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Biomedical subjects

M Roy

Publications and source records attributed to M Roy.

At least 307 records · Page 17Linked to original sources

Intubation and other experiences in cardiac surgery: the consumer's views.

Recently publications have advocated earlier weaning and early extubation of the trachea in patients after cardiac surgery. Greater comfort of the patients is one of the advantages claimed for this policy. One hundred consecutive adult patients were questioned on the fifth postoperative day to assess the relative comfort or discomfort of the patients during tracheal intubation and ventilation. Overnight tracheal intubation and ventilation were easily tolerated by over 90 per cent of patients who had received morphine and diazepam. There was a high incidence of amnesia. Some of the other claimed advantages appear inconclusive and further study is desirable to elucidate the effect of early removal of the tracheal tube upon the indicence of pulmonary complications.

Adult↗

[Intrapulmonary deposition of inframicron particles during inspiratory apnea (author's transl)].

An experimental approach of the intrapulmonary deposition of particles with a diameter below 1 micron, suspended in the surrounding atmosphere, was done on two normal subjects during inspiratory apnea with a Whitby impactor. The first results seem to agree with those of literature and confirm the importance of pulmonary morphometric factors in the deposition processes. Numerous methodological problems remain, but it appears that the technique would be useful to evaluate the likelyhood of deposition of submicron particles which are presently known to be pathogenic.

Apnea↗

[Tracheo-bronchial and pulmonary depositions as measured by radioactive tracers. Study on healthy and pathological subjects (author's transl)].

The result of a study done on 52 subjects including a thorough ventilatory functional test and the radioisotopic measurement of inhaled particles deposition, by working out the TB/P ratio, revealed that: 1. giving aerosol needs an exacting technique when used for quantitative aims; 2. ratio TB/P is increased in patients with chronic broncho-pulmonary diseases, because of a predominantly tracheo-bronchial deposition of particles; 3. in patients with a satisfactory ventilatory function the TB/P ratio is increased; on the other hand in patients with ventilatory disorders, the ratio is normal. The repartition of particles deposition between the compartments TB and B depends therefore not only on factors involving ventilatory functional values but also on the physiopathological factors not included in them.

Bronchi↗

Hepatic regeneration and erythropoietin production in the rat.

The regenerating liver produces erythropoietin in response to hypoxia. The amounts of erythropoietin produced in animals subjected to hepatectomy are significantly higher than those observed in sham-operated animals. Hepatic erythropoietin production appears to be dependent upon the stage of regeneration with the highest levels being produced during the period of greatest proliferation and increase in liver mass.

Animals↗

Age-related variations in hepatic regeneration and erythropoietin production in the rat.

Erythropoietin (Ep) is produced mainly by the liver and spleen during fetal and neonatal periods and by the kidney during adolescent and adult life. The liver is also an important extrarenal producer of Ep in the hypoxic, anephric adult animal. Subtotal hepatectomy results in a substantial elevation in serum Ep levels at 30-72 hours after hepatectomy in rats subsequently nephrectomized and rendered hypoxic. Ep production is related to the mass of regenerating liver with peak Ep production occurring during times of greatest tissue proliferation. Regenerative and erythropoietic responses to hepatectomy decline with advancing age. Rats undergoing repeated hepatectomies do not recover full liver mass but the initial rate of regeneration increases following each successive hepatectomy. Ep levels decline in anephric hypoxic rats undergoing multiple hepatectomies when compared to sham-operated controls.

Age Factors↗

Aortic valve replacement combined with myocardial revascularization. Late clinical results and survival of surgically-treated aortic valve patients with and without coronary artery disease.

From 1967 through 1973, 80 consecutive patients underwent simultaneous aortic valve replacement (AVR) and coronary bypass grafting. Fourteen (18%) experienced no angina pectoris and had no history or electrocardiographic evidence of coronary atherosclerosis. Seven of these 14 had severe multiple vessel disease. All operations were performed under normothermic conditions without coronary perfusion. Seven patients (9%) died during operation. Intra-operative myocardial infarction was documented in eight (10%). After a mean follow-up of 35 months, overall mortality was highest in aortic regurgitation patients [seven of 13 (54%)] compared to aortic stenosis [17 of 54 (31%)] (P less than 0.07), and mixed pathology [1 of 13 (8%)]. Thirty-one of 34 (91%) grafts in 25 patients were patent an average of 12 months postoperatively. After 42 months a 65% actuarial survival was found in the combined AVR and graft(s) series versus a 76% survival in 300 AVR patients proven by angiography not to have severe coronary atherosclerosis.

Adult↗

Double-blind evaluation of oral L-prolyl-Lleucyl-glycine amide in Parkinson's disease.

A 4-month double-blind study comparing the effect of increasing oral doses (up to 1.0 g daily) of synthetic L-proyl-L-leucyl-glycine amide (PLG) and placebo in 20 parkinsonian patients showed no significant improvement in objective scores of functional disability. However, important trends and some significant results were observed with the lower doses of PLG. These essentially negative results may be attributed to poor intestinal absorption of the compound, a short biologic half-life in the blood, or administration of oral doses that were much higher than required, or a combination of factors. In further studies with this peptide, which are encouraged, the intravenous route should be used until the question of intestinal absorption is resolved.

Adult↗

Histopathologic spectrum of vaginal adenosis and related changes in stilbestrol-exposed females.

A total of 98 colposcopically directed biopsies were obtained from the vagina, cervix, and cervicovaginal ridge (hood) of 80 young women believed to have had intrauterine exposure to stilbestrol (DES). Specific investigation of the patient's medical records corroborated the history of maternal stilbestrol administration in 36 patients (45%), while in the remainder the drug history was regarded as presumptive since medical records were unavailable for review. The findings did not differ significantly in those biopsies taken from patients with confirmed or presumptive drug histories. Histologic evidence of vaginal adenosis was detected in vaginal biopsies from 43 patients. In 30 cases (70%) benign Müllerian-type glandular epithelium was in the superficial vaginal wall, residing on the mucosal surface and/or in the lamina propria. The glandular epithelium predominantly was of endocervical type, but in six instances it resembled endometrial or fallopian tubal epithelium. The glands were accompanied by varying degrees of squamous metaplasia in 22 cases. When extensive the metaplasia produced transformation zones similar to those seen in the normal cervix. Vaginal biopsies of adenosis from the other 13 patients (30%) revealed squamous metaplasia without demonstrable glands due to complete transformation of all antecedent glandular epithelium by squamous metaplasia. Our studies indicate that squamous metaplasia is a component of major importance in the natural history of adenosis and that the concept of adenosis should be broadened to include those examples comprised exclusively of metaplastic epithelium. In such examples metaplasia is identified by the immaturity and poor glycogenation of the squamous cells and their accompanying squamous pegs which often contain residual gland openings or squamous "eddies." Similar findings were present in biopsies of seven cervicovaginal ridges and in cervical biopsies from 37 patients, except for the absence of endometrial or tubal type glands in the latter site. Although no adenocarcinomas were detected, six patients had squamous dysplasia of the vagina and/or cervix. In no case were premalignant or dysplastic changes of glandular cells found. Our findings support the thesis that stilbestrol-associated adenosis represents anomalous embryologic localization of the original squamocolumnar junction in the vagina rather than in the cervix. It is closely related to so-called cervical "erosions." The development of squamous metaplasia accounts for modifications in the clinical and histologic appearances by producing transformation zones which then may be subject to the same oncogenic stimuli for squamous neoplasia as are their counterparts in the cervix.

Adolescent↗

Six-year results of treatment with levodopa plus benzerazide in Parkinson's disease.

A combination of levodopa and a peripheral dopa-decarboxylase inhibitor, benzerazide (Ro 4-4602), was studied over a 75-month period of observation in 132 patients with Parkinson's disease. The combined therapeutic approach was without biological toxicity, was well tolerated by 95 percent of patients, and was highly effective: 72 percent of patients improved by more than 50 percent on a functional activity scale and the group as a whole improved on an objective battery by a mean of 46 percent. Neurologic side effects of abnormal involuntary movements, falls, and oscillations in performance were not improved over levodopa used alone. The combined therapy is to be preferred over the use of levodopa alone in the symptomatic management of Parkinson's disease.

Adult↗

Colposcopic evaluation of the abnormal Papanicolaou test in pregnancy.

Colposcopy, including colposcopically directed biopsies in selected cases, was employed to evaluate over 300 pregnant patients with abnormal Papanicolaou tests suggestive of mild dysplasia or worse (Class III to V). Over half of the patients had benign disorders determined by colposcopic examination. All cases of invasive disease were diagnosed by colposcopy and biopsy, and the patients were treated accordingly. Only 3 diagnostic conizations were necessary in the antepartum period. The majority of patients with cervical intraepithelial neoplasia were seen post partum, and appropriate therapy was instituted. In the pregnant patient with an abnormal Papanicolaou test, colposcopy has proved to be a reliable and safe method of evaluation and has virtually eliminated the need for conization.

Biopsy↗

The effect of parity on placental weight and birth weight: interaction with placental alkaline phosphatase polymorphism.

The effect of parity on placental weight and birth weight is examined through a series of birth records from an Indian population in Calcutta. Placental weight and birth weight increase with parity, the maximum increment occurring between parities 1 and 2. This is compatible with a hypothesis of sensitization of the mother to foetal, paternally derived, antigens. The three common placental alkaline phosphatase enzymic genotypes have no effect on determining foetal development.

Adult↗

Proportion with low birth weight infants in an Indian population and its relationship with maternal age and parity.

The overall proportion of low birth weight infants is found to be relatively higher in the Indian population. Data collected from two hospitals in Calcutta, India indicate that although the proportion of infants weighing less than 2,001 g is approximately 10%, the dependence of this proportion on maternal age and parity is similar to the studies conducted elsewhere, suggesting a definite biological significance of the phenomenon. The proportion of low birth weight infants is found to be the greatest for the first and late pregnancies, the minimum being at the third birth rank. Young mothers showed a tendency to have an increasing proportion of low birth weight infants with increasing birth order; whereas for older mothers a general U-shaped dependence of the proportion on parity is suggest from the analysis.

Adolescent↗