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Biomedical subjects

J M Hunter

Publications and source records attributed to J M Hunter.

At least 127 records · Page 7Linked to original sources
PubMed1985

Use of atracurium and vecuronium in patients with oesophageal varices.

The effects of atracurium (initial dose 0.5 mg kg-1; incremental doses 0.2 mg kg-1) and vecuronium (initial dose 0.1 mg kg-1; incremental doses 0.04 mg kg-1) are described in patients with portal hypertension and some degree of liver dysfunction, and the findings compared with those from normal patients. With these doses there was no evidence of gross resistance to the two neuromuscular blockers in the patients with liver problems, although the duration of action of the initial dose was somewhat shorter, and the same may have been true of incremental doses. The method of elimination would suggest that atracurium may be the better drug in patients with severe liver dysfunction, but the use of small doses of vecuronium is not contraindicated in this type of patient.

Adult↗
PubMed1985

The use of different doses of vecuronium in patients with liver dysfunction.

The clinical neuromuscular effects of two doses of vecuronium (0.15 mg kg-1 and 0.2 mg kg-1) were investigated in 20 healthy patients and 20 patients with cirrhosis, and compared with previous work in which vecuronium 0.1 mg kg-1 was given under identical conditions of anaesthesia and monitoring. Ten healthy patients received vecuronium 0.15 mg kg-1 and 10 received 0.2 mg kg-1. Similarly, 10 patients with cirrhosis received vecuronium 0.15 mg kg-1 and 10 received 0.2 mg kg-1. Vecuronium 0.1 mg kg-1 has previously been shown to have a somewhat shorter duration of action in cirrhotic as opposed to healthy patients. In this study, vecuronium 0.15 mg kg-1 was found to have a similar duration of action in both groups, and vecuronium 0.2 mg kg-1 had a significantly longer action in the cirrhotic group. It is suggested that vecuronium should be used with caution in patients with hepatic dysfunction and that, in such patients, monitoring of neuromuscular function is desirable.

Adult↗
PubMed1985

Isolation of serine:glyoxylate aminotransferase from cucumber cotyledons.

Serine:glyoxylate aminotransferase, a marker enzyme for leaf peroxisomes, has been purified to homogeneity from cucumber cotyledons (Cucumis sativus cv Improved Long Green). The isolation procedure involved precipitation with polyethyleneimine, a two-step ammonium sulfate fractionation (35 to 45%), gel filtration on Ultrogel AcA 34, and ion exchange chromatography on diethylaminoethyl-cellulose, first in the presence of pyridoxal-5-phosphate, and then in its absence. The enzyme was purified approximately 690-fold to a final specific activity of 34.4 units per milligram. Electrophoresis of the purified enzyme on sodium dodecyl sulfate-polyacrylamide gels revealed two polypeptide bands with apparent molecular weights of approximately 47,000 and 45,000. Both polypeptides coeluted with enzyme activity under all chromatographic conditions investigated, both were localized to the peroxisome, and both accumulated in cotyledons as enzyme activity increased during development. The two polypeptides appear not to be structurally related, since they showed little immunological cross-reactivity and gave rise to different peptide fragments when subjected to partial proteolytic digestion. Antiserum raised against either the denatured enzyme or the 45,000-dalton polypeptide did not react with any other polypeptides present in a crude cotyledonary homogenate. The purified enzyme also had alanine:glyoxylate aminotransferase activity, but was about twice as active with serine as the amino donor.

Journal Article↗
PubMed1985

Acute acalculous cholecystitis following multiple skeletal trauma. A report of three cases.

Three cases of acute acalculous cholecystitis are reported in patients with multisystem failure following major long-bone trauma. The diagnosis should be suspected in any such patient who develops septicaemia from an unidentified site. A high index of suspicion should be maintained, especially in patients who are sedated or in receipt of mechanical ventilation of the lungs and in whom physical signs may be minimal or absent.

Acute Disease↗
PubMed1985

Vecuronium in the myasthenic patient.

The use of vecuronium in six patients with myasthenia gravis undergoing thymectomy is described the train-of-four twitch technique was used to monitor neuromuscular function. The first two patients received an initial dose of 0.02 mg/kg and incremental doses of 4 micrograms/kg, which is in the order of one fifth of that normally used. Satisfactory depression of the first twitch of the train-of-four, however was not obtained and, therefore, in the remaining four patients the doses were doubled. At this dose satisfactory depression of the first twitch was achieved. Neostigmine 5.0 mg produced adequate reversal of residual neuromuscular blockade and the train-of-four twitch response recovered to normal levels. With reduced dosage and with careful neuromuscular monitoring, vecuronium can be used safely in the myasthenic patient.

Adolescent↗
PubMed1985

Tendon salvage and the active tendon implant: a perspective.

The purpose, as well as the value, of the two-stage system in the salvage situation is for the surgeon to perform all the reconstructive surgery needed at Stage 1. Nerves are repaired, vessels are repaired if necessary, the intrinsic system is inspected, a Swanson implant is added if needed, and pulleys are built. If everything is done correctly at Stage 1 and if the tendon grafting technique goes well, the patient will have a good result. The concept of the active tendon implant with its many possible applications will set a trend for great advancement in the future.

Adult↗
PubMed1984

Hypothesis of leprosy, tuberculosis and urbanization in Africa.

Leprosy today is a problem of global magnitude affecting possibly up to 15 million people. Its rise and fall in medieval Europe is an historically fascinating enigma. Partial cross-immunization by epidemic tuberculosis, reinforced by the growth of cities, has been proposed as a mechanism in leprosy's European disappearance, but evidence is lacking. In the case of Africa in recent decades, analysis of leprosy and tuberculosis rates, and of levels of urbanization, albeit with imperfect data, suggests a possible environmental health for leprosy, the existence of some cross-interference between tuberculosis and the milder, paucibacillary form of leprosy, and a negative correlation between leprosy and urbanization. It is argued that the rise of the city in Africa, acting through a combination of influences, including tuberculosis, is leading to a decline of leprosy.

Africa↗
PubMed1984

Disease rate as an artifact of the health care system: tuberculosis in Puerto Rico.

It is demonstrated that the reported rates of tuberculosis in Puerto Rico comprise a direct, positive measurement of location, infrastructure and numbers of personnel in the health care system. The disease map does not reflect true geographic prevalence, but it is a measurable artifact of the health care system. Areas of high and low reporting and zones of minimum patient contact, are identified in the interests of program management.

Delivery of Health Care↗
PubMed1984

Comparison of vecuronium, atracurium and tubocurarine in normal patients and in patients with no renal function.

Vecuronium (initial dose 0.1 mg kg-1; incremental doses 0.04 mg kg-1) was given to 21 normal and 21 anephric patients. There were no gross differences between the two groups in the effect or in the duration of action of either initial or incremental doses, except in two anephric patients who were resistant to the agent. Reversal with neostigmine was satisfactory. In normal patients the initial dose of vecuronium was slower in onset of action than was atracurium 0.5 mg kg-1 (26 patients): the first two incremental doses of vecuronium were administered significantly earlier than the corresponding increments of atracurium (0.2 mg kg-1), but the duration of action of increments over-all was not greatly different. However, in anephric patients, except in the resistant patients, the behaviour of vecuronium was similar to that of atracurium (26 patients). A comparison with an initial dose of tubocurarine 0.5 mg kg-1 given to 20 anephric patients and tubocurarine 0.6 mg kg-1 given to 21 normal and 20 anephric patients showed tubocurarine to be longer acting and considerably less predictable. This was particularly so in the anephric group, in which its action sometimes persisted after neostigmine had been given.

Adolescent↗
PubMed1984

Atracurium in the myasthenic patient.

The use of the new competitive muscle relaxant, atracurium, is described in five myasthenic patients presenting for thymectomy. With an initial dose of 0.1 mg/kg, that is approximately one-fifth of that normally used, and incremental doses of 0.02-0.04 mg/kg, satisfactory clinical conditions were achieved. Neuromuscular function was monitored throughout using the train-of-four mechanical twitch response, and residual neuromuscular blockade was reversed satisfactorily at the end of the procedure with neostigmine 5.0 mg. A marked increase in the magnitude of the first twitch of the train-of-four to greater than control levels, accompanied by pronounced fade, was found on reversal. In reduced dosage and with careful neuromuscular monitoring, atracurium is safe to use in the myasthenic patient.

Adult↗
PubMed1984

Erythromycin stearate in treating chlamydial infection of the cervix.

A total of 157 women attending departments of genitourinary medicine were treated for chlamydial infection of the cervix with erythromycin stearate 500 mg twice a day. Chlamydiae were eradicated from the cervix in 64/80 women treated for seven days and in 51/77 women treated for 14 days. In 12 of those treated for seven days and 15 of those treated for 14 days, reinfection was the probable cause of reisolation after treatment. The possibility of latent infection with Chlamydia trachomatis could not be excluded in five women, but was not more likely to occur with the shorter treatment course. Erythromycin stearate 500 mg twice daily for seven days appears to be an effective regimen for the treatment of uncomplicated chlamydial infection of the cervix.

Chlamydia Infections↗
PubMed1983

The pseudosynovial sheath--its characteristics in a primate model.

The characteristics and long-term fate of the pseudosynovial sheath formed in response to a gliding tendon implant were examined. A primate model was chosen to reproduce the human clinical situation. Hunter passive gliding implants were implanted in 32 digits of eight Macque monkeys. Surgical syndactylism was created to the adjacent active digits to provide passive range of motion of the digits. No implanted digits demonstrated progressive flexion contractures. Radiographs revealed passive excursion of the implants of an average of 2.5 cm. Biopsies were taken at various time intervals and locations for histological examination. The pseudosynovial sheath has three descriptive layers: an intima, media, and adventitia. This sheath becomes mature and stable at 8 weeks. The intima cells contain a glycosaminoglycan substance and have a secretory capacity. The media cells have large amounts of collagen and provide structural and vascular support. The adventitia is a highly vascular structure composed of loose fibrous tissues that demonstrates clefts that may represent gliding planes. The pseudosynovial sheath was found to be a morphologically stable structure that showed no propensity for longitudinal contracture. The sheath appears to have the characteristics necessary to provide a good bed for a tendon graft.

Animals↗