Search PubMed⌕ Search

Biomedical subjects

J E Lewis

Publications and source records attributed to J E Lewis.

At least 109 records · Page 6Linked to original sources
PubMed1989

Neuroendocrine and stress hormone changes during mirthful laughter.

Positive emotional activities have been suggested as modifiers of neuroendocrine hormones involved in the classical stress response. To detect changes in these components during a mirthful laughter experience, the authors studied 10 healthy male subjects. Five experimental subjects viewed a 60 minute humor video and five control subjects did not. Serial blood samples were measured for corticotropin (ACTH), cortisol, beta-endorphin, 3,4-dihydrophenylacetic acid (dopac)--the major serum neuronal catabolite of dopamine, epinephrine, norepinephrine, growth hormone, and prolactin. Repeated measures analysis of variance showed that cortisol and dopac in the experimental group decreased more rapidly from baseline than the control group (p = 0.011, p = 0.025, respectively). Epinephrine levels in the experimental group were significantly lower than the control at all time points (p = 0.017). Growth hormone levels in the experimental group significantly increased during baseline (p = 0.027) and then decreased with laughter intervention (p less than 0.0005), whereas, the controls did not change over time (p = 0.787). ACTH, beta-endorphin, prolactin, and norepinephrine levels did not significantly increase. The mirthful laughter experience appears to reduce serum levels of cortisol, dopac, epinephrine, and growth hormone. These biochemical changes have implications for the reversal of the neuroendocrine and classical stress hormone response.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1988

Electromagnetic field focusing probe (EFFP)--a new angioplasty tool.

An electromagnetic field focusing probe (EFFP) consists of a radiofrequency generator, solenoidal coil, and a hand-held or catheter probe. The probe is operated in the near field (distance within one wave length of an electromagnetic field source) of a coil, which induces eddy current in a biological tissue. The induced eddy current is converged maximally at the tip of the probe upon contact of the tip with the tissue. The probe produces very high temperatures depending on the wattage selected. In this study, the EFFP was used to evaporate atheromatous plaques in human cadaver abdominal aorta specimens, which were then studied histologically. Gas produced by this technique was analyzed and the volume found to be related to power delivered, but in such small amounts as to be of no embolic significance. While temperature varied with wattage and time of application, it was maximal at the probe tip and easily controlled, resulting in clean obliteration of plaque.

Angioplasty, Balloon↗
PubMed1987

Thymoma. A clinicopathologic review.

The clinical and pathologic features of 283 patients with thymoma treated at the Mayo Clinic (147 female and 136 male; ages 16 years to 90 years; mean, 52 years) were examined. Forty-six percent of the patients had myasthenia gravis and 10% had other paraneoplastic phenomena. The tumors were locally invasive at operation in 32%, including 6% with metastasis to lung or pleura. Intrathoracic recurrence was noted postoperatively in 15% of those who had total excision and distant metastasis developed in 3% of patients. Thirteen percent died of their thymomas and 16% died of myasthenia. Overall 5-year survival was 67% and 10-year survival was 53%. Poor prognostic factors included presence of tumor-related symptoms, large tumor size, local invasion or metastasis in initial operation, and predominantly epithelial histologic features. Although true thymomas are composed of cytologically benign elements, they show a propensity for local invasion and intrathoracic recurrence. They rarely metastasize outside the thorax.

Adolescent↗
PubMed1987

Neonatal diaphragmatic hernia. An improving outlook with extracorporeal membrane oxygenation.

In a 15-year period, 89 newborns were treated for congenital diaphragmatic hernia. The patients were divided into three groups, depending on postoperative therapeutic support available: group 1, ventilator therapy only; group 2, ventilator therapy plus pulmonary vasodilators (tolazoline hydrochloride); and group 3, ventilators, tolazoline, and/or extracorporeal membrane oxygenation (ECMO). The three groups were identical for presenting symptoms, signs, and preoperative blood gas determinations. The survival for each group was as follows: group 1, 17 (40%) of 42; group 2, 14 (45%) of 31; and group 3, 12 (75%) of 16. Complications requiring further operations were identical. All survivors in groups 1 and 2 are normal developmentally, while one of five group 3 ECMO survivors has developmental delay and another has long-term ventilator dependence. These data suggest that ECMO, an invasive technique for newborn respiratory failure, improves survival in congenital diaphragmatic hernia.

Combined Modality Therapy↗
PubMed1987

Newborn duodenal atresia: an improving outlook.

From 1973 through 1983, 20 newborns with congenital duodenal atresia were treated. These patients are compared with our previous series and with other published series. There were no fatalities among the 19 patients who underwent operation, an improvement from the 72 percent survival rate in our previous series. Fifty-five percent of the patients had associated congenital anomalies, which frequently complicated their management. The use of a transanastomotic jejunal feeding tube resulted in delayed oral feeding and prolonged hospitalization, and cannot be recommended.

Abnormalities, Multiple↗
PubMed1987

Angiopyroplasty using electromagnetically induced focused heat.

A metal-tipped catheter capable of inducing and withstanding extremely high temperatures suitable for angiopyroplasty has been developed. The probe utilizes external radiofrequency (RF) energy focused on the tip. A relatively inexpensive catheter and RF source make this a very plausible alternative to laser systems.

Angioplasty, Balloon↗
PubMed1987

Lentigo maligna presenting as an eczematous lesion.

A case of lentigo maligna manifesting as an eczematous lesion is presented. Unlike previous reports of dermatitic lesions of lentigo maligna, hyperpigmentation of the specimen was noted on microscopic examination.

Aged↗
PubMed1986

Duodenal atresia: a comparison of techniques of repair.

Although duodenal atresia is a common cause of congenital intestinal obstruction, the optimal technique of repair remains controversial. In a 10-year period, 41 newborns (20 male, 25 premature) underwent either side-to-side duodenoduodenostomy (SDD, 10 infants), side-to-side duodenojejunostomy (SDJ, 9 infants), or diamond-shaped duodenoduodenostomy (DDD, 22 infants) in a nonrandomized series. One-layer anastomosis was used in each case, and gastrostomy was placed in most patients. Groups were compared for survival, prematurity, associated anomalies, time until feeding onset, total hospitalization time, and complications. The three groups were identical for survival (all 100%), prematurity (60% SDD, 67% SDJ, 59% DDD), and serious associated anomalies (cardiac, gastrointestinal, Down's; 33% SDD, 44% SDJ, 50% DDD). The time until feeding onset was shortest with DDD (4.1 +/- 0.4 days), compared with 8.0 +/- 1.1 days for SDD and 9.6 +/- 1.9 days for SDJ (both P less than .05 v DDD). Total hospitalization was significantly less in DDD (16.2 +/- 2.1 days) v 24.2 +/- 3.1 days for SDD (P less than .05) and 28.3 +/- 4.3 days for SDJ (P less than .01). One complication necessitating reoperation occurred in each group (SDD, adhesions; SDJ, stenotic anastomosis; and DDD, missed second atresia). These data suggest that DDD is superior to SDD and SDJ for repair of duodenal atresia, resulting in earlier feeding and discharge.

Duodenal Obstruction↗
PubMed1986

The role of second-look laparotomy in necrotizing enterocolitis.

The mortality in newborns with necrotizing entercolitis (NEC) remains unacceptably high. To attempt to improve survival, the most critically ill 14 (of 32 total) newborns with NEC and perforation underwent planned second-look laparotomy 24 to 36 hours after initial exploration to reassess questionably viable bowel and resect if necessary, irrigate purulent material, and search for further perforation. Survival was 10/14 (71%) with, and 12/18 (66%) without second-look laparotomy. Culture-positive pus was found in 14 cases, while in 6 necrotic bowel, and in 2 others a perforation was found at second look. These data suggest that aggressive second-look laparotomy can improve survival in the critically ill neonate with NEC and perforation.

Enterocolitis, Pseudomembranous↗
PubMed1986

Immunologic mechanisms in the maternal-fetal relationship.

Until recently, the immunologic tolerance between a mother and her allogeneic fetus has been a highly speculative and poorly understood phenomenon. New data indicate that maternal acceptance of the fetal allograft necessitates a specific, protective immune response. This specific recognition apparently involves unique placental antigens with genes that are closely linked to HLA loci. Lack of recognition of these antigens, as in matings between partners with similar HLA profiles, may result in repeated spontaneous abortions caused by unsuppressed rejection mechanisms.

Abortion, Habitual↗
PubMed1986

3-(1H-tetrazol-5-yl)-4(3H)-quinazolinone sodium salt (MDL 427): a new antiallergic agent.

Syntheses for 3-(1H-tetrazol-5-yl)-4(3H)-quinazolinone sodium salt monohydrate (9; MDL 427) and the related formamido compound, 2-(formylamino)-N-1H-tetrazol-5-ylbenzamide (10), are described. Both compounds are active in the rat passive cutaneous anaphylaxis and passive peritoneal anaphylaxis tests. A 94:6 equilibrium mixture of 9 and ionized 10, respectively, forms in aqueous buffer systems at a pH-dependent rate. In addition, analogues of 3-(1H-tetrazol-5-yl)-4(3H)-quinazolinone (8) bearing substituents on the benzene ring, substituents at the 2-position, and heteroaryl groups at the 3-position other than tetrazole were prepared. These analogue sets demonstrated that an accessible electrophilic center and an acidic functionality were requirements for good antiallergic activity.

Animals↗
PubMed1985

Comparison of acebutolol and hydrochlorothiazide in essential hypertension.

In a multicenter, double-blind comparison of acebutolol and hydrochlorothiazide in patients with mild to moderate essential hypertension (diastolic blood pressure, 95 to 114 mm Hg) in 182 and 178 patients, respectively, each agent reduced systolic and diastolic pressures to a similar significant degree: acebutolol, 15.9 and 14.9 mm Hg; hydrochlorothiazide, 15.2 and 13.3 mm Hg (p less than 0.001 vs baseline). Acebutolol significantly reduced heart rate by 8.9 bpm at the end of dose titration (p = 0.001), with no further decrease seen during maintenance. Fourteen patients on each treatment regimen were discontinued from the study because of side effects. However, significantly more hydrochlorothiazide patients experienced side effects of arrhythmia, anorexia, and flatulence; in addition, more hydrochlorothiazide patients developed abnormal levels of serum glucose, uric acid, blood urea nitrogen, serum potassium, and chloride. In a single-center study of patients who remained hypertensive while receiving diuretics, six of nine patients receiving acebutolol concomitantly with a diuretic responded (seated diastolic blood pressure reduced below 90 mm Hg), whereas no patients receiving placebo and diuretic concomitantly responded (p less than 0.01). Patients taking both acebutolol and diuretic had significant reductions in diastolic blood pressure (11 mm Hg) and heart rate (16 bpm) compared with those taking diuretic alone (p less than 0.05, less than 0.01) and those taking both placebo and diuretic (p less than 0.05). No significant side effects were noted. Acebutolol is as effective as hydrochlorothiazide as monotherapy for mild to moderate essential hypertension and, in addition, is effective when added to a diuretic in patients who remain hypertensive while taking diuretics.(ABSTRACT TRUNCATED AT 250 WORDS)

Acebutolol↗
PubMed1985

Synthesis and antiallergic activity of some quinolinones and imidazoquinolinones.

A group of 1,4-dihydro-4-oxoquinoline-2- and -3-carboxylic acid esters with nitrogen functionality at the 8-position was synthesized, and 6-oxo-6H-imidazo[4,5,1-ij]quinoline-4- and -5-carboxylic acid esters were elaborated from these. Several of the compounds displayed activity in the rat passive cutaneous anaphylaxis (PCA) test for antiallergic activity. However, PCA activity in this series was accompanied by rat toxicity, as measured by a decrease in percent of normal weight gain over a 2-week period, following a single oral dose.

Animals↗