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Biomedical subjects

A Guttman

Publications and source records attributed to A Guttman.

68 records · Page 4Linked to original sources
PubMed1992

DuoDERM hydroactive dressing versus silver sulphadiazine/Bactigras in the emergency treatment of partial skin thickness burns.

The study compared DuoDERM Burn Pack Hydroactive Dressings (DHD) with silver sulphadiazine/Bactigras dressings (SSD/Bactigras) in the outpatient management of small partial skin thickness burns. Forty-eight patients were entered into the study, and randomly allocated into either the DHD or SSD/Bactigras group. Burn wounds were followed until complete re-epithelialization occurred. There were no statistical differences between the groups, either with respect to their composition or characteristics of healing in days, and patients' subjective responses to treatment. However, application was easier in the DHD group (93 per cent), compared with 71 per cent in the SSD/Bactigras group (P = 0.0009), and the SSD/Bactigras were easier to remove (96 per cent) versus DHD (66 per cent, P = 0.0004). Furthermore, the DHD group had significantly less dressing changes; a mean of three changes per subject in the DHD group compared with eight in the SSD/Bactigras group (P = 0.117). Two burn wounds became infected in the DHD group, and one in the SSD/Bactigras group. In this study both modalities were found to be equally suitable and effective for small partial skin thickness burns.

Adolescent↗
PubMed1992

Effect of operating variables on the separation of DNA molecules by capillary polyacrylamide gel electrophoresis.

The influence of operating conditions on the separation of double stranded DNA molecules in capillary polyacrylamide gel electrophoresis is presented in continuation of previous work. In this study, an equation was derived that relates the effects of electrophoresis variables such as gel concentration, field strength, molecular weight and temperature to the migration velocity. As a model system, phage phi X174 DNA restriction fragments obtained by digestion with HaeIII have been examined. As an illustration of optimized conditions, DNA molecules up to the 10(3) base pair range were separated at high temperature (50 degrees C) in less than 6 min and with efficiencies as high as 5000 plates m-1 s-1.

Bacteriophage phi X 174↗
PubMed1991

Capillary gel affinity electrophoresis of DNA fragments.

The incorporation of an affinity ligand within a polyacrylamide gel provides a general means of manipulating the selectivity of capillary gel electrophoresis separations. As an example of this approach, high resolution of DNA restriction fragments by capillary gel affinity electrophoresis has been achieved by adding a soluble intercalating agent, ethidium bromide, to the gel-buffer system. A migration model has been developed that can be used for selectivity optimization. Various parameters, such as ligand concentration and applied electric field, have been examined in terms of their influence on retention and selectivity of different-size DNA molecules. From this study, high-resolution separations have been developed with efficiencies as high as 10(7) theoretical plates per meter.

Chromatography, Affinity↗
PubMed1990

Vaginal evisceration.

A case of spontaneous vaginal evisceration is presented. Predisposing causes are the postmenopausal atrophic vagina, previous vaginal surgery, and the presence of an enterocele. Successful outcome is dependent on early recognition and surgical management.

Aged↗
PubMed1989

High-performance capillary electrophoresis in the biological sciences.

High-performance capillary electrophoresis (HPCE), the instrumental approach to electrophoresis, is a method undergoing rapid development at the present time. There is a high expectation that HPCE will become a widely applicable tool within the biochemical community. This review presents principles and instrumentation followed by typical applications of HPCE in the biological area. In the instrumentation area, particular attention is paid to current and future detectors, including laser-induced fluorescence and HPCE-mass spectrometry. In the applications section, both peptide or protein and oligonucleotide high-resolution separations are described for open-tube and polyacrylamide gel capillary columns. The use of isoelectric focusing and electrokinetic chromatography to manipulate separation is also presented. Future directions of methodology are suggested, and it is predicted that in the next few years HPCE will become a complementary tool to liquid chromatography and slab gel electrophoresis.

Biochemical Phenomena↗
PubMed1989

Variation in the effects of mononuclear cell products from different individuals on metalloproteinase secretion from human articular cartilage.

Human articular cartilage in organ culture shows a variable degree of endogenous metalloproteinase secretion depending on the individual from whom it was obtained. Cartilage with low endogenous levels are stimulated by interleukin 1 (IL-1) to levels comparable to the high endogenous group. Total blood mononuclear cell products obtained from different individuals either behave in a manner similar to that seen with IL-1, which results in sustained high levels of enzyme secretion, or show an initial stimulation followed by a subsequent dropoff in enzyme secretion even though incubation is continued in the presence of mononuclear cell products. The factor(s) causing this dropoff can be distinguished from IL-1. Production and regulation of such factors may reflect a mechanism whereby the action of IL-1 can be controlled during the inflammatory response.

Adult↗
PubMed1988

Rapid separation and purification of oligonucleotides by high-performance capillary gel electrophoresis.

Picomole amounts of oligodeoxynucleotides [polydeoxyadenylic acids, (dA)40-60] were baseline resolved and analyzed in less than 8 min by high-performance capillary electrophoresis with polyacrylamide gels. In addition, fast analysis of a crude 70-mer oligodeoxynucleotide and a slab gel-purified 99-mer oligodeoxynucleotide was accomplished, demonstrating the ability of high-performance capillary electrophoresis to characterize rapidly synthesized oligonucleotides. Besides analytical separations, 800 ng of a primer (20-mer) was isolated in less than 20 min. The purified species was collected in water and subsequently used as a probe in a standard dot-blot analysis. The use of high-performance capillary electrophoresis for the analysis and purification of a variety of biopolymers is simple, rapid, and has the potential for automation.

Electrophoresis↗
PubMed1987

The role of mononuclear cell products as modulators of cartilage degradation.

Human articular cartilage cultured in the presence of interleukin 1 (IL-1) produced from activated peripheral blood mononuclear cells, exhibits the concomitant release of a latent metalloproteinase and fragments of proteoglycan. The manner in which the activated form of the metalloproteinase degrades proteoglycan subunit and link protein suggests a role for this enzyme in cartilage degradation in vivo. While cartilage cultured in the continuous presence of purified IL-1 shows sustained release of metalloproteinase, tissue cultured in the presence of the total products released by activated mononuclear cells from some individuals showed initial stimulation followed by a decline, suggesting the presence of a modulator of IL-1 action.

Cartilage, Articular↗
PubMed1980

Structural changes in the perfused canine kidney exposed to the direct action of endotoxin.

We attempted to clarify whether structural damage or hemodynamic alterations is the primary cause of renal failure in the initial phases of endotoxic shock. Endotoxin (0.5 mg/kg) was infused directly into the renal artery and normal renal hemodynamics were maintained by cross-perfusion and controlled pressure. Direct exposure of renal parenchyma to endotoxin action was followed by changes in structure at the cellular and subcellular levels. The damage was unequally distributed and involved mainly the mitochondria and lysosomes of the distal and proximal convoluted tubules. No significant structural changes could be detected in the glomeruli or in the vascular compartment. There was no direct relationship between the degree of mitochondrial and lysosomal damage and the changes in enzymatic activity. The enzymatic systems associated with active Na transport and glycogen breakdown showed only slight alterations, while those related to energy production, hydrogen transfer and the respiratory activity of the cell were severely affected. These results indicate that structural damage in the nephron may contribute to the renal failure in the initial phase of endotoxemia.

Acid Phosphatase↗
PubMedDate not supplied

Fiberoptic intubation in the emergency department: a case series.

A prospective descriptive study was conducted to evaluate the feasibility of using fiberoptic bronchoscopy to replace blind nasotracheal intubation. The study was performed from November 1989 to August 1991 at a university teaching tertiary care hospital. Intubations were performed by three senior emergency physicians with no prior clinical experience in emergency fiberoptic intubation. Training in fiberoptic intubation was carried out on anesthetized patients, intubation manikins, and cadavers. All patients coming to the emergency department who would have been intubated in the blind nasotracheal manner were eligible for fiberoptic intubation, except for apneic patients and those intubated by residents learning other techniques. An independent observer collected the data. Forty-two patients were entered into the study, 22 males and 20 females, with an average age of 64 years. The success rate was 72% (30/42), with one of the investigators performing most of the intubations (22, 52%). His success rate was 82%. The other two investigators' success rates were 64% and 56%. Most failures were ascribed to coping with secretions. In conclusion, intubation with the fiberoptic bronchoscope can be a useful alternative to blind nasotracheal intubation. Success with this technique is dependent on the airway being free of secretions and blood.

Aged↗
PubMedDate not supplied

Emergency department use and misuse.

We conducted a 14-day survey of the emergency department (ED) at a university tertiary care teaching hospital to examine appropriate and inappropriate use of the ED. The results are based on a convenience sample of 849 patients, selected to represent a 1-week period. Three categories (CAT) of patients were defined. CAT I: patients had a medical condition that could only be assessed in the ED. CAT II: patients had a medical condition that required evaluation either in the ED or elsewhere within 6 hours of triage. CAT III: patients could wait to be evaluated 6 or more hours from time of triage. Patients in CAT II were matched with outpatient facilities (OPF), based on the time of presentation, the presenting complaint, investigative tests, and treatments required. Overall, it was found that 69% of the patients were appropriate users and could have been seen only in the ED. Fifteen percent of the patients were classified as inappropriate users and should have been seen at an OPF. The remaining 15.8% represented "gray zone" cases. An interview conducted on a subset of ambulatory patients revealed the main reasons for choosing to visit the ED were lack of awareness of other facilities, perceived seriousness of condition, trust in the ED staff, or proximity of the ED. It was concluded that misusers represent a small portion of our ED caseload.

Adolescent↗
PubMedDate not supplied

The prognostic significance of moderate hyperamylasemia in the evaluation of the emergency department patient.

Hyperamylasemia of greater than five times the upper limit of the normal range (200 IU/L) is highly specific for the diagnosis of pancreatitis, but the meaning of lower values is unclear. The purpose of this study was to evaluate the prognostic significance of amylase values > 200 and < 1000 IU/L. A controlled historical cohort study was conducted to determine whether moderate hyperamylasemia is associated with an increased severity of outcome compared to patients with normal amylase values. Subjects met certain inclusion criteria and had a serum amylase of > 200 and < 1000 IU/L (normal < 200 IU/L). The case group consisted of 44 patients (medium serum amylase = 307.5 IU/L) and resembled the control group of 77 patients (median serum amylase = 117.5 IU/L) with regard to sex distribution and presenting complaint. However, the case group was older, was on more medications, and had a shorter duration of symptoms prior to the ED visit (< 72 h). Analysis of clinically important outcomes revealed that the groups were similar in terms of 6-month mortality, general admission rate, ICU admission rate, and rate of surgical intervention. The proportion of patients who had radiologically or endoscopically documented gastrointestinal pathology was also similar. The results demonstrate that patients with moderate hyperamylasemia (i.e. amylase < 1000 IU/L), notwithstanding the fact that they are older, are on more medications, and have more acute symptomatology, did not have a worse outcome than patients with the same complaints and normal amylases.

Amylases↗
PubMedDate not supplied

Prenatal diagnosis of steroid 21-hydroxylase deficiency by allele-specific amplification.

OBJECTIVE: Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency (21-OHD) is the most common cause of ambiguous genitalia in females at birth. Here, we report the first prenatal diagnosis of 21-OHD by DNA analysis in Hungary. METHODS: Allele-specific amplification (ASA) of the DNA obtained by chorionic villus sampling was performed. RESULTS: The fetus had a homozygous nonsense mutation (Gln318Stop), suggesting a salt-wasting phenotype. Dexamethasone treatment of the mother was started on the 8th gestational week and, as the fetus was an affected female, it was continued until term. The newborn had normal external genitalia at birth, and severe salt-wasting crisis and postnatal virilization was prevented by mineralo- and glucocorticoid replacement therapy. CONCLUSION: 21-OHD was genotyped by ASA, and virilization of the fetus was prevented by antenatal dexamethasone therapy.

Adrenal Hyperplasia, Congenital↗