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Biomedical subjects

J W Johnson

Publications and source records attributed to J W Johnson.

At least 127 records · Page 7Linked to original sources

Effect of betamethasone on pressure-volume relationship of fetal rhesus monkey lung.

We have investigated the acceleration of fetal lung maturity following glucocorticoid administration. Air-filling of saline-filling pressure-volume curves were obtained on fetal rhesus monkey lungs after treatment with betamethasone. With air filling there was a marked increase in the total lung capacity (ml air/g at 40 cmH2O) in the treated animals. By normalizing the curves and plotting volume as a percent maximal volume, we examined the shape of deflation curves, a common functional measure of surfactant activity. We found little difference in the shapes between control and steroid-treated animals. With saline filling there was also a similar increase in the lung capacity. As surface tension has a negligible effect on saline pressure-volume curves, we conclude that the primary functional effect of glucocorticoids on the fetal lung may not be an alteration of surface forces. Rather the glucocorticoids seem to accelerate maturity more by increasing lung compliance through structural changes that allow the lung to contain more air for equivalent transpulmonary pressures or pressure changes. This may occur either by increasing the distensibility of already inflatable alveoli or by recruiting new units.

Animals↗

Patterns of intrauterine growth retardation.

A prospective study of 70 singleton pregnancies at high risk for intrauterine growth retardation (IUGR) was undertaken to determine 1) the differences in intrauterine growth patterns; 2) the diagnostic accuracy of obstetric techniques; and 3) the frequencies of perinatal complications. Thirty infants displayed signs of IUGR. Although only 14 infants had low birth weights, these 14, as well as the remaining 16 infants under study, displayed many other features of growth abnormalities, including a low ponderal index, short stature, and small head circumference. These data demonstrate various patterns of IUGR. Although the perinatal complications occurred primarily in the low-birth-weight group, the major growth abnormalities observed in the non-low-birth-weight group demonstrate the need for additional short- and long-term follow-up studies in both groups.

Adult↗

High-risk prematurity--progestin treatment and steroid studies.

Studies have been undertaken regarding the efficacy and modus operandi of 17 alpha-hydroxyprogesterone caproate (17 alpha-OHP-C) in preventing premature labor in high-risk patients. In a total of 70 patients, the treated patient population had a prematurity rate (12.8%) and a perinatal mortality rate (5%) which were significantly lower than those of the total placebo or untreated patient group (40.9 and 25%, respectively). In addition, sequential plasma steroid values were determined in 21 patients, 10 of whom delivered prematurely. The results indicate that low plasma progesterone (P) and 17 alpha-hydroxyprogesterone (17 alpha-OHP) levels precede the onset of preterm labor by weeks. Successful treatment with 17 alpha-OHP-C was characterized by elevated P levels. Plasma estradiol (E2) and cortisol (C) values did not vary with time of delivery or treatment. These findings support the progesterone block theory as an important mechanism affecting preterm delivery in this high-risk population.

Estradiol↗

Glucocorticoids and the rhesus fetal lung.

The effects of glucocorticoids on primate fetal lung function have not been clearly delineated. In this prospective study of preterm rhesus fetuses exposed in utero to betamethasone for 72 hours, the most significant alteration was a striking increase in maximum lung volumes. Functionally less significant increases in residual lung volumes were also noted. The lungs of the treated fetuses did not exhibit lower extract surface tensions or increased phospholipid concentrations. These findings suggest that the major effect of betamethasone is on lung connective tissue elements, with minimal effects on alveolar surfactant. Additional evidence of the multisystemic effects of glucocorticoids was obtained in that significant differences in fetal, adrenal, hepatic, and placental weights also were observed.

Amniotic Fluid↗

The pharmacologic inhibition of premature labor.

Oxytocin, elevated estrogen-progesterone ratio, fetal corticosteroids, prostaglandins, catecholamines, and changes in uterine blood flow have all been implicated as triggers of labor. In approximately one-third of cases of threatened premature labor contractions stop spontaneously. Thus placebo-controlled randomized trials of any new drug for inhibition of premature labor are necessary, as the spontaneous cessation of contractions always favors the claimed therapeutic efficacy. Alcohol inhibits the release of endogenous oxytocin and has an additional direct effect on the myometrium. In one study alcohol was more effective than placebo in the postponement of delivery. Isoxsuprine, ritodrine, and terbutaline have also been shown to be better than placebo in the inhibition of premature labor, and the beta adrenergic agents appear to be more effective than alcohol. Prostaglandin inhibitors such as indomethacin are currently under investigation. Success is correlated with early administration of the therapy, which requires treating some patients whose contractions might have stopped spontaneoulsy. As different factors may be involved in triggering premature labor, if one therapeutic approach fails another should be initiated promptly.

Adrenal Cortex Hormones↗

Cell-mediated immune responses of guinea pigs to an inactivated phase I Coxiella burnetii vaccine.

The ability of a killed phase I Coxiella burnetii vaccine to induce cell-mediated immune responses in guinea pigs was studied. Cell-mediated immune responses were assessed by the inhibition of macrophage migration and lymphocyte transformation assays. The macrophage migration response occurred rapidly and was detected at high levels, but was relatively short-lived. In contrast, the lymphocyte transformation response developed more slowly, and persisted for a longer period. The vaccine, given in a single dose or in two doses 1 week apart, protected guinea pigs from a subsequent virulent challenge.

Animals↗

Measurement of urinary renin activity by radioimmunoassay: sequential studies in acute renal failure in man.

Urinary renin activity (URA) was measured by radioimmunoassay in sequential studies of 5 patients with acute renal failure (ARF) and in 13 normal volunteers. URA was elevated during the oliguric phase of ARF and fell to low levels prior to resolution of oliguria. Plasma renin activity (PRA) varied approximately in response to changes in intravascular volume status. In normal volunteers, the very low URA values did not change following furosemide-induced increases in PRA. A simple, rapid, and accurate method is described for the measurement of URA in humans by radioimmunoassay of angiotensin I generated during incubation of urine with homologous plasma substrate. The urinary enzyme exhibited the same properties as purified human renal renin and the incubation product appeared identical to angiotensin I standard. Renin activity in urine was directly proportional to enzyme concentration and no evidence was obtained for interference from other proteolytic activities or from inhibitors or promoters of renin in urine.

Acute Kidney Injury↗

Fetal weight estimation by ultrasonic measurement of abdominal circumference.

The purpose of this study was to compare ultrasonic measurements of fetal abdominal circumference to ultrasonic measurements of fetal biparietal diameter, as a means of estimating fetal body weight. Of 58 fetuses who had abdominal circumferences measured, 48 (82%) of the predicted weights were within 15% of the actual birth weights. Forty-four of the same 58 fetuses had satisfactory biparietal diameter measurements, but only 21 (48%) of the predicted weights were within 15% of the actual birthweights. Ultrasonic measurement of abdominal circumference appears to be a more reliable index of fetal body weight than other currently available techniques.

Abdomen↗

Lesions in guinea pigs infected with Coxiella burnetii strain M-44.

Guinea pigs inoculated with the live M-44 vaccine strain of Coxiella burnetii were examined grossly and microscopically for the presence of Q fever-related lesions. Mild myocarditis was observed in 38% of the infected animals but in none of the control animals. Livers showed significant incidence of hepatitis, necrosis, and granuloma formation, especially during the first eight days of the infection. A much lower incidence of splenitis was also found but was considered to be of borderline significance. Generally, lesions were mild in nature, and none seemed to endanger the life of the animal or to cause observable distress.

Adrenal Glands↗

Patients at high risk for low-birth-weight delivery.

A retrospective analysis of 8,839 singleton deliveries was undertaken to determine the relationships of maternal age, maternal hemoglobin concentrations, and past obstetric performance to the incidence of low-birth-weight (LBC) delivery. Patients under 19 years of age and patients with hemoglobin values less than 9.0 Gm. per 100 ml. were found to have significantly higher incidences of LBW deliveries. In addition, the incidence of LBW delivery was found to vary in proportion to the number of previous LBW deliveries and inversely with the number of previous term deliveries.

Abortion, Spontaneous↗

Biological properties of the M-44 strain of Coxiella burneti.

The attenuated M-44 strain of Coxiella burneti was investigated for biological characteristics affecting its use as a live vaccine. After 25 serial passages in guinea pigs, the strain did not develop phase I properties detectable by the microagglutination test. Infectious organisms were not detected in untreated guinea pigs later than 12 weeks after inoculation; however, infection could be reactivated at later times by the production of stress (by pregnancy or drug treatment) in guinea pigs that had recovered. Evidence of reactivated infection was observed in recovered pregnant animals just before parturition at 46 weeks after infection, in methyl prednisolone-treated animals at 56 weeks, and in cyclophosphamide-treated guinea pigs at 96 weeks. A low rate of intercage and intracage infection was recorded.

Animals↗

Efficacy of 17alpha-hydroxyprogesterone caproate in the prevention of premature labor.

We conducted a double-blind study to determine the efficacy of 17alpha-hydroxyprogesterone caproate in preventing premature delivery in 43 high-risk patients. Premature delivery did not occur in 18 patients receiving the progestational agent, whereas 41 per cent of the 22 receiving the palcebo had premature delivery (P less than 0.01). The mean duration of pregnancy and the mean birth weight in the former group (38.6 weeks +/- 1.6 S.D., and 2836 g +/- 412 S.D.) were both significantly greater (P less than 0.025) than that in the latter (35.2 weeks +/- 6.7 S.D.; 2361 g +/- 1085 S.D.). The perinatal mortality rate in the group given the progestational agent (O per cent) was significantly less than that observed in the placebo group (27 per cent) (P less than 0.05). Although there were no complications attributable to the progestational drug, the study population was too small for assessment of immediate or long term safety. However, the results indicate a possible obstetric use for this drug.

Adult↗

Histogenesis of leiomyomatosis peritonealis disseminata (disseminated fibrosing deciduosis).

Leiomyomatosis peritonealis disseminata (LPD) is a rare clinical entity. Widespread subperitoneal nodules of apparent smooth muscle are found in patients who are pregnant or have recently been so. This clinical appearance together with mitotic figures found in frozen sections suggests malignancy. We believe, in contrast, that LPD is a benign reparative process in which fibroblasts replace subperitoneal decidua.

Abdominal Neoplasms↗

PSRO-an opposing view.

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American Medical Association↗