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Biomedical subjects

S Gross

Publications and source records attributed to S Gross.

285 records · Page 16Linked to original sources

Tricuspid valve prolapse: a common occurrence in the click-murmur syndrome.

Isolated mitral valve prolapse (MVP) may represent one end of a spectrum of disease involving dysfunction of multiple cardiac valves. Eighty-nine consecutive patients with MVP diagnosed by two-dimensional echocardiography (2-D echo) were prospectively studied specifically to determine the incidence of tricuspid valve prolapse (TVP) and its clinical correlations. Criteria for prolapse of the atrioventricular (A-V) valves by 2-D echo included extension of the valve leaflets behind an imaginary line defining the valve annulus. Forty-one of 82 patients with MVP had associated TVP. No significant differences existed between patients with isolated MVP and combined A-V valve prolapse with regard to sex, clinical history, symptoms, or physical examination. The parasternal long axis view was more sensitive than the apical four chamber view in diagnosing prolapse of either mitral or tricuspid valves. Thus, TVP is a frequent concomitant of MVP and occurs with equal frequency in both young and old patients.

Adolescent↗

The functional response of infants with persistent wheezing to nebulized beclomethasone dipropionate.

Lung function was measured in nine infants, ages 15-36 weeks, who had persistent wheezing, apparently following acute bronchiolitis, before and after 2 weeks of treatment with either inhaled nebulized beclomethasone dipropionate (BDP) or placebo in a randomized, double blind, crossover trial. The effect of nebulized albuterol (Salbutamol) was measured before and after the steroid treatment. Thoracic gas volume (TGV) and specific airway conductance (SGaw) were determined using a whole body plethysmograph, and forced expiratory flow at resting lung volume (VmaxFRC) was determined with a thoracoabdominal compression jacket. All infants had marked airways obstruction before treatment with mean +/- SE VmaxFRC of 24 +/- 4% predicted and SGaw of 37 +/- 5% predicted. Two weeks of placebo treatment had no significant effect on lung function, but after 2 weeks of BDP inhalation there was a significant rise in SGaw to 61 +/- 7% (P less than 0.005). VmaxFRC increased to 42 +/- 13% but the difference did not reach significance. Respiratory rate and clinical score for retractions and wheezing also fell significantly with BDP therapy (P less than 0.01 and P less than 0.001 respectively). Albuterol had no effect on lung function either before or during steroid therapy. Steroids may have a role in the management of persistent wheezing following bronchiolitis.

Administration, Intranasal↗

Lung function in infancy and childhood following neonatal intensive care.

Pulmonary function studies were performed in 11 neonatal intensive care survivors both during infancy and later in childhood. Lung function was compared with the respiratory support given in the neonatal period. The mean +/- SE thoracic gas volume was 96 +/- 4% predicted in infancy and rose to 122 +/- 8% predicted during childhood (P less than 0.005). The specific airway conductance (SGaw) in infancy was 57 +/- 7% predicted and rose to 90 +/- 8% predicted in childhood (P less than 0.0025). Abnormalities in SGaw were found only in ventilated infants, and there was a negative logarithmic correlation between the treatment score in the neonatal period and the SGaw in both infancy and childhood. The data indicate a long-term improvement in airway conductance of moderately affected infants with the development of mild hyperinflation in childhood possibly resulting from residual small airway abnormalities despite a symptomless clinical course. The residual abnormalities in prematurely born infants were in proportion to the intensity of treatment required in the neonatal period.

Child↗

Radiation-induced signal transduction. Mechanisms and consequences.

Over a dose range up to 50 Gy of low-LET (linear energy transfer) ionizing radiation and up to 5 kJ/m2 UVB, mammalian cells convert molecular damage into productive response (mostly gain of function). By inactivation of negative regulatory components, such as protein tyrosine phosphatases as one mechanism discovered, the balance between restraining and stimulating influences is disturbed and an increase in signal flow results. Also DNA damage causing transcriptional arrest produces a signalling cascade of as yet unknown details. Such stimulation of the intracellular communication network can lead to apoptosis, elevated cell cycling and differentiation processes possibly including repair and recombination. The outcome likely depends on integration of all signals received which is as yet ill-understood. Although accurate determinations of low-dose inductions have not been achieved for technical reasons, the dose-response curves of induced signal transduction likely show threshold characteristics, in contrast to the direct consequences of DNA damage.

Animals↗

A walking blood donor program for seriously ill premature infants.

Premature infants with hyaline membrane disease and related disorders are frequently hypovolemic. Furthermore, they frequently require repeated phlebotomies for laboratory evaluation of electrolytes, pH, oxygen tension, and other parameters. Adequate care of such infants is aided by small transfusions of heparinized blood. The walking donor program at the Sacramento Medical Center premature nursery furnishes these transfusions without exposing the infants to the hazards of receiving blood from many different donors. The program is described in detail, and the shortcomings of some of the alternative programs are pointed out.

Blood Donors↗

Cyclic parenteral nutrition during allogeneic bone marrow transplantation.

Two adolescents who underwent successful allogeneic bone marrow transplantation were nutritionally managed on a fat-free cyclic parenteral nutrition (PN) regimen. Serum concentrations of prealbumin, albumin, and transferrin were prospectively evaluated to assess the efficacy of nutritional therapy. Both patients tolerated the cyclic PN metabolically. Serial albumin and transferrin concentrations varied slightly and were less sensitive indices of changing nutritional status. In contrast, prealbumin concentrations decreased uniformly during periods of metabolic stress. At the cessation of Pn therapy, all serum proteins were within the normal range. Cyclic PN appears to be a safe, practical approach to the nutritional management of patients undergoing bone marrow transplantation.

Adolescent↗

A case of chromomycosis treated by a combination of cryotherapy, shaving, oral 5-fluorocytosine, and oral amphotericin B.

A case of chromomycosis from Comoro Islands was first treated without success with high doses of oral amphotericin B (3 g per day). Treatment with itraconazole (400 mg per day) was also unsuccessful. Then, in vitro tests were done to study the susceptibility of this Fonsecaea pedrosoi strain to antifungal drugs. It was resistant to itraconazole, sensitive to 5-fluorocytosine, and the combination of 5-fluorocytosine with amphotericin B was synergistic. The patient was then treated with this last combination of drugs, which seemed to be effective. The patient stopped this treatment after six months, and relapse occurred two years later. The best therapeutic strategy in cases of chromomycosis seems to be a combination of two drugs chosen according to the results of prior antifungal susceptibility testing.

Aged↗

A case of canine central nervous system cryptococcosis: management with fluconazole.

A three-year-old, female Labrador retriever was presented for acute generalized seizures. Disseminated cryptococcosis with central nervous system (CNS) involvement was diagnosed by serum and cerebrospinal fluid (CSF) fungal titers, histopathological examination, and magnetic resonance imaging (MRI). Fluconazole therapy resulted in prolonged, substantial clinical improvement for a period of one year. This report documents the diagnosis of a case of cryptococcal meningoencephalitis and its management with the new antifungal agent, fluconazole.

Animals↗

Printcultures for postmortem microbiology.

A modified printculture method for postmortem bacteriology was compared to the traditional tissue homogenate inoculum method. The two methods were comparable in their recovery rate of bacterial isolates. However, printcultures is an easy and rapid method; thus, it is superior to the traditional technique for postmortem culture. Histologic examination of most postmortem lung specimens with no bacterial growth showed no evidence of pneumonia or bronchitis, suggesting that the lack of growth is a reliable indicator of no bacterial infection.

Bacteriological Techniques↗