Perforated colon complicating pseudomembranous colitis.
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Biomedical subjects
Publications and source records attributed to A Hughes.
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The production of proteases by Candida albicans in batch cultures of human saliva supplemented with glucose was investigated with two clinical strains of Candida and both individual and pooled samples of whole saliva from volunteers. Salivary proteolysis during a 48-h period was estimated by biochemical and isoelectric focusing techniques. Candidal growth in saliva was associated with acid production and salivary proteolysis and there was a highly significant positive correlation between these two activities. Neither candidal growth nor proteolysis was observed in glucose-free control samples and with one strain of Candida cultured in the saliva of one individual. Isotachophoretic analysis of culture liquor showed a significant increase in acetate and pyruvate ions. The oral cavity provides niches that have a low pH and are periodically supplemented with dietary carbohydrates. The acidic proteases of C. albicans may play a role in the pathogenesis of oral candidoses.
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Of 50 cases of strabismus having surgical operations designed on the basis of A scan ultrasonography 45 (90%) had less than 10 dioptres eso- or exodeviation two months postoperatively; 22 eso-, 25 exo-, and 3 vertical deviations were included in the series. A scan ultrasonography is done preoperatively to find the diameter and thus the circumference of the globe. This is used with the angle of deviation to estimate the amount of recession and/or resection necessary to correct the deviation. Attention is drawn to the oculomotor axis, which is 10-12 degrees divergent to the anteroposterior axis and around which the recti muscles act. The oculomotor equator is at right angles to this axis and is closer to the limbus medially than laterally, so that excessive recession of the medial rectus is more likely than of the lateral rectus.
This study investigated prospectively the illness behaviour of 100 patients with temporo-mandibular (TMJ) dysfunction and 100 asymptomatic patients. It has previously been shown that a simple illness behaviour questionnaire (IBQ) can discriminate between patients with intractable facial pain and minor odontogenic pain [28]. The purpose of this study was to determine whether it was possible to prospectively identify those patients who may be resistant to conservative therapy. The results showed that the TMJ dysfunction patients had significantly increased levels of disease conviction (P less than 0.001), anxiety or depression (P less than 0.005), and were less likely to deny the existence of problems in their life (P less than 0.05) compared to control patients. However, the TMJ population was much closer to the control population than to a pain clinic population. In the small percentage (13%) of patients who failed to respond to conservative therapy, over half showed abnormal illness behaviour. Seventy-five percent of all the TMJ patients could be excluded from further assessment of abnormal illness behaviour at little risk of incorrect classification. Thus the illness behaviour questionnaire can be used as a screening device to identify those patients who require psychologic treatment rather than more aggressive surgical treatment.
The upper limiting temperature of growth of Staphylococcus aureus MF31 in heart infusion broth (HI) was about 44 degrees C but addition of monosodium glutamate (MSG) and soy sauce permitted the organism to grow above this temperature. This effect is similar to that of NaCl. Tomato ketchup, Worcestershire and HP sauces added to HI did not allow growth at the non-permissive temperature of 46 degrees C but death was delayed. Staphylococcus aureus died in unsupplemented chicken meat slurry at 46 degrees C but grew at 48 degrees C in slurry supplemented with 5.8% NaCl and survived incubation for 18 h at 50 degrees C in slurry supplemented with 5.8% NaCl and 5% MSG. Cultures grown at 37 degrees C had a D60 value of 2 min in 50 mmol/l Tris (pH 7.2) buffer. Cultures grown at 46 degrees C in HI containing 5.8% NaCl had a D60 value of 8 min in Tris buffer. Addition of 5.8% NaCl plus 5% MSG to the buffer increased the D60 by a factor of about 7 for both cultures. In storage experiments at room temperature, the culture grown at 37 degrees C and at 46 degrees C plus 5.8% NaCl died at about the same rate in salami. In milk powder, however, the count of 37 degrees C culture decreased from 10% g to 10(6)/g in 5 weeks while the count of 46 degrees C culture remained unchanged. In cottage cheese, freeze-dried rice and macaroni, the 37 degrees C cultures also died more rapidly. It is suggested that cultures grown at 46 degrees C plus 5.8% NaCl may be suitable for experiments with artificially contaminated foods.
37 type 2 diabetic patients with no clinical evidence of retinopathy or vascular disease were studied at diagnosis and following control of hyperglycaemia for evidence of abnormalities of coagulation, fibrinolysis and platelet behaviour. 38% showed hyperactive platelets, demonstrating either in vitro hyperaggregability, circulating platelet aggregates, or raised plasma beta-thromboglobulin levels. 36% showed abnormally raised factor VIII coagulant activity (FVIIIc) levels, though this was mainly in female patients. The mean level of FVIIIc decreased with treatment. Anti-thrombin III (AT-III) levels were decreased, and 33% of the patients had levels less than 80%. In this group AT-III increased following treatment. No abnormalities of fibrinolysis were demonstrated. These findings support the concept that diabetes can be associated with a hypercoagulable state, which is not necessarily dependent on the presence of overt vascular disease, or correlated with the degree of chronic hyperglycaemia (HbA1c levels).
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Forty-seven patients presenting with acute chest pain had in vivo platelet activity assessed by measuring plasma levels of the platelet-specific protein beta thromboglobulin (BTG), and by screening for the presence of circulating platelet aggregates. Nineteen patients with transmural myocardial infarction (MI), 21 patients with acute coronary ischaemia (CI), and 7 patients with non-cardiac chest pain (NCCP) were investigated in a serial study and compared with a normal control group. The means of all BTG determinations in the MI (34, +/- SD = 21-57) and CI (33, +/- SD = 19-57) groups were significantly higher than those in the NCCP group (24, +/- SD equal 17-34; p less than 0.01) and normal subjects (22,5 +/- SD = 14-37; p less than 0.001). There was no difference in BTG between those with MI or CI, nor between the NCCP group and normal subjects. Raised numbers of circulating platelet aggregates could not be detected in either MI or CI. The mean BTG levels in both MI and CI patients were significantly raised, compared to normal subjects, on the first day of admission to hospital and remained so on each of the subsequent nine days. Neither heparin plus warfarin nor sulphinpyrazone had any significant effect in lowering BTG levels. 15/40 patients (37.5%) following MI and CI had repeatedly raised BTG levels throughout the study period, and it is suggested that these patients represent an "at risk" group that may benefit from anti-platelet therapy in secondary prevention studies.
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The receptive fields of 125 single units recorded from the binocular region of rabbit primary visual cortex have been analysed. The population of 43% radially symmetric, 23% directional, and 23% orientation selective units is similar to that of rabbit monocular visual cortex. The relative scarcity of orientation selective units and the absence of orientation columns differentiates rabbit from cat primary visual cortex. However, the majority of binocular units had similar receptive fields in each eye and very unconventional receptive fields were not encountered. Tested binocular units demonstrated summation upon simultaneous stimulation of both receptive fields. In conjunction with findings reported elsewhere, these results suggest that rabbit and cat possess a similar provision for binocular vision in spite of some differences in their cortical organisation.
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Non-haemolytic febrile transfusion reactions are common in multi-transfused patients. It is generally accepted that the majority of these reactions occur when more than 0.5 x 10(9) leucocytes are transfused. Values equal to or lower than this threshold, which we have called for convenience the critical antigenic load for leucocytes (CALL), can be achieved by decreasing the leucocyte content in one unit of whole stored blood by about 80%. We have compared the efficiency of leucocyte depletion of whole stored blood, using fixed-speed centrifugation (Haemonetics Model 15 and Model 115 cell washer), variable-speed centrifugation (Dideco Progress 90 Cell Separator), and serial centrifugation (IBM 2991 Blood Cell Processor. Fixed-speed centrifugation was least effective in depletion leucocytes; a reduction of 25 and 60% was achieved using the Haemonetics Model 15 and Model 115, respectively. Variable speed and serial centrifugation produced more satisfactory results with leucocyte depletions of 82 and 89% using the Dideco Progress 90 Cell Separator and the IBM 2991 Blood Cell Processor, respectively. Platelet depletion of over 90% was achieved with all the cell washers, except the Haemonetics Model 15. Red cell losses varied from 3 to 30%. It seems unlikely that consistently high (over 90%) leucocyte depletion can be obtained using cell-washing techniques without associated high red cell losses.
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A survey of diameter spectra in presented for classic neurones of the cat retinal ganglion cell layer. From these, with the aid of retrograde HRP filling for central retina, a set of density distribution maps has been prepared for each of the major modes of the neuronal diameter spectrum. The total population of classical neurones, the presumed ganglion cells of Hughes ('75), confirms published values with a minimum of some 207,000 comprised 5,600 cells in the alpha mode, 80,700 cells in the beta mode, and 120,700 cells in the gamma mode. A proportion of classical neurones in the gamma mode do not fill by retrograde transport of HRP from either optic nerve or superior colliculus. Their morphology is characteristic and includes a conspicuous basophilic nuclear bar or fold; they remain subsequent to ganglion cell retrograde degeneration and resemble some profiles of the amacrine layer. It is presumed that they represent a class of displaced amacrine cells. Estimates based on ganglion cell identification by HRP filling indicate populations of about 80,000 cells in both the gamma and the beta modes and a total count of about 170,000 ganglion cells; a good agreement with Hughes and Wässle's ('76) optic nerve fibre count, but lower than the classic neurone count. It is concluded that the distribution maps for ganglion cells in each of the three modes of the soma diameter spectra are similar in form and resemble that of the total neurone density map. The ganglion cell population of the gamma mode in the visual streak is not found to increase in proportion relative to that of the beta mode, as has been reported elsewhere.
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