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Biomedical subjects

A Mayo

Publications and source records attributed to A Mayo.

At least 37 records · Page 2Linked to original sources
PubMed2000

Experimental acute necrotising pancreatitis: evaluation and characterisation of a model of intraparenchymal injection of sodium taurocholate in rats.

OBJECTIVES: To evaluate a simple model that produces progressive dose dependent pancreatitis, by intraparenchymal injection of sodium taurocholate. DESIGN: Open laboratory study. SETTING: Teaching hospital, Israel. MATERIALS: Forty eight Wistar rats. INTERVENTIONS: Sodium taurocholate was injected, 0.3 ml/100 g body weight, in concentrations of 5% and 10% into the pancreatic parenchyma of 32 Wistar rats, resulting in two distinct groups of severity. In 16 sham controls, saline was injected into the pancreas in similar fashion. Blood samples were withdrawn before, and 6, 24, 48, and 72 hours after induction of pancreatitis. RESULTS: Six hours after taurocholate injection, there was a sharp increase in the plasma activities of amylase, lipase, and lactate dehydrogenase (LDH). After 24 hours plasma activities of amylase and lipase decreased to near normal values while LDH remained slightly increased for 48 hours and decreased only after 72 hours. At 6 hours after the injection, interleukin-6 (IL-6) concentrations had increased slightly in the 5% group and decreased to the baseline values at 24 hours. In the 10% group, the increase in IL-6 values was significantly greater than in the 5% group (p = 0.04), and correlated well with severity of pancreatitis as defined by histology (p = 0.01) and mortality (p = 0.037). Twenty four hours after injection of taurocholate, morphological changes comprising diffuse necrosis of the pancreas, fat necrosis, and intestinal dilatation secondary to paralytic ileus were severe. Histopathological examination of the pancreas showed good correlation with the clinical findings and with mortality. No morphological changes were detected when saline was injected into the pancreas (sham control), and only mild rises of IL-6, lipase, amylase, and LDH activities were seen at 6 hours after injection. The mortality, after 10 days, was 80% in the 10% taurocholate group, 30% in the 5% taurocholate group, and 0 in the sham control group (p < 0.05). CONCLUSION: The intraparenchymal injection of taurocholate is easy to perform and highly reproducible. The histopathological injury is dose-dependent, as is the mortality. We conclude that this model is valuable for the study of new treatments for pancreatitis.

Animals↗
PubMed2000

[Laparoscopic cholecystectomy--1,000 procedures in a surgical department].

The first 1,000 laparoscopic cholecystectomies performed in our department were reviewed. There was no operative mortality; conversion to open cholecystectomy was necessary in 2%. In the last 600 cases the rate of conversion had decreased to 0.5%. There was common bile duct injury in 0.3%, with the injuries identified during primary surgery. This clinical experience is consistent with previous studies, which proved that laparoscopic cholecystectomy is safe and should replace open operation as the procedure of choice.

Adolescent↗
PubMed1998

The granulometer--a pocket scale for the assessment of wound healing.

In spite of the availability of high-tech devices for wound assessment, plastic surgeons recognize that the color and confluence of granulation tissue are the most important indicators of open-wound healing. We developed a simple and inexpensive pocket-size scale--the Granulometer--to facilitate a finer assessment and to standardize the documentation of wound healing. This device overcomes limitations set by conditions such as lighting or recent exposure to other wounds that could distort the examiner's perception of the wound in question. In this study we examined the inter- and intraobserver variations in judgment, and the validity of the Granulometer. Our results demonstrate that skin graft viability can be predicted accurately by this eight-grade scale. Since graft survival depends on proper wound healing, we believe that the Granulometer can also be used for fine assessment of wound treatment. The low inter- and intraobserver variations indicate that the Granulometer measurements are both reproducible and accurate.

Granulation Tissue↗
PubMed1997

Value of logistic discriminant analysis for interpreting initial visual field defects.

PURPOSE: The authors evaluate logistic discriminant analysis as a method for interpreting visual field results in initial stages of several ophthalmic diseases. METHODS: The authors retrospectively studied the visual field defects of 96 patients with early glaucomatous damage and prospectively studied 84 subjects with normal eyes (n = 28), cataracts (n = 27), diabetic retinopathy (n = 14), or hypertensive retinopathy (n = 15). The visual fields were examined at least twice with program G1 of Octopus 500 (Interzeag AG, Schlieren, Switzerland). Only one eye per patient was randomly selected and included in the study. The authors created a database with all visual field information provided by Octopus and applied logistic discriminant analysis (SAS Logistic Procedures, SAS Institute, Cary, NC) to obtain classification rules capable of qualifying visual field defects as glaucomatous or nonglaucomatous. The rules were tested with an independent sample. RESULTS: There were significant differences between the groups in the distribution of visual field defects tested by program G1. Logistic discriminant analysis correctly identified the glaucomatous or nonglaucomatous origin of the defects with a sensitivity of 65% to 85% and a specificity of 60% to 92%. CONCLUSIONS: Logistic discriminant analysis is a useful tool to aid in the interpretation of early glaucomatous and nonglaucomatous visual field defects.

Data Interpretation, Statistical↗
PubMed1996

Stratum corneum lipids: the effect of ageing and the seasons.

Stratum corneum lipids play a predominant role in maintaining the water barrier of the skin. In order to understand the biological variation in the levels and composition of ceramides, ceramide 1 subtypes, cholesterol and fatty acids, stratum corneum lipids collected from tape strippings from three body sites (face, hand, leg) of female Caucasians of different age groups were analysed. In addition, we studied the influence of seasonal variation on the lipid composition of stratum corneum from the same body sites. The main lipid species were quantified using high-performance thin-layer chromatography and individual fatty acids using gas chromatography. Our findings demonstrated significantly decreased levels of all major lipid species, in particular ceramides, with increasing age. Similarly, the stratum corneum lipid levels of all the body sites examined were dramatically depleted in winter compared with spring and summer. The relative levels of ceramide 1 linoleate were also depleted in winter and in aged skin whereas ceramide 1 oleate levels increased. The other fatty acid levels remained fairly constant with both season and age, apart from lignoceric and heptadecanoic acid which showed a decrease in winter compared with summer. The decrease in the mass levels of intercellular lipids and the altered ratios of fatty acids esterified to ceramide 1, are likely to contribute to the increased susceptibility of aged skin to perturbation of barrier function and xerosis, particularly during the winter months.

Adult↗
PubMed1996

Effects of positive and negative life events on time to depression onset: an analysis of additivity and timing.

While the relationship of life events to depression onset has occupied researchers for almost a quarter of a century, few studies have attempted to account for either the temporal patterning of events relative to episode onset, or, the effect of multiple events in a study period. In this report, we attempt to address the issues of timing of events, multiple events (both positive and negative) and multiple aspects (both positivity and negativity) of single events on latency time to depression onset, while simultaneously accounting for possible decay in the effects of events over time. We use the proportional hazards approach to model the effects of life events and consider modelling the change in impact of events with the passage of time. After interviewing 142 recurrent unipolar patients using the Life Events and Difficulties Schedule, we rated severity and positivity of life events reported during the 6-month period prior to onset. As we hypothesized, additional life events occurring after an initial provoking agent level event significantly alter the risk of illness onset. Additional severely threatening events decrease the time to onset, but positive events do not appear to delay onset. Interestingly, seemingly neutral events had a highly significant effect in shortening the time to onset. We note the many limitations imposed on the interpretation of these findings related to the selected group of subjects studied and encourage those who have more generalizable data to apply these methods of analysis.

Adult↗
PubMed1996

Intermediate filament aggregates in mitoses of primary cutaneous neuroendocrine (Merkel cell) carcinoma.

Primary cutaneous neuroendocrine carcinomas express different kinds of intermediate filaments and frequently in a 'paranuclear globular' pattern. We have observed the same pattern not only in interphase but also in mitotic cells, which are very frequent in these tumours. We report a quantitative and morphological study of eight primary cutaneous neuroendocrine carcinomas stained with different antibodies against cytokeratins (CAM 5.2 and anticytokeratin 20), neurofilaments (70 kDa and 200 kDa) and peripherin. We have found a predominance of CAM 5.2 expression in interphase cells and of neurofilament proteins in mitotic cells; 87.02% of the interphase cells were positive with CAM 5.2 whereas only 6.08% were positive for neurofilaments (P < 0.01); 35.41% of the mitotic cells were positive with CAM 5.2, whereas 50% were positive for neurofilaments (P < 0.01). A correlation between a globular pattern of intermediate filament proteins and prognosis has not been found. We describe for the first time the division of neoplastic cells with a globular pattern; the presence of intermediate filament proteins with a globular pattern in all mitotic stages; and the uneven distribution of this formation between the two daughter cells.

Aged↗
PubMed1996

Perforation of the terminal ileum induced by blast injury: delayed diagnosis or delayed perforation?

Blast injuries are rare, and although blast-induced perforations of the bowel have been described in the past, the entity of a delayed perforation caused by an evolving injury has not been reported. We report three men injured by the explosion of a terrorist bombing in open air. They suffered primary blast injuries, which resulted in isolated perforations of the terminal ileum. They were operated at different times after the blast event. The resected specimens were examined under light microscopy. One patient was operated immediately, and had three perforations in the terminal ileum. In the other two patients, abdominal complaints appeared only 24 and 48 hours later. These two patients were found to have hematomas in the wall of the terminal ileum, and small perforations therein, with almost no contamination of the peritoneal cavity. On histological examination, there were small perforations with disruption of all intestinal layers. In the vicinity of the perforations, the mucosa was necrotic and disorganized. The submucosa showed edema and vascular thrombi, and at several points mucus was shown dissecting through the muscularis propria, thus creating minute microperforations. Because of the findings in these patients, we suggest a mechanism of evolving damage to the bowel wall and delayed perforation rather than delayed diagnosis, after blast injuries. We suggest that patients exposed to a significant blast should be watched carefully for at least 48 hours.

Adolescent↗
PubMed1996

Clinical practicum in the ambulatory setting.

To address the growing need for a well-trained ambulatory nursing staff, administrators and educators in San Diego, California, developed an integrated education plan. This article shares their strategic plan for ensuring future nursing resources in the ambulatory setting.

Ambulatory Care↗
PubMed1995

Preliminary report of a prospective randomized study of octreotide in the treatment of severe acute pancreatitis.

BACKGROUND: Experimental and clinical studies on the effect of octreotide in the treatment of patients with acute pancreatitis have presented controversial results. Since January 1992, we have been conducting a prospective randomized study on the clinical effect of octreotide in severe acute pancreatitis, at three hospitals in Israel. STUDY DESIGN: The entering criteria included three or more of the Ranson's prognostic signs and computed tomographic findings of severe pancreatitis. Patients were randomly assigned to conservative treatment either with or without octreotide (0.1 mg injected subcutaneously three times a day). The end points of the study included: complication rate (adult respiratory distress syndrome [ARDS], sepsis, renal failure, pseudocyst, fistula, and abscess), length of hospital stay, and mortality. RESULTS: During the first two years (from January 1992 to December 1993), 51 patients entered the study. After evaluation, 13 patients were excluded due to failure to meet the entering criteria, incomplete data, or incorrect diagnosis. Of the remaining 38 patients, 19 were assigned to octreotide (treatment group) and 19 to conservative treatment alone (control group). The two groups were matched with regard to age, sex, etiology, and severity of disease. The complication rate was lower in the treatment group compared with the control group with regard to sepsis (26 compared with 74 percent, p = 0.004) and ARDS (37 compared with 63 percent, p = 0.1). The hospital stay was shorter in the treatment group compared with the control group (17.9 compared with 34.1 days, p = 0.02). Death occurred in two patients in the treatment group and six patients in the control group. CONCLUSIONS: Although some of the parameters did not reach statistical significance, these preliminary results suggest that octreotide may have a beneficial effect in the treatment of patients with severe acute pancreatitis. This study is scheduled to continue for two more years.

Abscess↗
PubMed1995

[Dead Sea bath salts for osteoarthritis of the knee].

26 patients with osteoarthritis of the knees were randomly divided into 2 groups of 13 each with patients of similar ages, sex distribution and duration and severity of disease. All were treated with daily baths at 34-35 degrees C for 20 min. containing Dead Sea bath salts (Group I) or sodium chloride (Group II). The study was double-blind and of 2 weeks duration. Patients were evaluated by a rheumatologist before, at the end of treatment and 1 month later. Clinical parameters evaluated included index of severity of osteoarthritis, patient's assessment of disease severity, range of movement of knees, soft tissue swelling, effusion and crepitus. There was significant improvement in the index of severity of osteoarthritis at the end of the treatment in both groups (p < 0.01). 1 month later, in Group I the significance of the index was still p < 0.01, but p < 0.05 in Group II. Patient's assessment of improvement was significant only in Group I at the end of the treatment period (p < 0.01). There was no statistical improvement in either group in the other parameters assessed.

Balneology↗
PubMed1991

Comparison of four different Doppler instruments used to measure linear and volumetric cardiac output: a study of reproducibility and agreement.

Values of stroke distance obtained from 25 subjects with the obsolete Transcutaneous Aortovelograph were compared with those from two commercially available Doppler ultrasound devices, the Doptek Decoder, and the Doppler unit of the Interspec-XL Ultrasound System. Also studied was the Quantascope, an ultrasound device designed to measure stroke volume. In the aortic arch, reproducibility was 4.8% with the Transcutaneous Aortovelograph, 9.1% with the Doptek Decoder, 17.2% with the Interspec, and 23.6% with the Quantascope. In the ascending aorta, reproducibility was worse, being 13.4% for the Doptek, 23.0% for the Interspec, and 28.1% for the Quantascope. There was close agreement between the absolute values of stroke distance obtained with the Transcutaneous Aortovelograph and the Interspec, but lower values were obtained by the Doptek Decoder. There is a need for an updated instrument dedicated to the measurement of stroke distance in the aortic arch.

Adolescent↗