Search PubMed⌕ Search

Biomedical subjects

R Hanson

Publications and source records attributed to R Hanson.

At least 73 records · Page 4Linked to original sources
PubMed1990

The natural history of nonalcoholic steatohepatitis: a follow-up study of forty-two patients for up to 21 years.

Forty-two patients with nonalcoholic steatohepatitis were followed for a median of 4.5 yr (range = 1.5 to 21.5 yr). Except for two patients with lipodystrophy, all were obese; 35 of 42 were women, 26 of 32 were hyperlipidemic and 15 were hyperglycemic. Upper abdominal pain was the most common reason for presentation. Initial liver biopsy specimens showed the presence of macrovesicular fatty infiltration, lobular (acinar) inflammation, apoptosis, Mallory bodies (in four cases) and fibrosis (in 18 cases). Cirrhosis was present at initial diagnosis in one subject and in another two subjects liver biopsy showed marked fibrosis with disturbed architecture. Serial liver biopsy specimens revealed minimal or no apparent progression of the disorder in most of the patients, in keeping with their benign clinical course. However, one patient showed progression from fibrosis to cirrhosis during the 5-yr observation period, and in the patients with extensive fibrosis the liver disease evolved from one of active inflammation to one of inactive cirrhosis without fat or inflammation. The patient with cirrhosis later died of hepatocellular carcinoma. The severity or type of hepatic change did not correlate with the degree of obesity, hyperlipidemia or hyperglycemia. However, in individual patients, poorly controlled diabetes and rapid weight loss preceded the onset of steatohepatitis. We conclude that nonalcoholic steatohepatitis is a cause of hepatic inflammation histologically resembling that of alcohol-induced liver disease but usually slowly progressive and of low-grade severity. However, the disorder may ultimately result in cirrhosis. Nonalcoholic steatohepatitis should be distinguished from alcoholic steatohepatitis and recognized as a further cause of "cryptogenic cirrhosis."

Adolescent↗
PubMed1988

The superiority of continuous cold blood cardioplegia in the metabolic protection of the hypertrophied human heart.

The effects of sanguineous and asanguineous cardioplegia on the generation of myocardial acid in the hypertrophied human heart during aortic clamping and reflow were elucidated by continuous intraoperative monitoring of myocardial pH in 42 patients undergoing valve replacement, with or without coronary bypass. The patients were divided into three groups: Group I (n = 14) received intermittent crystalloid cardioplegia; group II (n = 14) received intermittent blood cardioplegia; and group III (n = 14) received continuous blood cardioplegia. The groups were matched according to six previously elucidated determinants of myocardial acidosis. Measurements were made of myocardial pH, hydrogen ion concentration ([H+]), and the difference in pH units between myocardial pH and the pH of neutrality of water at the corresponding temperature (delta pHn). Throughout aortic clamping, myocardial pH in groups I and II fell significantly by 0.46 +/- 0.08 and 0.15 +/- 0.07 units, respectively (p less than 0.001) between the groups). In contrast, myocardial pH remained statistically unchanged throughout aortic clamping in group III (p less than 0.001 compared to groups I and II). Similar relationships were observed in [H+] and delta pHn during aortic clamping. During the early reflow, myocardial acidosis was observed in all three groups and delta pHn in group III increased from -0.26 +/- 0.10 at the end of aortic clamping to -0.57 +/- 0.07 during reperfusion (p less than 0.03). Patients in groups II and III required significantly less inotropic and mechanical cardiac support than patients in group I (p = 0.017). Hence, although continuous blood cardioplegia does not completely prevent acid accumulation during reflow, it provides better metabolic protection of the hypertrophied human heart than either intermittent crystalloid or intermittent blood cardioplegia.

Aged↗
PubMed1987

The effect of hypophysectomy on chloride balance in young-of-the-year bowfin, Amia calva.

The effect of hypophysectomy on chloride balance was examined in young-of-the-year bowfin, Amia calva. Hypophysectomy resulted in decreased serum and total body chloride levels but not in serum and total body sodium levels. Hypophysectomy resulted in decreased chloride influx with no effect on chloride efflux or sodium fluxes. Prolactin therapy reversed the effect of hypophysectomy on electrolyte balance but caused a significant reduction in serum protein.

Animals↗
PubMed1986

Relative tachycardia in ambulant children with borderline hypertension.

Borderline hypertensives who demonstrate tachycardia have a tendency toward the development of essential hypertension. However, the documentation of tachycardia in previous studies has been generally based on brief periods of observation. In the present study, we measured heart rates through a 24-hour period in 16 ambulatory mildly hypertensive subjects (ages 5 to 23 years). When compared with normal matched controls, significantly (p less than 0.05) higher heart rates were observed during the waking periods (99 +/- 9 vs 90 +/- 11) and sleep periods (72 +/- 12 vs 62 +/- 7). Similar observations were also made for 24 hours (90 +/- 8 vs 79 +/- 8). In addition, hypertensives also demonstrated thickened (during diastole) left ventricular posterior wall (0.96 +/- 0.17 vs 0.85 +/- 0.13 cm; p less than 0.05) and interventricular septum (0.98 +/- 0.17 vs 0.84 +/- 0.19 cm; p less than 0.05). It is suggested that tachycardia may be an early manifestation of borderline hypertension in children.

Adolescent↗
PubMed1985

Pulmonary carcinosarcoma and carcinoma: report of a case studied by electron microscopy, with critical review of the literature.

About 50 cases of pulmonary carcinosarcoma have been reported in the French and English literature. They have rarely coexisted with non-pulmonary neoplasms, never with other primary lung tumors. This report describes a 68 year old male smoker with a carcinosarcoma developing in the right upper lobe, one and a half years after a left upper lobectomy for a scar adenocarcinoma. By light microscopy, there was an admixture of adenocarcinomatous, chondrosarcomatous, and malignant spindle cell and giant cell areas. Electron microscopy showed well and poorly differentiated epithelial, smooth muscle and cartilaginous elements. This case is of interest because of its occurrence with another lung primary tumor; the specific diagnosis was made by transthoracic needle aspiration; and of the ultrastructural features. In the literature, carcinosarcomas have been divided into an endobronchial type, in which the carcinomatous component is squamous in 91% of cases, and a peripheral type, in which it is glandular in 50% of cases; the sarcomatous component shows no such correlation with type. The theories for the histogenesis of these tumors revolve around the concept that the carcinoma is the principal element, and the sarcomatous or stromal change secondary. Therefore, on the basis of this case, and of our literature review dealing with the pathology, clinical features and histogenesis of these tumors, we suggest that carcinosarcomas share important features with lung carcinomas.

Adenocarcinoma↗
PubMed1983

Lung structure as a risk factor in adverse pulmonary responses to asbestos exposure. A case-referent study in Quebec chrysotile miners and millers.

To investigate the hypothesis that lung structure may predispose to the development of asbestos-related pulmonary fibrosis, we carried out a case-referent study using data gathered in a cross-sectional study of Quebec chrysotile asbestos miners and millers. Tracheal and thoracic measurements were derived from the routine chest radiographs of 44 men with established radiologic fibrosis and compared with similar measurements for 88 men matched for age and cumulative exposure in the same industry who had not developed pulmonary fibrosis. Intrathoracic tracheal lengths were, on the average, shorter, and transthoracic diameters narrower in cases compared with those in referents. In addition, cases were shorter than the referents, suggesting that height might be an indirect measure of the structural characteristics relevant to the response to inhaled asbestos particles. Our findings are thus consistent with the hypothesis outlined, and they suggest a line of investigation that might be useful in relation to other inhaled pollutants.

Adult↗
PubMed1983

Diagnosis of maternal cystic fibrosis during pregnancy.

The third and fourth cases of maternal cystic fibrosis diagnosed during pregnancy are presented. Quantitative pilocarpine iontophoresis (sweat chlorides) must be performed to establish the diagnosis. Other important findings include recurrent or persistent respiratory symptoms, chest x-ray abnormalities, abnormal pulmonary function studies, and abnormal arterial blood gases. Gastrointestinal tract dysfunction and a positive family history for respiratory disease also suggest the diagnosis. Pregnant patients with cystic fibrosis require careful and frequent cardiopulmonary and gastrointestinal surveillance. A higher incidence of premature labor is noted and all patients are best managed in tertiary referral centers. Patients should also be monitored carefully during the puerperium because maternal pulmonary decompensation may occur during this time.

Adolescent↗
PubMed1982

Congenital neuromuscular disease with type I fibre hypotrophy, ophthalmoplegia and myofibril degeneration.

We report a 7-year-old boy with progressive, early onset somatic and cranial muscle weakness associated with external ophthalmoplegia, facial weakness, type I fibre hypotrophy and myofibril degeneration. We separate this condition from congenital fibre type disproportion because of the facial weakness, ophthalmoplegia, central nucleation, and lysis in type I fibres. The case, which is similar to that described by Bender and Bender (1977), nosologically should be classified between the centronuclear myopathies and congenital fibre type disproportion, and most likely represents a congenital or neonatal disturbance of trophic interaction between nerve and muscle.

Blepharoptosis↗
PubMed1981

Distress reduction and the effects of preparatory teaching films and patient control.

Fifty patients undergoing nasogastric intubation for gastric analysis participated in an experiment comparing the distress-reducing effects of four different types of information about an unpleasant procedure. Filmstrips depicted the procedure only; the procedure with common distressful sensations; the procedure with coping behaviors; and the procedure with coping behaviors to relieve common distressful sensations. Patients were also tested on their preference for control. Distress was measured by self-ratings on a 10-item Nasogastric Intubation Checklist. Pain, discomfort, and anxiety pre-, during, and postmanipulation- intubation were measured on a visual scale. Willingness to repeat the procedure was measured on a four-point scale. The study showed that: (a) Procedure with sensory and coping behavior information was effective in decreasing discomfort, pain, and anxiety for control and no-control preference subjects during and after the procedure, but was most effective in reducing intubation distress for subjects preferring no control. (b) Sensory information led to greater willingness to repeat the procedure. (c) Perceived control had little effect on distress reduction.

Adolescent↗