Biomedical subjects
Publications and source records attributed to C Fisher.
The first case of a carotid body chemodectoma that was diagnosed using dynamic radionuclide perfusion angiography and subsequently excised is presented. The value of this technic in the investigation of pulsatile tumors is emphasized.
In 48 patients undergoing renal biopsy there was a strong correlation (chi 2 11.45 (P less than 0.01)) between the demonstration of circulating and deposited immune complexes. Serial studies of circulating immune complex levels have shown fluctuations which only sometimes appear to coincide with clinical changes in individual patients.
Recurrence of adrenal cortical carcinoma 22 years after first presentation is reported in a 54-year-old woman with Cushing's syndrome. This tumour is normally associated with poor prognosis and prolonged survival is rare. Although the patient had remained well with apparent 'cure' in the intervening years, it is suggested that hormonal changes related to the menopause and the development of primary hypoadrenalism stimulated recurrence of malignant activity and return of Cushingoid features.
We report about a dialysis procedure, the circulation stability of which is comparable to hemofiltration treatment. Hemodynamic parameters were measured invasively and different procedures were compared for each patient. In RD and HF significant reduction in cardiac output (HF: --20%, RD: --21.5%), stroke volume (HF: --20%, RD: --17%), pulmonary artery pressure (HF: --57%, RD: --45:6%) and plasma volume (HF: --12%, RD: --15%) were found. Blood pressure and heart rate (HF: --1%, RD: --3%) remained stable despite the high utrafiltration rate. Peripheral resistance rose significantly (HF: + 20%, RD: + 25.9%). Compared with HG, the most important advantage during RD is the improved tolerance to treatment without typical hemodialysis-induced symptoms. In comparison to that, we found under conventional dialysis an inadequate increase in peripheral resistance (HD: + 6.1%). A following strong compensatory hyperventilation with drop in PCO2 was paralleled with typical symptoms like nausea and headache. Because of resttriction of this compensatory mechanism, hypotension and arrhythmia will be induced of the following peripheral tissue perfusion and central acidosis.
A patient developed acute interstitial nephritis following cephradine administration. The clinical illness preceding the interstitial nephritis and the eosinophilia in peripheral blood suggested an allergic reaction. Immunological studies demonstrated an allergy to cephradine and penicillins which was IgG2-mediated. It is probable, therefore, that allergy to cephradine caused the renal lesion from which there was full clinical and biochemical recovery.
Variations of plasma LH and testosterone in relation to sleep-related penile tumescence were assessed. Plasma LH and testosterone were measured at 10-20 min intervals in five normal adult men during 2 nights of sleep. Blood samples were obtained by means of an indwelling venous catheter while sleep was monitored polygraphically and penile tumescence recorded with a penile mercury strain gauge. Tumescent episodes were recorded in all subjects during 9 of the 10 nights of the study, and the percentage of time during sleep, which was associated with tumescence, ranged from 13% to 34%. Simultaneous REM and tumescence comprised 57.7% of total tumescent time. Abrupt elevations of plasma LH and testosterone were observed during the night without a significant relationship to stages of sleep. The mean of all hormonal determinations for the five subjects did not show significant differences in plasma LH and testosterone between fully and partially tumescent episodes and nontumescent periods. Mean testosterone during REM sleep with tumescence, a state of autonomic activation involving sexual function, was consistently higher for the five subjects than during periods free from REM and tumescence.
"Drip breast milk" is that milk which spontaneously drips from the contralateral breask during the suckling of an infant. Biochemically and immunologically, pooled drip milk resembled pooled mature expressed breast milk, although it has a lower fat concentration. About 15% of lactating women are capable of producing drip milk; volumes produced are up to 188 ml/donor/day. A milk bank is described which processes 1400 liters of drip milk/yr. Heat treatment of this milk with a semi-automated holder pasteurizer caused a 21% reduction in IgA concentration and a 36% reduction in lysozyme activity, as well as a decrease in the ability of the milk to inhibit the growth of E. coli. In comparison with boiling, pasteurization was as effective in reducing total bacterial content provided the milk initially contained fewer than 10(6) bacteria/ml.
Explore the source record for details and available documents.
1. A study has been made of the effects of changing the external calcium concentration, [Ca](o), and the temperature on both the number of quanta available for release by the nerve impulse (n) as well as the increase in release probability of a quantum p(t) during the release period (from 0 to T) following a nerve impulse at synapses in amphibian striated muscle.2. When [Ca](o) was increased in the low range from 0.25 to 0.4 mM at 18 degrees C, the average quantal content of the e.p.p. (m) increased as the fourth power of [Ca](o) and this was primarily due to a third power dependence of n on [Ca](o); the dissociation constants and power dependence of n on calcium determined in the [Ca](o) range from 0.25 to 1.0 mM were successfully used to predict the changes in size of the e.p.p. in the very high [Ca](o) range from 1 to 10 mM. When the temperature was increased from 7 to 18 degrees C in a [Ca](o) of 0.6 mM or 0.35 mM, n increased with a Q(10) of 2.5.3. When [Ca](o) was increased in the range from 0.25 to 1.0 mM at 18 degrees C, the probability that a quantum initially available for release is released during the release period (p(T)) was very sensitive to [Ca](o), increasing as the third power of [Ca](o) and with a dissociation constant of 0.13 mM. When the temperature was increased from 7 to 18 degrees C in a [Ca](o) of 0.6 mM or 0.35 mM, p(T) decreased.4. The histograms of latencies of individual quanta following a nerve impulse was very temperature dependent: the time to peak of the histograms (i.e. the interval in which most quanta fell) had a Q(10) of over 4 as did the time constant of decline of the histograms in the temperature range from 7 to 18 degrees C.5. The average number of quanta released up to time t during the release period following a nerve impulse, namely np(t), was well described by a stochastic process in which p(t) was determined by two reactions; one of these reactions released available quanta from the nerve terminal whilst the other made some of the available quanta unavailable for release by the nerve impulse.
1. A study has been made of the effects of changing the external calcium concentration [Ca](o) on the binomial parameters p and n that control the average quantal content (m) of the end-plate potential (e.p.p.) during trains of nerve impulses at synapses in amphibian striated muscle.2. In high external calcium concentrations (0.4 mM </= [Ca](o) < 1.0 mM) the increase in m of a test impulse following a conditioning impulse at different intervals (< 100 msec) was due to an increase in the number of quanta available for release, n; the increase in m of successive e.p.p.s in a short high frequency train was primarily due to an increase in n.3. In high external calcium concentrations (1.0 mM </= [Ca](o) < 10 mM) there was a decrease in m of a test impulse following a short high frequency conditioning train (4-5 impulses, 20-100 Hz) at different intervals (200 msec < 5 sec) and this was due to a decrease in the number of quanta available for release, n; in a long high frequency train (20 impulses, 20-100 Hz) there was an increase in m for the first few successive e.p.p.s followed by a depression of m which eventually reached a steady state and these changes in m were due to changes in n; the higher the frequency the greater was the depression in n during the steady-state period.4. In high calcium concentrations, the steady-state m reached in the first 20 impulses during continual stimulation at high frequency gave way to a decline in m over several minutes until a new depressed steady-state value of m was reached and this was maintained during the longest periods of stimulation (30 min); this decline in m was primarily due to a decline in the number of quanta available for release.5. These changes in the number of quanta available for release during trains of impulses are predicted in terms of a hypothesis in which facilitation is due to the accumulation of a residual calcium-receptor complex in the nerve terminal that determines the fraction of a pool of quanta which contributes to n, and depression is due to a decrease in the number of quanta in this pool.
1. Three sequential experiments, each lasting 8 weeks, were carried out on 576 singly-caged light hybrids. 2. In experiment 1 egg production was 84% using a conventional control diet, 61% with a basal low-protein diet, and 79% with the basal diet supplemented with 10 essential amino acids+L-glutamic acid (GA). 3. In experiment 2 supplementation with lysine and methionine (L+M) alone increased egg production significantly from 54 to 72%, compared with 83% with the conventional diet. 4. In experiment 3 egg production was 55% with the basal diet, 71% with the basal diet+L+M, 75% with a diet containing 141 g protein/kg+L+M, and 73% with the conventional diet. 5. In all three experiments supplementation with GA alone either gave no significant response or a depression in production. 6. Daily intakes of 1-24 g nitrogen as non-essential amino acids and 13 to 14 g total crude protein per bird resulted in good egg production. Supplementation of the basal diet with L+M resulted in a daily intake of 413 mg methionine/bird day which was considered adequate, and a daily intake of 710 mg lysine which was considered slightly inadequate.
A patient's refusal to participate in recommended treatment is a problem faced in all branches of medicine. However, psychiatry faces special problems because of its authority to impose hospitalization and treatment on unwilling patients. Nowhere is this more poignant than in the treatment of patients exhibiting suicidal behavior where the potential for imminent self-destruction exists. As part of a prospective study to develop utilization review standards for the hospitalization of suicide attempters, cases were identified where there was independent agreement between both the experts' standards and the treating resident psychiatrists that hospitalization was required. Despite this agreement, the patients were not hospitalized because the patients refused. By most criteria, these patients were a high risk group. They had made repeated suicide attempts, used lethal means which eventuated in serious medical consequences, and were still suicidal when referred for treatment. The emergency room psychiatrists reported feeling confused, anxious, and annoyed in dealing with these patients, and the patients signed out against medical advice. A review of these cases indicates that discussions of social control vs. medical responsibility and clear criteria for hospitalization should be incorporated into residency training programs since the emergency room resident faces these tension-producing issues frequently with several different types of patients. Moreover, utilization review criteria may help to set standards which will assist the psychiatrist in making these difficult decisions.
Explore the source record for details and available documents.
In 1974 Baudry confirmed Isakower's original and important concept that the spoken word in dreams may be a manifestation of the superego, but found that this is not always true and that there may be important contributions from drive and defense, according to the principle of multiple function. The particular type of dream speech most emphasized by Isakower--that characterized by a portentous, threatening, awe-inspiring, oracular tone--is extremely rare in dreams but may be observed in certain waking phenomena, e.g., psychotic delusions of self-observation or situations of life-threatening stress.
1. The utilisation of fat and fatty acids supplied as maize oil, tallow or lard in the diet of 2-, 4- and 8-week old turkeys has been investigated: a mixture of 10% fat and 15% cellulose replaced glucose monohydrate in a low-fat basal diet. 2. At 2 weeks of age the absorbabilities of the fats were 96, 57 and 91% for maize oil, tallow and lard respectively; at 4 and 8 weekds of age the corresponding figures were 97, 70 and 92% and 98, 74 and 90%. 3. The unsaturated fatty acids (18:1, 18:2) were highly absorbed from all fats; this was true also of the saturated acids (16:0, 18:0) in the maize oil, but in lard and, especially, tallow the absorbability of these fatty acids was lower. 4. The effect of age on the utilisation of tallow could be explained by the improvement in the absorption of these fatty acids. 5. The determined and calculated ME values of the fats are given.
A new method for differentiating psychogenic from organic cases of sexual impotence is described based on the assesst of nocturnal REM erection in nine patients. It is our tentative impression that in psychogenic impotence nocturnal REM erection may be normal in amount and degree and an excellent indicator of erectile potential. In these cases a marked discrepancy exists between the amount and degree of nocturnal erection and the patient's daytime performance level attained during attempted coitus or masturbation. In the organic patients, on the contrary, such a discrepancy does not exist; instead, the maximal nocturnal erection attained corresponds closely to and mirrors the patient's impaired waking performance. This new method may be very useful in the diagnosis, prognosis, and decision as to type of treatment, especially in difficult cases.
In a review of 156 total or partial nephrectomy specimens from patients over the age of 12 years, renal dysplasia was found 14 times. The cases were divided initially into five groups on the basis of the predominant pathological changes, namely (1) dysplasia (14 cases), (2) chronic pyelonephritis (31 cases), (3) calculous inflammation (58 cases), (4) hydronephrosis (35 cases), and (5) miscellaneous (18 cases). The diagnosis of dysplasia was made on gross and microscopic criteria and included 12 of segmental dysplasia, one of total dysplasia, and one multicystic dysplastic kidney. The principal differential diagnosis is from the irregularly scarred chronic pyelonephritic kidney. The criteria for the separation of the two are emphasized and, in particular, the distinction from those pyelonephritic kidneys with aglomerular scars. A high incidence of anomalies of drainage was found in association with dysplasia, but such were not always present. It was not thought that intrarenal reflux in infancy was an aetiological factor. Six of the cases presented with urinary infection, but only two had hypertension. It was thought that acquired glomerular damage was more important in the aetiology of hypertension than segmental glomerular agenesis.