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Biomedical subjects

R Freeman

Publications and source records attributed to R Freeman.

At least 379 records · Page 21Linked to original sources
PubMed1977

Renal angiography and the management of severe closed renal trauma.

The purpose of this study was to determine the place of selective renal angiography in the assessment of major renal trauma. Thirty-one cases of renal injury assessed by urography and angiography were reviewed, and the radiological features correlated with the subsequent clinical course. Based on the angiographic findings, a classification of these more severe injuries is proposed, and the prognostic significance of renal ischaemia demonstrated. Because conservative treatment in those cases with significant ischaemia is likely to fail, early elective surgery is recommended. In this selected group, viable renal tissue can be preserved, and the necessity for subsequent nephrectomy due to secondary haemorrhage, or continuing urine leakage, is avoided.

Adolescent↗
PubMed1977

Metabolic studies on two patients with nonhepatic tyrosinemia using deuterated tyrosine loads.

Metabolic studies on two patients with defects in the tyrosine oxidation pathway are reported. Serum tyrosine was greatly elevated in both patients (1.37 and 1.52 mmol/liter, respectively) and both excreted large quantities of p-hydroxyphenylacetic acid, p-hydroxyphenyllactic acid, and p-hydroxyphenylpyruvic acid. Deuterated tyrosine loads were administered to both patients, before and after lowering of the serum tyrosine concentration by dietary treatment, and to a normal adult control subject. In one patient the excretion of the deuterated (D2)-tyrosine load was more than 300 times that found in the control subject whether the test was done at high or low serum tyrosine level and the pattern of metabolites indicated a persistent defect in p-hydroxyphenylpyruvic acid oxidase. Enzyme assays on needle liver biopsy supported this finding. In the second patient excretion of the D2 label was 300 times that of the control at high serum tyrosine levels, but only 5 times normal at low serum tyrosine levels. This finding was interpreted as indicating substrate inhibition of p-hydroxyphenylpyruvic acid oxidase. The primary defect has not been established in this patient, but the findings are compatible with a defect in hepatic-soluble tyrosine aminotransferase.

4-Hydroxyphenylpyruvate Dioxygenase↗
PubMed1976

A case of pneumococcal typhlitis.

A 29-year-old man had abdominal pain for 24 hours. This and the results of an abdominal examination were typical of acute appendicitis. He had suffered sinusitis for two weeks. At operation, the appendix was normal; there was an abscess in the cecal wall, the exudate of which grew pneumococci. Incidental appendectomy was done and the patient was treated successfully with lincomycin hydrochloride, and later, cephalexin monohydrate. It is possible that the typhlitis was secondary to the upper respiratory infection.

Adult↗
PubMed1976

Studies of maternal plasma prolactin and amniotic fluid prolactin. Effects of chlorpromazine and prostaglandin F2alpha.

We have studied the effect of chlorpromazine and PGF2alpha on the blood and amniotic fluid levels of prolactin over a 1-hour period of time in women who were in the 14th-20th week of gestation. Following intramuscular injection of chlorpromazine, maternal plasma prolactin rose 1.0- to 2.5-fold. No significant change was noted in maternal plasma after PGF2alpha administration. Amniotic fluid prolactin declined by 6 to 56%. These changes may be dilutional.

Amniotic Fluid↗
PubMed1975

Recognition of infection associated with intravenous catheters.

Four cases are described in which the patients suffered from bacteriaemia due to infected intravenous infusions. Although all the patients were pyrexial, the white cell count was normal in all 4 cases at diagnosis and the infusion site appeared innocent. Following removal of the intravenous catheter and the institution of antibiotic therapy in each case, neutrophilia and localizing signs developed. It is stressed that a normal white cell count and an innocent appearance at the infusion site do not exclude this complication of intravenous therapy. Possible reasons for this presentation for sepsis are discussed.

Adult↗
PubMed1975

Isolations of aerobic sporing bacilli from the tips of indwelling intravascular catheters.

Following previous reports of the isolation of aerobic sporing bacilli from intravenous catheters and infusion sets, it was decided to analyse a series of catheter tip cultures to ascertain the significance of these isolations. Those catheters from which aerobic sporing bacilli were isolated behaved statistically differently from other catheters from which organisms were isolated, but were statistically similar to sterile catheters. Using the nitroblue tetrazolium (NBT) test no significant difference was found between patients with isolates of aerobic sporing bacilli and those with sterile catheters. The NBT test readily distinguished those patients from whom other organisms were isolated. In a small number of instances some evidence of a possible pathogenic role for the aerobic sporing bacillus was found, but the results clearly indicate that in most cases these organisms can be regarded as contaminants.

Aerobiosis↗
PubMed1975

Analysis of results of catheter tip cultures in open-heart surgery patients.

A statistical analysis of 628 consecutive catheter tip cultures is presented. All were from patients undergoing open-heart surgery. The previously noted effects of early removal are shown to be significant. The possible effects of stasis, flushing, handling, and place of insertion are discussed. The unresolved significance of isolations of aerobic sporing bacilli is noted, and a decreasing incidence of postoperative infective endocarditis in the same group of patients is an encouraging sign.

Aspergillus nidulans↗
PubMed1975

Twenty-four-hour secretory patterns of gonadotropins and prolactin in a case of Chiari-Frommel syndrome.

Plasma LH, FSH and prolactin secretory patterns were derived from the measurement of 20-min interval plasma samples obtained during a complete 24-h period in a patient with persistent postpartum amenorrhea and galactorrhea (Chiari-Frommel syndrome), before and after clomiphene citrate therapy. During nocturnal sleep, polygraphic monitoring was carried out to precisely identify sleep onset, specific sleep stages and waking periods. During the evening and nighttime hours, LH and FSH concentrations were markedly reduced, compared to the daytime patterns both before and after clomiphene therapy. A sleep associated rise of prolactin concentration was present, similar to the pattern found in normal subjects but at higher concentrations. The reciprocal nature of the nocturnal secretory patterns for LH and FSH and prolactin in this patient suggests an alteration in hypothalamic dopaminergic mechanisms which are thougt to control the secretion of these hormones.

Adult↗