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Biomedical subjects

J D Hardy

Publications and source records attributed to J D Hardy.

At least 55 records · Page 3Linked to original sources
PubMed1979

Congenital complete heart block in the newborn associated with maternal systemic lupus erythematosus and other connective tissue disorders.

Four babies with complete heart block associated with maternal systemic lupus erythematosus (SLE) are described, together with a 5th baby whose mother had serological abnormalities only. One baby had a rapidly fatal outcome, one has required digoxin for heart failure, and the remaining 3 are asymptomatic but remain in complete heart block. Additional manifestations were present in 2 of them. The spectrum of neonatal abnormalities that may occur in association with maternal SLE and related connective tissue disorders is discussed, together with the possible causes and the prognosis. We conclude that congenital heart block is more common than had previously been appreciated.

Adult↗
PubMed1978

Surgical management of Cushing's syndrome with emphasis on adrenal autotransplantation.

Cushing's syndrome may be caused by pituitary ACTH, ectopically produced ACTH, adrenocortical tumor or medication. Cushing's disease, due to excessive pituitary ACTH resulting in adrenocortical hyperplasia, remains a complex endocrine disorder for which no single treatment is wholly satisfactory. Twenty-two patients with surgically treated Cushing's syndrome are presented: Four with benign adrenocortical adenoma, two with adrenocortical carcinoma and 16 with adrenocortical hyperplasia. The four benign adenomas were excised with the one death due to respiratory failure and sepsis. Both patients with carcinoma and liver metastases died of their tumors. Of the 16 patients with adrenocortical hyperplasia and Cushing's disease, eight underwent subtotal adrenalectomy and thereafter eight had total intra-abdominal adrenalectomy with autotransplantation of adrenal tissue to the thigh. There was one operative death. Total adrenalectomy has now replaced subtotal resection in most clinics. All eight of the patients who had adrenal autotransplantation exhibited biopsy or functional evidence of some degree of graft survival. On patient stopped steroid replacement permanently and another developed recurrent Cushing's syndrome from the grafts. Of a total of 26 reported patients with adrenal autotransplants surveyed, 22 exhibited evidence of graft survival, 16 were able to discontinue steroid replacement therapy and three eventually developed recurrent Cushing's syndrome from the transplants. There is now strong evidence that most patients with Cushing's disease harbor a pituitary basophil ademona, and in the future the initial surgical attack may be directed to the pituitary rather than to the adrenals.

Adenoma↗
PubMed1978

Effect of pretreatment with norepinephrine on survival of cardiac allotransplants in dogs.

Two groups of puppies were studied regarding survival of the heart and the animal after epinephrine induced shock. All puppies in the control study died. In each of the eight puppies in the experimental group, the heart was removed and transplanted orthotopically into a healthy recipient. Six of the eight recipients died within hours, and the two which survived 14 days exhibited extensive cardiac structural changes at autopsy. The failure of recipients of hearts from these spinephrine-shock puppies to survive was in sharp contrast to the almost uniform survival of animals receiving orthotopic heart transplants from dogs subjected to irreversible hemorrhagic or endotoxin shock. This diference was due to the fact that the high levels of epinephrine infused were found to have produced extensive structural damage in the donor heart.

Animals↗
PubMed1977

Zollinger-Ellison syndrome: special considerations.

Twelve patients with Zollinger-Ellison syndrome and one patient with WDHA syndrome are reviewed. Three of the Z-E patients exhibited MEA, two having hyperinsulinism and one hyperparathyroidism. Ages ranged from nine to 71 years. Diagnosis of Z-E syndrome was established from history, gastric acid secretion, radiologic studies, serum gastrin measurements and from actual tissue biopsy in 10 of the 12 patients. Total gastrectomy was performed in 8 of the 12 Z-E patients, with abolition of the ulcer diathesis in all. However, in none of our patients was there objective evidence of subsequent tumor regression. Three patients remain alive. Four died of tumor, one from post-total gastrectomy complications, one from post-subtotal gastrectomy in another hospital, two from ulcer hemorrhage, and one from electrolyte imbalance with autopsy diagnosis of Z-E tumor. A patient is recorded in detail who exhibited both hyperinsulinemia and hypergastrinemia from a malignant islet cell tumor, had the tumor "debulked" four times over a 14 year period and whose hepatic metastases were temporarily abolished by streptozotocin infusion. The question is raised regarding relationships between chronic organic hyperinsulinism and subsequent hypergastrinemia.

Adolescent↗
PubMed1976

[Failure of acupuncture anesthesia. A psychophysical study (author's transl)].

Four volunteers judged eight levels of thermal stimuli induced by a Hardy dolorimeter, varying in intensity from extremely painful to a low level seldom even perceived. Half of the 406 stimuli were applied during acupuncture and half either before the insertion or after removal of the needles. The experimental design minimized or eliminated factors other than the needles themselves; i.e. no medications were given; the subjects were scientists accustomed to objectivity and, on a preceeding day or days, all became experienced in assigning a number (individually chosen) to the sensation produced by the different stimuli. Galvanic skin resistance was also tested. The results did not show any influence of acupuncture on pain perception or galvanic skin resistance.

Acupuncture Therapy↗
PubMed1976

Philadelphia chromosome in acute leukemia: case report.

A case report of serial chromosome studies on a child presumed to have acute lymphoblastic leukemia (ALL) is presented. Hematologic remission was achieved after 3 weeks and maintained until death 63 weeks later. The classic Philadelphia chromosome translocation was found, both at diagnosis and throughout the course of the disease, in a proportion of cells from PHA-stimulated blood cultures. The finding is related to other reports of Philadelphia-positive clones in ALL, as well as those in chronic myeloid leukemia and its acute transformation, and other myeloproliferative disorders. The origin of the Philadelphia chromosome in this case is considered in the light of current stem cell theory, and its relevance to lymphocytic neoplasia is discussed. We believe that the finding of a Ph1-positive clone in a cell line morphologically indistinguishable from normal lymphocytes in a case of acute leukemia is unique.

Bone Marrow↗
PubMed1976

Hemorrhagic shock in dogs. Comparison of treatment with shed blood alone versus shed blood plus Ringer's lactate: intravascular pressures, cardiac output, oxygen consumption, arteriovenous oxygen differences, extracellular fluid PO2, electrolyte changes, and survival rates.

The purpose of our study of hemorrhagic shock in dogs was to examine the efficacy of adding Ringer's lactate to shed blood replacement in increasing animal rates. The standard Wiggers' hemorrhagic shock technic was used in two groups of ten animals each. Intravascular pressures, cardiac outut, oxygen consumption, arteriovenous oxygen differences, extracellular fluid PO2 and pH, electrolyte changes, and survival rates were determined. There was a positive correlation between changes in cardiac output, central venous oxygen content, and PO2 and extracellular fluid PO2 as measured using subcutaneously implanted Silastic tubing and perforated plastic balls. Four of the dogs that received shed blood alone survived, whereas five of the dogs that received shed blood plus Ringer's lactate survived. This difference was not statistically significant.

Animals↗
PubMed1976

Leiomyosarcoma of the inferior vena cava: report of a case and review of the literature.

Leiomyosarcoma of the inferior vena cava is a rare and usually fatal disease. Only 45 cases have been reported in the world literature. The authors add one case and review all previous reports. The disease is one primarily of elderly women, arising from the middle third of the inferior vena cava with a wide range of symptomatology, varying form the Budd-Chiari syndrome to a few asymptomatic cases. The tumor may grow very slowly or occasionally very rapidly, shows extensive local invasion, and metastasizes more frequently than previously believed. While radiotherapy and chemotherapy have not been adequately studied, aggresive surgical intervention using the recent advances in vascular surgery appears to offer long term palliation and hopefully cures of this disease in the future.

Aged↗