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Biomedical subjects

D E Cook

Publications and source records attributed to D E Cook.

At least 19 recordsLinked to original sources
PubMed1994

Suspected trimethoprim/sulfamethoxazole-induced hypoprothrombinemia.

The following report illustrates a case of trimethoprim/sulfamethoxazole-induced hypoprothrombinemia in a patient receiving ongoing warfarin therapy for atrial fibrillation and aortic valve replacement. He was treated with trimethoprim/sulfamethoxazole (TMP/SMX) for sinusitis. During this time, the patient's prothrombin time international normalized ratio (INR) increased 3.5 times higher than the baseline value. The INR values decreased when the antibiotic was discontinued. If a patient is on warfarin and TMP/SMX is added, INR values should be monitored closely.

Aged↗
PubMed1989

Use of intraoperative ultrasound during hepatic resection in pediatric patients.

Five pediatric patients with primary liver tumors were evaluated preoperatively with ultrasound (US), computerized tomography (CT), and angiography, and tentative operative plans were formulated. Intraoperative US was subsequently used to examine these children, resulting in changes in operative strategy of all five patients despite their extensive preoperative evaluations. Intraoperative ultrasound appears to provide the most accurate assessment of both the extent of tumor and its vascular relationships. Thus, operative strategies may be precisely tailored on the basis of such information, allowing rational resection where appropriate, while futile attempts at removal of inoperable lesions may be averted.

Carcinoma, Hepatocellular↗
PubMed1989

Development of an effective short introductory course in diagnostic radiology.

As part of a general medical curriculum renewal, a new one-week course in diagnostic radiology was given to students at the beginning of their third year. The course format consisted of didactic presentations to the entire class, a single afternoon session of small group discussions of unknowns, and three daily case-of-the-day unknowns with prizes for correct responses. One hundred fifty-eight students were tested on the first and last days of the course; testing consisted of two parallel 46-item multiple choice questions given in a crossed design. Questions covered radiographic anatomy and pathology as well as proper test ordering. Differences in achievement before and after the course as measured by the pre- and post-tests were highly significant. The class achieved a mean of 27 (59%) correct responses on the pre-test and a mean of 37 (80%) on the post-test (F(1156) = 15.79; P less than .001). The reliability coefficient of the pre- and post-tests was about .30. A course critique was returned by 88 students. There was anticipated variation in the evaluations of the different didactic lecturers. Instructors receiving the highest scores were cited for their enthusiasm, clarity, and the relevance of their presentation. Conversely, those receiving low marks were cited as being unenthusiastic and boring, merely presenting example after example of radiographic abnormalities with little explanation. The afternoon small group discussions were perceived as the best part of the course. Despite the fact that moderator experience ranged from second year resident to full professor, the seminars received uniformly positive comments.

Education, Medical↗
PubMed1988

Diagnosis of anemia on computed tomography scans of the thorax.

Scans of 14 patients with hemoglobin levels of 7.6 to 10.2 grams/deciliter (gm/dL) were positive for the diagnosis of anemia. All demonstrated the interventricular septum and ascending and descending aortic walls. Scans of 23 patients with hemoglobin levels of 10.5 to 12.8 gm/dL were positive for the diagnosis of anemia in 11 and negative in 12. The ascending and descending aortic walls were seen 39% and 48% of the time, respectively. Scans of 13 patients with hemoglobin levels of 12.9 to 16.0 gm/dL were negative for the diagnosis of anemia.

Adolescent↗
PubMed1988

Evaluation of azotemic patients: diagnostic yield of initial US examination.

To determine whether renal ultrasound (US) is necessary in all patients with azotemia, the authors retrospectively evaluated renal US examinations in 394 azotemic patients. The patients included 119 patients considered clinically to be at high risk for postrenal urinary obstruction and 275 patients considered to be at low risk. In the high-risk population, 35 patients were found to have hydronephrosis (29%). In the low-risk population, three patients were found to have hydronephrosis (1%). In two of these patients surgical intervention resulted in reversal of the azotemia. The authors recommend that renal US be performed in all high-risk patients and in low-risk patients only if temporization and standard medical treatment do not resolve the azotemia.

Humans↗
PubMed1988

A fairy tale.

Explore the source record for details and available documents.

Aged↗
PubMed1986

Upper abdominal trauma: pitfalls in CT diagnosis.

Medical records and computed tomographic (CT) scans of 83 patients with upper abdominal trauma were retrospectively reviewed to determine errors in diagnosis using CT. Patients with possible pancreatic injury, small bowel perforation, or injury to an occult malignancy represented the most difficult diagnostic cases. A false-positive diagnosis of pancreatic injury occurred in seven of 77 patients (9%) and represented the most frequent error in the series. In three patients with subsequently surgically proved small bowel perforation, one duodenal and two proximal jejunal, the injuries were not correctly diagnosed on CT scans. In retrospect, positive CT findings were present in the case of duodenal rupture. Additionally, in two patients, duodenal rupture was suspected based on CT findings of extraluminal gas and fluid near the duodenum, but both cases were proved normal at surgery. The series included three patients with trauma involving unsuspected tumors in the liver, kidney, and stomach.

Abdominal Injuries↗
PubMed1985

Heterotopic bone formation in patients with DISH following total hip replacement.

Radiographs of 236 patients who underwent total hip replacement (THR) were evaluated for heterotopic bone formation. There was no significant difference in the presence and degree of ossification in patients with and without diffuse idiopathic skeletal hyperostosis (DISH). The authors conclude that DISH is not a significant risk factor in the development of heterotopic bone formation following THR.

Aged↗
PubMed1985

Alterations in hepatic microsomal drug metabolism and cytochrome P-450 proteins in spontaneously hypertensive rats.

Experiments were conducted to determine if substrate-specific changes in microsomal metabolism and liver proteins occurred in young (12-13 weeks) spontaneously hypertensive rats (SHR) fed ad libitum compared to age-matched normotensive Wistar Kyoto (WKY) control rats. The hepatic microsomal protein content in SHR rats was significantly increased compared to WKY rats while cytosolic and total liver protein levels did not differ between the two groups. Liver microsomal ethylmorphine-N-demethylase activity was substantially enhanced in SHR rats with only slight increases in cytochrome P-450 content and aniline hydroxylase activity compared to WKY rats. The substrate-specific increases in the microsomal drug metabolism in SHR rats were accompanied by an increase in the prominence of a protein with molecular weight 55,000 in the cytochrome P-450 region. These preliminary observations may be clinically relevant in that alterations in hepatic drug metabolism may be associated with endogenous biochemical processes underlying the hypertensive state.

Animals↗
PubMed1984

Effect of dietary 2-mercaptoethanol on the life span, immune system, tumor incidence and lipid peroxidation damage in spleen lymphocytes of aging BC3F1 mice.

The age-related decline in immune function, which is thought to be responsible for the increased incidence with age of certain diseases, including cancer, has been attributed primarily to a loss of T-lymphocyte function. As free radical reactions may contribute to cellular deterioration and loss of cell function with age, we investigated the effect of adding an immunopotentiating antioxidant, 2-mercaptoethanol (2-ME), to the diet of BC3F1 mice in a longitudinal study. For the study, young mice were divided into two groups, one of which received the 2-ME-supplemented diet. Approximately every 3 months for 2.5 years, mice from each group were sacrificed and the spleen lymphocytes assessed for immune function (proliferative response to concanavalin A, phytohemagglutinin, and lipopolysaccharide and the humoral response to sheep red blood cells). The accumulation of fluorescent products indicative of free radical damage was measured in the spleen lymphocytes and the cytochrome P-450 content and activity assessed in the liver. The effect of the 2-ME-supplemented diet on the mean and maximum life span and tumor incidence was also determined. The results showed that the animals fed the 2-ME diet had an increased mean and maximum life span and a postponed onset and decreased incidence of tumors. In general the T-cell-dependent immune responses were higher in the 2-ME-fed mice compared to the controls when the animals were young. No difference was observed between the two groups during mid-life. The responses declined in both groups during the latter half of the life span, but the responses of the 2-ME-fed animals declined to a lesser extent. The accumulation of fluorescent products of lipid peroxidation damage was also delayed in the lymphocytes of the 2-ME-fed mice. Cytochrome P-450 content and activity in the liver was not different in the two groups. The results suggest that the antioxidant activity of 2-ME delayed the accumulation of free radical damage in spleen lymphocytes, which resulted in a delay in the decline of immune function and was associated with the decreased tumor incidence and increased life span.

Aging↗
PubMed1984

Drug metabolism in spontaneously diabetic guinea pigs.

Both sexes of spontaneously diabetic guinea pigs exhibit hyperinsulinemia (greater than 4-fold normal). This diabetic state is associated with the inhibition of hepatic drug metabolism in males but not females.

Aminopyrine↗
PubMed1983

Catalytic activities of cytochrome P-450 from female rat liver: correlation with sex differences in drug metabolism in diabetic liver.

Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of detergent solubilized cytochrome P-450 fractions from normal and diabetic female rat liver microsomes revealed the induction of a 52,000 molecular weight microsomal hemeprotein in diabetic liver. Two major P-450 hemeproteins (DB IIA and DB IIB) were subsequently isolated from solubilized diabetic female rat hepatic P-450 fractions, while normal rat liver yielded only one major microsomal P-450, N IIA. When examined in a reconstituted drug metabolizing system, the aniline hydroxylation rate catalyzed by DB IIB (52,000 molecular weight) was 157% and 78% greater than the rates catalyzed by N IIA and DB IIA, respectively. The rates of ethylmorphine metabolism catalyzed by N IIA and DB IIB were similar; however, the rate of ethylmorphine metabolism catalyzed by DB IIA (54,000 molecular weight) was approximately 42% greater than the rates catalyzed by either N IIA or DB IIB. These results are compared to those previously obtained with P-450s isolated from diabetic male rat liver and indicate that diabetes induces P-450s with specific catalytic activities which can account for both the sex-dependent and sex-independent alterations in drug metabolism observed in diabetic rat liver.

Alanine↗