Biomedical subjects
Publications and source records attributed to J R Hall.
Accurate calculation of water vapor pressure for systems saturated with water vapor can be performed using the Goff-Gratch equation. A form of the equation that can be adapted for computer programming and for use in electronic databases is provided.
Fifty-three patients with pseudophakic bullous keratopathy (PBK) were treated with: Corneal transplant, Removal of the original intraocular lens (IOL), Replacement with a sutured-in posterior chamber IOL. Vitrectomy was performed in all but two cases. Eighty-eight per cent of the corneal transplants were clear and the vision was 20/200 or better in seventy-five per cent. Visual results are equal to other reported series where over one-third of the original IOLs were removed at the time of keratoplasty and were not replaced. We believe this is the first reported series using these procedures. The corneal transplants remain clear, the vision stable and pain alleviated after an average follow-up of 3 years.
A retrospective reviews of 195 consecutive patients who underwent elective cholecystectomy and operative cystic duct cholangiography (OCDC) were reviewed to establish criteria to correlate the preoperative laboratory data of liver chemistry tests and the actual biliary tract disease found in each patients. Patients who had a history of jaundice or other clinical indication for common bile duct exploration were excluded from this study. The patients were divided into four groups based on the results of the OCDC: I negative, II false positive, III false negative, and IV positive for choledocholithiasis. The results of the preoperative liver chemistry studies of the patients in each of the four groups were analyzed by the chi 2 method. The four liver chemistry tests were lactate dehydrogenase, SGOT, bilirubin, and alkaline phosphatase. When results of all preoperative liver chemistry tests were normal, there was no incidence of choledocholithiasis. As the number of chemistry test result elevations increased from one to four, the incidence of choledocholithiasis increased from 17% to 50% (p less than 0.001). Preoperative liver chemistry tests in selected patients undergoing elective cholecystectomy may provide a valuable indicator to the surgeon as to whether an OCDC should be performed at the time of surgery.
At least twenty-four reports of pneumothorax associated with the Marfan syndrome have appeared in the medical literature, but the frequency and optimal method of treatment remain unclear. We conducted a retrospective review of medical records from one genetics clinic and found that the frequency of spontaneous pneumothorax in patients older than 12 years with Marfan's syndrome was 4.4% (11 out of 249). Men were more commonly, but no more severely, affected than women. Seven patients had recurrent or bilateral pneumothorax. In 9 of the 11 patients, apical bullae were present and detectable on chest radiograph. Pneumothorax frequently recurred if not treated by resection of the offending bullae. We recommend that all adolescent and adult patients with the Marfan syndrome undergo chest radiography for ascertainment of the gross pathological condition of the lung. Definitive surgical treatment should be performed at the first occurrence of pneumothorax because of the high rate of recurrence after treatment with a chest tube, with or without pleurodesis.
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Stress has been found to a significant factor in the development of physical illness. The relationship between demographic factors such as gender and age and their influence on stress and illness has not been extensively investigated. The present study investigated the relationship among life events, affective disorders, life satisfaction, and stress symptoms in a cross-sectional sample of 463 ambulatory visitors to a voluntary health screening. Age relationships were found to be strongest for life satisfaction, stress symptoms, and life stresses, whereas gender was the major factor in depression. The importance of gender and age as moderators of stress relationships is discussed with its possible implications for life-stage development.
A survey of acute care/blood gas laboratories was conducted through the memberships of the Society of Critical Care Medicine ( SCCM ) and the National Association of Medical Directors of Respiratory Care ( NAMDRC ). Data were obtained from 227 laboratories and analyzed for operational characteristics, personnel, analyses performed, and quality assurance procedures. Analyses included blood gases/pH, saturation, P50, oxygen content, hematocrit/hemoglobin concentration, as well as sodium, potassium, calcium, osmometry, and glucose. Application of appropriate quality control was uneven in terms of types and frequencies of procedures. Education of laboratory personnel ranged from high school to graduate degrees, with the greatest numbers having associate-level and baccalaureate-level educations . Certification of laboratory personnel primarily was through the National Board for Respiratory Therapy, although 36% of the personnel had no certification or registration. Aspects of the acute care laboratory identified as needing improvement are educational and certification requirements for laboratory personnel and application of quality control procedures. The database developed from this survey will serve for ongoing assimilation of information related to the operation of acute care laboratories.
Fifteen patients with severe pancreatitis underwent cardiovascular monitoring in an intensive care unit. The principal findings were a high cardiac index and a decrease in systemic vascular resistance. A significant negative correlation was found to exist between these two parameters (p less than 0.001). Severe pancreatitis apparently results in hemodynamic changes similar to those observed in sepsis. The mechanisms responsible for these observations are not known, although circulating vasoactive compounds resulting from pancreatic necrosis remain a strong possibility. Despite demonstrating a significant decrease in left ventricular stroke work index and an abnormal elevation in pulmonary capillary wedge pressure, the existence of a myocardial depressant factor could not be conclusively proved from these data.
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An investigation has been made of the changes in the major phosphorus containing substances in Avena sativa during the first 8 days of dark germination. The endosperm, roots, and shoots were analyzed separately for acid soluble-P, phytic acid-P, inorganic-P, lipid-P, nucleic acid-P, and protein-P. Phytic acid-P comprised 53% of the total seed phosphate, while the sum of lipid-P, nucleic acid-P and protein-P comprised 27% of the seed phosphate. All these reserve phosphate materials were mobilized and transferred to the developing axis. The phosphate from phytic acid appeared almost entirely as inorganic-P in the roots and shoots. A close stoichiometry existed between the rate of loss of nucleic acid-P from the endosperm and its rate of appearance in the roots and shoots. Thus no net synthesis of nucleic acid occurred during the 8-day period examined. The rate of synthesis of lipid-P in the roots and shoots exceeded its rate of disappearance from the endosperm during the first 4 days of germination. Protein-P increased in the roots and shoots during germination, but at a rate less than its rate of disappearance from the endosperm. The results provide a relatively complete description of the over-all aspects of phosphorus metabolism associated with germination of oats.
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