Trainee anaesthetists and the laryngeal mask airway.
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Anesthesiology↗
Biomedical subjects
D Russell
Publications and source records attributed to D Russell.
Neurodevelopmental therapy and upper-extremity inhibitive casting for children with cerebral palsy.
The purpose of this research was to study the effect of intensive neurodevelopmental therapy (NDT) and upper-extremity inhibitive casting, separately or in combination, on hand function, quality of upper-extremity movement and range of motion of 73 children with spastic cerebral palsy aged 18 months to eight years. There was no significant difference between intensive or regular therapy and casting or no casting for hand function, between intensive and regular NDT, or between intensive NDT plus casting and the other groups for quality of movement and range of motion. Casting led to increased quality of movement and wrist extension after six months. Casting with NDT improved the quality of upper-extremity movement and range of motion. There appear to be no immediate benefits from intensive therapy alone.
Arm↗
Clonal deletion of autospecific B lymphocytes.
Using mice transgenic for functional, rearranged immunoglobulin heavy and light chain genes, it can be demonstrated that B lymphocytes reactive with cell surface-bound class I MHC antigen can be controlled by clonal elimination. Even low-affinity cell-bound ligands can induce deletion. Deletion can occur in the pre-B to B cell transitional stage or after the B cells exist the bone marrow, depending on where the cells first encounter autoantigen. IgD appears to play no role in protecting cells from deletion. It is argued that defects in B-cell tolerance alone may be sufficient to lead to systemic autoimmunity.
Animals↗
Interaction of imipenem with erythromycin and tetracycline assessed by microdilution checkerboard techniques.
Microdilution methodology was used to study the interaction of imipenem with erythromycin and tetracycline, a combination therapy that might be used for the treatment of serious pelvic inflammatory disease. The combination of imipenem and erythromycin showed no antagonism for Escherichia coli and Haemophilus influenzae but was antagonistic for Staphylococcus aureus, Enterococcus faecalis, and group B streptococci; the combination of imipenem and tetracycline was antagonistic for all strains except H. influenzae. Correlation between the results of kill curves and the measurement of fractional bactericidal concentration (FBC) indices was good, although FBC indices showed less antagonism than kill curves. Fractional inhibitory concentration indices showed poor correlation, rarely showing antagonism, and indeed showed synergy in three cases. If erythromycin or tetracycline is considered necessary in addition to imipenem in the treatment of pelvic inflammatory disease, it is probably more effective when given after the course of imipenem has been completed.
Bacteria↗
Detection of arterial emboli using Doppler ultrasound in rabbits.
The purpose of this study was to develop an animal model that could be used to test the ability of Doppler ultrasound to detect arterial emboli composed of materials that are often involved in cerebral emboli. Emboli introduced into the rabbit aorta via the left renal artery consisted of clotted whole blood, platelets, atheromatous material, fat, or air. The ultrasound examination was carried out continuously during the studies using a multifrequency transcranial Doppler apparatus with a 2-MHz probe, a sample volume of 15 mm, at a depth of 15 mm. The intensity of the Doppler spectrum was measured and displayed as a 15-shade color scale, each shade representing a 3-dB difference. The diameter of the aorta at the site of the ultrasound examination was similar to the diameter of the middle cerebral artery in humans. All 125 emboli introduced were clearly detected because they caused a Doppler signal at least 15 dB greater than that of the surrounding blood. These results show that the potential for emboli detection using Doppler ultrasound in the clinical situation is now considerable.
Animals↗
Patients' views of the consultation: comparison of a prison and general practice population.
Prisoners' perceptions of why they consulted the doctor, how ill they thought they were and what happened during the consultation were studied in Bedford prison using a questionnaire. Patients' perceptions were compared before and after the consultation and with the perception of the doctor. The figures from this study were compared with comparable groups in a similar general practice survey. Prisoners perceived themselves to be more ill than comparable groups living in the community and both doctor and prisoners perceived that the prisoners received less reassurance. Prisoners were less likely to attend the doctor because their treatment had not worked, or because the doctor had asked them to return than comparable groups living in the community. The perception of the doctor and the prisoners about what occurred in the consultation diverged. The doctors perceived that they provided more advice and support than the prisoners felt they received. These perceptions may reflect a more difficult doctor-patient relationship and poorer continuity of care in prison medicine. These problems might be overcome if the prison medical service were run by the National Health Service and prison doctors had no role in the management of prisoners.
Adolescent↗
Carbon disulfide exposure and neurotoxic sequelae among viscose rayon workers.
In Norway's only viscose rayon plant, carbon disulfide (CS2) concentrations in ambient air usually were between 30 and 50 mg/m3 during the first 23 years of production. From 1970/1971 until the factory was closed in 1982, corresponding values were 10-25 mg/m3. Through all of these years, high peak exposures of CS2 and H2S occurred. In 1986, 16 of the 24 men still at work in 1982 and with at least 10 years' experience in the spinning room agreed to participate in this study. Clinical neurological examination demonstrated abnormalities in 15; neuropsychological tests showed impairments of probable organic origin in 14. Thirteen had cerebral atrophy demonstrated by cerebral computed tomography (CT). Electromyography (EMG) was abnormal in six, neurography in 11. Regional cerebral blood flow measurements indicated flow asymmetries in eight, whereas Doppler investigation of the extracranial carotid and vertebral arteries, electroencephalography (EEG), and evoked response investigations were mostly normal. Based on these results and the exposure data, a diagnosis of CS2-induced encephalopathy was reached in eight workers; another six had an encephalopathy in which CS2 exposure was regarded as a partial cause. Correspondingly, seven had a neuropathy probably caused by CS2 exposure alone; in three others, CS2 was found to be the partial cause of a neuropathy. This indicates that long-term, relatively moderate exposure to CS2 in association with high peak exposures to CS2 and H2S involves a substantial risk of developing neurotoxic disease.
Adult↗
Non-Hodgkins lymphoma of the head and neck: experience in the Grampian area.
The records of 44 cases of non-Hodgkins lymphoma (NHL) presenting to the ear, nose and throat department in the Grampian area from 1980-1988 were examined in relation to site of occurrence, histology, age at presentation, clinical stage, treatment and survival. The median age was 67 years and there was a preponderance of high grade histology, especially in disease affecting the tonsil. Most deaths occurred in the first year; patients with high grade disease and those in stages three and four had a significantly poorer survival during the first year. The site of disease had no influence on survival.
Adolescent↗
Cluster headache: transcranial Doppler ultrasound and rCBF studies.
Transcranial Doppler and rCBF examinations were carried out in 25 cluster headache patients. Spontaneous and glyceryl trinitrate (nitroglycerin) provoked attacks were accompanied by a bilateral decrease in middle cerebral artery blood flow velocities. This decrease was more pronounced on the symptomatic side but the difference did not reach statistical significance. Mean hemispheric blood flow and rCBF were within normal limits during provoked attacks and similar to those found when patients were attack-free. During cluster periods middle cerebral artery velocities were significantly higher on the symptomatic side. Glyceryl trinitrate caused a bilateral middle cerebral artery velocity decrease which was significantly greater on the symptomatic side. Attacks provoked by glyceryl trinitrate appeared to begin when the vasodilatory effect of this substance was receding.
Adult↗
Maize sucrose synthase-1 promoter directs phloem cell-specific expression of Gus gene in transgenic tobacco plants.
Tobacco plants were transformed by using a chimeric gene construction, in which a corn sucrose synthase-1 gene (Sh) promoter was used to direct expression of the beta-glucuronidase (Gus) reporter gene. Expression of Sh-Gus activity in these plants was found to be cell type specfifc. GUS activity was detected only in the phloem cells but not in any other cell types of vegetative tissues. In addition, Sh-Gus expression was found to be anaerobically inducible in tobacco roots. Sh-Gus was also expressed at high levels in the endosperm tissue of maturing tobacco seeds. We thus demonstrated that the corn Sh promoter can direct cell-type-specific and inducible expression in a heterologous dicotyledonous plant.
Journal Article↗
The psychometric properties of a tinnitus handicap questionnaire.
The psychometric properties of a tinnitus handicap questionnaire are reported. There were two phases in this study. In Phase I, 87 questions were administered to 100 tinnitus patients. From their responses, 59 items that were either redundant, insensitive, or had low item-total correlations were eliminated. In Phase II, the resulting 27-item questionnaire was administered to 319 patients. Fifty-three of these patients also completed psychological and psychophysical measures that were used to validate the questionnaire. A factor analysis of patients' responses revealed a three-factor structure. These three factors appeared to reflect the physical, emotional, and social consequences of tinnitus (Factor 1), hearing ability of the patient (Factor 2), and the patients' view of tinnitus (Factor 3). Although the 27-item questionnaire had high internal consistency reliability and validity as reflected by correlations with life satisfaction and depression scales, it is recommended that only the items on the Factor 1 and the Factor 2 subscales be scored because of the low internal consistency reliability of the Factor 3 subscale. This questionnaire can be used to compare a patient's tinnitus handicap with the norm, identify specific areas of handicaps, and to monitor a patient's progress with particular treatment programs.
Female↗
Painless loss of vision after transurethral resection of the prostate.
A 74-year-old man developed complete loss of vision after transurethral prostatectomy under spinal anaesthesia. Eyesight returned to normal over the next 12 hours. A direct inhibitory effect on the retina caused by glycine absorbed with the irrigation fluid is suggested as a possible cause.
Aged↗
Seasonal, regional and secular variations of cardiovascular and cerebrovascular mortality in New Zealand.
Numbers of deaths from coronary heart disease (CHD) and cerebrovascular disease (CVD) were available for five years (1980-84) in the North and South Islands of New Zealand; estimated death rates were determined, and age correction made. There was a major seasonal variation by month in coronary and cerebrovascular deaths in both sexes and both islands, with a zenith in June/July/August (winter) and a nadir in December/January/February (summer). There was a less obvious, and less complete, linear trend, with declining secular (annual) mortality over the five years. This was more obvious in North Island but not proven in South Island. After standardising for age, coronary mortality rates (but not cerebrovascular mortality rates), were significantly higher in South Island than in North Island. Mortality from both CHD and CVD was significantly higher in males than in females.
Age Factors↗
Patency and flow velocity profiles in the internal carotid artery assessed by digital subtraction angiography and Doppler studies two years after endarterectomy.
A follow-up of 55 patients 2 years after a total of 60 carotid endarterectomies. Fifty-two patients who had a total of 57 endarterectomies survived the first 2 post-operative years and were re-examined using pulsed Doppler spectral analysis and intravenous digital subtraction angiography (IVDSA). One patient had died following a stroke and 2 after a cardiac infarction. The Doppler and IVDSA examinations revealed a non-symptomatic restenosis of the relevant internal carotid artery in 2 patients. There were no relevant occlusions and no symptomatic re-stenoses were detected. Spectral spreading of the Doppler signal at the site of the endarterectomy was found in 18% of the internal carotid arteries, whereas wall irregularities (diameter reduction less than 10%) were demonstrated in 25% by IVDSA. A stenosis or occlusion was found in 14 (25%) of the 57 ipsilateral external carotid arteries.
Blood Flow Velocity↗
Acetazolamide effect on cerebellar blood flow in crossed cerebral-cerebellar diaschisis.
We studied the effect of acetazolamide on cerebellar blood flow in 11 stroke patients with large, unilateral cerebral hemispheric infarcts and no evidence of cerebellar infarction, but with cerebrocerebellar diaschisis of cerebral blood flow. Blood flow was determined with xenon-133 inhalation and dynamic single-photon emission computed tomography at rest and 20 minutes after the intravenous injection of 1.0 g acetazolamide. After acetazolamide, the mean +/- SD increases in blood flow in the affected and contralateral cerebellar hemispheres were 11.1 +/- 3.7 and 12.0 +/- 5.3 ml/100 g/min, respectively; the difference between hemispheres was not significant. The absolute increase in cerebellar flow in these 11 patients was of the same magnitude as that in 12 healthy controls. We conclude that cerebellar vasoreactivity is intact in stroke patients with crossed cerebrocerebellar diaschisis of cerebral blood flow. Our results lend further support to the concept that reduced cerebellar blood flow is secondary to functional deactivation. Our patients were studied 2 weeks to 5 years after their stroke, indicating that this phenomenon may be persistent.
Acetazolamide↗
Cerebral vasoreactivity and blood flow before and 3 months after carotid endarterectomy.
We measured regional cerebral blood flow and cerebral vasoreactivity before and 3 months after carotid endarterectomy using xenon-133 inhalation with single-photon emission computed tomography and the acetazolamide test in 14 selected patients who had suffered cerebral transient ischemic attacks due to an ipsilateral internal carotid artery stenosis. The patients had neither clinical nor cerebral computed tomographic evidence of infarction. Baseline regional cerebral blood flow was symmetrical before and unchanged after endarterectomy. Before endarterectomy, vasoreactivity in the middle and anterior cerebral artery territories of the symptomatic side was significantly reduced (p less than 0.05); however, vasoreactivity was normalized 3 months after surgery. Our findings strongly suggest that the stenoses caused a reduction in perfusion reserve that was improved by carotid endarterectomy.
Acetazolamide↗
Trends and patterns in place of death for Medicare enrollees.
Two changes in the Medicare program in 1983 may have affected where aged persons die--the change from retrospective hospital reimbursement to the prospective payment system and passage of the Medicare hospice benefit. Patterns and trends in where people die--hospitals, other institutions such as nursing homes, decedents' homes, and other places--for persons 65 years of age or over from 1980 through 1986 are examined. The proportion of deaths in hospitals declined somewhat after implementation of prospective payment. The hospice benefit may have caused the shift among cancer patients away from hospital deaths toward deaths at home.
Aged↗
Hemodynamics of carotid occlusive disease.
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Acetazolamide↗