[Joseph Gensoul & amp; Amede Bonnet].
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General Surgery↗
Biomedical subjects
M Patel
Publications and source records attributed to M Patel.
Hemimandibulectomy without bone grafting: report of a case.
Some patients require hemimandibulectomy who are poor candidates for reconstructive surgery or who do not want to subject themselves to multiple surgical episodes. With the use of an articulated external skeletal fixation appliance, near-normal esthetics and function can be achieved in these patients without bone grafting. A report of one such case is presented.
Aged↗
The effect of iron on the survival of Vibrio cholerae O1 in dechlorinated tap water.
Many factors, such as temperature, pH, organic nutrients, types of water storage containers, etc., determine the survival of Vibrio cholerae in water. Since the survival of V. cholerae O1 has been shown to be much longer in metal drums used as household water storage containers than in clay pots and plastic drums, the present study was designed to explore the possible role played by insoluble iron on the survival of V. cholerae O1 in water. The possibility of iron acting as particulate matter for the organisms to adhere to was also examined by using inert glass beads in water. Survival of V. cholerae O1 in dechlorinated tap water, with and without inert glass beads, ranged from < 24 h to 10 d. The number of surviving bacteria was, however, very low. In the presence of impure ferric oxide (Fe2O3), survival in tap water ranged from 4 to 12 d and the numbers of surviving bacteria were very high. Iron was thought to play an important role in the survival of V. cholerae O1 in water. Differences between the numbers of bacteria and the length of survival in surface water and in sediment were unremarkable. The El Tor and classical biotypes gave similar results.
Animals↗
Effect of iron and pH on the survival of Vibrio cholerae in water.
Many physicochemical factors affect the survival of Vibrio cholerae in the aquatic environment. An attempt was made to study the combined effect of pH and iron on the survival of V. cholerae in water in a laboratory environment. None of the 6 strains of V. cholerae used survived at pH 5.0; survival of all strains increased with increasing pH. The effect of ferric oxide on survival was significant for V. cholerae O1 only, not for non O1 strains. The longest survival of V. cholerae non O1 was 82 d, of El Tor V. cholerae 68 d, and of classical V. cholerae 56 d.
Ferric Compounds↗
MRI in neonatal dural sinus thrombosis.
Dural sinus thrombosis in the newborn period is a rare but underrecognized condition which may cause seizures, macrocephaly, lethargy, and respiratory depression. A 10-day-old term infant with no pre- or perinatal risk factors for thrombosis presented with seizures and was found to have dural sinus thrombosis on computed tomography and magnetic resonance imaging (MRI). One week later, MRI revealed partial resolution and 3 weeks later disclosed a complete resolution of the thrombosis. Clinicians should consider the diagnosis of neonatal dural sinus thrombosis in infants presenting with seizures and/or increased intracranial pressure even in the absence of risk factors or when the cranial computed tomography is normal. MRI is the most sensitive diagnostic tool to establish the diagnosis and permit a noninvasive follow-up, contributing to our understanding of the natural history, associated pathology, and prognosis of this condition.
Cranial Sinuses↗
Dysphoric and depressive symptoms in chronic schizophrenia.
This study suggests that depressive symptoms are less common in severe, chronic, schizophrenic inpatients than would be predicted if these symptoms were manifestations of negative symptoms or drug-induced parkinsonism. The findings further suggest that depressive symptoms in such patients are independent phenomena which conform to a depressive syndrome. This depression does not represent a misidentification of the negative symptoms affective flattening and alogia, as measured by the SANS, or parkinsonism or akathisia. The study findings fail to support the view that long-term depot antipsychotic medication plays an important role in the genesis of depression and dysphoria in chronic schizophrenic patients. Depressive symptoms were found to occur as frequently, and dysphoria more frequently, in schizophrenic patients in the year after drug withdrawal compared with patients continuing on maintenance drug treatment for the same period.
Administration, Oral↗
Influence of ketorolac tromethamine on clot elastic strength in humans as assessed by thromboelastography.
STUDY OBJECTIVE: To evaluate the effect of ketorolac tromethamine on coagulation using thromboelastography (TEG). DESIGN: TEGs were performed in each patient before and after ketorolac administration. Each patient's predrug results were used as control measurements for comparison with the postdrug results. SETTING: Medical center surgical unit. PATIENTS: Twenty ASA physical status I and II patients undergoing minor elective surgery; 12 healthy volunteers. INTERVENTIONS: TEGs were performed in all subjects before and 60 minutes after the intramuscular (IM) administration of ketorolac tromethamine 60 mg. Ten surgical patients were studied in the intraoperative period, and 10 surgical patients were studied in the postoperative period. The 12 healthy volunteers did not undergo a surgical procedure. MEASUREMENTS AND MAIN RESULTS: Specific parameters assessed from the TEGs were reaction time (R time), coagulation time (RK time), clot formation rate (angle of deflection), and maximum clot strength (maximum amplitude of deflection). Ketorolac administration did not cause statistically significant changes in these parameters in any of the three groups studied. CONCLUSIONS: IM administration of ketorolac tromethamine 60 mg did not significantly alter the speed of formation or viscoelastic strength of clots as measured by TEG. These results provide additional support for prior clinical studies confirming the safety of ketorolac administration in the perioperative period.
Adult↗
Emergency percutaneous nephrostomy: technical success based on level of operator experience.
PURPOSE: The outcomes of emergency percutaneous nephrostomy procedures performed by operators with different levels of experience were analyzed. PATIENTS AND METHODS: A prospective study of 160 patients undergoing 169 emergency percutaneous nephrostomies was conducted. Three categories of operator experience were compared based on the number of percutaneous nephrostomies performed each year (level 1 = more than 20, level 2 = 10-20, or level 3 = less than 10). RESULTS: The level 1 operators (mean fluoroscopy time, 2 minutes; mean procedure time, 25 minutes) achieved success in 141 of 142 cases (99%) and failed in one case (1%), which was repeated successfully the next day. The level 2 operators (mean fluoroscopy time, 6 minutes; mean procedure time, 35 minutes) achieved initial success in all of 15 cases (100%), but three cases (20%) were repeated the next day because of catheter migration or malposition. Level 3 operators (mean fluoroscopy time, 10 minutes; mean procedure time, 42 minutes) were successful in 10 of 12 cases (83%), but in four cases (33%) the procedure had to be repeated. CONCLUSION: The experience of the operators played little role in the initial success rate of the procedure after they had performed 10 or more per year. However, the level of experience did influence the number of procedures that needed to be repeated, the prevalence of minor complications, and the mean fluoroscopy and procedure time.
Clinical Competence↗
Bronchiolitis obliterans organizing pneumonia in a patient with chronic myelogenous leukemia developing after initiation of interferon and cytosine arabinoside.
A 59-yr-old man developed fevers, shortness of breath, persistent cough and weight loss, shortly after initiation of therapy with interferon-alpha 2a and cytosine arabinoside for treatment of chronic myelogenous leukemia. Radiologic pulmonary infiltrates and lung tissue biopsy were consistent with bronchiolitis obliterans organizing pneumonia (BOOP). After discontinuation of the chemotherapeutic drugs, the pneumonic symptoms and chest roentgenogram infiltrates resolved. This report suggests that treatment with interferon-alpha, in combination with cytosine arabinoside, may produce the rare complication of BOOP.
Antineoplastic Combined Chemotherapy Protocols↗
Single local instillation of nonviable Staphylococcus aureus or its peptidoglycan ameliorates glucocorticoid-induced impaired wound healing.
An excess in glucocorticoid steroids, either from endogenous or exogenous sources, has been shown to inhibit wound repair. Key to this impairment is a diminution of the inflammatory response to wounding, fibroplasia, capillary formation, reparative tissue collagen accumulation, and wound breaking strength. Because a single local application at operation of nonviable Staphylococcus aureus or its peptidoglycan increases all of these processes in normal rats, we hypothesized that nonviable S. aureus and S. aureus peptidoglycan would each ameliorate glucocorticoid-induced impaired healing. Sprague-Dawley male rats aseptically received two 7 cm paravertebral skin incisions and underwent subcutaneous implantation of polyvinyl alcohol sponges. Two glucocorticoids were used: hydrocortisone, 8 mg intramuscularly, daily beginning 1 day before operation and continuing during the postoperative period; or a single dose of a long-acting preparation of methylprednisolone, 6 or 8 mg intramuscularly, on the day before operation. Controls received intramuscular injections of saline solution at the same respective times. At the time of the operation, one incision and the polyvinyl alcohol sponges on one side of the animal were instilled with saline solution while the incision and sponges on the opposite side were instilled with nonviable S. aureus (hydrocortisone study) or S. aureus peptidoglycan (two methylprednisolone studies). The data showed that, at postoperative day 7, the single local application at wounding of nonviable S. aureus or S. aureus peptidoglycan increased wound breaking strength in the control rats by factors of 1.6 in the hydrocortisone experiment and 1.4 and 1.6 in the methylprednisolone studies. These treatments prevented (in hydrocortisone-treated rats) or mitigated (in methylprednisolone-treated rats) the glucocorticoid-induced decrease in wound breaking strength. In addition, these treatments prevented the glucocorticoid-induced decreases in the inflammatory (largely mononuclear cells) response to wounding and in the accumulation within the polyvinyl alcohol sponge of reparative tissue fibroblasts, capillaries, and collagen.
Journal Article↗
Preparation and characterization of oxybenzone-loaded gelatin microspheres for enhancement of sunscreening efficacy.
The objective of our present study was to prepare and evaluate gelatin microspheres of oxybenzone to enhance its sunscreening efficacy. The gelatin microspheres of oxybenzone were prepared by emulsion method. Process parameters were analyzed to optimize the formulation. The in vitro drug release study was performed in pH 7.4 using cellulose acetate membrane. Microspheres prepared using oxybenzone:gelatin ratio of 1:6 showed slowest drug release and those prepared with oxybenzone:gelatin ratio of 1:2 showed fastest drug release. The gelatin microspheres of oxybenzone were incorporated in aloe vera gel. Sun exposure method using sodium nitroprusside solution was used for in vitro sunscreen efficacy testing. The formulation C5 containing oxybenzone-bearing gelatin microspheres in aloe vera gel showed best sunscreen efficacy. The formulations were evaluated for skin irritation test in human volunteers, sun protection factor, and minimum erythema dose in albino rats. These studies revealed that the incorporation of sunscreening agent-loaded microspheres into aloe vera gel greatly increased the efficacy of sunscreen formulation more than four times.
Animals↗
Computation of ammonium bisulfate aerosol deposition in conducting airways.
Experimental measurements of the growth of monodisperse dry NH4HSO4 aerosols by H2O vapor condensation have been reported in the literature. These data are incorporated into an aerosol deposition model to study the behavior of inhaled NH4HSO4 particles, which is of concern in relation to human health. The tracheobronchial tree is described by Weibel's model A morphology, and Landahl's formulas are used to compute particle deposition efficiencies. Enhanced losses in the trachea due to the action of the laryngeal jet are accounted for by using an empirical deposition efficiency equation. The effect of NH4HSO4 aerosol growth is quantitated by comparisons of total and intrabronchial deposition probabilities with those of a nonhygroscopic aerosol of equal aerodynamic size. Computations indicate that hygroscopic growth effects are a function of the size of the particles inhaled. Total deposition efficiencies of NH4HSO4-H2O droplet aerosols are greater than those of nonhygroscopic aerosols only if the former originate from dry NH4HSO4 particles exceeding a critical geometric diamter of 0.3 micrometer. Growth effects are explained in terms of the relative efficiencies of the dominant deposition mechanisms active in the lung.
Aerosols↗
Painful Horner syndrome associated with occlusion of the extracranial internal carotid artery: MR imaging.
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Arterial Occlusive Diseases↗
CT appearance of an oncocytic papillary cystadenoma of the larynx.
The CT appearance of an oncocytic papillary cystadenoma of the right laryngeal false cord is presented. This unusual tumor of the larynx with similar CT appearance to that of a cyst of the laryngeal saccule is discussed.
Aged↗
Re.: Acute noncontact compartment syndrome.
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Compartment Syndromes↗
Respiratory muscle strength in older adults.
Gender-related effects and two measures of muscularity, handgrip strength and fat-free mass (FFM), were examined to determine their relationship to respiratory muscle strength. Subjects were 101 healthy older adults. In 75 subjects, the magnitude of learning effect was examined over four weekly sessions. Maximal inspiratory pressure (PImax) was lower with increasing age in women, and maximal expiratory pressure (PEmax) was lower with increasing age in both genders. The PEmax correlated with handgrip strength and FFM in men only. Performance of PImax plateaued by the third visit in both men and women. Performance of PEmax plateaued by the third measure in women and was unchanged across four measurements for men.
Aged↗
Reliability and validity of the 12-minute distance walk in patients with chronic obstructive pulmonary disease.
Validity and test-retest liability of the 12-minute distance (12MD) walk, a measure of functional status, were examined in patients with chronic obstructive pulmonary disease. Four tests were administered at weekly intervals. Performance increased (p < .01) over the first three tests. Test-retest reliability was r34 = .98 (df = 46) for tests 3 and 4. The 12MD walk correlated with the Sickness Impact Profile, Physical Dimension (r = -.45); forced expiratory volume in 1 second % predicted ( r = .40); maximal inspiratory pressure (PImax) (r = .52); and exercise-related breathlessness (r = -.49). Exercise-related breathlessness and PImax accounted for 42% of the variance. The validity and reliability of the 12MD walk were supported.
Aged↗