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Biomedical subjects

H Alexander

Publications and source records attributed to H Alexander.

205 records · Page 12Linked to original sources
PubMedDate not supplied

Nosocomial fungemia in neonates associated with intravascular pressure-monitoring devices.

In the period from January, 1982, to March, 1983, eight infants in the neonatal intensive care unit at one hospital had blood cultures positive for Candida parapsilosis; six cases had occurred after December, 1982. Epidemiologic investigation included a case-control study comparing the 8 cases with 29 birth weight-matched controls. Logistic regression analysis indicated that the model that best fit the observed data included the following risk factors for fungemia: duration of umbilical artery catheterization; duration of receipt of parenteral nutrition; and estimated gestational age. Parenteral nutrition therapy was often administered through the umbilical artery catheters, which were also used for monitoring arterial pressure; transducer domes thus contained parenteral nutrition fluid. Transducers were usually disinfected with alcohol. Laboratory investigation showed that the heads of 6 of 11 in-use blood pressure transducers and 1 of 4 transducers in storage after cleaning were culture-positive for C. parapsilosis. After control measures were instituted no further cases occurred.

Blood↗
PubMedDate not supplied

Giant ovarian cysts: is a pre- and intraoperative drainage an advisable procedure?

There has been a considerable debate over the merits of a pre- or intraoperative drainage of giant ovarian cysts, which represented a very frequent approach before definitive surgery in the past. Including our presented case of a 57-year-old woman with a 49 kg mucinous cystadenoma, 19 patients with giant ovarian cysts weighing more than 40 kg were reported in the literature since 1970. An incidence of 37% of malignant and low malignant potential tumors was found. Based on a critical evaluation of the medical courses and the discussed miscellaneous advantages and complications, we conclude that a pre- and intraoperative drainage should be avoided.

Contraindications↗
PubMedDate not supplied

Multifaceted therapy after global brain ischemia in monkeys.

UNLABELLED: The pathophysiology of postischemic encephalopathy is complex, and includes tissue acidosis, edema, hypoperfusion, membrane dysfunction, impaired energy production, and possibly hypermetabolism. We tested the hypothesis that this multifactorial clinical problem must be approached with multifaceted therapy, with specific treatment aimed at each of the above postischemic changes. Eighteen minutes of complete global brain ischemia was produced with a higher pressure neck cuff in pigtailed monkeys. Control treatment postischemia (n = 9): 1) Normotension (MAP greater than or equal to 80 mmHg) restored within 2 min postischemia, 2) controlled ventilation for 24 hours with PaCO2 = 25 mmHg, 3) normothermia, and 4) phenytoin seizure prophylaxis from 20 hours postischemia. Experimental treatment (n = 10): Control treatment plus the following modifications: 1) Hemodilution to hematocrit 25% at 1-4 min postischemia, 2) brief hypertension (MAP 130 mmHg for 5 min) after accomplished hemodilution, 3) hypothermia for 6 hours, 4) pentobarbital 30 mg/kg i.v., 5) dexamethasone 4 mg/kg i.v. Outcome was evaluated at 96 hours postischemia by overall performance categories (OPC) (OPC I = normal, OPC V = brain death), neurologic deficit (ND) scores (100% ND = brain death, 0% ND = normal), and histologic damage scores of the brains. RESULTS: Brain death developed in 1/9 control and 0/10 treated animals. The number of awake monkeys (OPC I and II) at 96 hours postischemia was significantly higher in the treated group (7/10) than in the control group (2/9) (p = 0.05). The median ND scores for the two groups were 16 and 35% respectively (p greater than 0.05). The results strongly suggest that postischemic treatment may be beneficial and that a multifaceted therapeutic approach is worth pursuing.

Animals↗
PubMedDate not supplied

Medial collateral ligament replacement with a partially absorbable tissue scaffold.

The medial collateral ligaments and medial capsular structures of canines were resected and replaced with a carbon fiber-polylactic acid polymer tissue scaffold or allowed simply to "scar-in." After 4, 8, 12, and 26 weeks in vivo, the stability of the knees was quantitatively evaluated and the mechanical properties of the regrown structures determined. Histological sections of the regrown structures were examined after 26 weeks in vivo. At all time periods, the knees receiving tissue scaffold ligaments were significantly more stable than those knees allowed to stabilize with scar tissue. Initial strength, rapid ingrowth, and benign tissue reaction suggest this new composite material may be useful in the treatment of joint instability.

Animals↗
PubMedDate not supplied

Achilles tendon repair with an absorbable polymer-carbon fiber composite.

Twenty-seven patients were surgically treated for Achilles tendon rupture using a composite implant. The implant is ribbon-like in configuration and composed of filamentous carbon fiber coated with an absorbable polymer. When used to secure an Achilles repair, the implant acts as a scaffold for the regrowth of collagenous tissue. Rapid attachment of host tissue assures good, early repair strengths which allows for a more vigorous rehabilitation program. Fourteen patients have at least 9 months of follow-up (average follow-up, 14.4 months) and have been objectively and subjectively evaluated on a temporal basis for return of function. To date, complications have been minimal. Results have been very encouraging with 90% return of function at 18 months.

Achilles Tendon↗
PubMedDate not supplied

In vitro fertilization: increased VLA (very late antigen) integrins and fibronectin after acrosome reaction.

The pattern of detectable adhesion molecules (AM) on human ejaculated spermatozoa used for in vitro fertilization (IVF) of human oocytes was evaluated. The percentage of spermatozoa with the alpha chains 3, 4, 5, and 6 of the integrins (also called very late antigens, VLA alpha 3, 4, 5, 6), the alpha V and the beta 3 chains, as well as the matrix proteins laminin and fibronectin, were determined by flow cytometry using monoclonal antibodies against integrins and matrix proteins before and after the acrosome reaction. This reaction was induced by the low-temperature method according to P. Sanchez, E. Töpfer-Petersen, R. J. Aitken, and W. B. Schill (1991, Andrologia 23:197-203) and monitored by the binding of FITC-conjugated Pisum sativum agglutinin. Twenty-three of 34 investigated semen samples fertilized at least one oocyte (fertile group) and 11 samples did not induce a pronucleus formation or cleavage of an oocyte (infertile group). Significant differences in the classical semen parameters between both semen sample groups could be shown only for the percentage of progressively motile spermatozoa (p = .046, U test). The spermatozoa of the fertile group showed a significantly higher expression of VLA alpha 3 (p = .045) and fibronectin (p = .048). Additionally, after the loss of the acrosome a significantly higher expression of alpha 4, alpha 5, and alpha 6 chains of integrins (p < .05) was detected in the fertile semen group. In contrast, the inducibility of the acrosome reaction differed only to a nonsignificant extent (p = .094). These data suggest that spermatozoa showing a higher expression of the alpha chains of the integrins after the acrosome reaction have a better fertilization rate in vitro.

Acrosome↗