Secondary patient transfer by air: an audit of 3 years' experience of the Royal Air Force in the world-wide transport of critically ill patients.
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Biomedical subjects
Publications and source records attributed to S J Hunter.
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In a single-blind, randomised trial, 50 consecutive adult patients for inguinal herniorrhaphy under general anaesthesia received either an inguinal field block or bupivacaine instilled into the wound to provide postoperative analgesia. Bupivacaine instillation was found to be simple, safe and effective. The method is particularly appropriate for day-case surgery.
A potent inhibitor of carbonic anhydrase, 5-[3-hydroxybenzoyl]thiophene-2-sulfonamide (HTS), was shown to cause a 37% reduction in the area of resorption pits formed by isolated chick osteoclasts when used at a dose of 10(-7) M. HTS at doses of 10(-9) and 10(-7) M was also effective in reducing acid formation by the osteoclasts (14 and 36%, respectively). Additionally, the effect of HTS was found to be readily reversed by removing the agent, showing that it does not exert a toxic effect on the cells. This study indicates that the inhibitory effect of HTS on bone resorption is at the level of the acid-forming mechanism in osteoclasts and supports the view that carbonic anhydrase has a central role in the process.
We describe the performance of the pneuPAC hyperbaric variant HB, a ventilator designed for use in a one-man hyperbaric chamber. The ventilator delivered minute volumes of 11-23 litre at 1 atm abs to 7.6-16 litre at 2.5 atm abs. The delivered minute volume may be controlled easily from outside the chamber by manipulation of the ventilator rate, 11.5-31 b.p.m.
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Primary malignant melanoma is a very rare tumour of the oesophagus, and although this is the first case reported in a black patient in South Africa, the clinical, radiographic and histopathological features were characteristic of this malignancy. Primary oesophageal melanoma is a highly lethal tumour--fewer than 2% of patients are surviving 5 years after diagnosis. Flow cytometric DNA analysis of the resected specimen in this case revealed two populations of malignant cells, one of which had grossly abnormal DNA. Existence of two clones of malignant melanoma cells supports the observations that this tumour is biologically aggressive, radioresistant and almost always incurable.
Plasma insulin-like growth factor-I (IGF-I) concentrations are reported to decline with advancing age. Five IGF-binding proteins (IGF-BPs) have recently been characterized in human serum, although their biological role beyond circulatory transport of IGF-I is unknown. We studied plasma IGF-I (by RIA) and serum IGF-BPs (by Western ligand blotting) in healthy elderly (n = 21) and healthy young (n = 22) women to determine if aging alters IGF-I and its high affinity BPs. Plasma IGF-I was significantly lower in the elderly than in the young group (0.78 +/- 0.08 vs. 1.22 +/- 0.11 U/ml; P less than 0.005). The number and size of IGF-BPs did not differ between age groups, but the IGF-BP binding ratios (binding of one BP fraction/binding of all fractions) for the BP-53 acid-stable complex (41.5K and 38.5K BPs), the 30K IGF-BP, and the 24K IGF-BP were all lower in the elderly than in the young group (P less than 0.01 for each fraction, elderly vs. young). In contrast, the 34K IGF-BP binding ratio was significantly greater in the elderly than in the young (0.30 +/- 0.03 vs. 0.12 +/- 0.01; P less than 0.001) and correlated closely with advancing age (r = 0.64; P less than 0.01). The changes in IGF-BPs found in the elderly are quite similar to alterations in serum IGF-BPs previously reported in GH deficiency. Since several IGF-BPs in vitro have been shown to modulate the mitogenic activity of IGF-I, the serum IGF-BP changes noted above may be important for the growth and maintenance of connective tissue, muscle, and bone during the aging process.
Prognosis in oesophageal cancer is directly related to depth of invasion and lymph node metastases. However, without surgical exploration, assessment of the spread of oesophageal cancer is notoriously inaccurate and there is a need for another objective measurement of prognosis. In this study, the relationship of DNA-ploidy status to tumour length, histological appearance, extra-oesophageal spread and survival was examined in 42 patients with squamous oesophageal cancer. No correlation was found between DNA-ploidy status and tumour length or histological appearance. But the DNA-aneuploidy rate in cancers with extra-oesophageal spread was significantly greater than the rate in tumours localised to the oesophagus (P = 0.038). Short-term survival was poorer in patients with DNA-aneuploid cancers than in those with a DNA-diploid pattern. DNA analysis may prove to be a more accurate guide to prognosis in oesophageal cancer than either clinical or operative staging.
We investigated the effects of calcitonin (CT) and parathyroid hormone (PTH) on the distribution of actin, tubulin, vimentin, and on cell size in cultured chick osteoclasts. In addition, we studied the effects of colchicine on intracellular acidity. Osteoclasts were isolated from the endosteum of 2-3-week chick tibias and were maintained under culture conditions for 5 days. The cells were treated with CT for 30 min or PTH for 60 min and were observed after immunocytochemical staining of cytoskeletal proteins. In untreated cells, actin was found in both a filamentous and a punctate staining pattern, with indented or invaginated regions free of punctate spots. The tubulin distribution in untreated cells was characterized by a pattern of microtubules radiating from the cell center and running parallel to the cell edge. Vimentin staining was usually localized to the perinuclear area. There were no changes in cytoskeletal element distribution or morphology attributable to PTH treatment. Osteoclasts treated with CT were more irregularly shaped, contained more retraction fibers, and were more rounded, with a denser array of cytoskeletal elements in the cell center. In addition, the mean area of the CT-treated cells was significantly less than that of the untreated cells. The actin distribution after CT treatment was still characterized by both a filamentous and a punctate pattern. After CT treatment, vimentin staining appeared more centrally localized than in untreated cells and tubulin staining revealed microtubules which now extended to the retracted cell margin. These results indicate that isolated osteoclasts respond to CT by significant morphological changes which are reflected in the distribution of the major cytoskeletal elements. Disruption of the microtubular system by colchicine treatment also resulted in an initial increase in intracellular acidity, suggesting the involvement of microtubules in the movement of acid-laden vesicles to the exterior.
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Spontaneous emergence of fast-growing cells in prolonged culture of pleural effusion cells obtained from a patient with breast cancer has led to the establishment of a cell line designated as SH-3. By morphological criteria, as revealed by light and electron microscopy, SH-3 cells are epithelial and resumble the poorly differentiated cells of a series of established human tumor cell lines. Their karyotype is hypotetraploid and different from that of HeLa cells. Isoenzyme analysis has shown the presence in the cells of a bone-type alkaline phosphatase and of the fast (A) band of G6PD. The line is free of mycoplasma.
A continuous tissue culture line (SH-4) derived from pleural effusion cells of a patient with metastatic melanoma is described. The cells became established after five passages lasting a period of 5 months of slow growth. Doubling time of the continuous culture was 20 hr in passage 51. The cell line is now in passage 60. The cells of all passages examined appear spindle-shaped or oligodendritic as seen by light microscopy. Pigment deposition in the cells is light and incomplete, but more marked than in cells of the original pleural effusion as shown by electron microscopy. Chromosome complement shows a single peak with a modal number of 51.