Arthroscopic intubation.
Explore the source record for details and available documents.
Equipment Design↗
Biomedical subjects
J Boon
Publications and source records attributed to J Boon.
Histological patterns in endometrial samples from perimenopausal women.
OBJECTIVE: Evaluation of endometrial histology patterns in perimenopausal women. METHODS: Endometrial biopsies (202) taken from perimenopausal women by suction curette were assessed by light microscopy. RESULTS: Out of 142 adequate specimens a total of 82 (57.7%) specimens could not be classified in the well-defined categories of the fertile period because of mixed histological patterns. Of the 142 specimens, 59 (41.5%) showed abnormal secretory endometrium, three (2%) disordered proliferative endometrium and 20 (14.1%) a mixture of non-secretory and secretory endometrium. CONCLUSION: The often used histological classification for endometrium, with well-defined regular patterns based on normal cyclic changes, often does not apply to endometrial tissue obtained from perimenopausal women due to a mixed pattern within one biopsy.
Adult↗
Ongoing HIV dissemination during HAART.
Explore the source record for details and available documents.
Anti-HIV Agents↗
Comparison of tramadol and morphine via subcutaneous PCA following major orthopaedic surgery.
PURPOSE: To compare subcutaneous PCA tramadol with subcutaneous PCA morphine for postoperative pain relief after major orthopaedic surgery and for the incidence of side-effects. METHODS: In a double-blind randomised controlled study 40 patients (20 in each group) self-administered either tramadol or morphine for 72 hr after surgery via s.c. PCA. The following variables were recorded at various time intervals: (i) pain score by means of a visual analogue scale, (ii) drug consumption and total PCA demands, (iii) vital signs (blood pressure and heart rate), (iv) oxygen saturation and respiratory rate, and (v) side-effects (sedation, nausea/vomiting, pruritus, urinary retention and constipation). RESULTS: Both drugs provided effective analgesia. The mean consumption in the first 24 hr was 792 +/- 90 mg tramadol and 42 +/- 4 mg morphine. Thereafter, consumption of both drugs declined markedly. Moderate haemodynamic changes were observed in both the tramadol and morphine groups (with a maximum 20% decrease in mean blood pressure and a maximum 17% increase in heart rate) during the 72 hr period. Both tramadol and morphine were associated with a clinically and statistically significant (P < 0.001) decrease in oxygen saturation, but without changes in respiratory rates. Desaturation was less marked with tramadol. Tramadol appeared to cause more nausea and vomiting than morphine. Sedation was mild and only seen during the first few hours after surgery in both groups. CONCLUSION: Tramadol is an effective analgesic agent for the relief of acute postoperative pain when administered by PCA via the subcutaneous route. Under these conditions tramadol behaves much like morphine with a similar side-effect profile.
Adult↗
Making it happen. Organizing an overseas study trip.
Explore the source record for details and available documents.
Awards and Prizes↗
Diagnosis and surgical repair of partial atrioventricular septal defects in two dogs.
Partial atrioventricular (AV) septal defects consist of an ostium primum defect and malformation of the septal cusp of the mitral valve. A partial AV septal defect was diagnosed by means of echo-cardiography in 2 dogs. Transatrial septal blood flow was high enough in both dogs to warrant surgical correction. Defects were repaired through right fifth intercostal thoracotomies, with the aid of cardiopulmonary bypass. An incision was made in the right atrium to expose the AV septal defect, and the mitral valve was inspected through the septal defect. The cleft in the septal cusp of the mitral valve was repaired with mattress sutures of 6-0 polypropylene. The septal defect was closed with autogenous pericardium harvested from the right aspect of the pericardial sac. Both dogs survived surgery and were alive 15 and 42 months, respectively, after surgery, however, 1 dog developed progressive mitral regurgitation after surgery. Partial AV septal defects can be successfully repaired in dogs. Long-term prognosis probably depends on the adequacy of the mitral valve repair.
Animals↗
"Free speech". Teaching midwives' skills.
Explore the source record for details and available documents.
Clinical Competence↗
Open resection for subvalvular aortic stenosis in dogs.
OBJECTIVE: To describe the surgical technique for open resection of congenital subvalvular aortic stenosis in dogs and to determine outcome of dogs undergoing the procedure. DESIGN: Uncontrolled clinical trial. ANIMALS: 17 dogs with congenital discrete subvalvular aortic stenosis. PROCEDURE: Dogs were placed on cardiopulmonary bypass by catheterizing the femoral artery and both vena cavae. The aorta was cross clamped, and cold cardioplegia solution was administered. The aortic root then was opened with a curvilinear incision. A subvalvular discrete fibrous ring was resected in all dogs. Septal myectomy was performed simultaneously on 11 dogs. RESULTS: 15 of 17 dogs survived the operation and were discharged from the hospital. Mean +/- SD maximal instantaneous aortic systolic pressure gradient measured by means of Doppler echocardiography was significantly reduced from 119 +/- 42 mm of Hg before surgery to 41 +/- 10 mm of Hg 12 months after surgery. Despite substantial reduction in the systolic pressure gradient, 4 of 15 dogs died suddenly between 7 days and 30 months after surgery. Three of the 4 dogs that died suddenly had pressure gradients > or = 180 mm of Hg and ventricular tachycardia before surgery. Eleven dogs were still alive between 1 and 48 months after surgery. CLINICAL IMPLICATIONS: The procedure resulted in substantial reductions in systolic pressure gradients in dogs with severe congenital subvalvular aortic stenosis. However, some dogs with severe aortic stenosis died suddenly after surgery. Thus, this surgery should not be considered curative. Proof of a survival benefit in dogs undergoing this surgery will have to await longer term follow-up.
Animals↗
Ventricular tachycardia and myocardial dysfunction in a horse.
Ventricular tachycardia develops less frequently than supraventricular dysrhythmias and generally is more indicative of cardiac disease. The horse in this report had clinical signs of lethargy and hypophagia and was determined to have sustained ventricular tachycardia. Echocardiography was a valuable diagnostic tool and revealed an echodense area in the left ventricle that had subnormal ventricular performance. A primary heart problem of an inflammatory nature was suspected. The horse responded favorably to treatment with lidocaine, antimicrobials, and aspirin, as well as stall rest. The horse was used successfully as a sire and hunter-jumper after treatment, but subsequently died 2.2 years later of massive hemoperitoneum. Necropsy revealed an extensive area in the left ventricle that appeared thin and fibrotic.
Animals↗
Dynamic cardiomyoplasty for treatment of idiopathic dilatative cardiomyopathy in a dog.
In a dog with advanced dilatative cardiomyopathy, dynamic cardiomyoplasty resulted in improvement in clinical status and systolic function. Dynamic cardiomyoplasty involved surgical isolation of the right latissimus dorsi muscle on its neurovascular pedicle, transposition of the muscle into the thoracic cavity, wrapping the ventricles with the muscle, and implantation of a myostimulator for cardiosynchronous stimulation of the muscle. After a 2-week period, the latissimus muscle underwent a 50-day period of progressive burst stimulation to transform the muscle to a fatigue resistant phenotype. Thereafter, the muscle received cardiosynchronous stimulation at a 3:1 R-wave-to-burst ratio. This procedure may offer hope for long-term treatment of dilatative cardiomyopathy in dogs.
Animals↗
In vitro metabolism of 3,3',4,4'-tetrachlorobiphenyl in relation to ethoxyresorufin-O-deethylase activity in liver microsomes of some wildlife species and rat.
A qualitative study was performed of the capacity of hepatic microsomes of several wildlife species to metabolize 3,3',4,4'-tetrachlorobiphenyl (TCB). Hepatic microsomes of species environmentally exposed to polychlorinated biphenyls (PCBs): harbour porpoise (Phocoena phocoena), harbour seal (Phoca vitulina), common tern (Sterna hirundo), and hepatic microsomes from species experimentally exposed to PCBs: eider duck (Somateria mollissima), rainbow trout (Salmo gairdneri), flounder (Platichthys flesus), and Wistar rat, were incubated with 14C-labelled TCB ([14C]TCB). The mammals and birds were able to metabolize TCB at a rate that correlated with their ethoxyresorufin-O-deethylase (EROD) activity. No [14C]TCB metabolism was observed in the fish, despite elevated EROD activity in the trout. HPLC analysis of diisopropylether extracts of the microsomal incubations indicated the presence of 4-OH-, 5-OH-, and 6-OH-tetrachlorobiphenyl metabolites and a yet unidentified metabolite. The ratio of the different hydroxy metabolites formed varied for the various species.
Animals↗
Fractionation of central nervous system myelin proteins by reversed-phase high-performance liquid chromatography.
Chromatographic fractionation of central nervous system myelin proteins is hampered by their poor solubility in water and strong association with lipids. Moreover, several myelin membrane proteins undergo posttranslational acylation which further increases their hydrophobicity. Here, a method is described for a two-step delipidation and high-resolution fractionation by reversed-phase high-performance liquid chromatography of all myelin proteins. The elution was monitored of the two major protein components, i.e. myelin basic protein (MBP) and proteolipid protein (PLP), as well as of minor components, viz. myelin-associated glycoprotein (MAG) and myelin/oligodendrocyte glycoprotein (MOG). Whereas MBP and MOG elute as single sharp protein peaks upon chromatography, PLP and MAG are resolved into several different components. Following their delipidation and separation, all proteins including the hydrophobic transmembrane proteins can be transferred to fully aqueous solutions without detergents. The overall yield of myelin proteins obtained in this way exceeds 85%.
Animals↗
[Poverty and ignorance: puerperal fever in the Amsterdamse Binnengasthuis in 1845].
The 1845 annual report of the maternity ward of the Amsterdam Binnengasthuis gives an insight into the obstetric knowledge and developments at that time, with emphasis on puerperal fever. Since the introduction of clinical training of medical students in 1828, maternal mortality had risen from 2.6% to 9.0%. In the year reviewed, 1845, maternal mortality was 8.6%. The report concerns 395 indigent and malnourished women. Rickets was frequent. Delivery, presentation of the children, complications, operative deliveries and outcome of the children are described. Perinatal mortality was 12.5%. In the original text, an impressive epidemic of puerperal fever in the first 4 months of the year is described. It also gives us an authentic insight into the views on the dissemination of puerperal fever, both the 'epidemic' (influence of cold weather etc.) and the 'contagionistic' view (dissemination by miasmata: evaporations from the diseased women). C.B. Tilanus Sr. (professor of obstetrics), reacted tepidly to Semmelweis' discoveries.
Disease Outbreaks↗
Minor myelin proteins can be major targets for peripheral blood T cells from both multiple sclerosis patients and healthy subjects.
T cell recognition of myelin is likely to play a role in the pathogenesis of multiple sclerosis. Predominant protein components of myelin, myelin basic protein (MBP) and proteolipid protein (PLP), have been considered as possibly relevant autoantigens, especially since both proteins are encephalitogenic in various laboratory animals. It has remained unclear, however, to what extent the numerous minor proteins contained in myelin may serve as targets for human T cell responses to myelin. In this study, the abilities of several minor myelin proteins to trigger proliferative responses of human peripheral blood T cells were compared to that of MBP. By using a water soluble collection of myelin proteins as an antigen, including MBP as the major component, short-term T cell lines were generated. Proliferative responses were determined against the various proteins after their fractionation by HPLC. Short-term T cell lines from both multiple sclerosis patients and healthy control subjects displayed significant responses to several minor myelin proteins but failed to respond to MBP. Only the use of purified MBP as trigger antigen allowed the selective expansion of MBP-specific T cell lines. These findings indicate that minor myelin proteins may act as relevant targets for autoreactive human T cells.
Animals↗
Late radiation response of canine mediastinal tissues.
The mediastinal tissues which included heart, lung, trachea and esophagus of 70 adult beagle dogs were irradiated to a range of total radiation doses between 24 and 68 Gy given in 2, 3 and 4 Gy fractions. The purpose of the study was the calculation of alpha/beta ratios for morphologic and functional changes of the mediastinal tissues. Functional assays including echocardiography, electrocardiography, right heart hemodynamics and cardiac output were performed. Histomorphometric analyses of all tissues included in the field were done 2 years after treatment. Euthanasia was performed on 7 of 70 dogs prior to 2 years due to congestive heart failure and seven other dogs had signs of heart failure 2 years after treatment. Heart failure was thought to be caused by either pericardial effusions or constrictive pericarditis in these dogs. Heart failure occurred at doses of 62 and 68 Gy given in 2 Gy fractions, 60 Gy given in 3 Gy fractions and 52 Gy given in 4 Gy fractions. The ED50 values for pericardial fibrosis for 2, 3 and 4 Gy fractions were 46.1, 43.9 and 26.6 Gy, respectively. An alpha/beta ratio of 2.5 Gy was calculated by direct quantal response analysis. Small foci of myocytolytic lesions were detected in 11 dogs. Calculated ED50 values for myocytolysis were 70.4 Gy given in 2 Gy fractions and 50.8 Gy given in 4 Gy fractions. The estimated alpha/beta ratio was 3.2 Gy. Heart rates determined from physical examination and frequency of S-T segment changes increased with increasing dose. No other dose related changes were found in any of the other functional parameters. Functional changes were detected in the 14 dogs with clinical signs of heart failure. Focal consolidation and subpleural fibrosis were present in the irradiated lung volume. These late changes had no detectable physiologic effect in these dogs because of the small volume of lung irradiated. The ED50 values for lung consolidation were 54.3, 45.8 and 26.6 Gy after 2, 3 or 4 Gy fractions, respectively. The estimated alpha/beta ratio was 3.4 Gy. No dose-related changes could be detected in the trachea or esophagus at 2 years after treatment. These results demonstrate that lung and pericardium are the most responsive tissues in the mediastinum within the first 2 years after treatment. Myocardial lesions were present with high ED50 values, but were not found to be functionally significant at 2 years after irradiation. Human clinical data indicate that longer observation periods are needed for development of these lesions.(ABSTRACT TRUNCATED AT 400 WORDS)
Animals↗
The effect of a five-month delay on children's and adults' eyewitness memory.
Child witnesses must endure a delay of around six months between observing or being the victim of an alleged offence and being required to give evidence in a criminal court. While the legal profession seem to believe that young children's memories are particularly sensitive to the passage of time, developmental psychology can offer little relevant data to support or refute this presumption. In the present study, children aged six and nine years and adults witnessed a staged event and were subsequently interviewed in the days following the event and/or five months later. Results indicate that while all witnesses forgot information over this period, the younger children (six years) recalled slightly less information than the older children and the adults. The total amount of incorrect information recalled did not increase over the same period. Two different interviewing techniques were used--cued recall vs. 'enhanced' recall--the latter incorporating some aspects of the cognitive interview procedure. No differences were found relating to the interview techniques employed. The results underline the importance of recording initial interviews with child witnesses wherever possible.
Adult↗
Antigen processing by endosomal proteases determines which sites of sperm-whale myoglobin are eventually recognized by T cells.
This study reports an identification of the major processing products of an exogenous protein antigen, viz, sperm-whale myoglobin, as obtained after cell-free processing with partially purified macrophage endosomes. It is demonstrated that such a system yields fragments that are indistinguishable by high performance liquid chromatography analysis from those generated after uptake of myoglobin inside live macrophages. The concerted action of the endosomal proteases cathepsin D and cathepsin B can account for nearly all cleavages observed. Cathepsin D appears to be mainly responsible for the initial cleavage of myoglobin, while cathepsin B catalyzes the C-terminal trimming of initially released fragments. The fragments released by cathepsin D contain most, if not all, major epitopes for murine myoglobin-specific helper T cells. Interestingly, each known T cell epitope of myoglobin is located at the very N terminus of a different myoglobin fragment released upon processing. In order to explain this correspondence, noted also in several other protein antigens, a structural relationship is proposed between antigen processing by cathepsin D and antigen recognition by major histocompatibility complex (MHC) class II products. As is demonstrated here, this relationship may be used as a predictive tool for the identification of MHC-binding sequences as well as of T cell epitopes in their naturally occurring form.
Amino Acid Sequence↗
Endocarditis caused by Corynebacterium sp in a dog.
Mitral valve bacterial endocarditis, caused by Corynebacterium sp, was diagnosed in a dog. The bacteria had characteristics unlike those commonly recognized for most species of Corynebacterium. The primary source of bacteremia was suspected to be a pilonidal cyst of the sacrum. The dog was treated with a first-generation cephalosporin for 6 weeks, and the pilonidal cyst was surgically removed. Physical examination 1 year after initial examination revealed no abnormalities other than a cardiac murmur. On echocardiographic examination 1 year after treatment, the vegetative lesion was still present; however, chamber dimensions had returned to normal. Wall thickness and contractility remained increased.
Animals↗