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Biomedical subjects

L Hughes

Publications and source records attributed to L Hughes.

At least 91 records · Page 5Linked to original sources
PubMed1986

Cyclic prednisolone therapy for male infertility associated with autoantibodies to spermatozoa.

Seventy-six subfertile men with significant titers of antisperm antibodies were treated with a new corticosteroid regimen, consisting of prednisolone, 40 mg daily, rising to 80 mg daily if antibody titers did not fall, given from days 1 to 10 of the partner's menstrual cycle, for up to nine cycles. Twenty-five (33%) of the partners became pregnant during a treatment cycle, more than twice the expected incidence without treatment. No serious complications occurred, although one half of the patients had transient minor side effects. This regimen appears to be encouraging and suitable for further assessment in a prospective controlled trial.

Adult↗
PubMed1985

Estimation of the location of natural alpha-tocopherol in lipid bilayers by 13C-NMR spectroscopy.

Natural, 2R,4R',8R'-alpha-tocopherol (vitamin E), labelled selectively with 13C in the methyl group at position 5, was incorporated into unilamellar vesicles of egg phosphatidylcholine. The vesicles are impermeable to the shift reagent Pr3+ and, in the presence of this reagent, separate 13C resonances due to labelled alpha-tocopherol in the outer and inner monolayers could be observed with relative intensities, 2:1. Subsequent addition of the relaxation reagent Gd2+ causes broadening and greatly shortened spin-lattice relaxation times for the resonance due to alpha-tocopherol in the outer monolayer only. These data confirm that alpha-tocopherol is located in both halves of the bilayers with its more hydrophilic chroman moiety very near the lipid-water interface, and indicate that the methyl group at position 5 of the alpha-tocopherol in the inner monolayer must be at least 40 A from the aqueous interface of the outer monolayer.

Lipid Bilayers↗
PubMed1984

A fresh look at iontophoresis.

The rate of penetration of fluorescein and gentamicin ions into the anterior chamber of the rabbit was increased more than 100-fold by the passage of 1 mamp; the amount of drug that penetrates is better controlled by iontophoresis than by instillation. The potential value, the safety and the limitations of this procedure are discussed, and a theoretical basis for the increase is provided. Practical methods of using iontophoresis in the clinic are described. A 30-s application should result in a therapeutic level of the antibiotic in the anterior segment over a 12-hour period in eyes with an intact epithelium.

Animals↗
PubMed1983

Carotid plaque histology using real-time ultrasonography. Clinical and therapeutic implications.

To evaluate the ability of ultrasonographic imaging to detect plaque hemorrhage in carotid atheroma, a study was undertaken that compared pathologic findings to preoperative ultrasonographic findings. Ultrasonography identified two plaque categories based on the heterogeneous and homogeneous echo patterns of the lesions studied. Heterogeneous lesions accounted for 91 percent of intraplaque hemorrhages (30 of 33) and 100 percent of ulcerated lesions (15 of 15). In 41 of 50 specimens (82 percent), ultrasonography correctly identified the presence or absence of plaque hemorrhage. False-negative studies (3 of 50) were due to the minute foci of remote hemorrhages. False-positive studies (6 of 50) resulted from plaques that contained large amounts of lipid or cholesterol. Preoperative ultrasound carotid imaging can be used to detect the histologic characteristics of plaque. Since recent clinicopathologic studies have implicated intraplaque hemorrhage and ulceration in symptomatic carotid disease, this information may be of value in choosing therapy, especially for the asymptomatic patient.

Aged↗
PubMed1981

The results of intermittent high dose steroid therapy for male infertility due to antisperm antibodies.

Forty-five males who had been infertile for 2 to 10 (average 5.3) years, with significantly positive antisperm antibody tests (serum spermagglutination titers more than 32) and demonstrably improved sperm penetration of cervical mucus, were treated with repeated 7-day courses of methylprednisolone (MP) 32 mg three times a day from days 21 to 28 (in a few cases days 1 to 7) of their wives' menstrual cycles. Antisperm antibody tests were repeated after treatment and related to the occurrence of pregnancy in the wife. Fourteen wives (31%) became pregnant in a cycle following treatment of the husband. The production of pregnancy was always associated with a marked drop in sperm immobilizing titer and usually with disappearance of antibodies from seminal plasma; both of these effects were sometimes observed without a significant change in serum spermagglutination titers. Three patients (6%) had transient severe side effects, and 14 (26%) have had mild side effects, out of 54 patients treated so far.

Adult↗
PubMed1980

Pindolol in orthostatic hypotension: possible therapy?

The association of recumbent hypertension with orthostatic hypotension provides a clinical situation which is extremely difficult to treat. The present report describes two patients who presented with this disorder and evaluates the use of pindolol in their management.

Humans↗
PubMed1980

Long-term results of myocardial revascularization in early-onset arteriosclerosis.

The risk factors, anatomic disease states, and surgical results were compared between patients, who had coronary bypass operations before 40 years of age and patients who underwent bypass after 40. Elevated serum cholesterol levels were significantly more frequent in the younger group (P = 0.00704). However, these patients were a minority (12.6%) of the younger group the influence of elevated cholesterol levels on the subsequent course of the disease was minimal. The extent and location of coronary lesions and the states of ventricular function by ventriculograms were similar in the two groups. The surgical results were better in the younger group, but not to a significant degree. There were no operative deaths in the younger group and only two patients had perioperative myocardial infarctions. There is no justification for concern that the clinical course in early-onset coronary disease is accelerated. Also, the younger coronary disease patients are effectively treated by coronary artery bypass.

Adult↗
PubMed1980

Clinical comparison between patients with saphenous vein and internal mammary artery as a coronary graft.

From January, 1971, through May, 1978, the records of 1,239 patients who had comparable patterns of coronary artery bypasses were retrieved for study from the Ochsner computerized data bank. Seven hundred twenty-six patients had saphenous vein grafts (SVG) alone and 513 patients had internal mammary artery (IMA) grafts alone or in combination with SVG. Patients with IMA grafts had significantly improved survival over patients with SVGs, but after exclusion of biasing subgroups the improved survival was not reliably different (p = 0.1684). The percentages of patients who had unrelieved angina after operation were similar (5.0% versus 4.8%); the rates of nonfatal myocardial infarction and of postoperative congestive heart failure were also similar. When the recently done SVG bypasses were compared to those done before mid-1975, we found that unrelieved angina rates and nonfatal myocardial infarction rates were significantly improved in the recent group. We conclude that use of the SVG is indicated in some clinical situations and use of the IMA graft in others. Therefore, cardiovascular surgeons should be proficient in using both grafts.

Aged↗
PubMed1979

Steroid treatment of male subfertility caused by antisperm antibodies.

47 subfertile men with significant titres of antisperm antibodies were treated with one of two steroid regimens. The results were assessed by changes in sperm-counts and in serum antibody titres and by subsequent pregnancies. 15 oligozoospermic men were treated with prednisone 5 mg three times a day for 3--12 months. Sperm-counts became normal in 10 men and 4 of their wives became pregnant. 14 men with normal sperm-counts received the same treatment: antibody titres fell slightly and 3 of their wives became pregnant. 18 other men with normal sperm-counts were given one or more courses of methylprednisolone 96 mg/day for 7 days. There was a more pronounced fall in antibody titres in these men, and 7 of their wives became pregnant. Testicular biopsies in 3 men with high titres of antibodies and very low sperm-counts which became normal with prednisone showed adequate spermatogenesis; however, focal round-cell infiltration of seminiferous tubules was observed in 1 case. It is suggested that a steroid-responsive immune orchitis can occur spontaneously in man, and may contribute to the infertility of men with antisperm antibodies.

Autoantibodies↗
PubMed1979

Male infertility due to sulphasalazine.

Four young immigrants whose ulcerative colitis was controlled by sulphasalazine had oligospermia and infertility. No other cause for infertility was found in any of them nor in their wives. Findings on semen analyses rapidly improved in all patients on withdrawal of sulphasalazine, which resulted in four pregnancies in three of the wives. Reintroduction of sulphasalazine was followed by rapid deterioration in the semen of two patients. The frequency and importance of the effect of sulphasalazine on fertility requires further evaluation.

Adult↗
PubMed1979

Health hazard appraisal counseling--continuing evaluation.

A program of annual health examinations was expanded to include counseling based on a computerized appraisal of individual patients' specific health risk factors. Data obtained from a specially designed questionnaire, laboratory tests and a physical examination yielded a health hazard appraisal showing a number of weighted risk factors and their relation to ten leading causes of death as determined for that patient. From all of this information, a "risk age" was developed which could then be compared with the patient's "true age." The results were reviewed with each patient, and methods of correcting health hazards were stressed. The first annual retesting of a group of 107 examinees showed a net risk age reduction of 1.4 years (formerly reported in this journal). The longer term follow-up reported in this paper showed a net risk reduction of 2.38 years in a group of 26 examinees. The net risk age reduction in the two groups represented 32 and 40 percent, respectively, of the achievable risk age reduction when patients comply with suggestions made during risk reduction counseling. These findings indicate that health hazard appraisal counseling is an effective method of altering priorities of health practices.

Adult↗
PubMed1978

Physiological effects of rotational work shifting: a review.

The high cost of capital equipment, demands of the world markets, and continuity requirements of many technological processes have forced industry to operate three-shift, 24-hour days. Workers on fixed schedules experience no particular problems from shift work, but those who are shifted periodically can undergo physiological and emotional disturbances. These disturbances occur because most human systems function according to circadian rhythms that can be easily disoriented. The primary cause is the periodic shifting of the light-dark, wake-sleep cycles. Extensive literature exists on the cause and symptoms of disturbances in the human physiological rhythms. The information contained in this literature can be applied to protecting the health and well-being of the worker.

Accidents, Occupational↗
PubMed1978

The internal mammary bypass graft: a superior second coronary artery.

In a study of the initial 1,004 consecutive patients who had direct coronary artery bypass at Ochsner Medical Institutions, computer methods of data processing were used to compare the clinical results between patients who had saphenous vein (SV) grafts and those who had internal mammary artery (IMA) grafts. The factors compared were the long-term mortality rates, nonfatal myocardial infarction rates, relief or persistence of angina, and the percentage of patients who acquired congestive heart failure. A simple comparison showed the patients with IMA grafts did better in all four categories; however, in a subsequent analysis in which maldistributed factors were removed, the rates of anginal relief and congestive heart failure were not significantly improved. The major benefit appears to be an increase in longevity among patients who had IMA bypasses.

Aged↗