Showing papers by "St Thomas' Hospital published in 1979"
TL;DR: It is postulated that reduced L-rhamnose urinary excretion in untreated villous atrophy is due to a decreased absorptive area in the small bowel, whereas increased lactulose excretion indicates leakiness of the abnormal mucosa to larger polar molecules.
286 citations
TL;DR: The results are assessed in the light of the dynamic changes in energy metabolism occurring in early anoxia and suggest that ATP depletion in a specific cell compartment may be the primary trigger for early contractile failure.
Abstract: The precise mechanism responsible for early contractile failure after the onset of myocardial anoxia or ischemia has attracted speculation and controversy. The simple and attractive hypothesis that adenosine triphosphate (ATP) deficiency is responsible for this failure has often been dismissed on the basis of claims that there is only a small reduction in cell ATP content at a time when contractile activity is severely reduced. The premise of this article is that the changes in cell ATP content and distribution that theoretically should occur after oxygen depletion may not have been adequately considered and that previous measurements of cell ATP content may not have been carried out at the correct time. Using an isolated rat heart preparation and high speed freeze-clamping techniques it has been possible to demonstrate that a substantial decrease in myocardial ATP and creatine phosphate content occurs after the onset of anoxia but before the onset of contractile failure. Thus, during the first 5 seconds of anoxia contractile activity remains constant whereas ATP decreases by 25 percent and creatine phosphate by 50 percent. Thereafter, contractile failure occurs and the rate of utilization of high energy phosphates declines with the cell content at a plateau or possibly increasing. These results are assessed in the light of the dynamic changes in energy metabolism occurring in early anoxia and suggest that ATP depletion in a specific cell compartment may be the primary trigger for early contractile failure.
223 citations
TL;DR: In this article, the spatial resolving power, contrast sensitivity, and receptive field properties of retinal ganglion cells were studied in cats reared with either convergent or divergent squint in one eye.
Abstract: The spatial resolving power, contrast sensitivity, and receptive field properties of retinal ganglion cells were studied in cats reared with either convergent or divergent squint in one eye. Sustained-X cells in the area centralis of the squinting eye of the cats with esotropia without alternating fixation showed significantly poorer spatial resolution, and reduced contrast sensitivity compared with cells in the area centralis of the normal eye. These amblyopic sustained-X cells in the area centralis of the squinting eye had receptive field characteristics similar to those found in immature cells of young kittens. They had a shallow sensitivity gradient within a relatively widespread centre zone and a weak and widespread inhibitory surround. In contrast, the sustained cells in the area centralis of the normal eye revealed a typical, well defined, small centre zone with its sensitivity gradient extremely steep and its inhibitory surround strong and confined. A minor degree of amblyopia was also found in transient Y-cells in the area centralis of the squinting eye of these cats. However, no loss of resolving power was found in the cells in the area centralis of the squinting eye of the cats with esotropia or exotropia which showed alternating fixation. Thus, amblyopia occurs in those eyes which have lost the use of the area centralis as the normal visual axis during early postnatal development, and its organic lesion is already apparent in the retinal ganglion cells--the third order neurone in the afferent visual system. It is suggested that the loss of the ability to fixate results in inadequate stimulation of the central retinal ganglion cells due to the habitual presence of blurred images at the area centralis which prevents their full development during the critical period.
114 citations
104 citations
TL;DR: Cerebral blood flow, red-cell mass, and plasma volume were measured in 39 patients with venous haematocrit values in the range 0·47-0·58 and both groups demonstrated significant inverse relationships between CBF and haematography and blood viscosity.
94 citations
TL;DR: In this article, the levels of mercury cadmium and zinc were measured in tissues of puffin ( Fratercula arctica ) fulmar ( Fulmarus glacialis ) and Manx shearwater ( Puffinus puffinus ).
88 citations
TL;DR: The term keratoacanthoma was employed in his department at St Thomas' Hospital, London, in the 1940's by the late Dr G.B.DowIing.
Abstract: The term keratoacanthoma was employed in his department at St Thomas' Hospital, London, in the 1940's by the late Dr G.B.DowIing. It had been suggested by Dr Walter Freudenthal as a suitable descriptive, non-committal alternative to moUuscum sebaceum, applied to the same lesion by MacCormac & Scarff (1936) but applied also by some authors to molluscum contagiosum. The lesion itself was not new; it had long been recognized by surgeons and by dermatologists, and occasional case reports can be found in the proceedings of nineteenth century clinical meetings. However, the diagnostic label, if there was one, attached to such reports was commonly 'atypical' or 'self-limiting' epithehoma. Soon after the publication of MacCormac and Scarff's paper, Adamson (i937)» a dermatologist of great experience, agreed that they were describing a distinct entity, with which he
87 citations
TL;DR: In this article, the authors present a comparison of three methods of treatment for tibial plateau fracture: plaster, metal, and traction, and conclude that skeletal traction with early movement is safer than the other two.
86 citations
TL;DR: Because of the very low levels of NO2 at which an association with illness was observed and the inconsistency between the results in the UK and those from several studies in the US, it is possible that the NO2 levels were a proxy for some other factor more directly related to respiratory disease such as temperature or humidity.
Abstract: We examined the relation between lung function and respiratory illness in a population of 808 primary school children aged 6-7 years and the levels of nitrogen dioxide (NO2) in the kitchens and bedrooms in their homes. Complete data were collected on about 66% of the population. The children lived in a defined 4 square km area in Middlesbrough, Cleveland, UK. One week average outdoor levels of NO2 varied little over the area (14-24 ppb); The prevalence of respiratory illness was higher in children from gas than electric cooking homes (p approximately or equal to 0.1). Although prevalence was not related to kitchen NO2 levels (range 5-317 ppb) it increased with increasing levels of NO2 in the children's bedrooms in gas cooking homes (range 4-169 ppb, p approximately or equal to 0.1). Symptoms in siblings and parents were not related to kitchen NO2 levels. Lung function was not related to NO2 levels in the kitchen or bedroom. Because of the very low levels of NO2 at which an association with illness was observed and the inconsistency between our results in the UK and those from several studies in the US, it is possible that the NO2 levels were a proxy for some other factor more directly related to respiratory disease such as temperature or humidity.
82 citations
TL;DR: Information from 29 homes with the highest kitchen NO2 levels paired with 29 low NO2 gas cooking homes showed that the daily number of meals eaten and the frequency with which the cooker was used for heating and drying clothes were significantly greater in the high NO2 homes.
Abstract: The study was designed to determine whether there was an association between indoor levels of nitrogen dioxide (NO2) and respiratory illness and lung function in schoolchildren. NO2 was measured for one week in the winter outside and inside the homes of children aged 6-7 years living and attending primary schools in a defined 4 square km area in Middlesbrough, Cleveland, UK. Outdoor levels of NO2 measured at 75 points within the area ranged from 14-24 ppb weekly average. Measurements were also made in 428 kitchens with gas cookers, range 5-317 ppb, mean 112.2 ppb, and in 87 kitchens with electric cookers, range 6-188 ppb, mean 18.0 ppb. In a random subsample of homes the range of NO2 levels in 107 children's bedrooms in homes where gas was used for cooking was 4-169 ppb, mean 30.5 ppb, in 18 bedrooms in electric cooking homes the range was 3-37 ppb, mean 13.9 ppb. NO2 levels in the gas cooking kitchens were positively related to the presence of pilot lights, use of gas fires for main heating, number of regular smokers, and the number of people in the home. Information from 29 homes with the highest kitchen NO2 levels paired with 29 low NO2 gas cooking homes showed that the daily number of meals eaten and the frequency with which the cooker was used for heating and drying clothes were significantly greater in the high NO2 homes.
76 citations
TL;DR: It is concluded that release of endogenous GABA from glial pools in response to physiological increases in extracellular potassium is unlikely to be important.
TL;DR: The possibility of detecting administration of the natural androgen testosterone by its effect on the suppression of endogenous luteinizing hormone (LH) has been investigated and showed dramatic increases in the ratio of testosterone to LH.
TL;DR: Peroperative intravenous metronidazole dramatically reduced postoperative sepsis but failed to prevent infection in the presence of anastomotic breakdown.
TL;DR: Fluctuations of HDL-C with time appear to be related in part to variations in triglyceride-rich lipoprotein metabolism, which needs to be taken into account when making comparisons in epidemiological studies of the predictive powers of single on-entry measurements for future disease.
TL;DR: Two young men, tattooed early in 1977 by the same London tattooist, both rapidly developed lichenoid lesions confined entirely to the red dyed areas.
Abstract: Two young men, tattooed early in 1977 by the same London tattooist, both rapidly developed lichenoid lesions confined entirely to the red dyed areas.
TL;DR: The diagnosis of tuberculous peritonitis was made by laparoscopy and target peritoneal biopsy in eight patients treated in a London hospital between 1971 and 1978.
TL;DR: Fifteen non-puerperal women with breast abscess were seen during one year; the anaerobic abscesses were all subareolar; they were recurrent in 4 patients and were associated with retracted nipples in 7; andSquamous metaplasia with keratin plugging of the breast ducts was identified histologically in the 2 non-northern patients in whom duct excision was performed.
TL;DR: Cerebral embolism may complicate lesions of the subclavian arteries or aortic isthmus distal to the origins of the vertebral or carotid arteries due to retrograde propagation of occlusive thrombus.
TL;DR: Despite the advances in understanding of the pathogenesis of amyloid, there has been little progress in terms of the success of therapy, and the ultimate prognosis of patients with systemic amyloidsosis remains poor.
Abstract: Summary
This report is a review of the literature on systemic amyloidosis and concentrates largely on primary and plasma cell dyscrasia-related disease. Recent developments in the fields of amyloid structure and pathogenesis arc discussed and patterns of clinical presentation are described. It is emphasized that a combination of the carpal tunnel syndrome, macroglossia and specific mucocutaneous lesions necessitates an intensive search for an underlying plasma cell dyscrasia, and that immunodectrophoresis of serum and concentrated urine is essential to exclude a paraproteinaemia. Other diagnostic measures, including cutaneous histopathology, are considered. Despite the advances in our understanding of the pathogenesis of amyloid, there has been little progress in terms of the success of therapy, and the ultimate prognosis of patients with systemic amyloidosis remains poor.
TL;DR: The results confirmed the previous observations of Lader and Morris (1974) that the cortical evoked potential decreases rapidly with increasing concentrations of nitrous oxide, and the CNV, however, against prediction remains surprisingly well preserved up to the borders of unconsciousness.
TL;DR: The type and level of chromosome aberrations observed in CHO cells indicate that the mechanism of action of CHIP is similar to that seen with bifunctional alkylating agents.
Abstract: CHIP acts as a hypoxic cell sensitizer when used in conjunction with X-irradiation. A change in the extrapolation number of the radiation survival curve of chinese hamster ovary (CHO) cells is observed but the exponential slope (D 0 ) remains the same. Chinese hamster ovary cells appear to be less sensitive than C 3 H mouse mammary tumor cells to CHIP. The type and level of chromosome aberrations observed in CHO cells indicate that the mechanism of action of CHIP is similar to that seen with bifunctional alkylating agents.
TL;DR: A case of inflammatory fibrous histiocytoma arising in the left hypochondrium, which presented with a leukemoid reaction and was initially diagnosed as chronic neutrophilic leukemia, is described and the tendency of this highly malignant group of tumors to cause a systemic granulocytosis is commented upon.
Abstract: A case of inflammatory fibrous histiocytoma arising in the left hypochondrium, which presented with a leukemoid reaction and was initially diagnosed as chronic neutrophilic leukemia, is described. The difficulty of interpreting the hematological findings, especially as the spleen appeared to be enlarged, is discussed. The tendency of this highly malignant group of tumors to cause a systemic granulocytosis is commented upon and attention is drawn to the lack of satisfactory treatment.
TL;DR: Only 5.5% of 2612 homosexual males attending genitourinary clinics were found to be hepatitis-B surface-antigen (HBsAg) positive, and sexual contacts of these individuals may be at serious risk of infection.
TL;DR: The instrument offers an accurate reproducible and relatively noninvasive technique for measuring cardiac output and agrees very closely with the cardiac output determined by manual calculation from the same dye dilution curves.
Abstract: This study assesses a precalibrated dichromatic earpiece densitometer and microprocessor for the measurement of cardiac output by indocyanine green dye dilution. The measured cardiac output is compared with values of cardiac output simultaneously determined using a cuvette densitometer. The microprocessor computation of cardiac output agreed very closely with the cardiac output determined by manual calculation from the same dye dilution curves (standard deviation ±1.47%). The reproducibility of the earpiece densitometer (standard deviation ±5.2%) was virtually identical to that of the cuvette densitometer (±5.3%). In a comparison of earpiece and cuvette densitometers for 60 measurements of cardiac output following pulmonary arterial injection of dye and for 50 measurements following femoral venous injection of dye, correlation coefficients were 0.83 and 0.78 and the standard deviations of the differences of simultaneous measurements were 7.2% and 8.3% respectively. The instrument offers an accurate reproducible and relatively noninvasive technique for measuring cardiac output.
TL;DR: Nail changes, which included longitudinal striation, crumbling and brittleness were striking and preceded the appearance of other cutaneous lesions by a period of 5 months, confirming the presence of amyloid deposits in the nail fold and distal part of the nail bed.
Abstract: Summary
A case of systemic amyloidosis with an underlying lymphoproliferative disorder is described. Nail changes, which included longitudinal striation, crumbling and brittleness were striking and preceded the appearance of other cutaneous lesions by a period of 5 months. A nail biopsy confirmed the presence of amyloid deposits in the nail fold and distal part of the nail bed.
TL;DR: A dopaminergic influence on prolactin and TSH release in normal men, an inhibitory effect of TRH on bromocriptine stimulated growth hormone secretion, and no dopaminerential modulation of basal insulin secretion are suggested.
Abstract: SUMMARY
Six normal fasting males received on four separate occasions in random order (1) a placebo tablet followed 60 min later by 200 μg of TRH intravenously (2) bromocriptine 2.5 mg orally followed by TRH intravenously (3) bromocriptine 2.5 mg orally followed by a placebo injection and (4) placebo tablet followed by placebo injection. Plasma prolactin and TSH responses to TRH were decreased following bromocriptine pretreatment. The rise of plasma growth hormone after bromocriptine was inhibited by TRH. The rise in plasma FSH seen after TRH injection was not influenced by bromocriptine pretreatment. Circulating LH and insulin concentrations were unaffected by any drug administration. These results suggest a dopaminergic influence on prolactin and TSH release in normal men, an inhibitory effect of TRH on bromocriptine stimulated growth hormone secretion, and no dopaminergic modulation of basal insulin secretion.
TL;DR: 3-Hydroxypropylmercapturic acid was the only sulphur-containing metabolite of cyclophosphamide found in the blood and liver of rats, but S-(3-hydroxy[14C]propyl)-L-cysteine were tentatively identified in the bile of a rat dosed with [ 14C]cy...
Abstract: 1. 3-Hydroxypropylmercapturic acid has been identified in the urine of rats dosed with cyclophosphamide, isophosphamide, and trilophosphamide and was isolated as its dicyclohexylammonium salt from the urine of rats dosed with cyclophosphamide.2. Rats excreted in their urine 55·5% of the 14C of an i.p. dose (200 mg/kg) of [4-14C]cyclophosphamide during the first 24 h after administration, and a further 6·6% during the subsequent 24 h. Of the total radioactivity excreted during the first 24 h, unchanged cyclophosphamide represented 19·3% or less, 41·6% was due to the major metabolite, carboxyphosphamide, and 3-hydroxypropylmercapturic acid represented 11·9%. The 14C label in the mercapturic acid was located in the S-substituent.3. 3-Hydroxypropylmercapturic acid was the only sulphur-containing metabolite of cyclophosphamide found in the blood and liver of rats, but 3-hydroxy[14C]propylmercapturic acid and S-(3-hydroxy[14C]propyl)-L-cysteine were tentatively identified in the bile of a rat dosed with [14C]cy...
TL;DR: Eight patients with 12 chondrosarcomas were treated with radiation and razoxane and two tumors in 1 patient progressed unequivocally, three patients showed no change, and 7 tumors in 5 patients had complete or partial regressions.
Abstract: Eight patients with 12 chondrosarcomas were treated with radiation and razoxane (ICRF 159). Two tumors in 1 patient progressed unequivocally, 3 tumors in 3 patients showed no change, and 7 tumors in 5 patients had complete or partial (more than 50%) regressions. At least 2 complete regressions have responded for more than 2 1/2 years at the present time.