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Biomedical subjects

S C Hall

Publications and source records attributed to S C Hall.

51 records · Page 3Linked to original sources
PubMed1991

Anaesthetic management of Miller's syndrome.

Miller's syndrome is a rare congenital disorder with facial features similar to that of Treacher-Collins syndrome. This report details the anaesthetic management of an infant during multiple surgical procedures, beginning with pylormyotomy at one month of age. Airway management was difficult because of severe micrognathia and was accomplished using an awake intubation with a conventional straight blade modified for continuous administration of oxygen ("oxyscope"). Due to recurrent upper airway obstruction and the anticipated need for multiple surgical procedures in the first years of life, a tracheostomy was placed. Because of the multiple airway, orthopaedic, and nutritional difficulties, it is important that a prospective, multidisciplinary approach be used in these patients' care. Consideration should be given to early tracheostomy for airway maintenance.

Anesthesia, Inhalation↗
PubMed1991

Halothane potentiates the antitumor activity of gamma-interferon and mimics calmodulin-blocking agents.

This study reports effects of halothane on tumor cells in vitro. Cells from the human colon cancer cell line HT-29 were exposed to various concentrations of halothane for 8-72 h. The effect of this exposure on this colon cancer cell line, with and without coincubation with the biologic response modifier gamma-interferon (IFN-gamma), was studied. Using the tumor target cell survival (TTCS) assay, concentrations of halothane from 0.5 to 2% markedly augmented the antitumor activities of IFN-gamma against HT-29. The tumor cell cytostatic effects of IFN-gamma in the 0.75-6-unit/ml range were increased nearly 400% by concentrations of halothane as low as 1%. These results were confirmed in a separate cytolytic assay (Indium-111 release assay), which revealed that halothane concentrations in the 2-4% range markedly increased the cytolytic capacity of IFN-gamma at doses of IFN-gamma between 75 and 1,250 units/ml. The cytolytic activity of IFN-gamma was increased nearly 300% by doses of halothane as low as 1%. A nearly identical pattern of augmentation of IFN-gamma-induced antitumor activity was observed when the known calmodulin inhibitor trifluoperazine (TFP) was coincubated with IFN-gamma. At concentrations of 4-10 microM, the antitumor activity of IFN-gamma was increased nearly 400%. These observations suggest that the pattern of halothane potentiation of the antitumor activity of IFN-gamma is similar to that exhibited by known calmodulin inhibitors.

Antineoplastic Agents↗
PubMed1991

Mandibular fractures in an American inner city: the Harlem Hospital Center experience.

A retrospective study of 116 patients treated at Harlem Hospital for mandibular fractures between 1984 and 1987 was performed. Men comprised 84% of the population studied. The mechanisms of injury were assault with fists and blunt objects (33%), falls (10%), kicking (3%), penetrating injuries (3%), and vehicular accidents (1%). The body of the mandible (46%) and the angle (22%) were the most common fracture sites. Intermaxillary fixation with arch bars was the most frequent method of treatment (55%), followed by open reduction and internal fixation (33%). The complication rate with open reduction was relatively low (15%) despite the fact that 73% of these patients were heavy drug or alcohol abusers with documented poor oral hygiene. This study further substantiates the findings that in the poor inner cities, blunt trauma from drug-related violence has become the major cause of mandibular fracture. Treatment of these patients should include prophylactic broad-spectrum antibiotics, improved oral hygiene, and supplemental nutrition.

Adult↗
PubMed1991

Strategies for identification of covalent xenobiotic modifications in proteins by mass spectrometry.

The structural elucidation of covalent xenobiotic modifications in proteins is a powerful approach to identify compounds that may be responsible for genotoxic damage in humans. Many proteins, such as hemoglobin can be readily obtained in relatively large quantities. Since covalent modifications in proteins are not repaired, xenobiotic damage can accumulate over the lifetime of the protein and reveal exposure over extended time periods. Recently developed mass spectrometric methods are ideally suited to tackling protein structural problems involving covalent modifications. A variety of strategies to identify xenobiotic covalent modifications in proteins using mass spectrometry are discussed.

Amino Acid Sequence↗
PubMed1990

Anesthetic considerations in the pediatric cancer patient.

Cancer is second only to trauma as the leading cause of death in children 1-15 years of age. Pediatric cancer patients have unique physiologic, pharmacologic, and psychologic considerations that present a unique challenge to plan anesthesiologist. A thorough understanding of pediatric tumors, along with chemotherapeutics and their complications, is necessary to plan anesthetic management properly. Special attention is directed to the psychologic needs and preparation of both the patient and parents. Close cooperation and coordination among the pediatric oncologist, surgeon, and anesthesiologist are necessary for safe and expeditious operative care.

Adolescent↗
PubMed1990

Transoesophageal pacing for perioperative control of neonatal paroxysmal supraventricular tachycardia.

The perioperative management of a 16-day-old infant with recurrent supraventricular tachycardia (SVT) is discussed. Vagal manoeuvres and medication were not adequate in controlling the SVT. Since the patient was scheduled for extensive surgery in the prone position, it was decided to use transoesophageal pacing as the method of choice for conversion of SVT. Transoesophageal pacing succeeded several times in overriding the SVT and restoring normal heart rate and haemodynamic variables. The advantages and disadvantages of various methods of treating SVT in the newborn are discussed.

Cardiac Pacing, Artificial↗
PubMedDate not supplied

Sedation in pediatric patients.

Sedation is being used increasingly in children to allay anxiety and discomfort. Sedation can also increase the efficiency of performing both diagnostic and therapeutic procedures in children. There are a wide array of available sedation methods that are used by radiologists, gastroenterologists, hematologists/oncologists and emergency room physicians everyday. Indiscriminate use of sedatives has led to seizures, respiratory arrests and death in a variety of practice settings. With improved monitoring capability, more potent drugs and better understanding of the pharmacokinetics in children, it is possible to provide batter care.

Analgesics↗
PubMedDate not supplied

Do latex precautions in children with myelodysplasia reduce intraoperative allergic reactions?

Children with myelodysplasia have an increased incidence of latex allergy, which can lead to severe intraoperative allergic reactions. Despite widespread recommendations to avoid intraoperative latex exposure, little evidence exists to support the efficacy of this practice. We examined the incidence of intraoperative allergic reactions in children with myelodysplasia who underwent 1,025 operations in a 36-month period before and after institution of a standardized latex-avoidance protocol. Risk factors for an intraoperative reaction were found to be a history of latex allergy (p = 0.001) and surgery performed before institution of the latex-avoidance protocol (p = 0.01). The estimate of increased risk for allergic reaction was 3.09 times higher in cases performed without latex avoidance. Recognized violation of the protocol after its institution led to severe allergic reactions in three patients. Our experience suggests that a latex-avoidance protocol reduces intraoperative allergic reactions in children with myelodysplasia. Development of severe allergic reactions with violation of the protocol reinforces the importance of vigilance on the part of all operating room personnel in its implementation.

Child↗