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Biomedical subjects

J I Blenkharn

Publications and source records attributed to J I Blenkharn.

At least 55 records · Page 3Linked to original sources
PubMed1986

A randomized clinical trial of oral ursodeoxycholic acid in obstructive jaundice.

Forty patients with obstructive jaundice (bilirubin greater than 100 mumol/l) were entered into a randomized trial of oral ursodeoxycholic acid for 48 h before surgery versus no additional therapy. Pre-operative venous and operative portal total bile salt concentrations were higher in the bile salt treated patients (P less than 0.001). Portal endotoxaemia during operation was reduced in ursodeoxycholic acid treated patients (P less than 0.05). There was no significant difference in systemic venous endotoxaemia, renal function or postoperative morbidity or mortality. This study suggests pre-operative oral bile salt therapy may be of no clinical benefit in patients with obstructive jaundice.

Administration, Oral↗
PubMed1986

The isolation of Streptococcus pneumoniae from bile.

Streptococcus pneumoniae was isolated from the bile of two previously healthy adults presenting with extrahepatic obstructive jaundice. The organism was recovered on two occasions from both patients over periods of at least 10 days indicating established biliary colonisation and at the time of surgery pneumococci were present at multiple sites throughout the biliary tract. In one patient, pneumococcal cellulitis necessitating treatment with benzyl penicillin arose post-operatively at the exit site of an external biliary drainage tube. Both strains of pneumococci exhibited typical colonial and microscopical morphology. They were susceptible to optochin and demonstrated typical solubility in normal human and ox bile as well as in solutions of sodium deoxycholate and sodium taurocholate.

Adenoma, Bile Duct↗
PubMed1985

Biological activity of polynoxylin--an insoluble urea-formaldehyde condensation product.

The antimicrobial activity of polynoxylin, an alkali urea-formaldehyde condensation product, has been examined. The minimum inhibitory concentration (MIC) for 1000 clinical isolates of bacteria and yeasts was in the range 1024-16,384 mg/l. Cidal concentrations of the drug were within one dilution of the corresponding values for MIC, the results suggest a cumulative mode of antimicrobial activity. Formaldehyde, the putative active component of polynoxylin, was released into water from 10% (w/w) cream preparation which gave a maximum yield of 1.56 mg within 6 h. The limited water solubility of polynoxylin, cumulative mode of antimicrobial action and presence of pre-formed formaldehyde in the pharmaceutical preparation, suggest the possibility of sustained activity when applied to skin. The slow solubilization of particulate polynoxylin and gradual liberation of inhibitory degradation products may further enhance the inherent antimicrobial activity afforded by the presence of pre-formed formaldehyde.

Anti-Bacterial Agents↗
PubMed1985

Decreased biliary excretion of piperacillin after percutaneous relief of extrahepatic obstructive jaundice.

The biliary excretion of piperacillin has been assessed in 11 patients with obstructive jaundice due to hilar cholangiocarcinoma. After a 1-g intravenous dose administered 30 min before preliminary percutaneous transhepatic cholangiography, no drug was detected in the bile of seven patients; in four others, drug concentrations were far below the corresponding level in serum. After a period of external biliary drainage of up to 28 days, levels of antibiotic in bile after intravenous administration were only minimally increased. The results suggest that although the impairment of hepatic function may be improved by external biliary decompression when assessed by a fall in plasma bilirubin, the biliary elimination of piperacillin and related beta-lactam antibiotics may remain impaired for prolonged periods.

Adult↗
PubMed1985

Streptococcal bacteremia in hepatobiliary operations.

The incidence of fecal streptococci in bile is between 5 and 15 per cent of all positive culture findings. Fecal streptococci are not susceptible to the aminoglycoside or cephalosporin antibiotics, although these drugs are widely favored for prophylaxis during surgical treatment of the biliary tract. Over a three year period, 64 episodes of bacteremia have been identified in patients undergoing treatment for obstructive jaundice. Fifteen (23 per cent) of these episodes were due to fecal streptococci. The implications of this finding are discussed and the role of acylureidopenicillin antibiotics for prophylaxis considered.

Adult↗
PubMed1985

Colonoscopy related endotoxemia.

A pilot study of 20 patients who underwent colonoscopy was performed to investigate the occurrence of endotoxemia related to the procedure and its clinical significance. With the use of the limulus lysate method of assay, endotoxemia was demonstrated in 25 per cent of the patients during colonoscopy and 65 per cent afterwards, but was not associated with either concomitant bacteremia or any ill effects. The appearance of endotoxin in significant concentration in the presence of normal liver function and with no overt focus of infection, suggests that substantial absorption of bacterial products which originate in the intestine occur, but under normal circumstances cause no demonstrable deleterious effects.

Adolescent↗
PubMed1984

Septic complications of percutaneous transhepatic biliary drainage. Evaluation of a new closed drainage system.

In a consecutive study of 49 patients with obstructive jaundice who underwent preoperative percutaneous transhepatic drainage, the incidence of bacteria in bile at the time of insertion of the drainage catheter was 29 percent. Patients drained with a conventional open drainage system showed an increase to 100 percent positive cultures after 20 days drainage. In this group, there was also a high incidence of episodes of bacteremia preoperatively and postoperatively and a high incidence of positive wound cultures. An antiseptic barrier incorporated into the drainage system reduced the incidence of positive bile cultures during the drainage period although this did not afford a significant reduction in bacteremic episodes and positive wound cultures. Using a new closed drainage system, the acquisition of environmental organisms to the bile was eliminated which allowed a significant reduction in septic complications both preoperatively and postoperatively. This new closed drainage system increased the value of preoperative decompression of the obstructed biliary tree by preventing exogenous bacterial contamination and reducing associated septic episodes.

Bacterial Infections↗
PubMed1982

Systemic inflammatory complications following jejuno-ileal bypass.

The clinical and laboratory features of three patients with systemic inflammatory complications following jejuno-ileal bypass surgery for morbid obesity are described. The constellation of an asymmetrical polyarthritis, tenosynovitis, sterile skin pustules, mucous membrane ulceration and retinal vasculitis resembled Behçet's syndrome. Serum complement levels were normal and circulating immune complexes not regularly detected, although hypocomplementaemia, elevations in Clq and rheumatoid factor binding materials were noted prior to clinical relapse in one patient. Antibiotic therapy proved disappointing, whereas dapsone produced a sustained remission. Bacterial overgrowth was not invariably found which together with recurrence of symptoms following bypass reversal, suggest that bacteria may only be required to initiate, not perpetuate inflammatory complications.

Arthritis↗
PubMed1981

The correlation of fatty acid content of infected cells and virions with Newcastle disease virus (NDV) virulence.

Chick embryo fibroblasts (CEF) infected with virulent strains of Newcastle disease virus (NDV) showed a dramatic increase in total unsaturated fatty acids (UFA). This increase was not seen in cells infected with the avirulent strains of NDV, Sendai virus or influenza A (PR8). The virions of the virulent strains of NDV harvested from the chorioallantoic cavity also had a higher UFA content compared to the avirulent ones. The kinetics of UFA increase in the virulent strains could be correlated with published data on the kinetics of RNA and protein synthesis inhibition, polykaryon formation and membrane permeability changes.

Animals↗
PubMed1980

The effect of iodination on the haemolytic property and the fatty acids of Newcastle disease virus.

Treatment of Newcastle disease virus with iodine inhibits haemolysis and infectivity, but has no effect on haemagglutination. This is shown to be concurrent with the incorporation of iodine in the hydrocarbon chain of fatty acyl residues of the viral membrane lipid. It is concluded that iodine incorporation, by reducing membrane fluidity, is responsible for these biological phenomena.

Animals↗