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Biomedical subjects

T Win

Publications and source records attributed to T Win.

At least 19 recordsLinked to original sources
PubMed2005

Comparison of shuttle walk with measured peak oxygen consumption in patients with operable lung cancer.

BACKGROUND: The relationship between the shuttle walk test and peak oxygen consumption in patients with lung cancer has not previously been reported. A study was undertaken to examine this relationship in patients referred for lung cancer surgery to test the hypothesis that the shuttle walk test would be useful in this clinical setting. METHODS: 125 consecutive patients with potentially operable lung cancer were prospectively recruited. Each performed same day shuttle walking and treadmill walking tests. RESULTS: Shuttle walk distances ranged from 104 m to 1020 m and peak oxygen consumption ranged from 9 to 35 ml/kg/min. The shuttle walk distance significantly correlated with peak oxygen consumption (r = 0.67, p<0.001). All 55 patients who achieved more than 400 m on the shuttle test had a peak oxygen consumption of at least 15 ml/kg/min. Seventy of 125 patients failed to achieve 400 m on the shuttle walk test; in 22 of these the peak oxygen consumption was less than 15 ml/kg/min. Nine of 17 patients who achieved less than 250 m had a peak oxygen consumption of more than 15 ml/kg/min. CONCLUSION: The shuttle walk is a useful exercise test to assess potentially operable lung cancer patients with borderline lung function. However, it tends to underestimate exercise capacity at the lower range compared with peak oxygen consumption. Our data suggest that patients achieving 400 m on the shuttle walk test do not require formal measurement of oxygen consumption. In patients failing to achieve this distance we recommend assessment of peak oxygen consumption, particularly in those unable to walk 250 m, because a considerable proportion would still qualify for surgery as they had an acceptable peak oxygen consumption.

Adult↗
PubMed2005

gamma-L-glutamyltaurine.

The discovery of the dipeptide gamma-glutamyltaurine (gamma-GT; glutaurine, Litoralon) in the parathyroid in 1980 and later in the brain of mammals gave rise to studies on intrinsic and synthetic taurine peptides of this type. It was suggested that gamma-glutamyltransferase (GGT; gamma-glutamyltranspeptidase) in the brain is responsible for the in vivo formation of this unusual dipeptide. gamma-GT has been prepared by both synthetic and enzymatic methods. The chemical syntheses included the use of protecting groups and coupling methods. A wide spectrum of analytical and spectroscopic methods was used to confirm the structure of the synthetic compounds and to elucidate the position of the peptide bond. Enzymatic preparation of gamma-GT from taurine takes advantage of the selective transpeptidation action of GGT on L-glutamine, glutathione, gamma-glutamyl-p-nitroanilide or other glutamine donors. Although the functional roles of gamma-GT in the brain are only poorly understood, many of its established CNS effects have been reported in the last 25 years. Its effect on emotional arousal and its anti-conflict potencies are synergistic with the anxiolytic drug diazepam. gamma-GT exhibits anti-conflict potency, which is exerted by reducing aversion or phobia and/or the anxiety levels. gamma-GT also acts as endogenous modulator in excitatory aminoacidergic neurotransmission. It is suggested that such acidic peptides through N-methyl-D-aspartic acid receptors could be part of the neurochemical substrate underlying self-stimulation of the medial prefrontal cortex. Other gamma-GT effects in neural systems include: effects on the monoamine concentration in the brain; effects on aggressive behavior in the cat; effects on thyroid hormones in the rat; amelioration of electroshock-induced amnesia; potent and long-lasting antiepileptic action (on intra-amygdaloid injection); affect the glutamatergic system in schizophrenic disorders. Roles for gamma-GT in non-neural systems have also been reported, e.g., effects on the metamorphosis of amphibians; on plasma rennin regulation; on radiation protection; on uric acid levels; on human antibody-dependent cell-mediated cytotoxicity (ADCC) and many more.

Amphibians↗
PubMed2005

The distribution of microvascular response in Achilles tendonopathy assessed by colour and power Doppler.

OBJECTIVES: To assess the distribution of microvascular response on colour Doppler (CD) and power Doppler (PD) ultrasound (US) of the tendo Achilles (TA) in tendonopathy, and to look for any relationship between tendon morphology and symptoms. DESIGN AND PATIENTS: A retrospective, observational study was carried out on consecutive ambulant US patients with suspected tendonopathy, presenting with pain or an Achilles mass. Exclusion criteria were: use of steroids, and previous or possible rupture or surgery in either tendon or arthropathy. Using a 5-12 MHz linear array probe (ATL HDI 3000) both TAs were scanned. Tendonopathy was defined as tendon swelling and/or hypoechogenicity of the TA. The site, number and distribution of microvascularity, on CD and PD, and the anteroposterior size were recorded, with the analysis masked. RESULTS: Fifty-two patients presented with TA pain and six also with swelling. There were 34 males and 18 females, aged from 11 to 78 years (mean 45 years). Fifty-five TAs that showed tendonopathy with hypoechogenic areas were all observed to be over 5.9 mm (mean 11.1 mm, range 5.9-20 mm), of which 45 were symptomatic with abnormal PD and 24 with abnormal CD flow. It was observed that the extent and completeness of vessel branching was more extensive on PD than CD. All TAs demonstrating tendonopathy were over 5.9 mm in adults and all TAs that showed PD flow were over 6.5 mm. All microvessels originated towards the TA from the ventral surface usually into tendonopathy, and were 16-fold more frequent around the margins. There were 49 TAs with normal spectral US, and with no PD flow, with a mean size of 4.5 mm (range 3.0-7.4 mm). For the right and left TAs independently analysed and taking the 40 patients with a paired asymptomatic and symptomatic tendon: (1) There was a highly significant difference in size (P<0.00001) using the paired t-test (parametric) between the asymptomatic tendon (mean 5.2+/-1.4 mm (1 SD)), and the contralateral morphologically abnormal and symptomatic side (mean 9.7+/-1.4 mm). (2) There was no linear Pearson correlation (0.25) between TA size and duration of symptoms (P=0.11) for symptomatic tendons. (3) There was a positive Spearman correlation (0.84) between the number of vessels and TA size (P<0.00001). (4) There was a significant difference in the number of PD vessels using the non-parametric Wilcoxon signed test (P<0.00001) between the symptomatic and asymptomatic groups. CONCLUSIONS: (1) PD shows more tendon microvascularity than CD in TA tendonopathy. (2) All microvessels arise on the ventral side of the TA. (3) There is a non-linear relationship between tendonopathy, TA size and the amount of microvascularity, but not between PD and duration of symptoms. (4) Morphologically abnormal adult TAs were larger than 5.9 mm, and PD flow was only seen in TAs above 6.5 mm.

Achilles Tendon↗
PubMed2005

Effect of lung cancer surgery on quality of life.

BACKGROUND: Health related quality of life (HRQOL) after surgery is important, although very limited data are available on the QOL after lung cancer surgery. METHODS: The effect of surgery on HRQOL was assessed in a prospective study of 110 patients undergoing potentially curative lung cancer surgery at Papworth Hospital, 30% of whom had borderline lung function as judged by forced expiratory volume in 1 second. All patients completed the EORTC QLQ-C30 and LC13 lung cancer module before surgery and again at 1, 3 and 6 months postoperatively. RESULTS: On average, patients had high levels of functioning and low levels of symptoms. Global QOL had deteriorated significantly 1 month after surgery (p = 0.001) but had returned to preoperative levels by 3 months (p = 0.93). Symptoms had worsened significantly at 1 month after surgery but had returned to baseline levels by 6 months. Low values on the preoperative HRQOL scales were not significantly associated with poor surgical outcome. However, patients with low preoperative HRQOL functioning scales and high preoperative symptom scores were more likely to have poor postoperative (6 months) QOL. The only lung function measurement to show a marginally statistically significant association with quality of life at 6 months after surgery was percentage predicted carbon monoxide transfer factor (Tlco). CONCLUSION: Although surgery had short term negative effects on quality of life, by 6 months HRQOL had returned to preoperative values. Patients with low HRQOL functioning scales, high preoperative symptom scores, and preoperative percentage predicted Tlco may be associated with worse postoperative HRQOL.

Adult↗
PubMed2005

Relationship between pulmonary function and lung cancer surgical outcome.

The British Thoracic Society and American College of Chest Physician guidelines outline criteria for investigating patients for lung cancer surgery. However, the guidelines are based on relatively old studies. Therefore, the relationship between pulmonary function test results and surgical outcome were studied prospectively in a large cohort of lung cancer patients. From January 2001 to December 2003, 110 patients underwent surgery for lung cancer. All underwent full lung function testing in order to predict post-operative lung function. The hospital mortality rate was 3% and major complication rate 22%. There was poor overall outcome in 13%. Mean pre-operative lung function values were: forced expiratory volume in one second (FEV1) 2.0 L (79.4% of the predicted value), and carbon monoxide diffusing capacity of the lung (D(L,CO)) 73.6% pred. The mean post-operative lung function values were: FEV1 1.4 L (55.6% pred), and D(L,CO) 51.3% pred. All lung function values were better predictors of poor surgical outcome when expressed as a percentage of the predicted value. Using a threshold of pre-operative FEV1 of 47% pred resulted in the most useful positive and negative predictive probabilities, 0.90 and 0.67, respectively. Lung function values expressed as a percentage of the predicted value are more useful predictors of post-operative outcome than absolute values. The threshold of predicted forced expiratory volume in one second for surgical intervention could be lower (45-50% pred) than is currently accepted without increased mortality.

Adult↗
PubMed2005

Taurine analogues; a new class of therapeutics: retrospect and prospects.

Taurine was discovered more than two hundred years ago from animal sources. It is distributed in both mammals and non-mammals and its content is high in several tissues. For more than a century-and-a-half, taurine was regarded just as an end product of sulfur metabolism. Recently, taurine has been rediscovered and its beneficial effects in processes like epilepsy, hypertension, congestive heart failure and diabetes have been well-documented. It was patented and found some clinical utility, but being an amino acid, therapeutic use confronts limitations like restricted permeability and more. This necessitates the development of pro-drugs (analogues) mainly derivatives of taurine. A large number of taurine derivatives have been reported in the literature with partial to marked activity. Taurine derivatives like taltrimide, acamprosate and tauromustine, are already in the market as anti-convulsant, anti-alcoholic and anti-cancer agents. Many other analogues are effective in experimental models. The in depth analysis of these analogues and their biological actions can provide certain clues for further consideration. In the present review, attempts have been made to provide synopsis, synthesis and symbiosis of chemical and biological actions, which may provide future guidance and facilitate further research in this area. The successful journey of these analogues to clinical utility is a healthy and happy sign and an index of bright future, and we hope that this review will provide enough input to ignite the minds.

Animals↗
PubMed2004

Semi-quantitative assessment of tricuspid regurgitation on contrast-enhanced multidetector CT.

AIM: To assess whether the early regurgitation of intravenous contrast medium into the inferior vena cava (IVC) and/or hepatic veins on computed tomography (CT), indicates tricuspid regurgitation (TR), and if so, whether it be used to grade severity. MATERIALS AND METHODS: We identified 86 consecutive patients that had been investigated for possible pulmonary endarterectomy at Papworth Hospital. From these, 61 patients were selected in whom CT, transthoracic echocardiography, and right heart catheterization (RHC) had been performed within 6 weeks. Using an arbitrary visual scale, the degree of TR assessed by intravenous contrast-enhanced CT was compared with echocardiography. Results were analysed using a kappa weighted statistical test. In addition, CT and echocardiographic assessments of TR severity were correlated with pulmonary artery pressure measurements obtained by RHC (Spearman's rank correlation coefficient). RESULTS: CT assessment of TR had a sensitivity of 90.4% and a specificity of 100% in detecting echocardiographic TR. For TR graded as more than trivial by echocardiography, sensitivity of CT was 100%. With respect to RHC data, the correlation between severity assessment of TR between CT and echocardiography using the Kappa weighted coefficient was 0.56 (moderately good agreement). With respect to RHC data, the correlation between mean pulmonary pressure and TR grading on CT and echocardiography was r = 0.685 (p < 0.001) and r = 0.727 (p < 0.001), respectively. CONCLUSION: Early opacification of the IVC or hepatic veins on first-pass contrast-enhanced CT almost invariably indicates TR. There is moderately good agreement between CT and echocardiographic assessment of the severity of TR. Both CT and echocardiographic grading of TR correlate well with RHC measurements of pulmonary artery pressure.

Adolescent↗
PubMed2004

The value of performing head CT in screening for cerebral metastases in patients with potentially resectable non-small cell lung cancer: experience from a UK cardiothoracic centre.

AIM: To evaluate the whether screening for cerebral metastases in neurologically intact patients with potentially resectable non-small cell lung cancer patients is both worthwhile and cost-effective. METHODS: We prospectively performed computed tomography (CT) of the head in 105 consecutive patients with potentially resectable lung cancer over an 18-month period. None of these patients had neurological symptoms or signs. RESULTS: Five patients (4.8%) with cerebral metastases were identified using CT. At our institution the financial saving of avoiding five thoracotomies was pound sterling 45,000, whilst the cost of performing 105 head CTs was pound sterling 16,000. This represented a substantial saving for the healthcare provider and preserved the quality of life in five patients. CONCLUSIONS: We conclude that screening for cerebral metastases in neurologically intact patients with potentially resectable non small cell lung cancer patients is both worthwhile and cost effective.

Adenocarcinoma↗
PubMed2004

Transpleural ultrasound diagnosis of a pulmonary arteriovenous malformation.

Pulmonary arteriovenous malformations (PAVMs) are rare. We discuss a case of an 81-year-old female who attended hospital with a haemothorax. Ultrasound not only demonstrated an echogenic effusion in the right pleural space, but also identified an associated tubular structure. Doppler was applied to this structure, which exhibited pulsatile flow. This raised the possibility of a PAVM, which was subsequently confirmed on CT and angiography. Although, PAVM is a rare cause of haemothorax, the diagnosis should still be considered and transpleural ultrasound can detect these malformations non-invasively by the bedside.

Aged↗
PubMed2003

Determination of tributyltin in marine sediment: Comité Consultatif pour la Quantité de Matière (CCQM) pilot study P-18 international intercomparison.

The capabilities of National Metrology Institutes (NMIs-those which are members of the Comité Consultatif pour la Quantité de Matière (CCQM)of the CIPM) and selected outside "expert" laboratories to quantitate (C(4)H(9))(3)Sn(+) (TBT) in a prepared marine sediment were assessed. This exercise was sanctioned by the 7th CCQM meeting, April 4-6, 2001, as an activity of the Inorganic Analysis Working Group and was jointly piloted by the Institute for National Measurement Standards of the National Research Council of Canada (NRC) and the Laboratory of the Government Chemist (LGC), UK. A total of 11 laboratories submitted results (7 NMIs, and 4 external labs). Two external laboratories utilized a standard calibration approach based on a natural abundance TBT standard, whereas all NMIs relied upon isotope dilution mass spectrometry for quantitation. For this purpose, a species specific (117)Sn-enriched TBT standard was supplied by the LGC. No sample preparation methodology was prescribed by the piloting laboratories and, by consequence, a variety of approaches was adopted by the participants, including mechanical shaking, sonication, accelerated solvent extraction, microwave assisted extraction and heating in combination with Grignard derivatization, ethylation and direct sampling. Detection techniques included ICP-MS (with GC and HPLC sample introduction), GC-MS, GC-AED and GC-FPD. Recovery of TBT from a control standard (NRCC CRM PACS-2 marine sediment) averaged 93.5+/-2.4% ( n=14). Results for the pilot material averaged 0.680+/-0.015 micro mol kg(-1) ( n=14; 80.7+/-1.8 micro g kg(-1)) with a median value of 0.676 micro mol kg(-1). Overall, performance was substantially better than state-of-the-art expectations and the satisfactory agreement amongst participants permitted scheduling of a follow-up Key comparison for TBT (K-28), a Pilot intercomparison for DBT (P-43), and certification of the test sediment for TBT content and its release as a new Certified Reference Material (HIPA-1) with a TBT content of 0.679+/-0.089 micro mol kg(-1) (expanded uncertainty, k=2, as Sn) (80.5+/-10.6 micro g kg(-1)).

Journal Article↗
PubMed1998

A redox-triggered ras-effector interaction. Recruitment of phosphatidylinositol 3'-kinase to Ras by redox stress.

Reactive free radical species are known to trigger biochemical events culminating in transcription factor activation and modulation of gene expression. The cytosolic signaling events triggered by free radicals that result in nuclear responses are largely unknown. Here we identify a signaling cascade triggered immediately upon redox activation of Ras. We examined two physiologically relevant models of redox signaling: 1) nitric oxide in human T cells, and 2) advanced glycation end product in rat pheochromocytoma cells. Reactive free radical species generated by nitric oxide donors and the interaction of advanced glycation end product with its receptor led to the recruitment of p85/p110 phosphatidylinositol 3'-kinase (PI3K) to the plasma membrane, where it associated directly with the effector domain of Ras and became activated. Only the p110beta and p110delta (but not p110alpha) catalytic subunits were recruited by redox-activated Ras. Activation of downstream targets of PI3K such as protein kinase B/Akt and mitogen-activated protein kinase was found to be PI3K dependent. Our study demonstrates that nitrosative and oxidative stressors trigger Ras-dependent and PI3K-regulated events in cells and define a biochemical pathway that is triggered by redox signaling.

Animals↗
PubMed1998

Can staff training reduce behavioural problems in residential care for the elderly mentally ill?

The effect of a brief in-service training programme on the psychosocial management of behavioural disturbance in residential care is described. Although the incidence of problematic behaviour did not change 3 months after training, staff in the experimental homes reported a significant improvement in their management of problematic behaviour, as compared to the control home. However, these effects were not maintained a year later. The importance of post-training supervision and the sociocultural context of the home in the maintenance of psychosocial intervention in residential settings is discussed.

Aged↗
PubMed1997

Bradykinin B2-receptor activation augments norepinephrine exocytosis from cardiac sympathetic nerve endings. Mediation by autocrine/paracrine mechanisms.

We determined whether local bradykinin production modulates cardiac adrenergic activity. Depolarization of guinea pig heart sympathetic nerve endings (synaptosomes) with 1 to 100 mmol/L K+ caused the release of endogenous norepinephrine (10% to 50% above basal level). This release was exocytotic, because it depended on extracellular Ca2+, was inhibited by the N-type Ca(2+)-channel blocker omega-conotoxin and the protein kinase C inhibitor Ro31-8220, and was potentiated by the neuronal uptake-1 inhibitor desipramine. Typical of adrenergic terminals, norepinephrine exocytosis was enhanced by activation of prejunctional angiotensin AT1-receptors and attenuated by adrenergic alpha 2-receptors, adenosine A1-receptors, and histamine H3-receptors. Exogenous bradykinin enhanced norepinephrine exocytosis by 7% to 35% (EC50, 17 nmol/L), without inhibiting uptake 1. B2-receptor, but not B1-receptor, blockade antagonized this effect. The kininase II/angiotensin-converting enzyme inhibitor enalaprilat and the addition of kininogen or kallikrein enhanced norepinephrine exocytosis by approximately equal to 6% to 40% (EC50, 20 nmol/L) and approximately equal to 25% to 60%, respectively. This potentiation was prevented by serine protease inhibitors and was antagonized by B2-receptor blockade. Therefore, norepinephrine exocytosis is augmented when bradykinin synthesis is increased or when its breakdown is inhibited. This is the first report of a local kallikrein-kinin system in adrenergic nerve endings capable of generating enough bradykinin to activate B2-receptors in an autocrine/paracrine fashion and thus enhance norepinephrine exocytosis. This amplification process may operate in disease states, such as myocardial ischemia, associated with severalfold increases in local kinin concentrations.

Animals↗
PubMed1995

Vibrio cholerae non-O1 as a causal pathogen in cholera patients in Yangon, Myanmar.

Vibrio cholerae non-O1 was studied in patients with rice watery diarrhoea admitted to the Infectious Diseases Hospital, Yangon. The study was conducted during 1993-1994 to determine the association of the pathogen with the disease. Altogether 771 rectal swabs were collected and examined. V. cholerae were isolated by the standard methods. The seasonal, age and sex distribution, serotyping and susceptibility of these isolates to antibiotics were investigated, V. cholerae were isolated from 233 (3O.2%) samples. Among them, V. cholerae O1 were isolated from 117 (5O%) samples and V. cholerae non-O1 from 116 (5O%) samples. The seasonal, age and sex distribution was identical in both V. cholerae O1 and V. cholerae non-O1 groups. V. cholerae O139 was isolated during February 1994. Thus V. cholerae non-O1 was also one of the causal pathogens of cholera, like V. cholerae O1 in this community.

Adolescent↗
PubMed1994

The efficacy of aldose reductase inhibitor, antioxidant butylated hydroxytoluene and cysteine protease inhibitor E64 on hyperglycemia-induced metabolic changes in the organ-cultured bovine lens.

It is well known that polyol related sugar cataract formation is preventable with aldose reductase inhibitor (ARI) and newly developed different kinds of ARIs have been extensively studied for potential clinical use. The potency of AD-5467 ARI (Takeda) on hyperglycemic lenses was evaluated by measuring of phosphate metabolites in phosphorus-31, (31P) nuclear magnetic resonance (NMR) spectra. Moreover, the effects of antioxidant butylated hydroxytoluene (BHT) and cysteine protease inhibitor E64 on hyperglycemic lenses were evaluated for comparative study, since some studies showed that these agents also possess the delay or preventive effects in sugar cataractogenesis. The lenses were dissected out from bovine eyes and incubated in Dulbeco's modified Eagles (DME) media containing 5.6 mM and 40 mM glucose with or without the ARI, BHT, E64 for 24 hours. These were assessed by MNR spectrometer operating at 109.25 MHz for 31P. The morphologic changes of the lenses were revealed by histologic and ultrastructural examinations. The lenses incubated in high glucose medium showed significant decreased levels of adenosine triphosphate (ATP), associated with increased inorganic phosphates and sugar phosphates levels. The lenses treated with ARI or E64 showed 70% to 80% protection of ATP levels and those with BHT showed 100% protection of ATP levels. These results indicated that sugar catractogenesis is multifactorial process in which the other mechanisms are also involved besides the polyol pathway mechanism.

Aldehyde Reductase↗
PubMed1994

Giant urethral calculus.

This is a case report of a 56-year-old Malay male presenting with a giant urethral calculus. The stone measuring 70 X 50 X 40 mm and weighing 45 g was impacted in the posterior urethra. The giant urethral calculus was removed successfully through external urethrotomy.

Humans↗