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Biomedical subjects

J G Freeman

Publications and source records attributed to J G Freeman.

30 records · Page 2Linked to original sources
PubMed1986

Plasmapheresis in acute liver failure.

A series of 9 patients with acute hepatic failure and Grade IV hepatic coma received daily plasmapheresis until they recovered or death ensued. Of the nine, seven (77%) showed an improvement in coma grade and five (55%) survived to leave hospital. Plasmapheresis significantly decreased serum bilirubin, aspartate aminotransferase and plasma ammonia concentrations. Survival following plasmapheresis appeared substantially better than in a non randomized group of similar patients not plasmapheresed. The simplicity of the procedure, biochemical improvements observed and apparent efficacy, suggest that further evaluation of the technique as a means of providing temporary hepatic support is indicated.

Hepatic Encephalopathy↗
PubMed1985

Effect of isosorbide dinitrate, verapamil, and labetalol on portal pressure in cirrhosis.

The effects on portal pressure of the vasodilatory drugs isosorbide dinitrate and verapamil and of an alpha and beta blocking agent, labetalol, were assessed in 21 patients with cirrhosis and portal hypertension. The wedged hepatic venous pressure gradient (wedged minus free hepatic venous pressures) was used as an index of portal pressure and was not significantly changed by treatment with labetalol (n = 5) but was significantly decreased by verapamil (n = 6; p less than 0.05) and isosorbide dinitrate (n = 10; p less than 0.01). Long term administration of isosorbide dinitrate also had a significant effect (p less than 0.01).

Humans↗
PubMed1984

Anti-shock actions of a new converting enzyme inhibitor, enalaprilic acid, in hemorrhagic shock in cats.

A new angiotensin converting enzyme inhibitor, enalaprilic acid (MK-422), was given in a bolus of 0.5 mg/kg i.v., followed by an infusion of 0.25 mg/kg/hr to determine its effects in hemorrhagic shock. MK-422 produced no significant hemodynamic effects in sham shock controls, yet it effectively blocked the pressor effect of exogenously administered angiotensin I throughout the 260-min experimental period and reduced angiotensin converting enzyme activity by 90% as determined by radiochemical assay. In vitro studies on cat papillary muscles and pancreatic homogenates revealed no direct inotropic or antiproteolytic effect of enalaprilic acid. Nevertheless, converting enzyme inhibitor treatment maintained postreinfusion mean arterial blood pressure at a significantly higher value (P less than .01) than that of untreated hemorrhaged animals (66 +/- 5 vs. 27 +/- 10 mm Hg, respectively). Superior mesenteric artery flow for hemorrhaged cats was significantly higher (P less than .05) in the treated group both during the end of the oligemic period (6.1 +/- 0.4 vs. 3.8 +/- 0.8 ml/kg/min) and during the postreinfusion period (6.5 +/- 0.7 vs. 1.9 +/- 1.0 ml/kg/min). Moreover, enalaprilic acid blunted the marked rise in plasma cathepsin D (P less than .01) and myocardial depressant factor activities (P less than .01), and plasma amino-nitrogen concentrations (P less than .05) observed in the untreated hemorrhaged cats. These results indicate that enalaprilic acid improved the hemodynamic and metabolic status of cats in hemorrhagic shock.

Angiotensin I↗
PubMed1983

Serial use of aprotinin and incidence of allergic reactions.

Allergic reactions to aprotinin, a polypeptide, have been reported on several occasions. A survey of 136 courses of aprotinin, given to patients with gastric cancer as a protease inhibitor, has shown an incidence of less than 1% of acute anaphylaxis and a similar incidence of minor allergic responses. Two cases of acute allergic responses are described. Fifteen patients received repeated courses of aprotinin at 6-weekly intervals and no allergic phenomena were detected. Provided patients are challenged intra-dermally or with eye drops before each course, it is considered that aprotinin is safe to use in repeated fashion.

Aprotinin↗
PubMed1982

Controlled trial of terlipressin ('Glypressin') versus vasopressin in the early treatment of oesophageal varices.

In a randomised controlled trial the effect of intermittent bolus injection of triglycyl lysine vasopressin (terlipressin 'Glypressin') (2 mg that 6-hourly), an analogue of vasopressin, was compared with that of a constant peripheral intravenous infusion of vasopressin (0.4 units/Min) in the initial management of bleeding oesophageal varices in nineteen patients. Failure of vasopressin therapy was defined as continued bleeding of sufficient severity to necessitate the passage of a Sengstaken tube. Bleeding was controlled in 70% of patients treated with glypressin but in only 9% of patients given vasopressin. The glypressin group required significantly less blood after randomisation than the vasopressin group. Because of its efficacy, lack of side-effects, and ease of administration, glypressin appears to be valuable in the management of bleeding varices.

Adult↗
PubMed1982

Sulphasalazine and spermatogenesis.

The semen of 11 patients with inflammatory bowel disease treated with sulphasalazine (Salazopyrin) was analysed and compared with that of 6 men with similar disease not treated with the drug. The treated group had significantly reduced sperm population density and motility compared with the untreated group. Both groups had high numbers of abnormal spermatozoa compared with the standard for our laboratory, but there was no significant difference between the two groups for this parameter. Sulphasalazine has a deleterious effect on spermatogenesis.

Adolescent↗