L-cysteine, an antagonist to the toxic effects of an alpha-methylene-gamma-lactone isolated from Hymenoxys odorata DC. (Bitterweed).
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Animals↗
Biomedical subjects
L D Rowe
Publications and source records attributed to L D Rowe.
Toxicity of two crude oils and of kerosine to cattle.
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Animals↗
The effects of naltrexone on cadmium-induced increases in oral ethanol self-administration.
Adult male rats were exposed to a standard laboratory diet (N = 20), or an adulterated diet containing 100 ppm added cadmium (N = 20), for 60 days. On Day 61, half the animals from each dietary condition received subcutaneous implants of two 30 mg naltrexone pellets, and the remaining half the animals received identical implants of 30 mg placebo pellets. One week later, animals from groups created by this interaction (Groups Control-Placebo, Control-Naltrexone, Cadmium-Placebo, Cadmium-Naltrexone) were tested in an ethanol self-administration paradigm that presented a 10% ethanol solution (v/v) in both a choice and nonchoice format. The results indicated that cadmium exposure increased the oral self-administration of ethanol in the choice setting where water was offered as an alternative, and the opiate antagonist naltrexone failed to attenuate this effect.
Alcohol Drinking↗
Hymenovin. major toxic constituent of Western bitterweed (Hymenoxys odorata DC.)
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Animals↗
Newer techniques in fiberoptic bronchoscopy.
Flexible fiberoptic bronchoscopy has assumed a major role in the diagnosis and management of upper respiratory tract and pulmonary diseases. A new technique, utilizing a C-arm fluoroscopic control with an image intensification system, for the localization of peripheral lung lesions and subsegmental parenchymal infiltrates, is described. This method has proved useful in the early histologic and cytologic diagnosis of nonendoscopically visible bronchogenic carcinoma and in the drainage of lung abscesses. By employing a transendotracheal tube route with a ventilating, side-arm adaptor, continuous airway control and a selected inspired oxygen or anesthetic content is maintained. In addition, the problems of arterial hypoxemia, airway resistance, and ventilation-perfusion abnormalities are minimized. Several representative cases are discussed.
Aged↗
Aortic arch anomalies in adult disorders of deglutition.
Congenital vascular anomalies of the aortic arch are unusual etiologies of dysphagia in the adult. Swallowing abnormalities associated with compression of the esophagus primarily occur at birth or in the immediate neonatal period. However, as the result of arteriosclerotic vascular disease or aneurysm formation, anomalies which were asymptomatic postnatally may produce dysphagia in the adult. A retrospective analysis of 59 cases with aortic arch anomalies presenting initially in adulthood revealed characteristic clinical signs and symptoms. An aberrant right subclavian artery with left aortic arch was the most frequently encountered abnormality. The embryologic development of each vascular anomaly is described and the value of selective arteriography with contrast esophagography is stressed. Patients with minimal swallowing impairment are treated with dietary management alone. Surgical division of the anomalous artery is indicated only when severe dysphagia is associated with progressive life-threatening anorexia and weight loss.
Adult↗
Value of radionucleotide scanning in the staging of head and neck carcinoma.
The presence or absence of distant metastases in squamous cell carcinoma of the head and neck is critical in making rational therapeutic decisions. Radionucleotide bone and liver scans are frequently utilized in the initial evaluation of these patients for possible distant metastases. The true value of routine bone and liver scans in the initial staging of primary squamous cell carcinoma of the head and neck is unknown. One hundred eighteen patients with primary squamous cell carcinoma of the head and neck, evaluated during a five-year period, were retrospectively reviewed. Eight percent were stage I, 18% stage II, 21% stage III, 53% stage IV. Because metastatic carcinoma of the head and neck is primarily regional or pulmonary, the low prevalence of liver and bone metastases limits the usefulness limits the usefulness of these radionucleotide scans. We conclude that routine bone and liver scanning is not a valuable diagnostic technique in the initial staging of head and neck carcinoma when clinical or biochemical evidence of distant metastases is not present.
Adult↗
Tracheotomy for infant botulism.
Botulism is a serious intoxication caused by ingestion of food containing preformed botulinus toxin and characterized by rapidly progressive bulbar paralysis, generalized weakness, and respiratory insufficiency. In 1976 a distinct clinical entity of infant botulism was recognized. The disease apparently results from intraintestinal toxin production which produces a defect in neuromuscular transmission by interfering with release of acetylcholine at cholinergic synapses. Five cases of infant botulism were identified at the Children's Hospital of Philadelphia between 1975 and 1977. Initial symptoms included constipation, slow feeding, lethargy and weak cry. Four of the patients progressed to respiratory insufficiency requiring nasotracheal intubation. Three of the infants with respiratory failure required tracheotomy. Because infants with respiratory failure may require support for months, we recommend that a tracheotomy be performed early in the management to avoid the complications associated with prolonged intubation. The effectiveness of antitoxin or antibiotics to treat infant botulism remains questionable and therefore prolonged respiratory supportive care is the mainstay of therapy. In addition, we offer guidelines for decannulation in cases of infant botulism. None of the patients in our series could be decannulated prior to initial discharge from the hospital.
Botulism↗
Upper airway obstruction in infectious mononucleosis.
Life-threatening upper respiratory obstruction is an unusual complication of infectious mononucleosis. Although the majority of fatalities result from progressive bulbar paralysis or the Guillain-Barré syndrome, airway impairment primarily occurs as a result of pharyngeal lymphoid hyperplasia and associated faucial arch edema. Recent experience in a young child with infectious mononucleosis who exhibited progressive hypersomnolence, sleep apnea, and stridor during sleep is presented. In addition, a retrospective analysis of 72 cases of respiratory complications of infectious mononucleosis provides guidelines for specific airway management. Mild upper respiratory obstruction with persistent fever, severe odynophagia, and malaise is treated with parenteral corticosteroids. Immediate tonsillectomy using a halothane and oxygen induction technique is recommended for severe airway occlusion. Tracheotomy is currently reserved for those patients with progressive alveolar hypoventilation, hypercarbia, atelectasis, and bulbar paralysis. In general, tonsillectomy is well-tolerated, eliminating airway obstruction, improving swallowing function, and rapidly resolving pharyngeal discomfort.
Adrenal Cortex Hormones↗
Complications of intubation.
Endotracheal intubation with current inert low-pressure, high-volume cuffed tubes is a safe procedure associated with few complications in the vast majority of patients. However, complications related to mechanical difficulties and mucosal injury can occur even under ideal circumstances. Immediate complications are primarily associated with problems during intubation and extubation while early and late complications represent the short- and long-term effects of epithelial trauma.
Equipment Failure↗
Neonatal airway obstruction secondary to nasopharyngeal teratoma.
Neoplasms of the nasopharynx are rare in neonates and infants. The most common nasopharyngeal tumors encountered in this age group are teratomata--neoplasms containing multiple heterotopic tissues. Of the four basic histologic types, dermoids are most frequently seen. An unusual case of a true teratoma in a premature infant with severe upper airway obstruction is presented. An extensive review of the world literature confirms the rarity of this lesion.
Airway Obstruction↗
Computerized axial tomography in inflammatory pseudotumor of the orbit.
Although thyrotoxicosis and orbital complications of acute ethmoid or frontal sinusitis are among the most common causes of unilateral exophthalmos, inflammatory pseudotumor is frequently accompanied by progressive acute unilateral proptosis. Because the associated chemosis, scleral erythema, and ophthalmoplegia constitute a spectrum of clinical findings present in numerous inflammatory orbital disorders and systemic diseases, the diagnosis of inflammatory pseudotumor is one of exclusion, often requiring orbital biopsy. Four patients without evidence of sinusitis, endocrinopathy, collagen vascular disease, or Wegener's granulomatosis are described. The diagnosis of orbital pseudotumor was disclosed by computed axial tomography, thus avoiding orbitotomy. The finding of scleral and choroidal thickening with enhancement following intravenous contrast injection represents a select group of patients with orbital pseudotumor and differentiates them from patients with endocrine exophthalmopathy or neoplasms. This noninvasive technique is extremely valuable because early diagnosis is critical for successful treatment. All four patients responded dramatically to high-dose corticosteroid therapy. In the absence of significant clinical response, however, Wegener's granulomatosis, lymphoma, and rhabdomyosarcoma, especially in younger patients, must be carefully excluded. Orbital exploration or decompression or both are used when proptosis, headache, or orbital pain does not resolve promptly, visual acuity deteriorates, or the diagnosis remains unknown.
Adolescent↗
Progressive neonatal airway obstruction secondary to cervical thymic cyst.
Cervical thymic cysts are extremely unusual neoplasms that only rarely produce signs and symptoms of upper airway tract compromise. Less than 7% of patients initially have dyspnea or hoarseness. We report the first known case of progressive neonatal airway obstruction secondary to a rapidly enlarging cervical thymic cyst. Because one half of these benign tumors may demonstrate mediastinal extension, computed axial tomography or B-mode ultrasonography or both is recommended prior to surgical excision. Review of the literature confirms that the majority are successfully removed via a transcervical approach without recurrence.
Airway Obstruction↗
Severe upper airway obstruction caused by bullous pemphigoid: diagnostic usefulness of the flow-volume curve.
The site and severity of upper airway obstruction accurately determined by analysis of the flow-volume curve obtained from a dyspneic patient with bullous pemphigoid. The limitation of maximum inspiratory flow to 0.5 L/s and of maximum expiratory flow to 0.7 L/s over most of the vital capacity suggested that the lumen of the extrathoracic trachea was narrowed to a diameter of 3 mm. The marked improvement in flow with the patient breathing a helium-oxygen mixture further confirmed that flow was limited in a large central airway. The predictions made from analysis of the flow-volume curve were confirmed by fiberoptic bronchoscopic examination and by computerized axial tomography, which revealed severe supraglottic obstruction. After a tracheostomy was performed, maximal inspiratory and expiratory flows were normal.
Airway Obstruction↗
Spatial analysis of midfacial fractures with multidirectional and computed tomography: clinicopathologic correlates in 44 cases.
The use of conventional tomography and recent application of computed tomography to the assessment of facial injuries permit a more precise preoperative spatial analysis of complex midfacial fractures. Forty-four patients sustaining Le Fort I, II, or III maxillary fractures underwent multidirectional or computed tomography (CT) or both. The patterns of fractures of the maxilla and associated fractures of the mandible, zygomas, nasoethmoidal complex, frontal sinus, skull base, and cranial vault were correlated with surgical or clinical findings or both. In 91% of cases, CT or multidirectional tomography or both correctly identified the spatial pattern of fracture of the maxilla and its supporting pillars. Pure Le Fort II fractures were seen in only nine patients, while an isolated pure Le Fort I or III fracture was not encountered. Le Fort II and III fractures were commonly associated with additional tripod, frontal sinus, or nasoethmoidal complex dislocations.
Facial Bones↗
Multiresidue assay for benzimidazole anthelmintics by liquid chromatography and confirmation by gas chromatography/selected-ion monitoring electron impact mass spectrometry.
A multiresidue method utilizing all-disposable labware has been developed for 8 benzimidazole anthelmintics from ovine, bovine, and swine muscle and liver tissues. After an initial extraction with ethyl acetate and subsequent evaporation, a 3-component extraction using hexane, ethanol, and 0.2N HCl was used for final cleanup. Clean extracts were produced for separation and determination by reverse-phase liquid chromatography at 298 nm, using methanol and aqueous buffer as mobile phase. A synthesized internal standard, 2-(n-butylmercapto)benzimidazole, was used for quantitation of all drugs. Results are included along with statistical information verifying the performance of the method. Spiked control tissues and incurred drug tissues were used for an intralaboratory study with a concentration range of 50-1470 ppb. A series of standard curves at 0, 50, 100, and 200 ppb were analyzed. Overall recovery at the 100 ppb level averaged 92% (CV 8%) in liver tissues, across all 3 species and 88% (CV 5%) in muscle tissues across all 3 species. Results were confirmed by gas chromatography/mass spectrometry with acid hydrolysis of the remaining extract in 2N HCl followed by re-extraction of the amine and derivatization to the tert-butyldimethylsilyl derivative. The anthelmintics were identified by gas chromatography/selected ion monitoring electron-impact mass spectrometry. Ion ratio measurements were taken and compared to standard material. CVs averaged 10% or less for all drugs tested.
Animals↗