Biomedical subjects
Publications and source records attributed to D K Jones.
The case is presented of a 14-year-old boy in whom influenza B virus infection caused pneumonia, acute renal failure and disseminated intravascular coagulation (DIC). Survival was achieved by prompt treatment of DIC with clotting factors and heparin. DIC should be diligently sought in severe viral infections because appropriate therapy may be life-saving.
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A case of severe bacterial meningitis complicated by alcoholism, lobar pneumonia and coma, is described. Although triple antibiotic therapy had been ineffective, the patient made a rapid and complete recovery when treated with cefotaxime alone.
Venous whole-blood eosinophil counts were performed on 50 occasions in 42 patients with varying patterns of asthma. None of the patients studied had received systemic corticosteroids during the previous year. Patients with acute severe asthma, as defined by symptomatic airways obstruction with a tachycardia of at least 120 beats/min, showed eosinopenia (21 x 10(9)/l +/- SD 57 x 10(9)/l). Patients with chronic asthma, as defined by symptomatic airways obstruction with a heart rate of less than 100 beats/min, showed appreciable eosinophilia (1048 x 10(9)/l +/- SD 708 x 10(9)/l). Finally, asymptomatic patients had a variable total eosinophil count but with values lower than those of patients with chronic asthma (345 x 10(9)/l +/- SD 431 x 10(9)/l). Eosinophilia may contain chronic asthma, thereby mediating bronchial damage, whereas absence of eosinophils in acute asthma enables vasoactive mediators to enter the systemic circulation, possibly causing circulatory disturbances.
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Three patients with malignant mesothelioma of the pleura presented with unilateral pleural effusion and recurrent horizontal linear opacities on the chest radiograph. Although an initial diagnosis of pulmonary embolism was made in all three patients and two received anticoagulants, it is more likely that the opacities represented plate atelectases due to restriction of basal lung expansion by severe chest pain. It is suggested that the early manifestations of malignant mesothelioma of pleura may be confused with recurrent pulmonary embolism.
The effective use of aqueous and oily pilocarpine was studied in 19 glaucomatous eyes. The aqueous drops were used 4 times a day while the oily drops were used only twice. It was found that the oily drops were better than the aqueous drops in lowering the mean intraocular pressure and the maximum pressure reached during the day. no statistically significant difference was found between the 2 pilocarpine treatments in the reduction of daily variation of intraocular pressure. It is felt that oily drops used only twice a day would lead to better patient compliance and better control of chronic simple glaucoma.
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We have used an isolated rat lung model to compare the quality of preservation of different flush techniques with each other and with topical cooling alone. Lung injury was assessed by recording lung weights after reperfusion after 4 and 6 hours of ischemia. The flush solutions studied were intracellular (Collins-Sacks), traditional extracellular, extracellular with low potassium plus dextran, and extracellular containing blood, mannitol, albumin, and prostacyclin (Wallwork's solution). Flushing with Wallwork's solution before both 4 and 6 hours of ischemia gave superior protection from lung edema after reperfusion over all the other methods.