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Biomedical subjects

C D Park

Publications and source records attributed to C D Park.

At least 19 recordsLinked to original sources

Depth of a central venous catheter tip: length of insertion guideline for pediatric patients.

BACKGROUND: In pediatric patients, several studies have been undertaken to establish central venous catheter (CVC) tip optimal depth. Assessments of catheter tip position using chest radiographs may be misleading, whereas transesophageal echocardiography (TEE) has been shown to accurately monitor catheter tip placement at the superior vena cava-right atrial (SVC-RA) junction. The aim of this study was to issue a guideline for ideal catheter insertion depth, from the right internal jugular vein (IJV) using TEE to confirm the position of the catheter tip at the SVC-RA junction. METHODS: Over a 6-month period, we studied 60 right internal jugular vein catheterizations in infants and children undergoing surgery for congenital heart disease. Positions of CVC tips were confirmed to be at the SVC-RA junction by TEE. Distance from the skin puncture site to the SVC-RA junction, height, weight, and age were recorded. RESULTS: Distances measured were found to be highly correlated with patient height. The following guideline allows the CVC tip to be positioned above the RA in 97.5% of patients with an accuracy of 95%: optimal depth of insertion (cm) = 1.7 + (0.07 x height) in patients whose height is between 40 and 140 cm. CONCLUSION: The model proposed for the insertion of the CVC tip in pediatric patients could be used to prevent inadvertent catheter tip placement into the atrium.

Catheterization, Central Venous↗

Human B cell interleukin 10.

Interleukin 10 (IL-10) is a novel lymphokine which exhibits strong DNA and amino acid sequence homology to BCRF1, an open reading frame in the Epstein-Barr virus genome. Using a wide panel of EBV positive and EBV negative cell lines, it has been shown that EBV positive B cell lines derived from patients with AIDS and Burkitt's lymphoma (AABCL) secrete large quantities of B cell IL-10, compared with EBV-positive B cell lines obtained from patients with undifferentiated lymphomas of Burkitt's and non-Burkitt's types. In contrast, EBV-negative B cell lines do not express IL-10 by Northern blot analysis, ELISA or even PCR. B cell IL-10 is confined to a narrow window in the B cell differentiation pathway, and whereas IL-10 expression is detected in mature and preplasmacytic stages, none of the pro-B, pre-B, or myeloma cell lines produce IL-10. EBV exerts direct effect on the production of B cell IL-10, and purified tonsillar B cells infected with EBV were triggered to secrete IL-10. The large amount of IL-10 secreted by B cells derived from AIDS-related lymphomas suggests that HIV-1 also exerts direct effect on IL-10 secretion. B cell IL-10 may function as autocrine growth factor for B cell lymphomas, and both IL-10 and BCRF1 seem to be involved in the pathophysiology of non-Hodgkin's lymphomas.

Amino Acid Sequence↗

Comparison of a daily and three intermittent retreatment regimens for pulmonary tuberculosis administered under programme conditions.

One daily and 3 thrice weekly retreatment regimens given for 12 months under programme conditions were compared. The daily regimen was rifampicin and ethambutol (RE7). The three intermittent regimens also contained rifampicin and ethambutol: one of them, rifampicin and ethambutol throughout (RE3); the next one supplemented with pyrazinamide for the first 3 months (REZ3); the last one supplemented with prothionamide for the first 3 months (REPt3). The pyrazinamide containing regimen was subdivided into ordinary and high dose groups. The subjects for retreatment were those who have had, at least, more than 6 months of initial triple chemotherapy of isoniazid, PAS and streptomycin at the health centres, and failed to convert to bacteriologically negative status. Among 419 patients who were available for sensitivity tests before commencing retreatment, 393 (94.3%) were resistant to isoniazid. Six hundred and seventy-four patients (674) were allocated randomly to the regimens: 64 patients were excluded due to various pretreatment reasons and 109 did not complete 12 months of chemotherapy. There remain 501 patients who completed their retreatment. As assessed at 12 months, a bacteriologically favourable response was achieved in 68% of 135 RE7 patients, 62% of 129 RE3 patients, 74% of 132 REZ3 patients, and in 79% of 108 REPt3 patients. Adverse reactions were uncommon: 4% in RE7, 5% in RE3 and 9% in REZ3, but 32% in REPt3. Relapse rates during 2 years after termination of chemotherapy were 15% in RE7, 14% in RE3 and REZ3, and 26% in REPt3, as calculated by life table analysis.

Adolescent↗

Pancreaticogastrostomy: a further evaluation.

The anastomosis between the remaining pancreas and the intestinal tract after various types of pancreatic resection has been the site of complications responsible for considerable morbidity and mortality. After Whipple resections reestablishment of pancreatic-intestinal continuity has generally been accomplished in some manner between the pancreas and upper jejunum. This suture line has at times failed, often as the result of postoperative pancreatitis, giving rise to hemorrhage, abscess, and fistula formation. Since 1963, 25 patients undergoing pancreaticoduodenal resection have had some portion of their pancreas implanted into the back wall of the stomach. The operations have been done by the resident and senior staff of the Department of Surgery at the University of Pennsylvania. Morbidity has decreased and operative mortality has fallen from 20-30% to 8%. The technique is not difficult and there seems to be less tendency for the anastomosis to leak. Pancreatic function is usually adequate. The procedure is useful after radical resection of the pancreaticoduodenal region or at times after pancreatic trauma.

Aged↗