Search PubMed⌕ Search

Biomedical subjects

J Eng

Publications and source records attributed to J Eng.

At least 109 records · Page 6Linked to original sources
PubMed1990

[Hairy cell leukemia and Mycobacterium malmoense infection].

We describe a patient with hairy cell leukemia and protracted fever. The patient's condition deteriorated during treatment with alfa Interferon 2b, and his fever persisted. A slight widening of the upper mediastinum appeared after 2.5 months. Mediastinoscopy with lymph node biopsy revealed granulomatous infiltrates with acid-fast bacilli. Cultures of the lymph node material later showed growth of Mycobacterium malmoense. The patient was treated with rifampicin, doxycycline, etambutol and cycloserin for sixteen months and remains afebrile and is gaining weight. His general condition is still improving. An aggressive diagnostic approach is necessary in febrile patients with hairy cell leukemia.

Adult↗
PubMed1990

Efficacy of continuous extrapleural intercostal nerve block on post-thoracotomy pain and pulmonary mechanics.

To assess the efficacy of continuous extrapleural intercostal nerve block on postoperative pain and pulmonary function, a prospective, randomized, double-blind, placebo-controlled trial was conducted on 56 patients undergoing elective thoracotomy. Infusion was started before closing the chest and was continued for 5 days. Subjective pain relief was assessed on a linear visual analogue scale. Pulmonary function was measured on the day before operation and daily for 5 days. There were 29 patients in a group which received bupivacaine and 27 in a control group which received saline. The bupivacaine group had lower pain scores (P less than 0.01) and required less papaveretum (P less than 0.01) than the control group. Forced vital capacity, forced expiratory volume in 1 s and peak expiratory flow rate were maximally reduced at 24 h to median values of 56, 60 and 57 per cent, respectively, of preoperative control values in the bupivacaine group, and to 25, 30 and 32 per cent in the control group. These differences are highly significant (P less than 0.01). Restoration of pulmonary function was superior in the bupivacaine group (P less than 0.01). There were no infusion-related complications. After thoracotomy, continuous intercostal blockade with bupivacaine is a safe and effective method of pain relief which reduces the early loss of postoperative pulmonary function significantly and more rapidly restores respiratory mechanics.

Adult↗
PubMed1990

NMR spectral analysis of kinetic data using natural lineshapes.

An automated rapid data analysis scheme for NMR spectroscopy time course studies is presented. This method uses a high signal-to-noise reference spectrum collected at the beginning of a time course as a lineshape model to analyze subsequent low signal-to-noise data collected with higher time resolution. The method is fast (approximately 1 s to evaluate two peaks in a 2K spectrum) and easily implemented on NMR spectrometer computers. An application of this method to spectroscopic studies on the heart is provided.

Humans↗
PubMed1990

Renal distribution and metabolism of [2H9]choline. A 2H NMR and MRI study.

Trimethylamines are required as substrates in the biosynthesis of a number of important molecules in the cell. Herein, we describe the use of choline, deuterated in its 9 methyl positions, as an NMR label for following the distribution and metabolism of methyl groups after intravenous choline infusion. Deuterium (2H) NMR spectroscopy of the rabbit kidney in vivo revealed a linear uptake of infused choline that was directly proportional to the rate of infusion. The sensitivity limit for the spectroscopic studies in vivo was in the order of 100 microM for a 2 min data collection. After the infusion, 2H NMR imaging of the kidney in vivo demonstrated high trimethylamine concentrations in both the cortex and inner medulla but not in the outer medulla. The inner medullary fraction, however, was more labile to diuresis induced by furosemide. Companion high resolution 2H NMR studies of extracts revealed a cortex betaine/choline concentration ratio of 0.69 +/- 0.05 (mean +/- SEM, n = 3) before furosemide administration. Following furosemide infusion, the cortex betaine/choline concentration ratio was 3 +/- 1 (n = 6). Thus, 2H renal images following furosemide treatment can be interpreted as metabolic maps of betaine distribution. In addition, extraction studies revealed high concentrations of labelled choline and betaine in the liver. These data demonstrate that 2H-labelled choline is an effective marker of choline methyl metabolism in vivo and should provide a unique tool for the investigation of this important substrate.

Animals↗
PubMed1990

Opossum (Didelphis virginiana) "little" and "big" gastrins.

1. "Little" gastrins from most mammalian species are 17 amino acid peptides and the precursor "big" gastrins are 34 amino acid peptides. 2. "Little" gastrins of the New World hystricomorphs, guinea-pig and chinchilla, are 16 amino acid peptides due to deletion of a glutamic acid in the region 6-9 from their NH2-terminus and the corresponding "big" gastrins are 33 amino acid peptides. 3. Antral gastrins from the opossum, a New World marsupial, have a glutamic acid deletion in the same region as the hystricomorph gastrins. 4. Opossum "big" gastrin is a 33 amino acid peptide with the following sequence: less than ELGPQDLPYLTADLSKKQGPWLEEEEAYGWMDF#.

Amino Acid Sequence↗
PubMed1990

Postoperative autologous transfusion in cardiac surgery. A prospective, randomised study.

To investigate the safety and efficacy of postoperative autologous blood transfusion (AT) using the Shiley hardshell venous reservoir, a prospective, randomised, controlled study was carried out in two matched groups of twenty patients undergoing elective coronary artery bypass surgery. The mean volume of shed mediastinal blood reinfused in the first 6 h postoperatively was 371.7 +/- 63.23 ml. Use of homologous blood was reduced from 760.5 +/- 108.37 ml in the control patients to 466.25 +/- 87.44 ml in the AT patients, a reduction of 38.7% (p less than 0.05). There was no statistically significant difference in the clinical outcome, overall blood loss, use of platelets, fresh frozen plasma and colloids, haematological indices, renal and hepatic functions, or clotting mechanism, although there was a reduction in the fibrinogen level in the patients who received AT (p less than 0.05). Mediastinal blood did not clot and was defibrinogenated. It contained significant levels of haemoglobin (8.175 +/- 0.506 g/dl), platelets (96.55 +/- 10.39 per mm3 10(3)), protein (42.5 +/- 1.13 g/l), calcium (2.385 +/- 0.054 mmol/l) and was well oxygenated (PO2 = 20.46 +/- 0.81 kPa). No patients developed bacteraemia or had any AT-related infections. We conclude that postoperative autologous transfusion using the Shiley hardshell venous reservoir is a safe and efficient method for reducing postoperative homologous blood requirement after coronary artery bypass surgery.

Adult↗
PubMed1990

Chest wall reconstruction after resection of primary malignant chest wall tumours.

In order to review the development of chest wall reconstruction, 37 cases of primary malignant skeletal chest wall tumours treated since 1958 were studied. These included chondrosarcomas (20), Ewing's tumours (7) and solitary plasmacytomas (10). Skeletal reconstruction was performed in 24 patients. Before 1972, Marlex mesh alone was used. Since then, a sandwich of two layers of Marlex mesh with a filler of methyl methacrylate was utilised successfully producing better functional and cosmetic results. Primary soft tissue closure was possible in all but 5 cases in whom latissimus dorsi myocutaneous flaps were used. All but one patient had an uneventful postoperative recovery with none requiring postoperative ventilatory support. The overall survival of 46% at 5 years and 27% at 10 years was encouraging. Familiarity with the techniques of chest wall reconstruction enables wide excision of primary chest wall tumours and the palliation and treatment of other malignant, infective and degenerative conditions since even large defects can be reconstructed with little functional disturbance.

Adolescent↗
PubMed1990

Isolation and amino acid sequences of squirrel monkey (Saimiri sciurea) insulin and glucagon.

It was reported two decades ago that insulin was not detectable in the glucose-stimulated state in Saimiri sciurea, the New World squirrel monkey, by a radioimmunoassay system developed with guinea pig anti-pork insulin antibody and labeled pork insulin. With the same system, reasonable levels were observed in rhesus monkeys and chimpanzees. This suggested that New World monkeys, like the New World hystricomorph rodents such as the guinea pig and the coypu, might have insulins whose sequences differ markedly from those of Old World mammals. In this report we describe the purification and amino acid sequences of squirrel monkey insulin and glucagon. We demonstrate that the substitutions at B29, B27, A2, A4, and A17 of squirrel monkey insulin are identical with those previously found in another New World primate, the owl monkey (Aotus trivirgatus). The immunologic cross-reactivity of this insulin in our immunoassay system is only a few percent of that of human insulin. Squirrel monkey glucagon is identical with the usual glucagon found in Old World mammals, which predicts that the glucagons of other New World monkeys would not differ from the usual Old World mammalian glucagon. It appears that the peptides of the New World monkeys have diverged less from those of the Old World mammals than have those of the New World hystricomorph rodents. The striking improvements in peptide purification and sequencing have the potential for adding new information concerning the evolutionary divergence of species.

Amino Acid Sequence↗
PubMed1990

Sodium-23 nuclear magnetic resonance imaging of the rabbit kidney in vivo.

The mechanism by which the mammalian kidney generates a concentration gradient of sodium from cortex to papilla is still not entirely understood. Studies of how the kidney as an organ generates this gradient have been hampered by the lack of a noninvasive method for monitoring the intrarenal sodium distribution. Herein, we demonstrate the value of sodium-23 nuclear magnetic resonance (23Na-NMR) imaging to nondestructively assess the intrarenal sodium distribution. 23Na-NMR images were obtained from a surgically exposed kidney preparation that showed the two-dimensional distribution of sodium in the rabbit kidney. In the antidiuretic kidney this gradient resulted in papillary sodium concentrations that were approximately threefold higher than cortical values. Serial 23Na-NMR images obtained during saline infusion demonstrated the kinetics by which the sodium gradient increases with diuresis. The half-time for 23Na washout of the medulla of the kidney was approximately 6 min with this protocol. In addition, a three-dimensional data set of the sodium distribution of the kidney was obtained with voxel dimensions of 1.5 mm3 by use of a three-dimensional 23Na-NMR imaging technique. Without surgical exposure, 23Na-NMR images of the rabbit kidney were collected under completely noninvasive conditions by use of a surface coil. The 23Na-NMR signal from the kidney was easily detected; however, to obtain images of comparable signal-to-noise ratio to the surgically exposed kidney, spatial and temporal resolution were significantly reduced.

Animals↗
PubMed1990

Insensitivity of maximum expiratory flow to bronchodilation in normal dogs.

We examined the effects of the inhaled parasympatholytic agent atropine and the sympathomimetic agent salbutamol on partitioned frictional pressure (Pfr) losses to the site of flow limitation (choke point, CP) in dogs to see how changes brought about by these agents would affect maximum expiratory flow (Vmax) and response to breathing 80% He-20% O2 (delta Vmax) in terms of wave-speed theory of flow limitation. In open-chest dogs, a Pitot-static tube was advanced down the right lower lobe to locate CP, to determine CP lateral and end-on pressures (PE), and to partition the airway into peripheral (alveoli to sublobar) and central (sublobar to CP) segments. Measurements were obtained at approximately 50% vital capacity. After inhalation, CP locations were unchanged with both bronchodilating agents. After atropine inhalation, Pfr central was decreased by one-half compared with base line. Despite the decrease in Pfr central, however, Vmax failed to increase after atropine because of altered bronchial area pressure (BAP) behavior at the CP site. After salbutamol inhalation, Pfr peripheral was reduced by about one-half compared with base line. However, Vmax failed to increase, because this reduction was too small to significantly increase the CP pressure head (i.e., PE). delta Vmax was also insensitive to these agents. Our results show mechanisms by which small changes in Pfr, as well as the complex interaction of changes in Pfr and BAP, may limit the use of Vmax in detecting bronchodilation at different airway sites.

Airway Resistance↗
PubMed1990

Successful closure of bronchopleural fistula with adhesive tissue. Case report.

Surgical closure of a bronchopleural fistula following right pneumonectomy for squamous cell carcinoma was achieved with monomeric n-butyl-2-cyanoacrylate. Previous attempts at closure by conservative and endoscopic means were unsuccessful. Tissue adhesives are useful in the surgical or endoscopic management of bronchopleural fistula.

Aged↗
PubMed1990

Primary malignant melanoma of the esophagus.

Three cases of primary malignant melanoma of the oesophagus are presented and the literature is briefly reviewed. This rare disease affects predominantly males in the sixth decade of life or later and the clinical and radiologic features are indistinguishable from those of more common oesophageal carcinomas. The tumours are often polypoid, located mainly in the lower two-thirds of the esophagus, and their histologic features resemble those of lentigo maligna melanoma, but with more aggressive biologic behavior. Because of the potential for extensive intramucosal involvement, multicentricity and high local recurrence rate, surgical treatment requires radical excision with a much greater margin than for the common squamous cell carcinomas. Though the outlook is poor, surgery is the favoured treatment with palliative or curative intent, with a 5-year survival rate of 4.2%. Radiotherapy, chemotherapy and immunostimulation currently serve mainly as palliative or adjunctive measures.

Adult↗
PubMed1990

Boerhaave's syndrome complicating acute myocardial infarction. Case report.

A case of spontaneous rupture of the oesophagus (Boerhaave's syndrome) following acute myocardial infarction is presented. Conservative management with chest drainage and parenteral, later jejunostomy, feeding was successful. Progress was monitored with methylene blue swallow. A review of the literature revealed only two previous cases of this type.

Aged↗
PubMed1990

Alterations in respiratory mechanics following thoracotomy.

Major alteration in respiratory mechanics occur in all patients following anaesthesia and thoracotomy because of a decrease in the functional residual capacity with minimal change in the closing volume leading to airway closure during tidal breathing and atelectasis. Diminished pulmonary reserve, because of non-pulmonary and pulmonary risk factors before operation, and/or restrictive ventilation and abnormal pattern of breathing due to postoperative pain sustain and aggravate these changes. These can proceed to postoperative pulmonary complications in some normal, and in many high risk, patients. Detection and correction of pre-existing pulmonary disease, smoking, sepsis and obesity is essential to reduce postoperative morbidity and mortality. Effective postoperative regional analgesia minimizes impairment of pulmonary function, aids in its recovery, and prevents postoperative pulmonary complications. The adjuvant use of chest physiotherapy and incentive spirometry should also help in decreasing the adverse affects of anaesthesia and surgery on the chest and thereby reduce the frequency and severity of postoperative complications.

Anesthesia, General↗
PubMed1990

Primary bony chest wall tumours.

A retrospective review of 81 cases of primary chest wall tumours was carried out to analyse their clinical, radiological and surgical features. There were 37 malignant and 44 benign lesions; 72 were found in the ribs and nine in the sternum, of which five were malignant and four benign. Benign tumours of the ribs outnumbered malignant ones by a ratio of 5:4. The distinction between benign and malignant lesions is difficult clinically and radiologically unless cortical destruction and soft tissue swelling are present. The pathological differentiation is also not possible in all cases. All the patients with benign tumours were treated by excision with no recurrences or deaths. The overall 5-year survival for primary malignant chest wall tumours was 43% and 10-year survival was 27%. These were the results of radical en bloc excisions. Based on our experiences we believe that all tumours of the bony chest wall should be considered potentially malignant and wide excision should be performed, not only to provide adequate tissue for diagnosis but also to allow the best chance of cure in malignant lesions.

Adolescent↗
PubMed1989

Chemical composition of a lipopolysaccharide from Legionella pneumophila.

Lipopolysaccharide isolated from Legionella pneumophila (Phil. 1) was examined for chemical composition. The polysaccharide split off by mild acid hydrolysis contained rhamnose, mannose, glucose, quinovosamine, glucosamine and 2-keto-3-deoxyoctonate, in molar proportions 1.6:1.8:1.0:1.5:4.1:2.7. Heptoses were absent and glucose was probably mainly phosphorylated. The carbohydrate backbone of the lipid A part consisted of glucosamine, quinovosamine and glycerol, in the molar ratios 3.9:1.0:3.4, with glycerol as a phosphorylated moiety. A complex fatty acid substitution pattern comprising eight O-ester-linked, exclusively nonhydroxylated acids, and nineteen amide-linked, exclusively 3-hydroxylated acids was revealed. Both straight- and branched (iso and anteiso) carbon chains occurred. The major hydroxy fatty acid was 3-hydroxy-12-methyltridecanoic acid and six others were of a chain-length above 20 carbon atoms, with 3-hydroxy-20-methyldocosanoic acid as the longest. Two dihydroxy fatty acids, 2,3-dihydroxy-12-methyltridecanoic and 2,3-dihydroxytetradecanoic acids, were also detected. These results suggest that L. pneumophila contains a rather complex and unusual lipopolysaccharide structure of considerable biological and chemotaxonomic interest.

Carbohydrates↗
PubMed1989

Malignant melanoma metastatic to the esophagus.

A rare case of metastatic malignant melanoma of the esophagus 11 years after wide excision of a cutaneous malignant melanoma is presented and the relevant literature reviewed. Symptomatic esophageal metastasis is unusual in malignant melanoma. Although the eventual outlook is poor in such cases, worthwhile palliation can be achieved by prompt diagnosis and treatment.

Adult↗