St Bartholomew's Hospital

About: St Bartholomew's Hospital is a healthcare organization based out in London, United Kingdom. It is known for research contribution in the topics: Population & Cancer. The organization has 11054 authors who have published 13229 publications receiving 501102 citations. The organization is also known as: St. Bartholomew's Hospital & The Royal Hospital of St Bartholomew.

The management of diabetes during surgery

Abstract: \"Diabetes offers a serious bar to any kind of operation, and injuries involving open wounds, haemorrhage, or damage to the blood vessels are exceedingly grave in subjects of this disease. A wound in the diabetic patient will probably not heal while the tissues appear to offer the most favourable soil for the development of putrefaction and pyogenic bacteria. The wound gapes, suppurates, and sloughs. Gangrene readily follows an injury in diabetics, and such patients show terrible proneness to the low form of erysipelas, and cellulitis.\" (Treves, 1896.) The advent of insulin revolutionized the treatment of diabetic patients undergoing surgery, a revolution that was extended by the discovery of antibiotics. Nonetheless, in unpractised hands surgery can still be disastrous for diabetics in terms of both morbidity and mortality. Even in good centres surgery carries a significant mortality and morbidity. Wheelock and Marble (1971) reported a 3.7% mortality in a series of 2780 patients studied between 1965 and 1969, while Galloway and Shuman (1963) had a 3.6% mortality and 17.2% morbidity in 667 cases. In the same period Alieff (1969) reported a 13.2% mortality. In diabetics undergoing renal transplantation there was two to four times the mortality compared with nondiabetics (Kjellstrand et al., 1972). The major causes of mortality and morbidity were and still are myocardial disease and infection. Obviously these are important in non-diabetics as well as in diabetics, but in the latter, poor control of diabetes with its attendant disturbances of electrolyte and intermediary metabolism will inevitably exacerbate these problems. Myocardial infarction itself is more likely to be mortal in diabetics (Soler et al., 1974) while resistance to infection is diminished in poorly controlled diabetes (Bagdade, Nielson and Bulger, 1972). Wound healing is also said to be impaired. Diabetics undergoing surgery tend to be a highrisk group. Three-quarters or moreof surgical

γ-Aminobutyric Acid Uptake by Sympathetic Ganglia

Abstract: EXOGENOUS γ-aminobutyric acid (GABA) accumulates against a concentration gradient in isolated mammalian nervous tissue1–3 and mixes with GABA stored in the tissue4. Thus, neurones which use GABA as an inhibitory transmitter might be identified by locating sites of accumulation of radioactively-labelled GABA using autoradiography5–7, assuming that exogenous GABA is only taken up into neurones already containing GABA. A correlation between GABA uptake and endogenous content has been noted in slices from different parts of the brain3 and in different nerve-ending fractions8–10. These experiments, however, do not show whether GABA can be accumulated in nerve tissue totally devoid of “gabanergic” neurones. To test this, we have measured the uptake of GABA by isolated sympathetic ganglia. The principal transmitter in the ganglion is acetylcholine while the postganglionic neurones are mainly adrenergic. By analogy with the brain, the ganglion contains negligible amounts of GABA, glutamic decarboxylase or GABA-transaminase11,12.

Stimulation of adrenal mitogenesis by N-terminal proopiocortin peptides.

Abstract: Although it was generally believed that corticotropin (ACTH) maintained both the size of the adrenal gland and its level of steroid production1, there is a growing body of evidence for a specific factor(s) distinct from ACTH which may be responsible for the stimulation of adrenocortical growth and proliferation. While direct neural influences have been proposed to be responsible for the compensatory adrenal growth following unilateral adrenalectomy2, several observations have suggested the involvement of peptides such as angiotensin3 and vasopressin4, which have other hormonal effects, or, for example, fibroblast growth factor5, which has more general mitogenic actions. Moreover ACTH inhibits cell proliferation in vitro6–8, and physiological doses in vivo cannot induce the compensatory growth and hyperplasia seen in the remaining adrenal gland after unilateral adrenalectomy9. These observations coupled with the lack of effect of chronic treatment with an ACTH antiserum on adrenal size10 and the existence of adrenal weight-maintaining activity in the plasma of patients with ACTH-secreting adenomas11, have led to the search for a pituitary factor related to ACTH which is capable of stimulating adrenal growth. We now report that peptides derived from the N-terminal non-γ-melanocyte-stimulating hormone (MSH) portion of the precursor of ACTH, proopiocortin, are potent stimulators of adrenal DNA synthesis in vitro and mitosis in vivo and may thus be involved in the physiological control of adrenal growth.