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Biomedical subjects

L Hicks

Publications and source records attributed to L Hicks.

11 recordsLinked to original sources

Gastroschisis wringer clamp: a safe, simplified method for delayed primary closure.

When primary abdominal wall closure in a newborn with gastroschisis cannot be accomplished safely, placement of a reinforced Silastic silo facilitates delayed primary closure (DPC). In this report we describe our experience with the gastroschisis wringer clamp (GWC). The GWC is an autoclavable, 140-g, aluminum alloy device reminiscent of an old wringer washing machine. It consists of two apposing serrated rollers that pull the Silastic silo through a slotted base plate. This protects the intestine and converts the circular defect into a vertical slit to ease DPC. The GWC is adjusted daily on the awake newborn in the nursery and the magnitude of each adjustment is gauged by the infant's cardiac and pulmonary status. For the past 10 years we have cared for 116 newborns with gastroschisis. The average birth weight was 2,530 g (range, 1,380 to 3,300 g). Eighty-six infants (74.1%) have undergone primary closure. The remaining 30 infants (25.9%) were treated by placement of a Silastic silo and application of the GWC, forming the basis of this report. The DPC operation was performed an average of 6.7 days (range, 3 to 23 days) following the application of the silo. Extubation was usually possible prior to the DPC, with the mean length of mechanical ventilation being 3.8 days. Three patients developed serious complications including two dehiscences of the silo-fascia interface. There were no deaths in this group of 30 patients. The GWC offers many technical advantages and can be easily reversed when the infant's cardiopulmonary status deteriorates. We advocate its adoption as a method of choice in the newborn with gastroschisis who requires DPC.

Abdominal Muscles

Lipreading in patients with schizophrenia.

This study was designed to explore whether schizophrenic patients who are able to maintain their gaze with adequate persistence could competently lip-read. Four lipreading tests, designed to assess recognition of syllables, words, and overlearned sentences, were administered to 15 schizophrenic and 15 normal subjects matched for age, sex, and educational level. The patients proved to be competent lip-readers susceptible to the blend illusion and were inferior only in lipreading of overlearned sentences. The latter difficulty may tentatively be attributed to the inadequacy of the patient's premorbid social network for establishing contextual cues that aid in the recognition of overlearned sentences.

Adult

Cellular pharmacology of cyclopentenyl cytosine in Molt-4 lymphoblasts.

The toxicity, uptake, and metabolism of the oncolytic nucleoside cyclopentenyl cytosine (CPEC) have been examined in the Molt-4 line of human lymphoblasts. This compound is known to be converted to its 5'-triphosphate, which inhibits CTP synthetase and depletes the pools of cytidine nucleotides. In the Molt-4 system, the concentration of drug reducing proliferation by 50% in a 24-h incubation was between 50 and 100 nM. Cytidine, uridine, and nitrobenzylthioinosine almost fully prevented the cytotoxicity of CPEC when introduced shortly before or together with the drug, but only cytidine was effective as an antidote when added 12 h after 200 nM CPEC. Studies of the cellular entry of CPEC revealed that nitrobenzylthioinosine fully blocked this process over a 60-s interval and for as long as 2 h, suggesting that the initial interiorization was mediated by facilitated diffusion. In Molt-4 cells incubated with tritiated CPEC, 9 metabolites could be distinguished: prominent among these was cyclopentenyl uridine (CPEU), the deamination product of CPEC; other major metabolites included the 5'-mono-, di-, and triphosphates of CPEC, and of CPEU, along with two phosphodiesters provisionally identified as CPEC-diphosphate choline and CPEC-diphosphate ethanolamine. When the accumulation of CPEC-5'-triphosphate was measured as a function of concentration of the drug in the medium, the process was found not to be saturable by levels of CPEC up to 1000 nM. In cells incubated with 200 nM drug, CPEC-5'-triphosphate accumulated rapidly and linearly for approximately 4 h, the time for doubling of the concentration being 2 h. After a 16-h incubation with 100 nM CPEC, the concentration of CPEC-5'-triphosphate was 50-fold that of the parent drug in the medium and could be readily monitored spectrophotometrically in high-pressure liquid chromatography effluents without recourse to radiolabeled nucleoside. In 2-h incubations, the concentration of free CPEC required to reduce CTP by 50% was 150 nM; this corresponded to a CPEC-5'-triphosphate level of 750 nM. After washout of extracellular CPEC, CPEC-5'-triphosphate decayed with a half-life that ranged from 9 to 14 h. Twenty-four h after washout of 200 nM CPEC (the concentration of drug reducing proliferation by 80%), cells had not resumed proliferation, and CTP pools were still depressed by 90%. Cytidine, uridine, and nitrobenzylthioinosine all strongly repressed the anabolic phosphorylation of CPEC when added to Molt-4 cells along with the drug.(ABSTRACT TRUNCATED AT 400 WORDS)

Antineoplastic Agents

Neuropsychological studies of blacks with cerebrovascular disorders: a preliminary investigation.

Very few studies have been conducted that examine brain behavior functions in blacks and other ethnic minorities. Recognizing that measures of higher cortical functions have cultural, experiential, and organic determinants, the present investigation was designed to ascertain whether findings reported in neuropsychologic studies of white patients with lateralized cerebral lesions are applicable to groups of black patients with lesions in similar locations. Thirty-seven patients with left (n = 15) and right (n = 22) cerebrovascular lesions were administered the Michigan Neuropsychological Battery (MNB). This battery is comprised of a number of objective standardized measures of higher and lower-level cerebral functions. With one exception, the performance of patients in the brain-injured groups was not systematically different on tests of higher brain functions. As expected, tests of lower-level somatosensory and motor functions showed a pattern of greater impairment on the side of the body contralateral to the lesion. But, in contrast to neuropsychological studies of white patients, a pattern of laterality specific deficits on verbal IQ and performance IQ was not observed. Methodological and theoretical implications of these findings are discussed.

Analysis of Variance

A comparison of circulating immune complexes, pregnancy associated beta 1-macroglobulin and galactosyltransferase as tumour markers for ovarian cancer.

Serial blood samples have been obtained from 12 patients with ovarian cancer who were treated by surgery and, generally, chemotherapy or radiotherapy. Some achieved clinical remission, but the majority relapsed after variable time interval. Three potential tumour markers (Circulating Immune Complexes, Pregnancy Associated beta 1-Macroglobulin and Galactosyltransferase) have been studied longitudinally in serum for clinical correlation, predictive value, and biochemical 'lead time' to clinically detectable progression. None of the 3 offered any signal advantage over the others, and each showed an inconsistent relationship to observed disease status, with high levels indicating a poor outlook and the converse not true. Thus, since the 'lead time' is short, and reliability low, none of the compounds can be strongly commended as individual markers for ovarian cancer.

Adenocarcinoma

Increased myocardial catalase in rats fed ethanol.

The effects of chronic intake of dietary ethanol upon catalase, an enzyme capable of metabolizing ethanol, as well as upon myocardial morphology and hemodynamics, were studied in the rat. Ethanol, comprising 36% of dietary calories, administered to rats for 5 weeks, was associated with increased myocardial catalase of 45.9 +/- 3.7 IU/mg protein, compared to 21.0 +/- 1.8 IU/mg protein in pair-fed controls. The enzyme activity remained significantly elevated after 18 weeks of ethanol. Hepatic catalase did not differ in these groups. Parallel cytochemical studies confirmed the increase in myocardial catalase by demonstrating an increase in peroxisomes. Gross and light-microscopic examinations revealed no abnormalities at either 5 or 18 weeks. Remarkably few ultrastructural abnormalities were seen in this material fixed by vascular perfusion. Hemodynamic studies after 5 weeks of ethanol revealed decreased left ventricle systolic pressure and decreased mean arterial pressure but no change in ventricular filling pressure. The possibility of catalase playing a metabolic and potentially protective role in rat myocardium chronically exposed to ethanol is discussed.

Animals

Peroxisomes (microbodies) in the myocardium of rodents and primates. A comparative Ultrastructural cytochemical study.

The occurrence of peroxisomes (microbodies), their cytochemical characteristics and their ultrastructural relationship to the neighboring organelles were investigated in the ventricular myocardium of four rodent (rat, rabbit, gerbil, and guinea pig) and two primate (Macaca java and Tupaya) species. The hearts were fixed by vascular perfusion with glutaraldehyde and incubated in alkaline diaminobenzidine media for visualization of catalase. The electron-dense reaction product of catalase was found in the myocardium of all examined species and was localized in 0.2--0.5 mum oval particles, surrounded by a single limiting membrane and located usually at the junction of I and A bands. The peroxisomes in the hearts of gerbil and Macaca java were especially long and tortuous. A close spatial association was found between the myocardial peroxisomes and mitochondria, lipid droplets, and the membranes of sarcoplasmic reticulum, especially the so-called junctional sarcoplasmic reticulum. These observations demonstrate the consistent occurrence of peroxisomes in the heart of various mammalian species and suggest that peroxisomes have important metabolic and physiological functions in myocardium.

Animals

Visual proprioception and postural stability in infancy. A developmental study.

The effect of conflicting visual, and mechanical proprioceptive information on postural stability was compared in two groups of infants. The older group could sit or stand unsupported, while the younger group could sit but could not yet stand. The results suggest that visual proprioception functions to maintain postural stability before infants have learned to stand.

Female

Nursing challenges in managed care.

The emergence of managed care organizations offers many opportunities, challenges, and threats for nursing and nurses. The goal of these organizations (ensuring maximum value from resources used) is congruent with the basic philosophy of nursing, which focuses on the total needs of the patient, not just disease, and on maintaining the health of the individual to minimize the need for expensive health care services. Within the structure of managed care, however, there is also a need for strong professional advocacy to ensure that the needs of the members are adequately met as the organization strives to maintain costs. In meeting the needs of the organization and of the members, the nurse also plays an important role in managing the resources used in producing health care services.

Continuity of Patient Care