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Biomedical subjects

R Smith

Publications and source records attributed to R Smith.

At least 1,567 records · Page 87Linked to original sources
PubMed1975

Pseudomyxoma peritonei-nonoperative management and biochemical findings. A case report.

The treatment of choice for pseudomyxoma peritoneai is surgical resection and removal of free mucus. Massive intra-abdominal reaccumulation of viscous mucus has usually been managed by repeat celiotomies. We characterized the mucus of one patient and showed large amounts of immunoglobulins and carcinoembryonic antigens. Intraperitoneal instillation of 5% dextrose and water made the mucus less viscous and easy to remove by paracentesis. The need for repeat celiotomies was obviated.

Carcinoembryonic Antigen↗
PubMed1975

Jejunal mucosal graft: a sutureless technic for repair of high bile duct strictures.

A simplified sutureless technic for the repair of high bile duct strictures is described. The technic combines the principle of a transhepatic tube together with a mucosal graft formed by removing a seromuscular patch near the end of a Roux-en-Y loop of jejunum creating a mucosal outpouching. The biliary tree is entered at the hilum of the liver and a latex rubber tube is drawn through the liver and anchored to the Roux-en-Y loop through the previously created mucosal diverticulum. The tube is pulled back into the liver carrying with it the sleeve of jejunal mucosa into the duct system in contact with the epithelium of the intrahepatic ducts. The technic is simple, easy, and quick. There is no difficult and tedious duct dissection of hepaticodochojejunal anastomosis to perform. It provides mucosa to mucosa approximation and eliminates the need for sutures through or near the mucosa to compromise the blood supply and prevent primary healing. The stent tube is easily removed without reoperation when desired. Finally, there is access to the biliary tree for daily irrigation, radiography, and cultures. From 1969 to 1972, sixty-one repairs were performed in fifty seriously ill patients utilizing the principles of this sutureless technic. All had had failure of previous attempts at repair with an average of 2.86 previous biliary tract operations per patient. Eight-five per cent of the patients have had an ultimately successful result. The mean postoperative hospital stay was only 19.6 days. Although the follow-up period is still short, these preliminary results are most encouraging.

Adolescent↗
PubMed1975

A modified assay for the detection of human adult active rosette forming lymphocytes.

A modified procedure is described for the detection of a sub-population of peripheral blood T-cells in normal human adults. This sub-population of T-cells has been called the active rosette forming cell by others. The advantages of this modified procedure compared with that previously described are: 1) the elimination of 60 mon incubation period for lymphocytes prior to the assay and 2) the elimination of the need for fetal calf serum in the assay. The mean percentage of RFC in the peripheral blood of 80 healthy adult controls using the modified procedure is 25.2+/-5.5% in buffer lacking FCS. The results were highly reproducible and comparable to the results obtained using the procedure previously described. It was concluded that a 60 min pre-incubation of lymphocytes and the use of FCS are not necessary when the appropriate SRBS: lymphocyte ratio is used in the determination of human adult active RFC. The use of this procedure in evaluating the immune competence of cancer patients is discussed.

Adult↗
PubMed1975

The effect of 1,25-dihydroxycholecalciferol on renal tubular reabsorption of phosphate, intestinal absorption of calcium and bone histology in hypophosphataemic renal tubular rickets.

1. 1,25-Dihydroxycholecalciferol (1,25-(OH)2-D3) was given at a dose of 5-0 nmol (2-1 mug) daily by mouth for 4-12 days to three patients with hypophosphataemic (type I), vitamin D-resistant rickets. 2. 1,25-(OH)2-D3 increased intestinal absorption and urinary excretion of calcium without significant effect on the renal handling of phosphate or its plasma concentration. 3. It is concluded that in this type of vitamin D-resistant rickets the renal phosphate abnormality is unlikely to be due to diminished endogenous production of 1,25-(OH)2-D3. 4. The difference between this condition and other hypophosphataemic states is discussed.

Bone and Bones↗
PubMed1975

Changes in the renal and extrarenal handling of phosphate induced by disodium etidronate (EHDP) in man.

1. The diphosphonate, disodium etidronate (disodium ethane-1-hydroxy-1, 1-diphosphonate; (EHDP), is known to increase plasma inorganic phosphate in man. The present study examines the mechanism of this effect. 2. When EHDP was given by mouth at a dose of 80 mumol (20 mg) kg-minus 1day-minus 1, plasma phosphate was significantly increased 24 h after the first dose but did not reach its maximum value for 2-3 weeks. When the drug was stopped, plasma phosphate returned to pretreatment values within 3 weeks. 3. Urinary excretion rate of phosphate was not greatly changed during treatment with EHDP despite the large increase in plasma phosphate, suggesting an alteration in renal handling. This was examined directly by infusing phosphate and inulin in six patients off and on EDPH. 4. EHDP had no effect on glomerular filtration rate (GFR) but produced a large increase in the maximum rate of renal tubular reabsorption of phosphate (TmP). The ratio Tm,P/GFR increased from a mean value of 1.15 mmol/1 to 2.10 mmol/1 on EHDP. This increase accounted for the hyperphosphataemia. 5. The same amount of phosphate infused at the same rate produced a greater rise in plasma phosphate when patients were on EHDP than when they were not, indicating a reduced net rate of entry of phosphate into tissues other than kidney. 6. Fasting total plasma calcium concentration and urine calcium excretion rate were not significantly altered by EHDP but the ability of infused phosphate to decrease plasma calcium was diminished. 7. It is suggested that EHDP alters phosphate transport in kidney and other tissues by a mechanism which is probably independent of the known hormonal influences on phosphate metabolism.

Administration, Oral↗
PubMed1975

Cervical cytomegalovirus excretion in pregnant and nonpregnant women: suppression in early gestation.

Comparison of 659 pregnant and 202 nonpregnant women with similar demographic characteristics showed overall rates of cervical cytomegalovirus excretion that were identical (9.5% vs. 9.4%) and were surprisingly high, especially since 89% of the pregnant group possessed antibody to cytomegalovirus when admitted to the study. Prevalence of cytomegalovirus among gravidas was significantly lower during the first (1.6%) than during the third (11.3%) trimester. Thus, early pregnancy appeared to exert a suppressive effect on viral excretion that waned with advancing gestation. A similar but less significant occurrence was observed in the two groups with respect to viuria. Increasing age also appeared to suppress the virologic expression of cervical and urinary tract infection, whereas multiparity seemingly produced such an effect only in the cervix. Among both cervical and urinary excreters, a few shed virus thoughout pregnancy, and others shed virus intermittently; however, viral shedding most commonly began in late gestation and frequently continued into the postpartum period. Primary infection was not documented, and antibody status remained unchanged with the advent of viral excretion in most cases. Thus, reactivation of endogenous virus seems the most likely explanation for viral shedding in our population. Similar rates of isolation of Neisseria gonorrhoeae in excreters and nonexcreters further argue against the other major possibility, venereal reinfection.

Amniotic Fluid↗
PubMed1975

Hormonal stimulation of ribosomal RNA synthesis in Achlya ambisexualis.

The experiments reported show that one of the early effects of the steroid sex hormone antheridiol is on the synthesis of rRNA and ribosomes. This is demonstrated in hormone treated cultures of Achlya ambisexualis (strain E87) by an enhancement of the incorporation of [3H]uridine into 26S and 18S rRNA and by an increase in measurable amounts of ribosomes per milligram dry weight of mycelium. Furthermore, since the hormone does not significantly alter the pool size or the specific activity of uridine triphosphate, this effect appears to represent an increased rate of RNA synthesis.

Fungi↗
PubMed1975

Medial conchal excision in otoplasty.

The most common cartilaginous deformities in protruding ears include an inadequate antihelical fold and an enlarged concha. We have employed medial conchal excision to correct deep conchas in 25 patients, all of whom were pleased with the postoperative result. Obvious wrinkling of the anterior skin occurred in four patients, and several patients displayed slight distortion of the helical crus. Medial conchal excision does not impede management of the antihelical fold with mattress sutures or by other means. We consider the risk of minor alterations of the concha justified if even slight distortion of the more conspicuous lateral auricle can be avoided.

Adolescent↗
PubMed1975

A new look at osteogenesis imperfecta. A clinical, radiological and biochemical study of forty-two patients.

In a clinical, radiological and biochemical study of forty-two patients from Oxford with osteogenesis imperfecta, it was found that patients could be divided simply into mild, moderate and severe groups according to deformity of long bones. In the severe group (seventeen patients) a family history of affected members was uncommon and fractures began earlier and were more frequent than in the mild group (twenty-two patients); sixteen patients in the severe group had scoliosis and eleven had white sclerae; no patients in the mild group had white sclerae or scoliosis. Radiological examination of the femur showed only minor modelling defects in patients in the mild group, whereas in the severe group five distinct appearances of bone (thin, thick, cystic and buttressed bones, and those with hyperplastic callus) were seen. The polymeric (structural) collagen from skin was unstable to depolymerisation in patients in the severe group, but normal in amount, whereas the reverse was found in the mild group. This division according to long bone deformity may provide, a basis for future research more useful than previous classifications.

Adolescent↗
PubMed1975

Coxsackievirus infection in mice.

White mice of the NYA: NYLAR strain were infected with coxsackie B1 or B4 virus and studied for persistence of virus, antibody conversion, histologic changes, and glucose tolerance during periods up to 13 months. Pancreatitis was observed during the acute phase of infection. Suggestions of subclinical diabetes were found during the first six months after virus inoculation. A normal glucose tolerance at 10 to 13 months suggestes that the functional lesion is temporary.

Animals↗
PubMed1975

Pyloromyotomy: Does surgery in infancy increase allergy?

One recently published article and several presentations at international meetings have suggested that there is an increased incidence of allergic and asthmatic manifestations, as compared with the general population, if a child undergoes surgery before the age of 2 years. The study explores the incidence of asthma and allergy in a group of patients who presented with pyloric stenosis. All of these underwent surgery. The technique of the study was a retrospective telephone review and the response rate was approximately 40%. The data show that there is no increase in the incidence of allergy or asthma in this population as compared with nationally reported figures.

Adolescent↗