Biomedical subjects
Publications and source records attributed to S Wright.
A case of Gilles de la Tourette's syndrome (TS) is described, in which a state of akinesia developed during an attempt to withdraw lorazepam by diazepam substitution. This was followed by sustained amelioration of the TS symptoms.
Uvulopalatopharyngoplasty is a commonly used modality for surgical treatment of snoring and obstructive sleep apnea. Although this procedure is thought to alter pharyngeal properties, its effect on pharyngeal mechanics has not been studied. The acoustic reflection technique was used to measure pharyngeal area at functional residual capacity and residual volume before and after uvulopalatopharyngoplasty in eight patients referred because of loud snoring. We also calculated the lung volume dependence of pharyngeal area, defined as the percent change in pharyngeal area between functional residual capacity and residual volume, normalized to the area at functional residual capacity. This parameter, which may be related to pharyngeal collapsibility, was obtained before and after uvulopalatopharyngoplasty. Preoperative sleep studies showed that one patient had obstructive sleep apnea (apnea index greater than 10). Uvulopalatopharyngoplasty resulted in a significant increase (p less than 0.01) in pharyngeal area (from 3.14 +/- 0.71 cm2 to 4.25 +/- 1.07 cm2) and residual volume (from 2.49 +/- 0.53 cm2 to 3.91 +/- 0.83 cm2). Following uvulopalatopharyngoplasty, the pharynx became stiffer, as manifested by a reduction in lung volume dependence of pharyngeal area from 19 +/- 12% to 8 +/- 13% (p less than 0.05). Six patients, including the patient with obstructive sleep apnea, reported improvement in snoring. Two patients reported worsening in snoring. One of the two was found to have reduction in pharyngeal area and lung volume dependence of pharyngeal area, and an increase in apnea index from 3 to 33. In selected snorers, uvulopalatopharyngoplasty results in improvement in snoring with a concomitant increase in pharyngeal area and a tendency toward lower pharyngeal collapsibility.
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Three hundred twenty-one patients with traumatic head and spinal cord injuries were studied. Forty-two of these patients (13.1%) received psychiatric consultation services. Two types of consultation patients were identified--one receiving psychiatric consultation services in the acute-care hospital and one receiving psychiatric services in the post-acute care, long-term rehabilitation center. In order to assess the impact of psychiatric co-morbidities on hospital length of stay and charges, 40 consultation patients (23 acute and 17 rehabilitation) were matched to 87 control patients who received no psychiatric services. Matching was done on severity of injury, age, and sex. Psychiatric consultation cases had significantly longer stays than did matched controls. There were no differences on total charges.
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Disruption of membrane integrity and function has been reported previously as one of the predominant effects of magnesium deficiency. In the current study, we have examined the uptake and binding of calcium by intestinal brush border membrane vesicles from chicks and investigated the effects of Mg deficiency on these processes. Both uptake and binding of calcium were significantly decreased in the membrane vesicles from animals given the magnesium-deficient diet. In addition, the calcium-binding activity of proteins isolated by chromatography on DE-52 cellulose of mucosal extracts was altered by the magnesium deficiency.
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Eighteen patients (ages eight months to 20 years) with disorders of immunoglobulin and antibody production received infusions of two preparations of intravenous immunoglobulin in a blind crossover trial. The incidence and severity of immediate adverse infusion reactions was significantly lower with low pH immunoglobulin; ten patients (56%) experiencing immediate reactions with the standard preparation and only one patient experiencing an immediate reaction with the low pH preparation (p less than 0.01). Infusion times were significantly less with the low pH preparation (p less than 0.02) and patient tolerance, determined by visual analogue scores, was significantly better than with the standard preparation (p less than 0.01). However, the incidence of delayed reactions (44%) was the same for both infusions.
Protective effects of rIL-2 modulation on immune tumoricidal activity (cytolytic activity as expressed in LU/spleen) as well as tumor mass was examined in a murine malignant tumor model. Using rIL-2 and Adriamycin both separately and concurrently to treat an established in vivo murine tumor, we demonstrate immune cytolytic function associated with drug treatment is rescued with pretreatment of IL-2 prior to administration of cytotoxic drug (i.e., to have greater tumoricidal activity as determined by lytic units/spleen than either rIL-2 or Adriamycin treatment alone). Reduction of tumor mass was observed whenever IL-2 was administered. A significant inflammatory response was observed in animals with drug and IL-2 pretreatment. This data suggests a more effective approach to the treatment of this tumor model is pretreatment of IL-2 prior to administration of chemotherapy versus either IL-2 or chemotherapy alone.
Pretreatment or concurrent use of an immune augmentation substance with a cytotoxic agent could lead to synergistic tumor reduction by drug and immunomodulating agents (i.e. through improvement of in vivo immune function). Our objective in this study was to determine whether the combination of pretreatment with recombinant interleukin-2 (IL-2) followed by chemotherapy (adriamycin) would be a more effective treatment using the Madison 109 malignant tumor model than either drug alone or IL-2 alone. Our results demonstrate that the immune cytolytic function associated with drug treatment is enhanced with pretreatment of IL-2 prior to administration of chemotherapy over a course of several days to animals which have had previously implanted tumor. This combination appears to be a more effective approach than IL-2 or chemotherapy alone.
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