One hundred forty-three patients underwent cardiac transplantation from 1980 to 1985; 122 received a heart, 19 received a heart-lung, and two received a heart-liver transplant. All patients received immunosuppression with prednisone and cyclosporine. General surgical complications have developed since transplantation in 40 patients (28%). Of these, 17 patients have required surgery: exploratory laparotomy (10 patients), inguinal or ventral herniorrhaphy (two patients), repair of false aneurysm of the femoral artery (two patients), repair of lymphocele of the groin (two patients), and incision and drainage of a perirectal abscess (one patient). Of the 10 patients who required laparotomy, three underwent sigmoid resection for a perforated sigmoid diverticulum (all survived), two underwent small bowel resection for perforation (both died), two had free intraperitoneal air with no site of perforation found (one died), one underwent a cholecystostomy and one a cholecystectomy for acute calculous cholecystitis (one died), and one underwent an elective pyloroplasty for gastric outlet obstruction secondary to vagus nerve injury during heart-lung transplantation and survived. All patients who underwent elective surgery survived. Six patients died without operation and at autopsy were found to have unrecognized general surgical complications including pancreatitis (three patients), cecal ulceration with sepsis (two patients), and jejunal perforation secondary to peritoneal dialysis (one patient). Eleven other patients had severe abdominal pain and five had gastrointestinal hemorrhage not requiring operation. Proper management of these patients includes early and aggressive diagnosis of conditions requiring operative intervention, strict attention to surgical technique, and careful titration of dose of immunosuppressive drugs. The 28% incidence of general surgical complications associated with heart and heart-lung transplantation emphasizes the role of the general surgeon in the management of these complex patients.

Adolescent↗

PubMed1984

Evidence for a change in capsid morphology during Sindbis virus envelopment.

Sindbis virus nucleocapsids were isolated from intact virus particles and from the cytoplasms of infected cells. These two isolates of purified nucleocapsids differed from one another in ribonuclease sensitivity and in sedimentation velocity. These findings suggest that a conformational change takes place in the Sindbis virus nucleocapsid during envelopment.

Capsid↗

PubMed1984

Methodological problems in studies of burn survivors and their psychosocial prognosis.

As the psychological adjustment of burn survivors is a subject of increasing interest, 21 studies on psychosocial adjustment to burns in adults and children are reviewed. These studies are commonly cited as a basis for determining the direction of future research. Eight methodological guidelines are applied to these studies of prognosis. Limitations are identified with the major focus of the paper being to assist in the development of more rigorous methodology in order to promote the optimal rehabilitation for burn survivors.

Adaptation, Psychological↗

PubMed1984

The stimulation of prolactin secretion by taurine: studies on the site of action.

Taurine's site of action within the central nervous system was localized by studying its effect on prolactin secretion following the microinfusion of 125 nmoles of this amino acid into discrete regions of the brain. Taurine was found to stimulate prolactin secretion only when microinfused into the arcuate nucleus of the hypothalamus. Taurine was not effective in other areas of the hypothalamus or in several extra-hypothalamic sites. Mannitol infusions (125 nmoles) into the arcuate nucleus, used as a control, were without effect on prolactin secretion. These studies extend previous observations on the prolactin-releasing action of centrally administered taurine and suggest further that the arcuate nucleus is one target site for this action.

Animals↗

PubMed1984

The corneal toxicity of presurgical skin antiseptics.

In a study of the corneal toxicity of some commonly used presurgical skin antiseptics, we used biomicroscopy, corneal pachymetry, healing studies, and electron microscopy to compare tincture of iodine (2% iodine, 2.35% sodium iodine, and 46% ethanol), Hibiclens (4% chlorhexidine and 4% isopropyl alcohol with detergent), pHisoHex (3% hexachlorophene and detergent), Lavacol (70% ethanol), 7.5% povidone iodine scrub (with a detergent), and 10% povidone iodine solution (without a detergent) in rabbits. Five minutes after application, moderate corneal epithelial edema was noted in all groups except the saline control group. After three hours there was marked corneal de-epithelialization, conjunctival chemosis, and anterior stromal edema in all groups except those treated with 10% povidone iodine solution and 0.9% sodium chloride. After one week all corneas had returned to normal. Accidental instillation of 7.5% povidone iodine scrub into the tear film of a 33-year-old man resulted in almost immediate chemical chemosis despite prompt irrigation, demonstrating the corneal toxicity of this substance. These results indicated that a 10% povidone iodine solution without detergent causes minimal corneal toxicity whereas the other presurgical skin antiseptics tested are toxic to the cornea.

Adult↗

PubMed1984

Effect of luminance, contrast, and eccentricity on visual acuity in senile macular degeneration.

We examined the effect of luminance on low contrast visual acuity in six patients with mild reductions in vision due to senile macular degeneration (SMD) and in six normals of approximately the same age. At the highest luminance tested the SMD patients showed a reduction in acuity compared to the controls, with eccentricity and contrast effects clearly shown. The SMD patients had difficulty performing the acuity task at the lower luminances (0.26 and 0.75 cd/m2); they showed little or no increase in visual acuity with increasing contrast levels at the lower luminances. Acuity was slightly influenced by target eccentricity at these luminances. These data suggest that the adaptation mechanisms allowing the normal visual system to operate efficiently over a wide range of luminances are affected in SMD, even when clinically measured acuity is only moderately depressed.

Aged↗

PubMed1984

Predicting visual resolution from detection thresholds.

Visual acuity is one of the most frequent health measures and is central to vision assessment in schools, industry, aviation, drivers' licensing, and ocular health examinations. There is a need for a rapid, simple, and interpretation-free measure of visual acuity which is amenable to automated and objective assessment. This study shows that a rapid (15 s) and simple contrast threshold measure for a 5 min arc spot correlates highly (r = 0.75) with letter acuity in 360 clinic patients. Assessments by optometrist and technician correlated highly (r = 0.88) as did repeated measures by the same examiner (r = 0.85). The instrumentation appears to be well suited for rapid, automated, and interpretation-free assessment of visual acuity and for visual acuity screening.

Humans↗

PubMed1983

HVA supplement. Prevention is a state of mind. Psychosexual aspects of family life.

Explore the source record for details and available documents.

Adult↗

PubMed1983

Serum lipids and glucose as associated with hemoglobin levels and copper and zinc intake in young adults.

The association of copper and zinc intake with serum total cholesterol, HDL-cholesterol, triglycerides, and glucose concentrations were studied in young adults (N=59). Three-day diet records, hair, fasting blood, and overnight urine samples were collected from each subject. Higher hemoglobin concentrations, diet zinc intake, and serum copper:zinc ratios were associated with lower HDL-cholesterol concentrations. Higher hemoglobin and hair copper concentrations were associated with higher cholesterol concentrations. Higher serum copper concentrations were associated with higher triglyceride concentrations and with lower glucose concentrations. Greater hematocrits were associated with lower triglyceride concentrations. Hemoglobin levels had the strongest relationship with cholesterol and HDL-cholesterol. These results appeared inconsistent with the hypothesis on copper:zinc imbalance and reports from animal studies.

Adolescent↗

PubMed1983

Dyslexic children have normal vestibular responses to rotation.

We examined the rotational vestibular responses of carefully screened dyslexic and control populations (34 dyslexics and 33 controls). The subject groups had equivalent performance IQs but differed significantly on verbal IQ and on silent and oral reading. Children with significant neurologic, visual, or hearing deficits were excluded. We measured eye movements provoked by sinusoidal rotation of the subjects (in total darkness) at low frequencies (0.01 to 0.16 Hz). Gain, phase, and preponderance (asymmetry) of the responses were calculated from the eye velocity and stimulus velocity waveforms. There were no differences between the groups in any of these measures. We conclude that there are no clinically measurable differences in this aspect of vestibular function in our carefully selected populations of dyslexic and control children.

Child↗

PubMed1983

Predictive eye movements do not discriminate between dyslexic and control children.

Pavlidis has suggested that predictive saccadic tracking eye movements distinguish between reading disabled and normal children. We have examined saccadic eye movement tracking in 34 dyslexic and 33 control subjects, between 10 and 12 yr old. The subjects were equivalent in performance IQ (WISC-R), with differences between verbal and performance IQ of less than 30 points. Children with neurological, visual or auditory deficits or histories of emotional problems and hyperactivity were excluded. There were no differences between the groups on the eye movement tracking task when scored objectively by computerized analysis of the eye movement records, or by ranking of the records by an experienced observer. Our results (and those of other recent studies) fail to support Pavlidis' contention that eye movements hold the key to dyslexia.

Child↗

PubMed1983

Epithelial carcinoma of the ovary in the reproductive years: clinical and morphological characterization.

In the 10-year interval from 1972 through 1981, 247 patients were treated for epithelial ovarian carcinoma at New York University Medical Center. Of this group, 31 patients (12.6%) were below age 40, and this group had distinctive features favoring longer survival. Of these patients 12 (38.7%) had borderline tumors, compared to 9 of 216 patients (4.2%) over 40 years of age (P less than 0.001). Stage I disease and well differentiated lesions were also common in the younger group. Early symptomatology and frequent gynecologic examinations during the childbearing years may also contribute to early detection of these tumors. The median survival in this group (7 years) was better than that reported for all ages. After careful evaluation, conservative surgical management can be considered for patients with Stage Ia disease which is either borderline or grade 1 carcinoma.

Adult↗

PubMed1983

Tracking eye movements are normal in dyslexic children.

We measured saccadic and smooth eye tracking movements in 34 dyslexic and 35 control subjects and were unable to show differences in any of the tasks or parameters measured. Subjects were carefully screened for neurological, optometric, audiological, and behavioral problems before admission to the study. We suggest that differences between our results and those of previous investigators are based on sampling differences. We conclude that while there may be children with reading disorders secondary to visual or oculomotor deficits, dyslexia can and does exist independent of such deficits. Because, in this and other studies, we have ruled out peripheral involvement, we feel that dyslexia is primarily a deficit of central information processing of written or spoken material.

Child↗

PubMed1983

Dark adaptation and the acuity/luminance response in senile macular degeneration (SMD).

Patients with senile macular degeneration (SMD) often complain of problems with adaptation and have best acuity under a restricted range of lighting conditions. We investigated dark adaptation and acuity over a wide range of luminances in eight SMD patients and six age-matched controls. Some patients showed evidence of altered dark adaptation, with a much longer time required to reach asymptotic sensitivity levels than shown by normals; others had difficulty with spatial resolution at different light levels. There was good correlation between symptoms and test findings; all but one patient who reported difficulties with adaptation demonstrated either retarded adaptation, aberrant acuity/luminance response, or both. These data provide evidence that the processes which adjust the sensitivity of the retina and the spatial summation properties of the retina are disrupted in SMD.

Aged↗