Showing papers by "University of Tennessee Health Science Center published in 1980"
TL;DR: In this paper, the role of vasopressin in DOC-salt hypertension was investigated in four groups of unilaterally nephrectomized rats: control rats given no further treatment, rats treated with DOC and given 1% saline to drink, or rats treated either with only DIC or 1% salt.
Abstract: To further characterize the role of vasopressin in DOC-salt hypertension, four groups of unilaterally nephrectomized rats were studied: control rats given no further treatment, rats treated with DOC and given 1% saline to drink, or rats treated with only DIC or 1% saline had similar pressor responses to exogenous vasopressin and angiotensin II. Within the DOC-salt group, two populations of rats were identified: one with normal pressor responsiveness to vasopressin, and one with markedly enhanced pressor responsiveness to vasopressin. Incidence of enhanced responsiveness increased with duration of treatment. Urinary excretion of vasopressin was elevated in the 1% saline and DOC-salt groups after 1 week of treatment, and in the DOC group after 4 weeks. However, the plasma vasopressin concentration was elevated only in the rats treated with both DOC and saline. It is suggested that vasopressin is essential for the expansion of blood volume in the early stages of DOC-salt hypertension, and functions as a direct pressor agent only in the later stages.
113 citations
TL;DR: The use of chemotherapy in earlier staged patients as adjuvants to definitive surgery or irradiation is underway in two clinical trials, where the effect of cyclophosphamide and estramustine phosphate as long‐term therapies is compared with no additional treatment.
Abstract: Results of the first nationally randomized trial of the National Prostatic Cancer Project revealed a demonstrable advantage for chemotherapy in the management of advanced disease (Stage D in relapse from endocrine therapy). Both cyclophosphamide and 5-Fluorouracil showed improved activity over standard therapy. A second trial for patients previously irradiated, with less tolerance to myelosuppressive agents, revealed an advantage for estramustine phosphate and streptozotocin over standard therapy. Subsequently completed trials have revealed activity for prednimustine and imidazole carboxamide (DTIC). Trials currently underway for newly-diagnosed Stage D and for Stage D disease clinically stable to diethylstilbestrol (DES) show promising activity for DES combined with cyclophosphamide. Current trials with single agents in advanced disease are comparing methyl-CCNU and hydroxyurea with cyclophosphamide; another is evaluating estramustine phosphate and vincristine alone and in combination. The use of chemotherapy in earlier staged patients as adjuvants to definitive surgery or irradiation is underway in two clinical trials, where the effect of cyclophosphamide and estramustine phosphate as long-term therapies is compared with no additional treatment.
91 citations
TL;DR: A total of 9 teeth were treated with a free gingival graft followed by a coronally positioned flap in conjunction with conditioning of the root surface with citric acid to reduce recession and increase the width of keratinized gingiva.
Abstract: A total of 9 teeth were treated with a free gingival graft followed by a coronally positioned flap in conjunction with conditioning of the root surface with citric acid. The grafting procedure was done 2 weeks after the subjects could perform adequate plaque control. Thirty days after grafting, a mucoperiosteal flap was raised. The root surface was thoroughly planed and conditioned with citric acid at pH 1.0, and the flap was then positioned coronally. Clinical measurements of the amount of recession, sulcus depth, and keratinized gingiva were taken preoperatively, and at 30 and 60 days after surgery. Recession was reduced by a mean of 3.24 +/- 2.08 mm. Width of keratinized gingiva was increased to a mean of 4.99 +/- 1.23 mm. Both of these findings were highly significant. Sulcus depth was not significantly changed.
71 citations
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TL;DR: Six cases thought to represent eclampsia occurring 3 or more days post partum are reported, as is a review of the pertinent literature.
70 citations
TL;DR: Five patients with childhood dermatomyositis, followed for 18 to 96 months, improved when treated with a combination of corticosteroids and methotrexate or cortic Fosteroids and cyclophosphamide after having become refractory to Corticosteroid therapy alone.
Abstract: Five patients with childhood dermatomyositis, followed for 18 to 96 months, improved when treated with a combination of corticosteroids and methotrexate (one patient) or corticosteroids and cyclophosphamide (four patients) after having become refractory to corticosteroid therapy alone. Complications of vascular involvement in childhood dermatomyositis or from immunosuppressive therapy were observed in most of these patients. Disease components involving skin, muscle, or systemic vessels sometimes varied independently in regard to disease activity or therapeutic responsiveness. In two patients with stable or improving muscle function, cerebrovascular complications occurred. Monitoring of disease activity was best accomplished by clinical evaluation; serum muscle enzymes usually failed to rise prior to or during periods of clinical worsening.
56 citations
TL;DR: The overall reaction rate in these pretreated high-risk patients was 6.8%, suggesting that this prednisone-diphenhydramine program may be the preferred prophylactic regimen when repeat RCM studies are necessary.
Abstract: Patients with a prior history of an anaphylactoid reaction (AR) to radiographic contrast media (RCM) have an increased risk of an AR during subsequent RCM studies. Based on previous studies in high-risk patients using prednisone or diphenhydramine to reduce the incidence of AR, high-risk patients were treated with a combined prednisone and diphenhydramine protocol in an effort to develop an effective, practical approach to this problem. All patients with convincing histories of AR to RCM with an essential need for a repeat RCM study received 50 mg of prednisone orally every 6 hours for 3 doses ending 1 hour before the RCM study, and 50 mg of diphenhydramine intramuscularly 1 hour prior to the procedure. Resuscitation equipment was readily available. One hundred forty-seven repeat procedures using RCM were carried out in 142 high-risk patients. No serious AR occurred. Two patients had generalized urticaria that resolved in 1 hour. The overall reaction rate in these pretreated high-risk patients was 6.8%, suggesting that this prednisone-diphenhydramine program may be the preferred prophylactic regimen when repeat RCM studies are necessary.
56 citations
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TL;DR: The effects of meclofenamate on renal hemodynamics vary with the state of sodium balance and in relation to PRA, and the mecl ofenamate-induced reduction in renal blood flow during sodium depletion was well correlated with control PRA.
Abstract: We compared the effects of sodium meclofenamate (5 mg/kg i.v.), an inhibitor of prostaglandin synthesis, on renal function in six unanesthetized dogs maintained for 5 to 7 days before the experiment on 100 mEq/day of NaCl and after sodium depletion by furosemide administration and salt deprivation. Plasma renin activity (PRA) during sodium depletion (12.35 +/- 3.93 ng ml-1 hr-1) was higher than during sodium repletion (1.46 +/- 0.47 ng ml-1 hr-1; P less than .05). The administration of meclofenamate did not alter mean arterial pressure, renal blood flow, urine volume, excretion of sodium and potassium or PRA in the sodium replete dog. However, during sodium depletion meclofenamate reduced renal blood flow from 168 +/- 35 to 105 +/- 23 ml/min (P less than .01) and urine flow from 0.32 +/- 0.09 to 0.16 +/- 0.05 ml/min (P less than .05) but did not affect mean arterial pressure, electrolyte excretion or PRA. The meclofenamate-induced reduction in renal blood flow during sodium depletion was well correlated with control PRA. After administration of meclofenamate, the urinary excretion of immunoreactive prostaglandin E2 fell by 66% (P less than .05) in the sodium replete dog and by 72% (P less than .05) in the sodium depleted dog. This study demonstrates that the effects of meclofenamate on renal hemodynamics vary with the state of sodium balance and in relation to PRA.
31 citations
TL;DR: Rectal thiopental is an effective alternative to an i.m. cocktail for sedating children before CT scans and may reduce the number of nondiagnostic scans.
Abstract: The sedative effects of rectal thiopental sodium and an intramuscular cocktail of meperidine hydrochloride, chlorpromazine hydrochloride and promethazine hydrochloride were compared in 72 pediatric patients undergoing computerized tomography (CT). Pediatric patients scheduled were randomly assigned to receive either the i.m. cocktail (2.0 mg/kg of meperidine, 1.0 mg/kg of both chlorpromazine and promethazine) or 25--45 mg/kg of thiopental rectally before scanning. Side effects, and onset, duration and depth of sedation were recorded by 14 unblinded investigators. Clarity of CT scans was rated by two blinded radiologists. Additional doses of sedatives were administered as necessary. Sedation was not achieved in 3% of the thiopental group or in 14+ of the i.m. cocktail group. Additional sedatives were required by eight patients in the thiopental group and by five patients in the cocktail group. The mean time for onset of sedation was 8 minutes with thiopental and 18 minutes with the cocktail. The mean duration of sedation was 7 hours for the cocktail group and 2.75 hours for the 25-mg/kg rectal thiopental group. All scans were diagnostic (acceptable) in the rectal thiopental group, but 14% of those in the i.m. cocktail group were nondiagnostic. Rectal thiopental is an effective alternative to an i.m. cocktail for sedating children before CT scans and may reduce the number of nondiagnostic scans.
31 citations
TL;DR: The data indicate that mammary nerve stimulation mimics that of suckling upon depletion, repletion, and the release of PRL into the circulation and add further support to the hypothesis that these phases are independent processes.
Abstract: A 50-70% depletion in the anterior pituitary concentration of PRL occurred within 5 min of electrical stimulation of a single abdominal mammary nerve of urethane-anesthetized lactating rats previously nonsuckled for 6-8 h The stimulus parameters were: 1-msec pulses, 10-20/sec at 5-30 V applied 5 sec on and 10 sec off The anterior pituitary concentration of PRL remained low for another 15-30 min after depletion, then repleted to prestimulus levels by the 90th min The same pattern of depletion-repletion occurred when mammary nerve stimulation was applied for 5 min as when it was applied for 180 min In other experiments, plasma PRL concentration rose swiftly and attained a maximal level, 4- to 5-fold in Wistar rats and 8- to 10-fold in Holtzman rats, above basal concentrations within 10-15 min of mammary nerve stimulation The maximal level was sustained throughout the time the nerve was stimulated and for 45 min after the stimulation was stopped, ie the sustained secretion of PRL into the plasma occurred at the same time that depleted PRL was repleting Ligation of both adrenals or iv injection of the beta-adrenergic blocker, propranolol, before stimulation of the nerve had no effect upon the plasma PRL profile in response to mammary nerve stimulation These data indicate that mammary nerve stimulation mimics that of suckling upon depletion, repletion, and the release of PRL into the circulation and add further support to the hypothesis that these phases are independent processes
30 citations
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TL;DR: The etiology of sinusoidal fetal heart rate (FHR) patterns is diverse and consequently they have been associated with poor as well as normal fetal outcome.
21 citations
TL;DR: Evaluation by HPLC of the unsaturated 4-sulfated disaccharide produced by digestion of the urinary GAG with chondroitinases ABC and AC revealed rapidly and quantitatively the large amounts of dermatan sulfate present in Hurler, Hunter, and Maroteaux-Lamy urines.
TL;DR: The ischemic leg as the only clinical manifestation of an aortic dissection is rare and the radiologist should observe carefully for signs of dissection such as fusiform narrowing of a vessel, nonfilling of branches of the aorta, or displacement of the intima into aortIC lumen.
Abstract: The ischemic leg as the only clinical manifestation of an aortic dissection is rare. Without the usual symptoms of an aortic dissection, this diagnosis may easily by overlooked during routine peripheral angiography for the ischemic limb. Three cases are reviewed in which the patient was thought to have a spontaneous peripheral vascular occlusion, but was later found to have an aortic dissection without the usual thoracic or abdominal symptoms. The radiologist should observe carefully for signs of dissection such as fusiform narrowing of a vessel, nonfilling of branches of the aorta, or displacement of the intima into aortic lumen.
TL;DR: Beta endorphin was administered intravenously to six medication-free schizophrenic patients under placebo-controlled conditions and prolactin was significantly increased following beta-endorphin infusion compared to placebo infusions.
TL;DR: The unusual arrangement of the great arteries and the presence of bilateral coni were demonstrated with angiocardiography and confirmed on pathologic study.
Abstract: Clinical, anglocardiographic and necropsy data in a case of atypical d-transposition of the great arteries with an anterior pulmonary trunk are described. The unusual arrangement of the great arteries and the presence of bilateral coni were demonstrated with angiocardiography and confirmed on pathologic study.
TL;DR: In this paper, a numerical solution of the three-dimensional pollutant transport equation is obtained with the method of fractional steps; advection is solved by the moment and diffusion by cubic splines; topography and variable mesh spacing are accounted for with coordinate transformations.
TL;DR: It is suggested that potassium status or extracellular [K+] may play a role in determining the haemodynamic profile associated with steroid-induced hypertension.
Abstract: 1. ACTH administration (20 microgram day-1 kg-1) to sheep produces hypertension associated with a raised cardiac output and hypokalaemia. 2. The aim of the present experiments was to detail the haemodynamic changes associated with restoration of the extracellular potassium concentration in sheep with ACTH-induced hypertension. 3. After 7 days of ACTH treatment potassium chloride (10 mmol/h) was infused for 3 days to restore plasma [K+] to the pre-ACTH value. 4. ACTH reduced plasma [K+] from 4.4 +/- 0.1 to 3.2 +/- 0.2 mmol/l but 3 days of potassium chloride infusion returned plasma [K+] to 4.3 +/- 0.2 mmol/l. 5. ACTH increased mean arterial pressure from 67 +/- 2 to 88 +/- 1 mmHg in the first 7 days and it remained elevated during potassium chloride infusion (91 +/- 5 mmHg on day 10). 6. Cardiac output rose with 7 days ACTH treatment from 4.9 +/- 0.2 to 6.0 +/- 0.6 l/min but fell progressively with potassium chloride infusion to 4.9 +/- 0.3 l/min on day 10. 7. These studies suggest that potassium status or extracellular [K+] may play a role in determining the haemodynamic profile associated with steroid-induced hypertension.
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TL;DR: Data indicate that the addition of an amino group significantly increased the therapeutic index and ventricular refractory period but reduced the toxic index (lethal dose/toxic dose) when compared to the neutral-sugar cardenolide and genin.
Abstract: In anesthetized dogs, structure activity relationships among three cardiotonic compounds were determined by comparing the cardiovascular effects of digotoxigenin (the genin) to digitoxigenin-galactose (a genin-neutral sugar combination) and to digitoxigenin-aminogalactose (ASI-222, a genin-aminosugar combination) using either bolus i.v. injections or constant i.v. infusions. We recorded the effects of these drugs upon cardiac rate, mean blood pressure, left ventricular dP/dt, cardiac index, systolic time intervals, tension-time index, therapeutic index, ventricular excitability and the ventricular refractory period. The addition of an aminosugar group to digitoxigenin or an amine group to galactose-digitoxigenin results in an agent with greater ability to reduce heart rate and to increase cardiac contractility and cardiac index without affecting the tension-time index. Moreover, the addition of an amino group significantly increased the therapeutic index and ventricular refractory period but reduced the toxic index (lethal dose/toxic dose) when compared to the neutral-sugar cardenolide and genin. Our data indicate that such a substitution confers greater potency, prolongs the duration of activity and results in a compound with a greater therapeutic index.
TL;DR: Clinical experience has shown that the diagnosis and treatment of pain patients can be greatly facilitated by educating the patient about the complex nature of pain and by integrating the assessment of functional factors into the overall diagnostic work-up.
Abstract: Any pain experience results from the interaction of biological and functional (namely, psychological and environmental) factors. In some cases functional factors may be primarily responsible for exacerbating and maintaining pain, therefore, the physician should be attentive to a variety of signs that may indicate a significant nonorganic component to the patient's pain. Problems in case management commonly arise when the organic signature is blurred, for pain patients are notoriously resistant to any suggestion that their pain is not purely organic in origin. Clinical experience has shown that the diagnosis and treatment of pain patients can be greatly facilitated by educating the patient about the complex nature of pain and by integrating the assessment of functional factors into the overall diagnostic work-up.
TL;DR: Human platelets bind on an average of 5 × 105 molecules of lentil lectin/cell with an apparent dissociation constant of 3 × 10−7 M, and the hypothesis that glycoprotein II mediates platelet aggregation needs reevaluation.
TL;DR: The results suggest there is noradrenergic hyperactivity in the central nervous system which is not reflected in abnormal peripheral sympathetic nervous system function in this group of patients.
Abstract: 1. Eleven patients with essential hypertension and nine healthy normotensive volunteer subjects, all without a neurological disorder, had blood drawn and cerebrospinal fluid sampled for analysis of noradrenaline (NA). 2. Cerebrospinal fluid NA levels were elevated (P < 0.01) in the hypertensive patients but plasma levels of NA were similar between groups. 3. The results suggest there is noradrenergic hyperactivity in the central nervous system which is not reflected in abnormal peripheral sympathetic nervous system function in this group of patients.
TL;DR: A method is described for cytochalasin B induced enucleation of cultured mammalian cells grown in monolayers and centrifuged in 75 cm2 culture flasks, achieving yields of approximately 90% from normal human fibroblasts with routinely with a single centrifugation.
Abstract: A method is described for cytochalasin B induced enucleation of cultured mammalian cells grown in monolayers and centrifuged in 75 cm2 culture flasks. Enucleation yields of approximately 90% from normal human fibroblasts can be achieved routinely with a single centrifugation in the presence of 10 µg/ml cytochalasin B. No loss of cells due to flask breakage occurs at the maximum recommended rotor speed, and flasks can be successfully centrifuged several times.
TL;DR: The temporal sequence of the occurrence of membrane-associated particles in the plasmalemma and mitochondria during spermiogenesis is discussed and their possible function in these spermatozoa is discussed.
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TL;DR: PTA may be the most cost-effective approach to correctable renovascular hypertension, and not only lowers the blood pressure, but may also preserve or improve renal function.
Abstract: PTA may be the most cost-effective approach to correctable renovascular hypertension. Successful PTA not only lowers the blood pressure, but may also preserve or improve renal function. Patients who are not ideal surgical risks should be considered for this approach if their blood pressure is not controlled or if side effects from antihypertensive drug therapy are disabling. PTA should be performed in consultation with, and with the back-up of, a vascular surgeon.
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TL;DR: It appears that platinum diffuses relatively slowly into peripheral edema fluid resulting in a slower distribution phase, which suggests that the increased fluid levels in the edematous patient serve as a platinum reservoir in both central and peripheral body areas.
Abstract: The pharmacokinetics of platinum have been studied in an edematous patient and a non-edematous patient of equivalent body weight and renal function after each was treated with cis-dichlorodiammine platinum (II) for metastatic bladder cancer. Following each 15 minute intravenous CDDP infusion, the disposition of platinum was biexponential with a rapid distribution and slow elimination. While the rate of equilibration with peripheral fluids and tissues (lambda 2 phase) was slower in the edematous patient, the volumes of platinum distribution (V1 and Varea) were greater. This suggests that the increased fluid levels in the edematous patient serve as a platinum reservoir in both central and peripheral body areas. Moreover, it appears that platinum diffuses relatively slowly into peripheral edema fluid resulting in a slower distribution phase. An increased rate of platinum elimination (lambda 1 phase) was observed in the edematous patient. However, this observation was not anticipated and cannot be readily explained. Although further studies are indicated, these findings suggest that the increased volumes of platinum distribution in the edematous patient, coupled with the faster elimination, might require an adjusted CDDP dosage regimen for edematous patients.
TL;DR: The effect of isoniazid on urine glucose tests was investigated in 30 patients by comparing commonly used glucose oxidase methods to Clinitest and results indicate that isoniaZid does not cause clinically significant interference with the copper reduction method for urine glucose determination.
Abstract: Isoniazid has been shown by in vitro study to reduce Clinitest tablets. The effect of isoniazid on urine glucose tests was investigated in 30 patients by comparing commonly used glucose oxidase methods to Clinitest. Study results indicate that isoniazid does not cause clinically significant interference with the copper reduction method for urine glucose determination.
TL;DR: It is concluded that the distance between the NEM reactive site and the position of the glycosidic oxygen of beta-galactosides bound to the lactose site is greater than 8 A.
Abstract: N-ethylmaleimide (NEM) inhibits lactose uptake in E coli by reacting with the M protein component of the lac permease system In an attempt to estimate the distance between the NEM reactive site and the substrate binding site, we have synthesized a beta-galactoside with NEM as the aglycon moiety (NEM-gal) NEM-gal was a more effective inhibitor of lactose transport than was NEM Part of the inhibition by NEM-gal was caused by competition with lactose for the substrate binding site To estimate this part of the inhibition, we synthesized the saturated and thus the unreactive N-ethylsuccinimide (NES) analog of NEM-gal Nes-gal was a competitive inhibitor of lactose uptake The remainder of the inhibition by NEM-gal followed first-order kinetics with the same rate constant as NEM In addition, the protective effect of thiodigalactoside against the inhibition of transport by NEM was also observed against irreversible inhibition by NEM-gal We suggest that the reactivity of NEM was unaltered by bringing it near the beta-galactoside binding site by way of covalent attachment to galactose We conclude that the distance between the NEM reactive site and the position of the glycosidic oxygen of beta-galactosides bound to the lactose site is greater than 8 A
TL;DR: The case of a 69-year-old white man who suffered from advanced renal cell carcinoma (pulmonary metastases) and was treated with medroxyprogesterone acetate (MPA) and the pulmonary nodules had disappeared and the patient has suffered no side effects from the drug.
Abstract: The case of a 69-year-old white man who suffered from advanced renal cell carcinoma (pulmonary metastases) and was treated with medroxyprogesterone acetate (MPA) is reported. After diagnosis the patient had a right radical nephrectomy because the tumor extended through the renal capsuli however without lical metastases. Renal cell carcinoma with only capsular invasion was confirmed in the pathology report. All lymph nodes were negative for tumor and postoperatively the patients course was normal 6 months postsurgery the patient deferred further surgery recommended for removal of well-demarcated pulmonary nodules. 8 months later the nodules remained intact and the patient was started on a course of Depo-Provera (MPA) intramuscularly weekly (400 mg/week). 9 months after the treatment with MPA was begun the pulmonary nodules had disappeared and the patient has suffered no side effects from the drug.