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Biomedical subjects

M Carey

Publications and source records attributed to M Carey.

At least 145 records · Page 8Linked to original sources
PubMed1986

Adequacy of a modular tube feeding diet for burned patients.

Recent research on nutrition needs following thermal injury suggests that carbohydrate and caloric excess must be avoided while an attempt is made to meet relatively large protein requirements. The nutrition regimen in this investigation for adult and pediatric burned patients provides calories at twice the predicted basal metabolic rate, protein at 2.5 gm/kg/day, and carbohydrate at 5 mg/kg/minute. Lipids are provided to meet the caloric deficit after protein and carbohydrate administration. Even though such nutrients are readily provided parenterally, the high carbohydrate content of standard tube feedings makes it difficult to provide adequate protein without excess of carbohydrate and calories. As a result, a modular tube feeding, containing appropriate macro- and micronutrients and tailored to the individual patient, has been used in our burn units. The adequacy of the diet was assessed by the effect on nitrogen balance, weight change, selected serum indexes of visceral metabolism, and compliance with planned dietary goals. Patients remained in positive nitrogen balance more than 80% of the time while the modular diet was used in conjunction with other modes of therapy (parenteral and/or oral). More than 90% of the time, positive balance was achieved when the modular diet was used as the sole source of nutrition. Compliance with the caloric goal and physicians' diet orders for the modular diet exceeded, on average, the 80% level, which has previously been the established lower limit. The results in this study suggest that the modular diet is an appropriate method of nutrition support.

Adult↗
PubMed1986

Comparative efficacy of captopril and atenolol in moderately severe essential hypertension.

A randomized, double-blind study was undertaken to compare atenolol and captopril as second-step agents in the treatment of essential hypertension resistant to 5 mg bendrofluazide daily. Using a cross-over technique 28 patients were administered each drug sequentially for periods of 8 weeks with an intervening washout period of 2 weeks. Both drugs produced a significant reduction in both systolic and diastolic blood pressure (P less than 0.01). Captopril was more effective than atenolol at reducing diastolic pressure (P less than 0.05), but there was no significant difference in the systolic pressure. Neither drug produced side effects of a serious nature, but untoward symptoms were more frequent with atenolol. The effect of the drugs on myocardial function was assessed by comparing pre-treatment with post-treatment left ventricular ejection fractions, both at rest and with exercise, measured by MUGA scan. The resting ejection fraction was unaffected by either drug. During exercise, on captopril, the ejection fraction showed the normal increase over the resting baseline, but on atenolol there was no such increase.

Adult↗
PubMed1984

Photoaffinity labeling of the Sarcoma 180 cell surface by daunomycin.

We have used photoaffinity labeling to investigate the distribution and function of daunomycin binding sites in Sarcoma 180 cells. When native daunomycin is irradiated at 366 or 488 nm in the presence of cells, the drug is irreversibly incorporated into cellular molecules. The cellular acceptor for the photoincorporation cannot be extracted by chloroform-methanol nor can it be degraded by DNase. However, the drug acceptor is susceptible to trypsin digestion. These results show that the photoincorporation site is composed of protein but not of lipid or DNA. Furthermore, the fact that photoincorporation proceeds equally well at 0 degrees (where drug does not accumulate inside the cells) as compared to 37 degrees (where free drug concentrates in the cells) suggests that the labeling reaction occurs principally at the cell surface. The photolabeling process is not highly specific since it is not saturable at high drug concentrations and cannot be competed for by unlabeled daunomycin. When 2 X 10(5) daunomycin molecules are incorporated per Sarcoma 180 cell, the cells can still accumulate free drug. This result suggests that the photolabeling reaction does not occur at the drug transport locus. Photoincorporation of daunomycin also does not affect the viability of Sarcoma 180 cells, as judged by a cloning assay. Thus, there is probably no surface receptor for the drug which mediates cytotoxicity when occupied. This result is as expected from previous work predicting that the mechanism of daunomycin involves disruption of some generalized membrane property like fluidity. However, in a series of Sarcoma 180 sublines selected for increasing resistance to daunomycin, the photoincorporation increases in direct proportion to drug sensitivity. Consequently, daunomycin appears to be capable of photoaffinity labeling a cell surface protein which, although not directly involved in the mechanism of cytotoxicity is implicated in the expression of drug resistance.

Animals↗
PubMed1979

Trial of baclofen in amyotrophic lateral sclerosis.

A trial of the antispastic drug baclofen was made in amyotrophic lateral sclerosis. Some patients noted reduction of tonus and spasticity; but others had no benefit, nor was the course of the disease altered by long-term administration of baclofen. No major side effects occurred.

Adult↗
PubMed1979

Apolipoproteins in human cerebrospinal fluid.

The presence of apolipoproteins A-I, E, C-II, and C-III and the absence of apolipoprotein B was demonstrated in human cerebrospinal fluid. The concentration of apolipoproteins was measured by electroimmunoassay. Apolipoproteins E, C-II, and C-III were present in cerebrospinal fluid at 3--5% of their concentration in plasma; the cerebrospinal fluid level of apolipoprotein A-I was 0.4%. Most of the cerebrospinal fluid apolipoproteins were present in the rho less than 1.21 g/ml lipoprotein fraction. The major apolipoporteins of cerebrospinal fluid are E and A-I. The possible mechanism of transfer and the physiological and pathophysiological role of apolipoproteins in cerebrospinal fluid are postulated.

Apolipoproteins↗
PubMed1978

Arachnoid cyst and associated subdural hematoma. Observations on conventional roentgenographic and computerized tomographic diagnosis.

Information about computerized tomography (CT) of arachnoid cysts of the middle fossa (ACMF) is increasing, and it appears that certain CT characteristics may be diagnostic. The association of ACMF and subdural hematoma has been emphasized previously but is not common knowledge. We present three new cases of ACMF and associated subdural hematoma studied by plain roentgenograms, EEG, conventional brain scanning, CT scanning, and angiography. The cysts were clearly shown in each case by CT scan, but no subdural hematoma was visualized in our first two cases. Angiography was necessary to establish the associated hematoma. We review and emphasize computerized tomographic characteristics that may be pathognomonic of ACMF. It is suggested that angiography be included in the study of patients symptomatic with ACMF because associated subdural hematoma is not an uncommon lesion and may fail to visualize on CT scan. Angiography still remains the most conclusive study to establish or exclude the diagnosis of subdural hematoma.

Adolescent↗
PubMed1975

Effect of diet on serum accumulation and renal excretion of aryl acids and secretory activity in normal and uremic man.

The influence of diet on aryl acid metabolism was determined in normal and azotemic subjects. Aryl acid content of serum and urine was estimated by fluorometry in relation to hippuric acid as a standard (FI-Hipp). Secretory activity, a reflection of the biological potency of aromatic acids in serum and urine, was determined by bioassay. The urinary excretion of FI-Hipp and secretory activity of five normal persons on an ad lib diet was 0.78 and 2.25 mM/day, respectively; similar values were observed in two subjects with chronic renal insufficiency. Subjects were fed prunes and cranberries, since these foods contain abundant quantities of hippurate precursors. Prunes 1.5 g/kg body weight, caused the urinary excretion of both FI-Hipp and secretory activity to increase about tenfold in normal and azotemic subjects. Prune feeding caused the serum levels of FI-Hipp and secretory activity to increase about threefold. Cranberries increased the renal excretion of FI-Hipp and secretory activity as did the ingestion of a beverage containing benzoate as a preservative. On the basis of these studies it is clear that diet is an important determinant of the load of aryl acids for urinary excretion; in patients with renal insufficiency the ingestion of foods containing precursors may cause serum level of biologically active aryl acids to increase strikingly.

Benzoates↗
PubMedDate not supplied

Need-based waiting lists for hip and knee arthroplasty.

BACKGROUND: Need-based waiting lists have been shown to offer advantages over traditional time-based waiting lists. This study investigated the effect of their introduction in our orthopaedic practice. METHODS: Each patient on the waiting list for total hip replacement (n = 240) and total knee replacement (n = 98) was invited to attend a dedicated assessment clinic. At the clinic each patient had a joint score (Harris Hip Score or American Knee Society Score) calculated. Patients with the lowest joint scores were moved to the top of the waiting lists. Scores were repeated postoperatively. RESULTS: Validation of the hip replacement and knee replacement waiting lists reduced them by 20% and 11% respectively. The efficiency and transparency of the service were increased. CONCLUSION: Need-based waiting lists are easily introduced and offer significant advantages over time-based waiting lists. We advocate their introduction in other centres.

Arthroplasty, Replacement, Hip↗
PubMedDate not supplied

Expression of enhanced levels of small RNA polymerase III transcripts encoded by the B2 repeats in simian virus 40-transformed mouse cells.

Although specific viral genes are known which are sufficient to transform certain types of cells, viral transformation has been shown to be accompanied by a change in the level of expression of cellular genes. Assuming that this latter class of genes is involved in some way in the establishment of the transformed state, we and others have sought to characterize them. To this end, we constructed a complementary DNA library from a simian virus 40 (SV40)-transformed mouse cell line and screened this library for induced genes. Here we focus on the characterization of a specific cDNA clone called 10 lambda 5. We show that the clone 10 lambda 5 contains a B2 repeat, and that the levels of the small heterogeneously sized B2 cytoplasmic RNAs homologous to 10 lambda 5 are enhanced in transformed cells. Our studies show that these RNAs are a specific class of polymerase III transcripts containing a highly conserved 5' end. SV40 transformation results, therefore, in the activation of specific polymerase III transcripts as well as specific polymerase II transcripts.

Animals↗
PubMedDate not supplied

A long-term study and correlation of lymphocyte and neutrophil function in the patient with burns.

Twenty-five patients were studied to determine the effects of thermal injury on neutrophil bactericidal function and superoxide release and on lymphocyte proliferation. Neutrophils in patients with burns had depressed killing of Staphylococcus aureus for more than 150 days after burn injury, but killing of Escherichia coli returned to normal. FMLP-stimulated superoxide release by neutrophils in patients with burns was depressed for over 100 days after burn injury, whereas superoxide release by neutrophils in patients with burns stimulated with serum-opsonized zymosan was depressed for 42 days after burn injury. In patients with burns lymphocyte proliferation, with phytohemagglutinin as a mitogen, was suppressed for up to 85 days after injury, then returned to normal. The mixed lymphocyte response was suppressed up to 170 days after injury.

Adolescent↗