Biomedical subjects
Publications and source records attributed to W E James.
A remount cast for a removable partial denture can be made in the laboratory by making an elastomeric impression of the prosthesis on the cast after processing but before removing it from the cast. After the prosthesis is finished and polished it is placed in the impression, undercuts are blocked out, and a mounting cast is made.
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The case of a 15 year old girl with a rapidly progressing right sided hemiparesis is reported. The history and clinical manifestations were suggestive of either herpes simplex encephalitis or occlusion of the left middle cerebral artery. At necropsy an occlusive thrombosis of the left middle cerebral artery due to a segmental necrotizing granulomatous panarteritis was found. The cause was obscure. A plausible incriminating factor was the contraceptive pill.
Eight patients with severe lower limb ischaemia, aged 65-80, received defibrotide intravenously for periods from 5 to 21 days (mean 13 days). All patients had intractable rest pain. Five had ischaemic ulcers and 3 had minor gangrene. Five had previous arterial surgery and 6 lumbar sympathetic ganglion injections. Pretreatment ankle pressure indices ranged from 0 to 0.5 (mean 0.19). Rest pain, sleep disturbance and analgesic requirement were assessed on a nominal scale. Rest pain improved in 4 and sleeping pattern in 2 patients. One patient showed a diminution in analgesic requirement. Pressure indices improved in 5 patients. Amputation was performed in 4 patients. Adverse reactions included vomiting and diarrhoea (2), thrombophlebitis at infusion site (3) and generalized skin reaction (1). All patients had 'end-stage' peripheral vascular disease but some showed symptomatic benefit. Further evaluation of defibrotide is indicated.
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A method has been described to make a second set of complete dentures for a patient. The second set of dentures will reflect relined tissue contours, use of manufactured artificial teeth, and trial-packed, heat-processed denture bases. The new dentures are of equal quality to the original dentures.
To investigate the possibility that prolonged carbon monoxide (CO) exposure would depress myocardial function, six chronically instrumented, unsedated goats were exposed to 160--200 ppm CO for 2 wk, resulting in a mean carboxyhemoglobin saturation of 20%. Cardiac index and stroke volume remained unchanged during and after exposure. Hematocrit and hemoglobin concentration started increasing on the 10th day of exposure, this increase reached statistical significance (P less than 0.05) on the 6th postexposure day. Contractility (Vmax) of the left ventricular myocardium and heart rate were unchanged during exposure to CO, but both were significantly (P less than 0.05) decreased at some time during the 1st wk after removal from CO. If there was a decrease in intrinsic myocardial function during CO exposure, it may have been masked by increased sympathetic activity. The mechanism(s) that might produce the decrease in heart rate and contractility after removal from CO are not obvious. Possible explanations are discussed.
To determine if depressed myocardial function contributes to the reported decrease in cardiac performance at high altitude, six chronically instrumented, unsedated goats were studied before, during, and after 2-wk exposure to hypobaric hypoxia (PaO2 44 mmHg). Undistorted ventricular pressure wave form was obtained from a miniature transducer implanted in the left ventricular cavity. The relationship between (dP/dt)/28P and P was extrapolated to obtain Vmax as an index of myocardial function. With beta sympathetic blockade (practolol) and pacing to reproduce heart rates, Vmax was uniformly and significantly depressed (P less than 0.01) during chronic hypoxia, and returned to control values following descent to low altitude. Likewise, stroke volume following saline infusion was decreased at high altitude and returned to control values following descent. Acute relief of hypoxia at high altitude by administration of 100% oxygen by mask did not reverse the depressed Vmax. These findings indicate that chronic hypobaric hypoxia produces a depression of myocardial function which is reversible by chronic but not acute relief of hypoxia.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.