1151
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Brown J, Kamon J, Eldabi T, Paul RJ. PP10. Economic evaluation of adjuvant treatment for early breast cancer. Eur J Cancer 1997. [DOI: 10.1016/s0959-8049(97)85923-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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1152
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Scrivens J, Jackson A, Yates H, Green M, Critchley G, Brown J, Bateman R, Bowers M, Gidden J. The effect of the variation of cation in the matrix-assisted laser desorption/ionisation-collision induced dissociation (MALDI-CID) spectra of oligomeric systems. ACTA ACUST UNITED AC 1997. [DOI: 10.1016/s0168-1176(97)00239-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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1153
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Sculpher M, Brown J. OP25. A systematic review of health benefit valuation in economic evaluations in cancer. Eur J Cancer 1997. [DOI: 10.1016/s0959-8049(97)85905-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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1154
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Thompson E, Drummond M, Howell A, Jonat W, Brown J. OP27. Anastrozole 1 mg provides a cost-effective survival benefit, compared with megestrol acetate, for patients treated for advanced breast cancer. Eur J Cancer 1997. [DOI: 10.1016/s0959-8049(97)85908-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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1155
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Kennedy M, Kim KH, Harten B, Brown J, Planck S, Meshul C, Edelhauser H, Rosenbaum JT, Armstrong CA, Ansel JC. Ultraviolet irradiation induces the production of multiple cytokines by human corneal cells. Invest Ophthalmol Vis Sci 1997; 38:2483-91. [PMID: 9375566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Ultraviolet (UV) irradiation exposure represents a significant environmental and occupational hazard that can cause acute and chronic inflammatory changes in the exposed cornea. Acute exposure to solar UV irradiation or to UV irradiation from such artificial sources as tanning lamps can result in severe pain and inflammation in the cornea. Chronic exposure to solar UV irradiation is associated with several external eye diseases including pterygium and squamous metaplasia or carcinoma. In the skin, inflammatory responses to UV exposure appear to be mediated by the release of inflammatory cytokines. The role of corneal-derived cytokines in UV-mediated corneal inflammation has not been established. In this study, the effect of UV exposure on the production of proinflammatory cytokines by corneal cells was examined. METHODS Cultured human corneal stroma cells and whole human corneas received UV irradiation (10 to 100 mJ/cm2), and the production of the proinflammatory cytokines interleukin (IL)-1, IL-6, IL-8, and tumor necrosis factor alpha (TNF alpha) was measured by Northern blot analysis, enzyme-linked immunosorbent assay, cytokine bioassays, and immunohistochemical analysis. RESULTS The results indicate that acute UV exposure leads to a significant increase in the production of IL-1, IL-6, IL-8, and TNF alpha in human corneal stroma cells. Similarly, acute UV irradiation of whole human corneas ex vivo induces a significant increase in the production of IL-1, IL-6, IL-8, and TNF alpha. CONCLUSIONS Acute UV irradiation exposure results in the induction of cornea-derived proinflammatory cytokines. The local release of these proinflammatory cytokines by cells in the irradiated cornea may be responsible for UV-mediated corneal inflammation.
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1156
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Wiliams RC, Boucher R, Brown J, Scull JR, Walker J, Paolini D. Analysis of acetate counter ion and inorganic impurities in pharmaceutical drug substances by capillary ion electrophoresis with conductivity detection. J Pharm Biomed Anal 1997; 16:469-79. [PMID: 9589406 DOI: 10.1016/s0731-7085(97)00088-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Capillary electrophoresis with conductivity detection is a versatile new method for the analysis of counter ions in pharmaceutical drug substances. It is a sensitive and linear technique for determining inorganic ions and short chain carboxylic acids such as acetate. Both acetate counter ion and inorganic impurities can be separated and determined in the same assay.
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1157
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Calvert CA, Pickus CW, Jacobs GJ, Brown J. Signalment, survival, and prognostic factors in Doberman pinschers with end-stage cardiomyopathy. Vet Med (Auckl) 1997; 11:323-6. [PMID: 9470155 DOI: 10.1111/j.1939-1676.1997.tb00474.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Congestive heart failure (CHF) was evaluated by retrospective review of case records of 66 Doberman Pinschers presenting with overt signs of 2 weeks' duration or less. Left-sided CHF was predominant, the majority of dogs were male, most were 5 to 10 years of age, and CHF tended to occur in females at an older age. Sudden death occurred in 13 dogs (20%). The mean and median survival times of all dogs were 9.65 and 6.5 weeks, respectively. Both atrial fibrillation and bilateral CHF at the time of presentation were associated with significantly shorter survival times.
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1158
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Glasgow RE, La Chance PA, Toobert DJ, Brown J, Hampson SE, Riddle MC. Long-term effects and costs of brief behavioural dietary intervention for patients with diabetes delivered from the medical office. PATIENT EDUCATION AND COUNSELING 1997; 32:175-184. [PMID: 9423499 DOI: 10.1016/s0738-3991(97)00039-6] [Citation(s) in RCA: 120] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This study evaluated the 12-month follow-up results and costs of a personalized, medical office-based intervention focused on behavioral issues related to dietary self-management. Two hundred and six adults having diabetes attending an internal medicine outpatient clinic visit were randomized to either Usual Care or to Brief Intervention. The single session intervention involved touchscreen computer-assisted assessment that provided immediate feedback on key barriers to dietary self-management, goal setting and problem-solving counselling. Follow-up components included phone calls and videotape intervention relevant to each participant. Brief Intervention produced significantly greater improvement than Usual Care on multiple measures of change in dietary behaviour (e.g., covariate adjusted difference of 2.2% of calories from fat; p = 0.023) and on serum cholesterol levels (covariate adjusted difference of 15 mg/dl; p = 0.002) at 12-month follow-up. There were also significant differences favouring intervention on patient satisfaction (p < 0.02) but not on HbA1c levels. The costs of intervention ($137 per patient) were modest relative to many commonly used practices.
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Abstract
Transient global amnesia is an unusual syndrome involving a transient memory loss and inability to form new memories, without affecting other cognitive functions. Although the patient often lacks insight into the problem, the syndrome is very frightening for family members, who frequently present to the ED. The evaluation of the syndrome is the subject of some controversy. This review presents current understanding about the causes of transient global amnesia and an approach to the ED evaluation of the syndrome.
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1160
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Kottom TJ, Nolan LK, Robinson M, Brown J, Gustad T, Horne SM, Giddings CW. Further characterization of a complement-sensitive mutant of a virulent avian Escherichia coli isolate. Avian Dis 1997; 41:817-23. [PMID: 9454914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
An attempt was made to characterize the mechanism of complement resistance operating in a virulent avian Escherichia coli isolate. Using flow cytometry to detect antibody to C3, we found that there was significantly more antibody bound to a complement-sensitive mutant of this wild type than to the parent organism, suggesting that more C3 subunits were bound to the wild type. Neither the wild type nor the mutant degraded C3. Further, the mutant was phagocytosed to a significantly greater degree than the wild type by cultured phagocytes in the presence of C5-deficient serum. These data suggest that the wild type is resistant to complement, at least in part, because of its ability to restrict C3 deposition on its surface. Therefore, the decrease in virulence seen in the mutant may be related to its increased sensitivity to complement-mediated bacteriolysis or its enhanced susceptibility to complement-opsonized phagocytosis or both.
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1161
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Fischer K, Brown J, Scherer SW, Schramm P, Stewart J, Fugazza G, Pascheberg U, Peter W, Tsui LC, Lichter P, Döhner H. Delineation of genomic regions in chromosome band 7q22 commonly deleted in myeloid leukemias. Recent Results Cancer Res 1997; 144:46-52. [PMID: 9304706 DOI: 10.1007/978-3-642-46836-0_6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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1162
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Brown J, Hinds P. Assessing master's programs in oncologic nursing. Oncol Nurs Forum 1997; 24:1427-37. [PMID: 9380598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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1163
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Guinan P, Didomenico D, Brown J, Shaw M, Sharifi R, Ray V, Shott S, Rubenstein M. The effect of androgen deprivation on malignant and benign prostate tissue. Med Oncol 1997; 14:145-52. [PMID: 9468037 DOI: 10.1007/bf02989642] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The purpose of this research was to describe the changes in marker expression and histologic morphology following androgen deprivation in malignant and benign human prostates. Fourteen patients receiving pre-radical prostatectomy total androgen deprivation had pre- and post-androgen deprivation evaluation of marker expression and histologic morphology (both malignant and benign). Marker expression was significantly reduced for serum (p < 0.0001) and tissue (p < 0.004) PSA as well as bcl-2 expression (p < 0.008). There were significant histologic increases in vacuolization (p < 0.001), pyknosis (p < 0.04), fibrosis (p < 0.01) and lymphocytic infiltration (p < 0.008) in the malignant tissue. There were significant increases in squamous metaplasia (p < 0.0002), fibrosis (p < 0.0005), basal cell hypertrophy (p < 0.0005) and lymphocytic infiltration (p < 0.0002) in the benign tissue. Androgen deprivation therapy produces significant changes in marker expression and morphology in prostate specimens. At times these iatrogenic changes can be confusing. Clinicians and pathologists must be aware of these changes.
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Paisley MK, Stamper M, Brown J, Brown N, Ganong LH. The use of heparin and normal saline flushes in neonatal intravenous catheters. PEDIATRIC NURSING 1997; 23:521-4, 527. [PMID: 9355594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE To compare the effects of heparin versus normal saline flush solutions on the duration of patency of peripheral IV catheters in neonates. METHODS A quasi experimental design compared the outcomes in 87 infants who were 32 weeks or greater gestation at birth. Thirty-three received heparin and 54 received normal saline. RESULTS There were 159 starts among the subjects. No statistically significant difference in duration of patency between the groups was found. The duration was significantly longer for term than preterm infants and for insertion in scalp, arm, or hand than for leg or foot. CONCLUSIONS Gestational age and site of insertion were the only predictor variables related to duration of patency for IV catheters.
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1165
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Bois P, Collick A, Brown J, Jeffreys AJ. Human minisatellite MS32 (D1S8) displays somatic but not germline instability in transgenic mice. Hum Mol Genet 1997; 6:1565-71. [PMID: 9285795 DOI: 10.1093/hmg/6.9.1565] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Human minisatellite MS32 (D1S8) shows instability both in the germline and, at much lower levels, in somatic DNA. To investigate factors that influence somatic and germline mutation, large cosmid-based constructs containing MS32 were introduced into mice, bred to homozygosity and tested for instability in blood and sperm. Analysis of single copy and multicopy transgenic lines revealed somatic mutants occurring at a frequency comparable with that seen in man. As in humans, these mutants arose mainly by simple intra-allelic duplications and deletions. In contrast, analysis of sperm DNA from four different transgenic lines showed no trace of the complex recombination-based germline instability seen in man, even using PCR-based approaches capable of detecting very rare mutants. These data provide further evidence that germline and somatic mutation at human minisatellite MS32 occur via distinct pathways, that a major barrier exists to the transfer of germline instability from humans to mice and that the mouse germline appears to be protected from mitotic instability of the type seen in blood.
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Brown J. Outcome-oriented research on certification. Nurs Manag (Harrow) 1997; 28:10. [PMID: 9335829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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1168
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Adachi JD, Bensen WG, Brown J, Hanley D, Hodsman A, Josse R, Kendler DL, Lentle B, Olszynski W, Ste-Marie LG, Tenenhouse A, Chines AA. Intermittent etidronate therapy to prevent corticosteroid-induced osteoporosis. N Engl J Med 1997; 337:382-7. [PMID: 9241127 DOI: 10.1056/nejm199708073370603] [Citation(s) in RCA: 422] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND METHODS Osteoporosis is a recognized complication of corticosteroid therapy. Whether it can be prevented is not known. We conducted a 12-month, randomized, placebo-controlled study of intermittent etidronate (400 mg per day for 14 days) followed by calcium (500 mg per day for 76 days), given for four cycles, in 141 men and women (age, 19 to 87 years) who had recently begun high-dose corticosteroid therapy. The primary outcome measure was the difference in the change in the bone density of the lumbar spine between the groups from base line to week 52. Secondary measures included changes in the bone density of the femoral neck, trochanter, and radius and the rate of new vertebral fractures. RESULTS The mean (+/-SE) bone density of the lumbar spine and trochanter in the etidronate group increased 0.61 +/- 0.54 and 1.46 +/- 0.67 percent, respectively, as compared with decreases of 3.23 +/- 0.60 and 2.74 +/- 0.66 percent, respectively, in the placebo group. The mean differences between the groups after one year were 3.72 +/- 0.88 percentage points for the lumbar spine (P = 0.02) and 4.14 +/- 0.94 percentage points for the trochanter (P = 0.02). The changes in the femoral neck and the radius were not significantly different between the groups. There was an 85 percent reduction in the proportion of postmenopausal woman with new vertebral fractures in the etidronate group as compared with the placebo group (1 of 31 patients vs. 7 of 32 patients, P = 0.05), and the etidronate-treated postmenopausal women also had significantly fewer vertebral fractures per patient (P = 0.04). CONCLUSIONS Intermittent etidronate therapy prevents the loss of vertebral and trochanteric bone in corticosteroid-treated patients.
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1169
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Brown J, Higo H, McKalip A, Herman B. Human papillomavirus (HPV) 16 E6 sensitizes cells to atractyloside-induced apoptosis: role of p53, ICE-like proteases and the mitochondrial permeability transition. J Cell Biochem 1997. [PMID: 9213225 DOI: 10.1002/(sici)1097-4644(19970801)66:2<245::aid-jcb11>3.0.co;2-g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Infection of cervical epithelial cells with certain high risk HPV genotypes is thought to play an etiologic role in the development of cervical cancer. In particular, HPV type 16 and 18 early protein 6 (E6) is thought to contribute to epithelial transformation by binding to the tumor suppressor protein p53, targeting it for rapid proteolysis, resulting in loss of its cell cycle arrest and apoptosis-inducing activities. Recent data indicate that factors responsible for triggering apoptosis reside in the cytoplasm of cells, and not in the nucleus. In particular, the findings that mitochondria are required in certain cell-free models for induction of apoptosis and that bcl-2 is localized to mitochondria have focused attention on the role of the mitochondrial membrane permeability transition (MPT) in apoptosis. Here we present data to indicate that HPV 16 E6 expression sensitizes cells to MPT-induced apoptosis. We also report that HPV 16 E6 sensitization of cells to MPT-induced apoptosis occurs only in the presence of wildtype (wt) p53 expression. The extent of apoptosis induced by atractyloside (an inducer of the MPT) in normal, temperature-sensitive (ts) p53, and HPV-16 E6 transfected J2-3T3 cells, and the HPV expressing cervical carcinoma cell lines SiHa, Hela and CaSki was determined. C33A cells, which express mutant p53 but not HPV, were also exposed to atractyloside in the presence or absence of HPV 16 E6 expression. Dose-dependent apoptosis induced by atractyloside in normal J2-3T3 cells and cervical carcinoma cells was measured by loss of cell viability, nuclear fragmentation and DNA laddering. The sensitivity of cells to atractyloside-induced apoptosis was found to be: HPV 16 E6-J2-3T3 > CaSki > normal-J2-3T3 cells approximately ts p53-J2-3T3 approximately vector-J2-3T3 cells > Hela > SiHa > C33A approximately C33A 16 E6. Cyclosporin A (CsA), an inhibitor of the MPT, and ICE-I, a protease inhibitor, provided protection against atractyloside-induced apoptosis. These findings indicate that: 1) high risk HPV 16 E6 protein is capable of sensitizing cells to apoptosis; 2) HPV 16 E6 sensitization of cells to atractyloside-induced apoptosis occurs in a p53-dependent fashion; 3) the target of HPV 16 E6 sensitization of cells to atractyloside-induced apoptosis is the mitochondria; and 4) HPV 16 E6 sensitization of cells to atroctycoside-induced apoptosis involves an ICE-like protease-sensitive mechanism, regulating the onset of the MPT. These findings constitute the first evidence that mitochondria play a role in HPV 16 E6 modulation of apoptosis.
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Brown J, Hooper G, Kenyon CJ, Haines S, Burt J, Humphries JM, Newman SP, Davis SS, Sparrow RA, Wilding IR. Spreading and retention of vaginal formulations in post-menopausal women as assessed by gamma scintigraphy. Pharm Res 1997; 14:1073-8. [PMID: 9279891 DOI: 10.1023/a:1012113714552] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE In this paper we report on the first scintigraphic evaluation of vaginal dosage forms in post-menopausal women. To date, almost nothing is known about the in vivo performance of pharmaceutical formulations in the human vagina, which is a major deficiency in the rational design of drug delivery systems for both existing and new indications. METHODS The vaginal spreading and clearance of a radiolabelled pessary formulation and Replens (polycarbophil) gel, was assessed in six healthy, post-menopausal female volunteers over a six hour period using the technique of gamma scintigraphy. RESULTS In five out of the six subjects studied, clearance of the two formulations exhibited very little intra-subject variation. However, there was considerable inter-subject variability in clearance; in Subject 5 circa 80% of the products were retained whilst in Subject 2 less than 2% was present at the end of the six hour imaging period. Importantly, there was no evidence to suggest that either of the formulations dispersed material beyond the cervix, into the uterus, in any of the subjects studied. CONCLUSIONS The lack of significant retention of these products in most of the volunteers has obvious implications for the delivery of therapeutic agents. This study shows that gamma scintigraphy is an invaluable technique with which to assess novel formulations aimed at optimising retention in the vagina for topical or systemic drug delivery.
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Brown J, Haines S, Wilding IR. Colonic spread of three rectally administered mesalazine (Pentasa) dosage forms in healthy volunteers as assessed by gamma scintigraphy. Aliment Pharmacol Ther 1997; 11:685-91. [PMID: 9305476 DOI: 10.1046/j.1365-2036.1997.00193.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Rectal administration of enemas, foams and suppositories is the most efficient method of delivering locally-acting drugs to the distal colon, sigmoid colon and rectum. Healthy volunteers provide an effective population to compare different formulations for rectal drug delivery. However, there is still only limited comparative information available on the dispersion of such dosage forms in human subjects. Therefore, the objective of this scintigraphic study was to compare colonic spread of an enema, a rectal foam and a suppository formulation in healthy volunteers. METHODS This was a randomized, crossover study in eight healthy male volunteers. Each received Pentasa rectal formulations as either a 100 mL suspension enema (1 g mesalazine), one actuation of a non-CFC propellant rectal foam (1 g mesalazine in 5 mL concentrate, expanding to 40 mL on actuation), or one suppository (1 g mesalazine) on three separate occasions. The spread of the radiolabelled formulations was assessed over a 4-h period by gamma scintigraphy. RESULTS The formulations were retained by all subjects for the whole of the 4-h imaging period. The enema spread to the splenic flexure in 7 out of 8 subjects, but was retained in the rectum and sigmoid colon in one individual. The foam spread as far as the descending colon in four subjects. In the remaining individuals the foam was retained in the rectum and sigmoid colon. The spread of the suppository was limited and confined to the rectum. CONCLUSIONS The findings of this study are consistent with previous research and support the intended clinical uses of the enema, foam and suppository formulations to treat distal ulcerative colitis, proctosigmoiditis and proctitis, respectively. The results highlight the potential of gamma scintigraphy in providing in vivo 'proof of concept' data to help verify the targeting of pharmaceutical products to their intended site of delivery.
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1172
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Demellweek C, Humphris GM, Hare M, Brown J. Children's perception of, and attitude towards, unfamiliar peers with facial port-wine stains. J Pediatr Psychol 1997; 22:471-85. [PMID: 9302845 DOI: 10.1093/jpepsy/22.4.471] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Evaluated children's perception of, and attitude towards, unfamiliar peers with facial port-wine stains (PWS). Participants (ages 8 to 11 years) from three grades were shown videoclips of the same 6 children, 3 of whom (2 girls and 1 boy) were seen with a (fake) PWS by participants from one grade. Participants from different grades saw a different 1 of these 3 children with a PWS. Participants thought PWS would attract staring and teasing; for the boy it would cause self-pity and, for one of the girls, it would make getting a boyfriend more difficult, but the stain did not significantly affect participants' assessment of the attractiveness and character or willingness to interact/become friendly with the children on the video. Possible reasons for this discrepancy are discussed.
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Balestrieri P, Simmons G, Hill D, Brown J, Jackson A, Brull SJ, Maneatis TJ, Shefrin A, Bynum L, O'Hara DA. The effect of intravenous ketorolac given intraoperatively versus postoperatively on outcome from gynecologic abdominal surgery. J Clin Anesth 1997; 9:358-64. [PMID: 9257200 DOI: 10.1016/s0952-8180(97)00062-7] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
STUDY OBJECTIVES To examine the effect of timing of an intravenous (i.v.) dose (intraoperative vs. postoperative) of ketorolac tromethamine on pain scores and overall outcome after total abdominal hysterectomy (TAH) and myomectomy. DESIGN Prospective, randomized, placebo-controlled study. PATIENTS 248 ASA physical status I and II adult female patients scheduled for elective hysterectomy or myomectomy. INTERVENTIONS General anesthesia was administered that consisted of thiopental sodium for induction, enflurane or isoflurane in nitrous oxide-oxygen for maintenance, and small doses of fentanyl and midazolam. Patients were randomized into three groups to receive toradol/placebo on a dosing schedule of dose 1 given one-half hour prior to expected end of surgery, dose 2 given on awakening in the postanesthesia care unit, and doses 3, 4, and 5 given at 6, 12, and 18 hours, respectively, after dose 2; Group 1 patients received placebo (saline) for dose 1, ketorolac 60 mg i.v. for dose 2, and ketorolac 30 mg i.v. for doses 3, 4, and 5. Group 2 patients received ketorolac 60 mg i.v. for dose 1, placebo for dose 2, and ketorolac 30 mg i.v. for doses 3, 4, and 5. Group 3 patients received placebo for all doses. All patients were given i.v. morphine PCA postoperatively, and morphine usages, visual analog pain intensity (VAS) scores, as well as adverse events and median times to recovery milestones were recorded. MEASUREMENTS AND MAIN RESULTS VAS scores (mean) before dose 2 were significantly lower in Group 2 than Group 1, as were at-rest evaluations at 15 minutes and one hour. Group 2 patients also had decreased morphine requirements as compared to placebo. Both ketorolac groups (Groups 1 and 2) had significantly higher values for patient and observer overall ratings, case of nursing care, and tolerability as compared to placebo (Group 3). There were no significant differences among groups in adverse events or median times to recovery milestones. CONCLUSIONS Although it is possible to demonstrate an improvement in early postoperative pain scores with intraoperative ketorolac and better overall ratings of ketorolac both intraoperatively and postoperatively as compared with placebo, the lack of clinically significant differences in analgesic efficacy in the two active study groups indicates the need for a careful consideration by the clinician of the risks versus benefits involved in the administration of antiplatelet medication in the perioperative period.
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Wong DF, Singer HS, Brandt J, Shaya E, Chen C, Brown J, Kimball AW, Gjedde A, Dannals RF, Ravert HT, Wilson PD, Wagner HN. D2-like dopamine receptor density in Tourette syndrome measured by PET. J Nucl Med 1997; 38:1243-7. [PMID: 9255158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
UNLABELLED Tourette syndrome (TS) is a chronic neurologic disorder characterized by the presence of involuntary motor and phonic tics. There is evidence that TS is associated with an abnormality of the dopaminergic system, involving postsynaptic D2 receptors. We tested the hypothesis that D2-like dopamine receptors are elevated in TS. METHODS Twenty-nine adult patients with TS were studied by PET imaging with [11C]3-N-methylspiperone ([11C]NMSP). Two methods of data analysis were used. The first was a caudate-to-cerebellar ratio, measured at 45 min. The second method, applied in 20 subjects, was a two-PET scan procedure. Both used high specific activity [11C]NMSP, but the second scan was preceded by a dose of unlabeled haloperidol, which partially occupied the D2-like dopamine receptors. This was done to provide an absolute measure of receptor density (Bmax). All patients were compared to age- and sex-matched controls. RESULTS Neither group showed significant differences from their control group in caudate-to-cerebellar ratio. However, the two-PET scan Bmax measurement demonstrated that 4 of the 20 patients had significantly elevated D2-like receptors. In this group of 20 patients, multiple linear regression analysis revealed a trend between the severity of vocal tics and Bmax values. This Bmax measure also revealed a significant (p < 0.05) association with performance on the Wisconsin Card Sorting Test. CONCLUSION These findings suggest that not all patients with TS have an abnormality of D2-like receptors, but a subgroup of TS subjects has a significant D2-like dopamine receptor elevation. These findings also support the importance of applying a more quantitative method for Bmax determination to PET imaging analysis. The Bmax findings in the subgroup do not exclude an effect of intrasynaptic dopamine competition, but this effect may be less likely due to the high affinity of [11C]NMSP.
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Brown J, Higo H, McKalip A, Herman B. Human papillomavirus (HPV) 16 E6 sensitizes cells to atractyloside-induced apoptosis: role of p53, ICE-like proteases and the mitochondrial permeability transition. J Cell Biochem 1997; 66:245-55. [PMID: 9213225 DOI: 10.1002/(sici)1097-4644(19970801)66:2<245::aid-jcb11>3.0.co;2-g] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Infection of cervical epithelial cells with certain high risk HPV genotypes is thought to play an etiologic role in the development of cervical cancer. In particular, HPV type 16 and 18 early protein 6 (E6) is thought to contribute to epithelial transformation by binding to the tumor suppressor protein p53, targeting it for rapid proteolysis, resulting in loss of its cell cycle arrest and apoptosis-inducing activities. Recent data indicate that factors responsible for triggering apoptosis reside in the cytoplasm of cells, and not in the nucleus. In particular, the findings that mitochondria are required in certain cell-free models for induction of apoptosis and that bcl-2 is localized to mitochondria have focused attention on the role of the mitochondrial membrane permeability transition (MPT) in apoptosis. Here we present data to indicate that HPV 16 E6 expression sensitizes cells to MPT-induced apoptosis. We also report that HPV 16 E6 sensitization of cells to MPT-induced apoptosis occurs only in the presence of wildtype (wt) p53 expression. The extent of apoptosis induced by atractyloside (an inducer of the MPT) in normal, temperature-sensitive (ts) p53, and HPV-16 E6 transfected J2-3T3 cells, and the HPV expressing cervical carcinoma cell lines SiHa, Hela and CaSki was determined. C33A cells, which express mutant p53 but not HPV, were also exposed to atractyloside in the presence or absence of HPV 16 E6 expression. Dose-dependent apoptosis induced by atractyloside in normal J2-3T3 cells and cervical carcinoma cells was measured by loss of cell viability, nuclear fragmentation and DNA laddering. The sensitivity of cells to atractyloside-induced apoptosis was found to be: HPV 16 E6-J2-3T3 > CaSki > normal-J2-3T3 cells approximately ts p53-J2-3T3 approximately vector-J2-3T3 cells > Hela > SiHa > C33A approximately C33A 16 E6. Cyclosporin A (CsA), an inhibitor of the MPT, and ICE-I, a protease inhibitor, provided protection against atractyloside-induced apoptosis. These findings indicate that: 1) high risk HPV 16 E6 protein is capable of sensitizing cells to apoptosis; 2) HPV 16 E6 sensitization of cells to atractyloside-induced apoptosis occurs in a p53-dependent fashion; 3) the target of HPV 16 E6 sensitization of cells to atractyloside-induced apoptosis is the mitochondria; and 4) HPV 16 E6 sensitization of cells to atroctycoside-induced apoptosis involves an ICE-like protease-sensitive mechanism, regulating the onset of the MPT. These findings constitute the first evidence that mitochondria play a role in HPV 16 E6 modulation of apoptosis.
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