PubMed Health⌕ Search

Biomedical subjects

J C George

Publications and source records attributed to J C George.

At least 19 recordsLinked to original sources
PubMed2003

Cost-effectiveness of coarctation repair strategies: endovascular stenting versus surgery.

The cost-effectiveness of stent (ST) implantation for the repair of coarctation of the aorta (CoA) is not documented in the medical literature. Inflation-adjusted hospital costs for ST implantation and for surgical (SU) repair were obtained using the HBOC Cost Accounting System software and evaluated for all patients 5 years of age or older who underwent elective treatment of CoA between July 1997 and June 2001. The average age of the ST group (n = 10) to 9.5 +/- 3.5 years for the SU group (n = 12) (p > 0.10). The ST group had one failure due to inability to cross the CoA (failure rate, 10%). Successful repair was accomplished in all other ST cases and in all SU cases, with no residual systolic gradients at 1-year follow-up. Hospital length of stay for the ST group was 0.8 +/- 1.2 days compared to 3.5 +/- 0.5 days for the SU group (p < 0.001). The mean inflation-adjusted cost for the ST group was dollar 7,148 +/- 2,984 versus dollar 11,769 +/- 3,702 for the SU group (p < 0.005). By intention to treat analysis, the cost of repair in the ST-first group was dollar 8,325 +/- 3,354 given the 10% failure rate (p < 0.04 vs the SU only group). Sensitivity analysis demonstrates that cost of repair is lower with the ST-first strategy compared to SU only until the failure rate of ST implantation exceeds 39%. Repair of CoA using an endovascular stent strategy is cost-effective compared to conventional surgical repair.

Adolescent↗
PubMed2002

[Tick-borne diseases and changes in the ecosystem in Lorraine].

The number of persons suffering from tick-borne diseases has notably increased in the French region of Lorraine since the mid 1990s. Greater awareness of the pathology is insufficient to explain such an increase in incidence. Instead, the proliferation of ticks is a major factor in the increased incidence of cases, and is mainly due to a modification of the ecosystem. Prophylaxis is based upon appropriate information for persons concerned and requires a sound understanding of the biology and habits of the vector ticks. Numerous factors--anthropogenic, natural, social--may contribute to the destabilisation of a well-balanced ecosystem, but all are more or less the direct result of human activity. The geographic specificities of this region may be an additional factor in the emergence of tick-borne diseases.

Adaptation, Physiological↗
PubMed1998

Viral serologic survey of bowhead whales in Alaska.

Serum samples from 21 of 36 Eskimo harvested bowhead whales (Balaena mysticetus) were positive by virus neutralization (50% endpoint titer > or = 1:28 and/or 100% endpoint titer > or = 1:20) for antibodies to at least one virus serotype from the calicivirus family, vesicular exanthema of swine virus (VESV) and San Miguel sea lion virus (SMSV). Many animals were positive to more than one serotype when using the Spearman-Karber (S-K) method for calculating antibody titers. The most common serotype detected was VESV F55 with 6 of 36 (17%) by the Monto and Bryan (MB) titer calculation method, and 17 of 36 (47%) by the S-K titer calculation method. Vesicular exanthema of swine virus 1934B antibody was detected in 3 of 36 (8%) and 5 of 36 (14%) whales using the MB and S-K methods, respectively. Vesicular exanthema of swine virus J56 antibody was detected in 3 of 36 (8%) by the S-K method only. All whales < 8.5 m (estimated yearlings, n = 6) were seronegative for VESV J56 and 1934B while 10% and 17% of the whales > 8.5 m were positive, respectively. Whales assumed to be sexually mature (> 13 m) had a higher prevalence of antibody to VESV 1934B and SMSV 8 than those < 13 m. Gender had an effect on seroprevalence of antibody to VESV 1934B as titers > or = 1:28 (S-K method) occurred in 18% of the females and 7% of the males. Antibody to other serotypes (SMSV 8 and 12) occurred less frequently (< 6%) at an antibody titer > or = 1:28 by the S-K method. All 36 whale sera were negative for antibody to VESV-A48, B51, C52, D53, E54, G55, H54, I55, and K54; Tillamook calicivirus, and dolphin morbillivirus; and SMSV-1, 2, 4, 5, 6, 7, 9, 10, 11, and 13 by the S-K method.

Alaska↗
PubMed1997

Observations on the external morphology and vasculature of a fetal heart of the bowhead whale, Balaena mysticetus.

BACKGROUND: Specialized demands within the aquatic environment for over some 60 million years have shaped unique morphological expressions in the whales, dolphins, and porpoises (Cetacea). Detailed consideration of these features, particularly in the great whales, has often been constrained by difficulties in securing adequate specimens for study. We had the opportunity to examine external heart morphology in a rarely obtained and prepared specimen from the bowhead whale, Balaena mysticetus. METHODS: The external morphology and in situ relations of a formalin-perfused heart were examined grossly in a near-term bowhead fetus. Latex injections assisted visualization of coronary vasculature. Magnetic resonance imaging was used to clarify heart positioning within the thoracic cavity in two younger (early and mid-gestational) intact fetuses. RESULTS: The heart was globular in form, with a blunt apex and wide base; it was laterally broad relative to height yet considerably compressed between nearly planar atrial (diaphragmatic) and auricular (sternocostal) surfaces. The heart constituted 0.01 of body mass in the near-term fetus. Within the thoracic cavity, the heart tilted forward on its long axis, placing the great basal vessels in the region of the thoracic inlet. The aorta extended forward from mid-base in parallel with the pulmonary trunk, arched sharply to the left, producing in succession the brachiocephalic trunk, left common carotid artery, and the left subclavian artery. Bifurcation of the brachiocephalic trunk yielded the right common carotid and right subclavian arteries. The distal portion of the aortic arch was linked to the pulmonary trunk via the ductus arteriosus. The aorta then swung caudally over the heart base, descending beneath the bodies of the thoracic vertebrae. The ascending aorta featured three bulbous sinuses immediately distal to the three semilunar cusps of the aortic valve. Originating along the distal boundaries of the left and right sinuses were the left and right coronary arteries. The arteries were similar in size and, because each sent contributions along their respective coronary and interventricular grooves, the heart can be described as bilateral relative to arterial supply. Anastomoses were common within and between the two arteries. Venous return from the heart was comprised of the great, middle, and right cardiac veins, all three converging in the coronary sinus. The right cardiac vein also included tributaries that emptied directly into the right atrium. CONCLUSIONS: External heart morphology in the fetal bowhead whale examined was distinguished by a laterally broad conformation with significant compression between its cranial and caudal surfaces. Aortic bulb configuration in combination with an expandable aortic arch may support blood service to the heart during diastole. Vascular service to the heart featured a complex vessel network with extensive intraarterial and intravenous anastomoses that enable many alternate blood perfusion pathways and may be adaptive to water-column-pressure fluctuations experienced by a large diving mammal.

Animals↗
PubMed1995

Noradrenaline-induced hypothermia is suppressed in the vagotomized cold-exposed pigeon.

Vagotomized (VX) pigeons studied 2 days after surgery exhibited a significant decrease in cloacal temperature (Tb) and respiratory rate (Rf), and an increase in heart rate (Hf) and metabolic rate (M) at the thermoneutral zone, when compared with sham-operated (SVX) pigeons. The effect of intravenous noradrenaline (NA) on Tb, Rf, Hf and M was examined in SVX and VX-pigeons at 15 degrees C. Following NA administration, the Tb and Rf in the SVX-birds dropped from the preinjection level, but in VX-pigeons, they were not significantly altered. In SVX-pigeons, a total suppression of shivering was apparent following NA-injection, while in the majority of VX-pigeons, shivering was only slightly affected or even increased. The Hf in both SVX- and VX-birds increased following NA-injection. The responses to reserpine were qualitatively similar to NA, although much slower. There were no differences between SVX- and VX-birds with regard to Tb, M and Rf following acetylcholine (ACh) and eserine (Ese) injection. Hf increased after ACh+Ese administration in SVX-pigeons, but in VX-birds, it decreased after an initial surge. Shivering was suppressed for 18-20 min in SVX-birds and 30-50 min in VX-birds. It is suggested that the lack of the hypothermic effect of NA in VX-birds is due to the maintenance of oxygen uptake with unimpaired capacity for shivering.

Acetylcholine↗
PubMed1995

Effects of exogenous arginine vasotocin on circulating levels of thyroid hormones and melatonin in the pigeon, Columbia livia.

The effects of intravenous injections of two different preparations of synthetic arginine vasotocin (AVT), deamino-dicarba-arginine vasotocin and arginine vasotocin diacetate tetrahydrate on serum levels of thyroxine (T4), triiodothyronine (T3) and melatonin were studied in the resting pigeon. Although variations depending on factors such as the type of AVT preparation and the dose used and also the duration of treatment were apparent, both preparations of AVT produced an increase in serum levels of T4 and a decrease in that of T3. The T3:T4 ratio was also significantly lower in response to AVT administration. However, no statistically significant changes in serum levels of melatonin were discernible with the administration of either of the two AVT preparations, even though melatonin levels in most AVT-treated groups showed a trend (P > 0.05) to be higher than that in the controls. The rise in T4 levels is indicative of increased release of T4 and/or the inhibition of its conversion to the active hormone, T3. The drop in T3 may account for the AVT-induced reduction in the metabolic rate of the pigeon observed in an earlier study. The absence of a significant increase in melatonin indicates that AVT could not produce such a change in the daytime in resting pigeons, in contrast to that in flown homing pigeons, suggesting that the modulating effect of AVT on melatonin levels is dependent on the physiological state of the animal.

Animals↗
PubMed1994

Solitary plasmacytoma of the mastoid bone presenting as coalescent mastoiditis.

Acute mastoiditis is a complication of acute otitis media that produces air cell opacification and coalescence on computed tomographic (CT) imaging. This appearance, however, is nonspecific and may be seen in patients with infection and tumor. Magnetic resonance imaging (MRI) can aid in differentiating the two on the basis of differences in tissue signal characteristics and by showing the presence or absence of an associated soft-tissue mass. In this report, we demonstrate the utility of MRI as a complementary imaging modality to CT in the diagnosis of a solitary plasmacytoma of the temporal bone that was initially thought to be coalescent mastoiditis.

Biopsy↗
PubMed1994

Case report 824: Tuberculosis presenting as a soft tissue forearm mass in a patient with a negative tuberculin skin test.

Tuberculosis presenting as a soft tissue mass is rare. The diagnosis should be considered in patients with radiographic findings of massive soft tissue swelling and cortical bone destruction. Such patients may present with few clinical findings and have no evidence of prior exposure to tuberculosis or history of immunosuppression. Computed tomography may be of use in distinguishing infection from malignancy.

Aged↗
PubMed1994

Ruptured cystic mesenchymal hamartoma: an unusual cause of neonatal ascites.

Cystic mesenchymal hamartoma is an uncommon benign liver neoplasm usually seen in infants with an asymptomatic abdominal mass [1]. We report a neonate who presented with a ruptured cystic mesenchymal hamartoma which produced respiratory distress due to massive ascites. To our knowledge, this complication has never been reported.

Adolescent↗
PubMed1994

Langerhans cell histiocytosis of bone: MR imaging.

Magnetic resonance (MR) images of 12 pathologically proven lesions of Langerhans cell histiocytosis (LCH) of bone were reviewed retrospectively. MR identified all lesions, three of which were not identified on plain radiographs. In all cases, MR showed greater abnormality than did plain radiographs. With one exception, all lesions were hypointense on T1-weighted images and hyperintense on T2-weighted images. The lesions and associated soft tissue abnormalities were very conspicuous on short TI inversion sequences and T1-weighted post-contrast images. Follow-up MR studies in two patients after chemotherapy showed decreased size and enhancement of lesions compared with baseline studies.

Adolescent↗
PubMed1992

Effects of arginine vasotocin on cardiorespiratory and thermoregulatory responses in the pigeon.

1. The effects of intramuscular injections (10 ng, 100 ng, 1 mu or 10 mu/pigeon) of two preparations of synthetic arginine vasotocin (AVT), deamino-dicarba-arginine vasotocin (ddAVT) and arginine vasotocin diacetate tetrahydrate (AVTdt) on heart rate (HR), breathing frequency (BF), oxygen consumption (VO2), cloacal and foot temperatures (Tc and Tf) and shivering (S) were studied in the pigeon housed in a respiratory flow chamber maintained at a temperature of 22.5 degrees, during a 4 hr post-injection period. 2. In general, with the exception of the lowest dose, AVT-treatment produced hypothermic responses, as was indicated by Tc and Tf. 3. Both ddAVT and AVTdt produced increases in HR and BF when administered in high concentrations (10 micrograms/pigeon), the effect being more potent with AVTdt than ddAVT; with lower doses, the effects were considerably less pronounced. This increase in HR and BF is attributed to a probable compensatory response to the hypothermic effect. 4. With a 10 micrograms dose, ddAVT produced a greater decline in VO2 than AVTdt. Although other doses too evoked a drop in VO2 at certain post-injection time points, the effect was of lesser magnitude. 5. No significant shivering response was elicited, in spite of the drop in Tc. 6. It is suggested that, besides the antidiuretic function of AVT, its hypothermic effect would be of considerable importance in thermal homeostasis during flight in birds.

Animals↗
PubMed1990

Influence of chronic melatonin implantation on circulating levels of catecholamines, growth hormone, thyroid hormones, glucose, and free fatty acids in the pigeon.

Subcutaneous implantation of melatonin pellets (2 mg melatonin + 30 mg beeswax) for a period of 12 weeks, with reinforcement of implants every 2 weeks, caused significant increases in plasma levels of glucose and growth hormone (GH). Plasma levels of thyroxine (T4) were lower and the triiodothyronine (T3)/T4 ratio was higher in the melatonin-treated pigeons. However, melatonin treatment produced no significant effect on plasma levels of free fatty acids (FFA), T3, epinephrine (E), and norepinephrine (NE), although trends (P greater than 0.05) toward slight increases in FFA and T3 and decreases in E and NE were apparent. Since melatonin treatment caused increases in the levels of plasma glucose and GH and not in those of the other substances measured, it is suggested that melatonin enhances carbohydrate metabolism in preference to lipid metabolism in resting pigeons during the day (photophase) when pineal and circulating levels of melatonin are normally lower than during night (scotophase).

Animals↗
PubMed1990

A comparison between oral ciprofloxacin and intraperitoneal vancomycin and netilmicin in CAPD peritonitis.

This report describes a prospective, randomized comparison of oral ciprofloxacin and intraperitoneal vancomycin/netilmicin in the treatment of 50 consecutive episodes of CAPD peritonitis in 35 patients. Successful cure of peritonitis was achieved in 76% of subjects taking oral ciprofloxacin and 72% of those given intraperitoneal antibiotics. Satisfactory concentrations of ciprofloxacin in dialysate were achieved in all patients. Failure of ciprofloxacin was due to persistence of an isolate of intermediate sensitivity (1), to persistence with acquisition of resistance (1), and to relapse/reinfection in the remaining four cases (with resistant or moderately sensitive strains in three cases). Ciprofloxacin was well tolerated in the majority of cases. A significant rise in serum creatinine was noted in almost all patients taking oral ciprofloxacin. The advantages of oral drug administration indicate that oral ciprofloxacin is the preferred first-line treatment of CAPD-associated peritonitis.

Administration, Oral↗