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Biomedical subjects

J D Hughes

Publications and source records attributed to J D Hughes.

At least 19 recordsLinked to original sources
PubMed1992

The mersilene covered intraorbital implant.

The most widely used material for covering spherical intraorbital implants is sclera. Mersilene mesh is an alternative substance combining the advantages of permanent implant cover with low rates of infection and ready availability. We describe our experiences in the use of Mersilene mesh covered intraorbital implants in 14 patients. Our findings suggest that Mersilene mesh could be considered as a possible alternative choice of material for covering intraorbital implants.

Adolescent↗
PubMed1990

Salivary gland scintigraphy--a suitable substitute for sialography?

By comparing 27 patients who had both scintigraphy and sialography in the assessment of salivary gland disease, scintigraphy has been shown to correlate well with abnormal sialograms. It is suggested that scintigraphy could become the initial screening procedure in the assessment of salivary gland disease. A normal scintiscan is unlikely to miss significant pathology (as demonstrated by sialography), but sialography must always be performed if there is a suspicion of duct obstruction on scintigraphy. Patients suspected of focal salivary gland pathology such as tumour have not been investigated. The series documents the findings in patients who presented with facial pain, swelling or xerostomia suggesting sialadenitis, duct occlusion or Sjögren's syndrome.

Adolescent↗
PubMed1989

The reuse of OKT3 after previous rejection or induction therapy in cadaveric renal transplantation.

Twenty-three patients were retreated once and two patients were retreated two times with OKT3 after previous rejection or induction therapy in cadaveric renal transplantation. Retreatment was effective when the initial treatment was for rejection therapy or induction therapy protocols. Rejection reversal was 83% in the rejection group and 90% in the induction group. Long-term allograft function was 42% in the rejection group and 78% in the induction group. It is speculated that the immune response is more adequately controlled in the induction group. The antibody responses to retreatment were no antibody production (n = 9), antibody production on retreatment (n = 2), no change in antibody titer (n = 4), and increase in previously identified antibody titer (n = 3). Two patients with high titered antibodies had treatment failures caused by preformed antimouse antibodies. The only changes in antibody specificity occurred in patients with a change in preformed antibody. Retreatment of allograft rejection in patients previously treated with OKT3 has again been demonstrated to be effective. It is suggested that retreatment after OKT3 induction therapy may be the most effective.

Antibodies, Monoclonal↗
PubMed1988

Treatment of orthostatic hypotension: interaction of pressor drugs and tilt table conditioning.

We describe a patient with severe orthostatic hypotension in whom tilt table conditioning had a striking, beneficial effect. Upon presentation, the patient was unable even to sit, and the deconditioning associated with prolonged bed rest worsened his autonomic dysfunction. Although he was sensitive to the pressor effects of vasoconstrictor drugs (dihydroergotamine, caffeine, and a somatostatin analogue), these agents failed to stabilize his walking blood pressure. With drug therapy, however, the patient could maintain an adequate blood pressure while performing isometric exercises on a tilt table, whose angle was gradually increased during three weeks. After this conditioning program, pressor drug therapy made it possible for the patient to walk. Although the physiologic basis for this therapeutic response is unclear, our results indicate that tilt table conditioning may be an important adjunct to drug therapy in patients with severe orthostatic hypotension.

Caffeine↗
PubMed1986

Measurement of plasma vanillylmandelic acid by liquid chromatography with electrochemical detection.

A liquid chromatographic method with electrochemical detection is described for measuring plasma 3-methoxy-4-hydroxymandelic acid (VMA). Plasma is deproteinized by gel filtration and VMA is extracted into ethyl acetate, which is evaporated. VMA is oxidized to vanillin, which is purified by toluene extraction and quantified by high-performance liquid chromatography. The recovery of VMA through the entire procedure is 52 +/- 10% (mean +/- S.D., n = 19). The plasma VMA concentration in healthy young volunteers varies between 4.39 and 14.6 ng/ml, a range that is in excellent agreement with data obtained with mass fragmentography.

Chromatography, Gel↗
PubMed1986

Treatment of orthostatic hypotension with dihydroergotamine and caffeine.

Eight patients with orthostatic hypotension were treated with subcutaneous dihydroergotamine. Two doses of the drug (6.5 and 13 micrograms/kg) or placebo were given in a random sequence at 0600 h, and blood pressures were measured hourly throughout the day with patients in both supine and upright positions. To assess the effect of postprandial hypotension on the therapeutic response to dihydroergotamine, we gave breakfast, lunch, and supper on a fixed schedule at 0900 h, 1200 h, and 1700 h. Dihydroergotamine had a pressor effect in seven of the eight patients during the fasting period (0600 h to 0900 h), but this agent did not counteract the hypotensive effect of eating. Concomitant administration of caffeine (250 mg, 30 minutes before breakfast), however, maintained the beneficial effect of dihydroergotamine during the postprandial period. The combination of subcutaneous dihydroergotamine and caffeine represents a new therapeutic option for patients with severe autonomic neuropathy.

Adult↗
PubMed1986

Primary pulmonary hypertension. An analysis of 28 cases and a review of the literature.

The diverse potential etiologies and varying degrees of severity at the time of presentation suggest that primary pulmonary hypertension is a spectrum of disease states, all of which share the hemodynamic and pathologic correlates of pulmonary hypertension without a demonstrable cause. The course is variable, but manifestations of a low cardiac output or right ventricular failure imply a poor prognosis; the median survival is 2 to 3 years from the time of diagnosis. Although several systemic vasodilators have been demonstrated to improve pulmonary hemodynamics and ameliorate symptoms in some cases, these drugs may produce undesirable adverse effects, including death, in unresponsive patients. Additionally, the impact of vasodilator therapy on mortality from PPH has not been assessed. Combined heart-lung transplantation should be considered in patients who are unresponsive to vasodilators and who manifest the indicators of a poor prognosis.

Adolescent↗
PubMed1985

Renal transplant perfusion during aortoiliac aneurysmectomy.

Aortic surgery in recipients of renal transplants requires a method of maintaining intraoperative graft perfusion. A case is presented in which a temporary shunt from the suprarenal aorta to the ipsilateral common femoral artery was used to perfuse a renal transplant during aortoiliac aneurysmectomy. Other methods of renal graft perfusion are discussed.

Aneurysm↗
PubMed1985

The effects of eicosanoid synthesis inhibitors on normoxic and hypoxic pulmonary vascular tone in dogs.

Prostaglandins have been implicated as possible modulators of normoxic and hypoxic pulmonary tone partly because of studies using cyclooxygenase inhibitors, but these drugs may exert effects that are independent of prostaglandin cyclooxygenase. We evaluated the hemodynamic effects of the acute intravenous administration of 3 cyclooxygenase inhibitor drugs in doses that inhibit prostaglandin synthesis in intact anesthetized dogs: indomethacin 5 mg/kg, meclofenamate 5 mg/kg, and ibuprofen 12.5 mg/kg. During room air ventilation, the administration of indomethacin produced an increase in mean pulmonary arterial pressure (8.0 +/- 1.27 to 13.1 +/- 1.52 mmHg, p less than 0.01) and pulmonary vascular resistance (1.2 +/- 0.23 to 2.7 +/- 0.39, p less than 0.01), whereas meclofenamate and ibuprofen had no effect. Indomethacin given during hypoxic ventilation slightly but insignificantly increased pulmonary artery pressure and pulmonary vascular resistance when compared with hypoxia alone and with the administration of vehicle or meclofenamate. Treatment with indomethacin methacin or meclofenamate 5 mg/kg given subcutaneously twice daily for 2 days had no effect on normoxic or hypoxic pulmonary tone. The combined cyclooxygenase-lipoxygenase inhibitor BW 755C in doses of 25 mg/kg given intravenously did not inhibit hypoxic pulmonary vasoconstriction. We conclude that prostaglandins do not appear to play a major physiologic role in modulating normoxic or hypoxic pulmonary vasomotor tone in intact anesthetized dogs, and that the indomethacin-induced increases in pressure and resistance are independent of inhibition of prostaglandin cyclooxygenase.

Animals↗
PubMed1975

The relative safety of polymethylmethacrylate. A controlled clinical study of randomly selected patients treated with Charnley and ring total hip replacements.

Forty patients from a group of seventy elected to participate in a prospective randomized clinical study designed to evaluate the systemic effects of polymethylmethacrylate implanted with a Charnley total hip replacement, utilizing patients treated with a Ring total hip prosthesis ad controls. Intraoperative alterations in cardiovascular function were related to use of methylmethacrylate, but postoperative changes in pulmonary function, erythrocyte sedimentation rate, serum lactic acid dehydrogenase, serum glutamicoxalacetic transaminase, and alkaline phosphatase were not. Charnley total hip replacements were associated with more ectopic-bone formation twelve months postoperatively. The two "latent" infections recognized during the thirty-four months of the study were in hips without acrylic fixation.

Alkaline Phosphatase↗
PubMedDate not supplied

Catecholamine metabolism in kinky hair disease.

Kinky hair disease is a progressive neurologic disease associated with decreased copper absorption. Because dopamine-beta-hydroxylase, an essential enzyme in norepinephrine biosynthesis, is copper-dependent, we studied norepinephrine metabolism in vivo in 5 affected children. Patients with kinky hair disease had decreased plasma norepinephrine concentrations (196 +/- 25 pg/ml) in comparison to control patients (325 +/- 20 pg/ml, p less than 0.001). The ratio of total urinary norepinephrine metabolites to total dopamine metabolites was 0.25 +/- 0.04 in kinky hair patients and 0.52 +/- 0.03 in controls p less than 0.001). These data indicate that dopamine-beta-hydroxylation in vivo is decreased in patients with kinky hair disease; however, there was no correlation between serum copper concentration and catecholamine abnormality.

Adolescent↗