Swallowing. An unusual cause of syncope.
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Chest Pain↗
Biomedical subjects
K Maher
Publications and source records attributed to K Maher.
The Whitaker test: experimental analysis in a canine model of partial ureteric obstruction.
The Whitaker test has been described as a means of reaching a diagnosis in equivocal upper urinary tract obstruction, but there has been conflicting evidence regarding the validity of this test. The present study assesses the reliability of the test in an experimental model which creates an accurate and predetermined degree of partial obstruction of the ureter. The Whitaker test was performed using the standard perfusion rate of 10 ml./min. in male adult dogs using a long-term indwelling renal intrapelvic cannula before and after application of ureteric obstruction, and after one month. Control animals underwent a sham procedure. Results of in vivo and in vitro perfusion studies were compared. Perfusion studies at multiple flow rates were also performed. The Whitaker test reliably detected the presence of ureteric obstruction and the degree of partial obstruction could be determined. Multiple flow rate studies did not significantly improve test results. Provoked pressures in the highest grade of obstruction were less than expected and this may be due to pyelovenous reflux.
Animals↗
Population differences in intestinal permeability to chromium EDTA.
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Adolescent↗
Origin and fate of biliary sludge.
Biliary sludge is a collection of mucus, calcium bilirubinate, and cholesterol crystals that is usually recognized by characteristic echoes on ultrasonography. Its pathogenesis, clinical significance, and ultimate prognosis remain uncertain. We therefore studied the origin of biliary sludge ultrasonic echoes, using an ex vivo liver-gallbladder preparation, and determined the outcome of a group of patients identified to have gallbladder sludge by ultrasonography. Echoes were not generated by either an increase in the total solid concentration or by the graded addition of partially purified mucus glycoprotein. Cholesterol monohydrate crystals (greater than 50 micron) mixed with mucus produced echoes that were indistinguishable from gallbladder sludge observed in patients. To determine the natural evolution of gallbladder sludge in patients, we prospectively followed 96 patients found to have biliary sludge for a mean of 37.8 mo by serial ultrasound scans every 6 mo. In 17 patients (17.7%) biliary sludge disappeared and did not recur for at least 2 yr, in 58 patients (60.4%) biliary sludge disappeared and reappeared, and in 8 patients (8.3%) asymptomatic gallstones developed. There were 12 cholecystectomies performed: six were done for symptomatic gallstones (6.3%) and the other six for sludge associated with severe biliary pain attacks with or without recurrent acute pancreatitis. The finding of sludge represented precipitates being formed in bile. In some patients, it was a precursor form of gallstone disease.
Adult↗
Distribution of Campylobacter pylori in the human stomach obtained at postmortem.
The distribution of Campylobacter pylori, its prevalence, and its relationship to gastritis and urease activity have been studied in 54 postmortem stomachs. Infection was confirmed by finding C. pylori in a Gram-stained smear of gastric mucus harvested from the entire stomach. Eight tissue specimens were obtained from predetermined sites from each stomach and examined for histologic gastritis and urease activity. Thirty-seven per cent of stomachs were infected, and of these 80% had widespread histologic gastritis. The detection of urease activity provided information on the distribution of the organism and had a high correlation with histologic gastritis. The organism is capable of infecting any area of the stomach. Infection is common and is more prevalent in Polynesian subjects (60%) than in Caucasians (19%).
Adolescent↗
Na+/H+ ion-exchange property of postmortem human gastric mucus.
The Na+/H+ ion-exchange property of human gastric mucus and its relationship to age has been studied. Mucus was collected from 40 postmortem human stomachs (age range, 21-83 years) within 24 h of traumatic death. Twenty-one stomachs (age range, 21-76 years) were free of Campylobacter pylori infection and histologic gastritis. Mucus from these stomachs was consistently a cation exchanger at pH 6 in an in vitro system. The cation-exchange capacity of mucus from seven stomachs within the age range 55-70 years was 50% less than the cation-exchange capacity of mucus from eight stomachs within the age range 20-35 years. This study shows that human gastric mucus at pH 6 is a cation exchanger and that the ion-exchange capacity decreases with age.
Adult↗
A clinical-pathological study on chronic hepatitis in Auckland.
We prospectively analysed the liver histology and clinical data of 45 patients with a clinical diagnosis of chronic hepatitis. There was more chronic active hepatitis than chronic persistent hepatitis. In both, there were more men than women except in the subgroup of lupoid hepatitis, where all were women. As a group, chronic persistent hepatitis patients tended to have less severe abnormalities in biochemical liver function tests. Chronic hepatitis B infection accounted for 38% (17/45) of all patients. Of these, 53% (9/17) were Maori or Polynesian, although they only account for approximately 1/5 of the European population in Auckland. This correlated with the known high hepatitis B surface antigen carrier frequency in the Maori and Polynesian and the high incidence of primary hepatocellular carcinoma in this ethnic group. The present study also showed there are relatively few chronic active hepatitis patients, those with immunological abnormalities (lupoid hepatitis, 5/45), who are likely to respond to steroid treatment.
Adult↗
Digital fluoroscopy with a conventional fluoroscopic room and a nuclear medicine computer system.
The potential of a commercially-available nuclear medicine computer, with a digital video interface, supplied by its manufacturers, for digital fluoroscopy is described. In the absence of universally accepted standards against which the performance of digital fluoroscopy systems may be judged, the parameters included in the description of this system included linearity, uniformity, signal-to-noise ratio, matrix size at given frame rates and study sizes. In addition some examples of clinical studies involving subtraction are presented.
Cerebral Angiography↗
Pectin digestion in humans.
The digestibility of pectin, a component of dietary fiber was investigated in humans. The groups studied comprised healthy people with intact gastrointestinal tracts, and patients who had undergone total colectomy followed by ileostomy in the management of ulcerative colitis. The pectin content of the individual plant foods in the diet and the pectin content of the excreta were determined. Some loss of pectin occurred in the small intestine but most of the pectin was degraded in the large intestine.
Adult↗
Risk of infection associated with the use of Broviac and Hickman catheters.
A 4-month prospective medical records review was done to investigate the occurrence of central venous catheter-related infections. Nineteen percent of the patients developed a catheter-related infection, either local infection at the insertion site (8.9%) or septicemia (10.0%). There were 7.5 catheter-related infections per 1000 catheter-use days. The infection rate was five times greater in patients with Hickman catheters than in those with Broviac catheters (p = 0.01). Analysis by the life table approach produced a linear curve of catheter-related infection over time, suggesting a constant dialy risk of catheter-related infection.
Age Factors↗
Labetalol and renal function.
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Ethanolamines↗
Towards an accurate measurement of dietary fibre.
A method of acid and neutral detergent extraction of food has been used to measure the cellulose, hemicellulose and lignin content of a number of New Zealand foods. Foods can be classified as those high or relatively high in hemicellulose and those high or relatively high in cellulose and lignin. The accurate determination of this fibre content is of importance in understanding the physical, chemical and bacteriological effects of various fibre components in preventing or causing disease.
Cellulose↗
Nursing care of the terminally ill.
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Humans↗
T-cell receptor expression in lymphoid neoplasms. A comparison of phenotypic expression and genotyping.
T-cell receptor antibodies (TCR alpha beta and TCR gamma delta) were used for a flow cytometric study of 114 specimens of lymphoid neoplasms and normal controls in order to find out whether or not the expression of TCR proteins differs in between normal and neoplastic tissues. It was found that TCR alpha beta population was predominant in all categories except T gamma lymphoproliferative disorder (TGLD), T-cell lymphoblastic leukemia (T-ALL), and natural killer-like T-cell lymphoma (NKTL), in which three of 18, one of three, and two of two specimens, respectively, showed a predominant TCR gamma delta population. Natural killer cell lymphoma (NKL) showed essentially absence of either TCR alpha beta or TCR gamma delta protein. Therefore, TCR antibodies can be selectively used in cases of TGLD, T-ALL, and NKTL to substantiate their diagnoses. Furthermore, the absence of TCR protein is characteristic of NKL and helps to distinguish it from NKTL. Without the TCR antibodies, TCR gene analysis is sometimes needed to separate these two entities. When comparing with genotyping, 11 of 12 cases with TCR beta gene rearrangement and one of two cases with TCR alpha gene rearrangement expressed TCR alpha beta protein. One of four cases with TCR gamma gene rearrangement and both cases with TCR delta gene rearrangement expressed TCR gamma delta protein. Thus, TCR antibody phenotyping can reliably predict TCR genotypes under most circumstances.
Diagnosis, Differential↗
Collaborative nurse management of multifactorial moist desquamation in a patient undergoing radiotherapy.
Consultation and collaboration between health care professionals can facilitate and improve patient care. In this case, Radiation Oncology and ET nurses collaborated in the care of a patient undergoing radiotherapy for esophageal carcinoma and concomitant corticosteroid therapy for cicatricial pemphigoid. The patient had moist skin desquamation during radiotherapy and was successfully treated by moist wound healing techniques with a hydrogel (Vigilon, C.R. Bard, Inc., Murray Hill, N.J.). The clinical success of nursing collaboration in this case affected assessment and treatment of moist desquamation in the Radiation Oncology department at one institution.
Enterostomy↗