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Biomedical subjects

M D Fox

Publications and source records attributed to M D Fox.

At least 19 recordsLinked to original sources

The feasibility of HLA matching for lung transplantation.

The benefits of HLA matching have been clearly demonstrated in renal and cardiac transplantation. Recent studies suggest that HLA matching may be associated with improved survival rates for transplantation as well. However, the effect of HLA matching for lung transplantation has not been clearly demonstrated. Despite the possible benefits of HLA compatibility, matching for lung transplantation is based solely on ABO compatibility and lung size. Several factors limit the feasibility of utilizing HLA matching for lung transplantation. Among these factors is the time required to perform HLA typing, to identify appropriate recipients, and to allocate lungs; an additional constraint is the urgent need for transplantation in patients experiencing rapid clinical decline. The obstacles to using prospective HLA matching for lung allocation are significant, and matching lung donors and recipients according to histocompatibility status would require considerable effort. However, with supra-regional cooperation among transplant centers and procurement agencies, it appears feasible to consider HLA matching for lung transplantation. Given the potential for improved survival, a project should be undertaken to determine the impact of HLA matching on the outcome of lung transplantation.

ABO Blood-Group System

Magnetic backprojection imaging of the vascular lumen.

Current injected into a phantom model generated a magnetic field which was distorted above a simulated atherosclerotic lesion. The output of a Hall effect magnetic sensor was used in a backprojection to reconstruct the centroid of the simulated blood flow and thus localize the modeled atherosclerotic plaque region.

Arteries

Risk of preterm delivery from preterm labor in high-risk patients.

This study aimed to determine the incidence of preterm labor and birth (< 37 weeks' gestation) in patients at high risk for early delivery. In this retrospective, descriptive study, 17,186 women with high-risk factors for early delivery were studied over a five-year period (1986-1990). Study groups included women with prior preterm delivery, multifetal gestations, uterine abnormalities and cervical factors. The rate of preterm labor for all patients averaged 40% (range, 30-46%). The rate of preterm delivery in the four groups ranged from 14% to 30% and averaged 19.7%. In those who experienced preterm delivery, only 32% of cases were due to preterm labor with advanced cervical dilatation, failed tocolysis or preterm premature rupture of membranes. The majority of early deliveries were due to medical or obstetric disorders as well as to patient/physician factors. The incidence of preterm labor remains significant when women have high-risk factors for preterm delivery. However, the incidence of preterm delivery, particularly that due to avoidable factors, such as failed tocolysis and preterm rupture of the membranes, is considerably lower than that quoted in the literature.

Adult

No touch pulse measurement by optical interferometry.

Arterial pulsatility was measured using an optical interferometer. As opposed to laser Doppler flow meters, the prototype system we evaluated can detect pulsation profiles of major arteries with potentially useful information including pulse wave velocity, profile of pulse pressure, etc.

Adult

Galanin: a novel intraovarian regulatory peptide.

Galanin is a 29-amino acid peptide that acts as a neuropeptide in many tissues. To date, galanin action and the hormonal regulation of galanin gene expression have not been described in the ovary of any species. To study possible ovarian expression and regulation of galanin, immature gonadotropin-primed rats were given hCG (10 IU), and their ovaries were collected 0, 4, 8, 12, and 20 h after hCG treatment for determination of galanin messenger RNA (mRNA) concentration by solution hybridization. Galanin mRNA levels progressively increased after hCG administration, peaking at 12 h (2.4-fold increase vs. 0 h), with a subsequent return to 0 h levels at 20 h. To determine a possible ovarian role for galanin, rats were killed 48 h after gonadotropin administration, their ovaries were removed, and granulosa cells were harvested. These cells and the ovarian tissue remaining after granulosa cell collection (i.e. "shells") were each cultured for 24 h with increasing concentrations of galanin (0, 10, 100, and 1000 nM) in the presence or absence of LH. The medium was examined for steroid production and metalloproteinase inhibitor activity. In granulosa cell cultures, galanin increased the levels of estradiol by 26% and had no effect on progesterone, but decreased metalloproteinase inhibitor activity by 61% in the conditioned medium. In the shell cultures, galanin increased estradiol, progesterone, and androstenedione in the medium, suggesting that galanin acts on cells other than granulosa cells or that galanin action requires a paracrine interaction between granulosa and thecal cells. Our data demonstrate that galanin message is increased by hCG, and that galanin acts to amplify ovarian steroidogenesis while decreasing metalloproteinase inhibitor activity. These findings establish that ovarian galanin mRNA is hormonally stimulated and that galanin acts as an intraovarian regulatory peptide.

Animals

Laparoscopic Pomeroy tubal ligation as a teaching model for residents.

We reviewed our preliminary experience with laparoscopically directed bilateral midtubal resection for tubal ligation (endoscopic Pomeroy) as a potential teaching tool for the acquisition of endoscopic skills during residency training. Thirty-five laparoscopic Pomeroy and 206 banding procedures were reviewed. Age, parity and weight were similar in the two groups. The operative time for banding was reduced slightly after experience with > 10 procedures. In contrast, the operative time for laparoscopic Pomeroy procedures decreased dramatically after individual experience with only a few (< or = 5) procedures. The mean operative time for the Pomeroy group approached that of the more traditional banding technique at five procedures. Our data indicate that laparoscopic Pomeroy sterilization can be an effective teaching tool for operative laparoscopy, allowing residents to repeatedly perform an easy and safe procedure that incorporates basic techniques. Advanced operative endoscopic procedures could then be taught more efficiently after the acquisition of basic skills.

Adult

Noninvasive optical polarimetric glucose sensing using a true phase measurement technique.

The focus of this paper was to describe the development and testing of a noninvasive true phase optical polarimetry sensing system to monitor in vivo glucose concentrations. To demonstrate the applicability of this optical sensor for glucose measurement, we first calibrated the system and then tested it in vitro using both a glass test cell filled with glucose solution in the physiologic range, with a path length of 0.9 cm to approximate one centimeter path length present in the anterior chamber of the eye, and then on an excised human eye. Our technique used helium neon laser light which was coupled through a rotating linear polarizer along with two stationary linear polarizers and two detectors to produce reference and signal outputs whose amplitudes varied sinusoidally with a frequency of twice the angular velocity of the rotating polarizer, and whose phase was proportional to the rotation of the linear polarization vector passing through the glucose solution.

Blood Glucose

Scabies.

Scabies is highly contagious and is usually transmitted by direct personal contact. It typically presents as an intensely pruritic eruption. Atypical presentations are common in Norwegian scabies and in childhood scabies. Infestation is documented by visualizing the mite, its eggs or scybala on low-power microscopy. The treatment of choice is 5 percent permethrin cream, used in a single application at bedtime and removed the next morning.

Diagnosis, Differential

Erythema nodosum.

Erythema nodosum represents an inflammatory process in the septa between the subcutaneous fat lobules. The hallmark lesions are exquisitely tender, erythematous nodules that are distributed symmetrically on the extensor surfaces of the lower extremities. Erythema nodosum is considered an immunologic response, and a wide variety of clinically important antigens have been implicated. It may serve as a cutaneous marker for systemic diseases, such as tuberculosis, sarcoidosis, inflammatory bowel disease and lymphoma. The disease is diagnosed by deep elliptical biopsy and pathologic evaluation. The natural history is resolution with treatment of the underlying disorder or spontaneous regression of idiopathic disease.

Diagnosis, Differential

The effects of prone and supine positioning on arterial oxygen pressure.

An experimental study was conducted on 25 ventilated premature infants with RDS comparing PaO2 in the supine and prone positions. Analysis of the mean PaO2 showed significantly higher values in the prone position (p = .005). It is important for nurses to be aware of the implications of positioning on respiratory functioning and to integrate this knowledge in their practice.

Blood Gas Analysis

Color-flow US imaging through the analysis of speckle motion.

Reflections obtained from moving red blood cells on an ultrasound (US) scan of the abdominal aorta were enhanced with real-time Boolean operations on sequential frames of the image, as well as with frame subtraction and motion-detection processing. The Boolean operations used were the logical AND, OR, and Exclusive OR (XOR). Through the manipulation of output color lookup tables, the pixels within the flow field were given color representations. The resulting color-flow information can then be superimposed over the gray-scale image from the US imager to create color-flow imaging without the use of traditional Doppler US technology.

Adult