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Biomedical subjects

J Curran

Publications and source records attributed to J Curran.

At least 109 records · Page 6Linked to original sources

Genital ulcers in Kenya. Clinical and laboratory study.

Of 97 patients with genital ulcers attending a special treatment clinic in Nairobi, Kenya, 60 harboured Haemophilus ducreyi, four herpes simplex virus, and five Neisseria gonorrhoeae. Eleven patients had serological evidence of syphilis; of these one case was confirmed by darkfield microscopy. In the remaining cases no aetiological agent was identified. An enriched chocolate agar with vancomycin and serum was a useful medium for primary isolation of H ducreyi. Tetracycline was generally ineffective in the treatment of ulcers, but sulfadimidine was successful in almost 80% of cases.

Adult↗

Droperidol and endotracheal intubation. Attenuation of pressor response to laryngoscopy and intubation.

The cardiovascular responses to anaesthesia, laryngoscopy and tracheal intubation were studied in 20 healthy adult patients. The mean arterial pressure increase following intubation was 1.60 mmHg (SEM +/- 3.52 mmHg) in patients to whom droperidol 150 microgram/kg was given intravenously before anaesthesia compared with a rise of 26.50 mmHg (SEM +/- 4.35 mmHg) in a control group of patients.

Adult↗

Wolff-Parkinson-White syndrome in the neonate.

Of 16 infants who presented with paroxysmal supraventricular tachycardia in the neonatal period, 50 percent had an electrocardiographic pattern consistent with Wolff-Parkinson-White conduction, type A. It is suggested that infants have bypass pathways similar to or identical with a Kent pathway as part of normal maturation. Infants with paroxysmal supraventricular tachycardia have electrically active bypass tracts but these are documented in only about one half of the patients because of the short duration of recordings or because of concealment (the bypass tract conducts only in retrograde fashion). The activity of these pathways is enhanced by the predominant cholinergic innervation of the neonatal heart. Resolution of the arrhythmias and the Wolff-Parkinson-White pattern in most patients occurs because of anatomic maturation of the conduction tissue, development of adrenergic innervation and a decrease in cholinergic dominance. In some children, maturation is incomplete and the bypass fibers remain quiescent or become active under certain circumstances such as those associated with increased autonomic discharge. Extended surveillance is recommended for all infants who present with paroxysmal supraventricular tachycardia and the Wolff-Parkinson-White pattern.

Child, Preschool↗

Angiographic and ultrasonic findings in infected simple cysts of the kidney.

This paper describes angiographic and ultrasonic findings in three patients with proven infected renal cyst. The clinical picture was that of inflammatory renal disease. B-mode ultrasonography showed the characteristic features of renal cyst; however, this technique cannot differentiate between infected and simple cysts. Selective renal angiography demonstrated the following, enabling differentiation from simple renal cyst; hypervascular rim, irregular inflammatory vessels, indistinct interface between cyst and adjacent parenchyma, and prominent capsular branches. Since percutaneous puncture of an infected renal cyst or abscess carries risk of infectious complications, angiography appears justified only for those patients with fever and flank pain who have cystic lesions in the kidney confirmed by echography.

Adult↗

Inhibition of stimulated gastric secretion by an orally administered prostaglandin capsule. A study in normal men.

The effect of ingestion of a gelatin capsule containing 127 mug of 16,16-dimethyl prostaglandin E2 (DM-prostaglandin E2) or a liquid containing 127 mug of DM-prostaglandin E2 on stimulated gastric secretion in man was studied. DM-prostaglandin E2 significantly reduced the volume, acid concentration, and total acid output of gastric secretion. Secretory inhibition during the 3 h after treatment with the capsule was 37% (volume), 39% (acid concentration), and 60% (acid output). The DM-prostaglandin E2 capsule was nearly as effective as equivalent amount of DM-prostaglandin E2 in solution. Prostaglandin analogues, because of their oral effectiveness and duration of action, may have therapeutic value in peptic ulcer disease.

Administration, Oral↗

Topical analgesia before tracheal intubation.

The major toxic effects of local analgesic drugs are regarded as due to over-dosage. A technique of topical analgesia for tracheal intubation using lignocaine is described based on spraying the pyriform fossae to effect a superior laryngeal nerve block combined with topical analgesia of larynx and trachea which avoids excessive exposure of the lowere airway to the local analgesic. The results show lower levels of venous blood lignocaine with slower absorption of the agent than when similar doses are applied to the trachea. This method is accordingly recommended.

Administration, Topical↗

Preliminary study of frontal lobe 1H MR spectroscopy in childhood-onset schizophrenia.

Cerebral 1H MR spectra were recorded in 13 children and adolescents with schizophrenia and 12 healthy children and adolescents. Stimulated echo acquisition mode (STEAM) sequence was used to localize an 8-ml voxel bilaterally in the frontal gray matter. The frontal gray matter metabolite ratios for NAA/Cr, Ch/Cr, Glx/Cr, and mI/Cr in schizophrenic children and adolescents were 1.08 +/- .28, .64 +/- .23, 1.09 +/- .30, and .60 +/- .24, respectively. In comparison, these ratios were 1.59 +/- .35, .74 +/- .27, 1.23 +/- .36, and .58 +/- .29 in healthy children and adolescents. Decrease in the frontal lobe NAA/Cr of schizophrenic children and adolescents was statistically significant (P < .001). In contrast, the MR spectra localized bilaterally in the occipital gray matter (8 ml) showed no significant changes between the patients and the controls. In the occipital gray matter, the metabolite ratios were 1.21 +/- .26,.52 +/- .08, 1.00 +/- .11, and.55 +/- .12 inpatients versus 1.30 +/- .23, .45 +/- .10, 1.15 +/- .20, and .48 +/- .19 in controls. Our preliminary finding of reduced NAA/Cr ratio in the frontal gray matter is consistent with the neurodevelopmental models emphasizing dysfunction of frontal lobe areas in patients with schizophrenia.

Adolescent↗

MR-guided procedures using contemporaneous imaging frameless stereotaxis in an open-configuration system.

Frameless MR-guided procedures have had limited application using conventional closed magnets, due largely to the technical difficulties involved. As a result of in-room MR image-monitoring capabilities, new open-design magnets now allow frameless stereotaxis using contemporaneous imaging to guide more invasive procedures. We evaluate our clinical experience with this new technique. An open-design 0.2 T magnet (Siemens OPEN) combined with an in-room monitor was used for 33 frameless MR-guided procedures (aspiration cytology, biopsy, and/or treatment) in a variety of locations in the head, neck, spine, brain, pelvis, and abdomen. Success of the procedure was based on the ability to accurately position the instrument in the target region to allow biopsy and/or treatment. The open-design magnet allowed the physician to directly access the patient for frameless stereotaxis as the procedure was performed. The in-room monitor provided contemporaneous imaging feedback during the procedure for successful placement of the instrument in the target region. Twenty-eight biopsy and five treatment procedures were performed. In all cases the technique resulted in successful placement of the instrument within the target tissue to complete the procedure. MR-guided procedures using contemporaneous imaging frameless stereotaxis are possible in an open-design magnet with in-room image monitoring and offer exciting possibilities for further development.

Adolescent↗