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Biomedical subjects

B L Carter

Publications and source records attributed to B L Carter.

At least 109 records · Page 6Linked to original sources

Subepicardial adipose tissue producing echocardiographic appearance of pericardial effusion. Documentation by computed tomography and necropsy.

An isolated anterior echo-free space is generally regarded as a false-positive echocardiographic finding for pericardial effusion. Even when an anterior echo-free space is accompanied by a posterior echo-free space, the echo-free spaces have been occasionally reported to be falsely positive for pericardial effusion, principally in patients with cardiac neoplasms. The basis for these findings had never been adequately explained. In the present study, evaluation by computed tomographic imaging or necropsy examination of 5 patients in whom there was either an anterior or posterior echo-free space or both demonstrated that subepicardial adipose tissue is the echocardiographic imitator of pericardial effusion.

Adipose Tissue↗

Computer assisted tomography of urachal abnormalities.

Three examples of urachal abnormalities are presented: two urachal cysts and one urachal carcinoma. These cases demonstrate the value of computed tomography in detecting urachal abnormalities, particularly if there is no communication between the bladder and the urachal remnant. The embryonic development of the bladder is discussed, particularly with reference to the development of urachal abnormalities.

Adenocarcinoma, Mucinous↗

Computed tomographic detection of sinusitis responsible for intracranial and extracranial infections.

Computed tomography (CT) is now used extensively for the evaluation of orbital, facial, and intracranial infections. Nine patients are presented to illustrate the importance of detecting underlying and unsuspected sinusitis. Prompt treatment of the sinusitis is essential to minimize the morbidity and mortality associated with complications such as brain abscess, meningitis, orbital cellulitis, and osteomyelitis. A review of the literature documents the persistence of these complications despite the widespread use of antibiotic therapy. Recognition of the underlying sinusitis is now possible with CT if the region of the sinuses is included and bone-window settings are used during the examination of patients with orbital and intracranial infection.

Adolescent↗

Prediction of maintenance warfarin dosage from initial patient response.

This study was conducted to determine the reliability of two methods of predicting maintenance warfarin dosage. Fifty-nine patients were studied using Method 1 and 44 using Method 2. Both methods produced a statistically significant correlation between predicted and actual dose for the two populations. However, actual vs. predicted doses for individual patients were significantly different. Method 1 predicted a dose within +/- 2.5 mg/d of actual dose in only 40.7 percent of patients. With Method 2, the corresponding value was 56.8 percent. Although the linear regression was statistically significant in our population, many patients would have excessive or subtherapeutic dosage predictions.

Adult↗

Labetalol.

Labetalol is a competitive antagonist of alpha 1-, beta 1-, and beta 2-adrenergic receptors. The hemodynamic effects of the drug include reduced blood pressure, heart rate, and peripheral resistance, with little change in resting cardiac output or stroke volume. In open trials and controlled studies, labetalol was an effective antihypertensive. Labetalol compared favorably with beta-blockers alone or in combination with vasodilators, for the treatment of hypertension. Reductions in heart rate are less pronounced with labetalol as compared with propranolol. Labetalol produces rapid reductions in blood pressure when administered intravenously for severe hypertension. The most frequent adverse reactions to the drug include fatigue, postural symptoms, headache, and gastrointestinal complaints. Labetalol may prove advantageous when vasodilation in addition to beta-blockade is desired, or for selected patients experiencing adverse effects attributable to beta-blockade. Until the clinical profile of labetalol is better defined, the use of the drug should be limited.

Drug Interactions↗

Association between appropriateness of prescribing and prescription documentation.

The association between the quality of physician prescribing and the degree of prescription documentation in the medical record was studied in four family-practice offices. Carbon-copy prescriptions were collected for five months at each office, and 438 were randomly selected for evaluation. For each prescription, a case abstract was prepared from the medical record. The abstract summarized the patient's previous care related to the problem for which the prescription was issued. The abstracts were blinded and randomly assigned for review by a panel of physicians and pharmacists working in family practice, resulting in a total of 1866 evaluations. Each panelist evaluated appropriateness of drug choice, potential benefit, and degree of prescription documentation. Actual prescription documentation of drug name, strength, quantity, directions, and refills was determined by comparing the carbon-copy prescription with the medical record. Multiple regression analysis revealed a significant correlation between panel evaluations for drug choice and actual documentation of drug name, strength, and directions. Likewise, the mean rating of potential benefit was significantly associated with actual documentation of drug name, strength, directions, and refills. The mean rating of appropriateness of documentation was significantly associated with all five independent documentation variables. Drug name, strength, and directions were recorded in 94%, 60%, and 75% of the medical records, respectively. These data demonstrate a positive association between the quality of prescribing and actual prescription documentation in the medical record.

Analysis of Variance↗

Linen control.

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Bedding and Linens↗

A bifunctional gene product involved in two phases of the yeast cell cycle.

The cell cycle in Saccharomyces cerevisiae is divided into two distinct phases. Unbudded, mononucleate cells in the G1 phase can react to relevant environmental changes by mating, sporulating, or by entering stationary phase. DNA synthesis and bud initiation occur almost simultaneously and mark 'commitment' to the completion of mitosis. Temperature-sensitive mutations at the cdc28 locus are known to cause arrest in the G1 phase of the cell cycle at the restrictive temperature. Here we show that the cdc28 gene product is also active in post-G1 cell cycle functions, and that a different property of the gene product may be required for each phase of the cycle in which it acts.

Cell Cycle↗

Lipomatous hypertrophy of the interatrial septum: in vivo diagnosis.

Lipomatous hypertrophy of the interatrial septum (LHIS), a finding associated with obesity and advancing age, consists of the accumulation of adipose tissue, including fetal adipose tissue, in the interatrial septum cephalad and caudad to the fossa ovalis. Previous descriptions of this entity have been limited to autopsy examination. We report a patient in whom the diagnosis of LHIS was established during life by the use of computed tomographic cardiac imaging. As is often the case in patients discovered at autopsy to have LHIS, this patient had atrial fibrillation and, while in normal sinus rhythm, an abnormal P-wave morphology. This patient represents the first patient in whom the diagnosis of LHIS has been established during life. LHIS should be considered in the differential diagnosis of atrial fibrillation and other supraventricular rhythm/conduction disturbances, particularly in obese, elderly patients.

Aged↗

Computed tomography in the diagnosis of pericardial heart disease.

To evaluate the use of computed tomography (CT) in the diagnosis of pericardial heart disease, 53 patients were prospectively studied by computed tomography of the chest and cardiac ultrasound. A diagnostic-quality CT study was done for all patients; a technically satisfactory ultrasound examination was not possible in six patients. Of 47 patients in whom both chest scans and satisfactory ultrasound studies were obtained, computed tomography showed pericardial thickening not shown by ultrasound in five patients. Estimated size of pericardial effusion was the same for both computed tomography and ultrasound. Computed tomography provided quantifiable evaluation of the composition of pericardial fluid in seven patients with either hemopericardium or purulent pericarditis. Neoplastic pericardial heart disease was detected by CT scan in four of the 53 patients. Computed tomography of the chest provides a sensitive evaluation of the pericardium and quality of pericardial effusion, and is a valuable adjunct in patients in whom cardiac ultrasound is technically unsatisfactory.

Adult↗

Computed tomography and sialography: 1. Normal anatomy.

Computed tomography (CT) has made it possible to identify soft tissue structures not visible by sialography. This paper reviews the normal anatomy in the region of the parotid and submandibular glands in the axial transverse and coronal planes as imaged by CT before and after sialography. A clear understanding of the normal structures is important before undertaking an evaluation of disease.

Humans↗

Computed tomography and sialography: 2. Pathology.

Computed tomography (CT) has added a significant amount of diagnostic information to the imaging of the salivary glands. Two groups of patients were evaluated at two institutions to determine the impact of CT on the diagnosis of various diseases and to evaluate the contribution of CT versus conventional sialography, respectively. Patients were studied by each modality alone and in combination. Emphasis has been placed on the group that had CT combined with sialography, since benign and malignant tumors were found to be better evaluated by the two techniques together.

Female↗