Absorption of irrigating solution during hysteroscopic metroplasty.
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Absorption↗
Biomedical subjects
N M Ali
Publications and source records attributed to N M Ali.
Percutaneous epidural catheterization for intractable pain in terminal cancer patients.
We examined the effects of long-term percutaneous epidural catheterization for pain relief in nine terminally ill gynecologic cancer patients. All patients were free of side-effects such as respiratory depression, nausea, vomiting, urinary retention, or pruritus. Analgesia was excellent in six patients. Puncture-site skin inflammation occurred in four patients. Catheter dislodgement occurred in three patients. Although percutaneous epidural catheters were well tolerated in a few patients for an extended period of time, the frequency of catheter problems demonstrate that other methods such as catheter tunneling or implantable systems should be considered for long-term epidural administration of narcotics. This method appears to be most effective in patients suffering from pain due to nerve root involvement.
Analgesia, Epidural↗
Tolerance during long-term administration of intrathecal morphine.
We studied the time course of development of tolerance in four terminally ill cancer patients who were treated for intractable pain by intrathecal morphine administered by an implanted catheter and pump. The duration of treatment varied from 1.8 to 10.5 months. Our study shows that with disease progression, there was a constant patient-specific time rate of increase in the morphine dose requirements. Hence, for any given patient, the slope of the dose v time curve is effectively a constant over long periods. We also found that patients tolerate very high doses of intrathecal morphine without serious side effects.
Drug Administration Schedule↗
Hyperalgesic response in a patient receiving high concentrations of spinal morphine.
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Female↗
Observations on the gross changes in the secondary lymphoid organs of mice infected with Nematospiroides dubius.
Gross changes in the size of the secondary lymphoid organs were studied during infection with the nematode parasite Nematospiroides dubius. In the strong responder NIH strain, the wet weight of the mesenteric lymph nodes (MLN) increased rapidly following infection with 400 larvae to peak on day 28 at approximately three times the resting weight. Enlargement of the spleens was also marked but regression to normal size took place when the MLN had achieved maximum size. In contrast in C57BL/10 mice, a slow responder strain, the enlargement of the MLN following infection was relatively slow, and there was no evidence of the regression of the spleen, once maximum enlargement had been achieved. When adult worms were removed by anthelmintic, the enlarged MLN and spleens returned rapidly to normal size. However, in mice infected with irradiated larvae (25 krad) the MLN stayed enlarged, despite the absence of adult worms but the spleens of these mice returned to normal size fairly rapidly. It was suggested that irradiated worms survive, perhaps as arrested larvae in the intestinal tissue, for a fairly long time, thereby providing a continual stimulus for the MLN.
Animals↗
The pattern of peripheral blood leucocyte changes in mice infected with Nematospiroides dubius.
Experiments were carried out to define the haematological changes taking place during the first six weeks of a primary infection with Nematospiroides dubius. The general pattern of changes was observed to comprise a rapid increase in circulating leucocytes (4 to 5-fold increase) which consisted of a neutropl a, lymphocytosis, monocytosis and an eosinophilia. However, in strong responder NIH mice leucocyte counts returned to normal more rapidly than in other strains (by day 28). In contrast, in weak responder C57BL/10 mice the leucocyte counts whilst falling significantly relative to day 7 did not return to normal within the experimental period. Mice infected with irradiated larvae did not experience as high a leucocytosis as did mice given an identical number of normal larvae. The peak lymphocytosis, neutrophilia and monocytosis were all lower. The removal of adult worms from infected animals by treatment with pyrantel on days 9, 11, 13 and 16, also significantly altered the pattern of leucocytosis. The neutrophilia which was evident on day 7 returned rapidly to normal, whereas in mice which had retained their worms a peak neutrophilia was observed on day 14. These haematological changes were discussed and related to the failure of host-protective immunity to operate effectively during the early stages of a primary infection with N. dubius.
Animals↗
Effect of feeding on the fate of orally administered phenylbutazone, trimethoprim and sulphadiazine in the horse.
Phenylbutazone, sulphadiazine and trimethoprim were administered to three horses on two occasions, recently fed and unfed, and the effect of feeding on the pharmacokinetics of the three drugs assessed. The mean peak concentrations of phenylbutazone and trimethoprim were reduced by feeding by 34 and 75 per cent, respectively. The pharmacokinetics of sulphadiazine were not significantly affected.
Animals↗
Non-specific immunodepression by larval and adult Nematospiroides dubius.
Mice infected with Nematospiroides dubius generate weaker immune responses to concurrently administered sheep red blood cells (SRBC), than non-infected controls. The experiments described in this paper demonstrate that both adult and larval stages of N. dubius cause non-specific immunodepression of the response to SRBC. Mice which had been infected with larvae exposed to 25 krad. of irradiation, which prevents development to the adult luminal stages, produced as weak haemagglutination responses to SRBC as mice infected with normal worms even when SRBC were administered 6 weeks after infection. The removal of adult N. dubius by treatment with pyrantel 9, 11 and 15 days after infection with normal larvae did not restore the host's ability to respond to SRBC given on day 14. It was only when the mice had been without worms for 17 days that their capacity to respond normally to SRBC was restored. Mice infected with 60 or 400 transplanted adult worms produced depressed haemagglutination and plaque-forming responses to concurrently injected SRBC when compared with normal or sham-operated controls. The significance of these results is discussed in relation to the possible role of non-specific immunodepression in facilitating the survival of N. dubius in the host.
Animals↗
Survival to patency of low level infections with Trichuris muris in mice concurrently infected with Nematospiroides dubius.
Large, single-pulse laboratory infections with Trichuris muris are rejected by mice before patency, but low-level infections of fewer than 20 worms survive for long periods. Data are presented to show that the threshold at which an effective immune response takes place is significantly higher in mice concurrently infected with Nematospiroides dubius. In control CFLP mice trickle infections did not survive to maturity but in the slower responder C57 Bl10 mice egg production began on Day 35 and continued for a further seven weeks, with some mature worms present at autopsy. Concurrent infection with N. dubius resulted in trickle infections, T. muris surviving much better than in control mice, although these still showed some resistance to T. muris. It is suggested that the results support the hypothesis that T. muris elicits concomitant immunity in the host. Thus, the first worms to establish survive to patency at which time they can no longer be removed by the host, but once the immunological threshold has been exceeded incoming larvae are rejected by the host. Such a survival strategy would be very useful to T. muris in the wild.
Animals↗
Analysis of the mechanism of immunodepression following heterologous antigenic stimulation during concurrent infection with Nematospiroides dubius.
The suppression of immune responsiveness to heterologous antigenic stimulation during concurrent infection with Nematospiroides dubius was reproduced using soluble antigens derived from adult parasites. Immunosuppression appeared to be selective in that the administration of equivalent quantities of an irrelevant heterogeneous antigen had no immunosuppressive effect, and suppression was transferable using spleen cells from parasite antigen-treated donors. The differential immunomodulatory activity of parasite antigens from a variety of nematode species suggested that a correlation might exist between suppressor activity and chronicity of infection. A role for suppressor T cell activity in the infected host was implicated by the restorative effect of 2'deoxyguanosine treatment on the immune response, and non-specific suppressor cell activity was detected in splenocyte populations from infected mice. It is suggested that a parasite-induced defect in antigen processing led to the induction of suppressor cell activity in the infected host and that this may be one mechanism of parasite survival. The relevance of these observations to vaccination against chronic gastrointestinal nematode infections is discussed.
Animals↗
Nematospiroides dubius: factors affecting the primary response to SRBC in infected mice.
Mice infected with Nematospiroides dubius were incapable of responding normally to i.p. or i.v. challenge with SRBC. The HA and PFC response to SRBC in infected animals was characterized by a severe depression of antibody to SRBC on day 4 and a reduced HA peak titre during the following week. The greatest depression of the response to SRBC was associated with an interval of 14 days between infection and the administration of antigen, suggesting that a particular stage of the parasite contributed significantly to immunodepression during this critical period. It was proposed that a combination of parasite induced damage to the intestine, release of parasite secretory/excretory products and loss of appetite by the host produced trauma during which the host was incapable of responding normally. However, mice given low-level and long-standing infections also showed reduced responses to SRBC, although these animals were not severely depressed. It is possible that this generalized weakening of host immunocompetence is the inevitable consequence of a parasite mechanism which operates more specifically to suppress the expression of homologous immunity at the intestinal level.
Animals↗
Safety and efficacy of atracurium (BW33A) in surgical patients receiving balanced or isoflurane anesthesia.
Atracurium was administered in a dose range of 0.027-0.4 mg/kg and dose-response curves were established for both balanced and isoflurane anesthetic techniques. With balanced anesthesia, ED50 and ED95 were 0.12 and 0.27 mg/kg, respectively, while with isoflurane they were 0.07 and 0.13 mg/kg and the least-squares regression line R2 values were 0.71 and 0.64, respectively. With balanced anesthesia there was a significant increase in systolic blood pressure at the 0.04 mg/kg dose (P = 0.02), while with isoflurane the systolic and diastolic blood pressures decreased at the 0.3 mg/kg dose (P less than 0.03). These changes were clinically insignificant. Atracurium is a potent nondepolarizing muscle relaxant which is potentiated by isoflurane. Its cardiovascular effects appear clinically nonsignificant. There is no evidence of histamine release.
Adolescent↗
An unusual occurrence of total anesthesia machine failure during administration of an anesthetic.
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Anesthesia, Inhalation↗
Dose-response study of intracoronary beta-radiation with 32P in balloon- and stent-injured coronary arteries in swine.
PURPOSE: A dose-response study was performed in swine to investigate the vascular effects of 32P over a broad range of doses in order to define the therapeutic window of intracoronary radiotherapy (ICR) with 32P. METHODS AND MATERIALS: A total of 131 porcine arteries were subjected to balloon injury or stenting followed by 0-36 Gy of ICR from a centered 32P source wire to 1 mm beyond lumen surface or a sham ICR procedure. Animals were euthanized at 4 weeks, and vessels were harvested for histomorphometry. RESULTS: In the balloon-injured arteries, doses of 7 and 9 Gy did not impact restenosis. At doses of 14-36 Gy, neointima was markedly reduced, with mild dilatation at the highest dose, 36 Gy. In the stent-injured arteries, the lowest dose of 9 Gy failed to reduce neointimal growth, while 14-26 Gy showed the most favorable response. CONCLUSIONS: ICR with 32P features a broad therapeutic window. Doses of 14-26 Gy to 1 mm beyond lumen surface provided an optimal combination of efficacy and safety. Doses of 7 and 9 Gy were generally ineffective, suggesting a minimum threshold for ICR with 32P to effectively inhibit restenosis.
Angioplasty, Balloon, Coronary↗
Clinical experience with a spiral balloon centering catheter for the delivery of intracoronary radiation therapy.
PURPOSE: To develop and evaluate an intravascular radiation delivery catheter that incorporates a centering mechanism and that allows side branch and distal artery perfusion. METHODS AND MATERIALS: The Galileo Centering Catheter (Guidant Vascular Interventions, Houston, TX) incorporates a rapid exchange tip design. A unique spiral balloon allows centering and facilitates perfusion to the distal artery and side branches. The catheter contains a dedicated dead-end lumen for source wire delivery to the lesion site. The treatment area is precisely defined by radiopaque markers. RESULTS: In three clinical trials to date, radiation (or placebo) was delivered successfully to 300 of 312 patients (96%). With balloon inflation, TIMI grade 2 or 3 flow was achieved in side branches in 82% and in the distal artery in 77% of patients. Despite treatment (dwell) times ranging from 87 to 948 s (mean = 250 s), only 8% of patients required fractionation of treatment. CONCLUSION: The Galileo Centering Catheter is a safe and highly effective method for delivering intracoronary radiation therapy. Its unique design provides centering of the source while allowing side branch and distal coronary perfusion during treatment. This catheter would facilitate intracoronary radiation therapy and allow uniform and reproducible dose delivery to the target in the artery wall.
Angioplasty, Balloon, Coronary↗
Does sympathetic ganglionic block prevent postherpetic neuralgia? Literature review.
BACKGROUND AND OBJECTIVES: To examine specifically the role of sympathetic block in the prevention of postherpetic neuralgia by its application in the treatment of acute herpes zoster. METHODS: Data sources included a Medline search and cross-referencing of articles and text books. A total of 84 references were reviewed. Peer-reviewed articles were selected according to their relevance to the subject and originality. The data were critically analyzed by the author with the specific intention of avoiding bias. RESULTS: The opinion of the medical community is divided on the role of sympathetic block in preventing postherpetic neuralgia because of the lack of controlled trials and the conflicting retrospective reports as to its effectiveness. While many reports promote the early use of sympathetic blocks during acute herpes zoster to prevent postherpetic neuralgia, others deny their value. CONCLUSIONS: Considering the degree of uncertainty, and the seriousness of postherpetic neuralgia, sympathetic block in addition to treatment with acyclovir should be considered early during acute herpes zoster. Large controlled trials are needed to provide the necessary scientific evidence.
Autonomic Nerve Block↗
Computed tomography-guided intercostal cryoanalgesia: a new technique.
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Cryotherapy↗
Exchange transfusion with red blood cells preserved in adenine clears a child of severe falciparum malaria.
Falciparum malaria may be associated with significant morbidity and mortality. The degree of mortality and morbidity usually corresponds to the degree of parasitemia. Quinine and other antimalarial drugs are relatively slow acting and not always effective owing to the presence of drug resistance falciparum. Rapid reduction of the number of circulating parasites may be required. Exchange transfusion has been used as a safe and quick approach to decreasing the parasitemia and antimalaria drugs used to eradicate the rest of the Plasmodium. In the present report, a case is described of a child with severe falciparum malaria who was successfully treated with exchange transfusion using the new adenine and mannitol enriched preservative media, Adsol.
Adenine↗