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Biomedical subjects

S J Jay

Publications and source records attributed to S J Jay.

At least 73 records · Page 4Linked to original sources
PubMed1981

Fever response of patients on therapy for pulmonary tuberculosis.

The course of fever was examined in 75 patients with pulmonary tuberculosis treated with modern chemotherapy. Sixteen patients (21%) were afebrile and differed from 59 febrile patients (79%) by having lower incidences of the following: symptoms (p < 0.02), alcoholism (p < 0.01), lung cavitation (p < 0.01), "far advanced disease" (p < 0.05), and sputum smears containing "numerous" acid-fast bacilli (p < 0.01). Resolution of fever was variable (mean, 16 days; median, 10 days; range, 1 to 109 days). Thirty-eight patients (64%) became afebrile within 2 wk (group 1); 21 (36%) had fever for longer than 2 wk (group 2). Far advanced disease and high temperature (> 38.8 degrees C) on admission were more frequent in group 2 (p < 0.05 and p < 0.01, respectively). However, the groups did not differ in demographic features or in the frequency of symptoms on admission, alcoholism, lung cavitation, numerous acid-fast bacilli on sputum smears, or coexisting bacterial respiratory infection. Antimicrobial drug treatment of presumed coexistent bacterial infection in 19 febrile patients did not influence the course of fever. Analysis of variance and covariance were used to compare the independent effects of various antituberculosis drug regimens on the course of fever; no significant differences were observed.

Alcoholism↗
PubMed1981

Characterization of a spectrophotometric assay for angiotensin converting enzyme.

Although serum angiotensin converting enzyme (EC 3.4.15.1) activity has generally been shown to be increased in patients with sarcoidosis, considerable variation in the diagnostic usefulness of this test has been reported. We investigated the possibility that this variation may be the result of inhibition of the widely used spectrophotometric assay by various substances. We also prospectively examined the predictive value of measurements of this enzyme in serum from 100 patients being evaluated for sarcoidosis. The following did not significantly affect the results: storage at 4 or 25 degrees C for one week, hemoglobin, lipoproteins, or corticosteroid medications. Bilirubin, at concentrations of 20 mg/L of serum or move, significantly inhibited the assay. Sera with increased activity showed nonlinear reaction rates during the usual 60-min reaction interval, This was corrected by shortening the reaction time to 30 min. We found a predictive value of 88% when the serum angiotensin converting enzyme test was applied to the diagnosis of active sarcoidosis.

Acetylcholinesterase↗
PubMed1981

Pulmonary scintigraphy in fibrosing mediastinitis due to histoplasmosis.

The pulmonary scintigraphic findings from four patients with fibrosing mediastinitis due to histoplasmosis are reported. The ventilation/perfusion (V/Q) mismatch mimicked pulmonary emboli. However, in these cases the chest radiographs and/or gallium-67 scintigraphy were abnormal, suggesting mediastinal or hilar disease. Awareness of the nonembolic conditions that can result in V/Q mismatches is important in the interpretation of lung scans.

Adolescent↗
PubMed1980

Variability of the lateral position test in normal subjects.

An evaluation of the variability of the lateral position test (LPT) in normal subjects was undertaken. In 10 healthy, nonsmoking young adults, tests were performed in triplicate for 5 consecutive days. The results indicate that sizable differences in determinations of unilateral pulmonary function by the LPT can exist from day to day and from test to test on any given day in any given person. Variability of repeated measurements by the same observer and of measurements by different observers was minimal. In view of the great variability in repeated LPT results on the same subject, it is necessary to perform several tests in each subject before meaningful interpretation of the data can be made. This limits the usefulness of the LPT in the clinical assessment of unilateral pulmonary function.

Adult↗
PubMed1979

Pulmonary alveolar proteinosis: successful treatment with aerosolized trypsin.

A 37 year old man with pulmonary alveolar proteinosis and severe pulmonary physiologic impairment was treated empirically for 12 months with continuous oxygen, intermittent positive pressure breathing and aerosolized saline solution, heparin and acetylcysteine. Because of progression of disease, he was treated with aerosolized trypsin in a dose of 100,000 U twice daily for six months. This treatment was associated with dramatic symptomatic, chest roentgenographic and pulmonary physiologic improvement that has lasted for two and a half years without remission. The absence of adverse effects of trypsin aerosol allowed its administration in the patient's home. It is suggested that the preferred initial therapy for symptomatic alveolar proteinosis is aerosolized trypsin.

Adult↗
PubMed1977

Persistence of Mycobacterium tuberculosis in sputum without chest roentgenographic evidence of active disease.

Mycobacterium tuberculosis has been isolated consistently from sputum over an 11-year period in an asymptomatic 64-year-old man whose chest radiographs show evidence of healed primary tuberculosis (Ranke complex) but no evidence of parenchymal disease. A lymph node-bronchial fistula associated with the Ranke complex is the likely site of active tuberculosis; however, repeated examinations of the upper and lower respiratory tract have been normal. We attribute the persistence of infection in our patient to erratic usage of antituberculous drugs.

Humans↗
PubMed1977

Primary pulmonary sporotrichosis.

A 34-year-old alcoholic and drug addict developed cavitary pulmonary sporotrichosis that progressed slowly during 6 years. Pulmonary resection and pre- and postoperative therapy with amphotericin B were associated with prompt clinical improvement with no evidence of relapse during a 2-year follow-up. Histologic examination of lung revealed granulomatous inflammation with organisms consistent with Sporothrix schenckii, and interstitial talc (magnesium silicate) granulomas. The latter finding was consistent with the history of intravenous drug abuse. Although the presence of silicates in lung enhances the pathogenicity of some microorganisms, the relation of these findings to the pathogenesis of sporotrichosis in our patient is unclear.

Adult↗
PubMed1976

Determinants of lung bacterial clearance in normal mice.

The determinants of the lung clearance of Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus were studied in normal mice after exposure to an aerosol of viable bacteria and 99mTc-labeled dead bacteria. The fraction of bacteria in lungs that remained viable 4 h after exposure were: S. pneumoniae, 7.3%; K. pneumoniae, 121%; E. coli, 88.5%; S. aureus, 27.6%. The rate of physical removal of bacterial particles (Kmc) was determined from the change in lung 99mTc counts with time: Kmc ranged between 7 and 12%/h and and was similar in all species. The rate of mucociliary clearance and of intrapulmonary bacterial killing (Kk + Kmc) was calculated from the change in bacterial counts with time in animals that had received tetracycline to inhibit bacterial multiplication. Kk, the rate of intrapulmonary killing, was obtained by subtraction of Kmc from (Kk + Kmc). The calculated values for Kk were: S. pneumoniae, - 87%/h; K. pneumoniae, - 17%/h; E. coli, - 18%/h; S. aureus, - 22%/h. The rate of intrapulmonary bacterial multiplication (Kg) was estimated from the relationship of bacterial counts in tetracycline and nontetracycline-treated animals, assuming that tetracycline altered only Kg. Kg, expressed as the doubling time, was: S. pneumoniae, 310 min; K. pneumoniae, 217 min; E.coli, 212 min; S. aureus, infinity (no multiplication). The data indicate that the marked differences in the clearance of these species from the normal mouse lung result from the interaction of differing rates of in vivo bacterial multiplication and killing.

Aerosols↗
PubMed1975

The radiographic resolution of Streptococcus pneumoniae pneumonia.

To determine the characteristics of the radiographic resolution of bacteremic Streptococcus pneumoniae pneumonia we examined serial chest roentgenograms in 72 patients. Consolidation disappeared in all patients by eight to 10 weeks; volume loss (9 per cent), plural disease (9 per cent), and stranding (19 per cent) often persisted beyond eight weeks. Resolution occurred earlier in patients less than 50 years old (P less than 0.05) and in the absence of alcoholism and underlying airways disease regardless of age (P less than 0.05). Delayed clearing occurred when these complicating factors were present in patients over 50. Lung cancer was not responsible for delayed resolution of pneumonia. We conclude that an appropriate interval for serial radiographic examinations after therapy for pneumococcal pneumonia is six weeks.

Aging↗
PubMed1975

The course of untreated Mycobacterium kansasii disease.

Four patients with Mycobacterium kansaii pulmonary infection were followed without treatment for 10 to 14 years after diagnosis. Although spontaneous resolution of active disease occurred 5 years after diagnosis in one patient, slowly progressive disease in the absence of significant symptoms was documented in 3 patients during a 12-to-14-year follow-up period. Administration of antituberculous drugs resulted in rapid resolution of signs of active disease in these patients. These observations added to our limited knowledge of the natural history of M. kansasii disease.

Adult↗
PubMed1975

Respiratory complications of overdose with sedative drugs.

The records of 195 patients admitted to an intensive care unit with a diagnosis of sedative drug overdose were reviewed with special reference to respiratory complications. Endotracheal intubation with mechanical ventilation was required in 150 patients (77 per cent). Complications associated with mortality included difficult or traumatic intubation (P less than 0.001), initial hypotension (P less than 0.001), alveolar hypoventilation (P less than 0.02), and the presence of chest roentgenographic infiltrates (P less than 0.01). Infiltrates appeared on the chest roentgenograms of 72 patients (37 per cent) and were related to hypotension (P less than 0.05) and evidence of gastric aspiration (P less than 0.001). Eight of 9 deaths were due to progressive respiratory insufficiency, and bacterial pneumonia was documented at autopsy in 4 of 7 cases. High serum drug concentrations and the presence of shock or gastric aspiration on admission characterized the 9 patients (4.6 per cent) who died.

Adult↗