Biomedical subjects

J S Thompson

Publications and source records attributed to J S Thompson.

At least 217 records · Page 12Linked to original sources

PubMed1989

Concomitant cholecystectomy for asymptomatic cholelithiasis.

The outcome of 68 patients with asymptomatic cholelithiasis undergoing laparotomy for other conditions was reviewed to determine those most likely to become symptomatic postoperatively. Thirty-seven patients (54%) became symptomatic postoperatively. Eight patients (22%) required cholecystectomy within 30 days of operation or within the same hospitalization. These patients fasted for a longer period of time postoperatively (15 +/- 21 vs 4 +/- 3 days) than those undergoing later cholecystectomy. Significantly more of these patients required transfusion (38% vs 7%), mechanical ventilation (50% vs 11%), and total parenteral nutrition (50% vs 18%). Cholelithiasis frequently becomes symptomatic after laparotomy for other intra-abdominal conditions. Patients who require mechanical ventilation, transfusions, and parenteral nutrition and who are slow to resume enteral nutrition are more likely to require early cholecystectomy. Concomitant cholecystectomy adds minimal morbidity to other procedures and should be undertaken unless specific contraindications exist, particularly in this high-risk group.

Adult↗

PubMed1989

The excretion of ketorolac tromethamine into breast milk after multiple oral dosing.

We have studied the transfer of the analgesic ketorolac tromethamine into breast milk in ten women aged between 22 and 35 years. Ketorolac administration was started between 2 and 6 days after delivery. The breast milk was not fed to the infant because of maternal antibiotic use (6 patients) or because of jaundice of the baby. 10 mg of ketorolac was given four times daily for two days. Plasma and milk samples were collected on the two dosing days and on the first day after dosing. The plasma and milk were assayed for ketorolac concentrations by HPLC: the quantification limits were 10 ng.ml-1 and 5 ng.ml-1 respectively. The maternal plasma concentrations were within established ranges for ketorolac. In four patients the concentration of ketorolac in the milk was never above 5 ng.ml-1. At 2 h after dosing on both Days 1 and 2 there were quantifiable concentrations of ketorolac in the milk. The range was 5.2 ng.ml-1 to 7.9 ng.ml-1. The ratio of breast milk: plasma concentrations of ketorolac ranged from 0.015 to 0.037. The maximum potential amount of ketorolac that an infant may be exposed to daily could range from 3.16 mg to 7.9 mg, assuming a consumption of between 400 ml and 1 l of breast milk. On a weight-adjusted basis this is equivalent to between 0.16% and 0.40% of the total daily maternal dose.

Administration, Oral↗

PubMed1989

Disruption of canine jejunal interdigestive myoelectrical activity by artificial ileocolonic sphincter. Studies of intestinal motor response to surgically fashioned sphincter substitute.

We studied the effects of an ileocolonic sphincter substitute on canine small intestine motor activity. Recordings of fasting and postprandial myoelectrical activity were performed in three groups of animals in whom the following procedures had been performed: (1) electrode placement alone, intestinal continuity undisturbed (controls); (2) ileocolonic sphincter substitute fashioned in mid-jejunum; and (3) transection and reanastomosis at a similar location in mid-jejunum. Transection alone resulted in a decrease in slow-wave frequency, a shortening of the period of the interdigestive myoelectrical complex (IDMEC) and a prolongation of phase III of the IDMEC in the jejunum distal to the site of transection. The IDMEC period was also shorter at proximal electrode sites, but the incidence of IDMEC phase III complexes was similar on either side of the transection. However, in those animals in whom a sphincter substitute had been fashioned at the site of the transection, the incidence of IDMEC phase III complexes was significantly suppressed in the proximal intestine; IDMEC phase III frequency per hour (mean +/- SD transection vs sphincter substitute) was 0.59 +/- 0.20 vs 0.23 +/- 0.24, P less than 0.002; 0.61 +/- 0.24 vs 0.28 +/- 0.30, P less than 0.006; 0.61 +/- 0.24 vs 0.29 +/- 0.30, P = 0.008, at electrodes 10, 35, and 85 cm proximal to the sphincter substitute, respectively. In addition, the sphincter-substitute animals alone demonstrated, during fasting, recurrent propagated bursts of spike clusters and occasional prolonged spike bursts in electrodes proximal to the sphincter substitute.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗

PubMed1989

Alopecia after ileal pouch-anal anastomosis.

Severe diffuse hair loss in a young woman after ileal pouch-anal anastomosis prompted a review of the incidence and cause of this complication. Nine (38 percent) of 24 patients undergoing the ileoanal pouch procedure developed hair loss. Clinically apparent hair loss is more likely in females. The cause is probably multifactorial and is unlikely to be related to specific nutritional deficiencies in patients maintaining oral intake of nutrients. Hair loss in the perioperative period is transient and hair growth returns to normal as the patient recovers. Awareness of this problem is important and reassurance of the concerned patient is the appropriate management.

Adult↗

PubMed1989

Should intestinal continuity be restored after massive intestinal resection?

We reviewed our experience with 32 patients who underwent massive intestinal resection to determine when intestinal continuity should be maintained. An enterostomy was created in 21 patients (66 percent) at the initial resection because of questionable bowel viability and an unstable condition or the need for colonic anastomosis. Intestinal continuity was restored in only 20 percent of these patients. In 11 patients (34 percent), intestinal continuity was maintained at the time of resection. Only four of these patients (36 percent) had a satisfactory long-term outcome. Overall, intestinal continuity was maintained in 10 of the 22 patients (45 percent) followed over the long-term. Three quarters of patients with intestinal remnants shorter than 3 feet had an enterostomy. We believe intestinal continuity should be restored at the time of massive resection only in carefully selected patients when bowel viability is ensured, remnant length is greater than 3 feet, and a colonic anastomosis is not required. Maintaining intestinal continuity eliminates the inconvenience of the stoma but may cause dietary restriction and perianal discomfort.

Adolescent↗

PubMed1989

Suppression of diamine oxidase activity enhances postresection ileal proliferation in the rat.

To assess the influence of diamine oxidase activity on the adaptive process of the small bowel after resection, we administered aminoguanidine, a potent diamine oxidase inhibitor, to rats for 10 days after either small bowel transection (n = 5) or 80% jejunoileal resection (n = 7). Five or more additional animals from each group received saline as controls. Ileal mucosal homogenates from the resection group receiving aminoguanidine, when compared with those from resection controls, showed no diamine oxidase activity with increased putrescine content and ornithine decarboxylase activity. Mucosal proliferation, as measured by mucosal mass, protein content, and deoxyribonucleic acid content, was greater in the resected animals receiving aminoguanidine when compared with that of resection controls. Sucrase activity per gram of mucosa was almost identical in both resection groups. These results show that the suppression of diamine oxidase during the postresection adaptive period results in enhanced mucosal proliferation with no effect on mucosal functional differentiation. Diamine oxidase may play a regulatory role in adaptive intestinal proliferation.

Adaptation, Physiological↗

PubMed1989

The influence of intestinal resection on the growth of intestinal neomucosa.

Intestinal resection stimulates proliferative activity in the intestinal remnant. The aim of this study was to determine the influence of intestinal resection on the growth of intestinal neomucosa. Forty-eight New Zealand white rabbits had 2 x 5-cm ileal defects patched with adjacent cecal serosal surface. Group I (n = 24) served as controls. Group II (n = 24) underwent simultaneous 50% enterectomy. Neomucosal coverage was significantly greater in Group II at 1 week (36 +/- 11% vs 67 +/- 9%, P less than 0.05) and 2 weeks (94 +/- 2% vs 99 +/- 1%, P less than 0.05), but was similar at 3 and 4 weeks. There was significantly more neomucosa at 1 week in the animals that underwent resection (134 +/- 55 mm2 vs 199 +/- 54 mm2, P less than 0.05). Degree of patch contraction, glucose uptake, and disaccharidase activities were similar in each group. Ornithine decarboxylase activity and crypt cell production rate were significantly greater at 1 week in the animals that underwent resection. Intestinal resection results in an early increase in neomucosal growth and increased proliferative activity. Since contraction of the patches occurs to a similar extent in both groups, the total amount of neomucosa was not increased. Thus, performing patching at the time of resection is not necessary for optimal growth.

Animals↗

PubMed1989

Characterization of the termini and transposition products of Tn4399, a conjugal mobilizing transposon of Bacteroides fragilis.

We have isolated a 9.6-kilobase conjugal transposon, Tn4399 from Bacteroides fragilis, that is capable of mobilizing nonconjugal plasmids in cis. Here we characterize the ends of the transposon, its target-site requirements, and the products of transposition into the B. fragilis chromosome and two sets of B. fragilis-Escherichia coli shuttle vectors. With the exception of an additional cytosine residue in the left end, there are perfect 13-base-pair (bp) inverted repeats at the ends of Tn4399. Insertion of Tn4399 resulted in a 3-bp target-site repeat in 8 out of 12 independent transpositions and showed a high insertion-site specificity. A remarkable feature of Tn4399 insertions is the presence of an additional 5 bp located between the right inverted repeat and the target-site repeat. Four sequence variations of the 5 bp were found, with absolute conservation at positions 1, 2, and 5. Only two of the variations were present in junction fragments of all three copies of Tn4399 contained in the chromosome of the original donor strain, B. fragilis TM4.2321. Tn4399 appears to represent a new type of conjugal transposon. In contrast to Tn916 and Tn1545, described in streptococci, Tn4399 creates a target-site repeat and contains an additional 5 bp at the right end only, between the transposon and the target sequence. In addition, Tn4399 can mobilize plasmids in cis.

Bacteroides fragilis↗

PubMed1989

Effect of the duration of infusion of urogastrone on intestinal regeneration in rabbits.

Urogastrone (UG) increases the rate of mucosal regeneration on patched intestinal defects. Our aim was to determine the effect of the duration of UG administration on regeneration of serosa patched ileal defects in rabbits. Group I (n = 18) were controls. Group II (n = 15), Group III (n = 10) and Group IV (n = 5) received UG 1.5 micrograms/kg/h subcutaneously for 7 days, 14 days or 21 days respectively. Animals were sacrificed at 7 day intervals up to 21 days after patching. Neomucosal growth was significantly greater in the animals receiving UG and was greatest in Group IV. Group II and III animals had less contraction of the patched defect and greater neomucosal surface area than Group I animals at each interval but had a lesser effect than animals receiving UG continuously. Crypt cell production rate was significantly greater in UG treated animals at 7 and 14 days but fell to control levels at 21 days. Prolonging the duration of UG infusion increased the quantity of neomucosa produced by intestinal regeneration. However, UG stimulation of mucosal cell migration and proliferation occurred transiently within 14 days after patching.

Analysis of Variance↗

PubMed1989

T10B9.1A-31 anti-T-cell monoclonal antibody: preclinical studies and clinical treatment of solid organ allograft rejection.

T10B9.1A-31 is an immunoglobulin Mk (lgMk), CD3b class, murine monoclonal antibody. It is not itself mitogenic, but it partially blocks mitogenesis produced by concanavilin-A, phytohemagglutinin, and a soluble antigen cocktail and is lytic for human peripheral blood T lymphocytes (PB-T) in the presence of fresh autologous human complement and rabbit complement. It reacts with a monomorphic epitope found on all mature PB-Ts that modulates in vitro and in vivo with the CD3/T-cell antigen receptor (TCR) complex, but unlike OKT3, which reacts with CD3 proteins, T10B9.1A-31 reacts with an epitope of the TCR alpha/beta heterodimer. Immunoprecipitation of HPB-ALL with T10B9.1A-31 or OKT3 revealed that T10B9.1A-31 does not react with the 20-to 26-kd polypeptides that compose CD3, and T10B9.1A-31 failed to bind to the PEER cell, which is CD3 gamma/delta positive, TCR alpha/beta negative. Phase 1 clinical trials demonstrated that T10B9.1A-31 caused a rapid decrease in PB-Ts and no toxic effects other than fever, chills, rigors, and transient hypotension. These side effects were absent in methylprednisolone (MP)-pretreated patients. Phase II studies revealed that T10B9.1A-31 reversed steroid refractory acute rejection in three of five renal allografts treated with cyclosporine (CyA) and prednisone (P) maintenance immunosuppression, reversed steroid and polyclonal antisera refractory rejection in three cardiac allograft recipients receiving CyA/P, and attenuated acute rejection in three of three renal patients receiving baseline azathioprine/prednisone (AZA/P) when used as primary therapy. Rerejection was not seen when patients received CyA baseline immunosuppression but was seen in patients maintained on AZA/P OKT3 was efficacious in treating rejection following T10B9.1A-31 therapy. Side effects of T10B9.1A-31 appears to reverse acute rejection crisis effectively in renal and cardiac transplantation with a low incidence of rerejection in CyA-maintained patients and with fewer, milder side effects. Sequential therapy with OKT3 is possible because OKT3 and T10B9.1A-31 are of different isotypes and idiotypes.

Animals↗

PubMed1989

The effect of the route of delivery of urogastrone on intestinal regeneration.

Urogastrone (UG) administered subcutaneously increases the rate of intestinal regeneration (neomucosal growth) on patched intestinal defects. Our purpose was to determine the optimal route of delivery of UG for intestinal regeneration. In 22 New Zealand white rabbits (2.1 to 3.4 kg) 2 X 5 cm ileal defects were patched with adjacent cecal serosal surface. Group I (n = 6) served as controls. Group II (n = 5), group III (n = 6), and group IV (n = 5) received UG, 1.5 micrograms/kg/hr, intravenously, subcutaneously, and intraluminally via miniosmotic pumps. Neomucosal growth was assessed 7 days after patching. Serum UG levels were detectable in only the intravenous group. Coverage of the patched defect and neomucosal area was significantly greater and contraction of the defect less in the groups receiving UG (p less than 0.05). Neomucosal area was highest in the intravenous group (286 +/- 16 mm2), intermediate in groups III and IV (236 +/- 19 and 215 +/- 20 mm2), and lowest in the control group (152 +/- 17 mm2; p less than 0.05). Sucrase and maltase activities were significantly higher in the intravenous group. Crypt cell production rate and ornithine decarboxylase activity were greater in the UG-treated animals. UG stimulated intestinal regeneration by all routes of delivery. The intravenous route had the greatest effect and was associated with the highest serum levels of UG. These findings have implications for the mechanism of the trophic effect of UG on the intestinal epithelium.

Amine Oxidase (Copper-Containing)↗

PubMed1989

Pseudothrombophlebitis in neuropathic arthropathy.

The pseudothrombophlebitis syndrome is a complication of large, ruptured, or dissecting popliteal cysts. We report a patient with neuropathic arthropathy of the knee and the pseudothrombophlebitis syndrome secondary to a dissecting popliteal cyst. This represents another form of arthritis associated with this syndrome.

Arthrography↗

PubMed1989