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Biomedical subjects

M J Lema

Publications and source records attributed to M J Lema.

At least 37 records · Page 2Linked to original sources
PubMed1993

A comparison of postoperative epidural analgesia between patients with chronic cancer taking high doses of oral opioids versus opioid-naive patients.

Our study evaluated 116 surgical patients with cancer who received postoperative epidural analgesia with bupivacaine (BUP) (0.1%) and morphine (MS) (0.01%) during 5 days after epidural-light general anesthesia. Patients in group I (n = 17) were taking opioids in doses larger than 50 mg of morphine daily for 3 mo or more, whereas patients in group II (n = 99) were opioid-naive. Postoperative epidural infusions were started at 10 mL.h-1 for group I and 5 mL.h-1 for group II. All patients were evaluated every 6 h for pain, withdrawal, and overdosing. Dynamic pain scores were kept below 4/10 by titrating infusions and/or giving intravenous (IV) MS 4 mg every hour as needed. Fifteen patients were taking opioids for 3-6 mo and the remainder for more than 6 mo. Mean oral MS preoperative usage for group I was 183 mg (90-360 mg range). All patients experienced adequate analgesia. Group I required more epidural (137 vs 44 mg) and IV (48 vs 10 mg) MS and had a longer requirement for analgesic therapy (9 vs 3 days) when compared with group II. Daily epidural and IV MS usage were always more for group I by two- to threefold. No patient experienced respiratory depression or opioid withdrawal during the hospitalization. Thus, epidural BUP-MS appears to provide adequate postoperative analgesia while preventing withdrawal in opioid-dependent patients, if three times the normal dosage and duration of therapy are employed.

Administration, Oral↗
PubMed1991

The development of academic anesthesiology at the Roswell Park Memorial Institute: James O. Elam, MD, and Elwyn S. Brown, MD.

In the early 1950s, Drs. James Elam and Elwyn Brown were recruited to establish the department of anesthesiology at the Roswell Park Memorial Institute. With substantial financial support from both the New York State coffers and the Institute's director, Dr. George Moore, Elam and Brown were able to create a department of anesthesiology renowned for clinical excellence and basic science research. Their work on carbon dioxide elimination led to a redesigning of the soda lime canisters that is still in clinical use. By popularizing mouth-to-mouth rescue breathing, these two anesthesiologists changed the manner in which emergency aid was given and won international acclaim.

Anesthesia Department, Hospital↗
PubMed1989

High-performance ion-exchange chromatography of myosin using a DEAE-5PW column.

High-performance ion-exchange chromatography of myosin using a DEAE-5PW packing was used to purify myosin from skeletal, cardiac and smooth muscle. This method produces high-speed resolution (30-min analysis) of myosin from contaminating myofibrillar proteins. The column has a high capacity for binding myosin (up to 1 g) and can be used for small-scale preparation of highly purified myosin. Gel analysis in the presence of sodium dodecyl sulfate showed recovery of myosin with very little contamination of other myofibrillar proteins. Myosin was also recovered from small biopsy samples (0.1 g) by a direct extraction technique with recovery of biological ATPase activity.

Animals↗
PubMed1986

Myosin isozymes in rabbit and human smooth muscles.

Although multiple forms of myosin in cardiac and skeletal muscles have been identified, it has not been firmly established that myosin isozymes are present in adult smooth muscle. Myosin, extracted from human thoracic aorta and lower saphenous vein and rabbit aorta and uterus, was analyzed by pyrophosphate gel electrophoresis to determine if myosin isozymes are present in these tissues. In all smooth muscle tissues studied, two myosin isozymes were detected and labelled as smooth muscle 1 and smooth muscle 2, smooth muscle 2 being the faster migrating isozyme. Bovine cultured smooth muscle cells from the media of thoracic aorta also contained two forms of myosin. However, cultured fibroblasts contained only one form of myosin. Extracting myosin from either relaxed or contracting rabbit aortic smooth muscle did not influence the mobilities of smooth muscle 1 and smooth muscle 2 on pyrophosphate gels, suggesting that the degree of light chain phosphorylation did not significantly alter the electrophoretic mobility under our conditions. Smooth muscle 1 and smooth muscle 2 myosins each contain heavy chains (200,000 daltons) and light chains (20,000 and 17,000 daltons) in addition to filamin (235,000 daltons), which is closely associated with the native protein. Myosin peptide maps of rabbit aorta and uterus revealed areas of substantially different banding patterns between smooth muscle 1 and smooth muscle 2 from the same tissue. Similar peptide maps of smooth muscle 1 bands were produced from the different tissues, but the smooth muscle 2 maps were dissimilar.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1977

Increased ferritin synthesis and release by Hodgkin's disease peripheral blood lymphocytes.

Peripheral blood lymphocytes from patients with all stages of untreated Hodgkin's disease and from normal healthy adults were shown to synthesize and release ferritin in vitro. Ferritin synthesis was confirmed by immunoelectrophoresis, double immunodiffusion and autoradiography. Hodgkin's disease lymphocytes synthesized ferritin 4.2 times faster and released it 2.4 times faster than did normal lymphocytes, whereas total protein synthesis was faster in normal lymphocytes. Patients with nodular sclerosis and perhaps those with absence of fever had the highest synthetic rates; however no relationship was observed between relative rates of lymphocyte ferritin synthesis and sex, age, anatomical stage and presence of splenic or hepatic involvement by tumor. Addition of iron to normal human lymphocytes produced little or no change in ferritin synthesis. These data indicate that part of the intracellular ferritin detected in peripheral blood lymphocytes from patients with Hodgkin's disease and from normal individuals resulted from de novo synthesis rather than from uptake and storage of serum ferritin, and suggests that elevated ferritin levels detected in the serum and tumor tissue of Hodgkin's disease patients originate from lymphocytes.

Adult↗