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Biomedical subjects

J Gill

Publications and source records attributed to J Gill.

At least 109 records · Page 6Linked to original sources
PubMed1992

Cholecystectomy. The impact of socioeconomic change.

The impact of our evolving health care system on a commonly performed surgical procedure, cholecystectomy, was assessed in a county-subsidized and private university hospital setting. Although condition on admission, use of resources, and outcome were unchanged in the private setting between 1980 and 1988, significant differences were noted among the largely uninsured patients at the county facility during this same time interval. There was a significant increase in the acuity of illness among patients undergoing cholecystectomy at the county hospital in 1988 as compared with 1980. These data suggest that alterations in reimbursement strategies and allocation of resources are significantly impacting on patient care, particularly in nonprivate health care facilities.

Adult↗
PubMed1992

Lisinopril and nifedipine administration inhibits the ex vivo uptake of [45Ca2+] by platelets from hypertensive diabetic patients.

1. The effect of administration of the angiotensin converting enzyme inhibitor (ACEI), lisinopril (Carace; 10-40 mg twice daily) and the calcium channel blocker, nifedipine (Adalat Retard; 20-40 mg twice daily) on ex vivo [45Ca2+] uptake by platelets from hypertensive diabetic (type 1 and 2) patients was investigated. 2. At the end of at least 3 months treatment, blood was collected prior to the patient taking the morning dose of medication and washed platelets prepared. [45Ca2+] uptake was monitored following the addition of adrenaline, isoprenaline and dibutyryl cAMP (dbcAMP), as well as in unstimulated (zero) platelets. 3. Both nifedipine and lisinopril significantly inhibited the ex vivo uptake of [45Ca2+] by platelets when this process was stimulated by adrenaline, isoprenaline and dibutyryl cAMP. Basal uptake was also inhibited in both groups. 4. These data consolidate the hypothesis that ACE inhibitors may possess calcium channel/calcium mobilisation blocking properties. Apart from its hypertensive action, lisinopril may also reduce platelet activity via modulation of calcium dynamics, thereby reducing the incidence of vascular complications associated with diabetes mellitus.

Adult↗
PubMed1992

Diurnal changes in cortisol level, neutrophil number and lyzozyme activity in foals during the first 13 weeks of life and in their lactating mothers.

In the blood of 11 foals and their lactating mothers (Standardbred) diurnal changes in the cortisol level, neutrophil number and lysozyme activity were studied during the first 13 weeks of life. The investigations began when a foal reached 7 days of age and were repeated every two weeks till 13 weeks of age. Blood samples were taken from the jugular vein every 4 hours for one day. Experiments were repeated in two following years. In the first year 6 mares and 6 foals born by these mares were examined, and in the second year--5 of the mares from the first year and the 5 new foals borne by them. All horses were kept and fed under the same conditions. Diurnal rhythm in neutrophil number and lysozyme activity was found neither in foals nor in mares. In the cortisol level a diurnal rhythm was found as early as in the first week of life of a foal as well as in the first week of lactation in mares. The mean diurnal values of cortisol level and lysozyme activity in foal blood were lower by 58% and 22%, respectively, in comparison with mares.

Animals↗
PubMed1992

Suppression of Helicobacter pylori reduces gastrin releasing peptide stimulated gastrin release in duodenal ulcer patients.

Helicobacter pylori increases gastrin release in duodenal ulcer patients. This may be through disruption or changes in the mucus layer affecting the access of luminal stimulants to gastrin releasing cells. The effect of suppressing H pylori on gastrin release stimulated by a non-luminal stimulus, gastrin releasing peptide (GRP), was examined. Eleven patients with active duodenal ulcer disease and colonised with H pylori received an intravenous infusion of GRP (2.9 pmol/kg/minute for 30 minutes) and the plasma gastrin response was measured. Basal and peak pentagastrin stimulated acid output were also determined. Patients were treated with tripotassium dicitratobismuthate (De-Nol) and metronidazole to suppress H pylori and the tests were repeated. Suppression of H pylori decreased plasma gastrin concentrations during GRP infusion, but acid output was not affected. Chromatographic analysis of the forms of gastrin in plasma showed a significant fall in gastrin 17, the predominant form found in the gastric antrum. Gastrin 34 did not fall significantly. This study shows that suppression of H pylori decreases the hypergastrinaemia caused by the nonluminal stimulant, GRP, mainly via decreasing gastrin 17.

Adult↗
PubMed1992

Differential changes in alpha- and beta-adrenoceptor linked [45Ca2+] uptake in platelets from patients with anorexia nervosa.

[45Ca2+] Uptake was studied in response to adrenaline, isoprenaline, noradrenaline, and (Bu)2cAMP in platelets from patients with anorexia nervosa. In both controls and anorectics, adrenaline, isoprenaline, noradrenaline, and (Bu)2cAMP stimulated [45Ca2+] uptake. In receptor subtype characterisation studies on control platelets, adrenaline-stimulated [45Ca2+] uptake was blocked by yohimbine (an alpha 2-adrenoceptor antagonist) and the specific beta 2-adrenoceptor antagonist ICI 118,551, but not by atenolol (a beta 1-antagonist). Isoprenaline action was blocked by ICI 118,551, but not by yohimbine. Noradrenaline-stimulated [45Ca2+] uptake was blocked by yohimbine but not by ICI 118,551. In platelets from anorectic patients, there was a significant increase in noradrenaline-stimulated [45Ca2+] uptake, a significant diminution in adrenaline and isoprenaline-stimulated [45Ca2+] uptake, but no significant difference in (Bu)2cAMP-stimulated [45Ca2+] uptake, when compared with controls. Basal uptake was also significantly enhanced in anorectics and was found to be inhibited with verapamil but not adrenoceptor antagonist. These data firstly indicate that both alpha 2- and beta 2-adrenoceptor activation elicits [45Ca2+] uptake by platelets. It is proposed that this stimulated [45Ca2+] uptake does not reflect changes in cytosolic Ca2+ but to localized changes of Ca2+ at the plasma membrane, possibly associated with receptor activation, per se. The respective increase and decrease of alpha- and beta-adrenoceptor activity in platelets from anorectic patients is in accord with other reports of changes of adrenoceptor number and type in platelets and other cells from anorectic patients. There may also be an increase in calcium channel activity in platelets from anorectics.

Adolescent↗
PubMed1992

Amiodarone. An overview of its pharmacological properties, and review of its therapeutic use in cardiac arrhythmias.

Amiodarone, originally developed over 20 years ago, is a potent antiarrhythmic drug with the actions of all antiarrhythmic drug classes. It has been successfully used in the treatment of symptomatic and life-threatening ventricular arrhythmias and symptomatic supraventricular arrhythmias. In patients with left ventricular dysfunction amiodarone does not usually produce any clinically significant cardiodepression and the drug has relatively high antiarrhythmic efficacy. Preliminary studies indicate that amiodarone may have a beneficial effect on mortality and survival in certain groups of patients with ventricular arrhythmias, an action probably related to both its antiarrhythmic and antifibrillatory effects. The adverse effect profile of amiodarone is diverse, involving the cardiac, thyroid, pulmonary, hepatic, gastrointestinal, ocular, neurological and dermatological systems. Interstitial pneumonitis and hepatitis are potentially fatal, but the vast majority of adverse events are less serious, and some may be dose dependent. Pretreatment monitoring, regular assessments and the use of minimum effective doses are, therefore, necessary. Thus, with appropriate monitoring to control its well recognised adverse effects amiodarone has an important place as an effective 'broad spectrum' antiarrhythmic drug which has, so far, been used when other treatments have proved ineffective. More recent preliminary data also suggest that it may also have a beneficial effect in the prevention of sudden death in some patients.

Amiodarone↗
PubMed1992

Painful ophthalmoplegia secondary to a mucocele involving the sella turcica, superior orbital fissure, and sphenoid sinus.

A case of painful ophthalmoplegia associated with an extensive lesion involving the sella turcica, superior orbital fissure, and sphenoid sinus in a 57-year-old man is reported. Even though nasal and ocular symptoms and signs represent the usual features of sphenoidal mucoceles, extension to the intracranial cavity as seen in this lesion is rare. Surgical exploration via a sublabial, transseptal approach revealed a mucocele of the sphenoid sinus. This case exhibited extensive and aggressive behavior simulating a malignant neoplasm.

Bone Diseases↗
PubMed1991

Autoantigen-induced self lysis of human myelin basic protein-specific T lymphocytes.

Cytotoxic T cells reactive with myelin basic protein (MBP) may be isolated from most human subjects. Since activated T cells express major histocompatibility complex (MHC) class II antigens, we assessed whether MBP-specific, CD4+ T cells could present MBP or synthetic MBP peptides to themselves and whether this provoked self lysis. We examined two MBP-specific cell lines and eight T cell clones recognizing four different MBP epitopes. All T cell populations presented MBP as well as synthetic peptides to themselves eliciting self lysis of the T cell clones. CD4+ T cell populations recognizing another central nervous system (CNS) protein, proteolipid protein (PLP), or the recall antigen, Candida, did not exhibit this antigen-induced, autocytolytic activity. However, activated, PLP-reactive T cells were susceptible to lysis by cytotoxic MBP-specific T cells in the presence of MBP. These results suggest that antigen-induced self lysis of activated human T cells might limit an autoimmune response within a target organ independent of other immunoregulatory mechanisms.

Autoantigens↗
PubMed1991

A new method for continuous recording of motor activity in horses.

1. The use of an electronic recorder for the horse motor activity was described. 2. Examples of different types of motor activities are given in Figs 1-8. 3. The ultradian pattern of activity in all records was stressed. 4. The possibility of receiving of more physiological informations by this type of apparatus is discussed.

Animals↗
PubMed1991

Diurnal changes in lactic and pyruvic acid levels and pH values in foals during the first 13 weeks of their life and in their lactating mothers.

1. The diurnal changes in the levels of lactic (LA) and pyruvic (PA) acids and values of pH were studied in standard-bred mares and their foals, for 13 weeks of foal life, throughout 2 years. 2. The studies began when a foal was 7 days old and were repeated every 2 weeks until foals reached 13 weeks of age. 3. Blood samples were taken every 4 hr for one day, each second week. 4. In the LA, PA levels and pH values no diurnal rhythm was stated in lactating mares during study periods. 5. In foals the diurnal rhythm in LA and PA occurred in the 3rd month of their life, with the acrophase at night hours. 6. The significant correlations between foal and their mother metabolites studied were observed. 7. The environmental factors (air temperature, humidity) influence fluctuations of the amplitude in parameters studied in the horse blood.

Animals↗
PubMed1991

Influence of pregnancy and lactation on diurnal and seasonal changes in lactic acid and pyruvic acid levels and in values of pH, pCO2 and pO2 in the mare blood.

1. The diurnal changes in the levels of lactic (LA) and pyruvic (PA) acids and in values of pH, pO2 and pCO2 were studied in the blood of barren and later on in pregnant and lactating mares, throughout three subsequent years. 2. Blood samples were taken every 4 hr, for one day, each month, throughout 3 years. 3. The mares were kept and fed in the same conditions, lighting was natural. 4. In barren mares, diurnal rhythm in LA, PA, pO2 and pCO2 was found. 5. The pregnancy as well as lactation masked diurnal rhythms in parameters studied, except the LA level during lactation but then the acrophase was shifted by 3-4 hr. 6. Seasonal cyclicity was found in the values of LA, PA and pCO2 in barren mares. The pregnancy abolished cyclicity in LA level and modified the behaviour of PA and pCO2 values causing a shift of acrophases and lowering the amplitudes of the indices. 7. In the pO2 tensions no seasonal cycles were observed. 8. In the values of pH neither diurnal rhythms nor seasonal cycles throughout study years were observed.

Animals↗
PubMed1991

Influence of pregnancy on diurnal and seasonal changes in cortisol, T3 and T4 levels in the mare blood serum.

1. The diurnal changes in the level of total protein, cortisol, T3 and T4 were studied in four barren and four pregnant standard-bred mares, kept and examined under the same conditions. 2. Blood samples were taken every 4 hr. for one day each month, throughout one year. 3. In barren mares, a diurnal rhythm in cortisol level (acrophase at 0530 hr in summer and at 0830 hr in winter) and in T3 level (acrophase at 1330 hr in summer and at 1800 hr in winter) was found. 4. In pregnant mares, a diurnal rhythm in cortisol level only till 5th month of pregnancy was observed. 5. A diurnal rhythm in T3 level was found throughout the pregnancy, with acrophase always at 1400 hr. 6. No diurnal rhythm in the total protein content and in the T4 level was observed. 7. In both groups of mares the seasonal cyclicity in T3 and T4 levels were found. A seasonal cyclicity in cortisol level was found only in pregnant mares. 8. Pregnancy abolished seasonal cyclicity in total protein and showed it in cortisol level. 9. Pregnancy in mares modifies diurnal rhythms as well as seasonal cycles in secretion and metabolism of the hormones studied.

Animals↗
PubMed1991

Influence of pregnancy on diurnal and seasonal changes in glucose level and activity of FDPA, AlAT and AspAT in mares.

1. The diurnal changes in the glucose level and in activity of FDPA, A1AT and AspAT in four pregnant standard-bred mares were studied. 2. As a control four barren mares, were kept and examined in the same conditions. 3. Blood samples were taken every 4 hr for one day, each month, throughout pregnancy, or one year. 4. A diurnal rhythm in activity of A1AT and AspAT in barren mares was found. The pregnancy masked diurnal rhythm in activities of both transaminases. 5. No diurnal rhythm in glucose level and FDPA activity in both groups of mares was observed. 6. Seasonal cyclicity was found in all indices studied, in both groups of mares. 7. The pregnancy did not abolish cyclicity in parameters studied but modified their behaviour--causing a shift of acrophases (glucose, FDPA, AspAT) and lowering the amplitudes (FDPA, A1AT, AspAT).

Alanine Transaminase↗
PubMed1991

Disorders of the avian integument.

The avian integument consists of highly specialized structures that show extreme variations between species. Feathers are the most obvious part of the integument, and their color and beauty forms an important basis for the attraction of birds to humans. Any disorder in the feathers can be distressing for a client and frustrating for the avian practitioner. The cause of some disorders may be apparent, but others have a complex pathogenesis involving management, human-bird interaction, malnutrition, psychologic factors, disease, or hormone imbalances.

Animal Nutritional Physiological Phenomena↗
PubMed1991

A comparison of intravenous propafenone and flecainide in the treatment of tachycardias associated with the Wolff-Parkinson-White syndrome.

UNLABELLED: We compared the electrophysiological effects of intravenous propafenone and flecainide on accessory pathway conduction by a randomized crossover study in 16 patients with Wolff-Parkinson-White syndrome. The antegrade refractory period of the pathway increased from 256 +/- 18 msec at baseline to 288 +/- 13 msec on propafenone (P less than 0.05) and to 296 +/- 27 msec on flecainide (P = 0.075). The minimum preexcited RR interval during atrial fibrillation or incremental atrial pacing was prolonged from 225 +/- 37 msec to 262 +/- 22 msec by propafenone (P less than 0.05) and to 301 +/- 31 msec by flecainide (P less than 0.005). The prolongation was significantly greater with flecainide than propafenone (P less than 0.05). Both drugs increased tachycardia cycle length (TCL) from 310 +/- 35 msec to 354 +/- 37 msec (propafenone P less than 0.005) and to 352 +/- 37 msec (flecainide P less than 0.01). Both propafenone and flecainide blocked antegrade conduction in the pathway in five patients. Both drugs rendered atrial fibrillation noninducible in seven patients and orthodromic tachycardia noninducible in five patients. CONCLUSIONS: (1) Flecainide causes a greater prolongation of minimum preexcited RR interval than propafenone; (2) There is no significant difference between propafenone and flecainide on the inducibility of arrhythmias, TCL, or incidence of antegrade conduction block.

Adult↗
PubMed1991

Automatic recognition of ventricular arrhythmias using temporal electrogram analysis.

Future antitachycardia devices must be able to deliver a variety of therapies according to the requirements of the underlying arrhythmia. To ensure that appropriate treatment is prescribed the device must use a detection algorithm that is able to discriminate between multiple arrhythmias. Current criteria such as rate, change of rate, duration at high rate, and high rate stability are inadequate for this purpose. Many algorithms that evaluate the morphology of the endocardial electrogram are of too great a complexity to be incorporated in implantable devices that require real-time analysis without undue power consumption. In this study the sensitivity of a simple morphological technique (temporal electrogram analysis) is examined. The method sets threshold 'rails' above and below the isoelectric line and classifies ECG complexes according to the sequence and duration of rail excursions. A total of 27 ventricular tachyarrhythmias were induced in 25 patients (17 with a history of recurrent arrhythmias and eight undergoing risk stratification postmyocardial infarction). Temporal electrogram analysis (TEA), initially detected the onset of the ventricular arrhythmia in all patients whose surface ECG showed polymorphic or right bundle branch block pattern tachycardia, in 5/8 of cases with left bundle branch block pattern and in 4/5 of patients with concordant complexes across the precordial leads. After minor modifications the overall sensitivity of the method was improved to 95% (26/27 arrhythmias detected). TEA is a technique of low computational demands, which in this study, reliably discriminated between resting sinus rhythm and ventricular arrhythmias.

Adult↗
PubMed1991

Changes in some haematological and metabolic indices in young horses during the first year of jump-training.

Effects of an 18 min exercise test, on three separate occasions during a one year jump-training programme, was studied in seven horses. Determinations were carried out on venous blood for packed cell volume, haemoglobin, total protein, lactate and pyruvate, glucose, free fatty acids, insulin, glucagon, blood gases, bicarbonate, pH, aldolase, aspartate aminotransferase and alanine amino-transferase. Exercise caused a slight increase in lactate and pyruvate, total protein, aldolase, alanine aminotransferase, pO2, bicarbonate and pH. Glucose, free fatty acids and pCO2 levels decreased. Training caused no significant difference in these changes. However, during the year, increases in lactate and decreases in pH (resting levels) were observed.

Alanine Transaminase↗