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Biomedical subjects

A Jordan

Publications and source records attributed to A Jordan.

At least 91 records · Page 5Linked to original sources
PubMed1991

Peribulbar anesthesia. Effect of bicarbonate on mixtures of lidocaine, bupivacaine, and hyaluronidase with or without epinephrine.

The pH-adjustment of local anesthetic solutions with sodium bicarbonate may shorten onset time and improve spread of neural blockade. The authors undertook a prospective, double-masked, randomized study to see if a pH-adjusted mixture of lidocaine, bupivacaine, and hyaluronidase had faster and more complete onset of neural blockade, when used for peribulbar anesthesia. Eighty patients were randomly assigned to four groups and received a peribulbar block with one of four mixtures: group 1 (L) = 2% lidocaine, group 2 (LPH) = 2% lidocaine with 0.06 meq/ml sodium bicarbonate, group 3 (LE) = 2% lidocaine with 1:100,000 epinephrine (commercially prepared), or group 4 (LEPH) = 2% lidocaine with 1:100,000 epinephrine with 0.06 meq/ml sodium bicarbonate. To 5 ml of each of the preceding groups, 5 ml of 0.75% bupivacaine and 150 units of hyaluronidase was added. After each block, extraocular muscle movement was followed in each quadrant until akinesia developed. In the event of incomplete akinesia, blocks were supplemented at 20 minutes. The LPH group had the fastest onset to complete akinesia (7.0 +/- 2.0 minutes, mean +/- SEM) when compared with the onset time of all other groups (group 1 = 11.5 +/- 1.9 minutes, group 4 = 13.1 +/- 1.4 minutes, and group 3 = 16.0 +/- 1.8 minutes, significance greater than 95% by analysis of variance). Furthermore, when compared with group 3 by analysis of variance, group 4 had a faster onset time. The authors conclude that pH-adjustment of solutions with bicarbonate of either lidocaine/bupivacaine/hyaluronidase or commercially prepared lidocaine with epinephrine/bupivacaine/hyaluronidase decreases the onset time of peribulbar anesthesia.

Anesthesia, Local↗
PubMed1991

[Chemoembolization in primary hepatocellular carcinoma].

The only generally recognised form of treatment for primary liver cell carcinomas is partial liver resection; occasionally this may be curative. This form of treatment is only applicable in 5% to 30% of patients. All drug-based forms of treatment have proved of little value. The new interventional radiological method of chemo-embolisation has shown results in improving survival rates which are comparable with resection. By using a new coaxial catheter system, embolisation can be performed as a selective intrahepatic procedure; it has few side effects and the quality of life subsequently does not deteriorate.

Carcinoma, Hepatocellular↗
PubMed1990

pH-adjusted bupivacaine and hyaluronidase for peribulbar block.

The onset of akinesia of the extraocular muscles was assessed after peribulbar block with a plain or pH-adjusted solution of 0.75% bupivacaine and hyaluronidase. Thirty-five patients were randomly assigned to receive either 0.75% bupivacaine with hyaluronidase 15 units/ml (pH 5.45 +/- 0.12) or the same pH-adjusted solution (0.15 mEq sodium bicarbonate per 30 ml of 0.75% bupivacaine to give a final pH of 6.82 +/- 0.09) in a double-blind, prospective manner. Onset of akinesia was determined to the nearest minute. Supplemental injections were given after 20 min in the event of incomplete akinesia. The group receiving pH-adjusted bupivacaine had a statistically faster onset time for complete akinesia than did the control group (5.3 +/- 1.2 min vs. 14.3 +/- 2.3 min, respectively; P less than 0.001). Five of 17 patients in the control group required a supplemental injection, whereas only one of 17 patients in the treatment group had a supplemental block at 20 min (P less than 0.05). Thus, pH adjustment of a solution of bupivacaine and hyaluronidase with sodium bicarbonate hastens the onset time and improves the initial success rate of peribulbar block.

Bupivacaine↗
PubMed1990

[Partial resection of primary liver cell cancer].

Between 1985 and 1990, 47 patients with primary hepatocellular carcinoma (HCC) underwent surgery (n = 27), chemoembolization (n = 12) or palliative resection followed by chemoembolization (n = 5). In 85% of the patients a T3/T4 tumor stage was found, 68% had liver cirrhosis and 42% were older than 70. Mortality was 18.7% after liver resection and 0% after chemoembolization or combined treatment. Average survival was 4.4 months after chemoembolization, 11.6 months after resection and 11.6 months after palliative resection of the HCC followed by chemoembolization with angiostat/adriblastin.

Aged↗
PubMed1988

Food and Drug Administration guidelines for reproductive toxicity testing.

The Food and Drug Administration generally requires reproductive toxicity testing of all new drugs to be used by pregnant women or women or men of reproductive potential. These requirements may vary among the centers within the FDA. Reproductive and developmental toxicity is usually tested in one or two animal species and is divided into three segments to represent treatment throughout the reproductive process. The FDA monitors adverse drug effects on human reproduction through postmarketing surveillance.

Clinical Trials as Topic↗
PubMed1988

Recombinant interleukin-2 (rIL-2) improves immune response and host resistance to septic challenge in thermally injured mice.

Impaired immune competence leading to decreased resistance to sepsis is a major cause of death in burn patients. We have previously shown that increased mortality from a septic challenge correlated with impaired splenocyte interleukin-2 (IL-2) production and response to T cell mitogens in mice subjected to a 25% surface area scald burn. We report now that the addition of recombinant (r) IL-2 (100 U/ml) in vitro to splenocytes from burned animals restored mitogen responses to normal. Burned mice intraperitoneally received 16,000 U of rIL-2 (selected on the basis of dose-response experiments) once daily in 0.5 ml 5% dextrose (5% D) on days 1 through 6 after thermal injury and were compared with burned mice treated with only 5% D. Both groups were subjected to cecal ligation and puncture 10 days after burn; 4 days later, there were no survivors in the 5% D group, whereas 45% of the rIL-2 group remained alive (p = 0.001; Gehan statistic). We found that rIL-2 treatment at the dose selected resulted in no apparent toxicity in burned mice. Finally, splenocytes from rIL-2-treated burned mice showed improved responses to T cell mitogens in vitro compared with 5% D-treated controls. We conclude that rIL-2 therapy may have a role in the restoration of immune competence after thermal injury.

Animals↗
PubMed1987

Suppression of interleukin 2 production in an animal model of thermal injury is related to prostaglandin synthesis.

We performed studies using an animal model of thermal injury to confirm the observed decrease in interleukin 2 (IL-2) production in burned patients and to explore the underlying mechanisms. Ten mice subjected to a 25% scald were compared with ten anesthetized littermates (controls) and six untreated mice (normal mice) 1, 3, 5, 7, 10, 14, and 21 days after burn. Production of IL-2 by splenocytes was stimulated by concanavalin A alone, or in the presence of the cyclooxygenase inhibitor indomethacin or flurbiprofen. The IL-2 content of the resulting supernatant was determined by the response of the IL-2-dependent cell line CTLL-2. The IL-2 production was significantly suppressed in the burned mice at three days (mean +/- SEM, 30.9% +/- 5.2%), five days (19% +/- 5.5%), seven days (41.6% +/- 6.4%), and 21 days (20% +/- 4.5%). Significant enhancement of IL-2 production by indomethacin was seen in the burned group (mean, 95%), but not in controls (mean, 23.8%) or normal mice (mean, 17.2%), and similar effects were seen with flurbiprofen. In separate experiments the effects of exogenous prostaglandin E2 on lymphocyte blastogenesis and IL-2 production were studied, and an increased susceptibility to the inhibitory effects of prostaglandin E2 was observed following thermal injury.

Animals↗
PubMed1987

Effects of low X-ray doses in Saccharomyces cerevisiae.

Three strains of Saccharomyces cerevisiae with different capacities for repair of radiation damage (RAD, rad18, and rad52) have been tested for their colony forming ability (CFA) and growth rates after application of small X-ray doses from 3.8 mGy to 40 Gy. There was no reproducible increase in CFA observable after application of doses between 3.8 mGy and 4.7 Gy. X-ray doses of 40 Gy causing an inactivation of CFA from 90% to 50%, depending on the repair capacity of the strains used, caused a reduced increase in optical density during 2 h buffer treatment in comparison to unirradiated cells. This reduction however, is reversible as soon as the cells are transferred into nutrient medium. One hour after transfer into growth medium the portions of cells with large buds (G2 and M phase) and cells with small buds (S phase) are drastically different in irradiated cells from those obtained in unirradiated cells. The time necessary for separation of mother and daughter cells is prolonged by X-ray irradiation and the formation of new buds is retarded.

Cell Cycle↗
PubMed1986

[Frequency of a positive result in the chlorpropamide-alcohol flush test in type I and type II diabetes].

146 newly manifested diabetics (91 type I, 55 type II) and 20 non-diabetics were examined with the help of the chlorpropamide alcohol flush test. Also under different criteria of valuation of the increase of skin temperature (1.5 and 1.8 degrees C, respectively) no significant differences between the positive findings of the test in type I and type II diabetics were the result. Decisive for a positive result is according to our investigations the pre-existing initial temperature of the skin area, the room temperature and the air humidity. In such a case the initial temperature of the skin area depends on the moment of the last food intake.

Adolescent↗
PubMed1986

Mechanisms of immunosuppression associated with severe nonthermal traumatic injuries in man: production of interleukin 1 and 2.

Depression of cell-mediated immunity in patients following severe traumatic injury has been well documented in vitro and in vivo. However, the exact mechanism of this defect is still controversial. In this study, we have investigated the ability of injured patients' peripheral blood mononuclear cells (PBMC) to produce two important immunoregulatory molecules, interleukin 1 (IL 1) and interleukin 2 (IL 2). Eighteen traumatic injury patients were studied during the course of their hospital stay and their results compared with a group of 18 normal age- and sex-matched controls. The results showed the following. (1) Production of IL 2 by normal PBMC in response to optimal doses of mitogen may vary with sex as well as age. (2) Adherent mononuclear cells from trauma patients produced at least as much IL 1 as normals. (3) IL 2 production, however, was markedly suppressed (normals, 1.6 +/- 0.2 U; traumatic injury, 0.6 +/- 0.1 U; P = 0.001) and persisted for as long as 50 days postinjury. OKT4+ cells were not significantly decreased at any time, nor were OKT8+ suppressor/cytotoxic cells increased at any time. Decreased IL 2 production in patients treated with steroids or those who were septic was not different from that in those patients who were not treated with steroids or were not septic. These results suggest that the cause of the defect in IL 2 production in traumatic injury patients is not related to a lack of the IL 1 signal, producer T cells, or Ia+ monocytes or to increased suppressor T cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗
PubMed1986

Cowden's disease: a further indication for prophylactic mastectomy.

Cowden's disease (multiple hamartoma syndrome) is a syndrome involving abnormalities of multiple organ systems. Transmitted in an autosomal dominant pattern, it carries a high frequency of mammary carcinoma in early middle age in affected women. The hyperkeratotic cutaneous and gingival markers of the disease are its principal overt manifestations. Prophylactic bilateral total mastectomy with optional immediate reconstruction is recommended for women Cowden's disease. An illustrative family with the disease is presented in which one affected young woman was found to have invasive mammary carcinoma with regional metastasis at the time of prophylactic mastectomy.

Adult↗
PubMed1984

Histocompatibility antigen frequencies in patients with chronic lymphocytic leukaemia: possible identification of a subgroup with relatively benign disease.

A series of 57 patients with chronic lymphocytic leukaemia was typed for HLA-A, B and DR antigens and compared with a control population of equal size. There was an increased frequency of HLA-A1 and B8 in the patient group, although it was not statistically significant after allowance for the number of specificities tested. A subgroup of patients lacking both A1 and B8 differed from the others in sex ratio, degree of lymphocytosis and incidence of hypogammaglobulinaemia at presentation. This subgroup also had less need for treatment within 6 months of presentation. While these findings must be considered preliminary, it is possible that tissue typing may help to identify patients with a relatively benign form of the disease.

Aged↗
PubMed1981

Care of mildly ill children enrolled in day-care centers: management by parents and by trained home workers.

Because child day-care regulations exclude ill children, parents are frequently faced with problems in finding an alternative care arrangement. This pilot study compares home care of mildly ill children by parents (46 preschool children) with care by trained home workers (23 preschool children) during 20 weeks in 1977. Episodes of illness in children cared for by trained home workers showed a slightly shorter duration (median 3.0 days, range 2 to 11 days versus median 5.2 days, range 2 to 14 days) and a less severe course (fewer and milder signs of illness) when compared with episodes of illness in children cared for by parents. Other selected activities involved in the management of the mildly ill children were comparable. Although larger studies are needed, it appears that if parents desire an alternative care arrangement for their children during mild illness, care by a trained home worker may be convenient and safe.

Child↗
PubMed1980

A survey of Moraxella corneal ulcers in a derelict population.

Infection with diplobacilli of the Moraxella group was the most common cause of bacterial corneal ulcer in a population of derelict alcoholics living in the Bowery district in New York City from 1965 through 1968. No distinction could be made between Moraxella subspecies on the basis of severity of ulcer or antibiotic sensitivities. Of 100 Bowery inhabitants examined, 35 harbored Moraxella in their noses. After 1968 and coinciding with an improvement in nutrition and sanitation, but with no apparent change in the incidence of alcoholism in this population, we noted a marked decline in the incidence of corneal ulcers caused by Moraxella species.

Adult↗
PubMed1980

Basic tear flow. Does it exist?

Tear flow and volume were measured in 15 normal volunteers, divided into young and old age groups, using subjective fluorophotometric analysis and Schirmer testing with and without topical anesthesia. Proparacaine 0.5% was found to anesthetize cornea and conjunctiva better than cocaine 4% and produced fewer complications. Older subjects responded to stimulation with less reflex tearing than younger subjects, but had an identical rate of physiologic tear flow, and equivalent corneal and conjunctival sensitivity. Tear flow and volume decreased significantly below physiologic values in both age groups following topical anesthetic instillation. Lid margin and cilia stimulation increased the tear turnover rate more than 300% despite adequate topical anesthesia. Flow rates determined by Schirmer testing with topical anesthesia were higher than both physiologic tear flow and tear flow following topical anesthesia when these values were determined by fluorophotometry. As sensory input was decreased, tear secretion fell correspondingly, implying that all significant tear flow results frp, reflex secretion.

Adult↗