.I 1
.U
87049087
.S
Am J Emerg Med 8703; 4(6):491-5
.M
Allied Health Personnel/*; Electric Countershock/*; Emergencies; Emergency Medical Technicians/*; Human; Prognosis; Recurrence; Support, U.S. Gov't, P.H.S.; Time Factors; Transportation of Patients; Ventricular Fibrillation/*TH.
.T
Refibrillation managed by EMT-Ds: incidence and outcome without paramedic back-up.
.P
JOURNAL ARTICLE.
.W
Some patients converted from ventricular fibrillation to organized rhythms by defibrillation-trained ambulance technicians (EMT-Ds) will refibrillate before hospital arrival. The authors analyzed 271 cases of ventricular fibrillation managed by EMT-Ds working without paramedic back-up. Of 111 patients initially converted to organized rhythms, 19 (17%) refibrillated, 11 (58%) of whom were reconverted to perfusing rhythms, including nine of 11 (82%) who had spontaneous pulses prior to refibrillation. Among patients initially converted to organized rhythms, hospital admission rates were lower for patients who refibrillated than for patients who did not (53% versus 76%, P = NS), although discharge rates were virtually identical (37% and 35%, respectively). Scene-to-hospital transport times were not predictively associated with either the frequency of refibrillation or patient outcome. Defibrillation-trained EMTs can effectively manage refibrillation with additional shocks and are not at a significant disadvantage when paramedic back-up is not available.
.A
Stults KR; Brown DD.
.I 2
.U
87049088
.S
Am J Emerg Med 8703; 4(6):496-500
.M
Antidepressive Agents, Tricyclic/*PO; Arrhythmia/PP; California; Electrocardiography; Emergencies; Emergency Service, Hospital/*; Female; Human; Length of Stay; Male; Prognosis; Retrospective Studies; Tachycardia, Sinus/DI/TH.
.T
Tricyclic antidepressant overdose: emergency department findings as predictors of clinical course.
.P
JOURNAL ARTICLE.
.W
There is controversy regarding the appropriate utilization of health care resources in the management of tricyclic antidepressant overdosage. Antidepressant overdose patients presenting to the emergency department (ED) are routinely admitted to intensive care units, but only a small proportion develop cardiac arrhythmias or other complications requiring such an environment. The authors reviewed the findings in 165 patients presenting to an ED with antidepressant overdose. They found that major manifestations of toxicity on ED evaluation (altered mental status, seizures, arrhythmias, and conduction defects) were commonly associated with a complicated hospital course. Patients with the isolated findings of sinus tachycardia or QTc prolongation had no complications. No patient experienced a serious toxic event without major evidence of toxicity on ED evaluation and continued evidence of toxicity during the hospital course. These data support the concept that proper ED evaluation can identify a large body of patients with trivial ingestions who may not require hospital observation.
.A
Foulke GE; Albertson TE; Walby WF.
.I 3
.U
87049089
.S
Am J Emerg Med 8703; 4(6):501-3
.M
Adult; Aircraft/*; Altitude/*; Blood Gas Monitoring, Transcutaneous/*MT; Conjunctiva/*ME; Female; Human; Male; Monitoring, Physiologic/*MT; Regression Analysis; Transportation of Patients/*MT.
.T
Transconjunctival oxygen monitoring as a predictor of hypoxemia during helicopter transport.
.P
JOURNAL ARTICLE.
.W
As the use of helicopters for air transport of critically ill patients increases, the availability of monitoring devices for physiological parameters during flight becomes important. It has long been known that arterial PO2 (PaO2) decreases during unsupplemented, non-pressurized flight. In this study, the authors examined the use of the transconjunctival oxygen (cjO2) monitor for assessing the adequacy of arterial oxygenation during helicopter flight in four healthy volunteers. Arterial PaO2 as measured by conventional blood gas analysis was compared with cjO2 at ground level, 5,000 feet, and 10,000 feet altitude. Mean PaO2 dropped significantly from 93.5 to 81.5 to 58.5 mm Hg, respectively (P less than 0.001, analysis of variance with repeated measures). Mean cjO2 also decreased significantly from 63.8 to 52.0 to 34.8 mm Hg, respectively (P less than 0.001, analysis of variance with repeated measures). Within individual subjects, cjO2 was an accurate predictor of PaO2 (P less than 0.001, multiple regression analysis). The relationship between cjO2 and PaO2 was linear with a regression coefficient of 1.147. The authors conclude that the transconjunctival O2 monitor may be useful for monitoring the adequacy of arterial oxygenation during helicopter flight in hemodynamically stable patients. The results of study also support the use of supplemental oxygen in all patients subjected to helicopter transport.
.A
Shufflebarger C; Jehle D; Cottington E; Martin M.
.I 4
.U
87049090
.S
Am J Emerg Med 8703; 4(6):504-6
.M
Adolescence; Adult; Aged; Blood Glucose/*ME; Diabetes Mellitus/BL; Emergencies; Female; Glucose/*AD; Human; Hypoglycemia/*TH; Male; Middle Age; Prospective Studies; Solutions.
.T
Serum glucose changes after administration of 50% dextrose solution: pre- and in-hospital calculations.
.P
JOURNAL ARTICLE.
.W
A prospective clinical trial was conducted to estimate the rise in serum glucose level after an intravenous bolus of 50 ml of 50% dextrose solution (D-50) in the emergency department setting. Fifty one subjects with altered levels of consciousness were studied. Of these, 23 patients were known diabetics, and 28 were not diabetic. The change in glucose level for the total study group ranged from a low of 37 mg/dl to a high of 370 mg/dl, with a mean of 166 +/- 77 mg/dl. The mean for the diabetic and non-diabetic groups were 177 +/- 80 mg/dl and 154 +/- 75 mg/dl. These results suggest that serum glucose levels cannot be quantitatively predicted after a single intravenous bolus of D-50.
.A
Adler PM.
.I 5
.U
87049092
.S
Am J Emerg Med 8703; 4(6):511-3
.M
Aged; Aged, 80 and over; Case Report; Female; Human; Intubation, Gastrointestinal/*AE; Pneumothorax/*ET/RA/TH; Suicide, Attempted.
.T
Nasogastric intubation: morbidity in an asymptomatic patient.
.P
JOURNAL ARTICLE.
.W
An unusual case of a misdirected nasogastric tube is described. An elderly woman was brought to an emergency department following intentional drug overdose. Initially unrecognized errant placement of a large-bore nasogastric tube resulted in tension pneumothorax, pneumonia, and subsequent death. Pertinent medical literature is reviewed, clinical considerations for the elderly patient are discussed, and suggestions for proper nasogastric tube placement are offered.
.A
Gough D; Rust D.
.I 6
.U
87049093
.S
Am J Emerg Med 8703; 4(6):514-5
.M
Abdominal Injuries/ET; Accidents, Occupational; Accidents, Traffic/*; Adult; Amputation; Blood Transfusion/*; Case Report; Female; Fractures/ET; Human; Pelvic Bones/IN; Shock, Hemorrhagic/ET/*TH; Wounds, Nonpenetrating/*CO.
.T
Massive transfusion without major complications after trauma.
.P
JOURNAL ARTICLE.
.W
A case of massive degloving injury of the trunk, with open pelvic fracture, and evisceration of abdominal contents from blunt trauma is presented. The most significant aspect of this case was the transfusion of 173 units of packed cells and 176 units of fresh frozen plasma in the first thirty hours. The patient ultimately recovered and returned to work.
.A
Brotman S; Lamonica C; Cowley RA.
.I 7
.U
87049094
.S
Am J Emerg Med 8703; 4(6):516-9
.M
Adult; Carbon Monoxide Poisoning/CO/*TH; Female; Human; Labor; Pregnancy; Pregnancy Complications/*TH; Pregnancy Trimester, Third; Respiration, Artificial; Respiratory Distress Syndrome, Adult/ET/*TH.
.T
Acute carbon monoxide poisoning during pregnancy.
.P
JOURNAL ARTICLE.
.W
The course of a pregnant patient at term who was acutely exposed to carbon monoxide is described. A review of the fetal-maternal carboxyhemoglobin relationships and the differences in fetal oxyhemoglobin physiology are used to explain the recommendation that pregnant women with carbon monoxide poisoning should receive 100% oxygen therapy for up to five times longer than is otherwise necessary. The role of hyperbaric oxygen therapy is considered.
.A
Margulies JL.
.I 8
.U
87049096
.S
Am J Emerg Med 8703; 4(6):523-4
.M
Case Report; Child, Preschool; Drug Administration Routes; Emergencies; Human; Male; Phenytoin/*AD/BL; Status Epilepticus/BL/*DT; Tibia.
.T
Intraosseous infusion of phenytoin.
.P
JOURNAL ARTICLE.
.W
In the critically ill child, administration of fluids and medications via the intraosseous route often proves life-saving. The authors describe the case of a child with status epilepticus in whom phenytoin was administered via the intraosseous route, and seizure resolution and therapeutic serum levels were achieved. Intraosseous drug administration should be reserved for the rare critically ill child in whom vascular access proves impossible.
.A
Walsh-Kelly CM; Berens RJ; Glaeser PW; Losek JD.
.I 9
.U
87049098
.S
Am J Emerg Med 8703; 4(6):532-6
.M
Alcohol Drinking; Case Report; Emergencies; Esophageal Diseases/CO/*DI/SU; Human; Male; Middle Age; Rupture, Spontaneous; Syndrome; Vomiting/ET.
.T
Boerhaave's syndrome: an elusive diagnosis.
.P
JOURNAL ARTICLE.
.W
Boerhaave's syndrome represents a diagnostic dilemma for the emergency physician. The prognosis of this truly life-threatening emergency is darkened by any significant diagnostic delay. Unfortunately, classic or expected symptoms and signs are frequently absent at presentation, a circumstance that leads to frequent misdiagnosis. Two cases of Boerhaave's syndrome with "atypical" clinical presentations are reviewed and discussed. It is clear that Boerhaave's syndrome should always be suspected in the evaluation of any sudden chest, abdominal, or back pain associated with emesis. However, emphasis should be placed on the fact that this entity may occur without emesis. The chest radiograph is the most helpful diagnostic aid. Undoubtedly, maintenance of a high degree of suspicion by the emergency physician for Boerhaave's syndrome will lead consistently to earlier diagnosis, and subsequent aggressive intervention should result in considerable reduction in rates of both morbidity and mortality.
.A
Schwartz JA; Turnbull TL; Dymowski J; Uehara DT.
.I 10
.U
87049099
.S
Am J Emerg Med 8703; 4(6):537-9
.M
Adult; Case Report; Electrocardiography/*; Extrasystole/*PP; Female; Human; Male; Middle Age; Tachycardia, Sinus/*PP; Tachycardia, Supraventricular/*PP.
.T
Cases in electrocardiography.
.P
JOURNAL ARTICLE.
.A
Zimmers T.
.I 11
.U
87049100
.S
Am J Emerg Med 8703; 4(6):540-2
.M
Bone Marrow; Child; Child, Preschool; Drug Administration Routes/IS/*MT; Human; Infant; Needles.
.T
Intraosseous infusions: a usable technique.
.P
JOURNAL ARTICLE.
.W
Intraosseous infusions were widely used in pediatric patients during the 1930s and 1940s. Recent reports have re-introduced this concept and confirmed its safety and ready accessability for fluid and drug administration. However, these reports have not addressed the difficulties encountered during insertion of the intraosseous needle. Spinal needles, standard metal intravenous (IV) needles, and bone marrow biopsy needles have been suggested for intraosseous infusion. These needles were tested for ease of insertion on a pediatric cadaver leg. The site for needle placement was also evaluated during the study. It was found that the 13-gauge Kormed/Jamshidi disposable bone marrow/aspiration needle was the easiest to insert and did not plug with bone or tissue during insertion. An area proximal to the medial malleolus was found to provide a stable, relatively flat, and easily penetrable location for needle placement. This method was successfully utilized in ten pediatric and five adult patients. Intraosseous needle placement is a safe, rapid method to gain access to the venous circulation. By utilizing these techniques, a stable, usable fluid line can be established in even the most dehydrated pediatric patients.
.A
Iserson KV; Criss E.
.I 12
.U
87049101
.S
Am J Emerg Med 8703; 4(6):543-4
.M
Adult; Case Report; Cellulitis/CI; Human; Injections, Intravenous; Male; Pulmonary Edema/CI; Suicide, Attempted/*; Turpentine/*AD.
.T
Intravenous hydrocarbon abuse.
.P
JOURNAL ARTICLE.
.W
The case of a man who injected turpentine intravenously in an attempt to kill himself is reported. The patient developed immediate pulmonary edema and hypoxia, followed later by cellulitis at the site of injection. Although only one death to date has been attributed to this form of chemical abuse, extensive local reactions, pulmonary involvement, central nervous system depression, and febrile reactions should be anticipated, and such patients should be admitted to the hospital. Patients should be observed for local reactions and myonecrosis around the site of injection, especially as these occur 12-24 hours later.
.A
Wason S; Greiner PT.
.I 13
.U
87049102
.S
Am J Emerg Med 8703; 4(6):545-8
.M
Abdomen; Administration, Inhalation; Adolescence; Adult; Alopecia/CI; Case Report; Cocaine/*; Drug Contamination; Human; Hypertension/CI; Male; Pain/CI; Substance Abuse/*; Thallium/*PO.
.T
Thallium poisoning in cocaine abusers.
.P
JOURNAL ARTICLE.
.W
The users of illicit drugs is endangered by both unpredictable concentrations of the drugs and by unexpected adulterants that may be present. Cocaine has been adulterated or admixed with numerous substances, among them local anesthetics, amphetamine, phencyclidine, and strychnine. We report three cases of thallium poisoning following nasal insufflation of a substance that was believed to have been cocaine.
.A
Insley BM; Grufferman S; Ayliffe HE.
.I 14
.U
87049103
.S
Am J Emerg Med 8703; 4(6):549-51
.M
Adult; Case Report; Ethchlorvynol/*; Female; Human; Injections, Intravenous; Male; Pulmonary Edema/*CI; Substance Abuse/*.
.T
Pulmonary edema induced by intravenous ethchlorvynol.
.P
JOURNAL ARTICLE.
.W
The intravenous injection of ethchlorvynol is an uncommon cause of noncardiac pulmonary edema. Two cases of intravenous ethchlorvynol-induced pulmonary edema are presented. The patients fell asleep after injecting the liquid contents of Placydil capsules (ethchlorvynol) and awoke several hours later with severe dyspnea. Arterial blood gases demonstrated marked hypoxia. Chest radiographs revealed bilateral diffuse alveolar densities. The patients' symptoms and radiographic findings resolved after several days of supportive care. Changes in the lung caused by ethchlorvynol may be the result of direct effect of the drug on the lung.
.A
Conces DJ Jr; Kreipke DL; Tarver RD.
.I 15
.U
87049104
.S
Am J Emerg Med 8703; 4(6):552-3
.M
Adolescence; Atropine/*TU; Baclofen/*PO; Bradycardia/CI/*DT; Case Report; Human; Hypotension/CI/*DT; Male.
.T
Atropine in the treatment of baclofen overdose.
.P
JOURNAL ARTICLE.
.W
A patient suffering baclofen overdose successfully treated with atropine is reported. Three hours after admission for ingestion of at least 300 mg baclofen as a single dose, the patient became comatose and subsequently bradycardic, hypotensive, and hypothermic. A prompt increase in heart rate and blood pressure followed administration of 1 mg of atropine sulfate. Atropine appears to be useful in treating cases of baclofen overdose complicated by bradycardia and hypotension.
.A
Cohen MB; Gailey RA; McCoy GC.
.I 16
.U
87049105
.S
Am J Emerg Med 8703; 4(6):554-5
.M
Administration, Oral; Adolescence; Burns, Chemical/*ET; Case Report; Colloids; Epiglottis/*IN; Human; Male; Pharynx/*IN; Salicylic Acids/*AD; Suicide, Attempted/*; Tongue/*IN.
.T
Ingestion of Compound W, an unusual caustic.
.P
JOURNAL ARTICLE.
.W
A case of an unusual caustic ingestion involving Compound W, an over the counter wart remover is presented. Chemical burns of the tongue, pharynx and larynx developed. The active ingredient in this preparation: salicylic acid in a flexible collodion vehicle produces caustic injury through a keratolytic action, which may be enhanced by the presence of collodion.
.A
Sacchetti A; Ramoska E.
.I 17
.U
87049106
.S
Am J Emerg Med 8703; 4(6):570-1
.M
Allied Health Personnel/*; Electric Countershock/*; Emergency Medical Technicians/*; Human; Lidocaine/TU; Recurrence; Ventricular Fibrillation/MO/*TH.
.T
EMT-D fibrillation: more shocks for the future [editorial]
.P
EDITORIAL.
.A
Thompson BM.
.I 18
.U
87049107
.S
Am J Emerg Med 8703; 4(6):572-4
.M
Adolescence; Child; Child, Preschool; Emergencies/*; Female; G Suits/*UT; Human; Male; Massachusetts; Retrospective Studies; Transportation of Patients.
.T
Estimating prehospital demand for pediatric antishock garments.
.P
JOURNAL ARTICLE.
.A
McCabe CJ; Cadigan RT; Bugarin CE; Azzara CV.
.I 19
.U
87049108
.S
Am J Emerg Med 8703; 4(6):574-5
.M
Emergency Service, Hospital/*; Human; Thoracic Injuries/*SU; Transportation of Patients/*MT; Wounds, Penetrating/*MO.
.T
Emergency department thoracotomy [letter]
.P
LETTER.
.A
Hoffman JR.
.I 20
.U
87049109
.S
Am J Emerg Med 8703; 4(6):575-7
.M
Adult; Career Choice/*; Emergency Medicine/*ED; Female; Goals; Human; Internship and Residency/*; Male.
.T
Academic aspirations of residents.
.P
JOURNAL ARTICLE.
.A
Lundberg T; Hedges JR.
.I 21
.U
87049271
.S
ASAIO Trans 8703; 32(1):104-7
.M
Adult; Antithrombin III/BL; Blood Proteins/AN; Case Report; Female; Fibrinogen/AN; Heparin/*TU; Human; Hypercholesterolemia/BL/*TH; Lipoproteins, HDL Cholesterol/BL; Lipoproteins, LDL/*BL/IP; Lipoproteins, LDL Cholesterol/BL; Male; Middle Age; Plasma Volume; Plasminogen/AN; Precipitation.
.T
Selective continuous elimination of low density lipoproteins (LDL) by heparin precipitation: first clinical application.
.P
JOURNAL ARTICLE.
.A
Eisenhauer T; Armstrong VW; Wieland H; Fuchs C; Nebendahl K; Scheler F; Seidel D.
.I 22
.U
87049272
.S
ASAIO Trans 8703; 32(1):108-10
.M
Anaphylaxis; Cellulose/*AA/AN; Ethylene Oxide/AE/*AN; Hemodialysis/AE; Human; Kinetics; Membranes, Artificial/*; Sterilization.
.T
Extractable ethylene oxide from cuprammonium cellulose plate dialyzers: importance of potting compound.
.P
JOURNAL ARTICLE.
.W
Our results suggest that ethylene oxide retention after sterilization is increased in cuprammonium cellulose plate dialyzers containing potting compound. In contrast, cuprammonium cellulose plate dialyzers without potting compound were characterized by a rapid disappearance of retained ethylene oxide after sterilization. Whether these findings explain the low incidence of SARD with cuprammonium cellulose plate dialyzers that do not contain potting material is a matter for continued study and experimentation.
.A
Ing TS; Daugirdas JT.
.I 23
.U
87049273
.S
ASAIO Trans 8703; 32(1):11-6
.M
Adult; Aged; Case Report; Comparative Study; Creatinine/ME; Female; Human; Kidney Failure, Chronic/*TH; Male; Middle Age; Peritoneal Dialysis/*; Peritoneal Dialysis, Continuous Ambulatory/*; Ultrafiltration; Urea/ME.
.T
Peritoneal dialysis.
.P
JOURNAL ARTICLE.
.A
Nolph KD; Twardowski ZJ; Khanna R.
.I 24
.U
87049275
.S
ASAIO Trans 8703; 32(1):114-9
.M
Animal; Carotid Arteries/*TR/UL; Collagen/*AN; Compliance; Delayed-Action Preparations; Dogs; Heparin/AD/AN/*TU; Microscopy, Electron, Scanning.
.T
Development of a small caliber vascular graft by a new crosslinking method incorporating slow heparin release collagen and natural tissue compliance.
.P
JOURNAL ARTICLE.
.A
Noishiki Y; Miyata T; Kodaira K.
.I 25
.U
87049276
.S
ASAIO Trans 8703; 32(1):120-2
.M
Adolescence; Adult; Aged; Aluminum/*TU; Antacids/AN/*TU; Hemodialysis/*; Human; Middle Age; Strontium/AN/*BL; Uremia/*BL/TH.
.T
Strontium overload in uremic patients on regular dialytic treatment.
.P
JOURNAL ARTICLE.
.A
Canavese C; Pacitti A; Salomone M; Santoro MA; Stratta P; Mangiarotti G; Talarico S; Sabbioni E; Pietra R; Vercellone A.
.I 26
.U
87049277
.S
ASAIO Trans 8703; 32(1):123-6
.M
Cellulose/AA; Human; Kidney Failure, Acute/TH; Kidney Failure, Chronic/TH; Kidney, Artificial/*; Membranes, Artificial; Prosthesis Design; Uremia/TH.
.T
A bag-filter model of a new pret a porter artificial kidney.
.P
JOURNAL ARTICLE.
.A
Bazzato G; Coli U; Landini S; Fracasso A; Morachiello P; Righetto F; Scanferla F.
.I 27
.U
87049278
.S
ASAIO Trans 8703; 32(1):127-9
.M
Calcium/BL; Calcium Carbonate/*TU; Female; Hemodialysis/*MT; Human; Kidney Failure, Chronic/BL/*TH; Male; Phosphates/*ME; Phosphorus/BL.
.T
Calcium carbonate as a phosphate binder in hemodialysis patients.
.P
JOURNAL ARTICLE.
.W
Calcium carbonate appears to be as effective as aluminum hydroxide in binding dietary phosphorus in hemodialysis patients. The long-term safety of this medication appears acceptable in view of today's therapeutic options.
.A
Taber TE; Hegemen TF; York S.
.I 28
.U
87049279
.S
ASAIO Trans 8703; 32(1):130-3
.M
Animal; Artificial Organs; Capsules; Endocrine Glands/*TR; Peritoneal Cavity/*SU; Rats; Rats, Inbred Strains.
.T
An intraperitoneal receptacle for macroencapsulated endocrine tissue.
.P
JOURNAL ARTICLE.
.A
Aebischer P; Panol G; Galletti PM.
.I 29
.U
87049280
.S
ASAIO Trans 8703; 32(1):134-7
.M
Animal; Artificial Organs/*; Hypocalcemia/*TH; Microscopy, Electron; Parathyroid Glands/CY/*TR/UL; Peritoneal Cavity; Rats; Rats, Inbred Strains.
.T
A bioartificial parathyroid.
.P
JOURNAL ARTICLE.
.A
Aebischer P; Russell PC; Christenson L; Panol G; Monchik JM; Galletti PM.
.I 30
.U
87049281
.S
ASAIO Trans 8703; 32(1):138-42
.M
Adult; Bilirubin/BL; Female; Fluorescence; Human; Hyperbilirubinemia/ET/*TH; Liver Diseases/*TH; Male; Middle Age; Phototherapy/*; Plasma/*/RE.
.T
Innovation in blood purification for hepatic failure: direct photoirradiation of plasma.
.P
JOURNAL ARTICLE.
.A
Totsune K.
.I 31
.U
87049282
.S
ASAIO Trans 8703; 32(1):143-4
.M
Human; Membranes, Artificial/*; Middle Ear Ventilation/*/IS; Oxygen; Permeability.
.T
Permeation rate to oxygen of membrane tympanostomy tubes.
.P
JOURNAL ARTICLE.
.A
Rodgers VG; Borovetz HS.
.I 32
.U
87049284
.S
ASAIO Trans 8703; 32(1):148-50
.M
Animal; Blood Glucose/*AN; Dogs; Electrodes; Insulin Infusion Systems/*; Prosthesis Design; Rabbits; Support, U.S. Gov't, P.H.S..
.T
Short-term in vivo operation of a glucose sensor.
.P
JOURNAL ARTICLE.
.A
Gough DA; Armour JC; Lucisano JY; McKean BD.
.I 33
.U
87049285
.S
ASAIO Trans 8703; 32(1):151-6
.M
Adhesiveness; Animal; Dogs; Elasticity; Human; Rubber/*; Stress, Mechanical; Surgery; Tissue Adhesives/*.
.T
A novel elastomeric surgical adhesive: design, properties, and in vivo performances.
.P
JOURNAL ARTICLE.
.A
Matsuda T; Itoh T; Yamaguchi T; Iwata H; Hayashi K; Uemura S; Ando T; Adachi S; Nakajima N.
.I 34
.U
87049286
.S
ASAIO Trans 8703; 32(1):157-62
.M
Acrylic Resins/*; Electrochemistry; Implants, Artificial/*; Kinetics; Muscle Contraction; Muscles/PH; Povidone/*.
.T
Contractile behavior of electrically activated mechanochemical polymer actuators.
.P
JOURNAL ARTICLE.
.A
De Rossi DE; Chiarelli P; Buzzigoli G; Domenici C; Lazzeri L.
.I 35
.U
87049287
.S
ASAIO Trans 8703; 32(1):163-7
.M
Animal; Aorta/PA; Blood Pressure; Cholesterol/BL; Heart Rate; Hypercholesterolemia/PA/PP/*TH; Male; Plasmapheresis/*; Rabbits; Regional Blood Flow.
.T
Long-term repetitive plasmapheresis in hypercholesterolemic rabbits.
.P
JOURNAL ARTICLE.
.A
Kutsumi Y; Fujiwara R; Tamai T; Takai H; Nakai T; Miyabo S.
.I 36
.U
87049289
.S
ASAIO Trans 8703; 32(1):17-23
.M
Adolescence; Adult; Bicarbonates/*TU; Child; Evaluation Studies; Follow-Up Studies; Hemodialysis/*/AE/MT; Hospitalization; Human; Middle Age; Morbidity; Risk; Time Factors; Uremia/PP/TH.
.T
Rapid high-efficiency bicarbonate hemodialysis.
.P
JOURNAL ARTICLE.
.A
Keshaviah P; Collins A.
.I 37
.U
87049290
.S
ASAIO Trans 8703; 32(1):171-6
.M
Aged; Aluminum/BL/*PO; Case Report; Diabetic Nephropathies/TH; Encephalitis/*CI; Female; Hemodialysis/*AE; Human; Kidney Failure, Chronic/ET/*TH; Male; Middle Age; Nephrotic Syndrome/CO/*TH; Uremia/*TH.
.T
Acute fatal hyperaluminemic encephalopathy in undialyzed and recently dialyzed uremic patients.
.P
JOURNAL ARTICLE.
.A
Bakir AA; Hryhorczuk DO; Berman E; Dunea G.
.I 38
.U
87049292
.S
ASAIO Trans 8703; 32(1):181-3
.M
Animal; Arteries/ME/*SU; Collagen/BI; Dogs; Hydroxyproline/BI; Laser Surgery/*; Support, U.S. Gov't, P.H.S.; Tensile Strength; Veins/ME/*SU.
.T
Laser welding of large diameter arteries and veins.
.P
JOURNAL ARTICLE.
.W
Based on our preliminary studies and the results of this study, we conclude that argon laser welding of 4-8 mm internal diameter veins, arteries, and arteriovenous fistulas may have several potential advantages compared to conventional suture techniques. The benefits of laser repairs may include improved mechanical properties, and absence of the foreign body response related to sutures. Laser welding is sterile, nontactile and possibly time conserving, and the wounds heal rapidly without aneurysms or excess tissue proliferation.
.A
White RA; Kopchok G; Donayre C; Lyons R; White G; Klein SR; Abergel RP; Uitto J.
.I 39
.U
87049293
.S
ASAIO Trans 8703; 32(1):184-6
.M
Aspirin/*PD; Blood Platelets/DE; Cell Division/DE; Cells, Cultured; Dipyridamole/*PD; Endothelium/*CY/DE; Human; Ibuprofen/*PD; Kinetics; Umbilical Veins.
.T
Effect of antiplatelet drugs on human endothelial cell growth in tissue culture.
.P
JOURNAL ARTICLE.
.A
Evans DK; Campbell J; Herring M; Glover J.
.I 40
.U
87049294
.S
ASAIO Trans 8703; 32(1):187-92
.M
Animal; Blood Platelets/*PH; Blood Vessel Prosthesis/*; Dogs; Femoral Artery/*SU; Femoral Vein/DE/*TR; Fibrinogen/*PH; Indium/DU; Iodine Radioisotopes/DU; Polytetrafluoroethylene/*; Radioisotopes/DU; Support, U.S. Gov't, P.H.S.; Thrombosis/*PP; Tropolone/AA/DU; Vitamin E/BL/*PD.
.T
Quantitation of platelet and fibrinogen deposition on PTFE and vein grafts in dogs and the effect of vitamin E on graft thrombosis in the acute phase.
.P
JOURNAL ARTICLE.
.A
Dewanjee MK; Solis E; Mackey ST; Gonzales G; Chesebro JH; Kaye MP.
.I 41
.U
87049295
.S
ASAIO Trans 8703; 32(1):193-7
.M
Animal; Biocompatible Materials/*; Blood Vessel Prosthesis/*; Dogs; Microscopy, Electron, Scanning; Polyurethanes/*; Silicones/*; Siloxanes/*; Surface Properties; Thrombosis/*PC.
.T
Evaluation of a new antithrombogenic polyurethane-polysiloxane complex biomaterial.
.P
JOURNAL ARTICLE.
.A
Ohkubo N; Hirose H; Matsuda H; Nakano S; Shirakura R; Maeda S; Ohtani M; Yoda R; Kawashima Y.
.I 42
.U
87049296
.S
ASAIO Trans 8703; 32(1):198-200
.M
Adult; Aluminum/*AE; Case Report; Deferoxamine/*TU; Fractures/*DT/ET; Hemodialysis/*AE; Human; Humeral Fractures/DT/ET; Humerus/RA; Kidney Failure, Chronic/TH; Male; Osteomalacia/CI/*CO; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Wound Healing/*DE.
.T
Fracture healing with deferoxamine therapy in a patient with aluminum-associated osteomalacia.
.P
JOURNAL ARTICLE.
.A
Phelps KR; Einhorn TA; Vigorita VJ; Lundin AP; Friedman EA.
.I 43
.U
87049297
.S
ASAIO Trans 8703; 32(1):201-6
.M
Animal; Assisted Circulation/*; Dogs; Electrocardiography; Heart-Assist Devices/*; Myocardial Infarction/PP/*TH; Nuclear Magnetic Resonance/DU/IS/MT.
.T
Therapeutic effect of a left ventricular assist device on acute myocardial infarction evaluated by magnetic resonance imaging.
.P
JOURNAL ARTICLE.
.A
Nakatani T; Takano H; Noda H; Fukuda S; Nishimura T; Yamada Y; Kozuka T; Akutsu T.
.I 44
.U
87049298
.S
ASAIO Trans 8703; 32(1):207-10
.M
Animal; Cattle; Cerebrovascular Disorders/ET; Comparative Study; Heart, Artificial/*/AE; Human; Prosthesis Design; Sheep; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Comparison of clinical and animal recipients of a pneumatic artificial heart.
.P
JOURNAL ARTICLE.
.A
Taenaka Y; Olsen DB; Riebman JB; Burns GB; Crump CL.
.I 45
.U
87049299
.S
ASAIO Trans 8703; 32(1):211-6
.M
Angioplasty, Transluminal/AE/*IS/MT; Animal; Dogs; Heart Failure, Congestive/ET/PP/*TH; Heart-Assist Devices; Hemodynamics.
.T
Experimental evaluation of extrapulmonary arterial balloon pumping (EPABP) for right heart failure of diverse etiologies.
.P
JOURNAL ARTICLE.
.A
Miya J; Maeta H; Asakura T; Hori M.
.I 46
.U
87049300
.S
ASAIO Trans 8703; 32(1):217-20
.M
Animal; Aorta/SU; Assisted Circulation/*; Cardiac Output; Coronary Circulation; Dogs; Heart/PP; Heart Atrium/SU; Heart-Assist Devices/*; Myocardial Infarction/PP/*TH.
.T
The effect of left ventricular assistance on the area of infarcted myocardium.
.P
JOURNAL ARTICLE.
.A
Wei CM; Yada I; Kusagawa M.
.I 47
.U
87049301
.S
ASAIO Trans 8703; 32(1):221-5
.M
Cardiac Output; Emergencies/*; Heart, Artificial/*AE; Human; Hypertension, Pulmonary/ET/TH; Monitoring, Physiologic.
.T
Drive system management of emergency conditions in three permanent total artificial heart patients.
.P
JOURNAL ARTICLE.
.A
Mays JB; Hastings WL; Williams MA; Barker LE; DeVries WC.
.I 48
.U
87049304
.S
ASAIO Trans 8703; 32(1):238-41
.M
Allylamine; Animal; Chronic Disease; Disease Models, Animal; Echocardiography; Heart/DE; Heart Failure, Congestive/CI/PA/*PP; Microscopy, Electron; Myocardium/PA/UL; Sheep; Support, U.S. Gov't, P.H.S..
.T
Large-animal model of chronic congestive heart failure induced by intracoronary allylamine.
.P
JOURNAL ARTICLE.
.A
Beck LS; Strickland RD; Bagley BL; Mortensen JD; Hammond ME; Ashton AH; Head DR; Braun MR; Weiler MJ.
.I 49
.U
87049306
.S
ASAIO Trans 8703; 32(1):242-7
.M
Animal; Assisted Circulation/*; Blood Chemical Analysis; Body Temperature; Cattle; Evaluation Studies; Heart-Assist Devices/*; Human; Implants, Artificial; Prosthesis Design; Respiration; Support, U.S. Gov't, P.H.S..
.T
In vivo evaluation of a permanently implantable thermal ventricular assist system.
.P
JOURNAL ARTICLE.
.W
The System 7 pump/actuator/engine combination has demonstrated biologic compatibility and physiologic effectiveness and responsiveness in five TVAS in vivo studies. The recent 75-day implant supports the feasibility of extended reliability of the system components. Postoperative system maintenance was necessary only because of the nonhermetic design of System 7. However, the ability to pump 11 l/min at 120 beats/min, synchronize at beat rates of 144 beats/min, and pump against mean arterial pressures of more than 150 mmHg while maintaining hematologic and biochemical values within physiologic range sets a very optimistic stage for System 8 hardware. A System 8 concept is shown in Figure 14. The System 8 hardware will include a thermal salt package capable of providing completely untethered circulatory support for a nominal 8-h period. Recharge will be accomplished with a transcutaneous transformer in 1 h. Thermal management problems become minimal, with an average energy input of 15.8 W (peak of 24.9 W). The human preclinical testing of System 8 will start in 1988.
.A
Sugita Y; Navarro RR; White M; Whalen R; Kiraly RJ; Harasaki H; Nose Y.
.I 50
.U
87049307
.S
ASAIO Trans 8703; 32(1):248-52
.M
Animal; Chronic Disease; Disease Models, Animal; Dogs; Heart/*PP; Heart Failure, Congestive/PA/*PP; Heart Ventricle/PP; Myocardium/*PA; Support, U.S. Gov't, P.H.S..
.T
Experimental chronic left ventricular failure in the dog.
.P
JOURNAL ARTICLE.
.A
Hagiwara K; Freed PS; Wasfie T; Bar-Lev A; Mandell G; Cardona R; Stein PD; Sabbah HN; Kantrowitz A.
.I 51
.U
87049309
.S
ASAIO Trans 8703; 32(1):258-62
.M
Comparative Study; Evaluation Studies; Heart/PH/PP; Heart, Artificial/*; Human; Microcomputers; Prosthesis Design; Support, Non-U.S. Gov't; Ultrasonics.
.T
Instrumentation for deriving pneumatic TAH control signals from the driveline pressure and flow.
.P
JOURNAL ARTICLE.
.A
Wurzel D; Wildevuur W; Kolff J.
.I 52
.U
87049310
.S
ASAIO Trans 8703; 32(1):263-8
.M
Animal; Arterioles/PA; Assisted Circulation/*; Cattle; Heart/*PP; Heart Ventricle/PP; Heart-Assist Devices/*; Hemodynamics; Prosthesis Design; Pulse; Regional Blood Flow; Renal Circulation; Support, Non-U.S. Gov't.
.T
Idioperipheral pulsation during nonpulsatile biventricular bypass experiments.
.P
JOURNAL ARTICLE.
.A
Tsutsui T; Sutton C; Harasaki H; Jacobs G; Golding L; Nose Y.
.I 53
.U
87049311
.S
ASAIO Trans 8703; 32(1):269-73
.M
Assisted Circulation/*/AE; Beta-Thromboglobulin/AN; Blood Coagulation; Blood Platelets/PH; Heart-Assist Devices/*/AE; Human; Lactate Dehydrogenase/BL; Prosthesis Design; Stress, Mechanical.
.T
Investigation of the flow in a centrifugal blood pump.
.P
JOURNAL ARTICLE.
.A
Affeld K; Schichl K; Yoganathan A.
.I 54
.U
87049312
.S
ASAIO Trans 8703; 32(1):274-7
.M
Analysis of Variance; Azure Stains; Extracorporeal Circulation/*; Heparin/*BL; Human; Regression Analysis; Stains and Staining.
.T
Rapid assay for heparin during extracorporeal circulation.
.P
JOURNAL ARTICLE.
.A
Ross RL; Whittlesey GC; Splittgerber FH; Salley SO; Klein MD.
.I 55
.U
87049313
.S
ASAIO Trans 8703; 32(1):278-81
.M
Animal; Blood Pressure/*; Heart Surgery/*; Heart Ventricle/SU; Myocardial Contraction/*; Support, U.S. Gov't, P.H.S.; Swine; Systole/*.
.T
Right ventricular end-systolic pressure-dimension relationship during left ventricular bypass in anesthetized pigs.
.P
JOURNAL ARTICLE.
.A
Farrar DJ; Compton PG; Verderber A; Hill JD.
.I 56
.U
87049314
.S
ASAIO Trans 8703; 32(1):282-7
.M
Bioprosthesis/*ST; Heart Valve Prosthesis/*ST; Human; Prosthesis Design; Quality Control; Stress, Mechanical.
.T
Mechanical factors influencing the durability of heart valve pericardial bioprostheses.
.P
JOURNAL ARTICLE.
.A
Gabbay S; Bortolotti U; Josif M.
.I 57
.U
87049317
.S
ASAIO Trans 8703; 32(1):297-9
.M
Animal; Arteriovenous Shunt, Surgical/*/AE; Dogs; Hemodialysis/AE/*MT; Kidney, Artificial/*; Perfusion; Polytetrafluoroethylene/*; Prosthesis Design; Silicones/*; Support, Non-U.S. Gov't; Thrombosis/ET.
.T
PTFE-silicone self-sealing dialysis prosthesis.
.P
JOURNAL ARTICLE.
.A
Schanzer H; Martinelli GP; Bock G; Peirce EC 2d.
.I 58
.U
87049318
.S
ASAIO Trans 8703; 32(1):30-4
.M
Alloys/*; Animal; Anticoagulants/TU; Blood Pressure; Blood Vessel Prosthesis/*; Dogs; Monitoring, Physiologic; Prosthesis Design; Support, Non-U.S. Gov't.
.T
Nonsurgical implantation of a vascular ring prosthesis using thermal shape memory Ti/Ni alloy (Nitinol wire).
.P
JOURNAL ARTICLE.
.A
Sugita Y; Shimomitsu T; Oku T; Murabayashi S; Kambic HE; Harasaki H; Shirey E; Golding L; Nose Y.
.I 59
.U
87049319
.S
ASAIO Trans 8703; 32(1):300-4
.M
Female; Follow-Up Studies; Hematocrit; Hemodialysis/*MT; Human; Kidney, Artificial; Kinetics; Male; Middle Age; Urea/ME.
.T
Long-term experience with routine single-needle dialysis. A review.
.P
JOURNAL ARTICLE.
.A
Vanholder R; Hoenich N; Bogaert AM; Ringoir S.
.I 60
.U
87049320
.S
ASAIO Trans 8703; 32(1):305-8
.M
Anemia/*ET; Female; Hemodialysis/*/AE; Human; Kidney Failure, Chronic/BL/*TH; Male; Manganese/BL; Middle Age; Nickel/BL; Trace Elements/*BL; Zinc/BL.
.T
Trace metals and anemia in chronic hemodialysis patients.
.P
JOURNAL ARTICLE.
.A
Hosokawa S; Nishitani H; Tomoyoshi T; Yoshida O.
.I 61
.U
87049321
.S
ASAIO Trans 8703; 32(1):309-14
.M
Animal; Blood Vessel Prosthesis/*; Comparative Study; Dogs; Endothelium/CY/UL; Evaluation Studies; Female; Male; Microscopy, Electron, Scanning/MT; Polyesters/*.
.T
Evaluation of a new vascular graft prosthesis fabricated from ultrafine polyester fiber.
.P
JOURNAL ARTICLE.
.A
Noishiki Y; Watanabe K; Okamoto M; Kikuchi Y; Mori Y.
.I 62
.U
87049323
.S
ASAIO Trans 8703; 32(1):319-22
.M
Blood Coagulation/*DE; Blood Coagulation Tests; Fibrinolysis/*DE; Human; Kinetics; Microscopy, Electron, Scanning; Polymethacrylic Acids/*PD.
.T
Effect of a hydrogel with long polyethyleneoxide chains on blood coagulation and fibrinolysis.
.P
JOURNAL ARTICLE.
.A
Nakao A; Ohkura K; Nonami T; Harada A; Takagi H; Mori Y.
.I 63
.U
87049324
.S
ASAIO Trans 8703; 32(1):323-6
.M
Adsorption; Blood Coagulation/*DE; Blood Coagulation Factors/*ME; Blood Proteins/*ME; Human; IgG/*; Platelet Adhesiveness/*DE; Polyurethanes/*PD; Serum Albumin/*; Support, U.S. Gov't, P.H.S..
.T
Reduced platelet adhesion and activation of coagulation factors on polyurethane treated with albumin-IgG complex.
.P
JOURNAL ARTICLE.
.A
Mohammad SF; Olsen DB.
.I 64
.U
87049325
.S
ASAIO Trans 8703; 32(1):327-9
.M
Animal; Aorta/*RE/UL; Coronary Vessels/*RE/UL; Dose-Response Relationship, Radiation; Heat; Human; Lasers/*; Microscopy, Electron; Rabbits; Ultraviolet Rays/*.
.T
Thermal effects of far ultraviolet excimer laser radiation on biologic tissue.
.P
JOURNAL ARTICLE.
.A
Wollenek G; Laufer G.
.I 65
.U
87049326
.S
ASAIO Trans 8703; 32(1):330-3
.M
Animal; Cattle; Erythrocytes/UL; Hemoglobins/AN; Hemolysis/*; Mathematics; Membranes, Artificial; Microscopy, Electron, Scanning; Models, Theoretical; Plasmapheresis/*; Pressure.
.T
A model of hemolysis in membrane plasmapheresis.
.P
JOURNAL ARTICLE.
.A
Ding LH; Jaffrin MY; Gupta BB.
.I 66
.U
87049327
.S
ASAIO Trans 8703; 32(1):334-8
.M
Adult; Animal; Blood Vessel Prosthesis/*; Cell Survival; Cells, Cultured; Comparative Study; Cross-Linking Reagents/*; Culture Media; Dogs; Endothelium/*CY; Female; Fibronectins/*; Human; Polyesters; Polytetrafluoroethylene; Pregnancy; Species Specificity; Umbilical Veins; Veins.
.T
Fluid shear disruption of cultured endothelium: the effect of cell species, fibronectin cross-linking and supporting polymer.
.P
JOURNAL ARTICLE.
.A
Lundgren CH; Herring MB; Arnold MP; Glover JL; Bendick PJ.
.I 67
.U
87049329
.S
ASAIO Trans 8703; 32(1):342-5
.M
Animal; Biocompatible Materials/*; Capsules; Chromatography, Gel; Collagen; Drug Screening; Implants, Artificial/*; Lactates/ME; Polymers/ME; Time Factors.
.T
Tissue developed around bioresorbable implants. Load-bearing versus histology.
.P
JOURNAL ARTICLE.
.A
Richardson PD; Sasken H; Parhizgar A; Aebischer P; Panol G; Chiu TH; Galletti PM.
.I 68
.U
87049335
.S
ASAIO Trans 8703; 32(1):363-6
.M
Animal; Biocompatible Materials; Catheters, Indwelling/*; Comparative Study; Diabetes Mellitus, Experimental/*DT; Dogs; Insulin Infusion Systems/*; Polyethylenes/*; Silicone Elastomers/*.
.T
Use of polyethylene-lined silicone rubber cannulae in long-term insulin infusion in the dog.
.P
JOURNAL ARTICLE.
.A
Wigness BD; Rohde TD; Dorman FD; Buchwald H.
.I 69
.U
87049336
.S
ASAIO Trans 8703; 32(1):367-9
.M
Adult; Aluminum/*BL/IP; Case Report; Chromatography, Gel/MT; Deferoxamine/AD/*BL/IP; Female; Hemodialysis/*; Human; Infusions, Intravenous; Male; Middle Age; Molecular Weight; Uremia/*BL/TH.
.T
Chromatographic studies of aluminum-desferrioxamine complex in uremic patients.
.P
JOURNAL ARTICLE.
.A
Canavese C; Pacitti A; Salomone M; Pramotton C; Segoloni G; Bedino S; Testore G; Lamon S; Vercellone A.
.I 70
.U
87049337
.S
ASAIO Trans 8703; 32(1):370-3
.M
Adult; Aged; Aluminum/*TU; Blood/*; Female; Follow-Up Studies; Hematocrit; Hemodialysis/*; Human; Kidney Failure, Chronic/*BL/TH; Male; Middle Age; Phosphates/*BL; Support, Non-U.S. Gov't; Ultrafiltration/*.
.T
Reduction in aluminum load after one year of hemodiafiltration.
.P
JOURNAL ARTICLE.
.A
Ahmad S; Vizzo JE; Scribner BH.
.I 71
.U
87049338
.S
ASAIO Trans 8703; 32(1):374-6
.M
Adult; Aged; Blood Chemical Analysis; Female; Follow-Up Studies; Hemodialysis/*MT; Human; Kidney Failure, Chronic/BL/TH; Male; Middle Age; Support, Non-U.S. Gov't; Time Factors.
.T
Short hemodialysis--10-year follow-up.
.P
JOURNAL ARTICLE.
.A
Raja R; Kramer M; Goldstein S; Caruana R; Lerner A.
.I 72
.U
87049339
.S
ASAIO Trans 8703; 32(1):377-8
.M
Adult; Aged; Hemodialysis/*MT; Human; Kidney Failure, Chronic/*PP/TH; Middle Age; Nutritional Status/*; Parathyroid Hormones/BL; Serum Albumin/AN; Time Factors; Uremia/*PP/TH.
.T
Rapid blood flow short dialysis does not adversely affect clinical, biochemical, or nutritional status of patients.
.P
JOURNAL ARTICLE.
.A
Rubin JE; Friedmann P; Berlyne GM.
.I 73
.U
87049341
.S
ASAIO Trans 8703; 32(1):384-7
.M
Blood/*; Dextrans; Human; Kidney, Artificial/*; Molecular Weight; Structure-Activity Relationship; Support, U.S. Gov't, Non-P.H.S.; Ultrafiltration/*.
.T
Macromolecular charge affects hemofilter solute sieving.
.P
JOURNAL ARTICLE.
.A
Leypoldt JK; Frigon RP; Henderson LW.
.I 74
.U
87049342
.S
ASAIO Trans 8703; 32(1):388-91
.M
Human; Hypercholesterolemia, Familial/BL/*TH; Lipoproteins, LDL/*BL/IP; Microscopy, Electron, Scanning; Plasmapheresis/IS/*MT; Temperature; Ultrafiltration/IS/MT.
.T
Comparison of plasmafractionation filters and filtration techniques in the clinical practice of LDL-apheresis.
.P
JOURNAL ARTICLE.
.A
Kochinke F; Baeyer HV; Schwaner I; Schwerdtfeger R.
.I 75
.U
87049345
.S
ASAIO Trans 8703; 32(1):397-400
.M
Animal; Blood/*; Cattle; Electrolytes/BL; Membranes, Artificial/*; Microscopy, Electron, Scanning; Permeability; Polytetrafluoroethylene/*; Water.
.T
Extraction of solute-free water from blood by membrane distillation.
.P
JOURNAL ARTICLE.
.A
Sakai K; Muroi T; Ozawa K; Takesawa S; Tamura M; Nakane T.
.I 76
.U
87049346
.S
ASAIO Trans 8703; 32(1):401-4
.M
Adult; Aged; Blood/*; Burns/PP/*TH; Catheters, Indwelling; Edema/ET/*TH; Female; Heparin/TU; Human; Kidney Failure, Acute/ET/*TH; Male; Middle Age; Ultrafiltration/*.
.T
Continuous arteriovenous hemofiltration for the treatment of anasarca and acute renal failure in severely burned patients.
.P
JOURNAL ARTICLE.
.A
Hubsher J; Olshan AR; Schwartz AB; Zoranski B; DeClement F; Bendlin A; Hensell D; Brezin JH; Krevolin LE; Chinitz JL.
.I 77
.U
87049347
.S
ASAIO Trans 8703; 32(1):405-9
.M
Blood Component Removal/*IS/MT; Disposable Equipment; Erythrocyte Count; Hematocrit; Human; Leukocyte Count; Membranes, Artificial; Plasma/*; Platelet Count; Polyethylenes.
.T
An automated plasma collector with innovative membrane and cassette-like disposable set.
.P
JOURNAL ARTICLE.
.A
Yamazaki Z; Kanai F; Hiraishi M; Ohnishi K; Idezuki Y; Takahama T; Fujimori Y; Asano K; Inoue N; Shibata Y; et al.
.I 78
.U
87049348
.S
ASAIO Trans 8703; 32(1):410-3
.M
Animal; Blood Component Removal/*IS/MT; Cattle; Ceramics/*; Filtration; Hematocrit; Membranes, Artificial/*; Plasma/*; Support, Non-U.S. Gov't.
.T
Design of a plasma separator using ceramic membranes.
.P
JOURNAL ARTICLE.
.A
Sakurai H; Ozawa K; Takesawa S; Sakai K.
.I 79
.U
87049349
.S
ASAIO Trans 8703; 32(1):414-7
.M
Assisted Circulation/*; Blood/*; Cardiopulmonary Bypass; Creatinine/ME; Female; Heart Surgery; Heart-Assist Devices/*; Human; Intra-Aortic Balloon Pumping/*; Kidney Failure, Acute/ET/*TH; Male; Middle Age; Postoperative Complications/*TH; Ultrafiltration/*.
.T
Continuous renal replacement therapy in patients with acute renal dysfunction undergoing intraaortic balloon pump and/or left ventricular device support.
.P
JOURNAL ARTICLE.
.A
Paganini EP; Suhoza K; Swann S; Golding L; Nakamoto S.
.I 80
.U
87049350
.S
ASAIO Trans 8703; 32(1):418-21
.M
Filtration; Human; Mathematics; Membranes, Artificial; Plasmapheresis/*MT.
.T
Relationship between Staverman's reflection and sieving coefficients in a plasma fractionator.
.P
JOURNAL ARTICLE.
.A
Mineshima M; Hasuo Y; Kaneko I; Era K; Agishi T; Ota K; Sakai K.
.I 81
.U
87049351
.S
ASAIO Trans 8703; 32(1):42-5
.M
Evaluation Studies; Foreign Bodies/*PA; Heart, Artificial/*/AE; Human; Skin/*PA; Support, U.S. Gov't, P.H.S.; Time Factors.
.T
The microscopic evaluation of skin buttons used in a long-term human total artificial heart recipient.
.P
JOURNAL ARTICLE.
.A
Murray KD; Abbott T; DeVries WC; Gaykowski R; Olsen DB.
.I 82
.U
87049353
.S
ASAIO Trans 8703; 32(1):425-8
.M
Adsorption; Biocompatible Materials; Blood Proteins/*IP; Charcoal/*; Hemodialysis/*; Hemoperfusion/*; Human; Kidney Failure, Chronic/TH; Molecular Weight; Polyurethanes.
.T
Elimination of low molecular weight proteins during hemoperfusion of dialysis patients using a urethane-sheet embedded with powdered charcoal.
.P
JOURNAL ARTICLE.
.A
Kawanishi H; Tsuchiya T; Sugiyama M; Nishiki M; Dohi K.
.I 83
.U
87049354
.S
ASAIO Trans 8703; 32(1):429-34
.M
Animal; Biocompatible Materials; Blood Component Removal/*/IS/MT; Dextrans; Dogs; Filtration/MT; Human; Hypercholesterolemia/BL/TH; Membranes, Artificial; Molecular Weight; Plasma/*; Support, Non-U.S. Gov't.
.T
Effect of plasma solute-membrane interaction on mean pore diameter.
.P
JOURNAL ARTICLE.
.A
Horiuchi T; Malchesky PS; Usami M; Emura M; Nose Y.
.I 84
.U
87049357
.S
ASAIO Trans 8703; 32(1):444-8
.M
Animal; Ceramics/*; Comparative Study; Heart Valve Prosthesis/*; Materials Testing/*; Sheep; Support, Non-U.S. Gov't; Venae Cavae/PH.
.T
Development of a fine ceramic heart valve for use as a cardiac prosthesis.
.P
JOURNAL ARTICLE.
.A
Mitamura Y; Mikami T; Yuta T; Matsumoto T; Shimooka T; Okamoto E; Eizuka N; Yamaguchi K.
.I 85
.U
87049360
.S
ASAIO Trans 8703; 32(1):46-8
.M
Animal; Assisted Circulation/*IS; Cattle; Heart Rate; Heart-Assist Devices/*IS/MT; Hemoglobins/AN; Male; Postoperative Care; Support, Non-U.S. Gov't; Time Factors.
.T
Roller screw electric motor ventricular assist device.
.P
JOURNAL ARTICLE.
.W
The roller screw electric VAD is easier to manufacture and 25% lighter than the previously described drum cam model. This device requires 12 to 15 W to pump 6 to 8 l/min with minimal hemolysis. The motor drive has functioned for periods up to 93 days in vivo with no measurable wear. The compliance chamber volume varies by 100 cc during VAD function but does so while maintaining pressure variations below 15 mmHg. Compliance chamber volume loss of 2 to 5 cc/day is explained by gas transport through SPU. The subcutaneous sampling port provides ready access to the sealed system.
.A
Richenbacher WE; Pae WE Jr; Magovern JA; Rosenberg G; Snyder AJ; Pierce WS.
.I 86
.U
87049361
.S
ASAIO Trans 8703; 32(1):461-6
.M
Adult; Aged; Assisted Circulation/*; Case Report; Child, Preschool; Echocardiography/*; Female; Heart/*PP; Heart Surgery/*; Heart-Assist Devices/*; Hemodynamics; Human; Male; Middle Age; Monitoring, Physiologic/*; Postoperative Complications/TH.
.T
Natural heart recovery under left ventricular assist device pumping studied by echocardiography.
.P
JOURNAL ARTICLE.
.A
Nakatani T; Takano H; Beppu S; Noda H; Fukuda S; Fujita T; Akutsu T; Nimura Y; Manabe H.
.I 87
.U
87049363
.S
ASAIO Trans 8703; 32(1):474-7
.M
Animal; Axons/UL; Collagen/PH; Extracellular Matrix/*PH; Female; Glycoproteins/PH; Heparitin Sulfate/PH; Implants, Artificial/*; Laminin/PH; Membranes, Artificial; Mice; Microscopy, Electron; Myelin Sheath/UL; Nerve Regeneration/*; Sciatic Nerve/CY/*PH/UL.
.T
Regeneration of transected sciatic nerves through semi-permeable nerve guidance channels. Effects of extracellular matrix protein additives.
.P
JOURNAL ARTICLE.
.A
Aebischer P; Valentini RF; Winn SR; Kunz S; Sasken H; Galletti PM.
.I 88
.U
87049365
.S
ASAIO Trans 8703; 32(1):482-5
.M
Animal; Antibody Formation; Drug Hypersensitivity/*; Ethylene Oxide/*TO; Female; Hemodialysis; Human; IgE/AN; Male; Mice; Mice, Inbred Strains; Passive Cutaneous Anaphylaxis/*; Rats; Rats, Inbred Strains.
.T
Animal model for ethylene oxide (EtO) associated hypersensitivity reactions.
.P
JOURNAL ARTICLE.
.A
Chapman J; Lee W; Youkilis E; Martis L.
.I 89
.U
87049366
.S
ASAIO Trans 8703; 32(1):486-9
.M
Adolescence; Aged; Blood Proteins/AN; Case Report; Chronic Disease; Complement/AN; Demyelinating Diseases/*TH; Female; Follow-Up Studies; Human; Immunoglobulins/AN; Inflammation; Male; Plasma/*; Polyradiculoneuritis/*TH; Ultrafiltration/*/IS/MT.
.T
Treatment of chronic inflammatory demyelinating polyradiculoneuropathy by plasma filtration.
.P
JOURNAL ARTICLE.
.A
Abe Y; Baba M; Baba T; Tamasawa N; Kurahashi K; Hirai Y; Nakahata H; Matsunaga M; Takebe K.
.I 90
.U
87049367
.S
ASAIO Trans 8703; 32(1):49-51
.M
Aged; Blood/*; Heparin/TU; Human; Middle Age; Suction; Support, Non-U.S. Gov't; Ultrafiltration/*MT; Urea/BL; Vacuum.
.T
Clinical trials with predilution and vacuum suction: enhancing the efficiency of the CAVH treatment.
.P
JOURNAL ARTICLE.
.A
Kaplan AA.
.I 91
.U
87049368
.S
ASAIO Trans 8703; 32(1):490-4
.M
Alanine Aminotransferase/BL; Animal; Aspartate Aminotransferase/BL; Blood Coagulation Tests; Creatinine/BL; Dogs; Electrolytes/BL; Erythrocyte Count; Erythrocytes/AN; Exchange Transfusion, Whole Blood/*; Hematocrit/*; Hemoglobins/*/*AN; Platelet Count; Polyethylene Glycols/*; Solutions; Support, Non-U.S. Gov't; Urea/BL.
.T
Physiologic effects of pyridoxalated-hemoglobin-polyethylene glycol conjugate solution in exchange transfusion.
.P
JOURNAL ARTICLE.
.A
Matsushita M; Iwashita Y; Iwasaki K; Ohki H; Nasu M; Horiuchi T; Chen JF; Goldcamp J; Murabayashi S; Harasaki H; et al.
.I 92
.U
87049369
.S
ASAIO Trans 8703; 32(1):495-9
.M
Aged; Blood/*; Blood Proteins/AN; Case Report; Cryoglobulins/*IP/ME; Female; Human; Immunoglobulins/AN; Sjogren's Syndrome/BL/*TH; Ultrafiltration/*/IS/MT.
.T
Clinical evaluation of a multilayered cryofilter for highly selective cryoglobulin removal.
.P
JOURNAL ARTICLE.
.A
Emura M; Horiuchi T; Malchesky PS; Goldcamp JB; Usami M; Sakamoto H; Matsushita M; Suzuki M; Nose Y.
.I 93
.U
87049371
.S
ASAIO Trans 8703; 32(1):500-2
.M
Blood Pressure; Catheters, Indwelling/*ST; Hemodialysis/*ST; Human; Kidney Failure, Acute/*PP/TH; Kidney Failure, Chronic/*PP/TH; Polyurethanes; Quality Control; Support, Non-U.S. Gov't.
.T
Minimum performance standards for double-lumen subclavian cannulas for hemodialysis.
.P
JOURNAL ARTICLE.
.A
Bregman H; Miller K; Berry L.
.I 94
.U
87049374
.S
ASAIO Trans 8703; 32(1):511-4
.M
Catheters, Indwelling; Diabetes Mellitus, Insulin-Dependent/DT; Equipment Failure/*; Follow-Up Studies; Human; Insulin Infusion Systems/*.
.T
Implantable continuous intravenous insulin infusion device. Restoration of flow after slow-down.
.P
JOURNAL ARTICLE.
.A
Kernstine KH; Kryjeski SR; Wigness BD; Goldenberg FJ; Rohde TD; Dorman FD; Chute EP; Rupp WM; Buchwald H.
.I 95
.U
87049375
.S
ASAIO Trans 8703; 32(1):515-20
.M
Animal; Dogs; Fibrinogen/AN; Implants, Artificial/*AE; Microscopy, Electron, Scanning; Oxidation-Reduction; Platelet Aggregation; Polyethylenes/*AE; Regional Blood Flow/*; Support, U.S. Gov't, P.H.S.; Thrombosis/*ET.
.T
Blood flow and surface-induced thrombosis.
.P
JOURNAL ARTICLE.
.A
Grasel TG; Wilson RS; Lelah MD; Bielich HW; Cooper SL.
.I 96
.U
87049376
.S
ASAIO Trans 8703; 32(1):52-7
.M
Aluminum/*BL/IP; Blood Proteins/AN; Deferoxamine/*TU; Hemodialysis/*MT; Human; Kinetics; Permeability; Time Factors.
.T
Removal of aluminum from chronic dialysis patients by administration of desferrioxamine and dialysis.
.P
JOURNAL ARTICLE.
.W
In order to perform quantitative in vitro and clinical studies on the removal of Al by the combined therapy of DFO administration and HD, an HPLC system for measuring DFO was established and a leaky membrane with enhanced permeability to middle molecular substances was developed. The DFO infusion caused rises in plasma Al levels (regarded as indicating the elution of accumulated Al) in patients undergoing HD. Plasma levels increased most in long-term patients and those with bone pain. Examination of Al clearances demonstrated that this increased plasma Al content passed through HD membranes at levels of more than 80 micrograms/l, and that the leaky membrane was more effective for removal of Al as well as DFO than the conventional one. Although a 1:1 complex between DFO and Al in an aqueous solution was confirmed, the formation of Al-rich complexes in vivo was suggested. It is concluded that Al-DFO complex formed in vivo can be effectively removed across the leaky membrane.
.A
Ono T; Iwamoto N; Kataoka H; Taniguchi Y; Sakai Y; Kunitomo T.
.I 97
.U
87049377
.S
ASAIO Trans 8703; 32(1):521-4
.M
Animal; Artificial Organs/*; Cardiopulmonary Bypass/*IS; Dogs; Extracorporeal Circulation/IS; Hemodynamics; Lung/*PH; Membranes, Artificial.
.T
A portable, pumpless, AV bypass ECCO2R system, with a hollow fiber membrane lung.
.P
JOURNAL ARTICLE.
.A
Fukui Y; Kawamura T.
.I 98
.U
87049380
.S
ASAIO Trans 8703; 32(1):534-7
.M
Extracorporeal Circulation/*AE; Female; Human; Infant, Newborn; Infant, Newborn, Diseases/BL/*TH; Male; Oxygen/*BL; Partial Pressure; Respiratory Distress Syndrome/BL/*TH; Thrombocytopenia/*ET.
.T
Thrombocytopenia in neonates after extracorporeal membrane oxygenation.
.P
JOURNAL ARTICLE.
.A
Anderson HL 3d; Cilley RE; Zwischenberger JB; Bartlett RH.
.I 99
.U
87049381
.S
ASAIO Trans 8703; 32(1):538-41
.M
Acute Disease; Animal; Assisted Circulation/*; Blood Pressure; Cardiac Output; Comparative Study; Dogs; Extracorporeal Circulation/*; Heart/*PP; Heart Diseases/*TH; Heart Ventricle/PP; Heart-Assist Devices/*.
.T
Vented cardiac assistance: ECMO versus left heart bypass for acute left ventricular failure.
.P
JOURNAL ARTICLE.
.A
Eugene J; Ott RA; McColgan SJ; Roohk HV.
.I 100
.U
87049383
.S
ASAIO Trans 8703; 32(1):546-9
.M
Adolescence; Adult; Aged; Female; Human; Male; Middle Age; Morbidity; Ontario; Peritoneal Dialysis, Continuous Ambulatory/*AE; Peritonitis/EP/*ET/PC; Staphylococcal Infections/EP/*ET/PC; Staphylococcus aureus; Staphylococcus epidermidis; Support, Non-U.S. Gov't.
.T
The CAPD peritonitis rate is not improving with time.
.P
JOURNAL ARTICLE.
.A
Fenton SS; Pei Y; Delmore T; Cattran DC; Bowman C; Johnston N; Campbell I; Clarke WT; Richardson RM.
.I 101
.U
87049384
.S
ASAIO Trans 8703; 32(1):550-3
.M
Animal; Glucose/*; Milk Proteins; Osmolar Concentration; Peptides/*; Peritoneal Dialysis/*MT; Protein Hydrolysates/*; Rabbits.
.T
Peptides as substitute osmotic agents for glucose in peritoneal dialysate.
.P
JOURNAL ARTICLE.
.A
Klein E; Ward RA; Williams TE; Feldhoff PW.
.I 102
.U
87049385
.S
ASAIO Trans 8703; 32(1):554-6
.M
Adult; Heart/*PP; Heart Ventricle/PP; Human; Infusions, Parenteral; Kidney Failure, Chronic/PP/*TH; Myocardial Contraction/*; Peritoneal Dialysis, Continuous Ambulatory/*MT; Posture; Systole/*.
.T
Effect of intraperitoneal infusion volume and posture on left ventricular systolic function in patients on continuous ambulatory peritoneal dialysis.
.P
JOURNAL ARTICLE.
.A
Franklin JO; Alpert MA; Twardowski ZJ; Khanna R.
.I 103
.U
87049386
.S
ASAIO Trans 8703; 32(1):557-9
.M
Adult; Diabetic Nephropathies/TH; Female; Glomerulonephritis/CO; Human; Kidney Failure, Chronic/ET/*TH; Male; Patient Education; Peritoneal Dialysis, Continuous Ambulatory/AE/*IS; Peritonitis/PC; Quality Control; Support, Non-U.S. Gov't; United States.
.T
A multicenter trial to evaluate the use of the CAPD "O" set.
.P
JOURNAL ARTICLE.
.A
Lempert KD; Kolb JA; Swartz RD; Campese V; Golper TA; Winchester JF; Nolph KD; Husserl FE; Zimmerman SW; Kurtz SB; et al.
.I 104
.U
87049387
.S
ASAIO Trans 8703; 32(1):560-3
.M
California; Demography; Follow-Up Studies; Human; Kidney Failure, Chronic/*TH; Nevada; Peritoneal Dialysis, Continuous Ambulatory/*/AE; Peritonitis/ET.
.T
Long-term outcome of continuous ambulatory peritoneal dialysis. The Southern California/Southern Nevada experience.
.P
JOURNAL ARTICLE.
.A
Nissenson AR; Gentile DE; Soderblom RE; Brax C.
.I 105
.U
87049388
.S
ASAIO Trans 8703; 32(1):564-6
.M
Animal; Diltiazem/*PD; Glucose/*ME; Male; Peritoneal Dialysis/*; Proteins/*ME; Rats; Rats, Inbred Strains; Support, Non-U.S. Gov't; Urea/*ME; Verapamil/*PD.
.T
Effects of calcium channel blockers (verapamil, diltiazem) on peritoneal transport.
.P
JOURNAL ARTICLE.
.A
Lal SM; Nolph KD; Moore HL; Khanna R.
.I 106
.U
87049389
.S
ASAIO Trans 8703; 32(1):567-71
.M
Blood/*; Human; Kidney Failure, Chronic/*TH; Kidney, Artificial/*; Membranes, Artificial; Models, Biological; Nephrons/PH; Ultrafiltration/*/IS/MT.
.T
Continuous arterio-venous hemofiltration in a wearable device to treat end-stage renal disease.
.P
JOURNAL ARTICLE.
.A
Murisasco A; Reynier JP; Ragon A; Boobes Y; Baz M; Durand C; Bertocchio P; Agenet C; el Mehdi M.
.I 107
.U
87049390
.S
ASAIO Trans 8703; 32(1):572-4
.M
Adolescence; Adult; Aged; Disposable Equipment; Evaluation Studies; Female; Human; Kidney Failure, Chronic/TH; Male; Middle Age; Peritoneal Dialysis, Continuous Ambulatory/*IS; Support, Non-U.S. Gov't.
.T
Multicenter evaluation of a bagless CAPD system.
.P
JOURNAL ARTICLE.
.A
Suki WN; Walshe JJ; Ashbrook DW; Gentile DE; Tucker CT; Ash SR; Ahmad S.
.I 108
.U
87049391
.S
ASAIO Trans 8703; 32(1):575-80
.M
Adult; Aged; Aged, 80 and over; Comparative Study; Creatinine/ME; Female; Glucose/ME; Human; Kidney Failure, Chronic/*ME/TH; Kinetics; Male; Middle Age; Peritoneal Dialysis/*; Peritoneal Dialysis, Continuous Ambulatory/*; Phosphates/ME; Potassium/ME; Sodium/ME; Support, Non-U.S. Gov't; Urea/ME.
.T
Daily clearances with continuous ambulatory peritoneal dialysis and nightly peritoneal dialysis.
.P
JOURNAL ARTICLE.
.A
Twardowski ZJ; Nolph KD; Khanna R; Gluck Z; Prowant BF; Ryan LP.
.I 109
.U
87049392
.S
ASAIO Trans 8703; 32(1):58-63
.M
Blood Substitutes/*AD; Half-Life; Hemoglobins/*AD/ME/TU; Human; Kinetics; Liposomes/*AD; Oxygen/BL; Phosphatidylcholines/*; Support, U.S. Gov't, Non-P.H.S..
.T
Liposome-encapsulated hemoglobin as a red cell surrogate. Preparation scale-up.
.P
JOURNAL ARTICLE.
.A
Beissinger RL; Farmer MC; Gossage JL.
.I 110
.U
87049393
.S
ASAIO Trans 8703; 32(1):581-2
.M
Air/*; Diaphragm/*RA; Human; Peritoneal Dialysis, Continuous Ambulatory/*/AE; Posture.
.T
Is air under the diaphragm a significant finding in CAPD patients?
.P
JOURNAL ARTICLE.
.W
The incidence of air under the diaphragm in CAPD patients is very low, and causes directly attributable to standard CAPD techniques are even lower. Bowel perforation generally causes a larger volume of air collection under the diaphragm.
.A
Lampainen E; Khanna R; Schaefer R; Twardowski ZJ; Nolph KD.
.I 111
.U
87049394
.S
ASAIO Trans 8703; 32(1):583-6
.M
Antigens, Neoplasm/*IP; Breast Neoplasms/IM; Extracorporeal Circulation/IS/*MT; Female; Human; Immunosuppression; Male; Neoplasms/*IM; Plasmapheresis; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Extracorporeal removal of tumor antigens.
.P
JOURNAL ARTICLE.
.A
Shettigar UR; Kolff WJ; Gregonis D.
.I 112
.U
87049395
.S
ASAIO Trans 8703; 32(1):587-90
.M
Animal; Calcinosis/PA/*PC; Cattle; Delayed-Action Preparations; Diphosphonates/*TU; Heart Valve Prosthesis/*; Male; Microscopy, Electron, Scanning; Rats; Silicone Elastomers; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Inhibition of bioprosthetic heart valve calcification by sustained local delivery of Ca and Na diphosphonate via controlled release matrices.
.P
JOURNAL ARTICLE.
.A
Golomb G; Dixon M; Smith MS; Schoen FJ; Levy RJ.
.I 113
.U
87049396
.S
ASAIO Trans 8703; 32(1):591-6
.M
Animal; Blood Platelets/*CY; Cattle; Fibrin/*AN; Fibrinogen/*AN; Heart Valve Prosthesis/*/AE; Indium/DU; Iodine Radioisotopes/DU; Radioisotopes/DU; Support, U.S. Gov't, P.H.S.; Thrombosis/*ET; Time Factors; Tropolone/AA/DU.
.T
Quantitation of platelet and fibrinogen-fibrin deposition on components of tissue valves (Ionescu-Shiley) in calves.
.P
JOURNAL ARTICLE.
.W
With 111In-labeled platelets and 125I-labeled bovine fibrinogen, regional mapping of platelet and fibrinogen deposition on leaflets and sewing rings was obtained. Ten Holstein calves received 25-mm mitral valves (ISLM) and were killed 1, 14, and 30 days after implantation. Twenty-four hours before the calves were killed, 350 to 450 microCi of 111In-labeled platelets and 200 to 250 microCi of 125I-labeled bovine fibrinogen were administered intravenously. The components of the tissue valves, i.e., three leaflets and sewing rings, were separated. Each leaflet was cut into four sections: free edge, central zone, flexion zone, and attachment zone. From the radioactivity in blood, leaflet zones, sewing rings, area of leaflet zones, platelet count, and fibrinogen level in blood, the mean regional density of adherent platelets, fibrinogen-fibrin, and fibrinogen/platelet were calculated. The density of platelets and fibrinogen deposited on the components of the valves decreases with time postimplantation. The number of fibrinogen molecules per platelet is fivefold to 20-fold higher than that of the receptor concentration on platelets on leaflet zones, suggesting the heterogeneity of fibrinogen-fibrin in thrombus and components of the valve.
.A
Dewanjee MK; Solis E; Lenker J; Tidwell C; Mackey S; Didisheim P; Kaye MP.
.I 114
.U
87049397
.S
ASAIO Trans 8703; 32(1):597-600
.M
Adult; Human; In Vitro; Lipid A/*PD; Lipopolysaccharides/*PD; Luminescence; Neutrophils/CY/DE/*PH; Salmonella/*IM; Support, Non-U.S. Gov't.
.T
Neutrophil stimulation by lipid A and lipopolysaccharides from Salmonella minnesota.
.P
JOURNAL ARTICLE.
.A
DeBari VA; Uychich PM; Orsini AJ; Ingenito AC; Needle MA.
.I 115
.U
87049398
.S
ASAIO Trans 8703; 32(1):601-4
.M
Animal; Arteries/SU; Blood Vessel Prosthesis/*; Dogs; Femoral Artery/SU; Microscopy, Electron, Scanning; Silicone Elastomers; Support, U.S. Gov't, P.H.S.; Vascular Patency/*.
.T
Maintenance of compliance in a small diameter arterial prosthesis.
.P
JOURNAL ARTICLE.
.W
This study demonstrates that 20 to 30 microns porous, Replamineform silicone rubber prostheses remain isocompliant with adjacent arterial segments up to 8 months following implantation. This finding contrasts with the results of currently available prostheses, including autologous vein, which rapidly become minimally compliant. We conclude that this vascular construction is stable over the long-term following implantation and may improve the success of small internal diameter arterial reconstruction by eliminating failures caused by intimal hyperplasia.
.A
White RA; Klein SR; Shors E.
.I 116
.U
87049399
.S
ASAIO Trans 8703; 32(1):605-8
.M
Animal; Elasticity; Implants, Artificial/*; Microscopy, Electron, Scanning; Polyvinyl Alcohol/*; Prosthesis; Prosthesis Design; Rabbits; Tensile Strength.
.T
A new hydrogel and its medical application.
.P
JOURNAL ARTICLE.
.A
Tamura K; Ike O; Hitomi S; Isobe J; Shimizu Y; Nambu M.
.I 117
.U
87049400
.S
ASAIO Trans 8703; 32(1):609-11
.M
Animal; Biopsy; Factor XIII/*; Gelatin/*; Hemostasis/*; Heparin; Liver/CY; Male; Rats; Rats, Inbred Strains; Support, Non-U.S. Gov't; Thrombin/*; Wound Healing/*.
.T
A new hemostatic material, G.T.XIII.
.P
JOURNAL ARTICLE.
.A
Sugitachi A; Kato M; Masuzawa M; Terada A.
.I 118
.U
87049401
.S
ASAIO Trans 8703; 32(1):64-7
.M
Adult; Aged; Catheterization/MT; Catheters, Indwelling/*; Comparative Study; Female; Follow-Up Studies; Human; Male; Middle Age; Peritoneal Dialysis/*; Support, Non-U.S. Gov't.
.T
Preliminary experience with the Swan Neck peritoneal dialysis catheters.
.P
JOURNAL ARTICLE.
.A
Twardowski ZJ; Khanna R; Nolph KD; Nichols WK; Ryan LP.
.I 119
.U
87049402
.S
ASAIO Trans 8703; 32(1):68-70
.M
Adult; Bilirubin/*BL/IP; Case Report; Female; Human; Infant, Newborn; Infant, Premature/*; Jaundice, Neonatal/BL/*TH; Resins; Support, Non-U.S. Gov't; Ultrafiltration/*MT.
.T
Bilirubin removal from a jaundiced premature infant by resin hemoperfusion.
.P
JOURNAL ARTICLE.
.W
To summarize the results: Bilirubin removal by hemoperfusion was successfully performed for the first time on a premature infant. The hemoperfusion caused no adverse effects on the clinical state of the infant. The bilirubin removed in 90 min--13 mg--indicates the existence of a large extravascular pool. Hemoperfusion is suggested for bilirubin removal from newborn babies, reducing the need for blood exchange with bank blood.
.A
Brandes JM; Mor L; Sideman S; Zeltzer M; Sujov P; Blazer S.
.I 120
.U
87049404
.S
ASAIO Trans 8703; 32(1):76-80
.M
Cellulose/*; Complement Activation; Hemodialysis/*MT; Human; Leukocyte Count; Membranes, Artificial/*; Platelet Count; Surface Properties.
.T
Development of a regenerated cellulose non-complement activating membrane for hemodialysis.
.P
JOURNAL ARTICLE.
.W
We have developed a new cellulose membrane in which the active hydroxyl and carboxyl groups of the original cellulose fibers are masked with cationic synthetic polymers. The membrane was shown by in vitro and clinical tests to affect the activation of the complement system very little, and it retains the high dialysis efficiency, good tolerance to steam autoclave sterilization, and economical production cost characteristics of the original cellulose membrane. It thus appears that the new cellulose provides the optimum combination of qualities needed in a hemodialysis membrane.
.A
Akizawa T; Kitaoka T; Koshikawa S; Watanabe T; Imamura K; Tsurumi T; Suma Y; Eiga S.
.I 121
.U
87049405
.S
ASAIO Trans 8703; 32(1):81-4
.M
Antibodies, Monoclonal/*TU; Antigen-Antibody Complex/*; Autoimmune Diseases/*TH; Human; Kinetics; Membranes, Artificial/*.
.T
A membrane-immobilized monoclonal antibody immunoadsorption system.
.P
JOURNAL ARTICLE.
.A
McManus DE; Randerson DH.
.I 122
.U
87049408
.S
ASAIO Trans 8703; 32(1):93-7
.M
Aged; Ascitic Fluid/*TH; Case Report; Diabetic Nephropathies/TH; Female; Hemodialysis; Human; Kidney Failure, Chronic/ET/TH; Male; Middle Age; Peritoneovenous Shunt/IS/*MT.
.T
External peritoneo-venous shunt for intractable ascites.
.P
JOURNAL ARTICLE.
.A
Inagaki Y; Amano I.
.I 123
.U
87049453
.S
Br J Anaesth 8703; 58(11):1207-9
.M
Animal; Disease Models, Animal; Human; Respiratory Distress Syndrome, Adult/DI/*ET/TH; Sheep.
.T
Acute/adult/animal respiratory distress syndrome [editorial]
.P
EDITORIAL.
.A
Royston D.
.I 124
.U
87049454
.S
Br J Anaesth 8703; 58(11):1210-3
.M
Anesthesia, Inhalation; Atracurium/*ME; Child; Child, Preschool; Human; Infant; Isoflurane; Isoquinolines/BL; Kinetics; Liver/PP; Liver Diseases/BL/*ME/PP; Nitrous Oxide; Support, Non-U.S. Gov't.
.T
Pharmacokinetics of atracurium in anaesthetized infants and children.
.P
JOURNAL ARTICLE.
.W
The pharmacokinetics of atracurium were studied in infants and children anaesthetized with isoflurane and nitrous oxide in oxygen. There were no significant differences in volume of distribution (area) (139 v. 152 ml kg-1), clearance (5.1 v. 5.3 ml kg-1 min-1), T1/2 alpha (2.1 v. 2.0 min), or T1/2 beta (19.1 v. 20.3 min) between children with normal hepatic and renal function and those with moderately impaired hepatic function presenting for hepatic transplantation. There were significant differences in volume of distribution (area) (176 v. 139 ml kg-1) and in clearance of atracurium (9.1 v. 5.1 ml kg-1 min-1) between infants and children with normal excretory function. In infants the clearance of atracurium in ml m-2 min-1 (153 v. 133) tended to be greater and the T1/2 alpha and T1/2 beta tended to be shorter (1.0 v. 2.0 and 13.6 v. 19.1) than in children with normal excretory function; however, these trends did not reach statistical significance. Plasma laudanosine concentration was around 100 ng ml-1 greater in patients with liver disease than in normal children from 15-45 min following a bolus of atracurium 0.5 mg kg-1.
.A
Brandom BW; Stiller RL; Cook DR; Woelfel SK; Chakravorti S; Lai A.
.I 125
.U
87049455
.S
Br J Anaesth 8703; 58(11):1214-7
.M
Anesthesia, Intratracheal; Atracurium/AD/*PD; Biliary Atresia/PP/*SU; Drug Administration Schedule; Female; Human; Infant; Infant, Newborn; Intraoperative Care; Liver/*PP; Male; Neuromuscular Blocking Agents/*.
.T
Use of atracurium during major abdominal surgery in infants with hepatic dysfunction from biliary atresia.
.P
JOURNAL ARTICLE.
.W
The use of atracurium during major abdominal surgery was assessed in 20 infants with hepatic dysfunction caused by biliary atresia. An initial dose of 0.6 mg kg-1 provided excellent intubating conditions in all patients. Subsequent neuromuscular blockade was monitored with a peripheral nerve stimulator and incremental doses of atracurium were given on reappearance of a single twitch. Neuromuscular conduction was allowed to return at the end of surgery and by careful timing of increments it was necessary to antagonize the neuromuscular blockade in only two patients.
.A
Simpson DA; Green DW.
.I 126
.U
87049457
.S
Br J Anaesth 8703; 58(11):1224-8
.M
Adolescence; Anesthesia, Inhalation/*AE; Child; Child, Preschool; Female; Halothane/AD/*AE; Hepatitis, Toxic/*ET/PP; Human; Infant; Liver/*DE/PP; Male; Postoperative Period; Prospective Studies; Support, Non-U.S. Gov't; Time Factors.
.T
Prospective study of liver function in children following multiple halothane anaesthetics at short intervals.
.P
JOURNAL ARTICLE.
.W
In the 4 years January 1981 to December 1984, 186 children received 1362 halothane anaesthetics. Twenty-five patients were anaesthetized with halothane at least 10 times in a year. No patient developed postoperative jaundice. Sixty-nine children were exposed to two halothane anaesthetics within 28 days on 149 occasions and serial estimations of serum liver enzyme concentrations were obtained. Minor increases in the concentrations of serum AST and ALT were recorded in 10.6% and 4.7% of patient entries, respectively. Postoperative GGT and SAP concentrations were increased in 2.7% of patient entries. Patients in whom enzyme values were increased before the first anaesthetic were no more likely than other subjects to develop further changes.
.A
Wark H; O'Halloran M; Overton J.
.I 127
.U
87049458
.S
Br J Anaesth 8703; 58(11):1229-33
.M
Atracurium/*PD; Child; Child, Preschool; Female; Histamine/BL; Histamine Liberation/*DE; Human; Infant; Male; Neuromuscular Junction/DE; Time Factors; Vecuronium/*PD.
.T
Histamine release during the administration of atracurium or vecuronium in children.
.P
JOURNAL ARTICLE.
.W
The histamine releasing potential of equivalent bolus doses of atracurium 0.6 mg kg-1 or vecuronium 0.12 mg kg-1 was evaluated in 20 children anaesthetized with halothane. Blood samples were obtained before, and at 2 and 5 min after the administration of the neuromuscular blocker. The twitch response to 0.15 Hz was also evaluated. None of the 10 patients receiving vecuronium had a significant increase in plasma histamine concentration. In two of the 10 children receiving atracurium, the plasma histamine concentration increased markedly, but without any apparent clinical manifestations. Recovery of neuromuscular function (to 95% twitch height) after vecuronium 0.12 mg kg-1 was faster than after atracurium 0.6 mg kg-1 (P less than 0.02).
.A
Goudsouzian NG; Young ET; Moss J; Liu LM.
.I 128
.U
87049459
.S
Br J Anaesth 8703; 58(11):1234-41
.M
Adrenocorticotropic Hormone/BL; Anesthesia, Inhalation; Catecholamines/BL; Child; Child, Preschool; Halothane; Hormones/*BL; Human; Hydrocortisone/BL; Infant; Midazolam/*PD; Postoperative Period; Premedication/*; Pulmonary Gas Exchange; Respiration/*DE; Support, Non-U.S. Gov't; Surgery, Operative.
.T
Ventilation, ventilatory carbon dioxide and hormonal response during halothane anaesthesia and surgery in children after midazolam premedication.
.P
JOURNAL ARTICLE.
.W
In 14 intubated, spontaneously breathing children with body weight (bw) ranging from 8.3 to 25.6 kg, the influence of midazolam 0.1 mg kg-1 i.m. (group M0.1, n = 7) and 0.2 mg kg-1 i.m. (group M0.2, n = 7) as premedication, on sedation, ventilation, ventilatory response to carbon dioxide and hormonal stress response was studied in connection with minor surgical procedures during halothane anaesthesia. The concentrations of catecholamines, ACTH and cortisol were measured immediately after induction, during undisturbed anaesthesia, during surgery and 15 min after the end of the surgical procedure. Sedation was better and plasma catecholamine concentrations during undisturbed anaesthesia were less in children receiving the larger dose of midazolam. During surgery and in recovery there were no differences in hormone concentrations. In recovery, the concentrations of all hormones were significantly greater compared with during undisturbed anaesthesia. During surgery, VE and respiratory rate were somewhat lower in group M0.2 while E' CO2 was similar. A dose dependent depression of the response to carbon dioxide was found. However, clinically, the ventilatory response to carbon dioxide after surgery was considered to be adequate in both groups.
.A
Charlton AJ; Hatch DJ; Lindahl SG; Phythyon JM; Norden NE.
.I 129
.U
87049466
.S
Br J Anaesth 8703; 58(11):1278-84
.M
Adult; Alcuronium/AI/*PD; Atracurium/AI/*PD; Comparative Study; Electromyography; Evoked Potentials/DE; Human; Muscle Contraction/DE; Muscles/*DE; Neostigmine/*PD; Neuromuscular Blocking Agents/*; Toxiferine/*AA.
.T
Evoked electromyographic and mechanical responses of the adductor pollicis compared during the onset of neuromuscular blockade by atracurium or alcuronium, and during antagonism by neostigmine.
.P
JOURNAL ARTICLE.
.W
The effects of atracurium and alcuronium on the evoked mechanical and electromyographic responses of the adductor pollicis were investigated in 30 adult patients. The ulnar nerve was stimulated with trains of four supramaximal pulses of 0.2 ms duration and a frequency of 2 Hz at intervals of 20 s. The mechanical response was measured using a strain gauge force transducer and the evoked compound action potential (ECAP) was recorded simultaneously using a Medelec MS91 electromyography system. Depression of the electromyographic and mechanical responses, caused by atracurium, was similar during onset and antagonism of blockade. During onset of blockade by alcuronium, the mechanical response was depressed to a significantly greater extent compared with the ECAP. This difference was not observed during antagonism with neostigmine. The rates of onset of atracurium and alcuronium were generally similar, but the rate of onset of mechanical fade was greater in the alcuronium group. There was no significant quantitative difference between the rates of antagonism of alcuronium and atracurium when assessed by the mechanical first response ratio. Electromyographic first response and electromyographic and mechanical train-of-four ratios recovered more rapidly in the atracurium group. These findings suggest that the differences between mechanical and electromyographic measurements of neuromuscular blockade are drug-specific and are more pronounced during the onset of blockade than during its antagonism by neostigmine.
.A
Harper NJ; Bradshaw EG; Healy TE.
.I 130
.U
87049467
.S
Br J Anaesth 8703; 58(11):1285-9
.M
Adult; Atracurium/*AI; Comparative Study; Edrophonium/*PD; Human; Middle Age; Muscle Contraction/DE; Neostigmine/*PD; Neuromuscular Blocking Agents/*AI; Time Factors; Vecuronium/*AI.
.T
Antagonism of profound neuromuscular blockade induced by vecuronium or atracurium. Comparison of neostigmine with edrophonium.
.P
JOURNAL ARTICLE.
.W
The effectiveness of neostigmine 0.07 mg kg-1 and edrophonium 0.8 mg kg-1 as antagonists of profound neuromuscular blockade induced by vecuronium 0.1 mg kg-1 or atracurium 0.5 mg kg-1 was studied in 59 healthy patients. The antagonists were administered 5 min after total ablation of the twitch response and the end-point of recovery was a train-of-four ratio of 70%. In 30 patients given vecuronium the mean time to reach this point (duration TOF70) was 66.7 min in the control group (no antagonist), 43.5 min in the group given neostigmine and 59.8 min in the group given edrophonium. The duration TOF70 was shorter in the neostigmine group than in the control (P less than 0.01) and edrophonium (P less than 0.01) groups. The duration TOF70 did not differ from control in the edrophonium group. In 29 patients given atracurium, the durations TOF70 were 66.4, 44.1 and 54.9 min in the control, neostigmine and edrophonium groups, respectively. The durations TOF70 in the neostigmine (P less than 0.01) and edrophonium (P less than 0.01), groups were shorter than control. The duration TOF70 of the neostigmine group was shorter than in the edrophonium group (P less than 0.01). These results show that profound neuromuscular blockade cannot be rapidly antagonized by either of these two agents, but if reversal is required under these circumstances, neostigmine would be the more effective drug.
.A
Caldwell JE; Robertson EN; Baird WL.
.I 131
.U
87049468
.S
Br J Anaesth 8703; 58(11):1290-5
.M
Atracurium/*AI/PD; Comparative Study; Edrophonium/*PD; Human; Muscle Contraction/DE; Neostigmine/*PD; Neuromuscular Blocking Agents/*AI; Time Factors.
.T
Antagonism of atracurium-induced neuromuscular blockade by neostigmine or edrophonium.
.P
JOURNAL ARTICLE.
.W
Antagonism of atracurium-induced neuromuscular blockade by neostigmine or edrophonium has been studied using the tetanic (50 Hz) and train-of-four (2 Hz) or single twitch responses of the adductor pollicis muscle in 22 anaesthetized patients. A further nine patients not given an anticholinesterase acted as a control group. In two groups (six patients for each anticholinesterase) in whom antagonism was attempted at 95-98% blockade of the tetanic response, recovery of the tetanic response after two or three doses of edrophonium 0.75 mg kg-1 i.v. was not statistically different from that in the control group; recovery after two doses of neostigmine 2.5 mg i.v. was significantly faster (P less than 0.001). Recovery of the single twitch response after antagonism with edrophonium, although longer than that with neostigmine (P less than 0.01), was significantly shorter than in the control group (P less than 0.05). When edrophonium is given at the commencement of recovery, the initial rapid antagonism of tetanic block is not sustained, whereas antagonism by neostigmine is more persistent and the recovery phase is significantly shortened. In a further two groups of patients (n = 5) given atracurium 0.3 mg kg-1 i.v., antagonism was not attempted until the peak height of the tetanic contraction had reached approximately 50% of the control value.(ABSTRACT TRUNCATED AT 250 WORDS)
.A
Astley BA; Hughes R; Payne JP.
.I 132
.U
87049469
.S
Br J Anaesth 8703; 58(11):1296-9
.M
Adult; Atracurium/*PD; Evoked Potentials/DE; Female; Human; Male; Middle Age; Muscle Contraction/*DE; Neuromuscular Blocking Agents/*; Time Factors; Tubocurarine/*PD; Vecuronium/*PD.
.T
Reappearance of the train-of-four after neuromuscular blockade induced with tubocurarine, vecuronium or atracurium.
.P
JOURNAL ARTICLE.
.W
The characteristics of train-of-four recovery after atracurium or vecuronium were studied, under enflurane anaesthesia, and compared with those associated with tubocurarine-induced blockade. Ten patients each received vecuronium 0.1 mg kg-1, atracurium 0.5 mg kg-1 or tubocurarine 0.5 mg kg-1. Neuromuscular blockade was calculated as the percent depression of the first twitch, and was determined at the time of reappearance of the second, third and fourth twitches of the train-of-four. The pattern during recovery from blockade induced by the three neuromuscular blocking agents was similar, with T2, T3 and T4 reappearing at approximately 93%, 89% and 86% residual blockade, respectively. These results are different from those previously reported by Lee (1975) indicating that, under enflurane anaesthesia, the train-of-four count may give an incorrect estimate of the degree of neuromuscular blockade.
.A
O'Hara DA; Fragen RJ; Shanks CA.
.I 133
.U
87049470
.S
Br J Anaesth 8703; 58(11):1300-2
.M
Anesthesia, General/*MT; Anesthesia, Inhalation; Comparative Study; Enflurane; Female; Human; Male; Muscle Contraction/*DE; Neuromuscular Blocking Agents/*; Nitrous Oxide; Thiopental; Transducers; Vecuronium/*PD; Visual Perception.
.T
Comparison of visual and measured train-of-four recovery after vecuronium-induced neuromuscular blockade using two anaesthetic techniques.
.P
JOURNAL ARTICLE.
.W
This study evaluated train-of-four recovery after the administration of vecuronium, comparing measured with visually observed responses. Responses to supramaximal stimuli of the ulnar nerves were measured by a force transducer, and compared with visually observed movements of the contralateral thumb. For the 10 patients anaesthetized with nitrous oxide and enflurane, the second, third and fourth twitches visually reappeared at 84 (+/- 10)%, 76 (+/- 11)%, and 70 (+/- 12)% measured blockade, respectively. For the other 10 patients, anaesthetized with a narcotic-barbiturate technique, the second, third and fourth twitches reappeared at 81 (+/- 8)%, 68 (+/- 9)%, and 59 (+/- 11)%. These results were not different for the two anaesthetic techniques.
.A
O'Hara DA; Fragen RJ; Shanks CA.
.I 134
.U
87049471
.S
Br J Anaesth 8703; 58(11):1303-7
.M
Adult; Aged; Anesthesia, General; Cholinesterase Inhibitors/*ME; Female; Galanthamine/BL/*ME/UR; Human; Kinetics; Middle Age.
.T
Pharmacokinetics of galanthamine (a long-acting anticholinesterase drug) in anaesthetized patients.
.P
JOURNAL ARTICLE.
.W
The pharmacokinetics of the long-acting anticholinesterase drug, galanthamine, were investigated in eight patients. After i.v. injection of 0.3 mg kg-1, the decrease in the serum concentration of galanthamine followed a biexponential curve. The serum concentration decreased rapidly from 543 +/- 47 ng ml-1 to 128 +/- 14 ng ml-1 between 2 and 30 min with a T1/2 alpha of 6.42 +/- 2.15 min, and then declined more slowly with a T1/2 beta of 264 +/- 28 min. Total serum clearance of galanthamine amounted to 5.37 +/- 0.87 ml min-1 kg-1, and the renal clearance was 1.36 +/- 0.10 ml min-1 kg-1. The cumulative urinary excretion of galanthamine between 0 and 48 h after injection amounted to 28.0 +/- 5.4% of the administered dose. The biliary excretion of galanthamine during 24 h amounted to 0.2 +/- 0.1% of the dose. There was no evidence of glucuronide or sulphate conjugation of galanthamine.
.A
Westra P; van Thiel MJ; Vermeer GA; Soeterbroek AM; Scaf AH; Claessens HA.
.I 135
.U
87049472
.S
Br J Anaesth 8703; 58(11):1308-16
.M
Anesthesia, General/*; Anesthesia, Spinal/*; Animal; Cardiac Output/DE; Chlormethiazole/*ME/PD; Hemodynamics/*DE; Intestines/BS; Iodohippuric Acid/ME; Liver Circulation/DE; Regional Blood Flow/DE; Renal Circulation/DE; Sheep; Subarachnoid Space.
.T
A sheep preparation for studying interactions between blood flow and drug disposition. VI: Effects of general or subarachnoid anaesthesia on blood flow and chlormethiazole disposition.
.P
JOURNAL ARTICLE.
.W
Blood flow through and chlormethiazole extraction ratios across lungs, liver, kidneys and gut were measured in awake unrestrained sheep (controls) and with the same animals anaesthetized with 1.5% halothane or whilst undergoing high thoracic subarachnoid blockade with amethocaine. In the control-drug studies, chlormethiazole infused to sub-sedative blood concentrations produced no significant changes in haemodynamics or in the kinetics of iodohippurate (renal and hepatic blood flows). Chlormethiazole was eliminated predominantly by the liver (mean extraction ratio and clearance, respectively, 0.90 and 1.3 litre min-1) and lungs (0.15; 0.6 litre min-1). Renal clearance was absent or negligible (greater than 0.1 litre min-1). Because of pulmonary clearance, mean total body clearance was derived from analysis of pulmonary arterial concentrations. Under general anaesthesia, there were significant reductions in mean cardiac output, hepatic and renal blood flow (to 54%, 63% and 43% of control); chlormethiazole mean hepatic extraction ratios and clearance were reduced, respectively, to 82% and 56% of control, and its pulmonary and renal clearances were abolished. With subarachnoid anaesthesia there were no significant changes in haemodynamics or in chlormethiazole extraction ratios or clearances.
.A
Runciman WB; Mather LE; Ilsley AH; Carapetis RJ; Upton RN.
.I 136
.U
87049473
.S
Br J Anaesth 8703; 58(11):1317-20
.M
Adult; Aged; Bronchi/*; Bronchoscopy; Human; Intubation/AE/*MT; Male; Middle Age.
.T
Placement of double-lumen endobronchial tubes. Correlation between clinical impressions and bronchoscopic findings.
.P
JOURNAL ARTICLE.
.W
Double-lumen endobronchial tubes were placed "blindly" in 23 patients undergoing thoracotomy. Clinical criteria suggested satisfactory positioning in all cases; however, subsequent fibreoptic bronchoscopy revealed malposition in 48%. Bronchoscopic findings included the inability to view the bronchial cuff, narrowing of the bronchial lumen of the tube at the level of the cuff and herniation of the cuff over the carina. The potential hazards associated with these findings are discussed.
.A
Smith GB; Hirsch NP; Ehrenwerth J.
.I 137
.U
87049474
.S
Br J Anaesth 8703; 58(11):1321P-1340P
.M
Anesthesia/*; Anesthetics/*; Animal; Human.
.T
Proceedings of the Anaesthetic Research Society. Leeds meeting. April 11-12, 1986. Abstracts.
.P
JOURNAL ARTICLE.
.I 138
.U
87049475
.S
Br J Anaesth 8703; 58(11):1341-2
.M
Animal; Dogs; Human; Respiration, Artificial/*; Respiratory Dead Space/*; Tidal Volume.
.T
Deadspace during high frequency ventilation [letter]
.P
LETTER.
.A
Fletcher R.
.I 139
.U
87049476
.S
Br J Anaesth 8703; 58(11):1342
.M
Atracurium/*AE; Histamine Liberation/*DE; Human.
.T
Histamine liberation with atracurium [letter]
.P
LETTER.
.A
Owen RT.
.I 140
.U
87049477
.S
Br J Anaesth 8703; 58(11):1342-3
.M
Analgesia/*MT; Human; Injections, Spinal; Morphine/*AD; Thoracic Injuries/*TH.
.T
Intrathecal morphine and multiple fractured ribs [letter]
.P
LETTER.
.A
Dickson GR; Sutcliffe AJ.
.I 141
.U
87049478
.S
Br J Anaesth 8703; 58(11):1343
.M
Animal; Atracurium/*AE; Female; Human; Pre-Eclampsia/*ME; Pregnancy; Rabbits; Seizures/CI.
.T
Use of atracurium in pre-eclamptic patients [letter]
.P
LETTER.
.A
Fujita RA; Choi HJ.
.I 142
.U
87049507
.S
Br J Dermatol 8703; 115(4):421-9
.M
Adolescence; Adult; Aged; Calcitonin/BL; Cholecalciferols/*TU; Dihydroxycholecalciferols/BL/TU; Female; Human; Hydroxycholecalciferols/BL/TU; Male; Middle Age; Parathyroid Hormones/BL; Psoriasis/BL/*DT; Support, Non-U.S. Gov't.
.T
An open study of vitamin D3 treatment in psoriasis vulgaris.
.P
JOURNAL ARTICLE.
.W
Active forms of vitamin D3, 1 alpha-hydroxyvitamin D3 and 1 alpha,25-dihydroxyvitamin D3, were administered in an open-design study to 40 patients with psoriasis vulgaris in three ways: to 17 patients 1 alpha-hydroxyvitamin D3 was given orally at a dose of 1.0 micrograms/day for 6 months, to four patients 1 alpha,25-dihydroxyvitamin D3 was given orally at a dose of 0.5 microgram/day for 6 months, and 19 patients were given 1 alpha,25-dihydroxyvitamin D3 applied topically at concentration of 0.5 microgram/g of base for 8 weeks. Improvement was observed at the end of the individual study periods in 13 (76%) patients in Group 1 with a mean period of treatment (+/- SD) of 2.7 +/- 0.6 months, in one patient in Group 2 at 3 months after the start of treatment, and in 16 (84%) patients in Group 3 when the chemical was applied for 3.3 +/- 1.2 weeks. No side-effects were observed in any of these trials. These data suggest that psoriasis may respond to active metabolites of vitamin D3 and that abnormalities in vitamin D metabolism or in responsiveness of the skin cells to active metabolites of vitamin D may be involved in the pathogenesis of this skin disease.
.A
Morimoto S; Yoshikawa K; Kozuka T; Kitano Y; Imanaka S; Fukuo K; Koh E; Kumahara Y.
.I 143
.U
87049508
.S
Br J Dermatol 8703; 115(4):431-3
.M
Adolescence; Adult; Aged; Dihydroxycholecalciferols/*TU; Female; Human; Male; Middle Age; Ointments; Psoriasis/*DT.
.T
Successful treatment of psoriasis with topical application of active vitamin D3 analogue, 1 alpha,24-dihydroxycholecalciferol.
.P
JOURNAL ARTICLE.
.W
We treated 11 psoriatic patients with topical 1 alpha,24-dihydroxycholecalciferol, a new synthetic analogue of active vitamin D3. In 10 of 15 tests the lesions cleared completely within 1-4 weeks, although some relapses occurred shortly after cessation of treatment. There were no side-effects. We suggest that 1 alpha, 24(OH)2D3 merits further investigation as a potentially useful topical therapy for psoriasis.
.A
Kato T; Rokugo M; Terui T; Tagami H.
.I 144
.U
87049509
.S
Br J Dermatol 8703; 115(4):435-45
.M
Antibodies, Fungal/*AN; Antigens, Fungal/*IM; Counterimmunoelectrophoresis; Cross Reactions; Dermatomycoses/*IM; Deuteromycetes/*IM; Human; Hyphomycetes/*IM; Immunoelectrophoresis, Two-Dimensional.
.T
Circulating antibodies and antigenic cross-reactivity in Hendersonula toruloidea and Scytalidium hyalinum infections.
.P
JOURNAL ARTICLE.
.W
Twelve (34%) of thirty-five patients with an active infection on the palms or soles caused by Hendersonula toruloidea or Scytalidium hyalinum were found to have circulating antibodies to these organisms by counter immunoelectrophoresis or immunodiffusion, compared with 9% of uninfected controls. In every instance there was cross-reactivity between the positive patients' sera and the heterologous non-dermatophyte antigen. Using crossed and intermediate gel immunoelectrophoresis it was found that cytoplasmic extracts of H. toruloidea and S. hyalinum showed 34 and 41 precipitin peaks respectively, most of which were shared by both organisms. No cross-reactions were observed between the non-dermatophyte cytoplasmic extracts and hyperimmune animal antisera raised to Trichophyton rubrum, Trichophyton interdigitale, Aspergillus fumigatus or Candida albicans. Exoantigens prepared from the two non-dermatophytes showed similar cross-reactivity between the two species. It appears that H. toruloidea and S. hyalinum are very similar in antigenic structure, a finding which lends support to the view that they may be closely related. They are also antigenically distinct from other pathogenic fungi which commonly infect skin, a fact which may be useful in their cultural identification as well as their recognition in tissue specimens.
.A
Moore MK; Hay RJ.
.I 145
.U
87049511
.S
Br J Dermatol 8703; 115(4):453-66
.M
Administration, Topical; Dose-Response Relationship, Radiation; Erythema/*DT/ET; Human; Indomethacin/*AD/TU; Models, Biological; Skin/RE; Ultraviolet Rays/*AE.
.T
A quantitative study of the effect of topical indomethacin on cutaneous erythema induced by UVB and UVC radiation.
.P
JOURNAL ARTICLE.
.W
The effect of indomethacin gel on UVB and UVC erythema was assessed objectively using a reflectance instrument. When indomethacin was applied immediately after irradiation, UVR (ultraviolet radiation) dose-dependent suppression of erythema was demonstrated for both wavelengths until 36 h after irradiation when both indomethacin and control gel base-treated sites were equally erythematous. Suppression of erythema also occurred when application of indomethacin was delayed until 24 h after irradiation, showing that for both wavelengths prostaglandin synthesis remains increased throughout this period. The degree of suppression at any time, however, was no greater than that achieved by a single application immediately after irradiation, indicating that the eventual equal erythema of indomethacin and gel base-treated sites was not due to tachyphylaxis or inadequate dosage. Construction of dose-response curves for the indomethacin-responsive and indomethacin-unresponsive components of erythema shows that in human skin the difference in erythemal response to UVB and UVC radiation is not due to the formation of different mediators at these wavelengths.
.A
Farr PM; Diffey BL.
.I 146
.U
87049512
.S
Br J Dermatol 8703; 115(4):467-74
.M
Adolescence; Adult; Behavior Therapy/*; Combined Modality Therapy; Dermatitis, Atopic/DT/*TH; Human; Hydrocortisone/TU; Middle Age; Ointments; Pruritus/DT/*TH; Support, Non-U.S. Gov't.
.T
Behavioural treatment of scratching in patients with atopic dermatitis.
.P
JOURNAL ARTICLE.
.W
A behavioural method of habit reversal, in combination with a hydrocortisone cream, was compared with the use of cream alone in the treatment of 17 patients with atopic dermatitis. The patients were assigned randomly to two groups, one of which received the combination treatment and the other regular ointment treatment. The patients' skin status was assessed before and after treatment, and the patients recorded their scratching during the study. Both groups improved, but the group which received habit-reversal therapy improved significantly more. A strong correlation was found between reduction in scratching and improvement in skin status.
.A
Melin L; Frederiksen T; Noren P; Swebilius BG.
.I 147
.U
87049513
.S
Br J Dermatol 8703; 115(4):475-84
.M
Adolescence; Adrenal Cortex Function Tests; Case Report; Child; Child, Preschool; Cosyntropin/DU; Cushing's Syndrome/CI; Dermatitis, Atopic/BL/*ME; Female; Human; Hydrocortisone/BL/*ME; Infant; Male; Seborrhea/BL/*ME; Skin Absorption/*; Support, Non-U.S. Gov't.
.T
Effect of percutaneous absorption of hydrocortisone on adrenocortical responsiveness in infants with severe skin disease.
.P
JOURNAL ARTICLE.
.W
Percutaneous absorption of hydrocortisone was studied in 18 children (aged from 6 weeks to 14 1/2 years) with atopic or seborrhoeic dermatitis, by measuring their serum cortisol before and after application of 1% hydrocortisone cream. Endogenous secretion of cortisol was suppressed with dexamethasone. A 24 h absorption test was performed on nine children. In six, percutaneous absorption was detected. The highest serum cortisol level was reached within the first 6 h. A 4 h absorption test was developed on the basis of the 24 h test. This short absorption test was performed on nine children, and in eight of them absorption of hydrocortisone was detected. The rise of serum cortisol ranged from 98 to 2669 nmol/l. The 2 h ACTH test was performed to evaluate the effect of previous treatment with topical glucocorticoids. Suppressed adrenocortical function was found in five of 13 children, and was associated significantly with high post-application serum cortisol levels. This occurred more often in infants with a severe skin disorder than in older children or in those with mild or moderate skin disease.
.A
Turpeinen M; Salo OP; Leisti S.
.I 148
.U
87049514
.S
Br J Dermatol 8703; 115(4):485-93
.M
Adult; Allergens/*IM; Dermatitis, Atopic/*IM; Human; Immunologic Tests; Male; Mites/*IM; Pruritus/IM; Skin Tests.
.T
Challenge reactions in atopic dermatitis after percutaneous entry of mite antigen.
.P
JOURNAL ARTICLE.
.W
We succeeded in reproducing an eczematous lesion on the apparently normal skin of a patient with atopic dermatitis by scratching and continuous application of an ointment containing ferritin-labelled mite antigen. Percutaneous entry of mite antigen was demonstrated in skin biopsies by Fe-staining. Scratched skin first showed an urticarial reaction typical of type I allergy which later changed into an eczematous reaction typical of type IV allergy. This change was also shown histologically.
.A
Gondo A; Saeki N; Tokuda Y.
.I 149
.U
87049515
.S
Br J Dermatol 8703; 115(4):495-6
.M
Adult; Case Report; Diagnosis, Differential; Female; Human; Neutrophils; Skin Diseases/*DI; Syndrome; Syphilis/*DI.
.T
Secondary syphilis mimicking Sweet's syndrome.
.P
JOURNAL ARTICLE.
.W
We describe a patient with secondary syphilis and facial skin lesions which resembled Sweet's syndrome clinically and histologically. We suggest serological tests for syphilis in patients with Sweet's syndrome.
.A
Jordaan HF; Cilliers J.
.I 150
.U
87049516
.S
Br J Dermatol 8703; 115(4):497-9
.M
Case Report; Child; Ecthyma, Contagious/*CO; Granuloma/*ET/PA; Human; Male; Skin Diseases/*ET/PA.
.T
Giant orf in a normal individual.
.P
JOURNAL ARTICLE.
.A
Pether JV; Guerrier CJ; Jones SM; Adam AE; Kingsbury WN.
.I 151
.U
87049517
.S
Br J Dermatol 8703; 115(4):501-6
.M
Blister/*ET/PA; Burns/*CO/PA; Case Report; Cicatrix/PA; Human; Infant; Male; Microscopy, Electron.
.T
Blisters over burn scars in a child.
.P
JOURNAL ARTICLE.
.W
We present the case of an 11-month-old baby with a burn that healed normally over a month, but subsequently developed successive crops of blisters over the scar. There were no changes in his general condition. Clinical, immunological, histological and ultrastructural studies provided a diagnosis of mechanical dermatitis produced by microtrauma. Electron microscopy studies revealed the sub-epidermal nature of the blisters and the presence of underlying fibrin deposits.
.A
Pedragosa R; Serrano S; Carol-Murillo J; Hernandez JV; Vidal J.
.I 152
.U
87049519
.S
Br J Dermatol 8703; 115(4):514-5
.M
Aged; Case Report; Female; Human; Killer Cells, Natural/*IM; Lymphomatoid Granulomatosis/*IM; Skin Diseases/*IM.
.T
Natural killer cells and lymphomatoid granulomatosis [letter]
.P
LETTER.
.A
Rongioletti F; Bernengo MG; Crovato F; Rebora A.
.I 153
.U
87049520
.S
Br J Dermatol 8703; 115(4):515-6
.M
Anti-Inflammatory Agents, Non-Steroidal/*; Human; Photosensitivity Disorders/*ET; Propionates/*AE; Propionic Acids/*AE.
.T
Persistent phototoxicity after benoxaprofen [letter]
.P
LETTER.
.A
Sneddon IB.
.I 154
.U
87049559
.S
Br J Obstet Gynaecol 8703; 93(11):1121-3
.M
Female; Human; Pregnancy; Propranolol/TU; Puerperal Disorders/*DI; Thyroiditis/*DI/DT; Thyroxine/TU.
.T
Postpartum thyroiditis--an underdiagnosed disease.
.P
JOURNAL ARTICLE.
.A
Ramsay I.
.I 155
.U
87049560
.S
Br J Obstet Gynaecol 8703; 93(11):1124-31
.M
Adolescence; Adult; Colitis, Ulcerative/BL/*CO; Comparative Study; Crohn Disease/BL/*CO; Female; Hemoglobins/AN; Human; Infant, Low Birth Weight; Infant, Newborn; Labor, Induced; Labor, Premature/ET; Pregnancy; Pregnancy Complications/*ET; Retrospective Studies.
.T
The effects of inflammatory bowel disease on pregnancy: a case-controlled retrospective analysis.
.P
JOURNAL ARTICLE.
.W
Retrospective analysis of 82 pregnancies in women with either ulcerative colitis or Crohn's disease suggested that, in general, neither disease had a major effect on pregnancy outcome. The birth-weights of babies born to women with inflammatory bowel disease were marginally lower than those born to women in a control group matched for age and parity, but the difference was statistically significant only in women with Crohn's disease. In both disease groups there was a higher frequency of low haemoglobin levels in pregnancy than in the matched control groups. There were no statistically significant effects of ulcerative colitis or Crohn's disease on duration of pregnancy, mode of delivery or raised blood pressure and/or proteinuria. In the absence of a relapse, a diagnosis of inflammatory bowel disease should not influence obstetric management.
.A
Porter RJ; Stirrat GM.
.I 156
.U
87049561
.S
Br J Obstet Gynaecol 8703; 93(11):1132-5
.M
Comparative Study; Extraction, Obstetrical/*AE/*MT; Female; Human; Infant, Newborn; Infant, Newborn, Diseases/ET; Labor Complications/*TH; Labor Stage, Second; Obstetrical Forceps; Pregnancy; Puerperal Disorders/ET; Retrospective Studies; Vacuum Extraction, Obstetrical/*AE.
.T
Fetal and maternal effects of forceps and vacuum extraction.
.P
JOURNAL ARTICLE.
.A
Punnonen R; Aro P; Kuukankorpi A; Pystynen P.
.I 157
.U
87049563
.S
Br J Obstet Gynaecol 8703; 93(11):1145-9
.M
Amniotic Fluid/AN; Comparative Study; Female; Fetal Blood/AN; Fetal Membranes/AN; Human; Interferon Type I/*AN; Placenta/AN; Pregnancy/BL/*ME; Support, Non-U.S. Gov't.
.T
Alpha interferon in human pregnancy.
.P
JOURNAL ARTICLE.
.W
The concentration of interferon-alpha was measured by a specific two-site immunoradiometric assay in a variety of fluids and tissues collected during human pregnancy. Maternal blood and blood and tissues from non-pregnant adults contained little or no interferon-alpha. Fetal blood, fetal organs, placenta, membranes, amniotic fluid and decidua all contained significant and roughly equivalent amounts ranging from 1.1 to 10 u/ml (or per g of tissue). These findings demonstrate that the fetus and its immediate surroundings are permeated with interferon. It is suggested that this may play a role in regulation of the maternal-fetal graft relation.
.A
Chard T; Craig PH; Menabawey M; Lee C.
.I 158
.U
87049564
.S
Br J Obstet Gynaecol 8703; 93(11):1150-4
.M
Adult; Centrifugation/MT; Comparative Study; Female; Human; Macrophages/MI; Phagocytes/*PH; Phagocytosis/*; Pregnancy/BL/*PH; Staphylococcus epidermidis.
.T
Enhanced phagocytosis of mononuclear phagocytes in pregnancy.
.P
JOURNAL ARTICLE.
.W
The phagocytic activity of peripheral blood mononuclear phagocytes for Staphylococcus epidermis of healthy non-pregnant and pregnant women throughout pregnancy was examined in relation to gestational age. The study included 30 healthy non-pregnant women and 90 healthy pregnant women equally distributed across the three trimesters. Two variables were investigated: the number of mononuclear cells in phagocytosis and the average number of bacteria per monocyte in phagocytosis. As pregnancy progressed a gradual and significant increase was found in the number of monocytes in phagocytosis and a significantly higher proportion of macrophages with six or more bacteria per phagocyte.
.A
Koumandakis E; Koumandaki I; Kaklamani E; Sparos L; Aravantinos D; Trichopoulos D.
.I 159
.U
87049566
.S
Br J Obstet Gynaecol 8703; 93(11):1161-2
.M
Adult; Female; Heparin/TU; Human; Pregnancy; Pregnancy Complications, Cardiovascular/*DI/DT; Pulmonary Embolism/*DI/DT; Warfarin/TU.
.T
An unusual presentation of pulmonary thromboembolism in late pregnancy. Case report.
.P
JOURNAL ARTICLE.
.A
Hussein IY; Critchley HO.
.I 160
.U
87049568
.S
Br J Obstet Gynaecol 8703; 93(11):1166-8
.M
Case Report; Endometrial Hyperplasia/*CO/PA; Female; Hemangioma/*CO/PA; Human; Middle Age; Ovarian Neoplasms/*CO/PA.
.T
Haemangioma of the ovary with associated endometrial hyperplasia. Case report.
.P
JOURNAL ARTICLE.
.A
Grant JW; Millward-Sadler GH.
.I 161
.U
87049569
.S
Br J Obstet Gynaecol 8703; 93(11):1169-70
.M
Adult; Carcinoma, Squamous Cell/PA/*SC; Case Report; Cervix Neoplasms/*PA; Female; Human; Ovarian Neoplasms/PA/*SC.
.T
Ovarian metastasis from stage 1B squamous carcinoma of the cervix. Case report.
.P
JOURNAL ARTICLE.
.A
Cassidy LJ; Kennedy JH.
.I 162
.U
87049570
.S
Br J Obstet Gynaecol 8703; 93(11):1171-5
.M
Aged; Female; Human; Menopause; Ovarian Neoplasms/BL/*PA; Sertoli Cell Tumor/BL/*PA; Steroids/BL.
.T
A feminizing Sertoli-Leydig cell tumour in a postmenopausal woman. Case report.
.P
JOURNAL ARTICLE.
.A
Dhont M; Vandekerckhove F; Praet M; Vanluchene E; Vandekerckhove D.
.I 163
.U
87049571
.S
Br J Obstet Gynaecol 8703; 93(11):1176-80
.M
Adult; Arteritis/*PA; Case Report; Cervix Diseases/*PA; Female; Human; Middle Age; Necrosis.
.T
Isolated arteritis of the uterine cervix. Three case reports.
.P
JOURNAL ARTICLE.
.A
Padwell A.
.I 164
.U
87049572
.S
Br J Obstet Gynaecol 8703; 93(11):1181-6
.M
Adult; Case Report; Female; Human; Hydatidiform Mole/*GE/PA; Karyotyping; Mosaicism; Pregnancy; Uterine Neoplasms/*GE/PA.
.T
Diploid complete hydatidiform mole, mosaic for normally fertilized cells and androgenetic homozygous cells. Case report.
.P
JOURNAL ARTICLE.
.A
Ford JH; Brown JK; Lew WY; Peters GB.
.I 165
.U
87049573
.S
Br J Obstet Gynaecol 8703; 93(11):1187-90
.M
Carcinoma, Mucinous/PA/*SC; Case Report; Cervix Neoplasms/PA/*SC; Female; Gallbladder Neoplasms/*PA; Human; Middle Age.
.T
Carcinoma of the gall bladder metastatic to the cervix. Case report.
.P
JOURNAL ARTICLE.
.A
Hall PA; Lemoine NR; Ryan JF.
.I 166
.U
87049575
.S
Br J Ophthalmol 8703; 70(10):718-23
.M
Convergence, Ocular/*; Electrooculography; Eye Movements/*; Form Perception/*PH; Human; Pattern Recognition, Visual/*PH; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Vergence amplitudes with random-dot stereograms.
.P
JOURNAL ARTICLE.
.W
Random-dot stereograms were found to be capable of producing fusional vergence amplitudes in the absence of monocular contours. These vergence amplitudes are not an artefact of monocular contours provided by the target borders or test instrument and are comparable in range to vergence amplitudes measured clinically with second degree fusion targets in an amblyoscope. We conclude that diplopia of monocularly recognisable contours is not necessary for producing fusional vergence amplitudes.
.A
Archer SM; Miller KK; Helveston EM; Ellis FD.
.I 167
.U
87049576
.S
Br J Ophthalmol 8703; 70(10):724-6
.M
Cataract Extraction/MT; Human; Lens Capsule, Crystalline/SU; Lenses, Intraocular/*; Surgical Instruments/*.
.T
Posterior chamber intraocular lens implantation--a new forceps to simplify capsular bag fixation.
.P
JOURNAL ARTICLE.
.W
The case for capsular bag fixation of the Sinsky-Kratz type of posterior chamber intraocular implant lens is presented, and the various methods in use to position implant lenses are outlined. The new forceps are described and the rationale for their adoption and use is given in an illustrated, step-by-step fashion. Their additional use in anterior chamber intraocular lens implantation is mentioned. There is a brief summary of the author's experience with this instrument.
.A
Bates R.
.I 168
.U
87049579
.S
Br J Ophthalmol 8703; 70(10):737-41
.M
Aged; Cataract Extraction/*; Cornea/PA; Corneal Diseases/*ET/PA; Female; Human; Male; Middle Age; Ultraviolet Rays/*AE; Visual Acuity.
.T
Regression of Labrador keratopathy following cataract extraction.
.P
JOURNAL ARTICLE.
.W
Labrador keratopathy (LK) is an acquired corneal degeneration thought to be caused by chronic exposure to solar irradiation. Reports so far suggest that it is a progressive or at least a stationary condition. There are no detailed reports on recommended therapy. A prospective clinical study was conducted to show regression of LK following extracapsular cataract extraction. Seventeen black patients (26 eyes) with LK and mature cataracts underwent extracapsular cataract extraction. The severity of the LK was recorded photographically pre- and postoperatively. The follow-up ranged from 6 to fifteen months. Twenty-four eyes (92%) showed regression of the LK. The reduction in exposure to ultraviolet light as a result of aphakic photophobia could be one of the factors which have led to the regression of the LK.
.A
Dahan E; Judelson J; Welsh NH.
.I 169
.U
87049581
.S
Br J Ophthalmol 8703; 70(10):748-50
.M
Adolescence; Adult; Athletic Injuries/*EP; England; Eye Injuries/*EP; Eye Protective Devices; Female; Human; Male; Soccer; Tennis.
.T
Sussex Eye Hospital sports injuries.
.P
JOURNAL ARTICLE.
.W
To assess the prevalence of sports eye injuries in our area a register was kept over the 18 months from October 1982 to March 1984. Squash, association football, badminton, and tennis were the main offenders. The severest injury was from a golf ball, involving a fractured zygoma. There was one retinal dialysis, and one lens dislocation requiring extraction. Spectacles were broken in six cases and a contact lens in one. Glass fragments needed operative removal in one case, but there were no penetrating injuries. The value of eye protection, not worn by any of our patients, is emphasised.
.A
Gregory PT.
.I 170
.U
87049584
.S
Br J Ophthalmol 8703; 70(10):764-5
.M
Capillaries/PA; Case Report; Choroid Neoplasms/*BS/PA; Fluorescein Angiography; Human; Male; Melanoma/*BS/PA; Middle Age; Neovascularization/PA; Retinal Vessels/*PA; Support, Non-U.S. Gov't.
.T
Inferences from beading of a retinal vein draining a choroidal melanoma.
.P
JOURNAL ARTICLE.
.W
Beading of a retinal vein draining a choroidal melanoma is reported, showing that the endothelial proliferation producing the beading is a response to some blood borne factor(s) traversing the vein and that retinal capillary non-perfusion adjacent to the beaded vein is not a necessary part of the process.
.A
Johnson RN; Irvine AR; Char DH.
.I 171
.U
87049585
.S
Br J Ophthalmol 8703; 70(10):766-8
.M
Fundus Oculi; Human; Lighting; Photography/*; Retina/*PA; Retinal Vessels/PA.
.T
Photographic recording of slit-lamp appearances of the ocular fundus.
.P
JOURNAL ARTICLE.
.W
The four methods of illumination in the use of slit-lamp biomicroscopy of the anterior segment, described first by Vogt, are equally useful in the posterior part of the eye. Examination of the ocular fundus is more difficult. In particular, photography of the central and peripheral parts of the fundus demands additional technical arrangements if all the appearances of biomicroscopy are to be recorded.
.A
Kenyeres P; Slezak H.
.I 172
.U
87049586
.S
Br J Ophthalmol 8703; 70(10):769-71
.M
Dose-Response Relationship, Radiation; Eyeglasses/*; Human; Lens, Crystalline/RE; Pupil; Retina/RE; Sunlight/*AE; Ultraviolet Rays/AE.
.T
Sunglasses--an ocular hazard?
.P
JOURNAL ARTICLE.
.W
A suggestion that protective eye gear can pose a threat either to the crystalline lens or to the retina is examined from an epidemiological point of view. It is concluded that it may accentuate a pre-existing high-risk hazard but has little significance for low-risk hazards.
.A
Weale RA.
.I 173
.U
87049587
.S
Br J Ophthalmol 8703; 70(10):772-8
.M
Adult; Aneurysm/*PA; Blood Coagulation Tests; Case Report; Diabetic Retinopathy/BL/*PA; Female; Fluorescein Angiography; Hemoglobin A, Glycosylated/AN; Human; Male; Middle Age; Retinal Vessels/*PA.
.T
Retinal cotton-wool spots: an early finding in diabetic retinopathy?
.P
JOURNAL ARTICLE.
.W
Five insulin dependent diabetic patients are reported on who had a few small retinal cotton-wool spots or 'soft exudates' either totally isolated or associated with fewer than 10 microaneurysms. These observations suggest that cotton-wool spots may be an early finding in diabetic retinopathy. Significant biological abnormalities in these patients were high levels of glycosylated haemoglobin and mild increases in thrombin generation, indicating slight activation of the coagulation system. The possible significance of these clinical and biological findings is discussed.
.A
Roy MS; Rick ME; Higgins KE; McCulloch JC.
.I 174
.U
87049588
.S
Br J Ophthalmol 8703; 70(10):779-81
.M
Adult; Case Report; Human; Male; Optic Atrophy/*ET; Plant Poisoning/*; Vision Disorders/ET.
.T
The presumed neurotoxic effects of Catha edulis--an exotic plant now available in the United Kingdom.
.P
JOURNAL ARTICLE.
.W
Bilateral optic atrophy is reported in two patients who, although they were long-standing users of the leaves of Catha edulis, had chewed larger quantities than usual. Since the leaves of this plant are used widely throughout its native area as the source of a mildly stimulant narcotic, the effect in these cases may be an idiosyncratic reaction to an unusually large dose.
.A
Roper JP.
.I 175
.U
87049589
.S
Br J Ophthalmol 8703; 70(10):782-96
.M
Case Report; Child; Child, Preschool; Female; Human; Laurence-Moon-Biedl Syndrome/*PA; Male; Microscopy, Electron; Mitochondria/*UL; Pedigree; Pigment Epithelium of Eye/UL; Retina/*UL; Retinal Degeneration/GE/*PA; Rods and Cones/UL; Support, Non-U.S. Gov't.
.T
Histopathology of mitochondrial cytopathy and the Laurence-Moon-Biedl syndrome.
.P
JOURNAL ARTICLE.
.W
Clinical and histopathological studies of two patients with distinctly different inherited juvenile retinal dystrophies indicate that the ocular defect in mitochondrial cytopathy involves the underlying pigment epithelium, whereas in the Laurence-Moon-Biedl syndrome the photoreceptor cells are primarily affected.
.A
Runge P; Calver D; Marshall J; Taylor D.
.I 176
.U
87050029
.S
Blood 8703; 68(6):1196-200
.M
Antibodies, Monoclonal/*IM; Antibody-Dependent Cell Cytotoxicity; Bone Marrow/*IM/PH; Endothelium/*IM; Fibroblasts/*IM; Hematopoiesis; Human; Stem Cells/IM; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Lysis of human fibroblast colony-forming cells and endothelial cells by monoclonal antibody (6-19) and complement.
.P
JOURNAL ARTICLE.
.W
The murine IgG2a monoclonal antibody 6-19 binds to a wide variety of nonhematopoietic cells including human marrow-derived stromal cells but does not bind to marrow or peripheral blood cells. We studied the effects of this antibody and rabbit complement on marrow cells. Fibroblast colonies were eliminated from light density marrow cells by a single incubation with monoclonal antibody 6-19 and complement. The growth and composition of granulocytic and erythroid colonies were unaffected. Specific complement mediated cytotoxicity of the antibody was confirmed on passaged human fibroblasts derived from marrow (more than 99.6% of fibroblasts are killed by a single treatment). Similar results were obtained with human umbilical cord endothelial cells. In addition, such treatment abolished the initiation of Dexter culture stroma. Incubation of bone marrow cell suspensions with this antibody and complement will allow the study of stroma-free marrow cells in long-term liquid cultures.
.A
Abboud CN; Duerst RE; Frantz CN; Ryan DH; Liesveld JL; Brennan JK.
.I 177
.U
87050030
.S
Blood 8703; 68(6):1201-6
.M
Anemia, Macrocytic/*PA/PP; Animal; Bone Marrow/CY/*PH; Cell Differentiation; Cell Division; Colony-Forming Units Assay; Growth Inhibitors/RE; Growth Substances/PD; Hematopoiesis/*; Mice; Mice, Mutant Strains/*PH; Radiation, Ionizing.
.T
Sl/Sld mouse bone marrow stroma in vitro contains an active radiation-sensitive inhibitor of normal hemopoiesis.
.P
JOURNAL ARTICLE.
.W
Sl/Sld mice have a defective hemopoietic microenvironment. It has been assumed, based upon previous studies, that the primary abnormality in these mice is simply lack of a necessary supportive or inductive material within the hemopoietic stroma. We used in vitro long-term bone marrow cultures to characterize further the nature of the hemopoietic microenvironmental defect in Sl/Sld mice. Sl/Sld mouse bone marrow cells consistently produced less than 10% of the total hemopoietic cells and multipotent and unipotent hemopoietic progenitor cells produced in cultures of marrow from normal, congenic +/+ mice. If fresh Sl/Sld and +/+ marrow cells were mixed prior to establishing long-term marrow cultures, there was a direct correlation between number of Sl/Sld cells added and degree of inhibition of +/+ hemopoiesis. A pre-established, confluent Sl/Sld adherent stromal layer inhibited hemopoiesis by fresh +/+ marrow cells by nearly 70%, as compared with dishes with irradiated +/+ or no stroma. This inhibitory effect was abrogated by irradiation of the Sl/Sld stroma prior to addition of the fresh +/+ marrow cells. Similarly, unirradiated, but not 9 to 200 Gy irradiated Sl/Sld stroma inhibited proliferation of the factor-dependent FDC-P1 hemopoietic progenitor cell line. Thus, the Sl/Sld hemopoietic microenvironment actively inhibits hemopoiesis in vitro, and this inhibition can be at least partially eliminated by irradiation of the Sl/Sld stroma.
.A
Zuckerman KS; Prince CW; Ribadeneira M.
.I 178
.U
87050034
.S
Blood 8703; 68(6):1224-31
.M
Antibodies, Monoclonal/DU; Blood Platelets/DE/*ME; Calcium/PH; Epinephrine/*PD; Fibrinogen/ME; Human; Magnesium/ME; Platelet Aggregation/*/DE; Platelet Membrane Glycoproteins/DE/*ME; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Time Factors.
.T
Expression of fibrinogen receptors during activation and subsequent desensitization of human platelets by epinephrine.
.P
JOURNAL ARTICLE.
.W
Epinephrine causes platelet aggregation and secretion by interacting with alpha 2-adrenergic receptors on the platelet surface. Platelet aggregation requires the binding of fibrinogen to a specific receptor on the membrane glycoprotein IIb-IIIa complex. Although the IIb-IIIa complex is identifiable on the surface of resting platelets, the fibrinogen receptor is expressed only after platelet activation. The current studies were designed to examine the effect of occupancy of platelet alpha 2-adrenergic receptors by epinephrine on the expression of fibrinogen receptors and on the aggregation of platelets. The ability of epinephrine to induce the expression of fibrinogen receptors was studied under two different conditions: acute stimulation (less than 1 min) and prolonged stimulation (50 to 90 min), the latter of which is associated with a reduction or "desensitization" of the platelet aggregation response. Expression of the fibrinogen receptor was monitored with 125I-fibrinogen as well as with 125I-PAC-1 (PAC-1), a monoclonal antibody that binds to the glycoprotein IIb-IIIa complex only after platelets are activated. Epinephrine caused an immediate increase in PAC-1 and fibrinogen binding that was dependent on occupancy of the alpha 2-receptor by epinephrine and on the presence of extracellular free Ca (KCa = 30 mumol/L). By itself, 1 mmol/L Mg was unable to support induction of the fibrinogen receptor by epinephrine. However, it did decrease the Ca requirement by about two orders of magnitude. Prolonged stimulation of unstirred platelets by epinephrine led to a 70% decrease in the aggregation response when the platelets were subsequently stirred. Despite their decreased aggregation response, desensitized platelets bound PAC-1 and fibrinogen normally, indicating that the loss of aggregation was not due simply to a decrease in fibrinogen receptor expression. Although desensitization was not affected by pretreatment of the platelets with aspirin, it was partially prevented when extracellular Ca was chelated by EDTA during the long incubation with epinephrine. These studies demonstrate that once platelet alpha 2-adrenergic receptors are occupied by epinephrine, extracellular Ca is involved in initiating the aggregation response by supporting the induction of the fibrinogen receptor and the binding of fibrinogen. Furthermore. Ca-dependent reactions subsequent to fibrinogen binding may be necessary for maximal platelet aggregation and are impaired when platelets become desensitized to epinephrine.
.A
Shattil SJ; Motulsky HJ; Insel PA; Flaherty L; Brass LF.
.I 179
.U
87050049
.S
Blood 8703; 68(6):1329-32
.M
Cell Membrane/UL; Fetal Blood/PA; Human; Infant, Newborn; Lymphocytes/*PA; Microscopy, Electron, Scanning; Microvilli/UL; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Wiskott-Aldrich Syndrome/DI/*PA.
.T
Morphological abnormalities in the lymphocytes of patients with the Wiskott-Aldrich syndrome.
.P
JOURNAL ARTICLE.
.W
Lymphocytes from 18 patients with the Wiskott-Aldrich Syndrome (WAS) were examined by scanning electron microscopy (SEM). Most peripheral blood lymphocytes from normal individuals are covered with slender microvillus projections, but a large proportion of lymphocytes from WAS patients were found to be relatively devoid of microvilli. A lymphocyte morphology scoring system was developed to quantify the density of microvilli: Grade 4 classified those lymphocytes with greater than 75% of the surface covered with microvilli with progressive decrements to grade 1, which were those without microvilli. The mean lymphocyte morphology score of eight normal individuals was 3.62 +/- .22. The mean lymphocyte score of WAS patients was substantially lower (2.89 +/- .27, P less than .001). In addition, WAS lymphocytes often were qualitatively abnormal, with short, blunted microvilli. These morphological criteria were used to diagnose WAS from the cord blood lymphocytes of one "at-risk" patient. Thus, WAS is the first primary immunodeficiency in which morphological abnormalities have been identified that can aid in diagnosis.
.A
Kenney D; Cairns L; Remold-O'Donnell E; Peterson J; Rosen FS; Parkman R.
.I 180
.U
87050056
.S
Blood 8703; 68(6):1376-83
.M
Erythrocyte Deformability/*; Erythrocyte Membrane/*PH/UL; Erythrocytes/DE; Heinz Bodies/*/UL; Human; Membrane Proteins/BL; Microscopy, Electron; Molecular Weight; Oxidation-Reduction; Phenylhydrazines/PD; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Quantitative relationship between Heinz body formation and red blood cell deformability.
.P
JOURNAL ARTICLE.
.W
The ultimate cause of destruction of red blood cells (RBCs) after oxidative damage with Heinz body formation is not well understood. We correlated the changes in RBC morphology and membrane protein composition after oxidant treatment with the alterations in deformability of whole cells and cell membranes. The incubation of RBCs with phenylhydrazine concentrations of 0.3 to 100 mg/dL at 37 degrees C for one hour led to a dose-dependent formation of Heinz bodies, ranging from isolated Heinz bodies at 1 mg/dL to a confluent coating of the inner membrane surface at 100 mg/dL phenylhydrazine. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed the presence of a large quantity of hemoglobin bound to the ghost membrane of treated RBCs. Electrophoresis with and without dithiothreitol indicated that disulfide bridges are abundant between hemoglobin molecules and are also present among membrane proteins but are not the major bond between hemoglobin and membrane. Changes of spectrin, ankyrin, band 3, and band 6 and the appearance of a 260,000-dalton complex were also observed. With phenylhydrazine concentrations below 30 mg/dL, even in the presence of multiple Heinz bodies, the RBC deformability measured by filtration through 2.6-, 4.5-, and 6.8-microns pores and the membrane deformability determined by a filter aspiration technique were not altered. With 100 mg/dL phenylhydrazine, when the entire membrane was coated with Heinz bodies, RBC filterability and membrane deformability were drastically reduced. These results indicate that oxidative damage of RBCs with discrete Heinz body formation causes focal membrane rigidification but does not affect the global cellular deformability until the Heinz bodies nearly cover the entire cell endoface.
.A
Reinhart WH; Sung LP; Chien S.
.I 181
.U
87050059
.S
Blood 8703; 68(6):1394-7
.M
Consanguinity; Fetal Hemoglobin/GE; Gene Amplification; Globin/*GE; Haplotypes; Homozygote; Human; Pedigree; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Thalassemia/*GE.
.T
Beta zero-thalassemia in association with a gamma-globin gene quadruplication.
.P
JOURNAL ARTICLE.
.W
We have studied the hematology, hemoglobin composition, and globin gene arrangements in one young Turkish boy with a beta zero-thalassemia homozygosity and in 11 of his relatives. Evidence is presented that the chromosome with the beta zero-thalassemia determinant carries a gamma-globin gene quadruplication, perhaps in a -G gamma-G gamma-G gamma-A gamma-gene arrangement. The eight gamma-globin genes in this patient produced G gamma and A gamma chains in a 95 to 5 ratio, and nearly 99% of the patient's hemoglobin was of the fetal type. The clinical condition resembled that of a thalassemia intermedia. HbF levels in eight beta-thalassemia heterozygotes varied between 0.5 and 4.2% and the percentages of G gamma in this HbF averaged at 87% or 95%; this level is to some extent related to the haplotype of the normal chromosome. All subjects carried four alpha-globin genes; a new BglII polymorphism was observed within the psi alpha-globin gene.
.A
Yang KG; Liu JZ; Kutlar F; Kutlar A; Altay C; Gurgey A; Huisman TH.
.I 182
.U
87050061
.S
Blood 8703; 68(6):1402-6
.M
Cell Differentiation/DE; Cell Division/DE; Cell Line; Dimethyl Sulfoxide/PD; Drug Resistance; Granulocytes/*CY; Human; Neuraminidase/ME; Sialic Acids/*PH; Sialoglycoproteins/*PH; Support, U.S. Gov't, P.H.S.; Thioguanine/PD; Tretinoin/PD.
.T
Hyposialylation of differentiation-inducer-resistant HL-60 cells.
.P
JOURNAL ARTICLE.
.W
The total sialic acid concent of retinoic acid (RA)-resistant or 6-thioguanine (6TG)-resistant HL-60 cells was more than tenfold lower and of dimethylsulfoxide (DMSO)-resistant HL-60 cells was approximately twofold lower than that of parental, wild-type (wt) HL-60 cells. Neuraminidase-inaccessible, ie residual cell-associated sialic acid after neuraminidase treatment, was four- to twelvefold lower in the three differentiation-inducer-resistant sublines than in the parent line. Neuraminidase treatment of 125I-labeled surface membrane glycoproteins (SMGs) from wt HL-60 cells converted the two-dimensional gel electrophoretic pattern to one having features in common with RA- and 6TG-resistant cells. However, neuraminidase treatment did not alter the sensitivity of wt HL-60 cells to differentiation induction by RA, hypoxanthine (purine base), or DMSO. These results indicate that differences in peripheral, neuraminidase-accessible sialic acids are important determinants of the gel electrophoretic mobility of the SMGs of the HL-60 line and sublines but are not likely related to the differentiation-resistance mechanism. Further studies are required to determine if hyposialylation of cryptic, neuraminidase-inaccessible sites has functional significance.
.A
Gallagher RE; Giangiulio DA; Chang CS; Glover CJ; Felsted RL.
.I 183
.U
87050062
.S
Blood 8703; 68(6):1407-10
.M
Animal; Blood Proteins/*TO; Cytotoxicity, Immunologic; Drug Synergism; Human; Hydrogen Peroxide/TO; Kinetics; Mice; Neoplasms, Experimental/*IM; Neutrophils/*PH; Rabbits; Species Specificity; Support, U.S. Gov't, Non-P.H.S.; Support, U.S. Gov't, P.H.S..
.T
In vitro tumor cell cytolysis mediated by peptide defensins of human and rabbit granulocytes.
.P
JOURNAL ARTICLE.
.W
We examined the activity of defensins, cysteine-rich cationic peptides that are abundant in the cytoplasmic granules of human and rabbit granulocytes, against various tumor targets. The three human defensins, HNP-1, HNP-2, and HNP-3, lysed human and murine targets in chromium release and dye exclusion assays. Defensin-mediated tumor cell lysis was concentration-dependent, inhibited by serum, and dependent on temperature-sensitive events. Lysis was first detected by three hours of incubation and it reached a plateau between eight and 14 hours. In vitro exposure of murine teratocarcinoma cells to HNP 1-3 abrogated their oncogenicity in vivo. Nonmalignant target cells were also susceptible to defensin-mediated lysis. Four rabbit granulocyte defensins exerted marked (NP-1, NP-2) or moderate (NP-3a, NP-3b) cytotoxic activity, whereas defensin NP-5 was not cytotoxic. When tumor cells were incubated with human defensins in combination with hydrogen peroxide, synergistic cytotoxicity was detected. As defensins are released from granulocytes by various stimuli, their release could contribute to extracellular cytotoxicity which is independent of reactive oxygen intermediates.
.A
Lichtenstein A; Ganz T; Selsted ME; Lehrer RI.
.I 184
.U
87050064
.S
Blood 8703; 68(6):1415
.M
Glycoproteins/*DF; Human; Thrombosis/*GE.
.T
Mode of inheritance of type II protein S deficiency [letter]
.P
LETTER.
.A
Vicente V; Alberca I; Castro M; Lopez Borrasca A.
.I 185
.U
87050065
.S
Blood 8703; 68(6):1415-6
.M
Anemia, Sickle Cell/*BL; Erythrocytes, Abnormal/PH; Hemoglobin, Sickle/*; Hemoglobins; Human; Polymers.
.T
Deoxyhemoglobin S polymer formation in sickle cells [letter]
.P
LETTER.
.A
Schechter AN; Noguchi CT; Rodgers GP.
.I 186
.U
87050482
.S
Br J Rheumatol 8703; 25(4):328-30
.M
Arthritis, Rheumatoid/*EP/ET; Great Britain; Human; Time Factors; United States.
.T
Recent trends in rheumatoid arthritis.
.P
JOURNAL ARTICLE.
.A
Silman AJ.
.I 187
.U
87050485
.S
Br J Rheumatol 8703; 25(4):342-4
.M
Aged; Anti-Inflammatory Agents/*AE/TU; Arthritis, Rheumatoid/*CO/DT; Female; Human; Male; Middle Age; Osteoarthritis/CO/DT; Peptic Ulcer/CI/*ET.
.T
Peptic ulcer in rheumatoid arthritis--intrinsic or related to drug therapy?
.P
JOURNAL ARTICLE.
.W
The reported incidence of peptic ulcer disease (PUD) in patients with rheumatoid arthritis (RA) is higher than that of the general population. Unusual susceptibility to PUD in RA, independent of therapy, has been suggested. To compare RA patients with others who had similar drug exposure but no known predisposition to PUD, 120 patients hospitalized for treatment of severe arthritis (65 with RA, 55 with osteoarthritis) were assessed by questionnaire for PUD history, drug history and other relevant variables. The relationship of PUD to sex distribution, smoking, alcohol consumption and anti-inflammatory therapy followed expected patterns. We found high but similar PUD rates in RA and osteoarthritis (OA) patients (RA 15%, OA 18%). This suggests that a common factor (probably drugs) is responsible. We feel that the documented high incidence of PUD in RA is most probably related to drug therapy. Available methods cannot determine if PUD ever occurs as a primary manifestation of RA.
.A
Malone DE; McCormick PA; Daly L; Jones B; Long A; Bresnihan B; Molony J; O'Donoghue DP.
.I 188
.U
87050490
.S
Br J Rheumatol 8703; 25(4):366-71
.M
Adrenal Cortex Hormones/*TU; Adult; Aged; Arthritis, Rheumatoid/BL/*DT; Female; Human; In Vitro; Leukocyte Count/DE; Male; Middle Age; Monocytes/DE/*ME; Prednisolone/PD; Superoxide/*BL.
.T
Effect of corticosteroid therapy on blood monocyte superoxide generation in rheumatoid arthritis: studies in vitro and ex vivo.
.P
JOURNAL ARTICLE.
.W
Rates of superoxide (SA) generation by blood monocytes stimulated ex vivo were studied before and during corticosteroid treatment of rheumatoid arthritis (RA) patients, in control patients and in healthy controls. The direct effect on stimulated SA production of pre-incubating cells with prednisolone in vitro was also studied. Significant inhibition of monocyte SA output stimulated with IgG-treated zymosan (ITZ) and fluoride ion (F), but not serum-treated zymosan (STZ) was demonstrated following steroid therapy in RA. No inhibitory effect of prednisolone could be demonstrated in vitro, using ITZ, STZ and F as stimuli. Our data on blood monocyte yields, size and cytochemistry suggest that the in vivo effect is due to a shift in blood monocyte traffic.
.A
Bell AL; Hurst NP; Nuki G.
.I 189
.U
87050491
.S
Br J Rheumatol 8703; 25(4):372-5
.M
Actuarial Analysis; Adult; Aged; Aged, 80 and over; Arthritis, Rheumatoid/*DT; Azathioprine/AD/AE/*TU; Comparative Study; Female; Human; Male; Methotrexate/AD/AE/*TU; Middle Age; Support, Non-U.S. Gov't; 6-Mercaptopurine/AD/AE/*TU.
.T
Comparison of methotrexate with azathioprine or 6-mercaptopurine in refractory rheumatoid arthritis: a life-table analysis.
.P
JOURNAL ARTICLE.
.W
Methotrexate (MTX) appears to be useful in patients with rheumatoid arthritis (RA) refractory to other drugs but its long-term toxicity and efficacy are uncertain. A retrospective study of MTX in such patients in comparison with the purine analogues, azathioprine and 6-mercaptopurine was made using life-table analysis. Eighty-four patients took MTX in a median dose of 7.5 mg/week whilst 55 received purine analogues, 100 mg/day (median). By 12 months, 19.3% of patients had ceased MTX due to toxicity, compared with 29.3% for purine analogues. Toxicity severe enough to warrant stopping therapy was uncommon after 8 months with either drug. At 12 months 61.5% of the MTX patients had achieved defined criteria of improvement compared with 25.6% for the purine analogues (p less than 0.05). The number of patients improving on purine analogues did not increase substantially after 6 months, whereas the number improving with MTX continued to 12 months. MTX in a low-dose regimen is useful in refractory RA and superior to low-dose purine analogues.
.A
Sambrook PN; Champion GD; Browne CD; Cohen ML; Compton P; Day RO; de Jager J.
.I 190
.U
87050492
.S
Br J Rheumatol 8703; 25(4):376-9
.M
Azathioprine/AE/TU; Chlorambucil/AE/TU; Connective Tissue Diseases/*DT/GE; Cyclophosphamide/AE/TU; Drug Resistance; Human; Hypoxanthine Phosphoribosyltransferase/*GE; Immunosuppressive Agents/*AE/TU; Lymphocytes/*DE/EN; Mutation/*.
.T
Thioguanine-resistant mutations induced by cytotoxic drugs in lymphocytes of patients with connective tissue diseases.
.P
JOURNAL ARTICLE.
.W
Cells with mutations at the hypoxanthine-guanine phosphoribosyl transferase (HPRT) locus may be detected in vitro by their resistance to the toxic effects of thioguanine. We have assessed HPRT mutants in peripheral blood lymphocytes of patients with connective tissue diseases who have been treated for long periods with cytotoxic drugs. The results from patients treated with cyclophosphamide were abnormal suggesting the presence of drug-induced mutations. The results from patients treated with chlorambucil or azathioprine did not differ from controls--either these drugs have not induced mutations or, more likely, the technique is not sufficiently sensitive to detect them. These possibilities are discussed. Specific mutations induced by cytotoxic drugs in patients with connective tissue diseases have not been previously recorded.
.A
Palmer RG; Smith-Burchnell CA; Dore CJ; Denman AM.
.I 191
.U
87050493
.S
Br J Rheumatol 8703; 25(4):380-3
.M
Antilymphocyte Serum/*TU; Arthritis, Rheumatoid/BL/IM/*TH; Combined Modality Therapy; Hemoglobins/AN; Human; Immunosuppressive Agents/*TU; Leukocyte Count.
.T
Intensive immunosuppression in intractable rheumatoid arthritis.
.P
JOURNAL ARTICLE.
.W
Twelve patients with intractable rheumatoid arthritis were treated with antilymphocyte globulin (ALG), prednisolone and a cytotoxic agent, usually azathioprine, and were followed for 1 year. There was a significant (p less than 0.05) improvement in the mean score for early-morning stiffness, grip strength and the severity of nodules and vasculitis at 6 weeks and 3 months when compared to the initial visit. However, in most patients, this benefit was not sustained despite continued cytotoxic and steroid therapy. A rise in the haemoglobin and fall in ESR was maintained throughout the study period.
.A
Binder AI; So A; Ansell BM; Denman AM.
.I 192
.U
87050495
.S
Br J Rheumatol 8703; 25(4):388-90
.M
Carpal Tunnel Syndrome/*DI; Electrodiagnosis/*; Human; Median Nerve/PP; Neural Conduction.
.T
Clinical tests for carpal tunnel syndrome: an evaluation.
.P
JOURNAL ARTICLE.
.W
Five clinical tests in common use for diagnosis of carpal tunnel syndromes have been shown to have little diagnostic value, either individually or in various combinations. No physical sign is useful in the diagnosis of this condition, which should be suspected on the basis of presenting symptoms and confirmed by electrodiagnosis using standard median nerve conduction tests.
.A
Golding DN; Rose DM; Selvarajah K.
.I 193
.U
87050496
.S
Br J Rheumatol 8703; 25(4):391-2
.M
Aged; Case Report; Female; Hodgkin's Disease/*CO/PA; Human; Joint Diseases/*ET/PA; Knee Joint/*PA; Synovial Membrane/*PA.
.T
Synovial involvement in Hodgkin's disease.
.P
JOURNAL ARTICLE.
.W
We report a case of monoarthropathy in a patient with Hodgkin's disease, due to invasion of the synovium, with apparently normal juxta-articular bone.
.A
Barton A; Hickling P.
.I 194
.U
87050497
.S
Br J Rheumatol 8703; 25(4):393-5
.M
Adult; Arthritis/*ET; Case Report; Cystic Fibrosis/*CO; Human; Male; Vasculitis/ET.
.T
Episodic arthritis in cystic fibrosis: a case report.
.P
JOURNAL ARTICLE.
.W
Episodic arthritis is an uncommon manifestation of cystic fibrosis. We describe the case of a 21-year-old man with cystic fibrosis who suffered from episodic arthritis associated with vasculitic skin lesions. Aetiology is discussed with reference to the possible role of immune complex disease.
.A
Summers GD; Webley M.
.I 195
.U
87050498
.S
Br J Rheumatol 8703; 25(4):396-8
.M
Case Report; Celiac Disease/*CO; Fingers/*RA; Human; Male; Middle Age; Scleroderma, Systemic/*CO/RA.
.T
Sclerodactyly complicating coeliac disease.
.P
JOURNAL ARTICLE.
.A
Zammit-Maempel I; Adamson AR; Halsey JP.
.I 196
.U
87050501
.S
Br J Rheumatol 8703; 25(4):412-3
.M
Carpal Tunnel Syndrome/*ET/PP; Diabetes Mellitus/CO/*DI; Glucose Tolerance Test; Human.
.T
An assessment of glucose tolerance in patients with idiopathic carpal tunnel syndrome [letter]
.P
LETTER.
.A
Pal B; Mangion P; Hossain MA.
.I 197
.U
87050502
.S
Br J Rheumatol 8703; 25(4):413-4
.M
Anti-Inflammatory Agents, Non-Steroidal/*AE/TU; Arthritis, Rheumatoid/*DT; Gastroscopy; Human; Stomach Ulcer/*CI.
.T
Gastric ulceration and NSAIDs in RA [letter]
.P
LETTER.
.A
Collins AJ; Davies J; Dixon AS.
.I 198
.U
87050503
.S
Br J Rheumatol 8703; 25(4):414-5
.M
Adult; Arthritis, Infectious/*ET; Case Report; Coagulase/AN; Human; Male; Middle Age; Staphylococcal Infections/*DI; Staphylococcus epidermidis/EN.
.T
Coagulase-negative Staphylococcus as a cause of joint infection [letter]
.P
LETTER.
.A
Morris IM; Mattingly PC; Gostelow BE.
.I 199
.U
87050505
.S
Br J Rheumatol 8703; 25(4):415-6
.M
Arthritis, Rheumatoid/*PP; Human; Pain Measurement/*MT.
.T
Agreement between horizontal and vertical visual analogue scales [letter]
.P
LETTER.
.A
Dixon JS.
.I 200
.U
87050506
.S
Br J Rheumatol 8703; 25(4):416-7
.M
Adult; Aged; Arthritis, Rheumatoid/*TH; Braces/*; Equipment Design; Female; Human; Knee Joint/*; Male; Middle Age; Osteoarthritis/*TH.
.T
TVS brace in patients with rheumatoid arthritis or osteoarthritis of the knee [letter]
.P
LETTER.
.A
Jawad AS; Goodwill CJ.
.I 201
.U
87050507
.S
Br J Rheumatol 8703; 25(4):417-8
.M
Adenocarcinoma/*RT; Case Report; Human; Male; Middle Age; Prostatic Neoplasms/*RT; Radiation Injuries/*; Reiter's Disease/*ET.
.T
Reiter's syndrome after radiotherapy for prostatic carcinoma [letter]
.P
LETTER.
.A
Stevens H; Hickling P; Tyrrell CJ; Hammonds JC.
.I 202
.U
87050508
.S
Br J Rheumatol 8703; 25(4):418
.M
Arthritis, Rheumatoid/*ET; Colitis, Ulcerative/CO; Crohn Disease/CO; Human; Intestinal Diseases/*CO; Lipodystrophy, Intestinal/CO.
.T
Preliminary evidence of gut involvement in the pathogenesis of rheumatoid arthritis? [letter]
.P
LETTER.
.A
Haslock I.
.I 203
.U
87050509
.S
Br J Rheumatol 8703; 25(4):419-20
.M
Arthritis, Rheumatoid/*MI; Clostridium Perfringens/*IP; Feces/*MI; Female; Human; Male; Support, Non-U.S. Gov't.
.T
Clostridium perfringens and rheumatoid arthritis [letter]
.P
LETTER.
.A
Struthers GR.
.I 204
.U
87050594
.S
Br J Urol 8703; 58(5):479-83
.M
Adult; Aged; Citrates/UR; Female; Glycosaminoglycans/UR; Human; Hydrogen-Ion Concentration; Magnesium/UR; Male; Middle Age; Recurrence; Support, Non-U.S. Gov't; Urinary Calculi/*UR; Zinc/UR.
.T
Inhibitors of urinary stone formation in 40 recurrent stone formers.
.P
JOURNAL ARTICLE.
.W
The excretion of four inhibitors of urinary stone formation (zinc, magnesium, citrates and glycosaminoglycans (GAG) was studied in 20 normal controls and 40 recurrent calcium stone formers who were placed on a fixed diet restricted in calcium, oxalates and purines. We were unable to show any abnormality in the excretion of Zn, Mg or GAG. In 11 patients, a low level of urinary citrate was a significant feature that was associated in most cases with a urinary pH value above 6. Citrate concentration (per litre) and output (per 24 h) were found to be lower than in the controls in 19 and 33% respectively of the determinations. The overall ratio of average urinary citrate concentration in patients and controls was 0.56, a figure in agreement with previous data.
.A
Francois B; Cahen R; Pascal B.
.I 205
.U
87050596
.S
Br J Urol 8703; 58(5):488-93
.M
Adult; Case Report; Child, Preschool; Colon/PA; Colonic Diseases/*CO/PA; Female; Human; Intestinal Fistula/*CO/PA; Kidney/PA; Kidney Diseases/*CO/PA; Male; Middle Age; Pyelonephritis, Xanthogranulomatous/*CO/PA; Urinary Fistula/*CO/PA.
.T
Fistula and sinus formation in xanthogranulomatous pyelonephritis. A clinicopathological review and report of four cases.
.P
JOURNAL ARTICLE.
.W
Fistula or deep sinus formation as a complication of xanthogranulomatous pyelonephritis (XPN) has not been described previously in the British literature. We present the clinicopathological features of one case of a nephrodiaphragmatic sinus complicating XPN, and three cases of nephrocolic fistula, including the first recorded case of fistula in childhood XPN. The detailed clinical, radiological and pathological features of XPN and its complications are reviewed. Total nephrectomy, together with primary excision of sinuses or fistulae, is the treatment of choice.
.A
Parsons MA; Harris SC; Grainger RG; Ross B; Smith JA; Williams JL.
.I 206
.U
87050597
.S
Br J Urol 8703; 58(5):494-8
.M
Aged; Carcinoma, Squamous Cell/PA/SC; Case Report; Female; Human; Kidney Neoplasms/PA/RA/*SC; Lung Neoplasms/*PA; Male; Middle Age; Tomography, X-Ray Computed.
.T
Renal metastases from carcinoma of the lung.
.P
JOURNAL ARTICLE.
.W
Five cases of clinically manifest solitary and bilateral renal lesions metastatic from the lung are presented. These cases are unusual in that renal metastases are usually silent lesions discovered at autopsy. Review of the autopsy data from this hospital identified renal metastases in 19% of patients who died from carcinoma of the lung. This incidence parallels that of other series. A solid renal lesion which is identified in a patient with a history of pulmonary carcinoma should raise the suspicion of renal metastases, especially if computed tomography of the mass demonstrates relative homogeneity and minimal enhancement. More frequent use of the abdominal CT scan in staging patients with lung cancer will render metastatic carcinoma from lung to kidney a more frequent ante mortem diagnosis.
.A
Becker WE; Schellhammer PF.
.I 207
.U
87050598
.S
Br J Urol 8703; 58(5):499-503
.M
Adult; Aged; Endoscopy; Female; Human; Male; Middle Age; Ureter; Ureteral Calculi/RA/*TH.
.T
Rigid ureteroscopy for the treatment of ureteric calculi: experience in 120 cases.
.P
JOURNAL ARTICLE.
.W
Over a 1-year period, rigid ureteroscopy has been used to retrieve ureteric calculi in 120 patients. The technical details, causes of failure and the complications are described. An initial success rate of 78% was obtained. It was concluded that ureteroscopy should replace blind procedures for the extraction of ureteric stones.
.A
el-Kappany H; Gaballah MA; Ghoneim MA.
.I 208
.U
87050599
.S
Br J Urol 8703; 58(5):504-6
.M
Adolescence; Bladder, Neurogenic/*CO; Child; Child, Preschool; Endoscopy; Female; Human; Infant; Male; Polytetrafluoroethylene/AD; Vesico-Ureteral Reflux/ET/RA/*TH.
.T
Endoscopic correction of vesicoureteric reflux secondary to neuropathic bladder.
.P
JOURNAL ARTICLE.
.W
Eleven patients with vesicoureteric reflux secondary to neuropathic bladder were treated by endoscopic injection of pyrolised polytetrafluoroethylene (Polytef) paste. Thirteen of the 15 ureters treated showed disappearance of reflux after one injection. The amount of Polytef paste injected varied from 0.2 to 0.9 ml (mean 0.45 ml). There were no complications, except in one ureter where distension of the collecting system was slightly increased compared with the pre-operative urogram.
.A
Puri P; Guiney EJ.
.I 209
.U
87050600
.S
Br J Urol 8703; 58(5):507-13
.M
Animal; Bladder/*DE; Cyproheptadine/PD; Dose-Response Relationship, Drug; Female; Human; In Vitro; Ketanserin/PD; Methysergide/PD; Muscle Contraction/DE; Muscle, Smooth/*DE; Serotonin/*PD; Serotonin Antagonists/PD; Support, Non-U.S. Gov't; Swine; Urethra/*DE.
.T
Influence of serotonin on lower urinary tract smooth muscle in vitro.
.P
JOURNAL ARTICLE.
.W
The influence of serotonin (5-hydroxytryptamine) on human detrusor and on pig detrusor, trigone, bladder neck and urethral smooth muscle was explored in a series of in vitro experiments. Serotonin evoked a dose-dependent and reversible contraction of the detrusor. The reverse response was triggered in trigone, bladder neck and urethral smooth muscle--a dose-dependent and reversible relaxation. The maximum amplitude of this relaxation was 85 +/- 15% of the relaxation produced by electrical nerve stimulation. The effect of serotonin was unaltered by blockade of ganglia, alpha- and beta-adrenergic receptors, cholinergic receptors and prostaglandin synthesis. The serotonin antagonists ketanserin, methysergide and cyproheptadine partly inhibited the effect of serotonin. The antagonism differed in potency on strips of different origin. The antagonists were ineffective or minimally effective in blocking responses to nerve stimulation. The effect of serotonin was probably mediated by specific serotonin receptors different from the serotonin-S2-receptors predominating in vascular smooth muscle. Serotonin is a potential neurotransmitter in lower urinary tract smooth muscle, but its importance in micturition physiology and pathophysiology is unknown.
.A
Klarskov P; Horby-Petersen J.
.I 210
.U
87050601
.S
Br J Urol 8703; 58(5):514-9
.M
Adult; Bladder/PP; Female; Human; Middle Age; Pressure; Urethra/PP; Urinary Incontinence/DT/*PP/SU; Urination; Urodynamics/*.
.T
The pressure-volume plot and prediction of treatment outcome in female incontinence.
.P
JOURNAL ARTICLE.
.W
A graphic representation of the micturition cycle by a pressure-volume plot has been obtained in 120 women, both incontinent patients and normal controls. The pattern of contraction during voiding allowed prediction of the outcome of treatment. Patients with urethral sphincter incompetence and a sustained detrusor contraction had a good result from colposuspension even if detrusor instability was found during filling. Where the urethral sphincter was competent, patients with urge incontinence with or without detrusor instability during filling cystometry had a good response to drugs, providing a sustained detrusor contraction was present during voiding. Urethral sphincter incompetence was characterised by a low detrusor voiding pressure.
.A
Wheelahan JB.
.I 211
.U
87050604
.S
Br J Urol 8703; 58(5):526-7
.M
Adolescence; Adult; Aged; Aged, 80 and over; Female; Follow-Up Studies; Hematuria/*ET; Human; Male; Middle Age; Time Factors.
.T
A 5-year follow-up of undiagnosed haematuria.
.P
JOURNAL ARTICLE.
.W
Eighty-four patients with haematuria were seen during 1976 and 1977. This symptom was investigated but no definite cause could be found. Five or more years later they were followed up. Although some patients had experienced further urological symptoms, none was found to have developed a malignancy in the genito-urinary tract. Possible causes of their bleeding are discussed.
.A
Appleton GV; Lutchman GD; Charlton CA.
.I 212
.U
87050605
.S
Br J Urol 8703; 58(5):528-33
.M
Cardiovascular Diseases/MO; Comparative Study; Estradiol/*AA/AE/TU; Estrogens, Synthetic/*TU; Ethinyl Estradiol/TU; Follow-Up Studies; Human; Male; Neoplasm Metastasis; Orchiectomy/*; Prognosis; Prostatic Neoplasms/*DT/MO/SU.
.T
Comparison of primary orchiectomy with oestrogen therapy in advanced prostatic cancer. A 2-year follow-up report of a national, prospective prostatic cancer study.
.P
JOURNAL ARTICLE.
.W
Two hundred and seventy-seven patients with advanced prostatic cancer were treated by either orchiectomy or oestrogen. During the 2-year follow-up period, the response to treatment was considered more favourable in the oestrogen group, and this response was particularly emphasised in patients with poorly differentiated tumour and metastases at the time of diagnosis. Further evaluations included the cardiovascular side effects of oestrogen therapy.
.A
Haapiainen R; Rannikko S; Alfthan O.
.I 213
.U
87050610
.S
Br J Urol 8703; 58(5):551-2
.M
Adolescence; Adult; Follow-Up Studies; Human; Male; Middle Age; Penile Erection; Penis/*IN/SU.
.T
Fracture of the penis and long-term results of surgical treatment.
.P
JOURNAL ARTICLE.
.W
Twenty-five patients with fracture of the penis were treated surgically between 1968 and 1984. Long-term follow-up was obtained in 17. In no case were there any early post-operative complications. All patients stated that they were achieving normal, painless erections; two patients developed a slight penile curvature but this did not affect their sexual activities. We strongly recommend early surgical intervention because of these encouraging results. Urethral injury associated with the fracture did not occur in this series.
.A
Ozen HA; Erkan I; Alkibay T; Kendi S; Remzi D.
.I 214
.U
87050612
.S
Br J Urol 8703; 58(5):557
.M
Aged; Case Report; Human; Male; Neoplasm Recurrence, Local/SU; Penile Neoplasms/*SU; Sarcoma, Kaposi's/*SU.
.T
Kaposi's sarcoma of penis.
.P
JOURNAL ARTICLE.
.A
Maiche AG; Holsti P; Grohn P; Wasenius VM.
.I 215
.U
87050613
.S
Br J Urol 8703; 58(5):558
.M
Aged; Case Report; Fistula/*ET; Human; Male; Polycythemia Vera/*CO; Postoperative Complications/*; Prostatectomy/*; Prostatic Diseases/*ET; Skin Diseases/*ET; Thigh; Urinary Fistula/*ET.
.T
Prostatocutaneous urinary fistula to the thigh after retropubic prostatectomy in a patient with polycythaemia rubra vera.
.P
JOURNAL ARTICLE.
.A
Snooks SJ; Dharmasena F; Mitchell TJ; Crisp JC.
.I 216
.U
87050614
.S
Br J Urol 8703; 58(5):558-9
.M
Adult; Case Report; Human; Hydronephrosis/*CO/RA; Kidney/*AB; Male.
.T
Giant hydronephrosis in a pelvic kidney.
.P
JOURNAL ARTICLE.
.A
McGlinchey J; Walsh A.
.I 217
.U
87050615
.S
Br J Urol 8703; 58(5):559-60
.M
Adenocarcinoma/*DI; Case Report; Endometriosis/*DI; Human; Male; Middle Age; Prostatic Neoplasms/*DI.
.T
Endometrioid carcinoma of the prostatic utricle.
.P
JOURNAL ARTICLE.
.A
Gillatt DA; O'Reilly PH; Reeve NL.
.I 218
.U
87050616
.S
Br J Urol 8703; 58(5):560-1
.M
Adolescence; Case Report; Cysts/SU; Epididymis/*SU; Human; Male; Spermatic Cord Torsion/*SU.
.T
Torsion of a large epididymal mass.
.P
JOURNAL ARTICLE.
.A
Hedelin H; Eddeland A; Johansson S; Mark J.
.I 219
.U
87050617
.S
Br J Urol 8703; 58(5):561-3
.M
Adrenal Gland Neoplasms/BS/RA/*SC; Case Report; Female; Human; Kidney Neoplasms/*SU; Middle Age; Nephrectomy; Postoperative Complications/RA; Renal Artery/RA.
.T
Bilateral adrenal metastases from renal carcinoma treated surgically with prolonged survival.
.P
JOURNAL ARTICLE.
.A
Fox M; Grant JB; Grainger RG.
.I 220
.U
87050618
.S
Br J Urol 8703; 58(5):563
.M
Aged; Bladder/*SU; Case Report; Female; Human; Reoperation; Time Factors; Urinary Diversion/*.
.T
Rehabilitation of bladder after 32 years of suprapubic cystostomy.
.P
JOURNAL ARTICLE.
.A
Pawar HN; Davenport TJ.
.I 221
.U
87050619
.S
Br J Urol 8703; 58(5):564-5
.M
Adult; Case Report; Human; Male; Ureter/*AB/RA.
.T
Inverted Y ureter in the male.
.P
JOURNAL ARTICLE.
.A
Harrison GS; Williams RE.
.I 222
.U
87050620
.S
Br J Urol 8703; 58(5):565-6
.M
Case Report; Genital Neoplasms, Male/*PA; Human; Lymphoma/*PA; Male; Middle Age; Spermatic Cord/*PA.
.T
Primary lymphoma of the spermatic cord.
.P
JOURNAL ARTICLE.
.A
Hautzer NW; Nikolai V.
.I 223
.U
87050621
.S
Br J Urol 8703; 58(5):566
.M
Actinomycosis/*CO; Adult; Case Report; Human; Kidney/*AB; Kidney Diseases/*CO; Male.
.T
Primary renal actinomycosis in the presence of horseshoe kidney.
.P
JOURNAL ARTICLE.
.A
McGibney D; Clarke PB.
.I 224
.U
87050622
.S
Br J Urol 8703; 58(5):567
.M
Case Report; Female; Human; Intervertebral Disk Displacement/SU; Intraoperative Complications; Laminectomy/*AE; Middle Age; Ureter/*IN.
.T
An unusual ureteric injury.
.P
JOURNAL ARTICLE.
.A
Defay P; L'Hermite J; Wiederkehr P; Raul P; Guillemin P.
.I 225
.U
87050623
.S
Br J Urol 8703; 58(5):568-9
.M
Human; Urinary Catheterization/*MT.
.T
A new method for changing suprapubic catheters.
.P
JOURNAL ARTICLE.
.A
Hamilton JB.
.I 226
.U
87050681
.S
Br Med J (Clin Res Ed) 8703; 293(6557):1293-5
.M
Acquired Immunodeficiency Syndrome/EP; Communicable Diseases/*EP; Great Britain; Human; Lyme Disease/EP; Meningitis, Meningococcal/EP/PC; Rabies/EP/PC; Salmonella Infections/EP/PC.
.T
Report from the PHLS Communicable Disease Surveillance Centre. Public Health Laboratory Service [published erratum appears in Br Med J (Clin Res Ed) 1986 Nov 22;293(6558):1356]
.P
JOURNAL ARTICLE.
.I 227
.U
87050700
.S
Brain 8703; 109 ( Pt 5):1043-58
.M
Adult; Child; Electromyography; Female; Human; Male; Middle Age; Movement/*; Muscle Spasticity/*PP; Muscles/PP; Reflex, Abnormal/PP; Reflex, Stretch/*; Support, U.S. Gov't, Non-P.H.S.; Support, U.S. Gov't, P.H.S..
.T
Movement deficits caused by hyperexcitable stretch reflexes in spastic humans.
.P
JOURNAL ARTICLE.
.W
Spastic patients were instructed to make accurate, rapid ankle dorsiflexion and plantarflexion movements over different distances to a target. Ankle position and surface electromyograms (EMGs) from tibialis anterior (TA) and soleus (SOL) muscles were recorded. In 3 of 8 spastic patients tested, dorsiflexion evoked velocity-dependent activation of the antagonist (SOL) muscle which impeded the movement to the extent that the limb unintentionally reversed movement direction. We propose that this activation is reflex in origin since it is tightly synchronized, has a large peak amplitude, occurs about 50 ms after the initiation of the movement, and is velocity dependent. One of the 3 patients who had reflex-induced antagonist activation in dorsiflexion also demonstrated sustained clonus during plantarflexion. This usually occurred only if the target had been overshot so that the return of the limb stretched the soleus muscle and triggered clonus. We conclude that in some patients, hyperactive stretch reflexes cause movement deficits.
.A
Corcos DM; Gottlieb GL; Penn RD; Myklebust B; Agarwal GC.
.I 228
.U
87050701
.S
Brain 8703; 109 ( Pt 5):805-43
.M
Animal; Corpus Striatum/*PH; Dopamine/PH; Female; Forelimb/*PH; Methamphetamine/PD; Motor Cortex/*PH; Psychomotor Performance/*PH; Rats; Rats, Inbred Strains; Stereotyped Behavior/DE; Substantia Nigra/*PH; Support, Non-U.S. Gov't.
.T
The contributions of motor cortex, nigrostriatal dopamine and caudate-putamen to skilled forelimb use in the rat.
.P
JOURNAL ARTICLE.
.W
Skilled forelimb use was studied in rats with unilateral lesions of the sensorimotor cortex, the caudate-putamen, or the dopaminergic nigrostriatal bundle, in a task involving reaching for food. Limb preference and efficiency were evaluated, as well as the relationship between limb use, spontaneous, and methamphetamine-induced rotation bias, both preoperatively and postoperatively. To induce use of the nonpreferred limb, a bracelet, which prevented reaching but not other movements, was attached to the forearm of the preferred forelimb. Whereas small cortical lesions of the forepaw area of the sensorimotor cortex mildly influenced limb preference and use, larger lesions changed preference. Furthermore, medium-sized sensorimotor cortex lesions impaired contralateral limb use, although surprising recovery occurred on the forced tests with the bracelet. Large cortical lesions abolished effective reaching even on the forced tests. Impairments similar to those following sensorimotor cortex lesions were also obtained following small and large caudate-putamen lesions. By contrast, unilateral dopamine depletions not only blocked use of the limb contralateral to the depletion but also impaired use of the ipsilateral limb. There was recovery in use of the ipsilateral forelimb but not the contralateral forelimb. Correlational analysis showed a weak relation between methamphetamine-induced rotation and limb preference preoperatively but no significant relation between these two variables postoperatively. The similarity in the deficits following sensorimotor cortex lesions and basal ganglia lesions suggests that skilled forelimb use depends upon a shared neural organization within the two systems.
.A
Whishaw IQ; O'Connor WT; Dunnett SB.
.I 229
.U
87050702
.S
Brain 8703; 109 ( Pt 5):845-83
.M
Adult; Aged; Aged, 80 and over; Cognition/PH; Corpus Striatum/PH; Female; Frontal Lobe/*PP; Human; Laterality/PH; Male; Memory/PH; Mental Processes/*PH; Middle Age; Neuropsychological Tests; Parkinson Disease/*PP; Psychomotor Performance; Support, Non-U.S. Gov't.
.T
Frontal lobe dysfunction in Parkinson's disease. The cortical focus of neostriatal outflow.
.P
JOURNAL ARTICLE.
.W
This study investigates the hypothesis that, as a consequence of Parkinson's disease, disturbed caudate outflow will lead to deficits in cognitive functions dependent upon the integrity of the prefrontal cortex, the cortical focus of caudatofugal signals. Since Parkinson's disease also involves lesions in extra-striatal midbrain cells which reduce the extrinsic supply of dopamine to this cortical region, such functions are at double risk. Forty nondemented parkinsonian patients were drawn from a pool of 100 consecutive patients and matched with 40 normal control subjects according to age, education, IQ, and sex. All patients were quantitatively rated on neurological indices of disease. Neuropsychological assessment of the patient and normal groups included tests of general intelligence, psychomotor skills, memory, visuospatial and executive functions. No global cognitive decline was observed in the parkinsonian group. Moreover, memory and visuospatial abilities were generally intact. A small cluster of deficits emerged, interpreted as reflecting impairment in the ability to spontaneously generate efficient strategies when relying on self-directed task-specific planning. In addition, several tests thought to be sensitive to frontal lobe function distinguished patients with symptoms strongly lateralized to the right versus left side of the body. Deficits in strategic planning were later investigated in relation to severity of disease and to patient attributes including IQ and age, both of which were relevant to performance on specific tasks. Results were compared with previous investigations in parkinsonian patients and discussed from the perspective of both animal and human studies involving damage to the cerebral cortex and basal ganglia. As the prefrontal cortex is thought to play a crucial role in self-directed behavioural planning, the validity of an outflow model in predicting the consequences of caudate nucleus dysfunction was supported.
.A
Taylor AE; Saint-Cyr JA; Lang AE.
.I 230
.U
87050703
.S
Brain 8703; 109 ( Pt 5):885-96
.M
Animal; Axoplasmic Flow/*DE; Doxorubicin/*PD; Fucose/ME; Male; Methionine/ME; Neurons, Afferent/DE; Peripheral Nerves/*DE; Rats; Rats, Inbred Strains; Sciatic Nerve/DE; Support, Non-U.S. Gov't.
.T
The effect of doxorubicin on slow and fast components of the axonal transport system in rats.
.P
JOURNAL ARTICLE.
.W
The study was designed to investigate the changes in axonal transport that result from disturbances in protein synthesis. Doxorubicin, an antineoplastic drug which interferes with the function of DNA, has a selective effect on peripheral sensory nerves because of the high vascular permeability in the dorsal root ganglia. After the intravenous administration of a moderate dose (4 mg/kg) to male Wistar rats, the transport of slow component a (SCa) was found to be retarded, transport velocity being decreased by 17% (0.85 +/- 0.06 mm/day vs 1.03 +/- 0.06 mm/day in controls). The transport kinetics of the fast anterograde and retrograde components (aFC and rFC) were unchanged after the administration of a dose of 6 mg/kg, although the relative amount of aFC was decreased by 27% (3.2 +/- 0.9% vs 4.4 +/- 1.1% in controls). It is suggested that the neuronopathy induced by doxorubicin is mediated by changes in axonal transport.
.A
Sidenius P.
.I 231
.U
87050705
.S
Brain 8703; 109 ( Pt 5):915-38
.M
Adolescence; Adult; Aged; Case Report; Central Nervous System Diseases/ET; Creatine Kinase/BL; Eye Diseases/ET; Female; Human; Lactates/BL; Male; Middle Age; Mitochondria, Muscle/*ME; Muscular Diseases/*CL/CO/GE; Neurologic Examination; Succinate Dehydrogenase/ME; Support, Non-U.S. Gov't; Tomography, X-Ray Computed.
.T
The clinical features of mitochondrial myopathy.
.P
JOURNAL ARTICLE.
.W
The clinical features of 66 patients with histologically defined mitochondrial myopathy are described. The age of onset of symptoms ranged from birth to 68 years, but was before 20 years in 61%. Nineteen patients had similarly affected relatives. Three groups of cases could be identified clinically: a combination of progressive external ophthalmoplegia and weakness of the limbs induced or increased by exertion (55%); such limb weakness alone (18%); and those with clinical features, such as ataxia, dementia, deafness, involuntary movements and seizures, predominantly or exclusively arising from the CNS (27%). There was considerable overlap between these groups, and pigmentary retinopathy, present in 36% of patients, occurred in all three. At a mean disease duration of twenty years, 9 patients (all from Group 3) were severely disabled but 42 were still able to work. In vitro studies of mitochondrial metabolism, performed in 33 cases, most commonly showed deficiencies of the mitochondrial respiratory chain localized to complex I (18 patients) or complex III (9). No typical clinical picture emerged for any of the identifiable biochemical defects.
.A
Petty RK; Harding AE; Morgan-Hughes JA.
.I 232
.U
87050706
.S
Brain 8703; 109 ( Pt 5):939-52
.M
Aged; Aged, 80 and over; Amyotrophic Lateral Sclerosis/*PA; Anterior Horn Cells/*PA; Cell Count; Female; Human; Image Processing, Computer-Assisted/MT; Male; Middle Age; Motor Neurons/*PA; Spinal Cord/PA; Support, Non-U.S. Gov't.
.T
Focal loss of anterior horn cells in the cervical cord in motor neuron disease.
.P
JOURNAL ARTICLE.
.W
In a three-dimensional study of the distribution of anterior horn cells in the C8 segment of the human spinal cord we have recognized lateral and medial zones of motor neuron groupings, but have not been able to recognize subgroups of neurons within these groupings resembling the anatomical columns described by earlier investigators. This observation does not invalidate the concept of functional groupings within these anterior horn cell pools. In studies of the same segment in cords obtained at autopsy from patients with motor neuron disease, zones of focal loss of motor neurons were identified, without consistent severity or distribution at different sectional levels. These findings imply varying resistance to the disease in different pools of motor neurons.
.A
Swash M; Leader M; Brown A; Swettenham KW.
.I 233
.U
87050707
.S
Brain 8703; 109 ( Pt 5):953-67
.M
Adolescence; Brain/PP; Case Report; Child; Corpus Callosum/PP/*SU; Female; Human; Male; Motor Skills/*PH; Neural Pathways/PP; Neurologic Examination; Neuropsychological Tests; Seizures/SU; Stereognosis/PH; Support, Non-U.S. Gov't; Touch/*PH.
.T
Effects of early and late transection of the corpus callosum in children. A study of tactile and tactuomotor transfer and integration.
.P
JOURNAL ARTICLE.
.W
Five children, aged 6 to 16 years, were tested for unilateral discrimination and interhemispheric transfer of tactile information as well as tactuomotor learning at various intervals before and after therapeutic callosotomy. Comparison of preoperative and postoperative capacities revealed that younger children are considerably less affected by the interruption of callosal transmission than older children. Bilateral organization of speech and participation of the anterior commissure can largely be excluded as possible compensatory mechanisms. The most plausible explanation for the excellent preservation of interhemispheric integration of tactile functions in the younger patients appears to be continued reliance on ipsilateral pathways. The relatively greater deficits observed in the older children, on the other hand, suggest that sensorimotor functions come to depend more extensively on contralateral pathways as the corpus callosum reaches functional maturity.
.A
Lassonde M; Sauerwein H; Geoffroy G; Decarie M.
.I 234
.U
87050708
.S
Brain 8703; 109 ( Pt 5):969-85
.M
Adult; Antibodies, Viral/AN; Environment; Female; Human; Leukocyte Count; Longitudinal Studies; Male; Middle Age; Multiple Sclerosis/*GE/IM; Suppressor Cells/*.
.T
Suppressor T cells in family members of patients with multiple sclerosis.
.P
JOURNAL ARTICLE.
.W
Previous serial measurements of lymphocyte subpopulations in individuals with multiple sclerosis (MS) have demonstrated periodic reductions in the number of OKT8 positive (T8+) cells. In this longitudinal study, involving twice monthly samples from each participant and carried out in two phases lasting at least six and three months respectively, we have confirmed that fluctuations in T8+ cells occur in patients with MS and also found a significant reduction in this lymphocyte subpopulation in patients' spouses but not their siblings, compared with unrelated controls. The changes observed in spouses were related in time to those occurring in patients on 10/13 occasions from 5/9 families; no temporal relationship occurred in the remainder. Taking two or more low T8+ values as significant, 12/13 patients, 7/9 spouses, 6/13 siblings and 4/13 controls (chi 2 = 12.5; P less than 0.01) were abnormal at some stage. Our results provide indirect evidence for the role of environmental factors in determining certain immunological abnormalities present in patients with MS and illustrate the role of family studies in determining the specificity of these changes to the disease.
.A
Hughes PJ; Kirk PF; Compston DA.
.I 235
.U
87050709
.S
Brain 8703; 109 ( Pt 5):987-1002
.M
Female; Human; Male; Middle Age; Parkinson Disease/*PP; Psychomotor Performance; Reaction Time; Space Perception/*PH; Support, Non-U.S. Gov't.
.T
Visuospatial function in Parkinson's disease.
.P
JOURNAL ARTICLE.
.W
Previous research on visuospatial function in Parkinson's disease is reviewed. The present experiment was designed to test two fundamental aspects of spatial ability, namely right-left discrimination and the manipulation of those concepts in different spatial perspectives. Measures of accuracy and reaction time were taken. The performance of patients with Parkinson's disease did not differ from that of normal subjects in the spatial components of the task. Neither a review of the literature, nor the results of the present study, give support to the idea of a generalized visuospatial deficit in Parkinson's disease.
.A
Brown RG; Marsden CD.
.I 236
.U
87050917
.S
Burns Incl Therm Inj 8703; 12(7):457-60
.M
Animal; Burns, Inhalation/*ME; Dextrans/DU; DTPA/DU; Extracellular Space/*ME; Lung/*ME; Rabbits; Technetium/DU.
.T
Early detection of extravascular lung water in an inhalation injury animal model [published erratum appears in Burns Incl Therm Inj 1987 Feb;13(1):82]
.P
JOURNAL ARTICLE.
.W
A rabbit inhalation injury model using a dual tracer radioactive isotope technique (Rowland et al., 1986), has been utilized with small- and medium-sized molecular weight tracers. There is oedema formation at 2 h after smoke inhalation or fluid resuscitation and especially with the combination of inhalation injury and fluid resuscitation [corrected]. This oedema appears to have decreased by 24 h post-injury. There does not appear to be any difference between the small- and medium-sized tracers in the transit times of tracer in the lung vascular compartment. The increases in extravascular water volume have been confirmed by gravimetric analyses of the lungs. Thus the pulmonary oedema in the rabbit animal model is detectable within 2 h post-injury, with a return towards normal values some time within 24 h if fluid challenged for short periods. Fluid resuscitation exacerbates the amount of oedema that developed. The onset of pulmonary oedema may therefore be earlier than previously seen clinically, and fluid resuscitation modifications may be of benefit in smoke inhalation injury.
.A
Stewart RJ; Yamaguchi KT; Rowland RR; Santibanez AS; Rahimian J.
.I 237
.U
87050918
.S
Burns Incl Therm Inj 8703; 12(7):461-4
.M
Animal; Burns/*PP; Cytochromes/ME; Male; Mitochondria, Liver/EN/*PH; Oxidative Phosphorylation; Rats; Rats, Inbred Strains; Succinate Dehydrogenase/ME.
.T
Functional changes in rat-liver mitochondria during the early phase of burn injury.
.P
JOURNAL ARTICLE.
.W
Using succinate as a substrate, the respiratory control ratios of liver mitochondria from burned male Sprague-Dawley rats with full skin thickness burns covering 20 per cent of the body surface area were increased at 15, 30, 45 and 60 min after burn, the peak being at 30 min post-burn. A sham group acted as control. In comparison with the sham group, the specific activity of succinic dehydrogenase was slightly decreased and the activities of cytochromes b and c + c were decreased significantly 30 min after burning. All the results suggest a lack of increased metabolic activity during the early phase of burn injury.
.A
Wang XM; Chen KM; Wang Y; Shi SP.
.I 238
.U
87050919
.S
Burns Incl Therm Inj 8703; 12(7):465-9
.M
Axilla/*; Burns/*CO; Contracture/CL/ET/*SU; Human; Neck/*; Surgical Flaps.
.T
Burn contracture of the neck-axillary region.
.P
JOURNAL ARTICLE.
.A
Leung PC; Cheng JC; Ma GF.
.I 239
.U
87050920
.S
Burns Incl Therm Inj 8703; 12(7):470-4
.M
Adult; Burns/*SU; Case Report; Cicatrix/*; Female; Human; Male; Surgical Flaps/*.
.T
Use of scarred flaps and secondary flaps for reconstructive surgery of extensive burns.
.P
JOURNAL ARTICLE.
.W
We report the usefulness of scar flaps and secondary flaps in the surgical repair of extensively burned patients. Burn scar contractures repaired with scarred axial pattern flaps, scarred musculocutaneous flaps and scarred fasciocutaneous flaps are described. However, it is our contention that their application should be strictly limited. An example of the use of scarred secondary axial pattern and musculocutaneous flaps for reconstruction of a burned ear is shown.
.A
Hyakusoku H; Okubo M; Suenobu J; Fumiiri M.
.I 240
.U
87050921
.S
Burns Incl Therm Inj 8703; 12(7):475-8
.M
Bacterial Infections/IM; Burns/*IM; Female; Human; Male; Rosette Formation/*.
.T
Evaluation of E and EAC rosette-forming cells in patients with thermal injuries.
.P
JOURNAL ARTICLE.
.W
Thermal injuries lead to changes in both the cell-mediated and humoral responses of the patient. This study was undertaken to assess these responses in the post-burn period and also to see if bacterial infection altered these responses. It has been concluded that alterations in the cell-mediated and humoral immune responses following thermal injuries are altered by infection and consequently are also important in the healing process.
.A
Priya D; Keswani RK; Singh V; Saini AS.
.I 241
.U
87050922
.S
Burns Incl Therm Inj 8703; 12(7):479-83
.M
Adult; Burns/*PX; Child; Counseling/*MT; Female; Human; Male; Parents/*PX.
.T
A multidisciplinary group approach to counselling the parents of burned children.
.P
JOURNAL ARTICLE.
.W
This study has shown that a multidisciplinary group approach to counselling parents of burned children will decrease parental anxiety, and that medical, psychological and social problems will feature primarily in group discussions.
.A
Rivlin E; Forshaw A; Polowyj G; Woodruff B.
.I 242
.U
87050923
.S
Burns Incl Therm Inj 8703; 12(7):484-90
.M
Accidents, Occupational/*; Adult; Australia; Burns/*EP; Burns, Chemical/EP; Eye Burns/EP; Female; Human; Male.
.T
Epidemiology of industrial burns in Brisbane.
.P
JOURNAL ARTICLE.
.W
A retrospective epidemiological study of industrial burns admitted to the Royal Brisbane Hospital was conducted over a period of 7 years. A total of 182 patients were included in this survey--173 males (95 per cent) and 9 females (5 per cent). The proportion of industrial burns has decreased from 31.5 per cent to 18.5 per cent of total admissions to the burns unit over the past 10 years. Fifty per cent of the burns occurred in males less than 30 years old. The average age was 31 years. Two-thirds of the burns covered less than 10 per cent of the body and 84 per cent covered less than 20 per cent. While scalds were the commonest cause of industrial burns in our study (19.4 per cent), flame burns with clothing ignited caused the most extensive burns. Face and hands were the most common sites involved. Burns to these regions were mainly caused by flame and electrical burns. Eye burns comprised 5.5 per cent of the sample and were due to chemicals, gas explosions and electric flash. Twenty-six patients (14 per cent) suffered respiratory injury. Only one patient out of our series of 182 died. Progress has been made in industrial safety in the past few years but carelessness and human error still take their toll.
.A
Pegg SP; Miller PM; Sticklen EJ; Storie WJ.
.I 243
.U
87050924
.S
Burns Incl Therm Inj 8703; 12(7):491-5
.M
Accidents, Home; Burns/*EP; Denmark; Female; Fires; Human; Male.
.T
Epidemiology of severe burn injuries.
.P
JOURNAL ARTICLE.
.W
The epidemiology of severe burns is analysed. From 1 September 1982 to 31 August 1983 75 patients, 27 females and 48 males were admitted to the Burns Unit in Copenhagen. The majority of burns were domestic and fire was the predominant cause. The most vulnerable areas were the arms and the legs, and small children still have the highest incidence of thermal injury. As predisposing factors were of significance in several accidents, the importance of further prevention is stressed.
.A
Lyngdorf P.
.I 244
.U
87050925
.S
Burns Incl Therm Inj 8703; 12(7):496-501
.M
Animal; Electric Injuries/*ET/MO; Human; Lightning/*; Mice; Rats; Rats, Inbred Strains; Support, Non-U.S. Gov't.
.T
Lightning injury caused by discharges accompanying flashovers--a clinical and experimental study of death and survival.
.P
JOURNAL ARTICLE.
.W
During the 17 years preceding March 1985, 140 patients sustained lightning injuries caused by 44 thunderbolts. Fifty patients showed evidence of current flow through their bodies. These 50 victims were classified into two groups, the first consisting of 9 victims who showed rupture of their clothes or linear superficial dermal burns along their whole bodies from head to feet, indicating the occurrence of surface flashovers. The remaining 41 patients showed no evidence of this flash effect. It is noteworthy that in the first group 5 of the 9 survived, whereas in the second group only 6 among 41 survived. The result indicates that when a flashover occurs along the whole body, the probability of survival is higher than 50 per cent. The conditions which determine death or survival were investigated experimentally, imposing artificial lightning voltage impulses on rats and developing flashovers on them. The rats survived when the voltage drop caused by flashover occurred immediately after the peak point, and the current waveform exhibited a sharp peak. In contrast, the rats were killed when the voltage drop caused by flashover was delayed by more than 20 microseconds, and the current waveform showed a blunt cone shape. It has been concluded that a fast flashover appreciably diminishes the energy dissipation within the body and consequently results in survival.
.A
Ohashi M; Kitagawa N; Ishikawa T.
.I 245
.U
87050926
.S
Burns Incl Therm Inj 8703; 12(7):502-4
.M
Adult; Burns/*CO; Calcinosis/*ET; Case Report; Human; Male; Skin Diseases/*ET; Time Factors.
.T
Calcinosis cutis--a rare late complication of burns.
.P
JOURNAL ARTICLE.
.W
Pillars of calcification are rarely found in the skin. An interesting case is described where rows of new bone developed in the skin which had been grafted 31 years previously to cover partial skin thickness burns of the shin. The problems of heterotropic ossification are discussed.
.A
Heim M; Blankstein A; Friedman B; Horoszowski H.
.I 246
.U
87050927
.S
Burns Incl Therm Inj 8703; 12(7):505-7
.M
Adult; Bladder Fistula/*ET; Case Report; Electric Injuries/*CO; Human; Intestinal Fistula/*ET; Intestine, Small/*; Male.
.T
Abdominal visceral perforation secondary to electrical injury: case report and review of the literature.
.P
JOURNAL ARTICLE.
.W
A patient with a vesico-enteric fistula was successfully treated with resection of the small intestine and dome of the bladder and drainage of the intervening abscess. A search of the literature reveals this to be a very unusual complication of high-voltage electrical injury.
.A
Miller FE; Peterson D; Miller J.
.I 247
.U
87050930
.S
Burns Incl Therm Inj 8703; 12(7):521-5
.M
Burns/*RH; Hand Injuries/*RH; Human; Occupational Therapy/*; Play and Playthings/*.
.T
The use of games in occupational therapy of hand burns.
.P
JOURNAL ARTICLE.
.W
The need for active range of motion in hand burns is obvious and through adapted games the patient's interest is aroused and provides an incentive for active participation in his/her therapeutic programme. All the games are for individual players, on different intellectual levels, and provide different active ranges of motion: for fingers, wrist, elbow and shoulder. Most of the games were made by a former patient, now retired, copied from games in the collection of the occupational therapist, and some of the games are of Israeli idea and manufacture. All the games can be gas autoclaved and therefore be used from patient to patient. The games also provide a much needed outlet for intellectual stimuli and distraction from the burns unit and all it signifies.
.A
van Straten O.
.I 248
.U
87051060
.S
Can J Ophthalmol 8703; 21(6):216-24
.M
Anterior Eye Segment/RE; Choroid/RE; Eye/*RE; Human; Light/*AE; Pigment Epithelium of Eye/RE; Retina/RE; Vitreous Body/RE.
.T
The potential damaging effects of light on the eye (Part I).
.P
JOURNAL ARTICLE.
.W
The electromagnetic spectrum consists of radiant energy that is classified according to specific wavelengths. Man is constantly exposed to a portion of the electromagnetic spectrum, particularly to radiation in the ultraviolet, visible and infrared regions. The tissues of the eye and skin are particularly sensitive to the non-ionizing wavelengths of radiant energy. Although both tissues possess endogenous protective mechanisms to minimize the effects of such exposure, problems still occur due to the absorption of radiation. The cornea, lens and retina have been shown to be susceptible to damage from light in the ultraviolet, visible and infrared range. Part I of this two-part article examines the structures of the eye that are most susceptible to light damage; part II, which will be published in the next issue of the Journal, focuses on eye protection.
.A
Jordan DR.
.I 249
.U
87051061
.S
Can J Ophthalmol 8703; 21(6):225-6
.M
Equipment Design; Human; Irrigation/IS; Suction/*IS; Support, Non-U.S. Gov't; Vitrectomy/*IS.
.T
A new variable suction system with finger-tip control.
.P
JOURNAL ARTICLE.
.W
We have developed a variable suction system for irrigation, aspiration and vitrectomy. The system is regulated by the operator's finger-tip.
.A
Peyman GA; Diamond J.
.I 250
.U
87051062
.S
Can J Ophthalmol 8703; 21(6):227-30
.M
Abducens Nerve/*; Adolescence; Adult; Aged; Case Report; Child; Cranial Nerve Diseases/SU; Evaluation Studies; Human; Middle Age; Oculomotor Muscles/*SU; Oculomotor Nerve/*; Paralysis/*SU.
.T
Supramaximal horizontal rectus surgery in the management of third and sixth nerve palsy.
.P
JOURNAL ARTICLE.
.W
Supramaximal medial and lateral rectus surgery was performed to correct horizontal deviations in seven cases of sixth nerve palsy and three cases of third nerve palsy, with satisfactory results in most cases. The advantages and disadvantages of such procedures are discussed.
.A
Kattleman B; Flanders M; Wise J.
.I 251
.U
87051063
.S
Can J Ophthalmol 8703; 21(6):231-5
.M
Adult; Brain Neoplasms/*CO/PP/RA; Case Report; Female; Human; Male; Middle Age; Nerve Fibers/PP; Tomography, X-Ray Computed; Vision Disorders/*ET; Visual Acuity; Visual Fields/*.
.T
Nerve fibre bundle visual field defects and intracranial mass lesions.
.P
JOURNAL ARTICLE.
.W
Nerve fibre bundle visual field defects are the hallmark of pathology at the optic nerve head or retina. In the present series, six eyes of four patients with large intracranial mass lesions demonstrated such field defects with visual acuity spared in three of the involved eyes. In no cases did visual function in the opposite eye offer a clue to the localization of the lesion.
.A
Hupp SL; Savino PJ; Schatz NJ; Sergott RC; Bosley TM.
.I 252
.U
87051064
.S
Can J Ophthalmol 8703; 21(6):236-41
.M
Carbamazepine/TU; Case Report; Fasciculation/DT/PP/*SU; Female; Follow-Up Studies; Human; Middle Age; Oculomotor Muscles/*.
.T
Superior oblique myokymia: when treatment is necessary.
.P
JOURNAL ARTICLE.
.W
A 56-year-old woman presented with a 10-year history of torsional diplopia and right monocular oscillopsia. These symptoms, which had been intermittent at first, continued practically uninterrupted during the last 2 years. She was diagnosed as having superior oblique myokymia of the right eye. Adequate trials of oral carbamazepine, baclofen and phenytoin were unsuccessful in suppressing her symptoms. One year after her initial presentation, she underwent a right superior oblique tenectomy and a right inferior oblique recession. She eventually required a second operation on her other eye to cure her of an annoying diplopia on down-gaze.
.A
Staudenmaier C.
.I 253
.U
87051065
.S
Can J Ophthalmol 8703; 21(6):242-5
.M
Case Report; Cellular Inclusions/UL; Cytoplasm/UL; Female; Human; Lymphoma/*PA/RA/UL; Microscopy, Electron; Middle Age; Orbital Neoplasms/*PA/RA/UL.
.T
Signet-ring cell lymphoma in the orbit: a case report and review.
.P
JOURNAL ARTICLE.
.W
The authors report on the first case of signet-ring cell lymphoma involving the orbit. This variant of non-Hodgkin's lymphoma contains either vacuolated or eosinophilic cytoplasmic inclusions that squeeze the nucleus to one side of the cell. In this case, the inclusions were eosinophilic and stained positively for PAS, immunoglobulin M (IgM) heavy chain and kappa light chain. Electron microscopy showed granular electron-dense material trapped within distended loops of rough endoplasmic reticulum. Twenty-two cases of signet-ring cell lymphoma previously reported elsewhere in the body are reviewed, and their clinical significance is discussed.
.A
Dolman PJ; Rootman J; Quenville NF.
.I 254
.U
87051142
.S
Can Med Assoc J 8703; 135(11):1248
.M
Accidents, Traffic/*PC; Automobile Driving/*; Canada; Human; Lighting/*.
.T
Daytime vehicle lights [letter]
.P
LETTER.
.A
Frizzell JB.
.I 255
.U
87051143
.S
Can Med Assoc J 8703; 135(11):1250
.M
Human; Nicotinic Acids/*; Nomenclature.
.T
"Vitamin B3" [letter]
.P
LETTER.
.A
Hoffer A.
.I 256
.U
87051144
.S
Can Med Assoc J 8703; 135(11):1251-2
.M
Adult; Aged; Burns/*ET; Child; Child, Preschool; Heat/*; Human; Legionnaires' Disease/*PC; Risk; Water Supply/*.
.T
Balancing the risks: Legionella pneumophila pneumonia and tap water scalds in the home [editorial]
.P
EDITORIAL.
.A
Stanwick RS.
.I 257
.U
87051145
.S
Can Med Assoc J 8703; 135(11):1254-6
.M
Aerospace Medicine/*; Canada; Human; Legislation, Medical/*; Physician-Patient Relations/*.
.T
Aeronautics Act and the doctor-patient relationship.
.P
JOURNAL ARTICLE.
.A
Johnson DG.
.I 258
.U
87051146
.S
Can Med Assoc J 8703; 135(11):1257-9
.M
Canada; Female; Genetic Screening/*; Human; Human Rights/*; Infant, Newborn; Legislation, Medical/*; Pregnancy; Quebec; Truth Disclosure/*.
.T
Genetic information and the law: constraints, liability and rights.
.P
JOURNAL ARTICLE.
.A
Knoppers BM.
.I 259
.U
87051150
.S
Can Med Assoc J 8703; 135(11):1278-81
.M
Acute Disease; Adult; Aged; Aged, 80 and over; Allopurinol/*AE; Anti-Inflammatory Agents, Non-Steroidal/*AE; Antibiotics/*AE; Cephaloridine/AE; Cimetidine/*AE; Female; Fenoprofen/AE; Human; Indomethacin/AE; Kidney/PA; Male; Middle Age; Nephritis, Interstitial/*CI/DI/PA; Penicillins/AE.
.T
Drug-induced acute interstitial nephritis: report of 10 cases.
.P
JOURNAL ARTICLE.
.W
Between January 1979 and June 1985, 10 patients with acute allergic interstitial nephritis were seen in a clinical nephrology service at a large regional hospital. The onset of renal failure was temporally related to the use of a drug: a nonsteroidal anti-inflammatory agent (NSAID) (in four patients), cimetidine (in three), antibiotics (in two) or allopurinol (in one). The onset of renal failure was acute in three patients and insidious in seven. Two patients also exhibited marked proteinuria. Clinical features such as fever, rash, hematuria, pyuria with or without eosinophiluria, and mild to marked proteinuria had led to suspicion of the disease. The diagnosis was confirmed by renal biopsy findings of inflammatory cells, predominantly lymphocytes, plasma cells and eosinophils. Three patients required hemodialysis; two of them received steroids as well. Steroid therapy was also used in two patients with NSAID-induced proteinuria. Renal function improved in nine patients by 35 days, but one patient continued to have slow but progressive deterioration of renal function. Acute interstitial nephritis can be distinguished from other forms of acute renal failure by heavy renal uptake of gallium 67, maximal 48 hours or more after injection. The improvement in renal function after discontinuation of the implicated drug, the characteristic histopathological findings of allergic interstitial nephritis, and the presence of eosinophils and sometimes IgE in the blood suggest a hypersensitivity reaction.
.A
Handa SP.
.I 260
.U
87051152
.S
Can Med Assoc J 8703; 135(11):1286
.M
British Columbia; Cacao/*PO; Child, Preschool; Disease Outbreaks/*EP; Female; Human; Plants, Edible; Salmonella/*IP; Salmonella Food Poisoning/*EP/ET.
.T
Salmonella nima in British Columbia.
.P
JOURNAL ARTICLE.
.I 261
.U
87051153
.S
Can Med Assoc J 8703; 135(11):1287
.M
Adult; Canada; Child; Human; Influenza/PC; Influenza Vaccine/*AD; Orthomyxovirus Type A, Human/IM; Vaccination/*.
.T
Supplementary statement on influenza vaccination in 1986-87.
.P
JOURNAL ARTICLE.
.I 262
.U
87051154
.S
Can Med Assoc J 8703; 135(11):1299, 1301
.M
Canada; Human; Physicians/*SD; Schools, Medical/*.
.T
Medical school cutbacks would be unfair to young Canadians, conference told.
.P
JOURNAL ARTICLE.
.A
Sullivan P.
.I 263
.U
87051155
.S
Can Med Assoc J 8703; 135(11):1305-8
.M
Human; Physicians/*; Prisoners/*; Torture/*.
.T
Doctors and torture: a tortuous issue.
.P
JOURNAL ARTICLE.
.A
Gilmore A.
.I 264
.U
87051156
.S
Can Med Assoc J 8703; 135(12):1336
.M
Philosophy, Medical/*.
.T
Philosophy of medicine [letter]
.P
LETTER.
.I 265
.U
87051157
.S
Can Med Assoc J 8703; 135(12):1336-7
.M
Amniocentesis; Chorionic Villi/AN; Ethics, Medical/*; Female; Human; Pregnancy; Pregnancy Trimester, First; Prenatal Diagnosis/*.
.T
First-trimester fetal diagnosis: prudential ethics [letter]
.P
LETTER.
.A
Bennett MJ.
.I 266
.U
87051158
.S
Can Med Assoc J 8703; 135(12):1337, 1340
.M
Aged/*; Aged, 80 and over; Angina Pectoris/*DI; Electrocardiography; Exercise Test; Human.
.T
"Silent angina" in the elderly [letter]
.P
LETTER.
.A
Cohen G.
.I 267
.U
87051159
.S
Can Med Assoc J 8703; 135(12):1340-1
.M
Canada; Female; Human; Jurisprudence/*; Premenstrual Syndrome/*PX; Violence.
.T
Legal implications of premenstrual syndrome: a Canadian perspective [letter]
.P
LETTER.
.A
Robinson GE.
.I 268
.U
87051160
.S
Can Med Assoc J 8703; 135(12):1343-4
.M
Acute Disease; Anesthesia, Inhalation/*AE; Hepatitis, Toxic/*ET; Human; Isoflurane/*AE.
.T
Acute hepatitis after isoflurane anesthesia [letter]
.P
LETTER.
.A
Webster JA.
.I 269
.U
87051161
.S
Can Med Assoc J 8703; 135(12):1345-6
.M
Accidents, Traffic/*; Adolescence; Adult; Athletic Injuries/ET; Canada; Child; Human; Transportation/*.
.T
The dangers of off-road vehicles to young drivers [editorial]
.P
EDITORIAL.
.A
Wiley JJ.
.I 270
.U
87051162
.S
Can Med Assoc J 8703; 135(12):1347-9
.M
Academic Medical Centers/*EC; Canada; Fund Raising; National Health Programs; Research Support.
.T
It's time to put universities first.
.P
JOURNAL ARTICLE.
.A
Osmond DH.
.I 271
.U
87051163
.S
Can Med Assoc J 8703; 135(12):1351-2
.M
Aerosols; Child; Human; Infant; Paramyxovirus Infections/*DT; Respiratory Syncytial Viruses; Respiratory Tract Infections/*DT; Ribavirin/AD/AE/*TU; Ribonucleosides/*TU.
.T
Ribavirin: indications for use in pediatrics. Infectious Diseases and Immunization Committee, Canadian Paediatric Society.
.P
JOURNAL ARTICLE.
.I 272
.U
87051165
.S
Can Med Assoc J 8703; 135(12):1361-3
.M
Adolescence; Adult; Aged; Female; Follow-Up Studies; Human; Interview, Psychological; Male; Middle Age; Motivation/*; Ontario; Paraquat/PO; Suicide/EP; Suicide, Attempted/*PX; Time Factors.
.T
Changing motivation in severely suicidal patients.
.P
JOURNAL ARTICLE.
.W
While the ambiguity of suicidal patients' stated motivations has been studied in some detail, less attention has been given to the changeability of their motivations. Twenty-six patients who had taken an overdose of paraquat, a highly lethal herbicide, were questioned about their motivation at the time of admission and 24 hours and 3, 7 and 10 days later. Although 25 patients claimed that they wished to die at the time of admission, all of the 14 surviving patients wished to live at the time of discharge from hospital. Of the 12 patients who died, 6 stated that they no longer wished to die in the last interview before their death. During the following year 3 of the 14 surviving patients killed themselves. The findings emphasize the importance of thoroughly assessing all aspects of the suicidal patient's situation in determining risks. The patient's stated intentions should be but one factor considered.
.A
Wright N; Adam KS.
.I 273
.U
87051166
.S
Can Med Assoc J 8703; 135(12):1365-6
.M
Accidents, Traffic/*; Adolescence; Athletic Injuries/*ET; Child; Child, Preschool; Fractures/ET; Human; Male; Seasons; Transportation/*.
.T
Injuries associated with off-road vehicles among children.
.P
JOURNAL ARTICLE.
.W
Off-road vehicles have attained growing popularity, expanding markets and increasing rates of associated injury, especially among young people. In 1984-85, 148 patients were treated at the Children's Hospital of Eastern Ontario, Ottawa, for injuries suffered in off-road vehicle accidents. The average age of the patients was 14 years. Soft-tissue injuries occurred in 33 patients, 21 of whom had severe injuries. There were 179 fractures in 133 patients. One patient died as a result of his injuries. The most common mechanism of injury was losing control of and tumbling from the machine. Seventeen patients were struck by their own vehicles, and 39 collided with objects such as cars, trees or people. The health care costs of these accidents are no less serious than the concerns for the appropriate legislation to protect consumers, particularly the young.
.A
Wiley JJ; McIntyre WM; Mercier P.
.I 274
.U
87051167
.S
Can Med Assoc J 8703; 135(12):1369-72
.M
Acute Disease; Adult; Animal; Bites and Stings/*CO; Case Report; Cats; Emergencies; Female; Fetal Death/ET; Human; Pasteurella Infections/*TM; Pregnancy; Pregnancy Complications, Infectious/*ET; Septicemia/*ET; Zoonoses/TM.
.T
Pasteurella multocida septicemia during pregnancy.
.P
JOURNAL ARTICLE.
.A
Rasaiah B; Otero JG; Russell IJ; Butler-Jones DA; Prescott JF; West MM; Maxwell BE; Beaver J.
.I 275
.U
87051168
.S
Can Med Assoc J 8703; 135(12):1372
.M
Adult; Blood Coagulation Tests/*; Case Report; Drug Interactions; Female; Human; Partial Thromboplastin Time/*; Prothrombin Time/*; Trazodone/*AE; Warfarin/ME.
.T
Reduction of prothrombin and partial thromboplastin times with trazodone.
.P
JOURNAL ARTICLE.
.A
Hardy JL; Sirois A.
.I 276
.U
87051169
.S
Can Med Assoc J 8703; 135(12):1373
.M
Case Report; Female; Human; Infant; Ovarian Diseases/*MO; Sudden Infant Death/*ET; Torsion.
.T
Ovarian torsion related to sudden infant death.
.P
JOURNAL ARTICLE.
.A
Kasian GF; Taylor BW; Sugarman RG; Nyssen JN.
.I 277
.U
87051170
.S
Can Med Assoc J 8703; 135(12):1377-9
.M
Acquired Immunodeficiency Syndrome/EP; Adult; Age Factors; Canada; Female; Herpesviridae/IP; Herpesvirus Infections/*EP; Human; Infant; Male; Middle Age; Sex Factors.
.T
Laboratory reports of herpesvirus infections in Canada in 1985.
.P
JOURNAL ARTICLE.
.I 278
.U
87051171
.S
Can Med Assoc J 8703; 135(12):1401-4
.M
Abnormalities, Multiple/*; Child Advocacy; Ethics, Medical/*; Human; Infant, Newborn; Infanticide/*; Parents/PX; Quality of Life.
.T
Ethical issues in infanticide of severely defective infants.
.P
JOURNAL ARTICLE.
.A
Lister D.
.I 279
.U
87051239
.S
Cancer 8703; 58(12):2571-5
.M
Aged; Bone Marrow/UL; Chromosome Aberrations/*; Female; Human; Male; Middle Age; Myeloproliferative Disorders/GE; Preleukemia/*GE; Prognosis; Support, U.S. Gov't, P.H.S..
.T
Chromosome studies in preleukemic states. V. Prognostic significance of single versus multiple abnormalities.
.P
JOURNAL ARTICLE.
.W
The prognostic value of marrow chromosome findings was examined in 242 patients with preleukemic myelodysplastic syndromes (MDS) or myeloproliferative disorders (MPD), with emphasis on the significance of single versus multiple karyotypic changes. In both groups, the results showed that patients with multiple chromosome abnormalities in a marrow clone had a very high probability of early death, from progression to leukemia or from other complications of hematopoietic dysfunction. Conversely, in patients with a hemic clone having only one karyotypic alteration (involving a single chromosome or single translocation), survival over 2 years was only slightly reduced as compared to those without chromosome abnormality. The only single karyotypic alteration perhaps associated with a markedly shortened survival was monosomy 7. These findings suggest that the conclusions of previous studies concerning the grave consequences of chromosome alterations in preleukemia largely reflect the clinical significance of clones with multiple cytogenetic changes. Prior knowledge of the karyotypic status of preleukemic patients should be helpful in evaluating current attempts to find effective treatment for these difficult disorders.
.A
Nowell PC; Besa EC; Stelmach T; Finan JB.
.I 280
.U
87051240
.S
Cancer 8703; 58(12):2576-8
.M
Adult; Case Report; Drug Evaluation; Female; Human; Interferon Type I/*TU; Male; Melanoma/*TH; Middle Age; Neoplasm Metastasis; Recombinant Proteins/*TU; Skin Neoplasms/*TH.
.T
Recombinant leukocyte A interferon (rIFN-alpha A) in the treatment of disseminated malignant melanoma. Analysis of complete and long-term responding patients.
.P
JOURNAL ARTICLE.
.W
Ninety-six patients with disseminated malignant melanoma received thrice weekly intramuscular injections of leukocyte A recombinant interferon (rIFN-alpha A, Roferon-A, Hoffmann La Roche) at doses of 12 X 10(6) U/m2 or 50 X 10(6) U/m2 with or without cimetidine as an immunorestorative agent. Four patients, two with prior chemotherapy, demonstrated either a complete response (3 months, soft tissue metastasis) or exceptionally durable response durations (months) of 29+ (soft tissue; lung lesion), 31+ (soft tissue), and 35+ (soft tissue; liver lesions). None of these patients had particularly characteristic clinical parameters. As noted previously, using chemotherapy, a small proportion of patients with advanced malignant melanoma, despite prior therapy, may achieve prolonged objective regression with rIFN-alpha A.
.A
Creagan ET; Ahmann DL; Frytak S; Long HJ; Itri LM.
.I 281
.U
87051241
.S
Cancer 8703; 58(12):2579-84
.M
Adolescence; Child; Child, Preschool; Female; Human; Infant; Infant, Newborn; Male; Mesonephroma/MO/PA; Neoplasms, Embryonal and Mixed/MO/*PA; Ovarian Neoplasms/MO/PA; Support, U.S. Gov't, P.H.S.; Teratoma/MO/PA; Testicular Neoplasms/MO/PA.
.T
Nongerminomatous malignant germ cell tumors in children. A review of 89 cases from the Pediatric Oncology Group, 1971-1984.
.P
JOURNAL ARTICLE.
.W
Clinical and morphologic features of 89 cases of childhood yolk sac tumor (YS) and embryonal carcinoma (EC) (29 associated with teratomas) submitted to the Rare Tumor Registry of the Southwest Oncology Group (1971-1979) or the Pediatric Oncology Group (1980-1984) between 1971 and 1984 were reviewed and submitted to statistical analysis. This review showed an improved survival for each 5-year period regardless of tumor site, no statistically significant difference between "pure" tumors and those mixed with other teratomatous components, no statistically significant difference between YS and EC in children, a better than reported prognosis for sacrococcygeal tumors occurring after the neonatal period, a particularly poor prognosis for neonatal "benign" sacrococcygeal teratomas resected without coccygectomy when they recur as YS, excellent survival for all testicular tumors regardless of age or the presence of EC, and the occurrence of mediastinal tumors in females.
.A
Hawkins EP; Finegold MJ; Hawkins HK; Krischer JP; Starling KA; Weinberg A.
.I 282
.U
87051242
.S
Cancer 8703; 58(12):2585-8
.M
Aged; Animal; Cats; Diarrhea/CI; Drug Evaluation; Female; Head and Neck Neoplasms/*DT; Human; Male; Middle Age; Mitoguazone/TO/*TU; Nausea/CI; Support, U.S. Gov't, P.H.S.; Vomiting/CI.
.T
Phase II trial of methylglyoxal bis (guanylhydrazone) (MGBG) in advanced head and neck cancer.
.P
JOURNAL ARTICLE.
.W
Methylglyoxal bis (guanylhydrazone) (MGBG) is an inhibitor of polyamine synthesis. In vitro studies demonstrate the accumulation of some tumor cells in S and G2 phases of the cell cycle. Nineteen patients with advanced head and neck cancer were entered in a Phase II trial of MGBG. MGBG, 500 mg/M2, was administered as a brief intravenous infusion weekly for 4 weeks, then every 2 weeks. Dose modifications were based on cumulative toxicity after 2 weekly treatments. All but three patients had prior exposure to chemotherapy for disease recurrence. Of 17 patients evaluable for response and toxicity, one brief partial response was observed. The most common toxicities were mild to moderate nausea, vomiting, diarrhea, and stomatitis. Myelosuppression occurred in three patients. Dose modifications were required in four patients; a maximum dose of 700 mg/M2 was tolerated. The results of four other Phase II single and combination chemotherapy trials of MGBG in head and neck cancer are reviewed. The single agent response rate in 59 patients was 22% (range, 6%-41%). The poor response rate observed in this trial was similar to that in other trials in which a heavily pretreated group of patients was evaluated. It is concluded that single agent MGBG is not a useful drug in heavily pretreated recurrent disease patients. However, because of its biochemical effects, further testing in combination with cycle specific agents and in larger numbers of patients with minimal prior treatment may be warranted.
.A
Forastiere AA; Natale RB; Wheeler RR.
.I 283
.U
87051243
.S
Cancer 8703; 58(12):2589-93
.M
Adult; Aged; Antineoplastic Agents, Combined/*TU; Bone Neoplasms/*SC; Breast Neoplasms/*DT; Female; Fractures/ET; Human; Middle Age; Spine; Time Factors.
.T
Clinical course of breast cancer patients with osseous metastasis treated with combination chemotherapy.
.P
JOURNAL ARTICLE.
.W
Between July 1973 and December 1979, 1171 patients with metastatic breast cancer were treated with doxorubicin-containing chemotherapy. Of those patients, 195 had osseous metastases only. Upon initial diagnosis, 48% had osteolytic metastases; 13% had osteoblastic metastases; 38% had mixed metastases; and 1% had diffuse osteoporosis without any obvious bone destruction. The most common sites of involvement were the dorsal spine (62%), lumbosacral spine (72%), and pelvis (79%). Objective response to chemotherapy was observed in 59% of patients; complete responses were noted in 7%, and partial responses in 52%. The median survival was 28 months (range, 1-118 months). The median time lapse between the start of chemotherapy and disease progression was 14 months (range, 1-109 months). In 32 patients who responded to the treatment, chemotherapy was discontinued after 2 years, and their median duration of continued remission at 39 and 75 months after the completion of therapy. The incidence of pathological fractures was 57%; the most common sites were the spine, which sustained compression fractures, and the ribs. The incidences of hypercalcemia and spinal cord compression due to metastases were 19% and 10%, respectively.
.A
Scheid V; Buzdar AU; Smith TL; Hortobagyi GN.
.I 284
.U
87051244
.S
Cancer 8703; 58(12):2594-9
.M
Adolescence; Adult; Antineoplastic Agents, Combined/*TU; Bleomycins/AD; Case Report; Cisplatin/AD; Dysgerminoma/*DT; Etoposide/AD; Female; Human; Lymphatic Metastasis; Neoplasm Recurrence, Local/DT/SU; Ovarian Neoplasms/*DT.
.T
Chemotherapeutic complete remission in patients with metastatic ovarian dysgerminoma. Potential for cure and preservation of reproductive capacity.
.P
JOURNAL ARTICLE.
.W
Two patients with metastatic dysgerminoma of the ovary were treated with a combination of etoposide, bleomycin, and cisplatin at The University of Texas M.D. Anderson Hospital and Tumor Institute at Houston. Both patients achieved a complete remission. Patient 1 developed a massive recurrence in the para-aortic lymph nodes 21 months after diagnosis and treatment with right salpingo-oophorectomy alone. She received four cycles of chemotherapy and is free of disease 21 months from the start of chemotherapy. Patient 2 had Stage III dysgerminoma and a lymphangiogram positive for tumor in the para-aortic lymph nodes. After surgery she received three cycles of chemotherapy and is free of disease 20 months from the start of chemotherapy. Both complete remissions were documented with second-look laparotomy. Chemotherapy may be an alternative to radiotherapy for the treatment of metastatic dysgerminoma and should also be considered for selected patients with Stage I disease. A literature review further supports the conclusion that additional clinical trials might expand the indications for chemotherapy in patients with this disease.
.A
Gershenson DM; Wharton JT; Kline RC; Larson DM; Kavanagh JJ; Rutledge FN.
.I 285
.U
87051245
.S
Cancer 8703; 58(12):2600-5
.M
Antineoplastic Agents, Combined/AE/*TU; Case Report; Cisplatin/*AD; Follow-Up Studies; Gastrointestinal Diseases/CI; Human; Male; Neoplasms, Embryonal and Mixed/*DT/MO; Raynaud's Disease/ET; Support, Non-U.S. Gov't; Testicular Neoplasms/*DT/MO.
.T
Long-term survival and morbidity in patients with metastatic malignant germ cell tumors treated with cisplatin-based combination chemotherapy.
.P
JOURNAL ARTICLE.
.W
Forty-three of 79 patients treated for clinically metastatic germ cell cancer survived for a median of 66 months (range, 52-83). In patients without previous chemotherapy the 5-year survival rate was 69%, whereas only 32% of patients with prior chemotherapy survived for 5 years. Limited disease, complete clinical response, histopathologically proven postchemotherapy tumor necrosis or complete resectability of a posttreatment mature teratoma indicated a favorable prognosis in patients without prior chemotherapy. Only 20% to 30% of the patients with less than a clinical complete response or with posttreatment residual malignant tumor can be salvaged by second line therapy. Posttreatment mature teratoma should be resected completely whenever possible, as this condition may lead to reactivation of the malignancy even after several years. Raynaud-like phenomena and/or gastrointestinal problems are the main long-term sequel (10%-15%) after modern multimodality treatment of advanced germ cell cancer (fertility-related problems are not considered here). In the majority of surviving patients, the lifestyle seems unaffected by the previous intensive treatment, evaluated about 5 years after discontinuation of all therapy.
.A
Fossa SD; Aass N; Kaalhus O; Klepp O; Tveter K.
.I 286
.U
87051246
.S
Cancer 8703; 58(12):2606-10
.M
Antineoplastic Agents/AD/AE; Combined Modality Therapy; Female; Human; Infant; Infant, Newborn; Male; Rhabdomyosarcoma/CN/*EP/PA; Support, U.S. Gov't, P.H.S..
.T
Infants younger than 1 year of age with rhabdomyosarcoma.
.P
JOURNAL ARTICLE.
.W
Of a total of 1561 patients registered in the Intergroup Rhabdomyosarcoma Study (IRS) as of May 1983, 78 patients (5%) were younger than 1 year of age. These infants did not differ from the older children (1-20 years of age) in male/female ratio, clinical grouping, or survival rates. Infants younger than 1 year of age had a significantly greater frequency of undifferentiated sarcoma, 18% versus 7% in older children (P less than 0.005). Infants also had a significantly greater proportion of cancers with botryoid pathology, 10% versus 4% in older children (P less than 0.005). When reviewed by the newly proposed IRS cytopathologic classification, there was no difference in pathologic types between the two age groups. Infants younger than 1 year of age had a higher rate of bladder-prostate-vagina primary tumor sites than older children, 24% versus 10% (P less than 0.05). In addition, infants tended to receive less of the prescribed doses of chemotherapy and radiation therapy than older children, and to develop more toxicity to treatment than older children. Despite these differences, the overall survival curve for the two age groups appears to be similar. In contrast to Wilms' tumor and neuroblastoma, in which age (less than 1 year) is a favorable prognostic factor, age does not appear to be an important prognostic factor in rhabdomyosarcoma.
.A
Ragab AH; Heyn R; Tefft M; Hays DN; Newton WA Jr; Beltangady M.
.I 287
.U
87051247
.S
Cancer 8703; 58(12):2611-6
.M
Adult; Aged; Antineoplastic Agents, Combined/AE/*TU; Bleomycins/AD; Doxorubicin/AD; Female; Human; Liver Diseases/CI; Lymphatic Metastasis; Male; Mechlorethamine/AD; Methotrexate/AD; Middle Age; Mycosis Fungoides/*DT/SU; Neutropenia/CI; Skin Diseases/CI; Skin Neoplasms/*DT; Splenectomy.
.T
Treatment of advanced stage mycosis fungoides with bleomycin, doxorubicin, and methotrexate with topical nitrogen mustard (BAM-M).
.P
JOURNAL ARTICLE.
.W
Ten patients with advanced stage (TNM IIB-IVB) mycosis fungoides were treated with a combination chemotherapy program consisting of bleomycin and methotrexate weekly, doxorubicin every 3 weeks, and topical nitrogen mustard daily (BAM-M). Seven patients obtained histologically documented complete remissions ranging from 4 to 105+ months in duration. Median survival is 16.5+ months. Three patients in whom splenomegaly was detected during their staging evaluation underwent splenectomy. These three patients have had unmaintained disease-free survivals of 36+, 100+, and 105+ months. This study indicates that BAM-M is effective therapy for advanced stage mycosis fungoides and suggests that the therapeutic role of splenectomy should be evaluated further.
.A
Zakem MH; Davis BR; Adelstein DJ; Hines JD.
.I 288
.U
87051249
.S
Cancer 8703; 58(12):2622-4
.M
Evaluation Studies; Gallium Radioisotopes/*DU; Human; Lymphography; Lymphoma, Non-Hodgkin's/*RA/*RI; Retrospective Studies; Support, Non-U.S. Gov't; Tonsillar Neoplasms/*RA/*RI.
.T
Value of gallium scans and lymphangiography in non-Hodgkin's lymphoma of the Waldeyer's ring.
.P
JOURNAL ARTICLE.
.W
In 37 patients with seemingly localized non-Hodgkin's lymphoma of the Waldeyer's ring (WR-NHL), lymphangiography (LAG) and/or gallium-67 scans (Ga-67 scans) were done. Before these procedures, 20 patients were diagnosed as Stage I, and 17 as Stage II. LAG was done for 30, and Ga-67 scans for 32, 25 of whom had both. Five patients (16%) were upstaged to Stage III or IV by Ga-67 scans. Only one (3%) had abnormal LAG findings, in whom Ga-67 scans also showed abnormal accumulation in the para-aortic region. Because of this low positive rate, LAG is not recommended for staging of WR-NHL.
.A
Shigematsu N; Kondo M; Kubo A; Hashimoto S.
.I 289
.U
87051251
.S
Cancer 8703; 58(12):2628-31
.M
Adult; Antibody Formation/*; Antibody-Producing Cells/IM; Comparative Study; Female; Human; Immunity, Cellular/*; Immunoglobulins/AN; Leukoplakia/IM; Male; Middle Age; Mouth Diseases/*IM; Mouth Neoplasms/IM; Oral Submucous Fibrosis/*IM; Rosette Formation; Support, Non-U.S. Gov't.
.T
Cell mediated and humoral immune responses in oral submucous fibrosis.
.P
JOURNAL ARTICLE.
.W
Cell-mediated and humoral immune responses were assessed in 50 patients with oral submucous fibrosis (OSMF) and the results were compared with those of 50 patients with oral-leukoplakia, 50 oral cancer patients, and 50 normal healthy adult controls. The number of high-affinity rosette-forming cells (HARFC) was found to be significantly decreased in OSMF and oral cancer, whereas the number of total rosette-forming cells (TRFC) remained unaltered. Levels of serum IgA, IgD, and IgE were found to be elevated both in OSMF and oral cancer. Immunologic derangements were found to be more pronounced in oral cancer than in OSMF. The enumeration of HARFC along with the estimation of serum levels of IgA, IgD, and IgE indicates that OSMF can be an intermediary stage in the malignant transformation of a normal cell, and that these parameters may serve as markers for the early detection of oral cancer.
.A
Rajendran R; Sugathan CK; Remani P; Ankathil R; Vijayakumar T.
.I 290
.U
87051253
.S
Cancer 8703; 58(12):2640-5
.M
Aged; Bone Marrow/PA; Case Report; Endometrium/PA; Female; Histiocytosis, Malignant/*CO/PA; Human; Lymph Nodes/PA; Male; Middle Age; Phagocytosis; Tuberculosis/*CO.
.T
Tuberculosis-associated hemophagocytic syndrome. A systemic process.
.P
JOURNAL ARTICLE.
.W
Virus-associated hemophagocytic syndrome has been recently identified as a benign, reactive histiocytic proliferation distinct from Rappaport's malignant hystiocytosis. Other etiologic agents, including different bacteria, have also been identified. Three autopsy cases of hemophagocytic syndrome associated to acute tuberculous sepsis are presented. Benign histiocytic proliferation with striking hemophagocytosis was present in a disseminated, multisystemic pattern in all three cases. A relationship between systemic histiocytic proliferation and an anergic status in these patients is suggested.
.A
Campo E; Condom E; Miro MJ; Cid MC; Romagosa V.
.I 291
.U
87051254
.S
Cancer 8703; 58(12):2646-55
.M
Adolescence; Adult; Aged; Bone Neoplasms/*CL/IM/PA; Child; Child, Preschool; Female; Human; Infant; Lymphoma/*CL/IM/PA; Male; Middle Age; Neoplasm Recurrence, Local; Prognosis; Time Factors.
.T
Malignant lymphoma of bone.
.P
JOURNAL ARTICLE.
.W
A total of 422 patients with malignant lymphoma of bone who were seen at the Mayo Clinic from 1907 through 1982 were placed into four major groups based on stage of disease. There was one group with primary lymphoma of bone, one group with multifocal osseous lymphoma, and two groups with lymphoma of bone and nodal or soft tissue (or both) disease. The last-mentioned two groups were separated on the basis of time of onset of osseous lymphoma in relation to the nonosseous disease. The stage of disease was the single most important prognostic indicator of overall survival in malignant lymphoma of bone. The 5- and 10-year survival rates were, respectively, 58% and 53% for patients with primary bone lymphoma, 22% and 12.5% for patients with bone and nodal or soft tissue (or both) disease, and 42% and 35% for patients with multifocal osseous disease. Features having no significant prognostic value were sex of the patient, histologic grade of the lymphoma (according to the Working Formulation and the Kiel system), and presence of T-cell features or cleaved cells (or both). This study is not able to adequately address efficacy of treatment. In fact, treatment may be very important in outcome.
.A
Ostrowski ML; Unni KK; Banks PM; Shives TC; Evans RG; O'Connell MJ; Taylor WF.
.I 292
.U
87051255
.S
Cancer 8703; 58(12):2656-61
.M
Adult; Aged; Carcinoma/CF/*SC; Case Report; Female; Head and Neck Neoplasms/CF/*PA; Human; Male; Meningeal Neoplasms/CF/RA/*SC; Tomography, X-Ray Computed.
.T
Meningeal carcinomatosis in head and neck cancer. Report of six cases and review of the literature.
.P
JOURNAL ARTICLE.
.W
Head and neck cancer has rarely been reported to be a cause of meningeal carcinomatosis. These tumors are known more for their local invasiveness rather than distant metastasis. This would appear to preclude meningeal involvement, but close proximity to multiple cranial nerves may provide an access to the meninges. Six cases of head and neck cancer with meningeal invasion are presented. All six cases had malignant cells in their cerebrospinal fluid. Three cases had malignant cells recovered from a ventricular specimen after lumbar punctures were negative. The most common clinical finding on presentation was cranial nerve involvement. The optic nerve was involved most often with nerves VI and V the next most frequent. Headache was present in four patients and seizures occurred in two. No patient had meningismus. Our current treatment plan involves insertion of an Ommaya Reservoir and intraventricular methotrexate. Only patients whose primary head and neck tumor shows a response to systemic therapy undergo Ommaya placement. Meningeal carcinomatosis in head and neck cancer may be more prevalent than previously thought and the likely mechanism is via direct extension rather than hematogenous spread.
.A
Redman BG; Tapazoglou E; Al-Sarraf M.
.I 293
.U
87051258
.S
Cancer 8703; 58(12):2675-9
.M
Carcinoma/*BL/SU; Female; Follow-Up Studies; Gastrectomy; Human; Male; Stomach Neoplasms/*BL/SU; Testosterone/*BL.
.T
Serum testosterone level of patients with gastric carcinoma before and after gastrectomy.
.P
JOURNAL ARTICLE.
.W
The serum testosterone level (STL) was determined in 84 male and 32 female patients with gastric carcinoma and in 58 male and 20 female patients with benign diseases as a control group. The STL of the male patients with carcinoma was lower (446 +/- 149 ng/dl) than that of the male control group (532 +/- 132 ng/dl) (P less than 0.001). Even 17 male patients of the early carcinoma showed lower STL (440 +/- 117 ng/dl) than the normal group (P less than 0.001). In the female patients, it was also lower (31.6 +/- 16.0 ng/dl) than in the control group (46.3 +/- 15.3 ng/dl) (P less than 0.005). The postoperative STL of the cases surviving the gastrectomy was higher than the preoperative data in 32 male patients (P less than 0.005) as well as in 12 female patients (0.025 greater than P greater than 0.01), whereas it obviously decreased in the patients who died of recurrence. Therefore, it appears that gastric carcinoma decreases the STL by some mechanism.
.A
Inutsuka S; Kodama Y; Natsuda Y; Kumashiro R; Maekawa T.
.I 294
.U
87051259
.S
Cancer 8703; 58(12):2680-5
.M
Adolescence; Adult; Aged; Blood Proteins; Female; Human; Lipids/*BL; Liver Neoplasms/SC; Lymphatic Metastasis; Male; Middle Age; Neoplasm Metastasis; Neoplasms/*BL; Sialic Acids/*BL; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Total and lipid-associated serum sialic acid levels in cancer patients with different primary sites and differing degrees of metastatic involvement.
.P
JOURNAL ARTICLE.
.W
Serum total sialic acid (TSA) and lipid-associated sialic acid (LASA) levels have drawn considerable interest because of carbohydrate aberrations in malignant cells. The current investigation determined the TSA, LASA, total protein (TP), and TSA/TP values for 171 cancer patients with various primary sites and differing degrees of metastatic disease, 102 patients with nonmalignant diseases (pathologic controls), and 42 normal individuals. Data analysis indicated significant (p less than 0.01) increases in the mean (+/- SD) TSA and TSA/TP values in the cancer patients (78.1 +/- 19.2 mg/dl and 12.4 +/- 3.8 mg/g, respectively) and in the pathologic controls (76.0 +/- 7.5 mg/dl and 11.6 +/- 2.5 mg/g) when compared to the normal controls (67.3 +/- 7.1 mg/dl and 9.0 +/- 1.1 mg/g), and a significant decrease in the mean TP values in the cancer patients (6.4 +/- 1.1 g/dl) and pathologic controls (6.6 +/- 1.1 g/dl) when compared to normal controls (7.5 +/- 0.5 g/dl). No significant difference was observed between groups in LASA values. Further analysis of the data in patient subgroups based on the tissue involved, specific disease, or severity of the malignancy indicated that the lack of specificity of the markers was due primarily to restricted subgroups and that the sensitivity of TSA and TSA/TP increased as the malignancy became more severe. The results show that TSA/TP was the most useful of the markers tested for detecting malignancies. This marker should prove useful for monitoring malignant disease recurrence and/or progression and for evaluating the effectiveness of various therapeutic approaches.
.A
Plucinsky MC; Riley WM; Prorok JJ; Alhadeff JA.
.I 295
.U
87051261
.S
Cancer 8703; 58(12):2689-96
.M
Adolescence; Adult; Aged; Case Report; Chondrosarcoma/*DI/PA/RT; Female; Human; Male; Middle Age; Protons/TU; Skull Neoplasms/*DI/PA/RT; Temporal Bone/*; Tomography, X-Ray Computed.
.T
Chondrosarcoma of the temporal bone. Diagnosis and treatment of 13 cases and review of the literature.
.P
JOURNAL ARTICLE.
.W
Chondrosarcoma of the temporal bone is a rare lesion. Clinically it has been confused with multiple sclerosis, glomus jugulare tumors, meningioma, and chordomas. The cranial nerve palsies frequently observed with the tumors are related to the anatomic locations of the tumors. Thirteen patients with this entity are presented and the eleven other cases in the literature are reviewed. Histologically the tumors are low grade and exhibit myxoid features. The myxoid features must be differentiated from chordoma and chondroid chordoma. The tumor locations preclude surgical excision and conventional radiation therapy can cause unacceptable neurologic sequelae. Proton beam therapy has been effective in short-term results and appears capable of avoiding serious neurologic side effects.
.A
Coltrera MD; Googe PB; Harrist TJ; Hyams VJ; Schiller AL; Goodman ML.
.I 296
.U
87051265
.S
Cancer 8703; 58(12):2720-5
.M
Carcinoma/*PA/RA; Carcinoma, Oat Cell/PA/RA; Case Report; Cerebral Ventricle Neoplasms/RA/*SC; Female; Human; Lung Neoplasms/PA; Male; Middle Age; Tomography, X-Ray Computed.
.T
Diffuse subependymal periventricular metastases. Report of three cases.
.P
JOURNAL ARTICLE.
.W
Three clinicopathologic cases with a remarkable pattern of extensive diffuse subependymal periventricular spread of cerebral metastases from solid systemic cancer are reported. Two patients had a small cell carcinoma of the lung. In the third case, the histologic features of the brain metastases were consistent with a neuron-specific enolase-positive, small cell anaplastic carcinoma. Involvement of the choroid plexus and leptomeninges was moderate or absent. Intraparenchymatous nodular metastases were not found except in one case in which rare nodular superficial cortical metastases were present. The clinical data were nonspecific except for orthostatic hypotension, in one patient, which was probably due to the infiltration of the floor of the third and fourth ventricles. Results of the cerebrospinal fluid examination, available in two cases, were normal. The only diagnostic investigation was contrast-enhanced computed tomography scanning.
.A
Vannier A; Gray F; Gherardi R; Marsault C; Degos JD; Poirier J.
.I 297
.U
87051266
.S
Cancer 8703; 58(12):2726-35
.M
Age Factors; Child; Child, Preschool; Denmark; Female; Human; Male; Neuroblastoma/*MO/TH; Prognosis; Regression Analysis; Sex Factors.
.T
Prognostic factors in neuroblastomas treated in Denmark from 1943 to 1980. A statistical estimate of prognosis based on 253 cases.
.P
JOURNAL ARTICLE.
.W
Multivariate analysis on an unselected patient population consisting of all 253 children treated for neuroblastoma in Denmark during 1943 to 1980 shows that stage, age, and treatment given are independent prognostic variables. Calendar year of diagnosis, sex of the patient, and site of primary tumor were not significant prognostic factors. Further analysis shows that multimodal treatment with surgery, irradiation, and chemotherapy, especially in patients older than 1 year of age with Stage II disease, has influenced the survival significantly. The fact that age at diagnosis and the administration of chemotherapy have independent prognostic significance can be explained by the theory that all neuroblastomas are virtually congenital; therefore, the difference in age at diagnosis largely reflects the difference in growth rates of the tumor. Thus, according to this theory, age may be a measure of the probability of micrometastases in addition to the clinical extent or stage of the disease, as it represents the duration of the disease. Additional chemotherapy may thus have eradicated these micrometastases in the older children, since the age influence on Stage II disease disappeared when multimodal treatment was given in this study. The implications for treatment policy are discussed in view of this theory.
.A
Carlsen NL; Christensen IJ; Schroeder H; Bro PV; Erichsen G; Hamborg-Pedersen B; Jensen KB; Nielsen OH.
.I 298
.U
87051267
.S
Cancer 8703; 58(12):2736-9
.M
Adult; Breast Neoplasms/*GE; Case Report; Human; Male; Pedigree; Support, Non-U.S. Gov't.
.T
Familial breast cancer in males. A case report and review of the literature.
.P
JOURNAL ARTICLE.
.W
The occurrence of breast cancer in two related males, an uncle and nephew is reported. A review of previously reported cases of male breast cancer occurring in families and the association with other cancers in other family members is included. In previous reports on breast cancer in males, familial or hereditary factors have not generally been recognized as a major contributing factor. Of ten families reported (including our own) where there is sufficient information given, six families (60%) had females with breast cancer. It appears there are some families in which males as well as females have an increased risk of developing breast cancer.
.A
Kozak FK; Hall JG; Baird PA.
.I 299
.U
87051268
.S
Cancer 8703; 58(12):2740-3
.M
Catheterization; Human; Male; Neoplasms/*CO; Peritoneum; Pleural Effusion/*SU.
.T
Pleuroperitoneal shunting for malignant pleural effusions.
.P
JOURNAL ARTICLE.
.W
Traditional therapy for malignant pleural effusions includes thoracentesis or tube drainage with instillation of irritants to achieve pleurodesis. This can require a lengthy hospitalization, causes pain and discomfort, and has an appreciable failure rate. Because of these drawbacks, the authors used a shunting device to transfer fluid to the peritoneal cavity in 17 patients with malignant pleural effusions. Eleven patients had undergone previous therapeutic thoracenteses and three had chest tube placement with failed sclerosis. The shunt was a subcutaneous valved pump chamber with attached pleural and peritoneal catheters, which used manual compression to transfer fluid against the normal abdominal/pleural pressure gradient. Operative placement under local or general anesthesia was performed without complication. Five patients achieved minimal benefit, either because of moribund status or their inability to compress the pump effectively. In the other 12 patients, there was radiographic evidence of diminished or stabilized pleural effusion; respiratory symptoms were effectively palliated, and no further treatment for their effusion was required. Peritoneal dissemination of malignant cells has not been clinically detected. We feel that pleuroperitoneal shunting is a valid new method for treatment of malignant pleural effusions which can effectively palliate respiratory symptoms with low morbidity. Advantages include the absence of external tubing and the possibility for only a short hospitalization or even outpatient placement. Shunting is applicable for patients who are able to perform the requisite pumping and is particularly suitable for those with trapped lungs or who have failed attempted pleural sclerosis.
.A
Little AG; Ferguson MK; Golomb HM; Hoffman PC; Vogelzang NJ; Skinner DB.
.I 300
.U
87051269
.S
Cancer 8703; 58(12):2744-50
.M
Adult; Aged; Autopsy; Echocardiography; Electrocardiography; Female; Heart/*PP; Heart Neoplasms/SC; Human; Male; Mesothelioma/*PP; Middle Age; Pleural Neoplasms/*PP; Support, U.S. Gov't, P.H.S..
.T
Cardiac abnormalities in patients with diffuse malignant pleural mesothelioma.
.P
JOURNAL ARTICLE.
.W
Many patients with diffuse malignant pleural mesothelioma have dyspnea or chest pain. Cardiac symptomatology is frequently difficult to differentiate from symptoms of pleuropulmonary disease. To better define the clinical characteristics of cardiac involvement in patients with mesothelioma, the electrocardiographic (EKG) and echocardiographic findings in 64 patients with biopsy-proven malignant pleural mesothelioma were reviewed. A total of 19/64 (30%) patients had autopsy studies available for review. The EKG was abnormal in 55 patients (89%). Over half (60%) had an arrhythmia, including sinus tachycardia (42%), premature atrial and ventricular contractions (13%), atrial fibrillation (3%), and atrial flutter (1%). Over one third (37%) had a conduction abnormality, including bundle branch block (13%), hemiblock (8.5%), and incomplete right bundle branch block (13%). Echocardiography revealed a total of 13 patients with pericardial effusions, two with pericardial thickening, and one with an anterior sonolucent space. Of 19 autopsies, cardiac invasion was found in 14 (74%), with more than half to the pericardium and more than one quarter to the myocardium. It is concluded that: clinical cardiac abnormalities occur in the great majority of patients with malignant pleural mesothelioma, pathologic cardiac invasion occurs in the great majority of patients with pleural mesothelioma, and the EKG and echocardiogram are helpful in differentiating cardiac involvement from progressive pulmonary disease in patients with pleural mesothelioma.
.A
Wadler S; Chahinian P; Slater W; Goldman M; Mendelson D; Holland JF.
.I 301
.U
87051270
.S
Cancer 8703; 58(12):2751-7
.M
Aged; Bladder Neoplasms/DI/PA/*TH; BCG Vaccine/*TU; Carcinoma/DI/PA/*TH; Case Report; False Negative Reactions; Female; Flow Cytometry/*; Human; Male; Middle Age; Support, U.S. Gov't, P.H.S..
.T
Monitoring intravesical bacillus Calmette-Guerin treatment of superficial bladder carcinoma by serial flow cytometry.
.P
JOURNAL ARTICLE.
.W
Simultaneous urinary flow cytometry, cytologic, and cystoscopic examinations were performed at 3-month intervals for a minimum of 1 year on 29 patients receiving intravesical bacillus Calmette-Guerin (BCG) treatment of superficial bladder carcinoma. Flow cytometry (FCM) and cytology were concordant in 57 of 103 examinations; both FCM and cytology were positive in 38 instances, and carcinoma was confirmed by biopsy in 35 (92.1%). In 16 instances FCM and cytology were negative, but carcinoma was present on biopsy in 5 (31.3%). Three examinations were suspicious by both techniques. The 46 determinations with discordant FCM and cytology were subdivided into pathologically confirmed recurrences (25 instances) and no evidence of pathologic and/or cystoscopic disease (21 instances). In the 25 instances of recurrences, FCM was positive in 18 (72.0%), suspicious in 3 (12.0%), and negative in 4 (16.0%), while cytology was positive in 3 (12.0%), suspicious in 9 (36.0%), and negative in 13 (52.0%). Most patients had a severe BCG-induced inflammatory response that caused an elevation of the hyperdiploid population, believed secondary to epithelial regeneration and proliferation. In the 21 instances without detectable recurrence, hyperploidy led to a relatively high proportion of positive (15) and suspicious (4) results by FCM, but only eight had distinct aneuploid populations. It is possible that this latter group, at least, is harboring occult carcinoma. Conventional cytology in the nonrecurrent group was positive in 1 (4.8%), suspicious in 7 (33.3%), and negative in 13 (61.9%). In those instances when tumor was confirmed by biopsy, the false-negative rate for FCM was 19.7%; the false-negative rate for cytology was 40.9%. Thus, FCM appears to be more sensitive but less specific than conventional cytology, having a lower false-negative but a higher false-positive rate. Although serial FCM provides an objective quantitative measure of aneuploid stemlines and hyperdiploid populations in bladder irrigation specimens and can be helpful in following intravesical BCG therapy for superficial bladder carcinoma, it should still be used with conventional cytology. The greatest difficulty with FCM at present, as with conventional cytology, is in cases of marked inflammation. The results reported here were obtained under the most stringent conditions and represent the minimum level of accuracy. Potential improvements in the technique, with the addition of immunologic or other markers, hold hope of further increasing the accuracy of FCM.
.A
Badalament RA; Gay H; Whitmore WF Jr; Herr HW; Fair WR; Oettgen HF; Melamed MR.
.I 302
.U
87051271
.S
Cancer 8703; 58(12):2758-63
.M
Aged; Biopsy; Bladder Neoplasms/PA/*RT/SU; Carcinoma, Transitional Cell/PA/*RT/SU; Human; Male; Middle Age; Preoperative Care; Support, U.S. Gov't, P.H.S..
.T
Transitional cell carcinomas of the urinary bladder. Effects of preoperative irradiation on morphology.
.P
JOURNAL ARTICLE.
.W
The effects of preoperative irradiation on the morphology of transitional cell carcinomas (TCCs) were evaluated by studying the pretreatment biopsy and radical cystectomy specimens from 35 patients. Twenty-six of these patients had received 2000 rad within the week preceding surgery, and nine patients had received no preoperative treatment. The frequency of bladders without residual TCC was 23% for irradiated and 22% for nonirradiated cases. Of the TCCs classified as papillary in the biopsy specimens and irradiated, 79% lacked a papillary component at cystectomy, but in no case was the invasive component eliminated or regression from muscle invasion to superficial TCC noticed. Flat carcinoma in situ (CIS) did not respond to irradiation. At cystectomy nuclear pleomorphism was greater than at biopsy in 60% of the irradiated TCCs, whereas all nonirradiated cases retained the same grade as at biopsy. In addition, irradiation induced squamous differentiation in neoplastic cells only, without affecting the nonneoplastic urothelium.
.A
Neumann MP; Limas C.
.I 303
.U
87051547
.S
Cardiovasc Clin 8703; 17(2):1-273
.M
Heart Diseases/*PP; Heart Ventricle/*PP; Human.
.T
The right heart.
.P
JOURNAL ARTICLE.
.I 304
.U
87051550
.S
Cardiovasc Clin 8703; 17(2):133-44
.M
Adult; Aged; Chronic Disease; Female; Heart Failure, Congestive/*PP; Heart Ventricle/PP; Hemodynamics; Human; Hypertension/PP; Male; Middle Age; Posture; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Vascular Resistance.
.T
Assessment of right and left heart interactions: application of the resistance ratio in chronic congestive heart failure.
.P
JOURNAL ARTICLE.
.A
Cody RJ; Kubo SH.
.I 305
.U
87051551
.S
Cardiovasc Clin 8703; 17(2):145-55
.M
Coronary Disease/PP; Heart Failure, Congestive/PP; Heart Valve Diseases/PP; Heart Ventricle/PH/*PP; Human; Hypertension/PP.
.T
Effect of the left ventricle on the right ventricle.
.P
JOURNAL ARTICLE.
.W
The importance of the once-obscure right ventricle is becoming evident. Even in disorders that primarily affect the left ventricle, the once-considered-passive conduit has proved essential for maintenance of normal cardiac output. In coronary artery disease, the function of the right ventricle is affected by both its circulation and the after-load placed on it by dysfunction of the left ventricle. In congestive heart failure, right ventricular function relates to functional capacity, whereas left ventricular function does not, and right ventricular ejection fraction is a useful prognostic guide in these patients. In mitral and aortic valvular disease, the role of the right ventricle is only now becoming evident, and the precise interplay of all factors has yet to be explained. In systemic hypertension, it is likely that the pulmonary circulation is affected by the same humoral factors that elevate systemic pressures.
.A
Baker BJ; Franciosa JA.
.I 306
.U
87051552
.S
Cardiovasc Clin 8703; 17(2):159-69
.M
Animal; Chronic Disease; Coronary Disease/CO; Heart Enlargement/ET/*PA; Heart Failure, Congestive/ET/*PA; Heart Valve Diseases/CO; Heart Valves/PA; Heart Ventricle/*PA; Human; Hypertension/CO; Lung Diseases, Obstructive/CO.
.T
The pathology of the right heart in chronic hypertrophy and failure.
.P
JOURNAL ARTICLE.
.A
Murphy ML.
.I 307
.U
87051558
.S
Cardiovasc Clin 8703; 17(2):219-29
.M
Case Report; Coronary Disease/CO/SU; Female; Heart Failure, Congestive/*ET/PP/SU; Heart Ventricle/*PP; Human; Intraoperative Complications/*PP; Intraoperative Period; Male; Middle Age; Mitral Valve Stenosis/SU; Postoperative Complications/*; Preoperative Care; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Perioperative right heart failure: etiology and pathophysiology.
.P
JOURNAL ARTICLE.
.W
A considerable amount of literature has been devoted to compromise of the right ventricle in spontaneous myocardial infarction. Little information is available regarding disproportionate dysfunction of the right ventricle associated with cardiac operation and the recovery period therefrom. Recognition of the problem is of paramount importance, if support measures are to be implemented. A great deal has yet to be learned regarding the appropriate support for the acutely failing right ventricle. Much remains to be accomplished regarding the assessment of right ventricle reserve, defining the role of risk factors, and quantitating the value of measures to optimally protect the right ventricle from injury during the perioperative period. Recognizing that the integrity of the right ventricle can be altered by numerous preoperative, perioperative and postoperative factors will provide an enlightened disposition on the part of the surgical team. Awareness of these considerations in the planning and conduct of surgical procedures should reduce morbidity and mortality from perioperative right ventricular failure. The imposition of new or unexpected morbidity during operation on a relatively unrelated problem represents surgical imperfection. Appropriate effort toward minimizing insult of the right ventricle could result in significantly decreasing the incidence and severity of perioperative right ventricular failure before the impetus of the continuing clinical problem dictates improvement in techniques to more appropriately treat this frequently preventable problem.
.A
Fisk RL; Guilbeau EJ.
.I 308
.U
87051559
.S
Cardiovasc Clin 8703; 17(2):231-8
.M
Cardiopulmonary Bypass/*; Heart Failure, Congestive/*TH; Heart Ventricle; Heart-Assist Devices; Human; Intraoperative Complications/*TH; Lung/BS; Pulsatile Flow.
.T
Perioperative right heart failure: treatment.
.P
JOURNAL ARTICLE.
.W
When right ventricular failure prohibits separation from cardiopulmonary bypass, standard methods of increasing pulmonary blood flow should be employed, including correction of hypoxia and acidosis, volume loading, and inotropic support of the right ventricle. Infusion of pulmonary vasodilators--particularly low-dose nitroprusside--should be used if the pulmonary vascular resistance is elevated. If pulmonary blood flow remains unsatisfactory, systemic intra-aortic balloon counterpulsation should be employed. In refractory cases, right-atrial-to-pulmonary-artery bypass using the Bio-Medicus centrifugal pump is the recommended therapy for those centers that do not have the Pierce-Donachy pneumatic ventricular assist-pump available. For refractory right ventricular failure following the surgical repair of congenital cardiac defects in which the placement of right atrial and pulmonary artery cannulae is not technically feasible, use of high-frequency high-volume ventilation appears to be quite promising. Utilization of pulmonary artery counterpulsation or the creation of an atrial septal defect may also be lifesaving, but is not recommended as the therapy of choice.
.A
Gaines WE.
.I 309
.U
87051560
.S
Cardiovasc Clin 8703; 17(2):239-49
.M
Heart Failure, Congestive/DT/ET/*PP/SU/TH; Heart Ventricle/*PP; Human; Intraoperative Complications/DT/*PP/SU/TH; Support, Non-U.S. Gov't; Vascular Resistance.
.T
Right ventricular failure associated with left ventricular failure.
.P
JOURNAL ARTICLE.
.W
RV and LV failure frequently coexist. Experimental evidence suggests that RV failure results from a primary insult to the right ventricle and an increase in pulmonary vascular resistance. LV failure results in an elevation of the left atrial pressure and thereby a reduction in the transpulmonary hydrostatic gradient. Because RV function depends on the contraction of the left ventricle, this contribution is reduced during LV failure. Treatment should be aimed first at restoring LV function. If RV failure persists and is not due to a simple mechanical problem, treatment of RV failure should be commenced. If volume loading, inotropes, and pH adjustments do not result in adequate RV output, a mechanical assist device should be considered. RHBP is the most powerful device, and it is capable of restoring systemic perfusion even when there is no residual RV function. Clinical results with this device have been most encouraging--most patients demonstrate improved RV function and a decrease in pulmonary vascular resistance after several days of treatment, allowing them to be weaned from assist. However, this technique is very invasive and requires constant close attention. PABC is a simple but less powerful assist device. Experimental studies suggest that if RV function is not extremely depressed--cardiac output is greater than 50 percent of normal--PABC may be effective in restoring systemic perfusion to normal levels. Current results suggest that RHBP remains the gold standard for severe RV failure, but further clinical experience with PABC may more clearly define its role in the management of RV failure.
.A
Spence PA; Baylis CE; Peniston CM; Salerno TA.
.I 310
.U
87051563
.S
Cardiovasc Clin 8703; 17(2):35-44
.M
Heart Defects, Congenital/*PA; Heart Valve Diseases/CN; Heart Ventricle/AB; Human; Pulmonary Valve/AB; Tricuspid Valve/AB.
.T
Pathology of congenital malformations of the right heart.
.P
JOURNAL ARTICLE.
.A
Edwards JE.
.I 311
.U
87052045
.S
Circulation 8703; 74(6):1181-5
.M
Administration, Cutaneous; Administration, Oral; Drug Tolerance; Human; Infusions, Intravenous; Nitrates/*AD/ME; Ointments; Time Factors.
.T
Tolerance to organic nitrates.
.P
JOURNAL ARTICLE.
.A
Abrams J.
.I 312
.U
87052046
.S
Circulation 8703; 74(6):1186-90
.M
Animal; Coronary Disease/DT/*PP; Dogs; Drug Evaluation; Drug Screening; Fibrinolytic Agents/TU; Heart/DE/*PP; Heart Ventricle/PP; Human; Myocardial Contraction/DE; Support, U.S. Gov't, P.H.S.; Systole/DE.
.T
Assessment of ischemic regional myocardial dysfunction and its reversibility.
.P
JOURNAL ARTICLE.
.A
Ross J Jr.
.I 313
.U
87052050
.S
Circulation 8703; 74(6):1208-16
.M
Blood Flow Velocity; Comparative Study; Echocardiography/*/MT; Fetal Heart/*PH; Gestational Age; Heart Ventricle/PH; Human; Prospective Studies; Reference Values; Stroke Volume/*; Support, U.S. Gov't, P.H.S..
.T
Changes in intracardiac blood flow velocities and right and left ventricular stroke volumes with gestational age in the normal human fetus: a prospective Doppler echocardiographic study.
.P
JOURNAL ARTICLE.
.W
We used Doppler echocardiography to quantitate the changes in intracardiac blood flow velocities and right and left ventricular stroke volumes in 80 normal human fetuses from 19 to 40 weeks gestation. Blood flow velocity spectra across the aortic, pulmonary, tricuspid, and mitral valves were digitized to obtain peak velocities (m/sec) and flow velocity integrals. Aortic and pulmonary diameters were measured at valve level from two-dimensional echocardiographic images and cross-sectional area was calculated assuming a circular orifice. Ventricular stroke volume was calculated as the product of the cross-sectional area of a great vessel and the flow velocity integral through that vessel. The pulmonary arterial and aortic diameters increased linearly with gestational age (r = .82, r = .84), and pulmonary arterial diameter consistently exceeded aortic diameter. There was a positive relationship between stroke volume and gestational age: stroke volume increased exponentially from 0.7 ml at 20 weeks to 7.6 ml at 40 weeks for the right ventricle (r = .87) and from 0.7 ml at 20 weeks to 5.2 ml at 40 weeks for the left ventricle (r = .91). Similar results were obtained for right and left ventricular and combined cardiac outputs. In 44% of the fetuses it was possible to quantitate both right and left ventricular stroke volumes. There was a close correlation between right and left ventricular stroke volumes in these fetuses (r = .96) and right ventricular stroke volume exceeded left ventricular stroke volume by 28%.(ABSTRACT TRUNCATED AT 250 WORDS)
.A
Kenny JF; Plappert T; Doubilet P; Saltzman DH; Cartier M; Zollars L; Leatherman GF; St. John Sutton MG.
.I 314
.U
87052052
.S
Circulation 8703; 74(6):1226-34
.M
Adolescence/*; Androstenedione/BL; Apolipoproteins/BL; Caucasoid Race/*; Child; Dehydroepiandrosterone/AA/BL; Estradiol/BL; Human; Lipids/BL; Lipoproteins/*BL; Louisiana; Male; Negroid Race/*; Progesterone/BL; Sex Hormones/*BL; Sex Maturation; Support, U.S. Gov't, P.H.S.; Testosterone/BL.
.T
Racial (black-white) comparisons of the relationship of levels of endogenous sex hormones to serum lipoproteins during male adolescence: the Bogalusa Heart Study.
.P
JOURNAL ARTICLE.
.W
The cross-sectional relationship of endogenous androgens (testosterone, androstenedione, and dehydroepiandrosterone sulfate [DHEA-S]), estrogen (estradiol) and progestin (progesterone) to serum levels of lipoprotein cholesterol (very low-density [VLDL], low-density [LDL], and high-density lipoprotein [HDL]) and apolipoproteins (apo A-I and apo B) were studied in white (n = 251) and black (n = 258) adolescent boys, ages 11 to 17 years, as part of the Bogalusa Heart Study. Black boys had significantly higher levels of estradiol, HDL cholesterol, and apo A-I, and lower levels of androstenedione and VLDL cholesterol than white boys, independent of age and adiposity. Age was correlated strongly with testosterone and androstenedione, and moderately with DHEA-S and estradiol levels in both races. However, only in white boys was age consistently related to VLDL cholesterol (positively), HDL cholesterol (negatively), and apo A-I (negatively). Overall, testosterone was associated inversely with HDL cholesterol and apo A-I in white boys, while progesterone was related positively to apo A-I in both races after adjusting for age and adiposity. However, these relationships were found to differ with age. Partial correlations between levels of sex hormones and lipoproteins adjusted for age and adiposity showed no associations in the 11 to 12 year age group in boys of either race. A significant positive relation of testosterone to VLDL cholesterol, and inverse relations of testosterone to HDL cholesterol and apo A-I and DHEA-S to HDL cholesterol were apparent only in white boys in the 13 to 14 year age group.(ABSTRACT TRUNCATED AT 250 WORDS)
.A
Srinivasan SR; Freedman DS; Sundaram GS; Webber LS; Berenson GS.
.I 315
.U
87052053
.S
Circulation 8703; 74(6):1235-42
.M
Cineradiography; Comparative Study; Coronary Disease/*RA/TH; Coronary Vessels/RA; Evaluation Studies; Follow-Up Studies; Heart Catheterization; Human; Image Processing, Computer-Assisted; Methods; Random Allocation; Retrospective Studies; Risk; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Time Factors.
.T
Optimal detection of the progression of coronary artery disease: comparison of methods suitable for risk factor intervention trials.
.P
JOURNAL ARTICLE.
.W
To assess the best method of quantitating progression of coronary disease, we studied four measurements in 114 coronary segments from 35 medically treated patients from whom angiograms were obtained 5 years apart. Only stenoses of less than 70% that were visualized in nearly identical projections on both angiograms were evaluated. Vessel edges were measured by use of catheter calibration and an automated computer algorithm yielding two "absolute dimensions" (mean and minimum diameters) and two measurements (percent stenosis and atheroma area) that required a "normal reference" diameter. The coefficient of variation for repeated segment measurements was less for mean and minimum diameter than for percent stenosis and area of atheroma. The best measure of progression of coronary disease as determined by t test comparison of different methods was the change in mean diameter over time (6.7 +/- 14.1% decrease), whether calculated on a per coronary segment or per patient basis (p less than .001). Based on this measurement and its standard deviation of progression of coronary disease in this patient subset with relatively benign disease, it is estimated that 470 patients per group would be required for an interventional study to demonstrate a 33% reduction in disease progression (207 patients for 50% reduction) at a 95% confidence level and 90% power.
.A
Ellis S; Sanders W; Goulet C; Miller R; Cain KC; Lesperance J; Bourassa MG; Alderman EL.
.I 316
.U
87052055
.S
Circulation 8703; 74(6):1248-54
.M
Angina Pectoris/*PP; Angina, Unstable/*PP; Cardiac Pacing, Artificial; Circadian Rhythm/*; Coronary Disease/*PP; Coronary Vessels/RA; Electrocardiography; Heart Atrium/PP; Heart Catheterization; Hemodynamics; Human; Male; Middle Age; Rest.
.T
Resting angina with fixed coronary artery stenosis: nocturnal decline in ischemic threshold.
.P
JOURNAL ARTICLE.
.W
Atrial pacing was performed in 16 patients with angina at rest and significant coronary artery stenosis (greater than 70%) over 2 consecutive days in the morning (10 A.M. to 1 P.M.), in the afternoon (4 to 7 P.M.), and at night (12 midnight to 3 A.M.) to assess possible circadian variations of their ischemic threshold. Overall, the incidence of resting angina was highest at night. All pacing results were positive (greater than or equal to 1.0 mm ST segment shift) and tended to be reproducible in nine patients, whereas some or all were negative in seven. Among all positive results, ischemic thresholds at night were significantly lower than those in the morning and in the afternoon (125 +/- 3 vs 138 +/- 3 and 139 +/- 2 beats/min, mean +/- SEM; p less than .005). In nine patients, 19 pacing tests produced ST segment elevation, of which 13 were performed at night (68%). We conclude that patients with resting angina and severe coronary stenosis often exhibit a nocturnal decline in their ischemic threshold, which seems to facilitate development of transmural ischemia during atrial pacing.
.A
Figueras J; Cinca J; Balda F; Moya A; Rius J.
.I 317
.U
87052056
.S
Circulation 8703; 74(6):1255-65
.M
Adult; Aged; Angina Pectoris, Variant/ET/*PP; Cold/DU; Coronary Vasospasm/ET/PP; Coronary Vessels/DE/*PP; Ergonovine/DU; Exertion; Female; Histamine/DU; Human; Hyperventilation/PP; Male; Middle Age; Support, Non-U.S. Gov't; Vasoconstriction/*/DE.
.T
Local coronary supersensitivity to diverse vasoconstrictive stimuli in patients with variant angina.
.P
JOURNAL ARTICLE.
.W
It has been shown in different groups of patients with variant angina that coronary spasm can be reproduced by physiologic maneuvers and pharmacologic agents. It is not known, however, to what extent different stimuli can induce spasm in the same patient. To investigate whether coronary arterial spasm results from specific abnormal agonist-receptor interactions or from a local nonspecific coronary supersensitivity to different stimuli, 28 patients with vasospastic angina were submitted to a series of diverse vasoconstrictive stimuli known to provoke coronary spasm. Ergonovine, hyperventilation, handgrip, cold pressor, and exercise-tests, were carried out in all 28 patients. In the last 15 patients histamine was also administered. Spasm was provoked by ergonovine in 96% of patients, by hyperventilation in 54%, by histamine in 47%, by exercise in 46%, and by the cold pressor and handgrip tests in 11% and 7%, respectively. No significant differences were found in the responses to provocative tests of patients with normal coronary arteries or nonsignificant stenoses and those with significant lesions. In the same individual, spasm was induced by at least two vasoconstrictive stimuli, although with a different mechanism of action, in 82% of patients and spasm was induced by three or more stimuli in 39%. Tests were repeated in at least 23 patients and short-term reproducibility paralleled sensitivity. These results suggest that in patients with variant angina, a local nonspecific supersensitivity rather than an abnormal specific agonist-receptor interaction plays a major role in the genesis of coronary arterial spasm.
.A
Kaski JC; Crea F; Meran D; Rodriguez L; Araujo L; Chierchia S; Davies G; Maseri A.
.I 318
.U
87052058
.S
Circulation 8703; 74(6):1280-9
.M
Comparative Study; Death, Sudden; Electrocardiography/MT; Follow-Up Studies; Heart Ventricle/PP/RI; Human; Membrane Potentials; Monitoring, Physiologic/MT; Myocardial Infarction/CO/DI/*PP; Prognosis; Prospective Studies; Risk; Stroke Volume; Support, Non-U.S. Gov't; Tachycardia/DI/PP; Time Factors; Ventricular Fibrillation/DI/PP.
.T
Late potentials detected after myocardial infarction: natural history and prognostic significance.
.P
JOURNAL ARTICLE.
.W
The risk of developing spontaneous ventricular tachycardia (VT) and/or sudden death ("arrhythmic events") was prospectively assessed in 165 patients who survived acute myocardial infarction. Signal-averaged electrocardiograms (ECGs) were performed before hospital discharge and then serially at regular intervals over the following year. In addition, 24 hr Holter monitoring was performed and left ventricular ejection fraction was determined. Sixty-five patients (group 1) had abnormal signal-averaged ECGs (voltage in the last 40 msec of the filtered QRS less than 20 microV or filtered QRS duration greater than 120 msec), 92 had normal signal-averaged ECGs (group 2), and eight had bundle branch block (excluded from analysis). In group 1, spontaneous normalization of the voltage in the last 40 msec of the QRS complex occurred in 30% of patients after 12 months, although total filtered QRS duration did not change overall. During follow-up of up to 20 months (median 11), seven patients died suddenly and six presented again with spontaneous, symptomatic VT. Eleven of 65 (17%) group 1 patients had an arrhythmic event compared with one of 92 patients (1%) in group 2 (p less than .001). The sensitivity of the signal-averaged ECG as a predictor of arrhythmic events was 92% with a specificity of 62%. Patients with subsequent arrhythmic events had considerably lower voltage in the last 40 msec of the QRS (11.0 +/- 8.3 vs 32.0 +/- 21.9 microV; p less than .001) than those without such events, and longer filtered QRS complexes (121 +/- 14 vs 105 +/- 12 msec; p less than .001). Multivariate logistic regression determined that the signal-averaged ECG provided independent prognostic information from the presence of complex ventricular ectopy and the degree of left ventricular dysfunction assessed at the time of hospital discharge. Signal-averaged ECGs provide important prognostic information in identifying patients at risk of arrhythmic events after myocardial infarction. Dynamic changes in the terminal QRS voltage are observed during the first year after myocardial infarction.
.A
Kuchar DL; Thorburn CW; Sammel NL.
.I 319
.U
87052059
.S
Circulation 8703; 74(6):1290-302
.M
Adult; Biopsy; Calcium Gluconate/PD; Comparative Study; Dobutamine/*PD; Endocardium/AN/DE/PA; Heart/*DE/PP; Heart Catheterization; Heart Failure, Congestive/*ME/PP; Hemodynamics/DE; Human; Male; Middle Age; Myocardium/*AN/PA; Radioligand Assay; Receptors, Adrenergic, Beta/*AN/DE; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Assessment of the beta-adrenergic receptor pathway in the intact failing human heart: progressive receptor down-regulation and subsensitivity to agonist response.
.P
JOURNAL ARTICLE.
.W
We developed methods for identifying beta-adrenergic receptors in human right ventricular endomyocardial biopsy tissue with the radioligand (-)[125I]iodocyanopindolol (ICYP). Specific ICYP binding in a crude, high-yield membrane preparation derived from endomyocardial biopsy tissue was high (specificity greater than 90%), of high affinity (KD around 20 pM), saturable and stereospecific for the (-) vs the (+) isomer of isoproterenol. Subjects with mild-moderate and severe biventricular dysfunction had respective decreases in beta-adrenergic receptor density of 38.2% and 57.7% when normalization methods were averaged, with no significant differences in ICYP dissociation constant. A subgroup of subjects was subdivided by left ventricular ejection fraction (LVEF) into those with mild cardiac dysfunction (LVEF less than 0.50 greater than 0.40) and severe heart failure (LVEF less than 0.20) and given graded sequential infusions of dobutamine and calcium gluconate. Those with severe cardiac dysfunction had marked impairment of the dobutamine dP/dt and stroke work index response, whereas these responses to calcium did not differ in the two groups. These data indicate that in the intact human heart endomyocardial biopsy may be used for direct analysis of beta-adrenergic receptors, heart failure-associated myocardial beta-adrenergic down-regulation begins with mild-moderate ventricular dysfunction, reduction in myocardial beta-receptor density is related to degree of heart failure, and beta-receptor down-regulation is associated with pharmacologically specific impairment of the beta-agonist-mediated contractile response.
.A
Fowler MB; Laser JA; Hopkins GL; Minobe W; Bristow MR.
.I 320
.U
87052060
.S
Circulation 8703; 74(6):1303-8
.M
Cardiac Output/*/DE; Cardiomyopathy, Congestive/DT/*PP; Coronary Disease/DT/PP; Diuretics/TU; Heart Catheterization; Heart Ventricle/DE/PP; Hemodynamics/DE; Human; Prospective Studies; Rheumatic Heart Disease/DT/PP; Vasodilator Agents/TU.
.T
Maintenance of cardiac output with normal filling pressures in patients with dilated heart failure.
.P
JOURNAL ARTICLE.
.W
Therapy of elevated ventricular filling pressures in patients with dilated heart failure may be limited by concern that cardiac output will be further compromised. Twenty-five patients with severe symptoms and ejection fractions of 25% or less were studied to determine the lowest ventricular filling pressures that could be achieved with vasodilator and diuretic therapy while maintaining cardiac output. In 20 of 25 patients normal pulmonary capillary wedge pressures (PCWs) were achieved (mean 10 mm Hg compared with 30 mm Hg at baseline). Stroke volume was 60 vs 39 ml at baseline. Stroke work index was 30 vs 19 g-m/m2. For each patient, over the range of PCWs, stroke volume and stroke work index were maintained and were often maximal at the lowest PCW achieved. The upright position was well tolerated in patients with normal supine PCW. Normal filling pressures can be achieved in patients with congestive heart failure without compromise of cardiac output. While congestive symptoms should be improved, the feasibility and benefit of maintaining normal filling pressures over a long term must be established.
.A
Stevenson LW; Tillisch JH.
.I 321
.U
87052061
.S
Circulation 8703; 74(6):1309-16
.M
Aortic Valve; Aortic Valve Insufficiency/PP/SU; Aortic Valve Stenosis/PP/SU; Heart Catheterization; Heart Valve Prosthesis/*; Hemodynamics/*; Human; Mitral Valve; Mitral Valve Insufficiency/PP/SU; Mitral Valve Stenosis/PP/SU; Postoperative Period; Prognosis; Stroke Volume; Systole.
.T
Hemodynamic predictors of outcome in patients undergoing valve replacement [published erratum appears in Circulation 1987 Mar;75(3):650]
.P
JOURNAL ARTICLE.
.W
The afterload-corrected end-systolic volume index (ratio of end-systolic stress to end-systolic volume index [ESS/ESVI]) was previously useful in predicting outcome in patients with mitral regurgitation undergoing valve replacement. Therefore we tested ESS/ESVI together with standard hemodynamic variables as possible predictors of outcome in 39 patients with various valvular lesions who underwent valve replacement. Thirteen patients had preoperative mitral regurgitation, 16 had aortic stenosis, nine had aortic regurgitation, and one had mitral stenosis. Twenty-seven patients (group S) had a satisfactory outcome as defined by a return to NYHA class I or II together with a normal postoperative ejection fraction. Twelve patients who died, remained in class III or IV, or had a subnormal postoperative ejection fraction were deemed to have an unsatisfactory result (group U). Mean right atrial pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, end-diastolic volume index, end-systolic volume index (ESVI), and end-systolic wall stress were all greater in group U, whereas ESS/ESVI and ejection fraction were lower in group U. When these and other factors were submitted to stepwise discriminant multivariate analysis, ESS/ESVI and ESVI were the only independent predictors of outcome. However, when patients with mitral regurgitation (who might have biased the study) were excluded, discriminant analysis showed ESVI as the only independent predictive variable. We conclude that end-systolic indicators of ventricular function are superior to other standard hemodynamic variables in predicting outcome of valve replacement.
.A
Carabello BA; Williams H; Gash AK; Kent R; Belber D; Maurer A; Siegel J; Blasius K; Spann JF.
.I 322
.U
87052062
.S
Circulation 8703; 74(6):1317-22
.M
Adolescence; Adult; Child; Child, Preschool; Color; Comparative Study; Echocardiography/IS/*MT; Evaluation Studies; Heart Septal Defects, Ventricular/*DI/PA; Heart Septum/PA/RA; Heart Ventricle/PA/RA; Human; Infant; Support, U.S. Gov't, P.H.S..
.T
Color Doppler detection of multiple ventricular septal defects.
.P
JOURNAL ARTICLE.
.W
Combined two-dimensional and Doppler echocardiography has a high sensitivity and specificity for detection of isolated perimembranous ventricular septal defects. However, muscular or multiple ventricular septal defects may be difficult to diagnose with noninvasive methods, particularly in older children, necessitating angiography for accurate diagnosis. Detection of single and multiple ventricular septal defects with two-dimensional color flow mapping was compared with detection by standard two-dimensional imaging and Doppler. Both techniques were compared with four-chamber left ventricular angiography. Fifty-one patients (age 3 months to 25 years, mean 5.6 years) were studied. Eighteen had solitary ventricular septal defects, 18 had multiple ventricular septal defects, and 15 patients with intact ventricular septum served as a control group. At least one ventricular septal defect was detected by color Doppler and two-dimensional/Doppler methods in all patients with ventricular septal defect proved by angiography with no false positives. In the detection of multiple ventricular septal defects, the sensitivity of color Doppler was 72% and that of two-dimensional/Doppler was 38% (100% specificity in both). Color Doppler failed to identify multiple ventricular septal defects in five patients (two weighing less than 4 kg and three with reduced pulmonary blood flow). However, no large additional muscular defects were missed by imaging and color Doppler. Color Doppler is useful for the detection of ventricular septal defects and has higher sensitivity than two-dimensional/Doppler for multiple ventricular septal defects. The contribution of color Doppler appears to be in the detection of additional small muscular ventricular septal defects.
.A
Ludomirsky A; Huhta JC; Vick GW 3d; Murphy DJ Jr; Danford DA; Morrow WR.
.I 323
.U
87052063
.S
Circulation 8703; 74(6):1323-33
.M
Adult; Aged; Comparative Study; Electrocardiography/IS/*MT; Electrodes; Female; Human; Male; Membrane Potentials; Microcomputers; Middle Age; Minicomputers; Support, Non-U.S. Gov't; Tachycardia/*DI/DT/SU; Time Factors; Vectorcardiography/IS/MT.
.T
Characterization of the spatial distribution of late ventricular potentials by body surface mapping in patients with ventricular tachycardia.
.P
JOURNAL ARTICLE.
.W
Low-level activity at the end of the QRS complex was analyzed from 63 thoracic leads in 15 normal subjects and in 21 patients with ventricular tachycardia (VT). The latter had old myocardial infarction and no conduction disturbances and had not been receiving antiarrhythmic drugs. In both normal subjects and patients with VT, isopotential maps of the time-averaged and filtered (25 Hz high-pass) electrocardiograms during the terminal portion of the QRS were dipolar, i.e., they showed single positive and negative regions. For patients with VT, the extrema were either distant, with one over the precordial area and the other over the back, or close together in the precordial region. In 10 patients, maps recorded after administration of antiarrhythmic drugs remained the same while QRS duration was prolonged. In six patients, maps recorded before antiarrhythmic surgery showed distant extrema for septal or posterobasal VT sites of origin and close extrema for anterior or posteroapical sites. Generally, QRS duration was reduced and maps were modified after surgery. Late potentials can be well detected with only three orthogonal leads because their distributions are dipolar, but maps provide additional information about their distribution, which may be related to conduction delay sites and possibly to VT sites of origin. Sources near the torso surface would produce close extrema, whereas deeper sources would produce distant extrema.
.A
Faugere G; Savard P; Nadeau RA; Derome D; Shenasa M; Page PL; Guardo R.
.I 324
.U
87052064
.S
Circulation 8703; 74(6):1334-45
.M
Adolescence; Adult; Arrhythmia/*DI; Child; Comparative Study; Computers; Electrocardiography/IS/*MT; Electrodes; Female; Heart Ventricle/PP; Human; Long QT Syndrome/*DI; Male; Middle Age; Vectorcardiography/MT.
.T
Mapping of body surface potentials in patients with the idiopathic long QT syndrome.
.P
JOURNAL ARTICLE.
.W
Body surface potential maps were recorded from 140 chest leads in 25 patients affected by the idiopathic long QT syndrome (LQTS) and in 25 healthy control subjects matched for age and sex. Potential time integrals of the QRST and ST-T intervals were calculated at each lead point and displayed as isointegral (ISOI) maps. The main abnormalities noted on the QRST and ST-T ISOI maps were one area of negative values larger than normal in the right anterior and inferior thorax and a complex multipeak distribution of the integral values. At least one abnormality was present in 19 (76%) of the patients with LQTS and four (16%) of the control subjects (p less than .001). Each ISOI map was also represented as a weighted sum of nine fundamental components (eigenvectors) to detect and quantitate the nondipolar content. The percent contribution of the nondipolar eigenvectors (all eigenvectors beyond the third) was significantly higher in the LQTS group than in the control group (p less than .005). Specifically, an abnormally high nondipolar content on the QRST ISOI maps was observed much more frequently for patients with LQTS than for control subjects (nine or 36% vs one or 4%), and this was also true on the ST-T ISOI maps (14 or 56% vs one or 4%). No correlation was found between the major abnormalities on body surface maps and syncopal episodes. However, the high prevalence (76%) of these alterations among the patients with LQTS and their infrequent occurrence in the control population strongly suggests that they may be useful markers for the diagnosis of atypical cases. The prominent electronegative area on the anterior thorax can be related to delayed repolarization of a portion of the anterior wall of the heart. This finding is in agreement with the hypothesis that lower than normal right cardiac sympathetic activity is the main pathogenetic mechanism of LQTS. Multipeak distribution and high nondipolar content suggest regional electrical disparities in the ventricular recovery process. This may in part account for the high susceptibility of patients with LQTS to malignant arrhythmias.
.A
De Ambroggi L; Bertoni T; Locati E; Stramba-Badiale M; Schwartz PJ.
.I 325
.U
87052065
.S
Circulation 8703; 74(6):1346-54
.M
Cardiac Pacing, Artificial; Cardiopulmonary Bypass; Cineradiography; Comparative Study; Computers; Electrocardiography/IS/*MT; Electrodes; Evaluation Studies; Heart Catheterization/IS/*MT; Heart Ventricle/PP/RA/SU; Human; Intraoperative Care/*MT; Support, Non-U.S. Gov't; Tachycardia/DI/SU.
.T
Endocardial catheter mapping: wire skeleton technique for representation of computed arrhythmogenic sites compared with intraoperative mapping.
.P
JOURNAL ARTICLE.
.W
Guiding surgical therapy of ventricular tachycardia by preoperative endocardial catheter mapping necessitates improvement of the accuracy of localization of the arrhythmogenic site. We therefore used a new mathematical cineradiographic method during catheter mapping to compute the position of left ventricular arrhythmogenic sites relative to three anatomic reference points: the centers of aortic and mitral valve ostia and the left ventricular apex. To enable the surgeon to identify the position of the computed sites, a wire skeleton (one for each patient) representing a single or multiple arrhythmogenic site(s) relative to the anatomic reference points was constructed. This wire skeleton was inserted into the left ventricular cavity during surgery. Side branches of the device indicated preoperatively localized arrhythmogenic sites. Results in eight consecutive patients were compared with those of intraoperative simultaneous mapping of 64 endocardial sites. Sixteen morphologically distinct monomorphic ventricular tachycardias were mapped by catheter and 15 by intraoperative mapping. In 12 ventricular tachycardias an identical morphology was recorded during both techniques. The distance between arrhythmogenic sites localized with both methods was 1 cm or less in 11 of these 12 ventricular tachycardias and 2 cm in one ventricular tachycardia. These results indicate that endocardial catheter mapping combined with wire skeleton representation of computed positions of arrhythmogenic sites is reliable for guiding surgical therapy of ventricular tachycardia and since some of the ventricular tachycardias were inducible only during either preoperative or intraoperative mapping, both techniques have an additive value. In addition, the wire skeleton proved convenient during surgery by identifying the arrhythmogenic sites.
.A
Hauer RN; de Zwart MT; de Bakker JM; Hitchcock JF; Penn OC; Nijsen-Karelse M; Robles de Medina EO.
.I 326
.U
87052066
.S
Circulation 8703; 74(6):1355-64
.M
Acetylprocainamide/BL; Aged; Cardiac Pacing, Artificial; Dose-Response Relationship, Drug; Drug Evaluation; Electrocardiography; Female; Heart Catheterization; Heart Conduction System/*DE; Heart Ventricle/DE; Human; Infusions, Intravenous; Male; Middle Age; Procainamide/*AD/BL; Prospective Studies; Tachycardia/BL/DT/*ET.
.T
Effects of incremental doses of procainamide on ventricular refractoriness, intraventricular conduction, and induction of ventricular tachycardia.
.P
JOURNAL ARTICLE.
.W
The short-term effects of incremental doses of procainamide (7.5, 15, 22.5, and 30 mg/kg) on right ventricular effective refractory period, intraventricular conduction, and induction of ventricular tachycardia were determined in 31 patients who had a history of sustained, unimorphic ventricular tachycardia. QRS duration during incremental ventricular pacing was used as an index of rate-dependent changes in intraventricular conduction. The mean plasma procainamide concentrations corresponding to the incremental doses were 5.5 +/- 1.2 (+/- SD), 9.0 +/- 1.6, 12.6 +/- 2.2, and 16.3 +/- 3.2 mg/liter. Each incremental dose of procainamide up to a dose of 30 mg/kg resulted in a significant increment in right ventricular effective refractory period and each dose up to 22.5 mg/kg potentiated a rate-dependent prolongation of QRS duration. After the 7.5 mg/kg dose of procainamide, induction of ventricular tachycardia was suppressed in eight of 31 patients. After higher doses of procainamide, induction of ventricular tachycardia was suppressed in two additional patients. In three of 10 patients in whom the induction of ventricular tachycardia was suppressed by 7.5, 15, or 22.5 mg/kg of procainamide, sustained unimorphic ventricular tachycardia was again inducible after a higher dose of procainamide. In three of 31 patients, only nonsustained ventricular tachycardia was inducible after a 7.5 to 22.5 mg/kg dose of procainamide; however, in two of these three patients, sustained ventricular tachycardia was again inducible after administration of a higher dose of procainamide. In conclusion, during electropharmacologic testing with procainamide, it is worthwhile to test a dose of 7.5 mg/kg, because this dose is often effective in patients who respond to this drug. However, the results of this study indicate that procainamide may be effective in suppressing the induction of sustained ventricular tachycardia at a relatively low plasma concentration, but not at a higher plasma concentration. Therefore, during long-term therapy with procainamide it may be important to avoid plasma procainamide concentrations not only lower, but also higher than the concentration that results in the suppression of induction of tachycardia.
.A
Morady F; DiCarlo LA Jr; de Buitleir M; Krol RB; Baerman JM; Kou WH.
.I 327
.U
87052067
.S
Circulation 8703; 74(6):1365-70
.M
Angina Pectoris/*TH; Angina, Unstable/DI/ET/*TH; Angioplasty, Transluminal/*/MT; Coronary Vessels/*/RA; Electrocardiography; Follow-Up Studies; Human; Myocardial Infarction/*CO/DI; Recurrence; Time Factors.
.T
Coronary angioplasty for early postinfarction unstable angina.
.P
JOURNAL ARTICLE.
.W
Coronary angioplasty was performed in 53 patients in whom unstable angina had reoccurred after 48 hr and within 30 days after sustained myocardial infarction. Single-vessel disease was present in 64% of the patients and multivessel disease in 36%. The preceding myocardial infarction had been small to moderate in size in the majority of the patients. The left ventricular ejection fraction was more than 50% in 80% of the patients. Forty-five patients were refractory to pharmacologic treatment; eight were initially stabilized but once again became symptomatic with light exertion. Angioplasty was performed in 35 patients 2 to 14 days and in 18 patients 15 to 30 days after infarction (average 12 +/- 7 days after infarction). The initial success rate was 89% (47/53). The success rate of the patients treated at 2 to 14 days was lower (29/35, 83%) than that of patients treated at 14 to 30 days (18/18, 100%) but did not reach statistical significance (p less than .06). There were no deaths related to the procedure. In four of the six failures, emergency bypass surgery was performed and two patients sustained a myocardial infarction. Furthermore, a myocardial infarction complicated the angioplasty procedure in two other patients; thus the overall procedure-related myocardial infarction rate was 8% (4/53). At 6 months follow-up 26% (14/53) of all the patients who underwent angioplasty had recurrence of angina, which was successfully treated with repeat angioplasty, bypass surgery, or medical therapy. There were no late deaths. Late myocardial infarction occurred in two patients. Thus the total myocardial infarction rate after angioplasty at 6 months was 11% (6/53 patients).(ABSTRACT TRUNCATED AT 250 WORDS)
.A
de Feyter PJ; Serruys PW; Soward A; van den Brand M; Bos E; Hugenholtz PG.
.I 328
.U
87052068
.S
Circulation 8703; 74(6):1371-8
.M
Angioplasty, Transluminal/*AE/MT; Comparative Study; Coronary Disease/*CO/RA/SU; Coronary Vessels/*IN/RA/SU; Emergencies; Human; Prognosis; Time Factors.
.T
Coronary dissection and total coronary occlusion associated with percutaneous transluminal coronary angioplasty: significance of initial angiographic morphology of coronary stenoses.
.P
JOURNAL ARTICLE.
.W
Coronary dissection and total coronary occlusion leading to emergency coronary surgery are the most frequent complications of percutaneous transluminal coronary angioplasty (PTCA) and their occurrence usually is unpredictable. To identify angiographic characteristics of coronary stenoses that may affect the incidence of these complications, the diagnostic pre-PTCA coronary angiograms of 38 consecutive patients (group I) undergoing emergency coronary surgery for dissection or occlusion were reviewed and compared with the angiograms of a random sample of 38 patients (stratified for left anterior descending and right coronary arteries) from a group of 1151 who did not need emergency coronary surgery (group II). Stenosis morphology before angioplasty was considered "complicated" if at least one of the following criteria was present: irregular borders, intraluminal lucency, and localization of stenosis in curve or at bifurcation. Baseline characteristics, maximum inflation pressures, types of balloon catheters used, and routinely registered angiographic stenosis properties (severity, length, eccentricity, and calcification) were similar in both groups. Irregular borders before PTCA were present in 22 of 38 patients in group I vs 10 of 38 in group II (p less than .05), intraluminal lucency in 22 of 38 vs nine of 38 (p less than .05), localization in curve in 27 of 38 pts vs 16 of 38 (p less than .05), and localization at bifurcation in 11 of 38 vs 15 of 38 (NS). Complicated angiographic morphology of coronary stenosis may represent a risk factor for dissection or occlusion. Therefore, although the predictive value of these findings is low, detailed evaluation of angiographic morphology of coronary stenoses may improve patient selection and reduce complication rates of PTCA.
.A
Ischinger T; Gruentzig AR; Meier B; Galan K.
.I 329
.U
87052069
.S
Circulation 8703; 74(6):1379-89
.M
Comparative Study; Coronary Vessels/*/RA; Drug Evaluation; Electrocardiography; Heart Catheterization; Heart Ventricle/DE/RI; Hemodynamics/DE; Human; Hydroxybutyrate Dehydrogenase/BL; Myocardial Infarction/DT/EN/MO; Myocardium/EN; Streptokinase/*AD; Time Factors.
.T
Which patients benefit most from early thrombolytic therapy with intracoronary streptokinase? [published erratum appears in Circulation 1987 Feb;75(2):394]
.P
JOURNAL ARTICLE.
.W
The effect of thrombolysis in acute myocardial infarction on enzymatic infarct size, left ventricular function, and early mortality was studied in subsets of patients in a randomized trial. Early thrombolytic therapy with intracoronary streptokinase (152 patients) or with intracoronary streptokinase preceded by intravenous streptokinase (117 patients) was compared with conventional treatment (264 patients). All 533 patients were admitted to the coronary care unit within 4 hr after onset of symptoms indicative of acute myocardial infarction. Four hundred eighty-eight patients were eligible for this detailed analysis, and 245 of these were allocated to thrombolytic therapy and 243 to conventional treatment. Early angiographic examinations were performed in 212 patients allocated to thrombolytic therapy. Patency of the infarct-related artery was achieved in 181 patients (85%). Enzymatic infarct size, as measured from cumulative alpha-hydroxybutyrate dehydrogenase release, was smaller in patients allocated to thrombolytic therapy (median 760 vs 1170 U/liter in control patients, p = .0001). Left ventricular ejection fraction measured by radionuclide angiography before discharge from the hospital was higher after thrombolytic therapy (median 50% vs 43% in control patients, p = .0001). Three month mortality was lower in patients allocated to thrombolytic therapy (6% vs 14% in the control group, p = .006). With the use of multivariate regression analysis, infarct size limitation, improvement in left ventricular ejection fraction, and three month mortality were predicted by sum of the ST segment elevation, time from onset of symptoms to admission, and Killip class at admission. Thrombolysis was most effective in patients admitted within 2 hr after onset of symptoms and in patients with a sum of ST segment elevation of 1.2 mV or more. On the other hand, no beneficial effects of streptokinase on enzymatic infarct size, left ventricular function, or mortality were observed in the subset of patients with a sum of ST segment elevation of less than 1.2 mV who were admitted between 2 and 4 hr after onset of symptoms.
.A
Vermeer F; Simoons ML; Bar FW; Tijssen JG; van Domburg RT; Serruys PW; Verheugt FW; Res JC; de Zwaan C; van der Laarse A; et al.
.I 330
.U
87052072
.S
Circulation 8703; 74(6):1407-15
.M
Animal; Cerebrovascular Circulation; Comparative Study; Coronary Circulation; Dogs; Epinephrine/TU; Heart Arrest/MO/PP/*TH; Pressure; Respiration, Artificial/*; Resuscitation/*IS/MT; Support, U.S. Gov't, P.H.S.; Time Factors; Ventricular Fibrillation/PP/TH.
.T
Vest inflation without simultaneous ventilation during cardiac arrest in dogs: improved survival from prolonged cardiopulmonary resuscitation.
.P
JOURNAL ARTICLE.
.W
Myocardial and cerebral blood flow can be generated during cardiac arrest by techniques that manipulate intrathoracic pressure. Augmentation of intrathoracic pressure by high-pressure ventilation simultaneous with compression of the chest in dogs has been shown to produce higher flows to the heart and brain, but has limited usefulness because of the requirement for endotracheal intubation and complex devices. A system was developed that can produce high intrathoracic pressure without simultaneous ventilation by use of a pneumatically cycled vest placed around the thorax (vest cardiopulmonary resuscitation [CPR]). The system was first tested in a short-term study of the maximum achievable flows during arrest. Peak vest pressures up to 380 mm Hg were used on eight 21 to 30 kg dogs after induction of ventricular fibrillation and administration of epinephrine. Microsphere-determined myocardial blood flow was 108 +/- 17 ml/min/100 g (100 +/- 16% of prearrest flow) and cerebral flow was 51 +/- 12 ml/min/100 g (165 +/- 39% of prearrest). Severe lung or liver trauma was noted in three of eight dogs. If peak vest pressure was limited to 280 mm Hg, however, severe trauma was no longer observed. A study of the hemodynamics during and survival from prolonged resuscitation was then performed on three groups of seven dogs. Vest CPR was compared with manual CPR with either conventional (300 newtons) or high (430 newtons) sternal force. After induction of ventricular fibrillation, each technique was performed for 26 min. Defibrillation was then performed.(ABSTRACT TRUNCATED AT 250 WORDS)
.A
Halperin HR; Guerci AD; Chandra N; Herskowitz A; Tsitlik JE; Niskanen RA; Wurmb E; Weisfeldt ML.
.I 331
.U
87052073
.S
Circulation 8703; 74(6):1416-23
.M
Analysis of Variance; Animal; Blood Flow Velocity/DE; Coronary Circulation/*DE; Dogs; Dose-Response Relationship, Drug; Flowmeters; Heart/*DE/PH; Hemodynamics/DE; Iohexol/DU/*PD; Support, Non-U.S. Gov't; Support, U.S. Gov't, Non-P.H.S.; Time Factors.
.T
The immediate effects of iohexol on coronary blood flow and myocardial function in vivo.
.P
JOURNAL ARTICLE.
.W
Radiographic techniques used to quantify coronary blood flow all require bolus injection of contrast material, which markedly alters the flow being measured. Newer nonionic contrast agents have been shown to have fewer adverse hemodynamic, inotropic, and rheologic effects compared with ionic media and it has been suggested that they might not substantially affect coronary blood flow. Six dogs were instrumented with electromagnetic flow probes and subendocardial ultrasonic crystals. Intracoronary injections of iohexol (300 mg/ml iodine) were administered to establish a relationship between the dose and rate of contrast injection and the effect on flow and regional myocardial function. Two and 4 ml volumes of iohexol were injected at 3 ml/sec; 4 ml volumes were administered at 1 and 4 ml/sec. The 2 and 4 ml volumes decreased coronary flow by a mean of 31% (p less than .01) and 77% (p less than .001). The 4 ml injection at 1 and 4 ml/sec 77% (p less than .001) and 69% (p less than .001). The magnitude of the fall in flow was directly related to the dose, and the rate at which the flow nadir was attained was directly related to the rate of injection. Decrements in fractional shortening were temporally delayed by several beats compared with the flow changes and showed mean decrements of 19% to 29%. The effects on regional myocardial function were independent of contrast volume. However, the degree of dysfunction was more profound with slower infusion rates, suggesting that prolongation of contrast-induced ischemia was a major modulating factor.(ABSTRACT TRUNCATED AT 250 WORDS)
.A
Friedman HZ; DeBoe SF; McGillem MJ; Mancini GB.
.I 332
.U
87052074
.S
Circulation 8703; 74(6):1424-33
.M
Animal; Comparative Study; Coronary Circulation; Coronary Disease/DT/PP/RI; Dogs; Drug Screening; Female; Human; Male; Microspheres; Myocardial Infarction/*DT/PP/RI; Myocardium/PA; Necrosis; Recombinant Proteins/*TU; Superoxide Dismutase/*TU; Support, U.S. Gov't, P.H.S..
.T
Reduction in experimental infarct size by recombinant human superoxide dismutase: insights into the pathophysiology of reperfusion injury.
.P
JOURNAL ARTICLE.
.W
To determine the importance of reperfusion injury and the ability of the free-radical scavenger recombinant human superoxide dismutase (h-SOD) to prevent it, open-chest dogs underwent 90 min of proximal circumflex coronary artery occlusion, and only at the moment of reperfusion received either h-SOD (400,000 IU bolus into the left atrium followed by a 300,000 IU iv infusion over 1 hr) or saline. After 48 hr the surviving animals were killed and measurements were made of the risk region (by postmortem angiography) and infarct size (by gross pathology). All measurements were made by investigators blinded to treatment given, and the code was broken only at the end of the study. Hemodynamic variables and collateral flow during ischemia were similar in the two groups. Infarct size in control animals (n = 8) averaged 22.4 +/- 3.1% of the left ventricle and 52.2 +/- 7.1% of the risk region, compared with 13.3 +/- 0.8% of the left ventricle and 33.6 +/- 2.1% of the risk region in h-SOD-treated dogs (n = 8) (p less than .05). Infarcts in treated animals were not only smaller, but also exhibited a distinctive "patchiness," suggesting protection along vascular distributions. Furthermore, analysis of the relationship between infarct size and collateral flow measured during ischemia in the two groups indicated that protection by h-SOD was greatest in animals with the lowest collateral flows. This study supports the concept that reperfusion of ischemic myocardium results in a separate component of cell damage, presumably linked to the generation of oxygen free radicals on reflow. Since the h-SOD preventable reperfusion component of injury was most pronounced in hearts with the most severe ischemia, scavenging of oxygen radicals at the time of reflow may offer a novel and particularly promising therapeutic approach for the protection of ischemic myocardium.
.A
Ambrosio G; Becker LC; Hutchins GM; Weisman HF; Weisfeldt ML.
.I 333
.U
87052075
.S
Circulation 8703; 74(6):1434-40
.M
Animal; Comparative Study; Coronary Circulation; Dogs; Drug Screening; DTPA/*DU; Gadolinium/*DU; In Vitro; Myocardial Infarction/*DI; Myocardium/PA; Nuclear Magnetic Resonance/*DU/IS; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Tetrazolium Salts/DU.
.T
Magnetic resonance imaging of acute myocardial infarction: gadolinium diethylenetriamine pentaacetic acid as a marker of reperfusion.
.P
JOURNAL ARTICLE.
.W
We examined the effects of a paramagnetic contrast agent, gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) on magnetic resonance images of acute myocardial infarction with and without reperfusion. Twenty-two dogs underwent occlusion of the left anterior descending coronary artery (LAD). In 10 dogs (group I) the LAD remained occluded for 3 hr and in the other 12 (group II) for 2 hr followed by 1 hr of reperfusion. Gd-DTPA (0.34 mM/kg) was administered to five dogs in group I at 2 hr and 5 min after occlusion and to seven dogs in group II 5 min after reperfusion. At 3 hr after ligation, the hearts were excised and imaged with spin echo and inversion recovery pulse sequences on a 0.35 Tesla magnetic resonance imager. Reperfused hearts given Gd-DTPA demonstrated a significant increase in contrast between normal and reperfused myocardium as compared with nonreperfused hearts and reperfused hearts not given Gd-DTPA. This enhancement was particularly prominent in the inversion recovery images. Studies performed in vivo in two additional dogs demonstrated similar enhancement with reperfusion with Gd-DTPA in gated spin echo images. Contrast-enhanced magnetic resonance imaging allows the detection of reperfusion early in the course of acute infarction.
.A
Peshock RM; Malloy CR; Buja LM; Nunnally RL; Parkey RW; Willerson JT.
.I 334
.U
87052076
.S
Circulation 8703; 74(6):1465A-1468A
.M
American Heart Association; Caloric Intake; Cardiovascular Diseases/*PC; Diet/*ST; Human; Nutritional Requirements; United States.
.T
Dietary guidelines for healthy American adults. A statement for physicians and health professionals by the Nutrition Committee, American Heart Association.
.P
JOURNAL ARTICLE.
.W
This statement for physicians replaces the American Heart Association's Diet and Coronary Heart Disease, published in 1978. The current guidelines propose an optimal preventive diet for coronary heart disease. Emphasis is placed on the reduction of both saturated fat and total fat. Complex carbohydrates are recommended as the major replacement for calories from fat. Polyunsaturated and monounsaturated fats partially replace calories from other fat sources. Cholesterol and sodium guidelines are expressed relative to caloric intake, with an upper limit on each. The use of alcohol as a possible means of preventing cardiovascular disease is not advised. Maintenance of ideal body weight by calorie control and an adequate level of activity is emphasized.
.I 335
.U
87052078
.S
Circulation 8703; 74(6 Pt 2):IV1-153
.M
Critical Care/*ST; Emergencies; Heart Diseases/*TH; Human; Resuscitation/*ST; Support, Non-U.S. Gov't.
.T
Proceedings of the 1985 National Conference on Standards and Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care. July 11-13, Dallas, Texas.
.P
JOURNAL ARTICLE.
.I 336
.U
87052086
.S
Circulation 8703; 74(6 Pt 2):IV129-33
.M
Adolescence; Child; Child, Preschool; Emergency Medical Services/*; Health Services Needs and Demand/*; Health Services Research/*; Human; Infant; Life Support Care/*; Pediatrics/*; United States.
.T
A needs assessment of advanced life support and emergency medical services in the pediatric patient: state of the art.
.P
JOURNAL ARTICLE.
.W
The outcome from cardiopulmonary arrest in children in the prehospital and hospital setting is generally poor. The event that compromises the cardiac status is often respiratory embarrassment, and the presenting rhythms are often bradyarrhythmias and asystole. Emergency medical services (EMS) systems have primarily an adult focus and may not be organized to manage optimally the critically ill and injured child. Data from a survey of training programs demonstrate that paramedic and EMT education in pediatric emergencies may be inadequate. Forty-one percent of the programs surveyed had less than 10 hr of pediatric training. Data suggest that EMS providers may not be equipped to manage children effectively. The Los Angeles EMS System for children is described. There are two levels of receiving facilities: Emergency Departments Approved for Pediatrics and Pediatric Critical Care Centers. The system is voluntary and has 85% of the hospitals in compliance with the guidelines. Early recognition of the prearrest state, improved training, and equipping of prehospital care personnel, development of EMS services for children, dissemination of an advanced pediatric life support course, as well as research in pediatric CPR may improve the outcome of resuscitation in the pediatric population.
.A
Seidel JS.
.I 337
.U
87052087
.S
Circulation 8703; 74(6 Pt 2):IV13-7
.M
Allied Health Personnel/*; Community Health Services/*; Electric Countershock/*; Emergency Medical Technicians/*; Human; Support, U.S. Gov't, P.H.S.; United States.
.T
Special considerations for defibrillation performed by emergency medical technicians in small communities.
.P
JOURNAL ARTICLE.
.W
Defibrillation by minimally trained ambulance technicians can significantly improve survival after out-of-hospital cardiac arrest in communities of all sizes. However, special consideration must be given to the development of such services in small communities, chiefly because of problems associated with the low volume of true emergency calls. Communities considering implementing programs by which defibrillation is performed by the emergency medical technician (EMT-D) must first evaluate their ambulance response times and, if inadequate, alter their system of ambulance response. After implementation of such a program, a permanent, formal skill maintenance program must be established. Defibrillation protocols must allow for the fact that many patients will refibrillate after successful conversion, yet no advanced care beyond the defibrillator will generally be available. Finally, every community instituting an EMT-D program must maintain a system of monitoring EMT performance and patient outcome that documents acceptable survival-to-discharge rates as well as the safety of the program. For smaller communities a regional or statewide evaluation system may be preferable to individual community programs.
.A
Stults KR; Brown DD.
.I 338
.U
87052090
.S
Circulation 8703; 74(6 Pt 2):IV18-22
.M
Educational Measurement/MT; Human; Life Support Care/*ED; Resuscitation/*ED; Support, Non-U.S. Gov't.
.T
Education and evaluation in emergency cardiac care programs (CPR and advanced cardiac life support): state of the art.
.P
JOURNAL ARTICLE.
.W
To increase the survival rate for out-of-hospital cardiac arrest, improvements in training must be made so that lay rescuers are motivated and have the ability to get involved. To overcome some of the fear and lack of involvement, better education strategies are needed. Adults learn didactic information through understanding and skills through repetition and reinforcement. Due to the fact that there is limited time that adults will commit to learning CPR, methods of simplification of the techniques need to be used so that there can be sufficient repetition and reinforcement. Teaching two-rescuer CPR to lay rescuers should not routinely be done. Most adults, particularly those around high-risk individuals, should learn one-rescuer CPR. Infant resuscitation should be taught predominantly to those around small children. Methods of reinforcement through the mass media should be attempted on a routine basis. Whenever possible the courses should be spread over a period of time to allow for repetition and reinforcement, thereby maximizing learning. Advanced cardiac life support (ACLS) should be widely taught to health professionals. ACLS instruction needs to be spread over time, whenever logistically possible, to enhance learning and retention. Good, validated examinations are needed and should be routinely rotated. Better methods of evaluation are needed to look at the benefit of these types of programs and to improve the cost-benefit ratio.
.A
Atkins JM.
.I 339
.U
87052092
.S
Circulation 8703; 74(6 Pt 2):IV27-8
.M
Drowning/*TH; Human; Methods.
.T
Near drowning.
.P
JOURNAL ARTICLE.
.W
Several conditions that contribute to drowning and near drowning must be considered in the treatment of near-drowned victims. Regardless of the cause, mechanical ventilation should begin as soon as possible and closed-chest cardiac massage should be administered when there is any question about the adequacy of cardiac output. After aspiration of either fresh or seawater, a large intrapulmonary physiologic shunt can occur, which requires aggressive mechanical ventilatory support to ensure adequate oxygenation and to return pulmonary function to normal. Near drowning is a multisystem disease and, while abnormalities of the lung and brain have been emphasized, definitive therapy must be tailored to each patient and must address all of the patient's needs.
.A
Modell JH.
.I 340
.U
87052096
.S
Circulation 8703; 74(6 Pt 2):IV4-8
.M
Electric Countershock; Emergency Medical Services/*; Human; Life Support Care; Resuscitation; Support, Non-U.S. Gov't; United States.
.T
Emergency medical service systems in acute cardiac care: state of the art.
.P
JOURNAL ARTICLE.
.W
Over the last two decades, emergency medical services in the United States have been greatly improved. Organization of prehospital providers of health care has improved the outcome of many patients, particularly the trauma patient and the acute cardiac patient. In Seattle as many as 40% of outside-the-hospital cardiac arrest victims with ventricular fibrillation have been saved when there is rapid delivery of basic life support by first responders followed by advanced life support by paramedics. Although these systems are growing and improving health care, many lack adequate medical control or physician involvement. Emergency medical service systems must have physicians involved in their management to meet their full capabilities. It has become apparent that four factors are critical in determining the ability to resuscitate an individual once a cardiac arrest has occurred: time to starting any of the rescue procedures, use of electrical defibrillation when indicated, use of epinephrine, and adequacy of the technique of basic life support, particularly the ventilation component. To provide defibrillation at the earliest possible time, defibrillation by first responders such as emergency medical technicians appears to be of benefit. With the advent of automatic and semiautomatic defibrillators, first responders and family members may also be able to defibrillate victims. The use of defibrillation by people with less training than paramedics, however, must be approached with caution to ensure that there is adequate medical control and that the individuals who use these devices are properly trained.
.A
Atkins JM.
.I 341
.U
87052097
.S
Circulation 8703; 74(6 Pt 2):IV42-50
.M
Animal; Cough; Dogs; Human; Resuscitation/*MT; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Modifications of cardiopulmonary resuscitation based on the cough.
.P
JOURNAL ARTICLE.
.W
The ability of cardiopulmonary resuscitation (CPR) to provide adequate vital organ blood flow during prolonged resuscitation has long been questioned, as has the mechanism of blood flow during CPR. Because coughing during cardiac arrest has been shown to produce adequate anterograde flow to maintain consciousness in man without compressing the heart, cough CPR has been used as a model of a pure "thoracic pump" mechanism on which to base modifications of CPR. In the thoracic pump mechanism, the left heart is a passive conduit for blood expressed from the pulmonary vasculature to the aorta, and there is selective flow to the brachiocephalic vascular bed because of its low pressure veins, which are protected by closure of thoracic inlet venous valves. Right heart flow from systemic veins to the lungs occurs between applications of pressure. Four alternative modalities exploiting the thoracic pump concept were studied in dogs during ventricular fibrillation with angiographic and pressure recordings: cough CPR, simultaneous chest compression and lung inflation, abdominal compression with lung inflation, and inflation of a vest and binder. The latter technique was associated with successful defibrillation and recovery after more than 30 min of circulatory support during ventricular fibrillation. Preliminary studies in a primate preparation indicate that this technique might be useful for prolonged circulatory support in man when defibrillation is not initially available or successful.
.A
Criley JM; Niemann JT; Rosborough JP; Hausknecht M.
.I 342
.U
87052098
.S
Circulation 8703; 74(6 Pt 2):IV51-9
.M
Animal; Dogs; Heart Arrest/*TH; Heart Massage/*MT; Hemodynamics; Human; Support, U.S. Gov't, P.H.S..
.T
The influence of manual chest compression rate on hemodynamic support during cardiac arrest: high-impulse cardiopulmonary resuscitation.
.P
JOURNAL ARTICLE.
.W
Considerable effort has been expended in recent years by a number of laboratories to improve methods of cardiopulmonary resuscitation. This article briefly summarizes 5 years of investigation by our group on hemodynamic support during external cardiac massage. In most studies, long-term canine preparations were used, and implanted transducers allowed precise hemodynamic measurements. Although cardiac output was depressed with all CPR methods, manual chest compressions of high velocity, moderate force, and brief duration at a rate of 120/min seemed to optimize systemic and coronary blood flow. This method was termed high-impulse CPR. High-impulse techniques now have been applied extensively in the clinical setting, and preliminary observations also support their efficacy in man. Based on this experience, it is suggested that the American Heart Association guidelines be changed to recommend a manual chest compression rate of 120/min during closed-chest cardiac massage.
.A
Maier GW; Newton JR Jr; Wolfe JA; Tyson GS Jr; Olsen CO; Glower DD; Spratt JA; Davis JW; Feneley MP; Rankin JS.
.I 343
.U
87052099
.S
Circulation 8703; 74(6 Pt 2):IV60-2
.M
Airway Obstruction/*TH; Foreign Bodies/*TH; Human; Methods.
.T
Foreign body airway obstruction: considerations in 1985.
.P
JOURNAL ARTICLE.
.W
Management of foreign body airway obstruction continues to be a major controversy in emergency medical care. Much of the disagreement is without doubt based on lack of a uniformly accepted model of acute airway obstruction representative of the clinical event. A variety of models have been used to assess different aspects of airway obstruction by foreign bodies. These models have analyzed, among other variables, kinetic energy and inertial and aerodynamic forces in attempts to focus on specific aspects of this controversy. Human volunteers, anesthetized and paralyzed patients, and cadavers have also been used. In several recent studies it was concluded that subdiaphragmatic pressure is the treatment of choice, while in at least one additional study firm back blows applied with the patient's head hanging downward were recommended as the treatment most likely to relieve airway obstruction. It seems likely that these apparently conflicting views can be reconciled and that a consensus recommendation for treatment of this emergency can be effected.
.A
White RD.
.I 344
.U
87052100
.S
Circulation 8703; 74(6 Pt 2):IV63-5
.M
Heart Arrest/*TH; Human; Respiration, Artificial/*MT/ST; Respiratory Insufficiency/*TH.
.T
Alternative methods of ventilation during respiratory and cardiac arrest.
.P
JOURNAL ARTICLE.
.W
Artificial ventilation is a cornerstone of basic life support-cardiopulmonary resuscitation (BLS-CPR). Recent data corroborate clinical studies performed in the 1950s and 1960s, suggesting a need to change the present American Heart Association standards for artificial ventilation. These studies show that gastric insufflation followed by regurgitation and pulmonary aspiration are a major hazard of artificial ventilation with an unprotected airway. Present BLS-CPR standards require that ventilation be performed rapidly between external chest compressions or with incremental breaths. These methods of ventilation predispose the victim to gastric insufflation. Alternative methods of ventilation with longer inspiratory time and thus lower flow rate and peak inspiratory pressure are suggested. Additionally, rescue personnel, particularly EMTs and paramedics, should be taught how to apply cricoid pressure to prevent gastric insufflation in victims with an unprotected airway.
.A
Melker RJ.
.I 345
.U
87052103
.S
Circulation 8703; 74(6 Pt 2):IV75-9
.M
Animal; Bicarbonates/*TU; Dogs; Resuscitation/*MT; Sodium/*TU; Support, U.S. Gov't, P.H.S.; Ventricular Fibrillation/*TH.
.T
Failure of sodium bicarbonate to improve resuscitation from ventricular fibrillation in dogs.
.P
JOURNAL ARTICLE.
.W
To determine the value of sodium bicarbonate in resuscitation from ventricular fibrillation and the prevention of spontaneous refibrillation, sodium bicarbonate (1 meq/kg) or placebo was administered on a random basis to 16 pentobarbital-anesthetized dogs 18 min after the induction of ventricular fibrillation and cardiopulmonary resuscitation. Defibrillation was attempted 2 min after the administration of bicarbonate or placebo. All animals were successfully defibrillated, but three of eight bicarbonate-treated and two of eight control animals died in electromechanical dissociation (p = NS). Spontaneous refibrillation occurred in three animals in each group (p = NS). Successful resuscitation was not dependent on treatment, arterial or mixed venous Pco2, or arterial or mixed venous pH but correlated strongly with coronary perfusion pressure (p less than .003). Spontaneous refibrillation occurred without relation to any identifiable variable. The gradient between diastolic aortic and right atrial pressures was 24 +/- 2 mm Hg in controls and 23 +/- 2 mm Hg in treated animals over the entire 20 min of cardiopulmonary resuscitation (p = NS). However, among animals successfully resuscitated, mean diastolic coronary perfusion pressure averaged 27 +/- 2 mm Hg compared with 20 +/- 1 mm Hg among those dying in electromechanical dissociation (p less than .02). For the final 2 min of resuscitation, after drug administration, these gradients were 31 +/- 2 and 23 +/- 2 mm Hg, respectively (p less than .01). Microsphere determined myocardial perfusion correlated with the diastolic aortic-right atrial perfusion pressure gradient (r = .86) and was 0.43 +/- 0.03 ml/min/g in survivors and 0.22 +/- 0.01 ml/min/g in nonsurvivors (p less than .01).(ABSTRACT TRUNCATED AT 250 WORDS)
.A
Guerci AD; Chandra N; Johnson E; Rayburn B; Wurmb E; Tsitlik J; Halperin HR; Siu C; Weisfeldt ML.
.I 346
.U
87052106
.S
Circulation 8703; 74(6 Pt 2):IV9-12
.M
Allied Health Personnel/*/ED; Electric Countershock/*/ED; Emergency Medical Technicians/*/ED; Human; Support, U.S. Gov't, P.H.S.; United States.
.T
Defibrillation performed by the emergency medical technician.
.P
JOURNAL ARTICLE.
.W
As a means of providing defibrillation as soon as possible for those suffering out-of-hospital ventricular fibrillation, numerous communities have trained and authorized emergency medical technicians (EMTs) to provide defibrillatory shocks (EMT-D). The findings of four controlled studies and the experience of various communities have answered important questions. EMT-D programs have been shown effective in urban, suburban, and rural communities with and without paramedic backup. EMT-D programs appear safe, with errors of commission being extremely rare and errors of omission being of acceptably low incidence. Issues still to be resolved include the degree and amount of training that should be given and whether manual or automatic defibrillators should be used. Medical supervision and quality control is the most important aspect of EMT-D programs. At its core, the success of EMT-D programs is confirmation of the principle of early defibrillation. Wider dissemination of early defibrillation will improve survival from sudden cardiac death.
.A
Eisenberg MS; Cummins RO.
.I 347
.U
87052264
.S
Clin Otolaryngol 8703; 11(5):303-5
.M
Conversion Disorder/*ET; Esophagogastric Junction/PP; Esophagus/PP; Gastroesophageal Reflux/CO; Gastrointestinal Diseases/CO/DI; Human; Manometry; Pressure.
.T
The globus sensation.
.P
JOURNAL ARTICLE.
.A
Linsell JC; Owen WJ.
.I 348
.U
87052265
.S
Clin Otolaryngol 8703; 11(5):307-16
.M
Carcinoma/PA/*RA/SU; Case Report; Human; Laryngeal Neoplasms/PA/*RA/SU; Laryngectomy; Male; Neoplasm Staging; Tomography, X-Ray Computed/*.
.T
Computed tomography: a mandatory investigational procedure for the T-staging of advanced laryngeal cancer.
.P
JOURNAL ARTICLE.
.W
Eighteen patients underwent computed tomography (CT) prior to total laryngectomy. In order to assess the accuracy of CT scanning in the evaluation of carcinoma of the larynx, CT scans were prospectively interpreted and the extent of the tumour was recorded. The tumour extent was evaluated on whole-mount histologic sections of the laryngeal specimens, prepared in the horizontal plane, similar to the CT scan. The results were compared to assess the ability of CT to identify tumour infiltration in the horizontal plane accurately. Based on these findings it is clear that CT has its influence on the T-staging and on the choice of treatment of laryngeal cancer, i.e. radiotherapy versus surgery.
.A
Gerritsen GJ; Valk J; van Velzen DJ; Snow GB.
.I 349
.U
87052266
.S
Clin Otolaryngol 8703; 11(5):317-21
.M
Adolescence; Child; Child, Preschool; Human; Infant; Parents/*; Pharyngitis/*ET; Regression Analysis; Smoking/*; Tobacco Smoke Pollution/*AE; Tonsillectomy.
.T
Children's sore throats related to parental smoking.
.P
JOURNAL ARTICLE.
.W
There has been concern that the smoking of tobacco can adversely affect the health of non-smokers. This is most cogent in children who are subject to smoke at home. The aim of this study is to relate children's sore throats to the smoking habits of their parents. The parents of 154 children were asked about the age, sex, birthweight, method of postnatal feeding and age at starting school or day nursery of the child, the frequency of sore throats, smoking habits and history of tonsillectomy of all members of the household, the size of family, the dwelling size, and the occupation of the father. Analysis by multiple regression showed a significant association between children's sore throats and maternal smoking. Reduction in domestic cigarette smoke exposure should benefit the child by reducing the number of sore throats he or she suffers.
.A
Willatt DJ.
.I 350
.U
87052267
.S
Clin Otolaryngol 8703; 11(5):323-7
.M
Adolescence; Bacterial Infections/*ET; Child; Child, Preschool; Human; Middle Ear Ventilation/*AE; Otitis Media with Effusion/*ET/MI; Prospective Studies; Risk; Swimming/*.
.T
Bacteriological aspects of swimming with grommets.
.P
JOURNAL ARTICLE.
.W
A prospective bacteriological and symptomatic study was carried out on 50 swimmers and 50 non-swimmers who had grommets inserted for secretory otitis media. The risk of developing otorrhoea with positive bacterial pathogens was similar for swimmers (7.9%) and non-swimmers (8.0%). Subdividing the non-swimmers into 'wetters' and 'strictly dry' there was a similar risk of ear symptoms and pathogens. All children who swim before the insertion of grommets should continue to do so postoperatively with no added risk of ear infections.
.A
el Silimy O; Bradley PJ.
.I 351
.U
87052268
.S
Clin Otolaryngol 8703; 11(5):329-36
.M
Adult; Female; Human; Male; Nose/*PH; Respiratory Airflow/*; Support, Non-U.S. Gov't; Thermography/IS/*MT.
.T
A non-invasive method of demonstrating the nasal cycle using flexible liquid crystal thermography.
.P
JOURNAL ARTICLE.
.W
The relationship between air flow at 38 degrees C and area colour change on a flexible liquid crystal film was found to be virtually linear between the values of 1 and 31 min-1 cm-2. This value of flow per unit area corresponded to values expected at the level of the nostril during quiet breathing. A series of 6 subjects were asked to breathe over a flexible liquid crystal film regularly during the day and the area of colour change produced by flow from each nostril was examined. Four subjects showed a regular change in relative flow through each nostril whilst 2 subjects showed a constant flow through each nostril. This simple and non-invasive technique provides a method of examining the nasal cycle in adults and children in health and disease.
.A
Canter RJ.
.I 352
.U
87052269
.S
Clin Otolaryngol 8703; 11(5):337-43
.M
Carcinoma/*PA/PP; Cell Movement; Human; Laryngeal Neoplasms/*PA/PP; Lymphocytes/PH; Microscopy/*MT; Mitosis; Photography; Videotape Recording/*.
.T
Video time-lapse microscopy of human laryngeal carcinomas in vitro.
.P
JOURNAL ARTICLE.
.W
Twelve human laryngeal carcinomas and 14 normal vocal cord epithelia were studied in vitro by the method of tissue culture incorporating video time-lapse microscopy. Different events were photographed by taking 'stills' from the television monitor during play-back. Outgrowths from both tumour and normal explants formed only as monolayers. Mitoses were mainly found to be localized approximately mid-way between explant and the edge of the outgrowth. Some cells were seen to become suddenly active producing oscillating blebs and sometimes they detached themselves from the monolayer culture and changed appearance. This was more prevalent in the tumour cultures. In both tumour and normal cell cultures lymphocytes were observed and their normal chemokinetic movement was changed into a rapid chemotactic attraction by the presence of a mitotic epithelial cell. These lymphocytes appear to represent T-suppressor cells. The present study has shown that primary tissue culture can be a valuable tool in the study of laryngeal carcinoma. The interaction between mitotic tumour cells and lymphocytes may represent a transformation of T-lymphocytes into LAK cells.
.A
Wang H; Boxall J; Hellquist H; Proops D; Michaels L.
.I 353
.U
87052270
.S
Clin Otolaryngol 8703; 11(5):345-51
.M
Carcinoma/*GE/PA; Cell Division; Epithelium/PA; Human; Hyperplasia; Laryngeal Neoplasms/*GE/PA; Polyploidy/*; Precancerous Conditions/*GE/PA; Support, Non-U.S. Gov't; Vocal Cords/*PA.
.T
Hypertetraploid cells in vocal cord epithelia.
.P
JOURNAL ARTICLE.
.W
DNA measurements yield information about the nature of cells and may provide diagnostic and prognostic information. Static cytofluorometry was performed on smears removed at microlaryngoscopy from 107 vocal cord lesions (96 patients). All stem cell lines were diploid except 3; 2 carcinomas and 1 severe dysplasia were polyploid. The mean proliferative activity (percentage of nuclei greater than diploid peak) was 2.1% for the group of epithelia with hyperplasia and mild dysplasia, 3.1% for those with moderate dysplasia, 4.0% for severe dysplasia, and 6.8% for carcinomas. Hypertetraploid cell nuclei (HT cells) were not found in epithelia with hyperplasia and mild dysplasia. Seven out of 15 patients with epithelia showing moderate dysplasia had HT cells; 5 of these patients developed a carcinoma. One of 8 without HT cells developed a severe dysplasia. Nine patients with severe dysplasia had HT cells; 4 had recurrences and 4 developed carcinoma within 4 years. In 14 patients without HT cells, 3 had recurrences and 1 developed a carcinoma 6 years later. HT cells were found in 15 patients with T1 & T2 carcinomas; residual carcinoma was present in 2 after radiotherapy and 4 had recurrences within 11 months. Fourteen patients with T1 & T2 carcinoma did not have any HT cells; one had residual carcinoma after radiotherapy and 3 had recurrences between 18 months and 4 years. DNA measurements and, especially, the demonstration of epithelia with HT cells prove to be of prognostic importance.(ABSTRACT TRUNCATED AT 250 WORDS)
.A
Olofsson J; Franzen G; Lundgren J.
.I 354
.U
87052272
.S
Clin Otolaryngol 8703; 11(5):365-7
.M
Ethmoid Bone/SU; Human; Orbit/*SU.
.T
The Patterson operation for decompression of the orbit.
.P
JOURNAL ARTICLE.
.W
A modification of Patterson's external antro-ethmoidectomy operation is described which provides a more direct and simpler approach than the transantral operation for decompression of the orbit.
.A
von Haacke NP; Wilson JA; Dale BA; Adams GG.
.I 355
.U
87052273
.S
Clin Otolaryngol 8703; 11(5):369-72
.M
Adult; Epistaxis/*ET; Female; Follow-Up Studies; Human; Male; Nasal Mucosa/*BS; Recurrence; Support, Non-U.S. Gov't; Varicose Veins/CO/*SU.
.T
Transection of varicose vessels in the nasal mucosa of patients with recurrent epistaxis. A 2-year follow-up.
.P
JOURNAL ARTICLE.
.W
Twenty-two patients with recurrent nose bleeds and varicose vessels on the nasal septum were subjected to transection of the vessels and followed-up for 2 years. One month after the operation, it was not possible to identify the original vessels. In other locations new varicose vessels began to appear after 1 month, and at the end of the follow-up period were observed on 9 out of 10 operated sides. The transection resulted in an immediate decrease in the frequency of nose bleeds and at the end of the control period 12 (55%) of the patients had had less than 4 bleeds during the previous year in spite of the observed rapid formation of new vessels. Mucosal atrophy with symptoms of increased nasal crusting occurred in 3 patients. Transection of varicose vessels in patients with nose bleeds leads to a decrease in the number of bleeds.
.A
Beran M; Petruson B.
.I 356
.U
87052274
.S
Clin Otolaryngol 8703; 11(5):373-82
.M
Animal; Cats; Denervation; Ganglia, Autonomic/*UL; Human; Nasal Mucosa/DE/*IR/SE; Neostigmine/PD; Rhinitis, Vasomotor/*ET/SU.
.T
Autonomic microganglia of the nasal mucosa and their relation to vasomotor rhinitis.
.P
JOURNAL ARTICLE.
.W
The classical concept of the autonomic innervation of the nasal mucosa states that the postganglionic sympathetic neurones lie in the superior cervical ganglion and those of the postganglionic parasympathetic neurones are in the pterygopalatine ganglion. We have carried out a study of the fine structure of the respiratory nasal mucosa in man and in the cat using the techniques described by Jabonero, Champy Maillet and Koelle-Friedenwald. The most striking finding was the presence of microganglia deep within the mucosa of the inferior turbinate close to the glands. These microganglia were cholinergic in nature since they demonstrated a positive reaction to anticholinesterase. From this we deduce that the nasal parasympathetic pathway has its postganglionic neurones not only in the pterygopalatine ganglion but also in these microganglia of the inferior turbinate. Each of four groups of cats were submitted to different techniques, including administration of neostigmine, inferior turbinectomy and Vidian neurectomy. Resection of the microganglia by means of turbinectomy reduced the hypersecretion caused by neostigmine and this was most noticeable when a Vidian neurectomy was carried out in addition.
.A
Galan Cortes JG; Perez Casas A; Suarez Nieto C.
.I 357
.U
87052276
.S
Clin Otolaryngol 8703; 11(5):389-95
.M
Animal; Human; Otorhinolaryngologic Diseases/*.
.T
Oto-rhino-laryngological Research Society. London, October 1985. Abstracts.
.P
JOURNAL ARTICLE.
.I 358
.U
87052382
.S
Clin Nephrol 8703; 26(4):169-73
.M
Adult; Animal; Anti-Inflammatory Agents, Non-Steroidal/AD; Crystallization; Drug Interactions; Female; Human; Hydrogen-Ion Concentration; Kidney/*DE; Male; Middle Age; Rats; Triamterene/AD/*AE/UR; Urine/*DE.
.T
Triamterene-induced crystalluria and cylinduria: clinical and experimental studies.
.P
JOURNAL ARTICLE.
.W
We examined the occurrence of crystals and casts in the urine of healthy subjects after administration of triamterene and the site of crystal formation in experimental animals. Twenty out of twenty healthy subjects had abundant triamterene crystals and casts in acid urine after receiving a single 100 mg dose. Casts were present in the urine from 2-11 hours after administration of the diuretic. Cast formation occurred in acidic urine and was prevented by alkalinization of the urine with potassium citrate. Animal studies showed that crystallization and cast formation occurred in the medullary and papillary collecting ducts of the rat kidney. These findings provide a possible explanation for the reported nephrotoxicity of triamterene, particularly when given to patients who are receiving non-steroidal anti-inflammatory agents.
.A
Fairley KF; Woo KT; Birch DF; Leaker BR; Ratnaike S.
.I 359
.U
87052386
.S
Clin Nephrol 8703; 26(4):192-4
.M
Age Factors; Biopsy/*/AE; Hematuria/ET; Human; Infant; Infant, Newborn; Kidney/*PA; Kidney Diseases/PA.
.T
Percutaneous renal biopsy in infants and young children.
.P
JOURNAL ARTICLE.
.W
Records of 55 percutaneous renal biopsies performed in 53 children aged 5 days to two years were reviewed. Radiographic or ultrasound imaging techniques were not utilized during the biopsy procedure. Forty-nine of 55 biopsy attempts yielded sufficient tissue for histologic evaluation (89.1%). Transient gross hematuria not requiring intervention was the sole complication and was noted in 6 of 55 biopsy attempts (10.9%). Percutaneous renal biopsy can be performed safely in very young children and the success of the procedure is comparable to that in older children.
.A
Sweet M; Brouhard BH; Ramirez-Seijas F; Kalia A; Travis LB.
.I 360
.U
87052389
.S
Clin Nephrol 8703; 26(4):209-12
.M
Antithrombin III/AN; Blood Proteins/AN; Comparative Study; Female; Fibrin/*; Fibrinogen/*AN; Fibrinopeptides A/*AN/BL; Heparin/*AD/AN; Human; Male; Peritoneal Cavity/*; Peritoneal Dialysis, Continuous Ambulatory/*AE.
.T
Intraperitoneal fibrin-formation and its inhibition in CAPD.
.P
JOURNAL ARTICLE.
.W
The intraperitoneal fibrin formation and its inhibition by intraperitoneal heparin (5000 U) was investigated in six patients on CAPD. The intraperitoneal heparin concentration decreased linearily from 1.78 U/ml to 1.13 U/ml during a 4-hour dwell time. The antithrombin III-concentration increased to 0.56 +/- 0.1 mg/dl, reaching 1.87% of normal plasma values. The antithrombin III-portion of total protein was 0.62% in plasma and 0.79% in dialysate. The fibrinopeptide A-concentration, a specific product of thrombin action on fibrinogen was 37.1 +/- 11.8 ng/ml in plasma (normal range: less than 2.5 ng/ml) and 153.4 +/- 16.8 ng/ml in dialysate during regular CAPD. After the addition of 5000 U heparin the fibrinopeptide A-concentration in dialysate decreased to 11.6 +/- 2.6 ng/ml during a 4-hour dwell time. In vitro experiments showed no remarkable inhibition of fibrin formation by heparin without antithrombin III in dialysate. We suggest that the fibrinopeptide A is produced intraperitoneally and the antithrombin III-concentration in dialysate is sufficient to inhibit the fibrin formation after acceleration by heparin.
.A
Gries E; Paar D; Graben N; Bock KD.
.I 361
.U
87052390
.S
Clin Nephrol 8703; 26(4):213-5
.M
Aged; Aged, 80 and over; Case Report; Female; Glomerulonephritis/*CI/DI; Human; Ketoprofen/*AE; Nephrotic Syndrome/*CI/DI; Osteoarthritis/DT; Phenylpropionates/*AE.
.T
Reversible membranous glomerulonephritis associated with ketoprofen.
.P
JOURNAL ARTICLE.
.W
An 87-year-old woman presented with the nephrotic syndrome 12 months after administration of ketoprofen, 100 mg daily for osteoarthritis. Clinical course and laboratory data were consistent with drug-induced nephropathy. Kidney biopsy showed membranous glomerulonephritis. Evolution was favorable with resolution of proteinuria after drug withdrawal and steroid administration. A review of the literature on nephrotic syndrome associated with NSAID reveals membranous glomerulonephritis to be an unusual complication.
.A
Sennesael J; Van den Houte K; Verbeelen D.
.I 362
.U
87052415
.S
Clin Orthop 8703;  (213):115-7
.M
Adolescence; Case Report; Cervical Vertebrae/*SU; Female; Follow-Up Studies; Human; Osteoma, Osteoid/*DI/SU; Spinal Neoplasms/*DI/SU.
.T
Osteoid osteoma in a cervical pedicle. Resection via transpillar approach.
.P
JOURNAL ARTICLE.
.W
Lesions in the pedicles of the cervical spine are both a diagnostic and technical challenge. An osteoid osteoma of the pedicle of the fourth cervical vertebra occurred in a 17-year-old girl. Resection of the tumor adjacent to the dura medially and the vertebral artery anterolaterally was accomplished via a transpillar approach. The transosseus approach preserved the facet joints and posterior elements and obviated the need for an interbody fusion.
.A
Hershman E; Bjorkengren AJ; Fielding JW; Allen SC.
.I 363
.U
87052416
.S
Clin Orthop 8703;  (213):118-24
.M
Adolescence; Adult; Elbow Joint/*IR; Human; Laterality; Movement; Muscles/*IR; Proprioception/*; Scoliosis/*ET/PP.
.T
Upper extremity proprioception in idiopathic scoliosis.
.P
JOURNAL ARTICLE.
.W
Twenty-three patients with idiopathic scoliosis were tested for upper extremity proprioceptive function. All subjects had documented progression of deformity, with an average curvature of 34 degrees. The average ages for scoliotics and 18 control subjects were 16.1 and 20.8 years, respectively. Controls had no spinal deformity and underwent identical test procedures. The test results showed that scoliotic subjects had significant asymmetry between right and left limbs in their threshold for detection of joint motion (p less than or equal to 0.005) and in their ability to reproduce angles to which their elbow joint had been previously positioned (p less than or equal to 0.025). Slight asymmetry also was observed in the reproduction tests of the control group (p less than or equal to 0.013); however, there was no significant asymmetry seen in this group for the threshold test. Performance of bilateral limbs was designated good and bad for both groups; the limb that performed better in proprioceptive function was designated good limb. Analysis of data showed that the scoliotics' good and bad limbs performed inferiorly in both threshold and angle reproduction tests when compared with normal controls. The results of this study imply, but do not localize, a neurologic deficit in scoliotic patients.
.A
Cook SD; Harding AF; Burke SW; Whitecloud TS; Barrack RL; Leinhardt TM.
.I 364
.U
87052417
.S
Clin Orthop 8703;  (213):125-36
.M
Adult; Ankle Joint/*IN/RA; Bone Nails/*; Follow-Up Studies; Fracture Fixation, Intramedullary/IS/*MT; Fractures/*SU; Human.
.T
A new approach to the treatment of ankle fractures. The Inyo nail.
.P
JOURNAL ARTICLE.
.W
The Inyo nail is a new intramedullary device for the treatment of fractures of the distal fibula. It is a tapered V-shaped nail made of malleable stainless steel, which provides rigid fracture fixation. Torsional stress is resisted because of its triflanged shape. It may be introduced closed, using the image intensifier. Two groups of patients were evaluated: Group I was treated with the Inyo nail and Group II was treated by the Association For the Study of Internal Fixation (ASIF) technique. Eighty-five percent of the patients in Group I were rated as good, compared with 63% in Group II. There was significantly less morbidity and complications in Group I. Several factors must be observed in the treatment of ankle fractures. Stress radiographs must be obtained intraoperative. Surgery may be indicated in unstable supination lateral rotation Type II injuries, if these occur in patients with high physical demands. Anatomic reduction of the lateral malleolus must be obtained. Early weight-bearing and motion produces the best result. Late reconstruction of malunions can be accomplished using the Inyo nail.
.A
McLennan JG; Ungersma JA.
.I 365
.U
87052419
.S
Clin Orthop 8703;  (213):137-40
.M
Adolescence; Athletic Injuries/RH/*TH; Braces; Football/*; Human; Immobilization; Knee Injuries/RH/*TH; Ligaments/*IN; Prospective Studies; Time Factors.
.T
Nonoperative management of isolated grade III collateral ligament injury in high school football players.
.P
JOURNAL ARTICLE.
.W
In a prospective study, 24 high school football players with isolated Grade III injuries of the medial collateral ligament (MCL) of the knee were treated by conservative management. This included an active rehabilitation program, progressing from immobilization and controlled motion in an orthotic rehabilitation knee brace, to muscle strengthening and agility exercise. A stable knee was achieved in 22 cases; the average recovery time was 29 days. The athletes returned to competitive sports at a mean time of 34 days. These results confirm previous reports of successful nonoperative management of isolated Grade III MCL injuries.
.A
Jones RE; Henley MB; Francis P.
.I 366
.U
87052420
.S
Clin Orthop 8703;  (213):141-9
.M
Aged; Female; Follow-Up Studies; Human; Knee Joint/*RA; Knee Prosthesis/*; Male; Photogrammetry/MT; Statistics; Tibia/RA.
.T
Tibial component fixation in knee arthroplasty.
.P
JOURNAL ARTICLE.
.W
Using roentgen stereophotogrammetric analysis (RSA), the integrity of the bond between the tibial component and the tibia was studied in seven knees, implanted with a cemented Kinematic total knee prosthesis for gonarthrosis. Migration ranging from 0.3 to 1.9 mm over a two-year period occurred in all seven cases. Displacement, induced by external forces, ranging from 0.2 to 1.0 mm was observed in five cases. Measurable migration and inducible displacement may be the rule rather than an exception in total knee arthroplasty (TKA). Accordingly, absolute rigid fixation would not be necessary for successful function of a TKA.
.A
Ryd L; Lindstrand A; Rosenquist R; Selvik G.
.I 367
.U
87052421
.S
Clin Orthop 8703;  (213):150-3
.M
Adult; Aged; Casts, Surgical; Evaluation Studies; Female; Femur/PP; Human; Knee Injuries/PP/*TH; Knee Joint/PP/*RA; Male; Middle Age; Patella/PP; Rupture; Tendons/PP.
.T
Ruptures of the extensor mechanism of the knee joint. Clinical results and patellofemoral articulation.
.P
JOURNAL ARTICLE.
.W
The functional results of 28 cases of rupture of the quadriceps and patellar tendons are reported. Excellent or good results were noted in 15 of 18 quadriceps and 7 of 10 patellar tendons. Radiographic comparison with the opposite knee disclosed incongruences between the patella and the femoral groove in the tangential view and/or cranial-caudal position of the patella in the lateral view in 13 of the quadriceps tendon ruptures and seven of the patellar tendon ruptures. Patients with residual pain had patellofemoral incongruity but since two-thirds of the patients with incongruity were asymptomatic, incongruity alone may not be the cause of the symptoms. There was no positive correlation to muscular strength or range of movement. Nevertheless, exact adaptation of the patellar tendon and periarticular tissue seems necessary to obtain correct patello-femoral articulation. Reinforcement of the tendon with a wire cerclage is recommended to decrease the tension on the suture line and the consequent risk of a secondary rupture. In acute ruptures of the quadriceps tendon end-to-end sutures are sufficient.
.A
Larsen E; Lund PM.
.I 368
.U
87052422
.S
Clin Orthop 8703;  (213):154-8
.M
Adult; Child; Human; Implants, Artificial; Knee; Ligaments/*SU; Orthopedic Equipment/*; Orthopedics/*MT; Polyethylene Terephthalate; Prosthesis.
.T
A modified technique for anterior cruciate ligament (ACL) surgery using a new drill guide for isometric positioning of the ACL.
.P
JOURNAL ARTICLE.
.W
In reconstructing the anterior cruciate ligament (ACL) it is important to place the inner ends of the drill channels correctly, to get the ACL into an isometric position. Anatomic studies demonstrate the value of a modified surgical technique using a special drill guide for standardized positioning of the anterior cruciate substitute. The drill guide consists of a metal frame with one adjustable and one fixed guide tube. Drilling is done from the anteromedial aspect of the tibia, upwards, through the joint space and the femur in a straight line, both channels being drilled in a single procedure. The precision of guided drilling was superior to that of free-hand drilling in positioning the ligament in the correct anatomic place.
.A
Odensten M; Gillquist J.
.I 369
.U
87052423
.S
Clin Orthop 8703;  (213):159-62
.M
Adolescence; Bone Diseases, Developmental/*CO; Dislocations/*ET/RA; Female; Femur/GD; Human; Knee Joint/RA; Male; Mathematics; Patella/*GD/RA; Retrospective Studies.
.T
Patella alta and the adolescent growth spurt.
.P
JOURNAL ARTICLE.
.W
The presence of patella alta has been linked to recurrent dislocation of the patella and the patello-femoral stress syndrome. It is not known whether patella alta is an inherited or acquired trait. To investigate the relationship of patella during the adolescent growth spurt, serial orthoroentgenograms (growth study films) were retrospectively analyzed in 19 patients. Two were found in whom proximal patella migration could be correlated (r = 0.85) with femoral growth rate. This was significant at the p = 0.01 level. Girls had a higher correlation of patella height to growth rate than boys. In certain cases, patella alta is an acquired rather than inherited condition; this supports the theory that overgrowth during the growth spurt can lead to patella alta in some individuals.
.A
Micheli LJ; Slater JA; Woods E; Gerbino PG.
.I 370
.U
87052424
.S
Clin Orthop 8703;  (213):163-6
.M
False Negative Reactions; Human; Knee Injuries/*DI; Knee Joint/*PP; Ligaments/IN; Movement; Physical Examination/MT; Support, Non-U.S. Gov't; Tibia/*PP.
.T
Accurate interpretation of the Lachman test.
.P
JOURNAL ARTICLE.
.W
In a consecutive series of patients with knee complaints, tibial rotation consistently affected the interpretation of the Lachman test (passive anterior tibial translation in slight knee flexion). To perform the Lachman test correctly, the anterior tibial force must be applied posteromedially on the proximal tibia. This is best achieved by having the leg under examination on the same side of the bed as the examiner, and with slight external tibial rotation. Reaching across the bed to examine either leg can create either false positive or false negative Lachman results due to inadvertent tibial rotation (internal tibial rotation decreases translation) and inaccurate comparisons of the injured and normal legs. The importance of tibial rotation must be recognized if the Lachman test is to be used reliably and with maximum sensitivity.
.A
Frank C.
.I 371
.U
87052425
.S
Clin Orthop 8703;  (213):167-71
.M
Exertion; Fractures/EP/*RI/TH; Human; Male; Military Personnel/*; Pain/ET/*RI; Physical Education and Training; Prospective Studies; Technetium Tc 99m Medronate/DU; Tibia/*IN/RI.
.T
Medial tibial pain. A prospective study of its cause among military recruits.
.P
JOURNAL ARTICLE.
.W
In a prospective study of 295 infantry recruits during 14 weeks of basic training, 41% had medial tibial pain. Routine scintigraphic evaluation in cases of medial tibial bone pain showed that 63% had abnormalities. A stress fracture was found in 46%. Only two patients had periostitis. None had ischemic medial compartment syndrome. Physical examination could not differentiate between cases with medial tibial bone pain secondary to stress fractures and those with scintigraphically normal tibias. When both pain and swelling were localized in the middle one-third of the tibia, the lesion most likely proved to be a stress fracture.
.A
Milgrom C; Giladi M; Stein M; Kashtan H; Margulies J; Chisin R; Steinberg R; Swissa A; Aharonson Z.
.I 372
.U
87052426
.S
Clin Orthop 8703;  (213):172-6
.M
Double-Blind Method; Exudates and Transudates/DE; Follow-Up Studies; Human; Injections, Intra-Articular; Knee Joint/PP/*SU; Methylprednisolone/*AA/TU; Movement/DE; Pain/PC; Support, U.S. Gov't, Non-P.H.S..
.T
Intraarticular methylprednisolone acetate in knee arthrotomy.
.P
JOURNAL ARTICLE.
.W
Ninety-eight arthrotomy patients undergoing meniscectomy were given intraoperative intraarticular methylprednisolone (40 mg) or placebo using double-blind technique and were evaluated clinically at three days, two weeks, four weeks, eight weeks, and twelve weeks after operation. Patients who received methylprednisolone showed small but statistically significant accelerated rehabilitation time with respect to subjectively evaluated pain and range of motion, through two weeks after operation. After two weeks, there was no further advantage over placebo through 12 weeks of rehabilitation.
.A
Whittaker RP; Menkowitz E; Becker D.
.I 373
.U
87052427
.S
Clin Orthop 8703;  (213):177-82
.M
Adult; Aged; Female; Femur/RA; Human; Knee Joint/*RA; Male; Middle Age; Osteoarthritis/PA/*RA; Tibia/*RA; Tomography, X-Ray Computed; Torsion.
.T
Tibial torsion in patients with medial-type osteoarthritic knee.
.P
JOURNAL ARTICLE.
.W
Computed tomography measurements of tibial torsion were evaluated in 85 patients with medial-type osteoarthritic knees and in 24 normal adults. Although there were no differences in the degrees of femoral torsion or knee joint rotation, external tibial torsion was observed to have a mean value of 11.3 degrees, significantly smaller than the 23.5 degrees observed in the normal adults (p less than 0.01). The more advanced the osteoarthritic stage, the greater was the reduction in external tibial torsion. Reduction of external torsion of the tibia was most severe at the proximal tibial metaphysis.
.A
Yagi T; Sasaki T.
.I 374
.U
87052428
.S
Clin Orthop 8703;  (213):183-8
.M
Adult; Bone Screws; Case Report; Femoral Fractures/*SU; Femoral Neck Fractures/SU; Fluoroscopy; Fracture Fixation, Internal/*; Fracture Fixation, Intramedullary; Hip Fractures/SU; Human; Male.
.T
Ipsilateral femoral neck and shaft fractures. Report of two cases using an alternate technique.
.P
JOURNAL ARTICLE.
.W
A technique for ipsilateral femoral neck and shaft fracture using the sliding compression hip screw with plate combined with trochanteric antegrade Ender nailing of the femur was applied in two cases. Ender nails can be passed without difficulty past a compression hip screw and the bicortical plating screws. The hip and femur can be fixed internally through a single approach in a single position. Sliding compression hip screw devices can provide excellent preliminary stable femoral neck fixation. Blood supply to the femoral head is not disturbed while the femoral intramedullary fixation is performed. Antegrade Ender nailing avoids the common knee complications associated with other retrograde techniques. Decreased operative time, less blood loss, less technical difficulty, and early mobilization are important factors in the multiple-injured patient. Femoral intramedullary fixation may require open reduction, circlerage to ensure stability, and maintenance of alignment in case of significant comminution to allow early crutch ambulation. This mode of fixation may be advantageous for selected cases.
.A
Harryman DT 2d; Kurth LA; Davis CM.
.I 375
.U
87052429
.S
Clin Orthop 8703;  (213):189-96
.M
Bone Cements/AE; Bone Resorption/PA/*RA; Case Report; Follow-Up Studies; Hip Joint/PA/*RA; Hip Prosthesis/*AE; Human; Male; Middle Age; Osteoarthritis/RA; Reoperation.
.T
14-year follow-up study of a patient with massive calcar resorption. A case report.
.P
JOURNAL ARTICLE.
.W
The authors present an in-depth clinical, radiographic, and pathologic analysis of a 62-year-old man with massive bone reabsorption around the proximal femur in a total hip arthroplasty (THA). The THA was revised 13 years after implantation. Thirty millimeters of calcar resorption was noted radiographically. Evidence of stem bending was present on examination of the femoral implant, and marked wear of the acetabular cup was noted. The pathologic evaluation of removed calcar bone and cement revealed a histiocytic mass invading the bone. Intracellular and extracellular polymethylene debris was noted within the invasive mass. Evidence of fragmented methylmethacrylate cement was also present. The bone-cement interface in the excised calcar region contained segments that showed active bone remodelling around the cement without an interposed membrane. It is possible that this case of calcar resorption began with histiocytic activation and recruitment by polyethylene wear debris followed by active bone lysis. The process may be perpetuated by the fragmentation of cement, as motion occurred at the calcar bone-cement interface, and may represent an extreme example of a process occurring in cases of calcar resorption in general.
.A
Johanson NA; Callaghan JJ; Salvati EA; Merkow RL.
.I 376
.U
87052430
.S
Clin Orthop 8703;  (213):197-200
.M
Adolescence; Adult; Case Report; Follow-Up Studies; Human; Male; Osteochondritis/*SU; Osteochondritis Dissecans/RA/*SU; Osteotomy/MT; Talus/*SU.
.T
Closed percutaneous drilling for osteochondritis dissecans of the talus. A report of two cases.
.P
JOURNAL ARTICLE.
.W
Two cases of osteochondritis dissecans of the talar dome treated by closed percutaneous drilling are presented to illustrate a procedure for high-risk patients. The operation is performed with the aid of an image intensifier. The ostoechondral fragment is percutaneously drilled to avoid open operation and osteotomizing the medial malleolus.
.A
Gepstein R; Conforty B; Weiss RE; Hallel T.
.I 377
.U
87052431
.S
Clin Orthop 8703;  (213):20-33
.M
Acetabulum/RA; Adolescence; Adult; Bone Diseases, Developmental/*CO/RA; Case Report; Epiphyses, Slipped/RA; Female; Femur Head/RA; Femur Neck/RA; Follow-Up Studies; Hip Joint/GD/*RA; Human; Legg-Perthes Disease/RA; Male; Middle Age; Osteoarthritis/*ET/RA/SU.
.T
Etiology of osteoarthritis of the hip.
.P
JOURNAL ARTICLE.
.W
More than 90% of patients with so-called primary or idiopathic osteoarthritis of the hips in whom sufficient data were available to make an assessment of the normality of the hip joint at the cessation of growth clearly showed demonstrable abnormalities in the hip joint. The most common are mild acetabular dysplasia and/or pistol grip deformity. This latter deformity is associated with mild slipped capital femoral epiphysis (recognized or unrecognized at the time), Legg-Perthes' disease (recognized or unrecognized at the time), multiple epiphyseal dysplasia, spondyloepiphyseal dysplasia, and/or the presence of an intraacetabular labrum, as well as, in certain instances, acetabular dysplasia. When these abnormalities are taken in conjunction with the detection of other metabolic abnormalities that can lead to osteoarthritis of the hip and which may not be recognized readily, such as hemochromatosis, ochronosis, calcium pyrophosphate disease, and monarticular rheumatoid arthritis, it seems clear that either osteoarthritis of the hip does not exist at all as a primary disease entity or, if it does, is extraordinarily rare.
.A
Harris WH.
.I 378
.U
87052432
.S
Clin Orthop 8703;  (213):201-6
.M
Aged; Bone Wires; Calcaneus/*SU; Case Report; Dislocations/ET/*SU; Female; Fractures/*SU; Human; Male; Middle Age.
.T
Fracture dislocation of the calcaneus. A report of two cases.
.P
JOURNAL ARTICLE.
.W
In two typical cases of calcaneal fracture dislocation, the primary fracture, which runs forward and medially from a point behind the sustentaculum tali, is associated with inversion of the hindfoot. The calcaneus splits into a small anteromedial and a larger posterolateral fragment. Rupture of the lateral collateral ligament allows the posterolateral calcaneal fragment to move laterally to lie immediately subjacent to the distal fibula. Closed reduction is impossible. Open reduction of this rare fracture dislocation is essential. A lateral approach to the calcaneus is generally sufficient, but a second medial incision may be required.
.A
Court-Brown CM; Boot DA; Kellam JF.
.I 379
.U
87052433
.S
Clin Orthop 8703;  (213):207-10
.M
Adult; Case Report; Follow-Up Studies; Human; Immobilization; Male; Synostosis/*RA/RI; Ulna Fractures/*RA/TH.
.T
Radioulnar synostosis following an isolated fracture of the ulnar shaft. A case report.
.P
JOURNAL ARTICLE.
.W
In the case of a 19-year-old man, overuse of his nondominant forearm resulted in a radioulnar synostosis. Despite the persistence of the synostosis, the patient adapted to loss of forearm rotation. No further treatment was necessary. Isolated fractures of the ulnar shaft are slow in healing. Several authors observed that early function may be beneficial. However, excessive activity causing motion at the fracture site may cause subperiosteal hemorrhage and soft tissue trauma and may stimulate exuberant callus formation. Fractures of the ulnar shaft, even undisplaced, need to be immobilized to prevent overuse.
.A
Posman CL; Little RE.
.I 380
.U
87052435
.S
Clin Orthop 8703;  (213):216-22
.M
Adult; Aged; Backache/*DT/ET; Female; Follow-Up Studies; Human; Injections, Intra-Articular; Lidocaine/TU; Male; Metrizamide/AD; Middle Age; Spinal Diseases/*DT/PA/RA.
.T
Facet joint degeneration as a cause of low back pain.
.P
JOURNAL ARTICLE.
.W
Recognizing that not all patients with low back pain have lumbar disc disease, the authors began to inject facet joints in June 1982 and have experience now with 21 patients, each injected under fluoroscopic control with a mixture of local anesthetic and steroid. One technical problem occurred when large osteophytes blocked access to the facet joints. Otherwise, there were no complications and minimal morbidity. Most patients (15 of 20; 75%) had an initial response, but a much smaller number (six of 18 followed more than three months; 33%) had a lasting response. Repeat injections, when done, always led to temporary improvement but rarely to lasting relief (one of five; 20%). Three factors characterized the patients: a negative screening examination for other causes of back pain or sciatica; back pain with tenderness localized over one or more facet joints; and radiologic changes of degenerative joint disease within the facet joints. Facet joint disease may be a significant cause of low back pain. The above three criteria are useful in clinical identification of patients with this problem. Facet joint injections play an important role in the diagnosis and treatment of low back pain.
.A
Lewinnek GE; Warfield CA.
.I 381
.U
87052436
.S
Clin Orthop 8703;  (213):223-31
.M
Aged; Case Report; Chymopapain/*AE; Female; Follow-Up Studies; Human; Intervertebral Disk/*DE/PA/UL; Intervertebral Disk Chemolysis; Intervertebral Disk Displacement/RA/*SU; Prolapse; Support, U.S. Gov't, P.H.S.; Tomography, X-Ray Computed.
.T
The effects of chymopapain on prolapsed human intervertebral disc. A clinical and correlative histochemical study.
.P
JOURNAL ARTICLE.
.W
Light and electron microscopy were used to demonstrate extensive matrix degradation in a failed chymopapain-treated disc as compared with an untreated degenerative control disc. Both specimens contained viable cells with patches of degenerative cells. There was a loss of disc height in the chymopapain-treated disc, but no improvement of symptoms. These results illustrated that even in well-circumscribed cases with documented disc protrusion into the spinal canal, the disc space narrowing following injection may aggravate the symptoms of nerve root entrapment, especially if a low-grade lateral recess stenosis is associated with the disc protrusion. The persistence or aggravation of symptoms probably is related to these anatomic considerations. The low level of enzyme activity in the injected area may or may not be correlated with the clinical response to treatment.
.A
Suguro T; Oegema TR Jr; Bradford DS.
.I 382
.U
87052437
.S
Clin Orthop 8703;  (213):232-6
.M
Adult; Case Report; Female; Follow-Up Studies; Fractures/*RA/TH; Human; Immobilization; Osteopetrosis/CO/*RA; Spinal Injuries/ET/*RA.
.T
Stress fracture of the vertebral arch in osteopetrosis.
.P
JOURNAL ARTICLE.
.W
Stress fracture of the fourth vertebral arch occurred in a 21-year-old woman with a benign osteopetrosis. The fracture healed in three months after application of a body cast. It seems likely that the osteopetrotic bone resists force, in parallel with the cortical layer, but is fragile to forces at right angles to the plane of the cortical layer.
.A
Suzuki S; Awaya G.
.I 383
.U
87052438
.S
Clin Orthop 8703;  (213):237-40
.M
Accidents, Traffic; Adolescence; Adult; Female; Follow-Up Studies; Fracture Fixation, Internal/AE; Human; Male; Middle Age; Spinal Cord Injuries/*CO; Tibial Fractures/*CO/SU/TH.
.T
The management of tibial fractures in acute spinal cord injury patients.
.P
JOURNAL ARTICLE.
.W
Of 34 tibia fractures in 28 acute spinal cord injuries, 13 patients had complete and 15 had incomplete neurologic lesions. Tibia fractures were divided into three groups: Group I, nonoperative treatment; Group II, early open reduction and internal fixation; and Group III, Type III open injuries. Group I included 17 fractures, of which nine (53%) had delayed union, malunion, or nonunion. The average time to union was 6.5 months. Seven patients had pressure sores and pulmonary emboli. Eleven fractures were noted in Group II. One delayed union (9%), one superficial wound infection that healed uneventfully, and one deep vein thrombosis were noted. The average time to union was 12 weeks. All six Group III tibias had delayed and nonunions, regardless of treatment. Nonoperative fractures healed at a prolonged rate, while open reduction and internal fixation enhanced the rate and time to union. Fractures treated with early open reduction and internal fixation, excluding Group III patients, had the least orthopedic and medical complications. Open reduction and internal fixation is a justifiable alternative to nonoperative treatment in the uncomplicated tibia fracture regardless of neurologic lesion for improved medical and fracture care.
.A
Garland DE; Saucedo T; Reiser TV.
.I 384
.U
87052439
.S
Clin Orthop 8703;  (213):241-8
.M
Adolescence; Adult; Comparative Study; Female; Follow-Up Studies; Human; Knee Joint/*SU; Male; Middle Age; Orthopedics/AE/*MT; Osteoarthritis/*SU; Patella/SU; Postoperative Complications/*SU; Reoperation.
.T
The Maquet procedure--anterior displacement of the tibial tubercle. Indications, contraindications, and precautions.
.P
JOURNAL ARTICLE.
.W
Maquet recommended 2-2.5 cm of anterior tibial tubercle elevation for patients with symptomatic osteoarthrosis of the patellofemoral joint. Fifty-three patients with osteoarthrosis were divided into three groups. The first 12 patients were treated by the classical Maquet procedure; 11 were totally relieved of patellofemoral pain, but there was one failure and five complications. In the second group of 32 patients, the patella was realigned within its groove to alter tracking of the patella to the proximal femoral condyles when necessary. Fish-mouthing technique and insertion of a drain after surgery were done. After a two-year follow-up examination, there were two failures and five complications. A third group of nine patients was treated with Ferguson's modification of Maquet's operation using a 1.25-cm tibial tubercle elevation through a transverse incision; two of the nine had complications, subsequently treated successfully by converting Ferguson's operation into the Maquet operation, as modified for Group II. The modified Maquet procedure can be an effective and reliable treatment of patellofemoral arthrosis with a relatively low incidence of complications.
.A
Radin EL.
.I 385
.U
87052440
.S
Clin Orthop 8703;  (213):249-50
.M
Achilles Tendon/*IN/SU; Adult; Case Report; Female; Follow-Up Studies; Human; Rheumatic Fever/DT; Rupture; Steroids/AE; Tendon Injuries/PC.
.T
Bilateral simultaneous achilles tendon ruptures. A case report and review of the literature.
.P
JOURNAL ARTICLE.
.W
Bilateral simultaneous Achilles tendon ruptures are rare, with only ten cases reported in the English literature. Our case is that of a 44-year-old woman, along with a review of the literature. Affected persons usually are on chronic steroid treatment and in the fifth to seventh decades of life. The patient may have concomitant systemic disease, and the injury occurs with relatively mild trauma. The goals of treatment are mainly preventative, i.e., cessation of steroids as soon as possible and protective bracing of the remaining intact Achilles tendon.
.A
Price AE; Evanski PM; Waugh TR.
.I 386
.U
87052441
.S
Clin Orthop 8703;  (213):251-63
.M
Animal; Bone Marrow/*ME/PA/UL; Cell Differentiation; Cells, Cultured; Collagen/BI; Electron Probe Microanalysis; Hematopoietic Stem Cells/ME; Hydroxyapatites/BI; Male; Microscopy, Fluorescence; Minerals/*ME; Osteogenesis; Rabbits.
.T
Mineralization in in vitro cultures of rabbit marrow stromal cells.
.P
JOURNAL ARTICLE.
.W
Localized regions of mineralization were found in confluent cultures of rabbit marrow fibroblastic cells. The mineralized tissue developed within clusters of giant fat cells in the spaces between the cells. Investigations with light and electron microscopy demonstrated that in these sites there was some differentiation of the fibroblastic cells in an osteogenic direction, shown by changes to more polygonal shapes, and the synthesis of well-banded collagen similar to that found in bone tissue. Differentiation may be due, in part, to increased cell density in a confined space. Growth of the mineralized tissue was observed in the living cultures with a fluorescence microscope. Electron probe microanalysis confirmed that the mineral formed was hydroxyapatite. Initiating sites of mineralization included membranous vesicular bodies, lipid, and products of cellular degeneration. Once initiated, mineralization appeared to spread rapidly into adjacent collagenous and other structures, suggesting the appearance of a mixture of skeletal-type and dystrophic mineralization.
.A
Howlett CR; Cave J; Williamson M; Farmer J; Ali SY; Bab I; Owen ME.
.I 387
.U
87052442
.S
Clin Orthop 8703;  (213):264-78
.M
Biomechanics; Bone Regeneration; Bone Resorption; Human; Ilium/PA/*PP; Models, Biological; Osteoporosis/DT/PA/*PP; Probability/*; Stochastic Processes/*.
.T
A stochastic analysis of iliac trabecular bone dynamics.
.P
JOURNAL ARTICLE.
.W
Published normal histomorphometric data were used to derive distributions of thicknesses of trabecular plates and completed bone remodelling units (the basic multicellular unit carrying out bone remodelling, the BMU, when completed is termed a structural unit BSU). A stochastic model was set up to investigate the predictions of current BMU theory. Each of 100 trabecular "thicknesses" was drawn from the appropriate normal distribution using a pseudorandom number generator. Each day, each of its two surfaces when quiescent was assumed to have a 1:900 chance of initiating a remodelling cycle. Resorption (active, 12 days; reversal phase, 27 days) was followed by formation (94 +/- 35 days) and resulted in BMU balance when resorption depth was 36.8 +/- 9.2 micron. Fenestration (thickness less than 0) was assumed to lead to permanent loss of the trabecula. The original model unrealistically increased its mean trabecular thickness as thin trabeculae were lost. This was corrected by assuming that thin trabeculae had greater osteoblastic stimulation and a consequent tendency to thicken, perhaps due to higher mechanical loading. Over 20 years, 14% of trabeculae were lost when the BMU balance was exact and the distribution of trabecular thicknesses was unchanged. About one-half of fenestrations were due to deeper-than-average resorption cavities developing in thin trabeculae, and the remainder to coincident remodelling on both surfaces. A 10% fall in osteoblast lifespan resulted in an additional 36.7% loss of trabecular bone volume and mean trabecular thickness fell to 83.1 micron, compatible with Courpron's data. Simulating more rapid mechanisms of bone loss, approximately 50% of trabeculae could be lost after ten years by the arrest of bone formation; the doubling of resorption depth with unchanged bone formation; and a doubling in the rate of initiation of new BMUs with unchanged bone formation rate, all three followed by complete recovery of BMU balance after only two years. In each case, mean trabecular thickness fell only transiently but trabeculae continued to be lost after recovery. Prolonged osteoblast life span was the most likely explanation for the increased mean trabecular thicknesses and trabecular bone volumes seen in patients with osteoporosis, when treated with sodium fluoride plus calcium supplements or daily injections of parathyroid peptide hPTH 1-34.
.A
Reeve J.
.I 388
.U
87052443
.S
Clin Orthop 8703;  (213):279-88
.M
Adolescence; Bone Neoplasms/*SC/SU; Carcinoma/*SC/SU; Case Report; Combined Modality Therapy; Female; Follow-Up Studies; Human; Neoplasm Recurrence, Local/SU; Radius/*SU; Sella Turcica/SU; Skull Neoplasms/RT/SU; Tibia/*SU.
.T
Evolution of a case of multicentric giant cell tumor over a 23-year period.
.P
JOURNAL ARTICLE.
.W
A 17-year-old girl had a multicentric giant cell tumor originating in the sphenoid and sella turcica that was observed for 23 years. During the first 12 years, the same lesion also appeared in the right proximal tibia and left distal radius. Curettage of the tibial lesion and packing with processed bovine bone were followed by a chronic osteomyelitis with continued intermittent wound drainage. Curettage of the radial lesion and packing it initially with autogenous iliac bone graft and subsequently with methylmethacrylate bone cement were followed by local recurrences. The radial lesion eventually was eradicated by a segmental resection of the distal radius. The resulting bony defect was bridged with a bicortical autogenous iliac graft and stabilized with a bone plate to produce a painless solid wrist fusion. No further tumor recurrence has been noted for the past two years.
.A
Wu KK; Ross PM; Mitchell DC; Sprague HH.
.I 389
.U
87052444
.S
Clin Orthop 8703;  (213):34-40
.M
Animal; Bone and Bones/*PP; Cartilage, Articular/ME/*PP; Disease Models, Animal; Human; Osteoarthritis/*ET/PP; Proteoglycans/ME; Rabbits; Stress, Mechanical; Support, U.S. Gov't, P.H.S..
.T
Role of subchondral bone in the initiation and progression of cartilage damage.
.P
JOURNAL ARTICLE.
.W
Osteoarthrosis is a physiologic imbalance, a "joint failure" similar to "heart failure," in which mechanical factors play a role. The initiation and progression of cartilage damage are distinct phenomena. One of the mechanisms of initiation may be a steep stiffness gradient in the underlying subchondral bone. Progression of cartilage lesions probably requires stiffened subchondral bone. In such situations, transverse stresses at the base of the articular cartilage could cause deep horizontal splits in that tissue. The most likely cause of subchondral stiffening in an otherwise congruent joint is repeated failure of the musculoskeletal peak dynamic force attenuation mechanisms. The health and integrity of the overlying articular cartilage depends on the mechanical properties of its bony bed. In certain models of osteoarthrosis, alterations of the bony bed occur before the cartilage changes and suggest that this can occur in clinical conditions. Stiffening of the subchondral bone also can effect joint conformation, which involves deformation of articular cartilage and bone to create maximum contact areas under load.
.A
Radin EL; Rose RM.
.I 390
.U
87052446
.S
Clin Orthop 8703;  (213):41-9
.M
Cartilage, Articular/IM; Case Report; Complement 3/AN; Female; Hip Joint/SU; Histocytochemistry; Human; IgA/AN; IgG/AN; IgM/AN; Inflammation/IM; Knee Joint/SU; Male; Middle Age; Osteoarthritis/*IM/PA/SU; Support, Non-U.S. Gov't; Synovial Membrane/*IM.
.T
Immune pathology in polyarticular osteoarthritis.
.P
JOURNAL ARTICLE.
.W
Although osteoarthritis (OA) generally is considered a disorder of mechanical origin, the common occurrence of chronic mononuclear cell infiltrates in the synovium in conjunction with immunofluorescent evidence for immune-reactant products in cartilage of surgical case specimens (knees, hips, and peripheral joints) has suggested the local involvement of immune processes in the arthritis. Further, the findings of polyarthropathy in the majority of these cases have indicated the propensity for a systemic disorder. Wide variations were noted in both synovial and cartilage immune changes, quite different to those found in rheumatoid arthritis, along with the frequent asymptomatology of the many joints involved. These features, with and without other causative factors, suggest that immune reactions of local and/or systemic origin occur at times in a population at risk for joint degradation.
.A
Cooke TD.
.I 391
.U
87052450
.S
Clin Orthop 8703;  (213):77-83
.M
Animal; Cartilage, Articular/*DE/ME/PA; Disease Models, Animal; Estradiol/*PD; Female; Human; Male; Organ Culture; Osteoarthritis/*ME; Ovariectomy; Prostaglandins/BI; Proteoglycans/BI; Rabbits; Stains and Staining; Support, U.S. Gov't, P.H.S.; Tamoxifen/*PD.
.T
Estrogens and osteoarthritis.
.P
JOURNAL ARTICLE.
.W
Clinical and laboratory observations suggest that a relationship exists between sex hormones and the development of osteoarthritis. The mechanisms whereby these hormones influence the pathophysiology of osteoarthritis have been explored. Tamoxifen, an estrogen antagonist, reduced erosive changes in meniscectomy-induced osteoarthritis in rabbits. By contrast, estradiol worsened it. There was no effect of either agent on the incidence of osteophytes in this model. Both estradiol and tamoxifen affected proteoglycan, prostaglandin, and proteoglycanase production by cartilage components. These observations suggest that cartilage is a sex hormone-sensitive tissue. This may have therapeutic implications in the future.
.A
Rosner IA; Goldberg VM; Moskowitz RW.
.I 392
.U
87052451
.S
Clin Orthop 8703;  (213):84-91
.M
Animal; Anti-Inflammatory Agents, Non-Steroidal/AE/*TU; Atrophy/ME; Cartilage, Articular/*DE/ME/PA; Dogs; Extracellular Matrix/ME; Hindlimb; Human; Immobilization; In Vitro; Inflammation/DT; Osteoarthritis/*DT/ME/PA; Pain/DT; Proteoglycans/ME; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Synovial Fluid/ME.
.T
Nonsteroidal antiinflammatory drugs in treatment of osteoarthritis.
.P
JOURNAL ARTICLE.
.W
It is clear that some synovial inflammation occurs in joints affected by osteoarthritis (OA) and it is well recognized that many patients with OA experience a decrease in pain and joint stiffness following administration of salicylates or other nonsteroidal antiinflammatory drugs (NSAIDs). However, neither the extent to which synovitis contributes to the cartilage breakdown in OA nor the effects of chronic administration of NSAIDs on the natural history of OA in humans is known. Recent studies indicate that several NSAIDs, including salicylates, suppress proteoglycan synthesis in articular cartilage in vitro. The effect on OA cartilage is more marked than that on normal cartilage. Other studies show that salicylate feeding may suppress proteoglycan metabolism in degenerating cartilage in vivo, aggravating the decrease in proteoglycan content caused by the disease itself. However, no effect of salicylates on normal articular cartilage has been observed in vivo. In damaged cartilage the magnitude of NSAID-induced suppression of proteoglycan metabolism appears to be related inversely to the proteoglycan content of the tissue. In addition, the NSAIDs used in treatment of arthritis today may differ with respect to their in vivo effects on articular cartilage metabolism due, in part, to differences between the molar concentrations of these drugs in synovial fluid.
.A
Brandt KD; Slowman-Kovacs S.
.I 393
.U
87052473
.S
Clin Pediatr (Phila) 8703; 25(12):600-4
.M
Attention; Attention Deficit Disorder with Hyperactivity/DI/*PX; Child; Female; Follow-Up Studies; Human; Language Development Disorders/PX; Male; Psychiatric Status Rating Scales; Social Behavior.
.T
Pediatric management of nonpervasively "hyperactive" children.
.P
JOURNAL ARTICLE.
.W
Sixty-five children viewed by their teachers as hyperactive were evaluated as to whether they would benefit from stimulant medication. All underwent extensive neurodevelopmental and educational testing. Additional information was obtained from school and parent questionnaires and interviews. Children were not placed on medication unless they demonstrated characteristic impulsive, inattentive, and/or overactive behavior in two of three environments (home, school, clinic). Fifty-two children (80%) were not placed on medication. Follow-up was completed in 80 percent, and 93 percent of these children were doing well with nonpharmacologic interventions. Initial comparison of children not placed and placed on medication revealed that age, race, SES, amount of resource help and retention could not distinguish groups. Children placed on medication had difficulties earlier in school (chi 2 = 4.88, p less than 0.05), weren't as delayed academically (chi 2 = 6.30, p less than 0.05) and had less neurodevelopmental disorders (chi 2 = 9.01, p less than 0.01). If a careful psychosocial history does not reveal impulsive, inattentive, and/or hyperactive behavior outside of school, a child should be evaluated to rule out neurodevelopmental and educational problems.
.A
Landman GB; McCrindle B.
.I 394
.U
87052476
.S
Clin Pediatr (Phila) 8703; 25(12):612-4
.M
Adolescence; Anxiety; Chest Pain/DI/*ET/PX; Child; Depression; Female; Follow-Up Studies; Headache/ET; Human; Male; Recurrence; Stress, Psychological/CO.
.T
The natural history of idiopathic chest pain in children. A follow-up study.
.P
JOURNAL ARTICLE.
.W
Repetitive chest pain of obscure origin is commonly encountered in older children and adolescents. A questionnaire study was conducted to determine the long-term outcome in 31 patients diagnosed as having idiopathic recurrent chest pain after an average 4.1-year follow-up period. Although 45 percent reported having had persistent symptoms, chest pain had disappeared in 81 percent of those followed more than 3 years. Equally reassuring is the fact that in no case did occult disease subsequently appear to account for the initial symptoms. This study supports the current clinical approach of limited diagnostic evaluation and reassurance in the management of these patients.
.A
Rowland TW; Richards MM.
.I 395
.U
87052477
.S
Clin Pediatr (Phila) 8703; 25(12):617-9
.M
Adolescence; Alcoholic Intoxication/BL/*EP; Blood Glucose/AN; Canada; Child; Child, Preschool; Electrolytes/BL; Female; Human; Hypoglycemia/ET; Infant; Male; Retrospective Studies.
.T
Ethyl alcohol ingestion in children. A 15-year review.
.P
JOURNAL ARTICLE.
.W
Information on ethyl alcohol intoxication in children is scarce. A retrospective study was conducted by chart reviews of 27 patients with documented ethanol ingestion admitted to the Alberta Children's Hospital, Foothills Provincial Hospital, Calgary General Hospital or Holy Cross Hospital from 1969 to 1984. Six patients had hypoglycemia and one experienced a convulsion. The rate of alcohol elimination was found to be greater than 6.2 mM/L/hr (28.4 mg/dl/hr), approximately twice the rate seen in adults. Six patients had hypokalemia, and two had severe metabolic acidosis.
.A
Leung AK.
.I 396
.U
87052478
.S
Clin Pediatr (Phila) 8703; 25(12):620-3
.M
Adolescence; Ambulances; Child; Child, Preschool; Emergency Medical Services/*; Female; Heart Arrest/EP/TH; Human; Infant; Intensive Care Units/*; Male; Mobile Health Units/*; Pediatrics; Prospective Studies; Resuscitation; Seizures/*EP/TH; Sudden Infant Death/*EP/TH.
.T
Should the Mobile Intensive Care Unit respond to pediatric emergencies?
.P
JOURNAL ARTICLE.
.W
Between October 1982 and October 1985, the Mobile Intensive Care Unit (MICU) in Jerusalem responded to 625 pediatric emergencies, representing 5% of the total MICU case load. The most common medical problem was seizures, diagnosed in 205 cases (33%). The second most frequent group related to trauma (175 cases; 28%). There were 71 cases (11.4%) of cardiac arrest. Resuscitation was attempted in 37, but there were no long-term survivors. Almost all cardiac arrest patients were found in asystole, and most had antecedent serious medical problems. Compared with the adult population, children were less likely to require or benefit from an advanced level of prehospital care. When resources for advanced care are limited, priority should be given to adult emergencies.
.A
Applebaum D; Slater PE.
.I 397
.U
87052479
.S
Clin Pediatr (Phila) 8703; 25(12):624-5
.M
Bronchoscopy; Case Report; Child; Diagnosis, Differential; Female; Foreign Bodies/DI/*RA; Human; Infant; Male; Respiratory Tract Infections/DI; Thoracic Radiography/*; Trachea/*.
.T
Normal radiographic findings after foreign body aspiration. When the history counts.
.P
JOURNAL ARTICLE.
.W
Foreign body aspiration in children is frequently associated with unilateral emphysema or atelectasis on chest x-ray. Two cases are reported of tracheal or bilateral foreign bodies in which the original chest x-rays were read as normal, but the history was suggestive of the foreign body aspiration. Early bronchoscopy can prevent the long-term morbidity that results from unrecognized tracheobronchial foreign bodies.
.A
Musemeche CA; Kosloske AM.
.I 398
.U
87052480
.S
Clin Pediatr (Phila) 8703; 25(12):626-8
.M
Case Report; Human; Infant, Newborn; Infant, Premature, Diseases/*TH; Intubation, Intratracheal/*/MT; Male; Pulmonary Emphysema/*TH.
.T
Endotracheal tube modification for therapy of right-sided pulmonary interstitial emphysema.
.P
JOURNAL ARTICLE.
.A
DeWitte DB; Batton DG; Prudent L; Maisels MJ.
.I 399
.U
87052481
.S
Clin Pediatr (Phila) 8703; 25(12):629
.M
Hemangioma, Cavernous/*PA; Human; Klippel-Trenaunay Disease/PA; Puberty/*; Skin Neoplasms/*PA.
.T
Growth of cavernous hemangioma with puberty [letter]
.P
LETTER.
.A
Stickler GB.
.I 400
.U
87052482
.S
Clin Pediatr (Phila) 8703; 25(12):629
.M
Adolescence; Anorexia Nervosa/*DH; Body Weight; Caloric Intake/*; Diet/*; Human.
.T
The food exchange system in the treatment of anorexia nervosa [letter]
.P
LETTER.
.A
Kreipe RE; Trott M.
.I 401
.U
87052485
.S
Clin Pharmacol Ther 8703; 40(6):610-4
.M
p-Aminohippuric Acid/ME; Adult; Blood Pressure/DE; Comparative Study; Dopamine/ME/*PD; Female; Heart Rate/DE; Human; Hypertension/*ME; Infusions, Intravenous; Inulin/ME; Kidney/*DE; Male; Middle Age.
.T
Enhanced dopamine renal responsiveness in patients with hypertension.
.P
JOURNAL ARTICLE.
.W
The purpose of the study was to compare the renal effects of low doses of exogenous dopamine to assess the responsiveness of renal dopaminergic receptors in normotensive and hypertensive subjects. Eight hypertensive patients and seven normotensive volunteer subjects were studied. Inulin and para-aminohippuric (PAH) clearances, natriuresis, and fractional excretion of sodium increased significantly after intravenous dosing with dopamine (2 micrograms/min/kg) in both groups. These increases were significantly higher in hypertensive than in normotensive subjects: 31.8% +/- 3.7% vs. 16.2% +/- 1.2% for inulin clearance (P less than 0.01), 83.3% +/- 10.5% vs. 41.1% +/- 3.4% for PAH clearance (P less than 0.01), and 331% +/- 38% vs. 216% +/- 26% for natriuresis (P less than 0.01). These findings suggest hyperresponsiveness to dopamine during hypertension. This enhanced response to exogenous dopamine can be considered as a further argument favoring the existence of a deficit in dopaminergic activity during hypertension. Dopamine also induced a significant reduction in blood pressure and increased heart rate in hypertensive subjects but no significant change in blood pressure and heart rate occurred in normotensive subjects.
.A
Andrejak M; Hary L.
.I 402
.U
87052486
.S
Clin Pharmacol Ther 8703; 40(6):615-9
.M
Acetylation; Adult; Amrinone/AA/BL/*ME/UR; Human; Infusions, Intravenous; Kinetics; Male; Phenotype.
.T
Effect of the acetylator phenotype on amrinone pharmacokinetics.
.P
JOURNAL ARTICLE.
.W
Ten healthy male subjects were phenotyped with isoniazid for their acetylator status and then received intravenous amrinone at a dose of 75 mg during a period of 10 minutes. Blood samples were drawn at specified times during a 24-hour period after dosing. Plasma concentrations of amrinone were determined by a specific HPLC method. The plasma concentration data were fitted to a biexponential model by nonlinear regression. The mean apparent first-order elimination t1/2 for amrinone in the slow acetylators was 4.4 hours, whereas it was 2.0 hours in the fast acetylators (P less than 0.05). There was little difference in the volume of distribution at steady state. Clearance was lower in the slow acetylators, 16.6 L/hr, than in the fast acetylators, 37.2 L/hr (P less than 0.05). The AUC was higher for the slow acetylators, 4.96 micrograms X hr X ml-1, than for the fast acetylators, 2.20 micrograms X hr X ml-1 (P less than 0.01). Concentrations of amrinone and its N-acetyl metabolite in the urine from each volunteer were determined. The ratio of N-acetylamrinone to amrinone was calculated and, as expected, the fast acetylators had a higher ratio than did the slow acetylators (P less than 0.01).
.A
Hamilton RA; Kowalsky SF; Wright EM; Cernak P; Benziger DP; Stroshane RM; Edelson J.
.I 403
.U
87052487
.S
Clin Pharmacol Ther 8703; 40(6):620-6
.M
Adult; Diazepam/ME/*PD; Double-Blind Method; Drug Evaluation; Drug Interactions; Human; Kinetics; Psychomotor Performance/*DE; Pyrimidines/ME/*PD; Random Allocation.
.T
Combined effects of buspirone and diazepam on objective and subjective tests of performance in healthy volunteers.
.P
JOURNAL ARTICLE.
.W
The combined effects on performance of two anxiolytics with different mechanisms of action were evaluated double-blind and crossover in 12 healthy students. Objective (tracking, divided attention, Maddox wing, etc.) and subjective (visual analogue scales and questionnaires) tests were done before and twice after single oral doses. Diazepam (0.15 and 0.30 mg/kg) impaired performance dose relatedly and rendered the subjects drowsy, calm, mentally slow, and clumsy. Buspirone (15 mg) proved inactive in objective tests but matched diazepam (0.30 mg/kg) subjectively. In combinations, buspirone added to the effects of diazepam in Maddox wing and letter cancellation but tended to counteract diazepam effects on divided attention and learning acquisition. Subjectively buspirone prolonged diazepam-induced sedation. Increased calmness caused by diazepam was not affected by concomitant buspirone. It is suggested that combining small doses of buspirone to diazepam does not cause any additional decrement in psychomotor performance. Possible advantages of the diazepam-buspirone combination in therapeutic use are discussed.
.A
Mattila M; Seppala T; Mattila MJ.
.I 404
.U
87052489
.S
Clin Pharmacol Ther 8703; 40(6):634-42
.M
Adolescence; Adult; Chromatography, Gas; Drug Interactions; Human; Kinetics; Male; Platelet Aggregation/*DE; Prostaglandin Endoperoxides, Synthetic/PD; Random Allocation; Thromboxane A2/*AA/*AI/BL/PD.
.T
Quantitation of drug levels and platelet receptor blockade caused by a thromboxane antagonist.
.P
JOURNAL ARTICLE.
.W
SQ 28,668 is a structural analog of thromboxane A2. It inhibits the effects of thromboxane in vitro. Fifty-six healthy male subjects were given either placebo or three equal daily doses of SQ 28,668 ranging from 25 to 1200 mg. Plasma drug concentrations increased in a dose-dependent manner. The shape of the plasma drug concentration-time curve was consistent with enterohepatic recirculation. The effects of SQ 28,668 on ex vivo platelet aggregation suggested that SQ 28,668 is a specific competitive antagonist of thromboxane A2 with a platelet receptor dissociation constant (estimated by Schild analysis) of about 19 nmol/L. Approximately 94% occupation of thromboxane receptors by SQ 28,668 was required to produce a small but measurable increase of the template bleeding time. Dose-ranging studies of antithrombotic drugs are difficult and expensive. For this reason, a method was developed that allows estimation of the dose of a thromboxane receptor antagonist that would be expected to be therapeutically equivalent to a given dose of aspirin.
.A
Friedhoff LT; Manning J; Funke PT; Ivashkiv E; Tu J; Cooper W; Willard DA.
.I 405
.U
87052491
.S
Clin Pharmacol Ther 8703; 40(6):650-5
.M
Adult; Blood Pressure/DE; Debrisoquin/*ME/PD; Drug Interactions; Guanidines/BL/*ME; Human; Isoquinolines/*ME; Kinetics; Liver/DE/*ME; Liver Cirrhosis/*ME; Male; Metabolic Clearance Rate/DE; Middle Age; Phenotype; Pulse/DE; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Effect of cirrhosis and debrisoquin phenotype on the disposition and effects of pinacidil.
.P
JOURNAL ARTICLE.
.W
Pinacidil is an investigational vasodilator currently undergoing clinical trials as an antihypertensive agent. It is metabolized in humans to pinacidil N-oxide. To determine whether pinacidil's metabolism or effects were influenced by either liver disease or the subject's debrisoquin phenotype, eight patients with chronic stable cirrhosis and 13 healthy subjects were studied. Seven of the healthy volunteers were extensive metabolizers of debrisoquin, whereas six were of the poor metabolizer phenotype. Neither the clearance of pinacidil nor the production of the N-oxide was altered by the subjects' debrisoquin phenotype. Cirrhosis produced a 50% reduction in pinacidil's clearance (20.7 +/- 1.4 vs. 42.1 +/- 5.1 L/hr; P less than 0.0005) and a prolongation in the elimination t1/2 from 3.9 +/- 0.3 to 6.1 +/- 0.6 hours (P less than 0.01). Less pinacidil was metabolized to the N-oxide metabolite in the patients with cirrhosis than in the normal individuals. Thus pinacidil's metabolism and clearance are reduced in patients with cirrhosis but are independent of debrisoquin phenotype.
.A
Shaheen O; Patel J; Avant GR; Hamilton M; Wood AJ.
.I 406
.U
87052492
.S
Clin Pharmacol Ther 8703; 40(6):656-64
.M
Blood Proteins/ME; Chromatography, High Pressure Liquid; Female; Fetal Blood/*AN; Fetus/*ME; Human; Infant, Newborn; Kinetics; Maternal-Fetal Exchange; Pregnancy; Ritodrine/BL/*ME; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Ritodrine pharmacokinetics.
.P
JOURNAL ARTICLE.
.W
The purpose of this study was to add to the limited information available regarding the pharmacology of ritodrine in the peripartum period when treatment fails and labor is not inhibited. Plasma or urine samples from eight parturients and 13 infants were studied; in addition plasma samples at delivery were obtained from a total of 26 mothers and infants. All the mothers received ritodrine in the 24 hours before delivery. Plasma and urine ritodrine (free and conjugated) were determined with HPLC by electrochemical detection. In maternal plasma, an apparent rapid distribution phase with a t1/2 of 32 +/- 21 minutes was followed by a prolonged equilibrium phase with a t1/2 of 17 +/- 10 hours. Seventy-six percent of the ritodrine excreted by the mother was in the form of a conjugate. Ninety percent of the ritodrine excreted by the neonate was also excreted in the form of a conjugate.
.A
Kuhnert BR; Gross TL; Kuhnert PM; Erhard P; Brashar WT.
.I 407
.U
87052493
.S
Clin Pharmacol Ther 8703; 40(6):665-72
.M
Adolescence; Adult; Aged; Aging; Cimetidine/*PD; Comparative Study; Drug Evaluation; Gastric Acid/*SE; Gastric Mucosa/*DE; Human; Hydrogen-Ion Concentration; Infusions, Intravenous; Male; Middle Age; Random Allocation; Ranitidine/*PD.
.T
The effect of single intravenous doses of cimetidine or ranitidine on gastric secretion.
.P
JOURNAL ARTICLE.
.W
Intravenous cimetidine, 300 mg or 400 mg, or ranitidine, 50 mg, was administered as a single dose to 36 volunteers in a randomized, crossover fashion. Aspirates of gastric juice were obtained after dosing, and the pH, titratable acidity, gastric fluid volume, and gastric acid output were determined from baseline through 71/2 hours for each subject. Each intervention significantly increased pH and suppressed hydrogen ion concentration, gastric fluid volume, and gastric acid output. Both the magnitudes of the changes when compared with baseline and the time of the mean maximum effects were similar in all three drug regimens. The effect of all three interventions on gastric fluid volume and gastric acid output diminished sharply after 6 hours. The data indicate that the gastric secretory response to all three interventions did not differ substantially.
.A
Frank WO; Peace KE; Watson M; Seaman JJ; Szego PL; Braverman A; Mico B; Dickson B.
.I 408
.U
87052494
.S
Clin Pharmacol Ther 8703; 40(6):673-8
.M
Absorption; Adult; Aerosols; Blood Glucose; Comparative Study; Double-Blind Method; Epinephrine/AD/BL/*ME; Heart Rate/DE; Human; Injections, Subcutaneous; Male; Potassium/BL; Random Allocation; Tremor/CI.
.T
Systemic absorption of inhaled epinephrine.
.P
JOURNAL ARTICLE.
.W
To determine the systemic absorption of epinephrine when it is given by inhalation, six normal volunteers were given 15 puffs, followed by 30 puffs, of epinephrine from a pressurized aerosol (160 micrograms epinephrine/puff). The peak mean (+/- SE) plasma epinephrine levels were 1.50 (+/- 0.61) and 4.22 (+/- 1.93) nmol/L 1 minute after each dose, respectively. The effect on physiologic finger tremor correlated with the plasma epinephrine level and returned to baseline 20 minutes after taking the higher dose. There was a small fall in mean plasma potassium levels of 0.45 mmol/L and a small rise in plasma glucose levels of 0.81 mmol/L. On a separate occasion an injection of 0.3 ml of 1/1000 (300 micrograms) epinephrine was given subcutaneously to the same individuals. This caused a peak plasma epinephrine level of 2.43 (+/- 0.47) nmol/L at 10 minutes, and this was still raised at 2.05 (+/- 0.41) nmol/L after 40 minutes. The maximum fall in the mean plasma potassium level was 0.43 mmol/L after the injection.
.A
Warren JB; Doble N; Dalton N; Ewan PW.
.I 409
.U
87052495
.S
Clin Pharmacol Ther 8703; 40(6):679-85
.M
Adult; Blood Pressure/DE; Drug Therapy, Combination; Echocardiography; Female; Heart Rate/DE; Heart Ventricle/DE; Human; Hydrochlorothiazide/TU; Hypertension/*DT; Male; Middle Age; Nitrendipine/*TU; Propranolol/TU; Support, Non-U.S. Gov't.
.T
Effect of the calcium channel blocker nitrendipine on left ventricular mass in patients with hypertension.
.P
JOURNAL ARTICLE.
.W
Reductions in left ventricular (LV) mass have been reported after antihypertensive therapy with certain sympatholytic agents and converting enzyme inhibitors, but little or no improvement has been noted after vasodilator therapy. In this study we evaluated the effect of the calcium channel blocker nitrendipine on echocardiographic LV mass. During a 12-month period, nitrendipine was used as monotherapy in 30 patients and in combination with propranolol or a diuretic in an additional 28 patients. Nitrendipine monotherapy lowered supine blood pressure from 148/97 to 136/83 mm Hg, but LV mass did not change significantly. Supine blood pressure decreased from 155/103 to 134/86 mm Hg in patients receiving combination therapy but, again, changes in LV mass were not significant. These data suggest that nitrendipine is effective in lowering blood pressure, but this is not associated with a significant decrease in LV mass in patients with mild hypertension.
.A
Drayer JI; Hall WD; Smith VE; Weber MA; Wollam GL; White WB.
.I 410
.U
87052588
.S
Compr Ther 8703; 12(10):16-22
.M
Age Factors; Aged; Analeptics/TU; Antidepressive Agents, Tricyclic/*AD/AE/BL; Depression/BL/CO/DI/*DT/TH; Depressive Disorder/BL/*DT/TH; Electroconvulsive Therapy; Female; Human; Kinetics; Male; Memory Disorders/DI; Middle Age; Monoamine Oxidase Inhibitors/TU; Nutrition Disorders/ET; Prognosis; Psychotherapy; Suicide.
.T
Treatment of depression in the elderly.
.P
JOURNAL ARTICLE.
.A
Grossberg GT; Nakra BR.
.I 411
.U
87052589
.S
Compr Ther 8703; 12(10):23-8
.M
Anticoagulants/TU; Arterial Occlusive Diseases/*DT/ET; Basilar Artery/*/PP; Cerebellum/BS; Cerebral Infarction/PP; Embolism/PP; Fibrinolytic Agents; Human; Migraine/ET; Subclavian Artery/PP; Vertebral Artery/*/PP; Vertebrobasilar Insufficiency/*DT/ET.
.T
Treatment of patients with vertebrobasilar occlusive disease.
.P
JOURNAL ARTICLE.
.A
Caplan LR.
.I 412
.U
87052590
.S
Compr Ther 8703; 12(10):29-35
.M
Aging; Benzodiazepine Tranquilizers/TU; Circadian Rhythm; Diagnosis, Differential; Female; Human; Insomnia/DI/DT/*ET/PP/TH; Male; Myoclonus/CO/DT; Prognosis; Psychophysiologic Disorders/DT; Restless Legs/CO/DT; Sleep Apnea Syndromes/CO/TH.
.T
Clinical aspects of insomnia.
.P
JOURNAL ARTICLE.
.A
Browman CP; Winslow DH.
.I 413
.U
87052591
.S
Compr Ther 8703; 12(10):3-5
.M
Arteriosclerosis/*SU; Human; Lasers/MT/*TU.
.T
Laser angioplasty.
.P
JOURNAL ARTICLE.
.A
Ferris EJ; McCowan TC; Baker ML.
.I 414
.U
87052592
.S
Compr Ther 8703; 12(10):36-41
.M
Electroconvulsive Therapy; Female; Human; Patient Care Team; Pregnancy; Pregnancy Complications/DT/*PX/TH; Psychotherapy; Psychotic Disorders/*CO/DT/TH; Psychotropic Drugs/TU; Recurrence.
.T
Psychosis and pregnancy.
.P
JOURNAL ARTICLE.
.W
Close, continuous collaboration among the obstetrician, the psychiatrist, and nurses in both disciplines is required to improve the mental health of a patient whose psychosis is associated with pregnancy. These most complex cases require not "either/or" management but the combined attention of specialists in both disciplines.
.A
Chang SS; Renshaw DC.
.I 415
.U
87052593
.S
Compr Ther 8703; 12(10):42-52
.M
Dopamine/AI; Drug Interactions; Human; Intestinal Absorption; Kinetics; Schizophrenia/DI/*DT; Tranquilizing Agents, Major/AE/ME/*TU.
.T
Schizophrenia and antipsychotic drugs.
.P
JOURNAL ARTICLE.
.W
A variety of effective drugs are available for the treatment of schizophrenia. Knowledge of the side-effect spectrum of the various classes of antipsychotic drugs is necessary for the clinician to arrive at a rational choice of medication. In general, the preferred drug will be a high-potency neuroleptic. The following basic principles of clinical psychopharmacology should be followed: Consider risk and benefits; clinical experience is prerequisite; establish the diagnosis; select the appropriate class of psychotropic drug for the primary diagnosis; within drug class, the drugs are usually equally effective for patients with the diagnosis; give a dose that is high enough to be effective; choose target symptoms that can be monitored to indicate when to stop or increase the drug; avoid use of multiple drugs when possible; drugs are only one element in a comprehensive treatment strategy. Other modalities need equally careful consideration, e.g., psychotherapy, group therapy, family treatment, and vocational rehabilitation; and consultation with other subspecialists should be sought readily when indicated.
.A
Nurnberg HG; Levine PE.
.I 416
.U
87052594
.S
Compr Ther 8703; 12(10):53-60
.M
Aged/*; Anxiety/CO/DI/*DT; Depression/CO; Diagnosis, Differential; Female; Human; Male; Propranolol/TU; Tranquilizing Agents, Minor/CL/ME/TU.
.T
Management of anxiety in the elderly.
.P
JOURNAL ARTICLE.
.W
Clinicians need to be aware of the cardinal manifestations of clinical anxiety in their geriatric patients. A variety of psychotherapeutic, behavioral, and chemical interventions can effectively and safely treat anxiety in geriatric patients and thereby greatly diminish morbidity and mortality.
.A
Nakra BR; Grossberg GT.
.I 417
.U
87052595
.S
Compr Ther 8703; 12(10):61-7
.M
Acute Disease; Dyskinesia, Drug-Induced/ET; Dystonia/CI; Female; Human; Male; Movement Disorders/*CI; Neuroleptic Malignant Syndrome/ET; Parkinson Disease, Symptomatic/CI; Psychomotor Agitation/CI; Tranquilizing Agents, Major/*AE.
.T
Clinical and neurobiologic implications of antipsychotic-induced movement disorders.
.P
JOURNAL ARTICLE.
.A
Rubin EH; Zorumski CF.
.I 418
.U
87052596
.S
Compr Ther 8703; 12(10):68-72
.M
Depressive Disorder/TH; Electroconvulsive Therapy/*AE; Evaluation Studies; Human; Risk; Seizures/*ET; Support, U.S. Gov't, P.H.S..
.T
Electrically induced seizures (ECT).
.P
JOURNAL ARTICLE.
.A
Milstein V; Small JG; Small IF.
.I 419
.U
87052597
.S
Compr Ther 8703; 12(10):7-15
.M
Alprazolam/TU; Anxiety/*DI/DT/ET; Behavior Therapy; Brain/ME; Fear/*; Female; Human; Lactates/ME; Male; Monoamine Oxidase Inhibitors/TU; Oxidation-Reduction; Panic/*; Phobic Disorders/DI/TH; Pyruvates/ME.
.T
Panic anxiety: diagnosis, etiology, and treatment.
.P
JOURNAL ARTICLE.
.A
Raj A; Sheehan DV.
.I 420
.U
87052707
.S
Contact Dermatitis 8703; 15(2):100
.M
Adult; Case Report; Dermatitis, Contact/*ET; Facial Dermatoses/ET; Female; Food Handling; Human; Hypersensitivity, Immediate/*ET; Occupational Dermatitis/ET; Shellfish/AE; Shrimp/*; Urticaria/*ET.
.T
Regional variation in elicitation of contact urticaria syndrome (immediate hypersensitivity syndrome): shrimp.
.P
JOURNAL ARTICLE.
.A
Maibach HI.
.I 421
.U
87052708
.S
Contact Dermatitis 8703; 15(2):100-2
.M
Adult; Case Report; Dermatitis, Contact/*ET; Female; Food Handling; Food Hypersensitivity/*ET; Human; Vegetables/*AE.
.T
Contact allergy caused by bamboo shoots.
.P
JOURNAL ARTICLE.
.A
Kitajima T.
.I 422
.U
87052709
.S
Contact Dermatitis 8703; 15(2):102-3
.M
Allergens/*; Animal; Azo Compounds/*AE; Dermatitis, Contact/*ET; Dyes/*AE; Guinea Pigs; Textiles.
.T
Disperse blue 106, a strong sensitizer.
.P
JOURNAL ARTICLE.
.A
Hausen BM; Menezes Brandao F.
.I 423
.U
87052710
.S
Contact Dermatitis 8703; 15(2):103
.M
Dermatitis, Contact/*ET; Hair Dyes/*AE; Hair Preparations/*AE; Human; Phenylenediamines/*AE.
.T
Paraphenylenediamine-free hair coloring mousse.
.P
JOURNAL ARTICLE.
.A
Maibach HI.
.I 424
.U
87052711
.S
Contact Dermatitis 8703; 15(2):103-4
.M
Aged; Case Report; Dermatitis Medicamentosa/DI/*ET; Dermatitis, Contact/*/DI/*ET; Human; Ibuprofen/*AE; Male; Patch Tests.
.T
Contact dermatitis to ibuprofen.
.P
JOURNAL ARTICLE.
.A
Veronesi S; de Padova MP; Bardazzi F; Melino M.
.I 425
.U
87052712
.S
Contact Dermatitis 8703; 15(2):104-5
.M
Adult; Case Report; Catgut/*AE; Dermatitis, Contact/*ET; Female; Human; Sutures/*AE.
.T
Catgut dermatitis.
.P
JOURNAL ARTICLE.
.A
Gola M; Francalanci S; Campolmi P; Sertoli A.
.I 426
.U
87052713
.S
Contact Dermatitis 8703; 15(2):105
.M
Benzydamine/*AE; Case Report; Dermatitis Medicamentosa/*ET; Dermatitis, Contact/*ET; Human; Male; Middle Age; Patch Tests; Pyrazoles/*AE.
.T
Contact dermatitis from benzydamine hydrochloride.
.P
JOURNAL ARTICLE.
.A
Balato N; Lembo G; Patruno C; Bordone F; Ayala F.
.I 427
.U
87052714
.S
Contact Dermatitis 8703; 15(2):106
.M
Adult; Azo Compounds/*AE; Case Report; Dermatitis, Contact/*; Dyes/*AE; Female; Human; Patch Tests; Textiles.
.T
Contact dermatitis to basic red 46.
.P
JOURNAL ARTICLE.
.A
Foussereau J.
.I 428
.U
87052715
.S
Contact Dermatitis 8703; 15(2):106-7
.M
Acrolein/AA/*AE; Aged; Aged, 80 and over; Aldehydes/*AE; Case Report; Cheilitis/*CI; Dermatitis, Contact/DI/*ET; Female; Human; Patch Tests; Sunscreening Agents/*AE; Toothpaste/AE.
.T
Cheilitis: occult allergy to cinnamic aldehyde.
.P
JOURNAL ARTICLE.
.A
Maibach HI.
.I 429
.U
87052716
.S
Contact Dermatitis 8703; 15(2):107-8
.M
Aged; Case Report; Dermatitis Medicamentosa/*ET; Dermatitis, Contact/DI/*ET; Eyelid Diseases/CI; Human; Male; Patch Tests; Phenylephrine/*AE.
.T
Allergic contact dermatitis to phenylephrine.
.P
JOURNAL ARTICLE.
.A
Ducombs G; de Casamayor J; Verin P; Maleville J.
.I 430
.U
87052717
.S
Contact Dermatitis 8703; 15(2):108
.M
Adult; Case Report; Dermatitis, Contact/*ET; Hand Dermatoses/*CI; Human; Male; Music; Resins/*AE.
.T
Allergic contact dermatitis to colophony in a violoncellist.
.P
JOURNAL ARTICLE.
.A
Angelini G; Vena GA.
.I 431
.U
87052718
.S
Contact Dermatitis 8703; 15(2):108-9
.M
Adult; Aged; Dermatitis Medicamentosa/*ET; Dermatitis, Contact/*ET; Female; Human; Leg Ulcer/DT; Male; Middle Age; Triterpenes/*AE.
.T
Contact allergy to Centelase.
.P
JOURNAL ARTICLE.
.A
Vena GA; Angelini G.
.I 432
.U
87052719
.S
Contact Dermatitis 8703; 15(2):109-11
.M
Anti-Inflammatory Agents, Topical/*AE; Case Report; Child; Dermatitis Medicamentosa/*ET; Dermatitis, Contact/*ET; Human; Male; Patch Tests; Triamcinolone/*AA/AE.
.T
Contact allergy to amcinonide.
.P
JOURNAL ARTICLE.
.A
Kubo Y; Nonaka S; Yoshida H.
.I 433
.U
87052720
.S
Contact Dermatitis 8703; 15(2):112-4
.M
Agricultural Workers' Diseases/*CI; Animal; Animal Feed; Case Report; Dermatitis, Contact/DI/*ET; Human; Male; Middle Age; Occupational Dermatitis/*ET; Patch Tests; Photosensitivity Disorders/*DI; Quinoxalines/*AE; Swine.
.T
Occupational photocontact dermatitis from Olaquindox.
.P
JOURNAL ARTICLE.
.A
Francalanci S; Gola M; Giorgini S; Muccinelli A; Sertoli A.
.I 434
.U
87052721
.S
Contact Dermatitis 8703; 15(2):114-5
.M
Adolescence; Adult; Aged; Amantadine/AA/AE; Antiviral Agents/*AE; Dermatitis Medicamentosa/*ET; Dermatitis, Contact/*ET; Female; Herpes Labialis/DT; Herpes Zoster/DT; Human; Idoxuridine/AE; Male; Middle Age.
.T
Contact allergy to antiviral agents.
.P
JOURNAL ARTICLE.
.A
Angelini G; Vena GA; Meneghini CL.
.I 435
.U
87052722
.S
Contact Dermatitis 8703; 15(2):115-6
.M
Dermatitis, Contact/DI/*ET; Female; Human; Male; Perfume/*AE.
.T
Allergy to perfume mixture.
.P
JOURNAL ARTICLE.
.A
Rudzki E; Grzywa Z.
.I 436
.U
87052723
.S
Contact Dermatitis 8703; 15(2):117
.M
Adult; Agricultural Workers' Diseases/DI/*ET; Animal; Case Report; Cattle/*; Dermatitis, Contact/DI/*ET; Human; Male; Occupational Dermatitis/DI/*ET; Patch Tests; Radioallergosorbent Test; Saliva/*.
.T
Contact eczema from cow saliva.
.P
JOURNAL ARTICLE.
.A
Camarasa JG.
.I 437
.U
87052724
.S
Contact Dermatitis 8703; 15(2):118
.M
Agricultural Workers' Diseases/*ET; Dermatitis, Contact/*ET; Human; Hydroxybenzoic Acids/AE; Lichens/*; Male; Photosensitivity Disorders/*ET.
.T
Photosensitivity to oak moss [letter]
.P
LETTER.
.A
Fernandez de Corres L.
.I 438
.U
87052726
.S
Contact Dermatitis 8703; 15(2):58-62
.M
Adult; Case Report; Dental Alloys/*AE; Dermatitis, Contact/*DI/PA; Female; Human; Middle Age; Mouth Diseases/*DI/ET/PA; Mouth Mucosa/PA; Nickel/AE; Patch Tests/IS/*MT; Skin Tests/*MT.
.T
A new method for intraoral patch testing.
.P
JOURNAL ARTICLE.
.W
Intraoral patch testing was performed in 3 subjects, 2 of whom were contact sensitive to nickel. Maxillary acrylic plates carrying test pieces containing 66% nickel were applied for 48 h, and readings were performed 24 h after removal. Few if any clinical signs were detected, but biopsies from the mucosal contact sites showed lichenoid reactions. Biopsies from control sites showed no or slight non-specific inflammatory reactions.
.A
Axell T; Spiechowicz E; Glantz PO; Andersson G; Larsson A.
.I 439
.U
87052727
.S
Contact Dermatitis 8703; 15(2):63-5
.M
Dermatitis, Contact/DI/*ET; Female; Human; Male; Occupational Dermatitis/DI/*ET; Patch Tests; Quinazolines/*AE.
.T
Dermatitis from quinazoline oxide.
.P
JOURNAL ARTICLE.
.W
Dermatitis from 2-chloromethyl-4-phenyl-6-chloroquinazoline-3-oxide, an intermediate product in the preparation of chlorodiazepoxide, is described in 29 workers at a pharmaceutical plant. All were patch test positive to quinazoline oxide (1%) and six to 0.05%. In most patients, the face was earlier and more severely involved than the hands. Some were sensitized even if they did not have much contact with it, doing such work as washing the clothing of other workers, or working at a distance of 100 m from the production line building.
.A
Rebandel P; Rudzki E.
.I 440
.U
87052728
.S
Contact Dermatitis 8703; 15(2):66-8
.M
Adult; Case Report; Cyclohexanecarboxylic Acids/*AE; Dermatitis, Contact/DI/*ET; Epoxy Compounds/*AE; Ethers, Cyclic/*AE; Human; Industrial Oils/*AE; Male; Middle Age; Occupational Dermatitis/DI/*ET; Patch Tests.
.T
Allergic contact sensitization to the glycidyl ester of hexahydrophthalic acid in a cutting oil.
.P
JOURNAL ARTICLE.
.W
Allergic contact dermatitis is reported in 5 machine operatives working with a cutting oil containing an epoxy compound used as a stabilizer. Positive patch test reactions to this compound were obtained in all 5 men and were negative in 25 controls.
.A
English JS; Foulds I; White IR; Rycroft RJ.
.I 441
.U
87052730
.S
Contact Dermatitis 8703; 15(2):73-8
.M
Color; Dermatitis, Contact/DI; Hemoglobins/AN; Human; Patch Tests/*; Skin/AN/*PP; Skin Tests/*; Spectrophotometry/*; Support, Non-U.S. Gov't.
.T
Skin reflectance measurements of patch test responses.
.P
JOURNAL ARTICLE.
.W
Skin reflectance values were used as an objective measure of skin haemoglobin content at patch test sites to facilitate quantification of the erythematous response to contact allergens in patients with allergic contact dermatitis. Reflectance measurements of patch test responses correlated well with the clinical scoring and provided a numerical measure of reaction severity. Experimental contact allergen formulations were also evaluated by this method.
.A
Mendelow AY; Forsyth A; Feather JW; Baillie AJ; Florence AT.
.I 442
.U
87052731
.S
Contact Dermatitis 8703; 15(2):79-84
.M
Adult; Dermatitis, Contact/DI/*ET; Female; Gloves, Surgical/*; Human; IgE/AN; Latex/AE/IM; Male; Middle Age; Patch Tests; Powders; Radioallergosorbent Test; Rubber/*AE/IM; Sorbic Acid/AE; Support, Non-U.S. Gov't; Sweat; Urticaria/DI/*ET.
.T
Discomfort from rubber gloves indicating contact urticaria.
.P
JOURNAL ARTICLE.
.W
Rubber glove intolerance is a common dermatological problem and hypersensitivity of both delayed and immediate types occur. In order to study immediate skin reactions induced by rubber gloves, 15 patients with discomfort and itch produced by rubber gloves were examined. The patients were provoked by wearing rubber gloves, scratch tested with gloves, rubber chemicals and powders. RAST-tests were performed using an extract from the rubber tree (Hevea brasiliensis). In 6/15 patients, contact urticaria was confirmed, in 3 of whom IgE antibodies to latex were demonstrated.
.A
Wrangsjo K; Mellstrom G; Axelsson G.
.I 443
.U
87052732
.S
Contact Dermatitis 8703; 15(2):85-90
.M
Adult; Chlorohydrins/*AE; Dermatitis, Contact/*ET/PC; Epichlorohydrin/*AE; Epoxy Resins/*AE; Human; Male; Middle Age; Occupational Dermatitis/*ET/PC; Patch Tests; Phenols/AE.
.T
Sensitization to epichlorohydrin and epoxy system components.
.P
JOURNAL ARTICLE.
.W
In an epoxy resin manufacturing plant, 26 of 228 (11.4%) workers had work-related eruptions; 19 were patch tested. The test series consisted of chemicals used in the manufacturing process, a standard battery and some other sensitizers. The prevalence of sensitization to epichlorohydrin and/or epoxy resins in the whole group was 6.1%. A relatively high prevalence (3.5%) of epichlorohydrin sensitization was found. 10 cases of sensitization to liquid epoxy resin (MW about 385) were observed, in 7 cases combined with allergy to solid epoxy resin (MW 980). Sensitization to Bisphenol A was not seen.
.A
Prens EP; de Jong G; van Joost T.
.I 444
.U
87052733
.S
Contact Dermatitis 8703; 15(2):91
.M
Administration, Topical; Case Report; Cephalexin/AD/*AE; Dermatitis Medicamentosa/*ET; Dermatitis, Contact/DI/*ET; Female; Human; Leg Ulcer/DT; Middle Age; Patch Tests.
.T
Contact dermatitis to cephalexin.
.P
JOURNAL ARTICLE.
.A
Milligan A; Douglas WS.
.I 445
.U
87052734
.S
Contact Dermatitis 8703; 15(2):92
.M
Acrylic Resins/*AE; Adult; Case Report; Chloramphenicol/AE; Dermatitis, Contact/*ET; Female; Human; Middle Age; Neomycin/*AE; Occupational Dermatitis/*ET; Ophthalmology/*; Polyurethanes/*AE; Tetracaine/*AE.
.T
Occupational contact sensitivity in oculists.
.P
JOURNAL ARTICLE.
.A
Rebandel P; Rudzki E.
.I 446
.U
87052735
.S
Contact Dermatitis 8703; 15(2):92-3
.M
Acrylates/*AE; Adult; Case Report; Dermatitis, Contact/*ET; Human; Male; Occupational Dermatitis/*ET.
.T
Allergic contact dermatitis from UV-curing acrylate in the manufacture of optical fibres.
.P
JOURNAL ARTICLE.
.A
Maurice PD; Rycroft RJ.
.I 447
.U
87052736
.S
Contact Dermatitis 8703; 15(2):94
.M
Benzoates/*AE; Case Report; Dermatitis, Contact/DI/*ET; Female; Human; Middle Age; Patch Tests; Sunscreening Agents/AE.
.T
Allergic contact dermatitis from isopropyl dibenzoylmethane.
.P
JOURNAL ARTICLE.
.A
English JS; White IR.
.I 448
.U
87052737
.S
Contact Dermatitis 8703; 15(2):94-5
.M
Adult; Antifungal Agents/*AE; Case Report; Dermatitis Medicamentosa/*ET; Dermatitis, Contact/*ET; Female; Human; Pyridones/*AE.
.T
Contact dermatitis due to cyclopyroxolamine.
.P
JOURNAL ARTICLE.
.A
Goitre M; Bedello PG; Cane D; Pulatti P; Forte M; Cervetti O.
.I 449
.U
87052738
.S
Contact Dermatitis 8703; 15(2):95
.M
Adult; Case Report; Dermatitis, Contact/DI/*ET; Female; Human; Hypersensitivity, Delayed/DI/ET; Hypersensitivity, Immediate/DI/*ET; Nickel/*AE; Patch Tests.
.T
Immediate hypersensitivity to nickel.
.P
JOURNAL ARTICLE.
.A
Tosti A; Melino M; Labanca M; Ragazzi R.
.I 450
.U
87052739
.S
Contact Dermatitis 8703; 15(2):96-7
.M
Adult; Case Report; Dermatitis, Contact/DI/*ET; Ethambutol/*AE; Hand Dermatoses/ET; Human; Male; Occupational Dermatitis/DI/*ET; Patch Tests.
.T
Contact dermatitis to ethambutol.
.P
JOURNAL ARTICLE.
.A
Holdiness MR.
.I 451
.U
87052740
.S
Contact Dermatitis 8703; 15(2):97-8
.M
Acetamides/*AE; Case Report; Cosmetics/*AE; Dermatitis, Contact/*ET; Facial Dermatoses/*CI; Female; Human; Middle Age.
.T
Contact allergy to chloroacetamide in an "anti-wrinkle serum".
.P
JOURNAL ARTICLE.
.A
de Groot AC; Weyland JW.
.I 452
.U
87052741
.S
Contact Dermatitis 8703; 15(2):98-9
.M
Adult; Case Report; Dermatitis, Contact/DI/*ET; Human; Male; Patch Tests; Plants/*.
.T
Contact dermatitis to Pastinaca sativa.
.P
JOURNAL ARTICLE.
.A
Picardo M; Cristaudo A; de Luca C; Santucci B.
.I 453
.U
87052742
.S
Contact Dermatitis 8703; 15(3):119-25
.M
Adolescence; Adult; Age Factors; Aged; Aged, 80 and over; Automatic Data Processing; Child; Dermatitis/*EP; Dermatitis, Atopic/EP; Dermatitis, Contact/EP; Female; Foot Dermatoses/EP; Hand Dermatoses/EP; Human; Male; Middle Age; Occupational Dermatitis/EP; Patch Tests; Sex Factors.
.T
An analysis of 501 consecutive contact clinic consultations.
.P
JOURNAL ARTICLE.
.W
A simple micro-computer program was used to analyse the results of testing 501 consecutive patients attending a patch test clinic. 64% of males and 71% of females had positive tests; 17% of males and 12% of females had occupational dermatitis; 16% of males and 15% of females had irritant contact dermatitis; and 13% of males and 19% of females had a history of atopic eczema.
.A
Vestey JP; Gawkrodger DJ; Wong WK; Buxton PK.
.I 454
.U
87052743
.S
Contact Dermatitis 8703; 15(3):126-31
.M
Adult; Australia; Case Report; Dermatitis, Contact/*ET; Female; Human; Male; Patch Tests; Plants, Toxic/*; Rhus.
.T
Contact dermatitis from Grevillea 'Robyn Gordon'.
.P
JOURNAL ARTICLE.
.W
Grevillea 'Robyn Gordon' is an Australian hybrid plant which may cause allergic contact dermatitis. Over the past 8 years, it has been planted extensively in Australia and is now being exported to the United States and other Western countries. Recently, an explosion in incidence of contact dermatitis due to this plant has been seen. 24 patients who were suspected of being sensitive to it were patch tested to fresh plant and extracts with confirmation of sensitivity. A cross sensitivity to Toxicodendron was demonstrated clinically and on patch testing. The allergen in Toxicodendron, 3 pentadecylcatechol, is closely linked in chemical structure to 5-pentadecylresorcinol, present in Grevillea banksii and tridecylresorcinol in Grevillea robusta. Patch testing in patients sensitive to Grevillea 'Robyn Gordon' with tridecylresorcinol produced positive reactions, thus implicating the sensitizing role of long chain alkyl resorcinols in Grevillea 'Robyn Gordon' allergy. There is a likelihood that this sensitizing potential extends to other plants of the Grevillea genus, e.g., Grevillea robusta. With the spread of Grevillea 'Robyn Gordon' to other markets, this problem will become increasingly common.
.A
Menz J; Rossi ER; Taylor WC; Wall L.
.I 455
.U
87052744
.S
Contact Dermatitis 8703; 15(3):132-5
.M
Dermatitis, Atopic/CO; Dermatitis, Contact/CO; Female; Food Service, Hospital; Hand Dermatoses/*EP; Human; Maintenance and Engineering, Hospital; Male; Occupational Dermatitis/*EP; Patch Tests; Personnel, Hospital/*; Psoriasis/CO.
.T
Occupational skin disease in hospital cleaning and kitchen workers.
.P
JOURNAL ARTICLE.
.W
Skin disorders were reported in 33% of catering staff and 35% of women cleaners who returned a questionnaire, and were employed in a large hospital. Hand dermatitis occurred in 15% of the caterers and 12% of the cleaners. In the majority, the dermatitis was irritant in origin and related to their wet work occupations. Cleaners had a high prevalence of jewellery dermatitis. Limited patch testing revealed a majority positive to nickel, but a third were negative, indicating that jewellery reactions often but not invariably predict nickel sensitivity. Few subjects were atopic, but some psoriatic patients with hand problems were encountered. Most workers were able to carry on in their occupations despite having hand dermatitis.
.A
Gawkrodger DJ; Lloyd MH; Hunter JA.
.I 456
.U
87052745
.S
Contact Dermatitis 8703; 15(3):136-9
.M
Adolescence; Adult; Age Factors; Aged; Child; Chromates/AE; Dermatitis, Contact/*EP; Female; Human; Male; Middle Age; Nickel/AE; Patch Tests; Retrospective Studies; Sex Factors.
.T
Age and sex incidence of allergic contact dermatitis.
.P
JOURNAL ARTICLE.
.W
A retrospective study of patients patch tested between 1968 and 1970 was undertaken and case records of 200 patients with unequivocal positive patch tests were studied for age and sex distribution. There was an overall female preponderance (61%), with 2 peaks of incidence in the 10-20 and 40-50 year age groups in females, but only 1 peak of incidence in the 40-50 year age group in males. There was a steady decline in all sensitivities after the 6th decade of life in both sexes. Nickel sensitivity was more common in females (92%), whereas dichromate sensitivity predominated in males (64%). Of the 200 patients, only 5(2.5%) were atopics, all of whom were females.
.A
Walton S; Nayagam AT; Keczkes K.
.I 457
.U
87052746
.S
Contact Dermatitis 8703; 15(3):140-2
.M
Adult; Case Report; Dermatitis, Contact/*ET; Female; Hand Dermatoses/*CI; Household Products/AE; Human; Sodium Hypochlorite/*AE.
.T
Sensitization to sodium hypochlorite causing hand dermatitis.
.P
JOURNAL ARTICLE.
.W
2 patients are reported with chronic hand dermatitis related to sensitization to sodium hypochlorite, as the active component in a bleaching product. To avoid irritant reactions in patch testing, a sodium hypochlorite concentration of 1.0% appeared to be useful. It is concluded that with regard to the frequent use of bleaching agents, allergy to sodium hypochlorite must be considered in certain cases of unidentified chronic allergic hand dermatitis.
.A
Habets JM; Geursen-Reitsma AM; Stolz E; van Joost T.
.I 458
.U
87052747
.S
Contact Dermatitis 8703; 15(3):143-51
.M
Animal; Dermatitis, Contact/*ET/PA; Epidermis/PA; Female; Guinea Pigs; Irritants/*; Solvents/TO; Support, Non-U.S. Gov't.
.T
Animal model for assessment of skin irritancy.
.P
JOURNAL ARTICLE.
.W
Irritant skin reactions from repeated open applications of low concentrations of sodium lauryl sulphate (SLS) have been studied macroscopically and microscopically in guinea pigs. After 3 applications daily for 3 days, 2% SLS aqueous solutions gave a naked eye assessment, increase in epidermal thickness and total dermal inflammatory cell response, which was greater than for a 1% SLS solution. The dermal inflammatory cell response was mainly mononuclear (lymphocytic) in nature. With the SLS reactions as control, various organic solvents were studied and ranked against the SLS reactions and internally. Trichlorethylene was the most irritant solvent, ranking as high as 2% SLS. Other chlorinated hydrocarbons and aromatic hydrocarbons tested caused irritant reactions. The alcohols and acetone gave no reaction. White spirit was as irritant as trichlorethylene. Thinners were less irritant, around the level of the 1% SLS control reaction. The 4-day experimental design is a convenient and suitable animal model for screening irritant potential, and provides information relevant to the pathogenesis of irritant contact reactions.
.A
Anderson C; Sundberg K; Groth O.
.I 459
.U
87052748
.S
Contact Dermatitis 8703; 15(3):152-6
.M
Adult; Aged; Female; Glycine/*AA/TO; Herbicides/*TO; Human; Irritants/*; Male; Middle Age; Patch Tests/MT; Photosensitivity Disorders/*CI.
.T
Irritation, sensitization, photoirritation and photosensitization assays with a glyphosate herbicide.
.P
JOURNAL ARTICLE.
.W
Glyphosate, a widely utilized herbicide, was evaluated for acute irritation, cumulative irritation, photoirritation and allergic and photoallergic contact potential in 346 volunteers. The herbicide was less irritant than a standard liquid dishwashing detergent and a general all purpose cleaner. There was no evidence for the induction of photoirritation, allergic or photoallergic contact dermatitis. 10% glyphosate in water is proposed as a diagnostic patch test concentration.
.A
Maibach HI.
.I 460
.U
87052749
.S
Contact Dermatitis 8703; 15(3):157-63
.M
Animal; Coumarins/*TO; Dermatitis, Contact/*ET; Female; Freund's Adjuvant/AD; Guinea Pigs; Irritants; Skin Tests/MT; Support, Non-U.S. Gov't.
.T
The sensitizing capacity of coumarins (I).
.P
JOURNAL ARTICLE.
.W
10 coumarins used in perfumery, cosmetics and ointments, have been investigated by 2 different methods to determine their sensitizing capacity. Only 1 of the compounds, 4-methyl-esculetin, which serves as a sunscreen agent, was found to be a weak sensitizer. All other coumarins were negative. It is assumed that this dihydroxycoumarin becomes a sensitizer when it is enzymically oxidized to the corresponding orthoquinone in the skin.
.A
Hausen BM; Schmieder M.
.I 461
.U
87052750
.S
Contact Dermatitis 8703; 15(3):164-8
.M
Acne/*CI/PA; Adult; Case Report; Chlorophenols/*AE; Human; Male; Occupational Dermatitis/*ET/PA; Pentachlorophenol/*AE/AN; Tetrachlorodibenzodioxin/AA/AN; Wood/*.
.T
Chloracne from pentachlorophenol-preserved wood.
.P
JOURNAL ARTICLE.
.W
A patient is presented who developed chloracne after exposure to lumber which was pressure-treated with pentachlorophenol (PCP). It was presumed that his disease arose via percutaneous absorption of polychlorinated aromatic compounds (dioxins and furans) which are known to contaminate technical grade PCP. The patient's condition improved after treatment with oral isotretinoin.
.A
Cole GW; Stone O; Gates D; Culver D.
.I 462
.U
87052751
.S
Contact Dermatitis 8703; 15(3):169-72
.M
Asia; Cobalt/AE/*AN; Construction Materials/*; Human; Nickel/AE/*AN; Occupational Dermatitis/EP; Solubility; Spectrophotometry, Atomic Absorption; Support, Non-U.S. Gov't.
.T
Cobalt and nickel content of Asian cements.
.P
JOURNAL ARTICLE.
.W
The total cobalt and nickel concentration of 11 brands of Asian cement ranged from 8.1 to 14.2 micrograms/g and 14.9 to 28.5 micrograms/g, respectively. These metals exist mainly as insoluble salts; the water-soluble concentration of cobalt and nickel in the cements ranged from 0.39 to 0.65 micrograms/g and from 0-1.2 micrograms/g, respectively. 1.5% (4/272) of construction workers in a prefabrication construction factory had cobalt sensitivity. All had allergic contact dermatitis from chromate in cement. No worker had isolated cobalt sensitivity and cement dermatitis. It appeared that sensitization to cobalt in cement occurs only secondarily to an existing cement dermatitis. 1.8% (5/272) workers had nickel sensitivity: 2 with allergic contact dermatitis to nickel in their watches, 2 were asymptomatic and 1 had allergic contact dermatitis to chromate and cobalt in cement. The low prevalence of cobalt and nickel sensitivity from cement was probably related to the low concentration of soluble cobalt and nickel salts in the cement. However, these insoluble salts can form soluble complexes with body fluids on eczematous skin and sensitize the skin.
.A
Goh CL; Kwok SF; Gan SL.
.I 463
.U
87052752
.S
Contact Dermatitis 8703; 15(3):173-7
.M
Female; Human; In Vitro; Ions; Nickel/*ME; Permeability; Skin Absorption/*.
.T
Permeation of nickel salts through human skin in vitro.
.P
JOURNAL ARTICLE.
.W
The impact of occlusion and the role of the counter ion on the permeation of nickel ions through skin have been examined using excised human skin. A highly sensitive electrochemical method was used to quantify the amount of nickel permeating the skin. The investigations show that nickel ions are capable of permeating the skin barrier when applied under occlusion. The process is slow, having a lag time of approximately 50 h. The permeation rate, and thus the physical amount being bioavailable, is considerably increased when aqueous nickel chloride is used in comparison with aqueous nickel sulphate. With respect to nickel permeation of the skin, we conclude that the choice of salt is an important consideration in patch testing.
.A
Fullerton A; Andersen JR; Hoelgaard A; Menne T.
.I 464
.U
87052753
.S
Contact Dermatitis 8703; 15(3):178-82
.M
Adult; Aged; Aged, 80 and over; Dermatitis, Atopic/*DI; Dermatitis, Contact/*DI; Eyelid Diseases/*ET; Female; Hand Dermatoses/CO; Human; Male; Middle Age; Patch Tests.
.T
Eyelid dermatitis: the role of atopy and contact allergy.
.P
JOURNAL ARTICLE.
.W
Patients with eyelid dermatitis were studied with patch tests and a clinical point method for the diagnosis of atopic skin disease. In 38 patients, contact allergy was found in 11. The dermatitis was an expression of atopic dermatitis in 15 patients.
.A
Svensson A; Moller H.
.I 465
.U
87052755
.S
Contact Dermatitis 8703; 15(3):186
.M
Asthma/*CI; Case Report; Dermatitis, Contact/*ET; Dyes/*AE; Human; Male; Middle Age; Occupational Dermatitis/ET; Occupational Diseases/*CI.
.T
Contact dermatitis and asthma from reactive dyes.
.P
JOURNAL ARTICLE.
.A
Thoren K; Meding B; Nordlinder R; Belin L.
.I 466
.U
87052756
.S
Contact Dermatitis 8703; 15(3):187
.M
Adult; Case Report; Dermatitis, Contact/*ET; Fungicides, Industrial/*AE; Human; Male; Nitriles/*AE; Occupational Dermatitis/ET; Paint/*AE.
.T
Contact dermatitis from tetrachloroisophthalonitrile in paint.
.P
JOURNAL ARTICLE.
.A
Meding B.
.I 467
.U
87052757
.S
Contact Dermatitis 8703; 15(3):187-8
.M
Adolescence; Adult; Aged; Case Report; Dermatitis Medicamentosa/*ET; Ethylmercury Compounds/*AE; Female; Human; Pharmaceutic Aids/*AE; Preservatives, Pharmaceutical/*AE; Thimerosal/*AE.
.T
Systemic reactions due to thiomersal.
.P
JOURNAL ARTICLE.
.A
Tosti A; Melino M; Bardazzi F.
.I 468
.U
87052759
.S
Contact Dermatitis 8703; 15(3):190-1
.M
Administration, Oral; Adult; Case Report; Cimetidine/*AE; Dermatitis Medicamentosa/*ET; Human; Hypersensitivity, Delayed/*CI; Male.
.T
Delayed hypersensitivity to oral cimetidine.
.P
JOURNAL ARTICLE.
.A
Peters K.
.I 469
.U
87052760
.S
Contact Dermatitis 8703; 15(3):191
.M
Adult; Case Report; Human; Male; Medicine, Oriental Traditional/*; Purpura/*ET; Suction/*AE; Vacuum.
.T
Puhang-induced purpura.
.P
JOURNAL ARTICLE.
.A
Eun HC; Park HB; Lee YS.
.I 470
.U
87052761
.S
Contact Dermatitis 8703; 15(3):192
.M
Acne/DT; Adult; Allergens; Case Report; Decanoic Acids/*AE/TU; Dermatitis, Contact/*ET; Drug Combinations/TU; Erythromycin/TU; Human; Male; Vehicles/*AE; Zinc/TU.
.T
Allergic contact dermatitis due to diisopropyl sebacate.
.P
JOURNAL ARTICLE.
.A
Dooms-Goossens A; De Veylder H; De Boulle K; Maertens M.
.I 471
.U
87052762
.S
Contact Dermatitis 8703; 15(3):193
.M
Female; Human; Male; Patch Tests/*MT; Resins/AD/*AE; Skin Tests/*MT; Vehicles.
.T
Patch testing with colophony at 60% concentration.
.P
JOURNAL ARTICLE.
.A
Bruze M; Dahlquist I; Fregert S.
.I 472
.U
87052763
.S
Contact Dermatitis 8703; 15(3):195
.M
Dermatitis Medicamentosa/*ET; Human; Hypersensitivity, Delayed/*CI; Patch Tests.
.T
Rash from oral codeine [letter]
.P
LETTER.
.A
van Ketel WG.
.I 473
.U
87052833
.S
Crit Care Med 8703; 14(12):1001-3
.M
Blood Transfusion/*AE; Complement Activation; Complement 3/*AN; Human; Prospective Studies; Respiratory Distress Syndrome, Adult/*ET; Risk; Septicemia/*CO; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
C3a and adult respiratory distress syndrome after massive transfusion.
.P
JOURNAL ARTICLE.
.W
We compared the degree of complement activation in 15 patients receiving massive blood transfusions and 21 patients with the septic syndrome and examined its association with other risk factors for adult respiratory distress syndrome (ARDS). Patients with massive transfusion (n = 8) as their only risk factor for ARDS had lower C3a levels (250 +/- 80 ng/ml) and a lower incidence of ARDS (0%) than patients with massive transfusion plus other risk factors (n = 7; C3a, 600 +/- 120 ng/ml; ARDS, 55%) or patients with the septic syndrome (n = 21; C3a, 540 +/- 80 ng/ml; ARDS, 19%). In our patients, the degree of complement activation appeared to reflect the presence of complicating clinical conditions.
.A
Ketai LH; Grum CM.
.I 474
.U
87052834
.S
Crit Care Med 8703; 14(12):1004-9
.M
Animal; Conjunctiva/ME; Dogs; Hemodynamics; Hemorrhage/PP/*TH; Oxygen Consumption/*; Resuscitation/*.
.T
Cardiorespiratory and conjunctival oxygen tension monitoring during resuscitation from hemorrhage.
.P
JOURNAL ARTICLE.
.W
Placement of an unheated miniaturized oxygen electrode against the palpebral conjunctiva permits noninvasive measurement of tissue oxygen tension. In this study, the relationship between conjunctival oxygen tension (PcjO2) and standard cardiorespiratory variables was examined during a sequential resuscitation protocol after acute hemorrhage. Anesthetized dogs were rapidly bled to a mean arterial pressure of 40 mm Hg and then retransfused with the shed blood in a stepwise fashion. PcjO2 fell to 2% of control values after hemorrhage and did not return to prehemorrhage values until more than 90% of the shed blood had been reinfused. PcjO2 was among the last set of cardiorespiratory variables to return to control values during resuscitation and was the last noninvasive variable to normalize. The ratio of PcjO2 to arterial oxygen tension decreased from a prehemorrhage value of 0.76 +/- 0.05 (SEM) to 0.02 +/- 0.003 after hemorrhage, and did not increase to values greater than 0.50 until resuscitation was more than 90% complete. Conjunctival oxygen monitoring may play an important role in assessing the adequacy of resuscitation after acute hemorrhage.
.A
Abraham E; Fink S.
.I 475
.U
87052837
.S
Crit Care Med 8703; 14(12):1023-5
.M
Adult; Aged; Cerebrovascular Disorders/*ME; Epinephrine/UR; Female; Human; Male; Middle Age; Norepinephrine/UR; Oxygen Consumption.
.T
Metabolism in acute cerebrovascular disease.
.P
JOURNAL ARTICLE.
.W
Oxygen consumption (VO2), CO2 production, respiratory quotient, resting metabolic expenditure (RME), and urine catecholamine levels were measured in 52 patients with acute cerebrovascular disease. RME correlated positively with urinary norepinephrine and epinephrine excretion; its maximum value was 187% higher than expected for an uninjured resting person of equivalent age, sex, and size. VO2 correlated positively with the urinary catecholamine excretion. These facts imply that the sympathetic nervous system might directly influence VO2 and RME. Moreover, the hypermetabolic state should be taken into consideration when caring for patients with cerebrovascular disease, as malnutrition might cause weight loss and a decrease in immunity.
.A
Touho H; Karasawa J; Sawada T.
.I 476
.U
87052838
.S
Crit Care Med 8703; 14(12):1026-7
.M
Acquired Immunodeficiency Syndrome/*CO/MO; Adult; Critical Care; Female; Human; Intensive Care Units; Male; Medical Records; Opportunistic Infections/*CO; Prognosis; Respiratory Insufficiency/*CO/MO; Sarcoma, Kaposi's/CO.
.T
ICU survival of patients with the acquired immunodeficiency syndrome.
.P
JOURNAL ARTICLE.
.W
The ICU records of 31 patients with the acquired immunodeficiency syndrome were reviewed. Of 23 (74%) patients admitted for respiratory failure requiring intubation and mechanical ventilation, 20 (87%) patients had Pneumocystis carinii and/or cytomegalovirus pneumonia. Of the eight patients admitted without respiratory failure, five (63%) were monitored after brain biopsy. Respiratory failure patients remained in the ICU for 10 +/- 1 days, compared to 5 +/- 1 days for those without respiratory failure (p less than .05). Overall mortality was 24 patients (77%); 21 (91%) of 23 respiratory failure patients died, compared to three (38%) of the eight without respiratory failure (p less than .01). All seven ICU survivors lived to hospital discharge.
.A
Schein RM; Fischl MA; Pitchenik AE; Sprung CL.
.I 477
.U
87052839
.S
Crit Care Med 8703; 14(12):1028-31
.M
Equipment Design/*; Human; Intubation/*IS; Tidal Volume; Work of Breathing/*.
.T
Work of breathing through different sized endotracheal tubes.
.P
JOURNAL ARTICLE.
.W
The ability to breathe spontaneously through an endotracheal tube is a usual prerequisite before an intubated patient can have it removed. Other researchers have measured air flow resistance through endotracheal tubes. In this study, we evaluated work of breathing in joules per min and tension-time index while three normal volunteers breathed through different sized endotracheal tubes. Four 27.5-cm endotracheal tubes were used. Subjects breathed with a constant tidal volume of 500 ml. By increasing respiratory frequency, minute ventilation was increased from 5 to 30 L/min. As tube diameter decreased, work and the tension-time index increased. Changes were magnified at higher minute ventilations through the 6- and 7-mm endotracheal tubes, and the tension-time index critical fatigue level of 0.15 was approached or exceeded.
.A
Shapiro M; Wilson RK; Casar G; Bloom K; Teague RB.
.I 478
.U
87052840
.S
Crit Care Med 8703; 14(12):1032-7
.M
Adolescence; Adult; Aged; Critical Care/*; Dobutamine/*TU; Female; Hemodynamics/*DE; Human; Male; Middle Age; Oxygen Consumption/*DE; Postoperative Period.
.T
Hemodynamic and oxygen transport effects of dobutamine in critically ill general surgical patients.
.P
JOURNAL ARTICLE.
.W
The effects of dobutamine on hemodynamic and oxygen transport were evaluated in 43 studies on 34 critically ill general (noncardiac) surgical patients. Dobutamine, beginning at a low dose (2.5 micrograms/kg X min) significantly increased cardiac index (CI), oxygen delivery (DO2), and oxygen consumption (VO2), while decreasing mean arterial pressure, pulmonary artery and wedge pressures, and systemic and pulmonary vascular resistances; blood gases, pH, and pulmonary shunt were not significantly changed. These effects were seen in postoperative and septic patients, as well as in patients with normal, low, and high control CI. These responses were poor in terminally ill and hypovolemic patients; however, when the latter were given additional fluids, their responses were markedly improved. The hemodynamic effects of dobutamine are well known, but the DO2 and VO2 effects, which suggest improved tissue perfusion, have not been appreciated.
.A
Shoemaker WC; Appel PL; Kram HB.
.I 479
.U
87052841
.S
Crit Care Med 8703; 14(12):1038-44
.M
Adult; Aged; Cardiac Output/*; Cardiography, Impedance/*; Comparative Study; Critical Care; Electrodes; Female; Human; Intensive Care Units; Male; Middle Age; Plethysmography, Impedance/*; Pulmonary Wedge Pressure; Thermodilution/*.
.T
Comparison of transthoracic electrical impedance and thermodilution methods for measuring cardiac output.
.P
JOURNAL ARTICLE.
.W
Cardiac output was measured 120 times in 27 critically ill patients using the thermodilution and transthoracic electrical impedance methods. Both the minimum and mean values for the distance between the inner electrodes, and a variety of values for the resistivity of blood (rho) were substituted in the Kubicek's empiric formula for calculating cardiac output by transthoracic electrical impedance. Using the mean distance between the inner electrodes and a rho-value of 150 ohm X cm gave the best agreement between the methods (mean difference 0.17 +/- 2.4 L/min). Ventilation alone or with positive end-expiratory pressure did not significantly affect the bias of the estimate, but both affected its precision when compared with measurements in spontaneously breathing patients (SD of mean difference 2.4 and 3.2 L/min, respectively, vs. 1.5 L/min). The pulmonary artery wedge pressure was significantly higher in patients with an abnormal diastolic impedance waveform (zero-wave), but there was no relationship between wedge pressure and base impedance per unit length between the measuring electrodes.
.A
Donovan KD; Dobb GJ; Woods WP; Hockings BE.
.I 480
.U
87052842
.S
Crit Care Med 8703; 14(12):1045-9
.M
Birth Weight; Blood Pressure/DE; Dopamine/*TU; Female; Heart Rate/DE; Human; Infant, Newborn; Infant, Newborn, Diseases/*DT; Male; Prospective Studies; Retrospective Studies; Support, U.S. Gov't, P.H.S.; Urination/*DE.
.T
Effect of high-dose dopamine on urine output in newborn infants.
.P
JOURNAL ARTICLE.
.W
To achieve adequate arterial BP, adequate capillary filling time, and adequate peripheral pulses, hypotensive newborn infants often require higher doses of dopamine that reportedly reduce urine output in adults. Whether these larger doses of dopamine also reduce urine output in newborns is not known. Therefore, we determined the effects of administering high-dose dopamine (more than 20 micrograms/kg X min) on the urine output of 15 newborn infants. Five infants were studied prospectively and ten retrospectively. In the prospective study, urine output was determined as the dose of dopamine was increased; in the retrospective study, urine output was determined as the infants were being weaned from high doses of dopamine. Both data sets demonstrate that administering high-dosage dopamine does not reduce the urine output of sick newborn infants. Therefore, we conclude that doses of dopamine previously reported to decrease urine output in adults do not do so in sick newborn infants. Consequently, when necessary, high doses of dopamine may be used in sick newborn infants to achieve cardiovascular stability without reducing urine output.
.A
Perez CA; Reimer JM; Schreiber MD; Warburton D; Gregory GA.
.I 481
.U
87052843
.S
Crit Care Med 8703; 14(12):1050-2
.M
Blood Gas Analysis; Blood Gas Monitoring, Transcutaneous/*; Comparative Study; Human; Infant, Newborn; Monitoring, Physiologic; Patient Transfer/*; Respiration, Artificial; Respiratory Distress Syndrome/*BL/TH.
.T
Transcutaneous carbon dioxide monitoring during neonatal transport.
.P
JOURNAL ARTICLE.
.W
We studied the value of transcutaneous carbon dioxide (PtcCO2) monitoring during neonatal transport. Thirty-two neonates with respiratory distress were alternately enrolled in an experimental group (results of PtcO2 and PtcCO2 available for clinical management) and a control group (results of only PtcO2 available). Although differences were not significant, infants in the experimental group had more changes in the intermittent mandatory ventilation (IMV) settings during transport, and more such infants arrived at the receiving hospital with acceptable pH and PCO2 values. On arrival at the receiving hospital, two patients in the control group had acidosis and hypercarbia and were placed on IMV immediately on arrival. No such patients were encountered in the experimental group. For patients needing IMV during transport, the percentage of study time spent with PtcCO2 measurements in the normal range (35 to 45 torr) was greater for the experimental group (p less than .02). Continuous PtcCO2 monitoring during transport offers the opportunity to further decrease the risks of transporting a critically ill neonate.
.A
Jacob J; Rose D; Stilson M; Davis RF; Gilbert D.
.I 482
.U
87052844
.S
Crit Care Med 8703; 14(12):1053-4
.M
Child; Child, Preschool; Fibronectins/*BL/DF; Human; Infant; Prognosis; Purpura/*BL/CO; Shock/BL/CO.
.T
Plasma fibronectin in severe infectious purpura of children.
.P
JOURNAL ARTICLE.
.W
Plasma fibronectin levels were determined in 34 children admitted with severe infectious purpura. Fibronectin concentration was decreased in severe infectious purpura as in other sepsis, but there was no significant difference between shock and nonshock patients. Fibronectin levels were lower in children with ecchymotic or necrotic purpura on admission than in those with petechial purpura; they were lower in those who developed cutaneous sequelae, but it is not known if correction of fibronectin deficiency may limit the extent of purpura and prevent the cutaneous sequelae.
.A
Leclerc F; Martinot A; Beuscart R; Chenaud M; Diependaele JF; Mazurier C.
.I 483
.U
87052846
.S
Crit Care Med 8703; 14(12):1058-63
.M
Anuria/TH; Blood/*; Case Report; Child, Preschool; Critical Care/*; Equipment Design; Female; Hemodialysis/*; Human; Infant; Infant, Newborn; Kidney Failure, Acute/*TH; Male; Peritoneal Dialysis; Ultrafiltration/*.
.T
Early experience with continuous arteriovenous hemofiltration in critically ill pediatric patients.
.P
JOURNAL ARTICLE.
.W
The applicability of continuous arteriovenous hemofiltration (CAVH) for renal replacement therapy was evaluated in three infants and two young children with catastrophic medical and surgical illnesses. In the first four patients, CAVH was used in conjunction with either peritoneal or hemodialysis. In the fifth patient, CAVH was the sole renal replacement therapy employed; in this critically ill anuric infant, we were best able to evaluate the ability of CAVH to continuously control fluid, electrolyte, and acid-base balance, and allow the administration of adequate parenteral nutrition. The difficulties encountered were related to anticoagulation, establishment of adequate vascular access, and selection of an appropriate hemofilter for the performance of the technique. Despite the application of suction-assistance, we were unable to effectively employ a prototype pediatric hemofilter to attain a level of plasma ultrafiltration consistent with the objectives of therapy. However, we were able to effectively and safely employ an adult hemofilter for these purposes; modifications were made in the adult hemofilter system before its application in the smallest pediatric patients. Our experience suggests that, even in critically ill infants, CAVH can be successfully applied as an effective renal replacement therapy. However, further experience is required before its potential impact on patient survival can be assessed.
.A
Leone MR; Jenkins RD; Golper TA; Alexander SR.
.I 484
.U
87052847
.S
Crit Care Med 8703; 14(12):1064-5
.M
Adult; Cardiac Output/*; Case Report; Equipment Failure/*; Female; Heart Catheterization/*; Human.
.T
Spuriously high cardiac output from injecting thermal indicator through an ensheathed port.
.P
JOURNAL ARTICLE.
.A
Stoller JK; Herbst TJ; Hurford W; Rie MA.
.I 485
.U
87052848
.S
Crit Care Med 8703; 14(12):1066-7
.M
Critical Care/*; Euthanasia/*; Euthanasia, Passive/*; Hospitals, Teaching; Human; Resuscitation/*.
.T
Patient care categories: an approach to do-not-resuscitate decisions in a public teaching hospital.
.P
JOURNAL ARTICLE.
.A
Davila F; Boisaubin EV; Sears DA.
.I 486
.U
87052850
.S
Crit Care Med 8703; 14(12):1078-9
.M
Case Report; Coma/*CI/TH; Critical Care; Female; Human; Ibuprofen/*PO; Middle Age; Suicide, Attempted.
.T
Coma caused by ibuprofen overdose.
.P
JOURNAL ARTICLE.
.A
Chelluri L; Jastremski MS.
.I 487
.U
87052852
.S
Crit Care Med 8703; 14(12):1082-3
.M
Adult; Bacteroides melaninogenicus; Bacteroides Infections/*DI/DT; Case Report; Clindamycin/TU; Diagnostic Errors; Epiglottitis/DI/*MI/TH; Human; Laryngitis/*MI; Male; Tracheotomy.
.T
Acute epiglottitis in the adult.
.P
JOURNAL ARTICLE.
.W
Acute epiglottitis in the adult is uncommon. This case reports a young man with acute epiglottitis secondary to a Bacteroides melanogenicus supraglottic abscess. This pathogen has not been previously described as being causitive of epiglottitis.
.A
Devita MA; Wagner IJ.
.I 488
.U
87052853
.S
Crit Care Med 8703; 14(12):1084-6
.M
Anesthesia/*AE; Human; Intraoperative Period; Monitoring, Physiologic/*MT; Respiration, Artificial/*AE.
.T
Anesthetic and ventilator mishaps: prevention and detection [editorial]
.P
EDITORIAL.
.A
Weingarten M.
.I 489
.U
87052937
.S
Curr Probl Surg 8703; 23(10):721-88
.M
Adult; Aged; Aged, 80 and over; Amputation; Angiography; Arterial Occlusive Diseases/RA/SU; Arthropathy, Neurogenic/DI/ET/TH; Diabetes Mellitus/*CO/PP; Diabetic Neuropathies/DI/ET/SU/TH; Foot Diseases/DI/*ET/PC/PP/RA/SU/TH; Gangrene/ET/SU; Human; Intermittent Claudication/ET/SU; Ischemia/DI/ET/PP/SU/TH; Middle Age; Tibia/BS.
.T
The diabetic foot.
.P
JOURNAL ARTICLE.
.A
Corson JD; Jacobs RL; Karmody AM; Leather RP; Shah DM.
.I 490
.U
87052938
.S
Curr Probl Surg 8703; 23(11):789-865
.M
Ascitic Fluid/PA; Axilla/SU; Breast Neoplasms/SU; Female; Gastrointestinal Neoplasms/SU; Groin/SU; Head and Neck Neoplasms/SU; Human; Intestinal Perforation/SU; Male; Neoplasms/*SU; Omentum/*SU/TR; Ovarian Neoplasms/SC; Pelvic Neoplasms/SU; Peritoneal Neoplasms/SC/SU; Postoperative Complications; Support, Non-U.S. Gov't; Surgical Flaps; Thoracic Surgery.
.T
The greater omentum: its applicability to cancer surgery and cancer therapy.
.P
JOURNAL ARTICLE.
.A
Williams R; White H.
.I 491
.U
87053002
.S
Chest 8703; 90(6):789-90
.M
Dyspnea/*DT/ET; Human; Lung Diseases, Obstructive/CO; Psychotropic Drugs/AE/*TU.
.T
Treatment of dyspnea with psychotropic agents [editorial]
.P
EDITORIAL.
.A
Rice KL.
.I 492
.U
87053003
.S
Chest 8703; 90(6):790-1
.M
Amyloidosis/*PA/TH; Human; Lung Diseases/*PA/TH; Prognosis.
.T
Clinical aspects of pulmonary amyloidosis [editorial]
.P
EDITORIAL.
.A
Gertz MA; Greipp PR.
.I 493
.U
87053004
.S
Chest 8703; 90(6):791-2
.M
Bronchi/PA; Exudates and Transudates/PA; Human; Irrigation/*; Lung Diseases/IM/MI/*PA; Pulmonary Alveoli/PA.
.T
Bronchoalveolar lavage can be clinically useful [editorial]
.P
EDITORIAL.
.A
Baughman RP; Thorpe JE.
.I 494
.U
87053007
.S
Chest 8703; 90(6):802-5
.M
Airway Obstruction/*CO; Anesthesia, Inhalation/*AE; Case Report; Human; Intubation, Intratracheal/*AE; Male; Middle Age; Obesity/CO; Pulmonary Edema/*ET/PP; Risk.
.T
Post-extubation pulmonary edema following anesthesia induced by upper airway obstruction. Are certain patients at increased risk?
.P
JOURNAL ARTICLE.
.W
Pulmonary edema due to upper airway obstruction can be observed in a variety of clinical situations. The predominant mechanism is increased negative intrathoracic pressure, although hypoxia and cardiac and neurologic factors may contribute. Laryngospasm associated with intubation and general anesthesia is a common cause of pulmonary edema in children. However, only seven cases of pulmonary edema presumably due to laryngospasm have been reported in adolescents and adults. Five of the seven had other risk factors for upper airway obstruction, and in four, the diagnosis of "laryngospasm" could be explained by other factors. Patients with underlying risk factors for upper airway obstruction, such as a forme fruste of sleep apnea or nasopharyngeal abnormalities, appear to be at increased risk for the development of pulmonary edema in the setting of intubation and anesthesia. This form of pulmonary edema usually resolves rapidly without the need for aggressive therapy or invasive monitoring.
.A
Lorch DG; Sahn SA.
.I 495
.U
87053008
.S
Chest 8703; 90(6):806-9
.M
Catheterization/AE/*MT; Extravasation of Diagnostic and Therapeutic Materials/ET; Hemothorax/ET; Human; Intensive Care Units/*; Phlebitis/ET; Pneumothorax/ET; Prospective Studies.
.T
Central vs peripheral venous catheters in critically ill patients.
.P
JOURNAL ARTICLE.
.W
A prospective study of 2,209 intravenous catheters was performed in a multidisciplinary intensive care unit to determine when and why catheters were removed and which sites of insertion were associated with the least morbidity. Techniques of insertion were vigorously supervised. Central and peripheral catheters were cared for by identical protocols. Overt phlebitis or inflammation around the site was 14 times as common with peripheral catheters (353/1,024) than with centrally inserted central catheters (18/713), even though peripheral catheters were removed on the average at 2.9 days and centrally inserted central catheters at 6.2 days. Pneumothorax occurred in seven out of 713 patients with centrally inserted central catheterization, one with hemothorax and two with pneumothoraces requiring thoracostomy tubes. Five were treated successfully with simple catheter aspiration. Three patients out of 1,496 with peripheral or peripherally inserted central catheters required phlebectomy for suppurative thrombophlebitis. We concluded that overall morbidity in critically ill patients is lower from centrally inserted central catheters than peripheral intravenous catheters, with peripherally inserted central catheters in an intermediate position. Supervision of techniques of insertion has to be kept at a high level to keep complications of central catheterization at an acceptable level. Peripheral catheter sites would be better maintained with more frequent replacement of the catheter.
.A
Giuffrida DJ; Bryan-Brown CW; Lumb PD; Kwun KB; Rhoades HM.
.I 496
.U
87053010
.S
Chest 8703; 90(6):815-21
.M
Adult; Anthropometry; Human; Male; Medroxyprogesterone/*AA/TU; Middle Age; Sleep Apnea Syndromes/*DT; Sleep, REM; Support, U.S. Gov't, Non-P.H.S.; Tidal Volume; Transducers, Pressure; Vital Capacity.
.T
Effects of medroxyprogesterone acetate in obstructive sleep apnea.
.P
JOURNAL ARTICLE.
.W
We studied the effects of medroxyprogesterone acetate, a respiratory stimulant, on the incidence and duration of episodes of apnea and disordered breathing in 13 nonhypercapnic men with obstructive sleep apnea. Nocturnal polysomnography was done before and after four weeks of treatment with medroxyprogesterone acetate (60 mg/day) and one week after cessation of treatment. There were no significant (p less than 0.05) differences in the mean frequency of apneic episodes per hour of sleep before (31.3 +/- 5.7 [+/- SE]), during (26.8 +/- 6.6), or after (23.6 +/- 7.0) treatment, or in the mean number of disordered breathing episodes per hour of sleep before (19.4 +/- 5.6), during (21.4 +/- 5.8), or after (23.1 +/- 6.3) the period of treatment. Medroxyprogesterone did not alter significantly the total time of apnea or the total time for disordered breathing, expressed as percentages of total sleep time. Arterial oxygen desaturation during apnea and disordered breathing did not change with treatment. Medroxyprogesterone increased the minute ventilation and occlusion pressure responses to hypercapnia measured in the awake state; however, the results of this study demonstrate that medroxyprogesterone does not improve the breathing disorders during sleep in the nonhypercapnic patient with obstructive sleep apnea.
.A
Rajagopal KR; Abbrecht PH; Jabbari B.
.I 497
.U
87053012
.S
Chest 8703; 90(6):827-31
.M
Adult; Aged; Amyloid/ME; Amyloidosis/*PA/SU; Birefringence; Bronchial Diseases/PA; Female; Human; Lung Diseases/*PA/SU; Lung Neoplasms/PA; Male; Microscopy, Polarization; Middle Age; Tissue Distribution; Tracheal Diseases/PA.
.T
Amyloidosis of the lower respiratory tract. Clinical and pathologic features in a series of 21 patients.
.P
JOURNAL ARTICLE.
.W
Twenty one cases of amyloidosis of the lower respiratory tract were seen at a single center. In three patients, multifocal bronchial amyloid plaques led to stenosis and atelectasis, and in two, small pseudotumor masses were an incidental bronchoscopic finding. Two patients had nodular parenchymal amyloidosis, in one of whom the lesions were progressive and in the other static. Fifteen patients had diffuse parenchymal amyloidosis. Two of these had severe interstitial involvement and died in respiratory failure; eight had congestive cardiac failure, and parenchymal amyloidosis was a post-mortem finding; two had senile cardiorespiratory amyloidosis, also found at autopsy; and in three, the amyloidosis was associated with malignancy. The degree of respiratory embarrassment seemed to be related to the amount of amyloid in the gas diffusion zones, irrespective of the etiology of amyloidosis.
.A
Cordier JF; Loire R; Brune J.
.I 498
.U
87053013
.S
Chest 8703; 90(6):832-6
.M
Aged; Alprazolam/AE/*TU; Double-Blind Method; Drug Evaluation; Dyspnea/*DT/PA; Exertion/*; Female; Human; Lung Diseases, Obstructive/*DT/PP; Male; Middle Age; Random Allocation; Respiratory Function Tests; Statistics; Support, Non-U.S. Gov't.
.T
Effect of alprazolam on exercise and dyspnea in patients with chronic obstructive pulmonary disease.
.P
JOURNAL ARTICLE.
.W
To evaluate the efficacy of a mild anxiolytic, alprazolam, in relieving dyspnea, we conducted a randomized, placebo-controlled double-blind study on patients with chronic obstructive lung disease. Twenty-four patients had alprazolam (0.5 mg bid) or placebo administered for one week, followed by placebo for one week, then either placebo or alprazolam for the third week. Assessment tests were performed at the outset, end of the first and second weeks, and finally end of the third week. The parameters measured were: pulmonary function, exercise testing on a bicycle ergometer, and the distance covered in a 12 minute walk. Subjective sensations of dyspnea at rest and during guarded exercise, as well as subjective feelings of calmness or anxiety were also recorded. There was no difference in mechanical lung function, but the PO2 tended to decrease and PCO2 to increase after alprazolam administration. The maximum exercise level attained and the distance covered in the 12 minute walk was unchanged. The subjective perception of dyspnea was the same before and after alprazolam, at rest and during exercise. We conclude that alprazolam is not effective in relieving exercise dyspnea in patients with obstructive lung disease.
.A
Man GC; Hsu K; Sproule BJ.
.I 499
.U
87053014
.S
Chest 8703; 90(6):837-41
.M
Adult; Aged; Cardiac Output; Female; Half-Life; Human; Kinetics; Lidocaine/*ME; Liver/*ME; Male; Middle Age; Regional Blood Flow; Respiration; Respiration, Artificial/*; Support, Non-U.S. Gov't.
.T
Effect of mechanical ventilation on hepatic drug pharmacokinetics.
.P
JOURNAL ARTICLE.
.W
Mechanical ventilation was able to induce a decrease in cardiac output and regional blood flow, especially hepatic flow. Thus, hepatic elimination of drugs with a high hepatic-extraction ratio, which was linked to alteration in hepatic blood flow, could be reduced during mechanical ventilation. The aim of this work was to determine the effect of mechanical ventilation on pharmacokinetic parameters of lidocaine, which is a well-known nonrestrictive elimination drug at the hepatic level. Five patients (mean age, 58 years) with normal hepatic function and quite similar gasometric parameters before and after weaning from mechanical ventilation were studied. With a washout period of 48 hours between mechanical ventilation and spontaneous ventilation, each patient was submitted to the following protocol: lidocaine in a bolus (1.5 mg/kg intravenously), followed by infusion (1.0 to 1.7 mg/min for 120 minutes). The results were that the peak plasma concentration after the bolus during mechanical ventilation was 3.22 +/- 0.37 mg/L (mean +/- SE) vs 2.40 +/- 0.35 mg/L during spontaneous ventilation (p less than 0.02). Steady-state plasma concentration during mechanical ventilation was 2.10 +/- 0.20 mg/L vs 1.64 +/- 0.16 mg/L during spontaneous ventilation (p less than 0.01). Total clearance was 604.2 +/- 87.0 ml/min during mechanical ventilation vs 775.0 +/- 112.1 ml/min during spontaneous ventilation (p less than 0.01). Elimination half-life was 245.2 +/- 50.6 minutes during mechanical ventilation vs 160.0 +/- 40.6 minutes during spontaneous ventilation (p less than 0.05). Distribution volume was 188.6 +/- 50.2 L during mechanical ventilation and 183.0 +/- 50.8 L during spontaneous ventilation (not significant). These preliminary data clearly demonstrated a decrease in lidocaine elimination in patients submitted to mechanical ventilation, but the magnitude of dosage adjustment of such a highly hepatic-extracted drug in patients submitted to mechanical ventilation remains to be investigated.
.A
Richard C; Berdeaux A; Delion F; Riou B; Rimailho A; Giudicelli JF; Auzepy P.
.I 500
.U
87053016
.S
Chest 8703; 90(6):849-51
.M
Adult; Angiography; Angioplasty, Transluminal/*; Case Report; Graft Occlusion, Vascular/RA/*TH; Human; Internal Mammary Artery Implantation/*; Male; Middle Age; Myocardial Revascularization/*.
.T
Percutaneous transluminal angioplasty of right and left internal mammary artery grafts.
.P
JOURNAL ARTICLE.
.W
Four patients with recurrent severe angina and evidence of myocardial ischemia two to six months after surgical coronary revascularization have been submitted to percutaneous transluminal angioplasty of the distal insertion of internal mammary artery grafts or of the recipient vessel distal to it. These cases illustrate the feasibility and safety of transluminal angioplasty of right and left internal mammary artery grafts, using the mammary artery as a way of access.
.A
Steffenino G; Meier B; Finci L; von Segesser L; Velebit V.
.I 501
.U
87053018
.S
Chest 8703; 90(6):857-60
.M
Adult; Female; Forced Expiratory Flow Rates/*; Human; Male; Maximal Midexpiratory Flow Rate/*; Pressure; Reference Values; Smoking; Statistics; Support, Non-U.S. Gov't; Vital Capacity/*.
.T
Maximum flow ratios at mid-vital capacity in young healthy adults.
.P
JOURNAL ARTICLE.
.W
Upper airway obstruction is usually diagnosed by visual examination of maximum expiratory and inspiratory flow-volume curves and by calculating a ratio of expiratory to inspiratory flow at 50 percent of vital capacity (mid-vital capacity flow ratio); however, reference values of this ratio have not been well established, and considerable variability exists. The purpose of this study was to examine the range of mid-vital capacity flow ratios in a group of healthy subjects and to determine if some of the variability is accounted for by different maximum inspiratory pressures. We measured maximum expiratory and inspiratory flows at 50 percent of vital capacity from the flow-volume curves, and maximum inspiratory pressures in a group of 60 healthy nonsmokers (30 men and 30 women) whose ages ranged from 21 to 40 years. We found that mid-vital capacity flow ratio (mean +/- SD) was 0.72 +/- 0.19 in men and 0.77 +/- 0.18 in women. The coefficient of variation of the mid-vital capacity flow ratio was 28 percent for men and 23 percent for women. The 95 percent confidence limits for the mid-vital capacity flow ratio were 0.65 to 0.79 for men and 0.70 to 0.84 for women. Maximum inspiratory pressures (mean +/- SD) were 129 +/- 30 cm H2O in men and 91 +/- 16 cm H2O in women, not significantly different from previous studies. Normalizing maximum inspiratory flow for maximum inspiratory pressure did not reduce the coefficient of variation, which became 29 percent in men and 30 percent in women. We conclude that the range of mid-vital capacity flow ratios is wide, and it cannot be reduced by standardizing it for maximum inspiratory pressures.
.A
Hoffstein V; Brown I; Taylor R; McLean P; Zamel N.
.I 502
.U
87053019
.S
Chest 8703; 90(6):861-8
.M
Adult; Case Report; Child; Comparative Study; Death, Sudden/*PA; Female; Follow-Up Studies; Heart Conduction System/*PA; Heart Defects, Congenital/*SU; Human; Infant; Male; Postoperative Complications/*PA; Support, U.S. Gov't, P.H.S..
.T
Conduction system in cases of sudden death in congenital heart disease many years after surgical correction.
.P
JOURNAL ARTICLE.
.W
The conduction system and the entire heart were examined histologically in four patients with congenital heart disease who had surgery many years before they died suddenly. All were asymptomatic, in sinus rhythm and living normally. The sudden death may have been related to alterations in the conduction system, previously present, or introduced by the previous surgery, or related to inflammatory phenomena, an outgrowth of the previous surgery.
.A
Bharati S; Lev M.
.I 503
.U
87053020
.S
Chest 8703; 90(6):869-75
.M
Colorimetry/MT; Heat; Human; Kininase II/*AI/BL; Quality Control; Sarcoidosis/*EN; Statistics; Support, U.S. Gov't, Non-P.H.S.; Ultrafiltration.
.T
An angiotensin-converting enzyme (ACE) inhibitor in human serum. Increased sensitivity of the serum ACE assay for detecting active sarcoidosis.
.P
JOURNAL ARTICLE.
.W
Measurement of serum angiotensin-converting enzyme (ACE) is extremely useful as an aid in the diagnosis and longitudinal evaluation of patients with sarcoidosis. We have detected a human serum ACE-inhibitor which affects the ACE level obtained by activity measurements. The effect of the inhibitor can be eliminated by a mere eight-fold dilution of the serum sample with physiologic saline. We recommend that serum ACE be performed with 1:8 dilutions of serum to eliminate the effect of the ACE inhibitor. The inhibitor has a MW above 50,000 daltons, and reversibility of inhibition by dilution appears to be ion dependent. Dialysis of an inhibitor-containing serum sample against saline causes the inhibition to become irreversible, allowing the distinction between alinearity of the assay vs an inhibitor effect when a serum has ACE activity greater than 50 units/ml. The source of the serum ACE-inhibitor remains to be determined.
.A
Lieberman J; Sastre A.
.I 504
.U
87053021
.S
Chest 8703; 90(6):877-87
.M
Actuarial Analysis; Adult; Aged; Angioplasty, Transluminal/*/AE/EC; Coronary Disease/PA/SU/*TH; Coronary Vessels/AH; Emergencies; Follow-Up Studies; Human; Middle Age; Myocardial Infarction/SU; Myocardial Revascularization/MO; Vascular Patency.
.T
Coronary angioplasty is the treatment of choice for multivessel coronary artery disease.
.P
JOURNAL ARTICLE.
.A
Hartzler GO.
.I 505
.U
87053022
.S
Chest 8703; 90(6):888-92
.M
Case Report; Clinical Trials/*MT; Dihydromorphinone/TU; Double-Blind Method; Dyspnea/*DT/ET; Female; Human; Lung Diseases, Obstructive/*CO; Middle Age; Narcotics/*TU; Random Allocation; Research Design.
.T
Single-patient randomized clinical trial. Opiates for intractable dyspnea.
.P
JOURNAL ARTICLE.
.A
Robin ED; Burke CM.
.I 506
.U
87053023
.S
Chest 8703; 90(6):893-4
.M
Aged; Case Report; Heart Catheterization/*MT; Human; Male; Vena Cava, Superior/*AB/RA.
.T
Abnormal position of flow-directed right heart catheter.
.P
JOURNAL ARTICLE.
.A
Schonfeld AJ; McKinney RG.
.I 507
.U
87053024
.S
Chest 8703; 90(6):895-6
.M
Animal; Capillary Permeability; Human; Infection/*CO; Myocardial Infarction/CO; Pulmonary Edema/*ET/TH; Shock/CO; Shock, Septic/CO.
.T
Pulmonary edema induced by sepsis.
.P
JOURNAL ARTICLE.
.A
Altschule MD.
.I 508
.U
87053028
.S
Chest 8703; 90(6):914-6
.M
Angiography; Case Report; Coronary Vessel Anomalies/*RA; Electrocardiography; Exertion; Human; Male; Middle Age; Sinus of Valsalva/*AB/RA.
.T
Dual left coronary systems.
.P
JOURNAL ARTICLE.
.W
Dual left coronary systems, one originating normally and the other anomalously from the right sinus of Valsalva, is described in a 53-year-old patient with atypical chest pain with exercise-induced ST-depression in the anteroseptal area (V2-4). Clinical consequences of this hitherto undescribed anomaly are discussed.
.A
Das B; Puram B; Kim CS.
.I 509
.U
87053029
.S
Chest 8703; 90(6):916-8
.M
Aged; Case Report; Female; Human; Male; Middle Age; Pulmonary Embolism/RA; Thromboembolism/*RA/TH; Vena Cava, Inferior/*AB/RA/SU.
.T
Duplication of the inferior vena cava in thromboembolic disease.
.P
JOURNAL ARTICLE.
.W
Recurrent pulmonary embolism from the lower extremities or pelvis, despite anticoagulation, often requires interruption of the inferior vena cava (IVC). We report two patients in whom interruption of the IVC failed to ameliorate symptoms. Both patients demonstrated a previously unrecognized duplication of the IVC. We stress the importance of excluding abdominal venous anomalies prior to interrupting the IVC using surgical or percutaneous methods.
.A
Reinus WR; Gutierrez FR.
.I 510
.U
87053030
.S
Chest 8703; 90(6):918-9
.M
Case Report; Female; Human; Leiomyosarcoma/*CO/SC; Lung Neoplasms/*CO/SC; Middle Age; Pleura; Pneumothorax/DT/*ET; Tetracycline/AD.
.T
Pleurodesis in metastatic pneumothorax.
.P
JOURNAL ARTICLE.
.W
A 57-year-old woman with bilateral pneumothoraces secondary to pulmonary metastases from leiomyosarcoma of the uterus was treated successfully by intrapleural instillation of tetracycline.
.A
Rammohan G; Bonacini M; Dwek JH; Das A.
.I 511
.U
87053034
.S
Chest 8703; 90(6):926
.M
Carcinoma, Bronchiolar/*CO; Case Report; Female; Human; Lung Neoplasms/*CO; Middle Age; Pneumothorax/*ET/SU.
.T
Spontaneous pneumothorax. A complication of lung cancer? [letter]
.P
LETTER.
.A
Bouros D; Andrianopoulos E.
.I 512
.U
87053035
.S
Chest 8703; 90(6):926-7
.M
Human; Lung Neoplasms/*RA; Lymphatic Metastasis; Lymphography/MT; Mediastinoscopy; Neoplasm Staging/*MT; Tomography, X-Ray Computed/*.
.T
Staging with CT [letter]
.P
LETTER.
.A
Daly BD Jr; Faling LJ; Gale ME; Jung-Legg Y; Snider GL; Karp DD; Chang HS.
.I 513
.U
87053036
.S
Chest 8703; 90(6):927-8
.M
Follow-Up Studies; Heart Valve Prosthesis/*; Human; Polyethylene Terephthalate; Silicones; Tricuspid Valve/*SU; Tricuspid Valve Insufficiency/SU.
.T
Tricuspid annuloplasty [letter]
.P
LETTER.
.A
Ferlan G; Bex JP.
.I 514
.U
87053037
.S
Chest 8703; 90(6):928
.M
Atrial Fibrillation/*TH; Case Report; Electric Countershock/*MT; Male; Pulse; Running.
.T
A new method of cardioversion [letter]
.P
LETTER.
.A
Smith T.
.I 515
.U
87053304
.S
Drug Intell Clin Pharm 8703; 20(11):857-9
.M
Case Report; Female; Human; Middle Age; Obesity/*ME; Theophylline/*BL.
.T
Intrasubject variability of theophylline clearance in a morbidly obese patient.
.P
JOURNAL ARTICLE.
.W
It is well appreciated that theophylline pharmacokinetics exhibits wide intersubject variation. Within-subject changes in clearance have been generally reported in patients with acute exacerbations of disease states such as cor pulmonale or heart failure. Apparent random changes in theophylline clearance within the same patient have recently been reported. This report describes a case of suspected changes in the clearance of theophylline in a morbidly obese patient (250 kg) over a two-month period of time. Frequent dosage adjustments were required to maintain theophylline concentrations within the range of 8.2 to 27.3 micrograms/ml. Possible explanations for these changes included hypoxia and medically induced starvation. Daily theophylline doses ranged from 600 to 1600 mg/d. It is concluded that in some individuals, within-subject changes in theophylline clearance can be substantial, thus requiring frequent monitoring of theophylline concentration.
.A
Slaughter RL; Nairn D.
.I 516
.U
87053305
.S
Drug Intell Clin Pharm 8703; 20(11):860-2
.M
Adult; Case Report; Human; Kidney Failure, Acute/*CI/PP; Male; Phenylpropionates/*AE; Suprofen/*AE.
.T
Suprofen-induced acute renal failure.
.P
JOURNAL ARTICLE.
.W
A case report of acute flank pain with reversible renal failure in a young adult after taking three doses of suprofen is presented. Blood urea nitrogen and serum creatinine values returned to normal from significantly elevated levels on admission.
.A
Henann NE; Morales JR.
.I 517
.U
87053307
.S
Drug Intell Clin Pharm 8703; 20(11):869-73
.M
Adipose Tissue/*ME; Adolescence; Adult; Aged; Cefamandole/*ME/TU/UR; Chromatography, High Pressure Liquid; Drainage; Female; Human; Kinetics; Male; Middle Age; Obesity/*ME/TH; Stomach/SU; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Surgical Wound Infection/*ME/PC.
.T
Cefamandole distribution in serum, adipose tissue, and wound drainage in morbidly obese patients.
.P
JOURNAL ARTICLE.
.W
Distribution and elimination of cefamandole 2 g iv were studied in 11 morbidly obese patients during a gastric bypass operation and again on the first postoperative day. Serum, subcutaneous adipose tissue, wound drainage, and urine were analyzed by high performance liquid chromatography for cefamandole and pharmacokinetic parameters from the intraoperative period were compared to those obtained postoperatively. Total body clearance was significantly greater (p less than 0.001) postoperatively (297 ml/min) than intraoperatively (254 ml/min). Volume changes were unpredictable but the elimination rate constant tended to increase postoperatively. Renal clearance and percentage of urinary recovery were significantly increased (p less than 0.01) postoperatively. The patients had a mean (+/- SD) volume of the central compartment of 10.3 (+/- 2.3) L, volume at steady state of 18.3 (+/- 3.9) L, and elimination rate constant of 1.67 (+/- 0.63) h-1. Tissue concentrations of cefamandole were highest during the first hour after drug administration and were less than 1 microgram/g after 3.5 hours. Mean wound drainage concentrations ranged between 10 and 12 micrograms/ml during a dosing interval and dropped to 7 micrograms/ml 12 hours after the last dose. Intraoperative dosing of cefamandole is required to maintain subcutaneous adipose tissue concentrations greater than 1 microgram/g during procedures longer than three hours in morbidly obese patients. A postoperative dose of cefamandole 2 g iv q6h will provide sustained and therapeutic concentrations in the wound drainage of morbidly obese patients.
.A
Mann HJ; Buchwald H.
.I 518
.U
87053308
.S
Drug Intell Clin Pharm 8703; 20(11):873-5
.M
Adult; Aged; Body Weight/*DE; Hospitalization; Human; Indoles/*AE; Male; Middle Age; Molindone/*AE/TU; Schizophrenia/*CO/DT.
.T
Effect of molindone on weight change in hospitalized schizophrenic patients.
.P
JOURNAL ARTICLE.
.W
A retrospective review was conducted to assess the effect of molindone on weight. Monthly weights and neuroleptic dosages during the first three months of psychiatric hospitalization were compared between matched groups of patients receiving molindone, a combination of molindone and other neuroleptics, or other neuroleptic drugs. We found no significant differences in weight gain among the three groups. Our results challenge the common opinion that molindone can be associated with a lack of weight gain compared to other antipsychotics.
.A
Parent MM; Roy S; Sramek J; Lawson W; Herrera J.
.I 519
.U
87053309
.S
Drug Intell Clin Pharm 8703; 20(11):876-80
.M
Dermatology/*; Drug Compounding; Florida; Interprofessional Relations/*; Pharmacists/*; Physicians/*; Prescriptions, Drug.
.T
Survey of the professional interrelations between dermatologist and pharmacist.
.P
JOURNAL ARTICLE.
.W
A national survey of dermatologists and pharmacists was conducted to characterize the involvement of the community pharmacist in the area of skin diseases and to elicit suggestions to improve professional interrelations. The results show the dermatologists' major complaint is pharmacists' inability or unwillingness to compound prescriptions. The study clearly indicates the need for increased communication between the two professions in matters such as inventory control, prescription refill procedures, and substitution guidelines. The pharmacists, in general, admitted a deficiency in their educational preparedness to recognize common skin disorders, thus limiting their ability to assess the severity of patients' complaints.
.A
Araujo OE; DeSantis DA; Doering PL.
.I 520
.U
87053310
.S
Drug Intell Clin Pharm 8703; 20(11):881-2
.M
Drug Therapy/*; Drugs/*AD; Pharmacists.
.T
Drugs don't have doses--people have doses! A clinical educator's philosophy [editorial]
.P
EDITORIAL.
.A
Cipolle RJ.
.I 521
.U
87053311
.S
Drug Intell Clin Pharm 8703; 20(11):882
.M
Pharmacy/*TD; United States.
.T
Controlling the metamorphosis of pharmacy [editorial]
.P
EDITORIAL.
.A
Whitney HA Jr.
.I 522
.U
87053312
.S
Drug Intell Clin Pharm 8703; 20(11):883-5
.M
Pharmacy/*TD; Pharmacy Service, Hospital/*TD; Specialism; United States.
.T
Clinical pharmacy--specialty or general direction? [editorial]
.P
EDITORIAL.
.A
Provost GP.
.I 523
.U
87053313
.S
Drug Intell Clin Pharm 8703; 20(11):885-6
.M
Education, Pharmacy/*TD; Pharmacy/*TD; United States.
.T
Do basic scientists fiddle while the clinical faculty burns? [editorial]
.P
EDITORIAL.
.A
Whitney HA Jr.
.I 524
.U
87053314
.S
Drug Intell Clin Pharm 8703; 20(11):886
.M
Aminoglycosides/AN; Antibiotics/*AN; Drug Incompatibility; Drug Stability; Heparin/*AN.
.T
Heparin and aminoglycosides instability [letter]
.P
LETTER.
.A
Hutchison SM.
.I 525
.U
87053315
.S
Drug Intell Clin Pharm 8703; 20(11):886-7
.M
Human; Imipramine/AD/*ST/TU; Therapeutic Equivalency.
.T
Imipramine treatment failures: defective generic products or inadequate doses? [letter]
.P
LETTER.
.A
Stewart RB; Tingle D; Hampton A.
.I 526
.U
87053316
.S
Drug Intell Clin Pharm 8703; 20(11):887-8
.M
Adult; Case Report; Epidermolysis Bullosa/*DT; Human; Male; Phenytoin/*TU.
.T
Phenytoin treatment of RDEB vegetans [letter]
.P
LETTER.
.A
Pini LA; Girolomoni G; Coppini M; Pincelli C.
.I 527
.U
87053317
.S
Drug Intell Clin Pharm 8703; 20(11):888
.M
Case Report; Diltiazem/ME/*PO; Human; Kinetics; Male; Middle Age; Suicide.
.T
Massive diltiazem overdosage: clinical and pharmacokinetic observations [letter]
.P
LETTER.
.A
Malcolm N; Callegari P; Goldberg J; Strauss H; Caille G; Vezina M; Spenard J.
.I 528
.U
87053318
.S
Drug Intell Clin Pharm 8703; 20(11):889
.M
Adult; Case Report; Danazol/*AE; Female; Hepatitis, Toxic/*ET; Human; Pregnadienes/*AE.
.T
Hepatitis associated with danazol [letter]
.P
LETTER.
.A
Ohsawa T; Iwashita S.
.I 529
.U
87053320
.S
Drug Intell Clin Pharm 8703; 20(11):890
.M
Human; Kinetics; Phenytoin/*BL.
.T
Comment: predicting phenytoin levels [letter]
.P
LETTER.
.A
Stevens MR.
.I 530
.U
87053321
.S
Drug Intell Clin Pharm 8703; 20(11):890-1
.M
Great Britain; Pharmacy/*MA.
.T
Comment: pharmacy manpower contrast--U.K. [letter]
.P
LETTER.
.A
Bailie GR; Goldberg LA.
.I 531
.U
87053529
.S
Emerg Med Clin North Am 8703; 4(4):623-874
.M
Critical Care/*; Human; Intensive Care Units.
.T
Emergency department management of critical illness.
.P
JOURNAL ARTICLE.
.I 532
.U
87053543
.S
Endocrinology 8703; 119(6):2417-21
.M
Animal; Cimetidine/*PD; Corpus Luteum/DE/PH; Diphenhydramine/*PD; Female; Graafian Follicle/CY; LH/BL; Ovary/*DE; Ovulation/*DE; Progesterone/BL; Sheep/*PH.
.T
Ovarian function in ewes treated with antihistamines.
.P
JOURNAL ARTICLE.
.W
Ewes were treated systemically during the periovulatory period with the antihistamines diphenhydramine (H1-receptor antagonist) and(or) cimetidine (H2-receptor antagonist). None of the treatments prevented ovulation. However, the combination of drugs inhibited subsequent function of the corpus luteum (CL) as assessed by serum measurements of progesterone. Administration of antihistamines did not alter pituitary secretion of LH. Injection of small quantities of diphenhydramine and cimetidine into the antrum of the preovulatory follicle also caused aberrant luteal activity, but no blockade of ovulation. Intrafollicular injection of histamine reversed the inhibitory influence of antihistamines on the CL. Antihistamines suppressed preovulatory thecal edema and antral influx of plasma transudate containing LH. Thus, the effects of antihistamines appear to have been exerted at the follicular level. Function of matured CL was not compromised by peripheral administration of antihistamines. Actions of histamine within the preovulatory ovine follicle do not appear to be a prerequisite for ovulation, but apparently do have an impact on ensuing luteal function. We propose that a hyperemic reaction to histamine in preovulatory follicles enhances vascular filtration of LH. As a consequence, maximal permeation of the avascular granulosal layer of the follicle by LH leads to a normal luteinization response.
.A
Halterman SD; Murdoch WJ.
.I 533
.U
87053545
.S
Endocrinology 8703; 119(6):2427-32
.M
Animal; Decidua/*IM; Estradiol/PD; Female; Immunoglobulin Fragments/*ME; Immunoglobulins/*ME; Oils; Organ Weight/DE; Ovariectomy; Ovum Implantation; Progesterone/PD; Rats; Secretory Component/*ME; Stress, Mechanical; Support, U.S. Gov't, P.H.S.; Uterus/AH/*IM.
.T
Immunoglobulin and secretory component regulation in the rat uterus at the time of decidualization.
.P
JOURNAL ARTICLE.
.W
To determine the effect of decidualization on uterine immunoglobulins (Igs), we measured the levels of IgG, IgA, and secretory component (SC) after induction of artificial decidual cell reactions (DCR) in hormonally primed ovariectomized rats. When progesterone-treated (2.5 mg/day, 3 days) rats received an intraluminal instillation of oil or a needle scratch stimulation in one uterine horn, the stimulated horn had an increase in wet weight and cytoplasmic protein relative to the contralateral horn. Under these conditions, IgG levels increased 10-fold in the lumen of the stimulated horn. This response was selective for IgG, because induction of DCR had no effect on accumulation of IgA or SC in the stimulated horn. The progesterone-induced accumulation of IgG after DCR was further enhanced by estradiol. The addition of a small amount of estradiol (0.2 microgram) on day 3 of a 4-day progesterone pretreatment resulted in further increases in both the wet weight of the stimulated horn and the concentration of IgG in the lumen. The amount of IgG in the lumen of the stimulated horn was 5-fold greater than that in the stimulated horn after progesterone alone. Levels of IgA and SC, however, remained unchanged with this treatment. These results indicate that movement of IgG into the uterine lumen occurs as a part of the DCR and that both an appropriate endocrine balance and physical stimulation are essential for maximal IgG accumulation. Further, they suggest that IgG may play a central role in early pregnancy, which results in the successful implantation of the blastocysts.
.A
Stern JE; Wira CR.
.I 534
.U
87053547
.S
Endocrinology 8703; 119(6):2439-44
.M
Animal; Antigen-Antibody Reactions; Chlorides/*ME; Human; Male; Mice; Mice, Nude; Pilocarpine/PD; Prolactin/*PH; Support, Non-U.S. Gov't; Sweat/*PH; Sweat Glands/*PH; Water-Electrolyte Balance.
.T
Modulation of the chloride concentration of human sweat by prolactin.
.P
JOURNAL ARTICLE.
.W
The purpose of this study was to determine whether the availability of PRL modulates the chloride concentration of human sweat. Full thickness human skin grafted into the back of immunoincompetent, nude, congenitally athymic mice heals in about 6 to 10 weeks and survives the life of the mice. Mice have no sweat glands in the back so this system provides a useful model for study of the physiology and pathology of human sweat glands. The graft can be induced to sweat and the sweat collected for analytical studies. Presumably normal skin obtained from 7 individuals undergoing reconstructive surgery was grafted successfully into 11 mice. On 49 occasions sweat was induced by pilocarpine iontophoresis and collected for 45 min. The chloride concentration was 12.9 +/- 6.7 meq/liter, values typical of normal human sweat. Nine mice bearing grafts were injected with rabbit anti-human PRL (hPRL). The chloride concentration of sweat obtained a day later was significantly elevated. The concentration generally increased after a second and sometimes a third injection of anti-PRL. The average maximum sweat chloride obtained was 61.9 +/- 8.25 meq/liter. Serum of rabbits that had not been exposed to hPRL was prepared and diluted in the same way as the anti-hPRL. The chloride concentration of sweat of 3 mice that received the preparation for several days remained unchanged at the low normal level. We conclude that depletion of PRL increases the concentration of chloride in human sweat.
.A
Robertson MT; Boyajian MJ; Patterson K; Robertson WV.
.I 535
.U
87053549
.S
Endocrinology 8703; 119(6):2451-4
.M
Animal; Chromosome Mapping; Genes, Reiterated; Prolactin/*GE; Rats/*GE; Somatotropin/*GE; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
The related genes encoding growth hormone and prolactin have been dispersed to chromosomes 10 and 17 in the rat.
.P
JOURNAL ARTICLE.
.W
We have assigned the rat GH gene to chromosome 10 and the rat PRL gene to chromosome 17. DNA from a series of mouse BWTG3 x rat hepatocyte somatic cell hybrids, each of which has retained a unique complement of rat chromosomes, was analyzed for the presence of rat GH and PRL genomic fragments by Southern blotting. Radiolabeled complementary DNAs (cDNAs) encoding rat GH and rat PRL were used as molecular probes. Based upon these assignments, we conclude that the evolutionarily related GH and PRL genes have been dispersed to different chromosomes in rat as in man.
.A
Cooke NE; Szpirer C; Levan G.
.I 536
.U
87053552
.S
Endocrinology 8703; 119(6):2467-75
.M
Animal; Cell Nucleus/ME; Cytoplasm/ME; Endometrium/CY/*ME; Estradiol/*PH; Female; Follicular Phase; Luteal Phase; Macaca fascicularis; Menstruation/*; Mitotic Index; Myometrium/ME; Ovariectomy; Progesterone/PH; Receptors, Estrogen/*ME; Support, U.S. Gov't, P.H.S..
.T
Immunocytochemical localization of estrogen receptors in the macaque endometrium during the luteal-follicular transition.
.P
JOURNAL ARTICLE.
.W
We examined changes in estrogen receptors (ERs) in endometrial stromal and epithelial cells in cynomolgus macaques during artificially induced menstruation and repair. We used Silastic implants filled with either estradiol (E2) or progesterone (P) to treat spayed animals for 14 days with E2 followed by 14 days of E2 plus P. We then withdrew the P (but not the E2) implants and removed uteri 0, 0.5, 1, 2, 3, 4, 5, 7, and 14 days later. Uterine tissues were assayed biochemically for ER content, fixed for histology and frozen for immunocytochemistry of ER with monoclonal antiestrophilins. On day 0, ER levels in endometrium were low [1330 +/- 201 (n = 9) fmol/mg DNA]. An increase in total receptor was evident by 3-4 days of P withdrawal 2762 +/- 190 (n = 6) fmol/mg DNA; P less than 0.001]. Total receptor concentrations increased linearly with time from 0.5-7 days of P withdrawal (r = 0.88). On day 0, staining for nuclear ER in the glandular epithelium and stroma of zones I, II, and III of the endometrium was negative. Beginning at 12-24 h and continuing through 4 days of P withdrawal, nuclear staining became detectable and increased in intensity only in endometrial stromal fibroblasts and myometrial smooth muscle cells. The glandular epithelium of the endometrium did not develop nuclear staining until 5-7 days of P withdrawal, coincident with a 10-fold increase in the mitotic index of the epithelium of the upper zones. Thus, the increase in endometrial ER levels that occurred during the first 5 days of an induced luteal-follicular transition took place almost exclusively in stromal fibroblasts.
.A
McClellan M; West NB; Brenner RM.
.I 537
.U
87053553
.S
Endocrinology 8703; 119(6):2476-83
.M
Amanitins/PD; Animal; Calcitriol/*PD; Calcium-Binding Proteins/*GE; Cycloheximide/PD; Dactinomycin/PD; Duodenum/*PH; Gene Expression Regulation/DE; Male; Rats; RNA, Messenger/GE; Support, Non-U.S. Gov't; Transcription, Genetic/DE; Translation, Genetic/DE.
.T
In vivo effects of transcriptional and translational inhibitors on duodenal vitamin D-dependent calcium-binding protein messenger ribonucleic acid stimulation by 1,25-dihydroxycholecalciferol.
.P
JOURNAL ARTICLE.
.W
The in vivo stimulation of vitamin D-dependent calcium-binding protein (9 K CaBP) synthesis by 1,25-dihydroxycholecalciferol [1,25(OH)2D3] in the rat duodenum has been analyzed using a specific [32P]complementary DNA probe for rat 9 K CaBP and inhibitors of RNA transcription (actinomycin D, alpha-amanitin) or protein synthesis (cycloheximide). The relative amounts of 9 K CaBP messenger RNA (mRNA) were assayed by dot-blot hybridization and the relative amounts of 9 K CaBP by RIA. Both inhibitors were injected at doses which significantly inhibited by 80-95% [35S]methionine or [3H]uridine incorporation into protein and RNA, respectively. In vitamin D-deficient rats, a single 1,25(OH)2D3 injection (650 pmol/100 g BW) resulted in a rapid production of 9 K CaBP mRNA which was significantly detectable as early as 3 h, and was followed by an increase of 9 K CaBP levels. Injection of actinomycin D (25 micrograms/100 g BW) 1 h before 1,25(OH)2D3 treatment and repeated every 4 h did not prevent the hormone-induced elevation of duodenal CaBP mRNA, even when the actinomycin dose was doubled and given 2 h before hormonal treatment. alpha-Amanitin (2 micrograms/100 g BW) also failed to block the hormonal stimulation. The protein synthesis inhibitor cycloheximide (25 micrograms/100 g BW) did not cause any change in the 1,25(OH)2D3-induced CaBP mRNA but blocked the CaBP increase after hormone injection. Thus, transcription inhibitors did not prevent the in vivo hormone-induced elevation of 9 K CaBP mRNA, which suggests that 1,25(OH)2D3 increases 9 K CaBP synthesis by increasing 9 K CaBP gene expression at one or more posttranscriptional steps. More precise data will be obtained by measuring the rate of 9 K CaBP gene transcription on isolated nuclei from rat duodenum.
.A
Dupret JM; Brun P; Thomasset M.
.I 538
.U
87053554
.S
Endocrinology 8703; 119(6):2484-9
.M
Animal; Dopamine/PH; Estradiol/*PD; Female; In Vitro; Kinetics; Ovariectomy; Pituitary Gland, Anterior/*DE/PH; Prolactin/SE; Rats; Receptors, Dopamine/*DE/ME; Secretory Rate/DE; Spiperone/ME; Steroids/PD.
.T
Direct effect of estradiol on the number of dopamine receptors in the anterior pituitary of ovariectomized rats.
.P
JOURNAL ARTICLE.
.W
The effect of 17 beta-estradiol (17 beta E2) on anterior pituitary dopaminergic receptor (D2) content was studied in vitro in relation to PRL secretion. Anterior pituitaries from ovariectomized rats were incubated for short periods in medium 199, with or without the steroid. Dopamine (DA) receptors in partially purified pituitary membranes were quantified by equilibrium binding using [3H]spiperone; the PRL released into the incubation medium was analyzed by RIA. Addition of 10(-10) to 10(-6) M 17 beta E2 to the incubation medium of anterior pituitaries rapidly and reversibly decreased the number of DA receptors (P less than 0.01 to 0.001), while increasing PRL release, in a dose-related fashion. The maximal effect on both receptor numbers and PRL secretion was obtained with 10(-8) M 17 beta E2. This effect involved no change in receptor affinity (Kd = 0.11 +/- 0.01 nM in presence or in absence of 17 beta E2). This estrogen-induced decrease in DA-binding capacity was apparently not the result of the occupation of spiperone binding sites by the steroid, since after a 30-min incubation with 10(-8) M [3H]17 beta E2, no radioactivity was detectable on the partially purified membranes. Moreover, the presence of 17 beta E2 at the same time as the labeled D2 ligand did not modify the kinetics of association or dissociation of spiperone with pituitary membranes. This decrease in anterior pituitary DA receptor content and the increase in PRL release were already significant after a 7-min incubation in the presence of 10(-8) M 17 beta E2. Finally, these effects of 17 beta E2 were not mimicked by its 17 alpha-stereoisomer, nor by progesterone, or testosterone. These results suggest that the stimulatory effect of 17 beta E2 on PRL secretion may be due, at least in part, to the desensitization of anterior pituitary cells to DA. The steroid may produce this desensitization directly by decreasing the number of D2. The short latency of this effect likely discards the possibility of a genomic action of 17 beta E2.
.A
Pasqualini C; Bojda F; Kerdelhue B.
.I 539
.U
87053555
.S
Endocrinology 8703; 119(6):2490-6
.M
Animal; Cell Differentiation/DE; Cryptorchism/*PA; Dibutyryl Cyclic AMP/*PD; Dose-Response Relationship, Drug; Germ Cells/CY; In Vitro; Male; Mice; Spermatogenesis/DE; Spermatogonia/*CY; Spermatozoa/*CY; Support, Non-U.S. Gov't; Vitamin A/PD.
.T
Dibutyryl adenosine cyclic monophosphate regulates differentiation of type A spermatogonia with vitamin A in adult mouse cryptorchid testis in vitro.
.P
JOURNAL ARTICLE.
.W
Surgically prepared cryptorchid mouse testes containing only type A spermatogonia were cultured with (Bu)2cAMP in combination with vitamin A (retinol). Treatment with (Bu)2cAMP and retinol for 12-24 h and with basal medium for an additional 8 days stimulated mitotic activity in type A spermatogonia and induced differentiation of germ cells. However, (Bu)2cAMP alone did not induce differentiation of type A spermatogonia. Moreover, when cryptorchid testes were treated with (Bu)2cAMP for longer than 3 days in the presence or absence of retinol, differentiation of type A spermatogonia did not take place; disintegration of the seminiferous tubules occurred instead. When the cryptorchid testes were cultured for 24 h in a medium containing a fixed concentration of retinol and varying concentrations of (Bu)2cAMP from 0.001-0.4 mM, there was a dose-dependent increase in the number of differentiated and mitotic germ cells and type A spermatogonia. Likewise, at a fixed dose of (Bu)2cAMP and increasing concentrations of retinol, a dose-dependent increase in the number of differentiated and mitotic germ cells occurred. However, the number of type A spermatogonia was decreased. The addition of puromycin, cycloheximide, and actinomycin D to the medium completely blocked retinol-(Bu)2cAMP-induced differentiation of the germ cells. The present results suggest that cAMP and retinol trigger biochemical events promoting the synthesis of specific macromolecules involved in the proliferation and differentiation of type A spermatogonia.
.A
Haneji T; Koide SS; Nishimune Y; Oota Y.
.I 540
.U
87053556
.S
Endocrinology 8703; 119(6):2497-501
.M
Animal; Exons; Female; Gene Expression Regulation; Hypothalamus/*PH; Lactation/*; Peptide PHI/*GE; Pregnancy; Rats; RNA, Messenger/GE; Support, Non-U.S. Gov't; Support, U.S. Gov't, Non-P.H.S.; Support, U.S. Gov't, P.H.S.; Vasoactive Intestinal Peptide/*GE.
.T
Hypothalamic vasoactive intestinal peptide messenger ribonucleic acid is increased in lactating rats.
.P
JOURNAL ARTICLE.
.W
Vasoactive intestinal peptide (VIP) has been proposed as an inducer of PRL release. Moreover, immunocytochemical studies suggested an increase in the VIP content in the hypothalamus of lactating rats. We investigated whether this increase is regulated at the level of gene transcription. A sensitive RNA detection assay that uses in vitro transcribed RNA probes corresponding to specific exons of the VIP gene was devised to study VIP gene expression. Using this method, an approximately 2000-base long RNA containing the coding sequences for VIP was detected in rat hypothalamus. This RNA also contains the coding sequences for the VIP-related peptide PHM/I (peptide histidine methionine amide or isoleucine amide). An identical VIP-encoding RNA was previously identified in the rat cerebral cortex. A 2-fold increase was observed in hypothalamic VIP mRNA during lactation. In addition, the levels of this mRNA increased in the hypothalamus at the time of sexual maturation. Taken together, our results suggest a physiological regulation of VIP gene expression associated with its potential role as a neuroendocrine hormone.
.A
Gozes I; Shani Y.
.I 541
.U
87053562
.S
Endocrinology 8703; 119(6):2547-52
.M
Adenosine Cyclic Monophosphate/ME; Animal; Biological Transport; Female; Homeostasis; Iodides/*ME; Iodoproteins/ME; Pregnancy; Rabbits; Support, U.S. Gov't, P.H.S.; Thyroid Gland/EM/*ME; Thyrotropin/PD.
.T
Autoregulation of iodide transport in the rabbit: absence of autoregulation in fetal tissue and comparison of maternal and fetal thyroid iodination products.
.P
JOURNAL ARTICLE.
.W
Maternal and fetal rabbit thyroid glands were compared as to their ability to respond to excess iodide in vitro with a reduction in subsequent iodide transport activity. Preincubation of maternal thyroid tissue slices for 2 h with excess iodide (30 microM) resulted in a 31% reduction in the subsequently measured thyroid-medium radioiodide concentration ratio. In contrast, similar iodide pretreatment had no significant effect on fetal iodide transport. In all other respects, fetal iodide transport, although it was 10 times higher, did not differ significantly from maternal transport activity. Combined radiolabeled maternal (125I) and fetal (131I) rabbit thyroid tissue was eluted on Sephadex G-25 columns. Fractions were analyzed for both 125I and 131I activity, and the maternal to fetal ratios (125I/131I) were determined for each fraction. The majority of iodoproteins eluted with the void volume, and the 125I/131I ratio was constant in these fractions. Thereafter, two peaks of elevated 125I/131I activity could be observed. Peak A eluted below lysozyme (Mr = 14,300) and above insulin (Mr = 6,000), with an apparent mol wt of 8,000 to 10,000. A second peak, peak B, eluted from the column at a site similar to that of MIT or a protein of Mr of 2,000. Ascending paper chromatography of this latter peak of 125I/131I activity and MIT was carried out in two solvent systems. In both systems, peak B comigrated with MIT. These findings suggest that the failure of fetal thyroid tissue to exhibit autoregulation may be associated with the reduced iodination of a compound with an approximate Mr of 8,000 to 10,000. The role of this substance in iodide transport remains to be identified. The reason for the apparent increase in the labeling of MIT observed in maternal vs. fetal tissue is unknown.
.A
Price DJ; Sherwin JR.
.I 542
.U
87053563
.S
Endocrinology 8703; 119(6):2553-9
.M
Animal; Biological Transport/DE; Cats; Cattle; Cycloheximide/PD; Emetine/PD; Homeostasis/DE; In Vitro; Iodides/*ME; Iodoproteins/PH; Molecular Weight; Proteins/BI; Puromycin/PD; Sheep; Thyroid Gland/*ME.
.T
Autoregulation of thyroid iodide transport: evidence for the mediation of protein synthesis in iodide-induced suppression of iodide transport.
.P
JOURNAL ARTICLE.
.W
The role of protein synthesis in iodide-induced suppression of subsequent iodide transport (iodide autoregulation) was studied in cat thyroid slices. Thyroid slices were pretreated for 60-120 min in the presence or absence of either excess (30 microM) sodium iodide, inhibitors of protein synthesis, or both. Tissue was then washed in the presence of 2 mM methimazole to prevent subsequent iodination reaction and remove excess iodide. Iodide transport activity was finally evaluated by measurement of the ratio of tissue to medium iodide concentrations in 90-min incubations. Addition of 0.1 mM cycloheximide during the preexposure of thyroid tissue to excess iodide had no effect on either control levels of iodide transport or iodide-induced autoregulation. However, if thyroid tissue was treated with cycloheximide alone for 1 h before preexposure to excess iodide, there was a significant reduction in the degree of iodide-induced induced autoregulation. Similar results were obtained with pretreatment of the tissue with 0.5 mM puromycin and 1 microgram/ml emetine. These findings suggest that protein synthesis is involved in the mechanism of thyroid autoregulation of iodide transport. Cycloheximide had no effect on the ability of excess iodide to reduce TSH-stimulated cAMP formation. Two-dimensional gel electrophoresis-isoelectric focusing and Sephadex G-25 column chromatography employing dual-isotope comparison of iodoprotein labeling of control and cycloheximide-treated tissue suggest that the ability of cycloheximide to suppress iodide-induced autoregulation is associated with the reduced iodination of an 8- to 10-kilodalton soluble component of the thyroid gland.
.A
Sherwin JR; Price DJ.
.I 543
.U
87053565
.S
Endocrinology 8703; 119(6):2568-73
.M
Adenyl Cyclase/*ME; Animal; Calcitriol/*PD; Calmodulin/AI/*PH; Chickens; Duodenum/CY/*EN; Enzyme Activation/DE; Forskolin/PD; Guanylyl Imidodiphosphate/PD; Intestinal Mucosa/CY/EN; Male; Sodium Fluoride/PD; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Stimulation by 1,25-dihydroxyvitamin D3 of adenylate cyclase along the villus of chick duodenum.
.P
JOURNAL ARTICLE.
.W
Administration of 650 pmol 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] to vitamin D-deficient chicks increased adenylate cyclase activity in the basolateral membrane of duodenal epithelial cells within 24 h. This increase in enzymatic activity was accompanied by an increase in calmodulin content of the basolateral membrane. Although neither exogenously added calmodulin (up to 10 micrograms/ml) nor calcium (from 10(-7)-10(-5) M) stimulated enzyme activity, calmodulin antagonists trifluoperazine, W7, and W13 inhibited it. When calmodulin content, adenylate cyclase activity, and alkaline phosphatase activity were measured in cells sequentially eluted from the tip to the base of the villus, cells from the midregion and base had the highest calmodulin content and adenylate cyclase activity, whereas alkaline phosphatase activity (a brush border membrane enzyme) was highest in cells eluted from the tip. Adenylate cyclase activity was increased by 1,25-(OH)2D3, particularly in cells from the midvillus. Our results indicate that the response of adenylate cyclase activity to 1,25-(OH)2D3 varies along the villus and suggest that calmodulin may be involved.
.A
Long RG; Bikle DD; Munson SJ.
.I 544
.U
87053567
.S
Endocrinology 8703; 119(6):2580-5
.M
Animal; Calcification, Physiologic/DE; Calcitriol/*AD; Calcium/ME; Collagen/ME; Dose-Response Relationship, Drug; Male; Osteogenesis/*DE; Proline/ME; Rats; Support, U.S. Gov't, Non-P.H.S..
.T
Chronic administration of 1,25-dihydroxyvitamin D3: increased bone but impaired mineralization.
.P
JOURNAL ARTICLE.
.W
Male Sprague-Dawley rats were infused continuously for 13 days with vehicle or 75 pmol (31.2 ng)/day 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] by means of Alzet osmotic minipumps implanted s.c. Animals infused with 1,25-(OH)2D3 exhibited mild hypercalcemia (11.2 vs. 10.2 mg/dl in controls), a 136% increase in the serum concentration of 1,25-(OH)2D3 (187 vs. 79 pg/ml), and a 59% decrease in serum 25-hydroxyvitamin D (12 vs. 29 ng/ml). The proximal tibial metaphysis of these animals was characterized by increased trabecular bone volume (15% vs. 6.5%), osteoid accumulation (4.2% vs. 0.1%), increased osteoblast surface and number (31% and 19/mm vs. 21% and 14/mm, respectively), and decreased osteoclast surface and number (11% and 2/mm vs. 36% and 6/mm, respectively). Similar but less striking changes were seen in the lumbar vertebra. Increases in the fat-free weight and calcium content of the tibia and lumbar vertebra were consistent with the increase in trabecular bone volume after 1,25-(OH)2D3 infusion. However, tetracycline labeling and the incorporation of 45Ca in these bones were reduced by 1,25-(OH)2D3 infusion. In addition, mineralization lag time was prolonged in the lumbar vertebrae of 1,25-(OH)2D3-infused rats. Our findings indicate that chronic 1,25-(OH)2D3 administration increases bone mass, but at the cost of impaired bone mineralization.
.A
Wronski TJ; Halloran BP; Bikle DD; Globus RK; Morey-Holton ER.
.I 545
.U
87053570
.S
Endocrinology 8703; 119(6):2598-605
.M
Animal; Cell-Free System; Cycloheximide/PD; Dexamethasone/*PD; Gene Expression Regulation/*DE; Isoelectric Point; Male; Molecular Weight; Rats; RNA, Messenger/*GE; Thymus Gland/*PH; Time Factors; Translation, Genetic/DE.
.T
Glucocorticoid-induced messenger ribonucleic acids in rat thymic lymphocytes: rapid primary effects specific for glucocorticoids.
.P
JOURNAL ARTICLE.
.W
We examined the mechanism underlying the rapid (15-120 min) glucocorticoid-mediated increase in the synthesis of proteins envisioned as mediators of the initial steroid effects in thymic lymphocytes. Analysis of about 1500 in vitro translation products on giant two-dimensional gels revealed rapid hormonal influences on only 7 mRNAs, 6 whose translation products have mol wt and pIs identical to those proteins whose synthesis has been found to be increased after the addition of glucocorticoids to thymus cells. The additional mRNA codes for glucocortin, whose induction in thymus as well as other target cells has been reported. mRNA inductions for proteins 1, 2, and 1N are detectable 15-30 min after the addition of dexamethasone to isolated thymus cells and continue to increase until 2 h, whereas the mRNAs for proteins 4 and 5 are not increased until after 1 h. The mRNA for protein 3 is elevated by 1 h, but attempts to quantitate the change at earlier times have failed because this protein focuses poorly. The parallel between these in vitro translation results and the increased synthesis of individual proteins seen in whole cells demonstrates that increased mRNA levels underlie the cellular changes. Other hormones, such as estradiol, testosterone, and T3, at 10(-6) M and deoxycorticosterone at 10(-8) M do not induce these messages. Partial inductions of 1 and 2, but not 1N, are seen with deoxycorticosterone at 10(-6) M, consistent with its classification as a partial glucocorticoid agonist. Cycloheximide does not block the rise in mRNA for the most rapid inductions, 1, 2, and 1N. The results indicate that dexamethasone rapidly and specifically induces 6 thymus cell mRNAs in addition to the one coding for glucocortin. The cycloheximide results suggest that at least 3 of these represent primary steroid hormone responses.
.A
Colbert RA; Young DA.
.I 546
.U
87053571
.S
Endocrinology 8703; 119(6):2606-10
.M
Animal; Female; Gene Expression Regulation; Gonadotropins, Chorionic/PD; Molecular Weight; Ovary/*PH; Peptide PHI/*GE; Rats; RNA, Messenger/GE/*ME; Support, Non-U.S. Gov't; Support, U.S. Gov't, Non-P.H.S.; Support, U.S. Gov't, P.H.S.; Vasoactive Intestinal Peptide/*GE.
.T
Detection of vasoactive intestinal peptide-encoding messenger ribonucleic acid in the rat ovaries.
.P
JOURNAL ARTICLE.
.W
Vasoactive intestinal peptide (VIP) has recently been detected in rat ovaries and has been shown to stimulate steroidogenesis by cultured rat granulosa cells. In this study we investigated whether the VIP-messenger RNA (mRNA) can be detected in the ovaries, thus suggesting local synthesis of the peptide. To study VIP-gene expression, a sensitive RNA detection assay which uses in vitro transcribed RNA probes corresponding to specific exons of the VIP gene was developed. Using this method, an approximately 2000-base RNA band containing the coding sequences for VIP was detected in rat ovaries. This RNA also contains the coding sequences for the VIP-related peptide (peptide-histidine-methionine). An identical VIP-encoding RNA was previously identified in the rat cerebral cortex. However, the VIP-mRNA quantity in the cortex was 12-fold-higher as compared to the ovaries. These results may reflect the differences in VIP concentration in the two organs. The finding of VIP-encoding mRNA in the rat ovaries suggests a local synthesis of VIP in the ovaries.
.A
Gozes I; Tsafriri A.
.I 547
.U
87053572
.S
Endocrinology 8703; 119(6):2611-22
.M
Animal; Cell Compartmentation; Cell Membrane/EN; Enzyme Activation/DE; Estradiol/*PD; Female; Hydrogen-Ion Concentration; Hypothalamo-Hypophyseal System/PH; Kinetics; Magnesium/ME; Methylation; Methyltransferases/*ME; Ovariectomy; Phosphatidylcholines/*BI; Phosphatidylethanolamines/ME; Pituitary Gland/*EN/IR; Rats; S-Adenosylmethionine/ME; Tissue Distribution.
.T
Estradiol activates methylating enzyme(s) involved in the conversion of phosphatidylethanolamine to phosphatidylcholine in rat pituitary membranes.
.P
JOURNAL ARTICLE.
.W
17 beta-Estradiol (E2) affects the sensitivity of pituitary cells to several neurohormones as LHRH, TRH, or dopamine, presumably by modulating receptor coupling mechanisms. We attempted to pinpoint the membrane processes underlying this modulation and studied the effect of E2 on pituitary membrane phospholipid methylation. Anterior pituitary membranes prepared from ovariectomized (ovx) or ovx plus E2-treated rats were assayed for phospholipid methylation. Methylated phospholipids were separated by TLC. Incorporation of [3H]methyl groups into phospholipids increased with membrane concentration and incubation time with S-adenosyl-L-methyl [3H]methionine; it was not Mg2+ dependent and was inhibited in a dose-dependent manner by S-adenosyl-L-homocysteine, methyltransferase inhibitor. pH was found to be critical. Formation of phosphatidyl-monoethanolamine, phosphatidyl-dimethylethanolamine, and phosphatidylcholine was markedly stimulated by treatment with E2. The effect increased progressively when animals were killed 15 h to 5 days after E2 implantation. The response involved a shift in the maximum velocity (Vmax) although there was no change in the available substrate for the methylating enzyme. This change in Vmax probably reflects changes in the amount of the methylating enzyme itself. Administration of 17 alpha-estradiol, an inactive stereoisomer of E2 was ineffective, pointing to a stereospecific interaction. After differential centrifugation of pituitary membranes, the highest specific methyltransferase activity was found in light mitochondrial (L) and microsomal (P) fractions and the lowest in nuclei (N) and the heavy mitochondrial (M) fractions. After sucrose density gradient centrifugation, methylated phospholipids were preferentially recovered from fractions corresponding to the endoplasmic reticulum and/or secretory granules. E2 treatment for 5 days did not modify the subcellular distribution of methyltransferase activity but stimulated it in all fractions; in contrast, it did not modify the activity of the other enzymes measured as fraction markers. Under the same experimental conditions, phospholipid methylation in membranes prepared from cortex, and anterior and mediobasal hypothalamic structures was not affected by the steroid, with the exception of a slight increment of [3H]methyl incorporation into mediobasal hypothalamic membrane phospholipids after 5 days of E2 treatment. These results indicate that E2-induced changes in pituitary responsiveness might be concomitant with selective effects of the steroid on specific membrane enzymatic activities involved in coupling mechanisms.
.A
Drouva SV; LaPlante E; Leblanc P; Bechet JJ; Clauser H; Kordon C.
.I 548
.U
87053573
.S
Endocrinology 8703; 119(6):2623-8
.M
Animal; Antibodies, Monoclonal/*IM; Antibody Specificity; Antigen-Antibody Reactions; Antigenic Determinants; Binding, Competitive; Cell Membrane/ME; In Vitro; Liver/ME; Mammae/ME; Placental Lactogen/*IM/ME; Radioligand Assay; Receptors, Prolactin/*ME; Receptors, Somatotropin/*ME; Sheep; Support, Non-U.S. Gov't.
.T
Inhibition of binding of ovine placental lactogen to growth hormone and prolactin receptors by monoclonal antibodies.
.P
JOURNAL ARTICLE.
.W
From a single cell fusion, five stable hybridomas secreting antiovine placental lactogen (oPL) antibodies were obtained. Three of these secrete immunoglobulin (Ig)G subclass, and the other two secrete IgM class antibodies. Ascites fluids were raised in mice for each clone and were used as the antibody component for the development of solid phase RIA. Three solid-phase RIAs were successfully established using individual IgG subclass monoclonal antibodies, but the IgM class antibodies were ineffective. In all three individual solid-phase RIAs, the binding of [125I]iodo-oPL to the immobilized antibody was inhibited by unlabeled oPL, but not by ovine pituitary PRL (oPRL), ovine GH (oGH), or ovine pituitary extract. Two of the IgG subclass antibodies were able to inhibit the binding of [125I] iodo-oPL to PRL receptors(s) and to GH receptor(s) in rabbit mammary gland and liver, respectively. One of these two IgG subclass antibodies was more effective at inhibiting the binding of oPL to PRL receptor(s) in rabbit mammary gland, whereas the other one is more effective in inhibiting the binding of oPL to GH receptor(s) in rabbit liver. These antibodies, however, could only weakly inhibit the binding of [125I]iodo-oPRL to rabbit mammary gland and were ineffective in inhibiting the binding of [125I]iodo-oGH to rabbit liver. The addition of monoclonal antibodies in both radioreceptor assay (RRA) for PRL (RRA-PRL) and for GH (RRA-GH) did not affect the parallelism of the displacement curve of oPL standard. Our results suggest that oPL might contain two distinct binding sequence(s): one responsible for the binding of oPL to PRL receptor(s) and the other responsible for the binding of oPL to GH receptor(s). These two binding sequences might overlap or be located adjacent to one another. The interaction of monoclonal antibodies with these binding sequences of oPL may block the binding of oPL with PRL and GH receptor(s). Alternatively, our studies suggest that the monoclonal antibodies do not bind to hormone receptor(s)-binding sequence(s) in oPL, but the interaction between oPL and monoclonal antibody might alter the conformational structure of the oPL which will consequently lead to a lower binding of oPL to PRL and GH receptor(s).
.A
Chan JS; Nie ZR; Seidah NG; Chretien M.
.I 549
.U
87053574
.S
Endocrinology 8703; 119(6):2629-34
.M
Adenyl Cyclase/*ME; Animal; Calmodulin/AI/IM/*PH; Cell Membrane/EN; Enzyme Activation/DE; In Vitro; Rats; Support, U.S. Gov't, P.H.S.; Thymus Gland/*EN; Trifluoperazine/PD; Triiodothyronine/*PD.
.T
Calmodulin mediates the stimulatory effect of 3,5,3'-triiodothyronine on adenylate cyclase activity in rat thymocyte plasma membranes.
.P
JOURNAL ARTICLE.
.W
We have previously demonstrated that T3 increases adenylate cyclase activity in rat thymocyte plasma membranes by a mechanism that is calcium dependent. In the present studies we have examined whether calmodulin participates in this response to T3. Initial experiments provided evidence that calmodulin is involved in regulating the activity of the guanyl nucleotide-dependent adenylate cyclase in this tissue. Thus, compared with findings in freshly prepared membranes, dialysis of thymocyte plasma membrane preparations for 20 h at 4 C decreased their calmodulin concentrations from an initial value of approximately 600 ng/100 micrograms protein by about 50% and decreased adenylate cyclase activity by approximately 80%. Although storage of the same preparations under comparable conditions resulted in no change in calmodulin content, it caused an approximate 30% decrease in adenylate cyclase activity. Addition of calmodulin had no effect on adenylate cyclase activity in fresh or stored membrane preparations, but produced a dose-dependent increase in enzyme activity in preparations that had been dialyzed. Further, when added to freshly isolated membranes, three calmodulin antagonists, trifluoperazine, calmidazolium, and calmodulin antibodies, all produced a concentration-dependent inhibition of adenylate cyclase activity, and this was completely reversed in all cases by the addition of high concentrations of exogenous calmodulin. The stimulation of guanyl nucleotide-dependent adenylate cyclase activity that T3 induced in fresh membrane preparations was present in membranes that had been stored, but was absent in those that had been dialyzed. In addition, the response to T3 in fresh membranes was inhibited or abolished by all three calmodulin antagonists. Both in dialyzed membranes and in the presence of antagonists, the response to T3 was restored by the addition of exogenous calmodulin. We conclude that calmodulin influences the activity of the guanyl nucleotide-dependent adenylate cyclase in rat thymocytes and ultimately mediates the stimulation of enzyme activity that T3 produces. Such mediation very likely explains the calcium-dependent nature of the stimulatory effect of T3 on thymocyte adenylate cyclase activity.
.A
Segal J; Rehder MC; Ingbar SH.
.I 550
.U
87053577
.S
Endocrinology 8703; 119(6):2649-54
.M
Amenorrhea/PP; Animal; Bone Diseases, Metabolic/*PA/PP; Bone Resorption; Dogs; Female; Hysterectomy; Menopause; Osteoblasts/*PP; Osteogenesis; Ovariectomy; Ovary/*PH; Support, Non-U.S. Gov't.
.T
Osteoblastic insufficiency is responsible for maintenance of osteopenia after loss of ovarian function in experimental beagle dogs.
.P
JOURNAL ARTICLE.
.W
Bone loss developing after cessation of ovarian function in humans represents a major health problem. To establish the value of ovariohysterectomy in female beagle dogs as a model for bone loss and to study static and dynamic parameters of bone associated with the negative bone balance occurring after cessation of ovarian function, we performed iliac crest bone biopsies before and 4 months after ovariohysterectomy in eight beagle dogs and in five sham-operated controls. Cessation of ovarian function was documented by an increase in serum levels of LH 4 weeks after ovariohysterectomy. There was no change in serum calcium, phosphorus, and creatinine during the 4 months of the study. Cancellous bone mass and trabecular mean wall thickness decreased significantly after ovariohysterectomy (P less than 0.01). In addition, the number of osteoblasts was increased and the bone formation rate per osteoblast, that is, the activity of bone-forming cells, was decreased (P less than 0.01). Parameters of bone resorption were not significantly altered in the animals with ovariohysterectomy. No changes in histomorphometric parameters of bone structure, formation or resorption were observed in the sham-operated controls. These data indicate that ovariohysterectomy in beagle dogs may serve as a useful model for bone loss associated with cessation of ovarian function. Osteoblastic insufficiency appears to play a major role in the maintenance of bone loss occurring after ovariohysterectomy in beagle dogs.
.A
Malluche HH; Faugere MC; Rush M; Friedler R.
.I 551
.U
87053578
.S
Endocrinology 8703; 119(6):2655-60
.M
Age Factors; Animal; Body Weight; Female; Male; Rats; Rats, Mutant Strains; Receptors, Androgen/*PH; Sex Factors; Somatotropin/*SE; Support, U.S. Gov't, P.H.S.; Testicular Feminization/*PP.
.T
Growth hormone-secretory patterns in androgen-resistant (testicular feminized) rats.
.P
JOURNAL ARTICLE.
.W
To investigate the role of androgen receptors in the expression of the male GH-secretory pattern in adult rats, the GH-secretory patterns in androgen-resistant (testicular feminized) rats were compared with their normal male and female littermates. All animals were prepared with intraatrial Silastic catheters and bled every 15 min for 8 h (0800-1600 h). Normal male littermates displayed a characteristic low frequency, high amplitude pattern of GH secretion with bursts of GH occurring every 2.5-3 h and separated by prolonged trough periods where GH values remained low or undetectable (less than 5 ng/ml) for 45-90 min. Normal female littermates showed a characteristic high frequency, low amplitude pattern of GH secretion with pulses of GH occurring every hour. Compared to normal male littermates, females had lower individual GH peak amplitudes and shortened GH-trough periods which contain higher GH levels. GH-secretory profiles displayed by testicular-feminized animals qualitatively and quantitatively resembled those of the normal female littermates. These data suggest that androgen receptors are necessary for the expression of masculine GH-secretory patterns.
.A
Millard WJ; Politch JA; Martin JB; Fox TO.
.I 552
.U
87053579
.S
Endocrinology 8703; 119(6):2661-9
.M
Age Factors; Animal; Bromocriptine/PD; Dopamine/*PH; Dose-Response Relationship, Drug; Estradiol/PD; Estrogen Antagonists/*PD; Estrogens/*PH; Female; Hypothalamus, Middle/*DE; Pituitary Gland, Anterior/*DE; Prolactin/*PH; Rats; Receptors, Estrogen/DE; Support, U.S. Gov't, P.H.S..
.T
Antiestrogen action in the medial basal hypothalamus and pituitary of immature female rats: insights concerning relationships among estrogen, dopamine, and prolactin.
.P
JOURNAL ARTICLE.
.W
We have examined the effects of nonsteroidal antiestrogens (AEs) and estradiol (E) on dopamine (DA) levels and turnover rates in the medial basal hypothalamus (MBH) and on serum and pituitary PRL to gain insight into DA-PRL-E/AE interrelationships. In 21-day-old female rats, E was found to increase MBH DA levels and turnover and serum PRL concentrations in a time- and concentration-dependent manner. Changes were observed by 1 day, and after 3 days of E treatment (1 microgram/day), MBH DA levels increased 2-fold (to 1300 pg/mg tissue), and DA turnover rates increased 5-fold (to 1170 pg/mg tissue . h). The AEs tamoxifen, monohydroxytamoxifen, CI628, and LY117018 (50 micrograms/day for 3 days) weakly stimulated uterine weight gain and significantly suppressed the uterotropic action of E. The AEs LY117018, monohydroxytamoxifen, CI628, and tamoxifen competed with E for binding to the MBH estrogen receptor and displayed relative binding affinities of 190%, 185%, 6.7%, and 1.4%, with E set at 100%; these affinities are similar to those found for uterine estrogen receptors. The AEs increased DA turnover rates only 2-fold, and they antagonized the E-induced 5-fold increase in DA turnover rates very successfully. In animals treated with bromocriptine, E and AE failed to increase the low serum PRL levels, yet they evoked significant (approximately 2-fold) increases in DA turnover rates and nearly 2-fold increases in MBH DA content. Hence, a part of the actions of E and AE on MBH DA appears to be exerted independently of changes in circulating PRL and may occur by direct action of these compounds on the estrogen receptor system present in the MBH. In addition, these studies reveal that AEs behave as partial estrogen agonists/antagonists in terms of their effects on MBH DA turnover.
.A
Toney TW; Katzenellenbogen BS.
.I 553
.U
87053586
.S
Endocrinology 8703; 119(6):2720-7
.M
Animal; Glycoproteins/ME; Hypothyroidism/*ME; Kidney/ME; Liver/ME; Male; Metabolic Clearance Rate; Pituitary Gland/*ME; Rats; Structure-Activity Relationship; Thyroid Gland/ME; Thyrotropin/BL/*ME; Tissue Distribution.
.T
Differences in the metabolic clearance of pituitary and serum thyrotropin (TSH) derived from euthyroid and hypothyroid rats: effects of chemical deglycosylation of pituitary TSH.
.P
JOURNAL ARTICLE.
.W
We compared the MCR, volume of distribution, and rapid phase (rt1/2) and slow phase half-lives of purified pituitary rat (r) TSH, TSH from crude pituitary extracts of normal and hypothyroid rats, TSH from hypothyroid rat sera, and TSH secreted from hypothyroid rat pituitaries incubated in vitro. For 3 h after iv bolus injection into euthyroid rats, 125I-labeled rTSH was determined by acid precipitation in serum and various organs, and unlabeled TSH was measured by RIA. The MCR of TSH from normal pituitary extracts (0.53 +/- 0.02 ml/min) was similar to that of unlabeled purified rTSH (0.52 +/- 0.03), while those from hypothyroid pituitary extracts (0.32 +/- 0.03) and hypothyroid sera (0.33 +/- 0.01) were decreased. The reduced MCR of TSH from hypothyroid pituitaries was due to a decreased distribution volume (8.4 +/- 0.6 ml) compared to that from normal pituitaries (11.4 +/- 0.7) and hypothyroid sera (10.9 +/- 0.8). The decreased MCR of circulating TSH from hypothyroid sera reflected an increase in its rt1/2 (12.6 +/- 0.5 min) vs. that from both normal (5.1 +/- 0.5) and hypothyroid (5.7 +/- 0.4) pituitaries. The rt1/2 of secreted TSH from incubated hypothyroid rat pituitaries (8.5 +/- 0.9) was intermediate between those of circulating and pituitary forms of hypothyroid rTSH. The clearances of intact bovine TSH (bTSH) and deglycosylated bTSH (dg-bTSH) were compared. The dg-bTSH MCR was found to be increased (0.71 +/- 0.02 ml/min) compared to that of bTSH (0.59 +/- 0.02), primarily due to a decreased rt1/2 for dg-bTSH (3.8 +/- 0.1 min) vs. bTSH (4.7 +/- 0.2). Uptake of purified [125I]rTSH was highest in the kidney at all times, varying from 43% of the injected dose at 5 min to 54% at 180 min. We conclude that in the euthyroid rat, 1) the metabolic clearance of TSH differs between pituitary and serum forms and appears to depend on specific molecular features that vary with the physiological state of the animal from which the TSH is derived; 2) since chemical deglycosylation increased the clearance of TSH, we speculate that the chemical basis for changes in TSH clearance may be related to alterations in its carbohydrate structure; and 3) for normal pituitary TSH, the kidney is the major organ of clearance.
.A
Constant RB; Weintraub BD.
.I 554
.U
87053589
.S
Endocrinology 8703; 119(6):2744-54
.M
Animal; Brain/*DE; Brain Mapping; Diencephalon/PH; Estradiol/*PD; Female; Hamsters; Hypothalamus, Middle/PH; Laterality; Mesencephalon/PH; Ovariectomy; Progesterone/*PD; Sex Behavior, Animal/*DE; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Intracranial sites regulating the biphasic action of progesterone in estrogen-primed golden hamsters.
.P
JOURNAL ARTICLE.
.W
Diencephalic and mesencephalic neural sites regulating the biphasic effect of progesterone (P) were investigated using the hormone implantation technique in ovariectomized female golden hamsters primed with estrogen. Double barreled cannulae were implanted unilaterally and bilaterally in the medial preoptic area, anterior hypothalamus, ventromedial hypothalamus (VMH), central gray, or interpeduncular nucleus. Testing was conducted using a sequential paradigm; facilitation tests commenced after 44 h of estrogen priming. P-filled cannulae placed in the VMH region facilitated lordosis behavior in 42% and 60% of unilaterally and bilaterally implanted females, respectively. In the anterior hypothalamus, only P implants adjacent to the VMH area effectively promoted receptivity. Lordosis behavior was also observed in 20-36% of females with P implants in the medial preoptic area. P implants in central gray and interpeduncular nucleus regions had no significant facilitating effect on sexual behavior. Tests for inhibition occurred 24 h after facilitation testing and consisted of a pretest, followed by systemic P administration and a behavioral test 4-5 h later. During the pretest for inhibition, females that were receptive in the facilitation test attacked males more rapidly than previously nonreceptive animals and showed decrements in lordosis scores after systemic P delivery. This biphasic effect of P completely inhibited receptivity among several animals in the VMH group. Additional experiments, however, investigating the biphasic effect of P implants in the VMH suggested that the occurrence of copulation in the facilitation test may have been involved in mediating the subsequent increase in aggressive behavior and the suppression of sexual responsiveness in the inhibition test. Nevertheless, a final experiment showed that when P was implanted sequentially in the VMH, facilitation and, more importantly, a later reduction in lordosis behavioral scores occurred even when copulation was eliminated in the facilitation test. P implants in mesencephalic regions exerted no significant inhibitory effect on receptivity. These findings demonstrate that the biphasic action of P in the female hamster is regulated by nerve cells located in the diencephalon, especially in the VMH region.
.A
Takahashi LK; Lisk RD.
.I 555
.U
87053590
.S
Endocrinology 8703; 119(6):2755-61
.M
Animal; Antimycin A/AA/PD; Bacitracin/PD; Biological Transport, Active; Cadaverine/AA/PD; Endocytosis/DE; In Vitro; Male; Muscles/*ME; Oligomycins/PD; Rats; Temperature; Triiodothyronine/*ME.
.T
Energy-dependent uptake of 3,5,3'-triiodo-L-thyronine in rat skeletal muscle.
.P
JOURNAL ARTICLE.
.W
The uptake of [125I]T3 in rat skeletal muscle was investigated by incubating intact soleus muscles with a tracer amount of [125I]T3. At 37 C [125I]T3 uptake increased asymptotically; at 60 min the muscle contained 10% of the total [125I]T3 or 0.238 +/- 0.021% per mg wet tissue. At 0 C the [125I]T3 uptake was 1/5 of that at 37 C. The specific [125I]T3 uptake, determined by subtracting the uptake in the presence of 10 microM unlabeled T3 from the total [125I]T3 uptake, attained a plateau after 60 min. Washout experiments, done by first incubating the muscle for 60 min at 37 C or 0 C with [125I]T3 and then at 0 C for 3 h with unlabeled T3, showed that 21 +/- 2% or 58 +/- 4% of the radioactivity, respectively, was released, indicating an intracellular location of the hormone after incubation at 37 C. Addition of increasing concentrations of L-T3, D-T3 and L-T4 caused a progressive inhibition of the [125I]T3 uptake; the 50% inhibitory concentrations being 400 nM, 7 microM, and more than 15 microM, respectively. Preincubation of soleus muscles with metabolic inhibitors almost completely inhibited [125I]T3 specific uptake, with oligomycin and antimycin causing 98 +/- 4% and 81 +/- 3% reduction, respectively. Monodansylcadaverine and bacitracin, inhibitors of receptor-mediated endocytosis, reduced the specific [125I]T3 uptake in a dose-dependent manner up to 67 +/- 3% and 62 +/- 2%, respectively. These results indicate the presence of a saturable, stereospecific, and energy-dependent process responsible, at least in part, for T3 uptake in rat skeletal muscle. This specific T3 uptake may be a receptor-mediated endocytosis process.
.A
Pontecorvi A; Robbins J.
.I 556
.U
87053592
.S
Endocrinology 8703; 119(6):2768-72
.M
Animal; Cells, Cultured; Estradiol/*PD; Female; Pituitary Gland, Anterior/*DE; Prolactin/*SE; Rats; Receptors, Angiotensin/*DE.
.T
Effects of 17 beta-estradiol on angiotensin II receptors and prolactin release in cultured pituitary cells.
.P
JOURNAL ARTICLE.
.W
Angiotensin II (AII) binds to specific receptors in the lactotroph and stimulates PRL secretion from isolated rat pituitary cells. Since estrogens exert major regulatory actions on PRL secretion, the effects of estradiol (E2) on pituitary AII receptors and PRL responses were studied in vivo and in cultured rat anterior pituitary cells. In female rats, treatment with E2-containing Silastic capsules for 4 days caused a significant increase in PRA from 1.3 to 3 ng/ml X min and a 38% decrease in the binding of [125I]AII to anterior pituitary membrane-rich fractions (P less than 0.01). In vitro studies showed that treatment of cultured anterior pituitary cells with 1 nM E2 for 4 days caused a 57 +/- 6% decrease in AII receptor concentration with no change in binding affinity. Reduction of AII receptors by E2 in 4-day cultures was dose dependent and was demonstrable with E2 concentrations that occur in plasma during the estrous cycle (0.01-1 nM). The decrease in AII receptors in cells incubated with 1 nM E2 was near maximum after 24 h of culture, and results were similar when receptor concentrations were calculated per unit protein or per cell. Despite the substantial decrease in AII receptors, E2 treatment did not specifically decrease the responsiveness of the pituitary cells to AII stimulation. Thus, PRL responses to AII (10 nM) or TRH (100 nM) were unchanged after 1 day of E2 treatment and were increased after 4 days of treatment. These findings demonstrate that E2 has a direct inhibitory action on expression of pituitary AII receptors that is not accompanied by a decrease in AII-stimulated PRL secretion. In the rat pituitary, estrogen modulation of postreceptor events is the predominant determinant of lactotroph responsiveness during stimulation of PRL release by AII.
.A
Platia MP; Catt KJ; Aguilera G.
.I 557
.U
87053593
.S
Endocrinology 8703; 119(6):2773-82
.M
Ammonium Chloride/PD; Antibodies, Monoclonal/DU; Breast Neoplasms/*PP/SE; Cell Compartmentation; Estradiol/*PD; Estrogen Antagonists/PD; Female; Gene Expression Regulation/DE; Glycosylation; Human; Leupeptins/PD; Molecular Weight; Monensin/PD; Neoplasm Proteins/*PH/SE; Protein Processing, Post-Translational/DE; Support, Non-U.S. Gov't.
.T
Processing and estrogen regulation of the 52-kilodalton protein inside MCF7 breast cancer cells.
.P
JOURNAL ARTICLE.
.W
A 52K glycoprotein is secreted by human breast cancer cells in culture after estrogen stimulation. Using monoclonal antibodies, we have quantitated and characterized the corresponding proteins of the cell compartment. Using pulse-chase experiments, we have shown that about 40% of the 52K protein is secreted, the majority being successively processed into a 48K and a 34K protein. This last protein is very stable. The processing is inhibited by lysosomotropic agents and leupeptin, suggesting that it occurs in acidic vesicles, such as lysosomes or endosomes. Estradiol increased the intracellular level of immunoreactive 52K related proteins by 4-fold. Its effect is, however, more obvious in the medium, since there is a constitutive level in the cell. The stimulatory effects of estradiol on [3H]mannose and [35S]methionine incorporation into these proteins were similar and the endoglycosydase H sensitivity of the proteins was not altered, suggesting that estradiol did not modulate the glycosylation step. Antiestrogens did not stimulate synthesis and glycosylation of the 52K related proteins. Estradiol also increased the stability of the 52K precursor as well as that of total proteins. We conclude that the secreted 52K protein is the precursor of two cellular proteins of 48K and 34K. Estradiol stimulates both the intracellular accumulation of these proteins and the secretion of the precursor.
.A
Morisset M; Capony F; Rochefort H.
.I 558
.U
87053596
.S
Endocrinology 8703; 119(6):2803-8
.M
Adenosine Triphosphatase, Calcium/*ME; Animal; Cell Membrane/EN; Enzyme Activation/DE; Female; Male; Rabbits; Reticulocytes/EN; Steroids/*PD; Structure-Activity Relationship; Support, U.S. Gov't, Non-P.H.S.; Support, U.S. Gov't, P.H.S.; Thyroxine/*PD.
.T
Structure-activity relationships of sex steroid analogs determined in vitro in a thyroid hormone-responsive membrane Ca2+-ATPase model.
.P
JOURNAL ARTICLE.
.W
Physiological concentrations of L-T4 were found previously to stimulate Ca2+-ATPase activity in vitro in reticulocyte membranes from female rabbits and to inhibit this enzyme in reticulocyte membranes from males. In these previous studies, preincubation of intact cells or ghosts with testosterone (5 X 10(-11) M) converted female-source reticulocyte membranes to male-type responsiveness to thyroid hormone (inhibition of Ca2+-ATPase activity). Preincubation of reticulocyte membranes with 17 beta-estradiol (5 X 10(-11) M) converted male-source membranes to female-type responsiveness (stimulation by L-T4 of membrane Ca2+-ATPase activity). Using this sex steroid-sensitive thyroid hormone-dependent membrane enzyme system, we investigated the structure-activity relationships of analogs of sex steroids and unrelated steroids. 5 beta-Androstanes were active compared to testosterone in assays using female-source membranes, while 5 alpha-androstanes were less active. Within the 5 beta-androstanes, activity was dependent on at least one hydroxyl group at the C3- or C17-position. Nongonadal steroids tested were less active, establishing specificity of the sex steroid effect in assays using female-source membranes. Assayed in male-source membranes, estrone and 3-hydroxy-1,3,5-(10)7-estratraen-17-one (equilin) were active compared for estrogen effect with 17 beta-estradiol, while estriol was less active. The activities of hydrocortisone and aldosterone were 76% and 71%, respectively, in this system. These structure-activity relationships are distinct from those described for gonadal steroid-cytoplasmic binding proteins or nuclear interactions, and represent a novel sex steroid-thyroid hormone effect on activity of a membrane enzyme.
.A
Lawrence WD; Osawa YM; Davis PJ; Blas SD.
.I 559
.U
87053600
.S
Endocrinology 8703; 119(6):2840-7
.M
Adenosine Cyclic Monophosphate/*PH; Animal; Calcium/*PH; Cells, Cultured; Endorphins/ME; Gene Expression Regulation; Immunoassay; Male; Pituitary Gland/*PH; Pituitary Gland, Anterior/PH; Pro-Opiomelanocortin/*GE; Rats; RNA, Messenger/GE; Support, Non-U.S. Gov't; Time Factors.
.T
Calcium ion and cyclic adenosine 3',5'-monophosphate regulate proopiomelanocortin messenger ribonucleic acid levels in rat intermediate and anterior pituitary lobes.
.P
JOURNAL ARTICLE.
.W
The role of the second messengers cAMP and Ca++ in the control of proopiomelanocortin (POMC) gene expression was investigated with the use of hybridization with cloned complementary DNA probes. The effects of cAMP-related drugs on POMC messenger RNA (mRNA) levels were assessed in primary cultures of intermediate (IL) and anterior rat pituitary cells maintained in serum-free medium. 8-Bromo-cAMP (1 mM), but not 8-bromo-cGMP (1 mM), induced a 2-fold increase in IL and anterior lobe cell after 2 days of treatment. A similar increase was obtained with the adenylate cyclase-activating drugs forskolin (1 microM) and cholera toxin (100 ng/ml) or the phosphodiesterase inhibitor RO 20-1724 (100 microM). At 48 h, all these treatments had increased beta-endorphin accumulation in the medium and transiently decreased the cellular beta-endorphin content in IL cells, suggesting a parallel effect of cAMP-related drugs on secretion and biosynthesis. Incubating the cells with the Ca++ channel antagonists D600 (50 microM), verapamil (50 microM), and the dihydropyridine nifedipine (0.1 microM) decreased basal POMC mRNA levels, whereas the dihydropyridine BAYK 8644 (0.1 microM), which activates the Ca++ channel, increased POMC mRNA levels after 2 days. In addition, nifedipine decreased the stimulatory effect of forskolin, whereas BAYK 8644 further stimulated the forskolin-increased POMC mRNA levels in IL cells. We conclude that both Ca++ and cAMP may regulate the gene expression of POMC.
.A
Loeffler JP; Kley N; Pittius CW; Hollt V.
.I 560
.U
87053601
.S
Endocrinology 8703; 119(6):2848-55
.M
Animal; Calcium/*PH; Cobalt/PD; Fishes/*PH; Gallopamil/PD; Ion Channels/PH; Osmolar Concentration; Pituitary Gland/*SE; Potassium/PD; Prolactin/*SE; Secretory Rate/DE; Support, U.S. Gov't, Non-P.H.S..
.T
The role of calcium in prolactin release from the pituitary of a teleost fish in vitro.
.P
JOURNAL ARTICLE.
.W
The release of PRL from the pituitary of a teleost fish, the tilapia (Oreochromis mossambicus), has been previously shown to be dependent on calcium. However, the source(s) and specific action(s) of calcium in the secretory process have not been identified. Also undefined are the mechanisms by which regulators of PRL cell function may alter calcium distribution. In the present investigation, the elevation of medium K+ concentration during static incubations to a depolarizing concentration (56 mM) produced no change in cumulative PRL release over control levels during the 18-20 h of incubation. During perifusion incubation, exposure to high K+ concentrations briefly stimulated (less than or equal to 10 min) and then depressed PRL release. In contrast, reduced medium osmotic pressure elicited a rapid elevation in PRL release that was sustained for 2 h or more. D600, a calcium entry blocker, at 10(-5) M diminished the K+-induced pulses of PRL release. The same concentration, however, did not alter the release of PRL evoked by reduced osmotic pressure. In contrast, CoCl2, which blocks a range of calcium-mediated processes in addition to calcium influx, suppressed PRL release during perifusion and static incubations in hyposmotic medium. These findings suggest that while PRL secretion from the tilapia pituitary is calcium dependent, calcium entry through voltage-regulated plasmalemma channels may not be a prerequisite to the actions of reduced osmotic pressure.
.A
Grau EG; Shimoda SK; Ford CA; Helms LM; Cooke IM; Pang PK.
.I 561
.U
87053603
.S
Endocrinology 8703; 119(6):2861-3
.M
Animal; Female; Hamsters/*PH; Light; Maternal-Fetal Exchange; Melatonin/*PH; Periodicity/*; Pineal Body/*PH; Pregnancy; Reproduction; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Maternal melatonin communicates daylength to the fetus in Djungarian hamsters.
.P
JOURNAL ARTICLE.
.W
Daylength (photoperiod) influences the rate of reproductive development in the juveniles of some photoperiodic species. Recent studies show that daylength during the prenatal period is perceived by the fetus and that this perception can profoundly influence postnatal reproductive and somatic development. Using the photoperiodic Djungarian hamster, we assessed the role of the maternal pineal gland and its hormone, melatonin, in this prenatal perception of daylength. Maternal pinealectomy eliminated the influence of prenatal photoperiod on testicular and body weights of male pups, suggesting that a product from the maternal pineal gland communicates daylength to the fetus. Infusion of the pineal hormone melatonin into pinealectomized dams for various durations during gestation mimicked the effect of varying the prenatal photoperiod on both testicular and body weights. These results indicate that pineal melatonin is involved in this novel form of communication from mother to fetus.
.A
Weaver DR; Reppert SM.
.I 562
.U
87053604
.S
Endocrinology 8703; 119(6):2864-6
.M
Animal; Calcitriol/*PD; Cattle; Gene Expression Regulation/DE; In Vitro; Parathyroid Glands/*PH; Parathyroid Hormones/*GE; Protein Precursors/*GE; RNA, Messenger/ME; Support, U.S. Gov't, P.H.S.; Transcription, Genetic/DE.
.T
Suppression by 1,25(OH)2D3 of transcription of the pre-proparathyroid hormone gene.
.P
JOURNAL ARTICLE.
.W
When bovine parathyroid cells in culture are exposed to the active vitamin D metabolite 1,25(OH)2D3, a significant decrease in the steady-state levels of pre-proparathyroid hormone (pre-proPTH) mRNA occurs. The possibility that the fall in specific mRNA is due to a decrease in rate of transcription of the PTH gene was examined in this study. In the presence of 1,25(OH)2D3, there was a rapid and steady decline in PTH gene transcription rate which fell to a minimum of 10-15% of control at 24 h. The effect was observed at physiological levels (10(-11)M) and was also fully reversible.
.A
Russell J; Lettieri D; Sherwood LM.
.I 563
.U
87053605
.S
Endocrinology 8703; 119(6):2867-9
.M
Animal; Biological Assay; Caseins/BI; Cells, Cultured; Immunoassay; Pituitary Gland, Anterior/*CY/SE; Prolactin/*AN/IM/SE; Rats; Structure-Activity Relationship.
.T
A novel bioassay for lactogenic activity: demonstration that prolactin cells differ from one another in bio- and immuno-potencies of secreted hormone.
.P
JOURNAL ARTICLE.
.W
A reverse hemolytic plaque assay for detecting casein release from individual mammary cells in culture was developed as a bioassay for PRL. Treatment with rat PRL caused dose-related increases in the percentage of mammary cells that released casein and the average size of casein plaques that formed. The assay exhibited exquisite sensitivity (156 fg rat PRL per assay slide) and could be used to evaluate the biopotency of PRL released from individual cells. By combining this "plaque bioassay" with a standard plaque assay for measuring the secretion of immunoreactive PRL, it was possible to compare the bio- and immuno-potencies of hormone released from the same pituitary cells. The results of three separate studies revealed major differences among PRL secretors in these potency estimates. Given the existence of PRL variants with different biological and immunological efficacies, these findings suggest that PRL cells differ from one another in the molecular form(s) of hormone released.
.A
Frawley LS; Clark CL; Schoderbek WE; Hoeffler JP; Boockfor FR.
.I 564
.U
87053606
.S
Endocrinology 8703; 120(1):1-9
.M
Animal; Cell Membrane/AN; Cross Reactions; Liver/*PH; Molecular Weight; Rats; Receptors, Insulin/IM/*IP; Species Specificity; Tissue Distribution.
.T
Purification and immunological characterization of the rat liver insulin-like growth factor-II receptor.
.P
JOURNAL ARTICLE.
.W
Rat liver microsomal insulin-like growth factor-II (IGF-II) receptor has been purified to homogeneity using a single step affinity chromatographic procedure on agarose-IGF-II with elution at pH 4. Determined by either IGF-II binding or a direct RIA for receptor, purification of 2000-fold was obtained. The mean recovery was 28% for five such preparations. Sodium dodecyl sulfate-electrophoresis and autoradiography of purified receptor, radioiodinated receptor, and affinity-