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Biomedical subjects

J Freeman

Publications and source records attributed to J Freeman.

At least 235 records · Page 13Linked to original sources
PubMed1987

Novel nucleolar antigens in autoimmune disease.

Antinucleolar antibodies are of interest in 2 important areas, namely, autoimmune diseases and specific products involved in the "mitogenic cascade." The former have delineated a series of novel nuclear and nucleolar elements including the recently described proliferating cell nuclear antigens (PCNA), some of which are present in the nucleolus only at specific times in the G1-S phase of the cell cycle. Important new proteins such as "fibrillarin" (34 kD/pI 8.5) and a 125 kD nucleotide containing protein have been identified with antinucleolar antibodies. Protein p145 is a nucleolar PCNA that is present in growing and dividing cells but not in normal resting tissues. Antinucleolar antibodies offer powerful tools, not only for identification of specific nucleolar proteins important in the cell cycle, but also for purification of their genes and analysis of mechanisms of gene control that operate the "time windows" of the cell cycle.

Amino Acid Sequence↗
PubMed1987

Radiologic artifact.

Explore the source record for details and available documents.

Administration, Cutaneous↗
PubMed1986

Clinical pharmacology of vinzolidine.

Vinzolidine (VZL), a new semisynthetic vinca alkaloid, was studied by using 3H-labeled VZL administered PO in four patients. At single doses from 1.5 to 36.5 mg/m2 (0.034-0.919 mg/kg) radioactivity was rapidly absorbed with a half-life of absorption of 1 h and a peak at 4 h. Plasma decay of radiolabel followed a biphasic pattern with an alpha half-life of 10.48 h and a beta half-life of 172 h. The apparent plasma clearance was dose-dependent. The total radiolabel recovered was 52.9% +/- 11.4% of the administered label, with 90% in the feces. HPLC analysis revealed that in all extracted plasma, urine, and feces the predominant material was unchanged VZL. Several metabolites were observed but not identified.

Dose-Response Relationship, Drug↗
PubMed1986

[Lightning stroke].

A case is reported of a 23 year old white man who was struck by lightning. The patient suffered cardiac and respiratory arrest. Immediately, he received external cardiac massage and artificial breathing, which were successful. He was then admitted to an intensive care unit, where the diagnosis of acute myocardial infarction was made, on the basis of electrocardiographic abnormalities, a significative elevation of cardiac enzymes, and ultimately a thallium-201 scintigraphy. There were no complications of this heart injury, except for a persistent sinus tachycardia, which was treated by the infusion of a beta-blocking agent (oxprenolol). This case showed the importance of rapidly undertaking resuscitative measures in these circumstances, and to admit such a patient to an intensive care unit to undergo continuous cardiac monitoring, because the possibility of potentially serious cardiac complications, like life-threatening cardiac rhythm disturbances or acute myocardial infarction, as well as preventive, or curative, treatment of the complications which may follow lightning injury. This attitude is justified by the usually excellent prognosis of these patients.

Adult↗
PubMed1986

Duration of disease, duration indicators, and estimation of the risk ratio.

The authors investigated how duration of disease and duration of risk until onset of disease relate prevalence odds ratios and cumulative incidence ratios, respectively, to incidence density ratios in a steady-state population. Using information on durations, they demonstrated how incidence density ratios may be estimated from the information available in variants of the case-referent study and their cohort study analogues. The standard case-referent study involves an incidence series of cases and a prevalence series of noncases. One variant is a study of a prevalence series of cases and a prevalence series of noncases. Another variant involves comparison of two incidence series for sequential incident events. Factors associated with disease risk have been termed risk indicators, and, by analogy, factors associated with disease duration are defined as duration indicators. These duration indicators may be identified through the study of duration ratios. Ratios of durations in steady-state populations may be combined with the prevalence and cumulative incidence information available in the variants of the standard study designs to obtain estimates of incidence density ratios.

Cross Infection↗
PubMed1986

Difficulty in diagnosing complications of Caroli's disease.

Congenital cystic dilatation of the biliary tree (Caroli's disease) is a rare condition that usually presents with ascending cholangitis. This report demonstrates the difficulty of recognizing other complications of Caroli's disease antemortem. A 35-year-old man developed a subphrenic abscess and malignant transformation of the biliary tree; both were clinically undetected. Episodes of pain, pyrexia, or weight loss should be assessed carefully and the complications of Caroli's disease considered before attributing such symptoms to recurrent cholangitis.

Adenoma, Bile Duct↗
PubMed1986

Is chronic synovitis an example of reperfusion injury?

In an attempt to define why the joint synovial cavity is prone to develop persistent synovial inflammation we show that hypoxia is induced by pressure changes caused by exercise in the presence of an inflammatory effusion. On resting 'reperfusion injury' may take place. The biochemistry of reperfusion injury has only recently been defined and perhaps surprisingly for an insult that has hypoxia as its central ingredient involves the subsequent production of oxygen derived free radical species. We apply the reaction sequences that are believed to occur during hypoxic/reperfusion injury to the joint synovial cavity and, on the basis of reported 'in vivo' observations, suggest novel therapeutic approaches that we believe are applicable to the treatment of persistent synovial inflammation.

Animals↗
PubMed1986

Treatment of fecal incontinence in children with spina bifida: comparison of biofeedback and behavior modification.

Two experiments compared the effects of biofeedback training to behavior modification in the treatment of 33 children aged 5 to 16 who had fecal incontinence secondary to myelomeningocele. Biofeedback involved providing visual feedback and rewards for successively stronger sphincter contractions during training sessions and requiring 50 sphincter contraction exercises daily. Behavior modification involved attempting to defecate immediately after the evening meal each day, receiving a reward for defecating in the toilet without an enema or suppository, and receiving an enema if unsuccessful for two consecutive days. In experiment I, eight children were offered biofeedback alone in an attempt to replicate previous studies. Biofeedback alone was found insufficient; addition of behavior modification was necessary. Experiment II systematically investigated the relative contribution of these two treatments. Overall, patients who received only behavior modification for three months showed as much clinical improvement as patients who received behavior modification plus biofeedback. This suggests that previous reports, because they have not controlled for nonspecific treatment effects, have overestimated the value of biofeedback in this population. However, a subgroup of patients (27%) were identified for whom biofeedback provided additional, specific benefit. These were children who had spinal cord lesions below L-2 and who initially had two or more bowel movements daily. The combination of behavior modification and biofeedback resulted in a greater than 50% reduction in the frequency of incontinence for 64% of patients, and results were well maintained at follow-up one year later.

Adolescent↗
PubMed1985

Risk of illness after exposure to a pediatric office.

To determine whether well children visiting a pediatrician's office are at risk of acquiring common communicable diseases, we conducted a prospective cohort study during the winter of 1983-1984. The occurrence of respiratory or gastrointestinal illness or fever in young children in the week after a visit to a pediatric office (office group) was compared with the occurrence of these illnesses in a similar group of children (home group) not exposed to the office during the study period. One home comparison subject was matched by age and sex to each of 127 children three years of age and under who were seen for well-child care in a private pediatric office with a common waiting room. The adjusted relative risk of the development of illness during the study week for the office group as compared with the home group was 0.95 (95 per cent confidence interval, 0.66 to 1.37), indicating no effect. We conclude that exposure to a pediatric office is not an important cause of the common infections in young children that have incubation periods of a week or less.

Child Health Services↗
PubMed1985

Topical antimicrobial toxicity.

Three topical antibiotics and four antiseptics (1% povidone-iodine, 0.25% acetic acid, 3% hydrogen peroxide, and 0.5% sodium hypochlorite) were directly applied to cultured human fibroblasts to quantitatively assess their cytotoxicity. The four antiseptics were found to be cytotoxic; all of the cytotoxic agents except hydrogen peroxide were subsequently found to adversely affect wound healing in an animal model. Comparison of bactericidal and cytotoxic effects of serial dilutions of these four topical agents indicated the cellular toxicity of hydrogen peroxide and acetic acid exceeded their bactericidal potency. Bactericidal noncytotoxic dilutions of povidone-iodine and sodium hypochlorite were identified. These experiments provide evidence that 1% povidone-iodine, 3% hydrogen peroxide, 0.5% sodium hypochlorite, and 0.25% acetic acid are unsuitable for use in wound care. This sequence of experiments could be used to identify bactericidal, noncytotoxic agents prior to their clinical use.

Acetates↗
PubMed1985

A new transtracheal catheter for ventilation and resuscitation.

We describe a new catheter for emergency ventilation of patients difficult to intubate. This catheter can be inserted through the crico-thyroid membrane or the first or second intertracheal ringspace with ease in an almost atraumatic fashion. The outside part of the device, with its dual attachment system, can be connected to conventional resuscitation equipment by its 15 mm male end or to a high-pressure oxygen source by its luer-lock fitting. A double angulation maintains the intratracheal portion of the catheter in the axis of the trachea and the external part in close contact with the larynx. A Velcro band attached to two lateral flanges keeps the catheter in place. The results of transtracheal catheterization of 48 patients by means of this new device are discussed.

Catheterization↗
PubMed1985

Reduced pulmonary capillary blood volume as a long-term sequel of ARDS.

Lung function was evaluated in nine survivors of ARDS. All patients were asymptomatic at rest at the time of the study, ie, 5.5 to 19 months after extubation (mean 12.5). Six had mild to moderate exertional dyspnea. Chest x-ray films showed no gross parenchymal abnormalities. Spirometry and pulmonary mechanics were either normal or minimally altered, particularly in smokers. At submaximal exercise levels, effort was limited by tachycardia in eight patients; one subject showed ventilatory and cardiovascular limitations. It was concluded that spirometry and pulmonary mechanics are restored to normal within six months after extubation, and gas exchange abnormalities persist after ARDS and might be related to intrapulmonary shunts at rest, whereas during exercise a decreased pulmonary capillary blood volume might be the primary factor.

Adult↗
PubMed1985

Pharmacokinetics of low-dose 1-beta-D-arabinofuranosylcytosine given by continuous intravenous infusion over twenty-one days.

The pharmacokinetic parameters of low dose 1-beta-D-arabinofuranosylcytosine (ara-C) infusions were studied in 11 patients, 6 males and 5 females, with a mean age of 68.5 +/- 13.8 (SD) years. The drug was infused to 4 patients with pre-leukemia (refractory anemia with excess blasts), 5 patients with acute myelogenous leukemia, and 2 patients with secondary leukemia due to chemotherapy, at a dosage of 20 mg/m2/day over 21 days. The patients' blood and urine were analyzed for ara-C content by radioimmunoassay. Mean steady state plasma levels of 7.7 +/- 4.7 ng/ml (31.7 +/- 19.3 nM) (n = 189) and a range 0.6 (2.5 nM) (lower limit of assay) to 29.7 ng/ml (122.1 nM), with significant inter- and intra-patient variations, were reached within about 2.7 h. The plasma levels of ara-C decreased rapidly, with a t1/2 alpha of about 12 min following discontinuation of the infusion, followed by a very slow t 1/2 beta of about 19 h. Other parameters (mean values of 10 or 11 patients) were: area under the curve, 182.1 +/- 64.8 ng X day/ml; total body clearance, 188.7 +/- 54.8 liters/h; renal clearance, 3.1 +/- 1.4 liters/h; volume of distribution at steady state, 53,913 +/- 17,626 liters; and recovery of ara-C in urine, 1.43 +/- 0.69% (n = 226) of daily administered ara-C. A linear relationship was observed with administered dose when the mean plasma levels of our study were compared with the ones reported for conventional ara-C infusions. Plasma clearance was comparable to that observed in conventional dose, when the observed values were extrapolated to the dose administered in this study.

Aged↗