Biomedical subjects
Publications and source records attributed to J M Black.
This article describes how debridement and dressings are used to clean wounds prior to closure with myocutaneous flaps. Post-operative care focuses on promoting flap perfusion, especially by reducing pressure on the flap and by promoting wound drainage. Rehabilitation of the patient is imperative to reduce recidivism.
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We report a survey of Consultant Geriatricians in Scotland with regard to the provision of continuing geriatric care. There are wide variations in the numbers of patients that individual consultants are responsible for, the type and geographical site on which a service is provided, and also in views on the adequacy of staffing levels. Quality of physical surroundings and nursing care are generally thought to be more than adequate. Consultants believed their main contribution was providing expert medical advice, and felt their patients' quality of life could most be improved by increased diversional therapy. There are wide geographical differences in the number of private nursing and residential homes in Scotland but they have had some influence on the criteria for placement of patients in continuing hospital care.
The efficacy of docosahexaenoic acid (DHA) in suppressing eicosanoid synthesis by peritoneal macrophages in vivo was influenced by the relative amount of dietary DHA when linoleic acid (LA) was held constant. Increasing DHA from 0 to 37% of the fatty acids in diets containing 10 weight % fat (of which LA was 40%) caused an eleven-fold increase in the DHA content of macrophages. Limited retroconversion of DHA to eicosapentaenoic acid was observed. Macrophages in animals consuming DHA synthesized significantly lower amounts of leukotriene E4, prostaglandin E2 and 6-keto prostaglandin F1 alpha in vivo upon stimulation with zymosan. The maximum inhibition of eicosanoid synthesis was observed when the dietary DHA/LA ratio was 0.16 and no further inhibition occurred when the ratio was increased up to 0.81.
The effects of dietary n-3 and n-6 polyunsaturated fatty acids on the fatty acid composition of phospholipid, Ca++. Mg++ ATPase and Ca++ transport activities of mouse sarcoplasmic reticulum were investigated. Mice were fed a 2 weight percent fat diet containing either 0.5 weight percent ethyl esters of 18:3n-3, 20:5n-3 or 22:6n-3 as a source of n-3 polyunsaturated fatty acid or 0.5 weight percent safflower oil as a source of n-6 polyunsaturated fatty acid for 10 days. Olive oil (2 weight percent) was used as a control diet. Although feeding n-6 polyunsaturated fatty acid induced very little modifications of the phospholipid sarcoplasmic reticulum fatty acid composition, feeding n-3 polyunsaturated fatty acid altered it markedly. Inclusion of 18:3n-3, 20:5n-3 or 22:6n-3 in the diet caused an accumulation of 22:6n-3, which replaced 20:4n-6 and 18:2n-6 in phospholipid sarcoplasmic reticulum. The saturated fatty acids were significantly increased with a concurrent reduction of 18:1n-9. These changes in the fatty acid composition resulted in a decrease in the values of the n-6/n-3 polyunsaturated fatty acid ratio and a decrease in the ratio of 20 carbon to 22 carbon fatty acids esterified in the phospholipid sarcoplasmic reticulum. This was associated with a decrease in Ca++ uptake by n-3 polyunsaturated fatty acid enriched sarcoplasmic reticulum vesicles as compared with n-6 fatty acid and control diet sarcoplasmic reticulum vesicles. However, neither the affinity for Ca++ nor the maximal velocity of ATP hydrolysis activity of Ca++.MG++ATPase were altered by the different diets.(ABSTRACT TRUNCATED AT 250 WORDS)
The efficacy of individual omega-3 polyunsaturated fatty acids (PUFA) in altering eicosanoid synthesis in peritoneal macrophages was studied by feeding mice for 10 days a diet containing 2 wt % fat, which included 0.5 wt % ethyl esters of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) or linolenic acid (LNA). Upon stimulation with calcium ionophore A23187, macrophages from these animals produced significantly lower amounts of leukotriene C4, leukotriene B4 and 12-hydroxyeicosatetraenoic acid, prostaglandin E2 and 6-keto prostaglandin F1 alpha compared with those obtained from animals on the diets containing olive oil or safflower oil. The decrease in leukotriene synthesis was similar in the animals fed DHA, EPA or LNA diets. This depression of eicosanoids by DHA and EPA was associated with decreased levels of arachidonic acid (AA); however, LA that altered eicosanoids did not have the same effect on AA levels.
1. Male CD-1 white mice, 18-20 g body-weight, were given semi-purified diets containing 100 g menhaden oil (MO) or hydrogenated coconut oil (HCO)/kg for 23 d. Mice were killed on days 0, 3, 5, 7, 14, 23. After 23 d of MO supplementation the remaining mice were switched to the HCO diet for an additional 10 d. 2. The progressive change(s) in the polyunsaturated fatty acid (PUFA) composition of cardiac and brain phospholipid classes were followed during the MO supplementation and depletion periods. 3. The content of fatty acids 20:5n-3, 22:5n-3 and 22:6n-3 increased immediately following ingestion of the MO diet and continued to increase at a steady rate in both heart and brain phospholipid classes. 4. In general, the period required to reach steady-state was 1 week for n-3 PUFA and 18:2n-6, and 2 weeks for 20:4n-6. 5. Cessation of MO consumption for 10 d resulted in marked decreases in the content of n-3 PUFA and increases in n-6 PUFA in cardiac phospholipids in particular. Brain phospholipids were less responsive. 6. The results suggest that dietary fish oil must be consumed for at least 1 week before maximum changes in PUFA composition are observed, and fish oil ingestion must be continuous to maintain elevated n-3 PUFA levels in heart and brain phospholipids.
The rate and extent of modification of fatty acid composition of mice lung and kidney by dietary menhaden oil (MO) was investigated. White mice were fed 2 wt% safflower oil and either 10 wt% MO or 10 wt% hydrogenated coconut oil (HCO) for 23 d. The stability of dietary MO-induced fatty acid modifications was assessed by replacing the MO diet of a group of mice after 23 d with the HCO diet for an additional 10 d. Mice were sacrificed on d 0, 1, 3, 5, 7, 14, 23 and 33. The n-3 polyunsaturated fatty acid (PUFA), 20:5n-3 and 22:6n-3 were rapidly incorporated into lung and kidney phosphoglyceride (PL) classes during the first 7 d of MO ingestion relative to the controls. After 1 wk of MO consumption, the rate of incorporation either plateaued at an elevated level or continued to increase at a much more gradual rate. A marked increase in the content of 22:5n-3 in lung and kidney was observed. A concomitant and rapid decrease was observed in the n-6 PUFA, 20:4n-6, 22:5n-6 and 18:2n-6. The minimum content of 20:4n-6 was reached between 1 and 2 wk, whereas the minimum levels of 18:2n-6 and 22:5n-6 occurred within 72 h. The n-6/n-3 PUFA ratio in lung and kidney and PL classes increased in mice fed HCO and decreased in mice fed dietary MO. When dietary MO was removed, the n-3 PUFA levels decreased with a concomitant increase in n-6 PUFA after 10 d of HCO consumption.(ABSTRACT TRUNCATED AT 250 WORDS)
Prior to closure of pressure ulcers, the patient's wound must be clean, and he must be in a stable condition. Closure involves rotating flaps of muscle and skin into the wound. Maintaining adequate blood supply to the flap and teaching the patient how to prevent new ulcers are the foci of post-operative care.
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The cases of six patients are reported illustrating that chest pain may be a prominent feature of sarcoidosis. It may be severe and be the chief presenting symptom. In the cases described it was mostly retrosternal and had few consistent aggravating factors. In each case there was bilateral hilar lymph node enlargement and it is suggested that htis was chiefly responsible for this relatively uncommon symptom of sarcoidosis. It is also suggested that undue persisting pain may respond to corticosteroid administration.
A rapid slide test for the detection of degradation products of fibrinogen/fibrin (FDP) using a new antibody-coated latex particle is described. The latex particle has been specifically coated with antibody to fragments D and E. The latex agglutination test (Thrombo-Wellcotest) has been compared with the tanned red cell haemagglutination inhibition immunoassay (TRCHII) in 143 patients with a variety of clinical conditions. There is a high degree of agreement between the methods with a coefficient of correlation of 0.83. The method provides a rapid, simple screening test for fibrin degradation products.