Biomedical subjects
Publications and source records attributed to B Morag.
The appearances of 34 parapelvic cysts diagnosed by computed tomography (CT) in 29 patients are described. The majority were found as an incidental finding but some caused hydrocalycosis and, in one instance, hypertension. Their etiology, CT features, and differential diagnosis are discussed. The specificity of CT in these cases eliminates the need for invasive diagnostic procedures.
A post-traumatic false aneurysm of the abdominal aorta was diagnosed 8 years after blunt abdominal trauma with blast, sustained during combat. Severe persistent backache with erosion of D12 and L1 vertebrae were the presenting symptoms. The aneurysm was repaired by tube graft replacement.
Captopril was administered prior to renal vein renin sampling in an attempt to select patients amenable to surgical treatment for renin dependent hypertension. Renal venous blood for plasma renin activity was taken only after captopril stimulation. Sampling from the antecubital vein before and after this provocation showed a marked rise in renin, thereby confirming the efficacy of the test. Elimination of the initial selective renal vein sampling shortens the catheterization period without affecting the accuracy and dependability of the procedure.
The indications, technique and results of percutaneous drainage in 20 patients with abscesses and other fluid collections are presented. Special emphasis is placed on the complementary use of ultrasound and computed tomography and the relative indications for the use of each. Of the 20 patients, 5 had hepatic abscesses, 7 had subphrenic or subhepatic abscesses, 3 had pancreatic pseudocysts and the remaining 5 had loculated fluid collections in either the abdomen or chest.
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Mycoplasma gallisepticum strains have a membrane-bound lysophospholipase which hydrolyzes lysophospholipid generated in these membranes by treatment with an external phospholipase. This paper studies the hydrolysis of the membranous lysophospholipids by an enzyme residing in the same membrane (intramembrane utilization) or in adjacent membranes (intermembrane utilization). To study intermembrane hydrolysis, the phospholipids of M. gallisepticum were labeled with [3H]oleic acid. Membranes were prepared, heated at 65 degrees C, and subsequently treated with pancreatic phospholipase A2. This resulted in membranes whose enzyme was heat inactivated, but which contained lysophospholipid. When these membranes were mixed with M. gallisepticum cells or membranes, the lysophospholipid was hydrolyzed by the membranous lysophospholipase. To study intramembrane hydrolysis, [3H]oleyl-labeled membranes of M. gallisepticum were treated with pancreatic phospholipase A2 at pH 5.0. At this pH, lysophospholipid was generated but not hydrolyzed. Adjustment of the pH to 7.4 resulted in hydrolysis of the lysophospholipid by the membranous lysophospholipase. These procedures permitted measuring the initial rates of intramembrane and intermembrane hydrolysis of the lysophospholipid, showing that the time course and dependence on endogenous substrate concentration were different in the intramembrane and intermembrane modes of utilization. They also permitted calculation of the molar concentration of the lysophospholipid in the membrane and its rate of hydrolysis, expressed as moles per minute per cell or per square centimeter of cell surface.
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The changing role of diagnostic radiology in modern medicine is reviewed. Special emphasis is placed on the ever-increasing use made of diagnostic procedures for therapeutic purposes. Percutaneous catheter introduction, formerly utilized only for diagnostic vascular procedures, has now been adapted for use in the renal and biliary systems. Treatment may be definitive and may replace surgery. Examples include embolization for the control of internal hemorrhage, removal of retained biliary calculi and intravascular foreign bodies, drainage of a fluid-filled cavity, and dilatation of an area of arterial stenosis. Palliative treatment, as part of the management of malignant tumors, includes intraarterial chemotherapy, preoperative embolization and percutaneous relief of inoperable obstructions of the renal or biliary tracts. Illustrative cases are presented and the indications, techniques and complications of these procedures are discussed.
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A case of severe duodenal hemorrhage in a septic renal allograft recipient is presented in which successful occlusion of the gastroduodenal artery by Gelfoam emboli also resulted in severe hepatic infarction and gallbladder necrosis. These complications were caused by reflux of emboli from the gastroduodenal artery into the distal branches of the hepatic artery.
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Employing the techniques of complement fixation, immunofluorescence, and in vitro lymphocyte transformation assay, the antibody and cell-mediated immunity to cytomegalovirus (CMV) were studied in the serum, peripheral blood lymphocytes, tonsillar lymphocytes, and cord blood lymphocytes. The study population consisted of 32 children undergoing tonsillectomy and adenoidectomy. In the lymphocyte transformation assay, three strains of CMV (AD-169, ADH-1-41, and Davis), herpes simplex type 1, and phytohemagglutinin were employed as antigens. Sixty-five percent of the subjects were found to have CMV-specific antibody activity. The lymphocyte transformation response to phytohemagglutinin was similar in all subjects. No CMV-specific lymphocyte transformation activity was detected in cultures of cord blood lymphocytes. Significant cell-mediated immunity was observed in the tonsillar lymphocytes of 30% (3/10) of the seronegative individuals and in the peripheral blood lymphocytes obtained from one such subject. Over 75% (16/21) of the seropositive subjects demonstrated cell-mediated immunity against one or more strains of CMV in the peripheral blood lymphocytes and tonsillar lymphocytes. In the lymphocyte transformation assay, no cross-reactivity was apparent between CMV and herpes simplex type 1. These studies demonstrate the presence of strain-specific systemic and mucosal cell-mediated immune response to CMV in humans. The frequency and distribution of lymphocyte transformation responses to the three CMV strains suggest antigenic heterogeneity of CMV.
Emboli of a main artery cause serious complications in patients suffering from acute myocardial infarction, in whom the surgical risk is high. In order to save the limb, embolectomy is indicated and should be considered. Early diagnosis and prompt surgical intervention with the use of the Fogarty catheter simplify the embolectomy procedure and enable restoration of circulation to the ischaemic limb. Thirty-two embolectomies were performed in twenty-eight patients suffering from acute myocardial infarction. Patients with cardiac compensation survived the surgery and recovered. However 50% of the patients in whom acute myocardial infarction was accompanied with congestive heart failure and arrhythmias died. The cause of death was the underlying disease. Considering the severity of the acute myocardial infarction this group of patients represents the expected mortality.
Congenital membranous obstruction of the inferior vena cava is a rare phenomenon resulting from failure of anastomosis between the right subcardinal vein and the liver. A case is reported in which the presenting symtpom was bleeding from esophageal varices. Cirrhosis was present and other signs of vena caval obstruction were minimal. The diagnosis was made only after an ineffective mesenterico-caval shunt had been performed. Venacavography or pressure measurements in the inferior vena cava are mandatory before attempting a porta-systemic shunt operation.