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Biomedical subjects

D Robinson

Publications and source records attributed to D Robinson.

At least 361 records · Page 20Linked to original sources
PubMed1989

Ultra-high-speed teleradiology with ISDN technology.

A solid-state, personal computer-based, image digitization and transmission system was developed that uses integrated services digital network (ISDN), a technology under development for ultra-high-speed data transmission over normal phone lines. Thousands of images have been transmitted to a site more than 15 miles away, with data rates exceeding 56,000 bits or 7,000 bytes (1 byte = 8 bits) per second with nearly perfect accuracy. Present modification of the system hardware and software should increase the data rate to 128,000 bits, or 16,000 bytes, per second. With this rate of transmission, remote radiologic image transmission should become a practical, routinely available diagnostic tool.

Computer Communication Networks↗
PubMed1989

Nafamstat mesilate attenuates pulmonary hypertension in heparin-protamine reactions.

Rapid protamine reversal of heparin anticoagulation in awake sheep caused, after 1 min, a approximately 15-fold increase of arterial plasma thromboxane B2 (TxB2) levels, a 4-fold rise of pulmonary vascular resistance (PVR), a 2-fold rise of pulmonary arterial pressure, and after 3 min, a 2-fold rise of ovine arterial plasma complement C3a levels (P less than 0.05). Infusion of nafamstat mesilate (FUT-175), a protease and complement pathway inhibitor, before protamine reduced these increases by approximately 60-90% (P less than 0.05). FUT-175 did not modify heparin + protamine-induced leukopenia, suggesting that FUT-175 incompletely blocked C5a production. We also learned that infusing protamine first and heparin 5 min later did not increase either plasma C3a or TxB2 levels or PVR while the activated clotting time increased only minimally. Thus, in awake sheep, the sequence of heparin and protamine infusion influences complement activation and pulmonary vasoconstriction. FUT-175 pretreatment reduces thromboxane release and pulmonary vasoconstriction probably by limiting complement activation.

Animals↗
PubMed1989

Effect of body mass and other factors on serum liver enzyme levels in men attending for well population screening.

Alcohol abuse is usually regarded as the most likely cause of elevated serum liver enzyme values in those attending for well population screening, but we have found increased body weight to be an important contributing factor. We have measured serum levels of alanine amino-transferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT) in approximately 21,000 men attending for routine health screening, and related these to behavioural factors such as alcohol consumption, cigarette smoking, exercise level and obesity. The levels of all three enzymes were positively correlated with levels of alcohol consumption. Decreasing levels of physical activity were associated with increases in mean ALT and GGT levels. Cigarette smoking showed only a weak effect on ALT and AST, which became non-significant after multivariate statistical analysis, but increasing consumption of cigarettes was associated with increased mean levels of GGT. In contrast, all three enzymes showed marked increases in mean levels with increasing body mass index (BMI). The effect of obesity was particularly important in the case of ALT: the prevalence of increased ALT values in obese subjects (BMI greater than or equal to 31 kg/m2) was more than eight times that in those with normal weight (BMI less than or equal to 25 kg/m2), even after allowing for the confounding effect of alcohol consumption. This study is concerned solely with male subjects, but we hope to extend the analysis to females in the near future.

Adult↗
PubMed1989

Multicentric giant-cell reparative granuloma. A case in the foot.

A case of multicentric giant-cell reparative granuloma in the foot of a 17-year-old boy is reported. Initially, there was a calcaneal lesion and 6 months later, three additional lesions in the forefoot. The calcaneal lesion was treated by curettage and bone grafting, and those in the forefoot by wide excision. The patient has now been free of disease for 18 months.

Adolescent↗
PubMed1989

Nocardia asteroides infection of an Austin-Moore hemiarthroplasty in a nonimmunocompromised host. A case report.

A case of Nocardia asteroides infection of a hip prosthesis in a nonimmunocompromised patient is presented. The infection developed soon after the operation, and did not respond to empiric treatment by multiple antimicrobial drugs. Reoperation and removal of the prosthesis was necessary. The authors found no previous cases of nocardiosis complicating arthroplasty reported in the literature.

Aged↗
PubMed1989

Microbiologic flora contaminating open fractures: its significance in the choice of primary antibiotic agents and the likelihood of deep wound infection.

A clear understanding of the significance of wound contamination as well as knowledge of the microbial flora that could be expected are needed in order to administer a rational and effective antibiotic treatment for open fractures. We have conducted a prospective study of the contaminating microbial flora in 89 open fractures. In addition, two more cultures were taken of all wounds not primarily closed. Wound and fracture healing were followed in all patients. Most fractures were Gustilo grade II (58.4%) caused by work-related accidents. Wound cultures were positive in 83% of all fractures, and a total of 84 strains of bacteria were isolated. In 39.3% of cultures, various species of aerobic Gram-negative rods (most commonly Pseudomaonas aeruginosa) were retrieved, followed by Staphylococcus epidermidis (34.5%) and Staphylococcus aureus (26.1%). Repeat cultures were mostly either negative (59.5%) or grew saprophytic organisms that were usually nonpathogenic (such as various species of saprophytic Bacillus bacteria). The only cases that developed deep wound infection were those where a repeat culture 1 day after debridement grew the same organisms as the initial organisms. We conclude that (a) most open fractures are already contaminated upon the patient's arrival at the emergency department, in many cases by potentially pathogenic staphylococci and Gram-negative organisms; (b) contaminating organisms are community acquired and, as such, are sensitive to most routine antibiotics; and (c) persistence of the same organisms in a repeat culture taken 1 day after debridement signifies technical failure of debridement and a subsequent very high risk of infection. Therefore, achieving adequate wound asepsis immediately following debridement is of the utmost importance.

Adult↗
PubMed1989

Endodontic access: an update, Part II.

Part two of the series on root canal access discusses treatment of the premolars and the mandibular and maxillary molars, and offers additional treatment recommendations.

Bicuspid↗
PubMed1989

A general practice comparative study of a new third-generation oral cephalosporin, cefixime, with amoxycillin in the treatment of acute paediatric otitis media.

A total of 325 eligible paediatric patients were entered into an open, randomised, multicentre general practice study to assess the comparative efficacy of a new third-generation oral cephalosporin, cefixime, with respect to that of amoxycillin in the treatment of acute otitis media. The dose of cefixime was 100 mg once daily (six months to five years), 200 mg once daily (five to 10 years) and 300 mg once daily (10 to 16 years). The dose of amoxycillin was as currently used by the participating general practitioners: 62.5 mg tds (six months to one year), 125 mg tds (one to seven years) and 250 mg tds (seven to 16 years). Both were in the form of an oral suspension. The two groups (160 patients on cefixime and 165 on amoxycillin) were comparable at study entry with respect to all parameters assessed. Overall there was a 95 per cent favourable clinical response seen in both groups (95 per cent confidence limits: 92 and 98 per cent respectively). Adverse events were comparable in both groups, except that there were more gastrointestinal side effects seen with cefixime (13 per cent) compared with amoxycillin (4 per cent), but only three patients in each group had to be withdrawn because of side effects. These results demonstrate that cefixime given once daily is a safe and effective alternative to amoxycillin in the treatment of acute otitis media in children, and also has the advantage of less frequent dosing.

Acute Disease↗
PubMed1989

Ulnar tunnel syndrome caused by an accessory palmaris muscle.

A case of ulnar nerve compression at the wrist caused by an accessory palmaris brevis muscle is presented. At operation, the muscle belly was excised and both Guyon's and the carpal tunnels released. The patient experienced complete relief of symptoms.

Adult↗
PubMed1989

Ethylene glycol toxicity.

Ingestion of ethylene glycol is a rare occurrence, but it is an attractive agent for intoxication and suicide. Treatment is aimed at rapid excretion of the EG, prevention of the formation of metabolites, and the prevention and treatment of renal failure. Prior to discharge, Mr K revealed that he had drunk the antifreeze because he was despondent about his work situation. He had a short, but intensive trajectory that followed the three-system-involvement classic to EG poisoning, with the renal system most severely affected. Mr K was discharged from the hospital one week after admission and referred to appropriate community resources for counseling. The critical care nurse plays a key role in alleviating the hazards of this complex disorder through complete and ongoing assessment of all systems.

Critical Care↗
PubMed1988

Acute meningo-encephalitis on dose reduction of zidovudine.

In a study of treatment by zidovudine in 106 patients with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex, an acute meningo-encephalitic illness developed in 4 of 21 patients within 17 days after the dose of zidovudine had had to be reduced because of myelotoxicity. 3 of the 4 patients had previous clinical evidence of HIV encephalopathy. AIDS-related opportunist infection of the central nervous system was excluded. This acute meningo-encephalitic illness probably results from an increase in HIV replication following dose reduction.

AIDS-Related Complex↗
PubMed1988

The construct validity of interview-based assessments in family counseling.

The construct validity of family therapists' assessments of client functioning was evaluated with data collected in a clinical setting (N = 1,165). The assessments were provided by the therapists in the context of the intake interview. The convergent and discriminant validities of various dimensions of client functioning were evaluated through analyses conducted within the therapist-generated judgments and with data collected directly from clients. The analyses were generally supportive of the construct validity of the assessments. A factor analysis of the client functioning data also is reported.

Counseling↗
PubMed1988

DNA haplotypes of the human apoprotein B gene in coronary atherosclerosis.

Haplotypes of the apoprotein B gene, localised to chromosome 2, were identified using restriction fragment length polymorphisms (RFLPs) for the enzymes XbaI and EcoRI. Four haplotypes were identified at this locus, X1R1 (H1), X1R2 (H2), X2R1 (H3) and X2R2 (H4); where the X1 and X2 alleles were characterised by gene-related fragments of 5.0 and 8.6 kb respectively and the R1 and R2 alleles by fragments of 13.0 and 11.0 kb respectively. Although the polymorphic sites are less than 10 kb apart, they were found to be in linkage equilibrium. The value of the disequilibrium parameter (D) was 0.0042, approximately 7.5% of the theoretical maximum (Dmax = 0.054). No disease association could be demonstrated between either apoB RFLP, or haplotype, and coronary athersclerosis in our population from south-east England. This was in accordance with a study of apoB RFLPs for a population from the West Coast of the United States, but in contrast to a study of an East-Coast population. There are no previous data for the association between apoB haplotypes and coronary atherosclerosis.

Alleles↗
PubMed1988

Morphological studies of an ion-dependent perinuclear cataract model.

The perinuclear region of the rabbit lens is susceptible to alterations in the ionic composition of incubation medium. Rabbit lenses and a comparable cell type, red blood cells, were stressed during ex vivo incubations in isotonic modified Earle's medium with 131 mM NaCl replaced by either 232 mM sucrose or 131 mM choline chloride at pH 7.2 (normal) or 9.2. Our parallel NMR study revealed that these experimental media maintain normal intracellular pH and phosphorus metabolite levels. The present study demonstrates that lens transparency, normal fiber cell ultrastructure and volume were maintained in either sodium chloride or choline chloride containing media at normal or elevated pH. Similarly, normal morphology, mean cell volume (MCV) and mean cell hemoglobin concentration (MCHC), 86.8 +/- 0.03 micron 3 and 33.2 +/- 1.0 g dl-1, respectively, were maintained in red blood cells in either sodium chloride or choline chloride containing media. In sodium chloride deficient media at both normal and elevated pH the lens developed a nuclear cataract based on slit-lamp examination; however, SEM examination showed that fiber cell morphological abnormalities were confined to a narrow band, 50 micron wide, in the perinuclear region of the transition zone. Damage consisted of ruptured cell membranes and an absence of identifiable interdigitations with the combination of sodium chloride deficiency and elevated pH. The major abnormality produced during incubation in sodium chloride deficient medium at normal pH was the presence of numerous smooth-surfaced cellular protrusions along the vertices of the perinuclear fiber cells. In addition, the sodium chloride deficient medium, pH 9.2, produced a volume loss both in the lens and RBC (4.5 +/- 1.5% and 5.6 +/- 1.1%, respectively). The sodium chloride deficient medium, pH 7.4, produced no volume loss in the lens or red blood cells (MCV 86.0 +/- 0.05 micron 3). Further studies indicated that the cataract induced by sodium chloride deficiency (pH 9.2) is irreversible. The mechanism for perinuclear opacification due to ion deficiency remains to be elucidated.

Animals↗