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Biomedical subjects

R E Henry

Publications and source records attributed to R E Henry.

At least 19 recordsLinked to original sources
PubMed1993

Successful oral acyclovir desensitization.

A 65-year-old woman with the acquired immunodeficiency syndrome (AIDS) complicated by recurrent mucocutaneous herpes simplex virus (HSV) infection developed angioedema on the initiation of her second course of oral acyclovir therapy. Oral rechallenge in hospital three days later confirmed acyclovir hypersensitivity. Vidarabine and foscarnet therapies were abandoned after treatment failure and unacceptable toxicity. Acyclovir desensitization was accomplished using a protocol derived from oral penicillin desensitization regimens. Mucocutaneous HSV infection responded to intravenous acyclovir followed by chronic oral suppression without recurrences of HSV or hypersensitivity. This report is an example of acyclovir hypersensitivity and successful oral desensitization.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Sudden cardiac death caused by coronary ostial compression by an aneurysm of the sinus of Valsalva.

A 22-year-old man was asymptomatic until he died suddenly after being startled. Post-mortem examination was normal except for aneurysmal dilatation of the left Sinus of Valsalva, the upper margin of which formed a flap-like ridge, partially occluding the ostium of the left main coronary artery which arose immediately above it. Further compression of this "slit-like" orifice by aneurysmal distention was the proposed cause of myocardial ischaemia and arrhythmic death.

Adult↗
PubMed1986

Pneumoperitoneum associated with mechanical ventilation.

The true incidence of pneumoperitoneum associated with mechanical ventilation is unknown, but current estimates range from rare to 7 percent of intubated intensive care unit patients. This syndrome should be strongly suspected when pneumoperitoneum develops in a mechanically ventilated patient with a combination of (1) peak inspiratory pressure (PIP) greater than 40 cm H(2)O; (2) positive end expiratory pressure (PEEP) greater than 6 cm H(2)O; and (3) coexistent evidence of significant pulmonary barotrauma. An illustrative case report is presented where this entity was recognized and the patient managed without laparotomy. Controlled prospective studies should determine the true importance of this problem.

Adolescent↗
PubMed1984

Influence of ethanol and ambient temperature on skin blood flow.

Patients frequently arrive in the emergency department under the influence of alcohol after exposure to extreme conditions of heat or cold. While ethanol ingestion and ambient heat are recognized to have vasodilatory action, previous studies of their interactive effect are limited and guidelines for patient care are vague. Xenon-133 skin perfusion studies allow direct quantitative assessment of the net effect of multiple variables on skin vasculature. Using Xenon-133 to measure cutaneous blood flow in the lower extremity, we studied four groups of 12 healthy men at 20, 25, 30, and 35 C. Half of each group ingested 60 mL of 95% ethanol in fruit juice, while the other half received placebo only. Skin perfusion at baseline and 50 minutes after ingestion of ethanol were measured. Vasodilatation was observed at 25 and 30 C in subjects who had ingested ethanol. At 20 and 35 C vasoconstriction or vasodilation, respectively, occurred in all subjects with no additional influence of ethanol observed. The influence of heat or cold on skin blood flow appears to dominate over the influence of moderate amounts of ethanol at these temperature extremes. Specifically, in patients exposed to extreme temperatures while under the influence of ethanol, there is no benefit from the agent on cutaneous blood flow at or below 20 C, and there is no enhanced heat loss at 35 C or above.

Adult↗
PubMed1981

Prospective use of xenon Xe 133 clearance for amputation level selection.

Xenon Xe 133 clearance was used to select the most distal amputation level that would allow sufficient blood flow for healing. Capillary blood flow was first measured at the most distal potential amputation level, then at successive proximal levels until an amputation site was found that had a capillary skin blood flow rate greater than or equal to 2.6 mL/min/100 g of tissue. Xenon Xe 133 in saline (100 to 500 mCi) was injected intracutaneously at each level, and flow rates were determined using a gamma camera interfaced with a computer system programmed for the Ketty-Schmidt formula modified for capillary blood flow. There were 45 cases, including one toes, six transmetatarsal, five Syme's, 25 below-knee, four knee disarticulation, three above-knee, and one hip disarticulation amputation. All amputations in patients with flow rates exceeding 2.4 mL/min/100 g of tissue healed, with two exceptions.

Aged↗
PubMed1981

Radionuclide imaging of the biliary tract.

Cholescintigraphy with technetium-labeled biliary agents has great value in evaluation of the patient with suspected acute cholecystitis. Visualization of the gall bladder virtually excludes acute cholecystitis and obstruction of the cystic duct. Nonvisualization of the gall bladder, however, is not specific for acute cholecystitis and may also occur in some patients with chronic cholecystitis or pancreatitis. Interpretation of gall bladder nonvisualization, therefore, must be correlated with the clinical presentation. Biliary tract imaging is also useful in evaluation of some focal abnormalities within the liver, neonatal jaundice, detection of bile leaks or bile reflux, and biliary-enteric shunts. The role of technetium-labeled biliary agents in the evaluation of patients with jaundice is less clear. Excretion of tracer into the gut excludes complete biliary tract obstruction, but the test may be nonconclusive at higher serum bilirubin levels. If persistent common bile duct activity is observed with delayed excretion into the gut, the diagnosis of partial obstruction may be made, but this procedure will be inconclusive if the common bile duct is not visualized and/or significant hepatocellular disease is present. Ultrasonography and abdominal CT are the preferred tools for the diagnosis of biliary tract obstruction at present, but newer biliary tract agents which achieve better hepatic extraction and greater bile concentration at high serum bilirubin levels may improve the diagnostic efficacy of cholescintigraphy.

Biliary Tract↗
PubMed1980

Quantitative measurement of skin perfusion with xenon-133.

Quantitative assessment of skin perfusion has value in both medical and surgical therapeutic decision-making. We have adapted a technique using intradermal xenon-133 dissolved in saline for use with a gamma camera interfaced to a mini-computer. It allows rapid evaluation of several sites simultaneously. The monoexponential washout rate of the injected tracer during the first 6 min is entered into the Schmidt--Kety equation to provide blood-flow rates in ml/min per 100 g. Reproducibility of the method in normal subjects is satisfactory. An important experimental variable is ambient temperature, since perfusion rates in normal limbs at low temperatures can approach those levels found in ischemic limbs. The intradermal technique has practical advantages over other methods for study of limb or skin perfusion.

Adult↗
PubMed1977

Detection of bronchopleural-subarachnoid fistula by radionuclide myelography: case report.

Radionuclide myeloscintigraphy has previously been used to demonstrate subarachnoid fistulae. In the present case a patient with bronchogenic carcinoma developed spontaneous pneumocephalus postoperatively. Chest radiographs showed an air-fluid level in the postoperative area. Various diagnostic tests were used, but only a radionuclide myeloscintigram showed the presence of a bronchopleural-subarachnoid fistula.

Adult↗
PubMed1975

Brain scans, dexamethasone therapy, and brain tumors.

Eight men with primary or metastatic brain tumors were examined with brain scans before and after the administration of dexamethasone. All patients demonstrated some improvement in their clinical neurologic status during therapy, and two patients had a dramatic response. Seven of the eight patients examined showed a decrease in the apparent size of the original lesion on recent brain scan while receiving dexamethasone. Comparison of immediate scans obtained 15 to 20 minutes following the administration of sodium pertechnetate Tc 99m with those obtained two or three hours later suggests that the change in apparent size of the original lesion results from decrease in peritumor edema.

Adult↗