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Biomedical subjects

J F Thompson

Publications and source records attributed to J F Thompson.

At least 181 records · Page 10Linked to original sources
PubMed1994

Lymphoscintigraphy to identify sentinel lymph nodes in patients with melanoma.

Lymphoscintigraphy (LS) has been performed for 8 years in patients of the Sydney Melanoma Unit, to define lymphatic drainage patterns. Over the past 2 years, LS has also been used to locate the sentinel lymph node prior to surgery. Our technique for LS and subsequent sentinel node biopsy has an accuracy of 97%. All sentinel nodes must be marked to ensure the successful application of the sentinel biopsy technique. We have found that the axilla and groin average just over one sentinel node per draining node group for lesions on the trunk and upper limb, but have noted that drainage to the groin differed when lower limb lesions were studied. Because of the anastomosis of lymph vessels in the upper thigh, multiple sentinel nodes are identified in the groin in some patients. We have found an average of three sentinel nodes in the groin when lymph drainage from lower limb lesions was studied with LS. This difference demands a modification of the LS technique, with early imaging of the groin nodes to identify all sentinel nodes in each patient. The depth of the sentinel nodes can also be measured and the location of all interval nodes marked on the skin. This ensures that all sentinel nodes and interval nodes can be removed at the time of surgery.

Arm↗
PubMed1994

Noise pollution in the anaesthetic and intensive care environment.

Noise in the operating theatre, recovery room and intensive care unit is above internationally recommended levels. The psychological and physiological effects of noise are reviewed. Equipment and conversation among the staff are major sources of noise in these areas. Equipment design, modification of nursing care procedures, and increased awareness of noise created by the staff may be effective in reducing noise pollution in these areas.

Equipment Design↗
PubMed1994

Haemodynamic actions of a nitric oxide (EDRF) synthesis inhibitor in conscious baboons (Papio hamadryas).

1. The haemodynamic effects of intravenous nitric oxide inhibitor, N-nitro-L-arginine (NOLA), were examined in four conscious non-restrained baboons (Papio hamadryas). Mean arterial pressure, (MAP), systemic vascular resistance (SVR) and cardiac output (CO) were measured at timed intervals up to 24 h after a bolus injection of NOLA. 2. N-nitro-L-arginine increased blood pressure in a dose-dependent manner up to 9.5 mg/kg. Increases in blood pressure were accompanied by increases in SVR and decreases in CO, with a significant fall in heart rate. 3. One animal received 9.5 mg/kg NOLA and became unconscious, suggesting cerebral vasospasm. 4. Vascular effects of nitric oxide contribute significantly to the regulation of arterial blood pressure under physiological conditions in the baboon.

Amino Acid Oxidoreductases↗
PubMed1994

Risk factors and outcomes associated with low birthweight delivery in the Australian Capital Territory 1989-90.

The objectives of this study were to describe outcomes of low birthweight (LBW; < 2500 g) babies born in the Australian Capital Territory (ACT) and to identify risk factors associated with LBW in the ACT. A cohort study was conducted involving all births recorded in the ACT Maternal and Perinatal Data Collection sets for 1989-90. Status at discharge is presented for 9373 births each weighing more than 499 g born in 1989 and 1990, classified by birthweight. Other outcomes are given for live births (n = 9309) only. Adjusted odds ratios for significant risk factors for LBW are given for 9084 singleton births whose computer records contained all relevant information. Perinatal mortality rates for LBW babies are consistent with other States, apart from 500-999 and 1500-1999 g babies which have higher rates. Eighteen per cent of LBW babies are transferred to other hospitals. Low birthweight babies are more likely than normal birthweight babies to have 1 and 5 min Apgar scores less than 7, to need resuscitation and to take more than 5 min to establish respiration. Risk of LBW is associated with maternal primiparity, age 35 years or more in primiparous women, history of one or more spontaneous abortions, induced abortions or perinatal deaths, chronic illness, public health insurance and single marital status, and with fetal female sex and congenital anomalies. Babies born weighing less than 2500 g in the ACT have more adverse outcomes and are much more likely to be transferred than normal birthweight babies.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Effects of total hepatectomy: studies in a porcine model.

The effects of total hepatectomy in a porcine model were studied. A portacaval shunt was constructed prior to hepatectomy, and the excised segment of inferior vena cava was replaced with a Dacron graft as soon as the liver had been removed. While the vena cava was clamped, venous return from the lower body to the heart was maintained using an extracorporeal veno-venous bypass system. The results of the study revealed that surprisingly few haemodynamic, biochemical or coagulation disturbances occur within the first 5 h following total hepatectomy in the pig, an animal with remarkably close anatomical and physiological similarities to man. In the anhepatic period which follows total hepatectomy during clinical liver transplantation, the situation is more complex, because pre-existing liver disease and portal hypertension, as well as major blood loss, often provide other reasons for metabolic and haemodynamic instability and coagulation disorders. The possible relevance of the findings in this large animal model to events that occur following total hepatectomy in the clinical situation is discussed.

Alkaline Phosphatase↗
PubMed1994

Isolated limb perfusion with urokinase in the treatment of extensive vascular thrombosis of the lower limbs.

Isolated limb perfusion with urokinase was used in combination with balloon catheter embolectomy in three patients with extensive vascular thrombosis in the lower limbs after conventional methods of treatment failed to restore perfusion to the lower limb. The technique and its results are described and discussed. It is suggested that isolated limb perfusion with urokinase is safe and is worthy of further investigation in the treatment of critically ischaemic lower limbs.

Aged↗
PubMed1994

Subclavian artery aneurysm: the role of magnetic resonance imaging.

Subclavian artery aneurysms are rare. Diagnosis is important as complications can be life threatening. A case is reported which is diagnosed by magnetic resonance imaging; moreover it is suggested that magnetic resonance imaging is now the initial imaging modality of choice in the investigation of these lesions.

Aged↗
PubMed1994

Maximizing efficacy and minimizing toxicity in isolated limb perfusion for melanoma.

Isolated limb perfusion (ILP) with melphalan is an effective treatment for recurrent melanoma, but complete remission is achieved only in about 40% of patients. Regional toxicity is common, causing short-term disability and occasional longterm incapacity. Methods to maximize the efficacy and minimize the toxicity were investigated in 210 ILPs undertaken at the Sydney Melanoma Unit. Toxicity was found to be related to peak melphalan concentration, as well as to the area under the curve and maximum temperature. A dye dilution technique has been developed to measure perfusion circuit volume, so that a drug dose can be given to achieve an appropriate concentration. ILP with cisplatin was less effective and produced greater toxicity than ILP with melphalan; other drugs and drug combinations warrant investigation. Prophylactic ondansetron successfully controlled post-operative nausea and vomiting in most patients. Daily measurement of serum creatine phosphokinase (CPK) allowed early recognition of impending severe toxicity, with the greatest risk if CPK exceeded 1000 IU/l after the first post-perfusion day. Isolated limb 'infusion' (ILI) with melphalan, using percutaneously inserted catheters, is a much simpler procedure than ILP and has been found to be effective and easily repeated. The morbidity of ILP and ILI may be minimized by excluding the foot or hand with a rubber bandage.

Chemotherapy, Cancer, Regional Perfusion↗
PubMed1993

Cholesterol 7 alpha hydroxylase promoter separated from cyclophilin pseudogene by Alu sequence.

The promoter for human cholesterol 7-alpha hydroxylase has been cloned and sequenced. In the regions previously described, our sequence agrees well with one report but not with another. At position -469, we find a widespread MaeII polymorphism. At -2636, there is an Alu sequence flanked by runs of adenines. Upstream of the Alu sequence, there is a cyclophilin pseudogene oriented in the opposite direction.

Amino Acid Isomerases↗
PubMed1993

Donation and retrieval of cadaveric organs in Australia. Accepting the challenge.

Most transplant programs in this country are significantly restricted by a chronic shortage of donor organs. This article examines the sources of transplantable organs, the concept of brain death, reasons why potential donors may be missed in hospitals, the often perceived difficulty in approaching next-of-kin, and the medical requirements and logistics of organ retrieval. The lives of many people are affected by organ donation and transplantation. For those receiving a transplant it can be a gift of incalculable value; for those who agree to donation it may represent one positive outcome from an otherwise tragic situation. These unique circumstances provoke a wide range of emotions and reactions. Health care professionals need to act responsibly towards both donor families and potential transplant recipients. Their involvement in the process of organ donation is an important part of their role in the care of critically ill or injured patients.

Adolescent↗
PubMed1993

Intraoperative streptokinase: a useful adjunct to balloon-catheter embolectomy.

Intraoperative thrombolysis was attempted in 31 acutely ischaemic legs after operative arteriography had demonstrated residual distal thrombus or occlusion following balloon-catheter thromboembolectomy. There were 30 patients, 16 men and 14 women, aged 43-82 (median 73) years. The indication for operation was severe ischaemia with sensorimotor loss in 25 limbs, failed percutaneous thrombolysis in three and acute graft occlusion in three. A total of 21 perfemoral, 11 perpopliteal and four graft embolectomies were initially performed. Following arteriography, 100,000 units streptokinase was infused down the isolated distal arterial tree over 30 min and arteriography repeated. Complete lysis was achieved in 11 legs (35 per cent) and partial lysis in 12 (39 per cent). Additional procedures required included six operative angioplasties and six bypass grafts. After operation pedal pulses were restored in 14 limbs (45 per cent), with a viable leg in 23 cases (74 per cent) at the time of patient discharge or death. There were five wound haematomas but no evidence of systemic fibrinolysis. Four amputations were required, none in the group undergoing successful lysis, and there were seven deaths, five from cardiac disease. Arteriography after balloon-catheter embolectomy is essential to detect residual thromboembolus and intraoperative streptokinase appears to be a safe and effective way of removing this.

Adult↗
PubMed1993

Identification of an ethanol-soluble protein as beta-amylase and its purification from soybean seeds.

In the 60% ethanol extract of soybean seeds, a prominent protein band was visible after polyacrylamide gel electrophoresis, which had a molecular weight of about 55 x 10(3) M(r). This protein was purified to homogeneity by buffered ethanol extraction and preparatory gel electrophoresis. Since the N-terminus was apparently blocked, the protein was cleaved with cyanogen bromide and the largest fragment was isolated and a partial sequence determined. The sequence of the 27 N-terminal amino acid residues matched a published soybean beta-amylase peptide sequence. In addition, the purified protein had a high specific activity for beta-amylase and was not a glycoprotein. Furthermore, the partial sequence (106 nucleotides) of a cDNA clone, isolated from a soybean seed cDNA library by antibody screening, matched the cDNA sequence of soybean beta-amylase except for one base. Therefore, the ethanol-soluble protein was identified as beta-amylase. The enzyme was purified to homogeneity using a two-step purification procedure with a yield of over 50%.

Amino Acid Sequence↗
PubMed1993

Right chylothorax following left radical neck dissection.

The development of a right chylothorax following left radical neck dissection for melanoma is reported. Chylothorax following neck dissection is extremely rare, with only 12 cases documented in the literature. Seven of these were bilateral and three were unilateral (all left-sided); unilateral right chylothorax after neck dissection has not been reported previously. Chylothorax is more common after intrathoracic surgery or trauma. Regardless of its cause, the condition is potentially serious and sometimes fatal. Our patient was successfully managed without further surgery. The aetiology and management of chylothorax following neck dissection are discussed.

Chylothorax↗
PubMed1993

Unilateral piriformis syndrome in a patient with previous melanoma.

Several years after undergoing surgery for a malignant melanoma on his left lower back, a 51 year old man developed intermittently severe pain in his left posterior thigh. Plain X-rays showed no abnormality, but computerized tomography and magnetic resonance imaging scans demonstrated an abnormal soft tissue mass in the left sciatic notch. Although a metastasis from the original melanoma was suspected, exploration of the suspicious area revealed only hypertrophy of the left piriformis muscle. This was due to regular gymnasium exercises designed to selectively build up the musculature of the left lower limb, which the patient had undertaken in the firm belief that it would help to prevent a recurrence of his left-sided melanoma. Complete relief of the unilateral piriformis syndrome was achieved by division of the hypertrophied piriformis muscle, thereby relieving the pressure on the left sciatic nerve as it passed through the greater sciatic foramen.

Buttocks↗