Search PubMed⌕ Search

Biomedical subjects

G Ho

Publications and source records attributed to G Ho.

At least 73 records · Page 4Linked to original sources
PubMed1986

Polyarticular septic arthritis.

Seven adult patients with nongonococcal polyarticular septic arthritis are presented with a literature review of the clinical features of polyarticular bacterial infection. Polyarticular septic arthritis occurred in 19% of reported cases of septic arthritis in adults. Similar to monoarticular disease, the knee was the most commonly affected joint, and Staphylococcus aureus was the most frequently isolated microorganism. Pneumococcus, group G streptococcus, and Hemophilus influenzae had an increased association with polyarticular infection. Five of our 7 patients had underlying rheumatic diseases and the immediate mortality rate was 57%. Review of the literature yielded an overall mortality of 23% for polyarticular septic arthritis compared to the 9% mortality of septic arthritis in general. The subset of patients with polyarticular infection superimposed on rheumatoid arthritis had a mortality rate of 56%.

Aged↗
PubMed1986

The clinical spectrum of gouty arthritis in women.

We reviewed crystal-proved gouty arthritis in 23 women. Twenty-one (91%) developed gout after menopause onset. Tophaceous gout occurred in six (26%), polyarticular involvement in 13 (57%); 70% manifested an underlying arthropathy, usually osteoarthritis. We studied 75 men with crystal-proved gout for comparison. Women developed gout significantly later compared with men, more often were receiving diuretics before gout onset, and more frequently manifested renal insufficiency and monoarticular involvement. These differences were significant when controlled for the women's later age at onset. Significantly more men than women had alcoholism and an identifiable precipitating event for acute attacks. There were no significant differences in race, age, family history of gout, disease duration, hypertension, distribution of joint involvement, tophi, or mean serum urate concentration. Gout in women is overwhelmingly postmenopausal, apparently associated with diuretic therapy and renal insufficiency independent of the effects of age. Articular characteristics in men and women are remarkably similar.

Adult↗
PubMed1985

Two-dimensional echocardiographic detection of preclinical aortic root abnormalities in rheumatoid variant diseases.

Two-dimensional echocardiographic findings of subaortic fibrous ridging, aortic leaflet thickening, and aortic root dilatation and thickening are described in a group of 36 patients with rheumatoid variant diseases. The group consisted of 25 patients with ankylosing spondylitis, nine patients with Reiter's syndrome, and two patients with inflammatory bowel disease and spondylitis. No patient had clinical or laboratory evidence of aortic regurgitation or heart block. Subaortic fibrous ridging or marked leaflet thickening was noted in 11 of 36 patients; in contrast, no such changes were found in an age-matched control group of 29 men. The subgroup of patients with subaortic fibrous ridging or leaflet thickening (11 patients) had significantly longer disease duration (28.1 versus 17.7 years) and higher incidence of aortic root echo-density (82 versus 36 percent) than the remaining patients. It is concluded that a significant portion of patients with ankylosing spondylitis or Reiter's syndrome have echocardiographic evidence of aortic root involvement prior to the clinical onset of aortic regurgitation.

Adult↗
PubMed1984

Radiographic appearance of the sternomanubrial joint in arthritis and related conditions.

The sternomanubrial joint (SMJ) was evaluated on the lateral chest radiograph in 177 patients with rheumatic disease and 69 non-rheumatic controls. Abnormalities were categorized as inflammatory changes, proliferative changes, or bone fusion. Patients with rheumatoid arthritis, psoriatic arthritis, or gout were found to have an increased incidence of inflammatory changes. Rheumatoid variants predisposed to early fusion of the SMJ. Patients with diffuse idiopathic skeletal hyperostosis (DISH) exhibited massive and unique hyperostotic changes.

Adult↗
PubMed1983

Hemophilus influenzae septic arthritis in adults.

Hemophilus influenzae is an important but uncommon cause of adult septic arthritis. We report two cases and review 23 previously published cases. Two-thirds of the patients had systemic diseases, local factors, or both which predisposed them to septic arthritis. The acute disease was monarticular in 48%, polyarticular in 24%, and accompanied by tenosynovitis and/or bursitis in 28% of cases. Extraarticular sites of H. influenzae infection were found in 60% of cases. These sites represented either likely portals of bacterial entry or foci of infection resulting from hematogenous dissemination of H. influenzae. The most characteristic synovial fluid finding was the presence of Gram-negative pleomorphic microorganism. However, misinterpretation of the Gram-stained smear was common and led to an erroneous initial diagnosis in several instances. Prompt sterilization of the infected synovial fluid was the rule once an appropriate antimicrobial agent was administered. A favorable outcome was reported in 88% of cases.

Adult↗
PubMed1982

Therapy for septic arthritis.

The usefulness of the results of serial cultures of synovial fluid in assessing the response to medical therapy of acute bacterial joint infections was examined. A five-year retrospective survey disclosed 32 synovial fluid culture-proved cases of septic arthritis in adults. Thirteen of the patients had well-documented evidence of (1) duration of articular symptoms (presumably reflecting the presence of infection) and (2) subsequent time required to sterilize the synovial fluids (as determined by serial synovial fluid cultures). We found a positive correlation between duration of symptoms and length of time during which serial cultures of synovial fluids remained positive after initiation of treatment. In the seven patients with good outcome, cultures remained positive for 2.4+/-1.9 days, as opposed to 8.2+/-2.4 days in the six patients with poor results. The time required to sterilize the synovial fluid appears to be a reliable indicator of response to therapy and an accurate predictor of outcome. Our data show that the rapidity in achieving synovial fluid sterility is of paramount importance in the successful treatment of infection, preservation of articular integrity, and restoration of joint function.

Acute Disease↗
PubMed1981

Different sites of action for morphine, ethanol, barbital and pentobarbital within the guinea-pig ileum longitudinal muscle/myenteric plexus preparation.

Morphine, ethanol, barbital and pentobarbital reversibly inhibited in a dose-dependent manner, the electrically evoked contractions of the guinea-pig ileum longitudinal muscle/myenteric plexus (LM/MP) preparation, in vitro. The ED50s for inhibition were 0.2 microM for morphine and 120, 8 and 0.3 mM for ethanol, barbital and pentobarbital respectively. To determine whether the site of inhibition was pre- or postjunctioal we studied the effects of graded concentrations of these drugs on the contractions evoked by exogenous acetylcholine (ACh). A correlation between the inhibition of the electrically and ACh-evoked muscle contractions suggests that morphine acts primarily prejunctionally while ethanol acts both pre-and postjunctionally. The inhibition by barbital and pentobarbital, however, can be accounted completely by a postjunctional depression. These results may explain our previous observation of cross-tolerance between morphine and ethanol in this preparation, and the lack of cross-tolerance between these drugs and barbital.

Acetylcholine↗
PubMed1981

Reciprocal relationship of synovial fluid volume and oxygen tension.

To investigate the impact of synovial fluid volume on oxygen tension (PO2) and other metabolic correlates, 24 specimens of synovial fluid from the knees of 22 patients were analyzed for volume, number of leukocytes (WBC), pH, PO2, PCO2, glucose, protein, and complement (CH50) levels. Concurrent arterial blood samples were obtained in 21 instances. Synovial fluid PO2 values varied inversely with volumes of synovial fluid (r = -0.54, P less than 0.01), but when patients with rheumatoid arthritis were excluded, the correlation was more significant (r = -0.76, P less than 0.001). When synovial fluid PO2 dropped below 45 mm Hg, intraarticular acidosis resulted. The decrease in pH (r = 0.93, P less than 0.001), the lowering of glucose values (r = 0.89, P less than 0.001), and the rise in PCO2 (r = -0.79, P less than 0.01) can be explained by a shift toward anaerobic metabolism coupled with the impaired elimination of its products. Systemic acidosis and hypoxia were not found. Intraarticular hypoxia most likely represents circulatory imbalance at the level of the synovial membrane, although an inverse relationship of synovial fluid PO2 and WBC was also noted. Complement and protein levels had no correlation with volume, pH, or respiratory gas tensions of synovial fluids. Our data support the importance of the effective blood flow to the joint in maintaining homeostasis. The volume of synovial effusion and the compliance of the joint capsule appear to be important determinants of the articular blood supply.

Adult↗
PubMed1981

Antibiotic therapy of septic bursitis. Its implication in the treatment of septic arthritis.

Infected olecranon, prepatellar, and infrapatellar bursae offer a unique opportunity to study the response of a closed-space infection to antibiotic therapy. Using percutaneous needle aspirations, serial bursal fluids were cultured. The length of time necessary to achieve culture sterility with antibiotic therapy (an average of 4 days in 25 patients) was correlated with the duration of symptoms prior to diagnosis (r = 0.68, P less than 0.001). In patients treated within 2 weeks from onset of symptoms, bursal fluid sterility was achieved within 1 week of therapy, while longer duration of symptoms was associated with delayed response. When antibiotic therapy was continued for 5 additional days after documented culture sterility, all 19 patients in the prospective trial were cured (average followup period of 6.8 months). In septic bursitis, the effects of delay in treatment are deleterious by prolonging culture-positivity despite adequate antibiotic therapy. By analogy, delay in treatment of septic arthritis may result in the persistence of an adverse environment which can lead to further articular damage. After accurate diagnosis of septic bursitis, a therapeutic approach consisting of prompt and appropriate antibiotic usage, frequent needle drainage, and treatment duration based on the culture results of serial aspirations is effective and may be applicable in the management of certain nongonococcal bacterial joint infections.

Adolescent↗
PubMed1980

Scintigraphic evidence of transient unilateral sacroiliitis in a case of Whipple's disease.

Investigation of low back pain by quantitative sacroiliac joint scintigraphy (QSS) can detect the presence of sacroiliitis not apparent by roentgenography. Transient unilateral sacroiliitis was documented by QSS in a patient with Whipple's disease during tetracycline treatment, when the peripheral arthropathy was in remission. Thus, the pattern of inflammatory spinal disease, if associated with the intestinal disease, differs from that of the peripheral arthritis.

Arthritis↗
PubMed1979

Quantitative sacroiliac joint scintigraphy. A critical assessment.

With quantitative sacroiliac joint scintigraphy (QSS), sacroiliac joint-to-sacrum (SIS) ratios greater than or equal to 1.40 are abnormal for our method. High SIS ratios are associated with roentgenographically appreciated sacroiliitis and with early clinically evident sacroiliitis. Although highly sensitive, QSS abnormalities are not specific for inflammatory sacroiliac (SI) joint disease. High SIS ratios are also seen in rheumatoid arthritis, degenerative abnormalities of the lumbosacral spine, and metabolic bone disorder. Other disorders with roentgenographic SI joint abnormalities must be studied scintigraphically before QSS can be employed as a useful diagnostic test.

Humans↗
PubMed1979

Comparison of nonseptic and septic bursitis. Further observations on the treatment of septic bursitis.

Of 30 cases of olecranon and prepatellar bursitis, ten were septic. Fever, tenderness, peribursal cellulitis, and skin involvement over the bursa were more common in the septic cases. A high leukocyte count, low bursal-to-serum glucose ratio, and positive Gram-stained smear of the bursal fluid distinguished septic from nonseptic bursitis. Rheumatoid arthritis and gout may be accompanied by nonseptic bursitis. Septic bursitis may be associated with a sympathetic sterile effusion in a neighboring joint or adjacent fascial space. The duration of antibiotic treatment necessary to sterilize bursal fluid was proportional to the length of time infection had been present. A prospective antibiotic program disclosed an average of 12 days for successful therapy. A bactericidal agent against penicillin-resistant Staphylococcus aureus is the drug of choice.

Anti-Bacterial Agents↗
PubMed1979

Acute metabolic interaction of ethanol and drugs.

Addition of ethanol in vitro was found to inhibit the microsomal metabolism of a variety of drugs such as meprobamate, aminopyrine, pentobarbital and zoxazolamine. In all cases, a mixed type of inhibition was obtained. When the concentration of alcohols of different chain lengths required to inhibit 50% of the metabolism of drugs was plotted against their corresponding octanol-water partition coefficients (Po/w) it was found that the inhibitory potency of alcohols is linearly related to the partition coefficients, with a slope of 0.98. In vivo acute administration of ethanol also resulted in decreased whole body metabolism of meprobamate, aminopyrine, pentobarbital, zoxazolamine and aniline. In vitro addition of pentobarbital, phenobarbital and meprobamate had no significant effect on ethanol metabolism by liver slices. Acute pretreatment with these drugs also had no effect on the rate of ethanol metabolism in vivo as measured in the whole body or as estimated from the rate of decrease of blood ethanol concentration. It appears therefore that acute metabolic interaction of ethanol and drugs is a one sided phenomenon, i.e. ethanol inhibits drug metabolism, whereas drugs do not inhibit ethanol metabolism. Ethanol inhibition of drug metabolism in vitro appears to result from a modification of the lipophilic milieu that surrounds the cytochrome P-450 in the microsomal membrane. Interference with the hydrophobic sites may either directly or indirectly affect the catalytic activities of the microsomal enzyme.

Animals↗