Demonstration of parotid maxillary sinus nasal fistula by radionuclide salivary imaging.
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Adult↗
Biomedical subjects
D Patel
Publications and source records attributed to D Patel.
Anaesthesia for combined heart and lung transplantation.
In December 1983, Harefield Hospital started a programme for combined heart and lung transplantation. Fifty-two transplants have been successfully performed, with 36 survivors (April 1986). Patient selection and anaesthetic management of both donor and recipient are discussed. Two case histories are presented which illustrate the principles of anaesthetic management and postoperative care.
Adolescent↗
Antibodies to food and environmental antigens in serum, respiratory tract and intestine of pigs.
Serum antibodies to food, bedding and dust were detected in pigs by precipitation and ELISA. There was an age-related decrease in the number of animals with precipitating antibodies and in the specific activity of IgG and IgM antibodies. Antibodies to food, bedding and dust were detected in respiratory and intestinal secretions, but there were differences in the distribution and isotype of antibodies to these three antigens.
Age Factors↗
Aneurysms of the pulmonary arteries--a case report.
A fifty-five-year-old male demonstrated over a three-year period marked enlargement of pulmonary aneurysms. This can be a fatal condition owing to rupture of the aneurysms.
Aneurysm↗
Percutaneous decompression of cecal volvulus.
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Barium Sulfate↗
Four methods to recruit renal functional reserve.
The acute changes in creatinine clearance (Ccr) in response to intravenous amino acid infusion and to oral meat and milk protein meals were studied in seven healthy control subjects (Acute study). Para-aminohippurate clearance (CPAH), Ccr, inulin clearance (Cin), and plasma renin activity (PRA) were measured in seven different healthy control subjects following 1 week of low-protein diet, 0.7 g/kg per day, and again after one week of high-protein diet, 2.0 g/kg per day (Chronic study). In the acute study Ccr increased to a similar extent with each of the three stimuli, 20.1 +/- 6.2% (SD), 12.6 +/- 6.2% (SD) and 19 +/- 6.2% (SD) with amino acid infusion, 80-g meat protein and 80-g milk protein meals respectively. In the chronic study Ccr was 21%, Cin 26%, CPAH 8%, and filtration factor (FF) 14% greater during the high-protein diet than the low-protein diet, while PRA was increased by 43% on the high-protein diet. We conclude that an 80-g protein oral meal is probably sufficient to elicit the maximum acute increase in Ccr, since all three acute responses were similar, and similar in degree, to those previously reported, and may therefore be of value in measuring maximal filtration capacity. In contrast to one previous report, meat and milk proteins induced similar changes in Ccr. Thus milk protein cannot be regarded as a dietary substitute for meat in any diet designed to reduce glomerular hyperfiltration. Renin may play a part in the increase in glomerular filtration rate through the action of angiotensin II on the efferent arteriole, increasing filtration fraction.
Adult↗
Arthroscopy update #2. Arthroscopic removal of femoral intramedullary rod.
A 51-year-old man with a femoral shaft fracture previously treated by open intramedullary rod fixation developed a symptomatic distal migration of the rod. A technique for arthroscopic removal of the femoral rod is described. This report highlights the expanding role of arthroscopy in the treatment of orthopaedic disorders.
Arthroscopy↗
ICMR Task Force Study on hormonal contraception. Biological activity of ethinyl estradiol present in the breast milk.
A study was conducted to compare the biological activity of the estrogenic component of the endogenous steroids in breast milk samples collected during various phases of lactation with those milk samples collected from women who were on estrogen therapy. The estrogenic biological activity in the milk sample was assessed by the immature mouse uterine weight gain assay. Milk samples collected during postpartum period from six different study groups, viz., control colostrum of 1-3 days and 4-6 days, transitional milk (10-20 days) and mature milk (1-3 months) were compared with colostrum and mature milk of women treated with Lynoral (ethinyl estradiol 0.1 mg) three times a day for three days. Estrogenic activity was observed only in animals injected with milk extracts of colostrum samples from both control and Lynoral-treated women; however, they were not significantly different from each other. Therefore it is not the exogenous estrogens, but the endogenous estrogen present in large quantities in the colostrum that is responsible for the biological activity.
Animals↗
Effect of very low molecular weight heparin-derived oligosaccharides on lipoprotein lipase release in rabbits.
Oligosaccharide fragments of heparin were prepared using flavobacterial heparinase. Following sizing, these oligosaccharide fractions were administered (i.v.) to rabbits and were examined for their ability to release lipoprotein lipase. The decasaccharides (dp = 10, Mr avg = 2,800) were the smallest oligosaccharides which resulted in substantial lipase release. The plasma lipase levels obtained with decasaccharides were comparable to low molecular weight heparin and one-third those obtained when heparin was administered at an equivalent dose. The peak plasma lipase concentration was observed 10 min following heparinization and fell off rapidly over the 60-min time course. The lipase release activity paralleled the in vivo pharmacokinetics of the heparin and decasaccharide sample as determined by monitoring their anti-Factor Xa activity. No activation of purified bovine milk lipoprotein lipase or plasma lipase was detectable at the concentrations studied, indicating that the increase in circulating lipolytic activity was due entirely to release. Lipoprotein lipase accounted for a major portion of the released activity with hepatic triglyceride lipase representing the remainder of the lipolytic activity. The sized decasaccharide sample was characterized with regards to its structure and anticoagulant activity. The decasaccharides exhibited reduced anticoagulant activity possibly making it a better drug candidate in the treatment of atherosclerosis.
Animals↗
Bucket handle tear of a discoid medial meniscus. Arthroscopic diagnosis--partial excision. A case report.
A case of a rare, large discoid medial meniscus with a bucket-handle tear is described. The radiogram was normal and the clinical impression was torn medial meniscus. A diagnostic arthroscopy revealed an unusually large medial discoid meniscus with a bucket-handle tear. Open partial excision was performed following the arthroscopy.
Adult↗
Arthroscopy update #1. Treatment of osteochondrosis dissecans of the knee by arthroscopic curettage, follow-up study.
Thirty-seven patients with osteochondrosis dissecans involving the femoral condyles of the knee were treated with arthroscopic removal of all partially or completely detached osteochondral fragments and with curettage of the crater to bleeding bone. Ten patients underwent a repeat arthroscopy five to 15 months later. All defects had filled with fibrocartilage.
Adolescent↗
Plica as a cause of anterior knee pain.
Precise anatomic and pathologic classification of patellar plicae is possible. Strict adherence to the indications outlined in this article should permit good results from pathologic plica resection. It must be reemphasized that normal plicae should not be excised.
Adolescent↗
Effect of oral alcohol on left ventricular ejection fraction, volumes, and segmental wall motion in normals and in patients with recent myocardial infarction.
A first-pass nuclear angiogram and a multiple-gated acquisition study were obtained in 10 normal physicians and in 10 patients with a 7-to-10 day old transmural myocardial infarction. After the scan the subjects drank 2 oz. of whiskey. After 60 minutes, the multiple-gated acquisition study was repeated. In the normal group the left ventricular ejection fraction was 68% before and 72% after alcohol. The left ventricular end-diastolic volume increased from 89 to 97 ml while the left ventricular end-systolic volume decreased from 29 to 27 ml. The stroke volume rose from 61 to 70 ml/beat (p less than 0.05). The cardiac output increased from 4.0 to 5.0 l/min (p less than 0.05). In the infarction group, the left ventricular ejection fraction was 58% before and 56% after alcohol administration. The left ventricular end-diastolic volume fell from 111 to 96 ml, while the left ventricular end-systolic volume declined from 50 to 44 ml. The stroke volume fell from 61 to 52 ml/beat, while the cardiac output fell from 4.5 to 3.8 l/min. In the left ventricular infarction zones, alcohol produced in 9 of the 10 cardiac patients a decline in the left ventricular regional ejection fraction. In the normal group, alcohol produced no significant changes in the regional ejection fraction. The normal and the postinfarction patients responded differently to alcohol.
Adult↗
Remission of angina pectoris: correlation with the stress thallium-201 test.
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Angina Pectoris↗
Occlusive disease of the middle cerebral artery.
We studied 20 patients with severe occlusive disease of the mainstem middle cerebral artery (MCA) or its major division branches, and 25 patients with internal carotid artery (ICA) disease. MCA disease patients were more often black, female, younger, and had fewer TIAs than the ICA disease patients. Neurologic signs in patients with MCA disease evolved progressively during days to weeks, whereas ICA disease patients more often had an acute onset of nonprogressive deficits. CT commonly showed restricted subcortical or wedge-shaped infarcts in MCA disease patients. All MCA disease patients had stroke, but 40% of ICA disease patients had no infarction. MCA lesions usually affected the mainstem MCA or its major superior division. Patients with MCA disease seldom had recurrent ischemia in the same vascular territory as the stroke and had a low incidence of subsequent cardiac death.
Adult↗
Racial differences in the distribution of anterior circulation occlusive disease.
We compared clinical and angiographic features of 26 white and 45 black patients with symptomatic occlusive cerebrovascular disease. White patients had more transient ischemic attacks, carotid bruits, and more severe occlusive disease of the internal carotid artery origin. Blacks had more severe disease of the middle cerebral artery stem and supraclinoid internal carotid arteries. Differences were not explained by racial differences in the prevalence of hypertension, diabetes, hypercholesterolemia, or ischemic heart disease. Since the middle cerebral artery lesions in blacks do not correlate with other accepted epidemiologic, clinical, and laboratory markers of atherosclerosis, the lesions may arise from a disorder that differs from atherosclerosis.
Aged↗
Intraluminal clot of the carotid artery detected radiographically.
Nine patients had intraluminal filling defects identifiable as clot within the internal carotid artery at angiography. Thrombus was unilateral in eight, bilateral in one. Eight of the 10 clots were attached to atheromatous plaques. Three patients had serious concurrent illness: pancreatic cancer, rheumatoid arthritis with arteritis, and chronic pulmonary disease with polycythemia. In three patients, the clot was related to severe atherosclerosis. In three other patients, all young, the carotid thrombi remained unexplained though two of these patients had coagulation abnormalities. No patient had a new stroke after surgical or anticoagulant treatment.
Adult↗
Comparison of sensitivities of ELISA and radioimmunoassay for detection of class-specific antibody in mouse serum.
The limits of detection of IgG1 antibody in a standard mouse antiserum by a single antiglobulin enzyme-linked immunosorbent assay (ELISA) and 2 amplified systems, a double antiglobulin ELISA and a double antiglobulin radioimmunoassay (RIA), were compared in microtitration plates with the same antigen preparation and antisera. Compared with the single antiglobulin ELISA, both amplified assays demonstrated a 64-fold increase in sensitivity for the detection of antibody at high dilutions of standard antiserum. It is concluded that the amplified ELISA offers a safer assay than the amplified RIA and of equal sensitivity for comparable consumption of antisera.
Alkaline Phosphatase↗