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Biomedical subjects

J R Wallace

Publications and source records attributed to J R Wallace.

At least 37 records · Page 2Linked to original sources
PubMed1992

Urine calcium and serum ionized calcium, total calcium and parathyroid hormone concentrations in the diagnosis of primary hyperparathyroidism and familial benign hypercalcaemia.

A relationship between serum concentrations of ionized calcium and parathyroid hormone (PTH) in persons without parathyroid overactivity was defined by performing an oral calcium load test. As a result, a serum PTH concentration greater than 2.6 pmol/L in a hypercalcaemic patient was regarded as suggestive of hyperparathyroidism. Fasting serum PTH concentrations in 58 patients with surgically and histologically proven primary hyperparathyroidism (PHPT) were all above 2.7 pmol/L (range 3.2-84.5). Thirteen of 20 patients with familial benign hypercalcaemia (FBH) had fasting serum PTH concentrations greater than 2.6 pmol/L (range 1.6-6.1). There was a significant correlation between serum PTH and age in the FBH patients only. Fasting urine calcium excretion (CaE) ranged from 14 to 222 mumol/L of glomerular filtrate in PHPT and 3-34 mumol/L of glomerular filtrate in FBH. The best biochemical discriminant between patients with PHPT and FBH was a plot of fasting serum PTH against CaE. A plot of post-calcium load PTH against post-load CaE showed no further significant advantage in discriminating between the two conditions.

Adolescent↗
PubMed1988

Initial equilibration of albumin in rabbit hindpaw skin and lymph.

We compared initial plasma to extravascular and plasma to lymph equilibrations of 125I-labeled rabbit albumin in hindpaw heelskin of anesthetized rabbits during control conditions, increased venous pressure (IVP), and intra-arterial infusions of papaverine or bradykinin. Plasma tracer concentrations were maintained constant during the experiments. Control prenodal lymph specific activity relative to plasma specific activity (L*/P*) was significantly greater (P less than 0.01) than extravascular specific activity relative to plasma specific activity (M/P) following 3, 5.5, and 11 h of tracer infusion. Papaverine increased lymph flow and lymph albumin flux (LCL) 2.4-fold, without significantly changing the extravascular albumin mass (MA). IVP increased LCL 2.5-fold and decreased MA 25%. L*/P* at 3 h was twice control following papaverine. M*/P* at 3 h was not significantly affected by papaverine or IVP. Bradykinin increased LCL 10-fold and MA 2.3-fold. L*/P* and M*/P* were 3.1 and 4.3 times control, respectively. The data are consistent with extravascular albumin distributing into two pools that equilibrate with plasma at different rates. Papaverine and IVP affect the faster pool, whereas bradykinin affects both pools.

Albumins↗
PubMed1986

Assessment of antimicrobial penetrance into the pancreatic juice in humans.

The penetrance of mezlocillin, metronidazole and trimethoprim-sulfamethoxazole into the pancreatic juice of humans was measured in ten patients convalescing from acute pancreatitis at the time of endoscopic retrograde cholangiopancreatography. Therapeutic levels were obtained in the serum for all three antimicrobial agents; simultaneously aspirated nonbile stained pancreatic juice contained therapeutic levels of metronidazole and trimethoprim-sulfamethoxazole. Mezlocillin was not present in a therapeutic level in any patient with nonbile stained pancreatic fluid.

Acute Disease↗
PubMed1986

Social, economic, and surgical anatomy of a drug-related abscess.

The "letting of pus" has been a surgical triumph throughout medical history. This study was initiated to expand our knowledge of the etiologic, economic, and surgical aspects of an abscess. The records of 651 patients undergoing intraoperative incision and drainage of an abscess over a 12-month interval were analyzed. The abscesses were due to injection of illicit street drugs in 421 patients (64.7%), perirectal, pilonidal or sweat gland inflammation in 118 patients (18%), complications of diabetes in 22 patients (3.4%) and a prior operative procedure in only 18 patients (2.8%). Fifty-three of the 421 patients with a drug-related abscess were randomly selected for an indepth review. Eighty-three per cent of the patients had positive cultures including 75 per cent with a single organism and 25 per cent with mixed flora. Staphylococcus aureus was present in 62 per cent of the cultures and 41 per cent of the isolates were methicillin resistant. The average length of hospitalization was 12.4 days with a range of 1 to 61 days. The average cost of hospitalization was $10,651 which increased to $24,383 if the patient had a mycotic aneurysm. The estimated annual cost of treatment of this sequela of injected illicit drugs was 6.9 million dollars in our hospital.

Abscess↗
PubMed1985

The beneficial role of calcium supplementation during resuscitation from shock.

The role of calcium (Ca) in resuscitation from hemorrhagic shock is controversial and in the present report three regimens were compared: supplementation (Ca-S), avoidance (No-Ca), and Ca channel blockade (Ca-B). This was studied in 40 splenectomized dogs subjected to reservoir shock (MAP 60 torr/90 min, then 40 torr/30 min) and treated with: a) 20 ml/kg balanced electrolyte solution (BES); b) shed blood; c) 30 ml/kg BES; and d) 250 ml autologous bank blood. Three groups of six dogs received Ca-S (0.5 mEq/kg), No-Ca, or Ca-B (verapamil 0.15 mg/kg) in BES. Postoperative therapy of 50 ml/kg/d BES with Ca-S, No-Ca, or Ca-B was given for 3 days. The effects of parathyroidectomy (P) via wide thyroidectomy in 22 dogs treated with calphosan (20 ml/d) and L-thyroxin (0.02 mg/kg) preceding shock was also studied as above: Ca-S/P, No-Ca/P, and Ca-B/P; four sham dogs had anesthesia but no shock (Anes/P). Studies done before, during, and after shock and on day three included systemic pressures (MAP), central pressures (CFP), cardiac output (CO), resistance (SVR), heart work (LVW), and outcome. Post-resuscitation Ca was significantly less in all groups (1.6-3.7 mg%) compared to Ca-S (4.8 mg%). Compared to Ca-S dogs, the post-resuscitation studies in the No-Ca and Ca-B dogs showed lower MAP, CO, and LVW in both intact and hypoparathyroid animals. Post-resuscitation CFP was also lower in the Ca-S and Ca-S/P dogs compared to the other euparathyroid and hypoparathyroid dogs. Death after the initiation of resuscitation occurred in two No-Ca/P and three Ca-B/P dogs. These data suggest that calcium supplementation plus an intact calcium-parathyroid axis enhance the resuscitation effort.

Animals↗
PubMed1984

Visual-motor processing: relationships among age, dimensional variation, and the use of information redundancy.

This study examined the hypothesis that age-related superiority in the ability to process complex stimuli was linked with age differences in the use of information redundancy. Seventy-two children (6-9 years of age) solved a series of puzzles that varied in complexity and redundancy. Significant correlations between age and completion times were found only for those puzzles that included some degree of information redundancy. Completion times on multidimensional puzzles that lacked redundancy were not significantly age related.

Age Factors↗
PubMed1984

Assessment of pancreatic ductal penetration of antibiotics.

Pancreatic ductal penetration of antibiotics is not uniform. Antibiotic therapy for pancreatic and pancreatic related infections, theoretically, is enhanced by drugs that reach the ductal system. The pancreatic ductal penetrance of Cefamandol (1 gm), Amikacin (7.5 mg/kg), and Chloramphenicol (1 gm) given as a single intravenous dose prior to endoscopic retrograde cholangiopancreatography was studied in ten patients. Serum and pancreatic juice were collected simultaneously, frozen, and later assayed for antibiotic concentration. Each antibiotic achieved its expected therapeutic serum level. In contrast, pancreatic ductal levels of Cefamandol and Amikacin were subtherapeutic, whereas Chloramphenicol levels were therapeutic. Further studies are needed to identify other antibiotics with good pancreatic ductal penetrance.

Amikacin↗
PubMed1982

Modified bilobular ("gemini") pectoralis major myocutaneous flap.

The bilobular or gemini type of pectoralis major myocutaneous flap evolved from a desire to simplify the closure of large surgical defects of both mucosa and skin that could not be satisfactorily closed primarily. Previously, such defects often required combined or multiple reconstructive procedures such as myocutaneous and deltopectoral flap operations. The mucosal and skin defects are closed by two skin paddles supported by a single muscular vascular pedicle. The skin paddles are fashioned side by side and separated from each other as the muscle is folded between them parallel to the vascular axis. All of the defects were successfully closed and the major portion of all grafts survived. This operation permits single-stage reconstruction after ablation of tumors or treatment of complications which produced large through-and-through mucocutaneous defects of the head and neck area.

Adult↗
PubMed1979

Aggression during competition: effects of age, sex, and amount and type of provocation.

Three experiments were designed to examine the expression of instrumental and hostile aggression by 6- to 10-year-old children during a competitive game. The rate at which a child pressed a button which allegedly interfered with his opponent's progress on the task was the measure of instrumental aggression. Pressing a second button presumably caused one's opponent to hear an aversive noise and served as the measure of hostile aggression. The task was designed in an attempt to isolate (a) frustration from attack as the instigator of aggression and (b) instrumental from hostile aggression as the desired outcome. In all three experiments the measures of instrumental and hostile aggression were generally highly correlated except under provocation conditions during which the number of attacks exceeded the number of frustrations. This suggested that the task was successful in tapping two different classes of aggressive responding. In Experiment 1 older children (N = 161 males and females) expressed more of both instrumental and hostile aggression than did younger children, and males were more aggressive than females on both measures. However, neither measure of aggression varied as a function of level of provocation. This finding was discrepant from the authors' previous research which had focused solely on instrumental aggression. Apparently, the introduction of attack and the opportunity for hostile responding changed the experimental situation. In order to focus more directly on this issue, Experiments 2 (N = 60 males) and 3 (N = 56 males) used various combinations of attack and frustration with 9- and 10-year-old males. Attack, prior to frustration, elicited the greatest amount of hostile aggression. Frustration, with no attack, resulted in the highest level of instrumental aggression. The complex relationship between these sources of provocation and instrumental and hostile aggression was discussed.

Age Factors↗
PubMed1977

Adult intussusception in Glasgow 1968-74.

A further review of adult intussusception in Glasgow between 1968 and 1974 is presented. A higher than expected incidence of idiopathic intussusception has been found both in this and in the earlier Glasgow series of Smith and Gillespie (1968)--44 per cent and 50 per cent respectively.

Adult↗