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Biomedical subjects

W Smith

Publications and source records attributed to W Smith.

At least 289 records · Page 16Linked to original sources

Tentative diagnoses facilitate the detection of diverse lesions in chest radiographs.

The influence of clinical history upon detection has been frequently studied. In a unique investigation, detection of diverse abnormalities commonly encountered in practice was tested, and the influence of clinical history was conceptualized as suggesting a tentative diagnosis. Categorical prompts that were correct for specific abnormalities resulted in detection superior to that with unprompted reading. Prompts that were plausible but incorrect for abnormal and normal cases led to very few false-positive responses, and subsequent reports of specific abnormalities were as accurate as in unprompted reading. It is concluded that appropriate clinical history results in improved perceptual performance rather than simply improved decision-making.

Adult↗

In utero bladder diversion--problems with patient selection.

Based upon the concept that an obstruction-maldevelopment sequence is reversible after diversion, it has been suggested that the fetus with a bladder outlet obstruction is a potential candidate for in utero intervention. We report an infant who had both renal and pulmonary dysplasia at birth despite a technically successful diversion at 22 weeks' gestation. The poor outcome suggests that the organ damage either occurs so early that it precludes corrective surgery, or that the maldevelopment is not the result of obstruction, but rather a primary mesodermal defect.

Abdomen↗

A double blind trial of nitroglycerin vasodilator ointment in patients undergoing cytotoxic chemotherapy.

A randomized double blind controlled trial has shown that topical, nitroglycerin vasodilator cream applied to the intended injection site in patients undergoing cytotoxic chemotherapy for various malignancies, produced detectable vasodilation and a decrease in minor aids to venepuncture compared to placebo. It did not decrease the number of attempts at cannulation needed nor the overall cannulation failure rate and cannot be recommended for general use in cytotoxic chemotherapy clinics.

Administration, Topical↗

A comparative study of laser beam characteristics in blood and saline media.

Little information is available concerning the influences on laser radiation exerted by the various media through which lasing is done. The effects of saline solution and blood on argon laser beam divergence and projection were studied. In addition, the resulting effects on arterial tissue were evaluated after lasing through these media. This was performed with the fiber tip held in various positions relative to the arterial wall. The presence of blood, even in a diluted form, increased beam divergence and reduced forward projection. Perpendicular lasing through saline solution resulted in crater diameters similar in size to the core diameter of the fiber used irrespective of energy levels (424 +/- 97 microns at energy = 2 W X 5 seconds and 490 +/- 80 microns at energy = 2 W X 10 seconds). In contrast, lasing through blood produced much wider craters that increased in size with the higher energy level (878 +/- 215 microns at 2 W X 5 seconds and 1,294 +/- 314 microns at 2 W X 10 seconds). Arterial wall damage could also be inflicted at a greater distance when lasing through blood than through saline solution. Lasing arterial tissue through blood with the fiber tip held parallel to and in contact with the arterial wall resulted in wide craters when lasing was performed in a "static" as well as a "dynamic" fashion. Lasing through saline solution in these positions produced no visible damage to the arterial wall. These results provide some guidelines that may be useful in the clinical application of Argon laser revascularization.

Arteries↗

A new X-linked mental retardation syndrome.

We have studied a three-generation family with 11 moderately to severely retarded males and three mildly retarded females (presumably manifesting carriers). The patients have a phenotype different from that of all other previously described types of X-linked MR (XLMR). These include short stature, macrocephaly, "coarse" facial appearance including prominent forehead and supraorbital ridges, hypertelorism, broad nasal tip with anteverted nostrils, and thick lips. All postpubertal males had macroorchidism (volume greater than 25 ml). Chromosomes were normal including fragile X analysis. X-ray findings of skull, spine, and hands were normal. The intellectually normal relatives do not resemble their affected relatives except for increased head size and testicular size. These findings suggest a new variant of XLMR different from fragile X-linked MR, the Coffin-Lowry syndrome, and other XLMR conditions.

Dentition↗

Localization of an anti-CEA monoclonal antibody in colo-rectal carcinoma xenografts.

A mouse monoclonal anti-CEA antibody (11.285.14) has been examined for tumour localization potential by assessing its distribution in immunodeprived mice with xenografts of human colon carcinoma cell lines HCT-8, HRT-18, HT-29, and LS174T and a xenograft (HRVB) established from a primary rectal carcinoma. With four carcinomas (HCT-8, HT-29, LS174T, and HRVB) preferential tumour localization of 125I anti-CEA was seen. Compared with 131I normal IgG1 localization indices of up to 4.4:1 were achieved. Up to 10% of the injected dose of 125I anti-CEA was present/g of tumour tissue and with the largest xenografts examined (3-4 g) up to 40% of the total body reactivity was localized in tumour tissue. The tumour localization of 131I labelled antibody was visualized by external gamma camera imaging. Overall antibody localization correlated with the CEA content of the xenografts and the fourth colon carcinoma xenograft (HRT-18) and an osteogenic sarcoma xenograft (791T), both with very low CEA levels, showed no localization of the monoclonal antibody.

Animals↗

Assessment of the antidiabetic activity of epicatechin in streptozotocin-diabetic and spontaneously diabetic BB/E rats.

(-)-Epicatechin has previously been suggested to rapidly reverse alloxan diabetes in rats. We have assessed the therapeutic value of the compound in two further animal models of insulin-dependent diabetes mellitus, namely streptozotocin-diabetic rats and the spontaneously diabetic BB/E rat. There was no indication of a reversal of established diabetes in either the streptozotocin-diabetic or the spontaneously diabetic BB/E rats. Moreover, epicatechin also failed to halt the progression of the disease in prediabetic BB/E rats. Earlier claims of the potential use of epicatechin as an antidiabetic agent must therefore be treated with some caution.

Administration, Oral↗

Successful pregnancies from the transfer of pronucleate embryos in an outpatient in vitro fertilization program.

Twenty-nine infertile women were given clomiphene citrate (100 mg/day, days 3 to 7), human menopausal gonadotropin (150 IU/day, days 7 to 12 or 13), and human chorionic gonadotropin (2000 IU) for the induction of ovulation. Eggs were collected by laparoscopy and preincubated for 6 hours before being cultured with spermatozoa for fertilization. Approximately 16 to 18 hours after insemination, the eggs that showed two pronuclei were transferred to the patient's uterus. As confirmed by the ultrasonic appearance of a gestational sac, six women who received pronucleate embryos became pregnant, and three pregnancies resulted in normal full-term deliveries. These results confirm that, unlike requirements for most laboratory and farm animals, the requirements of synchrony between the preimplantation human uterus and developing embryos are not very stringent. In vitro fertilization treatment procedures can thus be made simpler by the transfer of embryos at the pronucleate stage.

Adult↗

In vitro effects of argon laser radiation on blood: quantitative and morphologic analysis.

Use of the argon laser to recanalize stenosed arteries may require delivery of the beam through blood. To assess the degree of hemolysis and debris formation, 84 samples of citrated whole blood were exposed to argon laser radiation with varying power (1, 2 and 3 watts) and duration (5, 10, 20 and 40 seconds). Compared with control samples, only blood samples exposed to a power of 3 watts for 40 seconds showed a marked decrease in hematocrit (from 37 +/- 1.3 to 33 +/- 1.4%, p less than 0.01) and a marked increase in both free hemoglobin concentration (from 0.2 +/- 0.2 to 1.3 +/- 0.5 g/100 ml, p less than 0.01) and debris weight (from 0.9 +/- 0.3 to 2.8 +/- 0.5 mg, p less than 0.01). Scanning electron microscopy of debris from samples of whole blood, washed erythrocytes and platelet-rich plasma lased at 3 watts for 40 seconds documented the presence of membrane denaturation of blood elements, resulting in their fusion to form complex mesh-like conglomerates. Similar morphologic changes were observed in whole blood samples exposed to a "hot tip" rather than laser radiation. These data indicate that: 1) argon laser radiation with a power of 3 watts does not produce apparent hemolysis or debris formation for exposure periods up to 20 seconds, and 2) the effects of laser radiation on blood are probably mediated by thermal denaturation of cell membranes, as suggested by the same morphologic changes produced by thermal injury from a "hot tip."

Argon↗

Laser recanalization of acutely thrombosed coronary arteries in live dogs: early results.

Laser recanalization was attempted in thrombosed coronary arteries of 10 dogs. In all dogs a coronary thrombus was obtained by passing a low grade electrical current through a guide wire advanced into the artery. Recanalization was then attempted using an argon laser with energy levels ranging from 3 to 30 J. In six dogs a 140 micron core optical fiber was positioned proximal to the thrombus and lasing was done during fiber advancement. The thrombosed artery was recanalized in one dog, perforated in four and neither recanalized nor perforated in one. In the remaining four dogs a steerable guide wire was advanced across the thrombus and a catheter was passed over the guide wire and exchanged for a 200 micron core optical fiber. After fiber withdrawal, mechanical recanalization without lasing was performed in one of the four dogs. In the remaining three dogs, both the fiber and the catheter were again advanced distal to the thrombus and lasing was done during withdrawal; this caused coronary perforation in all dogs. Laser recanalization of thrombosed coronary arteries in dogs using currently available techniques is feasible but results in a very high incidence of perforation.

Acute Disease↗

Experimental evaluation of complete electrically powered ventricular assist system.

The LVAS utilizing an intrathoracic blood pump and a parathoracic, electrohydraulic energy converter has a number of promising features. These include: transcutaneous energy transmission and an implanted variable volume device which eliminate the need for percutaneous access; utilization of an intrathoracic blood pump and variable volume device which allow the diaphragm and abdominal cavity to remain intact; parathoracic or subcutaneous location of the transformer secondary, energy converter, internal battery and interconnecting elements allowing replacement with a minor surgical procedure; employment of the "biolized" continuous blood contacting surface which has the potential of long-term use without anticoagulants and utilization of an electrohydraulic energy converter which provides synchronization without requiring transducers and associated electronics and which provides lubrication of mechanical components. The development effort, which began separately in 1977 and has been conducted jointly by Nimbus and the Cleveland Clinic since 1980, has demonstrated that the above features can be incorporated in a reliable LVAS. In particular, the system in vivo test series have demonstrated the soundness of the basic concepts and led to refinements which were demonstrated in the 6-1/2 mo test. All elements of the system have been utilized during the in vivo test program. Component tests of significance include: LVAS and total heart blood pump in vivo experiments of up to 7 mos duration which demonstrate the blood compatibility of the biolized surface without the use of long-term anticoagulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗