prostacyclin production was estimated in 24 and thromboxane A2 production in six third-trimester pregnant women by measurement of excretion of urinary metabolites before and after ingestion of either 1000 mg of acetaminophen or placebo. RESULTS: Compared with control (549 +/- 61 pg/well, mean +/- SD), production of prostacyclin in vitro was significantly inhibited by acetaminophen at 10 micrograms/ml (321 +/- 25) and 100 micrograms/ml (257 +/- 14). This inhibition is similar to inhibition by 10 micrograms/ml of indomethacin (228 +/- 11). Excretion of prostacyclin metabolite was significantly lower after ingestion of acetaminophen (2233 +/- 446 vs 1246 +/- 199 pg/mg creatinine, mean +/- SEM) but unchanged after ingestion of placebo (1745 +/- 304 vs 1712 +/- 211). There was no difference in response between normal and hypertensive women, and there was no effect of acetaminophen on thromboxane metabolite excretion. CONCLUSION: Acetaminophen in typical oral doses results in reduced production of prostacyclin by endothelial cells in culture and in a reduction in prostacyclin, but not thromboxane, production in pregnant women.

6-Ketoprostaglandin F1 alpha↗

Randomized comparative trial of indomethacin and sulindac for the treatment of refractory preterm labor.

This study was designed to investigate the efficacy and safety of sulindac in the treatment of preterm labor. Thirty-six women in preterm labor who had failed initial attempts at tocolysis with magnesium sulfate were randomized to receive either oral indomethacin or oral sulindac for 48 hours. The mean gestational ages at admission were 29 and 30 weeks for the sulindac and indomethacin groups, respectively. There was a significantly greater hourly fetal urine output, deepest amniotic fluid pocket, and amniotic fluid index in the sulindac group. A trend toward higher fetal ductus arteriosus flow velocities noted in the indomethacin group was not seen in the sulindac group. The drugs had similar success in delaying delivery for 48 hours or 7 days. The mean birth weights were 2000 and 2323 g for the sulindac and indomethacin groups, respectively. Sulindac appears to be as effective as indomethacin for refractory preterm labor but with fewer fetal side effects.

Adult↗

Calculated bicarbonate or total carbon dioxide?

To test the relationship pK' = 6.103 + log[HCO3calc] - log[HCO3meas], we used a Corning 168 blood-gas analyzer to analyze 500 blood samples for pH and PCO2, from which we calculated a value for bicarbonate. We also analyzed 500 venous blood samples, collected simultaneously, for potentiometric total carbon dioxide with the Ektachem 700 analyzer. In a similar study of 415 arterial and venous blood samples, we determined total carbon dioxide colorimetrically with the SMA 6/60 analyzer. The coefficients of determination (r2) found for the difference observed between the calculated and measured bicarbonate values vs the pK' in the two studies were 0.86 and 0.96, respectively. The results also confirmed the positive bias caused by organic acids in the Ektachem method for total carbon dioxide. Analysis of the SMA 6/60 results indicated a significant decrease of the pK' in patients classified as having a metabolic acidosis.

Acidosis↗

Optical methods for monitoring temperature in spectrophotometric analysers.

A procedure is described for monitoring the temperature in the reaction cuvettes of analytical systems that use photometers. The method employs the temperature-dependent change in absorbance of solutions of either 3,5-dinitrosalicylic acid or cresol red. The procedure is simple to perform and is especially useful in monitoring the temperature in instruments such as centrifugal analysers where the reaction cuvette is inaccessible. In some of the instruments studied, methodological changes were required to ensure that reactions were carried out at the selected temperature.

Hydrogen-Ion Concentration↗

Interaction between phenytoin, 5-(p-hydroxyphenyl)-5-phenylhydantoin and valproate in the rat.

The effect of valproate on the pharmacokinetics of phenytoin after a single i.v. injection is described in this study. Valproate is shown to significantly increase the total clearance, i.e., 23.8 to 30.4 ml . min-1 . kg-1 and volume of distribution, i.e., 0.92 to 1.25 liter . kg-1. No significant change was shown for the half-life of phenytoin. The pharmacokinetic parameters calculated for unbound phenytoin showed no significant differences between those rats infused with phenytoin or phenytoin-valproate. Significantly higher concentrations of 5-(p-Hydroxyphenyl)-5-phenylhydantoin (HPPH) were observed in those rats given an i.v. injection of phenytoin-valproate. In vitro studies with rat liver microsomes demonstrated that valproate inhibits the metabolism of HPPH to its glucuronide. This was further exemplified when significant differences were observed in the clearance and volume of distribution of HPPH in rats given an i.v. injection of HPPH or HPPH plus valproate. The results of this study demonstrate that in the rat valproate displaces phenytoin from serum proteins and that this interaction accounts for the increased volume of distribution and clearance of total phenytoin when valproate is coadministered. However, this displacement had no effect on the pharmacokinetics of free (unbound) phenytoin. Valproate is shown to be an inhibitor of the glucuronidation of HPPH which may explain the significantly increased concentrations of HPPH observed in the rats administered phenytoin-valproate.

Animals↗