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Biomedical subjects

J N Norman

Publications and source records attributed to J N Norman.

17 recordsLinked to original sources
PubMed1985

Post operative stimulation of cell mediated immunity.

The consequences of altered immuno-competence resulting from anaesthesia and surgery are potentially hazardous to the patient with malignant disease. Malnutrition also produces reduction in cell mediated immunity, a condition which is commonly incurred in patients with neoplastic disorders. Numerous agents have been claimed to stimulate the immune responses but few have proved to be of practical value. This paper reports the use variously of protease inhibitors, using Aprotinin, and post operative nutritional therapy, following major surgical resection for carcinoma - specifically as regards their influence on parameters believed to relate to cell mediated immunity. No clinical, metabolic or immunologic benefit was identified from either method of post operative stimulation of cell mediated immunity, although this study did confirm post operative depression of these parameters. The significance of these changes is unclear but there is no evidence to support an immunological mechanism for either of these approaches being of benefit in clinical practice.

Adult↗
PubMed1979

Volume infusion in experimental refractory shock.

The postulated contribution of primary myocardial failure to the pathogenesis of refractoriness of shock to conventional therapy is in direct contradiction to the widely advocated clinical practice of infusion of large volumes of fluid in shock resuscitation. A standard volumes of fluid in shock resuscitation. A standard canine haemorrhagic shock model, in which refractory shock is induced by maintaining an arterial blood pressure of 40 mmHg for 2 h, has been used to assess the effects of volume infusion to maintain a central venous pressure of 0--2 mmHg for a further 2 h and the tolerance of such an infusion by the heart in refractory shock. Fluid infusion ensured significantly better figures for oxygen balance than in those animals where additional fluid was not given, and the volumes required appeared to be well tolerated by the shocked myocardium. Primary myocardial failure does not appear to be a major aetiological factor in refractory shock, and provided that the usual monitoring parameters are recorded, volume infusion remains a major part of shock resuscitation.

Animals↗
PubMed1979

The nature and therapy of refractory shock.

A standard experimental shock model was used to investigate the nature and treatment of refractory shock. Peripheral vasodilatation secondary to hypoxia appeared to be the primary problem in pathogenesis, such factors as myocardial or reticuloendothelial depression being of a secondary nature. Protease inhibition using aprotinin (Trasylol) was ineffective in therapy, but glucocorticoids in pharmacological dosage produced a significant improvement in cardiodynamic and oxygen metabolic factors, provided that the agent was administered early.

Animals↗
PubMed1979

Accidental hypothermia and rewarming in dogs.

1. Twenty lightly anaesthetized dogs were cooled to 29 degrees C by cold-water immersion. Ventilation was spontaneous and the animals were allowed to shiver freely. Metabolic heat production and respiratory heat exchange were measured during rewarming. 2. The animals were divided into four groups each of five dogs and each group was rewarmed by a different technique. The control group was allowed to rewarm spontaneously; a second group was given warm (45-50 degrees C) fully humidified air to breathe in addition; a third group was rewarmed in a hot-water bath (42-44 degrees C) and the remaining group was given in muscle relaxant to abolish shivering and rewarmed by warm inspired air only. 3. The group rewarmed in hot water achieved normal core temperature most rapidly but there was no difference in the rewarming rates of the group rewarmed spontaneously and of the group given warm air to breathe in addition. 4. The group given a muscle relaxant and rewarmed with warm inspired air required 12 h to achieve the same core temperature as the shivering groups achieved in 2 h. Compared with the heat produced by shivering the amount of heat which it was possible to transfer across the respiratory tract was so small that it did not materially influence the rate of rewarming.

Animals↗
PubMed1979

Helicopter passenger survival suit standards in the UK offshore oil industry.

Special protective clothing for helicopter passengers in transit to and from installations in the U.K. offshore oil industry is considered essential. Such clothing is required to increase the survival chances in the unlikely event of a helicopter ditching. This paper discusses the nature of the threat to life in such an event and proposes standards for the specific protective clothing required to meet it. Test criteria are also outlined, to ensure that standards set are maintained.

Aerospace Medicine↗
PubMed1979

Management of a complex diving accident.

After the accidental ascent of a diving bell from 80 m, one diver died from pulmonary barotrauma and the other-though grossly ill-survived. After recompression therapy, this diver was tetraplegic with evidence of patchy microcirculatory damage of brain, cord, liver, kidneys, and gut. All systems eventually returned to normal, except the spinal cord, mainly because of the post-recompression phase of management, in which pharmacological doses of steroids, hyperbaric oxygen, and dextran were used. Although function returned in the upper limbs, the diver remained paraplegic.

Accidents↗
PubMed1978

The absence of benefit of proteinase inhibition with aprotinin in severe shock in dogs.

A standard canine shock model has been used to assess the role of proteinase inhibition in the treatment of severe shock. Conventional therapy, i.e adequate volume replacement, was ensured in all experiments, while in the treated groups aprotinin (Trasylol) was administered at different stages of the haemorrhage. Despite other reports to the contrary, no benefit was demonstrated in the period of established refractory shock even when proteinase inhibition was commenced at an early stage of haemorrhage. It is concluded that proteinase inhibition cannot be recommended for shock resuscitation.

Animals↗
PubMed1978

Pancreatitis and duodenal obstruction due to periampullary carcinoma associated with familial polyposis coli.

Duodenal lesions are being reported in cases with familial polyposis of the colon. A case is described presenting with duodenal obstruction and pancreatitis complicating a peri-ampullary carcinoma in a patient with familial polyposis (adenomatosis of the colon and rectum). Upper gastrointestinal lesions notably in the duodenum include duodenal polyps and carcinoma and peri-ampullary malignancy. It is suggested that endoscopy and hypotonic duodenography be considered in patients with adenomatosis of the colon and rectum presenting with non-colonic alimentary symptoms.

Adult↗
PubMed1975

Effect of supplements of zinc salts on the healing of granulating wounds in the rat and guinea pig.

It has now been universally accepted that zinc deficiency interferes in some way with wound healing, but the claims that the addition of zinc supplements to the normally nourished rat accelerates wound healing to super-normal levels has, on investigations, produced contradictory results. In this study the rate of healing of granulating wounds on the backs of two species of animals, the rat and the guinea pig, has been studied when supplements of zinc salts were given in association with a normal diet. The zinc supplements were administered either orally, parenterally, or topically. There was no difference in the rate of healing in either species of animal given zinc supplements by any of the routes used.

Administration, Oral↗
PubMed1975

Effect of supplements of zinc salts on the healing of incised wounds in the rat and guinea pig.

Zinc deficiency affects healing as shown by measurement of two parameters of wound healing in the rat, namely the rate of healing of an excised, granulating wound and the development of tensile strength in an incised wound. The rate of healing of granulating wounds in two species of animals, the rat and the guinea pig, is not affected by the addition of supplements of zinc salts to the normal diet (J. Nutr. 105, 815-821). In this study, the development of tensile strength in incised wounds in rats and guinea pigs was measured at 7 and 14 days after wounding in animals given supplements of zinc salts by either the oral or parenteral route. No difference in tensile strength was observed at these times in the wounds of either rats or guinea pigs given zinc supplements.

Administration, Oral↗