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Biomedical subjects

T King

Publications and source records attributed to T King.

At least 91 records · Page 5Linked to original sources
PubMed1991

Brachial plexus palsy with the use of haloperidol and a geriatric chair.

An 81-year-old white man was admitted to an intermediate care facility because of increased wandering and confusion secondary to dementia. On the first day after admission, the patient tried to leave the facility and was hitting and kicking the employees. Haloperidol 0.5 mg tid was prescribed to help control his behavior. He became more agitated and confused; haloperidol was then increased to 1 mg qid and the patient was confined to a geriatric chair to prevent injuries. Cogwheel movements, rigidity, and marked sedation were documented. A right brachial plexus palsy was diagnosed. This case demonstrated the hazards of two commonly used interventions in a nursing home: antipsychotic agents and the geriatric chair.

Aged↗
PubMed1991

Maternal clofibrate administration amplifies fetal peroxisomes.

To study the effects of peroxisome proliferators on fetal biogenesis, 400 mg/kg oral clofibrate was administered to pregnant mice beginning at d 6 of gestation. Maternal/fetal tissues from three separate experiments were harvested between gestational d 13 and 19 and maternal/fetal tissues were assayed for peroxisomal matrix, membrane-associated, and integral membrane proteins. By comparison to control pregnancies that received vehicle only, clofibrate produced a 4- to 5-fold increase in the levels of peroxisomal membrane protein 70, a 1.5- to 2-fold increase of dihydroxyacetone phosphate acyltransferase (DHAP-AT) sp act, and a 1.2- to 1.8-fold increase of catalase sp act in fetal liver of 19 d gestation. Fetal liver endoplasmic reticulum and peroxisomes were also amplified as visualized by electron microscopy. Clofibrate exhibited maximal effects on maternal tissues by 6 d of oral treatment with increases in peroxisomal membrane protein 70 occurring most clearly in maternal liver; DHAP-AT activity was increased in maternal liver, kidney, and brain but not in lung. Slight increases in DHAP-AT activities were evident in fetal brain, lung, and placenta as compared with the greater increases in liver and kidney. There was a general increase in peroxisomal proteins between 13 and 19 gestational d in all fetal tissues except placenta, and the effect of clofibrate was evident by gestational d 13 in lung and placenta. Minimal changes in the activities of acid phosphatase (lysosomal enzyme) or glycerol-3-phosphate acyltransferase (microsomal enzyme) were observed in maternal or fetal tissues although the latter enzyme was increased 10-30% by clofibrate in maternal brain, fetal lung, and placenta.(ABSTRACT TRUNCATED AT 250 WORDS)

ATP-Binding Cassette Transporters↗
PubMed1990

Evaluation of the need for follow-up in an out-patient clinic.

We have identified 164 patients regularly attending a chest clinic whose condition had been defined as stable on the basis of clear-cut criteria. These patients were randomly allocated to either routine follow-up at 3 monthly intervals (the 'follow-up' group) or annual follow-up (the 'discharge' group). After 1 year, on the basis of a questionnaire sent to the patients' general practitioners, there were no significant differences in outcome between the two groups apart from a just-significant increase in deaths in the 'follow-up' group. Nevertheless, at the conclusion of the trial clinic doctors felt that only 45% of patients and general practitioners that only 27% of patients should be discharged from the clinic. At the conclusion of the study patients in the 'discharge' group were significantly more likely to feel that they had been attending too infrequently and that their condition had worsened, although the latter was not borne out by objective data. We suggest that all these patients could have been discharged from the clinic without any difference in outcome. This study highlights the reluctance of clinic doctors and general practitioners to consider and effect the discharge of stable patients from routine clinic attendance.

Ambulatory Care Facilities↗
PubMed1989

Human rhabdosarcoma cell-induced aggregation of blood platelets.

The ability of tumor cells shed into the circulation to cause adhesion and aggregation of blood platelets may be involved in successful metastasis of primary tumors. Rhabdosarcoma is a rare, early metastasizing tumor previously uncharacterized for ability to alter platelet function. It was found that human rhabdosarcoma cells (American Type Culture Collection) dose dependently induce biphasic aggregation of human blood platelets in heparinized platelet-rich plasma; aggregation responses could also be elicited in citrated plasma. Aggregation caused by rhabdosarcoma can be inhibited by apyrase treatment of either rhabdosarcoma or platelets, and by pretreatment of platelets with prostacyclin, cilostamide, inhibitors of thromboxane A2 production, or TMB-8; only apyrase and prostacyclin inhibited both phases of aggregation. Tumor cell supernatant contained only enough ADP to cause a negligible, reversible aggregation response. Hirudin, verapamil, and triazolam do not inhibit rhabdosarcoma-induced aggregation. Aggregation of platelets by rhabdosarcoma cells thus appears to involve ADP, from tumor cells and/or platelets, and platelet calcium mobilization and thromboxane A2 synthesis and release.

Adenosine Diphosphate↗
PubMed1989

Do chest physicians follow-up too many patients?

We have examined the pattern of attendance of 750 randomly selected regular attenders at a chest outpatient clinic and sought the patients' views on the frequency of their follow-up appointments and the possible consequences of discharge to the care of the general practitioners. In addition, the clinic doctors and the patients' general practitioners were asked about the appropriateness of the frequency of follow-up and whether the pattern of attendance should change or the patient be discharged. Patients were most commonly seen at three monthly intervals. Clinic doctors felt that 24% and general practitioners that 9% of patients attended too often while only 2% of patients felt that this was the case. Clinic doctors recommended discharge for 28% and general practitioners for 21% of patients. Sixty-nine per cent of patients felt that their condition would be unchanged or would improve if they were discharged to the care of their general practitioners. Our findings suggest that at least 20% of our patients should be discharged to the care of their general practitioners, and, if the patients are correct in their interpretation of the consequences of discharge, that as many as 70% could safely be discharged.

Adolescent↗
PubMed1989

A specific LTD4/LTE4-receptor antagonist improves pulmonary function in patients with mild, chronic asthma.

LY171883 is a new selective LTD4/LTE4-receptor antagonist. To evaluate the efficacy of LY171883, we studied 138 nonsmoking asthmatic patients, 18 to 65 yr old, in a double-blind, randomized block-design study. All patients were required to demonstrate a greater than or equal to 15% increase in FEV1 after inhaled bronchodilator use and were then randomly assigned to either LY171883 (600 mg) or placebo twice daily for 6 weeks. Assessment of efficacy was measured by inhaled metaproterenol use (mg/wk), symptoms, twice-daily peak expiratory flow, and weekly FEV1 measurements. LY171883-treated patients had improved FEV1 values upon completion of the treatment period compared with placebo recipients (p = 0.003). Metaproterenol use decreased in both groups, but treatment differences, though not statistically significant, favored LY171883 (p = 0.089). Of patients who used at least 23 mg/wk of metaproterenol (36 inhalations) at initiation of the study, those who received LY171883 used significantly less metaproterenol than those who received placebo (p = 0.007). LY171883 was well tolerated and reduced the need for a bronchodilator drug while improving pulmonary function. Results of this study support the hypothesis that leukotrienes LTD4 and/or LTE4 may be important in the pathogenesis of asthma in humans.

Acetophenones↗
PubMed1988

Rooms with a VDU.

Explore the source record for details and available documents.

Computer Systems↗
PubMed1987

Pulse oximetry for tapering supplemental oxygen in hospitalized patients. Evaluation of a protocol.

In a randomized study, we determined the clinical and financial effects of replacing arterial blood gas measurements with finger pulse oximeter readings during the process of tapering supplemental oxygen in hospitalized patients. The 16 patients in the control group, whose management followed conventional practice in our hospital, received a total of 57 arterial blood gas measurements during the 6.6 (mean) days it took for them to taper to their discharge supplemental oxygen level (usually room air). The 13 patients randomized to the oximeter study group had their arterial oxygen saturation monitored by pulse oximetry. The physicians of patients in the oximeter group were at liberty to obtain arterial blood gas determinations during the study if they desired. The oximeter study group had fewer (p less than 0.005) arterial punctures for blood gas measurements (total of 16 for the group) and fewer (p less than 0.001) days on supplemental oxygen (mean of 2.7 days per patient). We conclude that substituting noninvasive pulse oximetry for arterial blood gas measurements during reductions of supplemental oxygen shortened the days of oxygen use and decreased the number of arterial blood gas determinations in our patients. In addition to reducing the discomfort to patients, the use of oximetry was of financial benefit in that it reduced medical personnel time, blood gas analyzer use, and duration of oxygen administration.

Adult↗
PubMed1986

MRI in acoustic neuroma: a review of 35 patients.

This retrospective study is aimed to assess the diagnostic efficacy of MRI in relation to contrast enhanced CT and air-CT-cisternography. MRI examinations were performed in 35 patients with suspected neurosensorial damage and suggestive of acoustic neuroma: 27 presented on MRI with unilateral tumors, 3 patients had a bilateral tumor and 5 patients were negative on all imaging modalities. The total number of acoustic neuromas detected was therefore 33. To date microscopic analysis has been performed on 12 tumors and histological data based on type Antoni A and Antoni B classification is available. Contrast enhanced CT detected 19 tumors, yielding an overall sensitivity rate of 58%. Air-CT cisternography identified an additional 5 tumors with a sensitivity rate of 100%. MRI identified 33 acoustic neuromas in 30 patients and was negative in 5 patients (sensitivity and accuracy 100%). Considering sensitivity in relation to location, MRI was much better than contrast enhanced CT for internal auditory canal (IAC) tumors (100% versus 36%) and better for cerebello-pontine angle tumors (CPA) tumors (100% versus 68%). The evolution of MRI technique, the various pulse sequences used and their actual selection is discussed. Seven patients received a paramagnetic contrast agent (Gadolinium-DTPA) with the additional benefit of a better demonstration of the tumor. The results suggest that MRI is the best non invasive technique for demonstrating acoustic neuromas.

Adolescent↗
PubMed1983

Preliminary studies on the venom of the colubrid snake Rhabdophis subminatus (red-necked keelback).

Following the bite by Rhabdophis subminatus, preliminary studies were instituted on its venom to determine the mechanism of the clinical poisoning. A method for milking these snakes is presented. The i.v. LD50 in mice was 1.29 mg/kg. Three peaks were obtained on Sephadex G-100 and although none were lethal by themselves, a combination of two of the peaks produced immediate death in mice. The venom had no phosphodiesterase, fibrinolytic or thrombin-like activities, but it did have some phospholipase activity. Further biochemical and pharmacological studies are in progress.

Adult↗