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Biomedical subjects

B Burns

Publications and source records attributed to B Burns.

At least 19 recordsLinked to original sources
PubMed1992

Rearrangement of BCR genes in malignant lymphoma.

The Philadelphia chromosome, originally thought to be associated solely with chronic myelogenous leukemia (CML), has since been identified in acute leukemias and in some cases of lymphoma. The Philadelphia chromosome results from reciprocal translocation of genetic material between chromosome 9 and 22 involving the c-abl and BCR genes respectively. Southern blot analysis of the BCR genes was carried out on biopsy specimens from 49 patients presenting with malignant lymphoma without a previously documented CML phase. In two patients, BCR gene rearrangements were detected in the malignant lymph nodes but not in the bone marrow samples. A third patient showed BCR gene rearrangements in the bone marrow but not in the lymph node. From this limited study, it seems that the overall incidence of BCR gene rearrangement in malignant lymphoma is similar to that observed in adult AML.

Blotting, Southern↗
PubMed1991

Safety and immunogenicity of human rotavirus vaccine strain M37 in adults, children, and infants.

Rotavirus vaccine strain M37 (serotype 1), recovered from the stool of an asymptomatic newborn infant and serially passaged in cell culture, was given orally to adults, children, and infants. Serologic responses were detected by neutralization assay or EIA in 59% of 17 adults (10(5)-pfu dose), 55%-60% of 21 infants and children (10(4)-pfu dose), and 70% of 10 infants (10(5)-pfu dose), vaccine virus was shed by 24%, 20%-36%, and 70%, respectively. In adults, neutralizing antibody rises to strain M37 and the related serotype 1 strain Wa occurred with equal frequency (41% vs. 47%). In pediatric subjects, the former were more frequent (36%-40%) than the latter (10%-18%). This was also true of 8 infants who received two doses of vaccine. Mild gastrointestinal illnesses occurred with equal frequency in pediatric subjects who received vaccine or placebo. Thus, strain M37 was well tolerated and immunogenic in young infants, but elicited primarily vaccine-strain-specific rather than serotype-specific neutralizing antibody responses.

Adult↗
PubMed1991

Small-bowel carcinoid presenting in association with a phytobezoar.

An unusual case of a recurrent, postoperative, small-bowel obstruction is presented. The obstruction was due to a phytobezoar proximal to the site of a primary carcinoid of the small bowel. The radiologic findings of a mobile, intraluminal filling defect and a more distal, fixed mural mass are reviewed. The cause of the recurrent obstruction was likely a "ball-valve" effect of the phytobezoar at the site of stenosis caused by the carcinoid. This case emphasizes the value of small-bowel imaging in repeated small-bowel obstruction.

Bezoars↗
PubMed1991

Role of a soy-based lactose-free formula in the outpatient management of diarrhea.

The introduction of a soy-based, lactose-free formula during the acute phase of diarrheal illness in infants has been shown to reduce stool output and duration of diarrhea in hospitalized patients. In the United States, most infants with acute diarrhea are treated as outpatients. In the present study, infants with diarrhea who were treated as outpatients were randomly assigned to receive either a soy-based, lactose-free formula alternating with oral rehydration solution from the beginning of therapy ("early feeding") or oral rehydration solution alone for the first 24 hours of therapy, followed by a soy-based, lactose-free formula alternating with oral rehydration solution (control group). Twenty-nine infants were randomly assigned to the early-feeding group and 27 to the control group. Twenty-one (72%) of 29 in the early-feeding group resolved their diarrhea at the end of 48 hours of therapy compared with 12 (44%) of 27 in the group fed oral rehydration solution only (P = .02). It is concluded that the introduction of a soy-based, lactose-free formula from the beginning of therapy for acute diarrhea in children treated as outpatients is safe and may shorten duration of diarrhea while maintaining adequate caloric intake.

Ambulatory Care↗
PubMed1990

Insulinoma in a patient with annular pancreas.

Intraoperative ultrasonography has facilitated the localization of insulinomas. In this report, we describe a patient who was found to have an insulinoma in association with an annular pancreas. Because such tumors can be in close approximation to major pancreatic ductal structures, intraoperative ultrasonography can be useful for not only localizing the lesion but also delineating the related anatomic features. Although the optimal management of an asymptomatic annular pancreas has not been determined, our patient had no evidence of chronic pancreatitis and no narrowing of the duodenal lumen; therefore, no bowel bypass procedure was done.

Adenoma, Islet Cell↗
PubMed1990

A prospective randomised controlled trial of antimicrobial prophylaxis in hydrocephalus shunt surgery.

Despite attempts to reduce their incidence, shunt infections remain a major complication of the treatment of hydrocephalus. Various forms of antimicrobial prophylaxis are in use, but no controlled, statistically valid trial has been conducted to assess their efficacy. Such a trial was therefore carried out and its design is described here. After a 1-year retrospective and prospective study by members of the United Kingdom Hydrocephalus Group to establish feasibility and infection rates, a statistical study showed that at least 712 patients would be required. Six centres were enrolled to fulfil these requirements, and ethical committee approval was obtained at each. The chosen prophylactic regimen was 10 mg vancomycin administered into the ventricular system during surgery. Adults and children undergoing insertion or revision of ventriculoperitoneal shunts were included unless they were receiving therapeutic antimicrobials. Randomisation was by computer-generated numbers. Controls received the antimicrobial regimen, if any, currently used in that centre, the only difference between the two groups being intraventricular vancomycin in the test group. Diagnosis of shunt infection included accepted clinical and microbiological criteria reinforced by measurement of serum C-reactive protein levels. Follow-up was for at least six months. After 2.5 years only 158 patients had been enrolled in the trial, 80 controls and 78 tests. There were 5 preventable infections in the control group and 2 in the test group. In view of the small total the planned statistical analysis was not possible. Therefore, while no problems were encountered with toxicity, the trial failed to enroll enough patients to answer the question of efficacy of antimicrobial prophylaxis in shunt surgery and the reasons for this are discussed.

Cerebrospinal Fluid Shunts↗
PubMed1979

Morphologic features of prognostic significance in uterine smooth muscle tumors: a review of eighty-four cases.

Independent microscopic review of the most cellular and pleomorphic areas of 84 smooth muscle tumors of the uterus by two pathologists yielded 23 leiomyosarcomas, 43 cellular leiomyomas, 16 bizarre leiomyomas, and two intravenous leiomyomas. Greater than 5 mitotic figures/10 high-power fields (hpf) correlated with malignant clinical behavior, but this occurred in only 75% of the leiomyosarcomas. Five cases with fewer than 5 mitoses/10 hpf pursued a malignant course. The mean age of the patients with malignant tumors (52.5 years) was similar to the mean age of those with bizarre leiomyomas (48.0 years) but those patients with cellular leiomyomas were significantly younger (42.0 years; p less than 0.01). Gross evidence of extrauterine extension was diagnostic of malignancy as was vascular invasion by anaplastic tumor. Fifteen of the 19 patients with leiomyosarcoma died of disease at an average of 28 months postoperatively. Inadequate sampling and interobserver variation are discussed.

Adult↗
PubMed1979

DLO2 in excised lungs perfused with blood containing sodium dithionite (Na2S2O4).

If the excised lung is perfused with blood containing the chemical sodium dithionite (DDT), the PO2 of pulmonary capillary blood is everywhere zero and the membrane diffusing capacity for O2 (DmO2) can be measured by a standard rebreathing technique. The reaction rate of DDT with O2 is not rate limiting in the DmO2. In 15--25 kg dogs anesthetized with pentobarbital sodium (30 mg/kg, iv), left lower lobe was excised, suspended horizontally and perfused with autologous blood at 25--27 degrees C. DDT was added to the blood and the rebreathing alveolar disappearance curves for O2 were measured. The DmO2 ranged from 6 to 43 (ml/min.Torr, STPD) at lung volumes of 240--780 ml (FRC at 6 cmH2O end-expiratory pressure). Lung weight, pulmonary artery pressure, and the DmO2 were stable in the presence of DDT. Histopathology indicates that dithionite in the concentrations used does not harm the lung. Effects of inequalities in the distributions of ventilation, volume, and diffusing capacity were examined in a two-compartment model and compared with the experimental findings.

Animals↗
PubMed1978

Evaluation of the central canal of the spinal cord in experimentally induced hydrocephalus.

The central canal of the spinal cord has been proposed as a significant compensatory alternative pathway of cerebrospinal fluid (CSF) flow in hydrocephalus. Ten dogs were made hydrocephalic by a relatively atraumatic experimental model that simulates the human circumstance of chronic communicating hydrocephalus. The central canal was studied by histopathology and compared with 10 normal control dogs. In both groups the central canal of the spinal cord was normal in size, configuration, and histological appearance. In this experimental model dilatation of the canal and increased movement of CSF does not appear to be a compensatory alternative pathway.

Animals↗
PubMed1977

The production of cerebrospinal fluid in experimental communicating hydrocephalus.

Utilizing an atraumatic model to produce chronic hydrocephalus, CSF production was measured during and after development of communicatin hydrocephalus. CSF volume production was significantly lower in animals with increased pressure. Animals with chronic hydrocephalus and normal pressures had abnormal CSF production. Diminished CSF production appears to offer a potential compensatory mechanism when CSF absorption is altered.

Animals↗
PubMed1977

The Wien effect in compensated metabolic acidosis.

CSF and blood acid-base values were measured in compensated metabolic acidosis, induced in anesthetized dogs by infusion of dilute HCl during hyperventilation. We observed cerebral blood flow-related steady-state differences in PCO2 between CSF and arterial venous blood from the brain. The steady-state values of CSF-blood PCO2 differences and blood H+ activity were intermediate to those observed by us previously during uncompensated acidosis and alkalosis (J. Appl. Physiol. 34: 249-254, 1973). These results are consistent with predictions of the "charged membrane hypothesis" proposed by us to explain CSF and blood acid-base relationship during uncompensated acid-base derangements (J. Appl. Physiol. 34: 243-248, 1973).

Acidosis↗
PubMed1977

Evaluation of cerebrospinal fluid production in the development of communicating hydrocephalus.

Diminished absorption of cerebrospinal fluid (CSF) is the most common cause of communicating hydrocephalus. Soon after the absorptive capacity is decreased, the CSF pressure increases, producing ventricular enlargement if the process is not halted. CSF production was measured by ventriculo-cisternal perfusion during and after the production of communicating hydrocephalus, using an atraumatic animal model. Animals with chronic hydrocephalus and normal pressure had normal CSF production. CSF production tended to be lower in animals with increased pressure. When CSF absorption is compromised, decreased CSF production does not appear to be a significant compensatory mechanism.

Acute Disease↗
PubMed1977

Saturation kinetics for steady-state pulmonary CO transfer.

Steady-state diffusing capacity of the lungs for carbon monoxide (DLCO) was measured in 13 anesthetized, paralyzed dogs ventilated at constant tidal volume and rate, using four different inspired CO levels (190, 600, 1,110, and 2,000 ppm). DLCO increased and reached a maximum as the inspired CO level was raised from 190 to 600 ppm. Further increases in inspired CO concentration were accompanied by a decrease in inspired CO concentration were accompanied by a decrease in DLCO. CO dead space and Pao2 remained constant at all inspired O2 levels. In some experiments a second set of measurements was made, the results of which were similar to those of the first set. The results cannot be explained by changes in CO back pressure, pulmonary capillary volume, or reaction rate of CO with hemoglobin, but can be explained if there is carrier-mediated CO transport in the alveolar capillary membrane.

Animals↗