Another double 'tails-up' capnograph.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to C Imray.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
BACKGROUND: The level of cerebral desaturation, which is associated with a change in level of consciousness during carotid endarterectomy, was measured by near-infrared spectroscopy. METHODS: Patients were recruited in two centres over 24 months. Surgery was performed under deep and superficial cervical block using 0.5 per cent bupivacaine, with temazepam as a premedication. Cerebral oxygenation was measured by Critikon 2020 near-infrared spectrophotometers (Johnson and Johnson Medical, Newport, UK). RESULTS: Forty-nine procedures were performed on 45 patients (39 men; age range 52-84 (mean 68) years). Recordings were made from the ipsilateral frontal site in 38 patients, from the ipsilateral temporal site in 23 and bifrontally in eight patients. Monitoring failed in three subjects. Percentage changes in regional cerebral oxygen saturation are detailed below. CONCLUSION: Significantly different levels of cerebral desaturation occur in patients with neurological compromise during carotid endarterectomy compared with those who are unaffected.
Explore the source record for details and available documents.
Acetazolamide is a useful prophylactic for acute mountain sickness causing marked reduction in headache, nausea, vomiting, weakness, etc. Improvements correlate with increased arterial oxygen concentrations, reduction in proteinuria and peripheral oedema and other objective measures of acute mountain sickness. Evidence that Acetazolamide is beneficial for pulmonary oedema or cerebral oedema is scanty because of the lower frequency of these severe forms of mountain sickness. Dexamethasone, used prophylactically, also reduces the symptoms of acute mountain sickness partly due to its euphoric effect. Use of Acetazolamide as a treatment for established acute mountain sickness has been investigated. Large doses of Acetazolamide increase arterial oxygen levels over a few hours and this leads to a reduction of symptoms but data is limited and faster acting carbonic anhydrides inhibitors such as Methazolamide may be preferable in an emergency situation. There is no comparison of the effectiveness of Acetazolamide with other drugs used for treating acute mountain sickness such as steroids and calcium channel blocking drugs. Also, there is no data on drug combinations which could have additive effects and thereby be more beneficial than individual drugs.
Explore the source record for details and available documents.
Increased arachidonic acid concentrations in experimental rodent colonic cancer have been described recently. In humans, a reduced erythrocyte stearic acid to oleic acid ratio has been reported in patients with colorectal cancer and it has been proposed that similar changes exist in the cancer tissue. The long chain fatty acids in the cancers of 15 patients with colorectal cancer were measured and compared with values in the unaffected mucosa. The values were expressed as mean (SD) mg fatty acid/g tissue and compared by analysis of variance. In the cancer tissue arachidonic acid was increased (0.703 (0.109) mg/g v 0.603 (0.127) mg/g, p less than 0.05) as was docosahexaenoic acid (0.211 (0.066) mg/g v 0.148 (0.039) mg/g, p less than 0.001). In contrast, the stearic acid to oleic acid ratio in the cancer tissue was increased rather than decreased, as previously suggested (0.36 (0.05) v 0.29 (0.7), p less than 0.01). Increased arachidonic acid and docosahexaenoic acid concentrations may be related to reduced lipid peroxidation, which is a feature of rapidly growing cells. Alternatively, the increased arachidonic acid values could be due to enhanced desaturase activity upon linoleic and linolenic acid, leading perhaps to increased formation of prostaglandins and other lipoxygenase products.
Severe biliary acute pancreatitis is frequently associated with persisting bile duct stones, which has important implications with regard to management. In mild cases, cholecystectomy with operative cholangiography during the same admission is the treatment of choice. In patients with a severe attack, however, management remains controversial. There is increasing evidence to suggest that early biliary decompression with endoscopic sphincterotomy is associated with a lower morbidity and mortality than a conservative regime. In certain situations endoscopic sphincterotomy may also obviate the need to explore the common bile duct, and in high-risk patients may allow surgery to be avoided altogether.
Seventy-five nude mice received subcutaneous inoculation with 1 X 10(7) cells of the human colonic cancer cell lines COLO-320 or HT-29. Tumour growth was assessed over 4 weeks in animals given one of three iso-caloric diets; standard diet, high saturated fat (20% coconut) diet and high n-3 fat (20% Maxepa fish oil) diet. The n-3 diet produced significant tumour growth reduction compared to the other diets for COLO-320 at 3 to 4 weeks (P less than 0.05 at least) and similarly for HT-29 at 4 weeks (P less than 0.05). Significant incorporation of n-3 fatty acids occurred in red cell membranes, adipose tissue and both neutral lipid and phospholipid fractions of tumour lipids in animals fed Maxepa (P less than 0.01 at least). This was accompanied by reduction of linoleic acid and arachidonic acid in these tissues (P less than 0.01 at least) but was most marked in the metabolically labile phospholipid fraction. There was high mitotic activity in the tumours from all the groups but there was no difference according to diet.
Explore the source record for details and available documents.
Cerebrovascular accident or stroke is a common cause of death and disability. Carotid endarterectomy is a surgical procedure performed to prevent ischaemic stroke. This article provides an overview of atherosclerotic carotid disease and issues involved with carotid endarterectomy.
Ninety nude mice were inoculated subcutaneously with 1 x 10(7) cells of the human colonic cancer cell lines, SW-620 and LS174T. Tumour growth was assessed weekly for three weeks whilst the animals were receiving one of three diets: control (4.6% fat), coconut (20% fat, saturated fatty acids) and Maxepa (20% fat; n-3 fatty acids). At the end of the study SW-620 tumour weights (mean +/- SD, gm) were: control = 0.38 +/- 0.22, coconut = 0.43 +/- 0.31, Maxepa 0.20 +/- 0.16; the LS174T tumour weights were control = 1.33 +/- 1.27, coconut = 0.47 +/- 0.74, Maxepa = 0.38 +/- 0.56 (p less than 0.001, analysis of covariance). The Maxepa diet produced significant retardation in tumour growth (p less than 0.001). This was associated with reduced levels of linoleic acid and arachidonic acid in adipose tissue and tumour lipids with incorporation of n-3 fatty acids (all p less than 0.01 at least, analysis of variance). Moreover, the Maxepa diet produced significant reductions of plasma cholesterol, phospholipids and triglycerides (all p less than 0.01).