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Biomedical subjects

J A Sullivan

Publications and source records attributed to J A Sullivan.

At least 19 recordsLinked to original sources
PubMed1992

Amplification for listeners with steeply sloping, high-frequency hearing loss.

Two experiments were conducted to determine the effects of various upper cutoff frequencies on performance of listeners with steeply sloping, high-frequency hearing loss. The upper cutoff frequency of individually prescribed responses was systematically adjusted to 0.71, 1.79, and 6.0 kHz. Measures of nonsense syllable recognition and subjective ratings of speech intelligibility and speech quality were obtained at three overall gain settings for each frequency response. Experiment 1 assessed performance on tests in quiet and Experiment 2 assessed performance on tests in noise. Nonsense syllable recognition improved as the upper cutoff frequency increased, particularly for tests in noise. In contrast, the subjects gave significantly poorer quality ratings for the shaped response with the highest cutoff frequency (6.0 kHz). Few significant effects of cutoff frequency were found for ratings of intelligibility in either quiet or noise.

Aged↗
PubMed1992

Hip stabilization in severely involved cerebral palsy patients.

Thirty-two patients (48 hips) with total body involved cerebral palsy (CP) underwent medial release and proximal femoral osteotomy for hip subluxation or dislocation. Twenty-eight hips were rated good, 15 were rated fair, and five were rated poor at follow-up. The better located the hip preoperatively and the better the reduction obtained at operation, the better the final result. The major factor that correlated with a good result was early operation, performed before significant deformity had occurred.

Adolescent↗
PubMed1991

The accuracy of tibial intramedullary alignment devices in total knee arthroplasty.

The accuracy of a tibial medullary alignment device is assessed radiographically in 30 varus and 30 valgus knees undergoing total knee arthroplasty. The results suggest that although the device is reliable and accurate for varus knees, it may lead to malalignment of up to 5 degrees in valgus knees. Overall neutral alignment was achieved in 83% of the varus knees and 37% of the valgus knees. Tibial bowing was the main source of error and was present in 66% of the valgus knees, with mean of 3 degrees. Preoperative long films or cross-checking with external alignment devices is recommended to assure neutral alignment in genu valgus deformity.

Congenital Abnormalities↗
PubMed1990

Does cardiopulmonary bypass alter enflurane requirements for anesthesia?

This study on dogs determined whether the requirement for enflurane anesthesia was different pre- versus postcardiopulmonary bypass (CPB). Male mongrel dogs (n = 16) were anesthetized with enflurane in oxygen. Tracheal intubation was performed, monitors placed, and end-tidal enflurane concentration measured via a Puritan-Bennett Anesthesia Agent Monitor. MAC was determined by the tail-clamp method. CPB was then initiated using aortoatrial (n = 6, group 1) or femoral artery-vein (n = 4, group 2) cannulation or none (n = 6, group 3, control). CPB was maintained for 1 h using a bubble oxygenator, a crystalloid prime, and flows of approximately 70-80 ml/kg with a mean systemic pressure maintained between 50-70 mmHg. Following separation from CPB, MAC was again determined. The reduction in enflurane MAC following CPB was 30.1 +/- 21.5% (mean +/- SD; P less than 0.05 vs. pre-CPB) in group 1 but there was a wide range of reduction produced (3.8-58.8%). The degree of MAC reduction (19.8 +/- 8.6%; P less than 0.05 vs. pre-CPB) produced by CPB in group 2 was much less variable in degree (range 13.0-32.4%) but did not differ from group 1. Although pre- versus post-CPB mean systemic pressure fell from 83 +/- 13 to 69 +/- 15 mmHg (P less than 0.05), this is above the level likely to produce a reduction in MAC. No other significant hemodynamic changes were observed. Temperature pre- versus post-CPB was not different. The degree of hemodilution and acid-base disturbances are unlikely to be the explanation.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Inhalation↗
PubMed1990

Ligamentous injuries of the knee in children.

Ligamentous injuries, although uncommon in the skeletally immature patient, can be found in isolation or associated with physeal injury or long-bone fracture. Four new cases of ligamentous injury in the child show that recognition and management of these injuries are important to achieve good recovery. In addition to history and physical examination, standard and stress roentgenographs, examination under anesthesia, and arthroscopy are important for early diagnosis.

Adolescent↗
PubMed1989

Both recombinant interleukin-1 (beta) and purified human monocyte interleukin-1 prime human neutrophils for increased oxidative activity and promote neutrophil spreading.

Both purified human monocyte interleukin-1 and recombinant interleukin-1 (beta) primed neutrophils for increased superoxide production and chemiluminescence in response to f-met-leu-phe. In addition, purified human monocyte interleukin-1 and recombinant interleukin-1 (beta) altered neutrophil shape. Recombinant interleukin-1 (alpha) used at the same concentration of interleukin-1 (beta) did not prime neutrophils for increased superoxide production after stimulation with f-met-leu-phe. Interleukin-1 expressed by monocytes in response to endotoxin stimulation could act as a modulator of neutrophil function.

Humans↗
PubMed1989

Giant cell reaction in a phalangeal bone.

A case of the rare and non-neoplastic lesion, giant cell reaction of bone, is described. The pathological and radiological features of this lesion are reviewed and an aetiological mechanism is proposed to account for its unique histopathological features. Recognition of this lesion and its non-neoplastic nature are important so as to avoid surgical ablation of the affected bone.

Adult↗
PubMed1989

Surgical repair of stenotic ostial lesions of the left main coronary artery.

Fourteen patients with isolated stenosis of the left coronary artery ostium underwent vein patch angioplasty. An anterior approach between the aorta and pulmonary artery to expose the left main coronary ostium was used in 12 of 14 patients. There were no deaths, and postoperative angiograms in 13 of the patients showed normal coronary ostial contour with normal runoff. Two perioperative myocardial infarctions were observed. Four of the 14 patients underwent an urgent operation. Isolated coronary ostial stenosis appears to be a distinct clinical entity occurring in younger patients, mostly female, and often with a short clinical course. Unstable pain and hemodynamics are observed. The common pathologic cause of the stenotic lesion is not clear.

Adult↗
PubMed1988

Spatial and temporal characteristics of the increase in intracellular Ca2+ induced in cytotoxic T lymphocytes by cellular antigen.

The increase in intracellular Ca2+ concentration [( Ca2+]i) in cytolytic T lymphocytes in response to target cell binding was investigated by ratio image fluorescence microscopy. Ca2+ mobilization from intracellular stores occurred at a site distal to target cell contact and was transient. Extracellular Ca2+ influx resulted in an increase in [Ca2+]i that was prolonged and distributed more proximal to the target cell. Oscillations in [Ca2+]i were observed after target cell contact, although the periodicity was dependent on the presence of extracellular Ca2+. The Ag-specific reorientation of cytoplasmic granules occurred well after [Ca2+]i had begun to decline to a resting level, but was dependent on extracellular Ca2+. These studies indicate that the Ag-stimulated increase in [Ca2+]i exhibits considerable spatial and temporal variation, and that these characteristics are altered by the availability of extracellular Ca2+. The results also suggest that these changes in [Ca2+]i may play a role in the cytoplasmic events that accompany T cell-mediated cytolysis.

Animals↗
PubMed1988

Spontaneous oscillations of intracellular calcium and growth hormone secretion.

A novel combination of two single cell assays allowed the simultaneous measurement of intracellular calcium concentration and hormone secretion in normal pituitary cells. [Ca2+]i was recorded using the fluorescent Ca2+ indicator fura-2 and digital imaging microscopy. This technique was combined with a reverse hemolytic plaque assay for growth hormone in order to identify somatotropes and quantitate the amount of hormone released. A dynamic profile of rhythmic calcium oscillations was found in spontaneously secreting somatotropes. Each somatotrope displayed a distinct frequency (one pulse every 5-30 s) and amplitude (range 50-450 nM) generated asynchronously from cell to cell. The amount of growth hormone (GH) released correlated directly with both the frequency and amplitude of calcium oscillations at the level of single GH cells. Furthermore, calcium excursions in somatotropes were rapidly suppressed by either (i) removal of extracellular calcium, (ii) somatostatin (1 mM), or (iii) the calcium channel blockers cobalt (2 mM) and verapamil (100 microM). These observations demonstrate that spontaneous calcium oscillations are characteristic for normal somatotropes. These oscillations are related to spontaneous hormone secretion and due to influx through calcium channels in the membrane. Somatostatin, the physiologic inhibitor of GH secretion, suppresses calcium transients. These findings suggest that the intracellular signaling information may be encoded both in the frequency and amplitude of calcium oscillations.

Animals↗
PubMed1988

Dual stimulation of phospholipase activity in human monocytes. Role of calcium-dependent and calcium-independent pathways in arachidonic acid release and eicosanoid formation.

Human peripheral blood monocytes, prelabeled with [3H]arachidonic acid (AA), release labeled eicosanoids in response to soluble or particulate stimuli. Treatment with 12-O-tetradecanoate phorbol-13 acetate (20 nM), calcium ionophores, A23187 (2 microM) or ionomycin (1 microM), or serum-treated zymosan (300 micrograms) resulted in production of cyclooxygenase (CO) metabolites, 6-keto-PG-F1 alpha, thromboxane-B2, PGE2, PGF2 alpha, PGD2, PGB2, 12-L-hydroxy-5,8,10-heptadecatrienoic acid; 15-lipoxygenase products, including 15-hydroxyeicosatetraenoic acid (HETE); and unmetabolized AA. Labeled 5-lipoxygenase (LO) products, 5-HETE, and leukotriene-B4 were detected only after exposure to ionophore or serum-treated zymosan. The calcium dependence of 5-LO activation was confirmed in experiments where calcium was omitted from the incubation medium, and EGTA (0.5 mM) was added, as well as by direct measurement of increased intracellular calcium in phagocytosing monocytes. Combined or sequential treatment with two stimuli increased the release of unmetabolized AA without a commensurate augmentation of labeled metabolites, indicating that release of CO and LO metabolites does not necessarily reflect the extent of phospholipase activation. Quantitation of individual eicosanoids by RIA confirmed results by using radionuclides. These studies show the following. Activation of human monocyte phospholipase may be regulated by at least two pathways, one "12-O-tetradecanoate phorbol-13 acetate-like," which is largely independent of calcium, and another which is mediated by increased intracellular Ca2+ ("ionophore-like"). "Physiologic" stimulation of monocyte arachidonate release, such as that seen accompanying phagocytosis of opsonized particles, may occur via either a calcium-sensitive or calcium-insensitive pathway or both. Calcium may regulate eicosanoid formation at the level of phospholipase or 5-LO. Free AA, CO products, and 12- or 15-LO products are ordinarily released after phagocytosis, but leukotriene-B4, 5-HETE, or other 5-LO metabolites are produced only under conditions where calcium concentrations are optimal.

Arachidonic Acid↗
PubMed1988

An experimental comparison of four hearing aid prescription methods.

Four hearing aid prescription methods were compared. A digital master hearing aid was used to produce the prescribed frequency gain characteristics. Measures of speech recognition and paired comparison judgments of relative speech intelligibility and speech quality were obtained at three output levels for each of the experimental frequency gain characteristics. No single prescriptive method emerged as being clearly superior. Relative performance of the four prescriptive methods varied as a function of output level. Similar results were observed for both speech recognition testing and paired comparison testing.

Adult↗
PubMed1988

Relationship of free intracellular calcium to the cytolytic activity of Entamoeba histolytica.

Entamoeba histolytica adherence and destruction of host cells is required for in vivo pathogenicity; amebic in vitro adherence is mediated by a galactose- or N-acetyl-D-galactosamine-inhibitable surface lectin (Gal/GalNAc adherence lectin). Free intracellular Ca2+ concentration [( Ca2+]i) was measured in living amebae and target cells during amebic cytolysis of Chinese hamster ovary (CHO) cells and human polymorphonuclear neutrophils by utilizing the Ca2+ probe Fura-2 and computer-enhanced digitized microscopy. Motile E. histolytica trophozoites had oscillatory increases in [Ca2+]i in head or tail regions; however, there was no increase in regional or total amebic [Ca2+]i upon contact with a target CHO cell. Target CHO cells and polymorphonuclear neutrophils demonstrated marked irreversible increases in [Ca2+]i within 30 to 300 s following contact by an ameba (P less than 0.01); increased [Ca2+]i preceded the occurrence of nonspecific surface membrane permeability and death of the target cell. Target CHO cells contiguous on a monolayer to a cell contacted by an ameba experienced a rapid but reversible rise in [Ca2+]i (P less than 0.01) and were not killed. Galactose (40 mg/ml) totally abrogated the rise in target CHO cell [Ca2+]i that followed contact by amebae (P less than 0.01); immunoaffinity-purified amebic Gal/GalNAc adherence lectin (0.25 micrograms/ml) induced a rapid and reversible rise in CHO cell [Ca2+]i (P less than 0.01) which was inhibited by galactose. Amebic [Ca2+]i was not elevated following parasite adherence to target cells; a rapid and substantial rise in target cell [Ca2+]i occurred which was mediated, at least in part, by the Gal/GalNAc adherence lectin of the parasite and led to the death of target cells.

Adhesiveness↗
PubMed1988

Cutaneous vascular spiders in cirrhotic patients: correlation with hemorrhage from esophageal varices.

Ninety-two consecutive male cirrhotic patients had esophagoscopy to determine the presence and size of varices, and a concomitant skin examination for assessment of cutaneous vascular spiders. Thirty-one subjects bled from varices within 10 days of the spider evaluation, and this group was compared to 61 individuals who never bled. Our results show that incidence of spiders (90%) and varices (91%) is nearly identical, that frequency of variceal bleeding is higher among subjects with spiders compared with those who lack these lesions (36% vs 11%, p less than 0.05), and that the spider profile may be useful to identify individuals who are at increased risk for variceal hemorrhage. Frequency of bleeding was 50% (p less than 0.01) when greater than 20 spiders were present and 63% (p less than 0.01) when multiple atypically located lesions were detected. Large spiders (greater than 15 mm) correlate best with large varices and have the strongest association with bleeding (80%, p = 0.0002). If evidence of benefit from prophylactic treatment of esophageal varices can be established, then elements of the spider profile may serve as a discriminating marker to assist in selection of appropriate patients for therapy.

Adult↗
PubMed1987

Mechanical consequences of rod contouring and residual scoliosis in sublaminar segmental instrumentation.

The mechanical performance of contoured Luque rods in a neuromuscular model of spine deformity was examined to define an upper limit of deformity above which rod stresses would exceed the endurance limit for 316L stainless steel and therefore predict fatigue failure. Bovine constructs varying from 0-120 degrees scoliosis were loaded axially, with strain recordings obtained at the apex of the curve. Relatively low loads produced enough tensile stress to contemplate implant fatigue in all except the nondeformed (0 degrees) construct. Construct stiffness was found to decrease rapidly in spines with greater than 38 degrees deformity. In addition, data on patients who had suffered rod fracture from four different centers were found to compare favorably with experimental observations. We conclude that the vulnerability of Luque rod constructs to implant failure, from a mechanical standpoint, is greater than is generally assumed. Cross-linking of rods was found to increase stiffness. Methods to decrease tensile stresses in the implants and increase stiffness include external immobilization, larger diameter rods, and procedures to enhance correction.

Adolescent↗