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Biomedical subjects

R Merchant

Publications and source records attributed to R Merchant.

At least 19 recordsLinked to original sources
PubMed1994

Outcome of the treatment for sarcoidosis.

The clinical characteristics and pathology of sarcoidosis are well defined; however, the optimal therapy for this disorder remains unclear. Although patients respond, acutely, to corticosteroid therapy, it is not clear that these agents ultimately alter the natural history of this disease. These observations and that corticosteroids have significant side effects suggest that only patients who will clearly benefit from corticosteroid therapy should be treated. In a prospective study of patients' with sarcoidosis (n = 98), we limited our use of corticosteroids to those patients who had objective evidence of recent deterioration in lung function or serious extrapulmonary disease. All patients with sarcoidosis fulfilling these criteria were treated with corticosteroids. Patients were tapered off corticosteroids after they were treated for 1 yr. Of the 98 study subjects, 91 had not received therapy for the disease and 7 were on therapy before entry into the study. Of the 91 previously untreated patients, 55 were observed without therapy and 36 were treated with corticosteroids. Of those who were observed off therapy, only eight deteriorated. Of these latter patients, six responded and stabilized with the administration of corticosteroids for treatment of the underlying disease, to antibiotics for an associated bronchiectasis, or to diuretics for treatment for congestive heart failure; two were lost to follow-up. None of these six patients deteriorated while receiving corticosteroids. Of the 36 patients who deteriorated and were treated with corticosteroids, 20 remained stable and 16 improved clinically. Of the 37 patients who were eventually tapered off corticosteroids, five deteriorated and required reinitiation of corticosteroid therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Correlation between integrated evoked EMG and respiratory function following atracurium administration in unanaesthetized humans.

In six healthy volunteers, integrated evoked electromyography (IEEMG) measured in response to ulnar nerve stimulation was correlated with respiratory function-tidal volume (VT), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum negative inspiratory pressure (NIP), hand grip (HG) and head-lift during steady-state infusion of subparalytic doses of atracurium. Studies were carried out at train-of-four T4/T1 = 0.2 and T4/T1 = 0.6. When T4/T1 = 0.2, all subjects had difficulty with swallowing and phonation, none could sustain any head-lift and HG was 26 per cent of control. However, VT was normal, FVC was 80 per cent, FEV1 was 82 per cent, and NIP was 50 per cent of control. AT T4/T1 = 0.6, all assessments of peripheral strength were normal, and all respiratory measurements were not significantly different from control, except for NIP which was 73 per cent of control (P less than 0.05). We conclude that an IEEMG of 0.6, recorded from the hypothenar muscles, in unanaesthetized subjects is consistent with near normal respiratory function.

Adult↗
PubMed1989

Endoscopy in the diagnosis of genital tuberculosis.

From 1977 to 1986, endoscopy (laparoscopy, cystoscopy and hysteroscopy) was used in the evaluation of women for pelvic tuberculosis. Among 687 cases of diagnostic laparoscopy, pelvic tuberculosis was suspected in 101 (14.7%) from the appearance alone. The appearance was correlated with other criteria for the diagnosis. Definitive evidence was found in 70 cases. All 101 patients were placed on an antibiotic. Seventy-three patients reported for follow-up for more than two years. Of them, six (8.2%) were judged to be cured. Thirty-eight (52.05%) improved as determined by second-look laparoscopy and/or negative histopathology or hysterosalpingographic evidence. Eleven women (15.06%) had an intrauterine pregnancy; nine delivered normally, and two underwent termination of pregnancy for medical reasons. There were three tubal pregnancies (4.1%). In 15 cases (20.5%) the disease remained stationary.

Cystoscopy↗
PubMed1988

Cardiopulmonary toxicity of adoptive immunotherapy.

Adoptive immunotherapy, the administration of interleukin-2 (IL-2) and interleukin-2 activated cells, leads to tumor regression in some patients with advanced cancer. Although this new therapeutic modality offers hope for the future, at present, a multitude of toxicities limit the total dose and duration of therapy. Among the toxic side effects a purported third space or vascular leak syndrome is the most serious. In this review, we detail the evidence for a third space syndrome (peripheral edema, ascites, oliguria, elevated serum creatinine levels) and cardiopulmonary dysfunction (hypotension, respiratory distress, pulmonary edema, hypoxemia) with adoptive immunotherapy in human and animal studies. We conclude that IL-2 administration is associated with increased pulmonary microvascular permeability, infiltration of the lung parenchyma with large esterase negative lymphoid cells, hypoxemia, systemic hypotension, positive fluid balance and, in animals, transient pulmonary hypertension. These abnormalities do not seem to be caused by IL-2 directly; the causes may be mediated by IL-2 activated lymphocytes or other IL-2 activated cellular mediators.

Animals↗
PubMed1982

Glia cell stimulating factor (GSF): a new lymphokine. Part 1. Cellular sources and partial purification of murine GSF, role of cytoskeleton and protein synthesis in its production.

The effect of activated-lymphocyte supernatant on glia cells was investigated. When treated in vitro with Concanavalin A (ConA), murine spleen cells released a soluble product, termed glia cell stimulating factor (GSF), which stimulated RNA and DNA synthesis in cultured murine glia cells. Furthermore, GSF appeared to promote the maturation of undifferentiated glia cells to astrocytes having a high content of glial fibrillary acidic protein. GSF secretion occurred after a lag period of 16 hours and proceeded at a constant rate for more than 48 hours. This GSF produced by ConA-stimulated murine lymphocytes has an apparent molecular weight between 60,000 and 80,000. Antigenic stimulation of primed lymph node cells with BGG resulted in a similar GSF production. Cellular sources of mitogen-induced GSF were investigated by using isolated lymphoid populations. GSF release by ConA-activated pure T-lymphocytes reconstituted with peritoneal macrophages was equivalent to that of unseparated spleen cells, whereas GSF production by T-lymphocytes alone was low. Macrophages alone did not elaborate detectable levels of GSF. GSF was also secreted by enriched -B-lymphocytes populations stimulated by Protein A. Formation of GSF was suppressed when cytochalasin B or cyclo-heximide was added to the cultures, while colchicine failed to have any effect. DNA synthesis is not required for GSF production as determined by resistence to treatment with mitomycin C. The data indicate that the GSF production and secretion mechanism is much like that described for other lymphokines.

Animals↗