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Biomedical subjects

D Gross

Publications and source records attributed to D Gross.

At least 19 recordsLinked to original sources
PubMed1992

Correlation between trans-stilbene oxide-glutathione conjugation activity and the deletion mutation in the glutathione S-transferase class mu gene detected by polymerase chain reaction.

Glutathione S-transferase (GST) class Mu activity was determined in 145 unrelated hospital patients in Berlin by measuring their conjugation activity towards the specific substrate trans-stilbene oxide (TSO) with two substrate concentrations (50 and 250 microM) in homogenates prepared from lymphocytes. Eighty individuals (55.2%) had an activity lower than 10 pmol/min/10(6) lymphocytes and were classified as GST class Mu deficient. In 142 of 145 cases, phenotype was confirmed by the results of a genotyping procedure using the polymerase chain reaction technique. Two fragments of 273 and about 650 bp including one and two introns, respectively, could always be amplified from genomic DNA in individuals with high GST class Mu activity and could not be amplified in persons with impaired glutathione-TSO conjugation activity. This indicates that persons with low activity carry a large deletion mutation within the GST class Mu gene. The enzymatically determined antimode between low and high activity determined as 10 pmol/min/1 million lymphocytes in the assay with 50 microM TSO could be clearly confirmed by genotyping.

Adult↗
PubMed1992

Hypertonic saline treatment of uncontrolled hemorrhagic shock at different periods from bleeding.

Hypertonic saline has been recently recommended for treatment of patients in hemorrhagic shock. Infusion of hypertonic saline at different periods in cases of uncontrolled hemorrhagic shock was studied in rats. The animals were divided into six groups: in group 1 uncontrolled hemorrhagic shock was induced by tail resection and no hypertonic saline was administered; in group 2 hypertonic saline was administered 5 minutes after shock was induced; in group 3 hypertonic saline was administered 15 minutes after shock was induced; in group 4 hypertonic saline was administered 30 minutes after shock was induced; in group 5 hypertonic saline was administered 60 minutes after shock was induced; and in group 6 hypertonic saline was administered 120 minutes after shock was induced. Tail resection in rats in group 1 was followed by a mean +/- SEM bleeding of 2.7 +/- .03 mL in 5 minutes. Infusion of hypertonic saline after 5 and 15 minutes resulted in additional bleeding of 6.3 +/- 1.0 mL and 3.8 +/- 0.5 mL, respectively, and a drop in mean arterial pressure to 36 +/- 8 mm Hg and 56 +/- 9 mm Hg, respectively. Mortality was 80% in group 2 and 53% in group 3. Infusion of hypertonic saline 30 and 60 minutes after shock was induced did not alter bleeding, mean arterial pressure, or survival. Infusion of hypertonic saline within 15 minutes of hemorrhagic shock resulted in increased bleeding, hypotension, and early death. Infusion 30 minutes or later did not alter these variables. This potential danger of early hypertonic saline therapy should be considered in the treatment of patients in trauma.

Animals↗
PubMed1992

TSH producing pituitary tumor: biochemical diagnosis and long-term medical management with octreotide.

A 50 year old man with hyperthyroidism secondary to inappropriate secretion of TSH is described. On presentation T3 (42.1 nmol/L), T4 (265 nmol/L) and TSH (17.9 mU/L) were all markedly elevated. A diagnosis of a TSH-secreting pituitary tumor was suspected on the basis of a blunted TSH response to TRH and the absence of suppression of TSH by T3 or bromocriptine, but TSH/alpha subunit molar ratios were uncharacteristically less than 1. Nevertheless, the presence of a tumor was confirmed by computed tomography which demonstrated a 15 mm pituitary macroadenoma. The patient was treated with octreotide which resulted in normalisation of thyroid hormone levels. The duration of action of a single 100 micrograms injection of octreotide was at least 56 hours. The suppression of thyroid hormone levels was similar regardless of the treatment regimen with octreotide (100 micrograms tid, 250 micrograms bid, 100 micrograms bid and continuous subcutaneous infusion (CSI] and no escape was observed during a 16 month treatment period. TSH alpha subunit concentrations were also suppressed during long-term treatment with octreotide (3.3 micrograms/L falling to 1.1 micrograms/L), although no acute changes were noted after administration of single dose octreotide 100 micrograms. Three times the octreotide therapy was discontinued. The incremental rise in TSH and the maximum level of TSH achieved was less on each subsequent occasion, suggesting a suppressive effect of octreotide on the tumor itself. Despite suppression of TSH with octreotide over a 13 month period the pituitary tumor showed no shrinkage on repeat MRI scanning. In conclusion, this patient demonstrates that the differential diagnosis of inappropriate TSH secretion based only on biochemical test may be unreliable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed1992

"Scoop and run" or stabilize hemorrhagic shock with normal saline or small-volume hypertonic saline?

The controversy over a policy of "scoop and run" or stabilizing hemorrhagic shock when evacuation time is short has not yet been settled. Small volumes of hypertonic saline have been suggested as effective therapy when the scoop-and-run policy is adopted. In the present study small-volume hypertonic saline treatment and normal saline treatment of "uncontrolled" hemorrhagic shock (UCHS) in rats were compared with no treatment, which best simulates the scoop-and-run policy. The rats were randomly assigned to three groups. Uncontrolled hemorrhagic shock was induced by 12% resection of the terminal portion of the rats' tails. In group I (n = 13) the animals were untreated. In group II (n = 6) UCHS was treated by administering 41.5 mL/kg 0.9% NaCl (NS). In group III (n = 6) UCHS was treated by administering 5 mL/kg 7.5% NaCl (HTS). Resection of the rats' tails in group I was followed by bleeding of 3.3 +/- 0.3 mL in 15 minutes with a fall in mean arterial pressure (MAP) from 100.9 +/- 7 to 63.5 +/- 5 mm Hg (p less than 0.001). The early bleeding and hemodynamic responses were similar in all three groups. Further blood loss in the first hour in group I was 0.5 +/- 0.2 mL, and MAP rose spontaneously to 73.2 +/- 6 mm Hg (p less than 0.05). The NS infusion in group II was followed by further bleeding of 4.1 +/- 0.9 mL (p less than 0.01) and a further fall in MAP to 53.8 +/- 7 mm Hg (p less than 0.01) after 60 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

[Rheologic studies before and after therapeutic cytapheresis and plasma exchange treatment].

Changes in rheological properties of human blood before and after platelet pheresis were measured in patients with myeloproliferative diseases as well as in a control group of platelet donors. Although the subjective feeling of the patients during measurement did improve, a better rheological situation could not be demonstrated by the rheological parameters used. A reduction of platelets does not influence the viscosity of whole blood or of plasma. On the other hand, the viscosities of whole blood and plasma differed significantly before and after plasma-pheresis in patients with monoclonal gammopathies. The control group comprised patients without hyperviscosity syndrome and did not show any change in rheological parameters.

Blood Component Removal↗
PubMed1992

[Occurrence of post-traumatic temporo-mandibular ankylosis. Trial of classification of anatomo-pathologic lesions].

According to the authors, who have an 18-year experience, the treatment of temporomandibular ankylosis in children consists in the resection of the ankylosis block and of the corresponding neck of the condyle, along with the preservation of the capsule and articular disk and a dynamic blockade with the mouth open until the mandibular condyle is completely reconstructed. After witnessing the constitution of ankylosis in a child who was initially examined 3 weeks after the trauma, we were able to carry out a thorough clinicopathological examination of the areas of tissue characterizing incipient ankylosis, both in the condylar cartilage and in the underlying bone. The initial stage produces the progressive emergence of the bony surfaces, which then bear no cartilage. This is osteogenesis as well as cartilage resorption, as evidenced by the presence of neoformed Haversian canals at that level. This is a formal argument in favor of a systematic dynamic blockade with the mouth open in all cases of fresh condylar surface and the menisceal surface of the joint is the best way to prevent ankylosis or malunion.

Ankylosis↗
PubMed1992

The combined effect of small volume hypertonic saline and normal saline solutions in uncontrolled hemorrhagic shock.

Recently, small volume hypertonic saline solution (HTS) has been suggested for treatment of trauma casualties. Previously, we reported that small volume HTS treatment of uncontrolled hemorrhagic shock (UCHS) leads to increased bleeding, hemodynamic deterioration and early mortality. In the present study, large volume normal saline solution (NS) combined with small volume HTS was used to treat UCHS in rats. The rats were randomly assorted into four groups. Group 1 (n = 9) included rats in which UCHS induced by 12 per cent resection of the tail was untreated; group 2 (n = 8) consisted of those in which UCHS was treated after 15 minutes with 41.5 milliliters per kilogram of sodium chloride, 0.9 per cent (NS); group 3 (n = 7) included rats in which UCHS was treated with 5 milliliters per kilogram sodium chloride, 7.5 per cent (HTS); and group 4 (n = 9) included rats in which UCHS was treated by a combination of HTS and NS. In group 1, resection of the tail was followed by bleeding of 4.9 +/- 0.3 milliliters in 15 minutes, a decrease in mean arterial pressure (MAP) from 105 +/- 5 to 51 +/- 3 torr (p less than 0.001) and pulse rate from 377 +/- 9 to 305 +/- 22 beats per minute (p less than 0.05). Further loss of blood after 30 minutes was 0.5 +/- 0.2 milliliters, MAP rose to 58 +/- 6 torr (p less than 0.05) with the death of two rats. Infusion of NS in group 2 was followed by further bleeding of 3.3 +/- 1.0 milliliters (p less than 0.01) and rise in MAP to 76 +/- 9 after 30 minutes. Infusion of HTS in group 3 was followed by bleeding of 1.9 +/- 0.3 milliliters (p less than 0.05) and fall in MAP to 57 +/- 14 torr (p less than 0.05). Continued loss of blood in this group resulted in further fall in MAP to 36 +/- 11 torr (p less than 0.01) with death of 71 per cent (p less than 0.01) of the rats in four hours. Combined HTS and NS infusion in group 4 was followed by bleeding of 2.0 +/- 0.4 milliliters (p less than 0.05) and an increase in MAP to 93.0 +/- 3.0 torr (p less than 0.005) after 30 minutes with the death of only one animal in four hours. Total loss of blood in the three treated groups was similar and significantly higher than in the untreated group.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1991

Effect of injured vessel size on bleeding following hypertonic saline infusion in "uncontrolled" hemorrhagic shock in anesthetized rats.

Hypertonic saline (HTS) infusion in "uncontrolled" hemorrhagic shock (UCHS) leads to increased bleeding from injured vessels, fall in mean arterial pressure (MAP), and early mortality. The effect of injured vessel size on blood loss in response to HTS treatment was studied in Neurolidal Ketalar anesthetized Hebrew University strain rats. The animals were randomly assorted into 4 groups: In group I (n = 8) UCHS was induced by resection of 8% of the terminal portion of the rats' tail and the animals were untreated. In group II (n = 8) UCHS was induced as in group I and the animals were treated with 5 ml/kg NaCl 7.5% (HTS). In group III (n = 9) UCHS was induced by 50% resection of the animal's tail, and the animals were untreated. In group IV (n = 12) UCHS was induced as in group III and the animals were treated with 5 ml/kg HTS Resection of 8% of the animal's tail was followed by bleeding of 2.6 +/- 0.3 ml and fall in MAP from 107 +/- 7 to 80 +/- 10 torr (P less than .005) within 5 min. Resection of 50% of the animal's tail was followed by bleeding of 4.3 +/- 0.4 ml (P less than .01) and fall in MAP to 41 +/- 6 torr (P less than .001) after 5 min. Infusion of HTS in group II was followed by further blood loss of 4.9 +/- 07 ml within 4 hr while in untreated group I, blood loss was only 3.4 +/- 0.4 ml (P less than .05), MAP remained unchanged, and there was no mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Children's understanding of action lines and the static representation of speed of locomotion.

Children's understanding of the static representation of speed of locomotion was explored in 2 experiments. In Experiment 1, 20 7-year-olds and 20 9-year-olds drew pictures of 2 people walking and running at different speeds. Children then made judgments about pairs of unambiguous drawings of a person walking or running, as did a sample of 20 adults. The drawings varied according to whether action lines, background lines, or no lines were present. Children were asked to say which figure appeared to be moving faster. In Experiment 2, 20 7-year-olds, 20 9-year-olds, and 21 adults sorted ambiguous drawings of a person walking and running at different speeds. The pictures again contained action lines, background lines, or no lines. In the drawing task, children more frequently used page position and biomechanical information than action lines to represent fast and slow walking and running. In the judgment task, 7- and 9-year-olds offered equivalent judgments of action lines and background lines, whereas adults distinguished between these pictorial devices. In the sorting task, all subjects distinguished between action lines and background lines and judged that pictures containing action lines looked faster than pictures containing background lines and pictures without lines. Taken together, the results indicate that subjects' judgments were influenced by the form of locomotion and degree of ambiguity in the depicted events they saw. The findings are consistent with the view that different categories of pictorial devices exist, but the effectiveness of each device is contingent upon the perceiver's experience with it and the context in which it appears.

Acceleration↗
PubMed1991

[Dynamic bite block in fractures of the mandibular condyle and following surgery of temporomandibular ankylosis in children].

Early mobilization is the rule in cases of fracture and temporomandibular joint surgery. When prematurely discontinued, it may sometimes prove insufficient to prevent temporomandibular ankylosis in the child. Blockade in the open-mouth position is in keeping with an important general orthopedic rule, i.e., immobilization of joint fractures in position of function (ankylosis is loss of function, and is reflected by the child's inability or limited capacity to open his/her mouth). Continued night wear of re-habilitation devices, once consolidation is acquired, affords active joint mobilization during meals that is sufficient owing to the strength of the elevator muscles (five times than of the depressors).

Ankylosis↗
PubMed1991

[Lingual-mandibular remodeling resection in prognathism].

The combination of --hypoplastic upper jaw, with narrow soft palate, --glossoptosis (or low, propulsive tongue), associated with protrusion of lower jaw, is well known. Early, exclusively orthopedic management combines enlargement of the superior arcade; functional/postural re-education of the tongue. Surgical management comes in later; it associates modeling resection of the tongue intended to position the tongue against the palate, with Chevron's mandibular resection, suppression of the first premolar, and salvaging the mental nerve. This type of osteotomy is indicated whenever a 6 to 8 mm mandibular retrusion is required. Fixation is monomaxillar, via extemporaneous splinting, associated with low external cortical osteosynthesis. The latter allows for gain of motor activity as early as the second day post-surgery.

Adolescent↗
PubMed1990

Effect of leukotriene inhibitor LY-171883 on the pulmonary response to Escherichia coli endotoxemia.

The effect of the leukotriene D4 (LTD4) receptor antagonist, LY-171883, on the respiratory and cardiovascular changes in endotoxemia was studied in 20 unanesthetized sheep. In group 1 (n = 2), 4 mg/kg LY-171883 was injected iv. In group 2 (n = 12), Escherichia coli endotoxin (1 micrograms/kg) was infused iv, and in group 3 (n = 6), 4 mg/kg LY-171883 was administered 15 min before and 30 min after the same dose of endotoxin. Infusion of LY-171883 in group 1 did not alter baseline ventilatory and cardiovascular measurements. A two-phase pulmonary response was observed in group 2: an early pulmonary hypertension phase in which pulmonary artery pressure (PAP) increased from 18.7 to 51.2 mm Hg (p less than .001), with a fall in cardiac index (CI) from 171 to 114 ml/min.kg (p less than .01). The ratio of peak inspiratory/expiratory flow rate (PIF/PEF) increased from 1.08 to 1.35 (p less than .01) and the respiratory rate from 50 to 70 breath/min (p less than .005) 30 min postendotoxin. The flow rate measured at midexpiration time (V50) decreased from 81% to 25% of its peak expiration (p less than .001) and the airway resistance increased from 3.8 to 32.7 cm H2O/L.sec (p less than .001). The second permeability phase was characterized by an increase in pulmonary lymph flow (QL) from 8.5 to 35.2 ml/h (p less than .01), a decrease in PaO2 from 76 to 61 torr (p less than .01), and an increase in pulmonary shunt ratio (Qsp/Qt) from 16% to 31% (p less than .005).(ABSTRACT TRUNCATED AT 250 WORDS)

6-Ketoprostaglandin F1 alpha↗
PubMed1990

Treatment of uncontrolled hemorrhagic shock with hypertonic saline solution.

Hypertonic saline solution (HTS) treatment of uncontrolled hemorrhagic shock (UCHS) induced by incision of three major branches of the ileocolic artery, leading to free intra-abdominal bleeding, was studied in rats. The rats were divided into two groups. In group 1, the abdominal wall was closed immediately after induction of hemorrhage and the rats were divided into six subgroups--1a, five untreated; 1b, 14 treated with 5 milliliters per kilogram of sodium chloride 7.5 per cent (HTS) after five minutes; 1c, eight had HTS infused after 15 minutes; 1d, nine had HTS infused after 30 minutes; 1e, nine had HTS infused after 60 minutes, and 1f, nine had HTS infused after 120 minutes. In rats in group 2, the abdominal wall was kept open during HTS therapy and bleeding was estimated by the amount of sponges used to absorb shed blood. These rats were also divided into six subgroups--2a, five untreated; 2b, nine had HTS infused after five minutes; 2c, six had HTS infused after 15 minutes; 2d, six had HTS infused after 30 minutes; 2e, eight had HTS infused after 60 minutes, and 2f, six had HTS infused after 120 minutes. UCHS in group 1 was followed by a fall in the mean arterial pressure (MAP) from 99 to 46 torr (p less than 0.001) in five minutes and a gradual rise to 63 torr (p less than 0.01) after 30 minutes, with a survival rate of 80 per cent. HTS infusion five minutes after hemorrhage was followed by a further fall in MAP to 37 torr (p less than 0.01) after 30 minutes and a mortality rate of 85.7 per cent (p less than 0.01). HTS treatment after 15, 30, 60 and 120 minutes also led to a further fall in MAP and increased mortality. In group 2, the hemodynamic response to intra-abdominal vessel injury in untreated rats was similar to that of those in group 1 and the amount of sponges used to absorb shed blood was 2.4. After five, 60 and 120 minutes of HTS treatment, the hemodynamic response was similar to that in group 1. Five and one-half (p less than 0.01), 3.5 and 3.0 sponges, respectively, were used to absorb shed blood.(ABSTRACT TRUNCATED AT 400 WORDS)

Abdominal Muscles↗
PubMed1990

Tracheal mucus clearance in high-frequency oscillation: effect of peak flow rate bias.

We have reported previously that high-frequency oscillation of the chest wall (HFO/CW) enhances the tracheal mucus clearance rate (TMCR) in dogs. This enhancement of TMCR may be due in part to the expiratory bias in peak flow rate (VE/VI greater than 1) that occurs during HFO/CW. We examined this factor in 8 anaesthetized, spontaneously breathing dogs by comparing TMCR during the following manoeuvers: 1) HFO/CW, applied by means of a thoracic cuff; 2) symmetric high-frequency oscillation via the airway opening (HFO/AO), applied by means of a piston pump driven by sinusoidal signal; 3) HFO/AO with an expiratory bias in peak flow, and 4) HFO/AO with an inspiratory bias in peak flow. All manoeuvers were of 5 min duration and were performed at 13 Hz and an oscillatory tidal volume of 1.5 ml.kg-1. In the latter two manoeuvers, the piston pump was driven by a nonsinusoidal signal such that peak VE/VI was greater than and less than unity, respectively. A high-impedance, cross-current flow of warmed, humidified air was provided at the tracheal tube. The order of manoeuvers 2, 3 and 4 was randomized, while manoeuver 1 was repeated at the end. TMCR was determined by direct bronchoscopic visualization of charcoal particle transport. Each HFO manoeuver was bracketed by a control period of spontaneous breathing. We found that TMCR during HFO/CW was 2.4 x control (p less than 0.001), in line with previous results.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗