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Biomedical subjects

R Roth

Publications and source records attributed to R Roth.

At least 127 records · Page 7Linked to original sources

Therapy of symptomatic pyelonephritis in women.

A prospective randomized controlled study was performed on 44 women with community-acquired, uncomplicated pyelonephritis requiring hospitalization. The study was designed to determine if an extended course of therapy (21 days) would be more effective than the conventional 10-day course of therapy. All patients initially received either gentamicin or tobramycin parenterally for 48 to 72 hours, and then were prescribed an oral agent that possessed in vitro inhibitory activity for the urinary pathogen to complete the course of therapy. Duration of medication was assigned according to a table of random digits. Of the 22 women receiving the 10-day treatment 17 were cured, 4 experienced a reinfection and none had a relapse, compared to 12, 5 and 3, respectively, of 22 receiving the 21-day treatment. Analysis of the therapeutic failures did not demonstrate any superior response for either treatment program (p less than 0.75 and greater than 0.50). No statistically increased incidence of adverse drug reactions occurred in patients receiving the extended course of therapy. Our data do not support an extended course of therapy in women with acute symptomatic pyelonephritis uncomplicated by structural abnormalities.

Adolescent↗

Out-of-hospital cardiac arrest: factors associated with survival.

One hundred eighty-seven cases of cardiac arrest of presumed cardiac etiology were analyzed to determine factors associated with successful out-of-hospital management by paramedic teams. Field and in-hospital records were reviewed to determine the response time of the advanced life support team, the ECG rhythm on arrival, the presence of paramedics on scene at the time of the arrest, whether bystander CPR had been initiated, and the eventual outcome of the resuscitation attempt. A significant difference in survival-to-leave-hospital was seen in patients in whom ventricular fibrillation or ventricular tachycardia (VF/VT) was present on arrival (15.3%) compared to patients with asystole, idioventricular rhythms, blocks, or electromechanical dissociation (3.4%). Survival rates in patients in whom CPR was being performed by a bystander were 24% in the VF/VT group and zero in the "OTHER" rhythms group. When the advanced life support team arrived in less than four minutes, survival rates in the VF/VT group and "OTHER" rhythms group were 23.1% and 7.7%, respectively. When the field team arrived in less than four minutes and a bystander was performing CPR, the survival rates were 42.9% in the VF/VT group and 15.8% in the "OTHER." These data suggest that efforts to improve survival from out-of-hospital cardiac arrest in a community should be directed toward public education, reduction in response times of paramedic units, and lay CPR training.

Aged↗

Use of a murine monoclonal antibody which binds to malignant keratinocytes to detect tumor cells in microscopically controlled surgery.

A new murine monoclonal antibody, termed VM-1, stains basal cell carcinoma cells and at least some squamous cell carcinoma cells. This antibody was used to visualize the tumor margins during microscopically controlled surgery using immunofluorescence (IF) and immunoperoxidase (IP) technics. Our experiments demonstrate that VM-1 is helpful in detecting small islands of tumor cells in the tissue at the margins of skin cancers. Thus, tissue staining with this antibody should improve the accuracy of microscopically controlled excision, and hopefully will decrease the rate of tumor recurrence after surgery.

Animals↗

Inhibition of benzo(a)pyrene monooxygenase by alpha-naphthoflavone may be partially mediated by the metabolite 9-hydroxy-alpha-naphthoflavone.

alpha-Naphthoflavone (ANF) inhibits beta-naphthoflavone-induced rat liver microsomal benzo(a)pyrene metabolism and is transformed by these microsomes into alpha-naphthoflavone metabolites. We determined the inhibitory effect on benzo(a)pyrene (B(a)P) metabolism of several of these metabolites and of 6-methoxy-ANF, using beta-naphthoflavone-induced rat liver microsomes. 9-Hydroxy-ANF was the most active inhibitor (I50 = 1.47 microM) and was metabolized from ANF by these hepatic microsomes in concentrations which are inhibitory. Therefore, 9-hydroxy-ANF a microsomal metabolite of ANF, may play a role in the inhibition of B(a)P oxidation by ANF.

Animals↗

Superiority of two-dimensional echocardiography in the diagnosis of congenitally bicuspid aortic valve.

This study compares the role of M-mode and two-dimensional echocardiography in the evaluation of the nonstenotic, congenitally bicuspid aortic valve. Ten asymptomatic healthy subjects (age 20-35 years) with a systolic ejection click and short systolic murmur were evaluated. M-mode echocardiograms were entirely normal. The aortic root, diastolic closure line, eccentricity index of the aortic valve, and left ventricular size and function were normal in every subject. The two-dimensional parasternal long axis view of the aortic root was also normal in all patients with bicuspid aortic valves; there were no abnormalities of systolic excursion of the aortic cusps and doming of the aortic valve was absent. Images obtained in the two-dimensional parasternal short axis view of the aortic root at the level of the aortic valve revealed only two cusps, anterior and posterior, in all patients. The classic closure pattern of the normal tricuspid aortic valve forming a "Y" was absent in every subject. Instead, a horizontal closure line along the "X" axis was demonstrated in all patients; changing the angulation of the transducer in various positions did not alter this pattern. All subjects had increased reflectance of echoes along the line of diastolic closure, probably resulting from redundancy of the aortic cusp tissue. We conclude that because of the inability of the M-mode echocardiographic technique to accurately diagnose this condition in the study group, two-dimensional echocardiography should be the technique of choice in the evaluation of patients with a suspected bicuspid aortic valve. Recognition of this condition is important in view of its susceptibility to subacute bacterial endocarditis, aortic stenosis, and regurgitation.

Adult↗

Developmental follow-up of hyperventilated neonates: preliminary observations.

A group of 13 newborn infants greater than 37 weeks' gestation were selected to be hyperventilated because of severe hypoxemia refractory to conventional mechanical ventilation, ie, failure to maintain PaO2 greater than 50 torr with an FIO2 of 1.0, despite PaCO2 less than or equal to 40 torr and pH greater than or equal to 7.40. Eleven survived; nine were available for follow-up evaluations. As a group, the nine infants were exposed to a PaCO2 less than or equal to 20 torr for 51.8 +/- 11.8 (mean +/- SEM) hours, to PaCO2 less than or equal to 15 torr for 11.8 +/- 3.3 hours, to a pH greater than 7.50 for 64.4 +/- 18.6 hours, and to a pH greater than or equal to 7.60 for 6.1 +/- 2.9 hours. One infant was lost to follow-up after a normal assessment at nine months. the other eight infants (seven AGA, one markedly SGA) were at least 1 1/4 years old at the time of evaluation. The seven AGA infants had a normal developmental quotient (mean 110 [range 96-130] by Stanford-Binet or Bayley assessment); the one SGA infant had a Bayley score of 89. All eight had normal neurologic examinations. These preliminary findings are reassuring with respect to neurologic and developmental outcome following prolonged hyperventilation.

Child Development↗

A rapid, inexpensive and easily quantified assay for phagocytosis and microbicidal activity of macrophages and neutrophils.

The objective of the present study was to develop a technique to quantitate the phagocytic and intracellular microbicidal activity in different populations of phagocytes, i.e. neutrophils and macrophages. Elicited peritoneal neutrophils and macrophages as well as alveolar macrophages and adherent splenic macrophages were used as representative cell types. The method to assess intracellular killing was based upon dye uptake and concentration by a dead micro-organism; methylene blue was used as the indicator dye and the test organism was Saccharomyces cerevisiae. Phagocytosis was measured by counting, microscopically, the number of ingested yeast (Saccharomyces cerevisiae) within the neutrophils or macrophages. A number of killed yeast, i.e., those which took up the dye, were readily visualized. The temporal pattern of phagocytosis and killing was determined concurrently. Splenic macrophages demonstrated the slowest phagocytic activity whereas neutrophils and alveolar macrophages manifested a similar phagocytic activity. Peritoneal macrophages exhibited a continuous increase in activity throughout the test period. Microbicidal activity was similar for all 4 cells types. The new technique for measuring phagocytosis and killing provides a rapid, inexpensive and easily quantified assay for assessing discrete phagocytic cell functions.

Animals↗