PubMed Health⌕ Search

Biomedical subjects

Terence J Ryan

Publications and source records attributed to Terence J Ryan.

15 recordsLinked to original sources
PubMed2007

What are subcutaneous adipocytes really good for?

Our acute awareness of the cosmetic, psychosocial and sexual importance of subcutaneous adipose tissue contrasts dramatically with how poorly we have understood the biology of this massive, enigmatic, often ignored and much-abused skin compartment. Therefore, it is timely to recall the exciting, steadily growing, yet underappreciated body of evidence that subcutaneous adipocytes are so much more than just 'fat guys', hanging around passively to conspire, at most, against your desperate attempts to maintain ideal weight. Although the subcutis, quantitatively, tends to represent the dominant architectural component of human skin, conventional wisdom confines its biological key functions to those of energy storage, physical buffer, thermoregulation and thermoinsulation. However, already the distribution of human superficial adipose tissue, by itself, questions how justified the popular belief is that 'skin fat' (which actually may be more diverse than often assumed) serves primarily thermoinsulatory purposes. And although the metabolic complications of obesity are well appreciated, our understanding of how exactly subcutaneous adipocytes contribute to extracutaneous disease - and even influence important immune and brain functions! - is far from complete. The increasing insights recently won into subcutaneous adipose tissue as a cytokine depot that regulates innate immunity and cell growth exemplarily serve to illustrate the vast open research expanses that remain to be fully explored in the subcutis. The following public debate carries you from the evolutionary origins and the key functional purposes of adipose tissue, via adipose-derived stem cells and adipokines straight to the neuroendocrine, immunomodulatory and central nervous effects of signals that originate in the subcutis - perhaps, the most underestimated tissue of the human body. The editors are confident that, at the end, you shall agree: No basic scientist and no doctor with a serious interest in skin, and hardly anyone else in the life sciences, can afford to ignore the subcutaneous adipocyte - beyond its ample impact on beauty, benessence and body mass.

Adipocytes↗
PubMed2003

Lymphoedema: Pathophysiology and management in resource-poor settings - relevance for lymphatic filariasis control programmes.

Low cost reduction of morbidity in lymphoedema is an essential goal in the management of lymphatic filariasis. This review emphasises the role of movement and elevation, and refers to the literature on the effects of these on the venous and lymphatic system. The patient with lymphoedema becomes increasingly immobile and the affected limb is often in a permanently dependent position causing venous hypertension and resultant overloading of the failing lymphatics. The evidence that breathing exercises are important for reducing venous hypertension and inducing lymphatic flow is discussed.The contribution of a damaged epidermis to lymphatic failure is emphasised. Loss of barrier function encourages penetration of bacteria and stimulates repair mechanisms that generate cytokines, which, in turn lead to inflammation. Management programmes that improve the health of the epidermis play a part in reducing lymphatic load.In taking morbidity management of lymphoedema into the general health services there are benefits in promoting skin hygiene and self-help regimes that can ameliorate many diseases along with lymphoedema.

Journal Article↗
PubMed2003

Use of herbal medicines in wound healing: a perspective paper.

Healing of chronic lower extremity wounds is a global problem, especially in the developing world where it is often only folk and traditional medicine that can be afforded. In the structured health services of the developed world, there are usually a wider range of possible therapies. In India, traditional medicines flourish in parallel with Western systems, and those who treat wounds may use the expertise of more than one system. Ayurveda is a traditional system that has evolved in India over centuries using especially native plant sources as remedies. Like many Asian systems, its theoretical basis concerns balance and energy in the individual. In this perspective paper, the author advocates awareness of plant products available for wound healing and a study of the extent of their utilization. They must be developed for safe use and their efficacy reviewed, taking into account cure well-being and patient satisfaction as well as cost. Developing a list of products and classifying them appropriately is a beginning for such studies.

Journal Article↗
PubMed2002

Plasma proteins in a standardised skin mini-erosion (I): permeability changes as a function of time.

BACKGROUND: A standardised technique using a suction-induced mini-erosion that allows serial sampling of dermal interstitial fluid (IF) for 5 to 6 days has been described. In the present study, we studied permeability changes as a function of time. METHODS: We examined IF concentrations of total protein concentration and the concentration of insulin (6.6 kDa), prealbumin (55 kDa), albumin (66 kDa), transferrin (80 kDa), IgG (150 kDa) and alpha-2-macroglobulin (720 kDa) as a function of time, using an extraction pressure of 200 mmHg below atmospheric. RESULTS: At 0 h after forming the erosion, mean total IF protein content (relative to plasma) was 26 +/- 13% (SD). For the individual proteins, the relative mean concentrations were 65 +/- 36% for insulin, 48 +/- 12% for albumin, 30 +/- 19% for transferrin, 31 +/- 15%for IgG and 19.5 +/- 10% for alpha-2-macroglobulin. At 24 h, the total IF protein content was higher than at 0 h (56 +/- 26% vs 26 +/- 13%; p < 0.05, diff: 115%), as were some of the individual protein concentrations: prealbumin (50 +/- 24 vs 25 +/- 13%; p < 0.05), albumin (68 +/- 21 vs 48 +/- 12%; p < 0.05) and IgG (55 +/- 30 vs 31 +/- 15%; p = 0.05). ln the interval 24 h to 96 h the concentrations were relatively unchanged. CONCLUSIONS: The results indicate that fluid sampled at 0 h after forming the erosion represents dermal IF before the full onset of inflammation. From 24 h onward, the sampled fluid reflects a steady state of increased permeability induced by inflammation. This technique is promising as a tool for clinically sampling substances that are freely distributed in the body and as a model for studying inflammation and vascular permeability.

Adult↗
PubMed2002

Plasma proteins in a standardised skin mini-erosion (II): effects of extraction pressure.

BACKGROUND: A standardised suction technique has been used to sample plasma proteins in dermal interstitial fluid (IF) serially for 5 to 6 days from a suction-induced skin mini-erosion. Increased protein concentrations ascribed to inflammation have been shown from day 1 onward. In this study, we assessed the effect of two different extraction pressures on IF sample composition. METHODS: Total protein concentration and the concentrations of insulin, prealbumin, albumin, transferrin, IgG and alpha-2-macroglobulin were assessed daily in healthy volunteers. Samples were extracted at 50 mmHg and 200 mmHg below the atmospheric. RESULTS: At 0 h after forming the erosion, mean total IF protein content (relative to plasma) was lower in the samples extracted at -200 mmHg than at -50 mmHg (26 +/-13% (SD) vs 48 +/-9.8%; p < 0.05). There were no significant differences at 24, 48, 72 or 96 h. Of the individual proteins, expressed as area units (AU) for area under the curve (AUC) from 0-96 h, albumin was lower in IF sampled at -200 mmHg (2.49 +/- 0.68 vs 3.08 +/- 0.36 AU; p < 0.05), as was transferrin (1.91 +/- 0.52 vs 2.40 +/- 0.42 AU; p < 0.05). Extraction volumes were significantly higher at -200 mmHg (AUC diff: 60%; p < 0.05). CONCLUSIONS: Samples of IF extracted at 0 h at -200 mmHg contained lower protein concentrations, indicating an increased water fraction and an intact sieve function of the vascular wall. The difference in protein concentration extracted at higher and lower pressure from 24 h onward was less pronounced. Lower pressure should be used to sample substances of greater molecular size.

Blood Proteins↗
PubMed2002

Common denominators for the low-cost management of leg conditions.

Diseases of blood supply and drainage of the leg are common, and they frequently contribute to poverty. Management must include self-help low-cost therapy. The phlebologist, lymphologist, angiologist, or dermatologist must seek to distill their knowledge for the health worker in the general health services. Such knowledge should focus on the venous system, which is amenable to simple maneuvers such as breathing, elevation, and movement. However, the mechanisms underlying the functions of the blood vessels and lymphatics and the organ they supply or drain are inextricably interwoven. Care of the veins, the lymphatics, and the epidermis depends on attention to each together and at the same time. New knowledge of cytokines produced by the epidermis and their effects on angiogenesis and permeability suggest that care of the epidermis by washing and emollients has equal value as elevation and movement. Such maneuvers cost little and are usually available.

Journal Article↗
PubMed2002

Risk factors for the swollen ankle and their management at low cost: not forgetting lymphedema.

Lymphedema is a common global problem that affects the lower limb. Lymphatics are the pathways for the traffic of the immune system as well as the drainage system of the skin. Disruption of the normal function of the lymph may lead to limb swelling often exacerbated by obesity and immobility. This article presents developments in understanding and suggests principles of management with a view to promoting debate about this neglected condition.

Journal Article↗