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Biomedical subjects

M Hamlet

Publications and source records attributed to M Hamlet.

12 recordsLinked to original sources

Slipped capital femoral epiphysis: early mechanical damage to the acetabular cartilage by a prominent femoral metaphysis.

On the basis of intraoperative observations in 13 consecutive adolescents (14 hips) with slipped capital femoral epiphysis (SCFE), we found that when the anterior femoral metaphysis was level with or extended past the epiphysis, it caused labrum and cartilage damage. As a result of an impingement between the metaphysis and the superomedial acetabular rim, the labrum revealed erosions, scars or tears. Further jamming of the metaphysis into the joint damaged the adjacent acetabular cartilage, varying from a partial- to a full-thickness cartilage loss. In all patients, the femoral head cartilage was intact; no avascular necrosis was present. Our findings suggest that arthrosis in SCFE can be triggered by early mechanical damage of the acetabular cartilage.

Acetabulum↗

Efficacy of antiperspirants on feet.

Nineteen male soldiers participated in a study of the effectiveness of two antiperspirants (aluminum chlorohydrate and aluminum zirconium tetrachlorohydrex glycine) in reducing foot-sweat accumulation and injuries. Each subject was tested before and after antiperspirant application, with a 1-hour treadmill march at 5.6 km/hour in a warm environment. Both antiperspirants decreased (p less than 0.05) foot-sweat accumulation over 50%. There was also a tendency, although not statistically significant, for subjects to incur fewer blisters with antiperspirant use. However, the antiperspirants also increased (p less than 0.05) the incidence of irritant dermatitis. Nevertheless, these data suggest that the application of antiperspirants to the feet has merit in reducing serious foot injuries (blisters, trench foot) exacerbated by wet feet.

Adult↗

Induced vasodilation in the treatment of posttraumatic digital cold intolerance.

Induced vasodilation was used in 10 patients with posttraumatic cold intolerance. Eight of 10 patients improved. Before the treatment program and cold exposure, the injured digits were an average of 1.5 degrees C cooler than the control digits. After cold exposure, the mean temperature difference was 3.2 degrees C. At the conclusion of the study, the temperature differences between the injured and control digits were an average of 0.1 degree C before cold stress and 1.0 degree C after. Associated with this measured improvement was an improvement in cold tolerance. This was maintained 1 year later by 67% of the patients. One year after the completion of this study, nine patients were treated at home on a less controlled program with improvement in 67% of patients.

Adaptation, Physiological↗

Insulin and cortisol improve heat tolerance in isolated perfused rat liver.

Isolated rat livers were perfused at 37 degrees, 41 degrees, 42 degrees, and 43 degrees C with and without insulin and cortisol. Two additional groups were perfused at 42 degrees C with either hormone alone. The perfusate contained red blood cells, amino acids, and albumin in Krebs-Ringer bicarbonate. Bile flow was significantly increased by hormones at 37 degrees C. Bile flow was also increased by hormones at all other temperatures. At 41 degrees C, K+ leakage was the only parameter that indicated injury. Insulin and cortisol significantly reduced K+ leakage at this temperature compared to those without hormones. At 42 degrees C, insulin and cortisol reduced K+ leakage, increased bile flow, reduced transaminase release, and improved ultrastructural integrity. The enhanced bile flow was due primarily to insulin. A reduction in K+ leakage required both insulin and cortisol. Transaminase leakage responded to either hormone alone or in combination; however, only the cortisol-treated group showed a statistically significant reduction in transaminase leakage. At 43 degrees C, indications of irreversible injury were evident and hormones had no beneficial effects. Loss of membrane homeostasis appeared to be the initial event.

Alanine Transaminase↗

Integrity of perfused rat liver at different heat loads.

Isolated rat livers were perfused for 90 minutes at temperatures from 37 degrees to 43 degrees C. to evaluate the effects of heat alone on bile production, alanine aminotransferase, and asparate aminotransferase release, and light and electron microscopic structure. Bile production reached a plateau after 45 minutes at 43 degrees C. and after 60 minutes at 42 degrees C. At temperatures between 39 degrees and 41 degrees C., bile production was not significantly different from that produced at 37 degrees C. The timing and levels of alanine aminotransferase and aspartate aminotransferase released into the perfusates were similar, with increases after 45 minutes at 43 degrees C., after 60 minutes at 41 degrees and 42 degrees C. and after 75 minutes at 39 degrees and 40 degrees C. At the end of the 90-minute perfusion, light microscopy indicated vacuolization and severe dissociation of hepatocytes at 42 degrees and 43 degrees C., and pronounced centrilobular vacuolization at 41 degrees C. Electron microscopy demonstrated that hepatocytes had sustained extensive damage at 41 degrees to 43 degrees C. Mild focal and probably reversible damage occurred at 39 degrees and 40 degrees C. Since pH and O2 levels were regulated in a nonrecirculating system and perfusion rates were constant, neither acidosis, hypoxia, nor circulatory inadequacy were responsible for the alterations. Therefore, changes were attributed to the direct effects of heat, reflected a continuum from no detectable damage at 37 degrees C. to occasional necrosis of individual cells at 39 degrees to 40 degrees C. and culminated in widespread necrosis at 41 degrees to 43 degrees C. with a 90-minute exposure. These results reflect a time/temperature relationship over a range of temperatures. A hypothesis for the sequence of events in the pathogenesis of heat-induced hepatic injury is described.

Alanine Transaminase↗

ACTH regulation of tissue-CRF.

The influence of the anterior pituitary on tissue CRF was investigated in two sets of experiments using lesioned, hypophysectomized, adrenalectomized donor rats. Donors were injected with 1 or 0.5 anterior pituitary equivalents 3 h before transfer of plasma to recipient animals. Injection of 1 pituitary equivalent significantly reduced levels of corticosterone in recipient rats compared to saline injection at 3 different time intervals following the transfer. In a second series of experiments donor animals received replacement with saline, ACTH, TSH, or PRL at 0, 2 and 4 h following adrenalectomy; transfer of plasma to recipient animals was at 5 h. Of the three hormones injected only ACTH significantly reduced tissue CRF activity in donor animals. Recipients of these donors showed suppressed levels of corticosterone compared to recipient animals whose donors were injected with saline, TSH or PRL. The ACTH dose-response curve indicates that the effective dose for suppression of tissue CRF in donor animals is in the range of 1-10 mU/ml. Results of these experiments clearly show that tissue CRF is inhibited by the anterior pituitary hormone ACTH rather than by elevated levels of corticosterone. These experiments suggest that feedback regulation of tissue CRF release by ACTH may occur in response to prolonged physical stress.

Adrenalectomy↗

Increased survival in experimental dog heatstroke after reduction of gut flora.

A study was undertaken to determine if gut flora contribute to the pathophysiology of experimental canine heatstroke. Fifty animals in four groups were anesthetized with sodium pentobarbital (25 mg/kg) intravenously. An air temperature of 42-46 degrees C was maintained adjacent to the dog with a water-heated blanket for approximately 2 h until rectal temperatures rose to 43.5 +/- 0.4 degrees C. Animals were then cooled passively in room air (28 degrees C, 20% RH) until death or until 18 h elapsed, and were euthanized. Reduction of intestine stool and bacterial contents with antibiotics, cathartics, and enemas prior to heatstroke increased the incidence of 18-h survival from 20.0% to 70.6%; antibiotics administered after heatstroke did not alter the incidence of survival over control values. These data suggest that gut flora, presumably through endotoxemia, contribute to the evolution of heatstroke pathophysiology.

Animals↗

Survey for positive Limulus amoebocyte lysate test in plasma from humans and common research animals.

A survey for positive Limulus amoebocyte lysate tests was conducted on apparently healthy humans, mongrel dogs, rats, mice, rabbits, and squirrel monkeys. Only mongrel dog (45.8%) and human (32.8%) plasma samples gave positive tests. In dogs, a significant correlation between positive Limulus amoebocyte lysate tests and the presence of intestinal parasites was found. Positives found in human plasma samples were thought to be due to the presence of background levels of endotoxin or some possible mimicker substance found in the plasma after chloroform extraction. It was concluded that there was a need to distinguish between these positive Limulus tests and those which represent significant endotoxemia.

Animals↗

Peritoneal lavage cooling in an anesthetized dog heatstroke model.

This study was undertaken to compare cooling in room air (27 degrees C, 20% RH), ice slush surface cooling, and peritoneal lavage cooling (6-10 degrees C) as methods for lowering body temperature in an anesthetized dog heatstroke model. We anesthetized 19 animals with sodium pentobarbital (25 mg/kg) intravenously, and maintained them in an ambient temperature of 42-46 degrees C with a water heating blanket approximately 2.0 h until rectal temperatures rose to 43.2 +/- 0.2 degrees C. At the maximum rectal temperature, the heating blankets were removed, and animals were cooled, observed until death occurred or 18 h elapsed, and then sacrificed. The data demonstrate that maximum cooling rates of rectal temperature were: peritoneal lavage, 0.56 degrees C/min; ice slush, 0.11 degrees C/min; and 27 degrees C air cooling, 0.06 degrees C/min. The incidence of 18-h survival for lavage-cooled dogs when supported with normothermic dialysis every 4 h was significantly greater than for either ice slush or air cooled dogs.

Animals↗

An anesthetized dog heatstroke model.

This study was undertaken to develop an anesthetized dog heatstroke model. Forty-six animals were anesthetized with pentobarbital sodium (25 mg/kg) intravenously, and maintained at an ambient temperature of (42-46 degrees C) with a water-heated blanket over 2.5-3.0 h until rectal temperatures rose to 43.0-44.5 degrees C. Animals then cooled passively until death occurred or until 18 h elapsed, and were prepared for autopsy. Liver, kidney, and brain temperature, mean weighted skin temperature, mean weighted surface heat loss, and metabolic rates were obtained. There were no significant differences between liver, kidney, brain, and rectal temperatures during the heating and cooling periods. Cardiac output rose to 127% of initial value, and dropped rapidly to zero at 43.4 degrees C rectal temperature. The rapid decline was accompanied by a doubling of heart rate and a rapid drop in blood pressure and respiratory rate. Cheyne-Stokes respiration and apnea preceded bradycardia followed by asystole or ventricular fibrillation. Certain serum constituents demonstrated modest elevations suggestive of widespread tissue damage. Autopsy did not reveal a clear pattern of heat injury, with the exception of consistent congestion of the major organs and karyorrhexis of lymphocytes. These data are in agreement with similar data from human heatstroke victims and other heatstroke modeling in dogs, and support the concept that the anesthetized dog can in many respects provide an adequate model for human heatstroke.

Anesthesia, Intravenous↗