St Thomas' Hospital

About: St Thomas' Hospital is a healthcare organization based out in London, United Kingdom. It is known for research contribution in the topics: Population & Pregnancy. The organization has 12105 authors who have published 15596 publications receiving 624309 citations. The organization is also known as: St Thomas's Hospital & St. Thomas's.

A comparative study on the metabolism of human insulin and porcine proinsulin in man.

Abstract: SUMMARY 1. The metabolism of unlabelled monocomponent human insulin and porcine proinsulin was studied in ten normal subjects (five males and five females) by using a priming dose-constant-infusion technique. In each subject, the metabolic clearance rate (MCR) was measured at four separate steady-state hormone concentrations averaging 16-21 6 punitslml (insulin) and 4-2-42.8 ng/ml (proinsulin). 2. For insulin the MCR fell progressively from 34 ml kg-' min-' at a mean fasting insulin concentration of 3.8 punitslml to 11.4 ml kg-' min-' at the highest concentration achieved (280 punits/ml); for proinsulin MCR averaged 3.7 ml kg - ' min-' at a mean plasma concentration of 4.2 ng/ml and fell to 2.71 ml kg-' min-' at 10.7 ng/ml, remaining constant thereafter at concentrations up to 71 ng/ml. 3. The half-disappearance time (T+) from the plasma, after the end of the infusion, averaged 4.3 min for insulin and 25.6 min for proinsulin. 4. The apparent distribution space (DS) was similar for both hormones (83 ml/kg of insulin and 98.9 ml/kg of proinsulin). 5. There was a direct correlation between T+ and DS for both hormones. 6. Although the higher MCR of insulin was reflected in its shorter T+, there was, for each hormone, no relationship between MCR and T+. 7. The biological potency of porcine proinsulin, as judged by its effect on plasma glucose, was approximately 5% of that of insulin. 8. The responses of serum growth hormone and cortisol were shown to be directly related to the degree of hypoglycaemia induced.

Meta-Analysis of Genome-Wide Scans Provides Evidence for Sex- and Site-Specific Regulation of Bone Mass

Abstract: Several genome-wide scans have been performed to detect loci that regulate BMD, but these have yielded inconsistent results, with limited replication of linkage peaks in different studies. In an effort to improve statistical power for detection of these loci, we performed a meta-analysis of genome-wide scans in which spine or hip BMD were studied. Evidence was gained to suggest that several chromosomal loci regulate BMD in a site-specific and sex-specific manner

A 5-year prospective study of Astra single tooth implants.

Abstract: Aim— To evaluate the AstraTech Implant ST (Molndal, Sweden) for single tooth replacement clinically and radiographically after 5 years in function. Subjects and method— Fifteen patients (age range 16 to 48) with missing maxillary anterior teeth (6 central incisors, 8 laterals, 1 bicuspid) had four 13 mm and eleven 15 mm single tooth implants provided. All patients were seen at 4- to 6-monthly intervals for oral hygiene maintenance. Periapical radiographs using Rinn holders and a long cone technique were taken at the crown insertion and after 1 year, 3 and 5 years. Results— No implant losses were observed in 14 of the 15 patients available for evaluation. No abutment screw loosening or soft tissue problems were observed. At crown insertion the mean bone level was 0.46±0.55 to 0.48 ±0.56 mm apical to the top of the implant neck and there were no statistically significant changes in the radiographic bone level over the 5 years of the study (0.36±0.37 to 0.43±0.46 mm at year 5). One crown was recemented after 18 months in function and 1 crown was replaced because of a fracture to the porcelain incisal edge. Conclusion— The Astra Tech Implants ST were highly successful in single tooth replacement and bone levels during 5 years of function were stable. Resume Le but de cette etude a ete d'evaluer cliniquement et radiologiquement le systeme Astra Tech Implant ST pour le remplacement d'une dent, apres cinq annees en fonction. Quinze patients de seize a 48 ans avec une dent anterosuperieure manquante (six incisives centrales, huit laterales et une premolaire) ont ete implantes avec quatre implants de 13 mm et onze de 15 mm. Tous les patients ont ete revus a des intervalles de quatre a six mois pour l'entretien de l'hygiene buccale. Des radiographies periapicales utilisant la methode de Rinn avec long cone ont ete prises lors de l'insertion de la couronne et apres une, trois et cinq annees. Aucune perte implantaire n'a ete observee pour quatorze parmi les quinze patients. Aucune vis de l'implant ne s'est devissee et aucun probleme de tissus mous n'a ete observe. Lors du placement de la couronne, le niveau osseux moyen etait de 0.46±0.55 a 0.48 ±0.56 mm apicalement par rapport au sommet du col de l'implant. Il n'y avait aucune variation statistiquement significative pour les niveaux osseux radiographiques durant les cinq ans a la fin desquels ces mesures etaient respectivement de 0.36±0.37 a 0.43 ±0.46 mm. Une couronne a ete rescellee apres 18 mois. Une autre a ete remplacee suite a une fracture du bord incisif en porcelaine. Le systeme implantaire Astra Tech ST s'est revele excellent pour le remplacement unitaire, les niveaux osseux durant les cinq annees de fonction sont restes stables. Zusammenfassung Ziel: Das Astra Tech Implantat ST (Molndal Sweden) uber einen Zeitraum von 5 Jahren in Funktion klinisch und radiologisch zu untersuchen. Material und Methode. 15 Patienten (Alter zwischen 16 und 48) mit fehlenden Zahnen in der Oberkieferfront (6 zentrale Inzisiven, 8 laterale Inzisiven, 1 Pramolar) wurden vier 13 mm und elf 15 mm lange Einzelimplantate eingesetzt. Alle Patienten wurden alle 4 bis 6 Monate nachkontrolliert und die Mundhygiene uberwacht. Nach dem Einsetzen der Kronen und 1 Jahr, 3 und 5 Jahre nach dem Einsetzen der Kronen wurden periapikale Rontgenaufnahmen mit dem Filmhaltern des Rinnsystems und der Langtubustecknik aufgenommen. Resultate: Bei den 14 von insgesamt 15 Patienten, welche nachuntersucht werden konnten, war kein Implantatverlust zu verzeichnen. Es konnten keine lockeren Schrauben bei den Prothetikaufbauten und keine Probleme an den Weichgeweben beobachtet werden. Beim Einsetzen der Kronen lag das Knochenniveau 0.46±0.55 bis 0.48±0.56 mm apikal vom Oberteil des Implantathalses und es fanden wahrend der 5 Jahre dauernden Beobachtungszeit keine statistisch signifikanten Veranderungen im radiologischen Knochenniveau statt (0.36±0.37 bis 0.43±0.46 mm nach 5 Jahren). Eine Krone musste nach 18 Monaten in Funktion rezementiert und eine Krone wegen einer Porzellanfraktur der Inzisalkante ersetzt werden. Schlussfolgerung: Die Astra Tech Implantate ST waren fur den Einzelzahnersatz sehr erfolgreich und die Knochenniveaus waren wahrend der Beobachtungszeit von 5 Jahren in Funktion stabil. Resumen Intencion— Evaluar clinica y radiograficamente el implante Astra Tech ST (Molndal Suecia) para sustitucion de diente unico tras 5 anos en function. Sujetos y metodo− 15 pacientes (rango de edad de 16 a 48) con ausencia de dientes maxilares anteriores (6 incisivos centrales, 8 laterales, 1 bicuspide) recibieron cuatro implantes unitarios de 13 mm y once de 15 mm. Todos los pacientes fueron vistos con intervalos de 4 a 6 meses para mantenimiento de higiene oral. Se tomaron radiografias periapicales usando soportes Rinn y tecnica de cono largo en el momento de insercion de la corona y al ano, 3 y 5 anos. Resultados— No se observaron perdidas de implantes en 14 de los 15 pacientes disponibles para la evaluacion. No se observaron movilidades en los pilares o problemas de los tejidos blandos. En el momento de insertion de la corona el nivel medio de hueso fue de 0.46±0.55 a 0.48±0.56 mm apical de la parte alta del cuello del implante y no hubo cambios estadisticamente significativos en el nivel radiografico de hueso a lo largo de los 5 anos del estudio (0.36±0.37 a 0.43±0.46 mm en el quinto ano). Una corona se recemento despues de 18 meses en funcion y una corona se sustituyo por fractura de la porcelana en el borde incisai. Conclusion— Los implantes Astra Tech ST fueron altamente exitosos en la sustitucion de dientes unitarios y los niveles de hueso a los 5 anos se mantuvieron estables.

Circulating Humoral Factors and Endothelial Progenitor Cells in Patients With Differing Coronary Collateral Support

Abstract: Background—The mechanisms underlying the variation in collateral formation between patients, even with similar patterns of coronary artery disease, remain unclear. This study investigates whether circulating humoral or cellular factors can provide an insight into this variation. Methods and Results—Thirty patients with isolated left anterior descending coronary artery disease underwent percutaneous coronary intervention with collateral flow index (CFI) determined using a pressure wire. Patients with inadequate (CFI 0.25) compared with those with adequate (CFI0.25) collateral support had, or tended to have, lower concentrations of coronary sinus growth factors and plasma exerting a weaker effect on endothelial cell migration and angiogenesis in vitro. However, there was an inverse correlation between serum mitogenicity and CFI (r0.61, P0.01). No significant differences were detected between the 2 groups in plasma levels of total vascular endothelial growth factor, vascular endothelial growth factor 165, or placental growth factor. There was a strong positive correlation between numbers of CD34/CD133-positive circulating hemopoietic precursor cells and CFI (r0.75, P0.001). In patients with inadequate, compared with those with adequate, CFI, the numbers of differentiated endothelial progenitor cells (EPCs) appearing in the circulation and in culture were significantly reduced by 75% (P0.05) and 70% (P0.05), respectively. Conclusions—In this study, inadequate coronary collateral development is associated with reduced numbers of circulating EPCs and impaired chemotactic and proangiogenic but not mitogenic activity. These findings are consistent with current efforts to enhance collateral formation by augmentation of circulating EPCs. (Circulation. 2004;109:2986-2992.)