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Biomedical subjects

C B Wheeler

Publications and source records attributed to C B Wheeler.

At least 19 recordsLinked to original sources
PubMed1992

Stevens-Johnson-type reaction with vancomycin treatment.

OBJECTIVE: To report a case of Stevens-Johnson syndrome caused by vancomycin. CASE SUMMARY: Stevens-Johnson syndrome is an acute mucocutaneous process characterized by epidermal and mucosal desquamation. Its pathogenesis is poorly understood. Mortality rates have ranged from 30 to 100 percent. We describe a case of Stevens-Johnson syndrome related to the use of vancomycin in a 71-year-old woman with rheumatoid arthritis receiving treatment for an infected cervical fusion site. Classic "target" lesions distributed throughout the trunk and extremities along with erosive lesions involving the oral and vaginal mucosae were observed in this patient. DISCUSSION: A number of agents have been implicated in the etiology of Stevens-Johnson syndrome. Serious cutaneous reactions to vancomycin, however, have been uncommon. Cessation of vancomycin treatment in our patient led to eventual resolution of her symptoms. CONCLUSIONS: Vancomycin is a potential causative agent of Stevens-Johnson syndrome.

Aged↗
PubMed1985

Colpocephaly: clinical, radiologic, and pathogenetic aspects.

Colpocephaly is an anatomic finding in the brain manifested by occipital horns that are disproportionately enlarged in comparison with other parts of the lateral ventricles. It has been considered to result from localized outpocketing of the ventricular cavity due to failure of thickening of overlying brain. Four new cases are presented here, including a child of near-normal development who appears to be the first reported case of colpocephaly with an associated chromosomal anomaly. Our patients support the view that colpocephaly is a disorder of diverse causation that can arise from a variety of degenerative or encephaloclastic insults to the developing brain.

Cerebral Ventricles↗
PubMed1983

Gastric secretory and mucosal injury response to severe head trauma.

The problem of gastric secretory and mucosal injury response was evaluated in 19 patients who had suffered a severe head injury. Fifteen of 19 patients had some evidence of gastrointestinal hemorrhage. In 7 cases, this was marked. The mean volume of gastric secretions ranged from 36.4 ml/hour on Day 1 to 47.6 ml/hour on Day 6. The mean value of titratable acidity ranged from 3.4 meq/hour on Day 1 to 3.9 meq/hour on Day 6. Possible risk factors were analyzed as a means of predicting specific subgroups of severely injured patients who would be more prone to have gastrointestinal complications. During the first 6 days after injury, there was no significant association (correlation coefficient not significant at the 0.05 level of significance) of the presence of an intracranial mass lesion, elevated intracranial pressure, brain stem dysfunction or prior episodes of hypotension or hypoxia, sepsis, shock, or the requirement for pressor agents with elevated gastric acid output, mucosal erosion, or hemorrhage. Because no specific risk factor or factors could be identified, all severely brain-injured patients should be on some form of therapy for the prevention of gastrointestinal complications.

Adult↗
PubMed1981

A gonioscopy lens for pulsed-laser trabeculotomy.

We designed an indirect gonioscopy lens capable of handling the high powers generated by short-duration pulsed lasers. The lens is composed of an equilateral quartz prism within which the entire laser beam is internally reflected and connected to the cornea with saline solution. The reflected beam subsequently passes through the index-matched cornea to the trabecular region. Chromatic aberration is minimal because refraction is eliminated by arranging the laser beam so that is crosses the dielectric interfaces in a near-normal direction. The reflection losses amount to less than 5%, even without antireflection coatings. A prism of glass is sufficiently robust to handle the 100-kW pulses from a dye laser.

Gonioscopy↗
PubMed1980

Prevention of acute gastrointestinal complications after severe head injury: a controlled trial of cimetidine prophylaxis.

Cimetidine prophylaxis significantly reduced the risk of gastrointestinal bleeding after severe head injury in this prospective, double-blind clinical trial. Cimetidine effectively reduced both the volume and the acidity of gastric secretions after brain injury without producing adverse side effects. The most common endoscopic finding was superficial, erosive, mucosal lesions in the proximal stomach. Cimetidine prophylaxis was not shown to reduce the incidence of these lesions in this study but did diminish their severity and the likelihood that they would complicate the management of these patients.

Adolescent↗
PubMed1980

Canine gastric sling fibers: contractile properties.

The contractile properties of canine sling fibers and the longitudinal and circular muscles were characterized and compared. The longitudinal and circular muscles developed spontaneous contractions, but the sling fibers developed no spontaneous phasic contractions. The cholinergic receptors of all three muscles were excitatory. The alpha- and beta-adrenergic receptors of the longitudinal and circular muscles were inhibitory, but the sling fiber alpha-adrenergic receptors were excitatory and the beta receptors inhibitory. Large concentrations of atrophine induced contractions of all three muscles. Some of the contractile properties of the sling fibers are more similar to those of the distal esophageal circular muscle than to those of the gastric longitudinal and circular muscles. The sling fibers together with the esophageal circular muscle may play an important role in the gastroesophageal sphincter mechanism.

Acetylcholine↗
PubMed1980

Susceptibility of brain and skin to bacterial challenge.

The brain is a uniquely protected organ. Once the protective barriers are overcome, the brain is susceptible to bacterial infection. Using a reproducible rat model, the susceptibility of brain tissue to challenge by S. aureus or E. coli was quantitatively compared to that of skin. Brain was significantly more susceptible to the presence of bacteria than was the skin of the scalp. The development of infection in skin required at least 10(5) organisms, while brain infection could be produced with as few as 100 organisms.

Animals↗
PubMed1979

Extinguishing the flaming burn victim.

The multipurpose dry chemical fire extinguishers are unusually efficient in extinguishing many classes of fire: A) ordinary combustible; B) flammable liquids and C) electrical equipment. This exemplary performance of multipurpose extinguishers is associated with minimal toxic effects to humans. Following contact of soft tissue with the multipurpose dry chemical, the tissue exhibits a remarkable ability to resist infection and a normal capacity to heal following injury. This negligible toxicity of the multipurpose dry chemicals makes them safe for extinguishing the flaming clothes of human burn victims.

Animals↗
PubMed1979

Single treatment laser iridotomy.

A technique is described for producing an iridotomy in the treatment of closed-angle and secondary glaucoma using a single pulse from a dye laser. It was successful in 28 out of 32 eyes treated, and no significant complications were encountered.

Coumarins↗
PubMed1979

Side-effects of topical proteolytic enzyme treatment.

The results of this study indicate that short term treatment of wounds with topical enzymes appears to be safe and is accompanied by no clinically significant side-effects. Topical wound treatment with this enzyme did not interfere either with healing of experimental wounds or the activity of the antibiotics. Wounds subjected to this enzyme treatment exhibited a normal capacity to resist infection, even though this enzyme interferred with leukocyte phagocytosis in vitro. The potential benefits of this treatment in experimental wounds as an adjunct to antibiotics considerably outweigh its damaging effects. Its clinical use in patients must await the results of carefully controlled clinical trials in which the efficacy of this treatment is evaluated.

Administration, Topical↗
PubMed1977

Laser iridectomy.

The laser energy required to achieve an iridectomy in the human eye is calculated as a function of laser beam radius and pulse duration. Two widely different models of the stromal pigment distribution are used in order to embrace the range of coloured irides encountered in practice. The attendant hazards to the cornea, lens and retina are also considered, resulting both from self absorption and also by thermal conduction from the heated iris. These calculations are used to interpret experimental iridectomies attempted over the last ten years and to provide a theoretical foundation for the specialized techniques of iridectomy currently employed. Finally, a new single pulse technique, suggested by these calculations, is formulated and results of preliminary dye laser experiments presented. These results are very encouraging because full-thickness iridectomies were formed in both blue- and brown-eyed rabbits with only 40 mJ of incident laser energy. It was found that the threshold laser energy required for iridectomy was sensibly constant over the visible spectrum for the brown-eyed rabbit. However, for the blue-eyed rabbit the energy had a pronounced minimum in the yellow portion of the spectrum.

Animals↗
PubMed1976

Calculation of retinal temperature distributions resulting from laser irradiation of the eye: I. Continuous lasers.

The paper develops a simple analytic expression for the maximum temperature rise attained in the retina as a function of laser power, exposure duration, retinal absorption parameters and image radius. It is assumed that the laser beam has a Gaussian intensity distribution and is absorbed, following Beer's law, in both the pigment epithelium and the choroid layers of the eye. The final expression is mathematically accurate to 1% and is valid for image radii ranging from 20 to 500 mum and for exposure times from 30 ms to infinity. Consequently, this analysis is ideally suited to the interpretation of laser threshold damage experiments using shuttered gas lasers operated in their uniphase mode. Finally, the problem of defining a safe exposure level to laser radiation is considered. However, the lack of available information on minimum retinal image diameter and maximum absorption coefficient permits only an estimate of this parameter to be made.

Lasers↗