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Biomedical subjects

D W Noble

Publications and source records attributed to D W Noble.

10 recordsLinked to original sources
PubMed1991

Adrenaline, fentanyl or adrenaline and fentanyl as adjuncts to bupivacaine for extradural anaesthesia in elective caesarean section.

We have compared the effects of extradural fentanyl and fentanyl plus adrenaline with adrenaline alone as adjuncts to extradural bupivacaine in patients undergoing elective Caesarean section. Forty-five patients were allocated randomly to receive 0.45% bupivacaine 20 ml with adrenaline 4.5 micrograms ml-1, fentanyl 4.5 micrograms ml-1 or adrenaline plus fentanyl (4.5 micrograms ml-1 of each) as supplements. The main outcome measures were time to bilateral analgesia of T6 or higher, need for intraoperative analgesic supplements, observer rating of intraoperative analgesia and patient assessment of analgesia using a 10-cm visual analogue scale. The time to onset of analgesia to T6 was reduced insignificantly by the fentanyl solutions compared with adrenaline only. The quality of analgesia as assessed by the need for analgesic supplements was superior for the patients given fentanyl. An observer rating of pain and visual analogue pain scoring by the patient also indicated superior analgesia with fentanyl supplementation. Two patients experienced respiratory depression after extradural fentanyl and were given naloxone. Two neonates were also given naloxone. Close supervision is therefore recommended in the early postoperative period when this technique is used.

Adjuvants, Anesthesia↗
PubMed1990

Comparison of i.m. ketorolac trometamol and morphine sulphate for pain relief after cholecystectomy.

I.m. ketorolac trometamol 30 mg was compared with morphine sulphate 10 mg after cholecystectomy in a double-blind, multiple dose, randomized study of 100 patients. Assessments of pain were made immediately after operation (day 1), and the next morning (day 2). Pain intensity (verbal response score and visual analogue scale) was recorded before injection and then over a 6-h period. Pain relief was assessed also. The effect of ketorolac on operative blood loss and platelet function was examined. Time to commencing oral intake and the duration of administration of i.v. fluids were recorded. Adverse events were noted. Ketorolac produced significantly less analgesia than morphine on day 1, but on day 2 the two drugs produced a similar effect. Blood loss was not increased by ketorolac, although platelet function was impaired. Repeated i.m. administration of ketorolac did not produce any serious adverse effects.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1990

Volatile agent use.

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Anesthesia, Inhalation↗
PubMed1987

Effects of H-2 antagonists on the elimination of bupivacaine.

The effects of two histamine H-2 antagonists, cimetidine and ranitidine, on the elimination of bupivacaine were studied in four male volunteers. The cimetidine-treated group demonstrated a statistically significant decrease in clearance of bupivacaine. These results indicate that concomitant administration of cimetidine and bupivacaine may increase the likelihood of toxicity of the latter agent.

Bupivacaine↗
PubMed1977

Fetal proteinuria in diagnosis of congenital nephrosis detected by raised alpha-fetoprotein in maternal serum.

High concentrations of alpha-fetoprotein (alpha-FP) were found at 14, 19, and 21 weeks gestation in the serum of a woman with a history of unexplained fetal death in her previous pregnancies. The alpha-FP concentration of the liquor also was high at 21 weeks and the pregnancy was terminated. Though the fetus was macroscopically normal, measurement of albumin, alpha-FP, IgG, and alpha2-macroglobulin in the fetal urine showed a selective proteinuria, and congenital nephrosis was diagnosed after examination of the fetal kidneys by electron microscopy. Possibly some fetuses reported to be "false-positive for neural tube defect" may have had renal lesions of this nature. Examination of fetal urine may be the simplest initial diagnostic procedure in any future case.

Adult↗
PubMed1977

Nonspecific DNA binding of genome-regulating proteins as a biological control mechanism: measurement of DNA-bound Escherichia coli lac repressor in vivo.

Binding of genome regulatory proteins to nonspecific DNA sites may play an important role in controlling the thermodynamics and kinetics of the interactions of these proteins with their specific target DNA sequences. An estimate of the fraction of Escherichia coli lac repressor molecules bound in vivo to the operator region and to nonoperator sites on the E. coli chromosome is derived by measurement of the distribution of repressor between a minicell-producing E. coli strain (P678-54) and the DNA-free minicells derived therefrom. Assuming the minicell cytoplasm to be representative of that of the parent E. coli cells, we find that less than 10% of the repressor tetramers of the average cell are free in solution; the remainder are presumed to be bound to the bacterial chromosome. The minimum in vivo value of the association constant for repressor to bulk nonoperator DNA (K(RD)) calculated from these results is about 10(3) M(-1), and analysis of the sources of error in the minicell experiment suggests that the actual in vivo value of K(RD) could be substantially greater. The value of K(RD), coupled with in vitro data on the ionic strength dependence of this parameter, can be used to estimate that the effective intracellular cation activity of E. coli is no greater than about 0.24 M (and probably no less than 0.17 M) in terms of sodium ion equivalents. The minicell distribution experiments also confirm that the association constant for the binding of inducer-repressor complex to bulk nonoperator DNA (K(RID)) is [unk] K(RD)in vivo. These results are used to calculate minimum in vivo values of K(RO) and K(RIO) (association constants for repressor and for inducer-repressor complex binding to operator) of about 10(12) M(-1) and about 10(9) M(-1), respectively. The results fit a quantitative model for operon regulation in which nonspecific DNA-repressor complexes play a key role in determining basal and constitutive levels of gene expression [von Hippel, P. H., Revzin, A., Gross, C. A. & Wang, A. C. (1974) Proc. Natl. Acad. Sci. USA 71, 4808-4812].

Bacterial Proteins↗