Acute normovolemic hemodilution.
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Biomedical subjects
Publications and source records attributed to J Gallagher.
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In 20 cases routine static bone scans were no value in the detection of delayed fracture healing. Using the 7.5-15 min net uptake of technetium labelled phosphate, disturbed fracture healing was detected in a series, of 37 cases. Normally healing fractures had an increase of 3 per cent per month and delayed unions less than half that amount. Non-unions had no net uptake.
The prevalence of infections caused by Mycobacterium bovis was estimated in two populations of wild animals in the south west of England. A variety of mammalian species was trapped on farm land where incidents of infection with tuberculosis had occurred in cattle. Bacteriological analysis of lymph node samples and lesions showed that the only animals acting as a reservoir for M. bovis were badgers. Examination of arthropod ectoparasites of infected badgers proved negative for M. bovis and suggests that these are unlikely to act as vectors in transmission of the disease.
The obstetrical outcome of 357 pregnancies complicated by "spurious" labour was documented and compared with that in a control group. Patients with spurious labour were more likely to have had a spontaneous or induced abortion in the preceding pregnancy. In almost 85% of patients, the painful uterine contractions had ceased within 1 hour of hospital admission and there was no increased fetal morbidity in this group. There was a significantly increased incidence of meconium-stained liquor in patients who continued to have painful uterine contractions, but in whom labour did not ensue. Placental abnormalities were significantly more common in patients with spurious labour.
Digital subtraction angiography (DSA) was used to study the cardiovascular system in more than 400 patients and was specifically compared with conventional angiography of the aorta and renal arteries in 30 patients. For the renal arteries, the overall accuracy of DSA was 71% (50/70). Excluding 11 cases of inadequate visualization of the renal arteries on DSA, the sensitivity of the new technique was 93% (55/59) and the specificity 91.5% (54/59). Aortic disease, including intravascular clots and occlusions, was faithfully delineated by DSA.
A 24-yr-old man developed sensitization to Quillaja bark (soapbark) dust at his work place. Within 3 mo of being employed in a factory processing Quallaja bark to produce saponin, he experienced asthma symptoms while handling the bark but only nasal symptoms on being exposed to the purified saponin. Bronchial provocation using Quillaja bark dust resulted in immediate bronchoconstriction as well as faintness, diffuse erythema, and hypotension. Radioallergosorbent test (RAST) using the pulverized crude Quillaja bark was markedly positive, and cross-reactivity between gum acacia and gum tragacanth was demonstrated using this technique.
Treating pediatric patients in an adult general hospital intensive care unit requires flexibility both in terms of equipment and utilization of space, and in the approach of the staff to the patient and family unit. Integration of the care of children in an adult hospital is described.
A worker with occupational asthma due to toluene diisocyanate (TDI) was studied. Detailed immunologic studies, including those for p-tolyl isocyanate IgE antibodies and the presence of leukocyte inhibition factor for isocyanate antigen, were negative. Clinically, the subject noted more pronounced symptoms beginning on Monday morning, followed by weekend off work, and lessening of her symptoms over the working week. Methacholine challenges were negative when performed on three separate occasions, including the time when maximum symptoms were present, and again six months later, before and after bronchial challenge testing. A dose-related response to TDI was observed on bronchial provocation testing using nonirritating concentrations of TDI of 0.0165 and 0.030 ppm. This case provides evidence that the response of the airway to TDI may not always be accompanied by hyperreactivity to methacholine. Screening programs utilizing methacholine challenges may not always identify sensitized workers, since a negative methacholine challenge test does not exclude TDI sensitization.
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During the period 1973 to 1976 inclusive, 1206 badger carcases were examined for evidence of tuberculosis and other diseases. Tuberculosis was the major cause of natural death, killing 39 per cent of the natural death cases, followed by bite wounding and starvation. Road traffic accidents were the greatest single cause of death.
To evaluate the progression of conduction system disease in myotonic muscular dystrophy, nine patients underwent serial electrophysiologic studies at a mean of 35 months apart. At the initial study, seven patients had first-degree atrioventricular block and three of these seven had disease in the His-Purkinje system (HV greater than 55 msec). At the second study, seven patients had prolonged HV intervals, and during the almost 3-year period, HV intervals increased by at least 5 msec in all seven patients. No electrophysiologic or electrocardiographic measures could be found that correlated with progression of conduction disease in these patients. Because of the failure of electrophysiologic measures to predict progression of conduction disease in these patients, electrophysiologic studies are recommended only for symptomatic patients. If significant disease is found in either impulse formation or conduction, permanent pacemaker therapy is warranted.
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Host defenses were evaluated in 70 healthy aged volunteers. Individuals who had diseases or who were taking medication known to affect the inflammatory and immune responses were excluded from the study. Volunteers were followed for 24 months to correlate their state of health with the evaluation of host defenses. Polymorphonuclear leukocyte function and the serum opsonic capacity for Escherichia coli and Staphylococcus aureus were normal. Assays of complement components and activity revealed unexplained elevations in native C3 and properdin, normal concentrations of factor B, normal conversion of C3 by inulin, and normal levels of hemolytic complement. The levels of IgG and IgA did not differ from levels noted in younger controls, but the concentration of IgM was decreased and that of IgE increased. The prevalence of autoantibodies was low. None of the volunteers were anergic, but lymphocyte responses to mitogens were depressed in three-day cultures. The number and percentages of E-rosette-forming cells and cells bearing surface IgD or IgM were normal. No lymphopenia was noted.
The modification of Middlebrook's 7H11 oleic acid albumin agar medium by the addition of fresh bovine serum and lysed sheep red cells to encourage growth of Mycobacterium bovis is described. The improved medium was made selective by the addition of antibiotics and a comparative trial of this medium and the guineapig test in the isolation of M. bovis from badger tissues is reported. A close agreement between the two tests was found; the guinea-pig test detected 95% of all isolations and culture detected 91%.
The gross and histological appearances of the lesions of tuberculosis in 36 wild badgers found to be infected with Mycobacterium bovis are described. These badgers were examined over a period of two years during an investigation into the possible epidemiological association of tuberculosis in badgers and cattle. The possible significance of the lesions in transmission of M bovis to cattle and other badgers is discussed. The histological appearance of the lesions was considered to be indicative of a lesser hypersensitivity reaction than is seen in the bovine.
Cross-reactivity between major classes of aeroallergenic pollens has been estimated by comparing the inhibitory effects of selected allergens upon the reaginic activity of other native and non-native varieties, as measured by the radioallergosorbent technique (RAST). Common allergenic determinants were demonstrated in indigenous and nonindigenous ragween species. Although patterns of inhibitory capacity were less uniform among grass pollens, endemic species tended to have more common allergenic properties than nonendemic species. Tree pollens exhibited the greatest degree of heterogeneity, confirming the previous view that these pollens tend to be less cross-reactive. Concomitant skin test threshold studies utilizing the same groups of pollens were in general agreement with in vitro results. Because, threshold skin testing was affected by a number of uncontrollable variables, however, the current modification of RAST in estimating cross-allergenicity was more accurate and reliable than data based upon cutaneous tests. It was concluded that reagin neutralization by the RAST method is the best currently available method of assessing cross-allergenic properties of pollens.
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