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Biomedical subjects

A S Kong

Publications and source records attributed to A S Kong.

At least 19 recordsLinked to original sources
PubMed2001

Absorption of lidocaine during aspiration anesthesia of the airway.

STUDY OBJECTIVE: To determine the optimal solution to use when anesthetizing the airway by aspiration of lidocaine. DESIGN: Randomized, double-blind clinical study. SETTING: University hospital. PATIENTS: 96 adult ASA physical status 1,II, and III patients, scheduled for diagnostic flexible bronchoscopy. INTERVENTIONS: Patients were randomized to receive one of 5 solutions of lidocaine: Group A (n = 16): 1% lidocaine, 0.2 mL. kg(-1); Group B (n = 16): 1.5% 0.2 mL. kg(-1); Group C (n = 32): 2% 0.2 mL. kg(-1); Group D (n = 16): 1% 0.3 mL. kg(-1), and Group E (n = 16): 2% 0.3 mL. kg(-1). Fiberoptic bronchoscopy was performed after the airway was anesthetized with this aspiration technique, using the assigned lidocaine solution. The scope was manipulated in the trachea to test for anesthesia. MEASUREMENTS AND MAIN RESULTS: Successful airway anesthesia was determined by tolerance to bronchoscopy without sustained coughing, and also by the number of lidocaine supplements, if any, that were given via the bronchoscope. Arterial plasma concentrations of lidocaine were measured in 33 patients from Groups C, D, and E. All solutions provided equally effective anesthesia of the airway. All patients tolerated endoscopy through the vocal cords, and 94 patients required no supplementary anesthesia, or only one dose of lidocaine, during bronchoscopy to the carina. The highest peak plasma concentrations of lidocaine were 5.02 and 6.28 microg. mL. No patient had signs of toxicity. CONCLUSIONS: This technique produced anesthesia of the airway to the carina, safely, suitable for awake intubation, in 94 of 95 patients. The use of 1% lidocaine, 0.2 to 0.3 mL. kg(-1), so that the volume is 10 to 20 mL, is recommended.

Absorption↗
PubMed2001

Lacrimal fossa block: an audit of a minimally invasive regional anaesthetic technique for endoscopic dacryocystorhinostomy (DCR).

The lacrimal fossa block (LFB), a new development to provide regional anaesthesia for endoscopic dacryocystorhinostomy, is reported. Cadaveric study showed that the block needle, inserted as described, made direct contact with the periosteum of the frontal process of the maxilla within the lacrimal fossa. This technique enables both relevant divisions of the trigeminal nerve to be anaesthetized through a single entry site and, as this injection is confined to the anterior part of the orbit, ocular complications are minimized. An audit of 66 patients has shown that this technique, combined with standard intranasal local anaesthesia, provides good intraoperative analgesia, causes minimal diplopia and has a high level of patient acceptability.

Adult↗
PubMed1999

Anesthesia of the airway by aspiration of lidocaine.

PURPOSE: Lidocaine instilled onto to the back of the tongue of a supine subject and aspirated has been reported to provide effective topical anesthesia of the airway. The purpose of this study was to observe endoscopically the fate of lidocaine so instilled and document the efficacy of anesthesia for awake fibreoptic intubation. METHODS: In Part I of the study, a fibreoptic bronchoscope was positioned in the pharynx of three volunteers lying supine and the route followed by tinted lidocaine solution instilled onto the back of the protruded tongue during mouth breathing was observed. In Part 2, the airway of 39 patients requiring awake fibreoptic intubation was anesthetized by having them gargle twice with 5 ml lidocaine 2%, followed by instillation of 0.2 ml-kg(-1) or 20 ml lidocaine 1.5% (whichever was less) onto the dorsum of their tongues as described above. The efficacy of anesthesia was scored by the patient reaction (coughing or gagging) to instrumentation in the pharynx, at the glottis, and in the trachea; to passage of the tracheal tube into the trachea; and to the presence of the tube in the trachea. RESULTS: Lidocaine instilled on to the back of the tongue was swallowed initially but ultimately pooled in the pharynx and was aspirated. In all patients the trachea was intubated without requiring supplemental lidocaine, and all but one patient tolerated the tracheal tube in situ. CONCLUSION: A combination of lidocaine gargles and lidocaine instilled on to the back of the tongue and aspirated provides effective anesthesia of the pharynx, larynx, and trachea for awake fibreoptic intubation.

Adult↗
PubMed1993

Subdural block.

Explore the source record for details and available documents.

Adult↗
PubMed1992

Rupture of membranes before the onset of spontaneous labour increases the likelihood of instrumental delivery.

We studied obstetric outcome in 350 consecutive nulliparous women in spontaneous labour and term pregnancy. Women who presented with rupture of membranes before the onset of contractions were more likely to deliver by forceps compared with those in whom contractions preceded rupture of membranes. This increased likelihood of instrumental delivery was significant with and without the use of extradural analgesia in labour (P less than 0.05 and P less than 0.001, respectively). Furthermore, significantly more women with premature rupture of membranes received extradural analgesia in labour (P less than 0.01). We conclude that any study which aims to examine the influence of extradural analgesia on the outcome of delivery should include premature rupture of membranes as a bias factor.

Adolescent↗
PubMed1992

An audit of induction of anaesthesia in neonates and small infants using pulse oximetry.

The frequency and severity of hypoxaemia during induction of anaesthesia in neonates and small infants at the Norfolk and Norwich Hospital, a district general hospital, was compared, using pulse oximetry, with that of the nearest specialist hospital, the Queen Elizabeth Hospital for Sick Children in London. There were differences in staffing and the choice of anaesthetic techniques between the hospitals. One third of the patients in both hospitals experienced desaturation of more than 5% (moderate or severe hypoxaemia) at one or more recordings during induction. The highest incidence of hypoxaemia was associated with awake intubation. There was no statistical difference in the incidence or severity of hypoxaemia between the hospitals. In the district general hospital, moderate or severe hypoxaemia of greater than 30 s duration was more likely if an anaesthetist with a regular paediatric operating list was not present at induction (p < 0.01).

Anesthesia, Inhalation↗
PubMed1989

Longitudinal study of serum antibody response to bovine corneal protein (BCP 54) in Behçet's disease.

Serum samples from a patient diagnosed as having active Behçet's syndrome with iritis were evaluated by the enzyme-linked immunosorbent assay for antibodies against a purified bovine corneal protein, molecular weight 54,000 daltons (BCP 54). Significantly elevated antibody levels to BCP 54 were found in all serum samples collected over a 2-year period. Anti-BCP 54 antibody levels remained within a very narrow range, at least twofold higher than those of controls. In contrast, no antibody to retinal S antigen was detected. These results indicate the presence of specific anti-BCP 54 autoantibodies in sera from a Behçet's patient and suggest that autoantibodies may play a role in the etiopathogenesis of uveitis.

Adolescent↗
PubMed1981

Studies on a new lymphocyte mitogen from Bordetella pertussis. I. Induction of proliferation and polyclonal antibody formation.

Pertussis B mitogen (PBM), isolated from culture supernatant fluids of Bordetella pertussis, is a potent mitogen for mouse and human lymphocytes. In mice, > 95% of the blast cells recovered from PBM cultures bear surface immunoglobulins. Therefore, PBM seems to induce proliferation of mouse B lymphocytes, but not T cells. The proliferative response observed is nonspecific because cells from all mouse strains tested, including germfree animals, are responsive. Moreover, the mitogenic activity of PBM is independent of T lymphocytes, macrophages, or serum factors. When human peripheral blood or cord blood lymphocytes are cultured in the presence of PBM, a high level of thymidine incorporation by these cells is detected. Furthermore, PBM can induce polyclonal antibody formation by both mouse and human lymphocytes. Despite similar methods of isolation, PBM is distinct from the lymphocytosis-promoting factor of B. pertussis, a previously described T cell mitogen.

Animals↗
PubMed1979

The in vitro effects of Bordetella pertussis lymphocytosis-promoting factor on murine lymphocytes. IV. Generation, characterization, and specificity of cytotoxic lymphocytes.

Cytotoxic effector lymphocytes were induced in cultures of mouse spleen or lymph node cells by lymphocytosis promoting factor (LPF). The LPF-activated cytotoxic cells: (a) were not generated unless proliferation occurred; (b) sedimented in the lighter density fraction of a bovine serum albumin gradient; (c) were large, blast-like cells; and (d) were lysed by Thy-1.2 antiserum plus complement and, therefore, were T cells. Neither LPF alone nor supernates from stimulated cultures were cytotoxic. Unlike the situation with concanavalin A and phytohemagglutinin P, LPF-stimulated cytotoxic effector lymphocytes required no further addition of mitogen for maximal cytotoxicity. The effector cells displayed specificity, destroying only allogeneic but not syngeneic normal cells; in the case of tumor cells, both allogeneic and syngeneic cells werelysed in the absence of added mitogen. The reason for differentiated cytotoxicity toward syngeneic tumor and normal cells is not clear but may have some relevance to in vivo tumor rejection initiated by Bordetella pertussis.

Animals↗
PubMed1979

The in vitro effects of Bordetella pertussis lymphocytosis-promoting factor on murine lymphocytes. III. B-cell dependence for T-cell proliferation.

The nature of the helper lymphocytes in lymphocytosis-promoting factor (LPF)-induced proliferation was explored. Removal of macrophages from adherent splenocytes by either carbonyl-iron incubation or passage through Sephadex G-10 columns did not affect their synergistic function. Nor did cytolysis with Thy-1.2 antiserum and complement. The helper cells were found to be surface immunoglobulin-positive (sIg+) because they are retained by anti-Ig columns, susceptible to lysis by rabbit anti-mouse immunoglobulin and complement, and occurred in the sIg+ fractions of splenocytes after separation on the fluorescence-activated cell sorter. Further delineation of the surface markers on helper cells showed that complement receptors are not the determining marker for synergistic function. The requirement for B-helper cells in the stimulation of T lymphocytes by LPF is unique for a mouse of T-cell mitogen.

Animals↗
PubMed1977

The in vitro effects of Bordetella pertussis lymphocytosis-promoting factor on murine lymphocytes. I. Proliferative response.

The lymphocytosis-promoting factor of Bordetella pertussis is a potent mitogen for murine lymphocytes in vitro. The stimulatory response was not the result of specific antigen stimulation. Spleen and lymph node cells were responsive, whereas normal thymocytes were unresponsive. However, DNA replication was induced in cortisone-resistant thymocytes by lymphocytosis-promoting factor (LPF). Bone marrow cells were not stimulated by LPF.

Animals↗
PubMed1977

The in vitro effects of Bordetella pertussis lymphocytosis-promoting factor on murine lymphocytes: II. Nature of the responding cells.

The mitogenic response of murine lymphocytes to the lymphocytosis-promoting factor of Bordetella pertussis has been shown to be due to activation of T cells. The selectivity of responsiveness to LPF with respect to the population of T cells which is stimllated, differs from that of PHA as well as Con A, and the surface receptors are different. A population of adherent cells, which does not appear to consist of macrophages or other phagocytic cells, is required for the T-cell response.

Animals↗