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Biomedical subjects

J E Jackson

Publications and source records attributed to J E Jackson.

At least 19 recordsLinked to original sources
PubMed1992

Transjugular and plugged liver biopsies.

When a liver biopsy is indicated the transabdominal approach using either a Menghini or Tru-Cut needle has been shown to be an extremely safe procedure with very low morbidity and mortality rates in patients with normal or only mildly disturbed coagulation. When the coagulation status is severely deranged, however, several methods of obtaining a liver biopsy have been devised to circumvent the increased risk of bleeding. The transjugular approach has been shown to be both successful and relatively safe. The less cumbersome technique of plugging the needle track after percutaneous transabdominal biopsy has been reported relatively recently. Although it is likely that the latter method will produce good biopsy samples in the majority of cases (and in this regard it may prove to be better than the transjugular route), considerably more experience is required before its true complication rate is known. In a hospital where large numbers of transjugular biopsies are performed by experienced radiologists and in which skilled pathologists are used to interpreting the histological appearances of small, crushed liver samples, there is no compelling reason to change to the plugged biopsy technique. The more difficult question is whether hospitals in which the radiological and histological skills necessary for consistent success with the transjugular approach are not available should adopt the plugged biopsy method. The answer to this question is probably in the affirmative, but will depend on the confidence and interventional experience of the local operator and on more detailed factual information concerning the safety of the plugged method. With regard to the latter point, the publication of a large controlled study on the safety and efficacy of plugged liver biopsy would be a valuable contribution to the world literature on the subject.

Biopsy, Needle↗
PubMed1992

Case report: therapeutic bronchial artery embolization in a case of Takayasu's arteritis.

The pulmonary arteries are frequently involved in Takayasu's arteritis with a reported incidence of 41-100% in affected individuals. Patients are usually asymptomatic, however, often despite extensive pulmonary involvement. We describe a patient with Takayasu's arteritis who presented with haemoptysis caused by bronchial artery hypertrophy secondary to occlusive pulmonary arterial disease, who was treated by bronchial artery embolization. This is, to our knowledge, the first reported case of haemoptysis secondary to Takayasu's arteritis successfully treated by embolization.

Adult↗
PubMed1992

Patency of side branches after peripheral placement of metallic biliary endoprostheses.

During a 28-month period, the authors placed 91 Wallstent endoprostheses in 55 patients with malignant obstructive jaundice. Five patients developed recurrent jaundice between 2 and 60 weeks after stent insertion due to stent occlusion by tumor overgrowth on seven occasions. To assess long-term segmental side-branch drainage through the walls of such endoprostheses, the cholangiograms obtained following stent occlusion were reviewed. In all five patients, evidence of drainage of intrahepatic ducts through the side of the mesh was observed. Although the number of patients in the series is small, this initial experience suggests that long metallic endoprostheses can be placed peripherally in the intrahepatic bile ducts without the potential risk of infection or occlusion of undrained, noninvolved segments. This policy may delay or prevent endoprosthesis occlusion in many patients.

Adenoma, Bile Duct↗
PubMed1992

Evaluation of plant extracts for antileishmanial activity using a mechanism-based radiorespirometric microtechnique (RAM).

Extracts of eleven plants used in Nigerian traditional medicine have been evaluated for possible antileishmanial activity using a radiorespirometric microtest technique based on in vitro inhibition of catabolism of 14CO2 from a battery of 14C-substrates by promastigotes. Of 13 methanol extracts tested, 5 from Gongronema latifolia, Dorstenia multiradiata, Picralima nitida, Cola attiensis, and Desmodium gangeticum, were active at concentrations of 50 micrograms/ml or less against a visceral Leishmania isolate.

Animals↗
PubMed1992

Quantification of right to left shunt at rest and during exercise in patients with pulmonary arteriovenous malformations.

BACKGROUND: Current treatment of patients with pulmonary arteriovenous malformations requires serial embolisations by means of steel coils or balloons. Measurement of right to left shunt is the most specific index of response to treatment. A new method of measuring shunt has been developed that is less invasive than traditional methods. METHODS: Right to left pulmonary shunt (expressed as percentage of cardiac output) was measured at rest in 19 patients with pulmonary arteriovenous malformations and six normal subjects by using intravenously injected albumin microspheres labelled with technetium-99m. The technique was compared with a simultaneous shunt measurement in subjects breathing 100% oxygen while they rested. The microsphere technique was adapted to measure the right to left shunt during exercise in 12 patients and five normal subjects with a new method of quantification. RESULTS: The mean (SD) shunt at rest as measured by the microsphere method was 23.2% (15.6%) in the patients and 2.7% (1.2%) in the normal subjects. When these values were compared with those of the 100% oxygen method the difference in mean values was 1% and the limits of agreement between the two methods -32% to +45%. The microsphere method is less invasive (arterial blood gas sampling is not required), quicker, and more comfortable for patients than the 100% oxygen method. In five of the normal subjects the mean (SD) 99mTc microsphere shunt increased from 2.9% (1.3%) at rest to 5.1% (2.9%) during exercise. In the 12 patients studied during exercise the shunt increased from 33.7% (12.7%) at rest to 41.7% (13.3%) during exercise in eight but decreased from 22.6% (2.4%) at rest to 17.6% (2.2%) during exercise in four. Arterial desaturation during exercise correlated with change in the size of the right to left shunt during exercise (r = +0.80). CONCLUSIONS: The microsphere method allows measurement of right to left shunt at rest and during exercise. Serial measurements at rest provide a simple, safe assessment of the physiological response to embolisation in patients with pulmonary arteriovenous malformations.

Adolescent↗
PubMed1992

Insertion of Hickman central venous catheters by using angiographic techniques in patients with hematologic disorders.

During a 9-month period, 69 Hickman catheters were successfully inserted by using angiographic techniques in 59 patients with hematologic disorders. A pneumothorax, which did not require drainage, developed in one patient. No other significant complications occurred at the time of insertion. Eighteen catheters were removed electively, 15 are still in situ, six were removed for thrombosis, and five were accidentally removed. Infection precipitated removal in six subjects. Ten patients died with the catheter in place. Five catheters were removed in patients with refractory septicemia of unknown origin. One catheter burst during an injection and had to be removed. Three patients were lost to follow-up. There were 3.24 infectious episodes per 1000 days of catheterization, more than twice the rate found in some other series. The results of this study are compatible with the growing body of evidence in favor of the angiographic insertion of Hickman catheters. The apparently high rate of infection is ascribed to factors other than insertion in the angiography suite, including the high proportion of bone marrow transplantation patients.

Adolescent↗
PubMed1977

Reduced dose of Rho(D) immune globulin following induced first-trimester abortion.

A double-blind study of women after first-trimester abortion supports the efficacy of low-dose Rho(D) immune globulin (human) in the prevention of Rh sensitization. Twenty-seven per cent of patients demonstrated a fetomaternal blood leak based on Kleihauer-Betke stains. In follow-up testing, the percentage of positive titers and the absolute titer of detectable antibody at various intervals were related to the dose of administered immune globulin. This study confirmed the possible risk of sensitization in Rh-negative postabortal women and suggests the practical use of single low-dose immune globulin preparations in prevention.

Abortion, Induced↗
PubMed1976

Age-related immunity to measles, mumps and rubella in Middle American and United States children.

Serum samples from 3000 1 to 15-year-old children residing in the Dominican Republic, Honduras and the Republic of Panama were analyzed for measles, mumps and rubella susceptibility. These data were compared with results obtained on sera drawn from 2221 United States children of similar ages. It was found that children in all areas usually acquired immunity to measles early in life and tended to contract mumps and rubella somewhat later. Immunity data from the urban areas of the United States closely resembled that from the urban areas of the Dominican Republic. Honduran and Panamanian children showed much higher age-related frequencies of rubella, susceptibility. When compared to the other Middle American countries studied, the rural Honduran sample showed significantly higher age-grouped susceptibility rates for measles and simultaneous triple rate revealed a consistent bias, indicating that the attack rates of the three infections are not entirely independent.

Adolescent↗
PubMed1975

Immunization of children with attenuated measles-rubella bivalent vaccine.

The effects of simultaneous administration of Schwarz-strain measles virus vaccine and Cendehill-strain rubella virus vaccine as a single bivalent injection was evaluated in 346 children susceptible to both diseases. With placebo and monovalent controls, four bivalent preparations were used in a double-blind protocol to determine the effects of variations in the concentration of one or both components. No unusual reactions occurred and simultaneous administration did not enhance clinical reactivity. For measles, the seroconversion rate was 97% for monovalent vaccine and 97% to 100% (average 98%) for bivalent vaccines. For rubella, the rate was 100% for monovalent vaccine and 94% to 100% (average 99%) for bivalent vaccines. Thus, the vaccines were as safe and effective when given together as when given separately.

Bronchitis↗
PubMed1975

Clinical evaluation of a new measles-mumps-rubella trivalent vaccine.

In a series of clinical studies of a combined measles (Schwarz strain), mumps (Jeryl Lynn strain), and rubella (Cendehill strain) vaccine, 1,481 children received the vaccine or a placebo. The vaccine did not cause any significant reactions. The frequencies of mild, transient fever or rash or both in triple-susceptible vaccinees were similar to those that follow use of Schwarz strain measles vaccine alone. Measles, mumps, and rubella seroconversion rates in triple-susceptible vaccinees ranged from 95% to 100%. Geometric mean antibody titers were as high as those that usually result from use of these same virus strains as monovalent vaccines.

Antibodies, Viral↗
PubMed1975

A field with a liver measles-mumps-rubella vaccine.

Three lots of Lirutrin (measles-mumps-rubella live, attenuated virus vaccine) were evaluated in a double-blind, placebo-controlled clinical study involoving 273 children. The vaccine consisted of a combination of Schwarz strain measles, Jeryl Lynn strain mumps, and Cendehill strain rubella vaccine viruses. The frequency of positive clinical findings was essentially the same in susceptiable vaccinees, immune vaccinees, and placebo recipients; indicating that the observed symptoms were not caused by the vaccine. Antibody assay of paired serum samples revealed that measles, mumps, and rubella seroconverison rates in triple susceptible vaccinees were excellent, ranging from 96 to 98 per cent with all three lots combined. Results of this study show that Lirutrin trivalent vaccine is well tolerated and highly effective.

Antibodies, Viral↗