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Biomedical subjects

J E Carter

Publications and source records attributed to J E Carter.

At least 19 recordsLinked to original sources
PubMed1992

Is cardiopulmonary bypass effective for treatment of hypothermic arrest due to drowning or exposure?

Various techniques have been advocated for resuscitation from hypothermic arrest caused by ice-cold freshwater drowning or exposure. We have resuscitated five such patients after emergency hospital admission using cardiopulmonary bypass initiated via median sternotomy. All patients presented to our facility with core temperatures less than 26 degrees C. Three patients had been in full cardiopulmonary arrest for more than 30 minutes prior to arrival. The fourth patient presented in ventricular fibrillation; the fifth was admitted to the hospital in sinus bradycardia that quickly deteriorated to asystole. All had cardiopulmonary bypass emergently initiated via median sternotomy. All were rewarmed on bypass to 37 degrees C and all survived at least 24 hours. Three of the five patients are currently alive and well with normal neurologic function. Cardiopulmonary bypass is an effective technique for resuscitation after hypothermic arrest due to near drowning and/or exposure.

Adult↗
PubMed1992

Torsade de pointes complicating acute myocardial infarction: the importance of autonomic dysfunction as assessed by heart rate variability.

Torsade de pointes is a polymorphic ventricular tachycardia associated with QT-interval prolongation rarely reported to occur in the setting of an acute myocardial infarction. Autonomic dysfunction has been implicated as a major stimulus for the development of this dysrhythmia. We describe the case of an 80-year-old woman who presented with an acute myocardial infarction and progressive QT-interval lengthening. An 89-beat run of torsade de pointes occurred during the time of the peak creatine phosphokinase (CPK) without electrolyte abnormalities or antiarrhythmic therapy. Assessment of autonomic tone using power spectral analysis of two consecutive 24-h Holter recordings was performed indicating that a transient decrease in heart rate variability and increase in sympathetic tone preceded the tachyarrhythmia. This case shows the potential usefulness of heart rate variability analysis as a marker for autonomic dysfunction and arrhythmogenesis, particularly during myocardial ischemia.

Aged↗
PubMed1992

Sequence, ontogeny, and cellular localization of murine surfactant protein B mRNA.

We have isolated and characterized murine surfactant protein (SP-B) cDNAs and determined both the cellular distribution and developmental expression of SP-B mRNA. The nucleotide sequence of the composite SP-B cDNAs and cloned genomic SP-B DNA predicted a primary translation product of 377 amino acids (molecular mass = 41.7 kDa) that contained a single asparagine linked glycosylation site. The 410 base 3' untranslated region contained a novel sequence consisting of a (CCA)21 repeat. Tissue specificity and developmental expression of SP-B mRNA was assessed by Northern blot analysis. A single 1.6-kb mRNA species was detected specifically in lung tissue. In fetal mouse lung SP-B mRNA was detected at low levels on day 15 of gestation and increased markedly between days 16 and 17, reaching adult levels by birth. In situ hybridization analysis of SP-B mRNA demonstrated SP-B expression primarily in bronchiolar and alveolar epithelium, although discrete bronchial cells also contained the SP-B mRNA. The murine SP-B mRNA was expressed in proximal and distal epithelial cells within the respiratory tract and shares a close structural relationship to SP-B from other species.

Animals↗
PubMed1992

Zidovudine and cytomegalovirus retinitis.

A 38-year-old bisexual man with acquired immunodeficiency syndrome (AIDS) who was being treated with oral acyclovir for herpetic stomatitis had a history of blurred vision OS that was diagnosed as cytomegalovirus retinitis. The patient refused ganciclovir administration. Two additional lesions developed OS in the succeeding four months. All clinical evidence of active retinitis cleared after zidovudine was administered, and the patient has remained free of any clinically active retinal lesions for 28 months while continuing to receive acyclovir and zidovudine. Although ganciclovir and foscarnet are the drugs of choice to treat cytomegalovirus retinitis, this observation may be fortuitous for patients whose other AIDS manifestations suggest using zidovudine rather than ganciclovir or for patients whose cytomegalovirus retinitis appears to be resistant to agents currently used to treat this infection.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Risk factors for the central nervous system manifestations of gastroenteritis-associated hemolytic-uremic syndrome.

Hemolytic-uremic syndrome is usually a consequence of enteric verotoxigenic Escherichia coli infection, and a prevailing hypothesis contends that systemically absorbed verotoxins are responsible for the multiple organ involvement. In an attempt to determine whether the central nervous system (CNS) manifestations could occur owing to factors that reflect a toxin insult, the authors studied the association of clinical and laboratory variables with the development of neurological disease. Ninety-one patients with hemolytic-uremic syndrome from 1982 through 1990 were included. Twenty-seven (18 female, 9 male) had a CNS disorder; 17 of these had seizures and there were two deaths. Multivariate analyses led to the following observations: female gender (odds ratio [OR] 8.50; 95% confidence interval [CI] 2.08 to 50.0), prolonged use of an antimotility pharmacological agent (OR 8.50; 95% CI 1.69 to 42.81), and an increased hemoglobin level (OR 1.11; 95% CI 1.05 to 1.17) were associated with an increased risk for developing a neurological manifestation. Prior administration of a blood product was associated with a decreased risk (OR 0.12; 95% CI 0.02 to 0.52). The findings suggest that other mechanisms for CNS disease may exist in addition to direct toxin insult.

Adolescent↗
PubMed1991

Comparison of body composition and somatotype of trained female triathletes.

The body composition and somatotype of 16 trained female triathletes aged 18.8-32.8 years were measured. All of the subjects were engaged in a competitive training programme and participated in the same triathlon. Anthropometric variables included height, mass, selected diameters, girths and skinfolds, and a Heath-Carter anthropometric somatotype. Body composition was determined by hydrostatic weighing procedures and skinfold patterns. Comparisons were made with Olympic swimmers and runners. The triathletes had a mean body mass of 55.2 kg and a mean height of 162.1 cm. When compared to swimmers, the triathletes were somewhat shorter and significantly (P less than 0.005) older. On most other measures, including a balanced mesomorph somatotype of 3.1-4.3-2.6, they were similar to swimmers. This group of triathletes were generally heavier, less lean, more mesomorphic and less ectomorphic than elite runners. Reported body densities from other studies indicated little difference between the triathletes and other groups. Skinfold patterns were similar in shape for all groups, but the runners had smaller values, at all sites, than either swimmers or triathletes. Because of lack of information on cyclists, adequate comparisons were not possible. Regression analysis indicated that training parameters were more important than anthropometric measures in the prediction of performance. It was concluded that this group of triathletes were closer, with respect to both body composition and somatotype, to swimmers than to runners.

Adolescent↗
PubMed1990

Hyperacute T-wave criteria using computer ECG analysis.

Hyperacute T waves (HATWs) have been described as tall-amplitude, primary T-wave abnormalities sometimes seen in the early phases of transmural myocardial infarction. Despite numerous human and animal studies addressing the presence and significance of HATWs, there are no widely held, reliable ECG criteria for their accurate identification. Using a specially designed computer program on a Hewlett-Packard Realm ECG analysis system, we screened 13,393 adult ECGs to identify those having T-wave amplitudes greater than accepted standards (limb leads, greater than 0.5 mV; precordial leads, greater than 1.0 mV). Patients with other known causes of primary and secondary tall T waves were excluded from the study sample. Patients with tall-amplitude T-waves who then developed clinically verifiable myocardial infarction were labeled the HATW group. The HATW group (21) represented 4.1% of the tall T wave group (513) and 0.16% of the entire sample. The remaining patients, who did not meet HATW criteria, were called the early repolarization variant (ERV) group (51). Both groups underwent comparative computer morphology analysis. Nine parameters were statistically significant in discriminating HATWs from early repolarization variants. A combination of J-point position/T-wave amplitude of more than 25%, T-wave amplitude/QRS amplitude of more than 75%, J-point position of more than 0.30 mV, and age of more than 45 years predicted HATWs from a control group with a specificity of 98.0% and a sensitivity of 61.9% and with positive and negative predictive values of 92.9% and 86.2%, respectively. We conclude that HATWs have characterizable discriminating ECG morphology as determined by computer ECG analysis compared with a control group.

Electrocardiography↗
PubMed1990

Dental maturity in children with chronic renal failure assessed from dental panoramic tomographs.

Children with chronic renal failure are known to lag behind normal children for both height achievement and bone age. In the present study, dental maturity was assessed by scoring dental panoramic tomographs using two methods. The method of Dermirjian gave closer estimates of the chronological age than that of Leinonen. With the former method, dental maturity was found to be slightly delayed in children with chronic renal failure, although this was not statistically significant.

Adolescent↗
PubMed1990

Static and dynamic differences among five types of skinfold calipers.

Thirty-eight skinfold calipers were compared in terms of dial accuracy, downscale force, and pressure at jaw openings of 10, 20, 30, 40, and 50 mm. Dynamic measures were made on four thicknesses of foam rubber. Foam rubber was used to simulate the compressibility of skinfolds and to eliminate subject and tester variability. Five caliper types were tested: 10 Harpenden (HRP), 9 Lange (LNG), 12 Slim Guide (85SG), 4 Skyndex (SKN), and 3 Lafayette (LF). Within-type variation was small and consistent across openings for dial accuracy, force, pressure, and foam rubber compressed thickness. Between-type pressures differed (p less than 0.01), with the HRP and LNG calipers having the highest but similar pressures and the SKN, LF, and 85SG calipers having the lowest but similar pressures. LF and LNG calipers (which differed from each other) had higher compressed foam rubber means than HRP, SKN, and 85SG calipers (p less than 0.01), which were similar to each other at three of four thicknesses. When average pressure was used as the covariate, differences between types were still large, with 97.5-99.3% of the variation explained by type. Compressibility of foam rubber was shown to be caliper specific. It is concluded that there are static and dynamic differences between the five major types of skinfold calipers. When measurer error is eliminated, the HRP, 85SG, and SKN calipers are similar to each other, but they give lower values than the LNG or LF calipers by approximately 50-100%, depending on compressed thickness. These differences should be noted when comparing skinfolds measured with dissimilar calipers.

Anthropometry↗
PubMed1989

Renal vein thrombosis and response to therapy in a newborn due to protein C deficiency.

A newborn infant was diagnosed as having renal vein thrombosis due to heterozygous protein C deficiency and no other predisposing factor for thrombosis. He responded adequately to treatment with streptokinase, fresh frozen plasma and subsequent anticoagulation with heparin and warfarin (Coumadin). Four years from diagnosis he remains well with no recurrence of thrombosis and with normal renal function.

Drug Therapy, Combination↗
PubMed1989

DNA determinants of structural and regulatory variation within the murine beta-glucuronidase gene complex.

The murine beta-glucuronidase (GUS) gene complex, [Gus], encompasses the GUS structural element, Gus-s, and a set of regulatory elements which serve to modulate Gus-s expression. Three common GUS haplotypes representing virtually all inbred strains of laboratory mice have been compared with respect to GUS mRNA sequence. Results of such comparisons revealed sequence variations which target the location of one of the GUS regulatory elements to sequences within Gus-s and which account for known electrophoretic and heat stability differences among GUS allozymes of the three common GUS haplotypes.

Alleles↗