Biomedical subjects
Publications and source records attributed to G Hardy.
Author describes the anatomical basis and the possibilities of application of the dorsal metacarpal vascular pedicled reverse flap used first in this country. The vascular pedicled flap ins suitable to cover the skin and soft part defects over the dorsal surface of the ground phalanx of the long fingers and over the PIP joint.
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Because of the susceptibility of some vitamins to oxidation, they are not normally added to TPN mixtures until shortly before addministration. Vitamin C (ascorbic acid) is oxidised rapidly, especially in the presence of trace elements. The aim of this study was to investigate the stability of ascorbic acid in complete TPN mixtures in Ultrastab multilayer bags, which are designed to reduce oxygen transmission and thus oxidation, in comparison with standard EVA bags. Ascorbic acid content was determined in two typical TPN mixtures providing 16 g nitrogen, 2000 kilocalories, electrolytes, trace elements and multivitamins, with and without fat emulsion, during storage at 5 degrees C for up to 3 months. In EVA bags ascorbic acid degraded by more than 75% during 24 h and was undetectable in 2-3 days. In contrast, there was a comparatively small initial loss of 15-30% ascorbic acid in mixtures stored in multilayer bags, with little further loss during 1-3 months. Bags containing fat emulsion retained higher concentrations of ascorbic acid after storage compared to those without fat emulsion, but all mixtures in multilayer bags maintained 60-80% ascorbic acid activity after 3 months. Since ascorbic acid is the most oxygen-sensitive vitamin, complete TPN mixtures with vitamins could be compounded in multilayer bags for an extended shelf life, rather than admixing just prior to administration.
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An assessment was made over a period of 14 days of the rate of glutamine degradation in different intravenous solutions kept at 22-24 degrees C, 4 degrees C, -20 degrees C and -80 degrees C. At room temperature (22-24 degrees C) degradation rates in mixed parenteral nutrition solutions and aminoacid/dextrose solutions ranged from 0.7-0.9%/day, in Perifusin 0.6%/day, and in dextrose alone as low as 0.15%/day. At 4 degrees C, glutamine degradation was <0.1-0.2%/day in all solutions examined, at -20 degrees C it was minimal (<0.04%/day) and at -80 degrees C, it was undetectable. Glutamine degradation was found to be associated with the formation of equimolar quantities of ammonia. No glutamate formation was detected. It is concluded that it is possible to store glutamine in parenteral nutrition solutions kept at 4 degrees C, with about 2% loss over a period of 14 days. The degradation is sufficiently slow to consider the use of intravenous glutamine in nutritional therapy.
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Five patients with pigmented villonodular synovitis (PVNS) of the knee demonstrate the value of preoperative, contrast medium-enhanced CT scanning. The technique is shown to be particularly useful in locating recurrent lesions and in demonstrating that popliteal and posterior calf masses are due to PVNS affecting the knee joint itself. In two of the five patients PVNS was not considered a possibility before the CT scan, and none had evidence of bone erosion on plain radiographs. In none of the patients was the unenhanced CT scan able to demonstrate evidence of decreased radiolucency due to fat within the tumour or density greater than the adjacent skeletal muscle, indicating haemosiderin deposits.
This study compared the impact of helpful and hindering events, as perceived by 40 clients, in two forms of psychotherapy: an exploratory, relationship-oriented therapy, and a prescriptive, cognitive/behavioural therapy. All clients received eight sessions of each type of treatment in a crossover design. Events were obtained by self-report both during and at the end of each period, and content analysed for type of therapeutic impact by three trained raters. Results showed that during treatment the most commonly occurring helpful impacts across both types of treatments were 'problem solution', 'awareness' and 'reassurance', while the most commonly occurring hindering impact was 'unwanted thoughts'. Similar impacts were reported at the end of each period, with the addition of 'personal contact'. In addition, it was found that 'problem solution' and 'reassurance' impacts were more commonly reported in prescriptive treatment, whereas 'awareness' and 'personal contact' impacts were more prevalent in exploratory treatment. Only the prevalence of 'unwanted thoughts' was correlated (negatively) with outcome. Some possible reasons for the lack of correlation between reported impacts and outcome are suggested.
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Suppressor cell activity was studied in 30-non-transfused renal dialysis patients using the Concanavalin A enhancement method. Suppressor cell numbers were estimated in 19 patients by the T suppressor (T gamma) rosette technique and in 15 patients using a monoclonal antibody (OKT8) specific for T suppressor cells. The role of prostaglandin secreting monocytes in the observed suppression was investigated in 6 patients using the prostaglandin secreting inhibitor flurbiprofen. Both suppressor cell numbers and activity were either normal or low compared with normal healthy controls. Flurbiprofen at concentrations of 10(-4) and 10(-6) M caused a decrease in activity in both patients and normal controls. The results indicate that the increased suppressor cell activity and number reported in dialysis patients may be due to the effect of blood transfusion previously administered to the patients.
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