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Biomedical subjects

M Kane

Publications and source records attributed to M Kane.

At least 91 records · Page 5Linked to original sources

Role of screening in prevention and treatment.

Since viral hepatitis may be the most common form of chronic viral disease in the world, strenuous attempts are being made to reduce the incidence. To achieve this, strategies are being developed by various national and international bodies involving both the immunisation and screening of certain groups of the population. These strategies are by no means universal, and the value of screening specific groups is the subject of much debate. This paper will address a number of the issues related specifically to the question of screening for hepatitis B virus and hepatitis C virus (HBV and HCV, respectively) namely (a) what is screening?; (b) why should we consider screening?; (c) who should we consider screening?; (d) what are the benefits and liabilities of screening?; (e) what constitutes an acceptable screening test?; (f) should we be screening for HBV or HCV?

Blood Donors↗

ABH-related antigens in human male genital tract. A histochemical examination.

The localization of ABH related antigens in human male reproductive tract was examined using monoclonal antibodies and an avidin biotin complex method. No positive reaction with blood group antibodies on spermatozoa was observed in testis and ductus epididymidis apart from erythrocytes and endothelial cells. The expression of ABH and ABH related antigens in ductuli efferents testis, ductus epididymidis, seminal vesicle and prostate was complexly coded by a combination of H, Se, Le and X genes. The results obtained in this study indicate that the ABH antigens detected on spermatozoa of seminal stains are coating antigens and not inherent to the cell membrane, and the ABO, H, Se, Le and X genes are subjected to a tissue-dependent differential expression.

ABO Blood-Group System↗

[Factors changing the length of analgesia in spinal anesthesia].

So as to determine the effects of some factors on the duration of bupivacaine spinal anaesthesia, a prospective controlled study was carried out on 152 ASA I or II patients. They were randomly allocated to six groups. The patients of group I were given 4 ml of 0.5% bupivacaine at 27 degrees C. The patients of group II were given 4 ml of a mixture including 3 ml of 0.5% bupivacaine, 1 ml fentanyl in 1 ml of 10% dextrose solution. The group III was given 4 ml of a mixture including 3 ml of 0.5% bupivacaine, 0.20 mg adrenaline. The group IV was given 4 ml of a mixture including 3 ml of 0.5% bupivacaine, 0.15 mg clonidine. The patients of group V were given 4 ml of 0.5% bupivacaine at 20 degrees C and those of group VI were given 4 ml of 0.5% bupivacaine at 5 degrees C. There is significant difference between regression times of sensory analgesia of group II and group I, group IV and group III, group VI and group V. The choice of product to lengthen analgesia in spinal anaesthesia depends on the use of each anaesthesist, the characteristic of patients and the duration of surgery.

Adolescent↗

[The effect of the local anesthetic temperature on spinal anesthesia using 0.5% bupivacaine].

The aim of this study was to compare spinal anaesthesia with 0.5% bupivacaine at 20 degrees C and 5 degrees C. One hundred two patients ASA I-II were randomized into two groups. After atropine and IV fluid administration, patients of group I received intrathecally at L3-L4 level 0.02 ml.cm-1 of plain 0.5% bupivacaine at 20 degrees C, while patients of group II received the same solution and the same doses but at 5 degrees C. No significant difference was found between the times for installation of sensory and motor blocks nor between the durations of motor block in the two groups. On the other hand significant differences were found between the durations of sensory block in group I (283.33 min +/- 9.40 min) and group II (314.35 +/- 8.80 min) (P < 0.001) and all the more (P < 10(-9)) between the cephalad block extensions in group I (D 7.45 +/- 0.14) and group II (D 4.82 +/- 0.20). Therefore plain bupivacaine 0.5%, isobaric at 20 degrees C, seems to get the properties of an hyperbaric solution when cooled at 5 degrees C.

Anesthesia, Spinal↗

Demise of a myth?

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Accommodation, Ocular↗

Restrictive workplace smoking policies: impact on nonsmokers' tobacco exposure.

The health consequences of exposure to environmental tobacco smoke (ETS) are well documented. Although nonsmokers are generally aware of the health risks of ETS exposure, the majority of nonsmokers are regularly exposed. The most common source of exposure is the workplace. Restrictive workplace smoking policies are being used as a primary means of reducing ETS exposure. However, few studies have focused on the relation between workplace policy and ETS exposure. We performed two studies which examined the relationship between smoking policy, self-reported ETS exposure, and salivary cotinine concentrations. Study I, a pilot study, focused on a workplace-based sample of 106 volunteers; Study 2 examined exposure among 881 nonsmokers in workplace settings. In both studies, more restrictive workplace smoking policies were associated with a lower proportion of nonsmoking volunteers with detectable salivary cotinine. In Study 2, the larger study, the only other variable found to be significantly related to cotinine detection was the presence of smokers in the home. These results suggest that restrictive workplace smoking policies may reduce employees' overall ETS exposure.

Adult↗

Electrophoretic phenotyping of erythrocyte enzymes.

Erythrocyte acid phosphatase (EAP), esterase D (ESD) and phosphoglucomutase (PGM) phenotypes among the erythrocyte enzyme types of blood groups are surveyed and a modified cellulose acetate membrane isoelectric focusing (CAM-IEF) method for their exploration is described. The phenotyping procedures are usually classified as either equilibrium or non-equilibrium IEF. Equilibrium IEF, which is based on differences in pI values, includes three methods: (i) a narrow pH range of carrier ampholytes, (ii) a relatively narrow pH range of carrier ampholytes containing chemical separators and (iii) immobilized pH gradient gels. Among the three methods, immobilized pH gradients provides a better resolution of isozymes. Conversely, the disadvantages of immobilized pH gradients include longer focusing times and complex gel preparations. Moreover, immobilized pH gradients are unsuitable for stain analysis because of the insensitivity of PGM1 detection. A hybrid IEF system and a commercial immobilized pH gradient dry plate have overcome these problems. However, EAP typing is extremely expensive and ESD typing is not well distinguished by hybrid IEF. As each method has both merits and demerits, the most suitable technique should be selected based on the kind of erythrocyte enzyme types and sample conditions. On the other hand, non-equilibrium IEF is a rapid method because isozymes are detected on the basis of their charge differences under non-equilibrium conditions. Moreover, the appropriate addition separators increases the charge difference and provides a good resolution within a shorter time. Addition of more separators produces a narrow pH range in the gel and takes a substantially longer time to reach the optimum pH range for charge difference.(ABSTRACT TRUNCATED AT 250 WORDS)

Acid Phosphatase↗

Evaluation of enzyme immunoassay (EIA) as a screening method for hepatitis B markers in an open population.

Commercially available kits for detection of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs) by enzyme immunoassay (EIA) were evaluated in American Samoa during a public health programme to eliminate the transmission of hepatitis B. The first 19,184 serum specimens obtained, representing 68% of the total cooperating population, were initially tested for anti-HBs, and those without detectable antibody were tested for HBsAg. All the antigen-positive serum samples, and a selection of the antigen- and antibody-negative specimens were tested by radioimmunoassay (RIA) for detection of both markers. Compared with the standard tests, the EIA kits for anti-HBs and HBsAg performed well; sensitivity and specificity were 90.3 and 96.0%, respectively, for antibody, and 97.8 and 97.9% respectively for antigen. Substantial disagreement between the EIA and RIA tests for HBsAg was found only for specimens considered weakly reactive by EIA. Few differences were found between three EIA method options for follow-up HBsAg testing of weakly reactive serum specimens; each option contributed about equally to improved test specificity for these 'borderline' specimens. Based on their demonstrated equivalence to the standard RIA tests, we conclude that the EIA kits for anti-HBs and HBsAg detection are suitable for use in hepatitis B control programmes in open populations.

Evaluation Studies as Topic↗

Value of transesophageal echocardiography as an adjunct to transthoracic echocardiography in evaluation of native and prosthetic valve endocarditis.

To determine if transesophageal echocardiography provides better visualization of valvular vegetations than transthoracic echocardiography, we used both methods to evaluate 24 consecutive patients (mean age, 54 years; 15 female patients and nine male patients) referred for symptoms suggestive of infectious endocarditis. Ten of the 24 patients had one or more valvular prostheses. Echocardiograms were classified as positive or negative based on visualization of valvular vegetations or abscesses. Of ten patients with a final diagnosis of infectious endocarditis on extended follow-up, transthoracic echocardiography was positive in five patients. Transesophageal echocardiography not only yielded abnormal findings in all ten of these patients, but also revealed additional information in four of the five patients with abnormal transthoracic echocardiographic examinations. Among the 14 patients who, on subsequent follow-up, were found not to have infectious endocarditis, transthoracic echocardiography was normal in 13 and falsely abnormal in one. Transesophageal echocardiography revealed no evidence of infectious endocarditis in any of these patients. The ten patients who were determined to have infectious endocarditis all had positive blood cultures and no alternative cause for their clinical presentation; in seven patients in this group who underwent operative or postmortem evaluation, infectious endocarditis was confirmed. All patients without infectious endocarditis were demonstrated to have other causes for their clinical presentation. We conclude that transesophageal echocardiography is a highly valuable test in the work-up of patients with suspected infectious endocarditis, especially those patients with inconclusive or normal transthoracic echocardiograms. In addition, transesophageal echocardiography may be of benefit to patients with previously documented infectious endocarditis and a complicated clinical course in whom additional cardiac lesions are suspected but not demonstrated by transthoracic echocardiography.

Abscess↗

Phenotyping of erythrocyte acid phosphatase and esterase D by high field strength isoelectric focusing on cellulose acetate membrane.

Phenotyping of erythrocyte acid phosphatase (EAP) and esterase D (ESD) by cellulose acetate membrane isoelectric focusing (CAM-IEF) under a nonequilibrium condition is described. In an attempt to improve the method of CAM-IEF, we shortened the electrode distance to provide a higher field strength at a given (low) voltage. Various carrier ampholytes for EAP typing and various chemical separators for ESD typing were also tested. Good separations were obtained after 30 min IEF for EAP typing and 25 min for ESD typing. When applied to blood stains and stored for various periods at room temperature, the stains up to 8 months old could still be phenotyped for EAP and those up to 4 weeks old for ESD. CAM-IEF is suitable for routine forensic work of EAP and ESD phenotyping.

Acid Phosphatase↗

[Comparison of adrenaline and clonidine to extend the analgesic effect of bupivacaine without glucose in spinal anesthesia].

So as to determine the effects of adrenaline and clonidine on the duration of isobaric bupivacaine spinal anaesthesia, a prospective controlled study was carried out on 20 ASA I or II patients. They were randomly allocated to two groups. The patients of group I were given 4 ml of a mixture including 3 ml of 0.5% bupivacaine, 0.2 mg adrenaline. The patients of group II were given 4 ml of a mixture including 3 ml of 0.5% bupivacaine, 0.15 mg clonidine. The segmental level of sensory loss was tested using forceps. The time course required for maximal spread on the sensory blockade did not differ in the two groups: 4.00 +/- 1.01 min. for group I and 3.60 +/- 0.90 min. for group II. No difference was observed between median highest levels of sensory analgesia. Regression times were 520.70 +/- 79.52 min for group II and 360.40 +/- 51.47 min. for group I. Significant prolongation of motor block was also associated with the addition of vasoconstrictors. It is concluded that addition of 0.15 mg clonidine may be useful to increase duration of isobaric bupivacaine spinal anaesthesia.

Adult↗

Time to recurrence varies inversely with thickness in clinical stage 1 cutaneous melanoma.

The thickness of a tumor has been identified as the principal prognostic factor in cutaneous malignant melanoma. However, time to recurrence has not conclusively been related to thickness. A retrospective study of 216 patients with a primary cutaneous malignant melanoma that recurred was conducted to clarify this relationship and investigate possible independent relationships between age at diagnosis and sex of patients to time to recurrence. The results of analysis of linear regression revealed an inverse linear relationship between thickness and time to recurrence (p less than 0.001). Patients more than 50 years of age at the time of diagnosis were shown to relapse sooner than those less than 50 years of age (p = 0.014). Sex was not a significant factor in predicting time to recurrence (p greater than 0.10). These results suggest that thickness of tumor provides an indication of time to recurrence in those patients destined to recur and stress the need for long term surveillance in patients with a history of malignant melanoma because of the possibility of late relapse even with thin lesions.

Female↗

[Injuries caused by automobile dragging: a report of three cases].

Three cases of victims who were dragged a long distance by automobiles are reported. Injuries caused by such dragging are discussed. [Case 1] A 50-year-old man was found dead under an automobile after having been dragged for a distance of 530 m. Deep abrasions were found in the right temporal region, both scapular regions, the buttocks, and the heels. There were excoriations toward upper side in the right hypochondriac region along the rib arch, and multiple rib fractures with and without severe hemorrhaging. Alcohol levels were 3.54 mg/ml in the femoral venous blood, and 4.54 mg/ml in the urine. It seemed that the victim was drunk and had been lying on his back and that the automobile's underbody had caught him in his right hypochondriac region and had compressed the thoraco-abdominal regions. [Case 2] A 50-year-old drunken man, who had been lying on his back on the side of a road, was dragged by a car for a distance of 2 km. The victim showed marked and deep abrasions of the back, the buttocks, the lateral surface of both ankles, and on the ulnar surface of the left forearm. In the left forearm, the ulna and soft tissues had been rubbed flat and were blackened. The alcohol levels in the femoral venous blood and in the urine were 3.31 and 4.19 mg/ml, respectively. [Case 3] An 83-year-old woman was found dead on the side of a road. In the right temporal region, the skull had been rubbed flat and the right cerebral hemisphere was exposed and flattened. Severe abrasions were observed on both shoulders, the buttocks, and on the back surfaces of the lower extremities. Her sandals and a broken cane were found on the road 2 km from the scene. The offender has not yet been arrested. Injuries caused by the road surface in traffic accidents usually take the form of excoriations or abrasions, and the three victims of this report showed severe and characteristic injuries. Excoriations or abrasions develop into abrasive injuries, defects of the skin or soft tissue, and to the exposure of the internal organs from continuous, prolonged dragging. Some of these accumulated injuries might have been caused by frictional heat.

Accidents, Traffic↗