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Biomedical subjects

E Moss

Publications and source records attributed to E Moss.

At least 55 records · Page 3Linked to original sources
PubMed1990

Effect of propofol on brain retraction pressure and cerebral perfusion pressure.

We have studied the effect of propofol, at a rate of 30 mg kg-1 h-1 for 5 min reducing to 6 mg kg-1 h-1 for a further 5 min, on brain retraction pressure (BRP) in 15 patients undergoing craniotomy. The response of BRP showed two distinct patterns. BRP was reduced by an average of 3.3 mm Hg (P = 0.005). Mean arterial pressure was reduced in all patients by an average maximum of 28.3 mm Hg (P = less than 0.001), which caused a significant reduction in cerebral perfusion pressure (CPP) by 22.9 mm Hg (P less than 0.001). It is concluded that, by reducing BRP, propofol provided suitable conditions for intracranial surgery, but care should be taken to avoid excessive reduction in CPP.

Blood Pressure↗
PubMed1989

Retrospective study of early postoperative convulsions after intracranial surgery with isoflurane or enflurane anaesthesia.

Retrospective analysis of the case records of 383 patients undergoing elective intracranial surgery showed that, in the first 24 h after surgery, 13.9% of patients receiving low concentrations (0.4-1 MAC) of isoflurane had one or more convulsions after operation, compared with 8% receiving enflurane (0.4-1 MAC). Controlled ventilation was required as part of the therapy for convulsions in 4.9% of the isoflurane group and 3.6% of the enflurane group. These differences between the groups were not statistically significant.

Anesthesia, Inhalation↗
PubMed1988

Vasitis nodosa and associated clinical findings.

To establish the prevalence of vasitis nodosa in patients who had undergone vasectomy segments of vas deferens resected from 40 patients at the time of vasectomy reversal were examined histologically and immunohistochemically. The findings were correlated with clinical history and postoperative outcome. Controls comprised segments of normal vas deferens excised at vasectomy. Twenty of the 40 vasovasostomy specimens showed vasitis nodosa; in 13 this was associated with sperm granulomas and in two with spermatocoeles. The vasitis nodosa was characterised by multiple small ductules extending from the central lumen of the vas into the muscle layers and adventitia. In 14 cases there was mucinous metaplasia of the epithelium lining the ductules. The number of nerve fibres in the submucosa and muscle layers was reduced after vasectomy. In patients with vasitis, however, hyperplasia of nerve fibres in the adventitia (16 of 20 cases) and formation of neuromas were seen. Nerve fibre hyperplasia was seen in only one, and sperm granulomas and spermatocoeles in none of the 20 specimens without vasitis nodosa. The development of vasitis nodosa was independent of the patients' age or the interval between vasectomy and reversal. The restoration of fertility did not seem to be affected by previous vasitis nodosa.

Adult↗
PubMed1987

Ratings of emotion in faces are influenced by the visual field to which stimuli are presented.

This experiment was designed to assess the differential impact of initially presenting affective information to the left versus right hemisphere on both the perception of and response to the input. Nineteen right-handed subjects were presented with faces expressing happiness and sadness. Each face was presented twice to each visual field for an 8-sec duration. The electro-oculogram (EOG) was monitored and fed back to subjects to train them to keep their eyes focused on the central fixation point as well as to eliminate trials confounded by eye movement artifact. Following each slide presentation, subjects rated the intensity of the emotional expression depicted in the face and their emotional reaction to the face on a series of 7-point rating scales. Subjects reported perceiving more happiness in response to stimuli initially presented to the left hemisphere (right visual field) compared to presentations of the identical faces to the right hemisphere (left visual field). This effect was predominantly a function of ratings on sad faces. A similar, albeit less robust, effect was found on self-ratings of happiness (the degree to which the face elicited the emotion in the viewer). These data challenge the view that the right hemisphere is uniquely involved in all emotional behavior. The implications of these findings for theories concerning the lateralization of emotional behavior are discussed.

Adult↗
PubMed1987

Comparison of recovery after halothane or alfentanil anaesthesia for minor surgery.

Recovery after anaesthesia was assessed using the Maddox Wing Test (MW), Critical Flicker Fusion Threshold (CFF), Choice Reaction Time (CRT), Line Analogue Rating Scales (LARS), a Tracking Test and a test of Semantic Memory in 44 patients who had undergone minor gynaecological surgery. The patients were allocated randomly to one of two groups and received either methohexitone, nitrous oxide, oxygen and halothane or methohexitone, alfentanil, nitrous oxide and oxygen. Immediate recovery was more rapid in the alfentanil group (P less than 0.01), but apnoea (P less than 0.05) and hiccups (P less than 0.05) were more common. Except for the CFF test, which showed the alfentanil patients to be less sedated than the halothane patients on the morning after anaesthesia (P less than 0.05), the results of the tests were similar in both groups and showed, initially, substantial impairment of psychomotor functions which gradually returned to baseline values. This comparison with halothane anaesthesia indicates that a technique using methohexitone and alfentanil is suitable for day-case surgery.

Adult↗
PubMed1986

Pernicious anaemia and mucosal endocrine cell proliferation of the non-antral stomach.

There is a recognised association between pernicious anaemia and the development of gastric carcinoma, endocrine cell hyperplasia, and carcinoid tumour. Multiple endoscopic biopsies from the body mucosa of seven patients with pernicious anaemia showed small intestinal metaplasia with varying degrees of inflammation, fibrosis, and expansion of the lamina propria. Using conventional silver and lead stains, endocrine cells were inconspicuous. Staining for the general neural and neuroendocrine markers NSE and PGP 9.5 revealed a proliferation of endocrine cells in the epithelium and isolated clumps of endocrine cells in the lamina propria. The clumps were composed of two cell types, either small or large. Some of these endocrine cells showed gastrin, 5HT, VIP and substance P immunoreactivity of varying intensity. Ultrastructurally nine morphologically distinct types of granules were found some of which correlated with the immunohistochemistry. Some separate islands were composed solely of endocrine cells while others had a definite neural component, suggesting that the former arise from 'budding off' of enteroendocrine cells and the latter originate from the neuroendocrine cells of the lamina propria plexus. Thus there may be a dual origin of carcinoid tumours. Carcinoid tumours associated with pernicious anaemia tend to be multifocal and are infrequent. Less than 50 such cases have hitherto been reported. Our findings of endocrine cells proliferations in seven cases of pernicious anaemia indicate that this may be an adaptive change that occurs frequently and provides the basis on which carcinoids, less frequently, develop.

Adult↗
PubMed1986

Integrated psychotherapeutic treatment of somatoform and other psychophysiological disorders.

In this article, we have described a subgroup of patients referred from a general medical setting and suffering from a cluster of similar physical and emotional symptoms, while presenting similar psychodynamics and personality traits. In contrast to a certain scepticism in the psychiatric community about the usefulness of psychotherapy with these people, our experience suggests that when a number of diverse psychotherapeutic techniques are drawn upon in an integrated fashion, psychotherapy can be an effective clinical tool. The coping-rest model, with its combination of physiological, behavioural and dynamic approaches, has been particularly helpful. We present 3 representative cases, which reflect the overall clinical and personality features of the subgroup and the integrated psychotherapeutic approach that was utilized.

Adaptation, Psychological↗
PubMed1985

Neural markers in carcinoma of the lung.

Small cell carcinoma (SCC) is considered to be of neuroendocrine origin. Neurone specific enolase (NSE) and PGP 9.5 are markers of neural and neuroendocrine differentiation. S-100 protein is a marker of glial differentiation. The expression of these markers in endobronchial biopsy and lung tumour resection specimens was studied to see if any diagnostic, prognostic or therapeutic implications would emerge. Zamboni fixed endobronchial tumour biopsy specimens from 20 patients were examined. Twelve of these were cases of SCC and 8 were non-SCC. Of the 12 SCC, 7 were positive for NSE, 6 for PGP 9.5 and 5 for S-100 protein. Cases which showed a positive reaction for NSE had a mean survival of 9.1 months compared with 3.9 months for those with a negative reaction, but the number of cases is too small to assign any statistical significance. There was no difference in survival times between positive and negative reactors for PGP 9.5 and S-100 protein. All 8 cases of non-SCC showed positive reactions to all three markers. Of 32 formalin fixed lung tumour resection specimens 6 were cases of SCC, 25 non-SCC and 1 a chemodectoma. Three of the 6 cases of SCC showed positive staining for NSE, 3 for PGP 9.5 and 1 for S-100 protein. Of the 25 non-SCC, 10 were positive for NSE, 12 for PGP 9.5 and 6 for S-100 protein. The 1 chemodectoma stained positively for all three markers. Neuroendocrine markers are of little value in differentiating SCC from non-SCC. Positive staining for NSE in SCC may be an indicator of prolonged survival but further investigation is required.

Adenocarcinoma↗
PubMed1985

Pharmacokinetics of Sch 34343 in rats and dogs.

The pharmacokinetics of 14C-Sch 34343 were studied in rats and dogs following intravenous and intramuscular dosing. In both species, it was rapidly absorbed after intramuscular dosing. The serum AUC for total radioactivity and for intact drug after intramuscular dosing were similar to those obtained after intravenous dosing. Following both routes of drug administration, the elimination of half-life (T 1/2 beta) was 7 min in rats and 25-32 min in dogs. Following intravenous dosing of 14C-Sch 34343 to rats, radioactivity in tissues disappeared rapidly with time indicating no tissue accumulation. Highest concentrations of radioactivity were seen in the kidney. Liver, lung, skin and heart appeared to have concentrations of radioactivity similar to those of blood. Sch 34343 was excreted rapidly and primarily into the urine in both rats and dogs. After either route of dosing, urinary excretion of total radioactivity ranged from 84 to 93% and that of intact Sch 34343 from 41 to 51% of the dose, respectively. In addition, the effect of pretreatment with probenecid on the pharmacokinetics in rats and dogs and in anephric rats were also evaluated. Pretreatment with probenecid prolonged the elimination half-life in both rats and dogs. Anephric rats had a longer half-life than normal rats.

Animals↗
PubMed1983

Metabolic basis of the species difference to aflatoxin B1 induced hepatotoxicity.

Primary metabolism of aflatoxin B1 by the liver microsomal enzymes from a range of animal species showed both quantitative and qualitative differences. Quail was shown to have the most rapid metabolism of aflatoxin B1. The major product of metabolism in this case was found to be aflatoxin B1-8,9-dihydrodiol suggesting that the quail microsomes produced high levels of the proposed reactive intermediate aflatoxin B1-8,9-epoxide. Using this system to generate the epoxide, the ability of the cytosol prepared from each species to conjugate epoxide with reduced glutathione was investigated. Large differences in ability to conjugate were observed ranging from 0 to 72% for quail and mouse respectively. Differences in both primary and secondary metabolism of AFB1 were noted between male and female Fischer 344 rats.

Aflatoxin B1↗
PubMed1983

Effects of 2% enflurane on intracranial pressure and cerebral perfusion pressure.

Ten patients with cerebral tumours were anaesthetized with thiopentone, 70% nitrous oxide in oxygen and fentanyl. Ventilation was controlled to give mean PaCO2 4.8 (range 3.6-6.7) kPa. Enflurane 2% was administered and ICP and MAP were recorded continuously for 10-15 min. The changes in ICP were not significant and ranged from -18.5 to 5.5 mm Hg. There were significant decreases in MAP (P less than 0.001) and CPP (P less than 0.001) during the administration of enflurane. In four patients the administration of enflurane had to be terminated prematurely because of a low CPP. Thus, enflurane has very little effect on ICP in patients with cerebral tumours and low concentrations of enflurane can safely be used during anaesthesia for intracranial operations, provided that the arterial pressure is monitored carefully.

Anesthesia, Inhalation↗
PubMed1983

Intensive management of severe head injuries. A scheme of intensive management of severe head injuries.

Seventy-six severely head-injured patients, 67% of whom had Glasgow Coma scores of five or less on admission, were managed according to an intensive treatment regime which included controlled hyperventilation (under full muscular paralysis), high-dose steroids, dehydrating agents, diuretics and hypnotics (Althesin and thiopentone). Intracranial pressure (ICP) was measured throughout the period of controlled ventilation. Treatment was directed to keeping the mean ICP below 25-30 mmHg and to the prevention of increases in ICP during chest physiotherapy and other noxious stimulation. Six months after injury 46% of patients had died and 4% were vegetative survivors, whilst 43% had made a good recovery or were only moderately disabled. Features associated with worse than average prognosis were: low coma score, pupillary abnormalities, respiratory dysrhythmia and ICP greater than 30 mmHg. Spontaneous hyperventilation was a relatively good initial feature. These results support the employment of intensive care in severely head-injured patients, particularly those with diffuse brain injury.

Adolescent↗
PubMed1982

Pulmonary candidiasis complicating a severe burn treated with miconazole.

A 33/4-year-old boy received a 50 per cent body surface area burn in a house fire. On the eighteenth day post burn he was moribund and a diagnosis of pulmonary candidiasis was made following tracheal cultures and X-ray changes after a period of progressive deterioration during which he had received multiple antibiotics and assisted ventilation. Treatment of this pulmonary candidiasis was with intravenous miconazole. The child's clinical condition rapidly improved over the following 24-48 hours and the X-ray changes resolved. He was subsequently discharged fully healed.

Burns↗
PubMed1982

Attitudes towards mental illness in a sample of Israeli rehabilitation workers.

Forty-six rehabilitation workers from the Tel Aviv metropolitan area were tested for their views about mentally ill people. It was found that these workers were ambiguous in their attitudes. In some respects they were more tolerant than the general Israeli population. In others, they displayed the same negative views towards the mentally ill as other researchers have found in Israeli society. This ambiguity may be due to the fact that while their professional ideology forces them to express "tolerant" opinions, they nonetheless are influenced by the attitudes prevalent in Israeli culture. Then, too, these negative attitudes may also stem from disappointing professional experience with chronic mentally ill clients. Mainsteam psychiatric professionals could assist these rahabilitation workers by offering more consultative, back-up services.

Adult↗