Search PubMed⌕ Search

Biomedical subjects

R Gale

Publications and source records attributed to R Gale.

At least 109 records · Page 6Linked to original sources
PubMed1986

Neonatal advantage of epidural anesthesia in elective and emergency cesarean sections: a report of 531 cases.

In 147 elective and 384 non-elective cesarean sections, the need for neonatal respiratory assistance at birth was significantly greater for babies born under general anesthesia compared to epidural anesthesia, and the differences could not be explained by differences in pre-operative risk factors. For 114 babies on whom blood gas data were gathered prospectively, a greater proportion born under general anesthesia were acidemic and hypercarbic. Our results complement a growing body of retrospective and clinical data suggesting that epidural anesthesia is preferable to general in all but a few cesarean sections. Ideally, this suggestion should be tested in a randomized clinical trial.

Acid-Base Imbalance↗
PubMed1984

Neutrophil activation by immune complexes and the role of rheumatoid factor.

Membrane activation of human neutrophils by preformed immune complexes and heat aggregated human gammaglobulins was studied by chemiluminescence. Strong neutrophil activation was found with human-albumin rabbit-antialbumin complexes prepared at equivalence, with maximal activation occurring in slight antigen excess. Furthermore different preparations of heat aggregated gammaglobulin which were of large size also showed similar activity. In contrast, heat aggregates of small size were inactive and blocked the chemiluminescent response found with larger active aggregates. A purified monoclonal rheumatoid factor with specificity for IgG modulated these responses when preincubated with preformed complexes or aggregates. Both enhancement of the neutrophil chemiluminescence response with inactive preparations and suppression of the response with highly active preparations were observed. Kinetic studies of the neutrophil chemiluminescent response varied with respect to the activating preparation, but were generally biphasic. This observation suggested an initial direct membrane activation followed by a more delayed response reflecting phagocytosis of complexes. We have demonstrated the direct activation of neutrophil chemiluminescence by laboratory preparations of immune complexes. The chemiluminescent responses observed were influenced by both the size and immunochemical properties of the activating complexes and by the presence of rheumatoid factor. These observations may have important implications in the immunopathogenesis of immune-complex-mediated diseases.

Animals↗
PubMed1983

An interactive microcomputer program for calculation of combined parenteral and enteral nutrition for neonates.

A responsive, iterating program is described (available on diskette from first author), which enables the physician to formulate a balanced, total parenteral nutrition (TPN) for low-birth-weight and sick newborns. The program allows for the possibility of TPN or simultaneous intravenous, intraarterial, and oral feeding. It calculates the overall balance of fluids, nutrients, calories, electrolytes, minerals, trace elements, and vitamins. It features the integration of algorithms and limit tests of nutritional balance, to produce a feeding program that can be modified by clinical considerations of the physician, specific for each patient. The entire procedure can be accomplished, and a record of the entries and orders to the pharmacy and to the ward staff printed, within about 4-5 min. The program, which is written in BASIC, can be accommodated within and operated with a 16K byte microcomputer, equipped with a monitor, a printer, and a diskette or other program storage device.

Computers↗
PubMed1983

The Rh antigen Tar (Rh40) causing haemolytic disease of the newborn.

Haemolytic disease of the newborn (HDN), in the fifth child of an Israeli of Moroccan origin, disclosed anti-Tar in the serum of the mother. This anti-Tar, the second reported example, is the first to cause HDN and was stimulated by previous pregnancies. Tests on blood from the family show that the Tar antigen in this family is associated with a CDe complex which gives rise to a weak expression of the D antigen. A study of 1327 donors in Jerusalem revealed one Tar + propositus.

Coombs Test↗
PubMed1983

Direct activation of neutrophil chemiluminescence by rheumatoid sera and synovial fluid.

The majority of paired sera and synovial fluids from 21 patients with rheumatoid arthritis produced a rapid chemiluminescent response when incubated with human neutrophils. Synovial fluid gave considerably higher responses than the paired serum specimen. In contrast little or no response was found with paired sera and joint fluid taken from patients with gout, psoriasis, and osteoarthritis and with sera from healthy donors. A similar chemiluminescent response was observed when neutrophils were preincubated with large aggregates of heated human gammaglobulin (HAGG), which were used as a model of immune complexes. Smaller nonreactive aggregates of gammaglobulin became reactive after preincubation with a purified monoclonal rheumatoid factor (mRF) which had a high avidity for aggregated IgG. The addition of this monoclonal rheumatoid factor also caused enhancement of chemiluminescence by rheumatoid sera. Further evidence suggesting that the active material found in these rheumatoid specimens contained complexed immunoglobulin was obtained by indirect immunofluorescence. Neutrophils developed intracellular immunoglobulin inclusions after preincubation in reactive rheumatoid sera but not with nonreactive or normal sera. However, activation of neutrophil chemiluminescence by rheumatoid specimens did not correlate significantly with levels of rheumatoid factor or immune complexes suggesting that the activating complexes were of a particular type. In conclusion we have shown the direct activation of neutrophil chemiluminescence by rheumatoid sera synovial fluid and suggest that the activation is caused by large IgG-containing immune complexes. It is possible that this activation may have important implications in the immunopathogenesis of the rheumatoid inflammatory process.

Arthritis, Rheumatoid↗
PubMed1982

Increased neonatal risk from the use of general anesthesia in emergency cesarean section. A retrospective analysis of 374 cases.

Three hundred seventy-four consecutive cases of cesarean section were reviewed retrospectively for differences in neonatal outcome with respect to method of anesthesia used. In 205 elective sections no difference in neonatal outcome was observed irrespective of anesthesia method. However, in 169 nonelective operations the proportion of neonates needing respiratory assistance at birth was twice as high in the group who received general anesthesia as in the group who received epidural anesthesia (25.3% vs. 12.8%). These preliminary results suggest that general anesthesia may increase the degree of central depression of the fetus already compromised by hypoxia before surgery. An investigation of this question on other sets of data and in a prospective trial should be done.

Anesthesia, Epidural↗
PubMed1981

Storage pool disease of platelets in an infant with thrombocytopenic absent radii (TAR) syndrome simulating Fanconi's anaemia.

This study reports the first example of 'storage pool disease' thrombocytopathia B (aspirin-like) in the family of a 4-month-old infant with thrombocytopenic absent radii (TAR) syndrome. In the infant and his father, platelet ADP and 5HT stores were normal, bleeding time was prolonged, released platelet anti-heparin activity, platelet aggregation (PA) to collagen and secondary aggregation to ADP were all significantly decreased and PA to l-epinephrine totally absent. Platelet function studies of the mother, a first cousin to her husband, were normal. This report provides further evidence to the hereditary nature of TAR syndrome. The impaired platelet function is a valuable aid in the diagnosis of TAR syndrome and Fanconi's anaemia.

Abnormalities, Multiple↗
PubMed1980

Thalassaemia as a model of recessive genetic disease in the community.

In order to gain understanding of some of the problems of genetic counseling for a severe recessive disease in England, a Greek Cypriot extended family including 87 living members and known to be transmitting a beta-thalassaemia gene was investigated for the extent and the sources of their knowledge about thalassaemia. 42% of members tested carried beta-thalassaemia trait: nearly half were already aware of this, but only 10% of the non-carriers were aware of their status. The study illustrated many of the difficulties in conveying accurate counselling to a whole community and the need for active involvement of all health workers, especially general practitioners. This study is also relevant to the approaching possibility of genetic counseling for cystic fibrosis.

Cyprus↗
PubMed1979

A syndrome resembling progressive systemic sclerosis after bone marrow transplantation. A model for scleroderma?

Six long term survivors of bone marrow transplants developed a syndrome similar to progressive systemic sclerosis (PSS). Cutaneous involvement (6/6), pulmonary disease (6/6), musculoskeletal involvement (4/6), keratoconjunctivitis/positive Schirmer's test (4/6), Raynaud's phenomenon (2/6), and renal and cardiac disease (1/6) were similar to findings in PSS patients. T and B lymphocyte counts and functions were also similar. This PSS-like syndrome, including visceral involvement, after bone marrow transplantation lends support to an immunologic hypothesis of the pathogenesis of progressive systemic sclerosis.

Antigen-Antibody Complex↗
PubMed1977

Propionic acidemia and anorectal anomalies in three siblings.

Three siblings suffering from recurrent vomiting, hypotonia, hyperpnea, dehydration, and ketoacidosis were diagnosed as having ketotic hyperglycinemia secondary to propionic acidemia. They also had leukopenia and thrombocytopenia, and two of them had anorectal malformations, one an imperforate anus with rectoperineal fistula, and the other an ectopic anus. The occurrence of propionic acidemia and anorectal anomalies in three siblings out of eight children in a consanguineous marriage suggests an autosomal recessive genetic inheritance.

Amino Acid Metabolism, Inborn Errors↗
PubMed1977

Accumulation of carbon dioxide in oxygen hoods, infant cots, and incubators.

The concentration of carbon dioxide in the air of oxygen hoods, infant cots, and incubators was found to be as high as 1% v/v (30 times the "fresh air" level of about 320 microliter/liter). The physiological and clinical implications of the consequent long-term exposure of infants to atmospheres of such composition are discussed.

Beds↗
PubMed1976

Human B-lymphocyte antigens expressed by lymphocytic and myelocytic leukemia cells. I. Detection by rabbit antisera.

A previously uncharacterized human B-lymphocyte antigen has been detected by rabbit antisera raised to papain digests of spleen cell membranes. The unabsorbed sera reacted in both cytotoxicity and immunofluorescent tests with normal B lymphocytes and cultured B-cell lines but not with normal T lymphocytes or cultured T-cell lines. The cytotoxicity titers against B cells were as high as 1:32,000, whereas the same sera undiluted were negative against T cells. By immunofluorescent staining 6-14% of unfractionated normal lymphocytes and 48-85% of B-rich lymphocyte preparations were positive. Normal peripheral blood granulocytes, platelets, erythrocytes, and phytohemagglutinin blasts were negative. The antisera reacted with the same high titers against leukemia cells from approximately 70% of the patients with acute lymphocytic leukemia, acute myelocytic leukemia, chronic myelocytic leukemia, and seven of eight cases of chronic lymphocytic leukemia. From absorption studies it appeared that the same antigen was being expressed by leukemia cells and normal B lymphocytes. Using immunofluorescent staining the anti-B-cell antisera were able to detect positive leukemia cells in the bone marrow of patients with advanced leukemia and to monitor the elimination of these cells after chemotherapy. Soluble B-cell antigen was found in the serum of some leukemia and lymphoma patients do but not in normal serum.

Antigens↗